The Art of Veterinary Medicine

Someone mentioned this term last weekend during a global meeting to discuss professions in the rehab community collaborating and working together.  The comment was that veterinarians have lost the 'art' of veterinary medicine.  The individual, although in the animal rehab business, was not a veterinarian.  So why do they think that and is this a common thought amongst non-veterinarians, or even amongst veterinarians themselves?  

For those that were in the 2003 and later graduating classes at the Ontario Veterinary College, "The Art of Veterinary Medicine" was a course that was added into the program  to try to improve communication and conflict resolution for graduating vets (PLEASE correct me if this is not the case)  Since I graduated prior to this, it was not a course I was familiar with, but understood that if you mentioned it to any veterinarian who went through it you obtained an eye roll and a comment about it being useless.  I was surprised as I personally DO find that the "art" in what we do seems to often be missing.  I have encountered many vets that have difficuilty straying from the text book and therefore a client that will not perform the gold standard is left with no other options.  But that is another blog!!!!!  However this course, as much as it had good intentions, did not seem to address the concerns that they were trying to improve upon.

So what is MY definition of the term?  There is so much that encompasses being a veterinarian and this has evolved and grown throughout the years.  As the role that animals played in the household changed, it also changed what we needed to offer clients and drove huge changes in what was considered standard of care.  Anesthetics changed, surgical techniques changed, vaccine protocols changed, and the ability of veterinarians to specialize in different fields became more commonplace.  This had a two-fold effect.  1) Better potential for high quality diagnostics and medicine and 2) an unfortunate "passing off of cases" that we see a lot in human medicine.  

We often get compared to how things are done on the human medicine side, which is very common in my field of rehabilitation.  Referrals to specialists in human medicine are common place.  Many professionals such as physiotherapists and chiropractors do not need referrals. I myself have used these services and never thought anything of it.  This is my problem though.  Everyone becomes extremely good at ONE thing.  In my opinion, this however reduces that "art".  It reduces the ability to think outside the box and address people as a "whole".  Having dealt with the human health care field particularly with my mother who has a GP, an endocrinologist, a cardiologist, a neurologist, and an opthamologist.  When she was hospitalized for a stroke one specialty would come change a medication and the other specialty would change it back.  The right hand never seemed to know what the left hand was doing.

Veterinarians are trained in pharmacology, surgery, anaesthesia, nutrition, internal medicine, cardiology, emergency medicine, neurology, and infectious disease.  We learn about large animals, small animals, and exotics and anatomy and physiology of these different species. When that animal comes to us vomiting, or limping, we already have a list of medical, orthopedic, neurologic, traumatic, and infectious diagnoses to rule out.  Here comes the art.  The art, is knowing when to collaborate with that specialist.  The art is communicating with that client to know which one of the options (gold standard, or minimalistic or somewhere in between) they would like to pursue.  The art is looking at the entire animal and knowing that weakness may not be Degenerative Myelopathy but it may be a bleeding hemangiosarcoma, or cardiac disease.  The art is developing an amazing bond with that client and patient.  The art is not judging them because you were taught that feeding RAW food was bad and wrong, but it is helping them do it in the safest way possible.  The art is finding out what their expectations and beliefs are and blending that into the best medical plan for that animal.  

So do we need to change our approaches?  Yes.  Do we need to teach the "art" of veterinary medicine in vet school?  Yes.  Is it entirely missing in veterinary medicine?  No.  There are amazing wonderful vets out there and generalizing to say the "art" is missing is not true nor is it solving any concerns that may be present.  Is this influenced by finanacial factors, corporate protocols, or changes in admission criteria????  I don't know.  What do YOU think?

Veterinary medicine is so much like human med school but it is SO very different in many ways.  I hope we continue to encourage the art, and the bedside manners that we are accustomed to having in vet med.