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Developing a Healthy Working Relationship with Your Veterinarian|
By Susan Brown, DVM
Veterinarians are bound by the Principals of Veterinary Medical Ethics of the American Veterinary Medical Association, by the Veterinarian's Oath and by the rules of the state where they practice. These rules are in place to protect all sides of the veterinary-client-patient relationship (VCPR). Following are some of the principals and rules:
Patient needs: Veterinarians shall first consider the needs of the patient; to relieve disease, suffering or disability while minimizing pain and fear. The veterinarian's first responsibility is for the patient's welfare. The doctor should explain the optimal treatment, regardless of your personal situation. Then he can present alterations to that best-care scenario taking into consideration your financial and physical limitations.
Honesty and fairness: Veterinarians shall be honest and fair when relating to others.
Medical records: Veterinarians must keep medical records on all patients. Clients have the right to obtain copies of these records. Please allow adequate time to obtain copies. (There may be fees associated with this service.)
Informed consent must take place between the veterinarian and the client. A consent form should outline both the risks and benefits of the recommended treatment, test or drug. When a client signs an informed consent form then it is understood that permission is given for the treatment, and risks and benefits are understood. If a client decides to forgo the recommended treatment, then a waiver form should be signed indicating the treatment or tests that are being waived and the possible consequences. This absolves the veterinarian from liability. Informed consent is important to the VCPR because it defines how the client and the veterinarian together make decisions about the patient. Both doctor and caretaker have to be straightforward and sincere. The veterinarian has to give adequate information on the risks and benefits and the client has to express questions, concerns or inability to fulfill the agreement.
Veterinary-client-patient relationships: A VCPR must be established in order for a veterinarian to prescribe prescription drugs. A veterinarian must have seen and examined your rabbit in order to prescribe medication. Even if another veterinarian from another practice saw this pet before, if this is a different practice, the new veterinarian must establish a new VCPR with your pet to continue treatment.
The interval between examinations and medication refills is at the discretion of the veterinarian based on the individual pet. For instance some medications can have adverse effects on the liver or kidney and therefore periodic blood testing and exams may be needed to keep your pet safe.
A minimum of an annual examination is necessary no matter what medication is being prescribed as the veterinarian is potentially liable for any adverse reactions to the prescribed medication, or lack of effectiveness.
These are some of the basic responsibilities that bind a veterinarian both ethically and legally. Other desirable qualities a veterinarian hopefully has would include a calm demeanor, good listening skills, an open mind, good communication skills, empathy and a sense of humor. These behaviors are not taught in veterinary school and there are no "Principals" covering them. Some veterinarians have these skills naturally and others develop them over time, particularly if they have the assistance of a conscientious client such as you.
Although you can't control the behavior of your veterinarian or the staff at the hospital, your behavior can influence their response towards you. It's understandable that when your rabbit is ill, you will feel anxious, and it is a difficult situation because you are not in total control. However, a confident, calm, and open approach will help you develop a winning relationship with your veterinarian. Your positive energy will decrease your rabbit's stress level and improve your relationship with the staff of the hospital.
Gather information: Before you leave for the vet's office, gather information on your rabbit. Bring contact numbers for the main caregiver if this is not the person transporting the bunny to the vet.
If you have been keeping a record of your animal's condition, make sure you bring that along. If your rabbit has not visited this veterinarian, write down the date of birth, sex and any previous medical problems.
Advocate for your bunny: Organize any information you have collected about your pet's problem before you go to the vet. You are encouraged to be an advocate for your bunny and to gather articles (include date and source) on his medical problems or on questions that you may have. The internet and textbooks can be both good and bad sources of information so being clear on the source and the date of what you have gathered will help your vet determine its accuracy.
Discuss financial issues at home: Discuss what level of financial commitment are able to make before the visit. This can help reduce strained conversations in the veterinary office and helps you be clear and confident about exactly what you can and cannot afford. Most of us would like to believe that we don't have any constraints when it comes to our furry friends, but this is not always the reality.
Arrive at the vet's office on time: Being on time is a courtesy that should be extended to any business that works by appointment. If you are going to be late, call ahead and let them know.
What if the vet is running late? If you are using a practice where the veterinarian is chronically late for his appointments, then call ahead and see if he is on time. If not, ask when would be the best time for you to arrive.
If you have time restrictions let the receptionist know the amount of time you may have for the appointment when you check in. Appointments often run late in many of the medical service professions. Hopefully it is because each patient is being treated as an individual rather than in a factory assembly manner. Also sometimes the veterinarian needs to see a patient with an emergency. Work with the receptionist on what your options might be if appointments are seriously delayed such as dropping off your rabbit and returning, or rescheduling the appointment.
Communication in the exam room: Be respectful and helpful. Treating a veterinarian or his staff with respect is no more then how you would wish to be treated. Allow your veterinarian to work through the process of collecting information, doing an examination and making recommendations. The time for an in depth discussion of options, concerns and ideas will be available after the vet has completed the history collection and exam process.
Discuss materials you have collected regarding your bunny. Sometimes you can leave the material with the receptionist so that the veterinarian can read it before the exam. Then be willing to listen to his concerns and have a discussion about the issues.
Be straightforward with answers: Your veterinarian depends on your complete and honest answers to questions that are pertinent to the diagnostic process. Although you may be reluctant to admit that you didn't notice that your rabbit's water bottle was empty or he ran out of hay the day before, a competent veterinarian will be focused on providing assistance to your rabbit and is not concerned with judging your behavior.
If you will be physically unable to follow through with the veterinary care plan, then you need to tell your vet and alterations will have to be made. For instance, if you need to clean and medicate your bunny 4 times a day and you work a full time job five days with no help during the day, then this care plan is destined for failure. You will only be doing your bunny a disservice if you agree to this and then don't follow through.
Ask questions, then listen: If you are unclear about anything or have additional ideas, then ask questions! If you are confused about anything, then ask for clarification. If you think of questions after you get home, then call the veterinary office and leave them with the staff to get answers for you. Listen to the entire answer to your question and then ask for more clarification if needed. If you will be communicating with other family members at home, write down the answers or record the conversation with the veterinarian's permission.
Follow through with instructions: If you find that you cannot follow through, because you are having trouble administering the medication, your rabbit your veterinarian and alert them so an alternate plan can be formulated. Otherwise, there can be serious consequences for your pet, including such things as creating resistant bacteria, prolonging illness, or creating secondary disease to the original problem.
Make progress reports. These are extremely important particularly during care plans that are extended over a long period of time. It is much easier for you to call in to the vet's office to make your report then for them to track you down and leave messages. Also be aware that information on how well your rabbit did or did not respond to the treatment can also affect how other rabbits in the veterinary practice will be treated. Other people's rabbits are depending on you also.
Ask for options: If you are feeling uncomfortable on any level about the care plan your veterinarian has outlined then you need to ask for options. As stated, it is the veterinarian's duty to explain to you the best care he can provide. That does not mean that financially, physically, philosophically or otherwise this is the plan that you feel is best for your pet. Your veterinarian will not know that you need other options unless you tell him.
Unless your pet is experiencing a life-threatening emergency, if you feel unable to make an immediate decision regarding the care plan, ask for time to think it over. If your veterinarian thinks that your rabbit's health will not be adversely affected if you take 24 or more hours to make a decision, then by all means take the time if you are feeling unsure about any aspect of the care plan.
Second opinion: Getting a second opinion does not mean that you are unhappy with your present vet, it may mean you are simply exploring all your options. Do not be intimidated by "upsetting" your current veterinarian by seeking a second opinion. It is part of being an advocate for your pet to seek other opinions or ideas should you feel it is necessary. A competent veterinarian will not be offended by this and will generally welcome another opinion on a case.
Staying with your pet: The ability to be present during diagnostic or surgical procedures is at the discretion of the veterinarian. There are many reasons why you being there may not be a good idea:
Gaining the privilege of being able to be with your pet during some of these procedures will depend a great deal on how you communicate and work with your vet. If you demonstrate, respect for the veterinary staff, a calm demeanor with your rabbit and have educated yourself on your pet's condition and on the diagnostic or surgical procedure, then you might be allowed to participate on some occasions. When clients are present during some of these procedures possessing these criteria, it can be a very calming and helpful experience for both the rabbit and the veterinary staff.
Reporting problems: Report problems to the veterinarian or his staff first, before discussing it publicly. Most problems are created by poor communication and can be cleared up fairly easily. If you feel too uncomfortable speaking with the staff member directly you can write a letter to them or you can speak to a superior if there is one such as a practice manager or practice owner. Write down, review and clarify your complaints and be clear before you make your call. Conflict is usually an emotional event; so writing down your concerns will help you make sure everything is covered.
Write down your suggestions for resolution before making the complaint. The complaint is only part of the process. You need to be clear on what you feel is a fair resolution to the issue. Think about this ahead of time.
Speak respectfully when lodging your complaint. It is likely a resolution will be reached more quickly if you start out with the assumption that there was a communication problem and that there is a resolution. Think about how you would want to be treated in a similar situation. Competent veterinarians want to know about problems and attempt to resolve them. Any relationship takes work to make it benefit both parties and in this case all three parties, your rabbit included.
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