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24 Aug 2000

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Seven Signs of a Great Vet 

She'll check both body and soul, ask about some pretty gross stuff, and become a trusted friend. There are many excellent veterinarians to choose from. But you've got to know what to look for. After interviewing some of the nation's leading veterinarians, I came up with these seven signs that they all agree distinguish a great vet. 
A good vet: 

1. Has a sweet-smelling office with a warm and fuzzy atmosphere. 
2. Takes a detailed history and conducts a thorough nose-to-tail exam. 
3. Addresses Fluffy's bad behavior as aggressively as his bellyache. 
4. Isn't afraid to say, "I don't know." 
5. Should conduct appropriate lab tests before prescribing treatment. 
6. Delivers a clear explanation along with his prescription. 
7. Telephones to see how Rover's doing. 

1. A good vet hangs up his or her shingle at a sweet-smelling office with a warm and fuzzy atmosphere. 
One whiff can disclose a lot about the standards set by the vet in charge. The facility should be clean and pretty much odor-free; the staff, upbeat, courteous, and caring. "I think the cordiality and respect with which you are treated is something people need to look for in a veterinarian," says John Saidla, D.V.M., director of continuing education at the College of Veterinary Medicine, Cornell University. "By respect, I'm including respect of your time. I want the vet to be reasonably prompt with appointments." 
This courteous, respectful attitude, Dr. Saidla believes, should filter down to everyone in the office. 
2. A good vet takes a detailed history and conducts a thorough nose-to-tail exam. 
Every vet I interviewed for this article agreed that to do the physical exam justice, a vet must allow at least 30 minutes for the initial "well care" appointment or sick visit. Less than that and your pet's getting seriously shortchanged. 
The history should include questions such as: Where did your pet come from? How is the animal cared for at home? How does it fit into the family? Are there other pets at home? What other animals is this pet exposed to? Has the pet had any health problems? What is the purpose of the visit today? If the purpose of the visit is to address a health concern, then the vet needs to ask a lot of focused questions. 
"Some extremely busy practices don't have time to ask those questions, and they start acting like acute-care clinics for human medicine-just get the patient in and out. To properly diagnose problems that are present and prevent complications in the future, the history-taking part of an initial visit should take 10 to 15 minutes or more, " Dr. Vite notes. 
And that's before the vet conducts a thorough physical exam, which could take another 10 to 15 minutes. 
"Even if the pet is in for well care and vaccinations, the stethoscope should be out. The otoscope should be out. Every single part of that animal's body, from nose to tail, should be examined. The vet needs to listen to the heart, listen to the lungs, feel the belly. It's really the most important part of the animal's annual visit." 
Dr. Saidla preaches hand washing as part of the exam process. "I wash my hands as soon as I walk into the exam room. I wash them again when I'm finished with the exam. But I also wash them before and after the oral exam," he explains. "I wouldn't want a doctor looking in my mouth who's had his hands in someone else's mouth." 
Finally, says Dr. Saidla, vets need to be tuned in to the subtle signs of how your pet is behaving during the physical exam. "People think that pets can't talk. Sure they talk if you're observant," he says. "You don't have to tell me where you hurt. I can watch you and often tell you where you hurt." 
3. A good vet addresses Fluffy's bad behavior as aggressively as his bellyache. 
"Among the most common reasons a person gives up on an animal and has it put to sleep are behavior problems," says Dr. Vite. "That's why, during an initial meeting, a good vet will ask not only how the pet's feeling but how it's behaving." 
Does your dog jump up? Does your puppy chew on your fingers? Are you having trouble with your cat clawing the furniture? A good vet will offer helpful solutions, provide how-to videos, or ask a technician to go over the basics of housebreaking, for example. This is all part of preventive health care. 
Dr. Marder, an expert in pet behavior, couldn't agree more. "It's as important as paying attention to vaccines," she says, "especially in the first puppy and kitten visit. In puppies, you have chewing and housebreaking issues; in kittens, you have clawing, eating plants, using a litter box. A vet needs to explain that these are normal animal behaviors that can be controlled. The best time to start training is when the animal is young. In terms of preventive health care, there's one more thing that many vets neglect to mention. 
According to Dr. Vite, there are certain breeds of animals that are predisposed to certain diseases. A pet owner should know this because, many times, there are actions that can be taken to minimize risk and keep the pet healthy. 
4. A good vet isn't afraid to say, "I don't know." 
"It's a good vet who acknowledges his limitations," says Dr. Saidla. "The worst thing a vet can do is act as if he or she knows it all. In the course I teach at Cornell on the art of practicing veterinary medicine, I tell students to put their honest self forward. Be honest with themselves and with the people they deal with. Be straightforward. Acknowledge your limitations. Don't take on difficult cases or surgeries that you're just not up to. Get someone to assist you. That's what referral centers are for. That's what other vets in the practice are for." 
5. A good vet should conduct appropriate lab tests before prescribing treatment. 
The days of taking a cursory look down Fido's throat and prescribing a course of antibiotics is long gone. Or at least it should be. 
"To give you a two-week supply of antibiotics without doing the appropriate lab work is not good practice," says Dr. Saidla. "A good vet may give a 24-hour sample of antibiotics if the animal has a fever and there's a high suspicion of a bacterial infection or if the animal might have serious consequences if it did have a bacterial infection (a dog with a slight fever and a bad heart murmur, for example). But the full course of antibiotics should not be prescribed until lab tests confirm the bacterial infection." 
6. A good vet delivers a clear explanation along with his prescription. 
Your doctor breaks the news: Fifi has diabetes, and here are the injections you'll need to give her. Your head fills with questions: Why? How? When? What does this mean? A good vet should anticipate those questions and explain as much as he or she can about the disease process. 
"It's not enough to toss out the name of the disease," says Dr. Vite. "Today, people want information." What the disease is. How the animal may have gotten it. How the owner can treat the animal. Why you have to give the medication regularly. Where the nearest emergency clinic is. How the disease process will change the owner's life. 
"It's the careful veterinarian who delivers the treatment regime in writing," says Dr. Brown, "and takes the time to answer all questions." 
7. A good vet telephones to see how Rover's doing. 
Granted not every office visit requires a follow-up phone call. But follow-up is extremely important to an animal getting well. So if your pet is sick or lab tests have been run, someone from the office should call the very next day. (It doesn't have to be the vet; it can be a technician or the receptionist.) 
If the animal is taking medication, this is a good time to ask how you and your pet are doing with the pills. Have you been able to get them into him? Do they make him sick? If yes, it's time to make adjustments. 
"Those quick follow-up calls mean a lot to people," says Dr. Saidla. "If you don't get called back, the vet may be too busy or not paying attention to the things he needs to do. When a vet calls back, it certainly cements the bond because it's over and above what people expect." 
In addition, a good vet returns all non-emergency calls within 24 hours. 
A Word about Credentials 
Virtually every veterinary hospital displays the sheepskins of its attending vets. But can a diploma clue you in as to how good a vet someone is? Not really, says Charles Vite, D.V.M. Obviously, having a degree from an accredited veterinary school is a prerequisite for practicing veterinary medicine. But most every vet does. And it doesn't appear to matter much which school is his or her alma mater. (Incidentally, veterinarians who've graduated from the University of Pennsylvania are awarded a V.M.D. degree; all other veterinary schools confer a D.V.M. degree. Essentially, these initials represent the same doctorate degree in veterinary medicine, but one is a Greek abbreviation and the other Latin.)
"America's veterinary schools all provide excellent training," Dr. Vite assured us, "and turn out very good vets."
Unfortunately, there are some not-so-good vets from some very good schools too. Accreditation can help tell you if your vet's got what it takes-and if her veterinary practice is up to standards.
The American Board of Veterinary Practitioners (ABVP) certifies vets with a broad knowledge base who are graduates of accredited veterinary schools, have completed a one-year approved internship program and a two-year approved residency program (or five years of "excellent experience in practice"), are committed to attending continuing-education programs, and pass a rigorous three-part exam to test their knowledge and ability to recognize, analyze, and solve clinical problems. Recertification is required every 10 years.
In addition, there are 19 other boards and colleges approved by The American Veterinary Medical Association (AVMA) that certify veterinarians in various specialties like cardiology, surgery, and dentistry. To become board-certified as a specialist, a veterinarian must have extensive postgraduate training and sufficient experience as well as pass an exam set by the AVMA-approved specialty group. Today, there are over 5,600 board-certified diplomats in practice.
The American Animal Hospital Association (AAHA) certifies veterinary hospitals that meet more than 300 individual standards in areas including emergency service, surgery, and nursing care. (For a referral to an AAHA hospital, visit the AAHA Web site at www.healthypet.com or call (800) 883-6301.)
Of course, a vet doesn't have to be board-certified to be good, and many excellent veterinary hospitals do not boast AAHA certification. So you may have to use your own judgment and intuition in deciding whether your vet makes the grade. One note: Being a member of the AVMA doesn't confer any special honor on your vet. It just means he's paid his dues -- literally.

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