In Practice A practitioner ponders

A practitioner ponders

2012-05-10T07:35:06-07:00

I was bitten by a dog last month – quite badly. It was one of those determined, practiced lunges that come without warning. There was even some chewing, and not a glimpse of remorse. It was an elderly dog with a foul mouth brought in by an incompetent owner, and these circumstances only made the situation seem worse.

I was triaged within 10 minutes of arrival at A&E, thus satisfying performance statistics. The decision was eventually made that my wounds merited the attention of a hand trauma specialist at another hospital on the following day.

I began pondering the circumstances of the attack around midnight in bed when the pain relief had begun to subside and I had run out of trial positions for relieving the pressure on my swollen, oozing (and, sadly, dominant) hand.

I was now privy to the knowledge that the dog had previously sent a...

A practitioner ponders

2012-04-16T02:16:26-07:00

The question ‘What makes a good vet?’ is one I ask myself often. It came up recently in discussion with a final-year veterinary student.

As an undergraduate I would have listed traits like excellent surgical skills, an ability to communicate well with clients, encyclopaedic medical knowledge, the ability to deal calmly and efficiently with stomach-churning, adrenal-gland milking emergencies, and so forth.

The student's concept of the good vet was similarly focused on clinical prowess – essentially, the ability to perform, confidently and competently, a series of diagnostic and therapeutic tasks, with a smattering of ‘good communication’ thrown in because we are taught that good clinicians are good communicators.

However, experience has taught me that this picture is incomplete. Bradley Viner, in his book ‘Success in Veterinary Practice: Maximising Clinical Outcomes and Personal Well-being’, cites a study in which general practitioners list the hallmarks of medical excellence in their postgraduate...

A practitioner ponders

2012-01-11T08:21:53-08:00

I've been thinking lately about customer service.

I'll give a couple of examples. There is a very small Italian restaurant in London that I go to three or four times a year. The food is perfectly good though nothing outstanding, but the patron always recognises me and greets me like a long-lost cousin. Nearby, in a London club, a young maître d’ used to insult his guests with such cheerfulness as to charm them and never troubled them for their room number for the bill; instead, he memorised their faces and kept print outs showing who was staying in which room. In both instances, the chef might think that customers are buying his food, but we are actually buying customer service – the atmosphere created by the front-of-house people. What can we learn from this and apply in our surgeries?

Complaint handling is another area that we all know...

A practitioner ponders

2011-12-21T04:02:11-08:00

The current emphasis on evidence-based veterinary practice in veterinary schools and journals is very necessary, but an unacknowledged victim of this progress is the humble case report. I thought it was just my imagination, until a friend sent me an editorial from the recently launched Journal of Medical Case Reports, which stated that ‘case reports have become a casualty of the pursuit of the impact factor’ (Kidd and Hubbard 2007).

In other words, case reports have low citation value and may therefore negatively affect a journal's impact factor – so it is no surprise that the prevalence of case reports in high-impact journals is decreasing.

Don't get me wrong – large studies are critically important to the future of veterinary medicine. Systematic reviews and meta-analyses, particularly in human medicine but increasingly in the veterinary field, have demonstrated that some treatments that we have relied upon for decades...