Friday, March 2, 2012

893. Sophisticated Singaporean pet owners

Yesterday, Friday, I had a meeting with Mr Min, Dr Vanessa and Dr Daniel, seated facing them in the small consultation room, at around 11.30 am when Dr V came to work. The topics covered were:

1. Trend of better educated younger clientele.

"Nowadays, Singapore clients are better informed, esp. on specific diseases as they research the internet," I said. "Therefore, the vet must be able to provide additional value and know the answers to resolve their problem. Clients already know some answers.

For example, megaesophagus in the dog. The diagnosis is easy. Give me 3 solutions or treatments," I asked Dr Vanessa. I continued as clients were waiting outside: "Vets can see the megaesophagus on the plain chest X-ray, but don't expect the owner to see it. That is why I had a barium meal done on the shih tzu so that the owner can really see the dilated esophagus. In fact, there was an esophageal diverticula in the front part of the esophagus.

Dr Gladys had warned that the dog could get aspiration pneumonia if he was given the barium meal," I looked at Dr Daniel who was present during the X-ray. "But this test had to be done and the risk taken. Now, the owner is satisfied with knowing what cause regurgitation in his dog for the past 3 months. As to the cure, that's another matter. Get the diagnosis accurately in a manner that the owner can relate to. Not just showing some area on the plain X-ray and expecting the owner to be convinced as that was not possible in this case earlier."

I read out a text message from a young girl whose rabbit had just given birth to 2 kits. "She's very knowledgeable," I said to Dr Daniel who had diagnosed pregnancy after palpation of a soft abdominal lump and predicted one rabbit.

I had said that "X-rays are necessary to confirm how many babu rabbits were there or whether it was a hairball as diagnosed by the young girl who had earlier texted me to say her 5-month-old rabbit was not eating and drinking.

I had asked: "When did you see the rabbit being mated by the 6-month-old male?". She said: "2 weeks ago."

She asked whether she ought to X-ray and I said it was not necessary. "Just separate from the male, keep her in a quiet place, feed her the fiberplex to move her bowel since the stool pellets are harder and syringe her with electrolytes. She came all the way from Tampenis and it was good that she had good news from her text message 3 days after consulting me.

2. Be meticulous in recording.
Proper and accurate recording ofsurgical procedures, hospitalisation records and anaesthetic records. "All vets will be responsible for their own records," I said. "When there is litigation, such records will be evidence of professionalism or lack of care," I said. "If you want to continue working as a vet, you have to be aware of the trend towards a litigious society and the many regulations of the veterinary authority. Such as the requirement to submit rabies and microchip records monthly. I cited examples of disciplinary enquiries of the liposuction death case where the anaesthetist record was said to be "doctored" and the acupuncturist who prescribed drugs but failed to keep proper and accurate records.

"There are more newspaper complaints and litigation in the medical profession nowadays," I said to the two young vets. "It is best to learn from the failings of others. Unless you want to be suspended or struck off for negligence or for not providing a reasonable standard of care. In the old days, there was not so much need to keep detailed records of anaesthesia and surgery. But times have changed and it is best to be up to date on trends and regulations."

"You two younger vets have at least 30 years of practice to look forward. It will be bad to be suspended or become infamous in litigation. Unfortunately, as a licensee, my name will be dragged in too in such circumstances."

Much more had been said by me than I can record. It is not easy to be a vet or doctor nowadays and so one must be careful. Very careful.

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