Friday, October 16, 2009

Callused Elbows, removed teeth & cancer

A few days ago, I expressed unhappiness with the treatment I received from my vet. When I picked Ginger up after a supposed routine visit to have her teeth cleaned, a patch of callus removed from an elbow, and her nails clipped, I was informed that a tooth had to be removed. After I got home, I checked Ginger's mouth and could see no evidence of tooth removal. Furthermore, when I read the pages of advice they sent home with me, the callus had been transformed into a "tumor" and the implications of the description were that radiation treatment might be required if they didn't get it all.

After pouring over the material, I concluded that whoever wrote the it had made some mistakes. I voiced my concerns to a few people in discussions, and not everyone agreed with me. One person advised me to go off and look for a new vet if I wasn't happy with this one. I asked whether I had legitimate complaints. If I did then the focus should not be on my unhappiness but on the vet and her techs and helpers. Why should I have to go on a quest to seek a new vet? Why shouldn't the vet correct her problems?

Furthermore, I couldn't know beyond doubt that my assessment was correct. My vet runs her facility with her husband, 2 or 3 other vets, and a passel of techs and helpers. They are all good. They take time with the girls, and answer all my questions, but I have never been happy with her forms and instructions. The instructions are often confusing, sometimes replete with legalese, and usually containing copious amounts of general information I can't imagine a use for.

If I was right in my assessment (and even if I wasn't), the problems I described are inherent in any bureaucracy. Any organization might create a database, forms and procedures to be filled out by underlings, but unless those underlings are willing and able to manage the database, and fill the forms out properly, problems are going to be created with their confused if not unhappy clientele. It is impossible to flee from all bureaucracies.

When I took Ginger back for her one-week check, the tech at the desk said the vets weren't available, but she would record my complaints and questions; which I saw her doing – at least she wrote quite a lot in a little pad.

And then this morning I took Ginger back to have the staple removed from the spot where the callus had been. A busy tech took her in the back where she removed the staple. A few minutes later she handed Ginger back to me. I asked her about my complaints and concerns, but she had never heard of them. The information I had given to the tech a week prior had not made it to the tech who removed Ginger's staple. But this new one said she would check Ginger's chart and get back to me in a few minutes.

A few minutes later the Office Manager, Cheryl, who had once been a Tech, invited me into an examination room where she apologetically told me she would try to answer my questions. So I went through my concerns and complaints one more time. Cheryl called the forms up on a computer and saw that they did indeed say that Ginger's upper right Incisor had been removed, then she looked in Ginger's mouth as I had and verified that it was still there.

In regard to the callus which was described on the invoice as a "mass" and in the instructions as a "tumor," she said that the terms were interchangeable, but when I complained that the alarming terminology was very like the terms I read on a report about Trooper who did have cancer, Cheryl said that the vet looked at all possibilities but determined that the "mass" or "tumor" was indeed a benign callus and nothing to cause alarm.

The tech who filled out the form should have provided a note to that effect. Cheryl said that the tech had done a poor job filling out the form and would be reprimanded.

FURTHER COMMENT:

I have observed over the years that several kinds of conflict exist in the Dog-Human world. For example, breeders often generalize about ignorant and inept owners. You may be a well-informed and competent owner, but some breeders, at least in the on-line discussion groups, will make you prove it – and then not totally believe you.

Some well-informed and competent owners, on the other hand, will generalize about breeders, believing them to be more interested in winning show-ring points than in producing healthy dogs. The vast catalogue of genetic diseases in the various dog breeds gives ample evidence of this serious problem. Owners who attempt to confront show-ring breeders about the use of "famous sires," and genetic disease are often abused unmercifully for their effrontery.

Do vets and techs sometimes generalize about ignorant and inept owners? I have seen hints that some do. And do owners sometimes complain about the information and instructions received from vets and techs? I have nothing more than personal experience in this latter regard. I have waded through the poor writing of more than one tech, but I now content myself with having at long last learned what I needed about Ginger. Do I have confidence that this vet will solve her forms and procedures problems? Definitely not, but I do have confidence that some of those who work for her have learned my name, that my problems and concerns will be discussed at the next staff meeting ,and I have high hopes that the particular forms created for Ginger and Sage in the future will receive a bit more attention than in the past.

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