Over my
thirty years, I have practiced with colleagues who
have been co-workers, employers, employees,
associates, neighbors, and consultants; the last
category being veterinarians who travel great
distances and charge enormous fees to repeat what
you just said. All doctors develop a certain
practice style; something neither good nor bad, just
different. As you might guess, my approach to
medicine mimics my approach to politics; I am
conservative. Knowing most ailments in most species
will heal on their own, I resist cleaning out my
pharmacy plus my client’s wallet just to give the
illusion I alone am responsible for the patient’s
restoration to health.
At the other end of the spectrum, are practitioners
who truly believe every case is but a heartbeat away
from flat-lining and only through their miraculous
intervention can the patient be saved. Done
properly, this approach can be economically
rewarding, so I really should take a second look at
my practice style, but again like politics, my
convictions are firm. Let me put a face with my
point.
On June 23rd, 1997 a client led an injured gray mare
into my clinic. The patient had been racing into the
corral when she took the gate corner too tight and
hooked her hip on the bolt hinge which sticks six
inches through the backside of the post. I am unsure
why hinge bolts are so long as issued from the
factory, but if you leave the extra sticking out
eventually your economic loss will be your
veterinarian’s economic gain. So you understand my
treatment decision, the upper body of a horse has an
unbelievable ability to heal from an open wound. You
could take a chainsaw and whack off enormous pieces
of flesh from your horse’s chest, ribs, and hips and
then treat the wound in the worst possible manner
and in six months your pony will be as good as new.
Somehow, this truth remains a secret.
I clipped, cleaned and explored the wound. Embedded
among the dangling remnants of horse flesh were
fragments of hip bone, so I extracted the
free-floating pieces and trimmed away the dead and
dying tissue. I explained we would leave this wound
open as more tissue would die over the next week due
to the crushing impact from the hard steel bolt.
Non-verbal cues hinted the client disagreed and
wanted sutures. Horse people love sutures. In years
since, as a compromise I will agree to sutures only
if I can put them as far from the wound as possible,
such as in the opposite leg. Few clients choose
Option B. If I compromise and put in sutures, then
we would be in agreement, but both be wrong; so much
for the benefits of reaching across the aisle.
Later that evening, the husband and wife solicited a
second opinion from a doctor who occupies an
approach to medicine polar opposite to mine. More of
the “cold steel is the way to heal” type, he took
one look and announced “this mare is suffering
arterial bleeding and needs emergency surgery.” One
hour and hundreds upon hundreds of dollars later,
the gray mare walks out of surgery with sutures
everywhere. The next day, word gets back to me the
horse owners speak lovingly of doctor number two,
but are disappointed with me. Armed with logic and
experience, I requested a few moments of the owners
time to futilely argue my point, proving once again
Mark Twain’s adage, “It is easier to fool someone,
than to convince them they have been fooled.”
I wish I could say the story of the old gray mare
was a onetime occurrence, but that would be lying. I
stubbornly and rightly refuse to let clients force
me to practice medicine in a manner inconsistent
with what I know to be true. However, because
veterinary medicine is a free market commodity,
clients can take their animals and their wallets to
whatever clinic best matches their beliefs and this
brings me to my point. With the full, complete,
oppressive and forever implementation of Obamacare
you will get whatever the compassionate doctors at
the Internal Revenue Service prescribe whether you
like it or not. Using the fiasco of the Obamacare
sign-up launch as an example of the quality of the
new health care in America, does it not scare you
that from now on there will be no such thing as a
second opinion? It does me.
|