Weekly Posting of the Conservative Cow Doctor


Second Opinions

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.

Home     |     Products     | Copyright (c) 2009 Krayton Kerns  All rights reserved.