Selecting a Veterinarian

(Article from Veterinary Information Network [VIN] by Phyllis DeGioia)

There are as many different ways to operate a veterinary clinic as there are breeds of dogs. In general, no one breed is all good or bad, but it's important to find one that suits you. You and your veterinarian are the mainstay of the team that will take care of your pet's health, so it's best if you find a veterinarian that you can work with.

Clinics vary in their hours of operation, number of veterinarians and technicians on staff, services offered, bedside manner, appointment scheduling, prices and dozens of other details. When choosing a new veterinarian, decide which factors are most important to you.

Below are 10 steps to help you select.

1. Call around
Specifics such as hours and appointment length can be shopped by phone. If you want to spend 30 minutes with the veterinarian when you book an appointment, find a few clinics that schedule that way. Are you on a tight schedule yourself? Maybe 10- or 15-minute appointments are the ticket. But remember the wait at your own doctor's office; popular practices can sometimes get backed up, and emergencies alter schedules. Does the practice have overnight staff? Most clinics cannot afford to have someone there overnight. Although prices can be shopped by phone, it's much more important to ensure that this is the right place and right group of people for you to work with, rather than the right price for certain procedures.

2. How emergencies are handled
Most send critical cases to the local emergency clinic overnight. That raises another question: who provides emergency services? Are the services shared with other clinics or are cases sent to a central facility? You might have an issue with one of the other clinics or the emergency center may be too far away to be of use in an emergency.

3. Know the rules
Veterinarians graduate as generalists. They can (and many do) perform everything from orthopedic surgery and radiology to dermatology and dentistry. They work on any species of animal, although fewer do these days. Some prefer certain species or activities best and will advertise those special interests, such as feline or reptile medicine.

If you have cats, you might prefer a waiting room that doesn't have barking dogs. However, those specialty clinics don't necessarily have more training with cats than the veterinarian down the road. More experience perhaps, but again, not necessarily. For day-to-day care, most people will find that location and other points mentioned are more critical to a happy client-doctor-patient relationship than board certification. And part of that relationship is trusting that when appropriate, referral to the right specialist will be made without hesitation.  If you are in real need of a specialist, ask about credentials. True specialists will have extra certification. The veterinary profession has many board certifications available to practitioners, so usually any initials after DVM indicates some kind of additional expertise. 

4. Ask around
Friends and neighbors with pets almost always have stories to tell about their favorite veterinarian. Unfortunately, they may also have some bad experiences to relate. As is true for most services, recommendations are one of the best ways to find a good veterinarian. It's one of the few ways to judge medical or surgical ability, since there is no skill rating system for veterinarians.

5. Do the rounds.
After you've narrowed down the field to one or two clinics, call to ask if there's a time you could take a tour. What are you looking for? Well, cleanliness and order are important, as are relatively new-looking equipment, cages in good condition and a friendly tour-guide. Are there lots of certificates on the walls indicating the veterinarians and technicians keep up-to-date through continuing education?

6. Plan a test run
Make an appointment with the clinic you like best and decide for yourself whether it suits you. Yes, it will likely cost the price of a visit, but it will be worthwhile to get set up with a veterinarian you like before a crisis hits. Bring a pet for the appointment only if you have one that isn't terrified about a trip to the clinic as it will give you a chance to see how the staff and doctors handle the animals. If Fluffy is the nervous type, you can attend on your own. There may be a few places that won't charge for the visit if it's just for a chat, but don't expect it. Good veterinarians are in high demand.

7. Be proactive
Once you've picked a clinic, remember your own responsibilities. If Fluffy gets sick, call to ask for advice. Don't expect a diagnosis over the phone, but ask if you need to bring Fluffy in. In illnesses requiring follow-up care, keep in touch with the clinic if symptoms change. Ask what to expect so you can call if that doesn't happen. Give all prescriptions as directed. Keep scheduled recheck appointments. Bring a list of questions with you if you think you might forget to ask something.

8. Understand why there are ranges in costs
Many people shop around for the best price on this surgery without understanding why cost varies among veterinary practices. Ask the clinic how they handle elective surgery as an indicator.

a) Does each pet receive a complete physical examination prior to surgery? That's your best defense again performing surgery on an animal that may have infectious disease, a heart murmur, or be debilitated from parasites.

b) What safety precautions are taken during surgery? While most surgery is uneventful, emergencies sometimes arise. Early detection of impending problems greatly aids our ability to intervene and correct the problem. A breathing tube should be placed on all anesthetized animals, as that keeps the airway open and allows for supplemental oxygen or gas anesthesia as needed. A heart (EKG) and oxygen monitor allows the surgeon to keep track of heart rate and rhythm as well as the amount of oxygen in the blood. The practice should also have a "crash box" handy, which contains emergency drugs and supplies. 

c) What safety precautions are taken after surgery? Surgery patients lose body heat through anesthesia and the opening of body cavities. It patients get too cold, the heart can be affected. Patient temperature should be monitored at regular intervals after surgery and supplemental heating provided as needed. Your pet's gum color, pulse, and respiration should also be monitored. Does the surgeon scrub, cap, gown, and glove for every surgery? Does the surgeon use a fresh, sterilized surgical pack for each patient?

d) Will you receive written post-surgical care instructions? It's hard to remember everything.

9. Anesthesia and pain control
What is the level of anesthesia and pain control practiced by the clinic? Anesthesia doesn't control pain once the pet wakes up. Pain medication should be offered. There are large significant differences in anesthesia and pain control techniques among veterinarians. Does the clinic require any lab work prior to anesthesia? Does the clinic practice adequate pain control? Are multiple types of pain relief used depending on the procedure and the individual patient? Are the drugs and dosages chosen for that individual, or is a standard protocol used for every patient no matter what? Does the clinic put an intravenous catheter in every surgical patient and support the patient with intravenous fluids? How are the anesthetized patients monitored? Is there a person dedicated to monitoring the patient?

10) Drop offs
Does the clinic allow or encourage drop offs for established patients to help pet owners with time constraints?

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