How to find a good vet

Seattle Times 

Tails of Seattle Pet Blog  

Posted by Neena Pellegrini

Carl Ware, chief operating officer at Pilchuck Veterinary Hospital in Snohomish, and Dr. Carin Smith, an author, consultant, trainer and speaker in Central Washington, who works with veterinarians to improve their practices, answer this week's questions.

Question: Generally, what separates a good vet from a mediocre vet? What separates an extraordinary vet from a good vet?

Smith: The client's perception! What one person thinks is good or extraordinary may be different from another. "Extraordinary," to me, is the veterinarian who can work with each client as an individual so each client feels the vet is great, from his or her unique points of view.

Question: What can pet owners expect from good and/or extraordinary vets?

Ware: Good or extraordinary veterinarians communicate in a timely and thorough manner with clients and leave no health-related questions unanswered.

Smith: Good communication. When a veterinarian is a good communicator, he or she is able to communicate what's going on with the pet, what the best program is for the pet to remain or get healthy and what the veterinarian's abilities are (thus, when to refer to a specialist).

Question: What are the first things a pet owner should do when searching for a new vet? The Washington State Veterinary Medical Association will list members but not recommend them. How do pet owners winnow the list?

Ware: Consumer-opinion websites provide a good source of information about client experiences. The Better Business Bureau will know if complaints have been registered about a service or veterinarian.

Smith: The best way to find a veterinarian who is good is to ask friends and family. Go beyond asking whether they like their vet and ask what it is they like -- because their likes and priorities may differ from yours.

Question: Does where a vet was educated really matter?

Ware: No. The standards for medical education in this country are extremely high.

Smith: No, as long as they attended a veterinary school accredited by the American Veterinary Medical Association , which applies to U.S. veterinary schools and some in other countries.

Question: How does a pet owner assess how smart a vet really is? How can a pet owner better judge the keenness of a vet's diagnostic skills and whether the vet has kept up to date on new studies, medications or new options on treating different conditions?

Smith: What is "smart?"

If it is an accumulation of knowledge, then basically, you can't tell how "smart" they are unless you are another vet, and even then, you only know that based on how much you also know.

If "smart" is a skill level, then again you can't tell how "smart" they are unless you are another vet, and even then, you only know that based on how much you also know about those skills.

If "smart" is being able to solve problems, then you can get some clue by how the veterinarian communicates with you when or if your pet has a problem, but then you are not really "seeing" how well they solve problems, but how well they communicate how they solve problems (the communication being a separate step from the problem-solving).

I'd answer this question with another question: What is it about being "smart" that you want? How would a "smart" vet translate into how the vet worked with your pet?

Ware: Veterinarians must receive 20 hours of continuing education every two years. It may be useful to ask your veterinarian about continuing-education courses he or she attended in the past year.

State-of-the-art veterinary practices employ technology to enhance diagnostic skills. Ask what diagnostic equipment is available on-site.

Question: How or why does a vet's curiosity or general level of interest matter in an owner's selection process?

Smith: Only as much as the client desires this in a veterinarian. In general, one might assume that a curious/interested vet would be someone who was curious/interested in keeping up with medical knowledge and skills, but how are you as a client going to judge that? Frankly it is tough. Back to the recommendations of people who have had experience with the vet -- recommendations.

Question: How involved should a pet owner expect to be in making medical decisions? Some owners are knowledgeable and may want to weigh in on approaches and medication.

Smith: As involved as they want to be. Some people want to be more involved than others, and a 'good' vet should be able to work with the client and involve that client at the level they want to be involved.

Many vets just leave people confused because the vet thinks every client wants to know all the information and all the choices, but the client hears an avalanche of information and choices and does not have any clue what is the best thing for the pet!

Other people may 'hear' the vet make one clear recommendation and feel they want more information or more choices. So the best veterinarian is able to work with people at either end of that spectrum, based on what the client wants.

Question: What does a pet owner do when a vet seems to be more interested in the client's wallet than his/her pet? How can pet owners assess whether they are being overcharged or paying for procedures their pets don't really need?

Ware: A veterinary practice that is more concerned with maximizing revenue instead of serving clients in a cost-effective manner will be at a competitive disadvantage and will have a difficult time surviving in this age of enlightened consumers.

Smith: One approach (that I do not recommend) is to phone up a bunch of vets and ask them what they charge for something. However, most vets know what items are 'shopped,' such as spays and neuters, and they price those items competitively or base them on their expertise and expenses.

You also may not be getting the same procedure. Surgery is one thing, but what about anesthesia and anesthetic monitoring? Do they have a tech watching the pet throughout the procedure and recovery, and do they use an IV catheter and other items for safety?

So if you are looking for a low-cost spay/neuter, you can find it that way, but you won't necessarily be comparing the same spay across different vet practices.

But with any other items, you are really in the dark because medicine is not a one-size-fits-all. If, for example, your pet is throwing up and you phone a series of vets to ask what it would cost to treat, some might quote you their exam fee and some might quote you the exam fee plus "what else might be needed."

If, in that case, you went with what sounded cheapest, you would not necessarily end up with what was actually the cheapest. So it still goes back to trust, which goes back to that personal recommendation. Don't wait for an emergency to find a family vet!

Question: What are the signs that a general vet may be in over his/her head on a case and a specialist may be needed?

Ware: It is not an issue of veterinarians being "in over his/her head" when they decide to engage specialists. Specialists provide a depth of knowledge that is the results of years of specialized study and applied learning during residency training.

General-care veterinarians often use specialists to complement their skills.

Question: What about a second opinion? How should these be handled? What if the vet resists or becomes defensive? How does a pet owner seek a second opinion without jeopardizing the relationship with the current vet? Should the second opinion come from a different clinic or is it appropriate to consult another vet in the same practice?

Smith: This is one place I see pet owners go awry.

IF you are going to get another opinion then, my goodness, go to someone who has MORE knowledge than the one you see now!

Going across town to another vet will not get you more expertise. If you want more expertise, ask your vet to refer you to a specialist, and/or ask your vet to consult with a specialist (often the latter is a little cheaper, though not free, and the specialist could sometimes direct your vet to further or different approaches they are able to do right at that practice).

It is perfectly OK to ask a vet if they've talked about your case to others in their own practice, but please assume that they DO this as a matter of course. If you ask that, don't be surprised if they respond with surprise or even defensiveness because it sounds as if you don't trust them at all and assume they are a doofus who doesn't even talk to his/her colleagues in the same practice. One way to say this diplomatically is to assume that they DID talk to their colleagues and ask what those colleagues thought.

If the vet resists or becomes defensive, then don't react negatively. Simply say you'd be more comfortable if you could see a specialist and would prefer it if they referred you because that way they and the specialist could share information about your pet.

Remember that the way you ask can set up or diffuse defensiveness. Ask in a way that shows you trust your vet and want more information, not in a way that says "I don't trust you."

Question: If a pet hates the vet, should the owner look for a new vet?

Ware: Not necessarily. Some pets do not respond well to different environments. The pet's attitude toward a veterinarian does not suggest that less-than high-quality care will be delivered.

Smith: Few pets hate the vet, but some vets have different abilities to 'get along with' some pets. If your pet is fearful or aggressive, it could be that way with ANY vet -- but look at how the vet responds and see if they are making progress, approaching with care and compassion, using calm communication. If you are not comfortable with how they work with your pet then by all means go to a different veterinarian.

Question: If someone owns a pet other than a dog or cat -- say a ferret, hamster, bearded dragon lizard, parrot -- how important is it to find a vet who specializes in these kinds of animals? How does one go about finding vets who specializes in these critters?

Smith: The word 'specialist' has a legal meaning in veterinary medicine, and it applies to veterinarians who have received further training and are "board certified" -- the number of vets who are board certified in working with exotics, reptiles, amphibians or birds is very small, but if you can find one, that's great! Otherwise look for a veterinarian who has a special interest in your type of pet, because they will need to be able to handle it safely and know how to do an exam on that type of animal.

Question: Conversely, vets probably are using their own criteria in evaluating clients. What are THEY looking for?

Ware: All businesses, including veterinary practices, like pleasant clients who love animals and have the resources to invest in the health and well being of their pets.

Smith: Clients who understand that preventive medicine is important for several reasons: pets stay healthy longer, problems are caught sooner and, thus, overall costs are less in the long run.

Clients who communicate clearly and take responsibility for their end of the pet's health care -- asking questions when they don't understand, letting the vet know their own limitations, such as when they are not able to carry out a treatment. For example, if you aren't able to give your pet a pill, say so and ask for help.

Clients who are knowledgeable but not know-it-all -- the difference being someone who has read up about a disease and comes in with questions, versus a client who has read up about a disease and comes in asking for a specific drug.

Clients who make appointments and arrive on time (assuming the vet is equally timely!).

Clients who have owned their own business or who understand the real costs of health care are great, because they have an easier time understanding the reasons for fees.
For example, women who have had a hysterectomy and actually looked at the human-surgery hospital bills, have a whole new understanding of the spay procedure, including costs and the aftercare. Vets DO use the same procedures, drugs and equipment.

Dr. Carin Smith, president of Central Washington-based Smith Veterinary Consulting, works to help veterinarians and their teams create successful lives and careers. She is a consultant, speaker, trainer, and author who gained experience in both large- and small-animal practice before moving full time to consulting with other veterinarians and veterinary associations. She is a member of the Association for Conflict Resolution, the American Society of Training and Development, the Veterinary Hospital Managers Association and the Society for Human Resource Management. She is a member and has served on the board of directors of the American Veterinary Medical Law Association.

Carl Ware is chief operating officer at Pilchuck Veterinary Hospital in Snohomish. He previously served as hospital director at San Francisco Veterinary Specialists. He has more than 30 years of hospital and veterinary experience. He holds a bachelor's degree in economics from Northwestern University and a master's degree in health-services management from the University of California at Berkeley.