Monday, February 16, 2009

Depressed Economy Making General Practioners More Proficient

Since veterinary medicine does not require residency and board certification in a given specialty to practice, the majority go into practice right from veterinary school and practice what is known as general medicine and surgery. This leaves a wide range of skills attained by the general practitioner, with some leaving most highly technical diagnostics, procedures, and surgeries to referral based specialists, while others utilize mentorship and continuing education to upgrade skills, knowledge, and diagnostic equipment in order to make it less necessary to refer highly technical cases.

In a depressed economic climate with the general populace having less disposable income and desire to spend, pet owners are increasingly saying no to referral specialized medicine, to a degree that I have heretofore not seen. Many of my colleagues agree with this assessment clearly witnessing this trend. Left no other recourse than just doing nothing or putting a patient to sleep, I, as well as many of my colleagues, feel inclined to offer these pet owners the alternative of letting us take a shot at some of these highly technical, referral based cases.

For example, just over two years ago (my home state of Florida was in recession before most of the country), a lady brought her cat to me because of chronic ear infections, which later turned out to be the result of a tumor deep in the ear canal. The necessary surgical procedure to resolve the problem, a total ear canal ablation (TECA), is a surgery that many GPs leave to the realm of board certified veterinary surgical specialists. With the owner unwilling not able to spend the kind of money necessary for the referral care, I offered her the option to have me do it. I explained her that I had scrubbed in on a few of these surgeries as a student, and felt that I may be able competently perform a TECA if I reviewed the anatomy well and re-studied the procedure. At any rate, it was a better alternative to simply electing euthanasia, especially since I was not going to charge for OR time, just for anesthesia and medications.

The end result of this case could not have gone better. The tumor had been contained and completely removed, and that patient is still alive and well. Since then, after having gotten a few more TECA procedures under my belt, I now feel justified in charging for my OR time when performing a TECA, which still saves the pet owner $1500 - $2000. when compared to what it would cost a surgical specialist to perform a TECA.

This is a very common story in the veterinary industry right now, whether GPs out of necessity venture into highly sensitive or technical surgery, or become proficient in advanced imaging like ultrasound and echocardiography. While the underlying reality of the cause for this trend is indeed quite sad and distressing, if we can weather this recession and come out survivors, we will have done so while as a side effect, creating a more highly skilled generation of general veterinary practitioners.

Wednesday, February 11, 2009

Disgraceful Whittemore Enterprises

At this year's North Atlantic Veterinary Conference, I was very excited to visit the exhibit hall where I could browse for much needed IV fluid pumps to upgrade my animal hospital. With medical equipment of this kind ranging from $500 to $5000 each, one has to be very careful about going unnecessarily high tech and paying too much for machines that will not offer return on vestment for years, vs resisting going too low tech enough and skimping.

AT one particular professional looking stand, I found two perfect IV pumps that I was impressed with for the price. One important thing about pumps is that they accept standard fluid set tubing, because many in the industry are calibrated to accept only fluid tubing made by the pump manufacturer, letting them have a monopoly on you to by keeping you necessarily having to always buy only their tubing - this is a lovely little scam, since used tubing is disposed of per patient, leaving us constantly having to buy new tubing. This salesman told me that standard tubing line are fine. I took him at his word and bought the pumps with my business visa check card.

Well, the pumps came, and the first time I tried to use them, I found that they were not accurate with the standard tubing lines that I had. I called the company tech department, who told me that they were not accurate because I did not USE THEIR TUBING! What's more, the pumps were also defective, not allowing a fluid rate higher than 100 ml per hour, making completely useless for any patients over 100 pounds.

Of course, I was rather displeased, having been lied to by the salesperson, who got on the telephone to tell me that I needed to send to pumps back to have them recalibrate for standard tubing, as well as have them looked at to figure out why they will not accept higher fluid rates. Having a little faith in this company at this point for having lied, sent defective equipment, and left my practice still in under strain without fluid pumps, I told him that I would send the pumps back, but for good, and to simply refund my money and let us part ways. At this the salesman told me that it is not their policy to take returns under any circumstances, that the only recourse was to provide me with a company credit to perhaps buy some other medical equipment from them - AS IF I HAD ANY INTEREST OF EVER BUYING ANY EQUIPMENT FROM THEM AGAIN!

One significant character flaw I concede is my propensity to have a bit of a temper. It takes allot for it to surface, but once it rears its ugly head, the flood gates tend to open. On the verge of losing my temper, I gave this salesperson one last chance to do business scrupulously, and asked him, "Is this really how you want to go about this? Because if it is, we are going to have a very big problem. I suggest you check with your supervisor [who happens to be the company's owner], and ask him if he would reconsider his position, given the fact that you misrepresented your products, and on top of that, are defective and useless for any patients that weigh over 12 pounds."

At this he left me on hold for 5 minutes, and returned with his bosses answer that he will not refund my money for the defective pumps that I purchased, but that I am again welcome to receive company credit to instead purchase other types of medical equipment from them. Temper now lost, I told him exactly where he can stick those pumps, and informed him that under no uncertain terms (perhaps spiced with a few colorful metaphors), that he will live to regret his decision.

While it hurts greatly to be out $2000 in a rough economy, and still have my practiced compromised without much needed functional IV fluid pumps for my practice, what appalls me the most about the actions of this company, is that they can act with such deliberate dismissal of ethical business practices, and proceed with such unethical, borderline criminal, behavior.

The very moment I got off the telephone, I proceeded straight to my bank with whom I have loyally kept all of my practice finances since 2004. I explained the situation to them and they advised me that I should send the pumps back immediately, after which they could provide me with a provisional refund for the cost of the fluid pumps, while they launch a dispute investigation against this company. While I have right on my side and am confident that my bank will find in my favor, I have to live for the next several days with the anxiety that I cannot be certain that the weasel who owns this company may somehow convince my bank to find in his favor. What's more, I have already out of necessity had to allocate that provisional refund to buy IV fluid pumps from another company that was highly recommended by a close colleague - not having IV fluid pumps places a big strain on a practice, and I had no time to wait. As such, I am in danger of essentially having $2000 essentially stolen from me, while even worse, having to live with the knowledge that a group of thieves under the guise of legitimate business men, got away with it.

Whichever way this turns out is in the hands of my bank at this point, so I have to move forward with the hope that they will honor my long and good standing relationship with them by doing what is right. No matter the outcome, however, my mission is clear: to share my story and expose this company for the bunch of unethical, immoral scoundrels that they are. For my readers who are veterinarians and physicians, the company is, Whittemore Enterprises, based in Rancho Cucamonga, California, and can be found at the website below:

Step one of my expose is this very blog, which I encourage all my readers, not just the vets and physicians, to forward this blog to any vets and physicians you know. My next step will be to start a massive letter writing campaign, beginning with all the major Veterinary Conferences that allow this company to have an exhibit, followed by letters and e-mails to every state veterinary board and every state veterinary medical association, starting of course with California. After this, I plan to file a complaint with the California Better Business Bureau, then start gathering as many veterinary hospital e-mails across the nation as I can to warn them about Whittemore Enterprises. As the icing on the cake, I will write to the editors of every veterinarian journal and publication so that they may spread the word that Whittemore is bad news.

To the owner Mr. Bill Whittemore, you have demonstrated that you do not engage what your website preaches as its mission statement, ". . . providing what the customer needs at an excellent price and then standing behind that purchase . . ." Quite the opposite, you showed me that you employ deceptive salespeople that lie customers into buying your equipment, then when it does not have features that were promised or even work properly, you try to hold the customer hostage by claiming a "no returns" policy.

You could have simply refunded my money, taken your miserable pumps back, free to sell them another day to some other unsuspecting poor soul. I would have been out of your life, and you would have never heard from me again. Through your deplorable actions, however, you will probably not ultimately get to steal my $2000, and now you will not be rid of me for quite some time.

Sunday, February 8, 2009

Hail To A Fallen Hero

As reported by, black Labrador Retriever Marley spent a 9 year career as a search and rescue dog, with tours of duty that included crawling and sniffing through the World Trade Center ruins after 9/11, and performing her duties amidst the destruction of 8 different hurricanes. According to Marley's owner and handler, Captain Mark Bogush, no matter how devastating and challenging the scene, Marley approached her job with a nose that never quit, and with a singular focus to find survivors.

As the 12 year old dog layed on a table at an animal hospital suffering from bloat (and what I am assuming were likely severe complications arising from that, but the reporting did not get into details) was given a 50% chance of surviving emergency surgery. For Captain Bogush, the answer was clear, to say goodbye to his heroic companion and coworker, and let her go in peace by euthanasia, at her side, stroking her as she parted from this earth.

As a trainer of search and rescue dogs, Captain Bogush maintained that he spent years preparing himself for the possibility Marley could suffer a fatal injury in a disaster area. Still, the decision to euthanize Marley was almost too painful to bear. "It tore your heart out," he stated. "I'm sure I was blabbering at the time. It was hard to see her through the tears."

A friend had asked Bogush at a party if he wanted a dog because a young black Lab was damaging his friend's house. The friend had a newborn infant and did not have the time or patience to train the likes of a destructive Labrador puppy named Marley.

After Bogush saw Marley literally dragging his friend's wife as she tried to walk her, the fire rescue captain knew he had witnessed a trait essential for all search and rescue dogs: high energy. Captain Bogush had just joined Tampa Fire Rescue's first urban search and rescue team. Another dog, Jessie, was already under search and rescue training by Lt. Roger Picard. Bogush did not know if Marley would develop the skills to work along with Jessie. He began her training slowly, by first taking a favorite toy and throwing it into thick brush. "If she doesn't quit, that's a good search dog," Bogush stated. "She searched and searched until she found that goofy little toy. She was a lucky find."

The next step was to have another person go and hide in possession of the toy. Shortly thereafter, Marley treated search and rescue like a game of hide-and-seek. Captain Bugush truly felt that Marley's main motivation for searching for people amidst the World Trade Center rubble, was the idea that someone may "pop up and play with her," Bogush mused.

Marley had been retired from search and rescue for three years at the time of her passing. Although she never found a single survivor in her career, it was her tenacity that saved firefighters precious time and energy that she is most remembered for according to Captain Bogush.

Marley will be remembered by those who loved her and had the privilege to work with her, as a pioneer, a friendly, outgoing dog who licked children's faces in pediatric care units and, even through her retirement, a dog who still kept on sniffing for snacks or treats.

Bogush stated, "The nose was her biggest quirk. That nose never stopped working."

I salute you Marley, and the thousands of service dogs like you, for in the short years you spend on this earth, you most certainly make it a better place!

Monday, February 2, 2009

Florida Couple Has Deceased Dog Cloned

5 years ago, Nina and Edgar Otto of Boca Raton, Florida, lost their beloved yellow Labrador, Lancelot. According to a recent Associated Press article from January 28, 2009, deeply saddened by the loss of their Lancelot, the Ottos had samples of his DNA frozen, guessing that some day dog cloning would be available. Just 10 weeks ago, their wish came true, as a biotech company known as BioArts International successfully cloned Lancelot (the 10 week old puppy clone is named Lancelot Encore) for the mere low price of $155,000. Lancelot Encore is genetically identical to Lancelot the first.

While the scientific achievement is remarkable, the ethical question remains if this should be done. For animal rescue workers, they would likely view spending $155,000 on a dog as rediculous, with shelters overflowing with dogs in need of homes (many of which are pure bred Labrador Retrievers). To people of faith, they may feel that this crosses the line into playing God, with science attempting in an indirect way to cheat death.

There is also the question of whether the cloned dog is the same as the original dog. Although they are genetically identical, the cloned dog will ungergo, even with the same owners, uniquely different sets of experiences that may lead to this dog being an individual pet, separate and distinct from the original dog. From a faith perspective, does this dog have the same soul as the original dog (I am a person of faith who refuses to accept that our pets do not have souls)?

These implications of the Ottos's choice to have their deceased dog cloned, are very subjective and difficult to ponder from any perspective. I do not agree with their choice, but my disagreement has little to do with animal rescue or faith. For me, this circumstance reminds me of my previous blog post, "Oh Bernie, My Bernie," an article that deals with pet loss, using my own personal experience of the loss of my beloved Yellow Lab, Tiffany, to get my point across. For this topic, the following excerpt from my article seems to be the most relevent:

The point of this story is that I see owners everyday devastated by the passing of their beloved pet. They feel as I did after Tiffany's passing, that they will never bond with another animal like the one that have just lost. They are correct that it will never be the same, but make no mistake, when the time is right, there will be other great animals in your life that you will love for a completely different set of reasons, yet with a sense of fulfillment of the same magnitude.

Obviously comsumed with a sense of loss, it seems that the Ottos either could or would not understand this sentiment, and so chose to instead attempt to relive the past. I understand their desire to do so, but the past is behind us for a reason, to carry memories of and learn from, but not to try to relive. In any endeavor, when we try to relive the past, we are almost always met with disappointment and the realization that we were different people in the past, and what sustained us then, simply is not appropriate in the present.

It has been 2 1/2 years since my loss of Tiffany, and I still miss her dearly, as if I left a part of me behind. As much as I will always miss my dog, I realize that Tiffany was the right dog that came at the right time for that period of my life. The right dog for my present journey is my current Yellow Lab, Bernie. It took me a little while to accept, but since this realization hit me, I have been enjoying every moment of our ride together since - not any better or any worse than the journey I enjoyed with Tiffany; just different. I love Tiffany and will always miss her, but even if I had $155,000 to throw away, I would not even netertain the idea of having her cloned.

While I know that the Ottos actions, however misguided, were born out of the memory of the joy and love they experienced with Lancelot the first, they would have done better for themselves to move on from the past, and engage in a future with an enitirely new dog.