Monday, September 27, 2010

Choosing a Vet

Maisy just adored the old vet clinic. So did I.

I received some devastating news last week: my beloved vet clinic is permanently closing on Friday. I spent the first 12 hours panicking and calling and emailing everyone I know (including several local yahoogroups), looking for a vet referral. The next 12 hours were spent googling like crazy, doing a cursory review of the clinics I’d received feedback about. I reluctantly ruled a few out due to location, and in the end, narrowed down the feedback to three clinics that look promising.

I’m now in the process of touring these clinics, an undertaking which is both fascinating and overwhelming. It’s required me to think about my priorities, both in terms of what I need from a vet, and what I simply want. I then took those priorities and came up with a list of questions to ask prospective vet clinics. As a side note, I found Speaking for Spot by Dr. Nancy Kay very helpful; there is a chapter on touring vet clinics, and supplied a few additional questions. Today, I thought I’d share what the process has been like so far.

I started by making a free-form list of things that are important to me in a vet clinic. I didn’t try to organize them or rank them in order of importance, I just wrote everything down. Once I’d exhausted my brain, I labeled each item as either a “must have” or “would like to have.” In case anyone is interested, my “need” list includes: being good with fearful/anxious dogs; having a clinic-wide dedication to low-stress handling; being exceedingly patient with drama queen dogs and their paranoid owners (I’m being honestly, okay?); and accepting both dogs and cats. The “want” list includes: a clinic that uses a blend of western and holistic approaches, which I define as taking a minimal approach to vaccines, being willing to use titers (especially for rabies), being open to a raw food diet, but also being willing to use antibiotics, flea and tick preventative, and heartworm medication as needed; a clinic that will be available for urgent visits; a clinic knowledgeable in behavior, and especially positive reinforcement training; and a clinic that’s conveniently located.

From there, I created a list of questions. I went down my list and wrote down different questions I could ask in order to figure out whether or not a clinic meets that need or want. I included general, open-ended questions, as well as specific questions. I quickly realized that my questions fell into five broad categories.

Handling and Behavior
Since one of the most important things to me is how well a clinic handles my pets, I am asking specifically how they do this: What are their general procedures for restraining a pet? How many people usually help with blood draws? Who will be doing the restraint: a vet tech or a kennel assistant? How do they modify their general procedures for fearful dogs? Are they familiar with the work of Dr. Sophia Yin?

In this category, I’ve also included questions on a clinic’s knowledge of behavior. I’ve been asking scenario types of questions. What would they do if my dog growled at them while they were handling them? If my dog was having on-leash aggression, what types of tools would they recommend? Under what circumstances should I use a prong or shock collar? How should I discipline my dog when she does something naughty? All of these questions helped me suss out if they are on the same page, training-wise, as me.

Appointments and Hospitalizations
Since I really want a clinic with good urgent-appointment availability, I’ve been asking questions about making appointments. What is the length of their typical appointment? At multi-doctor practices, will we be able to see the same vet for routine visits? I also want to know about how they handle hospitalizations because I have pets with chronic health problems. Specifically, how are pets supervised overnight? Where do they recover from anesthesia (under direct supervision, or in a kennel in the back)? How do they assess stress and pain, and what are their visiting hours and policies? Can I go “in back” with my pets? Do they have an isolation ward for contagious pets?

General Orientation to Medicine
I really want a vet that will be open to alternative medicine, and yet still be able to recommend more conventional approaches when needed. As a result, I’ve been asking questions about both flavors of medicine. What is their recommended vaccine schedule, and how do they feel about titers? What diet do they typically recommend for a healthy dog, and would they be able to help me formulate a home-cooked diet? How do they feel about those people who feed raw? (Note: that question is specifically worded as though I have a bias against raw feeding. I don’t, but if the vet does, I’m hoping this question will pick it up.) Do they ever prescribe supplements, and if so, what kind? On the flip side, at a more holistically-inclined vet, I’m asking about their vaccine schedule for puppies, under what circumstances they would recommend antibiotics, and whether or not they prescribe heartworm medication.

I am definitely an owner who wants to know more before I make decisions. I like research, and I like being able to ask questions. As a result, I asked what kind of resources they have for patient education, whether or not they will give me print-outs detailing my pet’s lab results, and whether or not I’ll be able to talk to the vet between appointments.

Professional Skill
It might seem odd that this question is last. After all, a vet should be a stellar clinician first, right? But here’s the thing: I have no way of knowing if a vet is good or not. I’m not a vet, so how can I really assess their skills? Instead, I checked my state’s board website to see if any of the vets I’m considering have anything on their records. I checked to see what, if any, accreditation they have. Then I asked about their techs: are they certified, and why or why not? What kind of continuing education events do the vets attend? How often do they have staff meetings, and what types of topics do they cover? Where are their lab work and x-rays developed and read?

Even more important, I want to be sure that my future vet knows when a case is over their head, and so I’ve been asking what types of specialists they have a relationship with, and what types of cases they typically refer out. I’m asking what types of surgeries they do on a regular basis.

The answers have been interesting, and so far, I haven’t found the “perfect” clinic. It probably doesn’t exist. I’m not quite ready to make a decision, but I’m close. But no matter which clinic I choose, my tours and interviews have helped me feel more comfortable.


Eliz said...

I'm so interested in what you've discovered! You'll have to fill me in.

Crystal said...

I'll let you know as soon as I decide. I need to go tour Lake Harriet, I think.

Liz said...

Wow, this is great Crystal. I also will be very curious to hear your final decision. These are all wonderful questions, and many I have failed to ask myself before committing to certain doctors or clinics (and kicked myself for not asking after the fact).

Funny side note/story--while I don't feed my dogs raw consistently (need more freezer space!), I am more than open to incorporating it as part of their diet. My old vet--who I did like, but was very old school--once commented on how nice my dogs teeth were. I said, well it must be the raw bones I have been feeding them. He seriously gasped and said--"you don't know where those have been! They may have been handled improperly and could contain bacteria." Well, they may, but theyre also being sold in a store as "human food." I got his point, but it also made me laugh. I had no idea until very recently how unversed most vets are on canine nutrition.

Crystal said...

Thanks, Liz. I admit, I didn't do much research to choose my first vet, and while I was happy with them, I wouldn't go back.

I was kind of desperate when we chose the second- the one closing now- so didn't interview them as closely, but I've loved them.

But now I know a lot more about what I want in a clinic, what I need in a clinic, and what's worked (and didn't) for me in the past. I hope the new clinic is awesome.

Joanna said...

Thanks so much for this post! I've never had a regular vet with Ira, since we've gone through moves and seeing a handful of specialists over the past few years. I want to check out a holistic vet close to my current apartment and I'm hoping they'll be my regular vet for my future puppy. And Jasper, I guess, but I'm bad and don't take him in regularly.

Kristen said...

Great post! We had to find a new vet a month ago due to the tests we wanted not being available at the place we used to go. We still maintain a relationship with that clinic because the -are- nice to us (even if they don't do what we need), they will come in 24-7 for an emergency (and have for me!), donate services to the shelter I volunteer at, and they do accept a payment plan if necessary.

But our new vet... separate exit! You get in the exam rooms RIGHT away, great restraint! You pay while in the room, no silly standing in line in the waiting room with a stressed out pet!

Good luck in your search!

Jules said...

Excellent post. I hope you find a clinic that will work for you.

Louise Kerr said...

Good Post Crystal however don't ever contemplate moving to a country area in Australia. Most of our city vets would never meet your criteria let alone the one vet clinic that I have access to in a 170 km radius from my home. Luckily they understand that as a pet care professional and a scientist that I have a great deal of knowledge and are happy to let me share that when it comes to making decisions about my pets. What does get up my nose however it some of my grooming clients who think the vets are gods and can do no wrong. Then there is Caesar Milan lol and how wonderful (not) his training methods are. Slowly, slowly I educate.

Crystal said...

Louise, I think any country area would make it more difficult to find what I'm looking for. I'm fortunate to live in a major metro area (Minneapolis/St. Paul, Minnesota), so I have LOTS of resources available to me.

My parents, on the other hand, live in rural South Dakota, and have very little available to them. They don't even have an emergency clinic nearby. I have three to choose from, two of which are about 10 minutes away.