Looking for Dr Right

Searching for the ideal vet
By John Woestendiek, March 2014

We don’t ask for much.

For starters, we want you to have the brains of Einstein, the compassion of Mother Teresa and the patience of Job.

In terms of medical skills, we’d like you to possess the sleuthing abilities of television’s Dr. House, the empathy of Dr. Dolittle and the bedside manner of Marcus Welby, MD (but not be so ancient that you remember that kindly TV doctor).

While we appreciate old-school wisdom, charm and values, we don’t want our dog’s doctor to be behind the times. Instead, he—or far more likely these days, she—should be a fairly recent graduate of a respected veterinary school, possess a search-engine-like ability to stay on top of all the latest medical developments and technology, and constantly be attending seminars, preferably without ever leaving the office.

As for those offices, we’d like them to have the accessibility of a ’round-the-clock convenience mart, the cleanliness of an operating room, the aroma of a gentle spring rain and the affordability of a dollar store. In your waiting room, we’d prefer not to wait.

We appreciate communication skills (including the all-important ability to close one’s mouth and listen). We want you to explain things clearly and simply, and lay out options—all while taking your time, with our dog and with us, so we don’t feel like we’re being rushed through an assembly line.

We want you to have confidence, but not such an excessive amount that you don’t seek input from others. We want you to admit when an educated guess is an educated guess, and refrain from predicting the unpredictable. Don’t give our dog needless and expensive tests, or vaccinate them unnecessarily. Don’t encourage us to prolong their lives at all costs. Don’t look at us with dollar signs in your eyes, even though we are the source of your income.

We want to be comfortable in your presence, and our dogs to be, too. We want to like you, and trust you. You should like us too, and be absolutely bonkers about our dog. You should be genuinely thrilled—don’t even try to fake it—every time you see him or her.

Validate, if you would, our parking, our dogs and us.

Remember our dog’s name, and ours, and be there for us through all the ups and downs, all the joy and heartache, right up to the end, maybe most importantly at the end.

At that time, we want you to treat our dogs, and us, as we’d hope you have all along the way: honestly, compassionately, straightforwardly and with dignity.

On second thought, we ask for a lot.

Our strong emotional attachments to our dogs lead us to have some pretty high standards—and go to some pretty great lengths—when it comes to choosing a veterinarian. For most of us, the nearest one won’t do. A competent one isn’t enough. We want the vet of our dreams.

As a nation, we’ve grown more dog crazy, and more dog savvy; on the road to becoming better-informed dog owners, we’ve also become more demanding ones.

Given all those factors, it’s understandable that we have such great expectations of veterinarians. But those high hopes are also an indication of continuing public faith in the profession. Part of the reason we’re willing to invest time and research in seeking Dr. Right is that we’re pretty sure he or she is out there—findable, accessible and maybe even affordable.

The day may come, if it hasn’t already, when our high regard for veterinarians—our view of them as altruistic sorts, on our side and not solely after money—starts to fade, just as it has over the years for lawyers, politicians and (though less drastically) doctors.

Medical care for our dogs is becoming more like the human system, which many might argue is no model at all, what with its exorbitant costs, its overly comfy relationship with pharmaceutical companies and all the corporate ordered protocols aimed at getting the most money out of ailing humans in the least time.

As with the human system, veterinary offices are becoming increasingly corporate. That tends to lead to more rushed and impersonal treatment; longer waits; shorter visits; and doctors who are prone (or ordered from above) to sell you and your dog on every imaginable diagnostic test, vaccination, medication, surgery or treatment.

At the same time, we and our dogs are hanging around the planet longer in part due to all those new drugs, tests and procedures. The longer life is prolonged, the more tough decisions we face, weighing questions about the promise of technology, risks and side effects, the quality of life, when to try to buy more time, when enough is enough, and how to afford it all.

Managing our dog’s health care seems well on the way to becoming as tortuous and frustrating a struggle as managing our own.

Many of the procedures and services once available only to human patients —once seen as unimaginable or frivolous when applied to canines (except to test on them first to make sure they’d be okay for us)—are now routinely offered for dogs. They are referred to specialists. They go to psychiatrists. They undergo chemotherapy. They receive bone-marrow transplants, and dialysis, and “bionic” prostheses.

Many of these carry price tags so frightening that increasingly, we’re turning to health insurance for our dogs. We fear that, just as with our own health, it would only take one medical disaster for our dog to bankrupt us.

Obamacare for dogs? It may be laughable now, but will it still be in 50 years? Truth be told, some old-school veterinarians have long been practicing a version of it (unofficially and without the aid of insurance companies or websites), charging clients, of all things, what they can afford.

With independent veterinary practices dwindling and facing more pressures, such kind-hearted vets are becoming harder to find, and are finding it harder to be kind-hearted. Veterinary care is becoming colder, more complex and more expensive, a big business that, if it’s not careful, may soon come across as looking that way—as being much more concerned with its bottom line than all those creatures great and small.

Between our high expectations and veterinary medicine’s changing realities, a shift in our generally favorable view of veterinarians wouldn’t be all that surprising. On the other hand, they help animals, and we love them—nearly unconditionally—for that. Maybe that’s enough to keep vets from falling out of our good graces and joining the ranks of other once-beloved professions.

In any case, a new era has clearly dawned for veterinary medicine, one that includes corporately owned mega-practices, pricey technology, life-prolonging treatments and its own almost-as-perplexing version of health insurance. It’s enough to make some pine, at least a little, for the days of James Herriott, the semi-fictional country vet who, though he never attempted anything as cutting-edge as stem cell therapy, could always be counted on to be gentle, to be considerate, and to be there.

For now, based on some nonscientific opinion gathering by The Bark, most dog owners still seem to think that while not all vets are perfect, the perfect vet is out there. We think we know what makes him or her perfect. And, based on comments solicited from readers, most of us still manage, eventually, to find him or her.

“Why is my vet perfect? He is knowledgeable and experienced … unfailingly gentle and kind with animals and courteous to their owners,” wrote a reader named Frances. “He always explains everything in detail and is never, ever patronizing or dismissive of anxieties … [He] always comes across as someone whose priority is the welfare of the animals in his care, not profits or kudos. If I had to choose just one criterion upon which to base a choice of vet, it would be trust—trust in their expertise, their advice and their ability to care for my animals.”

When The Bark asked readers to describe their ideal veterinarian, they responded in large numbers, and quite passionately. They seemed, nearly unanimously, to appreciate a vet who hears them out, realizing the value of their observations and opinions about their companion animals. Most veterinary clients would rather feel part of a team, as opposed to following the dictates of a vet who comes across as one not to be questioned.

Based on the comments (read them all at thebark.com/finding-dr-right), dog owners place a priority on reasonable rates, as well as accessibility and flexibility. Readers also seemed to appreciate the veterinarian who offers weekend hours and is willing to stay open late, or go the extra mile … or 15 … or 20.

A reader named Robin said she chose a veterinarian who exhibited superior listening skills and a high degree of dedication to her job. Because Robin’s pup, Ali, suffers seizures and gets stressed out by office visits, Robin made an appointment with a mobile vet. Despite some dauntingly inclement weather, Dr. Joan showed up.

“So there she was, on my birthday, when we had a surprise snow storm overnight, and the snow was approaching hip height,” Robin said. “And she backed her trailer up our driveway for a NAIL TRIM …”

While accessibility, technical know how and communication skills were among the qualities readers listed as most important in a veterinarian, compassion may rank even higher. Dog owners want a veterinarian with heart. They put a premium on empathy, and perhaps rightly so, given that a vet’s patients can’t talk. Dog owners get some reassurance when they see vets connect with their dogs in a non-verbal way.

A reader named Jen said the vet of her dreams has a good reputation for his surgical skills, and his office has low staff turnover, another good sign, she says. But “first and foremost” is “his genuine affection, care and liking for the animals he works with. He gets down on the floor and hugs them if they are comfortable with that, lets them lick his face and talks to them before any examinations or procedures …

“My most recent favorite Dr. Todd tale was when I took my dog, Inca, in for a checkup. The day before, she and my other dog, Domino, had discovered an old slug trap in the strawberries filled with sour beer and rotten slugs. Unbeknownst to us they (delightedly, I’m certain) rolled in it … When I warned Todd not to hug Inca this time and told him what she had done, and that we hadn’t been successful in getting the stink off her, he got down on the floor, hugged her, looked into her eyes and said, ‘Good dog, Inca!’ In other words, ‘way to act like a dog.’”

We don’t expect to feel the love when we go to our own doctor; we do at the vet’s office.

Why? In part, it’s because we’re jaundiced by our own medical experiences, conditioned to not expect the surest, swiftest, most compassionate and fairly priced service. Most of us wouldn’t dream of asking our family doctor to meet us after hours at the office, much less grant us a same-day appointment, make a house call, cut us a break on the price of treatment or let us run a tab. We don’t require our pediatricians to “ooh” and “ahh” over our human babies, or to pat them on the head or toss them a treat. But a vet who treats our dog aloofly may be on the way to becoming our former vet.

Rightly or wrongly, we tend to see veterinarians as a warm-hearted bunch —people who got into their field not for the money, but because of their deep and abiding love for animals. We’re not so sure that a love for humans is what motivates most doctors.

Maybe that’s one reason veterinarians in the past decade have generally shown up above doctors in polls ranking professions for honesty and ethical standards. Dr. Nancy Kay, recently retired from veterinary practice, and author of the books Speaking for Spot and Your Dog’s Best Health: A Dozen Reasonable Things to Expect from Your Vet, is among those who sense that a shift is under way in the public’s perception of veterinarians.

“Maybe we’re still held in higher regard than medical doctors, but not by very much,” she says. “It used to be veterinarians were revered and given the benefit of the doubt.” Now, she says, it’s more common to hear criticism from people who feel vets are “not embracing enough of a holistic approach” and are “out for the money.”

Kay also says that, in some cases, the criticism is merited.

The average vet school student graduates with $150,000 worth of debt, according to Kay. They go into a job earning maybe $50,000 a year. Meanwhile, clients are turning elsewhere for some of the products and services that traditionally brought in profits for veterinary practices—to low- or no-cost clinics for spaying, neutering and rabies vaccinations, or to Wal-Mart and online discount stores for prescriptions.

Add in the high cost of keeping up with technology, and conditions get even riper for questionable behavior, such as a vet recommending a procedure or test that might not be necessary.

Kay says vaccinations are a good example of that.

The American Animal Hospital Association (AAHA) revamped its list of recommended vaccinations, and the intervals at which they should be administered, 11 years ago. But, Kay notes, some vets still routinely over vaccinate based on the old recommendations. Many a client, after receiving a cute reminder postcard in the mail, still brings his or her dog in annually for distemper and parvovirus vaccinations, even though the AAHA now recommends those vaccinations be given at three-year intervals.

The AAHA also now recommends that vaccinations for parainf luenza virus, bordetella and leptospirosis be administered only after looking at an individual dog’s risk of exposure. But some vets—either not up on the changes or not wanting to pass up potential profits—tend to take a more blanket approach to vaccines.

“Some vets either don’t know better or they want the money,” Kay says. “They over-vaccinate to subsidize their other services, disregarding the potential risks to the animals, and people are catching on to that.”

As they do, suspicion can spread and public faith can erode, just as it can in any occupation. A few bad apples, uninformed apples, careless apples or greedy apples, can—especially in the Internet age—taint how the public sees the whole barrel.

So how do you find Dr. Right— that vet who’s the perfect combination of compassion and clear-headedness; one who, when it comes to finding answers, isn’t wholly holistic or wholly high-tech; one who exhibits not simply heart, and not simply brains, but that much-desired combination of the two?

Two things to keep in mind: First, one pet owner’s Dr. Right may not be every pet owner’s Dr. Right. Second, you might have to go through a few Dr. Not-Quite-Rights along the way.

Let your own head, and your own heart, be your guide.

Do some research. Get input from friends. Get input from strangers. Pick the brains of your fellow dog-park denizens. Ask people not just if they like their vet, but why they like their vet. Volunteer at your local humane society, and see whom they trust and turn to. Check into complaints filed with state veterinary boards or Better Business Bureaus. Go online and read customer reviews, but take them, like everything else on the Internet, with a grain of salt. Visit and interview vets. Chat up the support staff. Bring a notepad. Ask vets where they got their training. Do they have a dog? Do they do any pro bono work, such as helping homeless dogs in the community? Are they, when it comes to technology, up on the latest or living in the past? See if you feel a connection, and—as perhaps you might do with a potential suitor—let your dog give them a sniff and offer an opinion.

Some vets might be smooth talkers who say all the right things but fail to make a connection with your dog. Other vets might have a near-magical ability to empathize with your dog, but no people skills at all.

One paradox of veterinary medicine is that many of those who go into it do so because they prefer dealing with animals to dealing with people. They find out pretty quickly—year one in most veterinary schools—that it’s not going to work that way. While they examine animals, they have to communicate with humans—often, anguished, demanding or sobbing ones.

“What all vets have in common is we love animals, but the majority of our time is spent dealing with their humans,” says Kay, who spent 32 years in private practice. Some veterinarians are better at that than others.

As with medical doctors, veterinarians generally adopt one of two styles of communication. In the paternalistic model, the doctor is clearly in charge, does most of the talking and, generally, keeps some emotional distance. Under what’s called the relationship-centered model, the vet looks at the bigger picture— the dog and the dog owner, and the bond between them. Clients are encouraged to share facts, express opinions and help decide on a course of action.

What leads a vet to become one or the other is probably a mix of factors, including personality type, sociability and the training they received in school. Some might assume that, under a paternalistic style (with the doctor taking the reins) clients can be shuttled in and out more quickly and efficiently. Kay says studies have shown that’s not the case.

Readers who shared their thoughts on what makes for the ideal veterinarian seemed to prefer the relationship centered style, even if they didn’t call it by name. They want a vet who comes across as warm, and a vet who listens. “No vet can possibly know as much about my dogs as I do, from living with and observing them closely day by day,” said a reader named Lynda. “That’s okay—I don’t expect the vet to know that—but I do expect the vet to listen to me and take my observations and instincts into account in the diagnosis.”

That, she added, “requires a third characteristic—not too heavy on the ego, please. I don’t want a vet who tries to play God or take over my primary responsibility for my dog’s well-being. I want someone who doesn’t feel threatened by my input.”

“A good vet is a professional who outright would let a dog lick her, a cat be her hissy self [and] a pet parent speak about their furry four-legged child before coming up with conclusions,” said a reader named Carmen. “A vet should love what she is there for, the pets …”

Several commenters said the ideal vet doesn’t let rules or protocol trump compassion, and isn’t so wrapped up in cutting-edge technology that he or she gives no credence to more natural treatments.

“I appreciate a vet who is willing to work with me and consider both clinical and alternative healing, which includes holistic and palliative care in certain circumstances,” said a reader named Marilyn. “I believe my companion animals, much as humans, want to be with their loved ones and not in a hospital cage during their final days/ hours. I think vets are, at times, too wedded to vet-school protocols to the exclusion of the human-animal bond. Pity.”

A reader named Susan in Tucson said she’d never forget how her veterinarian let her lay on the floor with her dog Luka as he received IV fluids in a last ditch effort to save his life.

“Her heart is so big that she knew if I could do this myself, it would mean the world to my big mama’s boy, and it would mean everything to me. He was very ill with chronic kidney disease, which [had been] diagnosed the day before, though [he was] only six years old. The next day, I had to make the hardest decision ever, and I’d not have been able to do it without her. I spent another couple of hours in a private room, talking quietly to Luka, my Malamute, and then we did have to let him go.”

Several commenters said they seek veterinarians who feel a connection with the dogs they treat, the humans they encounter and the community they’re in. A vet who volunteers his or her services to help less fortunate dogs is seen as one who likely has the compassion and dedication they’re looking for.

“Two things stand out for me,” wrote Tom. “I want a vet (and have one, thankfully) who knows about all the shiny new diagnostic tests s/he can perform, and who doesn’t recommend them just because they exist … Second, I want my vet to be active in animal welfare. Frankly, I think the veterinary community at large has been strangely, sadly absent from the humane movement— at least in any organized way. At best, that’s a huge lost opportunity to improve the conditions of the companion animals whose brethren they treat, and to end unnecessary shelter euthanasia.”

A reader named Nina echoed those opinions: “I look for someone who defines what they do as a service rather than strictly a business. They show compassion and respect for all animals and their families. The vet volunteers his or her services at an affordable clinic; they board and protect pets of abused women while [the women] are looking for a new, safe home; they get involved in community fundraisers … This way of seeing and operating in the world informs everything they do— from hiring staff who are knowledgeable, kind and efficient to encouraging their clients to make informed decisions about issues such as vaccinations and other treatments.

“One of the vets I frequented for almost 20 years I am leaving because they are changing their paradigm from service to business,” she added. “The front desk is no longer attended by caring staff, and making money seems to be the major concern. Needless to say, they are losing clients, including me.”

Call a medical doctor when you’re seriously ailing and, with some luck, you’ll get an appointment—say, three weeks from Thursday. Call a vet about your seriously ailing dog and you’re likely to hear “bring ’em right in.”

Visit that medical doctor—arrive 30 minutes before your appointment, please—and the receptionist may or may not issue a friendly greeting, and may or may not make eye contact before handing you multiple forms to be filled out while you wait, 45 minutes or so, before being shown into an exam room, where you wait some more.

Visit that vet and you and your dog will more likely be greeted with some excitement, get a pat on the head, maybe get a treat, and have but a brief wait to see not just an assistant, but the actual doctor—all of which sometimes happens, unlike with human medical care, even before the question is asked: “How are we going to be paying for this?”

In some ways, at least from a consumer perspective, human medical care could benefit by becoming more like traditional veterinary care.

From all indications, though, the opposite is happening.

With large corporations running a growing percentage of veterinary practices, with those practices becoming larger, with treatments becoming more sophisticated and expensive, with pet insurance creating more hoops to jump through, with everybody running to keep up with technology, there seems less time for niceties, or empathy.

The way things are heading, one often doesn’t get to choose a veterinarian these days as much as a veterinary practice. You might find the veterinarian of your dreams, but then actually get an appointment with the one who’s available. As pet health insurance slowly catches on, you might find the practice of your dreams, only to learn it doesn’t honor the particular brand of pet insurance you’ve purchased.

And, as veterinary practices become more like big businesses, that quality time you spend with your vet might dwindle—maybe at that vet’s choice, maybe due to corporate orders.

“It’s not the profession I went into 25 years ago,” says Nick Trout, a staff surgeon at Angell Animal Medical Center in Boston and a contributing columnist for The Bark.

Traditionally, Trout says, vets have been seen as “having an animal’s best interest at heart rather than being out to make money.” Given that their patients can’t talk, vets spend more time examining them, “as opposed to the seven minutes you seem to have with an MD who’s watching the clock and having to crank through on the cases.” Vets, generally, have been seen as more accessible, patient and understanding than the average medical doctor.

Trout, who has authored three nonfiction books, has also written two novels. In the first of those, The Patron Saint of Lost Dogs, the main character, Cyrus Mills, a veterinary pathologist whose career has kept him in the laboratory, takes over his father’s small town veterinary practice and, through connecting with dogs and people, finds his life changed for the better. In its sequel, Dog Gone, Back Soon, slated for release this spring, Mills copes with pressures stemming from what Trout calls the “corporatization” of veterinary care.

While the book is fiction, the trend is real, and global.

For example, Trout says, “Small mom-and-pop practices no longer exist in Sweden; they’ve all been bought out by corporations” that operate under a “colder, more clinical” business model. “What worries me is that takes away that one-on-one, that ability to put in more time with an individual … When you’re accountable to a bigger business model, you’re not going to get away with that.”

Technology is playing a big role, too. Keeping up with it can require large investments—the kind that small, independent veterinarians are hardpressed to make.

“Pet owners demand higher technology,” Trout says. “The days of a single general-practice vet being the only one you’re going to need are getting lost. We as humans demand specialization, and pet owners are not different … We kind of want it both ways. We want the James Herriott style, but we want the state-of-the-art technology.”

With veterinary schools packed and graduates competing for jobs, Trout says, many will find that, to get a job, they’ll need to put a lid on their idealism and toe the corporate line: “You will work for us in the way we work— you will do this test, this test and this test,” Trout says.

He doesn’t think this bodes well for the profession.

“We’re losing that personalized touch, that one-on-one, that sort of relationship you get between a dog and a vet and an owner—that sort of love triangle that goes on through the animal’s lifetime.”

To many of us, the search for the veterinarian of our dreams involves a lot of the same considerations as our search for a mate: it’s largely, but not entirely, a matter of the heart.

We want someone we can trust.

We seek kindness, sensitivity and compassion. We avoid those with angry streaks, those who are unpredictable or who might just be after our money.

We value honesty, dependability and dedication, and we like someone who, while keeping up with the times, still has some good old-fashioned values.

We prefer them to be, if not tail-waggingly happy, at least pleased to see us come through the door.

We want a good communicator, who knows how to listen and isn’t distant or aloof—someone who, when he’s there, is actually there and when he’s not, is only a text or phone call away.

And once we have found them, we tend to never let them go—at least, not until we have to move to a new town and start all over again.

We don’t require our vet to like long walks on the beach at sunset, but we do appreciate one who will be there when needed—not to lecture, dictate or nag, but to be supportive and help us solve the problems that come up in life.

And, it goes without saying, they must love dogs.

John Woestendiek is a Pulitzer Prize–winning journalist, editor of the website Ohmidog! and author of Dog, Inc.: How a Collection of Visionaries, Rebels, Eccentrics and Their Pets Launched the Commercial Dog Cloning Industry.