{"id":18096,"date":"2019-02-28T13:42:36","date_gmt":"2019-02-28T18:42:36","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18096"},"modified":"2023-03-03T15:46:00","modified_gmt":"2023-03-03T20:46:00","slug":"what-can-doctors-learn-from-veterinarians","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/advice\/what-can-doctors-learn-from-veterinarians\/","title":{"rendered":"What Can Doctors Learn From Veterinarians?"},"content":{"rendered":"

At my last physical, my doctor greeted me with a smile before sliding into a chair behind a computer. \u201cDate of your last period?\u201d she asked, without looking up from the screen. \u201cStill taking a multivitamin?\u201d She clicked through my latest labs, typed, typed some more, gave me a short lecture on the importance of vitamin D and then stood up from behind the computer to perform a quick exam. It was over within minutes.<\/span><\/p>\n

My cats, Francesca and Isabella, had a very different experience at their annual checkup, which lasted well over 30 minutes. The veterinarian asked\u00a0<\/span>how I was doing and if I had any questions or concerns to discuss. Then he focused on his two patients, taking time to watch them walk around the room. Bending down to their level, he gently listened to their hearts, felt their abdomens and checked their teeth. After lovingly picking up Isabella and placing her on the scale, the vet praised her for having lost one pound. \u201cWhatever you\u2019re doing is working,\u201d he said, noting Isabella\u2019s progress in her chart.<\/span><\/p>\n

On average, human patients spend about\u00a020 minutes<\/a> in the exam room and possibly only a fraction of that time with their doctors’ full attention.\u00a0In one\u00a0recent study<\/a>, patients got about 11 seconds to speak before doctors interrupted them.\u00a0What those interrupting doctors said next varied. But in only 40 out of 112 clinical interactions tracked by researchers did doctors ask why patients had come in for care.<\/span><\/span><\/p>\n

After sitting through Francesca and Isabella’s appointment, I wondered if their vet would consider taking me on as a patient, too.\u00a0I know that one pound is a big deal for a cat, but I\u2019d appreciate the same level of enthusiasm from my primary care provider when I lose weight. I couldn’t help but think that doctors could stand to take a few pointers from vets. And I’m not alone; a growing number of experts agree that MDs need more exposure to the veterinary world.\u00a0In fact, there are human and animal providers who say the two fields are more alike than they are different, and that doctor-vet collaboration would improve health and healthcare across all species.\u00a0<\/span><\/span><\/p>\n

The veterinary approach<\/h2>\n

Animals are vocal; they bark and purr, hiss and squawk. But they don’t talk. The simple fact that cats,\u00a0dogs and domesticated pigs can\u2019t describe or even point to their pain means that ongoing, direct engagement with patients is essential in veterinary care. Veterinarians have no choice but to become fluent in nonverbal communication. Learning how to extract diagnostic clues from an exam room, and the creatures inside it, is a fundamental part of their training \u2014 and something that physicians may be too rushed to practice.<\/span><\/p>\n

\u201cWe like to teach the students that the first and one of the most important parts of the physical examination happens before the veterinarian touches the animal,\u201d says Dr. Leslie Sharkey, professor and chair of clinical sciences at Cummings School of Veterinary Medicine at Tufts University. \u201cIs the pet hiding? How it is walking? Does it seem bright and curious or disinterested and depressed?\u201d<\/span><\/p>\n

Pets sometimes hide their pain; it\u2019s a survival strategy and a vestige of their days in the wild. So veterinarians will look for other signs of distress, often relying on owners to fill them in on what\u2019s going on at home \u2014 has the animal been less active than usual, eating or drinking less? \u201cObservation in an exam room is key,\u201d says Dr. Virginia Rentko, medical director of the Cummings School of Veterinary Medicine’s Hospital for Large Animals and Foster Hospital for Small Animals at Tufts. \u201cA hunched back may indicate abdominal pain and \u2018walking on eggshells\u2019 could indicate joint pain.\u201d<\/span><\/p>\n

\u201cJaguars have breast cancer, eagles get heart attacks. All these commonalities are really, really important.\u201d<\/span><\/p><\/blockquote>\n

As my markedly different trips to the doctor and vet made me realize, connecting with patients isn\u2019t a requisite in human healthcare. In doctors\u2019 defense, practicing medicine is now only part of their job. <\/span>Heightened patient-load demands, administrative work and mandatory use of electronic health record systems (EHR) are consuming an increasing share of their time and attention.\u00a0In 2018, one study reported, doctors saw an average of about 20 patients a day<\/a>, although physicians I spoke with anecdotally told me that number sounded low. According to another study<\/a>, doctors spend about two hours doing computer work for every hour spent with patients.\u00a0Veterinarians face these stressors too, albeit not to the same degree.<\/p>\n

But EHR and administrative burdens aren\u2019t going anywhere. Neither is the need for strong doctor-patient relationships, which can influence health outcomes. A patient who feels rushed or uncomfortable might be less inclined to ask an embarrassing question or point out a potentially cancerous mole. To provide quality care, doctors will need to communicate effectively in spite of screens. And even though veterinarians aren’t subject to identical job constraints, they still might be a source of guidance for overloaded doctors.<\/p>\n

Crossing the species divide<\/h2>\n

Beyond taking cues from veterinary bedside manner, some experts argue that doctors should forge a collaborative relationship with pet providers in order to<\/span> make headway on shared diseases and clinical challenges.\u00a0<\/span><\/p>\n

\u201cThe two fields are very much the same,\u201d says Dr. Barbara Natterson-Horowitz, a cardiologist and co-author of the bestselling book <\/span>Zoobiquity<\/span><\/i>. The patients are too: \u201cJaguars have breast cancer, eagles get heart attacks. It\u2019s still remarkably common for physicians to assume that human disease is unique to humans. All these commonalities are really, really important.\u201d<\/span><\/p>\n

As a cardiologist, Natterson-Horowitz spent her career treating human patients. Then, a little more than a decade ago, the\u00a0Los Angeles Zoo asked her to perform cardiac imaging on a chimpanzee, her first non-human patient.\u00a0\u00a0<\/span><\/p>\n

\u201cI remember that experience well because of the extreme familiarity that I felt,\u201d she told me, describing the scene at the zoo hospital: \u201cA team of doctors around a patient, the EKG monitor, the pulse oximeter \u2026 It was inspiring. It was this moment of personal evolutionary connectedness to that chimpanzee who was lying there, and cultural commonality that I felt with the veterinarians in the room. Every physician, every veterinarian, every caregiver has that flipped experience of connecting with and becoming the patient.\u201d<\/span><\/p>\n

Now, Natterson-Horowitz works at the crossroads of human and veterinary medicine. She regularly leads interdisciplinary conferences to facilitate information-sharing on issues, such as pain management, where she sees relevant overlap. \u201c<\/span>It becomes extremely informative to learn from the animal experts in pain management whose patients never have words,\u201d she says. \u201cVeterinary specialists talk about how you use physiologic signs and behavioral signs to detect pain.\u201d<\/p>\n

Another area where collaboration makes sense, Natterson-Horowitz says, is mental health. \u201cI believe in psychotherapy and psychotropics,\u201d she says, \u201cbut I also think there\u2019s something helpful about looking at the ecology of what\u2019s going on in an animal\u2019s life to induce these behaviors.\u201d By studying maladaptive behaviors in animals, and how vets treat them, doctors could open up their understanding of human disorders and strategies to mitigate them.<\/span><\/p>\n

“It was this moment of personal evolutionary connectedness to that chimpanzee who was lying there.”<\/span><\/p><\/blockquote>\n

Humans who self-harm (e.g., cutting) often can\u2019t explain the behavior themselves, Natterson-Horowitz pointed out. Animals in captivity also exhibit self-harm. \u201cIsolation is a powerful inducer of self-injury in animals,\u201d she says. \u201cThis is a really critical piece of information.\u201d<\/span><\/p>\n

Learning about conditions associated with self-harm in animals could potentially help human patients. \u201cThere are a number of things that vets do extremely expertly to reduce self-injury that are behavioral,\u201d says Natterson-Horowitz, \u201c[like] decreasing boredom, creating purpose, restoring challenges in life, particularly foraging for food and occupying their mouths and paws, depending on what the animal is.\u201d A vet, for instance, might put a goat into a horse\u2019s stall to provide companionship and combat isolation.<\/span><\/p>\n

Other experts share Natterson-Horowitz’s belief in the value of cross-species care. A growing, veterinarian-led movement called One Health\u00a0<\/a>was launched about 15 years ago<\/a>.\u00a0The original goal was to unite human and animal\u00a0medical professionals \u2014 as two branches of the same field \u2014 to control outbreaks of zoonotic diseases such as\u00a0Ebola, SARS, avian flu and rabies. Over time, proponents of One Health have sought to apply its philosophy more broadly: Joint initiatives are underway to fight\u00a0antibiotic resistance<\/a>; a team of vets and doctors is calling for coordinated treatment of\u00a0owner-pet obesity;<\/a>\u00a0schools of medicine and veterinary medicine are encouraging interdisciplinary study.<\/p>\n

This level of collaboration differs radically from the centuries-old practice of animal research, in which species from fruit flies to mice to dogs are studied as human proxies. Instead, this approach challenges human exceptionalism by putting humans and non-human animals, as Natterson-Horowitz calls them, on the same plane.<\/p>\n

\n

Ready to book a doctor’s appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

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