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“‘Every day is a school day’, so it would be very sad if I felt I had learned everything I could”

01 March 2021, at 7:55am

“There’s nowt as strange as folk” or so they say. And then there’s “Time’s a great healer” to boot. How many colloquial idioms can we string together, I wonder? Here’s the issue that got me thinking along those lines: by the time your dog or cat is referred to me, quite often its eye condition has improved, sometimes completely resolved. I call it “David’s distance healing ministry” and normally the owner and I have a good laugh about it as I check the eye to see that there is no underlying problem. It stands to reason that everyone is pleased to see the improvement that’s just occurred naturally while waiting for the consultation, wouldn’t you say? Apart from when they’re not, of course.

So today, little Willow’s owner (names changed for confidentiality reasons you’ll understand!) was delighted when I could find no reason for the ocular irritation that she had suffered the week before but that now has completely resolved. She was delighted that everything was now well and quite content to leave the reasons for the initial pathology and its “miraculous” cure as part of the mystery of veterinary medicine. It was only me who was left perplexed and wishing I knew the whole story.

But yesterday little cross-bred dog Hazel’s owner was just about incandescent with rage that her vet had referred the dog for a specialist consultation, but that now it had completely fixed itself. I reasoned with her that this was much better than her vet failing to refer the dog and things getting worse and worse. But there seemed to be no way of calming her down whatever I said – my reasoning with her just seemed to make matters worse. I could see an RCVS complaint and a VDS claim speeding towards me from the horizon even if the owner’s ire wasn’t directed against me specifically. “Would giving you a free consult today help?” I asked, and of course in an instant the complainant was all sweetness and light. Interesting!

Really it didn’t harm me at all – in a busy morning of consultations, losing one fee was neither here nor there. Let’s face it, my overheads are just my little yellow car and the occasional upgrade of ophthalmic equipment, so it’s not as if I have to pay the wages of employees from other vets through nurses, receptionists and the like, so I can easily forgo a few pounds to pour oil over troubled waters. But is doing that just rewarding someone who has kicked up a stink? Is it going to encourage her to do the same thing next time?

One thing that really annoys me – and I have to say there aren’t many but here’s one for sure – is hearing a client railing at a receptionist and then along comes a qualified nurse and everything miraculously improves. Or more com­monly the same volte-face occurs between seeing the nurse and a consult with the vet. Or maybe it’s between an encounter with a new graduate and then an “upgrade”, as they would see it, to a senior colleague within the practice. When actually, the new grad may have more up-to-date knowledge than the old duffer (being one myself now, I feel I can use that term for those of us with over 30 years’ practice under our belts). But they don’t have the same experience with dealing with clients, the smooth talk to smooth the ruffled feathers of the owner rather than their beloved pet chicken or the number of grey hairs that make owners think you know what you are talking about.

In those pre-COVID days when I took students doing their EMS around with me on my ambulatory referral service – what we used to call seeing practice – I would tell them that if it was an ophthalmic complaint I’d do the talking and let them learn, but if it was anything else it was up to them to sort it out – I’ve forgotten everything other than eyes over the past three decades! Well not quite, I must admit, but sometimes looking at the new cardiac drugs on the market or the novel surgical procedures in orthopaedics it feels like it. On the other hand, “every day is a school day”, so it would be very sad if I felt I had learned everything I could. I’m always happy to learn how I can improve. Maybe that’s why we call it veterinary practice: practising every day to be better and never feeling you’ve got it all sorted!

FELLOW AND DIRECTOR OF STUDIES at UNIVERSITY OF CAMBRIDGE

David Williams, MA, VetMB, PhD, CertVOphthal, CertWEL, FHEA, FRCVS, graduated from Cambridge in 1988 and has worked in veterinary ophthalmology at the Animal Health Trust. He gained his Certificate in Veterinary Ophthalmology before undertaking a PhD at the RVC. David now teaches at the vet school in Cambridge.

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