Vets' inferiority complex is fuelling the mental health crisis...discuss

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Bob Russell — Mon, 28 Oct 2019 13:32:54 GMT

We are not GP's in the human sense because we are dentists, surgeons, practice nurses, councillors and much else.

What we are not is miracle workers (although on occasions we are!) and we cannot be specialists in everything. We know a bit about most things, not a lot about a few!

Our CPD requirements and pressures of practice life do not give us that option without significant sacrifice.

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Julie Innes — Mon, 28 Oct 2019 09:44:44 GMT

[quote user="Arlo Guthrie"]That's interesting. I wonder if their expectations have changed, or if your expectation of their expectations has changed (perhaps as a result of too much supervet)? [/quote]

I do genuinely think their expectations have changed- by the time they arrive in the surgery they have googled and come armed with what they think they know and what they want you to do, according to Dr Google. Everyone is an expert nowadays, and they are no longer (in many cases) prepared to just listen and accept your opinion. In days gone by, they would have no idea if the treatment wasn't right. Nowadays they will be kept right by all the facebook forums they are members of...

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Joyce Whitehead — Sat, 26 Oct 2019 13:50:30 GMT

I agree that vets are not GPs and I by no means refer loads, but orthopaedics is such a (to me) difficult thing to get right, with the potential for lots of things going wrong, that, having attempted it as a younger vet, I know I hate it and I am not good at it. I think it is important to know my own’s limitations as well as my own abilities. I would very rarely refer soft tissue surgery as I know I can do that.

I am also not suggesting that only specialists repair bones, but I have seen some incidents of disasters when orthopaedic surgery has gone very wrong in non expert hands, and in some of those instances the owner was nit informed that the surgeon was not very experienced in orthopaedics. Informed consent is extremely important to me.

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Dinu Catilina — Sat, 26 Oct 2019 00:44:33 GMT

[quote user="Joyce Whitehead"] And I’m not afraid to say to owners that I wouldn’t want my GP repairing my fracture so they wouldn’t want me doing theirs.[/quote]

But we are not GPs. I don't say you should do what makes you uncomfortable or that everyone should have a go at everything but vets are not GPs. Vets are, at varying degrees, more than a GP regardless of doing or not doing surgery. There is zero chance that a GP can and will do as much as we do with our patients regardless of it being medicine, soft tissue surgery, orthopaedics, etc.

I'm not having a go at you but really you are suggesting indirectly that not specialists should not fix bones.

In my opinion referring to ourselves as GP is a degradation of the profession that reduces us to a being a filtration and distribution hub for the local referral centers. One of the beauties of our profession is the heterogeneity of our work and while a non specialist will never be as good as a specialist there are things than we can do just as well.

Maybe the issue starts with the university teaching hospital. I have this opinion (which may be very wrong) that exposing students to the non-realistic approach of referral teaching hospitals is creating an expectation that the new grads can not meet in their first years of practice. All of the new grads I've seen, who were incredibly clever and well informed vets, struggled in their first years to understand that good enough is sometimes enough for clients and patients.

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Anthony Dennison — Fri, 25 Oct 2019 16:52:11 GMT

[quote user="Neil Wheadon"]In essence for many new graduates they have ditched the OOH obligation (which may be as little at 1 in 10) for more sole working. Which would I chose if I were a new grad, I think I know[/quote]

I've never thought of it like that. I think I'll use that line in the future in discussions about recruitment at our practice. Thank you!

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Joyce Whitehead — Fri, 25 Oct 2019 14:03:23 GMT

I suspect that, like many things, the level of pastoral care varies enormously from practice to practice. We as a small independent practice have always prided ourselves on supporting our younger vets as much as we can, they know they can always phone for advice at any time.

For me, the stress I used to feel as a younger vet when I attempted anything orthopaedic has been taken away by referring them. And I’m not afraid to say to owners that I wouldn’t want my GP repairing my fracture so they wouldn’t want me doing theirs. We are lucky as we are in a relatively affluent area with a lot of insured dogs, so can refer most things we would like to. We do refer other things too but not as often.

I think my confidence to say to owners - these are your options and rough costs, but if I were you I’d think along the lines of x/y - has increased over the years, although I am very aware I have a lot of things I don’t know much about! I definitely enjoy mentoring younger vets, but also very much enjoy discussing difficult cases with them and getting newer ideas back.

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Neil Wheadon — Fri, 25 Oct 2019 12:36:58 GMT

[quote user="Arlo Guthrie"]I have absolutely no idea what the situation is for new and newish grads out there in practice and whether there is a good level of pastoral care from more senior vets, or quite the reverse.[/quote]

I feel a massive change

25 years ago

Bigger practices, multivets, on call

Now

Smaller practices, sole vets, no on call (and longer hours)

In essence for many new graduates they have ditched the OOH obligation (which may be as little at 1 in 10) for more sole working. Which would I chose if I were a new grad, I think I know

Neil

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Bob Russell — Fri, 25 Oct 2019 11:31:17 GMT

Don't fully agree. Many people still consider the veterinary practice to be a one stop shop.

Perhaps there has been a degree of reeducation over the last decade or so but a lot of people still expect the eye problem to be sorted by the same person that fixes the broken leg.

I have always been honest with clients when I go outside my comfort zone!

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Arlo Guthrie — Fri, 25 Oct 2019 10:12:17 GMT

[quote user="Julie Innes"](well, possibly I could, but no one wants me learning on their animal)[/quote]

Well, given the choice between a £15,000 referral, and you having a stab at it, um, sorry Daisy, but we'll just have to keep our fingers crossed!

(Serious point, though).

[quote user="Julie Innes"]I don't think the issue for me is clients not wanting to pay for "best" treatments- I have always understood that and worked around it. The issue for me is their changed expectations[/quote]

That's interesting. I wonder if their expectations have changed, or if your expectation of their expectations has changed (perhaps as a result of too much supervet)?

I must say, I don't expect a GP to know as much (in a particular field) as a referral practitioner, and I find it hard to believe the general public does either. I think everyone is familiar with the concept of referral in human medicine.

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Julie Innes — Fri, 25 Oct 2019 09:06:41 GMT

Funnily enough, as I have gotten older (and wiser?) my inferiority complex has gotten worse! I feel I should be more able than I think I am, and I question myself far more! We have a new grad working with us just now, and I am so impressed at how capable she is (although I did teach her myself, she has been seeing practice here since she was 15 and all through vet school!)

I don't think the issue for me is clients not wanting to pay for "best" treatments- I have always understood that and worked around it. The issue for me is their changed expectations- I am not a "supervet", there are some things I can't do (well, possibly I could, but no one wants me learning on their animal) Other vets often make me feel inferior, if I'm honest- they all seem so confident and sure of themselves!

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Arlo Guthrie — Fri, 25 Oct 2019 08:37:42 GMT

[quote user="Bob Russell"]I think more experienced clinicians could offer a lot more 'pastoral' care to the less confident.

There are enough people judging us without adding in-house pressures as well.[/quote]

That's a really interesting thought, and (I thought) a very well-chosen word!

I have absolutely no idea what the situation is for new and newish grads out there in practice and whether there is a good level of pastoral care from more senior vets, or quite the reverse.

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Bob Russell — Thu, 24 Oct 2019 14:24:04 GMT

I think more experienced clinicians could offer a lot more 'pastoral' care to the less confident.

There are enough people judging us without adding in-house pressures as well.

RE: Vets' inferiority complex is fuelling the mental health crisis...discuss

Marie Kubiak — Thu, 24 Oct 2019 14:18:21 GMT

[quote user="Gillian Mostyn"]I think too many vets are beating themselves up when they can't provide what they see as 'perfect care'. It isn't a 'failure' to dispense corticosteroids for a dog that is intense pruritic but cost or client apathy prevents investigation or other treatments. Not all dogs have to have 3 monthly bloods if they are on NSAIDS for them to be fine for years. An osteoarthritic cat in CRF can still have metacam...better a short pain free life than a long painful one! An old cat with a very large abdo mass doesn't necessarily have to have investigations.[/quote]

I found this mindset was something I got more comfortable with as I got more experienced. Coming out of university with the referral approach drilled into me and no experience of trying a different tack it was all much more stressful to compromise learned protocols. Certainly with exotics, you get used to winging it and making things up as you go along to fit the situation and the stress declines sharply as confidence goes up. Is this a bigger issue as we have a greater drop off of vets due to other factors before they hit the stage when they have that confidence to go it alone and not feel bad about it?

Marie

RE: Vets' inferioritycomplex is fuelling the mental health crisis...discuss

Arlo Guthrie — Thu, 24 Oct 2019 13:58:12 GMT

[quote user="Gillian Mostyn"]I really like the message behind this news article.[/quote]

Gillian Mostyn - I was thinking exactly the same when I read the press release; glad you picked up on it too!

I wonder whether it is something that is a greater problem for younger vets than older ones (I guess we all get more comfortable in our boots and more pragmatic as we age). Should it be part of the syllabus? I wonder if the RVC has actively promoted the research to the other Unis?

RE: Vets' inferioritycomplex is fuelling the mental health crisis...discuss

Sarah Keir — Tue, 22 Oct 2019 21:47:32 GMT

I've just watched a TED talk that fits nicely with this.

RE: Vets' inferioritycomplex is fuelling the mental health crisis...discuss

Bob Russell — Tue, 22 Oct 2019 16:47:31 GMT

I am significantly more laid back about my clinical skills and abilities than I was in earlier years. I took it quite personally when something went wrong.

Now I appreciate I cannot get them all right. Owners do not always want complex answers and clinical choices range from a quick injection of something through to full referral.

What I do try more now is to explain the options to clients and listen to their choices. I no longer try to be right all the time.

All this 'Gold standard' stuff is designed to put vets under pressure, much of it unfair.

If in doubt I ask what budget is available and how far owners wish to take investigation then it is often much easier to formulate a treatment plan that fits.

We are not going to be right much of the time, just close enough. Accept this and do your best and the pressure drops!