Let me show you a picture

I love the digital age; laptops, smart phones, iPads, tablets, digital radiography, 3D ultrasound, countless numbers of applications that allow doctors to work closer with doctor buddies and clients.  Our clinic sends e-mails for reminders to clients, we text information to let them know how their babies are doing after surgery and while they are recovering from an illness.  I send radiographs to clients and colleagues over my iPhone!  I have an application on my iPhone that allows me to measure an ECG on my patient, upload it into their record and send it to a cardiologist to have it read!  I take some of my continuing education hours (required to maintain my doctor license and keep me up to date on what is now considered standard medical protocols) on-line and video webinars, without having the expense of travel to conferences (which saves my clients money by keeping our expenses lower).  The internet helps me educate my client about their pet's general health by providing me with mediums such as Facebook, Twitter and this blog.  What a wonderful world we live in!

Recently a client came into my office, without her pet.  She explain to the technician that her dog had a rash on it's belly and wanted some medicine for it.  My tech explained that medicine could not be dispensed without benefit of a physical examination by the doctor and that she would be happy to make her an appointment.  Frustrated the pet owner reiterated that she didn't need to see the doctor, she just wanted something for rashes.  My tech further explained that her pet's rash could be caused by many things and we want to be sure that her pet gets the best we have to offer, we want to be sure that we send her home with the proper medication.  This was not what she wanted to hear.  So...she asked for the doctor.  Interrupting my regular appointment, I went to the front desk to talk with the lady.  I explained how it was necessary for me to exam her pet, I need to be sure of what medication would be needed.  It would not financially benefit her for me to send home a medication that may not work if I was treating the wrong condition.  I also pointed out that it is against the law (VCPR) for me to dispense medication without examining the patient (the dog had never been to our clinic).  That is when she whipped out her armory! She pulled out her smart phone to show me a picture of her dog's belly and the rash that covered it.  As interesting as her picture was, I resisted the urge to actually say out loud 'lady your aren't getting the picture!",  I politely looked at the picture and again reiterated that I could not and would not diagnosis her pet based on a picture.  She huffed and walked out.

Technology is great, these modern gadgets allow doctors to practice medicine with greater efficiency and precision.  However, these gadgets are just tools and do not replace a good old fashioned physical exam.  During an exam we can smell, feel, listen to our patient,  this provides us with a great deal of information.  Many health conditions mimic each other and often times we need very specific tests for specific diseases.  The physical examination helps guide us to which tests would be appropriate.  This is  not only good for our patient but also better for our client's pocketbook; saving money for medications that may not be needed and being sure that we prescribe the correct medication for the condition needed and not diagnosing based on trial and error.

I understand the hurried world we live in; never enough time in a day to get things done, too many irons in the fire, and lots of demand from others on our time.  Our gadget's help us reduce some of these demands, they will not however replace our experience, our senses and our personal knowledge.  Use these tools wisely and with common sense, don't ask  your doctor to treat your precious baby by way of Skype.  If your pet is truly your precious baby, care enough to provide them with the best medicine available, make an appointment and have them examined by your veterinarian.