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Trust issues: When it comes to vets, don’t believe everything you see on TV

I got an email this week imploring me to watch a recent segment on “20/20” titled “Is Your Veterinarian Being Honest With You?” If there’s one thing I’ve learned from Stephen Colbert, it’s that headlines consisting of ominous leading questions are always trustworthy, so I was eager to see this fearless foray into the dark underbelly of my own profession.

What I got instead was a batch of clips heavily edited to generate suspicion and mistrust of a vast group of men and women who have, in good faith, chosen to spend their lives helping animals. There were brief assurances that most veterinarians are just fine (aww, thanks!), but those asides weren’t enforced with giant text splashed across the screen like the scary bits were. The overall thrust was clear. Be afraid. Be very afraid.

The report is framed by interviews with a disgruntled former veterinarian who says he was tasked with “upselling” clients on services and procedures. He recalls being berated by his boss for telling one owner to simply monitor a dog’s lump, and being told to use the “c-word” in order to scare people into more procedures. “Was it cancer?” asks the reporter.

“No,” sighs the ex-vet. “It was a benign fatty tumor.”

That’s the entire exchange. And I find it more than a little baffling, honestly. On the surface, I agree with him. Any time I diagnose a benign fatty tumor (called a lipoma, and found very frequently in dogs), I recommend that owners just monitor it. They cause no trouble at all, and I’m averse to unnecessary cosmetic surgery. But the veterinarian being interviewed says nothing about how he came to his recommendation. I can’t give that advice without first confirming what I’m dealing with, and I do that by performing a simple aspiration—sucking some cells out with a needle and taking a look at them under a microscope. Usually, it turns out well. It’s just fat. Keep an eye on it, and go home in peace knowing that I didn’t make my recommendation based on a wild hunch.

But sometimes that simple test reveals something ugly. Sometimes it is the c-word. And if I find out, I might be able to cure that dog now with a minor surgery rather than let it develop into a severe problem months or years down the line. I agree that people shouldn’t be scared out of their wits, but I fail to see how this kind of precaution is upselling. From where I stand, it’s common sense. If the owner just wants me to say “don’t worry, everything is fine” regardless of what might be wrong, then why go to a vet in the first place?

The segment went on to generate similar suspicions about vaccines and dentistry, both important parts of animal care. Sometimes it was right, showing a few bad apples recommending vaccines more frequently than advised based on current knowledge. Other times it was wrong, showing off a pit bull with an ostensibly healthy mouth despite the camera zooming in to show an obvious mass growing on the dog’s gums (seriously). But isn’t that kind of disparity to be expected in any profession? Isn’t it too easy to throw a few sketchy veterinarians, dentists, mechanics, or (ahem) television reporters into the spotlight, and forget about all the good ones?

My career is absolutely dependent on trust, and I’m well aware that if I lose it, I lose everything. It is impossible to take proper care of a patient when every decision is clouded by suspicion of an ulterior motive. Reports like this are frustrating because they remind me that trust is so easy to dismantle from a distance, but can only be built up-close. I hope that readers do watch the segment, and find it comforting rather than frightening. How? There are so many excellent veterinarians in Charlottesville (and beyond), and if you’ve spent time working with one of them, you know that they are nothing like the caricature presented in “20/20”’s cynical scare-piece. You don’t trust them because you have to. You trust them because they’ve earned it by taking good care of you and your pets. That is their job, after all.

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