WHAT WE LEARN VS. WHAT WE SEE
We train in very highly specialized veterinary hospitals, where common veterinary medical conditions are, ironically, uncommon.
I don't know if an aural hematoma has ever been seen on soft tissue surgery service—I know I've never heard of one. Or simple
anal sacculitis. One of my classmates called me about a month after we graduated to share war stories and asked me if I, too,
had missed the lecture on emptying anal sacs, since it was something every other dog owner requested in general practice,
but something we never heard about or saw in school.
We learn how to manage intense medical and surgical cases, we learn to formulate a wide range of rule-outs, and we learn to
hunt zebras. And when a patient comes in with big problems, it is a little easier to frame the diagnostic and therapeutic
plans—it's obvious to everyone that a fractured femur needs attention.
But it isn't always obvious to owners, even when the owner is a veterinary student, that the pet's lifestyle, type of housing,
environment, activity level, and diet and method of feeding must all be considered and integrated into a plan for the care
of that pet by the veterinary team.
A VITAL CONVERSATION
This is what we're trying to get to in the guidelines, to emphasize the comprehensive nature of preventive veterinary medicine—something
that so many veterinarians perform superbly. But many may fall short in their ability to communicate just how comprehensive
a visit the "yearly exam" is. It isn't "just a shot" or "just a physical exam." At its best, the wellness or preventive care
visit provides the opportunity for a vital conversation between the veterinary team and the owner to provide the optimum care
for the pet for its future, with a plan to revisit the plan on a regular basis.
By using the familiar SOAP (subjective, objective, assessment, and plan) approach, the framework for the preventive care visits
fits with our more traditional problem-oriented cases. And instead of treating today's problem, we are preventing tomorrow's.
Michael R. Moyer, VMD, is the Rosenthal Director of Shelter Animal Medicine and an adjunct associate professor at the University
of Pennsylvania's School of Veterinary Medicine. He is also president of the American Animal Hospital Association and a member
of the AAHA-AVMA Preventive Healthcare Guidelines Task Force.
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