It's impossible to even estimate how much animal suffering and zoonotic disease have been prevented since the introduction
of effective broad-spectrum parasite control products. Without a doubt, year-round parasite prevention and control have done
much to improve the state of pet and human health. These products are safe, effective and affordable.
Why then do internal and external parasites and the diseases they transmit continue to expand in spite of safe and effective
prevention measures? If anything, the ranges and distributions of parasites have increased. The range of many ticks has expanded
greatly, the prevalence of internal parasites is still high, and heartworm infection has gone from a regional disease to being
reported in all states.
Why? Because, quite simply, these preventive medications are inconsistently or inappropriately prescribed and administered.
These products need to be recognized and recommended as a first line of defense against parasite diseases that are frequently
asymptomatic and yet have serious ramifications for both pets and people. Merely mentioning or even recommending a measure
is simply not enough. Veterinarians must strongly advocate for parasite control and prevention, stressing the benefits of
administration but also the potential ramifications of non-use.
If nothing else, veterinarians need to recognize the moral and potential legal ramifications of a lack of preventive care
advocacy. When a cat gets heartworm disease and the client sends a complaint to the medical board stating that her veterinarian
didn't recommend heartworm preventive or educate her on the risks of heartworm disease in cats, it's the practitioner's responsibility
to show not only that the conversation did occur, but it took place annually. This requires more than a check box on a template—it
includes thorough documentation of the conversation and the use of "declined" codes in the practice management software.
Other protective processes include having clients sign waivers if they opt to decline certain vaccinations and parasite testing.
What happens to those reminders for preventive testing, vaccines and medications that a client either chooses not to pursue
or the veterinarian decides not to recommend or administer? If they remain in "red" as overdue year after year, the client
no longer receives reminders for these services from the practice on an annual basis. That often means the veterinarian doesn't
have the opportunity to conduct a risk assessment every year. Updating reminders, regardless of whether a preventive care
service or product has been previously pursued, is an important responsibility when acting as an advocate for the patients
in your care.
When an industry issue goes "global," those who serve that industry respond and help implement a fix. Improving client communication
skills by utilizing free tools such as those provided by the Partners for Healthy Pets initiative (see http://partnersforhealthypets.org/) can take you from "powering through" preventive education to enjoying the conversation with clients.
Preventive care vaccine and prescription drug manufacturers and distributors are also taking huge steps to help practices.
It's no longer just about product advertising and special promotions but about educating and assisting practices. Many companies
offer programs that help practices track and improve compliance, train their support teams and educate clients more effectively.
We need to stop placing blame for poor compliance on our clients and take responsibility for our level of advocacy. In many
cases, the weak link in the chain of preventive health isn't the pet owner but the pet healthcare provider who, for a number
of reasons, fails to accept his role as an advocate. Take a minute and rate yourself on a scale of one to 10 with one being
the worst and 10 being the best advocate for the health and longevity of your patients.
Now, make a firm commitment to upping your game by getting back to the reasons you became a veterinarian in the first place—reconnecting
with your role as a trusted advisor and advocate. By reigniting this passion you'll experience the ultimate professional satisfaction
by watching both your patients and practice thrive.
Dr. Michael Paul, @mikepauldvm on Twitter, is a nationally known speaker and columnist and the principal of Magpie Veterinary
Consulting. He lives in Anguilla in the British West Indies. Jessica Goodman Lee is a practice management consultant with
Brakke Consulting based in Dallas.