I know everyone at my local shelter has pets, and know all the vets in the area, the good the bad and the ugly.. Talking with the staff, they probably can't "recommend" a vet, but you can ask them who they use for their own pets.

I know my time volunteering at the shelter I've learned way more about the vets in my area than I care to know, and I know who won't touch my pets with a ten foot pole.

Connie February 2nd, 2009 12:15:48 PM

Thanks for this post! Is there an ideal etiquette for switching veterinarians or veterinary clinics? Currently, not all of my cats see the same vet, and I know it can be inconvenient for everyone.

Sarah February 2nd, 2009 12:17:17 PM

If I can chime in -- Connie's advice is a GREAT addendum to 1 & 2. My experience was that rescuers and shelter volunteers had the most valuable advice (depending on the kind of shelter you have locally -- sometimes they're just thrilled that you clearly intend to actually contact a veterinarian in the first place!).

Sarah February 2nd, 2009 12:20:03 PM

After 35 years or so, with multiple pets, and many visits, I still do not know how to best advise someone to find an ethical, amicable veterinarian/clinic in my locale that would be consistantly suitable for their pets needs.

I recently received an inquiry to a specific vet, that the person was 100% satisfied, yet personally know others who have been very unhappy. So what is one to say or recommend?

Online reviews can be distorted, particularly when anonymous, both good & bad. Complaints in most states are kept from the public & sealed.

I can point out a few things that are questionable,from my observations:

1. what does the medical record form look like? If obtaining copies, does it appear to have sections easily "redacted"

2. who is filling in the medical record? The vet or tech/assistant/secretary?

3. Are other motives a factor in your pet's care, such as training,clinical studies/trials or educational use?

I'm sure I'll be prompted to think of a few more, as other posters comment.

Barbara A. Albright

Pocket's Story of New Hampshire, advocating moral & ethical veterinary pet care

Pocket's Story from NH February 2nd, 2009 12:21:25 PM

I lucked out with my equine vet.  When we moved here, I called up the local university large animal clinic and asked for a recommendation.  In retrospect, being a state university, they probably are hesitant to make actual recommendations.  They did tell me that two practices locally had graduates from the university, and listed them for me...the one I called was (and is) fantastic. 

My equine vet gave me a recommendation for the (also fantastic) small animal practice we're using now; I wish I'd thought to ask her years ago, before our elderly dogs started having elderly dog issues.  The equine vet, naturally, does most of her own work on her own pets, but the various employees at the equine practice had some good recommendations for small animal practices.  We're so glad to have good vets now.

Galadriel February 2nd, 2009 12:29:14 PM

Sarah: That's a great post topic. I'll get to it later this week. Thanks!

Dr. Patty Khuly February 2nd, 2009 12:38:56 PM

The local ER probably also knows which day practices are good and which dreadful. I know we did - we saw the disasters from the dreadful ones!

Maria Shanley February 2nd, 2009 12:43:33 PM

Nice summary of some steps to take.

I did a little different varation on the topic last year, please feel free to comment so you get a trackback from How to be VetSmart.

The one thing I think is a great strategy is too actually talk with those who have used the service and other businesses involved with pets.

The pet businesses usually monitor the feedback from their clients  and so re usually a great third party referral source to get the right feedback. They hear all the pros and cons from their customers.

Ark Lady February 2nd, 2009 12:48:18 PM

Galadriel: Recommendations from specialists can be invaluable. The problem is one you touched on: Most specialists are in the business of seeking referrals from general practitioners, not the other way around. If they show favoritism to one GP by referring clients to them they risk insulting the rest of their referral base. Nonetheless, if you ask for an "off the record" recommendation and they choose to go there, you'll probably get a great one. They're in a great position to know who the best of the best practitioners are. 

Dr. Patty Khuly February 2nd, 2009 01:14:27 PM

Dr. K, you seem to imply that positive reviews should be given more credence than negative ones, asserting that negative reviews may be placed by competitors. ( . . negative reviews are sometimes fraudulently posted by competitors), positive reviews with specific statements about the quality of a hospital’s medical care can be helpful.")

I would passionately argue the opposite, and I further argue that you can use reasoned deduction to see that I am right. It is the positive reviews that more often seem "planted," either by employees of the business or their friends and associates. How can you tell?

Here is how:

If you see a negative customer review which is either the FIRST review of the business on a ratings site, or the first review after a long lapse (in other words, a long time since the last prior review), and that review is followed by a FLURRY of positive reviews all in the same time period, it stands to reason that the positive reviews are probably "plants" by the business or its friends to keep the numeric rating up and SWAMP the negative reviews.

This is especially true if it includes facts a normal client would be unlikely to know. For example, after I gave a negative review to the place where Toonces was overdosed, a positive review showed up touting their AAHA membership, and citing the EXACT PERCENTAGE of veterinary hospitals that are members of AAHA. Clients don't walk around with that information in their heads, and this person was posing as a client.

If you see a pattern of negative reviews followed in close succession by a flurry of positive reviews, this is yet another sign that the positive reviews are "plants."

The reason? No one but the business and its associates are going to be closely monitoring their reviews to see when a negative one shows up. A deluge of positive reviews -- no matter whether they have "detail" or not (sometimes ESPECIALLY if they have detail -- there is a very recognizable "vet speak" after a while) -- is a sure sign that they are planted, either put their by the business themselves or solicited by the business. Trust me, we clients don't have "google alerts" turned on with your hospital's name in their, just waiting to be able to voiciferously defend you if another client finds fault with your services.

My advice:

1. Give negative reviews MUCH more weight than positive ones, especially if the above-described pattern holds true. And MOST especially if the negative review indicates harm or death of a patient.

2. Don't just rely on word of mouth or internet reviews. Especially not just positive ones! File a FOIA request with your state board of veterinary medical examiners to find out if the veterinarian has been disciplined. If they have been disciplined for PATIENT CARE-related stuff (not so much a short license lapse -- any of us could do that) then you need to think LONG and hard about it. Ask yourself if you would want your pet treated as described in the document.

3. FIND OUT if they have, and use, licensed vet techs. Obviously, the better practices do.

4. ASK about supervision and monitoring -- of BOTH the staff, and the patients.

For state board contact info, so you can request disciplinary records, please see: The Companion Animal Protction Alliance.

Stefani February 2nd, 2009 01:17:04 PM

PS - another way you can tell "planted" reviews from real ones -- most of these sites have "user accounts" and logins. REAL people tend to review more than one business, and not all of them will be veterinary establishments. Veterinary "plants" tend to do shotgun reviews -- one time only positive reviews of that particular business. Total dead giveaway.

Stefani February 2nd, 2009 01:20:29 PM

I wholeheartedly believe that the company that comes up with an affordable, easily transportable & reliable "lie-detector" will make millions!

Can you just imagine: "Do I really need that engine overhaul?", "Do you really think I'll benefit from your recommended surgery/treatment, Doc?, "Is my pet likely to have a good life with this treatment?", "Do you feel this is ethical & compassionate treatment for my pet?"

If government & legal authorities would uphold laws & regulations, no one would have to worry about this topic, especially in light of the companion animal "status".

A few more thoughts, Barbara A.

Pocket's Story from NH February 2nd, 2009 02:13:15 PM

I was surprised by your omission of AAHA-accredited hospitals. Obviously it's not a fail-safe screening method (as a previous poster alluded to), but generally speaking, contacting the AAHA-accredited hospitals is a good place to start. When a client of mine asks me for a recommendation for a hospital in a new area because they're moving, I tell them to start with the AAHA-accredited ones, which can be found using the "Find a Hospital" search on their website:

http://www.healthypet.com 

Maybe not all the accredited hospitals take their status as seriously as we do, but I believe strongly that it's a sign of wanting to be the best possible.

JCB February 2nd, 2009 02:19:45 PM

Dr. K, thanks, obviously very timely for me on this one. :)

I'd also suggest a license check with the state licensing agency (many are on line now) .  (You'd be surpirsed how many out right frauds are actually out there.)  I also "google" everyone these days using variations of their names (many professionals publish under last name with initials instead of first name and many people use their middle name, etc.).  I take negatives seriously because so few people actually go to the trouble to report someone anywhere; however, I also take them with a grain of salt since all professionals end up kissing a few frogs too.  In addition, frankly, I'm a little suspicious of any professional who hasn't held their ground against an obstinate client because it may mean the professional doesn't stand their ethical grounds.

PJBoosinger February 2nd, 2009 02:35:39 PM

JCB, re AAHA accreditation: "Maybe not all the accredited hospitals take their status as seriously as we do, but I believe strongly that it's a sign of wanting to be the best possible."

That's the problem. AAHA only skims the surface when it comes to inspecting businesses, so as you imply, whether or not a business meets up to the "spirit" of what AAHA hospitals are supposed to provide is TOTALLY up to the conscientiousness of the business, or LACK thereof.

Given my experience, I do believe that there are hospitals out there using AAHA accreditation to falsely promote an image that they don't live up to, and make no real effort to live up to. The AAHA practice I went to where my cat was OD'd routinely left their patients in the care of unlicensed assistants with no direct supervision. It is also my personal opinion (this is not a statement of fact, but opinion based on studying records) that they modified and doctored records after the fact to cover things up.

They admitted they had not one single solitary licensed tech.

When I reported this, and the vet board decision, to AAHA, the sent the hospital a letter of warning and required them to provide revised drug dosing protocols.

But ANYONE can make up ANY protocol and lie and say they are employing it when THEY ARE NOT.

W. Edwards Deming, a physicist and quality improvement pioneer said:
"In God We Trust, All Others Bring Data."

AAHA is not requirign data to back up the assertions of practices. Therefore, they are trusting vets. Hmm, are vets Gods, or do some people and organizations just think they are?

Where are the announcedd inspections?

Where are the customer satisfaction surveys -- and I mean ALL the customers, not volunteers?

Where is the OUTCOMES assessment or anything having to do with application of clinical protocols?

AAHA will remain meaningless unlesss and until they start doing those things. It's a marketing tool.

I say this is spite of the fact that the hospital I go to know is AAHA. But I don't go to them because they are AAHA. I go to them because they use ONLY licensed technicians, and I have evaluated many of their protocols as best I can and find that they are practising at a high level.

In other words, I'm using the kinds of objective criteria that AAHA should, but apparently doesn't.

Stefani February 2nd, 2009 03:24:46 PM

Re: typo in the above post. I meant to say: Where are the UN-ANNOUNCED inspections?

Stefani February 2nd, 2009 03:26:32 PM

I have been a vet tech since 1971. I have worked at single doctor practices and multi doctor practices. I currently am working at the best practice I have ever worked at (and believe it or not, in all those years, that adds up to only four!). I found this all feline practice after sending out over 100 resumes, and interviewing at 18 practices in two weeks. I did that for a number of reasons, but one of them being...if I was unhappy there, I would know where and where I wouldn't wish to go back to. I also breed Cornish Rex cats, and done that since 1988. I have been an asset to every practice I have worked at, got glowing reviews and excellent references each time. I stay in touch with every veterinarian I have ever worked for. Ok, so I am different. But that experience helps me advise people who adopt cats from me on how to find a good veterinarian. I tell them I would rather have them go to a good mixed animal practice than a bad feline only practice. I probably have over 300 bookmarked websites on feline healthcare information, so that the owners of my cats can be educated clients also. I advise them to when taking their medical records to a new veterinarian to keep the original copies themselves and take in copies for the clinic to keep (that also impresses the receptionist or technician that usually has to copy your records while you wait). I also go a lot on what the front desk staff is like. If they are rude or unkempt or attending to non-work related things while you the client is waiting to be helped and the person doing the hiring, whether it be the veterinarian or an hospital administrator, puts up with that kind of performance, that speaks volumes to me. Check to see if the practice has a website. Is it a canned site, or personal? Does it have information on the staff, besides the veterinarian? To me, that tells me that the practice values their staff and that the staff is more likely to be happy, too. I also advise making a consult appointment with a new veterinarian. Yes, it will cost you an office call, but may be able to answer many of your questions, doubts, and concerns without ever having to take your pet in for the first time. So all that takes a lot of time? Yes. I think many people take more time and research picking out a car than they do a veterinarian (or a mate)and if your pet is a priority to you, then your efforts will not go unrewarded, I can assure you.

Teri February 2nd, 2009 04:44:37 PM

I think it's important for a pet owner to honestly evaluate what they want from a veterinarian. Do you want the "Cadillac" approach to every medical situation your pet may encounter, no matter the cost? Is that feasible for your family? Or is price honestly an issue? Are you the type who will always minimize costs unless it's a life or death situation? Are you "old school", as in, "just gimme the strongest antibiotics you got, Doc, and we'll see how he does"? Or are you willing to shell out for sophisticated testing, specialist referrals, etc.? Are you enthusiastic about preventive care, or do you tend to only take your pet in when it's ill? I'm not trying to make judgements about any of these attitudes, just that different "types" of clients are best suited to practices that operate with a similar mindset, and overall I think most people are happiest when they find a practice that fits them in those ways.

anna February 2nd, 2009 06:19:13 PM

Nice post and helpful comments too.  I might add to consider whether the clinic is corp or private owned, as this can make a big difference in treatment protocols. 

In regards to AAHA accreditation - well its ideal I guess but my vet of 20 years just did it last year ;)   Private owned clinic just never had the time to go through all the steps but I am proud he did but it wouldn't be a deal sinker for me if a clinic was or was not AAHA approved.

Another thought, if you have a purebred dog check with your breeder who may know a breeder in your state and can get feedback for you - or if you have a like breed you could look for breeder of that breed in your area example have a an english mastiff but no OEM breeder in your area try and see if their is a bullmastiff  breeder in your area etc....

LC February 2nd, 2009 06:43:01 PM

Dr. K - great article!

Teri - great suggestions!

As for how we found our vet(s), we employed tactic #10 on your list - with a vengence.  We hit a dozen clinics before we found two that met our standards, we felt comfortable with, had faith in, had the facilities we needed, were willing to accept our "crazy, natural ways" of feeding and treatment whenever possible, and throughout everything maintained wonderful relationships with both us AND our pets (no matter how ornery a rescue pup might be acting).

To be honest, it cost us a fortune in vet visits... lol... my cats and dogs each had several checkups in the period of one year, and the two we chose not only met the above criteria, they remained in the room with us until we were finished questioning them.  It wasn't wham-bam-thank you ma'am!  But rather a comfortable discussion in both cases where I honestly forgot we were in a clinic and this poor guy probably had a dozen people waiting for him.  Neither vet gave any indication of being rushed or hurried, and both gave thorough and complete explanations to all my questions - regardless of how bizarre they may have seemed. 

I have to admit, as a Vet it must be a difficult appointment when you read "annual checkup" on the patient sheet and walk in to a CIA style interrogation.  ;O)  Ok, maybe it wasn't that bad - but you'd have to ask the Doc to be sure, I wasn't the one sweating out the questions.  lol

Kim February 2nd, 2009 07:04:04 PM

Think I'd go with #10.. Would make a list of my priorities, and expectation.. and make surprise visits to a couple of offices.. I would want to listen to the interaction of the staff...  the vet to staff.. and also the patient owners in the waiting room..  Would then bring my guy in for a routine check up .. and  see what the interaction between the vet, and Socks.. If Socks licks the guy.. we're close to being in the ball park.. If he crawls up my shoulder on the way down my back.. I'd have to think twice.. and weigh things..

barri February 2nd, 2009 09:10:54 PM

Stefani, I will not argue one bit that Toonces would 99.9% assuredly not be brain-damaged had a licensed tech administered his insulin. But I cannot agree that licensed techs are any assurance at all for ethical & compassionate care.

They are under the "thumb" or the given direction by the owner/vet at the clinic, both bad or good. If you ask a tech any question, the answer is "I'm only the tech, I can't answer that" (even though they may & are capable of giving the answer or supplying you with the information"....just like asking a nurse for the results of your EKG or X-ray.

And honestly, I don't even want to hear "yes, I'm a licensed vet tech that graduated from Great Bay Community College"---I would be scared half to death and wonder what they were taught to be "acceptable" to a companion pet.

I can't speak for everywhere, but in retrospect, some of these tech students went out for "clinical training" to perhaps "unsavory" places to be possibly "abused" as in, the "I'm YOUR boss attitude" by peers, secretaries, etc. without interference from the real "trainers" which should be the volunteer vets themselves.

Internships are often frought with ego-ridden, power-seeking people given way too much authority . Just another opinion.

Barbara A. Albright/New Hampshire

Pocket's Story from NH February 2nd, 2009 09:23:13 PM

Barb, while you are correct that licensure is no guarantee of compassion or ethics in a 'vet tech', nor is it a gurantee that they will not make errors, it IS, in fact, a guarantee of a certain minimal level of competence and training -- a guarantee that you won't get any other way.

I agree with the AVMA on one thing: The ONLY person who should get to be called a "vet tech" is one that IS LICENSED. Everyone else is a mere veterinary assistant.

I really doubt you would let someone who had never been to vet school operate on your pet and serve as your pets vet. I don't think you'd want some guy off the street playing nurse to an elderly relative in a nursing home. Likewise, I don't want people without formal training playing "vet tech" with my beloveds.

I think lots of people sing themselves a lullabye trying to convince themselves that this doesn't matter -- Because it's so hard to find places that have and use LVTs, and when you do they are more expensive. People don't want to pay the price, so they don't want to believe it matters. But everything has it's price. For me, the price is a 1-2 hour drive plus very expensive prices. But if I didn't do that, the real cost would be much more -- another brain damaged cat, or a pet dead from a error of incompetence in nursing care. Been there, done that. I'm going to do my darndest never to go through that heartwrenching nightmare again.

As it pertains to Toonces brain damage, the irony is this: If he hadn't been left alone for 10 and 13 hours respectively with no treatment, there is a good chance that in spite of the "dosing error" he would not have been as damaged as he was. There have been many cases of large insulin ODs being given to pets, but if it is realized immediately -- or as soon as symptoms manifest -- the animal can be given a glucose bolus immediately followed by a glucose drip and monitored till danger passes. They usually come through fine then. But that couldn't happen for Toonces, because he was given an OD, and then left alone in a cage overnight with no one monitoring him.

Another point: I will never again leave a pet ANYWHERE that doesn't have 24 hour staff. That is another reason I go to the vet I do now. They have a regular clinic and ER collocated so patients are NEVER left alone with no monitoring.

Stefani February 2nd, 2009 10:28:14 PM

Stefani, Thanks for "straightening me out", theory, education, and licensure have no correlation with morality, ethics and compassion. I guess I'll never get past the "knee jerk" reaction of the subject. Especially in light of what I "witnessed"...but it certainly isn't in the expectations of college tuition or written in the program description.

I just sincerely hope those graduating students go on to discern what is right from wrong and not bow to the "wrong".

Sometimes I have days where I believe that "no/minimal medical care is better than BAD care and those are by far the safest people and pets" Barbara A. Albright/advocate for ethical pet care in NH

Pocket's Story from NH February 2nd, 2009 10:51:52 PM

I agree that #10 is a good thing to do, but if anyone makes that "suprise visit" that Barri advocates, please try to find out if what you're seeing/hearing is what normally happens there before making up your mind. Some days are always a bit more rushed/crowded/backed up, such as Saturdays, so they may have frazzled staff and clients, but that's just one slice of time. Try to come at a time you might aim for an appointment, which, depending on your schedule, might be more laid back for everyone. Also, watch to see if the staff is moving quickly with the people clients and yet trying not rush the patient animals - there's a difference, especially on busy days. And I also think asking others who work in the field (vets & staff, shelter/rescue people), who they like is a good way to go. However, it's better to offer names and carefully watch their faces for signs of things they may not say out loud. Sometimes a tightening of the mouth is all you'll see, but it could be a sign to ask others to see if you get a similar reaction.

Speaking of licensed techs - try to find out what they actually do versus what the vet does. If it is a small, single vet practice, where the vet does all blood draws, reads all tests, and checks everything his long-time 'mere assistants' do, and you trust that vet, then don't automatically assume that things aren't as good as at a clinic with 'real techs.' I have met some licensed techs who were rushed, unappreciated, and pissed off at their boss, and their care of the animals was nowhere near as good as anyone would want. I am one of those 'mere assistants' and I assist with exams, simple prep and monitoring before and after surgery, grooming, and even some receptionist duties. I add value to the practice by caring about my work with animals and making things run smoothly for the vet and other staff.

KateH February 3rd, 2009 10:13:15 AM

One additional PS to Stefani's post on phony positive reviews ("plants") and recommendations given to vets. Beware of rescue groups recommending the vets they (the rescues) associate with. It is perhaps a little known fact, but some rescue people have formed close alliances with certain vets, which they have maintained for many years. They (the rescues) will protect these alliances at any cost. They can be totally subjective in evaluating these vets and disregard any flaws these vets might have. They will deny and dismiss any objective evidence of wrongdoing by their vets, even at the risk to safety of the animals the rescue have in their care. These rescue people become their vets' fans (in the true sense of the word: they defend them FANATICALLY), their advocates and vicious adversaries of anyone who questions THEIR vet. I have had very disturbing experiences with some rescue zealots flooding review sites with raving five star "plants" in response to some grieving owners' accounts of their pets' deaths at the hands of the vets they associate with. And they call themselves rescuers! Don't get me wrong: I do rescue work too but not alongside the zealots who think the vet who gives them a discount is GOD.

Natalie Kramer February 3rd, 2009 11:07:03 AM

Great comments! Goes to show that veterinarians are not necessarily in the best position to recommend other veterinarians. 

On the AAHA issue: I've had cause to recommend that people try an AAHA hospital first if they have nothing else to go on. I agree-the standards do mean something. Where I am, however, there are so few that I often forget about this viable approach.

Dr. Patty Khuly February 3rd, 2009 11:45:51 AM

kateH, thank you for sharing good insight! Barb A.

Pocket's Story from NH February 3rd, 2009 02:47:03 PM

http://www.doctorscorecard.com/doctors?sta=AL Asproolee’s Story A negative review and real dirty comments by vets and their staff!

Check it yourselves!

Fotini February 3rd, 2009 02:53:27 PM

I have a friend who has moved with his family many times for business. Everywhere he goes, he looks up an Oklahoma State University vet school grad. Because he's a OSU grad. "They're the BEST!" he says of the Oklahoma State veterinarians. Well ... maybe if you have cattle. In fact, EVERYONE KNOWS that Cornell, UCD and Penn vets ROCK. And hey hey, Dr. K, I meet your sis and brother in law this weekend.:)

Gina Spadafori February 3rd, 2009 06:01:17 PM

Sometimes you'll find exactly what your looking for when you are not looking for it.

That is how we found our Vet please don't ask me to try to explain it!

LOL

Robert February 3rd, 2009 07:26:08 PM

Hmmm, hadn't thought about looking for alums of Vets I liked.  I'm sure the one I liked best was an OSU grad now that I think about it.  :)

PJBoosinger February 3rd, 2009 07:51:18 PM

Of course, you could always use Stempy's Checklist to help you choose a vet. http://stempy.net/checklist.html

Greg Munson February 5th, 2009 02:08:55 PM

Excellent tips for finding the vet who's right for you! Here's one more ... we wrote a <a href="http://www.tripawds.com/2008/12/21/vet-confidential-book-review/">book review for "Vet Confidential"</a> and recommend every pet owner read it before any trip to the veterinarian.

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