One Veterinarian to Cure “The Holding Pattern”
What Is the Holding Pattern?
“The holding pattern is what I call it when a veterinarian just repeats what was done at the last visit, without giving you any options for discovering predisposing factors or perpetuating circumstances that cause your pet to have the same problem over and over again,” says Doc Truli, “It wastes money and shows shoddy medical practice.”
Imagine this: your pet has itchy skin. Maybe a few sores, maybe a bacterial or yeast infection. You went to your veterinarian and your pet received a steroid injection and antibiotics. Probably you also took home some medicated shampoo. If your veterinarian practices integrative medicine, you likely also took home some omega 3 fatty acids and prescription skin support food. Maybe your veterinarian ran the appropriate diagnostic tests for skin problems: a skin scrape cytology, skin tape cytology, fungal culture, trichogram and maybe an endocrine and thyroid function blood panel and serum allergy tests. The cost was tremendous and the results were pretty good. For a few months.
Now imagine you returned to the animal hospital for a recheck about 2-4 weeks after initiating treatment. You are given a refill of steroids and antibiotics and sent on your way maybe another US$100 lighter. What happened? You were put into the holding pattern.
“Skin problems have initiating factors, predispositions and perpetuating factors,” says Doc Truli. “For example, an initiating factor may be a flea bite. A predisposition is a family history of allergies and a perpetuating factor may be obesity causing skin folds to rub together and prevent adequate air and sunlight from healing the skin.”
Ideally, you would like every veterinary visit to advance your pet’s health and your understanding of your pet’s healthcare. You were all excited to go to your recheck and you were scheduled with a different veterinarian. (Or worse, you switched the hospital to get a “free first visit.”) They did not know you or your pet. They had medical notes, but they did not know where you were in your understanding of medicine or skin and they did not know your goals. Also, in a 10 minute recheck, they looked at your pet (having not seen the original condition of the skin) and they refilled your medications and sent you on your way. Is that worth your money? No!
Now, what should have happened? You should have continued your pet’s care with the original veterinarian. Why? Well, do you think that a picture or a medical description can really explain the details of your pet’s skin? No! Seeing, smelling and touching your pet’s skin stays with your veterinarian. Notes can only cover so much. You reached a point of understanding at the initial visit. Your veterinarian who saw your pet initially knows whether or not you can give your cat pills or whether you can clean your dog’s ears. They know if you can name an antibiotic and they know if you confuse the steroid and the antibiotic unless they place the pills in different colored bottles. All the personal details matter so much.
One Veterinarian is the Direct Path to a Cure
Most importantly, your veterinarian had another step in mind. A proper follow-up recheck visit should include a plan for the next step of management for your pet’s condition. For example, maybe the underlying factor that caused your pet to acquire an infection is still present. Maybe you need to treat your dog’s oak tree allergy or else an infection will just recur. Perhaps you need to eliminate a predisposing factor like a hairy ear canal, and now that the ear infection is better, your pet is comfortable enough for the ear cleaning procedure. Does a different veterinarian know to advance the health of your pet in these ways? Probably not. Therefore, do not let your animal hospital book your follow-up care with a different veterinarian. Even if you like and trust all the vets at your local animal hospital, continuity of care is critical to improve your pet’s health and save money.