The Dog Parent and Veterinarian Relationship
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Welcome to the Wag Out Loud pawdcast, where we are obsessed with bringing you helpful tips on canine health care, nutrition, and overall wellbeing. If you'd like to support the show, check out the amazing online events, products and resources that I personally recommend on the Wag Out Loud website. I'm your host, Krista and I'm super excited to be bringing you yet another tail wagging episode.
Dr. Bonnie Bragdon has a unique background that combines veterinary medicine, practice management and industry innovation. She began her career in practice, serving for nearly 10 years as an associate veterinarian, owner-veterinarian and animal control director with clinical and leadership responsibilities. In addition to her responsibilities as a clinical practitioner, Dr. Bragdon excelled in practice operations management and enjoyed coaching and mentoring her team for maximum performance. She transitioned to executive leadership in the animal health industry, where she continued her career development learning new skills in sales, marketing, and teaching adults. She is the co-founder of the Independent Veterinary Practitioners Association, the first nonprofit association dedicated to uniting and empowering independently-owned and locally-operated veterinary clinics in continuing to shape the business and practice of animal health care. She also frequently serves as a subject matter expert for DailyPaws.com regarding pet health issues.
Hello dog lovers! We are so glad that you tuned into yet another informative Wag Out Loud episode. And I am thrilled to be chatting with my guest, Dr. Bonnie Bragdon. And she is going to talk about the dog parent and veterinarian relationship. So Dr. Bonnie, thanks so much for being with us today.
I'm really excited to be here, Krista. I love talking to dog parents. It's very exciting. I don't get enough of that these days. And so I'm glad to be here.
Awesome. Well, before we get started, would you please introduce yourself and share why do you enjoy working with other veterinarians and helping them to excel in their roles? They have many roles, doctors, caregivers and practice owners.
Yeah, so I’m Dr. Bonnie Bragdon. I practiced for about 10 years after veterinary school. So I've owned a practice, I actually also managed an animal control facility, I left that career as a practitioner and entered what we call an animal health industry. And I work with drug companies and animal practices. And I like that intersection where health, science and clinic management all comes together. And I think I have some unique insights that'll help dog owners and give a little bit of inside knowledge about how to navigate those relationships.
The Strain that Vets, techs and other in vet practices are under
Well, I am so excited. You're the expert. So school us today, Dr. Bonnie. We're going to be talking about the importance of developing a healthy relationship with your vet for the personalized care for your dog. And we're going to talk about the cost of care, the questions that you should be asking to make sure that you're not being taken advantage of. So before we dive deep, I just wanted to do a shout out to all of the veterinarians, the techs and the other team members of these veterinary practices because I don't know if a lot of us realize the pressure, the stress that they are all under especially now these days. Do you want to talk about that?
Yeah, so During COVID, a lot of us went out and got new dogs, had time with our dogs and understood that maybe things weren't quite right, we got caught up on preventative care. And we went to the veterinarian very often, during a time when there's a shortage of veterinary help veterinarians, trained technicians. And so it's been very stressful to bring that all together allow veterinarians to do the medicine and practice the way they want to, as well as be able to have time for themselves and not be so stressed. And so I am very grateful to any dog owner that just is a little more patient than normal. I now actually go to the veterinarian to get care for my own animals, and I have to be a lot more patient and understand things are taking longer in that so that staff can deliver quality care and aren't rushed. So it takes a lot of patience these days.
Yeah. And I think sometimes we forget that the practice is a business. Right?
Different Types of Veterinary Practice Structures and Ownership
So and that's something that we should talk about, right. So what I am very, very passionate about, because I am an insider, and I am a veterinarian, I don't practice now. So I have to seek care for my own pets, and very passionate about helping dog owners to understand the different types of practices. So dog owners have a large number of choices of where they get care. They can go to a corporate practice, which is a national practice with standards across the United States, kind of like going to McDonald's, you get the same hamburger, so you know what to expect. You can also seek care at a an independent practice. And those can be one doctor practices all the way up to 30 Doctor practices. There are even nonprofit practices these days. So those are our practices that support low income folks, folks who might struggle to pay for care. So everybody has an opportunity to choose the kind of care they would like and how personalized that is, and what kind of relationship they have with their veterinarian. And they just need to understand those differences. To be able to ask the right questions.
That's a really good point. Well, how do you want to start this conversation about forming a healthy relationship with our veterinarians?
What Kind of Veterinary Care Do You Seek for Your Dog?
Yeah, I think the most important thing is to consider the kind of health care you want for yourself, as well as for your dogs. And we all have different philosophies about how we would like to live our lives. Some folks want to live full out, and hey, you know, I'm going to eat doughnuts and smoke cigarettes. And that's great. And my grandma lived to 100. And she drank a glass of whiskey every day. And other folks are like, No, you know, I want to be very restrictive about my health care and make sure I work on it, and take care of myself to the optimum. And one of the things that I think is most important is to also to assess risk. So am I somebody who really wants to minimize risk and take absolutely no risks, and make sure that I get the best outcomes? Or am I maybe, you know, maybe I want to have a little more value added care. And I'm, you know, maybe willing to take a little bit more risk, because I'm having to pinch pennies and things like that. And so, first and foremost, consider what's important to you philosophically, ethically, morally, what style of healthcare you like, and then think about your budget. And once you put that all together, have a conversation with your veterinarian, because what I think so many times people forget is your veterinarian, has their style of care that they want, and they like to deliver. There's actually some experts in the veterinary profession who talk about burnout. And they talk more about burnout, not so much about compassion and empathy and kindness and sympathy. They're actually talking about burnout from a moral and ethical standpoint. So there's a lot of diversity in how we feel like our pets should be cared for. Some of us feel like our dogs should receive every bit of the same care as we receive. And other folks feel like maybe the budget is more important than the the type of care that's delivered. So veterinarians kind of get stuck in the middle. Because they're trying to advocate for their patients. They're trying to meet the budget and the philosophy and the moral needs of the client. And then they're trying to navigate these relationships. And it can be and their own personal feelings about what type of care should be delivered. And that can be very stressful for them. So I'll give you a you know, an example. Let's say that you really prefer to have a heavy emphasis on Eastern philosophies of medicine. Let's say that naturopathy, homeopathy, herbal medications, those are very very important to you as a health care consumer both for yourself, as well as Your Dog, it's important to find a veterinarian that also maybe even specializes or has those types of knowledge and moral and ethical style of medicine. And then you have that automatic match. So you're not at odds of what you're trying to accomplish for your dog.
Risk vs Choice
That makes total sense. And I know when we first met, we talked in depth about this risk versus choice, and how to mitigate risk. Can you talk about because I know we mentioned vaccinations and flea and tick medications? And what are the choices versus the risks? And what should we look out for when talking about treatments?
Yeah, so we started off with like, what are the steps to get the right relationship with a veterinarian to meet your needs and your dog's needs? You know, number one, decide what your philosophy is, and what kind of style of medicine you want for yourself and your pets. Second, I think is that assessment of risk and understanding what type of risk and lifestyle you and your pet live. And then the third step is budget after that. And so when I talk about risk, you know, I could have, let's say, a Jack Russell Terrier, that's a breed that can be a couch potato, or they can be a working dog. So if I'm, if I were practicing today, and I had a Jack Russell Terrier that came to me and it lived on a farm, part of his job was to help keep, you know, the farm free of rats, keep folks safe from all the diseases that rats can carry, versus a Jack Russell Terrier that maybe lives as a companion for somebody who lives in an urban environment, the needs for different preventative care, vaccinations, parasiticide, is different. So the lifestyle of that hunting dog, that dog is going to get exposed to far many more infectious diseases than the dog maybe that sits on the couch, maybe even is trained to go to the bathroom inside. And so first thinking about what lifestyle risks there are. So the hunting dog has a risk of getting infected with ticks and fleas and and leptospirosis and all kinds of diseases carried by rats, whereas the couch potato is not going to have that kind of exposure. And so then once we know what the risk is due to lifestyle, then having a very focused conversation with your veterinarian about what vaccinations and parasiticide are needed. And if you tend to be somebody who prefers the fewer medications more than non traditional medications, there are things you can do to change your lifestyle to make risk of infectious diseases lower. So for instance, there are veterinarians I work with just like dog owners, who are very focused on integrative and maybe non traditional styles of practice. And for them, they prefer to have the least number of vaccines, they prefer to have the least number of parasiticides and medications on a regular basis, and so forth. What I've instructed those folks is that, you know, those pets who are going to receive fewer vaccines and fewer parasiticides should lead a less social life, and more restricted in what they access. So let's say, you know, I'm worried about that dog's immune system, I'm worried about vaccinating that dog, and I don't vaccinate it, or I vaccinate it less frequently, then I might restrict that dog from social activities because I don't want it to get infected. Or I might restrict it to a very small playgroup, like having all of the same dogs in that same playgroup, which aren't exposed to other dogs with the potential infectious diseases. So, for instance, let's say that I'm a foster mom, and I really like fostering dogs. And it's important to me that I give back by fostering that's a scenario where I'm going to have a lot more exposure to infectious diseases where vaccination is important that my own personal pet be vaccinated, as I rescue and bring in these dogs, but I where I don't know what the exposure’s been. So I may have to choose if I don't want to vaccinate as much, I may have to give up fostering in order to keep my own personal pet healthy.
Titer Testing
Or like everybody that follows this Show, we know about titer testing, and if we know that our dogs have the antibodies for you know the various diseases, then we should feel comfortable instead of over vaccinating or re boosting.
Right. Now, there are some differences. So I did you know, I gave you a case case study that was extreme and what I was kind of thinking back and harkening back to is we did have, we've had some sporadic, not common, but we've had some sporadic outbreaks of canine influenza. And there are a number of different strains just like there are with people and birds and so some are more pathologic and, and problematic than others. And so absolutely titer testing is very, it's pretty reliable when it comes to core diseases like distemper, rabies and Parvo. I didn't do titer testing when I was in practice, but I do believe it's very good for helping understand if that dog has been well vaccinated. There are other diseases that we just you know, we don't have the ability, we don't have the knowledge or the information to predict whether that titer is going to be protected, or even if we can commercially test titers. And so the respiratory diseases are a little bit more difficult than some of the other core diseases. And so with canine influenza. And I keep thinking about that one, because we did have a new strain. There were some folks that that had some pretty difficult times with their personal pets, because they were very generous with fostering. So in that scenario, with fostering one of the very easy husbandry ways to manage through that is through isolation and quarantine. And so rather than if you if you don't want to vaccinate, and you know that you are very worried about that keeping your own personal pets isolated from those that you're bringing in, and that way you can manage exposure, and then just you know, managing as you go between the populations.
That makes a lot of sense. Thank you for sharing that. Well, we are at a point in the show where we need to take a quick commercial break. So we'll see you on the flip side, everybody. Stay tuned.
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Welcome back, everybody. We are talking with Dr. Bonnie Bragdon. And how to have the best relationship with your vet. So very important, because Dr. Bonnie aren't we a team? It's not so many people hold veterinarians way up on this pedestal and almost feel that they can't say anything or ask questions, which they really should be. They shouldn’t be intimidated, right?
Conversations with Your Vet
No, they shouldn't be intimidated. And I would hope every one of my veterinary colleagues would agree with me when I say, if a veterinarian’s making you feel intimidated, and that's not a good relationship, and you need to search for a veterinarian that you're comfortable with. And that's the same for our physicians as well. And what is so fabulously wonderful about veterinary medicine is you can, I'm pretty sure I find the veterinarian who matches your philosophy, matches your medical style, your morals, your ethics and feelings and thoughts about your dog and the care that that dog should receive. It just takes a little work to find that veterinarian, and I'm gonna go off on a bit of a tangent but there I know a veterinarian in Texas, her whole practice is limited to helping rodeo bulls live their best life, in competitive sport. So no matter how you feel about, you know, animals and competition and how we have those types of relationships, there's a veterinarian and her whole career is dedicated to making sure that those bulls are competing in rodeos are healthy and competitive. And then will live a long and healthy life. And I never would have known that. So finding that right veterinarian for your dog is absolutely possible. It's just a matter of doing some research. First, you know, starting off with the practice website, and then having a conversation with the staff as well as the veterinarian and asking all of those questions. And I think some important questions to ask just like you, you know, you kind of prodded me is, you know, what is your philosophy regarding preventative care? You know, what is your philosophy regarding vaccination? And I would like to stop and say, a veterinarian philosophy about vaccination. parasiticide is very much formed by their experiences in practice, fairly self evident. So there's a lot of diversity and you'll hear me talk a lot about vaccination, for the very important reason that I worked in an animal control environment. And when I was in animal control I saw I saw far, many more animals die from preventable diseases because they weren't vaccinated. However, if you look at the World Health Organization's paper on vaccination and preventative care, they state in the developed world, that there are probably as many pets that are over vaccinated as many over vaccinated pets as there are under vaccinated pets. And so that's where we need a balance, right? And so some very interesting data that I don't have top of head anymore, but there are veterinary deserts, in certain environments in the United States, just like there are food deserts and healthcare deserts for people in that people are unable to get basic care and the basic vaccines. So these puppies have not been vaccinated for Parvo. And so those areas Parvo and distemper have very high prevalence, diseases, which probably certain veterinarians have never even seen in their career. So given my experience in a rural environment in the South in animal control, where vaccination was not highly valued by the community, I saw outbreaks of distemper and Parvo however, I went to practice at a very upscale area where vaccination was very prevalent, and I never saw another distemper case and I saw very few Parvo cases. So again, going back to that idea of understanding, lifestyle and risk, and then that dictates what preventative care, you should seek from your your healthcare provider.
Cost of Treatment?
All right, good tip. And when we talk about cost when we're looking at cost, you know, everything now is so expensive. And what are the questions that we need to ask to make sure that we're not overpaying for the services that we're paying for?
Right. And, again, it's still gonna go back to that idea of risk. And risk is something I am very passionate about talking about, because I think so many times we read in the media, and we get very overwhelmed, right? So for me, myself, personally, I'm like, Oh, my God, I could be I could get monkey pox, I could get Ebola, I could get COVID. Now we've got flu. And we get all of this information. And we don't really have any help to understand what the relative risk is, what's the risk that I'm going to get the disease or that my dog is going to get a disease, what is the risk that the dog is going to get sick and die from the disease and what is the risk for preventing or treating that? So I'll give you an example. I have a colleague that I've worked with in the past. And she lives in Chicago, and I'm here in the South. And she sent me this picture of this dog. And she's like, convinced like, Oh, my God, I'm, I'm like, I found this, this insect on my dog, I am convinced it is this rare disease, he is going to die, I am freaking out, what should I do? And I said, well, the likelihood that that insect carries the disease, that it's going to kill your dog as low. The likelihood that that bug, if it has the infectious disease is going to infect your dog is low, you got got the insect off the dog almost immediately. And frankly, to be very blunt, there's no treatment. And if the dog is already sick, there's unfortunately nothing you can do about it. So giving that stepwise process and thought about risk, there's no need to panic over a weekend. There's no need to seek expensive consultation at an emergency practice. And it's okay to monitor that dog and how they are progressing and feeling. So having that stepwise conversation with a clinician, what is the risk that my dog is going to get this disease? What is what is the likelihood that the pet with the likelihood of outcome is going to be? How much will it cost to treat? And how much will it cost if I kind of watch or take other measures to monitor this disease process. And so if we think about, for instance, parvo virus, that's a very expensive disease to treat, that one, when we see a pet come in or dog come in, and we've diagnosed parvo virus, we know we want to hospitalize, we want to maximize the care that that dog is getting, we want to put in place an IV catheter and do everything we can because mortality can be as high as 20 to 30% in those puppies. However, if I have a dog come in, and maybe has an upper respiratory disease, it's got a honking cough, you know, without playing in the playground with the dog at the dog park, it's probably it might be viral might be respiratory, that's one where I might be able to watch and not give antibiotics, and watch for signs that the dog is getting progressively worse. So it's this idea of being able to understand the risk of death, and then kind of kind of trading care based on budget and based on the likelihood of a good outcome versus, you know, a poor outcome.
Is the Veterinary Industry Broken?
Sure. Well, I think we can all agree that in human medicine that the medical industry is broken. I'll just say that. So do you feel that there are improvements that can be made in veterinary medicine and the industry?
Yes. So it is absolutely fascinating. I just came back from a conference, run by the ASPCA. And that conference, I just my hat's off to that group and the leadership they've shown, they're bringing to the veterinary profession, a conversation around access to care. And the conversation is around the spectrum of care. So veterinarians, especially veterinarians, in my age, we were taught to offer gold, you know, silver and bronze care. So kind of better, best, you know, minimum care. And that's not pleasant, right? That's not a fair conversation to have with somebody. Well, you know, if you can't afford it, we're just gonna kind of get you the basics and send you out the door. And that's, that's not a fair conversation to have with anybody. However, if we talk about the spectrum of care, right, we can have a conversation around, how much care do we deliver to minimize risk? And if we think about a surgical case, for instance, if I've got a puppy that comes in a six month old puppy that's being spayed or neutered, you know, Can I can I get you know, not do bloodwork on that pet, you know, you know, what is the risk if I put that pet under anesthesia, and I need to do you know, a castration or a spay, and I don't do pre, you know, pre surgical bloodwork does that, you know, what's the what's the likely outcome? Well, in a young animal, the likely outcome if I don't spend the money on pre surgical bloodwork, that that pet is probably going to get through surgery, okay. However, I don't know there could be a risk, I could miss a liver shunt. I could miss a congenital kidney problem. And so that's where we're starting to have more conversations around the spectrum of care. So we can deliver good quality value care to people that meet their budget. Now I had clients, it had nothing to do with their budget. They would go without for themselves in order to make sure that that pet, get every type of care absolutely possible in order to make Make sure they minimize risk at all cost. And then there were others who said, No, I really, I have to meet my budget. And so let's have a conversation around how we're going to do a good quality job. But maybe I'm willing to take a little bit more risk.
Malpractice in Veterinary Medicine
Well, since we're talking about risk, it makes me unfortunately, go right to malpractice. Because we are so emotionally bonded with our dogs. And if something happens, whether it was human error, or you know, they went the less expensive route, and something was missed, you know, whatever that is, there has to be a lot spent on malpractice insurance in a veterinary practice. Because isn't it prevalent?
Yeah, malpractice is very different, for better or for worse. And this, this is controversial. So most states, here in America, consider animals to be property. No matter how much we love or care about our animals, at the end of the day, from a legal standpoint, they are considered property. Now, we still have, we have far more responsibilities for caring for our animals than we do regular property. So it's kind of this weird dynamic, where legally, that animal is considered property. But we have all these humane and welfare very expanding and very good laws about how we have to take care of these animals. And because animals are considered property, it does mitigate and lessen what happens when there is malpractice. And so that, you know, there's pros and cons to that, right? The good side of lowered malpractice is that that cost is not passed on to consumers. Now, the difficult part is if you feel like, you know, there has been malpractice, you may not be able to recover financially. But the way that I think about this is oftentimes I think we feel like getting, you know, a financial outcome from malpractice is a way to feel like we've been, you know, paid back not just on the damages, the financial damages, but also the emotional damages. And I think if we're able to kind of have a better conversation than physicians have, then I think we can keep the cost of care low, but still be able to acknowledge and provide people with closure, that that animal was every bit as important to them as any person, and that that problem or malpractice or negligence was every bit as emotional and problematic and dear to them as if it were a human. One of the things we don't always talk about is part of the stress that veterinarians feel I know myself personally, I have felt this is when there is an error or some other malpractices happen. I know I personally have felt it very deeply. I think that's why I don't practice today is because it's emotionally difficult for us as well. We well I, most veterinarians that I know, never want anything to go wrong. And when something does go wrong, they feel horribly about it. Really, I think it would be great to have a conversation among healthcare providers in veterinary medicine as well as legal and ethical folks and experts as well as owners or pet parents, so that we can have a better more balanced conversation around. Yes, financial damages need to be paid in order for that person to be paid back for the cost of care if it was negligent or malpractice to also have some form of acknowledging the grief. And you know, the difficulties and the emotional burden that comes with those. Those problems that crop up? So I don't have an exact answer. But the privileges that we have in veterinary medicine and animal health, is that if we just develop closer relationships with pet parents, we have such huge opportunities to really shape the future of Veterinary Medicine, unlike human medicine, because it's human medicine. There's so many government laws and policies and there's so many things that have to force or form the scenario where we have a huge opportunity in veterinary medicine to really make it something that works for everybody.
Well said, Well, Dr. Bonnie, we are out of time. But I want to quickly let everybody know you co founded the Independent Veterinary Practitioners Association. Can you quickly tell us what that is about?
Yeah, so I believe that everybody should have choice in the type of care they receive. Whether that's the most expensive or the most value added. And in veterinary medicine today, it is becoming consolidated and corporatized. So larger and larger companies are owning more and more veterinary practices. And I want consumers to know that they still have an option of seeking care with a practice that is owned by the veterinarian who works there. And oftentimes, those veterinarians and those healthcare providers can be more flexible in order to provide personalized care.
Dr. Bonnie Bragdon Contact Info
I love it. Thank you for that. That's an amazing organization. Well, as we are leaving today, how can people find out more about you and the association?
Website for the IVPA is https://www.iveterinarians.org/
Social Media URLs or Tags
Facebook: https://www.facebook.com/iveterinarians/
LinkedIn: https://www.linkedin.com/company/independentveterinarian/
Yes, so they can visit visit us at https://www.iveterinarians.org/. And you can actually go on there and find one of our members. So you know for sure that it is a veterinary owned practice. That is another thing that I would advise people to ask questions. Oftentimes, these practices are not branded. And so as you're seeking care, ask the question, you know, who is it that dictates policy and procedure, medical SOPs, medical protocols? Is that the veterinarian here on site? Or is that a company and a group of veterinarians and a group of administrators off site. And if it's a group of administrators off site, that doesn't mean the care, it still is good quality care. It's just it might be more restrictive. And those veterinarians in the clinic may not be able to make those personalized touches, right. So those veterinarians who work for practices that have rigid policies are going to give you the company’s philosophy on vaccination, parasiticide, whereas an independent practitioner can have a more personalized conversation to really give you the kind of preventative care that meets you and your pet's needs.
Great info. Dr. Bonnie, thank you so much for all that you do. And for being here. This is all good information. I really appreciate it.
I just wish I could talk to all your people. So if you get any questions, I love answering questions. So I'm absolutely very serious if there's a way to get those questions to me. I mean, I cannot advise on specific cases. But I can guide people as to what questions to ask their veterinarian so they can get the right, right care that they need. And I love answering this questions.
All right, everybody. You heard it. So give me your questions. I'll forward it on to Dr. Bonnie. Thank you so much. And we'll be back next time.
Thank you for your time today.
Thanks again to our sponsor Genie’s Therapeutics for sponsoring this episode. Fetch some Genie’s Therapeutics Hemp Signature Blend for your dog at GeniesTherapeutics.com. And be sure to use the code WOLspecial to receive free shipping and 10% off.
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Hey Winston was that another tail wagging episode?
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