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Finally, a chance to participate! - by L Mokres, DVM
Posted 6:53 PM, May 15, 2007, byI finally got to join up the Medicine and Horses students today. Due to a rigorous lab schedule, I am only able to attend one of the four sessions this spring, which is frustrating as I put so much work into the course behind the scenes. The most rewarding part of this course is seeing students grasp a new concept or discover something about themselves that they did not know before, and I miss that when I can not attend.
Ah, well, I at least made it out today, albeit a bit late. I teach a portion of the course based on doing a physical exam, though the exam is a metaphor for any situation that involves patient contact and/or patient communication—it could be a physical exam, a procedure such as a spinal tap or skin biopsy, breaking the news to someone that they have cancer or a loved one is in intensive care--you name it. What I try to lay bare is the fact that physicians can get away with some pretty bad bedside manner. Whether their patient is comfortable or not, in a physical or emotional sense, should be a top concern. However, the fundamental pathology that underlies poor bedside manner is that they simply don’t care—they just want to get in, get out, and get on with it, and the patient’s impression of them is disregarded. Veterinarians DO NOT HAVE that luxury, in particular large animal veterinarians. If we disregard the signals that a horse is sending when she is not comfortable with how she is being approached, handled, etc, we could very easily get ourselves critically injured and even killed. We have absolutely *no* leeway in equine practice for ignoring the feedback that our patients provide us, in particular because it is nonverbal. Horses are big and fast and they will let us know when they are unhappy.
As such, horses provide a wonderful tool to provide feedback to the students, as they learn to pay attention to the signals that a patient sends while being worked with. Some patients, out of fear or respect for the physician, will not speak up when they are uncomfortable, and those physicians with good bedside manner will be able to pick up on this discomfort, without having it spelled out or spoon fed to them, and respond accordingly. *That* is good bedside manner, and *that* is what I want to teach in this section. Despite the fact that I actually had an overly cooperative mare, who was not about to kick or bite at anything but flies, it seemed that the students really got the message, and I was so happy to be able to open their eyes to this aspect of medical practice!
--posted for Lucia Mokres, DVM by B Kane
Comments
Comment by: C. Truong at May 21, 2007 1:12 AM
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I'm disappointed I didn't get to take part in the physical exam portion of Horses and Medicine this week. It sounds like an extremely high yield exercise and learning experience. Having just experienced being on the "patient side" of medicine (by proxy--my sister just gave birth this weekend and I was one of her birth attendants) I took time to notice how she reacted to each member of her medical team. By far her preferences went to those professionals that were in tune with her emotionally and not necessarily ones that she saw the most or were higher up in the hierarchy. As L.M. said, as a caretaker, "Whether [a] patient is comfortable or not, in a physical or emotional sense, should be a top concern." And certainly I hope to be a clinician that would enable patients to feel comfortable telling or asking me anything when they have concerns that impact their health and care.