5 things that worry a new doctor

5 things that worry a new doctor

Mar 01, 2006

We know the first year in practice brings special challenges. It's a major life transition to move from school to the workforce no matter what your profession. And in veterinary medicine, associates hold the lives of pets in their hands almost from Day 1, which gives the experience even more intensity.

To learn more about recent graduates' experiences in the workforce —and how owners can make them feel more comfortable and help them hit the ground running—we asked Dr. Philip VanVranken, a 33-year veteran of veterinary medicine and owner of Dickman Road Veterinary Clinic in Battle Creek, Mich., to act as a mentor to recent graduate and Veterinary Economics Editorial Advisory Board member Dr. W. Andrew Rollo, who's an associate at Gibraltar Veterinary Hospital, a five doctor, small animal practice in Gibraltar, Mich. The two doctors exchanged regular e-mails over the course of a year and discussed everything from basketball to making mistakes.

We're planning to run four articles this year that share portions of their conversations, which we hope will stimulate discussion and help both associates and owners understand each other better and learn to work together more effectively.

Near the beginning of their discussion, Dr. VanVranken asked Dr. Rollo what his top worries were as he made the transition to practice. Here we share his responses and Dr. VanVranken's advice.

Concern #1: Do I know enough?

Dr. Rollo: I think I can speak for 90 percent of my classmates (and the other 10 percent are in research) when I say that I was concerned about whether I knew enough. Confidence as a doctor is something they can't teach at school and something everyone has to figure out on their own in the real world.

In the first couple weeks, I found myself running out of the exam room into the office and looking up what I had just told a client about a certain disease or condition. One time I suggested Addison's disease as a possible diagnosis. The owner began asking many questions about the condition such as treatment and prognosis. I'd never dealt with an actual patient with hypoadrenocorticism and probably slept through the lecture years ago. To my surprise, when I opened the closest reference I could find, I learned that what I told the owner was right.

Dr. VanVranken: I understand feeling concerned about your confidence. But, not to worry, clients have confidence in doctors who work hard for their patients. Think of it this way: Every pro baseball team has a fan-favorite, and it's usually not the 10-year veteran with the big salary. Instead, it's the rookie making the league minimum salary. He runs out every ground ball, is remorseful when committing a fielding error, and makes himself available to fans and reporters. The moral of the story is you can bat 245 and still win fans' admiration. Everyone pulls for the individual who strives to please.

Concern #2: Making mistakes

Dr. Rollo: To be human is to err, and I'm aware that I'll make mistakes. Sometimes it's in the exam room; a few weeks in, I told a client that she could get Demodex from her dog. Hours later I realized that I'd mixed up Demodex with scabies. Needless to say, I had to make a humbling phone call later that day to re-educate the client. Luckily I have a great team around me for help and support along the way.

Dr. VanVranken: We all make mistakes, even after 30 years of experience. Granted the mistakes aren't as frequent, but they still happen. Get used to them and learn from them. There's a lot of dung out there and the challenge is to step in as little as possible. Your experienced team will help you in that regard.

Another thing that will help is to spend a few minutes each night at home reading about one difficult case you saw that day. After a couple of years, you'll have read about almost every disease.