An important part of any veterinary hospital is to have a medical philosophy that the whole staff can agree on.  It can be very damaging to have one doctor with one view on a vaccination protocol, and another doctor who views it differently.  Clients will be left confused when one doctor believes in year round heartworm prevention and another doctor recommends seasonal protection.  Inconsistent medical messages will undermine the recommendations and ultimately the integrity of the practice.  Differences in opinion can occur between a technician and doctor, or a manager and receptionist.  But the most likely divide in the practice occurs between two doctors that are a generation apart.

            Over the span of thirty years a lot can change in medicine.  Having only been out of school for five years, I am impressed with the knowledge and tools today’s students are walking away with.  There are many things in place to help bridge the gap between the vetted doctor and the one with the crisp diploma.  For experienced doctors there are more and more opportunities for continuing education to help keep up with the latest research and technology.  For new graduates there are growing opportunities with internships and residencies to gain hands on experience with cases before being thrown to the wolves.  However, these bridges are not always ideal to help bridge the gap.  Suppose an IMHA case comes in on the third week and the doctor who still owns the Monkees last album has one way of treating the case because it has worked well for the last thirty years.  The doctor who just did a summer internship a few years ago with some monkeys feels otherwise based on the recent literature.  So how do the vetted doctor and the new graduate come together to have one comprehensive medical philosophy for the hospital?

The answer is a symbiotic relationship that benefits everyone.  Plenty has been said about mentoring a new doctor.  It is easy to have good intentions and say that you will mentor a new graduate, but you have to put a structured plan in place to make it work.  A practice that is taking on a new hire probably is busy and can’t wait to unload some of the workload on the new doctor.  After doing a hundred cystotomies and hospitalizing fifty renal disease patients it is easy to forget how stressful that first one can be.  The younger doctor knows how to do these things, but may still have the first time jitters.  The vetted doctor needs to make sure there is time to talk through these cases, to scrub in during these procedures even if it just means you are going to hold a hemostat for an hour.  The vetted doctor’s presence will considerably raise the confidence of the new doctor and also allow her to see, “this is how I do it.”  In return the newer doctor will be more likely to adapt her medical practice in that fashion.  On the flip side, having the more recent graduate in the practice is the ultimate continuing education for the other doctors.  That doctor has come out of four years of schooling instructed in recent research and protocols.  Medicine is so rapidly evolving that there are many tricks the new doctor has in her bag for the other doctors to learn from.  Most of us in private practice don’t have time to review literature with our colleagues for several hours a week, but the new graduate has just been absorbing everything she can learn from that hotshot internal medicine resident at school.  So pick her brain and be willing to adapt just as she should be willing to continue to learn the practical application of what she has just learned the past four years.  You may find a new hybrid type of medicine is being practiced in your hospital, which is a good thing because a less than excellent standard of medicine can develop from one that does not evolve.