Wear your stethescope … and use it!

When I became a member of this profession in 1956, practitioners never wore a stethescope. It was considered pretentious. Stethescopes were kept in a drawer or, at most, hung on a peg on the wall, and used when a thoracic problem was presented.

I opened a practice in a community with a very large and varied animal population, but one which had never had a resident veterinary practitioner. Livestock owners usually knew how sophisticated our training was, but most small animal clients had no idea. I was often called “Mister Miller,” asked if I  “had to go to school to be a vet” and even asked if a correspondence course was available.

Starting out with a strictly house-call mixed practice, I was frequently asked if I planned to open a “shop.”

TV programs showing veterinarians at work didn’t exist then.

Although the valley did not yet have any MDs, the public knew of their training and respected them.

I decided to emulate the physician’s image. So I worked by appointment, something extremely rare then. I wore a white medical smock. My nearest neighboring colleague wore an apron. There was only one straight small animal practitioner in our county back then. The rest of us (about a dozen in a huge rural county) did mixed practice.

I wore my stethescope and I soon found myself using it on every patient I saw, even if for a rabies shot. Stethescopes back then weren’t nearly as efficient as today’s, but the more I used mine, the more I could hear.

I learned that in order to recognize the abnormal, one must be thoroughly familiar with the normal. Eventually I began to detect unsuspected abnormalities in apparently healthy animals, such as an early cardiac murmur.

This inspired me to make an ophthalmoscopic examination part of every routine physical. The variations possible in a normal retina can only be recognized after seeing hundreds and hundreds of eyes.

The same concept applies to abdominal palpation and thoracic percussion, to palpation of the lymph nodes and examination of the mouth and throat.

Thoroughness is the mark of the skilled clinician. 

 

Comments




  • My first job was in a very rural part of Virginia in the 80's.  I routinely saw MBB's (mauled by bear) or HBT (hit by train).  I had a particularly backwoods client bring in a hound dog with a long list of problems.  As I looked in the ears the client remarked "Golly, that is just like a reglar doctor!"  As I used the stethoscope I got the exact same comment.  So of course I had to grab his dog by the testicles and instruct the owner to have his dog "turn his head and cough".

    cheapskate, 5 years ago | Flag

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