Dr. Roark practices at Cleveland Park Animal Hospital in Greenville, S.C. He is a popular veterinary conference speaker and
a regular contributor to several veterinary publications and websites. He can be found on Twitter @DrAndyRoark and Facebook
Dr. Andy Roark
Ironically, one of the biggest weaknesses veterinarians have is directly tied to a key reason many of us enter this profession.
It's a trait that is also one of our greatest common strengths. Veterinarians derive great pleasure from addressing a problem
and fixing it. We may even feel a strong need to solve problems immediately. Few things are more gratifying than "fixing" an ill or injured patient. Making an immediate difference for a patient, and
for the people who love that animal, is energizing.
While this compulsion often drives veterinarians, it may also hold us back. Patients with Cushing's syndrome and other conditions
that require long-term care and ongoing communication with pet owners often do not have an immediate emotional pay-off. In
fact, it can be weeks before the earliest positive results are realized. These cases are marathons rather than sprints to
glory. The extended and involved nature of these types of conditions can be daunting, and many practitioners feel a subtle,
yet persistent desire to refer these patients away.
While some patients with advanced conditions do require referral to veterinary specialists, many cases, especially dogs with
canine hyperadrenocorticism, are well within the case management capabilities of general practitioners. They simply require
commitment from both the doctor and the client.
Correct the pitfalls that affect your cases
A 2007 review of treatment adherence in human psychiatric patients highlighted four predictors of treatment concordance problems
associated with clinician factors: poor doctor-patient relationship, poor explanation/communication, poor empathy, and inadequate
follow-up.1 By avoiding similar pitfalls in veterinary practice, we can improve patient care and successfully manage more of our canine
patients with Cushing's syndrome and other chronic diseases.
Strengthen the doctor-client relationship
Weak doctor-client relationships can lead to client mistrust and low perceptions of value in the services received. A demonstrated
long-term commitment to the resolution of a chronic disease such as Cushing's syndrome may be the single strongest medical
tool that a veterinarian can employ. Trusted doctor-client relationships can take time to build, and ideally exist before
a patient faces a diagnosis of a chronic disease. However, these relationships often must be forged as treatment progresses.