So, I am going to talk about what separates the good from the bad. Some pertains specifically to ER medicine, some to both GPs and ER. I'll elaborate as I go.
A good veterinarian does a full physical exam - whether at an annual exam for vaccines or at a sick patient exam. This is a head-to-toe exam that should include listening to the heart and lungs, feeling all the lymph nodes, palpating the abdomen, examining the head and mouth, a rectal exam, a full set of vitals, and a weight.
There are 12 important things that can be learned from a rectal (such as the presence of malignant rectal cancer or prostatomegaly in older pets). So if your vet isn't checking there, request that they put on a glove and find the lube.
A good (especially ER) veterinarian takes a thorough history and listens carefully while doing it. This includes any medications your pet is currently on or that you might have administered at home, any previous medical history whether related to the current problem or not, and a myriad of other questions.
A good veterinarian recommends diagnostic testing for a problem with no obvious cause. If the owner cannot afford diagnostics, a good veterinarian will carefully select the safest treatment that will be the most efficacious.
A good veterinarian vaccinates on a 3 year schedule. It is well-known and accepted in veterinary medicine that yearly vaccines are not necessary or healthy, and that they may contribute to the development of immune disease in cats and dogs.
(I won't say that bad veterinarians vaccinate yearly. It is taking the veterinary community a long time to come around on this subject, and many otherwise excellent veterinarians are still doing once a year vaccines. Become informed before having your pet vaccinated yearly! Know what vaccines are required by law (rabies), recommended for your animal's particular lifestyle (such as FeLV/FIV for outdoor cats), and know what is not recommended.)
A good veterinarian is a member of
VIN or another continuing education/learning site, is interested in getting help with cases from colleagues, and refers when a case is not going well and could use the services of a specialist (owner finances allowing, of course). Many good vets aren't members of VIN, but I believe one hallmark of an interested, informed veterinarian is a VIN membership (or the equivalent for large animal and other non-small animal veterinarians).
A good (GP) veterinarian offers overnight care to any ill, post-operative, or injured animal - especially if they are painful, require IV fluids, or any monitoring. Many owners cannot afford this, but the offer should always be made.
A good veterinarian keeps excellent, legible records. Whether hand-written or typed, they should follow a general SOAP format : subjective (physical exam, history, overall patient assessment), objective (hard data such as labwork, xrays, etc), assessment (differential diagnosis, other recommended testing), and plan (medications prescribed and administered, fluids given, etc). Every day an animal is in the hospital, a new SOAP should be done. If another veterinarian can't clearly follow the notes and understand them (or READ THEM, in some cases), your pet could suffer the consequences.
A good veterinarian will inform owners if a mistake that affects their pet's health or safety has been made.
What do I think is not necessarily an indicator of a good veterinarian?
Bedside matter doesn't mean doodly-squat, to be perfectly frank. I know some well-loved veterinarians that are complete and total quacks. I also know some harsh, abrasive doctors that are excellent clinicians.
** Addendum: I meant to say that bedside matter does not necessarily correlate with capability as a doctor. I know some very cold fish doctors that are brilliant. If your vet doesn't mesh with you...but does a good job, I would personally choose to stick with that - but that's just me.
Your veterinarian should be concise, explain any medical problems clearly, have a list of possible differentials if the cause for illness is unclear, and a clear plan of attack for treatment and further testing. We don't always have the answers, but a veterinarian should be up front about that. Owners should know that we don't always know either - but we will try our darndest to figure it out. If not - you should be given a referral.
A good veterinarian selects excellent pain control for any procedure that is painful. Butorphanol ("torb") is no longer considered acceptable premedication for a painful procedure. Studies have shown that its analgesic properties last only about 30 minutes to an hour. A pure mu opioid (like hydromorphone, morphine, oxymorphone, or fentanyl) should be coupled with a sedative/tranquilizer like acepromazine, Valium, Domitor, or midazolam for pre-medication/pain control.
A good veterinarian has someone monitoring anesthesia during surgery. This includes monitoring blood pressure, oxygenation, end-tidal carbon dioxide, and heart rate. More importantly - the PATIENT should be monitored - gum color should be checked, pulses periodically assessed, and auscultation of the lungs and heart should be done.
A good veterinarian takes the time to educate owners on the "whys" of preventative care, diagnostic testing, and treatment plans. This may extend to giving owners hand-outs with information that they can take home to read. (I do this frequently, as diagnosing disease in the ER can be very stressful for owners, and they do not always fully absorb information.)
I could go on in this vein for hours on end, but this is a good starting point. Let me know what you guys think...what have you found has been most important to you in a veterinarian - and what has turned you off most about a veterinarian?