Monday, November 21, 2011

The Incredible (?) Dr Pol

Since I haven't seen a patient in weeks, I have no exciting stories to relay. On the other hand, I am curious as to how many of you guys are watching this National Geographic show? It is causing an uproar in the veterinary community.

If you follow my blog at all, you know I have a passion for high quality medicine, staying updated on current diagnostics and treatments, and generally practicing with compassion and integrity. I am passionate about being the best vet I can possibly be. I am also passionate about spreading the word regarding what veterinarians really do, how much training we undergo, how expensive our education is, and how important GOOD, competent health care is for your pets.

Thus, I am a little dismayed by the way the new National Geographic show portrays veterinarians. Don't get me wrong - Dr Pol seems like a compassionate, good man. He has been doing his job a long time. I am not bad-mouthing him. What bothers me is that he is very outdated in his methods.

Granted, this is a reality TV show. It is being twisted to portray things exactly as NatGeo wants them portrayed. I understand that. But when I see Dr Pol doing an orthopedic surgery (in this case, a femoral head osteotomy) without a cap, mask, or gown on, and minimal sterile surgical technique, I cringe inside. This is a major surgery in which the head of the femur is cut off. Infection is a very, very big concern. Further, this dog - undergoing painful, major surgery - was not even intubated or on anesthesia of any sort. Had this dog arrested during surgery, saving him would have been difficult to impossible without control of his airway and an IV catheter. There was also no evidence of any pain medication being administered.

This way of doing things is very, very out-dated and considered well below the standard of care.

So far, the show presents veterinarians in a very dismal light. In our clinic, patients undergoing surgery are on IV fluids, intubated so that we can breathe for them as necessary, provided with adequate analgesia, and absolute sterile technique is maintained at all times. Yet, Joe Average Pet Owner is unaware of this. Many owners see all veterinary care as equal. Dr Pol's show reinforces the idea that veterinary medicine hasn't advanced since the days of James Herriot and that we all do things in this "old school" fashion. The opposite is true.

Further, it reinforces the idea that all vets are in veterinary medicine strictly for the love of animals, that we practice substandard medicine that puts patients at risk, and that there have been no improvements in veterinary anesthesia and analgesia in the last dedcade. It's setting the perception of veterinary medicine back 50 years or more. There is no discussion of proper sterile technique, referral for complex cases, chemotherapy, digital xray, constant rate infusions (CRIs) for pain control, or any of the many, many advancements that have been made in all areas. We can do amazing things for animals, yet this show reflects none of that. For Pete's sake, I watched in amazement as he amputated a dog's tail in an exam room with minimal pain medication, no anesthesia, and NO sterile technique.

It's disheartening. Everyone loves "Good 'ole Doc." He's cheap, he's quick, and he's "old school." Unfortunately, old school doesn't usually benefit critically ill or injured animals. This was evidenced when he gave a nauled puppy a shot of steroid (absolutely NOT indicated in trauma anymore - in human or animal medicine) and left it in a cage. He described the dog as "in shock" - yet he provided no pain medications, IV fluids, or oxygen to stabilize the shock. He placed the puppy in a cage where it died. I treat this kind of thing on a daily basis, and a shot of steroids isn't going to fix a badly mauled animal. It was heartbreaking.

Anyone watching it? What do you think?

33 comments:

Fledgling said...

I hadn't heard of it (too busy studying to watch much TV), but found a couple clips after reading your post. The one I watched showed him removing porcupine quills from a couple of hounds. The thing that got me about it was that they didn't even recover the dogs in the clinic after sedating them...they just carried them still asleep out to the client's pickup and put them in the bed of the truck. I feel like that's asking for an anesthetic death.

Anonymous said...

Oh yes, I've watched it - and my eyes bugged out a few times. Sadly, I believe this sort of thing is not uncommon. The further out you get from the cities, the more likely.
A couple years ago, I called around vets re. getting a friend's cat declawed (yes, I know the controversy, she agonized over the decision and had reasons). It was amazing how little pain management there was. In many cases, none. Anesthesia protocols not so hot either in many cases.
People assume their animals are getting great care at vets. In some cases, they are. But having been in the back of quite a few practices, people would be appalled if they knew what went on at times.

Anonymous said...

Same anon here - I have watched a similar ortho surgery on a dog at a small animal practice with just gloves. I forget - might have been scrubs but I believe just shirtsleeves rolled back. No gowns or caps in the place - and this is not a country practice. I've talked to quite a few practices that have no opiates at all on the premises, no matter what. Ortho, eye enucleation, whatever - if they're lucky, they get an NSAID. One vet, for surgeries, owners can optionally elect for analgesia, otherwise the animal gets nothing. Sadly, Dr. Pol isn't the worst out there.
That puppy in shock that died - Dr. Pol did say something about pain medication, I don't know what kind. But yeah, no fluids, no nothing.
Another one that got me was that horse that was down - it was obvious the way it's leg was, and lying it's head down, that something was terribly wrong. Yet it was left to lay there, and bled to death.
He does seem a kind man, but...

Outrider said...

I haven't seen it, but from your description I'm appalled. It's telling that though he's a mixed practitioner, I don't see many horses featured other than the farm owned by the racing QH/APHA trainer.

My horse clients, including my racing clients, wouldn't tolerate this low standard of care. They're grumpy if I leave the CR processor back at my office, they take the scope and power float for granted, and they'd riot if I injected a joint without sterile prep and gloves. I'm truly afraid to see what Ol' Doc might do for a surgical colic or a septic joint. Personally, I did not become a veterinarian so I could obtain the personal phone number of every backhoe operator in my region. :-)

puppynerd said...

I haven't seen the show (no cable), but the standard of care you described sounds very much like that of the 'highly recommended' vets in our community. It took us a long time (and a long drive) to find a vet we were happy with after bouncing through many popular local docs.

It's definitely still out there, and some people apparently prefer it. Many of the people who we asked for referrals actually drive from the city to our rural town to get their 'old-fashioned country-style' vet care. Kinda scary and sad for the animals if you ask me.

Anonymous said...

I've seen dogs discharged unconscious also. Aside from the risk to the animal, I believe that's a public health risk.
Seriously, watching that show, I wondered how that vet wasn't worried about coming up before the board.
I was particularly struck by that puppy you mentioned - his theory was that he couldn't take it right to surgery, as it was in shock. So the steroids, some sort of pain medication (unless that was just the steroids) and cage rest were supposed to help it recover enough for surgery. Obviously not.

Elizabeth said...

I had never heard of him so I watched a few of his video's Good ole Doc.. he would not be operating on my animals.. Too many people don't know the difference between good medicine and bad medicine. It's scary and the fact NG promotes it makes is worse.

Anonymous said...

I live in central Michigan, and know Dr. Pol and his family. And I agree with everything each of you have said! There are vets in this area who have a much higher standard of care. I've worked for them! After I was laid off, several friends suggested I apply at Pol's, but I wouldn't work there. The only reason he has a show is because his son Charles is a producer in Hollywood - yes, the same Charles who 'assists' him in the first couple of shows. People here tend to be proud of the show, but I'm ashamed! Animals are treated better here in rural Michigan, at other vets!

foffmom said...

I haven't seen this (no TV since 1992 and proud of it!) but I would be appalled at the described level of care! My vets would never be so inept or cruel.

ERDOC said...

It's tragic, embarassing, and I'm disappointed in Nat Geo for picking this style of medicine to display on their show. Editing aside, you can see poor choices made over and over again.

I will not stand for this below-standard-of-care medicine. Having a low - cost option is fine, but not providing pain medications or appropriate treatments is unacceptable.

Would this be accepted if it was about a human physician who operated based on the standard of care of 20 years ago?? NO!

Nicki said...

I haven't seen it. Sounds like I don't want to

Anonymous said...

BAFVMD
The most incredible thing is that Dr.Pol hasn't been sued and lost his license. The mauled puppy left to die in a cage ?? It would have been kinder to euthanize it. I had to stop watching after seeing so much bad veterinary medicine. I'm a shelter veterinarian and we use inhalant anesthesia, pain meds and full monitoring during surgery. Did you see him taking rads with no gloves???

Anonymous said...

So I am an internship trained GP vet and found your blog by googling the show while I wad halfway through the first episode. I am shocked and saddened by the quality of care that Dr. Pol provides to his clients. I work in a large city but I would still imagine that country vets should still abide by general principles of sterility and pain management. I am saddened to think that clients may have visions of me performing major surguries under sedation with only a pair of clean gloves on. I feel sorry for his clients and patients for the way that they are treated. I also feel that this show sets our profession back several decades.

Anonymous said...

For example, in Minnesota veterinarians have been disciplined for not using appropriate pain management. I wonder, has anyone on the Michigan board watched this show? Will anyone make a complaint to them? I'm afraid that I hope so.
I feel bad for Dr. Pol, but that really is not standard of care. The puppy and the horse were really heartbreaking - any animal deserves better.

Outrider said...

I watched the first ten minutes of the first episode, which included an emergency with a down horse.

For starters, I don't allow anyone, especially not children, to approach a down horse on the side with legs. The risk that a horse might kick out or thrash is high; human safety should always come first in a large animal emergency. Second, lifting a live horse in the bucket of a tractor? Yikes! Has PLIT seen this footage? Third, any down horse has rabies unless proven otherwise.

Sadly, the horse died of an apparent pelvic or long bone fracture with associated laceration of a major blood vessel. Chances are good the ride in the tractor bucket contributed to the death of the horse, though this certainly wasn't discussed.

I couldn't watch any more. Horrifying.

Anonymous said...

As only an RVT, I was furious while watching. Even I know you place a puppy on oxygen and start IV therapy after an attack! It makes the average joe think pets die for no reason when really its neglegence. No sterility. His son "assisting " is a joke. DO THEY EVEN OWN AN ANESTHETIC MACHINE?? Remind me NEVER to go there if in that area!!!

Anonymous said...

This attack is completely unfair and unfounded. I am a client of Dr. Pol's and have been using him for over fifteen years. He's done several operations on my pets. Infection = 0, complications = 0. It sounds to me that the vet who writes this blog is all about cover your butt medicine. It's vets like you who charge 500 - 1000 dollars for an emergency call or 200 - 500 for a castration. When did owning an animal become just for the rich. I can tell you Dr. Pol has the don't call me Dr., I work for a living attitude about being a vet. It's a large reason that he has 19000 clients in a rural community. He is there because he loves his job, loves the people and loves the animals. He gives people an affordable option by weighing risk vs. cost to help give people a choice between paying the rent and doing the right thing for their dog or pet. You want your fancy lab coats, machines, masks, help yourself. Me I'll take the guy who doesn't need a bunch of fancy equipment to cover his ass. He does it right the first time. And people, who are you to judge the puppies care? Do you know that an iv wasn't administered off camera. Have you bothered to follow up on the animals chart. To sit there and judge Dr. Pol when you weren't there, couldn't see more than 30 seconds of television looking at the dog, to act like only if you were there you could save him, is terrible. You are all practicing arm chair medicine from your couch. Shame on you!!!!

Anonymous said...

You're worried about the cost. We're worried about the well being of the animal. Doing things at least according to standard of care doesn't have to cost a lot more. Sterile technique doesn't cost much of anything. Morphine is pennies. IV saline is very inexpensive. Sure, most practices don't have a heated table. But most of what we're talking about is not expensive at all.
A couple of operations without infection or complications mean nothing, as far as the quality of care at that clinic (of course, I am happy for your animals good outcome). But do you know if your animals had appropriate pain management? You can't tell by looking at them. Were they monitored appropriately during surgery? You probably weren't there to see. Did they get through it because of quality care, or good luck? Even doing it wrong, you don't get problems every time.
Having seen good vet care, it was very clear that what was happening on that show was not good. Seriously, he probably could be taken before the board. That puppy in the cage for example, probably that horse as well. And even lack of sterile technique for surgery.
If you haven't seen it done according to the modern standard of care, you probably don't realize what it should look like.
I am not a vet by the way, I am an owner, but I have been in the back of quite a few vet clinics, good and bad. That one is bad.
I do think Dr. Pol is a nice person, and probably well-intentioned. He's just very badly out of date. And vets are responsible for keeping current.

Anonymous said...

You're worried about the cost. We're worried about the well being of the animal. Doing things at least according to standard of care doesn't have to cost a lot more. Sterile technique doesn't cost much of anything. Morphine is pennies. IV saline is very inexpensive. Sure, most practices don't have a heated table. But most of what we're talking about is not expensive at all.
A couple of operations without infection or complications mean nothing, as far as the quality of care at that clinic (of course, I am happy for your animals good outcome). But do you know if your animals had appropriate pain management? You can't tell by looking at them. Were they monitored appropriately during surgery? You probably weren't there to see. Did they get through it because of quality care, or good luck? Even doing it wrong, you don't get problems every time.
Having seen good vet care, it was very clear that what was happening on that show was not good. Seriously, he probably could be taken before the board. That puppy in the cage for example, probably that horse as well. And even lack of sterile technique for surgery.
If you haven't seen it done according to the modern standard of care, you probably don't realize what it should look like.
I am not a vet by the way, I am an owner, but I have been in the back of quite a few vet clinics, good and bad. That one is bad.
I do think Dr. Pol is a nice person, and probably well-intentioned. He's just very badly out of date. And vets are responsible for keeping current.

The Homeless Parrot said...

Thank you, Anon - you summed that up beautifully.

Anonymous said...

Most of these comments leave me shaking my head. Having never lived in the city and having owned hundreds of different animals over the years I think most all of you have lost your minds. Dr. Pol looks to me to be a kind, caring, practical veterinarian. We're not talking about human care here. These are animals and while I am an animal lover, owning dozens right now including cattle, dogs & birds, one needs to be practical with the cost and kind of care administered. Your idea of "humane" treatment is what has been marketed by veterinarians who just like today's human doctors are way more interested in making money and covering their asses. I'll take Dr. Pol and his staff any day.

The Homeless Parrot said...

Anon - you are missing the point. I'm not even advocating expensive changes for Dr Pol. I'm advocating simple, inexpensive things he could do to better protect the animals and people he serves. Caps, gowns, and masks are cheap and would improve the sterility of his surgery.

Opioids like Dilaudid and morphine are insanely cheap (pennies for an injection) and could significantly increase the comfort of his patients.

I'm not advocating that every patient get chemotherapy for cancer, I'm advocating for simple things that improve animal care and outcomes.

You say they are "just animals," and I totally understand that mentality. However, if Dr Pol negligently killed one of your animals by not doing something as simple and inexpensive as intubating it for a surgery, how would you feel?

In this day and age, people demand excellent care for their pets. The best plan should ALWAYS be offered. If a client can't afford that, then plan B, C, and sometimes Z should be offered, so that the patient's suffering is relieved in some form. I absolutely believe in this approach to medicine. The problem is, Dr Pol doesn't offer Plan A (which many clients DEMAND). He offers plan Z from the get-go.

If you don't want to do chemo for your pet, fine, don't. I won't judge you. But that doesn't mean that another person doesn't want that option.

You are obviously not a reader of my blog, because you'd see that I care enormously about my patients and their owners, and I spend every single day thinking about how I can improve in every facet of veterinary medicine.

Recently, an owner brought me a very, very sick dog that needed an abdominal exploratory surgery. I knew he would likely die without it. They did not have enough money to do the surgery. Knowing the dog would die without it, I stayed 3.5 hours beyond the end of my shift (time I could have been spending with my newborn daughter) doing the surgery. In the end, I discounted close to $800 from the bill so that they could afford it. In other words, I DIDN'T GET PAID for those 3.5 extra hours (I'm paid on production), and I missed time with my daughter. For my patient.

Lastly, what's wrong w/ making money? I - just like you - have a family to support and bills to pay. Where does this idea that medical professional can't make money or need to make money or WANT to make money come from?

The Homeless Parrot said...

Anon - would you want your badly mauled puppy to get a shot of steroids and be placed in a cage to die? Or would you want to know about options like IV fluids, IV pain medications, and oxygen therapy to stabilize him? That puppy might have lived with any attention to proper triage and care.

IDrPets said...

To one of the Anonymous posters that wrote "Your idea of "humane" treatment is what has been marketed by veterinarians who just like today's human doctors are way more interested in making money and covering their asses."
Yes, I can understand why you don't care about proper health care for your animals. Obviously your animals do not mean much to you. YOU are not the type of person that cares about what your animals need. You care about what your wallet needs. Perhaps if you valued a few choice animals you'd appreciate that they deserve a much higher level of care then Dr. Pol offers. But don't blame me for careing dearly for my pets and patients. Yes there is a higher cost associated with conscientious veterinary care. The greater the level of care offered the greater the expense. That's typical in most fields, not just veterinary care.

Anonymous said...

I spoke to someone on a veterinary board (unfortunately not Michigan) - I happen to know them, didn't make a complaint or anything. That person was going to watch the show (recorded). I'll be very interested to hear their impression.
(Same anon as earlier - the one who likes modern vet care)

Kate said...

Besides the animals' medical situations, which are sad and terribly out of date, the fact that this man is (even loosely) connected with a university and "teaches" students is scary. The university should eliminate him from the clinical rotations based on the completely backward and CRUEL methods shown. No one enters vet med to become rich: we do it because we love both medicine and animals. Those that enter the clinical side of the profession also love the relationships that they develop with the clients and pets. While Dr. Pol seems to love clinical practice, he has made some critical mistakes. The first is neglecting to keep up and the second is to advertise this on TV. Every time he violates OHSA laws and the standard of practice on TV, a visual record of his low standard of care is out there for everyone to see. Maybe this will affect some of his pending board complaints.

Anonymous said...

Kate,

You say pending complaints. Does that mean you know of some?
Interesting.

saveabull said...

I'm an LVT in NY. I'm watching this show for the first time and I'm stunned. This doctor may be well intentioned, but his methods are very old school. The puppy "in shock" would almost certainly have survived in the clinic where I work. He would have had several techs working on him, likely would have had 2 IV caths in place and fluids started even before a vet made it to the treatment room. I'm amazed this show is still being shown...it only makes our jobs more difficult.

Anonymous said...

This man should retire,his medicine is barbaric

Anonymous said...

Well I answered some of my own question - I looked up Dr. Pol on the Michigan site. He has not beene disciplined, but does have open formal complaints against him. It doesn't say how many.

Anonymous said...

I think it's safe to say we're not in it for the money: look at the cost of vet school!

I have not seen this show, but I heard that there is a new one coming out with NBC. Hopefully that one will be better. It's supposed to be a comedy, but hopefully it still sets a better example.

Anonymous said...

Well this is good news for me - looked on the Michigan site for Jan Pol and...

Probation 05/26/2012
Fine Imposed 05/26/2012

Anonymous said...

I'm glad people picked up on the travesty that is this TV show! I was one of those high-falootin' vet students who had the "privilege" of shadowing Dr. Pol for 3 weeks during school. I would address my comment to the person who felt compelled to come to his defense:

There is no defense. Look, he may be a decent, God-fearing family man, but I know you base your defense solely on the fact that his services are cheap. But I can also tell you that he can be a cantankerous type A personality, who is liable to not be such a "sweet ol' Doc" if anyone dare challenge him to practice a standard of care worthy of the 1980's, let alone 2012.

You asked if owning pets is now a privilege only of the rich? No. But it is a privilege of the intelligent and responsible, and finding the best deal for your pet's care is not synonymous with responsibility. We veterinarians have spent the better part of the last two centuries trying to get our profession taken seriously, and we are bound by oath to continue our education and update our skills and practices accordingly. As it was pointed out, practitioners like Dr. Pol could modernize their practices 20 years for just pennies on the dollar.

But sometimes stubbornness and cantankerousness (not to mention laziness) can get in the way of that.