Creative Disruption columnist Dr. Bob Lester is the chief medical officer at WellHaven Pet Health, a former practice owner and a founding member of Banfield Pet Hospital and the Lincoln Memorial University College of Veterinary Medicine. He serves on the boards of Pet Peace of Mind, WellHaven Pet Health and the Lincoln Memorial veterinary college. He is president-elect of the North American Veterinary Community.Read Articles Written by Bob Lester
If you asked me why veterinary practices have exam rooms, I’d have to admit that before now, I hadn’t given the question much thought. We certainly need exam rooms to examine pets, but do we need to examine pets in an “exam room”? Maybe not.
I’m not suggesting we get rid of exam rooms, but perhaps we should rename them “classrooms.” We certainly do more in the room than simply examine.
How would your team’s mindset change when asked to see Mrs. Smith and Fluffy in Classroom 2 instead of Exam Room 2? How would your client’s perspective shift after being welcomed into Classroom 2 instead of Exam Room 2? How would pet behavior change? How would your own?
This line of reasoning is not dissimilar to the one that catalyzed the shift from “waiting rooms” to “reception areas.” Calling out the most uncomfortable function of the room seems counterproductive. Maybe we should rebrand them once again and call them concierge or guest service rooms, but I wax tangential.
A Different Approach
As progressive veterinary professionals, we strive to partner with caring pet owners in order to provide their four-legged family members with longer and happier lives. To achieve that end, we spend our days, and sometimes nights, educating clients about great pet care. Isn’t a classroom a more appropriate place for these partnerships to begin, grow and thrive than an exam room? Classrooms inspire collaboration, learning, sharing and behavior change. Exam rooms evoke negative connotations that feel just the opposite.
A colleague I admire told me that in his practice-owning past, in an effort to better educate clients, he took a cartooning course. (Bear with me here.) He covered one wall in every exam room with a whiteboard and used it to educate/entertain his clients during every exam with cartoons teaching great pet care. His is one of the best examples I know of a classroom vs. exam room approach. Unsurprisingly, his clients loved it. I suspect that compliance, retention, pet lifespans, team morale and his bottom line all prospered as a result. Plus, he had a lot of fun.
Back to School
Veterinary schools, on the other hand, would benefit from more exam rooms and fewer classrooms. The North American Veterinary Medical Education Consortium cited “graduate career-ready veterinarians who are proficient and confident” as its No. 1 strategic goal — emphasis placed on “career-ready.” The vast majority of veterinary graduates wind up in some form of primary care clinical practice, so the most important consideration is how we better prepare future colleagues for career readiness, proficiency and confidence?
An idea (spoiler: not original): Focus on exam rooms and hands-on clinical skills, communication instruction, real-world primary care clinical interactions and practice management course work. Simple.
Good news. New veterinary schools require core curriculum training in communication, clinical skills, practice management and clinical rotations in real-world classroom settings. It seems as though academia is discovering value in moving students out of the classroom and into the exam room. Our future colleagues are graduating more confident and practice-ready, having spent more time in exam rooms.
What Did You Learn?
A quick rant: We, as veterinary professionals, are committed lifelong learners; it’s in the Veterinarian’s Oath. We know that our education didn’t stop the day we received our licenses. To ensure that, we are all competent and up to date, and our state veterinary medical examining boards are charged with assuring the public of our ability to practice at a minimum standard. State boards (on which I was privileged to serve) do this by means of requiring us to complete approved continuing education course work.
So, some vet professionals travel to a distractingly attractive destination like Las Vegas, Orlando, San Diego, D.C., Hawaii — you get the picture. Once we are there, a wide variety of topics relevant to maintaining our competence is offered. We attend (or not, if the pool/beach/casino call) courses offered in dark rooms, amid a sea of hard straight-back chairs during which brilliant minds give 45-minute PowerPoint presentations. I’d contest that anyone might have a tough time gleaning all the knowledge offered in this circumstance.
If we attended, did we in fact learn anything? Did our behavior change upon returning to our practice, our exam/classrooms?
Worse yet, which lectures do we typically choose to attend? Most often, we pick topics we are fascinated by and that correspond with areas in which we have high competency. As you might imagine, we have a telling tendency to skirt dull topics.
Do we approach our professional development by means of a gap analysis — comparing our actual performance to desired performance — and by intentionally attending lectures that help us fill in our professional gaps? Do we actively focus on the lacking areas? Do we attend lectures related to topics that when seen in our practice we generally defer to a colleague? (For me, it’s reptile cases.) Do we regularly get out of our comfort zones and challenge ourselves to tackle something we’re not good at? Have we developed any new skills or service offerings lately? I love to attend lectures on a variety of subjects, and there are a number of lectures I should attend in recognition of my gaps. Call me guilty.
Where We Go From Here
Recently, I heard a striking quote by the late Alvin Toffler, a futurist and author of the 1970 book “Future Shock”: “The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn and relearn.” Learn, unlearn and relearn — the hard part is unlearning. The learning part is easy.
The obvious solution is one I’m not ready to sign up for. (Color me hypocrite.) It’s periodic recertification. Every few years we would complete an assessment to demonstrate our ongoing competence and commitment to lifelong learning. The American Board of Veterinary Practitioners recertifies every 10 years. Kudos! ABVP-certified veterinarians are walking the walk. Am I ready to sign up for recertification? Heck no. I still have NAVLE nightmares. (Actually, I’m from the pre-NAVLE era, but the nightmares are the same.)
In the meantime, it’s up to each of us to embrace lifelong learning and treat practice as one big lifelong classroom experience. The good news is that life is an open-book test. Fortunately, ours is an honorable profession, and the vast majority of us love to learn. I may even attend a few reptile lectures this year. Or not.
A takeaway: Try renaming your exam rooms as classrooms for one month. See what happens. My practice is going to try it. I’m betting good things transpire. Let me know what happens.