Where being the advocate for your pet is our primary concern.
Finding the courage to embrace truth and manage change

Veterinary Medicine has one of the best public images of any profession. Now for the first in our lifetime we face a difficult ethical challenge, that of revising our vaccination recommendations. We say light-heartedly that half of everything we learned in Vet School was wrong; we just don’t know which half. Although most Veterinarians enjoy a challenge, it is always difficult to make a transition from what we thought we knew and were comfortable with, to  new and less familiar ways of doing things. Most organizations like most people tend to resist change.

A recent column about change by Denise Thornby RN, President of the American Association of Critical Care Nurses, can serve to inspire us, and remind us that we are not the only ones to face the difficulty of change.  The reality is that our knowledge of medicine and our healthcare system will continue to evolve and change.  We must be open to challenging our thinking and perceptions so that we can see the choices available to us, in order to progress to a better way of helping our patients. If we are to achieve an improved outcome for our patients, we have to acquire the information needed, go forward, and occasionally step out of our comfort zone. We not only have the choice, we have the responsibility, an obligation to our patients to provide the most up to date medicine we humanly can.

Hopefully the choice is easy to take the high road, to obtain and implement new knowledge. Thornby points out that Courage is the power to let go of the familiar. Each of us has the power to change – to change our perceptions, to change our understanding, and to change our recommendations.

Managing change and transition is not easy, even if the change is positive. Even if it means we benefit financially. But what if it means we don’t benefit financially?

I am the first to admit when faced with changing my vaccination recommendations I experienced the same reservations, and yes, even fear and anger, just as many of you. “The experts must have overlooked something,” I said. We all experience the same fazes when faced with change. Then I got a grip on my anger and disbelief and did some research.  I found out the studies have been done, and although nothing is ever completely without a little pocket of unknowns, enough is known to warrant change. I was shocked to find that there are no studies that show antibody titers wane with time for certain diseases. I was shocked to find that no studies have been done to show that re-administration of MLV vaccines like distemper and parvo actually  “boost” the immune system. In fact, studies show they have no effect.

Let’s try to learn from some examples of how others have managed ethical challenges that necessitate change.

Edsel is a name that, to my generation, is synonymous with failure. When I was twelve, if you wanted to insult someone you might say, “ Your dad bought an Edsel. “ Fortunately for me, my dad bought a Nash Rambler. Edsel’s failure wasn’t just because the front grill of the Edsel looked like a horse collar. Every other car that came off the assembly line was a Fairlane and every other car was an Edsel. Workers were confused and made mistakes. In 1960 Ford did the ethical thing. They responded to the dismal performance of their product without explaining themselves, but with an offer to buy back all Edsels as a trade in on any Ford product along with a $300 discount.

Since that time I have always been fascinated by how organizations and corporations handle mistakes, embarrassments, and change.

In 1994, when it was discovered that Pentium chips made a mathematical error in division once every 27 thousand years, Andy Grove at Intel did not go into denial. He did not say to his customers, you don’t need a new chip, this won’t affect you, or our chips are not that bad. He replaced chips for anyone who wanted one, and he fixed the problem with Intel’s future chips. Today there are new chip manufacturers with chips that are probably just as good as Intel.  Intel still has its position and prestige intact. Many customers would prefer an Intel chip because their integrity was tested and they stood behind their product. Their response, instead of working against them, served to enforce their truth, Intel makes good products and stands behind them.

Several things made Intel different; #1 They were in a business that was used to change, #2 Their CEOs were not in a fortified palace where news of the real world had to penetrate layers of people from the periphery.  # 3 Andy Grove made a decision to deal with the problem in an ethical and far sited manner, regardless of the cost. When placed on the defensive they could turn on a dime. They recognized that what had worked in the past would not work in the present.

In the Eighties many Dentists had the idea that there was mercury in our old lead fillings. Even my high-school friend and racquetball companion (a dentist) tried to tell me I needed all my fillings removed and replaced. He probably believed that, although no scientific data existed to support that recommendation. The American Dental Association said this mercury theory was not true, but many Dentists persisted in this practice. Finally government agencies had to intervene. Dentists have survived this bump in the road along with many others.

Then there is the Catholic Church with their problems with child molestation. They tried to cover up. They denied how serious the problem was. After twenty years of moving abusive priests around they were dragged into court and before the press. Then they fought among themselves over how to deal with the problem.  Now another bad decision, they are contemplating bankruptcy to limit liability. The result: contributions are down 30% and new organizations are arising from within to take control of the money. Worthy projects are being stopped because of lack of trust. A Cardinal resigned.

There was the tire separation and rollover fiasco. While Ford and Firestone pointed fingers, blamed each other and hired lawyers to try to slither their way out of liability, the credibility of both companies was destroyed.

I n contrast, the South Carolina Fire Marshals realized that Firemen had omitted a lot of arson. They took charge and said,” We have a problem and we are going to address it.” With a little hard work in only one year the number of arsons attributed to firemen was reduced from thirty per year to three.

Our profession has not reduced the number of vaccine associated fibrosarcomas in the 10 years we have known about the problem.

The Veterinary profession could learn from these examples. We are harming pets by causing fibrosarcomas, possibly hypothyroidism and IMHA. The research has been done to support reduced vaccination recommendations. More importantly research shows that unnecessarily repeating vaccines has no effect. The AVMA Council on Biologic and Therapeutic Agents concluded that no research exists to support our present prevailing recommendations.  Drs like Ford, Schultz and Wolf have presented the data and made persuasive arguments with persistence and dignity. After 7 years less than 7% of Veterinarians have changed. I feel it is fair to say many refuse to listen.

I have filed complaints about Veterinarians giving unnecessary vaccines. I am truly saddened that my complaints have been necessary. I do not think Veterinarians are intentionally committing fraud. I am not asking that anyone be punished.  I do not want to see our public image degraded. I picture myself as being like that one insurance clerk that brought the issue of tire separation to the forefront. This is a wake up call.  Look at how long others and I have tried to work within the system. Ask yourself if the public has a right to know the truth and make informed decisions on their pet’s health.

I am open to suggestions on how to evoke change. I will remain committed. I will not be drawn of center by angry remarks. I will not respond to accusations or attacks on me personally. This issue is not about me. I intend to confine my comments to sharing of scientific data only. Feel free to ask me about the science behind what I have said, but do your homework first. If you can point out that something I have said is inaccurate, show me the data and I will be open to change.

The AVMA, State and Local VMAs have circled the issue because it is unpopular.  From articles in magazines from Dog World to Readers Digest the public knows more about this than our leaders. Moral leadership and far- sited businessmen have failed to appear to lead our profession through this tough time. We have one of the best public images of any profession. Are we willing to prove we deserve it?

Rosalynn Carter said;” A leader takes people where they want to go. A great leader takes people where they don’t necessarily want to go, but ought to be.” I pray every day that a great leader will emerge from within our profession. All I can do is make waves.

I am asking Veterinarians to get the facts and make an informed and open-minded decisions. Compromise is good as long as it is recognized that it is a compromise. One Issue of the JAVMA should be devoted to a review of the literature. How about having a CE Course on VIN on Vaccinations by people like Dr Alice Wolf, Dr Margie Scheck and or Dr Ron Schultz?

Williams Bridges, in his book, Managing Transitions points out that before we can make transition we must leave our comfort zone, travel through a time of unsettledness, and then finally arrive at a new beginning. We go through times of mixed messages, one step forward and one step backwards, to finally arrive at a new beginning. I know that for most of us, the more we research the data available, the more easily we will realize a path that is clear.

Bridges recommends these strategies to reduce the stress.

One: Avoid the neural zone. Avoid taking the path of least resistance. You feel that change will never end so you want to avoid it or - If change is so good, … you go first.

 Two: Take timeouts. Take more time to take care of yourself, and you will have more energy to manage transition.  

Three: Take stock. Reflect; What are the long-term consequences? Above all, tell yourself the truth.

Four: Force yourself if you have to, for the only difference between a rut and a grave is the forward motion.

Fifth: Be proactive. Read, and be prepared for the fact that what you learn is not always what you expect. If you have not learned to surf the Internet now is the time. Go to www.Ivis.org and do a search for articles by Ron Schultz.

Last: Spend time with people who empower you to be the best you can be. Avoid the nay- sayers, the angry and reactive, and those in denial. They expect very little of you.  Keep the vision you had when you first started out to be a Veterinarian.

You have a choice and a voice in the future of our profession. I know you didn’t ask for this, but you are a Veterinarian, this is your profession, and this is in front of you. You could make a difference.

Sincerely,