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
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
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
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.
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
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
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
Three: Take stock.
Reflect; What are the long-term consequences? Above all, tell yourself the
Four: Force yourself if
you have to, for the only difference between a rut and a grave is the
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.
Bob Rogers, DVM