Letters to the Editor

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Preparing students for practice

Dr. Milligan's letter1 on the need for colleges of veterinary medicine to provide students an educational experience, including hands-on training, that will prepare them for general practice should be required reading for academic clinicians and veterinary college administrators. Education of interns and residents in the details of tertiary care should not, in my opinion, be the primary goal of in-clinic veterinary college training, and colleges that can't provide their students adequate in-clinic training in primary care veterinary medicine should make other provisions, without increasing educational time or student indebtedness. Primary care may not be as glamorous as tertiary care, but it is a basic need for our future colleagues and for most of the animal-owning public.

Eric Gonder, DVM

Goldsboro, NC

1. Milligan PJ. Preparing for practice (lett). J Am Vet Med Assoc 2019;255:1112.

Relief practice tips

I wish to comment on the recent JAVMA News story “Relief practice not just a temporary gig.”1 The information about relief practice as a career was well presented and thoughtful. Having practiced relief veterinary medicine for 5 years (after owning a practice for 40 years) at 4 different practices, working a total of 4 to 6 days each month, I wanted to provide some additional thoughts. Relief practice presents many unique situations that can be challenging. Keeping the following points in mind might help:

  • • If out-of-town travel is required, discuss housing arrangements and dining accommodations in advance with the veterinarian being relieved.

  • • If possible, arrive at the practice the day before you begin employment. Becoming familiar with the clinic layout, particularly where medications and supplies are kept, makes the first day less confusing.

  • • Arrange for a short meeting with the staff to introduce yourself and start to become familiar with staff members’ names and how they wish to be addressed.

  • • Be flexible and, to the extent possible, adopt the hospital's usual procedures and protocols, even if that necessitates mental adjustments on your part. There is enormous variety in the day-to-day management of veterinary hospitals.

  • • Understand that staff members may not recognize that there is more than one way to manage and treat patients and that imposing different ways of managing and treating patients, keeping patient records, or arriving at a diagnosis can affect staff in negative ways. Fitting into the environment of the practice is helpful.

One downside of relief practice is that you will not always be able to follow through to resolution of a patient's medical issues, leaving you wondering about the outcome of the case. Still, since I have retired from practice ownership, the ability to pick and choose when, how long, and where to practice has left ample time to pursue other interests. Not being burdened with managing staff, overseeing day-today hospital operation, or handling the numerous other distractions that come with hospital ownership is a major advantage to relief veterinary medicine.

Ed Wolff, DVM

Stevensville, Mont

1. Burns K. Relief practice not just a temporary gig. J Am Vet Med Assoc 2019;255:12141221.

More on depression

I want to thank Dr. Mertens for her clear and correct observations about chronic depression.1 I am currently 70 years old and have had chronic depression since my early 30s. One of the more difficult aspects of dealing with this disease has been that despite my professional successes, I have always felt like a failure in my personal life. I am fortunate that I have had friends and relatives who—without judgement—reached out to help me in those times when chronic depression became severe acute depression with suicidal ideation.

I remember that in the beginning, my doctors would not include in my medical record that I had chronic depression because doing so would have made getting medical or life insurance impossible. Selective serotonin reuptake inhibitors have been essential to managing my illness, and I have had the benefit of intervention counseling on several occasions during severe episodes. Throughout all this, I have been successful at hiding my depression from colleagues and clients, allowing me to prosper in my profession. If only I could have had that success in my personal life!

Depression is a disease no less than diabetes or renal failure and requires appropriate treatment, which, unfortunately, many veterinarians fail to receive. I have often felt that I was on a cliff edge in a great storm and that I might fall off into the great abyss at any moment. But through all that, I have survived.

Thank you, Dr. Mertens, for your detailed and concise comments about a mental illness that is all too common and often hidden from the public. I hadn't heard previously about remission, but your letter gives me new hope that I may no longer need to hide my embarrassment and fears from the world.

A. R. Williams, DVM

Acworth, Ga

1. Mertens K. Depression in veterinary medicine: a firsthand perspective (lett). J Am Vet Med Assoc 2019;255:13371338.

  • 1. Milligan PJ. Preparing for practice (lett). J Am Vet Med Assoc 2019;255:1112.

  • 1. Burns K. Relief practice not just a temporary gig. J Am Vet Med Assoc 2019;255:12141221.

  • 1. Mertens K. Depression in veterinary medicine: a firsthand perspective (lett). J Am Vet Med Assoc 2019;255:13371338.

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