Saturday, 30 June 2012

Two steps forward, one step back...

After a fairly good couple of weeks, with great comments from the insurance ombudsman and potentially promising developments on research here, I got an email this week that brought me back to reality.

I'd had a fairly typical enquiry from someone wanting to send their horse here. As usual, I need vet consent and the owner wanted me to talk to the vet about our rehab first.

That's always something I'm happy to do, so the owner passed my number to the vet.

I realised we might have an uphill struggle when it took the vet 2 weeks to call me. Fair enough - maybe he had more important things to do, but it was the owner who was paying his bills (and who had to chase him several times).  Eventually he did ring me and we were on the phone for a while; I sent him the research info, abstracts and detail on the horses who have been here previously.
I updated the owner and waited for him and the vet to speak.

10 days later (!) I had an email telling me that the vet wouldn't agree to the horse coming here because he wasn't convinced by the science behind our rehab!

I must admit, I have never had this sort of response from a vet before and I was pretty astonished. I don't think vets (or anyone else!) are entitled to pick and choose whether they want to be convinced by science - its either proven or its not!

Bear in mind that the vet's preferred line of treatment wasn't some fantastic new therapy but 6-9 months' box rest and remedial farriery (both of which the owner was understandably objecting to, both of which have a much lower success rate for returning horses to work than our rehab).
As the saying goes...

20 comments:

dreams579 said...

just to play devils advocate slightly, not being convinced byt the science, and questioning it, is what all scientists do and its what helps push the knowledge forward. admittedly, the vet here isn't doing that, but it is perfectly within his right to not be convinced by it.

what he's not entitled to do, is push that belief onto the owner and block the owner's wishes in bringing their horse to you. ultimately, the course of treatment must be what the owner wants and agrees to, as you say, they are the ones paying the bills and ultimately, they (and the horse) will have to be the ones to live with the decisions. a vet should only advise a certain course of treatment - they don't have to agree with the owner's decision.

amandap said...

Interesting. I wonder if he is convinced by the science of heart bars etc? lol

I do get frustrated when people try to argue that science is required to explain what they are seeing before they will accept it or at least give it a go.

amandap said...

ps. Wonder what 'science' says about the development of a horses body and hooves standing or (usually tight) circling for months on end in box rest? Oh and what about science and a horses mental state on months of box rest?
Does 'science' reveal any negative effects of box rest? As with remedial shoeing... is there any?

Neets Human said...
This comment has been removed by the author.
Neets Human said...

mmm time to start looking for a better vet.. If vets start losing clients because they are blocking the best course of action they may start waking up.

NB post above deleted for typo ;)

Nic Barker said...

Emma, he can believe the earth is flat if he wants to... ;-)

amandap said...

The thing is an approach such as Rockley's isn't going to do any harm but what harm could possibly be done by highly interventionist, medical model approaches? Just look at the surgery described on the last but one blog entry comments! A horse spends 99.9% of it's life on it's feet, how can such a radical approach be managed postoperatively without further serious medical and chemical intervention for pain relief alone?

So many people, both professional and non professional fail to grasp the ability of hooves to try to heal themselves if given the right environment and comfortable appropriate exercize.

Barbara said...

Not just vets, human doctors too can be determined to be blind to even consider something different than the previous (and unsuccessful) treatment. This owner now has a problem. Find a different vet who is interested in alternatives or let the closed minded one tell him how to spend his money and treat his horse. I know what my decision would be.
And I would have much more respect for the vet if he said
'In my opinion I don't see how this can help, but it's your horse, if you want to try it - do it.'
or some similar degree of professionalism.

Writergirl said...

That is just terrible! Any chance the owner could fire the vet and get a second opinion / referral from a more reasonable one? So sad to think of this lost opportunity...!

lytha said...

Amandap: "the science of heartbars" OMGosh *ROTLF* good thing I just swallowed my Hawaiian Punch, I may have messed up this laptop!

Nic Barker said...

Amanda and Lytha - my thoughts exactly :-)

Barbara - totally agree, and I never mind vets being sceptical or wanting to withhold judgement.

Sarah Wilson said...

I would be finding myself another vet. This one is entitled to their opinion but the owner doesn't have to agree and is perfectly entitled to a second opinion.

It sounds very much like their mind was made up before they even spoke to you Nic. Smacks of sheer arrogance to me.

Jassy Mackenzie said...

I found myself looking around for the Like button under your comment, Sarah Wilson!

Jassy Mackenzie said...

and the other point is: what harm could 3 months of barefoot possibly do, compared to the systemic devastation and associated risks of 6-9 months of box rest? Isn't "first do no harm" one of the most important points of the veterinary creed and is this vet not forgetting it?

Clare said...

This kinda thing makes me so angry! When will they get it through their heads that are horses are more than just attractive field ornaments. Surely you have enough research to show this does work !?! Doh!

M's mum said...

""... And I would have much more respect for the vet if he said
'In my opinion I don't see how this can help, but it's your horse, if you want to try it - do it.' ...""

^^^^^ THIS!!!! ^^^^^ So totally agree!! Where do these so-called professionals get off, blocking outright what an owner wants to do, especially when the approach at Rockley can so obviously do no harm, and potentially do a whole MASSIVE heap of good. I just hope that as the years go by and more of the old-school horse vets are pensioned off (!), that the new generation of vets are more open-minded to different approaches. I think I can see this happening in my corner of the world (both my horse's vet and vets I work with) so fingers crossed. I really hope this horse's owner is brave enough to seek a second, more open-minded opinion.

Nic Barker said...

Agree with all the comments - and glad it wasn't just me :-)

M's mum - it was actually a very young vet, which perhaps was the issue (ie lack of confidence). I've found the more experienced vets are the easier they find it to understand what we do ;-)

M's mum said...

That's really interesting Nic - of course, you're totally right that inexperience/lack of confidence could be a huge issue, I hadn't thought of that at all. Confident enough to say 'no' though, which is such an enormous shame. :0(

amandap said...

The worrying thing is a young vet may well be sticking to what they are taught!

Lytha, never mind the lap top that would have been such a waste of Hawaiian Punch. lol

cptrayes said...

I wouldn't mind if there were any properly conducted trials with big enough numbers and the control group required to be statistically valid, to prove that his preferred treatment will work. But there is none. Not one study exists that has any level of statistical confidence that would satisfy a scientist.

So why is he happy to go with one lot of anecdotal evidence, and not another.

Eeejit.

Can you refer the poor owner to a more pro-barefoot vet in her area that she can get a "second opinion" from?

If you can't, ethically, can one of us?

C