Tough decisions: Why is Veterinary Medicine Difficult?

One of the main reasons that Veterinary Medicine is considered such a stressful occupation is that there are so many difficult decisions to make. Some are life and death, and some are as simple as refilling a pet's medication. The questions start the minute that we walk into the door each morning. Questions like, "Doctor, can we squeeze in one more appointment today?" "Will you look at this pet's record to approve medications?" "Does this tooth need to be pulled?" "Is this blood work ok to do surgery?" "Do I need another suture to close this incision, or will it be ok?”  And the questions from clients, 

"What kind of food should I feed my puppy?" "Why does my dog lick his feet?”, and "What should I do about treating my cat's recent illness?" 

When we are continuously making decisions day-to-day, it can become overwhelming. The weight of the constant barrage of difficult decisions causes a type of decision fatigue. It is like overworking a muscle when you lift weights — at some point, our muscles will fatigue. Our decision-making "muscle," our brain, starts to tire and may even quit working properly like a spent muscle. We have such a responsibility to our patients and clients to make the best decisions for the pet's health and collaborate to help them make the right decisions for their families. 

 

Here is an example that created multiple decisions from this week at Warren Woods Veterinary Hospital.  

Saturday, during a busy workday, we had a plastic Rubbermaid container left on our doorstep, sealed with duct tape and containing a very young, terrified pregnant cat. She had fleas, tapeworms, and giardia (an intestinal parasite). She was abandoned with a note written in sharpie on the container's lid to please find her a home. We realized that she was pregnant as soon as we saw her and confirmed it with an abdominal ultrasound exam. Now we have decisions to make. Do we keep her until she has her kittens, spay her before she has them, turn her over to animal control to take care of her, how do we treat her worms and fleas without harming her kittens? Where do we keep her that will be low stress in a busy veterinary hospital?  

So many difficult decisions and responsibilities just because someone cowardly dumped her on our doorstep. Caring for a cat-like this takes money, time, and resources. We are not an animal shelter, but sometimes people treat us like one. What to do?

Are there ways that we can improve our decision-making ability and protect ourselves from decision fatigue?

Create routines and delegate simple decisions. If you set some rules and guidelines for your team, you can decrease the number of questions asked. We have a system for refilling prescriptions so that refills can be ok'd ahead of time for a year. There are protocols for blood testing, vaccine recommendations, and surgery protocols to make it easier for the team to stay ahead without asking for permission. If your team knows your morals, values, and the rules of the practice, they can make some of the decisions without involving you in every little thing. 

Schedule your day and decrease your options. If you always wear the same thing or pack the same lunch, it will reduce the brainpower needed to start your day. Have a routine that you follow each morning, so there is no reason to make any decisions. Leave at the same time and take the same route to work. Answer your email only once per day for a limited time, and have a specific scheduled time to make phone calls.  

Don't second guess yourself. There are no perfect decisions, so once you decide, try to move on to something else. Try not to rehash each choice to predict if you made the "right" decision. Self-doubt will create confusion that adds more decisions and creates stress. Just make a well-thought-out choice, take a breath, and vow to move on. 

The solution to difficult decisions is to retain your capacity for decision-making. The less energy spent on more minor choices will increase your ability to deal with the unexpected. You will be more confident and decisive if you avoid fatiguing your decision-making muscle. 

We kept the cat.

Dr. Julie Cappel