We are all perfectionists as veterinary professionals. We want to do our best and want the best outcome for every patient. And I freaked out easily at the beginning of clinical rotations when I started to deal with real cases just because I was so eager for so called perfectionism.
I had a patient that was clinically normal but had high liver enzymes. I wanted to do something immediately because I wanted those elevated values to be down to normal. Therefore, it was not surprising that I was very confused when the clinician advised the client to monitor their pet and have a recheck in one month. Why not do something right off the bat? I also had patients that were clinically normal but had somewhat low urine specific gravity. When the clinician asked me what was my plan, I immediately thought of a serum chemistry or at least a renal panel. However, what the clinician suggested was to keep an eye on the patient before we proceeded with any other tests.
Sometimes we are too eager to bring those values back to normal and might have ignored some medical common sense. When we are dying to bring those values back to normal, it’s wise to ask ourselves what the patient really needs. Is it a truly concerning value that warrants an immediate workup, and how do we maximize the benefit-to-cost ratio from the client’s point of view?
Just like one of the interns in our school says, trust the patient more than the machine. We are treating the patient, not the values. Values do not make sense unless taking overall clinical judgment into account.