On Thursday Oct 15, 2011, I paid a visit to my mentor, a
senior vet. I asked if he has an X-ray of urinary stones
in the cat as I had not seen one in over 30 years of
practice. He said that cats usually suffer from urinary
sand and he had none. At that time, he showed me an
X-ray of the Chihuahua with at least 10 urinary stones
stuck in the os penis. The bladder was full due to
urethral obstruction and there were no radio-dense
stones seen in the bladder. A younger vet had
referred this dog to him. Well, this is the type of
surgery with wounds that are difficult to heal sometimes
and so it is wise to refer to this senior vet.
"Do you use urohydropropulsion by syringing saline to
flush back the stones to the bladder and then remove
them from the bladder?" I asked him, just in case I can
get some tips from his long hours spent in veterinary
medicine and surgery. He is likely the most experienced
vet in Singapore as he puts in the long hours over 40
years of practice when many vets would have been burnt
out or work short hours.
Obviously the most efficient and simple way is to cut a
hole into the urethra behind the penile bone and take
the stones out. Then stitch up the urethra. Where the
complications come in is that the urethra does not close
properly and the male Chihuahua will leak urine through
this hole, soiling the apartment floor. If the healing
is good, the male dog pees normally.
"No point opening up the bladder as there are not stones
seen inside," he said. "The bladder is full and any
stones inside may not be visible but are likely to be
small."
On another matter, I was surprised when he asked me
whether the presence of 50 veterinary practices nowadays
can be supported by the number of dogs and cats.
He said: "30 years ago, there were only 5 practices -
myself, Deveraj, Cho Chak Nam, Animal Clinic and The
Veterinary Surgery. I estimated that the number of
dogs have increased twice but the number of vet practice
has increased 10X. Many dog owners did not license their
dogs in the old days. What do you think (of the impact
of so many vet practices)?"
"I estimated that the number of dogs would have
increased at least 3X based on the number of licences
issued and the fact that micro-chipping of dogs is
compulsory and enforcement action for unlicensed dogs,"
I replied. "Some newer vet practices will not be
profitable as prices will have to be below costs for
such practices in order to attract clientele.
"However, Singaporeans tend to go for proximity and
therefore, convenience and affordable costs will bring
some business to the new practices and with good
personality, some of the newer practices will do very
well. Experience and white hairs don't count for most
Singaporeans. It is proximity and personality of the
younger vets."
I was surprised to see a notice on his reception counter
educating members of the public not to be abusive
towards his staff. Such notices have been put up by the
Singapore General Hospital some 2 years ago but no
longer seen and are put up in some government offices or
statutory boards like the National Library Board.
Life must be more stressful for some members of the
public nowadays such that they become abusive at serving
staff. Three Sundays ago, I was on the receiving end of
the abusive dog owner who made an appointment to consult
Dr Vanessa. He was rude and shouting inside the
consultation room where Dr Vanessa and I were present
while Dr Vanessa examined his dog's paw. Dr Vanessa kept
mum and I left the room, forgetting about the behaviour.
At the end of consultation, this man forced his way into
the Surgery room where I was consulting with another dog
owner and shouted at me to go to the back of the
practice and pay him for advice as to what's wrong with
my management of Toa Payoh Vets. He was loud and his
adult son pulled him away. Such type of clients should
be banned and I told Dr Vanessa how to handle such
clients in the future. If she keeps silent, she
encourages repetition of anger and abuse to me and the
staff, except to herself.
Another of Dr Vanessa's client, a young Indian man,
punched his fist into the gypsum wall of the
consultation room when his family members and him were
performing rites on his old dog with oral tumours. The
dog had just been put to sleep by Dr Vanessa and the
family had prepared some flowers and funeral
paraphernalia for the farewell ritual and to wait for
the cremation man. Dr Vanessa left the room to attend to
another dog at the kennels. I was at the reception area.
Suddenly, there was a loud explosive bang on the wall
separating the reception from the consultation room. I
went inside the consultation room to investigate the
bang and since the family was grieving, I did not raise
any complaint about the damage.
You can see the dent on the wall when you enter the
consultation room of Toa Payoh Vets.
I spoke to Dr Vanessa recently about these two clients
of hers. In my 30 years of veterinary practice, I had
not encountered such rage. I told her that she had to
let such clients know that their behaviour is not
acceptable by me, the Principal. If she keeps silent,
such behaviour will continue.
"What will you do?" she asked me. "I don't talk to them
about their behaviour but focus on consultation."
Well, such anger was not directed at her in the first
place. In fact, she was the doctor in charge and
consulted. But ignoring such misbehaviour is not good
for the team as she obviously cannot work alone. If the
vet does not care for the team, the vet should not be
accredited to work at Toa Payoh Vets. This is my policy.
This is how she should handle this matter.
I said: "Ask your client courteously - 'Is there some
deficiency in my veterinary services to you? How may I
help you to improve our veterinary services?"
This is better than keeping silent. I am prepared to ban
such abusive clients from Toa Payoh Vets even if they
say Dr Vanessa is the best vet in Singapore! Poor anger
management is very dangerous to veterinary staff as some
angry males do assault and kill. So, it is wise that the
Principal or the associate vet know how to handle such
clients. Putting up "educational notices" on the walls
of Toa Payoh Vets telling clients not to abuse staff is
not the answer, in my opinion. This is because the vast
majority of Toa Payoh Vets clientele is excellent. The
abusive ones make up 1% of the clientele and so I don't
permit such "educational notices" to be put up.
The younger generation is into a new golden age of the
internet. Those that can manage their anger will
prosper. As for those that cannot, the service providers
will shun them and not provide them any services if they
think that "cash is king" and that they are masters of
the universe.
TOA
PAYOH VETS
