Veterinarians vs. MDs

Discussion in 'Health and medical' started by Tristan Miller, Feb 24, 2004.

  1. Greetings.

    Who would be more qualified in dealing with typical trauma operations, a veterinarian operating on
    human patients or a regular medical doctor operating on animal patients?

    To make this question a bit more objective, let's roughly set out some definitions and assumptions:

    1) By "qualified" I mean the average success rate of the operations. That is, a low incidence of
    physician error leading to complication/aggravation of the injury or patient mortality.

    2) By typical trauma operations, I mean common serious emergency injuries such as knife and bullet
    wounds, internal injuries caused by falls, etc., which would lead to death or serious
    disfigurement if not treated.

    3) Assume both the veterinarian and MD are trained and experienced in general surgery for trauma
    patients for their respective fields, but not for each other's fields.

    4) Assume the animal patients are only common mammalian housepets (cats, dogs, ferrets, rabbits) --
    no birds, reptiles, exotic mammals, or farm animals.

    5) Assume the operations are being carried out with access to a full range of both medical and
    veterinary supplies (drugs, instruments, etc.) and assistants (who are not allowed to provide
    coaching to the doctor).

    If I had to hazard a guess, I would say the veterinarian would be more successful since they must
    have a broader education and experience with varying anatomies; they should be able to extrapolate
    from what they know of all the different animals they treat and apply that knowledge to human
    physiology. On the other hand, an MD, while they may have had some surgical practice with lab
    animals, may not be able to anticipate some important subtle variations among the different species
    they would be expected to treat.

    Regards, Tristan

    --
    _ _V.-o Tristan Miller [en,(fr,de,ia)] >< Space is limited / |`-' -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
    <> In a haiku, so it's hard (7_\\ http://www.nothingisreal.com/ >< To finish what you
     
    Tags:


  2. "Tristan Miller" <[email protected]> wrote in message
    news:[email protected]...
    > Greetings.
    >
    > Who would be more qualified in dealing with typical trauma operations, a veterinarian operating on
    > human patients or a regular medical doctor operating on animal patients?
    >
    > To make this question a bit more objective, let's roughly set out some definitions and
    > assumptions:
    >
    > 1) By "qualified" I mean the average success rate of the operations. That is, a low incidence of
    > physician error leading to complication/aggravation of the injury or patient mortality.
    >
    > 2) By typical trauma operations, I mean common serious emergency injuries such as knife and bullet
    > wounds, internal injuries caused by falls, etc., which would lead to death or serious
    > disfigurement if not treated.
    >
    > 3) Assume both the veterinarian and MD are trained and experienced in general surgery for trauma
    > patients for their respective fields, but not for each other's fields.
    >
    > 4) Assume the animal patients are only common mammalian housepets (cats, dogs, ferrets, rabbits)
    > -- no birds, reptiles, exotic mammals, or farm animals.
    >
    > 5) Assume the operations are being carried out with access to a full range of both medical and
    > veterinary supplies (drugs, instruments, etc.) and assistants (who are not allowed to provide
    > coaching to the doctor).
    >
    > If I had to hazard a guess, I would say the veterinarian would be more successful since they must
    > have a broader education and experience with varying anatomies; they should be able to extrapolate
    > from what they know of all the different animals they treat and apply that knowledge to human
    > physiology. On the other hand, an MD, while they may have had some surgical practice with lab
    > animals, may not be able to anticipate some important subtle variations among the different
    > species they would be expected to treat.
    >

    Last Wednesday, I did an upper GI endoscopy on my 10 year old golden retriever for a fishhook in the
    stomach - the veterinarian had neither the equipment nor the expertise/training to do it himself.
    The dog was abdominally distended, listless, and anemic.

    As it turned out, the source of bleeding was not the fishook, but a ruptured spleen secondary to a
    hemangiosarcoma, which we found at exploratory laparotomy. The vet asked me to scrub since he hadn't
    done a splenectomy since vet school. I did the case. My observation of his operative skills led me
    to the conclusion that he was no better surgeon for major cases than a human family practicioner.
    The dog is recovering very well, although the ultimate prognosis is unknown until we get the path
    report back.

    Mammalian anatomy is pretty constant. While I am sure that there are vets that are skilled surgeons,
    those skills vary considerably by training and experience and it is clear to me that your average
    vet does not have the skills or knowledge necessary to do major operations, such as for trauma, on
    animals OR humans. Neither do family practicioners. If you're talking about a general surgeon vs
    your local veterinarian, the answer is obvious IMHO.

    HMc
     
  3. "Howard McCollister" <[email protected]> wrote:

    >If you're talking about a general surgeon vs your local veterinarian, the answer is obvious IMHO.

    Of course, but to compare apples to apples you need to consider a surgeon at a major vet practice or
    teaching hospital. (The OP did specify equal experience.) Few local vets do a lot of major surgery
    these days; it's turfed off to specialists just as it is in human medicine.

    Surely the technical and medical issues are indistinguishable, so if ethical and "value of life"
    issues are ignored, what makes one better equipped to handle variations in anatomy and physiology?
    It must be the vet since his training and experience has involved multiple species from day one.
     
  4. "Carey Gregory" <[email protected]> wrote in message
    news:[email protected]...
    > "Howard McCollister" <[email protected]> wrote:
    >
    > >If you're talking about a general surgeon vs your local veterinarian, the answer is obvious IMHO.
    >
    > Of course, but to compare apples to apples you need to consider a surgeon
    at
    > a major vet practice or teaching hospital. (The OP did specify equal experience.) Few local vets
    > do a lot of major surgery these days; it's turfed off to specialists just as it is in human
    > medicine.
    >
    > Surely the technical and medical issues are indistinguishable, so if
    ethical
    > and "value of life" issues are ignored, what makes one better equipped to handle variations in
    > anatomy and physiology? It must be the vet since his training and experience has involved multiple
    > species from day one.

    The whole concept of Chevy mechanic working on a Ford, and vice versa, and which is better, is
    pretty silly and has no practical application. Nevertheless, to play the game...if you are talking
    about birds or turtles, then I concede that your typical general surgeon would have no clue.
    However, bird anatomy is irrelevant to human anatomy so the ability to operate on a bird is in no
    way germane to this thread. If you are talking about variation in mammalian anatomy and physiology,
    then I contend that a veterinarians experience of operating on dogs, cats and pigs certainly doesn't
    make him or her any more qualified to operate on a human than a general surgeon's human training and
    experience makes him qualified to operate on dogs, pigs or cats. Those variations don't represent as
    wide a gulf as one might think.

    One should also bear in mind that the vast majority of general surgeons complete their training
    having operated many times on various mammals, whereas I sincerely doubt that any vet has ever
    operated on humans. I have, many times over the years, done various operations on dogs, pigs, cats,
    goats, sheep.

    General surgeons typically spend 6 years learning their trade after medical school (including a year
    in the animal lab), as opposed to veterinarians who go into practice right out of school. The most
    disparaging remark a surgeon can make to another surgeon relative to technical skill is to ask them
    where they got their veterinary training. This is because the lack of formalized surgical training
    leads to deviations from the technique standards taught to general surgeons.

    The original question would have more of a point if there was standardized formal programs for
    training veterinary surgeons. As it is, the number of veterinary surgeons competent to do major
    operations on animals, let alone humans, is very low, especially outside of the relatively few vet
    schools around the country. If you *were* able to find a veterinarian with equal training AND
    experience, then I would agree that he or she would very possibly do just as competent a splenectomy
    on a human as the general surgeon could do on a dog, pig or cat.

    HMc
     
  5. poboxdc

    poboxdc Guest

    Tristan Miller wrote:
    >
    > Greetings.
    >
    > Who would be more qualified in dealing with typical trauma operations, a veterinarian operating on
    > human patients or a regular medical doctor operating on animal patients?
    >
    > To make this question a bit more objective, let's roughly set out some definitions and
    > assumptions:
    >
    > 1) By "qualified" I mean the average success rate of the operations. That is, a low incidence of
    > physician error leading to complication/aggravation of the injury or patient mortality.
    >
    > 2) By typical trauma operations, I mean common serious emergency injuries such as knife and bullet
    > wounds, internal injuries caused by falls, etc., which would lead to death or serious
    > disfigurement if not treated.
    >
    > 3) Assume both the veterinarian and MD are trained and experienced in general surgery for trauma
    > patients for their respective fields, but not for each other's fields.
    >
    > 4) Assume the animal patients are only common mammalian housepets (cats, dogs, ferrets, rabbits)
    > -- no birds, reptiles, exotic mammals, or farm animals.
    >
    > 5) Assume the operations are being carried out with access to a full range of both medical and
    > veterinary supplies (drugs, instruments, etc.) and assistants (who are not allowed to provide
    > coaching to the doctor).
    >
    > If I had to hazard a guess, I would say the veterinarian would be more successful since they must
    > have a broader education and experience with varying anatomies; they should be able to extrapolate
    > from what they know of all the different animals they treat and apply that knowledge to human
    > physiology. On the other hand, an MD, while they may have had some surgical practice with lab
    > animals, may not be able to anticipate some important subtle variations among the different
    > species they would be expected to treat.
    >
    > Regards, Tristan
    >
    > --
    > _ _V.-o Tristan Miller [en,(fr,de,ia)] >< Space is limited / |`-' -=-=-=-=-=-=-=-=-=-=-=-=-=-=-
    > = <> In a haiku, so it's hard (7_\\ http://www.nothingisreal.com/ >< To finish what you

    Answer: "regular medical doctor"
     
  6. In <[email protected]>,
    Vet in NZ <[email protected]> wrote:

    *My answer would in general probably be the human doctor, not because of the *doctors skills but
    because of animals greater ability to withstand trauma *and cope with surgery better than humans. At
    least I feel this is true for *cats and dogs. If the patient were a bird however I believe the
    doctor would *be in trouble!

    ...

    You have a point.

    This reminds me. I was at a county-health-department-sponsored CE meeting recently, and the MD
    director of the department made several comments to the effect that if a disaster should arise, he's
    calling us all (referring to the vets in the room of course) to act as physicians, because we won't
    have enough physicians in the event of true emergency. He went on to specifically state that if his
    arm were hanging off, and the MD surgeons were all off doing brain surgery, he would want one of us
    to sew his arm back on (because we're all SOOOOOO skilled with microvascular surgery, right?). He
    further exclaimed that as a young, new graduate physician in Vietnam, he had no business removing
    bullets and such from people's lungs, but he did it because he was there and no one else could, and
    it went fine, and if we had to step up to the plate and do it we could too. I'm not sure all of us
    were entirely comfortable with this thought :).

    Dr. Dubin can confirm, I'm sure :)

    --
    hillary israeli vmd http://www.hillary.net [email protected] "uber vaccae in quattuor partes
    divisum est." not-so-newly minted veterinarian-at-large :)
     
  7. Josh

    Josh Guest

    <[email protected]> wrote in message
    news:[email protected]...
    > Tristan Miller wrote:
    > >
    > > Greetings.
    > >
    > > Who would be more qualified in dealing with typical trauma operations, a veterinarian operating
    > > on human patients or a regular medical doctor operating on animal patients?
    > >
    Alternate question- who would win in a fight between a lion and a gorilla? Answer: one lives on the
    savannah, one in the cloud forest, so we'll never know.
     
  8. Josh

    Josh Guest

    "Howard McCollister" <[email protected]> wrote in message
    news:[email protected]...
    >
    >>
    > The original question would have more of a point if there was standardized formal programs for
    > training veterinary surgeons.

    I would say that the American College of Veterinary Surgeons (http://www.acvs.org/flash.html) might
    have something to say about that statement, as would the folks who do a residency to get boarded.

    >As it is, the number of veterinary surgeons competent to do major
    operations on animals, let alone
    > humans, is very low, especially outside of the relatively few vet schools around the country.

    Your citation, please? I googled "competant veterinary surgeons" and "number of" and didn't get
    anything specific.

    >If you *were* able to find a veterinarian with equal training AND experience, then I would agree
    >that he or she would very possibly do just as competent a splenectomy on a human as the general
    >surgeon could do on a dog, pig or cat.
    >

    Your "equal" there is fallacious. A veternarian with equal training and experience would be an MD
    who went through a human surgical residency. A veterinarian with comperable training and experience
    would have gone through vet school and a veterinary surgical residency (after the rotating
    internship, of course). There's a bunch of those, and amazingly enough there's more outside of vet
    schools than in. I'd bet a number of them would be willing to take you on, but they wouldn't,
    licensure being important to making a living and all.
     
  9. "Howard McCollister" <[email protected]> wrote:

    >One should also bear in mind that the vast majority of general surgeons complete their training
    >having operated many times on various mammals, whereas I sincerely doubt that any vet has ever
    >operated on humans. I have, many times over the years, done various operations on dogs, pigs, cats,
    >goats, sheep.

    I find this the best point you've made, but at the same time it highlights the point that mammalian
    A&P and surgical techniques are all very similar.

    Where I think you're wrong is your assumptions about veterinary training and equating your local vet
    with all veterinary surgeons. Your local vet is no more an example of the state of the art than the
    average family practice physician is in human medicine. You should visit one of the major veterinary
    hospitals sometime; I think you would be surprised.
     
  10. [email protected] (Hillary Israeli) wrote:

    >have enough physicians in the event of true emergency. He went on to specifically state that if his
    >arm were hanging off, and the MD surgeons were all off doing brain surgery, he would want one of us
    >to sew his arm back on (because we're all SOOOOOO skilled with microvascular surgery, right?).

    John Hasler's right. In a mass casualty incident, no one will be getting their limbs sewn back on.
     
  11. "Carey Gregory" <[email protected]> wrote in message
    news:[email protected]...
    > "Howard McCollister" <[email protected]> wrote:
    >
    > >One should also bear in mind that the vast majority of general surgeons complete their training
    > >having operated many times on various mammals, whereas I sincerely doubt that any vet has ever
    > >operated on humans. I
    have,
    > >many times over the years, done various operations on dogs, pigs, cats, goats, sheep.
    >
    > I find this the best point you've made, but at the same time it highlights the point that
    > mammalian A&P and surgical techniques are all very similar.
    >
    > Where I think you're wrong is your assumptions about veterinary training
    and
    > equating your local vet with all veterinary surgeons. Your local vet is
    no
    > more an example of the state of the art than the average family practice physician is in human
    > medicine. You should visit one of the major veterinary hospitals sometime; I think you would be
    > surprised.

    5 or 6 years ago we took one of our other golden retrievers to the University of Minnesota vet
    school. She was a puppy then, and needed two triple pelvic osteotomies to correct bilterally
    dysplastic hips. I talked at length with the vet orthopedist, reviewed the xrays, discussed the case
    at length (I wanted to know exactly what I was investing $3000 in). I was very impressed with his
    knowledge, his professionalism, and his plan. He was clearly an expert and I felt our dog (and my
    $3000) was in good hands. The OR facility at the U of M was likewise excellent.

    So, I was somewhat taken aback as I observed his operative technique. It was clearly not at the same
    level of meticulousness and respect for tissue that had been part of my training, nor that of my
    partner orthopedic surgeons whom I observe occasionally. Now, that dog 6 years later is perfect.
    Those two operations were completely successful and she runs like crazy without any hint of
    arthritis. My wife (horse person) tells me her gait is a little funny, but I don't see it and it
    absolutely does not impair her activity in any way. I was and am very impressed with the U of M vet
    school. We have had other dealings with them with other animals we own, all of which have only
    confirmed my impression of their excellence.

    Nevertheless, I must agree with one of the previous posters here that dogs seem to be substantially
    more resilient to operative trauma than humans and I think this observation must be reflected in the
    operative technique used by even these veterinary surgeons who reside at the pinnacle of that art.
    It wouldn't fly in humans (reflected by my postion in this thread), but I sure don't argue with the
    results when a veterinary surgeon operates on a dog.

    Could a human surgeon do as well operating on a dog? Sure. As we have established, the variations in
    anatomy and physiology are not that big a deal, but more to the point, there would never be a
    penalty for being overly meticulous in any operation. That is not true of casual tissue handling
    when operating on a human.

    HMc
     
  12. In <[email protected]>,
    Carey Gregory <[email protected]> wrote:

    *[email protected]y.net (Hillary Israeli) wrote: * *>have enough physicians in the event of true
    emergency. He went on to *>specifically state that if his arm were hanging off, and the MD surgeons
    *>were all off doing brain surgery, he would want one of us to sew his arm *>back on (because we're
    all SOOOOOO skilled with microvascular surgery, *>right?). * *John Hasler's right. In a mass
    casualty incident, no one will be getting *their limbs sewn back on.

    Hey, it's not like I *want* to try to sew someone's limb back on! I'm just reporting what the county
    health department guy said :)

    --
    hillary israeli vmd http://www.hillary.net [email protected] "uber vaccae in quattuor partes
    divisum est." not-so-newly minted veterinarian-at-large :)
     
  13. On Mon, 23 Feb 2004 21:15:53 +1300, "Vet in NZ" <[email protected]>
    wrote:

    >My answer would in general probably be the human doctor, not because of the doctors skills but
    >because of animals greater ability to withstand trauma and cope with surgery better than humans. At
    >least I feel this is true for cats and dogs. If the patient were a bird however I believe the
    >doctor would be in trouble!

    Damn, that's what I wanted to say! Dogs, cats, even rabbits recover more quickly than humans during
    routine spaying and neutering. I'm not saying their pain thresholds are any greater, I'm just saying
    that there seems to be less recovery time.

    Therefore, it would make sense that animals are able to recover more quickly after surgery, and as
    such, be able to withstand more traumatic injuries, pound for pound, than a human. Although I
    wouldn't dream of letting a MD operate on my rabbit, because their choice of anesthetics might end
    up killing the little fella.

    Children are also more able to withstand trauma, from my understanding.
    --

    candeh
     
  14. <[email protected]> wrote in message
    news:eek:[email protected]...

    > Children are also more able to withstand trauma, from my understanding.
    > --

    Yes and no, mostly no. Children, given their smaller size, are more susceptible to heat loss, blood
    loss, and volume changes than adults. Changes in such parameters that would not be a big problem for
    an adult can have grave consequences in children.

    HMc
     
  15. Anonymous

    Anonymous Guest

    <[email protected]> wrote in message
    news:eek:[email protected]...
    > On Mon, 23 Feb 2004 21:15:53 +1300, "Vet in NZ" <[email protected]> wrote:
    >
    > >My answer would in general probably be the human doctor, not because of the doctors skills but
    > >because of animals greater ability to withstand trauma and cope with surgery better than
    > >humans. At least I feel this is true for cats and dogs. If the patient were a bird however I
    > >believe the doctor
    would
    > >be in trouble!
    >
    > Damn, that's what I wanted to say! Dogs, cats, even rabbits recover more quickly than humans
    > during routine spaying and neutering. I'm not saying their pain thresholds are any greater, I'm
    > just saying that there seems to be less recovery time.
    >

    I'm not sure I want to know how you became familiar with recovery times of humans during routine
    spaying and neutering. :)

    Bill

    > Therefore, it would make sense that animals are able to recover more quickly after surgery, and as
    > such, be able to withstand more traumatic injuries, pound for pound, than a human. Although I
    > wouldn't dream of letting a MD operate on my rabbit, because their choice of anesthetics might end
    > up killing the little fella.
    >
    > Children are also more able to withstand trauma, from my understanding.
    > --
    >
    > candeh
     
  16. Anon

    Anon Guest

    On 2004-02-24 07:17:31 -0500, Tristan Miller
    <[email protected]> said:

    > Who would be more qualified in dealing with typical trauma operations, a veterinarian operating on
    > human patients or a regular medical doctor operating on animal patients?

    This is one of the *stupidest* threads I've ever read. Isn't this question basically like asking if
    Superman and Batman got into a fight, who would win? You people are giving this topic *way* too
    much thought.
     
  17. "anon" <[email protected]> wrote in message
    news:2004022521513175249%[email protected]...
    > On 2004-02-24 07:17:31 -0500, Tristan Miller <[email protected]> said:
    >
    > > Who would be more qualified in dealing with typical trauma operations, a veterinarian operating
    > > on human patients or a regular medical doctor operating on animal patients?
    >
    > This is one of the *stupidest* threads I've ever read. Isn't this question basically like asking
    > if Superman and Batman got into a fight, who would win? You people are giving this topic *way* too
    > much thought.

    Ahhh. A cold splash of sanity. Thanks....I...needed that...

    HMc
     
  18. "Howard McCollister" <[email protected]> wrote:

    >
    >"anon" <[email protected]> wrote in message news:2004022521513175249%[email protected]...
    >> On 2004-02-24 07:17:31 -0500, Tristan Miller <[email protected]> said:
    >>
    >> > Who would be more qualified in dealing with typical trauma operations, a veterinarian operating
    >> > on human patients or a regular medical doctor operating on animal patients?
    >>
    >> This is one of the *stupidest* threads I've ever read. Isn't this question basically like asking
    >> if Superman and Batman got into a fight, who would win? You people are giving this topic *way*
    >> too much thought.
    >
    >Ahhh. A cold splash of sanity. Thanks....I...needed that...

    Well, of course it's a dumb question! But on sci.med, where 80% of all posts are from people whose
    haldol needs to be increased significantly, it at least has some entertainment value.

    Oh, and Superman would definitely kick Batman's ass.
     
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