Fear Free Practice With It You ll Thrive, Without It, You Might Not Survive Dr. Marty Becker

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Ralph Stewart
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1 Fear Free Practice With It You ll Thrive, Without It, You Might Not Survive Dr. Marty Becker I ve been a practicing veterinarian for over 35-years and I ve seen three previous transformations of significance: 1. Feline Medicine I grew up on a family farm/ranch in rural Southern Idaho. In that environment, cat and veterinarian didn t belong in the same sentence (would be as odd as smoking and healthy). By and large the vast majority of cats with barn cats, lived in the haystacks or were outside cats. Very few ever went to a veterinary hospital for treatment and even fewer for preventive care. Eventually veterinary medicine realized that cats, too, were beloved pets, weren t just small dogs, that they were a separate species that needed their own meds, dosages and treatment protocols. 2. Dentistry Circa my graduation in 1980, dentistry consisted of the occasional ultrasonic teeth cleaning and a lot of pulling rotten teeth. Talk of prevention was rare. Then came veterinary dentists and the blossoming of dental care with a focus on prevention (daily oral care), digital dental radiographs, dental suites and advanced therapy. 3. Pain management Have pity on this profession that for so long, we ignored the existence of and consequences from pain in pets. Thankfully, we started to focus on pain, developed multimodal pain management, and made the prevention or relief of animal pain or suffering a priority. Of course, feline medicine is limited to cats that receive veterinary care (still far to few). And although 80% of companion animals have dental disease by the age of three, the majority of pets suffer in silence with a mouth full of inflammation and infection. Pain management is widely offered, but this only helps with pets that have pain (trauma, joint or disc disease, post surgery). The most important transformation in the history of companion animal medicine is here now. And rather than just affecting a species or a condition, this initiative involves every pet, every veterinary visit, every practice, every day, forever. This make or break transformation is creating Fear Free veterinary visits. The polar opposite of a fad, Fear Free has become a practice imperative if you re going to thrive, or even survive. Too strong of a statement? Far from it. You should fear not being a Fear Free veterinarian, technician, hospital team member or facility. Why? Because pet owners can see, hear, feel if you re Fear Free and can measure success. Before Fear Free, companion animal practices largely competed on location, convenience, curb appeal, quality of medicine and price. Of these, the most subjective is quality of medicine. You ve heard it said a dozen ways, hundreds of times, but it s literally impossible for a pet owner to judge the quality of medicine. How do they know inside of the incision that did a better job of surgery than someone else. Or that another veterinarian could have removed that carnassial tooth with much less trauma, or done a much better job of cleaning out infected ears. Fear Free is different and a differentiator, because pet owners can easily tell at every moment-of-truth (outside the hospital front

2 door, in reception area, exam room, interaction with technician and veterinarian, getting preventive care) whether their pet is calm or anxious/stressed/fearful. Our profession, and increasingly pet owners, are coming to understand that maladaptive fear is the worst thing a social species can experience and that it causes permanent damage to the brain. And that going to a veterinary practice (or grooming or boarding) where the pet will experience fear, is causing repeat, severe psychological damage to the pet. Conversely, taking a pet to a facility that looks after both the pet s physical and emotional wellbeing, is better for both the pet and the pet owner. The Bayer Veterinary Healthcare Usage study showed conclusively that the #1 reason people weren t taking their pets to the vet as often was because of the stress to the pet. And #3 was stress to the pet owner taking the stressed pet to the veterinarian (#2 was money btw). So in providing a Fear Free experience for the pet, you can eliminate two of the top three reasons people aren t taking pets to the veterinarian. More pet owners visiting the veterinarian for their pet s accidents, illnesses and preventive care means everybody wins. The pet gets optimal care. The pet owner is doing the best job possible as the surrogate. The practitioner and hospital team member get to practice at a level that s rewarding (financial success and emotional wealth). The practice thrives. Not only can pet owners measure if their pet is fearful or Fear Free, there is going to be a big push in the very near future to education pet owners on how they can provide their pets with a more Fear Free home environment, how they must work with the veterinary team to deliver a calm pet to the practice, and where they can find veterinarians and veterinary hospitals that are certified Fear Free. For individuals and facilities that remain fearful, many will wither and some will die. For those that embrace the necessity of looking after the physical and emotional wellbeing of pets (plus pet owners and team members), they are going to thrive.

3 Apples & Oranges: Significant Differences between Fear Free and Fearful Veterinary Practices Dr. Marty Becker There are three things I can pretty much predict someone will say every time these situations arise: 1. Cute baby in sight. I ve always loved children and, like everyone else who sees a baby, I always say in a syrupy sweet voice, Ahhh.she s so cute! The baby could be wrinkled, bald, and spewing pablum, and we still say the same thing. 2. Pets lower blood pressure. Since veterinary school I ve been privy and partner to the human-animal health connection and wrote an award winning book on the subject called The Healing Power of Pets. When doing the initial book tour in 2001 and every time since then, when the book s subject title comes up, 7 out of 10 people say, I hear pets lower blood pressure. It s like that s the only benefit of pet companionship anyone has ever heard of. 3. Fear Free veterinary practice. I ve yet to speak on this subject without at least several members of the audience assuring me, We ve been doing Fear Free for years. In some ways, yes, they have, but in most of them, no, they haven t and here s why. Starting in the late 1980s, working with famed veterinary behaviorist and inventor (Gentle Leader) Dr. R.K. Anderson, we tried to become All Treat Veterinary Hospital vs. All Pain Veterinary Hospital by deploying treats at every moment of truth in a veterinary exam or procedure. Yes, this helped reduce anxiety and stress for pets, and is a component of a less-stress visit, but it wasn t Fear Free. Fear Free is a multimodal approach to removing or reducing anxiety/stress/fear triggers, mitigating these same factors when they arise, and always having the pet s emotional wellbeing in our hands (along with physical wellbeing). Let me contrast a Fear Free (FF) practice with one that remains fearful for pets, pet owners, and the hospital team: 1. Primary focus. The North Star for a FF practice is the emotional wellbeing of all stakeholders (pet, pet owner, practitioner, practice team). In a fearful practice, the focus can be medicine, money, or both. 2. Hiring. FF practices hire for attitude and genuine care and compassion for pets and people. They re looking for that special 1 out of 10. Fearful practices hire for performance above all, and pay little or no attention to attitudes of compassion in their team members.

4 3. Harmony. Fearful practices care more about getting the job done than the emotional environment of the business, out front and in back. Fear Free practices know both pets and people can easily detect, and are put off or made anxious by, stressful interactions among members of the hospital team. 4. Design. In the fearful hospital, design is all about curb appeal, efficiency, durability, safety and cost. The FF practice has colors that please pets and people, use high coefficient of friction floor coverings, use a lot of soundproofing, have species-specific exam rooms (some have species-specific treatment areas), and have the ability to isolate pets who are hospitalized for procedures or treatment from pets who are currently being treated or examined to minimize the viral spread of fear. 5. Where pets are parked. In the fearful hospital, appointments are booked without thought, and in doing so aggressive pets can be side-by-side with fearful ones, dogs with cats, or new puppies with hyperkinetic, emotionally damaged pets. Fearful hospitals pack the schedule and the waiting area with nervous pets and people. Fear Free practices utilize the exam rooms (with enough rooms and the technology) for checking pets in-and-out, bypassing that stewpot of stress called reception. If there aren t enough rooms or the technology, FF practices have pet owners check in (leaving the pet in the vehicle) and then go back outside and wait with their pet in the vehicle or outdoor area until it s their turn to be seen. 6. Pace. Fearful hospitals are all about auguring the pets through the system to help as many animals medically as possible. More pets = more money. FF facilities are all about smart scheduling (looking how to minimize stress for individual pets and people), being more relaxed, working to remove or reduce excessive noise, and not being afraid to delay or stop a procedure if fear flares. 7. Exam. In a fearful facility, almost every pet is put up on the exam room table for exams and procedures. In FF, the pet is given the choice of where to be examined and treated (on the table, floor or lap). 8. Hold still. To examine ears, eyes, wounds, or to draw blood or give vaccinations, fearful practices using restraint, which is designed to protect the healthcare provider. FF practices use Gentle Control or Stress Less handling, which are designed to protect both the pet and the person. 9. Sedation. In fearful practices, sedation is rarely used and is thought of as a last resort. Sedation is a resort reached for early and often in a Fear Free practice. FF practices have a saying, If you can t abate (as in anxiety/stress/fear) then you must abate (with sedation). 10. Records. It s all about the medical record in a fearful practice, whereas in the FF practice, there s a great medical record but it s bookend is a great emotional record. It includes things like the anxiety/stress/fear triggers for this unique pet and pet owner; where the pet likes to be examined; what Gentle Control method works best; what treat

5 the pet likes best, what tricks the pet knows, with cue words; what products (compression garments, chill pills, pheromones, sedatives) work best with this pet. So just as not every baby really is the cutest one every born, and pets do so much more than lower blood pressure, Fear Free is not about adding treats and a warm bedside manner to your get er done veterinary strategy. And you can take that to the bank, fearlessly guaranteed!

Fear Free Practice With It You ll Thrive, Without It, You Might Not Survive Dr. Marty Becker

Fear Free Practice With It You ll Thrive, Without It, You Might Not Survive Dr. Marty Becker I ve been a practicing veterinarian for over 35-years and I ve seen three previous transformations of significance: