Decision-Making in Veterinary Practice The first-ever guide to rational decision-making in veterinary practice
The practice of veterinary medicine entails crucial decisions about patient care on a daily basis. Whether to admit patients displaying symptoms, whether to pursue diagnoses or prioritize therapeutic trials, whether to advise overnight stays after routine surgery, whether to refer patients; the answers to questions like these can significantly influence patient outcomes and standards of care. However, veterinary clinicians are seldom trained to analyze their patterns of decision-making, relying instead on the existing culture of a practice to dictate their behaviors. This can lead to irrational decisions, institutional inertia, reluctance to comply with evidence-based medicine, and failure to optimize patient outcomes.
Decision-Making in Veterinary Practice provides the first-ever dedicated guide to rational principles for decision-making in veterinary practice. Rooted in the study of normative ethics, it seeks to pose important questions and develop processes by which they can be answered. The book promises to transform the clinical performance of clinicians and practices that utilize it.
Decision-Making in Veterinary Practice readers will also find:
Discussions of key issues based on extensive clinical experience and evidence Detailed discussion of important decision determinants like time of day, patient weight, criteria for stopping treatment, and more Essential insights on clinical decision-making and clinical reasoning
Decision-Making in Veterinary Practice is ideal for all veterinary practitioners, veterinary students, and clinical skills instructors.
“Decision Making in Veterinary Practice offers expert medical knowledge and an ethical sensibility to illuminate everyday veterinary issues like animal euthanasia, treatment of elderly patients, and moral stress. The result is an unparalleled practical road map to fulfilling the patient advocacy role of the veterinarian. I wish I had the benefit of Dr. Kipperman's wisdom when I was a young veterinarian. All veterinarians should read this terrific book—veterinary students, new graduates, and seasoned professionals.”
Simon Coghlan, PhD, BVSc University of Melbourne Victoria, Australia
“Decision Making in Veterinary Practice is a detailed and thoughtful discussion of many key aspects of veterinary clinical decision making. Drawing from decades of personal experience as an internal medicine specialist and practice owner, Dr. Kipperman provides numerous realistic case examples to illustrate both the challenges facing clinicians and many potentially helpful strategies for improving decision- making and optimizing patient outcomes.”
Brennen McKenzie, MA, MSc, VMD Adobe Animal Hospital Los Altos, CA
“Decision Making in Veterinary Practice is a helpful resource focused on how decisions are made, and how decision-making can be improved in the interests of veterinary patients. It contains many excellent case examples documenting positive and negative outcomes of decisions. A unique aspect of this book is its disclosures of Dr. Kipperman’s experiences as an internist – including humble accounts of lessons learned and insights into the moral distress experienced by veterinary specialists.”
Anne Quain, BVSc, MVetStud Sydney School of Veterinary Science Sydney, Australia
Contributors xiii Acknowledgments xv Introduction: Why a Book on Decision-Making in Veterinary Practice? xvii Section 1 Fundamental Concepts in Making Clinical Decisions 1 1 How to Define Your Success as a Clinician 3 Barry Kipperman 2 How to Obtain a Patient History 17 Barry Kipperman 3 Informed Consent 25 Barry Kipperman 4 Risks, Benefits, and Ageism 37 Barry Kipperman 5 Client Education Beyond Informed Consent: The Most Important Thing an Owner Needs to Know 47 Barry Kipperman 6 Euthanasia 53 Barry Kipperman and Kathleen Cooney 7 Referrals 67 Barry Kipperman 8 The Influence of Economics on Decision-Making 77 Barry Kipperman 9 How to Optimize Patient Outcomes 91 Barry Kipperman 10 Medical Errors 107 Barry Kipperman and Jim Clark Section 2 Principles of Diagnosis 121 11 The Influence of Patient Weight on Decision-Making 123 Barry Kipperman 12 The Influence of Age and Aging on Decision-Making 129 Barry Kipperman 13 The Day of the Week Matters 135 Barry Kipperman 14 The Time of Day Matters 141 Barry Kipperman 15 Serial Monitoring of Laboratory Results 147 Barry Kipperman 16 Overdiagnosis and Useful Diagnosis 155 Barry Kipperman 17 The Minimum Database 167 Barry Kipperman 18 In What Order Should Tests Be Performed? 173 Barry Kipperman 19 Diagnostic Errors 179 Barry Kipperman 20 Providing a Prognosis 189 Barry Kipperman Section 3 Principles of Treatment 199 21 Inpatient or Outpatient? 201 Barry Kipperman 22 The Therapeutic Trial 207 Barry Kipperman 23 Interpreting Therapeutic Outcomes 217 Barry Kipperman 24 Setting Goals and Therapeutic Endpoints 227 Barry Kipperman 25 Pain Management 235 Barry Kipperman Index 245
Barry Kipperman, DVM, DACVIM, MSc, DACAW, is a specialist in small animal internal medicine and animal welfare. Dr. Kipperman founded a small animal specialist and emergency hospital in the San Francisco Bay Area and spent 33 years in practice before transitioning to teaching and writing. He is a Lecturer in Veterinary Ethics at the University of California at Davis, School of Veterinary Medicine, Davis, CA, USA and Adjunct Associate Professor at the University of Missouri College of Veterinary Medicine, Columbia, MO, USA.
