Home | Contact Us | FAQ | Search & Site Map | Link to Us
Sign In | Join | Other 45 Sites in Network
Home
Discussion Groups
General
GeneralCardiologyVisionDentistryPharmacyLaboratoryNutritionAlternative
Diseases and Disorders
AIDSAlzheimer'sArthritisAsthmaCancerBreast CancerDiabetesEpilepsyGlaucomaHepatitisHerpesLupusProstate BPHProstate CancerProstatitisSinusitisTinnitus

Medical Forum / General / General / February 2004

Tip: Looking for answers? Try searching our database.

Veterinarians vs. MDs

Thread view: 
Enable EMail Alerts  Start New Thread
Thread rating: 
Tristan Miller - 24 Feb 2004 12:17 GMT
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

Signature

  _
 _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

Howard McCollister - 24 Feb 2004 13:16 GMT
> Greetings.
>
[quoted text clipped - 33 lines]
> 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
Carey Gregory - 24 Feb 2004 16:04 GMT
>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.
Howard McCollister - 24 Feb 2004 18:07 GMT
> >If you're talking about
> >a general surgeon vs your local veterinarian, the answer is obvious IMHO.
[quoted text clipped - 8 lines]
> 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
Josh - 25 Feb 2004 13:08 GMT
> 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.
Carey Gregory - 25 Feb 2004 19:18 GMT
>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.
Howard McCollister - 25 Feb 2004 20:39 GMT
> >One should also bear in mind that the vast majority of general surgeons
> >complete their training having operated many times on various mammals,
[quoted text clipped - 10 lines]
> 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
poboxdc@ix.netcom.com - 25 Feb 2004 04:49 GMT
> Greetings.
>
[quoted text clipped - 42 lines]
>  / |`-'  -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=  <>  In a haiku, so it's hard
> (7_\\    http://www.nothingisreal.com/   ><  To finish what you

Answer:  "regular medical doctor"
Vet in NZ - 23 Feb 2004 08:15 GMT
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!
Conversely I think a vet would have a better chance of success in a
caesarian operation on a human than a doctor would on a horse, under field
conditions. Again this is not down to the vets skills but due to the horses
poor ability to tollerate such operations. A doctor would have much better
success with a cow. So you see the question is a bit unfair really as it all
depends on the patient.

> > Greetings.
> >
[quoted text clipped - 44 lines]
>
> Answer:  "regular medical doctor"
Hillary Israeli - 25 Feb 2004 12:31 GMT
*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 :)

Signature

    hillary israeli vmd  http://www.hillary.net  info@hillary.net
               "uber vaccae in quattuor partes divisum est."
                not-so-newly minted veterinarian-at-large :)

Carey Gregory - 25 Feb 2004 19:27 GMT
>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.
Hillary Israeli - 25 Feb 2004 20:53 GMT
*hillary@hillary.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 :)

Signature

    hillary israeli vmd  http://www.hillary.net  info@hillary.net
               "uber vaccae in quattuor partes divisum est."
                not-so-newly minted veterinarian-at-large :)

candeh@thelast.mile - 25 Feb 2004 22:11 GMT
>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
Bill - 25 Feb 2004 23:32 GMT
> >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
[quoted text clipped - 6 lines]
> 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
[quoted text clipped - 7 lines]
>
> candeh
Howard McCollister - 25 Feb 2004 23:36 GMT
> 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
Josh - 25 Feb 2004 12:50 GMT
> > 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.
anon - 26 Feb 2004 02:51 GMT
> 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.
Howard McCollister - 26 Feb 2004 05:10 GMT
> > Who would be more qualified in dealing with typical trauma operations, a
> > veterinarian operating on human patients or a regular medical doctor
[quoted text clipped - 3 lines]
> 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
Carey Gregory - 26 Feb 2004 23:25 GMT
>> > Who would be more qualified in dealing with typical trauma operations, a
>> > veterinarian operating on human patients or a regular medical doctor
[quoted text clipped - 5 lines]
>
>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 a.s.
 
Sign In
Join
My Latest Posts
My Monitored Threads
My Blog
My Photo Gallery
My Profile
My Homepage

Start New Thread
Enable EMail Alerts
Rate this Thread



©2008 Advenet LLC   Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.