Episode 152 | When Diagnostics Are Negative Or Normal

In this episode Dr. Cari Wise discusses the challenges that veterinary professionals face when diagnostic testing comes back negative or normal.

She shares a recent personal experience of feeling shame and self-judgment when expensive diagnostic testing came back normal , and explains that this is a common reaction among veterinarians when tests don’t provide the expected answers.

Dr. Wise emphasizes the importance of recognizing and challenging our own money stories and releasing self-judgment and control.

She encourages veterinary professionals to get curious about their own emotional experiences, the stories they tell themselves, in order to shift their experiences in the moment.

Key Takeaways:

1. Veterinary professionals often feel shame and self-judgment when diagnostic tests come back negative or normal.
2. The connection between money and self-worth in our society contributes to self-judgement and shame.
3. Veterinarians create opportunity when they recognize and challenge their own money stories.
4. Veterinarians are not responsible for the outcome of diagnostic tests, but rather provide options and recommendations.
5. Not having an answer at a certain point in the diagnostic process is normal in veterinary medicine.
6. Even if tests are normal, they can still rule out many potential issues and bring peace of mind to the client.
7. Discomfort and fear are part of the human experience and should be acknowledged and explored.
8. Letting go of the need for control and accepting that not every case will have a clear answer can bring peace and fulfillment in the veterinary profession.


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Music Credit: Music by Lesfm from Pixabay



Website: https://joyfuldvm.com



Music Credit: Music by Lesfm from Pixabay


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This transcript is auto-generated and may contain typos. 

This transcript is auto-generated and may contain typos.

Hi there. I'm Dr. Cari Wise, veterinarian, certified life coach and certified quantum human design specialist. If you are a veterinary professional looking to uplevel your life and your career or maybe looking to go in an entirely new direction, then what I talk about here on the joyful DVM podcast is absolutely for you. Let's get started. Hello my friends. Welcome to Reflection Friday here on Friday,

December 22nd, 2023. We are getting down to the end of the year. Today, I wanted to jump in here and share with you my thoughts on navigating the situations where the diagnostic testing that we perform comes back negative or normal. Specifically when we're talking about animals that we are, have concerns about having a medical condition. So we've done a physical exam, we have determined,

we have our rule out list of things that it might be, and we make recommendations to the client to do some diagnostic testing. And I'm talking specifically about situations where then the client shares with us their own financial concerns. So where they have a very limited budget on spending money. And this really came about this week and, and what really prompted this,

this message today was an experience that I had with a client and a cat that I've seen over the last few weeks where my recommendation for diagnostics actually included referral. And that was because I believed that was in the best interest of the cat. And what I had suspected was going on with it in regard to I was a suspected hypertrophic cardiomyopathy, some weird symptoms.

And so I had recommended referral to get a cardiac workup. And when it was all said and done, that was just outside of the budget of the client, which is completely fine. And what I was able to do diagnostically kind of down that same path, was different in-house than what they were going to get if they referred. And we talked about all the different options and the owner elected ultimately to come back and for me to do the diagnostics that I could do within our own hospital,

understanding that I didn't have the capabilities to do an echo and some other things. And so that's what they elected to do. That was more within their budget and that's what they chose. So the kitty came in, we did the diagnostics, and it was all said and done. Everything was normal. So the blood work was normal, the radiographs was were normal,

the blood pressure was normal. So all these things that I had been really concerned about with this kitty were all normal. And I had this moment of, of what I can only, as I've considered it, can must, must be the emotion of shame. So judging myself. So this is so important for us to realize where shame comes from. 'cause shame is always tied to judgment.

So I had this moment of judging myself, judging my recommendations for diagnostics because I didn't get the information I thought that I was going to get. And that is the point of what I wanna share today is that I know that I'm not alone in this. That sometimes when we recommend diagnostic testing, especially when we have an animal that's ill and a client then expresses their own financial concerns,

if those tests don't come back with the answer, we blame ourselves. We get into this whole story internally about how we maybe shouldn't have spent their money or it wasn't a good use of their money to do these tests because the tests were normal or the tests were negative because we don't have the information that we were hoping to have to give that client an answer for why their pet is doing what it is doing.

So it's this combination of a self-judgment. I made a bad medical decision in recommending that they do these things because they didn't get any useful information. And also judgment of like I talked them into spending their money and now we don't have, we still don't have any answers. So we get into their money story and we get into, quite honestly, their perception of the value of the diagnostic testing.

Now why do we do this? Well, number one, everybody has a money story. I have a money story. You have a money story. All our friends and family and parents, everybody has a money story. And a lot of that money story isn't a great money story. So what I mean by that is there's a lot of anxiety and stress put on each other and ourselves around money to cut to the chase.

We have equated our safety and our human value to our finances. That's a completely inappropriate connection, but it is one that has been transformed and and passed on year after year after year, generation after generation. It's a great opportunity for us to clean up our own money story. And as much work as I've done on this in my own life and with my clients over the years,

sometimes it just pops up. And I noticed this week, which is why I wanted to share with this, that in this particular case, it popped up for me again, that very old habit story of if you don't find the answers, you've wasted their money. It's a terrible story. It feels awful, and it's not always true. Now, however,

it's I I'd say it's not ever true. Let me step back. It's not ever true that that's true. If I don't find answers, it doesn't mean that I've wasted their money with their diagnostics. There's so many different areas of this to unpack. Number one, I didn't spend their money. They did, I gave them choices. They made choices.

So that was their choice. I wasn't the one, I didn't talk them into anything. I gave them options. We moved forward on the path that they wanted. This is the kinds of things we have to remind ourselves of. The second part of that is the, the judgment of not having an answer, even though I've done some testing. So there's a should in there.

We always have to watch for the should. So the I should know what's going on by now, I should have an answer. But why thinking that I should have an answer at this point in the process takes me outta the reality that this is the practice of veterinary medicine. There are always gonna be unknown variables, and all we can ever do is make the best decisions at the time with the information and resources that we have.

And that is what we did with this case, both myself and the client. So here we are now, diagnostic test, complete money spent, and I don't have an answer for them. And as I was getting ready to communicate with them and, and it had been decided in advance that I would email them with all the results once everything was back in from all the different places that we sent things.

As I was crafting this email, I noticed that I was uncomfortable. And I thought, what is that? 'cause I'm super curious. Whenever I feel uncomfortable, like I wanna know why I'm feeling uncomfortable, because I know it's always gonna be created by a story that I'm telling myself. So first I gotta identify how, what am I feeling and then what is the story?

So I noticed I felt shame. So knowing what I know about shame, I know shame is always judgment. So then I had to ask myself a better question. What am I judging myself for? That's where I was able to identify, oh, I'm judging myself for not having answers. There's, I should know what's going on now. And then also tied that is a,

a shouldn't I shouldn't have recommended the test is tests because it didn't get us anywhere. It's total nonsense when I say it out loud. Hopefully as I'm saying this stuff, you're probably noticing you've said the same things, but hopefully you can also see the comedy in this. Because if the, if those di exact same diagnostic tests had revealed something specific, then I wouldn't have zero drama around the money that they spent or the information that I had.

The opportunity here is to realize that even normal and negative information is super valuable. I know that you already know that, but sometimes we just have to remind ourselves of this that we've ruled out a whole bunch of stuff with these tests, even if we haven't identified the thing that's causing what we're seeing. So we are making progress in this journey of practicing veterinary medicine.

And then what's furthermore, as we have had clients before who have probably said to us things like, you know, well I shouldn't have spent that money 'cause I don't know anything more than I did. Right? So like, where does that narrative come from? I've said it to myself, but I said it to myself because at some point, probably multiple times in my career that's been offered to me by a client.

And that's just a place that I have more work and opportunity to do, to let that be neutral, to remind myself that they always get to decide for them, and that I'm never recommending something outside of what I truly think is in the best interest of the pet. So as long as I'm in integrity with my recommendations, that's where I am really comfortable letting owners decide for themselves,

right? So I don't put it on me to make those decisions, their evaluation of their decisions with the information later, right? So hindsight kind of situation, again, I have to just remind myself I don't control that. And whether or not they remain comfortable in the way that they have decided to invest in their pet, it's not something I'm ever gonna control.

They're gonna control that. So all this is going on. I'm typing up this email and I send the email off with the information and you know, the next step recommendations on what we could do next to try to investigate this a little bit further if they want to. And the email that I received back was all gratitude. And that's the point of the story today,

is that it's very easy for us to get all caught up in our own heads with our own judgments of ourselves and our decisions and the information that we gained and how far in the process of practicing veterinary medicine and coming to a diagnosis, we are with any particular patient. We are by nature, very self judgmental, which we need to release quickly. Judging ourselves so harshly doesn't help the clients.

It doesn't help us. It definitely doesn't, doesn't help us enjoy our jobs and it completely takes us out of the opportunity to experience the truth. In this case, the truth from this client was all gratitude. Even though we still don't know exactly what's happening with this cat, we know a lot of things that aren't happening. And that gave her so much peace of mind just being able to do the test that we did.

Because I noticed by listening, by the tone of her email and by the words that she used, that she was also in her own judgment around money and around how her finances and her budget had altered the, the decisions that she made for her own pet. And so we have to remember that everybody has a money story and that we're all just doing the best that we can.

And when we dive into each other's money story, that actually just compounds the negative experience for all of us. In this case, she did the, she made the best choice she could for her pet with the information and the resources that she had available. Just as I made the best recommendations I could for her pet with the information resources that I had available together,

we made a decision. She ultimately chose how she wanted to proceed. I then carried out her wishes. We got the information that we could get from what I had recommended. Though that information was surprising to me. It didn't turn out, I didn't get the results I was anticipating getting, that's okay. I'm still not a a crystal ball reader. I can't predict the future.

Neither can you. We're not supposed to know a hundred percent what's going on until we have some data that can back it up, right? We can have our hunches, we can have our best guesses, and sometimes that's all we have to move forward for through in treatment. And that's okay too. It's always an owner decision on how many diagnostics they wanna do.

But I just needed to remind myself in this moment that, yeah, we, we both made the best decisions we can and we don't have the answer that we thought we would have, but we do have a lot of information. And she was very relieved because some of the things that I thought might be going on with this cat, which were scarier things we were able to rule out.

And so these negative and normal tests, although it didn't give us an answer, it gave this owner great peace of mind, even in just the things that we know that it's not at this point. And she was thankful to have done the test that she did and you know, the path that we, that she has then decided to go forward with.

My point of this is when we get caught up in our own drama, when we get caught up in the fear of anticipating how an owner's going to react to anything that we share with them, we ruin our own experience. We make our jobs so much harder. We also have opportunity to do what I did, to get curious, how am I feeling?

What's the story I'm telling myself that's bringing up that emotion for me? Is that story true? Is it useful? Is there another perspective? Am I still in my lane? Because as soon as I start to get a little bit curious about what I'm experiencing, that puts me back in my own power, which then allows me to release control of the things that we're never minded control in the first place.

As we continue to practice walking that line, staying on our side of the highway when it comes to how veterinary healthcare works with our clients and our patients. This practice of veterinary medicine actually is a lot of fun. And it's not as stressful as we've created it to be. The stress and anxiety that we create in veterinary medicine is mostly self-created because it's all driven by trying to avoid discomfort and to avoid fear,

which my friends discomfort and fear are part of the human experience. They're going to be there. We cannot avoid discomfort and fear by controlling all the things around us, by being perfectionists, by doing it all right. Especially in a career like the practice of veterinary medicine. We must continue every day to remind ourselves that this is the practice. There are no certainties here,

that we will always just do the best that we can in any given moment. And that as long as we just keep doing our part, which is making recommendations and letting clients to decide for themselves, we will help patients and clients all along the way. Alright, my friends, something just to consider as you go through the next week. I hope you have a wonderful holiday and I'll see you next time.

Bye for now.