Mind Over Miller: Exercise your right to write prescriptions

Although doctors of veterinary medicine have the same prescription writing authority as physicians do, many practitioners infrequently write prescriptions. I wrote many during my practice career, and I want to share the reasons that I did so.

Two years after graduating from veterinary school, I opened a private practice in a small country town. Although Thousand Oaks had a small human population, it had an enormous animal population, including thousands of beef cattle, dozens of horse farms, a mink ranch, a camel breeding farm, and an elephant training center.

Until my growing small-animal practice necessitated a hospital, I ran a house-call practice, even spaying dogs and cats on ironing boards and on the tailgate of my station wagon (wearing a cap, mask, and gown—a rarity in the 1950s). Since I traveled with a limited pharmaceutical armamentarium, I wrote prescriptions rather than dispensing drugs. Even after I opened a small hospital, I continued writing many prescriptions because I had observed several benefits from this practice.

• I didn't have a lot of money tied up in drugs, which was an advantage since I had no money. I had opened my practice on the proverbial shoestring. Moreover, I was not compelled to dispense what I happened to have in stock. I could prescribe whatever I thought was best for my patients.

• The local pharmacy saw me as an ally rather than as a threat. When I first opened my practice, the pharmacy had a large veterinary section, with an extensive display of both large- and small-animal products. A few years later, the veterinary section was gone. When I commented on it, the pharmacist said, "Well, before you came here, I was the only game in town. Now I just send the folks to you. Besides," he winked, "I make more money from your prescriptions than I ever did from that section."

• My professional prestige was elevated in clients' eyes. Back then few people understood the depth of veterinary schooling—some even asked if I had to go to school at all. Sending clients to a pharmacy with a prescription awed them. They thought that only "real doctors" could write prescriptions.

Prescription writing also taught me a little about the bond between people and pets. When I handed clients a prescription, they did not often ask, "Is this the same drug that people take?" Instead, they asked, "Is this the same drug adults take?" This was my first clue that pets play an important role in clients' lives: They are surrogate children!

If I were still practicing, I'd write prescriptions whenever it was appropriate. And as I handed the prescription to a client, I'd say, "Here is a prescription for——. You can fill it at any pharmacy or at the pharmacy counter here in the hospital." At the pharmacy counter, all of the dispensing would be done by staff members, not doctors.

To some it may seem like I'd be forfeiting income, but I disagree. I'd gain respect because of my professionalism, and ultimately, I'd increase my income through practice growth.

Robert M. Miller, DVM

Robert M. Miller, DVM, is an author and a cartoonist, speaker, and Veterinary Medicine Practitioner Advisory Board member from Thousand Oaks, Calif. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner. Visit his Web site at www.robertmmiller.com.