Can there be too much transparency?

Intersection of Crosstown, Rutledge and Line

If you have followed our Facebook page for any length of time, you will know that Charleston Harbor Veterinarians was designed under two big philosophies that we feel makes us a unique veterinary practice in the South Carolina Lowcountry.  One is a home-like atmosphere, with the goal of decreasing pet stress during the veterinary visit.  The other is transparency in all our medical and surgical procedures, with the goal being to give the owner the opportunity to be side-by-side with their pet through many medical procedures.

We received our first complaint today.  I have been dreading this day.  I think that most veterinary professionals aim to please their clients and their community, making hearing that someone has been dissatisfied by your services devastating.  What surprised our team the most today was that the complaint came from someone who was not a client; we had never seen her pets and we don’t even know if she even owns a pet.  And, it involved our philosophy on transparency.

Our facility has excellent visibility on the crosstown, and our surgical suite is positioned at the front and center of the building.  This was no accident.  The location for the surgical suite in the interior of the building is away from the main flow of foot traffic within the clinic, greatly decreasing chances for bacterial contamination from clients and pets coming to visit.  It is also located close to the treatment room, to be easily accessible during emergencies.  As an added bonus, the room has two large windows facing the crosstown traffic, adding not only natural light into the clinic but also visibility from the outside into what has traditionally been in the past, the most off-limit room to pet owners in a veterinary practice.

This is where the complaint occurred.  This morning, Dr. Kahuda performed a relatively minor surgical procedure on a dog in our surgical room, during the hours of normal morning rush hour traffic.  Keeping with practices for best surgical standards, the surgical suite was scrubbed ahead of time and free of clutter, Dr. Kahuda wore complete sterile attire (gown, caps, mask, booties, gloves), and a licensed surgical technician and an experienced assistant wore appropriate caps, masks, and booties.  All three of the staff members spent 100% of their effort monitoring and caring from this pet throughout the anesthetic procedure, both with monitoring equipment and direct observation.  While the patient was recovering beautifully post-operatively in the treatment area, Dr. Kahuda received the phone call: a human operating room nurse driving through the crosstown could see the surgical procedure while sitting in her car at the light and was displeased.

This phone call has occupied the minds of our team all morning and into the afternoon.  I walked outside into the rain multiple times to stare into our windows, just trying to understand how much detail one could view in the car across the street that would upset someone enough to make a call.  Our staff sat in confusion.  We called a pediatric nurse who I am close friends with to get her opinion.  This is what we as a team basically settled on:

  1. Our transparency is no secret.  We want to offer every client who walks through our doors a tour of our facilities. When you visit with your pet, you will quickly see that there is no “back” to take your pet away from you for treatments.  Our entire treatment room is enclosed in glass, easily visible from Exam Room 3.  Many of our medical treatments are performed in the exam room, with the client by our side.
  2. We are proud of our transparency.  If you can see inside our facilities from the street, you can bet that we are going to be following proper veterinary surgical protocol!  You will never see a staff member perform a procedure without properly maintained equipment or attire.  You will never see us treat a pet with anything but compassion and respect.  You will never see a technician texting on her cell phone instead of monitoring your pet during anesthesia.
  3. We do care about the privacy of our pets and owners.  This patient’s face was away from the window and the surgical site was covered in sterile draping throughout the procedure.  The draping would cover the majority of the surgical site from visualization on the street.  When clients fill out a new form to meet us, they let us know the level of their pet’s care they want to personally see and if they are willing to give permission for the posting of any pictures to our Facebook site.  We do not talk about you behind your back or gossip about your pet’s private medical concerns to other people.  We don’t have HIPPA laws in veterinary medicine, so our staff instead strives to operate by “The Golden Rule”.
  4. We ask our clients about the “open windows” policy when we meet them.  The pet’s owner in question today is a close friend of the veterinary assistant mentioned above.  The owner said that she desires our transparent policy, which she says assures her that when she leaves her pet here for the morning, she knows that she can trust the level of treatment that will be performed.  It shows we have nothing to hide.

I wish we had thought enough in advance to offer the person who called if she would like a tour and a chance to meet us.  In retrospect, I would have invited her to our Open House on March 29th from 12pm-4pm.  Instead, I am inviting all of you to visit us during the Open House, where we will have a Teddy Bear Surgery demonstration that will have active opportunities for participation for our younger visitors.  You will be able to see (on our Teddy Bear patient) the level of care that we can offer to our pet patients.

I know that we will never be able to please everyone.  My hope and joy would be to be able to provide outstanding service to those members of the community whose philosophy of pet care matches our our own and get the pleasure out of getting to know them and their pets on a personal level.

So, what do you think? Leave your comments below.


Janette Blackwood, DVM

Charleston Harbor Veterinarians @ the Teddy Bear Picnic

Come out on Sunday March 8th from 1:30pm-4:30pm to Hampton Park and bring your Teddy Bear!  The doctors at Charleston Harbor Veterinarians are proud to be a part of this 6th annual event. Dr. Blackwood and Dr. Kahuda will be at the Teddy Bear first aid station, doing physical exams and possibly even a surgery or two!  This is a great family event and is so close to the new Charleston Harbor Veterinarians at 280 Rutledge Avenue.  We’re excited to see you and your Bear!

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Charleston Parks Conservancy – Teddy Bear Picnic

In an effort to connect children and families to our parks, the Charleston Parks Conservancy is once again hosting its annual Teddy Bear Picnic. This free event encourages families to get outside and take advantage of Charleston’s vast network of more than 120 parks and green spaces. The sixth annual Teddy Bear Picnic is 1:30-4:30 p.m. Sunday, March 8 in Hampton Park. Activities include Teddy Bear first aid station, crown making, seed planting, face painting, cookie decorating, environmental education, booths with worms and more. John Cusatis will provide live music and other entertainment will include dancing and hula hooping. Food will be available for purchase or families are welcome to bring a picnic. The afternoon wraps up with a Teddy Bear parade. Don’t forget your bear!

Environmental Enrichment for Your CAT!

By: Dr. Christa Kahuda

Keeping your cat indoors has kept him safe from many health hazards such as infectious diseases and injuries.  However, most outdoor cats lead busy lives. They explore, hunt, scavenge for food, and they might interact with other cats. In contrast, our indoor cats have little to do and boredom may set in. For some cats, indoor confinement and other adverse experiences can even lead to health problems such as inappropriate behavior, obesity, and chronic conditions such as lower urinary tract disease.  Studies conducted over the last several years have found that by modifying the indoor environment for our cats we may be able to reduce some of these conditions and unwanted behavior.

The first line of therapy for your indoor cat is environmental enrichment.  This means providing for all the resource and social needs of your cat.  Consider the categories below – you may find many ways to easily improve your cat’s indoor environment!Charleston Harbor Veterinarians Cat Sleeping

Food:  Cats prefer to eat individually in a quiet and safe location where other animals, appliances, or sudden movement will not startle them.  Cats are also natural predators and some prefer hunting and stalking behaviors.  You can stimulate these situations by also hiding small amounts of food around the house or by using a food puzzle container from which your cat can release food pieces.

Water:  Each cat may have a preference for freshness, taste, movement, and container of their water.  Be sure to provide a variety of options for your cat’s drinking water and be sure to change the water and clean the bowl regularly.

Litter Boxes: Litter boxes should be provided in several locations throughout the house.  Those locations should be quiet and convenient for your cat.  The locations should also provide an easy escape route.  You may need to test several types of litters to determine which your cat prefers, but generally unscented clumping litters should be considered.  Litter boxes should be scooped daily and completely cleaned weekly.

Space:  The cat’s environment should include appropriate areas for scratching (horizontal and vertical), climbing, resting, and hiding.  Raised platforms, shelves, or window seats often appeal to cats.  Some cats enjoy playing and hiding in cardboard boxes.

Play:  Cats have preferences regarding interaction with their owners.  Some may like to be petted while others prefer to play.  Provide a variety of toys for your cat. Some cats prefer toys that they can throw around themselves. Other cats prefer toys that require owner participation, such as those you wiggle and dangle. Stimulating play for a cat involves opportunities to “hunt,” so move toys in such a way that they mimic the movements of a rodent or bird. Introduce new toys periodically to keep your cat from becoming bored.

Resources:  Often indoor cats compete for resources – you may start to notice intercat aggression due the perception of limited resources.   Provide multiple ‘spaces’ for each cat and also be sure to provide separate/safe locations for food, water, and litterboxes. 

Phermones:  Phermones are chemical substances that are produced naturally by cats.  Synthetic forms of these phermones may reduce anxiety in cats when used in combination with environmental enrichment.  (consider ‘Feliway’)  

Please feel free to contact us with questions or concerns regarding your indoor cat! 

Adapted from “Pandora syndrome” by C.A. Tony Bluffinton, DVM

Dr. CK

My mission: Time for a change…

By: Dr. Christa Kahuda

Charleston Harbor Vets | Tucker

Years ago I set out to become a veterinarian because I love animals (obviously – otherwise I made a very bad decision) AND, just as importantly, I enjoy people – especially teaching people!  Yet more often than not I find animals cower in fear, pace, and pant when they come to see me and their families dread the visit just as much.  There is so much good that is done during a veterinary visit – there must be a way to make it better for everyone.  We need to change the accepted standard.  When Dr. Blackwood and I set out to create our own practice we took a step back and noted the many triggers and frustrations for our patients and their owners.  We made it our goal to find solutions…To make it easier and more comfortable to be the best pet owner you can be.  To tailor our practice to you.

Here are some of the things we noticed about the typical vet clinic and how we’ve set out to change them:

  1.  It feels like a cold hospital:  The typical medical grade floors, seating, and décor are largely removed.  You will find you feel you are walking into a friend’s living room when you enter CHV.  Get comfortable and relax in our home-like atmosphere with a cup of coffee and a snack for you and your pet.
  2. The waiting room is stressful:  How often do you hope that you are the sole visitor in the waiting room because otherwise your dog will completely embarrass you with his unruly behavior?  Do you hope you can find a quiet corner to hide your cat’s carrier?  Believe it or not, the veterinary team struggles with the waiting room just as much!  The receptionists dislike clients staring at them, the doctor winces whenever a dog fight almost breaks out, and the nurses hate trying to be heard over the phones, conversations, and barking.   The solution:  ELIMINATE the waiting room!  You may walk into the clinic, be greeted by a team member – and escorted immediately into a private room.
  3. The exam room is uncomfortable:  In many cases once you escape the waiting room you end up  in a tiny, hot room with uncomfortable seating, harsh lighting and unsettling pictures of heartworms and fleas.  Check out the changes we’ve made:
    • larger than average exam rooms
    • outdoor windows in every room
    • dutch doors:  you will no longer be captive inside a closed room wondering if you were forgotten!  Our doors allow you to let your pet off leash or out of the carrier separated from other pets while still allowing you connection with the hospital staff
    • free WiFi
    • comfortable seating and décor for you and your pet
  4. The unseen treatment areas are distressing:  It is sometimes worrisome to allow your pet to be taken to the back treatment area for diagnostics.  We will make it our goal to do most procedures in the exam room.  If your pet is taken to the special procedures area – you will find you can watch each step of the process through large windows.  You will even be able to catch glimpses of the OR and dental surgeries.
  5. The laboratory testing is concealed and results are confusing:   Diagnostics on the microscope will be able to be viewed in the exam room and either Dr. Blackwood or myself will explain our findings directly and clearly.  Your pet’s blood work will largely be run in-house with results that day – and often during the visit.  You will be able to ask questions and make informed decisions while meeting with your doctor without waiting days for results.
  6. The pet is in new and scary situations:  Encouragement and positive support with healthy treats and a calm quiet environment will help to relax your pet.  Team members trained in low-stress techniques, limited use of metal exam tables, a designated feline room, comfortable resting areas, and other small alterations in standard procedures will go a long way to a better experience for all.
  7. Lack of communication:   We can email, text, phone, facetime, Skype, facebook, or even meet in person – with the many ways to communicate we promise to connect with you on your level.  Part of the connection form lets you tell us how to reach you – and provides you with various methods of contact for us.  We want you to have all the information you need so that as a team we can keep your pet healthy and comfortable.
  8. Healthcare is expensive:  The advances in medicine for both humans and our pets have made costs increase.  While we cannot magically make the costs go away, we will work hard to be open-minded and flexible with our medical recommendations to keep your pet healthy.

So, those are a few of the ways we want to change what a visit to the vet looks like and hopefully if even a little bit of that resonates with you we’re on the right track.  I imagine we’ll have all sorts of new ideas to implement over the years and we can’t wait to get started by meeting you and your pets very soon!

Dr. CK