Certainly didn't mean to cause a controversy on the FML!
 
One FML'er writes:
>I have found Dr. Williams posts to be rather informative and appreciate
>him taking the time out of his hectic schedule to post.  However, those of
>you who have emergencies or serious health concerns should NOT be relying
>on information from afar.  What I am saying is that no vet can accurately
>diagnose a ferret's problem via email or phone - sight unseen.  This is
>NOT information to rely on.  Again, Dr. Williams knows his stuff BUT
>cannot possibly diagnose without examination.  Any vet who claims to be
>able to do this is simply wrong.  One can "guess" based on symptoms but
>cannot be positive.  Human doctors don't abide by this, either.  I do hope
>he continues to post, because it does educate all of us about illnesses."
 
There is much truth in what this person says.  Please, especially
considering my schedule, never postpone a trip to the vet for a serious
illness until after your thread has finished on the FML.  In times of
crisis, even a non-ferret-knowledgeable vet can save a life.  We so often
hear tales of the errors of non-ferret knowledgeable vets, but we don't
hear how many lives have been saved simply by their knowledge of veterinary
medicine in general.
 
However, I must strongly disagree with the contention that veterinary
consultants must have physical access to patients.  Pathologists rarely
if ever have access to patients, but examine slides and come to concrete
diagnoses, same with radiologists.  I generally try to gather as much
information as possible on difficult cases.  More strightforward cases
can be handled with less.  In general, the specificity of my comments on
a case are in direct proportion to the specificity of information I have
on a patient.
 
In my experience, most of my consults arise due to a veterinarian not being
terribly knowledgeable about the species or being unable to reconcile some
piece of data with clinical signs.  A lot of my consultations revolve
aroung the question as to whether acquired data on a patient supports a
particular mode of therapy, or what therapy would be appropriate.
 
The majority of cases are actually readily diagnosable based on experience -
adrenal disease, insulinoma, and a number of the other common diseases of
ferrets.  But there are a lot of cases that don't fit neatly into one
category or another, and I often need to consult directly with a vet.
(On my site at http://www.afip.org/ you can find more information on
Consultation over the Internet and how to maximize my (or any other vet's)
ability to help you from a distance.)
 
I cannot agree that consultation over the Internet is a waste of time -
I've helped way too many animals in this fashion over the years.  As
director of a telemedicine department at the largest second-opinion
pathology center in the world, I have been able to gain a lot of experience
in the utility of remote diagnosis - when it can help and when it can't.
My goal is to be a good consultant - and help the owner and the
veterinarian to come to an appropriate diagnosis and course of treatment -
not to supplant or undermine the owner-veterinarian relationship.
 
Regarding the number of posts per day - I will simply continue to answer
emails and forward to the list - I implicitly trust BIG to be able to
prioritize and use as many as he wants per day.  From time to time, I
receive emails offline that are appropriate for the FML - after
anonymizing, I generally cross post my response to the FML.  Please if
you want to prevent a personal communication from going to the FML in any
form, let me know!
 
Bruce Williams, DVM, DACVP
[Posted in FML issue 3198]