Physicians Today Are Under Siege

Today, 12 to 14 hour days are not enough for a physician to deliver quality health care. Health
care reform has diverted so much of a doctors day to other, non-patient concerns: leaving little
time left to deal with the truly important issues such as patient care, staff and practice welfare.

tention to the owner. The dog
must do something for the own-
er, such as sit, come or stay, in
order to get what it wants: food,
comfort or play. "In this way the
dog becomes socially submis-
sive," Dr. Barlia says, and the
owner is at the top of the dog's
social order.
When an owner brings an an-
imal to Dr. Barlia, the owner and
patient are interviewed for 60-
90 minutes. The doctor is look-
ing for information about the
animal's environment, how the
animal is treated, if there are
children in the home, if the an-
imal is left alone during the day,
etc.
New acquaintances will often
ask Dr. Barlia, "I have a dog that
does this, that or the other. What
should I -do?" Most often he an-
swers, "I don't know without in-
vestigating."
It is for this same reason that
Dr. Barlia no longer makes
house calls for dogs, preferring
to bring the animals into his
standardized environment, his
"open field."
He can learn a lot about a dog
and its problems just by watch-

PHO TO BY B IL L HANSEN

Professional
Fees

The Animal Behavior Insti-
tute charges $89 for the initial
evaluation of a dog. According
to Dr. Barlia's partner, Jim
Lessenberry, the average
client spends $200-$250 for
the evaluation and two-three
follow-up visits.
"But we work with the
client so that we get it done,"
Mr. Lessenberry says. "We
don't want them to worry that
every time they have to come
in they will be charged."
Some clients never have to
return after the evaluation;
others invest thousands of dol-
lars to correct their pet's be-
havior, he said.
For a cat, Dr. Barlia visits
the client's home. For a $129
consultation fee, Dr. Barlia ob-
serves the cat and makes rec-
ommendations. Subsequent
visits are unnecessary; up-
dates and follow-up recom-
mendations are handled over
the telephone without charge.

ing how the animal reacts to
his office living room. Posture
and facial expressions come into
play, he says. A relaxed animal
will play with the bone on the
floor, explore the whole area and
cross through the center of the
room.
A dog with a problem will stay
near its owner or just explore the
sides of the room.
For animals that can be
helped, Dr. Barlia prescribes ex-
ercises and follow-up visits. The
owner must fill out data sheets
and do homework.
In some cases, animals are
boarded at the Metamora farm
in order to undergo more so-
phisticated procedures like shock
treatment or medication.
Dr. Barlia boasts a 90-95 per-
cent success rate in modifying
behavior, but says therapy isn't
prescribed for every client.
"Sometimes, the environment
won't allow the behavior modi-
fication," he says. If the pet is
dangerous to children in the
home or if Dr. Barlia believes
therapy will offer little im-
provement, then he suggests eu-
thanasia.
"It sounds callous," Dr. Barlia
says, "but we live in a human en-
vironment, not an animal
environment." He also offers
to help the family find another
pet.
Dr. Barlia's grandparents
went to Cuba from Europe
around the turn of the century.
His family left Cuba in 1961 —
"the second year after the revo-
lution" — and came to Detroit
where family and friends were
living. Dr. Barlia graduated from
Oak Park, did undergraduate
work at Inter American Univer-
sity of Puerto Rico, and com-
pleted his bachelor's, master's
and doctorate (1978) at Wayne
State.
He sees 8-10 new clients a
week and his partner sees 5-6.
In addition, he testifies as an ex-
pert witness in court cases in-
volving dog bites, race-track
incidents and accidents. His tes-
timony often involves whether
the animals were housed cor-
rectly or whether the accident
could have been avoided.
He occasionally will be asked
to deal with zoo animals and, a
few years ago, received a letter
from Taiwan asking for help
with a monkey. Dr. Barlia rec-
ommended another behaviorist
because, he said, "I'm not a great
primate man."

❑

Today, this prognosis
can be changed, leav-
ing a physician em-
powered and in
control of practice "INIV
assets. Ergo-
nomic Decision
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IF' presented as a practice pro-
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(A Medical Practice Management Group)

Farmington Hills, MI - (810) 474-8665

WE PI FIGHTING T-CA
YOUR I IFF

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