The thing I hate about being a veterinarian

In my day to day life as a veterinarian, there is something that I dread doing. This particular thing makes me squirm, twitch, drool and retch. I try to avoid it at all costs, and I consider myself to be blessed if I have technicians willing to do it for me. Want to guess what it is?

Expressing anal glands? (Nope. I secretly think it is rewarding to do this)

Doing a dental on a pus filled, rotting mouth? (Fun times!)

Sifting through dog puke to make sure it threw up all the rat poison? (Love it, even though I am a sympathy puker)

Draining a 4 day old, putrid, maggot infested cat bite abscess? (No, although dealing with maggot wounds sometimes makes me reconsider my career choices.)

As gross and vomit inducing as all of the above may be, the thing I hate doing the most as a veterinarian is talking to clients about money.

That may surprise those of you non-veterinarians out there, but if you were to take a poll I have a feeling you would find many vets feel the same way. We came into this career to do the best we possibly can for each patient, and when finances intervene it gets tricky and heart wrenching. We find ourselves having to consider and weigh the best interests of the patient, the finances of the client, and the demands of our business. I love and want to help animals, and yet I have to make a living. These sometimes competing interests can put us in a horrible dilemma, where no matter which way we turn someone gets hurt.

After vet school I practiced for about 3 years in the desert of Southern California. If you are nuts enough to stay with me on this blog you will realize how much I learned out there. Anyways, in that area were a lot of backyard Chihuahua breeders.

Chihuahuas are cute little dogs. Sometimes they can be little bitty land sharks, but regardless of their nature the females often have a teeny pelvis and have to give birth to puppies with larger than normal skulls. As a result, it is a breed in which pregnant females often need to undergo a Caesarian section.

One day, a man I will call Mr. Smith came running into the clinic with his pregnant Chihuahua, “Precious.” Precious weighed all of 5 pounds, and had been in unproductive labor for 2 days. By this point she was cold, weak and in tremendous pain. Her puppies were dead, and lodged in her pelvic canal.

I quickly did an exam on her, and started her on emergency treatments….warming her, giving her IV fluids and a dose of pain medication. I told Mr. Smith that the only hope for saving Precious was to do an emergency C-section. She would need to be on intravenous fluids, pain medication and antibiotics. The total cost for treatment was going to be 600-800 dollars.

Mr. Smith scoffed, and told me that the only money he had was the forty dollars he had in his pocket…not even enough for the initial exam. He didn’t own any credit cards, and insisted there were no relatives he could call, or items he could pawn. I had a sweet, shivering, dying dog whose owner could not possibly afford the treatment needed to save her life.

I went and begged and pleaded with my boss, who kindly but reluctantly allowed me to cut Mr. Smith a break. I would give Precious the treatment she needed, we would spay her so she could no longer have puppies, and we would only charge Mr. Smith $100.00, which would need to be paid within 5 days. Mr. Smith appeared to be grateful, and left Precious in my care.

The surgery went extremely well, and 2 days later Precious was bright, happy, and munching on the daily chicken I would bring her. Mr. Smith thanked us, and took Precious home.

Guess what? He never paid us a cent.

About 2 months later, Mr. Smith returned to the clinic with “Angel,” another pregnant Chihuahua with the exact same problem as Precious. Dead puppies. Unproductive labor, this time for 3 days. Cold. In tremendous pain. Dying.

Now, the veterinarian in me wanted to rush Angel back and get to work saving her. However, this would have meant doing another 600-800 dollar procedure at no cost. I spoke to my boss, who as gently as he could told me we could not afford to extend more charity to this man who had yet to pay us ANYTHING for the first C-section. He told me I could offer to have Mr. Smith sign ownership of Angel to us, or I could offer to put Angel to sleep at no charge, which would at least end her suffering.

I went back into the exam room and explained this all to Mr. Smith. He was very angry. He told me there was no way he was going to let me “steal or murder” his dog. He kept begging me to save her. He cried. He pleaded. He told me that his mother had just recently died and Angel was the only friend he had left in the world. He asked me how I could be so cold and heartless. Didn’t I see she was suffering?

It was an awful situation. In the end, Mr. Smith yelled that I was a cold hearted witch that only cared about money. He took Angel home, where I am sure she died a horrible, painful death. That case still haunts me.

Now I know some of you may be agreeing with Mr. Smith…that I was cold, that I should have just done the surgery and saved Angel. I could have let him make payments, or taken a post-dated check, or just gone ahead and done the surgery at no cost. The kind, compassionate veterinarian in me agrees with you. After all, it wasn’t Angel’s fault that her owner could not afford the surgery, right?

Here’s the thing though….when would it end? What if in another few months Mr. Smith came into the clinic with no money, with another sick dog that needed help? What about the clients that sacrificed and stretched to pay for their animal’s treatment? If I continued to give my services away for free, I would either bankrupt the hospital or find myself without a job and a mountain of student debt, a car payment, insurance payment, rent, etc.

It is expensive to operate a veterinary hospital. For your average clinic, by the time you factor in the daily cost of employee salaries, supplies such as medications, electricity, water, waste disposal, taxes, etc. it costs at least $2800 per day.

This is why I hate discussing money with owners. I feel guilty, because there is a part of me that feels bad for charging people for what I do. In a perfect world, I could give each pet the best care every time. Money would be no object AND I would make enough to pay my bills and save a bit.

However, that dream world doesn’t exist. I used to think human doctors had it so easy because insurance paid for everything. Hmm. It seems like they aren’t even close to figuring that one out. How do you provide good quality health care to everyone when good quality health care is REALLY expensive? Like I said, it is a dilemma.

We veterinarians are not rich. We don’t go into this profession to make a gazillion dollars. Many of us are happy if we have enough left over to put into savings. We want to practice good medicine, and we want to use our knowledge and expertise to save lives. It breaks our heart when this isn’t possible, and it crushes our souls when we get accused of loving money more than the well-being of our patients.

There are, of course, a few dishonest veterinarians out there that try to milk clients for everything that they are worth…who pad the bill with unnecessary tests, or the most expensive medications. Trust me…they are few and far between. Our profession abhors them.

If you own a pet, please consider that veterinary care is often quite expensive. Plan for it, and consider having a savings account, or looking into pet insurance. Take your dog or cat into the vet for annual exams so that potential problems can be addressed early on. Remember that when we present you with a treatment estimate we are not trying to scam you. We care about your pet, and we need to get paid for what we do so we can continue on caring for pets for many years to come.

If you are a vet that has found yourself in the same dilemma, my next blog entry will be for you. (Compassion fatigue). In the meantime, be kind to yourself and remember that you can only do what you can, with what you have, given the situation in front of you. Take care.

 

About hteyler

I decided in 8th grade that I wanted to be a veterinarian. I never deviated from that goal, and after a ton of studying and hard work I graduated from Colorado State University with my Doctorate of Veterinary Medicine in 2004. I spent the first few years out of vet school in the southern California desert. After a few years I missed the mountains, so I took a job at a small animal practice in Park City, Utah. Somehow, in the middle of all of that the teaching bug bit me. I am now the Resident Veterinarian at Broadview University, West Jordan. Also, I have four cats, Pete, Sally, Tommy and Roger. If I told you much more, you would decide I am a hopeless nerd. For example, I am obsessed with the TV shows LOST and Supernatural.

Posted on July 2, 2012, in Uncategorized. Bookmark the permalink. 131 Comments.

  1. My daughter is studying to be a vet. When I hear people moan about the cost of veterinary care, I can’t help but point out to them that unlike doctors, vets have to study every species of animal. They have to become pharmacists, radiographers, surgeons, dentist, obstetricians and oncologists. I ask them to tally up the bill if a person in their family went from a general practitioner to a specialist to a radiologist, maybe into surgery and then to the pharmacy. The cost would be a heck of a lot higher, so they should stop moaning about the vet :)

  2. These cases must be very painful to deal with. Does a veterinarian not have the authority to seize an animal that they know is suffering and won’t receive proper treatment? At least to humanely euthanize? Surely what Mr Smith did is animal cruelty. I believe a veterinarian should definitely be granted this authority in these extreme cases.And they should have authority to initiate an investigation into the breeding operation. No one should be breeding animals if they don’t have a veterinary fund. What recourse would Mr Smith have to reclaim an animal that he was going to let suffer unbearable, fatal distress? I know it will be pointed out that this will discourage owners from seeking vet treatment, but at least it helps that one animal, instead of helping none. And maybe eventually society will get the message that if you can’t properly care for an animal, it will be taken away from you.
    Thankfully, we now have enough awareness that owners who ignore suffering in their pets often get outed by family, friends or neighbors, and the owner sometimes ends up with no option but to seek vet attention in the long run. I am curious as to what vets would choose as their best realistic solution to this tragically common scenario. If they could have anything they wanted, political correctness aside, what would it be? A special fund for needy cases, contributed to by more solvent pet owners? Authority to seize animals? Government funding for emergency life saving treatments? Any funding would surely be abused by the unscrupulous, so there would have to be no consideration of returning the animal to the owner. But what clinic needs to add finding homes to their duties? It is a truly complex issue to address, with seemingly no really “good” options, only the lesser of different evils.
    Thanks for sharing what it is like on your end of the equation. It seems no one is left unscarred when involved with animal welfare. Warm regards. Elizabeth

  3. This case would haunt you no matter how it turned out because you are compassionate. However, you did the best thing and should not feel guilt. Mr. Smith takes no responsibilities for his pets’ care or financial responsibilities. When he couldn’t get his way with his tantrum, he emotionally black mailed you. You were right not to buckle and do as he asked or cut him another deal. Our only hope is that he learned from it and will not continue this behaviour.
    Andi, RAHT

  4. Alban and Jean Girard

    God Bless You Dear Cousin, and may he always guide you. You are St. Francis’s hands.

  5. You were gracious enough to cut “Mr. Smith’s” bill down to only a mere $100 which he rudely did not pay after getting possession of his dog back — which in my opinion is bad karma (case in point, look at what happened to his other dog he tried to bring in). Not in a million years would I ever think you were a heartless ‘witch’ for refusing to preform the surgery. However, a number of vets do have a policy that 1. your animal is not released until payment is received and/or 2. if payment cannot be made and all procedures are performed, the vet is now the sole owner of that animal (this is stated before any medical procedures are preformed). What irks me about this story is that you let this person leave with a dog you knew was in pain and required immediate medical attention and you never reported the incident (if this were me, I would be calling the local animal shelter/animal control informing them of animal abuse because this is essentially animal abuse and no where in your write-up did you mention doing anything about the situation other that refusing to perform the surgery). In my opinion, you should had never given the dog back to Mr.Smith without receiving payment from him (or even partial payment). As you mentioned, there are a few vets that will milk people for more money — I have gone through this many times with vets and I have yet to find a trust worthy veterinarian and I’ve owned my one cat for 6 years now. I’ve been milked out of a lot of money over the years (I’m talking about thousands of dollars here). I love my two cats and I would do anything to keep them healthy and alive. As a RESPONSIBLE pet owner, I feel it’s my obligation to keep a “pet slush fund” handy should I ever need to seek medical attention for my animals (that way I’m not scrambling to find the funds to pay the vet bill).

  6. What a wonderful expression of the harrowing issue of dealing with inconsiderate pet owners. When my (human) children were young, we had enormous medical bills. Our insurance was weak at the time but governed by my job. The boys were both well into their teens before we finally paid those bills off. Rather than file bankruptcy, we managed to pay each doctor and hospital something every month. We went without “nicer” things but met our obligations. Too many people want things handed to them so they can buy cigarettes, alcohol, or the latest iPhone and not pay their debts.

  7. Thank you so much for telling with words the dilemnas we feel every day
    . Same thing happens here, in france.

  8. Mr. Smith should have been reported to authorities for cruelty and neglect. After the first free surgery, it was malicious to let another of his dogs get pregnant in the first place.

  9. Thank you for sharing your insight with us. In my life I have had 4 kitties and only 1 is still living; she will be 18 tomorrow. I have done everything my kitties Doctors have ever instructed even when I have to pinch pennies else where BECAUSE that is the commitment I made to my fur kids when I accepted them.

    I recently talked to my kitty’s Dr. about DVM education and was surprise (yet pleased) to find out how much schooling was involved (similar to that of a human Dr.) and how expensive that is.

    I wish more people who make the commitment to own a pet would take that responsibility seriously and for as long as their pet will live… which could be quite long. And don’t give the DVM grief.

    My 3 kitties who have left me had a variety of things wrong, one died of Basel cell carcinoma, another from heart & kidney disease and the other from something unknown. All very expensive but all kitties, very loved and taken care of by the very very best Doctors.

    I appreciate all that you do and even more so that you still do it even in light of having to deliver bad news, having to deal with the heartache of putting animals to sleep, having to deal with vomit & poop and all of those other awful things, and jerk clients on top of it all. There are many of us out there that really appreciate and value your skills and compassion and the healing and help you provide! Blessings to you all.

    Higgy >^..^<

  10. Angel was “the only friend he had left”? What about Precious? The man is simply an irresponsible pet owner. He should have and could have had those dogs spayed for a relatively small amount of money. It breaks my heart that they had to suffer because of his negligence. No one should expect to receive something for nothing.

  11. Karen,, thank you for enlightening us who have animals. We had a vet who was charging outrageous fees. Then we found the most compassionate vet every. She deserves every penny she charges. She takes care of our three guys.

  12. Charlotte White

    Well said – a dilemma that you, health care, plumbers, and others who fix things/pets/people in emergency situations face. Once you have the goods, why pay?

  13. Thank you for writing this. I think all us have gone through at least one experience like this, if not more. I really appreciate you voicing it so well.

  14. We have many animals in our family, and our veterinarian is on our speed dial, and recognizes our number when it shows up on call display – I would never begrudge the fees associated with taking care of our animals health, any more than I would say that our family doctor shouldn’t be paid for her time. I know many vets, and none of them are trying to take advantage of us, we choose to have our animals, and know that money will be needed to take care of them.

  15. I’m a pet owner & I can imagine that it isn’t difficult to be a vet.

    Be strong & positive, there are many people that SUPPORTS your great work! You’re important to us!

  16. Your client should have been reported for animal abuse- I heard there’s a registry now in NY state- hopefully other states will follow. I’ve always admired veterinarians- even more than human physicians, exactly because of the heart wrenching situation you just described.

  17. I am a hairstylist and have similar problem. They try to get free stuff all the time and complain about the prices. It cost alot to run a salon and our products keep going up! My issue is that there are a million salons to go to and/or they will do it themselves. So it is always hard to not give a bit just to keep them around. I too love what I do and it makes me mad that people take advantage. I do think vets need to come up with some better payment plans or someting….at least for their valued clients who have alays payed for their bills. Not many people have $800 sitting around anymore. I had to do a fund raiser for my Boston this year and sell my dinning room table to pay for her eye surgery. I had a good job when I got my dogs and know struggling to even make more than the poverty level. So it is hard to not care for my pets like I use to. :(

  18. It’s difficult to realize that compassion has its limits. Unfortunately striving to be selfless and fully compassionate won’t pay the cost of running a business or paying a mortgage. I found this discussion very thought provoking. Sometimes what might be considered “doing the right thing ie relieving a pet’s pain and suffering” has to be redefined. Big questions with a lot of thoughtful comments. Thank you!

  19. i am a veterinarian who practiced in India before I immigrated to the USA. I worked at the Veterinary Polyclinic owned by the government. We treated all patients for free. By the end of the year our budget ran out and we wrote scripts for drugs or suture material and the farmers would add all their last pennies to buy it so that I could do a rumenotomy or a Caesarean.

    Here in the USA, balancing clients; budgets while doing our best for our patients is a constant strain especially while repaying mega loans that are acquired while starting.Thank God here in New York city the Humane Society treats patients for much much less than the ASPCA and there is a place that I can send my Mr.Smith to. Ofcourse Mr. Smith will have to prove his poverty.

  20. Extremely well-written. I hate the financial side of my job. Sometimes it’s almost worse in referral because the bills are always expensive. UK has the advantage of a very well set-up pet insurance system, which relieves the stress of financial constraint by a huge margin. I’ve only just moved to the US, but money seems to haunt every consult, and I find ways left right and centre to reduce the costs.

  21. This is a really great story. Well, I mean it’s sad but explains things so well. Sorry it happened to you :/

  22. Mr Smith can’t possibly have been such a loving pet owner if he only brought BOTH Precious AND Angel in to the vet after DAYS of unproductive labour. It’s an awful thing, but maybe only the experience of watching poor Angel die a horrible death would make him a) stop letting his chihuahuas breed with too-large males, or bring them in immediately rather than waiting til their puppies were dead inside them. People like Mr Smith make me pretty damn mad.

  23. It’s so important that pet owners understand how expensive it is to own a dog. This is why I love it that pet shelters repeatedly ask you if you understand that there will be medication, medical procedures, etc down the road that you will be responsible for if you take ownership. I understand that he could not afford to help his dog, and his reaction could have been out of desperation, but in the end he is the only one who can take blame for his dog’s suffering. :(

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