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.
When I tell people what I do for a living (Veterinarian), I usually get one of four responses:
RESPONSE ONE: “Oh my gosh you are a vet! Well, my 8 year old female dog has had this nasty discharge from her hoo-hah for the past five months! I’ve been giving her Tetracycline from the feed store, but it isn’t getting any better! What do you think about that?”
RESPONSE TWO: “You are a vet? Well, last week I took my dog, Fifi to the vet because her breath is NASTY! They wanted to charge me TWO HUNDRED AND FIFTY DOLLARS JUST TO CLEAN HER TEETH! That is an outrage! You must be rich!”
RESPONSE THREE: “You are a vet! Oh wow…my brother is too! Did you serve over in Afghanistan?”
RESPONSE FOUR: “Oh, that is SO wonderful! I love animals and people always told me I would make a good vet. You must love playing with the cute little puppies and kittens every day!”
Okay, so I’m generalizing a little bit, but not much. In future blogs I’ll address responses one and two. As for response three…I am only four feet tall, so it always fascinates me that people think I could be in the military. Anyways, today, I am going to talk about response four…what I call the “puppies rainbows sunshine and kittens” response.
Let me start by staying this…becoming a veterinarian is HARD. Just because you “love animals” does not mean you can be a vet. For starters, it requires eight years of schooling…generally four years of undergraduate studies and then another four years of veterinary school. If you want to specialize in something like surgery or ophthalmology, there is even further training. In order to graduate you have to pass courses such as Microbiology (Fun!), Anatomy and Physiology (Loved it!), and Organic Chemistry (the bane of my existence). Also, you’ve got Pharmacology, Immunology, Anesthesia, Internal Medicine, Virology, etc.
Also, keep in mind that after going to college for eight years, many veterinary students will graduate with a heavy amount of debt. We go to school as long as dentists and lawyers, accumulate the same amount of debt, and receive a starting salary far below any of the the other professionals. It is a problem.
After I graduated, I quickly realized that as hard as veterinary school was, it was merely laying a foundation for EVERYTHING else I still had to learn. For example, in school we discussed performing a C-section, and watched a video, but I never actually did one. The first one ever was on a sweet golden retriever that belonged to a sweet old woman…talk about pressure! Fortunately, it all went well and I had 12 cute, wiggling, chirping golden retriever puppies at the end of it. (Okay, so there is an example of playing with puppies)
Anyways, after veterinary school you must learn how to do medical workups for owners that have limited funds. You learn how to deal with clients that are frustrated, upset, angry, grieving, slightly bonkers, neglectful, and just flat out crazy. You learn to deal with different personalities of bosses/associates/technicians.
As a vet, you will routinely get puked on, peed on, bled on and pooped on. I quickly learned to keep my mouth SHUT when I was expressing a dog’s anal glands. You learn how to carefully watch the body language of dogs and cats, and how to deal with owners that insist there is NO way that their beloved FLUFFY is going to wear a muzzle….even if “FLUFFY” is a 90 pound German Shepard who wants to eat your head.
Have you noticed how much I’ve mentioned actually has to do with dealing with people? It slays me when people say “Oh, you must love being a vet because you don’t have to deal with people!” Dogs and cats come to the clinic with owners attached to them…people that I must communicate with if I have any hope of helping their pet.
After school, you also learn how much of your job deals with death. The most common cause of death in companion animals is euthanasia. As a vet, there will be some days or even weeks that you feel that all you do is help animals to die, and comfort their grieving owners. It is a sad day when I go to write up my charts and see a pile of sympathy cards waiting to be signed. You learn the stories of the owners and come to a deep understanding of how loved their pet has been, and how painful the loss is going to be for them. For example, I once euthanized an old cat that belonged to a woman who was a shut-in…the cat was literally her only friend and companion. Her home was full of pictures of the two of them together, from the time he was a kitten. His toys were scattered everywhere. After I put him to sleep and she said her goodbyes, I took his body back to the clinic and kept thinking about how alone this poor woman was now. My heart was very heavy that day.
So….if you or someone you know “wants to be a vet,” be sure you/they understand everything that it entails. You can’t just “love animals.”
That is the whole point of this blog….to try to show people the real side of veterinary medicine. It is a hard, frustrating, rewarding, entertaining, painful, stimulating career. It is full of life and death, triumph and failure, joy and grief. You have the opportunity to touch people’s lives, particularly when helping them cope with the death of a beloved dog or cat. And, every now and again, you actually do just get to play with the cute kittens and puppies.