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Thursday, June 11, 2009

"Do I Have To Pay Again?"

How many of you have gone to your doctor for a problem, had a tentative diagnosis made, and a treatment plan prescribed? Then if the treatment doesn't work, you go back again. Would you demand free treatment then? Would you demand a refund on your money for the medicine that didn't fix you?

What about a mechanical problem on your car? You take it to the garage and they replace a part they suspect is the problem. Well, the problem doesn't go away. Would you demand that they fix it for free since you already paid once?

In situations like this I bet that most people realize that not all problems can be fixed quickly, and that it's often a process that can take some time or trial and error. Why does it seem like people don't consider vets in this equation?

It's not uncommon for me to have clients that are unhappy about having to pay for a follow-up exam. We also have people that don't want to pay for a second round of medications when the first ones didn't work. It seems that they think that because we didn't diagnose and correct the disorder on the first go-round, that we should somehow be responsible for any further follow-up. I hate to tell them (and any readers who feel this way), but medicine is not always precise. I sometimes tell people that medicine is as much art as science. Some problems are easy to diagnose and fix. Others simply aren't, and take repeated visits and attempts to find just the right solution. These follow-ups cost the doctor time and money, and so that cost gets passed on. Our knowledge and time is worth money. If we didn't get paid for it, we couldn't do what we do. Failing to correct a problem on the first visit is not a sign of incompetance. It's indicative of the disease process itself, not the attending doctor. Sometimes an important part of the diagnostic process is response (or lack of response) to therapy.

So give your vets (and physicians, and mechanics) a bit of break. We really do want to help and do it as quickly as possible. When we have to see you back it doesn't mean that we didn't do our job, but that we're actually doing it!


  1. I agree. It's especially annoying when they decline the diagnostics and then get mad when the meds don't work. Um didn't you just force me to guess about your pet's condition? Duh. My husband-an engineer-thinks that all tests that come back normal or negative should be free. We've had endless discussions on why this is not the case. No wonder clients don't get it-spouses don't get it!

  2. As an engineer doesn't he have to learn how to do tests on machinery and structures? And doesn't he understand that a negative result is a GOOD thing? Running the test is part of the process, and a normal result means that you have ruled out that possibility. If we knew what the results would be, we wouldn't need to run the test!

  3. He agrees that it's good, but feels it was unecessary and therefore should be free. We've gone round and round about it. He's not a good patient and would probably not be a good pet owner! Ugh :)

  4. But listen, I once went to a mechanic because my check engine light was on, had them investigate, and paid them for it. They said the car was fine. I went on my way and that evening the car died. So yeah, I insisted they deduct the cost of the original "check-up", plus the cost of the tow. You really wouldn't?

  5. No, I wouldn't. In my mind they ran tests and didn't find anything wrong. Sometimes that happens, and it's not until things continue to go wrong that you recheck it again. It's not always possible to find the problem on the first try, and missing something doesn't mean that there was negligence or incompetence. I wouldn't have insisted on them paying for the tow or deducting the cost. But my father was a mechanic at one point and was in the car business, plus I understand how diagnostics can work, so I have a different perspective.

  6. In ancient China the doctor didn't get paid if the patient didn't get better. I don't think that's economically feasible now that medicine has gone beyond plants, needles and tea, but it's an interesting historical nugget.


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