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Thursday, August 6, 2009

The Clients You Want

The last two days I have been dealing with a rather difficult case and a rather great client. In fact, he was the kind of client that every vet wants to have. Let me explain.

Maggie is a dog I've seen before, a 10 year old large breed dog. She's had arthritis problems that we've been managing, but over the last month she has had more difficulties moving around. I saw her yesterday to be evaluated, and noted that she was weak and had pale gums. The owner is actually in another state for his job, and wasn't going to be home for weeks. He wanted to handle anything over the phone so his wife wouldn't have to worry about things. I called him with my initial assessment and my plan to run some tests. He said that he was willing to try and figure out what was going on, but also didn't want her to suffer if there wasn't anything we could do. Then he dropped a bombshell on me that honestly I can't say I've ever really heard from a client.

"Tell you what, doc. Go ahead and go up to five or six hundred. I don't want you to have to worry about calling me. Just do what you need to do."

Wow. If only every client could tell me that. It wasn't really the fact that I could get money out of him. My eyes didn't light up with dollar signs. It was the freedom he gave me that mattered. He gave me the leeway to make my own decisions on what was necessary, and the budget to actually do these things. I didn't have to call him on every choice or negotate what we could or could not afford. It was so nice to not have to call him every time I wanted to do a different test or change my diagnostic plan. I was allowed to be a doctor and the trust to proceed as I felt was best.

Over the next 24 hours I ran some tests, sent some to our diagnostic lab for further information, and kept in regular contact with the client. Each time we talked honestly about Maggie's situation, and each time he told me to go ahead and do what I thought was best for her. He wasn't worried about another $100-200 if we could help her, and was willing to do surgery or other treatment if necessary.

I wish that I could say that the story had a happy ending. Maggie was anemic, and it appeared to be a problem relating to her spleen. I was concerned about a tumor, and took some x-rays. There was fluid around her lungs, and when I tapped her chest to examine it, there was blood. My final diagnosis (unconfirmed) was a type of blood cancer called hemangiosarcoma, which can be very malignant. The owner made the decision to put her to sleep since there probably wasn't much we could do for her, and I agreed with him. Maggie passed away very quickly and peacefully.

In our last conversation I thanked him for his concern, care, and realistic attitude about his dog. I really appreciated how he wanted to go as far as necessary with the case and that he trusted me to make the decisions as to which diagnostic tests to do next without having to check with him. I also respected him for wanting the best for Maggie, whether that was treatment or letting her go.

I know that not everyone can be that relaxed with hundreds of dollars, and it doesn't mean that people without that money love their pet any less. But it was a great relief and honor to be able to actually do what was needed without any real barriers. I felt the freedom to actually be a doctor with no limitations. I really wish we could have saved Maggie, but despite that I have to say that this was one of the most satisfying cases I've had in a long time. I look forward to dealing with this client in the future when they decide to get another pet.

4 comments:

  1. I hope I'm that kind of client. My lab was hit two weeks ago, when I took him in I told the vet my husband was going to balk @ anything over $500 but I wanted to do what was best for my dog.
    I had to have Mugsey put to sleep 8 days ago but the vet bill without the ashes was $448. We had waited for some improvement for almost a week and he was just getting worse, back end was paralyzed, tail quit wagging, he became incontinent.
    I do enjoy your blog very much. I think I've read the whole thing!

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  2. Glad you're enjoying it, TC. I'm sorry that Mugsey didn't do better.

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  3. Too bad about the outcome, but at least you got a diagnosis and know there was not much to be done. Nice to have good umderstanding clients.

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  4. The vet even took him home to his hot tub to see if that would help the swelling or relieve him somehow.
    I tried to be understanding, I even hugged the vet and his assistant because they were getting misty eyed too.

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