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Wednesday, May 18, 2011

Reluctant To Tell The Hard Truths

One of my idols is Dr. Gregory House from the long-running TV show "House".  Though he is quite a jerk, unfeeling, and conceited, he can say things that nobody else can, and is usually right.  In the real world he would have likely been fired long ago despite his brillance, so you're not likely to find many people like him.  But I really wish I could be as blunt with my clients as he is with his.

Many to most veterinarians are very non-confrontational, introverted people (myself included).  It takes a lot for us to reall sit down and say the hard things to people, even if they need saying.  When I was a new vet, I was more likely to be direct.  Then I started realizing that I actually needed to improve my diplomacy and communication skills, and learned how to be very politically correct in my speech and writing.  Now that I'm entering my 14th year of practice, I think the pendulum is swinging back the other way and I'm getting tired of having to be "PC".

I often think that clients shouldn't have a pet because they can't afford basic care, or simply won't do it.  Rarely have I ever actually said anything to them in a direct way.  Why?  We're vets, but we're human, and it's hard to confront someone in this way.  Also, we don't want to drive people away from our clinic and want to have a good reputation as sympathetic and caring.  So when I see those people I normally go back and complain along with the rest of the staff, or come online and blog about it.

Not today.

I had a client come in to get a rabies vaccine for her dog.  The only reason she was doing this was because her other dog has supposedly bit someone and was under quarantine from Animal Control because the rabies vaccine wasn't current.  These dogs weren't current on any vaccines, didn't take heartworm or flea prevention, and hadn't seen a vet in years.  The owner admited it was because she didn't have the money, and couldn't do anything further for them.  As I was talking to her, something shifted in me, and I braved my non-confrontational nature to say what I really wanted to say.

I talked to her about the severe and life-threatening risks of heartworms, distemper, and parvo.  I told her that she was allowing her dogs to be at risk for disease and potentially even die.  And then I did what I have never done in a situation like this.  I suggested that maybe she should find homes for them with someone who actually can do basic preventative care.

Many reading this may wonder why it's so hard to talk about it.  "They shouldn't be having pets if they can't afford it!  You're a coward if you've never talked to clients about this!"  And you'd probably be right on both counts.  But it's different to talk about it with friends and colleages compared to actually confronting someone.  In your own lives think to difficult things you've had to say to people.  Most of the time we avoid it for as long as possible, if not forever.  Is that wise?  Certainly not.  Avoiding this discussion only hurts the pet, and denies the client needed truth and a reality check.

Now this doesn't mean that you need to be cruel or argumentative.  I was careful to be as polite as possible.  But I did see the client get a little wide-eyed at the suggestion that she give up her pets, which made me cringe inside.  However, it needed to be said, and I don't regret doing so.  In fact, I'm now more likely to do it again in the future.

In our modern society there seems to be too much emphasis on "being nice", or being "politically correct".  It seems that everyone has to be careful never to offend anyone else, like somehow people have an inherent right not to be offended.  But tip-toeing around issues often keeps necessary truths from coming up, and doesn't really get to the heart of the issue.  You can be more polite than Dr. House and still say what you need to say.  When you do so you're actually doing the person a favor as well as helping yourself.

So I'm going to start being more direct with people from now on, and work on my diplomacy skills in telling them what they need to hear, not what they want to hear.  The longer I practice the less tolerance I have for ignorance and foolishness.

Or maybe I'm just getting a bit crotchety as I get older!

8 comments:

  1. I think perhaps you are treading a very fine line here. Everything you have said in this post is absolutely true - but you seem to forget that for many people who are poor, their pets are all they have, and they give them a reason to wake up in the morning. Yes it is selfish to keep them when you can't afford routine shots and such, but is it really right to tell them that love and companionship are only for the well-to-do? I don't think so. I think this is one of those cases where if you consider all factors involved there really is no right answer. How about instead of telling people to give up what might be the only good thing about their lives - which they probably aren't going to do anyway and may just end up avoiding any veterinary care whatsoever in the future, you set up a fund for them, through which you can ask for donations via a box or something, and your more well-to-do clients that you seem to favor so much can help out. The energy you're using to judge people would be far better spent judging those who are selfish with their money and won't help others.

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  2. Yeah, Anon, but is it okay for the animals to suffer because of it?

    I admit, I'm an extremely poor college student, but I do make sure that my puppy (not a puppy, but eh) gets his shots, flea preventative, etc. Mother refuses to let me "waste" money on heartworm preventative because it's not really prevalent over here, but I'd like to start up when I get out of the house.

    While I would immediately go into debt if my dog needed it (within reason), not everyone can do that. Heck, right now, I may not be able to. We're on the verge of losing the house, my dad lost his job, etc. That wasn't the case when we got our dogs.

    You can't assume it was always that way...well, the cases where it's been going on for years is a slight exception.

    Anyways...just my opinion.

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  3. Anonymous, I am trying to be careful. However, it's not a matter of judging someone. In fact, I don't judge at all, and I'm not sure what you're seeing that makes you think this.

    It really comes down to whether or not the person can do even the bare minimum preventative care. If they can, I'm not worried about how much money they have or don't have. If they can't (or won't) even do basic care, then I believe that they shouldn't have the pet.

    We do have a donation-based charity fund, but it doesn't get as much money as you might think, and we reserve it mostly for people who need emergency or serious illness care rather than preventative care. There simply isn't enough money from donations to be able to cover everyone who can't afford vaccines and heartworm prevention.

    Anonymous, you seem to be saying (and correct me if I'm wrong) that if the person loves the pet and if the pet brings them joy, then it's perfectly okay for them to allow that pet to be at risk for parvo, distemper, leukemia, heartworms, and other fatal illnesses. How is this fair to the pet?

    And it has nothing with someone being well-to-do. If you take on ownership of a pet, you also willingly take on responsibility for that pet's health and well-being. If you are not prepared for the financial aspect of that care, then you're not ready for the responsibility.

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  4. In reference to the first comment, the same thing can be said for people who have kids they can't afford to care for. "But I love them, and they love me", but then they live in sometimes very unsafe conditions, and cannot afford to give them medicines when they are sick or even get them vaccines that would keep them healthier because they do not have insurance. I only say this because I have seen it first hand and had to personally act on behalf of the kids. Sometimes the best things for a pet is to allow someone to care for them who can, or get help in caring for them.
    No that does not mean that only the well off should have kids too, but what I am saying is that using the logic that you are using, well just doesn't hold up all around. Doing the best you can by those that you care for is the best. If you really do love them, then making that sacrifice is worth it to see them live a longer healthier life. This is coming from someone who has to sacrifice things for my dog, but she is worth it and keeping her around and healthy is of very important to me. I am not wealthy, and we just get by most of the time, but if I felt that I could not provide for my dog, then I would give her up to a good home(of course I would visit her ;)). Thanks Dr. Appreciate your bluntness, as I needed reminding of how important preventative care is. I guess I need to get my dog in soon for some more heartworm meds.

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  5. I have to agree that that this is a very fine line to tread.

    Once upon a time, in my younger days, I would have said that if you can't afford basic health care, you shouldn't have a pet. But...I've had the opportunity over recent years to spend a great deal of time in a big city with a large population of homeless people. I am struck by how many of these people, who do not have access to those basics many of us take for granted (a roof over our head, food on the table, healthcare, jobs), have dogs that they obviously adore and do the best they can to care for, often going without food so their pet can be fed. Most, if not all, of them are in their situation through no fault of their own and these pets are the only friends and companions they have. A previous poster is correct - who am I to pass judgement? Instead, I count my blessings every day for being able to enjoy all that I have, including my pets, and I take every possible opportunity I can to share that with those less fortunate - opportunities that can be as simple as picking up an extra bag of kibble at the grocery store for that homeless person sitting around the corner with his best buddy and cart of worldly possessions.

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  6. Again, this has absolutely nothing to do with passing judgement. I'm not making any value or character judgement at all when I'm looking at these issues. It really is a very simple situation. Can you financially afford to do the bare minimum care for your pet? To me this means core vaccines and heartworm prevention as a minimum. If you can afford this, I'm fine with it. If you can't afford this basic care, I believe that you shouldn't have a pet. Why is that a hard assessment?

    Remember, nobody has a RIGHT to a pet. Yes, pets enrich our lives and give great joy. But if we're keeping a pet that we can't afford because we want the companionship, this isn't good, it's SELFISH. We are putting our own wants and desires over the health and well-being of the pet.

    If someone who can't afford vaccines and heartworm prevention gets a pet, and then that pet comes down with parvo or heartworms, how nice is this for the person and the pet? These conditions are very preventable, but forgoing prevention puts the pet and person in a worse position. If they cannot afford prevention, how are they going to afford treatment?

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  7. and then there are those pet owners who will buy their animals - dogs in particular the best of food bowls, best of beds and toys and who inevitably have a well bred dog to shower all this on and who bring their dog to the vet when it is unwell BUT and this is an important BUT, they fail to give the dog a life - they don't walk it, spend quality time with it in an interactive way, give it the opportunity to interact with other dogs and have no obedience training. This is to my mind worse than not bringing the dog to the vet because you cannot afford to do all the preventative stuff. I know of many people, and I genuinely mean that - MANY, who have a dog, leave it in teh back garden all day to yell and yap and destroy, come home, bring it in feed it and the next day it all starts again. They are never walked, never see another dog, never play - why do people have them - its beyond me. The vets don't see this side - they see a well fed dog, all concerned owners and usually an antichrist who distrupts the waiting room. The vet probably thinks the animal is well looked after - I would disagree and say they have no life. This is far worse than someone who won't bring the dog or cannot bring them to the vet because of cost.

    By the way Chris I don't think you are being judgemental - I do think you have the animal's best interest at heart and that is what a vet should have. Its a tough call.

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  8. I agree Chris, pets are not a right. I have seen so many times someone who gets a pet and thinks it's ok to let it suffer with preventable and treatable problems just because they want a dog. Not fair.

    And maybe I'm getting crabbier too but my list of things I won't do or will stop doing when I own a practice is getting longer!

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