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Tuesday, January 4, 2011

Where Does Obligation End? Part 2

Back in November I started the most recent poll, asking if veterinarians had an obligation to provide treatment for a pet even if the owner couldn't afford it.  The question was based on a situation with a client, and though it was one of the more extreme situations I've seen, it wasn't the first one on this subject.  The results of the poll surprised me somewhat, as I didn't expect such a large percentage to say a vet has an obligation to treat.

I'm Not Sure--12%

I think that many people don't realize how much money it takes to run a veterinary practice.  Most vets run on a slim profit margin, and it's not uncommon for veterinary clinics to go out of business.  The most common reasons for such failure usually revolve around the vets not charging for services, giving away services, or having too low prices.  While it may seem nice to a client to have low veterinary prices, these low prices often come at the cost of the veterinarian.  Not charging and keeping prices too low are key reasons for vets to end up in a failed business, and ending up having to close their doors.

Veterinary practices are expensive.  Routine in-house blood analyzers can cost over $20,000.  An electronic tonopen, used for measuring eye pressure during glaucoma screens, runs around $3000.  My practice usually spends $2000-3000 per week ordering routine supplies, vaccines, and medications (and we're an average practice, not a really big one). About 40-45% of our monthly budget goes into meeting our payroll.  Each month we have to pay rent, utilities, unemployment insurance, liability insurance, benefits for the staff, data and phone lines, and a long list of other expenses that most people don't think about.  We are a profitable practice, but there isn't a lot of wiggle room.

So let's say that we took the obligation to treat all pets, even if the owner couldn't afford it.  When we're using medications, bandaging, surgical supplies, and so on to treat pets for free, it still costs our business to order them.  We still have to pay all of our obligations.  I can't call the phone company and say "We gave away about $1000 in services to needy pets this month. We're a little short on our phone bill.  Can you give us a break this month?"  I'm not sure my staff would stick around long if I told them I couldn't pay them for their hours worked because we did a lot of charity services this week.  And I wouldn't get far with our suppliers if I wanted to order more things but hadn't brought in enough money to do so. We have expenses and bills regardless of how much money comes in.  When we lose more money than we make we have to close he business.  And who can we help in those situations?

It's really nice to wish that we could see any pet and treat it.  But the reality is that this is not sustainable. I know that many of the people who voted were likely thinking of their own pets, and looking at themselves as the exception.  "Well, the vet makes enough money I'm sure he could afford to absorb a few hundred dollars for my pet."  Once in a while this may be the case, and I don't have a problem with vets who do occasionally help out clients by writing off costs or allowing payments.  But this can't be maintained by any vet.  And remember that there are many people who want the same consideration.  If the poll numbers are representative, 30% of the clients are expecting the other 70% to help pay for their medical care.   Or looking at it another way, veterinarians are being expected to keep their high level of medical quality and services, but doing so with 30% less income.  It simply can't be done.

So here's my question for anyone who voted "Yes" to the question "Do veterinarians have an obligation to treat a pet even if the owner can't afford it?"  How are the veterinarians supposed to pay their bills and stay open if they treat every pet without regards for payment or compensation?