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Saturday, January 21, 2012

"You're Going To Let My Dog Die?"

Today my associate saw a dog who was in pretty bad shape:  painful in the abdomen, lethargic, not able to urinate or defecate, and generally not doing well.  She found a firm mass in the abdomen and the dog had apparently eaten part of a steak bone. However, the mass was larger than the size of the bone, so she knew something else was going on.  Being a great doctor, she obviously developed a treatment plan that started with radiographs and went from there.  

As commonly happens the client said that they couldn't afford to do anything, and in fact had come to us because they couldn't afford the $100 to walk in the door at the emergency clinic.  We gave them the information for Care Credit, and they were declined.  She didn't really have many options at this point and told the client this.  The client's response?

"So, you're just going to let my dog die?"  followed by "What vet doesn't take payment plans?"


And this isn't the first time I've run across this attitude and comment.  Plenty of clients think that it is our obligation to treat pets and do surgery, even if the client doesn't have any way to pay.  After all, if we really loved animals we'd just go ahead and do it (another comment I've heard before).  If the client can't pay and we decline to treat for free, somehow we are the ones letting the pet die, not the client.  It's our fault that we won't give away hundreds or thousands of dollars in services, but it's not the client's fault that they don't have any funds in a savings account or have such horrible credit that they can't qualify for a payment program.

I really think many people don't realize that we can't operate a veterinary practice without charging.  There are so many little things that people never think about....payroll, rent, utilities, liability insurance, worker's compensation, taxes, and many dozen other items that quickly build up and take up any revenue.  We as vets have our own personal mortgages, student loans, and other debts, as well as families to support.  And most vets aren't driving BMWs or Lexuses while living in 4000 square foot homes.  If we give away too many services, we can't pay our bills.  If we fall behind on our bills, we have to fire staff, cut services, and eventually will go out of business.  In fact, such discount practices are the number one reason veterinary practices close, and it's much more common than anyone outside of the profession realizes.

It's also not smart for most vets to set up their own in-house credit system.  I've seen this done, and more times than not clients fail to make payments appropriately.  Practice consultants routinely say that this is a bad idea for vets to do.  And if someone doesn't have good enough credit to have credit cards or Care Credit, this means that their revenue and ability to repay people is below acceptable standards.  In other words, they are very poor risks. So why should the vet take those risks?  I know that everyone says "Oh, don't worry, I'll be the one to make payments on time."  Call me cynical, but in my personal experience that is rarely the case.  Which is why most vets don't take payments, especially for first-time clients (which this dog was).

So what happens in these situations?  Unfortunately, the pet suffers.  But who is responsible for that pet's care?  It's the owner, not the vet.  The vet is the agent of treatment, but we can only advise decisions.  Ultimately the client must agree to the treatment plan, and the client is also ultimately responsible for the pet's well-being.  If the client can't pay, it's simply not the vet's fault or responsibility.  And most of us have learned not to let the client guilt us into doing it anyway.

In this case the client had enough money to afford euthanasia, which was the best decision if they couldn't do any diagnostics or treatment.  The dog didn't have to suffer for long.

It's about personal responsibility, folks. Something I think that much of American society has forgotten.  Too many people want to blame others for their failings and hard situations, when the huge majority of the time the fault is really with the person themselves.  People need to take responsibility for their own actions and for the care of the people and pets entrusted to them.