It may surprise you to learn that many vets are obsessed with money. It comes up all the time whenever we get together. But I’m not trying to say that vets are generally money-grubbing. In fact, I’m saying the exact opposite: Many vets are absolutely obsessed with helping their clients save money.
Plenty of vets have full-blown money complexes and project their own financial worries onto their clients. They don’t value their own work, and they assume their clients don’t, either. They are convinced that people don’t want to spend money, and so they constantly work to provide their services in the least expensive manner. Striving for affordable care is a good thing — until corners start getting cut. Unfortunately, some vets do cut corners.
In the last year I have been to two major veterinary conventions and attended dozens of lectures on subjects including trauma, surgery, and infectious diseases. Every last one had something in common: The speaker brought up the subject of money.
Among vets, the money talk generally goes something like this:
1. Drug A is a good choice because it’s cheap.
2. Drug B works better, but it’s more expensive, so you’ll probably want to use Drug A.
3. Although Procedure C is the best option, most vets will never perform it because it’s too expensive, so you may want to use a cheaper but less effective way to try to get the job done.
4. Treatment D is good because your clients won’t have to pay much for it.
I reiterate: Providing effective care without wasting resources is a good thing. But some vets go beyond that into outright financial paternalism. They choose a lower level of care in order to save money for their clients — without giving the clients the opportunity to choose a higher level of care.
Two years ago, I was at a conference in Texas. At a lecture midway through the event, I commented casually to my neighbor that I generally recommend X-rays for vomiting patients that come to my office. My neighbor, whose voice was an exact dead ringer for Hank Hill’s, took issue. “Wellllll,” he drawled, “I think that’s a waste of money. I start with an antinausea injection. Most of the time, that’s all they need.”
Dr. Hank Hill’s treatment plan will indeed be sufficient in many cases, but not in all of them. If a dog is vomiting because he ate some mildly offensive (to his gastrointestinal tract) garbage, then an antinausea shot will set him right. If, on the other hand, the dog is vomiting because he has swallowed coins (which happens more often than most people realize), he’ll be in big trouble if those coins aren’t found and removed fast — and they show up clearly on X-rays.
Don’t get me wrong: I don’t insist on X-rays for every vomiting animal. I recommend them, and let the clients decide how they want to spend their money. It’s not up to me.
Here’s a true story that I offer as evidence that these matters aren’t merely hypothetical. Many years ago before I was with my current employer, I was involved at the tail end of a trainwreck of a case.
The patient was a 4-year-old female dog who had been vomiting. The first vet did not want to waste the client’s money on X-rays and administered powerful anti-nausea medication. The dog improved for two days, but then started vomiting again. A second vet gave more antinausea medication, which worked for two days. The third vet took X-rays and discovered a rock in the dog’s intestines.
In surgery, it was discovered that a portion of the dog’s intestines had died — a common complication when foreign bodies are in place for long periods. The affected portion and the rock were removed, and her intestines were repaired with sutures. I met the dog for the first time three days later, after the sutures failed and her intestinal contents leaked into her abdomen, causing fatal sepsis.
Needless to say, the dog’s owner was very upset. Money was no object for her. She had wanted the highest possible level of care for her dog, but she had not received it. It had not been offered, because the first two vets wrongly assumed that she would not want to spend money on X-rays.
I am a working man, and I know that money is a scarce commodity. I understand that sometimes clients cannot afford my recommended diagnostic and treatment plans, so I work with them to find less expensive alternatives.
If you bring your pets to my emergency surgery, I’ll give you the information you need to make educated decisions about their care — and let you decide what action to take. I think it’s inappropriate for veterinarians to decide how clients should spend their money.