There’s no situation harder for me than walking into an exam room and meeting an untrusting pair of steely eyes and crossed arms. That’s it! That exact expression to the right.
The internet, bookstore, and media are rife with sensationalistic stories about veterinarians trying to soak their clients, offering tips to help you combat those sneaky vets for only $19.95 plus S/H. I hate those stories- not because they’re exposing my “secrets”, but because they set up this combative atmosphere of distrust that make it very difficult to do my job well.
When someone comes into the office with this attitude, it’s apparent from the first moment. Every piece of advice is met with a sniff, every recommendation met with, “how much is that?” and “is that reallllly necessary?”
The questions are fair, but the tone says, “I don’t trust you.” It makes it near impossible to have a good working relationship. Most of the time disgruntled people holding an estimate in hand wait until I leave the room before asking the tech, “Is this a joke?” – but not always.
Let me be clear: I have a job, and that job (making pets better) involves recommending tests and treatments that cost money. I can’t do it for free, nor should I. But I don’t ever recommend anything that isn’t in the pet’s best interest solely because it makes the bill higher. Do some vets do that? I’m sure some do. Do most? I highly doubt it.
If you trust that that is my purpose, welcome. Let’s work together. If you don’t trust me, you should find another vet you do trust.
I recommend things that people can’t afford all the time. It’s my job to at least offer those things. How unfair would it be for me to make an assumption about you and what you can and can’t afford without giving you the chance to make that decision yourself? I’ve seen people on very limited incomes pay for a $5000 surgery and a guy in a $90,000 Range Rover (I know this because he told me himself what he drove and how much it cost) decline $200 in medications for his elderly father’s sick poodle. You just never know.
It’s a sad reality these days that medical practitioners have to function with one eye on the case and one eye on the potential lawsuit. It’s the reason informed consents are so long and the reason we have to tell you all the options even when you don’t really want to hear them. I’m not trying to make you feel badly when I tell you what the options for treatment are, but I do need to inform you. I have to. The standard of practice demands it. Whether or not you accept those recommendations is up to you.
I’ll be straight with you if you be straight with me. If you can’t afford my recommendations, let’s figure out the best use of what you can afford. This just doesn’t work if there isn’t some fundamental belief on your part that I really want what’s best for your pet.
I owe you the same. People come to the vet wanting to help their pet the best they can, and if you can’t afford the optimal treatment you should be able to figure out a Plan B without having to endure a lecture. We are both responsible for setting the right tone for a good visit. This is why I stopped playing the Mortal Kombat theme as I walk in the door (kidding.)
I strongly suspect that the people who are so combative and stingy are the same ones who would ask the surgeon “how much” when they take their ailing grandmother to the doctor. They’re no more concerned for their pet than if it were a used-up newspaper.
We are not rich and have had to decline “possible options” at times, but we have always, with the help of our very compassionate vet, been able to find care/procedures that we can afford that will help our pet in the best way possible.
I’m pretty sure when you were a little girl comforting every stray dog, cat & squirrel that came into your neighborhood, you weren’t saying to yourself, “how can I make more money on this animal!?!” People are entitled to make a decent living from their work (even stingy old Ranger Rover drivers) and veterinarians perform one of the most essential services for our family and we are more than happy to purchase their services.
Don’t let them get you down Dr. V – there are occasionally bad bananas in the bunch and you have to know that they aren’t treating you and their pet any worse than they treat ANYONE! It’s definitely their loss!
Aww…you are doing it right, Doc. Stuff like that reminds me how much I like my animals.
That is my worst fear, my pets needing something and I am not able to afford it!
Really great post, Dr. V! You’re my kind of vet! My fuzzies have a great one, too. I’ll admit that sometimes the bills freak me out, but I trust my pet’s vet very much and my commitment to the fuzzies warrants that if I CAN follow the vet’s recommendation, I will, whether I take it with a large gulp or not. Sometimes, though rarely, I expect the ginormous bill and it’s just a wee bit smaller than I thought it would be–plus, my fuzzie pooch or kitty feels SO much better! That’s the goal. Thanks to the great vets out there for doing right by us and our furry beasties…
Same here , thats my worst fear as well not being able to afford something but I have always been a proponent of proactivity and preventative care. Dr V, I wish you were my puppies Vet 🙂
PS That guys face in the picture is kinda creepy LOLOLOL
I went to istock photo and typed in keyword “skeptical”. True story.
I think you’re right to blame the media for focusing so much attention on negative perceptions of veterinarians. I work with veterinarians every day, and I have never seen more compassionate, more dedicated professionals. They all are in it for the love of animals, not for money!
Keep your head up, Dr. V. There are those of us who know how much you care about your patients 🙂
I’m amazed at how many people think their vets are out to fleece them.
If you can’t trust your vet, find another one. If you can’t find one you can trust, maybe it’s you…
Financial advisors don’t deal with dog poop (sorry, had to use that word) in their offices! If you were just in it for the money, there are many other options for a career choice where you would deal with a lot less crap! (Ha, play on words!) I will spend whatever it takes (within my means) to treat my pet, and I don’t question my vet’s charges. I look at it the same way I look at my doctor’s charges. They do what they need to do and charge what they need to charge. Only once did a vet make me feel bad about my decision, and it wasn’t a money issue. She was a vet oncologist and told me I needed to amp my dog’s leg when he had cancer. I had my reasons for not doing that (his age being the biggest), so I feel like she treated him with less than her best effort because of my decision. She never even “talked” to him when he went for his radiation visits. 🙁 Even in her case, I don’t think she was in it for the money. But I question whether or not she was in it “for the love of the game.”
P.S. My regular vet reassured me that he would have made the same decision in this case if it was his pet, given all that he knew about my dog. I felt better about that.
Sometimes I think Pru’s vet and the staff get iffy with me because I always ask how much a shot/procedure/check up is going to be when I schedule the appointment. It’s not that I am thinking the office is trying to over charge me or what not, it’s because I am working with an incredibly show string budget and I always want to make sure I have enough money in my bank account before the appointment. Sometimes I feel I have to tell the staff that so they don’t think I’m a stickler or not wanting the best care for my pets (that is not it in the least! I would definitely be the patient that would find a way to pay for the $5,000 surgery if needed). But then again I am extremely paranoid at times.
If it is anything like my office, it’s probably because the staff is just super gun shy about giving estimates over the phone because people will do their darndest to force you to honor that exact number once they get in, even if they are asking for entirely different things than they did over the phone.
Why would anyone go to a vet they don’t trust, except in an emergency. We are sooooo lucky to have Patti and Holly, and their wonderful support staff.
ps… they also give me an estimate prior to doing work, which I think is a very good and considerate idea.
I do the same. I think to do anything else is probably not wise.
I honestly think people who ask ‘how much?’ are doing the math in their head if they can afford it, AND still care for the dog (outside the vet) in the manner that is acceptable.
HOWEVER, that being said, I will 100% of the time ask for the price of a medication, as many meds prescribed can be bought at big box stores, drug stores, etc. and the difference in money can be spent on other requirements for the animal (food, vet, etc.).
Example: soley for the reason of medical support from the shelter (they provde vet and med service), I am fostering (vs. adopting) a dog that requires daily anxiety medication (Clomicalm). Called a vet – they wanted $42 for 60 25mg pills. Chain drugstore wanted $35. If I used my AAA card at this chain drugstore it was down to $26 (which they didn’t tell me of course). I called Costco – they want $15! for the same generics. So from $42 to $15 for the same meds – same count and dosage…a 60% reduction in price.
You can’t shop around for xrays, etc. but medication has HUGE profit opportunities for everyone in this world. Dr. V. can you tell me why vets are hesitant to write or call in a prescription when you ask them to, versus you buying it there? I actually stood and gave the vet the Costco phone number (for a previous dog) so they could confirm how inexpensive Cephalexin was at Costco vs. what they were charging…they didn’t believe me.
P.S. As for vets, within a 3 mile range of my house a NON-SPECIALTY vet can run anywhere from $35 to $75 per visit so there is a large range in price.
I have ZERO problem with people asking “how much?” I don’t do a thing without people getting an estimate telling them exactly how much. It’s the “how much (because whatever it is I’m sure you are gouging me inflection)” that makes it hard to work with some people.
I don’t like calling in prescriptions because it is very difficult to get some pharmacies to let you do it as a veterinarian. It is always a challenge. I am happy to provide a written prescription, though.
I am behind you here, doc V. If these folks are busily asking “How much?” then it doesn’t seem to me like they’re too concerned about their fuzzy kids. Although….I was in a pinch once, and had no money whatsoever. During this dry season, two of my dogs go into a brutal fight, and the loser was an old girl named Jamie. She was lacerated all over her legs and she had lost a tooth. When I called the local emergency vet, I found out that I just couldn’t afford to go in because I didn’t have the money. >_< So, I patched my girl up myself. Yes, I trimmed the fur away from her wounds, rinsed them thoroughly, packed them with antiseptic gel, wrapped her legs in gauze and compression bandages. Yay for know some first aid! Couldn't do anything for the tooth though…that's a shame.
The tech a talk to, bless her heart, called me back after I had hung up and asked me if there was any way I could get the money, and when I said I couldn't, she burst out "But she'll get MAGGOTS!" I wanted to hug her through the phone.
Wow, I totally butchered my English there. I mean, it’s so bad I don’t know if I can fix it. Sorry! I’ll bake cookies for you guys later!
PS – Jamie is fine, except for some slight scarring (and the tooth).
I don’t want to be the negative Nellie in the room, but how can the media be totally to blame when the AVMA releases commercials urging pet owners to see the vet TWICE a year for “wellness exams”. Images of dogs drinking out of puddles and kids playing with dogs suggest that you’ll get some deadly zoonotic disease if fido isn’t seen every six months.
I have an excellent relationship with my vet & trust her absolutely. I understand that vets run a business and need to make money like the rest of us. These videos are total fear mongering and suggest that dogs are disease carrying vessels just waiting to infect you and your family without the intervention of a vet.
you can see the videos here; If it doesn’t come up in a hyperlink, just copy and paste into your browser bar.
http://www.youtube.com/watch?v=7VGxCTz3OTs&feature=player_embedded
http://www.metacafe.com/watch/779996/american_veterinary_medical_association_launches_risky_business/
I wouldn’t say the media is entirely to blame for anything, but it certainly doesn’t help.
I have caught countless cases of early renal disease, cancer, heart disease and- yes- parasites during regular preventive care exams. They serve a real and valid purpose. I like twice yearly exams, and it’s pretty much the standard of care in the field, but at least once a year is OK too.
I use a product that deworms on a monthly basis along with heartworm preventive, so I don’t necessarily tie that visit to deworming.
Honestly, I really don’t consider that fear-mongering at all. Not to make out pets to be sesspools of disease, but they absolutely carry things (very commonly, I might add) that can be transmitted to humans, especially children. Public health is actually considered part of our job — most people aren’t aware of these illnesses and wouldn’t know what to look for. Veterinarians are not only supposed to keep pets healthy, but we’re supposed to keep our antennas up for things in animals that could threaten the health of pet owners. Those commercials are informative, not fear-mongering. They are bringing to people’s attention the things we commonly see in practice and of which people are frequently unaware.
I hope Im not gullible but I always just pay for whatever the vet recommends….I dont earn much but I figure I cant reallybe stingey when it comes to Squeaky’s health, and I’d rather overpay slightly (if that is even the case, which I’m sure it isnt) and have him well than not and him suffer the consequences. Most vets I havehad experience with dont seem to be out there to rip you off.
I usually ask “how much?” not because it will impact our decision but I’m inquisitive about that kind of stuff. I also put everything in spreadsheets so it is my MO.
I really appreciated the vet at NC State who said “you have the option to test more” (because he had to). As I was about to say “Do it,” he said “I need to tell you that testing won’t really matter. Any treatment will mean a poor quality of life. You seem to want to do the best by him and I think it will be a waste of a test because any treatment that comes from it would be almost cruel.” As an owner, it was really helpful because you have the love for the animal but not the medical background to tell you what it really means for the pet. Having a person of science put the science aside – and guiding us to the most humane way to deal with the illness – was just priceless for us. It takes a really special person to be a vet!
And that’s kind of the heart of the matter, I think- having a dialogue. These are your options, this is what I think based on my experience. If we can start a dialogue we can figure it out. I just feel shut down sometimes before we can even get that point.