Thursday, January 8, 2009

what goes around comes around?

that was a comment written in response to my last post, and i'm curious as to what the writer meant?

if she meant that i will be punished for actually charging for the services that i render and expecting payment, then i am - frankly - stunned.

it goes without saying (if you read my blog) that i work my butt off, that i care about my patients and what happens to them 100%, that i stay up nights worrying about what i could have done better as a doctor, what i missed, what i neglected to do. and i don't do this out of concern for liability. i do this because i want to be the best vet i can be. i strive to achieve that ideal EVERY SINGLE DAY - no matter how tired, how stressed, how sick i am. i don't let myself off the hook for one moment.

and in a mere 6 months, i have discovered that people are dishonest or uninformed and that my judgment of character is often wildly, wildly wrong. thus, it is impossible to form an objective standard by which to judge people.

examples: a man and his young son brought me their beautiful 2 year old cat. money was tight, and the cat was extremely ill. in 2 days, he went from sporadic vomiting to throwing up every time you touched him. i finally made the decision to go to surgery with him, although the owner didn't have the money. he thanked me profusely -telling me that he couldn't go home and tell his son that he didn't exhaust every option. he assured me he would make payments. i looked at the man and his son, and i trusted them. i went to surgery, the cat died afterwards likely due to cancer. that was FOUR months ago. the man has not made a single payment on the $830 bill. not even a $5 payment - despite numerous phone calls and bills.

another example would be the couple who wanted to give their dog with possible hemangiosarcoma a chance at 6 months of life (read the post a couple down on this page). after talking to them at great length, they decided they wanted the dog to have that chance - the chance that there wouldn't be gross metastasis, that i could take the tumor out and give the dog 6 months. we were on the same page before surgery, and i was confident. these people really seemed to trust my judgment and like me. they were 100% on board. aftewards, when the dog was euthanized due to metastatic cancer, they didn't want to pay the bill because they thought i just should have known that the cancer had already spread.

those are but 2 examples where my judgment of people has been terribly wrong. i could give you dozens more, and most long time vets could give you hundreds.

since there is no objective standard by which to judge people, their financial situations, or their honesty - then i have to assume all are alike.

it sucks, and it may sound heartless - but i am a veterinarian. i work in a business that profits from me, and i have to make money to support that business. do i hate turning away those with sick animals that cannot afford proper treatment? of course. but at least i can offer them humane euthanasia to stop suffering. sometimes that is all that i have to offer them.

last night at work was terrible. i saw 3 animals with life-threatening conditions. none of the owners had money. one was a tiny (1 lb) chihuahua with 2 open fontanelles (soft spots in the skull) through which the brain was trying to push. he also had terrible hydrocephalus ("water in the brain" - which really means dilated ventricles filled with cerebrospinal fluid) which was causing him to have neurologic disease. the puppy needed to be hospitalized and treated overnight with the plan to take him to surgery.that would have cost $800-1000 (surgery an additional $3000 at a referral institution). the young couple that owned him had $103 with them. i offered euthanasia. they declined. the dog went home with steroids. did it suck? hell yes. would i have preferred to keep that dog in the hospital and knock the bill down quite a bit? hell yes. could i pay my technicians, the overhead cost of our 20,000 square foot modern facility with digital xrays, ultrasound, and soon a CT scanner if that was what i had done? no.

and that was only one of the 3 cases with no finances that i saw last night.

it's not an ideal world. it's a harsh and unfair world. but unfortunately - we have to live in it. i do my best every day, and i try to help people whenever i can - at work and outside of work. and if what goes around truly comes around ... well then, i feel like i can rest easy at night.


Can'tSpell, DVM said...

Been there, done that, have the t-shirt. I try not to let it get me too jaded. But it's hard.

Shannon said...

My two cents is that the owners have to take some responsibility for their pets. An animal is not a possession, its a member of the family and before you adopt or purchase one, spend some time thinking about how you would handle a medical catastrophe. What are you willing to pay to keep that family member alive and well. How would I cope in the event that I lost my job or was unable to work. And if the answer is "I won't" or "I can't" or "I don't know" spend some more at the drawing board before committing to a pet that has the potential of living 15-20 years and costing upwards of thousands of dollars in routine medical costs (Speaking from personal experience, I have an HCM cat who gets six month bloodwork, annual cardiology exams and routine medication, I estimate it sets me back about $1200 - $1500 a year).

Yes, I have deep sympathy for the animals. I think the people are irresponsible ones. This is obviously also a personal perspective as someone who volunteers in cat rescue and way too often hears "I can no longer afford to keep her" as the reason for abandoning a cat.

Sorry to long.

jameswcalvin said...

I respect you and your thought process about this whole situation you are going through. at the end of the day its a business and you need to pay bills the office needs to pay their overhead and maybe make purchases to better the office as the CT scanner. you can't if you are cutting back prices for services. keep up your great work you seem to be doing and don't let nay sayers get to you. pets are responsibilty and need to be treated as such. the mechanic isn't going to cut me a break on rebuilding my motor just cause I don't have the money and I'm nice to him.

Superior Parrot said...

Your job is hard enough. Try not to let vague statements make you feel bad. Remember the healing and life saving you do, not the mean-spirited people who would have you down on their level.

The Homeless Parrot said...

thank you for the supportive words. you are all the kind of owners i relish seeing. unfortunately, you are not the majority. but i'm not getting jaded. i know - deep down - that i do a good thing every day, and i know that i do truly care - and that's what matters, right?