Monday, September 13, 2010

Suddenly letting it get me down...

Ok lately, the burden of being a veterinarian has been resting more heavily on me than the joys of it.

Friday night, a family of three rolls up, all smelling vaguely of alcohol (not that I'm judging, I drink, too). They were what can only be described as a term that rhymes with "night crash." Their dog had been hit by car. It weighed >100 pounds. It could not walk, had blood draining from both nostrils, a respiratory rate of >100, and other signs of polytrauma.

That's an automatic $500 deposit to get started (a Class I form). I knew they didn't have it, but I wasn't about to watch the dog die in front of me if I could fix some of the immediate problems (shock, pneumothorax) relatively quickly.

I placed an IV catheter, administered shock fluids, tapped his chest, and gave him a dose of pain medication. Meanwhile, the owner is running in and out of our lobby, disturbing everyone else present by setting off our loud door alarm, making phone calls, and talking belligerently about the money. He was trying to find another vet to see his dog.

In the end, they took the dog to a local GP who (according to his google internet reviews) is "only in vet med for the animals, not the money." He had $100 to pay us for the $300 worth of services I rendered. He was declined for CareCredit.

Last night, he called back for a refund on my misdiagnosis. Yes, you read that right. I didn't talk to him. My tech told him to call back and speak to the office manager if he had a complaint. According to him, the dog just had a broken/dislocated elbow, nothing else. It did, however, spend the entire weekend at the other vet's office (for $250, according to the owner).

If I had talked to him, I would have said, "Sir, I did not diagnose your dog with anything other than shock after being hit by a car. I recommended pain medications, IV fluids, hospitalization, and xrays. You declined due to your financial restrictions and elected to take the dog elsewhere, leaving us with a $200 unpaid bill. That does not constitute a diagnosis. I'm glad to hear that your dog did well. Have a nice night."

I need a day off. Sometimes veterinary medicine is downright infuriating. To work the hours that I do, as hard as I do, only to be harangued and treated badly by owners, thrown under the bus by other veterinarians, and thought of as a money grubbing just makes me feel sad and helpless and hopeless for the state of humanity.

The thing is, I do love animals, and I love what I do. It's the best job in the world and can be so amazingly rewarding. Vet school was not free, however. I work for an employer that must pay the electrical bills, pay the staff, provide the medical supplies we use at great cost to us, and keep the doors to our clinic open. Where do people think that money comes from???

It only takes one bad owner to erase the memories of all the great ones, all the thank you cards, grateful smiles, hugs, and enthusiastic reviews. Why does 1 bad apple so thoroughly spoil the bunch?


rgcarr said...

Have you sunk to quoting Michael Jackson. YOu do need a break!

Holly said...

go to my flickr site and look at our newest family Puzzle. She was an abandoned barn kitty that I just could not leave there....she's about 4 weeks old now and full-of-Herself!

Hugs to you....I think there is something in the air, my weekend was full of Stoopid too!

Jennifer said...

The sense of entitlement going on in this country is amazing. It is the same appeal to the masses that the Dems use when talking about the health care bill. The attitude that someone richer than them should have to pay for their responsibilities...and that those "rich people" deserve to pay for everyone else.

Megan said...

I hear you :( Nothing like pulling an animal through a life-threatening situation only to have the owner come back for their recheck appointment screaming about being overcharged and how-dare-you-expect-me-to-pay-for-a-recheck?! and I-demand-a-25%-discount!!.... and then I lose sleep wondering what *I* could have done differently, how *I* could have been a better communicator or better doctor. 20 bucks says this dog's owner didn't lose any sleep wondering whether he could have been a better communicator. Grrrr.

rebecca said...

There are people who are good with people. There are people who a good with animals. There very few people in this world who are able to navigate managing both with grace and finesse.(Really, why would anyone who gets a full dose of joy from animals even bother with human beings except when necessary.) :) I would say that you are rare for being good at both and that your patients and their owners are very fortunate to have you. Hang in there.

Anonymous said...

The world is full of scared, small people who have to put others down to feel decent about themselves -- and it's so much easier to feel superior to a mere animal.

You seem like a decent person doing decent necessary work in the world; try to remember the people who appreciate you. ;-)

The Homeless Parrot said...

Thanks for the pick-me-up, dinner with the husband, and a bit of retail therapy + 4 new books has put things in perspective. That and the dream I had last night about my first real boyfriend, who recently died of cancer at the age of 29.

On the bright side, I diagnosed and was able to do surgery on 2 foreign bodies this weekend - one that had gone undiagnosed for 3 months, while the dog lost weight (15#!). Both owners were very grateful, so it was encouraging.

Anonymous said...

Your employer's business model is lacking. There should be a buffer built in to the fees that will offset the "pro bono" work that you do for the love of animals. You will have owners that never question your bill and others that will always question it. The majority remain in the middle. Accept it for what it is or turn a cold shoulder to the suffering. Which will get you more sleep?

The Homeless Parrot said...

Anonymous #2: Obviously, I don't turn a cold shoulder to the suffering - otherwise, I would have sent the dog out the door with no treatment. I'm lamenting the difficulty of working with belligerent owners who expect everything for free and are not thankful for things that we do - despite their lack of funds. Our business model is a BUSINESS. We have to be paid for our services. We are not subsidized by the government or insurance companies or any other service. We fund ourselves.

Elizabeth said...

HP.. You do good work. You care... it is as simple as that..

You can't fix stupid, it is as simple as that.

Outrider said...

>>There should be a buffer built in to the fees that will offset the "pro bono" work that you do for the love of animals.>>

So, the good clients who pay their bills should subsidize the jerks who don't?

That's what you're recommending.

The local veterinary school had a charitable fund at one time and allowed interest-free loans. According to one of my clients who used the fund to pay for an emergency surgery, the school goes unpaid 90%+ of the time. Every time my client came in with a payment, they were stunned.

Euthanasia is often the best option for animals with expensive problems owned by people with no money. Consider the neglected fracture repair HP described a few day ago. True, the dog lived for a while, but suffered terribly.

Let's hope HP doesn't see this "elbow fracture/dislocation" back in her waiting room in a few weeks.

Mary said...

HP, I'm sorry you're getting so bummed out by your job :( I think it's because you're professional and you care so much that you want to take care of everyone the best you can that makes 1 bad apple negate all of the good stuff.

You know you're a good person and a good vet. And it sucks when some moron can make you question that or let it affect your mood.

I try to tell myself that the jerk must be really unhappy to take their frustration out on me. Sometimes that even works :)

Nicki said...

I know you you feel. I have bad clients ruin an otherwise great day. There are definately down sides, but you get past them and learn not to let them bother you as much.