In my very first Daily Vet entry I promised you posts on the economics of the veterinary profession. Yet here I am, one full month after commencing this blog and nary an entry on the dollars. Let’s remedy that, shall we? 

It’s the elephant in the room on most every veterinary visit, isn’t it? The vet has gone over all her findings and laid out your choices. And now you’re fretting in the seat in the corner of the room. Maybe the whole place is spinning as you contemplate how to raise the inevitable: the cost of all this wondrous medicine. 

If you’re lucky, she beats you to it, timing her discussion of the prices just as you open your mouth to beg forgiveness for launching into the unsavory details of your pet’s expenses. 

In case you’ve never noticed the difference, this doesn’t ever happen as you sit in the (human) ER. As you writhe in severe abdominal pain wondering what that CT scan will cost––not to mention your appendicitis surgery––your ER doc will NOT get into the nitty gritty. More than likely he doen’t even know what your diagnosis means for your finances. All the vagaries of health insurance reimbursements and out-of pocket expenses are as mysterious to him as they are to you at the moment.

Not so for our side of the medical profession. We may not know all the nitty gritty but we can offer you a ballpark figure. We even have the ability to disappear into the front office’s bowels to crank out a detailed estimate for your approval. 

The options can be stunningly complex once you factor in the many levels of care veterinarians have to offer by way of hoping your pet can be saved––or at least made comfortable. 

This is a stressful topic for us vets. After all, it’s frustrating to know what’s best and still not be able to make it happen. Then there’s the emotional side of it to consider. We know you’re in agony trying to figure out how you’re going to scrape up the dollars for a down payment on services. Sometimes we even require you to make your entire payments up front.

That’s when we oftentimes have to face your wrath. However kindly it’s delivered, it’s clear that many of you are concerned with why veterinary medicine gets so fussy when it comes to the money thing. So here’s where I inform you on our side of the coin. It’s a concept veterinarians and veterinary staff members understand well but which is understandably lost on many pet owners:

Medicine is expensive, whether it’s for humans or for pets. Veterinary medicine is actually very efficient relative to your own care. Consider the spay, a procedure fraught with all the perils of any major abdominal surgery. This procedure, for which veterinarians charge an average of $100 to $500, goes for a multipe of ten times that on the human side––or more. 

Problem is, just as in human medicine, the divide between the haves and have-nots is a cavernous one. Almost never do we have the luxury of assuming our clients can pay for the best––or even the least––we can offer. In fact, the extremes of your inability to pay can make for appalling situations not only for you, but for those of us who have to attend this daily struggle with compassion. 

Imagine having to discuss finances with clients fifteen times a day––when your primary concern is complicated enough by the art and science of healing your patients. Imagine working in a situation where sometimes it seems the sole benefit of your occupation is the ability to end suffering therough euthanasia––cold comfort, that one. 

With this in mind, is it any wonder veterinarians are preoccupied with the ethical, moral and stress-related considerations afforded by money matters in animal medicine? We may not always have the benefit of a warm bedside manner with which to convey our compassion. Indeed, sometimes we have to steel ourselves against the stress of the financial aspects with colder attitudes you might find distasteful (no, I’m not defending for this behavior on the part of my colleagues, merely explaining how it happens). But we always feel your pain, one way or another.

In any case, here’s hoping this brief diatribe brings you closer to understanding why veterinary medicine sometimes dwells on the dollars. 

Your thoughts? (I welcome them all, as always.)

Dr. Patty Khuly