Comparing canine back surgery emergencies and human-kinda-healthcare
About a month ago, one of my favorite colleagues got taken to task by a physician client. She was incensed by the fact that her little dog had had to wait three days to be surgically treated for his paralyzing disk injury.
She’d arrived with her Shih-tzu at his specialty hospital’s emergency room the Friday evening before Labor Day and consequently wasn’t eligible for surgery until Tuesday—after the holiday—due to the surgeons’ collective “laziness.” (I’m sure she didn’t say that but such was the implication.)
In fact, this physician-client had called all South Florida specialty hospitals and none would undertake this surgery on an emergency basis. For the record, only the University of Florida offered to perform the procedure right-quick--but she’d refused. On such a weekend, a mere resident would be taking on the case, not the experienced neurosurgeon she felt she’d rather handle her dog’s care.
Put yourself in her position. Making phone calls in rapid succession, scared out of your wits for your dog’s life, not understanding how the “veterinary system” works, and knowing that in any human hospital this procedure would have been accomplished ASAP by your choice of providers.
I would have been stressed to the hilt, too.
So my friend, he took her justifiable frustration in stride. In his explanation, he’d pointed out that there were accepted criteria for the canine emergency neurosurgeries such as her dog had required. Her dog had not met the emergency criteria (which is indeed far more lax than for humans). Because the dog could feel his extremities (even though he couldn’t use them), this procedure was not considered an immediate surgical emergency.
She countered with the “sooner is always better when it comes to nerves,” mantra. And he’d had no choice but to agree unreservedly. Of course sooner surgery is better—especially with a potentially crippling back injury like her dog’s.
Problem is, the criteria for pets is different because this kind of surgery requires specialized doctors, specialized technicians, specialized equipment and lots ad lots of cash to get them to all come in at the drop of a dime. They’re not all standing by their beepers waiting for the call that comes four nights a week. In fact, if those calls come only one night a month, it makes no sense to raise all your prices to cover the expense of on-call staff time.
Add to that the higher rates for reuniting an on-call high-tech staff on a holiday weekend and suddenly, a three-thousand dollar surgery turns into a ten-thousand dollar extravaganza. Most pet owners are not physicians with high enough incomes to handle that level of care.
That’s when she argued for a two-tier system. “If I can pay, why then can’t I buy it?” Because a two-tier system that only works for one pet once every three months is an extravagance. Unfortunately. And, after all, specialized vs. non-specialized medicine is already effectively a two-tier system. It gives the willing and capable owners among us a method of paying for better care if we can afford it.
The upshot is this: For all the advances in veterinary medicine, pet medicine continues to lag far behind human care. This is less obvious in a day-to-day setting and, ironically, surprisingly pronounced when it comes to accessing top-tier care. Sure, it’s impressive that this level of care is even available, but we still have a long way to go before its affordability (either through pet health insurance or some miracle in cost-containment) brings it in line with were human healthcare is today.
But as with most things in life that seem amazing from afar, I’ll offer some wise words of caution with respect to human-style veterinary care: Be careful what you wish for.