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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

The cost of veterinary care (and why Dolittler dwells on the dollars)

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October 16, 2008 / (23) comments


This is an interesting topic raised by a recent commenter who expressed some annoyance at my preoccupation with issues surrounding the money side of vet medicine. It’s not a charge that hasn’t been leveled against me before—nor have previous comments always been as diplomatic as this last one.

However it’s delivered, it’s clear that many of you are concerned with why Dolittler dwells on the dollars.

After processing this latest expression of concern over my mental health on the subject of the economics of veterinary practice, I realized that many of you may not have been exposed to a concept the veterinarians and veterinary technicians on Dolittler understand well:

Veterinary medicine is fraught with the consideration of financial issues at all levels. In small animal practice, almost never do we have the luxury to assume that our clients can afford the right care for their pets.

Just as in human medicine, the divide between the haves and have-nots is a cavernous one. The extremes on the low-end can be similarly appalling, with veterinary medicine’s sole benefit the ability to euthanize our patients—a cold comfort, that one.

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.

With this in mind, is it any wonder a personal, pet health blog like Dolittler is preoccupied with the ethical, moral and stress-related considerations afforded by money matters in animal medicine?

I could never claim to offer you a glimpse into the “real world of veterinary medicine” if it wasn’t.

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

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COMMENTS (23)
1
by Amanda on 12/15/2008 11:36am

"Additionally, imagine the puppies coming in from the local petstore, backyard breeder, etc. Who gets a puppy from those sources? Those who don't do background research, those who don't see an animal the same way we do (oftentimes). Often they think the cost of the dog is the #1 factor, they don't take into account all the healthcare their 'teacup' chi or yorkie or whatnot will need."

I bought a pet store puppy. Yes I knew he was probably from a puppy mill. But he needed a good home and love as much as a breeder's puppy. He still cost me 600.00 to purchase(10 years ago!)
Through the years I have spent thousands of dollars on his various ailments (not even accounting for routine health checks/vaccines/etc)Most recently on a hematoma that has just recurred.
I'm at a crossroads regarding money. I just spent 1500.00 on surgery 6 weeks ago, and am facing that cost again. I cannot afford it. Does that make me a bad pet owner? Am I one of "those people" who shouldn't have a pet because they can't afford it?
IMO I believe everyone regardless of financial circumstance should be entitled to the love and companionship that a pet gives. If you can afford the daily requirements of life expenses (food, shelter, vaccines, collar, leash, litter, etc), then you deal with anything else that pops up along the way. Perhaps you can spare the monthly $$ for insurance (which I would highly recommend to anyone after the last few years with my aging pets!!). But even if you can't, if you can give that animal the best life possible, all the love you can, and they are returning that to you 10fold, you are doing better for them than many other animals out there have.
I'm sorry for ranting, but I was a little offended. As pet lovers, we will do everything we can for our animals, and if it comes to the point where we just can't do anymore without serious financial hardship for ourselves, we shouldn't be made to feel guilty about it.

2
by Liz on 12/03/2008 12:18pm

  Barbara A. Albright/New Hampshire - thank you for  being of sound mind and heart. 


Sarah's expressed hesitancy in adopting another pet is indicative of what one can expect when the "healers" of our animal friends turn them away at the door because of their owner's inability to pay for their services.


Here, Sarah and many others dedicate their life and effort to providing the primary care and by far the most important care of all to our animal friends.  They provide them with a home, love, attention and see to it that their basic needs are met each and every day of our animal friend's lives but God forbid they need 15 minutes of a "healer's" time.  If you don't have an owner with the right credit score or the ability to pay for our love and dedication to you, the door is closed and all personnel is out of the office.  Can you imagine pet owners demanding the pets somehow pay for thier love - or the SPCA be able to compensate them for a life time of food and toys and bedding or treats?  And the vets get the glory when they are literally being destructive of a good thing by turning people away at the door...It's like God saying to the good christians who spent their life living the teachings of Jesus - "had you only tithed a bit more at church, the pearly gates would open for you". 


 

3
by Nena on 10/21/2008 02:02am

I don't have too much to say. But when I tell people I am getting into the vet tech field, they frequently say, "Oh good, that's where the money is." They're just trying to be nice and make small talk, so I really have to bite my tongue. Yeah, a job which averages about $13/hr. That's where the money is.

The perception of veterinary clinic finances are completely warped to anyone who does not actually deal with them. I think of it this way: my last uninsured office call to a doctor: $210. My cat's: $45. The math isn't too hard here.

4
by LorriM on 10/18/2008 06:47pm

well thanks for the comment I was diplomatic....I am not always.
I am just more concerned that for the pennies you might miss the dollars. It is easy to get bogged down in money issues. Trust me, no knows this more than I do. With as many as I take care of and feed, my vet bills are large and constant. But I know from personal experience that sometimes when the only focus is money (in vet and life in general) you miss out on some really good things.
having said that, I am a big advocate of people having pets even if it does seem like they can't afford the best for them. I have seen one small pet, (actually even one picture of a pet) change a life where it might make all the difference in the world. It IS about money, but it shouldn't be. If it wasn't about money some of the 90% dying in the shelters wouldn't be either. I think sometimes we should stop sending money to countries that expect the USA to always help out, and gets some much better programs funded at home.
of course, I'd like to win the lottery too, but I won't wait the dollar on the ticket....

5
by whitney on 10/18/2008 04:32pm

Thank you, Dr. Khuly. I knew the box was exactly what I was looking for what I saw that it was called "Hug" (the top of the box has a carving of a boy hugging a dog). Max's favorite thing to do was stand on two legs and give someone a hug.

6
by Dr. Patty Khuly on 10/18/2008 08:36am

btw, Whitney, your site is gorgeous...great pic of Max's collar and memento box. It's a beautiful idea.

7
by Dr. Patty Khuly on 10/18/2008 08:35am

So sorry, Whitney. It sounds as if you did your best, given the circumstances. I've not yet found a reasonably priced dose of cyclosporine. It is getting less expensive, though, as time goes by...

8
by whitney on 10/18/2008 02:27am

Today I had to make the difficult decision to have my dog euthanized because I couldn't afford his treatment. I just wanted to say that I appreciate vets (like my dog's) who are sensitive to the fact that some people can't afford treatment, and it has nothing to do with how much we love our pets. My dog was like a child to me...I adopted him from the humane society when his previous owners abandoned him. I doubt anyone had ever loved him as much as I did. I doubt I'll ever love another dog the way I loved him. But I simply couldn't afford his medication, ciclosporin, a treatment which--at best--would only have managed his autoimmune hemolytic anemia, not cured it. Although it was the most difficult decision I've ever had to make, I think it was for the best. So thank you for being one of those vets who understands that sometimes people can't afford treatment, and for understanding that it doesn't mean we don't love our pets just as much as wealthier people.

9
by Dr. Patty Khuly on 10/17/2008 04:29pm

Stefani: You're right. There's a huge range and it varies from region to region. A cardiac consult here doesn't exactly compare to one in California, price-wise, for example. I need to keep that in mind when making broad statements.

And, yes, it's true that we're often forced to find less expensive alternatives. It helps to have someone you trust tell you which vets do most for less. It also helps to have knowledge that allows you to skip certain tests with a minimum of risk. But that's where things get murky.

10
by Stefani on 10/17/2008 01:58pm

These prices that you have been quoting for cardiac workups and ER care etc are way less than what I see in the metro area where I live. People often have to choose between going to the practices likely to provide the best care ($$) vs. a practice that is more affordable but that doesn't have all the best equipment or licensed techs, etc.

11
by Dr. Patty Khuly on 10/17/2008 09:18am

Ahhh, Sarah, the occupational hazards of job like ours...
Never does a week go by that I have to restrain myself from taking one home. Sometimes, though, you just have to go for it. $350 sounds about right for a basic cardiac workup. Consider it your adoption fee?

12
by Sarah on 10/16/2008 09:23pm

thanks dr. k. but the topic was finances and i was wondering how much it'd cost me ;). my parents' cat developed a murmur and had a cardio consult for $350ish. his (later diagnosis of) hyperthyroidism is more expensive than that. i'm mulling it over. the unfortunate fact is every time i go there is gonna be somebody (or many somebodies) i'd like to take home...especially if they are facing euthanasia. it was a much better idea to volunteer when i couldn't take anyone home!

13
by Linda C. on 10/16/2008 08:25pm

I have an idea of where we could find the money to help with the medical expenses. The USA is currently wasting 100's of millions, perhaps billions $$ (donation and tax monies) yearly corralling, confining, killing and disposing of the bodies of millions of surplus pets. More pets don't even get to the pounds to be counted and suffer and die along country roads and in back alleys. Question: "What's worse than finding a dead pet in the back yard? Answer: "Finding part of a dead pet." None of these animals came from another planet on a space ship. Each came from a pair of unfixed pets. Just think, if everyone who cared would spay/neuter/adopt and help others to do the same, in a matter of a few years we could have that money available to use to helping save pet's lives.

14
by Barbara A. Albright/New Hampshire on 10/16/2008 07:47pm

Since this is my 2 year anniversay of a week in hell, I'll be a bit pessimistic.

People don't want their loved ones via pets or humans thought of in an economic pricetag. Healthcare, while the best can be had, is fraught with unnecessary waste to the tune of alarming dollars. Yes, less so in petcare. And while I have enjoyed the benefit of specialty practice, I fear that if it takes the path of human care, it too will become unreachable. Repeated tests of no benefit, passed around like a cookie tray, from doctor to doctor---everyone getting a slice of the pie.

I'll digress a bit here. Do clinics and/or veterinarians think chances are slim for the clients to run into each other and compare notes & costs? Nothing can be more irksome than to have someone describe a particular surgery, diagnostics, etc. and quote you nearly half the cost you may have paid earlier for the same/similar.

In this new "economic climate" , fees for service will be certainly more of an issue for everyone, jobless or not, no matter what bracket.

And although I feel likewise about the breeders for $$$$, I hope some will admit, that shelters aren't placing a lot of the pets with people that value them anymore than the adoption fees, and maybe not at all.

Ok-----jump all over me, I'm being negative!!

15
by Stefani on 10/16/2008 05:55pm

Re: "Unfortunately people who can't afford pets often have them"

And, if you've worked in a shelter, you also know that EVEN SO, there aren't enough homes.

This is a tough situation. I do believe people need to provide for their pets, and I do that for mine. But I also know that many people couldn't afford the outlays I have absorbed.

Does that mean they shouldn't have pets when the alternative for so many pets is euthanasia?

I really wish there was a national subsidy fund for good pet parents who are not well off economically to help them afford the care they surely want to be able to provide. Sigh.

16
by Dr. Patty Khuly on 10/16/2008 05:25pm

Sarah: Not insane...just off topic... ;-) Seriously, go for it. A grade one doesn't stress me out too much in the absence of other major issues, though you may want to save your pennies to have a cardiologist check him out if it worsens or fails to resolve...always a tad dicey but not too bad.

17
by Sarah on 10/16/2008 04:48pm

so would i be insane to bring home a big & sweet adult male cat with a grade 1 heart murmur from the shelter i'm volunteering at? :(

18
by emily on 10/16/2008 02:45pm

With new vets exiting their training with an average $110,000 debt profitability is not going to get any less important--or shortages of vets in less affluent career paths.

19
by Jenni on 10/16/2008 12:49pm

I am not a vet or vet tech, but I've volunteered at shelters and have heard stories from the trenches (friend is a vet tech). I don't think there is another issue that looms as large in a general veterinary practitioners office as that of the almighty dollar. Unfortunately people who can't afford pets often have them. Also, they tend to be less educated and the animals are less likely to have had regular healthcare, shots, general preventative medicine.

Additionally, imagine the puppies coming in from the local petstore, backyard breeder, etc. Who gets a puppy from those sources? Those who don't do background research, those who don't see an animal the same way we do (oftentimes). Often they think the cost of the dog is the #1 factor, they don't take into account all the healthcare their 'teacup' chi or yorkie or whatnot will need.

Then, the people who are breeding for $$$- is the dog worth the money to save it? It's a question of economics, often, more than wanting to save a precious pet.

While I feel sorry for those who don't have any money to treat beloved pets, it's truly difficult to imagine that I could keep my composure when dealing with backyard breeders and irresponsible pet owners.

That said, I have six permanent resident dogs. I have a healthcare fund for them which I used to add to monthly. I left one job for another this summer, and once I had finished training my replacement at my old job the gal I was replacing at the new job decided she wanted to stay. I am now unemployed in a field which doesn't hire in the winter. Despite the fact that I have funds laid by for the dogs- it makes me very nervous to be in this position.

I can easily see how economics plays a very important role in veterinary medicine- no matter how much one would hope it wouldn't.

20
by Lori on 10/16/2008 11:22am

IMHO--if you take on the responsibility of raising a pet then part of that is the care and health of that animal. Last year my baby girl sweet darling angel (lol) got really really sick!! between the ER vet-with whom i got a discount becuase of my vet and my vet--the bills were over $900.00.
When it became apparent that the bills were going to be more than what i could afford i spoke to him and told him he would be paid within a month and i followed through on that--I paid him 350.00/week until the balance was paid.
I would no more "stiff" him than I would my child's doctor!!
Of course he has seen all my critters at one time or another and he knows how much we love them all.
Keep up the great work!! I read and share your emails with family and friends!!

21
by Hobson on 10/16/2008 11:21am

Wish it weren't so but $ concerns drive a majority of pet/client/vet interactions. We vets have to find out where in the broad spectrum each client lies and balance the client's budget and care philosophy with our need to be paid. I hate that part so much that years ago, I disconnected myself from that and let staff members discuss finances after I discuss diagnostic and treatment options. When someone asks me what something costs I tell them I don't know and don't want to know but will gladly let a staff member prepare an eastimate and discuss it with them. Pet care and Veterinary medicine would be much more fun and rewrding if $ were taken out of equation. Maybe pet insurance will become more available if congress allows it to be a tax free benefit tha employers can offer.

22
by Dr. Patty Khuly on 10/16/2008 11:12am

Debby: Historically we have provided payment plans for lots of clients. Unfortunately, we were only getting paid about 20% of the time--usually well after 90 days--so we've suspended this consideration except for those who have a proven track record of paying their split-bills.

23
by Debby on 10/16/2008 10:49am

My cats will always get whatever tests & treatment their doctor deems necessary, and if I have to go without something else for a bit, so be it. If I ask price it is only for personal budgeting purposes. It is a sobering reality for me while reading your blog, that others, especially the porsche-driving types, do not feel the same.

My heart breaks for those who want to do the right thing, but due to job loss or other emergency expenses, cannot. I think there are funds out there from charities that could help with major surgeries, etc, but probably not enough of them. Would you or other doctors consider payment plans for the expensive treatments? Half down on treatment, and so much per month til the bill is paid, for reliable clients?

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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