Found this blog on a websearch, and have read all the posts.  I find it all very interesting; but what do you do in the case of veterinary negligence or malpractice?  Yesterday afternoon my cat was released from a local vet clinic with over $300 in current service charges and a request that we make a follow-up appointment for further testing (she had an enlarged liver) for the middle of the following week. 

Feeling somewhat uneasy regarding her diagnosis and the treatment she'd received while in their care (beginning with the first visit four days earlier), I put them off.  Less than four hours later, she was seen by another veterinarian who found her *extremely* dehydrated (10 - 12%) due to her illness (she hadn't been eating/drinking, to the best of my knowledge) and informed me that she would've surely died before next week. It was a medical emergency, and the first practitioner had insisted that she wasn't dehydrated (I'd asked him) and that her food/water intake was fine. ???:-(   Since he was unable to so much as weigh her, much less get a sufficient blood sample from her (for full CBC testing -- in the words of the second vet, virtually all her veins were collapsed with bruising evident), he should have swallowed his egoistic self-promotion, confirmed her condition and advised me to seek emergency care elsewhere.

I have never in all my 20+ yrs of pet ownership encountered such professional incompetence.  Perhaps $300 doesn't seem like very much for veterinary care, compared to some of the other stories shared here; but in this case we were charged for what could have easily been a fatal mistake! Our shy girl is thankfully doing better; but she will require weeks of intensive home care, not to mention the hundreds of dollars in added medical expenses incurred.  I am considering stopping payment on the check; but not sure of the possible repercussions of such action or what other options for recourse exist.

Jen M, to answer your question: no, you cannot deduct it from income later, unless you have already reported it as income (albeit uncollected) at the time of service.

"Stefani,We cannot deduct it as a business loss unlesswe are on an accrural accounting system (where you first report it as income even if you were not paid) and then deduct it later if you conclude that you are not going to get paid. So there are no tax benefits. Most of us are on a cash accounting system, where we only report what we are acturally paid as income. We cannot go back and deduct this bill from our income. Not fair but according to the IRS, our charitable work is worth nothing, even if performed for a non-pofit group."

But if you deduct it later, you're reporting less income for the business, correct?  (I'm not a numbers or finance whiz, so I may have it wrong.) 

Either way, I think it sucks that you cannot write it off as a loss, regardless of your accounting system.  Loss is loss.

There was a time when I could not truly afford vet care, and when that happened, my vet worked things out with me.  I was slow to pay, because at the time I was truly struggling.  Now, however, I would not DREAM of not paying my vet!  Instead, I shuffle resources if I have to.  I want to keep my vet, so I treat them as well as I possibly can!  (I say "them," because it is a multi-vet practice.)

I know that times are desperate for some, but I think the "I left my wallet at home" trick is really, really sleazy.  If you can't afford the care your pet needs, just be honest with the vet!

It is essential we treat you all well, because we want GOOD care for our pets from TRUSTED sources.  If you don't get paid, you go away.  Then what?

I don't think what you are doing is at all unreasonable, Dr. K.  My vet's office has also changed their policy now.  They don't do installments.  If I'm having  a hard time responsibly, we talk and see what we can do within my means.  If I need to spend more, I just figure out how to get the money.  End of story.

That sucks. 

I understand your handing over the pets though. Thinking about it, what good do you do by keepin them? It makes YOU responsible. Now instead of you footing the bill for Fluffy's med procedures you also have room, board, food, and care until the owner comes up with the cash. Yes you can bill for that too but if someone can't pay the bill..they probably can't pay for extras. So you keep this dog of the bum and it takes up cage space for a client who can pay. Or your staff has to walk/feed it instead of the other animals. And at what point do you turn it over to the pound and assume the owner won't come back? I can't see how you WOULDN'T turn over the pet! Just send the idiot to collections! 

I have never appreciated people imagining what I think. 

If you have a question, such as, "Marjorie, based on your comment, do you believe companion animals are only for the welathy," then by all means, ask that quesiton, so I can answer it.  I mean, I could write something equally as absurd as, "Barb A./NH, you must feel animals don't deserve medical care when they're ill, if the owner believes it is too expensive."  Does that represent your position?  I doubt it.  Kind of ridiculous for me to write something so sanctimonious, and clearly intended to be acrimonious, huh?  Well...right back at ya'.

What I find especially amusing is the fact that my decades of experience in animal welfare and canine legislation prove to me that income has almost no bearing on a person's resolve to be a responsible, ethical owner.  I've met the poorest people who are excellent, dedicated pet owners, and far too many wealthy people who view pets as disposable accessories which are ignored or discared when they become inconvenient. 

That crystal ball of yours needs some fine-tuing, Barb A./NH.

Marjorie: I think you have eliminated 95% of pet-owners with your statements. You must feel that companion animals are only for the well-to-do.

Oh, and I should add, during one of my visits to this specialty clinic, there was an irate man yelling in the reception area.  I discreetly asked a staff member what was going on.  As best I could gather, the man's dog was being discharged because he refused to pay 80% of estimate for procedures up-front, as is that clinics' 100% policy.  His dog was ill, but the clinic wouldn't treat until he paid.  He yelled and stormed about, accusing the doctors and staff of malpractice and inhumanity for not treating a sick animal.  Eventually, he and his dog left.

I told the story to my husband, saying that I wanted to go up to him and explain that, based on my limited experiences and what I've heard from veterinarians I know, despite his claims about wanting the best for his pet, he likely WOULD default on the bill, as have sooooooo many others before him.  Veterinarians don't have policies like this to be mean.  They're usually born from negative experiences.  

Lots of people talk a big game.  Then the bill comes, and it separates the women from the girls.  ...Those committed to their animals' welfare, and those not-so-committed-after-all.

Dr. Khuly,

I recent endured a spate of veterinary expenses, and was required to pay up-front, for most of them.

The first $2,000 was the standard 'treat then pay before you leave', type.  That got the diagnosis.

The next $1,300 was for the specialist clinic to briefly examine her, devise a treatment plan with an estimate, more examination and testing, then pay before you leave.

The result of those tests led to a recommendation for surgery, the next day.  I was handed an estimate during the course of exams, with the high estimate of $4,800.  "When you bring her in tomorrow morning, 80% of the high estimate is due upon admission."

So, the next morning ($1,300 lighter), I brought her in, paid an additional $4,000, and left her there.

Picking her up two days later, it was only about another $1,000 to settle my account and leave with my dog.

Two-weeks later, complications developed, which led to another stay, with 80% of high estimate due upon admission: $1,700 in that case.  Two days later, it was another (comparatively irrelevant) $800 before we were out.

So, $10,000 over maybe 3 weeks...virtually all of it on-the-spot payment.

I taught responsible dog ownership for many years.  I counselled.  I preached.  I pleaded.  "Buy pet insurance or, better yet, start a savings account or obtain a credit card, just for emergency veterinary expenses."

I will never understand why so many people just don't seem to care about providing for the animals in their care.  There are no rainy days in their world.  But when the rain comes, it's all sob story, and we just can't afford it BS. 

Part of being a good steward means providing reasonable care.  I'm not talking about doing every possible treatment, much less cutting-edge, experimental procedures.  Fracture repair, tumor removal, chemotherapy, hip replacement, etc., aren't exactly out of the norm.  When my dog was ill, there were talks of why I'd spend so much money, rather than just putting her down.  (Such as that SNL line about a $7,000 total hip replacement for a cat being $7,000 more than the previous treatment: total cat replacement.)  Given this was a treatable condition, I would generally respond that, the next time the person were to get a paper cut, I'd be sure to put him/her down, as well.  (I find far too many people are awfully quick to jump to "euthanasia" for animals, in circumstances that wouldn't even be a consideration for humans.)  To me, a financial justification for "euthanasia" is unethical, nearly every time I've heard it used.

Sure, I can afford to plop down $10,000 on a whim.  Heck, my last hotel room was $2,000/night.  But I tell you, there isn't anything I can think of that would be off-limits, when it comes to being a good steward of my animals.  If I had to sell the clothes off my back, so be it.  Then again, I take the ethics of animal ownership very, very seriously.

As such, I just can't comprehend the types of people who'd refuse to pay a $67 bill. 

My good friend is a veterinarian.  I remember one case, where she had a client default on a $50 bill, abandoning the dog at the clinic (racking-up daily boarding fees, in the mean time).  $50??????  Really?  If you can't pay a $50 veterinary bill, you have no business having a pet.

Another DVM: Can you imagine how baffled I am? Scamming a cash cow so badly over one dog, with SEVEN more in the household? And we are not talking your average cheapie owner that goes once a year for vaccines. I can't remember an appointment under $200 & usually average $300 !

Well, they say scammers never think of the future but grab what they can when the opportunity presents itself.

Pocket's Story from NH & Blabby Barbara's Blog

Do I do pro bono work?  Yes.  Have I held checks, or allowed clients no-interest payment plans for unexpected emergencies?  Yes.  Have I been stiffed recently?  No, because there's a new practice in my area, and I think he's receiving most of the deadbeat calls now.  I have a long, long memory, and I require cash up front for deadbeats.  This tends to deter them from trying me again.

The economy has hit my practice, and my neighboring colleagues' practices, very hard.  We're all down 30-40%.  That hurts, considering that my student loan is $750/month.  That's almost as large as my mortgage, and the bank would be remarkably intolerant if I were unable to pay up.  Likewise, my utilities, cell phone, medical insurance, car insurance... they all have to be paid.  For the first time in my practice history, I'm barely breaking even.

Recently, I read an article stating that 53% of veterinarians' clients make more money than the veterinarian.  Most veterinarians I know are not wealthy people; we are merely comfortable.  Until now.

My vet hospital also requires a 50% payment upfront based on the estimate.  I don't mind.  As a consumer you have to realize that if the business loses money, my costs go up.  It's protection for both you and your clients.

Hobson, Now we're into the area where I get paid :)

agadoresmama, And the couple of people we've been discussing so openly but probably totally behind their backs appear to have been nearly silent.

barb- I'm not saying people should be silent- I'm just saying it seems those who holler loudest aren't usually victims... 

Good point, voluntary pro bono work should be done out of the goodness of our hearts without expecting anything from iti other than gratitude and being able to sleep well at night.  Involuntary probono work (getting stiffed) is a different story. although I can deduct my hard costs (employee time and materials) my time cannot be deducted according to the 4 CPA's I have used in he past. If you know another way I would be happy to hear about it.  

Hobson, It's very fair.  if you're on cash basis accounting, you didn't record income from these clients (tax benefit is not paying tax on the income you didn't receive) AND you do still get to include any actual costs you incurred in your expenses; alternately, you might be able to write these expenses off as a charitable donation (both result in tax benefits as they lower the income on which you pay taxes).  Over time, there is NO difference between cash basis and accrual basis for the vast majority of businesses, accrual merely evens out the peaks and valleys of income and expense.  BTW, if properly structured there are ways to write off some of your "time" as well but then it isn't pro bono.  Charitable work is QUITE valuable even though it doesn't put cash in your pocket.

Stefani, We cannot deduct it as a business loss unless we are on an accrural accounting system (where you first report it as income even if you were not paid) and then deduct it later if you conclude that you are not going to get paid. So there are no tax benefits.  Most of us are on a cash accounting system, where we only report what we are acturally paid as income. We cannot go back and deduct this bill from our income. Not fair but according to the IRS, our charitable work is worth nothing, even if performed for a non-pofit group.

Can you at least deduct it as a business loss when this happens?

Hi Rob VBVH, What are those initials , BTW?

Only ONCE was I asked to pay the bill, before allowed to see my pet......hmmm, never thought of it that way before. Not that it matters, but I have actually gone out to put my pet in the car (on cool day of course) and walked back in to pay.

I think if that ever happened to me again, I'd literally jump out of my skin.

ag: Victims that stay silent allow victimization to continue & spread. Those that stay silent are sadly embarrassed or perhaps to depressed or affected by their status to be able to rise out of it. I have seen first-hand terrible un-employment in the 70's and what it does to self-esteem and confidence, not to mention mental, physical, & emotional changes---is not very pretty.

I know how that feels And I agree half and half if it's over a certain amount

Shannon- you sound a lot like me- I have limited funds and I just had the Tightrope procedure done on my pitbull to the tune of $1800 so far....

PJB- whew- I will keep this brief-the people who REALLY need help aren't the ones who STIFF other people. People who STIFF others ARE DEADBEATS.

HONEST people don't walkinto a vet's office, receive their services and then skip out.  You would swallow your pride and tell the vet the truth, because your pet is worth it to you.

I am tired of the I'M A VICTIM excuse that is used by SO many.  Those who scream it loudest are the biggest deadbeats.  Those who truly ARE victims are usually silent and try to get by and do the best they can.

As the Eagles say-GET OVER IT!

BTW I don't think Dr K LAVISHES while others do without...you must be new to her blog- she may be a few rungs higher on the ladder, but she has the same problems and concerns the rest of us do..

"I hear what you're saying but would it be better had these owners chosen to put their pets down? We've had that discussion on here and everyone would be screaming bloody murder over what awful humans they are"...nope, I sure wouldn't.  Nothing wrong with electing humane euthanasia if your pet is suffering and you can't afford to treat...regardless of the condition, there should be no shame in that.  I have more respect for someone who elects euthanasia for their pet in unquestionable pain from severe dental disease (as we've been using as an example...we're talking the kind of dental disease that makes eating excruciating and requires several hundred dollars worth of extraction services) because they can't afford the necessary treatment than someone who presents said pet for treatment with no intentions of paying.  It's a hard choice to have to make, but it's a choice every put owner needs to be willing to make.

I do not believe that PJ is arguing against taking reasonable steps to get payment. I believe PJ is arguing against making harsh judgments about these people based on hearing only one side of the story.

At least, that's where I find the shocking lack of charity in so many of the comments in this thread.

Getting a credit card first, giving (and getting signed) an estimate and requiring partial payment up front, sending reminder letters or an invoice when payment is due or past due, applying an interest charge or late fee to past due amounts, forwarding seriously past due amounts to a collection agency, they're all reasonable things to do and normal business practice in other kinds of businesses.

Judging and condemning the people who haven't paid yet, without any information at all about their circumstances and intentions, is not reasonable. Or charitable or kind, or evidence of your own moral superiority.

PBJ - you're right I'm making an assumption.  But I believe that Dr. K's point is that these were rountine situations where people made NO attempt to pay or make arrangements for payment.  You forget your checkbook, fine.  Then take your pet home, get your checkbook and drive back to the vet or write out a check and mail it immediately.  I have to assume that if they had done this, Dr K would have mentioned it.  So absent evidence to the contrary, I think its fair to assume that they had no intention of paying. 

And if you can't pay, then you need to be honest up front about it. Too embarrassed to say so in the office?  Then send what you can with a note of apology.  Dr K's practice is in a major metropolitan area - and I'd be willing to bet that there are low cost resources through a local humane agency.  But of course, these folks would  have to take the time to find this out and its so much easier to just stiff the vet.

Sorry, I'm just not buying your position. If I were than I could justify 'borrowing' your car because I need transportation to get to a job. Cause hey, we all have to be flexible in these difficult times.  I wonder how sympathetic you would be if your car was stolen for this reason.

Unless its a matter of life and death you don't buy things you can't pay for.  and if its a matter of life and death, at least tell the truth after the work is done and see what can be arranged.  (After all, they can't re-tartar the dog's teeth, can they?). 

I'm a bit late to the conversation and have not read any comments yet.

Here's what we do: pets are not presented to the clients (to go home) until the payment transaction is complete. For extensive procedures or if the client volunteers that they may have difficulty paying we will provide an estimate and attempt to establish a Care Credit account or demand 50% up front before accepting the patient.

We live in an area with a variety of client incomes; we rarely turn away patients; we charge the appropriate amount for our services, we usually are paid in full; we rarely don't get paid.

Times ARE tough so these scenarios happen more frequently. That just means we've become better at making sure we recieve payment.

-Rob

I'm coming in late to this discussion.  I have been the poor one (heck, I'm the poor one now!  Have you seen what vet techs get paid?!).  I have no health insurance.  I went to the hospital with a possible emergency, and before I was seen by anyone, I made sure they know I didn't have insurance.  They wanted to know how I would pay.  I told them I would make payments.  I'm still making payments, but I am making them, and on time too!

Our clinic has a fund for clients who are having hard times (who isn't in Michigan!).  We are careful how we use it.  A client with health issues of her own asked if we would use the fund to do a dental on her dog - who was the dog described above, with rotten teeth, health issues caused by the teeth, yadda, yadda, yadda.  We used the fund.  Two weeks later she was back with another pet (a new one!), insisting we should use the fund for this one's annual wellness exam.  When the doctor refused, gently explaining the criteria for using the fund, he was cursed out by a screaming client, who flung herself out the door, still screaming about how unfair and hateful our clinic is, because we won't help a poor woman, and we couldn't possibly really love animals.  No, she won't be returning, though she did write a letter of apology to the doctor.  Unfortunately, that apology can't be made to all the clients who were exposed to her temper tantrum.  She was sent a copy of her records and asked to find another vet for her pets.

Anlina: I apologize, I misunderstood your intent. It is a worrisome situation & it does not condone dishonesty. It gets scary when a state announces "IOU's" in lieu of payment and one can only wonder the trickle down effect and being in the same position.

Maybe we are all going to be trading IOUs soon.

Barb, I'm not saying that people don't end up in terrible circumstance beyond their control. I know they do. It happens all the time. I've been there in the past and I feel for people who are getting screwed over by life.

What I am saying is that we have a choice in how we react to difficult circumstances. We see difficult circumstances bring out both the best and the worst in humanity - being in a crappy situation does not limit your options to acting unethically or harming others; there is always another choice.

I don't blame you one bit! you got bills to pay to- and food to buy to feed yourself & family- you got to have gas for your car, pay your doctor and insurance deductions,  car payment, put kids thru school  { and kids needs aren't cheap either}, mortgage payments, extra.  with people like this ..I can't but worry if the pet is truly loved and cared for...what kind of home-life does this precious animal have? I have always paid my vet bills... even if It meant I couldn't pay a utility bill, or use the mortgage paymeny money anf  use next paydays money for all the mortgage payment & pay on the utilities what i could till I was caught up...those bills will be around for me till I die- my dog is here for only a short time- they just don't live long enough...

PBJ-

I usually thoroughly enjoy your comments as they often represent another side to Dr.K's posts.  However, I've noticed sometimes while you offer the other side of the argument, you also attack Dr.K.  I suppose that's in your nature, but maybe more people would take your side more objectively if you didn't try to speak so negatively about Dr. K.  Many people are on here because they admire her professional opinions, value her knowledge and, well, like me, just look forward to reading a great blog that could someday (and has) help me take care of my own animals.  Many of us feel a personal connection with her, even not having met her (she's a great writer...Wharton must have done something, huh?), and I'm afraid that all the negativity you sometimes project takes away from your opinions.  I think, perhaps, more people, including myself would take you more serious, if you just simply stated your case for the opposing side, realizing that at the end of this blog there is no judge in a black robe and no slap of a wooden gavel.

Having said that, you offer an interesting opinion.  No, we don't know these people.  No we don't know their circumstance.  What we do know from this blog is that they received a service for which they did not pay.  While Dr. K may continue to receive the same compensation, the clinic/hospital she works for surely takes a hit on it's profit.  If this trend continues, at what point would the clinic have to shut down?  I mean, it's common sense, right?  No profit=no business.   I think it is more trampling into a moral debate when we begin taking up for theives, even though their plights seem justified.  Grocery stores are continually faced with women stealing formula. Is it ethical?  No, stealing is never ethical.  Is it ethical for the big chain grocery store to turn in the poor mother just trying to feed her baby? Hmmm.  Is it ethical for the grocery store to not make any profit on the formula they sale because it's all being stolen?  The whole scenario, including Dr.K's point, is that on either side, it's quite frankly, a sucky situation.  But given that this is a VET blog, why would you not expect to here the VET side of it?  

I feel as though you are trying to justify stealing, just because it's a worthy cause.  And while that may be true, and you may win an ethics argument about greater good, you should be well aware of the law, and that it is illegal to steal.  If we look at the law objectively, the mother stealing formula should have the police called on her, and the people stiffing their vets for payment should be taken to court. It's a hardened stance to take, I know!

But certainly setting up arrangements to make payments or a deposit plus payment plan could be set up before leaving the office.  Being a vet already is a field with high stress and (relatively) low income for the amount of time, loans, and schooling put into the profession. 

If we wish to make veterinary care more difficult to access and the field less desirable to enter (and therefore lower the quality of candidates) this is the way to go.  Unfortunately, the veterinary profession cannot afford to carry the weight of the recession on their shoulders.  While I would gladly donate to a fund for low income clients of my vet, I would not advocate that they hand out free care.  Free care devalues the care provided. 

Jen

PJB: You're right, we are making some assumptions that we have no information to base it on. For instance, the dental case could be an elderly dog with rotten teeth brought in by a client in tattered clothing & walked all the way for lack of vehicle.

And yes, having not a silver spoon in my mouth makes it less frightening for my personal circumstances, because I can learn all over again how to do without.  My fear in observation is the potential for widespread "desperation". with not enough resources to handle it, no matter how much good will available.

Anlina: Lots to learn, I think. There are many, many people who become victims of circumstance & one is called unemployment. Others are victims of crime, natural disasters, & accidents. No one makes these choices.

BTW, all this talk about stiffing the vet reminded me to stop by the clinic & pay for an add-on test. It turned out to be a pain for the front desk, as it wasn't even in the computer yet & they had to track down the test copy still on the desk. I feel better though, I can erase it from my crowded memory banks!

A few weeks ago I walked out on my exotic vet without paying the bill. Oops! I was wrangling a screaming baby parrot and a large, terrified bunny intent on kicking her way to a broken back. The only other person in the waiting room had a python. On the floor. I realized my mistake half-way home and turned the car around. I was embarrassed, but the receptionist was really sweet about it.

I have six pets, five of them exotics. I go to the exotic vet at least five times a year. He gives advice on bird behavioral issues. I rely on them when one of my pets has a life-saving emergency. To stiff them seems not only inappropriate, but stupid.

A person cannot go into the hospital without the hospital knowing up front how they are going to be paid. 

You can't rent a car withouth having a deposit on your credit card. 

So, what is the problem with having a deposit put on a credit card to cover vet expenses? 

This is the way it has to be now.  I want my service providers to be there for me. 

For Dr K's critics, just how much should she be expected to do pro bono for the unfortunate?  If you don't know someone, how are you supposed to tell the difference between someone down on their luck or someone who is dishonest, or just doesn't want to work? (they all tell you the same story) Over the past few years I have done anywhere from $20k to $50k yearly in free and discounted work for Humane Societie in 2 counties, plus getting stiffed for anywhere from $3k to $20k a year.  I now offer them Care Credit if I don't know them and if they are turned down, at least we can say we tried.  I am proud to say that no one has ever been to my clinic and left because they could not pay without at least a shot for pain, antibiotics or dexamethasone.

I have donated lots of time and effort over the years.  I prefer to donate it personally to someone I know is in need.  I worked with a low cast spay group, and they flocked in with their fancy Lexus or other SUV, with an address in exclusive areas of town for the s=cheapie surgery for the stray they have had for years, and moved with several times...

We do the paper work before they ever see their pet.  I cant tell you hwo many times womeone offers to make payments, and when we cant do that, and they dont have their pet in their arms yet, they dig in their pocket and pull out ALL the money.  They had it with them, just trying for a scam....

My last deal was a woman whose husband owns a trucking company.  She was looking for a job, and saw our ad.  Took care of her dogs ruptured anal gland, and check was written on closed account.  She doesnt answer her phone now....

Well, there certainly seems to be a lot of vibrant discussion and varying positions.

Wouldn't it be wonderful if we could take the time and energy (especially all of the anger) that are feeding this thread and:

1) Continue (for those who are already) helping as much as we can to lessen the burden of others,

2) Consider (for those who do not) helping to serve those who are struggling (even the tiniest bit can make a difference),

3) Try in some way (for those of us who have little) to reach out and do what we can,

4) And show some generosity of spirit (from all of us, for all of us) to everyone, while understanding that we cannot truly understand anyone's 'story' by just having tidbits of information. Sure, we can come to conclusions based on information we have, but I would be loath to make assumptions. There is always more...

Don't forget to check in with your local shelter, veterinary hospital, rescue groups, and animal related organizations to see what supplies and funds they may be collecting to help support families and animals in need. Regardless of the different views here, I'd think we could all agree that it's a sad, sad thing for someone to have to surrender a beloved family pet because of their economic situation. None of us want to see anyone or anything suffer, I'd hope. We can't change everything as individuals, but we can exact change as a synergistic effect (just as good things can be prevented from happening by being chronically negative). Oh-it's summertime-remember to support those small local festivals and fairs put on by rescue groups and shelters!

Yes, we have control in that we have the power to choose. Even if, let's say, you have a mental illness that compels you to steal, you have the choice to get seek help and the choice to try and right situations where you may have wronged someone. Or you can just blame your circumstances, say it was completely out of my power and choose not to take any responsibility. 

Some times life screws us over, but I don't buy for a second that we're helpless victims of circumstance. Some times your available choices may suck, but you always, always have choices.

Barb, I haven't stolen anything since I was 5 and Mom made me return the pack of gum and wouldn't let me keep it when the grocer tried to give it to me.  We just did without too.  However, I'm not willing to try and convict these clients based on the information Dr. K provided which is obviously biased and I see lots of people leaping to conclusions and painting with wide brushes and that always annoys me because it's rarely, if ever, fair to anyone.  Oddly, those of us who've been poor are at an advantage over those who've always had plenty and suddenly find themselves destitute.  The newly poor like this have no idea where to start and there certainly isn't a free training course for them.  (I notice no one wants to address the inequitable positions you've referenced a couple of times :)

People "always" have control?  Really????  Not from what I've seen and, more so, not from what science tells us about how the brain works!

2CatMom, And what precisely do you point to as evidence this is deliberate?  Can Dr. K read minds?  Just curious, what would you have done if that vet had said no and 5 more after that said no too?

We don't always have control over our circumstances, but we always have control over how we deal with them. It doesn't matter how destitute you are, you can choose to steal or you can choose to ask for help, make arrangements or defer things. Being financially hard up doesn't absolve anyone from being responsible for their actions. We always have choices.

This story reminded me of the last time I had a lump removed on my 8yr dog, Boomer.  Before I went to the vet to pick him up after surgery, I stopped by the bank and using the ATM, transferred the cash from my savings to my checking to be able to use my check/debit card at the vet.  So when I get to the vet, I go to pay, and the card is declined.  So I run next door to the gas station, use the ATM to check my balance, and everything looks fine.  I run back to the vet, have them try it again, this time showing them the ATM receipt with the amount of money I have in checking, and still the card is declined.  It's 4:15, the vet closes at 5pm.  My bank is 20 minutes away.  So, by the Grace of God, I make it to the bank, who then wants me to talk to an account rep, because "something went wrong with the ATM maching in transferring the money and instead of adding the money to your checking account, it subtracted it."  At that point, I freaked! I told the poor little girl behind the counter what was going on, and that I HAD to have the money NOW so I could go pick up my dog, and that I didn't care about what they did wrong, they just had to give me my money, or close out my account and give it all to me right now!  I'm sure I wasn't very nice.  I made it by the skin of my teeth back to the vet, paid in cash, and the vet tech that I had been dealing with walks out all calmly with my dog, and then looks at the receptionist and said, "See, I told you she would be back, she's a regular!"  Had it been the regular receptionist, I bet she would have just handed over my dog, and told me to come back the next day...but I never even DREAMED of asking to do that!  I understand how torn a vet could be in that situation, I feel for you Dr. Khuly!

Wow, PJB. Yeah people are hurting, but I don't think the solution is to deliberately stiff the individual service providers. I'm all for sharing the pain, but putting my vet out of business is not going to help.

And I'm really shocked at the tack you took with Shannon. Like her, I was a full time student living on a work study stipend when my cat got very sick and needed expensive surgury. But being an honest person I spoke to the vet up front and explained my situation.This was a new vet in a new city and he didn't know me from diddly. I do think he was impressed with my offer to sign an agreement (unheard of 25 years ago) on a payment plan. We agreed to $50/month (which is a lot of money when you have $3500 to get you through 9 months of school).And I paid every cent of that bill over a period of years. Any extra cash that came my way (from birthdays or Christmas) went to that bill. That's what honest poor people do. They don't stiff someone who has saved their pet's life, they don't pass bad checks, they work it out.

And theft is still theft. Sorry, I don't buy the Les Miz sob story. We're not talking about a loaf of bread or a homeless person- we're talking about a neuter and dental care. Yes, these are important procedures, but we're not talking life and death as far as I can tell. 

Unfortunately, its people who don't seem to appreciate that service providers have bills to pay and have to eat like everyone else that makes the type of arrangement I was able to make 25 years ago unheard of today.

And now the Miami Herald has the arraignment up along with the arrest affidavit :)

PJB - I never personally attacked you or judged the circumstances in which the individuals in Dr Khuly's are in.  I grew up being taught right from wrong and taking something, such as a service provided for you with properly compensating the person who provided it is wrong.

I will reiterate once again.  You do not know my circumstances.  I did not post anything all that revealing except for the fact that I've been there.  And while you may believe otherwise I have.  I'm closing this debate for myself because you aren't focused on the issue, you're focused on tearing down those who dare to have an opinon that differs from yours.

Welcome to the world I have practiced in for 27 years! These conditions are nothing new for me. I live in an area with 2 industries: vacation resort and commercial fishing.  Not a hotbed for skilled, educated workers.   We have the highest dropout rate in the state, I had many clients who got free health care for themselves, food stamps for groceries and then expecte the same from me. These folks don't come in for anything routine, they let their pets roam free only to get shot, poisoned, attacked by other animals or hit by cars.  They also don't vaccinate and bring in a lot of parvo dogs. It is an example of how they live their lives. But they always have a pack of smokes in their pocket and I see them in the conveniece store buying beer and lottery tickets. When I don't extend them open credit, I get cursed to my face and badmouthed in my small community.  I was a sucker for a long time, got burned and tried to recover through court and collections, both a waste of time. If the client got out the door without paying in full, I only recovered 10%.  Now, If I have not seen the pet before, we get deposits for the full amount, if they can't pay that then we go to plans B, C or D.  That does screen them. I don't ask for deposits for routine procedures, but still get stuck with the forgotten wallet. I still get burned and go against my policy when there is a sick/hurt pet I can help and the exam room is full of crying kids.  The paying clients end up subsidizing these folks, a good example of involuntary wealth redistribution. I still sleep OK most nights. Part of doing business balancing compassion and responsibility.

Shannon, you don't seem to have a problem judging others so...  What's good for the goose, is good for the gander.  If you can't take the heat, don't throw flames.  And I DO know you because what you said reveals volumes about you.

Wonder what time Tyler's hearing is going to be held...

PJB - You are not in position to judge me.  You don't know me.  So let's keep the personal insults to ourselves and discuss the matter at hand here.

Well, unfortunately, Dr. K chose not to give that kind of detail for these clients, merely her conclusion that they're likely deadbeats and inflammatory language so all would presume the same and that they were intentional thieves.  I'll give Dr. K that she knows her audience well.  Most inhaled that bait.  I prefer when she's in a more objective and informative mode but I'm starting to wonder...

Directed to Boosinger:

Today I helped at a low-cost spay clinic.  A mom drove up in an ancient station wagon with a couple cats to be spayed.  The kids raised the money with a lemonade stand.  ($20 a cat for spay, exam, shots, etc and GOOD pain control).

Contrast that with a lady driving a new model honda with designer sunglasses who didn't want to pay for the three cats she brought to the clinic- including a cat that was VERY pregnant.  She said her husband would rather shoot them.

Contrast that with the couple who was talking about buying cigs but claimed not to have money for the clinic.

A cat came in from a home with little resources, and volunteers/poeple from rescue chipped in the funds for that cat.

In order to pay for supplies and the necessities for these essential clinics in our underserved (animal-wise) area basic costs have to be paid.  Heartless, but so many peope who could afford the clinic would PREFER not to pay, even if it meant being less than hoenst about having the money (one lady was complaining about being tight on funds to pay because she bought her 5 year old a wii).  Sometimes, it comes down to a matter of priorities, and it is not Dr. Khuly's nor anyone else's responsibility to take on basic, non-emergency care for someone else's animal.  Even in emergencies there comes a point where you have to reaize you can't save them all.  Even if you did, if the owner does not prioritize the care of the animal (fiscally) and show fiscal responsibility for their care, they are likely to be remiss in other animal care duties (ie dog hit in road and repaired once for nada, got hit again three months later).

Regardless, by sending a gentle letter reminding the client that services were rendered in good faith and that payment arrangements can be made, lines are opened for communication regarding the affordability of the bill and ways of making it affordable to the client.

I could never work FT as a vet or vet tech because I couldn't deal with the numerous people that place a low priority on their animals and the cost of basic animal healthcare (ie get dog spayed or amp up the speakers for my car- car wins).  It's too bad that innocents (the animals) get wrapped up and bear the consequences of the whole mess.

Jul

Barb, You're probably seeing more of it than most.  There's plenty of blame to go around too.  Some people are very much responsible for the circumstances they currently find themselves in; others, not at all; and many along the line between the two ends of the spectrum.  My worst fear is it's going to get much, much worse before it gets better because we're all doing everything except stopping the "fix" that's being engineered by the same people who mucked it up.  I just feel sure this is actually an extension of the mid to late 80's because we did the same thing then.  It took a little over 20 years for this cycle and I fear them fixing it will result in a shorter lead time for the next one.  The AG used the term "nation of cowards" and I'm very much afraid he's right and not just on race relations.  We aren't made of the same stuff any more.

Aw well, back to the cat serial murder by afternoon...

PJB: Barb, I hear what you're saying but would it be better had these owners chosen to put their pets down? We've had that discussion on here and everyone would be screaming bloody murder over what awful humans they are.

_________

This is a straw argument because it presumes that there are no choices between stiffing Dr. K. and euthanizing the pet. And all of your arguments assume in one direction at least as much as other arguments assume in the opposite direction. Plus personally, I could do without the personal swipes at other posters.

My view is that being poor, or rich, does not entitle anyone to steal. When services are needed and can't be paid for, the right thing to do is to talk to the vet about what you can and can't do, do what you can, and take responsibility for the support of your pets.

I've had the misfortune to deal with several people who could absolutely afford to care for their dogs; they just couldn't be bothered. One put an ad on Craig's List threatening to euthanize their diabetic dog if she didn't find a new home by the time the bottle of insulin ran out. Truth be told, the dog was their breeding gravy train and now that she was worthless to them they were dumping her.

So there are plenty of people who are not noble human beings just struggling to make ends meet.

Dr. K. will most likely have to change her practices to collect some cash up front and that will put an end to the debate about whether the folks who stiffed her were desperate or just selfish. My guess is that there will some of both.

PJB: You are right, many can't afford so much as $50 out of their meager unemployment check. The first instance was honest: the client said upfront her funds were limited. She didn't skip out, she signed promissory notes.

The following two with elective dentals are questionable. Perhaps antibiotics could have bought some time to make alternative arrangements, I don't know. But no effort was made to pay a meager amount or "promise to pay in installments". From the description it sounds like a deliberate, pre-planned scam, with more details perhaps I'd think differently.

I doubt the parvo pup was pre-meditated, either---half payment came in.

I have no reasonable suggestion. People have run personal debt up, some have decreased or no income. Even those that have been living modestly well within means are hit broadside. I really am scared about this, I am seeing it.

Yepm, the clinic I work at also takes a 50% deposit for surgeries, it must be paid beforehand. THe client is given a written estimate, which they sign.

"Possibly but the latter cannnot EVER justify the former."  Really? Shannon, get back to me when YOUR child is hungry and homeless and sick.  If you can say that then, well, I don't even want to know you.  For many, and I would think a vet would know this, a pet is one step removed from being a child, at best.  There are far worse things than being humiliated and watching your child or pet suffer is amongst them.  Shannon, full time student, My dear young person, you haven't a clue what it is to be truly desperate.  I hope you never do because you might choke on that arrogant ego you're puffing around with.

Barb, I hear what you're saying but would it be better had these owners chosen to put their pets down?  We've had that discussion on here and everyone would be screaming bloody murder over what awful humans they are.  Most people don't take in animals knowing they'll lose their job three years later, while the economy is tanking, when they can't get any kind of job and are competing with 20 others on the same corner, begging.

I grew up pretty poor.  My mother couldn't get credit after divorcing my father (after he held a gun to her head) so my grandmother co-financed a car for her.  My grandmother ended up having to file for bankruptcy and I watched my mother weep when they took the car even though the payments had all been on time and in full; with less than 6 months remaining on the note.  Lovely people even kindly put the repo on my mother's credit record as though she'd defaulted!  I know what it is to be homeless and hungry.  I know what it is to be ill and have a child to feed.  I remember picking up pop bottles to return for the deposits so we could eat.  I know what it is to be desperate.  NOBODY gets to lecture me in this area unless they've at least come close or are broad minded enough to at least be able to put themselves in those shoes.

And, just FYI to all, taking something without instant payment isn't always stealing and it's far from always being illegal.

PJB: I hear you and I too am getting worried sick, delivering the ever increasing unemployment checks to people my age that have been dependent on a job/income for life. And yes, the homeless that were never homeless before. It is down right horrible & frightening.

 This has been in the works for years, 2005 being the crazy "false peak" of average wealth. Home prices with no real tangible value. It happened in the late 80's and it was right before everyones eyes. Stock market insanity.

 I have been one of those "poor" people, driving around in a car with a gallon of: oil, water, and antifreeze in my trunk. Eating peanut butter sandwiches for 2 weeks to pay the rent. Having next to no heat until money for the fuel. Working 2 jobs for decades, but despite all that, if I couldn't pay for something, I did without. That meant a frostfree refrigerator, a color tv, new furniture, name it. No handouts for college education from a struggling family, and didn't dare take on additional massive debt.

 Shannon: "We may not be a society that cuts off hands for stealing bread when one nothing but we aren't a society that condones taking advantage of a professional's trust and than stealing from them. Because when all is said and done, despite these people's situations, its still theft."

Thanks, you remind me about the shoe on someone elses foot. Yes, we are a society that condones theft & breach of trust, particularly if you are the non-professional "nobody". But it isn't right.

PJBossinger: "There is a difference between stealing and desperation".  Possibly but the latter cannnot EVER justify the former.  These clients stole, just like what it would be called if your gassed up your car than pulled away from the pump or took a cartful of groceries from the store without paying for them first.

I've been desperate.  I'm a full time student who works full time hours to pay my tuition and support myself and my three cats.  I also have a student loan and line of credit out so that I can buy groceries and my metropass and pay my rent.  And you know what.  it doesn't matter.  My cats never go without.  But I would never ever dream of walking into my vets, having them examined or treated or vacinated and than leave without paying because that would dishonest.  It would humiliating.  And it would be illegal. 

We may not be a society that cuts off hands for stealing bread when one nothing but we aren't a society that condones taking advantage of a professional's trust and than stealing from them.  Because when all is said and done, despite these people's situations, its still theft.

And as much as we, as readers of the blog, aren't in a position to judge the nonpaying clients situations, we also aren't in a position to judge the way that the Dr K or the owners of her clinic choose to run it.

"has done lots of pro bono, but there is a huge difference between offering it and having it "taken'"  Barb, I see that she does some pro bono but "lots"?  Well, that's exactly why I asked when she was going to take her own advice and publish a list; it may support "lots" or it may not.  (I'm not actually expecting to see such a list however.  If what is published in her blogs is the extent of her pro bono, then it certainly doesn't meed my definition of "lots".)  There is a difference between giving and having it taken.  There's also a difference between stealing and desperation.  Society professes there is a decent safety net for us all but there isn't; many professionals profess they will help but then don't and that is exactly what leads to much of the desperation.  For all we know, these clients think they will be able to pay but their pets were in need now (and who knows how long they'd watched them suffering).  What would you do?  I can't say I wouldn't do the same in their circumstances but then we don't know their circumstances only that Dr. K has lept to some conclusions.

We aren't a society that cuts off hands for stealing bread to eat when one has nothing.  We should not be a society that cranks up the collection mechanism and takes judgments, further pushing the needy down, unless and until we know their intent was wrongful.

"we should... publicly documenting freebies. If we keep track of our gifts, we'll feel less taken advantage of when clients abscond before paying their bills, more satisfied with ourselves and our daily work, and far more likely to take pride in how much we contribute to helping people and pets in need. And doing this doesn't require that we actually do anything we aren't doing already"  Dr. Patty Khuly, June 1, 2008.  Renee, it's a bit different when someone seems to be speaking with fork-ed tongue over a rather short period of time; expounding one position as advice and then doing something different oneself.  Always reminds me of young women who are anti-abortion, until they're "accidentally" pregnant.  Oops, now it's ME and affects MY life, oh my, I've changed my mind!

And, I wasn't talking about socialism but the societal debt one owes when society DID pay for something (like college) for you.  Like it or not, education has been socialized in this country (with the tuition and fees that students paying being merely a drop in the bucket of the actual costs) and, if it weren't, how many professionals could really have paid for their educations?  If one isn't in that group that could have coughed up 100%, they OWE society a return on society's investment in them.  (If one took a single penny in student loans, they REALLY don't get to claim they paid for their own degree as, at a minimum, society fronted the money for them.)

"don't know what their internal practices are... unforseen situations"  Um, correct me if I'm wrong but doesn't Dr. K have an MBA (Master's of Business Administration) from Wharton?  Charging clients and collections are pretty standard to ANY business.  I'd be a little surprised if that wasn't touched on in Wharton's MBA program and she's worked at Sunset for how long and they're not availing themselves of this portion of her talents?  "I'm not likely to see any of it--ever", "We've never managed to get anything like that going for our place. But then...I'm not in charge, either.", and  "my policy is changing".  No, I don't know Sunset's exact policies but I see in these three statements Dr. K say "she" won't see the money and "her" policy is changing while disclaiming that she sets policy/makes decisions.  All that together just screams inconsistency, inefficiency and poor business practices in my book.

I agree it is partly up to the individual but then I'd like to see our society succeed and thrive too and that requires everyone to act like they're in the society, not above it - not to be touched when things get tough for a significant portion of the society; no need to pony up when the going gets tough. "There is help for those who struggle and don't have the ability to thrive on their own" Yeah, I suppose tent cities are "help" but...  No, there really isn't much help for those in need, less these days than ever before (people lose jobs = tax revenue down = cuts in welfare when those in need are increasing in number) sadly.  That's OK, I know most people have their blinders on and want to delude themselves that a safety net exists and that anyone in desperate need has only themselves to blame somehow, someway.  It sucks when you realize it's a delusion, that most are a pink slip and a couple of months from tent city and food stamps that only pay for half what your family needs to eat and Section 8 housing that takes years to acquire and (if you're really lucky) those cash benefits from the state that won't provide you with enough to keep your family in toothpaste and TP and so very many are finding that out right now.

We're losing 80,000+ jobs per week from the economy, have been for months now and will continue to do so.  The tent cities sprang up in CA first but they're spreading ("From Seattle to Athens, Ga.") and this was last September and as far back as summer 2007 in Ontario, CA.  I guess it will get better when we mandate health insurance and jail those who have absolutely nothing with which to pay premiums; at least they'll have a roof over their heads, food, medical care; their children in foster care.  Now, of course, we'll all be paying hefty taxes to maintain them in jails and all their pets, well we know what will happen to them.  But go ahead and keep those blinders on and tell me professionals with even decent paying jobs shouldn't take some hits, step up their pro bono, be criticised for failing to do so or the temerity to whine.

Hold on a minute, PJB...perhaps you weren't subscribing when the vet hospital link had little Dusty dog as a patient, belonging to a homeless man & treated for a week. Or a few other posts regarding pro bono for the homeless with pets out in the "field".

Although it often appears that my comments revolve around what shouldn't happen in veterinary medicine, I havn't been clouded to not remember or recognize the good will & compassion.

Dr. K has done lots of pro bono, but there is a huge difference between offering it and having it "taken".

Renee, I agree with your thoughts & PJB in that as this economic mess continues & hopefully recovers , that all the bad businesses fall to the way-side during a shakedown. That includes serving stale food to nearly outdated groceries, to substandard service.

PJB.

Unless we're actually working within the walls of Dr. K's practice we don't know what their internal practices are. It would be irresponsible for me to assume, based on the three examples above, that we can accuratly define what these policies are. As businesses grow and evolve, adjustments have to be made to accomodate unforseen situations. Sometimes, veterinary businesses do err on the side of being too trusting of their client base. I agree, that is not good business. In the case of the two, where fees and policies for sevices were clearly outlined, there was a responsibility on the part of the clients-regardless of their situation-to communicate clearly what their needs were. And to all: Let's not forget that it's early, and they still may come in to resolve their bills. Someone may have actually forgotten their wallet-hard to believe things like this happen but they do (I acutually had a client who showed up for his appointment one day and had forgotten to bring his dog)-or there may have been some disagreement between spouses/partners and the other will pay.

I really can't agree with what I think your message is-that if some fail, all must in some way, diminish their own success? You are right, these are difficult times. Some can rise to meet the challenge and succeed, others might just have marginal success, and yet others might fail entirely. It is in part, up to the ability of the individual to adapt and seek alternative means and to meet the challenge of what might seem to be insurmountable circumstances. There is help for those who struggle and don't have the ability to thrive on their own. In a socialist society certainly, 'wealth' is distributed more evenly, but this just isn't where we are.

I don't know how many service providers (and local businesses) do not provide pro bono work. Some do not, but there are many who do so without flashing such acts in neon. Yes, I've seen the occasional veterinary practice that does nothing beyond what their business entails, but I've seen many, many more that go beyond expectations. Reaching out to others is, to me, an act of grace and heroic-whether it hits the pages of the newspaper or is done discretly. I can be disappointed that there are those who do not lend a hand, but I won't hold them accountable or judge them-that's something I'll leave to a higher power-and to the law of attraction.

Renee, I tend to agree with you.  However, the fact that Dr. K's office doesn't seem to know how/makes little attempt to to collect from the real deadbeats tells me how sloppy their internal business practices are.  THAT really trims the profit margin.  If they cleaned up their own act, they could help those in difficulty better in these lousy economic times because they'd have a wider profit margin all the time.  In addition, I find it offensive to presume people are being deadbeats.

I'm not expecting vets (or other professionals) to run themselves out of practice but for them to expect to flourish while others perish is unreasonable too.  We are in this mess together and people will remember which professions helped and which were arrogant after the recovery and there will be repercussions.

Most professionals really do very little pro bono work and that's really irritating.  Not one person gets through a professional school on their own dime these days and most do so substantially on the public's dime.  Professionals owe a substantial debt to society for their education and future earnings capacity.  They have a fiduciary duty to organize their practices to be efficient so they are positioned to repay that debt over their careers.

Dr. K,

What Jenn describes is very similar to what has been instituted at our clinic.  And it has been very effective. We charge a pretty high interest rate AND a monthly statement handling fee. We are a one-doctor practice with a couple of techs, a kennel guru, and two admin people.  I am fortunate to have a Boss/Vet who gave me a great deal of autonomy. 

Communication prior to any procedure is absolutely essential.  We tell our clients, "We don't intend to spend your money without your permission." In most cases, we can project at least some of the fees for them. For example: looking at a mass will probably involve a needle aspirate. Ear problems will involve cytology, etc.  We make every effort to communicate and update the client on fees.  It seems that many of the unpaid accounts resulted from miscommunication and services rendered without prior approval.

Once someone has incurred a balance, communication all along the way is equally important. It is also very important to collect their information just as if they'd applied for a line of credit. (But then we have the FTC Red Flag Rules to consider now. I "QC" EVERY statement and often include a personal note in them. )  Court costs are about $70 in our area.  So yes, we do end up $70.00 further in the red on that account but the client/defendant is held responsible for it. 

Essentially, it boils down to good faith and communication.  Our AR has been reduced well over 60% since I took an interest in it, BUT I don't think we will ever get it to zero. Nor do I think we want it to.  Some of it is just the cost of doing business and we try very hard not to penalize everyone for the ill will of a few.

@PJBoosinger

I understand your concern over an individual's financial condition and I do worry about animals who can't benefit from good, professional care. There are groups in some locals that can supplement those with money concerns regarding veterinary services.There are even groups that supplement food and supplies for families with pets. It takes work to research and the willingness to overcome one's personal issues about reaching out for help.

The question I put forward is, what happens when you expect the service provider to absorb the costs of care? Operational costs for veterinary practices are huge, and most of these businesses function at a fairly low profit rate. That does not leave much room for 'error'. This potentially places one's veterinary professional in the same position as the client; with little means to retain excellent staff, maintain or purchase necessary equipment, and a possible decline in quality of care.

I think it's really important for open communication to take place between the provider and the client, regardless of how 'embarrassing'it is to not have the means. That discussion has to take place in all levels of life now-with mortgage companies, banks, human medical facilities, even the local grocer sometimes. As tough a topic as it is, this at least would have left Dr. Khuly with an understanding of her clients' needs, and neither party would be feeling as though there was theft involved.

I've had plenty of clients try to get out of paying simply because they didn't want to use a credit card. I think for many those days are over for the time being and a genuine crisis exists. This requires reaching out and making arrangements ahead of time when at all possible.

I used to be the office manager for a tax firm.  While the bread and butter was audits for large corps and NFPs, we did a good bit of farm tax work and personal taxes.  Many of these people would 'forget their wallets' when they came to pick up the taxes or would ask us to mail the taxes to them with a bill.  When I started there, it was routine for accounts to be half a year or a year in arrears, with the client only paying if/when they came in to have next years taxes done.

Interest did accumulate, but at a very low rate.  Regardless, the CPAs would have me write off the interest when they paid (so they only paid the original bill). 

At one point they decided to have me implement a collections plan.  I was able to get 90% of the people to pay in full or start making payments.  I had a basic form letter which let them know their overdue balance (at 30 days), reminded them that we provided our services in good faith, and let them know that they can call to setup payment arrangements.  I included a return envelope and a copy of the bill.  if there was no response, at 60 days I let them know that further inaction might result in their bill being referred to a collection agency. 

By giving them a chance to call and explain the situation and/or setup a payment plan, the lines of communication were opened and many paid.  At first, even those were were extremely overdue were sent the 30day letter.  It was very effective.

Might be food for thought.

The university teaching hospital where I take my seriously ill cats (or ER needs - usually on a holiday weekend) has a fund set up to help people who can't pay their bills. I often donate in memory of a lost pet or in honor of a resident who has finished his/her residency. I can't give much, and owe a ton of money on my own vet bills, but I figured that even a little bit will help.

SophieM: But how much does that cost? You must work for a bigger hospital, right? I'd love to know. We've never managed to get anything like that going for our place. But then...I'm not in charge, either.

http://www.pbs.org/moyers/journal/07032009/watch.html

I work for a veterinarian and am in charge of "customer care" and, ultimately, accounts receivable.  All these great  suggestions (other than prepayment for entire procedure) still won't prevent getting stiffed by those setting out to get something for nothing.  Anyone can give a credit card number or check and later cancel or stop payment on the transaction.  

We DO take everyone to court for failure to pay (or failure to communicate) after 90 days.  It doesn't matter if they owe us $50.00 or $5,000.00.  (We don't use collections agencies, it hasn't been worth it for us.) Some may never pay but in most cases we get a call from some realtor who is trying to help someone qualify for a home loan.  That "someone," it seems, has  an outstanding judgement against them because we took them to court and can't move forward without clearing it.  Last week we received over $750.00 to pay an account that had been in arrears for over two years.  It doesn't fully prevent the sting of the bite it helps (prophylactically) when I explain our terms in advance to the next client who "forgets" a wallet.

On CareCredit: I carry it for my clients--even though it's not a good deal for either of us. Still, there have been a few who qualified and it gave them peace of mind to know they had been approved for x amount just for vet care--just in case. But it's always these 'planners' who qualify. Most who seem to really need it don't. 

At my vet, if you're a new client you're asked to supply your credit card number when you drop your pet off. Seems like a perfectly fair policy to me.

<<I'm sure it's getting tough on everyone. I think asking for 50% upfront on anything but a usual visit makes sense. I think people are often embarassed to say that they're broke - perhaps vets will more often need to have a conversation which goes along the lines of: do you want the Lada, the Toyota, or the BMW treatment plan? Or if you can't afford any of those, maybe we can figure out a bike. Or running shoes. Clients don't know there are options & it might be that the vets need to open the conversation about bills and what is possible for the family to pay at this time.>>

I think this is really going to have to be the case. Even I have cut back my vet visits to a need only basis for a while. I don't think that most people have ever suffered like what is going on, but some people in some areas are totally clueless to what is going on as well. I know the town I moved from is one of those places, and I imagine Miami is too to some extent.

Being poor doesn't give anybody a free pass on morality, honesty, or common decency.  And calling them out on it doesn't make you an uncompassionate Scrooge, either. 

Well, hello, I see Scrooges in the room!  Oh, please, skip the prosecutor.  If you feel that strongly about it, at least commit the justifiable homicide yourself.  No biggie, they might be one bullet shy of committing suicide anyway.  Yes, they're poor, let them die (or at least send them to jail; the rest of "us" don't want their kind around).

In my city there are some charities which aim to help out folks with unexpected pet care costs. Here's one:

http://vancouverhumanesociety.bc.ca/emergency.html

and there are vets still willing to work out payment plans etc. BTW, we're one of those places where vets cannot hold an animal for lack of payment.

I'm sure it's getting tough on everyone. I think asking for 50% upfront on anything but a usual visit makes sense. I think people are often embarassed to say that they're broke - perhaps vets will  more often need to have a conversation which goes along the lines of: do you want the Lada, the Toyota, or the BMW treatment plan? Or if you can't afford any of those, maybe we can figure out a bike. Or running shoes. Clients don't know there are options & it  might be that the vets need to open the conversation about bills and what is possible for the family to pay at this time.

Prosecute, prosecute, prosecute.  They know what they did, they did it intentionally...and they'll probably do it again to someone else if they never face consequences.  They're no different than those who knowingly write bad checks, steal credit cards, or commit other forms of financial fraud - it's a crime, plain and simple, and it's inexcusable. 

And I'll bet Karma bites some of you in the arse on a regular basis for the assumptions you make.

Around here, the businesses post in very large letters the names of people who have stiffed them, be it by bad check or whatever ...

May not help,   but at least it might forewarn the next person who might have dealings with them...

And ya know, the same people who say they have no money ALWAYS seem to have enough to buy that $5.00 pak of smokes, or get their nails done....

Susan,  Sure, it would be just fine to leave the animal in pain.  That's OK but let's not let the vet take a little hit in their pay!  "I refuse to believe..."  Speaking of holier-than-thou attitudes...  There are 6 others, you might want to look them up.  :)

@PJBoosinger

"Then there were the other two. They received estimates in advance. They received phone calls during the procedure to obtain approvals for estimate adjustments based on the new circumstances. And in both cases they OK’ed the dental extractions. (So you know, it’s hard to know you need to perform extractions until you get a pet under and perform a thorough oral exam, ideally with X-rays)."

Damn right they played Dr. Khuly. They had multiple opportunities to say, "no, I'll have to put that off." Or they could have paid even part of the bill, the part they had the advance estimate for.

As I have often said to the clients who have stiffed ME...I refuse to believe that NOTHING is the best that you can do.

Your holier-than-thou attitude is completely out of line.

I neglected to mention what was a new one for me. I made an appointment for one of my dogs to see a new vet. Not a full exam - a booster shot and a meet-and-greet. I was required to pay in advance for the basic visit just to make the appointment, via credit card over the phone. I did think that was a little much, though it was not a large sum.

"But I'm not. Not at all. Tell me you can't pay today and I swear I'll help. I'll find freebies to treat fleas and other parasites. I'll swing a shot. I'll cough up some antibiotics."  Gee, I don't see dental extraction there which is what you say these 2 needed but even you couldn't tell them that until...  You don't want to feel like a chump.  Maybe they aren't accustomed to having to beg.

"a new game afoot"  Inherent in that is they are playing you, having some fun.  You must be presuming they have the money and just don't want to pay.  Yes, let's make that presumption, bootstrap it with calling them deadbeats, file criminal charges for theft of services.  How many steps before one feels justified in holding hostages, I wonder?  BTW, the newly poor already feel ashamed, their faith and trust in others gone because we don't have the safety net we've always promised people will be there if they lose their jobs or become ill.  Hell, we don't even have work houses or poor houses; they're ending up in tent cities or under bridges, all their worldly goods gone (including pets).  50 years ago, Americans would have (DID) pull together.

Yes, it's the economy and some people are desperate.  And how much are those who still have pitching in to help those who no longer have?  It makes me weep to think these people felt they had to stoop to stealing and probably did so because their former vets had a "cash up front" policy so they knew better than to even ask!

"My Dear Wormwood, ... And the greatest of these is Pride."

I was a receptionist at a vets once. The clients who had previously had financial issues with the clinic got a letter in front of the number of their file. Most clients had a client number that would look something like: 2487. Clients who had previously been dodgy with payments got a letter in front of the number, making it something like MX2487. If a client happened to glance at the number on the file, they would never know that the letters in front of the client number meant anything, but it gave everyone else, from receptionists to vet techs to vets, a heads-up that payment might be an issue as soon as the file was in their hands.

Most clients were required to pay for proceedures at check-out. Only a few clients had the priviledge of 'running a tab' and getting billed later. Those would be the ones who had been going there for years and always paid on time. The clinic did take post-dated checks, though.

Unfortulantely, I think some people skip out just because they know they can get away with it. They figure, what's the vet going to do? I know one of my friend's relatives just got $2,000 worth of work done on his dog, knowing full well what the cost would be, then announced that he had no intention of paying the vet bill. There are quite a few not-so-nice people in the world.

As other's have said this is not "just" happening to Vets. In my computer business I have gotten stiffed more inthe last year than in the 10yrs I have been open.  However I still extend credit and let my good customers take the computer out of the shop. But you notice I said my "good" customers, for all others it is cash or credit... New customers will have to earn my trust.

I have been with my vet clinic more than 25 yrs and have never been asked for money up front, I have been given estimates though. I happened to be at the vet clinic today and overheard the receptionist ask a client for a 50% deposit on the estimate the client was given. Since I know my vet pretty well when I saw her I asked if there was a new policy. She said yes sadly they have started to ask clients for a 50% deposit/or credit card number for anything major as more and more people are skipping out on payment.. Didn't ask what major meant but I can guess. She told me that I didn't have to worry about that as it did not apply to clients like me.. However I made it clear that I would not have a problem with the policy.. I like to be paid for my work, so why shouldn't my Vet be paid for her services...

Keeping a pet as hostage is illegal in many states, I wouldn't even go there, if it was legal.

I don't see conditions improving for quite some time; this is the worst I've witnessed in 22 yrs. at the USPS. My region un-employment is still on the rise. If a congressional vote comes up for 5 day delivery...urge your Reps to go for it! The economic & carbon footprint savings will be enormous. I do not want to see a bailout , but it is probably coming.

Sure does suck to be a victim. Not only financially, but your faith and trust in humanity goes into the toilet. I swear it only happens to good folks, as the well-versed in scamming & deception are always on the lookout.

I am sorry that this happened to you. I am glad that it is a business transaction and not "personal". When it hits you on a personal level---it is really bad. A friend has recently had a home robbery...her first thought was about the dogs & what could've happened to them, but luckily did not.

Your clinic needs future protective measures, even if that requires drivers license & verification of address.

I pass by 3-4 vet clinics every day, I often wonder how they are keeping staff & doors open. Many large buildings & storefronts are vacant.

Pocket's Story from NH

Blabby Barbara's Blog

Can you sue for theft of services and bring criminal charges?  I'm not advocating this as an option for all cases, but if there is a particularly large bill or the person is a repeat offender, why not put some teeth into the situation?

Asking for an upfront payment sounds reasonable.  In this economy, the rules are changing.

Tough, owning a dog hotel myself I am seeing this more n more too---I have been asking for a deposit from those I don't know... had one pickup last week hefty bill with product "forgot check book" thought I would never see them again and they stopped by and paid with cash!  I almost fainted thought for sure it was gone...had a bounced check two months ago tried to phone them, left msgs sent a letter bla bla  then I just filed it away and wrote it off - they came by today too and paid cash ....

I think people want to pay their bills but right now so many are robbing Peter to pay Paul it just might take awhile? Sure there are crooks out there, but really (I think) a majority of people feel like crap if they can't pay their vet bill... A couple others who havent paid I called and offered payments too so now I have a few clients on payments, which I have never done but its better than no payment ?  I also had one client offer a trade for some work around the property so I took that too, at this point I'd probably take chickens in payment ;) LOL

I think a deposit is fair, but since its a new policy it will of course take time for people to adjust...

It's definitely time to re-evaluate your payment policy and ensure that you position yourself where the client is held accountable for non-payment. There are any number of ways to do this. It's a tough line to maintain when we're in a profession that has to balance business and compassion, but people come into a service provider or retail store knowing that there are fees attached. There have to be easy to follow (and consistent) procedures to deal with those who try to circumvent the payment system.

I'm not a fan of Care Credit. The fees to the business are too high, and if a client does not have the credit cards or available cash, they aren't likely to be in a position to be approved.

I don't see anything wrong with asking for a deposit up front. CARE Credit can be downright awful if someone gets sucked into the 3 months/6 months interest free deal. If you don't pay it all off in time the interest rate for the ENTIRE balance (retroactive) is over 22%.

I'm seeing the same problem in the medical field.. except, our medical treatment isn't as high.. Just yesterday I had to okay for a patient to be seen with a passed balance, and a new problem Ouch.. That hurt.. but we run into a problem with abandoning the patient..

On a brighter note.. One of my staff took her new puppy to the vet and he treated the puppy. The puppy subsequently passed away from parvo.. She ended up getting another puppy.. She took the puppy to the vet.. and  continues to take the puppy, and has been paying..

There will always be deadbeats.. but it does hurt to shell out bucks when you don't have it.. What about credit cards?  I took Socks in for a PE, and the week after an ear infection..

The worst part of getting stiffed is that you a reluctant to extend credit to folks who would pay you.

I had the honor of providing routine annual services to a school teacher (who makes more than I, and gets the summer off). She also asked for a years supply of heartworm prevention, a years supply of flea meds, and a couple of large bags of food.

She wrote  a check on a closed account for the entire amount. 

After giving her the option of honoring the check without success,  I sent the matter to the District Attorney. Now there is a warrant out for her arrest.

I don't think my vet will release the animal unless the owner has paid, so don't feel bad about requiring payment up front.  If you're that concerned, you could look into partnering with CareCredit or some company that will provide credit to your clients.  I haven't read the fine print on CareCredit, but at least one local evet uses it, and it seemed fair.

It stinks that you're getting stiffed but seriosuly? You let them walk out with the pet and you haven't been paid? How well does "oops, no wallet" work at the supermarket or a restaurant? The market would keep the groceries. The restaurant would keep either your license or a credit card or SOMETHING to ensure that they'd be paid-- or they'd call the police. You're a business; it might behoove you to act like one.

We routinely ask clients for partial payment upfront for many surgeries. Including expensive dentals etc. If we have clients without money we do what we can to create a payment plan with our credit company, or even for a few clients do montly payments inhouse.  If you're handing them a estimate its not hard to put right onto it that a 50% deposit is due before procedure and remaining upon checkout.

Helping is one thing, being taken advantage of it quite another.

The entire paradigm of our economic existence is held hostage by our inability to think out of the box and our inexplicable reluctance to throw everything we have into innovation in this area.

Just some food for thought

If someone claimed to have forgotten their wallet or check book, I'd ask them to go home and get it. It's not as though people live an hour away from their vet's office. I don't know how many times I've had to drive home and back again because I forgot to bring a urine sample (my dog wouldn't go at the vet's, but I could easily catch one at home).

I don't know if doing this might cause someone to abandon their pet, or if they would just admit they couldn't pay and then you could try to work out arrangements, nor whether those arrangements would be more likely to get them to pay than if they just walked out the door without any payment plan, but it seems worth a try.

I recently moved and changed vet offices in the process. Then I bought a new puppy and was actually quite shocked that they didn't want his neuter charge in advance of the surgery. I did have to sign a promissory note regarding the total, but no money was handed over until I picked up my groggy from anaesthetic bundle of trouble.

Reminds me of when I started out my career as a musician many moons ago.  Getting stiffed was routine. You had to have a big brute to deal with the club owners and get paid.  Even Led Zeppelin's manager carried a gun when it came time to "collect" when they first started playing the U.S.  It's still the reason acts demand "up front" money before they set foot on the stage.

I have actually heard of vets refusing to release the animals until the bill is paid. Yes, really. I have no idea whether it is legal. I guess since the animal is technically property, it might be. But there is something chilling about that.

Still, I can tell you from the heart that I feel your pain. I am a small practice attorney and we do a lot of work for people who can't give us a big retainer up front. And there are a lot of people with a lot of chutzpah who will stiff you without a second thought -- and sometimes we're not even allowed to quit!

But anyway, for years and years now vets have been asking for deposits and/or prepayments for major procedures here in the DC metro area. I don't see anything unreasonable about it. You have an absolute right to decide whether or not to extend credit. What these people have done to you is theft of services, and that is reprehensible.

I've noticed that our vet's office has been a lot quieter lately, too. The economy here is horrible... I think we're at 12% unemployment now.

I see no problem with requiring clients to pay (or at least make a down payment) prior to receiving services... especially for new clients. That way, you're in charge of whether or not you want to give the freebies.

Stiffing the vet on an elective procedure like a spay? Unless that dog had pyo or something and needed it out ASAP... that's ridiculous. Wait until you have the money! (Not that stiffing the vet is ever an acceptable option, but there's something even shadier about doing it when the procedure wasn't even immediately medically necessary, IMO.)

The vet we go to requires at least a credit card imprint UP FRONT before they'll undertake any expensive procedures.  You get the estimate in advance, with the caveat that the final bill may be more (or possibly less) than the estimate.  And they don't start until you pony up.

I understand this, and luckily for us, we've had the resources to handle everything to date.  Not sure what would happen if the credit card was maxed out and I had no $$ in the bank, though.  That would suck.

This is really a difficult situation. I don't blame you for feeling taken advantage of, Dr. Khuly. I'm furious -- and often desparate -- when clients don't pay me (as has been increasingly the case in this economy).

That said, in my case the clients tend to be large companies, not individuals. I can't even imagine the shame the people might feel at not being able to pay when it never used to be a problem. And admitting they need help, even to themselves, makes their economic situation seem even more tangible. Ask for charity? No way.

They love their dogs, and they're no doubt rationalizing that you have a thriving practice. I'm not saying it's right to stiff you. It isn't. And I agree up front payment for clients that you don't know is reasonable. I'm just saying that I doubt many are thinking they've gotten away with anything; most are doubtless harder on themselves than you could ever be.

Can you send a collections agent after them?  If a friend had one after her for an overdue library book, I would think a larger bill like this would be even more worth sending one. 

So sorry. I meant to say "Well many may disagree, I don't think your policy of upfront payment is *unfair."

Too early in the morning, not enough coffee yet.  My apologies.

Wow! That is an awful thing to do.  Our pets are our financial responsibility, not our vets.  I would NEVER dream of accepting a service and than walking out.  It's like taking a cart full of groceries to your car and not stopping to pay.  It's theft, plain and simple.  Well many may disagree, I don't think your policy of upfront payment is fair.  My regular vet doesn't ask for it, but the emergency clinic does.  Enough to cover the estimate, which is developed after your animal has been assessed by the triage nurse.

My vet does a 50% payment upfront for surgeries.