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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.

 

Can Human Medicine Take a Hint From How We Treat Our Animals?

March 16, 2010 / (10) comments


I'm big on learning lessons anywhere I can. In veterinary medicine it's the human medical profession that offers us the most cues: Whether it's basic dentistry or hardcore radiation oncology, human researchers and medical providers usually pave the way. But sometimes … it's the other way around.

 

Consider human health insurance and managed care. Maybe — just maybe — vet medicine's got the upper hand. That's what I argued, anyway, in a recent column for USA Today (catch it under Life online every Friday).

 

Yes, ultimately the pet health insurance industry has a lot to teach human health … if only because it's based on a competitive, fee-for-service model in which everyone participates, competes and questions costs every step of the way.

 

Sure, I qualified this bold statement like crazy:

 

Nonetheless, it's unlikely that pet insurance, as it's currently designed, could ever be held up as a model for human health insurance … the difference between pets and humans is responsible for this disconnect. The human-animal divide is vast and lies fundamentally in the willingness of an individual to shoulder any cost, no matter how huge, to save themselves or their children, while the reality is otherwise for pets.

"Why? Because most of us consume health care for our pets with the almighty stop-treatment figure buried somewhere inside our very human brains. Like it or not, pets are not like Grandma.

 

I caught lots of flak for this (from both pro and con camps), but I stood firm. Lessons can and should be learned … if only so that someone can do a better job bringing humane treatment solutions to a human hospital near you.

 

And I'm not the only veterinarian who thinks this way. Dr. Karen Oberthaler (a VMD like me) just penned a piece for Newsweek along these lines. Here's an excerpt:

 

When I say I'm a veterinary oncologist, I am usually met with a bemused, slightly incredulous reaction. I'm often asked, 'Do people really treat their pets for cancer?' As a matter of fact, they do. Not only do I administer radiation and chemotherapy to cats and dogs (not to mention the occasional ferret and hedgehog) on a daily basis, but I work in one of the most sophisticated veterinary hospitals in the country, with a neurosurgeon, a dermatologist, an ophthalmologist, and a host of other specialists. Pet owners routinely rack up $10,000 bills to save the life of an animal that they consider a beloved member of the family.

 

After this intro, here's what she offers (among other choice tidbits):

 

No family wants to subject its already sick pet to uncomfortable tests or dump thousands of dollars into dead-end diagnostics. So why do we do that to our grandparents? Clearly the stakes are different: we're talking about the people who brought us into the world. Vets, also, are not saddled with the threat of career-ending malpractice lawsuits. While most pets are treated like children, legally animals are property — I can't be sued for more than their face value. We're also not buried under paperwork, which accounts for our ability to spend more time with clients.

 

She's got a point. What's more, she offers plenty of others. Now, if only human medicine would see fit to sit up and listen.

 

 

 

Dr. Patty Khuly

 

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COMMENTS (10)
1
Pet Med teach Human Med
by on 03/16/2010 09:07am

Dr Patty,

Thanks for a great article. I am one of those who battled my dog's cancer with chemo. Unfortunately she still succumbed to the cancer. But we knew we did everything we could for her. And it was my vet & I's choice. Big government wasn't deciding for me.

I think the politicos in DC could learn from Pet insurance. I can buy pet insurance anywhere, from any company, in any state; why not let Americans do this with their human health insurance? Makes good logical sense, that's why, plus the fact that it would not give them a power hold they want.

Maybe Obama should consult his dog when it comes to health insurance!

2
by on 03/16/2010 01:47pm

I rather thought that part of why pet insurance can operate the way it does is because it has such low caps. In horses, you can insure with major medical for as much as you're willing to pay, up to the value of the horse's mortality insurance. If the horse is only worth $5000, you can only get major medical for up to $5000 a year--and then anything claimed for will be excluded in the future, so they won't continue to pay for an ongoing problem or even new problems in that area. In dogs, it seems the cap is often about $10k or $15k (for the life of the dog, not for just one year).

But a single ER visit for a person can exceed $15k in just a few hours, and a serious injury can run into the hundreds of thousands.

3
Can Human Medicine Take a hint from how we treat our animals?
by on 03/16/2010 02:58pm

One major difference that I have found is that I can make payments when I have a human emergency, but when I had a pet emergency the day after Christmas, it was pay right now ($5,000) to fix, pay up now to euthanize, or take your pet home to die. If the ER had been willing to work with us (and not "no exceptions") our dog would still be with us.

4
RSS Feeds?
by on 03/16/2010 06:02pm

Dr Khuly, I've been following you for years and have followed your blogging here from Dolittler... but I can't follow a blog without an RSS feed! Please tell me there's one in the works...?

5
by on 03/17/2010 12:38am

With the exception of the salutation (Dr. Khuly, I took note!) I second dbarbee5's comment #1.

Great post.

6
RSS feed...and ER expenses
by on 03/17/2010 08:54am

The RSS feed should be on its way. I'll check on that. Thanks!

As to having to pay up front at an ER––what a can of worms that is! The problem ERs run into is that most people won't pay when offered a plan. I've been on the losing end of that proposition more than a hundred times in my career. We're talking tens of thousands of dollars because I wanted to save an animal's life and hoped the owners would do the right thing.

Yes, for every ten of those there's probably one or two who would (and do) pay, but in an ER, the anonymity and the greater likelihood of a poor outcome skew the odds further against being paid.

Veterinarians––for better or worse––run businesses. I agree that there has to be a better way, which is why our hospital offers CareCredit. At the moment, the ability of our clients to get credit on the spot means that more lives are saved. Not everyone qualifies. But it helps.

7
by on 03/17/2010 11:42pm

dbarbee53, you CAN'T just buy pet insurance from any company in any state. You can only buy pet insurance from companies doing business in your state. Really. Honestly. When I was looking for pet insurance for my dog, there were two companies that pretty well met what I was looking for--and only one of them offered insurance in my state.

Also, you really don't want every insurance company to be able to sell insurance in every state without being subject to consumer protection regulation in your state. At least, not unless you love the way the credit card companies are well-run for the benefit of their customers--that rates, terms, and conditions are reasonable, and that the notice you get of changes and your opportunity to refuse those changes is reasonable. Because all the credit card companies are legally based in the state of Delaware, because Delaware offered them almost no regulation at all. The same thing would happen with health insurance if companies were allowed to sell across state lines without being subject to the laws of the state they sell in, or aggressive federal regulation. Your premiums, coverage, and procedures necessary to get your medical bills paid could be changed arbitrarily, because some state would offer them the Delaware deal for credit card companies, and they'd all legally incorporate there.

We have some power to negotiate cost with both veterinarians and pet insurance companies, because at bottom we have the option of refusing treatment for our pets. That's a power that, for good and ill, we don't have for ourselves and our human family members.

8
vet vs human
by on 03/19/2010 09:27am

As a practicing ER doc, pet boutique owner and dog owner, I couldn't agree with you more! I recently went through the "end of life" process with my 14 yo Norwegian Elkhound. My decision to allow her to end her life in a loving environment should be the model for humans as well. Far too many times, I have seen the dwindling of human life, far beyond what we would consider "humane" for our animals, yet we persist. Thus, health care costs for humans skyrocket, creating a vicious cycle that has not yet been broken. We should stop, look and learn from our furry companions and veterinary medicine colleagues

9
There are basically 3 things government should provide to its pe
by on 03/25/2010 11:19am

There are basically 3 things government should provide to its people. Safety, infrastructure and healthcare.

Pet health care (HC) could serve as kind of a model, but so could the early parts of the 20th century in US. Before HC was corporatised, private individuals selected their own HC based on free market principles, ask your grandma about it.

Also, we have our neighbors to the north, as well as EU, and plenty of (what we consider) third world countries providing reasonable care for its citizens. Its shameful that we quarrel over what should be basic human (and doggy) rights.

10
One major difference that I
by on 05/25/2010 04:44am

One major difference that I have found is that I can make payments when I have a human emergency, but when I had a pet emergency the day after Christmas, it was pay right now ($5,000) to fix, pay up now to euthanize, or take your pet home to die. If the ER had been willing to work with us (and not "no exceptions") our dog would still be with us.

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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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