Earlier this week I received a Facebook query that went something like this: "My dog needs surgery but the surgeon my regular vet recommends works at a hospital that’s gotten lots of bad online reviews. Can you recommend someone else?"

Because this hospital happens to be my go-to hospital for specialty work, I was surprised. But by the time I’d read all of the reviews I felt I’d understood the problem more fully and probably should have expected all the negativity. Here’s a summary of the primary complaint: THIS HOSPITAL ONLY CARES ABOUT MONEY!!!

(Sorry for the caps. I know, they hurt me too, but that’s the best way to describe the level of anger with which many of these reviews were written.)

My curiosity now piqued, I looked into reviews of other specialty hospitals in my general vicinity. And guess what? They all sported the same exact breed of comment:

"Money, money, money!"

"They don’t care."

"They have no soul."

"And they call themselves animal lovers?"

Ouch!

But it’s to be expected, I guess. After all, these are the hospitals whose prices are steepest and where the short-term nature of the relationship means that love is easily lost — presumably because it never got a chance to develop in the first place. It’s also the case that business practices at these places are extra-strict, which often makes for an acrimonious first date:
 
Him: Payment plan?

Her: We call that a credit card here.

Which only makes sense. Think about it: Payment plans are based on trust. And there is no easy trust between parties when the expense of a pricey emergency procedure divides them. Not when, 1. The owner doesn’t have the ready cash; 2. The veterinary facility can easily rack up thousands of dollars in drugs and supplies on one patient; and 3. So many owners either refuse to pay after the fact or never come back for their pet. 

As a veterinarian who’s spent waaaay too much time working after-hours shifts, I can promise you this: Without an owner who says price is no object and lays down a credit card for the price of the Cadillac plan’s estimate, there is no easy solution to this dilemma. All else requires the veterinary hospital to risk taking a  loss on it all — which, truth be told, would happen every day of the week if we let it.

Want a recent example?

An older patient. A trusted client. He racked up a $2,000 bill before getting transferred to the specialist’s. Because the owner was indisposed, I drove the pet over myself. The specialists were paid up front for over $10,000 in work. It’s been a month and my patient’s doing great ... but I’ve not seen a dime. That’s trust for you.

Those were the thoughts rattling around in my head when I finally decided to pen a little response to the negative reviews I’d just read:

As a Miami-area veterinarian, I've had cause to send hundreds of my patients and at least five of my own pets to this hospital. If there's a complaint the cause is almost always the same: "We love the care but we hate dealing with the money thing."

As I see it, the problem here is not the hospital itself but the money issue in general. Consider that the level of care we can now provide our animals is far more sophisticated than our ability to pay for it. This fact has a way of setting up adversarial relationships between pet owners and veterinarians, especially when it comes to the highest levels of care. That's why I too often see negative reviews for the best-equipped, best-staffed practices.

Until we come up with a better way to distribute care to animals so that more of us can afford the amazing things veterinary medicine can do, I foresee plenty more nasty reviews in this space. It's so sad — especially when the people there are so good.

What do you say? Do I have it all wrong?

 

Dr. Patty Khuly

Today's art: bite the hand by Old Sarge (aka Doug Geisler)