Here are a few choice words that apply to the topic of money in veterinary medicine (more specifically, to it’s lack thereof): Stressful. Frustrating. Tragic. And how does the veterinarian fit into all this? Uncomfortably, to be sure.

Interestingly, both altruistic impulses and lifestyle-related desires are increasingly drawing people to the discipline of veterinary medicine. Challenging, socially responsible, and family-friendly with plenty of room to maneuver for the occasional fits of ambition; what’s not to love?

Ummmm … the money thing?

No, no, no, I’m not talking about how little we make in comparison to our human medical counterparts (way less than half, on average, but who’s counting?). In this case, it’s more to do with how heavily imbued with financial consideration our work lives can be.

Which brings us to today’s topic: How the introduction of financial issues manages to make veterinary medicine an inhospitable place to make one’s way in the world. Because unless our clients consider money no object, how we treat our patients is governed largely by what they can afford.

Which is no fun.

No, it’s no fun offering estimate after downgraded estimate, waiting for credit card limits to be raised or Care Credit approval while the pet waits for treatment. It’s no fun having to make clients signs things and tell them their pet can’t have life-saving surgery because their check bounced the last time they paid us.

It’s enough to make us feel like the used car guy down the street. (You’ll have to take the 1998 Kia, ma’am. It’s the only thing on the lot you can afford.)

But here’s the flip side:

One of my veterinary assistants is a part-time college kid who’s lucky enough to qualify for our health insurance program. Not that it’s a great plan, as HMO’s go, but it’s something. So when he hurt his foot at home one weekend, he drove himself to the ER. There they did two X-rays, found that no major damage had been done, offered him 400 mg of ibuprofen, and sent him on his way.

The bill was $1,400; he has to pay about $300 of it. Which will take months — maybe a year — for him to pay off on his current budget. "And," he said, "I didn’t know I should’ve gone to urgent care instead. No one told me what the prices would be. I never got an estimate. If I’d known, I wouldn’t have let them take the pictures."

Chalk it up to naiveté. But it shouldn’t be that way. People should know how much things cost before the billing department gets to it and the invoice arrives in the mail a few days later.

Here’s another one: A friend of the family recently fainted in church and hit her head on a pew. Concerned bystanders called in the rescue and much was made of a simple bump on the head so that when all was said and done, $23,000 in ambulance fees, emergency care and tests (all negative) confirmed that not even a concussion had resulted from her "wow it’s hot in church" mishap.

Needless to say, she has no health insurance. She may be in tears over a bill she’ll never be able to pay, but you and I will be footing that bill.

And how did it come to all that? Because no one gave her a choice in the matter of all these tests. She just assumed that’s what happens in this bewildering place when you bump your head. And no one’s coming to your bedside with a running tally of what you’re racking up, bill-wise, asking you to choose an a, b or c approach. In fact, the staff who provides the care has no clue what things cost.

Contrast that to vet medicine, where how much something will cost is the first order of business — because it’s assumed you will have to pay the bill when services are rendered — and you start to wonder whether the bane of my existence at work (talking money morning, noon and night) might not be the right approach, after all.

What say you?

Dr. Patty Khuly

Pic of the day: Cat Bank by Wombatunderground1

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