Originally published in the September 2014 issue of Veterinary Practice News Last month I spent $2,600 on my newly adopted dog’s healthcare, which is a lot of money in anyone’s estimation—except, perhaps, our own. Here’s the breakdown: $800 was incurred as a result of drugs, diagnostics, supplies, tech time and overhead costs required for the OE, gastropexy and dental extractions I performed in-house. But the bulk of the sum was spent on a first-rate root canal (sans crown) at a top-notch veterinary dentist’s place (at a very generous 50 percent discount, I might add). All this for one adopted Malinois, a retired working girl who deserves nothing less after a life of service than world-class care. Indeed, all our pets do. Whether their job is to take down a bad guy, sniff out an IED or commandeer the couch, what we did for Tika is what we’d recommended for any patient in her position. Unfortunately, few of our clients can afford it. Given that the average person would have had to pay about $6,000 for that kind of work, referral is a non-starter. That’s a sum only the 1 percent or the well-insured can shoulder. Needless to say, the $2,600 broke my monthly budget, as I am buying a practice, saving for college and still paying off student loans. But don’t cry for me. No, cry for those who truly can’t afford these services because they’re unaware of insurance options, can’t get their vet care at cost, or are, like most of us, slumming it in the lower 99 percent. Or rather, cry for their pets, most of whom live without any kind of dental care whatsoever, much less Tika’s. Trouble is, the care we’re morally obligated to recommend has to span everything from Tika’s Escalade plan (specialist referral) to the lowliest Toyota Yaris approach (a shelter spay and some scripted-out clindamycin), because there’s no other way to know what level of care a client prefers (and can afford) without flying their options up the flagpole first. Though, admittedly, most will fall squarely in the Lexus through Camry camp, you can be sure there’ll be lots of handwringing over finances along the way. After all, no one wants to compromise on their loved ones’ care, not when even better care is dangled just beyond their reach. Given that reality—and I’m not telling you anything you don’t already know—is it any wonder we veterinary professionals are increasingly accused of taking advantage of the human-animal bond? Fleecers, scoundrels and price-gouging rogues, they accuse, claiming we run afoul of our oaths, hold their pets’ healthcare hostage, and, worst of all, care less for animals than for our own padded behinds. (If I had a dollar for every time I’d heard that last ditty I could pay off Tika’s Amex balance in a heartbeat.) As evidence, they cite a variety of our veterinary “misdeeds.” Consider the following oft-referenced examples of our “uppity” behavior: Conspicuous Consumption No matter that you’re the practice’s top rainmaker, invested early in Apple, bought real estate before the boom and deserve every penny given your intrepid financial decisions, your purchases may nonetheless invite that age-old obnoxious client-ism that declares, “I’ve just paid off my veterinarian’s new Navigator.” Whenever these comments arise, the insinuation, of course, is that we make too much. Apparently, veterinarians should look, dress and drive like James Herriot and Dr. Pol (never mind his own fortune). Gorgeous Digs (more conspicuous consumption) That fancy new facility? Sure, it just won our profession’s top award for Dream Hospital of the Year and that’s awesome. It shows that our profession has graduated to a new level of respectability. But when the fountain out in front costs more than the average car, some of your sticker-shocked clients might just be wishing the new place were a little less fantabulous—and maybe even questioning your priorities, too. Up-front Payments and Limited Options We require payment up front, but often offer too few financial options or third-tier healthcare concessions for the truly desperate Sure, it’s up to every individual pet owner to take financial responsibility for their pets’ healthcare, but that won’t wash the bad taste from their mouths when they fail to meet our “demands.” Nor will it keep them from writing nasty reviews on Yelp about our “bloodthirsty” ways. We’re “Too Good” at What We Do We’re taught to offer the best. Our academics may be on the decline, but we still manage to turn our top 10 percent into serious clinicians trained to meet the demands of the relative few who expect nothing less than the best quality care. Consider: If the impressive price tag attached to high-quality care (read: $5,000 for a back) is untenable for those of us who labor in the lower 90 percent of our profession, how can we expect even 99 percent of U.S. pet owners to shell out specialty-worthy sums? No doubt it’s utterly demoralizing to elect amputation because you can’t afford the plate. Or worse—how crushed must you feel when you find yourself morally obligated to dump your comatose cat at the clinic’s back door because you can’t afford to treat and hope a tech will take pity on him? I can see a cash-strapped client’s side of things when I witness their pain in the face of what they might be forgiven for interpreting as profligacy. And they’re not wholly wrong. After all, when we claim to be doing our utmost to raise the standard of care for all animals—per our Veterinarian’s Oath—do we not catastrophically fail in our mission when so many of us raise the bar so uncompromisingly high? It’s a decent argument. But does that translate to an excessively compensated veterinary workforce? Are we adopting an increasingly “entitled” point of view? An informal poll would indicate rapidly increasing dissatisfaction with our collective earnings, presumably as a result of the recent influx of more financially burdened individuals. Ballooning debt, relatively stagnant starting salaries, a reduction in per capita work hours and unprecedented unemployment levels conspire to reduce the profession’s average effective income. Paradoxically, all this internal handwringing is happening in spite of the pervasive client perception that we’re overpaid abusers of the human-animal bond. They intimate that we jack up our prices because we know a certain percentage will pay, leaving the rest to suffer on the sidelines reading about the miracles of chemo, CTs and cruciate surgery. I don’t have the answer. I never promised you one. But I do have an opinion: As a profession we have to get a whole lot better at offering financial options. Sure, I get it when you say it’s not your job to make sure your clients take responsibility for their pets. But think of it this way: Unless we step up and show them how, it’s unlikely to happen anytime soon.
