A very wise veterinarian once told me, "You can't love your patients more than their owners do." It seems silly to think about, but it really resonates with me. No one goes into the veterinary profession without a strong love of and desire to help animals. We are a bunch of bleeding hearts; I know I am. The problem occurs when people expect us to foot the bill for their animal's care. Don't get me wrong; I very much doubt there are people who will walk up to their veterinarian and say "give me that drug/surgery/treatment for free," but people do have a habit of making vets feel guilty when they need to charge for their services. I've often heard people say such things as "my vet is ripping me off," "I could buy a wing on this hospital for how much I've paid you," "can't you tell me what to do without doing an exam (ie, charging a fee)" and "can't you just help me out a little bit?"
Some of those comments certainly sound like innocent banter. After all, who wouldn't want to crack a joke at the $1000 bill I just paid for my dog's emergency visits this past week? (We tell my dog..."It's a good thing you're cute...") It's most likely just a sticker shock reaction, but it still strikes a nerve. The insinuation is that vets are getting rich off of ill animals at the client's expense. Veterinarians go to school for 8 years (4 years college, 4 years doctorate) to learn how to treat animals. It is super expensive to pursue vet med, with OOS (out of state) costs ranging in the 200,000 range. The average starting salary for a veterinarian in private small animal practice is between 60,000-70,000. Compare this with human medicine, where after the internship and residency years (both of which are options for the veterinarian, though not mandatory), the lowest paid physician (primary care) will be making 150,000 with the same amount of educational debt. So veterinarians have a lot of bills. And like any other professional in the world, they do want to take home some kind of paycheck at the end of the day.
Though pet insurance is available, most people do not take advantage of it. That means whatever you see on the bottom of the bill is the total cost that you need to pay. In contrast, in the human medical arena, you pay for insurance for yourself, your spouse, and your family (or receive such benefits as part of your employment package). Insurance takes care of most of the cost of medical care, so all you see at the bottom of the bill is a $20 copay. This makes people pretty unaware of how much medical care costs, and they often gawk at the price of veterinary care.
But this really brings me to my main point. Consider this scenario: You are a veterinarian working at an overnight emergency hospital. It is 2 in the morning and all other vet clinics in the area are closed. A client comes in with his young dog that was hit by a car. The dog is laterally recumbent and has labored breathing. You rush the dog into the back where your techs begin to attend to the dog. The dog needs an IV catheter, fluids, X-rays, and blood work at the minimum. The client looks at you and says "How much is this going to cost? I only have $50." What do you do? The dog is suffering. Your emergency exam fee is $127 and that doesn't even cover diagnostics, treatment, hospitalization, or surgery if necessary. The dog is young and could probably live another 10 or so years. You don't want to euthanize a treatable dog, but how much of the cost do you eat? $1000? $2000? $5000? If the owner can't afford treatment for his own pet, should you take responsibility for the pet's treatment? Or do you euthanize the dog, knowing that it will eat you up inside but you can't shoulder the cost for every person that can't afford to pay?
Veterinarians are faced with this decision every day. I read an article once that quoted a veterinarian who comped $50,000 in one year alone for various people who couldn't afford veterinary care(!!!). This doesn't even take into account the stray animals and wildlife that vets will often treat, or shelter animals that need care that they offer a discount for. Is this fair for the vet? Should vets be expected to lower the price for every client that can't pay? Should clients who can't get loans from friends or neighbors expect to get a payment plan from their vet? Should people who can't afford vet care not own pets? I definitely don't think so, but I believe that some responsibility for care should fall to the owner. And I definitely believe the veterinarian shouldn't be made to feel guilty when they charge what their education, overhead, support staff, and supplies are worth. It's a difficult question with no easy answers.
Some food for thought...
DVM2016
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