Written by Elizabeth Colleran, DVM
Three weeks ago, a long standing and wonderful client of ours scheduled a long-awaited dental procedure for her cat Lily. Until we could get her scheduled, she was on pain medication for the cavities we had previously diagnosed. Since we know that dental pain is the same in the cat as it is in people, we knew she was uncomfortable despite the fact that she was still eating. The only significant change the client noticed was that she tilted her head just slightly to one side while eating.
When finances collide with the need for treatment
The wait for Lily’s dental procedure wasn’t because we didn’t feel the urgency to get it done, but because the owner’s husband had recently been laid off and money was an obstacle. Of course, this is not an unusual story. We are always faced with the circumstances of this beloved cat, at this time, in this family. The context of life is always critical. Children are in college. The recession hurt nearly everyone. A dear friend of mine who is a tenured professor lost her home.
Last week, a young man came in with Joey, a beautiful though overweight orange tabby male who could not urinate. Joey’s dad is a student at our local university and works part time delivering pizza. Naturally, he was worried about Joey, but also about what it would cost to fix his problem. Once our doctor evaluated Joey and made his guardian aware of the emergency nature of this condition, our technician sat down with Joey’s dad to review a treatment plan to relieve his obstruction, treat his pain and try to prevent recurrence.
Helping clients decide on affordable treatment options
Our best effort is always the most reliable form of treatment, the one with the best chance for a good outcome. Joey’s dad just did not have the resources, as a young student living on his own, to afford this approach. So we modified his treatment plan so that we could help Joey in a way that his guardian could tolerate financially. We had to acknowledge that this new plan was less than ideal and had some increased risk of not being successful, but we would do our best under the circumstance to save Joey.
When money is part of the challenge of treating a life-threatening or serious condition, we always have to work with our clients to make the best decision we can based upon what is possible, what is useful, and what the risk is. Plan A gives us the best possible chance of a successful outcome. But there is always a Plan B and even a Plan C.
The cost of providing the best possible veterinary care
Part of life as a veterinarian, or a human dentist for that matter, is the fact that medical care costs money. Most people who have health insurance for themselves are unaware of how much they would pay for medical services without insurance. We veterinarians entered our profession out of an abiding desire to make the quality of life better for companion cats and others. Every year we invest lots of time and money making our practices better. We work at staying current on new forms of therapy, new diagnostic tools and new techniques. We train staff and buy equipment. I don’t know any feline specialists who would do otherwise.
When money becomes part of the decision about providing care to a cat, as it very often is, we all wish that we could always do the right thing at every occasion without considering costs. The fact is we cannot. As much as 40% of every dollar we charge in fees goes toward salaries for our support staff. None of them can afford to sacrifice their paychecks. When the rent, utilities and all the other expenses are added in, there is little left. None of us entered this profession to become wealthy. It is not a profession where that is likely or often even possible.
Communication is key
We do love our profession, our clients and patients and believe that we are making lives better for cats. We try to work with our clients on finding a financial solution that provides the optimal level of care for their cats while staying within the client’s financial limits.
Most complaints about fees are usually the result of miscommunication between veterinarian and client. It usually happens when a client doesn’t tell us up front that they need Plan B or Plan C. We always feel terrible when that happens. The most important way to prevent such encounters is to communicate with one another, openly and honestly.
When my own dog disappeared into the canyon next to our home for 5 days, he returned with a broken pelvis and a broken canine tooth. Even with a professional courtesy discount, the tooth alone cost $1,400 to fix. We know what it’s like to face veterinary expenses, and we do our best to offer options based upon the cat, the family and the times.
Our first goal is always to offer the best possible care. When that isn’t possible, we try to get the best outcome with the resources that are available.
Dr. Elizabeth Colleran is a 1990 graduate of Tufts University School of Veterinary Medicine. She holds a Masters of Science in Animals and Public Policy, also from Tufts University School of Veterinary Medicine. In 2011, she was the President of the American Association of Feline Practitioners (AAFP). She is a Diplomate of the American Board of Veterinary Practitioners, Specialty in Feline Practice. As the spokesperson for the AAFP initiative Cat Friendly Practice, she speaks at major conferences around the country. Dr. Colleran owns the Chico Hospital for Cats in Chico, CA and the Cat Hospital of Portland in Portland, OR.
