Monday, October 6, 2014

Making Vet Care More Accessible. How comfortable are you thinking AND acting outside of the box?

I think that one of the biggest complaints we hear about in veterinary medicine is that it is too expensive. A hard complaint to dismiss. I would never balk at the gripe of $1,000 being trivial. If you end up at the ER and need an emergency exploratory surgery you should expect to pay about $3,000. Most of us don't have this cash hanging out in our back pockets. BUT, should you find yourself in a similar predicament you should expect to add another zero to that estimate. And, we are talking about the same diagnosis, the same surgery, and the same treatment care. Not a bad deal when you compare it that way, is it?

This babies story..

As a follow up to my previous blog,"Taking A Stand And Facing Consequences," I thought I would share my attempt at putting my money where my mouth is.. So, I am including our written Jarrettsville Vet Financial Constraints Policy with everyone. Why am I doing this? Well, beside the persistent nagging yearning for transparency, I also feel that the existing system is met with great bitter frustration from people desperate to take care of their pets in need of immediate care they cannot afford to provide.

In our efforts to provide help to more people, AND never turn away a pet in need, Jarrettsville Vet has adopted the following payment protocol;

It is important to remember that when discussing a treatment plan with a client that every patient and every client should be treated the same. We provide an examination and an assessment for each case. Do not make any assumptions about any pet or client without discussing all possible options. One of the worst mistakes we can make is to deny care because we assume the client cannot, or will not pay for it.

Financial concerns can be discussed after the options are provided. We are assuming that people can’t or won’t pay and yet too many people internally/staff are complaining (or departing) because they are not paid enough. We need to stop expecting that people can’t or won’t pay and start treating everyone equally. Assumptions have no place here. Prepare for every option and adjust as they are accepted or declined.

Any client who has financial constraints should be given all options to allow us to help them with the care of their pet. To assist our clients in caring for their pets, and to remain aligned with our clinics mission of never denying care, we are enacting the follow new policies;

Every client is expected to pay the initial $50 exam fee. This is where we start and this is what we relay to clients calling in seeking an appointment for their pet. IF, they state that they cannot afford this, it is at the veterinarian’s discretion as to whether they are willing to waive the exam fee. If the vet declines to waive the fee we can reach out to the rescues. If no one is willing to help with this call me and I will take the case over. I will either see the pet pro bono, or authorize the JVC donation fund to pay for the exam.

After the exam the diagnostics need to be discussed. Every vet should become comfortable providing care with limited diagnostics. There is, in some cases, no other option. My goal for JVC is to provide care to our patients and to never turn away anyone in need. But, I am also most obligated to you, the staff. I will never ask you to do something you are not comfortable with, nor will I ask you to compromise or participate in something you don’t feel is right. If you feel caught in between call me and I will gladly help.

Our goal is to help our clients and their pets and we must do whatever we can to achieve this. We do not allow convenience euthanasia’s, walk-in euthanasia’s without prior DVM consent, and we should not allow them internally due to lack of resources.

If the client cannot afford the care needed or recommended for their pet, their options are as follows;
1. Seek care elsewhere if they choose to euthanize and we are unwilling to oblige.
2. Seek pro bono care elsewhere.
3. Continue services at JVC.

If they choose to stay with us and are unable to leave a deposit for the entire estimate, they are required to apply for CareCredit. CareCredit is the most expensive plan we offer, BUT, it guarantees payment to us. I ask for this because in many cases the client is not calling and is just telling us that they did not get approved. To provide this option we must make sure that the estimate is accurate. Also, please notify the client that they need to ask for the amount at the high end of the estimate. They are welcome to use our phone and we are happy to help them should they have any questions or concerns. A declined CareCredit fax must be submitted via fax to the clinic for us to offer the EBCS payment plan.

If CareCredit is declined EBCS can be offered. To be eligible for EBCS the client must leave a 30% deposit for the estimate.

Estimates must be accurate and must be given as a range. The client should ask for CareCredit at the high end, and will be given an EBCS payment plan for the high estimate. If the bill is lower we will shorten the payment period. All estimates need to be in writing and submitted in the chart. The client needs to sign the estimate and be given a copy.

If the client does not have the 30% to leave as a deposit they must either leave collateral OR go to a local pawn shop and provide the deposit. I am no longer going to accept no deposits being left. And, there are no exceptions. If you have a problem call me, or the hospital administrator and we will resolve it.

I am persistently trying to offer assistance and run the fine line between taking care of pets and the staff. If any staff members feel compelled to assist a client and/or a patient they are welcome to donate their time and services. I appreciate the generous compassionate dedication of all of the JVC team but we are consistently helping people who do not pay us back and do so at the expense of us collectively.

Every client needs to be given a daily update of their bill and every hospitalized patient is required to be paid in advance at the beginning of the time of services.

Lastly, no pet will be euthanized or allowed to be privately cremated without the bill being paid. If a bill is not paid, or transferred to me the vet who provided the services will be held responsible for the invoice. (I never ever want this to happen! I will gladly shoulder the responsibility so that no one else has to cover someone else’s bill!!)

I am including a list of pawn shops. I am also including their hours of operation. I feel very strongly that we are offering to help, willing to put our necks on the line to help them and they in turn need to also put a little skin in the game. Anyone who is unwilling, or unable to, provide a deposit can sign their pet over to a rescue and we will help that rescue get the care that pet needs. I know this might not always be fair, and I apologize for this, but that is life. I can offer to help care for your pet, I just have to expect that you will put your pets needs first and do what they need.

There are other options that I am exploring and hope to be able to offer soon. I have spoken with the founder of A crowd funding site that helps people raise the needed funds to care for their pet in the darkest of hours and most desperate of times. is a 501(c)(3) non-profit organization based in Massachusetts. The mission is to remove obstacles for pet owners so they have more opportunity to provide excellent medical care for their pets.

So, where do you stand?

What can you do?

Do you put your money where your mouth is?

Do you think, and act, and make miracles happen?

And when do you dare to live and think outside of the box?

I am a small animal practitioner in Northern Maryland. My goal is to help more pets. It is the reason I went to vet school and the reason I get up every morning to try again. I believe that miracles happen everyday, that amazing things are possible if you just dream, believe, and work to make them a reality.

If you have a pet question, seek better care for your pets and want to help other pet people, please join me at Pawbly is a free online social media platform built by pet people to help other pet people. It is free for everyone to use.

You can also find me at the clinic, Jarrettsville Vet, in Harford County Maryland. I am also on Twitter @FreePetAdvice.

Related Blogs;

What Can We Do To Help More Pets?

Burnt Out From Being Burned.


  1. Some people can be good and some can be great,but it is rare to fine people who are both. Bless you and those on your staff who are supportive of your concepts.

    1. Hello,
      It is the only way I can imagine practicing medicine. If you don't care, or if you abandon your want for care, it costs you deeply, and the cost is far greater than I could bear. It is the only way. It isn't the easiest and it certainly isn't the most profitable, but it is what I feel is right and kind and I use those two as my guide with every step.
      Many thanks for reading, and for being an inspiration in a sea of ambivalence and indifference.

  2. Thank you for doing everything you can - literally - to assist responsible pet owners when they are faced with a financially challenging situation. EBCS/ is thrilled to partner with you in this endeavor, and we look forward to helping JVC and its clients.

    Your JVC financial policy is comprehensive, well thought out and provides a multi-faceted approach for mitigating the financial barriers to veterinary care. By offering and combining multiple resources for payment (Care Credit, JVC Donation Fund, PetChance,org, pawn shops, and now EBCS/ payment plans), you are giving pet owners every reasonable opportunity to provide for their pet's health care so they don't have to choose between their pet's life and their pocketbook. At the same time, you are not absolving them of their financial responsibility. To me this is a "win-win," and I hope more practices will follow your example in the future.

    1. Hello,

      Many thanks for helping us in being able to offer another option. I hope to help more pets and more people and I am grateful to have others who are as concerned about pets and peoples ability to provide options.

      It should never ever be just about the money..JVC will do its best to insure that at least under our roof it isn't.

      Wishing you continued success and looking forward to making pet care more accessible across more borders in the future!

      You rock Suzanne!

  3. I love that you've shared your thoughts, policies, and willingness to work with pet parents, so many vets are all about the money and nothing else. I like that you mentioned referals to rescues for those who have strong financial constraints. What a great idea for a vet to actually think about that.

    1. Hello!
      Many thanks for reading and for taking the time to leave your thoughts. I do believe that most vets want to be helping pets, we just need to understand that it all doesn't, or can't happen in our clinics.