Sunday, October 15, 2017

1:15 pyometras left this ER alive..

I asked people to share their pet care stories with me,, and oh my goodness, did I ever get them! The stories that have been forwarded about pet parents experiences in veterinary clinics, ER's and the treatment they and their pets have been given has crossed every single scenario about everything imaginable in between. Most are sad and very disheartening. This is a part of the current state of my profession.

I work as a vet assistant at an emergency vet clinic in XXXX. I find it very heartbreaking every time I have to tell someone who can't afford our services how much it would cost to test their pet! At our clinic our exam fee is $69.00 (just the physical), radiographs are $190, complete bloodwork is $160 and a parvo test is $70; that is just a start. Where I work all payments are due in full at the time of service no exceptions! If the pet needs surgery or hospitalization it is around $1000!! In the over 1 1/2 years I have worked here (using pyometra) I have only seen one survive (1 out of 15) and all the others have been euthanized.  What my employers have told me is the the reason why the policy is in place is because our clinic has been "used and abused" and people will walk out without paying their bill! I simply find this hard to believe. I wish that there was something I could do. One of the problems is that the clinic I work at is owned by ALL the veterinarians in the county (so they can get the weekends, evenings and holidays off).  At some points I wish I could quit my job because I am tired of the heart break from watching pets go without care or very little care because the owners can't afford anything better!

These are the statistics the veterinary profession is striving so hard to disregard, excuse and shift the light from. We try so hard to maintain our public persona of being "the trusted healthcare provider for your four legged family," yet we cannot hear, acknowledge, or accept the pleas, cries, and heartbreak from those we have abandoned? We don't want these testimonies made public. These are opportunities lost. These are part of the greater divide leading to skepticism and divisiveness. These are our patients lives, our clients grief, and significant part of the swell of tragedies on both sides of the exam room table. This is how we got here. Stop blaming, stop shaming, start talking.. even if it is uncomfortable in the exam room for that 5 minutes before the fate on the wall is written and sealed.

I am going to do A LOT of talking about pyometras. I have to. I have to because stories like the one above are happening at a proportional skyrocketing rate and no one is telling people they have options. That, that my friends is.. (well, I stated it clearly in my video),,, that, as a private practitioner to a community we have served for over 60 years is called killing our patients. Every night I fall asleep I wonder how many I won't wake to in the morning?

More than 1 in 15 pyometras is NOT what I see in private practice. In fact in 12 years, with (approximately) three times as many cases, I have lost 1. One in 45. That dog was euthanized because she was comatose at arrival and needed overnight care her family could not afford. She deserved better. She waited over a week before she came from two states away to find me. One in 15 happens because people are scared and vets don't offer it another way. Try! For GODS SAKE try! Try fluids, antibiotics, TRY EVERYTHING BEFORE EUTHANASIA. Let's see what the statistics look like after that motto of "compassion before euthanasia" is the cornerstone of our practice in practice.

There ARE ALWAYS (ALWAYS!!) options. Until these options are given to every single case I am going to keep talking. Here is where I will start.

Say the following instead;
YES! To fluids!
YES! To antibiotics!
And, yes, to finding a vet you can afford, who won't use words that revolve around anything else but giving you and your dog the help they need to try to recover from this infection. Help in understanding there are options, and that you have choices, and your  deserves a chance.

We, the veterinary profession, have compiled every single marketing brochure with a cute puppy or kitten being coddled by a smiling white coated stethoscope draped professional all beaming glee front and center. This is the persona we pitch. The stories that have been sent to me are far from what we lobby ourselves as. We pitch ourselves as the hands of healing and compassion and yet the public has become weary of our lured commercials. To many the profession has become an over priced commodity only sought when disaster meets impending death. The educational obligation we have to our clients cannot be over emphasized.

Where to go from here? Just say NO TO EUTHANASIA and YES TO EVERYTHING ELSE!

Recently I have been flooded with requests for pyometra consults. At every single one of these meetings I ask if the client was "ever told this might happen if they didn't spay their dog?". Every single one of them have all said "No, I didn't know this could happen, and I certainly had no idea it would be this expensive." Most thought the vet profession was recommending spaying and neutering as a part of  our revenue generating income stream. A compulsory line item equivalent to the vaccines, preventatives, and dental cleanings we propose as being 'needed' while they heard "optional". We are not informing clients as to why these items are vital to our patients health and longevity. And, if we are in some small ancillary footnote, we are not providing these with data, written take home explanations that we know to be true as our own real-life previous horror stories that a previous client learned the hard way. We know these cases, we have lived through them. Why not use these experiences as a pay-it -forward exchange? Why to are we not also giving estimates for procedures now and later? A real-life tangible cost risk analyses. "It will cost you $250 to spay now, or, $2,000 to spay a pyometra later. Either way, there will be a spay involved." We say this to ourselves, don't we? We have no hesitation asking clients to sign a medical release that places blame back on them when they go "against our medical advice" and leave the clinic without medications, hospitalizations, and follow up specialist consults, but, why not with the more routine day to day omissions? Do I lose clients over my hard sells and case based experience? Absolutely! I absolutely am much more concerned about my patients health than my clients liking me. They may question whether I am trying to up-sell them, but I put my experience into my practice and they can't turn around later and not say that "I didn't tell them this wasn't a possibility." Further, I put my money where my mouth is. Every client has the ability to pay forward for care, use third party billing, and in some cases I will give the client a break, or the product on the house. This marketing scheme is written into every manufacturer contract I sign, it is also provided with an in-clinic resource guide for clients with financial constraints.

I know the reply from veterinarians ready to jump and attack this blog. I know their defensive tone deaf ears and accusatory vitriol to these stories is all the same. Blame, shame, and excuse the heartbreak. We tell them and each other that "it is their fault. Theirs alone." It is not. Let the stories prove this to be wrong. We have yet to stand up to our accusers and provide culpability.

Clients are not given options based on numbers. All made available at the initial consult. Every single option given and then let the client decide. Veterinary medicine does not provide enough transparency. And the numbers don't lie. Give them prices, choices, and prognoses ALL UP FRONT.

Where are those numbers? Want to argue with your credibility intact? "SHOW THEM THE NUMBERS! Not just your own, show them mine too. Tell them that my clinic provides 90 (plus) % survival rate at $1100, and then give them yours. Let them decide what to do with their family members life. is about saving lives, and providing options with data. Let the data set the standard of care and integrity via transparency be the guide.

If you care about pets, believe in making happy endings happen, and want to help others please join me on our Jarrettsville Vet Facebook page, our Pawbly Facebook page,and also on Twitter and YouTube.

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