The Problem and The Compulsion

I have had this conversation a thousand times before.

A thousand times I have explained the same problem, the same outcomes, the current state of our profession, and the same desperate passionate plea to provide better for the sake of all living things.

With each plea for help, pitch for the solution, and nodding heads of understanding, the problem remains here at my feet grinning. 

The problem sits, consumes and grows.

Problems this big, the kind of big that swallows lives and breaks hearts, can define a life. 

I may have come to vetmed to save pets lives, but this profession is more than practicing medicine, it is about protecting and saving lives. When I can't do this it's a big problem. This problem has gripped my life's work and taken it into a place I never thought I would become so compelled and stuck within.

What do you do with a problem that allows suffering, denies culpability and consumes as it festers? Well, I guess if I am me I dig in. 

I am now companions with my problem. My problem has become my compulsion. As compelled as I was to become an adult and leave the shadows of a small existence in an even smaller northern town. Compelled to be unburdened by the confines of a family fleeing a city that left them feeling monitored and microscopic. To the girl who I once was compelled to find a bigger life with a chance at freedom to the cost of a uniform. To be compelled to go to sea for a decade to buy your second chance elsewhere. Compelled to fight and outlast the years it took to get into veterinary school and quench that little girls soul still alive inside her and be the Herriott she heralded. I am compelled to do this too. Shake the ground so hard that the tallest tress tremble and the smallest beings benefit. Just like all of these before I will not stop until this to is notched in my belt and a little piece of kindness is given back to those who never formed the language to ask.

Here's the pitch, (for the one-thousandth-plus time), in small bites;

"The house is ALWAYS stacked against you." Whatever veterinary clinic you walk into, (and for my analogy: any casino), they have the upper hand, almost all of the control, and very little, (if not intentionally absent), motivation to provide you all of the options available to you and your pet and no upfront transparency to allow you to be prepared, informed or flexible once you walk in their door. I used to hope that moral fortitude, ethical foundations, and our own soul-filled desire to make a difference within the profession we were all so passionate about might motivate a righting of the compass, but it appears the gap grows ever wider and the despair ever deeper. 

"There are so few governing rules in veterinary medicine that it has allowed the single minded behemoths to eat up the landscape for profits without limitations." If you work in a profession that is being acquired by venture capitalists there is a dollar figure so alluring you take notice. Why is it happening so quickly in veterinary medicine? Money. Just money. We are perfectly positioned to be so lucrative the vultures are eating us up in record numbers in record time. Here's the facts that allow vetmed to be so profitable. For many people our pets are our reasons for everything. Price is not set by, nor limited, nor overseen, nor fixed, nor ceilinged, for anything from anyone at anytime. We, the profession, the individual and the facility, can charge anything we want for anything you need/want. The reason; well pets are property, and the market will bear what costs are, until it's 2 am and your pet is dying and you have no other options, AND, no one publishes their prices. Consumers don't ask, don't know, and don't have the ability to query costs before, nor, negotiate during a pet visit. You are a victim to an establishment that now has you hostage, and we know it. How does that feel when your pet is dying, sick, and you are both at the mercy of someone just out to make money? The house is ALWAYS stacked against you. And no, you shouldn't trust us. We don't work for us, or you, or pets anymore.

What is the price you put on your pets head? Maybe its not a question you have ever had to ask yourself but be warned it is the only question the VC's in this arena care about. If they think you will spend $20,000 for a pyometra that's what they ask. How many of you have access to that at 2 am? How many of you couldn't afford this and will have only one other option given to you; euthanasia. 

The system is getting worse as the money gets fatter cats, fatter. Ask your vet if they work for a corporately owned VC? Ask them if they received a sign-on bonus? What if that sign-on bonus was $250,000? Who do you think is going to pay for that? How much is the price on your pets head worth? How else can those sign-on bonuses be paid? I promise it isn't coming out of the fat-cat at the top of the food chain who owns the place, and btw has zero interest, nor experience, nor knowledge of any aspect of vetmed other than its profitability.

So, now that you understand the money, let's talk about the other thing the house has on its side; liability.

Liability is managed in CYA documentation. We are very good at this. We are, after all now owned by the fat-cats with the fat-cat lawyers. Although the single veterinary practitioners liability insurance hasn't met any other kind of human medical malpractice comparison, we pay hundreds, they pay tens of thousands, when we start to ask $20,000 for a pyo, (remember pets are property, we only need to provide "replacement" value) it might be time to change the valuation of our culpability. 

Are you beginning to believe that the house has this gig rigged yet?

Let's talk about signing documents? Are we the only profession in the world that has customers sign something AND NOT GIVE THEM A COPY IMMEDIATELY? Why is that? And why can't clients turn the table on this practice? Why aren't we providing guidance to save lives instead of practicing a professional skill to avoid liability while we with hold access and options? (More on this via Pawbly.com soon).

Here are some of the stories I get sent every day. (Find all of them on my YouTube channel and Pawbly.com)

From my friend;

"My cat was a diabetic. He was having some kind of crisis and needed emergency surgery? Our $5,000 walk-in deposit went to $10,000 within a few hours. We didn't have the $5,000 and we certainly couldn't pay the $10,000." I knew what was coming next. Yes, they euthanized."

What the actual,,,, I have never had a emergent diabetic case that needed surgery. And every, (yes people EVERY) case has options. Like, let's start with insulin and fluids. Basic medicine every vet was taught. We don't practice affordable care because it is not maximum-profits care.

The practice owner I met last week at the veterinary career fair summed it up perfectly. "It is our job to offer best practice care (i.e. most profitable) and if they cannot afford that, then we offer other options." Sounds kind of unfair to you, the consumer, doesn't it? 

To the weekly requests I receive to unblock a cat, look for a nasopharyngeal polyp, or save a pyometra (all of these cases are given with real-life pets on my YouTube channel) for a tiny fraction of the costs being given elsewhere, I have to remind myself that I am not alone. I cannot fight for all of these pets, provide all of these services alone. And so my war with the current state of vetmed wages on. 

Unblock cat here.

Cat with polyp case here. And here.

Pyometra here.

For those of you who don't care, maybe you think you are sheltered? Some of you are. Some of you have a great vet who you know and care about, and, who you believe cares about you too. Some of us are still out here working for ourselves. Putting our own reputation and shingle on the line. We are affordable because we care about you AND your pet. We value what we always have; being a trusted part of our community. We care about lives, legacies, and ethical traditional vetmed values. But what will happen when we leave, or retire, or die? What will happen to you and your pet when we have to decide what the future holds for our clinics? What happens when its 2 am, we are closed and you need help from someone else?  What do you think your vet will do for you when you are at the front door of the fat-cat clinic? Ask them? Don't wait until you find out in real-time with a real emergency.

Go back to rule number 1. The house always wins. When your pet needs something, critically needs something you will very quickly be reminded that pets are now a luxury for the rich. No longer the middle class, but the rich. Rich people seek other rich people to get richer,, they don't apologize for this. When I started in vetmed in the 80's an exploratory surgery, let's say for a corncob stuck in the intestines, was about $300. Ten years ago it climbed to about $1,000 to $1,500. Five years ago $4,000. Today, at almost every specialty, and some ER's it is $10,000. How many people can afford this? What happens when a corn cob isn't removed? Your pet dies. Dying of a treatable condition used to be far less common because veterinarians had obligations they took personal responsibility. We had our own practice to protect. We were a part of our community and word would get around fast if we failed to help, failed to provide care, or even worse if we failed to provide an affordable service. 

the easiest thing for you to do, and the way the house insures its victory, is by you giving up. Once you sign that euthanasia form, it is over. You have conceded all and given permission. I know, and I do believe that there is no greater gift then ending suffering kindly, but, how many pets are given up on because vet med has made any other outcome impossible? There is a war coming to vetmed. There will be enough people forced to abandon the one being they love more than anything this world holds and the war will be for them. There is a class action lawsuit that will follow, and with this a littany of others will follow. People will have their voices heard and this profession will have the first righting forced upon them after never have had one before. 

Property. As the legal liberties are awarded, and the price points become both transparent, publicly provided, and openly traded services will provide some degree of stability and fairness. Does the profession want to lose the legal status of pets being property? No. With this definition there is a limit to liability we face when clients seek compensation for damages. But, the classification of property 

ways to escape being a victim;

independent practices. find, meet and ask the owner what you can do, or need to do, to be cared for. P.S. "get insurance" should not be, and cannot be, the only answer.

This profession has wounds that run deep. We have apologies to be spoken, and we have a path that cannot continue at the pace and prices we are requesting.

I have been a veterinarian for almost 20 years. I have seen every kind of case with every kind of pet parent behind it. Very, very few are without hope nor options. I have also owned a practice for almost all of this time. Are the prices skyrocketing into exorbitant? Yes, they already have. Are there veterinarians and owners out there profiting without remorse? Absolutely. When you live in a place that loves money more than life, profits more than 

Be very careful what you wish for? Want to be the one-and-only decision maker for your pet? Then they are property. Want to have every treatment option available for the most beloved being in your life? Better have deep pockets and instant availability for those dollars. Want to be insulated from heartbreak because your love for your pet leaves you vulnerable? Just remember that the person who decides whether or not your pet gets the care they need has a limitless ceiling and you are at the ends of their strings. They give you care based on two things; your ability to pay, and their willingness to help you. Thats it. Feeling like a your pet is a pawn in a venture capitalists portfolio? They are. Welcome to my problem. I suggest you get pissed enough to do something about it before you get screwed and have your heart broken over the loss of your treatable companion.

And maybe think about the price on your pets head before it's 2 am and you have to consider it, and start demanding a change now. The divide between need and access is getting wider and the 

Here's what's ahead;

its time to put liability CYA paperwork in pet parents hands.

its time that pet parents be given all of the options, with written line item estimates, before a deposit is given.

its time for transparency;

its time to publish who owns the clinic you are at.

who was given a sign-on bonus that might have influenced the price on your pets head.

its time to publish average costs of care before a pet parent drives to your facility at 2 am.

its time for accountability outside of the faces of the veterinarians who are already emotionally bankrupt and emotionally unwell.

its time for the public to re-think the laws that dictate the unconditionally loving, uniquely beloved soul sleeping/purring next you in bed every night as disposable/replaceable property.

it's time to compel the house to meet your needs and standards and put them out of business before they bankrupt your ability to love your pet.