Too often pet parents want to avoid the vets office because they fear they cannot afford to go. This was not always the case. Veterinarians were, (and some of still desire to be), trusted, humble, affordable and focused on patient care over financial ability. Everything was offered. Everything was affordable. Every person around the pet care was honest and the veterinarians reputation mattered. Our names were our badges of respect in the community. In those days everyone knew everyone else and you didn't need credit cards or credit ratings. While life was simpler so were the options we had for diseases.
No one should ever have to leave the vets office feeling broken, especially, heart broken, and certainly not bank account broken. The goal of this blog is to also be able to leave with a sense of being heard and offered options to meet a wider spectrum of financial ability. I am also here to be transparent and honest. I have been a practicing veterinarian and hospital owner for 20 years.
If your pet is an integral part of your life, and you have financial stability to permit advanced specialty care, there are numerous highly skilled veterinarians working in impressively modern facilities that rival human care, without limits, and pushing the barriers of miraculous. There are almost no limits to what we can do, or what is available to save your pets life. In modern veterinary medicine there are no horizons we will not let you pay for. We will never abandon hope nor options as long as you can pay.
When you cannot we offer euthanasia and an alleyway with best wishes to finding someone else who cares enough to do it at their own expense. You are not guaranteed anything in life and you sure as heck aren't our problem if you lack the cash (or credit) to get your pet out of whatever pickle you find yourself in. If society wants us to be better than this, more compassionate, and self sacrificing it has yet to take a good long look in the mirror and ask itself what it has ever given back for someone less fortunate. While I meet some amazingly kind people in my day to day life I more often meet angry, demanding, accusatory jerks. If you want someone to be kind to you you might want to be kind to others first.
The public wants to believe that veterinarians are in this for the love of animals, but lets be real honest, we are here for pets, not people. People, well they will break you, sometimes intentionally.
For every person who comes to me seeking affordable care they are always nice at the beginning. They are always nice when they have little to bargain with, a dying pet in their lap and a promise to pay us back. The reality is that their past behaviors for how important that pet in their life is is a very good prognostic indicator for how likely they are to actually pay you back. Many of the emergency surgery requests I get on a daily basis have not vaccinated their pets in years, or ever, have never used preventatives, and never spayed/neutered their pets. The owner will tell you how much they love their pet, swear that they are good for the money to pay you back for services, and yet they have tattoos, nails, and a new car in the parking lot. There isn't one vet out there who isn't nodding their head right now. If your pet was everything to you their health, safety and current precarious position would be in good hands at the over-priced, yet-capable ER right now. Spare us the excuses.
When it comes to an immediate medical or surgical plea for emergency care be open, honest, courteous and ready to compromise/negotiate. If you want to be a belligerent, angry, accusatory, demanding bully I (and I expect everyone else who actually went to vet school and sacrificed what we had to (like 8 years of our life) is very unlikely to help you. I am only here to help your pet who is in this predicament only as an innocent victim. Remember this. For most of the people I see they have little to negotiate, less to compromise, and still would rather see their pets as theirs, even if that means deceased, instead of treated.
Always Be Kind. Then ask what you can do to keep your pet alive.
Here are my tips to finding affordable care for your pet;
First, always be the example you want your vet to be. Be kind, compassionate, and be focused on your pet as the center of everything you do. In simple terms, if you want the vet to put your pet above all else, do the same.
Remind the vet who your pet is to you. Maybe this doesn't seem sensible to you, after all you already know what your pet means to you, but, us vets, well we see so many pets that we have to emotionally distant ourselves from them so we can maintain some degree of analytical, scientifically based care. We have to be able to do and not be encumbered by fear/stress/grief/longing/loving/emotions. It is a sad truth that we need to have a layer of armor even when we came here to be healing and compassionate. Life strips the soft vulnerable layer from you as a protective mechanism to survival, but life is about love so remind your vet to see the world, your pets life, as an extension of this.
Remind yourself that you can find help. Affordable help, and don't give up. I see a lot of people who find me after they have asked for help in dozens of other places. The key to these people; they all adored their pets, and they all refused to give up until they found the care they needed. I have dozens of examples of this. Dozens. Here are some real-life examples:
Blocked Cat. Meet the many cases I saw in the previous blogs. Go to Pawbly.com. Read through the storylines. We post the cases and the invoices. All are real cases that I saw, treated and helped. This is the power of finding a veterinarian who is passionate about petcare, the immense power of keeping the patient in the focus of all we do, and, very importantly, working with a team that is independently, privately owned. You, every client facing a veterinarian who is not being given affordable options for their pets care, have options, rights and ways to find help. Ask hard questions, and document everything.
Here is my step-by-step approach to finding affordable, meaningful care.
1. Provide an accurate, honest, brief description of what is going on with your pet. When it started, and list any and all medications, foods, and supplements that you are giving. I strongly recommend that you put this in writing and email it to yourself and the vet clinic you are at. Document everything. Every word, every name of every employee you interact with. These documents are your best way to keep everyone honest and accountable. Document and then disperse to the veterinary provider. Insist that they acknowledge receipt of your email. Document this too.
2. Your vet will then perform an examination. When they come back to you after the exam ask them to provide it to you in writing. If the vet does not return ask to speak to them, and ask for the exam findings in writing. Get a copy of the physical exam before you leave. Write down who you spoke to at every interaction.
3. Ask for their top differential diagnosis. Ask them to try to narrow down them to three. In some cases this might be impossible based on the lack of diagnostics. The differential diagnosis MUST be recorded. You should ask the veterinarian to review what you record for errors and accuracy. Many medical terms sound alike. Spelling and specificity matters. I use an app on my phone to email myself these notes. You can use a pad of paper.. Whatever works for you,, BUT, record and provide a copy to the clinic/hospital. This insures everyone is being provided correct information. Before consenting to anything ask what the veterinarians differential diagnosis(es) are. Write this down and ask the vet to confirm that you have it correct.
4. The estimate that you are going to be given should be explained line by line. You should be able to write down why each item is recommended. This will take time but it must be explained to you so you understand what the veterinary team is asking to do and why. Get a copy for yourself and take notes on this copy.
5. From the list of differential diagnoses ask the veterinarian which are treatable and which are not. They may not know, but they should have an idea as to which would need immediate interventional care AND be curative, and which will not. From those that are treatable ask for the estimate to treat. If this is cost prohibitive ask if there is a more conservative/affordable way to treat so that you can be transferred to another veterinary clinic (like your vets office) where the cost of care might be a small fraction of what it is here.
6. Omit any disease and treatment plan for a non treatable disease. Say for instance a brain tumor. While there are possible treatment options for this (and actually high success rates for brain tumors, most pet parents do not consent to brain surgery, or organ transplants, etc). If it is not treatable, or affordable for you to treat, ask them to only do the diagnostics for the treatable.
7. Ask the veterinarian to provide you one, yes, just one, diagnostic, to help identify the presumptive differential diagnosis. Write this down. Ask them to confirm this. If they argue, or refuse, remind them that every veterinarian was trained by this. Using the skills we were taught to be able to identify 1, just 1 test to do next. It is absolutely your right, and our responsibility to provide honest, transparent work-ups for your pets care. This is how I practice medicine. Why my vet clinic is so popular. Why we get so many requests for transferring care. We have conversations. Meaningful, honest conversations. We are here to help. We help in anyway we can. We are able to give away care. We are that focused on pets being given a compassionate chance.
If I have a very sick patient I will almost always ask for a comprehensive blood work panel (full chemistry (25 to 27 items on this), a CBC, a urine, tick borne disease (common in my area), fecal (intestinal parasites or parvovirus) and a thyroid panel. Cost for this is about $250. I will also ask for xrays (3 view chest and abdomen) for about $300. In the ER setting where these panels might be $600 each you can ask for a minimum database. The veterinarian should be able, and willing to scale down these to one or two items. You need to ask and get the answer to these presumptive differential diagnoses in writing. (Please see the disease specific blogs for what the minimum database is for each).
If you end up at my clinic and ask us for help this is what we will ask of you.
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