Speechless; Screaming into the Vacuum.

I have been quiet.. for a while. Its not like me.. so, people have been asking..

"Where's the blog gone?"

I have  been blogging for long enough to know where the audience is, what they are interested in, and how I can coexist amongst these. The dilemma is that once you amass an audience they require frequent attention. They won't stick around if you don't keep them fed, assuaged and entertained.

It's the end of a year. A time for reflection, introspection, and self critical analysis. Except, lately, I have been feeling a little lost. Which will be evident to those who know me once I start speaking here. I cannot try to bluff my way through a blog. The past vulnerability I have displayed would make the shallow attempt at plausibility obvious.

The problem isn't the lack of self-purpose, nor is it the voice loud enough to proclaim it. It is that I get overwhelmed... don't we all? Overwhelmed with problems, challenges, pressures, and doubt that our little lives can influence a change big enough to matter. And, if it doesn't matter why invest so much effort in the trying?

I feel/fear that my voice too often lives in a vacuum. A place where those who need it cannot access it, and those threatened by it do whatever they can to suppress it. It is a mountain of challenge..

OR, have I become the girl crying "Wolf!" so often that even I am sick of my own pleas for help? Do I still relate to her? Identify with her cause and, if so, can I still muster/resurrect/maintain the energy to be her?

When I feel really small and inconsequential I get overwhelmed, and, then I get quiet, pensive, and introverted as I search for the return to my path within.

So, I sat here quiet, for months. Searching for the next reason to write. Hoping something entertaining, relevant, meaningful would miraculously fall in front of me. It hasn't. I am still here in the same spot wondering and wandering through the routines of my days.

Now that I am not swimming in the vortex of cancer watching my beloved puppy die I have had more free time to think. (Not always a good thing).

I have gone back to work full force. Immersion into other peoples worries, the pets I adore helping, and the clinic that is such a mash of intricate working parts the greasy wheels echo needs I can't fill fast enough.

The tapestry of issues, needs, and unfilled voids is equally overwhelmingly daunting. The chaos surrounds and I continue to sit small and lost.

Every day there is a reminder of work unfinished. Tasks no one else is going to face publicly, and a mountain of requests for help I cannot complete.

A small sampling includes;

"This sounds exactly like my cat. I was told by my specialist (after a $900 bill) that he most likely wouldn't have polyps because hes too young (2 years 8 months). They told me they could look for polyps, but that it would be an additional $2600 and that they may not find anything. I am considering traveling 4 hours to you and just sent an email to Krista. Thank you so much for this video, I feel like I  may have found the answer to helping my cat!"  This was in response to a YouTube video I posted on removing a nasopharyngeal polyp in a cat. The video, which documents the entire procedure, lasts 2 minutes and 38 seconds.

I get tons, and tons, of requests to look for a polyp in a cat who has been given a $1500 (plus) estimate to have this performed.

"Why is there such a price discrepancy?" they all ask.

"Ask them, I have no idea.. really, I don't. But I know I am not the only one who does this procedure. Nor am I (probably) the cheapest." It is a curt, terse, quip  reply. (I am equally appalled, angry and afraid the throngs will find me in a drove of cat-carrier caravans).

I also get referrals from other clinics to help the clients they won't. I would love to say 'can't' but they can, they just won't and don't. Almost always due to cost. They won't offer a payment plan, or even third party billing plan, and they won't budge on whatever that "why?" is. It is infuriating. I suppose I should feel at least grateful (not the right word, maybe, consoled?) that they cared enough (also probably not the right word), to tell them other places do care enough to.

Here's my New Years (2019) proclamation.

Jarrettsville Vet will take care of our clients when they need us. Not just when it's profitable, convenient, and easy enough to do so. Through the adorable puppy and kitten days, to the vomiting, diarrhea, urinary blockages, pyometras, and nasopharyngeal polyp days. We will be honest, offer options to every ailment, and every budget, and help you help your beloved furry family members every single day. It is what people who have pets they consider family want. It is who we are in the clinic and out of the clinic. It is why I will keep making videos, with prices included in them, and screaming into the vacuum.

We might be small, but we are mighty and unwavering in our mission and purpose.

Can one person change the world? Only if they inspire a change others need and build a team that is as determined as she is. It's time to stop being quiet again. It's time to get back to work outside of the clinic.

I guess we'll both see how I sound on  December 29 in 2019?

Here is where I fall prey to the profession I feel is so important and vital. I can scream into a working vacuum at the clinic, but, at home in the  quiet moments I am screaming this,, all the damned time.

There are pets with treatable conditions out there who are lucky enough to have a family that loves them as an integral part of their lives. We, the veterinary profession, knows this. We feel the same way. It was what motivated us to go to vet school. This intangible need to take care of those who lack a voice but impact our lives so profoundly. Somewhere in the quest for greedy profiteering, status, titles, and shiny towers we lost who we were and why we came. We started blaming, shaming, and distancing ourselves from our clients all at the expense of our patients (and I would add ourselves). There are always options outside of economic euthanasia. There is dying in this profession. Some, (a fraction of what is actually going on), are untreatable, the rest, the patients being denied care, cheated from the actual treatment because we knowingly exhausted resources in the discovery phase, and the emergencies at 2 am who aren't told that cheaper exists after 8 am, are the skeletons that lead our suicide statistics. We, this profession turned lobbyists, did it to ourselves. We forgot. We forgot to care, to over extend for the sake of that wet nose. We forgot that vet school was always a poor investment. We forgot what it is like to live paycheck by paycheck because we also made poor life choices. And, we forgot that the legacies of our lives are the actions of the moment.

When we deny options that work for people we deny them the ability to care for their pets. We undermine the bonds our profession relies on for current and future viability. This reflects on our professions integrity and credibility. 

Here I am screaming.. is anyone there?

For more information on who Jarrettsville Veterinary Center is please visit our Facebook page, or our website.

If you have a pet question or a story about your pet to share so we can start to help others who might be in the same situation you are (or were), please visit us at Pawbly.com. It is free to use and open to everyone.

If you want to learn more about pet care visit my YouTube channel here. 

Veterinarian Rants. Our Failure To Take Responsibility or Compromise

Sweet Baby Rae, looking for a home now, come meet her at the clinic

 In general I get a bit miffed when I read many of the most popular current veterinary blogs these days. (I admit I have angst,, I'm working on it. Based on current affairs it is going to take a while).

Not to say that I am not equally guilty of self-sought pity parties, BUT, I am utterly sick of veterinarians claiming naive oversight to the huge pitfalls that plague our profession. My latest tirade is centered on Andy Roark's published article on "The Bad Economics Of Veterinary Medicine." Written by a surgical specialist (which is the absolute best way to make over $200,000 a year in vet med), it serves to explain that we are underpaid, in huge debt, and struggling "to practice the best quality medicine possible ... at the lowest possible cost."

Wylan,, lap dog

I went to vet school before the advent of outrageous school debts, (yes, these days did exist). They are the same days that students looking into colleges with published price tags made decisions based on what you could get into AND what you could afford.  I don't know if this rationale is still employed? Most of my friends with college age kids use the axiom "if they can get in I will find a way to pay for it" thinking. (HUH? Maybe that was the spawn of the economic dilemma? So much for "leading by example?"). Every single student knows what their school is going to cost. My parents were open and honest about this price tag. It was the single reason I attended a free and flipping hard painfully brutal school that began with the all caps "UNITED STATES",, and ended with .."ACADEMY". It was not fun, nor easy, but then neither was vet school. I had excellent pre-vet training. I also had no debt. While I agree with the premise that vet students get very little (or more aptly NO) business training, the field of medicine has not changed that much save for one BIG exception,, women (we are classes of primarily women) got empowered in the 80's. We were fed a steady diet of "you can do, and have, anything you want" and we believed it. This gender equality mantra remains strong and ingrained. We all wanted to be veterinarians with the same delusional dream-like perception of saving the fluffy critters we adored. That tiny simple equation led to personal quests that provided the market to supply and permit almost "anyone can get in" vet schools to feed the demand (at outrageous costs). These determined students didn't do their homework, didn't employ a better discipline than their equally over extended in debt parents (who not coincidentally also bought houses they and the mortgage companies knew they couldn't afford), got in to schools they couldn't afford, dismissed the price tag, and fed the off-shore pop-up vet school machine that doesn't have a conscious nor responsible soul.

Coot insists Loon make room.

When the motto is "vet school at any cost" the collateral damages include sensible debt loads, expected post graduation income, calculated debt to income ratios, a long term vision for a life to include other debt related items (house, car, kids, vacations), and, we also forgot to reflect on the pressures, realities and landscape we were stepping into once we got out of vet school.

We all trained with vets before we went to vet school (it is after all a pre-requisite). How many of those vets drove luxury cars? How many of them lived a lavish life? How many of them were arrogant outspoken advocates for anything? How many of them gently warned us about the pit falls of vet med? (OK, all of mine did, I just thought I would be different and knew better). They were, and remain, humble quiet hard working 'salt of the earth' people. They also rarely complained. Why was that? It wasn't that they worked less than we did. It also wasn't that they didn't have financial pressures, bad clients, or weren't ridiculously underpaid for their degree of expertise.

Quality control crew

Here's where we failed to stay in the firm footsteps of our veterinary forefathers. We forgot to think about our futures past our own graduation, OR, if we did we thought we would be different.

I have new vet school grads seeking employment with over $400,000 of school debt. I know they will never, (yes, never), pay them back. I also know I can't pay them enough to get out from under that rock. At some point their bad debt decision IS going to affect their professional decisions, my ability to provide a satisfactory workplace and something will give. Will it be theft? Or, adding diagnostics that aren't truly indicated? Or, self-medicating to avoid self-doubt/loathing/futility? The potential scenarios were all too bleak to warrant employment.

Dempsey

Too many vets want to blame the economic environment, plea for pity that they didn't know what they were getting into, didn't know how much they would make, AND THEN want to charge clients more to compensate for these, WHILE, arguing about how intelligent and skilled we are. It is an argument that sounds like it is based on a juvenile temper tantrum.

We are all consumers. Perhaps not all in the same market places, BUT, we vets balk about the cost of human healthcare, brag about how much more efficient and sensible we are, (where else can you get your exam, blood work, x-rays AND a diagnosis in the same building for less than a grand?), and then try to berate our customers for not understanding the value in our services. Why? Why do we show contempt for the exact things we disparage the MD's for?

Charlie

If my clients cannot afford, (yes, I do believe them because we have already shelved the pointing fingers and placing blame argument as fruitless, haven't we?), then we find affordable options. It is exactly what my mentor did all those decades ago. It is the cornerstone of the mercy AND accessibility we pride ourselves in being so much better at than our counterpart MD's. "Best medicine" is great IF your clients can afford it, and it is a death wish to your patients who cannot. Get off your soapbox pedestal and work with people to save your patients. How many of us don't offer options because there is not an incentive that is economically feasible for us to do so? And then why do we denigrate the vaccine/spay/neuter clinics? (Starting to look like a vicious avalanche on a merry-go-round yet?).

Lilly gets her ultrasound

Let's go back to the Bad Economic's article..  Let's discuss the only example cited; "The best example of this is the dilemma of overnight care in general practice". It isn't that over night care options have changed. What has changed is our perception of what makes us the most money, what our clients can manage, or want to do (many of mine do not want to go to the ER based on previous experiences there (shelter head from angry ER vets,, sorry,, truth)), what is considered "best medicine", and it is STILL (just like it was for the old timers) cost prohibitive to provide 24/7 care at my clinic. Nothing here has changed.

Except,, I follow the precedent set by the vet I learned from. I do not live in the vet clinic (the ultimate all access vet).. but I do provide help after hours to the best of my ability.

Pinkie

Here's my favorite example, I do orthopedic surgeries for the clients who cannot afford it elsewhere. I literally say this; "I only do the surgeries that you cannot afford to do where they should be done; at the referral center." My knee surgery is about $1500, referral is about $3500. They are the oranges, I am the apple. Go to the specialist, if at all possible. Your pet will stay and be provided with excellent 24/7 oversight for 3 days. Mine go home post-op 6 hours later for you to stay up all night next to them to monitor. We rarely keep pets overnight. Why? well, because there isn't any staff member who stays overnight and I don't want your pet here without supervision. I send my patients home with my email, phone number, and directions to the ER. How many post-op patients have gone to the ER overnight, NONE (knocking furiously on wood). That's best medicine based on the client economics... it is what we do with every patient in every situation.

My pup Jekyll

Where is the responsible ownership of acquiring bad debt?

My personal debt is not my clients problem. Nor is it my business to judge or scrutinize where they allocate their resources. My problem is their pets needs and figuring out a mutually agreeable compromise to getting to "better."

It is time to be fair, honest and transparent.. the finger pointing, self-pity and arguing for a landscape economic environment which has not changed save for our naive oversight and self-imposed debt.

Reference article; The Bad Economics Of Veterinary Medicine. by Sarah Boston, DVM, DVSC, Dipl ACVS.

My related blogs;

Ethical Fatigue. The Crossroads Of Vet Med and the Public Conscious Awakening.

Euthanasia. Why Do We Make It So Convenient?

Affordable Options Are Everyone's Right

The Jarrettsville Veterinary Center Policy For Clients With Financial Constraints

Rescue Economics, When The Expense Costs You Your Ability To Care.

We Don't See You. How Vet's Became Biased and Lost Our Clients in the Process.

Compassion Fatigue.

Rocky,, eye on the prize

As always JVC, and I, are here to help you and your pet. If you would like to meet the amazing staff and hear more about the ways that we can help you and your pet live longer happier and healthier lives we would be happy to show you how the face of veterinary medicine and the care we provide can ext end past the traditional options of hope and luck. Please also follow our amazing Facebook page JarrettsvilleVet. Or find our 2017 Jarrettsville Vet Price List here.

If you would like to learn more about pet care or ask a free pet related question please visit Pawbly.com. It is free to use and open to all of those who love pets.

If you want to help others and you have experience with pet care please join us on Pawbly.com. Pet care is about helping others and we are built on this alone. I also have educational videos on YouTube, or @FreePetAdvice.

And of course we hope that you will Please always Be Kind.