How can a vet love animals, yet not allow a client to make payment arrangements?

I get this question often.  Unfortunately in the current economy , I get it more and more.   I love medicine, and I love animals.   If I didn't love animals, I would have chosen a different career.   My salary allows me to pay my bills (including student loans), and live a comfortable middle class life.  It does not allow me to take exotic vacations, purchase fancy cars, own a beach house, or go on wild shopping sprees.  I am not a rich doctor. If I do take a short vacation, that means cutting back on other expenses that month in order to afford it.  There are plenty of careers with similar education requirements which would allow me to earn more money.   In short, I am not 'in it for the money', but yes, it is my career, and my only source of income.  It is not a hobby.   I'm sure my plumber likes being a plumber, but he expects to be paid.  

The sad reality is that people often cannot be trusted.  Most veterinarians already know what I'm talking about, so for non-vets who may not understand why we often can't extend credit to pet owners, imagine this scenario. You are approached on the street by a person whom you have never met.   The person says to you, possibly while crying "My car just broke down, and I need $1,000 for an emergency repair.  The engine just blew up.  I have never taken the car to a mechanic before, and it has never had an oil change or any routine maintenance.  I don't get paid for another week and a half.  I've already asked all my family members, and they won't lend me money.   I don't have a checking account or a credit card.  I just tried to get a loan at one of those cash advance places, but they won't give me anything because I didn't pay them back last time.  If you loan me $1,000, I promise I'll pay you back when I get paid"   Would you do it?   No?   Well, believe it or not, this is a very typical scenario in veterinary medicine.

Several years ago, I received an emergency call while I was having a holiday meal with my family.  The caller was someone we had never seen before.  She told me point blank that she had called several other practices and they would not see her because she had no money.  She told me she would have money the following week, and since I had not yet been burned badly, I agreed to see her.  She had a true emergency.  A little dog in labor with a puppy stuck in the birth canal.  My plan was to attempt to remove the puppy, then see if the mother could have the rest naturally.   If a c-section was needed, I planned to offer euthanasia at no charge to end the dog's suffering.  I had no plans to do a free c-section, especially because I was not the practice owner, and did not think the boss would take kindly to it.

I met the owner at the clinic, and after an exam and a radiograph, I knew the dog was in trouble, and was not going to have the puppies without a c-section.   I offered euthanasia, and the owner begged me to help her.  So I did.  She signed a paper promising to pay in full on the next payday.  I gave up the chance to return to my family meal, even though I would not see some of my family for another year.   I did not have a staff on hand, so I placed an IV, induced anesthesia and did the surgery by myself.   I had told the owner beforehand that since I was working alone, I would not have time to attend to the puppies.  I would focus on mom, and I would not do the surgery unless the owner agreed to let me spay her.   The little dog did very well through surgery, and the puppies survived after all, despite not receiving immediate care after delivery.  I felt good about saving the dog and the puppies, and confident that I (and my boss) would be paid.

Well, payday came and went, and I did not receive payment.   After multiple phone calls, the owner came in and paid $20.   That was the first and only payment I received.   $20 covered the cost of the IV catheter, fluids, and anesthesia induction injection.   It did not cover the gas anesthesia, suture material, monitoring equipment, radiographs, pain medication, overhead, or my time.   This surgery should have cost at bare minimum $1,000.   That would have covered expenses, and allowed a profit for the practice.  Because yes, my boss and I depend on profits to pay practice expenses, pay employees, provide benefits to employees so they can make a living, attend lectures to keep current, and cover our own salaries.   If we collected just $20 from each client, we would go broke.   I continued attempts to collect money from the client, but her phone numbers were soon disconnected, and even the collection agency could not collect anything.  She never had any intention of paying, and I was left feeling angry at being taken advantage of.   Worse, I knew that the puppies probably never received basic care such as de-worming or vaccines, and that they probably grew up to have puppies themselves, and contribute to pet overpopulation.   The puppies were purebreds, so it is quite possible the owner sold them and made money off of the deal. My boss was very nice about it, and chalked it up to a learning experience.   Had she not been so understanding, I could have been in trouble, could possibly have even lost my job.   Basically, I allowed this person to steal money from her. This is not an isolated incident either.   Unfortunately, more often than not, when someone promises to pay, they don't.   I have learned that if relatives, health care credit lenders, and credit card companies will not extend credit to someone, I should not either.

Does this mean we vets are heartless and never extend charity?  Of course not.  Most of us do.   Some of us volunteer services to help animals in natural disasters.  Some of us examine, vaccinate, and find homes for the abandoned animals that end up on our doorsteps.  Some of us donate money to animal related charities. Some of us provide shelter for animals whose owners are temporarily living in battered women's shelters.  Some of us do provide discounted services for local shelters or rescue groups.   And yes, some of us do allow clients to pay later in certain situations.  

What makes me willing to extend credit?   If the person has been a client in good standing, and is hit with an emergency, or is going through financial hardship, I try to help.    If the pet has been coming to me for years, getting routine care, I feel the owner is more deserving of help than the owner of an 8 year old dog who has never received any care.   If the person is making an effort to do the right thing, I'm more likely to help.   Let me share another story.    I recently had the great pleasure of meeting a wonderful family who had just moved to my area looking for work.   Their dog had received previous vet care in another state before the people lost their jobs.   The dog was very sick.  She had an infection which required immediate surgery, and the cost was beyond their means.   They did not ask for me to reduce my fees, nor imply that I was obligated to do so.  Instead, they went home, made phone calls, and managed to scrape together half of the expected fee.   They did not say so, but I suspect they sacrificed to get that money.  In short, they were TRYING.   They finally asked if it would be possible to pay the other half the following month.  After discussing it with my boss, we decided to allow it.  The surgery was a success, and the owners were grateful.  They sent us a nice card and treats the next week, and they paid in full exactly as promised.    If all clients were like that, I'd never turn away a request for charity.   Unfortunately, this family is in the minority.

So, this had been a very long-winded way to say that while I love animals, I do have to make a living, and unfortunately, that means some animals do not get the care they need.  I will never turn away an animal in pain.  My personal policy is to do euthanasia at no cost if needed, to end suffering.   What I cannot and will not do is work for free for someone who has no intention of holding up their end of the agreement, and has no appreciation for my efforts.