Wednesday, February 1, 2012

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.


31 comments:

  1. It has gotten so bad in ER that they now collect deposits up front of 70-100% of the estimate. The only payment plan they offer is Care Credit.

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    1. I can only say one thing. If I were a Veterinarian I would eat Ramen if I had to as I could NO WAY turn away a sick animal! I have taken in sick animals and taken them to the Vet, paid for it myself, and lived on Soda Crackers until payday. I love animals so very much I could NEVER EVER not help one who is ill!!! If you are a Vet that turns a sick animal away because of MONEY, don't tell me you love animals. Love whether it be Human or Animal means you will do anything possible to help. It has NOTHING to do wilth the almighty dollar!

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    2. This is the reason why. As I am an animal lover. I met some total strangers in a pet store with a very pregnant Shih Tzu. 2 days later when it was a Holiday this dog "Charlie" was is big trouble. They had no money or credit and me being the animal lover agreed to put it on my credit card. The owner said he would have money on Friday and said they would pay me back ! It has now been almost 8 weeks since I saved them all. I even sent one of my clients to him to buy one of the pups. My client said the pup was loaded with fleas. So I took a new bottle of flea shampoo over to the man with the now spayed Shih Tzu knowing he just got paid for a pup. He took the shampoo and would not let me in the house. So I felt I got a kick in the butt, and he still took the flea shampoo. So one thing lead to another and I, a total stranger to them is out $1400.00 on MY CREDIT CARD. This is why Vets need to get paid. You can not operate and keep your doors open if people do not pay. Sad as this is, and it brings tears to my eyes. I feel I saved the life of 4 dogs and did not even get a note to thank me. Not one from the Vet for bringing them in to see him, nor from the people with the Shih Tzu " Charlie".

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  2. I usually wish I had the balls to turn around and say, "Well if YOU loved animals, you wouldn't have acquired one unless you could afford to take care of it and you would have gotten it its routine vaccinations, had it spayed or neutered and not allowed it to be crawling with fleas, heartworms and stuck puppies. So I guess we're even."

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    1. I know! It's really frustrating isn't it? Sometimes they act as if it's OUR fault that the dog got pregnant, got parvo, got HBC, etc. I used to say that if I ever won the lottery, I'd never turn an animal away for any reason. Now, I realize that in some cases, that would just be enabling neglectful people to continue acquiring and neglecting pets. Like giving money to a drug addict.

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  3. As a vet tech, my simple answer to this question is "because I also love eating and having a home to live in".
    Like GrumpyERVet said, when my dog got sick and had to go to a referral clinic, I had to pay half of the high-end estimate as a deposit when I left her there.

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  4. Yep, those darn bad apples. We don't extend credit (except CareCredit), get 50% deposit on anything left in the hospital or over $200, and don't even accept checks anymore. Gotta keep the boat afloat and can't do that with a large accounts receivable or third-party collections.

    I *still* eat way too much ramen than can actually be good for me.

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  5. I'll be in the vet work-force starting in May. How do you answer the question, "Don't you love animals?" I'd rather not reinvent the wheel if someone has found a way to approach this.

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    1. Here's how I answer "Yes! Of course I love animals. That is why I chose to spend my youth learning as much as possible about animal health and illness. There is little I love more than being able to help a sick animal feel better. It really makes my day when I can help a pet." Then when they say "well if you REALLY loved animals you would do it for free," I respond "oh, actually I do! I do a lot of volunteering as often as possible, of course not as much as I wish I could but we all have to make a living!" Then when they say that I should be working for THEM for free, I try to look taken aback and I say "well, no, I only do that by prior arrangement with certain organizations I work with. This is a place of business and our fees are set. Feel free to speak to the owner if you take issue with the fee schedule."

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    2. Sure I love animals, but I also love my staff and my job. With the shear number of people that ask me for assistance each day, if I helped even half of them, this hospital would not be open to help anyone. My staff expects to be paid, the gas company expects to be paid, and the hospital expects to be paid.

      I am responsible for paying for my pets, my children, etc, I cannot afford to pay for yours too.

      I hope that helps you once you are out in practice. When people get personal or abusive, I tend to get a little, um, less considerate. I have found that the best way to deal with a bully is just to laugh at them: loud, knee slapping laughter. Seriously, it confuses them big time. They are totally ready for you to get mad or upset or offended... When you laugh, you completely strip them of that power. And frankly, it keeps me from throwing a punch. And it makes you look a little insane, like the kind of crazy that it would be dangerous for *them* to throw a punch either. While they are confused, your staff has the time to call the police if they have been especially threatening.

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    3. Yes, I love animals, and I love helping them and their owners. Unfortunately, if I gave away services for free, I'd soon go out of business, and then I wouldn't be able to help anyone. Perhaps you can call a friend or relative who would be willing to loan you some money?

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    4. Does "blank" ( insert occupation ) love working in their chosen occupation ? Why don't they do it for free ?

      You can ask the person who is asking this if they work for free. You can also ask if you can come by their place of work & get free services/stuff. :)

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    5. Thank you so much, everyone, for your wonderful advice!

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    6. Well, yes I love animals. Don't you love yours enough to be responsible for it?

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    7. "Of course I love animals. That's why (and because I'm obliged by Dutch law) I am offering the most basic palliative treatment (sometimes including euthanasia), regardless of your ability to pay me for it. But in order for us to keep this place running, we need to charge a reasonable fee. With my wages I pay for my living expenses amongst which the insurance I have for my two dogs. Insurance I have, because I can't afford some of the treatments that might be necessary in their lives."

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    8. This comment has been removed by the author.

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  6. Excellent post, very well written!

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  7. I'm an RVT at an after hours emergency hospital. We will *sometimes* arrange a payment plan if people are denied for care credit. We lost about $20,000 last year on deadbeats who promised to pay but didn't. The staff hasn't had a pay a raise in over two years either.

    A leash costs $5 - surgery for a diaphragmatic hernia after getting hit by a car because they were off leash, running around in the street can cost over $5000

    I also want to add that usually there is no real relationship between an emergency hospital and client. Remember, payment plans are based on trust and why should we trust someone we have never met before? And when so many people promise to pay but never send a dime or those who never come back for their pet after we have racked up thousands of $$ in expenses?

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    1. It does not even cost $5000 for a human hernia surgery! I love when people get charged $80 for a simple nail trim at the vet office. How can anyone back up prices like this? You can't, I can't. I work on humans, but the price of care for animals, and humans is so out of control.I just had surgery on my dog, and the vet wanted to charge me $31.00 for an antibiotic that I got at a regular pharmacy for $11.00. All the up-pricing being done by both human, and animal healthcare workers is rediculous. If you see how muh it actually costs for a med, or item, the mark ups are around 200% of the actual cost. Stop taking money from companies to push their products, and stop charging people for things that really are not needed! Then, and only then will the cost of animal/human healthcare go down. I don't take money from big pharm, nor from any company I pur hase from. Nor do I have patients pay rediculous amts for medication I know they can get a much better price for elseware. We don't euthanize a human for their inability to pay either. I can't imagine killing a mom with puppies all perfectly healthy because I refuse to help them. Vets that are willing to put an animal to death because if the all mighty dollar make me sick. WWJD?

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  8. My favorite story from the ER is chihuahua with the stuck puppy. Owners had tried to pull the pup themselves, and pulled the head off. Momma was in distress and needed immediate surgery. Owners don't have any money, can't borrow and can't apply for Care Credit. None of the employees at the clinic have room at the inn, and can't offer rescue. We offer humane euthanasia. They decline and get this...
    They will take the dog to the ER two towns over. Because, the last time this happened.....yeah, you read that right. The last time this happened, that ER rescued the dog, fixed her and put her up for adoption.
    So in this instance, that act of "kindness" enabled this family to repeat their same mistakes and cause the suffering of more dogs.
    There is no easy answer.

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    1. Yes there is a very simple answer. Require all animals you see to be spayed/neutered. Problem solved for any repeats for that animal. You can't fix all problems with bad owners, but you can fix some. I give free neuters/spays with every surgery. Also with all new patients they each getspay/neuters, or they go to someone else period.

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  9. Wait! You mean medical professionals have mortgages and grocery bills? But I thought medical care was a right and that I shouldn't have to pay for it!

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  10. I really could have done without the mental image of a poor dachsund puppy's head being pulled off.

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  11. This was a fantastic post. I came here from an entry where some poor lady was in a rather desperate situation in that she was really struggling to pay her vet bills. I sent her a bit to help her.

    Anyways, I'm planning to go to school to become a vet tech in the next year or so after I move. While it would be work I would love, I know that I'm going to have to deal with clients that are ignorant or stupid and they will make me want to bang my head against the wall.

    I'm going to try to not let stories like this keep me from doing a line of work I would enjoy. With most jobs, I know you have to take the good with the bad, and the wonderful responsible pet owners will hopefully make up for the morons I will inevitably be forced to deal with. I strive to be one of the good clients when I take my cats in. I always pay my vet fees in full, no matter what. So I hope you can take comfort in the fact that there are pet owners out there that don't suck. XD

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  13. Well Im not a vet but Im going to school for vet tech and I have one disagreement I have a puppy that we got a few months ago who is now sick and Im having trouble finding a vet thay will take payments Im on unemployment at the moment and have limited income I have a regular vet my puppy has had his shots and has been dewormed but I know live a hour away from the vet we were using and our puppy is so sick that drive would be hard on him Ive called every vet in my area and have had no luck so I ask myself for thoughs of us who are responsable with our pets we suffer because no one will take the chance on thoughs of us who are trying to get our dogs see it

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    1. It sucks that you're on unemployment, but so are a lot of other people. However, like this post said, vets have a business to run. They have families to feed, staff to pay, and buildings/supplies to pay for. If they constantly extend credit to people (who aren't guaranteed to pay them, btw), they are likely to end up bankrupt and on unemployment themselves.

      If you can't get a bank loan or a credit card for your sick pet, take stuff to a pawn shop, borrow money from family (or strangers), take out a payday loan, and/or have a garage sale. It is possible to come up with money if you are truly determined.

      Pets are a privilege, not a right, so if you have nothing to pawn/sell, payday loan places won't give you money, and no one to borrow money from, maybe you should find people who can take good care of your animals until you are back on your feet again.

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    2. So well put, Pets are a privilege, not a right. We once had a couple that owned a pet that they could no longer take care of the special needs. We could have found a home (we actually had someone willing) but they would not listen that there were other people that we could get to care for the pet and the pet did not have to have end of life as the end of the story. I would hope that all of us (me included) would love our pets more than our pride and be willing to do whatever it takes for them, even give them to someone who could provide for them, if we cannot. I see it too often and then the vets are made out to be the bad guys because they 'will not' treat for free.

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    3. My vet of over 15 years just demanded full payment of a large emergency bill and would not even let me carry a $100.00 balance for 2 weeks. This is absurd especially when the vet got upset when I suggested the cat be put down because I did not have the money. I have found a loaning company to give me a loan but I have to pay 40% interest for a signature loan. If this is how a loyal customer of over 15 years is treated, I will be looking for a new vet. I have interviewed several vets and they have all told me they would have worked out payments as low as $50.00 per month by simply leaving post dated checks for the payments. Every vet I explained my situation to was appalled and shocked when they found out who the prominent vet was.

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  15. I have been with my vet for over 15 years and we have always paid our bills, never suggesting he reduce fees or accept a lower amount. My vet has even botched a very expensive surgery not once but twice passing on the cost to me which I also paid. The vet had to eventually hire someone else to do the surgery a third time after I asked the pet to be put down. I have paid this same vet for over 10 declaws, neuters, spays and several litters as I am a breeder. I lost my job in January 2013 and my cat became blocked on June 7th 2013. I was out of money but my brother had a credit card and offered to help me. We got enough money to pay for everything except $100.00 dollars of the bill and asked if we could pay that on our next pay day. We were told by the vet that we could not even carry a $100.00 balance after paying over 300.00 to have the cats bladder drained. The vet was very upset when I suggested we put the cat down stating I should at least give him the chance to survive. I was not expecting the vet to do a $1,000.00 surgery that may eventually be necessary to save him, but to treat a client of over 15 years that has always paid their bill like a stranger has opened my eyes to this vet. I am searching for a new vet and my interview process includes what happens when emergencies occur and if that vet will work out payments with me. I have lived at the same address for over 10 years, have a great track record of paying my vet bills and believe my pet deserves better from the person I have intrusted his survival with.

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