Sunday, April 22, 2012

This Shouldn't Be Necessary, But Here...


From 1948 until the late 1970’s our little city had one veterinary hospital. A guy built this hospital, sold it to another, who sold it to my boss, who eventually retired and sold it to me in 1981. The city was and is kinda the ugly sister in this area. The residents who worked, worked factory jobs, had Bob or Stan stenciled over the pocket of their shirts, inhaled asbestos, got dirty hands. At best our city was lower middle class, except for those bad neighborhoods that lay claim to the worse economic titles critics lay on the unemployed, the old and lonely, or that bunch they simply dismissed.  

We kinda had the corner on crime, ignorance, and irresponsibility, and our clients reflected this. For decades, nobody else wanted to try to run a veterinary practice here. And then some doctors I knew announced that they were going to open a veterinary hospital in our city, and this made it into the local newspaper. I found out about it when one of our more annoying clients, Clair, threw it in my face. She was not a sweet lady. She was a bit profane, a touch more than a little crude, monumentally ignorant, and lacking in the social graces. She sneered into my face, and with that same tone that a nasty sixth grade girl uses when she really wants to hurt your feelings, she told me about the new hospital, and then to really rub it in, she injected that now that we would have some competition, we would have to lower our fees. 

You know, those fees that were always too high for her comfort, the ones that were making us rich at her expense. We cost her more for her cat than her own medical care. She’d tell you that without having to ask.

Now, I knew the doctors who were gonna be across town, and they liked to practice the highest quality medicine possible in those days, and they charged appropriately for their work. So they were going to have much higher fees than this woman had ever seen, particularly at our practice. So I quietly mentioned to this woman that if we used her logic, flawed as it was, we would actually be able to raise our fees. She was dumbfounded. She had no clue then, and probably still does not.


Today I did a little research. Very little, very quickly. Pardon if some of these numbers are a tad inaccurate, but even if there’re a bit off this makes what I checked out far more accurate than the information many use to draw certain conclusions. For they are working from little or no information, whatsoever. 

According to the Wall Street Journal, there are 954,000+/- physicians in this country. According to the Bureau of Labor Statistics, a government agency, we have 691,000 people working as physicians in this country. Which either means we have a hecka number of unemployed physicians around here, or some folks aren’t real good with numbers. Who do I believe? Eh, I don’t much care. 

I just needed some numbers to make a point. And since these are simply numbers, albeit big numbers, and figures don’t lie, but liars sure can figure, I will toss out some of these for your perusal. Hopefully, what I have to say, using actual numbers for illustration, will carry a bit more weight than the spouting of those folks who have no bleeping idea what they are talking about. Or about which they are talking, if the niceties mean that much to you.

According to the Bureau of Labor Statistics 2,737,000 registered nurses work here. And although I think this number a bit low, the Bureau says we have 61,400 veterinarians. From this I hope you will agree that we are a small profession. We don’t have a lot of clout. Up until recently we were more like a friendly club than an industry. We operate in this tiny niche, and try to get by without making a lot of waves. And we deal with our clients as individuals, and not from the perspective of massive industry.

Calling upon the BLS again, I noticed that the median income for physicians is about $166,000 per year. Median is not the same as “average”. It translates into half the physicians make less than this figure, and half more. The median income for veterinarians is $82,000. And in case you were wondering, the registered nurses’ median income is $65,000. For comparison, truck drivers have a ‘mean’ salary of about $40,000. ‘Mean’ is a bit different from median. This one does mean average, and the BLS uses the average earnings for most jobs and apparently reserves median for those overpriced professional. So I guess they are ‘mean’ to those plain ole workin’ folks. 

In case you are wondering, I’m here to defend my fellow veterinarians against the charge that we are money grubbing liars and thieves. I’m not here to attack the earnings of physicians or nurses. And I’m certainly not going to disparage truck drivers. Truth be known, I’ve always wanted to drive truck, long haul, cross country. Might even try it after I retire from this nonsense.

I like truck drivers, and admire them. Any driver that borrows $100K for his own rig, deals with the cost of diesel, the retard four wheelers, the inconsistency of insurance companies and the irrational insanity of government regulation earns his/her money. And every time they get on the binders in time to keep from squishing that mini-van full of women and children they should be paid brain surgeon money. But let’s be real here. You can get a CDL after days of schooling and with some proper mentoring, you can do that job just fine.

Registered nurses are angels, and I’ve trusted my life to them on occasion and I admire what they do. I absolutely fold when I have to deal with sick people. Nurses are worth every penny and more. Many have advanced training and advanced degrees, but you can become a nurse with an AA.

Physicians put in those eight years of college, plus internships and residencies. That truck driver has been working for ten to fifteen years before the physicians draw their first serious paycheck.

Well, veterinarians put in those same eight years of college, and many have the internships and residencies. We also bring a little something to the table. For this we do twice as well as the ‘mean’ truck driver, a bit more than the median RN, and less than half what a median physician nets.

So why did Clair think we cost her more to care for her cat than she paid for her own medical care? Well, mostly because Clair was WRONG! And she had no clue.

Ya see, Clair had a good job that paid benefits. One of those benefits was a medical plan that gave her access to doctors and hospitals whenever she wished, and it cost her a $5.00 co-pay to see her doctor and another five for her prescriptions. Small wonder my charges were higher.  Her doctor visits were worth about $75.00 in those days, and the prescriptions many dollars more. Her hysterectomy cost somebody over $30,000, but she paid five bucks. When I spayed her cat, I charged far less than 0.5% of that $30K. But yeah, I cost HER more than her own medical care.

That medical benefit cost her employer more than $1000.00 a MONTH for Clair’s family. But Clair never saw that. She just expected it. I cost her more than she WANTED to pay. She WANTED to spend her money on fun stuff. I ruined that. My fees infuriated her, for she thought I took everything away from her and took it home. So I was getting rich off of her. 

Don’t matter at all to Clair what I was actually making. After expenses, at that time I was taking home about 14% of what I charged, before taxes. Clair never figured that out. I was not out-performing her physicians, or their nurses.

But to Clair, I was simply a money grubbing liar and thief. And that, was that.

16 comments:

  1. Well said - you should also point out that licensed veterinary technicians also have an equivalent education as an RN and make about 1/3 as much money. Nobody goes into vetmed wanting to make money ;)

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  2. Great piece. From one "thieving liar" to another, you've spoken well for many of us. And it doesn't help that our nation's entitlement mentality has increased over the years.

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  3. I hear lots of people complaining about the costs of veterinary care. I am in Canada and because we don't pay for our health care directly out of our pockets, we generally have no idea what medical cares costs, as we never see a bill. We do pay for it through our taxes. It is my choice to have pets and my responsibility to take care of them. I see lots of people who can afford veterinary care but choose not to spend the money on the pet in question, the say they can't afford it. But they are choosing to spend their money on other things.
    Everyone has needs, yes you have to feed the kids and pay the mortgage but you don't "need" the latest iPhone, iPad, 60" TV, camera ..
    My Pets have "needed" lots of Veterinary care in the last few months and they got everything they needed because their "needs" come before my "wants". For us it is that simple. I can wait for what I want. It is much more important they get what they need. It is all about priorities.

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    1. Well said. Also a Canadian and know people who have matted, flea ridden, non-vaccinated dogs who are never walked or socialized. Yet they have the very best 'toys'. Priorities, shaking head.

      No respect from me. My two wee ones are my priority and their welfare more important to me than any toys. And in turn they bring me more joy than anything I could buy.

      Interesting to hear the comparison of wages between Vets and Physicians. Having similar training/education years I thought they would be more on par wage wise. Especially since Vets need to learn about more than one species of animal. Very interesting.

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    2. And if I may add one more comment while here...


      With the shortage of doctors in my Province visits are short, sweet and don't let the door hit you in the ass on your way out. Getting accepted to see a new doctor rare and far in between. Not to mention if you have seen one doc in town for any length of time no one else will touch you with a ten foot pole even IF they had the time to see you.

      When I take my dogs to the my Vet for whatever reason I NEVER get the impression he is bored with my questions or having to answer them. I never ever feel rushed or like I have wasted my time going to the appointment as I do when I visit my doctor. I never feel he is ordering tests or suggesting procedures that are futile. He is not trying to jack up the bill, I am confident he is simply trying to provide the best care of his ability for my dogs.

      I have such respect for him and why when I read of some of the stories here of ignorant patients 'owners' I am amazed! But guess there are idiots to deal with in every profession.

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  4. @Elizabeth, I am a veterinarian in the USA and I have had a difficult day. I am so glad to hear your comment. It really makes me happy. Thank you.

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  5. Rationally I know that my health care seems to be less because I have health insurance. But it still hurts to fork over roughly $200 every time we go to the vet. I've considered pet insurance but many of our most costly incidents wouldn't have been covered (chronic illnesses for example). A human friend lost her health insurance when her husband lost his job. On Friday she dropped $400 just to see her family practice doc, get three blood tests, and one prescription. That's more than her food budget for the month. Like most of us in the USA she was accustomed to her $25 copays for the office visits. Without insurance it was $250 just to walk in the door. And they held her debit card hostage until the appointment was over and the charges cleared. It's not that you guys charge too much, it's that our yardstick is inaccurate.

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    1. When people tell me what pet health insurance "won't pay for" it makes me crazy. You need to review all the companies -- they are not all the same.

      No, I don't work for a pet health insurance company. But I have pet health insurance that is the only reason I have been able to keep my dog healthy and happy with a very grim diagnosis. She has cancer, and thanks to preventive care that discovered it early and a great partnership between my own veterinarian and a veterinary oncologist, her disease has retreated and she has outlived her prognosis. She is asymptomatic today. It won't last forever, and she will die of cancer. But that could be a long time away, thanks to cutting-edge care and pet health insurance.

      Some companies do not cover this particular cancer in her breed. I asked. And I went with another company.

      Look around, ask questions and don't go by past experience. The industry has changed and will continue to change.

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  6. @VBB I am so glad I could make you feel a little better today. I am betting you have clients that appreciate you and what you do as much as I appreciate my Vets. You probably just didn't see any of them today.. Maybe tomorrow... Two of my crew are here with me today because of the work my Vet did, how great is that...

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  7. I have been unemployed for almost a year. cobbling together gigs that pay something. Making jewelry, cleaning houses, etc. Veterinary medicine is a trade, like human medicine. But a refrigerator doesn't suffer when not fixed. A car might not work right away, but it will not really die. I can tell someone if their doctor is running CIY tests, but that doesn't pay. And if I ask to be paid for my knowledge, I am somehow a bad person. F-that. If your IQ can get there, take the classes needed to understand. And then ask why I charge for my knowledge.

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  8. I didn't go into vet medicine because of the money, but it is nice to be able to feed your family with that DVM. Knowledge is power, so they say.
    Now it's off to work I go....I need to win the lottery to be able to retire. har.

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  9. I think the vast majority of us pet owners value and appreciate our vets. I know I do. She came to my house last night and waded valiantly into the battle against the dreaded foe that is my large and asininely aggressive cat. I will never go elsewhere because she earns every penny I pay her.

    I also treasure my cats much more than I treasure my iPad and such. If the shit hit the fan, I'd be ponying up the money to maintain my living furry children over just about anything else.

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  10. I find it interesting that people complain about veterinary fees when hospitals have debt collectors working for them - now in-hospital, too, and with aggressive tactics (http://www.nytimes.com/2012/04/25/business/debt-collector-is-faulted-for-tough-tactics-in-hospitals.html). Imagine if vets hired debt collectors and used them like this; I know they lose a lot of money from people who don't pay their bills.

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  11. Perhaps this is a mentality in America. When we take one of our crew to the vet we have a conversation about costs but generally agree to move forward with what is recommended. The only time we don't do this is in a senior animal where knowing the diagnosis doesn't really matter because the problem cannot be fixed. An example would be our 16 year old cat who had a hyper-thyroid. They found cancerous cells in her blood work and the vets want to go further to find out what kind of cancer. When I asked if it made a difference they explained that if it was in the spleen they could take it out but it wouldn't necessarily make her any better. They never could get that thyroid under control either. So she ate like a horse for about 9 more months. She was feeling good most of the time, very affectionate which was not like her. Then one day she was done. We knew it and we took her in to have her humanely euthanized so she wasn't in pain and so that she didn't starve to death.

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  12. One other thing I wanted to mention about prices is a situation we have in the province of BC. A group of vets is suing a group of Indo-Canadian vets for undercharging. It should be interesting.

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