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Is it a vet's responsibility to make veterinary care affordable for pet owners?

Posted in Our Community @ Jul 2nd 2015 - By Judy Gillespie, Vetanswers
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Today I received an email from Vetanswers member Dr Liz Chmurycz with the following:

Hi Judy,

I have a question that I would appreciate if you could ask all of the other vets out there.

Is it a vet's responsibility to make veterinary care affordable for pet owners? 

I just had a heated discussion with a client (now ex client), who believes that it is the vets responsibility to make vet care more affordable for pet owners.

Thanks,

Liz 

What are your thoughts?  Both Liz and I would be very interested to hear what you think so please add your comments below....

 

Comments

Judy @ Jul 3rd 2015 12:30am
I'll go first with my original response to Liz's email: My personal opinion (& I know I'm not a vet) is to ask another question... Is it a human GP / specialist / dentist's responsibility to make healthcare affordable? On the other hand I do believe it's a vet's responsibility to offer a range of health care options to suit a range of budgets - from "If we do nothing (cost $0) this is what will happen", to "This is the treatment I would recommend ($xxx)" and of course the options in between. I know this probably isn't going to make you feel any better because it's always horrible to have these sorts of arguments and I wasn't there but often a client's anger can be misdirected - it's aimed at you but they may really be angry at themselves because they can't afford the care that they know is available. It's easier to blame you for offering veterinary care that's "too expensive" than face the fact that it's a financial expense that they may not have anticipated and may be putting them in a deeper hole financially than they already are. Or they may just be an a$%hole ... (excuse my language but sometimes it's called for!)
Louise Kerr @ Jul 3rd 2015 9:43am
I agree with Judy on this. Just because we can do all the modern procedures doesn't mean we should. Quality of life is important for animals and continued procedures and life extended far past what an animal is designed for by evolution is not IMO justified. As an animal communicator I am often asked to communicate with animals at the end of their lives and they almost always say "it is time for me to move on as I am needed elsewhere. Please tell my carers I want to go peacefully" I would prefer if more vets made the decisions a consultative process rather than you must do this. I also agree that vets should be compensated correctly for what they can do and not offer services below cost.
Gillian Shippen @ Jul 3rd 2015 11:00am
I don't believe it is the vet's responsibility to make veterinary care "affordable" for pet owners. I mean where does it stop, what do they consider "affordable"? Pet ownership is a privilege and not necessarily a right - I say this because it is an individual's responsibility to ensure they can afford anything that is not necessarily an essential item - personal responsibility seems to have gone out the window these days. Having said that I also get dismayed when I read/hear noble exclamations from some vets that they only wish to practice "Gold" or "Platinum" standard medicine; this sounds very noble as they are only thinking of the patient but it may well come down to whether or not the owner of that patient actually does something. We must give people options - it is not for us to deny them those options as long as all they are in the interest of the patient and not going to compromise the patient. Ok admittedly sometimes there are no other options other than to desex that pyometra affected dog but there are some other conditions where although best practice states to do a pre-anaesthetic bloods, if it comes down to the owner not doing anything over us not doing the PAB's then let's not do the bloods. On the flip side, we also should not make assumptions that a client would not be interested in a treatment or may not be able to afford it. It is their decision, not ours. We all have those clients that have plenty of money but refuse to spend any more than a certain amount on their pet. We also all have that client that we know is struggling to make ends meet but they will place themselves in debt to help their pet. The awesome client that never whinges what the cost is, and then the one that no matter what will always complain. That is the name of the game no matter what industry people are in. My Husband is a mechanic - the issues I describe to him every day, he can give me right back with his clients, even right down to the emotional blackmail! The important thing is to give the choice - at least three I think is the ideal from what I remember from some article I read once. One last example on choice - just this week I purchased a new laptop. The staff at the store were fabulous, really helpful and friendly but I was peeved to find out that the extended warranty the item I purchased "comes with" actually cost me an extra $90. I was not informed nor was I given the choice - I was deceived into believing it came with the purchase cost, not an added extra. Should I have checked? Maybe, but the wording the sales person chose to use led me to believe it "came with it" no options was given. Costs need to be discussed - unfortunately what also comes with the territory is the client that seemingly gets offended by us discussing costs and assuming we are only in it for the money. Some times we just cannot win no matter what we do!
Anne Fawcett @ Jul 3rd 2015 2:12pm
Yes and no. A vet has a responsibility to the client and animal in front of them, and to their employer, and thus there can be constraints on charges. But as a profession we can also work to ensure services are accessible and affordable to those who need them most. I don't think there is a blanket solution. We do need to ensure we don't price people out of seeking vet care, and we need to make sure that those who have low incomes have access to quality care for their animals. To this end as a profession we should be lobbying for more Government support.
Judy @ Jul 3rd 2015 3:17pm
Thanks Louise. I wonder if most vets think they do offer a 'consultative process' but clients perhaps don't see it that way? In which case it may in fact be a communication issue more than anything else. And I also agree with you - vets should be compensated fairly and not feel guilty for doing so.
Judy @ Jul 3rd 2015 3:20pm
I think you may be right Gillian - there are definitely situations where you're not going to win no matter what. Anything to do with finances is difficult enough but when emotion also enters into it, it becomes so much harder for everyone involved.
Judy @ Jul 3rd 2015 3:26pm
Thanks Anne - lobbying for Government support is an interesting concept. There is so much research that supports the benefits to people of pet ownership and I hate the idea of people not being able to have a pet because of the expenses. My other concern is how pet insurance is almost becoming unaffordable for many - is this going to make a difficult situation worse?
Liz @ Jul 3rd 2015 10:24pm
It is the word "responsibility" that I found the real challenge - Affordability means different things to different people, and sadly, it is proportionate to the true value that the owner has placed onto the pet. We all know the owners who value their pet so much, that they will do all that they feel is reasonable and fair, whilst others who value their pet so little, that even spending $20 is too much. And it has nothing to do on how much disposable income the people have. It is our (vet) responsibility to ensure that we are always fair, honest and transparent in our dealings with the pet owners (and I wrote a blog for Vetanswers after 2014 ava conference on that very topic), but that is as far as our responsibility towards affordability goes. Short of working for free, or winning lotto, veterinary work is a business, and as such, has bills that need to be covered, and profit generated, no different to any other business. Do I use cheaper materials to reduce costs, to increase affordability to the pet owner, even if such cheaper materials may not be in the animal's best interest? (there are so many human examples of using substandard materials that had an adverse effect on the human, just to save money). I talk to all of my new puppy/kitten owners about budgeting for vet fees and/or get pet insurance, so it is a topic I am upfront about. I am also an advocate of every pet owner having a sum in their head that they are willing to spend on their pet each year - so it then doesn't matter if a particular service costs $250 if your annual budget is $1000 for that pet. I tell pet owners to put $5 to $10 a week aside as their pets "emergency fund". Many conditions we see as vets are easily preventable by pet owners, if they put in a little bit of elbow grease - such as brushing their pet's teeth (will reduce/slow rate of periodontal disease), investing in good flea control, have regular vet checks to nip little problems in the bud before they become big expensive problems. The responsibility for that lies in the owner. Vets cannot go into people's homes, take their pets into the vets for a vet check. Ultimately, the owner is responsible for their pet, and has to accept that veterinary fees are part of that. They can choose which vet they want as their pet care provider, and must weigh up the experience, knowledge, facilities, environment, cleanliness, ethics, core values, convenience, "after sales" support of the vet hospital that they choose, and not base it on just fees alone. Yet, many pet owners are basing their choice on price alone, which goes against the well propagated myth that we are a community of animal lovers - well, we are, but for many they don't care how much it costs so long as it costs them nothing or very little. I agree that the government needs to be more supportive of the veterinary profession, rather than be a hindrance (and add to our costs of business which they currently do). I agree that pet insurance fees are high, as I was shocked when our own dogs insurance premium went up to $980, but I paid it, and am thankful for that as our darling Piper is a true vets dog (complex problems galore that require advanced veterinary intervention - allergy desensitisation is her latest condition, but her file is only 22 pages long for a 1 year old, so still time for her to get every other disease in the vet textbook). I have pet insurance for my own dog, because I do not want a specialist to discount their fees for me because I am a colleague - it is because if Piper ever needed the MRI or advanced chemo, I want to be in a position to give it to her - it is because I value the specialists and I value the health of my own pet. I would never ever say to the specialist that they are responsible for affordable vet fees, because the responsibility to be able to afford them is mine - or if I can't afford them, then it is my responsibility to accept the consequences (whether it be euthanasia, the pet suffering with the condition, or seeking another opinion).
Liz @ Jul 3rd 2015 10:33pm
To put the original statement by the client into context - the amount was for $250 for a procedure that the owner wanted a quote on, and it was for a non life threatening, common, but preventable condition. The treatment would slow the ongoing progression of disease, and whilst not immediately necessary, would benefit the dog long term.
David Butchart @ Jul 6th 2015 9:50pm
What is affordable? Clearly current levels lead to low levels of compensation for both nurses and vets including practice owners. We can't complain about making it more affordable for pet owners and complaining about remuneration in the same sentence! There is an affordable alternative out there, it's called pet insurance...... and it costs less than most owners pay for coffee each week.
Judy @ Jul 9th 2015 10:38pm
Thanks David, I certainly agree with your comments regarding current levels of compensation and affordability and I also agree that pet insurance could possibly provide the solution BUT I also think we're a long way from pet insurance actually providing the solution. You can read my thoughts on pet insurance here: http://www.vetanswers.com.au/blog/post/a-52-price-increase-this-year-or-119-over-5-years-is-never-going-to-be-ok/228

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