Musings of a Veterinarian

Archive for April, 2014

Celebrity Kitty In The House!

April 23, 2014 By: Dr. K Category: Just For Fun

A few months ago I received a rather random email. My SPAM filter does a nice job at eliminating those pesky male enhancement ads and thwarts the Nigerian princes who will give me millions if I send them my bank account info. But it missed this one.

It read: “Could you get in touch with me about your video of Piggles in the garbage.  WAe [sic] would like to use it for a show that we produce for Animal Planet.”

Dubious to say the least. I used our trusty friend, Google, and found out that the person and production are real! After discussions with the producer, Miss Pigglesworth, a discarded cat at my clinic, is going to be a star!

Coming to a home near you this summer on Animal Planet’s Bad Dog:

How’s Your Quality of Life?

April 21, 2014 By: Dr. K Category: Opinion

These days veterinary magazines are bombarded with articles about balancing life and work, staying healthy, dealing with stress and burnout, and managing debt load. These articles are the canary in the coal mine indicating a stressed out, oftentimes dissatisfied workforce.

I’ve had the unique experience of working at multiple practices over the past several years while functioning as an emergency and general practice relief veterinarian. One thing remains constant in the spectrum of all practices: This profession chews you up and spits you out.

The practices with the worst policies and employee treatment churn through employees who leave due to dissatisfaction from dysfunction. Veterinarians in the best practices oft times struggle but know they are lucky when they hear the horror stories of the comrades abroad. Burnout is real and rapid. Why?

Veterinary medicine is not puppies and kitten, rainbows and unicorns. Period.

The field has been romanticized by the likes of James Herriot and Nick Trout (who I read and love), misrepresented by Dr. Pol, and placed on a pedestal by the general public. Practicing veterinary medicine in 2014 means many things to veterinarians:

1. We deal with money problems. And not just our own.

New graduates arrive on the scene with exorbitant amounts of student loan debt – sometimes surpassing $250,000. New graduate pay doesn’t come close to sustaining a reasonable standard of living when accounting for student loan repayments (which peskily knock on the door six months after graduation). Indebtedness looms large.

The general public has the impression veterinarians are rich. This is so absurd it’s laughable. I haven’t heard of too many human specialists get accused of being in it for the money.

Veterinarians are asked to perform services for free. Every day, many times a day. Giving away services is noble and self-sacrificing. And if I really cared about their dog/cat/ferret/stray I would do my job for free. I would ignore overhead, my loans, paying my employees, offering benefits, and keeping the practice cost effective for clients who are willing to pay for services…If only I cared enough.

The psychological battering sucks the life out of you. And it never ceases.

2. We see the worst in humanity far more often than we see the best.

No law prevents horrible human beings from owning pets. Too many animals are owned by people who intentionally neglect or harm them. Generally obnoxious, self-righteous people crank it up a notch when it comes little Fluffy.  The stress of making life or death decisions that are many times tied to finances cultivates the worst in people. I’ve been the recipient of more than one comment about stealing the food from a child’s mouth.

3. Semper Fi

Clients have expectations that we should always be available. This has led to late evening office hours, 12-16 hours days, and added appointments to an already full schedule. It is far too common for vets to work 50-60 hours a week or more, through the evening and weekend, and even in the middle of the night after a full day of work. I have had experiences with clients who are angry we are closed on a Sunday, angry I wanted them to head to a staffed emergency center at 3am for a blocked cat, and even angry because *gasp* I was a “lady doctor” and not that man doctor they usually see.

Battling fatigue is unhealthy for the body and the mind. Missing time at home is corrosive to families.

If it’s that bad, why am I even a vet?

Well, if we are honest with ourselves, we vets will admit we’ve asked ourselves this question on more than one occasion. So why do it? There are good cases, happy endings, excellent practices, loving clients. There are thankful employers, friendships built, and grateful pets.  There is an inherent “rightness” in what we do. And there is reward. For many, that is enough to combat the heaps of emotional (and sometimes literal) crap we wade through on a daily basis. For others, like a vet school classmate I recently spoke with, it was not.  She is now working outside of the profession and is happier because of it.

Can you have a reasonable quality of life when practicing veterinary medicine?

That’s up to you. My theory on having it all goes like this:

There are three things we all want/need to have a balanced life. Work, Family/God, and Sleep. It is easy to have two. The third is where it gets difficult.

I can’t imagine working full-time and taking care of my daughter/home/husband while also maintaining my sanity and not losing my identity. I’ve struck my quality of life balance by working part-time, raising my daughter, and getting the down time I need to still be me.

I’ve got it all together, don’t I? … Wait, did I say three things? Let’s not forget the fourth…MONEY! By working part time I sacrifice money. And there’s the rub.

We do the best we can in this profession. Finding a balance is tough. Maybe you need to cut your hours. Maybe you need to own your own hospital and set your own rules. Maybe you have a personality that lets the turmoil roll off of your back and you are unaffected. Or maybe you need to step out of the profession and see if the grass really IS greener.

You can’t have it all, no matter what job you chose. There is no magic equation. Some of the best advice I have ever heard came from the former CEO of Commerce Bank Vernon Hill.

If your circumstances aren’t going to change, you need to accept them or change yourself. It’s that simple.

And that friends, is how you get the quality of life you want.

One Decision Away From the Frying Pan

April 02, 2014 By: Dr. K Category: Opinion

The AVMA recently posted a story that gives me a sickening knot in my stomach. Find it here.

The summary of the story is this: A dog owner took her dog to the emergency clinic after she had been spayed that morning but her regular veterinarian because the dog was retching and her incision was bleeding. The emergency veterinarian believed the dog needed exploratory surgery and quoted the owner for the surgery and required half the amount as deposit. The owner had some money but not anywhere close to the deposit. She did not have a credit card. The owner and the owner’s sister were both declined Care Credit, a credit line for medical urgencies and emergencies. The veterinarian sent the dog home with a pressure bandage on her abdomen but the dog died overnight. The owner posted a grief-ridden post on Facebook that has been shared thousands of times.

A resulting maelstrom on social media has lead to death threats and harassing phone calls to the employees of the emergency clinic. And it affirms my feelings that we veterinarians are just one decision away from a social media lambasting that can forever affect our careers.

I understand both sides of the story in this particular case. I am not going to debate the virtues and faults of both sides in this post as nobody has enough information except the two parties involved. My own soapbox for pet ownership is well known but let me refresh you.

Pet ownership is a privilege, not a right.  When you decide to care for an animal you assume full responsibility for its care. I do not expect everyone to have the means to afford every treatment offered. It is highly unreasonably and irresponsible to expect someone else to foot your bill when you cannot afford the care recommended or required. If veterinarians discounted their services for everyone who had financial need, they would rapidly go out of business.

Veterinary medicine is a service AND a business. Businesses must make money to survive. Veterinarians offer many discounted services and have tens of thousands of dollars in veterinary care walk out of their clinics without a sniff of payment every year. It is horrible business practice to give away services regularly but we do it. While most owners are good for payments when extended a payment plan, many others are not. The appalled pet lovers are likely the ones who would have paid a bill if extended the credit. They don’t appreciate the concept of getting stiffed for an entire several thousand dollar bill. And until, as a business owner, you see how unpaid bills affects your bottom line and the ability to pay and you go through the arduous and oft times ineffective collections process – well – you just don’t understand both sides of the coin.

Every day practices are evolving to meet clients’ financial needs while providing the optimal care for the patient. Pets are property by law but have intrinsic value as living beings and family members and we veterinarians, more than any one else, understand this. It’s not a perfect system but most of the time payment plans and Care Credit make it work.

Soapbox dismount.

What concerns me most about today’s social media environment is angry pitch-fork yielding mobs can tear down a person or practice with little knowledge of the facts of the situation or the inner workings of a practice. And it’s all done under the anonymity of the internet resulting in some of the cruelest, foulest, uncensored vitriol posted for all to see. We veterinarians, as well as others in the public service field, have our reputations at stake and can potentially have them destroyed by one disgruntled client. It’s terrifying.

Have you seen this story about the veterinarian who committed suicide after an angry online mob drove her in to financial dire straights?

Every day I make the best decisions I can for my patients while working within a clients’ financial means. If I cannot achieve an outcome that jives with my standard of care, we have the adjust our approach to make it work even if that includes the option of euthanasia.

I fear for the future of good practitioners and public servants when it is so easy for information to pass from person to person without fact checking, intricate knowledge and understanding, and censorship. We will start to practice like we have one foot in the fire which will affect the practice, the client, and the patient. Everybody gets burned.