In the space of an hour on social media, I saw posts:
1) Calling out pet owners for using liquid ivermectin (sold for livestock) on dogs to prevent heartworm infestation. Ivermectin is the active ingredient in popular heartworm preventives, and the argument was that the dose/quality was hard to get right when using the livestock product, which is true, but … misses why people are using it.
2) Calling for greater communications/education about preventive and wellness care for pets as part of a post about 40% of pets who never see a veterinarian, as if many of these people aren’t aware. Many would take their pets in, were it not for money or other issues, such as transportation and a lack of veterinarians where they live.
In both cases, these posters completely miss the damn point:
Many people can’t afford the cost of flea/tick/heartworm preventives, and they’re doing the very best they can for the pets they love.
Ditto with wellness/preventive care, which can also run several hundred to a couple thousand a year if your dog needs very regular dentals (which is pretty much all small dogs, and NO a “no-anesthetic” dental is not dental care, no matter what your feed store says).
Note before I go on: Most veterinarians are NOT getting rich. They’re carrying massive student debt burdens, and even with decent salaries they can barely scrape by. Saving for a home, the kids’ college or retirement? LOL! They’re working stiffs just as you and I are, and they are not calling the shots because they don’t own the practices. While previous waves of veterinary practice purchasers have come from within the veterinary community, big-money investment funds are jumping on board now, picking up veterinary practices to bundle, maximize profit and flip, in the same way investors have stripped many communities of the entry-level homes that are necessary to provide stable neighborhoods and grow middle-class wealth, turning entire communities into renters who aren’t invested in their communities and who can be evicted at will.
In short: Veterinarians are as much a victim of this corporate greed as we are.
Wanna fix this?
1) Quit bashing pet-owners AND veterinarians for trying to do the best they can. And no, don’t give me that “if you can’t afford X level of care for a pet, you shouldn’t have one” or “if that vet really loved animals, they wouldn’t insist on charging XYZ that I can’t afford!” Understand that even those veterinarians who own their own practices need to pay their bills, their employees, their insurance, taxes and so on, and those who work for corporations largely cannot reduce your bill because they’re not allowed to. And veterinarians, quit bashing people who can’t afford care. No, you don’t have to care for their pets if they can’t afford it, but you can acknowledge the issues and offer lower-cost alternatives when discussing care. If that still doesn’t help, stabilize for transfer or euth if that’s the owner’s decision, and try harder not to judge.
2) Acknowledge the structural problems, both of the veterinary industry and of a country in which the gap between rich and poor grows wider by the day, and the middle class is hanging by a thread. Nothing will get better as long as this keeps getting worse.
3) Continue to develop spectrum of care offerings to help the pets owned by people of all income groups. The gold-plated, top-level standard of care is out of reach for many, and even with pet health insurance (assuming you can afford the monthly premium), most plans are reimbursement, meaning you still have to pay up front. Many people have no access to credit and little if no savings, and pet insurance cannot help them. We need alternatives to help these people and their pets. Because guess what? They WANT to do better by their pets. They just can’t.
4) Acknowledge that much of the costs of veterinary care passes through from large companies that set prices for drugs such as … ivermectin (!) for the pet market. There is no excuse for the price-gouging on meds that have been generic and widely available for decades and are dirt cheap to produce.
5) Fund our great public universities again, so tuition is within the realm of possibility for those who enter professions that serve us all (and this includes veterinary medicine even if you don’t have animals, since veterinarians are a key component of public health protection). Yeah, that means taxes, which are supposed to be for the greater good, and there’s no good greater than an informed, educated citizenry with critical thinking skills, and professionals whose level of education and skill helps us all, from protecting our health to building/re-building our infrastructure. Tax the rich, who’ve been getting all the benefits of tax breaks while getting richer and richer still while schools, roads and other public goods crumble.
6) Fund loan forgiveness programs that pay off student loans for those who work a set period in underserved communities. And allow refinancing of debt when lower interest rates are lower, and allow personal bankruptcies for those who can no longer pay. (For the life of me, I don’t grok why it’s acceptable to bail out banks/industries — while allowing their execs to walk away wealthy — while shouting “personal responsibility” at ordinary people who need a break.) For those new grads who don’t need the assistance, they don’t need to sign up. But helping those who need a hand will not only help diversify a very white veterinary workforce (and as such, help to reach communities where veterinarians are few), but will also put veterinarians back in rural areas, where farmers/ranchers desperately need them.
That would be a start, and it would sure be better than pet-owners trashing veterinarians who are themselves in a bind, and veterinarians getting frustrated with pet-owners who can’t afford care. We’re whistling as we walk by the elephants in the room, and we need to stop doing that.
By the way, I expect none of this to happen, since these problems are largely a tiny piece of a bigger picture of a dying system in which the country has decided its citizens are not as important as its corporations and rich donors to political campaigns.
May I add:
Back in the olden days (when we had gas powered internet and a thing called AOL Chat that some remember) Cheryl Jones, who helped moderate my chat room (yes, I was the one of the first to start this snow ball rolling that I am now going to trash) coined the phrase “get off the net and call your vet”. It is still true. You make that point in the beginning. When you try and bypass spending a little money by using Dr Google, you make it hard for me to keep the cost of repairing your gaff reasonable. This isn’t a 65 Chevy that you can fix in your garage usually. I try (and so does the practice I work for) to tell you when you can put a band-aid on something. I know some practices (especially corporate owned ones) will tell you to bring in that dog that sneezed once when you spilled pepper while making cookies (OK who puts pepper in cookies?). But really, most of us don’t want to rip you off. We truly do want to help. But our landlords and suppliers want us to pay bills too.
Also, because we have become a litigious society, we often cannot recommend less treatment without putting our licenses at risk. Happens to me every day. If I say your dog needs surgery to save its life, I don’t do that if another, less expensive and just as rewarding, option is available. I don’t like when another business (car repair, plumber, grocery store) does that to me. Treat others as you would like to be treated. But often we get threatened with lawsuits or bad Yelp reviews when we are doing the best we can with what the owner has (had) to offer. We don’t like losing patients over finances. We are not callous evil Cruella DeVilles who are in it for the money. But if we do something and the outcome is less than optimal and the client sues, we can’t do anything to help others. There may be work arounds, but it puts us at risk,; even if we tell the client it isn’t the optimal. We are in “protective” mode most the time. I have had clients video my whole exam and recommendations. What should I do? I have to go with top shelf then because 30 minutes later it’s on YouTube. And DR X down the street has stated that the treatment I gave you, because you had $12 was not “standard of care”. I cannot tell you how many times I have been told I was nothing but a money grubbing pet hater.
And, yes, I agree with funding the public schools again. The cost of a degree is now beyond many GOOD veterinary candidates ability to pay. Put less emphasis on GPA too. Just because you can regurgitate facts and figures and do classes that have no value in the real world (statistics? We don’t need no stinkin’ statistics. 87% of the time we make up statistics <.01p). Many of the best veterinarians I know are hands on…not book learnin' There is a lot to be said for practical ability. I honestly try and dissuade young people from going into a profession I dearly love doing But we are going the way of many professions like druggists, dentists and physicians who are going corporate. I have not talked to a younger graduate recently who wants to open their own practice.
I think a step in the right direction is preventive care….my vet does offer monthly fee program which goes to the preventive care…..exams, appropriate blood work for age and if you choose dental you can also pay monthly for that