Brian Edwards Media

On Vets, Specialists and Debt Collectors – A Rave!

Felix and Max

Felix and Max

On Monday, on Jim Mora’s Afternoons panel, I launched a full frontal assault on what I consider the avarice of two professions – vets and medical specialists.

My ire, in the case of the veterinary profession, was occasioned by the cost of treatment for our two cats, Max and Felix, amounting not to hundreds but to thousands of dollars in this year alone and to tens of thousands over their lifetime.

I should add that the care and treatment which the cats received was invariably excellent. I have no complaint on that score.

Nor have I any complaint about the care and treatment I’ve received from medical specialists, which is fortunate since I’m a confirmed and fully paid-up hypochondriac.

As with the vets, it’s less their fees which anger me than  their debt-collector mentality to payment.

This was exemplified in a consent form which I  recently had to sign before seeing a specialist. What seemed to me an inappropriate and offensive amount of space on the form was devoted to the perils of non-payment of the bill. When I remarked on this during the subsequent consultation, the specialist, to my surprise, entirely agreed. He didn’t like the form either and he hadn’t drawn it up. The professional body representing his specialist field had.  

I firmly believe that the labourer is worthy of his hire. We should all pay our debts. But there’s a significant difference between buying something you know the price of but can’t afford and have no intention of paying for, and taking your cat or dog to the vet or yourself to a specialist for treatment. Where health is concerned, whether yours or your animals’, neither the outcome nor the cost of that treatment can be definitively predicted. You may be in for a much larger bill than you anticipated.

The consent forms which both vets and specialists defend as a responsible warning to their clients of the cost of treatment and their obligation to meet that cost, actually invite the client to gamble on the duration and outcome of the treatment and to weigh that outcome against their ability to pay.

People are of course more important than pets, but the options presented by vets to pet owners can often be stark. When our cat Felix was hit by a car more than a year ago and ended up with a broken leg, the choice we were offered was between surgery to repair the leg (most expensive), amputation (less expensive), putting Felix down (if we couldn’t afford either of the other options).

On another occasion I came home to find Felix’s brother Max trapped under the sliding garage door. I picked him up and, without thinking, drove him to our regular vet. Max was OK but in the rush I’d forgotten to bring my wallet and didn’t have any money with me to pay the bill. I said I’d drop the money in later that afternoon but was distracted by another emergency. Early the next morning I received a call from the clinic demanding immediate payment. The sum was a measly $100. As I handed the cash over I made no secret of my anger to the vet. As I was leaving the receptionist whispered to me. “We’re under instruction to always get the money before people leave. It’s really embarrassing.” The owner of the practice later apologised.

This debt-collector mentality seems to me to be at odds with the essentially caring nature of both professions and, in the case of the medical profession, with the Hippocratic Oath.

Well, my radio rave produced an angry response from one vet who wrote to Jim Mora who forwarded the email to me. Here’s part of that email:

 I have worked for some years as a vet in small animal clinics around the world & payment for services &goods received has always been a sticking point. We are not subsidised for the work we do and we do (try to) run as a business. We are in the caring profession but we are not a charity. We have an obligation to give first aid treatment, whether that be pain relief or to carry out euthanasia on a sick pet. We are not obliged to do work for free. Some practices have a clause in their consent form such as that mentioned by Mr Edwards to protect themselves from those people who run up $1000s of work & then scarper. It also stimulates the conversation about payment so that the vet can set up a payment plan with the owner if they need that.

I thought this was a pretty fair response from a vet who’d apparently been stiffed by quite a few clients. I ended my reply: “I suggest you consider setting up practice here. You’re precisely the sort of vet the area desperately needs.”

My reply produced a further email including:

The greater issue here is the perception that vets are a caring profession and, as such, shouldn’t demand payment for their work. Pets are a luxury item and being able to cover their on-going costs should be a consideration when buying them. One wouldn’t buy a Porsche and take it to the garage expecting them to do work on it out of charity. I think there is a middle ground between us threatening legal action and being taken for mugs and unfortunately we often end up covering the costs of treatment for animals where the owners cannot pay….. We aren’t business-people and we do struggle with that side of the job. On behalf of us all, I apologise.

There was of course no need to apologise. If I have a reservation about this entirely reasonable response, it’s that there’s usually a world of difference between how most people feel about their pets and how they feel about the things they buy. Most people love their pets, are distraught when they get sick and grieve when they die. And pets play a significant role in mental health, particularly of the elderly.

But if it’s true that “pets are a luxury item” then it must also be true only the well-off can afford to have pets. One possible resolution to this “sticking point” might be for veterinary clinics to operate a sliding scale of fees based on an estimate of the client’s ability to pay. I’ll call that “The Socialist Solution” – cumbersome but just!

Yes, yes, yes, I hear  you! “Can’t afford to take your pet to the vet? Should have got pet insurance. Can’t afford so see a specialist? Should have got medical insurance.”

Yeah right! Only thing that’s wrong with that scenario is that pet and medical insurance can also only be afforded by the well-to-do. Catch 22.

So my Afternoons correspondent is probably right – pets are a luxury item. But I think every student vet should leave university with a clear understanding of the intense and meaningful relationship between most pet owners and their animals and that no-one should enter this profession with the primary aim of making a stack of money, unless they’re proposing to set up practice in Beverly Hills.

I really liked the specialist I went to see a week or so back. We spent ten minutes on what was wrong with me, ten minutes on his bloody insensitive debt-collecting form and the rest of the time having a laugh. This is what normally happens when I consult a specialist. Laughter, they say, is the best medicine. But it doesn’t come cheap.

Felix, who had all his shots, has just come down with cat ‘flu. Max is starting to look a bit seedy too. Look for me in the Three Lamps area of Ponsonby. I’ll be playing my harmonica and carrying a cardboard sign that reads: “Wife and 2 Burmese to support.”

Think I’m getting a cold.

25 Comments:

  1. Well, there is always a solution to every problem – sign up to half an insurance premium and pay half the cost of the treatment. I refer to the cats of course who – as I’m sure you will appreciate – are by far the most important consideration here.

    I did it with my dear old Golden Retriever (who was actually white) and it wasn’t a bad compromise. Half a debt is better than a whole debt.

  2. Suggest you train the cats to accompany you on your harmonica, with a bit of dancing. Brian and his dancing Burmese should be good for a few dollars.

    Failing that dob the vet in to Fair Go.

  3. The mealy mouthed Nanny State Governments that have steered this beautiful country over the last twenty five years, have in the process excised almost every single thing about it that made it a desirable place to live. We have been reduced to a monotonous day in and day out drudgery of user pays milking, and the now overpowering mentality of money, money, more money and ‘f’ you, pay now or we’ll set the dogs on you, has reached truly inhuman proportions!
    There is little or nothing left of the rugged individualism and number eight wire mentality that made Kiwis worth knowing. The middle class are barely surviving, the middle aged are out of work, and if you don’t have a house in AK, then you are close to starving, along with your kids who are back living with you!
    Full on bullying of their fellow Kiwis is now the Governments idea of fiscal appropriateness, so deep is the disconnect with their people, yet they seem to be forever proud of it.
    “As long as the Govts in surplus, then damn the people” is their mantra. Inhuman treatment of your countrymen or women is never something to be proud of, yet they crow like bantam chooks everytime they save a cent and can take credit for it on TV.
    Something is very wrong in the State of Denmark.
    Very wrong indeed.

    • 3.1

      “As long as the Govts in surplus, then damn the people”
      The government is not in surplus and it’s still “damn the people”.

    • 3.2

      VERY WELL SAID !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  4. At the risk of sounding like one of Monty Python’s three Yorkshiremen… vets and specialists? You were lucky, you want to try dentists!

    I’m sorry, I know they have a business to run but I’m afraid $900 for a root canal and thousands for something like an implant is just ridiculous. In their case it does seem to be greed… I recall being on a course once with a guy who did nothing but complain about what his ex-wife was demanding he pay for his children, then left in a AMG Mercedes CLK sports convertible. Next day I asked him his profession… I’m sure you can guess the answer.

    My suspicion is backed up by the low cost of dental work in Asia. Similar quality, similar skills and education. Yes the rents are cheaper and no doubt so is the dental hygienist. But not by a factor of several hundred percent methinks.

    They simply know that pain, disfigurement and an inability to masticate anything more than wilted lettuce is something we will pay to avoid, and leave us to suffer until we can.

    As for the socialism argument… there’s very good capitalist reasons for the state to subsidise dental care as it does medical care: because bad teeth lead to a bad heart, and then the taxpayer can be up for hundreds of thousands in surgery, lost productivity, sickness benefits etc.

    Why they don’t do their actuarial sums and fix the issue is beyond me.

  5. If I take my car to the mechanic and find he hasn’t fixed it properly, I get an apology and a free fix. Try that with a doctor (or, I assume, a vet).

  6. But but but but……. Brian, write a letter to John Key, I am sure he will sort it all out.

  7. 7

    Jasperdene Harmonious

    “I should add that the care and treatment which the cats received was invariably excellent. I have no complaint on that score.”

    “Nor have I any complaint about the care and treatment I’ve received from medical specialists,…”

    And:

    “As with the vets, it’s less their fees which anger me than their debt-collector mentality to payment.”

    OK, you’re not too cool about the terms of payment, but where does “avarice” come into play, when you’re beaming with the quality of care that is rendered to both you and your cats?

    • Read paragraph two! Then consider the meaning of “less” in the English language. If I am less angry about A than B it doesn’t mean I’m not angry about A. Quite the contrary. I’m bloody angry about these fees, but the “debt collecting” mentality just adds insult to injury. My mistake here was in trying to be fair, thus opening the door for nitpickers like you.

  8. Cat treatment cheaper in Raro or wherever you sun yrself every couple of months? _sarc_

    • Just pathetic, Cnr Joe. I’m 77, have worked and saved all my life and this disbars me from complaining about rorts which affect the poor considerably more than they affect the comfortably off? When in Raro we always visit the Esther Honey Foundation which runs a volunteer animal hospital and clinic. We go there to make a donation and visit Orlando, a little ginger tom whose life we saved many years ago. On our recent visit we were saddened to find that Orlando had died. There is a memorial to him in the clinic grounds. You really are locked into an inflexible mindset.

      • 8.1.1

        Noone should apologize for visiting Raro – a delightful place that depends on tourism and serves it well.

  9. Brian, deary, you’ll just have to resign yourself to the situation we other old age pensioners have to grin and bear:
    you may have teeth or pets. Not both.

    Not without a Lotto win, anyway.

  10. Greater transparency (of which this is a case of)doesnt make things right.Too often ethics are overridden by personal gain.
    Rather than a punitive paragraph about what will happen if you dont pay,an arrangement to pay of the debt would seem to be of greater value.Finance (hp)companys do this and although some of their rates are exorbitant the general terms used would create a far more polite exchange,If this doesnt work then the debt collectors should be called.
    Its like a teacher I had at Intermediate who used to hit us (hard and painfully)and then would say that was just in case.
    As for the Burmese I have four .Ones permanantly locked inside(hes just too much trouble )and the other 3 although very smart manage to find themselves in perilous situations .One managed to ride on the roof of my car around a hair pin bend and down the road for a mile until a kind pedestrian stood on the road and stopped me.To my suprise she lifted Little Bonty off the roof into the car whence he lay down on the front seat and proceded to take a nap.
    You’ve got to love them.

  11. Sorry forgot to add quite a few drivers were waving at me as I drove long with the cat on the roof .I just didnt realise the danger of the situation and thought they were just friendly souls.

  12. Crikey, here’s a topic that has driven me crazy for years!

    One vet (30+ years ago) boasted that he liked to “collect gold and paintings”, he was cruel to horses and should have been struck off. It’s not a new phenomenon, greed, you do have to ‘shop around’ for a competent ‘no frills’ vet (avoid flash clinics).
    Most rural vets are now just ‘cow technicians’, they appear to follow money and have very little regard for animals.

    I’ve encountered a succession of greedy incompetent vets (and dentists!) who’ve tried to screw every last cent from clients …”Do you want me to put on this bandage?” ALWAYS say “No thanks!” because you are paying for every minute they are working on your animal, every chat about the weather, every simple procedure.

    I suggest:
    Do a First Aid course (human), carefully tend every small scratch and injury on a cat immediately, clip the hair away and clean the wound, no matter how small. Cats get sick really fast from cat scratches acquired in border disputes.

    Massage your cat and groom it well so it enjoys being handled. Make it a good mattress from an old (clean) sack filled with eucalypt leaves and pine needles to keep fleas at bay. Don’t use chemicals if possible, keep your cat away from other cats, birds, and rodents (dead or alive).

    You might be able to teach your Burm to walk on a lead … I met a guy in ChCh Central who walked 5 cats and a couple of dogs around the block every night. Most of them weren’t on a lead, Burmese are supposed to learn easily, they are more like dogs than cats!

    Feed your cat moist food to keep the kidneys in good order, and no salt, no cheap biscuits.

    Our old (15) ginger cat ‘Claude’ will walk with us to the river and back (2 km) and spend the rest of the day in his purpose built house sleeping on his back.

    Oh … and try to avoid vets.

  13. ‘a sliding scale of fees based on an estimate of the client’s ability to pay. I’ll call that “The Socialist Solution”’

    Sacrilege and theft! That is the ultimate Capitalist Solution – the well-proven method of maximizing profits practiced by multinationals (and consultants!) all over the world.

    The Socialist Solution of course is to tax everyone and make all vets state employees. There will of course be a long waiting list then to receive free treatment of average quality in shabby premises and conditions.

  14. You make some excellent points in your blog Brian.

    I have long thought this about dentists and dental specialists. A couple of years ago I needed the services of a periodontist. I was provided with a similar consent form to the one you describe.

    I decided not to sign it, or, at any rate, not until I had had a conversation with the periodontist about why it was so draconian. In the end we agreed to disagree about the style and inherent philosophy of the consent form. The conversation ended with the periodontist ‘firing’ me because he didn’t think we could have a professional relationship based on ‘trust’. His word.

    I found this to be hugely ironic. The consent form is based on the assumption that clients won’t pay and need to threatened with dire consequences if they don’t. There is no evidence of trusting the client to pay. In fact its the opposite.

    I, like thousands of others, provide services to clients and send out invoices accordingly. As I pointed out to my periodontist ‘friend’, I do not expect to be paid immediately and indeed sometimes wait for a month or even two to get paid. In practically all cases I do get paid.

    I do not understand why the medical and dental profession don’t employ similar practices to myself and thousands of others.

    By the way I did find another periodontist where we were able to agree some flexibility over the payment of his fees.

  15. Towards the end of the 1980’s Veterinary Journals started carrying articles on income maximisation. Practitioners were looking around at lawyers,, Dentists and Medico’s and saying ‘if them, why not us ‘

    This income maximisation meant providing new services, which previously in some cases, may have been deemed unnecessary. They were explained as ‘taking necessary assessment .

    I mean the automatic hook up to drip of any injured or very sick animal, the array of blood tests,
    The X-rays and the admission of animal to hospital with ensuing costs.
    And so on on.

    Well of course often these tests are necessary, but in my practice we started calling it the ‘unnecessary blood test ‘ or ‘don’t just diagnose do some tests ‘ do anything and charge it out’

    It is hard for the pet owner to point to an unnecessary procedure.
    Also the advent of computer data/ invoice analysis allowed the concept of the average surgical fee, and the average consulting fee. It was obvious that the money was made for animals admitted and operated upon.
    The computer could also put in a figure for depreciation and ongoing costs of the clinic building and hardware.
    The sky opened up.
    Soon the average surgical fee went from tens of dollars to several hundred, and now as we know in this case [ Brian Edwards and others] often thousands.
    The kind family Vet had vanished, and morphed into a mercenary.

  16. 16

    Hey Brian, Miss you on the telly. What do you think about Gareth Morgan & the anti-cat crusaders?