My dog’s recent surgery has been eye opening for me in many ways- some of which are totally unexpected. For example, my experience (well Kane’s too) has led me to create mental parallels between the treatment Kane and I received from the NC State vet school (and vets in general) with the treatment I received from “people doctors” when I encountered health difficulties.
Note: My own past health problems include and appendectomy and severe (and undiagnosed) intestinal problem that caused me to lose almost 35 pounds in about 30 or so days- this was due to a combination of throwing up everything I ate and pretty much not eating a single thing except for a few small handfuls of cheerios occasionally. During these two significant events in my life I dealt with about 7 doctors, a surgeon, and two hospitals.
The only reason I thought about this is because there is a stark difference in the way I was treated by people doctors and the way Kane was treated by his doctors at the vet school.
Ever since I first brought Kane to the NC State vet school I have been treated with respect, kindness, genuine concern, and patience. Doctors (including Kane’s neurologist who is one of the leading doggy neurologists in the nation) took the time to call me daily to update me on Kane’s condition. After Kane’s surgery I had a half hour phone conversation with his surgeon where she explained the surgery in detail and promised to walk me through the surgery when we could meet in person. She kept her word (via a resident since she was pulled into an emergency surgery) and I spent about a half hour looking at my Kane’s x-rays and his MRI- with the resident explaining in detail what I was seeing, what was wrong, and what a normal dog’s spinal column would look like.
In addition, both times we visited Kane, the doctors wheeled our dog into a visiting room and spent at least twenty of our forty-fifty minute visit conversing with us about his care and about our family in general. It was an interesting thing to see, this dog with a foot long scar up his back laying in the middle of a room with a little girl draped over him and myself (or my wife) talking with two to three doctors. And when it came time to discharge Kane the doctor went over his discharge papers with me and made sure I knew to have her paged when he came back in so she could stop by and check up on us. Moreover, when I got the bill it was about $4, 700 or so dollars. How much would it cost to get the same surgery Kane had for a person? Is the human version of the surgery that much more difficult? Even putting that aside, I looked to the small items on the bill, the x-rays and surgical tools, and their cost was all within what I might expect.
Since we closed with costs, why not begin with them here. Back in 2001 I was charged about $14,000 for a basic appendectomy- $10,000 in hospitalization fees and $4,000 for the appendectomy. I am willing for the sake of argument to ignore the hospitalization fee since the vet school hospital can place their patients in kennels/run. However, I am having trouble seeing how a rather common procedure like an appendectomy cost about four times what my dog’s spinal surgery cost. I would think it takes greater skill to play around near the spinal cord than to pull out an appendix- although both, no doubt, do require a tremendous amount of skill. Moreover, I only saw my doctor the morning of surgery and after surgery for all of 10 minutes. Consequently, a nurse was pretty much my only contact.
Several years later when I developed what would be an undiagnosed (even after three months and four doctors) stomach/intestinal condition I learned the joy of bouncing between doctors who couldn’t remember my name or barely cared to put an ounce of effort into diagnosing me. When I went for expensive contract tests and Cat Scans (covered by my insurance) I would ask the doctor administering the test (I had three) the results only to have them tell me, “Sorry, I can only tell your doctor the results. He will tell you.” I think that after drinking eight cups of nasty chalky milk like concoction I would have at least been given an answer by the expert whose job it was to read the test(s). Nope.
And when I went hope and waited for the results I went days without a call from the doctor when it was apparent that the doctor who administered the test new the result almost immediately. It was almost always my duty (thanks to their lack of initiative) to call and request the results. Sometimes, I would have to call several times and demand to know the results- lest I be transferred around four or five times and be forced to leave a message to which no one would respond. And NEVER did the doctor himself get on the phone to talk with me, only secretaries and nurses, but never the doctor.
Moreover, the few times I did talk to doctors (and these were strictly exam room conversations) it was short, curt, and lacking in almost anything friendly and respectful. I received incorrect diagnoses, but never explanations. I received short answers, but never a simple sign of patience on their part with my lack of medical knowledge [Note: I am better now thanks to House, M.D. and Scrubs]. I received stern and inquisitive looks, but never any sign of actual concern.
The BIG Question(s)
So why the differences? Why the difference in cost, concern, and care?
Here are a few of my guesses, and please feel free to disagree with me and comment about your own answers to this question (feel free to also provide example from your own life of dealing with human and animal doctors).
(1) He Who Pays is Treated Better. Not many dogs carry doggy insurance and vets aren’t obliged (like people doctors in many hospitals) to treat clients who can’t pay. As a result, vets know that the person who brought in the animal is the person paying the bill in 99% of cases. While your doctor might ignore your request for an explanation of a procedure, would he ignore your HMO or Medicare if they asked a similar question? Could the problem be that since your doctor only feels obligated to explain treatment decisions to third party payers that they don’t feel like possibly having to explain themselves twice? Also, since most folks who walk into a vets office can’t afford to pay as much to fix their cat or dog as they would a person, this might serve to keep costs down. Well, at least until the federal government implement a MediBARK program (and MediPURR lest they appear anti-feline) to pay for veterinary care.
(2) He is as Unto God. Could it be that people doctors have an overinflated view of themselves? Sure back surgery on Fido might be just as tricky as back surgery on Billy Bob Thornton, but if Fido dies it isn’t quite as serious as if Billy Bob Thornton dies (no Bad Santa 2). Perhaps the stress of this leads to a more calloused view or at least leads to more of a fear of connecting with patients. Moreover, perhaps the power of controlling the life or death of another person does corrupt as absolutely as one might think? I don’t know. What do you think?
(3) Fewer Lawsuits. Unless your dog is a purebred their is little value in suing a vet. You don’t win pain and suffering if your vet is negligent and you don’t get compensation for all the hugs, frolicking on the beach, and duck hunting you could have done with your dog. Perhaps this leads to both a decline in the cost of service AND a greater willingness to be open with patients who they DON’T see as a potential lawsuit in the making.
(4) Is the Motivation Money? Are people doctors more likely to decide to become doctors because of money? And even though vets certainly don’t have a low median income, are they more likely to choose their profession based on a love of their clients- animals? Moreover, let us assume that both enter their profession with an equal amount of enthusiasm for saving lives and helping people. Is it easier to stay in love with the animals than the people- since we all know it is much easier to find a human jerk than his/her animal equivalent.
What do you guys/gals think? veterinarians