On The Emerging Wave Of Scrutiny

The author discusses the scrutiny that comes with working in a veterinary practice.

Mr. X practically crashes through your front door with Remy the miniature poodle in his arms.

“He was hit by a car. I think he’s gone,” he sputters.

Fortunately, your well-trained receptionist is at the ready. “Do we have your permission to evaluate him and perform any life-saving measures, if necessary?”

Upon hearing him answer in the affirmative, she whisks Remy back without waiting for a technician to triage. If the dog’s almost dead, she reasons, Doc will need him in back with an IV catheter pronto. And you’re already waiting.

You’ve stepped out of surgery and ripped off your gloves upon hearing the front office commotion, leaving a cat spay on the table for your best tech to close.

You tube him. Another tech’s already got an IV running. You do your best CPR. You’ve done everything you and your techs were trained to do. But Remy’s gone.

You explain the loss to your client and the work you undertook on his behalf.

A couple of months later, there’s an article on Slate.com describing how angry your client was that you charged him several hundred dollars for CPR on his dead dog. Nowhere does it mention that the bulk of that low-hundreds bill was for the private cremation he elected.

You’re angry. But at least your name’s not in the piece. In fact, it could have happened to any vet. This might not even be your case they’re detailing. But it sucks anyway to know your best efforts went not merely unrecognized, but bitterly criticized, to boot.

“What would they have had me do?” you wonder.

In case you hadn’t noticed, the traditional news media have begun serving us a whopping bolus of reality we’d be remiss to ignore: Veterinarians are increasingly treated to a level of scrutiny previously unheard of in our profession.

Last year, one of our own even penned an exposé of sorts on our profession’s unethical tactics in applying high doses of guilt to rack up the bill. In February, a Los Angeles NBC affiliate ran a bewilderingly aggressive undercover series on how veterinarians cheat clients by offering unnecessary services.

We’ve entered a new age of veterinary medicine, one where clients are more emboldened to address our inadequacies, lawsuits are on the rise and the media is happy to rip into us for profit and for sport.

On the one hand we deserve greater scrutiny. It comes with the territory. Many of our clients are no longer content to sit idly by as we practice our James Herriot-style medicine. They often expect the best for their “children”—specialists, overnight care, rehab.

We’ve entered a new age of veterinary medicine, one where clients are more emboldened to address our inadequacies, lawsuits are on the rise and the media is happy to rip into us for profit and for sport.

Nonetheless, they don’t think it fair if we take them for a ride based on the degree of attachment they profess for their pets. Stories like Slate’s and KNBC-TV’s in L.A.—not to mention one disgruntled veterinarian’s personal crusade—trade in the dissatisfaction of clients who have felt “abused” by their veterinarians.

It’s clear there’s an undercurrent of sensitivity in our pet-owning population on this issue. When news pieces like this achieve unprecedented audiences it’s hard to discount it out of hand. There must be some degree of truth to the popular feelings they feed off.

Though I hate to think so, it’s clear that some veterinarians—even if only a minority—overdo it. We can all point to one or two in our communities, can’t we? But the majority of us? We’re just doing what we were taught.

Most of us are trying to practice the high-quality medicine we’d risk malpractice not to offer. Sure, we also present alternatives when our clients are unable to pay (sometimes this even comprises the bulk of what we do) but we nonetheless try our best to do the right thing by our patients.

Unfortunately, this condition often leaves our clients feeling guilty. But is it our domain to address their feelings of inadequacy at the expense of our patients? It’s a darn good question. Welcome to the world of damned-if-you-do-damned-if-you-don’t veterinary medicine.

Dr. Khuly blogs regularly at www.dolittler.com.

My Follow-up Thoughts on the HSVMA

In the March issue, I treated you to a discussion of the Humane Society of the United States and its new organization for veterinarians, the Humane Society Veterinary Medical Assn. After reading it, HSUS Executive Vice President Andrew J. Rowan, Ph.D., kindly requested I address some “factual inaccuracies and misperceptions” presented therein.

Due to space limitations the entire letter cannot be printed here (please email me for a copy). However, I’ll address Dr. Rowan’s major points exemplified by the following bulleted excerpts:

• “The HSUS has supported well-operated feline trap-neuter-return programs for years.
• We do not oppose breeding per se, and for those who wish to purchase from a breeder, our website provides guidelines and general advice.
• We do promote adoption of animals from shelters as a first option.
• Our position on farm animal welfare is far more nuanced than you represented to your readers. Our board-approved statements reflect a longstanding realism about individual food choices in a pluralist culture.
• The same thing can be said for our position on laboratory animals.
• Historically, HSUS staff and programs played a major role in the dramatic reduction in shelter euthanasia … raising the potential for communities to reach the point at which no healthy and adoptable animal is euthanized in a shelter.
• For our part, we believe that the vast majority of the public support most if not all our positions and that a majority of veterinary practitioners do as well.” 

I concur that many veterinarians support most of the HSUS’s points as outlined here and in its position statements. Indeed, I personally agree with most of its initiatives and support almost all the causes it publicly champions. I cheer when it succeeds on issues I care about.

However, my basic complaint with the HSUS stands.

The HSUS has long been the leader in setting standards for animal-control facilities and humane population control. Its original mission was to find humane ways to end life. I’d argue that you continue that tradition by enabling facilities that kill for population control, supporting their antiquated approaches and defending their inadequacies.

My “misperception,” as Dr. Rowan calls it, is the same as that of many others in the animal welfare community. We view the HSUS as an organization willing to shift its public stance to reflect prevailing sentiments as part of an ongoing drive to court public favor for financial gain.

We who watch the HSUS alter positions and act in ways we believe contradict its public statements refuse to engage in the game of advanced semantics you play with animal lives at stake.

Why should we veterinarians trust your organization over our own AVMA? For all its failings on key welfare issues such as forced molting and foie gras production, at least the AVMA acts predictably and honestly in what it believes is the best interest of its membership. At least the AVMA is largely free of the hypocrisy that affects not-for-profits that curry public favor to expand their political power and their coffers at the expense of their public mission. 


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