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Do You Trust Your Vet?

 


I think it is very important for a veterinarian to be able to forge great relationships with their clients. Personally, I feel very privileged to have so many regular clients that value my judgement and entrust me with their pet’s wellbeing. However, I do appreciate that not all clients will appeal to the way I practice. In similar effect, I find that I get along with certain clients more than others. That being said, it is essential that a vet and client don’t ever allow their differences to get in the way of the patient’s health. Ultimately, we all seek the same outcome: a healthy pet, free from any pain or suffering.

 This brings me to the hot topic of complaints received from clients.

I think one of the hardest complaints I can ever digest is being accused of ‘over-servicing’.

I hope this post helps bridge the gap of mis-communication between veterinarians and clients. I simply don’t understand the term over-servicing when it comes to what I offer.

Such complaints leave me feeling quite perplexed like ‘Megsey’ below.

MEgseys manipulative expression

In my consultations, I do my best to be very thorough. I examine the patient head to toe, get as much history as possible and offer an array of recommendations relevant to each case. If I get booked a consult to examine a lump on a dog, I don’t just focus on the lump in question.

I don’t take any shortcuts and always try and conduct a full examination.

This includes a fine needle aspirate of the lump examined under the microscope and complete physical examination. I also discuss diet and so much more. However, when I am running really behind in my consultations, I find myself having to focus on the issue in question and trying to address it appropriately. If I also discovered multiple health issues in your pet, I then recommend booking you in for another consultation to tackle all these unexpected issues in more details.

Furthermore, if I’m booked a geriatric patient, I always recommend performing a blood test even if their physical examination was normal. There is no way I can be 100% sure that the inner workings of your pets are sound purely based on my physical examination. Almost 50% of the geriatric profiles I run, I find abnormalities. Diagnosing issues early on for my geriatrics can be very helpful in their long term management.

For example, ‘Ralph’ came in for a routine health check and I recommended running a blood test as he was greater than 8 years of age. His blood results revealed elevated liver enzymes. We are currently working him up for a suspect underlying Cushing’s condition and we may have caught it in the very early stages.

As with any disease, early treatment gives for a better prognosis.

Ralph impatiently waiting for his liver treat.

Ralph getting his lips ready for his treats

Basically, I can definitely be accused of overloading my clients with a wealth of information. Nowadays, I find that people lead very hectic life styles and bringing their pet to the veterinarian is only limited to a serious ailment or an annual vaccination booster or health check. Hence, I seize this opportunity to give their pet a full physical examination, check up on their diet, training and any other health issues. I discuss dental health, skin health, arthritis and range of issues.I simply can’t help myself; I just want to give my clients all the best options for their pet to be in elite health!

Obviously some clients perceive my thoroughness as an attempt to squeeze them for more money. They feel that my intentions are not genuine and all my recommendations are ‘unnecessary’ and fuelled with greed.

To those people, I say you have got me all wrong; if I wanted to make money, I would not be working as a veterinarian.

The veterinary industry is far from a lucrative business. The average veterinarian is severely underpaid and overworked. If only you knew how many hours I work/week excluding afterhours and my weekly earnings!

To make matters even more frustrating, veterinarians are often trained to think that an over-servicing complaint often indicates that we have failed in our communication with the client as they were not prepared for that cost. Personally, I find that the owners who do complain are usually the ones who have been given a very good estimate and the overall price was $20-50 give or take more than expected.

I really strive to give good estimates on cost of procedures or workups but they are estimates not exact figures. I can’t know exactly what I am going to find on the chest x-rays or ultrasound and so I can’t factor in an exact cost for treatment when I have yet to come up with a diagnosis.

I definitely could do better with my consultation estimates but that can be very challenging when I am heavily booked. We are generally booked 15 minute slots for each consultation in which we must examine the patient, get all the history and discuss all treatment options with the owner and answer all their questions. Ultimately it boils down to this:

‘If your pet requires medication for an infection, I must simply prescribe it and you have to pay for it!’

I was once specifically accused of over servicing a client and to this day, I really can’t understand what I could have done better. I believe I communicated openly with the owner and discussed all treatment options clearly. This lovely and hyperactive 12 month old poodle was booked in as she was excessively straining to urinate. Her examination and history revealed she was suffering from cystitis. Cystitis can be quite uncomfortable and painful; a burning sensation is felt each time the patient urinates. I discussed my recommendations and advised the owner that her dog would require a course of both antibiotics and anti-inflammatory/pain relief.

The owner debated with me the need for anti-inflammatory as the dog was bright and alert. I went on to explain that cystitis is inflammation of the bladder and can be quite irritating and painful. It was the reason why her dog was frequently urinating. While she may appear bright, she is obviously not feeling 100% as she has an urgency to urinate frequently. The next morning, the owner dropped in and demanded to get credit back on the anti-inflammatory medication and accused me of over-servicing her. I actually felt awful for her dog and was glad I had managed to give her one shot of anti-inflammatory which would give her pain relief for 24 hours.

It really hurt me to be accused of over-servicing when all I cared about was her pet’s welfare.

I simply wanted her to be free of pain and to help her recover quickly.

Sometimes, I find it very challenging to convince certain owners of the merit of medications. I often meet very arthritic dogs that the owners decline any type of treatment for. They say they are old and it is normal for them to slow down. Some people don’t understand that animals can feel pain too and simply can’t express them like we do. They don’t stop eating or start moaning about their agony until it has reached completely intolerable levels.

And my latest accusation of over-servicing has left me quite baffled. This lady called us very distressed and wanting some advice about her cat. She was in the process of moving house and her cat’s anxiety had spurred on an episode of self-trauma. The cat seems to scratch its face excessively whenever it is anxious. The client wanted to see if we recommend admitting the cat to hospital for sedation or any necessary medication while they move. The nurse consulted me about the phone call and I said we would be happy to assist the owner and have the cat in hospital.

The nurse recommended my behavioural services and the client was quite keen.

However, after much discussion, the client cancelled the appointment she made as she decided it is best to monitor the cat at home instead of overwhelming her with a trip to the vets. I looked up the patient’s history and found that the patient may truly be suffering from underlying anxiety and her behavioural issues had not been addressed. A week and a half later, I called the owner to check up on her cat and make sure she had settled down with the move.

I had to leave a voice message asking about the cat and explaining that I am happy to offer my behavioural advice on this case. The owner returned my call and we had an in-depth discussion about her cat’s condition and different treatment options. Basically I emphasised the importance of getting her cat checked out soon as the owner had clearly stated the cat had severely traumatized herself and the scratching had still been ongoing after the move. I was concerned the cat may have acquired secondary skin infection. I also briefly touched on behavioural modification and anti-anxiety medication with the owner and what that would involve.

To my utter surprise, the client calls the next day and cancels the appointment she made with me and accuses me of ‘over servicing’ her and asks the nurse not to tell me.

Upon hearing her feedback about my services, I felt very bitter just like ‘Forrest’ below did.

forest

I simply don’t understand how me calling a client to check up on her cat and offer my services is perceived in a negative context. I didn’t hold a gun to the owner’s head and ask her to call me back. She chose to do so willingly and spoke to me for over 20 minutes. This experience has left me feeling exploited and undermined for being so passionate about what I do.

I would like to end this post by asking you for your feedback.

What do you perceive as an over-service by a veterinarian?
Have you ever experienced it?
If so, can you please expand on that experience and tell me why you felt over serviced?

I never ever want to be accused of ‘over-servicing’ a client again, so I’m all ears for your input!

pippa

Filed under: Favourite Articles, Hardships Source: http://rayyathevet.com/2012/06/18/do-you-trust-your-vet/


 

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Rayya The Vet

I was born overseas and grew up in Lebanon. About 9 years ago, I left my family and friends behind to pursue my dream of becoming a veterinarian in Australia.

I have now been out in practice for the past 5 years. I absolutely love being involved with all types of animals and consider it my "calling". Whilst my job can be quite an emotional rollercoaster ride, I cannot fathom doing anything else for as long as I am living. I simply feel blessed every day that I am practicing what I truly love.

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11 Comments

  1. avatar

    This is an enlightening post, and I agree wholeheartedly with the need to be thorough to avoid misdiagnosis and other risks. What brought me here, though, is the absolutely adorable photo of Megsey! The dogs are too precious! All so lovely!

    • avatar

      Hey Ee. You can never be too thorough, that’s for sure. ‘Megsey’ sure is pretty and her begging face manipulates many of us to overfeed her :-)

  2. avatar

    I think you have to regard the context. I have been double-charged and triple-charged by vets because I am Caucasian rather than local, and on two occasions people have masquerade as vets: one was a sales person in a pet shop and another was a vet’s wife. As such, ethics and vet practice are not exactly synonymous in Malaysia.

    I ask questions, lots of them, and I find the good vets are very happy about this as they understand the challenges to ordinary consumers to find proper care. I love people like you who do the whole thing right but it’s not everyone who does it – or everyone who wants to hear. Some people find too much info confusing and upsetting. It’s a style issue.

    I can see why calling someone sounds like a hard sell because vets here tend not to call until they know you really well. I appreciate follow up calls, and am delighted when a vet does so. Funnily enough, one of my vets tells me that I am the only person who knows who calls to leave a message at his office to say my cat is well again. He says that most people don’t bother to report back at all and he is sometimes in agony, wondering if his patient is ok!

    The other issue, refusing to treat an illness in a pet, is just mean. One can only hope that the Poodle owner gets cystitis so that she/he can get some empathy going.

    • avatar

      Hey Ellen.

      That is pretty insane to hear vets triple charge or others pretend to be vets. I guess there isn’t much auditing of vets in Malaysia.

      I think it is crucial to ask questions so that you can make informed decisions on behalf of your pets. They are counting on you to make the right decision.

      I totally agree with your vet, we don’t often get progress reports on pets unless it is bad news. I would love to receive more calls saying my pet is doing great now.

      Thank you so much for sharing your experiences and views on vet services specifically in Malaysia

      I only hope that more regulations are set in place to ensure that the veterinary services are improved in Malaysia.

  3. avatar

    I think my vet’s a pretty decent guy. Don’t feel over-charged on my part at all. My dog had a hemorrage in her ear, he did the operation, and the rest of the follow up check-ups were free of charge. He said it was part of the operation to take care of my dog. She passed away a few years back, and I have a new dog now. But we’re still with the vet cos we like him.

    • avatar

      Hey May. Thanks for sharing your great experience with your vet. Sounds like you found yourself a really terrific vet. Establishing that kind of relationship with your vet is crucial to ensure your pet is in prime health :-)

  4. avatar

    I got a bad experience from the vet, it cause me hard to believe the vet. I bring my love dog to visit vet and after come back, it die in few hours. I called to ask the vet said, “oh, really? May be I give a too strong medicine.” So irresponsibility vet. I really sad and why can be so irresponsibility to the animal?

    I hope now will have getting more good vet like you…

    • avatar

      Hey Joey. That’s just absolutely terrible news about how you lost your pet. I hope you can find a vet you trust if and when you have a new pet. Goodluck!

  5. avatar

    It is true, in Malaysia for some circumstances like races, some vets (or any services provider) will charges other races for higher prices. In Malaysia, it is uncommon doctor will call the client for the second day and asking how is the situation, or patient will call back to the doctor. Even if you do so, the client might think ” ok, the doctor call maybe want to nail my money again”, they will have this kind of thought in some point. People messed out with follow-up call and hard-sell call.
    I’m currently in US and have a rabbit as a pet. The level of treating a pet and a human patient is similar. Malaysian haven’t see how ridiculous cost for vet in US compare with Malaysia BUT they were more professional.(let’s be honest). But as long as my bunny is doing great I happy with it. Having a pet is like having a child, need to have a saving fund to prepare for it. When your own child get sick, you need money for medicine, similar to animals. Unfortunately some owner don’t have this mindset, or not really ready to have pet.
    The medical practices/ethnics in Malaysia still little bit different from other countries. It also possible people overlook, or get experienced Malaysia’s medical industry quality, and they assume the vet is the same.
    From your words, I believe you are a professional vet and try to provide the save those animals. It is nothing wrong to your practice, it is the culture perceptions in medical industry.

    • avatar

      Hey Beatrice. Thank you so much for your very insightful outlook about the Malaysian cultural perception of vets and owning pets. I totally agree, even in Australia, some people own pets that they really shouldn’t. Owning a pet is a luxury and requires you to be responsible of your pet’s well being in sickness and in health!

      I personally have experienced being charged more for being a foreigner in Singapore. My Chinese Singaporean friend sent me out as bait in a pet shop. I asked the price of the fish and what he quoted me was 5x what he quoted her. It was quite unbelievable!

      I look forward to the day I visit Malaysia and enjoy this beautiful country with all its ups and downs :-) .

      So happy to hear you have vets you trust to look after your little bunny :-)

  6. avatar

    to those people who think you are over-servicing, it may be because they never equate the importance of their pets’s live with that of a human. To them, an animal is only worth so much because of their short ‘shelf-life’. So, why bother spending so much?

    or it could simply due to the fact that they are ill informed about pet care. it simply does not get pass their head that pet can have complex illnesses like humans do even though they do not always explicitly display their discomfort.

    I wished you were in Malaysia because I have many questions I want to ask a vet but never seemed to get a satisfactory answer.

    keep it up.

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