The Veterinary Industrial Complex

dturm wrote:
I have avoided commenting on this topic. While I believe 4X$Dodger’s observations may be accurate, I don’t feel all of the conclusions are warranted.

It is true that with the technological improvements and increase in knowledge have changed the field of veterinary medicine. This offers a much wider understanding of animals and their diseases and so many more options to deal with them. This does come at a cost, but the benefits are real. To say that this is “harming pet care overall” just isn’t warranted.

Another aspect to what has happened may be a misconception that many have about medicine. There is a reason it’s call “the ART of medicine.” So many think all you have to do is run a test, take a blood sample, do a radiograph/mri/ultrasound and you have an answer. That’s just NOT the way it is. Diagnosis is hard and many conditions/diseases don’t follow the book or multiple diseases are present at the same time and complicates our job. It’s sad to admit how many times we guess about what’s going on – with some pretty good evidence and reasoning – but still a guess.

You can end up spending $$$$ and still not have an answer or the answer you want. This situation can result in frustration and anger aimed at your vet. This situation is more often unreasonable expectations compounded by poor communication.

I hope the profession has not gotten to the point where needless tests or procedures are done in the name of $$$ or CYA.

I know after running a 4-5 doctor practice with 15 employees, the decisions about equipment purchasing can be difficult. It has always been about patient care, not income generation. Business decisions were never about the equipment purchase then pushing utilization to justify cost. It's always about the need for utilization for patient care to justify the cost.

There is no doubt that veterinary care costs have risen. It is also true that there are some veterinarians who push the best care/technology/medicine available.

You always have a choice and I still believe that veterinary care in this country is a bargain.

Doug, DVM

I think that first off you must admit that as a Vet you come to this discussion with a built in bias. Regardless of your good intentions and however you may operate your practice you cannot extrapolate your actions to most or even many vets.

My Biological Father was a Doctor and head of a hospital, My nephew is a head and neck surgeon (Otolarangologist) My sister in Law has been an OR and ER nurse for her entire career. As a former Cancer patient with stage four Squamous cell carcinoma of the head and neck I am not naive about medicine or the challenges of Diagnosis OR the financial issues involved in private practice.

I do agree that medicine is partly an art and intuition and my point is that is exactly what is lacking at so many vets now.

And while the decision to purchase a particular piece of equipment may indeed pivot on a patient care analysis you still must be able to pay for that machine. Which means it MUST be used. It must carry it's own weight, financially speaking.

The vets that own their own businesses are essentially businessmen. You absolutely must make payroll and all the rest of the expenses and turn a profit if you are to survive. Now we all know that most Vets and Doctors try to keep out of money discussions with patients. This is simply smoke and mirrors. Of course you know what it all costs, otherwise you wouldnt be in business long.

I know it makes Vets and Doctors uncomfortable to talk about business and money but the reality is that it is part of what you must do.

As for poor communication and out of line expectations, I agree these can complicate things, however in my direct experience it is the Vets that are not listening or questioning nearly enough. Despite telling one Vet repeatedly that Nigel WANTED to eat But could not bring himself to do it, he continued to use the phrase in conversation and in writing that Nigel had no appetite. This was clearly not true. He did have an appetite and wanted to eat but no matter how he tried he just couldnt bring himself to do it. The second vet we went to got this point.

And lastly I am afraid that Vets have long since been ordering tests to up income AND to mitigate liability.

And no I did not have unreasonable expectations nor am I not able to communicate clearly and precisely with the Vet or any other doctor for that matter. But what I saw and experienced were real and when put together with many other Vet visits all across this country I can say with surety that in many cases Vet/Pet care in this country is needlessly expensive, (sometimes more than a human doctors visit)and less about what is actually needed for the patient than generating income to support overly large practices.

Happily the Vet that put Nigel out of his misery we found in a small town in Oregon. He was by far the most concerned, compassionate vet we had seen. He was a one man practice with about two or three employees. His goal was CLEARLY centered on Nigel and his well being.

Technology is a tool only a tool and it can often give misleading or outright false results. (my cancer was misdiagnosed twice) but too often it seems that it has become a crutch in diagnosis rather than one of many tools including intuition, experience and that elusive "ART" that also needs to be brought to bear in patient care.