Is It Your Vet’s Job to Keep the Cost of Care Down?

This is one of the most common misperceptions I’ve heard from pet owners. And let me tell you, it hurts.

Personally, I’m not in this career for the cash. Like most of my colleagues, I do it because I love it, and I chose veterinary medicine over other careers that might have been more lucrative. But I completely understand why frustrated pet owners say such things sometimes. As consumers, we’ve all been there — feeling as if all anyone cares about is getting money from us. That feels even worse when we are under stress and finances are tight. It’s no wonder these emotions frequently bubble up for pet owners caring for sick or injured loved ones.

Whenever I look at a cost estimate for a pricey surgical procedure, diagnostic test or medical therapy, I can’t help cringing. It’s not because I don’t understand why the cost is what it is — medicine is a sophisticated and technology-based field — it’s because I worry about how it will affect possibly cash-strapped owners and their pet-in-need.

But what should my role be, as a veterinarian, in keeping costs low? I wonder about that often, and I’ve never seen or heard an answer. It certainly wasn’t a topic covered in veterinary school.

Costs, Ethics and Care

How much should cost factor into the treatment plans offered to pet owners? Should medical options be withheld if the veterinarian knows they are too expensive for a pet owner to afford? Is it unethical to offer only the highest-quality care that promises the greatest chance for success, if you know some pet owners won’t be able to afford it? What about offering only the least expensive option when others may offer greater chances of success? And what about treatment options that are affordable, but which the veterinarian doesn’t believe in as strongly — should those even be offered? All of these options make me uncomfortable.

When faced with such questions, I remind myself that there is more than one way to approach most medical problems. Cost is only one of the factors that dictate which path to take. When I develop a medical treatment plan, I keep three other factors in mind to weigh against the cost question:

1. Pet owner circumstances. People live their lives under a variety of circumstances. These differences are particularly obvious when we discuss veterinary care options. For example, some of us have a house full of pets that all require consideration, while others have a single “furbaby” who gets as much attention as we have to give. Some people have flexible work schedules that allow for frequent treatments, assistants who are able to help give medications and rehabilitate injuries, advanced medical training of their own, pets who are willing patients or boatloads of disposable income (although these people are few and far between). Others of us do not have any of these things when faced with a veterinary care need.

The way we approach medical treatments is highly dependent on the particular circumstances of both the medical case and the pet owner. Some plans will work well and be effective for one pet owner but not for another due to that person’s particular situation.

But just remember: Your veterinarian can’t know what your personal circumstances or limitations are unless you share them.

2. Pet owner attitude. We naturally believe that others see the world (including pets) as we do. In my experience, however, there are enormous differences in how people view companion animals. I see dog owners who have never let their pet inside the house, and others who have given up sleeping in their beds so that their dogs will be more comfortable there. I know cat owners who have not traveled in years because of concerns about a pet in fragile health, and I know cat owners who think that life-prolonging medications are “unnatural.”

I make it a point not to judge people as “good” or “bad” pet owners, because everyone has different experiences, philosophies and deep-seated beliefs about life, death and animals.

I see so much variation, in fact, that it is nearly impossible for me to anticipate how people will feel about a given treatment plan until we discuss it. I discuss the most aggressive treatment options not because I want to shame anyone into taking every measure possible or to get as much money as I can from them. I discuss these options because I never know how a pet owner will view such options, and I learned a long time ago that making assumptions about people is a good way to end up looking foolish.

3. My responsibility to pets. As a veterinarian, it’s my job to take the best care possible of each pet. In order to do that, I need to talk to pet owners about the full range of medical care options, including those with the best chance of success. That doesn’t mean every owner has to agree to the most aggressive course. It just means I have to be honest in explaining what I believe the best choices are. It’s my job to make a pet better as quickly and painlessly as possible.

So yes, I always want to provide the best care I can, with the best outcome possible. But as veterinarians, if our goal is the long-term health of pets, then we need to do what we can with the resources people have. That means doctors and pet owners need to create effective medical treatment plans together. To be a meaningful part of this process, pet owners should take an active role: Read up on topics of concern, bring lists of questions, listen intently and ask for clarification when needed. Understanding your options, and the benefits and drawbacks among them, is important.

Communicate and Consider

When it comes to the veterinarian’s role in controlling the cost of medical care, there’s no clear-cut answer. Unfortunately, we doctors can’t change the cost of medicine, and some treatments require quite a financial stretch on the part of the pet owner (while others ultimately may turn out to be simply unaffordable). But it would be wise for doctors and pet owners to take all factors into consideration together when making decisions like these. Honest input from all sides goes a long way toward crafting the best — and yes, most realistically affordable — treatment plan possible.

Read more articles by Dr. Andy Roark.