2003 by Barbara Monaghan, DVM
Audience: Executive Leadership, Foster Caregivers, Public, Shelter/Rescue Staff & Volunteers, Veterinary Team
We have a common goal: to improve the health and well being of animals. Why, then, is it sometimes difficult for veterinarians and animal welfare groups to come together in a seamless manner to achieve this end? Bringing together groups with a common goal but different perspectives is never seamless; just watch your local groups of politicians in action as an example. The dynamics of the veterinarian-animal welfare group relationship must be thoughtfully engineered in advance. In doing so, we will decrease miscommunication and increase our mutual satisfaction in helping animals live a better quality of life. I hope to help the non-veterinarian animal caregiving professional gain a better understanding of the demands placed on the veterinarian in this relationship.
I will start by saying that one day I realized I had turned into my former boss. I was starting my day by reviewing my surgery docket. Every single one of my scheduled procedures was a free or heavily discounted spay or neuter. However, the discounts were not what got my dander up. At least half of the individuals or groups involved either wanted me to do their pet's procedure first so that it would not have to spend the night and incur hospitalization charges or they were refusing routine vaccinations or basic testing that was a requirement of the certificate they were using. I was trying to decide how I would do five surgeries at once so they could all "be first" when I snapped. I ranted and raved about paying the light bill and not having enough hours in the day, etc., while my technician calmly watched me have my meltdown. It seemed that every day was turning into this. It was my own fault. I had been sought out by many animal welfare and breed rescue groups and asked to help them provide medical and surgical care to their charges and I said yes, over and over again. Before I knew it I was working with so many groups that I hardly had time for my regular clients. That was the day I became a "resentful giver".
Pick the Right Veterinarian
I became a veterinarian because I love animals and I love the art and science that is the practice of medicine. I work long days and love almost every minute of it. I volunteer my time to all kinds of non-profit agencies, not just the animal welfare groups. I participate in many programs that benefit animals, especially sterilization programs, because I am appalled at the numbers of animals euthanized in the United States every year. I am the profile of your veterinarian. This is the first and most important consideration an animal welfare group must give to their choice of a vet. Who are you asking to help you? You must research your choice to be certain that you are enlisting the help of a vet that is almost as passionate about your cause as you are. It is not a forgone conclusion that everyone with a DVM or VMD is a good match with a non-profit animal welfare group. Yes, most of us love animals, but that is a minimum requirement. Your vet must mentally be a volunteer. A person that shares those fibers in common with Lion's Club Volunteers, Junior League, Civiettes, Shriners and all of the other wonderful community-oriented groups. Remember, just because you choose animal rescue and welfare as your charity does not mean your vet will choose that very same charity. Your vet may contribute to charity through financial donations to the United Way and choose not to discount veterinary services in turn. Every time you ask your vet to perform any service or consultation, you are asking that person to volunteer his or her time, and time is money. All of us choose to contribute to community in different ways. You need to match with the vet that already thinks like you do, rather than trying to modify a relationship with a vet that chooses a different venue for charitable contributions.
A Veterinarian's Time
So that brings me to my next point: the value of your veterinarian's time. How much do you think it is worth and how much are you actually paying for it? When a veterinarian discounts a procedure it is typically a donation of time, skill and knowledge that you get for free. In some cases your vet is giving you a deeper discount on his or her hard costs (materials, drugs, etc.) as well. Most vets donate their time freely. For example, how many vets charge their clients for telephone consultations? I doubt many. Try calling your attorney for some free phone time. Even some physicians are charging for telephone calls under certain circumstances. My point is time is very valuable and should be spent wisely. Getting into veterinary school is more difficult than getting into medical school. Your vet is a top notch doc by simple virtue of having a DVM. The average veterinarian was academically qualified to get into any number of professional schools (e.g.: law, medical, or veterinary). When a person makes the choice to become a veterinarian, he or she makes a conscious decision to be compensated less for their knowledge and skill. My point is that you pay less for a DVM than you do for an MD for comparable diagnostic and medical skill (I am talking about direct skill comparisons not for example, more advanced diagnostics available to humans). Some would argue that in itself is a discount. One reasonable approach to the donation of DVM time is to consider the recruitment of a recent graduate. New graduates are generally very enthusiastic, willing to help and very competent in basic procedures. However, it is imperative that this cooperation receive the blessing of the practice owner in advance, as it is the owner who is donating the new associate's time.
The next hurdle is the very basic issue of money. It is the obligation of all non-profit agencies to be able to stretch a dollar a country mile before they part with it. Everyone wants the best deal for the dollar and there is no arguing that inexpensive and cheap are not the same word. The first money question is, what type of veterinary medicine consumer is your group? Do you want your vet to use the best available anesthetic gases, quality suture material and intraoperative monitoring during surgical procedures? Or do you mind recently outdated suture material donated by a nurse at the local hospital and injectable anesthetics instead? In the end, the result is a spayed cat, but one surgery costs quite a bit more than the other. This is how costs can vary from hospital to hospital regardless of markup. The first protocol lowers the risk of complications before and after surgery, but if the complication rate is low to start you have to ask yourself if you are either willing to pay for the reduced risk or instead spay more cats in the meantime. It is important to know in advance how your vet will be willing to work with you to minimize your expenses. For example, it is reasonable to ask if your patient can be scheduled early in the day for surgery and receive same day discharge to save hospitalization expenses. But you may cross a line if you ask your doctor to compromise their own practice standard by using outdated suture material to save money.
Here is an example of a lesson I learned. One of my clients works very hard for a local rescue group. I routinely performed pediatric spays and neuters for her. One day she came to me and said in order to save money she was going to start vaccinating the animals herself. I agreed that this was a fine idea and took the opportunity to explain to her that when I vaccinated her dogs I did a very thorough exam on every animal and she was paying for my ability to detect heart murmurs, ocular problems, etc. I told her that I would let my technicians vaccinate her dogs at cost or I would sell her the vaccines to do it. After all, just about anyone can give a shot. Of course, I reminded her that each animal I performed surgery on deserved and would receive a physical exam and that I would do it at no charge. She indicated that she was interested in a more holistic approach to animal care and planned to use alternative types of vaccines. I cautioned her about efficacy issues with holistic vaccines and asked her to do her homework before discontinuing the protocol I had recommended. The choice was hers. She said she was consulting another vet. I agreed to do the surgeries but that the dogs could not be put in my hospital's general population for every animal's mutual protection, and she agreed. Unfortunately, every single dog she vaccinated with her new protocol came down with parvo before we ever had the chance to spay them. Several of the dogs died. In the end, she misspent her hard-earned money, and I felt a little used and betrayed because she chose the advice of another vet, who was unwilling to spay her dogs at a discount but would provide her with the alternative vaccines when I treated all of the dogs at a huge discount. Everyone was a loser that day, except maybe the guy who sold her the vaccines. I am not commenting on the effectiveness of alternative vaccines. My point is, invest your money wisely and treat your current relationship with your vet as a valuable commodity.
Issues that come between the animal welfare groups and veterinarians usually involve money. The bottom line is that most people do not realize the significant overhead that is involved. We pay the same amount for drugs and sutures your physician does. Veterinarians should be reasonably compensated for the services they provide. Rescue groups receive special consideration from veterinarians. Reasonable compensation for the vet with special discounts for the group can be done hand in hand. What irritates most vets is the fact that not only are you asking for these breaks, everyone is. So many people have some special circumstance that they feel qualifies them as a "good Samaritan" and entitled to low cost vet care. Some folks may even behave belligerently when the vet cannot discount their costs enough. The classic example of what rankles us all is the well-off client with the poodle, that they have bred three times, asking for a discount spay.
Veterinarians must avoid becoming the resentful giver. Rescue groups should pace the requests they make of their veterinarians. In the end a common vision, coupled with mutual respect and open communication, will result in a constructive relationship that will benefit all of the humans and animals involved. It is attainable, you just have to do your homework in advance.
Barbara Monaghan, DVM
Barbara Monaghan received her DVM from Auburn University in 1981. Barbara is a small animal pracitioner and a partner in two animal hospitals in Huntsville, Alabama. She has been on the Executive Board of the Alabama Veterinary Medical Association for the past three years, serving as Chairman of the Small Animal Affairs Committee. She has also served as Veterinary Advisor to the Alabama Humane Federation and collaborated with the Federation in writing and applying for a Maddie's Fund grant.