Meanwhile, I'm still toiling over burnt pads, heat stroke, near-drownings, allergies, insect bites and barbecue-rib dinner indiscretion (read: diarrhea). That's summer's cruelty in a nutshell for most veterinarians.
Despite my veterinary doldrums, it's times like these I can honestly say I prefer my lot over my colleagues' on the human side. In fact, that's almost always true —— that is, if you except those moments when I ponder my paycheck's paucity relative to my physician friends'. But then, that's the subject of another column's bitter whinge.
For today it's all about the biting human health care debate and how American animals factor into the divide. Because —— as I'll posit for your consideration —— their health care system is not so very different from ours. Not fundamentally, anyway. And yet there's much that human medicine can learn from how we do things in the animal arena.
Sure, pets have no third-party payment system that meddles in their health care delivery. Not a formal one. Nonetheless, they do come attached to intermediaries that act as such. We, their owners, effectively serve as animal HMOs when we decide what works for our non-human brood and what might not —— cost-wise.
So how different is that from what you experience when you're told your plan can't afford to cover an MRI for your chronic back pain or work up your diabetic parent for the possibility of primary pancreatic disease?
Not that veterinary medicine suffers from the same kind of blanket, systematic atrocities, and it's not as insidiously, bureaucratically fraught. But the upshot is still the same. Because from a provider's point of view, it's still so wrong.
Can you imagine having to deal with back-to-back appointments where the first pet gets a top-notch radiation oncologist and the next is put down for the same condition? It happens to me weekly. The disparity would be especially disgusting were it not for veterinary medicine's cold comfort: euthanasia.
Much has been made of how posh animals have it, relative to many humans. Undeniably, pets at the high end have fewer hoops to jump through and a fee-for-service environment that's customer-driven. Compared with much of human health care, ours is a system that's almost a pleasure to navigate.
I'd never leave you waiting for an hour. I'd fire a surly receptionist or a technician too rough with my patients. My fees are low for what I do (not to mention my staff's). I work hard to please you because I know my clients can take their business elsewhere. And of course, because I care — not only for your experience as a customer, but because you play a huge role as my partner in serving the overall health of your pet. All of which makes me a satisfied worker.
Utopian, perhaps … but only if you can pay for it.
It's not that veterinarians don't care for those who can't afford it. It's because we're not equipped, financially, to service low-income patients through any particular system. There's no cost-offsetting, Medicaid-style option. Consequently, we can't afford to underwrite all our needies —— at least not routinely —— and still service the rest of our patients in the competitive fashion to which they've become accustomed.
Just as in human health care, veterinary medicine is stratified into the have and have-nots. The divide is chasmic … and utterly calamitous for the low end. And we live with it, why? Because we accept that if human health has got it so bad, how can we expect to do any better?
Still, here's the scary truth: Despite the hand-wringing, I believe we accomplish far more per patient than the average doc.
Animals can't tell you where it hurts when you ask. But their veterinarians have more than an inkling as to where the damage lies. Perhaps this perspective makes us better at pinpointing exactly where the human system goes wrong. Perhaps our competitive system, overall job satisfaction, low-cost structure and significant (if comparably paltry) paychecks provide an insight into what ails human health.
Sure, I can tell you where it hurts. Just don't expect me to tell you how you fix it. Not while I still can't serve every animal who needs me.
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