s*****d
发帖数: 2451 | 1 比较长，但是很写实。
The thing I hate about being a veterinarian
In my day to day life as a veterinarian, there is something that I dread
doing. This particular thing makes me squirm, twitch, drool and retch. I try
to avoid it at all costs, and I consider myself to be blessed if I have
technicians willing to do it for me. Want to guess what it is?
Expressing anal glands? (Nope. I secretly think it is rewarding to do this)
Doing a dental on a pus filled, rotting mouth? (Fun times!)
Sifting through dog puke to make sure it threw up all the rat poison? (Love
it, even though I am a sympathy puker)
Draining a 4 day old, putrid, maggot infested cat bite abscess? (No,
although dealing with maggot wounds sometimes makes me reconsider my career
choices.)
As gross and vomit inducing as all of the above may be, the thing I hate
doing the most as a veterinarian is talking to clients about money.
That may surprise those of you non-veterinarians out there, but if you were
to take a poll I have a feeling you would find many vets feel the same way.
We came into this career to do the best we possibly can for each patient,
and when finances intervene it gets tricky and heart wrenching. We find
ourselves having to consider and weigh the best interests of the patient,
the finances of the client, and the demands of our business. I love and want
to help animals, and yet I have to make a living. These sometimes competing
interests can put us in a horrible dilemma, where no matter which way we
turn someone gets hurt.
After vet school I practiced for about 3 years in the desert of Southern
California. If you are nuts enough to stay with me on this blog you will
realize how much I learned out there. Anyways, in that area were a lot of
backyard Chihuahua breeders.
Chihuahuas are cute little dogs. Sometimes they can be little bitty land
sharks, but regardless of their nature the females often have a teeny pelvis
and have to give birth to puppies with larger than normal skulls. As a
result, it is a breed in which pregnant females often need to undergo a
Caesarian section.
One day, a man I will call Mr. Smith came running into the clinic with his
pregnant Chihuahua, “Precious.” Precious weighed all of 5 pounds, and had
been in unproductive labor for 2 days. By this point she was cold, weak and
in tremendous pain. Her puppies were dead, and lodged in her pelvic canal.
I quickly did an exam on her, and started her on emergency treatments….
warming her, giving her IV fluids and a dose of pain medication. I told Mr.
Smith that the only hope for saving Precious was to do an emergency C-
section. She would need to be on intravenous fluids, pain medication and
antibiotics. The total cost for treatment was going to be 600-800 dollars.
Mr. Smith scoffed, and told me that the only money he had was the forty
dollars he had in his pocket…not even enough for the initial exam. He didn
’t own any credit cards, and insisted there were no relatives he could call
, or items he could pawn. I had a sweet, shivering, dying dog whose owner
could not possibly afford the treatment needed to save her life.
I went and begged and pleaded with my boss, who kindly but reluctantly
allowed me to cut Mr. Smith a break. I would give Precious the treatment she
needed, we would spay her so she could no longer have puppies, and we would
only charge Mr. Smith $100.00, which would need to be paid within 5 days.
Mr. Smith appeared to be grateful, and left Precious in my care.
The surgery went extremely well, and 2 days later Precious was bright, happy
, and munching on the daily chicken I would bring her. Mr. Smith thanked us,
and took Precious home.
Guess what? He never paid us a cent.
About 2 months later, Mr. Smith returned to the clinic with “Angel,”
another pregnant Chihuahua with the exact same problem as Precious. Dead
puppies. Unproductive labor, this time for 3 days. Cold. In tremendous pain.
Dying.
Now, the veterinarian in me wanted to rush Angel back and get to work saving
her. However, this would have meant doing another 600-800 dollar procedure
at no cost. I spoke to my boss, who as gently as he could told me we could
not afford to extend more charity to this man who had yet to pay us ANYTHING
for the first C-section. He told me I could offer to have Mr. Smith sign
ownership of Angel to us, or I could offer to put Angel to sleep at no
charge, which would at least end her suffering.
I went back into the exam room and explained this all to Mr. Smith. He was
very angry. He told me there was no way he was going to let me “steal or
murder” his dog. He kept begging me to save her. He cried. He pleaded. He
told me that his mother had just recently died and Angel was the only friend
he had left in the world. He asked me how I could be so cold and heartless.
Didn’t I see she was suffering?
It was an awful situation. In the end, Mr. Smith yelled that I was a cold
hearted witch that only cared about money. He took Angel home, where I am
sure she died a horrible, painful death. That case still haunts me.
Now I know some of you may be agreeing with Mr. Smith…that I was cold, that
I should have just done the surgery and saved Angel. I could have let him
make payments, or taken a post-dated check, or just gone ahead and done the
surgery at no cost. The kind, compassionate veterinarian in me agrees with
you. After all, it wasn’t Angel’s fault that her owner could not afford
the surgery, right?
Here’s the thing though….when would it end? What if in another few months
Mr. Smith came into the clinic with no money, with another sick dog that
needed help? What about the clients that sacrificed and stretched to pay for
their animal’s treatment? If I continued to give my services away for free
, I would either bankrupt the hospital or find myself without a job and a
mountain of student debt, a car payment, insurance payment, rent, etc.
It is expensive to operate a veterinary hospital. For your average clinic,
by the time you factor in the daily cost of employee salaries, supplies such
as medications, electricity, water, waste disposal, taxes, etc. it costs at
least $2800 per day.
This is why I hate discussing money with owners. I feel guilty, because
there is a part of me that feels bad for charging people for what I do. In a
perfect world, I could give each pet the best care every time. Money would
be no object AND I would make enough to pay my bills and save a bit.
However, that dream world doesn’t exist. I used to think human doctors had
it so easy because insurance paid for everything. Hmm. It seems like they
aren’t even close to figuring that one out. How do you provide good quality
health care to everyone when good quality health care is REALLY expensive?
Like I said, it is a dilemma.
We veterinarians are not rich. We don’t go into this profession to make a
gazillion dollars. Many of us are happy if we have enough left over to put
into savings. We want to practice good medicine, and we want to use our
knowledge and expertise to save lives. It breaks our heart when this isn’t
possible, and it crushes our souls when we get accused of loving money more
than the well-being of our patients.
There are, of course, a few dishonest veterinarians out there that try to
milk clients for everything that they are worth…who pad the bill with
unnecessary tests, or the most expensive medications. Trust me…they are few
and far between. Our profession abhors them.
If you own a pet, please consider that veterinary care is often quite
expensive. Plan for it, and consider having a savings account, or looking
into pet insurance. Take your dog or cat into the vet for annual exams so
that potential problems can be addressed early on. Remember that when we
present you with a treatment estimate we are not trying to scam you. We care
about your pet, and we need to get paid for what we do so we can continue
on caring for pets for many years to come.
If you are a vet that has found yourself in the same dilemma, my next blog
entry will be for you. (Compassion fatigue). In the meantime, be kind to
yourself and remember that you can only do what you can, with what you have,
given the situation in front of you. Take care. | s****t
发帖数: 17096 | 2 太极端了，这例子
这个mr.smith就是个asshol，没有啥代表性撒
try
Love
【在 s*****d 的大作中提到】
: 比较长，但是很写实。
: The thing I hate about being a veterinarian
: In my day to day life as a veterinarian, there is something that I dread
: doing. This particular thing makes me squirm, twitch, drool and retch. I try
: to avoid it at all costs, and I consider myself to be blessed if I have
: technicians willing to do it for me. Want to guess what it is?
: Expressing anal glands? (Nope. I secretly think it is rewarding to do this)
: Doing a dental on a pus filled, rotting mouth? (Fun times!)
: Sifting through dog puke to make sure it threw up all the rat poison? (Love
: it, even though I am a sympathy puker)
| f*a
发帖数: 3132 | | w****2
发帖数: 5760 | 4 铜球
【在 f*a 的大作中提到】
: 求摘要。。
| z*****e
发帖数: 14786 | 5 貌似有点闹心，同求摘要。。
【在 f*a 的大作中提到】
: 求摘要。。
| Y******Y
发帖数: 8753 | 6 摘要就是Mr. Smith, AKA, backyard breeder, is an ungratful. cold-hearted A-
hole | I****s
发帖数: 6150 | 7 已阅
【在 Y******Y 的大作中提到】
: 摘要就是Mr. Smith, AKA, backyard breeder, is an ungratful. cold-hearted A-
: hole
| s*******a
发帖数: 2596 | 8 看完，给个摘要，vet最难过的事情就是和病宠家属提钱。operate一个vet clinic需要
很多资金。在救命和收钱的节骨眼上最难受的是兽医。她是多么的想救命可是家属没有
钱的话，她的爱心也救不了很多条命。我也很同意这文章的观念，看病求医是需要钱的
，好设备医院更需要钱 建议养宠家长正视vet cost而且可以做好准备。 | b********i
发帖数: 10335 | 9 其实我觉得应该让你把全篇都翻译过来
【在 s*******a 的大作中提到】
: 看完，给个摘要，vet最难过的事情就是和病宠家属提钱。operate一个vet clinic需要
: 很多资金。在救命和收钱的节骨眼上最难受的是兽医。她是多么的想救命可是家属没有
: 钱的话，她的爱心也救不了很多条命。我也很同意这文章的观念，看病求医是需要钱的
: ，好设备医院更需要钱 建议养宠家长正视vet cost而且可以做好准备。
| m**********2
发帖数: 2646 | 10 看得我窝火， Mr. Smith根本就是一黑breeder, 拿狗来赚钱却不顾人家死活.
版上的各位都是把狗当家人的，都买了保险也不会为给狗看病斤斤计较。
lg早就想养狗了，好几次都差点从路边抱只免费赠送的puppy回家,我考虑到各种无法预
见的开销（生病，事故。。。），硬给拖了几年，等两人工作都稳定下来才把Theory带
回家.就算是健康的狗狗，食物，玩具，体检什么的，一年下来也真的是不少钱。 | | | l******8
发帖数: 9475 | 11 美国的医疗机构黑不黑？ 85.51%的水分。
今天刚交了$100。
三针麻药 + CT。 医生的钱另算。 | s*****d
发帖数: 2451 | 12 好小孩儿，表扬，顺便摸摸～～
其实我想转这个的意思就是，想让大家知道为什么vet有的时候那么不近人情。
也是要像倒数第二段一样，养宠物的时候请三思，他们真的很花钱。最好投保或者有一
定的存款能应急。宠物不像人，有health insurance，所有的钱都要从口袋里实实在在
真真正正得掏出来。
vet作为这个职业，当然是想要给每一个病人最好的治疗和照顾。谁都想能够妙手回春
，成为一个好医生，但是这每一步都需要钱。
【在 s*******a 的大作中提到】
: 看完，给个摘要，vet最难过的事情就是和病宠家属提钱。operate一个vet clinic需要
: 很多资金。在救命和收钱的节骨眼上最难受的是兽医。她是多么的想救命可是家属没有
: 钱的话，她的爱心也救不了很多条命。我也很同意这文章的观念，看病求医是需要钱的
: ，好设备医院更需要钱 建议养宠家长正视vet cost而且可以做好准备。
| s*****d
发帖数: 2451 | 13 这个例子是极端，但是不罕见。我也见过很多这样的。
被这样的坑两次，谁都不敢再赊账了。。
【在 s****t 的大作中提到】
: 太极端了，这例子
: 这个mr.smith就是个asshol，没有啥代表性撒
:
: try
: Love
| Y******Y
发帖数: 8753 | 14 I think the author(vet) was being to nice to him. I would have turned him
away the second time he walked in. People WON'T change.
【在 m**********2 的大作中提到】
: 看得我窝火， Mr. Smith根本就是一黑breeder, 拿狗来赚钱却不顾人家死活.
: 版上的各位都是把狗当家人的，都买了保险也不会为给狗看病斤斤计较。
: lg早就想养狗了，好几次都差点从路边抱只免费赠送的puppy回家,我考虑到各种无法预
: 见的开销（生病，事故。。。），硬给拖了几年，等两人工作都稳定下来才把Theory带
: 回家.就算是健康的狗狗，食物，玩具，体检什么的，一年下来也真的是不少钱。
| w****2
发帖数: 5760 | 15 赞简要
【在 Y******Y 的大作中提到】
: 摘要就是Mr. Smith, AKA, backyard breeder, is an ungratful. cold-hearted A-
: hole
| K***a
发帖数: 5176 | 16 每次看着这种不负责任的owner总是很气愤，可是做不了太多，只能自己不那样 | r*****a
发帖数: 27155 | 17 养狗需要钱，穷逼莫养狗
我觉得这篇写得挺好的
【在 f*a 的大作中提到】
: 求摘要。。
| R******0
发帖数: 6158 | 18 感觉写得不错啊，作为普通的pet owner，就是得给孩子们买保险，定期体检，注意预
防 | r*****a
发帖数: 27155 | 19 人家贷款学医也不容易
【在 l******8 的大作中提到】
: 美国的医疗机构黑不黑？ 85.51%的水分。
: 今天刚交了$100。
: 三针麻药 + CT。 医生的钱另算。
| z******o
发帖数: 3285 | 20 我觉得做个手术付个800，解决一个大问题，值得。但是经常小毛病，随便摸一下，就
一个标准的exam fee没了，也没干什么，我就来给你交水电费的。这钱对我来说浪费的
太轻易，对他们来说赚的太容易。这种情况我是不高兴的。你要是真治好了一个比较严
重的毛病，我愿意花钱。
所以现在小毛病都先自己诊断，尽量不去花冤枉钱。只希望家里动物都健康，生病真焦
心，耽误工作都得回家看着。 | | | l******8
发帖数: 9475 | 21 美国的教育, 工作等进入了一个恶性循环体系.
【在 r*****a 的大作中提到】
: 人家贷款学医也不容易
| s*****d
发帖数: 2451 | 22 虽然你看不见，但是你所谓的"摸"一下才是最见功夫和经验的。当然因为看不见，大部
分主人都必须要见到化验单才甘心。而且标准检查也是最重要的。等到有病才来治，费
用往往高得多。几十个摸一下都不止。
心，就
【在 z******o 的大作中提到】
: 我觉得做个手术付个800，解决一个大问题，值得。但是经常小毛病，随便摸一下，就
: 一个标准的exam fee没了，也没干什么，我就来给你交水电费的。这钱对我来说浪费的
: 太轻易，对他们来说赚的太容易。这种情况我是不高兴的。你要是真治好了一个比较严
: 重的毛病，我愿意花钱。
: 所以现在小毛病都先自己诊断，尽量不去花冤枉钱。只希望家里动物都健康，生病真焦
: 心，耽误工作都得回家看着。
| z******o
发帖数: 3285 | 23 某人也是这边医学院毕业的 他跟我说当时那位vet没做什么仔细检查
我倒没有留意。。不过上回去那位医生很仔细地检查了，我还挺高兴的。
【在 s*****d 的大作中提到】
: 虽然你看不见，但是你所谓的"摸"一下才是最见功夫和经验的。当然因为看不见，大部
: 分主人都必须要见到化验单才甘心。而且标准检查也是最重要的。等到有病才来治，费
: 用往往高得多。几十个摸一下都不止。
:
: 心，就
| b********i
发帖数: 10335 | 24 说实话是自从人娃出来后，我现在心理是越来越强大了。
当时第一次带他们去做follow up的check，那感觉。。。儿医翻腾我家小娃就跟烙饼似
的---那会儿可是脖子还没硬呢。。。我当时居然有醍醐灌顶的领悟---原来小娃还可以
这么玩～～
然后头几次小娃病了还心急火燎诚惶诚恐。到后来越发淡定，虽然无论如何上赶着也要
带到医生那里让他们花几分钟摸摸才踏实，不过经验证明好像他们医生每次要说什么我
预先都能猜的差不离。---当然其实这个还是应该感谢各路大神保佑，小娃们在生病上
不那么特立独行。否则肯定是我的猜测比医生的诊断更扯淡。
有时候就感慨对猫狗的研究还是比对人类少太多了，要不然做宠物医生的能更给力。不
过也是无可奈何的事情。。
【在 s*****d 的大作中提到】
: 虽然你看不见，但是你所谓的"摸"一下才是最见功夫和经验的。当然因为看不见，大部
: 分主人都必须要见到化验单才甘心。而且标准检查也是最重要的。等到有病才来治，费
: 用往往高得多。几十个摸一下都不止。
:
: 心，就
| s****t
发帖数: 17096 | 25 黑，给人看病的更黑
奥巴喊着要医疗改革，其实最应该改革的医疗精简提高效率
最好的服务代表更多的钱和浪费
美国的未来30年肯定要被医疗和退休制度搞垮
【在 l******8 的大作中提到】
: 美国的医疗机构黑不黑？ 85.51%的水分。
: 今天刚交了$100。
: 三针麻药 + CT。 医生的钱另算。
| r******l
发帖数: 652 | 26 还好我这里偶尔寄些COUPON到家，上个月出门旅行，送MAX去boarding时打了三针才$68
. |
|
