Being a veterinarian is so much more complicated than just treating sick animals. The job title should really read Doctor of Veterinary Medicine, detective, forensic expert, animal psychic, counsellor, and psychologist. I still laugh when people suggest that one goes into veterinary medicine because he/she loves animals and doesn’t like working with people. The reality is that in order to be an effective vet, clear communication and interaction with clients are essential skills. (The patients have yet to verbally respond to my questions regarding their ailments. I guess if I start hearing responses, I have either achieved Dr. Doolittle status or desperately need a vacation).
As a veterinarian, it is my responsibility to objectively and unassumingly offer consistent recommendations and treatment options to every client. It has been demonstrated in numerous industry surveys that what a client is willing to spend on diagnostics and treatment of their loved one has more to do with trust in their veterinarian and less to do with finances. Regardless, what becomes challenging is managing a case with a client that you know is working on a fixed income. Often times it is like working with one (or both) hands tied behind your back. Unfortunately, veterinary medicine is not reliably like an episode of “McGuyver” where a piece of chewing gum, some dental floss, and a box of raisins will disarm a bomb. The point being there is not always a viable conservative treatment option.
Enter VetCareComplete pet insurance. Thank goodness there is a program that will allow owners to take financial considerations out of the picture! Veterinarians are practicing the medicine they were trained to provide! Ah, but here’s the rub and the point of this blog entry…even if we can do something, should we?
Boy, that’s a loaded question. Quality of life is an important consideration that often seems to take a back seat in the human medical field. We pull out all the stops to keep someone alive and it seems that even living wills or advanced medical directives don’t necessarily perform as they were designed to. Just because veterinary pet insurance like VetCareComplete removes the financial burden from our decision making, does that give us unlimited ability to treat every problem to it’s extreme?
Imagine this scenario: a 13 year old female spayed Chow presents with an enormous tumor in it’s belly, extremely abnormal blood work, and a life threatening abnormal heart beat. This dog is collapsing in the exam room and appears as if it could go into cardiac arrest at any moment. This is was an actual case I saw about 6 years ago and it will always remain at the forefront of my memory. Here’s why: I looked at this dog and everything in my gut said “this is a dog that has reached it’s life expectancy, has major life threatening problems, and needs to be euthanized.” I related to the owner that the prognosis was grave, that the likelihood of successful treatment was low and that the options were immediate referral to a critical care facility or euthanasia. The owner said, “I will do ANYTHING you tell me to do, but I will not euthanize this animal.”
The choice was clear. We immediately sent the dog to a 24 hour speciality clinic that had boarded surgeons, internal medicine specialists, and cardiologists. After evaluation, the specialists echoed my grave prognosis and were advocating euthanasia. The owner called me from the clinic and said, “I will do ANYTHING the specialists tell me, but I will not euthanize this dog.” I spoke with surgeon and explained the owner’s position. Reluctantly, the dog was taken to surgery to remove a giant liver tumor. As it turns out, the tumor was benign, a large portion of the abnormal blood work returned to normal, and yet the life threatening arrhythmia remained. When the dog had recovered from the abdominal surgery, it went to a cardiologist who implanted a pacemaker. The dog was back to it’s old self. Once on death’s door the dog returned to our clinic with a normal quality of life. Six months later, this wonderful example of never-say-never died of completely unrelated causes.
I have used this example many times in the exam room when discussing quality of life and euthanasia of a patient. In situations like these, there is no wrong decision. Had that owner decided to euthanize the Chow, I would have told him that it was a good decision made in the best interest of the dog and that I supported it 100 percent. In this case, the owner did not personally support the idea of euthanasia and it was my responsibility to manage the case appropriately. It can be very difficult for owners to separate “best interest of a loved one” from the selfish desire to hold on to a loved one as long as possible. The bottom line is that it is not the job of the veterinarian in these cases to decide the course, but to help guide owners through the difficult task of evaluating all the options.
This particular owner probably spent upwards of $15,000 in a relatively short period of time treating this animal and was blessed to have the means to do so. VetCareComplete does not provide the answer to “should we do something” but it will certainly make the decision of “can we do something” a lot simpler knowing that compelete coverage is available when needed. It will always be up to owners and veterinarians working together to sort out the “should we” question.
At VetCareComplete, we look forward to worrying about the finances for you.
Dr. Keith
