“I don’t care how much it costs!” The refrain is heard every day in veterinary practice. I have no idea who has some money, who has none, who has less than none, who has won the Lottery. The fluent and well spoken often have nothing to spend on their animals; the incoherent and almost incomprehensible sometimes have thousands in their back pocket.
Money determines which procedures and treatments are carried out. I tend to discourage clients from spending ridiculous sums on their animals. The increasing availability of MRI scans, for example, has certainly enlightened many conditions in the dark backward and abysm of the brain; but it seems that many in the profession are falling back on such diagnostics in cases where it is obvious that something is untreatable. The cost of an MRI scan for a dog? Over £1,000. The cost of the apparatus? Over £1m.
I do care what it costs. The food banks here in the north-east are thriving. When clients tell me that they “don’t care how much it costs”, it is a cause for anxiety.
There was recently a letter in the Veterinary Times by a clinician still traumatised by the abuse from a client who insisted that his puppy should have a CT scan – but would not pay for it. Vets do receive abuse and threats: I reckon on about one tirade every six months. It’s a professional millstone that we cannot respond in kind. Worse, we then receive a letter of complaint through the Royal College. More paperwork. More diplomacy. Surely it’s easier in the Foreign Office.
Some people have their animals insured. Great. Early in my career, I was called out to see a lame horse. On examining it, I found it needed a more extensive work-up than I had the equipment and the experience for. The owner, tab smouldering in the corner of her mouth, agreed that referral was appropriate, especially given the excellence of the insurance policy she had. I suggested an equine practice that might help her. She recoiled, drew hard on her cigarette, shook her head and told me she’d had to sue it for the death of her last horse. So I referred her to a different practice. Her horse went along and was treated appropriately. She left an insurance claim at the practice – for a cat belonging to someone else. There’s bravado for you.
Sometimes, “I don’t care how much it costs!” means, “How dare you mention money! That’s all you vets think about! None of you care!” I think we do care but in a way they’re right – each consultation, I go through all the treatment options and their expenses in detail. Some people are embarrassed that they do not have enough money for the treatment. I praise them wholeheartedly – out of relief that they can spend their money more appropriately. I was once appalled to hear that a client had needed to move house, having spent £5,000 on futile colic surgery for her horse. It is a weakness that must not be exploited by vets.
Besides, there are usually cheaper ways of doing things. Try another practice, for example, as the prices are arbitrary and differ vastly. I have removed a cat’s thyroid (thyroidectomy) in three different practices for £200, £500 and £800. Same surgeon, same procedure, same equipment. I find it extraordinary that clients rarely compare prices on surgery.
Is it a rich man’s world? Most vets who have been qualified for more than ten years earn between £35,000 and £50,000 a year. The farm vets get paid the least, then the equine; the small animal vets are the richest of us all. Where I live, that is often considerably richer than most of our clients.
Then again, compared to the other middle-class professions (accountants, lawyers, medics), we are a poor relation. However, I’d rather squeeze the purulent anal glands of a basset hound than inspect the haemorrhoids of an obese Yorkshireman or advise a crook under which floorboards to hide his or her money. “I don’t care how much it costs . . .”