Tuesday, February 25, 2014

Musings of Dr Liz - Bullying, Rorting, Vets and Community Attitudes

Dr Liz's musings is about .... well, my musings.  (A warning about this one.... it is written with a heavy heart, and in response to the events in the past few days in Australia and overseas (an opinion piece against veterinarians in a newspaper, and the deaths of model/media icon Charlotte Dawson and US veterinarian, Shirley Koshi).


Veterinarians are part of the noblest professions in the world, but it is equally the most misunderstood.  Whilst we all accept that people who can kick a ball around a field, or hit a white thing into a hole at a long distance earn a lot of money, we don't criticise them for this, or pay them less. We buy the trashy tabloid magazines which wouldn't know the truth if they ever came across it, perpetuating this image of stardom and allowing them to make more money.

Yet, the humble veterinarian, who often works under extremely stressful conditions, with the lives of loved pets under their direct control, are amongst the lowest paid of professionals, and with the longest hours. We don't seek fame or fortune.  We don't advertise on TV on how hard we work, or the care we take.  We don't go on strike for our rights to decent pay or working conditions.  We don't complain (much) about our interrupted family lives, in looking after the loved animals that are under our care.

Sadly, we do expect something in return for our contributions to our society.  We do expect to be treated in the same way as we treat others - which is with respect, dignity, honesty and integrity.  As a profession, we work towards the betterment of our pets and their loving pet owners. 

As a result of what we expect, and what we know we deserve, it hurts deeply - really really deeply, when it is implied or we are accused of rorting or scalping pet owners.

It hurts because it simply is not true.  Even the gentlest, forgiving souls would be affronted by such an accusation.

I have distant family members who earn a lot more than I do (as they often boast about their income at family BBQ's), yet have supported the "vets are scoundrels and rip people off" on social media. A recent family incident occurred  when I charged one family member $400 for a procedure that I should've charged $1400 for, and was actually done for less than the cost of performing that procedure to me.   That $400 was still too much for them.  Surely they understood what they wrote was not private - I could read it too - it is social media after all.  In essence, what they wrote, and the abuse against vets that was written (even though not directed at me), was full of spite and meanness.

That was one of many lessons I learnt of what some people think of my beloved profession, and of what I spend every breathing moment doing.  In my mind, it spoke more about how they valued their pet, rather than of me or my profession.  It was "It's just a dog", kind of value, and "I had better ways of spending $400", which was said.

 I tell myself the same thing as my father used to tell me when I was bullied at school - the comments reflect more on the person who says them  than on you - I remember this as I read another report of a colleague who commits suicide as a result of similar bullying. These colleagues are unable to deal with this continual attack, and must wonder  "why did I choose a profession that is thought off so poorly by the general public".

Today I read a disturbing opinion published in a popular newspaper about how vets are "scalping" pet owners in recommending and performing unnecessary procedures. In reading that article (which you can read here), it touched a nerve. I wrote about this kind of attitude  on Feb 4th 2014, weeks before the article was published. It was as if I wrote the response to the article before I even knew it existed!

My first thought to the journalist's opinion was to ignore it.  After all, we are in a democracy with free speech... they are entitled to their opinion, and I, as an individual,  must respect that right.  But then something niggled at me all day... and so I re-read it, and realised the copy  wasn't even worthy to line my budgie's bird cage with. 

But still, something was bothering me about it.  I couldn't get it out of my head.  So I read it again. 

This article  probably didn't even relate the true veterinary consult experience that it was talking about. It read like fiction.  It is  an opinion piece in a newspaper, and it talks about something that a tiny number of our community love to talk about - which is that vets are a rip off. 

I read that article, and, in my view, if the story is real, the only person who got short changed was the poor dog.  It was failed by both the veterinarian (who performed a substandard procedure in cosmetic plaque cleaning (by flicking tartar off in the consultation room and not addressing true dental disease), and the pet owner (who failed to understand that her pet had dental disease, not a cosmetic stain of the teeth).

The irony of the situation is that the vet provided an excellent customer service experience, in providing a service which satisfied the client. She walked out happy, as instead of booking her pet in proper assessment of the oral cavity,  and appropriate treatment, she walked out with some furry stuff wiped off her pet's teeth.

And sadly, because the vet provided excellent customer service to the paying owner, the most important customer, which is ALWAYS the pet, was forgotton. 

This beautiful, placid dog may or may not have dental disease, but we will never know.  The  author of the opinion is unlikely to subject her placid dog to a general anesthetic to determine if that may be the case. 

Equally, this dog may be placid because  he has hypothyroidism, or it may have dental disease because it is diabetic. But, I suspect if annual health screenings was even suggested to this owner, because of her pre-conceived ideas of "healthy", the vet would be accused of over-servicing.
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Failing to diagnose such conditions, or failing to recommend diagnostic tests has been argued in the courts to be negligence. Welcome to the veterinary version of Catch 22 - you're damned if you do, and you're damned if you don't!

There is a saying my old Prof used to say "you miss more for not looking, than not knowing"... and this statement I remember whenever I see another skin case, or another coughing dog, or the "aint doing well dog".  

If the opinion article which has sparked these musings is of any reflection of community sentiments (as it claims to be), then it appears vets will miss a lot of diagnoses.  Our pets will not receive the treatment they deserve, and we will be back to practicing veterinary medicine from the 1930's, where the lifespan of dogs was 7 years, but they had plaque scraped off in the consultation room. After all, in the view of this minority, to perform oral cavity assessments and treatments to 21st century standard,  is "scalping" the client.

If that is what the community wants, then, sadly,  veterinary work will be part of my "past experiences" rather than current vocation. No matter how much I love to read James Herriot, I certainly do not want to practice 1930's veterinary medicine.

At the end of the day, I am thankful that the original newspaper opinion which prompted this musings is just that, one persons opinion, and that, overall, it is the opinion of a noisy minority.

But minority's are able to inflict harm -we can say "sticks and stone may break my bones but words will never hurt me", but we know that public words and opinions do hurt - and it can kill -  as it did  Charlotte Dawson, and as it did  my colleague, Shirley Koshi in the US this past weekend. They never knew each other, or even of each other's existence, but both died on the same weekend, and both as a result of ongoing negative opinion and cyber bullying  which they had endured for years, until it became too much for both of them. 


It is with compassion and hope in my heart  when I say - enough is enough!   Let us start showing some kindness to each other, and trust that we are all working towards the same goal, which is the ultimate great health of the pet that is in front of us.

I am Dr Liz, the mad vet from Bellambi Lane. For Happy, healthy pets... always.

















Friday, February 21, 2014

Why this vet has Pet insurance for her dog!



This vet is putting her money where her mouth is.  When we picked up our beautiful little Piper from the RSPCA at Rouse Hill,  one of the first things we did  was

This is Piper in February 2014
set up the four week free Pet Insurance that is available through our vet hospital.  For more information on what we offer to all puppies and kittens less than 12 months of age, it's all here! 

And when we knew that was set up, we then finalised it with her proper long term  Pet Insurance Plan.

You might think this is strange, that a vet would insure her own dog, especially when she has a veterinary hospital, that is capable of performing a lot of procedures and treatments.  You might also think it a waste of my money, as I wouldn't be able to claim for a lot of the things, or unlikely to claim, simply because I could do virtually most of the things she could possibly need.

I know that we live 20 minutes from my vet hospital, and that Piper is likely to be travelling in and around Dapto and Shellharbour - which meant in an emergency, she may end up at one of my colleagues' veterinary hospitals.  I knew that they would (as they should) charge me for the optimal care that she deserves,  and they couldn't (as they shouldn't) allow an account, for me to pay when I could afford it.

The decision was made simply because I took my vet hat off, and looked at Piper as a beautiful puppy belonging to a loving family.  And with that, I wanted the absolute very very best for her if anything went wrong.

"Piper" (formerly Tammy), with Tegan and Paige at Rouse Hill
RSPCA
 
What if she needed an MRI?  A CT scan? Chemotherapy? What if she needed spinal surgery or eye surgery?  What if she needed lifesaving treatment that cost $5000 or $10 000 or even more?  Could I afford that?


There isn't a general practitioner vet in Wollongong that is a specialist in chemotherapy, or has an MRI or CT scanner in their back pocket! 

As a mother of four children, in a very small business, if I had to face this financial question,  the answer would have to be -- well, its not "no" but it would pose a huge financial strain on me and my family... and I would have to make a decision on the care of Piper based on money, not on what is best for her.

And as a vet, I hate that money can stop me from doing what needs to be done to help any pet, including my own.


My family faced that dilemma in 2009, when our beloved dog Teddy was diagnosed with lymphoma. (Teddy's story)

The irony of that situation was that I was going to start pet insurance policy on him when he turned 7, and a colleague (upon hearing of it), said to me "how stupid is that".  He was actually the speaker at this pet insurance seminar. 

Out of respect for his opinion, I didn't take out pet insurance for Teddy.  Less than two months later, our dog Teddy was diagnosed with Stage 3 B cell Lymphoma, and needed expensive chemotherapy and a specialist Oncologist for his treatment.  My other alternative was to euthenase him, or trial cortisone. Chemotherapy gave Teddy an extra 18 months. Cortisone would've given him an average of 6 weeks, and at the rate he was deteriorating, no treatment meant he would be pushing up daises quickly.

Pet insurance would've covered  him, and his entire treatment would've cost me only the excess, which was $125 per year plus any other non claimable expenses (such as his special food and special additives)


As it was, all added up, his chemotherapy at Sydney plus what we did when we could, cost upwards of $15 000, spread over 9 months.  He responded poorly to the medications, there were a lot of complications, and we were thankful that we had the best Oncologist looking after him - Teddy had a quality and a quantity of life that we would not have had otherwise. 

Doing what we did, and spending what we did  - we did not regret it.  But.... when he was no longer in remission, we had no more funds to fight his horrible cancer. We gave him the best life we could, and gave him dignity in the final months of his life.  We knew we made mistakes, and we learnt from them.  One of the mistakes was not having pet insurance for him. 

If we did have pet  insurance, then we would've had the funds to go through the second round of chemotherapy for him.

Now I hope that my pet insurance  for Piper ends up being a "waste of money" and I never need it.  My insurance for my house, my car and my family's health insurance is in the same camp, if that is the case. 

But for the same reason that I have house and car insurance,  if I ever do need it.... it is peace of mind.

If Piper ever gets sick, I don't want to tell my vet that  I can't afford the bill, even if that vet is me.

 If Piper needs specialist treatment, the specialist isn't going to say "Its Ok Liz, you can pay later!, nor do they say "it's free to you because I like you".  Maybe it is pride, but I could never ask someone to give me a loan, and I would certainly never ask a professional to give me one.

That is why this vet, Dr Liz, the mad vet of Bellambi Lane, has taken out pet insurance for her newest family pet, Piper, and why she puts money aside to cover for the rest of Piper's care, as well as the care for the rest of her pet family - our pet care is part of our family budget.
















Saturday, February 15, 2014

Dr Liz's Gratitude Project - My Healing Angel

The Gratitude Project is all about appreciating life.  In a veterinarians life we have to deal with all aspects of life -  birth, death, sickness and health. And unfortunately, we get to deal with this over and over, as our pets are never with us for long enough. 

Recently, a client thanked me for my gentleness and kindness with her beloved dog - I was the first vet in his 17 years that he would ever accept treats from, and who didn't muzzle him to examine him (he was very growly and cranky usually).

I thanked the owner for her kind words, but said it was all thanks to the Healing Angel by my side, who guides me in my daily work.

My Healing Angel watches over my waiting room (pictured below) and all of those who come in to Russell Vale Animal Clinic.



I am grateful for the Healing Angel, whose gentle presence helps all veterinarians, including me, in our daily endeavours with our animal brethren.