I've been thinking a lot lately about money. It's not my fault, really -- I hate to think about money. I live my life reasonably frugally with only the occasional out-of-brain shoe-buying extravaganza. So most of my home financial management consists of peeking at my bills and accounts a couple times a month and (usually) breathing a sigh of relief: a little up, a little down, overall okay.
No, sadly, my reflections on money are inspired these days by clients at my workplace. It seems February is a tough month for people financially. (And probably also in other ways, but let's confine our discussion for the sake of [relative] brevity.) People are paying off Christmas. Here in the North, fuel bills are higher. Probably medical bills are higher, with seasonal flu and all. I guess if you have kids, there's probably "kid expenses" in there somewhere, too, that fluctuate with the time of year.
So it should come as no surprise -- but it does -- that lately our clinic has seen a steady stream of clients without sufficient funds to properly address their pets' care needs. Most of these folks are people we've never seen before -- as an ER clinic, that's not too unusual.
It is also sadly common that some of the pets that come to us are in critical condition and require a lot of work (and resources) to try to return them to good health. And, let's face it, folks, that costs money.
And, dunno why it matters, but I suppose I should take a moment to explain that I do not come "from money." I grew up lower middle class, at best. We weren't poor, but if our family had a car that would start in the morning, well, that was a good day. -- But when I asked my mom if I could get a puppy when I turned thirteen, I was told, "We can't afford it." We couldn't, and so that was that.
Unfortunately, not everyone out there thinks these things through as realistically as my parents did, and so I hear a lot of griping about money on my job. I have heard all of the following questions (and more), and here in the privacy of my own blog, are the answers I'd like to give:
Why does it cost so much money for (hospital care/surgery/medications)?
I don't own a practice, but I've worked in management long enough to know that there are layers and layers of cost behind most items.
Also, I own my own house. And car. So even though both of those items are paid off, I still have to pay property taxes, and utilities, and insurance. With a business, these expenses multiply exponentially: every employee needs to be covered by medical insurance and workman's comp; every product delivered has shipping fees; the printer and fax machine require toner and paper; all those phone lines need actual phones, and a service contract; the pills we send home are placed in a vial… with a label… that gets printed… by a computer….
The horse is dead now, right? I can stop beating it?
Also, there's education involved in what we do -- previously and ongoing. So if you bring your pet to me and my staff for evaluation, often it's because you don't know what's wrong with it or how to fix it. If you did, you probably just would do so at home, right? -- But we do. Or at the very least, we can quickly eliminate some of the theories you're entertaining, such as the idea that it was your dog's shampoo that caused its bone cancer. (Not unless you're using "Fructis, Now with more Uranium!" this month.)
Suffice it to say that training to become a doctor is expensive, and most of us graduate with six-figure debts. And many of us never achieve six-figure incomes. This is also true of technicians. All that training comes with a dollar figure. If you think you could do better, go get your own degree.
And if you want high-tech diagnostics (ultrasound, endoscopy, digital radiography), well, it should stand to reason the equipment itself gets pretty pricey pretty fast. Some things you can't do with just a head loupe and iris scissors.
Which leads nicely into the next question:
Why don't you just donate your services? Are you so heartless that you'd let my pet die over a few hundred bucks?
Let's say for a moment that I would do this. Let's face, I do do this, a little bit, for each patient, every day: I clean the ears, or clip a wound, or give a little extra pain medication without charging for it. Every veterinarian does. But let's say I was willing to perform your dog's C-section for free, because she'll die without it.
My question to you is: What gives me the right to give away the time, wages, resources, and efforts of all of the rest of the clinic staff (from receptionists to technicians to the other doctors who monitor the aftercare, to the office manager, and the kennel techs who clean up all that gross organic matter no one wants to think about….), as well as donating my own time? This would be like you going to your work place and telling everyone they were all going to work for free today and have to chip in $20 each to buy lunch because you decided not to charge a client or patron. Let's say you work with thirty other people -- how would that go over, do you think? What if you were one of those thirty other people? What if, every day, another person wanted to give it all away?
And then there's the ultimate question:
But I'm down on my luck -- have you no humanity or compassion?
Do you want my honest response to this question? Here it is: I think you're lying.
And even if I don't think you're lying outright, how am I supposed to determine the veracity, or worse, the deservedness of your claims?
I have no litmus paper I can press to your forehead which will magically divine your true nature. Maybe you are an upstanding citizen who had the misfortune to suffer an accident which requires your reliance on a disability paycheck, and this little dog is the only light in your day. Maybe you eat cat food every night just to be sure the dog also has enough to eat.
But maybe you're a millionaire oil executive who beat his wife and snorted all his millions up his nose, and now this is what you've become. Maybe your dog sleeps in a cold garage every night. How could I ever know such a thing?
I'll tell you one thing: it does little for my sympathies when I see that you and all the friends in your posse have iPhones and are wearing North Face jackets and Seven for All Mankind jeans, or that you drive a brand new Land Rover. Do you really think we don't see this?
-- I know, I know, none of this matters to the dog, who still needs help.
So then, here are my own questions, back to you:
Why are you more deserving than the other twenty people who are sitting in my lobby? Why should they have to pay their bills and you don't?
I had a little old lady (regular client of ours) bring her cat in one day, and, I confess, I felt a little bit sorry for her so I told her I wouldn't charge her for her recheck exam that day. She stopped me and said I had to charge her. I'm sure the look on my face expressed my surprise, and she said simply, "Things cost money." You could've knocked me over with a feather. But then, she was German, so I oughtn't have been too surprised.
But she's right. Things do cost money, as I detailed above. And if you don't realize that by now, then I'd be curious where you stole your clothing and vehicle and gas from, because I'm pretty sure there's no charity at most of those dealerships, either.
Furthermore, if you thought it through, the logic goes like this: If it costs $X to run a clinic per day, and that figure is divided fairly among 100 people, then each person will pay 1/100 of X. However, if half the people don't pay (and if you think you're the only person asking for charity today, you are very much out of touch with reality, my dear), then each person who does pay, will pay 1/50 of X. Capisce?
So, if you think paying $70 for an office visit is bad, imagine if it was $140. Or, if you aren't planning on paying us anyway, think of something you do pay for, like gas: How about if it was $10 a gallon instead of $5. Suddenly you aren't so sympathetic to those people who don't pay, right? I mean, they could just choose not to drive … if they can't afford it.
If none of your friends or family will lend you the money, then why should *I* trust you? (After all, they know you, and I just met you.)
I confess, one of my colleagues actually said this to a client once, and I've always wanted to use it myself. I mean, it makes sense, right? If your own circle of friends doesn't think you're good for the money, then why should I extend credit to you?
Why didn't you prepare for this day?
You are holding in your arms a living breathing thinking feeling organism, one which you claim to love "more than anything." Did you never stop to think something might happen to him someday, that illness or injury would befall them the way it befalls all of the rest of us who walk through this world? Whether it's a simple accident of slipping off an icy porch, or the onset of diabetes: shit happens. So you'd better prepare for it. And if you aren't prepared for it and are looking for someone to blame, here's a mirror.
…. because the bonus question is not a question, but a statement. For a select few of you:
This is your fault.
Whether it's the two-pound chihuahua bred to the ten-pound poodle on her first (juvenile) heat cycle who now needs a C-section because those puppies are just too damn big.
Or the morbidly obese Labrador who simply cannot recover from a torn knee ligament because there's too much weight for him to lift, and he's too big for you to manage yourself at home.
Or the designer Peek-a-poo puppy that you paid so much money for that you didn't have enough left over for a couple of vaccinations (nice rhinestone-studded collar, by the way).
-- Oh, yes. I've euthanized all these animals. And more. And because I am a compassionate person who has enough Life experience to understand that I may not understand the whole picture of your situation, and who am I to judge, I will stand on my tongue if I have to, so that I do not sermonize you as you stand there in your genuine grief with tears rolling down your face.
There are so many stories I want to tell, to spill them out of my heart onto the page, with the hope of purging my soul of the lingering pain I feel for these poor critters. Some of them are ten, fifteen, twenty years dead now. But they live on in my memories. And I barely knew them. And I wonder why they had to die.
For money? Money is just a part of reality. And you know that. So don't blame me.
