Every once in a while, a client walks right out the door (with Fluffy in tow) confidently proclaiming, “I’m sorry that I don’t have the money right now…but I promise to pay as soon as I can.”

And that’s when I kick myself for not demanding a deposit before having doled out my services indiscriminately (which 9 out of 10 times could have been delayed until the owner had the available funds to contribute to his pet’s cause). 

Unfortunately, for reasons of convenience, necessity or misplaced parsimony, owners sometimes fail to inform us, in advance, of their inability to foot their bills. And that’s just not fair. Because someone’s going to have to pay for what was done: drugs, supplies, rent, lights, phones, staff, health insurance, taxes, etc…(and most of the time I would have come up with a solution for them, anyway).

This past week, I’d mentioned an owner’s sly departure while we were busy with other patients. She’d been visiting her pet, a severely hypocalcemic new mom, who’d suffered a bout of severe tremors when her calcium was depleted by her bountiful litter of pups and their energetic suckling.

Now, this was a new client. (But she’d been referred to us by an old client.) So, against my better judgment (in keeping with my basic unwillingness to talk money while someone’s pet is trying to die), I restored this seizuring mom to normalcy and fed her six pups all day while her owner went off to work. 

When 5:30 rolled around, she was back. The techs showed her how to feed the pups, counseled her on how long to keep mom away and described the diet she’d require to prevent further calcium depletion. She also received a calcium supplement.

The next thing I know—she’s gone. What’s more, mom and the pups are nowhere to be found. So I did what most modern people do: I called her cell phone from my own (not the hospital’s number, of course). When she answered I asked where she might be and whether she was aware that she’d left without paying for the services we’d performed.

She acknowledged her failure to stop at the front desk but went so far as to say she’d informed me that she had a new job and had just moved to the area so she assumed I knew she couldn’t pay immediately. (That’s why you left out the back door without so much as a “by your leave”? That’s not what normal, considerate, forthright people do. That’s what guilty people do when they want to steal our services.)

When I informed her that she needed to come right back and pay, or give me a credit card number over the phone, she claimed to be very happy with my services (No ----, I just saved your dog’s life and spared you a day of pup feeding while you went to work.). She also claimed to have every intention of paying for the services she received. (Right—when you get back on your feet.)

Normally, I don’t get involved in these discussions. I keep out of it for all kinds of reasons. But this case was so blatant, so disrespectful and so annoying that I felt well justified in my directness.

Granted, if she’d showed up without any cash, I’d still be required by law to hand over her pet. And I would never have considered doing otherwise. However, the flagrancy of her misbehavior compelled me to address the situation personally:

Not only had she irresponsibly (and purposely) bred her dog, she’d done so at the exact time she’d be least likely to pay for any fallout from the breeding (while moving and changing jobs). Moreover, this woman was as clueless as they come on issues related to the health and safety of the mother and her pups. She’d brought this situation on herself and now she was getting around it by stepping on others.

Had I known she had no money, I would not have failed to treat her dog. I would have offered life-saving care and sent her on her way. I wouldn’t have been happy about the situation (in light of this owner’s immense stupidity), but it would have been a more just solution to the crisis. Instead, she racked up quite a bill (the estimate was known to her) with “best-care” options elected at every turn.

You may think this situation unusual. It isn’t—especially in a ER environment (or anytime we’re working with new clients). Unseemly though it may be for the ER staff to take your money before treatment is offered, it makes complete sense to me. On average, nine out of ten [unknown, emergency-only] clients will fail to repay if given the chance to pay on installments. The car payment, the dentist, the department store bill, whatever… They’ll always come first.

In these opening money discussions, I’ve heard owners say we’re just out for the money, that we don’t really care for our patients’ well being. If we were, we’d find a way to help their pets. Well, here’s some anecdotal evidence for you: every single client I’ve let walk out the door (within the last year) without paying fully has not yet paid me back. How can you keep your doors open with these permissive payment policies in place if clients have proven time and time again that, given half a chance, they won’t pay you back?

If I truly felt I was helping the destitute—that would be another story (and I do discount services for strays and under other special conditions). But often I find myself doing work for people like this woman. They are not truly disadvantaged—they’re just taking advantage of us. In these cases, the money is only incidental. What really hurts is to have your services considered so insignificant that they deserve no compensation.