by Marcy LaHart, J.D.
By sheer coincidence, I had my twice yearly dental cleaning on Tuesday-the same day that I took my 12 year old cat to the vet to have his teeth cleaned. The bill for my cleaning was $115.00. Karma’s was $598.01. This is not really a fair comparison because, unlike me, who white knuckled it through the scraping and polishing, Karma had to be anesthetized. For Karma there was pre –surgery blood work, an electrocardiogram, cardiac monitoring, and pain control. And he had goopy ears-my vet determined the nature of the goop and cleaned them- as service that Vicki, my dental hygienist, did not undertake in regards to my own ears. And to be fair, Karma’s teeth were much worse than mine-I brush and floss-he refuses.
While many of my friends and family would be aghast that I shelled out almost $600.00 to have my cat’s teeth cleaned on the not so lucrative salary of a public interest lawyer, let me be clear that I do not begrudge the animal hospital a penny. Karma is a fine little pussy cat that has been a part of my life for a long time, I would not want any corners cut that would jeopardize his well being. But I find it incredibly hypocritical that when I am in the unenviable position of taking on a veterinarian for malpractice, which occurs far more often than I wish, the lawyers for those same veterinarians that collect $600 for a kitty dental, or $3,000 for a hip replacement will argue that “like it or not your honor, animals are property under the law and even if my client was negligent, poor Mrs. Jones is only entitled to the fair market value of Boots.” Vets charge like our pets are “members of the family” but when their own negligence causes their non-human patient’s death, they insist that your beloved companion should be valued like a sofa or toaster oven and that the grieving pet owner should be entitled to replacement value only.
Karma is a rather unremarkable looking solid black cat. Sadly, thousands of similarly unremarkable looking black cats await new homes in shelters nationwide. The average adoption fee for an adult neutered domestic shorthair cat is about $65.00. Obviously it would have been much more cost effective to replace Karma with a new cat than to have his teeth cleaned. But of course I did not even consider that option, because Karma is a unique individual with a personality of his own. There will never be another cat quite like Karma, a once feral kitten flushed out from under an abandoned house by my husky, and who now sleeps on my chest most nights. My emotional attachment to Karma motivates me to provide whatever veterinary care he needs at a price far in excess of his “fair market value.”
Veterinarian associations and their insurers are vehemently opposed to any legislation that would explicitly allow a pet owner to collect more than the fair market value of a negligently killed companion animal. When the topic is considered, they rhetorically spout a parade of future horribles that paralyzes even the most well intentioned and animal friendly of law makers. They claim malpractice premiums will soar, which of course vets must pass on to their clients, thereby pricing the average Joe right out of pet ownership. According to the veterinary medical associations’ lobbyists, vets will have to do all sorts of currently unneeded diagnostic tests just to cover their asses, and the courthouse steps will be clogged with greedy attorneys anxious to file frivolous suits on behalf of supposedly grieving pet owners. It will be the end of the world as we know it.
For a little reality in response to “the sky is gonna fall” scenario, I would point to the well measured work of a Harvard Law School graduate named Christopher Green, who has carefully scrutinized the veterinary community’s repeated assertion that valuing pets as more than a sofa will cause insurance premiums to “skyrocket.”
According to Green, while companion animal veterinarians’ average salaries have doubled in the last 10 years to a healthy $107,071 (putting them in the top 5% of U.S. wage earners), the majority still only pay a paltry $191 for their malpractice insurance! BY dividing this liability coverage cost among the average number of clients per veterinarian (1755 according to the AAHA), Green points out that each pet owning household is currently paying only 11¢ per year for their share of veterinary malpractice insurance ($191 annual premium ÷ 1755 clients per veterinarian = 11¢ per client). Even if a veterinarian purchases the maximum $1 million/$3 million coverage for a cost of $246, that still comes out to only 14¢ per client––mere pennies per pet owner each year. Notably, in flat dollars this level of malpractice insurance costs only $4 more than it did in 1989. Adjusting for inflation, Green concludes that veterinarians are actually paying 39% LESS for these malpractice policies than they were 19 years ago. This price decrease was verified by the country’s largest veterinary liability insurer the AVMA-PLIT.
Veterinary malpractice premiums are cheap because the handful of awards in veterinary malpractice cases have been nowhere near the available policy liability limits, and therefore insurance companies have little or no risk when issuing policies, no matter how incompetent their insured. The largest verdict in a veterinary malpractice case ever was $39,000; most are only a small fraction of that.
ABD Insurance and the California VMA calculated exactly how much they would have to increase veterinary liability premiums if emotional damages for companion animal loss were allowed, and capped at $25,000. The results published in DVM Magazine found that each veterinarian’s annual premiums would just about double, rising by $212. Dividing the predicted price increase by the average number of clients per veterinarian, each pet owner’s annual veterinary costs would increase by less than 13¢, going from less that 12¢ a year to almost a whole quarter a year. This 13¢ rise in the cost of annual veterinary care is hardly enough to price anyone out of pet ownership.
Unfortunately, regardless of the truth, groups like the FVMA and AVMA have powerful lobbyists that have made the “premiums will skyrocket” rhetoric their mantra, and our legislators fall for it hook line and sinker. Holding veterinarians accountable for their mistakes, not matter how egregious the circumstances, is as popular a notion as making nun-beating an Olympic event.
Veterinarians make their living only because of the emotional attachment that exists between a companion animal and his or her guardian. But for that bond, people would go get a new cat or dog rather than pay for a dental or a hip replacement or even an annual wellness exam with vaccines. Seems to me if you are going to make a living off that bond you’ve got a lot of damn nerve to turn around and trivialize it the moment something goes wrong.
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I don't like the last paragraph. I'm going to school in the fall to later become a vet tech-- not so I can feed off everyone's emotions. For one, it's a good field to be in because the pet industry will keep going and for two, because I'd rather work with animals then my current job.
Also, I've never heard of a dental cleaning being around $600. My dog's was less than $100.
ashleigh May 2nd, 2008 07:14:00 PM
Ashleigh - No offense but I can't get "MY" teeth cleaned for under a $100 and I don't need to be anesthetized. My female lab who weighs about 60lbs will be having her teeth done later this month and when you include pre-anesthetic blood work, IV therapy, monitoring etc ( all of which I believe are completely necessary) I fully expect to pay at least $400 and that is if she doesn't need any extra dental work done.
Elizabeth May 2nd, 2008 07:35:00 PM
I have no idea why my dogs' was so inexpensive, maybe it's the geographical location.
ashleigh May 2nd, 2008 07:48:00 PM
Wow, I'm going to stop complaining about the $250-$300 I pay for kitty teeth cleanings - including as you said, preop testing, anesthesia, cleaning, extractions, pain meds and antibiotics. If I didn't have dental insurance my last bill at my dentist would have been around $150.
2CatMom May 2nd, 2008 08:21:00 PM
Good looking cat in the picture,
Marcy LaHart May 2nd, 2008 10:13:00 PM
Ms. LaHart (and Dr. Khuly),
I am deeply grateful and certainly pleasantly surprised to see this post. Every word of it is spot on, and also thank you for quoting Green's amazing, ground-breaking paper.
Last summer, I testified in support of legislation that was proposed in my neighboring city, The District of Columbia, that would have permitted an owner to recover modest and limited (CAPPED) amounts of non-economic damages in VERY limited cases where PROVEN (in a court of law) veterinary negligence causes the DEATH of a pet (capped at $2,000 and ONLY recoverable when a pet dies; it would NOT have been recoverable in a case like what happened to my cat, who survived by was left drastically brain damaged by an insulin overdose, and the expenses his care cost me in the last two years of his life were approximately $16,000, mostly due to the brain damage). The legislation also would have allowed the recovery of a maximum of $7,500 in cases where a vet deliberately, maliciously kills an animal (NOT euthanasia -- for example, when a vet gets pissed off at a crying patient and beats him to death. Those rare, rare instances that happen a few times a decade, but stunningly, they do happen).
Needless to say, the owner of the city's largest animal hospital and a representative of the DCVMA fought this provision using all the very lame arguments you cite. The hospital owner said his insurance costs would go up and he'd have to pass it on to clients. They managed to lobby this out of the legislation.
I believe his concern about his client's wallets was entirely feigned, since I found a blog he runs online where he talked fondly about the "gravy train" vets enjoy in marked up prescriptions, bragging that he marked up Rx's 100% and added a $5.00 RX fee until the competition got so stiff he had to cut his markup in half. Sounds like a guy who is focused on INCREASING costs to his clients, not decreasing them. He has a product now, the stated goal of which is "marketing" and focuses on revenue generation. I've never read anything he has ever written on quality of care. In 2001 he was found to have 8 unlicensed vets practising at his hospital. The board found out about it but he was never fined nor disciplined in any way for it. Moreover -- as he admitted, he pays a few hundred a year for more than $1 million of coverage. What does he have to fear? Are his vets PROVABLY beating patients to death? If they aren't, the higher category of fines proposed in this law would never have affected him. Are they killing animals through negligence that will be proven in a court? Well, first of all those cases are rare because most clients won't bring them even when that happens, for emotional or financial reasons. But even if they do, we are only talking about $2,000 maximum recovery. If he can't absorb that every 5 years or so given his multi-millions in revenue a year (the most expensive and profitable hospital in DC) . . . then poor him. But he CAN afford it.
They just FIGHT ANY ACCOUNTABILITY whatsoever. And win, over and over. Calling our pets worthless because they were adopted from a shelter and telling us that our pet has "no market value." Well, my pets are all "worthless" rescues who have big market value, because of the money I put into vets pockets due to my love of them.
That large award you talk about - -- $39k in the Bluestone v. Bergstrom case? Well, according to press reports, it cost the Bluestone $300,000 to prosecute that case to closure.
When I reported the vet who left my cat with his untrained, unlicensed, unqualified son, who gave my cat a 10x overdose of insulin, the vet board fined him only $250. Something is wrong with that. And like most decisions, it is so measely that it has NO deterrent value, which is what I and other owners care the most about.
Good vets must stand up for quality. And hold bad vets accountable, not cast their lots with scoundrels and stand with them in arguing for un-accountability.
Many devoted owners pay more out of pocket for their pets health than they do for their own -- after all, most of us have insurance coverage, but not for our pets. Is it not JUST for us to be able to expect some kind of enforced QUALITY standards and accountability when things go wrong due to negligence? And am I crazy to expect that the GOOD vets should step forward and stand up for that very thing?
It's going to get harder for vets to do this thing you describe -- make money off the love we have for our pets, and then call them worthless property when their malpratice kills or injures them. NOT because the law is catching up -- it's not, the vet anti-pet lobby is as strong as ever. BUT because there is a growing national coalition of us consumers out here who are making lots of noise now and are going to get noisier, smarter, and reach more fellow consumers on this issue until things change and we see that we can hang it up because the vets themselves have actually decided to stand up for accountability and quality, rather than fight it.
Accountability DOESN'T involve devaluing the life lost due to your actions.
Stefani May 2nd, 2008 10:34:00 PM
Excellent guest blog Attorney LaHart!
This has been my pet-lovers/owners mantra, in part, for the last 18+ months, to raise public awareness of the dual-sided advantage of the veterinarian in providing medical care!!
Fortunately at least 7 states have recognized this issue and are proposing legislation to change the "non-economic damages" to represent the unique emotional attachment people have for their pets. Colorado has a great statute proposed that I posted in part on a previous blog-- that addresses deliberate and/or negligence on the part of the veterinarian.
My own experience is a classic and "perfect" example or a pre-planned, horrific, end-of-life veterinary SCAM with an elderly dog and her emotional, grieving "weakened" owner/long standing client. Client places trust and follows instructions of 'new veterinarian' employed at Edgefield VH of Hampstead, NH to go to "particular" referral clinic "Dover Veterinary Hospital, Dover, NH. Owner is deceived into prolonging dog's hopeless situation for an entire week (unbeknownst---for the benefit of vet tech students of Great Bay Community College of Stratham --formerly NHTCC) headed by Peg MacGregor, DVM , while John MacGregor, DVM,DACVIM takes on responsibility of Scottie "Pocket's" case. To top it off, other clinic employed Cathy Gajewski, DVM breaks euthanasia state statute and controlled substance act of NH , (because clinic is unlicensed for DEA schedule 11 drugs) and administers potassium chloride to 'euthanize' pet in front of owner (me).
Client now owes bill just shy of $3000, has paid $2400, and approximately $700 to original scammer clinic. What was Pocket worth? To me, she was priceless. In legal terms, she was "depreciated" to 0$ . What is the price I pay to live with the sight, feeling, and knowledge that my dog was cruelly used, tortured, and murdered, while I helplessly did nothing? What is the price of the torment and guilt I carry? What is the price of knowing that the little Pomeranian that was "euthanized" on Sunday (owners not present) was also brutally tortured? What is the price to know that Dover Veterinary Hospital has broken the law for years and NO ONE CARES??
So, I can hire an attorney, if one can be found, to recapture $2400--- BIG DEAL!! It would be worth more to do it (to me)---simply to put an end to this cruel abuse.
Where are the good, ethical veterinarian voices, the humane society members, the legislators, the NH Board of VM, the Attorney General's Office, the media, in this wonderful state of New Hampshire, that has been my home since 1st grade??? DEAD SILENT-- You can only imagine the wide circle of SCAM and deception.
It has changed my life forever. For any new reader's ---details "Pocket's Story from NH"
http://walnut-hill.bravehost.com
Barbara A. Albright/New Hampshire May 2nd, 2008 10:47:00 PM
Dr. Bernie Rollins challenged us to address this discrepancy in vet med when he spoke to the MVMA this February. It's ridiculous that pets are defined sometimes as family, sometimes as property, depending on which is financially convenient. We can't have it both ways.
Megan May 3rd, 2008 12:08:00 AM
Ooooh sorry! I forgot to make sure everyone knew that was Karma in the picture.
Dr. Patty Khuly May 3rd, 2008 08:26:00 AM
I'd really be interested to see a source that shows average salary for a companion veterinarian is over $100K.
Michelle Schwab May 3rd, 2008 02:05:00 PM
When one posts in haste, no doubt booboos are made. My apologies and correction that Peg MacGregor is a VMD, a "Bellweather" receiving Penn. graduate.
And not to mislead the readers, that I might consider $3000 a paltry sum,far from it; it represents MANY weeks of my "net" pay and certainly a more than adequate sum that "should" have guaranteed a peaceful and humane death of my Pocket.
It is a paltry sum to sell one's integrity for, and in taking in the big picture---hardly a sum to fight for recovery for the tremendous harm inflicted to my pet and to myself and family.My deepest hope is that this cruel, unethical, inexcusable veterinary behavior will permanently end.
Barbara A. Albright/New Hampshire May 3rd, 2008 05:58:00 PM
Attorney LaHart & Dr. Khuly,
I did forget to ask a few legitimate questions regarding veterinary malpractice insurance policy. Are there any typical "exclusions" or situations not covered?? Would simple fraud and violation of state and federal laws allow insurance payment to either legal representation of the insured or payment of a possible judgment??
How would a liason with a state-sponsored OR private college affect a malpractice insurance policy?
Do licensed vet techs carry insurance also, or is there an umbrella policy by the clinic or veterinarian?
Barbara A. Albright/New Hampshire May 4th, 2008 12:43:00 PM
Hello,
My cat was killed I believe due to negligence at a veterinary emergency speciliast. He had fluid taken from his abdomen. She stated she had nicked his spleen during the procedure and had put a bandage on to stop bleeding. He went into to trauma on the way home, he was literally dying and had to be euthanized at my own vet who was around the corner.
I'm not sure if I can make a complaint at a Veterinary Medical board for medical negligence. Does anyone have any idea what avenues I can pursue to make a complaint other than with a state licensing board, which I also plan to do?
I don't wish to pursue a legal action or lawsuit. But I want to make sure a complaint or complaints is made against this Veterinarian and the hospital.
Thank You for any help/advice.
El May 14th, 2008 09:20:00 PM
El,
Re: your options for pursuing a complaint against a vet.
The most appropriate audience for your complaint is the veterinary board. If I were you, I would emphasize the fact that the vet released your cat when he clearly was not yet stable, and knowing something had gone wrong during the surgery. Based on your account, it sounds like continued monitoring was called for, not release. Without more info, I can't say for sure, but I can tell you that many vet boards have disciplined vets for releasing animals too soon after surgery when they needed monitoring due to special circumstances.
The veterinary medical board is basically the same thing as the state licensing authority. If you need more info about getting in touch with your specific state board, you can contact me via the website that links to my name on this post. Info on how to get in touch with me can be found there.
Stefani May 16th, 2008 12:18:00 PM
having 8 feline "children", birds and rats...i have spent many hours and dollars for their care...which they absolutely deserve!!!
My oldest kitty, Millie, is 20! She has been in the care of the same vet for half of her life. She has had some somewhat serious issues as of late and i am in a tight financial depression right now, as most of us are...
i had called my vet to see if they could see her and bill me...i was told that the dr's would call me to discuss financial arrangements...STILL WAITING!!!! 7 days later!!!!
i have paid thousands and thousands of dollars to them...for over 12 years...
They Care????
They did some dental work on her last year...cleaning and treating an abcessed tooth...i was later told that due to her extremely aggressive behavior she had received "numerous" sedative injections...no wonder she could hardly walk for 3 days!!!!!!!! i don't remember what they charged me!! i had to pay for the injections because they had issues with her behavior???!?!?!?
i don't normally add my stories to these computer forums...i am just so frustrated and disillusioned with the veterinary field right now!
i have many more stories to express....i will leave it at that!
vickie June 13th, 2008 12:24:00 AM
I really would like to know where you get the figure of $100K as the average small animal vet salary. I'm a small animal vet, work insane hours, and make a FRACTION of that. I also pay almost $400 for my malpractice insurance, a big chunk of money for me! It is nice to hear people being ok with the cost of a dental. As an emergency vet, I have had countless people scream at me when I present them with estimates for their critically ill animals. I think people forget how much health insurance covers for their medical issues. We use the same products as human hospitals and charge a fraction of the price.
Courtney Brown June 18th, 2008 08:11:00 PM
As a vet, you probably read the DVM magazine. Vets net according to this magazine $1M!!!!!
Fotini June 22nd, 2008 04:24:00 PM
As a practicing small animal veterinarian I have to say that I believe the life of any animal is priceless--that is why I am in this PROFESSION (not this business). I always make every effort to make sure that pet owners are given all of their options when deciding on a course of treatment for their pet whether it is vaccines or surgery. The pet owner then authorizes diagnostics/treatment.
I have to say this is when the owner tells us how much the pet is worth to them. On a daily basis I hear 'it's not the money doc we love Sparky to death, but...." And then the owner declines much needed diagnostics or even treatment. Of course I am not talking about obvious cases of negligence or malpractice on the part of the vet, but the same person who declines tests or treatment is the same person who will sue because you did not diagnose or save their pet. In animal medicine we have to get consent from the owner for EVERYTHING we do. The owner can decline any number of tests, usually citing financial reasons, and then if the pet should die it is suddenly priceless. You can't have it both ways. If the pet was not treated as priceless in life, the owner should not be allowed to claim that it was when it is dead.
And BTW $100K salary is only enjoyed by vets working in larger urban areas and/or working for a corporation--there are plenty of rural vets 'in the trenches' that would think they died and went to heaven if they made that much money.
tlove September 24th, 2008 04:03:00 PM
yo this is very helpful wen trying to become a vet
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Hello to evryone who is using this info. My teacher assigned us a job and i got lucky had to talk about vets they are wonderful people who care about animals wich are very important to our enviroment. Well. thanks to vets who have the time to take care of our pets who very dearly we love.
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vets suck
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cynthiachen December 23rd, 2009 09:12:04 PM
Maybe we should start holding attorney's accountable. We'll start with that article of yours. You should study what is happening in human medicine before you start typing. Lets ask a few questions to our genuis attorney.
How much does it costs for a Veterinarian to go to school?
How much does it cost a Veterinarian to run a practice.....pay staff, pay for equipment, real estate, utilities, pharmaceuticals ect?
How much are Veterinary expenses and salary compared to what your Human Dr. and Hospitals get paid?
Lets take an example of that last question...shall we?
Your dog comes to the veterinarian because it swallowed a toy. "It" needs bloodword, x-rays, fluids, surgery, hospitilization, anitibiotics, pain medication etc................$2500
You go to the hospital and have your "appendix out"..........$20,000 (approx)
So as Veterinarians we are supposed to charge less why? We go to the same amount of schooling and our "profit" margins are way less. As a Veterianrian who believes in accountability and high quality medicine. I have to "compete" with low cost vaccine clinics, low cost veterinary hospitals and clients that ask how much on the phone to my staff. They never ask about my credentials or experience. Then, you want the proffession to be accountable as companions versus property. I agree with you on thatone! I think we should also charge as if they are irreplaceble companions as well. Its about time I get paid properly for my time and knowledge like our MD counterparts. Lastly, your personal dental cleaning example is a poor comparison. What about what your dentist gets paid for dental films, root canals, fillings, and surgery?. Most dentists work less hours and make more money than Veterinarians. Their patients also don't have owners that decline treatment and fight over cost. I'll recite a quote I was told from one your collegues "Veterinary medicine is an untapped field for litigation". I'm sure there was no monetary implication to that quote! We must then ask what most of your collegues get per hour on average (excluding pro-bono feel good attorneys) $175/hr?
Dr. House December 29th, 2009 01:15:21 PM
As a practicing small animal veterinarian I have to say that I believe the life of any animal is priceless--that is why I am in this PROFESSION (not this business). I always make every effort to make sure that pet owners are given all of their options when deciding on a course of treatment for their pet whether it is vaccines or surgery. The pet owner then authorizes diagnostics/treatment. I have to say this is when the owner tells us how much the pet is worth to them. On a daily basis I hear 'it's not the money doc we love Sparky to death, but...." And then the owner declines much needed diagnostics or even treatment. Of course I am not talking about obvious cases of negligence or malpractice on the part of the vet, but the same person who declines tests or treatment is the same person who will sue because you did not diagnose or save their pet. In animal medicine we have to get consent from the owner for EVERYTHING we do. The owner can decline any number of tests, usually citing financial reasons, and then if the pet should die it is suddenly priceless. You can't have it both ways. If the pet was not treated as priceless in life, the owner should not be allowed to claim that it was when it is dead.And BTW $100K salary is only enjoyed by vets working in larger urban areas and/or working for a corporation--there are plenty of rural vets 'in the trenches' that would think they died and went to heaven if they made that much money
I agree with this vet and Dr. House
What an idiotic article.
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House, et al
You cite the high costs of human medicine and ask why the heck vets shouldn't be able to charge as much?
You are aware that the high cost of human medicine is largely to support a gargantuan infrastructure that has built up around it -- and while surgeons make a GREAT DEAL of money, it pales in comparison to the aggregate amounts that are paid out for the procedures they perform.
Humans have health insurance. This is part of the inneffecient megalith middleman that is driving up costs. Yet the one thing it does is allow us to pay for our procedures.
Each of the last 6 years I have spent more on my pets' medical care than on my own non-elective medical care. This is because it comes out of my pocket.
If humans had to pay the $20k for the surgery out of pocket, there were be a lot of dead humans.
That's one of the reasons why you can't charge as much.
Another reason is that you are living in a dream world if you think for a minute that as a whole (with exceptions notwithstanding) your profession is practising at the same level as medical doctors. You are freakin dreaming.
You are also dreaming if you think you are held to any kind of standards, at all, other than those dictated by your conscience.
If pet people could purchase the SAME KIND of insurance coverage for their pets as they do for themselves, at comparable costs, many would. This is nowhere NEAR existing.
Also, if you have any inkling of things heading in that direction, you'd best sign up for the SAME kind of accountability as medical doctors -- and liability.
As for tlove and "you can't have it both ways," this is a dramatically hypocritical statement. Yours is the profession that banks (literally) on our love of our pets and turns around and cries "worthless property" when its members are called to account for negligence, substandard practice that lead to deaths and injuries.
I don't envy the fact that you deal with owners who aren't committed to doing the best they can for their pets, and I know that you do deal with this. My sympathies lie with you on that score.
However, those of us who do make it possible for you to do what y ou went to school for, and YES, we have expectations.
Competence, honesty, staying up to date, informed consent, conscientious staffing and business practices. When you kill our friends because you don't honor the trust we have placed in you and then cry "worthless" what do you expect?
Stefani December 30th, 2009 10:50:40 AM
What a brilliant and rationale article. Bravo, Marcy LaHart!
Stefani December 30th, 2009 10:53:29 AM
Stefani, I think the issue of owners refusing diagnostics and then suing is to muddy the waters, a thinly veiled attempt to shift the blame. The argument around veterinary accountability, non-economic damages, and the value of our pets' lives is clearly focused on cases of clear, documentable negligence or incompetence. No one in his right mind (no judge or any other arbitrating party in his right mind) would ever award damages, be they economic or not, to a pet owner refusing relevant or necessary diagnostics or treatment. Such owners exist, as we all know, shame on them! They do, I imagine, make lives difficult for their vets. The article and the argument are not about that. They are about the conundrum of benefiting from our bond with our pets as something certainly greater than mere property, and then hiding behind the "mere property" shame of excuse when our pets are harmed or killed. What's worse is that this incongruence results, as you say, in a lack of standards, thinner (to non-existent) margin of safety, cost cutting (read poorly trained support staff, among other things), and the general lack of incentive to making error avoidance a priority. Those gearing up to call us vet bashers, wait one second: I am not suggesting that there are no vets, who are intrinsically ethical and set high standards because of their inner ethics. They absolutely exist. My current vet practice seems to be that way, knock on wood. But those vets, who are motivated by stick and carrot only need just that: a good stick (adequatedisciplinary actions for documentable errors) and a juicy carrot (clean reputation due to higher standards and the resulting income).
I have had two pets severely harmed by vets, who failed to perform the necessary diagnostics, despite my desperate pleas to do all that was needed to get to the root of their distress. Both vets tuned into real...uh "charmers" when I demanded explanations for the missed diagnoses. One received a letter of advice from the State Board and the other, a letter of censure (both could have been avoided had they been honest and committed to improvement). To those of you wondering what to do when your pet has been harmed, as Stefani, I believe it is critical to file with the State board/licensing agency, however inadequate its action might turn out in the end. The other effective venue is becoming vocal: online reviews, your own web site, the press, you name it. These bad vets loathe the Internet. The First Amendment is their worst nightmare. The anti-SLAPP legislation drives them insane. You have to be absolutely truthful in your accounts and state the facts, with all the relevant documentation. Find out from a web site or a lawyer what you may and may not publish (your letters to the Board are fine, but not the vet's, for example), what is and what isn't a matter of public record. You will greatly make up for what's lacking as far as meaningful recourse from the "authorities" by simply truthfully telling your story.
Natalie Kramer http://cpahclientsbeware.blogspot.com
Natalie Kramer December 30th, 2009 02:38:56 PM
@ Dr. House
Highly recommended!!! Companion animal guardians are getting smarter and smarter every day. We live in a cyber space world, after all--don't you agree?
http://www.isaronline.org/f/Harming_Companion_Animals_Monograph.pdf
Fotini December 30th, 2009 03:15:33 PM
Another reason is that you are living in a dream world if you think for a minute that as a whole (with exceptions notwithstanding) your profession is practising at the same level as medical doctors.
Veterinary medicine is only as limited by what owners are willing to spend for their "companions". Here is an example of high quality Veterinary medicine. In addition every University Veterinary Hospital practices on the same level......
http://www.nyc-vs.com/
http://www.floridaveterinaryspecialists.com/
Almost any diagnostic test that can be performed on "you" can be performed on your "companion". The gap between human medicine and Veterinary medicine is quite narrow. You local Veterinarian is equivilant to your GP. Your local Vet. doesn't have MRI and neither does your GP.Then again your GP can't do abdominal surgery. Your local Veterinarian can. We are responsible to know more information, and in several different species. I have actually spoken to Human physicians about my profession and that is statement is one they agree with. I admit there is a gap between Veterinary and Human medicine. The gap is alot narrower than what you allude it to be in your poor excuse for a post. You'd be more fun to argue with if you actually knew what you were talking about.
You are freakin dreaming.You are also dreaming if you think you are held to any kind of standards, at all, other than those dictated by your conscience.
Too bad you have no "conscience" when it comes to making posts that inacurate and poorly written. The internet community would be better off. Who knows what other dribble you have posted elsewhere that lacks any real merrit.
Dr. House December 30th, 2009 06:49:41 PM
Dr. House, on your example of surgery: human GPs do not perform surgeries. Surgeons do. Is there any doubt in your mind that a regular neighborhood veterinarian has less training in surgery than a human surgeon does? There are Board certified veterinary surgeons, soft tissue and others, as far as I know, and they have more training in surgery, but regular "GP" vets don't have as much as either human surgeons or veterinarians specializing in surgery. Same for anesthesiologists or radiologists. I don't know the figures, but just from the anecdotal evidence I have been privy to, rate of complications with spays in dogs and cats (due to purely surgical errors as well as anesthetic problems) is significantly higher than with human hysterectomies. This may also be due to cost constraints on veterinarians and other factors, but it also seems logical that this difference in complication rates would be due to less time spent in training for veterinarians. It's true that veterinarians need to know more about more species, as you say than human GPs, so they are in fact forced to learn more in a shorter time than human MDs. What is the result of this? Do veterinarians attain the same level of competence and expertise as human doctors in all of those areas? I think it's a possibility that at least some errors in veterinary medicine are the result of a broader area of expertise, acquired over a shorter time.
Natalie Kramer December 31st, 2009 01:02:17 AM
House, it is hysterical that you attack my writing when yours is full of grammatical errors, incorrect punctuation, and missing words.
LOL.
You are obviously a sociopath with narcissistic personality disorder to boot -- hence, your chosen pen name, "House." If you THINK like "House" and act like "House" and fancy yourself as brilliant as that fictional character, heaven help your patients and clients.
Stefani December 31st, 2009 04:33:27 PM
Natalie I see your point of view. But, I did not claim that GP Veterinariana were all knowing or more knowledgeable than a Veterinary specialist or Medical Specialist. However,a HumanGP doesn't read the majority of the radiographs they take, do anethesia or perfom any surgery.Your logical "assumption"that because Veterinarians are responsible for more information they have more complications than Human MDs is incorrect. Its simply not true.Complocations happen toALL doctors.However, Idiot Veterinarians and Idiot Human physcians have more complications than anyone else.Whichis why I agree there should be accountability in Veterinary Medicine.
Stefani, I am impressed that from two posts and the fact that I use House as a pen name you can label me as Sociopath. Nevertheless, I will sleep well tonight because your "diagnosis" is as incorrect as most of the dribble you post here. I posted the definition for your reference. Both my patients and clients are in good hands because like the show my pen name is only fictional. Thats why its a PEN NAME. Only an idiot like yourself would think that a proffesional would pattern themselves after a TV show. Which would be hard since I started practicing about 5 years before the show started. Since your typed the words "fancy myself" it demonstrates you were not born in the United States. I can only hope you haven't moved to this country and I will never have the "pleasure" of running into you.
S: (n) sociopath, psychopath (someone with a sociopathic personality; a person with an antisocial personality disorder (`psychopath' was once widely used but has now been superseded by `sociopath'))
PS. Feel free to print my posts and circle any errors with a red pen. Then attribute the grade you think they deserve. Fourtunately, It won't affect me as my academic career has ended. It may beneficial for you for some kind of therapy or if you "fancy yourself" an english teacher.
Dr. House December 31st, 2009 06:52:16 PM
Dr. House, my assumption is not that a higher scope of responsibilities results in a higher rate of error. My assumption is that less time spent on in training on each area within the scope would result in shallower knowledge and, potentially, a greater rate of error. You say that human GP do not read the majority of radiographs they take, and I assume that you meant that regular veterinarians do. That's just the problem. My cat's cardiomegally and increased pulmonary interstitial pattern was missed on an X-ray by a regular vet. Is he an idiot vet (according to your expression), or was his training in radiology a little too cursory, given the greater scope of other areas he had to "cover" in less time than an human MD? In other words, other things being equal (individual propencity to be an idiot, for example, which is probably about the same among both types of professionalsis) is decreased specialization for vets as compared with human MDs responsible for at least some fraction of errors in veterinary medicine? I believe it is a reasonable assumption. My cat's missed cardiomegally had a tragic ending, by the way.
Natalie Kramer December 31st, 2009 10:00:12 PM
Dr. House, I reread some of the posts, and it does seem to me that your attacks on Marcy LaHart and Stefani (calling them "geniuses" and other names) are uncalled for. If we are to have to have a civilized discussion, it should be kept civilized on all sides. I, for one, agree with Ms. LaHart's article and find no reason to call her names, even if your perspective causes you to disagree with her. Stefani's writing is not "dribble" as you suggest. It is an expression of frustration, anger, grief, and helplessness at the world, where pets have all the value of unique family members until they are harmed, at which point they become "mere property" for the convenience of veterinarians. You probably have not walked in our shoes, as victims of veterinary incompetence, whose pets' lives were cut short as a result of errors or negligence or vets cutting corners to reduce their costs. You seem to understand the importance of accountability in the veterinary profession, yet I have not seen you suggest any specific measures for achieving greater accountability. Ms. LaHart, at least, points to the causes of the lack of such accountability. You seem to be doing more along the lines of attacking people you disagree with or those who show anger and frustration at the problem. It would be more constructive to ponder specific measures to increase veterinary accountability and improve pets' safety.
Natalie Kramer December 31st, 2009 10:43:45 PM
Thanks, Nat.
They just live to hurt human clients, apparently, delve into the realm of the internet to continue it. Speaks volumes. No wonder they wish to remain anonymous.
Expat 006 January 1st, 2010 12:06:02 PM
Expat, it does speak volumes, sadly. A practicing vet not posting under his real name? Hmmm. Something to hide from the clients? I guess not all the "true" views are good for marketing. Sad.
Natalie Kramer January 1st, 2010 02:42:32 PM
wow the people posting here are clueless. It is amazing how you can attack dr house for his quotes but strefani accuses him of being a sociapath is okay. My brother is a veterinarian and he went into the profession because of his love of animals. Unfortunately people are more concerned with suing them, then health of their animals.
kim January 1st, 2010 06:05:44 PM
They just live to hurt human clients, apparently, delve into the realm of the internet to continue it. Speaks volumes.
Thats it! You have the whole Veterinary profession figured out. We spend years in school to carry out our sadistic fantasies to toture our clients. The Veterinary Medicine "thing" is just a cover. Our plan was working great until you exposed our cherade. Apparently I was too late to get to you because judging by your last post you have enough issues to last for quite a while.
No wonder they wish to remain anonymous.
EX-PAT 006 are the anonymous poster formerly known as Pat? I am glad you have a numerical desingation, as not to confuse you with EXPAT 001-005.
Dr.John Lewis January 1st, 2010 06:22:32 PM
Natalie
I am sorry for the loss of your cat. Cardiac disease in cats is extremely difficult to diagnose. An increased interstial pattern can indicate many "things" not just cardiac disease. One of the most common in cats being feline asthma. So that example doesn't serve as a measure of your Veterinarian's diagnostic capabilities. Infact, even a Veterinary cardiologist often needs to rely on a echocardiogram (or ultrasound of the heart) to diagnose and classify heart disease in a cat. If cardiac disease is ever suspected in cat than that test should beperformedas well as ablood pressure reading. In addition in our practice if we are unsure of our radiographic findings or require a second opinion we send them out to a veterinary radiologist. Again with cardiac disease in cats often a radiologist will advise echocardiogram if cardiac disease is suspected. Having said that cardiac disease can be a silent killer in cats even more so than in "humans". Unfourtunately enough, "Humans" die all the time from conditions that escape simple diagnostic tests. Finding examples in Veterinary medicine and claiming "it would never happen" in human medicine is simply not true.
http://www.annals.org/content/145/7/I-12.full
This is why in Veterinary University and and in Human hospitals M&M rounds are done.
MORBIDITY AND MORTALITY ROUNDSThe principal reason to conduct M&M rounds is: To review an individual patient's poor outcome in detail with all members of the treating team and in this way try to determine what led to the poor outcome and discuss ways to prevent a similar event from happening again.
Dr. House January 1st, 2010 06:46:32 PM
Dr. House, the patterns my cat showed on the X-ray were simply ignored: for three weeks, no referrals to a cardiologist, no meds, no further tests. In the meantime, my cat wasted away and suffered, not eating, sitting up all night and gurgling upon breathing at times. His CHF was identified by four other veterinarians on the same (original) X-ray. One was a 27 year old GP on an overninght shift at the ER; the other an internist; the third, a cardiologist, and finally, a radiologist. The cardiac enlargement was termed "severe" by these other vets, and the heart displaced the trachea pushing it up against the spine. Plus, there was significant fluid accumulation. My cat was known to be at least 16 years old. In the three weeks that Smokey went with no treatment, the condition progressed to what looked like pericardial effussion (according to the second set of X-rays taken at the ER). The vet received a formal letter of censure from the vet board and attended classes at the regional level to "improve his ability to read radiographs and ultrasounds." I believe there is enough evidence that my ex-veterinarian's diagnostic capabilities left a lot to be desired, and apparently, the vet board agreed with me, at least in part. Could the same diagnostic "capabilities" be found in a human GP? Anything is possible, but I think it would be unlikely, and if it happened, this human GP would probably receive more than a letter of censure. Thank you for your expressions of regret, by the way.
Natalie Kramer January 2nd, 2010 01:01:18 AM
If the radiographs were that severe than your first Veterinarian deserves no defense. Your are the exception. I'll explain further what I mean; in most cases in my area people will complain about high quality medicine, expensive daignostic tests, a complicated diagnosis and then seek out a low budget, incompetent Veterinarian. They will offer a wrong simple diagnosis a cheap "shot" (injection of vit b 12 or steroids) charge $75 and the client will think they are great. If the pet later dies its because it was meant to be and "good ole Dr. Johnson" was so nice. I wish more people were like you and seeked the right answer, and what was best for the pet. Low budget, incompetent Veterinirians should be held accountabe. I will make the obvious disclaimer that if both client and Dr. are aware of the issues and have discussed it and for economic reasons have chose plan "B" thats acceptable. I am talking about incompentance, and people hearing what they want to hear because its cheaper. I do think there are more competent Veterinarians than incompetant ones and the way that they practice medicine should be obvious to even the lay person. Asking a lot of questions, performing a thorough exam, spending time explaining finidings, and answering questions is a good first sign. Usually "Doc Johnson" flies in and out of the exam room to sell his magic "snake oil"; Vitamin B12, steroids or Penicillin. In my area the latter Veterinarian is the one who is more popular and has zero accountability.
Dr. House January 2nd, 2010 10:24:36 AM
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angel January 28th, 2010 03:50:14 AM
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