What the health care industry can learn from veterinarians

The Thinker by Rodin

In my last entry, I discussed feline wisdom. Cats have been on my mind lately and not just because my special feline is clearly in his decline. However, because of my elderly kitty’s problems I have seen a lot more of my veterinarian. I find in many ways that I envy my cat’s health care plan.

My cat does not have a plan, of course. His “plan” is to visit the Animal Medical Center in Herndon, Virginia as needed. I pay out of pocket for services rendered. Nor am I necessarily anxious to give up my wonderful physician. Still, when I contemplate the Rube Goldberg invention that is our current health care system I have to wonder why we let it get so complex, expensive and impersonal. It should work more like a trip to my local vet.

Last week I swung by the vet to pick up more prescription-diet cat food for my beloved and elderly cat Sprite. The vet techs behind the counter nearly know me by name now. “Oh yes, how is Sprite doing? Is the prednisone working?” Yes, I reported. He is drinking a lot more water and seems more his normal self. That day the vet happened to be standing at the front counter working on a chart when I arrived. If I had been a physician’s office, I would not expect to even glimpse a doctor until after I had been ushered into the examination room. So naturally, I assumed that the vet was not listening to my kitty problems. Yet she tuned in the whole conversation about how the medications were working out and my feline’s current bowel habits as she worked the chart, and spoke up. She was glad to hear that the medication was working. She suggested staying with the wet cat food because it was moister.

If this conversation had occurred at all in most doctors’ offices, the informal chat would turn into a consultation. My insurance company would be billed and I would be writing a check for a co-payment. However, at my vet’s office such advice comes at no extra charge.

Formal examinations of course come with fees attached. Nevertheless, calls to the vet to discuss a particular situation or to ask advice on a topic are invariably assessed at no charge. If they think the problem is serious enough then they will tell us to bring Sprite in. An examination usually costs us $35-$50, plus medications. If pills need to be cut, they are glad to cut them for us at no additional charge.

Unlike most doctors’ offices, where you are sent to read dated issues of magazines for an indeterminate time, generally our pet sees the veterinarian in within minutes of the arrival. For our amusement the office comes complete with a few roaming “office” cats. You can often find them sitting on a counter, or perched on top of a computer monitor. They generally do not mind being petted by strangers. If we have to wait, there is usually another friendly pet owner with whom to trade pet stories.

Everyone at our vet’s office is glad to see both our pets and us. The feeling of warmth for the animals is palpable. I do not know how your experience is at your doctor’s office. However, feelings of genuine concern for my malady of the moment are not typically what we experience. The crew behind the counter is, however, quite concerned about whether my insurance has changed since my last visit.

I am sure that there are many veterinarian specialists out there, but for the most part our vet’s office is a one-stop shop. They do pretty much everything, including making sure our cat’s nails are trimmed and that he is on the proper diet. Unlike many physicians’ offices that I have visited over the years, they are not anxious to order an expensive test or even prescribe medication. They stick with treating the most likely conditions first, and then work from there as necessary. If the animal is really sick, they can also keep it under observation. Of course, they can also board the animal if needed. Clearly, you will not get any of these services from your physician. They do not exist. Even if you can hardly move, you are most likely to just get a prescription and be sent home to convalesce.

Most of us probably would not want their doctor to cuddle or stroke us like we do with our pets. Yet wouldn’t it be nice when the situation warranted if your doctor gave you a hug, or gently squeezed your hand, or really empathized when you seemed to need it? Instead, your physician is more likely figuring out how to wrap up the conversation so they can get to the next patient. You may get some empathy from the nurse that takes your vitals. Generally, physicians will divorce your physical problems from your mental ones. A general practitioner will point you to a competent therapist, but most will not going to spend more than a couple minutes listening to your situational problems.

Although our pets might disagree if they could talk, most veterinary clinics feel inviting. This is not usually true of physicians’ offices. Instead, you wait until you are called and maybe listen to some bad Muzak. Then you get to wait for an indeterminate time in a small and lonely examination room, sometimes while partially disrobed. However at our vet, pets are welcomed and sometimes even fussed over during their time with the veterinarian. Vets know this personal attention is a part of what the animal expects and that it may help in their healing. For some reason we human animals do not typically receive bedside manners from our physicians.

When your pet is clearly dying and in pain, the vet will do the humane thing and with your consent put your pet to sleep. Yet in our country only Oregon comes close to offering a way for a physician to help you exit your life in a dignified and humane manner. Why is it that what is considered humane for an animal is frowned upon for us human beings? Are we not also animals? I believe that we humans also deserve a dignified exit from this life. How is it more humane to keep us lingering in a narcotic haze until death finally releases us from our misery? Having recently witnessed my mother die this way, I would never choose this for myself. Nor would have my mother have chosen this final exit, if she had had the choice.

I think that the business model underlying our current regular health care needs to radically change. It needs to treat people as human beings, instead of insurable objects who get fifteen minutes or less with a harried doctor. It also needs to insure everyone. Bill Clinton tried to overhaul our health insurance system early in his presidency and failed. Those living off the fat of the current system had undue influence. Yet if we were to rethink American medicine, perhaps a radical overhaul would be in order. A good place to start would be to examine what works so well in our veterinary clinics.

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