Perspective

Veterinary medicine falls right in the middle of the Venn diagram conversion of emotions and money. Pets are increasingly considered part of the family, and we the parents of our furbabies. But medicine costs money, and unlike with our human family members, most pets are not covered by insurance. This can make for a pretty bad situation when a pet gets sick and clients can’t afford their treatment.

As vets, we’ve all been called “money-grubbing”, or accused of only being in it for the money. We’ve been guilted and manipulated by people who tell us that “if we really loved animals we’d help” when they can’t afford treatment. And we do love animals, and we really do want to help, so we fall for it; or at the very least, we internalize it.

Taking It Personally

No one smart enough to get into vet school was stupid enough to go into this field for the money. We rack up insane amounts of debt to work long, stress-filled hours barely getting by. So when people accuse us of only caring about dollars and cents, we feel the attack at the core of who we are.

We immediately go on the defensive. We wave our 6 digit student loan debt, 10 year old cars, lack of retirement funds and barely existent savings accounts as badges of honor. “Look how much I don’t care about money,” we say. “I haven’t been on vacation since 2009.”

We feel guilty about charging for what we do, so we don’t. We don’t charge for an ear cleaning, or re-bandaging that paw even though it came off because Milo chewed it off and not because we didn’t put it on right. We only charge for extracting 4 teeth instead of 10 because some of them “practically just fell out of the mouth.” It seems harmless enough. We just want to help a pet out. And what does it cost us really? The bandage material is pennies, so it’s really just our time, right?

I have yet to meet a fellow vet who doesn’t experience this kind of money guilt, myself included. We feel like we’re taking something away from our clients instead of giving them something valuable. Our time and knowledge and services are valuable. WE are valuable. And we are under- appreciating ourselves every day. It’s not harmless. We are harming ourselves and our profession.

If we don’t value what we do, why should our clients? Why should they come and see us for their pet’s annual when they can go to a vaccine clinic down the road for half the price? Why should they call us when their pet is sick instead of just turning to Dr. Google?

We need to stop! But how?

How Much You Have, How Much You Give

We need to change the narrative we give to ourselves and to our clients.   Stop reinforcing the idea of how little we make. When a client, or even a friend or relative comments or complains about how much vets charge, don’t make it about how little you have, make it about how much you give. Talk about the value of the services you provide. It’s an affirmation. The more you talk about your worth, the more you will believe it.

Stop feeling guilty for charging money and for having money. Money pays our bills. It gives us the freedom to take care of ourselves and our futures.   We work hard and we deserve to have financial security. Educate yourself about personal finance. Take a good hard look at your student loan debt, your amortization schedule, your interest rates and how much it will cost you to continue to only make the minimum payments. Learn about Roth IRAs and 401ks and how to invest your money and start putting aside enough to make sure you can retire one day without winning the lottery. The more you learn about how to save, the more you will accept that you need to make a decent living.

And lastly, take a look at just how much you give. Add up all those “little” charges you leave off clients bills every day. Record every free recheck, wound cleaning, fluorescein stain… I’m not saying you need to start nickel-and-diming every client, but just be aware. Seeing the numbers, if only for yourself, will help remind you of your generosity as well as showing you just how much that generosity is affecting your own bottom line, so that you can be in control.

It’s okay to be generous with your time and skills, but make sure you’re doing it for the right reasons, not because you feel guilty. And make sure you’re taking care of yourself first. You’ve earned it.

[tweetthis]And make sure you’re taking care of yourself first. You’ve earned it.[/tweetthis]

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

I read an interesting post today on my social media page. It said:

“I continue to see rescues treat people in a way that will sadly keep irresponsible breeders and pet stores in business.”

Before you judge that statement, this person is heavily into rescue. I’m involved with rescue and I have more friends than I can count in it. I am a fan of tons of rescues and individual animals. However, I totally get her post and there are many who agree.

Of course, this statement is not about all rescues. I do believe we must take a step back every so often and do a reset, much like a dog shaking it off. I attended an animal shelter worker seminar years ago and the speaker asked us to raise our hands while he asked several questions. These questions were yes or no questions with no room for offering explanation. As we responded, the speaker would choose specific people to put their hands down based on their response.

We were asked if we had a fenced in yard, if we let our cats go outside, if we had kids, if we had other animals, if we lived in apartments, if our animals were home alone for more than four hours, if every one of our animals was up to date on vaccinations, had a recent fecal screening, were on heartworm preventives, flea control and so on. At the end of the questioning, only a few people had their hands still raised. He then revealed he was reading from a collection of adoption applications and only those with their hands still raised would qualify to adopt. Eye opening to say the very least.

He wanted us to see how we unintentionally narrow the chances for animals to find a home. He also read off some adoption fees from rescue groups that ranged from $100 to $500. The adoption fees for shelters ranged from $0 to $200. I have personally experienced interaction with rescue groups who seemed uninterested in my desire to volunteer, adopt or foster. I have also been the person reviewing adoption applications.

Am I Really Helping The Situation?

I turned down an adoption application because the other dog in the house, who was ten years old, was not neutered. I was adamant I was doing the right thing; downright adamant. The people had fallen in love with a dog at the shelter. They had been to the shelter several times meeting with the dog and discussing their decision. When I turned them down the wife started to cry. She told me they didn’t know that neutering their dog meant they were responsible pet owners but I made sure to correct her.

[tweetthis]I Rejected the Perfect Family For the Wrong Reason[/tweetthis]

She expressed that considering the dog’s veterinarian monitored health issues, neuter was considered risky at that point. She also advised me he’d never sired any puppies and was a stray when he joined their family as a young dog. Still, I said no.

A few weeks later they came back to the shelter. I smugly thought they had their dog neutered because of me and I could now approve them. They actually came to show me their new puppy. A puppy they purchased from a pet store because they didn’t have to meet any qualifications to buy him. I had just played a part in supporting a puppy mill.

It never occurred to me how many times I may have caused people to purchase an animal or denied an animal the chance to leave the shelter which didn’t make the space to save another one. Shelters need money to operate and this was a poor business decision because the truth is, shelters stay in business by making money. I wondered if any of my denied applicants adopted elsewhere and continued to donate to that shelter in appreciation.

It made me think about that speaker at the seminar. I have cats who go outside. That immediately disqualifies me to adopt from many shelters or rescues. The adoption process can be daunting to the potential adopters. Maybe that’s why some of my applicants appeared nervous instead of shifty.

Being treated as if the rescue or shelter is doing someone a favor by even considering their application after they have fallen in love with an animal is hurtful. Buying an animal is stress free. It’s also the last thing anyone in the animal field wants to have happen.

Having a little flexibility in no way means handing out animals to people who truly do not qualify for adoption. We work really hard to save animals and place them where we know they will be safe and loved. I started to focus on the interview portion of the application and looked at it as a conversation and not an inquisition.

Sometimes it’s just simple education that’s needed. Not everyone knows what crate training is or that spaying and neutering is by far the best way to prevent unwanted litters or most importantly, buying supports breeders and pet stores. Do all rescues spay or neuter their animals before sending them home? They should. Some people choose to use titers over vaccinations and this results in controversy due to local licensing laws.

They Seemed Perfect But I Was Wrong

I moved on from that fiasco. Then one day brought the perfect adoption application. These people had adopted a pit bull from a rescue that I knew had a grueling adoption process and high fees. They were known for taking on the more challenging dogs and many spent a long time in their rescue because of it. But their devotion to helping the dogs resulted in saved lives.  The couple provided impeccable veterinarian records, had tons of land that was all fenced in, wonderful references, and lived alone. They even owned a feed store and took their dog to work with them where he blissfully hung out behind the counter. They chose a puppy we had pulled from the South.

I already had an approved application on my desk but had not yet called the family. But because of this spectacular application, I bumped the people I had just met to get that puppy. I figured because the other applicant had listed a couple of other puppies they were interested in, they would just choose a different one. Instead, the applicant was devastated and decided to hold off on adopting because she didn’t want to put her children through that disappointment again.

Just a week later, the perfect couple walked in with the puppy. I thought they were visiting us but they were actually returning him. They said it wasn’t working out because he was not behaving in the store by staying behind the counter like their other dog. They said he was too hyper and they had changed their minds. I never felt so sick. I was floored. I took the puppy to the back, placed him in the kennel and started sobbing in shame.

I got up and called the other applicant to lie to her again. I told her the other application fell through and the puppy they wanted was available again. She had no animosity. She brought her family down the next day and that puppy went home. She regularly sent pictures of him with the family, loving life and thriving. I had made a poor judgement and while the puppy still had a happy ending, I had just gotten a crash course in compassion fatigue.

Compassion Needs to Extend To People Too

When did I become so full of myself? When did I lose my compassion? I was failing our animals, good people and setting a poor example for my staff. I did a reset and what happened next was, well, actually nothing monumental. I didn’t haphazardly hand out dogs and cats. I didn’t see a rise in returns. I didn’t get any complaints of animal abuse on our adopters. I didn’t see an increase of strays from animals turned loose. I started to treat people as I wanted to be treated myself; a concept we’re taught as children. I even stopped treating people looking to surrender like vermin and listened to their stories. Wasn’t I there to protect the animal first? I had to consider every scenario individually.

I’m not proud of the stories I shared. It just brings me back to the post my online friend made. Is it possible that a suddenly annoying applicant is reacting to our behavior? Is it possible someone with no volunteer experience needs your help to learn? It’s so hard for those of us in rescue not to lose our patience because we’ve heard it all and nothing surprises us anymore. We see the crossposts, we read about animal abuse and there’s a never ending population in need of our help. Most people in rescue don’t receive any payment for what they do. Shelter workers are underpaid. Yet somehow, we keep on keeping on.

I would gladly give up what I do for lack of work. In this field, however, that is highly unlikely.

[tweetthis]I started to treat people as I wanted to be treated myself; a concept we’re taught as children.[/tweetthis]

Originally published on thedodo.com

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

About the Author

Julie LeRoy is a former animal control officer and shelter animal care manager who is also a children’s book author.

Last month I was at a veterinary conference in Orlando when I ran into Paul Nicoletti, DVM. His hair was thinner than I remember and he moved a little more slowly, but he still had his warm, magnetic smile. When he saw me, he cut across some heavy foot traffic with a spryness that was impressive for someone in his mid-80s.

Dr. Nicoletti looked me in the eye, shook my hand, and asked how I’ve been. We talked for a few moments and then parted ways. The last thing he said was, “I enjoy your Facebook and I think other people do, too. I hope you’ll keep it up.” I loved that: “your Facebook.” It made me smile.

I heard last week that Dr. Nicoletti passed away.

For those who didn’t know him, Dr. Nicoletti was a professor at the University of Florida’s College of Veterinary medicine (which is where I met him). At different points in his career he served as the president of:

• The American Veterinary Medical Association (AVMA)
• The American College of Veterinary Preventive Medicine
• The Florida Veterinary Medical Association
• The Animal Disease Research Workers in the Southern States
• The Alachua County Veterinary Medical Association

He was recognized by the Florida Veterinary Medical Association as their Veterinarian of the Year in 1994 and presented with the Distinguished Service Award by the University of Florida’s College of Veterinary Medicine in 2003. He played a significant role in eradicating brucellosis in Florida, was inducted into the Florida Agriculture Hall of Fame (yes, it’s a thing), and created the Paul Nicoletti Public Health scholarship at the University of Florida.

What I’m saying is, the man’s resume was absolutely amazing. 

But I was totally unaware of that. 

To be honest, I knew very little of Dr. Nicoletti’s accomplishments, because he never talked to me about them. In all the times I visited with him as a veterinary student, I only remember him showing me one award. It was the National Teaching Excellence Award from The Student American Veterinary Medical Association, and he was proud of that one. 

This is an award that is given by veterinary students across the country to one teacher each year. It comes from student nominations and is intended to recognize those who both educate and inspire. The fact that this is the only award Dr. Nicoletti told me about exemplifies what I’ll always remember about him. 

Dr. Nicoletti was the first person in veterinary medicine to make me think deeply about what success really is. He was already retired when I started veterinary school, but there he was in the anatomy lab almost daily. He laughed, joked, and asked students how they were getting along. Faculty and staff came up to hug him.

He had a gift for being able to give advice without ever coming off as pushy or intrusive. You could tell people really appreciated his insight. If you met him once, you walked away feeling that he genuinely cared about you and wanted you to thrive and be happy.

Dr. Nicoletti made my experience in vet school better. He picked me up when he saw I felt beaten down. He reminded me that it’s great to be a veterinarian. I remember thinking, as I watched him enjoy the sunshine and eat lunch at a picnic table in the courtyard one day, “That’s what success looks like.”

Think about it: Here was a man in his 80s, long past official retirement, still going to work every day because he wanted to. And when he got to work, people were glad to see him. He had people to care about, and they cared about him. He showed up to support the individuals who could really use his encouragement and advice. 

It might sound like Dr. Nicoletti and I had a special bond or relationship, but we didn’t. He was like that with everyone. Lifting future vets up is just what he did — I think he saw it as one of his most important roles.

If I could go back to that conference last month and say one thing to Dr. Nicoletti, it would be this: “Thank you for all the times you picked me and a thousand other veterinary students back up. Thank you for so obviously caring about us and about veterinary medicine. Most of all, thank you for showing us all what a life with purpose and meaning looks like. I hope I can be like you.”

Ever since I watched Doc Brown leap out of a frozen DeLorean and tell Marty McFly they’re going Back….to the Future, I’ve dreamed about all the ways time travel would make my life better.

The trilogy taught me some important lessons: namely, mucking about with gambling winnings is an overall bad strategy, as is meeting your parents and disrupting the fabric of space and time. Taking this into account, I think I would prefer a more subtle approach. Maybe just a few words of wisdom to my younger self to help ease the transition into this whole adulthood and career thing, preferably wearing a compelling disguise.

But, since time travelling DeLoreans and flux capacitors are still but a happy dream, I can settle for the next best thing and write it here, for those still young enough to wonder what the future holds, instead.

One: Lift With Your Legs

I will never forget it: an older clinician in vet school asked me to lift an 80-pound retriever on the table since his own back was wrecked. I did it, with terrible form. He looked at me like I was crazy and told me I would regret lifting with my back. The very next day, I realized he was right.

It was the first of a long line of back pain experiences, unfortunately. Now I’m the older one standing with my hand on my lower back asking the younguns for help. I’m not old-old, just older than I was when I was young and stupid, and now I have the whole rest of my life in orthopedic shoes and a Posturepedic bed to look forward to. We wag our fingers because we care.

Two: Don’t Underestimate the Power of that First Job

Your first job sets the tone for your experience of veterinary medicine, whether you feel you’ve made an awful mistake or the best decision of your life. If you are fortunate enough to find a great one, value it, and the staff. Be kind. They are worth it.

If you got into a not-so-great first job (it happens to a lot of us!) remember: it does not have to define your career. I was shocked to see how many vets bounce all over the place for various reasons; we live in a different world now. Learn what you want from a job and don’t be afraid to look for a true mentor.

Three: Always Let Your Conscience Be Your Guide

Sorry for the Pinocchio quote, but seriously, it’s true. You will be asked to do things you don’t agree with. You will see things that bother you. You know in your heart what is the right thing to do- that won’t change over time. Effect change if you can, say no when you must, and realize that a job that asks you on a regular basis to do things that feel wrong is not healthy for your mental well-being.

Four: Learn to Float on the Vast Sea of Stupidity

From day one, you will be confronted with articles, “facts”, and assumptions about your work and your motivations, along with a very healthy helping of some of the worst advice known to man. I’ve been working on this one for many years now, but it boils down to this: You are but one person with a bucket looking out on the open ocean. Don’t worry about draining the ocean, just bail out your boat when you need to so you don’t drown. And for god’s sake, don’t go swimming. There’s sharks in them there waters.

You are but one person with a bucket looking out on the open ocean. Don’t worry about draining it.

Five: Have Whatever Family You Want

If you want kids, have kids even though people tell you that parents make terrible, lackluster veterinarians. If you don’t want kids, don’t have kids even though people tell you your life will feel unfulfilled. If you want to live in a treehouse with your BFFs from vet school and form a new wave commune, go for it even though people tell you to grow up and start acting like an adult.

Point is, no matter what choice you make on this matter, someone’s going to criticize you for it. So ignore them. They’re wrong. Your family is the one who holds you up, helps you out, and makes your life worthwhile. When your back goes out because you didn’t listen to my first bit of advice, they will bring you soup and vacuum for you and love you even if you can’t work for a while. Whatever form that family takes, love it and be proud of it, because they matter more than any other thing you have in your life. Even vet med.

No matter what choice you make, someone’s going to criticize you for it. So ignore them.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

I’ve diagnosed and treated a lot of conjunctivitis in my career as a veterinarian. But, I’ve never had to treat myself for conjunctivitis until this year. What misery! I had no idea inflamed conjunctiva (the pink tissue that lines your inner eyelids) feels like burning sandpaper contacts in your eyes. I never knew that the erythromycin ointment I prescribe commonly to cats feels like Vaseline on your eyeballs and obscures your vision like a greasy oil slick.

After a few days of strange discharge and redness in my eyes, I made a hurried appointment with the first ophthalmologist I could find, who saw me in her plush office in Chevy Chase. I explained to her that I has been suffering from the flu when days later my eyes developed symptoms of excessive tearing that progressed to sticky discharge, ocular redness, and burning. The doctor perfunctorily diagnosed me with “pink eye” and informed me that my eyes looked pretty average in regards to pink eye cases she’s diagnosed.

Her manner was not very empathetic, but I took some comfort knowing my condition appeared average. The doctor explained that she would prescribe antibiotic eye drops that “probably wouldn’t do anything for me” because I likely had viral conjunctivitis.

She hurriedly explained all of this while backing slowly out of the room with her manicured gloved hands up in the air. I had to delay her exit with my questions. Will there be a steroid in the drop? (My inflamed eyes were begging for something to soothe the inflammation). And, how many times a day do I have to instill the drop?

Her answers:

“No steroid in the drop; steroids can delay healing.”

And then, “Four times a day.”

(For a drop that probably won’t work and also won’t relieve my discomfort…. Great. Eerily this sounded like stuff I’ve said and done in the past. Can’t give you the relief you need because there’s a tiny chance it could make you worse. So, I’d rather practice doing no harm.)

As I left, she weakly offered, “if you start to have trouble seeing, do schedule a recheck exam”.

It was interesting to be on the receiving end of this bout of conjunctivitis and trip(s) to the doctor. Not only did I earn a new level of understanding and empathy for my patients with conjunctivitis but it really highlighted to me what’s important during a visit to your doctor.

Yes, I got my diagnosis and I got treatment. But, I didn’t really receive care.

I ended up making a recheck appointment a week later with a different ophthalmologist because once again I felt I needed to be seen quickly. The redness and discharge in my eyes had improved a lot, but suddenly I couldn’t sleep because my eyes seared in pain when I closed them.

This second ophthalmologist was outstanding. She greeted me with a warm smile and immediately gave some needed empathy: “Wow, I can hear how congested you are!” And then, “Oh, your poor eyes—they are soo inflamed! “ After her exam, she told me that she was going to remove some membranes lining my conjunctiva. I was nervous, but when the procedure was over I was thankful for the intervention.

Finally, she prescribed me another antibiotic eye drop. However, this drop contained a steroid! She also prescribed me an antibiotic ointment to instill at bedtime and re-wetting drops to use during the day. The coup d’etat was when I asked her how long I should use the drops. She informed me I was coming back for a recheck exam in 3 days at which time she may tell me.

It seems ridiculous that I was grateful that she wanted to follow my treatment. I’ve since been back to her two more times and finally my eyes have healed. Looking back on this experience I know both ophthalmologists were equally well trained and knowledgeable. However, there was a real chasm between what they provided. Diagnosis and treatment are important. But so is listening to your patient and being interested in their results and recovery.

That’s the difference between medical treatment and medical care.

Nicole Cohen DVM graduated from UC Davis School of Veterinary Medicine and completed a 1 year rotating internship in small animal medicine and surgery in northern California before moving to Washington DC. She has worked at Friendship Hospital for Animals as a primary care and emergency veterinarian for the past 10 years.