surgblumm Posted October 18, 2020 Share Posted October 18, 2020 All Physician Practice Policy Finance Conditions .edu Patient Meds Tech Social Video ADVERTISEMENT Suicide in veterinary medicine is a huge problem right now Garret Pachtinger, VMD | Physician | October 16, 2020 2K Shares Share Tweet Share I am a veterinarian. More specifically, I am a veterinary specialist, board-certified in emergency and critical care. I don’t play with puppies and kittens. I treat the worst of the worst in a specialty hospital setting with a state-of-the-art ER and ICU. Despite years of education, including veterinary school, internship, fellowship, and residency to obtain this education and specialty board certification, I was not prepared for the emotional toll of becoming a veterinarian. I recently read an article on KevinMD, “Doctors are killing themselves, and who is taking notice?” Whether you know this or not, this is not limited to doctors in human medicine. A quick Google keyword search “veterinarian suicide” will uncover over 1 million hits in less than half a second. ADVERTISEMENT Bluntly, suicide in veterinary medicine is a huge problem right now. The Centers for Disease Control and Prevention found male veterinarians are 2.1 times as likely and female veterinarians 3.5 times as likely to die by suicide compared with the general population. The much higher rate for women is especially concerning as more than 60 percent of vets are women. Why? Debt and financial pressures. New graduates are often more than $150,000 in debt. Unlike other medical fields, the median pay for a veterinarian in the United States is $85,000 a year. This means while some make more, there are also graduates who make far less. Even the median salary is less than half of that for physicians and surgeons. Try to live (rent/mortgage, groceries, car payment, food, health insurance, etc.) with $150,000 in debt with a salary of $60,000/year. Emotional stress. Unlike human medicine with the security blanket of health insurance, pet insurance is still widely underutilized. It’s also important to recognize that most pet insurance companies reimburse following a claim submission rather than providing the financial resources to pay for the bill at the time of payment. While a simple check-up may not be a financial risk for families, emergencies carry a financial burden as sick patients may require thousands of dollars of care … out of pocket. How many times can a pet owner yell at the veterinarian, “You are only in this for the money” as you euthanize their pet due to illness and the required financial commitment before you can no longer ignore these words? Access. This is two-fold for me. Access to lethal drugs and medications. Veterinarians commonly perform euthanasia procedures and have access to a plethora of widely used medications to assist in humane euthanasia. The second is access to the internet. Not veterinarians, but their clients. At some point, it is no longer possible to ignore vindictive negative Yelp reviews. “1 star – Dr. X would not help my dog and was only interested in my money.” In reality, the pet owner was likely given several treatment options as well as payment options, which were declined. Why can veterinarians no longer float the “I-O-U” card? The simple fact is that these hospitals would quickly have a debt load that was too heavy to carry, and they would close. There is significant overhead operating a veterinary hospital. Like human hospitals, veterinary hospitals have diagnostic equipment that is expensive to purchase and maintain. Radiology, including state-of-the-art digital X-ray and ultrasound, in-house laboratory equipment, anesthetic machines, and monitoring devices, surgical instruments, and physical examination tools, are a few examples. Veterinary hospitals are also pharmacies that require a significant overhead cost to stock. Unlike in human medicine, where you are provided a prescription form to take to your nearest pharmacy, most veterinary hospitals carry the financial burden and overhead of stocking and prescribing medications for the convenience of the client as well as prescription and non-prescription pet foods. Please don’t forget fixed overhead costs, including mortgage/rent, utilities, property taxes, insurance, medical disposal fees, building maintenance. Lastly – there are salaries! Veterinary hospitals employ receptionists, veterinary technicians, and veterinarians, as well as a multitude of other personnel cleaning kennels, feeding patients, and building maintenance. What’s the take-home? Emotional stress and suicide are truly problems in the medical field. This is not a MD/DO vs. VMD/DVM (doctor of veterinary medicine) thing. This is not a human patient vs. a 4-legged patient thing. This “thing” is about improving our understanding of suicide, mental health, compassion, and support. Regardless of how you practice and who you practice on, we are in this together. The debt, the long hours, the stress, the access to lethal drugs — we have to find ways to better support each other, put better safeguards in place, and ultimately decrease the prevalence of suicide in the medical field. Garret Pachtinger is a veterinarian. Image credit: Shutterstock.com Quote Link to comment Share on other sites More sharing options...
hemegrupe Posted October 18, 2020 Share Posted October 18, 2020 (edited) Pet Insurance should definitely be more mandatory. I looked it up and it seems that there's quite a wide range of salaries for Vets tho the annual average looks to be higher than 60K. I would think a figure that low might be for a super-newbie in their first half year, but even that seems ridiculous unless they were interning. Either way this is all really important information to stay mindful of, thank you for sharing it. Edited October 18, 2020 by hemegrupe Quote Link to comment Share on other sites More sharing options...
ANESMCR Posted October 18, 2020 Share Posted October 18, 2020 Interesting. Had no idea. Has this changed in the last 20-30 years? My old man was a large animal/primate vet, easily brought in over 200k/yr. I’m assuming the sample in this article primarily covers rural clinics etc? Quote Link to comment Share on other sites More sharing options...
surgblumm Posted October 18, 2020 Author Share Posted October 18, 2020 Two responses. I appreciated the humor , I agree with pet insurance. I look at the education of vets, thinking of cats and dogs, and even under 100,00 would put them in a better situation than a PA. This was an eye opener for me. Twenty years ago I operated on a large animal Vet who operated on the horses that ran in the races at Belmont and Aqueduct and he was one of the $250,000.00 Vet surgeons. I guess it's like comparing FP to Orthopedics or CTS. 1 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 18, 2020 Administrator Share Posted October 18, 2020 I struggle with this. I would actually prefer that small animal veterinarians (that is, those who treat pets, not farm/working animals) be taxed quite heavily in order to provide medical care for uninsured humans. Still, the fact that veterinarians are despairing is itself a depressing commentary on people valuing their pets more than the real humans who try to care for them. Quote Link to comment Share on other sites More sharing options...
MediMike Posted October 18, 2020 Share Posted October 18, 2020 2 hours ago, rev ronin said: I struggle with this. I would actually prefer that small animal veterinarians (that is, those who treat pets, not farm/working animals) be taxed quite heavily in order to provide medical care for uninsured humans. Still, the fact that veterinarians are despairing is itself a depressing commentary on people valuing their pets more than the real humans who try to care for them. Strongly disagree with this. Why would you single out an already underpaid profession for increased taxation based on providing healthcare to companion animals after undergoing doctorate level education? Tax the churches. The social commentary on valuing pets more than people can be transferred to valuing bank accounts more than people, especially when those institutions are such supposed proponents of the underserved. 1 2 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 19, 2020 Administrator Share Posted October 19, 2020 3 hours ago, MediMike said: Tax the churches. The social commentary on valuing pets more than people can be transferred to valuing bank accounts more than people, especially when those institutions are such supposed proponents of the underserved. How do the British say it... "made redundant"? I don't disagree that organized religion in 21st century America is not doing any sort of a good job at being a social safety net, but that job was ceded to the government increasingly throughout the 20th century, so they've not been needed and most churchgoers wouldn't even understand why they might tithe in order to provide a service redundant to what their taxes fund. Indeed, the idea of religious folks providing healthcare on their own terms is offensive to some: Catholic hospitals sued for not doing abortions or hysterectomies... Heck, just a few months ago Samaritan's Purse sent a mission hospital to New York, and yet ended up treating no patients and being told their belief systems weren't welcome. Now, there are certain religious organizations which are structured as centralized "endowed" entities, to the extent that their investment portfolios amount to wealth aggregation rather than any sort of mission-focus... but I think that's a fundamental problem with treating corporations as legal persons, just extended to the realm of religious corporations.. or rather, corporations formed by nominally religious bodies. The fact that Americans spend so much money on healthcare for their pets rather than healthcare for other human beings is unconscionable. Why single out the veterinary profession? Because unlike, say, casinos, the people and products involved in caring for pets could be substantially retrained/retooled to provide healthcare to humans who needed it. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 19, 2020 Moderator Share Posted October 19, 2020 my dad is still a Vet has been an amazing career for him but he is dismayed in that the specialty side of animal medicine is trying to follow human medicine. Pets don't live long enough to have insurance to pay like human medicine, and the loss of the primary care practitioner (he would do ACL repairs, eye surgery, abd sugery, traumatic fractures, whole thing.... I grew up in an animal OR) is driving the costs up while disconnecting the primary from the familes. Ends up having specialists saying "if you don't refer that ACL to me to repair you are committing malpractice" while the primary care fields wither.... Honestly from listening to him for a generation I think he really is onto something. Getting a primary care pigeoned holed into annual well checks and vaccines is a waste of a great clinician. Let them branch out and do it like they used to - but the now even have to residency and fellowships so it makes it hard.... I "think" I am glad I went into human medicine......... Quote Link to comment Share on other sites More sharing options...
ShakaHoo Posted October 19, 2020 Share Posted October 19, 2020 I know that every-time we take our pets to the Vet, we are charged $100's of dollars, and they want the money up-front or treatment is not rendered. They would rather let your animal die on the floor, unless they are able to swipe your credit card ahead of time. They charge us $65 for a physical (look in ears to see if they are pink, open mouth to look at dentition, listen to heart, touch belly for 1 second). Entire physical, 45 seconds. Blood work, another $150-200. Vaccines another $150-200. Tick/Flea prevention marked up, another $150-200. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 19, 2020 Moderator Share Posted October 19, 2020 2 hours ago, ShakaHoo said: I know that every-time we take our pets to the Vet, we are charged $100's of dollars, and they want the money up-front or treatment is not rendered. They would rather let your animal die on the floor, unless they are able to swipe your credit card ahead of time. They charge us $65 for a physical (look in ears to see if they are pink, open mouth to look at dentition, listen to heart, touch belly for 1 second). Entire physical, 45 seconds. Blood work, another $150-200. Vaccines another $150-200. Tick/Flea prevention marked up, another $150-200. yup and 45min in my office will generate bills for about 750$ 40 min joint replacement will run thosands, infusions of meds might be 30min and cost thousands Medicine is expensive..... heck considering starting my own practice (again) and the trip fee for a house call (just to get me to the house) will be $100 Quote Link to comment Share on other sites More sharing options...
MediMike Posted October 19, 2020 Share Posted October 19, 2020 10 hours ago, ShakaHoo said: I know that every-time we take our pets to the Vet, we are charged $100's of dollars, and they want the money up-front or treatment is not rendered. They would rather let your animal die on the floor, unless they are able to swipe your credit card ahead of time. They charge us $65 for a physical (look in ears to see if they are pink, open mouth to look at dentition, listen to heart, touch belly for 1 second). Entire physical, 45 seconds. Blood work, another $150-200. Vaccines another $150-200. Tick/Flea prevention marked up, another $150-200. ...I don't get what you're saying. Are you suggesting that you should be provided services you can't pay for? If you are belittling what they do to this extent why do you take your animals in? I also query why, if you find it such a hardship to pay for the care of a companion animal you even have one? Of course labs and medicine costs money, what do you think human medicine costs? You pay for the equipment, for the supplies, for the person to conduct the test, the person to interpret. I've never seen a vet office which didn't offer some form of payment plan outside of maybe the animal ED. 1 Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted October 20, 2020 Share Posted October 20, 2020 heck considering starting my own practice (again) and the trip fee for a house call (just to get me to the house) will be $100 Hmmm, have you considered being a plumber or an appliance service person? They get that much just to show up. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 20, 2020 Moderator Share Posted October 20, 2020 5 hours ago, ohiovolffemtp said: heck considering starting my own practice (again) and the trip fee for a house call (just to get me to the house) will be $100 Hmmm, have you considered being a plumber or an appliance service person? They get that much just to show up. That is actually what has got me thinking. $95 just to get dishwasher guy to show up. $185 for first 30 min then $90 each additional 1/2 hour!!!!! makes me wonder about a single payer (Medicare) and offer house calls. Quote Link to comment Share on other sites More sharing options...
ShakaHoo Posted October 21, 2020 Share Posted October 21, 2020 On 10/19/2020 at 7:29 PM, MediMike said: ...I don't get what you're saying. Are you suggesting that you should be provided services you can't pay for? If you are belittling what they do to this extent why do you take your animals in? I also query why, if you find it such a hardship to pay for the care of a companion animal you even have one? Of course labs and medicine costs money, what do you think human medicine costs? You pay for the equipment, for the supplies, for the person to conduct the test, the person to interpret. I've never seen a vet office which didn't offer some form of payment plan outside of maybe the animal ED. I am saying that in order to buy heart-worm and flea/tick medication, I am forced to pay for a "wellness visit." If I want my dog vaccinated for rabies, I have to get "a wellness visit." I can walk into CVS/Walgreens and get vaccines without having a "wellness visit." In fact, I got my flu shot at CVS this week without having someone look in my ears and mouth to determine it was safe. They also force bloodwork upon you. Your dog needs a heartworm test, your dog needs a parasite test, otherwise we cannot prescribe you the preventative medications. If my dog has been on the preventative medications since birth, and has no signs/symptoms of heartworm/parasites, why should I have to pay for these labs? My physician could order a full panel of labs on me every year, and test for autoimmune disorders, and rare hematologic conditions... afterall, I could test positive. Quote Link to comment Share on other sites More sharing options...
ShakaHoo Posted October 21, 2020 Share Posted October 21, 2020 And by the way MediMike... If you think there aren't clinicians in both human and veterinary medicine ordering unnecessary testing, and taking advantage of the unknowing consumer to increase revenue, and pad the bottom line, you need to open your eyes. Quote Link to comment Share on other sites More sharing options...
MediMike Posted October 21, 2020 Share Posted October 21, 2020 (edited) 38 minutes ago, ShakaHoo said: And by the way MediMike... If you think there aren't clinicians in both human and veterinary medicine ordering unnecessary testing, and taking advantage of the unknowing consumer to increase revenue, and pad the bottom line, you need to open your eyes. If you continue to go to such a clinician I think you should do the same. A vaccination is a tech appointment, not a vet appointment. Why would you go to a vet each time to obtain heartworm/flea preventative when that can be purchased elsewhere? If you are establishing care have them send the prescription to Chewy or Costco, it's a one time visit. There are medications I would not prescribe you without obtaining labs first, think any one of us can say the same. And yes, you show up to me as a patient and want a new medication for *blank* that has possible interactions/side effects then yes, I am going to charge you for a visit to compensate me for my time and charge you for the labs that I determine are necessary. Of course there are the outliers who order excessive testing, but painting all with the same brush is ludicrous. Edit: I'm going to stop responding to this thread in an effort to get the conversation back on track Edited October 21, 2020 by MediMike Bowing out Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted October 21, 2020 Share Posted October 21, 2020 12 hours ago, MediMike said: A vaccination is a tech appointment, not a vet appointment. Why would you go to a vet each time to obtain heartworm/flea preventative when that can be purchased elsewhere? If you are establishing care have them send the prescription to Chewy or Costco, it's a one time visit. I'm not agreeing or disagreeing with ShakaHoo, but every vet I've ever been to requires an appointment with the actual vet for a vaccination. Also, heartworm preventative requires a prescription, therefore again requires an appointment with the actual vet and whatever blood work they require before giving the prescription. But, there is also a reason for the blood work. If a dog has a heavy load of adult heartworms it can be extremely dangerous to then give heartworm preventative. Therefore the lab is ordered. Whether doing this lab on every dog (and maybe cat...never owned one) is best practice from a statistics standpoint I can't comment on...I'm not a vet therefore I don't pay attention. But, it's also questionable if annual vaccines and monthly heartworm prevention are best practice (read as "necessary"). Quote Link to comment Share on other sites More sharing options...
ShakaHoo Posted October 22, 2020 Share Posted October 22, 2020 23 hours ago, MediMike said: If you continue to go to such a clinician I think you should do the same. A vaccination is a tech appointment, not a vet appointment. Why would you go to a vet each time to obtain heartworm/flea preventative when that can be purchased elsewhere? If you are establishing care have them send the prescription to Chewy or Costco, it's a one time visit. There are medications I would not prescribe you without obtaining labs first, think any one of us can say the same. And yes, you show up to me as a patient and want a new medication for *blank* that has possible interactions/side effects then yes, I am going to charge you for a visit to compensate me for my time and charge you for the labs that I determine are necessary. Of course there are the outliers who order excessive testing, but painting all with the same brush is ludicrous. Edit: I'm going to stop responding to this thread in an effort to get the conversation back on track I have tried numerous times to have my vet write a prescription to fill online (through Chewy for instance)... they refuse to do it. Tell me there are a lot of fake medications on the internet, there is no quality control... The pet owner was forced to purchase through them through their office for many years. Within the last year they have “partnered” with a “reputable online pharmacy” that will mail the prescriptions to your home. As for being rendered services you can not afford... When a patient walks into the emergency room whether they are Bill Gates, or homeless, they get treated with no questions asked... When a family comes in with an animal in distress (for instance struck my a car) and the first question is “How are you gonna pay for this” I find it insensitive, and inhumane. Come up with a payment plan, but please don’t refuse or delay care... I have numerous times helped patients who can not afford care. In fact I got “talked to” by our medical director for not charging an army veteran who could not afford a physical exam... This is sadly what medicine is coming to... Quote Link to comment Share on other sites More sharing options...
kittryn Posted October 31, 2020 Share Posted October 31, 2020 On 10/19/2020 at 9:21 AM, ShakaHoo said: I know that every-time we take our pets to the Vet, we are charged $100's of dollars, and they want the money up-front or treatment is not rendered. They would rather let your animal die on the floor, unless they are able to swipe your credit card ahead of time. They charge us $65 for a physical (look in ears to see if they are pink, open mouth to look at dentition, listen to heart, touch belly for 1 second). Entire physical, 45 seconds. Blood work, another $150-200. Vaccines another $150-200. Tick/Flea prevention marked up, another $150-200. I don't understand why you even have a pet. Quote Link to comment Share on other sites More sharing options...
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