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Aug
05
2012

Next Time I’ll Go To The Vet

Over the last several weeks I have been trying to tie up a number of loose ends while getting ready for vacation. In the midst of all the last minute details I find myself in need of the healthcare industry both for me and our family’s dog, Maggie.

Maggie is old in dog years and her slow decline was finally reaching a point where we had to do something. Maggie’s quality of life had declined as well as her vision, activity and bladder control. Everything but her appetite – she could always eat. My wife and I talked about the options and knew it was time to put Maggie down. I called our veterinary clinic to talk to her Vet about the options and he was out of town but the office manager said she would have his “on call” Vet call me back, which she did within an hour. We discussed Maggie’s case and she agreed with our assessment and helped me schedule an appointment for her the next morning. The office staff called back later that day and took care of the instructions and payment options so we wouldn’t have to deal with those details on the appointment day, which they knew would be emotional.

 That night I lay in bed dreading the next morning. I smiled as I thought about a paper I wrote in college strongly advocating for euthanasia in America, because today I wasn’t even sure I could put down my dog.

I had some vision trouble three weeks ago and called my retinologist to ask some questions and seek some counsel. He also was out of town and I was given a number to call for his “on call” specialists. I called that office and couldn’t get close to speaking to the doctor. Apparently, I would have to first come in for a “complete evaluation” before this retinologist would speak to me. As I get older the “ologists” fill up an entire screen on my phone, so I am no stranger to the workings of specialists and healthcare and I knew this meant a half-day and $600 wasted. I told them “no” and waited for my doctor to return which happened to fall during the same time of Maggie’s appointment.

I have a mostly a sleepless night as I wait for the morning Vet appointment with Maggie. Our family is sad every time we think about putting Maggie down and so am I. My wife had to put our Sheltie down just two months ago so no doubt about it – it’s my turn. I hope to wake and find Maggie young and spry in the back yard but no such luck, as expected she needs help getting to her feet. I lift her into the Jeep and she senses my stress and is hesitant to go. We get to the Vet and they immediately lead us into a treatment room. The receptionist has completed our paperwork and takes my card for payment. The paperwork is complete. She shows me the back door and tells me I can leave that way when this is done if I want to. I really don’t (can’t) say much – they seem to understand.

I drive an hour to get to my retinologist’s office for a 9:40 a.m. appointment. I sit in the lobby and fill out the paperwork – the same paperwork I have filled out a dozen times before- and wait. Forty minutes later I an escorted back to an exam room to see the PA for a vision test and to get my pupils dilated. I then wait again. The retinologist (who I like and trust) is rushed and has, by my count, 8 patients in the office. I can hear him moving from room-to-room with rushed conversations to get through all the waiting patients ahead of me. Twenty-five minutes later he sees me and we decide I need an additional procedure and I am sent to another treatment room where I spend an additional 45 minutes waiting for him to clear a few unscheduled minutes to come administer this procedure.

I have been sitting with a “nervous” Maggie for two minutes when the new Vet comes in and introduces herself to me and Maggie. She pets and “loves on” Maggie and talks to her in quiet tones. She explains to me what is going to happen and notices Maggie is “panting” and very anxious. The Vet suggests and asks if I would like for her to administer a strong sedative. Once we determined it wasn’t for me I agreed with the approach and she gently administers the injection, which begins to settle Maggie. The Vet and her assistant leave us alone for 10 minutes to let the sedative take full effect. Maggie settles down and we both sit on the floor and she quietly falls asleep with her head in my lap. It was a great calming 15 minutes. The Vet comes back in and gets down on the floor with us, starts the IV and injects her again. She stroked Maggie and talked to her until she gave her “death shake” and stopped breathing. I was holding it together pretty well until the Vet herself starting weeping.

They gave me the room for as long as I wanted, showed me where I could wash my hands and face and let me be. I left through the back door 30 minutes after I arrived.

The doctor came in and performed the procedure which included an injection in my eye. I don’t care how numb you are the thought of an injection in your eye is not pleasant. The nurse (very nice) gave me the “post-op” instructions told me to just “reup” a prescription that I was given some time back (It was over a year old and was no longer valid which meant later I had to stand in the pharmacy waiting for a new prescription to be called in). I was escorted to the business manager. The business manager had a new computer program and couldn’t “figure out how much you owe”. After standing there for longer than I cared to, she finally said “we’ll just bill you”. When I got to the parking lot I received a text from the office which said “we forgot to schedule your follow up – we need see you next week, please come back to the office or call us”. I didn’t – I drove home now 3 ½ hours later.

I know it’s not an apples-to-apples comparison but as I sit on the plane with my family, finally on vacation, I feel good about only one of these interactions. Now, to get good healthcare in this country we are almost always willing to put up with an occasional hassle as a trade off. As a paramedic we always knew the specialist or two who were so good at their craft that we would chose them to be our doctors even though they were commonly known to have sub-human personalities. My doctors are good and I am sure if I asked them they would tell me with healthcare reimbursement the way it is they couldn’t make it without “stacking” and therefore forcing patients to wait, but it gets tiresome. I’m not complaining. I have health care, I pay dearly for it but I do have it, unlike so many others. I guess I am just saying, next time maybe I’ll just go to the Vet.

Steven Athey is the president of the EMS Consulting Firm, Health Care Visions. Steve has worked in the ambulance industry since 1971 and has managed large and small EMS organizations. Steve holds his undergraduate degree and his MBA from Texas Wesleyan University where he holds an adjunct faculty position in the School of Business. Steve can be reached at slathey@hcvems.com

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