Stop asking your clients to make medical decisions

Many of you ask clients whether they want a preanesthetic blood workup done on their pet prior to a surgical procedure. You ask whether they want post-surgical pain medication administered. You ask whether they want you to place an IV catheter or put their pet on IV fluids. But why? Why do so many of you put clients in a position to make medical decisions they aren't trained for?

The responsibility is yours

If it's medically appropriate for that patient to undergo a preanesthetic blood workup or if the pet needs post-surgical pain medication, then that's what you should say the pet needs. Of course, you should educate the client about why the pet needs this care. The client didn't go to veterinary school and doesn't know the physiological reasons for putting patients on fluids during surgery.

You must think about what's best for the patient—and communicate that to the client. You're the veterinarian. And you should make the medical decisions.

If you or I go into a human hospital, the doctor doesn't ask whether we want an ECG performed or whether we "think we should do a radiograph today." If the doctor feels a procedure is necessary, he or she tells us it's necessary and explains why. If we don't want the procedure, we have the right to refuse. But the decision about whether the procedure was necessary wasn't ours. It was the doctor's.

Stop hiding behind price

The argument I always hear for offering the decision to the client is about cost. "In human medicine, clients don't have to pay; they have insurance," people say. Well, first off, we do have insurance in this profession, if the profession would just support it. Second: So what?

Do you say to clients, "Mrs. Jones, I know that anesthesia is expensive, and we don't have to use that on Fluffy today. I have two big guys in the back that will hold her down during the surgery. Don't worry about it. We can save you some money." Well, of course not. You want to offer the best care possible.

And you should offer the best care possible. You must be the patient's advocate and not let money stand in the way of excellent patient care—especially when you don't know whether that client can afford a procedure or not. You should offer what's best for that patient, not judge the client's ability to pay. If the client doesn't want to have that procedure performed or can't afford it, he or she will let you know. Don't prejudge your clients.

Take a stand—make the decision

Here's my plea: Abolish the concept of offering optional medical services. If you feel that a procedure should be done and it's medically correct for that patient, then simply inform the client and explain the cost involved. Establish a standard of care in your practice—and then enforce it.

Don't ask your clients to make these decisions. They didn't go to veterinary school. They don't know why you should or shouldn't do that procedure. You are the medical expert. That's why they've come to you. Don't abdicate your responsibility!

Mark Opperman, CVPM

Veterinary Economics' Hospital Management Editor Mark Opperman is a certified veterinary practice manager and owner of VMC Inc., a veterinary consulting firm based in Evergreen, Colo. Send your comments to: ve@advanstar.com