Monday, April 18, 2011


I'm not sure why I'm still surprised at people's actions -- but I still am. I've been doing this a long time, and I've seen some unbelievable situations, but people like the one I'm about to describe just don't make sense.

This post isn't about the case, it's about the human interaction.

Clients arrive with their cat, who needs a blood transfusion.  They had been referred by their primary veterinarian (about 50 miles away) for continued treatment of a surgical complication which had resulted in hemorrhage.  The kitty was extremely critical with a PCV of 10% (prior to surgery it had been >40%), and the kitty was very weak, with white mucous membranes and a slowing heart rate.

At the front desk, the receptionist asked them to fill out the standard paperwork with their name, phone number, etc, as well as the pet's name, name of their primary veterinarian and the typical box which asks for a basic medical history, including if the pet is spayed/neutered, and if they are vaccinated.  The client left these both blank.

Receptionist, doing her job in getting paperwork handled, stepped into the client's exam room (while the patient was being evaluated and treatments initiated), to ask about the status of vaccine history.  The client became belligerent.

"HOW DARE YOU EVEN ASK ME THAT!" The client screamed at my staff member.  "YOU F**ING ALREADY HAVE THIS INFORMATION!"

The receptionist, somehow, managed to keep her cool and told the client 1) not to speak to her in that tone and 2) that she has no knowledge of his pet's history, as she is not a veterinarian.  While she realizes the doctors (myself and the referring DVM) have spoken to each other about his kitty, it is her job to make sure that the paperwork is completed. She was making no assumptions or judgements about the vaccine status of his cat, and just wanted him to reply "yes, up to date" or "no, out of date." The client backed off, for now.

I entered the room to discuss a treatment plan for his kitty, and the subsequent estimate, including 24 hours of hospitalization, blood typing, a blood transfusion, rechecking the PCV, and other supportive measures.  The client then again became irate.  He accused me of inflating prices to steal money from my clients, he claimed that "no other" facilities charges would even be a 1/3 of our charges, and that he just KNEW we were "screwing" him.  I tried to explain to him that "no other" facilities in our area have staff (veterinarians and technicians) in the hospital overnight, no other facilities stock blood for transfusions, and his regular facility did not feel that the care of his kitty was within their abilities.  

"I AM AN EMT!" He screamed at me -- "and I KNOW what these things cost.  You can buy that blood for $2! and you're charging me $300 for it!" (This is obviously not true -- blood costs quite a bit more than $2 to purchase, it expires frequently and we have to stock it even if we don't use it, and the cost of the transfusion also has to include administration, transfusion monitoring, staff time, plus some small amount of the fixed costs of keeping a hospital open 24 hours a day, including electricity, phone bill, water, tech wages, equipment, etc)

I was baffled.  If he actually was an emergency medical technician, then he should understand the costs of health care more than an average person !   He should realize that if this was his kid, and not his cat, the bill would be about 10 times higher than what I was presenting to him.  Regardless of this, he continued to insult me, my hospital, my staff, and anyone who crossed his path.  He continued to use abusive, aggressive, accusatory language, even stating that everyone in the community KNEW that we were only out for money, and that he hoped we went out of business. (I have quite a few "Thank you for saving my pet!" cards that I'd like to show him...)

The only option at this point was to reduce the estimate, and the only way to achieve this was by reducing the level of care to be provided to his cat (including returning the cat to the RDVM in the morning, and eliminating some helpful testing due to his unwillingness to let us perform them).  He accepted this lower version, however had plenty more to say --

Client: "So I'm not really comfortable what happens next.  I don't trust you guys.  What are you going to actually DO to my cat?"

Me: "We're going to start with a blood transfusion, oxygen, etc.........<i carefully explained the treatment plan for the fourth time>"

Client: "So what if she doesn't use the whole unit of blood? Will you just give it to her anyway? And what if she needs more blood or continues bleeding?"

I explained that we typically start with a "dose" of blood, and can give more from the same unit (without additional charges) if needed, however, blood once opened, must be discarded within a certain amount of time due to risk of contamination.  Additional transfusions (at additional cost) may or may not be necessary depending on the cause of hemorrhage, as well as other treatments/procedures/surgery/etc.  He accused me of having a "monopoly" on blood in the area.

My colleague, arriving to the hospital to start her shift, had been listening to the majority of his tirade.  Fed up, she stepped in.  "Actually sir, it's impossible to have a monopoly on blood.  Any veterinarian with a cat, a needle, and a syringe has access to blood.  They can collect blood from a healthy cat and give it to a sick one if they wish. It's something that we actually do here from time to time if we are out of stored blood, and if you don't wish to treat your cat at our facility, you are welcome to leave, against medical advice.  We're just trying to treat your cat, and I wish you could understand that we're not out to get you."

The clients left, and so did I.  The cat stayed to receive the transfusions, and hopefully, the cat does well.

I don't understand why a small portion of the population is like this.  It still surprises me every time just how awful some humans can be.     Why does he think we want to harm him or his pet?  How are we supposed to take care of pets without paying for the costs? Why does he expect us to come to work every day and not receive payment for our knowledge, skills, and services? How are we supposed to pay for our education, our equipment, or our employees?  I try to express these things, politely, in situations like this one.... but usually, I get nowhere.  I just don't get it.


  1. I honestly don't understand this mentality either. A few of the interactions that I remember the most from my days at the CSU Vet teaching hospital in Colorado were like this. I have to wonder about people who do this with you... do they treat other people in their lives this way? Do they do something similar at a physician's office? Or is it reserved specially for their vet? I have to think that they have some sort of guilt about their pet's condition and it comes out in this horrible form... or something along those lines.

    I'm sorry that as part of what you do, you have to deal with jerks like this. I hope you're able to treat his kitty, in spite of his poor treatment of you! -Tammy

  2. I wonder the same thing -- this type of person, old enough to have adult children, should have learned by now that "You attract more bees with honey than with vinegar." Presumably, people like this have been getting what they want for the majority of their adult lives by acting like a-holes! Who caves in to that attitude? Certainly, not me.

    What's really not fair is that this type of person walks in, insults me and everything I stand for, as well as my profession, place of employment, and co-workers... and we must stay professional, courteous and refuse the urge to tell them/him how we really feel.

  3. See...that's what I hate about our job. Putting up with sh*t like that. What gives people the right to act like that in ANY venue?? ARGH. Sorry you had to put up with that. People suck.

  4. Do people really think this kind of behavior gets them anywhere... seriously.. if anything it makes the situation worse.. who is going to even think of giving the person who acts this way a break on anything, even a figgin bandaide..

  5. Sounds like the cat owner is mentally ill and/or wanted try to push you to the point where you would eject him. Thus he could keep his money and claim to all his friends and family that the cat died because the vet denied services. He wanted off the hook finacially and he wanted to be able to blame you when the cat died.