Monday, November 27, 2017

The Accidental Veterinarian

I did not plan on becoming a veterinarian. In fact, when I was a child I was only dimly aware of what that was as we did not have any pets other than a gerbil, for whom professional medical care was honestly never a consideration. For many years I wanted to be a geographer or a historian at a university. Yes, I was a strange child. Then in high school my interest in animals and nature, which had always been there at some level, began to grow and I added research zoologist to the list. But veterinarian still wasn't on the radar.

My father was a practical man, and a man who had become cynical about academia. He was a physics professor at the University of Saskatchewan and he believed that academic jobs were becoming both increasingly scarce and increasingly unappealing due to university bureaucracy. Consequently he viewed my interest in pursuing an academic career in zoology, history or geography with growing apprehension. He was fond of the pithy German phrase, "Brotlose Kunst", which translates directly as "breadless art" - in other words a career or job that doesn't put bread on the table. He left the choice up to me, but made it clear that he recommended I pursue a profession instead.

I was a freakishly obedient teenager (mostly), so it came to pass that I spent a sunny Saturday afternoon in March of 1983, the year I graduated from high school, methodically going through the University of Saskatchewan's course calendar. The programs were listed alphabetically. I began eliminating them one by one - Agriculture (boring), Anthropology (Brotlose Kunst), Art (Brotlose Kunst)... and so on. As per the profered advice I paid particular attention to the professional colleges, but I steadily, inexorably, eliminated them all too - Dentistry (ha), Engineering (boring), Medicine (nope - sick people are gross) etc... I was comprehensively alarmed by the time I got to Theology (ha) as I had almost reached the end of alphabet without finding anything that made sense to me. There was only one program left. I turned the page and saw Veterinary Medicine written there.

Huh. Veterinary Medicine...

I couldn't think of a counter argument. In fact, the more I thought about it, the more appealing the idea became. This was essentially applied zoology! Moreover I reasoned that I had always liked dogs and cats, although I had never owned one...

In the impulsive way of 17 year olds I decided right then that, yes, this was Plan A. It also helped that the father of a girl I had a crush on was a professor at the vet college... But I knew absolutely nothing about the profession. I hadn't even read James Herriot. When I did find out more about it I began to waver (Herriot had the opposite effect on me than he did on most people) and completed a Biology degree first, but my faculty adviser echoed my father's advice - get a profession, go into veterinary medicine like you had planned. And so I did.

The great majority of my colleagues wanted to be veterinarians for as long as they could remember. In most cases they had to move a considerable distance to Saskatoon or Guelph to attend veterinary school. Their plan was clear and their commitment was strong. In contrast I still marvel at the accidental nature of my entry into the profession, a profession that has not only given me a wonderful career, but through which I met my wife and through which I moved to Winnipeg. What would have happened if the U of S hadn't offered Veterinary Medicine and the last entry in that course catalogue had been Theology...?

Some accidents are happy. This is one of them.

Thursday, November 16, 2017

The Anatomy Of A Vet Bill

Mr. Malloy was the type of jovial older guy who wore a camouflage coloured cap and red suspenders over an expansive gut. And the type of guy who loved cracking lame jokes. You know the type. Kind of annoying, yet also kind of lovable.
One day he was at the counter paying his bill when he said, "Holy Dinah! A hundred bucks? You gotta be kidding me? I must own a wing of this hospital by now!"
At the other end of the counter Mrs Chu was paying her $1500 bill and quietly exchanging knowing smiles with the receptionist.

If we had a hospital wing for every client who felt they had paid for one, we would be the size of the Pentagon by now. (Besides, veterinary hospitals generally don't have "wings"...)

But I get it. For a lot of people veterinary medicine is expensive.

Some in my profession push back against that statement and say that we just need to look at dentists and plumbers bills to see that we are not that expensive. No, dentists and plumbers are also expensive, just like us. A lot of modern life is expensive. For many people living paycheque to paycheque (47% of Canadians in 2017) a surprise $500 veterinary bill (or dental, or plumbing, or whatever) is difficult to manage, and a surprise $2000 bill is a potential financial catastrophe.

So now that we have established that veterinary medicine "is expensive", why is it expensive? The number one reason is that we have rapidly evolved to a point where our standards of care compare favourably to those for humans. The arguments about the rightness or wrongness and the whys and wherefores of this evolution are best left for another post, but the fact remains that we now practice close to "human level" medicine and consequently have some "human level" expenses. There are no special veterinary grade sutures, catheters, pills, computers, rent or education for that matter. In fact, for many of our supplies we pay more as we don't have access to the volume discounts the human hospitals do. It is interesting  to note that Americans complain about veterinary bills less often than Canadians because they know what human health care costs.

There are many scary expressions in a practice owner's lexicon - "audit", "lawsuit", "burst pipe", "crashed server" - but one of the scariest is "overhead". The others are avoidable, but overhead is unavoidable and in some practices it can gobble up almost all of the revenue. In my clinic I have calculated that it costs us $400 an hour to keep the lights on, the doors open, the supplies stocked and the non-veterinary staff in place. This is before any veterinarian gets paid. During the busy season this is easy to cover, but in the doldrums of January when you can hear the proverbial crickets in the waiting room you may see me obsessively watching the bank balance and line of credit. I might even be chewing my fingernails...

So, where does your money go? In our practice on a very broad average, for every dollar you spend about 25 cents covers veterinary salaries and benefits, 21 cents to staff salaries and benefits, 27 cents for variable costs like drugs, supplies, lab charges etc., and 15 cents for fixed costs like rent, computers, utilities, accounting, maintenance etc.. This obviously varies enormously from service to service, and it also varies a bit from year to year. Our veterinarians are on salary, so the 25 cents doesn't go straight to them, but in some practices vets are paid a percentage of their billings.

The mathematically astute among you will notice 12 cents missing. That is the theoretical "profit" or, more accurately, "return on investment", that is divided among the owners (there are seven in our practice) when we have kept a good eye on our overhead. I discussed this in a previous post, but in brief, those of us who own practices have to take out substantial loans to buy them, or, in the case of a new clinic, build them, so this money helps slowly pay those loans off. I suppose a theoretical non-profit clinic would be able to lower it's prices by that 12% and would have to somehow fundraise to build, expand etc.. It still would be expensive. Veterinary medicine is expensive. But - and forgive the self-serving nature of this comment - it is so worth it. What price can you put on health and love? Especially in a world where people are apparently buying thousand dollar smartphones...

Monday, November 6, 2017


Mook was my first "real pet". This statement may prompt hate mail from the gerbil lobby as I did have a gerbil named Bobo ( when I was twelve years old and I suppose I loved him, but to be honest, only in the way I loved my favorite toys. I really wanted a dog, but there was simply no way that was going to happen. My parents didn't have pets growing up (it was worn-torn Germany after all - there were many other priorities, like survival) and none of the people they knew once they emigrated to Saskatoon had pets. It simply wasn't part of their world. They didn't view it as a bad thing necessarily, but it was something "other people" did, like line-dancing or cross-dressing.

Then while I was starting second year biology at the University of Saskatchewan, we moved to an acreage about 20 km southwest of the city. It had always been my father's dream to own land and live in the country. Experimental plasma physicist by day, gentleman farmer by night (and weekends and holidays). He began to collect tractors and outbuildings to house these tractors.

One late autumn day a black-and-white kitten appeared in the tall grass around one of these outbuildings. It was good mousing terrain I suppose. It was a boy and it was probably about 10 weeks old. My parents had no idea what to do. I was preoccupied with school and with being a young adult with a car and a social life (such as it was...), so I didn't pay too much attention at first. The kitten was extremely friendly. It would run up to you and immediately begin rubbing on your pant leg, purring at an improbable volume for such a small creature. And in the way of cats who hone in on the least cat friendly person in any given crowd, he took a special liking to my father.

Winter can hit quickly in Saskatchewan and it can hit hard. After gentle badgering from the rest of us my father allowed the kitten to come into the detached garage and began to feed him there. He did this himself, saying he was in there all the time anyway. Sure, it was a nuisance, but not much of one. But the kitten was only to be allowed into the garage, nowhere else. Certainly not the house.

Somewhere around this time the kitten acquired a name. We called him "Mook" because my mother said that that was the chirping sound he made when he head-butted your hand, "mook, mook".

I imagine that many of you have already worked out for yourselves where this story is going. You are absolutely right. As winter set in the garage became quite cold as well. My father said, "Ok, the cat can come into the house, but only the basement. Nowhere else." Our basement stairs had a door at the top, so in theory it was relatively simple to keep him down there. Mook would however cry pitifully from behind the door. So soon my father said, "Well, during the day Mook can come up on the main floor, but at night he goes down. And he does not go into the bedrooms or my study."

A few weeks later I came home early from a Saturday running errands in town. My mother and brother were still out. When I came in the front door I heard an odd sound coming from upstairs. It was a shuffling and scraping noise and the sound of my father chuckling, although he was home alone. I went upstairs and saw that the door to my father's study was open. I peeked inside and saw him on his hands and knees, playing with Mook, both of them delighted.

I started veterinary school two years after Mook came into our lives and he was my constant study companion. He knew exactly where to lay on my desk where I wouldn't shoo him off. He made some of the abstractions that were being taught seem more real and he was a source of comfort when I was stressed.

In 1990 I graduated and moved to Winnipeg. Although I called him "my cat", Mook was really more my parents cat, so there was no question that he would stay. He continued to have adventures on the acreage including being quite seriously injured when he was either hit by a car or fell out of a tree, we're not sure which. My mother was visiting family in Germany when this happened, so my father nursed him back to health, giving pills, changing bandages and phoning me frequently for updates and advice. My father had never phoned me any other time for any other reason. Something shifted between us when he did this. Two adults talking together, needing each other. He passed away in 1994 from a brain tumour.

Then in 2002 my daughter Isabel was born. Mook was quite old by that point - I suppose 18 when I do the math. During one of the first visits with the baby to Saskatoon Mook padded into our room and clambered up onto the bed, where I was holding Isabel, trying to settle her to sleep. Mook curled up beside her, purring. I remember so very clearly how grateful I was to him and how strongly I felt the connection from Isabel to my father through this cat. A living link. I couldn't stop myself from crying.