A while back, an advertisement from a competing veterinary hospital crossed my desk. The glossy postcard was printed with the hospital’s logo on one side, and on the reverse, a statement indicating the surgeons were now offering “lifetime guarantees” on a particular commonly performed veterinary orthopedic procedure.
I don’t remember the exact details of what was promised, but I do recall the sour taste in my mouth I developed when I read the card. When I considered the implications of the above-mentioned “warranty,” I couldn’t help feeling a widening in the notch of disappointment regarding some aspects of my chosen profession.
As consumers, we’re constantly inundated with the concept of “Money Back Guarantees” for products or services. Nearly everything we purchase can be returned if we’re unsatisfied with the outcome, fit, taste, or performance. Though we are ingrained to be wary buyers, overly accommodating businesses and an overwhelming sense of entitlement pave the way for us to be lax in maintaining our end of the bargain.
We’re taught slogans like “the customer is always right” at a very early age. We expect “reward cards” at retail stores or fast food restaurants. Our competitive (and materialistic) society offers us advantages such as “perks,” “cash back,” “loyalty points,” or “rebates” for simply offering up our initial (and hopefully repeat) patronage.
We no longer simply accept an apology when dinner entrees are botched or flights are cancelled due to inclement weather. In addition to a full refund of our financial input, we demand further incentive for our “troubles.” “What’s in it for me?” pervades when we get anything less than our way.
Should these ideals apply to veterinary medicine?
As a veterinary oncologist, it would be impossible for me to offer any guarantees for how a patient might respond to any particular therapy. There are so few cancers I treat where I have enough evidence-based information at my disposal to offer owners an accurate sense of outcome. And I always have to keep in mind that patients can sometimes get better in spite of my intervention, rather than because of it.
The larger question is whether offering pet owners a lifetime guarantee on a particular procedure or treatment or therapy is actually detrimental to our profession.
I’m concerned that this approach to patient care further perpetuates an already damaged approach to the health care of our pets, where veterinarians are asked to offer gold standard medical care with a “car repair shop” mentality.
We’re often expected to determine a diagnosis without diagnostics, being accused of wanting to run every analysis in the book just for financial gain.
We are asked to treat based on possibilities rather than certainties when owners don’t want to put their pet “through anything,” even when the remedy could be far more toxic than the test.
Sick pets are “dropped off” with the hope of being restored to a state of wellness, not unlike an aging automobile in need of restitution.
People disapprove of the notion that medicine is an imperfect science, yet this is supported daily in exam rooms around the world.
Reality tells us patients can worsen despite our best attempts to heal them. Technological advancements designed to eliminate human error and streamline healthcare are ultimately subject to the fact that doctors are mere mortals. Repaired fractures break down. Incisions become infected. Samples get lost. Pets die. These are the bare truths of our profession.
Even when I’m certain the most appropriate treatment for a patient is drug “X,” I may prescribe that particular medication and the pet may wind up with a terrible and unpredictable allergic reaction. Statistics tell me a cat should be cured with a procedure I recommend, but they could experience relapse of disease within a few short months. I may offer a grave prognosis to a distraught owner, only to have them contact me a year later to let me know their pet is alive and well.
How can doctors offer a guarantee of services when dealing with a complicated living organism?
If we continue to treat veterinary medicine like other service industries, I’m certain all involved parties will wind up nothing short of disappointed.
Clients will not be happy when presented with the “fine print” that is sure to be tacked onto their warranties.
Veterinarians will not be happy feeling as though they must accurately predict an animal’s outcome or else be faced with refunding their fees.
The only guarantee veterinarians should offer is a commitment to upholding their oath taken upon graduation:
Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge.
I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics.
I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.