There is a fish in the ocean called a Cleaner Wrasse, and it is trusted by numerous, amazing kinds of fish to remove disease causing organisms from them.
This cleaner fish does not want anything, it doesn’t hope for fish to get ill, and it doesn’t complicate the relationship. It’s simply “makes a living“ whenever a fish with a health problem shows up. That’s it. Not complicated.
Doctors on the other hand, are a little different.
It used to be that doctors were “individuals”in small towns with a reputation and a good name. Their kids went to school with other kids. They were accountable to the community. What they did reflected on them for better or worse.
Until in 1960, the Supreme Court ruled that corporations could own the doctors.
This broke that bond between the doctor, those things like ‘reputation’ and ‘accountability’ in the community, because the corporations were solely profit motivated.
Behaviors, marketing practices, standards of care, and the “requirements“ of customers who were about to receive care were suddenly determined by non-doctors with long-distance last names, and reputations, who could hide behind, (and blame the mercenary nature of their behavior on) the “shareholders“.
They say: “I personally would never do this, it is mercenary and extortionist, but “the shareholders“ demand a profit on their stock investments.“
That cop-out has been used since the advent of “corporate“ structure.
Some of us remember when Union Carbide destroyed the lives of tens of thousands of people in Bhopal, India.
The cost cutting and deferred maintenance that led to that disaster; while certainly they were decisions made by a couple of key people, that stained legacy does not follow their family-name and their kids, it ended with the corporation. Their individual unethical and even criminal decisions and poor choices no longer reflect on them morally, but they should.
So, where am I going with this?
Veterinary medicine has taken the same turn, because now, veterinarians are increasingly “employee“ and they get cornered by corporate practice to do things that they may or may not think are “in the best interest of the pet.“
Like mandatory bloodwork before they can attempt a surgery in a terminally ill patient. Two views on all radiology even when the penny is obviously in the stomach or the fracture is non-comminuted-transverse and you’re referring: STILL the extra $100 for the second view.
Essentially, the establishment of ridiculous “minimum database“ items that mandate more spending before an appropriate treatment can be instituted.
This experience that I had while practicing in corporate-medicine sums it up perfectly:
An owner might (did) call up and tell me that their cat had a tapeworm. There is a dewormer that controls *all* intestinal nematodes and cestodes. I could have given the cat that pill, and know “for a fact” that it no longer had an intestinal worm of any kind. That’s far more “certain” than any test!!
However, in that particular corporation, I was unable to even dispense that tablet until I had entered the #SKU for a complete physical exam, and a fecal analysis. Only then, did the dialog box for the tablet open up.
That client, unknowingly, ended up spending at least $75 more than they needed to, because someone in Arizona figured out a way to make veterinarians over-practice, and oversell.
I was ‘done’ with corporate veterinary medicine in less than a year. I’d seen enough.
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