Monday, June 30, 2008

Incredible But True II

This is a little segment I like write periodically about recent experiences that seem hard to believe. Whether funny, inspirational, despicable, stupid, or miraculous, as incredible as these short stories may seem, they are oh so true. . .

Insensitive Client

A normally amicable and friendly client came in with his bulldog. My wife, who was about mid way through her pregnancy at this point, was in the exam room with us. The client asked her kindly how her pregnancy was going just as another technician entered the room, who happens to be about 55 years of age. Not having heard what the man said, but thinking that he was addressing her, the older technician asked, "What was that sir?" His reply shocked us all: "I asked how the pregnancy was going, a question clearly meant for Mrs. Welton, not you who is way too old and dried up for that."

Deadbeat Clients

4 months ago I came to the office on a Monday morning following a long weekend and inherited a case from the weekend attending veterinarian, of a very sick rottweiler. With neither myself nor the office manager present, the staff made the big mistake of allowing the doctor to begin an aggressive diagnostic work and treatment course for a patient whose owners had no previous history with our hospital, with no down payment. The canine patient, who was diagnosed with and under treatment for pancreatitis, diabetes, and hepatitis, needed several days of hospitalization to have any chance of survival. When I ordered the floor technician to enforce our policy of collecting 50% of the estimate before we go any further with treatment, the owners of course told us they had no money. When we directed them to Care Credit, they were quickly declined.

After I explained to them that they had already incurred a bill of $500 in diagnostics and treatments, and that I cannot run this up any further without any assurance of payment, they pleaded with me to continue, that they will make $200 payments every two weeks until the bill is paid off. Since the dog (who was a sweetheart of a dog) would die without treatment and my staff having already made the blunder of allowing this case to get this far without any funds from the clients, I reluctantly agreed to move forward.

What followed was a 2 week period which included several days of hospitalization, more diagnostics, and even late night telephone conversations to advise them at home. Their bill had accumulated to over $1200 after this period, and sadly the dog lost his battle with his many ailments and died. Grief stricken, the clients asked me if I would extend them just a bit more credit in order to arrange a private cremation so that they may keep his ashes. Even though they had not yet provided even a nickel toward their bill, out of compassion, I allowed this.

One week later, the owners called me excited and thrilled about the purchase of a new rottweiler puppy, bragging about how the breeder wanted $800 for the dog, but they talked him down to $600. I told them that I was glad that they were resolving their grief so well in such a short time, but that if they can afford $600 for a new puppy, then they can afford to pay the debt they owe to my hospital. To this, the clients assured me that they would square up when they come in for the ashes.

2 weeks later, the husband and wife clients came in to retrieve their dog's ashes, still not having made one single payment toward their bill. At this point, I began to feel very taken advantage of and finally put my foot down, telling them that they will not be permitted to get their ashes until their bill is settled. Once again they pleaded with me to allow them to have their ashes, that they were about to get paid on a contract next week, and their will would be settled then. This time, I did not give in, and told them that I will keep their dog's ashes safe and sound locked in my office, until such time that they pay their bill, after all, what is one more week to wait for the ashes.

Of course, next week came and went, still with no payment from these clients. Eventually, they sent their 16 year old niece to pick up the ashes, having her give us a sob story about how much it hurts her aunt an uncle to not have their dog's ashes, and begging us to release the ashes. I told her that the ashes will be released only after their bill has been settled. I also called the clients to tell them how appalled I was at their sending their young niece to manipulate us into giving the them the ashes.

Now 4 months later, the ashes are still in my office, as these people (they are no longer my clients so I refer to them as people, a term that I am not certain they even deserve) still have not made even one payment on their bill. We have long since sent them to collection and accept the situation as an expensive learning experience.

Impossible To Please Client

A client brought her cat in because he had been falling and unable to walk straight. The attending veterinarian observed the tell tale signs of acute vestibular syndrome (circling, head tilt, falling), a condition that affects the patients ability to balance due to inflammation of the brain stem. We do not know what exactly brings this on, but it tends to spontaneously resolve on its own over a period of hours to up to 14 days. During the recovery period, we treat the patients supportively with antinausea and antidizziness medication.

After the attending veterinarian explained all this to her (good news, considering that the client had thought her cat was suffering a stroke), she proclaimed that the doctor's explanation was not adequate, and she demanded better. Unable to appease the client, the doctor's only recourse was to refer her to a veterinary neurologist for another opinion, thinking that perhaps a neurologist may provide the certainty that this client was supposedly lacking.

Of course, the neurologist concurred with my doctor's assessment, reiterating the likely diagnosis. Still the client was not satisfied and demanded more concrete evidence. An MRI, a CT scan, a spinal tap, and $4000 later, the final diagnosis by exclusion due to lack of any lesions or abnormalities found on these tests, was vestibular syndrome. Still not satisfied, the client stormed out of the referral center with her cat.

As a courtesy, I telephoned the client first thing Monday morning. She explained to me that the cat had spontaneously recovered and was doing well, but was extremely unhappy that no one gave her answers. After spending 30 minutes on the telephone with her explaining the physiology of vestibular syndrome, and the fact that the cat's spontaneous recovery confirmed the diagnosis, she told me that she was not satisfied with any of the doctor's that had seen her cat, including the board certified veterinary neurologist, and demanded that we fax her the cat's records because she was going elsewhere to find another vet who would tell her what happened to her cat - this after 3 veterinarians has clearly done exactly that.

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