You’ve read the newspaper, you’ve read the news stories: “HMOs are good.” ” HMOs are bad.”
You’ve seen the ads that claim, ” We have a new HMO that’s not like all the others.”
With discussions about health care for humans dominating the news and the letters to the editor, it’s natural to compare human medical care with the treatment you get at your pet’s doctor.
My best friend and fishing partner, John, has a saying, “‘When I get sick, I call Jim first to see what he thinks. Then I go see my physician.’ I’m already armed with information. My veterinarian doesn’t depend on me to tell him where it hurts, he deals with patients who can’t talk. So he’s not so swayed by the words I use to describe problems. He depends more on his findings and his training to make a list of differential diagnoses.”
One day last week I was in a panic because I was two minutes late for my first appointment after lunch. I like being punctual. The occasion reminded me of my last visit to my physician. I was 30 minutes early, and waited 21/2 hours after my appointment time to get in.
People just won’t stand for that with their veterinarians.
With that in mind, I thought MyPetsDoctor.com readers would be interested in what Dr. John Mawk of Portland, OR, had to say about the practice of medicine. This commentary originally appeared in Portland’s The Oregonian in 1998 and is reprinted with permission.
DR. MAWK’S STORY
“Two nights ago we had to take a family member to the doctor. Although he was quite old, there wasn’t so much really wrong until the last few days. Then his eating dropped off and, on what proved to be his last day at home, he simply couldn’t walk any more.
We were late for our appointment, but they worked us in after a few minutes, anyway. The general practitioner who saw him was kind, yet succinct. She suspected that he had an advanced cancer, and she correctly diagnosed marked anemia.
We discussed an intermediate level of treatment while we notified and gathered the children, but she was emphatic: He wouldn’t live through the night without a transfusion, for which she wasn’t equipped. She referred us to an emergency hospital so we could get the definitive diagnosis we wanted. She sent the blood samples with us as well as the abdominal X-rays, and called ahead.
IN THE E.R.
The admitting people were efficient, and we waited less than 10 minutes to see the doctor, even though there were several patients in the emergency room. The hospital was very clean and quiet. The diagnosis was now more specific–a high degree of suspicion of an abdominal tumor.
A chest X-ray taken, developed, and read in a few minutes, failed to demonstrate metastases [spread of the cancer]. The doctor made our family member comfortable, began a transfusion, and called a surgical consultant. We were told to come back in two hours. I noticed a brochure for a grief support group on the wall of the emergency room and took one.
By the time our dinner was over (none of us were very hungry), two units of blood had been given, and the consultant who’d dropped by to see one of his other post-op patients had visited. He, too, felt that there was a tumor.
We were allowed to visit as long as we wanted. Even though the nursing technicians were busy, we never were made to feel in the way, but it was clear that the patient was tired.
THE DECISION
I dropped by and visited the next morning before surgery was to begin. The technicians were preparing things for surgery. I called at 7:30, as instructed, but the doctor was just opening [the abdomen]. I called back at 7:45, and the news was very specific: two bowel tumors, each quite large, and two liver metastases. I was told that it might be lymphoma, and that chemotherapy might work–if only the patient wasn’t so old.
I told the doctor I’d call right back. Then, after conferring with my wife, we elected to terminate care, right then. Dear Adson, our family dog, was allowed to simply die at that moment. He was cremated, and we’ll have his ashes in a week or so.
The cost for this excellent and very compassionate care, both during and after his life, was $1063. We felt the cost was very reasonable for a beloved family member who’d stood guard duty for eight years and was the friend of all who entered our home.
We’d ensured that his passing was comfortable, and we’d established a definite diagnosis. We’re fortunate enough to have been able to pay this much, which some readers no doubt will view as squandering money. We certainly could have stopped much earlier had we so chosen.
LESSONS LEARNED
My point is to note the high level of compassion, efficiency, and expertise that we encountered from veterinarians and their staff members. No one asked us for proof of ability to pay up front. No one asked us what plan we were members of, or declined to undertake the care of our pet because they weren’t on the right panel.
The doctors were concerned about their patient and his family. There were few forms to fill out and no long visits. There’ll be no endless review of events by insurance clerks questioning eligibility or the doctors’ decisions.
There was frank discussion. Three practitioners told us the same thing, and used words like “die” and “cancer”. Things were clean and, perhaps as a relic of the past, smelled antiseptic. No large wing of the building was devoted to administration.
The doctors were actively concerned that our 11 and 12-year old children were involved in decisions. The technicians and assistants were very supportive; even though they had seen death many times, they knew that this death would be very hard for us.
A TIME TO GRIEVE
There was time to grieve, and before readers conclude that this was “only a dog,” they should see the crying that went on outside our family circle by others who knew this gentle beast. And perhaps best of all, there was a definite end to things.
I certainly learned something two nights ago. I do something very high-tech, and I know that many times my colleagues and I cannot deliver services to our human patients as well as these veterinarians did to my pet.
Try as we might to achieve a result, the “system” of American medicine often traps us all–doctors and patients alike–in red tape, confusion, time waste, malpractice fear, and endless bureaucracy. American healthcare-reform planners might do well to reflect for a moment on what the medical experience is really all about. Take a good, long look at the veterinarians before we change further the course of American medicine. There are definitely lessons to be learned.”
EPILOG
Thank you, John R. Mawk, MD, for your touching story of the loss of your pet, and the salute to our colleagues who are out there doing their best, every day, for pets and caring pet owners like you.
