As a veterinary oncologist, discussions related to money are a difficult but essential part of my job. Veterinary cancer care is a completely elective, and expensive, enterprise. Unfortunately, not every owner can afford the recommendations I make, and not every pet with cancer will have the chance to undergo treatment by an oncologist.
It’s challenging to not allow finances to overshadow crucial aspects of the conversation with pet owners. Concerns about cost, especially those related to expensive diagnostic tests that have no therapeutic value for their pet, are common. The lingering public perception of veterinarians being “in it for the money” and looking to “take advantage of owners” contributes to the problem.
The many negative dialogues I’ve had with owners about finances over my career has created a tiny, irritating and completely biased voice in my head that enjoys uttering phrases such as, “This owner won’t treat their pet,” or “I don’t think they can afford the diagnostic tests, let alone the surgery.”
I’m professional enough to quiet that voice and discuss recommendations with owners based on facts rather than feelings. But it lurks within the recesses of my memory, eager to pipe up with dramatic banter.
Cost of Cancer Care
One of the times that internal voice is guaranteed to chime in is when I’m facing elderly owners of pets with cancer. Presumptions created from poor past experiences prematurely assume these owners lack the financial, emotional and time resources required for the care I recommend.
I’ve experienced many instances where the adult child's primary concern is the amount of money their parent(s) will shell out for their pet’s care.
The volume of that voice can sometimes be magnified when adult children of owners of pets with cancer are present during appointments. The children are usually there to provide both physical and emotional support for their parents, but sometimes boundaries are blurry and I’ve experienced many instances where the adult child’s primary concern is the amount of money their parent(s) will be shelling out for their pet’s care.
The concept of disagreement among family members about spending money on healthcare for a pet isn’t new. I’ve encountered it frequently among spouses, siblings and even in-laws. When finances, familial relations and furry friends intersect, I must tread lightly and be cautious in word and deed.
Willing Dog Owner, Resistant Son
The most striking example of an adult parent-adult child conflict I recall was that of Mrs. X and her son Mr. X Jr.
Mrs. X was a charming and sweet woman who owned a geriatric hound dog with lymphoma, a very treatable and common blood-borne cancer in animals.
Mr. X Jr. was the polar opposite in both appearance and demeanor to his mother. He was imposing, brusque and impatient, and much to my dismay, would accompany his mother to each of her dog’s appointments.
Despite the trials her beloved canine companion faced, Mrs. X would tell me, “You’re the doctor. You know better than I do what’s best for my dog.” She never refused my recommendations. She never balked at the cost of the treatments. Though she often showed outward signs of tears and sadness, she consistently and gratefully embraced my abilities to treat his cancer.
Suspicious of Vet
Mr. X Jr. spoke very little, but projected the facial expressions and body language of someone with little or no interest in what I had to say. He had the remarkable ability to change the tone of the conversation towards money, somehow bringing the financial aspects of the dog’s care to the forefront, rather than the medicine.
Mr. X Jr. did not support his mother’s decision to pursue cancer care for her dog because he was concerned about the amount of money she was spending. He also made it clear he had concerns I was preying on his mother’s emotions for my own monetary gain.
Whereas Mrs. X’s actions refuted my inner voice’s ramblings, Mr. X Jr.’s attitude fed my bias and strained my ability to do my job correctly. Though I understood why Mr. X Jr. was so protective over his aging mother’s finances, it was challenging to meet with the two of them each week.
Giving in to Mr. X Jr. meant stopping treatment for Mrs. X’s dog, and no longer having to deal with his judgmental ways. I even had an “out” since her dog was diagnosed with a terminal illness and I knew he could not be cured. But giving in would also mean compromising care for my patient, since there were options for her dog and fundamentally Mrs. X deserved the same treatment as everyone else.
Communication a Must
In the end, I maintained my loyalty to Mrs. X and her pet, and endured her son’s attitude with as much grace as I could muster.
I’m certain there are unethical practices occurring every day when it comes to seniors and people looking to take advantage of their status, but to assume a veterinarian is looking to “cash in” on someone because of his or her age is preposterous. It’s as bad as me assuming a son or daughter with such notions is acting out of selfish motivation to keep money within the family in order to inherit it.
There’s a difference between decisions made by parents that a child may not agree with and decisions that truly put their parents at risk. As is the truth for so many aspects of life, communication is key.
Children should be able to communicate their concerns with their parents. Parents should be able to tell their children their goals for the health care of their pets. And my role as a veterinarian is to present the facts and options in an honest, concise and ethical manner, keeping the patient’s best interests in mind.
We must trust in each other for the process to work.
And remember to quiet down the unhelpful voices in our heads that tell us to do otherwise.