Ummmm, WOW??? Read this to the END!!

Another reply to my post!

Paula,
You've received a great deal of excellent practical advice. Good thing I read ahead, because I'd have repeated many points, including:

>>> Ultimately, it's the owners' decision to commit to the level of care the pet needs, and along with it the subsequent costs. <<<--Julie Gildemeister
It's been my experience (internship in multi-specialty private practice, 2 years as a GP, and almost four years in emergency and critical care) that most people can find a way to afford the things they WANT. Sometimes, people want not to be evicted or have their car repossessed, or to buy groceries, and, for these reasons, are forced to cut corners on their pets' care. More often, they want a Hummer, or a 3000 sqare foot home, or a Carribean vacation, or season football tickets, or whatever... The bottom line is that the choice is theirs.

>>> The key is to not get emotionally involved. That's impossible to do day in and day out - we all get emotionally involved, even those of us who don't, if you know what I mean. <<<--Julie Gildemeister

>>> The key here is that the owner DECLINES further treatment, not that you refuse to continue further treatment. <<<--Julie Gildemeister

>>> Unfortunately there is no money fairy to pay these bills, and hospitals can't survive. It's your job as the doctor to make your recommendations, and the clients to choose yay or nay. <<<--Janet Ford
Exactly. You are no less successful as a veterinarian if someone won't let you do what's best for the patient.

>>> It does take some time to get emotionally detached. But after 17 years, I've learned that a) you can't save them all; b) you can't care more about the pet than the owner; and c) some decisions are out of your hands. I can live with euthanizing a suffering animal and eating the costs. Otherwise I can do basic stuff and ship, having them sign an AMA if needed. <<<

>>> no good deed goes unpunished. <<<--Janet Ford
This is "Golden Rule #2" at our practice; comes right after "Do unto others..." Rarely do we have a complaint on a case that does not clearly involve someone going far above and beyond to help a client or their pet.

>>> In order to survive and help more patients and do the greater good, that part has to be numbed a bit (at least in my case) or you can't function. <<<--Tony Johnson

>>> It is admirable that this affected you so deeply and helps give me faith in our profession. <<<--Tony Johnson

>>> Seeing a patient reunited with their family when the outlook looked so grim is really, really worth it. <<<--Amy Carr

>>> Don't get discouraged. This is still the best profession in the world. <<<--Amy Carr
Emergency practice (in particular) can be frustrating, and it can wear you down at times, but some of your clients can't (or more typically) won't do what you recommend. But when they do... boy, it's a fun job. With your obvious commitment to your patients--and to communication--you're likely to find that you have many more clients who comply with your recommendations.

It's good to see you thinking about this situation. It shows you are struggling to determine and set your own personal boundaries. For some, this happens early in our careers. For others, it's a difficult process that can take years (and a few jobs). The quicker you find your boundaries, and the more you stick to them, the happier you'll be in the long run. Keep in mind, however, that your boundaries will change with time, and you should be open-minded when you run up against those with different beliefs (because there are plenty of us out here!).
Yours was an excellent question. I wish all of our student externs asked tough ones like this. I'm going to guess you already have an internship lined up, but, if you don't I'd like to encourage you to come meet us in Phoenix before you take a job...
BG
W. G. Griswold, DVMEmergency Animal Clinic, PLCPhoenix, AZ