Vol. 60 February 1, 2012 “I Coulda Been a Vet!”

We got a free kitten for Christmas. His fuzzy black head with saucer green eyes popped right out of the top of the Christmas stocking, just after we registered surprise that the stocking was undulating. Within 24 hours that less-than-two-pound pile of free fur had cost us $150, thanks to “miscellaneous purchases” at PetCo. The first visit to the Vet cost $103.75; the second $161.25.

My mother thought I would be a good vet because of my comforting ways with animals. I thought being a physician was perhaps a nobler calling, and besides, Vet Schools were harder to get into than Med Schools in 1962. At the end of my medical school time I had ruled out obstetrics because they did half of their work at night, surgery because I couldn’t live without lunch, and psychiatry because I didn’t think it was medicine. That left internal medicine and pediatrics as the sole remaining specialties. I couldn’t decide, and so signed up for a joint internal medicine-pediatric internship, 6 months for each specialty.

I did my internal medicine rotation from July 1 to December 31. On January 1 I started my pediatric rotation in the ER. On January 3 I had the most painful ear infection I had ever had in my life. Despite this omen, but buoyed by the success of that magic bullet, amoxicillin, I signed up for a pediatric residency. Dr. Sydney Gellis, past Chief of Pediatrics at Tufts and a sympathizer with practicing pediatricians unlike the other normally aloof academicians of the day, used to extol us at national meetings to “at least charge as much for your shots as the vets do.”

Charlie, that’s the kittens name, got his Feline Viral Rhinotracheitis (FVRCP) shot at 2 months for $26. “Rhinotracheitis” is a fancy word for runny nose and windpipe inflammation, in other words, a cold. A rabies vaccination was $26 and the Feline Leukemia Vaccine and “snap” (FELV/FIV/+) was $61.25. In our pediatric office we charge $46 for vaccine administration. I really have no idea of what we actually get paid. Each insurer pays a different amount. We were offered Cat Health Insurance for $17 a month for life (the cat’s life; ALL of them presumably) with a $500 annual deductible, but we turned it down.

We pediatricians do circumcise infants, but we don’t neuter. We do guaiac tests for occult blood in stools ($36 charge) while the vet did a “Fecal Exam (flotation)” for parasites (I presume) for $21.75. The vet also charged $4 for “medical waste disposal” and $5 for “medical record set-up” which is something we pediatricians should think about, for the dirty diapers alone.

I wonder what the dues are for the American Veterinary Medical Association (AVMA)? They have 20 specialties listed under their banner, including Veterinary Radiology and Veterinary Dermatology, two lucrative specialties under my AMA banner. Of course, the dues for the American Association of Feline Practitioners (AAFP) would be extra. Like the American Academy of Pediatrics (AAP) and the AMA they both publish guidelines (“Feline Life Stage Guidelines”) , conduct multi-day, professional education conferences in resort towns, publish warnings about feline risks of obesity , and even sell a 118 page “Disaster Response Handbook”.

So, being a pediatrician may not be all that different from being a vet. While planning a new building for our group pediatric practice, I was reminded of how close it was when the architects remarked, “Except for the lack of stainless steel exam tables, this project is just like our last one, an animal hospital.” After all, half of my patients can’t talk, and I spend a lot of time dealing with their worried, anxious owners….excuse me,… parents.

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