In the previous posts, we examined why pet health care has become so expensive and what you, as a pet owner, can do to reduce your exposure to high priced veterinary care. Once your dog or cat is hospitalized, financial matters are still under your control. It has become common during the education of veterinarians to speak of the “Gold Standard” when discussing how to best diagnose and treat a disease condition. This method involves performing as many diagnostics as needed in order to absolutely confirm your diagnosis. It also enables communication with the client regarding the severity of the disease and its prognosis. Unfortunately, getting to this level of confidence often involves numerous laboratory tests, imaging modalities (ultrasound, MRI, X rays) and other costly procedures. Although a Gold Standard diagnosis is one which we would all like to have, there are financial considerations that may present when weighing the cost, value and likelihood of useful information learned from any particular test. Test results should provide information to answer at least one of these three questions:
1. Making a diagnosis. What is wrong with my pet companion?
2. What is the appropriate treatment for this condition?
3. What is the prognosis or future for my pet?
Once a clinical diagnosis is made, additional diagnostics are frequently recommended or encouraged to confirm. Even though this may eliminate any doubt, it may not change the treatment. For example, recently a dog was presented to the Brockton Animal Hospital with suspected bladder stones. Elsewhere, x-rays and possible ultrasound were recommended in order to confirm the number of stones and their possible composition. Either way, these stones needed to be surgically removed because they could be felt or “palpated” in the bladder by the doctor and the patient was extremely painful. Although additional imaging could have provided more information, it would not have changed the fact that the patient needed surgery. The expense saved on additional testing was therefor available to pay for the necessary surgery. Doctors are trained to use their hands, eyes, ears and critical thinking skills. Often these are ignored and additional testing is substituted. This results in increased costs.
Remember when any diagnostic or test is recommended for your pet, ask which of the following you can expect to learn:
1. Will the results help us to make a diagnosis?
2. Will the results help to provide information regarding the treatment?
3. Will the test results give us a better idea of prognosis?
Once you have a thorough understanding of the expectation, you can then make an informed decision regarding whether the additional information is worth the expense.
The cost of veterinary (and human) care has risen dramatically over recent years. Part of this increase is due to the availability of new technology, testing methods and medical education. Always make sure you have a thorough understanding of any medical recommendation that is made. Don’t be afraid to ask questions or to seek a second opinion. After all, it is your wallet and, even more important, your family member.