A message for the "human medical community"
CMAJ 1997;157:637
The brief article "Veterinarians' suggested fees may leave physicians feeling ill" (CMAJ 1997:156:1689 [full text]) deserves comment. Because we acknowledge the media's appetite for controversy, real or perceived, we ignored the original article, written for the Ottawa Citizen. However, when an excerpt from this article, with commentary, is printed in a human medical journal, we take serious exception.
Veterinarians are health care professionals and businesspeople who administer our own hospitals while maintaining standards required by the College of Veterinarians of Ontario: there are no publicly funded facilities. We provide complete anesthetic, radiologic, laboratory, dental and surgical services, and many of us provide specialized care such as endoscopy or diagnostic ultrasonography. We must maintain an inventory of all supplies that may be required for a procedure. How many physicians know the cost of an 8-mm endotracheal tube or a bottle of isoflurane? Our fees must reflect these overhead costs and pay for nursing, technical and other support staff while ensuring an adequate standard of living for ourselves. The Ontario Veterinary Medical Association employs an economist to examine the real costs of veterinary medicine. Our suggested fee schedule is based on this work.
When we perform a double-contrast urinary-tract study (usually a cystogram), we must cover the cost of tranquillizing agents, contrast media and delivery instruments, rare-earth screen radiographic plates, processing chemicals and equipment, radiologic equipment, a designated room for performing the procedure, dosimeters, view boxes and technical staff to assist. The animal must also be kept in hospital for the day. After these costs are covered, our fee pays us for performing the procedure, interpreting the film and advising the client. What does the fee paid to a physician cover? If it merely reimburses the physician for performing a procedure and interpreting film at a publicly funded facility, comparison of the 2 fees is impossible.
We can empathize with the human medical community's frustration with health care funding. However, to take that frustration out on another group of comparably educated health care professionals without examination of the facts is inappropriate. That such statements appeared in a national medical journal verges on the unprofessional.
Donna Petersen, BSc, DVM
Erik Petersen, BSc, DVM
Cumberland Veterinary Hospital
Orleans, Ont.
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