Fear, doubt, guilt and profit

Re: Fear, doubt, guilt and profit

Hannah Wynne Richards — Thu, 25 Sep 2014 09:35:28 GMT

I aquired a new patient 2 days ago. Another veterinary surgeon had diagnosed Cushings in an old pony - and said nothing to be done - just give bute for laminitis when (not if) it occurred. The owner googled it - and called me in!

I don't know, but I suspect this irrational dislike for charging could have been the reason the previous veterinary surgeon didn't offer treatment. Lifelong pergolide and metformin aren't cheap, and the pony's not worth much - but the decision on affordability is legally and morally the owners. We have absolutely no right to even attempt to decide for them by restricting treatment options to what we feel comfortable with.

Grrrrrrrrrrr!

Re: Fear, doubt, guilt and profit

Francisco Gomez — Fri, 19 Sep 2014 14:55:49 GMT

Client outrighteousness after 'feeling' that they're being ripped off:

[quote]

Car mechanics and garages (I'm convinced they charged me for some wiper blades that never made it onto the car)

[/quote]

Disgusting people... They're obviously don't care about my car suffering

[quote]

'Computer people' (the sort that would go and help my Mum, and she would fall for it)

[/quote]

Disgusting people... They're obviously don't care about my laptop suffering

[quote]

Dentists (except it never really crosses my mind that a dentist would try and pull a fast one, no pun intended)

[/quote]

Disgusting people... They're obviously don't care about my mouth suffering

[quote]

Doctors (as above)

[/quote]

Disgusting politicians... What the h*ll are they doing with the NHS money?!?

[quote]

Financial consultants (Anyone for a mis-sold pension?)

[/quote]

Disgusting people... They're obviously don't care about my future

[quote]

Electricians

[/quote]

Disgusting people... They're obviously don't care about my appliances suffering

[quote]

Plumbers

[/quote]

Disgusting people... They're obviously don't care about my 'pipes' suffering

> The immediate guilt transfer comes from misinformed individuals and poor education, usually from social media and TV. + a hint of irrational instinct. If you have been 'uneducated' on transferring blame to someone else, the easiest way is to the person who says: I can help your animal, but I won't if you don't pay me. Automatically that means that you don't care about animals and are therefore a bad person - It doesn't happens with electricians because there isn't the feeling that animal is being 'hurt' if you don't pay.

Re: Fear, doubt, guilt and profit

Hannah Wynne Richards — Fri, 19 Sep 2014 14:54:25 GMT

BVA need to do a better job of telling the public that for the average UK veterinary practice, the adjusted net profit ( payment for veterinary surgeons to do the work) is only 17.5% of ex VAT turnover, ie for every £120 an owner pays, the government skim off £20, and there's only £17.50 left to pay the veterinary surgeon - and a minimum of 30% of that is further stolen in taxes on income. (SPVS figures)

Wynne

Re: Fear, doubt, guilt and profit

Clare Tapsfield-Wright — Fri, 19 Sep 2014 14:45:13 GMT

I realised the other day that it is the first time I have bought a car or gone on holiday and not been told " I suppose our Fluffy paid for that " or similar comment . Another plus for not being a practice owner any more

Re: Fear, doubt, guilt and profit

Hannah Wynne Richards — Fri, 19 Sep 2014 14:41:02 GMT

But we're private businesses - so we have to make a profit in order to continue.

Wynne

Re: Fear, doubt, guilt and profit

Thomas Johnson — Fri, 19 Sep 2014 12:12:16 GMT

[quote user="Jo Dyer"]

I think that the feeling that we should not be making a profit, comes with the territory. We feel we are here to care, not to profit. Somehow we need to get our heads around the fact that no other profession or occupation in the world feels like this and nobody but us expects us to either! We need to carry on doing our jobs in a good enough way (it doesn't always have to be our best, because then we set unattainable standards which doom us to failure) and we need to accept that we are worth a good income in return.

[/quote]

I wonder if we also worry that the public opinion of vets is that we are expensive, so must be making big profits, so we want to be seen to be not making big profits?

Re: Fear, doubt, guilt and profit

Jo Dyer — Fri, 19 Sep 2014 08:27:24 GMT

Interesting article in the SPVS magazine this month (juxtaposed between articles on RCVS complaints procedure and Performance management/disciplinary matters) about perfectionism in the veterinary profession.

Perfectionism is defined as 'the tendency to employ high standards and overly critical self-evaluation' in this article. To this I would add 'overly critical evaluation of others' and also the fact that being overly self-critical can easily lead to low self-esteem.

As our profession demands the highest academic standards of any, it naturally selects for perfectionists; although my brother who is involved with medical education tells me that the medics are catching up quickly due to an increase in their selection demands.

I hypothesise that it is perfectionism which is responsible for most that is good and bad in the profession. Good: high standards, conscientiousness, altruism, empathy, to name but a few. Bad: poor mental and emotional health, low self-esteem, poor work-life balance.

Easier said than done, but I think it is worth getting the message out there loud and clear.

Why is it not only ok, but essential, to make a decent level of profit? Because we're worth it

Re: Fear, doubt, guilt and profit

Evelyn Barbour-Hill — Thu, 18 Sep 2014 20:26:18 GMT

You make my point, really, Arlo.

Of the people you list, only dentists and doctors are members of professions . Financial consultants might be, if they were chartered/certified accountants. Only dentists and doctors are in "caring professions". I think, without extensive evidence I admit, that dentists and doctors may also feel, as many veterinary surgeons do, this irrational guilt. for the reason I suggested.

Put it this way: most of us know that we are not really ripping people off, but we constantly agonise over whether what we are doing might be ripping people off because we know for sure we have the ability to do so if we choose. And we care.

We also know that a few of our members really are ripping people off.

Re: Fear, doubt, guilt and profit

Arlo Guthrie — Thu, 18 Sep 2014 18:10:48 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Arlo Guthrie"]What IS unique to the caring professions (I think) is guilt about seeking to make or maximising profit. [/quote]

That is because they know they have the power to, if they choose, maximise profits by ab-using their professional knowledge to push the public into buying things that are either unnecessarily expensive or just plain unnecessary. Or, in modern parlance, to rip off the public.

[/quote]

Oo, I dunno about that.

I can think of lots of people who can and do choose to use their professional knowledge to push the public into buying things that are either unnecessarily expensive or just plain unnecessary.

Car mechanics and garages (I'm convinced they charged me for some wiper blades that never made it onto the car)
'Computer people' (the sort that would go and help my Mum, and she would fall for it)
Dentists (except it never really crosses my mind that a dentist would try and pull a fast one, no pun intended)
Doctors (as above)
Financial consultants (Anyone for a mis-sold pension?)
Electricians
Plumbers

So vets are by no means the only people who are in a position to exploit their customers' lack of knowledge for commercial gain. What marks the caring professions out is that if you take advantage of someone's lack of knowledge, in many cases you would simultaneously be taking advantage of their suffering in a way that seems much more obvious and reprehensible than if you'd persuaded them to put a few extra quid a month into a pension they didn't really need, or to replace the boiler that still had a few years left in it.

Re: Fear, doubt, guilt and profit

Mark Hedberg — Wed, 17 Sep 2014 09:46:09 GMT

[quote user="J G Wray"]

It's pretty much vets in the UK. Dentists in the UK don't have much problem maximising their profit.[/quote]

You need to meet more dentists.

[quote]Vets abroad aren't blessed with the same weird vulnerability.

[/quote]

Yes they are.

Re: Fear, doubt, guilt and profit

J G Wray — Wed, 17 Sep 2014 07:38:01 GMT

[quote user="Francisco Gomez"]I wonder what qualifies you for such a statement, specially since the use of semantics is often at the core of your arguments ;-)[/quote]

Oh really, have you no idea how working in Basingstoke makes you utterly cosmopolitan?

Re: Fear, doubt, guilt and profit

Francisco Gomez — Tue, 16 Sep 2014 21:41:23 GMT

[quote]Vets abroad aren't blessed with the same weird vulnerability.

[/quote]

I wonder what qualifies you for such a statement, specially since the use of semantics is often at the core of your arguments ;-)

Re: Fear, doubt, guilt and profit

Evelyn Barbour-Hill — Tue, 16 Sep 2014 18:18:34 GMT

[quote user="J G Wray"]Recommended reading "Not to Worry" by Michele Klein all about why we use humour to cope with worry.[/quote]

Why thank you, your concern for my education is most touching. In turn may I recommend "Seven Types of Ambiguity" by William Empson?

Re: Fear, doubt, guilt and profit

Hannah Wynne Richards — Tue, 16 Sep 2014 17:23:46 GMT

Don't ask me. I find it utterly nonsensical.

Wynne

Re: Fear, doubt, guilt and profit

J G Wray — Tue, 16 Sep 2014 16:54:32 GMT

[quote user="Arlo Guthrie"]Almost any discussion about profit in ANY context is qualified in fear (of failure to make a profit) or doubt, especially in the context of small business. So I don't think that is either unique or weird.[/quote]

OK we can agree to differ. It's how I see things. It's just that these vet people are not incapable. They all have brains the size of planets and have been receiving positive affirmation of their wonderful personal attributes from a young age. So why would they get stuck with fear and doubt when the going gets tough, when budget practices or Corporates open up down the road, or personal or organisational pressures build?

[quote user="Arlo Guthrie"]What IS unique to the caring professions (I think) is guilt about seeking to make or maximising profit.[/quote]

It's pretty much vets in the UK. Dentists in the UK don't have much problem maximising their profit. Medics in the UK are largely employed by The People. Vets abroad aren't blessed with the same weird vulnerability.

I have some cod theories why this is so here, largely linked to some anachronistic sense of professionalism, antediluvian regulation, with a smattering of the bucolic and romantic, kind of like a "guilt recipe". I'm just asking how others can explain it.

Re: Fear, doubt, guilt and profit

Bob Russell — Tue, 16 Sep 2014 15:21:37 GMT

No idea of the joke and did try to find it on Google!

Instead found:

Jewish Telegram, "Begin worrying. Details to follow!"

Let us know the joke!

Re: Fear, doubt, guilt and profit

J G Wray — Tue, 16 Sep 2014 15:20:55 GMT

[quote user="Evelyn Barbour-Hill"]"I should vorry, I don't sell butter".[/quote]

Aaaah I do believe you're selling something though. Recommended reading "Not to Worry" by Michele Klein all about why we use humour to cope with worry.

Re: Fear, doubt, guilt and profit

Evelyn Barbour-Hill — Tue, 16 Sep 2014 15:06:36 GMT

[quote user="J G Wray"]

[quote user="Evelyn Barbour-Hill"]Aaaaaahhhhhh........ I do believe you're selling something. [/quote]

To sell something you need to be credible. I'm quite clear about my credibility. On the subject of profit, how's it going in Bangor, now Vet4Pets has reached even you?

[/quote]

I refer you to the old Jewish joke – if you don't know it I won't bore you with it, but if you do know it you will recognise the punchline: "I should vorry, I don't sell butter".

Re: Fear, doubt, guilt and profit

J G Wray — Tue, 16 Sep 2014 07:32:49 GMT

[quote user="Evelyn Barbour-Hill"]Aaaaaahhhhhh........ I do believe you're selling something. [/quote]

To sell something you need to be credible. I'm quite clear about my credibility. On the subject of profit, how's it going in Bangor, now Vet4Pets has reached even you?

Re: Fear, doubt, guilt and profit

Evelyn Barbour-Hill — Mon, 15 Sep 2014 22:52:02 GMT

[quote user="J G Wray"]

Oh dear. I don't recall this as a modern phenomenon. In 1983 I was instructed that all antibiotic was to be given by injection on three consecutive days.

[/quote]

1983 is not modern?

And clearly you felt slightly guilty about doing that, otherwise it would not have occurred to you to mention it here.......

[quote user="J G Wray"]Characterised as the search for venality by one, as a professional disgrace by another, profit[/quote]

Not recently on this forum it wasn't.

[quote user="J G Wray"]

If anyone is interested in getting away from these constraints then contact me off list, because there are now new opportunities to learn how.

[/quote]

Aaaaaahhhhhh........ I do believe you're selling something.

Re: Fear, doubt, guilt and profit

J G Wray — Mon, 15 Sep 2014 20:52:23 GMT

[quote user="Evelyn Barbour-Hill"]That is because they know they have the power to, if they choose, maximise profits by ab-using their professional knowledge to push the public into buying things that are either unnecessarily expensive or just plain unnecessary. Or, in modern parlance, to rip off the public.[/quote]

Oh dear. I don't recall this as a modern phenomenon. In 1983 I was instructed that all antibiotic was to be given by injection on three consecutive days.

There was no honourable time past.

Anyway back to profit. Characterised as the search for venality by one, as a professional disgrace by another, profit really isn't a comfortable subject here, which is a shame. Imagine how a community such as this could benefit from a fear, doubt and guilt free discussion, sharing and mutual support of the concept.

If anyone is interested in getting away from these constraints then contact me off list, because there are now new opportunities to learn how.

Re: Fear, doubt, guilt and profit

Evelyn Barbour-Hill — Mon, 15 Sep 2014 20:05:51 GMT

[quote user="Arlo Guthrie"]What IS unique to the caring professions (I think) is guilt about seeking to make or maximising profit. [/quote]

I am sad that in modern times some members of my profession see nothing wrong with that.

I am of course thinking of the "regular dental". Among other things.

Re: Fear, doubt, guilt and profit

Arlo Guthrie — Mon, 15 Sep 2014 16:24:55 GMT

[quote user="J G Wray"]As for going over your head well it doesn't need to[/quote]

I didn't mean this thread was going over my head :)

[quote user="J G Wray"]If you read, as I do, almost any discussion on this list about profit, it becomes qualified in fear (of failure to make a profit), doubt (about ability to make profit) and guilt (about seeking profit). That's weird.[/quote]

Almost any discussion about profit in ANY context is qualified in fear (of failure to make a profit) or doubt, especially in the context of small business. So I don't think that is either unique or weird.

What IS unique to the caring professions (I think) is guilt about seeking to make or maximising profit.

Re: Fear, doubt, guilt and profit

J G Wray — Mon, 15 Sep 2014 15:24:29 GMT

[quote user="Arlo Guthrie"]

[quote user="J G Wray"]

If we reduce operating a veterinary clinic purely to the generation of profits (as happens should it be owned by a group of distant financial investors), then our short-term profit will be increased by anything reducing costs / increasing revenue.

Spending less time/effort on surgical prep will yield dividends in treating post-op infections as well as reducing staff time and saving on the need of one of those costly autoclaves, not to mention consumables...
Encouraging unnecessary vaccinations might be a nice little earner.
Electing never to offer euthanasia as an option until you've maxed out all available funds.
Scaring clients into thinking their pet likely has a dangerous condition based on any run-of-the-mill initial presentation, spending a lot of money on you investigating/treating it, and then being delighted when against the odds it "pulls through against all the odds as a result of your fine treatment".
Placing "indecision" as a high quality in veterinary-staff hiring.
Choosing branded drugs when treating chronic conditions that aren't readily available for cost-comparison elsewhere and charging loads.
Only giving small amounts of chronic medicines at a time and insisting on seeing the pet before it gets any more.

[/quote]

To which I might add (on behalf of the RMB brigade): Selling commercial pet food in the full knowledge that it causes every illness and disease see in cats and dogs, all of which you can then treat.

Seriously though, I'd argue that some of the things on your list aren't just maximising profits, they are dishonest / fraudulent.

[/quote]

Sorry old fruit, I can't claim to have written this, twas a Mr Flynn.

As for going over your head well it doesn't need to. If you read, as I do, almost any discussion on this list about profit, it becomes qualified in fear (of failure to make a profit), doubt (about ability to make profit) and guilt (about seeking profit). That's weird.

JGW

Re: Fear, doubt, guilt and profit

bob lehner — Mon, 15 Sep 2014 14:05:50 GMT

[quote user="Arlo Guthrie"]Meantime, I found your post thought-provoking JGW (I don't mean to sound surprised - they often are, it is just that sometimes they fly over my head at about 37,500 ft[/quote]

Yep - I think JGW should write a book on opaque veterinary topics. Add a bit of explicit sex and it could sell well - 'Fifty Shades of Wray' ...perhaps ??