famous episode of the television show Seinfeld, Kramer decides to go to his
friend’s dog’s veterinarian and advises the dog has the same symptoms as he
does. He figures that the vet will treat him with the same medication but at a
huge discount compared to the cost of going to a medical doctor. While we all
agree this is great humor albeit quite ridiculous, we may not realize how wrong
Kramer was. In fact, he might have gotten a far greater discount, if this dog
was ill, going to the medical doctor and suggesting he had the same symptoms as
week a colleague told me a story about his dog and the cost to care for him.
Unfortunately his best friend died as a result of congestive heart failure, a
common illness that he and I see, and his dog received an echocardiogram as
part of his visit to the vet. The cost of this echocardiogram (ECG or EKG),
that required immediate payment, was about $800. The study also
included an abdominal sonogram, which appeared unnecessary, and was performed
by his vet, who is not a specialist in heart disease. The machine used to conduct
the test was likely an older model previously used on humans that cost a
fraction of the echo machines he uses for his patients.
or any other cardiologist had performed the same type of echocardiogram, with a
new and far more costly machine, we would be entitled to about $250 and would
hopefully receive payment from the insurer within a month. The dog’s “echo”
cost him more than twice he receives for performing an echocardiogram on a
human! And he had to pay in cash before the doctor agreed to do it! Many
cardiologists now have to call the patient’s insurer and give a detailed reason
why they wish to do the study before that insurer even agrees to pay for it.
years ago I met a person whose animal had thyroid disease and required thyroid
hormone to prevent the symptoms of hypothyroidism. She told me she purchased
this medication from her vet for about $60 each month. And yet the same
medication, if it were prescribed for her by a “human” doctor, can be purchased
for as little as $4 a month from a pharmacy at Wal-Mart, Target, or
for your dog is likely to run you over a hundred dollars while the average
Medicare reimbursement for a 12 lead ECG/EKG with interpretation is $18!
procedures and imaging studies, often performed with used and inexpensive
equipment are costing the owners of their pets much more than a medical doctor
would collect performing a similar procedure. And again, most vets demand
payment, sometimes thousands of dollars in advance.
hope that medicine is going to the dogs. I would like to be paid, by the
insurers, an equal amount to what the vets are billing for an ECG/EKG or an
echocardiogram on a dog.
Dr. Evan S. Levine is a cardiologist in New York and a Clinical
Assistant Professor of Medicine at Montefiore Medical Center – Albert Einstein College of Medicine, and affiliated with St. Joseph's Medical Center in Yonkers.
also the author of the book “What Your Doctor Won’t (or Can’t) Tell You”.
He lives in Connecticut with his wife and children.