What if every time you visited your doctor you paid no fee for service? No office fees. No consultation fees. Your blood pressure, heart rate, and all your vital signs were checked without any charge. Much of the diagnostic work? That’s free, too.
Wouldn’t that be great! But there is a catch.
It seems that you can’t leave the doctor’s office without a bag full of medicines — pills, tonics, specially formulated vitamins, etc. Some for ailments, real or imagined, you didn’t even know that you had. Your doctor refers to these as preventive maintenance. He recommends them to all his clients. So what if you don’t have a thyroid issue. Your doctor says that if you take these pills for the rest of your life you will never have to worry about your thyroid.
What’s with all these medicines, you wonder?
Well, that’s how your doctor makes his living: Selling medicine. At least that’s how he derives most of his income. Without pushing his products, he can’t pay his bills. Those school loans are astronomical. Then there is the mortgage, the kids’ college tuition, and, of course, that eight-party Caribbean cruise that’s been in the planning for the past six months.
That’s why you just bought a second medicine cabinet.
At least you will be able to run in the 5K next week. You thought the calf strain was going to put you on the sidelines. But the injection really did the trick. You feel as good as new.
Other goodies you got during the office visit were two plastic bags full of vitamins and stuff. Looks like an IV drip. You doctor called it a “jug.” “Hang a jug,” that’s what he said. It’s a concoction of his own making, only sold to special clients. Very exclusive – and expensive. He said you were going to need it. “You’re going to be really dehydrated after the race, especially after you take the stuff I gave you to flush out your system. Remember to take ‘flush’ just a few hours before the race.”
It's a great business model if you’re the doctor. If you’re the patient, it’s a drug-ridden health care model.
Welcome to the world of veterinary care at the racetrack.
Business model at the track
Here is how The New York Times described the veterinarian’s practice in a 2012 expose titled, “At the Track, Racing Economics Collide With Veterinarians’ Oath.”
Yet in the shed rows of America’s racetracks and at private training centers, racehorse veterinarians often live by a different code — unique in the veterinary community — one that emphasizes drugs to keep horses racing and winning rather than treating soreness or injury through rest or other less aggressive means, according to dozens of interviews and a review of medical and regulatory records.
Only veterinarians can legally prescribe medicine, yet they often let trainers, who are paid to win races, make medical decisions, including which drugs to use. These veterinarians also have a powerful financial incentive to prescribe drugs: they are both doctor and drugstore, and so the more drugs they prescribe, the more money they make. Selling and administering drugs, in fact, accounts for most of their income.
In contrast, veterinarians who treat small animals or pets earn most of their money from examinations and other professional services.
“Is it any wonder that our industry is being criticized for being overmedicated?” said Stuart S. Janney III, chairman of the Thoroughbred Safety Committee of the Jockey Club, an influential industry group.
The American Association of Equine Practitioners, the industry’s most influential veterinary group, acknowledges that “to a very large extent” medical treatments are geared toward when a horse is racing, rather than toward what might be in the horse’s best interest. And while the group has worked hard to make racing safer, it has made scant progress in changing how racehorse veterinarians earn their money.
“That’s a tough nut to crack,” said Dr. Jeff Blea, the association’s vice president. “You are talking about decades and generations of the way things are done.”
Cracking the nut
Can the horse racing industry survive with this conflicted business model in place? As Dr. Blea said, this is the way it’s been done for “generations.”
I’ve seen nothing from the veterinarian community, horsemen’s associations, or regulators to indicate that there is any serious effort afoot to change this drug-ridden business model. On the other hand, no one is rushing to defend this model, other than saying, in effect, “It’s always been this way.”
In this day and age, the mantra of “It’s always been this way” rings hollow.
There are solutions, which I’ll address in a future column.
But for now, let’s see how you did in that 5K.
You finished. Although you did fade in the homestretch. You thought your calf muscle was fine – until the next day. Now it’s worse than ever. Rest. That’s what you need. You should put yourself on the vet’s list for the summer and shoot for some races this fall. That’s what you should have done all along.