Some time ago I got a call from a man whose dog was not eating or pooping but was vomiting for several weeks. He asked for advice about a home remedy to make the dog poop. Since we have to watch what kind of advice we give over the phone, I talked him in to bringing the dog in to be seen.
The dog had clearly been in a bad way for some time, dehydrated and severe weight loss. The owner agreed to a blood test, and some prescriptions to deal with the vomiting. He refused further diagnostics, and in fact refused to pay for some of the other prescribed stuff, stating he could buy them cheaper at a vet supply.
Over the next few weeks, he called the Boss several times, demanding answers as to why the dog was not getting better. Boss Man told him that without further diagnostics to pinpoint the cause of the problem, he couldn't begin to speculate why the dog was still sick. Which turned into an altercation that ended up with the owner picking up the dog's records from our office and finding another vet.
Fortunately, the new vet wouldn't touch the dog without full diagnostic work up. A simple x-ray (which the owner refused to have done at our office) showed that the dog had eaten a sock. Unfortunately by this time the dog was so emaciated that surgical intervention was life threatening, so the dog was given some stuff to hopefully pass the sock on his own. I don't know whether it was successful or not.
Boss Man, through no fault of his own, was labeled a Bad Vet by the dog's owner. I see at least one of these types of reviews on the internet for just about every vet listed.
Unlike human hospitals who must treat everyone who comes through the door, veterinary hospitals are businesses and the depth of treatment depends on the owner's ability to pay. Diagnostics can run into the hundreds or thousands of dollars, hard to do in a bad economy. The scope of diagnostics and treatment is determined by what the owner can afford. It's a tough choice.
Like human medical science, veterinary science is not exact. Every practice has seen patients who we are sure will be fine suddenly take a bad turn and die, and those who we are sure we are seeing for the last time defy the odds and live to try to bite us for years. I've lost count of the owners who come in angry and tell Boss Man "you didn't tell me my pet was going to die!" or "you treated my pet and he's not better, I want a refund!" Sadly, these people are beyond reasoning with, and the reason why many vets won't touch a sick animal without full sets of diagnostic tests. Which of course makes the bill higher.
There are so many factors that determine how an animal will respond to treatment, and many of them are beyond our control. If something goes wrong, the vet gets blamed. The veterinary profession is definitely not for the faint of heart.