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My vet refuses to provide a prescription

Horse Care
#41

Why not just mark up regular services to cover the losses?

Well, you already complained about spending the $600 for a lameness exam! How many threads have we seen about people complaining about the cost of farm calls, emergency fees. etc. etc. You just can’t please horse people! IF vet raises their services fees, even just a hair, the clients will go to the next cheapest guy!

Why in the WORLD would a professional give you materials AT COST? In ANY business? Next time your plumber comes out to fix something, look at his “farm call”, and as well, I am sure that $0.75 piece of hose he replaced he charged you $15 for.

It’s universal, folks. You can hire a contractor to put in a new floor for you. I’m sure his price compensates him for the labor of installing the new floor, but I bet there is a mark-up for him ordering and purchasing the flooring material. I’m sure you can buy the same flooring online, or at Lowes for cheaper.

Offer your vet a nominal fee for a prescription to be written. Save the relationship!

But don’t forget, it is not as simple as just “writing a script”. Someone else has to file that information, log the script and put it in the records. Time = money. Also, I was told that my vet is wary about just giving out scripts, that he’d rather fax the info into the supplier for you. Too many things have happened, scripts are copies, signatures altered or forged, and it all comes back to the vet. They have to protect themselves. That script carries a lot of information.

For example, one script got copied and altered, for a substance that tested on the racetrack. Several horses pulled a positive test, the trainer was investigated and they found several bottles of medication in the trainer’s tack room. Was kinda against the guidelines to have that much at one time (like boxes of it). They traced it back to the vet that wrote the original script. He scripted ONE (1) bottle and they altered it to read ONE HUNDRED (100).

He spent a lot of time and $ defending himself, just over a piece of paper.

#42

My cat vet called in the script. I assume at 30/bottle, costco made some sort of profit. Or let’s even say costco was just using the thyroid med as a loss leader, making no profit.

Then surely, there was some point between $30 and $700 that was a more reasonable profit? Otherwise, each of us at that small animal practice are paying profit of $670 each, monthly. Just for the thyroid kitties. I will add that the $700 was for an initial “increased dosage” which supposedly would have been lowered after awhile, getting me to around $500/month.

I understand that the price I am asked to pay is to keep this vet practice alive in my town. However, at this point, he has priced himself out of my market - I can drive further and actually get better care/diagnostic skills and a reasonable markup, so that is what we do. I understand the cost of pickup trucks, medical equipment, employees, you name it. But there is a point where markups are too extreme.

I will add that I haven’t seen gouging in healthy vet practices. Maybe sizable markups, but not gouging.

1 Like
#43

We always provided a prescription if a client asked for it. Meds and veterinary care can be expensive, if they have the opportunity to save a little, we were happy to oblige. Mostly, we wrote them for stuff we didn’t carry or hearworm meds. We never charged.

#44

Does anyone else see a conflict of interest here? Vet exams horse - Vet recommends treatment - Vet prescribes drugs needed but only on the condition that Vet supplys drugs.

Seems entirely plausable to me that Vet could be prescribing unnecessary drugs for treatment simply to make more $.

IMO, a reputable Vet should be willing to write out a script for no additional charge.

As far as the excuse about their wholesale costs being higher and having to inventory the meds, etc. Most vets have the opportunity to belong to a large purchasing group that allows them access to competitive wholesale pricing.

#45

Our vet has infact offered to write a “script” for us, even saying “you know you can save a little money getting it from a vet supply, let us give you a script”!

They are amazing in every way and we will NEVER change!

2 Likes
#46

I’m very grateful for my vet. Last summer we tried alot of different things to treat my ponies heaves. She didn’t hesitate to write me a script for albuterol. When that didn’t work she dropped off a bottle of ventipulmin. Didn’t charge a farm call, and left a note telling me if it worked she’d call in a script to the company of my choice. Same with the pergolide the same pony is now on. She called in the script to a company she recommended, said if I wasn’t happy or found it elsewhere for cheaper she’d call in another one. They understand owning a pony with chronic health issues can be expensive. I tend to buy from them first, they’re mark up is not nearly as bad as the small animal vets in my area. $500+ just to neuter my cat, my equine vet charged me $45 to do it on the feed room counter. Another $35 and he had all his shots. FWIW I could also drive 20 minutes across the state line to NC and pay less then $200 to have the cat neutered and all his shots, etc done?! I know the small animal vets around here can’t pay that much more for supplies then the vet across the state line in NC does. So what’s their excuse for the outrageous fees?

1 Like
#47

pricing of drugs

My vet’s comment “I prefer to charge for my knowledge and skills and not for the drugs”. His drugs are less expensive than the local vet’s. He drives in from a couple of hours away and his farm call is about the same as the local guys. He’s a great lameness vet and we don’t use him for routine stuff -we spread that out to the locals so that we can get someone in an emergency.

#48

Some companies tell the vets that they do not sell to the online or mail order catalogs. Novartis makes Adequan I believe and that is one of the companies that reportedly does not sell to those companies- Bayer would be another. Vet offices are told by those company representatives to be ware of their products sold online as they may not be real and they can not guarantee that they were handled properly. Just FYI.

#49

Yes…it is clearly a conflict of interest. That is the main reason it is unethical. Writing scripts is a part of practcining medicine…equine or human. Trust me, vets are better off then the majority of human docs because they are a cash practice…no insurance companies that set thier rates like MD’s…often at levels that are below cost:0

I agree that I would much prefer to pay a higher rate of thier services or expertise…but the over charging for meds just make me crazy.

#50

Liver Yang Rising

[QUOTE=Liver Yang Rising;2254404]
Why not just mark up regular services to cover the losses?

Well, you already complained about spending the $600 for a lameness exam! [/QUOTE]

HEY!

Be careful who you address. I am the OP and I didn’t complain, I said I was fine with the exam and expenses…I am not fine with my vet refusing to write a script.

Be careful when you make these broad statements and who you direct them to…

I am WELL AWARE of the issues around prescription writing since I AM A PRESCRIBER.

My vet is usually great, so I am going to see what she says…I am hopeful she will be reasonable.

1 Like
#51

Here is a link that list all fifty states and the state regulations governing vets prescribing drugs. 25 states require a vet to write a script is you request it. :slight_smile: 26 states do not.:frowning:

http://members.verizon.net/~vze2r6qt/supplies/legal.htm#arizona

Click the link and scroll to the top and you will see all fifty states with a “yes” or “no” indicating if there is a regulation on writing scripts or not.

1 Like
#52

[QUOTE=Tiki;2252186]
I don’t get this ‘tradition’ of acting as vet and pharmacist, all in one and charging you up the ying yang for a piece of paper with their signature on it to buy the meds someplace else. [/QUOTE]

This is called CONFLICT OF INTEREST. It’s why so many animal owners are up in arms every time the vets try to horn in on yet another area, even those they’re not qualified to oversee. For example, in many states, vets want to make it illegal for someone to do body work (massage, Bowen, acupressure) without a vet standing right there. Give me a break. Most of the time the vet doesn’t even know how to do those procedures! They have a monopoly and they want to hang on to it.

#53

“Trust me, vets are better off then the majority of human docs because they are a cash practice…no insurance companies that set thier rates like MD’s…often at levels that are below cost.”

LOL! I issue the challenge to any MD or DO reading: I’ll compare student loan debt to income ratios ANYTIME!

Trying to draw comparisons between human and animal medicine is impossible for many reasons. The most pressing, in my mind, is the issue of insurance. The average human writes a check or presents their Visa card for their $15 doctor visit copay, or $50 ER copay, and never even sees a bill for the total amount of their visit or procedure. If people knew what health care truly costs, NO ONE would complain about the price of veterinary care.

As for veterinarians selling drugs, the vast majority of the ones I know have little desire to be pharmacists. If we did, we would have gone to pharmacy school and started out making 100k per year. :wink: However, in the not so recent past, there were very few outfits like Valley Vet or Jeffers, and your vet HAD to be the source of your drugs. Veterinarians, particularly large animal docs, got used to this business system. One can argue that a well managed practice should not have to depend on drug sales to support undercharged services. That’s a valid argument. Unfortunately, many practitioners have done it that way for so long that they are comfortable with it, and as we all know, change is hard.

The small animal heartworm preventative question is a completely different ball of wax from the large animal drug question. I have no problem writing a script for a client who wants to buy a bottle of SMZs from a reputable company. I DO have a problem with someone attempting to buy a foreign product from an internet pharmacy that is operating illegally. Bottom line: heartworm preventatives obtained from anyone other than a licensed vet were sold illegally at some point in the chain. If you use that Australian product, be aware that it might be labelled in kilograms, have Australian poison control numbers on it, and be outdated before you receive it. You have no idea how or where it was stored. If you use it, and your dog has a reaction, your vet is the one left to clean up the mess.

THANK YOU to animal owners like sid. I’ll be your vet anytime! :slight_smile:

2 Likes
#54

Right, CJ.

Let me know when you folks find a human clinic willing to perform an ovariohysterectomy, including pre-op bloodwork, anesthesia, post-op pain meds, and suture removal for even an order of magnitude more than the DVMs who do it day in and day out.

The longer I spend reading you people bitching and moaning about how all the equine vets are ripping you off, the happier I am to be out of full time practice.

Meanwhile you go out and buy breeches made with $5 worth of components for $250…

1 Like
#55

No one says vets don’t work hard or deserve a good income.

I am not loaded with money and cannot subsidize my vet no matter how wonderful and deserving she may be. I pay my bills and am willing to buy meds from my vet if the cost is reasonable. In this case there is close to a $100 difference and that is too much for me to absorb.

The question is not whether my vet deserves my business…it’s can my vet ethically refuse to provide me with a prescription of a med she recommended or charge me a fee for writing that prescription?

I say “no”.

1 Like
#56

In this case, ethics are personal, not professionally mandated. I attempted to explain to you why some vets write scripts in some instances and not in others.

Legally, 25 states don’t agree with you. :slight_smile:

#57

Sure, but 25 do!

I, too, don’t want my patients to buy drugs that are counterfeit or may not be stored, transported properly etc. But, I don’t refuse to write the prescription or tell my patients that they have to get their drugs at Rite-Aid…and if I stood to make any money on the situation (say, I was a stockholder in Rite-Aid) I would be even more circumspect.

I respect my vet and her opinion. And if I could afford to buy from her (or she was willing to meet the prices from reputable companies like Mountain Vet or Smart-Pak) then I would buy from her. But she doesn’t, so I have to take my pharmacy business elsewhere.

It isnt a slam on her…and she may indeed write the script for me…but while I think vets can make recommendations and share their concerns, I think it is unethical (personally and professionally) to withhold the script.

1 Like
#58

And I have agreed with you on that.

What I have disagreed on is the generalized squawking and screeching on this thread and on others like it where everyone chimes in about how all of us in the veterinary profession are living large on the big bucks we gouge by putting exorbitant markups on the drugs we dispense.

That’s BS, for the most part.

And the same folks who whine about that are the ones who whine about the barn call charges, the emergency fees, and the fact that the vet is late, etc., but who also expect the DVM to have all the latest high tech toys like DR, etc.

It gets old hearing that, folks.

1 Like
#59

Ghazzu, I agree with you. People spend a fortune on tack and clothing(horse and rider) but flinch at the vet who cares for the source of all our enjoyment asking to make a profit. No profit=no practice in the long run. I don’t pay any more for an emergency call in the middle of the night during a snow storm than I do for an emergency call on a bright, sunny morning. A 10 day hospitalization for horsie including all care, meds, room and board for less than $ 5000…my daughter’s trip through emergency room, intensive care and pediatrics over 36 hours=$15,000…son’s trip to the emergency room with meds and x-rays=$1500/4hours.
Maybe all of us human medical providers don’t charge for the prescription, but many do require an office visit to asssess the problem before prescribing. Most human primary care providers would refer to a specialist for a condition requiring diagnosis and treatment with ongoing injectable meds. Most equine vets do it all themselves, at all hours, in all conditions and at relatively low cost. I’m willing to pay a bit more for the convenience of one stop care for my horses by a skilled professional.

1 Like
#60

[QUOTE=hluing;2255298]
. . . . Trust me, vets are better off then the majority of human docs because they are a cash practice…no insurance companies that set thier rates like MD’s…often at levels that are below cost . . . . [/QUOTE]

Ghazzu - I always look for your posts. I enjoy your sense of humor. But this is one time you got a little off. CJ put quotation marks around the first sentence because it was a quote from hluing. CJ is with you on this, friend not foe.

Human medical expenses are incredible - $2,000 for an ultrasound that my vet would charge $25 for . . . & give me results on the spot. Plus which, my vet comes to the horse but I have to go to the hospital to have that ultrasound. (Yes, there is a farm call fee for the vet but it is minimal.)

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