Exams
I’m not apposed to a yearly “physical” with the VET but when my dog is coming in 3-4 times a year for vaccines or boosters I don’t want a physical exam or have to pay $50 for it every time especially when nothing is wrong with her.
I don’t consider a vet tech taking my dog’s temp a physical exam and I don’t think I should have to be chraged $50 for it.
[QUOTE=BuddyRoo;4208399]
Yes. It does.
Look. There were MANY clients at my clinic who, in the face of a pretty MINOR situation (<500$) would “elect” to euth. And in those cases, we would offer to take the pet, treat, and rehome.
Nowadays, veterinarians do not make money off of routine stuff if the practice is being managed well. You basically charge slightly over cost for vaccs but you DO charge for professional services–like an exam. A lot of people don’t even want to pay for that. And THAT is where the education and profession comes in.
Anyone can give an IM or sub q vaccine. A monkey can do it. Most clinics no longer charge much for the vaccine itselt–but for the service of an exam.
If people want to cut costs…take the risk of screwing it up yourself and just give the vaccs.
I choose to pay for the exam and vaccs and routine care w/ my vet so that I have an established relationship for the times when I NEED a pro. I was a “tech” for 10 years. I can give vaccs. Hell, I can do a spay, neuter, and a number of other basic surgeries if I had some iso or propofol on hand. That’s not the point. The point is that you’re paying for the expertise.[/QUOTE]
Sorry BuddyRoo, ANY vet whose clientele consists of 45% of non-paying people, should reconsider pricing policy.
[QUOTE=Ambrey;4208453]
I was made to feel guilty for not wanting to do intensive treatment on a 13 year old 3 legged cat with invasive stomach cancer [/QUOTE]
I’ve been reading this thread with interest, and several folk have posted about how their vet made them feel guilty for not allowing treatment/procedures or their vet “guilted” them into something they didn’t want.
People, take control of your lives. Instead of saying, “My vet made me feel guilty…”, say “I allowed my vet to make me feel guilty.”
See the difference? Try it in real life, and take ownership of total responsibility of your animals.
Other than that, I got nothing to add to this thread. I am fortunate to have a very good relationship with my small animal vet, and will be forever grateful for him for saving my now-17-year old Jack Russell’s life last fall, canceling his plans for the evening and spending three hours stitching the pieces back together instead of leaving for his long weekend in the mountains. The bill wasn’t small, but I felt it more than fair.
If I felt like I was getting “ripped off” I would be out of there. But I trust the man. That is worth more than money, in my book.
I never got out of there for that price, even when my dogs were both healthy. And $300 is the HIGHEST bill I’ve had from my low-tech vet, and that was when my dog was dehydrated and needed to be kept overnight.
How would the average transaction price come out at $200 when that’s the price for basic vaccinations/physical, and so many are spending thousands for expensive treatments? Mathematically, it doesn’t make sense unless you include the people who aren’t actually seeing the vet but just buying meds or food (you don’t include that in yours, do you? that would skew the results).
There is no reason even a high end vet shouldn’t offer a lower cost vaccination/annual exam.
Ahh, but that’s not what you said before. Your words were"…those 45% that are being priced out, were priced out the minute they got the animal". That is such elitist bollocks, I hardly know where to begin. What you seem to refuse to realize is that I, along with several other posters responding to you, are the ones that are being priced out. You can’t see it because you’re so focused on jacking up prices that you’re missing out on just how many clients you’re actually losing. And with your theoretical 45% getting smaller, and your theoretical 55% getting bigger, you’re accomplishing your aim very nicely; to make a VERY nice living, as is the right of every flamingly capitalist vet. :rolleyes:
The 45% are usually those who actually do want to do “everything” possible for their pet - but cannot pay for it AND have decided that it is someone else’s fault - usually the veterinary practice.
No, “we” probably can pay for it. We just don’t like bending over and handing you the KY whenever we need something out of the ordinary done for our pet.
As most vets will tell you the client they fear the most are the ones who come in saying "I don’t care what it costs’ ( code for because I can’t pay for it anyway).
Wow. If this is your “bedside manner”, no wonder you have the opinion of your clients that you do. I wonder how many of your “55%” know you feel that way. Bet they don’t. And bet if they did, they’d make tracks away from your narcissistic ass and find a vet that actually cares about them and their animals.
The folks that deeply care weigh their ( usually multiple) options and make their decisions based on their ability to pay and the possible outcomes are always a pleasure to work with.
Wrong again. You just described me, and I’m in your 45%. Oops.
I have no problem with those who choose to not cut a colic or a GDV for financial or other reasons. I have no problem with those who choose to euthanize their old kitty in renal failure rather than throwing a bunch of money at a poor prognosis. What I do have a problem with is making it MY fault that these often intensive procedures cost money. I have had clients spend ridiculous amts of money on cases which were hopeless, I have euthanized cases that were not hopeless but the clients were not up to treatment emotionally or financially. That’s part of it. The point is it’s NOT my choice, it’s theirs and the options have to be offered or it’s NOT good medicine. And it’s actually discrimination. I offer the same options to everyone. In fact I don’t even review my estimates by cost - I do it by procedure/treatment. The staff handles the costs. That enables me to offer my best recommendations without a profit/cost motive.
Again, bollocks. You can’t tell me that you don’t have a damned good idea of what each of your procedures/treatments cost. And how convenient for your conscience, that “the staff handles the costs”. Bollocks. They only calculate the costs of the procedures you recommend, at the prices you set.
Vets could stop offering advanced diagnostics/treatments to their clients and then when a client ( could even be you) truly has a need for it, it won’t be available and your vet won’t be experienced enough to utilize the technology.
Bollocks, again. “Advanced diagnostics and treatments”, if not available at my local vet’s practice, are referred to either the local veterinary specialist practice, or the university medical school. And I’d be willing to bet that neither of those entities are going anywhere, anytime soon.
I would also say that you are right- you won’t encounter me because dollars to doughnuts I live in a tougher area of the country economically than you do- and probably more rural. That’s why management is so darn important. While the rest of the country rode a wave of prosperity for the last 30 years, we have not. To keep the doors open for any of our clients these are lessons we have had to learn.
Apparently, you were absent when those lessons were taught, because from what you’ve written, you’ve yet to learn them.
I wish you luck. I think you’re going to need it. :yes:
[QUOTE=Ambrey;4208503]
I never got out of there for that price, even when my dogs were both healthy. And $300 is the HIGHEST bill I’ve had from my low-tech vet, and that was when my dog was dehydrated and needed to be kept overnight.
How would the average transaction price come out at $200 when that’s the price for basic vaccinations/physical, and so many are spending thousands for expensive treatments? Mathematically, it doesn’t make sense unless you include the people who aren’t actually seeing the vet but just buying meds or food (you don’t include that in yours, do you? that would skew the results).
There is no reason even a high end vet shouldn’t offer a lower cost vaccination/annual exam.[/QUOTE]
Because for every one of of the “spending thousands” there are even more getting a recheck on a skin problem or their anal glands expressed etc etc etc.
And to look at it mathematically- how many “spending thousands” procedures vs spending 100$ procedures can a vet can do in a day? ( ie total hip replacement vs treating an otitis externa).
The numbers I use are from extensive studies done by the AVMA, they are not guesses.
You are correct. I worded that badly, and it wasn’t even really what I meant.
I didn’t feel ripped off, or even pressured. I just felt like they were so used to people who wanted every last treatment provided to their pets that they’d lost perspective on what was appropriate and how to tell someone when it was just time to let the animal go.
I think that’s important in a vet, and when they stop giving that advice because they are afraid to lose high $$ clients, I think they are losing some of their integrity. That plus the inflation of basic care was enough to send me back in time a bit.
[QUOTE=ESG;4208517]
Ahh, but that’s not what you said before. Your words were"…those 45% that are being priced out, were priced out the minute they got the animal". That is such elitist bollocks, I hardly know where to begin. What you seem to refuse to realize is that I, along with several other posters responding to you, are the ones that are being priced out. You can’t see it because you’re so focused on jacking up prices that you’re missing out on just how many clients you’re actually losing. And with your theoretical 45% getting smaller, and your theoretical 55% getting bigger, you’re accomplishing your aim very nicely; to make a VERY nice living, as is the right of every flamingly capitalist vet. :rolleyes:
No, “we” probably can pay for it. We just don’t like bending over and handing you the KY whenever we need something out of the ordinary done for our pet.
Wow. If this is your “bedside manner”, no wonder you have the opinion of your clients that you do. I wonder how many of your “55%” know you feel that way. Bet they don’t. And bet if they did, they’d make tracks away from your narcissistic ass and find a vet that actually cares about them and their animals.
Wrong again. You just described me, and I’m in your 45%. Oops.
Again, bollocks. You can’t tell me that you don’t have a damned good idea of what each of your procedures/treatments cost. And how convenient for your conscience, that “the staff handles the costs”. Bollocks. They only calculate the costs of the procedures you recommend, at the prices you set.
Bollocks, again. “Advanced diagnostics and treatments”, if not available at my local vet’s practice, are referred to either the local veterinary specialist practice, or the university medical school. And I’d be willing to bet that neither of those entities are going anywhere, anytime soon.
Apparently, you were absent when those lessons were taught, because from what you’ve written, you’ve yet to learn them.
I wish you luck. I think you’re going to need it. :yes:[/QUOTE]
Wow. All I have to say is the person with experience will never be at the mercy of the person with a theory.
What was the average for high end vets in high income areas, though? I am sure there must be a range. I do know that the average office call for my current vet has to be much lower than for my old vet, based just on my observation.
[QUOTE=ESG;4208517]
Apparently, you were absent when those lessons were taught, because from what you’ve written, you’ve yet to learn them.
I wish you luck. I think you’re going to need it. :yes:[/QUOTE]
I would like to add one more thing in direct response to this - I have been succeeding at my chosen profession for over 20 years so while I will take the luck, I think it’s a little more than that. 
Ah good morning JSwan et al… I guess the fracus continues… 
NO worries, another fine day and I’ll be outside shortly…
JSwan, I thing your first post back to Dr j was a misunderstanding…
Yes it IS about money in the sense that vets are not charities, they are businesses. Vet med can never be strictly about the medicine, because it is a business. If you are losing money on 45% of your clients, you have to make it up somewhere. At least that was my take…
And if you don’t believe the numbers, my old boss had a average non-payment rate of ~ 20% (Equine practice). Add another 20-25%% for procedures done at or below cost and those numbers look about right…
“No matter how much the standard of care has risen it still does not justify the egregious costs associated with routine veterinary care - which often exceeds the costs for HUMANs to obtain similar care.”
I’ll have to say I strongly disagree with this. As Dr j pointed out you have to look at average transaction, not one specific thing. If you are paying a high cost for the vaccine, it is balanced out somewhere else. For example, I recently underwent OVH to the tune of 30,000. I know that I can get my dog spayed for 1% of that, so average transaction cost between human and veterinary medicine, has a long way to go… And since I always chat with my surgeons and anesthesiologists, I know that they are using the same drugs and procedures I would…And my OVH was done in less than an hour, so it was not complications that drove up the price… (and yes GAP, this was covered by insurance, aside from my copay, which alone was more than I would pay for an equivalent surgery in a pet…)
"The reason we have to is because of the outrageous prices for ROUTINE CARE and increasingly exclusive and upscale nature of small animal practices. If y’all keep going on the path you are on - that 55% is going to start dropping. Actually - it already has. If those percentages are correct 45% of animal owners cannot afford the prices you are charging for routine care.
"
Actually, I’ll bet the opposite is true, the 55% folks are growing or these practices would not be growing… And the other 45% are already being subsidized, and you want more subsidy?
And for the granite countertops, believe it or not, it is actually a selling point for many folks. Appearances matter…maybe not for you (and it wouldn’t for me either), but certainly for a large enough portion of the client base…
I have a good friend who has a low dollar, high volume practice…He talks about seeing an average of 4 patients per hour. He gets the patients in and out with just the basics. Is he busy? yes Does he make good money? Not really, but he lives very frugally… Is it good medicine? Probably not the best, but it’s what that client base wants. Is he happy? No, he’s been so burnt out, he has twice had to take extended leaves from the practice and is still looking for alternatives…
The burn out rate for vets is historically very high, maybe this “change” will allow vets to be happier in their work, resulting in more vets staying in practice (a large portion of my class no longer practice due to burn out). More vets in practice means lower prices for you due to supply and demand… Just another way to look at things…
Again, I say the answer for you is simple, make use of the low cost alternatives, they are out there…don’t go to foofytown for routine vaccinations…
“Even the most urban oriented client is eventually going to balk at these prices. Yet - when any attempt is made to make products or services more available to the public at a lower cost - through the form of direct competition, alternative medicine, certified layperson’s offering a greater range of services - the veterinary lobby attempts to quash them.”
ah, now were are opening a whole new can of worms…I smell a beef! I guess that would be a new thread though, so I’ll leave it…
“When I go to my dr for my annual and breast exam - he doesn’t offer a pedicure and boob job, then back me into a corner if I decline because if I was a really good wife and loved my husband - I’d make sure my boobs looked perky.”
Ah but they do push stuff. I have them calling me to schedule stuff I don’t need… My HMO is really pushy!
"That’s all I’m interested in. I can clip their nails and bathe them at home. If they get really sick or injured I want to be given the choice to end their life without having to be pressured into weeks or months of chemo, or painful surgeries - or have someone demand I hand over ownership so he can be ‘saved’.
My animals - my choices. My responsibility."
You said it, it’s your choice! But know that the nail clipping and such is going to defray costs on other things…
And I absolutely agree, the choice should be yours on how to treat your animal, but the vet has to offer ALL the options and unfortunately, needs to make sure you are clear about your choice to avoid later litigation…it happens…
And the handing over of animals happens mostly when the choice is financial, not old suffering cancer dogs…l. Nobody can demand you hand over the animal, but after you’ve euthanized enough potentially healthy young animals, then tell me you would not want to provide this option for people who could not pay… I’m talking animals with a great chance of survival if they underwent surgery… Really, many owners are grateful for this, it takes away the guilt of putting an animal down becasue of finacial concerns…
From Luvmy walkers
“You are reading my post incorrectly, so let me re-phrase: Lowering your prices a little, so a few more animals who have the misfortune of being owned by those who barely make middle class, can be helped by you, would that put you in the poorhouse? Does it really decrease your profit if you had more volume at lower cost?”
See the part about burn out above… And again, 45% of clients are already subsidized, and you want more?
There are planty of places that cater to people who can’t pay, vaccination clinics, low cost spay neuter programs etc. I don’t know why people think the average vet needs to be doing more of this kind of work… Really, all the ones I know do a fair amount already…
Ah well, rambled on way too much again…
[QUOTE=ESG;4208081]
Bollocks.
The simple truth is that many SA vets are just in it to make money. I have survived encounters with three clinics like those described here, and won’t bore you with the details, but in each case, treatments for small problems (a dime-sized skin tumor removed from a cat - one clinic quoted $1000, the one who did the procedure, $290), were quoted at ridiculous rates. I don’t give a rat’s patoot how aesthetically pleasing a vet clinic is, any more than I do if a human doctor’s office is full of fountains and designer furniture. I want good care at a reasonable price. Just because you spend $1million on building your clinic, doesn’t mean I have to pay for your extravagant taste. And my dog doesn’t care that your Saltillo tile floors and Spanish tile roofed, stucco clinic is the prettiest thing this side of the Rio Grande - he only knows that he gets poked and prodded in the same places, and Mommy growls at the stupid techs who ask the same questions and push the same unnecessary products, over and over. As others have said, no means no, goddamit! STFU and treat my dog, and let me pay you and get out of here- I don’t need a lecture on extraneous, unnecessary costs or a guilt trip from you! :mad: I used to work in a SA clinic, and know all too well the bill-padding that goes on. When I see it on my bills, I automatically start crossing things off the list, and start making arrangements to take the “kids” to a new vet.
I don’t want recent DVMs charging me nearly $400, and suggesting $1000 exploratory surgery for a glove my dog supposedly swallowed (which turned out to be the tech’s hand that got in the way in the x-ray), and then give me a hard time about “being too cheap to care for your dog properly”. Happily, I was borne out by the glove suddenly “deflating” and disappearing (:rolleyes: ) on subsequent x-rays, but the silly little twit only said, “Oh, well, you got lucky”, and never admitted that she was the one that screwed up in the first place. Never refunded any of my money, either, even after I went to the owner of the practice, who was a total ass, too. I guess that’s what you get when your vet gets her chops from Moo U. :rolleyes: And before anyone gets cranky, it’s not A & M.[/QUOTE]
This makes no sense, no tech hand in an x-ray is going to look like an injested glove…It will either look like lead (as in the glove the tech should be wearing) or you will see the bones of the tech… Nobody is going to mistake that for an injested glove (which would not look like a glove on x-ray anyway…)…
And I don’t know which moo-U you are refering to, but I’d guess it’s one that puts out plenty of competent vets but as with all vet schools, someone is at the bottom…
I think I love you foggybok!!
[QUOTE=dr j;4208585]
I think I love you foggybok!![/QUOTE]
LOL, do i have to tell my husband?
[QUOTE=Ambrey;4208531]
You are correct. I worded that badly, and it wasn’t even really what I meant.
I didn’t feel ripped off, or even pressured. I just felt like they were so used to people who wanted every last treatment provided to their pets that they’d lost perspective on what was appropriate and how to tell someone when it was just time to let the animal go.
I think that’s important in a vet, and when they stop giving that advice because they are afraid to lose high $$ clients, I think they are losing some of their integrity. That plus the inflation of basic care was enough to send me back in time a bit.[/QUOTE]
It’s not that they are giving these options and advice because they really want you to spend as much MONEY as possible…it’s because they want to give you all of the options. I agree that many vets are just not okay with letting things go and they do want to pursue as many options as possible, but not because of the money – because they want to see the animal live, or for whatever reason, don’t want to give up on them just yet. It’s against what vets stand for to keep pushing treatments on an animal that clearly won’t do well just because they want to rack up a bill. It may seem that way to others, but that vet may really think the animal has a fighting chance.
If, as an owner, you have a limit to what you want and can do financially, it is YOUR responsibility to be honest with your vet and let them know that. However, as an owner, you must be accepting that your pet may not survive as long, may contract certain illnesses/diseases, and above all, that you’re okay with euthanizing when your money runs out (if that is the limiting factor). Be up front about this and there should be no guilt or feelings of being pressured.
The reason vets give so many options, from the bare bones “send them home on painkillers and hope for the best” to the cadillac ICU treatment, is that if something happens and we don’t give that option, we don’t want you turning around and saying “I didn’t know that was an option! I would have done that if you had told me.” Lawsuits are much more common today than before and a lot relate to standard of care. As vets, we HAVE to offer all the options, even if they are totally out of the question and out of range, just so you as an owner can be informed. It really doesn’t mean you have to pick them.
Hell, my cat (an ER rescue I picked up before vet school) has multiple problems, and chronic/recurrent UTIs. I know that he probably has some underlying nerve disorder relating to his spinal trauma he suffered from his HBC incident, and I should have a contrast urethrogram/cystogram performed, and spinal rads. Can I afford it? Hell no! Even here at school, a large university, where we have tons of specialists and everyone is used to animals having everything done on them, the clinicians understood that I could not afford it and gave me the antibiotics and let him go home with a hope and a prayer that things won’t return. I think the reason they offered the things and never pressured me is that I told them up front I have NO money (I live off student loans), and they then started thinking of a plan based on that.
I’m not sure what I’m getting at, I’m just trying to put things into perspective.
Recently paid about 170$ for my cat to get a rabies shot. If there was an exam I must have blinked and missed it.
I find your assertion that a vet can charge ANYTHING he wants and the public better just shut up and pay a darn good reason to start closely examining exactly what this profession is doing.
Cutting edge veterinary medicine is not what we are talking about here. Most small animals do not require ‘cutting edge’ care - and when they do they go to specialists or ER’s.
We are talking about a profession that wants it cake and to eat it too. You say the standard of care is going up, costs are going up, expectations are going up - and basically saying that animal care is starting to become as standard and complex as care for humans.
Well - guess what. If that’s the way it’s going to be then you had better get used to people questioning your practices and attempting to control costs or attempt to end unfair practices.
There is no pet/animal insurance that offers ANYTHING close to what human policies offer. Vet medicine is still largely fee for service.
If the profession does not listen to its clients - then it will eventually have to answer to the legislature/government. If you don’t like that - then do something about it.
Pet owners can be a powerful lobby too. And I’ll tell you plain - pet ownership may not be a right but it’s also not an opportunity for vets to exploit the human/animal bond.
foggybok - You’re mistaken - I have no beef with anything. I think I understand and can argue from various points of view. But what I do know is that it is in the vet’s interest to discourage competition. That is the nature of business, and it’s acceptable to a point.
It is in the consumer’s interest to seek value and to compare costs and to insist that choices remain available.
I don’t go to foofytown for vaccinations - foofytown is coming to me whether I like it or not. Limiting choice and emotional manipulation are not appropriate. Though your HMO may be offering you additional services - they are probably not calling you a bad parent because you don’t take your kid to the HMO for a 100$ haircut you can get at a barber shop for 20$. As I wrote before my physician is not demanding I obtain a pedicure when I go in for a flu shot.
What vets seem to be complaining about is that they can’t make enough money.
Hmm. Well. Guess what happens to other businesses when they can’t make money. They go out of business and the remaining ones make more because they capture those clients. The only concern I have about access to vet care is in the large animal area. Truly large animal - not equine only which is becoming just as bad as SA practices.
Again - no beef necessarily - just recognizing the same thing that vets have been talking about - expenses, political issues, business matters - and how to maximize profit and still provide quality and affordable vet care.
EVERY business has to factor shrinkage into their operations. Vets aren’t unique in that regard. Nothing about the challenges facing vets as regard to their business operations are really that unusual - all business owners have to deal with those. The rest of the businesses seem to manage it without sticking it to their clients too much.
And yes - I do think vets are starting to really exploit the human/animal bond sometimes. That should bother all of us.
[QUOTE=dr j;4208472]
That is your interperatation. My guess is their average transaction, even in your area of the country is under $200.
Once again owning and animal is not a necessity or right. If you desire care you will have to pay the going rate - whatever that may be, whereever you may find it. I would guess your 50s practitioner is a great person and probably a darn good vet but I would also guess if you required the cutting edge of vet medicine you wouldn’t get it there. Your choice but don’t make it for others.[/QUOTE]
Just a note – any product, be it flea/tick/heartworm preventative or medication, if purchased over the internet or through something like 1-800-petmeds or the like, is NOT backed by a guarantee. Who was it earlier that posted saying they were treating a collie for HW because the product was purchased not through the vet? If it’s purchased through the vet, the company has to back their product and will pay for vet care if there is a complication or failure (in the case of HW preventative). You do NOT have this guarantee if you purchase it from an outside source.
It really isn’t all about the money – MANY practices WILL price match because of this, and because they want to maintain that high standard of care (including holding companies responsible for their products) for pets. It really isn’t all about cornering the market.
As an owner, would you rather save a few bucks here or there and get something that isn’t 100% reliable or guaranteed and risk your dog getting heartworm or a medication complication, and then having to pay for the treatment out of pocket, or are those few bucks peace of mind? I know for me what the answer would be, but I’ll leave that question open to you.
What do you think will happen? Just curious…there has never been any mention ever from any vet I know, in any class I’ve taken, or any publication I’ve read that mentions this “answer to legislature/government” you describe.
I’ve never disputed a charge, even when it was for something the vet had screwed up and I had to pay for 2x (didn’t stitch eye correctly after cat’s eye was removed and a 2nd operation was needed to do so), because I want to see the vet, I want the vet to do the procedures on my dogs/cats/horses, I don’t want someone who is not a vet working on my animals. $20,000.00 for my “crypto” cat, fine, she survived and lived to be 18 yoa (thank you Muller III and Briarcliff).
I want sympathy when I bring them to in to euth-ed; I want to get my vet in the middle of the night, not some emergency vet who makes me wait (yes this has happened altho some are good); and I expect to pay for it, whether it is a stomach tube or an IV or whatever.
If I pay the $$$ for vet prices, I want the vet to do the work, and to talk to me, and to treat me like a customer, not like I’m someone to get $ out of and a nuisance.
I have quit going to some vets because their staff were too busy talking on the phone to their boyfriends to talk to me, because the vet was only available occasionally and because the prices that were being charged were for a board certified vet when I was getting a flakey assistant who was more interested in her person problems with her boyfriend or when she was getting off work so she could party.
And I’m one of the ones who experts heroic measures and pays for them too. I pay for a board certified expert and I want a board certified expert, for every thing that is done at the vet’s.
I’m not questioning your competence; I’m questioning your pricing. Big difference.
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