Small animal vet rant

[dr_j]

[QUOTE=Rubyfree;4209740]
I have to say- I’m so, so sorry. Sincerely, no snarkiness intended here.
If that is virtually half of your clientele, I can see how you could become disheartened, dissuaded, and down right cranky. In my brief experience in veterinary medicine, these folks didn’t account for much ‘business’, as they rarely sought out veterinary attention. Please believe me when I say that I occasionally pray for a day when folks like that are at the least better educated about their animals. I’m sure you do as well.[/QUOTE]

What I find most interesting about this whole thread is how emotional so many of you are - especially in regards to the 45%/55% stat.

That is not some arbitrary number pulled out of the air to fire you all up, it’s a real stat that applies to all practices. Apparently many of you feel you are in that percentage and are offended by it, while in all likelihood, you are not. Even if you are, those are the stats, there is nothing emotional about it, it just “is”. And while the 45%ers may not account for as much revenue ( EUREKA!) they often account for more staff time, paperwork etc etc etc. than your best clients.

As an earlier poster stated, you folks are subsidizing those folks, like it or not. And while we could change our practice management to cater to those clients, it compromises everyone’s care, it burns out vets ( the ability to pay reasonable fees is one of the first methods of triage, like it or not - and keeps most practices from being completely swamped beyond what they can handle- which can and does happen).

And while it’s interesting to read all of your comments and insight, things look different from the trenches.

One of the vets on this thread had some very typical and excellent case examples. I will give you another. Arabian stallion, backyard horse owners, barbed wire. Couldn’t afford the 150 dollar first farm call/bandage/sutures etc. etc. Horse needed daily sedation, bandage changes for weeks- to months. DId we do it? Yep. DId we get paid for it. Nope. Should we continue to do work for clients that are in this predicament in the future? Are we SOBs for saying no? Spend your day on a couple cases like that. Pushing all your good routine care clients back or rescheduling them. Have your staff spend months trying to collect anything.

I am excited so many of you are interested in veterinary medicine!:winkgrin:

[dr_j]

[QUOTE=dalpal;4209332]
BULLSHIT…BULLSHIT…BULLSHIT…I “could” belong in your 55 percent premier club…but I refuse to be apart of that click. Not when there are other qualified vets in the area charging less.

I work 7 days a week, don’t go on holiday,…so sorry, no sympathy here on the “I had to miss out on the lake” pity party.[/QUOTE]

I am not asking for pity. I didn’t miss the lake party by the way… fortunately for me ( and my clients) I can survive on very little sleep. You probably do belong to your vet’s 55% club. It’s all stats and my guess you are in the 55% of the practice that provides most of his revenues. That stat applies across the board from the specialty practice to the low cost spay and neutur clinic.

And gee did you have to swear??? LOL

[dr_j]

[QUOTE=ESG;4208644]
I have experience and theory, so it looks like I’ll never be at anyone’s mercy. Lucky me. :D[/QUOTE]

My apologies. I didn’t realize you were a veterinarian.

And since you are questioning my pricing, wanna trade pricelists???

[ESG]

I wouldn’t presume. And since you are clearly perfect in your own mind, I’d hate to do anything to change that.

Bless your heart.

[dr_j]

[QUOTE=ESG;4210326]
I wouldn’t presume. And since you are clearly perfect in your own mind, I’d hate to do anything to change that.

Bless your heart.[/QUOTE]

I really don’t understand your personal anomosity. Everything I have posted in this thread is sound practice management theory that I didn’t invent. It is what it is. My perfection or lack thereof really has nothing to do with it. But if you want an opinion on that, I can put you through to my husband- who I am sure thinks like you do! :lol:

Really ESG, I invite you to continue this conversation via PM if you would like to get more personal details.

[CatOnLap]

[QUOTE=dr j;4208428]
Obviously you are not in the US. And obviously you could be a walking ad for keeping the govt out of our healthcare. But that’s a whole "nother post. :winkgrin:[/QUOTE]

only if you think that people should be priced out of health care the way pet owners apparently are.

Frankly, I think its appalling that price controls have not been levied on things like lawyers, veterinarians and other professions, but then, its even more appalling that 3% of the population control 90% of the wealth…and few of those top 3% actually work at all. But like you said, a whole 'nother thread.

[JSwan]

@dr j;4210103

What I find most interesting about this whole thread is how emotional so many of you are - especially in regards to the 45%/55% stat.

I’m not emotional about it at all.

You think it’s cute that animal owners are concerned about costs? I don’t think it’s cute at all, nor do I appreciate the condescension that has become so apparent in the posts by vets. I also notice that none of you have responded to some of the very legitimate complaints about the ‘extras’ that sa vets now insist that all pets “need.”

You’re either veterinarians, or resort managers. If you want to offer doggie day care and spa services for pets - that’s fine but foisting it off as part of quality veterinary care is ridiculous, as is charging exorbitant prices for BASIC care.

When I take my pets to the vet - they are no longer receiving quality veterinary care. They are receiving quantity. In the form of “extra” services that I do not wish, they do not require, and vets are trying to convince me are “necessary”.

When I go to my doctor - he provides medical care and advice. Not a facial. He also does not insist I purchase medications from him - he writes a prescription and then I find the best price I can from a pharmacy and have it filled.

When my dog needed medication for congestive heart failure - the most expensive pharmacy in town was LESS expensive for the SAME medication than what the vet was trying to charge me.

SA medicine is a bit of a racket in many respects. On one hand, y’all keep saying that it is starting to become more like human medicine - with all the higher standards, costs and issues associated with human medicine - and on the other hand you dismiss and ridicule any criticism or suggestion that maybe y’all should start acting more like doctors and not hotel managers.

You can’t have it both ways. And that’s what I’m saying. You want it both ways - to be treated the same as medical doctors and charge similar costs- and yet be free of any attempt to ensure access to basic services, to offer all kinds of non medically indicated or necessary services, and to charge whatever you want with no questions or oversight permitted.

Sorry that simply makes no sense.

The fact that people can’t afford their medication and have to make bus trips to Canada or Mexico to buy cheaper drugs (and unlike the fear mongering posts the drugs are often perfectly fine) is considered a horrible thing in human medicine and a reason to perhaps overhaul health care. (for better or worse)

And here again - when pet owners are compelled to do the same thing we’re bad pet owners. Well - what do you expect? You’re charging MORE for the same drugs that humans consider too expensive and purchase over the border! (I’m referring to the heart meds)

I don’t want to hear any more of this “pet ownership is a privilege not a right”. You know what - it’s not part of your job to make value judgments - it’s your job to provide veterinary care. Leave the moralizing to the clergy. Pets are luxuries that is true - but it is a fact that people develop deep emotional attachments to their pets. Being forced to compromise on their care is not something they want to do - it is something they are compelled to do quite often. It’s either that or take the animal to the shelter - and trust me - they are being forced to do so by the tens of thousands.

[Cielo_Azure]

[QUOTE=JSwan;4210760]
I’m not emotional about it at all.

You think it’s cute that animal owners are concerned about costs? I don’t think it’s cute at all, nor do I appreciate the condescension that has become so apparent in the posts by vets. I also notice that none of you have responded to some of the very legitimate complaints about the ‘extras’ that sa vets now insist that all pets “need.”

You’re either veterinarians, or resort managers. If you want to offer doggie day care and spa services for pets - that’s fine but foisting it off as part of quality veterinary care is ridiculous, as is charging exorbitant prices for BASIC care. [/QUOTE]

That whole post is fantastic. But the above says it all…

[CatOnLap]

Thank you so much JSwan for an excellent post.

Thanks especially for this analysis:

SA medicine is a bit of a racket in many respects. On one hand, y’all keep saying that it is starting to become more like human medicine - with all the higher standards, costs and issues associated with human medicine - and on the other hand you dismiss and ridicule any criticism or suggestion that maybe y’all should start acting more like doctors and not hotel managers.

You can’t have it both ways. And that’s what I’m saying. You want it both ways - to be treated the same as medical doctors and charge similar costs- and yet be free of any attempt to ensure access to basic services, to offer all kinds of non medically indicated or necessary services, and to charge whatever you want with no questions or oversight permitted.

[Riva]

wow… this whole discussion has just made me extremely grateful for the S/A vet I have. He is wonderful. Doesn’t try to get me to do anything extra. Was wonderful when my dog was having lameness issues and had no problem referring me to VHUPenn when he couldn’t figure out what was going on with her. When I took my cat in to get his teeth cleaned, the bill only came to $150 including everything. He is slightly more expenisive on his drugs, but he is a small, one man practice and I know he has more overhead. On the one drug he is much more expensive on, I simply get it elsewhere and he is fine with it.

JSwan, fantastic post!

[chaltagor]

[QUOTE=Horsegal984;4209432]
Just a note about Heartgard… The rumor mill has been circulating that it soon will be available OTC, and not just through a vet. [/QUOTE]

Really? I heard that Merial was going to sue the vets that were selling Heartgard to online pharmacies. Talk about only being in it for the money, no one realizes that the vets that sell HG to Petmeds are only doing it for money and have no interest in anyone’s pet at all, unlike your vet that actually has examined your dog and is able to save his life if need be.

@Horsegal984;4209432

The way my clinic handles 1-800-PETMEDS and some of the other shady pharmacies? We approve the first request(assuming it’s something the animal needs) and then we have a form letter we mail out to owners that explains the dangers of ordering through the online places like that.

You should also include all the court cases where Petmeds has been fined for intentionally breaking the law, locally and federally.

[chaltagor]

[QUOTE=JSwan;4210760]
You’re either veterinarians, or resort managers. If you want to offer doggie day care and spa services for pets - that’s fine but foisting it off as part of quality veterinary care is ridiculous, as is charging exorbitant prices for BASIC care. [/QUOTE]

I have to say, working in the veterinary field, that clients want this. They want everything in one place and are disappointed that our practice does not do any grooming, boarding or training. It’s not the vets pushing this, it’s a response to demand. I hear it almost every day; we have to fight people off who want grooming because we don’t want to do it! Boarding as well.

As for “pricing people out;” I’ve read a lot about this and it makes sense from the vet’s POV. It’s disheartening to see so many people with what we call the “rabies dogs.” It has nothing to do with income. Read that again: It has nothing to do with income. These are people who for whatever reason don’t want to spend money on their pets. You think we don’t see what kind of car they’re driving? Or the gizmos they and their children are talking on or playing with? Or their clothes? And they look us in the eye and say they can’t afford Tri-Heart? $36? Vets don’t want clients who don’t care about their animals. Vets love clients who care about their animals and will help them out if need be to do the best for the animal. We know who is who; guess who gets preferential treatment at my practice? The people who care, not the people with money. The pricing out gets rid of the jerks who think monthly heartworm preventative and feline leukemia tests are scams, the jerks who come in with a dog that has massive multiple mammary tumors or a horrible pyo and ask for euth. Totally unnecessary death, heartbreaking for all (all of the staff that is) and could have been prevented by a routine spay. No one likes dealing with these kinds of people, no matter how much money they have.

[PhoenixFarm]

I find this an interesting thread as I just paid $900 for vaccines, “exams”, and heartworm and flea/tick meds for three dogs.

Now, two of the dogs are extremely elderly (15+) and have untreatable, life-ending conditions which will not allow them to live out the summer. When it was mentioned to the vet that perhaps we didn’t need to go all out for the two oldsters, since they won’t, frankly, live long enough to contract a fatal case of heartworm and that since they’d both had extensive “exams” in the last 45 days by virtue of their various life ending conditions being diagnosed, I was told that I would not be given a rabies vaccine (which is required by law in my county, and yes, they check) or the flea/tick meds unless I committed to the “program.” So I spent approx $300 apiece on care for dogs who will be dead within 3 months. As they were giving me the bill, I was also given handouts on making end of life arrangements for the dogs which we all know are going to die!

It was the most surreal experience. I’ve got no beef with spending the $$ on the young dog–because I want him to become and old dog like the others. But seriously, I was floored by the situation with the old dogs.

Similarly, one of the oldsters, his diagnosis was precipitated by him having a crisis in the middle of the night and us going in on an emergency call with him. This is a dog (a 15 year old lab) that was a rescue, and is neurotic to say the least–great farm dog, but not well-equipped to deal with strangers, confinement and poking and prodding while being confined by said strangers. He’s also completely senile and often has a hard time figuring out who and where he is in our HOUSE. So needless to say, I took him in prepared to euth, rather than submit to him to a whole bunch of hospital care.

I was very clear about this throughout out the checking in process, and before I’d even seen a vet or a vet had even looked at him a tech came and tried to remove the dog from the room. He was panicing and thrashing to get back to us and I was like “WHat are you doing?” And she replied she was taking him for bloodwork and xrays. Keep in mind we had even seen the dr yet, so how she could even know enough of what was wrong with him to feel he needed bloodwork and xrays I don’t know. I removed the leash from her hand, and said firmly, “We’d like to discuss all the options, including euthansia with the vet before we do anything.”

Now, I will say, when we got face to face with the vet, she was very reasonable, and I after I had emphasized multiple times that I would put the old man to sleep rather than subject him to being left at the hospital and subjected to invasive tests or treatments, she seemed to get it, and we worked out a plan that was best for the dog. But, it did just stun me that they were going to sweep my dog off for extensive testing without even having seen him or checking with me.

I think my message to SA vets would be that as horse/farm people we have a different perspective on the nobility of suffering that the average suburban/urbanite does. I am completely unwilling to stretch my dogs’ lifespan even one more day than he can live his normal, happy life. Do I have to count my pennies? SUre, and yes that does guide some care decisions, but when it comes to end-of-life and suffering issues, I am not even the tiniest bit interested in prolonging a hopeless case if that period in which they are being prolonged will not be normal to the animal. Similarly, I know my animal, and I know what they can tolerate in terms of care and treatment. If I tell you an animal isn’t suitable for hospitalization it isn’t necessarily because I’m stupid or broke, but maybe, just maybe, because I know the animal isn’t suitable for hospitalization.

I’m sure as a SA vet your lives are filled with a cavalcade of stupid people. And I do have sympathy for that. But we aren’t all stupid, even if we aren’t all rich or don’t believe that every animal should be saved at any cost.

[Horsegal984]

[QUOTE=AiryFairy;4209577]
Sorry, but “no one is certain where those products come from” just smacks of fear-mongering to me. You have no idea and further, NO PROOF that the medications are anything but exactly what your clinic sells, obtained wholesale from the manufacturer (or have the manufacturers reported widespread theft and black market sales to 1-800-Petmeds??) within the expiration dates. The retailers are just that, RETAILERS, they’re providing a product and not treatment, so of course they’re not going to honor the warranty because they’re not involved in administering to the animal. They have no idea what a person does at home. Insinuating that the products are bad is just because they’re not purchased at a vet’s office is all about profits.[/QUOTE]

Don’t believe me, or the links posted? Google 1-800-PETMEDS. Check out the LOOOOOOOONG list of lawsuits against them, from owners, vets, and product manufacturers. Accodring to Merial themselves, they don’t have a F’n clue where Petmeds is getting their products, because they will not do buisness with them. ACCORDING TO MERIAL- warrenties on their products are null and void if purchased through petmeds or a similar site. The best that anyone can figure out? There’s a group of very unscruplous money hungry vets that are buying up large quanties of Heartgard and then reselling it to PetMeds. Those vets could be in Mexico, Germany, Australia, heck Antartica for all anyone knows. If those vets don’t care enough about the laws to keep them from doing it then who’s to say they didn’t let the product sit out in 100+ degree heat, or freeze for days on end. Which can very easially alter the effectiveness of almost any medication. Honestly, do I personally know that it ruins Heartgard? Nope, just know that Merial believes it will, and that’s enough for me.

Believe it’s fear tactics if you will, but I call it letting intelligent consumers make informed decisions.

BTW- 12 pack Heartgard Green on 1-800-PETMEDS $53.99
Same Heartgard purchased through our clinic’s online pharmacy? $49.00
Yes, you’re reading that right, and buying off the clinic’s online pharmacy keeps the product warrenty intact too.

Katherine
Vet Tech

[Horsegal984]

[QUOTE=chaltagor;4211249]
Really? I heard that Merial was going to sue the vets that were selling Heartgard to online pharmacies. Talk about only being in it for the money, no one realizes that the vets that sell HG to Petmeds are only doing it for money and have no interest in anyone’s pet at all, unlike your vet that actually has examined your dog and is able to save his life if need be.

You should also include all the court cases where Petmeds has been fined for intentionally breaking the law, locally and federally. ;)[/QUOTE]

ha ha yeah i know! I can’t verify the rumor, but that’s what I heard Maybe Merial chaged their mind, or maybe they’re trying to make the product more widely available so more owners will be able to get their dogs on it. Or lord knows Hartz is probably gonna come out with a heartworm prevention, which I’m sure will work just as well as their flea and tick products. ;D

Katherine
Vet Tech

[Ghazzu]

@chaltagor;4211249

Really? I heard that Merial was going to sue the vets that were selling Heartgard to online pharmacies. Talk about only being in it for the money, no one realizes that the vets that sell HG to Petmeds are only doing it for money and have no interest in anyone’s pet at all, unlike your vet that actually has examined your dog and is able to save his life if need be.

You should also include all the court cases where Petmeds has been fined for intentionally breaking the law, locally and federally.

I’d be very surprised if Merial does F-all about product diversion.
They talk the talk, but if they were really interested in dealing with the issue, they could certainly track lot numbers and identify the route the stuff was taking.

Me–I didn’t go to vet school to be a pimp for the pharmaceutical industry.

But it does chap my ass when the drug company offers me some product “on special” that is the same price as my clients are getting it through a catalog.

I’ve been scripting lots of stuff out for years, any road–I’d rather have a client annoyed at the pharmacy’s prices than mine…

I wouldn’t recommend Petmeds any more than I’d recommend any other business that routinely violates laws. If they don’t care about the law, I’d be suspicious that they might not care about counterfeit product.

Still, I do think there’s some wisdom in the admonition for those who buy all their health care over the internet to call the catalog’s in-house vet at 2AM when your animal has a problem…

[JSwan]

[QUOTE=Horsegal984;4211350 There’s a group of very unscruplous money hungry vets that are buying up large quanties of Heartgard and then reselling it to PetMeds.
Katherine
Vet Tech[/QUOTE]

Um - that’s what a lot of pet owners are complaining of. Except they’re complaining about the actual vet they’re seeing. Vets who may be unscrupulous or price gouging. Vets who aren’t providing good veterinary care - they’re providing quantity care and calling it vet care.

Never used PetMeds and don’t know from whom they are obtaining the drugs. Could be some of the same type of vets we’re complaining of here for all I know.

The price you charge to clients may be pretty close to what PetMeds is charging - but I seem to recall my last bill being a heck of a lot higher.

I still fail to see how vets could not comprehend that owners would have similar concerns about vet care as people do about human health care. People do not have a “right” to health care any more than an owner has a “right” to own a pet.

And yet it’s perfectly ok to express concerns about the spiraling cost of health care - but if owners express similar concerns about vet care we’re told we’re not good pet owners, we don’t deserve to have a pet, etc.

Sounds like a profession kinda sidestepping valid concerns.

[chaltagor]

[QUOTE=Horsegal984;4211364]
Or lord knows Hartz is probably gonna come out with a heartworm prevention, which I’m sure will work just as well as their flea and tick products. ;D[/QUOTE]

All I can think of is Marlon Brando: The Horror, the Horror.

[chaltagor]

[QUOTE=Ghazzu;4211391]
Still, I do think there’s some wisdom in the admonition for those who buy all their health care over the internet to call the catalog’s in-house vet at 2AM when your animal has a problem…:D[/QUOTE]

Oh, the things we say when that phone is put on hold! :lol:

[Horsegal984]

JSwan, I have no doubt… unfortunatly those vets have to practice somewhere, and it sounds like they’re all around you. I really do feel for you, and everyone else who lives in an area without a lot of options for veterinary care. Believe me, if I didn’t work in the field I would be in that 45% being discussed earlier. I have 2 dogs, 4 cats, and even though I do work in a clinic, I still have to make hard decisions when one of my guys gets really sick. My fiancee’s cat is 18yo, with a heart murmur, and borderline kidney values. Treating his heart will blow his kidneys, and vice versa. So he’s here as long as he’s happy, and when he’s not we’re not going to heroics. One vet at the practice would probably try to talk me into trying all sorts of things, which is why I don’t see that one. I stick with the other 4 that all realize that while my decision is motivated partially by my finances, it’s also whats going to be best for the animal.

Many of our cliets are at our practice because they got sick of paying boutique prices for average care a mile down the road. As most of our clients know we stay where we are because moving would cause us to have to be more like a boutique. We don’t want to do it, and while we might get more walkin buisness from moving, we get plenty through current client refferals. That to me tells me that what we do is working, our clinets are happy enough to refer others.

We work hard to keep prices low, and some ways that we help to stand out is by offering services that other clinics in the area don’t. We offer two services that are referral only, and other clinics send patients to us. However those services are set up as a clinic within a clinic, so that none of the higher costs of operating the referral buisnesses are reflected in out day to day costs in the practice.

Katherine
Vet Tech