I have no qualms paying any amount for top notch care. But that has to come with common sense, too. As mentioned above - the pre-pre visit, the pre-visit, the visit, and the mandated post-visit - all at a charge, with me needing to take time off from work - that’s where the small animal vets lose me. I don’t mind a single pre-visit before a procedure. But we aren’t doing quantum mechanics sending people to the moon - we are discussing a procedure, looking at the animal to ensure they’re a candidate, pulling blood if necessary, and getting it scheduled. It does not need to be a 3 week drawn out thing with multiple visits.
I finally found a vet that has a practitioner that does both large and small animal stuff - he is the coolest vet ever, super common sense but high level of care. He’s going to give me the Adequan for the dog and not require me to make an appointment for every dose. 
ETA: The middle aged dog had a TPLO. One pre-visit, she was diagnosed, blood was pulled, and we were scheduled for the procedure. The rehab post-procedure was a totally different thing - I think there was one post-visit for incision monitoring, but it was combined with one of the rehab appointments.