Posts Tagged ‘cost of veterinary care’

Price Shopping: To Be Avoided at All Costs

December 13, 2010

I recently exchanged emails with a woman who was feeling frustrated while searching for a new veterinarian.  Her search included some “fee shopping” and she was disgruntled to find that some vets had the nerve to mark up lab fees more than others.  She wrote to me to find out how she might gain access to the fees charged by commercial veterinary laboratories so she could figure out how much mark up each veterinarian applied. She mentioned that she’d found one vet she really liked, but she was “out of the running” because her office charged double the lab fees (exact same test) as two others she’d investigated.

Here’s how I responded.  I encouraged my email buddy to consider reasons why fees are not uniform from hospital to hospital. In some cases, laboratory testing is run “in house” requiring on site technician time and costs involved in maintaining equipment.  Certainly charges to the client for this should be higher. The expertise a veterinary specialist brings to interpreting laboratory test results may be greater than that of a general practitioner.  Shouldn’t a client pay more for this? Additionally, every clinic must pay its overhead to continue to provide good service, and the more “bells and whistles” the hospital has, the higher that overhead will be.  For example, if the hospital employs sophisticated equipment to monitor anesthesia, that’s a really good thing, right?  Chances are, the fees for surgery there will be higher in order to cover the costs of this advanced level of care.

I went on to explain that I truly discourage people from price shopping when it comes to veterinary care unless it is an absolutely necessity.  A sweet six-month-old Labrador is currently being treated at my hospital because she sustained a horrific thermal burn all along her back from a faulty heating pad used during her surgery at a low cost spay/neuter clinic. This has necessitated major reconstructive surgery over her back- a tremendous price to pay both in terms of money and what this poor dog is going through. By the end of our email thread my correspondent seemed convinced- she told me that she’d decided to use the vet she really liked in spite of more expensive lab tests. Hurray!

Now, I’m not completely naïve when it comes to how our current economy is influencing delivery of veterinary health care.  I realize that for many folks, price shopping has become a financial necessity.  When this is the case, I encourage the following:

-Do your best to avoid sacrificing quality of medical care.  The old cliché, “You get what you pay for,” is often true.  Be thorough in your investigation: don’t make up your mind based on brief over-the-telephone price quotes.  Visit the clinic, tour the facility, and meet the staff to feel confident this is a place you and your pet will feel comfortable.

-Watch for “hidden” fees.  Some clinics may offer an extremely reasonable quote for a surgical procedure, but then charge additional fees for the initial office visit or for post-surgical necessities like removing stitches.

-Keep in mind the potential for complications.  If a significant complication occurs due to substandard care (such as occurred with the Labrador mentioned above) you will end up spending a great deal more money treating it, not to mention associated emotional energy, than you would have spent at the better more expensive clinic to begin with.

When you chose your veterinarian, how did fees enter into your decision-making?  If so, how did things turn out? I’d love to hear about your experience.

Now here’s wishing you and your loved ones (including those who are furry or feathered) for a peaceful and healthy holiday season.   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller. 

Free holiday gift wrap with books purchased between now and December 25th (www.speakingforspot.com/purchase.html).

Reasonable Expectations V: Discussion of All Options Regardless of Cost

October 24, 2010

This is the fifth part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets. Parts one through four can be found at http://www.speakingforspot.com/blog.

Veterinarians wear many different hats when they are in the exam room. It’s a given they provide medical care for their patients. But did you realize that, for their clients they often assume the role of social worker, calendar planner, grief counselor, and even mediator when there are conflicting opinions between family members (mostly spouses)? Why on earth some veterinarians wish to also become financial planners for their clients is beyond me! These are vets who pick and choose which medical and surgical options to discuss based on what they think their clients can afford.

I don’t work this way- I believe in presenting every option that is reasonable for my patient and then letting my client determine what they can and cannot afford. This means that my client will hear all the same options whether he or she arrives at my hospital driving a Mercedes Benz sports car or a jalopy. The American Animal Hospital Association agrees with my modus operandi- they conducted a study documenting that ninety percent of people want their vets to present every option regardless of cost. Please hear what this is saying: it is perfectly reasonable for you to expect discussion of all options for your precious family member regardless of cost!

Let’s consider the example of a torn cruciate ligament. The knee joint contains cruciate ligaments that are responsible for keeping the upper leg bone (femur) in alignment with the lower leg bone (tibia). Cruciate ligament tears commonly occur in large breed dogs and there are several options for treating this injury. The least expensive option is rest and anti-inflammatory medications, the cost of which might be a few hundred dollars over the course of a several months. This nonsurgical least expensive approach restores mobility and use of the leg, but predictably results in arthritis within the knee and chronic lameness. The most expensive option is one of two highly specialized surgical techniques (referred to as TPLO and TTA) performed by board certified veterinary surgical specialists. Such surgery is the very best bet for restoring complete lifelong soundness to the knee. Depending on where the dog lives (everything is more expensive in California!) the cost for this surgery is $3,000-$4,000. Tack on post-operative rehabilitation therapy (on an underwater treadmill) and add another $500-$1,000 to your bill. The “in between options” include various surgical procedures that many general practitioners perform. While they are less expensive ($1,000 to $2,000) such surgery is less likely to result in an arthritis-free knee. Treatment of cruciate ligament disease is a clear example of, “You get what you pay for.”

Now there are a number of factors to consider when determining the best treatment option for a torn cruciate ligament. Perhaps the dog is ancient and debilitated and the risk for general anesthesia and surgery is too great. Perhaps there are other medical issues that are likely to be life ending soon- in this situation it would be irresponsible to choose surgery. There are many factors to consider, and finances may be one of them. But how would you feel if discussion of medical therapy for your dog’s cruciate ligament tear was purposefully withheld because your vet assumed you could afford surgery? Likewise, what if there was no discussion of referral to a surgical specialist because your vet felt it would be too much of a financial stretch for you? Do you want your veterinarian to be your financial planner or would you prefer to hear about all the options, then decide for yourself? Let me know how you feel about this. By the way, it might be wise to let your own veterinarian know as well!

Now here’s wishing you and your four-legged family members abundant good health.  

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller. 

You can support your favorite rescue group.  The Speaking for Spot Gives Back Program shares a portion of the sales proceeds with approved non-profit organizations when you purchase a book via the Speaking for Spot website and designate the organization at the time of purchase.