When is an exlap not an exlap

RE: When is an exlap not an exlap

Edward Jones — Fri, 01 Jun 2018 10:00:07 GMT

The vet that does the surgery should do the admit in non-routine cases like this, otherwise there's huge potential for communication breakdown. If the patient is already admitted and you're taking over the case you need to speak one to one with the owner over the phone, at least.

How can you be certain the anaesthesia and surgical complication risks were properly discussed otherwise?

Managing client expectations (regarding clinical outcome and cost) is potentially challenging in open-ended surgery like an ex-lap.

All my non-routine surgery is on a time basis, with extra fees for large or brachycephalic dogs.

RE: When is an exlap not an exlap

Anthony Dennison — Fri, 01 Jun 2018 09:33:42 GMT

We have fees for ex-lap, gastrotomy, enterotomy, multiplie enterotomies, enterectomy...

I would always give an estimate for worse case scenario. If I'm going in suspicious of a FB I will estimate for an enterotomy but warn it could be more if an enterectomy is required. Clients don't mind if the bill is cheaper than expected, but do if it's more expensive than expected...

Often if gastrointestinal signs are bad enough to warrant ex-lap and nothing is found, they require a few days hospitalisation to get them properly back to normal anyway which can bring you up to your original estimates anyway.

RE: When is an exlap not an exlap

Julie Innes — Thu, 31 May 2018 23:56:29 GMT

Yeah, we don't have an ex lap cost, would be GA + surgery time.

RE: When is an exlap not an exlap

ell — Thu, 31 May 2018 21:12:49 GMT

Thanks everyone All pretty much as I would have thought, thanks for that.

RE: When is an exlap not an exlap

Nicola Cole — Thu, 31 May 2018 21:00:09 GMT

Sorry-posted too soon. I much prefer to have covered most of the bases (briefly) than to have to call during the op incase can’t get hold of owners.

RE: When is an exlap not an exlap

Nicola Cole — Thu, 31 May 2018 20:54:40 GMT

I would usually estimate to include ex lap fee plus what I think I am most likely to be doing, then give a range around that depending on whether more needs doing than I suspected.

RE: When is an exlap not an exlap

Niall Taylor — Thu, 31 May 2018 20:14:59 GMT

[quote user="ell"]Dog was opened up and had swallowed a plastic duck.[/quote]

There you have it, as I've always said, quackery is bad for animal welfare.

Niall

RE: When is an exlap not an exlap

Joyce Whitehead — Thu, 31 May 2018 20:12:16 GMT

They need to keep that dog out of the bathroom! Sorry, irrelevant comment.

We tend to charge abdominal surgeries on a time basis, so a quick ex lap might be half an hour, whereas an end to end anastomosis obviously much longer. We add on things like fluids, drugs etc on top. So we can still give an estimate based on what might happen, as as said above, ring if things look like getting a lot more expensive if the owner wishes.

RE: When is an exlap not an exlap

Anthony Todd — Thu, 31 May 2018 19:12:41 GMT

I'd quote for an ex lap alone, warn that there may be additional costs depending on findings, then get someone to ring with the grim news and the extra fees [although a "plastic duck" may involve some sort of clarification].

[I'll bet the owner asked only "what colour was the duck.....]

RE: When is an exlap not an exlap

Clive Ansell — Thu, 31 May 2018 16:54:02 GMT

Most practice I have worked for charge a fixed fee for an ex-lap, and that is exactly wot it says on the tin - exploratory surgery, being a diagnostic procedure in its own right. Finding are then discussed and any additional work estimated and charged for.

Some practices charge an ex-lap, from £x, or a range £x - £y. Some charge a fixed fee plus drugs and consumables.

RE: When is an exlap not an exlap

Gillian Mostyn — Thu, 31 May 2018 16:48:31 GMT

I would only charge for an ex lap if I literally found nothing wrong and stitched it back up. If the dog had a procedure, that would then be charged appropriately. But obviously this would all be explained when the estimate is done.

RE: When is an exlap not an exlap

Martin Atkinson — Thu, 31 May 2018 16:11:05 GMT

[quote user="ell"]My question is this , is it just me or do you guys agree an exlap is what it says it is, an exploratory to see next course of action and then pricing according to required surgery which is obviously going to incur extra cost.[/quote]I have a different price structure for an ex lap and then enterotomy or enterectomy etc depending on what it turns out to be. The simple way is to charge per minute for surgery then it is a fair price so long as the owner knows that the quote for an ex lap is a minimum estimate with final cost unknown. I would generally say it is £X for the ex lap then I will call you with an estimate/prognosis for any additional treatment, and that is in the consent form.