I can't afford a vet. How would you respond

RE: I can't afford a vet. How would you respond

cairncross — Thu, 23 Jun 2022 17:39:08 GMT

This last 10 days we have had 2 pyometra 1 cat tail amputate 1 cat eye enucleation and 1 simple lump removal all opt for euthanasia all on grounds of cost , the lump need not even have been touched as it wasn't currently affecting welfare . I can't recall when these scenarios were last declined . Our charges are low 200 pounds for one of the pyo was offered they were a good long term client the other ops were quoted less again.

We have had 4 routine ops postpone to next month until after payday this is not a regular occurrence for us

Just over 10 days ago we PTS 3 dogs for one lady all elderly but being managed on meds for cardiac and or OA. She couldn't afford meds and diet any longer.

Sister in law works in furniture shop always positive but this week she has sold absolutely nothing not an item .

I think we are in a new world?

RE: I can't afford a vet. How would you respond

Andreas Ege — Fri, 17 Jun 2022 16:21:31 GMT

[quote userid="2457" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237671#237671"]I assume everyone has had the same experience as me ... The emergency C section with absutely no funds who, oddly, finds the money when PTS is discussed?[/quote]

Actually, no. ;-) Never been in that situation with a c-section yet. Had a couple of pyos where it came to that, and they opted for pts. Not nice indeed, but I can't take responsibility for every pet.

But yes if applying broader. The request for a house visit because they can't afford a taxi suddenly turns into 'I found a mate/ neighbour/ relative willing to drive me' if I can (hopefully) tell them, that my visit fee is more expensive than the taxi (I have worked for practices where the visit fee actually was lower than the taxi fee, though).

[quote userid="2457" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237671#237671"]but unless we get better at making these options clear - and sticking to them - the problems will continue. [/quote]

Absolutely. From my experience locuming, both in Germany and UK, I'd say practices that play a strict and clear course with difficult clients will have little of them and practices who give easily in have a lot.

Same with prizing especially out of hours. Years ago, the wife was working for a practice very cheap out of hours and was seeing a lot of unnecessary stuff while my practice charged noticeably (though imo not unreasonably) more was seeing relatively little. We had a lot of abusive clients, though, as the partners would react to every complaint by waiving part of the fee while her practice was stricter in that regard and seemed to have less of them.

Wasted 20 minutes of time yesterday on the phone (and finding a lay-by first) with an owner fishing for a vet 30 min drive away though living less then 5 car minutes (18 on foot by google maps) from a local vet at 10 to 8 for a kitten that allegedly hadn't eaten nor drunk for 3d and was bringing up clear liquid. After learning about the out of hours fee he decided to find another vet (allegedly wasn't registered anywhere). Hope the kitten was treated/ put to sleep and doesn't have to die from dehydration. But while I feel for the kitten, I'm not gonna make it my responsibility.

What helped me a lot with charging was to keep making it clear to myself that I'm not buying the animal but are selling my time and expertise. And clients who (unreasonably) complain about cost I usually explain that I would love to treat every animal free of charge to the highest standard, but if I do that I very quickly won't be treating any animals at all.

RE: I can't afford a vet. How would you respond

Gillian Mostyn — Fri, 17 Jun 2022 10:24:15 GMT

[quote userid="19228" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237663#237663"]Sky o2 etc are not obliged by theirvregulator to provide free service at 3am to anyone who claims they can't afford[/quote]

Neither are we. You should always be charging ... You simply can't refuse to see an emergency on the basis of non-payment. The difference is subtle but important, as a lack of money will severely restrict their options to first aid or PTS. It also gives you the opportunity to pursue the debt, and give the client fair warning that non payment means you can refuse to treat in future. I know most vets will always see an emergency, but it does put some control back into your hands.

I know it's really difficult when faced with these horrible situations in the middle of the night, but unless we get better at making these options clear - and sticking to them - the problems will continue.

I assume everyone has had the same experience as me ... The emergency C section with absutely no funds who, oddly, finds the money when PTS is discussed?

RE: I can't afford a vet. How would you respond

cairncross — Thu, 16 Jun 2022 19:26:06 GMT

Sky o2 etc are not obliged by theirvregulator to provide free service at 3am to anyone who claims they can't afford

RE: I can't afford a vet. How would you respond

Gillian Mostyn — Fri, 10 Jun 2022 13:38:02 GMT

[quote userid="7811" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237531#237531"]But I don't understand the people that can't afford to pay for PTS, but want a £300 casket...you can't afford it!![/quote]

Illustrates the conundrum.

'Cant afford' vs 'I choose not to spend my money on that'. Unfortunately, many people choose their SKY subscription, mobile phone contract and Friday night alcoholic binge over their vet. The problem is how to figure out the genuine 'can't afford' from the rest.

RE: I can't afford a vet. How would you respond

Julie Innes — Thu, 09 Jun 2022 10:20:09 GMT

Re: the original post. I have had 3 cases in the last week- 2 booked for routine neutering, 1 PTS, where the owners have "no money but can pay me on X date". I have done all 3 (although PTS wanted ashes/ casket, which I have said not until they pay!), because there were welfare issues (cat high risk of getting pregnant, bitch in house with entire male, old dog struggling). But I have established a date when the bill will be paid, and told the owners that we will remove them from our list if they don't pay by then.

That might sound daft, but if a neutering op is turned away on the day (when they suddenly realised they can't pay...) we still lose that money, as we can't fill that slot. But I don't understand the people that can't afford to pay for PTS, but want a £300 casket...you can't afford it!!

RE: I can't afford a vet. How would you respond

Julie Innes — Wed, 08 Jun 2022 11:14:39 GMT

I did open surgeries many years ago and really didn't enjoy them! The sudden influx at 5 minutes to closing when you were just beginning to get your hopes up...

Also with appointments you can plan things better. If something needs eg blood tests you can book it for a time you know there will be someone free to assist/ run the bloods. With open surgeries everything was sent off to come back later for proper work up. It was the old joke about bottle of dex in one hand and bottle of beta LA in the other....

I think clients do (rightly!) expect a lot more nowadays!

RE: I can't afford a vet. How would you respond

David Mills — Tue, 07 Jun 2022 20:57:07 GMT

We used to have open surgeries at the RS in both London hospitals. Wasn’t unusual to go on until 9pm. People waiting hours to be seen. Fights. Boozing in the waiting room. Rum old experience and very enlightening and educational. But I suspect wouldn’t work in a private practice these days.

you do see them advertised down here from time to time on sat and Sunday mornings for normal consult prices. I bet they’re mobbed with nonsense.

I suspect it works a lot better rurally where’s its less transactional. The nonsense people call us about at weekends makes me shudder if we ever tried it.

RE: I can't afford a vet. How would you respond

Joyce Whitehead — Mon, 06 Jun 2022 21:06:09 GMT

I’m another open surgery hater. My first practice we had them, I think officially 6-7pm, if we finished before the pub closed at 10 we thought we had done well and we hadn’t had a break for tea. (I’m talking 35 plus years ago). So we headed for a drink and if we were lucky there were some dried up sandwiches on the bar. My third job also open surgeries 6-7, we would finished by 8 most nights, but had a parvo outbreak at one point where we would have a massive queue along the road for vaccinations, often finishing at 10. So when I started in our own practice we always said no open surgeries, and I’m so happy we did that, even if we overrun it is in a controlled fashion.

RE: I can't afford a vet. How would you respond

rhona kerr — Thu, 02 Jun 2022 13:19:03 GMT

No thanks! Did them for years, completely added to the stress of the job, and I would not join a practice where that was my option to be seen in the morning

RE: I can't afford a vet. How would you respond

Bob Russell — Tue, 31 May 2022 10:51:38 GMT

Hated to see n empty waiting room at 6.30pm but an overflowing one by 6.45pm. Finished at 7.30 or later.

Open surgeries could be horrendous.

RE: I can't afford a vet. How would you respond

Derek Lyon — Tue, 31 May 2022 08:41:03 GMT

I retired 24 years ago and this thread brought back so many memories. I never let money enter my head and just called folks and or saw them day or night. At least I could sleep tight!!

RE: I can't afford a vet. How would you respond

Julian Earl — Mon, 30 May 2022 17:13:47 GMT

As others have said, there is no real right/wrong answer but suggest that they borrow money from friends or family not a complee stranger like you! Yes, there is always the RSPCA somewhere, surely?

My first reply suggesting this has vanished...??

I retired early nine years go but not much changes does it??

HTH?

JULIAN...

RE: I can't afford a vet. How would you respond

cairncross — Mon, 30 May 2022 08:19:25 GMT

Indeterminate finish time is common in the majority of careers , I don't think it has been an issue for recruitment or retention here the 2.5 potential late nights are compensated for by early finishes other days which gives flexibility. On call very definitely does cause an issue.

Our clients now have less to spend on pets and more pets to thin it out over. We cannot extract more from them for less in the future so part time pay cannot increase. Retention was good when you could work all hours and get an income that made dropping out have very significant consequences . Part time flexibility hours allows many to still work but it allows many to cut hours and it allows many to drop out all together as life is not dependant or built around the career. More and more flexible reduced hours is going to make the situation worse unless numbers if vets ? Triples or quadruples currently it's falling slightly

RE: I can't afford a vet. How would you respond

Michael Woodhouse — Sun, 29 May 2022 22:15:56 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237342#237342"]Surely if you advertise an open surgery from, lets say 5 - 7pm, then the door has to remain open until 7pm?. I would be a bit miffed if I were a client and arrived at 6-45pm to find the door locked.[/quote]

We never ran an open evening surgery, but advertised as 9.00-9.30 and 2.00-2.30. That doesn't mean we stop seeing people at 9.35, just we don't add any more to the list. If someone did arrive late then it would depend on how many waiting, what was wrong and what else happening that day, whether they were seen or not. Have absolutely sent people away. As I said in another post, it was the same with the GP until COVID.

We close at 6pm. So far recruitment not been a big issue.

RE: I can't afford a vet. How would you respond

cairncross — Sun, 29 May 2022 21:34:22 GMT

I don't think you can see the GP here anymore , there is a telephone deflection system you can ring and be put off with though. I hated appointments didn't want to know a problem case was coming soon hated the rigid timing the bluffing away minutes padding out the time .

Waiting has changed as everyone is tapping their phone at home or in the q

RE: I can't afford a vet. How would you respond

Lesley Strong — Sun, 29 May 2022 18:47:27 GMT

Even if you locked the door folk still chapped on it and expect to be let in and kicked off if you didn t admit them hence 9 oclock finish. The sign for the sunday surgery said emergency only but still vaccs/nails/bums /lame for 3 weeks would expect to be seen. Still remember after 30 odd years the prat who threatened to report me to RCVS bcause I pulled him up for presenting a routine EAG on a sunday

RE: I can't afford a vet. How would you respond

Clive Ansell — Sun, 29 May 2022 17:48:31 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237339#237339"]Just because it's an open surgery doesn't mean you keep letting them come in and join the list until everyone has gone home![/quote]

Surely if you advertise an open surgery from, lets say 5 - 7pm, then the door has to remain open until 7pm?. I would be a bit miffed if I were a client and arrived at 6-45pm to find the door locked.

RE: I can't afford a vet. How would you respond

bob lehner — Sun, 29 May 2022 10:11:19 GMT

Open surgeries were once the norm - and were horrible. Nothing worse than looking out into the waiting room and seeing it full, with a queue extending down the road. Unremitting pressure to keep things moving as fast as possible - with no time to catch one's breath - particularly annoying if working with a colleague who was slow, or a slacker. . The advent of appointments was a joy.

And speaking from the other side of the fence I would not entertain going to a vet/doctor/dentist or whatever without an appointment system. Even with appointments I get highly irritated if I'm kept waiting more than 15 minutes without good reason - It's just plain rude.

In days gone by the NHS used to book out-patient appointments for everyone at say 9.00 am - so 30 people would turn up at the same time and one might have to wait several hours to be seen. I once expressed my dissatisfaction about this to the consultant I was seeing - he seemed quite surprised - it obviously hadn't occurred to him that other people's time was precious.

RE: I can't afford a vet. How would you respond

Alastair Welch — Sun, 29 May 2022 08:48:51 GMT

Michael,

We ran an open surgery in my first job.

As a new graduate it was a great method of seeing lots of cases and honing skills to become efficient, but it quickly became tiresome. We would lock the door at closing time, but clients knew the surgery hours so surgery generally started with a queue followed by a steady stream followed by a bunch sneaking in just before the door was locked. Friday night was particularly busy with chronic issues that had festered for the week but wouldn't keep for the weekend.

Perhaps there is a surfeit of vets in Yorkshire but the rest of the country is a bit short. There is no recruitment crisis, we produce plenty of VS they just have too short a career. We need to find methods of turning veterinary medicine into a long term career option, and if you think this will help can we assume you'll include the phrase 'indeterminate finish time' in your next advert?

RE: I can't afford a vet. How would you respond

Michael Woodhouse — Sun, 29 May 2022 00:00:00 GMT

[quote userid="6765" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237338#237338"]I haven’t done an open surgery for years but remember looking in the waiting room at the end of a tiring day at 6pm and seeing 20 waiting. Then at 7pm another 10 arriving after their dinner. [/quote]

Just because it's an open surgery doesn't mean you keep letting them come in and join the list until everyone has gone home!

This thread is my kick up the bum to bring them back.

RE: I can't afford a vet. How would you respond

Alistair Graham-Evans — Sat, 28 May 2022 23:16:23 GMT

I haven’t done an open surgery for years but remember looking in the waiting room at the end of a tiring day at 6pm and seeing 20 waiting. Then at 7pm another 10 arriving after their dinner.
It wasn’t the best way to deliver service of a good standard. I had no social life as I didn’t know when I would finish and abandoned any attempt to join a squash ladder or engage in any activity outside work.

Fortunately those days are gone and it turned out that most people attending open surgery were only there because they couldn’t get an appointment so it was self - inflicted poor management and planning that blighted our lives!

Also if clients are paying a consultation fee don’t they deserve an undivided portion of your time rather than being rushed in and out as quickly as possible?

RE: I can't afford a vet. How would you respond

cairncross — Sat, 28 May 2022 07:36:04 GMT

At a family gathering last night about 20 3/4 of us have jobs with unpredictable finishes , variety of professions trades . Lorry driver and hospitality agri and equine seem to have it worst. 2 that have regular pm finish said it was negated by their commute.

Open clinic 5 nights per week is no good to anyone nothing can be planned but 2 nights per week or even 3 is very different and a good compromise. I have worked on the 6 day open clinic system terrible on reflection, an appointment only system which always ran over also as urgent cases in last 2 consults needed immeadiate work up ir something urgent or having just missed their slot was squeezed in at end and u resented this as you were meant to be finished and probably had planned something.

We now have a rota where staff work less than 3 open evening clinics per week .

Open morning clinics obviously mean op start times are unpredictable but we have a system of someone dropping out of clinic to start ops on a sort of triage basis which cushions this a bit. It would be better with one more vet which we are fingers crossed getting soon.

Lunch breaks are very unpredictable in timing but insisted on we have a pool table a sofa bed and almost finished I'd a soft sensory relaxing destressing area. Open clinics are intense as are phone calls etc . We have a relief receptionist who does 3h 3 afternoons per week soley to reduce this intensity on others .

RE: I can't afford a vet. How would you respond

Andreas Ege — Fri, 27 May 2022 15:59:25 GMT

[quote userid="2122" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237319#237319"]people do NOT mind waiting.[/quote]

That's a generalisation, and as such not always true. The ones that didn't/ don't like the waiting with open consults might a) not tell you (I find the British are a bit funny that way, very nice, saying thank you 3 times and then ring an hour later with a complaint - would imagine "not minding to wait" might be similar for some) and b) might find themselves a different practice that suits them better.

I've met quite a few clients who didn't like waiting, including in practices that changed from open consult to appointments. I certainly prefer having an appointment and knowing I will be seen at least close to the appointment time. I have changed GPs for that. Don't think I am that exceptional.

[quote userid="2122" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30299/i-can-t-afford-a-vet-how-would-you-respond/237319#237319"]Of course, in these days of "entitlement" it would require a pretty hefty shift of concept and belief, and for younger vets, seeing a *full* waiting room could be a trigger for panic! That said, once one understands that each client *knows* that there WILL be a wait, but that they WILL be seen, it will de-fuse that anxiety completely[/quote]

Don't think I fall under younger vets anymore and I really don't like open surgery that much. Worked it on and off in various practices, both employed and as locum. There are advantages to it, no doubt. If you're running late on an appointment system people are more likely to grumble than after an even longer wait in open surgery. You probably can see more clients in the same time.

There's also disadvantages. Never know beforehand what comes through the door and I like to look things up sometimes, especially with exotics. If I have a gap in consults I often do other things - phone calls, lab stuff, reading up, even cpd on a really quiet day - I find that much more tricky with open consults. With appointments, I can (and sometimes do) block myself a block out to deal with things like xrays, scans or semi-urgent inpatients that got hospitalised instead of having to leave it for the out-of-hours vet or next day. And I still have to work hard on not getting stressed looking at a full waiting room at 18.45. I do value a lunch break and especially evening finish I can somewhat rely on which time it'll be. Kind of makes planning what I do in the evening easier.

Not much kills a social life more efficient then "ok, I can be there at half seven. But it might also be eight. Or half eight. Depends how busy it gets. And then I haven't showered yet."

So, if I have a choice, I'd rather not do open surgery. Each to their own, I guess.

RE: I can't afford a vet. How would you respond

George Cooper — Fri, 27 May 2022 13:20:36 GMT

Hi James - and of course there are as many different responses and results as there are vets to do the answering! I am casting my mind back a few years - as I pointed out somewhere, as opposed to the current nightmare that is "practice", currently.

My reason for bringing the subject up is simply to enlarge the debate and for others to perhaps consider the alternatives. I still believe, despite vociferous opposition, that our own future lies with us, ourselves, and the way in which we deal with our clientele. So often I read the response of professionals where they actively resent clients - and my personal reaction to that is that they are probably getting what they are giving. Even amongst the respondents in these enlightened posts there are many who comment adversely on those who seek our services.

All that said - I have very little to propose that might alter what *gives* at the moment in practice - other than a change of mindset, and that is easier said than done.