Ashamed to call myself a vet?

Re: Ashamed to call myself a vet?

Anthony Dennison — Thu, 11 Oct 2012 11:54:32 GMT

[quote user="Clive Ansell"]

In the case of the C-section, they could have opted for PTS (I've had many cases now that when PTS is put forward as the only option they "find" the money)

[/quote]

I've had this a couple of times. If they can't afford treatment, with the welfare of the animal in mind sometimes PTS does become the only option.

Re: Ashamed to call myself a vet?

Martin Atkinson — Thu, 11 Oct 2012 11:33:10 GMT

[quote user="David Mills"]

At my last place, we instituted a policy of seeing something for free for euthanasia OOH. Everything else cost money, and cards would be pre-authorised before seen unless the client was a regular and known to pay his/her bills.

The economics worked out well, because it removed the heroics and to some extent the emotion from the 'I don't care what it costs because I'm never going to pay' brigade when they were presented with these options (things were either euthanased for free or people went elsewhere) and made sure work that was done was paid for with the card system. Many a person didn't ever show once the terms were explained, strangely enough.

As to the OP, I imagine the pomposity of the posting now appears rather silly in the cold light of a grey Monday. Almost always the client in this situation is talking a load of crap.

[/quote] Not wishing to enter one of your bitching contests David but given your comments to me involving pots and kettles, you accusing someone else of pomposity is rather in the same hypocritical scheme of things. But back to the first part of your post - I do agree with you here. We have a problem with a local pickie traveller community and I apply exactly the same policy although accusing me of racial prejudice is their latest thing I could reply that I'm just prejudiced against people who have no intention of paying. Strangely 99.9% of the time they go elsewhere.

Re: Ashamed to call myself a vet?

David Mills — Thu, 11 Oct 2012 10:59:42 GMT

[quote user="katie mountford"]

[/quote]

Both - if the former was a long-running thing then it'd put off if possible until a clinic day; the scheme was used mainly to reduce the unpaid work arising from the latter which was getting to unmanageable levels. Again if a client wanted to pursue treatment there would be re-authorisation of a card or a hefty cash deposit.

[quote user="katie mountford"]

If it was decided prior to the vet consult was that during the initial phone call, in which case was it vet/nurse or reception speaking to client?

[/quote]

Always a vet on the phone or a phone-handler who would act purely as an answermachine service.

[quote user="katie mountford"]

Did you have any cases that once at the clinic changed their minds and caused issues with regards to payment (emotional blackmail type clients!)

[/quote]

Rarely, but no treatment would be given without a financial safety net. Maybe it was a northern thing but we were quite blunt about costs and why.

Re: Ashamed to call myself a vet?

katie mountford — Wed, 10 Oct 2012 23:31:53 GMT

Did your free euthansia cover just those that had decided on euthansia prior to the consultation or did you also not charge for those that had decided on euth after the consultation (and realised they couldn't pay or the prognosis was poor etc!)? If it was decided prior to the vet consult was that during the initial phone call, in which case was it vet/nurse or reception speaking to client? Did you have any cases that once at the clinic changed their minds and caused issues with regards to payment (emotional blackmail type clients!) I'm just interested to know how it worked, I think its a good idea but potentially a it of a can of worms!

Re: Ashamed to call myself a vet?

Hannah Wynne Richards — Mon, 08 Oct 2012 15:15:25 GMT

Depends on whether you were given a bonus for turning out If I had an assistant who charged me a call out bonus-but then didn't charge the client I would be very annoyed-P45 annoyed in fact As for telephone advice-my views are well known-I'd still be using Vets Now if they didn't give telephone advice If they saw every case the profit would be theirs-not mine-but I'd be spared complaints from clients whowere grumbling that Vets Now wouldn't see them-round in a circle to the OP again

Wynne

Re: Ashamed to call myself a vet?

Evelyn Barbour-Hill — Mon, 08 Oct 2012 14:23:34 GMT

[quote user="mariette asselbergs"]Last night a cat with a bleeding growth in the ear. Not our client, no money,and she could safely go to a normal consult at a cheaper vet the next morning, but the fact that I saw it would cost her already 100 pound before any treatment. Was I free to say; By my quick look you don't need to worry that this is an emergency, go for a normal consult tomorrow? [/quote]

Yes.

[quote user="mariette asselbergs"] Or did I have to insist on the emergency Sunday evening call out?[/quote]

No.

Unless you had a very stupid employer who couldn't even trust you to make common-sense decisions (that were in any case in his best interest).

Re: Ashamed to call myself a vet?

David Mills — Mon, 08 Oct 2012 13:08:58 GMT

As to the OP, I imagine the pomposity of the posting now appears rather silly in the cold light of a grey Monday. Almost always the client in this situation is talking a load of crap.

Re: Ashamed to call myself a vet?

Clive Ansell — Mon, 08 Oct 2012 13:03:19 GMT

[quote user="mariette asselbergs"]

I had two such cases in the last weekends, both not our clients, no money (single parent and widow on benefits). One chihuahua in labour for 24 hours (unintended pregnancy) and in very bad state, owner was given estimate of 500-600 and paid 200 before and would accept a weekly payment plan. Chihuahua survived the operation (three rotten pups) but died 2 days later from multi-organ failure. Bill by then 700. Owner in big trouble with her family who now refuse to pay the rest. This was the risk, and I doubt if the practice will see the rest of the money. (I know I know it is unreasonable, but from the point of view of the people involved I can see why they are extremely upset by it all, No dog, and an outstanding bill of 550 when you are on 35 a week).

Last night a cat with a bleeding growth in the ear. Not our client, no money,and she could safely go to a normal consult at a cheaper vet the next morning, but the fact that I saw it would cost her already 100 pound before any treatment. Was I free to say; By my quick look you don't need to worry that this is an emergency, go for a normal consult tomorrow? (Like: as if this advice and decision had been given through the phone). Or did I have to insist on the emergency Sunday evening call out?

[/quote]

The clients should pay in full in both cases, and be pursued through the courts if necessary. In the case of the C-section, they could have opted for PTS (I've had many cases now that when PTS is put forward as the only option they "find" the money)

Both situations were avoidable, and arose solely because of a lack of care and responsibility on the part of the client. The pregnancy could have been avoided or ended through spaying or mis-mating injections, if they choose to bred they have to take the hit if it goes wrong. The mass in the cats ear could have been seen by a vet and been treated/removed, but the owner made the choice to not bother and requested your professional services on a Sunday night (should have been nearer £200!)

[quote user="mariette asselbergs"]

The proper ethical thing would be me paying this practice the 100 quid but that is about my total payment for the evening. So where's the balance?

[/quote]

Sorry, I don't mean to be harsh but that is just ridiculous. Client should pay, end of.

Re: Ashamed to call myself a vet?

Clive Ansell — Mon, 08 Oct 2012 12:36:39 GMT

Hot off the press this morning;

Client: " can I book my my elderly collapsed dog in for PTS, my vet (PDSA) have refused to see me today and can't fit me until later this week, and as it's only a PTS and I'm a PDSA client will I have to pay?"

History from PDSA: 0830 telephone call; collapsed dog asap appt offered for 0900, o' declined.

Booked for 1500 today when owner finishes work (payment upfront).

Re: Ashamed to call myself a vet?

Glenn Hodgson — Mon, 08 Oct 2012 11:09:45 GMT

A gereralisation but I appreciate the cynicism! Five stars from me.

Re: Ashamed to call myself a vet?

Hannah Wynne Richards — Mon, 08 Oct 2012 09:53:50 GMT

To whoever said about the owner on £35/week-if only- £65 spending money minimum-more if "disabled" and even more if alcoholic-it makes my blood boil that I'm bled white by taxation-in order to buy drinks for the wastes of space-more if around a dozen brats who will probably grow up to also be wasts of space-add all the fringe benefits-free house etc they're better off than some on minimum wage

Wynne

Re: Ashamed to call myself a vet?

Hannah Wynne Richards — Mon, 08 Oct 2012 09:41:17 GMT

I would see so as to prevent suffering-but the treatment options would be up front payment (cash or card-definitely not cheque) or PTS and owner takes home to bury-b****y owners(yet again )

Wynne

Re: Ashamed to call myself a vet?

Bob Russell — Mon, 08 Oct 2012 09:29:16 GMT

There are plenty of 'professional' bad-debtors out there so I tend to support the triage and PTS as options.

We are not there to support the unaffordable!

It amazes me when those same people go out for a fag and get back into a newer car than mine. I am not a charity and cannot afford to be but there are still clear welfare responsibilities. It is about time that the profession as a whole make it clear that this is the likely option if owners are unable to cope financially.

This is something that the BVA should really deal with rather than individual practices but the general public need to get a dose of reality. In the days of food banks being required to make ends meet the hardened bad-debtors make life impossible for those in genuine trouble.

Re: Ashamed to call myself a vet?

mariette asselbergs — Mon, 08 Oct 2012 07:40:06 GMT

I have the impression that this discussion is dominated by partners/sole charge vets or commissioned vets?

Because my dilemma in these cases is: I am being paid for this on call/weekend/night, not on a commision basis but I cost the practice money. If I see a patient with an obvious big risk that they don't pay, I can act ethically and with good conscience but the practice who pays me looses out, not me.

We muddle through with these cases and the best is to realise that they are only very few and I do think that practice managers calculate their prices taking these bad debts into account........

Mariette

Re: Ashamed to call myself a vet?

james herriot lied — Sun, 07 Oct 2012 23:53:16 GMT

[quote user="robloxley"]

surely the practice would tie their payment to the employee to the client having settled their bill, else what's the incentive for the employee to get any works paid for?

[/quote]

I'm not sure that's ever going to happen: the business risk is taken by the practice owner, as that person is also keeping the profits (if any, these days). Essentially, you'd be docking wages because of bad clients.

Not my idea, remember - I'm against incentivised OOH services.

Re: Ashamed to call myself a vet?

Rob Loxley — Sun, 07 Oct 2012 23:35:42 GMT

[quote user="james herriot lied"]a lot of practices will sweeten the experience of being on call by paying the duty vet an additional fee for each client seen. In such a situation, a non-paying client is a headache for the partners, as they have to absorb the cost of the call-out AND the payment to the duty vet[/quote]

surely the practice would tie their payment to the employee to the client having settled their bill, else what's the incentive for the employee to get any works paid for?

Re: Ashamed to call myself a vet?

james herriot lied — Sun, 07 Oct 2012 20:04:33 GMT

[quote user="Simon Neuhoff"]

I agree with you 100% with the exception of one sentence- "Unless the duty vet is on commission-based pay (don't get me started), ". I have never been paid on commision but even if I were I completely fail to see ANY difference between a sole charge practitioner (or for that matter a partner) who earns according to how he charges vs a vet on commission who does the same. Either of these could lead to someone overcharging and I see no moral distinction between them and no reason to suppose a commision based vet is any less ethical than a practice owner or partner.

[/quote]

Quite right, too - I'm falling into my own trap, aren't I?

But my point was really that if the vet is on commission-based pay, then s/he will be paid simply for seeing that client - a lot of practices will sweeten the experience of being on call by paying the duty vet an additional fee for each client seen. In such a situation, a non-paying client is a headache for the partners, as they have to absorb the cost of the call-out AND the payment to the duty vet. For vets on a straight rota with no such incentives, there's no such additional outlay.

A commission-based vet isn't any less ethical, but is certainly exposed to additional pressure to stay on the straight and narrow. As a locum, I come across the system occasionally for the OOH, but prefer to just stick to a flat rate. Most weekends it works out about the same anyway - although this weekend, I'd have made a lot more money by taking a cut.

Re: Ashamed to call myself a vet?

Simon Neuhoff — Sun, 07 Oct 2012 15:42:09 GMT

[quote user="james herriot lied"]

Whilst I'm firmly in the camp of seeing anybody in an emergency, regardless of ability to pay at the time, I can see the point that Gillian's making here: she's arguing only in relation to people who've been sacked already as clients. If somebody has been given their marching orders, for whatever reason, and had it explained to them very clearly and in writing that they have to go elsewhere, then in theory they should be obliged to make alternative arrangements. Relying on treatment from a place from which one is banned is foolhardy at best, and at worst in contravention of the AWA.

In practice, of course, we're better people than they are - and the best way of showing that is to treat. We're also, like it or not, completely unsupported in such situations - it's not really within the remit of either VDS or BVA (our support groups) and our Benevolent Patrician Royal College would be actively on the client's side, pretty much whatever the provocation, short of death threats. The RSPCA would naturally err on the side of condemnation of any vet who turned a client away - after all, the client is seeking help - and many of the charity organisations now live in their own bubble of controlled cash flow. Our colleagues down the road would be neither keen nor obligated to take a case on the basis that we didn't want to, and for those of us in assistant's positions, the boss will be unhappy whether the client is seen or not.

All of which means that on a Saturday afternoon, a client spouting all kinds of made-up nonsense about having been turned away by 30 other vets HAS to be seen. Unless the duty vet is on commission-based pay (don't get me started), then eighty quid ought to cover the consumables as a one-off - although we've had this debate before, and it wasn't fun by the end.

The only bit about this that I really don't understand is why we're having the debate in the first place: we're all on the same page, and the original anon's implicit accusation that there are those of us who aren't is, of course, unsubstantiated and based on what an unregistered client thought was useful to say to further their own aims. Before making up breathless thread titles, perhaps he or she would pay colleagues the respect of actually checking out the client's story properly: ask for the names of vets contacted, and then ring them directly.

[/quote]

Re: Ashamed to call myself a vet?

Lorna McHardy — Sun, 07 Oct 2012 11:13:59 GMT

[quote user="Stephen Courtney"]

I am always suspicious of people who say other vets won't see them, or that they won't answer the phone. I usually tell them that the other vets will see them especially if i phone for them...

[/quote]

Yes, I do that... get the owner's phone number and tell them I'll try to get hold of their vet for them. Surprise surprise, I almost invariably get through first time! That offer also separates the ones who are genuinely in the kind of panic that makes them unable to use a phone properly - it does happen - from the ones who respond with something on the scale from "thank you, but he's actually much better now" to "you f***zfvxxx!" and hang up.

Re: Ashamed to call myself a vet?

Anthony Todd — Sun, 07 Oct 2012 10:46:25 GMT

[quote user="Gerry Henry"]

Just do the right thing by the animal, occasionally you won't recover your fee but not very often.

[/quote]

The story is probably baloney but that's not the dog's fault is it?

Quick GA and suture and some antibiotics and my conscience would be clear.

How much does that actually cost me?

Remember all the stuff used is tax-deductible, what, net £10 all in?

Chances are, as Gerry says, you'll get paid and by the time you've challenged the story, fumed and fluffed around, you'd have it done and have a happy dog which should be the point.

Re: Ashamed to call myself a vet?

james herriot lied — Sun, 07 Oct 2012 08:16:37 GMT

Re: Ashamed to call myself a vet?

Clive Ansell — Sun, 07 Oct 2012 06:58:42 GMT

[quote user="Gillian Mostyn"]

But if someone doesn't pay, and continues to owe you hundereds of pounds with no intention of paying,do you continue to treat their pet effectively FOC?

[/quote]

Can't you just pack them off to the philanthropic Animal Trust down the road?

If not, basic triage and offer PTS.

Re: Ashamed to call myself a vet?

Clive Ansell — Sun, 07 Oct 2012 06:27:42 GMT

I would almost always offer to see a genuine emergency, we have a professional and moral duty to do so. The few occasions I have refused have been where clients have been threatening or abusive, and then it becomes an issue of personal safety. I would ascertain at the first point of contact if they are registered elsewhere, or if eligible for charity assistance and redirect them if appropriate.

Don't forget most "emergencies" are not emergencies, and most cases of can't pay are really cases of "I don't wish to pay if I can help it". I would offer to see, basic triage (not a full on consultation and discussion) and the offer of basic analgesia or PTS.

Almost all practices and OOH clinics I have worked would do so to, although some of the OOH clinics have strict policies regarding payment in advance and no payment = no treatment. One large practice I worked that did their own OOH had a policy of always offering to see, but if no money at all the animal is signed over for PTS.

Re: Ashamed to call myself a vet?

Michael Woodhouse — Sun, 07 Oct 2012 01:27:00 GMT

[quote user="Gillian Mostyn"]

[quote user="Gerry Henry"]Just do the right thing by the animal, occasionally you won't recover your fee but not very often.[/quote]

But if someone doesn't pay, and continues to owe you hundereds of pounds with no intention of paying,do you continue to treat their pet effectively FOC?

(I'm not talking of a new client with financial problems, I'm talking about an habitual offender!)

[/quote]

Pain relief or PTS yes. Money is secondary to me if the animal is suffering. They don't get full diagnostics or treatment FOC. I would never refuse to see anything if it needed seeing. The dog in question might have mended with a few staples and a shot of Betamox.

Re: Ashamed to call myself a vet?

Gillian Mostyn — Sat, 06 Oct 2012 22:46:07 GMT

[quote user="Gerry Henry"]Just do the right thing by the animal, occasionally you won't recover your fee but not very often.[/quote]

But if someone doesn't pay, and continues to owe you hundereds of pounds with no intention of paying,do you continue to treat their pet effectively FOC?

(I'm not talking of a new client with financial problems, I'm talking about an habitual offender!)