The vet charged me £xxx........ responses required

RE: The vet charged me £xxx........ responses required

Anthony Todd — Thu, 13 May 2021 17:51:43 GMT

[quote userid="7811" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230372#230372"]How are owners meant to understand that difference? [/quote]

As I have tried to explain, justification such as extreme selection prior to, and training to qualification , skill, experience, further education and post-grad education count for very little, even on the "say something" etc scale!

This is why the "add-ons" can be accepted far more than FRCVS or phD, let alone" I've been doing this for X blooming years, published on this condition, and know what I'm XXXXing doing.....I!!

Some of the time, this may be the reason for [eg] a blood Mg++ on a blocked cat,[ just as an example, but a good one!]

RE: The vet charged me £xxx........ responses required

Julie Innes — Thu, 13 May 2021 10:37:56 GMT

Agree re some prices. In our area a pyo op can be £380 or £1500. How are owners meant to understand that difference?

RE: The vet charged me £xxx........ responses required

Anthony Todd — Tue, 11 May 2021 16:13:22 GMT

[quote userid="4294" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230337#230337"]Where is all this money going? [/quote]

My old mate TY told of an optician of his acquaintance who, when asked why he was so expensive, explained that it was because of PROFIT.....

And so it is today with some practice owners!

RE: The vet charged me £xxx........ responses required

vs0u — Tue, 11 May 2021 15:39:56 GMT

And prices have gone mad, in my opinion. My first practice in 2006 used to charge £4 for a tube of fucithalmic, £25 for a consultation, £3 for an injection unless something expensive like metacam, no dispensing fees on anything, £25 for pre-op bloods, £20 for drip, £300 for ex lap. And other prices reflected those really - nothing unexpected. Out of hours consult was £56 before 11, £80 after. The most recent practice I worked in, all of those were at least 3-5 times as much, except the consultation that was £35. Neuter and vaccination fees probably only doubled but all non-shoppable things far more. Some of their prices are insane like £80 for a bag of fluids - say if you want to flush an abdomen or put an extra bag on a drip that is already set up. Veterinary wages have gone up perhaps 20% in that time. Where is all this money going?

RE: The vet charged me £xxx........ responses required

Anthony Todd — Tue, 11 May 2021 14:26:17 GMT

[quote userid="7811" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230333#230333"] profession being "Only interested in the money",[/quote]

I would agree if it was the profession, but it is now venture capitalists or people with just and solely an interest in their return on investment

RE: The vet charged me £xxx........ responses required

Julie Innes — Tue, 11 May 2021 12:34:36 GMT

unfortunately the reality is that the clients will never be prepared to alter their own lifestyle to pay for their pets.

I appreciate that we as vets have valuable skills that are worth paying for, and I have no guilt about the amount I charge. But to be honest, I don't really care about money all that much. I don't want to be a salesperson, so I don't sell food etc. If making money was my end goal I would have done something different. I have worked for practices before (for a very brief period!) where the whole aim was turnover, and I feel the clients sense this. I was told off for not trying to sell flea and worm treatment to a client who was struggling to afford an xray for her dog's broken leg...

I don't think it's the price itself that people get upset about- it's if they feel the main objective is to get as much money as possible from them. George is right, a lot of that comes down to discussions about options and being upfront with costs. Ironically, people now seem desperate to buy flea and worm treatments from me, although it is never pushed!

I feel it's so important for clients to see us as having their pet's welfare as our first priority. As there is more and more focus on the monetary side of things, more and more clients start to see us as a profession being "Only interested in the money", and this has a negative effect on all of us, as witnessed in this thread. All of us are trying to do the best job, but we all have to pay mortgages etc. It's noone's "right" to have a pet, BUT the poor pet didn't get a choice of owner!

RE: The vet charged me £xxx........ responses required

Anthony Todd — Mon, 10 May 2021 17:34:28 GMT

[quote userid="2122" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230312#230312"]it is how WE handle the consultation,[/quote]

Of course! But now, [and always] advice is cheap and perceived as valueless but actually DO & GIVE are perceived as the cost; the advice: well all, and everyone, gives advice....

After all you don't have to pay anything to ask a policeman anything [in a client's mind....]

Palpation, and all the other "skillful"" things are perceived that way, ie as not valuable.....

"Can't you give it an injection!!" To a very deceased dog is my best example!

RE: The vet charged me £xxx........ responses required

George Cooper — Mon, 10 May 2021 17:21:32 GMT

How often, dear Julie, to you enquire of your “impoverished” clients how many cigarettes the smoke every day, or how much they spent last Friday night, and the one before, when out drinking to celebrate their third cousin’s birthday, or the best friend’s uncle, or how many Indians, or Chinese, or Dominos, or MaccieDs they scoff each week? And - even more telling, ask how they enjoyed their last holiday in, where was it, Thailand?

We skip all that because of an underinflated sense of our own worth and an embarrassment brought to a head by threads such as this. And the thought that clients will migrate elsewhere - when the total REALITY is that clients have ZERO concept of what is ‘expensive’ vis a vis veterinary fees, nor can they compute the “value” of what is being done.

The ONLY thing that matters is that we restore their pet to health and happiness - and we do that with compassion, and understanding that “the vets” is a distress purchase, unwanted, unbudgetted, and stressful (=anger inducing).

If we do not “get” this, and we constantly and consistently massage our fees downwards. We will not be around to help ANY dearly beloved pets - we’ll be down and out.

it is my firm belief that, in practice, it is how WE handle the consultation, and the plan, to deal with client expectation firmly and assertively, and if we get sidetracked by “Oh dear - can ‘they’ afford this” then we are all better off re-wallpapering a room somewhere.

RE: The vet charged me £xxx........ responses required

patrick murphy — Mon, 10 May 2021 14:36:41 GMT

when I dip my toe back into employment, I find that the public gets really ornery re. the processing type fees, and the insurers often will not pay, then it is double ornery.

RE: The vet charged me £xxx........ responses required

Gillian Mostyn — Mon, 10 May 2021 13:20:52 GMT

[quote userid="7811" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230301#230301"]I have tried to keep my charges reasonable, as I can't stand the idea of animals suffering because people can't afford to bring them to a vet.[/quote]

But neither can you be responsible for other people's poor decisions. Or their choice to buy an iphone rather than a year's worth of pet insurance.

I think in an ideal world (!!) vets would stop undercharging for things like routine neutering, nails clips and EAGs (just because the owner perceives they are of low value... they're not if a vet is doing them!) and charge properly for our time rather than have big mark-ups on drugs and fees!

RE: The vet charged me £xxx........ responses required

Julie Innes — Mon, 10 May 2021 12:40:52 GMT

It's a difficult one. I have tried to keep my charges reasonable, as I can't stand the idea of animals suffering because people can't afford to bring them to a vet. On the other hand, I don't want a reputation as the "Cheap" vet!! And I want to be able to pay my staff well and reinvest in the practice. I spent the whole weekend stripping wallpaper in reception because I'm too tight to pay someone to do it! Got a quote to paint 3 rooms- nearly £2000! I'd rather spend that money on something else for the practice and do the painting myself!

If clients moan at me, I smile and ask them what they drive. then point out my 10 year old Nissan micra. That usually shuts them up :)

RE: The vet charged me £xxx........ responses required

Gillian Mostyn — Mon, 10 May 2021 08:52:47 GMT

[quote userid="9239" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230291#230291"]They don't ask us to show the markup on medicine so why the difference? It's something we buy from the lab and sell to a client. [/quote]

I didn't make the rules, I am just discussing them!

[quote userid="9239" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230291#230291"]I don't get this either. Surely we should be able to sell whatever we legally can at whatever price we want and allow the market to decide if it's acceptable or not.[/quote]

I think the difference is that people understand that products have a mark - up - and are free to shop around/get a written prescription. However, lab fees are not something the client can generally choose to shop around for, unless they change practice entirely. It does seem fair that if a lab fee is charged as, for example, 'fructosamine', the client could assume that the actual fee will be similar no matter where the test is carried out. It is the time and expertise that may vary.

I think it is a way for the RCVS to encourage as culture of transparency, rather than telling you what to charge. Charge whatever you wish, but don't 'hide' your charges within another fee.

[quote userid="9239" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230291#230291"]But in reality all practices I worked at charged the listed lab fee but received a 15-25% (average) discount from the lab which is in a way a hidden markup. Just like rebates. [/quote]

Absolutely - I don't know what the answer is to that.

RE: The vet charged me £xxx........ responses required

Evelyn Barbour-Hill — Mon, 10 May 2021 00:03:03 GMT

[quote userid="9239" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230291#230291"] No dog food, no collars, no dog toys. Waste of time and space. [/quote]

Absolutely agree.

Furthermore, "we don't sell pet food" is a damn good image to project.

PS When I qualified (dread words) this was in the Guide to Professional Conduct – it was unprofessional and you weren't allowed to operate a veterinary practice and a pet shop on the same premises.

RE: The vet charged me £xxx........ responses required

Stephen Courtney — Sun, 09 May 2021 20:36:04 GMT

my clinical side suspects that not many clients consider us a learned profession - and as we all know this country has had enough of experts

RE: The vet charged me £xxx........ responses required

bob lehner — Sun, 09 May 2021 19:45:22 GMT

[quote userid="9239" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230291#230291"]. I don't want to be a petshop nor a pharmacy and I have one flea spray in stock at all times. No dog food, no collars, no dog toys. Waste of time and space. [/quote]

Well said Dinu - I do applaud that!

Some practices have the most appalling range of tat in their waiting rooms - goodness knows who buys it - but I suppose someone must.

I guess I'm now a dinosaur - but I really don't find it sits comfortably with what used to be considered a 'learned profession'.

RE: The vet charged me £xxx........ responses required

Dinu Catilina — Sun, 09 May 2021 19:24:36 GMT

[quote userid="2457" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230283#230283"]To improve fee transparency, I understood that the OFT/RCVS ask that we all should be marking lab fees as charged but then listing sampling and interpretation fees separately.[/quote]

To me it doesn't make sense. They don't ask us to show the markup on medicine so why the difference? It's something we buy from the lab and sell to a client.

[quote userid="2457" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230283#230283"]I agree with this - I don't think it is fair to the client to simply mark up all lab fees by a certain percentage. The vet is entitled to charge what they see fit for their time, but just because the lab fee is more expensive doesn't mean the vet should also earn more for doing it![/quote]

I don't get this either. Surely we should be able to sell whatever we legally can at whatever price we want and allow the market to decide if it's acceptable or not.

[quote userid="5012" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230285#230285"]All of my regular practices now charge lab fees with no mark up, but add on sample taking, preparation, consumables and result interpretation and reporting. Seems fair to me.[/quote]

But in reality all practices I worked at charged the listed lab fee but received a 15-25% (average) discount from the lab which is in a way a hidden markup. Just like rebates.

[quote userid="2457" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230287#230287"]I also used to buy in bulk for things like household flea sprays, and charge much smaller mark-ups but then sold lots and lots. Never did understand the philosophy of making stuff like that so expensive that you rarely sold it. [/quote]

I dream of a time where we can charge fees and consumables only. I don't want to be a petshop nor a pharmacy and I have one flea spray in stock at all times. No dog food, no collars, no dog toys. Waste of time and space.

RE: The vet charged me £xxx........ responses required

Gillian Mostyn — Sun, 09 May 2021 09:17:51 GMT

[quote userid="5012" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230285#230285"]The same argument could be applied to mark ups on drugs; Apoquel vs Preds for example. [/quote]

When I was in charge of pricing, I often reduced the mark-up on the expensive stuff. Having the same mark-up didn't sit right with me - but I made sure I still made a good profit with a smaller mark-up.

I also used to buy in bulk for things like household flea sprays, and charge much smaller mark-ups but then sold lots and lots. Never did understand the philosophy of making stuff like that so expensive that you rarely sold it. But I guess if you just look at percentage profits rather than actual profits, selling one at 100% mark-up looks better on paper than selling than 100 at 50% mark-up. The danger of looking at percentages rather than actual figures... which does seem to be an issue with the corporate I mainly dealt with.

RE: The vet charged me £xxx........ responses required

Clive Ansell — Sun, 09 May 2021 08:56:31 GMT

[quote userid="2457" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230283#230283"]The vet is entitled to charge what they see fit for their time, but just because the lab fee is more expensive doesn't mean the vet should also earn more for doing it![/quote]

The same argument could be applied to mark ups on drugs; Apoquel vs Preds for example.

All of my regular practices now charge lab fees with no mark up, but add on sample taking, preparation, consumables and result interpretation and reporting. Seems fair to me.

RE: The vet charged me £xxx........ responses required

Gillian Mostyn — Sun, 09 May 2021 08:52:45 GMT

[quote userid="5904" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230270#230270"]

Bob Russell said:
A mark up on laboratory fees is not a major crime IMO. It helps to spread overall costs.

I now think Bob is right and it is the "better way".

[/quote]

Yes and no.

To improve fee transparency, I understood that the OFT/RCVS ask that we all should be marking lab fees as charged but then listing sampling and interpretation fees separately.

I agree with this - I don't think it is fair to the client to simply mark up all lab fees by a certain percentage. The vet is entitled to charge what they see fit for their time, but just because the lab fee is more expensive doesn't mean the vet should also earn more for doing it!

RE: The vet charged me £xxx........ responses required

Clive Ansell — Sun, 09 May 2021 08:52:39 GMT

A local independent garage I use charges £80.50 + VAT (£96.60) per hour.

My local Audi main dealer charges about £110 per I think.

That said, both will give a fixed price quotation for most work, and despite the main dealer higher hourly rate, they are often a tad cheaper, along with the reassurance of a main dealer warranty on all work and genuine parts used.

RE: The vet charged me £xxx........ responses required

Benjamin Alyoshkin — Sat, 08 May 2021 19:56:47 GMT

Is there an easy way to calculate a GP vet's hourly rate?

RE: The vet charged me £xxx........ responses required

David Mills — Sat, 08 May 2021 19:51:05 GMT

I normally ask mechanics or plumbers or builders what their hourly labour rate is.

£85 an hour in London (at least)

£79 elsewhere, average

And then detail what a vet's hourly rate is. Normally ends the convo sharpish.

RE: The vet charged me £xxx........ responses required

Benjamin Alyoshkin — Sat, 08 May 2021 17:39:50 GMT

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230182#230182"]

Neil

There's probably a carmechanic.org forum where they are discussing the same thing

[/quote]

Hi Neil, I think you found your own response! Sorry about the smiley, on my screen it's the true size of a modest watermellon

RE: The vet charged me £xxx........ responses required

Anthony Todd — Sat, 08 May 2021 15:05:35 GMT

[quote userid="6550" url="~/001/nonclinical/f/life-in-practice-discussions/29813/the-vet-charged-me-xxx-responses-required/230200#230200"]A mark up on laboratory fees is not a major crime IMO. It helps to spread overall costs.[/quote]

I now think Bob is right and it is the "better way".

A urine dip-stick, or any test, is just the beginning of a long discussion and advice on all sorts of related and unrelated avenues not "end-of!"

Even a negative test of anything usually leads to all sorts of avenues of advice and what-ifs, probably as much as the initial reason for the consult!!

There is also the undoubted reassurance to the client inherent in any test or ancillary even if it is totally negative.

And it helps the "Say something, do something, and [probably] give something" old adage......

RE: The vet charged me £xxx........ responses required

Clive Ansell — Sat, 08 May 2021 08:20:00 GMT

The best/worst/stupidest one I have come across, was a retired consultant urologist who complained in writing about a £12.50 fee for in house dipstick urinalysis. The practice owner telephoned him and asked what the fee would be for the same in private human medicine, only to be told that the question was impertinent. He didn't answer, but it is fair bet that it is not £12.50.