What would be interesting to ask vets about inflationary factors?

RE: What would be interesting to ask vets about inflationary factors?

Richard Carter — Tue, 04 Jun 2024 18:37:46 GMT

The dynamics change as others have said- young, idealistic, well insured- expect all the bells, families - perhaps not insured but may have had experiences that might not have gone so well (previous pets, friends, family so not so optimistic) other financial commitments, elderly with either no spare cash or has extra money available with minimal other interests so prepared to spend on companion pets. No two consults the same.

RE: What would be interesting to ask vets about inflationary factors?

Arlo Guthrie — Tue, 04 Jun 2024 13:35:23 GMT

[quote userid="2675" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244830#244830"]Oh and by the way we do this because of ‘public pressure’[/quote]

Richard Carter Always makes me when I hear that one! And the question I ask myself is: who has ever asked the public what it wants?

I don't know of any proper market research.

I suspect vets feel pressured by clients in pressured situations, but that is very different to asking pet owners outside of pressured situations (ie dealing with sick pet) whether they want a Rolls Royce service from their vet at a Rolls Royce cost.

It is a piece of research I would dearly love to do!

RE: What would be interesting to ask vets about inflationary factors?

Neil Wheadon — Tue, 04 Jun 2024 13:12:19 GMT

[quote userid="2675" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244830#244830"]The idea of vocation and moderately paid job where you had a decent quality of life, put down roots, bought into partnerships, raised families and were a central part of the community was so last year.[/quote]

Never a more true observation made. A GP friend laments the same.

I locum in an amazing practice where prices are reasonable, nearly everything is done in house and the clients love it. No wonder it was Pet Plan practice of the year a few years ago. It can be done and some practices do it and clients are cute enough to find them.

Neil

RE: What would be interesting to ask vets about inflationary factors?

Richard Carter — Tue, 04 Jun 2024 11:59:27 GMT

Unfortunately we’ve done it to ourselves- I remember clearly the management gurus in the 1990’s before corporate ownership who would be at bsava and other congresses advocating culling the bottom end by putting up prices ‘to practice the profession how you would like to’. The people who could see how this was heading were viewed as out of step. The idea of vocation and moderately paid job where you had a decent quality of life, put down roots, bought into partnerships, raised families and were a central part of the community was so last year. Shiny equipment, high end skills, extra qualifications ( advanced practitioners anyone?), degree nurse training and practice standards to cull the old fashioned on-the-kitchen-table clinics and we enter the 2000’s

Oh and by the way we do this because of ‘public pressure’

RE: What would be interesting to ask vets about inflationary factors?

David Mills — Tue, 04 Jun 2024 09:55:45 GMT

I don't think there is just one factor but the underlying issue is the packaging of veterinary services as a financial investment - the article Michael posted pretty much sums it up.

A lack of experience within the workforce is also relevant - the skills exit from the profession has been remarkable leaving inexperienced vets who are risk averse. This is fed into by corpspeak - that they are practising gold standard medicine by making everything have bloods before NSAIDs, and this feedback loop means that vets are building defensive walls and think they're doing a good job. The same applies to referrals. There are first opinion practices now divided into surgeons and medics, with the latter unable to make a decision about a lump removal without a "surgery input".

Regulatory pressures have always been there, along with the cascade, but the ownership of online pharmacies by corps is closing the playing field. Same with cremation companies.

Clients have always been clients but the heavily sanitised finance-free TV programs haven't helped. Like anyone clients want value for money, and they have seen prices go up, more tests being ordered that progress the case minimally and no longer being able to have most or all care carried out at their local vets.

The explosion of referral centres has in the main led to depersonalisation and higher prices - some of them are eye watering even from a vet's perspective. The smaller ones I have dealt with are the exception - and there are pragmatic fairly priced ones out there for now with a bit of research. One only needs to compare the prices of peripatetic surgeons (around £1.5k for a TPLO) vs the referral centres (at least £3k if you're lucky) - having a building to maintain does not double the cost to the client on any metric.

But overall it is the drive for turnover and profit which has led to the current situation. Never has there been such a divestment of the coalface work and the finance aspects. As that article details, corp management aren't interested in making animals better at a reasonable cost. Vets are a strange breed with a sense of vocation that is polar opposite to the corporate takeover.

RE: What would be interesting to ask vets about inflationary factors?

Arlo Guthrie — Tue, 04 Jun 2024 08:33:39 GMT

[quote userid="3169" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244819#244819"]I would say that by far the biggest driver in all of this is corporatisation. I think burying your head in the sand (or not wanting to offend 70% of members who for one reason or another have chosen to work for them) is foolish. [/quote]

I'm not burying my head in the sand and I am not worried about offending people (on the whole!). Not least because criticism of the corporate model is in no sense criticism of the vets who work in corporate practice.

I also think you might well be right. Corporatisation may be the biggest driver. Even some of the secondary inflationary factors we have listed are probably being driven to some degree by corporatisation - for example the refer all culture driven by companies which have invested huge sums in referral centres.

In fact, someone remarked to me the other day that one of the biggest problems is that a lot of that investment was borrowed and needs to be paid back.

That all said, the cost of care has not just risen at the corporates. Nor are the inflationary factors we have identified exclusive to corporates (ie defensive medicine, over diagnosis etc)

Furthermore, there are things we can do something about, and there are things we can't.

I'd argue that the corporate business model is a rather intransigent problem which we can't do much about (ultimately, the market will decide that one).

All the other things on the list are things we can.

... so I come back to my OP.

RE: What would be interesting to ask vets about inflationary factors?

Clive Ansell — Tue, 04 Jun 2024 07:42:28 GMT

[quote userid="3169" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244819#244819"]We should never earn the money doctors do. They are far higher trained, work longer hours (all so OOH for the first 10 years of their career, minimum), they have vastly higher responsibility (human versus animal patients) and do a different job. Vet salaries relative to other professions have been easy to find forever and if you want to earn doctor money - go to med school. If you are bright enough to get into the course then you are bright enough to realise what your earning potential may be.[/quote]

Agree.

Not moaning, and was just pointing out that our salaries do lag behind other comparable professions. I entered the profession with my eyes open and was fully aware of it.

In real terms I think salaries have dropped for younger vets. My nearly 2 year qualified Niece started on little more than I did 28 years ago.

[quote userid="3169" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244819#244819"]Maybe I am the idiot - I spent a couple of hours on Sunday patching potholes in the carpark, when other members tell me how the corporate will resurface the whole thing with no vet sweat.[/quote]

I would find that rewarding therapeutic

RE: What would be interesting to ask vets about inflationary factors?

Clive Ansell — Tue, 04 Jun 2024 07:34:55 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244813#244813"]Clive Ansell - might that be because you are a more experienced, confident clinician? Do you think these might be rather bigger issues amongst more recent grads or less confident clinicians?[/quote]

Yes and yes.

The key is communication.

I think what comes with experience is getting a good gut feeling as to which direction the consultation is heading; do they want supervet with all the tests, scans, bells and whistles; or do they want cheap and cheerful Yorkshire vet (Sorry again Michael) {Many will want Supervet and expect to pay for Yorkshire vet, so that hurdle has to be crossed early on}

I try too conduct a full and thorough clinical examination , and give an honest opinion as to my findings and possible outcomes, then discuss a range of options in a non judgemental manner.

RE: What would be interesting to ask vets about inflationary factors?

Michael Woodhouse — Mon, 03 Jun 2024 22:13:00 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244805#244805"]Are you sharing that to say: "The problem is corporatisation, no need to delve any deeper'? [/quote]

I would say that by far the biggest driver in all of this is corporatisation. I think burying your head in the sand (or not wanting to offend 70% of members who for one reason or another have chosen to work for them) is foolish. I think any move you come up with to make vet care more "affordable" will never fit with that corporate mentality of turnover --> profit. That and the way we have let OOH evolve to another overpriced corporate entity.

Maybe I am the idiot - I spent a couple of hours on Sunday patching potholes in the carpark, when other members tell me how the corporate will resurface the whole thing with no vet sweat.

[quote userid="5012" url="~/f/non-clinical-questions/30968/what-would-be-interesting-to-ask-vets-about-inflationary-factors/244810#244810"]That said, our salaries and rates are barely on a par with other professions still.[/quote]

We should never earn the money doctors do. They are far higher trained, work longer hours (all so OOH for the first 10 years of their career, minimum), they have vastly higher responsibility (human versus animal patients) and do a different job. Vet salaries relative to other professions have been easy to find forever and if you want to earn doctor money - go to med school. If you are bright enough to get into the course then you are bright enough to realise what your earning potential may be.

RE: Veterinary prices data gathering

Arlo Guthrie — Mon, 03 Jun 2024 11:14:01 GMT

[quote userid="5012" url="~/f/non-clinical-questions/30968/veterinary-prices-data-gathering/244811#244811"]1, 2 and 3. I don't find they apply much.[/quote]

Clive Ansell - might that be because you are a more experienced, confident clinician? Do you think these might be rather bigger issues amongst more recent grads or less confident clinicians?

RE: Veterinary prices data gathering

Judith Joyce — Mon, 03 Jun 2024 09:52:12 GMT

Agree about our salaries but inflationary pressure increased by employee churn (RCVS manpower survey evidences poorer vet retention (multifactorial) itself is a cost, less skilled vets work less efficiently than more skilled, ? higher complication rates (generalisation). WTD and demographic results in more flexible working conditions ? less work done per salary (another generalisation)

Corporates have another layer of mouths to feed (HQ costs and executive) in the food chain.

RE: Veterinary prices data gathering

Clive Ansell — Mon, 03 Jun 2024 09:36:42 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30968/veterinary-prices-data-gathering"]

So the next idea is to ask which of the following factors do you think is driving up the cost of the advice you give clients:

Striving for high clinical standards
The 'refer-all' culture
Defensive medicine caused by fear of risk (of treatment failure, of death by social media, of disciplinary)
Regulatory pressures (cascade etc)

and possibly

5. Fear of challenging clients.

[/quote]

Not easy to answer.

1, 2 and 3. I don't find they apply much. I try and have a discussion with the client about their expectations, then discuss and offer a range of options based on the findings of the consultation and go from there. No change to what I have always done, although there are more available options in terms of treatments and referral now.

4. Certainly a factor, but we have no control over it. I fell the cascade regs should be challenged in the courts; a kin to a money making cartel, that impacts clients and arguable affects animal welfare.

5. Not an issue to me. I treat them the same as any other, and I take the approach if they're not happy the door is over there.

+6 The exponential increase in the cost of OOH care

RE: Veterinary prices data gathering

Clive Ansell — Mon, 03 Jun 2024 09:28:30 GMT

[quote userid="13891" url="~/f/non-clinical-questions/30968/veterinary-prices-data-gathering/244808#244808"]as well as the manpower/skills shortage mentioned.[/quote]

I suppose it could be argued that this has driven up salaries, and the demand and rates for locums.

That said, our salaries and rates are barely on a par with other professions still.

RE: Veterinary prices data gathering

Clive Ansell — Mon, 03 Jun 2024 09:25:35 GMT

Cost and more particularly mark up on medicines?

This is part of a recent google review left by a dischuffed client.

Bill came to £260
They are charging extortionate amount for medication!!
Antibiotics Rilexine 300mg x 30 from ******** were £71, from an online order pharmacy they would have been £18 plus £29 prescription( that’s how much they charge for each prescription)

Apoquel 16mg x30 would have been £160 with ******* but they cost £56 online plus £29 prescription!! What is wrong with this place!!!
I need to move my dogs!

RE: Veterinary prices data gathering

Judith Joyce — Mon, 03 Jun 2024 08:25:25 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30968/veterinary-prices-data-gathering"]average GP vet[/quote]

Not sure what one of those is

I think most will have an opinion so could you not end up with much unmanageable data?. It's a question that needs some answers though. Each one you mention could start a conversation as well as the manpower/skills shortage mentioned.

RE: Veterinary prices data gathering

Arlo Guthrie — Mon, 03 Jun 2024 08:01:21 GMT

[quote userid="9440" url="~/f/non-clinical-questions/30968/veterinary-prices-data-gathering/244806#244806"]Would be interesting to know what the most stressful and time consuming components of veterinary practice are ?[/quote]

janine redman Yes, it would, and it does tie in with the subject, but can I come back to the OP - what everyone thinks of the my survey question ... ie asking which of the inflationary factors most affects you or affects you at all?

RE: Veterinary prices data gathering

janine redman — Sun, 02 Jun 2024 22:27:42 GMT

Would be interesting to know what the most stressful and time consuming components of veterinary practice are ?

RE: Veterinary prices data gathering

Arlo Guthrie — Sun, 02 Jun 2024 16:36:50 GMT

Michael Woodhouse wow - that's a punchy article. But I am not sure of the relevance to the OP. Are you sharing that to say: "The problem is corporatisation, no need to delve any deeper'?

My view is that corporatisation is only one of many factors (some of which, like the refer-all culture, may also be driven by corporatisation amongst other things), and it would be helpful to look at inflationary factors across the board, and not just single out corporatisation and ignore anything else ...

janine redman ... hi ... some of what you have written seems to tally with what I wrote, but I am not entirely sure ... what do you think of my survey question as is, or how would you change it?

RE: Veterinary prices data gathering

Michael Woodhouse — Sat, 01 Jun 2024 21:15:01 GMT

Have you seen?

RE: Veterinary prices data gathering

janine redman — Sat, 01 Jun 2024 20:12:29 GMT

I think increasing regulation and red tape whilst well meaning and well intentioned puts huge pressure on management . Practical application of clinical skills without constantly second guessing if you are missing something and will be held accountable is not a good way of working. This means a large amount of time covering all bases and time is costly

unrealistic expectations and lack of knowledge from the public who think everything can be diagnosed and fixed in one consultation puts huge pressure on clinicians . This means defensive medicine is practised

the lack of experienced staff to assist the younger members of the profession puts huge pressure on them and it’s costly to have two clinicians work up one case even though it pays dividends in the long run . Lack of expertise means more referrals

running the profession as a business primarily and a profession secondarily puts the priorities in the wrong order and even if you are not target driven you are always aware of it so costs to client creep up

but professional wages were always low compared to other similar professions so the cost to the clients who now consider pets as family not replaceable animals means that they are increasingly willing to spend huge amounts which drives excellence in referrals which in turn has to be financed .