[Film] Why have vet bills gone up so much?

RE: Why have vet bills gone up so much?

Arlo Guthrie — Mon, 25 Nov 2024 18:53:18 GMT

[quote userid="2131" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/246109#246109"]Yeah. Pretty good.[/quote]

A few people have said some nice things about these films, but that, from you, is high praise indeed! Thank you .

RE: Why have vet bills gone up so much?

Evelyn Barbour-Hill — Mon, 25 Nov 2024 14:44:38 GMT

Yeah. Pretty good.

RE: Why have vet bills gone up so much?

Arlo Guthrie — Sun, 24 Nov 2024 09:45:57 GMT

Thanks Michael Woodhouse - have tweaked that!

BTW - everyone - do click the 'like' button (assuming you do), because that will help make it visible to more people.

RE: Why have vet bills gone up so much?

Michael Woodhouse — Sat, 23 Nov 2024 23:35:53 GMT

I think your 2nd bleep might want work........

RE: Why have vet bills gone up so much?

Arlo Guthrie — Sat, 23 Nov 2024 10:27:42 GMT

Miriam Lodewyks and Evelyn Barbour-Hill sorry - missed your posts for some reason, but thank you both, glad you like them! (as I've said before, I feel a weight of responsibility to get them right).

And here is the next one. This is not yet publicly visible (world premiere here).

www.youtube.com/.../HxmkGKEwra4

RE: Why have vet bills gone up so much?

Evelyn Barbour-Hill — Thu, 14 Nov 2024 19:39:49 GMT

Yeah. Pretty good.

RE: Why have vet bills gone up so much?

Miriam Lodewyks — Tue, 12 Nov 2024 08:24:21 GMT

Thank you for these Arlo, I think they are excellent! I have shared where I can.

RE: Why have vet bills gone up so much?

Arlo Guthrie — Sun, 10 Nov 2024 22:05:43 GMT

Latest film premieres on VetSurgeon this evening …. Why emergency OOH vet care has gone up in price. Usual thing - if you like it, please click ‘like’ on YouTube and share it.

www.youtube.com/watch

RE: Why have vet bills gone up so much?

David Mills — Sun, 03 Nov 2024 20:17:54 GMT

[quote userid="12375" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245891#245891"]CVS floated in 2007, do you really think they are still playing a long game[/quote]

1999 - deregulation of ownership

2009 - 10% corporate ownership

2018 - 35%

2024 - 60-70%

Yep. Long game right there.

RE: Why have vet bills gone up so much?

David Mills — Sun, 03 Nov 2024 20:15:43 GMT

[quote userid="4181" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245903#245903"]Of the big 6 UK vet corporates, Linnaeus is privately owned (Mars family), CVS and Pets at Home are stock market listed, so that leaves 3 owned by VC?[/quote]

Linnaeus has had major VC funding - Sovereign Capital - that allowed it to be established in 2014.

CVS has major investment by VC Sovereign Capital.

PAH has been owned by Bridgepoint Capital and Kohlberg Kravis Roberts until 2018.

RE: Why have vet bills gone up so much?

Rob Loxley — Sun, 03 Nov 2024 16:55:50 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245905#245905"]Who or what is VC?[/quote]

Venture capital / private equity

RE: Why have vet bills gone up so much?

Clive Ansell — Sun, 03 Nov 2024 16:27:11 GMT

Who or what is VC?

RE: Why have vet bills gone up so much?

Rob Loxley — Sun, 03 Nov 2024 15:07:02 GMT

[quote userid="12375" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245888#245888"] circa 6%. In the same year an investor could perhaps get 3.5% return on cash in a bank. They are making some money but it’s hardly a fortune.[/quote]

The ONS put the average profitability of UK service companies at about 15% over the last 10 years.

RE: Why have vet bills gone up so much?

Rob Loxley — Sun, 03 Nov 2024 15:04:02 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245890#245890"]Given most of them are VC funded[/quote]

Of the big 6 UK vet corporates, Linnaeus is privately owned (Mars family), CVS and Pets at Home are stock market listed, so that leaves 3 owned by VC?

RE: Why have vet bills gone up so much?

Mary Lu — Sun, 03 Nov 2024 12:56:11 GMT

I'm afraid I can't remember the exact conversation but she isn't the first person I've spoken to that has said that.

Quick Google British gas profit margin was around 8.2% in 2023...not sure if this was calculated in the exact same way, but what messes with my head is that energy is a household essential, whereas pets are a luxury. Gas fees back home are significantly cheaper (£5 a summer month for one person whereas it's more like £25 here. Wages are about half of UK) and tightly regulated by government.

I have to be honest being the cynical person I am I think CMA investigations were launched there was a lot of anger towards cost of living and I wondered if it was a way to divert public attention.

RE: Why have vet bills gone up so much?

Arlo Guthrie — Sun, 03 Nov 2024 12:33:13 GMT

[quote userid="18902" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245887#245887"]I only say this because although CVS profits seem mouth watering, when I mentioned their profits to a friend who is senior in JP Morgan, her exact words were "that's peanuts". It wasn't said in a derogatory tone, it's purely a comment based on her experience of crunching numbers for corporates. [/quote]

Mary Lu Hi - I wasn't quite sure what you (or rather, they) meant here. Did they mean CVS profits in absolute terms, or as a percentage.

(I ask because I would not be surprised if they were peanuts in absolute terms, but they could still be huge in percentage terms, and the latter is what would equate to a pain in the wallet for pet owners - although if the 6% figure is correct, then that doesnt seem excessive).

RE: Why have vet bills gone up so much?

Clive Ansell — Sun, 03 Nov 2024 10:28:38 GMT

[quote userid="18902" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245887#245887"]whereas these days I'm told some are supermarket/broadband company managers. [/quote]

I was told some years ago, at the RSPCA or PDSA, can't remember which, that one of the head honchos used to work for Heinz.

So, if it's true, we are actually being run, literally, by bean counters

RE: Why have vet bills gone up so much?

Clive Ansell — Sun, 03 Nov 2024 10:16:40 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245886#245886"]Why the negativity towards clients in this way? So peculiar.[/quote]

Peculiar? maybe, but not altogether unexpected or surprising.

28 years as a full time vet at the coalface in first opinion practice, across many practices both employed and as a locum.

I've seen countless cases of practices and owners getting burnt by clients who don't pay, and renege on payment installments, after being given genuine extra help, often with no extra charges, to help them out where a large bill investigation or procedure is needed.

I used to sometimes be involved in chasing debts, filling court papers etc. A lot of work consuming valuable time being taken away from what we should be doing, treating patients.

It got so bad in one of the independent OOH clinics I once worked for, that they had to introduce a strict policy of payment in advance. OOH Staffie and Brachycephalic C-sections were notorious for it.

[quote userid="8991" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245886#245886"]Are people actually that cynical[/quote]

So, yes, some of us are.

[quote userid="8991" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245886#245886"]Are people actually that cynical that by helping people in limited and defined ways (whilst still turning a profit) they truly think that somehow you'll be inundated with impecunious owners?[/quote]

OK, hands up, I was taking it to the extreme a bit I admit, but I have worked in practices that have a reputation for being cheap or a soft touch for some hard luck story, and they just get inundated with the "my £5000 pedigree dog need and op and I've got no money" crew. Discounted work and credit plans are agreed in good faith, and many (sorry don't have numbers) do not, will not, and have no intention of ever paying.

If I can help someone out in genuine need and difficulty, I will of course do all I can for them, but I am not prepared to have the p*** taken.

[quote userid="8991" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245886#245886"]helping people in limited and defined ways [/quote]

Yes, with careful selection of clients and cases, and with defined parameters. Of course.

RE: Why have vet bills gone up so much?

Alastair Welch — Sun, 03 Nov 2024 07:50:31 GMT

CVS floated in 2007, do you really think they are still playing a long game?

RE: Why have vet bills gone up so much?

David Mills — Sun, 03 Nov 2024 00:09:20 GMT

[quote userid="12375" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245888#245888"]you really think that CVS’s profits are mouth (eye?) watering? Looking at their latest annual report they made £38.2M profit from a turnover of £647.3M, circa 6%. In the same year an investor could perhaps get 3.5% return on cash in a bank. They are making some money but it’s hardly a fortune. [/quote]

It isn't high margin as a bottom line, but if you think most of the core practices run at 20% profit at least that maybe gives you an idea / assumption / inkling of what the longer term 5-10y plan may be.

Market saturation (complete)

Centralisation (ongoing)

Consolidation (5-10y)

It's no surprise some premises are being left to rot (relatively speaking).

It's also no surprise that these businesses that they probably expected some kind of CMA involvement. Which practices do you think they'll divest themselves of when the judgement comes out?

Given most of them are VC funded, profit is immaterial but potential, market share, fee realisability, future profit options are the name of the game. It's a massive tick that they are even profitable at this stage. Having been involved in a few investment convos with new starts and established vet groups looking for liquidity, these guys have it right on. To think they are ever from here not going to at least wipe their faces is inconceivable. (For interest, look at how some of the indy referral tv-heavy places are faring - not well). Whether this is depressing for the profession is upto other people to decide but don't fool yourselves that all this CMA hasn't been modelled and that the big 6 aren't hugely attractive investment vehicles.

RE: Why have vet bills gone up so much?

Mary Lu — Sat, 02 Nov 2024 21:57:09 GMT

Yes I realised that mistake after posting.

I was enlightened by said friend so no I don't think it's a high profit margin, but the whole point is that the public thinks vets are a rip off, hence the CMA investigations

RE: Why have vet bills gone up so much?

Alastair Welch — Sat, 02 Nov 2024 21:54:19 GMT

Do you really think that CVS’s profits are mouth (eye?) watering? Looking at their latest annual report they made £38.2M profit from a turnover of £647.3M, circa 6%. In the same year an investor could perhaps get 3.5% return on cash in a bank. They are making some money but it’s hardly a fortune.

RE: Why have vet bills gone up so much?

Mary Lu — Sat, 02 Nov 2024 20:25:47 GMT

I am personally very curious to know how profit margins in the vet world compare to other industries. I only say this because although CVS profits seem mouth watering, when I mentioned their profits to a friend who is senior in JP Morgan, her exact words were "that's peanuts". It wasn't said in a derogatory tone, it's purely a comment based on her experience of crunching numbers for corporates.

From my experience of working for cheaper, seemingly more affordable practices versus ones that are more expensive, there is a basic difference in volume. To generate £200 in consult fees only, you either charge 4x 15 minute consultation for £50, or 6x10minute consults for £33. Cheaper ones also tend to have a higher volume of ops. It's different business models I think, places I've been where consults are cheap sometimes had the most expensive blood tests. Personally I prefer 15-20 minute consults. I can do the 10 minutes, but I find it mentally draining as there are so many options that need to be discussed. As a simple example an itchy dog no longer just has steroids as an option, it's diet, it's apoquel, it's cytopoint, it's food, and it takes time to go through the pros/cons, including something as basic as whether the client can even tablet their dog. So yes, costs to clients have increased, but on the basis of the work becoming more time consuming and mentally draining as well.

Regarding practices that were sold to corporates, and money issues aside, I think the degree of mental health issues (including older vets who were brutally honest about living on alcohol for significant periods of their career), burnout, and suicide rates are testament to the fact that the old model wasn't sustainable. I've had the pleasure of working at these types of practices and it's incredible having such a close client/practice bond, but I think we have to be honest about whether certain changes are for the better. It may be at the cost for clients, but personally I would rather see an improvement to the professions mental health.

Historically discounted schemes like cats protection £10 neuter vouchers, dogs trust £35 neutering, and PDSA have existed, which I think also encouraged the wrong people to have pets, and undermined the value of our profession. I understand that people's circumstances change, but more often than not we have the owners that spend £4K on a puppy then complain about a £50 consult. I had a client just last week complaining she can't afford to neuter her cat and it's cats protections fault for not offering vouchers anymore. Having pets is a luxury, and there are much more affordable pets such as guinea pigs and small furries.

Having benefited from the packages, perks, work permits, and certificate training funded by corporates, I think we have to be careful of the mindset of "corporate=evil". Certainly when I qualified the first corporate I worked for actually had very high standards of practice. However, in recent years they seem less and less inclined to invest in the practices, and changes to pricing and staffing are much more aimed at maximising profit for people up there. I wonder if it's because back in those days the regional directors tended to be very experienced vets, whereas these days I'm told some are supermarket/broadband company managers.

RE: Why have vet bills gone up so much?

David Mills — Sat, 02 Nov 2024 18:42:53 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245885#245885"]Would also have to be wary about getting a name for being cheap, or before you know it you'll have everyone from within a 50 mile radius that has been estimated for work asking if you can do it for a fiver. Then soon or later the "I've got no money, my Staffie needs a C-section" brigade will be on the doorstep[/quote]

Why do people ALWAYS come out with this tired, lazy, dogmatic, unsupported line that simply has no basis in reality.

Are people actually that cynical that by helping people in limited and defined ways (whilst still turning a profit) they truly think that somehow you'll be inundated with impecunious owners? Has anyone ever had this ever? I very very much doubt it. Why the negativity towards clients in this way? So peculiar.

RE: Why have vet bills gone up so much?

Clive Ansell — Sat, 02 Nov 2024 14:29:34 GMT

[quote userid="13891" url="~/f/non-clinical-questions/31062/why-have-vet-bills-gone-up-so-much/245883#245883"]Interested to know what would have happened with David's offer of £500 for periop fluids and surgery which also seems a valid treatment option depending on how sick it was.[/quote]

Would also have to be wary about getting a name for being cheap, or before you know it you'll have everyone from within a 50 mile radius that has been estimated for work asking if you can do it for a fiver. Then soon or later the "I've got no money, my Staffie needs a C-section" brigade will be on the doorstep.