Anyone noticed the veiled insult in the CMA report?

RE: Anyone noticed the veiled insult in the CMA report?

Cinzia Gandini — Fri, 12 Dec 2025 14:52:39 GMT

[quote userid="28638" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248078#248078"]the cheapest vet is unlikely to be the best[/quote]

I don’t think price defines the best vet. the price is influenced by many factors, including the cost of running the business, its profitability, the profit you aim to make, the vet’s level of empathy, and even how much time off they plan to take each year.

RE: Anyone noticed the veiled insult in the CMA report?

Evelyn Barbour-Hill — Mon, 08 Dec 2025 14:47:48 GMT

[quote userid="28638" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248096#248096"]an owner that can't afford a 'gold standard' dental with full mouth x-rays, scale/polish and extractions but has a pet with a fractured tooth that is compromising welfare would definitely benefit from a more 'cost-effective' compromise of extraction of painful fractured tooth cheaper procedure rather than PTS or bankrupting owner[/quote]

I know I'm going off the thread here, but this drives me mad. It rather depends on the tooth – small incisor or premolar, yes, extract it, job done. But a canine or a dog's upper 8 or lower 9 – in a tooth with little or no periodontal disease – endodontic treatment will cost little or no more than extraction, will be far less traumatic (literally) for the patient, far less traumatic (metaphorically) for the surgeon, and at the end the patient still has its tooth.

Back on the thread, it's absurd that, for instance, with a fractured femur or radius, the owner should be offered only amputation, euthanasia or very expensive referral for super-clever osteosynthesis, when any competent general practice should be able to fix the problem with pin or Sherman plate or something similar, even if the end result is not quite as perfect as that which the specialist orthopod might get (although, embarrassingly, it might be )

RE: Anyone noticed the veiled insult in the CMA report?

Dinu Catilina — Mon, 08 Dec 2025 12:54:09 GMT

[quote userid="8663" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248099#248099"]This leads to the discussion: should baby vets be learning through their own experience or through a more supervised system? Wouldn't that be better for our patients?[/quote]

Good question! What shoulder matter most though, what's the best for the patient or the best for the owner or a compromise between the two? Best for the patient is without a doubt not having a go at anything but then the cost will be absurd especially if we follow the human example where a procedure is done tens, hundreds of times under supervision before surgeons are set free in theatres. Do we even have enough specialists to supervise?

Should we change how the profession works without input from owners?

RE: Anyone noticed the veiled insult in the CMA report?

Alasdair Hotston Moore — Mon, 08 Dec 2025 09:28:09 GMT

[quote userid="28638" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248096#248096"]TPLO or Ortho procedures-I think there should be a clear difference between the experience level of the surgeon as this can make a difference[/quote]

I think that be be generalised to almost all surgeries to be honest. We even have evidence for a few (perineal urethrostomy jumps to mind but I'm sure I could find others). This leads to the discussion: should baby vets be learning through their own experience or through a more supervised system? Wouldn't that be better for our patients?

I'll put on my tin hat and disappear again

RE: Anyone noticed the veiled insult in the CMA report?

Kirstin Gribben — Sun, 07 Dec 2025 15:13:50 GMT

Agreed in some sense that an owner that can't afford a 'gold standard' dental with full mouth x-rays, scale/polish and extractions but has a pet with a fractured tooth that is compromising welfare would definitely benefit from a more 'cost-effective' compromise of extraction of painful fractured tooth cheaper procedure rather than PTS or bankrupting owner so I would always offer a range of options for any condition. My concern with the price comparison option is the unseen cost cutting measures-especially for neutering/amputation/tplo for example.

Neutering comparison in a GP practice could have the best care they could provide versus how do some practices save money or cut corners to increase profit:

-Fluids/pain relief/post op meds/buster collar/surgical suit provided as standard or just single pain relief at time of op?

-Surgical facilities: separate sterile op theatre versus single procedure room?

-Glove & gown versus just scrub?

-Qualified nurse monitoring GA versus layperson/unqualified?

-Other Nurse/VCA to monitor when returned to kennel or just left in kennel?

-GA monitoring equipment or just stethoscope?

-Any post op checks or follow up included or just send home?

For an amputation, same as above and some nsaids to go home versus pre-op antiobiotics if needed/nerve block/additional analgesia plan and thorough post op care plan. If more complex op-surgeon differences between new grad/experienced GP vet/certificate holder/specialist? All of these differences cost the practices a large amount but a client doesn't see or understand these benefits. I would certainly want my own pet to be operated at somewhere that focussed on providing the best care they could with good enough facilities and company support to allow this. I would worry that clients would be unaware of the differences and risk versus cost to make the decision for their pets if a price comparison only was set up. It may also result in larger practices price competing to get more cases and cutting corners.

TPLO or Ortho procedures-I think there should be a clear difference between the experience level of the surgeon as this can make a difference. I would class myself as a baby Ortho vet and do basic orthopaedic procedures-I clearly inform clients of this and always offer the local specialist referral as an alternative and don't take offence in the slightest if clients want a better standard/more experienced surgeon as I explain they pay for the experience and facilities that those places offer. I'm happy to still offer a cheaper option-as long as this is clear to the client and not just as a price comparison as I wouldn't want to imply that we offer an identical service.

RE: Anyone noticed the veiled insult in the CMA report?

Evelyn Barbour-Hill — Thu, 04 Dec 2025 20:01:19 GMT

[quote userid="13609" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248089#248089"]Right now I am looking to refer a cat for x-ray controlled full mouth extractions (unfortunately, we don't have dental x-rays available). The specialist I contacted would charge £4570 as a fixed price procedure. The practice nearby we sometimes refer to for dental x-rays would charge £950-1000. I do appreciate that the specialist is probably better[/quote]

RE: Anyone noticed the veiled insult in the CMA report?

Andreas Ege — Thu, 04 Dec 2025 18:44:00 GMT

[quote userid="28638" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248078#248078"]The part that frustrates me about this is the cheapest vet is unlikely to be the best and we don’t want to cut corners to compromise pet care[/quote]

Besides raising the question what "the best" is, as already pointed out, the reverse is unfortunately also true. Just because a vet or veterinary practice charges substantially more does not necessarily mean better outcome, or even better diagnostics, treatment and/ or knowledge.

I had it before that the practice I was locuming for did refer a guinea pig for bladder stone surgery, because the vet on ops that day did not feel confident and there was some concern from the x-rays that there might be more going on in the guinea pigs abdomen than just bladder stones. In hindsight, the exotics specialist operating the guinea pig did not know more about guinea pigs than I did at the time and a couple of weeks later the stones where back because the owner did receive zero information about prevention. Which is ok considering how wide a species range "exotics" covers. But I think there should not be a specialists fee, as charged in this case, if the specialists area of expertise does not cover the species referred.

I might be wrong, but I don't think this was/ is an exception.

Couple of months back I referred a tortoise with likely respiratory infection to a specialist, partially because I can't take horizontal x-rays, partially because the owner moved the tortoise to his brother who lives near London. It had extensive diagnostics (viral swabs, bloods, ct scan, though no bacterial culture and sensitivity) and in the end was treated for a respiratory infection in almost exactly the same way I would have treated it (different choice of empirical antibiotic being the only difference). Outcome likely same though certainly at a multiple of cost. Obviously, they ruled some potential causes out, but would I consider this "better"?

Right now I am looking to refer a cat for x-ray controlled full mouth extractions (unfortunately, we don't have dental x-rays available). The specialist I contacted would charge £4570 as a fixed price procedure. The practice nearby we sometimes refer to for dental x-rays would charge £950-1000. I do appreciate that the specialist is probably better, but are they/ is the outcome more than 4 times as good?

On the other hand I do the odd locum day for a practice providing mainly very basic care for a clientele that is at the lower end of the financial spectrum and often not very educated or very smart. They basically work on a budget (though even their prices have increase significantly in the last couple of years), i.e. they are "cheap", but they do provide a service that is needed as well because most of their clients simply could not afford another practice. And while we frequently have to compromise on diagnostics and treatments there, having the animals not seen by a more expensive "better" vet would certainly compromise their welfare much more. And if it is only to put an animal out of it's misery in an ethical way.

I actually sometimes have a bad conscience because they offered me a full time position at a decent salary, yet I can not imagine working full time for them even though I know and appreciate they do an important job that hardly anybody wants to do.

RE: Anyone noticed the veiled insult in the CMA report?

Dinu Catilina — Thu, 04 Dec 2025 16:29:17 GMT

I don't want to seem to offended by this statement but it all depends on how we define what a "best vet" is. Best from what perspective? Purely professional, purely financial, purely outcome based, purely from the owner's perspective?

It's not about cutting corners but we should evaluate if some of the things we do are worth doing. If the price is increased with 50% and the outcome is improved with 5% is it worth doing? What about the 80/5 ratio or 60/30? How do we define what is the "best pe care" .

And why is compromise wrong?

RE: Anyone noticed the veiled insult in the CMA report?

Beats — Wed, 03 Dec 2025 16:55:25 GMT

It's difficult to describe what makes a "good vet" practising "good medicine" as we all have different outlooks.

Is the "good vet" doing "good medicine" the one who does elbow dysplasia surgery regularly in any limping labrador with CT evidence of medial coronoid process disease?

Or the one who only gives metacam having checked that there is no broken nail or pedal dermatitis and doesn't think the evidence suggests surgery or anything else medical to be anything other than experimental and never recommends it?

Two extremes, one a lot more expensive than the other, but both may consider themselves to be the "good vet" doing "good medicine", just with different interpretations of what that might mean?

As a side note, the profit structure of the business would dictate which of these vets would be more profitable: https://avmajournals.avma.org/view/journals/javma/233/1/javma.233.1.30.xml

There are lots of other factors which may make each of us consider ourselves, or others, as a "good vet" doing "good medicine", but it would be rather subjective.

Having said that, we have Google reviews already, so would this not be somewhat re-inventing the wheel unnecessarily? From a consumer point of view, it has never been easier to see what others think of a given vet clinic from the perspective of being a client?

RE: Anyone noticed the veiled insult in the CMA report?

Michael Woodhouse — Wed, 03 Dec 2025 13:58:03 GMT

[quote userid="28638" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248078#248078"]we don’t want to cut corners to compromise pet care[/quote]

Playing devils advocate here, but why do you think that?

Again - what do you mean by 'best'?

I graduated in 2006, so 20 years a vet next year. 20-25 years ago every small animal practice I spent time in did orthopaedics. Pins, plates, ex fix were all bread and butter work. As a practice we would still do all those things, but so many no longer do. Over the top cruciates or lateral sutures work well. It was only ever the very complex things sent away. The vast majority went very well - we are currently dealing with significant complications from 2 of the last 4 cases we sent for ortho referral - so specialists don't quite walk on water. I did hold 2X AP designations but I let them both lapse as didn't gain me any additional work in the 5 year period. I'm no worse of a vet WITH postgraduate qualifications WITHOUT AP status.

I tend to think we should be looking at what corners can be cut safely, and over the value of treatments we are providing/offering. Maybe the cheapest option IS the best for the dog and the owner, at least some of the time. At the end of the day, they are only animals.

RE: Anyone noticed the veiled insult in the CMA report?

Rob Loxley — Wed, 03 Dec 2025 08:06:44 GMT

[quote userid="28638" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/248078#248078"]If this does happen, it will have to take into account the additional qualifications e.g. certificates/certAVP/advanced practitioner/specialist because there are differences in expertise within different fields- and should be price reflected[/quote]

But I can't imagine it will!

RE: Anyone noticed the veiled insult in the CMA report?

Kirstin Gribben — Wed, 03 Dec 2025 07:49:42 GMT

If this does happen, it will have to take into account the additional qualifications e.g. certificates/certAVP/advanced practitioner/specialist because there are differences in expertise within different fields- and should be price reflected. The part that frustrates me about this is the cheapest vet is unlikely to be the best and we don’t want to cut corners to compromise pet care

RE: Anyone noticed the veiled insult in the CMA report?

Lucy Fleming — Fri, 14 Nov 2025 08:45:32 GMT

Aside everything else, I just don't see how it would actually be useful for a large number of clients. You can compare a consult fee easily enough, sure. Preventative (preventive?) care like vaccines, parasite control products*, but they may not be reflective of the overall "trend" of pricing at the practice (tend to be pretty similar locally). You can provide prices for some/ most surgical procedures, though there's already the possibility of variability depending on whether you insist on/ package in things like bloods, charge follow up radiographs separately etc. But how do you compare the costs for a sick pet - the average cost for a year of treatment for a hyperthyroid or CRF cat? Already wildly variable depending on combination of owner preference and vet recommendations. The "average" cost for a vomiting dog or diarrhoea case? Seems impossible to come up with anything meaningful for pet owners. A year of NSAID treatment? Depends on how insistent the practice might be about biochemistry profiles as part of management.

(*argument about necessity a different matter)

RE: Anyone noticed the veiled insult in the CMA report?

Rob Loxley — Fri, 14 Nov 2025 08:05:12 GMT

[quote userid="9179" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/247973#247973"]or did a particularly well placed and aggreivable politician have to go to the vets a spend a lot of money once?[/quote]

Journalist, I think!

RE: Anyone noticed the veiled insult in the CMA report?

Chris Milligan — Mon, 10 Nov 2025 19:26:25 GMT

As an observer of news events in the UK I am astonished by how much of a snowball this whole situation has turned into. Here in Canada clients rarely leave even the most basic of consultations without a $250 bill (about 140 quid), and frequently closer to $500. With a handful of exceptions no one bats an eyelid. In the UK prices are still a fraction of this and it's triggered an industry wide investigation replete with damning reports. Am I missing something, or did a particularly well placed and aggreivable politician have to go to the vets a spend a lot of money once?

RE: Anyone noticed the veiled insult in the CMA report?

Alistair Graham-Evans — Thu, 06 Nov 2025 05:10:35 GMT

If you put a group of educated, intelligent people in a room and give them the power to make recommendations, collectively they often seem to come up with stupid, moronic ideas and seem blind to the consequences of their suggestions.
They have been working on this for ages but appear to have learned nothing and drifted into a parallel universe. I suppose they are contained in committee rooms and not given any real world responsibilities or they could be really dangerous.

RE: Anyone noticed the veiled insult in the CMA report?

bill bowler — Wed, 05 Nov 2025 15:55:24 GMT

Quite right- price comparison makes no consideration for quality of care and will drive us all down to the lowest common denominator with a lot of aggro for reception staff along the way.

RE: Anyone noticed the veiled insult in the CMA report?

Arlo Guthrie — Wed, 05 Nov 2025 13:00:40 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report/247929#247929"]they all work to differing standards and offer different standards of care; levels of expertise (certificate holders etc), range and quality of equipment, staffing levels, work loads, appointment availability and times, hygiene, cascade compliance etc etc. Making any accurate measurements and meaningful comparison would be nigh on impossible I would have thought.[/quote]

Clive Ansell Well, yes, exactly, and I wonder if that would have the effect of pushing the standards of care southwards.

I suspect if someone is comparing two practices on a price comparison site, one significantly more expensive than the other, the more expensive one is going to find it really hard to show the value in things you list.

So a lot of owners may just head for the cheaper one, as a result of which the more expensive practices might start to look at cutting back on things which owners don't seem to be buying.

Of course, easy to think binarily about all these things. In reality of course, not everyone comes to a practice from a price comparison website! It's just whether it would have an effect anyone would notice.

RE: Anyone noticed the veiled insult in the CMA report?

Clive Ansell — Wed, 05 Nov 2025 09:33:27 GMT

[quote userid="13763" url="~/f/non-clinical-questions/31264/anyone-noticed-the-veiled-insult-in-the-cma-report"]The CMA is talking about introducing a compulsory price comparison website to be overseen by the RCVS.[/quote]

I just cannot see how this would be workable or enforceable.

Setting aside the differing costs of running any business (Building, rent, rates etc) in different areas (Rural remote area vs central London), I work in many different practices locally, and they all work to differing standards and offer different standards of care; levels of expertise (certificate holders etc), range and quality of equipment, staffing levels, work loads, appointment availability and times, hygiene, cascade compliance etc etc. Making any accurate measurements and meaningful comparison would be nigh on impossible I would have thought.

We have had/have the RCVS practice standards scheme (PSS) which was/is a damp squib. I have worked in practices in the scheme that are truly awful, and in other not in the scheme that are fantastic. It is no more than a jumping through hoops box ticking exercise that gives no accurate indication of how good or not a practice is, and is totally pointless and meaningless. I have never had a single client ask about it or what it means.

RE: Anyone noticed the veiled insult in the CMA report?

Alasdair Hotston Moore — Wed, 05 Nov 2025 09:17:44 GMT

I do wonder is this is enforceable. Would the BVA have the bravado to challenge it?