Confusion VSA and CMA

RE: Confusion VSA and CMA

Evelyn Barbour-Hill — Thu, 19 Feb 2026 19:16:18 GMT

[quote userid="3169" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma/248395#248395"]Extra anaesthetics, extra surgical time taken up, more kennels to clean, but I don't doubt for a second - greater revenue from "dentals". [/quote]

For some, perhaps. It would rather depend upon how fees are structured, wouldn't it?

Personally I don't often do dental procedures (I take it that is what you mean by "dentals") in stages, partly because I have no problem with a procedure lasting 2, 3 or sometimes even 4 hours, but I have nothing against those who often do things in stages for medical reasons; nor do I have any hesitation to do part of the work to a suitable stage, and come back a couple of weeks later to complete the job.

I'm intrigued by "crack on and do the best you can in an hour". What do you do then about all the stuff that's still to be done?

RE: Confusion VSA and CMA

Beats — Thu, 19 Feb 2026 07:53:05 GMT

OK, think I get the idea better!

I don't have a problem with deciding to limit GA time and do as much as can in 1-2 hours and then come at it again at a later point (indeed I can see some logic to this), but personally I would start with the most obvious and beneficial interventions (extracting the obviously bad teeth) and finish with assessing for more subtle pathology that may benefit from further interventions (e.g. with xray of apparently OK teeth) or counting teeth - that way if I don't end up doing everything I have at least sorted the main issue? Also if yo utake out the bad teeth first there are less left to scale?

Most dogs I see for tooth extractions have obvious pathology rather than simply subtle pathology. If I was more on top of my patients and GA'ing to assess for subtle pathology in an apparently clinically normal dog, then i could see how this might make more sense? So perhaps for some vets with different caseloads it might not be as counterintuitive as it seems to us?

RE: Confusion VSA and CMA

Michael Woodhouse — Wed, 18 Feb 2026 23:11:33 GMT

[quote userid="12930" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma/248390#248390"]What is a "staged" dental?[/quote]

Seems to be one of two things, but sceptically I feel designed to extract more money from owners or to disguise poor technique.

You either GA, scale, radiograph, CT, probe, align chakra, faff about and then wake the dog up with bill 1, and then present owners with estimate 2 for the removal of the teeth noted as problematic at stage 1. An alternative seems to be to limit anaesthetic time to somewhere between 60-120 mins, once time runs out or some other end point reached (one side of mouth I've seen described), wake dog up and schedule to finish another day.

Extra anaesthetics, extra surgical time taken up, more kennels to clean, but I don't doubt for a second - greater revenue from "dentals".

RE: Confusion VSA and CMA

Beats — Tue, 17 Feb 2026 21:36:34 GMT

[quote userid="3169" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma/248386#248386"]The concept of 'staged' dentals makes me physically angry - crack on and do the best you can in an hour. [/quote]

What is a "staged" dental?

If I was to suggest a vet "staged" a dental I would mean you can (starting with the worst teeth) do what you can in, say, an hour and then come back to the rest another day? Or perhaps take out a proportion of the intended extractions and allow that part of mouth to heal and then go back for the others? i.e. "do it in stages"

I can't imagine either scenario making you physically angry (and you say about doing the best you can in an hour also), which leaves me intrigued as to what else a "staged" dental could be? One where one pretends to do a dental and didn't really do it? One done in a public theatre or perhaps broadcast on youtube as a spectacle?

Genuinely intrigued! (or perhaps just badly confused!)

RE: Confusion VSA and CMA

Arlo Guthrie — Tue, 17 Feb 2026 13:45:28 GMT

[quote userid="3169" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma/248386#248386"]My prediction was that the whole CMA review won't change much and things would stay about the same. With the VSA review at the same time - god knows. For every thing given to the profession, expect five things to be taken away. [/quote]

But one reason to be happy: ChatGPT estimated to me that 2-3 million knowledge based jobs will be made redundant by AI in the next three years, more if we get AGI.

But I think AI-powered robots that can hold a squirming cat are a little further off!

Although whether anyone will be able to afford a cat by then is another question entirely!

RE: Confusion VSA and CMA

Michael Woodhouse — Mon, 16 Feb 2026 23:43:32 GMT

[quote userid="6765" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma"]The client has information and a choice. If this is the case for everyone I don’t see a problem as long as the care is contextualised. [/quote]

I'm not sure. I think it can be relatively impossible for a lay person to compare the different offerings from different practices, and even as professionals we can argue until we are blue in the face how much value we put on everything. Do we need pre-anaesthetic bloods, dental radiographs, intra operative fluids, ET tubes in cats? Genuine question, how much of a safety factor is added to the anaesthetic if monitored by a RVN versus a lay person? I see vets boasting about tubing cats and intra operative fluids when the Brodbelt study associated them with greater risk of anaesthetic death in cats - how many vets tell clients that?

[quote userid="6765" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma"]1 - Over and inappropriate treatment - some owners and some vets are guilty [/quote]

I think the issue here is teaching in the Universities. No one is ever going to be 'wrong' offering all the bells and whistles, the only time it becomes absolutely wrong, in my opinion, is when that embellishment is deemed essential and we price ourselves out of the reach of owners and animals go completely untreated. The concept of 'staged' dentals makes me physically angry - crack on and do the best you can in an hour.

[quote userid="6765" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma"]2 - The stark economics are that if prescriptions are free or capped then the cost of services increases.[/quote]

Depending on what the CMA's final ruling is - I will make this crystal clear to my clients. You can't have your cake and eat it. If you take away the bit of cross subsidy from meds sales everything else gets vastly more expensive, or you travel long distances and pay huge sums to Vets Now etc OOH.

[quote userid="6765" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma"]3 - If one company owns all or most of the clinics in a locality there is no competition.[/quote]

Again, absolutely. This needed addressing and I've seen things from IVC and CVS in the last week looking at our 'new' branding, as though they came up with the idea.

[quote userid="6765" url="~/f/non-clinical-questions/31310/confusion-vsa-and-cma"]Some MP’s have recently posted on Facebook and seem to think the VSA review is all about vet fees. [/quote]

The problem is the timing is awful and the MPs have every opportunity to make this review about vets fees. Look at the social media posts on this. I said on here recently how much this concerns me and no one else seems bothered, prominent political vets and even the RCVS seem to be welcoming this. Not good.

My prediction was that the whole CMA review won't change much and things would stay about the same. With the VSA review at the same time - god knows. For every thing given to the profession, expect five things to be taken away.