Vet's pricing

[Deleted]

Our dog had surgery on her paw today to remove a cyst/growth/whatever. It was $193. Coupled with the $200 for her annual visit plus heartworm meds plus antiobiotics for the paw a couple of days ago plus ear meds because her ears are always a hot mess, this sweet pea cost us $400 this month (plus another $15 for dayboarding her while DH had surgery).

The total cost aside (I think our vet is pretty reasonable on procedures), I just hate and hate and hate how they do all this ala carte.

Would I like her to have the laser thingy to reduce scarring and promote healing? That will be $10.

Would I like her to have the extra pain meds? I picture her looking at me and saying, "Mommy, would you like me to answer that question if YOU need extra pain meds?" That will be another $25.

Blood testing is optional until the pet is 7 years old. She won't be 7 until July so I passed. They have tested and tested her for previous surgeries. Her blood type is the same. I can see that it might be useful every few years, but she seems to have some sort of surgery EVERY year. She's had her upper ear canal removed, her teeth cleaned twice, two growths removed from her eyelid, and so on.

Anyway, the pricing structure drives me NUTS. Why do I have to decide if she has the extra pain meds? If they think she will need it, build it into the cost of the surgery!

Does your vet do his pricing this way? I hate having to think, "Ok, do I want to pay for the laser? Do I want to pay for the additional pain shot?"

DH says the vet profiles you and knows you will pay for your dog's comfort!

[goldensam]

Our vet gives it to us straight and tells us everything they recommend.  They know I'll pay whatever I need to for my girls, but they never take advantage.

[milee]

May 29, 2014 19:52:08 GMT -5 @anne81 said:

Does your vet do his pricing this way? I hate having to think, "Ok, do I want to pay for the laser? Do I want to pay for the additional pain shot?"

I think a lot of people can't afford these things and that's why the vets ask.

When our dog was getting older and in a lot of discomfort I had to push the vet really hard to give me options - she didn't think we'd pay for anything.

That's probably true in many cases. I remember finding a dog that had been hit on the road (no tags, couldn't find an owner, in sketchy part of town), so I took it to a vet that I'd used once or twice for my other dog but didn't really have a long term relationship yet. She seemed shocked that I was actually intending on paying for surgery, meds, etc. to patch the dog up.  And then, even when I told her I'd pay for the bill, I think they just did minimal things to keep her comfortable, no aggressive treatment.  Not sure if that's because that was all they could do, but I suspect it was also partly to minimize their financial exposure on this obviously stray dog.

Turned out to be a great dog.  She was a sweetie.  I never regretted scraping her up and paying that bill.

[gacpa]

I really enjoyed the story, Milee.  Good for you! 

[truthbound]

All vets do it that way. Everything is on a per service price scale. It is really becoming a racket like human healthcare.

[Nazgul Girl]

  Well, as a person who used to be part owner of two vet clinics, all of that costs money to either give (medication) or perform - blood tests and laser therapy ( not that we had laser therapy back when I was in the biz).   Techs and supplies cost.   Rooms have to be cleaned.

  Although ala carte pricing may drive you nuts, I know that many owners want the choice of whether extra services are provided or not.   In today's economy, if the pet owner perceived ( correctly or incorrectly ) that the vet was "loading" the procedure with possibly needless extras, the pets would either be euthanized because they would have been considered too expensive to keep up, or the owners would have walked out the door, told all of their friends that Doc So-and-So was a real money-grubbing bastard, and not to go there with their pets.

  The pricing models were being changed to allow pet owners more choices in their costs and still be able to get good medical care for their pets.

  So, remember that you were able to save $35 on services that you really didn't want instead of being kind of mad about it.   

  
  

[raeoflyte]

Agree with nazgul.

Dh is a vet tech and we get awesome benefits, but with 3 dogs and 3 cats we still have to watch the budget. If you click with your vet ask them to give you an estimate based on what they would do if it were their pet. If the total cost works for you, go with it. If it doesn't ask what your options are.

Sent from my ADR6410LVW using proboards

[alabamagal]

Our vet does pricing like that.  I kind of like it.

I think that in the pet world, the vets have to separate between people who would do anything for their pets and those that are less likely to pay for things.  For example, we had a black lab who was getting up in years.  When she was 12, she started to lose weight.  Vet said she probably had some type of internal cancer, he could do some tests, possibly surgery and it could get expensive.  We chose not to.  She actually lived 2 more years, she was just really skinny at the end, but we kept her as long as she appeared to be enjoying life and in no pain, but we did have to put her down when she got really ill (at 14).  I doubt with any intervention she would have lived much longer.

Of course I am still paying on my vet bill of $700 from last year (almost paid off on no interest account) for a puppy that went to the vet the 2nd day we had her and died of parvo.  The vet gave us a 50/50 chance when we brought her in.

[NomoreDramaQ1015]

I like the ala carte pricing. When one of us goes to the hospital you almost need a PhD to understand how billing works and what you've just been charged for. I can talk to billing till I'm blue in the face and still not fully understand what's going on.

When our basset had a stomach tumor the vet whipped out his price binder and was able to give us the exact costs of every option we had available to us so we could price compare before we made a decision.

When Sabah had a tumor underneath her leg we knew almost down to the penny how much the surgery would cost thanks to everything being ala carte.

I've NEVER been able to do that for us, even with simple office visits.

I like knowing up front before I sign anything pretty much exactly how much it'll cost and being able to cross things off the list I don't want to pay for.

[The Walk of the Penguin Mich]

I think the pricing makes perfect sense. This way, you get to pick and choose what you are going to pay for.

When Gomez was sick and the vet was trying to figure out why he was losing weight despite eating well, I was able to pick and choose which tests to run on him which made the most sense. Other than the basic blood work (which really should be run regularly, because it gives the vet an idea as to whether or not the animal has kidney, liver or heart problems, or potential infections), I was more interested in the metabolic panels of testing, so I could pick and choose whether they would look at blood glucose (not diabetic), thyroid (no thyroid issues) and later looked at whether or not he had lost his ability to metabolize proteins.

When I took the mutt in recently because he was having repeated bouts of diarrhea, again they listed everything that they did in trying to figure out what was wrong.  He had an overgrowth of some pretty nasty bacteria in his gut, so he was given a shot of antibiotic and another shot of something to calm his gut, oral antibiotics and instructions that he was to let his gut rest for 24 hours, then start him on chicken and rice.  So the $70 vet bill for the exam, stool sample, 2 shots and oral antibiotics.

[Gardening Grandma]

Yes, Ours does as well. It helps me to understand why the total cost of a procedure is what it is.

If I ask, my vet will give me a verbal estimate of the cost; she'll outline options starting with the least invasive (least expensive). But she also knows that my dog's health and comfort are a high priority...

I wish my human health care providers were as transparent.... Now THAT's a different story..

[sheilaincali]

Our vet does this too. When we were last in the Lab was having a bad allergic reaction. They went through all the options and what every single thing would cost us. Cultures of the areas where she was itching, cream, cortizon shot, ear drops, testing of her ears to determine if there was an infection, etc.

I actually appreciate that they do this. That way there are no surprises and we can adjust her treatment to exactly what we want.  She is 12 and there were a couple of more invasive tests that we turned down. It was partially a price thing and partially a quality of life thing.  My baby gets very stressed out at the vet and them doing biopsies on what basically amounts to misc. skin tags would not make her happy.

My vet is a dog owner as well and I usually ask her "what would you do if it were your dog?" and she usually suggests the less invasive option.

[Abby Normal]

It can be frustrating, but not everyone can afford the extra's or wants to do them.  

I would totally do the laser, especially on a paw.  A friend of mine is a vet and she fell while biking.  Her hands looked like hamburger.  She went to the clinic and used the laser. Two days later her hands looked so much better. 

oh- and the blood test is for the ansthesia. Dogs can have adverse reactions as they get older.

[Abby Normal]

May 30, 2014 10:55:20 GMT -5 @anne81 said:

In an odd business model I lease my new dog and they provide all healthcare, medications, food and training for around $89 a month.  It's a little weird but good for people who've never owned a pet or don't want unexpected petcare costs.

It's tough because it can be expensive.  When our first dog passed we gave her medications to a friend of ours for their pet - I think it was about $200 worth. 

You lease a dog?

[Deleted]

There isn't the transparency that you guys are talking about. I didn't know what the procedure itself cost or the anesthesia or the cost of the bandage (yes, that's listed separately) until I paid the bill yesterday.  It is all broken out on the final bill, but no one said that the procedure would cost X. To be fair, I didn't ask. She had a growth on her paw, and it needed to be removed.

It cost what it cost.

These are add-ons.  They obviously aren't medically "necessary," but I'm being asked to decide on the spot whether to do them. I'm not talking to the vet; I am talking to the receptionist as I sign my dog in the morning of the surgery. This is two days after the visit with the vet himself.  The vet never mentioned the laser when we talked about the procedure.  They've never mentioned the laser before.

It isn't the situation that you guys are trying to describe.  Now to be fair, I really respect and like the vet.  His prices are very reasonable, and he obviously cares about the animals.  I have no complaint about anything except the add-ons.

[whoami]

Our dog is 9 and we have easily spent $10K on her assorted illnesses and surgeries.  Some stuff we ignore (like the senior blood work for no particular reason other than her age).  When she had TPLO surgery a few years ago, the itemized bill from the surgeon was right at $3500.  It ended up being a little less, as she cooperated with xrays and didnt need a cone since I had one at home, but it was nice to have the broken down bill to ask questions and toss out anything that I didnt need.  

I like that my vet gives me choices.  My dog will NOT take antibiotics orally, without a huge fight and even then will usually puke it up within a short time after swallowing.  We have disguised it every way possible and its worse than fighting with a kid to take meds.  The pills are about $70 vs the injection which is $175.  They seemed surprised the first time I was willing to spend an extra hundred but at least I know she is getting the meds and I wont be cleaning up dog puke for 10 days.  We had her anal glands removed, after a couple years of having them expressed at the vet every 3 weeks because they wouldn't empty themselves and 2 infections that required surgery and she hasn't had a problem since.

[kittensaver]

My vet has an interesting routine I'd never seen before: during the exam we discuss the issues and the recommendations, and when "the basics" have been agreed to (bloodwork etc), off goes the pet to the treatment area and in comes an office worker with the prices for all the options we discussed - the basic stuff I said 'yes' to plus other recommended stuff if we talked about it. At that point I have the option to say yes or no on paper to all the various things - and sign off on the basic treatment plan and its costs. I think he does it that way to take pressure off the face-to-face interaction.

[Phoenix84]

Well, this is partly why I don't like going to the dentist.

They charge for x-ray's, the exam, the teeth cleaning all seperately.  And they give you a bunch of "options."  I'd personally prefer not to do the x-rays unless there's something wrong, and just do the cleaning and exam, but they still try to tack on a bunch of extra stuff if you're not careful.

[The Walk of the Penguin Mich]

May 30, 2014 13:40:25 GMT -5 Phoenix84 said:

Well, this is partly why I don't like going to the dentist.

They charge for x-ray's, the exam, the teeth cleaning all seperately.  And they give you a bunch of "options."  I'd personally prefer not to do the x-rays unless there's something wrong, and just do the cleaning and exam, but they still try to tack on a bunch of extra stuff if you're not careful.

Xrays can see caries and bone loss due to periodontal disease.  Both of these problems are cheaper when you find them early.  It is cheaper to fill a one surface cavity than it is to fill a 3 surface cavity with a root canal.  It is cheaper to treat a possible pocket of bone loss than wind up needing to treat all 4 quadrants twice each year with a scaling and root planing.

Your choice, xrays are (IMNSHO) penny wise and pound foolish.  Pay $30 now to catch a problem that could cost you $3000 in a couple years.

[Phoenix84]

Maybe, but when I go to the dentist year in and year out and they keep telling me I have great teeth and they never find anything, it makes one question the cost.

[Phoenix84]

May 30, 2014 15:11:46 GMT -5 @anne81 said:

You lease a dog?

Yes.  If I'd known the system I wouldn't have gone in there but I did, DS fell in love with a dog, and now we lease it.   The organization gets to make all medical decisions (that they pay for).  It's really weird.  They won't let me buy out the dog for two years.

Man, that's weird.  I've never in my life heard of leasing a dog.

[The Walk of the Penguin Mich]

May 30, 2014 14:50:27 GMT -5 Phoenix84 said:

Maybe, but when I go to the dentist year in and year out and they keep telling me I have great teeth and they never find anything, it makes one question the cost.

They are not so interested in just the teeth, but the underlying bone that supports the teeth, especially at your age.  Your dentist should also be making periodic measurements of the pockets around your teeth too.  

[Deleted]

May 30, 2014 12:28:21 GMT -5 kittensaver said:

My vet has an interesting routine I'd never seen before: during the exam we discuss the issues and the recommendations, and when "the basics" have been agreed to (bloodwork etc), off goes the pet to the treatment area and in comes an office worker with the prices for all the options we discussed - the basic stuff I said 'yes' to plus other recommended stuff if we talked about it. At that point I have the option to say yes or no on paper to all the various things - and sign off on the basic treatment plan and its costs. I think he does it that way to take pressure off the face-to-face interaction.

Actually, this makes sense to me.  The vet has delegated the paperwork to someone whose time is less expensive.  I'd find it hard, though, to agree to the optional stuff without knowing what it costs.  I'd also be uncomfortable with the "optional" extra anaesthetic.  I agree with Susana- build the cost of the amount the animal is likely to need into the treatment, and be done with it.  If you don't get the extra, will the animal suffer needlessly?  If you do get the extra, have you paid unnecessarily for something that carries additional risk to your animal?

 

[kittensaver]

May 30, 2014 16:11:33 GMT -5 @athena53 said:

May 30, 2014 12:28:21 GMT -5 kittensaver said:

My vet has an interesting routine I'd never seen before: during the exam we discuss the issues and the recommendations, and when "the basics" have been agreed to (bloodwork etc), off goes the pet to the treatment area and in comes an office worker with the prices for all the options we discussed - the basic stuff I said 'yes' to plus other recommended stuff if we talked about it. At that point I have the option to say yes or no on paper to all the various things - and sign off on the basic treatment plan and its costs. I think he does it that way to take pressure off the face-to-face interaction.

Actually, this makes sense to me.  The vet has delegated the paperwork to someone whose time is less expensive.  I'd find it hard, though, to agree to the optional stuff without knowing what it costs.  I'd also be uncomfortable with the "optional" extra anaesthetic.  I agree with Susana- build the cost of the amount the animal is likely to need into the treatment, and be done with it.  If you don't get the extra, will the animal suffer needlessly?  If you do get the extra, have you paid unnecessarily for something that carries additional risk to your animal?

 

Well maybe I'm picking up on a not-so-good example, but I've never seen "extra anaesthesia" be "optional." You either need it for surgery or you don't.

When I have "extras" presented to me they are usually truly optional, for example - the option of taking home and administering pills (for one price) vs. having a long-lasting shot done in the office (for a higher price). Doing the ultrasound now vs. waiting until the other test results come in (of course as long as the situation is not life-threatening). A full, detailed blood panel because of age vs. doing a less thorough one to address only the issue at hand. Specialized diet food or supplements to address an issue first vs. going right to aggressive treatment. And so on . . .

But maybe that's just me. I will do whatever I absolutely MUST to care for my beloved fur babies. =^..^= I'm just glad I have a superior vet with a national reputation that I love and trust and who is honest about needed vs. optional treatments. I feel honored to be his client. If I didn't feel that way about him, I'd probably be looking for another vet . . .

(he knows I rescue bottlefeeders and he NEVER charges me for their assessments or exams, only for their treatments )

ETA: if anyone is interested, here is his book www.amazon.com/Releasing-Your-Hidden-Health-Potential/dp/1449908446/ref=cm_cr_pr_pb_t

[The Walk of the Penguin Mich]

Well maybe I'm picking up on a not-so-good example, but I've never seen "extra anaesthesia" be "optional." You either need it for surgery or you don't

Let me give you an example with this. Last year, I took Gizzy in to get his teeth cleaned. He had never had his teeth cleaned before and the vet did not have an easy time of looking in his mouth to see exactly what he needed, he just knew that he had quite a bit of plaque and calculus build up on his teeth.

I was told that they would try to do the cleaning with a light sedation. Normally, that was sufficient to clean cat's teeth. However, if Gizzy needed a tooth pulled or had other issues, they'd have to give him more and knock him further out in order to do more extensive treatment. I was told the tooth cleaning could cost anywhere from $150-300, depending upon (1) how much they could do under light sedation, (2) whether or not he needed further sedation for just a tooth cleaning, and (3) whether or not they had to pull one or more teeth.

They would use their judgement, and I suspect that the vet wanted to use as little sedation as possible because the more that they give, the more risky it is for the animal and the animal now requires more careful monitoring. Fortunately, I had a $150 vet bill. Light sedation was sufficient for the vet to get into his mouth, clean his teeth and determine whether any needed to be pulled.

[hoops902]

How much of the "extra painkillers" thing do people think is due to the pricing model, and how much is due to the fact that people just don't know what animals think/feel?  Is the dog whining after because it just had a surgery and is now in a cage, or because it's in pain?  I can see why a vet would want to just say "we can dope your dog up more if you want us to, but that's up to you".  I mean look at all the problems humans have with painkillers, and they can at least talk to tell us they're in pain. 

There's also likely some chance that these extra painkillers are for your benefit as the owner.  I suspect some whining is typical after a surgery.  How many of us would be whining after surgery (particularly if we couldn't speak, and could only make noises).  I wonder if any of this is just meant to make the owners feel better that their dog who would be fine without the painkillers now SOUNDS fine with them as they get more sedated.

[kittensaver]

May 30, 2014 16:33:29 GMT -5 The Walk of the Penguin Mich said:

Well maybe I'm picking up on a not-so-good example, but I've never seen "extra anaesthesia" be "optional." You either need it for surgery or you don't

Let me give you an example with this. Last year, I took Gizzy in to get his teeth cleaned. He had never had his teeth cleaned before and the vet did not have an easy time of looking in his mouth to see exactly what he needed, he just knew that he had quite a bit of plaque and calculus build up on his teeth.

I was told that they would try to do the cleaning with a light sedation. Normally, that was sufficient to clean cat's teeth. However, if Gizzy needed a tooth pulled or had other issues, they'd have to give him more and knock him further out in order to do more extensive treatment. I was told the tooth cleaning could cost anywhere from $150-300, depending upon (1) how much they could do under light sedation, (2) whether or not he needed further sedation for just a tooth cleaning, and (3) whether or not they had to pull one or more teeth.

They would use their judgement, and I suspect that the vet wanted to use as little sedation as possible because the more that they give, the more risky it is for the animal and the animal now requires more careful monitoring. Fortunately, I had a $150 vet bill. Light sedation was sufficient for the vet to get into his mouth, clean his teeth and determine whether any needed to be pulled.

Okay, this makes a lot of sense! But in my pet care world (maybe it's just me ) this would not be "optional." I would discuss this in some detail with the vet (like you did), and then sign off on a treatment plan with a range of cost (like you did - BUT with a max limit!) based on what they found out once they "got in there."

[Mardi Gras Audrey]

I agree with the other posters who mentioned that a lot of it depends on the $$ amount that the owner can afford.  By making things a la carte, there is a higher chance that an owner who is somewhat strapped for cash can afford the basic care and will get it done for their pet (vs. a higher bundled rate).

 I'd like to think that vets go into the business because they like animals.  It would cause sadness to the vet if the owner of a good dog/cat chose to put an animal down/surrender them because they couldn't afford the bundled $500 treatment package.  If the owner can afford the basic package and that animal can be treated/live a good life, the a la carte pricing is better for everyone involved.

My vet does some a la carte pricing.  I took my cats in for a checkup last year and 2 of them needed teeth pulled.  The vet had pricing based on their age/sedation need.  The older one was about $100 more than the younger one but you could add a la carte stuff to the younger package, which made it more inline with the older one.  I remember IV fluids stood out as an a la carte item for the younger one (included with the older one).  Apparently, it makes the anesthesia recovery easier but it isn't required in younger animals.  I chose to do it but I got the impression that most people don't because of the cost.

[Nazgul Girl]

May 30, 2014 11:33:53 GMT -5 @southernsusana said:

There isn't the transparency that you guys are talking about. I didn't know what the procedure itself cost or the anesthesia or the cost of the bandage (yes, that's listed separately) until I paid the bill yesterday.  It is all broken out on the final bill, but no one said that the procedure would cost X. To be fair, I didn't ask. She had a growth on her paw, and it needed to be removed.

It cost what it cost.

These are add-ons.  They obviously aren't medically "necessary," but I'm being asked to decide on the spot whether to do them. I'm not talking to the vet; I am talking to the receptionist as I sign my dog in the morning of the surgery. This is two days after the visit with the vet himself.  The vet never mentioned the laser when we talked about the procedure.  They've never mentioned the laser before.

It isn't the situation that you guys are trying to describe.  Now to be fair, I really respect and like the vet.  His prices are very reasonable, and he obviously cares about the animals.  I have no complaint about anything except the add-ons.

  But, they're not add-ons.   They're options.   You could just as well ask for the dog to be groomed ( after he recovere ) or given vaccines or purchase prescription dog food.   Those are options as well.   

[Deleted]

May 30, 2014 17:47:38 GMT -5 Nazgul Girl said:

May 30, 2014 11:33:53 GMT -5 @southernsusana said:

There isn't the transparency that you guys are talking about. I didn't know what the procedure itself cost or the anesthesia or the cost of the bandage (yes, that's listed separately) until I paid the bill yesterday.  It is all broken out on the final bill, but no one said that the procedure would cost X. To be fair, I didn't ask. She had a growth on her paw, and it needed to be removed.

It cost what it cost.

These are add-ons.  They obviously aren't medically "necessary," but I'm being asked to decide on the spot whether to do them. I'm not talking to the vet; I am talking to the receptionist as I sign my dog in the morning of the surgery. This is two days after the visit with the vet himself.  The vet never mentioned the laser when we talked about the procedure.  They've never mentioned the laser before.

It isn't the situation that you guys are trying to describe.  Now to be fair, I really respect and like the vet.  His prices are very reasonable, and he obviously cares about the animals.  I have no complaint about anything except the add-ons.

  But, they're not add-ons.   They're options.   You could just as well ask for the dog to be groomed ( after he recovere ) or given vaccines or purchase prescription dog food.   Those are options as well.   

No.  As I am signing the dog in for surgery, they do NOT ask me if I would like the dog to be groomed or if I would like to purchase dog food.  They are asking ME, not the other way around, at a time where I will admit that I am somewhat vulnerable because I want the best possible care for my dog if I want her to have more pain meds and for them to use the laser.  These are medical questions that I can't answer.  You are comparing apples to oranges.

I'll talk to the vet about the add-ons when we go for follow-up.  I have a lot of respect for the guy (everyone does), and he will probably write a note in her file about what she needs.