Do either of these veterinary visit scenarios sound familiar?
Scenario #1: During a routine annual checkup, you mostly discuss health issues with your vet. You ask, for example, whether he thinks dogs are generally over-vaccinated and whether your dog will really benefit from a booster shot at his age. You also mention that you’re not surprised your dog needs his teeth cleaned and that you’ve put it off because of the cost. Your vet, whom you adore, says he understands and that he will try to come up with a payment plan for the cleaning that will be comfortable for you. He is not specific.
You go to the front desk to pay and discover that your bill is $328. It seems that, to your surprise and horror, the Canine Senior Comprehensive blood work, done in addition to the regular wellness exam, costs $179. You do not say anything to the receptionist because you know it is not her fault but you suspect that she often bears the brunt of other clients’ surprise and horror because she is only is involved in the financial portion of the visit, not the medical one, which is riveting in a different way.
Scenario #2. You go to the clinic because your dog has been pawing at his eye. The exam, done with a special black light machine, indicates a corneal ulcer, and the vet (another one in the practice, whom you adore somewhat less because she once called your dog “peculiar”) prescribes antibiotic eye drops and a follow-up visit in a week. You phone to schedule the follow-up and discover — because it has occurred to you to ask — that it will cost as much as the initial visit. When you express surprise and horror you are offered a $10 discount but told that there are standard fees and costs “for billing purposes.” Your dog’s eye seems fine. You decide not to go back.
Pet insurance might have prevented the surprise and horror in both cases but you don’t have it because, by the time you discovered its existence, you pet was too old and had a pre-existing condition. And this post is not about pet insurance.
It’s about transparency of veterinary fees — or the lack thereof. It’s embarrassing for clients to have to bring up cost issues. Wouldn’t it be better if a fee sheet were handed out routinely to new clients, one detailing the cost of every procedure? And if, for any procedure not on the sheet — which would be handed out anew should there be major price hikes — the vet would, while discussing the need for the procedure, tell you the cost up front?
It’s true that people doctors don’t have to deal with this type of thing because insurance companies — whom we love to revile because they’re evil — serve as intermediaries. And I have nothing but respect for vets. Still, I’m a professional too, and I would never surprise a client of mine with hidden writing or editorial fees; we discuss and agree on all costs beforehand.
What do you think? Does your vet operate differently? Should she?
P.S. On a different topic — which has nothing to do with lucre, filthy or otherwise –I’m excited to announce that I’m going to be blogging for DogStarDaily.com, my favorite dog behavior/training site. Check out my first post here.
46 thoughts on “Friday Focus: Filthy Lucre & the Vet Visit”
Althought I absolutely adore my furry critter’s vet, and I know he’s thorough and worth every penny, I’ve learned that annual visits will each cost hundreds of dollars per pet due to their various “issues.” I do have pet insurance, but unless you get a premium plan, annual visits and dentals are generally not covered. I would totally love to get a cost sheet for every procedure; however, having worked in vet med previously, I know that it may have to come in the form of a tome–there is a LOT of care put into an animal by veterinarians and technicians, often to prevent future illness. I’ll be really interested to hear what the veterinarians who read your blog say…Have a great weekend! 🙂
Ah that makes sense — the details are probably more complicated than I realize. And I know I’m frustrated in part that money needs to be an issue when it comes to something I care so much about. I would certainly welcome comments from any vets who don’t run shrieking from this touchy topic (or from my blog in the future)!
I can relate to your story, but I am blessed with 2 vets that don’t have hidden bills. Our regular vet is always very open about the costs of anything she might suggest. Actually, I catched her on holding back on some treatments as she thought nobody would want to spend that kind of money.
Our other vet is specialized in Tradiotional Chinese Vetenerian Medicine and she always takes care we don’t pay to much. Example: when we come with Viva for an acupunture treatment she comes out to the parking lot (Viva is a fearful dog and feels very strongly against vet waiting rooms), does her “needle thing” and makes sure we only are billed for her (5 minute) time. That can beat any modern pain medicin in price (also in effect but that is an other story).
Its all about the vet I guess! It is a general “Show me the money” attitude you will find in any type of business. Also editors/writers, although those would be soon out of business 🙂 We should’nt treat vets any different: “Show me the value!”
Wow — that story about Viva is so sweet on both counts: the fact that the vet comes out to the parking lot to do acupuncture and the fact that you are only billed for 5 minutes! I do think there’s something about nontraditional medicine that lends itself to a more empathetic approach, even when it comes to money.
As for editors/writers — don’t you know that anyone can do that type of work… 😉
Awww, don’t get me started about our “super” vet (thats what I call her). She studied Chinese medicine in China itself, had her DVM in Denmark, specialised in joint problems and is an advocate for alternative treatment giving seminars, teached on universities, etc. She has got her PhD. on that subject and travelled the whole country (ok, just little Denmark) to handle the difficult cases everybody else had given up. She is such a great person that is so dedicated to her patients.
On the editor/writer, it would be nice to think anybody could do that. Like any misunderstood profession, TG only quality will prove itself 🙂
I see a blog post about your vet there — and why not? It sounds like she deserves some recognition for the wonderful work she is doing.
I think more and more people are taking a closer look at vet AND regular MD visits. But typically, we consumers are too stressed about the visit and/or too scared to ask about the cost. MDs don’t have fee sheets, and I don’t expect vets to either. And yet, as a practitioner in my own profession I agree to fees upfront with a client (in a formal engagement letter, no less). In the examples mentioned above, I think it is incumbent upon us to inquire about the fees upfront … but even that seems like a crap shoot. For example, why does Senior Canine Comprehensive Blood Work cost $179?
I think MDs do have fee sheets, in a sense — they’re determined by the insurance companies and we don’t see them. With vets there’s no intermediary. But the bottom line is we feel uncomfortable asking – just as I felt uncomfortable even writing this because I didn’t want any vets to feel disrespected.
Why *does* Senior Comprehensive Blood Work costs $179?
Edie and Rod – In a sense, MDs do have fee sheets. My best friend is a Coder for a doctor’s office. (You have to pass a major test to become one.)
There is a code for every procedure, and I do mean EVERY, and it has to be entered in for insurance purposes. Coders can even be prosecuted, along with the doctor, for miscoding and over-charging. So next time you visit the doctor, just think, your treatment is getting coded in the back room!
Interesting — and that makes sense. I guess we’re back to the beginning of the discussion and my first commenter, Carla, who worked in a vet clinic and said any list of procedures would be book length…
Yikes! Those are not great experiences. And, the only reason mine might have been a little better is I ask up front what this or that will cost. Sometimes cost will influence my decision. Sometimes not. I just want to do what ‘s best for Sadie and I’ll figure out paying for it later. But, to your point. Fees are not posted anywhere that I’ve ever seen. That might be a good idea. Or, a maybe have a fee sheet available for standard things like office visits, routine blood tests, spay, neuter, nail trims. and so on. I have to say on the plus side that our vets are pretty cost conscious and will give you a heads up if your heading down an expensive path. For example, when Sadie sliced the pad on her paw and I rushed her blood streaming everywhere to the vet I was told they could sedate and stitch her, or somehow or another bandage the pad to help it grow back together. Pads are notorious hard to heal and stitching, though way more expensive, would increase the odds considerably for a good outcome. The vet was willing to do what I wanted. I figured pay more now so I don’t have to pay more later, which is what I feared would happen if we just went the bandage route. Anyway, my next dog will have health insurance, I’m pretty sure.
The thing about my first experience was that thought I had put myself out there by saying cost is a factor with teeth cleaning; but — as per Clare’s comment — maybe the vet wasn’t aware how much the senior bloodwork would cost because that’s not on his radar but the front’s desk domain? I suspect my vets are cost-conscious too but maybe out of touch on fees for routine procedures.
I agree with you about pet health insurance — for sure I will go for that next time.
Oops. Almost forgot! Congratulations on blogging for DSD!!!
Thank you — and, belatedly, same to you!
Senior Comprehensive Blood Work costs $183 at my vet plus the cost of drawing the blood, the cost of the exam at which the blood work is ordered, etc., totaling a sum similar to what you paid. The odd thing here is that whenever I ask the vet what something will cost (which inevitably makes me feel like an inferior dog mother, because price “should” be no object), she says she doesn’t know, and that I’ll have to ask at the front desk. A friend who wants to neuter his two puppies was told by the same front desk that the charge would be $600 per pup. For comparison, he called another vet office to which he had taken his previous dogs, and was told that they would not give out prices over the phone. Rather, he would have to make an appointment ($70) at which he would be told the fees. I call this OPAQUE in the extreme.
You’ve hit the nail on the head, Clare — and also made me feel better about bringing up the topic: It’s the sense that you’re an inferior dog owner if you’re concerned about fees. Not giving give out prices for a standard procedure over the phone is really egregious.
Our regular vet always tells us the cost up front. They, husband and wife team, also take a great deal of time and answer all questions. They discuss the pros and cons of each suggested procedure. When we recently had Daisy’s teeth cleaned I was given a rate sheet with all the charges. There were a couple of optional precautionary tests that were listed. While I thought it was expensive I was prepared. There were no surprises. Transparency seems to sooth the financial sting.
In defense of vets in general they are human. I suspect this is an uncomfortable conversation for them as well.
P.S. Congrats on your new gig
Yes, it’s the surprise factor that’s the problem. When I know what to expect I can budget for it. A little transparency goes a long way.
And I do understand the problem — as much as I can — from the vet’s perspective. I have two friends who are physicians and I have no problem discussing my gripes about the medical profession with them — for example, why can’t I email my doctor with questions?? — and getting straight answers. They have as much (if not more) respect for vets as they do for members of their own profession. PhDs — not so much. I once caught them referring to “real doctors” before remembering I was a “fake” one…
Thanks for your congrats!
Although you adore the vet, it still sounds like you have a problem here. Is there an office manager or someone you could talk to about the billing? Some doctors don’t really know the costs and don’t like to bother with that kind of thing. But if you don’t feel comfortable with the communication about fees, you have every right to have it addressed. And especially since you’re self-employed, a big bill at the wrong time could be hard to cover.
That said, I’ll argue from another angle here. My vet is very good about communicating costs when discussing procedures. And she couches it in terms that make me feel comfortable about providing good care for my dog while still meeting very real fiscal concerns.
But when receiving emergency or after hours care at our local university vet hospital or a larger vet practice, the talk of costs gets to be disturbing. When my dog Christie suffered through continual seizures on a weekend, I felt uncomfortable going over minimum costs and expected charges before she could be admitted for treatment. I understand that they’ve probably had pets abandoned by people who decided not to pay the bill. But quibbling over a few hundred dollars when my dog is dying is just not comfortable to me.
And when Honey needed surgery, I was presented with a 3 page estimated bill. Yes, it was helpful to know, but what was I going to do? Have them euthanize my puppy over the cost of a surgery?
Part of these uncomfortable conversations was because I was dealing with vets who didn’t know me. My regular vet knows I’m not rich. But she also knows that I live in a very simple way so that I can have money for the things I most value. And at the top of that list is my (human and canine) family.
BTW, the blood work is probably being reviewed by a lab who is charging your vet for the service.
Yes, you’re right — it’s about relationships. The problem was, by the time I got to the front desk, the bloodwork had already been done. I imagine I would have approved it had my vet mentioned what it would cost; the surprise was the problem.
And yes, the emergency vet is the opposite of the regular vet’s office. The one time I was there, I had to charge a minimum amount on my credit card before Frankie, who had hypoglycemia, could be seen.
I had to take Rusty into the vet for an ear that had been ripped off by another dog. It was bleeding like crazy. The vet bandaged his ear and did a follow up a few days later for only $80. My regular checkups for Sadie and Rusty are $40 each dog. They raised their rate this year but sent out a postcard letting me know they were raising it from $35 to $40.
I just wished my vet knew more about nutrition and alternative medicine. He tells his clients to feed their dogs Iams for example.
Wow, that’s really reasonable Kelley.
I agree with you about nutrition; my vet recommended a chemical filled diabetic formula for Frankie when he was diagnosed with diabetes. Then again, the holistic specialist I went to had me rub Frankie’s neutering scar with vitamin E to clear the blockage from his pancreas. Very embarrassing for both me and Frankie and not demonstrably effective.
Congratulations on your new blogging gig!
I’ve had the same problem. Once the vet asked me if he should clean out my dog’s ears. Okay. That was $18/more. I felt naive. Another time I was getting 30 pills at a time for Lily. Every month I would have to schlep to the vet to pick them up. After a few months, I asked for 60 pills at a time. 60 pills were 1 1/2 the cost of 30 pills, cheaper in volume. I told them I wanted refund for the months that I had to pay for 30 days. They credited me the next time I came back.
I took my new hound to the vet and was told over the phone that since I was a new client and got a rescue the examination was free. When I went to pay the bill, it wasn’t. They took off 20 percent. I demanded the free examination and the office staff went to talk to the vet who complied. She said it was an error.
Asking prices at the vet should never make us feel guilty.
You’re good at speaking up for yourself — and for the greyhounds — Karyn, and for the most part at avoiding guilt! I was really good the other night at a pizza place, trying to insist on the price of the special offer. At the vet… not so much.
The clinic where I go for emergencies or to see a specialist, gives an estimate of the cost for procedures beyond the routine visit. It’s an itemized list of costs. I love it. I mean I hate it, cause it’s usually stomach dropping amounts, but I appreciate knowing. My regular vet that I see for check-ups, etc., doesn’t do this and I much prefer a vet who broaches the subject of cost rather than making me bring it up. But…that said, I’m getting better about not being uncomfortable asking.
Agreed — if costs are scary, it’s better to know about them up front. Good for you for getting over your discomfort about asking; I’m working on it too!
Just picked up on you from Saturday Blog Hop, good post, I got court out only the other week, George had a bad ear, I was told to bring him back in 7 days to see if it was getting better. With my vet over here in the UK they change £20.00 for just the consultation, which I though would be a one off with each disorder, no it was another £20.oo for less than a couple of minutes! won’t fall for that one again.
Thanks for dropping by! Sounds like you were in a similar situation to mine (#2). I guess the bottom line is: when in doubt, ask.
Operating costs being what the are, I ask about what it will cost me to walk in the door, the cost of examination and basic bloodwork when I go to a new vet – the substantial price hikes I experienced moving from a country area to city area drove home that point. Now I find myself having to ask those questions for procedures and the vet knows what some of the charges are but not all of course and not to the penny. The larger the practice, the more I find you have to ask each year.
In my 4 year experience working as Lake Shore’s treasurer, I always had a clear picture of the costs and what added costs may need to be applied in each case when dealing with surgeries, hospital recovery time and cost of that stay, staff attention to sutures, supplies, antibiotics, pain relief, etc. Asking for me is now second nature. Easy to make that a habit since I had *frequent* contact with the vets office. Most people go to the Vet’s once, maybe twice a year – I feel your pain!
Congratulations on writing at DSD!
Asking is a very good habit to get into — at a vet’s offices and in general. I’m inspired to try.
Thanks for your good wishes!
Wow, that is a huge bill. I don’t think it’s unreasonable for M.D.’s as well as Vets to have a list of costs. Quite frankly, too often the insurance company just pays when they ought to haggle or just denies payment when they ought to haggle and pay. There’s no doubt that the costs for all of it human and otherwise are inflated. Both professionals have us over a barrel.
I know my mom will pay just about anything to keep me healthy. I had tummy troubles after I was rescued. My medical bills were substantial. I know she does the same thing for my human brothers too. They go to the dentist, ophthalmologist, pediatrician, etc and she just pulls out the plastic and pays. What are you gonna do?
I do my part. I am adorable, but I don’t like the vet as much as my mom does. Every time I go something unpleasant happens. The first time I left with fewer body parts and the last time someone stuck me with a needle. I’ve asked mom if she wants me to bite them but she says we all have to endure.
Oh well. It’s a humans life!
Smell you later,
Happy Blog Hop!
Opie, thanks for dropping by for the blog hop; very nice to meet you. I salute you for showing such restraint at the vet after the indignities of body part removal and needle prodding.
I agree with you about insurance companies — though I think they tend to do more denying than paying without question. But foreinformed is forearmed!
I will speak for our present vet only. Every time there is any cost out of the ordinary stuff we’re used to, he tells us how much that will cost before it’s being done.
That’s excellent. Atypical I suspect but excellent!
Well, you obviously don’t have enough pets with health problems simultaneously or you would already be well versed in the cost of a senior blood panel! 😉 They definitely have gotten a lot more expensive in the past couple of years.
I spent half the summer at the vet – dog with disk disease, cat with arthritis and IBD, cat with hyperthyroid.
I don’t think it’s reasonable, though, to charge a full fee for a follow-up visit unless the fee for the initial visit is really a good deal. We always get a break on quick follow-up exams.
Perhaps because they once again want to put the green stuff in the ulcer and actually examine it they feel like it’s not a quick visit in this case.
We have a LOT of experience with corneal ulcers so if Frankie’s doesn’t clear up within just a few days, holler.
Nice to see you, Natalie — though I’m sorry to hear you’ve had such a tough summer, pet healthwise. The ulcer incident was a while back and Frankie’s eye is fine, but I appreciate your offer of help. And, yeah, you’re probably right about the exam; it’s just always a shock when you get charged $129 (or something like that) for a 5 minute peek at an already diagnosed problem. Here’s wishing you and your menagerie a much healthier year!
Congratulations, Edie on your new blogging gig with DogStar Daily.
Yes. I agree wholeheartedly. …. I discovered just the other day that the cost of cat flea/tick Frontline was $75! I had no idea it was that much….until I got my statement! Yikes! I wasn’t sure I really, really needed it… was only concerned that I might have seen a flea and some flea dirt on my indoor cats and thought perhaps the foster dog might have brought fleas with him. Ugh!
And, I don’t think pet insurance is any great bargain, either. I have it for my young dog, haven’t used it, and it sure isn’t 100% coverage….probably could have just put that $22 a month in a savings acct…
Thanks Mary for your congratulations — and your agreement! $75 is really high for flea medication — and a nasty surprise. Knowing my habits, I doubt that I would set aside money for health insurance– and I suspect that’s what the companies bank on, literally.
Just one thing that might forgive a vet charging a significant fee for the follow-up visit: my vet is very good about conducting business over the phone, as is the highly trained staff. She calls to see how Archie felt after the visit. She calls with lab results. When Archie eats a Vitamin D pill I dropped on the floor, the front desk puts me through to the vet immediately. All without charge. So I guess that by the time I have to follow up, I’ve amortized the cost to some extent.
My vet is very upfront about costs and I also ask prices ahead of time on certain things. There is no price I would not pay for my baby boy. I am also blessed to have pet health insurance.
The first time I asked about the cost of a visit while making the appointment, Iwas a bit uncomfortable. I felt I was going to be judged by the vet staff as being cheap about the care of my dog. But my very tight budget that month required that I know exactly how much it was going to cost to take my dog to the vet. I was pleasantly surprised that the staff graciously and enthusiastically provided detailed information about the exact cost and even made suggestions on ways to keep the cost down. I now ask for the cost of the visit every time I call to make an appointment. I have never been surprised by my bill and believe I have a much better relationship with my vet and their staff because of it.
I *hate* the fact that so much of my job is about money. I love when an animal is insured and we can make decisions on tests and treatments based on what the animal needs rather than what the owner can afford.
Thanks for an interesting article.
Thanks for dropping by! You’re the first vet that’s commented; I should have offered a special prize.
I am a vet, and personally feel uncomfortable talking finances with my clients, so I don’t. I do my exam, talk to the client about what diagnostics I would like to perform and the potential treatment plan. If it is a routine exam I discuss why I would recommend which vaccines for their pet, etc. My nurse puts together a sheet with the cost of everything, and I leave the room for the client and the nurse to be alone to discuss costs.
I have learned people don’t really feel comfortable telling me that is too much money, and I don’t feel comfortable discussing the charges either. They do seem to feel very comfortable talking to my technicians though.
According to what the client approves/disapproves, we actually have the client sign the cost sheet, agreeing to it. I know it seems overkill, but you would be appalled at the people that will try and scam a vet like they scam anything else.
I then return to the room, and we proceed. I understand perfectly not everyone can afford the cadillac of treatments–we don’t think you are bad if you can’t do everything. If I think a test is essential, I will reiterate that with the client and the technician will try and work with them to make it possible.
I am a HUGE fan of scripting out expensive veterinary drugs for human generics. Many times this is a perfect substitute, and makes it possible for the client to afford my $40 test or bloodwork, and they love getting a $4 prescription to get filled at Wal-Mart. I don’t sell Rimadyl or Metacam because it’s outrageously expensive (for me and for you) and if I don’t sell it in time, I have to throw it away and I’ve lost my money. I used to, and then I felt like I was pushing drugs. Not good.
Meloxicam (generic Metacam) is available at wal-mart, and is the tablet form of the drug. Depending upon the size of the dog, it will cost the owner from $2-4 a month. Now freeing up this money for the client, the client will (hopefully) have money to do the annual bloodword to make sure the drugs isn’t harming the pet’s liver or kidneys. My clients LOVE this, and it is better for the pet too because they get that bloodwork that they needed and I can make sure the medication is safe for them.
Sorry for the rant, it is something I feel passionately about, and wish more veterinarians were embracing this as we all get a bad name.
Like Dr. Marie says, I LOVE LOVE LOVE it when an animal is insured and I get to do what I want and not have to go through picking out the “most essential” tests and treatments. Sometimes you need them all!
I think you have inspired me to write a blog on being upfront about costs and $4 prescriptions. Would you mind if I mentioned your blog in mine?
Thanks for the inspiration, and best of luck in your new endeavors!
Thanks very much for this detailed comment, Dr. Laci. Sorry it took me a while to post it — it was captured by my rude spam filter for a while. I am glad I inspired you to write a post and I would be very pleased if you mentioned my blog in yours.
My opinion on this is that every veterinarian should provide itemized lists of cost either upfront or as asked for by the customer. My personal experience has lent me such opinions. I took my 15 lb miniature daschsund to be neutered and once I left I realized I didnt ask how much it was going to cost! Dummy! So I called and they said it was going to cost $170. So I asked why? All I said was can you please explain to me why it cost so much for such a little dog knowing they go by weight there. The woman became immediately defensive and copped an attitude with me. She ha enough nerve to ask me “well If you or your husband has surgery how much do you think it would cost?” I said that’s not the point. I just want to a brief list of what you do during the procedure and the costs of each thing. The woman refused to tell me! Every place In my area I called we more than kind and willing to give me an itemized list and cord over the phone! Why wouldn’t my vet do that!? I asked to cancel the appt and they insisted they had already done the surgery even though he had only been there for an hr. I’m more than disgusted and my pets are never going back there. I think all bets should be required to provide itemize lists of procedures and costs upfront!