Thursday, February 28, 2013

The Readers speak!

  1. OK, one reader speaks. The rest of you slackers, feel free to chime in any time. Our reader Jenna commented so eloquently on our previous post, we obtained permission to repost her remarks here as a separate blog post. 

    From Jenna:
    It's convenient to blame the current generation's parents for encouraging to follow their dreams, no matter how unrealistic, or the current generation, for expecting "someone", whether that be the government or Mom and Dad to bail them out. 
    You are on the brink of retirement. What do you have to say to someone like me, who graduated over a decade ago? I am NOT part of this new generation, nor am I of their parents' generation. I'm from the group stuck in between, the practice owners who are still paying back loans they once thought were reasonable and manageable. 
    I paid for my first year of veterinary school with savings I'd earned in a job I'd worked for half-a-dozen years before I applied to veterinary school. Unfortunately, I reside in a state with an expensive in-state veterinary school. I graduated with loans around the national average for the year that I graduated. After working for other people and doing my best to absorb all I could from my mentors, I set up practice in a rural community, figuring if I were good, I'd always be able to make a living in large animal practice. 
    I didn't anticipate the economy tanking. 
    I didn't foresee a hefty percentage of my clients leaving the area or losing their homes. 
    I didn't see all those farms being sold for development and paved over to build yet another shopping center or McMansion development. 
    I didn't expect veterinary schools to increase the number of new grads to a point that the number of practicing veterinarians would balloon out of control. 
    I didn't plan on those new grads starting their own practices when they couldn't find jobs. 
    I didn't guess that a huge percentage of those new grads would come from wealthy backgrounds, so they'd own nicer equipment (digital x-ray, etc.) than I could afford unless I overextended myself on credit, equipment that impresses clients but doesn't actually improve outcomes. 
    I had no clue those wealthy young grads would prefer "boutique" work, offering only the profitable, 9-5 services like lameness and "alternative therapies". 
    I didn't know the "retired" large animal veterinarians in my area had never actually given up the predictably profitable portions of practice (basically excluding illness and emergencies) or that a sizable number would come out of retirement when the stock market crashed. 
    I didn't realize the small animal veterinarians who had "retired" from large animal practice were selling vaccines and dispensing drugs to their "good" clients without ever setting foot on farms. 
    I didn't have an inkling I'd lose such a huge percentage of my routine work to lay people (e.g. tooth fairies), internet sales, and human chiropractors and physical therapists. 
    I never suspected that my colleagues, my fellow veterinarians, would find themselves so desperate for a source of income that they'd engage in race-to-the-bottom pricing in order to attract clients, any clients, even temporarily. 
    I banked on my clients' loyalty, only to find that if there are 10 practices working in an area that formerly supported 3, after a certain point this benefits only the clients, not the veterinarians... and after another, later point, this benefits neither group. Everyone loses.  
    Sure, I'm still a good veterinarian, but I am very, very tired of this profession. What does anyone have to say to people like me who did what we were supposed to do: work hard, pay back student loans in full and on schedule, all while providing full-service veterinary care? All this, and I bought a home I could actually afford, and as a result have never missed a mortgage payment.
    I'll soon be closing my practice and going on to a job as a non-practicing veterinarian. I've practiced just long enough that I will remember the good times without forgetting they were far in the past, in a practice climate far different than what I see in 2013. 
    The young people in my life will never be veterinarians, if I have anything at all to say about it. 
    And yes, Lindsay, veterinarians have a suicide rate double that of other high risk professions (law enforcement, military, physicians). I've already lost two colleagues to suicide.

    Jenna, we at VBB central feel your pain. A number of us are in the same situation! I remember my mom telling me "they can never take away your education, and that's your most valuable asset." I'm not sure that's true anymore in this economy!


  1. Jenna, would you mind sending a message to VBB so I can email you? I'd love to chat with you behind the scenes a bit.

  2. I feel your pain, but as a pet owner, can any of you explain to me why my 7-year-old Havanese was seen by a vet for a skin condition on his back and the bill was $140? There were no scrapings taken and that amount reflects a $15 bottle of shampoo and 14 days of Clavamox 2/x.

    My husband had to move six hours away for employment, and I know as well as anyone how bad the economy is, but just can't justify walking into my vet's office and plopping down $140 that I could use for food for my kids or gas for my car.

    1. Though a bit off-topic, I'll bite.

      It is impossible for me or anyone else here to speak for the fees which you describe, and that's not even taking into account what condition is present. That is a question for your veterinarian. Fees are often set to cover the cost of the tests, the veterinarian's professional time, and the overhead/operating expenses of the particular clinic/hospital, which are far more extensive than most realize.

      At the end of the day, you have a choice, and owning a pet is a luxury. How you choose to spend that $140 is your business. If your veterinarian is competent *and* the condition is treatable, I'm sure you'll be pleased with how you spent your money. None of us here at VBB central can determine this for you, though.

    2. $140 sounds about right for my practice for the same service (and I live in a semi-rural. My friends in the city would charge more). It's frustrating to have to pay an amount you don't expect, and it seems to be a problem a lot of people run into at the vet. Many clients don't know what to expect as far as the cost of medical care. A human doctor would likely charge 2-3 times that but you won't see that bill because insurance takes a portion out. If you're used to putting down a $20 co pay and then picking up deeply discounted meds at the pharmacy, $140 will seem like a huge and shocking amount.

      I know I feel the same when I have to repair my car or appliances. However, then I remember that unfortunately what I *want* to pay isn't necessarily what a service or part will cost.

      Two things I wish all pet owners knew:

      1) Proper health care for your pet is likely going to be a couple hundred dollars a year (including vaccines, routine testing and the occassional minor illness) and that will increase, not decrease as your pet ages.

      2)Health insurance is available for pets and many companies have plans that cover routine preventative care as well as illnesses or injury

    3. Yet another client unhappy about paying a bill that probably should have been higher.

      If you want a cost estimate, ask for one prior to making the appointment. If you don't want to pay for the service, don't bother to make an appointment. Resentful clients take up more time and drain more energy than they're worth.

      Because I am a large animal veterinarian, I had to look up "Havanese". Those puppies aren't cheap.

    4. $140 also sounds about right for the rural small animal practice I work at.

      Remember, that $140 pays for the lights, the heat/air, the building, salaries for all of the employees, the cost of the medication, the time it took to count out or mix up the medication, the container(s) the meds were put in, the cost of the doctor's education, the computers, the phones, the internet, continuing education for the staff so they are up to date on the best treatment for your pet's skin condition, up to date textbooks and other reference materials, the paper and ink they printed your reciept on, licensing fees, taxes, equipment, plus a bunch of other stuff.

      Vets can't give their services away- they have kids and cars that they have to pay for, too. Plus, they have to be able to pay their staff members, therefore paying for all of their staff members' kids and cars. My doctor not only has his family riding on his prices, but five other families as well. Be grateful it was only $140, because you were likely undercharged.

    5. As the owner of 5 pets, I almost laughed. I CHOOSE to have my pet, and taking quality care of my pets isn't a choice. It's a responsibility. And thank you, TBDVM, you took the words right out of my mouth. I have this argument with my sister-in-law every two months because she can ill afford to take care of herself because she job hops, and INSISTS vets charge too much. Nevermind the fact her physician only charges a co-pay. But I digress. If you can't afford your pet, make arrangements to earn additional income to pay for your luxury pet.

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    7. Suzy McQ - I appreciate your asking what your $140 covered. All the above replies are true. Recall too, that veterinary hospitals get no subsidies for providing care to a community. There are no tax breaks for businesses our size.
      I think the lack of transparency in human medicine disconnects people from the reasonable costs of care. My son recently had a dermatologic consult which we waited 3 months to get. Consult fee $140. We waited one hour despite have the first appointment of the day. The physician didn't physically touch my son. She listened to history and prescribed a medication, a $200 lotion which I am happy to pay to alleviate his discomfort. Now my son's condition will cost another $140 for a new dermatologist that will take us 3 months to get an appointment with to actually examine him, make a diagnosis and see if the formerly prescribed $200 medication is appropriate since he was never actually examined the first time. Did I get value for my money? Well no, his appointment was 4 minutes long, that cost me $35/minute.

      However, when I see a dog or cat for a dermatologic condition I still do a nose to tail physical exam including: eyes, ears, oral, skin, lymph node evaluation, musculoskeletal evaluation, heart and lung auscultation, nutrition discussion, pain and quality of life discussion. This takes about 30 minutes. I do this for every single patient at every single visit without the luxury of the actual patient having the ability to give us a history. If we charged the actual value of time spent on each patient, by the minute (much like a lawyer) your skin appointment would likely be much more. As stated above everyone must cover a small part of all the incidentals (utilities, salaries, state fees, licensing fees, education, equipment (dental, lab, radiology, derm, surgical), and inventory for us to keep our doors open.
      I hope that my clients feel they are getting valuable education, compassion and value for every dollar they spend.
      Again, thanks for asking your question. If you don't ask, then how are you to know where your dollars are going. Hope your Havenese is doing much better.

  3. Ditto to pets being a luxury. Pets require maintenance just like your car & your kids. If you can't afford that money, then don't have any of these. It's really that simple.
    BTW, $140 sounds cheap compared to fees I've paid for car repairs & sick kids & so on. :)

  4. Pets are a luxury. Veterinary medicine costs money. If you choose to own a pet, you take on the cost of caring for them. Sometimes they get sick or need care. $140 is cheaper than most any human medical bill, car repair bill, or numerous other things we pay for on a daily basis. Why do you complain when your vet charges you for care and not when the mechanic does?

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    2. Couldn't agree more.

      Whining about vet bills is a classic first world problem.