In this case, non-payment is a huge issue for vets and they need to keep their doors open for everyone else that needs care. Running a specialty like emergency medicine is even more expensive and carries higher prices as a result. They don't want to deal with trying to collect after the fact. Hence, they'll usually give two options: Pay at the time of service or sign up for something like CareCredit that will pay the vet upfront and deal with the collections on the backend. Some places offer third options, but these are usually problematic or involve charities.
Sorry to vent. Still makes me so angry and depressed. None of the vets wanted to entertain the fact that it was the drug, despite mountains of evidence. It doesn't feel like there's a culture of learning, just one of deflecting fault. I hate to be one of those "I've done my own research" types, but with animal care you really are on your own. This happened a few months ago, really miss that dog.
If your dog is bleeding out or not breathing, nobody is going to sit there waiting for you to swipe your card; they're going to try to at least stabilize your dog, and then talk to you about diagnostic options and so on. Emergency vets charge an up-front diagnostic fee and anything that is not "your pet will die if we don't act right now" has to be pre-paid.
There are no government funded veterinary clinics.
There is no legal right to emergency medical care for pets.
There is no government agency guaranteeing the vet ER gets paid if the owner isn't able to, or simply refuses. Debt collectors typically pay out a fraction of any debt they agree to collect...assuming the ER can even identify them. ER vets can't put liens on your property like hospitals can.
Most pets are not insured, and frankly pet insurance is a ripoff. Lots of exclusions and a lightning-fast "prior condition" reaction is how they avoid payouts. It's not regulated because in America, we don't Do That Sort Of Thing (no step on business snek, as business snek regulated by free market!)
Emergency medical care for humans is the most expensive kind of medical care there is. For one species, one usually able to communicate at least on some level.
Now imagine all that, multiplied by multiple species. Equipment, a pharmacy, and staff able to care for patients of almost any size, multiple species, of wildly variable temperament, who have nearly no ability to communicate or participate in their care. And who have an evolutionary drive to hide injury and pain, usually.
Part of the reason ER vet care is so expensive is because they do not "demand you pay" while your pet bleeds out or sits there on the table not breathing...and when people inevitably don't pay (in part because they're people like you who shout "well my dog died anyway, why should I pay you!?"). That has to get amortized over all the people who do pay.
The vast majority of pets that end up in the ER are dogs, and the vast majority of those are in the ER from getting hit by cars, into fights with other dogs, or poisoned/obstructed by things they ate - most of the time because they were not on a leash.
What do you expect ER vets to do? Who pays to keep the lights on? The massive pharmacy stocked? The staff trained? The imaging equipment working?
The magical pretend emergency animal care fairy?
just wait till you see what they do with human healthcare in this country
What an insulting, belittling comment. I don't know why you think veterinarians are charities, and don't know why feel entitled to pay people less than they're worth.
Veterinarians hold doctorates. Four years of undergrad, four years of vet school. Many emergency vets are board certified, meaning they've done an additional 3+ years in internships and residencies.
In running a practice, ideally you also want a 3-1 ratio of techs to doctors to monitor patients. Many states require at least an AA degree to become licensed. These days, it's common to find people who have undergrad degrees who go into vet nursing as a career. Therefore, clinics are paying for 3 others with degrees.
Add in costs like support staff, and the fact that 80% of medicine and equipment are repurposed from human use. Distributors don't give a shit that it's for animals and will charge a vet clinic the same as a human hospital.
Don't blame the vet for charging $5000 for a surgery. Blame owners who can't afford to raise a pet but have one anyway.
What an utterly callous statement. We're mostly well paid professionals here on HN, but to suggest that the average american should be able to come up with $500, much less 5k, on a moments notice is laughably out of touch with most people's financial situation.
I think people are missing that the point here is that the prices aren't being set in a competitive market, so $5000 may just be a monopoly price. Maybe pet owners should be forced to pay the cost of treatment, but whether that's $5000 or not is what the FTC is concerned with.
Pet owners should know this before getting a pet, or properly plan.
I think the following quote applies here:
“It is difficult to get a man to understand something, when his salary depends on his not understanding it.”
Then it's "why do I have to pay for that!?"
This has been a long time coming. As another comment said, with a few anecdotal exceptions I can think of, many vets simply aren't good business people. Margins have been incredibly small since veterinary care became a thing. Vet schools have required business literacy classes for a few decades, but this is an industry where people get into it to help animals first, not get rich.
Corporatization came in to fill a void, but whether it's good or bad, the economics for veterinary care, and especially consumer perceptions, are due for a reset.
But of course if you choose Banfield (PE shitshow), they’ll see them same day (drop off in the morning, pet waits in kennel surrounded by other sick dogs all day until a vet is free, pet goes back to kennel to wait until end of day). The charge is significant, but the pets waiting around locked up all day is what bothers me more. At checkout they’ll of course hit you with the “wasn’t this so expensive? You should buy our health insurance plan!”
Compare this to the vet in my parents town that will also see same day, but I walk into the exam room with the pet, meet face to face with the vet, and stay with the pet for the majority of the operation. And pay less in the end.
Are we saying that vets would rather be unemployed than to work such a market or is something preventing them from serving that market or does the actual demand for such services not exist?
I do not know why such places don’t offer standard services. The one by my house was nearly always empty, but still would not give my dog vaccines.
It's interesting that most people who like to defend the free market act as if consumers actually have choices most of the time.
That's just simply not the case nearly all the time.. or it's a complete illusion of choice.
Especially in any rural/smaller suburban area (of which the US predominantly is). It's not as if you have 1000 choices for everything around. That's only in large urban areas. The US is so spread out that it can't cram tons of competition in most of it's areas. And that is probably what is being exploited here.
In really rural areas, you find vets who will "work off the clock" for cash payments if they know you well, to cut out the company.
If vets are able to charge high prices and people will still pay them, maybe more vets will enter the market to provide services to the underserved market.
For consumers to make informed choices, they need to have some understanding of the domain.
If a Vet says Rover needs a XYZ procedure, how would the pet owner understand what a fair price is or what other treatment options are?
That wasn't unique to our area either. We've heard from several friends that they've had similar issues getting into vets.
What will be interesting is when they go buying up all the farm vets -- and then hiking THOSE prices up, which will put further costs on farms and animals, food and crops... and then that translates into an ADDITIONAL increase in costs of food/collapse of independent farmers and further control of the price-supply-line of all foods...
They alread did this in conjunct with pharma and agri-fertilizer bullshit...
I wouldnt be surprised if Monsanto is behind this...
Do these funds mandate the vendors from whom the vets can buy medicines and supplies from, likely the other companies they own.
This is "Serious Business" -- and these people are EVIL.
They dont give a fuck about anything, but have paid a bunch of quants to maths death into profits.
Like other forms of healthcare, people want to take care of their pets properly and that makes demand relatively inelastic. If one clinic isn't taking appointments, they'll go to another even if the prices are 20% or more higher, especially if that one is more convenient to access. Once they're there, they'll usually stay for a long time.
As an example, prior to certain surgeries, my wife offers drug A to the clients. It adds to the cost but increase the chance of survival. However, drug B is not an option because studies have shown in increases survivorship by 50%. She bakes it into the cost of the surgery and refuses to do the surgery without it. Clinic down the street offers both drugs as options, bringing the base cost of the surgery down.
So now she has a reputation of being expensive vet. If she offers drug b as an option, patients die more frequently and she has a reputation as a bad vet.
She'd much rather have the reputation as an expensive vet.
This is an emotionally charged industry where 99.9% of the customers have no clue what goes on business-wise behind the scenes. Yelp has been a curse, giving voice to these people.
Graduates who want to make money will go to commercial or fisheries operations, which pay better overall. We're in the bay area, one of the highest-demand regions in the highest-demand state. There aren't many people left to compete over. Corps are currently offering 5-6 figure sign-ons and bonuses in our area. Even if the salary can be matched and they accept, there's still the tech shortage snapetom mentioned. Those people are often commuting from places like Tracy to have reasonable housing costs and many have simply left the industry entirely. You can raise salaries, but there's still only a limited number of people with RVT licenses.
So why isn't supply increasing to meet demand?
They simply are not offering enough money. If 5 to 6 figure bonuses do not work, then they should be increasing pay to high 6 figures or 7 figures. I would be surprised if 7 figures does not solve their supply issue.
Of course, the "ideal" rarely happens, the point is, with every vet you add, issues of juggling staff, scheduling, and turnover skyrocket
To be fair to the companies, they do usually work to "maximize vet time" where they hire or outsource the other stuff the office does so the vet is spending most of their time vetting instead of paperwork and office work.
Some of that is changing depending on the corporation. Sometimes you'll see "Main Street Vet Hospital, a Megacorp Vet Clinic" or they'll rebrand speciality clinics and large hospitals with the corporation branding. However, a lot of small general practice clinics still make no mention of corporate ownership and clients would never know unless they ask. And they never ask.
I'm not going to argue whether it's bad. I've met plenty of good independent vets, plenty of bad ones. Plenty of good corporate vets, plenty of bad ones.