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PRICES, PROTOCOLS, PROFITS, PATIENTS AND PEOPLE

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 Prices, Protocols and The Patient
by T. J. Dunn, DVM

What to look for during your visit to the animal hospital:

The majority of dog owners maintain a strong loyalty to their veterinarian.  The Modern equipment and techniques are important tools enabling the doctor to better perform expected duties.main ingredient in this relationship is trust.  You trust that the doctor is competent, ethical and empathetic toward you and your dog; nevertheless, there are a few dog owners who have reservations about various aspects of the client-veterinarian-patient interaction.  Because every animal hospital has a unique set of prices, protocols, and quality of patient care, there are bound to be a few unpleasant situations.


In contrast to thirty-five years ago when I established my first practice, today’s prices for services and products, practice protocols, and patient care have changed drastically. Early in my career I was one of three veterinarians within a sixty-mile radius; an area that now has 16 veterinarians and 9 animal hospitals.  The evolution has been good for veterinarians and pet owners who now have a variety of choices relative to practice prices, protocols and patient care.  Clients (also known as the customers, consumers, end users) have very reasonable benchmarks that determine whether or not they have a positive experience when visiting an animal hospital.  If an experience is unfavorable the probability is the animal hospital staff failed to live up to pet owner expectations somewhere within the prices, protocols or patient care categories.

Having worked in two-dozen animal care facilities, including three of my own, I’ve HOW MUCH!!!witnessed a surprising diversity of ways to conduct the business of running an animal hospital.  On occasion we veterinarians fall short in solidifying client loyalty. Following are few examples why:

The Prices…

You do get what you pay for… sometimes.  Did you ever leave the animal hospital with a dull stomach cramp inflicted by your bill?  Always ask what the fees will be before you agree to a procedure or product.  I’ve worked in several practices where the cost of removing a pea-sized wart exceeds $400 and in others where the fee is closer to $125.   An unfavorable (to the client) event occurred in a practice where the doctor charged fifty-two dollars for a 1cc injection… the actual cost to the doctor was twenty-four cents.  Of course the client was unhappy! 

The fee for a simple fecal analysis for intestinal parasites can range from $12.50 to over $35 dollars. A single x-ray film (not counting the office call fee and the exam fee) at a practice I worked in is $125… and $70 for each additional exposure.  Not far away a different practice does the same thing for 50% less.  Am I advocating selecting a clinic based upon price alone?  Absolutely not, but you do have choices.

Another example of a client having an unhappy experience occurred when I was Experience and compassion are very importantabout to dispense a commonly used oral antibiotic for a dog’s skin infection.  The dog owner was shocked at the price.  I played dumb and asked the receptionist what the charge was for the 40 capsules, although I already knew the hospital’s cost having purchased tens of thousands of these capsules for my own hospitals.  Ninety-two dollars was the reply.  I put the medication back and wrote the dog owner a prescription.  As I expected, the local human pharmacy charged her twenty-four dollars.  That was my last day working in that practice!  I can choose where and for whom I work, lucky for me some practices even ask me to come back again.  You have choices, too.  Take a moment to reflect upon what your veterinarian’s priorities are… and where the prices, protocols and patient care rank within those priorities. 

The Protocols…

It is very interesting to me that one practice mandates strict adherence to certain Following protocols decreases the potential for errors.protocols and another practice considers the same protocols as optional.  For example, one practice strictly forbids any dog from being admitted for in-hospital procedures unless the Bordetella (canine cough) vaccine is up to date.  Another practice seldom even offers the vaccine!  Many veterinarians will not administer or prescribe worm medications until a fecal sample has been analyzed; others always prescribe a course of wormer for every puppy starting at the first examination whether or not a fecal exam is done.  When faced with an unusually tough or complicated case, many veterinarians encourage patient referrals to veterinary specialists, other veterinarians almost never send a case anywhere else for another opinion

I’ve worked in practices where clients were not allowed beyond the waiting and exam rooms; everywhere else was strictly off limits. Two blocks away a different practice welcomes visitors and pet owners any time for a tour of the entire practice and boarding facility.  I don’t know about you but I’d never leave my dog anywhere I couldn’t inspect!

Many practices state that blood and urine testing “have to be done” before a patient is anesthetized for a procedure and the client is not given the option to decline.  Such a protocol is actually good medicine and I do not criticize that standard of patient care.  Nor do I criticize the clinic that simply recommends blood and urine testing prior to anesthesia/surgery and permits the client to sign a paper indicating the presurgical tests were “recommended and declined”.  The only legal requirement dog owners have is to vaccinate their dog against Rabies. Everything else of a medical nature is done at your discretion.  If you do not want a canine cough vaccination but the clinic requires it before admitting your dog for services, you can choose to go to another clinic that recommends it, explains why, and allows you to make the final determination regarding what will or will not be administered to your dog.

While working in a corporate-owned practice I admitted a dog for neutering.  It was owned by an M.D. surgeon.  During the admission exam I produced the usual pile of papers to be read prior to accepting the patient.  The physician’s signature was required four different times and initials twice for all sorts of permissions and acknowledgements.  Looking anxiously at his watch the good doctor patiently shook his head at all the paperwork and said, “You know, my own patients don’t have to sign off on all these protocols!”  And I concurred by replying that either one of us probably could have finished the surgery by now.

The Patient…
Without exception the patient should be the first priority of any animal care The patient should be prioritizedfacility.  Prices and protocols should be tailored to effect an educated, efficient, and empathetic interaction with the patient.  Keeping the patient safe, secure, clean and properly managed is doable in an environment where protocols and prices are reasonable.

You have choices.  You can visit different veterinarians for breeding advice, for medical care, for surgical services, for boarding/grooming and for emergency care.  Objectively consider what you perceive to be the main priority of the practice.  Is the emphasis on prices?  Is it on protocols?  Or does kind-hearted patient care always take center stage?  We veterinarians too often use the term “our clients”, but nobody owns you or your dog.  You will do the client-doctor-patient relationship a service and keep all of us veterinarians on our best behavior if you take the time to inspect our prices, our protocols and most importantly our patient care.

     


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Taking radiographs (x-rays), doing ultrasound evaluations, CT Scans, and MRIs take special instrumentation and protocols to insure patient safety and reliability of data. Patient monitoring and safety protocols have advanced for pet care just as it has for human health care. Most pet owners like the convenience of having pet products available in the animal hospital... which adds to the baseline costs of doing business. There is no way to do cheap and safe major surgery.  Always ask for estimates of charges before going ahead with any procedure.

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