Episode 72: How much did you say it was? You are kidding me! A look at the cost of veterinary care.

Having spent my working life in veterinary practice, a lot of it as a practice owner, I am well used to comments about how much veterinary services cost, some in jest, some in shock and occasionally some in anger. Is this fare criticism though? Let’s take a closer look.Often the comments are in jest. I have been introduced a few times as “this is Bryan Gregor, my vet, the richest man in Timaru”.  I don’t think so. There is this perception that veterinarians have a license to print money. Another comment I sometimes hear is “it costs me less to see my doctor”. I will put this comment to bed straight away. At least in New Zealand, human medical expenses receive a government subsidy. The doctors fee, blood tests, xrays and medicines all have a large proportion of the expense covered by the government. Although this may not occur in every country, I am led to believe that it is common enough, so as the saying goes, you are not comparing apples with apples when you put the cost of veterinary treatment beside human treatment, and to reinforce this further, an ovariohysterectomy or spey of a female dog may put you back something like $350 dollars in New Zealand. Compare that with the human hysterectomy surgery which is pretty much the same surgery. I have seen a cost of $13 000 -$15 000 mentioned. So, lets pare back the veterinary fee and see where it goes. The kind of figures bandied around are approximately as follows. In New Zealand 15% of the fee is GST which is the equivalent of the VAT in England. About 20% pays the veterinary nurses, receptionists, and other support staff. About 20% pays for drugs and other items used in treatments, 20%ish pays for clinic overheads like the lease, insurance and management leaving about 20% as the vets income. To follow this through, if the vet didn’t actually charge for their time, the veterinary fee would only decrease by 20% so a $500 charge would only drop to $400. I do agree that sometimes vet bills may appear more expensive than they used to so lets look at what may have happened. When I qualified as a veterinarian, and bear in mind that this is almost 40 years ago, veterinary medicine was relatively rudimentary. Our companion animal pharmacy only really consisted of a few antibiotics, cortisone, eye and ear drops and an old anti-inflammatory called phenylbutazone. I am probably oversimplifying this but you get the point. Although blood tests were available from the commercial lab, it would take up to a week to get the results by the time the samples were put on the bus that only left the small town I first worked in twice a week. The tests were run at the lab and the results mailed out so it took upward of a week. The animal would be better or dead by the time we got the results so normally we didn’t bother. Anaesthetics were fairly crude, often just using intravenous barbiturates. Qualified veterinary nurses or techs were not a thing, and anesthetic monitoring was the exception rather than the rule.You get the picture.So these days the scope of what is available as far as veterinary treatment goes has advanced by light years. Drugs are unrecognizably advanced, but unfortunately, they come at a cost. The drug companies are always going to want to recoup their R & D spend.It has now become the expectation that clinics will have their own in house blood analysers, ultrasound machines, x-ray – both general and dental and more practices are now investing in CT scanners. These devices have gone from being a nice to have to a must have. I probably don’t need to say but a lot of them are quite expensive with clinics often having hundreds of thousand of dollars of gear. Unfortunately, they have to be paid for.Added to the client expectation, government and professional expectation is that practices utilize these ancillary tests. A simple example of this could be an unfortunate aneasthetic death. If a complaint is made and investigated by the regulatory authority one of the first couple of questions would most likely be “was there pre-anaesthetic blood testing done” and what monitoring was undertaken during the anaesthetic” which these days should include heart and breathing monitors, possibly an ecg, respiratory rate and the like. All requiring monitoring equipment and trained staff to operate them. There is a term that is used by most medical professions. Defensive Medicine. That equates to covering your backside. If something goes wrong or if a client doesn’t like what you have done have you done everything you could have done to prevent the event, and have you recorded it. Now the cynic in me says that defensive medicine can lead to over diagnosis and without a doubt, an increase in cost to the client.  There is no doubt that the increase in knowledge, diagnostics and available treatment comes at a cost but…. There is also a great benefit as far as results. If you know what you are treating and have the drugs or surgical techniques to get a good response this has to be a good thing, right.This increase in veterinary costs does throw up a huge ethical dilemma that vets and owners have to wrestle with. Vets by their nature want to do the best by the animal and the owner. What do you do if the owner cannot afford to pay for treatment? As veterinarians our first responsibility is to prevent suffering. If the owner cannot pay for the treatment unfortunately the course of action may not be very palatable to the owner. Some clinics will have a fund they can use at their discretion to cover some of the cost for some cases. This may have come from a bequest from someone or a fund set aside by the practice. Some clinics will take over the ownership of an animal, cover the costs of treatment and attempt to rehome it. In some areas there are charity organizations that may be able to help, either financially or some even have there own veterinarians and may be able to offer a subsidized treatment. And then of course there is the tragic situation where the only option in euthanasia. This is absolutely a no win for everybody concerned.Of course, there are other factors that affect veterinary fees. Geography is often mentioned. Rural verses urban. In my opinion this is not a big one. There are a couple of forces cancelling each other out. It may be harder to attract veterinarians to some rural areas meaning they are paid more. As I have previously commented on, veterinary remuneration probably only makes up 20% of the fee. On the other side, the overheads of the practice are probably lower. There is often more competition in urban areas, so I am not convinced about this urban vs rural thing.So how can pet owners keep their veterinary expenses to a reasonable amount. I know that there has been a lot of discussion on vaccinations but in the veterinary context, there are a number of potentially fatal conditions such as parvo virus, rabies and distemper which have really effective vaccinations available. Make sure your pets’ vaccinations are up to date. This is money well spent.If you have a car, you probably get it regularly serviced. Get your pet serviced. Regular check ups which are often associated with a vaccination booster will often detect health issues early. It is often much less expensive to treat a condition in the early staged and probably will have a better outcome than when it really gets established.Don’t skimp on the diet either. Be sure to feed a good quality balanced diet. Talk to your vet about this.If you are getting a pet please please please do a budget first. Find out howe much it is going to cost to feed it. To house it and consider health care costs. Also do your homework on specific issues your potential new pet may have. Are they prone to arthritis, breathing issues, specific cancers and any other conditions. Truthfully, some breeds are a lot more expensive to run than others. I will finish off with pet insurance. This has become quite common place. If you have pet insurance it takes a lot of the financial stress out of any decisions if your pet gets sick. Just a word of warning though. There are policies and policies. Read the fine print before you sign.So are veterinary fees expensive? Possibly. Are they justified? In my opinion yes and I hope that this has helped to explain some of the factors that influence the cost of your pet’s veterinary care.