Is Your Vet Ripping You Off? Choice Article

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http://www.choice.com.au/reviews-and-tests/money/shopping-and-legal/shopping/veterinarian%20costs.aspx

01.Mature market

We’re pretty confident most veterinarians won’t try to sell you something you don’t need next time you bring in your four-legged friend. But the Australian Veterinarian Association (AVA) readily admits that, as in all industries, some individual veterinary practices are more profit-driven than others. So how do you know if you’re being upsold? It doesn’t help that there are no standard fees for standard services.

The AVA says vets set prices in line with their overhead costs, and that such costs “vary widely from place to place”. National president Dr Ben Gardiner told us “it’s a free market, and if prices are too high the market will govern that. Customers will leave pretty quickly if they think they’re being overcharged.”

The Australian veterinary industry generated about $2.5bn in revenue in 2012-13, mostly from tending to household pets. But that doesn’t mean vets are getting rich. In fact, rates of pet ownership are declining, so there’s more than enough supply to meet demand these days, according to some industry analysts. With less new business coming through the door, the theory goes, any revenue growth for vets will have to come either from charging more for the same service or coming up with new services. The upshot is that many vets are, more than ever, under pressure to extract as much money as possible from every customer visit.

Price check

One pet owner told CHOICE she was quoted $30 and $66 for the same vaccine from two different vets in the same area. Another said a franchised practice charged up to $300 more for the same procedure than an independent one. In other words, prices are all over the shop. Gardiner argues that upselling and overcharging hasn’t reached the level of a systemic issue as far as the AVA is concerned, but he also makes clear that the financial pressure on vets is increasing as the industry continues to modernise, and practices have to keep up with higher equipment and technology costs. According to an IBISWorld report released in September last year, 30% of the revenue that veterinary practices take in goes toward buying new equipment, well above the average overhead for other parts of the industry.

In a 2011 paper published in the Australian Veterinary Journal, Dr John Baguley, then a lecturer in veterinary ethics and practice management at Sydney University, concluded that “revenue growth in recent years has been much stronger than demand growth” for pet care services. With more than enough vets available to meet pet owners’ needs until at least 2026, Baguley wrote, vets will have to raise fees if they want to grow revenue. Baguley, who is now Registrar at the NSW Veterinary Practitioners Board, declined to give us an update on the issue, citing restrictions of his regulatory role. But he did tell us the board doesn’t have the authority to regulate pricing and refers any complaints about costs to NSW Fair Trading.

According to Gardiner, pet owners may be paying more because vets are taking a more holistic approach. “These days a lot of vets are looking at the overall health of the animal, and that means pet owners have more options for treatments. Vets are moving more toward preventative care. If a vet offers a range of options that could benefit the animal, I wouldn’t call that upselling. But if there’s a degree of coercion involved – if the vet plays on the owner’s sentiments and pushes things the animal doesn’t really need – we would consider that to be a violation of our code of practice.” He also points out that vets across the industry were performing about $30m worth of pro bono work at last count, or about $15,000 per practice.

02.Going corporate

Our social media call-out on this issue yielded more than a few stories of apparent upselling and overcharging, but also some strong endorsements of trustworthy vets. Kerryn M said she shelled out $2000 to a large practice “notorious for upselling unnecessary tests”. After a regimen of blood tests and X-rays, anaesthesia and a two-night stay, the vet still hadn’t found the cause of her dog’s problem, which the vet assumed was abdominal pain. A vet at a smaller, independent practice immediately diagnosed the problem as back pain and prescribed an anti-inflammatory, which Kerryn says did the trick.

“Some [vets] use your love for your pet to earn a lot of money, which just isn’t fair,” Louise P told us. Jo T seconded that point, saying “my vet tried to upsell so many extras I simply couldn’t afford. It makes you feel really bad when you say no.” Other pet owners also believed larger corporate-style practices were more likely to upsell than independent ones - a view substantiated by one of CHOICE’s own staffers, an expert in consumer law who switched to an independent vet after noticing suspected upselling tactics at a larger practice.

Gardiner acknowledges the increasing corporatisation of the industry is an issue of concern to the AVA. “It’s certainly a change that needs monitoring. You don’t have to be a vet to own a veterinary practice. We’d be very concerned if any practice was instructing its staff to push a particular product based on any commercial relationship with the product maker, but we have no evidence that any such thing has occurred.”

While vets are under no obligation to disclose commercial relationships, a couple of pet owners, and our staffer, recounted some upselling episodes involving Hills pet foods. Some of the company’s product offerings, such as those targeted to pets facing oral health, food sensitivity and weight control challenges, may seem unnecessarily niche to some animal lovers. According to a report by the Australian Companion Animal Council, annual sales of premium wet and dry dog food went from $333m to $486m between 2004 and 2009 and accounted for 44% of the $1.1bn in sales in 2009 (cat food generated about $581m).

Greencross grows

One of the main issues with corporate style vets, according to one independent Queensland veterinarian practice we spoke to, is that the high overhead costs are passed on to customers whether or not they need any of the high-end products or services being offered. The practice requested anonymity, saying the head vet had recently been censured by the state veterinary board for speaking out against vet franchises.

The biggest veterinary franchise in Australia by far is Greencross Ltd, which as of August last year owned 81 veterinary practices across NSW, Victoria, SA and Queensland, and was listed on the ASX in 2007. The company has indicated it aims to acquire another 200 practices, which would give the corporation 10% of the vet market. Greencross generated $82.6m in revenue in 2011-12, a healthy share of the overall consumer spend. According to the ABS, the average Aussie household spent about $5.47 per week on veterinary services as of October 2011.

Sketchy oversight

Our investigation confirmed what some pet owners may already suspect: the Australian veterinary industry is essentially unregulated from the standpoint of customer service. Gardiner estimates that 70% of practices have at least one vet who is an AVA member, but only about half of all vets are AVA members and thus bound to its code of conduct. The code holds that vets “should make reasonable efforts to identify and avoid potential or perceived conflict of interest”, but doesn’t say anything specific about upselling or overcharging. And with growing operating costs and stiff competition for new customers, it seems reasonable to assume the $720 annual AVA fee may be an obstacle for vets surviving on thin profit margins.

According to Gardiner, the AVA “is not the police of the veterinary industry” and doesn’t conduct regular surveillance activity. So he was unable to give us an official update on a follow-up from our previous investigation. We asked: are vets following AVA guidelines issued in 2009 recommending core vaccinations only be given once every three years instead of annually? In that investigation we found some vets and vaccine manufacturers were using annual core vaccinations as a source of revenue, despite mounting evidence that such jabs pose a health risk to pets. Unnecessary vaccinations was a point of concern for two consumers who responded to our call-out for this story. And another CHOICE staffer, Mary G, recently received a reminder notice for core vaccinations for her cats even though they’d been vaccinated a year earlier.

Since the AVA isn’t set up to take complaints from consumers, Gardiner could only say “we haven’t been given any reason to believe vets aren’t following the new guidelines.”

03.Is it necessary?

CHOICE consumer law expert Katrina L suspects she’s been on the receiving end of at least two upselling incidents that left her $1437 out of pocket. In the first, she paid $819 for X-rays at a corporatestyle practice to determine whether her 10-year-old Shetland sheepdog had bone cancer or arthritis. The vet later said the treatment plan would have been the same in either case, but didn’t explain why the X-rays were necessary. Katrina’s experience is similar to that of another consumer we heard from, Andrea E, who said she was “recommended tests that cost a lot but wouldn’t have changed the treatment plan”.

Katrina’s suspicions were further aroused when one of the vets in the practice recommended a teeth cleaning and gave her a detailed demonstration of the teeth-cleaning power of Hills Oral Care dog food. The vet also recommended an expensive glucosamine supplement targeted at canines, but a different vet at the practice admitted there was no difference between canine and human glucosamine supplements and gave Katrina directions on the right dosage for her dog, quietly letting on that “the principal vet here kind of likes to sell the products we have here”. Katrina booked an appointment at an independent vet for the dental clean, which cost $618 and required putting her sheepdog under with general anaesthesia. She wishes she’d consulted with the local vet first, who said her sheepdog’s teeth “really weren’t that bad".

Be on guard

With the veterinary market facing a decline in new business, some vets have had to increase and diversify their services in order to shore up their revenue streams. New services on offer may include some of the following, and may or may not be advisable. Be sure to ask questions and, where appropriate, get a second opinion before agreeing to any expensive or invasive products or procedures for your pet.

- Acupuncture

- Canine dentistry

- Chiropractic services

- MRI scans

- Oncology

- Lens replacement for cataracts

- Cardiovascular surgery

- Nutraceuticals (dietary supplements that combine nutrients and pharmaceuticals)

- Premium pet food

- Parasite preventatives

- Grooming

- Geriatric care

- Behavioural advice and training

While there is no comprehensive list available from the AVA or other veterinary agency, we’ve identified a few common areas of upselling that you should generally question before approving.

- Unnecessary diagnostic tests that don’t affect treatment decisions

- Over-vaccinating

- Big mark-ups on products sold by vet practices

Is your vet well-equipped?

- Does the practice have certified (Cert IV) veterinary nurses?

- Does it have up-to-date anaesthetic and monitoring equipment?

- Does it have any objections to you looking around the hospital if you ask to do so?

Got a gripe?

If you believe you have a well-founded complaint against a veterinarian practice about upselling, overcharging or anything else, contact the veterinary board in your state or territory.

NSW

Veterinary Practitioners Board of New South Wales; 1300 366 653;

Complaints Officer, Mary Lydamore; [email protected]

WA

Veterinary Surgeons’ Board of Western Australia;

Registrar, Dr Sue Godkin; (08) 9317 2353; [email protected]

Tasmania

Veterinary Board of Tasmania;

Registrar, Anne Horner; (03) 6223 8071; [email protected]

Queensland

Veterinary Surgeons’ Board of Queensland; (07) 3087 8777;

Senior Veterinary Officer, Dr Laurie Dowling; [email protected]

SA

Veterinary Surgeons Board of South Australia; (08) 8331 9433;

Contact Officer, Sue Millbank; [email protected]

ACT

Veterinary Surgeons Board of ACT; (02) 6205 1700;

President, Dr Kevin Doyle; [email protected]

Victoria

The Veterinary Practitioners Registration Board of Victoria; (03) 9620 7444;

Registrar, Dr Sally Whyte; [email protected]

NT

Veterinary Board of the NT; (08) 8999 2028;

Registrar, Bernadette McKirdy; [email protected]

Contents:

01Mature market

02Going corporate

03Is it necessary?

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[DesertDobes]

I have quite a few issues with one of the vets we use due to cost and upselling. They also do not offer subsidised desexing for dogs over the age of 5 months because in their opinion the extra cost will encourage owners to desex early. Too bad if like me you believe in waiting until a dog is fully developed before neutering.

They blame the cost of visits to them as a result of locality but the other vets we use have a much smaller practise in a more remote part of NT and charge far less.

[Jed]

Last month, I paid a vet $2,600 for a spey due to a closed pyo. That included in house blood tests, 2 over night stays

But - I just phoned dentists to have a filling replaced

First one quoted $180 - $400

Second quoted $140 - $185

[tdierikx]

One needs to be a savvy consumer nowadays...

Personally, I like to train my vets - that way they understand exactly what I want, and what I don't - upselling will always get a big fat "no" from me, and I could care less what they think of me because of it. Thankfully there are enough good vets out there who truly do put the care of animals before the almighty profit margin. I'm happy to pay a fair price for services rendered, but I'm not looking for unnecessary "extras" thanks. I have a nasty habit of countering with my own list of products that I prefer to use, and why... *grin*

Funnily enough, I've never been knocked back vet treatment that I couldn't afford right at that moment - the various vet clinics I have used over the years have always been happy to extend credit if my animal needed care urgently - which has ALWAYS been paid in a timely manner, and thus makes me no risk to extend credit to in the future...

The worst vet experience I ever had was from a specialist clinic. I had a dog that was extremely claustrophobic and freaked out if placed in a crate or cage - the the extent of explosive diarrhoea and huge amounts of slobber. The specialist clinic refused to allow me to bring him in and stay with him until his procedure, and then to stay with him as he came out of the anaesthetic - they insisted that he would have to be dropped off, placed in a cage crate at the clinic until his procedure, then be fully awake and mobile (also contained in a cage crate while recovering)... I refused to accede to those conditions, as I knew my poor boy would have been a complete wreck for days after his cage experiences. In the end, I convinced my local vet that I trusted them to do the procedure, and I got to stay with my boy when he needed me before and after... and all was well with the world again - and it cost me a fraction of what the specialist quoted too. Funnily enough, the vet that I convinced to do that procedure now works in a specialist clinic... lol! She's an awesome surgeon, and has THE best bedside manner with both the animals and their owners.

T.

[Dame Aussie]

Yeah, you have to research prices and get a few quotes until you find one you think is reasonable I think.

When we moved we tried three or four different clinics and have now settled with one that had the best hours, prices and vets for us,

[tdierikx]

What I've also found is that quite a few of the more reasonably priced clinics are actually open longer hours than the more expensive ones... interesting, yes?

T.

[RuralPug]

What I've also found is that quite a few of the more reasonably priced clinics are actually open longer hours than the more expensive ones... interesting, yes?

T.

Pretty much the same in human medicine, too.

[Christina]

Yeah, you have to research prices and get a few quotes until you find one you think is reasonable I think.

When we moved we tried three or four different clinics and have now settled with one that had the best hours, prices and vets for us,

As above. Vets are businesses not charities & can & should be allowed to charge whatever they want. Its not a matter for government or any other bodies control.

The customer needs to educate themselves & research & use some common sense as to what seems to be needed in the way of food, vaccines, parasite control etc & ask questions about other things like tests, procedures etc that they may not understand.

If the vets doesn't respond in a way that they understand they need to go to one who will. Asking for a quote first is sensible too.

Being pushy for extra sales of surplus & sundry stuff would put me off going there. It can be on display as most people will look around while waiting & ask if interested.

Sometimes the cheapest is not always the best but for basic things like a vaccine/microchip for a young, healthy animal as long as they do a standard check any vet may be fine & cost for this varies heaps.

For breeders, those with multiple animals or special needs health wise or emotionally it is best to base the choice on meeting your needs for them & a good relationship rather than cost alone.

[OSoSwift]

The best price doesn't not mean the best vets or care. However it would be nice to have the choice.

We have one vet hospital - used to have three - and while you have a choice if vets to a point, you don't have a choice of hospitals and some fees are very high, such as $180 for a triennial C3+CC.

It would be great to have a choice

[Alyosha]

I do find it a bit depressing that the big corporate vet clinic thing seems targeted at making maximum profit, but not necessarily returning that to the staff. I have heard that some of teh big, more corporate style clinics don't necessarily pay too well, despite charging higher prices. I suppose big business is the same anywhere.

[Dame Aussie]

I do find it a bit depressing that the big corporate vet clinic thing seems targeted at making maximum profit, but not necessarily returning that to the staff. I have heard that some of teh big, more corporate style clinics don't necessarily pay too well, despite charging higher prices. I suppose big business is the same anywhere.

Yes, I was working for a big chain of clinics and I can tell you now the pay was terrible!

I usually gravitate toward the more family owned clinics as I find they have more experience and are more personable and friendly with the animals.

Edited September 11, 2013 by Aussie3

[tdierikx]

A vet clinic I used to frequent was bought by Greencross... the upselling push has gone through the roof, and costs have soared. The staff are pretty much the same as before, but are "advised" to upsell at every opportunity - it's even part of their KPI's to make more profit for the clinic... I don't go there any more, and neither do a few other long standing customers.

Another local vet clinic is a single owner operated clinic - his standard of care for the animals and interactions with owners is second to none... and he's cheaper and closer that the clinic I used to frequent. He is now my vet clinic of choice around here.

The vet clinic that the rescue I'm with uses is an hour's drive from my place, but I have no hesitation taking my dogs there for anything they need that isn't terribly urgent - they have reasonable rates (even better rates for rescue), and they have awesome vets and great equipment for tests and the like - which the local vet doesn't have.

As far as I'm concerned, anything over a $45 consult fee is a bit steep - especially when most visits for normal stuff take about 10-15 mins at most. Everything else they do is added on top of that, so keeping the starting price reasonable is a big one for me. $180 for a triennial plus CC is WAY over the top! I'm happy to pay a bit more than cost for the vaccine - and considering a C3 vial costs about $30 for the vet to buy, and syringes/needles are dirt cheap (say total to $35 for vaccine/syringe/needle) = about $80 to have it done at a vet clinic is reasonable.

As for microchips - I know we can get them for under $5 each... so there's some markup at vet clinics there from the prices I've been quoted.

Don't get me started of the prices vets charge for basic Clavulox - which cost them about $1 each to buy (for 250mg ones) - I got charged $75 for 20 tablets once... never again!

T.

[Staffyluv]

I don't go to my vet because he is the cheapest around - I go there because the staff and the vets seem to care for the animals.

They are certainly not the cheapest vet in town but they are also not the most expensive either.

I don't care what he charges me - he is in business, has staff and premises.. I assume (because I deal with small to medium business everyday) he charges what he charges to cover his overheads and make a profit.. After all, that is why we go into business - to make a profit.. It is a bonus if we love what we do.

Consumers have always been able to vote with their feet - if you don't like what a vet charges, find another..

[Danois]

I agree Staffyluv!

I choose my vet based on the service I get. The cost is secondary to that. I actually think its quite reasonable - around $50 for a consult and I'm always there at least 30 mins. By comaprison I just paid a dermatologist $270 for 15 minutes for me - and our vets act as our dog's GP, radiologist, dermatologist, oncologist, endocrinologist, orthopaedic specialist, surgeon, anaesthetist etc etc etc

I think it's insulting to say that you 'train your vet' - I let my vet do his job and don't tell him how to do it.

[Xyz]

I think it's insulting to say that you 'train your vet' - I let my vet do his job and don't tell him how to do it.

X2...

[espinay2]

I think the main problem is that a vet is in a position of trust. You are trusting their skill and knowledge just as you do the family doctor. Up selling may be fine in the general retail market, but when it comes to vets there is a huge emotional card they are playing which can also cross the line into a breach of trust. The average pet owner trusts that a vet, like their doctor, will recommend the right health care for their pet. Yes everyone should make themselves informed but the average pet owner does have a right to trust that the care being given or recommended is reasonable and correct without spending hours reading up and without feeing guilty that they are not providing their pet with adequate health care if they decline.

Edited September 12, 2013 by espinay2

[tdierikx]

I think it's insulting to say that you 'train your vet' - I let my vet do his job and don't tell him how to do it.

X2...

The only time I take my dogs to a vet is when they need something that I can't give them, or they have something wrong that I'm having difficulty pinning down the exact cause of. I usually know which tests I want done, or which medications I need for a certain issue, but don't have on hand in my dog medical kit.

Take for example a rescue foster pup with diarrhoea - I will need a fecal float to determine whether we are looking at coccidia or giardia - very similar symptoms, but very different drugs needed to treat effectively.

Having been involved with rescue for some years now, and having grown up on a farm where vet assistance isn't nearly as readily available as in the city, one develops a fairly broad range of animal illness diagnostic skills - and one invariably ends up using a vet only to confirm or deny a diagnosis and to put a treatment plan into place. The vets I use understand that I'm not the average city pet owner, and are happy to work WITH me to the benefit of my animals - in fact there have been occasions when a vet has called ME for help with diagnosing an illness in another client's dog. Being with rescue sure opens one's eyes to the myriad of interesting cases that can crop up, that's for sure - and I've seen and helped diagnose and treat a number of things that a regular suburban vet may never see in their entire careers.

So when I say I "train" my vets - I mean that they are fully aware of my experience base, and we work together to diagnose and treat the animals in my care. Most of them appear to appreciate a client that takes such an interest in the work they do actually.

T.

[Rosetta]

I think it's insulting to say that you 'train your vet' - I let my vet do his job and don't tell him how to do it.

X2...

While "train" may not be the best word we should feel we can question vets just like we question our own doctors about treatments etc. Long gone are the "doctors are Gods" days of yesteryear.

[espinay2]

I think it's insulting to say that you 'train your vet' - I let my vet do his job and don't tell him how to do it.

X2...

While "train" may not be the best word we should feel we can question vets just like we question our own doctors about treatments etc. Long gone are the "doctors are Gods" days of yesteryear.

Though in reality, how many people actually question a treatment their Doctor prescribes? (ask yourself how many times you yourself have actually done it?). Same when it comes to the average person and their vet. I think the large majority of dog owners who frequently post on this forum are not really 'average' either, rather they are more inclined to question than the 'average' owner. Can't count the number of times I have heard someone say 'my vet said 'this' so that is what I do - after all they are the vet'.

[Little Gifts]

I have stayed with my vet for reasons far more important than money. I've been with them since 1988 and a lot of the nurses and admin have been there since then too. It is a hospital so they have all the mod cons but are in a small town and have smaller and slightly daggier looking premises. I've been a VIP customer for at least 15 years now. They are open the same long hours as the more commercial vet practise that operates here too and not once have they ever tried to upsell me or charge me bogus fees. In fact I get loads of freebies in services and goods. They also provide homeopathic services and after hours support. They love animals. I love them! Although my favourite German vet is getting older now and I don't know how many more years she will be able to crawl around the floor with Tempeh saying "Dahlink!"!

Peiradise also has the most amazing vet for the rescues. She has this way of ignoring the dogs to alleviate their stress while still undertaking a thorough examination. It is uncanny to watch! And she takes on some difficult cases as a personal challenge, just for her own learning! We are very lucky to have her and I feel better knowing I have a vet with pei specific knowledge (on top of the amazing general doggy knowledge my own vet has). I know she totally cut back the price on Tempeh's entropian surgery just because she was a foster failure.

I think a good vet and practise become an important part of your community too. They are not just another business.