Last week I told you guys I would do an email on the cost of veterinary care.
As I told you all, I’ve seen this from several different perspectives, and I want to do my best to explain the reality of veterinary medical cost.
Many of you read the story of Jeannie, the dog that I had as a child.
The focus of the story was the moment I became a veterinarian and my very vivid memory of her impact on my life. Reading it again though, there are a few things that strike me now. She didn’t have vaccines….at one point my father thought she had distemper, and fact is that could have been right. She was not spayed. Until the fateful visit, she had never seen a veterinarian.
Our family was not poor, but was not rich. Veterinary care was low on our family list of priorities. There was a time in my life where I thought my bigger calling was to provide low cost veterinary care for families that needed it.
There are many veterinary clinics nationally that provide lower cost veterinary care, and they do it simply by seeing more people. As a business model, these clinics do quite well. They provide basic care, typically with a larger number of vets. The office calls are scheduled 10 minutes and product sales make up a lot of their profit. Clinics like this nationally are often associated with pet stores, and they generate traffic and provide basic care for many pets. I think these high volume clinics are a good thing because they provide basic vaccines, flea/tick/parasite control, and even some surgical procedures for people at a low price point.
I realized that for me early on, this would not be the way I practiced.
For one, I talk way too much to do anything in 10 minutes. More importantly, I need to know the patient, the client, the story.
So for the first 15 years or so, I simply worked as an employed veterinarian. I had no interest at all in dealing with the business part of the profession.
I practiced in 3 different practices, and filled in from time to time in 6 others. I saw many styles of veterinary medicine.
I saw some burn out
I saw some amazing compassion
I saw some greediness
I saw some poor management.
I saw some excellent management.
I played by the rules of the practice I was in as far as payment was concerned. One practice in particular paid very little attention to collections, and word got out that this practice would let you pay over time. I never knew anything about the profitability of the practice, but it was very very busy. Despite the fact that it was busy we could not invest in equipment, the staff had no insurance, our supplies would sometimes come C.O.D.
The fact is, the owner of the practice had a huge heart, but I would say he struggled with burn out the most of any vet I’ve worked with.
So when I opened Kindred Spirits I decided out of the door that I would have a modest practice and try to contain overhead. I saw that overhead was the issue in the veterinary practice and thought if I had a small place, that would keep costs in line.
I can see now I was looking at a small piece of the equation.
I would have a low volume practice with 1/2 hour appointments. I would find awesome staff and compensate them as well as I could. We would use the most up to date equipment and yet practice in a heartful way. When I did surgeries I would have just a few scheduled, with a technician with the pet from induction of anesthesia until they were awake and comfortable. I would never recommend a test I didn’t think was necessary. Frankly, I had no idea if it would work. Not that I didn’t think people would come, but as Mary and I started signing promissory notes, the numbers all looked so large.
6K for anesthesia monitoring equipment
4K for anesthesia machines
40K for lab equipment
50K for digital Xray
2.5K for surgical instruments…I had no idea surgery instruments were so expensive…
So 6 years ago last month, we opened and you know the rest. I have watched the books, taken out several more loans and gotten a few lectures from my accountant since then. Let me tell you what I’ve learned….
Having a business is harder than I thought.
Each veterinary practice is a little hospital. We re-create expensive equipment and have supplies for any problem. To treat a patient, I have to have all kinds of things in the clinic. We are a pharmacy, an inpatient hospital, a radiology department, a fully functioning lab, a shot clinic, and a therapy office all in one. I’m not complaining, I’m just sayin’
In retrospect, I think that my plan for the soul of the practice was great, but my understanding of the financial part was incomplete. So little of the overhead comes from the building…its all in the supplies and staff.
So I was right that the business part of veterinary medicine isn’t at all appealing to me.
But I do at least understand what I have to watch in order to keep this practice viable. The fees will always be fair, but I’m afraid you won’t ever be able to say cheap.
Now just as clearly as I see the reality of keeping the business alive, I also see the financial need of people and how pets enrich each of our lives.
This is where I need King Solomon. Or a huge benefactor that could pay for all of the people who can’t afford care.
I assume that most of my clients can afford a few hundred dollars for veterinary care over the year. I also assume that when it goes into thousands, most of us start to squirm. I say both of these things knowing darn well that there are people on both sides of this statement that are reading this right now.
So I have a few suggestions that might help.
First of all, when Becca was about 10, I went to the dentist and they said she needed braces. On the next visit the receptionist met with me and explained that the treatment included multiple steps and the way they decided to have patients pay for it was up front. She followed that with a statement that took the oxygen out of the room for me.
“So that will be $3500 today. ”
“Will that be a problem?”
Actually, that was a problem. I didn’t have a problem with the charge, or the collection policy. I had a problem with my checking account.
I didn’t have $3500
I actually didn’t have $500
I had some room on my credit cards, but not that much.
So she told me about Care Credit.
It is a credit card that has a 0% interest rate for 6 months.
I signed up, they paid the dentist and I paid over the next 6 months.
Well, its no coincidence that we have an account with Care Credit now…they pay vet bills too!!!
What they do to make it work is charge the professional a higher fee for the transaction.
For instance, if you use a Visa, the clinic pays about 2% for the convenience of the credit card.
With Care credit its 8%. But honestly, if it makes it work, I love it.
The next thing that many people find helpful is Pet Insurance. I am going to post a question on our Facebook about that one, because I would love to get some input from those of you that have it. Pet Insurance is by several companies, the one we recommend most is ASPCA, but many people are also using VPI. The bottom line with these is that you pay 25 bucks or so a month and then they pay for large veterinary bills. There are plans that will cover anything, but I don’t think that they are generally a good idea since the premiums are MUCH higher.
I have two concerns with Pet insurance. The first is what will they pay? The reason that we recommend ASPCA is that VPI has, in our limited experience, have refused some claims that they allowed when the clients appealed. I hate that game on the human medicine side, and am so afraid of it coming into veterinary medicine. I do have to say though, some people have VPI and love it. Click the links and see what you think.
This was a hard email topic for me. Basically, I would love veterinary care to be a right for my patients. But I also know that without doing my due diligence in regards to the business of veterinary medicine that the practice would not be present for long.
I have worked for vets that get carried away with the business of veterinary medicine, and ones that totally ignore it. For me, the path is in the middle.
So one of the curve balls that you guys have thrown me since we opened is your generosity to the Kindred Spirits Clientele at large. As many of you know, this email list all started with Jean Pierre and his owners that couldn’t afford his care. For you newbies, I had an older couple who had a dog that they loved. He had really bad teeth and they would not take any charity and wanted to save up for the cost of care. But they didn’t have any money coming in because he had a hernia and she had two strokes. I wrote an email about it and got a bunch of checks the next week. We reduced the fees by 25% and the community paid for his care, his shots and their food for that winter. In fact, we had $400 when it was left over. That whole story was the genesis of the Friends of Kindred Spirits.
Now FOKS is its own entity, non profit, defined by the IRS and can only provide services for seniors or feral cats. We use it to help people every month. But several of you wrote me after the last Email about Vega and the Doberman, and asked if you can send money to help through FOKS. The answer is no.
However, we do have a fund at the clinic called the Angel Fund that can help with things like the Doberman. The Monday after I wrote that email I saw the Doberman, the owner did bring him in. He gained 5 lbs in 7 days and looked great. They paid $200 on their bill and have $600 to go. I can only tell you this because we have no HIPPA in Veterinary medicine and because the owners are not on the email list and are anonymous to you.
If you would like to donate to the Doberman’s owners, you can send a check to
Kindred Spirits Veterinary Clinic
857 River Road
Orrington, ME 04474
Like any other choice you make, choosing a vet probably has more to do with value than price. Our job is to keep the value of the cost that you pay worth it. That is where we put our energy as a practice. If your pet is being spayed, I can’t tell you that you won’t be able to find a vet that will do it less expensively. But I can tell you that I we will minimize his/her risk with IV fluids, the most up to date anesthetics and monitoring tools. That we will check his/her bloodwork before and make sure that your baby is going to be ok. Your pet will be one of a few that will be having surgery that day, and he/she will have a tech with them from start to finish and will be waking up with a staff member sitting with them and one of us will call you when its finished. We will give pain medication during the procedure and send you home with plenty more just in case.
I hope that last bill makes more sense now.