Ways to Combat Overpricing Perception

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NStarz

Ohio State c/o 2016
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The Banfield thread got me thinking...

People often think they are getting ripped off at the vet. Obviously, that's not always the case, and it is merely due to people not having to pay for their own medical bills (because of isurance)...

What are some ways that you've see to combat this faulty perception?

I've heard of clinics keeping a comparison chart for clients--of what the procedure at that vet costs vs. the cost of a comparable procedure in human medicine.

This is a really important concept, I think. I've spoken to people that, when hearing how I wanted to go to veterinary school, tell me of their personal experiences of being "ripped off" or as having "products pushed on them" by the doctors.

Thoughts?
 
Charge less. Banfield is the walmart of the veterinary world. The bigger question is why from a business/fiscal standpoint they haven't been able to undercut all the local practices. They have all the business effeciencies to keep their costs lower than anyone and yet they are generally the most expensive.
 
Charge less. Banfield is the walmart of the veterinary world. The bigger question is why from a business/fiscal standpoint they haven't been able to undercut all the local practices. They have all the business effeciencies to keep their costs lower than anyone and yet they are generally the most expensive.


Where do you draw the line, though? If clients had their way, veterinary care would be free. And the people I've talked to about this were not using a Banfield veterinarian.
 
I've had success with explaining to people exactly what they're paying for. In the case of "$200 to spay my dog? Over at XXX spay/neuter clinic they'll do it for 50 bucks!" I told the owners exactly what was involved with the process from pre-op to recovery, from placing the IV catheter and ET tube to monitoring vitals and anesthesia during the surgery to post-op pain meds and care/monitoring. When you contrast this with XXX spay/neuter clinic, where they don't place IV catheters, the pets aren't monitored either during surgery or during recovery, you can't go to the doctor for follow-up care, and no pain meds are given (all true in the case of this clinic) people start to realize that there's not a $150 price difference for the exact same surgery, and they can make a decision based on their priorities.
 
I've heard of clinics keeping a comparison chart for clients--of what the procedure at that vet costs vs. the cost of a comparable procedure in human medicine.

This seems like a good idea on the surface, and maybe it would work for certain clients. However, I think a lot of people perceive human medicine and veterinary medicine as totally different entities. I mean, how many people still ask you if vet school is 2 years? And I've seen otherwise reasonable people be totally shocked by the fact that there are specialty vets. So they see the prices and they feel that it's logical that it costs less, and aren't really aware of the veterinarian's education level or that the cost of some drugs and materials are not any less for the vet.

I don't really know that explaining those things to them does any good, either..
 
Surely this is tongue in cheek?

Sure. But the industry as a whole is plagued by bad business practices. You can't compare us to human medicine because were very different fields.


If you charge for what your time is "worth" and people are unwilling to pay that amount and you end up sitting around doing nothing half the time is that really a good idea? As opposed to lowering some costs so your more competitive and you can keep your schedule full?

And I've worked with a few spay and neuter clinics over the last few years and with some our standard of care was very high. (Higher than some of the GP clinics I knew and worked for). They were also fairly profitable because of the economies of scale and having an well trained and very efficient staff.
 
Gah, NStarz! I wanted off this forum for a while, but you probably have noticed that this is a thorn in my side.

There are a ton of ways to mitigate this perception that vets are out to rob you blind and a lot of it is creating a sense of value for your services.

People want to spend money on their pets. Even during this recession, pet spending held steady with a majority of pet owners saying they intended to spend as much or more on their pets than in previous years. Many will continue to buy premium pet food even if it means cutting something people-related from their budget.

A lot of it comes down to better communication to create a greater sense of trust and of value for the time the customer gets to spend with you.

Exams - Most people have no idea what the doctor is looking for during check-ups and often people walk out wondering what their $75 was for. Explaining "When I'm moving his legs, I'm looking for signs of arthritis. In a dog Fido's age we might start seeing some changes here and we want to keep an eye on it." This empowers the customer with knowledge, a sense that you're engaged with their pooch AND a reason to come back to check for changes over time.

A common complaint heard is "My stupid vet won't give me eye meds for my dog without seeing her first!!! Money grubbing jerk!" Most people do not understand that it's illegal to write prescriptions without seeing the animal first. A simple, efficient explanation of the law would help here.

Follow up - Have a tech or receptionist do follow up calls to animals who came in sick or had procedures done. You have to be realistic about how much time to devote to courtesy calls, but people LOVE that stuff and you can instantly move into "I have the best, most caring vet ever" realm.

Oh and when a pet dies, send a card.

Pricing - do a better job of explaining the individual costs of every part of a procedure. What things are and what they cost. Explain that human-grade instruments and supplies are used and draw some parallels to human medicine when appropriate. Offer lower cost options as available, but do everything to avoid bill shock because nothing peeves people more.

Product pushing - Give your customers options. You are the professionals, most of them do want your opinion on what to use for their pet, but they want to know why. "Here's what we recommend and why" with the why part being important. Also, being honest about prices--"Hey our heartworm meds are a little more expensive than those online because we're a smaller office. We'd appreciate your business but are happy to write you a script." Avoid what happened to me recently, "Oh your dog has a stick in its eye, have you thought about a new flea and HW complete preventative?" :laugh:

Yeah, it sounds like a lot of wasted time talking, but vets and vet staff who are good at this are very efficient. And it's almost never just about pricing. Avoid sales and discounts, it makes a practice look cheap and will attract the coupon and discount trolls--who will jump ship to another practice for a penny in savings. And there will always be some who complain and the absolute crazies. Can't do anything about those.

So in short, communication and creating a perception of a personalized, valuable service is key.
 
I think the root of the problem is that a lot of people don't see their pet as worth the money, and don't understand why certain things are necessary/highly recommended in the cost. Whenever we had clients that were pissed at their final bill, the vet who owned the practive would go in and break down the bill for them. This was fluids, this was the anesthesia, this was pain meds, this was the cost of my time for the surgery, etc. People always want to dump the pain meds, which makes steam come out of my ears. Animals feel pain and it is wrong not to alleviate it, in my opinion.

I'm of the opinion that if you're going to bitch and gripe about the cost of your pet, you probably shouldn't have it. The one time that I went for a second opinion (within the same practice, to my dog's actual vet who was out the time I brought her in) was when the one vet wanted to take a bone biopsy, saw off her femoral head, etc, because she might've had bone cancer/ridiculous arthritis/whatever. I spoke with her "actual" vet and expressed my concern over the procedure that seemed unnecessary right off the bat for a dog who came in limping with ****ty rads. However, it wasn't the cost that held me back.

Anyway, long story short, I don't think there's an easy fix. Comparing prices, explaining prices, etc is usually wasted on the people that won't give up.
 
Gah, NStarz! I wanted off this forum for a while, but you probably have noticed that this is a thorn in my side.

There are a ton of ways to mitigate this perception that vets are out to rob you blind and a lot of it is creating a sense of value for your services.

People want to spend money on their pets. Even during this recession, pet spending held steady with a majority of pet owners saying they intended to spend as much or more on their pets than in previous years. Many will continue to buy premium pet food even if it means cutting something people-related from their budget.

A lot of it comes down to better communication to create a greater sense of trust and of value for the time the customer gets to spend with you.

Exams - Most people have no idea what the doctor is looking for during check-ups and often people walk out wondering what their $75 was for. Explaining "When I'm moving his legs, I'm looking for signs of arthritis. In a dog Fido's age we might start seeing some changes here and we want to keep an eye on it." This empowers the customer with knowledge, a sense that you're engaged with their pooch AND a reason to come back to check for changes over time.

A common complaint heard is "My stupid vet won't give me eye meds for my dog without seeing her first!!! Money grubbing jerk!" Most people do not understand that it's illegal to write prescriptions without seeing the animal first. A simple, efficient explanation of the law would help here.

Follow up - Have a tech or receptionist do follow up calls to animals who came in sick or had procedures done. You have to be realistic about how much time to devote to courtesy calls, but people LOVE that stuff and you can instantly move into "I have the best, most caring vet ever" realm.

Oh and when a pet dies, send a card.

Pricing - do a better job of explaining the individual costs of every part of a procedure. What things are and what they cost. Explain that human-grade instruments and supplies are used and draw some parallels to human medicine when appropriate. Offer lower cost options as available, but do everything to avoid bill shock because nothing peeves people more.

Product pushing - Give your customers options. You are the professionals, most of them do want your opinion on what to use for their pet, but they want to know why. "Here's what we recommend and why" with the why part being important. Also, being honest about prices--"Hey our heartworm meds are a little more expensive than those online because we're a smaller office. We'd appreciate your business but are happy to write you a script." Avoid what happened to me recently, "Oh your dog has a stick in its eye, have you thought about a new flea and HW complete preventative?" :laugh:

Yeah, it sounds like a lot of wasted time talking, but vets and vet staff who are good at this are very efficient. And it's almost never just about pricing. Avoid sales and discounts, it makes a practice look cheap and will attract the coupon and discount trolls--who will jump ship to another practice for a penny in savings. And there will always be some who complain and the absolute crazies. Can't do anything about those.

So in short, communication and creating a perception of a personalized, valuable service is key.

Haha sorry Barnyard! Excellent, well-thought out post. Thank you for your insight!

I think the profession is tarnished by a few money-grubbers and bad seeds. Very unfortunate.


I'm also of the (likely wrong) mindset that a lot of products used in the profession are sometimes unnecessary. Heartworm prevention is ideal for the average client, but I do not give my dogs HW prev. However, I would be more than 100% to pay for necessary treatment should the need arise (which is probably more expensive than the preventative). I don't love putting a ton of extra chemicals in my animals. Yes HW is deadly, but my dogs are very healthy and I would be willing and able to treat the condition should it arise.
 
And I've worked with a few spay and neuter clinics over the last few years and with some our standard of care was very high. (Higher than some of the GP clinics I knew and worked for). They were also fairly profitable because of the economies of scale and having an well trained and very efficient staff.

This wasn't meant to be a dig at spay/neuter clinics in general, just an example of a particular one in my area.

Great post, Barnyard Punch. I think that we get so used to daily routine of the clinic we forget that the clients might not realize what the vet is doing and why.
 
I agree with explaining exactly what's going on during an exam. I also think explaining the medications and vaccines better would make sense. We forget that not everyone knows what is in a vaccine and why it's important. Even just saying "This vaccine is called FVRCP and it protects against common cat upper respiratory infections as well as a deadly illness called panleukopenia" is going to explain WHY this pretty pink vaccine is actually important.

You can also save a lot of time by having techs do everything possible, making it so the doctor can just focus on doctor stuff and be able to see more clients. A tech is perfectly capable of explaining flea prevention, housetraining, how to avoid parvo, etc on puppy visits, leaving just the exam and any medical issues to the vet.
 
I don't love putting a ton of extra chemicals in my animals. Yes HW is deadly, but my dogs are very healthy and I would be willing and able to treat the condition should it arise.

You have just successfully managed to completely blow my mind. Congratulations.

edit: You do know what the treatment for heartworm disease is, right?
 
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Heartworm prevention is ideal for the average client, but I do not give my dogs HW prev. However, I would be more than 100% to pay for necessary treatment should the need arise (which is probably more expensive than the preventative). I don't love putting a ton of extra chemicals in my animals. Yes HW is deadly, but my dogs are very healthy and I would be willing and able to treat the condition should it arise.

I live in Canada where HW is not a very common occurrence, and even so, my dogs are all on HWP. I don't know if you've ever seen a HW positive case (which, judging from your 'probably more expensive' comment, makes me think that you haven't, which is fine), but I would NEVER subject my pet to the treatment if I could have somehow prevented them from contracting it in the first place. I saw my first HW+ dog this year, and witnessed the treatment on this poor dog and needless to say, I am 110% COMPLETELY on board with HWP. I'd rather my pets have chemicals on them than take the chance of them getting HW and potentially not having them at all.
 
I don't love putting a ton of extra chemicals in my animals.
Amazingly, heartworm treatment involves "a ton of extra chemicals." 🙄

Seriously though, I agree this is quite short-sighted and silly. The side effects of Immiticide are nothing to sneeze at. I am always amazed when I meet people involved in vet med who don't actually follow the recommendations they give to clients. We should know better and set an example.
 
I'm also of the (likely wrong) mindset that a lot of products used in the profession are sometimes unnecessary. Heartworm prevention is ideal for the average client, but I do not give my dogs HW prev. However, I would be more than 100% to pay for necessary treatment should the need arise (which is probably more expensive than the preventative). I don't love putting a ton of extra chemicals in my animals. Yes HW is deadly, but my dogs are very healthy and I would be willing and able to treat the condition should it arise.

You also have to remember that HWP is not just preventing heartworms. I think it would be beneficial to call it a parasite preventative instead of heartworm prevention. It is going to also protect against intestinal parasites as well. And while you may not think your dog will get intestinal parasites, they are everywhere at all times of the year and it is worth giving a once a month pill that can keep your pet (and yourself, yay zoonosis) from being infected from these intestinal parasites (which often times do not cause symptoms in dogs), but can be devastating to a person. Also, I would much rather give my dog a HWP pill then have to treat my dog for heartworms (which is toxic and has a very high potential of killing them).

Side Note: The "chemicals" in HWP do not stay in your dog for 30 days, it is no different than giving an antibiotic tablet. It stays in the system for a short period of time, which is why it is given every 30 days. 30 days is perfect for the stages of each parasite that the preventative kills. If you miss one dose any of the parasites that the preventative works against will be in the next stage of its life cycle and will not be killed and can cause a parasitic infection.
 
Gah, NStarz! I wanted off this forum for a while, but you probably have noticed that this is a thorn in my side.

There are a ton of ways to mitigate this perception that vets are out to rob you blind and a lot of it is creating a sense of value for your services.

People want to spend money on their pets. Even during this recession, pet spending held steady with a majority of pet owners saying they intended to spend as much or more on their pets than in previous years. Many will continue to buy premium pet food even if it means cutting something people-related from their budget.

A lot of it comes down to better communication to create a greater sense of trust and of value for the time the customer gets to spend with you.

Exams - Most people have no idea what the doctor is looking for during check-ups and often people walk out wondering what their $75 was for. Explaining "When I'm moving his legs, I'm looking for signs of arthritis. In a dog Fido's age we might start seeing some changes here and we want to keep an eye on it." This empowers the customer with knowledge, a sense that you're engaged with their pooch AND a reason to come back to check for changes over time.

A common complaint heard is "My stupid vet won't give me eye meds for my dog without seeing her first!!! Money grubbing jerk!" Most people do not understand that it's illegal to write prescriptions without seeing the animal first. A simple, efficient explanation of the law would help here.

Follow up - Have a tech or receptionist do follow up calls to animals who came in sick or had procedures done. You have to be realistic about how much time to devote to courtesy calls, but people LOVE that stuff and you can instantly move into "I have the best, most caring vet ever" realm.

Oh and when a pet dies, send a card.

Pricing - do a better job of explaining the individual costs of every part of a procedure. What things are and what they cost. Explain that human-grade instruments and supplies are used and draw some parallels to human medicine when appropriate. Offer lower cost options as available, but do everything to avoid bill shock because nothing peeves people more.

Product pushing - Give your customers options. You are the professionals, most of them do want your opinion on what to use for their pet, but they want to know why. "Here's what we recommend and why" with the why part being important. Also, being honest about prices--"Hey our heartworm meds are a little more expensive than those online because we're a smaller office. We'd appreciate your business but are happy to write you a script." Avoid what happened to me recently, "Oh your dog has a stick in its eye, have you thought about a new flea and HW complete preventative?" :laugh:

Yeah, it sounds like a lot of wasted time talking, but vets and vet staff who are good at this are very efficient. And it's almost never just about pricing. Avoid sales and discounts, it makes a practice look cheap and will attract the coupon and discount trolls--who will jump ship to another practice for a penny in savings. And there will always be some who complain and the absolute crazies. Can't do anything about those.

So in short, communication and creating a perception of a personalized, valuable service is key.


This is great! I love this list! We do call backs for every single client (including just wellness exams and vaccines). We send cards to new clients welcoming them, cards for clients who have lost a pet, and cards for clients who have a new puppy/kitten with a picture of the puppy/kitten.

Oh and explaining the law about having to see a pet first does not always work. For some people, they agree and calm down, understand and set up an exam, but other people just do not want to hear about it, do not care and still expect you to give medication to their pet. It is frustrating, but the majority of the time I would say it seems to work.

I also agree with the part of "Oh your cat is in kidney failure, have you thought about this F/T product?" At certain points, you just do not ask about "preventative products". I have had the doctor ask me a couple of times why I did not ask the client if they were interested in HWP and when I say, "Because the dog is here for vomiting, diarrhea, and has a 104 degree fever.", the vet seems ok with waiting to discuss HWP until the next well visit.
 
Also, being honest about prices--"Hey our heartworm meds are a little more expensive than those online because we're a smaller office. We'd appreciate your business but are happy to write you a script."
I would be kind of hesitant about this. That would come across to me as a guilt trip.

I think most people understand why your costs are higher compared to the 'Wal-Mart's of the world, they just don't care until it affects them directly.
 
I'm also of the (likely wrong) mindset that a lot of products used in the profession are sometimes unnecessary. Heartworm prevention is ideal for the average client, but I do not give my dogs HW prev. However, I would be more than 100% to pay for necessary treatment should the need arise (which is probably more expensive than the preventative). I don't love putting a ton of extra chemicals in my animals. Yes HW is deadly, but my dogs are very healthy and I would be willing and able to treat the condition should it arise.
....what? Maybe you should research this a bit.
 
Heartworm prevention is ideal for the average client, but I do not give my dogs HW prev.

Ideal??? Heartworm prevention is NECESSARY not ideal!! If someone can't afford heartworm prevention for his/her dog, then he/she SHOULDN'T HAVE A DOG. I realize some of the products carried by vets are expensive, but find a vet that will match the online pharmacy prices or find somewhere where you can order iverhart or similar products.

The treatment for heartworms is extremely painful and expensive. Plus, heartworms can cause damage to the heart and lungs that can remain even after the dog has been treated.

I hope vet school is sufficient enough of a wake up call to make you recognize the ignorance in your previous statement.
 
I would be kind of hesitant about this. That would come across to me as a guilt trip.

I think most people understand why your costs are higher compared to the 'Wal-Mart's of the world, they just don't care until it affects them directly.

Yeah, I mean more the sentiment, not to repeat that verbatim. People like to pay less for meds, but they're also willing to pay some amount of premium for convenience. Not being a pain the butt about making a script available and having a reasonable explanation about price discrepancies is more what I meant. Price breaks for volume seem like common sense, but you can't assume people have thought that much about it.
 
1. Cost perception - I am always empathetic to the costs of treating pets, but explain why the procedure/treatment is necessary (HWP, OHE, etc) and offer the client a tour of our facility to see what they are paying for. I let them put their hands on our heated surgery table, look at the recovery cages in the middle of the hospital, see the monitor, introduce them to the technicians, etc. I promise them that while their pet is under my care, it is just as important to me as if it were my personal pet. When they see our high-speed dental unit, and know we do extractions, not pulling teeth, they are appreciative of effort we make to ensure the pet is comfortable. If they still balk at the cost, maybe they ought to go somewhere else. You can't have high quality and be cheap. The term cheap negates the high quality aspect. We don't compromise our patient care for anyone.

2. I wonder -Nstarz - are you planning on being a holistic veterinarian? Because those are the only ones I know who don't advocate HWP unless you live in the desert. The benefits of monthly HWP (or ProHeart q6mo) FAR FAR FAR outweighs the few side effects of giving it (unless you have a dog with the MDR-1 gene but that is a whole 'nother issue in itself). I recommend you visit the American Heartworm Society's page and read the information presented there. We are all entitled to our own opinions, and I respect yours, but I hope it is an educated decision backed by your own research. Know the facts. I live in TN/GA and HWD is common around here, and it is not pretty. As a sidenote, I hope everyone's felines are on HWP as well. 🙂
 
2. I wonder -Nstarz - are you planning on being a holistic veterinarian? Because those are the only ones I know who don't advocate HWP unless you live in the desert. The benefits of monthly HWP (or ProHeart q6mo) FAR FAR FAR outweighs the few side effects of giving it (unless you have a dog with the MDR-1 gene but that is a whole 'nother issue in itself). I recommend you visit the American Heartworm Society's page and read the information presented there. We are all entitled to our own opinions, and I respect yours, but I hope it is an educated decision backed by your own research. Know the facts. I live in TN/GA and HWD is common around here, and it is not pretty. As a sidenote, I hope everyone's felines are on HWP as well. 🙂


Re: The MDR-1 gene... correct me if I'm wrong, but having that gene simply limits your choices, it doesn't keep you from giving preventative. You just need to choose interceptor or similar as opposed to Heartgard/Triheart/etc

There are two holistic vets in my area, and both of them recommend a "natural" form of HWP. Don't know much about it in dogs, but have seen good success in horses for internal parasites. Diatomaceous earth is the most common.

I don't have any kitties, but we recommend it for all our clients, usually in the form of advantage multi that takes care of everything 🙂
 
Re: The MDR-1 gene... correct me if I'm wrong, but having that gene simply limits your choices, it doesn't keep you from giving preventative. You just need to choose interceptor or similar as opposed to Heartgard/Triheart/etc

There are two holistic vets in my area, and both of them recommend a "natural" form of HWP. Don't know much about it in dogs, but have seen good success in horses for internal parasites. Diatomaceous earth is the most common.

I don't have any kitties, but we recommend it for all our clients, usually in the form of advantage multi that takes care of everything 🙂

Yes, typically they are just sensitive to Ivermectin type drugs (for HWP), but they keep expanding the list of drugs that cause reactions. We had an Australian shepherd test positive for the MDR-1 gene and it seized on both Heartgard and Intereptor. So we tested Bob every 6 months.
 
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I'm also of the (likely wrong) mindset that a lot of products used in the profession are sometimes unnecessary. Heartworm prevention is ideal for the average client, but I do not give my dogs HW prev. However, I would be more than 100% to pay for necessary treatment should the need arise (which is probably more expensive than the preventative). I don't love putting a ton of extra chemicals in my animals. Yes HW is deadly, but my dogs are very healthy and I would be willing and able to treat the condition should it arise.


http://www.heartwormsociety.org/

Please educate yourself. I second what those above me have said-whether or not you plan to be a holistic vet, saying statements like that in an interview if asked about heartworm preventative would get your app tossed in the reject pile. Saying "probably more expensive" and "a ton of extra chemicals" makes it seem like you're pretty ignorant about the actual disease process and treatment (even if you didn't mean to come across that way)
 
Re: The MDR-1 gene... correct me if I'm wrong, but having that gene simply limits your choices, it doesn't keep you from giving preventative. You just need to choose interceptor or similar as opposed to Heartgard/Triheart/etc

Ivermectin HW preventatives like Heartgard are fine for MDR-1 mutant dogs. The ivermectin dose for HW preventative is 6 mcg/kg, well below the toxic dose of 100 mcg/kg for MDR-1 mutant dogs.
 
I just wrote out a long post and it got deleted. Ugh.


So anyway. I appreciate your comments but am very offended by some of the implications. First of all, maybe my opinions are ignorant. That's quite possible--if not probable. However, they are not unfounded. I have a friend who is a veterinarian, who is no longer practicing (but did for 20+ years) and now works in pharmaceuticals. I would venture to say that she knows a bit more about the drugs being given to companion animals than a GP. Also, yes I do live in NJ. And yes, I do get my pets tested every 6 months. I did not mention the cost as prehibitory in my personal situation. As I said, we would be willing to pay for the treatment--the HWP over the long term (I believe) is cheaper. Cost is not an issue.

I would also say that an antibiotic is different than HWP and even flea/tick meds. Antibiotics are given in a reactionary fashion. Dog has infection = antibiotic given. The antibiotic is not in the dog's system 24/7/365. Once the infection has cleared up, the antibiotic is no longer given. HWP is given every month and so those drugs remain with the dog (which can be good for the intended effect, but can also lead to resistance and unwanted side effects).

No I do not plan on becoming a holistic veterinarian, and am frankly very offended at some of the statements being portrayed here. One, holistic (while not my intended field) is a DIFFERENT perspective and not something to be ridiculed. "Oh she has this opinion, she must be going into holistic veterinary med." Not sure if that was intended, but that was the way I perceived the comments. Also, you seem to be very offended that someone has a different opinion than yours, and different then the mainstream. I would hope that future veterinarians are open to thinking outside the box and are above personal attacks when someone's opinion differs from your own. It is possible that my opinion (which is apparently wrong and misguided) is that of your future clients, even colleagues.

I am shocked to read some of these posts. One misguided opinion "will not get me accepted to veterinary school?" Seriously? As far as I know, I don't already have a DVM. Maybe that's why I was going to veterinary SCHOOL. To LEARN. If I already had all the knowledge, I would not need 4 years of expensive schooling in order to be molded into one. They would just slap you with a certificate at the onset.

I will not apologize for being ignorant, and I am thankful to the few posters that have provided information for me to read into concerning the topic so that I can no longer be ignorant. I am also NOT apologizing for having a different point of view (albeit it so wrong in this case that it warrants personal attack).
 
Ugh NStarz the problem is that you have expressed strong opinions that go against the mainstream without doing the necessary research. Ivermectin is not in the animal's system 24/7/365, as somebody here has already pointed out to you. Its terminal half-life is 48 hours. It is also much less dangerous to the host organism than the compound used to treat heartworm disease.

This "friend" of yours in pharmaceuticals...what exactly did he/she say to you? Is that whose word you're going on about heartworm prevention? Have you talked to your pets' normal veterinarian about it? What does he/she say?

Ignorance is not an excuse, honestly. If you don't actually know what you're talking about, don't present it like you do. Even if you say "this might be misguided" before it, the fact that you're saying anything about it would appear to denote that you have researched the topic at least at a rudimentary level. And you shouldn't need others to point out the fact that you need to research something before you can actually form an opinion and discuss it, nor should you need others to directly point you in the direction to research.

So no, your "opinion" at the interview won't get you canned, but expressing such an opinion with a clear ignorance of why you hold it very well might.
 
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Cost might not be an issue to you... but do you understand the consequences of treating heartworm? It's not just giving two iverharts and sending you on your way. Why risk your dog's life to avoid "extra chemicals"? (What, beef flavor?)
 
I agree with the idea of talking about everything you are doing as you are doing it. One thing I've also started doing is taking off the earphones when I do a Doppler BP in the room with the client. It seems to engage the client in what is happening and encourage questions when they can actually hear the pulse themselves, and it gives them an appreciation for the specialized equipment and skill being used. With the earphones, in contrast, I think it looks more like I'm conducting some secret ritual in which they are not allowed to participate. I figure if I'm asking someone to fork over $45 for the procedure, I'd rather encourage their participation!
 
With the expansion of Internet pharmacies and price-shopping, I think that a reasonable step to consider is decreasing the mark-up on drugs and increasing the cost for services to compensate. People get grumpy when they see how much cheaper it is to buy drugs from Smartpak and Allivet than their local vet, and to some extent this is due to economies of scale that individual practices don't have, but it's not entirely out of line. After all, we don't go through years of rigorous training so that we can sell pills - we do it so that we have the knowledge and expertise, and we should charge accordingly, IMO. I love my vet and her practice is very reasonably priced, but it does somewhat irk me that she charges relatively little for her exams but charges $50 for one vaccine (exam free with vaccines), which I know probably costs about $10. The value added for me is the exam - I have other ways of getting vaccines (that goes double for large animal, where you can often get the vaccines at a feed store).

NStarz, I have to say that I agree with nyanko and others about the HWP. I'm a LA person and don't know much about HW (more now thanks to this thread), but the attitude of making this kind of decision contrary to standard practices willfully without seeking logical evidence or apparently paying attention to the arguments on this thread is not indicative of the kind of person suited to be in a scientific profession. Maybe we caught you on a bad day and you otherwise use rationale and logic to formulate opinions on treatments and risk/benefit calculations, but you struck out on this one.
 
The American Heartworm Society recommended preventative year-round. I think you should check into the research and information here. They likely know much, much more than your friend.

http://www.heartwormsociety.org/
 
NStarz, I have to say that I agree with nyanko and others about the HWP. I'm a LA person and don't know much about HW (more now thanks to this thread), but the attitude of making this kind of decision contrary to standard practices willfully without seeking logical evidence or apparently paying attention to the arguments on this thread is not indicative of the kind of person suited to be in a scientific profession. Maybe we caught you on a bad day and you otherwise use rationale and logic to formulate opinions on treatments and risk/benefit calculations, but you struck out on this one.

Point taken. Thank you for being civil about it!
 
I would also say that an antibiotic is different than HWP and even flea/tick meds. Antibiotics are given in a reactionary fashion. Dog has infection = antibiotic given. The antibiotic is not in the dog's system 24/7/365. Once the infection has cleared up, the antibiotic is no longer given. HWP is given every month and so those drugs remain with the dog (which can be good for the intended effect, but can also lead to resistance and unwanted side effects).

That statement is actually completely wrong when it comes to all of the ivermectin based heartworm preventions. Just realized nyanko made the point above.
 
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I agree with the idea of talking about everything you are doing as you are doing it.
Dittoing this. I think it's a grand idea to walk your clients through the process. Sure it gets tiring because you have to do it some 20 times a day, but I think the end result is worth it.

Also, was watching an episode of the All Creatures Great and Small series and Herriot was explaining something, ketonuria or some such, to a kid and gave a bare bones explanation and said something like "oh I'm boring you" trying to avoid the full explanation then the father said "no no, go on, for once I feel like I'm getting my money's worth outta yeh!" To my knowledge the series is based on all his books (haven't read them all) which means that situation likely happened at some point, so even in the 1920s the client still wanted to know what you were doing.
 
IMO, quality service quickly off-sets a high exam fee. The vet I currently use, while a little more expensive, goes above and beyond in the service department. The vet I used to use was cheaper but never made follow-up calls and seemed irked that I wanted to take up more of his time to ask questions. The vet I currently use is always willing to answer questions, make follow up calls (even after hours), etc. Little things, I know, but it makes all the difference in the world.

I also like the bill break-down. When I worked in a clinic, I would do this for clients on their estimates. It seemed to convince them that their animal really did need pain meds, etc.
 
I just wrote out a long post and it got deleted. Ugh.


So anyway. I appreciate your comments but am very offended by some of the implications. First of all, maybe my opinions are ignorant. That's quite possible--if not probable. However, they are not unfounded. I have a friend who is a veterinarian, who is no longer practicing (but did for 20+ years) and now works in pharmaceuticals. I would venture to say that she knows a bit more about the drugs being given to companion animals than a GP. Also, yes I do live in NJ. And yes, I do get my pets tested every 6 months. I did not mention the cost as prehibitory in my personal situation. As I said, we would be willing to pay for the treatment--the HWP over the long term (I believe) is cheaper. Cost is not an issue.

I would also say that an antibiotic is different than HWP and even flea/tick meds. Antibiotics are given in a reactionary fashion. Dog has infection = antibiotic given. The antibiotic is not in the dog's system 24/7/365. Once the infection has cleared up, the antibiotic is no longer given. HWP is given every month and so those drugs remain with the dog (which can be good for the intended effect, but can also lead to resistance and unwanted side effects).

No I do not plan on becoming a holistic veterinarian, and am frankly very offended at some of the statements being portrayed here. One, holistic (while not my intended field) is a DIFFERENT perspective and not something to be ridiculed. "Oh she has this opinion, she must be going into holistic veterinary med." Not sure if that was intended, but that was the way I perceived the comments. Also, you seem to be very offended that someone has a different opinion than yours, and different then the mainstream. I would hope that future veterinarians are open to thinking outside the box and are above personal attacks when someone's opinion differs from your own. It is possible that my opinion (which is apparently wrong and misguided) is that of your future clients, even colleagues.

I am shocked to read some of these posts. One misguided opinion "will not get me accepted to veterinary school?" Seriously? As far as I know, I don't already have a DVM. Maybe that's why I was going to veterinary SCHOOL. To LEARN. If I already had all the knowledge, I would not need 4 years of expensive schooling in order to be molded into one. They would just slap you with a certificate at the onset.

I will not apologize for being ignorant, and I am thankful to the few posters that have provided information for me to read into concerning the topic so that I can no longer be ignorant. I am also NOT apologizing for having a different point of view (albeit it so wrong in this case that it warrants personal attack).

I did NOT mean to offend you or attack you in any way, if you felt I did. I even stated that I respected your opinions. There are always those that go against the grain, and you are more than welcome to be one of those. I don't care either way, but I do believe someone should have facts/research to back up their beliefs if they intend on defending them. Hence my suggestion to look at the American Heartworm Society's page. Good luck in your endeavors to be whatever type of veterinarian you want to be (and I have nothing against holistic vets - they just practice differently).

opinions are like *******s - everyone's got 'em.
 
I did NOT mean to offend you or attack you in any way, if you felt I did. I even stated that I respected your opinions. There are always those that go against the grain, and you are more than welcome to be one of those. I don't care either way, but I do believe someone should have facts/research to back up their beliefs if they intend on defending them. Hence my suggestion to look at the American Heartworm Society's page. Good luck in your endeavors to be whatever type of veterinarian you want to be (and I have nothing against holistic vets - they just practice differently).

opinions are like *******s - everyone's got 'em.


I don't believe I was referring to your post. I really do appreciate the information! Thank you for your clarification!
 
I don't mean to belabor the heartworm preventative point, but I adopted a dog who was heartworm positive and went through the treatment with her. It was terrible, even though the dog was young, healthy and in the earliest stage (Class 1). The immiticide initially caused her incredible discomfort and the long weeks of cage rest that followed were almost as bad.

Immiticide is effective, and downright gentle compared to the treatments previously used. But about 5.2% of Class 1 and 2 (early-stage) dogs still DIE from it. So do 18.2% of Class 3 (later-stage) dogs. Immiticide also has an incredibly low margin of safety, so even a slight overdose can cause pulmonary inflammation, edema and death. Even at recommended doses, adverse effects like pain, swelling, tenderness, depression, coughing/gagging, depression/lethargy, anorexia, fever, lung congestion, and vomiting are common.

My dog went through several adverse effects herself. She ultimately came through it well, but I cannot imagine ever putting any animal I loved through that unnecessarily. Especially when it can be so easily prevented.

In comparison to immiticide, ivermectin (the main ingredient in heartworm preventative) is generally well tolerated, although large overdoses can cause problems. Ivermectin given to heartworm positive dogs also can cause problems, which is why those heartworm tests are so important. As others have pointed out, ivermectin has a very short half-life (24 to 36 hours in dogs). Nealy 90% is excreted in the feces without metabolizing at all.

NStarz, if you truly feel the way you do, I would highly encourage you to foster a dog who is going through treatment. I believe it would be an eye-opening experience.

It is fine to have your own opinions, but educate yourself first.
 
RE: HWP, if I hadn't been convinced before, opening up our anatomy dogs' hearts and seeing wads of worms pop out would have done it...

Tip: Keep a preserved HW+ heart in your clinic to show sticky clients.
 
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