Last week, the weather spit out a surprise 100 degree scorcher sandwiched between two gloomy overcast 60 degree-ers. It was on this blistering Thursday that I realized our air conditioner wasn’t working. So I waited the three days until the AC guy was available to come out, because of course everyone in the county came to the same broken AC realization on the same day, and let him poke around the unit while I sat in the living room with no idea what he was doing.
He came in 40 minutes later, after crawling into the attic, running some “diagnostics”, and writing a bunch of stuff down on a clipboard. “Well, for the most part it checks out OK,” Wes the repairman said.
“So why isn’t it working?” I asked.
“Well, I think your capacitor is worn down,” he said, launching into a 20 minute discussion about something that made zero sense to me because at that moment, all I heard was “flux capacitor” and I kept turning him into Christopher Lloyd in my head. Then I started picturing his van as a DeLorean and thinking about how cool that would be. As far as I was concerned, he could have told me I needed plutonium and a Mr. Fusion and I would have been helpless to protest. So I signed the estimate. What else could I do? It was hot out.
As he tinkered away on the AC unit, it all of a sudden struck me: oh my god, this is what happens to my clients each and every day when I’m trying to explain why their cat isn’t eating. Oh. Poor clients.
I can explain renal disease and the pancreas and intestinal tract until I’m blue in the face, but 95% of them have zoned out by the second sentence and are thinking two things:
- Can it be fixed?
- how much is it going to cost?
To this day I have no idea why my air conditioner needs a flux capacitor, what its normal lifespan is, and if the problem really was that or a $10 filter that needed to be replaced. I don’t know how important the other suggested repairs really were. All I can do is hope the person is trustworthy and is doing what I asked without padding the bill. Without a working knowledge of AC units, I have nothing to base my decision on other than a vague sense of “Well, he seems like he knows what he’s talking about.”
It really made me feel sympathy pangs for those people who question every single item on the veterinary estimate. I get it. We’re all used to being taken advantage of. So don’t despair, good people: I get why you do it, and I don’t have a problem with it. I have no need to be defensive if I’m recommending the proper things, and if I’m doing my job communicating, you’ll see why I want to do it in the first place.
And for the AC? I have cool air, but until the lightning strikes I won’t be able to tell how well he really fixed it. 1989, here we come.
Although I’d like to think veterinarians are slightly less predatory than auto mechanics when it comes to this sort of thing, I’m not so naive as to assume bill padding never happens. I’m curious as to what the public perception is of this: have you experienced what you think was an unnecessarily padded estimate from a vet? What made you suspect that?
Vicki in Michigan says
I am the check-authorizer for a charity that raises and disburses funds to help with medical expenses for homeless corgis.
I see a LOT of vet bills (from all over the country — interesting how much charges for the same things vary!).
This morning I looked at a bill for a femoral head ostectomy. They want $280 for a day of hospitalization, on the day of the surgery, when they are also charging $1700 for the surgery.
Like the hapless air-conditioner owner, I have no idea how much an FHO really costs, or really should cost. But $280, just to be there? For a dog in a cage, not a person in a room with a tv and a remote-controlled bed?
Ay yi yi……………………………………..
(This is the second of two FHOs we’ve helped with in the last few weeks. The other FHO was in another state, and was MUCH cheaper. Maybe if you take your DeLorean a/c to Texas, the bill would be a lot less…………)
Vicki in Michigan says
Dr. V, if you think $280 in this situation is reasonable, I would love to know that. I really don’t know how much this stuff should cost.
Some items really make me think “??WHAT??” — but I have no way of knowing whether it’s reasonable or not.
Especially when I’ve just seen a much cheaper bill for the same problem from another part of the country.
In my position, I can’t argue about costs — they’re a fait accomplis, and my job is to keep rescue from going broke. I just swallow, and authorize the check to reimburse the rescuer who has already forked over all those bucks. But I do wonder………..
Dr. V says
It’s so hard to say. Some clinics do a “soup to nuts” estimate that includes everything, while others do the human hospital approach and charge individually for everything down to suture packs and gloves. What does that $280 mean? Does it include nursing care and the post op IV fluids and monitoring? Is that all separate? Is this a specialist hospital or a generalist doing the surgery?
There’s no real right or wrong answer as to what is acceptable- one really needs to compare similar hospitals in that geographic region to know if it is over the top or not.
Mihaela (Dr. V) says
I have been very lucky to work with wonderful vets – so no, I never felt they were padding the bill. But it’s different with repair people. I ask enough questions until I understand enough – the way they answer at least gives me a gut feeling, and I am learning to trust that. But I do believe -strongly- that it’s their job (as well as vets’, and human doctors’) to explain things in a way that people understand. It is certainly possible. But then, my PhD is in Communication 🙂
the 7msn ranch says
You crack me up.
My experience with bills and my vet is quite the opposite. I’ll look at the itemized statement and have to remind him what he forgot to charge me for, to which he responds “oh, well, too late now ” or “I threw that in at no charge.” He’s much better at medicine than business.
Dr. V says
That’s been my experience with most vets (myself included.) I was hoping most people still have that feeling. I worked at one place where they hired someone to follow us around, audit the medical records and add in all the stuff we forgot to charge for because we all did that.
Tabitha W says
I don’t think I have ever had a vet do that. However, what i DONT LIKE is when they UNDER ESTIMATE.
My cat last year needed to have a dental and 2 teeth (that we could see) removed. He estimated about 400-500 dollars. When he called me several hours later and told me it would be closer to 900 (and the work had already been done) I nearly died. More teeth had to be removed and it took longer then he thought. We ended up agreeing on a price around the 700 mark.
SO I always encourage my very to give me the WORST POSSIBLE case so I can be ready for it. However, my vet charges $23.00 for a cat nail trim. I think thats a bit crazy.
With my first vet I had that problem. The vet was great at first, but then she moved on to a more populated town and her…apprentice? Protege?…took over. She changed everything on the itemized list to code so that it wasn’t clear what was costing what. When asked, she would say that’s just the way the business worked and leave it at that.
Needless to say, I went to another vet about 15 minutes further from my house. And boy, was it worth it. Super friendly staff, an amazing vet who crawled under a table and did a Twister pose to put my dog to sleep, just so that he wouldn’t have to move his hurt leg (he had bone cancer). I would have paid so much more, just for the service he gave me, but he charged me the absolute minimum for everything he did. He even sends us cards at Christmas. People like him give me more faith in humanity.
Oh I have had a sting of bad luck in that area. When my first vet retired, I kept going to his clinic and wasn’t sure what to make of his replacement. Well that replacement moved it to a bigger/newer office and basically doubled the price on everything.
As an example my 4 lb pom got all ‘I’m a big dog’ on me and run into the horses pasture who were all enjoying a nice run. Sure enough he got stepped on! After realizing he wasn’t dead, I picked him up and his front left leg just hung there and the poor things was screaming! I called the vets and raced him over. Before they could do anything I was told it was $250 to sedate him so they could x-ray the leg to see what was the matter… duh its broken? I agreed to the x-ray but was charged for everything – shaving his leg, catheder, IV bag etc. When I wouldn’t consent to the $1800 plating of his leg right on the spot, they took him in the back overnight so I could think. I ended up taking him to my friends vet the next day (against their recommendation) who also looked at the x-rays and said the surgery would not work as his leg bones were too tiny for even the smallest plate they made.(he held the plate to the x-ray to show me) so we ended up splinting the leg and letting it heal – cost from that vet including almost weekly cast changes, sedation and pain meds for 6 months $250!
I have told anyone who would listen that the first vet place is all about $$$ and have a friend who is a vet tech tell me that they also have high staff turnover and Dr Vet has 3 small kids and a nanny to look after. Oh and they are building a custom home. Word gets out all on its own it seems!
What I don’t like is when Vets say things like “I will just try this medicine, and if it doesn’t work then it is something else”. I have had trouble finding vets that actually do tests on my animals to verify something is wrong. I mean if I wanted to just try anything, I would go to the pet store and pick something up and save money. I have also had problems with vets charging me lots of money for an exam, but not doing a full exam and missing things like lumps on their chests. Very frustrating. I had one awesome vet that was about 40 miles from my house, but the staff told me I should find some place closer to my house, when I wanted to schedule on a day the doctor wasn’t in. My cat was supposed to come in for a final exam and a removal of stitches. I have yet to find a vet I feel will do everything in their power to help my animals while not charging an arm and a leg. I guess you get what you pay for 🙁
I’ve never had an extra-padded bill, but I have had vets who seem to want to do that. I just haven’t gone there.
For instance, I prefer to under-vaccinate my dogs than over-vaccinate them. I get their boosters every 3 years. When I went to get my boy neutered, the vet wanted me to updated his shots again… He’d just had them done for the second time about 8 months prior. It was an extra 85$ on the bill for all of them. I decided I didn’t like that quote and called a low-cost spay/neuter clinic, and while I might have to wait another 4 months to get the deed done, at least I don’t have to get his vaccinations done AGAIN, and I can donate the extra I’m saving to the program or a shelter.
Megan K says
I once had a vet give my cat a $46 antibiotic shot before consulting me about treatment. He said it’s pretty hard to give a cat a pill, and he’d have to be on pills for at least a week, so he just did me a favor and gave him a shot. This is despite the fact that my cat’s records show he gets a PILL EVERY DAY for another issue. Between not consulting me before treatment and not reading the file, that was our last visit to that clinic. Our new vet is FANTASTIC and actually works WITH you on treatment plans. Amazing!
I don’t feel like I’ve been overcharged, but I feel like I’ve been over-optioned. I’ve had the same vet for years, and if the dogs need surgery (spay, dental, neuter) I’m offered a “pain-free recovery” for an additional fee. Of course I want them to be pain free so I agree to it, but I wonder why it’s not included? Doesn’t everyone want a pain-free recovery for their kids?
… they are loopy as hell when they come home so I guess that’s what I’m paying for.
The answer is no. Some people care far more about the extra cost than they do about keeping their animals pain free. So, we often give owners the option, even when it’s obvious to us what they SHOULD choose. It’s just an unfortunate side effect of frequently facing situations where owners cannot afford the ideal care.
I think a lot of people feel they are overcharged by vets as 1) they believe medical care for an animal should be less than for a human, and 2) many people don’t have pet insurance, but do have their own health insurance, so when they are paying full price for vet services, it seems expensive in comparison.
Luckily, my vet is great and I’ve never had a problem with feeling like that – I know if she recommends something, that it is probably necessary. At the first vet I took my dog to (a chain), he was having problems peeing in the house, even though he was housebroken and we had a doggie door. The chain vet did all kinds of expensive tests and couldn’t figure it out. I took him to my current vet and just after spending some time with him, she could see that his issues were emotional – my poor sensitive, neurotic Gilbert! So I trust her judgment.
Here here on that first paragraph! I wish more pet owners would realize these things. I try to find a happy medium between “cheap” and “your veterinarian has a mortgage, student loans, and bills to pay herself” so that I make enough to make a living, but not trying to gouge.
We took our pets to a nearby clinic for 15 years that we loved. Then the vet owner sold the practice. The new vet owner was heavily in to marketing and pressured the other vets to sell services such as grooming, boarding and dog toys. The atmospher of the clinic turned from welcoming and professional to “we want your money” and very phony. We took pets to another clinic that was less convenient, but the care was excellent. Then, one of our very favorite vets from the old place started a mobile vet service. She listens, doesn’t add unnecessary stuff and negotiates on the bill when necessary. Oh, and she is an excellent veterinary physician.
Hawk aka BrownDog says
Vets are like doctors, you have to be comfortable with them and feel they are working to make your pet feel better, or stay well. Some vets just seem to try to “sell” you something every visit.
One of the vets in our clinic insisted on squeezing Pupper’s anal glands on every visit, despite the fact that she had firm poops and never scooted. Pupper would yelp and I’m sure those extractions were a big reason she hates the vet office. Finally we stopped seeing that vet and no one has ever suggested that Pupper needs that $35 procedure.
Doc Brown’s first name was Emmett, so how could you not trust the guy? I am suddenly experiencing an overwhelming urge to watch a certain movie. 1989? yesss!!!
When I first got my very own pet (shortly joined by my then-boyfriend’s pet), I was still using my parents vet who had known me since I was in diapers; he charged me $40 total for annual exams for both (that includes all their vaccines, including requesting lukemia vaccine even though they are indoor cats because I am paranoid), and I don’t recall how much the de-clawing was for the male cat, but the de-clawing and spaying for the female was $125 for BOTH, for the full surgeries. I can only assume that he literally charged me just materials and drugs. Even being a naive 19-20 year old, I realized he was doing me a huge favor, but our first vet bill when we stopped spending summers near my parents and had to have annual exams do by someone else was still a shock. I still cringe when I right out that $250 bill for their annuals, but my vet-school friends reassure me that he’s not ripping me off :-). We may be moving up near my parents if I get a job I just interviewed for (graduating law school next month), you can imagine my disappointment that our old vet is retiring this year……
PS The boyfriend is now the hubby, and our cats are happy healthy 6 year olds. And don’t shoot me for the de-clawing, we had to do it for our apartment policy at the time – and we rescued him from a shelter and her from a hoarder (she was so undernourished we thought she was around 3 months old till the vet told us she was 6 months) so I think they are better off and forgive me for the de-clawing 🙂