I’m here, I’m loving Orlando, and I’m sick as a dog. Which stinks, to put it mildly. So, I’m focusing my energy on things like standing up and walking, but the posts will come. Make sure to check out Facebook and Twitter as well, where I’ll be posting lots of candids. In the meantime, I have a post about a topic we got into a big discussion about a couple of weeks ago:
I loved Dr. Becker’s recent article about whether or not vets should offer spays for below cost. His answer, in a nutshell, is “no”. Mine is too. The responses ran the usual gamut of those who agreed and those who did not, but it got me thinking about the whole idea and how veterinarians are often caught in the middle when trying to explain to owners why prices are the way they are.
Myth: If a low cost facility can spay a dog for $50, you should be able to do it too.
Fact: To understand how a facility can afford to offer a procedure for such a low cost, you need to know what they do in order to make that economically feasible. Do the vets volunteer their time? Do they skip items like intravenous catheters, inhalant anesthesia, or post operative pain medications? If it’s the choice between having it done and not having it done, many people are fine with that. But in my clinic, if I’m taking a pet under my care, I feel obligated to do the procedure as safely as I can, and that involves pricier things like blood pressure monitoring and post-operative opiods. That’s expensive.
Not to say some low cost clinics don’t offer those things- they might. But many don’t, and it’s good to know what you’re signing up for.
Myth: Low cost = poor care.
Fact: Not necessarily. In fact, most of the low cost places I know in our area staff their clinics with the best vets. You have to be a good surgeon to complete that volume of surgery in a short amount of time. Less experienced vets are slower in surgery. They just are.
Many of these places subsidize their cost through fundraising and grants. I worked at a clinic that accepted county vouchers for $80 spays, and also performed spays for clients for the real cost of $250. The pets received the exact same high quality care with gas anesthesia, IV catheters, and dedicated monitoring, but one group received a subsidized cost. It was a 24 hour clinic that utilized the downtime by having the vet do those subsidized procedures at 2 am when nothing else was going on.
Myth: Complication rates are higher at low cost facilites.
Fact: Not necessarily. I don’t know of any specific data to show this one way or the other. It’s not about the rate of complications so much as what happens if there is a complication. If a pet has an adverse reaction to anesthesia- something that can’t be predicted- does the facility have the staff and resources to provide emergency care?
When your pet goes home that night and chews out the sutures, who do you call? If your pet licks the incision and it gets infected, who covers the cost of the antibiotics? Much of the time, owners are on their own.
The truth is, low-cost facilities perform an important service for people who cannot afford the more traditional costs associated with such a complicated procedure. They do this in a variety of ways, and for that I am glad. But that doesn’t mean a traditional clinic can take advantage of those same cost cutting measures and still stay solvent. It’s comparing apples and oranges.
So who should pay?
The one continuing refrain I always hear in these arguments, and this is the one that really gets to me, is “vets owe it to the community to take a bath on pricing, because they love pets/overpopulation is a big problem/the economy stinks.”
Now, it’s nice when vets offer their services at a discount- and trust me, every vet I know eats costs left and right for things they really shouldn’t because we feel badly and want to help. But is it an obligation? Many children suffer from a lack of proper dental care, but no one seems to be beating up on their local dentist for not doing more (nor should they.) Grocery stores aren’t lambasted for not giving food away to needy families. It’s easy to point fingers at the obvious target when someone can’t afford what they need, but there is a limit to what any one person or business can do. If there are no profits, there is no clinic.
One emergency facility I worked at had a list in the office of places people could call to ask for financial assistance for their pet. As the vet in charge of the case, I was in charge of helping people fund their care. I spent hours helping people try to find funds, and nine times out of ten instead of being happy, those people would be angry that they weren’t getting more. I consider myself a compassionate person, but I have to be honest: over time this sort of thing can burn a person out. It just does.
Low cost spay/neuter clinics have their place, and they do good work. I am glad they are there. But I could do without the idea that the provision of veterinary care is a right to all owners upon request, and an obligation of the provider to give said care without expectation of being paid a fair wage. The burden of care, at the end of the day, must lie with the owner.
What do you think? Have you ever used (or those in the field, worked at) a low cost clinic? Think it’s equivalent to a standard clinic?
I adopted our cat from our local SPCA shelter. They are a registered charity and operate pretty much solely on grants, donations and fundraising. They are a no-kill shelter and to encourage adoptions they have a fixed price for all cats at €80 per adoption. This includes having the cat be microchipped, brought up to date on standard vaccinations, de-flea’ing and worming medicine and spaying/neutering if required. As you can see, it’s hugely subsidized and the shelter absorbs the excess cost but the alternative is making it too expensive to adopt meaning they’ll be stuck with many more pets than they can care for and that requires even more money by way of facilities, supplies, staff, etc so it’s a no-win situation. I believe they are campaigning for legislation to allow for government-sponsored low cost TNR programmes in a current Animal Welfare bill as a way of trying to decrease the number of animals that come into their shelter. Unfortunately in a recession, it’s not likely to be a priority for the government.
This is an excellent article Dr. V. I’ve bookmarked it so I can reference it in the future.
My fear is that we can explain these points over and over again and yet we’re still going to have people complaining that we (vets) are ripping people off.
I had a chuckle when you commented on how every vet eats costs for things that we shouldn’t. I am guilty of that every single day. Can you imagine how amazing it would be to practice and not have to worry about the financial aspect of things?
People don’t realize how greatly discounted a “routine” spay or neuter is! If this was priced out as a normal surgery it should really be costing well over $1000.
You posted this a few days early! I’m like, 3/4 done with a guest post I was writing for you on low cost spay/neuter. I do both low cost and full service. The environments and staffing are very different. Everything you’ve said here resonates though. I’ll still email you my story when I’m done with it…
I’d still love to post it. I just needed it for today because I’m so stinking sick right now!
My vet does both full-cost and subsidized low-cost spay/neuters. She also offers a lower-cost option on the regular procedure — if I recall correctly, it’s the anesthesia that makes the difference. I opted for the higher of the two, but I had the luxury of being able to afford it. Trust me, I know how lucky I am to be in that position.
I wonder if some of the same people who berate vets for earning a living would say the same things to their child’s pediatrician? I certainly don’t want to discourage people from adopting, but having an animal in your family is a huge commitment in both time and money, and people need to understand that.
We had our puppy neutered at our regular vet. It was 4-5 times the cost of the low cost surgery we could have had done. I believe the care at our vet to surpass other regular cost or low cost clinics simply because they always go above and beyond for our dogs. That’s not to say that the care at low cost clinics isn’t good as well, just that our vet is one of the best. One thing our vet does is offer a 20% discount on all the vaccinations, visits and spay/neueter that a puppy needs in its 1st year, if you sign up for their puppy plan – this helped to offset the cost differential. If I were in financial need, I wouldn’t think twice about going to a low cost clinic. I think they are an absolute necessity – without them, there would be a lot more unwanted puppies.
Im a city girl who moved to the country to find our pole barn also included 20 cats. No joke, 20. Various ages and ranges of healthy to sickly and nice to really ferrel. Rumors abound of the traveling vets that will spay/neuter for $20/cat but I was never able to find them in reality. Very slowly, overtime, Ive adopted out all the kitties that have been born and have one or two of the grown ones fixed a year through a country vet who will perform the “barn cat” service for about $100/cat. I personally found it to be well worth it for the special ones that make our porch a better place. I was horrified to find though that they dont send them home with ongoing pain meds so for the ones that I can feed a pill to, Ive opted for at least one additional days worth of pain killers.
Nature has helped to weed out the population and we are now down to 4 healthy happy barn cats all spayed/neutered and living happily together.
It would be helpful to controlling the ferrel cat population to have a lower cost option available. More people would do it. I also understand though that a vet could donate every weekend to the task and still never get ahead.
Our vet gives a list of several options and the associated costs when you make an appointment for spay neauter – you can opt to go all out and get baseline bloodwork done beforehand, pain meds for longer times, etc. Since pets are often altered early in life, it’s nice to get all the bloodwork and screenings done, if you can afford it, so that you have a reference for anything that may crop up in the future. If you can’t afford to have everything done, you know what your options are and what the cost will be.
For regular patients, they often offer a payment plan for unexpected issues/emergencies or for seniors on a fixed budget that may not be able to pay in one lump sum. It’s nice to get help when you need it, and while unexpected expenses can happen, you shouldn’t adopt a pet unless you are able to pay for it’s care. I know there are alot of professionals out there who go above and beyond to help pets, and that’s wonderful, but vets need to survive too.
The first thing that came to mind was that our whole society is like this today. It must have been when you said “nine times out of ten instead of being happy, those people would be angry that they weren’t getting more”.
I am so tired of this whole “you owe me” attitude that most folks have today. And yes, I have used the clinic at the APA before out of necessity but you do what you have to.
I did not realize that vets were getting bashed any more than doctors/dentists or anyone else that makes what appears to be a decent living.
My husband just reminded me that we also have Care Credit that our Vet takes.
I am the vice president of the local humane society and we offer low cost spay/neuter and it is $87 for dogs and normally about $50 for cats..however, due to a grant the cats right now are $30. We are constantly looking for grants to cover the costs and donations too. Right now we have 4 grants just to keep the clinic going (4 surgery days a month). Some cover cats, some dogs, some for the vet, some for people who can’t afford the $87 and the payment becomes a sliding scale based on income, etc.. We also use a local college program and their instructor to help us in our recovery area as volunteers and for them to get some experience. They aren’t vet techs (no school around here) but all are in the medical field so with a little bit of training from the vet they can monitor recovery, breath sounds, etc. and know when to go get the vet if there is problems. We have special trained volunteers who handle intake, paperwork, payment,give the owners post op instructions when they pick the animal up, etc. We also have a few vet techs who volunteer as well to help the vet in actual surgery. Ours also includes pain medication (here the vets actually don’t include that in the surgery fee and it is optional..we said no way..the animals have to have pain medication we just opened them up). And finally if they can’t show proof of rabies it is $5 for the shot also not optional due to state law. So as you can see we get very, very creative on how to fund the clinics and keep the costs down.
Here a big issue between the low cost spay/neuter clinics and some of the vets here is the vets think we are trying to take away their business. Yes we may take a little bit of business away but I say a majority of the animals we see don’t even have rabies shots so that means they aren’t receiving regular vet care. Plus, we target the trailer parks, and assistance housing, low income areas,etc with our flyers and PR. i But I agree we are like apples to oranges and have a different clientele than the regulars vet office.
When the low cost clinic is located in the nicest part of town, when the clinic has billboards all over town advertising low cost spays, when the director drives a new Lexus, and when there is no regard to vaccination status or pre-surgical physical examinations, I would say that there is a profit motive there, which is competition to regular vets. That can only foster animosity.
My clinic in San Diego participates in our county’s Low cost Spay and neuter program. It is available to any vet to participate. The economic climate out here has become such that if I did not participate I was doing significantly fewer surgeries and struggle financially. The economy basically dictated that this would be the best way for me to help clients with their surgical needs and still be able to stay in business doing surgeries as part of my daily practice . The contract we work under allows for us to offer everything I feel is necessary to decrease the surgical risk (pre anesthetic blood testing and Intravenous fluids) but we cannot require it of our clients. They get to make choices about surgical risk for each of their pets. We do not skimp on gas anesthesia, high end patient monitors (O2, capnograph, EKG, temp and Blood pressure), and hands on technician monitoring. It is our choice to treat our low cost surgical patients the same as any other. I could not sleep at night if I did not use the highest standard of care for everyone regardless of ability to pay. Thanks for updating those who visit you site on the differences available to them because many people feel we are just trying to drive up the price of their surgery by offering testing and fluids.
:::waves::: I’m a tech at a low cost clinic in San Diego!
We offer low-cost spays and neuters, and same thing- the care is absolutely no different (o2 monitoring, anesthesia, EKG, temp, etc…). My vet participates for two reasons: she wants to aid in curbing pet overpopulation however she can, and also it is a great advertisment for her clinic. If we did not offer spays and netuers, we would only have about 4 surgeries a day. With the low-cost referrals, we get about 8 a day. Many of these customers then become regular clients. It’s good for the people who gets their animals neutered that otherwise might not be able to afford it, and it’s good for us.
:::waves::: I’m a tech at a low cost clinic in San Diego!
We offer low-cost spays and neuters, and same thing- the care is absolutely no different (o2 monitoring, anesthesia, EKG, temp, etc…). My vet participates for two reasons: she wants to aid in curbing pet overpopulation however she can, and also it is a great advertisment for her clinic. If we did not offer spays and netuers, we would only have about 4 surgeries a day. With the low-cost referrals, we get about 8 a day. Many of these customers then become regular clients. It’s good for the people who gets their animals neutered that otherwise might not be able to afford it, and it’s good for us.
I think that if a client cannot afford your services for spay/neuter, you should have a solution for them. The solution doesn’t have to be you cutting your costs, but could be “Well, if you fall within a certain income bracket, you can qualify for assistance with the local humane society. Please get your pet spay/neutered there. Let me give you their card.”
Because overpopulation is an issue, I think the right answer is giving the owner a feasible solution and knowing at the end of the day that pet will be fixed.
I’d probably encourage my clients to get the surgery done with government assistance programs if possible, and then come back for yearly check-ups and keep up with heartworm meds through your office, as those prices are much lower and affordable to them.
I say all this having been working with my local humane society as a volunteer vet tech, and I know they use the same precautions and post-procedure meds as a regular vet, so I’d say this is 9 times out of 10 a safe bet.
Did you see Katherine Heigle’s pro Neutering commercial? I hate Balls. Hilarious.
http://doodiepants.com/2011/12/10/katherine-heigl-hates-balls/
My vet offers everything possible a la carte. They recommend things, but if a patient’s guardian cannot afford post surgery meds, then they aren’t required to purchase them. We’ve been going there long enough now, that they automatically know that we will pay for everything necessary, but they still give me choices on meds if they are available, etc. I appreciate that they don’t just bundle everything together– although I always feel bad for the puppies whose parents can’t afford the pain meds 🙁 (Although I’m pretty sure they give them a day or two anyway…)
I love our vet– and luckily, so do our dogs <3
My name is Staci and I am an intern at Animal Rescue of Tidewater (ART) located in Norfolk, VA .I found Paw Curious while searching for other shelters and organizations that are big on spay/neuter like we are. One of our main goals at ART is reducing the killing of pets within our shelters in Southside Hampton Roads, Virginia. We endorse Trap-Neuter-and-Return (TNR) to help lower the number of strays that run through the neighborhoods. It is truly wonderful to see other shelters and groups supporting spay/neuter. I enjoyed reading your post and all the great actions that are being taken. Check out our services at http://www.artanimals.org/wordpress/services
One day a faster and less expensive way to have this done will be here. Right now it is being sought after by michelson.foundanimals.org. They are non-profit foundation offering up to 75 million in prize and grant money to anyone who could develop a non-surgical spay neuter method.