After more than 30 years in the veterinary field I have finally come to the realization that I’ve been doing things wrong all this time. I guess I’m a slow learner.
I last wrote an entry on anesthetic-free dental cleaning and how veterinarians are being cast in a very negative light by the proponents of these “procedures”. You can, obviously, read the post yourself. A bit of spleen was vented, and I felt much better afterward. I’m almost over it, I promise.
The other day, though, I had an epiphany. What I finally realized is that it doesn’t matter whether clients follow my advice or not. In fact, it’s absolutely financially more lucrative for me if my clients don’t take my advice on any preventive measures. Better yet, I can stop recommending preventives or screening at all. This would have two huge benefits to me.
First, I’d never be accused of “upselling”. Clients would come in for an exam once a year (just to satisfy our local requirements for a legal veterinarian-client-patient relationship, of course, not because it’s in the pet’s best interest). I’d pooh-pooh the need for any vaccines at all, which would confirm their niggling suspicions that the veterinary vaccine industry is a big scam.
No deworming either, so I can tell them I’m saving them money. Some vague recommendations about the pet’s current condition. Don’t recommend a specific diet, because those other greedy bastards (but not me) are all in the pockets of the big food companies. Don’t prescribe any expensive medications; clients think that money all just lines my pockets anyway, and they might actually cure something by accident.
Oh, and behavior problems! What a gold mine. I don’t recommend socialization or puppy classes or any obedience training (why would I – it doesn’t make me any money) and I end up with a lot of fearful, anxious biting dogs. Not only can I make money for my behaviorist partners in the pet ripoff crime, but I might even get some side action when that pet runs off and is hit by a car, or instigates a fight.
For older pets no routine screening to catch disease early; the exam was mostly fine, so what’s the point? When I see early dental disease, I’ll recommend that the groomer just physically restrains the pet and chips the tartar off the outside. The upshot of this would be clients that think I’m fantastic. “Dr Claws never upsells, and never tries to rip me off like the other money-grubbing untrustworthy veterinarians!” Here’s a sample of some Yelp reviews – it’s amazing how many people reference “upselling”.
“They upsold me on everything. I walked in and my estimated amount was a little over $100…when I left? Almost $400.” (Veterinarian recommended lab work which the owner agreed too, then complained about the price online. Why not just decline the procedure to start with?)
“…my gripe is with their pricing and upsell tactics.” (Veterinarian recommended dental cleaning.)
“This place will nickel and dime you to death. I have another dog and cat I would have brought here, but they are more concerned about that almighty dollar than they are about animals.” (Double whammy – upselling AND heartless vet who wants to be paid. Owner had an outstanding account of $200 for almost a year, and the vet had the nerve to send him/her to collections.)
“He didn’t try to upsell us on any extra tests or vaccines.” (Because the vet didn’t feel he needed them, or he would have recommended them. But wait… according to this reviewer, that would have been “upselling” rather than making the best recommendations for the pet. We can’t win.)
Second, my patients would end up getting sick more often and more seriously. Believe me, this would be very lucrative financially. The cost of a parvo vaccine from puppyhood to 10 years of age, considering that the minimum interval is every three years as an adult, and at a very “expensive” $30 a pop, would be just over $200. I can make way more than that treating the dog for parvo. Hospitalization, IV fluids, medications, nursing care, lab testing, intensive care for the severely affected puppies… a thousand bucks! Woo hoo!
Kittens with upper respiratory viruses like latent Herpes viruses are great, too. There’s the initial illness, which can be life-threatening and therefore expensive, and sometimes we end up with chronic nasal infections, sinusitis, or destruction of nasal tissues, which makes me more money, too. So why provide an inexpensive vaccine that prevents this disease?
And for the older patients it’s even better. The longer periodontal disease goes unrecognized (because groomers don’t have proper training in recognizing oral disease; they are hair stylists), the more money I make in oral surgery when that mouth finally goes so far south that most of the teeth need to be extracted.
The longer I ignore kidney disease in middle aged cats by not recommending blood and urine testing, the more money I can make in recommending hospitalization and IV fluids (a few years down the road) every couple of weeks when the cat presents in full out failure.
Obesity? Without fat dogs I wouldn’t be able to sell as many arthritis drugs, diet foods, and other treatments. Just recommending weight loss doesn’t make me any cash at all. And that little skin mass? If I ignore it until it’s more invasive and extensive, I can make more money on a bigger surgery.
Don’t even get me started on allergic dermatitis; it’s a great disease. You can’t cure the allergies, and if I never really try to find out what the pet is allergic to I can milk that problem for years. From a financial point of view I’m much better off dealing with chronic dermatitis and seeing a pet 4 or 5 times a year for the rest of its life than getting to the root of the problem and fixing it. So, the pet is miserable and uncomfortable most of the time. At least I’m not being accused of wanting to do unnecessary testing.
In fact, if I am to live up to my reputation as a money-grubbing ripoff artist, it’s actually better if people do not follow any of my advice on preventive care. We’ve obviously done too good a job preventing disease and people have little concept of the cost difference between preventing illness and treating it.
Fortunately for the general animal population I, like most veterinarians, really love animals. I’m in this for their sake, not “just in it for the money”. So even if it makes a certain subset of my clients suspicious of my motivations, I will take the financial hit and continue to recommend things that will keep my patients healthy and away from my hospital.