Are the cost of vets bills becoming a welfare issue?

[SilverLinings]

As a doctor this is not strictly true . Loads of things are treated imperically without any tests . Physio is the first port of call for lots of pains without any investigation.. so it totally depends on the differential the way you either proceed straight to the most likely treatment or with a battery of tests. When I learned my trade diagnosis was supposed to be done with out tests and you did the minimal number of tests to prove your theory … tick every box medicine has not improved the subject and tests are not without their own risks

Sorry, I didn't make my comment very clear. I meant in the cases where there are several possible differential diagnosis (particularly when one or more possibilities are very serious conditions such as cancer) and treatment options would be invasive and/or carry other risks. With both animals and humans a doctor/vet may go ahead and treat without further tests if they are pretty sure of the diagnosis and/or the treatment doesn't carry any risk of harm. For example, suspected cancer won't be treated without investigations to find out what type of cancer it is, where the tumour(s) is (are) and whether it has spread. Surgery wouldn't be ethical if it is possible a patient actually has something minor that could be treated with oral medication. Likewise with anomalies in blood test results where the symptoms could indicate a range of possible causes. Equally, I wouldn't expect a doctor to need to carry out a battery of tests to diagnose an infected cut or a case of flu etc.

The point I was attempting to make was that no clinician (NHS, private or veterinary) should carry out tests for the sake of it (waste of time and money, and can cause harm), but if they are needed to ensure that further treatment is appropriate and inadvertent harm not being caused (by determining the correct diagnosis) then the patient/owner needs to understand that if they do not consent to the necessary investigations then the clinician may not be willing/able to proceed with treatment.

I work in paediatrics, so not vastly different to vets in that the patient can't communicate and on occasion the parent/owner can muddy the waters! Don't start me on the number of inappropriate referrals our physio department gets though

 

[honetpot]

The point I was attempting to make was that no clinician (NHS, private or veterinary) should carry out tests for the sake of it (waste of time and money, and can cause harm), but if they are needed to ensure that further treatment is appropriate and inadvertent harm not being caused (by determining the correct diagnosis) then the patient/owner needs to understand that if they do not consent to the necessary investigations then the clinician may not be willing/able to proceed with treatment.

I had a test last week, consultant wanted it, although I had already told them I did not want an operation on the organ being scaned, as I have weighed up the possible side effects and complications. Its documented in my notes and has been confirmed several times. I didn't argue because if it makes them happy they have complied with the NICE guidelines, that ticks that box, but the test cost about £350, the contrast used is £150, for no benefit to patient, and wasted an OPD slot that could have gone to another patient.
The fact in is human medicine, common things like back pain you are examined and history taken, the GP usually has a choice, refer and pass on to a consultant, refer to physio and be on awaiting list, or send you for scan perhaps, or give a NSA, and most people get the last one unless there is a history of trauma, and then perhaps having been back a couple of times you get further up the scale of treatment. Perhaps the £350 scan would possibley give a better outcome quicker, would overload the existing system/cost.
There are occasions when people are misdiagnosed on how they present, but usually the examination and history is the basis of any further investigation, if your visting vet is the eqivaliant of a GP they are shifting through the common signs an sypmtoms before doing investigations. Its getting to the point where vets services are reduced due to lack vets and for some too expensive, if you have no fixed budget with human and animal treatment you pay for extra investigations and treatment, which is your choice, but I hope that in the UK the majority of human private treatment is carried out on an ethical basis, but there are occasions its not in the patients long term best interests.
Most people who own horses have a budget, even if they have insurance it often may not cover the full cost, but apart from the financial drain there is and emotional drain. Their is nothing worse I think than watching someone 'try everything' when you now with just about 100% certainity its not going to end well.
If you work in paeds you will know that most of your patients have already be through a system that decides there is a clinical need, it's not like a GP surgery where they may see perhaps ten children a day URTI, or a painful ankle, and they have to be triaged, and most will just need simple support.