Vet Monopolies

[BronsonNutter]

Are all vets corporate these days? How do I find out if my practice is?

They aren't all corporate - but quite a lot are and it isn't necessarily obvious if they are or aren't - this lack of transparency is one of the things brought up by the CMA. If you go on your vets website it should say at the bottom as to if they are owned by a corporate (e.g. IVC, CVS, VetPartners). Some of the best vets practices in the country are owned by corporates, so it doesn't mean that corporate = bad.

 

[rara007]

It’s kind of ironic non vets have only been able to own practices since 1998, and that was a reform post the CMA investigation back then. Unintended consequences…

 

[ecb89]

Back in the summer my dog had a couple of days being sick. As she’s a lab we were concerned she has eaten something and had a blockage. Took her to the vets and they wanted over £700 for the consultation, a bit of sedation as she’s a wriggly worm, an X-ray and an anti sickness. That’s a ridiculous amount.
Compared to earlier in the year by horse had cellulitis and the total charge of his bill was £700 which was 2 call outs, 2 lots of antibiotics, a colic flush as he went down with colic the next day, pain relief, sedation, topical cream etc.

 

[tda]

It’s kind of ironic non vets have only been able to own practices since 1998, and that was a reform post the CMA investigation back then. Unintended consequences…

I didn't know that

 

[paddy555]

Back in the summer my dog had a couple of days being sick. As she’s a lab we were concerned she has eaten something and had a blockage. Took her to the vets and they wanted over £700 for the consultation, a bit of sedation as she’s a wriggly worm, an X-ray and an anti sickness. That’s a ridiculous amount.
Compared to earlier in the year by horse had cellulitis and the total charge of his bill was £700 which was 2 call outs, 2 lots of antibiotics, a colic flush as he went down with colic the next day, pain relief, sedation, topical cream etc.

I'm equally lost but exactly the same thing for my animals. No one seems willing to explain why.

 

[Gamebird]

Deleted as double posted

 

[Gamebird]

I'm equally lost but exactly the same thing for my animals. No one seems willing to explain why.

Certainly in that example it is because small animal overheads are so much higher than in ambulatory equine practice. Staff costs are higher (small animal vets get paid more), more staff are involved (nursing staff, ACAs etc), building costs are higher. The dog was not sedated for the xrays because it was wriggly, but because the Ionising Radiation legislation says that except in emergenholding conscious animals for radiographs is not acceptable for staff safety, and because it is almost impossible to get a diagnostic quality radiograph in an unsedated small animal. There are other factors including the higher cost of a lot of small animal drugs in comparison to equine drugs (depending on animal size and drug choice it is usually more expensive to sedate a dog than a horse).
And a lot of equine work is to be honest pretty underpriced!

 

[smiggy]

Ok, at the risk of sounding like a complete boomer , one of the big issues here is the rise of gold standard veterinary care in every instance. I know we all want the best for our pets, but that’s why prices have gone up. 20 years ago, if something came in that needed a quick stitch up with sedation. I’d get them to sign a consent form, literally from a pad printed off ready. Give dog a quick jab of sedative, pop in kennel, get out ten minutes later , do job with minimum of fuss, reverse sedation and send home thirty minutes later.
Now I have to print off a three page admit form, find a vet nurse to admit dog. They will spend 15 minutes admitting dog, then do a temp, heart rate check. Dog then has an iv catheter placed, sedation given iv and supervised by a nurse the whole time. Once sleepy dog will be put on oxygen during procedure . Dog will stay several hours, most of which will be monitored by a nurse.
There will then be pages of notes and items added to the record.
You can see why second version is so much more expensive. Obviously it’s better , it’s “ gold standard” but the first version was perfectly adequate and fine and got job done , no dog ever died.
But now this “ gold standard” exsists, vets are too scared of being sued to do first version.
Contrast above with my recent experience of a horse related injury pneumothorax, sat in a and e waiting room for 2 hours before being assessed and then being told by the nursing auxiliary to go and sit in a chair by the nurses station so that “ someone might notice if I passed out “
World has gone a bit crazy in my opinion.

 

[paddy555]

Ok, at the risk of sounding like a complete boomer , one of the big issues here is the rise of gold standard veterinary care in every instance. I know we all want the best for our pets, but that’s why prices have gone up. 20 years ago, if something came in that needed a quick stitch up with sedation. I’d get them to sign a consent form, literally from a pad printed off ready. Give dog a quick jab of sedative, pop in kennel, get out ten minutes later , do job with minimum of fuss, reverse sedation and send home thirty minutes later.

I am old, this is what I always had, this is what I want. The surgery was often in someone's house, or just a small room somewhere, clerical support was often the wife, Nothing fancy. What I wanted was the experience of a vet. Didn't matter how fancy the accommodation was it was his experience that mattered. If they told me it was ultra serious they could refer me to a hospital. Otherwise they just got on with old fashioned stitching up etc etc. Nothing died.

Now I have to print off a three page admit form, find a vet nurse to admit dog. They will spend 15 minutes admitting dog, then do a temp, heart rate check. Dog then has an iv catheter placed, sedation given iv and supervised by a nurse the whole time. Once sleepy dog will be put on oxygen during procedure . Dog will stay several hours, most of which will be monitored by a nurse.
There will then be pages of notes and items added to the record.
You can see why second version is so much more expensive. Obviously it’s better , it’s “ gold standard” but the first version was perfectly adequate and fine and got job done , no dog ever died.
But now this “ gold standard” exsists, vets are too scared of being sued to do first version.

now I get this which I don't want. Not only do I not want it I have to pay for it all. That means that because the charges for small animals are so high I either have to take out insurance for what is basically pretty simple stuff which has been made a lot more difficult by this "gold standard" that I don't want or take a gamble. In the past I could afford to take the risk that I could pay the lower charges for the simple stuff so we were only talking about the more unlikely stuff I could risk. Now just for the simple stuff the bill is so high. I have 2 dogs coming soon. Their insurance will be £80pm.(together) Of course I don't mind paying to care for them as best I can, but I feel backed into a corner that I now need to insurance just for basic stuff. There is little choice.

Adequate is quite sufficient thank you. Don't need all the frills. Not even sure why we have ended up with all the frills.

 

[reynold]

Reading the above it seems a shame that 2 choices are not offered to the owner in the circumstances where there is a choice. The 'basic' type option, as described by smiggy above, and the gold standard care. Owners could then be given a simple (so they read it!) 'disclaimer' type form if they choose the basic option with the slight risks explained.

There is similar available for house insurance (e.g.) where you can have basic contents cover or the 'gold' cover. Similarly for horse insurance now that full cover (which now often doesn't even cover for the full cost of colic, etc., surgery) is so expensive. Some owners are choosing to have more basic cover or catastrophe cover and accept a certain amount of 'risk' themselves.

I think part of the issue with these corporate practices is that they now seem to only offer the 'gold' option (as I presume this is what makes the most profit) alongside a client base that is often completely risk averse and wants the 'quick' solution that reflects the overall impatience of modern life.

Not that long ago it was common with leg injuries to turn away and let time and dr. green do it's job. Now it's all joint injections, etc. - all of which cost money. There are also nowadays fewer people that accept that 'life' has a time limit for all sorts of 'pets'. In the old saying 'there is a time to live and a time to die' - seen on here over many years and many posts in regard to PTS.

Vets and doctors are dedicated to doing their best for their patients but they can't perform miracles, which is what some clients seem to want. It seems that the corporate vet companies have removed 'vet's discretion' from their way of working and forced their employees to only offer the most expensive care sadly, alongside offering 'treatment' when in older times it would have been the time for the vet to have a quiet, sympathetic, word and explain that nothing more could be done.

It's not easy for owners who want the best for their pets and also not easy for vets working for these corporates. As with train operating companies, water companies and a lot of other similar corporate entities it is all about shareholders and directors profits before the needs of the customers.

 

[Gamebird]

To be honest I'm also old in veterinary terms (25yrs qualified) and whilst I understand a lot of the above points, I can categorically say that I do not have a wife to do my clerical work (I have a husband, but he has his own career), nor do I want clients, let alone their pets, in my kitchen!

We can do better than cat speys on kitchen tables. Maybe try looking for a middle ground rather than glorifying the good old days. I was alive back then and I can definitely say that sometimes things did die.

 

[druid]

Just to point to out vets are legally obligated to offer gold standard care and can end up in trouble if they have a complaint and it wasn't offered. There is also now much higher minimum standards for clinics, offices, equipment and staffing than historically after the last CMA review which mean the "old fashion ed" practice is not possible.

 

[MurphysMinder]

I have been offered choice between basic and gold standard , although basic is not as basic as back in the day described by Landcruiser . I too am old enough to remember surgery on vets kitchen table type treatments, and yes animals did die in my experience. Most of those would have lived with today’s treatments . I would always choose best possible treatment for my animals taking everything into account and trust my vets to guide me . I think a lot of the problems seem to arise when people don’t trust their vets , that happened to me and I changed vets .

 

[paddy555]

To be honest I'm also old in veterinary terms (25yrs qualified) and whilst I understand a lot of the above points, I can categorically say that I do not have a husband to do my clerical work (I have a husband, but he has his own career), nor do I want clients, let alone their pets, in my kitchen!

We can do better than cat speys on kitchen tables. Maybe try looking for a middle ground rather than glorifying the good old days. I was alive back then and I can definitely say that sometimes things did die.

most vets with their practices based at home had a dedicated area, I don't remember ever having my cats on their kitchen tables.

it may be dismissed as amusing but those small practices, often with 2/3 vets in partnership did very nicely. I used one. Good standard of care. Overheads were low, wife (usually) had a job working from home as the receptionist and got paid the standard rate so money coming into the family rather than elsewhere. Travel from home to office for the vets was a lot less. Didn't have to get up and drive to the surgery. The vets practice as far as profits go did very nicely. Clients were happy. Practices were small, they did their own out of hours which was a great benefit to clients, lower number of clients so less out of hours cases plus they knew their clients so could more likely gauge a real emergency.
Clients knew their vets, often the same vet, they knew and trusted them as they had history with them.

You mock it but I'm not sure the clients did. Charges of course were a lot more reasonable. Certainly not glorifying it.

 

[Polos Mum]

Things have come a long way in lots of professions.

My mum was a NHS GP, when I was a kid if you called the surgery out of hours - you got an answer phone with our home phone number. If you called that, you got my Dad answering the phone (totally non medical in anyway!). He would write notes on paper and give them to my mum when she got back from the last call. He did get paid as her out of hours support I think - but not much.

This is UK and only 35-40 years ago.

If it was happening on the NHS, pretty sure some vets would have done similar.

 

[Marshpiper]

The sentence re out of hours……..yes they did, as nobody else to do it….but my goodness they worked some really long hours, and unless they could get a good locum, holidays were not an option….missed children’s important days…
I have huge respect for my vets, as I said in a previous post….

 

[Landcruiser]

I have been offered choice between basic and gold standard , although basic is not as basic as back in the day described by Landcruiser . I too am old enough to remember surgery on vets kitchen table type treatments, and yes animals did die in my experience. Most of those would have lived with today’s treatments . I would always choose best possible treatment for my animals taking everything into account and trust my vets to guide me . I think a lot of the problems seem to arise when people don’t trust their vets , that happened to me and I changed vets .

It wasn't me, it was Paddy's post you are referring to, I think.

That said, I had a Saturday job with my local vet when I was 15, waaaay back in the "good old days" of the 1970s. He was an old school Scot, used to pay me 50p now and then, and used me as a free assistant (which I was fine with, I loved every second). His practice was in his house.
He routinely castrated male cats with no anaesthetic - head first into a duffel bag, my job to hold the cat in a bag still, two quick nicks with a scalpel, pull out the testicle till it snapped off and the tube coiled itself back like a spring. Job done, no stitches, no pain relief.
All care and equipment was pretty basic, and health and safety didn't exist. He let me (at 15) stitch up cat spays. Can you imagine??? There was no Fear-Free (he routinely used a pole/noose catcher for both dogs and cats that were difficult to handle/approach in kennels).
I think we have moved on a very long way. It's fine to be nostalgic, but there is a danger of rose tinted glasses and not knowing what it was actually like back then. I saw what I saw and didn't know any different - lord knows what I didn't see.

ETA - he had an excellent reputation and was a very successful one man, one nurse (plus me for about a year) practice until selling out to a larger local practice to retire.

 

[Marshpiper]

Things have come a long way in lots of professions.

My mum was a NHS GP, when I was a kid if you called the surgery out of hours - you got an answer phone with our home phone number. If you called that, you got my Dad answering the phone (totally non medical in anyway!). He would write notes on paper and give them to my mum when she got back from the last call. He did get paid as her out of hours support I think - but not much.

This is UK and only 35-40 years ago.

If it was happening on the NHS, pretty sure some vets would have done similar.

I was going to mention doctors, and this was exactly the type of wonderful service we received…Maybe I am lucky to be able to recall the doctors and vets who looked after our families and animals…

 

[MurphysMinder]

It wasn't me, it was Paddy's post you are referring to, I think.

That said, I had a Saturday job with my local vet when I was 15, waaaay back in the "good old days" of the 1970s. He was an old school Scot, used to pay me 50p now and then, and used me as a free assistant (which I was fine with, I loved every second). His practice was in his house.
He routinely castrated male cats with no anaesthetic - head first into a duffel bag, my job to hold the cat in a bag still, two quick nicks with a scalpel, pull out the testicle till it snapped off and the tube coiled itself back like a spring. Job done, no stitches, no pain relief.
All care and equipment was pretty basic, and health and safety didn't exist. He let me (at 15) stitch up cat spays. Can you imagine??? There was no Fear-Free (he routinely used a pole/noose catcher for both dogs and cats that were difficult to handle/approach in kennels).
I think we have moved on a very long way. It's fine to be nostalgic, but there is a danger of rose tinted glasses and not knowing what it was actually like back then. I saw what I saw and didn't know any different - lord knows what I didn't see.

ETA - he had an excellent reputation and was a very successful one man, one nurse (plus me for about a year) practice until selling out to a larger local practice to retire.

Sorry , yes it was Paddy .

 

[druid]

I was going to mention doctors, and this was exactly the type of wonderful service we received…Maybe I am lucky to be able to recall the doctors and vets who looked after our families and animals…

This kind of sh1tty comment is exactly the kind of thing that is the reason vets are leaving the profession in droves. Suggesting vets don't care for animals or their owners is ridiculous.

 

[MurphysMinder]

I was going to mention doctors, and this was exactly the type of wonderful service we received…Maybe I am lucky to be able to recall the doctors and vets who looked after our families and animals…

My vets go above and beyond to look after my animals (and me) , including phone updates at 10pm and visiting on their day off .

 

[Marshpiper]

This kind of sh1tty comment is exactly the kind of thing that is the reason vets are leaving the profession in droves. Suggesting vets don't care for animals or their owners is ridiculous.

Think you have totally misunderstood, I was referring to the old days….but I still have wonderful vets and a doctor, but it’s just not the same…..I don’t have and certainly would not expect to have my doctors home number or indeed my vets,,,
My post was obviously badly phrased…apologies
A poster was talking about times gone by, and my post was in reply to that….

 

[paddy555]

It wasn't me, it was Paddy's post you are referring to, I think.

That said, I had a Saturday job with my local vet when I was 15, waaaay back in the "good old days" of the 1970s. He was an old school Scot, used to pay me 50p now and then, and used me as a free assistant (which I was fine with, I loved every second). His practice was in his house.
He routinely castrated male cats with no anaesthetic - head first into a duffel bag, my job to hold the cat in a bag still, two quick nicks with a scalpel, pull out the testicle till it snapped off and the tube coiled itself back like a spring. Job done, no stitches, no pain relief.
All care and equipment was pretty basic, and health and safety didn't exist. He let me (at 15) stitch up cat spays. Can you imagine??? There was no Fear-Free (he routinely used a pole/noose catcher for both dogs and cats that were difficult to handle/approach in kennels).
I think we have moved on a very long way. It's fine to be nostalgic, but there is a danger of rose tinted glasses and not knowing what it was actually like back then. I saw what I saw and didn't know any different - lord knows what I didn't see.

ETA - he had an excellent reputation and was a very successful one man, one nurse (plus me for about a year) practice until selling out to a larger local practice to retire.

good heavens, I first got my own animals in 1973 so remember that period well. Nothing like that, facilities were more basic but never that sort of thing. I'm not being nostalgic, I was there, living it and paying the bills some things where, some not. However the pendulum seems to have swung too far nowadays in the small animal area.

The biggest problem back in the 70's and the 80's were the equine vets. They came from an era when vets were mostly men. They had big problems.. Technically many were not particuarly good vets, secondly the female holding the horse was regarded as the stable girl to be talked down to if she was even considered worthy of conversation. . Sometimes I felt like saying "I am the owner and I am the one who is going to be paying your bill". Having dealt with the uselessness and lack of communication skills of some of them then one would hope they would have excelled on horse handling. Sadly not.

The thing that has improved the most over the years is when female vets joined the labour market in quantity. They brought communication and horse handling skills and medically they were a great improvement.
So that is one thing about earlier years that I don't miss with my "rose coloured spectacles"

 

[rara007]

1998 metacam came to market! 2004 licensed for cats.

I recently bought an adult pony that’s been castrated by….non vets. Pain relief and anaesthesia are relatively new inventions. I’m not sure there was pain relief available to cats before that other than steroids?

 

[Pearlsacarolsinger]

good heavens, I first got my own animals in 1973 so remember that period well. Nothing like that, facilities were more basic but never that sort of thing. I'm not being nostalgic, I was there, living it and paying the bills some things where, some not. However the pendulum seems to have swung too far nowadays in the small animal area.

The biggest problem back in the 70's and the 80's were the equine vets. They came from an era when vets were mostly men. They had big problems.. Technically many were not particuarly good vets, secondly the female holding the horse was regarded as the stable girl to be talked down to if she was even considered worthy of conversation. . Sometimes I felt like saying "I am the owner and I am the one who is going to be paying your bill". Having dealt with the uselessness and lack of communication skills of some of them then one would hope they would have excelled on horse handling. Sadly not.

The thing that has improved the most over the years is when female vets joined the labour market in quantity. They brought communication and horse handling skills and medically they were a great improvement.
So that is one thing about earlier years that I don't miss with my "rose coloured spectacles"

Interestingly my first interaction with an equine vet in the early 70s was with a middle-aged woman. She was very well known locally. Her husband treated the small animals.
The next vet, from a different practice was a woman of about my age at the time. She left the practice to have children and I "grew up" with 2 of her male colleagues, who retired fairly recently.
I do know that the woman went back to small animal practice as her children got older.

 

[Exasperated]

1998 metacam came to market! 2004 licensed for cats.

I recently bought an adult pony that’s been castrated by….non vets. Pain relief and anaesthesia are relatively new inventions. I’m not sure there was pain relief available to cats before that other than steroids?

The cat castration technique described earlier wasn’t limited to vets!
My grandad ‘sorted out’ several Tom kittens that got dumped on their farm over the years, happily kept them all their lives but absolutely, point blank, refused to have cat pi*s on everything….

 

[paddy555]

My vets go above and beyond to look after my animals (and me) , including phone updates at 10pm and visiting on their day off .

sadly not for me, I don't seem to have been so lucky . I have had excellent treatment but they also so nearly cost me 2 horses. One was misdiagnosed with botulism by a senior partner and I was told to PTS. I didn't. In the 2nd the equine vet wouldn't listen to me one afternoon about how ill my 7mo foal was when she examined him, I even had to demand a blood test, he deteriorated overnight further I rang the following morning twice to try and get him referred to horse hospital and they were too busy to speak to me so I was left on my own. I got him into horse hospital by that afternoon as an emergency. They didn't know if they could save him and he was there for a week.
I have had a lot of animals and appreciate mistakes happen but those were very serious ones and shouldn't have.

 

[Exasperated]

good heavens, I first got my own animals in 1973 so remember that period well. Nothing like that, facilities were more basic but never that sort of thing. I'm not being nostalgic, I was there, living it and paying the bills some things where, some not. However the pendulum seems to have swung too far nowadays in the small animal area.

The biggest problem back in the 70's and the 80's were the equine vets. They came from an era when vets were mostly men. They had big problems.. Technically many were not particuarly good vets, secondly the female holding the horse was regarded as the stable girl to be talked down to if she was even considered worthy of conversation. . Sometimes I felt like saying "I am the owner and I am the one who is going to be paying your bill". Having dealt with the uselessness and lack of communication skills of some of them then one would hope they would have excelled on horse handling. Sadly not.

The thing that has improved the most over the years is when female vets joined the labour market in quantity. They brought communication and horse handling skills and medically they were a great improvement.
So that is one thing about earlier years that I don't miss with my "rose coloured spectacles"

There was a lot of chauvinism and elitism, females dealing with horses then were often girl grooms, or wives or daughters of whoever paid the bills - hardly any women earned lots of disposable income - and vets tended to pride themselves on ‘telling it like it is’, rather than admit emotional scenes.
By today’s consumer standards, downright rude!
But there can be benefits to bluntness, and I think modern vets are so nervous of offending clients, shocking their mental health, whatever, there is a lot of pussyfooting around of no benefit to the animal, particularly the prolonging of no-hope cases.

 

[Exasperated]

most vets with their practices based at home had a dedicated area, I don't remember ever having my cats on their kitchen tables.

it may be dismissed as amusing but those small practices, often with 2/3 vets in partnership did very nicely. I used one. Good standard of care. Overheads were low, wife (usually) had a job working from home as the receptionist and got paid the standard rate so money coming into the family rather than elsewhere. Travel from home to office for the vets was a lot less. Didn't have to get up and drive to the surgery. The vets practice as far as profits go did very nicely. Clients were happy. Practices were small, they did their own out of hours which was a great benefit to clients, lower number of clients so less out of hours cases plus they knew their clients so could more likely gauge a real emergency.
Clients knew their vets, often the same vet, they knew and trusted them as they had history with them.

You mock it but I'm not sure the clients did. Charges of course were a lot more reasonable. Certainly not glorifying it.

I remember the Herriot novels early 70’s, and altho written as earlier reminiscences, were utterly recognisable at this time - typical terrace house with annexe / operating clinic somewhere at the back. Equine and farm practise saw almost all treatments / operations on visit, very occasional referrals to a university or specialist unit.
Herriot, and the equal opps / pay reforms, encouraged many more girls into veterinary careers, and into sciences generally.

 

[paddy555]

There was a lot of chauvinism and elitism, females dealing with horses then were often girl grooms, or wives or daughters of whoever paid the bills - hardly any women earned lots of disposable income - and vets tended to pride themselves on ‘telling it like it is’, rather than admit emotional scenes.
By today’s consumer standards, downright rude!

extremely rude. As the breadwinner and person paying their bill I expected better but then I suppose we (women) were treated as 2nd class citizens in the 70's. Problem was I didn't do the kitchen sink and pinny but.

I think modern vets are so nervous of offending clients, shocking their mental health, whatever, there is a lot of pussyfooting around of no benefit to the animal, particularly the prolonging of no-hope cases.

I don't have a problem with horses with that, I know enough to be aware of the success or otherwise of problems and treatments but with small animals it drives me mad.
i can't asses the seriousness of an old cat's situation. I'm not sure if they won't say because it runs up a nice bill or they carry on treating them just because they can which is not always good. If the cat is not going to be around after 2 months whatever they do then why can't they just say.
I don't want to PTS and go home wondering if it could have been saved if I had done differently. I want to be told it has little chance and will most likely not recover. That way I will feel better about my PTS decision.

It seems that the corporate vet companies have removed 'vet's discretion' from their way of working and forced their employees to only offer the most expensive care sadly, alongside offering 'treatment' when in older times it would have been the time for the vet to have a quiet, sympathetic, word and explain that nothing more could be done.

this.