Vet Monopolies

Polos Mum said:
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.
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Definitely! One of my school friends - Dad was a vet, Mum a part time NHS GP - her older sister (secretarial skills) generally had charge of the evening phone! If she wanted to ring me after school, had to use the phone box near their house.
 
Part of the problem is that although we do have some people on here who wish vets would be a bit blunter and 'tell it like it is', this is not necessarily true of the general population, especially in the small animal world. This is a horse forum, so it is not a surprise that people here tend a little more towards the practical, but even 15 or 20 years ago when I last did any small animal work, the more blunt approach was dying out - because it had to. Attitudes change.
You absolutely do have to worry about offending people, and about their mental health.
You guys might be a little more robust, but the in general clients are not, and pets are family members. The more agricultural old school approach being talked about would cause a barrel load of complaints these days - and we must take into account the potential escalation of mental health issues an unconsidered comment might cause, because this is a reality now. It's not a fear of offending people - it's real.
I'd be towards the pragmatic end of the spectrum; but even in the equine world I've had to temper my approach a lot in the last decade or so to reflect changing societal values.
 
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Gamebird said:
Part of the problem is that although we do have some people on here who wish vets would be a bit blunter and 'tell it like it is', this is not necessarily true of the general population, especially in the small animal world. This is a horse forum, so it is not a surprise that people here tend a little more towards the practical, but even 15 or 20 years ago when I last did any small animal work, the more blunt approach was dying out - because it had to.
You absolutely do have to worry about offending people, and about their mental health.
You guys might be a little more robust, but the in general clients are not, and pets are family members. The more agricultural old school approach being talked about would cause a barrel load of complaints these days - and we must take into account the potential escalation of mental health issues an unconsidered comment might cause, because this is a reality these days. It's not a fear of offending people - it's real.
I'd be towards the pragmatic end of the spectrum; but even in the equine world I've had to temper my approach a lot on the ladt decade or so to reflect changing societal values.
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I think this is very true. When I’ve had dogs/cats/Guinea pigs put to sleep, the vets are often a bit surprised (perhaps relieved?) at my pragmatic view of things and lack of outward emotion. I’m usually happy to just pay the bill there and then, for instance, and can have a little joke with the receptionist.

I can tell by the way the vets and staff talk and the arrangements made in these situations that they are used to dealing with very emotional and upset people.
 
Days since client threatened suicide to us = 0. That’s not unusual over a weekend we have someone that distressed. It’s about 10 days since the last ambulance was called for a client.
Days since a 4 figure bill (complex intensive care for 36 hours over the weekend) where the only alternative was euthanasia entirely due to waiting for written script medication to arrive = 1.
 
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Gamebird said:
Part of the problem is that although we do have some people on here who wish vets would be a bit blunter and 'tell it like it is', this is not necessarily true of the general population, especially in the small animal world. This is a horse forum, so it is not a surprise that people here tend a little more towards the practical, but even 15 or 20 years ago when I last did any small animal work, the more blunt approach was dying out - because it had to. Attitudes change.
You absolutely do have to worry about offending people, and about their mental health.
You guys might be a little more robust, but the in general clients are not, and pets are family members. The more agricultural old school approach being talked about would cause a barrel load of complaints these days - and we must take into account the potential escalation of mental health issues an unconsidered comment might cause, because this is a reality now. It's not a fear of offending people - it's real.
I'd be towards the pragmatic end of the spectrum; but even in the equine world I've had to temper my approach a lot in the last decade or so to reflect changing societal values.
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does it do anything more for people to tell them the vet will throw all medicines possible plus a massive bill at them but despite this the vet through their experience is 99.9% certain that it is very unlikely to work, and that within a couple of week or less the cat will be back to PTS. In the meantime it will have to come back, stressed at having to go to the vet's yet again, for blood tests. They will have a large amount of money to pay which these days many can't afford plus they have 2 weeks of agony getting their hopes up and down as the cat rallies then gets worse. That is all before taking into account how the cat is feeling, at best it is going to be stuffed with painkillers and probably unable to pursue it's normal life.

What happens to the mental health when in 2 weeks time the vet still has to say PTS.

the approach doesn't have to be blunt,, it can be very kindly explained but at some stage if one has a pet then you are going to have to accept, as with a person, there will be an end.
no reason not to offer an alternative ie in my experience and having seen this situation many times before I'm terribly sorry etc but I doubt there is going to be a good outcome. We can do this and this and it may keep him alive for a couple of weeks or it may be kinder to PTS, up to you. I have been in that situation with 2 cats in the last 9 months. First I got led on by the vet and about 3 days and £1300 later it had to be PTS no choice. Second cat they examined, found a lump, told me they could give endless meds and that would keep it going for a couple of months. The cat was already suffering,, couldn't carry on it's normal life so PTS then and there. It was horrible but not as horrible as the first cat.

I don't mind paying a large bill if there is hope and a realistic possibility of a good outcome but anything else is stringing people along.

if you don't then you are offending people like me, you are costing me a lot of money and most of all you are probably not acting in the best interests of the pet. There was outcry earlier about Landcruisers post about castrating cats yet it seems OK to keep an animal going for the sake of the owner's mental health.

as far as complaints go this is the precise reason I sacked my small animal vets. They were not open or transparent, didn't told it like it was and didn't follow my instructions to PTS. It caused that animal years of suffering and as for my own mental health it went through the roof and took months to recover. If only they had been honest with me. Still they won't be doing that with any of my animals in the future.

To my mind vets owe their client's honesty.
 
The most common complaint/query coming through the door we see is why wasn’t XYZ test done. Clients think they want pragmatic care until filled with grief and guilt they talk to Maureen at Tescos who’s dog with an entirely different list of symptoms had a scan for that so why didn’t Fluffy get offered that.
Honesty is imperative and it sounds like unfortunately your practice didn’t give you that.
People don’t hear what they don’t want to hear and many do behave very differently to how a hunting forum member might behave around death.
 
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rara007 said:
The most common complaint/query coming through the door we see is why wasn’t XYZ test done. Clients think they want pragmatic care until filled with grief and guilt they talk to Maureen at Tescos who’s dog with an entirely different list of symptoms had a scan for that so why didn’t Fluffy get offered that.
Honesty is imperative and it sounds like unfortunately your practice didn’t give you that.
People don’t hear what they don’t want to hear and many do behave very differently to how a hunting forum member might behave around death.
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Exactly. I recently dealt with a complaint concerning lack of testing for something that is an everyday condition that our vets see literally daily. I suspect if I put a photo of it on here 99% of people could tell me what it was straight away. Testing for confirmation would add probably £200 to the bill. However due to the issues raised by this complaint and the time spent on it and general unpleasantness of the whole experience we will probably be offering testing every time we see it now. None of us feel this is necessary, but if we offer and the client turns it down then we will be better able to defend ourselves against similar complaints.

And like you I also had a client threaten suicide yesterday. In this case if I did not find a way to make their geriatric on-it's-last-legs horse last a bit longer. I genuinely don't know the answer to that one. The problem is real!
 
Gamebird said:
Exactly. I recently dealt with a complaint concerning lack of testing for something that is an everyday condition that our vets see literally daily. I suspect if I put a photo of it on here 99% of people could tell me what it was straight away. Testing for confirmation would add probably £200 to the bill. However due to the issues raised by this complaint and the time spent on it and general unpleasantness of the whole experience we will probably be offering testing every time we see it now. None of us feel this is necessary, but if we offer and the client turns it down then we will be better able to defend ourselves against similar complaints.

And like you I also had a client threaten suicide yesterday. In this case if I did not find a way to make their geriatric on-it's-last-legs horse last a bit longer. I genuinely don't know the answer to that one. The problem is real!
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Every ear here now gets culture and cytology offered for a similar reason, even when the smell of Malassezia hits you when you walk in the room with the dog.
 
Gamebird said:
And like you I also had a client threaten suicide yesterday. In this case if I did not find a way to make their geriatric on-it's-last-legs horse last a bit longer. I genuinely don't know the answer to that one. The problem is real!
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I'm actually really shocked reading these posts. When you ask a vet or doctor for their knowledge and advice you do have to appreciate they are not god and don't know everything and cannot "save" everything .
 
tda said:
I'm actually really shocked reading these posts. When you ask a vet or doctor for their knowledge and advice you do have to appreciate they are not god and don't know everything and cannot "save" everything .
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I think it is a combination of hope and denial. They hope the animal will recover, but they won't except the inevitable. Even people you think are pragmatic and sensible can lose all sense of rationality when their soul mate has reached the point of no return.

I've seen it too often and just want to say 'Can't you see what's happening? Put the poor thing down, it's suffering!' They can see it alright, but the acceptance is too painful.
 
tda said:
I'm actually really shocked reading these posts. When you ask a vet or doctor for their knowledge and advice you do have to appreciate they are not god and don't know everything and cannot "save" everything .
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Ah but the majority of clients these days think you SHOULD know everything.....should NEVER make even the tiniest mistake.... and save every case

....and if you fall down on any of these they will apply mental pressure and/or threaten to sue you.

.....and should you then have the temerity to bill them for something that didn't go exactly as they think it should have... or the bill is higher than they wanted....then the gloves really come off.

Emotion overrides reality and commonsense.

Yes, I am jaundiced about modern vet practice, I am relieved to be retired, and I would and have discouraged people from entering the profession.
I used to have clients who specifically came to me with their ageing animals, because I was happy to give them my old fashioned opinion on the current and potential quality of life of their much loved pet.....
Just before I retired, I was working as a self employed part-time locum, mostly at 2 very different practices. The first was an independent one man band at which I enjoyed the freedom to treat/recommend as I saw fit. The second was taken over by a corporate and I was "encouraged" to offer the full "evidence based gold standard" to every pet coming through the door, with the simpler treatment options very much an afterthought.
 
Between NHS advances, super vet and Lewis Hamilton they are all to blame! Kindly suggesting it’s the end is rarely what these types need. They do need it blunt, and from several members of staff. Of course they’re the minority but they fill the majority of the time. The polite typical we’ve decided not to continue treatment clients are less frequent and quicker visitors.
Even 10 years ago I remember my first ear infection non resolution in a week complaint. He was a builder and if his work had been faulty then he would be expected to fix it for free so why wasn’t that the same. Who could I refer him to to fix this dogs terrible suffering (they’d not been too concerned about enough to bring it back in before this point but it’s now terrible) today and resolve the ear infection today, at my practices cost. I was less than 6 months qualified so in no position to be writing off bills. The suffering was all on me as I failed to give the correct treatment. Obviously nowhere can fix an ear infection in a day. And I bet had I offered his other half (the builder guy was only brought in to add beef for the complaint, he hadn’t been to the initial consult) the swab to check it was a typical common bacteria that would respond the first time, I’d have had a similarly hostile reply to the cost of vets and that’s outrageous. And she’d probably have still been unable to get the dog to comply and the outcome would have been the same!
When the swab came back those drops would have worked correctly applied.

And that’s a really simple example of how consults have gone from 10minutes to 15, and average costs risen.
 
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rara007 said:
Between NHS advances, super vet and Lewis Hamilton they are all to blame! Kindly suggesting it’s the end is rarely what these types need. They do need it blunt, and from several members of staff. Of course they’re the minority but they fill the majority of the time. The polite typical we’ve decided not to continue treatment clients are less frequent and quicker visitors.
Even 10 years ago I remember my first ear infection non resolution in a week complaint. He was a builder and if his work had been faulty then he would be expected to fix it for free so why wasn’t that the same. Who could I refer him to to fix this dogs terrible suffering (they’d not been too concerned about enough to bring it back in before this point but it’s now terrible) today and resolve the ear infection today, at my practices cost. I was less than 6 months qualified so in no position to be writing off bills. The suffering was all on me as I failed to give the correct treatment. Obviously nowhere can fix an ear infection in a day. And I bet had I offered his other half (the builder guy was only brought in to add beef for the complaint, he hadn’t been to the initial consult) the swab to check it was a typical common bacteria that would respond the first time, I’d have had a similarly hostile reply to the cost of vets and that’s outrageous. And she’d probably have still been unable to get the dog to comply and the outcome would have been the same!
When the swab came back those drops would have worked correctly applied.

And that’s a really simple example of how consults have gone from 10minutes to 15, and average costs risen.
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And not everyone is like that, but enough people are like that that it has changed the way that we practice.
 
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Gamebird said:
And not everyone is like that, but enough people are like that that it has changed the way that we practice.
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Sadly I think that is the same in lots of areas of life. A relatively noisy minority make a fuss so now kids can't do anything that might make them fall over, and you have to sign wavers to do even small things, terms and conditions for everything are 80 pages as every issue generates a new exclusion / indemnity you have to sign up to. Want to take a scout group to light fires you need hours and hours of risk assessment paperwork.

Over the summer in Thorpe Park there were 9 signs and a loud speaker announcement going continuously that "If you ride the log flume you will get wet" and the poor minimum wage staff checking seating told us again, just incase that wasn't obvious from the water everywhere and soaking people coming off the exit !!

People want someone to blame and will choose whoever is nearest, sadly.
 
The really silly ones I always remember the guy in the pub complaining his rare steak is still pink in the middle. We've all seen them 2 tables over!

Kept a vegan bulldog going for many years including a number of days on a ventilator - very high profile in 'conventional' news!

www.mirror.co.uk

Lewis Hamilton's dog health update after Ferrari star pulled out of F1 event

Lewis Hamilton's beloved dog, Roscoe, remains in a coma after the 12-year-old bulldog's heart stopped, having been admitted to hospital with pneumonia and placed under sedation for checks
www.mirror.co.uk www.mirror.co.uk
 
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paddy555 said:
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. :D:D

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"
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I wasn't accusing you personally of rose coloured spectacles. This has come up before on other threads about vet prices, insurance etc. I was talking about the perception that in earlier times vet care was no frills and basic and often done by gut instinct/experience rather than diagnostics, and was therefore cheaper. My point, I suppose, was just that we have moved on from those times, and that basic care had some big issues. Things were missed that wouldn't be missed now, and corners were cut that wouldn't be cut now. I think on the whole I prefer the "now" option.
 
quizzie said:
I used to have clients who specifically came to me with their ageing animals, because I was happy to give them my old fashioned opinion on the current and potential quality of life of their much loved pet.....
Just before I retired, I was working as a self employed part-time locum, mostly at 2 very different practices. The first was an independent one man band at which I enjoyed the freedom to treat/recommend as I saw fit. The second was taken over by a corporate and I was "encouraged" to offer the full "evidence based gold standard" to every pet coming through the door, with the simpler treatment options very much an afterthought.
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the bold part is precisely what I want. That is what I am asking the vet. In your opinion having seen dozens of cases with this problem is it likely to be cured/kept under control.

Beausmate said:
I think it is a combination of hope and denial. They hope the animal will recover, but they won't except the inevitable. Even people you think are pragmatic and sensible can lose all sense of rationality when their soul mate has reached the point of no return.

I've seen it too often and just want to say 'Can't you see what's happening? Put the poor thing down, it's suffering!' They can see it alright, but the acceptance is too painful.
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so I want the vet to give me a kick up the arse and point this out based on their experience. That way I can go away happy I have at least done the right thing however horrible it has been.

I don't need it done in the way of the agricultural old vets, or the hunting people it can be done nicely and kindly but that is what is needed.

I shop online so am thankfully spared Maureen at Tesco and for info I only look at vet sites/medical etc sites so I am also spared the SM frenzy. :D:D:D:D
 
Landcruiser said:
. I was talking about the perception that in earlier times vet care was no frills and basic and often done by gut instinct/experience rather than diagnostics,
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it was no frills and basic without a doubt. There were poor vets but without the current tests etc vets had to work based more on experience. Experience and knowledge mattered a lot. The vet could tell you that your elderly cat wasn't likely to survive this was D day. and you didn't need counselling for your mental health. Somehow you coped as you had to with the rest of life.
 
rara007 said:
The really silly ones I always remember the guy in the pub complaining his rare steak is still pink in the middle. We've all seen them 2 tables over!

Kept a vegan bulldog going for many years including a number of days on a ventilator - very high profile in 'conventional' news!

www.mirror.co.uk

Lewis Hamilton's dog health update after Ferrari star pulled out of F1 event

Lewis Hamilton's beloved dog, Roscoe, remains in a coma after the 12-year-old bulldog's heart stopped, having been admitted to hospital with pneumonia and placed under sedation for checks
www.mirror.co.uk www.mirror.co.uk
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Guided, resourced and pure, eh? Is that the divine intervention or the itemised bill from the vet?
For God’s sake, Hamilton’s mid forties, I thought blaming everyone else for absolutely everything only started with millenials - how long is this nonsense going to persist before the backlash kicks in?
 
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rara007 said:
The most common complaint/query coming through the door we see is why wasn’t XYZ test done. Clients think they want pragmatic care until filled with grief and guilt they talk to Maureen at Tescos who’s dog with an entirely different list of symptoms had a scan for that so why didn’t Fluffy get offered that.
Honesty is imperative and it sounds like unfortunately your practice didn’t give you that.
People don’t hear what they don’t want to hear and many do behave very differently to how a hunting forum member might behave around death.
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Well, that’s the ‘lack of transparency’ issue so widely cited in CMA.
quizzie said:
Ah but the majority of clients these days think you SHOULD know everything.....should NEVER make even the tiniest mistake.... and save every case

....and if you fall down on any of these they will apply mental pressure and/or threaten to sue you.

.....and should you then have the temerity to bill them for something that didn't go exactly as they think it should have... or the bill is higher than they wanted....then the gloves really come off.

Emotion overrides reality and commonsense.

Yes, I am jaundiced about modern vet practice, I am relieved to be retired, and I would and have discouraged people from entering the profession.
I used to have clients who specifically came to me with their ageing animals, because I was happy to give them my old fashioned opinion on the current and potential quality of life of their much loved pet.....
Just before I retired, I was working as a self employed part-time locum, mostly at 2 very different practices. The first was an independent one man band at which I enjoyed the freedom to treat/recommend as I saw fit. The second was taken over by a corporate and I was "encouraged" to offer the full "evidence based gold standard" to every pet coming through the door, with the simpler treatment options very much an afterthought.
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again, vet practice 2, the practising vet being discouraged from transparency - seems an increasingly serious issue, and, yes, a lot of people also seem very concerned about that.
 
The insurance arrangements where the bill is sent straight to the insurer without ever coming through the client don't help either from a transparency perspective .

It is for the dogs but Animal Friends deal direct with the vets - which sounds great - other than you have no idea what they have charged or for what - and with an older dog you have to pay 20% so you just get requests for money from the insurer and no idea what it relates to. I've asked the vets for copy bills but I get "we're just dealing directly with the insurers" so subtly refusing to give me a copy. I haven't made a massive fuss about it.


I am really not generally vet bashing - they are trying to walk a tightrope between some clients who "can't handle the truth" at one end of the spectrum and others that don't mind brutal honesty, and not having enough staff (in ours anyway) so the dog never sees the same vet twice. Dealing with people who don't pay, can't pay and then financial targets / trying to make a living.
I'm not surprised they can't fill vacancies - a lot calmer ways to earn a living.
 
Gamebird said:
Exactly. I recently dealt with a complaint concerning lack of testing for something that is an everyday condition that our vets see literally daily. I suspect if I put a photo of it on here 99% of people could tell me what it was straight away. Testing for confirmation would add probably £200 to the bill. However due to the issues raised by this complaint and the time spent on it and general unpleasantness of the whole experience we will probably be offering testing every time we see it now. None of us feel this is necessary, but if we offer and the client turns it down then we will be better able to defend ourselves against similar complaints.

And like you I also had a client threaten suicide yesterday. In this case if I did not find a way to make their geriatric on-it's-last-legs horse last a bit longer. I genuinely don't know the answer to that one. The problem is real!
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Threatening suicide is increasingly common, unfortunately, the student who doesn’t get their desired grade, the patient who doesn’t get the required outcome or prescription from their practice, even due to sold-out venue admissions(!): you can offer to call their next of kin or GP for support, you might refer them to a counsellor if your service provides them, suggest a contact to counselling services (public or private), or to a charitable service such as Samaritans. If they start seriously disruptive behaviour - police (as if police weren’t stretched enough already, but they can at least take next steps towards Sectioning a serious risk, and take responsibility out of your hands)
 
Exasperated said:
Threatening suicide is increasingly common, unfortunately, the student who doesn’t get their desired grade, the patient who doesn’t get the required outcome or prescription from their practice, even due to sold-out venue admissions(!): you can offer to call their next of kin or GP for support, you might refer them to a counsellor if your service provides them, suggest a contact to counselling services (public or private), or to a charitable service such as Samaritans. If they start seriously disruptive behaviour - police (as if police weren’t stretched enough already, but they can at least take next steps towards Sectioning a serious risk, and take responsibility out of your hands)
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😲😲 Seriously?! Should a vet really have to deal with any of that?! I really just want my vet to be able to get on with vetting.

I'm not even a vet and I feel fed up with the general vet bashing and crazy expectations just in this thread.
 
paddy555 said:
the bold part is precisely what I want. That is what I am asking the vet. In your opinion having seen dozens of cases with this problem is it likely to be cured/kept under control.


so I want the vet to give me a kick up the arse and point this out based on their experience. That way I can go away happy I have at least done the right thing however horrible it has been.

I don't need it done in the way of the agricultural old vets, or the hunting people it can be done nicely and kindly but that is what is needed.

I shop online so am thankfully spared Maureen at Tesco and for info I only look at vet sites/medical etc sites so I am also spared the SM frenzy. :D:D:D:D
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Is the shove from denial to despair for some people and then the vet is having to deal with a distressed owner that they don't really need on top of what is an already stressful job.

People in general don't seem able to cope with anything negative in their lives these days. I think there is too much protection from bad stuff (blurring of minor blood in online videos and censoring of certain words) and people just aren't used to dealing with it anymore.

Life isn't all sunshine and rainbows, sometimes you have to wade through a seemingly never-ending river of shite and people need to learn to deal with it, not be constantly told it can't happen to them.
 
Matafleur said:
😲😲 Seriously?! Should a vet really have to deal with any of that?! I really just want my vet to be able to get on with vetting.

I'm not even a vet and I feel fed up with the general vet bashing and crazy expectations just in this thread.
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Of course they shouldn’t, nobody should have to deal with that sort of emotional leverage and coercion - see earlier threads: .apparently common in vet experience today - do not accept ‘responsibility’ beyond forwarding that person to more appropriate (and hopefully better trained) adults
 
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