Vets letter to RCVS

[Tiddlypom]

Thanks to the vets who have replied on this thread.

Owners who feel ‘got at’ when asked by the vet whether the animal is insured or not are missing the point. Insurance, and if so with which provider, is just part of the animal’s history that the vet needs to know. It builds up a picture.

I self insure. If I get asked the insurance question, I answer honestly that I do not insure, but go to state in a friendly and non confrontational way that I still want to know what all the treatment options are. I have never been made to feel a lesser owner because I self insure, but then I’m not chippy about not insuring.

SA, you know you’ve been banned before under your previous username. Maybe chill a bit on this.

 

[Rowreach]

I think All Creatures Great and Small has a lot to answer for.

Reading some of the comments (and I don’t mean the ones from the vets) I’m just in despair. Who’d be a vet?

 

[meleeka]

When my vets ask if I’m insured I just reply with “No, but that doesn’t affect what I’d consider in terms of treatment”.
I’d hate to feel obliged to do loads of things to my vet phobic dog, just because she was insured, when I don’t think it would necessarily be in her best interests anyway. If it’s something that I think she’d cope with, with a good prognosis, I’m able to put it on a card I keep for this purpose.

 

[skinnydipper]

My vets are now corporate owned. Same building, same staff, but the prices are now set by the company who now own them. Consultation fee increased by £15 and written prescription increase of £8.

Rather than be seen OOH at the local practice it is now at another of the company's practices about 45 minutes away on a good day.

 

[Gamebird]

I think All Creatures Great and Small has a lot to answer for.

Reading some of the comments (and I don’t mean the ones from the vets) I’m just in despair. Who’d be a vet?

Unfortunately not me, not for much longer anyway. I've done 25 years. I'm not even 50 for a while yet. I could be looking at another 15-20 years and the thought fills me with despair. I will miss it, but I won't be in the job in 5 years time. I have set myself that as a goal to get out. It's a crying shame, but everything has changed so much that I don't really want to be part of it now. The biggest thing for me is probably the change in client perception of vets. I deal with the complaints for our practice and there are times when I think 'OK vet X, the client was right, that was a silly thing to say/do', and I hold my hands up and do my best to sort it out for all parties. I fully uphold the right of people to pet us know when they think we have done a sub-standard job - and believe me, I'd rather know so that we can sort it out. But some complaints are just ridiculous now and you can't do right for doing wrong.

Example - I went to an emergency late at night, did what I thought my best job (in terms of full clinical exam, taking time over discussion/explanation/offering options to client, handling of the animal, treatment etc.). Shortly after the bill was sent out we got a long and detailed complaint saying that I was rushed, had barely been there 15mins, had barely looked at the animal, didn't care, was negligent in my treatment etc. etc. and some other stuff that was frankly bordering on a personal attack. I honestly thought I'd done a really good job, and was pretty upset that my thoughts on the call out were so different from how the client saw it, and that they'd thought so badly of me as to make personal insults. It made me think I possibly wasn't good enough any more. Luckily my lovely practice manager gave me a kick, said 'that doesn't sound like the vet I know' and we looked into it. I had mobile phone records showing the time I arrived (had to ring them to open the electric gate) and left (I phoned my husband as I was leaving to tell him I was on my way back) which showed I'd been at their premises for nearly and hour - nothing like 15 mins! My clinical notes detailed a full clinical exam had been carried out, plus some extras etc. etc. When the client was confronted with these details they completely 'fessed up, said that they agreed that I'd been there a reasonable amount of time and actually done a good job, but they couldn't afford to pay the bill and found that in their experience making complaints usually got the bill reduced!

Now that is an extreme example, but it is not the first time, and left me, a tough old vet, pretty upset and feeling like a useless human being for at least a week. I hate to think of the turmoil it might have caused a new graduate! This might be an infrequent event, but it is indicative of the general change in attitude towards vets and things like this wear me out.

 

[SkylarkAscending]

Thanks to the vets who have replied on this thread.

Owners who feel ‘got at’ when asked by the vet whether the animal is insured or not are missing the point. Insurance, and if so with which provider, is just part of the animal’s history that the vet needs to know. It builds up a picture.

I self insure. If I get asked the insurance question, I answer honestly that I do not insure, but go to state in a friendly and non confrontational way that I still want to know what all the treatment options are. I have never been made to feel a lesser owner because I self insure, but then I’m not chippy about not insuring.

SA, you know you’ve been banned before under your previous username. Maybe chill a bit on this.

I’m fine with chilling on it - I was trying (clearly very badly) to explain/illustrate why people (customers) use the generalisations or have the perceptions that they do about vets. I don’t have those perceptions myself about the vets I use, or I wouldn’t use them.

 

[MurphysMinder]

I don’t think I have ever had a vet ask if my animal is insured as the first question, yes it may come up if more complicated treatment is needed , but that is it .
When I was facing the prospect of my dog having complicated surgery the vet booked me an appointment after scans just to discuss options and even then didn’t push me to go ahead (I did with a great outcome ).
I’m not a vet but my daughter is so I see some of it from both sides , and get so fed up with the money grabbing vets thing. Like Redders it is cheaper for my daughter to give me a prescription than get prascend/bute herself .

 

[Clodagh]

I think people are best off trying to seek out the smaller independent vets than the corporately owned ones.

Ive always said that horse vet fees are very reasonable compared to small animal. Even more so nowadays.

My local vet, and the one I use is corporate owned (I think, one man owns 3 practices, he’s not a vet).
There is also a far cheaper independent one.
I go corporate, the independent is dated, not actually nice to the dogs and has very few facilities.

 

[rara007]

Wonder how much that guy sold his practice to a corporate for…?!
And what his salary covered running a house wise vs. current vet salaries..!
£15 in ‘76 is £90+ now…
The 2 worst practices I’ve worked in were independent. Really dangerous and corrupt.
For better or worse the world has changed and I’m certainly glad there’s more options than bute or bullet now! And that you don’t need to be a farmer, game keeper or surgeons child to be of much use?!?

 

[ycbm]

But why is it a negative if it’s one of the first questions asked? Knowing budget saves all parties time and potential feelings of upset and guilt if we can tailor to budget from the off. I guess I just don’t understand why people choose to see it negatively. Why can’t it just be part of a conversation with a trusted professional?

Redders first of all can I thank you for your very professional responses and the time you've spent on them on this thread.

I think it feels negative to people who aren't insured but know that they will spend on whatever treatment they would allow for their animal, because it does carry an inference (I know you don't mean it this way) that if you aren't insured you will not pay for as much diagnosis and treatment as an insured person will.

I can't see quite what the point of the question is. You can't know what someone's budget is. If they aren't insured you can't make that judgement from looking at them - some of the most hard hearted people I've known about vet treatment have been extremely wealthy. I'm pretty sure you don't ask what savings someone's got if they tell you they aren't insured.

I would expect you to explain the optimum diagnostics and any later treatment you want permission to do, with a cost, and then discuss with the client whether and how they are going to pay.

Asking "Are you insured?" as the first question is only a necessity if your subsequent recommendations are going to differ if the answer is "yes". And that's the problem most people have with it. I do feel you should stop asking until later in the consultation.

I'll finish with a big thank you for the work you do and a metaphorical slap for the customers who make life difficult for you.
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[SkylarkAscending]

Thanks YCBM you have explained what I was trying to say far more eloquently than I did. Clearly writing is not my strong point!

 

[Goldenstar]

I don’t insure and with horses I have had the several experiences where the treatment was done in an more economic way when because I was not insured.
All these experiences have been when horses are have been referred to a centre of excellence for the problem.
Educating yourself is so important then it’s so much easier .
Apart from emergency’s don’t be afraid to take time out to think through what to do .
Don’t make expensive decisions by being bounced into thing in a room at the vets I will even say I am thinking about this I need ten minutes or if appropriate I take the horse home and sleep on it .
It’s very easy to get bounced into a situation where you have spent so much that you think if just keep going we will fix i have been in this situation once and I was made really unwell by the stress of it ,it was a terrible experience but I learnt from it .I don’t hang back now from saying to a vet this is what we are going to do .

My final point would that the inexperienced insured owner must understand that insurance is a years grace and many horses have conditions that can now be managed long term to give good quality of life and you do need a plan for how you can manage that because it’s expensive
It’s an ethically very difficult area.

 

[Gamebird]

I can't see quite what the point of the question is. You can't know what someone's budget is. If they aren't insured you can't make that judgement from looking at them - some of the most hard hearted people I've known about vet treatment have been extremely wealthy. I'm pretty sure you don't ask what savings someone's got if they tell you they aren't insured.

I would expect you to explain the optimum diagnostics and any later treatment you want permission to do, with a cost, and then discuss with the client whether and how they are going to pay.

Asking "Are you insured?" as the first question is only a necessity if your subsequent recommendations are going to differ if the answer is "yes". And that's the problem most people have with it. I do feel you should stop asking until later in the consultation.


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The point of asking is so that we can do things the most likely way to get a claim successfully made and paid. A lot of people don't realise that the T&Cs of their policy are that they have to notify their insurers straight away before embarking on treatment. They may also need to get up front clearance for things like MRI if they are counting on their insurers paying for it. Our practice also needs a claim form at the outset of treatment. We are trying to keep our outstanding debt as low as possible so try to get a claim form submitted very early in the process, followed by continuation claims as necessary, not submit one big claim several months down the line when we've been sitting bearing the costs of all the drugs, time and procedures for that period. If we know that we are dealing with a claim from one of the more difficult companies we may make extra sure to dot all the 'i's and cross all the 't's in our clinical notes to make absolutely sure they have no room to wriggle out of paying.

In short, it is an important question, and certainly in our practice it is used to help the client have the greatest chance of a successful claim. Frankly when it comes to deciding levels of treatment I do not give a flying fig whether the payment is coming from an insurance policy or out of a client's pocket. And there are lots of times when a client is very well insured, but does not wish to pursue expensive treatment because they don't feel it is right for their horse. That is absolutely fine. But for all the reasons above, and more, if you are planning to claim on your insurance we need to know. And we need to know early on in the treatment course. And therefore we need to ask.

 

[ester]

It's not just ability to pay that matters with the insurance thing though, the clock is also ticking if that is how the owner is going to be paying.
You've also got a lot more freedom of decision if you are paying rather than having to justify treatment plans with an insurance company.
(cross posted with GB on that last bit)

 

[ycbm]

The point of asking is so that we can do things the most likely way to get a claim successfully made and paid. A lot of people don't realise that the T&Cs of their policy are that they have to notify their insurers straight away before embarking on treatment. They may also need to get up front clearance for things like MRI if they are counting on their insurers paying for it. Our practice also needs a claim form at the outset of treatment. We are trying to keep our outstanding debt as low as possible so try to get a claim form submitted very early in the process, followed by continuation claims as necessary, not submit one big claim several months down the line when we've been sitting bearing the costs of all the drugs, time and procedures for that period. If we know that we are dealing with a claim from one of the more difficult companies we may make extra sure to dot all the 'i's and cross all the 't's in our clinical notes to make absolutely sure they have no room to wriggle out of paying.

In short, it is an important question, and certainly in our practice it is used to help the client have the greatest chance of a successful claim. Frankly when it comes to deciding levels of treatment I do not give a flying fig whether the payment is coming from an insurance policy or out of a client's pocket. And there are lots of times when a client is very well insured, but does not wish to pursue expensive treatment because they don't feel it is right for their horse. That is absolutely fine. But for all the reasons above, and more, if you are planning to claim on your insurance we need to know. And we need to know early on in the treatment course. And therefore we need to ask.

I understand needing to ask the question at some point, but what was being discussed was asking it before the animal has even been examined to discover what the basic problem is that brought it to the vets.
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[Gamebird]

I understand needing to ask the question at some point, but what was being discussed was asking it before the animal has even been examined to discover what the basic problem is that brought it to the vets.
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I get that bit. But you said 'I can't quite see what the point of the question is'. I was letting you know that it is actually a very important question, and why.

 

[ycbm]

It's not just ability to pay that matters with the insurance thing though, the clock is also ticking if that is how the owner is going to be paying.

But that too is very dependant on the owner. I would expect the vet to discuss with me what the optimum treatment timings are, and if the absolute best chance for the horse would result in a stage of treatment given after the 12 months has expired, and would be given before only to squeeze it in to my insurance claim, then I would pay for it.

I found it most disconcerting with my last horse when the vet said "well we've got 12 months then" as her response to me confirming that I was insured. What was that even supposed to mean? It's not difficult to put a very negative interpretation on it at a corporate owned hospital . She should not have said it.

 

[Fluffypiglet]

I think what bothers me most about this is the impact on pets and the impact and additional stress for our vets. It’s already known to be an incredibly stressful job and if additional stressors are added by bad corporate practices then we will lose them. The old practice I referred to was bad because of their customer care. One vet I disliked because he was a patronising ar$e! The other vets who were offering surgery we didn’t want weren’t bad as vets but it felt like they were having to try and persuade us. They shouldn’t have to do that. It meant we were all on edge and irritated before we got to the care of the cat!

 

[ycbm]

I get that bit. But you said 'I can't quite see what the point of the question is'. I was letting you know that it is actually a very important question, and why.

I didn't deny it was an important question and I explained exactly why I felt it should be asked later.

I think the fact that many of your clients and at least one experienced vet are finding it upsetting and/or making them question your fees should suggest that changes in timing need to be made.
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[Clodagh]

Well as a result of this thread I’ve emailed my practice and told them they are wonderful. So it’s achieved something.

 

[ycbm]

Well as a result of this thread I’ve emailed my practice and told them they are wonderful. So it’s achieved something.

The last bill I paid (£700+) I did make sure the whole team heard me loudly say "Is that all, I thought it would be more" because I know how much people complain.
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[MurphysMinder]

Well as a result of this thread I’ve emailed my practice and told them they are wonderful. So it’s achieved something.

I know how much they will appreciate that too. My daughter is always thrilled with the cards and gifts she receives from grateful patients.

 

[Gamebird]

But that too is very dependant on the owner. I would expect the vet to discuss with me what the optimum treatment timings are, and if the absolute best chance for the horse would result in a stage of treatment given after the 12 months has expired, and would be given before only to squeeze it in to my insurance claim, then I would pay for it.

I found it most disconcerting with my last horse when the vet said "well we've got 12 months then" as her response to me confirming that I was insured. What was that even supposed to mean? It's not difficult to put a very negative interpretation on it at a corporate owned hospital . She should not have said it.

And again if we know you are insured I have successfully had conversations with the veterinary advisers at insurance companies and got them to extend the 12 month deadline in cases where it may benefit them by waiting. Eg. 'if we wait a bit longer then the procedure might turn out to not actually be necessary, whereas if you [the insurance company] insist on a 12 month cutoff then we may end up spending £Xk of your money on something which we may have been able to avoid altogether by waiting a little longer - say 15 or 18 months'

 

[Clodagh]

I am usually asked when I register a dog at a practice (about insurance) and the vet then doesn’t broach it.

 

[ycbm]

And again if we know you are insured I have successfully had conversations with the veterinary advisers at insurance companies and got them to extend the 12 month deadline in cases where it may benefit them by waiting. Eg. 'if we wait a bit longer then the procedure might turn out to not actually be necessary, whereas if you [the insurance company] insist on a 12 month cutoff then we may end up spending £Xk of your money on something which we may have been able to avoid altogether by waiting a little longer - say 15 or 18 months'

I'm glad to hear that. I wonder why a young vet said what she said to me in December, if that's the case in your practice.
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[MurphysMinder]

But that too is very dependant on the owner. I would expect the vet to discuss with me what the optimum treatment timings are, and if the absolute best chance for the horse would result in a stage of treatment given after the 12 months has expired, and would be given before only to squeeze it in to my insurance claim, then I would pay for it.

I found it most disconcerting with my last horse when the vet said "well we've got 12 months then" as her response to me confirming that I was insured. What was that even supposed to mean? It's not difficult to put a very negative interpretation on it at a corporate owned hospital . She should not have said it.

I would take that as the vet intending to get the most value from your insurance for you , as horses don't have lifetime cover.
When my dog had afore mentioned surgery there was a possibility he would need it on another leg, first treatment would take me to insurance maximum but vet worked out that if needed it would be ok for him to do second leg after renewal so again I could claim the max, I didn't have it done but appreciated that the vet offered this option.

 

[ycbm]

I would take that as the vet intending to get the most value from your insurance for you , as horses don't have lifetime cover.
When my dog had afore mentioned surgery there was a possibility he would need it on another leg, first treatment would take me to insurance maximum but vet worked out that if needed it would be ok for him to do second leg after renewal so again I could claim the max, I didn't have it done but appreciated that the vet offered this option.

The best time to have said it was not before we had even x rayed. After the x ray of the lame leg we had the discussion that we should x ray the other leg so that if there was arthritis in that one too, they could be treated and claimed together rather than risk an exclusion for arthritis in the forelegs. That was a good discussion and covered the point at precisely the right time.

I've just think to protect themselves that the timing of insurance discussions needs to change. I'm not trying to criticise vets here, it just seems pretty obvious to me that if vets want to stop the accusations of profiting from insurance, they need to be more nuanced about how and when they ask the question.

Can I repeat for the avoidance of doubt that I am very thankful for the services given in the last year for all my animals, small and large.
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[AmyMay]

I simply can’t understand anyone being offended by a vet asking if you have insurance. After all if you have insurance you have it for a reason and would surely want the vet to know

Thank you to the vets, once again, who have posted on this thread. You’re amazing at what you do

I too am going to email my vets today.

 

[scats]

My local vet, and the one I use is corporate owned (I think, one man owns 3 practices, he’s not a vet).
There is also a far cheaper independent one.
I go corporate, the independent is dated, not actually nice to the dogs and has very few facilities.

Fair enough. You have to make decisions based on whats best for you and your animals.

 

[Gamebird]

I'm glad to hear that. I wonder why a young vet said what she said to me in December, if that's the case in your practice.
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Because 99% of the time the 12 months is a hard deadline. I have just had experience in a couple of cases of using a common sense approach with the insurer's veterinary adviser and getting this extended. But it wouldn't be the norm. Usually the 12months is an important factor to have in mind when dealing with insurance cases, which not all clients are aware of, and is probably why it was mentioned.