Vets - should they have all the equipment?

[flowerlady]

Re previous discussion on my dogs nose re sneezing. Over the weekend she started having little spells when her breathing became an issue so Monday took her straight back to the vets (new vets opened in the village recently). The receptionist said oh there's not a vet in at the moment but if she requires more than just an injection or consultation then you'd have to go to our main surgery in ****. I said then you should have that on the door I thought this was a main surgery and you didn't tell me that when I bought her her on Friday and took £36 off me to look at her and inject her. So I rang my previous vets and told them what had happened booked her in for an appointment early Tuesday morning. Took her there the vet says well I think it may just be reverse sneezing

I said I know my dog and I am sure she has something up her nose blocking it at times and explained about the breathing now. So he says well we can sedate her and look but you can only look so far up a dogs nose without a very small endoscope! I said well look with that then while she's sedated

He says we don't have one and would if necessary have to refer you to Derby. So I said excuse this daft question but why don't you have a small endoscope? He says because they cost over £12,000 (I felt like saying well you charge enough in vet bills) but I didn't. Anyway they sedated her x-rayed her head and flushed her nasel passages found a small lump in her throat and say that will go on it's own. She hasn't sneezed once since so I think they must have flushed it out but said they couldn't find anything. That cost another £160. They can't afford an endoscope. Am I just behind the times where charges are concerned??

Sorry for long rant. But Lucy is happy now

 

[SusieT]

And you'd complain if they doubled their bills to afford the equipment...
It all comes out of private funding so until they have earnt enough/have enough money they simply can't have the equipment.
your 160 was paying for all the equipment they used to sedate etc

 

[CorvusCorax]

When my dog was having problems, he needed a procedure which was impossible at our small rural surgery so I had to take him to a city vets for his op/exploration/etc and no it was not at all cheap.

However I didn't think it was realistic to expect this vets, which is better equipped and more used to treating cattle and sheep, to be able to capably do a very fiddly exploration of my dog's nether regions - the surgery where we ended up taking is more used to doing these sorts of things.

 

[Aru]

the equitment is very expensive and most need constant tests and assessments from qualified people to keep it up and running safely.....particularly the newer tools for small animals....

If evey vet practice that was setting up had all the toys then the only clinics would be in large towns and cities.
A smaller clinic simply cannot afford to run in the same way as a larger one does.They are good for injections,general check up's etc but a small vet practice is more like a gp than a hospital

he did offer to refer you to somewhere that had the gear so i dont see what the issue is.....
charges sound fairly normal to me
you could ask for a broken down bill and see what exactly they are charging for?most practices are beginning to do that now

Glad to hear Lucy is ok either way!!

 

[flowerlady]

[ QUOTE ]
And you'd complain if they doubled their bills to afford the equipment...
It all comes out of private funding so until they have earnt enough/have enough money they simply can't have the equipment.
your 160 was paying for all the equipment they used to sedate etc

[/ QUOTE ]

But this vets has 3 surgeries and the main one I would have thought would have had this equipment. The vets I use for the horse was my next port of call they seem to have all the equipment but do large animals not just small like the vets I take lucy to. Sorry but yes I actually do expect them to have the equipment. You wouldn't set up business and say I can't afford the equipment to do the job but I can tell you what you may need to do and I will charge you for the privilage.

 

[flowerlady]

[ QUOTE ]
the equitment is very expensive and most need constant tests and assessments from qualified people to keep it up and running safely.....particularly the newer tools for small animals....

If evey vet practice that was setting up had all the toys then the only clinics would be in large towns and cities.
A smaller clinic simply cannot afford to run in the same way as a larger one does.They are good for injections,general check up's etc but a small vet practice is more like a gp than a hospital

he did offer to refer you to somewhere that had the gear so i dont see what the issue is.....
charges sound fairly normal to me
you could ask for a broken down bill and see what exactly they are charging for?most practices are beginning to do that now

Glad to hear Lucy is ok either way!!

[/ QUOTE ]

No no you misunderstood or I didn't explain very well. The vets that's opened in the village has a large practice that does horses etc and small animals but they opened a branch in our village but there was no vet there just 2 receptionists (no customers or patients)!!

My original vets has 3 practices which is the one I took her to and they didn't have the equipment and both of the vets have been going for years and years so yes I would expect if they deal with small animals that they would have an endoscope. I obviously expect too much

 

[CAYLA]

No input re the equiptment as suppose it depends on the client base and if it's worth it.....if another branch of the same practice had the equiptment then thats fair enough, we do and we book and share the equiptment between 2 branches.

Re the clinic being routine, if this is the chain of branches u usually use they should inform u re post IMO thats it's a routine and not an emergency clinic and a vet may not always be on premises so if need be u can not waste time and go straight to main clinic.

 

[flowerlady]

[ QUOTE ]
No input re the equiptment as suppose it depends on the client base and if it's worth it.....if another branch of the same practice had the equiptment then thats fair enough, we do and we book and share the equiptment between 2 branches.

Re the clinic being routine, if this is the chain of branches u usually use they should inform u re post IMO thats it's a routine and not an emergency clinic and a vet may not always be on premises so if need be u can not waste time and go straight to main clinic.

[/ QUOTE ]

Thank you I thought it must just be me. They did not inform me it was just a clinic. Infact when he first looked at her on Friday he said if it gets worse bring her back?????? So I did. What for if they can't do anything without the equipment?

 

[Aru]

Ah i did misunderstand i though you were talking about different branches of the same vet practice throughout your post...sorry bout that.

I still think it is too much to expect a rural mixed practice to have all the equitment though.
You need around 12000 people in an area before you can set up a basic vet practice.
If your talking about adding extra equitment that you will not be using regularly, then you need to be a very large practice with an established client base in order to offset the cost and keep the business going.

12000 euro endoscopes are not going to be found in small practices unless they are very specialised small animal clinics...they are just to expensive and not used enough.
An xray machine etc is more important.

Re the clinic being routine,it sounds like it might just be a new branch of the old clinic?
maybe the vet's were just out on the emergency call?
They may well have an xray machine there though so they would have been able to sort out your problem if you waited...
But if they are just a routine clinic and not an emergency one then then they should have told you.In case you had a genuine emergency in the future...

 

[SusieT]

There is an easy answer then, find another vet who does have it

As it is private and you can choose where to go, I have to say I would also not have been thrilled at the lack of equipment and would have gone straight to one with the equipment without faffing about with referrals. Vote with your feet

 

[at work]

It comes down to economics. We have referals partly because expensive equipment is not often needed, some things a small practice might spend thousands on and use once or twice a year. How long before you complain that the equipment used was out of date? But it perhaps hasn't even paid for itself yet. So to avoid that happening one place takes referrals when item is needed for diagnoses, so they get to use the equipment more often and it pays for itself.

Expecting them all to have everything is a bit like asking a GP to function like a city hospital.

 

[AmyMay]

[ QUOTE ]
But this vets has 3 surgeries and the main one I would have thought would have had this equipment.

[/ QUOTE ]

I have to agree - I would most certainly expect a 3 surgery practice to have at least an endiscope. Which nowadays is a pretty routine bit of kit to have.

.

 

[flowerlady]

As SS says an endoscope I would have thought would be used quite often so as not to cut open they are small animal vets and I still think they should have the equipment. My horse vet has one place they do large and small animals and if I will be going to them if I need something like this again the only reason I didn't have them both with the horse vet is they are about 15 miles away but that will not be a problem anymore.

 

[Wishful]

What is "all the equipment"?

Veterinary equipment ranges from X-ray machine, basic ultrasound, needles, syringes and scalpels to MRI machines, endoscopes for birds, hamsters, elephants and tigers and specialist orthopaedic plates and such like.

Some large animal practices are purely ambulatory - all the kit is carried in the vets' cars - others have a surgery base and others have a full hospital with several operating theatres and 10 consulting rooms.


My OH's practices has 3 branches. 1 of the branches doesn't have operating facilities, one has limited facilities and the main surgery has full operating facilities and a consulting room. There are reception staff there full time, and vets come in for the surgeries, or are called in for an emergency. There will probably be a vet in the main surgery most of the time, depending on what other calls have come in but vets will spend limited time at the branch surgeries, which are appointment only. The emergency number goes through to the main practice, and they will locate a vet. They have endoscopes, but it should be remembered that endoscopes come in lots of different sizes - and dogs come in rather different sizes compared with humans!

Equally vet practices are businesses. They have to look at bits of kit in the light of economics. Say a bit of kit costs £12,000, and has working life of 6 years, to be realistic, it would have to earn £2,000/year to be economically justified. Say an operation using it would be charged at £200 (and £100 of that is drugs), the bit of kit would need to be useful for about 20 cases in a year for it to be economic to use.

It's classic catchment area theory - a supermarket (or referral practice) has a far larger catchment area than a village shop (or standard village vet practice). You would expect to be able to buy potatoes at your village shop, but would not expect to find filo pastry, blueberries and tamarind paste there.

Cynically speaking - if you want a vet practice with all the toys, you're going to need to be looking at one of the specialist referral centres or universities, and be prepared to pay the costs that relate to buying and maintaining all the kit. This will reflect in the cost of all things (such as basic consults) as well as the more complex operations.

 

[flowerlady]

Wishful. The vets that didn't have the endoscope were the main operating one (not the village one that just opened). It is the one main emergency one. The village vets that have a main surgery didn't have one either at their main clinic which also deals with emergencies.

I just think that surely they would use an endoscope at least 20 times a year?

 

[star]

we have 2 different sized endoscopes, but we dont have a rigid rhinoscope so are still limited with how far we can look up noses. we just cant afford a rhinoscope as well. all this equipment costs a fortune. we have just splashed out on digital xray and now dental xray as well which will be far more useful than the rhinoscope we might need a couple of times a year. if we get a case that needs a rhinoscope we'll refer it. we are a big hospital practice but we still cant afford everything. some things are only within the scope of the referral hospitals.

we also have a branch practice where there is only a vet present for a few hrs in the morning and afternoon, no facilities for surgery etc. we do tell people this when they register with us and advise them if it's an emergency or thier animal needs surgery they will have to get to the main hospital.

 

[Wishful]

Indeed, but the "main base" of a 3 branch practice isn't really what I'd define as a referral centre. That's just a largeish practice. They probably have no more than a couple of consulting rooms! Oakham Vet Hospital is probably the main referral centre round that part of the world.

Going back to my supermarket analogy - branch practice is like a Spar, main surgery of that practice would be more like Tesco Metro, 20 vet practices would be like standard Tesco/Sainsbury supermarkets, moving up to the universities being more like Harrods or Selfridges!