Why are Vets so %$#ing Expensive? (…or, an update on the Brindle Dog)

Last week, I took the Brindle Dog to the vet. (YES!!! The Brindle Dog is still alive! It’s amazing and wonderful!)

I took her to the vet because she continues to decline and sometimes the only thing that reassures me is having the wonderful Dr. Beggs actually lay hands on her and talk me through my worries.

This is the appointment where I finally made the decision to stop trying to keep my dear old dog alive. No more diagnostics, no more trying to figure out how the cancer is spreading. Now she just gets her painkillers and steroids and antacids and all the other pills and supplements she needs to be comfortably pain-free. She’s a sweet grey-faced old girl, wobbly in the back end, slowing down both physically and cognitively, with the start of kidney disease, pale gums due to anaemia, and a newfound tolerance for the cat. Her most favourite thing in the world is treats, and her second most favourite thing is cuddles.

All kinds of things are falling apart for her now, but I have had over two years since her initial cancer diagnosis to say goodbye. It is okay now if she has to go. She’s tired. Partly that’s the anaemia, partly that’s the cancer, partly that’s old age (fourteen is pretty good for a shepherd!), and partly it’s her anxiety to keep performing well and stay on top of things. I try to mitigate that for her by anticipating her needs, and encouraging her to follow the Fluffy Dog’s lead, but she has always been a dog who feels responsible for warning and protecting her pack.

The old Brindle Dog has to pee an awful lot now. I’m up once or twice a night with her. She clicks down the hardwood hallway to the back door and whines softly, not wishing to bother me, but in need. My “mommy ears” hear even her tiniest squeak, and I go out into the yard with her, squinting at the night sky while she sniffs out the right spot. Then time for a quick cuddle before we both lie down and fall back asleep.

But back to this vet appointment. We had done bloodwork, one last draw to see what was going on before I made my decision to stop trying so hard. I’ve spent so much money on this dear dog over the last couple of years, all the checkups and medications and supplements and tests…. It adds up to a lot.

So I went to pay my bill after this visit and bloodwork and when the number popped up, I was surprised. “Are you sure this is right?” I asked, and the staff nodded warily, no doubt ready for a rant about the cost. “It seems wrong,” I said. “Are you sure you got everything? We did bloodwork, too. This seems too low!”

Now it was the staff’s turn to be surprised. I guess it’s not very often that people think they’re not being charged enough at the vet.

But the thing is, a veterinary business has a lot of overhead. For this particular visit, the bloodwork was less than $70 and the follow-up visit was less than $50.  Basically that means they lost money on my visit.

Here’s the service I got for this single visit:

• two different people dealt with me to book the appointment in two separate calls: in the first call, they kindly squeezed me in for a Saturday, then I called back and changed the appointment to another day.
• on the day of the appointment, I showed up early and called from the parking lot (phone call number 3) to let them know I was there and ask if I could come in (the Brindle Dog is horrible with other dogs). I couldn’t go in yet, so…
• when it was safe to go in, a staff ran out through the cold to knock on my car window and let me know I could go in.
• the Brindle Dog was cooed over, petted, and weighed. Staff recorded her weight and took me to my favourite room, while skillfully and discreetly keeping the Brindle Dog away from any other dogs.
• A vet tech came in and took a thorough history and listened to me describe my dog’s faeces, urine, energy, coat, lumps, appetite, water intake, oestrus, cognition, medications and supplements and treats, stamina, itchiness, and general demeanour. She took copious notes and was empathetic while at the same time asking pointed clarifying questions.
• Before she left, the tech asked if my dog would like a blanket to lie on, and when I accepted, she returned with a large, thick, soft, clean blanket.
• Before the vet came in, she and the tech reviewed the history.
• The vet came in, took the time to greet both me and the Brindle Dog in a sincerely welcoming way, and admired my old girl profusely. We went over the history together, and the vet did a physical exam. She discussed her findings with me and we talked about various options (including a possible blood transfusion  and an ultrasound). I agreed that we should do a blood test, and the vet went to get two techs to do the test right away so we could have the results before I left.
• Two vet techs came in to draw blood. Because many years ago I trained to be a vet tech and worked as one for a while, the people at this clinic always kindly allow me to be present for these kinds of procedures. I helped hold my old Brindle Dog while they drew her blood. The blood draw involves the education and expertise of the techs; their ability to soothe and manage an anxious, high-strung, confused old dog; the actual physical materials (syringe, alcohol, tubes, etc.); the lab equipment needed to actually analyse the blood, including not just the machines themselves, but the slides and the chemicals, and the knowledge needed to use them; and finally, the education and experience needed for the vet to interpret the results, explain them to an anxious owner, and make appropriate recommendations.
• The vet came back and I told her I want to start just letting the Brindle Dog go. We discussed what that means to me (I’d give antibiotics for an infection or stitches for a wound, but not blood transfusions for her anaemia, for example). The vet had compassion for my decision and was able to outline all my options without pushing any of them on me, so that it was very clear what I was declining and what consequences that might have. When I asked the question that all vets must dread (“Am I doing the right thing?”), she was supportive of my decision and respectful of how difficult it is.
• When we were done, the vet and staff worked together to make sure the Brindle Dog and I had a clear dog-free path out the front door to the car, and then I returned to pay my bill and discuss how cheap it was.
• After I left, they had to clean the floor of the exam room of fur and drool, clean / sterilise / replace any materials and equipment used, replenish the generous amounts of treats they’d given her, launder the heavy blanket they’d brought in, add any notes to the chart, compile my bill, process my payment, and send me a follow-up email with some additional information I wanted. (Also, one of the techs drawing the Brindle Dog’s blood got a full-frontal canine sneeze in the face, so there was some clean-up and washing of glasses involved there!)

I know that’s a lot of detail, and maybe the service I get there is a particularly good because I am a long-time client who does my damnedest to be polite and appreciative to every person with whom I interact no matter how anxious or stressed I am. But my point is that when you pay for veterinary services, you are not just handing your vet that full amount to put in her pocket. You are paying for staff, rent, utilities, materials, continuing education, sick time, repairs and replacement of equipment, and on and on and on. I had face-to-face contact with one veterinary doctor, two veterinary technicians, and three reception staff on the day of my appointment, and a fourth staff on the phone beforehand.

There are people at my work who walk in every day with a grande latte from Starbucks. People with season tickets to the Jets and / or the Bombers. People who have season tickets to the symphony or the theatre or who go to Mexico for ten days every winter. So many of these people are happy to ask Google or ask me (with my outdated and limited vet  tech experience) what to do with their dog / cat / bunny / budgie because “I don’t trust vets. They’re just out to make money!”

Right? How horrible that vets and techs and their staff have to earn a living like anybody else! How awful that they are trying to give the best service possible at reasonable prices in a competitive market! How reprehensible that they are starting local businesses and creating employment!

A big part of the problem is that people feel like vets are guilting them into choosing the most costly diagnostic and treatment options. But honestly, they’re not. The guilt is all yours, and that’s your own issue to work out. Vets are explaining all of the options and the potential consequences of declining those options, primarily because that is the correct, professional, and ethical thing to do, but partly (wait for it) because they don’t want to get sued by your sorry ass when you make a stupid decision. (Oh, yeah, add insurance to the list of bills they have to pay!)

You should trust and follow the advice of your typical veterinary doctor as much as you trust and follow the advice of your typical family doctor. Yes there are better and worse ones, yes there are ones who care more or less, but it’s on YOU to be an informed consumer and take responsibility for the decisions you make based on the information they give you.

Take the Brindle Dog, for example. Maybe if we did an ultrasound we’d find out more about how her cancer is spreading and we’d be able to try some different treatments to help her. Maybe a series of blood transfusions would prolong her life enough for her to have this whole upcoming summer to nap in the sunshine. But I decided not to do this. Partly because she’s gone through enough already. Partly because the meds she’s on now seem to be keeping her comfortable and happy. And yes—partly because of the cost. I know she will probably die sooner than she otherwise might because of these decisions. But that is MY decision. I am not going to whine that the vet should give me a discount or freebie on potentially life-saving or life-prolonging treatments. I chose to have this dog and she is my responsibility. Dr. Beggs and her team provided me with the information I needed to make a decision I can live with. And I am going to own that decision.

And honestly, if you have season’s tickets to pro sports or a daily latte or an annual trip to Europe and that’s more important to you than paying a medical professional to take care of your loved one, you don’t deserve a pet. These animals trust us to make good decisions on their behalf. We owe it to them to get them the professional care they need to the very best of our ability, even if we’re grumpy that there is a cost involved. Medical care for your pets is not optional.