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21 Responses to “Vets vs. Doctors”
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about 2 weeks after I was stitched up in the er, my dog had to be stitched up by the vet. very similar injuries with similar suture kits. my bill was over $1100, while the dog’s bill was $140. the dog received a more in-depth assessment…
my only beef with vets her in missouri- they passed a law in my county that people cannot vaccinate their own pets. a licensed veterinarian must administer the vaccine and submit the paperwork to the county. I used to be able to vaccinate (exact same brand vaccine as the vet uses) our 2 labs and buy them treats for under $20. The cost has more than doubled PLUS I have to pay for an examination, because they won’t administer the vaccine without checking out the dog. This drives the cost up between $50 and $90. It doesn’t matter that I don’t need a licensed doctor to administer flu vaccines to me (you can go to any drug store and pay $20) or that I’ve been a paramedic for over 20 years and have administered medicines to countless patients.
Both of my parents are doctors, and I recall more than once getting drugs or minimal treatment at the vet. There’s a lot of really basic medical care that is standard, and for which quality is determined not by complicated diagnostic technique but competent execution. I want my dad to do figure out why my kidney isn’t working, but stitches just take practice, so give me an RN for that. I know first hand that doctors often don’t get a lot of practice with that sort of thing, and I’ve got some pretty clumsily sewn scars to prove it.
I think this video makes a lot of excellent points.
But lets not forget that the only people and pooches included were those with the money to afford Vet care. Absent are those with little or no money to afford care or no owners who are put to death or allowed to die.
Treat me like a dog, but only if it is a dog with a rich owner.
I have seen this kind of competition and entrepreneurial, including all the customer service ethic, in human health care, too. At places that provide cosmetic surgery, homeopathic treatments, “wellness”, sports therapy, etc. IE those that fight for the same luxury dollars as vets.
Again, I agree with much of what the video says, especially about competition and the hold existing doctors and hospitals have over limiting competition, but lets at least admit that this is not apples and oranges, it is apples and candy bars.
Marty,
When I was employed in ERs they wanted me to get a full history and physical to sew someone up! A check box system was on the ER sheet, to prove that I did it! That does not mean I had to do the actual history and physical, only that I had to fill in the check-box. That meant that I could participate in an illegal process, and that would allow me to be in compliance with the hospital. I made too much noise about these things and ended up being told I would not longer be asked to return to any ERs by my employer, an ER physician service. You can bet if the billing was ever questioned, the doctor (me) would be the one, the powers that be, blamed and accosted for the legal implications!
The result in billing meant a much higher charge for the same procedure. I always complained it was a ridiculous waste of time, and likely, unethical behavior. A question about bleeding, and allergies would suffice in most laceration repairs. But, I am wrong! They have established the it is standard of care to carry out such wasteful, time consuming, expense raising, acts! Hospitals also know that if one has not insurance, they can actually collect more by fleecing that patient!
When I sewed up someone in my office, the fee charged more closely resembled your dog’s. $1,100 a whack?!! I could have made a good living doing that, alone! Then again, my local hospital complained I did too much stuff like that in my office. They were unhappy with my honesty,as well!
And, it was not that I lacked the abilities. I had been trained in large hospital as a general surgeon on trauma call, every time I worked! And that was before the government limited call time! I got more experience, than those who participate in residency training in today’s environment.
When I later practiced chronic pain management, I really understood how people were treated worse than animals, by their own doctors and government interference. My rebellious nature ended in permanent unemployment!
I find it extremely difficult to believe that Tricky Dick really thought that by limiting hospitals, health care costs would go down. No, I’m not buying that at all.
Trish,
He thought price controls were a good idea, why not hospital construction controls?
Just to share another anecdotal story –
We brought our dog to our vet because she developed a serious limp – the vet did some x-rays, stuck a needle in her for a biopsy and determined very quickly that it was cancer and the only option would be to amputate due to how advanced it already was. Less than a week later she recieved her surgery and was already home. The service we recieved from the vet was world-class. They even offered to allow us to watch the video of the surgery (we passed)! We also opted to do physical therapy with our dog and of course there were numerous medicines she had to take over a period of time – then to have on hand in case pain re-appeared. In total, it cost us less than $2000 – which we paid to one provider, not multiple – and we could not have been more happy with the service recieved (including silly little things like a doggie valentine card and a doggie birthday card). That included x-rays, surgery, anathesia, all of her medications, therapy, two nights at the vet and all follow up related to that surgery. They actually had the bill prepared for us when we went to pick her up – it was simple to read and they sat and explained every line to us. The staff really cared for our dog and it showed.
In contrast, my dad had to have his leg amputated below the knee. Between the multitude of appointments he finally got his surgery date. While a couple of the nurses were fantastic, the overall experience at the hospital was awful to say the least. The interactions with the doctor were quick, cold and very transactional. The insurance side of the equation was a fiasco and frustrating to say the least. Funny thing is, even the waiting room in the vet hospital was nicer than the places we met with the doctors (tv’s, better reading materials, etc). Thankfully the surgery went well. 4 months later we finally saw the bills… fortunately he has extremely comprehensive health insurance courtesy of the taxpayers and his union (state employee). There were probably 6-10 different providers who billed – everything from the anethesiologist to the hospital to the doctor who billed separate from the hospital to the physical therapist to you name it. The bills were confusing, seemed to bill twice in some cases and offered little to no explanations. Not to mention the ungodly cost of the medications. When totalled up, it was well in to the 6-figures. Or about 50 times more than what it cost for our dog to recieve better, more propt, and friendlier service.
One thing that keeps liability costs down is that in texas if a vet kills a pet the only thing they are on the hook for is the replacement cost of the pet.
The other is the incredible amount of paperwork/oversite that is required by human insurance is not present in the vet world.
Amazing how close these carbon based biologics are!
@Doc Michael
Interesting story. Unfortunately, I believe it entirely. I’m not exactly sure what type of business entity you were working for, but do you think that part of the reason behind the need for a full medical history was related to legal risk management? I say this, because it sounds like a classic example of a business going to great lengths to keep down costs. Obviously, that’s probably a little overboard, but that tends to be how things like that go. That would then bring up the idea of tort reform as a solution to keep down costs. I’ve never seen a really good financial analysis of what tort reform would do, and I’m an attorney with a vested interest in that subject, so I’m hesitant to take a position.
One thing that keeps liability costs down is that in texas if a vet kills a pet the only thing they are on the hook for is the replacement cost of the pet.
The other is the incredible amount of paperwork/oversite that is required by human insurance is not present in the vet world.
Yeah I mean this clearly isn’t a straight across comparison on any level. I mean, my cat occupies less space than a milk crate, eats like $.25 of food per day, isn’t apt to be traumatized by the manhandling she receives at the vet, and probably isn’t going to accidentally give the vet a disease.
Michael-
I’m thinking the exams were a way of allowing you to increase billing to medicare? Ambulances do a similar thing by checking the ‘patient unable to walk’ box, because, in the insurance company’s eyes, if you can walk you don’t need an ambulance.
The $1100 I paid was because it was in an er, where inflating costs is a real art. But, what else are you gonna do in the middle of the night and you have to work the next day?
Oh, that’s just great! You Reason people just can’t keep your mouths shut, can you? Now we’ll have state after state passing con laws for vets. Next it will be puppy health care reform.
@Marty, So you paid $1100 in the ER because you don’t have medical insurance, how much would you have been paying all along if you had it? I have a very affordable medical insurance plan here (subsidized by my employer, I pay $300 per year). I have *never* had any reason to go to the doctor since I’ve worked here. I’ve paid upwards of $1200 for nothing. On the other hand, you’ve paid $1100 for actual service rendered.
Starting with Mediaid/Medicare, insurances have only driven costs up. Simply because they often bilk providers on prices. A $10 prescription (including markup, labor, cost, etc) often gets reimbursed by the state for less than a dollar, pennies over drug cost. Private insurance takes their queues from the state, they pay maybe a dollar over drug cost. How can any provider make money like that? So they inflate their prices, to the point where the state reimbursement is profitable. That’s why when you get your medical bills, they’re so freakin’ high. If you’re lucky and you can, talk to your provider. Often times you can get better deals if you’re paying cash.
I’ve paid upwards of $1200 for nothing. On the other hand, you’ve paid $1100 for actual service rendered.
Uh, that’s how insurance always works. If you are lucky, you’ll always pay more in health insurance, auto insurance, homeowners insurance, etc, than the insurance company ever pays you. If you come out ahead on the insurance payments, then really bad things have been happening to you. But, think how much worse they would be if you didn’t have insurance.
‘@Marty, So you paid $1100 in the ER because you don’t have medical insurance, how much would you have been paying all along if you had it?’
I have good medical insurance, which did cover the bulk of the procedure. I was pointing out the differences in the actual costs of similar services.
$1100. You got off cheap. Several months ago I had to have 8 stitches in my left leg. Because it was a Saturday I had to go to the emergency room. When I got there I was taken to a treatment roon immediately after a woman passed out in the waiting room because of the blood on my leg. They just put a wrap arond the leg to catch the blood and then sent me for an EKG and a heart sonargram. I’m a big guy, 6′-5″ 290 lbs., they told me that since I was overweight they had to do these tests. I asked why they couldn’t just get the results of these same tests that I had done in that same hospital two weeks ago, and was told they couldn’t because of privacy laws. I finaly got the stitches and went home after 4 hours. When the insurance statement came in the mail, the final bill was over $4800. Imagine if I had to pay cash for that.
you had to pay more for 8 stitches than a good used car costs! ERs have pushing costs through the roof down to a science… They charge $68 every time they take an automatic blood pressure. $300 to hook you up to a 3 lead heart monitor, which is OLD technology.
‘Imagine if I had to pay cash for that.’ nobody would. that’s where medical savings accounts would kick this nonsense in the teeth.
Vets are more compassionate than md’s. when one of my dogs died, vet called me personally to tell me how sorry he was; sent me a sympathy card & a follow up phone call.
When my grand daughter had spinal surgery, the md came out said she’s going to be paralyzed & walked off. fortunately he was wrong, she is fine but he was a jerk.
#10, Legal risk management? I guess if that is if you think about it the same way as the war on terror. If you are afraid, you are going to be attacked by terrorists, then, by all means, spend a fortune for anti-terrorist measures. Should we spend that money on something that is not at all likely to pay off?! Can we afford it either way?
Risk management has been the cause of many of these things you cite. But, in the long run, much of it is, just, rhetoric to assure a bigger paycheck for the hospital (provider) involved.
Even, the above story,about the guy having an EKG for sutures? It should be blatantly obvious to the most casual observer, that this is only one, of many tricks, used to separate the patient from his money! It is unethical and immoral to make a person have an EKG, just because he walked into your ER! I think there is too much hype about “risk management” when you do a CT scan for everyone that has a bump on the head, too. It is not always cost effective to do so. But, “there is a minuscule chance that you might develop problems. We must have the CT!”! That is not very good risk management. If we made sure it was done, then who is going to pay for the needless tests? Who is going to call them out on this stuff? Can we afford to be wasteful when we know that the risk is actually over-blown? If we spend more on this type of thing, there will be less for patient care. But, it is the money we talk about and not so much the patient care. Caring for the patient, also means providing to him the most affordable care available. Not soaking everyone through over-billing!
Jim Collins,
Sounds like you were lied to! Privacy laws should not interfere with you obtaining those records, easily! They, obviously, knew a way to cheat you out of the money involved in having that test! There is getting to be a conflict of interest based on how much money they seem to be able to soak you for! They can manipulate you because you are ignorant of the things they are doing. That is why we should demand that high ethical standards be followed. If getting excess tests, pays them more, it should be obvious what rules they are playing by!
Laws were set up to keep doctors from owning certain typed of clinics because of the same conflict of interest ideas. It is required by law that the doctors tell their patients of any conflict of interest they might have by ordering tests at a facility they own.