How Veterinarians Really “Line their pockets”

Moneydoc

In the blogosphere, there are quite a few controversial topics regarding animal health. Some of the most common controversial topics include pet food diets, vaccines, spay/neuter, declawing and medications. While I am not too bothered by those who have different opinions on the subject, my pet peeve is when they bring up as an absolute fact that veterinarians only think a certain way about the controversial subject because of money. So I thought I would share my perspective on how veterinarians really make money.

Let’s start with the common myths

Selling kibble makes veterinarians rich

Anytime there is a debate about pet food diets, this sentiment always seems to come up. It often seems in response to a veterinarian stating their position on a particular diet or diets. This especially occurs when there is a battle against kibble diets. I have talked about this in other articles (The Raw deal on Raw diets) so I will repeat it here. Veterinarians are generally paid in three ways. We are either paid by salary, commission or production plus a base salary, or just straight production. As far as maintenance diets being sold in clinics, majority of clients will purchase these out of convenience when in for a visit vs  from a recommendation of a veterinarian. When they purchase the food, most veterinarians (outside of the clinic owner) make little to no commission on these products because the price of the diets would have to be  higher than the cost of the maintenance diets in retail stores . This is even the case with prescription diets which we prescribe to help treat a specific medical condition. I also often hear how pet food companies also offer continuing education for us. But what many don’t realize the purpose of these continuing education courses are to provide us with information on how we can incorporate diet with treatment of various medical conditions. Also, they are used to promote their products over their competition because a veterinary clinic will typically use just one company for all prescription diets.

728 x 90

Pushing unnecessary laboratory tests

The biggest challenge in veterinary medicine is that our patients can’t talk to us. So we end up relying on the owners giving us a good history, our previous experience, physical exam findings and what signs our patients show us. Sometimes it is obvious what is wrong such as in cases with wounds, or a pet who may be limping. But in other instances the signs may be ambiguous as in cases where they are just lethargic or have a decreased appetite. So we have to perform various diagnostics such as lab work and x-rays to find a diagnosis. Sometimes we can find out the problem and hopefully a solution. But in others we may be left scratching our heads of why a pet is sick. In most cases pet owners understand this , but there are some who deem these tests unnecessary especially if we can’t find out a diagnosis after performing them. Does this mean you should accept every test that your vet recommends? No not necessarily, it is important that you have a dialogue with your veterinarian what information can be gained from each recommended test and you make the ultimate decision. If you decide not to pursue those further diagnostics and treat instead, then you have to be comfortable that your veterinarian is providing treatment without all the information available to them. Sometimes it may not be an issue and the signs may be resolved. But in other cases you may need to return for those additional tests if the treatment is not effective.

Performing controversial surgeries (declaw, tail docks, ear cropping etc)

As many of these surgeries become more and more controversial, it seems like less and less veterinarians are performing them. Also, they are less pet owners who have a desire to have these procedures performed. Despite this, there are clinics that still offer this service for clients who are interested. As far as clinics using this as an income booster, I don’t see many promoting or even advertising they perform these procedures. Most clients have to call around to several places to determine if they can be performed or discover from word of mouth. Also, I don’t know of too many veterinarians who encourage or promote this directly to their clients even if they perform these surgeries themselves.

Pushing unnecessary vaccines

Just as in human medicine, it seems like the vaccine debate is picking up steam in pets. I am one to believe that vaccines should be given based on risk of the individual pet. Pets that have more exposure to other animals may need more vaccines vs pets that stay indoors most of the time. While I understand why some owners may be wary of vaccines especially after their pet has had a reaction, it bothers me when people state our recommendations are based on purely profits vs a pet’s health. Because if we wanted to make money regarding vaccines, we would recommend less of them. Some of the most expensive veterinary treatments are due to diseases related to lack of vaccination. A good example is the parvo virus which is seen in puppies not current on vaccines. The average cost to treat this disease is easily anywhere between $500 -$1000 dollars and this treatment does not even guarantee survival.

Not performing pro bono work

This is a little different from the other topics but still relevant. There are a few pet owners who feel that just because we won’t offer our services pro-bono when their pet is experiencing an emergency we must just be in our field just for the money. Believe me, if most veterinarians were just looking for a career based on money, being a veterinarian wouldn’t be the number one choice. For all the stuff we have to put up with between getting urinated on, exposed to excrement, getting bit and scratched by our patients, there are other well paying jobs with a lot less stress associated with them. There has to be a love or compassion for animals over money for anyone to deal with this.

Real ways veterinarians make money

Developing a good relationship with clients and pets

How most veterinarians make the money is with repeat business. There are many clients willing to travel great distances and only have their pets seen by a particular veterinarian because they have developed a great relationship. This happens when veterinarians take their time and listen to their clients and understand their pet. So if you run into a veterinarian who makes this effort to get to know you and your pet then he or she is a keeper.

Emphasizing good customer service all around

Even though other factors play a role , most pet owners respond most favorable to an overall experience at a veterinary clinic. If they have a positive experience from the phone call to the office, the check in process, visit with the vet, and the check out process, then they are likely to tell their friends to add referrals. So the general point I am trying to make is that emphasizing service is more important than trying to push a particular product for increasing profits.

Taking part in continuing education to learn special skills

If you examine most income reports from any veterinary clinic you see that professional services such as hospitalization, surgical procedures, and consultations are what maintain the clinic. Many times these professional services can make up for at least %80 of the hospital income. So if veterinarians are wanting to improve their income, there is the incentive to take continuing education classes to learn complicated procedures such as specialized surgeries, ultrasound, and other specialized diagnostic testing procedures. Many times veterinarians as myself will use money out of their own pocket to take these classes. This also may mean time away from family during these training sessions just to improve convenience for their clients.

Final perspective

As in every career there are people who have bad intentions and show these while performing their job duties. The point of this article is to point out that people shouldn’t apply a broad brush to a particular career just because of bad apples. This is especially irritating when the criticism comes from people who have no experience, or education in the field they are criticizing. Often these critics rely on just superficial knowledge they obtain from the internet claiming it to be the gospel truth.

6 thoughts on “How Veterinarians Really “Line their pockets”

  1. If vets truly want to develop a good relationship with customers, then perhaps they should instruct their office staff to do the same. If I leave on bad terms, it’s usually because of a staffer that pissed me off, not a vet.

    As for the kibble debate, I’d be more likely to believe your argument if it weren’t for the fact that every vet carries the SAME brand.

    • A lot of clients share your sentiment according to client surveys that their satisfaction with a clinic does not always rest solely with the veterinarian involved. That is why there are many firms that are hired to improve client satisfaction in veterinary clinics. Many of these firms mainly focus on client satisfaction from the phone calls to the check out process. This often focuses on the support staff playing a major role.

      As far as your comment regarding the kibble debate, it not entirely true that every clinic carries the same brand. The three most popular brands that veterinary clinics carry are Royal Canin, Purina, and Hill’s. Even if they did I don’t know how that would support that veterinarians make a lot of money off of kibble. You would have to have a general understanding of marketing and profit margins. Those three companies have the most money so they are able to market the product the most effectively to clinics. It is analogous to how Coke and Pepsi are able to dominate their brands in most fast food restaurants. As far as profit margins of course there is a markup of foods so the clinic get a profit from each sale but the markup is almost never enough to provide for the salary of a veterinarian. Most clients are quite aware of food prices in retail stores since that is where they mostly buy the product from vs other services the clinic provides. So clients are quite resistant to deviate too far from these prices to pay for their pet’s food. This is a perfect example how a client’s perception can control cost of a product.

  2. As someone who has stated a few of these attempting to explain to people why a vet might not be the best resource when it comes to certain topics, I do have to take the side of the people who say these things. I know you are attempting to defend the practices, but really you are simply digging yourself in deeper.

    Continuing education should be educational not one great big advertisement for the foods your clinic sells. Yes *you* personally probably don’t make money when you sell these foods, but the clinic owner does, and I am sure the clinic owner who agrees to sell these foods is very keen on keeping you educated on the products that make them money and not on things that don’t. And as someone who studied economics I can totally understand that, however as someone who has vowed to ‘do no harm’ I can’t believe you don’t see the harm in this. Diabetic cats do so much better on low carb high protein diets.. yet even the Rx food for diabetics has a fairly high percentage of carbs in it. Cats who have urinary crystals need to have a PH that is in the 6.0-6.5 range and lots of hydration to keep the crystals in check… yet a lot of vets prescribe a dry food diet that is high in plant based ingredients (which are alkalizing) simply because it has a low quality acidifier in it. You can do so much better…

    The only unnecessary test is one that will not change the outcome of the treatment. If you are going to treat the pet with the same course of treatment regardless of what the outcome of the test is, then is the test really necessary? I have one vet at the clinic I go to that believes it is. She thinks she needs to know everything and run every test. One recent example was when I brought my cat in with her recurring annual anemia and the vet – before even getting a CBC was already mentally scheduling me for ultrasounds because there was a slight murmur in my cat’s heart and thinking of all the tests she could run to determine how much heart damage was going on because of the murmur. I brought her back to the present and said lets run the CBC and go from there, and as it turned out that her RBC was so low and her blood so thick that it was probably the cause of the murmur. Once we put her on her annual dose of pred, the murmur went away. I don’t think the vet was attempting to ‘raise money’ for herself, but she was totally freaking me out and freaking my wallet out. If I had not gone through this before with my cat I probably would have climbed on board the test train and drained my vet fund for tests that were not necessary. I don’t think she was doing this to ‘raise money’ but because that is the world she lives in.. test everything, know every possible outcome.. which can be great, but sometimes knowing the answer doesn’t change the solution.

    Simply because you don’t do ‘controversial procedures’ doesn’t mean there aren’t vets out there who don’t. I used to work for a vet who claimed there was absolutely nothing wrong with any of those types of procedures and was very happy to do them and I am sure he still does. There are many out there who offer ‘combo packages’ to encourage these procedures. You probably won’t find signs on the front lawn nor on websites or facebook pages any more because of the reaction of people who find these procedures controversial and their extreme reactions – just look at the ‘best vet contest’ that was recently closed – but that doesn’t mean they don’t do them any more. Do they do them because it is healthy for the pet? No. Do they do it because of the profit? Probably some of them, but I bet if these procedures were required to be done at cost there would be a lot less people offering them.

    Vaccines. That is a very controversial topic since there is no consensus of DOI. There are some experts in the field that believe that most if not all vaccines confer a life time of immunity. If this is true, then any vaccine given after the initial one is ‘unnecessary’. Even the current recommendation of every three years is woefully out of date as there have been DOI challenges that have proven five and seven years. Since vaccines are not as safe as we are lead to believe (when was the last time you gave a client the package insert that comes with vaccines? when was the last time you had a conversation about possible side effects?) I think that even the current recommendation is ‘too often’ but there are still vets who do them annually, which IS too often. Many vets do not even consider the pet’s lifestyle when giving vaccines. I often wonder how many even bother reporting side effects to the FDA.

    I would never and have never chided a vet for not doing pro bono work. I have occasionally bristled under an annoying ‘baggage fees’ that are tacked on to keep the clinic healthy and robust, like medication dispensing fees and hospitalization fees when spending an afternoon at the hospital is part of the requirement of the procedure, but I very much want the clinic I use to remain in business and be healthy so that they are there whenever I need them. Paying vet fees isn’t easy, but it is part of owning a pet, and one I am glad to do – I just don’t want to feel nickle and dimed. Charge me more for the dental and skip the hospitalization fee.. Charge me more for the exam and skip the dispensing fee.. etc.

    While I don’t love my vet, I really really appreciate him (and the vet that works for him) because without them my cats would suffer. I thank them constantly, I bring them goodies when I think about it.

  3. Dr Alleyne,

    This is very interesting. I have had so many different types of veterinarians. I do cat rescue and have taken our cats to many many different vets as well as having moved 3 times I have had vets who charged very little and did not sell a bunch of retail items in their practices. They were mostly older vets who have presumably long since paid off their student loans (one graduated vet school the year I was born – 1966!) His particular interest was bringing low cost veterinary care to low income people in that city and his office was in an area with few veterinarians. But if I wanted something cutting edge, I did not go to him, I went to one of my different vets who was younger and (presumably) kept up more with research, had things like veterinary dental x-ray machines, etc. Then if something really bad happened (cat with complete endocardial cushion defect:() I went to the cardiology specialist at the state A&M. Of course I expected to pay different amounts to all these types of vets. Fortunately my regular vet (whom I adore) puts up with my requests regarding vaccines (I try to follow http://www.catvets.com/guidelines/practice-guidelines/feline-vaccination-guidelines but I do keep my negative cats vaccinated against FELV as I have positive cats). In some areas I politely request things he doesn’t typically do – for example I always request pre-surgery bloodwork while he recommends it only for cats over a certain age. I also get post spay and neuter pain drugs and I will not have spay/neuter done on a cat at a veterinarian’s office who will not provide them. Fortunately my vet tolerates a lot of my eccentricities. He also chooses to waive his exam fees (I have never asked him to do this) for me most of the time. This makes life much easier when you have quite a few animals. I’m surprised he does not charge me a lot more, I must be the biggest PITA client ever. Oh, I also request non adjuvanted vaccines for all my cats.

    I often speak up when people complain about high vet bills. I remind them that vets went to school for many years and really are underpaid when compared with similar professions such as MDs, that specialty vets cost many times less than specialty MDs, etc. It bothers me no end when people decide that because they can’t afford something or because they found this injured animal that is not theirs that the vet should provide free vet care. I had a wonderful vet who worked with the animals of the homeless for free (I would love to start a charity like this), but i never would have asked her for free vet care. I remind them that vets have mortgages or rents to pay, utilities to pay, staff to pay, and if they are providing people with too much free vet care they are not going to be able to pay these bills.

    Having said all that, I am a bit put off when I go into a vet’s office and it looks like a retail store with 1/3 or more of the floor space taken up by retail goods. Sorry for such a long comment!

  4. People will always be ignorant and oblivious to the veterinary field unless you work in it. We treat your fur babies as if they were our own. We made this career choice for the love of the animals and to help them live longer, healthier lives with their humans. It is also a business, and just like any other business, profits need to be made in order to pay the bills, the staff, and for the medicines and supplies to treat the pets.
    This article is spot on.

Feel free to leave a comment about this blog article

%d bloggers like this: