Sunday, December 13, 2009

A Veterinarian Breaks the Code of Silence



If you have been waiting for a veterinarian to confirm everything I have been saying about veterinary price-gouging and medically unnecessary services, your wait is over.

For eight years Matthew Watkinson worked as a vet. Then he quit and wrote a book about the rip-off industry he found himself in.

As he notes in an article in The Daily Mail, a great deal of veterinary care is based on price-gouging for medically unnecessary services:


Today you will notice more and more practices have sprung up throughout the country - especially in those affluent areas where the middle-class residents treat their pets as part of their family.

One might imagine that because there are so many more vets that animals need more medical help than ever. But the truth is far simpler. A whole industry has arisen out of squeezing the most money out of treating family pets.

During the 'health check' that goes with a jab visit, it is amazing how many problems the vet might find

It is not unheard of for vets to Google a pet owner's home to see which area the family live in. Big house in a posh road - well, you can offer more treatment to that pet owner, of course. I never witnessed this in my practice, but I heard of it happening. Charge more for your services so a vaccination that costs a few pence becomes a £35 'consultation'. And that isn't all.

While the owner might believe he or she is only taking their cat for a vaccination (and I have no problem with sensible preventative healthcare) for the vet, this visit can be a way to make even more money out of a perfectly healthy animal.
During the 'health check' which accompanies the vaccination visit, it is amazing the potential 'problems' the vet might find.

So your vet discovers your cat has a seemingly innocuous chipped tooth? I have known of cat owners told that despite the fact their cat is perfectly fine - and frankly animals in the wild break their teeth all the time and do not need expensive dentistry work - that to remove the tooth is justified 'just in case' it later causes a problem.

Having a tooth removed, especially a canine tooth, is major surgery - costing upwards if £100 - and should only be done if the cat is suffering because of it.
But more often than not, a loving owner will trust their vet and sadly go along with surgery that is not only unnecessary but plain risky for a pet who does not need it. Similarly, I have known vets suggest doing an 'exploratory' operation on a cat just because it had been sick. But like humans, cats and dogs get sick from time to time. The best response is to wait and see, not offer a battery of blood tests and invasive operations.

Having allowed their pet to have such an operation, the owner when the pet recovers will put this down to the operation being a success. It is not: if nothing was found, your pet would have begun feeling better anyway. Possibly sooner.


Watkinson goes on to note that veterinary insurance encourages price inflation and choices which too often lead to more pain and dysfunction, not less. He writes:


Which brings me to another issue that helps vets to carry out these expensive and totally unnecessary procedures - pet insurance.

These days, pet insurance is pushed as a 'necessity'. Sit in any vet's surgery and you are left in no doubt as you survey the dozens of adverts for it that 'good' owners have it while 'bad' owners do not.

'However you look at it, pet insurance is simply a licence to print money'

So unsurprisingly, the average middle-class family feels more comfortable having this insurance. They have medical insurance for their children, so it's only natural that they want the same for their family dog or cat. Insurance for a pet dog or cat costs on average from £60 to £250 a year. Worryingly, if you have pet insurance you can be sure your vet is more likely to offer your pet treatments - because your vet knows you won't be paying so you can afford it.

But, however you look at it, insurance is simply a licence to print money. Unfortunately, the only creatures insurance helps are vets. If you are a loving owner you will not want to put your pet through cruel, lengthy and costly procedures.


Watkinson also notes that many vets are complicit in the embrace and continued adoption of breed standards that result in deformed, disabled and defective dog.


But vets aren't only guilty of treating animals when there is no problem. Sadly they are guilty of creating problems in the first place. Take bulldogs. They have been hideously bred to have a characteristic collapsed face. This restricts breathing and stops them panting properly.

Ridiculous as it may seem, they have also created an animal that can't breathe fast enough to have sex. So a bulldog must be artificially inseminated by a vet using a general anaesthetic.

Once pregnant, the bulldog faces another dreadful side effect, again caused by breeding. Bulldogs have such a small pelvis that most are unable to give birth naturally. So 90 per cent of bulldogs require a Caesarean.

If the vet were truly putting the animal first, he would refuse to inseminate a bulldog in the first place. Instead, to ensure the welfare of the bulldog, vets should be insisting that pregnancies only occur in bulldogs that can mate naturally.
But, of course, they won't say that or refuse the breeder's wishes - after all, as a vet you are making money out of all of these medical procedures. An insemination costs around £80 to £300 depending on the exact procedure and a Caesarean £500.

One of the reasons there are so many vets now is that vets have created their own market.

I find it outrageous that, given their role, any vet criticises Cruft's for exhibiting these dog breeds. After all, it is the vets themselves who have aided and abetted these atrocities.

And this practice certainly isn't confined to bulldogs. We have dachshunds bred with elongated spines so they look 'attractive' for their breed. But these sausage dogs are prone to slipped discs and back problems which, in turn, makes more money for vets who do many operations a year to 'help' these issues (most of which do not work and cause more suffering to the dog.)

We have cats that can't breathe because of their overly flat noses and weep constantly from eyes that are too large, other cats and dogs without fur that can't go out in the sunshine as they will burn.

The current fashionable craze for miniature dogs is also damaging. These dogs are prized on their tininess - so the smallest dogs are chosen but in reality these are the runts of the litter that used to be allowed to die as they were so weak.
In turn vets are simply creating weaker animals. They are going against the force of nature, Charles Darwin's natural selection. And because weaker animals are surviving they need more medical care from vets who force them to survive.

This is great news for vets and the reason for their proliferation. But surely not for animal welfare, which they pledged, when they took their veterinary oath, to put first.


Read the whole thing at this link.

And while you are at it, read some of the posts below for an even wider look at some of the scams common in veterinary medicine today. A little knowledge may save you thousands!


12 comments:

Mongoose said...

Does he mention that even the vaccines themselves aren't medically necessary every year?

PBurns said...

Actually, as I noted in a recent article, vaccines (other than rabies) are not needed at all after the first year. See >> http://terriermandotcom.blogspot.com/2009/09/over-vaccination-is-bad-medicine.html

P

Viatecio said...

I really do wonder about all the people who insist that "My vet really helped my dog," or my favorite "But they're the professional, they went to vet school for X number of years, they're the expert and we should defer to them." Either those vets are REALLY good (and I'm sure they're out there) or those owners are so deep in the vet's pockets that they can't tell which end is up. *cough*MY PARENTS *COUGH*

If that guy ever goes back into the vet profession, I WILL move to the UK, despite all it's faults, become a citizen there and work for him. Probably won't happen, though.

HTTrainer said...

We need disclosure from an American vet as well.
Unfortunately, any search for information often brings us to the site of snake oil vendors. These folks know how to draw in the gullible.
Would that there were investigative reporters working for a newspaper with a backbone.

Anonymous said...

I find this really interesting, as I live in a posh area of Britain (the poshest, according to home values) and have experienced none of the practices the author claims exist.

In fact, when my dog was recently diagnosed with osteosarcoma, I was surprised that there wasn't an oncology clinic in my area. I learned there are very few specialty clinics in this country of 60 million, and they only work on referral.

I would even say the prevailing attitude here seems to be for less treatment, not more, than is commonly sought in America. There's very much a "stiff upper lip" factor to it, which in my experience is even more prevalent among the upper-crust Tory population. (I wouldn't be surprised if some of them still use their guns to put poor Duke down.)

Our vet never pushed surgery on us, never recommended expensive treatment, pursued less expensive and less invasive options that I inquired about, letting us finally come to our own painful decision about treatment. He even recommended we seek medications online rather than buying them from the clinic. I've heard similar stories from friends who use other vets at this clinic, and friends who use other vets have similar experience. Overall, I've found veterinary care here less expensive comparatively than just about anything else in this overpriced country.

Finally, the fact this article appeared in the Daily Mail leads me to question the motivation of the writer. My opinion of the DM couldn't be lower--it's a gossip rag. Every day they run nothing but innuendo and gossip disguised as news. I don't even know of a paper in the US to compare it to.

Just a word of caution. Don't take everything you read in a British newspaper, especially the DM, as gospel truth.

PBurns said...

Is your vet giving your dog booster shots for distemper and parvo after that first year? Is he/she is, then the practices being described are in play. Vaccines are for the life of the dog, but a vet will almost never tell you that, will they?

P.

dogdoc said...

My post exceeded the character limit. So, this will be in two parts.

Part one:
When I first read this article, I became angry. However, my emotions changed to very sad. You see, I have been a veterinarian since 2003. This is my second career. I was a paramedic for many years before deciding to go back to school and become a veterinarian. I was in my early thirties when I made that decision and it was no easy decision. I had no college education at that time. So, I started from scratch. I went to school for the next ten years to achieve my childhood dream of becoming a veterinarian.

Here I am in my late forties with hundreds of thousands of dollars in student loan debt. I don’t know if I will ever be able to pay it off. That is not a complaint, just a fact. It was my decision to go back to school. It was my decision to borrow all that money. I take full responsibility for my actions. Going back to school to become a veterinarian was the worst financial decision I have ever made. I was far better off financially as a paramedic before I went back to school. That being said, fulfilling my dream of becoming a veterinarian was worth it. I absolutely love what I do and my clients know it.

When I first made the decision to go back to school, my mentors warned me. “Don’t become a veterinarian for the money, become a veterinarian for the love of veterinary medicine.” “There are many other professions that are far easier in which you can make far more money.” I heard this over and over from many respected veterinarians who were my mentors. They are now my friends and colleagues. These words have rung true and have certainly made me question, at times, this terrible financial decision. Albeit, the most rewarding decision I have ever made. The advice my mentors gave me has been proven in many studies comparing veterinary income compared to other professions with similar education and education debt. We make far less.

I have never (and I mean never) heard of anything like I read in this article. I have been to many veterinary conferences and no one I have spoken to or heard lecture talks about over pricing their clients or putting pets through unnecessary procedures. Quite frankly, this is ludicrous.

As the author suggested, perhaps there are some “bad apples” out there that practice medicine with the thought of cheating their clients and exploiting their veterinary patients; I just have never met them. I assure you, if this is true, it is by far the exception not the rule.

dogdoc said...

Part two:

Let’s address the veterinary practice of vaccinations as this is a much heated and debated topic. The protocols of vaccination scheduling have been very dynamic and seem to be ever changing in recent years. I should also preface this by saying that I almost always vaccinated my own pets prior to becoming a veterinarian. I would either purchase them from the feed store or by mail order. I did this to save money. The truth is, I was very ignorant. I had no idea of the quality control of those vaccinations. Okay, let me cut to the chase. We don’t actually know how long a particular vaccine lasts in a particular pet without performing a titer on that pet. This is usually cost prohibitive. So, we use guidelines from studies and take the regions in which we live into consideration when determining vaccine protocols for a particular pet. This should be discussed with the client and an educated client makes the best pet parent. I firmly believe that education and good communication with my clients is paramount. In fact, the practice I work for does not pay its’ veterinarians to perform vaccinations. Although this is a recent change, it was made so that the doctors within the practice would feel free to follow a vaccine schedule they are comfortable with. Let me repeat myself, the practice I work for does not pay its’ doctors anything to vaccinate, period. And we are a very large practice with many hospitals in many locations in the US and abroad.

In reference to specialty veterinary medicine, it is true that there are more veterinary specialty practices than ever. Please understand, this is client driven. People, over the years, have demanded higher levels of care for their pets. This does come at a price tag however. Make no mistake; it is more expensive to provide this higher level of veterinary medical/surgical care. Most importantly, to suggest that advanced medical and/or surgical procedures are offered and performed on our veterinary patients just to make money is simply delusional. It is very sad that one of my colleagues has mistakenly misinformed the public with his writings. I am very proud to be a veterinarian and will continue to serve my clients and their pets with the respect they deserve. I am confident this is true for the majority of the veterinary profession.

PBurns said...

Dogdoc you are simply not very competent.

There I have said it.

The "news" about vaccines is not new. In fact, it is more than 25 years old and comes from no less an authority than Ron Schultz. See >> http://terriermandotcom.blogspot.com/2009/09/over-vaccination-is-bad-medicine.html

The only thing "new" here is that thanks to the Internet, dog owners are now finding out they have been ripped off for a generation. Did you not know this? Perhaps not; you are a new vet.

Titers?! Good lord man, have you not heard of T-cell immunity? If not look it up. Seriously. This is BASIC medical knowledge at this point and you should have learned it in veterinary school. Shocking if you did not.

You think that vets will not perform a a cruciate ligament operation just for the money? Really? Then it must be bell clanging news to you that doctors perform heart operations on humans just for the money. Use the Google to look up Tenet, Redding and Heart and see what you get.

As for vaccines, the stuff you order through the mail has the same chain of custody as the stuff you use in your office. Surely you know that? Admit it: the truth is that you have NO IDEA where those vaccines in your office were made, their quality, or how they were stored before you got to your office. Ordering from Drs Foster and Smith is as good as going to the vet. Only cheaper!

As for scamming vets being the exception, that's not quite true either, is it? In fact, there is an entire publication devoted to teaching the scams; it's called "Veterinary Economics" and it is cited on this blog if you want to look it up.

Yes, a lot of vets are honest, and everyone has to made a buck (I am not opposed to capitalism), but almost all veterinarians now engage in scams for the reasons that you yourself note: Your college bills are very steep (boo hoo!) and there are now too many vets in this country. So what do you do? You cannot lower your prices with all that debt swinging over your head. Answer: price-gouge, recommend medically unnecessary services, take kickbacks for referrals to specialists, make money on the side selling "gray market" flea and tick medications, add overnight stays for every surgery, recommend crucitate surgery for every limping dog, sell "prescription" dog food, and (of course) "communicate to your customers." Why stress all that communication stuff? Simple: that's how you turn your customers into "friends". Only when they confuse the nature of the relationship and begin to think of you as a "friend" can you really work that "human-animal bond" thing which all the veterinary business advisors say is critical to making the big money.

Got it!

P.

dogdoc said...

I really have no desire to fight with a fellow terrierman. Some of what I stated in my comments was taken out of context. This does seem to happen with e-mails/blogging, etc. It is unfortunate that you have stooped to the level of personal insults. I prefer that we dogmen stick together. We have enough enemies out there. I always have time to help fellow terriermen. If you ever need anything, please don’t hesitate to ask. Perhaps we can go on a hunt sometime and really get to know each other. I am certain we can learn from each other. Happy Hunting and Happy Holidays!

Respectfully,
dogdoc

PBurns said...

Dogdoc, I do not know you from Adam Had'em, you have never posted on this blog before, you clearly have not read the links at the bottom of this post, and your information on vaccines is a bit thin. That is all I am saying.

And, for the record, I did not take a thing you said out of context -- I just corrected what you said, provided links, and pointed out how your financial situation (self-devuluged by you), and the surplus of vets (feely admitted to by the AVMA), conspires to drive up prices and foster the delivery of medically unnecessary services.

My response is not personal. In fact, you remain entirely anonymous -- a condition that does not represent you well, but each to his own.

For the record, one of my areas of expertise is health care fraud. Google my name and you will see I know quite a bit about this topic, and so YES I know what kinds of frauds exist, how they work, and YES I have seen them in full flower in the field of veterinary medicine where there is little or no oversight, little or no consumer protections, and a gullible and emotional public waiting to have their wallets made thinner for no other reason than the theft is incredibly easy.

You dig? If so, then you know that most of us who have real dirt dogs have learned to put our dogs back together again by ourselves. I do not need a veterinarian to give me cephalexan and neither does anyone else. Nor do I need to buy hearworm medicine lyme vaccines, etc.

I greatly value vets, especially those who are good with internal sutures. But vaccines? Well-dog checks? Annual teeth cleaning? Testing for lyme in an asymptomatic dog? Year-round heartworm medication when the temperatures drop below 50 during the day? X-rays for every limp? Give me a break! Yet, this is what veterinary medicine is all about these day, and I am not the first to notice.

The simple truth is that vets are not more honest or less honest than car mechanics. And, for the record, I would never go to a mechanic that told me I could not change my own oil or that I had to buy my oil from him because "Lord knows where that other stuff comes from."

P

Voss said...

PBurns, I appreciate your knowledge on the subject. I recently had to scramble to find a new vet because my original clinic refused to approve my dog's prescription order online without another exam. He is 6 years old and has Addison's disease. His medication is lifelong, monthly, shots of Zycortal or Percorten. Both expensive. I got tired of bringing him in multiple times a year for the same "he's doing great" result and a bill. The original vet would repeatedly fall back on the WA state legislation of a proper Vet-Client-Patient-Relationship that states any care needs to coincide with seeing the animal within the last 12 months. I understand the need for this in other cases, but not a dog, who is fine otherwise, with a lifelong condition. Do I really need to spend money for a vet exam that tells me he is fine just to get approved on medication he needs to survive every month for his entire life? I found a new vet last minute, had an exam and got the medication approved. The original vet had also been charging 3x the amount of online for prednisone. If I were to get the Zycortal from them, $100 more than online. It is ridiculous and my dog's health was not priority. Any 'fighting' words for the original vet would be appreciated. Thanks,