Monday, May 31, 2010

A Vet Pushes His Dependency Model

This video is typical of how veterinarians are now selling a dependency model.

The message is not "if your dog is sick we can cure it." The message is that their wallet is empty and they you need you to fill it!

Watch the video.

This vet starts off with a generalized message about the importance of vaccines. He then goes on to note that he has been in practice for 30 years and never seen a case of distemper.

Does he explain why distemper is so rare these days? No he does not.

So let me explain it: Vaccines are good for life.

After that first round of vaccines given in Year One, your dog never needs a vaccine again other than a single rabies shot every three years.

And guess what? You can skip the vet for that rabies shot too.

You can get a rabies shot for $10 (complete) down at your local shelter, and without an $80 office charge tacked on to boot.

Notice that this vet never mentions any of this. He never says vaccines are good for the life of your dog. Instead he shilly-shallies around before finally changing tack:

"Bringing the dog in for vaccination is not about vaccination, but about bringing the dog in for an exam."

Eh? So vaccines are not about vaccines? They're about "exams"??


Vaccines are about vaccines, and let's not get confused about that, eh?

Routine office exams are about bill padding and selling unnecessary medical services.

This vet says you need to bring in your dog twice a year "to see what's going on."

You can skip that.

I can tell you "what's going on" if you are bringing in your asymptomatic dog to the vet twice a year: A whole lot of junk billing.

For starters, every "well dog" visit is going to cost you $80 or more just for crossing the threshold. Nothing done at all, so far.

As I have noted in the past, however, once a veterinarian gets you through the front door, their staffs are trained to start pushing nail trims (a charge), useless Lyme disease tests for asymptomatic dogs (a charge).

They may suggest a "prescription diet" (which they just happen to sell), and they will try to toss in a "booster shot" every time they think they can get away with it, and never mind if it is medically unnecessary.

Your dog will be tested for heartworm (even if it is under 6 months old and cannot possibly get it), and you will be given heartworm pills to dose your dog with every month, even if it's a Minnesota winter outside.

If your dog is spayed or neutered, there will be a push to keep the dog overnight so an additional charge can be tacked on to the bill. And, of course, you will want to get a stool test, right?

This is how it goes in the veterinary business these days.

What is being sold here is a "dependency model"

Dependency model veterinary practices generally have vets who make vague and mewing sales pitches like the one being given here.

Their goal is to get you in the door multiple times a year so that
pushy receptionists and "vet techs" can run through well-rehearsed scripts designed to get you to buy goods and services you do not need and did not ask for.

One way to get you in the door is to serve up a dish of confusion when it comes to vaccines.

For example, listen to this vet's line about how there might be different vaccine protocols for "different rates of exposure"?

What's that mean? I have no idea. It is complete nonsense.

Remember this same vet just said that in 30 years of veterinary practice, he had never even seen a case of distemper.

So much for "rates of exposure!"

In fact, rates of exposure has nothing to do with vaccination.

I am fully vaccinated against measles, mumps, rubella, and a whole lot of other diseases. I do not fear catching these disease when I ride subway cars filled with recent immigrants who have just entered America from God knows where.

They can all have measles, mumps and rubella, but I am not going to catch it because I was vaccinated as a child more than 45 years ago! In fact, a little exposure to a live virus is a good thing for my immune system, as it switches on my T-cells and gives them a brief workout.

What about dogs?

The same holds true for them.

The vaccines they get in Year One last a lifetime, and any dog walking through a park is going to have his immune system challenged, to positive effect, by latent diseases on fence posts and in the soil. No problem there at all.

So what is all this vague talk about "lots of different options?"

Simple: this is the windup a vet gives when he or she is sizing you up for a big bill.

And here's the pitch. It comes right out of the marketing literature and bill-padding training camps (more on them later) being funded directly by Big Pharma:

"The important part is to get that animal in and have him examined twice a year.

Every year in a dog's life, they say, is seven years in human years, so every year you are going through seven years.

It's not like you want to go in every year; you want to go in twice a year and have him examined."

If your vet tells you this, leave immediately and never come back.

Here's why: your vet thinks you are an idiot. You have just been insulted, and you should be pissed off about it!

A year is a year. There is not such thing as a "dog year." That's a story knocked up for a 7-year old to explain why his Cocker Spaniel is an adult at age 5, but his 7-year old self is not.

Question: Do you think this vet tells hamster-owners that because their animals live for only three years, "every month in a hamster's life is really two years in human years, so you need to bring in your hamster every month just to see what's going on."

Nope. And it makes no more sense for a dog.

A twice-a-year well-dog visit? Forget it!

Here's better advice: Between the end of your dog's first year, and the end of its fifth year, your asymptomatic dog does not need to see a vet at all.

At the age of five years, go in and get your dog's teeth cleaned, if you want, and do it again at age 10. In between, simply brush your dog's teeth once a week with human fluoride toothpaste and an old toothbrush retired from your sink.

Spend time on your dog, not money. Brush his coat once a day and make sure you run him thin not fat. Check him over for ticks and lumps. If your dog looks fine, and acts fine, it is fine.

Your leashes should be worn from use, not the magnetized swipe strip on your credit cards.

For the record, "Pet Doctors of America," is nothing more than a local veterinary clinic near Jacksonville, Florida.

So why the fancy name that suggests it's part of a national chain or an industry-wide trade association?

Simple: If you are a veterinarian pushing medically unnecessary goods and services, you need to claim as much authority as possible.

"Pet Doctors of America," I think we can agree, is a pretty big claim for a brick storefront located in a strip mall next to a Pappa John's.

Aside, from the grandiose name, however, this veterinary office is unexceptional in its sales techniques.

Selling medically unncessary services, price-gouging on meds, and bill padding is now normal in veterinary care.

Can you still find an honest vet?

Of course, but you're going to have to look.

The industry is changing rapidly and, in the field of ethics, at least, the change is not for the better. Support honest vets with your honest dollars. Stop feeding the liars, thieves, cheats, and conveniently ignorant.


Bjarne said...

Is there any risks with "over vacinating" your dog besides being riped off?

PBurns said...

See the article link at the end >> "Over Vaccination is Bad Medicine"

The short answer is YES: autoimmune disorders and tumors.

There is a reason vets do not over-vaccinate their own children and their own dogs.

Of course autoimmune disorders and cancercous tumors are merely a probability; money down a rat hole is guaranteed.


Viatecio said...

Um, wow, he just kinda blew through that whole thing like he either made it up on the spot or someone was very adept at flipping through cue cards. Half of what he said went in one ear and out the other.

On another note, I've never understood charging for a nail trim. It's a necessity that it be done, or else the dog will suffer if the nail is allowed to grow too long. Annual vax are NOT a necessity, nor are bi-annual exams or yearly teeth cleaning, and the dog will not suffer if not given these services. Nail trims with me have been and will always be free, and I just might "conveniently forget" to write in any patient's chart that it was done, if I can get away with it.

Internships start next quarter, and I'll be interested to see how this plays out in the 2 clinics at which I'm interning vs the OSU hospital where I'll go next winter.

bestuvall said...

May I suggest a book that has some great advice much like what you are saying..
"How To Afford Veterinarian Care Without Mortgaging the Kids" you can find it on the internet.. written by an old time vet with a lot of common sense.. I give away lots of copies every year. I got the book when I heard a "receptionist" tell a little older lady with a small fluffy that she needed to "retest' her dog for heart worm because it has "been a year" When the woman stated that she had dosed the dog faithfully every month.. the "receptionist" said "oh but if you give the medicine without the test your dog could DIE" I wanted to SCREAM NO .. your dog will not die. But your vet will be wealthier..
Now I have no problem with vets making money.. none.. but giving out false information and scaring people is just plain WRONG.
By the way.. Busby ( author of the book ) agrees with you about vaccines.. so do I

Bjarne said...

Thanks for the info Patrick!
I will check your links better next time.....

Anton said...

Unfortunatly you cant travel or particpate in athletic events without all that crap :-/

FrogDogz said...

If your dog is spayed or neutered, there will be a push to keep the dog overnight so an additional charge can be tacked on to the bill.

Yeah, I went through that one not long ago. I NEVER leave my dogs overnight, but this new clinic was pushing, and basically telling me that they "couldn't" release my dog the same day, as she had to stay 'for observation'.

"What time does your clinic close?", I asked them.

"6:00 pm".

"And what time do you re open?"

"8:00 am".

"And who's here overnight?"

"No one, unless we're called in on an emergency."

"So who exactly is 'observing' my bitch all night long?"

They let me take her home, finally, but they did make me sign a waiver. I did, and I also found a new clinic.

I also recently had a vet 'prescribe' a $4,000 MRI for a puppy who had been limping for less than a day. The owners were convinced that, if they didn't do the MRI, the puppy's leg would fall off. I convinced them to do the traditional 'crate rest, aspirin' regimen, and the puppy was fine two days later. I'm sure it's only a co incidence that, since this clinic got an MRI machine, everything from lameness to the sniffles seems to require an MRI.

bestuvall said...

ps.. if you go to his website. you can order in bulk.. no I am not related to him..but the book makes great gift.. or something for your next rescue raffle.. or "puppy pack"

PBurns said...

When vets get expensive machines like MRIs, they find every reason under the sun to use them to bill for them. In Hawaii, the put an end to nonsense use of MRI machines, but requiring three independent doctors to certify the need. The result is that if you really need an MRI, you can get it, but it's not trotted out for every sprain and headache. Health care costs in Hawaii are lower as a consequence, despite a lot of spinal cord injury (due to surfing) and breast cancer (probably due to a lot of DDT spraying in the 60s).

As for the Old Country Vet fellow, I have featured his videos and book on this blog before.... see the search engine. :)


Viatecio said...

"There is a reason vets do not over-vaccinate their own children and their own dogs."

It didn't dawn on me until now, but I do genuinely wonder how many vets follow their own advice and do stuff to their pets on the timetable as they recommend to their clients. I know it won't be too much, if any $$ out of their pocket--no office charge, wholesale vax prices (no markup) and probably same with meds--but do they really give their own annual boosters, yearly heartworm test, teeth cleaning, Lyme stuff, etc? Quite honestly, one would hope not because it's just intuituve that the vet would be smarter than that...but then again, the hallmark of "responsibility" in pet ownership is following along with what SOMEONE ELSE recommends who is interested in making a living.

I only ask because I know a lot of clients like to hear what "YOU" use because, hey, if "YOU" use it, it must be good...what about food? How many vets really feed what they sell in the clinic? I know I'll have a hard time with that because I frankly hate the majority of what vets sell and would never feed it. But if asked to give a recommendation? Do I do what Patrick mentioned and play the part of the [hypocrite] vet, or do I say what I really do?