I would think a vet might feel a bit more comfortable Teri, if an animal had insurance as they might feel there is a greater chance of them getting paid.  However, you are right that the client may not tell the truth.

>I have always had to pay bills before having the animal released back to me in two different practices.

This is it thou, if the client can't pay, they don't get the animal released, what does the vet do with a poorly dog/cat etc. 

I remember at the AMC, I had to pay 50% of the bill upfront before any treatment and they wouldn't take cheques or accept insurance claim forms and the bill had to be fully paid on the day of collection.  It made me suspect that they must have had cases before where the treatment was provided and the client couldn't pay.

Our experiences with the GUVH have been that consultations and initial treatments / tests (bloods, x-rays, scans etc) are paid immediately after consult is complete and thereafter a bill awaiting us for each individual visit.  When it was established over a period of time that the insurer was refunding the costs, further bills were sent direct by the hospital to the insurer.  Talking to others when there, that seemed to be fairly common but only when trust had been established between the Admin centre and clients (for want of a better description!)

> All payments to the practice must be made in full before leaving the surgery - regardless of the pet being insured - so nowt difference insofar as getting by the receptionist goes LOL.

At our vets with an insured pet, you only pay the excess and they claim the rest from the insurance, but even then, if arranged with the vet (who do seem more lenient with long-time customers), they are happy to wait for the payment to cover the excess.
You do need a note on your pets file from the vet though or you will not get past the receptionist.

Quoting Blue:I moved a year or so ago away from my previous vet , I can't fault their work but they were really taking the mick with the fees.   My current vet is more modest, excellent all round.  So overall I get the best value for money from them without sacrifices quality of care.  They are only 2 miles apart. One charges nearly twice the price for everything..

But surely that tells you something? There are TWO practices within 2 miles of each other, one charges half of the other yet the other is not going under. That means people DO use them, probably for good reason, or they would not still be in business....... It's perfectly possible of course that the two practices have entirely different overheads. As anyone is allowed to see any vet they want, everyone do have the choice where to go.

Quoting Teri:I have always had to pay bills before having the animal released back to me in two different practices yet when attending the Vet hospital they were happy to post bills out or send direct to the insurance company when they started to get very expensive over a short period.

Sounds like you've been unlucky. I can't remember the last time we paid for anything at the vets at the time of treatment -we just pay when we can, simple as that. They know they always do get paid eventually, and for larger bills will happily give us a few months if needs be. Anything else gets paid on payday LOL. We currently owe about £500 (had to have a dog stitched ten days ago) and there's never a word said about paying up. Of course, this has all been EARNED by us -the trust. It's not offered to everyone.

Hi Marianne

> Sounds like you've been unlucky.

Why it's the norm with vets around here and, from other posts, not exclusive to my area either :) 

> Of course, this has all been EARNED by us -the trust. It's not offered to everyone.

That appear to suggest that it's you who believes yourself lucky   I've used three different practices over roughly 20 years and even going back to the first one a notice said all fees had to be paid in full at time of treatment, so it's hardly a new age idea.  I don't go to the supermarket or chemist or clothes shop and expect them to say send the cash on - a vet practice is a business and, apart from those less able to afford due care for their animals and an understanding attitude by the vet given that info, I fully appreciate that its good business practice to have bills settled as and when the treatment and/or meds are dispensed.

I also believe I have the trust, EARNED, from my current and previous vets - but I respect their practice policies, one of which is payment due on day of treatment :)

Hi mastifflover,

> At our vets with an insured pet, you only pay the excess and they claim the rest from the insurance

I suspect that some vets, were an animal to need expensive treatment and ongoing checkups with meds etc, and the client be known to them over time, that it would be decent of them to let the client pay the minimum and get the rest from the insurance company - on the proviso they were satisfied that the client was suitably covered :)  After all were treatment for eg to reach £5k, I'd assume the vet would satisfy him/herself that the client's policy covered that amount and more if required? 

> This is it thou, if the client can't pay, they don't get the animal released, what does the vet do with a poorly dog/cat etc

True Spender - their choices would be limited.  I would hope that most practices have a back up scheme whereby instalments can be made but then again I would also hope the client was honest enough with the vet at the outset to avoid non-payment being a total surprise. 

Other than agreeing a payment in part basis beforehand, I'd guess there's little the vet could do other than release the animal, invoice the client and demand payment within say 30 days of date of invoice failing which outstanding amounts may then be sought through a debt agency, small claims court or similar .... but that's only guesswork of course!

I wonder just how common it is for vets to be told at the end of a consult or well into an expensive treatment that the client can't pay? 

>I don't know how your vet works JG but here the client has to pay up front.

I don't understand - do you mean that the client has to pay before anything's done?

>Does the client not still need to sign a form to give consent to a GA?

Yes, unless it's an emergency life-or-death situation. But many x-rays don't need a GA because of the restraint facilities.

>I have always had to pay bills before having the animal released back to me in two different practices

Nope - the animal is always released to the owner and never held to ransom - a deposit then payment by instalments can always be arranged.

>Other than agreeing a payment in part basis beforehand, I'd guess there's little the vet could do other than release the animal, invoice the client and demand payment within say 30 days of date of invoice failing which outstanding amounts may then be sought through a debt agency, small claims court or similar .... but that's only guesswork of course!

An excellent guess - that's exactly what happens! :-)

>I wonder just how common it is for vets to be told at the end of a consult or well into an expensive treatment that the client can't pay? 

Surprisingly common - you'd be amazed (I was!) just how many people 'forget' to bring their handbag/wallet when they attend with their animal, even when it's a pre-arranged consult and not an emergency, and only think to mention it to the vet as they're leaving the consulting room ...

> Surprisingly common

I should think that's why there are notices in the first place then, rather than just for the sake of it.

I genuinely believe vets are pro care before money - we rang up a HUGE vet bill over the Easter weekend most of which was paid by my debit card as OH thought he'd lost his wallet and cancelled all his bank and credit cards (wallet was returned to him but cards by then useless!).  The emergency vet practice later used for around £500 or so of treatment (already paid my own vet almost £200! beforehand) took the first couple of payments on each visit and on third visit wanted to keep my dog overnight. 

We explained that we didn't have any other cards and they were great and said we could just drop in when the bank had sent out new ones - even although they didn't know us from Adam :)  We duly collected out girl on Easter Sunday morning although she was back in again later that night and no mention was made of payment (shift changed) as they'd obviously recorded it and saved any embarassment.

I think if people are reasonable with vets over issues like this then most will be very understanding.  I'm sure no good vet (which IMO has to be the vast majority) would ever leave an animal to suffer rather than wait a bit for fees to be settled but their customers shouldn't expect to take liberties based on that view!

>I don't understand - do you mean that the client has to pay before anything's done? 

Sorry no, I meant there and then once the treatment has been given and as the animal is released.  With the AMC we had to pay 50% up front before the dog was treated.

For those vets that don't accept bills to the insurer direct, the client would have to pay before submitting the claim and having it approved so I'd be rather concerned about letting a vet loose on tests that he didn't feel legally obliged to tell us about. 

Insurance is not a bottomless pit, there is a limit per condition or period of time etc, etc depending on policy.

Out vet's practise used to let clients run up accounts but had trouble getting them to settle up so in the end they stopped it.  They will now only do it for a select few.  I just don't like owing money so I pay him there and then.  :-D With ongoing treatment, I've paid at the end.

>Other than agreeing a payment in part basis beforehand, I'd guess there's little the vet could do other than release the animal, invoice the client and demand payment within say 30 days of date of invoice failing which outstanding amounts may then be sought through a debt agency, small claims court or similar ....

That's fine but it all adds up, it takes time and money to reclaim unpaid monies.

Well I have a very good Vet who certainly is not money grabbing and his fees IMO are not over the top. However, were I think being insured makes a difference is in how much treatment is given to the animal. I do not have mine insured as I put money away for them and any puppy money that comes in goes into my dogs money pot. Recently when my dog was diagnosed with lymphoma, I had a referral to the University hospital. I e-mailed them to see if they received the referral and then telephoned to see if they had the referral. The response from the telephone call was ' I see you are not insured, do you realise how much this treatment will cost', my answer of course was I don't care about the cost. She then said she would go and talk to someone and come back to me. I had an appointment within 2 days (which I am eternally grateful for). I am convinced that if I hadn't pushed my girl would not have been seen as quickly and therefore may not be with us today. Now my own Vet wouldn't have needed to ask this question as they know that I would always pay anything required for my dogs.

Exactly that is right a choice we all have choice but that doesn't mean that someone isn't charging a lot more or making larger profits.  Marianne people will charge what people will pay.  There are more pet owners around today that there has ever been but I don't believe more vets. Where there is demand etc..

People are often swayed by fancy exteriors , some without any doubt think that means they get the best treatment. ( not everyone is born with good common sense :-)   

I manage part of a business that part made 2.2 million dollars last year, my first quarter this year I have done 1.1 million so I am pretty good at understanding how to make money. I actually have two centres that I personally manage one in Scotland and one near London.    I charge 2 completely different prices for services offered , believe it or not it is the Scottish one who's services are more expensive BUT our over heads for the office in London are 4 times that of our Scottish office.   My profit margin is 5 times that per person in Scotland than my Southern office.  We need both though and both make money.  Too complicated to go into here but it was just an example of how things are not as they seem at times.  The fundemental difference between my two centres is the type and size of customer.

Now comparing this back to the vet example I can 100% bet without even seeing the books that the vet surgery that the one that is a lot more expensive that the other has a higher % of customers that have insurance..    That is where some vets have been very clever at building relationships with insurers.  It is business.. 

Anyone on this thread or anywhere else for that matter who believes that the prices are due to overheads or the services offered alone in my opinion doesn't grasp or 100% understand business.

Charing more for a services doesn't mean your offer a better one ;-)

Hi Blue

> I can 100% bet without even seeing the books that the vet surgery that ithe one  that is a lot more expensive that the other has a higher % of customers that have insurance...

Completely agree :) 

The two vets nearest to me, about a 1 to 1.5 miles apart have very different price points for a number of "routine" treatments, the more expensive of which is largely in an area populated by the reasonably to very wealthy and an often well heeled elderly population.  It is in a large, very outwardly attractive, sandstone detached villa with various extensions and looks very impressive - YET, unlike a few others within reasonable commute, doesn't for eg have ultra sound equipment.  In the 12/14 years or thereabouts when using that vet I don't ever recall seeing a cross breed dog and frequently watched as clients were helped load their cars with tray after tray of tinned prescription foods for their dogs and cats.   That is the practice I left only because of their abhorrent behaviour explained earlier when having a dearly loved pet, well known to them, pts. :(  I didn't at that time insure my pets but noticed a great many did.

My current vet practice is equi-distant from home and again in a reasonably affluent area, large sandstone semi detached one time town house, but the fees for things like routine consults, vaccination, neutering and dental descale are quite a bit lower than the former yet hip scoring and private health certs for eg are higher which leads me to believe that possibly my current vet penalises (for want of a better word) anyone likely to be breeding ...... Perhaps because any/all breeders using that practice have insurance cover?  Perhaps in a category seen as more wealthy?  Perhaps some other reason?  Who knows!  Even so compared to a lot of price points posted here on other threads it does seem as though even routine procedures are much higher than the norm and I know compared to the vets I use on the coast when away with the dogs that I seem to pay dearly (at home) for their most basic welfare.  But then again I now have all of the dogs fully covered and perhaps this impacts on the comparisons ;)

my parents have been with my vets for well over 30 years (there is now only one partner left from the original 3) I have been attending that vets with various pets since I can remember, ive also done work experience there when I was at school.  I am still with that same vets although it is not my most local, but I trust them.  They are not the cheapest, we have these new vets all over our town which do offers on vaccinations and neutering so thats where I go for those, but for any other treatments I go to my own vets because of the relationship I have built with them.  They are aware that im not a complete novice and listen to my views.  we have a sign up saying all fees must be paid at time of treatment, when I was having a bad time of it a year ago I would have to take my mum with me to the vets to pay the bill so I could then pay her back when the insurance came through.  After doing this a couple of times the receptionist suggested that I just hand them my claim form and I have done that ever since.

Hi ClaireyS

I believe that having a long term trusting relationship with my vet, just as with my own GP, is very important :)  They get to know us over the years and, importantly, the animals too - they more easily remember their history, (not that everything wont be fully recorded anyway), know whether their clients are a little too paranoid (MOI! probably :-D ) and would also I believe be more understanding about unexpected or temporary problems with payment :)

I've used three different practices over roughly 20 years and even going back to the first one a notice said all fees had to be paid in full at time of treatment, so it's hardly a new age idea.  I don't go to the supermarket or chemist or clothes shop and expect them to say send the cash on - a vet practice is a business and, apart from those less able to afford due care for their animals and an understanding attitude by the vet given that info, I fully appreciate that its good business practice to have bills settled as and when the treatment and/or meds are dispensed.

Still seems unlucky to me if you after all these years STILL have not got that privilege -and even get asked to pay on the day if an animal is PTS.  I've never heard of any vet doing that. :( Let's see, I have used 3 different vets in the past 26 years in 2 different countries, and I've never been expected to pay up front, other than perhaps on the very first few visits. (That's obviously not counting referrals to different vets.)

Charing more for a services doesn't mean your offer a better one ;-)

That's DEFINITELY been my experience though -you DO get a better service at more expensive vets. When I said just now I've had 3 vets in 26 years -I forgot about the vaccination vet. I use a different vet for vaccinations as they are so extremely cheap. And there you REALLY do notice the difference. If it's not down to overheads, I'd like to know what it IS down to! My normal vet charges a lot more than the cheaper vet. He has a nice hospital (actual hospital status) in an affluent area with all facilities (but you get all sorts of people coming there, including those form the poorest areas of town), have good vets, most with extra qualifications, deals with referrals, whenever you are there the vet takes their time etc and you feel you get what you pay for and are never rushed, they do all they can to help out. The cheaper vet, they have small premises in a very poor area (very rough as well, an area which has been in the news more than once just recently and I'm not surprised at that) and they don't even have computers, they still write all notes down on cards like vets used to do in the 80's. Apart from the owner, they ONLY have vets that are newly qualified, it tends to be their first job (when they advertise for staff, they specifically mention they welcome people that have just qualified), and hence you get a lot of foreigners that have come to the UK from abroad (only place I have ever seen Indian vets for instance) -and so each vet only stays a short while then moving on to something better. Comparing these two vets are a bit like comparing a McDonald's to a posh restaurant, the difference is that big. And with the cheaper one, you get rushed appointments, it's a bit like a conveyor belt at times. Hence we'd NEVER take an animal there that actually needed some form of treatment -but vaccinations we go for as you typically save up to £20 per animal.

So in my experience you certainly DO get what you pay for.

Hi Marianne

>Still seems unlucky to me if you after all these years STILL have not got that privilege

I may well have if I ever asked for it :)  However I don't think it's appropriate TBH to not pay for something which I have received - as I mentioned before, I neither know of nor would expect any retailer to await payment for goods, so why should I expect a vet to await payment for his/her service and expertise?  I appreciate cirumstances can change for people in the long term (redundancy for eg) or minor problems occur (such as lost wallet scenario mentioned earlier) but other than something unforseen I personally wouldn't have more animals than I could realistically afford to look after in sickness and in health.

IMO there would be few if any vets anywhere near solvent never mind running a business efficiently if their clients expected that treatment was immediate but payment deferred as a matter of course.

regards, Teri

The way we see it Teri, and I think probably the vet does as well :), is that if they don't give us credit, we may go elsewhere (certainly there are other vets much closer to home to us) -and that would lose them quite a few grand every year, so they do well to keep us and it IS in their best interest. :)

> I don't see why they SHOULDN'T be allowed to make a decent salary? Why not?

i'm not suggesting that they shouldn't, it's hard work, takes ages to train for and is a job of great responsibility, damn right they should be paid well (i certainly expect to be when i get a grown up job after uni). but i'm sure you'll agree that the mark ups for treatments etc can be really huge. when it comes to ops etc fair enough as they are intricate and difficult, but someone above mentioned that they were charged a large amount for a telephone call. that to me seems a little unfair

> I also believe I have the trust, EARNED, from my current and previous vets - but I respect their practice policies, one of which is payment due on day of treatment :)

That has been my expereince too.  One of my current Vets is very good about you settling teh bill when you come back for the follow up such as stitches out, if something is an emergency, or out of hours.

I can certainly see why an individual would think like that Marianne, but TBH not the professional.  After all the abundance of overheads would still need paid on a regular basis, I shouldn't think the staff would OK not getting their salaries on time simply because the practice had a cash flow problem that should be easily avoided :)

Perhaps such arrangements are common in many practices or maybe it's a location thing or whatever, I have no idea and hopefully some more folks will expand on their experiences relating to that.  In the absence of further input though, I would expect that were there a sufficient number of clients settling accounts on an "as and when basis" this would have a knock on affect with general pricing so perhaps making treatment more expensive in the long run - for everyone ...

To be asked to pay on the day you have an animal put to sleep is quite frankly disgusting, regardless of what policies the vet upholds or prices it charges

I have a breeder friend who has relayed 3 very recent incidents to me with regards to her pups and their vets, she I think, (well know) would say that most vets are scamming insurance companies for all they can get. She has been so upset by the current trend and upset from her litter that she has lost all faith in vets.

This is from a stud and bitch that she paired together 3 years previous, all the pups did well or showed such promise she matched them again.

Case 1 -  owner reports to her that pup has a heart murmur, (no heart probs in the line) distraught owners tell her that the pup will have to go under general anesthetic. That has possible DCM. After months of worry etc, for breeder and owners pup given all clear, deduce simple puppy flow murmur. (At least that is what I told her it was)

Case 2 - Pup has tear stains, owner advised that pup will need a tear duct operation.

Case 3 - Pup has tear stains, owner advised (by different vet in different area completley) that pup will need a tear duct op.

In cases 2 and 3 the breeder asked both owners to hold off any operation and wait until the teething stage was over.

Both pups tear stains clearned up when they were adults.  Two unnecessary operations would have gone ahead, not to mention the risks of putting pups under general anesthetic.

That is 3 cases all from the same breeder from the same litter, from vets in different parts of the country.

Now touch wood, I've not had any of these probs, and to be honest I think my breeding days are over, but I'm really glad as I think this is a real worry.

I'm not bothered about vets doing extra tests when they know their insurance will pay for it, bloods etc, that is a plus for many animals, but actual unnecessary operations is a real, real, worry and it can only be about money.

Quoting Teri: In the absence of further input though, I would expect that were there a sufficient number of clients settling accounts on an "as and when basis" this would have a knock on affect with general pricing so perhaps making treatment more expensive in the long run - for everyone ...

I see what you mean -but the fact is you're not buying an actual product, it's a service, so it's not like going to a shop. It's also a service that usually is URGENT, and cannot be put off. If anything you can liken it to electricity, or oil, or the telephone bill, or the boiler being serviced -anything like that. There you aren't expected to pay on the day, you are billed later. Indeed we have oil central heating but we're not even expected to pay for the oil on delivery. :)

Hi Freds Mum,

yes, it was disgusting, heartbreaking and completely unforgivable :(  Despite multiple apologies, professing it was a mistake and accepting the insensitivity of the timing, they had lost my faith in them and so with it my future business.

Hi Marianne

>but the fact is you're not buying an actual product, it's a service

but in all likeliehood "products" will be used, i.e. medicines, theatre products, x-ray plates and unlike billion pound industries such as power suppliers the need to meet local rates, rent/mortgage payments, heating, lighting, pharmaceutical bills, staff wages (from other vets, nurses, receptionists, cleaners), vehicle expenses, plus all manner of other sundry items will be more readily felt in the pocket of a small private business than in the enterprises you use for comparison purposes :)

Every service has a price and every business needs to be run profitably to survive - the smaller the business the more tightly the reins need held.

Hi Carrington

that's a dreadful scenario :(  I have heard a similar tale before with two littermates in another breed allegedly having "heart" conditions which seemed to have disappeared after the first few weeks thankfully and neither pup was put through surgery.  TBF neither vet as far as I know was pushing for swift investigation so possibly just a little more "doom and gloom" in their original findings than was appropriate for naturally anxious new owners.

Teri

I know that my vet, does not keep in too much stock.  You have to order, pay, and then collect on delivery many products.  Trouble is if they had too much on tap, it is like with everything you can't afford to buy in new stock.

qutoing Carrington:I'm not bothered about vets doing extra tests when they know their insurance will pay for it, bloods etc, that is a plus for many animals, but actual unnecessary operations is a real, real, worry and it can only be about money.

I agree, but I'm not at all sure the cases you mentioned were in any way as wrong as you suggest. Two of the cases you mentioned you said were "tear duct operations". Are you sure the vets didn't just mean to FLUSH the tear ducts? To actually enlarge them would be really unusual and I'm unsure if it's ever done. Flushing would be the norm, and of course is something that only involves a GA and may well sort a problem out, so I can't  see it would be a big deal. Indeed I had it done on a dog of mine, hoping it would help his runny eyes. Yes, I agree, more often than not it would be OTT to use GA for runny eyes so soon, especially in a pup, but what I mean is it's a minor (and common) procedure all the same and not actual surgery at all. I saw it done may a time when I worked as a vet nurse and many times it made a huge difference to the animal.

As for the heart murmur, a dog of mine was recently diagnosed with one, picked up at a routine check up. I told the vet she had been intended for breeding, and I knew her breeder would be upset. The vet suggested he referred me to a cardiologist to find out exactly what the murmur was,  so that the breeder would know what she possibly had in her lines. That does involve a GA to do a proper heart scan. I said no, I wasn't prepared to do this as to me, a grade one murmur in a dog I haven't bred simply meant I will not breed from her -it's not going to change anything for me or for the dog to know more, and I know these scans are very expensive. It would only help the breeder, but I'm afraid then she would have to pay the £500 or so it would cost -I won't. But I understand WHY it was suggested, and saw nothing wrong in that. It was the responsible thing to do, to suggest we find out what is what, and had it been a dog of MY breeding, I'd definitely have done it. (And once again it would not have involved any money made by the vet as the dog would have had to see a cardiologist elsewhere. I'd think this would be the same with the other case, unless their vet happened to be a cardiologist.)

Another thing that helps a business offering veterinary services is people at a time when the dog is perhaps unwell often feel pressured emotionally to have what appears "the state of the art" services even if it is not always a greater service given. Emotionally they feel they are doing everything they can for the animal so when of if anything happens they are eased with "thinking" they did all they could.  

You just have to look at how much dentistry has changed.   It is not quite the same but it is a change in business practices Some Dentists have got fed up just being good dentists or you have the young up and coming dentists that don't need just job satisfaction, they want the flash £60-80K cars, lovely houses and private education for their kids.  20 years the biggest % of our dentists we woking class people in small NHS practices :-)

Qutoing Teri:but in all likeliehood "products" will be used, i.e. medicines, theatre products, x-ray plates and unlike billion pound industries such as power suppliers the need to meet local rates, rent/mortgage payments, heating, lighting, pharmaceutical bills, staff wages (from other vets, nurses, receptionists, cleaners), vehicle expenses, plus all manner of other sundry items will be more readily felt in the pocket of a small private business than in the enterprises you use for comparison purposes :-)

I give up on this discussion now (this part anyway) but again I don't agree -take the boiler repairman as an example. We're not talking a big business there, but a one or two man small local business, indeed MUCH smaller than the vets -yet they still don't expect to be paid on the day. :)

I too use a vaccination and neutering clinic that was a thorn in the side of the vets in my area, which was then bought out by one of the big vet chains and prices went up quite a bit, but still cheaper than my usual vet by about £20 for a puppy course, which when having to have several pups in a litter vaccinated makes quite a difference.  Boosters are about £10 cheaper, but again with several dogs makes a difference.

I do feel a tad guilty about taking that business away from my nice vet that I really like and trust, but then I am not made of money either and have to budget so the dogs get what they need.

I recently got a group of us together to have our dogs hip scored by a Vet an hour or more away from me as the Vet was an orthopaedic specialist experienced in doing a lot of x-rays, and could give an educated guess at the hip status (be interesting to see how close he will be to the actual scores), but by travelling there I saved about £100, less the share of the petrol.

>take the boiler repairman as an example. We're not talking a big business there

mine is from Scottish Gas so I think we are ;)

I saw it done may a time when I worked as a vet nurse and many times it made a huge difference to the animal.


Now you have my interest. These pups were an acquatances, so I really don't know the full details, just that the pups were advised to have tear duct ops and that they would need GA.

Out of interest as I really have no knowledge on this, can you explain the differences in the Flush and enlarging the ducts. I didn't even realise you could flush, and is that just for an animal with a clogged up pussy type eye, not for ongoing tear stain? These were apparently tear stains so I'm guessing that would be the enlarging tear ducts?

You can write an essay, I'm interested.

To Carrington: It can happen that a tearduct is just blocked, but whatever kind of debris (let's face it, we all get dirt in our eyes, but we can remove it easier than an animal can) or discharge/pus, and then the simple thing that is done is that a catheter is inserted into the opening of each duct (if you look closely in a mirror, you can see the opening to YOUR tearducts showing as a tiny hole in your lower eyelid corner, this is the same thing) -and then it is flushed through with just saline solution from a syringe. If the liquid comes out the other end via the nose, the duct is clear, but often it is blocked to start with and then a bit of pressure is needed and suddenly the blockage will flush away out through the nose and everything will flow normally after that. Like clearing a drain. :) If there was a blockage, the tears would not have been able to drain away, but will have ended up on the face instead as they had nowhere else to go.

If you were to permanently enlarge the tearducts, and again I am unsure if this ever IS done -you'd need to somehow stretch them, a bit like is done in humans with angioplasty. I.e. insert a balloon like catheter to enlarge the ducts. This is just total guess work, I would imagine it is POSSIBLE to do, but have never heard of it BEING done -but then again you don't always hear of all procedures that can be done these days. I had a cat once who was born with nostrils too small, and the vet cut them up to enlarge them -but eventually they grew back as small as they originally were, and this is what I'd imagine would always be a problem with anything similar -would the problem come back.

Thank you Marianne, I fully understand it all now so I guess a flush is normal then and it does make sense to flush a tear duct with tear stains, just incase of a blockage. i.e dirt etc.  Sorry vets! I agreed with my breeder friend at the time, but now I understand.

> We're not talking a big business there, but a one or two man small local business, indeed MUCH smaller than the vets -yet they still don't expect to be paid on the day.

I agree. My husband is a builder/decorator, whenever he finishes a job he usually will get paid on the day, but some people prefer to send a check in the post a week or 2 later, this is to pay for non-urgernt planned & pre-booked work (and in all fainess if you book somebody to do up your house you obviously have the money to pay for it). My OH works on his own, he pays for most materials out of his own pocket and if he needs to employ an electitcian, they get paid when he gets paid (the electrician knows this before taking on the work).

I think it's good that our vets are lenient with payment from trusted customers when the need arises, it means that I can be assured that my pets will get treatment weather I am struggling for money or not. I do believe there is a large profit for the vets, which is plenty to keep them ticking over if the odd customer every now & then needs a week or 2 to pay up.
I remember a few years back, my OH & I found an injured chicken on the road, we didn't know what to do with it, so we took it to our vets, they treated it free of charge (as it wasn't our chicken & we didn't know who owned it), the poor chicken died anyway, but if they can afford to do this, they can afford to help people who are stuggling for money but willing to pay the costs of getting thier pets health issues treated and only need a bit of time to pay in full.

Hi mastifflover

further up the thread you stated "The practice is strict with payment on the day as a rule   

I appreciate that vets, any vets, can use their discretion when dealing with long term clients who they know are good for the money if an unexpected and particularly costly emergency arises, but I would still be surprised if it's standard procedure with many vets for practical and financial purposes.  Going by your highlighted comment above it seems probable that "payment on the day" is the norm and exceptions given on their own merit, but not a regular occurence???

I have known my vet ever since I was born.  He was at school with and a friend of my eldest brother.  We have complete trust in eachother.  I don't have any of my animals insured but I don't expect him to wait for payment of the bill.  I have a credit card solely for vet bill use and I pay there and then.  It's then down to me to pay the bill off the credit card, not make him wait.

Debs

I think if you all saw how many debtors we have at our vets you would be shocked. Many bills go unpaid that even the debt collectors cann't get payment for. People are dispicable, many people just think they can get treatment and then just don't pay. We will do a payment plan if asked, but often people fault on those too. Scarily we are in quite an expensive area in the south of england. I dread to think what its like in less affluent areas.
And yes, all charges are the same whether you are insured or not, it does help however, to know if an animal is insured as it often limits what a client is willing to pay and limits the treatment options.

Soli said

> I have a credit card solely for vet bill use and I pay there and then.  It's then down to me to pay the bill off the credit card, not make him wait.

That's our preferred way too Debs - I would have thought that was the most common as well as fairest way to do things, unless a vet was prepared to deal directly with an insurance company (for those clients with insurance that is).

Lucyandmeg

>Many bills go unpaid that even the debt collectors cann't get payment for

I think that's terrible - regardless of whether or not we feel that fees are steep we never the less are the ones who choose to use a practice, authorise treatment etc and to do so with no intention of paying for the professional care given is basically stealing IMO.  I wonder if this is common nationwide and, if so, then contributes significantly to the fees we all have to pay?  After all businesses have to cover their overheads AND make a profit.

Thanks for the insight :)

lucyandmeg,

Must admit that is really shocking, I know this type of thing goes on in all trades that give some type of credit, but you would think that those would not do it to a vet as what happens if their animal needs urgent treatment the vet could refuse............. in a way I guess this may be why many vets do push the boat out when it comes to insurance and tests to re-coup much that they must loose. I be it is £1,000's when they add it all up. :-(

Every pet insurance claim form I have ever come across has a section where the vet (or appointed person) signs to state that all fees are the normal fees charged by that practice ie. are the same for all clients regardless of insurance status.

'Do you have pet insurance?' is often recieved very negatively, especially if asked before discussing treatment options. There are always options and vets are often faced with the difficult task of taking an educated guess as to which investigations are likely to be fruitful and can be performed within a clients budget. Often vets manage this well based on experience and can get to the root of the problem with the minimum of stress to the animal and the owners pocket. However insurance often takes the guess work out of investigations and that blood test which the vet was suspecting would be normal, and would have omitted on a tight budget, suddenly throws up an unexpected abnormality that leads to a completely different line of investigation and treatment. There is always the cheap way that gets results most of the time or the more thorough (and inevitably more expensive) way that means something more unusual is not missed. Vets cannot presume what level of finances an owner has but at the same time have a responsibility to provide treatment that is appropriate to the animal but not unaffordable for the owner. Unfortunately any questions regarding money are often seen as tactless at best!

Teri said about having a cradit card for vets bills only:That's our preferred way too Debs - I would have thought that was the most common as well as fairest way to do things, unless a vet was prepared to deal directly with an insurance company (for those clients with insurance that is).

It depends on what limit the credit card company will give you though. Certainly we could never pay our vets bills with a credit card. So far this year our vets bills have totalled roughly £3500. And credit cards charge a lot of interest.

The last vet I was with it was definately the case but my new vet (6 years with) it isn't. When they discuss options with people you are given a printed estimate of the costs if having op or investigations. He knows that we are insured but I know a few that use him who aren't and they are given the same options. example a friends dog had a serious accident, the friend wasn't insured but vet gave her the option that he would do the op and she would pay in installments. Some vets now do a direct debit monthly that you pay into and hopefully that will give people that aren't insured enough of a buffer if something serious were to happen.
I think I am very lucky with mine and the practice is excellent, they do a pet vac scheme where you take pup or dog and pay a one off fee of £90, that will then cover every vaccination for the dogs life, when I joined he wouldn't do it for my older dog as he said as he was old I wouldn't get the benefit of the club, now that to me isn't a money grabber.

Good points Goopter :)

> There is always the cheap way that gets results most of the time or the more thorough (and inevitably more expensive) way that means something more unusual is not missed

Very true!   I think in part what causes problems for some owners will inevitably be guilt if the options perhaps best taken up are outwith their finances.  Less of an issue with an insured client.

Hi Marianne

this thread is intended as a general topic of interest re fees and the insurance (if any) affect on them.  Like everything else it's opened up a wider picture of what happens in and around the same subject matter and it's interesting to get input from multiple view points :)

My comments about using credit cards were generalised - it's what I do and always have done (including years without insurance) and in more recent years have paid little or no interest at all because the fees are settled by insurance cover usually around the time of the bill coming in :)  I know many other people who find this the best option too, but it's not set in stone for anyone.  Your personal arrangements with your vet for payments etc are your own business - so I hope you don't feel that any comment was directed specifically at you.

Perhaps since you have so many animals you are very much the "golden goose" with your practice, however I would not expect that all practices could afford to take this view with many clients for the reasons of overheads and cash flow already pointed out.

Lucyandmeg's post surprised me as I was unaware that non-payment of fees was a large problem and raises the question that fees in general may be more likely to increase when there are substantial defaults on payment plans and, to a lesser extent, possibly where there are several payment plans in place for substantial sums. 

From my own experiences I know that puppy vacs for example have almost doubled in price at my practice in less than four years which is considerably higher than the cost of inflation.  The prices for microchips, pet passports and health certificates have also risen sharply and of course none of these are covered by insurance.  Doubtless there are increased prices for many other things too, again, well outwith inflation.  Consultation fees are up by around 20% in the last two years and so on.

Equally it may be that some practices have made little or no change to their costs - after all hundreds of different areas nationwide will reflect different levels of services offered (not implying compromising levels of care) and quite widely varied incomes of clients, numerbers of animals owned etc

regards, Teri

> the practice is excellent, they do a pet vac scheme where you take pup or dog and pay a one off fee of £90, that will then cover every vaccination for the dogs life

Sounds like an excellent arrangement Floradora and of course makes sound business sense as clients taking up the scheme are more likely to stick with the practice throughout the life time of their animals :)

> when I joined he wouldn't do it for my older dog as he said as he was old I wouldn't get the benefit of the club, now that to me isn't a money grabber.

I couldn't agree more - sounds like you have a lovely vet and they're worth their weight in gold!  I genuinely don't believe that vets in general are money grabbing at all.  Sure, they now "pad out" their income with sales of multiple foods, toys, crates, typical pet lovers paraphenalia but there's no harm in that at all.  I think some of the info and experiences provided so far has shown that there's every chance that some may need to find additional ways of creating expenditure in order to improve their income.

Thanks for the info, Teri