> but for a routine vaccination I really don't see how you can add in extra explanations without adding time. 

We had quite a lengthy chat with our vet when the dogs went in for their boosters :) partly because of Bramble's age - should he have the booster ? - and the rest was just how he had been doing as he had had negative tests earlier in the year for diabetes/kidney problems/Cushings etc. The vet hadn't met Tara before and so we had a chat about her (although at 10 she has no medical issues). There was no rush and it has helped develop our relationship with him (we've only been going there this year) which will be very important in the future, I'm sure, as both the dogs are getting on a bit :) :)

> We had quite a lengthy chat with our vet when the dogs went in for their boosters :-) partly because of Bramble's age - should he have the booster ?

Yes, of course you would expect that but the original proposition, somewhere further back in this thread :), was that all animal vaccination appointments should include full discussion on the pros and cons for an individual animal.  If the health check reveals nothing out of the ordinary and the client has booked an appointment for vaccination I don't see why the vet cannot just get on with it according to protocols.  If the client wants to discuss whether the protocols are appropriate for a perfectly healthy animal then I think it is only fair, to both the vet, and all those in the waiting area to book an appointment specifically to do so.

Sorry, I think discussing the pros and cons of any treatment - whether preventative or not - is part of good practice. 

How can most owners make informed decisions about their pet's health if they are not informed by a professional?

All I can keep saying is I really don't believe the average client wants more than the vet to work within the recommendations so I doubt they would be happy to see consultations for routine vaccinations extended to the time necessary to allow for any kind of meaningful exchange if you want to discuss whether those recommendations can possibly be correct and therefore have to pay more.
There are generally leaflets in the waiting room explaining why vaccinations are required and most people understand that anyway.

Except if the vet's interpretation of the recommendations is to vaccinate with core vaccines every year. The client would not be unreasonable in asking for this to be explained and should not have to pay extra. Anyhow, I think we'll have to agree to differ on this.

> Except if the vet's interpretation of the recommendations is to vaccinate with core vaccines every year.

Indeed.  You will have noted I have been careful to say "when the vet is following the routine recommendations" :)
I would also agree that the clients is always entitled to ask questions, it is only the proposition that vets take on routinely running through all the pros and cons that I would suggest would carry an unwelcome cost to most of us.

The routine recommendations by who?

Some vaccine manufacturers still say that the full booster should be given every year.  Some vets give the full booster every year because they always have done - they don't appear aware that there have been changes in this area of recent years.  Some vets give the 3 yearly booster, as recommended by the WSAVA.  Some vets titre test each year.  (Example of a vet who titre tests each year:  http://www.hydeparkvet.co.uk/services/vaccination.html )

Whatever the vet does, I don't want them just 'doing' it and making it seem that there is no choice.  There is a huge and important choice to be made and I don't want someone else making it, for my dogs.  Or, in fact, my clients' dogs.

> Whatever the vet does, I don't want them just 'doing' it and making it seem that there is no choice.

That's absolutely fine, your choice.  I would just question the fairness of booking an appointment to have a routine vaccination but then treat it as a consultation to discuss those recommendations or expect vets to fit this into such an appointment routinely. 

>I don't want someone else making it, for my dogs.  Or, in fact, my clients' dogs.

Wouldn't that be up to your clients? :)

Rabid,
Precisely, the wording of the current UK recommendations gives vets an immense amount of wiggle room. In short the protocol is pretty much at the vet's discretion, hence the need for discussion with the vet in every initial case.

>I would just question the fairness of booking an appointment to have a routine vaccination but then treat it as a consultation to discuss those recommendations or expect vets to fit this into such an appointment routinely. 

When do you suggest that we have this conversation, if not during an appointment??  It is going to take the same amount of time to have it on the phone, in fact arguably more if it is then decided that a vaccination or titre test is needed, since we then have to book an appointment as well. 

We don't need a longer appointment:  Time is programmed into consultations for discussion, it's not about 'hello' 'wham bam, here's your injection, see you next year'!!  It takes about 2 seconds to stick a needle in a dog and my own vet's appointments are 10 minute ones - plenty of time for discussion.  Even more time, if you then don't have the injection...

> It takes about 2 seconds to stick a needle in a dog and my own vet's appointments are 10 minute ones -

Well, there is the health check to be done as well but even if you devoted that whole eight minutes :) not sure what kind of meaningful discussion we would be taking about.