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Discussion on Vet Charging for Prescriptions | |
Author | Message |
Member: Brezniak |
Posted on Saturday, Oct 2, 2004 - 12:52 am: I wanted to know if anyone out there has ever had a veterinarian charge for writing a prescription. I was astounded to see on my last bill a fee for writing a script, especially since I have spent thousands of dollars in this practice and have several horses that need expensive ongoing medications. I had never heard of such a thing and almost think it is unethical. Now if they were faxing it somewhere, I maybe could see it but they aren't. |
Member: Mrose |
Posted on Sunday, Oct 3, 2004 - 9:43 pm: If someone isn't a regular client and asks for a prescription to use to buy meds through a catalog supply, he will charge a "nominal fee." I don't know how much, as I've never asked for one. I've never seen a fee for writing a script for meds if the horse is a patient of his and the script is for meds to treat a condition for which the vet is seeing the horse. Our vet usually just "doles out" the meds and seems to have a pretty good supply. |
Member: Imogen |
Posted on Monday, Oct 4, 2004 - 3:20 am: Diane - isn't it better to have the prescription fee listed clearly instead of the vet stocking the drug themselves and adding an unspecified markup?Normally here in Europe you have to pay for the vet to come out and administer most drugs as well - just occasionally they will let you buy the drug and administer yourself if it is an IM, low risk injection. Normally I would pay 40-50 euros for a vet visit plus drug costs. Last week I was able to pick up an EHV 1/4 injection that I needed from them for 28 euros which I still think is expensive (gone up 8 euros in 2 years). Even so I prefer that drugs, especially antibiotics, are properly controlled and not handed out like sweeties. All the best Imogen |
Member: Christos |
Posted on Monday, Oct 4, 2004 - 9:06 am: Where I live, vets would rather give you the drugs for free than have to approach a horse, let alone stick a needle in it. I'm thinking, lately, to start charging them for not making them touch the animal... |
Member: Janette |
Posted on Monday, Oct 4, 2004 - 9:34 am: Hi,The rules concerning charging for prescriptions at Dr.O's hospital are: If a client requests a prescription for a product that we carry in our pharmacy, we do charge a fee. If the patient requires a medication that we do not have there is no charge for the prescription. JanetteO |
Member: Miamoo |
Posted on Monday, Oct 4, 2004 - 1:53 pm: My mare was on Isoxoprine for a while. My vet wrote me a perscription because in his words "You can get it cheaper then we can sell it to you". I spend a fortune at this practice. I'm glad they are not raking me for my very last penny!Ella |
Moderator: DrO |
Posted on Monday, Oct 4, 2004 - 7:00 pm: The problem with the above discussions in one of real value vs perceived value. Both Ella and Diane comment that they both spend large amounts of money. Diane is very unhappy while Ella quite pleased, but we do not know if a similar call with similar dispensed medications, one with a prescription charge and one without, would be less for one or the other. It all depends how the charges are proportioned. Before a prescription is given records should be reviewed, thought goes into the appropriateness, and time to write out the script is required: if it is not paid for directly it is built into the rest of the bill.DrO PS: since we do not carry Isoxsuprine on our truck I do not charge for such a script but the real question here is whether the medication was the waste of money or not, for more see the article on Isoxsuprine. |
Member: Brezniak |
Posted on Monday, Oct 4, 2004 - 10:52 pm: I am pleased that all of you took the time to respond. Most of the drugs that I use are not injectables and are frequently given out by vets but require a script to obtain elsewhere. Most of the vets I use have a fairly high markup on them. Some of the drugs I need are very expensive and I could not afford them if I could not get a script. Some of them are human drugs that come from a human drugstore and my vet doesn't have anyway.I am in very frequent contact with my vet due to the nature of my horses problems. I doubt if they have to look up their records. I do spend a lot of time on the phone with them and I could see them charging for that. I have gotten scripts from this practice for years and never been charged a fee. Now, out of the blue it appears on my bill. If I go to my doctor, he does not charge me for writing a script. Maybe that is all part of an office visit, I don't know. I guess that I am insulted on a personal level because of the amount of business I do with these people. In comparison, I had used a different practice that had extended me very generous courtesies even though I never used them previously. That makes it even harder to take. |
Member: Oscarvv |
Posted on Tuesday, Oct 5, 2004 - 9:12 am: DianeI can imagine your frustration. how much did they charge for the prescription? I know it is more the principle than the amount. I have just asked my vet for an Adequan prescription. He recommended the drug and I will be curious to see if he fills it without issue/or charge. I can get the Adequan for $100 less than what he charges. he did just see the horse and I have written him two checks for a total of $3,000 in the last 3 months for this horse. I don't feel he should charge me for trying to save a 'few' dollars. human Dr's generally don't make money off of selling drugs, vets do, so IMO it is impossible to compare the two. -B PS Ever since my house was hit by lightening and sparks came out of my keyboard, I have lost my capital "h' and 'g' among other things,} so please ignore my typing errors. |
Member: Mrose |
Posted on Tuesday, Oct 5, 2004 - 11:51 am: Due to the differents costs of doing business, the involvement of various government agencies and insurance groups, I think it would be difficult to compare MDs to DVMs. I spend several thousand a year at my vets (for over a dozen horses & numerous cats and dogs.) My vet charges the same for any medications he gives out as he pays for them, but does charge for giving an injection, a farm call, or office visit. He doesn't charge for a script if it is something that has to be compounded at the pharmacy, or if it is something that he doesn't have on hand. If someone just walks in and wants a script for a med so they can order it online or from a catalogue, however, he will charge; and won't write the script unless he has seen the animal.It is my opinion that even tho' I spend lots each year at the vets, he has earned every penny and then some. Considering the long hours he puts in, and some of the difficult animal owners he must deal with, he is way underpaid. I sure wouldn't "squawk" about his charging a few bucks to write out a script if he did so. |
Member: Brezniak |
Posted on Tuesday, Oct 5, 2004 - 12:52 pm: Good points to think about. It is more the principle than the actual cost that I am concerned with. I agree that vets have can have long hours and difficult patients but when they decided to make this their career, they knew what it would entail. My horses and I are not generally difficult patients although I did have one TB that was nasty prior to getting pregnant. In that case, the vet I normally use refused to ultrasound her the result being someone else in the practice did it later than it should have been and I ended up with dysmature twins, a long hospital stay (elsewhere) for the one that lived, a large bill, etc., etc. But I am generally pleased with the vet I use now in the same practice. However, she does not make up the billing procedures. |
Member: Miamoo |
Posted on Tuesday, Oct 5, 2004 - 2:53 pm: Hi all,As a school guidance counselor I regularly work with the parents of my students. I have learned that to get the school and the parents on the same page, it is often not what I say but how I say it. I think it is similar with veterinary fees. It is not what they charge (we all know horses are expensive and if there is a way to get injured they will find it) but how it is charged. For example, I would rather have the Farm Call or Physical Exam be a few dollars more and then have them able to be more flexible while with my animals. I know the veterinary practice I use is one of the more expensive around (and the best I will add) on routine calls, but when at my house for one issue I will often ask, "Can you look at this while you are here?", they always do. Though I would NEVER ask them to do this uncharged I often find no charge on my bill. I would rather have it this way then a cheaper Farm Call or Physical and then a $20 charge because they looked at Bessie's scrape and another $10 because they said to put Furizone on it. I agree that the vets earn their money. They put in a lot of hours on the road and they spent a huge amount of time in school (and have to pay enormous tuition bills). There is a certain profit that a clinic needs to make to stay afloat and prosper. I believe that how they attach these charges to items can help create a happy client base or an angry one. Ella |
Member: Onehorse |
Posted on Wednesday, Oct 20, 2004 - 10:26 am: I just saw this string today and thought I'd tell you what my vet has done here in northeastern Illinois, which encompasses the charge vs. no-charge issue.He created for his clients (and anyone who wanted to sign up) a 'Basic Horse Health' six-week seminar. We met 3 hours a night, one night a week, for six weeks. We learned various things including how to test for vital signs, how to administer injections, anatomy of the horse (skeletal and muscular), diet/nutrition, what drugs we should have on hand for emergency purposes, when to call a vet or when to take your horse directly to an emergency hospital because every minute counts, etc. The goal was to make us better horse owners. The result? Many issues are handled by a phone call as opposed to a visit, once a diagnosis is made by my vet (after a visit if necessary) administration of medicines is accomplished without daily visits (and charges) by my vet, etc. He encourages 'graduates' to seek the best prices on drugs and writes the prescriptions when needed for free -- and asks us to send him the cost of the drug which he posts in a quarterly newsletter so other graduates can be 'educated shoppers.' He also tells us that if he supplies a drug, he marks it up 15% over what he pays for it and that includes administering it. What usually happens (at least in my case) when my horse needs medication my vet usually supplies the initial dose (the day of examination), writes the script, and then I attain what's needed and administer it myself from that point on. For the record: the seminar was not geared for us to replace our vet and do our own diagnosis, but allows us to focus on problems with knowledge and understanding, and deal with each situation efficiently in terms of time and money. The most important value of the seminar to me was (in addition to saving money) not feeling at a loss each time my horse showed an 'off' symptom and being able to make better decisions as to when I needed to have my vet come out, whether I needed to schedule a visit or call for an 'emergency' visit, or just speak to him on the phone 'intelligently.' Most of us who have taken the course will have a sign on our stall doors that lists all the vital signs of our equines (heartbeat, pulse, respitory rates, etc., at rest and after twenty minutes of activity) so any vet called will know what's 'normal' for that horse, whether we're there or not. The seminar cost each of us $200.00, but I have saved that in 'vet bills' many times over ... and when we 'graduated' we were given a kit that contained a stethoscope, thermometer (with a string attached to it, lol), flash light, and a few other items. I must say: that course, this web site, and 'smarter' discussions with my vet have given me greater peace of mind and financial savings. |
Member: Dres |
Posted on Wednesday, Oct 20, 2004 - 10:43 am: Rick.. what a great post.. i took a ''natural horsemanship'' course , 9 days.. one of the days was a visit from a vet that went over a lot of what you discus above.. the idea was to give the horse owner more knowledge of his equine partner then just how to ''train'' it.... i learned a ton then and would love a follow up 'course' like your above..a wonderful idea... Ann |
Member: Warwick |
Posted on Wednesday, Oct 20, 2004 - 11:35 am: What a cool idea, Rick. Sounds like you have a great vet to work with. |
Member: Klhanson |
Posted on Wednesday, Oct 20, 2004 - 5:00 pm: I am a physician (endocrinologist), and I am only paid for the actual contact with a patient. Therefore, all lab review, prescriptions written without the patient being seen, and so forth come out of my pocket, and are not paid for by the office visit. We are inundated with requests to fill prescriptions, and some of our patients are quite nasty if they do not have their refills called within an hour of their request. It is a courtesy on my part to call in the prescriptions, and not an obligation. Many physicians are now demanding that patients make an appointment to get the prescriptions filled.I would not begrudge my equine vet, nor my small animal vet, the extra charge for the prescription. I am making less every year, and suspect that it is even harder for vets, at least in my area. It takes time and effort to generate prescriptions, and I personally feel that it is courteous to acknowledge that time and effort, although I understand the frustration. I would assume that, no matter how much one spends with a vet, the money is well-spent, and, while I would hope that I get some consideration for spending large quantities of money with my vet, I would not expect to be given services that are otherwise billed. |
Member: Hwood |
Posted on Wednesday, Oct 20, 2004 - 11:26 pm: Rick, that is one of the most intelligent and helpful things I have ever heard. I know that many vets are "out straight," and may not have the time to offer such a course. Nevertheless, I am going to talk with our vet to see if he would be willing to do something similar here. It would seem that the result of such a course would benefit the vet (he makes $200x however many participants x however many weeks), the horse owners (who may have to make fewer vet calls or at least more informed vet calls) and the horses (who have more knowledgeable, competent owners.) |
Member: Brezniak |
Posted on Thursday, Oct 21, 2004 - 12:12 am: One of the practices I use also does various lecture/demonstration series but not quite what Rick described. I think it is an excellent idea. The equine practices in my area are all very busy and most that know me well would rather deal with problems over the phone that do not require them to make a house call.As for making less money every year, I think most of us are in that predicament too! |
Member: Ajudson1 |
Posted on Thursday, Oct 21, 2004 - 8:22 am: I want to echo what Holly said about Rick's post. My thoughts exactly. I am considered to be in kinda a "black area" which is outa the vets "normal area". Thankfully I have a wonderful knowledgeable farrier who I can call anytime I can't get ahold of a vet. Even so, I would love to take a course such as Rick's vet offered. The problem though is they are all stretched to their limits already so I don't know how they would find time to put together such a program. But I am going to mention it to a couple of vets outa different areas, and, who knows? Maybe they'll think it's a great idea too. |
Member: Jvecsey |
Posted on Sunday, Oct 24, 2004 - 8:04 pm: A vet I no longer use was charging me 3x the price she purchased meds for. Plus I had to pick it up from her. I called the Pharmacy on bottle and they wouold not quote me price since I was not a vet. So I called again and said I was Dr. so and so and found price. When I switched vets, he gave me the numbers of a few pharmacies who make equine prescriptions and the price was what first vet was buying it for. My friend is a human pharmacist and said only shelf items should carry a profit margin and not close to 200%!!My new vet says he wants to make money doing procedures not selling meds. |
Member: Ribbons |
Posted on Sunday, Oct 24, 2004 - 9:00 pm: I had conversation with one of my local vets two weeeks ago about how the veterinarians have been advised that they need to operate more like human doctors in order to make more money. Low and behold, this week I had the same vet out for an emergency call and was charged $20.00 for clipping around a wound. This same practice and others have done this numerous times on the same horse and never charged me. Had I been aware of the charge at the time, I would have grabbed the clippers and done the job myself. I was charged $80.00 for x-rays and then a $30.00 for an "x-ray set up fee" which I had also never seen on a bill before. I had always considered my vets to be most professional and to charge an honest rate.Not to shake me down with nickel and dime fees like the doctor,dentist, and bank! I wanted to get a second opinion and asked if I could have the x-rays to send myself Fed Ex to the nearest university clinic for a second opinion. There is a possible hairline leg fracture so I wanted to make sure they went out that day. They refused to let me have them, missed that days pick up which means they won't be received until Monday, and I bet I will be charged an fee for them sending them in addition to the usual Fed Ex.Which mean in the future I will consider not calling my local vet and head straight to the large animal clinic of the nearby university, but then again maybe they are starting to play the same game. We'll see when I get my bill from them tomorrow! |
Member: Onehorse |
Posted on Sunday, Oct 24, 2004 - 9:37 pm: Teresa,The fees you describe being charged, particularly the "x-ray set up fee" for $30 certainly sounds a little over the top, especially since you were charged $80 for the x-rays. I'm not sure I understand the "clipping" charge except to say it sounds like you got 'clipped,' especially if they also charged for a farm visit. However, before dismissing this veterinary clinic, why not call them and discuss the invoice. Let them know you're a long time customer and you think the charges are excessive, or at least have them explain the charges. As a business, they should attempt to satisfy you and keep you; as a customer, you need to understand their costs and charges. Then make the appropriate decision. Just don't act willy-nilly. |
Member: Ribbons |
Posted on Sunday, Oct 24, 2004 - 10:27 pm: Rick,Thanks for the reply. Your advice is good. The "clipping charge" was for clipping the hair around a puncture wound so the vet could get a better look and also keep the wound cleaner. Unfortunately, I understand the charges quite well. They also upped the price of Adequan $10.00 a dose in one go. I was considering ordering it on line and not until I read this thread did I even think that I would be charged a fee because I wouldn't be buying the product from the them. Now I know to ask. When I find out that my horse is okay and I stop fuming everytime I look at the bill, I will talk to the vet. |
Member: Ajudson1 |
Posted on Monday, Oct 25, 2004 - 8:28 am: It has always been my understanding that we can have our (meaning people) records and x-rays at any time. A dr can charge for the time he pays someone in his office to make copies of the records. That is up to the Dr., and so far I haven't had that happen. I don't see how a vet would refuse to give you an x-ray of your horse; I would think that by law you have every right to have that if you want it to go for another opinion, or further treatment.If vets have different laws they follow, I'd like to know about it. Unfortunately, it's always about the $$$$ and unless we speak up, it's only going to get worse. The last time I saw my regular dr, he told me the results of lab work. About 20 seconds worth of conversation. When I told him he could have sent me the results or phoned me, he laughed and told me he had a big college loan to pay off. Teresa, I would discuss the bill up front and in person once you quit fuming. I would count it as a positive that the vet even responded and came out to your place, around here if it isn't a routine call we are expected to trailor the horses there, just like we take dogs and cats to the vet. I wonder how long before all the dairy farmers have to take the whole herd of cattle in to the "office"? |
Member: Mrose |
Posted on Monday, Oct 25, 2004 - 10:25 am: Angie-at least your MD's honest!I am very lucky. My MD is also a personal friend who just happens to raise TB's and warmbloods and used to be an exercise rider at the track! She spends loads of times with all her patients. All the doctors I've worked for would release medical records and xrays to another doctor upon request. They would release them to a patient once their bill had been paid, which I consider fair. The vets I know follow the same practice. |
Member: Dres |
Posted on Monday, Oct 25, 2004 - 10:30 am: Hi All, a very sensitive subject indeed.. I had to change lameness vets just recently, my home vet has gotten married and is just doing repo work now.. anyway.. I found this gentleman highly recommended, used him and do like what I have seen with him.. THEN the bill came.. I about went thru the roof.. anyway I did call, and found out that it had been a gross billing error, new office help,.. I was charged dbl for everything.. yikes! after that was all discussed, he apologized , his office help wrote me a nice letter too..so yes, talk it out first.. The real question is who IS making money in the this horse biz.. ?? not the farrier .. not the vet .. not the trainer .. not the seller.. ?? we do it becus its a passion is my belief.. so talk it out.. |
Member: Suzeb |
Posted on Monday, Oct 25, 2004 - 11:19 am: It could be the way the vet does their business. A mobile vet does have to be The Doctor, The Pharmacist and The Dispensary all in one visit and have a reliable truck to carry all that expensive inventory. It is possible that some of these veterinary drug supply companies require that the vet place a minimum order. You can't just buy one bottle of something, you have to buy a case lot. The script charge is just the cost of doing business.Do talk it out....you may find that you are getting a good bargain elsewhere in the treatment protocol. |
Member: Parfait |
Posted on Monday, Oct 25, 2004 - 12:13 pm: Teresa,My vets also told me recently that they were going to operate more as professionals (read: charge more). I certainly got that impression when my vet charged me $35 for simply running his fingers down a front tendon (took less than 5 seconds) and another vet facility slammed me with nearly $1500 in fees for three visits concerning a tie-up on a horse. I value the work that vets do and was shocked at how little the Jr vets in the practice make however, I have noticed a great difference in the last year at the rates for my local vets. I have learned to haul up to the vet hospital where they do enough business to still charge at the old rates. Better vets too. I also can get scripts for free and buy my adequan on the net. If they want to run it like a business, I can take my business elsewhere. Kerry |
Member: Ribbons |
Posted on Monday, Oct 25, 2004 - 10:37 pm: Thanks everyone for the replies.Kerry, I think I will be loading up more often to the university, too. I took my horse to the one closest to us today and because the blankety, blank, x-rays did not arrive there from my local vet, I had to start again from scratch. In comparing the bills and subtracting out the meds from local vet, the bills were comparable except the bill from the university clinic included an ultrasound of the injury. Basically a free ultra-sound, right? Think I can use this line of reasoning with my hubby? Anyway, I guess like you, with the rising costs of veterinary services, I need to think of the business end of the relationship more than I have in the past. Susan, To his credit, our local vet does offer several preventative programs including worming, coggins, and vaccinations which really are a good value and one reason I have stuck with this particular practice. The other reason being he was the only equine vet in our area. Angie, I feel for the cattlemen. We don't have a vet who does bovine work around here anymore at any price. On the bright side, the horse's x-rays and ultrasounds were clear and my daughter still has her beloved pet to ride. |