“Why are vets charging <insert price for vaccine here> when it actually only costs <insert wholesale cost price for vaccine here>? They’re just out to get our money”. This is something I keep on hearing about the cost of the new vaccine, and indeed about vets more generally. It is also something I’ve tried to avoid raising on the RHD2 group (although it’s fine if people just mention the price they paid as part of their feedback), as I don’t want to end up getting into a big debate about the costs. I want the group to be available to help people to locate the vaccine, not to bash vets for how much they’ve decided to charge for it.
So, back to that original statement. Is it true? Are vets only out to make a profit out of us? I’m sure that there is an occasional practice who is pricing according to supply and demand in order to maximise profit, or who charge more than their level of expertise warrants, or just because they can get away with it, but I do believe that the majority of vets are pricing according to what is a sustainable way of running their practice. And it’s that majority I talk about in this blog here. I hesitate to use the word business, as I think vets have to tread a very tricky line between being a service industry and a business. I suspect that not many vets went into the profession with their primary aim to make a shed load of money; there are far easier ways of achieving this than spending 5+ years at vet school, spending years building skills and experience before finally embarking on practice ownership with all the risks that entails. Of course vets are a business and of course they need to make money. If they didn’t, their practices wouldn’t exist. I’m pretty sure that if vets ended up letting people off/giving reduced rates to every sob story that came in through their doors, they’d make themselves bankrupt pretty darn quickly, and that wouldn’t help any of us in the long run. Just to be clear though, I am not having a go here at anyone who has found themselves in difficult financial circumstances which means that they are struggling with the costs: I realise that circumstances change and this can happen. The majority of the voices I hear raising the question in the original statement are from people who have chosen to take on animals knowing the potential costs, and who in most circumstances actually could afford it…but just don’t want to.
Which brings me to the cost price of that vaccine v how much we end up paying. Yes, there will always be some level of variation, as different vets work out their pricing structure in different ways, and indeed the costs associated with running practices will vary – not least by location. I’m not talking about that sort of variation here. But I do want to highlight some of the additional costs involved in that little vial of vaccine which only costs <insert wholesale price here>. First of all, how does the practice get the vaccine in the first place? Someone has to sort out the paperwork and do the order. This means that there needs to be a person to do that, and they will need supplies such as a computer, pens, paper, email, scanner, and somewhere for all those things to be located – a building, a desk and chair…with power and light, heating and ventilation. They’ll probably need to make phone calls about it too. With something like RHD2, they probably needed the vet to spend some time reading and researching, taking care to understand the issues and working out how to navigate the process of getting the special import licence as well as the normal drug ordering procedure.
When you and I rang the practice to enquire about the vaccine, there needed to be a person answering the phone, who again needs a building, a phone line and equipment such as a computer, desk and chair. Then when the vaccine arrives, there needs to be someone to ring you up (on their phone bill) to advise you that it’s in stock and to book you your appointment. The delivery will need to be unpacked and stored somewhere appropriate – probably a special temperature controlled receptacle – in order to ensure that it remains safe and effective. When you arrive at the practice, you’ll notice that you’re heading into a building – which will have associated costs such as business rates, rent/mortgage, building and contents insurance, there will be heating/air con, lights. You’ll be greeted at reception and you’ll have a seat to sit on while you wait. And then when you see the vet, you will enter a consultation room which will be equipped with everything needed for the consultation – including a table, computer etc, all of which will need to be cleaned/disinfected by someone on a regular basis, which takes time and equipment.
You’ll have a consultation usually somewhere in the region of 10-15 minutes with someone who has trained for at least 5 years plus however much post-qualification experience they have. They will have professional fees and subscriptions to pay, professional indemnity insurance and costs/time for attending continuing professional development so that they and their staff can keep on top of ever emerging and improving practice. To put the consultation time and cost in context, it’s not the slightest bit unusual for a 20 minute-half hr consultation with a private medical professional to put you back somewhere in the region of £200. During this consultation, you’ll be given that vaccine, which will need to be drawn up into a syringe and at least one, probably two, needles will be used. The needles will then need to be stored in a secure sharps container ready to be disposed of as ‘clinical waste’ with the costs associated with that, and the syringe itself will also need to be disposed of, for which there will be a charge to the practice. There may also be other pieces of equipment used during the health check (stethoscope, thermometer, otoscope etc) which will need purchasing in the first place, maintenance, cleaning and probably fairly regular replacement, along with any consumables such as paper towels, cotton wool, disinfectants etc.
When the consultation is over, you’ll head back out to reception where you’ll see someone who will access the computer and take your money either using a card machine/phone line or cash into the till. At the end of the day someone will need to reconcile everything in the till and do the banking and accounts as appropriate. And the practice will need to pay for accountants, auditing of accounts, and a whole host of taxes including corporation tax, employment taxes and VAT. I’ve probably forgotten some things, but all of that is still a good amount of activity and expense to add on to a vaccine only costing <insert wholesale price of vaccine here>.
Of course it might be possible to do it more cheaply. It might be possible to negotiate doing things at a reduced price And if the vet can help out by doing this from time to time and is happy to do so, then great. I’m not intending to make anyone feel guilty for having negotiated mutually agreeable discounts with their vet, nor for those who have found themselves in a difficult financial situation. But I don’t think we should demand having things at cost or reduced price as if it’s our right, or suggesting that anything over and above the absolute cost of the vaccine must be the vet just being money-grabbing. As I said earlier, I am quite sure there are some practices who do seek to maximise profit potentially at the expense of clinical excellence, but I don’t believe that’s the majority. In the majority of cases, the bulk of those fees go on running expenses without there being an awful lot of profit, and a lot of any ‘profit’ is ploughed back into the practice in any case. This will help to to ensure that staff are fairly paid, well trained and up-to-date, that equipment is state-of-the-art, well maintained and available for use whenever needed, that the practice itself is clean and well maintained, and that staff wellbeing is considered as important. I don’t mind paying a bit more for some of the routine items if it means that there are things like x-ray, ultrasound, blood testing all available on site rather than having to wait for samples to be sent away or waiting for a referral for some of these other core services. And do you know what, I don’t mind if staff are paid a decent wage for the work that they do, so that they are able to excel at what they do and enjoy a good quality of life as a result. Don’t we all want that for ourselves? Why should our veterinary professionals and their teams be any different? The veterinary profession has one of the highest rates of work-related stress which can have very serious consequences. Strong, happy teams, with high moral and low staff turnover are all things I’d be really happy to see. It’s entirely my choice to keep pets and to rescue animals, that means that it’s my responsibility to ensure they get what they need and I don’t feel that I should demand that anyone else lives on a shoestring or has lower quality of life because of my choices. Ultimately, if we don’t pay our vets a decent price for the work that they do, it will only be to the longer-term detriment of the practice and hence the service that we and our animals will receive.