Vets turning away patients who can't pay up front

jane11

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This is a story about a dog, not a cat. It wasn't even our dog. But what happened to her upset me so much I had to vent somewhere, so here I am.

We rescue and care for special needs kitties. We've dealt with blind cats, FIV, FELV, stress cases, and amputees. There are only two of us, we are private and we do this out of our own pockets, so we don't usually take on any pets other than cats.

But a month ago we were contacted as a last resort by a vet tech who was trying to help a disabled man who'd been turned away by the practice she worked at and every other vet within twenty miles. This man's dog was extremely ill. Lethargic, whimpering, vomiting, and not eating or drinking.

He brought her in to see the vet who had cared for her for the past five years. After spending $500 on bloodwork, x-rays, and the exam, he was told that his dog needed to be hospitalized for observation and more tests - they gave him an estimate of $1200, or the option of euthanizing her for $350...

He was told that either way, he needed to pay in full up front. 

This man is severely disabled  - he has one leg and diabetic ulcers on the other - and lives on less than $700 a month. Oh, he also gets $15 a month in food vouchers. He had a longstanding relationship with this vet and ZERO outstanding bills with them, but they refused to offer him a payment plan. Their excuse was that they had changed their policy and no longer offered credit.

Every other vet he tried told him they wanted payment up front as well, although a few stated that if he had been their customer for five years they would have tried to arrange a payment plan. Finally, he tried the vet that we use - who also turned him away because he was "not an established account" - but the vet tech remembered that we were always helping unwanted cats, and called to ask if we would try to help this dog.

Of course, we did. Oh, and even though we HAD (as in "we're out of here")  a long standing relationship with this vet's office, they still refused to see her on OUR account until we put down $500 cash up front. So much for being a loyal - and lucrative, customer.

Sadly, the dog was in terrible shape and vomiting up blood that looked like coffee grounds by the time she was seen. Turns out she had been poisoned and had internal bleeding. She died that day. The vet actually commented that it was "too bad" that she had not gotten in sooner because she might have lived.

We've done A LOT of business with vets over the years. Even though we're a small rescue we probably average 50 pet visits a year. We've never seen this sort of attitude before, but I have noticed a lot of the vets we used to see have moved on, and most of the practices seem to be getting bigger and bigger. Our old vets drove pick ups, the new ones at this place all have BMWs and Mercedes...

Sorry to rant, but we're still disgusted and in shock. When did it become all about the money?
 

sarahd1987

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That's really awful and I've had similar feelings about the vet I use recently..

My kitten Sophie had an accident almost 2 weeks ago now. I'd stupidly forgot to close a window properly and she'd got out and fallen from the roof (I live in a house converted to flats and mine is like an attic conversion thing). I phoned the vet I'd been using for both my kittens. I'd not been there customer for a long time since my cats are still young, but they've had checkups done there, all their vaccinations and I also had to take one of my kittens another time after they were playing a little rough and Chloe got bitten on her neck, and they were also booked in to be spayed (And it was already paid for in advance).

Anyway, when she had her accident I phoned them asking if they could see her. I don't have a lot of spare money at the moment because I'm not working because of illness and they refused to see her that night unless I could afford to pay them the out of hour fee of £135 + whatever treatment is available and it came at quite a bad time when I barely had any money so I had to borrow some money from family just to be able to get her seen.

The next day she needed to go back in again to have another checkup and then a day later they wanted to see her again to do xrays so I had to find around another £300. After the xrays they found out she had broken her front right leg and needed surgery to put pins in, which was estimated to cost around £1000 - £1200. For the surgery and further treatment they did a direct claim from the pet insurance, but I still feel a bit disappointed about how they showed so little regard for her when she had her accident and wanted me to wait until the following day if I couldn't afford the out of hours consultation, even though she was limping a lot and seemed in pain... On their advertisements and things it says something like "We care for your pets as we would our own" but thats honestly a load of crap when they wouldn't even see her unless I could find the money to pay up front even though I'd been told in the past that they could do direct insurance claims.

I'm also very disappointed that when she has her bandages changed they dont allow me to be present when they're changing it because they want to change it in the back room and they dont want owners in there because of having other patients in there..On Thursday when her bandage was changed the latest time they told me there were some problems with her leg from the splint/bandage putting too much pressure on it and didn't really explain properly what the issue was and I'm the type of person who worries a lot when I don't know whats going on.

I have another appointment this afternoon for a bandage change and I'm going to insist I'm present when it's being done so I can see what exactly the problem is. I'm no vet but I want to see whats wrong so I have at least a little understanding of the problem rather than being told there's something wrong with it and not having it explained properly.

I feel like I'm stuck with this vet for now though because I couldn't find any other orthopedic specialists in my local area when I've called around other vets and she's going to need further surgery to remove the pins once her leg has healed up fully.. I think once Sophie's treatment is dealt with I'm going to look for another vet though for both my little girls..
 
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jane11

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This is really depressing. I thought maybe this was an isolated thing, but when our vet also started insisting on payment up front I realized that things have changed. 

I'm sorry, but if you're an established customer, and the vet has seen your cat before then I feel they really should show more concern. When we first started out we had a very tight budget and we never had a vet that refused to offer a payment plan. I never saw a vet turn away a cat who was sick, and they never lost a penny they were owed.

These days though, it seems too many places are just about making money. I wonder how some of these vets keep their customers?
 

blackcat416

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I love my vet! I have 7 cats that go yearly for their shots and I insist on blood work for all. My vet has all the latest gadgets in their office from the ear thermometer to the ear scope that I can also see inside my cats ears. I also appreciate their caring attitude to my pets. I completely understand, accept and obey the house rules for my vet. Once I enter the patients room, the vet and the vet tech take over. I can comfort my cats by talking to them but no touching or handling, the vet and vet tech do everything. I am interviewed by the vet on ailments or issues before each exam. On the other hand they are very open and frank with me. I have a very strict policy, I will not pay $1 for a dead cat. So, if you tell me my cat will be just fine if one of them needs a $3,000 surgery we go for it. But I am not paying $3,000 for a cat that will be in agony for 2 or 3 weeks then die or have to be put down.

Just last week, I had my Mamma Pooch at the vet, she is 20 years old, soon to be 21 on April 23rd. The vet I saw wasn't her usual vet, but asked me outright what my expectations were? Well if you can make her better, let's go for it, if not, Mamma Pooch will be very sadly missed. So he asked for authorization to do blood and urine work for diagnosis purposes and suggested she spend the night on an IV drip because she was dehydrated. As long as I can pick her up at 9am sharp I was fine with that. But in the off chance that Mamma Pooch decided to cross over the rainbow bridge during the night, I'm on the hook for a $15 urine test and a $60 blood test, we agreed and I didn't even get to say goodnight to Mamma. So I'm back at 9 am the next day and only get to say is Mamna Pooch ready, and I hear her screaming her guts out because she heard my voice. So $400 later Mamma Pooch is diagnosed with gallstones which she is way too old for surgery, even though her kidneys and liver are excellent we leave with a new special diet, 8 cans of special food, antibiotics for 5 days and some ointment for her ears. Mamma never felt better, the IV did wonders for her. While waiting for me to arrive they had already given her the first dose of medicine plus some more IV sub Q. She bounced around the house like a kitten when I let her out of the carrier. Had her blood and urine work had not come back good, Mamma would have had to make the trip over the rainbow bridge. She is no longer vomiting but if she does, I will know she is in pain. Otherwise on the new diet, she should live as normal as a 20 year old cat. I have no expectations except to love her and be loved back. Plus I bet Mamma had a better night sleep at the vet then I had in bed without her next to me sleeping on my hand.


So yes I love my vet! I also love my precious kitties much more, so much that I would never let them suffer one day of pain just because I will miss them. I also like all the new gadgets in my vets office, but someone has to pay for all of that equipment, 2 receptionists, 2 vet techs, 2 vets, lighting, heating, taxes, insurance, cleaning, furniture, TV, cable, telephones, answering service, etc. etc. Guess it's going to be the patients. If I was truly concerned with vet bills and cat expenses I would take out animal insurance for my tribe of 7. But for me, having no children, having not spent one penny on my
non-children's college tuition, I can say, how much do I owe you for my pets vet visit? Yes it's a shame that vets have to tell their patients, even long, existing, preferred customers what the cost will be up front or ask for a deposit on services to be rendered. Then again, so does my personal doctor, dentist and every hospital in the USA have the same signs posted in their reception area.
 

asherdash

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A similar thing happened to one of my girlfriends very close friend. Her puppy got really sick and shketone him to her vet.He seemed to be getting better then took a downturn on a weekend. I don't remember the exact fee but it was well over $2500.she paid the fee and they kept him over night. He went home the next day and got sick a few days later. She paid over $1000(borrowed from us and even a really bad ex boyfriend(I do I've him major points for this).. When the vet wanted still even more money and she said she would not be able to pay that much at one time,their tone got really ugly and pretty much laid a very big guilt trip on her.she tried another vet too and the same thing happened. In the meantime the puppy got worse and the decision was made that they couldn't save him anyway.
 

denice

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I think all of the vets here require payment at the time of service.  When I took one of my cats to the vet clinic I go to now, my chronically ill cat that I had been vet hopping with was very ill and needed to be hospitalized.  Because I was a new client I had to pay half the estimated costs up front.  I don't have to do that now but payment in full is expected before I leave with my cat.  Unfortunately a lot of people will have an animal hospitalized then when the bill turns out to be high they don't come back for their pet.  One of the vets I went to previously even had a sign up saying that animal control would be called for all animals not picked up on the day they are ready to go home.
 

sarahd1987

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I think all of the vets here require payment at the time of service.  When I took one of my cats to the vet clinic I go to now, my chronically ill cat that I had been vet hopping with was very ill and needed to be hospitalized.  Because I was a new client I had to pay half the estimated costs up front.  I don't have to do that now but payment in full is expected before I leave with my cat.  Unfortunately a lot of people will have an animal hospitalized then when the bill turns out to be high they don't come back for their pet.  One of the vets I went to previously even had a sign up saying that animal control would be called for all animals not picked up on the day they are ready to go home.
I think it's awful that someone would abandon their pet due to a large bill.. It's not like the vet are going to hold the pet hostage until they receive their money. I'm sure if someone couldn't pay the full amount they'd at least be able to set up some sort of arrangement..
 

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It's sad but I totally understand why vets do it. They kind of have to, or people will take advantage. Vets have to pay for their office rent/mortgage, utilities, pay the vet tech and receptionist's salaries, pay for supplies and of course they need to support their own families too. So they can't give away services for free. I unfortunately know a lot of people whose vet let them run up a tab and they stopped paying on it once the pet died or got better. My vet is an old small-town farm vet and he still allows people to make payments. But he gets burned a lot too. I don't expect every vet to be willing to put up with that.
 

denice

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I found this article that paints a bleak picture as far as finances for vets http://www.nytimes.com/2013/02/24/b...lling-demand-trap-new-veterinarians.html?_r=0

They on average have a debt to income ratio that is twice that of MDs and there is getting to be a surplus of vets which means incomes are falling.  I am sure there are vets that own thriving practices and are driving BMWs and Mercedes but I don't think that is true of the average vet.  The average vet is more likely to be struggling financially.
 

peaches08

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I found this article that paints a bleak picture as far as finances for vets http://www.nytimes.com/2013/02/24/b...lling-demand-trap-new-veterinarians.html?_r=0

They on average have a debt to income ratio that is twice that of MDs and there is getting to be a surplus of vets which means incomes are falling.  I am sure there are vets that own thriving practices and are driving BMWs and Mercedes but I don't think that is true of the average vet.  The average vet is more likely to be struggling financially.
And most people don't realize that it's harder to get into vet school than med school.  Yet look at the "pay off" for going.

I find the OP's story very upsetting, but I can understand why a lot of vets are going this way.  Throw in many owner's attitudes that they shouldn't have to pay if the animal dies and I can't understand why anyone would want to be a vet.  Vet's are not the Creator, they can only do so much.
 
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jane11

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Oh, I certainly understand those of you love your vets. Up until this happened I was one of you.

But, over the past year or so, I've seen a change in the way the practices around here are being run. Many of the vets we used to see are no longer working here. When the bigger "chain" practices with four or five vets opened they moved on. 

Our old vets were great folks. They drove pick ups and would make house calls in the country. They were part of the community and ate lunch at the same cafes we went to. We trusted them implicitly because it was obvious they truly cared about their patients.

With the newer vets around here you just don't  get that feeling. I can't explain it, you just have to experience it.

We always insist on going in back with our cats. That is how we are convinced our vet's are sanitary, and that the vet techs are properly handling the animals. Two years ago I watched as three young techs tried to give a sub-Q to a struggling cat. One of the techs dropped the line and it fell on the floor. She then tried to use it on the cat even though the needle had touched the floor and was no longer sterile. It was a simple mistake, made under stress, but I want to be there to see that it does not happen if I can prevent it. So I wouldn't use a vet who objected to my presence while my pet is treated.

The idea of refusing to pay if a pet dies is intriguing. Honestly, I wish we could do it.

I've never heard -or even thought of - telling a vet we would not pay the bill for an animal that dies. Do your vets agree to that?

We have paid MANY bills -in full- over the years for pets who died in surgery or under care for an illness. We always felt that if the vet renders service we had to assume they did their best and were due full payment even if the outcome was poor. 

I'm not sure I'd be comfortable telling my vet that "I will not pay $1 for a dead cat." - I'd be afraid they would simply refuse to treat the more seriously ill patients, and I'm not sure I'd be comfortable refusing to pay a vet who had tried his or her best and failed. But I do see your point, and it is a policy that would reduce a lot of uncertainty. I just don't know if it would work for us since we get so many seriously ill cats. I wish I felt differently, it would have saved us a mint over the years!

I agree with all of you who feel that patients should pay for the cost of their care. Someone has to.

But I don't agree with refusing to set up a plan for an established customer who has already spent $500 on tests for his pets. To me, that is way over the line of acceptable practice. If the expectations of eventual cost were so high they honestly felt they would not be paid, then they should have at least offered to euthanize on payments or at a lower cost. Some consideration was due not only for the owner, but for their patient, too.

Vets are physicians, not auto mechanics. Compassion should still be a consideration.
 

Willowy

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I don't think BlackCat 416 meant that they don't pay the vet if the cat dies (that would get you blacklisted by that vet pretty quick!), I think he/she meant that they won't spend money to treat a cat if the treatment doesn't have a high chance of success. I feel the same way.

The people who don't pay their bill if the pet dies or gets better obviously can't go back to that vet again. So they go to another vet, or (if the pet died) don't get anymore pets.

Yes, compassion should be a consideration and I agree they should at least offer some option for euthanasia. But agreeing to take payments for anything is a slippery slope. . .
 
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denice

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I know the vet clinic that I go to doesn't charge for euthanizing a cat that was a long standing client, particularly if they had a chronic illness that had involved a lot in the way of extra vet expenses.  Of course if someone wants separate cremation and return of the ashes there is a charge for that, actually the charge is from the crematory.  They have even been known to send a flower arrangement to the pets owner afterward.
 

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My dad is a semi-retired Vet and he treated pretty much anything that would walk through his door whether or not people had money because he was compassionate and couldn't turn an injured or sick pet away.    He probably has sent over $200,000 in bad debt to collection agencies over the years and still has probably $25,000 he is trying to collect on.  Medications and vet care costs money, utilities, rent, products, employees all need to be paid.   He had bills to pay and unfortunately wound up closing his clinic instead of selling it because of people who couldn't pay their bills and he had debts he had to pay anyways.   When people don't pay their bills, the vets can't pay their bills, utilities, rent etc.  I know some people keep their word but the vast majority of them do not.  That is the harsh reality.

Unfortunately people don't always keep their word and pay when they say they will.  The vet I work for doesn't do any billing other than care credit.  It's unfortunate that it has come to this but people don't keep up their end of the bargain a lot.  I think a lot of people get pets without understanding the expectations and the costs involved of owning one.  My husband went to the ER recently with chest pains, even though it could have potentially been a heart attack they wouldn't even start treatment without finances being settled (insurance and co pays),.

We have a couple of clients who put away a little money each payday for their pets for their routine things as well as for any emergencies that arise, I think that or having pet insurance is the way to go.
 
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cprcheetah

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I think it's awful that someone would abandon their pet due to a large bill.. It's not like the vet are going to hold the pet hostage until they receive their money. I'm sure if someone couldn't pay the full amount they'd at least be able to set up some sort of arrangement..
Unfortunately this is what has to happen, otherwise the vets don't get paid.  I work for a vet and if people can't pay their bill, they don't get their pet back until their bill is paid in full, I know it's harsh but too many people don't come back to pay their bill.  There is pet insurance people can get as well as Care Credit for finance options.  You don't go to the grocery store and ask them to let you take the groceries without paying for them.
 
I found this article that paints a bleak picture as far as finances for vets http://www.nytimes.com/2013/02/24/b...lling-demand-trap-new-veterinarians.html?_r=0

They on average have a debt to income ratio that is twice that of MDs and there is getting to be a surplus of vets which means incomes are falling.  I am sure there are vets that own thriving practices and are driving BMWs and Mercedes but I don't think that is true of the average vet.  The average vet is more likely to be struggling financially.
The vet I work for has a pretty thriving practice.  She just got a new car, her last car was 15 years old and she ran it pretty much into the ground :)  She loved it, but it was time for a new car.  She got a subaru.  But yes the average vet does struggle financially.  My dad is a semi-retired vet and he has a 1995 Dodge Truck that he drives.  He also has a Jeep Cherokee, but no new cars for him for a really long time.
 
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jane11

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I'm sure that vets do have problems with clients who don't pay. Every business deals with that, including ours. That is why I think that some lower cost option - even if is PTS - be made available to established clients who simply do not have cash on hand to deal with an unexpected crisis. That is just showing concern for the animals. I don't think anyone should be sent home with a pet who is suffering and be expected to watch it die slowly in misery. Especially not after they've tried to do the right thing. I mean, why accept $500 for tests and x-rays, then refuse to make humane arrangements for the cost of euthanasia? That just struck us as cruel.

I guess it just shows how different people's views can be on a subject.  We were clients of our vet practice for about seven years, going back to the previous ownership. We did a lot of business with them. But they've lost us over this incident, on top of the general change in atmosphere. We are telling everyone we know to go elsewhere, too. Word of mouth advertising in reverse, I suppose.
 

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It does sound like he was offered euthanasia, but couldn't afford it.  $350 seems awful steep for a euthanasia, or was that for taking care of the body as well?  I'm sorry the gentleman had to go through this, unfortunately too many people not paying their vet bills has ruined it for those who honestly care. I do know the vet I work for sometimes donates her care, we had a chihuahua with a bad cough, that we ended up xrays, doing bloodwork on and giving medications for all for no charge because the guy lost his job and honestly couldn't afford it.  Interestingly enough his xrays revealed a bladder stone not related to the cough, so the guy is rallying and trying to get money for that surgery.  We also have what's called our "Angel Fund" where we have medications that we can give to people who honestly cannot afford them. 
 
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jane11

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Cprcheetah -

He was offered euthanasia but only if he could pay  for it  in full after he had just paid $500 cash for the tests. $350 was the quote just for euthanasia we were told. Honestly, we feel the vet just didn't want to deal with him because he was low income. We could be wrong, but that is the nicest, and simplest explanation we could come up with.

The vet you work for sounds like our old vets. If a patient was out of work they would charge for an office visit and meds, and either send them home with advice and the meds, or offer them payments for half the amount.

But there was always an option for some level of care, even if it was just meds and hope for the best. I know. We started out with that with our first FIV+ kitty. We had lousy jobs and had to pay $125 each week for a month. But she lived for 5  years after her previous owner had been told by her vet she would be dead in a week.

You never can tell with cats.
 

sarahd1987

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Unfortunately this is what has to happen, otherwise the vets don't get paid.  I work for a vet and if people can't pay their bill, they don't get their pet back until their bill is paid in full, I know it's harsh but too many people don't come back to pay their bill.  There is pet insurance people can get as well as Care Credit for finance options.  You don't go to the grocery store and ask them to let you take the groceries without paying for them.
I'm not saying it's ok for people to not pay their bills, but surely pet owners have some rights to stop people taking their pets? A pet isn't like a tv/computer/whatever else, it's a living thing.. As far as I know, at least here in the UK if you have debt and have bailiffs came to take things for example, they can't take pet's (I might be wrong, but I'm sure I read/heard that somewhere)
 
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