I am now going to put on my kid gloves. I don’t actually know what those are, but I know one is supposed to put them on when handling a delicate topic. Or so the saying goes.
This is definitely a delicate topic. Mucho controversial. Even here in the practice between us doctors.
I am going to keep my opinion out of this one (yes, it will be hard) and try to stick to the facts as I understand them.
Saturday we had another angry client yelling at the receptionists. The reason this time (and several times before) is our policy on online pharmacies.
Dr. Sharp maintains the policy that we do not write prescriptions for online pharmacies. We will match the prices on items sold at Petmeds.com.
That’s it. Non negotiable.
This particular client was angry that a) we wouldn’t write him a script to buy his heartworm pills online and b) we wouldn’t match the price of the off-brand pharmacy he wanted to buy them at (it was cheaper than our cost).
At the moment, there is no law (in Texas) that says we have to write the script.
That could be changing, there is a bill called the “Fairness to Pet Owners Act” , backed by (surprise, surprise: WalMart) that could change that. The law would require DVM’s to provide scripts for all prescriptions for clients to fill wherever they want.
The AVMA has issued a statement opposing the bill (here’s a VIN article on the topic: http://news.vin.com/vinnews.aspx?articleId=19967 )
So, the reasons we give to not write the scripts include
- We don’t know where those pharmacies are getting their drugs (are they the real thing or counterfeit?)
- Drugs may be expired, or from a foreign country and may not be dosed properly
- The manufacturers won’t honor the guarantees on the products
The flip side of that is that clients take the same risks buying their human drugs on-line.
The biggest threat to the veterinary profession (uh oh, this is my opinion, darnit) comes from something I learned from my human veterinarian.
Well, she’s not a vet, she’s our family doctor, but that is the closest thing to a vet on the human side.
I love her, she’s a great doc. We have a mutually beneficial relationship, she’s my doc and I’m her vet. We text each other whenever our “kids” (hers are canine, mine are human) have issues.
Once, her husband was picking up her dogs after surgery and he about had a coronary over the cost of services. He said he could do all the same stuff in his office (he’s the office manager) for a fraction of the cost.
This was news to me. I thought things that happened on the human side (procedures, office visits, etc) were generally exorbitantly expensive. I thought all doctors were filthy rich. Being unable to bite my tongue, I expressed this sentiment to him.
With much exasperation and hand gesturing (he’s latin American, we are a very dramatic people) he exclaimed that that is not so in family practice. They have to see hundreds of patients a day to just break even. Their fee schedule is capped by the insurance companies (or the government?).
Did you catch that? It may not have actually been hundreds of patients a day (we latin Americans tend to exaggerate). OK, just texted my doc: she said 26-32 patients. Given her work schedule, that averages to about 5 patients an hour.
I generally see two patients an hour.
Point is: in family practice, in order to make money they have to see a large volume of clients. No pharmacy revenue in human med to offset their fees. They can’t raise their fees, so therefore they have to see more clients to make up for it.
Here’s the thing, if everyone starts getting their drugs from sources other than the vet, the vet will lose a huge chunk of his or her revenue.
However, the vet still has to make a living, pay his staff, pay for the overhead, etc.
I don’t know what percentage of our revenue comes from pharmacy sales, I’m going to guess half. So say we lose half our revenue. What do you think we will have to do to make that up?
Raise fees. A lot.
And if that’s not enough, perhaps be forced to see more clients. Office visits will become our main revenue source. Those leisurely hour-long visits when your pet is sick could likely be replaced by brief 15 minute problem-oriented ones. Just the facts please…
I don’t know about you, but one of my favorite things about the job is spending time, getting to know the pets, clients etc as individuals. Running clients through like cattle does not appeal to me.
Will the quality of care suffer? Probably.
I’m all for getting a good deal, I know times are a changin’ and in all likelihood I think our pharmacy as a revenue source may very well go the way of the dinosaur.
Are cheaper drugs worth the cost of more expensive office visits and fees in general? Less personal care? Possibly less thorough care?
Seems like a lot to pay.