Low-cost veterinary clinics arent inadequate

In recent weeks I've read articles concerning the relationship between nonprofit veterinary clinics (with or without a shelter association) and for-profit clinics. Most discuss the fact that the relationship is far from pleasant for many and that it takes finesse to achieve a balance that allows them to work side by side.

Those discussions relate to the declawing conversation (in a roundabout way, so please be patient).

My gripe is this: For-profit veterinarians who feel superior to nonprofits love to say, “You get what you pay for. We charge for what we do and make sure folks know what they get for their money.” These doctors' spay packages, dentals and so on show an itemized list of all the services provided with the cost at the bottom.

This implies my clinic is inadequate.

I am proud to say that in less than two years my high-volume, high-quality spay-neuter practice has spayed and castrated more than 10,000 cats and dogs (including serious pyometras referred to us by local veterinarians whose clients could not afford their prices), with minimal complications of importance and a loss of only four cats (though certainly significant to those owners). I don't try to be fast when assigned 50 cats in one day; I strive to do it right and be consistent every time. I've just naturally become fast.

All cats that can be handled are examined by a veterinarian before sedation. All dogs and cats receive gas anesthesia for maintenance. Dogs are intubated, cats only when nasal congestion or another issue is apparent (I can spay a cat faster than many people take to intubate one, so I don't routinely tube them). We give subcutaneous fluids and vitamin B12 injections to any cat that appears even remotely dehydrated (during winter this includes most feral cats) at no charge. We monitor breathing visually and attach a pulse-oximeter. Recovery is on a heated bed within eyesight of at least three people at any given time.

I could go on, but I think this disclosure issue when comparing clinics is a non-issue. It does, however, bring up a challenge I make to these same veterinarians who want to “show folks what they're paying for.” I dare you to include in your declaw package offered to every kitten owner who comes in the door everything they are receiving, making it obvious exactly what a declaw is!

I've been interested in the Paw Project, started by Jennifer Conrad, DVM, and have started asking people who declawed their cats whether they knew exactly what the procedure involved. Of the 18 I've asked so far, none had any idea, and most where disturbed and not sure they would have gone through with the surgery had they known. As veterinarians we are obligated to disclose exactly what we are doing for everything we do to someone's pet.

I used to do declaws, but I stopped more than a decade ago after seeing too many strays beat up on the streets come into the shelters I worked with.

So, all you veterinarians who like to list on estimates and invoices what clients are getting for their money, are you brave enough to include “amputation of distal phalanx” and be sure your clients are aware of what that is? If not, I think your bottom line is the dollar. Maybe it will take clients suing for misrepresentation to catch your attention.

Jennifer Doll, DVM

Solon, Iowa

I have to disagree with Dr. Joan Freesh's statement in “Why all the fuss about low-cost clinics” (November 2014) that “low-cost providers that do not require proof of financial need aren't really reaching those most in need.”

I own a low-cost (not nonprofit) veterinary clinic. We do basic medicine only and work closely with nearby full-service clinics for procedures, surgeries and so on. Because our overhead costs are low, we are able to provide decent veterinary care at a lower cost to the owner. We flat-out tell new clients that we are not just an inexpensive version of the clinic up the street. Those clinics provide valuable, sophisticated diagnostics and treatments not available at our clinic. We provide basic medicine only.

When opening in 2006, we considered requiring proof of income before taking a client. We opted not to work that way for one reason. There are plenty of folks out there on all kinds of government subsidies for any number of reasons. There are also a lot of people who are trying to make it the old-fashioned way. They're working hard, holding multiple jobs, scrimping, saving and trying to make an honest, decent life for themselves, their families and pets. I wanted to help those people who insisted on working. There was no way I was going to turn them away because they could not produce Section 8, disability or food stamps paperwork.

And yes, thankfully, we do have plenty of clients who can absolutely afford the full-service clinic. They come to us because of the care they receive and because they want to support our little storefront veterinary clinic. And I accept them happily because they can afford to do more for their pets and, to be quite honest, their transactions increase my average transaction fee so that I can stay open to help the others.

Susan McMillan, DVM

Burlington, Vermont