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Wednesday, March 21, 2012

Shot Clinics: Good Or Bad?

I stirred the pot a bit yesterday with my discussion on the poor business model veterinarians have related to prescription medications.  Today let me stoke the fire a bit and see if I can really get it boiling.

I believe that another bad business decision is related to vaccines.  When I was growing up working for a vet, the standard practice was that there was no office visit charged when a pet received vaccines.  So the clients came in and paid for the immunizations but not the exam.  Most vets charged this way back then and many still do.  While it seems to be an incentive for owners to come in for vaccines, it also places the emphasis on the wrong aspect of the visit.  The clients think they just need the shots.  In reality we need to do the exam and will happen to give the shots if everything looks good.  The most important part of the visit is a thorough exam by the vet.  Unfortunately, we now have 1-2 generations of pet owners who are used to this older model and are put off by vets who actually charge for exams.  Once again, poor business models by vets are hurting the profession as a whole and are making it difficult to change client perceptions.

Which brings me to "shot clinics".  These happen all over the country, sometimes in store parking lots, sometimes inside pet stores, or sometimes through mobile facilities.  Clients bring their pets for vaccines, minimal to no exam is performed, and the clinic charges minimal price for the injections.  This is another poor business model that harms the profession.

So why do I feel this way?  It goes back to my earlier comments about emphasizing the wrong thing.  The vets and technicians in these clinics often will not do a thorough exam, simply giving the shots and moving on.  Many things can be missed this way, such as periodontal disease, heart murmurs, tumors, and many other problems that the owner may not have noticed.  These clients likely won't go to a vet for a separate annual exam, which means that disorders can go missed for years, sometimes becoming very advanced where it may be more difficult to treat.  Once again the emphasis is on the vaccine, not on the exam, which is the wrong message to send to people.

"But what about poor people?  What about those who can't afford a regular vet?  Don't their pets need shots also?"  I'm going to be a bit harsh for a moment, but this is nothing I haven't said many times in the past.  If you cannot afford basic, proper care for a pet, you shouldn't have a pet at all.  If someone doesn't have the money for regular vet visits and preventative care, then they should get a hamster or guinea pig, not a dog or cat.  Pet ownership is not a right.  And doing annual vaccines alone is NOT sufficient for proper health care!  I simply can't emphasize that point enough.  Full physical exams are a necessity and can prevent more serious problems later on.

However, I do recognize that people fall on hard times.  I feel that shelters and discount vaccine clinics should have a means testing procedure.  Someone making $20,000 a year certainly would benefit from these clinics (though I'd argue they shouldn't have a pet at all).  Someone making $100,000 annually should be excluded from shot clinics.  There needs to be a way for people to prove income to justify getting discounted services. 

But all of this takes a change in the mindset of both veterinarians and consumers.  We have a lot of bad business practices to overcome.  It took a couple of generations to develop these bad habits, and it will take at least as many to break them.  Once we do so the profession will be in a better situation and the pets will be healthier.

13 comments:

  1. There is no way in hell I'd take my dog to a random clinic for shots. I just refuse to let someone that knows nothing about my dog treat him. Besides, if something goes terribly wrong as the result of an injection, there is a fully staffed and supplied vet hospital that can provide any care that my dog might need.

    I really dislike people that get animals they can't afford. They think they are helping a dog, but really they're just asking for trouble. If you feed a dog cheap discount dog food and never take him to the vet, you're being cruel. It's a shame that the government doesn't see it like that, thought.

    Before we got a dog, we planned a LOT. We just bought a house, and while we could have put down more money and gotten a lower mortgage, I wanted to keep money in the bank in case the dog needs surgery or something. I couldn't live with myself if I knew that my dog had to die because I didn't plan for his potential expenses well.

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    1. Whomever you first took your dog to knew nothing about your dog. You had to trust them. There are an awful lot of irresponsible owners regardless of their financial situations. There are a great deal of loving, responsible owners who happen to have little to no money. We don't know how they got into whatever situation they are in. However, if they can receive assistance for someone they love while trying to get back on their feet, so be it.
      Good luck to them.......both!

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  2. I take my dog to the vet for his yearly check up and for illness, and up until last year he received his vaccinations at the time of his yearly well visit. However, last year because of moving his yearly visit was pushed back a few months. I didn't want him to be delinquent on his shots so we took him to a shot clinic and then didn't need the vaccinations when it was time for his yearly.

    The price difference between his normal check up and just a physical without the shots was over $100. Since rabies, DHPP, and bordetella vaccines were less than $30 at the shot clinic, it is a not-insignificant difference.

    When I adopted my dog I was part of a two income family and I never thought twice when it came to paying whatever my vet charged. Now I am living on student loans and I have to be a lot more careful about my spending. I don't know that I could justify paying so much more to get my dog his shots at the vet's office this year.

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  3. Also, Erin, please keep in mind that people's circumstances in life change! Lots of people have experienced job loss in the past few years and divorces happen, etc. Planning ahead is only helpful if things go according to plan ;-)

    Being poor(er) and pet ownership shouldn't be mutually exclusive*, it just means that if there is an emergency you are faced with tougher decisions. My dog isn't going to die because I don't have an extra buffer in the bank, it means his treatment goes on my emergency credit card and every little corner that can be cut financially will be cut until it is paid off.


    *There are neglectful owners at all levels of financial stability.

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  4. I'm in agreement with this - I wouldn't ever take my dog to a mobile clinic either. Even when I've been financially challenged, I've managed to find a way to pay for whatever care my dogs have needed. However I do have to question how most rescues will follow those low-cost practices; for example they will find vets that will supply vaccines (and sometimes even antibiotics or other meds without an exam) and the rescue volunteers/staff will administer the shots, most of the rescues don't always feed their dogs a high quality diet, they will only take their rescued dogs to the vet when it's really obvious something is wrong, their dogs aren't heart worm tested either. I understand the budget limitations with operating a rescue - but if they are allowed to get away with minimal care for dogs/cats/etc and also applauded for their efforts at rescue, why are pet owners that are low-income (or not) that provide that same level of care criticized?

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  5. There are parts of this I agree with on some level and there are other parts that couldn't disagree with more.

    I agree that when in a normal clinic setting, the client should be charged for an exam and the animal's health be discussed yearly. Clients who want this information will happily pay for it and will seek out a situation that provides it (a veterinary clinic). Other people simply don't want this and wouldn't be able to afford the gammit of treatment even if you did unearth some underlying health problem. People are well aware that vaccine clinics serve a purpose; to give vaccines ONLY. Just as human influenza shots are doled out, so are vaccines for dogs and cats. Why?? For health of the animal POPULATION, not necessarily for the health of only the individual animal. Would Rabies and Distemper be as rare if vaccination wasn't easily accessible for low income pet owners? Probably not.

    The other thing that absolutely do NOT agree with is the assumption that poor people can't properly care for their animals. On a daily basis, I see those who are below poverty level provide better care than those who are driving luxury cars and living in McMasions. Hell, I AM a veterinarian and after my monthly student loan payments, I, myself, am just barely above the poverty level. Do I provide great care for my animals? Yes. Do they eat everyday? Yes. Do I provide them safety, shelter, love, attention, and enrichment? Yes. I do not think I'm alone. If you put restrictions that "poor people can't own pets" who will be there to absorb the massive amounts of pets that will no longer have homes? I agree that proper care is required when taking the responsibility on of owning a pet; however, I do not believe that your economic bracket dictates whether or not you can provide such care. I see plenty of happy, healthy, dogs every day who live wonderful lives. They may not be taken to the Doggie Spa weekly or being fed $90/bag dog food, but they have a happy life; and even though I'm a horse vet, I often am the one to put them asleep when they begin to have health problems. In my mind, euthanasia is just as moral and ethical as long drawn out treatment for chronic diseases.

    Vaccine clinics provide a necessary service to the pet population. Poor people aren't the enemy in the quest for animal health, irresponsible people are.

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  6. This is an interesting discussion. I have a friend who lives paycheck to paycheck. He adopted a dog from a neighbor when he found out that the guy was only feeding the dog ham. My friend did not know very much about dogs but felt so bad for this pup he took him off the guy’s hands. He learned a lot about proper pet care through me, and I learned a lot about low-cost veterinary services through this friend. In our city, many of the low-cost veterinary services DO require proof of financial need in order to qualify, and my friend was not “poor” enough. He couldn’t afford any of the vets in the nicer parts of the city, and so I accompanied him to vets in rougher areas, where the vets were very caring and competent but the places were always understaffed, disorganized, flea-ridden, smelled terrible, and you had to wait for HOURS to be seen. It reminded me of some free clinics for people. It was eye-opening to see some clients there who looked a little unkempt, but their pets had trendy collars and sweaters. Like my friend, these clients probably did not properly plan for a new pet and consider all the costs and unforeseen emergencies that can arise, but nonetheless they were doing all they could for their pet that they loved. People can get vaccines without seeing a doctor, and while I agree that the exam is of utmost importance, I think that it’s a good thing the vaccines are available at low cost for the people who really can’t afford the best care but refuse to give up their pet.

    On the other hand, again with my rescue we get all kinds of owner turn-ins where the owners just had a new baby or a new job or some other life-changing experience and decide they don’t have time for a dog anymore. And usually these are the dogs that have terrible ear, dental, and allergy issues that the owners just let go unnoticed. It’s so frustrating when people who have the means neglect their pets. But our rescue requires all dogs to go straight to the vet for exams, vaccines, and usually surgery or some other type of treatment before they are even considered adoptable and we would never skip the step of seeing the vet, because why would you risk sending off a sick dog to an adopter who will then turn around and bring it right back to you (or worse, dump it off at a shelter or on the side of the road)? I would be wary of any rescue that attempted to work around vets.

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  7. People who are well-off are capable of experiencing monetary loss.

    Just like poor people are capable of budgeting their finances in a way that provides support to their animals.

    Also, I blew waaaaay more money on my pet rats over the years than I have on my cats and dog, even throwing in the needed neuterings and yearly shots.

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  8. This is a very interesting discussion! I volunteer at the Mercer clinic for pets of the homeless of Sacramento, many of our clients line up the night before for our free services. We offer preventative care (vaccine, flea, heartworm preventative, per-surgery bloodwork, spay/neuter etc). We will refer or try to find low cost surgery options if the pet needs it. The clinic is run primarily by veterinary students and veterinarian volunteers. It's a non profit and all our funding comes from our community donations. We have some clients with more than 6 animals and they are homeless! Yes, they love their animals and to some that may be all they have. I struggle sometimes to wonder, do these people deserve to have pets at all if they can't afford their basic care or even basic care for themselves (especially the ones with 6+ animals?). Without our free clinic, what would these people do? I really feel as though we are helping, but are we also hindering?

    This is definitely a big ethical and societal topic that I find interesting and have not yet decided where I land on this spectrum. Although I do agree that all pets should be examined by a veterinarian at least once a year.

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  9. A good discussion, everyone, and I appreciate that it's being kept civil.

    Let me clarify a few of my own points. First, I still stand by my position that if you can't afford to properly care for a pet, you shouldn't have one. This is true regardless of what your actual income is. I've seen destitute people up things for themselves in order to do proper pet care, and I've seen people with iPhones and fancy cars who aren't willing to do even the most basic things. I agree that there are good and poor pet owners at all income levels. However, I don't think that people who make a good amount of money should be allowed to use discount clinics, and think there should be some means testing. Not only are they not doing the right care for their pet, they are using resources that someone else of lower income could have. And these low-cost clinics run on shoestring budgets as it is.

    Yes, many clients know that shot clinics only do vaccines and they're not getting full service. But we as a profession for a couple of generations have structured our business and education so that clients think that this is enough and is adequate. Which is the wrong message we need to be sending!

    Bottom line...if you can't afford regular veterinary care, basic vaccines, heartworm and flea prevention, DON'T GET A PET! You're not helping out the pet as much as you might think. And people who advocate such positions are in danger of being "enablers", continuing to promote bad behavior.

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  10. Oh, I also want to stand up in defense of shelters and rescue organizations based on some of Stefanie's comments. There are some poorly run shelters out there. But the majority that I have worked with over my career are simply doing the best that they can with very limited resources. Since they operate on grants, donations, and volunteers, they can't always afford to do the bare minimum. They certainly can't afford "premium" foods, and I don't begrudge them that point. Most shelters I know of will test for heartworms and felv/fiv and will seek appropriate veterinary care. I even had a shelter pay for a diaphragmatic hernia repair on a 4 month old kitten! So I actually have respect for most shelters and rescues.

    And that is a different situation than owners with limited funds. The shelters are there to take in rescues and then find homes for them, not to keep them for life. Pet owners CHOOSE to take in pets and will generally keep them for life. There is a difference in the willingness and choice, and there is significant responsibility that goes along with such decisions.

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  11. I totally agree with only having pets if you can afford them. They are expensive, don't get a pet on a whim. The only thing that I don't agree with is that statement of 'buy a hamster'. I have been doing observations at an exotic vet (including hamsters) and those five dollar hamsters can cost a really lot if they get a tumor, gut upset, or diese. Sadly some people are not willing to pay that for either financial reasons or just the fact that they paid very little so they don't want to spend money on it. This is somethign that everone needs to be aware of! five dollar hamsters can end up costing you just as much on a vet trip as a dog or a cat. And their surgeries are more expensive.

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