The vet is OUT: House calls in practice
Here’s a question for you: How much should a vet charge for a house call? I’m not talking about the large animal vet who does farm calls or the small animal vet who takes the hospital with her. Here I’m drilling you specifically about the vet who attends your pet pillow-side after hours, at lunchtime or on her free time as a “courtesy.”
While euthanasias are the mainstay of my house call practice, I’ll also drag myself out of the hospital for a client’s convenience (six dogs for annual visits, anyone?) or as a nod to those extra-stressed pets who can’t keep it together in a clinical setting.
For the record, I look forward to house calls—especially when they’re within working hours. Problem is, this means I have to give up precious time in the hospital where I could have seen three or more pets in the time it takes me to drive to a specific place and practice my craft with limited equipment—usually on my knees (yoga should be tax-deductible for vets—it keeps us nimble).
Still, I do enough of these that I felt well justified when I forked over a premium for my small SUV earlier this year (considering environmental impact and gas prices today, this is no small concession). Because it’s typically necessary to transport deceased pets (big dogs are more likely to be euthanized at home when they can no longer walk), a large cargo space was essential.
The other issue with house calls is that the time it takes to perform this function can be a slippery thing to estimate. Consider the three hours it took to attend the bedside euthanasia of last Sunday’s patient:
Drive to the hospital, pick up drugs and supplies, clear out cargo space, drive five miles in holiday-shopping traffic, wait for the entire family to arrive, watch each family member say goodbye, wait for the sedative to take effect, place a catheter without assistance, euthanize the patient, stretcher him out to the car, drive back, somehow get his 85-pound body into the hospital on my own (more support for the tax-deductibility of power-yoga), and drive home.
This case also required an additional trip to the detailer to shampoo the blood out of my cargo mat when his lung cancer inadvertently caused a hefty outpouring of fluid that sloshed off the protective plastic sheeting. (I ordered a rubber bucket mat off eBay yesterday).
Suffice it to say that house calls can be perilous—and expensive for the doc. And what may require an hour in a well-organized case can sometimes take hours given the vagaries of family life and unforeseen medical complications.
But how to charge? I don’t always know. While we apply a standard fee to any house call (an additional $80) plus the exam and any procedures or drugs it might necessitate, some house calls clearly should cost more: When I get a call on Sunday requesting an emergency euthanasia. When I spend more than an hour. When a tech is required. When it’s far away. There are so many variables that it’s hard to estimate the cost—and clients deserve to know roughly what it’s going to cost, right?
I ended up charging $125 for the house call on Sunday (plus the injections, catheter and at-cost cremation). I just didn’t feel comfortable charging more without an up-front explanation. Though the client is affluent, I couldn’t justify more under the circumstances. After all, I was served a superb cup of Cuban coffee, fielded offers for fruitcake and sandwiches, and lounged comfortably on a plush leather sofa while the family (a joy to converse with) regaled me with sweet stories of their dog’s past exploits.
Sure, I’d rather be home on a Sunday. I’d rather not spend hours working during my own family time. Still, if I’ve committed to offering this valuable service (which I believe is indispensable to my way of practicing), I can’t just pick and choose my cases. But I can be fair to myself in terms of what it’s really worth.