If I were to rank my clients’ complaints over business practices in veterinary medicine, the number one offending issue wins by a wide margin: It’s the price of emergency care. 

 

Truth be told, it’s a sore spot with me, too. Like the time I lost a client over an $800 ER bill when a cat chewed out her stitches on a $200 spay (the doc at the ER told this client she should ask me to pay). Like when an after hours euthanasia that couldn’t wait went for $600 instead of $150. Like when the ER runs up a bill on services that could have waited ‘til morning (when I could have done them for a fraction of the cost).

 

Of course, not every after hours service can wait. Not every E-clinic racks up the charges gratuitously (though two of the three in my area tend to do so with regularity). And hospitals that stay open all night make veterinary medicine doable for single-parent vets like me whose kid has to be in bed by 8:30 PM and for whom a midnight emergency is an automatic non-starter.

 

Moreover, we all understand that hospitals open all night have higher staff costs (whether it’s a busy night or not), often maintain fancier equipment, take on more risks (you try unlocking the door for the huge biker with a Rottweiler at 3 AM), and generally do their community a great service. They deserve to be paid more. 

 

But how much more? 

 

Aye, that’s the rub. When is it perfectly justified and when is it abusive? How is a pet owner to know? Even if he did know, what could he do about it? After all, the sick pet’s “parent” is a captive audience on a Sunday, right?

 

It’s inevitable, then, that this discussion is all about Monday-morning quarterbacking the average emergency hospital’s policies, procedures and prices. For that, I apologize profusely to those who run these places and work these unenviable shifts. Nonetheless, I consider it a necessary evil that we entertain this topic, especially now that fewer and fewer veterinarians take on their own emergencies.

 

What do I think is fair? Two times what the practice would charge if it operated under normal daylight, weekday conditions. What do I base this on? The fact that the higher overhead for these practices is primarily about paying staff more.

 

Sure, the laboratory’s machines are usually fancier and the alarm system may be more state-of-the-art, but the big ticket items are the veterinarians and technicians’ time. And because the average tech and doc are typically paid no more than double what they might make for a normal shift, I’d consider doublage prices fair––more for some specific services, perhaps.

 

But lately I’ve been reading about through-the-roof prices in veterinary emergency facilities across the country. On threads on VIN (the Veterinary Information Network) emergency practice owners defend their 1,000% markups on drugs and supplies (not that it costs any more to stock them off hours), their dual emergency and exam fees (one for walking in and one for getting the vet to see you), and their 3-5 times average practice fees for labwork. Crazy!

 

I don’t know about you, but these scary price-points make me wonder whether what the emergency industry doesn’t need is a little healthy competition. In my area we have five emergency hospitals within a 30-minute driving radius. All of them cater to the veterinarians in the surrounding community. And all of them charge roughly the same basic prices––far less than what I’ve seen for many other parts of the country.

 

Yes they’re pricey––but almost never more than 2-3 times what I would charge. Is it the heavy suburban competition that helps? It must. Though that doesn’t keep a couple of bad actors from running up the bill on things like midnight heartworm tests on blocked cats.

 

But enough of my diatribe. What’s it like in your area? What do you consider "fair"?