Padding the bottom line


With new tests come new costs. Do clients have a right to wonder? By Andy Kollmorgen

Many pets are full-fledged members of the family these days; they may even get a birthday present every year or be in line to inherit the family estate. So it makes sense that their medical treatment has increasingly come to look like human treatment. That means lots of tests, since diagnostics have become such a huge part of human medicine.

With tests comes the concept of preventative care, one that is much discussed when it comes to human health. Such proactive thinking is a long way from the time-honoured pet owner school of thought: wait until there’s a problem and then hurry to the vet and hope they can fix it.

Accordingly, some vet practices are now equipped with diagnostic technology that would have looked space age not so long ago. And if the equipment is not available in-house, the outsourcing of tests has become common practice.

But are pet owners right to wonder whether all the tests are necessary, and whether some vets are really just trying to drive revenue, unconsciously or otherwise? You won’t have to look too hard to find such theories on the internet. Animal vaccinations are another area of lively speculation.

In one widely reported recent case, a veterinarian in Canada who had been practising for 17 years, Dr Andrew Jones, went public with allegations that vets routinely upsell their customers by ordering unnecessary tests, shots and other procedures.

He left the industry after a dispute with the British Columbia Veterinary Medical Association and went on to write a book detailing instances of overservicing, much to the dismay of some of his former colleagues.

“I’m clearly not making friends within the veterinarian industry, but I feel I’m saying things that need to be said that aren’t being said,” Dr Jones told the ABC News website in the US when the story broke in 2013.

But why would vets resort to such tactics? Some say it’s the fact that times are getting tougher out there.

A 2015 survey of 200 companion animal vets in Australia conducted by the firm ACA Research found that the costs of running a practice are increasing, as is the number of customers who can’t pay their vet bills.

It doesn’t help that more and more pet owners are consulting Dr Google instead of visiting a qualified professional.

Better outcomes

When it comes to human health, charges of overtesting have been kicking around for a while. But the animal health experts Vet Practice talked to for this story roundly rebuffed the notion that it’s a big issue in veterinary medicine in Australia. They say it’s more of a media beat-up, actually.

It all might be a matter of perspective, but one thing is clear: the tests have made a big difference in animal health outcomes in recent years.

Imaging technologies such as MRI, CT, and ultrasound, initially used on people, have allowed veterinarians to locate tumours and damaged tissue, among other things, more precisely, and minimised the need for invasive techniques.

Likewise, new tests for infectious diseases have greatly improved the accuracy of diagnosis and speeded up the time line to proper treatment.

Professor Rosanne Taylor, dean of the Faculty of Veterinary Science at the University of Sydney, is a big believer in this new frontier of veterinary medicine.

“Many seek the best available care for their dogs, cats, horses, rabbits, birds and other pets. The veterinary profession has responded to this demand.”—Professor Rosanne Taylor, University of Sydney

She says the increased use of diagnostic testing in recent years has been a major step forward and often turns into a cost saving measure for pet owners.

She bristles at the suggestion that vets are overtesting to increase the flow of dollars into the practice.

“Veterinary science is a health profession that is undergoing rapid expansion in knowledge and capacity for more advanced care of animals,” Professor Taylor says. “Many seek the best available care for their dogs, cats, horses, rabbits, birds, and other pets.  The veterinary profession has responded to this demand by offering a greatly expanded diversity of services and treatments.”

These draw upon the latest advances in diagnostic imaging and include surgical techniques such as regenerative therapies, orthopaedics and even prosthetics, as well as cancer therapy, molecular diagnostics, and behaviour therapies among many other breakthroughs.

“The use of more sophisticated tests is often the most efficient and cost-effective way to reach an accurate diagnosis and enable appropriate treatment, and the outcome for pets has been remarkable, with healthy life spans extending every decade,” Professor Taylor says.

But she acknowledges that tests come with extra costs and says vets should discuss the matter carefully with clients.

“The breadth of choice and treatment remains a personal one for each client, with the majority of veterinarians still operating as general practitioners. Pet owners have this choice and should always ask for the range of diagnostic and treatment options available and their likely outcomes. There will be some owners who would choose these treatments if available, while other owners may not be able to do so.”

Professor Taylor adds that the vet school has a fundraising initiative under way to assist pet owners who may not be able to afford advanced tests and treatment.

Clearly communicate

The Australian Veterinary Assocation (AVA) declined to comment for this story, but it has gone on record previously to address charges of deliberate overtesting.

In 2014, then AVA president Ben Gardiner said part of the problem is that vets may not be effectively communicating the value of new diagnostic procedures to pet owners.

The communication breakdown “likely reflects the difficult reconciliation of the importance of pets in our lives with the rising costs of accessing the latest diagnostic and treatment services available”, Gardiner said.

The decline in publicly funded laboratory services across Australia hasn’t helped matters, he added.

Whether there are deliberate overtesters on the loose in veterinary medicine remains a matter of conjecture. For every comment along such lines in the media and on the internet, there is an equal number of opposing comments in praise of vets and the work they do on behalf of beloved pets.

But vet practices still have a problem if pet owners suspect they’re being heavy-handed with the diagnostics. Costs may inevitably rise with the technological advance of veterinary medicine, but pet owners generally aren’t in a position to understand this. What they do understand is high vet bills.

Overtesting may be a matter of perception, but perception can be everything.


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