Those of you old enough to remember going to Disney World in the 60's and 70's will remember buying A - E coupons when you entered the Magic Kingdom. You would tell the ticket lady how many of each type of ticket you wanted to purchase. An A ticket got your kid a ride on Dumbo the Flying Elephant, but if you wanted to go to Space Mountain or The Haunted Mansion, you had to use up one of your precious, more costly, E tickets. The same sort of thing happens in a veterinary clinic when it comes to choosing the level of care you want for your pet. You can decide if you want your pet to have A-class treatment, or E-class treatment or some treatment in-between the two. No one in this clinic is going to criticize any decision anyone makes in either direction. With A-type treatment we will do a good physical exam, make our best call on what condition or conditions may be going on and try some treatment before proceeding with more expensive workups. As we go up the diagnostic ladder adding more and more tests to pinpoint the disease, the cost obviously escalates. Many of our clients like us to try "A" treatment first and an equal number like to buy an E ticket, all the way up ultrasounds, CT scans, radiation treatment for cancer, expensive chemotherapy protocols and now, MRI scans. We maintain a strong referral network of specialists at specialty hospitals here in the Chicago area and at Purdue and the University of Illinois vet schools and can offer any level of care. We frequently have three specialists, a cardiologist, a radiologist, and a surgeon for the more difficult surgeries, in our clinic giving care to our client's pets. We very much enjoy working up the difficult cases as that is what keeps practice interesting. On the other hand, we have no problem taking a good history, doing a good physical exam and then "give it your best guess, a shot and some pills, doc". The only thing I won't do is to euthanize a pet that I think can be easily treated and cured with minimal cost.
Our profession in the past few years is experiencing a paradigm shift where we are seeing "layers" of veterinary care options dictated by a pet owners ability to pay. The new normal will be larger corporate-owned practices with the corporate mindset. The small practices are fading away. Pet insurance would be nice to help cover our fees, but honestly, even our highest fees are not that great. Nowhere near what the corporate practices charge. But!!...we do need the help of specialists off and on and you would be well-served to have a pet insurance policy.
"As more and more new graduates go into Mega- and corporate-owned veterinary clinics for a number of reasons, small private practices will become a thing of the past. Accountants, lawyers, investors and other non-DVMS on the West and East Coasts will continue to dictate fees to the rest of the nation with small regard to an individual pet owner's ability to pay. Corporate-owned practice employed veterinarians will have no discretion in charges". Ralph Miller, DVM