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I work in a veterinary school, and it's remarkable to see how worn down veterinarians are compared to my colleagues in "people medicine" (and my comparison grou

• deleted 3y ago
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• wing-_-nuts 3y ago
  > hoping someone will pay for a procedure to save their pet's life while being braced for "I guess we should put them down..." I'm sorry, but vet costs are completely out of whack with reality these days. The truth of the matter is that most people cannot justify spending thousands of dollars on a pet, no matter how much they are loved, and that DOES NOT make them bad or unfit owners. The story quoted $10k to remove a skewer a puppy swallowed, and then pressured the owner give the pup up when they couldn't afford that. Can you not see how that would be viewed as insanely predatory? For profit companies should not be involved in human or animal medicine. Once that cash cow is gone maybe vet school prices will come down to earth.
  • DangitBobby 3y ago
    Absolutely. Any time we have a routine visit, e.g. shots and a checkup, it costs us about $300. I can't remember a single vet visit we had that was less than $100, and we haven't had an emergency visit in years. I have no idea how most people afford it, I assume they just don't take their pets to the vet.
    • Mezzie 3y ago
      Vet costs vary wildly across different regions. I just took my cat in for an emergency (little idiot ate plastic and we had to see if she had a block in her when she was continuing to vomit blood) and got her examined, a shot of anti-nausea medication, imaging of her gi tract, and some bland food to take home (which had to be special as she's allergic to chicken protein) for $215. I thought that was pretty damn reasonable honestly.
      • jnwatson 3y ago
        Private equity is taking over vet clinics. In areas where they have the market locked, they raise prices
      • E39M5S62 3y ago
        I just did the same with a dog maybe a week ago. It was a little over $600. I'm in the exurbs of Chicago.
        • Mezzie 3y ago
          I'm in mid-MI, so I'm not even that far away. Crazy how prices vary.
  • Fomite 3y ago
    So one of the things that comes up a lot is that it's not actually that correlated with cost. Most vets I know (I also work for a state school, not a for profit company) are very sympathetic toward very large and expensive bills, and have always been up front about cost in a way that human medicine is not. There's also a myriad of ways they try to reduce bills when they can. The toll is from folks who aren't spending much smaller amounts of money on life saving procedures.
    • pc86 3y ago
      The absolute amount of money is irrelevant, it matters what percentage of a person's disposable income it is. $10k is nothing if you making half a million dollars a year and have $200k in credit with no balance, because your disposable income is probably $400-450k/yr. $200 is a ruinous amount of money if you make minimum wage and take the bus to work because your disposable income is very likely negative.
      • FrankoDelMar 3y ago
        Yeah, well if someone can't swing $200 they probably shouldn't own a pet.
        • ruined 3y ago
          one's financial situation may change very rapidly, and humans have an innate need for companionship and comfort.
        • r3trohack3r 3y ago
          > Yeah, well if someone can't swing $200 they probably shouldn't own a pet. I'm not sure poor people not adopting pets would meaningfully change the rate at which pets are born. It just results in fewer pets being adopted. Particularly true if shelters fix pets before putting them up for adoption. Most animals that have been bred as pets over 1000s of years are no longer permitted to live without a human caretaker. If they can't swing $200 for a life-saving procedure for a pet, I'd still advise them to adopt a pet to provide it a home for the window of time when the animal could happily live without any vet services. A no-cost (or low-cost) adoption is often a life-saving procedure for an owner-less pet.
  • Dig1t 3y ago
    >and then pressured the owner give the pup up when they couldn't afford that My wife is a vet and I hear about this often. From the vet's perspective, if the owner gives up the puppy then they don't have to put the puppy down. Putting down a puppy is heart-wrenching. You can't give out free medical care, she regularly gives as many discounts as she's allowed to give away, even some she's not supposed to, especially for cases like that. But in the end, the choice is A: put the puppy down or B: do the procedure for free but then the owner has to give up the animal. When presented that choice it's obvious you should try and convince the owner not to put the animal down.
    • vector_spaces 3y ago
      Why is it like that though? Like what are the economics of performing the procedure that it's possible for it to be free if the owner gives it up? Does someone different ultimately foot the bill?
      • hvs 3y ago
        The new owner pays for it.
        • CommieBobDole 3y ago
          How does that work, though? Is there a constellation of dog-seeking people hovering around veterinary offices that only want dogs that cost $10k and have recently had major surgery? People who are willing to donate $10k to save a dog's life but consider it very important that the current owner no longer have the dog anymore for some reason?
          • bb611 3y ago
            $10k means very different things to people of different socioeconomic statuses, but the new owner took a rinsing to keep this dog alive - german shepherd puppies from almost all breeders cost less than $5k. Likely the vet simply knew someone with deep enough pockets who loves dogs and was willing to take one for a well above market fee. It doesn't seem unethical to me that person only wants to save dogs they own.
  • makeitdouble 3y ago
    > The truth of the matter is that most people cannot justify spending thousands of dollars on a pet, no matter how much they are loved, and that DOES NOT make them bad or unfit owners. I'd argue not having the means to deal with emergency situations would make someone unfit to own a pet. I get that circumstances can change and costs increase, but I also feel too many people assume a pet doesn't cost much or isn't much of a comitment. You're right that the costs are crazy, and not taking it into account when deciding to take or keep a pet is irresponsible.
    • watwut 3y ago
      Or we accept that sometimes pets die and that if the operation costs 10000 then fit owner can still decide for the pet to die. That goes for fish, dogs or tarantulas.
      • makeitdouble 3y ago
        We're back to the article situation though, the with owners being bitter and unsupportive and the vets in depression and suicidal.
    • freedomben 3y ago
      We already have a crisis of homeless/stray animals out there. I can't imagine how much worse it would get if we only allowed the 1% of the population with $10,000 or more to spare in case the pet needs surgery to own pets. Also suicides will go up. Pets are an important source of companionship and oxytocin/closeness for people who live alone.
      • makeitdouble 3y ago
        This is a good point. Perhaps the direction should be more about subsiding pet care cost and moving towards fonancial support as part of the humans' medical insurance ? Basically pet ownership would require either 10k on the side or registration and justification to get proper insurance.
  • Fomite 3y ago
    Also, as for "Once that cash cow is gone maybe vet school prices will come down to earth." - the source of the rising cost is a combination of two things, neither one of which has anything to do with small animal medicine: 1) The loss of industry support for large animal vets 2) The loss of state funding for veterinary schools, which has put pressure on the one remaining dial available to those schools, which is tuition. This is a systemic problem that extends way beyond vet schools, but is particularly obvious there
    • momojo 3y ago
      What caused #1?
    • s1artibartfast 3y ago
      Also, regulatory and insurance capture. If anyone could perform veterinary medicine out of their garage, I imagine costs would come down significantly.
  • lotsofpulp 3y ago
    > Can you not see how that would be viewed as insanely predatory? I assume you must be an expert in the cost structure of operating a veterinary practice in that location, at that time, in order to determine a predatory and non predatory price. If you are not, I am not sure how you can make any claim about the prices. >For profit companies should not be involved in human or animal medicine. What kind of quality of life do you think veterinarians and doctors deserve? Should they be able to buy a Mercedes? C Class or S Class? Should they be able to buy a home in the better school district? How many square feet? These questions are relevant for determining the predatori-ness of the doctors’ prices. Even more relevant is whether or not you want the top caliber people spending years studying one of the most complex machines. Or they could go study how to deliver ads to people.
    • datameta 3y ago
      I wholeheartedly disagree. After seeing the prices of basics like saline in hospitals, I'm not surprised to learn of inflated prices obfuscated from the general public.
      • lotsofpulp 3y ago
        That one is obvious due to us knowing the hospitals sell to the government and insurers for much less. As far as I am aware, this does not apply to a veterinary business. The article also says it was $10k for emergency services at a vet hospital, including the aftercare. What are the labor costs of having highly qualified people, presumably in low supply, on call to provide these services? What are the costs of supplies like medicine, and malpractice insurance (if that applies)?
        • deleted 3y ago
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        • freedomben 3y ago
          The vets that I've been too (minus a non-profit clinic I went to once) absolutely charge outrageous amounts for saline and other things. It's a hard business, so like most time-of-use sales points they take advantage and charge for the convenience. I'm not making a value judgment, just pointing out that it definitely is something they do.
  • 9991 3y ago
    > no matter how much they are loved I don't buy it. If their kid needed a couple thousand dollars to live, a lot more people would be able to scrounge it up. If they can't do the same for their pet, maybe they actually do love their pet less ... and that's OK.
    • ryandrake 3y ago
      > If their kid needed a couple thousand dollars to live, a lot more people would be able to scrounge it up. While I agree that many (most) people would make it work if it were for a child, I wouldn't use the insanity of the US's human healthcare bills to justify anything. It's also insane and a travesty that you can walk into your hospital and walk out with multi-thousand dollar charges you cannot pay. Both can be terrible and unjustifiable.
    • watwut 3y ago
      Emotional attachment does not mean that human is not able to do rational decision. No matter how deep I love my dog, I do not have the same responsibility toward him then toward my child.
    • scythe 3y ago
      Your child is very likely to outlive you. In fact, to some, this is a major reason to have children. On the other hand, your pet will die in your lifetime, unless you are very old or die unexpectedly. So most people are probably prepared for this emotionally on some level.
      • AlgorithmicTime 3y ago
        [dead]
    • iteria 3y ago
      There are a lot of people who wouldn't spend a couple thousand dollars to save their own lives, let alone their kids. People get hit with thousands of dollars for their kid because once it gets bad enough, the system takes over and stick you with the bill. If people got a choice, they would not always choose their child. I can guarantee you this. We can see this where parents do get a choice: dental and vision care. There are a lot of kids suffering and going without because of a few hundred dollars.
  • protastus 3y ago
    I have yet to see evidence that it's out of whack. Vets are are doctors, have to employ staff, and have training, processes and tools analogous to human medicine. There's no vet industrial complex, so no administrative/insurance/legal parasitic overhead like in human medicine (in the US).
    • wing-_-nuts 3y ago
      >There's no vet industrial complex, so no administrative/insurance/legal parasitic overhead like in human medicine (in the US). You obviously haven't seen where private equity has been buying up private vet practices
    • freedomben 3y ago
      No, but costs are artificially higher than they need to be because the government restricts who can go into business by requiring advanced degrees, and the schools that provide those degrees make a lot of money doing so. It's certainly not an industrial complex anywhere near that of people medicine, but it's definitely out of whack thanks to regulatory burdens.
      • neuronerdgirl 3y ago
        I personally agree with the government that you should probably have an advanced degree before being allowed to cut into or administer drugs to a living creature.
        • freedomben 3y ago
          I'm by no means advocating a YOLO approach of no requirements, but there's definitely unnecessary bloat in the requirements. Just looking at the incentives, the people who make the rules benefit financially from making those rules as arduous and all-encompassing as they can get away with, and in order to become a rule maker you have to be fully in the system, so it's a positive feedback loop. The same mechanism can be seen with licensing rules on haircutters and stylists.
        • ndriscoll 3y ago
  • lowbloodsugar 3y ago
    We have pet medical insurance. It’s about $30/month per pet. If you can’t afford medical costs for your pet then your pet will die if something bad happens. Likewise if you take some magical fairy “society owes me taking care of my pet” then you’re going to be as disappointed as if you walk into a Chanel store and demand a free purse. Pets are a luxury, not a fucking right. It’s not anyone’s job to keep it alive if you can’t afford insurance or costs.
    • latchkey 3y ago
      Check what that insurance actually covers and do the math on it, especially over time (and even factor in current interest rates) and considering total coverage along with deductibles. You might think that you're covered, but in reality you aren't. I couldn't find any insurance that made better sense than just putting $30/mo into a money market account at 5.25%. The way the policies are written, they clearly are there to make money on people who are buying piece of mind comfort over looking at the reality of the costs.
      • lowbloodsugar 3y ago
        It has worked out positively for us so far, but yes, even with insurance it doesn’t cover everything. My point was not “buy insurance”. My point was “pets are an expensive luxury”. Pets. Plenty of farmers with working animals, and you won’t find them here complaining, because they aren’t under any illusions.
      • zargon 3y ago
        In my specific situation, I would have paid less money with insurance for just the diagnostics, not counting any procedures. (For a 16 year old cat.) Definitely do the math, but emergencies and diseases of old age can become extremely expensive. You may end up never needing it, but if you do, it can really reduce your costs. Personally I now prefer to pay out the $30/month and be covered for costs exceeding that, than to maybe get to keep the $30/month in the end.
  • dan-robertson 3y ago
    How much profit do you think is being made in that $10k skewer removal?
    • cowmoo728 3y ago
      probably a significant amount, otherwise private equity wouldn't be buying veterinary practices all around the nation. I know that the service I receive at a veterinary clinic I used to go to has become worse, a number of vets quit and were replaced with new younger ones, and the price increases have drastically outpaced inflation. all after the original partners sold to private equity.
      • dan-robertson 3y ago
        I don’t really know what the answer should be. I somewhat arbitrarily chose a vet, found the group they are a Bart of, and looked up their accounts up to autumn 2022: Turnover 987 = Goods sold 96 + services 776 + ‘health club’ 113 I didn’t look into the health club thing. I think it’s a subscription and it probably includes regular checkups, vaccines, and maybe some other random things. Staff costs 442 (50% of turnover) Lease payments 37 Profit 69.3 (~7% of turnover) I’m not very good at reading financial statements and I didn’t try to dig through all the costs. There are things like buying new equipment as well as things needed for each operation. The group spent 118m on buying up other practices, but I don’t know how much leverage they had. If we take those numbers in a conservative “what if they were trying not to profit” scenario where they have no leverage, that’s 177 in “profit” out of 987 in income, or about $1800 if you assign it proportionally to a $10k skewer removal (or $700 if the acquisitions are counted as free). I don’t know how those numbers look to you. To me, they don’t seem insane and I’m not sure the difference would matter much — I doubt the person unwilling to pay 10k would be willing to pay 8.2k. Also, I would guess that sort of surgery to be lower margin than routine things, though maybe competition drives it the other way.
  • giantg2 3y ago
    I've found most veterinary care and meds to be very affordable. Major surgeries or specialized equipment (for large animals like horses) can be expensive. Yeah, the schools are going to be expensive just as colleges are. Similar to med school, you're looking at high costs of educators, equipment, etc.
    • Fomite 3y ago
      They also cut costs when they can. Metronidazole for colitis as an example - it’s not the standard of care for humans, but vets use it all the time because it’s wildly cheaper (cents vs $100s for vancomycin or $1000 for Fidaxomicin)
      • giantg2 3y ago
        Even when it's the same meds, it's usually cheaper for the animal form (especially antibiotics).
  • gmarx 3y ago
    That puppy example is special. In many cases (most?) the fact that a pet needs more than $10k it is likely too much to put the pet through. No way I would give a dog chemotherapy for cancer for example
    • throwaway5752 3y ago
      That's not a reasonable thing to say. "Giving chemotherapy" is almost as general as saying "giving medicine". A young dog with a treatable cancer is not going to cost anything near $10k and should get many good years of life. Some cancers (eg, mast cell) have glorified Benadryl as "chemo". Just put in the effort to find a good vet, build a relationship, and trust them give you good advice. I'm not saying this to you, but this has been a terrible post on HN to read, the worst of the community is on display. Lots of confidently wrong people that are very quick to see the worst in others.
  • akira2501 3y ago
    > but vet costs are completely out of whack with reality these days. This industry, like so many others, has become a target for venture capital and consolidation. It's very quickly on it's way to becoming monopolized. Which makes headlines like this to me very interesting, because I assume they're designed to push people out of the profession and practice ownership and just sell it out to a firm when they come knocking. > For profit companies should not be involved in human or animal medicine. What is self ownership but an attempt to earn a profit? The issue isn't attempting to earn, the issue is the attempt to fully monopolize the market. I wish people saw through this more often.
  • Nifty3929 3y ago
    This is a very un-empathetic take towards people who spent many years in school, work very hard, and earn relatively little money for their trouble.
  • swatcoder 3y ago
    What do you expect surgery to cost? It's not like it was 1/10th the cost a while back and has suddenly became exploited by Big Veterinary or something. It was always expensive and you just wouldn't even ask unless you were especially wealthy or were unusually willing to sacrifice. What's changed (perhaps for the better) is the sense that pets are worth the sacrifice. If you're younger or from a more wealthy background, you may not have a good intuition how much more accepted it was that pets (and people) simply don't get all the care that they might. The idea that intense medical intervention is a right for people, let alone animals, is actually pretty new. Vets are NOT being predatory just because their work continues to be expensive.
    • tim333 3y ago
      The last vet surgery I paid for was in Indonesia and it was like 100x. There isn't some law of physics that makes it cost that.
  • barkerja 3y ago
    Do you know how much it costs to maintain and operate an imagining (MRI, X-Ray, etc.) machine? Do you know how much it costs to maintain staff (doctors, techs, office assistants, etc.) As someone that used to think the same way as you, and then got to see other side of the business (my wife is a Veterinarian who runs an urgent care facility) —— it’s easy to think the way you do without seeing the costs incurred on the other side.
    • ryaneager 3y ago
      Shouldn’t we as a society front the cost for the services ? I guess, socializing pet care is going to be a far step behind socializing human medicine and that is still a hot topic. There is enough wealth created in our economy to cover these costs, and more, but heaven forbid a company not make more profit this year than last.
      • massysett 3y ago
        Absolutely not, no. I can think of no basis to demand that non-pet owners pay taxes to subsidize pet owners.
      • s1artibartfast 3y ago
        What a silly idea. There is nowhere near enough money in the economy to cover these kinds of costs for pets. Every dollar in the economy is only 70k/person and the government already takes 28k/person. Why would I ever want to pay exorbitant prices for your pet. I don't even want to do it for mine.
  • snapetom 3y ago
    Ridiculous entitled view. At minimum, vets have to do undergrad + four years of vet school. If you find a board certified vet, they will have gone through 1-2 years of internships, and another 2-3 years of a residency, plus board exams. Technicians in many US states have to at least have an AA degree, but the competition is such that many have Bachelors these days. I know of a few that even have Masters. And a lot of drugs are re-purposed from human medicine. Syringes, IVs, antibiotics. The manufacturers are not giving vets a discount just because it's being used in a rabbit. You just never see those prices for yourself because insurance hides it. The vets have to pass it on to you because their business is not a charity. If you don't want top quality care for your pet and you don't value the skill and knowledge of a trained professional, there's plenty of bargain basement vets that are willing to cut corners.
    • heyoni 3y ago
      There are some items like medications and IV fluids rebranded for veterinary use. I assume it lowers the cost but don’t know for certain.
  • MiscCompFacts 3y ago
    Here’s prior discussion of VC firms buying up veterinary practices, and installing new management to squeeze out more value: https://news.ycombinator.com/item?id=36313967 https://news.ycombinator.com/item?id=36313967
  • michael1999 3y ago
    Many of the hard costs in veterinary medicine are exactly the same as human doctors. Rent is rent, stitches are stitches. Most of the supply chain is the same. So when they open a bag of saline, put in a line, gown up, open a pack of sutures, etc. those costs are exactly the same as a human doctor. Their ultrasound machine comes from the same factory as the one one at your obgyn. Equipping a surgical suite is an expensive thing.
• jncfhnb 3y ago
  Medical doctors have a higher suicide rate
  • pc86 3y ago
    That doesn't seem to be accurate, do you have a source? https://www.sciencedirect.com/science/article/pii/S016517812300121X#sec0006 https://www.sciencedirect.com/science/article/pii/S016517812... shows in 3.3 that not only is the veterinarian rate more than 2x that of physicians, but the upper end of the 95% CI for physicians is below the lower end of the 95% CI for veterinarians. It doesn't appear to be anywhere close.
    • jncfhnb 3y ago
      This study is about Austria and includes data going pretty far back. That being said I can’t find conclusive data elsewhere. Most research doesn’t narrow down to jobs neatly. I’ve found number suggesting suicide rates of 200-400% that of the general pop which is in the same ballpark above and blow. So ymmv.
      • pc86 3y ago
        I don't see any reason why the suicide rate among physicians and/or veterinarians would be wildly different in Austria than any other country, or globally. Even if there was, it'd have to very different to have it eliminate the 2x difference and on top of that actually make physician rates higher than veterinarians by any statistically relevant amount.
        • jncfhnb 3y ago
          Income, cost of living, patient expectations, healthcare culture, debt of schooling, etc. Idk anything about Austria in these regards either way. But as I said, cursory searches for doctor specific stats put it in the same ballpark as those cited for vets.
• meristohm 3y ago
  When I volunteered to walk dogs for a shelter I learned they offered training and support to deal with compassion fatigue. I appreciated that. My spouse and I had our dog euthanized last year because we did the calculations/justifications and the costs and risks of surgery (likely cancer and organ failure, per the ultrasound) didn't justify keeping our family member alive for perhaps a few more months. The experience changed my perspective about pet ownership/stewardship in general: unless I really need an animal companion or a working animal (e.g. herding), I will never own another pet. I find it a luxury I can do without. I've had three dogs die in my lap now, and that's enough. Visiting his grave in the back pasture on walks with my young daughter has opened up regular conversations about death, though, which I see as an upside. She was there wfor the funeral and touched his cold ear before we buried him. She asks a lot of questions and often wants the story of our dead dog's later life and eventual death, and after some consideration and kind words to the memory of our dog (I add no religious spin, just that his "spark of life" is gone and his body is being digested by other living beings underground, a fate for myself which I am absolutely fine with), because it feels good to say these kind words even though I am not under the illusion he's listening, we carry on walking.
  • s1artibartfast 3y ago
    I'm interested in your thoughts on this: >The experience changed my perspective about pet ownership/stewardship in general: unless I really need an animal companion or a working animal (e.g. herding), I will never own another pet. I find it a luxury I can do without. I've had three dogs die in my lap now, and that's enough. I understand not wanting to put yourself through the pain of loss, and have felt that too. Sometimes I don't want a pet because I feel the good times aren't worth the pain of parting. However, you went on to call it a luxury, which confused me. Is that because you will have to pay for the luxury, or because the animal will? I've never had a pet I thought had a bad life, and it sounds like you were a good owner, so I don't get what the downside is.
• Jka9rhnDJos 3y ago
  My daughter wants more than anything to be a vet. Has talked about it for years. Reading more and more anecdotes and research about what it’s like being a veterinarian, I’m scared to continue encouraging her. We have a particularly medically-needy dog, and have spent $10k on procedures and vet visits over the past few years, and she’s really comfortable and familiar with being at the vet office. In my position, would you encourage your child to chase their dream? Or would you be comfortable telling them every few weeks until they gave up that you don’t think they should be a vet? I’m asking in earnest because I’m torn with my desire to be encouraging and positive and tell her to chase a dream, with my desire not to set her up for misery or potentially suicide.
  • tasuki 3y ago
    > In my position, would you encourage your child to chase their dream? Or would you be comfortable telling them every few weeks until they gave up that you don’t think they should be a vet? Can't you do both? Let her know about the serious downsides (perhaps don't "repeat every few weeks until she gives up") and if she chooses it anyway, encourage her. This is her decision to make, not yours. She will be responsible for the consequences, not you.
    • Jka9rhnDJos 3y ago
      She’s 8. She’s not responsible for much of anything. She’s not mentaly capable of being responsible for making future career decisions. If she said she wanted to be an authoritarian dictator, I’d crush that dream fast. But she wants to help animals. And being someone that she looks up to, it doesn’t take much for me to crush a dream. So do I start crushing that dream now (her wanting to be a vet comes up weekly, so either I would ignore it or have to keep reiterating my position), and ruin any chance of her becoming a vet, or do I let her invest years into it before telling her I think her career choice is a bad idea?
      • chmod600 3y ago
        At 8 years old I'm not sure what the downside is to waiting a bit. It's not like she's accruing vet school debt right now.
• jnwatson 3y ago
  I really don't understand why anyone would become a vet. I love animals as much as the next person, which is why i don't understand why one would volunteer for this life. When having the cat put down, my first thought was for the cat and my personal sadness. My second thought was, wait, you folks do this for a living?
• anvil-on-my-toe 3y ago
  Imagine if they were compensated much more and therefore could take on a lighter case load. It's such a sad reality how the people who do important jobs in society are squeezed to the point of breaking, while so much wealth is hoarded so by few.
  • s1artibartfast 3y ago
    Imagine if vet care was twice as expensive.
• gloryjulio 3y ago
  It's just a fact that ppl don't want to admit that raising pets is a luxury. The cost of the healthcare is high and when the economy downturn comes like now, this kind of cost would be the first to be reduced.There is just not much money in this business
• dudul 3y ago
  Cry me a river. My cats' physical costs $300. The vet is in the room for 20min. When I had to put down one of them (literally had to, there was no other options) it ended up being close to $1000. Maybe don't charge insane amounts if having to put down a pet makes you suicidal.