A message for the "human medical community"
CMAJ 1997;157:637
Re: "Veterinarians' suggested fees may leave physicians feeling ill" (CMAJ 1997:156:1689 [full text])
I was dismayed to see once again another apples-and-oranges comparison of fees charged by veterinarians and physicians, which seems to imply that veterinarians' fees are excessive when compared with those charged by physicians who deal with the human species. These across-the-board comparisons fail to mention that most veterinarians must cover substantially higher overhead costs than any general practitioner and many specialists. Our professional education and training is perhaps even more comprehensive and arduous than a medical student's, for we are trained to be the GP, internist, surgeon, radiologist, anesthetist, pathologist, dentist, pharmacologist and psychiatrist, and not just for one species! This means that most of our practices must stock a full dispensary, have a surgical suite with instruments, anesthesia and monitoring equipment, an x-ray machine with automatic developer, blood-chemistry analysers and a staff of certified animal-health technologists.
Each veterinary practice is a hospital unto itself, and running a hospital is not cheap. How many Canadian radiologists have their own x-ray machines, own their own facility and employ the staff needed to run it? How many GPs have a full surgical suite in their little, 2-exam-room office?
It would have been more appropriate for CMAJ to compare the amount veterinarians keep after paying overhead costs with the payments physicians receive for providing a specific service. Try examining the fee breakdown for a specific procedure, such as an oophorohysterectomy, performed on a large dog versus the same procedures performed on a woman. The average fee for this operation at a veterinary clinic, which would include a pre-anesthetic examination, anesthesia, surgery, surgical materials, nursing care and an overnight stay in the hospital, is approximately $120. Do physicians honestly believe the same procedure on a human would fit within this meagre budget? I suspect the cost would be at least 10 times more.
In Canada, human medical and surgical care is subsidized by tax dollars, and physicians' fees appear to be "free." Our colleagues south of the border do not seem to take as much flak over their fees, no doubt because the owners of the pets they treat are only too aware of the real costs of health care.
As vets, we can console ourselves because we do not have to listen to patients complain about their piles, bowel movements and assorted aches and pains. Animals seem to put up with mild discomforts with grace and dignity. And, oddly enough, it is often human health care professionals who gripe the most about vet bills. Go figure.
Malcolm Macartney, DVM, MSc
McKenzie Veterinary Services
Victoria, BC
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