Tuesday, April 6, 2010

How do you choose a vet?

Last month, my husband and I purchased and moved into our first home. We were delighted to be able to find a home in our price range with a pretty large (by New Jersey standards) stockade fenced yard, and a nice quiet neighborhood to walk the dogs in. Hooray! Now, we face the problem of finding a new vet close to our new house. Our old vet was good but not great, and given that it would be a half-hour drive to get there, we decided to just find a new one closer to our new home. Plus, we need to also find out what kind of emergency vet services are available 24/7 in our area and pre-program these locations into our car GPS system, because we don’t want to be scrambling to find that information in the face of an actual emergency.
So, how do you go about finding a good vet? I decided to make a list of all the vets in my immediate area and call them to ask some basic questions:
• What are your prices for an annual physical exam, vaccinations, blood work, etc? Do you give the lyme disease vaccination (ticks are very prevalent in this area)?
• What are your (general) prices for emergency/surgical services?
• What are your regular hours and your emergency care hours/availability?
• How long does it usually take to get an appointment?
• How many vets are in your practice? Will I always be seeing the same one? Will they get to know me and my dogs?
• Do you give a rescue discount if I need to bring a BRAT dog (other than my own) in for services?
• Do you have specific experience treating Basenjis? Are you familiar with the diseases that are characteristic of the basenji breed (like Fanconi)?
Beyond this simple research, however, I’m struggling with an even more basic question – whether or not to go on a healthcare “plan” for my dogs. I’m not talking about pet health insurance, which is a pretty charged issue that I’d rather not get into here, but rather I’m talking about something like the national network of Banfield clinics (as an example, for illustrative purposes only – there are many types of similar clinic networks out there to choose from). I’ve heard about these types of networked clinics and their healthcare plans for years and I’ve never lived close enough to one to consider it, but now there’s a Banfield very close to my new home and I stopped in last weekend for some information about their healthcare plans. From what I understand, Banfield clinics are all over the country and if you are on any of their Wellness plans then you can go to any Banfield clinic for covered services. There are different plan levels that cover everything from basic services (annual physical exam, shots, bloodwork, etc) to more extensive services (teeth cleaning, etc), and once you pay the start-up fee then you just pay a monthly premium per dog. The benefit is that once you’re on a plan, you can go to the vet any time you want, without an appointment, and your basic services are covered free of charge (upper-level services will be provided at a discount). That means that my hypochondriac, over-mothering self can take my dogs to the vet any time they get a snarfle (doggie sniffles), and I don’t have to worry about paying $50 per dog just for walking in the door to get a professional opinion. That sounds like great news to me, but is it worth the monthly cost?

Let’s consider this for a second: An average vet visit at the regular vet (not Banfield) seems to cost me around $250 for both of my dogs. I take them once a year for their annuals, and then it seems like we go at least 1-2 more times a year any time we experience an unexpected health issue. Sometimes these visits involve services that are more than “basic” (and so wouldn’t be covered by the Banfield plan), sometimes not. Overall, I seem to spend about $750-$1000 per year on vet care for my two basenjis. The Banfield plan stands to cost me around $100 for the onetime start-up fee, and about $500 per year after that for both dogs. If we have a “good” year, meaning that we don’t have any unexpected health complications, we would be better off just going to the regular vet and paying $250 for our annual services. If we need to go to the vet twice a year, then we break even. If we need to go more than that, we’ll save money if we go on a Banfield-type plan. If only I had a crystal ball!

Apart from the cost, however, my decision about which vet to take the dogs to involves heavy consideration of factors like vet skill, bedside manner, basenji experience, and all the questions I listed above – many of which I can’t discover until I actually go to the vet. I can certainly call them and interview them, but I’m really struggling with balancing all of these issues and considerations to make my decision. The dogs are due for their annual shots in April, so I guess I really need to make a decision soon! Does anyone have any thoughts on this, or experience with these types of clinic plans?

8 comments:

  1. Google Banfield for problems. The question of a vet choice has become very difficult indeed!

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  2. I think I would make an appointment to meet the vet closest to my home whose answers "pass". I think you can tell a lot just by talking to him/her, and if at all possible, watching the interaction between the vet and any animal. (Maybe they'd allow you to watch an exam?)

    My first vet was not great with Ruby (in fact, he's the reason she decided she didn't care for vets); another vet in the same practice was very good, so we stayed with them and requested the good one. Several years later, a new vet took over and he was fabulous; alas, he sold the practice after a year, and I switched to a female vet, thinking that since Ruby responds best to women (after all, I'm the one who does her nails and teeth, bathing, feeding, brushing!), she'd be very comfortable with her. Big mistake - I could tell the first time we went to her that the vet did not LIKE Ruby! Wish I'd just gone to talk to her first, instead of taking Ruby to her when she needed treatment.

    We switched vets last summer and the new ones are the best! Ruby has a bladder tumor and is suddenly fearful of things, including riding in the car; she shivers and loses control of her bladder. One of the new vets actually comes to our house now to treat Ruby. (I wish she could treat me, too! ) We pay a premium for a house call, but it's worth every penny. When it's time, she will come to help Ruby cross the bridge.

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  3. Duh - forgot to say that my own preference is to pay as I go and skip the plan. My sense is that Banfield and similar make money on the deal because MOST people spend more on the plan than they actually consume.

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  4. I believe that Banfield is a payment plan that you sign up and commit to a year to - so if you signed up in January and (heaven forbid) all your dogs died in February, you're committed to paying for March through December.

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  5. I take my dogs and fosters to a wonderful practice who I have seen evolve over the last 20 years.

    They have excellent "bedside" manor, offer flexible hours, a mulit-pet discount, 24/7 emergency care, will do housecalls, price matching on meds, have a grooming salon, boarding and daycare and now have a staff of 7 vets (3 when I first started going there.) They also give a generous dicount to rescues/shelters.

    I originally went there for my cat (life before dogs) because they were close/convenient! None of my neigbors had pets so I didn't have any opinions to rely on. I can't believe I had such a wonderful outcome from such a casual decision.

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  6. If I were choosing a new vet right now I would not go with the "corporate medicine" scenario (i.e. Banfield or any similar organization.) The most important thing to me now would be a holistic approach and independent thinking. Ask the vets you interview what professional organizations they belong to, how much continuing education they do, what professional literature they read, what their approach is when a controversial issue arises. (Our vet shocked me when the melamine poisoning incident unfolded. I was incensed that the information dissemination to vets took so long. She wasn't particularly upset by it, and had fortunately not had any dogs in her practice affected by it. But it points to a larger issue of tunnel vision and an old style of practice.) Ask hypotheticals like, "What if we think my dog is having a dietary issue and might need to change foods? Are you more likely to recommend the prescription foods you sell just because they are there, or are you going to take a more individualized approach to determining the best nutritional path to take? What is your opinion of home cooked diets?" Ask what their approach is to determining when your dog needs to see a specialist (is it time duration of treatment without results? is it a certain level of illness or injury, i.e. there are certain diseases that should go to specialist care as soon as they are suspected. My own vet is a great surgeon but I have learned she is not a great internist.) Ask when they consider a dog to be a senior and what additional preventive and diagnostic care they recommend for elders. You can learn a lot by seeing if this person is dismissive of this level of inquiry by you or really wants to give thoughtful answers, and if they are someone who realizes that new information about wellness, illness and treatment is coming out so fast that they have to create a practice of keeping up with it. Also visit their waiting rooms and observe what the staff expects from owners waiting with their pets as far as behavior control. Does the staff know how to approach fearful or over-excited dogs, i.e. can they "read" a dog's behavior and adjust their own? (Sorry to go on and on. Posting as anonymous just because I'm a too rushed to create a profile. BRAT member Marlys Ray).

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  7. I'd like to comment to your question in several capacities: 1) I'm a certified vet tech, 2) A previous (& hopefully soon to be again) basenji owner, and 3) an ex-Banfield employee.

    There are SO many factors involved w/veterinary care! And, it's important to remember that there are definitely good vets (and STAFF) and bad ones out there. As far as the "wellness plan" question, it's a good way to spread out the cost of veterinary care and not have to worry about budgeting it. It automatically comes out of your account, and all your "necessities" are included. That said, they also include a lot of stuff that may or may NOT be "necessary" for YOUR particular dog. For instance, the Bordetella vaccine: definitely recommended if you board your dog frequently or if they go to the dog park and/or are in situations where they are exposed to other dogs. Bordetella is like a cold virus - in most dogs it's most irritating to the owner (listening to them cough), but it's pretty easy to treat w/antibiotics and cough suppressants and MOST dogs recover quickly. BUT, just like in humans, there's always the small percentage that develop into pneumonia. And, in some other species of pets, such as guinea pigs, it can be fatal. If you have a wellness plan, it'll probably "automatically" be administered, you've paid for it. You can request for it NOT to be given, but you're still going to pay for it. Ok, that's just an example. My point is, there's good points and bad points to them, but you need to be diligent as an owner.
    As far as veterinarians & staff: I recommend doing an "introductory" visit before allowing your basenji to be touched. See how the vet AND the staff approach your basenji. Remember, the staff is going to be touching your dog a lot more than the vet, and if surgery or ?? comes up where your dog needs to be out of your site, how are they going to treat him? Do they immediately try to muzzle your dog, because they saw "basenji" on the chart? When they walk in the room, do they get down to your dog's level, not make eye contact, and wait for your dog to approach them first? Or do they barrel towards him/her expecting utter and complete submission. If they manage to illicit a warning growl, how do they react? Do they elevate the stress level when it happens or work to decrease it? I've worked with a few people in my career who don't take the dog's level of comfort into account. My view is that if you're going to be our client, we're going to see this dog more than once. Do I want the dog to feel comfortable and happy or at least tolerant? If you have to drag your dog from the car to the front door with his brakes on, it's never a good sign, and the vet staff should work to relieve that tension, not make it worse.

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  8. But wait, I'm not finished!!

    As far as veterinary care, I think it's important to have a vet who doesn't think they "know it all". They need to be willing to look at EVERY concern that you have, and bring things to your attention that you might have missed. They need to give you ALL the options, both the most expensive and all-inclusive, and the one that starts conservatively and works up. They need to give you pros and cons of those options, not just TELL you how to treat your pet. If they're not SURE what's going on, they need to give you the option of seeking the advice of a specialist - BEFORE your dog is critical. If your dog is hospitalized, are they staffed 24 hours or will your dog be there alone for any amount of time? They need to be gracious of you calling to check up on him AGAIN, not give you stringent rules or be rude that you've called for the third time today (I'm a basenji owner, I do it too!) But, you also need to REALIZE that you're a "basenji owner"! Just like our dogs, we are high maintenance, over-concerned, and often overly tolerant of our dogs' poor behaviors. Veterinary staff find these types to be irritating - you interrupt our work flow. So be prepared to do a little give and take on this.
    LEARN how your veterinary staff deals w/patient's needs in house. Are potty walks scheduled and charted or do they just get taken out "thoughout the day". What if they get swamped? Ask for a full tour of the hospital including the surgical area (although you might not be able to go inside). Ask how they monitor their patients under anesthesia, including their dentals? ECG/EKG on every pet that's under? I personally don't feel an apnea monitor is enough. Your dog may be breathing but have developed a critical heart rhythm that's on the way to arrest. Do they have IV fluids as an OPTION? (This is bad - EVERY anesthetic patient should be on fluids - anesthesia is a kidney killer - maybe not today, but...) How many LICENSED vet technicians do they employ? Or do they "train in-house". Do they have access to ultrasound? Do they have endoscopy? Where do their surgery patients recover? Can the surgical staff see them at all times or are they in a different room? All VERY important questions. And someone mentioned 24 hr emergency - definitely critical!
    It's a lot to think about, but all important stuff, BEFORE your dog gets sick. Hopefully all you ever need is your annual exam and vaccines, but... what if there's more? You should feel confidant.

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