E-MAIL FROM A DOG OWNER Dec 28, 2009 Subject: Bill for treating wound and removal of maggots To:  <drsing_98@yahoo.com> Date: Monday, December 28, 2009, 12:08 PM   As spoken, I enclose a copy of the bill itemizing the treatment of my Husky. In your professional opinion, is the bill justified? I know there is nothing I can but at least I want to know that I have been overcharged or not?   Thanks.   Regards Name of owner

E-MAIL REPLY FROM DR SING
 
1.  Thank you for your e-mail of your vet's bill. As I have not seen the extent of the wound and was not present, I cannot say definitely whether you have had been overcharged when you said you were billed over $600 for treatment of a maggot wound in your large breed dog. The total bill was $641.20.

2. My comments are that I don't usually conduct the following procedures or provide the drugs/accessories for the treatment of maggot wounds performed by your vet, viz.,

2.1  Heartworm test $50 (not relevant to maggot wound treatment).
2.2  General Health profile $150 (some vets perform this test to screen the dog's health prior to sedation). 
2.3  (Insecticide)  Interceptor Spectrum $65
2.4  Buster Collar 25 cm $23
2.5  (Insecticide) Negasunt powder  $18
2.6  (Pain-killer) Rimadyl Inj $30
2.7 (Pain-killer) Carprofen 50 mg $9

Therefore, the costs would be reduced $345 and your final bill might be $641 - $345 = $296 assuming I used the same procedures as your vet. No 2 cases are exactly alike, just as no two condos for rent are exactly alike. I am using condo rentals are an illustration since you are familiar with this industry.
 
3. However, I do hospitalise the dog for 2 days for observation if the maggot wound is deep and large. In addition my consultation fee is $10 more than your vet. If you shop around there is at least one newer vet practice charging consultation fee at $18 which I believe to be the lowest in Singapore. 

3.1 If you deduct $296 for the above case, my "fees" may be considered cheap at $200-$300  range, since you don't pay for the items in paragraph 2. But some owners may have the perception that I am not a good vet since I don't give the extra drugs what all good vets should give and I had not practised defensive medicine by doing general health blood test and heartworm test.   

4. I use the real estate rental of a condo as an example since you are familiar with this topic. An owner in the same condo may rent out his apartment for $5,500 per month while you get a rental of $6,500 per month for your condo. 

4.1 Will you be considered a greedy landlord since you are overcharging by $1,000 compared to your neighbour?  You may claim that your quality of renovation, furnishing and furniture is vastly superior in quality and this may be true. Prospective tenants usually view various condos. This would probably be the case, as I know that is a common practice. No tenant will rent the first condo they see in Singapore. Supply is greater than demand. On the other hand, your tenant at $6,500 rental for your condo may be have a fixed company budget of $6,500 and may have other disbursements from you and therefore pay you $6,500.  In your situation, $6,500 rental may be justified. Still it appears you are overcharging if the "market rental" is $5,500. There are no fixed charges for veterinary treatment by the way as this will constitute price-fixing and the anti-monopoly authorities will nip it in the bud earlier on.   

5. Some dog owners do phone up vet practices to get quotations and then go to the cheapest vet in town. When the fees need to be kept low, obviously, the dog does not get the general health blood test, painkillers and Buster collars. Some owners have built a client-veterinary relationship of trust and goodwill and the vet will act according to the owner's financial means in the best interest of the pet and the client.  

6. Back to the condo rental industry, if the tenant wants a low rental, he has to sacrifice for the poorer quality of furnishing. If the pet owner wants the least veterinary cost, he has to scout around and find the least cost veterinary practice and there are such practices in Singapore if you do your research. 

7. I am sure that this dog with maggot wound will heal beautifully and that your daughter will be most happy. Call for quotations from vets all over Singapore next time.

8. In conclusion, I would say you are overcharged by $50 since vets in general don't consider the heartworm canis test necessary in the treatment of a maggot wound.

On the other hand, your vet may need to know that your senior dog did not have heartworms as he could have died when given sedation and the Interceptor Spectrum. If your dog dies, your vet may be sued for "medical negligence" for not checking whether your senior dog had heartworms and pre-sedation blood test first before sedation was given.

Defensive medicine is a good defence against litigation and veterinary complaint investigation. This apparently had been practised by your vet and you were charged for the higher costs.   

8.2 Your dog was given the best treatment available in veterinary medicine and it burnt a small hole in your pocket. You said that the veterinary practice was not a famous one equivalent to the human "Mount Elizabeth Hospital", but had you gone to the "Mount Elizabeth-equivalent" veterinary practice, your bill would be more than $600.

8.3  It is really hard to compare as there is a vet practice that will treat a maggot wound for around $100 - $150.      

9.  Shop around if you want the cheapest service provider. Inform the vet that you are in dire straits so as to get the least cost treatment. No frills. A house brand rather than branded goods. Ask for steep discounts and drive a hard bargain before the treatment. Risk being blacklisted or shown the door for a few dollars less.

9.1  I relate a personal incident I suffered recently. One day, a door-to-door vendor came to my surgery to sell goods. I bought a "Made in China" belt from him for $10.00 to give him some business since I know he needed some income as door-to-door sales are extremely hard work with more rejections than sales.  

The next day, the buckle fell off from its 4-screw catch and dropped onto the floor. The threads started peeling off the belt. I had to throw the belt away as the buckle fell again after being latched onto the catch.

So, was I being cheapskate? I should have bought a Pierre Cardin belt at $58.00 and would not have to show my clients that I wore a belt without buckles during consultation. It looked as if I was down and out. In dire straits. But my clients did not say a word and I quickly shopped around for a "branded" belt 2 days later.

Prices of goods and services vary greatly and if one goes for the cheapest, one should not be surprised at getting shoddy goods or services.    

10. I hope my reply is entertaining and to your satisfaction and put a smile on your face. I wish you a Happy and Prosperous Chinese New Year.
 

E-MAIL REPLY FROM OWNER Subject: Bill for treating wound and removal of maggots To:  <drsing_98@yahoo.com> Tuesday, December 29, 2009 12:27 PM   It's really very nice and entertaining of you to take the trouble to write a long email. You are absolutely right in your analogy of comparing the rental of an apartment with the fees charged for the treatment prescribed. I agree with you that no two vets will prescribe the same treatment and therefore at the end of the day, the costs will not be the same.   I have certainly learnt the lesson that I should ask for a quotation from different vets before taking the dog there for treatment but I think trust and confidence of the vet is really important. As a matter of fact, the wound is smaller than a ten-cent coin and I wonder if it is totally necessary to go to the extent of doing all the tests etc. I suppose lady vets tend to err on the extreme side of caution.   I wish you a blessed Christmas and a great New Year ahead.   Regards Name of owner