DoLittler: Blog

Last week our hospital received a terse letter from a client complaining about her $600 dentistry bill. “Outrageous,” she wrote. The owner had left in a rush without picking up her estimate, waving it off with an “I’m sure anything you need to be done will be fine with me. I trust you.”

So much for trust. Our fault, of course, for allowing her the privilege of running away without an estimate. But still…

The charges included full mouth dental X-rays, IV catheter, fluids, continuous EKG, eight extractions, 90 minutes of anesthesia, pain relievers and antibiotics. Did I mention eight extractions? With gum flap surgeries on most of them?

My colleague, one of the two practice owners, had been the one to receive the complaint against him. He took it well. He handled the issue by sending a friendly-toned, 500-word letter explaining the services provided in detail along with the price list for our local dentistry practice so the disgruntled owner could compare our prices with theirs.

Ours was 1/3 the price of the dentist’s—without adding in any of the incidental costs such as anesthetics, monitoring and other drugs.

So there.

This situation was not dissimilar to a New York City-residing family member’s. His two dogs had been seen by his regular vet for routine, six-month tick titers (his dogs hike the nearby woods every week). The upshot? $1200. Really. He showed me the bill. The bloodwork was $800 of it.

I’d never seen such a thing. The invoice was a shock to me. $200 exam fees and $400 of bloodwork on each dog? “Omigod!” I said. “And you pay this much regularly?”

Apparently.

Granted, this is a Manhattan vet in a fancy neighborhood. But for that price it seemed to me he could have taken his dog anywhere else and seen a 50% reduction in prices. I had no idea anyone would charge that much. That anyone would pay so much.

“So I’m getting ripped off?” he asked. I swallowed hard and explained I didn’t have any experience with NYC prices but that the same work at my place would’ve run him $200 tops—for both dogs. And I probably wouldn’t have charged an exam fee for simple six-month bloodwork. After all, his dogs weren’t examined. It seems the exam fee is part of every visit for his dogs, regardless of whether they’re actually examined or not.

Ouch! I’d never even heard of a $200 exam fee.

Recently, we’ve been re-thinking our prices at the place that I work. It’s a forty year-old hospital with great doctors (I think), low staff turnover and excellent equipment. But our basic costs are rising so rapidly that we’re having trouble staying solvent. Nonetheless, we have a healthy clientele that reflects forty years of wonderful care.

We’re proud of the fact that we offer our clients value, above all. We’re proud that we’re fair with our clients and work with them so that when they hit hard times their pets still get the care they need.

Unfortunately, that also means we carry a lot of clients who haven’t been able to pay us back. We barter with clients so that their dog’s heartworm treatment means five auto details instead of $500. But that don’t pay the bills. Still, we do it because it’s the right thing to do.

Other hospitals take our position, too. I know this because even the specialty hospital across the street prices itself so that clients can still afford their care. A typical back surgery (disc decompression) there costs $3,500. The specialists in the neighboring county charge $6,000. A cat scan across the street costs $750—nuts to bolts. The other place? $2,800. (I know because my Frenchie, Sophie Sue, had one there. I had no idea the price differential would be so high.)

Taking care of clients is so basic. But at what cost? As we struggle to deal with our receivables (I haven’t yet been paid for about $3,000 of work I did last month) and help our clients out, it somehow hurts to see that clients will pay more when they assume they should…when they don’t know the difference.

Perusing the invoice my relative presented me, examining dentist’s price list, hearing clients complain about our prices, I can’t help contemplating the inequity. I’m only human.