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Veterinary Practice News Editorial Blog:
Friday, February 13, 2009
Gag Me with a Pill Gun
By Somyr McLean Perry
Contributing Editor of VeterinaryPracticeNews.com and Veterinary Practice News
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| On average, a package of 12 pill guns costs a clinic about $10 to $12. So, why does it cost $11 to buy one? | After more than three months of battling my kitty's corneal ulcer, which seemed to be healing, I found myself back at the specialty hospital with her eye worse than the first time the ophthalmologist examined her.
The new treatment is more aggressive than before and more expensive. The cost of the ophthalmologist's services doesn't bother me ... he's not only board certified in ophthalmology, he's also a board-certified surgeon. The cost of the medications stings a little, particularly the antivirals. But I can deal.
But there's one thing on the invoice that just chaps my hide and offends me more than bad customer service. Can you spot it?
- Office call/brief: $65
- Fluorescein stain: $20
- One bottle of specially compounded antiviral ophthalmic drops = $45
- Two tubes of erythromycin ophthalmic ointment = $30
- One prescription of oral antiviral tablets 30 ct = $60
- One pill gun to administer oral antivirals = $11
What? $11 for a pill gun? I'm not talking about some gold-plated automatic pill popper here. It's the basic white-plastic pill gun with the blue rubber tip that every veterinary hospital in the nation has in inventory.
I realize that I have an unusual advantage in knowing the costs of certain veterinary items, but the kid ringing up my vet bill doesn't know that. So when I said, "Hey, that's an outrageous price for a pill gun that costs less than $2," the kid said, "Well that's not how much it costs here."
Huh?
In his book "Business Basics for Veterinarians," Lowell Ackerman, DVM, says that not only should the direct cost of materials be figured into the price, but so should the cost of ordering and dispensing them.
I get that. I get that just because a 1,000-count bottle of diphenhydramine costs less than $20, doesn't mean that the clinic is going to charge me $0.02 per pill. I also pay for the prescription bottle, the label, the technician's time to count the pills, and the convenience of getting the medication at the clinic instead of having to go to an outside pharmacy, which is why a $3 prescription turns into a $30 prescription.
But in the case of pill guns, or any retail or over-the-counter type item, overpricing these commodities makes clients suspect that they're being overcharged for everything on the vet bill.
Dr. Ackerman agrees with me on this one and in a section of his book titled "Value pricing," he writes, "One of the most important determinants for fee setting is the perceived value by clients. Clients do understand that extraordinary care is associated with extra expense, but most clients will quickly lose faith in a practice that overcharges for commodities, such as flea control products, heartworm preventives or even pharmacy items. Since these are not areas where the veterinarian directly adds value, overcharging for these items should be considered a significant faux pas. ... As a good general guideline for product sales, the charge to a client should never be such that you would feel embarrassed of guilty if the client were to learn your true cost."
With just a couple calls to vet clinic insiders, I discovered that on average a package of 12 pill guns costs a clinic about $10 to $12. That's at most $1 per pill gun. So did I pay a fair price for this little plastic pill popper? I'm thinking NOT, and that makes me question how ethically this specialty hospital marks up its prescriptions and services, too.
Perhaps a better way to handle it would have been this:
"Mrs. Perry, you need to start giving your kitty an oral medication that comes in a pill. Do you think your kitty will tolerate eating a pill? If not, I'll include a pill popper with your prescription at no extra cost."
That's what I would call value-added service.
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