[AlotOfReading]

My partner works in this industry and in fact has friends that are affected by this merger. While the FTC can and does have the ability to do many things simultaneously, the current situation in the vet industry is dire. Corporate vets are more profitable (through price-gouging), have a virtual stranglehold on increasingly limited labor pools, and are pretty much the only ones that can afford to invest in specialty medicine like emergency clinics these days. The FTC has been taking a firmer watch over the consolidation in recent years, but the trend is very clearly towards the extinction of locally run, family-owned practices that serve the community.

[Freebytes]

Emergency vets in many places will demand you pay $5,000 upfront (within minutes before surgery is performed) or your pet dies. Then, your pet will die anyway. It is a sad and exploitative industry.

[AlotOfReading]

I've found that the people actually providing veterinary healthcare are some of the biggest animal lovers you're ever going to meet. They adore animals to frankly unhealthy degrees. If even the local family-owned vet clinic is also doing something, it's usually not because they want to exploit hurt animals and exploit you, it's motivated by the necessities of the industry.

In this case, non-payment is a huge issue for vets and they need to keep their doors open for everyone else that needs care. Running a specialty like emergency medicine is even more expensive and carries higher prices as a result. They don't want to deal with trying to collect after the fact. Hence, they'll usually give two options: Pay at the time of service or sign up for something like CareCredit that will pay the vet upfront and deal with the collections on the backend. Some places offer third options, but these are usually problematic or involve charities.

[beckingz]

Yeah, the people I know who work in veterinary healthcare love animals. Many of them end up burning out because they have to deal with so much animal death.

[bmj]

A handful of years ago, we had to euthanize our (very old) cat. The plan was to have an at-home come in, but his conditioned worsened, and the service couldn't accommodate us, so I ended up going to an emergency clinic. Initially, it was a bit impersonal, but I was touched by the vet who, when administering the drugs, started crying right along with me.

[rozap]

Yep. This happened to us. After the dog was prescribed something (bravecto) she didn't really need, which had big risks we didn't know about, so much so that the FDA issued guidance about seizure risks. She had a seizure 48 hours after we gave it to her, and was dead within 72 hours. We paid like $3k in emergency vet care before they did any work, and she died within 30 minutes of them starting on her. 2 year old collie. Edit: just looked it up and the vet in question is owned by JAB.

Sorry to vent. Still makes me so angry and depressed. None of the vets wanted to entertain the fact that it was the drug, despite mountains of evidence. It doesn't feel like there's a culture of learning, just one of deflecting fault. I hate to be one of those "I've done my own research" types, but with animal care you really are on your own. This happened a few months ago, really miss that dog.

[KennyBlanken]

As someone who knows emergency vets, you have no idea what you're talking about and this is incredibly offensive. Vets don't go into veterinary care to get rich. They get into it because they care deeply about animals.

If your dog is bleeding out or not breathing, nobody is going to sit there waiting for you to swipe your card; they're going to try to at least stabilize your dog, and then talk to you about diagnostic options and so on. Emergency vets charge an up-front diagnostic fee and anything that is not "your pet will die if we don't act right now" has to be pre-paid.

There are no government funded veterinary clinics.

There is no legal right to emergency medical care for pets.

There is no government agency guaranteeing the vet ER gets paid if the owner isn't able to, or simply refuses. Debt collectors typically pay out a fraction of any debt they agree to collect...assuming the ER can even identify them. ER vets can't put liens on your property like hospitals can.

Most pets are not insured, and frankly pet insurance is a ripoff. Lots of exclusions and a lightning-fast "prior condition" reaction is how they avoid payouts. It's not regulated because in America, we don't Do That Sort Of Thing (no step on business snek, as business snek regulated by free market!)

Emergency medical care for humans is the most expensive kind of medical care there is. For one species, one usually able to communicate at least on some level.

Now imagine all that, multiplied by multiple species. Equipment, a pharmacy, and staff able to care for patients of almost any size, multiple species, of wildly variable temperament, who have nearly no ability to communicate or participate in their care. And who have an evolutionary drive to hide injury and pain, usually.

Part of the reason ER vet care is so expensive is because they do not "demand you pay" while your pet bleeds out or sits there on the table not breathing...and when people inevitably don't pay (in part because they're people like you who shout "well my dog died anyway, why should I pay you!?"). That has to get amortized over all the people who do pay.

The vast majority of pets that end up in the ER are dogs, and the vast majority of those are in the ER from getting hit by cars, into fights with other dogs, or poisoned/obstructed by things they ate - most of the time because they were not on a leash.

What do you expect ER vets to do? Who pays to keep the lights on? The massive pharmacy stocked? The staff trained? The imaging equipment working?

The magical pretend emergency animal care fairy?

[markovbot]

> It is a sad and exploitative industry.

just wait till you see what they do with human healthcare in this country

[bombcar]

There they don't even ask, they just start treating, because they know that the emergency costs will be borne by someone.

[snapetom]

>It is a sad and exploitative industry.

What an insulting, belittling comment. I don't know why you think veterinarians are charities, and don't know why feel entitled to pay people less than they're worth.

Veterinarians hold doctorates. Four years of undergrad, four years of vet school. Many emergency vets are board certified, meaning they've done an additional 3+ years in internships and residencies.

In running a practice, ideally you also want a 3-1 ratio of techs to doctors to monitor patients. Many states require at least an AA degree to become licensed. These days, it's common to find people who have undergrad degrees who go into vet nursing as a career. Therefore, clinics are paying for 3 others with degrees.

Add in costs like support staff, and the fact that 80% of medicine and equipment are repurposed from human use. Distributors don't give a shit that it's for animals and will charge a vet clinic the same as a human hospital.

Don't blame the vet for charging $5000 for a surgery. Blame owners who can't afford to raise a pet but have one anyway.

[wing-_-nuts]

>Don't blame the vet for charging $5000 for a surgery. Blame owners who can't afford to raise a pet but have one anyway.

What an utterly callous statement. We're mostly well paid professionals here on HN, but to suggest that the average american should be able to come up with $500, much less 5k, on a moments notice is laughably out of touch with most people's financial situation.

[kaashif]

There is an even more callous meaning that you didn't pick up on for some reason - they're not suggesting the owners should come up with $5000, they're saying the owners should kill or otherwise get rid of their pets once they can't afford them.

I think people are missing that the point here is that the prices aren't being set in a competitive market, so $5000 may just be a monopoly price. Maybe pet owners should be forced to pay the cost of treatment, but whether that's $5000 or not is what the FTC is concerned with.

[snapetom]

Calling that a monopoly price shows ignorance on what a monopoly is. Even large metropolitan areas have just a handful of emergency vet hospitals. Emergency vet hospitals don't have an army of vets on standby to handle cases. 2-3 is common and they might be just interns/residents supervised by a more experience vet. Scarcity and lack of supply have a much greater effect than collusion.

Pet owners should know this before getting a pet, or properly plan.

[snapetom]

Being able to come up with $500 or $5k at a moment's notice is part of pet ownership. If your financial situation prevents coming up with it, don't get a pet. You're just shifting irresponsibility in the guise of anti-corporate crusading.

[wing-_-nuts]

I expect this line of reasoning from corporate mouthpieces. To hear it from the mouth of a provider speaks to to your values.

I think the following quote applies here:

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

[KennyBlanken]

So many HNers are libertarian right up until it concerns something they need.

Then it's "why do I have to pay for that!?"

[snapetom]

I lost my shit at a redditor for complaining about a $500 overnight bill. $500 for a doctor and three nurses to watch over your animal like a hawk for eight hours, plus IV and medicine, is a damn bargain. I thought HN crowd would be smarter than that.

[djcannabiz]

In which country was this in do you know? I don't know if a price like that is even possible in the states lol

[snapetom]

This was pre-COVID in suburban midwest, if I recall. On the low-end of the estimate, and nothing happened that required intervention, but certainly possible in the market location. Major city? Good luck.

[snapetom]

My wife is a vet and is affected by this. We are not in the states affected, but she works for one of the corporations involved.

This has been a long time coming. As another comment said, with a few anecdotal exceptions I can think of, many vets simply aren't good business people. Margins have been incredibly small since veterinary care became a thing. Vet schools have required business literacy classes for a few decades, but this is an industry where people get into it to help animals first, not get rich.

Corporatization came in to fill a void, but whether it's good or bad, the economics for veterinary care, and especially consumer perceptions, are due for a reset.

[ensignavenger]

Could you explain this more? If the corp vets are price gouging, why are consumers choosing them over the smaller vets?

[jakear]

There’s no element of choice. Calling around my local vets every one is 3+ month wait for new patients. Even existing patients have week or longer lead times.

But of course if you choose Banfield (PE shitshow), they’ll see them same day (drop off in the morning, pet waits in kennel surrounded by other sick dogs all day until a vet is free, pet goes back to kennel to wait until end of day). The charge is significant, but the pets waiting around locked up all day is what bothers me more. At checkout they’ll of course hit you with the “wasn’t this so expensive? You should buy our health insurance plan!”

Compare this to the vet in my parents town that will also see same day, but I walk into the exam room with the pet, meet face to face with the vet, and stay with the pet for the majority of the operation. And pay less in the end.

[SkyBelow]

Where is the market for the vets who are a bit more expensive but only have a wait time of a few days, with emergency services available at a premium comparable to the PE's but with better treatment?

Are we saying that vets would rather be unemployed than to work such a market or is something preventing them from serving that market or does the actual demand for such services not exist?

[AlotOfReading]

Boutique practices exist, they're just a relatively new business model and targeted to wealthy urbanites. Take a look at Modern Animal [1] or Small Door vet [2]. Traditionally, the answer has been to just go to an emergency vet if you need rapid treatment.

[1] https://www.modernanimal.com/

[2] https://www.smalldoorvet.com/

[jakear]

That’s probably the emergency animal hospital. Sees the pet same day 24/7, pet waits with you in parking lot until they’re ready, and is taken immediately back to you when they’re done. Prices are high, and non-emergency services aren’t available. For instance vaccines/microchipping.

I do not know why such places don’t offer standard services. The one by my house was nearly always empty, but still would not give my dog vaccines.

[eatsyourtacos]

>why are consumers choosing them

It's interesting that most people who like to defend the free market act as if consumers actually have choices most of the time.

That's just simply not the case nearly all the time.. or it's a complete illusion of choice.

Especially in any rural/smaller suburban area (of which the US predominantly is). It's not as if you have 1000 choices for everything around. That's only in large urban areas. The US is so spread out that it can't cram tons of competition in most of it's areas. And that is probably what is being exploited here.

[bombcar]

Yep, and even the places where you have two vets, you dig in and find they're both owned/employed by the same company.

In really rural areas, you find vets who will "work off the clock" for cash payments if they know you well, to cut out the company.

[whimsicalism]

Most people are faced by more than one choice of vet. Most people do not live in rural areas.

If vets are able to charge high prices and people will still pay them, maybe more vets will enter the market to provide services to the underserved market.

[asdff]

These markets really are tiny and vets have been closing down over the years. Even in suburban areas you might only have a single vet within a reasonable distance of your home. People in this thread are even saying their entire local vet markets have been taken over already by these corporations.

[MrFantastic]

Most people would not know how to identify the most skilled vet clinics.

For consumers to make informed choices, they need to have some understanding of the domain.

If a Vet says Rover needs a XYZ procedure, how would the pet owner understand what a fair price is or what other treatment options are?

[ensignavenger]

If there really is only one vet in an area, then how is it judged they are price gouging and not just charging market rates?

[conductr]

It’s not. That’s a hypothetical that nearly never happens. Or when it does the pet owner just gets to decide if they want to pay, let the pet go without, or travel to nearest competition. If a place is that rural, it’s likely the vet can’t gouge as they need to eat too and nobody would hire them

[jrochkind1]

I go to a smaller vet with good prices and good care. They are not currently taking new customers/patients.

[akamia]

We had this challenge when we moved into our house. Our current vet was over 30 minutes away and we have to take our dog in 3x/week for fluids. Our new neighborhood has five vet clinics. Four were not taking any new patients. Luckily we were able to get into the fifth clinic because they were brand new and were building up their client list.

That wasn't unique to our area either. We've heard from several friends that they've had similar issues getting into vets.

[sokoloff]

We're in a similar boat. We only got our new dog into the practice because they'd cared for our previous dog for 13 years. The prices aren't great, but they're bearable and the staff there are absolutely first-rate animal lovers.

[elteto]

Because there are no smaller vets. Or they suck equally hard, there’s no guarantee that being smaller == better.

[ensignavenger]

Well, the above post said the cop vets were price gouging. If the local vets are price gouging too, then it seems to have nothing to do with corporate ownership.

[AlotOfReading]

Local clinics pay higher rates for supplies (few economies of scale) and depending on the practice, often do quite a lot of charity on the side. There are private practices that compete with the corps on margin, but they're relatively rare to my knowledge.

[samstave]

Because one typically only uses the Vet closest to the pet. If your only options are the guy(s) down the street(s) in any direction are "which vet is closest to me" and they ALL happen to be the same corporate entity who can grid the community with vets... you'll get gouged.

What will be interesting is when they go buying up all the farm vets -- and then hiking THOSE prices up, which will put further costs on farms and animals, food and crops... and then that translates into an ADDITIONAL increase in costs of food/collapse of independent farmers and further control of the price-supply-line of all foods...

They alread did this in conjunct with pharma and agri-fertilizer bullshit...

I wouldnt be surprised if Monsanto is behind this...

Do these funds mandate the vendors from whom the vets can buy medicines and supplies from, likely the other companies they own.

This is "Serious Business" -- and these people are EVIL.

They dont give a fuck about anything, but have paid a bunch of quants to maths death into profits.

[AlotOfReading]

Clinics are facing severe labor shortages. It doesn't matter what the demand is, because they have a limited supply of veterinary care to give. My partner's clinic recently became corporate-owned because they simply could not hire new vets to be able to take new clients. Any days off any vet took had to be covered by one of the others on their "weekend" or the clinic would be forced to shut down.

Like other forms of healthcare, people want to take care of their pets properly and that makes demand relatively inelastic. If one clinic isn't taking appointments, they'll go to another even if the prices are 20% or more higher, especially if that one is more convenient to access. Once they're there, they'll usually stay for a long time.

[snapetom]

Agree with the demand elasticity, but I'd like to add something about higher prices. It's been studied in the industry very well that you can't have good care without higher prices and "things." It's just not possible, and people that say their vets are "good and cheap" are just fooling themselves.

As an example, prior to certain surgeries, my wife offers drug A to the clients. It adds to the cost but increase the chance of survival. However, drug B is not an option because studies have shown in increases survivorship by 50%. She bakes it into the cost of the surgery and refuses to do the surgery without it. Clinic down the street offers both drugs as options, bringing the base cost of the surgery down.

So now she has a reputation of being expensive vet. If she offers drug b as an option, patients die more frequently and she has a reputation as a bad vet.

She'd much rather have the reputation as an expensive vet.

[whimsicalism]

Maybe it would be better if they charged more and paid their vets more so that there were actually enough workers to help people's pets? If that's what PE is doing because the local owners are too afraid to raise prices, more power to them.

[snapetom]

Higher prices == worse Yelp reviews. You then get a reputation for being expensive, and Yelpers warn people to stay away.

This is an emotionally charged industry where 99.9% of the customers have no clue what goes on business-wise behind the scenes. Yelp has been a curse, giving voice to these people.

[jacksnipe]

But why can’t local clinics get new vets? Because they can’t pay them enough, because they don’t price gouge?

[AlotOfReading]

In addition to what snapetom said, there are about 4400 annual vet jobs and 3200 new grads. Someone is going to miss out.

Graduates who want to make money will go to commercial or fisheries operations, which pay better overall. We're in the bay area, one of the highest-demand regions in the highest-demand state. There aren't many people left to compete over. Corps are currently offering 5-6 figure sign-ons and bonuses in our area. Even if the salary can be matched and they accept, there's still the tech shortage snapetom mentioned. Those people are often commuting from places like Tracy to have reasonable housing costs and many have simply left the industry entirely. You can raise salaries, but there's still only a limited number of people with RVT licenses.

[wolverine876]

> there are about 4400 annual vet jobs and 3200 new grads

So why isn't supply increasing to meet demand?

[AlotOfReading]

I have absolutely no idea why they haven't increased the number of residencies available (not a field I work in), but the process to become a vet is similar to other medical specialties. There's a limited number of slots available annually, and the number of slots is lower than the number of people retiring, let alone accounting for industry growth.

[lotsofpulp]

>There aren't many people left to compete over. Corps are currently offering 5-6 figure sign-ons and bonuses in our area.

They simply are not offering enough money. If 5 to 6 figure bonuses do not work, then they should be increasing pay to high 6 figures or 7 figures. I would be surprised if 7 figures does not solve their supply issue.

[snapetom]

It's not as simple as hiriing vets. It's having techs to support the vets. Minimum, you need two techs to support a vet, ideally three. Many states require techs to be licensed and have at least AA degrees, so you're paying for an additional 2-3 educated people plus the vet.

Of course, the "ideal" rarely happens, the point is, with every vet you add, issues of juggling staff, scheduling, and turnover skyrocket

[bombcar]

I'd assume it ends up being that once the company owns all of them it can assign vets to whichever office needs "coverage", jack prices, and raise salary somewhat, too.

To be fair to the companies, they do usually work to "maximize vet time" where they hire or outsource the other stuff the office does so the vet is spending most of their time vetting instead of paperwork and office work.

[snapetom]

Most of the corporations don't make it known that the clinic is corporate owned. They sweep in, buy the clinic, and keep the owner in charge. Marketing and branding is kept as-is to keep the small, neighborhood clinic feel.

Some of that is changing depending on the corporation. Sometimes you'll see "Main Street Vet Hospital, a Megacorp Vet Clinic" or they'll rebrand speciality clinics and large hospitals with the corporation branding. However, a lot of small general practice clinics still make no mention of corporate ownership and clients would never know unless they ask. And they never ask.

[ensignavenger]

If nothing changes for the customer, then why is it a bad thing? Why should consumer care who owns the clinic?

[snapetom]

Ideally they shouldn't care. I was giving an example of why consumers would choose to go to a corp clinic over independent - they simply don't know it's corporate owned.

I'm not going to argue whether it's bad. I've met plenty of good independent vets, plenty of bad ones. Plenty of good corporate vets, plenty of bad ones.

[bmj]

I think this is a bigger issue among emergency clinics. There used to be a few private emergency clinics in my area, but they are, to my knowledge, gone, and replaced by larger corporate operations.

[jollybean]

Locality / scarcity. There are just not that-that many vets around. Also specialized services, 'gotcha' billing etc..