OK, so here’s one of those posts where I ask for your opinion. I hope you see fit to surrender to my request. The issue under consideration relates to a website called VetCentric.com.
First, a primer: VetCentric is an online vet pharmacy and supply store. It goes out of its way to be friendly and informative on the topic of pets but exists primarily to grant vets the freedom to refrain from selling quantities of drugs and products out of their practices at high retail prices.
For my style of practice (I feel weird selling drugs and shampoos and stuff), it seems a great concept. Nonetheless, I do believe that my recommendations on products have some value. After all, I spend an inordinate amount of time selecting meds and products for individual patients and discussing their proper implementation.
On average, vets spend far more time discussing these issues than most human doctors do. (I base than on the average length of exam times for vets versus human docs.) So does this imply we have more need of the sale?—or that we are more deserving?
Consider also that retail sale is an undeniable piece of the structure of practice economics (for better or worse.) That’s partly because we have to operate in retail, foot-trafficky locations like high-volume corners alongside Blockbuster or The Foot Locker—so our lease rates are higher than for physicians. It’s also because an area’s hospital prices are set competitively (by high-volume, big in-house pharmacy vets who can easily lower their service prices when the drug and product income is substantial enough, thus leaving the rest of us to do the same if we want to compete for clients based on a $200 spay).
Still, I don’t like the appearance of selling stuff at huge mark-ups. For that reason, I often send my clients to 1-800-PetMeds or a similar online destination. This is especially useful for chronic use of such items where immediate action is not required (waiting two days to start your antibiotics is not practical). So it’s my Rimadyl, pet foods and glucosamine and chondroitin clients whom I instruct to refill online, sparing them the retail markup and me the hassle of Rx management and the stress of feeling like a vulture.
Problem is, I lose lots of income from this approach. God knows I make less than the average 12-year vet out there. Part of that comes from this kind of client-empathy, no doubt.
So VetCentric has found a way to partner with vets so that product and medication prices and inventory control are handled by another organization (them) whose prices are set at competitive online rates (comparable to PetMeds). The key is, vets get a cut of that. A small cut, no doubt, but it’s nonetheless an important contribution to the income of a vet that’s ultimately looking out for his or her clients. I like that.
How does it work? The vet applies a logo to the hospital website and instructs clients to navigate to VetCentric by clicking on an icon installed in their practice’s site. Once the client places an order (after passing through Dr X’s site) the commission is allocated to the vet and a check is sent out at the end of the month. It’s relatively simple.
Now that the issue is on the table, it’s your turn to tell me what you think. Is it tacky? Is it opportunistic? Is it fair? How would you feel if your vet suggested you do your pet shopping through your vet’s website? What if I tacked on a logo to this site to help fund my efforts to improve it (no meds just supplies)?
How about if a percentage of the proceeds went to a pet welfare organization? (I asked the company and they say they can easily cut two checks so your clients can verify this if they wish.) I ask this last question only because I think that’s what it would take for me to adopt this approach.
Sure, I think vets deserve a cut. Or do we? If so, how much is fair?
Now it’s your turn to sit on the hot seat…
Add Comment61 Comments
Interesting aproach & not a tacky one from my perspective. Because I have a multi-animal household, however, I'm looking for lower med & supply prices wherever I can find them.
I don't question the cost of top quality health care but will always try to save where I can so I like working with a vet who's willing to write prescriptions for me. Offer me the best price on prescription meds, non-prescription items & dog supplies of all kinds & I'll surely buy from you whether you're part of an online store or not.
Ellie September 12th, 2007 09:27:00 AM
Not tacky at all - you do have to make a living, you know! It certainly wouldn't bother me if my vet started doing that.
CDC September 12th, 2007 10:23:00 AM
I don't think it's tacky, but I do question the crediability of some sites like 1-800-Pet-Meds as they are known to sell grey market products such as Frontline.
My vet doesn't have a problem with clients getting scripts filled online. She will even price compare between what she has in her inventory and compare it to what something sells for at the local drug store. If amoxi is cheaper at the drug store, she call in the script for a client to have it filled there rather than having them pay out of pocket at her clinic. The only catch with that is if a owner cannot pill their animal, there is a good chance that they'll have to purchase from the clinic anyway to have the medication compounded.
As for kick backs, well those are a double-edged sword. It's safe to assume that there are vets out there that will call in scripts that aren't really necessary as a means of making a few extra bucks. I'm not saying that you'd do that, but like in human medicine, there is always abuse when it comes to getting money for selling product. In terms of human medicine, just look at how many kids are on drugs for ADD, ADHD, ect... Overwhelming doesn't even to begin to describe the abuse of these drugs and I think part of this abuse is due to kick backs. Of course there is more to it than that, but it's there and nobody seems to be motivated to do anything about it.
As long as a vet keeps things honest and respects a clients opinions on the companies that they order from, I don't have a problem with it.
Stacy September 12th, 2007 10:28:00 AM
I have two dogs and five cats, so saving money is always a concern. I do that by shopping sales, clipping coupons and carrying a points card to the various chain pet stores. I don't order through petmeds just because I want my vet's expertise and the option to call him if I can't remember what I;m doing or if I think something isn't working well. Because of that I'm good with paying what he charges for meds.
I don't think it would be tacky if you all wanted to go through petcentric as long as you'd give your patients the option of buying directly from you. I doubt you have a lot of patients who need as much help as I do (I have a brain injury and my memory sometimes is not what it should be), but for those who'd feel more comfortable buying from you, that should always be available. I can understand saving on chronic meds, but again, I would rather be able to get it from my vet.
I wouldn't mind of you put a logo on this site, or another affiliate link such as to Amazon. You need to be paid for your time the same as anyone else. I would certainly miss your site if you could no longer afford to maintain it. But, I don't understand why you feel the need to donate part of your profit from such a company to animal welfare. It seems to me that if you want to do this you could simply do it yourself without needing to justify using this company. I think that most people trust that you are a caring and very compassionate person without having to do so. After all, is the company willing to make less in order to get you to like them?
I think the real question is, what do you think about this? Would it make your life easier, or would it be giving over your profits to a company who doesn't do as much for your patients as you do? Personally, I'd vote to let vets keep their money they work hard for.
Cindy September 12th, 2007 10:29:00 AM
Not tacky at all.
It sounds more convenient for all involved, and I would always feel weird using something like petmeds, (or the contacts by mail things for that matter) since it feels like I'd be cheating on my doctor.
Though interestingly, most vets I've seen here have offices in the little 'professional parks' occupied by doctors and the like rather than in shopping centers, though there are a few in strip malls.
ellipsisknits September 12th, 2007 10:30:00 AM
I second both of the first 2 comments. Also, my daughter, who had 2 dogs at the time, did try the 1-800-petmeds, and seemed to find that after shipping,etc costs were added on, it wasn't much cheaper, e.g. for flea and tick prevention, than getting them at her vet's.
Diana September 12th, 2007 10:59:00 AM
ellipsisknits: I guess the storefront thing depends on your zoning. In Miami, vets can't get proper zoning anywhere but in prime retail locations or heavy-duty industrial parks. But in general, vet medicine is considered a retail industry--referrals don't typically make up the bulk of our clients (though that's not true in our case). Vets tend to cater more to a convenience-based crowd, so if they don't see the practice in their neighborhood they'll never know it exists.
Dr. Patty Khuly September 12th, 2007 11:35:00 AM
Is Vetcentric able to purchase drugs directly from the manufacturers? And do they? And, as far as Merial is concerned, is buying Heartgard from Vetcentric like buying it from you (they guarantee it and stand behind it if your dog gets heartworm anyway), or is it like buying it from 1800petmed (they say, so sorry, but we don't know that that's ours, so we can't guarantee it) ?
If they are buying directly from the manufacturers, and the manufacturers' guarantees where relevant are in force, then I'd say go for it. You need to be paid, and it's good to try to help your clients save while not trying to act like the public charity you can't afford to be.
Lis September 12th, 2007 12:27:00 PM
My vet uses VetCentric. I've bought HeartGard through them for the past couple of mosquito seasons and they are competitively priced with other on-line pet med sites.
Earlier this year when there was a false rumor that HeartGard had some of the contaminated ingredients from China, I called VetCentric and they were able to give me a direct number to Merial where I could discuss my concerns with them.
I didn't know that VetCentric gave money back to the clinic, but our vet does good work, she deserves a slice of the meds pie.
RKolosky September 12th, 2007 12:46:00 PM
I'd be for a setup like this, as long as my vet had enough drugs to cover my pet while I waited for shipping (for meds like antibiotics, pain killers, and other drugs that need to be started right away).
I've been to a vet that wrote all sorts of unnecessary prescriptions for a stray (they knew it was a stray too). I made the head tech tell me what each script was for, and ended up only getting 3 of the 8 recommended scripts (and the antibiotic was changed to a cheaper one that worked great). I felt that only 2 scripts were absolutely necessary, but one of the 'recommended' did sound like it would help the dog out a lot while recovering. But those other 5 scripts wouldn't have helped the dog much, even if I had the extra money to spend on a stray (he became one of the most loyal dogs I've ever had 8^)
So, in addition to allowing us to choose our med suppliers, a discussion or printout of what the drugs are for would be appreciated too. Some unnecessary drugs can be helpful, but others are just price-jacking by greedy vet centers (luckily, that vet center was the only one I've had this bad experience with).
Sherri September 12th, 2007 01:03:00 PM
Not tacky at all. In fact, it will make my life easier. And if there's money to be had, I would prefer it goes to the people who deserve it, in this case, you/vets. I think it is a win-win situation. But since it will appear on the vet/hospital's website, I will be assuming that this online company is reputable based on the vet/hospital's judgment.
Kate September 12th, 2007 01:41:00 PM
IMO it's a win-win: the client saves a little money and has greater convenience; the vet gets a little pay for - like you said - spending more time in consultation than MDs do.
I've gotten Potassium Bromide through VetCentric for almost 5 years, for one of my dogs who has a seizure disorder. My vet doesn't carry that since it has to be compounded, and from what I've heard from other pet owners it can get pretty expensive. But the price we pay from VetCentric is very reasonable.
Another benefit - for those with memory problems - is that they send email reminders when it's time to order a refill OR you can sign up for automatic refills at an interval you choose. I've been very, very happy with the service.
Barb September 12th, 2007 01:41:00 PM
Not tacky at all. With 2 dogs, 2 cats, and the assorted fosters that pass through, I'm all for saving money, as long as it doesn't compromise care. My own vets will write for online scripts, but as stated, often after shipping, tax, etc. are added, sometimes the savings are not really so much that it makes a lot of difference. (My vets don't really mark up their meds and products so drastically that they are making a killing). Their building is owned by the owner of the practice; built two years ago on property he bought years ago when it was only his "dream practice". But if my vet can supply meds needed immediately, and will write for the rest, I'll save where I can----after all my animals don't have a prescription plan with only a co-pay. I say, if it works for you and benefits you also, go for it!
Shellie September 12th, 2007 04:15:00 PM
I certainly don't find it tacky. It should be disclosed and script offered for other suppliers as well if requested. My guess is that most people will chose to purchase from you or the offered service if it is competative. I buy some medicines directly from the vet. My vet refers me out for some expensive medications, which he does not even stock due to lack of demand because of the cost. I respect the need to make money but many of us are stretching our budgets with expensive medications and procedures (not to mention the best food we can find) and need to save where we can. I know of some vets marking up items including drugs and supplements to more than MSRP and even double what it can be found for elsewhere. They also won't write prescriptons to purchase elsewhere. That I find tacky and not in the best interest of their patients.
Carol Lerner September 12th, 2007 04:24:00 PM
I think they deserve a cut, but a fair cut.
NO vets in my area will release prescriptions and
I have a dog that can not live without Atopica. I see it can sell on line for about $40.00 a month
and I am being charged $135.00 to $145.00 a month.
And I was sold Denosyl at $65.00 for a 30 day supply. I found out later you can buy
it on-line ( it is non prescrip) at 90 days for $70.99 .
So fair is fair
I cant protest and raise a ruckus as the community is close and I would
be black balled, and my dog would suffer. So I am at their mercy.
I really pity the poor folks who helps rescues , no price breaks in my community .
Angy September 12th, 2007 04:27:00 PM
In human medicine it is considered conflict of interest for a doctor to profit from the sale of drugs in his/her clinic.... for good reason. I think the same is true of (certain) vet clinics that price gouge and over-prescribe. I do not mean to say that all practitioners do this, but it does happen, and it shouldn't. So I think the site you mention is a great idea, and very noble of you to donate a portion of your proceeds to charity.
We get back what we give, so you are in good karma indeed :)
clover September 12th, 2007 06:04:00 PM
Angy: Did you know it was illegal for vets to withhold prescriptions? It' your *right* to receive a prescription for any product or pharmaceutical. It' also unethical, imo. Stand up for yourself, girl!
Dr. Patty Khuly September 13th, 2007 08:45:00 AM
I don't see anything wrong with providing a service for your clients. Personally, I wouldn't use it. I usually price check between Petmeds, Drs F&S, and KV to see where I can get the best price. There are a lot of people who wouldn't be comfortable (or don't have access to) shopping online from home, and this would be good for them. I don't have a problem with vets marking up items and selling them in their practice (as long as they aren't pushy about it). I've had instances where I needed items now (like in the midst of a tick infestation) and didn't care how much I was paying above retail. You should do it, and not feel bad about it. People have plenty of choices, and if their choice is mutually beneficial so much the better.
Chip September 13th, 2007 09:55:00 AM
I'm with Angy - it's frustrating to pay an exorbitant sum for something that you *know* should cost a quarter of what you're paying. My vet threw a flat-out fit when I asked if I could have a prescription during our last visit. And it was for Revolution, because I have four dogs and needed a year's worth, and she didn't have enough on hand to dose all four dogs. Should I have told her that she had to give it to me, legally? Instead I agreed to let her order it for me and call me when it came in. I'm a pushover.
Erin September 13th, 2007 05:07:00 PM
I think it's really a smart move for you.
On a side note, the vet I work for will not write a script for Heartguard to 1-800-PetMeds. Is this illegal? He understands that Merial won't back up the product if sold through PetMeds. We've lost some clients this way but he doesn't seem to care. I totally think you should put some cool online pet shop links on your site. We all trust you!
Kelly September 13th, 2007 10:20:00 PM
Kelly: I'm going to address that issue in tomorrow's follow-up post on script-writing. I've been talking to other vets about this and there may be reasons why they can deny a script in certain cases.
Dr. Patty Khuly September 14th, 2007 09:04:00 AM
A follow up would be great. I think everyone wants to be fair here. We understand that vets need to make a living, and that some medications have to be specially compounded. But it would be nice to know what we are entitled to legally and whether this varies by state. That way we can press the issue when we need to, but not hassle the vet when he/she is following the rules.
2CatMom September 14th, 2007 10:32:00 AM
If you conduct business on the web then you ought to get paid. If you refer clients you ought to get a cut - otherwise you are just advertising for someone else, and for free. If you send people to 1 800 pet meds, pet meds keeps the entire sale. Compassion or not, drugs are business and someone is going to make the money - you might as well get your fair share. You did spend oodles of your own time and money studying it all! A recommend from a Vet is a retailers' dream.
Just make sure the link tracking software is accurate. It wouldn't hurt to have your own website administrator invest in tracking software on the vet side. You don't want to lose affiliate commissions because of a software gliche.
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