Sirs:I have received and reviewed the complaint written by Ms. [redacted]. [redacted] about her dog[redacted]. It is unfortunate that her dog required medical care, and I certainly understand her concern that itcan be difficult to pay for such expenses, particularly when living on a fixed income. However,...
while Iam sympathetic to Ms. [redacted]'s concerns, her complaint is baseless and unreasonable for the followingreasons:1) Ms. [redacted]'s complaint states that the "purchase date" for the service (dental work) was08/31/2015. (Information taken from "Complaint Background.") This is incorrect. Ms. [redacted]had a dental procedure performed on her dog [redacted] at Mountain View Animal Hospital on09/01/2015, not 08/31. All communication between her and my staff occurred on 09/01. Wedid attempt a courtesy follow-up phone call to ascertain how [redacted] was doing on 09/02/2015 at9:59AM, (message left) but this phone call was not returned.2) Ms. [redacted] stated in her complaint that " ... they quoted $252.00 ... " [for the dental procedure].This is incorrect. [redacted] ([redacted]'s co-owner) signed a written estimate ranging between$252.00 and $340.20 when she dropped [redacted] off on the morning of 09/01/2015 (estimateenclosed). It was also explained to her that the full extent of her pet's periodontal diseasewould not be known until the pet was anesthetized and a full oral exam could be performed.This was also explained to her in writing both on the estimate form ("This estimate onlyapproximates the cost of this visit. It does not include any treatments that may be deemednecessary upon examination and commencement of the included treatments ... ") and on theFinancial Policy and Agreement ("I understand that in any medical case the total extent of theillness or injury may not be immediately or fully apparent. I understand that based upon theongoing response to treatment and/or complications that may be encountered, the finalcharges for treatment may be very different from those initially quoted." ). All fees in excess ofthe initial $252 dental cleaning package were associated with the extraction of a fracturedtooth. As Ms. [redacted] is aware, this fracture was not apparent until her dog was anesthetized,and we had no way to provide her with an estimate for those services until that time.3) Ms. [redacted] stated in her complaint, " ... the new total was over $538.00" [for the dental packageplus the extraction and associated services]. This is incorrect. Her total charges for the dentalprocedure performed on 09/01/2015 were $515.65 which she paid in two separate paymentson her CareCredit medical credit card ($252.00 and $253.65, both paid on 09/ 01/ 2015).4) Ms. [redacted] stated in her letter of complaint, "They charged me more than twice as much asthey quoted me for the dental." This is incorrect. She verbally authorized an estimate for$515.65, on 09/01/2015 at 10:35 AM. (This estimate is enclosed, along with the date, time, andinitials of the receptionist who presented this estimate to the [redacted] family.) Ms.[redacted]'s total charges for the dental procedure were precisely what she was quoted. It ishighly misleading for Ms. [redacted] to suggest that we exceeded our initial estimate, when she isfully aware that all additional charges were for a different service (tooth extraction)-a servicewhich she choose to have performed after receiving a full and accurate second estimate.5) Ms. [redacted]'s letter of complaint states that she agreed to have a dental cleaning performed,and that she was later told that a tooth had been extracted, raising her bill far in excess of herability to pay and in excess of any estimates that she had received. ("They called me from theiroffice, after my dog was under anesthesia, and told me they had to pull a tooth that had crackedoff on top. They told me x-rays were done ... The new total was over $538.00" Underling addedfor emphasis. Note that Ms. [redacted] has placed these events in the past tense, clearly implyingthat the services had already been performed BEFORE she was contacted.) Unfortunately hersequence of events and her implication of a lack of full consent are both incorrect. After [redacted]had been anesthetized, a full dental examination revealed that the lower right 2nd molar had acomplicated crown fracture. Please note that this tooth is located in the back of the mouth andcould not be fully visualized until after [redacted] was anesthetized. When this fracture was identifieda new estimate was prepared and Ms. [redacted] was contacted for permission, BEFORE anyadditional services were performed. She chose to have the tooth extracted and verballyaccepted a new estimate for $515.65. It was explained to her that she could wait to have thefractured tooth extracted, and that she could have this procedure performed elsewhere. Ms.[redacted] complained about the price, but made it very clear that she wished to have Dr. K[redacted]proceed with the extraction. Per her request, the extraction was performed and she wascharged accordingly. No additional charges (beyond the initial dental package) were placed onher bill until AFTER she had received and accepted an estimate for those services.6) As per the estimate that she authorized, Ms. [redacted] was charged $263.65 in total for theextraction of the fractured tooth (including all surgical supplies), for two dental X-rays, for aninjection of pain medication, and for dispensed medications. She was also charged $252 for adental package, which included the pre-anesthetic exam, anesthesia, anesthetic monitoring, anIV catheter, IV fluids, blood pressure monitoring, and the dental ultrasoniccleaning/polishing/fluoride treatment. All of these charges are reasonable and customary forthe veterinary industry. Although we do not have access to prices from our local competitors(due to anti-trust laws) there are a number of regional and national benchmarks for fees thatare published each year. Annually we review the fee schedules from The American AnimalHospital Association, the Well Managed Practice Guidelines (Benchmarks), and from VeterinaryProductivity, and set our prices accordingly. While I cannot vouch for what any otherveterinarian in the Treasure Valley is charging, I am quite confident that our fees are reasonableand consistent both with regional/national standards and with the quality of the medicine thatwe provide.7) The gist of Ms. [redacted]'s complaint seems to be that she could not afford the level of care thatshe requested-a realization that she apparently made after the services were rendered. It isperplexing to me why she did not seek a less expensive option prior to having us initiatetreatment. There exists in the Treasure Valley a veterinary provider (the Idaho HumaneSociety), whose stated mission is to provide both a substantially lower overall fee structure andthe option for partially subsidized care for those with demonstrated financial need. Ms. [redacted]had the option to choose among dozens of veterinary hospitals prior to scheduling [redacted]'s dentalwork. She was again given the option of seeking care elsewhere prior to having the extractionperformed. It was fully her choice to have all of [redacted]'s dental work performed at Mountain View,and she was insistent that it be performed that same day.Given the points noted above, Ms. [redacted]'s request (in her letter of complaint) to have "allcharges above the $215 ... returned to me" is both unreasonable and dishonest. She requested aservice, accepted an estimate for that service, received that service, and now does not want to haveto pay for it. It would appear that her strategy is to create a big enough furor that she is given ahefty refund, without regard for the facts of the case. While I understand that she did not wish tospend money, her dog had serious medical issues that required treatment. That treatment wasprovided to her dog (at her request), and was of exceptional quality. Despite her statements to thecontrary, it is well documented that she fully understood what she was spending BEFORE doing so,and voluntarily chose to have a variety of services performed on her pet. I am sorry that she is nothappy with the cost of those services, however that is a decision that she should have made beforeher dog received those services.Ms. [redacted] makes it clear that she has " used numerous vets" in the past. Apparently she wasnot sufficiently happy with any of them to return when [redacted] required dental work. That fact isparticularly telling. Unfortunately a very small number of veterinary clients remain perpetuallyunhappy, and bounce from hospital to hospital, never satisfied with the medicine, the service, or theprices. It is unfortunate that we could not make Ms. [redacted] happy, but I suspect from her historythat she will not be happy with any hospital for very long. As price is apparently her primaryconcern, it is my recommendation that she seek care in the future at the Idaho Humane Society,which may be able to provide her with some financial assistance.As to her present complaint, however, Ms. [redacted] has chosen to deliberately misconstruemany of the facts of this case. She was provided with accurate estimates for the dental work thatwas performed, and she agreed to those costs willingly. All of the services that she received werenecessary, and she was charged fees consistent with published regional and national standards.When she expressed concerns about cost she was encouraged to seek care elsewhere, which shedeclined. While she may be able to find less expensive hospitals, I am quite certain that she will notfind the same quality of care that she received at a lower price. Unfortunately at this time I can findno basis for providing her with a refund or even an apology. While I am sorry that she is not thrilledwith the service that she received from us, the cause appears to be her selective memory andunrealistic expectations.Please contact me if you have further questions or concerns.Cordially:
Craig *. M[redacted], DVM, DABVP
Sirs:I have received and reviewed the complaint written by Ms. [redacted]. [redacted] about her dog[redacted]. It is unfortunate that her dog required medical care, and I certainly understand her concern that itcan be difficult to pay for such expenses, particularly when living on a fixed income. However,...
while Iam sympathetic to Ms. [redacted]'s concerns, her complaint is baseless and unreasonable for the followingreasons:1) Ms. [redacted]'s complaint states that the "purchase date" for the service (dental work) was08/31/2015. (Information taken from "Complaint Background.") This is incorrect. Ms. [redacted]had a dental procedure performed on her dog [redacted] at Mountain View Animal Hospital on09/01/2015, not 08/31. All communication between her and my staff occurred on 09/01. Wedid attempt a courtesy follow-up phone call to ascertain how [redacted] was doing on 09/02/2015 at9:59AM, (message left) but this phone call was not returned.2) Ms. [redacted] stated in her complaint that " ... they quoted $252.00 ... " [for the dental procedure].This is incorrect. [redacted] ([redacted]'s co-owner) signed a written estimate ranging between$252.00 and $340.20 when she dropped [redacted] off on the morning of 09/01/2015 (estimateenclosed). It was also explained to her that the full extent of her pet's periodontal diseasewould not be known until the pet was anesthetized and a full oral exam could be performed.This was also explained to her in writing both on the estimate form ("This estimate onlyapproximates the cost of this visit. It does not include any treatments that may be deemednecessary upon examination and commencement of the included treatments ... ") and on theFinancial Policy and Agreement ("I understand that in any medical case the total extent of theillness or injury may not be immediately or fully apparent. I understand that based upon theongoing response to treatment and/or complications that may be encountered, the finalcharges for treatment may be very different from those initially quoted." ). All fees in excess ofthe initial $252 dental cleaning package were associated with the extraction of a fracturedtooth. As Ms. [redacted] is aware, this fracture was not apparent until her dog was anesthetized,and we had no way to provide her with an estimate for those services until that time.3) Ms. [redacted] stated in her complaint, " ... the new total was over $538.00" [for the dental packageplus the extraction and associated services]. This is incorrect. Her total charges for the dentalprocedure performed on 09/01/2015 were $515.65 which she paid in two separate paymentson her CareCredit medical credit card ($252.00 and $253.65, both paid on 09/ 01/ 2015).4) Ms. [redacted] stated in her letter of complaint, "They charged me more than twice as much asthey quoted me for the dental." This is incorrect. She verbally authorized an estimate for$515.65, on 09/01/2015 at 10:35 AM. (This estimate is enclosed, along with the date, time, andinitials of the receptionist who presented this estimate to the [redacted] family.) Ms.[redacted]'s total charges for the dental procedure were precisely what she was quoted. It ishighly misleading for Ms. [redacted] to suggest that we exceeded our initial estimate, when she isfully aware that all additional charges were for a different service (tooth extraction)-a servicewhich she choose to have performed after receiving a full and accurate second estimate.5) Ms. [redacted]'s letter of complaint states that she agreed to have a dental cleaning performed,and that she was later told that a tooth had been extracted, raising her bill far in excess of herability to pay and in excess of any estimates that she had received. ("They called me from theiroffice, after my dog was under anesthesia, and told me they had to pull a tooth that had crackedoff on top. They told me x-rays were done ... The new total was over $538.00" Underling addedfor emphasis. Note that Ms. [redacted] has placed these events in the past tense, clearly implyingthat the services had already been performed BEFORE she was contacted.) Unfortunately hersequence of events and her implication of a lack of full consent are both incorrect. After [redacted]had been anesthetized, a full dental examination revealed that the lower right 2nd molar had acomplicated crown fracture. Please note that this tooth is located in the back of the mouth andcould not be fully visualized until after [redacted] was anesthetized. When this fracture was identifieda new estimate was prepared and Ms. [redacted] was contacted for permission, BEFORE anyadditional services were performed. She chose to have the tooth extracted and verballyaccepted a new estimate for $515.65. It was explained to her that she could wait to have thefractured tooth extracted, and that she could have this procedure performed elsewhere. Ms.[redacted] complained about the price, but made it very clear that she wished to have Dr. K[redacted]proceed with the extraction. Per her request, the extraction was performed and she wascharged accordingly. No additional charges (beyond the initial dental package) were placed onher bill until AFTER she had received and accepted an estimate for those services.6) As per the estimate that she authorized, Ms. [redacted] was charged $263.65 in total for theextraction of the fractured tooth (including all surgical supplies), for two dental X-rays, for aninjection of pain medication, and for dispensed medications. She was also charged $252 for adental package, which included the pre-anesthetic exam, anesthesia, anesthetic monitoring, anIV catheter, IV fluids, blood pressure monitoring, and the dental ultrasoniccleaning/polishing/fluoride treatment. All of these charges are reasonable and customary forthe veterinary industry. Although we do not have access to prices from our local competitors(due to anti-trust laws) there are a number of regional and national benchmarks for fees thatare published each year. Annually we review the fee schedules from The American AnimalHospital Association, the Well Managed Practice Guidelines (Benchmarks), and from VeterinaryProductivity, and set our prices accordingly. While I cannot vouch for what any otherveterinarian in the Treasure Valley is charging, I am quite confident that our fees are reasonableand consistent both with regional/national standards and with the quality of the medicine thatwe provide.7) The gist of Ms. [redacted]'s complaint seems to be that she could not afford the level of care thatshe requested-a realization that she apparently made after the services were rendered. It isperplexing to me why she did not seek a less expensive option prior to having us initiatetreatment. There exists in the Treasure Valley a veterinary provider (the Idaho HumaneSociety), whose stated mission is to provide both a substantially lower overall fee structure andthe option for partially subsidized care for those with demonstrated financial need. Ms. [redacted]had the option to choose among dozens of veterinary hospitals prior to scheduling [redacted]'s dentalwork. She was again given the option of seeking care elsewhere prior to having the extractionperformed. It was fully her choice to have all of [redacted]'s dental work performed at Mountain View,and she was insistent that it be performed that same day.Given the points noted above, Ms. [redacted]'s request (in her letter of complaint) to have "allcharges above the $215 ... returned to me" is both unreasonable and dishonest. She requested aservice, accepted an estimate for that service, received that service, and now does not want to haveto pay for it. It would appear that her strategy is to create a big enough furor that she is given ahefty refund, without regard for the facts of the case. While I understand that she did not wish tospend money, her dog had serious medical issues that required treatment. That treatment wasprovided to her dog (at her request), and was of exceptional quality. Despite her statements to thecontrary, it is well documented that she fully understood what she was spending BEFORE doing so,and voluntarily chose to have a variety of services performed on her pet. I am sorry that she is nothappy with the cost of those services, however that is a decision that she should have made beforeher dog received those services.Ms. [redacted] makes it clear that she has " used numerous vets" in the past. Apparently she wasnot sufficiently happy with any of them to return when [redacted] required dental work. That fact isparticularly telling. Unfortunately a very small number of veterinary clients remain perpetuallyunhappy, and bounce from hospital to hospital, never satisfied with the medicine, the service, or theprices. It is unfortunate that we could not make Ms. [redacted] happy, but I suspect from her historythat she will not be happy with any hospital for very long. As price is apparently her primaryconcern, it is my recommendation that she seek care in the future at the Idaho Humane Society,which may be able to provide her with some financial assistance.As to her present complaint, however, Ms. [redacted] has chosen to deliberately misconstruemany of the facts of this case. She was provided with accurate estimates for the dental work thatwas performed, and she agreed to those costs willingly. All of the services that she received werenecessary, and she was charged fees consistent with published regional and national standards.When she expressed concerns about cost she was encouraged to seek care elsewhere, which shedeclined. While she may be able to find less expensive hospitals, I am quite certain that she will notfind the same quality of care that she received at a lower price. Unfortunately at this time I can findno basis for providing her with a refund or even an apology. While I am sorry that she is not thrilledwith the service that she received from us, the cause appears to be her selective memory andunrealistic expectations.Please contact me if you have further questions or concerns.Cordially:
Craig *. M[redacted], DVM, DABVP