Initial Business Response /* (1000, 8, 2015/03/15) */
Contact Name and Title: [redacted] J [redacted] , DVM owner
Contact Phone: XXX-XXX-XXXX
Contact Email: [redacted]@att.net
[redacted] is a 10yr old Chih mix initially seen at PetVets Animal Hospital on 11/7/14 by Dr [redacted] The dog presented for 'crying...
out in pain'. [redacted] has a long history of interm diarrhea and had diarrhea at the time of presentation. Dr [redacted] assessed that the pain was assoc with lumbar pain and discussed the possibility of IBD with the owner as to the cause of the diarrhea episodes. A full blood panel was submitted at the time. Dr [redacted] discussed the lab results the following day. Both the amylase and lipase were quite sig elevated (over 3x increase) and the [redacted] was elevated as well. The concern was that the dog's primary GI condition has caused inflammation to the pancreas and/or gall bladder. She recommended a full abdominal US to be performed. The US was scheduled for 11/17/14 and [redacted] was placed on a bland diet in the interim. I spoke with Dr [redacted] prior to the US as she would not be there the day of the procedure. She expressed her concerns regarding the pancreas and requested a full US and recheck of the pancreatic values. I performed the US and requested that the techs draw [redacted] blood for just an amylase/lipase check for pancreatic enzymes. In the interim, I spoke with Mrs. [redacted] extensively regarding the US results. The dog very likely has IBD, confirmation can only be done via biopsy, however, the US is very suggestive. A hypoallergenic diet is recommended with approp caloric intake. Overwt dogs, especially with primary GI disease, are very prone to concurrent pancreatitis. The pancreatic values went back to normal again and prevention of future inflammation within the GI tract is highly recommended. The owner was charged for the US and the two pancreatic enzymes. Unfortunately the US charges was put in separately from the bloodwork fee, although records will show that both were performed the same day. The owner was not charged for the 30 minutes consultation to discuss the US results as well as future recommendations. Subsequently, the owner called to complain about the $35.15 pancreatic enzyme lab fee. It was explained repeatedly that this was to recheck the pancreatic enzymes, as recommended. There was never a misdiagnosis. The dog's pancreatic enzymes were very elevated and after a week of a bland diet they were normal again. The dog was changed to a hypoallergenic diet and the owner educated about inflammatory bowel disease and its effects on the body, clinical presentation and sequela ( such as pancreatic dz). It is very frustrating as a veterinarian to have an owner balk in hindsight at a very nominal charge. Especially now that the dog is clinically doing better and the owner has been given valuable insight as to the pet's condition. PetVets has always been in excellent standing with the Revdex.com. All our veterinarians practice high quality medicine. A $35.15 charge is certainly not worth the situation that this very difficult owner has created. I spoke to Dr [redacted] regarding the charge at the time that the owner began contesting its value. I believe it is a matter of principal to not reverse a charge for a service which was recommended, performed and provided valuable information. It sets a poor precedence for future cases.
Initial Consumer Rebuttal /* (3000, 10, 2015/03/17) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Dr. [redacted]'s response makes it clear that we need to reestablish the ACTUAL client experience. I preface this with the fact that I have never filed a Revdex.com complaint against any business. I agree that this situation is difficult, but the difficulty lies with the fact that the entire situation could have been amicably resolved months ago had she simply called to discuss our concerns.
Messages were left for Dr. [redacted] on the following days:
12/26
12/27
12/30 (twice)
2/13 (twice)
2/19
(No calls in Jan since we hadn't heard or received anything, so we thought perhaps the issue was resolved. We received a 2nd notice bill in Feb upon my return from a business trip out of state)
Her claim of "It was explained repeatedly that this was to recheck the pancreatic enzymes, as recommended." is 100% untrue. On most of these calls, we spoke only with desk staff and left a messages for Dr [redacted]. The single exception was speaking with Dr. [redacted] once, but we were still told that we needed to speak with Dr. [redacted] since she's the owner and vet who consulted with us.
While I can agree with Dr. [redacted] that the amount is nominal in the scope of typical vet bills, I reject that the situation is not worth the time. At the time (and currently), we had a series of unplanned medical bills that stretched our budget. Receiving the bill for blood work several weeks after it was performed not only stretched us further, it completely surprised us because we were not told about it at the time it was performed, we'd already paid $200+ for blood work on the initial visit, and Pet Vets states very plainly on their website:
"Payment is expected when services are rendered. In order to focus on our patients' needs, customer service and minimizing costs, we do not bill." (http://i.imgur.com/KXMuuBn.png)
My wife and I are reasonable people. We wanted to know why we were getting this bill several weeks after the fact, as well as why it was not on the bill we paid at the time of service. We made every effort possible to contact Dr. [redacted], and only resorted to filing a complaint after it became apparent that she would never contact us on her own accord. On the morning before filing this claim on 2/19, I left a final message saying that if I didn't hear from her by EOD, I'd be filing a complaint with both the Revdex.com and the Illinois Department of Professional Regulation. Despite her claims of me being 'difficult', I have never been anything but polite with staff who answered the phone. I do agree with her though that this issue is a matter of principle and sets a poor precedent - that precedent being:
1. Running an additional panel without discussing anything with us beforehand, or informing us of it at time of service. The 2nd panel at issue here was not 'recommended' to us as she claims, our first knowledge of it was receiving the bill in question.
2. Sending a bill several weeks later, despite very clearly stating on her website that they do not bill and all payments are at time of service.
3. Ignoring every good faith effort we've made to discuss our concerns with her. Her response to the Revdex.com is the first time my wife and I are getting any information from her whatsoever regarding this matter.
With regard to some of the other medical details, it's significant to note that my wife was an animal care manager at PAWS Chicago and worked very closely with the chief of medicine & chief of shelter medicine daily. By her own admission, her experience by no means qualifies her to diagnose medical issues, but she has an above average understanding of vet medicine AND can empathize with the struggle of incredibly long, nonstop work days, countless phone calls to return, etc.
As Dr. [redacted] stated, [redacted] has had GI issues since day one. We've had him for 5 years now, and over that period of ownership there has been clear pattern of gut issues, to which we've always been attentive. Before fostering & ultimately adopting him, he was recovering from surgery for an anal sac rupture due to extreme obesity (he weighed ~20 pounds). With us, he's lost ~6 pounds and typically tends to fluctuate between 14 and 15lbs. Because of his history and his bilateral MPL, we've always been sensitive to his weight and diet.
Weeks before, [redacted] steadily gained weight despite consistent exercise/diet, my wife asked a PAWS vet what their thoughts were. Based on the conversation, she knew that a change to a limited ingredient diet was necessary. On 11/6/14, [redacted] symptoms, while familiar, intensified and she immediately scheduled an appointment at Pet Vets. The same day, she sent medical records attached in an email along with her personal observations & concerns. The email specifically outlined concerns over thyroid and allergy issues, with no mention of diarrhea. Additionally, there was mention of discomfort and anxiety, which did result in diarrhea directly in front of the vet's office. In Dr. [redacted]'s response, she seems eager to deem us responsible for his GI issues and tout how she 'educated' my wife about IBD. In reality, we were responsibly, under the supervision of a vet, trying to identify if perhaps a change in diet would solve his issue, and everything my wife was told during the consultation (which was approximately 10-15 minutes, not 30 as Dr. [redacted] claims), was information she was already well acquainted with due to her prior work experience.
Dr. [redacted] was professional & informative during our first visit. We agreed on a food trial and did a full BW panel including thyroid and suggested a bland beef diet. Wife explained that he had not done well with bland diets before, but went with recommendation. [redacted] stool quality worsened on the bland diet as expected, and didn't improve until switching diet as we initially wanted to do following her discussion with the PAWS vet). When Dr. [redacted] called about results, the conversation turned to pancreatic disease, she immediately suggested an U/S. My wife asked if it could be due to diarrhea. The answer was maybe, but his levels were triple the normal limit.
My wife revisited the office for the U/S on 11/17. The U/S was performed by an employee, NOT Dr. [redacted] as she states in her reply; she was not even present in the room at the time. The employee then took [redacted] in back, and returned a shortly with Dr. [redacted]. She spoke with my wife for about 10-15 minutes, talked about him simply being a "gut dog", and suggested a limited ingredient diet to prevent GI upset and pancreatic inflammation. My wife pays the bill & leaves. We were relieved that he was OK, even though we'd spent about $700 at this point just to confirm my wife's original suspicion, and had paid ~$300 for an a U/S that would not have been necessary if his blood work was going to be re-run regardless. Had Dr. [redacted] done this in the proper order and re-ran the blood work first, the levels returning to normal would have negated the need for us to pay for a costly U/S.
A month later, we received a bill in the mail for the $35 in question for additional blood work that we were not informed of at the time of his U/S visit. Once again, this is the first item on Pet Vets billing page:
"Payment is expected when services are rendered. In order to focus on our patients' needs, customer service and minimizing costs, we do not bill."
After a few failed attempts at contact, my wife spoke with Dr. [redacted] regarding the charge and expressed her concerns from a customer service standpoint, since the additional blood work was never mentioned to us, we'd already paid $200+ for blood work on the initial visit, and had already paid $300+ for an unnecessary U/S . Dr. [redacted] agrees that it's alarming, but that Dr. [redacted] is who we need to speak with. We left a message for Dr. [redacted] that day, as well as 6 more times over the span of the next 2 1/2 months. She has never returned a single call. Had she done so and fully explained what happened and her reasoning, we would have almost certainly reached an amicable solution here, as I understand that mistakes can happen.
With no other options due to Dr. [redacted] ignoring every attempt at contact, we filed this Revdex.com complaint. Regardless of cost, the misinformation on her website regarding billing practices coupled with her lack of integrity and negligent attitude towards a legitimate billing concern are unacceptable. While highly subjective, browsing a few other online reviews shows we're not alone in our opinion of the way she conducts business:
http://goo.gl/zngB6z - complaints of Dr. C's inattentiveness and procedures done without informing owner
http://goo.gl/kGozhV - complaints of Dr. C's innatentiveness and not returning client calls (12/28 review)
http://goo.gl/GMzoMZ - complaints of innatentiveness and failing to return calls
http://goo.gl/2sGCKH - complaints of the business failing to return calls
Initial Business Response /* (1000, 8, 2015/03/15) */
Contact Name and Title: [redacted] J [redacted] , DVM owner
Contact Phone: XXX-XXX-XXXX
Contact Email: [redacted]@att.net
[redacted] is a 10yr old Chih mix initially seen at PetVets Animal Hospital on 11/7/14 by Dr [redacted] The dog presented for 'crying...
out in pain'. [redacted] has a long history of interm diarrhea and had diarrhea at the time of presentation. Dr [redacted] assessed that the pain was assoc with lumbar pain and discussed the possibility of IBD with the owner as to the cause of the diarrhea episodes. A full blood panel was submitted at the time. Dr [redacted] discussed the lab results the following day. Both the amylase and lipase were quite sig elevated (over 3x increase) and the [redacted] was elevated as well. The concern was that the dog's primary GI condition has caused inflammation to the pancreas and/or gall bladder. She recommended a full abdominal US to be performed. The US was scheduled for 11/17/14 and [redacted] was placed on a bland diet in the interim. I spoke with Dr [redacted] prior to the US as she would not be there the day of the procedure. She expressed her concerns regarding the pancreas and requested a full US and recheck of the pancreatic values. I performed the US and requested that the techs draw [redacted] blood for just an amylase/lipase check for pancreatic enzymes. In the interim, I spoke with Mrs. [redacted] extensively regarding the US results. The dog very likely has IBD, confirmation can only be done via biopsy, however, the US is very suggestive. A hypoallergenic diet is recommended with approp caloric intake. Overwt dogs, especially with primary GI disease, are very prone to concurrent pancreatitis. The pancreatic values went back to normal again and prevention of future inflammation within the GI tract is highly recommended. The owner was charged for the US and the two pancreatic enzymes. Unfortunately the US charges was put in separately from the bloodwork fee, although records will show that both were performed the same day. The owner was not charged for the 30 minutes consultation to discuss the US results as well as future recommendations. Subsequently, the owner called to complain about the $35.15 pancreatic enzyme lab fee. It was explained repeatedly that this was to recheck the pancreatic enzymes, as recommended. There was never a misdiagnosis. The dog's pancreatic enzymes were very elevated and after a week of a bland diet they were normal again. The dog was changed to a hypoallergenic diet and the owner educated about inflammatory bowel disease and its effects on the body, clinical presentation and sequela ( such as pancreatic dz). It is very frustrating as a veterinarian to have an owner balk in hindsight at a very nominal charge. Especially now that the dog is clinically doing better and the owner has been given valuable insight as to the pet's condition. PetVets has always been in excellent standing with the Revdex.com. All our veterinarians practice high quality medicine. A $35.15 charge is certainly not worth the situation that this very difficult owner has created. I spoke to Dr [redacted] regarding the charge at the time that the owner began contesting its value. I believe it is a matter of principal to not reverse a charge for a service which was recommended, performed and provided valuable information. It sets a poor precedence for future cases.
Initial Consumer Rebuttal /* (3000, 10, 2015/03/17) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Dr. [redacted]'s response makes it clear that we need to reestablish the ACTUAL client experience. I preface this with the fact that I have never filed a Revdex.com complaint against any business. I agree that this situation is difficult, but the difficulty lies with the fact that the entire situation could have been amicably resolved months ago had she simply called to discuss our concerns.
Messages were left for Dr. [redacted] on the following days:
12/26
12/27
12/30 (twice)
2/13 (twice)
2/19
(No calls in Jan since we hadn't heard or received anything, so we thought perhaps the issue was resolved. We received a 2nd notice bill in Feb upon my return from a business trip out of state)
Her claim of "It was explained repeatedly that this was to recheck the pancreatic enzymes, as recommended." is 100% untrue. On most of these calls, we spoke only with desk staff and left a messages for Dr [redacted]. The single exception was speaking with Dr. [redacted] once, but we were still told that we needed to speak with Dr. [redacted] since she's the owner and vet who consulted with us.
While I can agree with Dr. [redacted] that the amount is nominal in the scope of typical vet bills, I reject that the situation is not worth the time. At the time (and currently), we had a series of unplanned medical bills that stretched our budget. Receiving the bill for blood work several weeks after it was performed not only stretched us further, it completely surprised us because we were not told about it at the time it was performed, we'd already paid $200+ for blood work on the initial visit, and Pet Vets states very plainly on their website:
"Payment is expected when services are rendered. In order to focus on our patients' needs, customer service and minimizing costs, we do not bill." (http://i.imgur.com/KXMuuBn.png)
My wife and I are reasonable people. We wanted to know why we were getting this bill several weeks after the fact, as well as why it was not on the bill we paid at the time of service. We made every effort possible to contact Dr. [redacted], and only resorted to filing a complaint after it became apparent that she would never contact us on her own accord. On the morning before filing this claim on 2/19, I left a final message saying that if I didn't hear from her by EOD, I'd be filing a complaint with both the Revdex.com and the Illinois Department of Professional Regulation. Despite her claims of me being 'difficult', I have never been anything but polite with staff who answered the phone. I do agree with her though that this issue is a matter of principle and sets a poor precedent - that precedent being:
1. Running an additional panel without discussing anything with us beforehand, or informing us of it at time of service. The 2nd panel at issue here was not 'recommended' to us as she claims, our first knowledge of it was receiving the bill in question.
2. Sending a bill several weeks later, despite very clearly stating on her website that they do not bill and all payments are at time of service.
3. Ignoring every good faith effort we've made to discuss our concerns with her. Her response to the Revdex.com is the first time my wife and I are getting any information from her whatsoever regarding this matter.
With regard to some of the other medical details, it's significant to note that my wife was an animal care manager at PAWS Chicago and worked very closely with the chief of medicine & chief of shelter medicine daily. By her own admission, her experience by no means qualifies her to diagnose medical issues, but she has an above average understanding of vet medicine AND can empathize with the struggle of incredibly long, nonstop work days, countless phone calls to return, etc.
As Dr. [redacted] stated, [redacted] has had GI issues since day one. We've had him for 5 years now, and over that period of ownership there has been clear pattern of gut issues, to which we've always been attentive. Before fostering & ultimately adopting him, he was recovering from surgery for an anal sac rupture due to extreme obesity (he weighed ~20 pounds). With us, he's lost ~6 pounds and typically tends to fluctuate between 14 and 15lbs. Because of his history and his bilateral MPL, we've always been sensitive to his weight and diet.
Weeks before, [redacted] steadily gained weight despite consistent exercise/diet, my wife asked a PAWS vet what their thoughts were. Based on the conversation, she knew that a change to a limited ingredient diet was necessary. On 11/6/14, [redacted] symptoms, while familiar, intensified and she immediately scheduled an appointment at Pet Vets. The same day, she sent medical records attached in an email along with her personal observations & concerns. The email specifically outlined concerns over thyroid and allergy issues, with no mention of diarrhea. Additionally, there was mention of discomfort and anxiety, which did result in diarrhea directly in front of the vet's office. In Dr. [redacted]'s response, she seems eager to deem us responsible for his GI issues and tout how she 'educated' my wife about IBD. In reality, we were responsibly, under the supervision of a vet, trying to identify if perhaps a change in diet would solve his issue, and everything my wife was told during the consultation (which was approximately 10-15 minutes, not 30 as Dr. [redacted] claims), was information she was already well acquainted with due to her prior work experience.
Dr. [redacted] was professional & informative during our first visit. We agreed on a food trial and did a full BW panel including thyroid and suggested a bland beef diet. Wife explained that he had not done well with bland diets before, but went with recommendation. [redacted] stool quality worsened on the bland diet as expected, and didn't improve until switching diet as we initially wanted to do following her discussion with the PAWS vet). When Dr. [redacted] called about results, the conversation turned to pancreatic disease, she immediately suggested an U/S. My wife asked if it could be due to diarrhea. The answer was maybe, but his levels were triple the normal limit.
My wife revisited the office for the U/S on 11/17. The U/S was performed by an employee, NOT Dr. [redacted] as she states in her reply; she was not even present in the room at the time. The employee then took [redacted] in back, and returned a shortly with Dr. [redacted]. She spoke with my wife for about 10-15 minutes, talked about him simply being a "gut dog", and suggested a limited ingredient diet to prevent GI upset and pancreatic inflammation. My wife pays the bill & leaves. We were relieved that he was OK, even though we'd spent about $700 at this point just to confirm my wife's original suspicion, and had paid ~$300 for an a U/S that would not have been necessary if his blood work was going to be re-run regardless. Had Dr. [redacted] done this in the proper order and re-ran the blood work first, the levels returning to normal would have negated the need for us to pay for a costly U/S.
A month later, we received a bill in the mail for the $35 in question for additional blood work that we were not informed of at the time of his U/S visit. Once again, this is the first item on Pet Vets billing page:
"Payment is expected when services are rendered. In order to focus on our patients' needs, customer service and minimizing costs, we do not bill."
After a few failed attempts at contact, my wife spoke with Dr. [redacted] regarding the charge and expressed her concerns from a customer service standpoint, since the additional blood work was never mentioned to us, we'd already paid $200+ for blood work on the initial visit, and had already paid $300+ for an unnecessary U/S . Dr. [redacted] agrees that it's alarming, but that Dr. [redacted] is who we need to speak with. We left a message for Dr. [redacted] that day, as well as 6 more times over the span of the next 2 1/2 months. She has never returned a single call. Had she done so and fully explained what happened and her reasoning, we would have almost certainly reached an amicable solution here, as I understand that mistakes can happen.
With no other options due to Dr. [redacted] ignoring every attempt at contact, we filed this Revdex.com complaint. Regardless of cost, the misinformation on her website regarding billing practices coupled with her lack of integrity and negligent attitude towards a legitimate billing concern are unacceptable. While highly subjective, browsing a few other online reviews shows we're not alone in our opinion of the way she conducts business:
http://goo.gl/zngB6z - complaints of Dr. C's inattentiveness and procedures done without informing owner
http://goo.gl/kGozhV - complaints of Dr. C's innatentiveness and not returning client calls (12/28 review)
http://goo.gl/GMzoMZ - complaints of innatentiveness and failing to return calls
http://goo.gl/2sGCKH - complaints of the business failing to return calls