Pricing of our services is an odd issue and one I have unresolved and conflicting feelings about.
I did work experience in the eighties with a vet who these days would be considered old-school. He inspired me to become a vet because I saw what he did and thought: “that is very cool – I want to be able to do that!”
One case which particularly stuck in my mind was a routine pyometra. A dog came in in the morning, with a complaint that she was drinking more than normal. He asked a few questions, examined her, kept her in for the day. After that morning’s open surgery had finished he knocked her out with thiopentone, put his hands inside a living breathing animal, fished out this huge sausage, tied things off, stitched her up and put her to one side to recover on a warm pad at the edge of the operating theatre while doing the next surgery.
On discharge he gave (as far as my memory serves) the same instructions we do now, and charged an all-in-one fee. As far as I could tell he made it up as he went along, probably by knowing how much his practice cost to run, the costs of the materials, and so on, as well as “what seemed fair”. His profit was probably built in to that.
Contrast this to when my mother took one of her 12-year-old dogs in to her local practice because when visiting her at the weekend I had found a slab fracture of the upper right PM4. The bill was two pages long and itemised things down to the catheter, the tape, the syringes used for the injections, and so on. Of course this is quite justifiable and indeed compulsory to do when you read the RCVS Guide to Professional Conduct, though one wonders the “resolution” of itemising required. Of course each item will have had its own mark up applied.
I am all for charging appropriately for our services, and for making a decent profit on it too – after all I do not work for free and expect a good salary for my skills – but the way in which the invoice was itemised made her (and I) *feel* like she was being taken advantage of. Perhaps a more client-friendly way would have been to put the items on in chunks or packages, e.g. “pre-operative preparation (including…1,2,3,etc)”. Once again I go back to my car being serviced – that is how they itemised the service charge and included an estimate for the brake system repairs it needed.
It did also remind me of when I was a locum in the dim and distant past and I was told to charge like that (i.e. every single little thing used) only for “certain” cases where the funding was coming from a third party. That sort of fraudulent behaviour is thankfully rare.
When charging a premium price for a service it’s important to explain the value in it and not have the arrogance to assume that the client can see the quality behind the work with their own eyes. Using this principle, I have done many “budgie work ups” at realistic prices because I explained the value to the bird of having a faecal, swab, blood screen and x-rays under general anaesthetic, and the drawbacks of the “here’s some enrofloxacin, see if it gets better” approach so many clients ask for at first.