All over the country you can find stuff like this. I only know about veterinary medicine, but I’m sure the same thing exists in human medicine and dentistry.

A cat spay at my hospital runs $280-350. A cat spay chez Dr. Val-Pac runs $35. A cat neuter at my hospital runs $118. I have a colleague in the southeast who is currently being run mad by a Dr. Val-Pac of his own who is neutering cats for a nickel.
The end result is the same, your cat won’t be able to reproduce.
Which would you choose? Why? Are they not the same service?

Of course the answer is no. The answer is way no. Big, bad, ugly no.
But people tend to see it that way. Which, of course, gives some people the impression that Dr. Val-Pac is a savior and I’m a money grubbing hag.

And the truth is that the reason that Dr. Val-Pac can afford to do what he does for what he charges is that HE LEAVES STUFF OUT!
Sometimes it’s little stuff like proper perioperative analgesia. I say “little” because analgesia wasn’t recognized as an important part of veterinary medicine until about 20 years ago — there are still doctors out there who don’t use analgesia for their surgical patients to “keep them quiet so they’ll heal better” — and many people consider analgesia a needless, and expensive, frippery.

Sometimes what gets left out is big stuff. Modern anesthesia instead of the injectable anesthetics that were popular 30 years ago. Sterile surgical instruments for each patient –no, I’m not joking. I’ve interviewed at, even done some work at, places where one instrument pack gets used per DAY. Sometimes the instruments aren’t even run through an autoclave. A disinfectant scrub and air drying on a paper towel is “state of the art” and very cheap.
Patient monitoring, IV fluids…… Sure, you can do without these things and probably most of your patients will do just fine.

Call me fussy, but I prefer far more certainty than “probably” and “most” for my surgical cases.

So when someone asks me why I’m so much more expensive than Dr. Val-Pac it’s really hard for me to not fall into a litany of the details. I would, but I’m trying to maintain a professional facade and it’s not very professional to tell someone that you think one of your colleagues is a quack (although why it’s okay for Dr. Val-Pac to insinuate that I’m a ripoff artist is another question entirely).

I guess I’ll just have to stick with “If you could afford a Mercedes, why would you purchase a Yugo?”
Which, I suppose, is a nicer way of saying “If you were looking for a doctor for yourself, would you chose someone who sent you a coupon in the Val-Pac?”