{"id":3597,"date":"2011-04-01T18:09:00","date_gmt":"2011-04-02T01:09:00","guid":{"rendered":"http:\/\/www.uncle-andrew.net\/blog\/?p=3597"},"modified":"2011-04-01T18:09:00","modified_gmt":"2011-04-02T01:09:00","slug":"you-get-what-you-pay-for","status":"publish","type":"post","link":"http:\/\/www.uncle-andrew.net\/blog\/?p=3597","title":{"rendered":"You get what you pay for."},"content":{"rendered":"<p>All over the country you can find stuff like this.  I only know about veterinary medicine, but I&#8217;m sure the same thing exists in human medicine and dentistry.<\/p>\n<p>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.<br \/>\nThe end result is the same, your cat won&#8217;t be able to reproduce.<br \/>\nWhich would you choose?  Why?  Are they not the same service?<\/p>\n<p>Of course the answer is no.  The answer is way no.  Big, bad, ugly no.<br \/>\nBut people tend to see it that way.  Which, of course, gives some people the impression that Dr. Val-Pac is a savior and I&#8217;m a money grubbing hag.<\/p>\n<p>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!<br \/>\nSometimes it&#8217;s little stuff like proper perioperative analgesia.  I say &#8220;little&#8221; because analgesia wasn&#8217;t recognized as an important part of veterinary medicine until about 20 years ago &#8212; there are still doctors out there who don&#8217;t use analgesia for their surgical patients to &#8220;keep them quiet so they&#8217;ll heal better&#8221; &#8212; and many people consider analgesia a needless, and expensive, frippery.<\/p>\n<p>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 &#8211;no, I&#8217;m not joking.  I&#8217;ve interviewed at, even done some work at, places where one instrument pack gets used per DAY.  Sometimes the instruments aren&#8217;t even run through an autoclave.  A disinfectant scrub and air drying on a paper towel is &#8220;state of the art&#8221; and very cheap.<br \/>\nPatient monitoring, IV fluids&#8230;&#8230;  Sure, you can do without these things and probably most of your patients will do just fine.<\/p>\n<p>Call me fussy, but I prefer far more certainty than &#8220;probably&#8221; and &#8220;most&#8221; for my surgical cases.<\/p>\n<p>So when someone asks me why I&#8217;m so much more expensive than Dr. Val-Pac it&#8217;s really hard for me to not fall into a litany of the details.  I would, but I&#8217;m trying to maintain a professional facade and it&#8217;s not very professional to tell someone that you think one of your colleagues is a quack (although why it&#8217;s okay for Dr. Val-Pac to insinuate that I&#8217;m a ripoff artist is another question entirely).<\/p>\n<p>I guess I&#8217;ll just have to stick with &#8220;If you could afford a Mercedes, why would you purchase a Yugo?&#8221;<br \/>\nWhich, I suppose, is a nicer way of saying &#8220;If you were looking for a doctor for yourself, would you chose someone who sent you a coupon in the Val-Pac?&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>All over the country you can find stuff like this. I only know about veterinary medicine, but I&#8217;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 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-3597","post","type-post","status-publish","format-standard","hentry","category-margarets-musings"],"_links":{"self":[{"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=\/wp\/v2\/posts\/3597","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3597"}],"version-history":[{"count":6,"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=\/wp\/v2\/posts\/3597\/revisions"}],"predecessor-version":[{"id":3616,"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=\/wp\/v2\/posts\/3597\/revisions\/3616"}],"wp:attachment":[{"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3597"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3597"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.uncle-andrew.net\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3597"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}