charge for unauthorized procedure

[gerio]

Hi..I generally like my vet and her associates, but this has been bothering me a bit.  My cocker mix recently had a bout  of pancreatitis.  He recovered nicely after 2 nights at the vet's.  When I went to pick him up, my vet told me she had used acupuncture to stimulate his appetite since he hadn't been eating.  I'm not sure this is something I necessarily believe in but chancesareI would have consented if asked.  However, I was not asked (i was reachable) and was charged $40 as part of the total $1100 plus bill.  This has been bothering me a bit.  Most lay people I've mentioned it to seem to think it's not ethical.  Are there any guidelines about this?  Many thanks.

[Margot49]

Due to the "connection", and it not being an astronomical fee, I would probably let it go but would probably "mention" it to her when the opportunity presented itself.  Like, "I was a little surprised to see that acupuncture was done as I didn't know that was considered a routine/typical treatment."  
If nothing else, should the situation present itself again (hope not!!) you know to ask before hand or let them know you want to be contacted before any treatments beyond the norm are performed.

[skydnsr]

Thanks for the feedback.  The only thing that I would add is that, if you think it would rupture the relationship to bring this up, it's really okay to let it go.  It's totally your decision.  There might also be some middle ground, such as just asking that she let you know "next time."  Or telling her that you need to know more about acupuncture and her training to do it before you approve for it to be done again.

[Misfits4Me]

Good luck and let us know what happens.....I agree w/ Skydner, too!  ;)

[gerio]

Hi--replied to all under comments, rather than each separately.  Thank you!!!

[gerio]

Thank you all so much for your responses.  When I read the first one, I thought those were my sentiments exactly.  Then I read the comments from Karla which made me re-think slightly.  But I still think I agree with Skydner.  The dilemma now is whether to bring it up or not.  I have a slight personal connection to her--mutual friend/relative kind of thing--but we're not what I would classify as "friends".  We have an appointment next week....have to think about this.  Plus I was told by someone that she's not a trained veterinary acupunturist.  I don't know if this is true or not.
Anyway, thank you again for taking the time to offer your very valid opinions.
Gerio

[skydnsr]

Karla, I'm also not trying to be disagreeable, but I think the difference is that acupuncture is not a "standard" treatment.  I personally believe in it, but a lot of people think that it's hocus-pocus and a total waste of money.  The vet should have determined beforehand that acupuncture is something that the OP was willing to pay for, if necessary.  Even if one believes in acupuncture's effectiveness, it's likely to be many times more expensive than the medication that would ordinarily be given as an appetite stimulant.  Therefore, on two counts -- clinical appropriateness and expense -- we are back to the issue of consent for treatment.  

I do see that $40 is a small part of an overall $1100-plus bill, and therefore it might not be worth antagonizing a doctor whom the OP otherwise likes.  But $40 is $40.  I disputed $50 of a $2200 dental bill because it was $50 more than I had been quoted.  In the end, it's up to the OP how much of an issue she makes of it.

I do like the way Jerry_NJ's vet conducts business.

[Jerry_NJ]

My vet always provides a written detailed listing of planned/scheduled work and treatments when our Westie goes in her hospital/clinic..  I also have to specify if I require notification of any identified work...and I can put a $$ limit on an authorization to proceed as required without my permission. That is a limited $$ blank check i.e.,do whatever is needed but not if it cost more that $$$ which requires my specific approval.

[Misfits4Me]

I have a different angle on this....If part of the clinic's protocol is to add an appetite stimulant to it's non-eating patients (Which is probably the case) & they added oral medication daily and charged you separately for the medication, would that be any different. Would they have contacted you for that? I don't believe my Vet would have checked with me! I'm curious as to what others think because I see this both ways.......No, I'm not trying to be a "Witch"....Just thinking here......  :)   Karla

[Margot49]

Very well put by sky denser and I agree.
I believe in and get acupuncture myself but would have expected fir my Vet to check with me first, which I am sure he would have.

[skydnsr]

I'm not a veterinarian, but I'm a human mental health therapist, and there are certain ethical principles that apply across all of the helping professions.  The principle that I think applies here is consent for treatment.  No treatment is supposed to be given without consent.  There are certain exceptions, such as in the case of a life-threatening emergency, but I think your vet would have a hard time justifying the use of acupuncture without consent in this situation.  I believe I would explain why I was uncomfortable with this and ask for a fee adjustment.  I would make it clear that I was not necessarily uncomfortable with the idea of acupuncture but with the fact that my permission was not asked.  If you are satisfied with the response you get, then I think a fee credit toward future services is acceptable.  That softens the settlement for them.  If you are not satisfied with the doctor's response, and you do not wish to continue using that clinic, then I would ask for a refund.  If the doctor totally rejects your point of view, then I would have a very hard time going back there.