Vet fees a lottery in Hong Kong, pet owners complain - but vets hit back
Living with 21 cats, housewife Cheung Ling ends up going to the vet more often than many pet owners. The bills add up to a substantial sum but Cheung is prepared for the expense of caring for her beloved felines. What infuriates her, however, is the large discrepancy in fees charged by veterinary clinics.
An overnight stay at a clinic can cost between HK$200 and HK$800. Charges for diagnostic tests, medicines, surgical procedures and miscellaneous services also vary considerably, Cheung says.
Bills for saline packs, to keep ageing cats hydrated as their failing kidneys lose the ability to filter and reabsorb fluids, can range from HK$100 to HK$300 each, and the tube connectors from HK$25 to HK$60.
"That's why I buy from a pet dispensary in Sham Shui Po now - the price of its products can be up to 10 times lower than in clinics," Cheung says.
There are 779 vets registered with the Veterinary Surgeons Board of Hong Kong. Under its code of practice, vets must discuss with clients the anticipated outcomes of various treatment options along with cost estimates before taking action. Pet owners should be briefed about changes to prognosis and costs, and veterinary clinics should display information about normal fees and charges for consultations, routine tests and procedures.
However, Cheung says most of the vets she consults fail to do this. Among the outrageous examples, Cheung cites the time she accompanied a friend to a clinic to have the woman's cat neutered. Her friend needed to submit proof of procedure to government officials so that she could keep the cat at her public housing flat.
"The vet charged her HK$300 just for the proof. We argued with the vet over the arbitrary fee and he eventually relented, and agreed to charge us HK$150. But other vets provide documentation without seeking any payment," she says.
Similarly, some vets charge hundreds of dollars for sending medical records to other clinics after the owners switch services, while others do so free of charge.
"Vets set fees at will with no oversight and most pet owners don't know where to file complaints [about their fees and services]," Cheung adds.
Complaints from animal-lovers such as Cheung can be expected to grow as pet ownership rises in the city. According to reinsurer Munich Re, the number of dogs in Hong Kong increased by 25 per cent between 2006 and 2011. Cat numbers rose even faster, by 65 per cent, in the same period. That added up to about 250,000 dogs and 170,000 cats in 2010, according to the latest census figures available.
Pet owners can write to the Veterinary Surgeons Board if they are dissatisfied with the fees and services of a registered vet, a board spokesman says.
The board received 50 complaints in 2013 and 53 complaints last year, covering the gamut of issues from drugs prescribed and diagnosis to medical explanation and treatment provided.
However, it has no jurisdiction over claims for refund or compensation. If a client seeks monetary compensation from a vet, he will have to file civil proceedings or take the case to the Small Claims Tribunal, the spokesman says.
Aggrieved pet owners could also take their complaint to the Consumers' Council or the police, but if they decide to take civil action against the surgeon, they will need to consult a lawyer.
The rising costs of animal care prompted former sports coach Mark Mak Chi-ho to set up the Non-Profit Making Veterinary Service Society in 2006. The society now runs four clinics in Prince Edward, Kowloon, where fees are about half of those in regular clinics, even though the 16 vets it employs are paid competitive rates.
"I can run the service at affordable prices because I do not earn any profits from the clinics," says Mak, who is also the society's chief executive. "Fees for routine procedures such as vaccinations and tests are lower [than other clinics] as such services do not require the skills of vets. Our tests are 30 per cent cheaper and vaccinations 20 per cent cheaper."
But Mak believes vets generally charge reasonable fees for their services, although there may be some black sheep in the profession.
"People need to understand that the nature of medical care for animals is different from that for humans. People can describe the kinds of problems they are having but pets can't, so vets need to spend a lot of time figuring out what's wrong with the animal and make a diagnosis.
"As a result, a vet consultation takes at least 20 minutes and a basic check-up will cost about HK$500, but a general practitioner is usually done with a human patient after several minutes. The expensive part comes from the diagnosis, not the treatment. It's not fair to say that vet bills are much more expensive than those for humans."
Alane Cahalane, a specialist in animal surgery, points out that veterinary fees are also a controversial issue in the US.
"But I believe you get what you pay for," says Cahalane, who heads the recently opened Veterinary Specialty Hospital of Hong Kong in Wan Chai.
"We try to offer medical expertise. Fees for specialist treatments are high because we are using the same equipment used in the finest human facilities. We use the same high-quality drugs and monitors, and a device called LigaSure from human medicine. We do joint replacements with the same expertise and hi-tech implants as in human medicine."
"It's wrong to assume that animal illnesses are easier to treat than those afflicting humans," says Derek Chow Wai-yee, a specialist in animal ophthalmology at the hospital.
"Cataract cases for animals are actually more complex than for humans. People will consult a doctor when they start to see fuzzy images. But with animals, the owners won't know their pets have a problem until the cataract is so serious the animals start walking into walls [because they can't see]. So many of the cases I treat are severe ones."
In fact, fees in Hong Kong are cheap compared with those in the West, including Australia, where many vets are trained, says Gary Lo Ka-shun, a GP vet with a clinic in Sai Wan.
Animal clinics are set up differently from human clinics. Veterinary clinics must also run small laboratories for their animal patients, with machines to do blood tests and X-rays. But test laboratories for humans are run separately and serve many more patients, which brings down the cost.
"We also do all kinds of surgeries. An operation to remove a stone in the urinary bladder can cost up to HK$10,000 at a vet clinic. In a private hospital for humans, the same procedure will be more than HK$10,000 as it involves fees for anaesthesia and post-operative work.
"So I get angry when people complain that vet fees are expensive because bills for private surgeries on humans are more excessive," Lo says.
Mak concedes that veterinary services lack transparency and charges set by some clinics can be arbitrary, but says pet owners should do some homework, too.
"There is a lot of information available online on treatments for humans. People will take the initiative to ask their friends about a condition and check out treatment options and prices.
"But many pet owners don't bother to do the same for their pets and just take the animal to a vet. Some owners say they wouldn't understand the information [about treatment choices] even if the vet explained in detail - they just want to make a payment and get it over with.
"Still, the Veterinary Surgeons Board does take complaints seriously. They tackle each complaint made. Even our clinics receive lots of complaints for all kinds of strange situations. And we must answer questions posed by the board for each of the complaints."
Disputes often arise, partly because the board does not set guidelines on which services are chargeable. "There's no oversight in this respect," Chow says. "Some clinics charge fees for filling in pet insurance forms. I don't charge myself, but you can't fault those who do as they might spend half an hour just filling in the form."
Language can present another barrier, as secretary Lam Tze-ting found when she consulted a vet from Taiwan for her nine-year-old Maltese, Nana, who developed a limp last year.
"I spent a lot of money. Each examination costs HK$500. I just accepted his advice. He suggested shots for [Nana's] joints every fortnight and each cost HK$500. But she didn't show any improvement after months of treatment," Lam says.
"After all that he said she had a tumour in the spleen and another between her left eye and nose. I spent HK$30,000 to remove the tumours.
"The vet spoke poor Cantonese. If I didn't ask further, he wouldn't take the initiative to explain. After this unhappy experience, I switched to a local vet."
Mak says pet owners should ask as many questions as possible when consulting a vet, especially when local nurses are acting as translators.
"They have to ask what the treatments are, why the tests are needed, possible outcomes for treatment and the cost."