Costs of care: Does every pet need an IV catheter?

(Shutterstock.com)We've all had that sinking feeling when comparing overhead costs with what you charge for phone-shopped services. It is the bane of the practice owner's existence-finding the balance between what's the gold standard and what you can actually afford.

My new associate and I have been working on our protocols. She hasn't been out of veterinary school nearly as long as I have and hasn't had the opportunity to look that careful overhead balance in the eye like I do every day. Her view is firmly on patient welfare, which is, of course, the most paramount of concerns for us all.

Don't be a pain-a protocol pointer

A quick plug for decreasing stress and pain for the patients as well: Plan to insert the catheter immediately after induction or at least after heavy premedication because catheters hurt!

So my associate thinks that every patient-even the ones coming in for quick elective surgeries-must have an intravenous (IV) catheter as a minimum standard of care. I used to offer catheterization as an option on every surgery, but many people phone shop these services and we often failed to mention it on the phone. Then clients would think that we were nickel and diming them when they dropped their pets off.

This feeling is not something that I can afford to risk. The clients tell their friends and post online that they felt like we were ripping them off-or they just decline it and everything goes fine and they think it was not necessary anyway. This issue is reputation management.

I cannot afford to just eat the cost of all this in an already stripped-down procedure. But, of course, if a patient did have something go wrong and you didn't have IV access, things could get even worse. So what should we do?

Negotiating the right balance

I think that the answer lies in a balance. At my hospital, we're creating a hospital-wide protocol to serve as a guide so everyone feels safe. Here are some things that we've looked at and found helpful along the way.

First, find out exactly what the IV catheter will cost you in materials and time. Factor in the cost of the catheter and the port with tape and flush. Allow additional costs for mistakes that require more than one catheter. Estimate how long it will take for a team member to insert the catheter as well (you should already know your overhead cost per minute).

Now, look at the cost that will be added to your procedure total and decide if it is something that you can add onto the client cost or should only offer as an option. Don't forget that your team is already offering lots of options and might appreciate it just being included.

If you truly cannot afford to add it to the client cost, consider making a flowchart to guide you and your team to consistent care every time. Maybe take into account the surgery type and length, patient parameters and potential risk.

Also decide where you will draw the line. For example, one of my colleagues says that any pet more than 7 years old gets an IV catheter no matter what. Find out what makes you-and your associates-comfortable.

Client communication caveat

If you do decide to include an IV catheter as an option, be careful about team training so that everyone is comfortable with how to pitch it. At the end of the day, you want healthy, happy patients and a healthy, happy bottom line.