“If someone loves their pet or horse or highly values their farm, would they go hunting for the cheapest vets in town?”   - Veterinary Practice
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InFocus

“If someone loves their pet or horse or highly values their farm, would they go hunting for the cheapest vets in town?”  

Quality, cost and value for money can be hard to unpick. For an uninformed member of the public, price can be the only indicator of quality when making purchases. The car market can be a good example of this, with prestige brands presumed to be better quality. However, when you look beyond the badge many components are similar between brands, and their true value can be seen when these pricey cars plummet in value only a few years after being bought new. Indeed, according to a recent article in Auto Express, the top nine worst depreciating cars are all prestige brands, including Maserati, Mercedes and BMW (Rosamond, 2022).

Why spend more than you need to? Well, bragging rights and showing off are certainly a factor, but the perceived quality is also a huge draw

So, why do people buy prestige cars? Why spend more than you need to? Well, bragging rights and showing off are certainly a factor, but the perceived quality is also a huge draw. Our architect (who designed our practice) bought herself a Maserati after wanting one for years. She ran it for a few months then got rid of it and went back to a sporty BMW, a relatively cheap brand by comparison. As an architect she was also quite expensive to us, but we wanted a good architect and got one. When looking for an architect to build our once-in-a-lifetime practice, we wanted quality. I didn’t ask around locally for the cheapest architect, just as if I was in a tricky legal situation I wouldn’t ask around for the cheapest lawyer in town.

Does this apply to vets? We often only hear the negative feedback regarding costs, but if someone loves their pet or horse or highly values their farm, would they go hunting for the cheapest vets in town? If they did, then would we want them as a client in this current climate of excess demand and undersupply of vets? Could this even apply to medicines and could a really expensive treatment be seen to work better than a cheap one? If we switch to a monthly arthritis injection at more cost, will there be a cost-related placebo effect over the cheaper daily dollop of NSAID in the dinner bowl?

The improvements in standard Parkinson’s motor function tests for the “expensive” placebo were shown to be better than those seen with the “cheap” one, and unsurprisingly both were less effective than the real treatment

Well, it turns out there is. There are a few studies out there, including an article in Neurology specifically on the effect of medication cost using Parkinson’s disease treatment as a model. The study by Espay et al. (2015) was a randomised double-blind trial where Parkinson’s patients were told they were being given either a cheap new drug or an expensive one. Both were placebos and were compared to levodopa, a known effective drug for treatment of Parkinson’s. The improvements in standard Parkinson’s motor function tests for the “expensive” placebo were shown to be better than those seen with the “cheap” one, and unsurprisingly both were less effective than the real treatment. The conclusion of the study was:

“Expensive placebo significantly improved motor function and decreased brain activation in a direction and magnitude comparable to, albeit less than, levodopa. Perceptions of cost are capable of altering the placebo response in clinical studies… This study provides Class III evidence that perception of cost is capable of influencing motor function and brain activation in Parkinson disease.”

There are not many studies specifically looking at this, but it would be an interesting thing to examine in veterinary practice. A good friend of mine is an excellent peripatetic surgeon. After reading this study I asked if this was why he always wore a smart shirt and tie for work. “If you look expensive, will the clients perceive you as being a better surgeon?” I asked. “Absolutely”, was his confident reply. He’s a scruffy specimen outside of work, so there must be something in it! 

‘If you look expensive, will the clients perceive you as being a better surgeon?’ I asked. ‘Absolutely’, was his confident reply

We of course have the complicating effect of our cost-payer not being the patient. I think the jury is still out, but I can just imagine James Herriot dusting off a bottle of something from the back of the shelf and telling a difficult client: “I’ve got this new drug here, it’s really expensive and it needs to be injected. Let me know how it goes, it is very new and difficult to get hold of and I am only using it on special cases.” 

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