Dr. Bruyette Responds to My Post

Dear Mr Muzika,

I am so sorry to hear about Dustin's passing. My condolences to you and your wife.

I am concerned about the tone of your e-mail and subsequent posting as there seems to be some confusion, which I hope to try to clarify. As I am sure you know when mis-information is posted on websites it can be quite challenging to sort out the truth from the emotion.

When I saw Dustin in November 2010 his creatinine and urine specific gravity were normal which indicated normal kidney function. He did have an increased BUN, which can be elevated as the result of diet and/or dehydration. At that time you and I discussed that the weight loss may be due to decreased caloric intake and given his dental disease it seemed reasonable to pursue that avenue prior to embarking on additional diagnostics. You agreed and had a dental procedure performed elsewhere.
You called me 3 weeks after the dental and told me that Dustin was doing much better. He was eating well and was gaining weight.

We then saw Dustin after you had been out of town for 12-14 days and called to say Dustin was not doing well. Since we did not have any appointment slots available we had you drop Dustin off so that we could examine him and obtain some blood tests. I then called you to inform you of those test results and we then discussed a treatment plan, which you approved. 

In addition, every day Dustin was in the hospital you were contacted by a doctor with a medical progress report and the billing department so that you would know what was happening with Dustin as well as be informed about the associated costs. At that time you authorized the charges and approved the treatment plan. Its very important that pet owners are well informed about both the medical and financial issues as we are well aware that cost is a well founded concern.

Your comments about VCA and our billing practices and charges are simply not true and I would be happy to discuss with you the realities of practice and the costs associated with running a hospital such as ours. Veterinary medicine is not plagued by the issues of third party payers, so your comments comparing veterinary to human medicine are not valid ones. Our hospital has 160 employees (36 of which are doctors), is open 24 hours a day, has both general practitioners as well as specialists and utilizes a great deal of sophisticated and expensive equipment. As such our overhead is much greater than the average, smaller general practice. That is one of the reasons that we always quote for our services. We do not take advantage of any pet owner as we are all pet owners and are in this profession to help animals as best we can.

This hospital writes off about $ 40,000 a month in charges to help those in financial need, offset the costs associated with their pets health care. If you know of another practice that does this please let me know.

I am very sorry you feel the way you do regarding this hospital, myself and our profession but we believe that we acted in Dustin’s best interest over the course of the 3 plus years we cared for him.

Sincerely,

David Bruyette, DVM, DACVIM
Medical Director

My Response:

Dear Dr. Bruyette:

I have never questioned the care given by John Chretin, who kept Dustin alive and who never suggested expensive diagnostic testing when the tests would not affect the treatment protocol, as with Lakshmi.

However, I do question your clinic's charges, regarding them as excessive. Indeed, you did suggest a treatment plan, but I had no provided knowledge of all the tests you were going to perform as part of that treatment, such as six tests for blood gasses in 4 days. Charging $75 for a bag of lactated ringers solution that cost you $2.50 does seem excessive, an $20 for giving an amoxi pill. These are just examples.

Dustin's sister obtained the same 4 day treatment with the same out come just a year and a half before, as 1/4th the cost of Dustin's stay at another VCA facility. Are your expenses really 300% higher than Adler's for the same number of animals seen? 

Now what comments did I make about your billing practices and charges are not true?  What specifically that I said, was not true? 

Dr. Bruyette, I was not communicated with each day of Dustin's hospitalization by a treating doctor or anyone on the medical staff. Yes, billing did contact me daily to authorize charges and asked to pay up front. I brought Dustin in Thursday, talked to you for 5 minutes on Friday, and another vet on Sunday. No vet say me with an overview of Dustin's condition or prognosis on Monday, the day of his release.  I was given a written care sheet for his home treatment, written by you, which I carefully followed. Perhaps you count that as a patient contact.

With a staff of 160, someone could have called to ask how Dustin was doing a few days after his release. Your letter is the first I heard from anyone at VCA regarding Dustin, and only after I posted my own story.

If you look at the below links of client reviews of their experience at VCA West LA, the common thread is that of over charging and average to less than average competence.

I am a shareholder of VCA stock. I receive and review all SEC statements, as well as VCA's own releases.  I have also talked to interns that have worked for you at VCA and had nothing good to say about practices there. VCA claims that even while the economy tanked, they held and even increased revenue by acquiring successful clinics, shrinking staff, and increasing service charges. They cut costs by firing people and increasing fees.  I know for a fact that Antech charges more for tests for independent and small vets, and even the City of LA, for their sheltered animals, compared to what they charge large volume vets, which is a fraction of what they charge independents. There is no heart in that, only business. 

Perhaps you write off $40,000 in charges a month, if you do, because you just cannot collect those fees.

Yours Truly,

Ed Muzika, Ph.D.

2 comments:

Anonymous said...

Ed wrote: "I have also talked to interns that have worked for you at VCA and had nothing good to say about practices there."
Ed, could you please inform us what the interns said? I don't care to know their names, just what they said. In particular, did they have anything to say about the quality of care?

Ed Muzika said...

No. They did not talk openly, but only agreed with my observations and allegations regarding excessive pricing, cost cutting, firing people to cut costs, and excessive testing. The two I known moved on after their internships, and did not want to stay.