She must have pushed my ornery button because the response was, “I’m a drug dealer.” My oldest inspected the shelter house floor for a hole to crawl into.
Madeline persisted asking, “What kind of life is that?”
My reply was, “It’s not what it used to be when we made good money for the work and risk we took. Now we constantly have to keep an eye on our suppliers that they don’t tread on our turf going directly to our customers.”
Mercifully, for Madeline and my daughter Megan, the president called the meeting to order with the Pledge of Allegiance and the 4-H pledge. By the time we were done pledging our health to better living, Madeline had it figured out. “You’re a vet, too!” she said.
Risks and rewards
My presentation included ringworm, warts, swine influenza, why we wash our hands, and why it is inhumane and illegal to drench market lambs or use some methods to alter udder balance. Madeline then cornered me to learn more about the animal pharmaceutical business.
She asked first about our return on the risk and effort for marketing drugs. I mentioned that it had diminished greatly over the three decades I had been in practice. The practice that we bought commonly had a 100 percent markup on drugs and gave services away. We immediately changed to a more moderate markup of 30 percent with a charge for services. Those markups paid for our staff, and we kept our service rates low.
We focus on what we believe is the right thing to do and on where we generate some income. Quality services keep our clients productive, and competitively priced pharmaceuticals keep their costs down.
I explained that margins have declined to as low as 3 percent, which removes much of the motivation to “sell” drugs and directs efforts more toward prevention of disease and judicious use of antibiotics when needed. I told Madeline that we work very hard to make the farms we serve more successful, and on the pharmaceutical marketing front, we follow my mom’s philosophy that you can shear sheep many times, but you can only skin them once.
There are people who believe that it is a conflict of interest for veterinarians to sell drugs because they might profit from them. Apparently, these people haven’t been in the situation where a medicine is needed now, but it will be three days before it can be shipped in.
This reminds me of a fire department with the motto, “When seconds count, we’re only minutes away.” I have a whole box of expired drugs to prove that we stock things for a potential need that never arose.
Checks and balances
Madeline asked how I knew that was really working. I said, “I review every invoice our cattle practice generates.” That let’s me know exactly what our clients use when they purchase from us to know if it is appropriate for their farm. I also have farms where I review their treatment records every month and some that we break drugs down into categories like treatment, prevention, reproduction, or supplies. I can watch trends and am happy to note that most of them are moving toward less treatment with more emphasis on prevention.
If we don’t sell the products and just write a prescription, I get much less information about what a farm is using. It makes it more challenging to fulfill my duty of overseeing the drug use on the farms for which I am the vet of record.
Of course, there are some farms where I don’t want to sell pharmaceuticals because they might not be able to pay, and it really puts a strain on our relationship. Madeline countered with, “I thought all farmers were rich!”
Then she asked, “What is this vet of record thing?” I told her all of agriculture is pretty tough economically right now. Vet of record is a signed agreement between the vet and the producer that formalizes our veterinary-client-patient relationship. We agree that they will do a good job of using and documenting antibiotic use, and the vet will provide oversight and be available for follow-up.
It requires that the vet have knowledge of the farm, which for most definitions means the doctor has been on the farm to do meaningful work and understand the operation at least once a year. For dairies, which can have residues in two ways, we require twice a year.
Madeline said, “Wow, I’ve never had our vet to our place, and we get their show pig mix all the time. We certainly don’t have a signed agreement.”
I replied that she may want to question the vet if that is the right way to do business. We find that a lack of working knowledge of the farm can mean products are sold that aren’t needed, and the results are limited.
Another way we know we are on the right track is that we use a reorder point-reorder quantity method of tracking our inventory. We did that for years, when we just got too busy to make sure it was updated. We hired some new management staff, and when we revisited the numbers, treatment quantities were reduced in a practice that has grown significantly.
Straight from the source
Madeline asked, “What about your suppliers going around you to your customers?” I gave a heavy sigh before I responded. It didn’t used to be this way. There was a time when our pharmaceutical representatives lined up to talk with us about their products. We were the gatekeepers, and our clients sought our opinions on drug use.
I’ve asked every drug rep to make an appointment to review every product in their portfolio and to make another appointment every time there is something new. I don’t really need to know about price specials, as we have managers to handle that. One representative has honored this request.
Now pharmaceutical company representatives spend the majority of their time going directly to the farm and cutting deals with them. Then they’ll want us to prescribe what they sold. I’m not real fond of being in that spot.
We also have companies offering “value-added services” to certain producers at no charge. These are the services that my role model vets who went before me created and implemented. I now fear that our younger doctors won’t have the opportunity to build that same kind of service portfolio because a drug company has found it advantageous for sales to provide services that would be better provided locally.
If they really cared about these things being done on farms, they would provide training and support on these services to local vets. Madeline seemed satisfied that this “drug dealer” was trying to do the right thing.
Meg and I got in the truck and headed home. She turned to me and said, “Dad, I’m proud that you work hard to run the clinic drug business the right way. I know it probably isn’t easy, but I know from working at the clinic that the farmers appreciate it, and it’s part of what pays for some of us workers.”
She was 14 years old at the time. If she could figure it out, you’d expect it to be easy for adults to understand as well.
