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Who has the highest fees in the country? Who has the lowest fees? Believe it or not, the answer to these two questions is sometimes the same province. The results of the 2009 CVMA Economic Survey for Practice Owners show consistencies in pricing for companion animal services, but bovine and equine fees vary considerably.
The results come from the 2009 CVMA Economic Survey for Practice Owners (Tables 1–3). The survey was distributed to veterinary hospitals across Canada in September 2009. To date, 671 responses have been received for a response rate of 22%. This response rate is identical to 2008; however, late submissions are expected to boost the response even higher. Representation was strong from all provinces providing an excellent opportunity to compare and contrast around the provinces. So, who has the highest fees in the country?
There is no easy way to accurately compare companion animal fees. To get a handle on the variety of procedures in companion animal practice, a sample of 21 procedural fees are used to build a weighted fee index. The national average is set at 100 and variations around the national average show how the average fees in the provinces compare with each other and the national average. If the fee index for a province is 105, average fees in that province would be 5% above the national average. To account for different philosophies in “shoppable” and “non-shoppable” fees, separate indexes were constructed to show average vaccine and elective surgery fees. Like the average fee index, these indexes were also calibrated, so that 100 equaled the national average.
To compare fees accurately from province to province, the indexes are subjected to a cost of living (COL) adjustment. The COL adjustment evens out the economic differences clients face in different provinces. For example, the COL is highest in Alberta where higher prices are commonplace and the COL index is 122; 22% above the national average. In contrast, the COL in Newfoundland and Labrador is lower and the difference is reflected in the lower COL index (81).
If the same economic forces were at play in all the provinces, one could expect the unadjusted fee index for companion animal practices to match the COL index. The companion animal fee indexes should be 122 in Alberta and 81 in Newfoundland. In perfect economies, the fees for procedures should match the COL. With this logic, the highest fees should reside in Alberta and the lowest in Newfoundland and Labrador. Alas, companion animal veterinary fees do not follow the COL. The highest fees for 2009 were in Ontario and the lowest in New Brunswick.
The COL adjusted fee index takes into account the COL and compares fees from the perspective of the client in a specific province. Clients in Alberta expect to pay 22% more for everything, so the fees are discounted by 22% to accurately compare them with other provinces. The same argument applies in reverse for Newfoundland and Labrador where companion animal fees are increased 21% to account for the lower prices. In a perfect economic world, the COL adjusted fees would equal 100 because the COL matched the fees in each province. Newfoundland and Labrador were the closest to a perfect match with a COL adjusted fee index of 98. This means that fees in Newfoundland and Labrador were 2% lower than the COL index would predict them to be.
The highest COL adjusted companion animal fees were found in Ontario with a COL adjusted fee index of 109, suggesting that these fees were 9% higher than the COL would have predicted. There was a tie for the lowest COL adjusted companion animal fees. Both New Brunswick and Saskatchewan had COL fee indexes of 87, suggesting their fees were 13% lower than the COL estimate.
In addition to the average fees for companion animal practices, the fees for elective surgeries and vaccines were adjusted for the COL and there was little change in the ranking. Ontario had the highest fees and New Brunswick had the lowest fees for elective surgeries and came in just behind Prince Edward Island with the second lowest vaccine fees. Alberta’s fees jumped to second place with vaccine fees equal to Ontario, and elective surgery fees that were 10% higher than the national costadjusted average.
There are 3 distinct types of bovine veterinary practices in Canada. Veterinarians in Alberta, Saskatchewan, and Manitoba are predominantly involved in a beef-oriented practice with the emphasis on reproductive procedures billed by the procedure. Bovine veterinarians in all other provinces work predominantly in dairy-oriented practices, in which the common method of charging involves billing by the hour for consultative services and reproductive procedures. While both types of practice exist in all provinces, it is impossible to accurately compare fees across the country. Table 2 shows hourly rates for provinces with dairy-oriented practices and fees for pregnancy tests and bull evaluations for beef-oriented provinces. The last column shows the fees for Cesarean section as one fee common to all types of bovine practice. Provinces with government regulated subsidized fees are shown as **.
The highest hourly rate for dairy-oriented practices in 2009 was in British Columbia where veterinarians charged $170.95/h, followed by Ontario with fees of $153/h, and Manitoba (a province with a mix of beef and dairy) at $149.68/h. Prince Edward Island was in last place with an average hourly rate of $141.40.
Comparing Cesarean section fees may be purely academic since many veterinarians did not perform the procedure in 2009, but the fee for Cesarean sections is still seen as the bellwether fee for all types of bovine practices. Inconsistencies abounded as the province with the highest hourly rate (British Columbia) was well below the national average for Cesarean section fees and the province with the highest Cesarean section fees (Prince Edward Island) had the lowest hourly rates.
In beef-oriented provinces, there was great variability in pricing. Manitoba had the distinction of having the highest pregnancy testing fees (performed on > 200 cattle) and the lowest fees for bull evaluations and Cesarean sections. In a similar vein, Alberta was tops in bull evaluation fees, and fees for Cesarean sections and the lowest fees for pregnancy testing. The only province with any consistency in bovine fees was Saskatchewan with average level fees across the board. In 2009, there was never more than a 4% deviation from the national average in bovine fees for Saskatchewan.
Equine fees differed significantly from province to province, but there was little deviation in fees within each province. For example, Manitoba and Saskatchewan were consistently below the national average for all equine fees listed, and British Columbia consistently had the highest. Ontario and Alberta were close to the national average with < 10% separating provincial equine fees and the national average.
In conclusion, who had the highest fees? After adjusting companion animal fees for the COL, Ontario veterinarians had the highest fees for 2009; consistently above the national average in elective surgery fees, vaccines fees, and overall fees. Bovine fees varied considerably, with veterinarians in British Columbia having had the highest hourly rate and the lowest Cesarean section fees. In comparison, veterinarians in Prince Edward Island had the highest fees for Cesarean sections but lowest hourly rate. The highest equine fees were consistently found in British Columbia.
Thank you to the 671 practice owners and staff members who completed the 2009 CVMA Practice Owners Economic Survey. If you have any questions about the CVMA Practice Owners Economic Survey please contact Darren Osborne at gro.amvo@enrobsod.
Use of this article is limited to a single copy for personal study. Anyone interested in obtaining reprints should contact the CVMA office ( gro.vmca-amvc@nothguorbh) for additional copies or permission to use this material elsewhere.