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That is really surprising. How do these places earn millions in revenue per month, pay labor relatively low wages, and still make such weak margins on surgery?
I'm sure it has a lot to do with the area, too. People in high COL areas probably pay 2x what everyone else does. Can't imagine people in the midwest or south lining up for $6k dog surgeries like we do here.
You're probably having the surgery done by a board certified orthepedic surgeon, which does cost more money.
You're also factoring in radiographs, anesthesia, anesthesiologist (depending on the facility), post operative care, post operative pain control. Wife did say $5k did seem a little high, but she has no clue what cost of care is in Seattle. The university hospital she trained at typically charged $4k.
The thing people don't realize is, medical care is stupid expensive. You're not only paying money for the high dollar equipment, you're paying for the trained staff it requires to practice good medicine. You're paying for sedation and anesthesia (which is not cheap). But, for humans, you have health insurance. Sure, you may see a bill for $1,200.. but you don't see the $45,000 the insurance company paid to the hospital/physician. Because there is no payment assistance like this in vet med, the costs seem high, but are in realty very bare bones cost.
Most veterinary practices break even on all the veterinary care they do and make their money on boarding and grooming.