I once got a circular from a company selling DIY lab testing machines to vets. The text said, "your clients are now ready for pre-anaesthetic profiles in young healthy animals". At that time, the company concerned didn't even have a vet in their employ.
They were (and still are) flogging toy blood testing machines that were not in any case fit for purpose, to vets with no training or experience in running a pathology lab, with the sales pitch that they could do the tests themselves and so keep the money. (What they didn't say was that in fact the DIY machine would cost the vet more to run than sending his samples to a professional lab!)
Many vets being a tad gullible, this line sold like hot cakes. Vets who had previously been very stingy about requesting blood tests suddenly started doing them wholesale. This of course increased the practice turnover. It took quite a lot of them a long time to realise it was doing nothing for their profits. Some of them never realised. The results are questionable anyway, and the whole thing is just one massive waste of money. It's exceedingly rare for any unsuspected problem to come up in such testing, and even rarer to find a problem you can do something constructive about. Mostly you get incidental abnormalities, which can cause all sorts of problems as people start fussing about these numbers and putting off necessary surgery and ordering more unnecessary tests.
When that circular came round I was shocked, and pointed out to a few people that this was entirely illegitimate advice, coming from people whose only aim was to market their product, and come to think of it, if I (as their professional colleague, not an unqualified salesman) had said the same thing but suggested they send the blood samples to my lab, would they not quite rightly see it as a cynical marketing exercise?
Nevertheless, the practice has become widespread. The Association of Veterinary Anaesthetists has tried to stop it, and various academics are finally realising what a pointless exercise it is and weighing in (though unfortunately some naive academics fell for the hype originally and passed the advice on to students). More widespread insurance cover has certainly made matters worse, as practices who might have had qualms about ripping off the poor owner are quite happy to rip off the insurance company. Of course they wouldn't see it as ripping off. (One of the insurance companies asked me about this a long time ago, and I told them what I thought, but nothing changed. I suspect they don't want to restrict cover because it might put them at a marketing disadvantage, and they don't have the meddling ethos the US human medical insurers seem to have - they don't dictate to the vet what is clinically appropriate.)
Many people have realised that the results are unreliable and the process very costly, but they have tied themselves in a marketing knot by boasting to clients how quickly they can get the blood tests done, and very few practices are prepared to step back and consider the fact that few blood test requests are genuinely urgent, especially pre-anaesthetic ones before elective surgery, and what they should be doing is sending all the routine stuff to be handled by people who know what they're doing (for about a third of the price of doing it themselves), and concentrating on identifying what is needed for genuine emergencies - a completely different set of requirements and kit as it happens. So this bad practice is seriously ingrained in the profession now I'm afraid. Some practices actually have a section on their anaesthetic consent form, making clients who decline these blood tests sign a disclaimer. I think that's moral blackmail.
The company selling the dodgy instruments became so successful that they bought out my business, hence my recent change of job. In the short period I worked for them I tried to put forward my view on the matter. I had a arts graduate saying "but wouldn't you want to pay the extra just to be absolutely sure?" I couldn't get it through that there was no way such testing could make anyone absolutely sure, and on the contrary a false sense of security could be a bad thing. I also pointed out that the more common situation was that incidental abnormalities caused a lot of trouble. She wasn't listening. Her own hype was completely ingrained, and in any case it was all about profit - "we have a duty to the shareholders".
I've had two elective surgeries myself, both private - one paid for by BUPA and one self-funded. Both times I had a pre-anaesthetic consultation. Neither time was any blood testing suggested. The second time (BUPA-funded) I asked the nurse, aren't you going to do a pre-anaesthetic blood test? She of course didn't realise my tongue was in my cheek, and said worriedly, no, why do you think you might need one, is there something you're not telling me? A colleague is going in for elective orthopaedic surgery in two weeks. She had her pre-anaesthetic consultation on Monday. No suggestion of any blood tests. This is simply not done in human medicine, so I can see no reason for vets to take this line.
I was at a class reunion last year, when one guy started boasting about how much money he was making. I challenged him about his practice of insisting on blood testing everything before it was anaesthetised. Pure profiteering (and remember, I make my living by doing blood tests - the only difference is I like to do them properly, and there is enough that nees doing without inventing it anyway). He argued back. Then it was revealed that a man in the same conversation, the husband of a classmate, was a consultant surgeon at a top teaching hospital - an orthopod I think. He also started criticising the profit-happy vet, saying that such testing was entirely unnecessary. A friend commented, you'll never persuade Richard out of that one, he's been adamant for years about blood testing everything. She then reminded me that Richard had been the dunce who had taken ten years to complete a five-year course (not actually allowed by the rules but they somehow got bent), and what was he doing at the party anyway because he hadn't graduated with us.
I sighed and wandered off to talk to more congenial company.
Sorry, this is a rant, but it drives me mad. If any vet suggests blood testing for general screening (as opposed to a real diagnostic requirement), you probably want to say no. (It doesn't fool everybody. My neighbour had a cat with a bite abscess and I had a look at him late one evening. I said best take him in first thing in the morning. The abscess burst on the consulting room table, but she still ended up with a big bill. She said to me, "I was stupid, I fell for that stuff about blood tests." She'd worked it out for herself.)
Pre-anaesthetic blood testing for no specific clinical reason is the veterinary equivalent of the extended five-year warranty.
[/rant]
Rolfe.
