SAVC GUIDELINE OF TARIFFS
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Guideline of Tariffs 2013
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Introduction to the Guideline of Tariffs: 1 January 2013 -31 December 2013
The South African Veterinary Council earnestly requests that all veterinary professionals read this introduction and the general notes thoroughly as they contain concepts that are very important to the interpretation of the guidelines that follow.
The Council and the Fees Committee wish to take this opportunity to thank the various role-players that made input to Council for consideration. The constructive comments and ideas are much appreciated.
Council does not intend to inhibit price competition between veterinary professionals and the purpose of listing the tariffs herein is to indicate what Council will use as a basis when investigating complaints relating to overcharging lodged by clients or touting by colleagues.
It must be stressed that the listed tariffs, despite the recommended minimum and maximum range, will only be used as a guideline. Other factors will still be taken into consideration that may affect the decision on whether the fees charged by a veterinary professional in the particular circumstances were indeed excessive and the client overcharged (fees in excess of the maximum tariff) or that the discount given for services rendered, (fees less than the minimum tariff) amounted to touting.
Such factors would include the:
Geographical area of the practice;
Community serviced by the practice;
Equipment and standard of facilities;
Experience of the veterinarian concerned; and
Commercial value of the patient.
Should veterinarians charge fees in excess of the maximum recommended tariff it is strongly advised that written consent is obtained from the client/ the person who requested the veterinary services indicating that the actual fees were discussed and agreed to, as this will obviate the need for Council to investigate a complaint of overcharging. It is not required to tell the client that the written consent is requested because the maximum guideline fee is to be exceeded. Written consent is a practice management tool that can protect the professional should a complaint arise.
It is the experience of Council that many complaints from the public are fees related. It is therefore strongly recommended that the client is kept fully up to date and informed as to the cost implications of a particular case. This is especially important if the original estimate is going to be exceeded in any way.
In terms of the current Rule 14 a veterinary professional is obliged to inform the person in charge of an animal in respect of which a service is to be rendered beforehand of the approximate fee, which he/she intends to charge for such service when such fee exceeds the fee usually charged for such service.
In compiling this Guideline of Tariffs the Council is acutely aware that it may not dictate to veterinarians what they may charge and does not seek to do so. However, in the preamble to the Veterinary and Para-Veterinary Professions Act, 1982, under which statute the Council fulfils its mandate, one of the purposes is stated as:
"To exercise effective control over the professional conduct of persons practising the veterinary professions and para-veterinary professions "
This impacts on the interest of the public, as clients of veterinary services, the intra-professional relationship of veterinarians and the dignity of the profession itself. It is therefore incumbent on Council, while not being prescriptive, to have a guideline tariff that can be used when there is a complaint regarding fees, from whatever source, against the profession in general or against an individual veterinarian.
The guideline needs to be seen in this light only.
Lastly the Council pertinently draws to the attention of veterinarians that any form of price fixing is prohibited in terms of the Competition Act, 1998 and price collusion between veterinarians is not acceptable.
December 2012, South African Veterinary Council
The following notes should be taken into account when referring to the listed tariffs:
The minimum and maximum range is wide enough to cater for the full economic and specie spectrum of veterinary practice as it exists in South Africa. The minimum tariff represents a reasonable return for modest practices that operate in poor areas, while still ensuring these practices are economically able to maintain minimum standards of practice as required, and give reasonable financial return to the veterinarians and their staff. This minimum range could also be used for newer graduates. The maximum tariff represents a reasonable return for higher quality facilities with substantial capital investment in infrastructure, equipment and personnel.
1. Due to the vast range of circumstances under which veterinary professionals practice in South Africa provision has been made for a recommended minimum and maximum tariff. However, ultimately the decision to set a particular fee appropriate to the circumstances of the individual, the client and the specie to be dealt with, remains the prerogative of the veterinary professional.
2. It is strongly advised that veterinary professionals obtain written consent from clients, in particular, when charging in excess of the recommended maximum tariff. It is not required to advise the client that written consent is requested because the maximum tariff is to be exceeded. The Council recognises that it may not dictate to veterinary professionals what they may charge. However, written consent is a practice management tool that can be used when a client queries the fee charged and can protect the professional should a complaint arise.
3. All tariffs EXCLUDE the costs of medicines, materials and VAT.
The retail price of medicines and materials should cover the wholesale price, markup, dispensing and packaging costs.
4. After-hours surcharge: An after-hours surcharge may be levied after normal consulting hours. The determination of what normal consulting hours constitute are at the discretion of each veterinary professional. Veterinary professionals should clearly communicate to clients during which hours an after-hours surcharge will apply. In particular veterinary practices that offer a 24 hour consulting service to the public should ensure that they do not mislead the public that a uniform consulting fee is charged if that is not the case. At the discretion of the veterinary professional the surcharge levied could either be as recommended in the guideline, alternatively a value of 25% of the normal professional fees for procedures performed on the patient during the after-hour period, could be added as a surcharge. This will especially apply to cases that require extensive treatment and surgery during an after-hours period.
5. Professional time: In the listed tariffs there are broad guidelines of the time needed for various procedures and these have been included only for reference. All procedures that are time related could be charged on an “actual time ” basis. The range based structure could be used to make allowances for the varying experience of the veterinary professionals performing the procedures, the complexity of the procedures and the commercial value of the specific patient.
6. Referrals and interpretation of tests: Time taken by veterinary professionals for interpretation of referred laboratory tests etc., and other referrals of whatever nature, can be charged to clients on a general time basis.
7. Travel costs: Veterinary professionals may use the listed kilometer rate in the guidelines alternatively, they may elect to charge the standard AA rate for their vehicles and then use the “actual time spent in vehicle” charged at the general hourly rate, which could be added to the AA rate.
8. Specialists: It is recommended that registered veterinary specialists charge for their specialist services at a rate of 1.5 times the fees charged by general veterinary professionals.
9. Supportive therapy and intensive care: It is recommended that the cost of the professional time of the person/s involved in the monitoring of the patient be itemised and reflected in the account.
10. Lecture and witness fees: It is recommended that veterinary professionals charge in accordance with the general listed hourly rates. However, as neither overcharging or touting plays any role in these fees, veterinary professionals are entitled to set their own fees.
HOW FEES ARE CALCULATED IN THE GUIDELINE OF TARIFFS OF THE SOUTH AFRICAN VETERINARY COUNCIL
The Veterinary Professions gives input on an individual basis and through the various bodies that represent the profession on fees currently being charged. These inputs are then considered by the Committee on Fees of the SAVC before the annual SAVC Guideline of Tariffs is published.
In the introduction to the Guideline there are very important concepts that the SAVC uses in deciding whether a fee is fair to all parties or not.
All fees are ranged based to cover most practices involved in a service to the public. Veterinarians are required to have registered facilities that have to comply with minimum requirements and the services rendered by veterinarians from these facilities include services that are usually performed in human hospitals/ clinics and not in the consulting rooms of medical doctors. There are no state hospitals for animals. Emergencies and stray animals are stabilised or treated by private practitioners before being referred to Animal Welfare Organisations. The costs of these animal welfare interventions are usually done Pro Deo by the Practitioner concerned.
It must be stressed that in a country with an economically diverse demographic position as seen in South Africa there will be a wide discrepancy of fees depending on the situation of the Veterinarian and the client.
South Africa is blessed with a wide range of Animal Welfare Organisations which go a long way in alleviating suffering amongst animals owned by people who cannot pay Veterinary Fees usually charged. Fees charged by Animal Welfare Organisations are heavily subsidised and cannot be compared to the actual cost of services rendered by a Veterinarian who is running a viable practice. The public are earnestly requested not to abuse the system by utilising Animal Welfare resources when they should be using the normal channels of Veterinary services.
The SAVC is committed to seeing that standards offered to the public in South Africa are comparable with those anywhere else in the world. We do recognise that to reach these standards the high cost of maintaining world class and facilities means that the fees charged will be commensurate with the facilities offered. We also realise that not everyone can afford this standard of Veterinary Care and take this into account when deciding on fees.
We strongly advise all clients to ensure that they are given estimates of costs especially where advanced procedures are to be carried out on their animals. We also advise owners to ask for cost updates where animals are hospitalised or have long drawn out therapy. To obviate confusion these estimates should be given in writing prior to treatment taking place. Various pet insurance schemes are available to the animal owners, which can assist animal owners in meeting the health expenses of their animals.
Dr John Adam, Chairperson of the Committee on Fees
Guideline of Tariffs 2013