Submission Number: 560891-00084
Received: 7/31/2012 10:36:48 AM
Commenter: Jim Schwartz
Organization: Next To Kin Foundation
Agency: Federal Trade Commission
Initiative: Request for Comments and Announcement of Workshop on Pet Medications Issues, Project No. P121201
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Self Referral is an structural barrier to trade - Tying In - as it is termed illustrating conflicts of interest casting a shadow on the objectivity of the veterinarian's advice therefore reducing trust (substitute reliance on the profession)while increasing veterinarian costs unnecessarily to the companion animal(s)guardian/owners.
1- In CPA work - hiring a CPA consultant from the same firm to give subjective advice - and then have the same firm's auditors audit the books - gives rise to the concern of objectivity
2- if the advisor (i.e. for example a doctor) is also the distributor and owned by the manufacturer - how reliable is the objectivity of the advice. (If Lily owns the Doc or Walgreens owns the doc etc)?
So the question is about self referral and objectivity relative to conflicts of interest.
As Maslow said, if all you know is hammer everything will look like a nail. If all one knows is a Rx fulfillment fee on top the the Rx ---???
The above is why fee only personal financial planning came into vogue and is preferred all things being equal in survey after survey. How reliable is the advice of the commission or fee and commission planner - if what he prescribes he gets paid for by transaction or fee and advice not just advice? And further, given the same advice to purchase let's say life insurance - will he or she be more inclined to sell the one policy with 150% first year commission versus one that has a 50% commission or a non commissioned product all things being equal?
(Note I was a co founder of NAPFA the largest fee only financial planning professional association. I have been retired from practice 16 years now).
So the bifurcation of advice from transaction - minimizes the conflict of interest - OF SELF REFERRAL -increasing substitute reliance of veterinarian profession.
The irony is the same veterinarians seeking to protect this self referral profit - tying in center - are typically the ones who bortz (complain) about the commissions their stockbroker, real estate agent etc make - when they continue to be in the self referral business themselves!
Self referral should not be allowed on prescriptions (except for acute and one time interventions as well as veterinary ER clinics) when the Rx needed is on an ongoing basis (ie. chronic basis).
The self referral is questionable but adding on a fulfillment price add on to the Rx is just exploiting economically the situation.
Bifurcate the advice from the product transaction (with the exceptions as noted)
PS The VCPR (Veterinary Client Patient Relationship) is a red herring. Personal property (which cats and dogs are) cannot per law be 'a patient' - they can be fixed, maintained - but only a human can be a patient. Federal law - correct me if I am wrong - only shows the VCPR relative to off label prescribing!!
See attached write up Next To Kin did