Veterinary clinics could consider charging according to the time and complexity a visit requires, rather than applying one exam fee to appointments with very different demands. In an opinion article published by the American Animal Hospital Association (AAHA) on April 1, 2026, veterinarian Melissa Magnuson describes a four-tier approach—and why she believes it can make the demands on a clinic team easier to recognize and discuss.
Why consider a time- and complexity-based exam fee?
A routine wellness check and a visit involving difficult handling, an involved medical history, or extended consultation may require very different amounts of a veterinarian’s and team’s time. Magnuson frames the issue with a practical question: “Why do we charge the same exam fee for visits that require very different amounts of time and expertise?”
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She describes the challenge of giving fearful, anxious, or stressed pets the attention they need while keeping the rest of the day’s schedule moving. A 30-minute appointment may not be enough for a fearful dog. A fractious cat may need multiple technicians, a quiet room, and consideration of strategic sedation. A complicated case or a client with a lengthy history may also require more discussion than a standard appointment.
When the extra time is routinely absorbed without accounting for it, Magnuson says, appointments can run late and pressure can build on staff. Her proposed model treats time and complexity as part of the service being priced, rather than relying on a behavior label or diagnosis to determine a fee.
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How the four tiers work
Magnuson’s framework groups appointments by the time and resources they require. It is a practice-management proposal, not a published fee schedule: the article provides no dollar amounts or formula for setting them.
| Tier | Typical visit | Time or resources involved |
|---|---|---|
| 1 | Standard wellness or straightforward medical exam | No additional time or resources |
| 2 | Urgent care, a mildly fractious pet, or another appointment that naturally runs longer | Additional time |
| 3 | Complex medical consultation, difficult handling, or extensive client communication | Greater complexity or handling and communication demands |
| 4 | Complicated second opinion or a very large fractious dog | A visit extending beyond an hour or requiring significant team involvement |
The tier is determined by the doctor during or after the appointment. That lets the framework account for what a visit actually required, including when its demands are clearer only as the team works through the case.
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What the model could change—and what it cannot
In Magnuson’s practice, she reports that clients have generally understood the structure when the team is transparent and communicates clearly. She also says the tiers gave staff shared language for discussing appointment time, complexity, scheduling, patient handling, and workload. These are her observations from practice; the article does not quantify client acceptance or establish that other clinics will see the same effects.
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1Clear out junk files and repair common Windows errors2Scan for outdated or missing drivers - takes under a minute3Repair Windows errors before they cause bigger problemsThe tiers do not remove the need to plan carefully for fearful patients or to have a skilled team handle them. Magnuson explicitly cautions that tiered fees will not solve every scheduling challenge. Her article is an opinion account, not a comparative study: it reports no measured financial results, controlled comparison, client survey, or burnout statistic.
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- EASY INSTALLATION: The folding medical exam table installs and disassembles easily, allowing it to be easily placed anywhere, allowing you to quickly set up and start using the table without spending extensive installation time or complicated processes
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What clinics should clarify before adopting tiers
The article offers a framework rather than an implementation policy. A clinic considering a similar approach would need to decide how its own fee levels are set and how the team explains the structure to clients; Magnuson’s account does not prescribe prices, a pricing formula, or detailed client-consent procedures. Its central distinction is that the fee reflects time and complexity required—not a pet’s diagnosis or a behavior label.
Source: Melissa Magnuson, DVM, “Opinion: Charging for time, not just the exam,” AAHA, April 1, 2026.
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