I agree that if the client is not satisfied, then there is a problem. However, medicine is not an exact science. In human medicine, there are many variables and judgement calls. We may not realize it as medical insurance covers many, (not all) of the costs.
We just went in for our annual vet visit and distemper inoculations. We ended up with a $338 bill for two dogs. The vet felt that Lucy had a mild bacterial skin irritation, and needed medicated shampoo. He also offered us a good deal on Frontline. I had been buying the generic version, but was not happy with it. I could have bought the Frontline online but for a few bucks more, I was happy to buy from my vet. He also gave me good advice on a few other issues. He gave the dogs a good exam, made me and them feel comfortable, (a vet that cringes when he sees a pit bull and a mastiff in the same room, doesn't inspire confidence), and told me not to hesitate to call him with any questions or problems. I do not feel in any way that I was 'ripped off'. When you choose to bring an animal into your life, you must accept financial responsibility.