If your veterinary hospital is like most, its not full of mercenary pirates looking to swindle pet owners. You care about pets, and it costs money to run your hospital. My pitch? Take the veterinarians out of these money chats and empower the nonmedical team to step up.
Don't lead with money. Lead with the medicine. "The services we provide are kinder and more thoughtful than our physician counterparts from the moment our clients enter the waiting room," says Naomi Strollo. (Shutterstock.com)Veterinary practices are often compared to human hospitals, but there's no comparison when it comes to finances. You need to address this topic with clients in some way, but how it's done can make you sound heartless and money-hungry vs. just taking care of business. Even when you communicate well, some clients will always be dissatisfied that you don't treat animals for free.
The services we provide are kinder and more thoughtful than our physician counterparts from the moment our clients enter the waiting room. We tend to clients' fearful pets and try to remove anxiety-causing situations. We rush around to limit wait times and supply multiple team members for every client and patient need. We even save them a trip to the pharmacy by supplying medication with full explanations before they leave our practice. Many times, we assist pets into vehicles. We truly cater to our clients, but when it comes to the payment part of a visit, we sometimes can feel like criminals because of the way we're treated.
How can we give great customer service and amazing care and still discuss payment without coming across as heartless?
It's all in timing and approach.
Don't lead with money
Remember, clients don't know about the stack of unpaid invoices sitting on the desk waiting to go to collections. They only know about their pet in the moment. If you hit them up for money when they walk in the door, then that's all they think you care about. You never took the time to know about their animal and their concerns before asking for money.
Why should they pay you anything or give you any payment information? You haven't done anything for them.
Asking for deposits or emergency fees or taking any financial information just screams to pet owners that you only want their money. They need to pay for setting foot in your building, no matter what happens.
Our clients should be able to feel the compassion we display every day toward their pet.
You know you're doing this right when customer service representatives, assistants and veterinary technicians roll out the red carpet for clients and take the time to listen to their concerns.
You know you're doing this right when customer service representatives, assistants and veterinary technicians roll out the red carpet for clients and take the time to listen to their concerns. Then the veterinarian addresses the issues and gives the pet owners time to decide which treatment plan to pursue. At this time, the veterinarian goes over these same options with a customer service representative who prepares treatment plans-with prices-for the different options. That way the client isn't presented with a single plan with a single price.
It's always best to invite pet owners to a private exam room when reviewing treatment plans. This takes away the possibility of an audience if they want to make a scene. It also gives them the privacy to be honest and admit without public shame that their funds are limited.
Empower your client service representative to manage some cost conversations
In my practice, the customer service representative (CSR) goes over the treatment plan, and that team member needs enough medical knowledge to explain products, services and procedures and why they're important. The CSR also knows which ones are less important than others if there's a need to downsize the treatment plan.
Top tips for cost conversations
Explain what you want to do. Pet owners should always receive a copy of possible treatment plans to look at during explanations. There's no need to read aloud the prices-the pet owners can see for themselves. Just explain the procedures.
Don't assume price is the problem. If pet owners aren't happy after a treatment plan explanation, don't automatically assume it's the money-they may just be distraught over their pet. Always offer to answer any questions. Don't be surprised if their first questions are about future care their pet needs. If the CSR can't comfortably answer their medical questions, don't sweat it. Bring in a veterinary technician.
Focus on consent, not cost. If clients accuse you of killing time talking over the treatment plan instead of caring for their pet, explain in a low, calm voice: "The veterinarian has already examined your pet, and she feels comfortable that your pet is stable. We don't want to start any procedures without your consent. This is just giving us permission to continue treatment." With this statement, you may take away the complaint, “You only care about money!" and show that legal consent for treatment is the next step.
Be careful if they can't afford it. If pet owners see the price and admit to not being able to afford the treatment plan, or say the bill is too much, or mention any other financial problems they're having, choose your words carefully.
"This is the recommended treatment by the veterinarian. I understand you weren't expecting this today. How would you like us to proceed?"
If you say, "How much can you afford?" you're showing that your care is all about the money and that it's time to negotiate. Instead, try saying, "This is the recommended treatment by the veterinarian. I understand you weren't expecting this today. How would you like us to proceed?"
Let the pet owners make the decision, not you. You're not saying any one thing on the list is not important. You're not focusing on money. You're letting the pet owners weigh the cost of care and the benefits of the treatment plan themselves.
We all would love to treat every animal the way we want without considering money, but we can't. Give the decision back to the clients and let them decide what care they can afford.
Offer options. What do you do when you present the treatment plan, the pet owners consider it, then say they can't afford it? If you already have a plan B estimate in hand, pull that out now and go over it. If you know a procedure, product or service you can mark off the list, do it. There's no need to get judgmental and try to make a pet owner feel guilty. You need to keep your personal opinions and emotions under control. Here's what that sounds like: "If we remove this injection, can we proceed with the rest of the treatment plan?"
If that doesn't help, remove another line and continue that way.
Once pet owners agree to a treatment plan, we get the signature. Then we notify the technician so they can start treatment.
But what happens if it's an emergency? …
In case of emergency
Start first, talk later. If a patient is critical, then starting care is more important than guaranteeing payment. You can get vitals, place an IV catheter, take blood samples and administer fluids while the veterinarian performs a physical exam. If a pet owner says they have no money while we're starting critical care, we lose professional time, an IV catheter, some fluids, some tubes and a few other items that won't break the bank. That's definitely not worth the word-of-mouth reputation hit or the angry client's complaints to local reporters, or the slandering money-hungry tweets that crop up. Of course, whenever a patient is not critical, then it's best to wait with the pet owner while they decide what they can afford.
Have time to talk now? Do some listening. If the patient is critical enough to warrant hospitalization, then your treatment plan may need a little cushion. Pet owners with pets who suddenly can't come home can be very emotional, so we need to assure them that we've already started caring for their animal. Sometimes we need to listen to their traumatic story or the history of illness to provide emotional support to the pet owner before we can proceed talking about finances.
Take words like "deposit" and "estimate" and "payment" out of your vocabulary. This will be all the owner hears.
Again, when you discuss treatment plans, treat them like a consent to proceed. We need consent on further treatment and hospitalization. Take words like "deposit" and "estimate" and "payment" out of your vocabulary. This will be all the owner hears.
Consenting with emotion. When explaining the consent form for treatment that explains cost, it's always best to start by explaining what's already been done for their pet. Pet owners need to see that you came to the rescue and started treatment before you knew anything about the pet owner.
Then explain the planned treatment and what outcome you hope to see. For example, “When the initial dose of morphine that we gave for pain wears off, we want to be able to give another dose right away so he won't feel any pain.” Explaining what the treatments are and why the pet needs them makes the owner feel more comfortable that you only care about their pets' needs.
When you reach the end of the consent form with prices, and pet owners see a price range, they can get angry. To explain the range, try saying, “This consent allows us to perform the treatments I just discussed. The range is in case something happens and we're not able to reach you and your pet needs further unexpected treatments. We just need your permission to continue the best care even while you're not here." This lets pet owners know you're only going to use the cushion if they're unreachable.
Don't make your doctors the villains
Veterinarians should not be arguing prices with clients-let the veterinarians be the superheroes, the ones in the red capes. Don't make them the villains. The pet owner's trust for the veterinarian and the medical team will become too clouded with money burdens.
Manage emotions first, up-front fee second. After clients sign the consent form, you need to assure pet owners that you're caring for their pet. If the patient is stable and the veterinarian approves, offer to let pet owners see the pet before they leave. You can also offer to have them wait somewhere comfortable in the practice to receive an update on their pet's care. An update from the veterinarian can also calm upset clients. No matter what, be sure to care for the pet owner's emotional needs, not just the patient's medical needs.
When pet owners are calm, you've assured them the patient's being cared for and you have the consent signature, only then should you proceed to financial consent.
If clients look puzzled when you ask them to handle the informed financial consent, explain that you need 10 to 20 percent of the cost of the treatment plan (whatever your hospital policy is) up-front. If they argue, speaking in a low, calm voice can help defuse things: "We understand this wasn't expected. Because the treatments are extensive to care for your pet, we need financial consent to allow us to proceed." Again, leave the decision to the owner, not you.
When “no” is the answer to financial consent-dig deeper. If the owner of an emergency patient can't or won't offer the financial consent (basically, a deposit), then be sure you're continuing this conversation in a private room, not the reception area.
If the problem is just signing financial consent today, then explain what you can do based on your hospital's policy on payment options.
Ask whether the pet owners are unable to leave a financial consent today or unable to consent to all the treatments. In some emergencies, people do run out without paying. If the problem is just signing financial consent today, then explain what you can do based on your hospital's policy on payment options. Inform them that without financial consent the practice can't continue treatment. This shows that you care and you gave the owners time, but you can't continue without financial consent.
If treatment is to continue, explain that the pet owners should remain in the building to continue care. They can find or phone family members or friends or explore other payment options. But remember, their financial consent is allowing you to continue treatment.
The best way to stop pet owners from thinking veterinarians are only after money is by taking veterinarians away from the money. Let the doctors practice medicine. Team members should be trained to handle difficult cost conversations and financial consents, and they must learn how to talk to pet owners. Showing care and compassion even on the way out can change how we're perceived that day and into the future.
Naomi Strollo, RVT, is Fear Free Certified and has been working in the veterinary field for more than 24 years. She practices emergency medicine and is a freelance writer. She also has a special interest in dog training, which enables her Akita, her pit bull and her Shiba Inu to all reside happily together.