Originally published in the September 2015 issue of Veterinary Practice News Pet owners may not budget for routine preventive care and can be surprised at the cost. A pet owner with an adult dog 1 to 6 years old can expect to spend $107 for a preventive veterinary care exam, distemper and rabies vaccines, intestinal parasite screen and heartworm test, according to the American Animal Hospital Association Veterinary Fee Reference, 9th edition.1 Add 12 months of flea/tick and heartworm prevention for $300, which averages $25 a month, and the visit would total $407. Too often, pet owners perceive that “shots” were $407! Your health care team’s ability to confidently explain financial information to clients affects their decisions to accept preventive care. Asked about price, 34 percent of pet owners say veterinary care is higher than they expected, according to the Bayer Veterinary Care Usage Study.2 Here’s how to handle financial conversations during preventive care visits. 1. Have technicians give an overview of services without prices. The technician should introduce himself, explain his role and prepare the client for which services are due. Say, “Good morning, I’m <your name>, the technician who will be assisting Dr. <Name>. For your preventive care visit, we will do a nose-to-tail exam, vaccines, heartworm/tick test, an intestinal parasite screen and refill 12 months of preventives. I will take a brief history, collect samples for testing and get your pet’s temperature, pulse and respiration. Then the doctor will begin the exam. Is there anything else you want to discuss with the doctor?” Say “preventive care exam” instead of “wellness exam.” Pet owners may perceive wellness exams as optional, while preventive care exams are actionable. Say “vaccines” instead of specific ones. Based on exam findings and history questions, the veterinarian may add or subtract vaccines. Saying, “We will refill” encourages 12 months of parasite protection. Asking, “Is there anything else you want to discuss with the doctor?” identifies “Oh, yeah, could you also check … ?” Many well pets have sick-pet problems—ears, skin or dental disease. Identify questions at the beginning of the exam so the doctor can prioritize which order to address concerns. Let’s say the veterinarian closes the preventive care visit by asking the client whether she has any questions. She replies, “Oh, yeah … My cat has been peeing outside the litterbox for a month.” Now you’ve added another 20 to 30 minutes to the exam time. If the technician had asked about other concerns at the beginning of the exam and identified the issue, he could have replied, “Whenever a cat has elimination problems, the doctor needs to determine whether it is a medical or behavioral problem. I will take your cat to the treatment area now to collect a urine sample and start the urinalysis test so we will have a solution for you today.” 2. Share prices when clients express concerns. Previewing services lets you gauge whether pet owners have financial concerns, and then you can discuss them. If clients ask about prices, prepare treatment plans or access fees on computers in exam rooms. Say, “Let me review the services and prices with you. Before deciding, let’s have the doctor perform an exam and then help you prioritize which services and products your pet will need.” If you notice nervous body language such as fidgeting or avoiding eye contact, ask, “Would you like to see a treatment plan that lists services and fees before we proceed?” If you’re unsure of the pet owner’s body language, invite the client to express any concerns. Say, “Do you have any questions before we perform these services, or shall we get started?” 3. Have the doctor focus on medical priorities. The veterinarian should echo the services and products that the technician described and take a collaborative rather than confrontation approach if the pet owner has financial limits. Say, “Good morning, <client name> and <pet name>. During <pet name’s> physical exam, I’ll focus on 12 areas, including eyes, ears, nose and throat, teeth and gums, coat and skin, heart, abdomen, limbs and paws, urogenital system, lungs, gastrointestinal system and weight. We will talk about my exam findings and what <pet name> needs. “<Technician name> shared with me that you are concerned about the cost of care, so I will help you prioritize services based on your pet’s needs and your budget. We will work together to help <pet name> get the care she needs.” If the client cannot afford all the preventive care services due today, take these actions: Schedule follow-up care now. This lets you stage the preventive care. Before checking out for today’s services, schedule a follow-up visit to finish the remaining services. For example, the patient had an exam and vaccines today but the client could not afford the heartworm/tick and intestinal parasite tests. Offer to schedule a technician appointment for the tests and explain the cost today. Try to schedule the diagnostics within the next two to four weeks, when the client is likely to have received another paycheck and the patient will get timely care. Enter a callback. If the client won’t commit to a future appointment today, express empathy while being a patient advocate. Say, “I understand that you’re unable to do the heartworm/tick and intestinal parasite tests today. I will call you a courtesy reminder in one month. You can schedule a technician appointment for those tests. We both want <pet name> to continue to be protected.” The 2003 AAHA compliance study found that 38 percent of pet owners surveyed would return for a medical progress exam or procedure as directed by their veterinarian if the practice followed up.3 Because veterinary medicine is a relationship business, use doctor and staff ID codes in your practice-management software. Each employee who interacts with a client would be tied to the transaction. Doctors’ names commonly print on invoices so clients know which veterinarian delivered care to their pets. Likewise, do the same for technicians and front-desk staff. Each staff ID code would have an invoice description such as “Your technician today was Todd” and “Your client care coordinator today was Jill.” If a callback for the heartworm/tick and intestinal parasite tests were entered today, Todd and Jill would be linked to the callback. Because the client will remember talking with Todd a few weeks ago, he would call and say, “Hello, <client name>. This is <technician name> from <Your Veterinary Hospital>. I am calling as a courtesy reminder that we need to do heartworm/tick and intestinal parasite tests for <pet name>. This is a 15-minute technician appointment. We can see <patient name> on Monday at 4 p.m. or Wednesday at 2 p.m. Which choice fits your schedule?” Known as the two-yes-options technique, this guides the pet owner to schedule an appointment and is more effective than “Do you want to make an appointment?” Preventive care services and products generate 38 percent of hospital revenue.4 When clients can’t afford all the services, have a plan to get them completed. You don’t want another year to pass without necessary diagnostics, vaccines or preventives. When you’re a patient advocate, your business also will be healthier. References The Veterinary Fee Reference, 9th edition, AAHA Press 2015; pp. 61. 2011 Bayer Veterinary Care Usage Study conducted by the National Commission on Veterinary Economic Issues, Brakke Consulting, and Bayer Animal Health. Accessed Dec. 26, 2013, at http://bit.ly/1M4Zx7X. “The Path to High-Quality Care: Practical Tips for Improving Compliance,” 2003 American Animal Hospital Association: pp. 9, 20 and 21. Myers, WS. “How to Conduct Effective Reminder Calls and Callbacks.” Communication Solutions for Veterinarians Inc., 2009: chapter 1, page 9.
