Yesterday I spent the afternoon at one of our VetBilling partner clinics. Whenever I’m there, I see how challenging it is to work with veterinary clients from all walks of life, and from a wide variety of socioeconomic backgrounds.
A situation occurred with one of the clinic’s longtime clients, and I’m sure it’s a familiar scenario that plays out in most veterinary practices almost every day.
The pet owner made an appointment for her adopted beagle/terrier mix after noticing that she was rubbing her right eye and had noticeable redness and sensitivity in the area.
One of the associate veterinarians examined the dog and initiated standard diagnostics: a corneal exam, a fluorescein stain, and tonometry. The client consented to all these recommendations.
The treating veterinarian diagnosed a corneal lesion and advised the owner that her dog would need some topical anti-inflammatory eye drops, along with some pain medication. These are standard and reasonable recommendations, and again the owner did not object.
When Financial Concerns Emerge at Checkout
When the owner went to check out after her dog’s exam was completed, her bill was $240. She then told the client service representative that she hadn’t realized it would cost that much, and she only had $80. That left the vet team scrambling to negotiate a financial solution that was workable for everyone.
When the treating veterinarian heard about this, she was understandably distressed. What had she missed? The client hadn’t explicitly expressed any financial concerns during the exam. She didn’t ask how much the diagnostics or the prescriptions would cost. In fact, she didn’t bring up money at all, until it was time to check out and pay.
I spent some time talking to the vet, who was truly baffled and feeling somewhat guilty because she didn’t see this coming. Of course she didn’t! She was busy examining the dog’s eye and worrying about the extent of the inflammation.
The vet shared with me that the owner talked incessantly throughout her dog’s exam, offering what seemed to be a lot of extraneous, unrelated comments.
But here’s the thing: embedded within all the seemingly “extraneous” comments, the pet owner was actually volunteering a fair amount of information about her financial situation – it just seemed extraneous and irrelevant to the vet because it wasn’t related to the dog’s clinical presentation.
The Subtle (and not-so-subtle) Clues That Clients Drop
Upon discussing the whole scenario after the fact (and reminding ourselves that hindsight is 20/20), the vet and I were able to identify several clues that could have prompted a brief, explicit discussion about the client’s finances, which might have prevented the surprise “I only have $80 today” at checkout.
The vet recalled that while she was examining the dog, the owner talked almost non-stop about her current life situation as well as a family member struggling with an addiction…and she also mentioned more than once that she had just lost her job.
The mentioning of a job loss was clue #1 that this client might have financial limitations.
As the exam progressed, the vet advised the client that if her dog’s eye didn’t improve within 24-48 hours, she should seek a consult from a board-certified veterinary ophthalmologist. The client responded by saying that she couldn’t afford to see a specialist.
That was clue #2.
These two significant clues offered by the client were subtle, subconscious invitations to directly address her financial concerns right then and there in the exam room – but these weren’t obvious and they weren’t explicit.
The vet shared with me that many of her clients with cost concerns will ask multiple times throughout an exam, “how much is this going to cost?”
But there are many other clients who are worried about finances and won’t ever say so directly. There are any number of reasons for this, but just a few include embarrassment or shame over their financial situation; having too much pride to ask for help; and fear of being judged as an irresponsible pet parent if they admit they have a limited budget.
Listening for “Openings” to Address Financial Concerns in Client Conversations
Learning how to “listen for openings” in client conversations can help identify those who aren’t comfortable stating their financial concerns outright. But it doesn’t come naturally to most people to listen for these openings.
To make matters more difficult, vets are attending to a host of issues while the pet and client are both in the room, and one’s attention can only be directed to so many things at once.
Attentive listening is a skill that must be learned, but the payoff is that we have more productive conversations and can identify potential issues before they erupt into full-blown problems.
Examples of Specific Clues to Listen For
Here are a few things you can listen for in client conversations that can clue you into financial concerns, even if the client never addresses it explicitly:
- Mentioning a recent job loss, as the client in this situation did.
- Sharing other financial setbacks: divorce, death of a spouse, eviction, a large tax bill, even the recent breakdown of a vehicle or large appliance.
- Discussing personal medical problems/treatment.
- Mentioning family matters that may have financial implications: addictions; illness or hospitalizations; legal problems; child going to college; parent moving to nursing home or assisted living, etc.
Clients talk about all kinds of things when they are in the exam room. It often seems like their whole life story tumbles right through the door with them! That’s because most people can’t just detach from whatever is going on in their life, especially if it is causing them stress.
Another reason they talk about these things in your clinic is that clients perceive their veterinarian as a safe person and an ally with whom they can share off-topic matters.
While it’s impossible to fully attend to everything a client says, you can train yourself to listen for certain key openings that may flag a financial concern. Taking a moment to address it right then and there is the best way to head off the “I don’t have any money” dilemma at the time of checkout.
Financial Conversations Can Be Short and Simple
Client financial concerns can be addressed simply and directly – there’s no need for a lengthy, in-depth discussion. You can say something like, “I noticed you mentioned that you recently lost your job. I’m so sorry to hear that! Given everything that we need to do with your pet today, do you have any financial concerns that you would like to talk about?”
If the client says yes, you can then ask if they’d like a written estimate for their pet’s treatment plan, if they’d like to discuss ways to keep costs down, or if they’d like information about your clinic’s available payment options.
Even if the client says no – remember they may be embarrassed to admit that they have budget constraints – be proactive anyway and quietly hand them a brochure from VetBilling®, CareCredit or Scratchpay that they can look over when you’re out of the room.
It’s also a good idea to have this information posted in your exam rooms and waiting area, as well as on your website. You should also regularly share your clinic’s payment options on your social media channels. Many clients postpone or skip veterinary appointments because they don’t know about alternatives to payment in full.
The earlier client financial limitations are identified, the better the outcome for the pet, the owner, and the clinic. You can then begin strategizing and formulating a financial plan before the client reaches the front desk to check out and says, “I only have $80 today.”
Step-by-Step Example for Addressing This Client’s Needs
Finally, here’s one step-by-step example of how to handle this client’s situation.
Recall that her total bill was $240. The first thing that should happen is that the client service rep handling checkout should review each item on the invoice. This helps the client understand exactly what transpired in the exam room: “Today Ranger had an eye exam, a fluorescein stain to check for abnormalities or trauma to the eye, a tonometry test to check eye pressure, and we’re sending you home with an ophthalmic ointment that should be applied 3 times a day.”
Clients often don’t realize or understand that while the vet was “doing something to their dog’s eye,” what actually occurred was that 3 separate diagnostic procedures were employed, each with a separate charge. It’s helpful to recap this information in case the client wasn’t paying close attention to what was going on in the exam room.
Upon hearing that the client only has $80 available, here is a breakdown of one possible response that can lead to a positive outcome:
1. “Ok Mrs. Smith, don’t worry, we can definitely work this out” (this acknowledges the reality of the client’s situation without judgment and puts her at ease.)
2. “Sometimes it’s hard to manage veterinary expenses that you weren’t expecting and that’s stressful for anyone.” (validates the client’s feelings and lets her know she isn’t alone.)
3. “Why don’t we have you pay the $60 exam fee for today, and we can put the remaining balance on a payment plan so you can spread the cost over time?” (introduces a potential solution that respects the client’s budget constraints without ignoring the clinic’s need to be paid. This is a starting point, you can always offer a lower down payment if needed.)
4. “Let’s set you up on a VetBilling payment plan. We can do 6 bi-weekly payments of $30, or 3 monthly payments of $60.” (Now you are presenting a specific action plan. Start with this offer, and if the client needs lower payments, move down from there.)
With a simple conversation like this, you are actually addressing multiple things at once. You are:
- meeting the client’s needs;
- generating positive rather than negative feelings;
- establishing or strengthening your connection with the client;
- demonstrating that you are an ally rather than an opponent;
- offering a problem-solving strategy.
This is a better solution for the practice too, because there’s no need to write off charges, discount, or feel cornered into offering pro bono services. And you won’t have a distressed or angry client on your hands. In fact, you’ll have the opposite: a client that is relieved, grateful, and will remember this positive encounter with your clinic for a very long time.
Take-Home Message: Learn to listen for openings in exam room conversations that may point to financial limitations. Many clients won’t express such concerns directly, due to embarrassment or fear. If you hear a key opening, it takes less than 30 seconds to sensitively address it by asking if the client has financial concerns they’d like to talk about, so together you can figure out the best strategy for getting their pet appropriately treated.