In veterinary school aka “the ivory tower,” we are taught what is termed the “gold-standard” of veterinary care. It includes complete diagnostics (blood tests, imaging, etc) to try to reach a diagnosis and consider all medical possibilities, while initially ruling out the most common diseases with the least invasive diagnostics. Where vet school fails is teaching students (most of whom will become real-world practitioners), how to develop an alternative plan when clients choose not to, for monetary or other reasons, perform all available diagnostics.
As an emergency clinician, sometimes speaking with a client can be more difficult than general practice for the following reasons:
- We have little or no client-patient relationship or history.
- Clients are stressed because their pet/family member is suddenly sick.
- We typically require payment in full, which ranges from $250-$1500 for many cases.
Over time, if you truly love emergency you find ways to connect with clients quickly, build trust, and treat their pet. Sometimes, however, our message of caring gets lost while attempting to offer the “gold-standard” and collect payment.
Recently, my clinic recently received a disheartening and constructive Yelp review from a client who earns a living in sales. His pet was seen for first-time seizures on emergency. This client was very upset after watching their family member suffer from two seizures. The client was approached with a “gold-standard” diagnostic plan and overnight monitoring for seizures at $1500. The next step is where we failed in client communication, or did we?
Shortly after reviewing that treatment plan, the client was asked what they could afford. (I infer they were initially shocked at the cost). At this point, the client (rightfully so) saw no value in the initial diagnostic and treatment plan and felt like they were buying a used car instead of investing in medical care for their pet.
Where we went wrong I believe is showing and explaining to these clients the value and the why to what we were recommending and then pausing to let them digest and decide for themselves. If at that point the client wanted their pet treated differently, offer plan B or C, but never underestimate what the client will spend to be sure their family member is safe and treated appropriately.
This review did hit me in the heart because many days despite adhering to the guidelines I mentioned above, offering multiple plans can feel like a sales pitch. We are relying on owners’ discretionary income to pay for their pets. I do not question the tests my physician wants to run. Is it right to offer the “gold standard” every time to rule out every disease under the sun? I think it is, but again that’s what I was taught in the “ivory tower.”
So are we sales people trying to find the best individual medical plan for each family’s budget? I believe that we are, but that does not have to have a negative connotation if the appropriate communication is delivered to our clients.
One way out of this dilemma is to promote methods of payment away from discretionary income. By advocating for pet insurance and wellness plans, the client plan becomes less money-focused and the “gold-standard” medical focus re-emerges without the haggle of a deal.