Conversations with clients about the cost of veterinary care for their beloved pet can be awkward, but it’s an issue the experts believe must be addressed head on. By John Burfitt
It’s a conversation most vets know only too well, having probably had it with a client at some point, usually in a clinic room or at the front desk of the practice.
The scenario usually goes something like this: an animal has just been treated and the vet hands over the bill. That’s when a puzzled look crosses the client’s face and they ask the question—“How can it possibly cost so much?”
More times than not, the client is genuinely confused, with little or no understanding of the true costs of health care for their four-legged friend. But there are also the times when every dollar comes under intense scrutiny.
That’s when there is a long list of questions, like why a blood test costs $300 and how could an ultrasound cost $700? It’s a situation that can be tough to negotiate, given there are no standard fees or guidelines set by the Australian Veterinary Association (AVA), leaving each clinic to figure it out for themselves.
“Discussions of costs in veterinary medicine can be a sensitive subject and one that many people—the vet and the client—feel discomfort with,” Dr Michelle McArthur of the School of Animal and Veterinary Science at the University of Adelaide says. “There is also no one way to approach this conversation as every client and every circumstance is different.”
The issue was explored in a 2007 Canadian study by Coe, Adams and Bonnett, which compared veterinarians’ and pet owners’ perceptions of the monetary aspects of veterinary care.
The study revealed that pet owners expected the care of their animal to take precedence over monetary aspects, and also expected vets to initiate discussions of costs up-front but claimed such discussions were uncommon.
The study concluded that by exploring clients’ expectations, improving communication, educating clients, and making discussions of costs more common, veterinarians may be able to alleviate some of the monetary challenges involved in vet-client interactions.
Dr McArthur believes it is up to the vet to establish clear and comprehensive lines of communication with the client from the very start, to ensure the realities of the fees involved are communicated along with care and empathy for the animal.
“While it might be difficult in the midst of an emotionally-charged clinical moment, it’s important to discuss costs up-front to avoid the client being surprised or overextended,” she says. “You have to take charge, and might need to say, ‘Before we go any further, I’d like to discuss the cost of these options with you’.”
Explaining the necessary treatments and associated costs allows the client to put the medical care into perspective, especially if you also point out that for humans in Australia, these costs are often covered by Medicare or health insurance.
“For some clients, explaining this difference can be helpful and justifying, but also remember that for some people, discussion of cost is akin to breaking bad news and as such requires ways of engaging in the sensitive conversation,” Dr McArthur says. “Be sure to also check with the client’s perspective, expressing empathy and developing a plan.”
After a treatment is not a time to become uncomfortable about the topic of money, says Dr Vic Wheeler, vet manager of the United Vets Group membership organisation. She advises a direct approach to be taken from the beginning, and importantly, the vet needs to have a clear understanding of their professional value.
“Vets have an amazing set of skills and a vast amount of knowledge, developed over many years, and we need to know that we are worth what we charge and shouldn’t be ashamed of it,” Dr Wheeler says. “We need to have confidence in communicating our value to our clients.
“As a profession, we have a tendency to take on board a client’s feelings around cost a little too much, so that we almost consider it our fault the pet won’t get the treatment it needs. The reality is that is not our responsibility.”
One thing she insists should never be considered, if challenged, is to offer a discount to the fee. “Doing this only further confirms that we weren’t really worth the fee we were proposing in the first place,” she says. “I’ve seen this often in practice and it is not a good way to deal with the issue.”
Dr Lindsay Hay of Sydney’s Baulkham Hills Veterinary Hospital has a few golden rules when it comes to discussing costs with clients. One is don’t apologise, another is never be afraid to offer real details of the cost of procedures.
“Don’t apologise for what you charge, but also be sure to set fair fees to begin with, that you are comfortable with and can justify,” he says. “You are right to charge for what you do as a professional—clients do not value something we don’t charge for.”
And if all else fails, including in the conversation details of what animal medical care actually costs can clearly get the point across. “Sometimes you need to educate the client, so you might tell them exactly what an X-ray machine or the various lab equipment costs, and maybe even show them behind the scenes,” he says. “Also, be patient and explain there are no subsidies to help pay for the costs of running a practice so the vet needs to charge for what they do to maintain the business, or there wouldn’t be a business offering the service.”
If a client is new, this might also be the ideal time to initially discuss the range of pet insurance options available that might save them expense in the long run. “Doing that can dramatically change the context of the discussions,” Dr Hay says. “This means that you can establish long-term relationships with clients who are more likely to be making judgements based on service than price and trust you to do the right thing.”