Talking finances in the exam room is one of the toughest things you will do as a new veterinarian. Unfortunately, vet school shelters us from this conversation because many of the cases we see there are already pre-screened by the referring vet. The owner comes prepared to pay the expensive work up fees, so it is an eye opening experience as a new vet when you get hit with your first big case that requires a $3-5K+ estimate conversation.
How do we broach this touchy subject with owners? Great question! We find this is a common new vet woe, and you are not alone in feeling awkward or uncomfortable having these conversations. To this day, we both still remember stumbling over our first financial conversations.
When you start discussing finances, it can really change the mood in the exam room. You may be jiving well with a client, and then when it comes time to discussing the cost of your plan, the mood shifts. It is normal for this conversation to make you feel like a salesperson or like you are bartering with a client over what is most important. There is NOTHING fun about that!⠀⠀
So, how do you talk finances in a way that enhances the pet-parent experience? Let's get into some easy tips that you can implement right now to help you feel less "icky" when talking money in the exam room.
1. Always start by explaining your diagnostic and treatment plan without a cost.
Discuss your diagnostic and treatment plan without numbers first to keep their focus on your plan. Explain the value of your plan in terms of how this diagnostic will rule out ABC and help guide treatment XYZ, and this will ensure the client grasps the importance of what you want to do. This strategy ensures the client has time to absorb the plan first and gives you time to answer any questions the client has for you.
The cost will always come second because the minute you mention cost, the client shuts down. We see it happen all the time because finances have a polarizing effect. The client may be nodding along and completely on board, but as soon as numbers are thrown at them, they lose focus. You will find this simple shift makes a big impact on their understanding and approval of your plan. ⠀⠀⠀⠀⠀⠀
2. Utilize support staff to go over estimates.
This is SO important! By utilizing your support staff to go over estimates, it separates you from the bill. We have both had owners hand us credit cards in the exam room, and that just makes you feel weird. By having your staff go over estimates, it gives the client time to process everything. Oftentimes, clients will be more honest with support staff. They may be more willing to share what they can afford that day, and it also gives the client some time to process everything now that they see what your plan costs.
3. If you have to discuss the cost, it is always better to give an estimate range without an estimate in front of them.
For bigger estimates, we feel it is always best to have a technician go over it first. It spares you from the cost, and clients are often more honest with support staff about what they can do. However, sometimes owners want you to just go ahead and tell them the cost. Other times your staff may not be available, such as on a busy overnight emergency shift, so it may fall to you instead.
If we give clients an estimate, we will discuss a range with them. We find that when the client sees the plan line item'ed out, they start to nit pick it. They will want to know exactly why there are three PCV/TS on there or four injections listed. The range provides you with some wiggle room in case something changes with the patient, and it also allows you to gauge what an owner can do. Some owners will approve your estimate right away, while others will tell you up front they only have $500 that day. We find this strategy keeps us moving forward efficiently and allows for pets to get treatment faster.
Pro-tip: Ask other associates in your hospital for common estimate ranges for specific diseases such as a blocked cat, DKA, CKD, etc, and memorize them so you can perform this step efficiently.
4. After your plan and the estimate have been discussed, answer questions and give the owner time to process everything.
It is important you always ask if a client has any questions about your plan. This allows you to ensure they fully grasp what you want to do and that they understand the value of your plan. Once their questions appear answered, we will give the client some time to process everything. We will say something like "We know this is a lot to think about. I am going to step out of the room for a few minutes and give you time to process everything. I will be back to answer any further questions and discuss our next steps then." From there, you can work together to tailor a plan that caters to their unique situation and budget.⠀
Here is a step-by-step plan to make this process seamless:
1. DVM: Start by going over your diagnostic and treatment plan. Ask if they have any questions and be sure they understand everything that should be done that day. After you have answered all questions related to your plan, let the client know you are going to prepare an estimate for them and that someone will be in shortly to go over it.
2. Tech: Pass the estimate off to your support staff to discuss it with the client. Payment options like Care Credit or ScratchPay can also be discussed at this time. Then, make sure your technician gives the client some time to think over this plan. Give clients 5-10 minutes alone to process everything after they have the plan and estimate.
3. DVM: Head back into the exam room to see if the owner has anymore questions and discuss what they have decided to do. At this point, you will be able to have a frank conversation about next steps since they have had time to process your plan and associated cost. ⠀
The financial discussion is not going to be easy, but it can be made smoother with practice. These four simple tips will be very helpful to you when you first start out, so be sure to save this post and start practicing now. You ability to master this discussion will be crucial to ensuring your patients receive the best care.