February 11, 2002

Copyright 2002 - The Veterinary Information Network (VIN). No portion of any VIN Organized Rounds discussion or event may be copied or distributed without the expressed permission of VIN.

***** Logging started: 2/11/2002 6:50:42 PM
Participants were from Missouri, Northern California, Alaska, and Nevada.

Heather Howell: Last week we had role playing at our staff meeting regarding client service. We picked scenarios out of a hat and took turns being the "bad" client service and "good.” It was interesting how often the words and the information was similar, but how it was presented made a difference. They say words are only 7% of the actual message. The rest is body language and tone of voice. Any way, we practiced with "challenging clients" and it was really fun and interesting.
So, what challenges have either of you faced with clients recently that you want to discuss? GA

Phyllis: Those clients that say do everything to save their pet, and then, when it comes time to pay the bill, they forgot their checkbook.
Laura: We had a "manic depressive" unhappy with all that we did/ and it was more than we would have normally done for a client i.e. picked up and delivered 2 felines

Heather Howell: Phyllis, we'll talk about yours first. Then we'll talk about Laura's, OK? Do you present written estimates before proceeding with procedures?

Phyllis: Yes, we do and we even have them sign them. We have a sign that clearly states we do not bill out.

Heather Howell: The reason I ask is that usually the most important part of dealing with challenging clients is preventing the situation from becoming challenging by having such safe guards in place. So, when some one forgets their check book what do you do?

Phyllis: Sometimes, we will hold the medications while they run home to get it - if that is truly the situation.
Laura: Yes we will also withhold meds

Heather Howell: Have you tried scheduling "pick up times" over the phone when their animal is ready and telling them at that time what the final bill is, which would tend to bring up any questions they have. Such as, "Fifi will be ready to go at 4pm, can you come in for your release appointment at that time? Ok, and I'd like to review the final bill with you so we can cover any questions and you'll be prepared for it when you come in."

Laura: That is a good point and I don't think to do it often enough
Phyllis: That is an excellent suggestion. I haven't quite worded it that way.

Heather Howell: That could also help clients who have every intention of paying.....some times it's nice to have your check ready rather than deal with that at the counter. Trust me, with two kids to bring with me, I'd rather write my check at home and just hand it over the counter when I get there. That could also help when clients say, "Oh by the way, I also need a bag of dog food. Can you add it to my bill" Then you can have it ready for them. I think discussing it in those terms, as if you're trying to help them, makes it easier. Then you don't feel like you're just focusing on the money.

Phyllis: We have scheduled discharge times but haven't mentioned the money when we called them. That's a good way to phrase it because people won't accuse you of just wanting your money.
Laura: When you say "review" the bill do you just start reading the charges off the invoice?

Heather Howell: Money is one of the biggest client challenges. I would probably tell them what was done and then give them the final amount. For example, I'd say "It looks like we gave Fifi her anesthetic, did the surgical procedure, had an antibiotic injection, are sending pain relief home with her and antibiotics home with her. That comes to $500. Any questions I can answer for you?" Some thing like that.

Laura: I'm always worried of sounding too much that way and had a very bad experience as a client in another vet office that sounded so money mongering it made me sick when my dog was dying
Phyllis: What is your response when they say they didn't expect it to be that high.

Heather Howell: Laura, that's why you have to be careful of your focus. Your focus should be informing the client what was done and then for their convenience letting them know their final bill before they come in. Not this was $10 and this was $40 and so on
Phyllis, when they didn't expect it that high..."Oh, did the doctor give you an estimate?" If yes, How much. If it is higher than the estimate, "Well, I can see why you're concerned, let me \check with the doctor and we'll call you back." An attitude of, Let's find out what happened.....If no estimate, then I say, "Let's have you talk with the doctor so you understand what was done and then we'll see if the bill is clear to you." Does that answer your question?

Phyllis: Yes, it does, thanks!

Heather Howell: Let's answer Virginia's question and then move back to Laura's challenge.

Virginia: I'm afraid we've created a "monster" at our clinic by giving an indigent client too many breaks on exam fees and medications (even going so far as to ask our Pfizer rep if he had any Rimadyl samples. Well, we've used all the freebies and this client is mad at us now because we charged him for the next refill. Any kind approaches?

Heather Howell: Any one? I would talk to the client in a room, let him know you have gone out of your way to help, asked the Pfizer rep for help and that now you must charge for the medication. Unless your veterinarian wants to give it to him at cost or a discount you don't really have a choice. All you can do is express concern and be honest with him.

Laura: This is a situation our small staff experiences when we are sometimes too generous at our employers expense. He usually bites his tongue and doesn't say I told you so.
Virginia:Well, my bosses OK'd it to start, and now is regretting it

Heather Howell: I guess it's the same as my answer to Phyllis, prevent the challenge in the beginning. If you choose to do some thing nice and bend the policies for the pet's sake then set up the ground rules in the beginning. Let the client know that you will give him as many samples as you can arrange but when they run out you will have to charge. When you bend a rule, explain to the client that is what you are doing. Make sure they understand that it isn't forever and that you are doing all you can for them.

Laura: Yeah,, years of that hardens them up pretty well/If it were my business I'd be broke- Anticipation of consequences Heather?

Heather Howell:Anticipate the response the client could have and try to cover all your bases before it becomes a challenge. It is great for us to be benevolent in this field. We are the ultimate pet stewards and some times we have to reach out and help those who can't afford care but you do have to set limits and stick to them or you can't continue your business.

Laura: I believe I have thwarted nasty situations by fielding that new client/new pet emergency/no money call first

Heather Howell: Good point. That's a common area where problems arise. Laura's challenge was a client that is unhappy even though you went out of your way and did more than you usually would. Care to expand on that so we can get input from Phyllis and Deborah?

Deborah: What I usually do is explain to the client that we try to help as many animals and people as often as we can, and always like to help as much as we can. However, we are a business as well as an animal hospital, and have bills to pay like everyone else. If we only provided services at no charge, we would not be able to stay in business, and would therefore not be able to help anyone. I always make eye contact when saying this, and it works for me (so far).

Heather Howell: That's an important message for people to hear and understand.

Phyllis: What do you do with the client that always has a hard luck story and no money. They try to make you feel bad for not allowing them to bill out.

Heather Howell: Offer Care Credit, ask them if they can borrow money from a friend or family member, ask them if some one they know will come in with a credit card to pay on their account and they can pay them back. Suggest they go to animal control to see if there is funding for services for low income, etc.

Deborah: Does anyone offer to hold checks for clients?
Phyllis: We do for our long time clients. Never on first time clients.
Laura: Yes I had never heard of this before working at a vets/Works OK for us. We would not use a sheriff department but a collection agency

Heather Howell: That's another alternative. People like to say "it's illegal". It's not illegal to hold a check to be deposited later. They should not post date it, you should hold it. But they can't be handled the same way as a check you aren't holding. They become a promissory note rather than a normal check. So if it bounces the local sheriff won't pursue it the same. If you hold a check, still have them sign a payment agreement. If the check bounces, that makes it easier for the collection agency if they go to court.
Let me say some thing about Laura's issue. Clients that seem unhappy after you bend over back ward....What I say is to ask them "what could we have done differently" Or "what more can we do" and to really listen. Often they just have some thing they want to say or get off their chest...If you listen and empathize, you generally don't have to do much more. They just want to be heard.

Laura: I agree Heather Kindness and listening go a long way in this business! Thanks for the tip

Heather Howell: Look on the rounds page of the website for dates and times of upcoming chats! Thanks for coming and good night all.

***** Logging stopped: 2/11/2002 8:02:05 PM Participants: Phyllis, Deborah, Laura, Virginia