CAUTION: Long rant in progress.
No this post is not a continuation of yesterday’s post on animal cruelty––nor was it intended as its corollary. Rather, today’s is a completely standalone rant on the subject of how some clients come to abuse of their veterinary care provider’s kindnesses.
I’ve posted here before on the subject of financial stress in recessionary times and how veterinarians are not immune. After all, we swim in the same economic waters the rest of you find yourselves in:
Our practices are less busy. Our transaction per client stat is way down. Our incomes are lower. And our expenses are higher. Its enough to make some of our practices wonder, week-to-week, how we’re going to make payroll.
Amid all this woe comes the inevitable stress: clients who can’t pay for their sick pets’ care.
It’s a completely understandable problem. Now that business is down, I rely on my sideline writing income to pay for my son’s braces, allergy shot co-pays and my own animals’ impressive expenses. “Basic” stuff like this I’d be hard-pressed to pay up on in a timely fashion in this economy if I waited for my veterinary paycheck to make it happen.
Still, I know I’d find a way. There are credit cards I could apply for, family loans I might seek, the daily stop at Starbucks I could skip. I’d manage somehow.
I feel for my clients. That’s why I’m offering discounts when they’re needed, using technician down-time to accomplish low-overhead tasks at a pittance of what they normally go for and generally try and work with my pet owning people by offering CareCredit payment options (essentially a credit card) and formulating payment plans in some special cases.
Yesterday’s clientele was no exception. When four morning clients decline the diagnostics I deem their pets require, you know it can’t be good.
It’s especially troubling given that most of my clients are not the jobless and foreclosed on. They’re upper middle-class––which in Miami means they still drive new model SUVs and buy Coach handbags instead of Gucci when the going gets rough. In other words, they’re like me. They still have some discretionary income to spend, in spite of the recession. But they’re also a bit like me in that they’re all a little scared. And they’d rather not spend if they don’t have to.
That’s where the story gets interesting. Because this post is not so much about clients who have selected their limits and refuse to spend on their pets. They’ve got their own priorities in order, after all, much though they’re not mine. No, this post is more about those who would run up a bill and run out on their payments.
Well...not exactly. They’ve all promised to pay. But only after getting their estimates, agreeing to services and crying poverty when it’s the front desk’s turn to collect. Literally crying––at least in one impressive case sourced from yesterday’s morning line-up.
Instead of paying as they’ve promised, they’re passing bad checks, post-dating them, offering serially declined credit cards, even throwing them at us when we refuse to see their next pet until their previous balance is paid down.
They cite their recent move, their aged parents’ ailing health, their high stress levels and their children’s expensive schools. Like that’s my problem.
Worse yet, they call us insensitive, abusive, unfair, cruel, money-hungry and penny-pinching. As if collecting on an unpaid, $800 outstanding bill constitutes “penny-pinching” on our part.
Some bounce check after check (for routine care!), and still they drop off their strays by the back door for low-cost spays and neuters with nary a rescue organization certificate in sight (with which we pay for a modicum of our expenses). Then they whine and count the years they’ve been coming to us when we say we can’t support their stray-collecting habit or their good works, whichever the case may be.
Another long-time client leaves a stray cat in our care for weeks(!) when her mother heads to the hospital. She never returns the calls and shows up with another stray and another bum credit card––after bragging that she’s moved to a new tony address. When asked to pay or else no kitty-cat services on the new one, she looks me in the eye and says it’ll be on my head if we lose her business.
It happens almost every day. And it’s enough to make me decline the next charity case, offer no discounts, negotiate not at all and act like a corporate hospital instead of the humane family establishment we’ve always been so proud of.
The older I get and the longer I’m in this profession, the more I see the foul side of this business. But I know the abuse will never stop as long as I let it get to me. And the only way to manage that? No exceptions and a cold heart when it comes to cash. Pay up front, put up or shut up, and take your business elsewhere if you don’t like it.
It’s stressful enough to make a veterinarian with any sense of self-preservation start to wonder whether it’s worth it at all.
Some get stressed and yell. Some commit suicide. Some turn their hearts to stone. Me? In a couple months’ time I’ll be three-daying it in practice. Because writing at home may not pay as well, but it sure beats the hit to my sanity and the threat of cold, cold heart.
Do you blame me?
Add Comment75 Comments
I just switched to a new vet. Before my first appointment, I had to pay in advance for the basic appointment before they would even put me on the schedule. And this vet has been listed as one of the best vets in the country. YOU HAVE TO SURVIVE. In fact, there is nothing wrong (and we already know that PJB is going to say you owe it to the world to work for free, so just ignore it) with expecting people to pay for your labor, knowledge and experience. There is no excuse for committing fraud and criminal acts like passing bad checks and paying with canceled credit cards. There are laws for that. Start asking for payment up front. DO IT. If my clients paid me what I was owed, I would be debt free and stress free, but I barely get paid half of what we earn -- because getting it all up front just isn't feasible. And my clients do the same thing, driving nicer cars than we do, going on more vacations, wearing fancier clothes and making more money. But when I ask to be paid, they cry poverty. Well, if you drove a Civic instead of a Hummer or a Navigator, you might have some money to pay my bill. If you bought your clothes at discount stores instead of paying for $700 shoes, you could pay for that procedure. Priorities, my friend, priorities.
Susan August 20th, 2009 09:44:43 AM
What the hell is wrong with people? These same people likely don't eat a restaraunt and walk out on the bill or get to the checkout at Walmart and cry poverty and expect a discount. Why do they view veterinary services as something they are entitled to without paying or paying the full cost? My vet got where they often would bill me, especially when my last dog was euthanized, but that was after going there for a number of years and they knew I would pay whatever was necessary to take care of my animals. I have given up plenty of my own wants in order to pay for care for my dogs. Unfortunately, I think the only choice is for your practice to become more hard-line until you know a client is good for it.
Di August 20th, 2009 10:02:42 AM
I have no coach handbags and no gucci either. I drive a not-so-new-Corrolla. I consider all those trappings (Coach bags and new model SUVs) a waste of $$, not my pets care. Even if I had more money, I really doubt I'd choose to spend it that way. Which is not to say that I might not find myself in a position where I literally could not pay, because that's not inconceivable, but it won't be because I've spent too much on luxury items.
Given the trappings you cite (designer handbags and new model SUVs) I'm betting your typical clients rake in more bucks than many people who manage to pay their vet bills, they just have different priorities.
Got a call from a friend last night about her dog, who is being treated for cancer and now has been hospitalized for acute pancreatitis. She is reeling from the cost, in part because he is being treated at the best local vet hospital which is also one of the most expensive, if not THE most expensive. I think sometimes they really do pile on the charges (they charged her $40 for moving her dog from one room to another . . . ). On the other hand, they are one of only three local hospitals I (guardedly) trust in terms of quality of care. They saved my Toonces life after he was overdosed, and the neurologist there at least told the TRUTH in the vet board hearing (which is more than many would have done, most would probably have found a way NOT to show up to avoid having to either tell the truth and implicate a colleague or lie and protect him). The have most of the best local specialists and the most cutting edge treatments. What price is the peace of mind knowing your pet is in the best possible available place? Is it worth being possible gouged a little bit? I'm talking about middle class people here, not people with Gucci bags.
Stefani August 20th, 2009 10:05:26 AM
OK--add one more to the list. I just handed a client a $156 estimate on care for a sick stray kitten. She agreed. My receptionist just informed me she paid HALF. Then walked out with a wave of the hand––as in, 'talk to my hand because you're not getting any more tan that'. I think I'm going to be sick today, I can just feel it.
Dr. Patty Khuly August 20th, 2009 10:16:42 AM
"Another long-time client leaves a stray cat in our care for weeks(!) when her mother heads to the hospital. She never returns the calls and shows up with another stray and another bum credit card––after bragging that she’s moved to a new tony address. When asked to pay or else no kitty-cat services on the new one, she looks me in the eye and says it’ll be on my head if we lose her business."
What a ...... ah, there are so many terms I could use and I can't select just one, so you can each pick your favorite.
Losing business like that shouldn't worry you. There are so many cases where the customer is not always right, and even though you feel for the animal, you can't deal with morons as if they weren't morons. While good clients may be cutting back, they will come back to full strength (so to speak) when they can, whereas morons were never fully contributing and never will.
KateH August 20th, 2009 10:27:25 AM
I think Stefani is correct--your clients have their pets on a different priority scale than their stuff. We are seeing more and more people declining stuff--that bordatella vaccine for the dog who never leaves home, the annual blood testing on seniors, maybe only 3 months of heartworm preventative instead of a year, that sort of thing. We are also doing a LOT more payment plans with really GOOD clients, and trying to do little things for free (I stopped charging for nail trims with exams) because all of us are in the same boat as you've said.
We do get the occasional person who wants a free ride, but I think we tend to weed these out before we get too far down the road, or maybe our average client just has a different order of priorities.
I'm sorry you're going through this--those little knife twists do add up and make you wonder if you should turn elsewhere...but when you get someone else who does recognize you're going a little extra for them and they are grateful for it, their kind words can go a really long way too.
drsteggy August 20th, 2009 10:35:48 AM
Maybe the next time one of them refuses to pay you could suggest she pawn her gucci bag to cover the costs. ; )
Money makes people do strange things. Being rude, refusing to pay your bills, or knowingly writing a bad check/ giving an invalid credit card are not appropriate behaviors. I think people got so used to the good times of endless credit and instant gratification when the economy was good that they just can't cope with it now. It's humbling to suddenly not have the money to support your lifestyle, and some people don't deal well with it.
It's perfectly reasonable to refuse service if someone has repeatedly failed to pay or has been irresponsible. Let them go to another clinic and try the same thing. Chances are that it won't fly there either.
Posey August 20th, 2009 10:41:19 AM
Such outrageous behavior. Walking out on bills after accepting an estimate? Threatening the "lose my business" line when they can't pay their bills?
It's frustrating from here, where I'm soon-to-be-unemployed with a hyperthyroid elder cat and a CRF/diabetic one, too, along with two youngsters. I have never skimped on their care, and they have had vet visits prioritized ahead of my own visits to the doctor. Now I wonder if affluent but choose-not-to-pay clients are going to spoil any chances of my vet working with me if it comes down to the wire and one of my cats needs care.
Kind of like the folks who overextended themselves buying McMansions and SUVs, and they now expect to be bailed out when I bought a little house and a little car to try to live within my means. The responsible folks somehow suffer for the behavior of the irresponsible ones... at the vet clinic, too, I'm afraid.
Feline August 20th, 2009 10:54:55 AM
Couple of things, Dr. K.
First, I'm terribly sorry you're experiencing this type of burnout. Secondly, I'm embarassed on behalf of pet owners everywhere who have given up EVERYTHING to be able to pay a veterinary bill, fallen over their own face trying to express just how grateful they were that the vet would agree to treat him at all, and sending them every spare nickel for six weeks until the debt was paid - followed by some flowers and a thank you card.
We had Fable and Juno at the vet yesterday with what I felt was great success. In, out, no concerns, no worries, no illness, one rabies vax and some dewormer - and I THANKED him when the bill came. $129CDN. In my own city the appointment plus rabies is just over $100 - before taxes! I have a level of trust with my vet, and I know that they will do the best they can by me in most situations.
The downer of the evening, however, was watching THREE seperate people bitch about their bills. One, an older dog with a Surolan Rx, the second received an estimate for "can't walk and is trying to bite everyone" and the third was bringing in a kitten for a routine appt.
It was all I could do when we got our post-visit coffee not to turn around and bring the whole staff a treat.
What is WRONG with people??
Kim August 20th, 2009 11:20:21 AM
Sounds as though you need to take a different approach to dealing with your client base-to maintain and increase income, and to obtain payment. Staff training, better presentation of recommendations, better attitude in general for all, etc...It's amazing what can be accomplished, even in difficult economic times. Using the economy as an excuse for all of a business's $$ problems just doesn't cut it with me. While the numbers of folks who can't afford even basic care might increase, there will always be people who have to say 'no', and with regret, and there will always be those who try to get something for nothing. And sometimes, you'll find that you can even 'turn' those who prefer to choose to spend their discretionary income and find some of those dollars coming in to you. Harsh message, but getting creative and thinking out of the box is good and wise business all of the time. Otherwise you just sink along with the other less resourceful businesses. At the end of the day, I wonder how many of your clients are accepting and paying for your recommendations. Maybe by starting there you can see how to ramp up your success rate.
Renee August 20th, 2009 11:24:28 AM
I too, am puzzled by the way people treat vets. Our vet is a very nice man. He works with a lot of our rescue animals, cuts me slack when he can, and the few times I've needed to wait for a paycheck to come in, waved his hand and said "Pay when you can". I watch people come in there and treat him like garbage. They refuse to pay, or promise to do so and never come back. They berate him. They accuse him of cheating them. They drive up in BMWs with $2,000 purse dogs and then raise Cain over the price of a rabies shot. They declaw their cats and then freak at the expensive of dental cleaning. It's really disgusting to me. I thank him often for being a very kind person and helping us when he can. I just imagine how much it would cost me to go to the hospital and have similar surgeries done, and happily pay my $300-$400 and shut up!
Jennifer August 20th, 2009 11:52:19 AM
Renee: I'd say about 50% of our business is completely unchanged. In fact, I just extracted two fractured molars (big 'uns) from two separate patients whose owners were willing to go the full nine yards on the care. But the others just leave me cold. Why do the annoying and stressful experiences have to take up so much of my energy? Needing some Buddhism right about now. That, and a new set of policies with respect to payment. Lots of the frustration comes from not being the one in control of setting those.
Dr. Patty Khuly August 20th, 2009 11:57:24 AM
Sounds like you need to switch into MBA mode. =7
Practically seeking, you cannot be compassionate if you are burnt out. Therefore, it's time to make some policy changes regarding payment IMO. Perhaps think of it like an insurance agent -- how likely is this person to walk out without paying in full? And then refuse service until the bill's paid. You could probably put sticky dots on the file folders of these scuzzy clients. "Sorry. We have a new policy that requires up front payment in full for clients that have taken advantage of our compassion in the past." They can take it or leave it (and undoubtably if they choose the latter, they'll try to take advantage of another vet).
Equanimity. I'll say it again, you can't be compassionate when you're burnt out. I truly hope you get that spark back as soon as you can. =) Perhaps through continuing your volunteer work, with patients you know are truly, truly needy.
Julie in OH August 20th, 2009 12:43:42 PM
The economy sucks. And I suspect it is going to get worse. Many people have probably never seen it this bad. It doesn't excuse bad checks and lack of payment. But then look at the statistics on the congress and their history with bad checks and lack of payment. Interesting examples of leaership to say the least.
if money is tight what I don't understand is why people simply don't differ the unnecessary things until cash flow problem is solved, or do some of the lighter things themselves.
either way, it's lose/lose for everyone. including the pets. sad but true.
But did you REALLY get into vet medicine for the money?....cause....
LorriM August 20th, 2009 12:43:55 PM
I don't miss this aspect of veterinary medicine and managing a clinic at all! I'll jump in and offer some "Buddhism" :-). I'd recommend focusing on the 50% of your clients that are willing to go all the way for their pets, and work on getting more clients like them, rather than spending all your energy on getting frustrated with the other 50% who don't put their pets first. Wouldn't you rather work with those A clients anyway? I'm a firm believer that we attract what we focus on into our lives, so why not spend more time focusing on attractinging new A clients rather than worrying about the less than desirable ones that drive you to distraction and make you question whether this wonderful profession you've chosen is worth it all. You're not going to change the 50% that are walking out on bills, won't pay their bills, and lie to get what they want.
And by all means, suggest revised payment policies to your owners. Maybe the time has come for veterinary practices to adopt the model we've seen with physicans for a long time now. You pay before you even see the doctor. Granted, in human medicine, in most cases, it's just a co-pay, but why not have set fees for routine visits such as annual exams, vaccinations, etc. and collect those fees at the beginning of the client visit.
Ingrid King August 20th, 2009 12:49:10 PM
I know you were probably so frustrated that it wasn't funny, but when I read of the client who said "it'll be on my head if we lose her business," how did you keep from bursting out laughing? To me, business is when you get paid for doing something-not freebies!
I'm sorry you have to deal with such an overload of idiots. I love hearing about your work, but boy oh boy, I couldn't deal with the people side of it at all.
rheather August 20th, 2009 01:28:55 PM
Just for Susan's edification... I drive a 1999 Ford F-150 with 125,000+ miles on it. I do have 3 homes and the total I paid for all 3 was less than $160,000 and it was all in cash. Don't think I've ever paid more than $12 for a purse. Brought home a stray last week and promptly ran her to the vet. They gave me a discount but I didn't ask for it. She'll be going back for a couple of grand in work too. (BTW, the local rescue offered to let me take her to their discount vet and I declined.) I've often taken foundlings in to vets and paid full price over the years. I have had one outstanding vet bill over all these years which was for a script of my son asked to have mailed while I was post stroke. I think it was about $16 and I was mortified. We've had our ups and downs financially just like any family and, when we can't afford it, we don't go to docs (human or animal) and it's because one is always accused of being a deliberate deadbeat for even asking for a hardship discount, so we do without. Susan, bite my you know what. Clearly you haven't actually read my past postings so I'm guessing you didn't get that far in this one :)
And I learned to get by on very little because I generally couldn't collect from my clients either since I took on the family law clients who hadn't a pot to piss in. I was able to fund my office with Bankruptcy which are always payment up front and I did those at half the going market rate at the time by being efficient, again for people in desperate circumstances and who often needed additional court work that I knew was coming and for which I knew payment wouldn't be. However, I became an accountant and a lawyer to help people and anything beyond a basic living was gravy in my book. But I sleep quite well at night knowing how many people (and animals) I've helped.
Been a while since Dr. K brought up the legal issues but I'll always be much harder on lawyers than any other professionals, including vets. I don't begrudge doc a general rant of frustration on this topic, only object when she appears to be getting a bit too jaded :)
And now I'm going to go spend some time cuddling my brood of 6 fur babies and try not to even turn on the computer for a couple of days. Poor me, woe for the poor vet... Enjoy the self/vet pity party y'all!
PJBoosinger August 20th, 2009 01:42:00 PM
I have to admit, there are some situations where working for a corporate chain is a plus - and this is one of them. First, doctors don't set prices - corporate does. There are things we can do to shave the bill down if needed (usually by removing hospitalization or staff time charges), but the bottom line is that everything is very specifically inventoried in the computer system and tied directly to both the medical records and invoice - if you end up giving something free of charge, you have to note in the medical record that you did so because there will be no record of the service. If you make a habit of giving things away for free, corporate will eventually notice and put a stop to it (and rightfully so). So, things cost what they cost, and the doctors and para staff don't have to shoulder the guilt of feeling like they overcharged for something or shouldn't have charged for something, etc. We don't do payment plans at all, and I'm so grateful for that. It's just a can of worms that doesn't need to get opened. The 10% of clients that are trustworthy enough to follow through simply don't make up for the 90% that would screw us over...and the fact that it's clinic policy (and not doctor discretion, ever) means that the policy is fairly applied. Again, no feeling guilty because you don't trust the client enough to offer a payment plan but can't say so to their face, no guilt that you let the practice down by making a bad judgment call if a client you vouched for failed to honor their agreement, etc. Clients are told payment is due the day services are rendered, and they are given a to-the-penny estimate (with verbal agreement if the client is staying for the length of the appointment or signed agreement if they're dropping their pet off) before treatment is initiated. If they tell us ahead of time they're having financial difficulty, we work with them to only do what they can afford that day. If they abscond on their bill, they get sent to collections. Period. Sure, we probably have a lot of potential clients who end up going elsewhere because of our policies - and that's just fine by me. I don't want their stress, and I don't want to watch their animals go without care because the owners can't or won't pay.
anna August 20th, 2009 02:16:53 PM
Dr. K: Of course that is completely outrageous! Unfortunately, a heck of a lot of people got lulled into this "I'll have money forever" type thinking with a roaring economy. I have been through a few recessions, and remembered how they felt.
As Stefani & I have said previously, "it is a matter of priorities". Sure , if we didn't have multiple pets or valued medical care...she would be driving a sports jag and I definitely would have a new Mercedes wagon! As it is, I bought my car used and it is 8 years old! I plan on having it another 8, just like my '95 Subaru backup car. Anything "nice" I have to wear is a gift or hand-over.
And yup, to continue on yesterdays topic, "what happened to Pocket" was in 2006, a point when spending by towns & the state was reaching all time highs. Taxes climbed by double digit increases. My salary actually went on the decline. Could I afford to be scammed (just like you) for $3700 ? Hell no, not with an IVDD surgery for Pearl for $4000 and at least matching $4000 on Dottie's well-being & eye care for her last couple of years.
It's morally wrong, but we are in a society that says "me first & screw you!", although I think things really are turning around.
Would I spend every nickel to achieve justice for Pocket, yes, I would. She was that important to us. The hell with the fancy clothes, cars, and furniture.
PJB: Would you kindly take a peak at my last blog , unless I am misinterpreting the state statutes, a lot of lawyers spouted a lot of BS to me about rules of the court. And I can't help but wonder how they are making so much income, to be fussy about "hourly" cases ??? Or is it fear??
email: walnuthl@gsinet.net
Barbara A. Albright/NH August 20th, 2009 02:23:16 PM
PJB: You had to come and crash, dintcha. And we were all having SUCH a good time. ;-)
Dr. Patty Khuly August 20th, 2009 02:26:04 PM
Clients who won't/don't pay and won't/don't get needed care for their animals are sickening. I see the parallel to that day in and day out, hour after hour, at the large urban shelter I work at. People dumping animals for paper-thin reasons, trading them in for others (unless I'm in place to block such an adoption; unfortunately staff doesn't do that much), griping about the already low cost of adoption fees with built-in s/n/vax/chips, rescuers who use up space and good will treating the place like a free boarding kennel.
If I had the power, these people would be shown the door and banned, animal-less. Their whacked out sense of priorities and cheapness makes them the kind of entitled/deadbeat/cold-blooded clients Dr K is talking about.
Gah, but they are legion.
oh holland August 20th, 2009 02:30:23 PM
oh holland, Believe me, I feel for you. I saw that for years (in good times) running a rescue program. It is ALL about priorities, plain & simple.
I forgot to add to my above post: A comment to NH or New England Vets--- how on earth can you on one hand tout senior wellness exams & care to discern underlying disease and then on the other-hand say "oh, yep, 9 phosphorus soon to be 18 ....oh, sure that is treatable and your dog will go home.."
That's right, I guess that depends on one's meaning of "home". This belongs on yesterdays blog.
Dr. Khuly, It is just plain wrong & you can never, ever judge by looks and possessions. I learned that over & over.
Barb A./NH August 20th, 2009 02:54:10 PM
Really Dr Patty, you are doing these people a favor when you insist they pay up front for services rendored. It's called "economic education" :) and people like them who didn't understand that are why we are in this mess.
I would suggest, on the side of "positive reinforcment" that you set up a rebate program, maybe a free check up visit for clients who pay up front and on time for a specified number of visits. Call it a good customer reward..whatever. I think it'd be a nice treat for you and your staff to focus on doing a little extra for the clients like that.
Wendy August 20th, 2009 02:57:55 PM
But did you REALLY get into vet medicine for the money?....cause....
LorriM August 20th, 2009 12:43:55 PM
No, I'm sure Dr K didn't become a vet exclusively for the money. She didn't become a vet to be ripped off and made a fool of either. Unfortunately people like the low lifes she's dealing with presently can colour our whole attitude towards (all) people.
I speak for myself now, but as far as extending people credit anymore, they're pretty much guilty until proven innocent. 20 years ago, when I started in business, I expected that people would pay their bills (as I would), now I know differently. I resent these people for changing my attitude, how dare they!
Oh and may I be the first to nominate PJB for her well deserved sainthood !
Alison August 20th, 2009 04:23:49 PM
PJB, Susan was making the point that you would likely say that Dr. K. should treat animals for free - and you did make a snide point about how YOU helped people without expecting payment, knowing you went into your profession to help people (as if Dr. K. didn't) and tied that in with a comment about not wanting to hear Dr. K. when she gets jaded. You do have a bit of a superiority complex about professionalism, and trying to juxtapose that with your personal life of being an animal lover is what sometimes gives people a perspective on you that I'm sure you don't mean.
KateH August 20th, 2009 04:37:13 PM
My husband and I are headed 200 miles from home with our two rabbits to see a specialist. One needs a routine physical, the other is going in for a molar extraction and trim. (It's bad. She's been on antibiotics for a bit already.)
We did not ask for an estimate because we've been through this enough times to know about how much this will cost us. We also know about how much it costs our vet, both financially and emotionally. (The bun with bad teeth has coded twice on his table.)
I don't see how people think they can get away with not paying for services rendered. It's asinine.We take pride in the fact that our vet have never had any issues with us and billing. No matter what. We know we're going in there with two bunnies and may only come home with one. But hang it all, our bills are always paid.
Kathleen August 20th, 2009 05:27:50 PM
Dr. Ingrid, I'm going to have to disagree with you about which 50% of the customers that you want to go after.
If you're providing a consumer product - say, electronics - you can choose to go after the high end of the market without hurting anyone. You can pick and choose who you service, and you can turn away a customer that you'd lose money on without any consequences.
Unfortunately, as with human medicine, we're dealing with the well-being of a thinking, living, feeling creature. Where do you draw the line between ethics and business? Do you provide the service, but hold the animals (which are chattel in our legal system) hostage until the owner pays at least the base cost of the services? Do you demand proof of the ability to pay while you've got a sick animal in pain on the table? If you're anything like the vets I know, the animal comes first.
Patty, I have a few business processes/resources that might help you. If you'd like, get in touch with me, you know how.
Karl Katzke August 21st, 2009 03:28:57 AM
I had a client in yesterday whose cat needed bloods for a suspected hyperthyroid, which is beeing half funded by our RSPCA and half funded by his soft-hearted sister because he has no money. I asked the client to leave the consult room as his cat was aggressive and needed firm restraint. He said "I'll just go get a pack of cigarettes."
Priorities?!?!?!
melvet August 21st, 2009 04:48:41 AM
I want to know if these people who cheated on you can still do their job.
There is no excuse for cheating anyone of proper, agreed upon, charges. It a thing called character. But then we as a people decided that character doesn't matter as long as THAT man can do his job.
Currently real unemployment is running 20-25%, we just don't count those who have fallen off the back end and don't get benefits. Where I work we have a 50% layoff and I am on a voluntary 20% reduction. (Which gives me time to to be a vet voyeur).
Not too long ago there was a post on employees that were not showing their due respect. So if you haven't laid off 25% of your staff in order to make ends meet, you are doing more than your share of propping up the economy, and being compassionate.
"Priorities". By adjusting your business priorities you can reduce your financial stress.
But I suspect we have to just suck it up when dealing with "those who can still do their job" ;-)
Bob Jones August 21st, 2009 09:54:42 AM
Karl Katzke - thanks for the promotion :-) - I'm not a veterinarian, just a former hospital manager.
I do agree with you that it's not quite as black and white as I depicted it in my response. Of course, the animal is always going to come first, and in emergency situations and with very sick animals, it does become a tug between ethics and business, and only each individual veterinarian's conscience can determine what to do. I do, however, think that even in a service business, and even in a business such as veterinary medicine, you CAN choose who you work with (well, at least you can if you own the clinic), at least most of the time.
Ingrid King August 21st, 2009 10:39:51 AM
PJ -- and you can bite mine, because your presumptions and assumptions are so misguided and arrogant. Choosing to dedicate one's career to help others is one thing, being swindled is another. A person should at least have the right to decide who will be the beneficiary of their assistance. As pointed out by Dr. K, she and her clinic do a great deal of work at discounted rates, for free or on credit. Can you walk into a bank and help yourself to a loan? Obviously not. But that is what these people essentially have done. Second, you assume that my husband and I do not do substantial work at greatly reduced rates or on payment plans for clients in distress. That assumption is wrong. Ironically, I find the people who have the least are the most likely to make good on their promises. We do lots of family law, and those are the clients who make far more than we do, and walk away from five-digit bills without a second glance.
Oh, I do read your posts in their entirety. When this subject last came up, you defended the individuals who ran out on their bills and/or passed bad paper and excoriated all those who suggested that their actions were improper or that any action against them should be taken.
Susan August 21st, 2009 11:47:29 AM
Bob Jones: That is the first real serious post you've written! Not that your others are less interesting.
I too suspect that the unemployment figures quoted everywhere are artificially "low". What part of the country are you seeing this??
Barb A./NH August 21st, 2009 08:41:31 PM
Because I work for a nonproft foundation that tries to help with the cost of veterinary care for struggling pet owners, I can really relate to this post. I know veterinarians I work with feel burnout/emotional fatigue in situations like this. There are many who are truly in need, and veterinarians often go out of their way to help these families and their pets. There are probably just as many who want a hand out because they feel they are owed it. Many who demand 'a break' are able to pay their bill; they just don't want to because their pet is not as important as other things in their lives.
I know that many abuse the good nature of veteriniarans - who put their patients' needs first always, often to their own detriment. No one who knows anything about veterinary medicine would accuse anyone of doing it for the money. Veterinarians and their staff are greatly underpaid when compared to their human medicine counterparts, and they take on so much more of the emotional burden. They love animals! That's why they decided to devote their lives to them. They are greatly affected by their suffering.
Veterinarians are the good guys (and gals), just like Dr. Khuly. Imagine a world without veterinarians - if no one could make a living at it. I, for one, wouldn't want to live in that world.
Tamara August 22nd, 2009 12:40:59 AM
I take care of many cats ,house and ferals/strays, and am always amazed at the IMO low cost at my veterinary practice and the incredible superb value/peace of mind I receive in return.
Many times my bill is less than $100.00 for an exam plus drugs for one of my precious critters. And I always feel so good/incredible thankful to the veterinarian and their staff for their invaluable training when my pet shows great improvement afterwards. Basically priceless.
My husband and I cannot afford our own care but do find veterinary care affordable for our beloved critters.
Compare those fees to human medical care and getting passed around from specialist to specialist. Vets do it all, primary care, dental care, eye and ear care etcetera, multiple animals, all different species , really quite amazing..
Or even compare veterinarian fees to a car mechanic/plumber/electrician etc when receiving quite often inferior expensive service/repair...
My veterinarian clinic does not take credit cards. Only local personal checks or cash. And as of last week is very busy.
Never did ask them why no credit cards. Suspect it is easier to take a bounced check offender to local court . However, I personally would be mortified to write a bad check. How could somebody go back to a business that they wrote a bad check to. Beyond my comprehension. So embarrassingly. Same as stealing.
I personally could not afford a multi thousand vet bill for one critter(have too many dependent critters so have to ration ) but I would never ever expect the vet. to do it pro bono..
I do know that the owner of my vet hospital very secretly does spay/neuter ferals at no cost(am part of a TNR group) because his customers would otherwise expect the same.
If I ever win the lotto, my first step would be to pay off any educational loans of my local vets, vet technicians.
I can dream a little, can't I. Dr Khuly you are very much appreciated and so are many other unmentioned vets.
If human health care could be run like the average local veterinarian office, we would be in great shape in the USA.
Marjan August 22nd, 2009 06:08:44 PM
"When this subject last came up, you defended the individuals who ran out on their bills and/or passed bad paper" I'm fully aware that some read it that way even though that is NOT what I wrote. And Susan goes on my "scroll past" list... I'm past bothering to argue with those who don't read what is actually written.
PJBoosinger August 23rd, 2009 09:02:15 AM
Barb, I'm slipping! I am in the Intermountain West. We are supposedly the least hit by it. Nearly half the people around here have government jobs.
Oh I can be serious, but too many people already take themselves too seriously and I don't need to add to that. On the internet people seem to think that every opinion is equal. It just ain't so. My opinion is worthless. At least that's what the prez says.
I hang around because Dr. Patty has a goat and is learning about it, and I have three of them and don't know a thing. So if the topic isn't goats I feel like the bored sixth grader blowing spit wads. I actually got in trouble at my daughter's back-to-school night. They were going to give ME detention, but really didn't want me back.
The goats have saved my life though. Six months ago I was walking with two canes because of back problems. Training these goats has forced me to get out. A couple weeks ago I took them on a three mile run with a three mile hike back. I am planning to pick up two older goats next weekend so they can actually carry stuff and we can start doing overnight hikes.
I actually just started my own blog a couple weeks ago where people can harrass me directly. When I am in my ascetic monk role I write about sensus plenior revealed by uncovering word play and riddles in Hebrew and Greek. And keeping the goats lets me pretend that I have a congregation. ;-)
Bob Jones August 24th, 2009 01:53:07 AM
Bob, So where's your blatant self-promotion? Link to your blog please! You and Barb and I can do a round robin of harassing each other :)
PJBoosinger August 24th, 2009 07:10:15 AM
Well the articles build on each other so here is an intro:
http://www.sensusplenior.net/?page_id=2
Then you should start at the oldest and work forward: http://www.sensusplenior.net/?m=200907
Theologians have speculated for 2000 years if sensus plenior exists. I am attempting to show that it not only exists but can be discovered, reproduced and verified.
Bob Jones August 24th, 2009 12:09:19 PM
Bob: Totally OT, but what led you into this exploration? What is your profession, if I might ask. email me directly through 'contact us' if you'd like. I'm just a curious girl.
Dr. Patty Khuly August 24th, 2009 12:48:19 PM
Here's an idea. When you present an estimate you also ask for a credit card imprint. You can't check into a hotel or rent a car without one. And that way if there is going to be a problem with paying, you know it upfront.
I also think your staff up front need some training on this topic. I'm sure there are ways to get a client to pay more than half....but if they take it and shrug, then you are making your practice an easy mark for the dishonest.
2CatMom August 24th, 2009 01:54:18 PM
As I've written here before, I have 4 house cats and care for an outside colony of, at present, 6 (all time high of 13). I'll add that I have a low to middle paying job, drive an 11 year old car and my closet has never seen a designer label.
I've gone to the same vet practice for the last 9 years. While I have never received a discount on the services provided for my own 4, I must admit that I have received "special pricing" when I have taken in some of the colony ... never asked for but given by the practice ... mini exam prices, one exam price for a litter of 3, etc.
The policy of the practice is that payment is due upon completion of exam. If other services are required, an estimate (giving both the low and high price) is written up; full payment is required of the low price, with a signed agreement to pay the additional monies if necessary. I find this policy fair and have never failed to make the payment requested.
Is money tight? Yes, but that's no reason to not pay someone for the services provided. It was my choice to have multiple pets ... it was my choice to take on the responsibility (and all that entails) of caring for a colony ... it is my choice to be the type of person who pays my bills!
What you are dealing with are what I call "special people" - we encounter them in all aspects of our everyday life - you know, the people who don't believe they need to stand in line with everyone else ... drive the shoulder rather than wait in traffic ... I'm sure if you think about it, you can add more to the list!
Enough of a ramble ... just wanted to reassure you that there are those of us out here who recognize the value of what you do.
Bernadette August 24th, 2009 04:30:01 PM
Bernadette: After the day I've had...bless you for that. :-)
Dr. Patty Khuly August 24th, 2009 05:39:24 PM
Bob, a complete surprise & interesting hobby!
Glad you didn't go or need the surgery route, right? My other had 18 long, long, long months of recovery for a spinal fusion. Actually, they have come out with better techniques since then.
I thought I'd, I mean... he would never recover and get back to work! PJB: have you updated your blog??
Barb A./NH August 24th, 2009 06:29:40 PM
No; I've been piddling around way too much the last couple of months. Time for me to buckle down, get the condo marketed and sold, the new dog properly trained, and start some serious efforts on the "new" house. I've gotten much of my research done and now the weather is starting to cool here a bit which I wanted to wait for before having contractors start working. Their work is hard enough without having to do it in 100 degree+ heat along with my 100 degree+ heated temperament.
PJBoosinger August 25th, 2009 11:27:52 AM
Dr. Khuly, I am sorry you have to deal with the world of morons on such a regular basis. Stay with us - the world needs vets like you!
My vet has been wonderful with me - and I wouldn't dream of not paying her. These are my KIDS we are talking about. IF I don't have the money for involved testing, she works with me to find the best treatment I can afford.
I took one of my dogs in two weeks ago - he had a nasty cyst that opened and got infected. He was put on antibiotics for a few days and scheduled for surgery. They offered to just put that day's bill with the surgery bill and I could pay it after he had surgery and I went to pick him up. I agreed, but felt just a bit funny for walking out without paying! A few days later when I picked him up after surgery, I paid the whole thing happily. 4 cysts removed surgically, pain meds, anesthesia, everything he needed and just $399. Including the earlier visit. To me, a bargain. A happy, though slightly gorky, healthy dog back.
Thanks to all the vets out there who help us keep our pets healthy and happy.
Robinsdogs August 25th, 2009 11:44:09 AM
Bernadette said it so much better than I could. "Special people" is a nice way to put my usual rant that starts and ends with four letter words with "entitelment" in the middle.
I had to give my credit card number in advance for a hair cut last month and it didn't phase me in the least. I'm reserving time with a person who has skills of value. It wasn't even a chi-chi salon. I can't believe people place so little value on your and your staff's time.
Anne August 26th, 2009 11:59:55 AM
While I 1/2 feel for you, I'm also 1/2 angry. I have a lot of serious economic problems. Much more so than you or your clients.
I have been a client of my local vet clinic since the early-mid 1990's; I first saw a young vet for a cat who has since passed away. I spent over 1o thousand there dealing with his kidney issues over several years. Now that young vet is middle aged, the owner of the clinic, and only there one day a week. THere are usually two vets one duty and several worker bee types checking people in and chatting with one another and on their cell phones.
My cat is way overdue for his annual checkup/shots. I also suspect that he has asthma. (He has horrible coughing fits once or twice a day.) I haven't taken him in because I don't want to deal with this issue, and my cat is suffering for it. The worker bees will not pre-authorize any kind of payment plan, nor will the doc who's known me for over a decade take my calls. I suspect that what I will be forced to do is make an appointment, be seen, and then force them to accept a payment plan. If vets are not interesting in discussing these issues up front with clients with whom they have a long history, you should expect that client will do what they have to.
And your suggestions that people look to family for loans, take out additional credit cards, etc, is offensive. How do you know what the circumstances of these people are? What the impact of asking for more credit will be, let alone whether they'd be approved? And is that Coach bag really or knockoff purchased at the Salvation Army?
Barbara August 26th, 2009 03:10:46 PM
I must say this is an interesting topic. I saw many of these situations working as a tech and as a first year veterinary student I have already begun to wonder how I will handle these types of situations. I am not becoming a DVM to get rich, I truly want to better the lives of animals AND their human counterparts. However, what people/clients need to understand is that their veterinarians have spent at least 8 years attending school to provide quality veterinary care to their pets. With this comes a hefty amount of debt; currently, graduates of veterinary school are strapped with an average of $120,000 to $140,000 in student loan debt. This means we are graduating with a mortgage, but no house to go with the payment, that will be the second mortgage. While I would venture a guess that most veterinarians would like to help EVERY animal that comes through the door without regard to money it just isn't possible. Veterinarians are expected to be compassionate at all times, but there comes a time when you have to put your foot down. Vets must make ends meet too. As a note, we pay nearly the same amount of money to go to school as our dental and medical school counterparts, but will not make anywhere near the same amount of money as they do, but we go in to veterinary medicine for reasons other than money!
Dee G. August 26th, 2009 05:42:17 PM
"Force them to accept a payment plan"???!!!
What on earth gives you the right?
anna August 27th, 2009 12:56:25 AM
IfIhad run up a 800 dollar vet bill I would be in jail. I have been going to my vet for 7 yrs. We have to pay for services then and now. If you make arrangments for payment and you don't pay or bounce a check you will have a couple of visitors in BLUE
Flo August 27th, 2009 05:17:15 PM
There is a yorkie backyard breeder/puppymill here who keeps her dogs in deplorable conditions. I met her when I was looking for a yorkie for the inlaws that was a little older. He was a year and a half and had fleas so badly he was anemic, had a blood infection, and it affected his liver values. Her other animals were also in deplorable conditions.
She is always on the local craigslist ranting about how local vets care more for their pockets than for animals, how vets want to put all dogs down and would rather kill than cure, etc. The vet I use she says charges inflated prices (are you kidding? She's well known as the most affordable vet in the area). Her inability to pay hjer bills is related to the relative worth she sees in ehr animals. She sees them as moneymaking machines. When I approached her about the condition of the dog we took she gave the excuse of vets being greedy. When, six months later, I ran into her again she said "See, he was perfectly healthy". Umm no, after six months and close to a grand in vet bills he's finally healthy enough to get neutered. Jsut because he doesn't appear to have a genetic defect didn't mean he was healthy when you gave him to me. He wasn't. He was a very sick dog.
If you can't afford them, don't have them. It drives me nuts. It's one thing if it's one time and you're a little short, but it seems most people I hear bitching about vet bills are habitual non-payers or underpayers,.
jen August 28th, 2009 01:45:18 PM
I work at a local emergency veterinary hospital at the front desk . You can't imagine the stories and reasons people avoided paying thier veterinary bill for the sick animals . Here are some "I just bought my puppy for $2000. and don't have any money to get him better from PARVO". or I just had you try to save my dog for 10 days for my wife and knew you did all the care you could for him as well as an individual cremation "I didn't know I had PAY to $3000 for this and I went on vacation so I now don't have the money"or "I sorry the credit card didn't go through my bills got to the account first" Daily we are also face with clients that sign to pay thier bill and then walk out. We feel it is a theft off services. Good Luck to all those Veterinarians that are also face with thes clients that refuse to pay thier bills.
jillvbv September 5th, 2009 08:41:43 PM
I am a vet technician. Thank you for hosting a place where we can vent about our lives as vet techs.
I work at a vet office that used to work with a national chain petstore. People would pay THOUSANDS for a "designer" mutt. Our office , per the contract form the petstore, would offer a discount on spays/neuters for the puppy. You would not believe the audacity of these new pet owners. They would think that because they spent sooo much money on their beloved shi-poo, shorky or whatever they bought, that the cost of the spay/neuter and vaccines should be bulit in to the cost they paid the petstore. News flash: When you take your pet in for services at a vet, nothing is free. It is truly not our fault that YOU CHOSE TO PURCHASE FLUFFY FOR $2,000.00 from a puppy mill that , gasp, has a upper respiratory infection that you , being a RESPONSIBLE pet owner, must now pay for the treatment.
I personally could not stand any of the people who bought these dogs . They are only perpetuating the cycle of puppy mills. Why not adopt a mix breed form the shelter? It is a lot cheaper.
I also got infuriated by the Owners of these dogs who did NOT want to spay or neuter because they wanted then to have a couple of litters to sell so they could get some in their "investment" back. What a bunch of losers.
Yah, we also deal with customers who think we pad the estimates with un-needed procedures , decline procedures, then complain that we did not do all we could for their pet.
We also have people who call us and explain that they have found a stray cat or dog and they want to bring it in to get checked over. We give them an initial estimate over the phone- silence. They then tell us that it is not their pet, why should they have to pay the bill?! WTF?!! We tell them that since they are bringing the pet in for services, they are assuming all costs for said pet. Well, then it becomes: Ya'll are just in this for the money, you don't really care about this pet, after all, arean't ya'll here to help animals? "Yes sir we are but we cannot give away free services. I can give you the number of a low cost facility...''''HIM:" ***CLICK***
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