How to Prevent Client Complaints and Bad Reviews

Transcription

1 How to Prevent Client Complaints and Bad Reviews Wendy S. Myers, CVJ, President, Communication Solutions for Veterinarians Inc., 6455 Montano Place, Castle Pines, CO 80108, USA; ; Csvets.com; Facebook.com/csvets; Meet your consultant Wendy S. Myers, CVJ, owns Communication Solutions for Veterinarians in Denver, Colorado. Her consulting firm helps teams improve client service, communication skills and compliance. Communication Solutions for Veterinarians has provided phone-skills training to nearly 5,000 veterinary teams in the United States and Canada. Wendy offers monthly CE credit webinars. She is a certified veterinary journalist and the author of five books and five videos. Her latest book is 101 Communication Skills for Veterinary Teams and DVD is Become a Client Communication Star. Wendy is a member of the American Animal Hospital Association and has been an instructor for AAHA s Veterinary Management School. Find Communication Solutions for Veterinarians at Csvets.com, Facebook.com/csvets, YouTube.com/csvets and Special GVMA member benefit: This course also is one of more than 50 CE programs at The Georgia Veterinary Medical Association has partnered with Communication Solutions for Veterinarians for special member savings. For one hospital enrollment fee, your entire team gets unlimited playback of the recorded webinar, 1 hour of CE credit, a handout, an online test and a CE certificate. Use promo code GVMA at checkout to save $10. What you ll learn: See complaints as opportunities for service improvements Why you need to respond with the speed of a Greyhound Identify the reviewer and investigate the situation How to be professional and gracious in your response Get templates that reduce errors, use brand tone of voice and let you personalize responses Take conversations offline where you can listen and reason with complainers without the Internet audience Treat jerks with genuine respect, even when reviews are ridiculous How to politely fire problem clients Use surveys to get immediate feedback after visits so you can provide solutions before emotions escalate Ways to encourage 5-star reviews 10 facts you need to know about reviews 1. Yelp users post 26,380 reviews every minute % of consumers read online reviews % will make purchases within one week of reading reviews % of consumers say a review must be written within one month to be relevant 2 5. Customers spend 31% more with a business that has excellent reviews 2 6. Reviews can have an impact of up to 10% on a company s search rankings 2 7. More than half of 18- to 34-year-olds say they trust online reviews more than opinions of friends and family 1 8. Star rating is the #1 factor that consumers use to judge a business % will visit a company s website after reading positive reviews Reading between one to three bad online reviews would deter 67% of shoppers

2 See complaints as opportunities for service improvements Emotions can run high when clients experience medical emergencies with their pets or when they are disappointed with your service. An angry client may lash out in the lobby or have the audience of the world when he complains in an online review. Whether addressing concerns face-to-face or through social media, communicate professionally and satisfy upset clients. Bad reviews are often the result of poor service. When switching veterinary hospitals, 3 out of 10 pet owners left due to service issues compared to 1 out of 10 over the cost of services, according to an American Animal Hospital Association (AAHA) State of the Industry Report. 3 Only 20% of negative comments are about the veterinary care provided, with most related to service issues or billing concerns. 3 If your hospital team fails to provide positive experiences, clients will complain but not necessarily to you. Research shows 13% of unhappy customers will share their complaints with 15 or more people. 4 Only 1 in 26 unhappy customers will complain directly to you. 4 Customers who don t complain may just stop doing business with you. Always challenge yourself by asking, What will we learn from this? Analyze your complaints. Ask yourself: Has this happened before? Have the complaints been documented? How often does the same complaint arise? Is there a pattern to this complaint in how it is received? Has the same client reported this previously? 4 Complaints and bad reviews invite you to evaluate your service goals and practices. 5 Ask: Are you more expensive than other clinics in your community? Are clients complaining about prices? Is your wait time long? Do receptionists have Golden Retriever smiles during phone and in-person conversations? Do you provide treatment plans before delivering care to surgical, dental and ill patients? Do treatment plans have easy-to-understand terms and clear financial policies? Do you schedule discharge appointments for hospitalized patients, or do doctors and technicians rush through discharge instructions with clients between busy evening exams? Do you accept multiple payment choices? (cash, checks, credit cards, third-party financing) When presenting invoices, do employees describe services first and then share totals? Why you need to respond with the speed of a Greyhound Your goal is to intervene and resolve situations before they escalate into negative reviews. Word-ofmouth referrals have long been a source of new clients for veterinary hospitals. Consumers access to mobile devises makes word-of-mouth become world-of-mouth. A client may even write a bad online review while waiting in your lobby. If a pet owner shares a complaint while at your clinic, resolve it now. Fix it before the client leaves and tells 15 friends and then the world on Yelp. Here are steps rebuild relationships with complainers: Look past the fury. Clients may curse and yell. Don t get emotionally hooked. Reply with a positive statement such as, I understand that you re upset about this situation. I will find a solution. Let s step into an exam room to talk about what we can do to resolve the problem

3 Have private conversations. An angry client loves an audience. Either the upset client will embarrass himself, or observers will side with him and then challenge you later. Both results in lose-lose experiences. Gracefully move an angry client to the privacy of an exam room, manager or doctor s office, or employee break room anywhere that s private. Walk and talk as you say, So you may have my complete attention and we can find a solution together, let s step into an exam room. Listen without interrupting. Let the angry client vent and get all his concerns on the table. Interruptions will escalate his anger. Take notes, jotting down themes so you can determine the real reason he is upset. Look up often to maintain eye contact. Use positive body language. Keep your chin up, shoulders back and look confident. If you cower, the client will know he s dominating you. Let s say you re at the front desk. The upset client is standing and you re sitting. He s in a position of authority and control. Stand to get on the same eye level. If you re in an exam room, don t stand behind the exam table. Remove physical barriers between you and the client. Stand at the end of the exam table, forming a L-shape with your body language, or stand shoulder-to-shoulder if you re explaining an invoice, treatment plan or consent form. If the client is concerned about the cost of care, say, I understand you re concerned about the cost of emergency care for your pet. Let s step into an exam room where you can have my complete attention, and we can review the quality of care your pet received together. Explain each item on the invoice and have a copy of the signed treatment plan and consent form available for reference. Echo the issue. This confirms you are listening. Using the client s words, repeat the issues back to him. You ll reduce tension and let the client gain control of his emotions. Echo the issue, not the emotion. Watch your tone of voice, never sounding condescending. Mirror the client s speech rate. If the client is in a hurry and talking quickly, then you should speak at a faster pace to indicate you re eager to help. Show empathy. Empathizing doesn t mean agreeing. You are simply acknowledging clients emotions or statements. Say, From what you ve told me, I understand why feel concerned. Apologize when appropriate. Say, I m sorry we didn t call you at 1 p.m. after your pet woke from anesthesia. I understand that you wanted to know right away that everything went well. Let me review the home-care instructions and medication so you can understand the quality of care that your pet received. Don t give away the practice. What gets rewarded gets repeated, so don t reward bad behavior. If you discount today s invoice, the client may explode again during the next visit to save even more. A Nottingham School of Economics study found unhappy customers will forgive a company that apologizes as opposed to giving compensation. 4 The study found 45% of customers withdrew their negative evaluations of companies when they received apologies, while only 23% changed their opinions in exchange for compensation. 4 Reply to social media complaints within one hour. 6 The administrator of your clinic Facebook page and other review sites should get alerts on smartphone apps and monitor even on weekends. A Convince & Convert study found 40% of respondents expect response within hours of leaving complaints. 6 You may not have all the answers but let the reviewer know you re looking into the situation. Let the client know when to expect a response

4 Identify the reviewer and investigate the situation Social media posts are public, so others can join in the negative comments, or bad reviews may influence readers opinions of your veterinary hospital. Find out who the reviewer is. The reviewer s name and description of the situation can lead you find him in your practice-management software, where you have the client s cell phone number and . Call the client so you can talk one-on-one. You ll prevent the situation from escalating and calm the pet owner because you re working together to resolve the situation. 6 If you can t reach the reviewer, respond on the review site. When others see the negative review, you want them to know you ve reached out to resolve the issue. Post a comment such as, <Reviewer name>, we value your feedback. I have left you a voic / / text requesting that you call me at our hospital at so we may work together to find a solution. Use staff ID codes in your practice-management software so you can easily identify which doctor, technician and receptionist served this client. You ve already informed the reviewer that you re gathering information, so next contact employees who worked with this client and patient. Confirm details in the medical record. Personalize responses. Avoid canned auto-responders on social media. Use the client s name and a conversational tone. Explain how you will fix the issue and take ownership if you made a mistake. 7 How to be professional and gracious in your response A bad review can ruin your day and suck hours of time to resolve. Don t let your emotions get the best of you. You want to appear professional and willing to help. Follow the Ritz Carlton principle to be Ladies and gentlemen serving ladies and gentlemen. Customers want to be treated with respect. Whether handling online reviews or onsite client experiences, be gracious and seek feedback that could improve your business. For example, when a client requests medical records, say, We would be happy to provide copies of your pets medical records. Our hospital strives to provide exceptional patient care and client service. May I ask why you re leaving us? If the cause is a service issue, see if you can resolve it to keep the client and prevent a bad review. Share reviews with your team. Discuss reviews even if ridiculous during staff meetings. 8 Your team needs to know about reviews and how you responded. If there is truth in the review, use it as an opportunity to brainstorm solutions and improve client service. You may find truth in complaints and see them as opportunities to improve future client experiences. Provide conflict-resolution training for your staff or rethink your hospital policies. Get templates that reduce errors, use brand tone of voice and let you personalize responses Be specific and apologetic in your online responses. 8 Let readers know you re remedying the situation and feel terrible that it happened. Include details such as, As I explained in the voic that I left you Details can deflate the critic s argument. Stick to the facts. If you struggle to respond to negative reviews, follow these best practices for responding: Thank the reviewer 2. Write in a conversational tone

5 3. If necessary, apologize 4. Address issues 5. Consider future readers Here are response templates from ReviewTrackers, which I customized for veterinary clinics: 11 Introduction: Thank you for reaching out to us and letting us know we dropped the ball. I am the practice owner/manager, and I am disappointed that we failed you. From your review, I see that your experience did not reflect our hospital s standards of service. I wanted to personally thank you for taking the time to provide feedback about your experience with us. It saddens me to hear about your experience. Body: I am looking into the situation and will contact you to correct it quickly for you and other clients. We love caring for pets and want every client to have the best experience possible. I am sorry your experience was not reflective of our reputation. Please know that your situation was an exception, and we won't allow for repeats. We are sorry we did not resolve the issue at the time of your appointment. That is our policy and we failed to stick to it. Please accept my sincere apologies for this matter and know that I am looking into the issue. Apologies are not enough. I take full responsibility for the actions and attitudes of our staff. I have already addressed the issue with our team. Thank you for taking the time to bring up these issues in your review. I am looking into it, and I have spoken to the staff members involved. Give us another chance. We will not disappoint. Closing: I have left you a voic / / text. Please call me at so we can work together to find a solution. We would appreciate the opportunity to serve you and your pets again. I want to work together to find a solution. I realize you may not be inclined to visit us again but please give us a chance. You won't regret it. By taking ownership, we hope to regain your trust. Just as you need to promptly respond to bad reviews, quickly post thanks for positive feedback. Say, <Client name>, we sincerely appreciate the time you took to write a 5-star review and share your experience with other pet owners. We have enjoyed caring for <pet name> and look forward to seeing you both soon! Take conversations offline where you can listen and reason with complainers without an audience Once you re able to talk with the client and fix the situation, show appreciation. Cautiously approach the subject of removing the review. Say, <Client name>, we value your business and the opportunity to care for your pets. Are you satisfied with the solution? If the client responds yes, consider asking, If you re happy with the outcome, may I ask you to consider removing your review? If the client does not remove the bad review, don t worry. A bad review shows you re not perfect but worked to fix the problem. Post that you spoke with the client and resolved the situation to his satisfaction so other readers stay informed. Consider asking the client to write a new review

6 Research shows 9 out of 10 times, customers will keep doing business with you after slip-ups but only if you fix the situation the first time. 7 Treat jerks with genuine respect, even when reviews are ridiculous If the review is a clear misrepresentation or inaccurate, contact the review site and dispute the comment. If you can prove that the information is false, the review site may remove the post. 5 Let s say a pet owner posted a negative review about a doctor who does not work at your hospital or is not a client of your practice. While you re waiting for the review site to respond to your dispute, post a statement such as, Dr. <Name> does not work at our veterinary hospital. You may want to share your feedback with the correct business so your concerns may be addressed promptly. or I checked our medical records and practice-management software, and I am unable to find information about you and your pet. Our hospital did not provide the care that you ve described. Could you please call our hospital at to provide more information? Several years ago, I had a one-star review posted to my business Facebook page. The reviewer did not leave any comments just the star ranking. His Facebook profile indicates he doesn t work in the veterinary profession, and I couldn t locate him in our client software. I contacted the reviewer twice through Facebook messenger, asking for specific feedback. After no response, I posted: We regret that our service disappointed you. Your review didn t include any comments. Could you tell us what we could do better? I ve still not received any reply and it s my only negative review. How to politely fire problem clients An American Veterinary Medical Association (AVMA) survey found 1 in 5 veterinarians had been victims of cyberbulling. 9 The organization offers a cyberbulling hotline with 30 minutes of free consultation for AVMA members and reputation-management services. While your team strives to create five-star experiences for pet owners, you won t please all clients. Do the best you can, but some clients you can do without. Here are four reasons to fire problem clients: 1. They make unreasonable demands. A pet owner calls 5 minutes before closing, asks you to refill her dog s medication, and then wait 30 minutes after closing time for her to arrive. 2. They negotiate prices. You recommend a dental treatment for a client s dog, and he tries to bargain over the price of anesthesia. He even asks, Can t you just clean his teeth without anesthesia? He s a good dog and will behavior for the procedure. 3. They miss appointments. A dog or cat owner may spend $600 or more on a pet s checkup, including an exam, vaccines, diagnostic tests and preventatives. If a client no-shows three or more times, he has cost you $1,800 in lost business. 4. They owe you money. Despite clear communication that payment is due at the time of service, the pet owner breezes by the checkout counter and hollers, Just put it on my account. Collection letters, calls, s and texts have been ignored. You question whether you ll ever get paid

7 Veterinary medicine is stressful enough without dealing with jerks. You can usually count on one hand the number of clients that you need to fire. After exhausting conflict-resolution efforts, it may be time to say good-bye. Send a postal letter not an or text that could be overlooked or deleted. In my Veterinary Practice Management Resource Book & CD, I have a polite You re Fired letter with these qualities: Explain why the relationship must end such as Our veterinary hospital takes pride in its compassionate, professional staff, and we expect mutually respectful relationships with our clients. Because of your interactions with our staff, I regret to inform you that our veterinary hospital will no longer provide services for your pets. Enclose copies of medical records. You don t want a fired client returning to pick up records and cause another scene in your lobby. End on a positive note such as We are confident that you will find another veterinary hospital that can meet your needs. Sign with authority. The letter should come from the veterinarian who owns the practice or the hospital manager. Having a leader s signature indicates the decision is final. Ways to encourage 5-star reviews Simply ask. The next time a veterinarian or technician sees a favorite client in the exam room, ask her to write a review. If you re going to collect samples, run lab work or take x-rays, ask good clients, While we take <pet name> to the treatment area to perform lab tests, could you write a review on Yelp, Google+ or Facebook? We value your opinion and would love to have you share it with other pet owners. Apple Maps integrate with Yelp points of interest, while Google has partnerships with Android smartphones. Make sure you lead clients to these top review sites. Yelp uses a proprietary algorithm to organize contributors content. Yelp says this algorithm lets them recommend the most helpful and reliable reviews. 8 The result is a good review can be viewed for less than 24 hours while a negative review could be seen for years. Your goal is to have a consistent stream of good reviews so you keep burying the bad. Use surveys for early intervention and to guide happy clients to review sites. Get same-day feedback after visits. Based on clients preferred communication of texts or s, Review Retrievers sends notices each day to visiting clients, asking them to give feedback on their experiences in its system. If a client rates the clinic with 1 or 2 stars, the clinic contact is alerted so he may resolve the situation quickly. If a client rates the hospital with 3 to 5 stars, he is directed to post reviews on Yelp, Google+ and Facebook. The clinic owns all reviews. Choose a provider that lets you own all reviews. Here are companies that offer veterinary reputation-management services: Review Retrievers, Vetstreet, IDEXX Pet Health Network Pro, DVM Reputation Guard (AVMA program), Vsmart, Demand Force,

8 Put links on your website homepage. Provide icons with links to review sites. At Shackelford Road Veterinary Clinic in Little Rock, Arkansas, reviews scroll on the home page, which also has a link to rate the hospital ( Add social media logos to your business cards, website, handouts, and anything you print. Put Like us on Facebook and Review Us on Yelp window decals on your front door and exam hallway doors. Remember, you can t make every client happy. Stay positive. Your next appointment is your favorite client who might rank you a perfect five stars. Which goals will you implement from today s training? References: 1. Shrestha, K. 50 stats you need to know about online reviews. Vendasta. Posted Aug. 29, Accessed April 18, 2017 at 2. Malamut, C. 14 compelling customer review stats you need to know in Capterra. Posted May 25, Accessed April 18, 2017 at AAHA State of the Industry Fact Sheet. Accessed April 18, 2017 at 4. MacDonald, S. Why customer complaints are good for your business. SuperOffice. Posted April 4, Accessed April 18, 2017 at 5. Werber, J. Extinguish negative veterinary practice reviews. Veterinary Economics. Posted June 2, Accessed April 18, 2017 at 6. Shukle, R. How to handle customer complaints via social media. Posted Dec. 29, Accessed April 18, 2017 at 7. Ciotti, G. How to talk to your angriest customers. Help Scout. Posted June 22, Accessed April 18, 2017 at 8. Scheidegger, J. Negative reviews, yelp and your veterinary clinic. DVM360 Magazine. Posted May 1, Accessed April 18, 2017 at 9. AVMA. Cyberbulling and how to handle it. Accessed April 18, 2017 at Hayward, M. How to write an appropriate response to a negative review. LinkedIn. Posted Jan. 28, Accessed April 18, 2017 at free review response templates. ReviewTrackers. Accessed April 18, 2017 at Helpful resources Book: Veterinary Practice Management Resource Book & CD with You re fired letter and 100 forms Video: Avoid getting hooked by raging clients Video: How to fire problem clients Videos: CSVETS YouTube channel Webinar: 6 awkward client conversations: Respond like a pro Webinar: How to deal with jerks Webinar: How to keep doctors on time Link

9 Best Practices for Financial Conversations Wendy S. Myers, CVJ, President, Communication Solutions for Veterinarians Inc., 6455 Montano Place, Castle Pines, CO 80108, USA; ; Csvets.com; Facebook.com/csvets; Meet your consultant Wendy S. Myers, CVJ, owns Communication Solutions for Veterinarians in Denver, Colorado. Her consulting firm helps teams improve client service, communication skills and compliance. Communication Solutions for Veterinarians has provided phone-skills training to more than 5,000 veterinary teams in the United States and Canada. Wendy offers monthly CE credit webinars. She is a certified veterinary journalist and the author of five books and five videos. Her latest book is 101 Communication Skills for Veterinary Teams and DVD is Become a Client Communication Star. Wendy is a member of the American Animal Hospital Association and has been an instructor for AAHA s Veterinary Management School. Find Communication Solutions for Veterinarians at Csvets.com, Facebook.com/csvets, YouTube.com/csvets and Special GVMA member benefit: This course also is one of more than 50 CE programs at The Georgia Veterinary Medical Association has partnered with Communication Solutions for Veterinarians for special member savings. For one hospital enrollment fee, your entire team gets unlimited playback of the recorded webinar, 1 hour of CE credit, a handout, an online test and a CE certificate. Use promo code GVMA at checkout to save $10. What you ll learn Presenting treatment plans using body language and teaching tools Utilizing your healthcare team to present treatment plans and financing choices Responding when clients decline care Offering payment plans through third-party financing Staging care when clients cannot accept Plan A Collecting deposits for life-saving emergencies Offering choices when clients have limited financial resources or no money Pet spending will reach a projected $61 billion in 2015, including $15 billion on veterinary care, according to the American Pet Products Association. 1 Pet owners may not understand the financial investment in responsible pet ownership. The ASPCA estimates the annual minimum cost of owning a medium-sized dog is $695 while annual cat ownership expenses are $ These estimates include basic care for food, veterinary checkups, cat litter, toys, treats, licensing and pet insurance. Your healthcare team s ability to confidently explain financial information to clients impacts their decisions to accept veterinary care. When asked about price, 34% of pet owners say veterinary care is higher than they expected, according to the Bayer Veterinary Care Usage Study. 3 Let s look at how you would handle financial conversations for three scenarios for preventive care, sick patients and emergency care: Preventive care visits Pet owners may not budget for routine preventive care and be surprised at the cost. A pet owner with an adult dog age 1 to 6 can expect to spend $107 for a preventive care exam, distemper and rabies vaccines, intestinal parasite test and heartworm test, according to the American Animal Hospital Association (AAHA) Veterinary Fee Reference, 9 th edition. 4 Add 12 months of flea/tick and heartworm

10 prevention estimated at $25 per dose or $300 for a year s supply. This preventive care visit would total $407. Too often, pet owners perceive that shots were $407! To help clients understand which services and products are needed for optimal preventive care, the technician should give an overview of services without prices. This lets you determine whether the pet owner has financial concerns, and then discuss them. The technician should introduce himself, explain his role and prepare the client for which services are due. Say, Good morning, I m <your name>, the technician who will be assisting Dr. <Name>. For your preventive care visit, we will do a nose-to-tail exam, vaccines, heartworm/tick test, an intestinal parasite screen and refill 12 months of preventatives. I will take a brief history, collect samples for testing and get your pet s temperature, pulse and respiration. Then the doctor will begin the exam. Is there anything else you want to discuss with the doctor? Say preventive care exam instead of wellness exam. Clients may perceive a wellness exam as optional, while a preventive care exam is actionable and pet owners want to keep their best friends healthy. Say vaccines instead of specific ones. Based on exam findings, the veterinarian may add or subtract vaccines. Saying, We will refill encourages 12 months of parasite protection. Asking, Is there anything else you want to discuss with the doctor? identifies Oh, yeah could you also check? Up to half of healthy pets have a sick-pet problem ears, skin or dental disease so identify questions early so the doctor can prioritize which order to address concerns. If clients ask about prices, prepare a treatment plan or access fees on computers in exam rooms. Then say, Before deciding, let s have the doctor perform an exam, and then help you prioritize which services and products your pet will need. If you notice nervous body language such as fidgeting or avoiding eye contact, ask, Would you like to see a treatment plan that lists services and fees before we proceed? If you re unsure of the pet owner s body language, invite the client to express any concerns. Say, Do you have any questions before we perform these services, or shall we get started? The veterinarian should echo the services and products that the technician described and take a collaborative rather than confrontation approach if the pet owner has financial limits. Say, Good morning, <client name> and <pet name>. During <pet name s> physical exam, I ll focus on 12 areas, including eyes, ears, nose and throat, teeth and gums, coat and skin, heart, abdomen, limbs and paws, urogenital system, lungs, gastrointestinal system, and weight. We will talk about my exam findings and what <pet name> needs. <Technician name> shared with me that you are concerned about the cost of care, so I will help you prioritize services based on your pet s needs and your budget. We will work together to help <pet name> get the care she needs. This collaborative approach shows the doctor s compassion and focuses the conversation on medical priorities rather than financial concerns. If the client cannot afford all the preventive care services due today, take these actions: Schedule follow-up care now. This lets you stage the preventive care, helping the client say yes and achieving optimal patient care. Before checking out for today s services, schedule a follow-up care visit to finish the remaining services. For example, the patient had an exam and vaccines today but could not

11 afford the heartworm/tick and intestinal parasite tests. Offer to schedule a technician appointment for the follow-up tests and explain the cost today. Try to schedule the diagnostics within the next two to four weeks, when the client is likely to have received another paycheck and the patient can get timely care. Enter a callback. If the client won t commit to a future appointment today, express empathy while being a patient advocate. Say, I understand that you re unable to do the heartworm/tick and intestinal parasite tests today. I will call you a courtesy reminder in one month. You can just schedule a technician appointment for those tests. We both want <pet name> to continue to be protected. The 2003 American Animal Hospital Association compliance study found 38% of pet owners surveyed would return for a medical progress exam or procedure as directed by their veterinarian if the practice followed up. 5 Because veterinary medicine is a relationship business, use doctor and staff ID codes in your practicemanagement software. Each employee who interacts with a client would be tied to the transaction. Doctors names commonly print on invoices so clients know which veterinarian delivered care to their pets. Likewise, do the same for technicians and front-desk staff. Each staff ID code would have an invoice description such as Your technician today was Todd and Your client service representative today was Jill. If a callback for the heartworm/tick and intestinal parasite tests were entered today, Todd and Jill would be linked to the callback. Because the client will remember talking with Todd a few weeks ago, he would call and say, Hello, <client name>. This is <technician name> from <Your Veterinary Hospital>. I am calling as a courtesy reminder that we need to do heartworm/tick and intestinal parasite tests for <pet name>. This is a 15-minute technician appointment. We can see <patient name> on Monday at 4 p.m. or Wednesday at 2 p.m. Which choice fits your schedule? Known as the two-yes-options technique, this guides the pet owner to schedule an appointment and is more effective than Do you want to make an appointment? Preventive care services and products generate 38% of hospital revenue, so it is equally important to practice health that you deliver optimal care to patients. 6 To help clients budget for routine care, consider preventive care plans. The 2015 AAHA State of the Industry Report found 80% of pet owners are interested in plans for preventive care. 7 Plans with monthly payments could help more clients accept optimal care. Design plans that echo your standards of care. AAHA-AVMA offers preventive care guidelines at Consider offering preventive care plans with an add-on Grade 1 dental procedure. Review and update the services and fees in plans annually. Download my proceedings on preventive care plans from the 2016 AAHA Convention at Research from Banfield Pet Hospitals, a leader in preventive care plans with more than 1.4 million pets enrolled, indicates patient visits are typically double for plan users. At Banfield, plan holders with dogs average three visits annually while cats visit four times per year. 8 Here are third-party providers that provide financing for preventive care plans: AVImark Wellness, Extend Credit Financing, PaymentBanc Financing, IDEXX Petly Plans,

12 Preventive care plans may help eliminate Do you want? negotiations in exam rooms. For example, a senior preventive care plan would include blood work and urinalysis. Follow the model in the pet insurance industry and aim for monthly payments ranging from $30 to $50. Don t slap clients with sticker shock at checkout. Have you ever slapped a client? You probably have and didn t realize it. While shadowing an exam during a consultation, I observed a client approach the front desk to pay. The receptionist said, That will be $302 today, slapping the client with sticker shock. The client replied, Wow! That s as much as my car payment. Instead of slapping the client with the total, the receptionist should have read the list of services and products off the computer screen and said, Today your dog had a preventive care exam, vaccines, an intestinal parasite screen and heartworm/tick screen. You have refills of his flea/tick and heartworm preventatives. Do you need any other medications or food today for any of your pets? Your total is $. Which payment method will you use today? Read the list of services and products off the computer screen, and then state the total. Don t say prices for each item, just the sum. Besides showing value, this allows the client to add more items if needed. State which payment methods you accept so new clients know which credit card to pull out of their wallets. When checking out new clients, say, Which payment method will you be using today? We accept cash, checks, all major credit cards and <third-party financing>. Besides subtly indicating that payment is due at the time of service, you ve also let the new client know about all payment choices. If a client has a multi-page invoice for a surgery, don t read three pages of charges because the client will brace himself for a whopping total. Instead, state general categories such as Your pet had a <surgical procedure>, which included an exam, preanesthetic testing, anesthesia, surgical monitoring, an IV catheter and fluids, pain-relief drugs, and nursing care. You re also going home with an E-collar and pain medication. Your total is $. Which payment method will you be using today? When you communicate value at checkout, you ll hear more pet owners say, Wow! Is that all? instead of Wow! It s how much???!!! Sick patient visits Whether a client is visiting for a pet s preventive care, an illness or an emergency, always be upfront about prices. This avoids surprises for both you and the pet owner. During a sick-patient visit, the technician is key in setting client expectations. Say, Hello, <client name> and <patient name>. I m <technician name>, the technician who will be assisting Dr. <Name> today. I understand that <patient name> has been vomiting for three days. I will ask you questions about her symptoms, and then the doctor will begin the exam. Once the doctor performs his exam, we will prepare a treatment plan that describes the services and fees. Then we will discuss your questions and the next steps. Once the veterinarian performs the exam, he will explain necessary diagnostics and answer the client s questions. After the discussion, the doctor would say, I will have my technician prepare a written treatment plan that lists the services that we just discussed, along with the fees. After you and the

13 technician have reviewed it together, we can begin your pet s treatment or discuss how you d like us to proceed. Always offer exams to concerned pet owners. A receptionist should never say, You could just wait and see if your dog is still limping tomorrow. Then you could call to schedule an appointment if he s not better. A veterinarian needs to examine the pet to determine the cause of illness or injury and needed treatment. Never give free advice over the phone, which could cause harm to the pet. Here are two scenarios and how to respond: If a work-in exam, say, If your pet has been vomiting and/or had diarrhea for more than 24 hours, a doctor needs to examine it. Then our veterinarian can diagnose and treat your pet. Seeking treatment sooner can help alleviate your pet s pain and let us provide care before the condition becomes serious. You should come in now for care. Let me give you directions on how to get here. If scheduling an urgent care exam, say, If your dog is limping, you should seek care now. Our veterinarian will examine your dog to determine if the cause is an injury or illness. Then our doctor can let you know what services and treatment your dog will need. We also will provide you with a written treatment plan that explains services and fees before providing care. We have an urgent care exam available at 1 or 3 p.m. today. Which time fits your schedule? Don t quote prices for sick-patient workups over the phone. A client may call you and explain that her cat has been vomiting and had diarrhea for three weeks. She may ask about the cost of care before visiting your practice. Because you don t know the cause of her pet s symptoms, you can t quote accurate fees over the phone. Instead, explain your exam fee. This is the starting point for the cost of care. Without seeing the patient, you won t be able to provide an accurate estimate of professional fees. Say, Let me explain what you can expect for an urgent care / emergency exam. The doctor will do a full medical exam, ask you questions about your pet s symptoms and then let you know what specific treatment your pet will need. Then you can decide how you want us to proceed. Our urgent care / emergency exam fee is $. Once the doctor has examined your pet, we will provide you with a written treatment plan that describes the needed services and fees. Emergency visits Emergency or specialty care can easily start at $1,000. Most pet owners will stop treatment of a sick or injured animal at $1,451, according to a DVM Newsmagazine survey. 9 Veterinarians report that in 38% of cases, cost limited treatment. Another 32% report said cost influenced his or her decisions to treat, and 41% of respondents cite that cost was not a factor (multiple answers were allowed). When facing non-life threatening emergencies, the technician would say, For <pet name s> emergency exam today, Dr. <Name> will perform a nose-to-tail exam, ask you questions about your pet s symptoms, and then we will create a treatment plan that summarizes the services that <pet name> will need along with our fees. Then you can decide how you want to proceed. What questions do you have before we get started? Before hospitalizing a patient, provide a treatment plan and get the pet owner s signature for consent. Clients need to know what care their pets will need and the associated fees. They don t want a

14 surprise bill at checkout, nor do you want to embarrass a long-time client who didn t bring the right payment method(s) with her. Even when a favorite client says, Just do everything, provide a written treatment plan. When the total cost of care may be unknown, create a treatment plan to stabilize the pet. A treatment plan has four purposes: 1. Gives you legal permission to treat 2. Explains needed medical care 3. Estimates the cost of care 4. States payment and deposit policies Say, To get your permission to admit your pet to the hospital, I need your signature on the treatment plan. We will keep a copy in your pet s medical record, and I ll also give you a copy to take home so you have information on the services and fees we discussed. Your payment policy on treatment plans could state: Payment is due when services are provided. Deposits may be required for emergencies, infectious disease cases and new clients. For your convenience, we accept cash, checks and major credit cards. We offer <third-party financing>, an interest-free medical payment plan for qualifying clients. When patients receive overnight hospital care, always call the client each morning with a medical and financial update. Let s say your doctors and technicians do medical rounds together each morning at 8 a.m. When you finish rounds at 8:30 a.m., technicians and doctors would call clients with updates. Should you reach the limit of the treatment plan, explain the additional needed care and get verbal permission over the phone with another employee listening as a witness to confirm consent. Offer to the client an updated treatment plan. She also could receive an updated treatment plan if she visits her hospitalized pet later that day. Say, <Client name>, I m calling to let you know that <pet name> is feeling much better today. He ate breakfast this morning and is resting comfortably. The doctor is continuing pain medication and fluid therapy to keep your pet comfortable. <Pet name> will need another day of hospitalization, monitoring and medications. Because we did not anticipate an extra day of hospitalization and treatments in your original treatment plan, I want to let you know those fees. For <pet name s> hospitalization, treatments and medications, the new amount will be $. Do we have your permission to provide the care that <pet name> needs? I m going to ask <employee name> to join our call to confirm that you agree to this treatment. Let me confirm your so I can send you the updated treatment plan that we discussed over the phone. You re welcome to come by and visit <pet name>. We re open until 7 p.m. tonight. I also could have a copy of <pet name s> updated treatment plan waiting for you at the hospital when you come to visit him. Collect prepayment for life-saving emergencies If a walk-in emergency arrives, your medical team may not have time to prepare a detailed treatment plan before starting life-saving care. Have the receptionist immediately escort the client and patient into an exam room and alert the medical staff. The doctor and technician would begin assessing the patient in the exam room, and then take the pet to the treatment area. While the client waits in the exam room, the receptionist would step into the exam room to present an emergency authorization form. This form

15 provides consent for life-saving care and has you collect initial funds so you know whether the client has financial limitations. Here s an emergency authorization form that you can adapt for your hospital: Please initial one of the following two options: I am authorizing the veterinarians at <Your Veterinary Hospital> to perform any and all necessary emergency treatment (i.e. intravenous fluid therapy, CPR, seizure control, pain control) and diagnostics (blood work, x-rays) up to the amount of $. When this limit has been reached, I will receive a revised treatment plan that explains the services and fees based on my pet s condition at that time. I cannot afford $ for emergency treatment and diagnostics at this time; however, I am able to pay and authorize up to $ for emergency care for my pet. I understand that I must authorize at least $ for the initial exam of my pet. Before my indicated limit is exceeded, I will meet with the veterinarian to discuss further options. I understand that emergency treatment does not guarantee the survival of my pet. I understand that this is a legal and binding contract, and it is my obligation to pay in full for all services rendered at the time of my pet s release from the hospital. In the event that your pet should go into cardiac arrest, please indicate how you would like our medical staff to proceed. Note: There will be additional charges if you chose to resuscitate. Please initial one of the following two options: Resuscitate (CPR) Do not resuscitate (DNR) Signature of owner or responsible party The client service representative would answer questions, have the client sign the emergency authorization form and collect the initial approved amount. The client would give the receptionist a credit card in the exam room. The receptionist would swipe the card on an exam-room computer or walk to the front desk to do so, and then return with the receipt to sign. Use the term prepayment in place of deposit. Pet owners may misinterpret the term deposit to mean they will get money back when the pet is returned in good condition. It s a common management practice for hospitals to collect a 50% prepayment or 100% of the low end of the treatment plan on emergencies. This helps reduce accounts receivable and bad debts while also making the client s bill upon discharge smaller because half or more is paid in advance. Train staff on this policy so they can confidently explain it to clients. Offer payment plans through third-party financing. If a client says, I can t afford treatment, the first no is not the final no. Never let money concerns get in the way of pets receiving the medical care they need. Present third-party financing so you can deliver needed medical care. Available through Henry Schein Animal Health, learn about Citi Health Card at Get information on CareCredit at Learn about Healthcare Finance Solutions at Say, I understand you re concerned about the cost of your pet s emergency care, which is $600. We offer <third-party financing>, a payment plan for approved clients, which has six months of deferred interest. Would $100 per month fit your family s budget? Third-party financing isn t just for emergencies. Clients can use it for dental procedures, preventive care, medications and more. Financing could help multi-pet families provide care to every pet, not just the one with the greatest medical needs

16 Offer choices when clients have limited financial resources or no money, including: Ask the pet owner if he has friends or family who can loan him funds Split the invoice between multiple payment methods of cash, check and credit card Provide supportive care to the patient, giving the client time to make financial decisions Have an Emergency Cash Options reference sheet available that lists the closest ATMs, Western Union (in Wal-Mart, grocery stores, etc.), check-cashing businesses and pawn shops Suggest pet insurance for future care Relinquishment of pet ownership to a rescue group or shelter Establish an angel fund Present treatment plans using body language and teaching tools Use positive body language when presenting a diagnosis or treatment plan. Body language accounts for 55% of face-to-face communciation. 10 Don t stand behind the exam table and talk across it. Clients might perceive this face-to-face posture as confrontational. Instead, stand at the end of the exam table, forming a L-shape between you and the client. Even better: Stand on the same side of the exam table, shoulder-to-shoulder with the client. This body language is collaborative rather than confrontational. Consider rolling stools for doctors to sit as they explain the diagnosis. Your goal is to be on the same eye level as the client. If the client is seated, you should be, too. Sit in a stool or kneel down so you re eye-to-eye. If the client is seated and the doctor is standing, he is in a position of dominance. Use visual teaching tools. Most pet owners have never seen an animal s dental procedure or surgery from start to finish. Some may even question, Oh, my pet has to go under anesthesia? Create photo books using websites such as Shutterfly, Walgreens or Costco. Place photo books in each exam room and your lobby. Be sure that photos are kid-friendly because children will want to see the images you re showing to their parents. Take a photo of a smiling technician in your in-clinic lab to demonstrate preanesthetic testing don t show a jugular blood draw on a patient (frightening!). If showing a surgery, take a wide-angle photograph of the patient covered with a surgical drape, a technician assisting, the veterinarian performing surgery and monitoring equipment. Avoid showing any blood. For a digital option, create slideshows on digital photo frames, tablets or exam room computers. When computer hibernate, your slideshow becomes the screen saver. IDEXX Pet Health Network 3D offers three-dimensional anatomical animations, radiographs and instructional home care videos. You can use the client communication tool as an ipad App or web-based application. For details, visit Explain service first, price last. Use the term treatment plan, which emphasizes needed medical care. Avoid saying estimate, which centers on price. Clients may jump to judgment if they see prices first without understanding the procedure. Educating clients before showing prices helps them make informed decisions. Cover prices with a dental report card (Virbac brochure #VP028) or preanesthetic-testing brochure. Explain each item, pointing to the left column of medical services. After you ve shared step-by-step photos and discussed medical services, reveal the price