The informed consent of the owner is an ethical and legal requirement.
The estimate is essential and always necessary for surgery.
Facebook posts with images usually get more engagement than straight copy.
Settling the bill
In every transaction, the moment where the client pays is a very important step. This is especially true for services, as the price is often less predictable for the client than when it comes to purchasing a product. This is even truer in a veterinary clinic, because most clients pay for a service that includes several elements (e.g., consultation, ultrasound, blood tests, biochemical analysis, injection) and products (for example, an injected drug and a treatment delivered), the details of which is often decided during the course of the consultation. This uncertainty results in anxiety for the client and often for the clinic team, especially vets. Managing this anxiety is done partly during the collection of payment, but also and especially prior to the delivery of the service or during it.
Clear pricing and transparency
The moment between stating the price and settling the invoice allows the client to mentally calculate — consciously or not — the balance between what they have received from the service and the price. Indeed, the notions of “expensive” or “cheap” are never absolute but relative. At the restaurant, everyone understands that they will pay more for a starter, a main course a dessert, two glasses of wine and a coffee than for just a main course and a pitcher of water. It is therefore important to present an invoice that is sufficiently detailed to remind the owner of all the services delivered and products purchased for the amount that he will have to pay: the list of services invoiced, medicines administered, medicines issued after the service and other potential products. If the prices are displayed and advertised including all taxes, it is recommended that you present the invoice with and without tax. Indeed, the taxes are only collected by the clinic on behalf of the State or the local authorities that have established them.
The invoice is not only given to the client, but also explained by the person in charge of collecting the payment, usually a receptionist. There is no need to use a vet’s time for this task. On the other hand, the receptionist may call upon the vet if a difficulty arises and cannot be resolved. Some clinics offer to issue the invoice for clients and only do so for those who request it. We strongly recommend issuing the invoice automatically. The annotated invoice makes it possible to explain the services provided and prices and to quickly raise a possible issue (billing difficulties have the tendency to fester if not resolved quickly). In addition, the detailed invoice may also be useful, once the client returns home, to understand and justify the amount paid, during a conversation with his or her spouse, friend or other person.
At the time of payment, practicality contributes to the client experience (Figure 7), which means accepting the main popular payment modalities in the country and keeping up-to-date innovations in this area, such as e-wallet payments or payments from the client’s mobile phone (the stage of development of these technologies depends on the countries and banking partners of the clinic. Here the idea is not to be an absolute pioneer, but rather not to fall behind.)
Special attention should be paid to insured pets to ensure that the clinic makes its client’s life as easy as possible in terms of paperwork and administration of claims.
👎 Mr Ben Jones: My cat is insured so, before leaving, I had handed my completed insurance claim form to the receptionist. I had ticked the box for my insurer to pay me and even provided a stamped addressed envelope. All the practice had to do was add their information and send it off. However, they sent it to my insurance company electronically with instructions to pay them and not me. My insurer duly obliged. I lodged a complaint with the practise manager. I received a verbal apology and, a few days later, a refund of their incorrect claim. However, I will not be returning.
Whatever efforts are made at the time of payment, it is often difficult to remedy errors or omissions made earlier in the process. The situation that everyone wants to have is one where the payment does not pose a problem because the owner already knows how much they will pay or at least has a good idea about it. For this, it is helpful to focus on two points: informed consent and the detailing the service rendered.
• The informed consent of the owner is an ethical and legal requirement from a medical perspective, it is also an essential part of ensuring client satisfaction. We will not consider the technical details of this but it is important to be clear that consent cannot be fully informed unless the owner knows the price of the service.
• Services are sometimes difficult to explain fully to the owner. It is important to explain diagnosis and treatment carefully, especially where the outcome is uncertain. Keep up a running commentary (for example, explaining and, wherever possible use a document or visual aid to demonstrate a point, for example an examination or surgical report, the explanation of the results of an additional examination on an image, etc.).
In real terms, it is a question of acting at three key moments:
1. Whenever possible and appropriate, it is helpful to produce a written, commented estimate to the client. Unlike what we saw for the invoice, the commentary on an estimate is most often the work of a vet, who is both more competent and legitimate to explain his technical options and their financial impact. This allows the vet to lay out the service in detail, shows competency, and assists with obtaining true informed consent.
− The estimate is essential and always necessary for surgery. For surgical cases we recommend an estimate with a set and exact price, and not a “range”. Where uncertainty exists, we recommend that the clinic handles this risk by adding a specified amount above the average onto the estimate. By limiting price “ranges” to exceptional cases, we gain clarity and efficiency. In this case, the invoice will be identical to the estimate as a rule. If the person who made the quote forgot an item, it is not the owner’s fault.
− The estimate is of great help in internal medicine, but it is not always technically possible to determine the amount of care required until the end of the problem encountered, especially for the most serious cases, such as hospitalisation of the animal. In this case, estimates can be recommended that present the budget for the first part of treatment, allowing for initial informed consent. When the initial care is at 80% of the original estimate, the vet in charge will re-examine the case and, if it is likely that the budget will exceed the planned amount, he will draw up a new estimate and contact the owner for renewed consent.
2. If, during the consultation, another element of service appears necessary in order to clarify the clinical examination or diagnosis (radiography, ultrasound, sampling and analysis etc.), it is necessary to explain this, the results expected and the price to obtain informed consent (Figure 8). It takes a little time, but avoids a lot of misunderstandings and even subsequent conflicts. Obviously, the detail will be proportional to the price of the service: it will take a little longer to present the details of an MRI and obtain the consent of the client than for an x-ray. Any additional service accepted by the client should be explained in full. For example, “the result of the Complete Blood Count we have done shows normal values for leukocytes, which allows us to rule out the hypothesis of an infection.”
3. Finally, at the end of the consult and before showing the client back to the reception desk where a member of the team will take care of the bill, we recommend that the vet summarises the actions he has taken and their price and states the total amount which, logically, is just the total of all the items to which the owner has previously agreed.
Once the client has left the building with their pet the challenge is to ensure that the excellent client experience continues and that the client remains an “Active Client” and does not become a “Lapsed Client”.
EducationBetter-educated pet owners are better clients and have animals with higher welfare levels. It is in everyone’s interest to educate owners. It is essential that veterinary practices take on this role of “Educator”; whilst most veterinary practices instinctively fulfil this role offline, many do not seek to occupy the role of “educator” online, not only is this missing a chance to get important messages across to owners but it also leaves a void which will be filled by other, less qualified people.
The website should have a resource that owners can turn to for more information about disease and management, it can be very time-consuming for practices to keep this up-to-date so it is worth considering commercially available plug-in options; some of these are very comprehensive and always kept up-to-date. Interactive symptom guides are useful so that if clients are worried about their pet they can discover how quickly they need to seek veterinary attention, giving peace of mind if it can wait until the morning and ensuring that animals that need urgent veterinary care receive it in timely fashion. Blogs are helpful for profiling current events within the practice and seasonal issues, case studies work particularly well here, owners tend to be more interested in the human, animal and emotional side of the story than the clinical details and it is still possible to get across any important educational messages in this way.
The Facebook page is a fantastic way to slowly educate owners and to highlight any local or seasonal issues. Posts should be written in a more informal way than on the website and should be designed to prompt a conversation rather than being a one-way broadcast (Figure 9).
Posts with images usually get more engagement than straight copy, consider adding using photo-editing software to add the post to an image, the practice logo can be added so that when shared the practice logo gets more exposure for instance (Figure 10).
Videos work well on Facebook, they do not have to be high quality, directed or long, very short videos of patients or staff work brilliantly and are easy to produce. Experimenting with taking a short video instead of a photo can produce interesting results.
Quizzes can be built in-house using software such as Quizzr or with the help of an external agency. Quizzes can coach the person taking the quiz, so that they learn as they go, they can then share the results of their quiz on their own social profile, increasing the audience and thus the exposure of the quiz. Quizzes can be serious or lighthearted ranging from “Poisons Quiz” to “What’s your Dog Personality — which breed of dog are you most like?” In designing the quiz it is important to consider what the audience are interested in and tailor it to their interests.
Avoiding the price checking
Clients with healthy pets can go for a year between annual health checks without visiting the vet practice. This can be dangerous as loyalty can wane over the course of a year and the owner may be tempted to price check or look at alternatives when the next annual health check or vaccination is due. Keeping in regular contact with clients helps reduce the risk of this happening and may mean clients come in more frequently.
Facebook can assist here; by posting regular stories about staff activities in the practice including news and events owners can feel more up-to-date with the practice. If clients can be enticed to join in with activity on the Facebook page the practice can become part of the daily life of the client. Posting details of staff leaving, new arrivals, locums and staff on maternity leave means that when the client arrives at the practice after a long break all the faces they see are familiar even if they haven’t ever met them before. Knowing about events that have happened in the practice, for example staff getting involved with charitable events, unusual cases or new equipment can give clients something to talk about when they go into the practice and make them feel more relaxed and like they are amongst friends.
Email marketing is an effective way of communicating with clients. The limiting factor for many practices is the number of client emails on the Practice Management System (PMS), the whole team must understand the importance of collecting the email addresses and feel comfortable asking the client. When sending emails use an email marketing platform, these produce professional looking emails and provide statistics. Email programs such as MailChimp and Campaign Monitor are relatively low cost and easy to use. It is worth authenticating your server, so that the receiving account recognises that the sender is legitimate, this is a process called DKIM and makes it less likely that emails are filtered out into the SPAM folder.
These email platforms will also provide detailed statistics on how many people are opening your emails, and how many are not delivered. Statistics you may want to monitor include:
• “Bounce” — non-delivery of the email.
• “Soft Bounce” — non-delivery because of problems with the recipient’s email, e.g., Mailbox full. There is no way to control this, most email platforms will keep trying for 72 hours and then give up.
• “Hard Bounce” — non-delivery due to the email address not being valid. A high hard bounce rate may reflect a problem with the accuracy of the email addresses on your system.
• “Open Rate” — the percentage of people opening the email, this will be affected by how appealing the subject line is as well as how people feel about your brand.
• “Click through Rate” — the percentage of people clicking on links within the email. A high click through rate is a good sign that the content is interesting and engaging to the users.
It is good practice to segment the database, that is send the email only to relevant people, for example an email about a promotion on cat food should only be sent to cat owners. Email can be used in a more overtly commercial way that Facebook; offers and promotions are usually better received via email. Consider combining updates and news from the practice with offers and promotions to entice owners back into the practice as frequently as possible.
Email is a highly effective tool for building up online reviews, use the PMS to download email addresses of clients who have seen a vet in the last month, filter out those who have already been asked for a review and email a simple link to a prefilled review form. For the purposes of collecting reviews many practices choose to filter out those that have had pets euthanized, instead sending these owners hand written cards.
Veterinary practices are judged by clients on the quality of the contact with the vet and the staff. In large practices, it is advisable to define processes to ensure a consistency in the pet owner experience. For instance, the consultation should follow a clear structure to make sure the client is “on board”. Finally, the physical aspects of the clinic help a lot and require investment.
Dr. Baralon graduated from the École Nationale Vétérinaire of Toulouse, France in 1984 and went on to study Economics (Master of Economics, Toulouse, 1985) and Business Administration (MBA, HEC-Paris 1990). Read more
Dr. Blaettner grew up in South Africa and Germany and graduated in 1988 after studying Veterinary Medicine in Berlin and Munich. Read more
Dr. Mercader established himself as a practice management consultant to veterinary clinics in 2001 and since then has developed this role in Spain, Portugal and some Latin-American countries. Read more
Dr. Samuel graduated from Cambridge University in 2001 and spent ten years working in both mixed and small animal practices. Read more