Sensitivity about this subject leads to a reluctance to discuss it openly, which then leads to high expectations but ultimately disappointment, embarrassment and complaints.
I am going to revisit this subject in the future more than once because there are lots of different aspects to it and lots of different techniques to discussing it.
It’s the four-letter F word: fees
Fees are a subject as emotionally charged as any other in this profession. Watch any fly-on-the-wall documentary on vets and the subject is never (or almost never) broached on-screen. However, money is the fuel that allows us to do our jobs: it pays for the electricity to run drip pumps, buys the pain relieving drugs, keeps the practice open and (just as importantly) pays our wages to put food in our mouths and a roof over our heads.
Nobody can work for free.
It took me a very long time before I could confidently discuss fees without some people thinking I was a “heartless swine who only thinks about the money”.
However, those who complain about fees don’t realise that, in most cases, a vet’s salary is relatively low (particularly when compared to other professions they could have gone into with the same amount, or less, effort and expense). It’s also unlikely that any one case in front of them will affect that salary.
It’s more likely they are broaching the subject of money somewhat reluctantly. If they don’t they will get a nasty e-mail (or worse) from the practice manager, asking them to explain why the subject wasn’t explored in depth and detail.
I don’t claim to be any sort of expert but, as with other subjects I’ve written about, I pay attention to my own thoughts and feelings when being dealt with by experts from other professions – comparing it to cars removes much of the emotional aspect while considering this.
For example, I have very little idea what goes on under the bonnet, and when I submit my car for diagnostic work I worry what the cost will be at the end of the day, particularly if they haven’t given me an idea beforehand. Not having much idea of what is involved (and a few nasty surprises in the past) means that the imagination can run riot.
It is that kind of worry that makes me broach the subject of costs at every contact with an owner – not in any kind of “obsession with money” way, just sympathy for their situation and a desire to get that subject out in the open. It also gives the client the chance to discuss the subject, and many clients show some relief when I bring it up. If they can’t afford my recommendations, then we can work something out together – dropping some less-than-essential tests, or home nursing, for example.
In a true emergency, say a cat RTA, I will get a basic history and then get the cat through to the prep room, get some good pain relief on board and, at least, get a catheter in (or start a drip in a really critical patient), which covers the burning essentials, ensures the patient is more comfortable and stable, and gives me time to assess what needs doing to fully assess the injuries.
It also gives the owner a little bit of time to recover from the shock of finding their companion in such a state. When I bring them through, owners are usually a little calmer and are even more relieved when they see their cat is more comfortable, while I can talk with a lot more authority about what has happened, what is wrong, and what needs doing.
I also try to be as “up front” about things as possible. I warn that I can’t give estimates too far into the future (particularly when different practices are involved), but I try to give an idea of future care and costs needed in any condition. Again, I find people find this more reassuring than anything.
As to why money and fees are often a taboo subject and, in some ways, linked to perception of caring is a subject for another day…