Opening Shots columnist Dr. Ernie Ward is an award-winning veterinarian, impact entrepreneur, book author and media personality. When he’s not with family or pet patients, Dr. Ward can be found contemplating solutions during endurance athletics and meditation and on his weekly podcast, “Veterinary Viewfinder.” Learn more at drernieward.com
If you have a question about practice life, personal well-being, leadership or veterinary careers, email email@example.comRead Articles Written by Ernie Ward
Q: A non-client pet owner called to request a second opinion. The previous veterinarian sent us the records, which contained notes about refusals, refunds and no-shows. This potential client sounds like a nightmare. How can I politely reject the owner without angering the person?
A: Let me share with you a country song I’m working on:
“It was somebody’s worst date,
and that one you wished
you’d never met.
But here now, in my arms,
It’s the dream I don’t want to wake.”
OK, so maybe it won’t be a hit single, but it does illustrate a critical point: People are different when they’re with different people, and we must be careful about judging a book by its cover. Furthermore, your potential client might be right about the earlier veterinary care.
At first glance, this pet owner looks like a potential risk. But if everyone rejected someone else because something didn’t work out with the person, we’d be all alone.
My best advice is this: Unless the notes show something genuinely unsettling, why not give the pet owner a chance? At least call the previous veterinarian to see if there’s more to the story. I’ve been through similar situations, and several resulted in incredible clients and community allies. Sometimes it’s oil and water, but other times you get delicious lemonade.
If you’re set on not seeing the caller, I’d simply say you’re not accepting new patients. You can go further and state you don’t think you’d be a good fit, but that response increases the risk of needless confrontation. If the person gets upset, remain quiet and take it. If the potential client is truly terrible, it’s better to endure the wrath over the phone than in your lobby.
I wish I had a better answer and could predict how your situation will turn out, but I’ve always believed in people’s capacity for change and good. I’ve had to discharge my fair share of problem clients, but I did so only after they’d earned it.
Let’s get back to making music.
Q: I’m a managing veterinarian at a corporate practice. Our practice manager removed her own outstanding balance of more than $2,000, a co-worker told me. Because I technically report to the practice manager, I don’t want to cause unnecessary problems by confronting her. Should I let it go or take action?
A: Being a leader is tough. Dealing with confrontation and handling uncomfortable situations are in the job description. The fact that a co-worker brought this issue to your attention means they view you as a superior, and you need to take action.
The first thing is to establish whether the manager obtained permission to erase her own debt or paid it off. You can do this by contacting your corporate supervisor or directly asking the PM. The risk of going above her is if the supervisor contacts the PM. “I just got a call from your managing DVM. Is everything OK?” I never advocate for losing control of the narrative.
I’m a direct communicator, so I’d advise a private, non-threatening conversation to find out. Try approaching it frankly: “It was brought to my attention that your account balance was recently adjusted to zero without a payment entry. I wanted to get the details so we make sure our financial reports and recordkeeping are accurate.”
Use the response to guide your next steps. There’s a chance the practice manager will either outright deny or potentially fabricate an excuse. You’ll have to judge whether you believe the PM and if additional action is needed.
There’s also the possibility she will become upset with you. Remain calm and measured. It’s important to realize that defensive or angry responses often coincide with guilt. If this happens, you need to follow the standard reporting procedures immediately.
Ignoring the situation signals to your team that you don’t consider it a serious offense or don’t take complaints seriously. Neither conveys leadership. The cherry on this conflict cake? Having knowledge of potential embezzlement makes you complicit and could further harm your practice and team. And if the practice manager is willing to steal, there’s no telling what other wrongdoings might be occurring.
These situations also provide insight into unknown problems and an opportunity to prevent future issues. It might be time to revisit your practice’s financial protocols, daily auditing procedures, employee discount and benefits programs, and payment plans. Never let a good crisis go to waste.
Being a leader is tough, but I bet you’re tough enough.
Q: Should my veterinarians continue discussing fees or train my support staff to do it? Because we lack experienced veterinary technicians, our doctors must review cost estimates for everything. As we’ve gotten busier, I’m trying to get my support staff to go over basic estimates, but either they’re not comfortable or the client wants to hear from a veterinarian. Honestly, it’s faster if the doctors do it.
A: As a long-time solo practitioner in small-town North Carolina, I know your struggle. I also know that keeping the distance between doctors and dollars is more efficient and profitable.
Veterinary professionals must understand fee structures and be comfortable charging for services. I say this because I’ve seen some veterinarians instantly default to discounts when confronted with explaining an invoice.
Other “money talk” insecurities manifest by the need to lecture clients about the high cost of running a veterinary clinic, enormous educational debt and rising staff wages. Such pointless debates waste time and risk your team appearing defensive to paying customers. Once you raise the stakes with the “it costs so much” chip, prepare to be one-upped by your clients. Everyone struggles with finances and makes sacrifices. Know when to hold ’em, fold ’em and walk away.
Some folks say doctors should never “talk money” or that it somehow dirties our white coats. To be clear, I have no problem with veterinarians discussing finances when needed, such as in a complex workup or if a client has questions or concerns. While fee conversations are unavoidable in our profession, having a trained team member review routine estimates and payment options is ideal in most circumstances.
I’d also like to note that the topic is highly personal. I know many successful veterinarians who do all the financial talking, while I prefer to delegate it to trained staff. You also need to consider your doctors’ comfort levels, training and experience, and if the conversations create additional stress. Given so many medical demands, veterinarians can’t afford to waste intellectual and emotional reserves persuading clients to part with cash, unless necessary. Then again, some love it.
Training your entire team is essential for this model to work. You must role-play various situations, including client pushback and refusals, and allow employees to fly solo once they’ve earned their wings. It takes time, but the results are plentiful, both in time saved and profit gained. You’ll be able to see more clients, and many team members will revel in the additional responsibility.