Discussing the cost of veterinary care is among the top stressors for many veterinary professionals. In a business that operates on a cash basis, these conversations are a necessity. But when decisions about life-saving care are made for purely financial reasons, the emotional toll on all involved in the conversation can be high.
Understanding the factors that create stress when discussing veterinary finances with clients — and developing strategies to mitigate them — is essential to supporting the mental health of veterinary team members, improving patient outcomes, and increasing client satisfaction.
Pets are considered a part of the bonded family unit by most pet owners. The inability to provide medical care for a pet creates distress for human family members. This can lead to emotional outbursts in the moment, frustration at the veterinary clinic's payment policies, verbal abuse of veterinary team members, and negative online reviews. In extreme cases, cyberbullying and harassment of the veterinary clinic may occur.
While abusive behaviors should never be tolerated, remembering the emotional toll that financial stresses can have on clients and expressing empathy throughout the conversation can often help keep conversations civil. The mindset that is not helpful in these situations — and that will create more tension between pet families and veterinary professionals — is the idea that “you shouldn’t own a pet if you can’t afford to care for it.”
There are several problems with this idea:
Thankfully, the mindset of pets being a luxury is not held by the majority of the veterinary profession. Instead of judging clients for bringing a sick or injured pet to our clinics with limited finances, we must work to find ways to connect with the client to openly discuss the best way to use their available funds in the moment.
We must work to find ways to connect with the client to openly discuss the best way to use their available funds...
Kate Boatright, VMD
Vet professionals understand the essential role pets play in their families' lives and that being unable to provide veterinary care for a beloved pet is distressing to the owner. We feel this stress, too. Many veterinarians will provide alternative options through a spectrum of care approach, seeking to find a diagnostic and therapeutic plan that fits the needs and limitations of the pet family. Unfortunately, in some cases — especially emergency situations, such as a gastrointestinal obstruction — there simply aren’t alternatives to a costly emergency surgery. Often, these cases result in either euthanasia or the surrender of the pet.
Situations such as this create moral distress, which is defined as “the experience of knowing the right thing to do while being in a situation in which it is nearly impossible to do it.”1 Moral distress has been associated with burnout and decreased professional fulfillment for veterinarians.2 While data is more limited on the effect these cases have on the rest of the veterinary team, anyone who has worked in a clinic has seen the emotional toll these cases take.
It is essential that veterinary team members have an opportunity to debrief together after a particularly stressful case or distressing conversation with a client. This will help to support the mental health of the team and provide an opportunity to evaluate the situation for things that went well and opportunities for improvement in the future.
Additionally, investing in team communication training can be an asset to your practice. Veterinary team members who are equipped to handle financial conversations with empathy, strong communication skills, and training in de-escalating emotional clients will have more successful outcomes for patients and more satisfied clients.
A Team Approach to Financial Conversations in Clinical Practice
Over the next several months, Dr. Boatright will explore ways to help reduce the stress of financial conversations and help to prepare pet owners for the costs of pet ownership — both expected and unexpected.
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Dr. Kate Boatright, VMD, works as a small animal general practitioner, freelance speaker, and author in western Pennsylvania. Since graduating from the University of Pennsylvania with her veterinary degree in 2013, she has worked throughout Pennsylvania as both a general practice and emergency veterinarian. Both in the clinic and outside of it, Dr. Boatright enjoys building relationships with her clients and educating pet owners on how they can keep their pets as healthy as possible. She loves being a veterinarian and educating students and colleagues on wellness, communication, and the unique challenges facing recent graduates. Outside of the clinic, she is active in many veterinary organizations, enjoys running, watching movies, and playing games with her husband, son, and cats.