I think it is very important for a veterinarian to be able to forge great relationships with their clients. Personally, I feel very privileged to have so many regular clients that value my judgement and entrust me with their pet’s wellbeing. However, I do appreciate that not all clients will appeal to the way I practice. In similar effect, I find that I get along with certain clients more than others. That being said, it is essential that a vet and client don’t ever allow their differences to get in the way of the patient’s health. Ultimately, we all seek the same outcome: a healthy pet, free from any pain or suffering.
This brings me to the hot topic of complaints received from clients.
I think one of the hardest complaints I can ever digest is being accused of ‘over-servicing’.
I hope this post helps bridge the gap of mis-communication between veterinarians and clients. I simply don’t understand the term over-servicing when it comes to what I offer.
Such complaints leave me feeling quite perplexed like ‘Megsey’ below.
In my consultations, I do my best to be very thorough. I examine the patient head to toe, get as much history as possible and offer an array of recommendations relevant to each case. If I get booked a consult to examine a lump on a dog, I don’t just focus on the lump in question.
I don’t take any shortcuts and always try and conduct a full examination.
This includes a fine needle aspirate of the lump examined under the microscope and complete physical examination. I also discuss diet and so much more. However, when I am running really behind in my consultations, I find myself having to focus on the issue in question and trying to address it appropriately. If I also discovered multiple health issues in your pet, I then recommend booking you in for another consultation to tackle all these unexpected issues in more details.
Furthermore, if I’m booked a geriatric patient, I always recommend performing a blood test even if their physical examination was normal. There is no way I can be 100% sure that the inner workings of your pets are sound purely based on my physical examination. Almost 50% of the geriatric profiles I run, I find abnormalities. Diagnosing issues early on for my geriatrics can be very helpful in their long term management.
For example, ‘Ralph’ came in for a routine health check and I recommended running a blood test as he was greater than 8 years of age. His blood results revealed elevated liver enzymes. We are currently working him up for a suspect underlying Cushing’s condition and we may have caught it in the very early stages.
As with any disease, early treatment gives for a better prognosis.
Ralph impatiently waiting for his liver treat.
Basically, I can definitely be accused of overloading my clients with a wealth of information. Nowadays, I find that people lead very hectic life styles and bringing their pet to the veterinarian is only limited to a serious ailment or an annual vaccination booster or health check. Hence, I seize this opportunity to give their pet a full physical examination, check up on their diet, training and any other health issues. I discuss dental health, skin health, arthritis and range of issues.I simply can’t help myself; I just want to give my clients all the best options for their pet to be in elite health!
Obviously some clients perceive my thoroughness as an attempt to squeeze them for more money. They feel that my intentions are not genuine and all my recommendations are ‘unnecessary’ and fuelled with greed.
To those people, I say you have got me all wrong; if I wanted to make money, I would not be working as a veterinarian.
The veterinary industry is far from a lucrative business. The average veterinarian is severely underpaid and overworked. If only you knew how many hours I work/week excluding afterhours and my weekly earnings!
To make matters even more frustrating, veterinarians are often trained to think that an over-servicing complaint often indicates that we have failed in our communication with the client as they were not prepared for that cost. Personally, I find that the owners who do complain are usually the ones who have been given a very good estimate and the overall price was $20-50 give or take more than expected.
I really strive to give good estimates on cost of procedures or workups but they are estimates not exact figures. I can’t know exactly what I am going to find on the chest x-rays or ultrasound and so I can’t factor in an exact cost for treatment when I have yet to come up with a diagnosis.
I definitely could do better with my consultation estimates but that can be very challenging when I am heavily booked. We are generally booked 15 minute slots for each consultation in which we must examine the patient, get all the history and discuss all treatment options with the owner and answer all their questions. Ultimately it boils down to this:
‘If your pet requires medication for an infection, I must simply prescribe it and you have to pay for it!’
I was once specifically accused of over servicing a client and to this day, I really can’t understand what I could have done better. I believe I communicated openly with the owner and discussed all treatment options clearly. This lovely and hyperactive 12 month old poodle was booked in as she was excessively straining to urinate. Her examination and history revealed she was suffering from cystitis. Cystitis can be quite uncomfortable and painful; a burning sensation is felt each time the patient urinates. I discussed my recommendations and advised the owner that her dog would require a course of both antibiotics and anti-inflammatory/pain relief.
The owner debated with me the need for anti-inflammatory as the dog was bright and alert. I went on to explain that cystitis is inflammation of the bladder and can be quite irritating and painful. It was the reason why her dog was frequently urinating. While she may appear bright, she is obviously not feeling 100% as she has an urgency to urinate frequently. The next morning, the owner dropped in and demanded to get credit back on the anti-inflammatory medication and accused me of over-servicing her. I actually felt awful for her dog and was glad I had managed to give her one shot of anti-inflammatory which would give her pain relief for 24 hours.
It really hurt me to be accused of over-servicing when all I cared about was her pet’s welfare.
I simply wanted her to be free of pain and to help her recover quickly.
Sometimes, I find it very challenging to convince certain owners of the merit of medications. I often meet very arthritic dogs that the owners decline any type of treatment for. They say they are old and it is normal for them to slow down. Some people don’t understand that animals can feel pain too and simply can’t express them like we do. They don’t stop eating or start moaning about their agony until it has reached completely intolerable levels.
And my latest accusation of over-servicing has left me quite baffled. This lady called us very distressed and wanting some advice about her cat. She was in the process of moving house and her cat’s anxiety had spurred on an episode of self-trauma. The cat seems to scratch its face excessively whenever it is anxious. The client wanted to see if we recommend admitting the cat to hospital for sedation or any necessary medication while they move. The nurse consulted me about the phone call and I said we would be happy to assist the owner and have the cat in hospital.
The nurse recommended my behavioural services and the client was quite keen.
However, after much discussion, the client cancelled the appointment she made as she decided it is best to monitor the cat at home instead of overwhelming her with a trip to the vets. I looked up the patient’s history and found that the patient may truly be suffering from underlying anxiety and her behavioural issues had not been addressed. A week and a half later, I called the owner to check up on her cat and make sure she had settled down with the move.
I had to leave a voice message asking about the cat and explaining that I am happy to offer my behavioural advice on this case. The owner returned my call and we had an in-depth discussion about her cat’s condition and different treatment options. Basically I emphasised the importance of getting her cat checked out soon as the owner had clearly stated the cat had severely traumatized herself and the scratching had still been ongoing after the move. I was concerned the cat may have acquired secondary skin infection. I also briefly touched on behavioural modification and anti-anxiety medication with the owner and what that would involve.
To my utter surprise, the client calls the next day and cancels the appointment she made with me and accuses me of ‘over servicing’ her and asks the nurse not to tell me.
Upon hearing her feedback about my services, I felt very bitter just like ‘Forrest’ below did.
I simply don’t understand how me calling a client to check up on her cat and offer my services is perceived in a negative context. I didn’t hold a gun to the owner’s head and ask her to call me back. She chose to do so willingly and spoke to me for over 20 minutes. This experience has left me feeling exploited and undermined for being so passionate about what I do.
I would like to end this post by asking you for your feedback.
What do you perceive as an over-service by a veterinarian?
Have you ever experienced it?
If so, can you please expand on that experience and tell me why you felt over serviced?
I never ever want to be accused of ‘over-servicing’ a client again, so I’m all ears for your input!