The Uncomfortable Client Questions
In this profession there are regular client questions, and there are awkward client questions, and then there are the Uncomfortable Client Questions. Regular client questions are no big deal, and awkward client questions deserve their own hilarious blog post at some point, but no one likes to talk about Uncomfortable Client Questions. Well, today is the day! The TLC staff has gathered several of our most common but most uncomfortable questions. Lots of these subjects come up everywhere in this profession, but a few are unique to us here at TLC. I have put together some answers for you that I hope will help people understand these difficult to discuss issues. Away we go!
Q: Why can’t you give me medications without seeing my pet? I know what the problem is, I just need the medications!
A: All states have laws that define the Veterinary Client Patient Relationship, or VCPR. In the state of Washington for example, the VCPR requires examination of animal(s) within the last year, or sooner if medically appropriate before a diagnosis can be made and treatment initiated. If we have not seen your pet for an examination within the last year, we cannot by law dispense medications until we have updated the exam. On top of that, there is a huge potential to miss other important medical issues by skipping out on the physical exam. Some medications can even be harmful or ineffective in certain circumstances, so in most cases it is important to evaluate the pet even if it was seen recently for what seems like a similar issue.
Q: Why is veterinary medicine so expensive? If you really loved animals you’d treat my pet for low cost or free. You only care about the money.
A: Imagine going to the mechanic, having your car serviced, and when it comes time to pay, saying “I can’t afford that, if you really loved cars you’d fix my car for free!” Or, imagine going to the grocery store, filling your cart with groceries, and then telling the cashier “I will pay you next week when my tax return comes in.” It sounds silly in that context, but in veterinary medicine we actually get similar statements routinely. Unfortunately, the cost of veterinary care continues to rise, just like the cost of gas, milk, and other necessary items and services.
There is a large amount of overhead in the operation of a veterinary clinic, no matter how small the clinic might be. TLC is not a big clinic, but we do have big costs, including medication and supply bills, equipment maintenance bills, licensing and continuing education fees, insurance fees, and of course the big one, payroll for our staff. Every time our suppliers are forced to raise prices, we are too. Believe me that reevaluating and raising prices is one of the most agonizing parts of clinic management.
As far as the comments about "just caring about money," saying that kind of stuff really hurts us as veterinary professionals. Just like with any business TLC does have to make a profit or I wouldn’t be able to pay my staff or myself, and I wouldn’t be able to continue to upgrade equipment or bring in new services in order to improve care for my patients and clients. Asking veterinarians and veterinary staff to work for free is unfair and unsustainable. No one should feel guilty for getting paid for the work they do, no matter their profession.
Q: Why can’t you let me pay my bill over time?
A: The simple answer is that veterinary clinics do not function well as banks. It is extremely time consuming and difficult to try to collect money that is owed to us, and sadly, many clients simply don’t pay their bills, even with the best of intentions at time of service. Because our margin of profit is often so small on products and services, unpaid accounts are incredibly stressful for us. We have bills to pay too, and we depend on steady income to make paying our bills possible. There are many options for funding pet care, and we are very happy to help clients figure out ways to get care for their pets in financially difficult situations. At TLC we encourage pet insurance, emergency funds, and we accept Scratch Pay. However, we have had to stop allowing charging to accounts here, as the amount of unpaid bills was becoming astronomical.
Q: Why isn’t the clinic open 24 hours a day, 7 days a week, 365 days a year? What happens if I have an emergency?
A: Veterinarians and veterinary staff put in long hours in a profession that is taxing on the brain, and on the heart. We need breaks from our jobs, just like anyone else. We need to spend time with our friends and families and pets, work on our hobbies, travel, rest, and “unplug” from our jobs so that we can be physically and emotionally available
to provide the best care possible to our patients and clients when we are at work. In our area, we are fortunate to have Washington State University Veterinary Teaching Hospital, which has an amazing emergency service. ER clinics allow general practitioners and our staff to enjoy our non-working lives, just like in other professions.
Q: So the clinic isn’t open 24 hours a day, 7 days a week, 365 days a year, I understand that, no one wants to be at work all the time. If I have questions after hours can I just find you or your staff on social media, look for your car in town, call around to see if you are at a friend’s house or out at a restaurant, corner you before church, hunt you down at your kids’ sporting events, or try to get your personal phone number from your friends and family?
A: Actually, no. As I explained in the previous question, veterinary professionals just can’t be “on” every hour of every day. We need our off work hours to do all of our non-work, normal day to day human things, like going to church, attending our kids’ events, vacationing, spending time with family and friends, going out for lunch, or scrolling mindlessly through Facebook for a few minutes. As veterinary professionals, it absolutely isn’t that we don’t want to help you, it is simply that we have to have time off just like anyone else so that we don’t burn out. This profession is notorious for causing compassion fatigue and burn out, and I myself don’t want to ever go down that road. I love my clients and patients and my job, and I want to keep doing it for a long time yet! In order to be at my best, I just have to be able to check out. It would be invasive of me to track down my favorite barista on her day off to make me a spiced chai, or Facebook stalk my my banker to address an issue with my account on a Sunday, or hunt down my grocery store clerk an hour after closing to see if I could just quickly come in and grab some milk. Veterinary professionals need the same respect for our personal time that any other person in any other profession does. This is why we are so grateful for emergency clinics, because they allow us to take time to breathe and enjoy our time off.
Q: I don’t like seeing a different veterinarian, I only want to see you. Why do you have another veterinarian working with you?
A: I work in the office an average of 11 hours a day, Monday through Friday. I am incredibly blessed to have my good friend and superb veterinarian Dr. Anna Pfeiffer helping me out on Mondays and on other days when I am not available. Having Dr. Anna here allows me to see appointments, and catch up on administrative work, helping me avoid being in my office late at night and on the weekends. This has really improved my quality of life, and the quality and quantity and diversity of surgery and medicine we can provide. Dr. Anna is an excellent surgeon and does all of the surgical work on my own animals. Having her here also adds another set of eyes, hands, and veterinary brain power to tough cases, which benefits everyone. While I am very flattered that people want to see just me, I want you to know that I trust Dr. Anna 100% not only with the care of my own pets, but the care of my patients, clients, and staff as well. I ask you to please trust me that I would never share my clients and patients with anyone that I didn’t fully believe in. If you trust me to care for your furry family members, I hope that you will also trust my judgment in whom I have working alongside me.
Q: I am worried you are going to lose the “small town feel” now that TLC is in the new building.
A: As TLC Animal Care has grown from a very small clinic with limited hours to a bustling business in need of more space, we have attempted to keep the clinic values and mission statement at the forefront of each new opportunity and decision. It is the mission of TLC Animal Care to provide high standard, compassionate veterinary care for our patients, centered on quality of life for the entire family. We strive to provide progressive, high quality veterinary medical and surgical services to our clients and their pets, while maintaining a “small town family feel.” We are committed to improving lives of pets and people by strengthening the human-animal bond, and keeping quality of life at the center of every decision.
That being said, with the new building comes some new changes. Change is hard, but in this case, these changes are for the better! Yes, we have added to our team, so there are some new faces. There are currently just 6 of us on the TLC Team, and we communicate constantly to make sure we are all on the same page regarding patient and client care. We now have two exam rooms. While we have definitely lost the “home garage studio” feel, our new exam rooms allow us to see more patients in a day without compromising the time we get to spend with each patient. We have new phone, computer, and technology systems. All of these updates were carefully chosen in order to make communication easier and reduce errors, making for more efficient and reliable service. So yes, we will continue to strive to improve our service for our clients and patients through new technology, equipment, and staffing, but we will also continue to provide the same “small town TLC Family” care that we always have.
Q: I can save a few bucks by getting my food/meds/etc online. Can you e-mail in a script?
A: As with any other small local business, we very much appreciate our clients shopping with us, even if they have to spend a few extra bucks to do so. We know that there are lots of online options, and we are extremely thankful to the clients that choose to make the extra little effort to visit us for supplies! This is especially appreciated after we have worked with a client to diagnose a pet and get that pet settled on a food or a medication that works. We do work with affiliate pet food delivery services and we have our own online pharmacy as well. If a client still wishes to shop elsewhere, we will provide written prescriptions for food or medications. We do not e-mail prescriptions to online pet medication pharmacies, unless we have expressly recommended that particular online business.
Q: I was scheduled to bring in one pet, but I brought along an extra pet without mentioning it when I made the appointment. Why can’t you see both of them right now?
A: Scheduling in a veterinary clinic is a little like a game of Tetris. We do our best to fit everyone in so that there is plenty of time to address the variety of appointment types we see in one day. Appointments can range from quick things like suture removals and vaccine boosters, to longer “sick-pet” appointments that might include bloodwork and radiographs. In order to keep the flow going and not run late, it is important that we schedule each appointment appropriately. Bringing a “surprise” pet to an appointment can be really disruptive to the schedule, even if it doesn’t seem like it would make much of a difference. If you schedule an appointment and then realize that another pet needs to come in too, just give us a call and we will be glad to help get that sorted out ahead of time for you!
Q: I expect to be with my pet the entire time he is here, including during procedures, surgeries, x-rays, dentals, etc. I hope that is ok with you.
A: Actually, that is typically not ok with us. While we focus strongly on the Human Animal Bond here at TLC Animal Care, one of our most primary concerns is making sure we provide excellent care for our patients when they are with us for procedures and surgeries. Having clients in the back with us for procedures adds to the stress for our patients as well as causes distraction for the TLC team. Equipment, medications, and other pets in the hospital can be dangerous for non-staff members to be around, and of course we always have to be mindful of liability as well. The Veterinary Client Patient Relationship is based in trust, and we ask that you trust us to care for your pets as if they are our own when they are with us for procedures and surgeries. Let us be the ones who worry about the actual nitty gritty of procedures and surgeries so that you can focus on supporting your pets when they are done and ready to go back to you.
Q: I refuse my pet to be vaccinated for rabies. I hope that is ok with you.
A: At TLC Animal Care, the only vaccine we absolutely require with very few exceptions is the rabies vaccine. Aside from being incredibly important for human and animal health, the rabies vaccine is required by law for dogs and cats in the state of Washington. If your pet does not have a veterinary documented valid reason he or she should not receive the rabies vaccine, we will need to make sure your pet is current on rabies before he or she can receive care here. This means that pets who are not current on rabies vaccination and are able to be safely vaccinated will receive the rabies vaccine while they are here. This policy is not negotiable.
Q: My pet is aggressive. Can you still see her for an appointment?
A: First of all, thank you for your honesty! Please tell us up front if your pet has been known to bite, or is fearful at the vet’s office, or has a history of aggression. Please don’t be offended if we ask you to keep your pet in the car until we can clear other patients and clients out of the lobby. Please don't reward your pet for being nasty to the veterinary staff. It is better for everyone involved if you are just honest about this behavior and let us do our best to work with your pet in a safe, low stress way.
We can usually work together to make sure your pet receives care while our doctors and staff and other clients and patients remain safe. In the exam room we may utilize safety tools such as muzzles or cat bags, and in some cases we will send your pets home with medication that will help them feel less anxious and fearful at the next appointment. Some pets do better in the room with clients, and some do better out of the room. On rare occasions we do need to use injectable sedatives to handle aggressive or extremely fearful pets. As long as we are all able to work together to help make an aggressive pet appointment as safe as possible for everyone, we are happy to do our best to provide quality care for that pet.
Q: Why does my cat have to be in a carrier, and my dog have to be on a leash to visit the clinic?
A: Two reasons: safety and liability. We do our best to space out our appointments appropriately, but sometimes there is more than one client in the lobby, allowing for potential interaction of pets. Many pets are ok with this, but some are definitely not! Especially when it comes to cats. Cats are already usually on edge about the car ride, and coming up the sidewalk into a lobby that might be full of dogs is not on their list of favorites. Even the nicest cat can become frightened and leap away from an owner. If that happens outside the lobby, the cat could easily be lost, or worse, hit by a car on the road. If a cat escapes in a lobby full of dogs, there is the potential for severe injury to the cat. Similarly, unrestrained dogs can run into the street, get into scraps with other pets, or cause harm to other clients.
Flexi-leashes are almost as dangerous as no leash, as the dogs on these leashes are able to stray several feet from their owners in a flash. The second part of the equation is liability. Our insurance company does not like it when pets are unrestrained, and our liability rises significantly in these situations.
If you find yourself without a leash or a carrier, just let us know! We have cardboard emergency carriers available, as well as handy slip leashes. Make sure your pet’s collar is not loose, and if you must use a Flexi-leash, please make sure it is in the locked position with a short lead.
Q: Why can’t I just get a diagnosis over the phone?
A: There are very few things that can be definitively diagnosed over the phone without seeing a pet in person. It is very easy to miss an issue or misdiagnose an issue without actually laying hands on an animal. In an ongoing case, we can sometimes help you via phone without seeing the pet, but most often we are going to want to see that pet, if only for a quick recheck. When we tell you that we need to see your pet to provide a diagnosis, we are not just trying to “get your money,” we are just practicing best medicine and meeting standard of care.
Q: I don’t want to talk to the tech or the receptionist, I just want to talk to the doctor right now, can you go get her.
A: There is one of me (well, two of us doctors on Mondays) and hundreds of you! We typically have a very full and well planned schedule, and I don’t often have time to break away to take unexpected phone calls or see unplanned visitors. It is absolutely not that I don’t want to talk to you, in fact my staff can attest that I would much rather stand around and gab than do my charts. Unfortunately I do have to get my work done in a timely manner in order to keep the schedule on track, and that means that I have set times that I can do call backs or visit with people. My staff is well trained and can answer a lot of your questions on their own. If it is a question that they can’t answer, they are excellent at gathering information from clients for me, and they will bring those questions to me in the surgical suite, while I’m charting, or otherwise occupied. I can usually give them an answer to relay to you so that you get your questions resolved quicker, but sometimes you may have to wait until I have a break in oder to get back to you. Please, don’t be afraid to call and talk to the TLC staff! They will always do their best to help you as quickly as possible!
This has been episode one (and hopefully the only episode ever) of Uncomfortable Client Questions! I know these things are hard to talk about, but I feel like honesty is always the best policy when it comes to communicating with our TLC family. Remember, you are always welcome to ask us questions about our policies! We are happy to answer you!
Enjoy your weekend, everyone!
- Dr. Andi 🐶🐱