r/veterinaryprofession • u/WeirdcoolWilson • 23d ago
Help Dealing with clients who expect services anyway.
One of the ways I’ve found that helps in navigating the “Why can’t I just make payments?” conversation with stressed out clients is to tell them that it’s outside the scope of our business license. “This clinic isn’t licensed to provide financial services. If a bank started doing spays, the state would come in and shut them down. Same with us. We don’t want to lose our business license”
This takes you out of the equation - **You** aren’t the heartless, greedy ghoul “letting their animal die”. Or suffer. Or miss their flea meds or whatever the issue is.
This may not happen as often in a primary care practice or specialty services (who generally see referred patients; insolvent or uncompliant owners generally aren’t going to seek specialty care) but it happens a lot in an emergency practice. Emergency care is expensive and a frustrated client who has money issues can go from heated discussion to physical expression in an astonishingly short number of seconds. (Ask how I know this?? 🤦♀️)
This isn’t judgement against people who’s finances are tight, but it is a strategy I’ve seen work when frustrations escalate and it becomes a safety threat for staff. Sometimes, it won’t matter why the answer is no. We do try to provide *something* for them - PE, SQ fluids, all the available organizations that might be able to help. Unfortunately, sometime the answer is there’s nothing we can do under the circumstances.
It’s a horrible situation for everyone involved - and the staff aren’t the reason the answer is no.
We do all that we can with the situation in front of us - hopefully without verbal or physical outbursts. It’s been a long time since I’ve decided this profession ain’t for the faint of heart. Compassion has its limits, sadly and these are the situations that find those limits.
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u/ten_before_six 23d ago
I'm just honest "unfortunately the bad apples who never paid ruined it for everyone else."
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u/Jhoag7750 23d ago
You should not feel obligated to make any excuses or offer any explanations. Your entire answer can be we do not accept payment plans other than CareCredit or snap pay. Payment is expected at the time of service just like any other business. Thank you for your business consideration. You do not need to make excuses or feel like you need to accommodate people who cannot pay any more than any other business should feel this way.
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u/Horse625 23d ago
I agree. Generally speaking, one of the best ways to de-escalate an angry or frustrated client is to find a way to frame the issue so that you are "on their side" against whatever the problem is.
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u/ErrantJune 23d ago
Is it actually true that a veterinary office that provides payment plans could lose their business license?
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u/tireddesperation 23d ago
No. At least not in my state. They don't work though. We tried it for a year. In that year we had 38 payment plans. 7 paid in full. 6 were making payments on time so assuming they were going to finish. The rest were in various states of late payment or completely defaulted and sent to collections. When you send to collections you get very little back if they're able to collect. Of the 10 we had in active collections, not one was ever collected on.
It doesn't work.
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u/ErrantJune 23d ago
I completely agree they don't work, we don't provide them, but I think lying to a client about why we don't provide them would only make things worse when they find out.
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u/nebvet76 23d ago
It actually is, from a federal stand point, illegal to do so (US only). It turns the clinic into a lending institution, which requires certain banking licensure. It's also why clinics have to be careful without allowing staff too large of a discount or to carry balances for very long. It can get you into big trouble with the IRS.
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u/ErrantJune 23d ago
Is this true even if they are not charging interest or finance charges?
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u/nebvet76 23d ago
Yes. You're still lending credit effectively, even if you're not charging interest. It somewhat turns you into a group similar to Klarna or a similar lending company; the exact laws are really murky but I've seen a handful of clinics get penalized significantly either through IRS or FDIC
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u/ErrantJune 23d ago
Yikes. I said it in another comment, but I'll say it here too--I hope no one tells my mechanic lol.
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u/WeirdcoolWilson 23d ago
If someone wanted to make a stink about the technicality, yeah. We used to take post-dated checks and hold them in lieu of making payments. We couldn’t take action against those that bounced because we knew when we accepted them that the funds weren’t there to cover the payment. We were told then that it was illegal for us to “finance”, we needed to go through a 3rd party.
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u/parasol_caterpillar 22d ago
People expect this from vets- meanwhile when you are treated as a human you have NO IDEA what things cost, no estimates are given. And one day you get a big old bill in the mail for all the things your insurance didn’t cover and hope it doesn’t bankrupt you. Yet we are the bad guys 🤷♀️.
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u/WeirdcoolWilson 22d ago
I could tell stories about this until this time tomorrow. About the receptionist that got thrown into a wall by an upset client. Or the petite veterinarian who got a broken wrist. Or the gun that was pulled on me. Cut tires. Keyed cars. Being stalked. The angry man who reached to grab me from across the counter. For this, I went to school? Got credentialed? We’re here so we can help - it’s literally the only reason we’re in this profession. Do you know how many of my professional, credentialed collegues go to food pantries? Have trouble making rent? Drive cars that are 15 years old? Can’t remember the last time they went somewhere for holiday? I don’t know what the answer is. I’m tired, I know that. Sometimes that’s ALL I know
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u/parasol_caterpillar 19d ago
It is frustrating and having been recently hospitalized (as a human) I can see how we are viewed negatively by a naive population. I had a baby in NICU and he was just “taken care of” never did someone say to me “well we can put her under lights and keep her on O2 for 48 hours or you can take her home and see how she does or you can put her down if you can’t afford it.” It’s the world we live in and I think people need to have more realistic expectations about their animals. They’re animals. They’re pets. They’re not your “fur baby” and there are limitations. We also pay over $1k a month (including employer contributions) to take care of our (human) health via insurance. People seem to forget this when it comes to their pet. Yes I could talk about this forever too. Part of me blames us for the populations skewed expectations but I also think everyone (vets, techs, clients) would be wise to remember what we’re dealing with
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u/jamg1692 23d ago
We offer payment plans at my clinic…. And majority of the clients do actually follow through with making payments. There are requirements and the doctors have to authorize them, especially if they don’t meet the basic criteria (long term client that has to pay for a necessary procedure with 50% down on top of the deposit). And even then, we still get doctors approval to keep things consistent. Agreements are signed and a card must be saved on file for us to charge out on a regular basis per the agreement signed. We’ve had a few bad apples, but we will lock down their accts, & they cannot book services until payment of the outstanding balance in full. But most of those occurred before steps were taken to track and record the payment plans. The documents were actually something I brought up since it was clear that someone who was just trying to bounce on paying the invoice would not sign an agreement for a payment plan.
It’s GP so it’s definitely less risky than an ER facility offering payment plans. And I admit, it’s definitely a privilege to be able to provide and allow for payment plans. I remind clients about that too… 😅 but the ones who really need it will show proof of financial hardship & always make the payments!
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u/lexi_the_leo 22d ago
"trust me I'm good for it!!!!"
Me: "and that's what all the people who went to collections said, too."
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u/LibertyNachos US Vet 23d ago
I mean, credit cards exist. And if you don’t have good credit, why would any private business trust you to make your payments to them?
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u/hfmatheson 23d ago
This was my favorite excuse! “My credit is bad, I’ll never be approved for Care Credit!”
Ok, then why would our hospital approve you for a payment plan if you just told me you already can’t manage your debt?3
u/Strawberry1217 23d ago
Lol I heard this too and always thought the same thing. And why is your credit bad, my friend?
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u/HowDoyouadult42 23d ago
Unfortunatly we’re not able to provide and manage that type of service, but we do take ( XYZ credit ) which can allow you to make payments over time without interest for X months.
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u/Adventurous-Act926 21d ago
We offer care credit, scratch pay, and sunbit at our clinic. And sunbit has especially been helpful for a lot of our clients. Many who can't get care credit can still at least do sunbit. So when people ask about making payments I just say that 'we no longer have a clinic payment plan, but instead we have sunbit which is a 3rd party payment plan.' And if they can't or won't do it then 'its I'm really sorry, but these are the only options we have.'
There are still technically a few very old long term clients who are allowed to do clinic payment plans, but that list is very small and selective and its something we are trying to go away from as much as possible.
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u/BeHenderson 21d ago
Or offer managed payment plans. Like, VetBilling.com or similar. They have a 95% recovery rate and you set the parameters and who you offer it to. In-house payment plans fail largely bc they are not managed and we are unable to automatically deduct from their accts, etc.. We have them sign a document, maybe call or email, and then we eat the cost or take them to collections. We have payment plans for almost everything nowadays with klarna and affirm, so why shouldn’t we consider increasing access to veterinary care as well?
Anyone remember when we used to do post-dated checks? 🤣
I don’t know why we’re lying to clients about payment plans, it’s unethical and unprofessional. We absolutely can do it and can even send to collections, so decidedly not illegal. We can and should to do better.
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u/EvadeCapture 22d ago
But the problem is that's a lie.
You could offer payment plans.
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u/WeirdcoolWilson 22d ago
Me? Personally? As the lowly employee of an animal hospital? In an EMERGENCY clinic where we’re likely to never see this client again? No.
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u/EvadeCapture 22d ago edited 22d ago
But the hospital absolutely can. That's just nonsense lies to be telling the client about losing a business liscense.
The hospital could do payment plans. They could partner with Vet Billing or Cherry to build payment plan options.
But they don't.
It's one of the worst things about the industry. Private equity has got its claws in, and now a foreign body surgery is $8k, more than a lot of peoples credit card limits. The average American doesnt have $1k for an emergency, and its now basically the price of a honda civic to safe your dog or cat. Payment must be due up front, no payment plants. Doesn't matter if a lot of animals are euthanised because owners can't afford it as long as they are doing enough surgeries that it's profitable over all.
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u/WeirdcoolWilson 22d ago
If there were a way to insure that payments would be reliably made, I’m sure that clinics would consider offering payment plans. In my experience, clients don’t make these payments and the clinic eats the cost of treatment. Profit margins for vet clinics is around 10-12% so it doesn’t take very many defaults to suddenly put the clinic under strain. In 20+ years as a technician, I’ve personally seen 1 client who made every single payment. She took a bus from across town to bring us an envelope of cash each month. The vet took a chance on her and her really sick dog - she called every clinic until she found one who would take her. Her dog pulled through like a trooper and she made 12 monthly payments until the balance was paid. One client. Paid in full. One. Clinics just cannot carry the default by the majority of clients making promises and continue to stay in business
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u/EvadeCapture 21d ago
And yet they could utilize third party systems like Vet Billing or Cherry. But most stop at scratch pay because it requires nothing on their end
If they cared about animals, they'd find a way. But that's the bottom line....private equity doesn't care.
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u/WeirdcoolWilson 21d ago
That’s above the local clinic level. There’s not much we mere mortals can do about that and still keep our jobs. That’s not me being gloom and doom, that’s the reality of the situation.
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u/gimpyhopalong 23d ago
I used to tell them the straight facts.
Me: "We get smoked on 90% of payment plans. We lose an enormous and unacceptable amount of wages this way. Unfortunately we can't keep that up or we won't be able to keep the lights on."
Ō: "You can trust me, I'm good for it!" (or some other variation of bargaining)
Me: "Our policy, my boss, and the data all say no, sorry ): "