he veterinary care cycle is a collaborative process that includes the veterinary team and the client. As veterinary professionals, our role is to gather a medical history, perform an exam and make a medical recommendation based on the animal’s needs. The client’s role is to make a decision about how they would like to proceed. The veterinary team then implements the client’s decisions. From there, the veterinary team and the client must wait to see how the patient responds before the cycle begins again.

This clear division of responsibility is powerful. It reminds us that our job is not to “heal animals;” our job is to offer the best medical recommendations possible (not to convince, coerce or control what the client decides to do), and then to implement the client’s decisions.

The Uncomfortable Truth

Providing veterinary care costs money and, let’s face it, most of us find conversations around money to be stressful. But the discomfort we feel doesn’t actually come from the client’s reaction to our treatment plan or the decisions they make. It comes from what we are individually making the client’s decisions and behaviors mean about ourselves, the perceived value of our services and our ability to do our jobs well.

Bluntly put: When they say no, we believe we failed (and it’s “their fault” for not saying yes). The truth is this, however, treatment plans and pricing are neutral. Independent of our beliefs, they have no ability to create an emotional reaction for us, or for the client.

Unfortunately, conversations about money tend to trigger a lot of fear and insecurity, which leads to less than optimal behavior by all parties involved. This happens because emotion fuels behavior—both ours as veterinary professionals and theirs as clients.

As veterinary professionals, our fear-driven behaviors show up as:

• Trying to guess in advance what a client will agree to and only putting those things on a treatment plan in an effort to avoid nasty comments or declined services.
• Eliminating diagnostic and treatment options before ever presenting them because we personally believe they are too expensive and feel shame or guilt about presenting them to owners.
• Client shaming, either overtly during a visit through efforts to convince a client to make a particular decision or after the fact in conversation with our team when we judge the client and share our disapproval of the choices the client made.

The bottom line is, these behaviors do nothing to save us from feeling uncomfortable, and actually erode trust with the clients which makes our job more difficult.

Navigating Client Decisions

Clients will have a range of responses to our recommendations, regardless of what those recommendations cost. Some may thank us and authorize everything we recommend; others may decline it all and lash out with those seven infamous words, “you’re only in it for the money.”

It’s crucial to remember that their reactions are fueled by their own emotion in the moment and we are not responsible for creating or managing their emotions or ensuring their comfort. Our only responsibility is to give them all the options, and then let them decide for themselves what they want to do.

Unfortunately, many of us fall into the trap of hyper-responsibility, believing we are responsible not only for patient outcomes, but also for the decisions clients make for their pets. We often believe if patients don’t get better or clients decline our recommendations, then we have failed. Neither of these things is ever true because we can’t be responsible for something we can’t control.

This mindset builds a wall of resentment toward clients and negatively impacts our client interactions. Furthermore, it leads to burnout, shame and guilt, especially when outcomes are less than ideal.

Remaining Neutral

Clients want to feel informed, respected and supported. As soon as we express an opinion (through our words or body language) about what we believe they should do, we put them on the defensive. However, when we can remain neutral, we create a safe place for them to ask additional questions and make the choices that are best for them in that moment.

In the long run, this serves the pet much better because the client won’t be afraid to return for additional care in the future. We often underestimate the number of pets that don’t receive care simply because the pet owner felt personally uncomfortable in a prior veterinary visit.

Treatment Plan Tips

The following are some actionable tips for creating and presenting treatment plans and pricing in a way that builds client trust and minimizes stress for the veterinary team.

1. Share your findings in real time. Talk out loud as you complete your exam so the client hears what you are finding, even when findings are normal. This practice not only educates the owner about their pet, but also creates perceived value for the exam itself and builds client trust in your services. Commend them for things they are doing well.

Example: “You’ve done a great job keeping Fluffy at her ideal weight, keep up the good work! Her coat is in great condition and I don’t see any evidence of fleas or other parasites. Great job!”

At the end, summarize your exam findings and share what diagnostic testing and treatments you’ll be recommending for the pet and why.

Example: “Fluffy appears painful in her right hind leg. Taking radiographs will help us determine the cause of her discomfort and what we can do to help her feel better.”

2. Address the costs directly. Being up-front about the costs from the start reduces anxiety in clients and allows them to make a decision more clearly.

Example: “I’m going to create a treatment plan with all the things I’m recommending today, including pricing, and then you can decide how you’d like to proceed so there are no surprises.”

Not only does this allow clients to relax instead of fearfully anticipating what you’ll say next, it also makes talking through the estimate much easier for everyone because clients already understand it is okay for them to say no.

3. Put everything on the plan. Anything you believe would provide useful information in diagnosing and treating the patient in front of you, put it all on the plan. Don’t spend any time trying to guess what the client will want to do. You can always modify the plan later, if needed, based on their response.

4. Don’t take it personally when clients decline. Remember, when it comes time for a client to accept or decline your recommendations, you’ve already done the first part of your job (exam, educate and make a medical recommendation). The next part of your job is implementation, and you can only implement based on what the client decides.

The decision is theirs alone to make. When you recognize you’re feeling offended or frustrated by their choices, remind yourself you’re only responsible for what you control so it’s okay to let it go.

5. You aren’t wasting your time. A “no” today isn’t a “no” forever. Clients learn through every veterinary interaction. Just because they decline today doesn’t mean they will decline next time, so don’t trim down your recommendations based on prior experience.

Clients appreciate consistency and acceptance of their choices. You’ll be surprised how many firm no’s turn to yes’s as trust in the relationship builds over time.