Advice on dealing with client complaints over fees.

Re: Advice on dealing with client complaints over fees.

Hannah Wynne Richards — Mon, 10 Jan 2011 13:54:07 GMT

The problem with an hourly rate for farm work is that you could be pressurised to work so fast that patient welfare could be compromised Back when I did farm work,we were still asked to do disbuddings/dehornings/castrations-and if on an hourly rate there would have been great pressure to get on with it,without waiting for the localto take effect. Luckily we charged per procedure.The same would apply to allowing epidurals time tofully take effect.Better toprice at a level that allows you to do a proper job

Wynne

Re: Advice on dealing with client complaints over fees.

Robert Whiteford — Sat, 08 Jan 2011 19:49:09 GMT

[quote user="robloxley"] Nail Clip Dog somewhere with 3 price bands - easy, difficult and nightmare![/quote]

Best is to have a fall back position of an hourly rate as the minimum charge. You then have, for example:

Calving A = average (£50)

Calving B = bugger (£60)

Calving C = very difficult (£100)

...or an hourly rate.......whichever is the greater. It makes farm clients and equine clients realise that the more they can do to help the better it will be for their wallet!..

Re: Advice on dealing with client complaints over fees.

Rob Loxley — Sat, 08 Jan 2011 14:23:10 GMT

[quote user="Utlendigur"]I've always felt there should be some way of pricing dependent on stress markers like blood cortisol[/quote]

I once came across Nail Clip Dog somewhere with 3 price bands - easy, difficult and nightmare!

Re: Advice on dealing with client complaints over fees.

Utlendigur — Sat, 08 Jan 2011 13:52:23 GMT

I've always felt there should be some way of pricing dependent on stress markers like blood cortisol (indwelling cortisol meter?). So those clients who brighten up the day, pay on time, follow instructions etc would get a discount (especially if they brought biscuits) for making us feel the job is worth it. The clients who quibble over every little charge, have large aggressive dogs, kick off at reception staff for being asked to - shock horror - pay their bill, etc would find it too expensive to cross the threshold

Re: Advice on dealing with client complaints over fees.

Bob Russell — Sat, 08 Jan 2011 11:26:24 GMT

[quote user="Michael Woodhouse"]

[quote user="sarah mason"]Why dont more practices have a leaflet on the front desk, similar to dentists, hairdressers and takeaways-detailing the cost of consultations, routine ops, typical procedures etc? [/quote]

Would save having to do a silly voice when ringing round the neighbours to compare a few prices!

[/quote]

We work out what it costs to carry out procedures and then price accordingly with adjustments according to whether I enjoy the procedure. I still cannot make my rabbit spays expensive enough to justify the huffing and puffing (from me), the hassle factor and the bad language. Fluff getting up my nose should be worth at least an extra fiver for these!

We do not actually know what our opposition charge but do make more general comparisons with regional and national published figures.

Our new accountants have got us to fill in a price survey so they may be back to tell me I am a mug, we will see!

We get grumbles in reception on occasions but rarely are they brought to my attention. Only very rarely do clients move practice on cost alone.

Re: Advice on dealing with client complaints over fees.

Hannah Wynne Richards — Sat, 08 Jan 2011 10:16:33 GMT

Luckily I'm on good terms with my neighbours,socan phone and say "Wynne here.What do you charge for such and such ?"

Wynne

Re: Advice on dealing with client complaints over fees.

Michael Woodhouse — Fri, 07 Jan 2011 21:26:39 GMT

Would save having to do a silly voice when ringing round the neighbours to compare a few prices!

Re: Advice on dealing with client complaints over fees.

sarah mason — Fri, 07 Jan 2011 21:20:10 GMT

Why dont more practices have a leaflet on the front desk, similar to dentists, hairdressers and takeaways-detailing the cost of consultations, routine ops, typical procedures etc?

Re: Advice on dealing with client complaints over fees.

Hannah Wynne Richards — Fri, 07 Jan 2011 16:35:09 GMT

Total agreement with Martin and Bob. Work out the true profit on the discounted rate, and you may find that if self-employed,you're working for less than minimum wage, and if employed, the veterinary surgeon is loosing money, and the whinging client is still threatening to go elsewhere if you don't discount further-not worth putting up with them

Wynne

Re: Advice on dealing with client complaints over fees.

Bob Russell — Fri, 07 Jan 2011 13:19:35 GMT

[quote user="Martin Atkinson"]

When I took over my practice I got rid of all the complainers and bad payers and still won't take any prisoners. In this situtation, after explaining politely what the charges are for, if the client is still not happy I do not feel I have to justify myself and would tell them I believe I charge a realistic fee for a good service and if they're not happy with that then they know what to do. If they don't go now they will go later and probably go through the whole routine with their next practice. I may make less with this attitude but I'm a lot less stressed and happier for it. Life really is too short for this.

[/quote]

This is the best approach in my view. Our new accountants were somewhat surprised that we have virtually no bad debtors!

Re: Advice on dealing with client complaints over fees.

Martin Atkinson — Fri, 07 Jan 2011 12:41:12 GMT

Re: Advice on dealing with client complaints over fees.

bob lehner — Fri, 07 Jan 2011 11:14:39 GMT

[quote user="Gillian Mostyn"]

would never reduce the cost unless a genuine mistake was made in treatment, communication or billing. Not only does this tell the client that arguing will get them a reduction, but that information will be happily passed onto all their friends and aquaintances. In the equine world the information could be spread far and wide! This will set you up for far more queries as everyone tries it on! You're better off losing one client than having arguments over every bill. You could also offend the good clients who have paid the full amount but then find out someone else got it cheaper!

Never forget that there are some people out there who are in the habit of challenging every bill they receive - be it from the vet, hairdresser or the plumber. Don't take it personally. As a partner it is easy to take things to heart and stew on them (as you are obviously doing.) Try not to - make a decision, carry it out and then forget it! Just put mistakes down to experience but, believe me, the public will never fail to surprise you with what they find to complain about!

[/quote]

Bang on - says it all. Nothing to add !

Re: Advice on dealing with client complaints over fees.

Bob Russell — Fri, 07 Jan 2011 10:22:53 GMT

Check the bill, make sure it is correct compared to previous ones (show examples if necessary). If it is different find out why and correct it, letting the client know what you are doing.

If it is correct get one of the other partners to countersign any letter confirming this to show a united front. There are many out there that use 'divide and conquer' to get bills reduced.

It is up to the client to decide if they wish to stay with you and they generally will if your charges are fair. If they go elsewhere they may well be back.

Unjustified discounting of a bill especially for farm or equine work is potentially a disaster!

Re: Advice on dealing with client complaints over fees.

Gillian Mostyn — Fri, 07 Jan 2011 09:43:39 GMT

I would also recommend giving estimates in as many intances as possible. I realise that this is easier in small animal practice than large/equine, but it really does reduce the incidences of complaints massively. If I were you I'd look into how this could be implemented.

Re: Advice on dealing with client complaints over fees.

Hannah Wynne Richards — Fri, 07 Jan 2011 09:38:55 GMT

Oh dear, oh dear,oh dear

The very worst thing you can do is give a discount toa complainer-it's like paying a blackmailer-they'llcome back for more

My reaction tothat sort is always "good riddence to bad rubbish "-suitably paraphrased so as to avoid trouble with Royal College-but not enough tobe in the least ambiguous

Wynne

Re: Advice on dealing with client complaints over fees.

Gillian Mostyn — Fri, 07 Jan 2011 09:34:03 GMT

I would never reduce the cost unless a genuine mistake was made in treatment, communication or billing. Not only does this tell the client that arguing will get them a reduction, but that information will be happily passed onto all their friends and aquaintances. In the equine world the information could be spread far and wide! This will set you up for far more queries as everyone tries it on! You're better off losing one client than having arguments over every bill. You could also offend the good clients who have paid the full amount but then find out someone else got it cheaper!

Re: Advice on dealing with client complaints over fees.

Wren — Fri, 07 Jan 2011 09:18:29 GMT

We get quite a few complaints of this nature and most of them stem from a practice culture of being slack with the billing in the past. A lot of clients are well known to us on a social/friendly basis and they've all got things knocked off because of this. The problem is that it hasn't been made obvious to them that the work has been done at a reduced rate - eg. by billing 'examine horse - no charge'. Instead the 'examine horse' bit has just been left off the bill. If you do something at a reduced rate/for free always make sure the client knows this!

Secondly one of the partners has historically been very generous with 'visit - no charge' and suchlike in the past but as an assisstant it is not my place to be doing this so if I go and give a horse a Flu/Tet booster the client will be billed for the full cost of the visit plus the full cost of the vaccination (around £45 for each depending on area etc.). This makes them very grumpy if they've previously only paid for the vaccination, not the visit and they can't see why I'm twice the price of my boss. Then next time they request my boss to come instead....

We know that our prices aren't much different to the other equine practices in the area but they'd have further to come to most of our clients so we're likely to be cheaper to the client. They can move if they like but are unlikely to save money.

Unfortunately when complaints are received (usually almost entirely because of cost of, rather than standard of, care) the answer in the practice is almost always to give a discount.

Re: Advice on dealing with client complaints over fees.

J G Wray — Fri, 07 Jan 2011 07:31:56 GMT

[quote user="Evelyn Barbour-Hill"]On the whole, I wouldn't recommend reductions, as it suggests to an outsider that you knew you were in the wrong, and Mrs. Bloggs will probably expect to get the same again with the next bill. [/quote]

Well said. Mr Cain is a partner now and if he is an equity partner it means he is paid last, after all other deductions including assistants salaries. Therefore, you share, along with your partners, the cost of this lost income. This point tends to get lost in the transiiton to partnership and is certainly lost on most employees.

Keeping track of concessions made is v difficult and unless all are briefed, including assistants, will come back to bite at some point.

Something that wasn't alluded to by Mr Cain was how much debt the equine practice carries, i.e. how long does it take to get paid the reduced fee? Equine work is notorious in this respect, so there may be a double whammy here with reduced fees and delay in payment because of dispute. So, cash flow and income is affected. Once again, the staff get paid whatever.

There may be some merit in discussing the case as suggested, but there may also be some merit in reducing your debt and improving your cash flow by letting this client go.

We've all done it. You cannot please all your clients all of the time. If you have charged correctly and have performed your duties with professional integrity, then on this occasion the Gallic shrug may be your answer.

JGW

Re: Advice on dealing with client complaints over fees.

Evelyn Barbour-Hill — Fri, 07 Jan 2011 02:15:17 GMT

When they say "Mr. X down the road does it for half the price", I'm tempted to say "well, you know what to do then!" and indeed with small animal owners I have done so often. Sorry, that's just by the way, it's not much help with the question.

How does the complaint arise? I'm a little puzzled. She's a longstanding client so she knows what the prices are. Have you put the prices up? Have you charged for something (e.g., the second examination) that your partners have not usually charged for? Is it one of those situations where she's saying "You didn't need to come to that horse! If I'd been at home I'd have dealt with it myself!"

First of all, try to put yourself in the client's shoes and see it from her point of view. You may not manage this feat! But try.

Anyway, if humanly possible, try and get her to sit down with you with the bill and go through it item by item. If you can't manage that, try to do the same on the phone: but that can be much more difficult as many people just don't listen properly and keep on interrupting. My general tactics in that case are to be very patient, but keep repeating myself. Be like a politician being interviewed on Today: just keep on saying what you want to say and don't get manoeuvred into an argument.

If you get the "ripping off" accusation again, count to ten before you answer! I'd be inclined to say something like "Now come, Mrs. Bloggs, I think you know really that we are not in that business. I'm fully occupied with honest work and I have no time to think up rip-offs even if I wanted to" If it goes on and onand on, you may get to the stage of "That is a very serious accusation Mrs. Bloggs and I would advise you to think very hard before repeating it" but at that stage you've probably lost your fee and your client anyway.

There is a section on the free CD from VDS which deals with this sort of situation. I would recommend it.

On the whole, I wouldn't recommend reductions, as it suggests to an outsider that you knew you were in the wrong, and Mrs. Bloggs will probably expect to get the same again with the next bill. What can work though is a token reduction (e.g. "well, Mrs. Bloggs, I can see that the callout was charged at the new mileage rate, which is certainly higher than what you are used to: I'll reduce it this time to the old rate") Then you knock say £5 or £10 off and honour is satisfied.

If after all that it's back to "There's plenty of other vets who do it cheaper" I'd suggest the Gallic shrug.

Re: Advice on dealing with client complaints over fees.

Michael Woodhouse — Thu, 06 Jan 2011 23:13:09 GMT

What a good first question! Where I work I have always thought that reductions were given very easily. I am employed so the question's not really for me.