Giving away care

IN A 2006 VETERINARY ECONOMICS BUSINESS ISSUES STUDY, 68 PERCENT of respondents say they offer some form of discounted care. Fifty-four percent provide pro bono care. Yet only 27 percent of respondents say they use an Angel Fund to support their pro bono or discounted care. (See Figure 1)

Should you discount or give away your services? If so, why, and how much? If not, why not?

Helping those in need

"Management experts say discounting is a bad idea," says Dr. Daniel Jones of Broken Arrow, Okla. "And there's no question that higher fees make it easier to invest in personnel, equipment, and facilities. However, in my former practice, it got to the point that even my friends could no longer afford my services." Dr. Jones sold that practice and joined a limited-service practice, where, he says, he functions more as a family doctor, referring patients for advanced diagnostics or complicated treatments.

Figure 1 How much are you giving away?

"Clients often tell me how much they appreciate the service," he says. "This is a niche market that provides low-cost services to those who can't afford to pay the fees at a full-service practice."

Dr. Cynthia Young, owner of Northwest Veterinary Practice in Tallmadge, Ohio, says she's also feeling the pressure of helping others while keeping her business afloat. But she won't "just say no," as she's often told to do.

"People have asked me if I ran a restaurant and someone ordered food and didn't have any money, would I feed them? And my answer is yes. I don't want to feel guilty about my business," says Dr. Young. "I have accomplished my lifelong dream of becoming a veterinarian and now I own a clinic, which I use as a tool to learn, practice, and teach others about animals and their care. Providing assistance to those in need enriches our own lives, as well as those of the pets and people we help."

Figure 2 Who benefits from discounts?

Dr. Young hits the nail on the head for many veterinarians: Helping others, through pro bono or discounted care, is often as much about making yourself feel good as it is about helping others. And, they say, if you can't do that then why own a business?

Summing up, these are the arguments in favor of discounts and pro bono work:

> It shows compassion to those in need, both the pets and the people.

> It gives back to your community.

> Helping pet owners afford good, responsible care encourages them to take better care of their pets.

> Spaying or neutering pets at a reduced rate or for free reduces the number of unwanted pets, when a client who can't afford the surgery might neglect it altogether.

> Discounts reward good, loyal, or high-volume clients.

> Coupons or referral systems draw in new clients.

Putting business first

On the flip side, many people argue that discounting services is terrible for business. And, ultimately, you're a businessperson.

"When we discount our services, it sends the message that we charge too much, and we end up diminishing clients' assessment of our services' value," says Dr. Kristi Freeman, who runs a business providing home euthanasia and hospice. "Yes, it's hard to watch our clients struggle with a financial decision. But sometimes these situations give people an opportunity to improve, learn, or gain character."

Those who argue against discounting or pro bono care say:

> You can't afford to give away your medical services.

> Clients tend to take advantage of practices that give discounts.

> It's hard to choose which clients are truly needy.

> Clients who come for discounts generally don't comply with recommendations and aren't good clients.

> There's too little time to devote to "projects."

> Once you start pro bono work, where does it end?

> Your fees are already reasonable and affordable.

> Working pro bono for some of your clients is unfair to others.

Alternatives to giving away services

So you want to help without giving away the farm? Some options from your colleagues:

> "Whenever a doctor discounts an item at our hospital, we itemize those services monthly on the doctor's paycheck," says Dr. Sara Mark, owner of Southwest Veterinary Hospital in Littleton, Colo. "Listing the amount discounted shows how much of the doctor's and his or her co-workers' income he or she decided to give away, showing the reality of cutting fees."

> "We donate $5 to an Angel Fund in memory of deceased pets, and $20 in honor of employees' birthdays in lieu of gifts," says one respondent to the 2006 Veterinary Economics Business Issues Study.

> "I volunteer with local shelters and other animal organizations as my form of pro-bono work. This doesn't take anything away from the practice itself," says another study respondent.

> Dr. Lowell Novy of Simi Valley, Calif., felt the pressure of wanting to help others, but needed to make a living. His solution: Start a 501(3)(c) nonprofit corporation. His team uses donations to augment below-cost care for homeless cats and dogs.

>Veterinary Economics Hospital Management Editor Mark Opperman, CVPM, recommends putting a set amount in each doctor's charity account each year. "Anytime the doctor discounts a service, the amount will be charged to that account," he says. "Once it's empty, no more discounts. It gives the doctor some control but also puts an endpoint on the amount of income discounted."