Mind Over Miller: Why honesty is the best policy for your veterinary practice

Recently, journalists have been visiting veterinarians pretending to be clients and have documented being sold "unnecessary" procedures, such as elaborate dental procedures for dogs with a minor amount of calculus and annual vaccinations when three-year intervals are recommended. The motive, it is inferred, is profit, and it saddens me to know that sometimes this is true.

It saddens me because it gives our profession a negative public image, and one that I think (I hope) is largely undeserved.

I built an incredibly successful practice, starting as a mom-and-pop house call practice that, by the time I retired, had 12 doctors on staff.

I have been reflecting on why that practice prospered as it did. I never advertised, never gave discounts, limited my practice to medicine and surgery by appointment, never held low-cost "shot clinics," and never did any of the promotional schemes that I see being touted today.

So what did I do to make that practice so popular?

Was it that I had a live person answering the telephone 24 hours a day? That helped, but I don't think that was the major factor.

Was it that I tried to the best of my ability to offer state-of-the-art medicine and surgery? Maybe, but we all know that nobody can master every aspect of this highly technological field, especially in a multi-species practice.

Was it the magnetic personalities of my colleagues and me? Come on now! We were all different, but we were all pretty ordinary.

No, I believe the secret of success was absolute honesty. I want every colleague and every veterinary student who reads this to take this to heart and pass it on. It has nothing to do with morality. But isn't what I advise the moral thing to do? Yes, of course, but I'm being pragmatic.

If you practice with absolute integrity-never making an exception, regardless of the potential financial reward-your practice will prosper. It will grow and grow. You'lll make more money in the long run as your reputation becomes known, as you build a clientele of trusting people who love their animals and rely upon you to take care of them.

How does someone practice with absolute honesty? Here are some examples:

• Be completely open. Do you have the experience and confidence to handle the case in an optimal manner? Tell the client. If you feel that the case should be referred, say so and say why. It is interesting that in the countless times I advised referral, probably half of my clients said, "Thanks Doctor, but I trust you. I'd rather you handle it."

• If there are several options in how to handle a case, explain all the options. Include the costs and the prognosis for each option. Allow the client to choose. Do not let the potential for profit push you to encourage just one option. Interestingly, many of my clients would say to me, "Doctor, if this were your pet, which would you choose?" I would then answer honestly and explain why, and if it were a more costly choice, express concern about the cost.

If the humane option was euthanasia, I would say, "I know what I would do if this were my pet, but she isn't mine, so you must decide." If the client asks what you would do, and you say, "I'd end your pet's suffering. It's the final kindness," the client can transfer the feeling of guilt to you and say, "OK, I have confidence in you. Whatever you think is best." If there is no response, the client could be opposed to euthanasia. If so, it's best to drop the subject. Say, "I'll do the best I can to make his remaining days as comfortable as possible." Then, do it. It also helps to explain what you are doing and why.

• Write your opinion and recommendations down and give them to the client. People often hear only what they want to hear, so writing it all down forestalls much confusion, denial, and misinterpretation of what we say. I would always put a copy of my advice in my records.

• Before dismissing the client, say, "Do you have any questions?" If they don't, add, "Well, any time you do, please just ask. I'll be glad to explain it again or clear up any confusion."

• Refer to the pet by name (not "your dog" or "your cat"). Also, express your hope that the animal responds well to treatment and feels better. Encourage the client to contact you if the pet's condition isn't getting better.

A favorable professional image requires sincerity, compassion, patience, kindness, and, above all, absolute integrity. Read those five factors again, then add competence, and you'll be successful.

Robert M. Miller, DVM, is an author and a cartoonist, speaker and Veterinary Medicine Practitioner Advisory Board member. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner. Visit his website at http://robertmmiller.com/.