Pain: When "It hurts" meets "How much does it cost?"

Help this dog (and your other patients) feel better by better navigating client communication issues. (Photo Getty Images)Once upon a time, many veterinarians believed pets didn't feel pain as much as people. And the research that shows gnawing, aching, piercing, short-term or chronic pain inhibits healing didn't exist yet.

Nobody gets to pretend anymore.

But you face clients every day who question whether pre- and post-procedure pain control or pain medications for long-term conditions are absolutely necessary.

Imagining scenarios with pet-owning “types” developed by Brakke Consulting for the Bayer Veterinary Care Usage Study, we asked two smart practice owners how they talk about pain in their practices.

Price shopper

The Price Shopper values veterinary care but shows great loyalty to practitioners who demonstrate that they keep costs down. This client questions any optional pain control and asks about the need for any items you itemize in a treatment plan.

“Money is always an object for these clients,” says Jeff Werber, DVM, owner of Century Veterinary Group in Los Angeles.. Dr. Werber gives these clients some choices between pain control methods. And he says that's because he'd rather see pets get some pain control after a procedure at his facility than no pain control somewhere else.

Instead of offering different or less costly pain control options she's not comfortable with, Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CCRP, says she breaks down the costs of pain control by the day. “I show clients that pain control is really a very inexpensive part of the process of caring for the animal,” she says.

TIP: Always assume clients don't know how important pain control is and take the time to answer their questions.

Downing, hospital director of the Downing Center for Pain Management in Windsor, Colorado, also recommends itemizing pain control in the treatment plan to show that you delivered the service and consider it a necessary part of the procedure, but listing the cost as zero.

“People used to ask all the time, ‘Do I need to spend that $20 for pain management?'” Dr. Downing says. “Today I just don't give them the choice.”

Procrastinator

The Procrastinator values veterinary care and likes your clinic, but finds visits stressful and so is less likely to visit. In these cases, Dr. Downing recommends emphasizing the risks of waiting and removing barriers to needed visits, procedures or medications with as much convenience and connection as you can muster. To do that, she shows:

> Emotional clients that she's bonding with the animal, telling the pet “it's OK, you're OK” to calm a patient and help a client feel at ease

> Left-brain, fact-focused clients that there's a plan, in bulleted highlights, so they feel a sense of quick understanding of the problem and the solution

> Context-hungry clients that their questions are good and that she takes the time for their “whys and wherefores.” (Why is the pet in pain? How do you know? How does this fix it?)

> “Flamboyant” or “expressive” clients that she's a little offbeat herself, with multiple piercings. “In our community we see lots of body art and piercing, especially with Millennial clients,” she says.

TIP: Listen and dig into the clients' needs and interests.

Take time to form the long-term rapport you need to bond clients.

Avoider

The Avoider is sometimes distrustful and likely has a do-it-yourself mentality. In these cases, Dr. Downing emphasizes the urgency of performing the procedure and providing pain control. “In chronic-pain cases, I explain the pain is real, the pain hurts and we need to deal with it now or we'll deal with it for a very long time.”

TIP: Smart practitioners can disagree about whether the highest standard is an “always” standard when well-meaning people lack funds or you can't provide the highest care for less every time. Explore your own practice philosophy.

When it comes to procedures, Downing emphasizes the long-term effects of client decisions made in the moment. “Clients need to know that bad management of acute pain can set up patients for chronic, long-term pain,” Downing says.

Neglector

The Neglector, the most passive type of pet owner, strongly resists investment in even minimum care. But sometimes Neglectors just don't know what the pet needs. If they care, Dr. Downing says their attitude can change with the right education.

TIP: Stop with the “ought to”s and “should”s and

start with the “need”s and “deserve”s.

“When we talk about pain management, we need to use the words ‘need' and ‘deserve,'” Downing says. “This dog needs this medication. This dog deserves to be pain-free. This cat deserves not to suffer.”