A tale of two values

How many times last week did you hear "Boy, you're expensive" or "Did I just pay for the whole veterinary hospital—or just your new car?" It's been said that if you don't hear some complaints about your fees, then your fees are too low, and I would agree. But how many complaints do you brush off before realizing you might have a real problem?

I believe that when clients grumble about your prices, they really aren't complaining about the cost but rather the lack of perceived value. Here's a mantra you need to memorize: Price is only an issue in the absence of value. If you're skeptical, perhaps I can convert you. Let's look at two real-life scenarios. In each one a client brings in her pet for an ovariohysterectomy—but under two very different sets of circumstances and with drastically different outcomes.

SCENARIO 1

Mrs. Jones has just moved into your area and needs to have her dog spayed. She asks her new neighbor for a referral, and her neighbor tells her about All Pet Animal Hospital. The hospital is just a few blocks away, and the neighbor has taken her pets there for years. So Mrs. Jones calls All Pet Animal Hospital to make an appointment, but before she can say a word she's put on hold for several minutes.

The receptionist finally comes back on the line and says, "Sorry for putting you on hold. We're busy today. What can I do for you?" Mrs. Jones explains that she's new to the area and wants to have her dog spayed. The receptionist, in a not particularly friendly or helpful tone of voice, informs Mrs. Jones that they do spays on Tuesdays and Thursdays and that she needs to make an appointment. Mrs. Jones asks how much it will cost. The receptionist hesitates, then asks, "How much does your dog weigh?"

Mrs. Jones responds that her dog weighs 55 pounds. The receptionist says, "Oh, that heavy. Hold on." A few minutes later she returns to the line and says, "That will be $350, and it will have to be paid when you bring in your dog—we don't bill." Although Mrs. Jones is a little put off, she remembers that her neighbor said it was a good practice and she doesn't know of any other veterinary hospitals in the area, so she decides to make the appointment.

On the day of the surgery, Mrs. Jones gets lost and is late arriving. She notices that the parking lot is in poor condition. The building is plain and looks like a converted gas station. No wonder she couldn't find the place; large trees in front of the building cover the sign.

As she enters the front door, Mrs. Jones immediately notices a strong animal odor. The waiting room is plain, with orange molded plastic chairs along the perimeter of the room and posters taped to the walls. Everything seems a little dark and dingy. A line of people has formed in front of a window on the other side of the reception area, and Mrs. Jones assumes she must get in line with everyone else, so she does. After 20 minutes, she finally reaches the reception window and looks in. The receptionist looks at Mrs. Jones and says, "What do you want?"

Mrs. Jones responds, "I'm here to bring in my dog, Casey, for a spay."

The receptionist looks at her computer and states, "You're late. You were supposed to be here half an hour ago." Mrs. Jones explains that she got lost, and the receptionist, looking frustrated, says, "Have a seat. We'll be with you shortly."

Mrs. Jones takes a seat in the waiting room. She notices the magazines are over a year old, cobwebs adorn the corners, and the floor is grimy. After waiting for half an hour, Mrs. Jones hears her name called. She returns to the reception window, and the receptionist informs her that they're ready to admit Casey. The door opens and a teenager in T-shirt and jeans comes out, takes the leash out of Mrs. Jones' hands, and walks Casey into the back.

The receptionist says, "You can pick up Casey after 5 p.m. tonight. We close at 5:15, so don't be late." Although Mrs. Jones feels a little bit insecure about leaving Casey at this point, she remembers that her neighbor did recommend the hospital, so she leaves the practice and heads off to work.

After worrying all day, Mrs. Jones returns to the hospital at 5 p.m. When she walks in, she finds the reception area full of clients and animals. The general atmosphere is chaotic and busy. Again there's a line in front of the reception window, so she stands and waits. It takes 15 minutes for Mrs. Jones to reach the front of the line, where she finds a different receptionist from the one this morning. Not looking up, the receptionist says, "What do you want?"

Mrs. Jones replies, "I'm here to pick up Casey."

The receptionist looks up and says, "It's 5:15. We're about to close." Mrs. Jones explains that she's been in line for 15 minutes. Looking exasperated, the receptionist says, "Have a seat."

Mrs. Jones takes a seat and waits ... and waits ... then finally hears her name called. She returns to the receptionist, who hands her a bill for $350. Mrs. Jones gives the receptionist a credit card, and a few minutes later Casey is brought out to the reception area led by the teenager in T-shirt and jeans. Mrs. Jones is told to come back in 7 to 10 days to have the sutures removed. But she leaves the hospital vowing never to return.

SCENARIO 2

Mrs. Jones has just moved into her new home, and her new neighbor (a better neighbor) invites her over for a cup of coffee. Mrs. Jones tells her neighbor that she needs to have her dog spayed, and her neighbor recommends Great Animal Hospital. So Mrs. Jones calls Great Animal Hospital, and a receptionist who identifies herself as Cindy promptly answers the call.

Mrs. Jones tells Cindy that she needs to have her dog spayed. Cindy is friendly and helpful and seems sincerely interested in Mrs. Jones. She even asks Mrs. Jones what her dog's name is as well as its breed and history. Cindy answers all of Mrs. Jones' questions and also tells her about the practice's Web site, where Mrs. Jones can learn more about the surgery and find information about the practice.

Cindy tells her that the Web site offers a virtual tour of the hospital as well as information about the doctors and services the hospital provides. Mrs. Jones is impressed; she can see the practice before setting foot inside and can download new-client forms to fill out ahead of time. Cindy also tells Mrs. Jones about the link for an online map with directions to the practice. Mrs. Jones makes the appointment, and Cindy tells her that Dr. Great would like to see Casey before the day of the surgery to make sure Casey is healthy enough to undergo the procedure.

On the day of the surgery, Mrs. Jones arrives at Great Animal Hospital on time. The night before, she received a call from the practice to remind her to withhold Casey's food and water. She even received an e-mail with information about Casey's surgery. Mrs. Jones has been at the practice already for Casey's presurgery exam, but she's again impressed by its appearance. The building is new, modern, and attractive. The parking lot is large and nicely landscaped. The sign is in plain sight, which makes the building easy to find.

Mrs. Jones walks in and is immediately greeted by Cindy, who says, "Good morning, Mrs. Jones. It's nice to see you again. Hi, Casey! How are you today? Are you ready for your surgery?" Mrs. Jones is impressed that Cindy recalls not only her name but Casey's as well. Then she remembers that a technician took Casey's picture the last time she was there; she imagines that the receptionist has pulled it up on the computer to help identify her and Casey when they came in—very smart indeed! Cindy gets all the information necessary and offers Mrs. Jones a cup of coffee or bottle of water. Mrs. Jones has a seat in the waiting room and observes that the room is clean and smells fresh.

The chairs are comfortable and current magazines are available for clients to read. There's even a TV on the wall showing a virtual tour of the hospital—the same one from the Web site, Mrs. Jones remembers. A few minutes later, Susan, the doctor's surgical technician, comes out and introduces herself. She also greets Casey and asks if Mrs. Jones would like to accompany her into the exam room so she can explain what's going to happen to Casey today.

Susan escorts Mrs. Jones and Casey into the exam room and explains the surgery. She shows Mrs. Jones a short presentation on a computer screen that illustrates a day in the life of a dog undergoing ovariohysterectomy. This helps Mrs. Jones feel more at ease, and she loves seeing exactly what's going to happen. Susan also explains the importance of presurgical blood work and postoperative pain medication. When she's finished, Susan asks if Mrs. Jones has any questions and then offers to show her around the hospital.

They proceed to the surgery suite, where Susan explains the anesthesia machines and monitoring equipment. She then takes Mrs. Jones to recovery and tells her this is where Casey will be monitored while she wakes up from anesthesia. At the end of the tour, Mrs. Jones gets to put Casey in a cage and give her a big kiss before she leaves. On the way out, Susan tells Mrs. Jones to come back between 5 and 6 p.m. to pick up Casey.

Mrs. Jones leaves the practice and heads to her office feeling comfortable that Casey will receive optimal care and treatment. At about 1 p.m. she gets a call from Susan, who says Casey is out of surgery and that all went well. She sets up an appointment for Mrs. Jones to come in at 5:10 p.m. so she can meet with the doctor and go over postoperative discharge orders.

At 5 p.m., Mrs. Jones returns to the practice and is again greeted by Cindy. "Good evening, Mrs. Jones. How are you? I was just in the back and saw Casey. She's fully awake, and I'm sure she's excited to go home with you. May I get you a cup of coffee or bottle of water while you wait?"

Mrs. Jones declines and has a seat in the waiting room. A few minutes later, she's escorted to the exam room. Dr. Great soon enters and tells Mrs. Jones that everything went fine. He reviews the discharge orders and gives Mrs. Jones a printed copy to take home. Mrs. Jones is then escorted to the reception desk, where Cindy reviews the statement, explaining all the services rendered and associated costs. The bill totals $350. Mrs. Jones presents a credit card and signs the slip.

A few minutes later, Susan brings Casey out and shows Mrs. Jones the incision line, again explaining how to keep it clean and dry. Susan helps Mrs. Jones to the car because she doesn't want Casey to jump up on the car seat. Mrs. Jones takes Casey home and later that evening receives a call from Susan, who inquires how Casey is doing and asks if Mrs. Jones has any concerns.

THE BOTTOM LINE

These two scenarios involve the same exact procedure and the same amount of money, but is there any difference in perceived value? You bet there is!

This is what I mean when I say that price is only an issue in the absence of value. We shoot ourselves in the foot when we tell clients that a spay is a routine procedure: drop the pet off in the morning, pick it up in the afternoon, no big deal. The pet might as well be dry cleaning! No wonder clients complain about veterinarians' prices. But instead of reducing the fee, let's enhance the perceived value of the service.

I believe veterinarians too often undervalue their services, minimizing them in clients' eyes. What's more, I think clients value our services more than we do. So the next time someone says to you, "Boy, you're expensive," respond that you're thrilled to be able to provide excellent care and treatment for the pet at a reasonable price—and then explain why the client is getting such value for his or her dollar. Be proud of your fees; only be ashamed if you're charging too little.

Mark Opperman, CVPM, is Veterinary Economics' Hospital Management Editor and owner of VMC Inc., a veterinary consulting firm based in Evergreen, Colo.