What's This Episode About?
This week’s episode is brought to you, ad-free, by our sponsor – Pets Best Pet Health Insurance. This week on the podcast, Dr. Roark and Stephanie have the pleasure of spending some time with their friend, Dr. Peter Weinstein. Our conversation takes a winding path through some timely and relevant topics in veterinary medicine – There is a lot of chatter about money right now in veterinary medicine, in a variety of contexts. We wanted to talk today about where we are when it comes to pet owners paying for services, how to get access to services for more clients and how we communicate with clients about pricing and any financial concerns they have. All of these things are tied to the level of care and service we provide to our patients. Let’s get into this…
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Episode Transcript
Stephanie Goss:
This week's episode is being brought to you by our sponsor, Pets Best Pet Health Insurance. Hey everybody, I am Stephanie Goss and this is another episode of the Uncharted Podcast. Andy and I are having a great conversation today with our dear friend, Dr. Peter Weinstein. For those of you who don't know Peter, he is an author having co-wrote the E-Myth Veterinarian with Michael E. Gerber. He's a veterinarian, he's been a practice owner, he sat on more committees and boards in the veterinary industry than I can count, and as always Peter is willing to share his ideas and thoughts freely with Andy and I.
Stephanie Goss:
And so when Andy and I were thinking about a series of conversations about money in veterinary industry, we could think of no better person to have some of this conversation with than Peter. Because he's got a lot of experience, he's got some unique perspectives, and Andy and I wanted to talk in particular a little bit about where are we at when it comes to pet owners paying for services? Do we really have a problem? If so, what problems do we have? How do we get access to more service for clients? And how do we communicate about pricing? Let's get into it. And now the Uncharted Podcast.
Dr. Andy Roark:
And we are back. It's me Dr. Andy Roark, along with Stephanie Goss, and the one and only Dr. Peter Weinstein. Peter Weinstein, thanks for being here.
Dr. Peter Weinstein:
Dr. Roark it is an honor and pleasure to be able to hang with you, but more importantly it's an honor and a pleasure to hang with Stephanie. So thank you for the invitation.
Stephanie Goss:
Thanks, Peter. It's so good to see your face. How are you doing?
Dr. Peter Weinstein:
I'm doing wonderfully. And of course those people who are listening to this can't see my face, but I'm glad you can.
Dr. Andy Roark:
Yeah. I remember we did a live podcast episode one time in Kansas City, and I was introduced and people were like, “Yay.” And Stephanie was introduced and the place just went bananas and I thought, that's how this is. That's what it is.
Dr. Peter Weinstein:
It's the way it's supposed to be.
Dr. Andy Roark:
It is.
Dr. Peter Weinstein:
The technicians never get the respect that they deserve, and Stephanie got it there and you got dissed.
Dr. Andy Roark:
Stephanie you were never a vet assistant were you? You were always a practice manager, correct?
Stephanie Goss:
No, I started at the front desk and then went to school and became a technician, but I did that about the same time I became a practice manager. I quickly realized that while I really liked nerding out on the medicine, I was really good at working with people, and the business side was really interesting, but I have done both.
Dr. Andy Roark:
Knock me over the feather, that is a part of you I can't believe I didn't know that or I didn't even remember that, that's incredible.
Stephanie Goss:
That's so funny. I thought you were going to tell this story about Kansas City when the lights went out and we were having technical difficulties.
Dr. Andy Roark:
Yeah, that was another one.
Stephanie Goss:
And we just kept going.
Dr. Andy Roark:
Yeah, we were recording a podcast and hundreds of people were watching and then all the lights went out I think it was on a timer and we we're plunged darkness. And I was like, “Just act natural Goss. Just act natural and keep talking.”
Stephanie Goss:
It's perfect for today Friday, it has been a day with technical difficulties, but we are all here and I am excited for this podcast because the three of us are going to nerd out about stuff we like talking about.
Dr. Andy Roark:
We are. I wanted to talk a bit about some, I always like to have these high level conversations, I very much enjoy having with Peter and always with Stephanie, we talk about stuff all the time, but high level conversations. There's a lot of chatter about raising staff pay which is happening and which is good, there is a lot of chatter about keeping vet medicine affordable for people, and that manifests in a lot of different ways. There's talks about pet health equity and things like that, and underserved communities, and also equity and availability to help drive diversity in our very white profession.
Dr. Andy Roark:
And so there's a lot of talk about money and medicine, and I wanted to unpack some of that today because it's hard for me to determine what is real in this conversation and what is hand waving. And so I just want to go ahead and open this up with the question of where are we when it comes to pet owners paying for services? A lot of people say that price is a problem, do you guys think that that's true or do you think that we are just biased towards the bad experiences when we have people who are not able or willing to pay for services? So let's just open with that, do you think that pricing in medicine at present is a real problem?
Dr. Peter Weinstein:
Well, I think that pricing is a problem in everything, and it's the cost of gasoline in Southern California is $2 a gallon less than it is in Texas. So pricing is going to be an issue for somebody somewhere, we've got such a discrepancy in income amongst the American population that within our own practices, we have pet owners with different levels of income. So I'm not sure we can talk about pricing, I'm not even sure we can talk about cost without talking about truly diverse demographics that we serve in all our practices, and trying to be everything to everybody makes it very challenging as well. So affordability, equity, availability, spectrum of care, all of these Pandora box topics I'm not sure we can cover in 45 minutes, or an hour, or even weeks because there are so many variables that you're getting at right now.
Dr. Andy Roark:
No, I agree with that.
Stephanie Goss:
To your point Andy, I think that it is very easy for our teams in particular to latch onto the negative experiences or the bad experiences with clients, right? It's the client who comes in and is ranting at your front desk and shouting at them, literally shouting because they don't want to pay for an exam to get their rabies vaccine. And they're mad that it's costing what is costing to get that, right? Those are the kind of experiences that stick out in our brains, and so it is very easy for the whole team to paint a very broad brushstroke across the client experience when it comes to price and say, “Well, clients are mad about our prices or clients are upset.” Especially when they are living day in and day out with people as a whole that are frustrated with life.
Stephanie Goss:
There's a lot of people that are mad about life right now, and who are tired and exhausted, and the last two years have been crazy for everybody. And so I think to a degree, I think the team's response right now is particularly colored by that maybe more than it has been in the past. And I also think that we are still struggling as an industry to Peter's point, to look at all of the things that make up how do we approach pricing? Because it is so varied, the demographics are varied, the cost factors for individual practices are varied, and we as a industry have really struggled with how do we educate clients on that? How do we explain that? Because the ones who try when we have tried, I know I have done this, I've been in that conversation with a client.
Stephanie Goss:
And I think about it at the end of the conversation and I go, “They didn't care about any of that.” Like I'm trying to explain to them why the fact that we have a $60,000 x-ray machine sitting in our hospital and being used makes the price of their pets exam what it is, right? We've all been there and struggled to communicate to owners why our pricing is the way that it is, and so I think that that is something that we have to deal with, but to Peter's point it is really hard because there's so many factors that complicate the money conversation in veterinary medicine.
Dr. Andy Roark:
Yeah, I agree with that. I think it's very regional, right? I mean, I've worked at some practices where I felt man like I am having money conversations all day, every day, and I've worked at other practices where I go, less so, not zero, but less so. I'm convinced that specialty medicine probably talks less about medicine without money than general practice, and did the general practice money conversations seemed to me to be much lower stress and lower stakes than what the emergency clinics have. And that's just because these people are showing they have an emergency and now they're talking about money as opposed to me saying, “Hey, here's a vaccine that would be good for your pet.”
Dr. Andy Roark:
And they're kind of going, “No, I don't know, or do I really want the flea medicine? My pet doesn't currently have fleas.” That's not how it is in emergency medicine, no one's there for preventive care, they have a pressing need and so those problems are really hard. At the same time Steph so you brought up the $60,000 x-ray machine and stuff like that, I was in the treatment room yesterday and I had this Dalmatian and he was like one year old, ad he was a nut ball. I mean, not bad, I mean he was wound so… You know those dogs that are just like a spring that is way overwound? That was this guy. And it was me, and a technician, and an assistant all just trying to get him to calm down so I could just do a physical exam that wasn't a rodeo.
Dr. Andy Roark:
And so I've got somebody who's helping to hold him, and then someone else who's trying to just talk to him and give him some treats and things like that, and I'm trying to just palpating these abdomen and stuff, and it tied the three of us up for 15 minutes probably, and that's just for the exam. And then by the time we run him back and forth and stuff and you go this pet owner came in for a 30 minute appointment, that's a half an hour of doctor time, it's a half an hour of licensed veterinary technic time, and a half an hour of assistant time. Plus, the front desk person is sitting up front and they're also being paid for their time.
Dr. Andy Roark:
And you go, I don't think that we're wildly overpriced for what people get when you look at the labor that it takes to do our job and do it well, and especially do it in a low stress or minimal stress environment. And so I never handle it well when people are like, “Oh, we charge too much.” I go, “No, I don't believe that we charge too much.” I 100% understand that people can struggle to pay for it, and I'm not saying it's not expensive because it is expensive, but when I look at what we provide I go, well, this does not seem unreasonable for the services that we provide to me at least.
Stephanie Goss:
Yeah.
Dr. Peter Weinstein:
I concur, it's just the perception. I mean, it's all about perception. And if you think about it Andy, if you were to take a $200,000 salary over the year, it's equivalent to $100 an hour, so half an hour of your time would be $50. Your tech time is probably $20 an hour, there's another $10. And then your assistance time might be $15, so maybe it's another $8. So there's $68 for that visit, and I don't know what your office call is, but that doesn't include all the overhead. So the price that the clients see doesn't reflect the cost to deliver those experiences, and what I don't think that we've done a very good job of as a profession is clearly giving a good value for the price and explaining the cost. Probably about 20 years ago out of Tampa Hillsborough County produced a flyer called the Cost of Compassion.
Dr. Peter Weinstein:
I don't know if you remember that, you probably were still nursing. And we haven't done a really good job of self-promoting the value proposition of the veterinary profession globally. We've spent our time pumping vaccinations and selling vaccinations and giving away exams for free, instead of charging for exams and giving vaccinate for free. So we need to be our own best cheerleaders so people truly can understand all of the different services that veterinarians can provide, because think of the convenience by going to your hospital. They don't have to go to another place to get a blood test done, they don't need to go to another place to get a radiographs taken. Can you tell me a doctor Stephanie or Andy where you can go in and get a colonoscopy, a dentistry, go home with a pedicure, a manicure, a bath, and a bag of food all in one location in one day?
Stephanie Goss:
No.
Dr. Andy Roark:
No.
Stephanie Goss:
No. And that's the thing is that when we have those conversations, I've had these conversations with family and I have put it in that frame of reference Peter, and every time it's like the light bulb goes on, but the problem that we have struggled with as an industry is how do we turn that light bulb on for more people more often? Because when people really stop and think about it and understand what we're offering, it's the question of when's the last time you went to your doctor and they recommended blood work or x-rays and you didn't have to go to at least two other places to get that done, right?
Dr. Andy Roark:
Yeah.
Stephanie Goss:
And so when they think about it in their own context for their own health they understand it, but we struggled to help them connect the dots back to this is A, why it's expensive and B, why it might take more time or there might be more steps involved. We have really struggled to connect those dots for people I think.
Dr. Peter Weinstein:
Stephanie one other thing, they can pick up a prescription before they leave and they don't have to go to the drug store as well. I mean, we just have done a really poor job of self-promotion, we really need to put on a cheerleader outfit, and I'm looking forward to seeing Andy in a cheerleader outfit, and start to be a cheerleader for our profession.
Stephanie Goss:
Yeah.
Dr. Andy Roark:
I did an interview with David Besler, and he's one of the co-founders of VEG, the Vet Emergency Group, and I really liked the interview with him and I think he's fascinating. And one of the things that he said, so we're talking about at VEG, they have these policies where it's things like as soon as the pet owner comes in they go straight to see the doctor before they fill out paperwork even, and that blew my mind. I was like how do you even do that? But he said it was important, and what he talked about was he said, in emergency care people are mad a lot of the time, and we talk about everybody being burned out because the clients are mad. And he said, “We do these things that make them angry.
Dr. Andy Roark:
We put barriers in that tick them off, and then we deal with them being ticked off all the time.” And he said, “If we just stop doing these things that make people mad, they're a whole lot easier to deal with.” And I've just been thinking about that a lot, and so let me put this back to you guys and say, are we doing things that just make pet owners mad, or that escalate these situations that we don't need to be doing? To me this feels very much like we don't promote ourselves and let people know what we're doing that's part of it, are there other things we do that unintentionally make the situation worse?
Dr. Peter Weinstein:
Well, depending on your definition of mad, are you talking about from a sanity level or from an anger level?
Dr. Andy Roark:
Raving mads. Frustration level, yeah.
Dr. Peter Weinstein:
All right. Because honestly the last 20 months or so have created a tremendous amount of mental health issues, not just in the veterinary profession, but in the world in general, but we still had issues prior to COVID and we will have issues after COVID because we have put up barriers. We have not made access easy, we haven't communicated clearly, and when somebody answers the phone and says, “Please have $500 ready and available before you come in,” we just set up a barrier to access. So I think part of what we need to recognize in this profession is that we have moved from the healthcare world to the service world, and that we should start to create a service based industry that clearly focuses on the needs of the pet and the pet owner from a service standpoint, and that we provide those services.
Dr. Peter Weinstein:
We need to listen more and talk less, we need to be listening to what our clients want and start to build practices for their needs. And so what VEG is trying to do, and some other companies are trying to do is to meet those needs. We really have not listened to what clients wanted and cost of care, access to care. And access to care isn't just financial, access to care is hours that you're open, locations for practices, it's the time that you're open in a two income community so that people can drop their pets off on their way to work. So again, we have to start to think of us maybe more as a service industry, and less of it as a healthcare industry.
Dr. Andy Roark:
Yeah. No, I like that a lot. I think that one of the things, I completely agree with thinking about the needs of pet owner and can we do that, I think that listening to what they want and what is important to them ideologically is also a place that we need to go. I think so many of us have spent so much time fighting with pet owners about what is important, as opposed to just saying, “Look, they think that this is important.” So I'll use example of nutrition, and they say, I want organic foods, or I want a minimal ingredient foods or things like that. And I go, I can fight with them about it, or I can try to understand why they feel that way, and then talk about our services and the things that we provide, and we recommend in the context of what they care about as opposed to trying to get them to care about what I care about. And I see a lot of people fighting that battle and I go, “God, there's got to be an easier way.”
Stephanie Goss:
One of the things that I think we have always struggled about or struggled with, at least as long as I've been in veterinary medicine, is nobody has enough time. And I don't know how important this factor is, but I noticed a dramatic difference in the ability to lower some of those barriers to Peter's point, and to your point Andy, to have the conversations that exists in a bubble where time exists. And so if I'm trying to do back to back 10 or 15 minute appointments, it is far harder to have a conversation with your one year old Dalmatian pet owner about why you might want to think about lifelong care for this pet, right? To have the nutrition conversations, to have the conversations about pet insurance, or the things that are not a two second blurb out of my mouth, right?
Stephanie Goss:
And so I think that that has been a challenge for a lot of us is that we have struggled particularly during this last two years because we have all been so overwhelmed. And I think we have been seeing more patients, and we've also been really inefficient due to the changes we've had to make in our workflow. Some of us have become more efficient with curbside, but some of us have also become incredibly inefficient, and that impacts the time that we have to have some of these conversations and really figure out how do we lower these barriers for the owners? How do we find out what's important to them? How do we meet their needs? And I think that that's to your point Peter about becoming a service industry, that's a big missed opportunity for a lot of us.
Dr. Peter Weinstein:
So here's a thought, you have 30 minutes if you want to stay on time. Now, I jest in lectures and I ask how many of you would be willing to give away a free office call if you had to make your clients wait 10 minutes or more? And 99% of the people would never do it because they can't stay on time, but you almost have to look at that 30 minutes and break it down to a minute by minute experience. How much of that time has to occur in the exam room? How much of it can be done in YouTube videos that are sent ahead of time? We have this cost of care conversation at the front desk, which is tantamount to having it at a Broadway theater.
Dr. Peter Weinstein:
Where somebody's on the stage wanting to perform, and they happen to be a really pissed off Hamlet or Othello or somebody and they're at the front of the stage wanting to put on a performance for everybody who is sitting in the lobby. Probably the best thing about curbside is taking payment at the car window, and they have to shout through the window, but the bottom line is we could be doing a lot of communication beforehand and afterwards so that there's no surprises. I think the role of the veterinary profession going forward is to be totally transparent and to avoid surprises.
Dr. Peter Weinstein:
Cost of care, I mean, maybe we should start publishing our fee schedules on our websites, and so people can see what the cost of care would be. Why don't we share our financial policies and have clients read them and sign that they've read them ahead of time? I mean, we never talk to a dentist about the cost of care, you never talk to your doctor about the cost of care. When I had Lasik $5,000 for a 15 minute procedure, I never talked to the doctor about the cost of care. It was presented to me well ahead of time, but we get stuck in that conversation.
Dr. Peter Weinstein:
So we really do need to rethink that 30 minutes and how we want to break it down, and really, I mean, if Andy's time is 10 minutes out of that 20, but Stephanie or some other team member could handle the other 20, the clients are going to probably get an even better value proposition because they're getting a full 30 minutes of team time and it's not as doctor centric from that standpoint. And I'm sorry, I went off on a tangent.
Dr. Andy Roark:
No, I think that's totally fine. I thought a lot about increasing transparency in this way, in a lot of human hospitals you go in and they have patient rights and responsibilities. And it used to be, it started off it was a patient bill of rights, and then it generally changed to a patient bill of rights and responsibilities. And I think that that's good, and I hear a lot of us talking about personal boundaries and boundaries in our practice, and clients beating people up. And I go, we should have client rights and responsibilities that say, “This is what you can expect from us. This is how you will be treated, and we will treat you this way. And this is what we expect from you in return, and if this doesn't work for you then you can go somewhere else.”
Dr. Andy Roark:
And I'm a big believer in that, in that empowerment of this is a relationship that we have with clients. And in order for it to be a healthy relationship you have to tell people what to expect, and then you have to deliver what people expect from you. And that's just basic relationship and trust building, but I think it's where we need to go in vet medicine as well. But the whole thing of like, “Hey, pet owner guess what this is costing or guess this is going to go,” that's not healthy. I think our society as a whole is moving much toward more towards, “Hey, here's what it is. You can Google around and find whatever you want to buy costs, and have an idea of what you're walking into.”
Dr. Andy Roark:
It still feels a bit opaque I think when they come into vet medicine, and we all know why that is. It's like when they walk in, I saw a little dog yesterday just in for lethargy and I'm like, “I have no idea what's wrong with that dog before they come into the building.” There's always going to be some of that, but I do think that we can increase some transparency. And if they're going to have a problem with the price, then it's better for everybody if they know it at the very beginning and we can just talk about that. I think people underestimate how much of an extra headache it is to not have money conversations until the end, or to get down this path of we've done these diagnostics and now let's talk about your budget.
Dr. Andy Roark:
It was like well, we should have talked about your budget before we started running that blood work. And so I think that that's the future, to Peter's point I think a lot of transparency there is… When I ask the question of, do we do things that tick pet owners off or that make them mad? I think this is a pretty darn good example of things that we do to make them mad, which is we bury the lead when it comes to talking about money, and then we wonder why tensions are high and they're frustrated. So what do we do about it? So Peter you and I have talked in the past about inefficiencies in practice and ways of becoming more efficient. So inefficiencies, financial vehicles, things like that like I said, I don't believe that vet medicine generally, and this is a broad generalization, I don't believe it's generally overpriced.
Dr. Andy Roark:
I think people get what they pay for whether or not they realize it. I think that that's true, and I think that we can make them realize it, and that's something that we should do. I think that it may be possible, and then this is why I'm really enjoying seeing the spectrum of care discussion bloom, and people start to talk about, “Hey, maybe there's multiple standards of care that are acceptable.” How do we talk about those? How do we present those? How do we get pet owners to see the difference between them? How do we as vets handle there being someone else at a different part of the spectrum of care operating down the road from us? Are we going to be okay with that? Can we be okay with that? I think those are all really fascinating, but as I unpack those things for you guys, what are you looking at as far as paths forward to try to keep that medicine feasible for the majority of pet owners?
Dr. Peter Weinstein:
Well, I think you have two topics that we need to cover. One is the spectrum of care discussion, which is a practice act, state board, delivery of care discussion because that will be an issue in some fashions, and then the transparency on the cost of care discussion. I do think that the spectrum of care isn't important because we were always told to give the gold standard, or the Cadillac standard, or the Tesla standard, whatever you want to call it, and try to talk the client into that standard of care. But I think where we really need to do is one of the most important questions I had on our welcome to the practice forum was where does the pet fit in your household? Where does the pet sleep?
Dr. Peter Weinstein:
Because you've got to understand how important that pet is to the family to most importantly understand where their availability to pay may come in. I think the other thing is as Andy noted, we have the discussion of cost of care after we have created a level of anxiety about the concerns that the pet owner has. Whereas, we really should have, and especially with a new client, before they even come in send them your bill of rights, and send them a financial policy that talks about the variable choices that they may have in how to pay for veterinary services.
Dr. Peter Weinstein:
Whether it is a pet health insurance that they probably never even heard of or knew about, and maybe there are a couple of companies that you suggest that they sign up for and explain that preexisting conditions aren't going to be covered, et cetera. And then maybe some third party options, care credit, et cetera, that could fit into those discussions. Have those discussions ahead of time so that when they come in they can focus on what's best for their pet, and maybe can come in prepared on the financial side of things. So two discussions, one is a clinical discussion, and the other is a financial discussion when it comes down to it.
Dr. Andy Roark:
I think that there's a lot of knobs that we can turn in both of those discussions. I 100% think that there's things that we can do to better communicate, and I think there's efficiencies that we can build in our practice, and we're seeing some of those. I think the pandemic was good in that specific way of pushing us to make some changes, and pushing technology forward in a way that I don't think otherwise would've happened. On the financial side, I mean, there's a pretty good indication that we could significantly increase the number of pet owners that we see that have pet health insurance if we just made clear recommendations and put it in their mind. And so part of it is just making a recommendation and putting it on their radar at the very beginning when it's a low stakes conversation. The other part of it I really think is talking honestly with people about their chosen dog breeds.
Stephanie Goss:
Yes.
Dr. Andy Roark:
I mean, really I saw a new study out just this last week and it was amazing, it was the difference in cancer rates in Boxers versus chihuahuas is amazing, it was amazing. Compared to your average dog, a Chihuahua is 50% less likely to get cancer than your average dog, and your Boxer is a hundred and some percent more likely to get cancer.
Stephanie Goss:
Likely.
Dr. Andy Roark:
Yeah, it really was. The English Cocker Spaniel was the worst dog for getting cancer that was out there. Mixed breeds were less likely to get cancer than pure breads just in general. It's just all these facts I just thought were fascinating, but these are the things that we talk to pet owners about, right? And be like, “Hey, you've got a Boxer we should look at this.” Or every Dachshund puppy I see is an easy conversation about common health problems, and “Hey, if I were you I would take a look at pet health insurance just because these are things we want to look out for.” Westy with allergies, a Cavalier King Charles and heart disease, and just the list goes on and on, on, but just talking to the people about the pet that they have and being like, “Hey, this is a chance to protect yourself from the very outset.” And just I don't think that we talked to them about finance before they need finance, and I think that's a problem.
Stephanie Goss:
Yes, I think that's another example to the earlier point where we as a whole, as an industry really struggle to have that conversation until we're in the thick of it, and that immediately puts up a barrier for clients and pisses them off. Because they're like I've been a client of yours for five years, why didn't you tell me that my Dachshund could need to have surgery with a neurologist because disc problems are real, right? I've watched clinics struggle with that conversation, and it's hard for me, and it always hurts my heart when I hear about friends struggling with that because I'm like, why didn't you have that conversation with them, right? Why didn't the pet insurance conversation be in every single puppy conversation that you had with that owner because we know for a fact that the statistical chance is significantly higher.
Stephanie Goss:
And it may not happen to them, their Boxer might not get cancer, or their Dachshund may not need surgery, but we know the statistics of it, and so it drives me crazy when we as an industry as a whole don't lean in more to some of the practices that our human health care counterparts have done. To Peter's point, we're not doing a great job of sending them the information early and often, we're not having the conversations about how can they pay for pet care? We wait until they ask us, this could be a problem for me how do I deal with it? Versus being proactive, and so I think that it creates incredible opportunity for us.
Dr. Peter Weinstein:
So this is going to be a fairly long-winded answer I believe, so I apologize ahead of time. I've done a talk called creating a user's manual for pets, all right? You buy a car they won't let you drive it off the lot until they teach you how to use all of the features and fancy buttons and everything else. You buy a dryer, washer dryer and it comes with the user's manual. And if something goes wrong it's like what frequently asked questions about a dryer that's not drying or whatever the case may be. We need to create a user's manual for a puppy from womb to tomb, what to expect on a year by year basis and some breed specific testing that you would do so that you can get ahead of the curve for glaucoma, for dry eye, for arthritis.
Dr. Peter Weinstein:
And the focus on breed specific education needs to start at the first puppy visit that says, “God, I'm so glad you got a Cavalier King Charles, I'm going to go put my kids' college tuition in the bank right now because I can guarantee you that between EARS, skin, eyes, and heart, you have just paid for private school.” I mean, correct me I'm wrong, but… Okay, sorry about the sarcasm, but seriously this goes back to the transparency conversation, and let me go retrograde in just a second, why don't pet owners come to the veterinarian and ask which pet should I get? Because it's going to cost me $10,000 for a French Bulldog just to buy it, and another $80,000 just to get it through its first two years of problems that it's got.
Dr. Andy Roark:
And I'll take that back as well to what you were talking about earlier on when you were talking about the YouTube videos and things like that, why don't we have resources that don't involve us spending our time in the exam room? Things like this I think it's a fascinating idea of how do you take this puppy and kitten information and package it up so that you get pets to consume it not during their visit? I think it would be fascinating to get a new puppy or kitten in, and then have an email an series that comes that has once a day here's an email, and here's a link to a short video on one thing. And then here's day two, and here's day three.
Dr. Andy Roark:
And people go, “Well, I mean, they're not going to open all those. They don't look at them.” And I go, “Buddy, they're not listening to 90% of what you say in the exam room right now, at least this way they would have it in the inbox and they would be able to back to it.” And so I'm very bullish on opportunities to do education like that, I think it's fun for me as a vet who likes to teach and it's just interesting, but also I think that we can do real good with it.
Dr. Peter Weinstein:
Yeah. Well, count me in I'm in with you from that standpoint. We have done a lousy job of education at all levels, and I think it's because of time constraints. And we really haven't done a very good job of communicating clearly, and teaching our staff the language of veterinary care. And so I'm going to just do a shout out to AVMA for their language of care study that just came out because there's some great tips and tools on how to better communicate with clients at all different levels, including the cost of care and cost savings issues of those things. So I think it's important to start to shut down our practices for a little bit and learn how to communicate, because this goes back to transparency, it goes back to honesty and trust that we can create by having better communication. And I don't think the cost of care becomes this big an issue when there's trust. Have you read Stephen M. R. Covey The Speed of Trust?
Dr. Andy Roark:
I have not, no. I have not.
Dr. Peter Weinstein:
This is Stephen Covey's son, and basically when people trust you the transactions go much quicker.
Dr. Andy Roark:
Oh, yeah.
Dr. Peter Weinstein:
We need to do a much better job of building trust, and then that 30 minutes becomes 10 minutes because when you tell the client what the needs are, they trust you and you can move forward from that standpoint. So, I mean, we've talked about a heck of a lot of stuff, but honestly it's really all about communication, building trust, and transparency about the value, about the different services that we were there, and also about listening because I don't think we listened to clients enough.
Dr. Andy Roark:
The state motto of North Carolina translates from Latin to be rather than to seem, and I love that, and I think about that a lot to be rather than to seem. I think that it almost feels like sometime we try to present ourselves in a way to entice pet owners, and I'm wondering if we shouldn't be transitioning more towards a matter of fact presentation of this is who we are, and this is what medicine costs, and this is what we do, and this is why we do it. And just being very maybe even a bit more out in the open than we are, and I say that for a couple reasons, right? Number one, I think it increases transparency, which increases trust.
Dr. Andy Roark:
Which is we said this is what we are, we said this is what we do, and now you're here and now this is what we're doing. I think that that does help speed that relationship along, but the other reason to put that stuff out there is… Oh man, now I'm trying to remember what I going to say. Where was I going with this? Oh, no, oh man-
Dr. Peter Weinstein:
It's Friday afternoon.
Dr. Andy Roark:
Put it out there to build trust and transparency, but then also just to let us set boundaries. It takes the load off of our shoulders of trying to be all things to all people, we said, “Hey, this is who we are, this is what we do, and if you don't like that, that's fine.” There was a study that came out recently, it's in a Canadian journal, Canadian Veterinary Journal, and it was talking about the relationship between customer satisfaction and veterinarian mental health. And what it basically said was to some degree, after a certain point the higher the customer satisfaction, the more negative the impact on the veterinarian's mental health. Meaning that if you try to please these people and you do everything in your power to please them, it has a negative effect on you. And I think that that's true, and I think that having a cap of this is who we are, and this is what we do I think that's probably a very healthy thing for us as professionals.
Dr. Peter Weinstein:
Well, you want to talk about transparency, what do clients see in your practice? The parking lot, the waiting room and an exam room. So the value of perception to them is three things, a parking lot, a waiting room, and an exam room. Give them a tour, let them see the technology that you've got within your practice, and maybe they can truly appreciate things from an overhead standpoint as well. And I think that we're talking about access to care and cost of care and the concepts of communication, well, communication starts before they even come in. The client experience starts before the client even comes in, and what about even having a video tour on the website?
Dr. Peter Weinstein:
I love what some of these realtors are doing with these 3D tours of homes, why not do that for your hospital and have that as a welcome. “Hi, I'm Dr. Andy Roark. I'd like to walk you through our hospital right now, just so you can get an idea of all the services and technology that we can provide for you and your pet.” And so even when they come in they have a higher perceived value. I think we just really need to bring that value proposition up as well to go along with this transparency and other conversations.
Stephanie Goss:
So there's some good news, because I feel like all three of us have as we do soap box a little on things that we're doing bad, right? And that we're struggling with as an industry because we have a lot of areas of opportunity. And I feel like this conversation could very easily feel beat up because there's a lot of room for us to grow and improve, but there's really good news because we know that the numbers of pets that are getting help and care have gone up in record numbers over the last two years. And specifically to Peter's point, an area where I think we're succeeding in spite ourselves, there has been statistical information that's out of North American Pet Health Insurance has done a study, they do a state of the industry report, right?
Stephanie Goss:
And we know that pet owners are accessing care at really high rates, we also know they have said to us, pet owners have said 50% of them that they would be more likely to seek out insurance or alternative options like care credit if we talked about it. So they're telling us what they want and it gives us an incredible opportunity to turn around and give them what they want. We can make these changes to your point Andy, doing things like having the simple conversation in the exam room, or to Peter's suggestion, putting educational videos on our website. These are all controllable things that we can fix, and we also know that we're succeeding in spite ourselves because the number of patients and clients that are accessing pet health insurance is going up year over year for the last five years, almost 24%.
Stephanie Goss:
So if we're doing such a horrible job of educating them, which we all anecdotally feel like we are, they're still seeking out things and ways that are helping them access our care which is good news. So I feel like this provides us an incredible opportunity to sit back as a whole, as an industry and think how can we get out of our own way? And how can we stop putting up some of these barriers? How do we make it easier for them to tell us what they want and actually actively listen to your point Andy?
Dr. Peter Weinstein:
Well, and I don't know Andy if you knew that I actually worked for Veterinary Pet Insurance now Nationwide for two years?
Dr. Andy Roark:
I think you had told me that before, it was before I knew you.
Dr. Peter Weinstein:
Well, I think you were still in vet school. So I ran their claims department for two years, so I have an integral understanding of pet health insurance besides having insured my pets even as a veterinarian, and having ensured my employees pets. And I had a breakfast meeting with Jack Stevens many years ago, and we sat down and I said, “Jack, if you could have gone direct to consumer, if you had the budget to do so back in the eighties would you have done so?” And he said, “Absolutely.” He said, “The veterinarians have been greatest barrier to the growth of pet health insurance. The consumers would've bought into it if the veterinarians weren't such a barrier.” And I'm begging my colleagues to get a better understanding of where pet health insurance can fit in to the practices.
Dr. Peter Weinstein:
I know there's tremendous misinformation and disinformation, and if you go online you'll get more negative websites than positives, but from a practice standpoint when I was in practice pet health insurance definitely increased the number of visits that we saw from clients, and their willingness to spend. And I still have my pets insured, so I think we have to do a better job of advocating for pet health insurances as veterinarians, and I think we also need to do at least take a neutral role and not be so negative about it. And have a couple of policies that you've tried for your own pets or for your clients, your employees pets and advocate for those. There's plenty of great resources and plenty of great companies that are out there, do your due diligence and consumers want to hear about it. Who better to hear about it from than you and not Dr. Google?
Dr. Andy Roark:
Yeah. I think this is a good place to wrap this up. I want to leave this with this thought though, and I'm curious if you guys are on board, I am very positive about vet medicine in the future. I mean, you look at the care that we're providing pet owners and how they seek it out and the compliance that is there, our services are in great demand and they're going to continue to be in great demand. And we do work that matters and that people see value in, and I feel like yes, we're working through things and the world is changing around us, but my honest belief in the future is that vet medicine is going to be a great place to be. And again, this is access to care, pricing of care, all the sorts of things.
Dr. Andy Roark:
There are things that we're going to work through, but I think that if we just support pet owners, and take care of our people of our staff, and run healthy businesses, I think that we're going to come out in a very good place doing work that matters and that we enjoy doing. And that's just a sweeping generalization for the profession. I'm still very bullish about where we're going, I think that the pandemic has pushed us forward in a lot of ways that may ultimately end up being very good for us. So do you guys agree with that? Parting thoughts.
Stephanie Goss:
Yes. I'll take a line out of Peter's book and just say yes to all of the above.
Dr. Peter Weinstein:
No, Andy I fully concur. I mean, I think we have a world of opportunity, and I think we need to embrace change and we need to look for ways to continue to improve each day every day and not look back. I think COVID curbside forced a change, and that force worked out okay. Prior to that, nobody wanted to change and guess what? We survived. Okay? So I'm suggesting that if you make a 1% change every day in a positive direction, stop looking through the freaking rear view mirror and look through the windshield and look to improve your practice just 1% every day. I think your practice, and your team, and everybody else will be benefited, and I think the profession will be benefited as well. We've got a great profession, we've got a world of opportunity, we need to get our off the break, put our foot on the gas, look through the windshield and set our own direction going forward and make sure your windshield is completely transparent.
Dr. Andy Roark:
Yeah, that's awesome. Great. Thanks guys.
Stephanie Goss:
I love it.
Dr. Andy Roark:
Hey everybody, you guys have a wonderful day and Stephanie and Peter have a wonderful weekend. I'll see you guys next week.
Stephanie Goss:
You too. Take care guys.
Dr. Peter Weinstein:
Thanks Andy. Bye-bye.
Stephanie Goss:
That's it for or another episode. Thanks so much for joining us this week. I really want to thank our guest Dr. Peter Weinstein, and I especially want to thank Pet's Best Pet Health Insurance for sponsoring this week's episode. Take care of everyone. We'll see you again next time.
