Shawna Castillo, Director of Care Plans at Otto, joins us to tackle a critical question from a practice manager struggling with client credit limitations. Despite offering CareCredit, Scratchpay, and VetBilling, many clients still face challenges. The burning question: How do we design wellness plans in a way that is not going to make my team or my doctors lose their ever-loving minds? Practice Management super nerd, Stephanie Goss and Shawna Castillo offer their perspectives on this subject. This week's episode of the Uncharted Veterinary Podcast is brought to you by Otto.
Shawna Castillo, with her 20 years of experience in the veterinary and animal health space, brings a wealth of knowledge to this topic. As a leader in people, processes, and technology, Shawna excels in influential team leadership, process improvement, client retention strategies, and customer success enablement. At Otto, she oversees the Care Memberships program, helping veterinary hospitals boost their economy, client retention, team efficiencies, and patient outcomes. Shawna's passion for understanding human and animal motivators and her love for using technology to strengthen the bond between pets, their owners, and veterinarians, makes her the perfect guest for this mailbag.
Stephanie and Shawna discuss the need for care plans, enabling pet parents, especially younger generations, to afford preventative care through manageable monthly payments. They discuss key factors to consider when designing care plans and strategies to overcome common barriers from associate DVMs, team members, and clients. Shawna's insights offer invaluable guidance for veterinary practice managers and leaders looking to implement effective wellness plans without overwhelming their teams. Let's get into this episode…
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Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.
Submit your questions here: unchartedvet.com/mailbag
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Episode Transcript
Stephanie Goss: Hey everybody! I am Stephanie Goss and this is another episode of the Uncharted Podcast. Today's episode is actually brought to us by our friends at Otto. And it just so happens that I have someone who is currently on the team at Otto here with me today.
And that is my good friend, Shawna Castillo. Now Shawna is actually here today because she and I are going to tackle a mailbag question.
Shawna and I go way back. We were both practice managers together. We both worked in corporate medicine together, we stayed in touch when she left and went into industry. And Shawna has had a variety of experience on the business side. And she is currently the Director of Care Plans at Otto which goes to what we're going to be talking about today.
Actually, we're going to be talking about wellness care in our practices, wellness plans, preventative care plans, whatever you want to call them. We are going to talk about how to make care accessible to our pet parents and how to do that in a variety of different ways. So let's get into this.
And we're back. It's me, Stephanie Goss, and today I am joined by one of my favorite people in veterinary medicine. I am joined by my friend, Shawna Castillo and Shawna is currently, Shawna, what's your actual title with Otto? Because that's like, I don't want to screw that one up, because it's all professional sounding now.
Shawna Castillo: Yes, it very much is. I am the Director of Care, our care memberships.
Stephanie Goss: Director of Care with Otto, and I have known Shawna for a really long time. I feel like it's like, oh, I'm just talking to my manager friend. Shawna and I have known each other for years. We were both managers. We didn't know it at the time, but we were both managers within NVA practices at the same time.
Way back when and then Shawna and I met when she was working with our mutual friend, Dr. Stacey Santee at Vet2Pet and Shawna is one of those managers that I have just always loved connecting and nerding out with about a variety of topics. We'll, like, get on the phone to ask each other a question that should take 10 minutes and it's, like, an hour and a half later.
Shawna Castillo: Like, like minimum.
Stephanie Goss: Yes. But Shawna is here today because I got a mailbag question. I actually had several of them about wellness plan things and since that's Shawna's current role now with Otto formerly TeleVet, for those of you who are like, oh, what's Otto? I don't know that I've heard of it. I bet you have. It's our friends at TeleVet and Otto is the new brand because TeleVet is tele, TeleVet made people, I think, think of telemedicine and only that.
And so they have done work over this last year and a half or two years rebranding into Otto and really leaning into automation and AI and all of the ways that technology can really improve our practices. And we'll get into that today. But, Shawna, welcome to the podcast. I'm so excited you're here.
Shawna Castillo: Thanks, Stephanie. It's an honor to be here. I'm really excited to get into this conversation.
Stephanie Goss: Me too. So that I'm not gonna, I'm not even gonna attempt to like, read your official bio or screw up your info. So besides the fact that you started as a, as a veterinary practice manager, we've known each other for years. Do you want to tell everybody a little bit about yourself and your kind of where you're at with Otto now?
Shawna Castillo: Yeah, yeah. Well, I actually started as a veterinary assistant. I have about 20 years of experience in veterinary medicine, 15 of those are clinical. So I started, you know, as early as it was legal for me to get paid working in a veterinary practice. Doing all the things that I could do and I've kind of worked myself up and I've done basically everything except for be a doctor.
So that's been really cool. And my most recent position in a clinical setting was a practice manager. I was also an area manager for a good amount of time, actually focusing most of my time implementing care plans in area hospitals. So, and about the last five years or so, I've been on the other side of veterinary medicine, focusing more on ways that technology can enhance the clinic experience.
And so, most recently for the last couple of years, I've been at Otto running our new care membership program.
Stephanie Goss: And I'm super excited to talk about this because you and I have we're both super passionate about I think wellness is a, is a word that we use a lot in veterinary medicine but really it's the idea of preventative medicine and kind of being the foundation of everything that we do in vet med because we know, yes, we see sick patients and we also know that when we see sick patients first when they're due for things preventatively and we're doing that that maintenance work We help prevent or at least slow some of those disease processes significantly.
And so I got a mail bag Oh, so you and I are both super nerdy about the idea of preventive care and we've both worked extensively with the concept of wellness plans, both in clinical practice as managers, as team members. You and I both worked within the NVA's PAW Plan framework, which we'll talk a lot about in today's episode, I'm sure, but also you worked with wellness plans in private practice as well, right?
Shawna Castillo: That's right. Yeah. And, you know, wellness plans have been around for decades at this point. And you said something earlier that I just have to Go back to, and you said something about it being foundational. And I think that is what I'm most passionate about is this idea of like foundational medicine, not necessarily calling it wellness or preventive because wellness is not one size fits all.
It looks different for every pet. And so that's what I really think care plans can change in the world of vet med. You know, they can really enhance client conversations planning, which we know like doesn't exist in, in the pet parent kind of population, you know, planning for pet care. And so that's what I think is really, a really cool way to kind of encompass like, you know, what the whole point of wellness or care plans are, and that is like really promoting foundational medicine.
Stephanie Goss: Yeah. And I'm going to stick a pin in that because we're definitely going to come back to you. I love the– we're going to come back to the specific change in language because I love the idea of care and transitioning away from the idea of it's just preventative or it's just wellness.
There's, there's a lot there to unpack, but I want to start us at the top because we got You know, we're, we're here today, A, because I love nerding out with you and I could talk to you all day long and I feel like you are someone that our our listeners may not be as familiar with as, as far as being a, a part of our industry and so, I wanted to have you here to nerd out, but also because I had a couple of mailbag questions and there was one that came through really recently that really stuck with me because it was from a practice manager who was really struggling because they have been doing all of the things for a really long time in their practice in terms of offering financing options for clients, you know, using our friends at CareCredit or using Scratchpay VetBilling, other, other payment options that have kind of been around forever And they also use pet insurance in their, in their practice, they take it, they promote it.
And they were saying, you know, we're really struggling because we're kind of in this place where as the economy has shifted and clients are having to really think more and more again about where they're putting their dollars, we're seeing more clients recently getting declined or not qualified for credit, or they have, they have their own credit cards, like they're not interested in, in a financing option. They just are choosing not to either choosing not to or not being able to spend the credit card dollars that they do have on care for their, for their pets. And so, you and I were planning to come on here today and have that conversation, and in the last couple of weeks, as we've kind of been prepping for this and talking about it, we've had this conversation that has been happening in the Uncharted community that really tied to it.
And it was so funny because we had, we kind of planned to start with one topic and then I texted you and I was like, Hey, how do you feel about going in this opposite direction? Because they really tie together. We had a friend of ours who is a practice owner and practice manager actually in Vancouver, Canada, so on my side of the world and he was asking some questions because he saw on social media a local ish clinic who was offering care plans or, wellness plans, how, whatever you want to call, call them.
And their plans, their advertisement on Facebook really was just, hey, we're offering unlimited consults. And there was no definition of what a consult was, but the ad itself was, we're offering care plans that have unlimited consults. We're also offering a discount. In this case, it was 10 percent off of additional things like meds, foods, other services.
And they had a set price, a membership price for a year of unlimited consults. And it very clearly said both doctor consults and technician consults. And so they were running a, you know, limited time offer. And then they were going to have a pricing after their initial special.
My friend who is the practice manager was just like, has, you know, has anybody else seen this? This seems absolutely insane because the price point was a few hundred dollars. I think their introductory was like in the, below 250 and then their, their initial price was going to be between like three and 350.
So for a couple hundred dollars a year, this practice was offering unlimited consults. And so our friend was just like, This seems crazy. How can I afford for clients to be able to come in as often as they want, whenever they want, and have visits for such a low price point? Like, I could not afford to pay my staff.
And I completely understood the panic. And I was also the one who had to jump in on the conversation and say, okay, let's take a deep breath for a second and let's start with some math. And the reason that I always start there is because in my experience doing PAW plans and care plans within my own hospital We went the route of having unlimited actual exams.
So in this case just for reference with the podcast today, I'm gonna go ahead and assume that when this practice says consults, they're talking about exams whether a DVM exam or a technician exam And we all know that every hospital does those differently like my you know, my hospital was we had sliding scale. So we had 30 minutes to 60 minutes. My sister hospital right down the street was 15 to 20 minute exam.
So, I don't know about your practices, Shawna, but like everybody does it different, right? When you say an exam, it never means the same thing in veterinary medicine.
Shawna Castillo: It never does. It means sick, you know, any type of doctor exam, any tech, any progress, any recheck. But yes, let's keep– I'm like itching to say what I have to say about this. So let's keep going with it. Yeah. Yeah.
Stephanie Goss: So I, you and I started nerding out about this and really broke it down to a bunch of questions that we really wanted to tackle around the idea of wellness plans or care plans for, for the purpose of the discussion today. Why, why they shouldn't be as scary as sometimes they feel, and I think I want to talk through certainly I have some, some thoughts on that, because I empathize with our friend, because I had been in that position, like my doctors did the exact same thing of, oh my god, the sky is going to fall if we have unlimited exams, you know, and it's a scary, it's a scary thing, because we work so hard
in veterinary medicine every day to make clients understand the value of an exam and to get clients coming in through the door and so I think the initial fear like gut wrenching fear reaction is Are we undoing all of that hard work? Are we devaluing the exam if we look at care on a level that could include unlimited exams.
Clients have open access. And so, I think I want to, I want to start with you. You had both from a practice perspective, you and I had I, in this case you know, I talked candidly on the podcast. I actually had a really great experience working in corporate medicine. I've had really great experiences working in private practice.
I've also had really calming experiences working in private and corporate practices. And so I think I really sit in the middle that there's one side is not good, one side is not evil, and I think what, especially when it comes to wellness plans, I think there is a lot of stigma in veterinary medicine around it being a corporate thing, and it's subsidized, and only big practices like corporate practices can afford to do it, and so since you and I both have a experience, both on the private and corporate practice side, as well as now your, your role in Otto you've had the privilege to have access to a lot of the same kind of data, actual data research that I do. And then some, because I know you guys have put a lot of work at Otto into doing research before you launched. Your version of care plans in the last couple of years. So let's start with some of the facts and, and un, you know, unpack some of the myths, I guess, around care plans and wellness plans and unlimited exams and all of that.
Shawna Castillo: Well, I think that it's always, first of all, I want to go back to this question, the mailbag question and then the practice manager in Vancouver. I think it's a really interesting, like kind of joint question that we're going to tackle here because it really does address the problems that we're seeing in the industry right now, which is affordability and volume, you know, but then specifically about unlimited exams, I think, you know, I think that is the part that really gets to be scary because people are like, how am I ever going to afford this?
Like you said, and it's important to stick to the facts here. First of all, usually when a plan is set up with unlimited exams, that does not mean it's a free for all. It doesn't mean clients to get to come. They get to come in anytime they want. Use any exam, you know, just skirt in through your already scheduled appointments. That's not happening.
Stephanie Goss: Right, and..
Shawna Castillo: That's number one.
Stephanie Goss: That's what, I think that's the picture that everybody gets in their head is if you offer unlimited exams, all of a sudden, any client can walk in the door whenever they want and demand your time and attention, right? Like that's the scarcity mentality for you that our lizard brain does and that's where we all are at. And that's why I empathized when the question got asked. Cause I was like, Oh yeah, cause that's exactly what my doctors thought.
Shawna Castillo: Right. And you're right, listeners. That is not feasible. It's not realistic. Like, don't do that. Don't do that. Please don't. But I think that what's really interesting about the idea of unlimited exam is it's wildly interesting to consumers, to your pet parents, because, okay, we have visits at an all time kind of low right now.
So visits are down. Compliance is down, but like spending is up. And we kind of all know that based on a million different articles that are being published right now and data that's being published and. What I think is really interesting is that when you think about shoppable items, what's the first thing that clients ask about when they call and try to make an appointment?
They'll want to be seen by a doctor or ask for meds and the responses that they need to be seen by a doctor. They always ask, well, how much is that going to cost? It's a massive barrier. So if you can break down that first barrier to getting clients through the door, then you can provide them with a treatment plan and typically encourage more from them. So I understand the strategy here of that neighbor clinic that just open that is offering unlimited exams. It makes a ton of sense to me because they want to encourage loyalty and retention from their pet parents in an age, a day and age where are the majority of our pet parents are incredibly brand disloyal.
You know, we've got millennials and Gen Zers making up a large majority of the pet parent population and they are the least brand loyal. So I think it's a really interesting way to encourage that loyalty and retention that we're all looking for.
Stephanie Goss: And I think the other thing that is really important to look at, and we'll we'll try and pull out some links for everybody in the show notes to some of the data, because there is a large amount of data and research that has been done over the years, you know, I think I know when I started doing wellness plans in my private practice, the only comparative that I had at the time really was Banfield Wellness Plans because that was the kind of the OG, you know, that was like, that was where it originated in, in vet med and It was like, okay, this is what it, this is what it is.
And I, and I think that that is what it is or can be for one company and one practice. And I, and I think that that is you know, fear myth number one. I think everybody gets it in their head that like, okay, what somebody else does is exactly what you have to do. And I, I know I fought that battle with my own doctors, even just within you know, our, our own little NVA region, you know, they have their own wellness plans.
They're called Paw Plans. And, and it was like, Oh, well, I don't want to do the same plans that our sister hospital 10 miles away does. I want to do them. You know, I don't want to do it at all because I don't want to have to do what they are doing. And I think that that is like the fear factor is that you have to take a model that someone has and you have to do it the exact same way. And I think that that, from the exam perspective, I think that that is what is really, really interesting, is that if we looked at plans that historically only included a limited number of exams, we would have never gotten to the place where someone along the line went out on a limb and said, we know that our loyal clients come in more often, right?
Like, when you think about those A clients in the practice, how often do they come in every year? They're not your once a year clients. You know, the Mrs. Smith who brings your team cookies at Christmas, she's in because she has the trainwreck pet. And she's in every six weeks for something, you know? So she's not in once or twice a year.
And we know that those clients, those, those A clients are coming in more frequently. And so somewhere along the line, someone said, well, what if we allow clients who are on a wellness plan or on a preventive care plan access to the practice? more easily? What if we give them more exams? And I think for me, I saw it in colleagues where it was like, okay, well, we'll have four exams, or we'll have two exams, and then it was like four, and then it was like, what about if we offer them, like, eight or ten?
And then it became unlimited. And so for me, watching it was a very slow progress, because I was exposed to a lot of practices, both private and corporate, who had wellness plans along the line. And I think to people who have not had that exposure, I could absolutely see where going from your model, where you maybe see the majority of your clients once or twice a year, to now saying, Hey, you could buy this plan for a couple hundred dollars and you can come in whenever you want. It seems big and scary. It totally does. Right?
Shawna Castillo: It does seem big and scary, but I think that like when you go back to the mailbag question where these clients, what we know, the data that we know has been published was that in 2023, there was some there was a study that showed that over 60 percent of pet parents who apply for traditional credit based financing don't get approved.
So that goes right back to this mailbag question of we've got clients who want to do. I presumably want to do what's being recommended, but they cannot for whatever reason. Now, this particular study showed that it wasn't necessarily because clients didn't have good credit, but it was because they didn't have built up credit. Like they didn't have enough credit. And I think that makes sense when we think about more and more young people getting pets,
Stephanie Goss: Exactly. When you think about the volume of Gen Z clients that you have, that straight out of, straight out of even sometimes high school, but the early stages of college, they're going out and getting pets. And I didn't have I didn't have credit when I, you know, was in college and just, you know, got, there was no way.
I, in fact, I have told this story on the podcast, like my very first CareCredit account, I only got because my boss co-signed for me as a practice, as an employee benefit. Because I didn't get, I didn't, I didn't qualify because I was a college student who had college, my only credit was that I had college loans, and I did not, I did not qualify.
So I, I can totally imagine the volume of of Gen Zers, especially, or, or even millennial. You know, although we're, I guess millennials are significantly older now, right? That argument doesn't hold water anymore.
Shawna Castillo: Don't tell anyone.
Stephanie Goss: We're elderly now. I don't even want to talk about Gen Xers cuz we're old. But Gen Z, they don't have credit and so to your point, it's not because they have bad credit. It's just maybe because they don't have enough of it. But whatever the reason, if they can't have financing, I also was just Having a conversation this weekend and I think it was, I was because I was just at, I was just at Uncharted and I was having a conversation and I think it was AVMA that just put out the study.
I'll have to check, either way I'll find the study and drop it in the show notes, but where the typical pet parent is unprepared for a like $1,000 unexpected bill or a $500. It was a really low threshold
Shawna Castillo: It was the Forbes advisor survey and it showed that something like 40 to well, at least something that I saw there was a Forbes advisor survey. They do this every year. They survey, you know, pet parents, all sorts of consumers. And it showed that like something like 40 or 45 percent of pet parents would not be able to afford that.
I think it was actually a $500. They wouldn't be prepared for a $500 unexpected vet bill. And that it's wild. So that's why I think, you know, care plans, that's why I'm a wellness or care plan enthusiast. Like, these are a tool. If you can build them in a way that works for your practice, which I think we should get into, like, what factors should we consider when we're designing these, these care plans?
Because If you can do that, if you can think about how this is going to work for not only your practice, your business, your team, but also your clients and patients, it can elicit the response and the results that you're looking for.
Stephanie Goss: Yes, and so I agree with you. I want to, I want to dive into that. I think I want to just tie up the, the piece about the unlimited exams being big and scary and recognizing that that is a barrier, right, for talking about this with your team, because I have talked to so many colleagues who did exactly what this friend did and was like, Oh my gosh, no, no way, because we're hallucinating and telling ourselves a story in our head that all of a sudden, All of the F and D clients who scream at the front desk are all going to show up whenever they want in your lobby because you've made care only $200 or $250 a year, right?
I think that's the, that's the horror scenario that plays in, in all of our heads and where I was going with the data piece was that we know that even when we give access to care via a wellness plan, whatever we want to call them and we offer unlimited exams, our average client, Only uses 2.5 of those exams and the high use typically comes in at four to six exams a year for those clients.
And so even though we're offering them unlimited, we know that they're not using it. And so for me, that was a big part of the bridge that I had to build with my doctors who were like, Yeah. The sky is falling. The sky is falling. These clients are just going to show up whenever they want was having that conversation about, Okay, look, here's what the data actually shows us.
And how can we reach a point of compromise where everybody feels comfortable that the clients are not going to be allowed free access to the practice? But this is not going to train wreck our day. And still, to your point, give the clients what they want, which is the feeling that they have support and access when they want it, where they want it.
Shawna Castillo: We'll get into this later, too, but. I think it's really important to think about what happens when those clients come in those four to six times. Like, I think the scariest part for people when you think about unlimited exams is that clients may come in whenever they choose and that just doesn't happen.
If you, communicate up front that these are scheduled appointments. It's no different, you know, you're not like giving them a hall pass to your schedule, you know, like they, this is no different as far as the SOP goes for scheduling appointments. They're just going to be more encouraged to come in on day one of that ear infection versus doing what Dr.
Google says. I mean, if I had a dollar for every time a client of mine, when I was a practice manager, would call and say, my dog has an ear infection. We live really close to a lake, so we had many ear infections and
Stephanie Goss: Sure. I can smell that from here.
Shawna Castillo: And they would say, okay, I actually, I think I'm going to hold off because I read online that I can do like, a vinegar dilution and we were like, ah, like sound the alarms, you know, like, no, you have an, an, an, an, a care plan and they had exams left because our plans weren't all unlimited.
We offered them in tiers, like with multiple, you know, maybe two or three here, unlimited here. Okay. But if they had exams left on their care plan, what was really cool is that we could we saw a noticeable shift in behavior from our clients where they would come in earlier and they would come in more frequently because they had those exams.
It broke down that barrier. It got them through the door. And then I have some data to share later. About the fact that at least with Otto's care plans, not only are we seeing clients come in more frequently, but also spend more at each of those appointments. So it's like true win, win, win for the practice.
Stephanie Goss: Okay, so let's start with, let's start with the, the question because the mailbag question was about how do we, how do we design wellness plans in a way that is not going to make my team or my doctors lose their ever loving minds, really was the gist of the question. And so, so let's, let's start there.
Like what, what are some of the factors that you, cause you've got such a breadth of experience. What are the factors that we should consider when we're designing care plans for our practices?
Shawna Castillo: In short, it really boils down to simplicity, profitability, and knowing, truly knowing what behavior you want to elicit from your clients. I call it long term changed client behavior. What are you trying to get them to do more of? And the reason I say all three of these things is because when I started at Otto, we had a lot of work to do.
We were offering a very traditional model of wellness plan that just was not particularly interesting to very many hospitals or very many pet parents at the practices that we're offering this. We kind of took a step back when I started and did a ton of research, and I interviewed dozens of practice owners and practice managers who are running their own program to understand, like, what were the pain points so that we could build something that was a real solution so we could understand what not to do essentially.
And a lot of what we heard was that plans are too difficult to manage or keep up to date. You know, we do price increases twice a year. How do we update these plans? How do we consume benefits? How do we keep track of what's used and what's not used? How do we keep track of the payments? You know, like all of that should be considered whenever you are designing a wellness plan or trying to, you know, I trying to decide if you're going to essentially buy or build this program.
Stephanie Goss: Yes.
Shawna Castillo: So that's kind of number one, like the administrative effort, you know, it really should be as simple as possible. The second one is the profitability of this.
How can you build these plans to still profit your practice and boost your bottom line? I mean, that is the whole point of these. They're not supposed to be discount plans. You're not supposed to lose money on these. There is a psychology component to this and that's what I love doing. That's why I love, you know, my job and building out plans with clinic leaders is because it's not just like throwing, you know, in clinic services into a bundle and say, and like throwing it at, at,
Stephanie Goss: Yes, yes.
Shawna Castillo: parents, you know, there is a strategy. And so, And you have to use that strategy to, to be profitable. And then again, thinking about what, what behavior you want to elicit from your clients. I think one thing that I experienced as a practice manager was that with my very traditional model of wellness plans, we would deal on an almost daily basis with client, with some sort of friction in a conversation with clients about what's included and what's not included.
And what we really realized was that These were super focused on what this kind of old school idea of what quote wellness is because we built them out to be, you know, what, what you probably think of when you think of a wellness plan, exams, vaccines, couple panels of blood work and plus or minus an add on of a spay neuter or dental cleaning.
But you notice I said blood work and that's what clients hear. They hear blood work and clients don't know that there are 300 different antec or IDEX panels of blood work or blood work. Plus, you know, so usually we're really specific about that one panel of blood work that's included, but they don't know what a CBC or a Chem 10 is.
They don't know what a Chem 27 gives us in additional diagnostic information. And so we would deal with these kind of very friction-y conversations that, you know, doctors like want nothing to do with. They're like, I don't want to explain this to you.
Stephanie Goss: Yes, yeah.
Shawna Castillo: And so, but, but what we realized when we locked these clients into this annual care plan that include a Chem 10, a Chem 10 was that it wasn't really encouraging the behavior that we wanted from them because we got them through the door.
Maybe they were on unlimited exams, but then when we, you know, presented additional treatment recommendations, they were frustrated that those additional treatment recommendations weren't included in the package that they were paying for. And so that's why we kind of reconceptualized care and we'll get into that later.
But I do think that those are like the big main points. It's like, what are you trying to see your clients do more of? How are you going to build something that profits your practice? And how are you going to manage this? You know, like in the most easy way possible.
Stephanie Goss: Well, and I think and you can probably speak to this, the specific data that you've seen in particular in your experience with Otto but one of the things that sold me on the eye on how powerful plans can be to support pet parents. There's two pieces of it. One is that you mentioned earlier
looking at the demographics of pet owners today, we have a huge amount of millennial and Gen Z pet parents, like vast majority, I think, at this point. Those consumers and those clients are used to the monthly subscription model. That's what they know. They've had Netflix from the beginning, our elderly millennials, and our Gen Zers are used to literally everything from, you know, their streaming services to a monthly subscription service at Panera.
Like, it is, that is the model that Gen Z has grown up on, and millennials have been there too. So when you look at it from that perspective, they want that. That's how they budget, that's how they plan their lives. They're looking for what is this going to cost me monthly, so that I don't have to think about that expense.
And I love that you brought up the psychology of it, because we really looked at that and spent a lot of time when we onboarded the team to the idea of using plans. I spent a lot of time with the team talking to them about the psychology of knowing that when clients have that sunk cost, they've already paid for it.
They've already budgeted the monthly, the monthly care cost. It becomes significantly easier to talk about the in addition piece because that piece is already gone in their mind. You don't, you don't have to think about it. Now you're talking about what the additional pieces are. So just like when we talk about our online pharmacies, and the idea of, you know, clients are, clients are not thinking about the things that are on auto ship to their house.
Because that money is already spent to them. It's a separate transaction from whatever they're buying that day in the practice. The same rule applies here. And so I love what you said about the profitability perspective because we actually know that when our clients are on a plan. That monthly subscription cost is out of, out of sight, out of mind.
So when they do come into the practice, we know that dropping the barrier of the exam cost, in particular with unlimited exams, gets them in the door faster because they're like, cool, I'm not gonna have to pay for that. They're not, that does not mean that they're not expecting cost for the rest of the visit.
In fact, we know from a data perspective that clients who are on plans, I think it's like 2.5 times higher at every subsequent visit, they're willing to spend two and a half times more than they would have historically spent prior to being on a care plan because that sunk cost is out of sight out of mind.
Shawna Castillo: And that's what we're seeing too with our care plans is that or the care memberships that Otto it, like you said, two times more at each step subsequent visit. Our care members are spending almost 100 percent more than they did the year prior. So the way that I always explain this is like, think about if you were to implement a program today, we, we, we would look at what the client spent on that very same pet the year prior.
And then we would wait one year and see. What we're seeing is clients are spending 100 percent more on their pets, almost when they sign up for a care membership, but then also they're spending about 65 percent more than non members. So the best of both worlds, you're, you're making good clients better.
Stephanie Goss:The ACT is going up no matter what.
Shawna Castillo: Exactly. Exactly.
Stephanie Goss: Yeah and I love that from the profitability perspective and that was, that was how I ultimately persuaded, negotiated, negotiated. You know, gently talked into, however you want to phrase that bulldozed, I suppose. there was one doctor I had to absolutely bulldoze into it.
But that was the conversation that I had with the doctors. Because the fear, especially if you have doctors who are paid on production the fear is, I'm going to lose all of this money if I have all of these clients who are now no longer paying for exams or not paying for services, or they're getting it, especially if your plans include a discount, the hallucination or the story that the doctors tell themselves in their head is, Oh, my God, my production check is going to be half of what it was before, right?
Like you're, I'm just never, I'm never going to make any money and I'm going to be doing all of this work because clients have open access to my schedule and it's the, it's the death spiral of catastrophe. And all of a sudden all of your doctors are Andy living in a box in the woods. Because that's what he does when he catastrophizes.
And that's how, that's how the doctors, the doctors feel. And so I think from a production perspective, you absolutely have to. Get in front of that. And the conversation I had with my doctors was like, listen, I, I have a trust bank built up with you. And do you, do you trust me? If you trust me enough, I'm going to make you, I'm going to make you a proposal.
I propose and I did this in my private practice. I said, I want you to do this with me for a year. And if after a year, your average client charge and your production have not gone up year over year. I will actually pay you the difference,
at the, we'll do, we'll do a, we'll do a true up. But I was, I looked at the data and I felt really, really confident because of what you said, Shawna, which is that the numbers prove it over and over and over again.
And, we're lucky to have access to companies like NVA and Banfield who do all of this data and put it out there, publish it for the industry, so we know historically how this has, has gone. I looked at all of that, and I felt really confident, and that was the bet that I made my doctors. And I had the one doctor that I had to bulldoze into it, and that was the only way that I got her to say yes.
And she did. And the next year, I absolutely did not have to cut her check because her production was up significantly because she had a large number of clients that were on plans and had that sunk cost and they were spending more. So the profitability went up for the clinic, but the profitability went up from a doctor's on production perspective as well.
Shawna Castillo: Yeah, I mean, I could add to that, when I was a practice manager, our medical director was all in on our wellness plans and his percentage of revenue generating per potential or, you know, percentage of the bottom line was large. It was like 40 percent and his average transaction was nearly double what our other doctors were, and his attribution for enrollments was like 90%. Like he was crushing. So I am team wellness or care plan 100%
Stephanie Goss: Yeah, yeah. Okay. So I want to talk, I think you, you came up with some really good points. The pieces that we need to consider when we're designing them. So we have to look at simplicity, which I think is really good. I think you know, we talked about the facts that Nobody wants to spend a significant amount of time, and you have to do your time, you have to do your research to figure out what is going to work for your team and your workflow, because simplicity does matter, that in and of itself could be a whole podcast, you've got to look at the profitability.
And you've got I love your point about knowing what behavior you're trying to elicit from, from your, from your clients. And I think the other the only other piece that I would add to it. To this and then I think we should take a quick break and then come back and talk about the other pieces of this because I want to get to the two other kind of chunks that we have on plans in general.
And then I want to talk specifically about what you guys are doing differently at Otto because I just think it's so cool and such a neat concept. The only other piece when it comes to designing them is I think it's really important that you not compromise your medicine when you're designing your, your plans, because I have seen so many of my colleagues really struggle with feeling like they have these plans that are not actually what they want.
And you spoke, Shawna, when you were talking about the blood work perspective, and that is absolutely friction from the client perspective, but it's also friction from the team perspective. Because if now, to your point, I have to go in and have a 25 minute conversation with this client about why their plan included a CHEM 10, but why Dr. Sarah is recommending a CHEM 27 and what the difference between those two things are and why I need her to pay the additional difference in what the plan doesn't cover. Now I'm compromising my medicine to a degree because I'm having to do extra work, I'm having to deal with client frustration, I'm having to deal with team frustration, and so we know, behaviorally, that that's when it, we know that that's when the behavior of the team starts to change. We shortcut our recommendations. We hold back on saying what we really want because we don't want to deal with that frustration factor, whether it's from the client's perspective or our own time and energy perspective. And so I think I am a huge advocate for, and you and I have talked about this extensively, like your plans, however you design them, got to take into account what your standard of care is at your practice. The medicine has to be what you believe in it or the plans will never work. And I see so many of my colleagues who try and do quote unquote wellness plans and get frustrated and give up oftentimes before even the first year is out because what they have built either inputs too much friction or is not their standard of care or both.
And so from a manager perspective, like that is the single biggest piece of advice that I can give to my, my fellow managers and practice owners. Sit down and you have to start with your standard of care. Okay, let's take a quick break and then let's come back and we'll dive into the last couple of pieces here to, to get to what you guys are doing differently over at Otto.
Shawna Castillo: Can't wait to get into it.
Stephanie Goss: Okay. We are back and, you know, we're departing from Andy and I's normal like headspace slash action steps because I'm, I feel like there's just so much more, Shawna, that you have to share with us that is actionable. We, we left off kind of talking about how do we, what do we consider when we're designing wellness plans. And we were talking about the profitability piece, and I think I think I wanted to ask, like, from your perspective now, because you've just been so immersed in the data and the the nerdiness from a data perspective behind this, like, what what are some of the things as we're designing plans that we can do to ensure that we have profitability and that we're also addressing the client's needs when it comes to care plans and maintaining everybody's sanity from the clinic's perspective, right?
Like, it's got to be sustainable because you and I both know as managers, if there's friction for the team, if there's friction for the clients, like I said before we went on break, this thing is not going to last the first year. Like, you're going to try it, you're going to dive in, and then you're going to go give up in spectacular fashion.
Shawna Castillo: 100%. Well, I think it goes back to this idea of, you know, thinking about how to make these profitable, thinking about the behavior you want to elicit and doing the work or doing the research. So I'll do a little research for you. We have this AVMA infographic. And it's really very interesting because what this infographic shows is what the highest revenue generating services in a clinic are based on their research.
And it shows that exams and consultations take up a large majority of them. And then we have additional revenue generating items broken down by pharmacy, lab, surgery and anesthesia, vaccinations, imaging and dentistry. What's really interesting to me, and I think just something to keep in mind, is that many times clinics plans only include about half of these listed services, these listed revenue generating items, and so how, maybe ask yourself, like, how could we include more of these?
That's something that I asked myself whenever I started at Otto. It's how we kind of conceptualize care memberships because we wanted to be more inclusive so that we could drive more standards of care and SOPs at each individual practice, because, you know, SOPs are different by region, by hospital, and it's not one size fits all.
Just like I said, with wellness as a definition, it's not one size fits all. We know that clients or clinic S.O.P.'s are also not one size fits all. And so that's why we develop something that would really encompass that and promote something that does encourage long term change client behavior and does encourage more spend from clients and more compliance and more visits.
So all of the things so that's what I would say, you know, how can we, that's what I would say is like do the research and find a program or, or, or build something that is really going to speak like your hospital's truth.
Stephanie Goss: Well, and so, okay, so that was the perfect segue because, um you know, when we get asked the question, like how do I design the plans? I think there's the starting with your standard of care and looking at the pieces that we've already discussed. And then I think the next piece is, what are my choices? Well, I can build it, I can do it myself and DIY it or I can buy it, meaning that I can use a third party service to build the plans and administer the plans for me. And there are two kind of options that kind of branches out in two ways. One is the traditional way that most people think of corporate practices doing it where you're buying it quote unquote, but you're doing it in-house, meaning that there's a team that your hospital is paying within the bigger organization to manage a lot of things. That's the experience that you and I may have had within NVA although my practice selected to run 'em ourselves. But you have help doing that,
right? And then there is the third party model where you're paying a third party company completely. Veterinary specific to build out and administer the plans for you deal with the software do all of that. You and I could do a whole podcast just about that piece, so I think that's I think from a building them perspective.
All you need to know is that there's a lot of options we've actually got some prior podcasts that I'll link in the show notes about care plans and that kind of go into some of the options including third party options but like you can absolutely build it yourself, or you can buy it, whether you buy it internally or you buy it from a, from a third party, if you're a private practice but now we have a new option, and that's really the heart of what I wanted besides getting to see your beautiful face and talk to you today, like, that is the heart of why I wanted you to come and talk about what you guys are doing at Otto, because just like everything else that that Otto has kind of done in terms of trying things just a little bit differently in veterinary medicine I feel like when you came on board the team and you tackled the idea of reinventing wellness plans and turning them into something different. You guys have done something truly, truly different here and I'm super excited to talk about it. So, tell us a little bit about, kind of, how care, which is what you call your plans, how care with Otto is different from the traditional kind of wellness plan model.
Shawna Castillo: Well, first of all, let me ask you a question, Stephanie. If you were given the option to be gifted a 100 gift card to your favorite store or a 100 valued gift basket from that same store, but mind you, remember how gift baskets work. Someone else puts the things in the basket and hands it to you. You're not choosing. What would you choose?
Stephanie Goss: I would, I would a hundred percent choose the gift card unless I like had seen everything that was in the gift like sometimes you just see a gift basket and you're like You Yes, it fits. This fits. The majority of the time, though, like 9. 9 times out of 10, I'm gonna choose the gift card, hands down.
Shawna Castillo: Nine times out of ten, you're gonna get jelly, like a jar of jam that you just can't stand the flavor of. Right? You're not gonna use it all. You're not going to use it all.
Stephanie Goss: You're not wrong.
Shawna Castillo: Okay. So, About 99 percent of the time when I ask people this question, they always say gift card because we're creatures of habit. People love control and you know you're going to get the most bang for your buck out of that.
You have control over what you're spending that on. And so that is the way that I will often describe Care via Otto and so care memberships were really built to help clients plan for pet care first and foremost. Like, so help veterinary clinics help clients plan for pet care. And the big differentiator is that instead of being incredibly specific about the benefits that are included in these plans, we've really broadened it.
And we've said, we're going to open this up and really actually focus more on flexibility because pet needs can change on a dime. And we don't want to put these pets in a box or limit what it covers or what the pet parent can do with these benefits once they enroll if their pets needs change. I know from being a pet parent and working for 15 years in a clinical setting that even if you have the healthiest pet, all it takes is one visit, one weird lump, or one weird cough for your wellness recommendations to take a complete 180 turn.
You know, we may not be focused on vaccines as much if we've got a chronically coughing dog, or if we've got a recent cancer diagnosis, or you know, if we're just dealing with chronic conditions, we've got an older pet with more chronic conditions, like priorities change.
Stephanie Goss: Or even, like, and I think that our minds as, as veterinary professionals automatically go to the old pet. But also, like, I think it's really important to think about the young puppy that, yes, they need, they need because, you know, doodles. Let's use a doodle for an example.
So Andy gets Skipper Roark the doodle, who is very bad and needs vaccines as a puppy, but then also, like, tries to eat, you know, socks out of the laundry basket, and then, all of a sudden, instead of, you need the vaccines, but maybe now you're doing surgery because you've got a foreign body, or x rays because you're worried you might have a foreign body.
Like, it's not just the older pets, it's all, it's all life stages, right?
Shawna Castillo: Exactly. And so that was another thing. We also wanted to open this up and say, this is not going to be species specific. This is not going to be age specific, breed specific. We're kind of taking all those limitations out of it. And we're saying any pet can enroll for any plan that this clinic.
Decides to build out and and it's going to be based on the actual pet's health care needs, both his both historic and anticipated needs. And so what we've done is we've kind of taken the labels off. We've said, we're not going to say that you only get five back or you, you get these five core vaccines because I know what happens there. If my pets only do for two core vaccines this year, I'm probably not going to be interested in that traditional plan.
Stephanie Goss: Mmm-hmm.
Shawna Castillo: So, we kind of opened it up and we said, let's make this a bundled credit essentially where the client enrolls in a plan. They get a predetermined amount of money. This amount of this credit is kind of based on the hospital's economic value.
So we do some economic exercises to see, you know, what have clients historically spent? What are your typical costs of very common procedures like spays, neuters, dental cleanings? Something I'm also really interested in knowing is like, if I brought an eight week old puppy in, what would my anticipated investment be in that puppy in its first year of life.
Because we all know clients are blown away by the cost of pet care. Once that new puppy kind of feeling wears off, they're like, man, this is
Stephanie Goss: expensive.
Shawna Castillo: Yep. Expensive. Yes. Maybe, I don't need a full year round supply of flea and tick meds if it's gonna be $400 and so we wanted to say no, like, like, really what we wanted to do was say yes.
Help clients say yes to pet care from the very beginning to get them started on that good behavior track. Because the earlier that happens, the earlier they get exposed to your, like, gold standard of care, the more likely they will be to carry that on throughout that pet's life and then future pet's lives.
So, it's a little bit like more probably involved than the way I'm explaining it, but really that is care memberships in a nutshell. We've kind of reconceptualized it and a lot of clients or, or a lot of people will say, well, is this kind of like pet insurance? And the answer is no. Because what we know about pet insurance is that it's really built to be for unexpected illnesses and injuries, and that is not.
Just what care memberships are for they are meant to be for both preventive care and maybe unexpected care. They're a lot more holistic in that sense.
Stephanie Goss: So they're basically help me, help me understand and wrap my brain around this piece. So you build out like plan offerings and the way that you guys are structuring that is to say, okay, we're going to look at the practice on an individual level, like what their standard of care is, what their medicine is like, and as a result of that, what the economic impact is.
Both from a profitability perspective to the clinic, but also as a spend amount, whether you're looking at the percent or the dollar for the average client and different like life stages. And then you guys are figuring out, okay. That could generally equate to X amount over the course of a year. And then, so then clients are able to basically make their monthly payment towards that amount.
But like, like I know when we think about insurance and one of the challenges to like get over, even on the human insurance side is like, okay, if I'm paying for insurance and I'm paying for it monthly, like, do I have to, do I have to wait the year before, you know, like when you have dental insurance, I think is the, is the best example is like you can get dental insurance, but you're not going to be able to get a, you know, a cavity filled or get a crown done until you've been on the plan for a year because they want your money before you spend it.
So how does, and I know that that's one of the barriers to conversation when it comes to pet health insurance as well as people think, Oh, there's, You know, I have to go through the waiting period or the pre existing conditions. We have all of those conversations as well. How does Care how does Care address that for them?
Shawna Castillo: So the four core benefits of care are health exams, an instant account credit, a bonus discount, and 24/7 teletriage.
And the way it works is that each hospital's plans are going to be different from other hospitals, because we're looking at each individual hospital's economic values. So we're looking at, you know, how much clients historically have spent in the year prior per pet. We're looking at what your average cost of certain various common procedures are like dental cleaning, space, neuters.
But then also, you know, I'm particularly interested in knowing, you know, what what you would tell me my anticipated investment in a new puppy or kitten would be, because we want to encourage clients to start thinking about this. We want to encourage these kind of planning conversations from the very beginning to help clients understand that their pet is an investment and that they're they really should be considering the gold standard of care.
And so, each clinic's plans are going to be specific to them in their values and in what the cost of the client is. The way it works is a client will enroll in a care membership. They will have access to the benefits for the course of 12 months. They will pay for it on a monthly basis over those 12 months, but they will get to utilize those benefits immediately after enrolling.
So the concept is really no different than a wellness plan in that you enroll and you get your benefits immediately. But the difference here is that we're saying you can really use these benefits towards anything, especially that instant account credit. We're not saying it's only good for vaccines.
We're saying it's good for whatever your doctor is recommending because what they're recommending is for your pet's wellness.
Stephanie Goss: Right, right. I love that. And do you, so I think one of the other, one of the other conversation pieces when it comes to designing plans is the debate over, are wellness plans really just a discount? You know, are you just discounting your services? How do you guys, how do you guys approach that with, with care plans?
Like, do, do you clients get a discount on everything? Do you have to give them a discount? What does that look like?
Shawna Castillo: As far as a built in plan discount it certainly helps to elicit interest from clients. Everyone loves a good deal. They're not required, so it really is dependent on each hospital's preference. My recommendation is to throw in a small built in discount just to make the plan feel really special and to encourage enrollments.
And the reason for that is because of the data that we have. And that is that when we see clients enroll their pets on these plans, they spend more, not only than they did the year prior, but then non members. So we really do just need to get these clients enrolled because it frees up their kind of, what is it called?
Discretionary like, spending, you know, they have more liquidity and they can say yes to more things when they have these monthly payments that they kind of, can bank on, you know, they're very predictable. And so I love the idea of like, kind of saying you get this savings account, if you will,
to your clients. Like we're going to help you save and plan for things that may be expected and even potentially unexpected. And then the psychology of it is that once the client spends that instant account credit, then a very small bonus discount kicks in on all out of pocket spend to encourage repeat visits and more in clinic spending to get that client loyalty because that bonus discount will be applicable to all out of pocket invoices throughout the course of the remainder of the one year subscription.
Stephanie Goss: I, I love that. I love that. And I agree with you, like, I think you and I, I don't know about your, how your plans were set up in your, in your practice, but our discount was not, was not large. Like, I think our Clients only got like a 10% discount on things. And you know that when you think about 10%, it's not that much money, like on your average ACT, like that's a couple of dollars.
It's not a whole lot of money and clients love to see that at the bottom of, it's like when you go, I hate to say it, but it's like when I go to the grocery store and I punch in my number and then they circle for me at the, and I never really look at, I mean I do like, cause I'm super competitive, like I want to, I want to get it as much as, as high as possible on every trip that I have, but I'm more interested on what have I saved over the course of the year and I think it's that same, it's that same psychology with our clients, because again, you guys, we're not trying to, we're not necessarily trying to put every client on a plan, like I think everybody's minds go to that place where we're going to try and put every F& D client who are in the lobby screaming at your CSRs and making them cry on a plan.
Stop thinking about those clients. Forget about those clients and think about your A clients. Think about the clients who are bringing your team Christmas presents. Think about the B clients that you maybe only see them twice a year, but they're really great when they're there. They make the team laugh. You like seeing the pets. They're happy to be on social. Like you're thinking about those clients now and you're, to your point, Shawna, you're trying to elicit that repeat. Spending behavior with those clients and you're incentivizing them with that that discount if they see even that small discount visit over visit and they know that they have access to, you know, additional additional content consults at a discounted rate or they're getting the benefit of being able to, like with Otto's plans, have access to the tele triage, where they can, if they have a question at 2 am they can hop on and they can ask a question of a certified team member that is really like an extension of your practice to be able to say, hey, I'm worried about this, can this wait until the morning or should I go to the emergency clinic? Or, you know, whatever those kind of things are, those are the kind of benefits that.
Bringing it back full circle to where we started this conversation, those kind of meet them where they're at. When they need it, when they want it, that is where the majority of our client base is at. Given that they are millennials and Gen Z, they want those benefits. And so I think that's why I was particularly impressed I remember when you first started at Otto and you and I had some, some nerd out sessions about plans and you you know, you told me what you were proposing and I, my mind was blown because I was like, this really is so different in so many ways. And also, I think it helps overcome a lot of the barriers, both for clients and for team members, in terms of dealing with traditional wellness plans.
Shawna Castillo: Well yeah, it kind of ticks all the boxes, right? We have what we're seeing, like a lot of hot topics right now are client loyalty, retention, volume, how can we increase ATC? That's kind of on the veterinary side of things. But what we also know about clients is that the number one barrier to pet care is finances.
So, Care plans, care memberships through Otto they really do kind of tick all the boxes, solve all the problems. And it's really cool to see and hear it from our members, you know, who are saying like, I never would have been able to do this had it not been for this Care Plan or to hear it from our clinic leaders who are using the memberships are offering it and they're saying this is completely changing our financial conversations with clients. And that's huge, right? Because no one wants to have a bad financial conversation with the pet parent. That's just you know, we don't want to avoid that at all costs.
And so if we can really create something that you can use as a tool that basically allows you to say, here is what we are recommending. Here's what we want to do with your pet today or in the future. And here is a solution. Here's a way that you could actually move forward with these recommendations.
Stephanie Goss: I love it. Okay. So, this has been, this has been super awesome. I, you and I could nerd out about, about the foundation of care, about all of the things that we've talked about today forever. And Also, our listeners are probably are probably done with us for the day I feel that way.
Shawna Castillo: You mean, you don't want to talk about wellness plans like all day long, guys? Not like what you had in store for today?
Stephanie Goss: If you do, if you, if you, because I already can imagine the questions that are going to come in from people.
So, two questions. One is if they want to find out more about Care Plans and Otto and all of the other things that you guys are into where can, where can they go?
Shawna Castillo: Okay, so they can check us out on our website, which is otto.Vet, V as in veterinarian, E T. And under the solutions tab, they can go to Otto Care to learn more about specifically care memberships, or anyone can feel free to reach out to me on LinkedIn.
Stephanie Goss: You know, because I love nothing more than getting access to cool things in veterinary medicine for my friends, and I consider all of our listeners my friends, whether they know it or not. And so I went to Shawna's team and said, Hey, let's make this as easy as possible.
And so the team at auto put together a page just for our uncharted listeners. And so if you guys head over to auto and it's. O T T O dot vet, like Shawna said, V E T, forward slash uncharted. The team at Otto has put together some info about care.
And so much Shawna for having this conversation with me today. Thanks for being here. I feel like we could parse apart like four other podcast episodes out of the things there, the things that we scratched the servers on today.
Shawna Castillo: One hundred percent! Well, it was a pleasure to be here. I love, love, love talking about these things with you. I love just relating to you on a manager level. So thanks for taking the time.
Stephanie Goss: Yeah, this was so fun. Thank you all for being here with us today. Have a great rest of your week, friends.
Otto have also put together an amazing deal that is exclusive for our Uncharted podcast listeners. That's right. Shawna's team stepped up big. They are waving the thousand dollar implementation fee. If you sign up for Care Plans after checking out the website, maybe talking with Shawna and doing a demo, but if you mentioned that you were an uncharted podcast listener, if you go to the landing page otto.vet/uncharted to get the information, they will waive a thousand dollar implementation fee when you sign up. That is an amazing deal. So don't miss out on that head over to otto.vet/uncharted to check out more about care, connect to a Shawna and sign up for your demo because I would want a thousand dollar implementation fee waived. No-brainer and we will see you next time!
