Q: Should we charge for follow-up exams when clients visit another practice’s emergency clinic because we’re closed? We offer the exams for free, but they take up a full appointment slot and often require time to review records and diagnostics. How do you handle this situation?
A: I understand the guilt that can accompany veterinarians when they can’t provide care. Such deep commitment to patients is part of our superpower but can be a fatal flaw in our happiness and professional fulfillment. You can’t be available to everyone for everything all the time, at least not for long.
Many doctors in human medicine harbor the same feelings we do. But does your general practitioner provide a complimentary exam after you go to the ER in the middle of the night? Chances are the answer is a resounding “No!” That should tell you something.
My short answer is that you should charge for follow-up visits like every other medical professional. Charging for these exams makes you fair and reasonable, not greedy and uncaring. Of course, there are exceptions to nearly every rule in life, but charging for a follow-up exam holds true in most scenarios.
Some veterinary practices offer follow-up discounts, but I’m not sure that’s helpful. By extending a discount, you arguably apologize for what I don’t believe you should be sorry for — in your case, being closed sometimes.
The foundation of this issue is often a general discomfort with charging clients for our services. Sometimes, we worry that we cost too much. Other times, we fret over public perceptions or believe we’re helping a pet owner facing financial insecurity. The concerns are valid, but you shouldn’t allow them to hurt your business’s finances or cause anxiety and burnout.
We must transcend feelings of price guilt and realize our worth to clients. Sure, some pet owners will complain about your prices just as they do about the cost of gas and groceries, but you must focus on doing your best for your practice, team and those who appreciate what you do. Giving away services rarely helps a business and can inadvertently reinforce negative price and value perceptions, further adding to your anguish.
Changing your free exam rule is as simple as charging for one. Some legacy clients might object to it or leave your clinic, but if they do, they weren’t with you for the right reasons. In the end, you’ll retain clients who understand that veterinarians need time off, too.
Q: We’ve given cash holiday bonuses to our team for years without withholding taxes, and now the state unemployment office is auditing us and demanding we pay taxes on these gifts. Any advice on how we should handle the problem?
A: I’ll file this topic under Reason 42 for opposing holiday bonuses. First, such gifts are taxable, so the sooner you take care of the state audit, the better.
I know some practice owners who use questionable tactics to dodge taxes on bonuses, but I sleep easier knowing I’m not bending the tax code. Consult your accountant. If you don’t have one, now’s the time to get one.
In addition to the tax matter, my main issue is that holiday bonuses, while a nice perk, can quickly turn into an employee expectation, especially when awarded consistently. Skipping or reducing the payout could hurt morale, and unequal bonuses can cause tension if team members compare what they received.
Also, a dip in a seasonal perk turns quickly from a “My boss is the greatest!” gesture to “My boss is greedy!”
Some argue that a “13th month of pay” rewards employee loyalty and avoids overpaying those who leave. However, a bonus check can’t fix a deeper cultural issue.
I believe in compensating employees fairly throughout the year rather than making them rely on a guesstimate bonus.
For a good example of bonuses gone bad, look no further than National Lampoon’s Christmas Vacation when Clark Griswold opens his annual Christmas bonus. Instead of the cash he was counting on, he receives a subscription to the Jelly of the Month Club. It’s a tragically funny moment in the movie and an important lesson for managers.
Griswold: “I’ve gotten a Christmas bonus every year but this one. You don’t want to give bonuses, fine. But when people count on them as their salary, well, what you did just plain … sucks.”
My sentiments exactly.
Q: I went for my annual physical exam after skipping them for years. No surprise that my doctor said I need to lose weight, eat healthier and exercise. I’m also prediabetic. I feel terrible and stressed most of the time, and I’m only a 35-year-old woman. What’s your best advice for improving my health?
A: First, let me say this: You’re not alone. Many of us, especially those in veterinary medicine, spend so much time caring for others — whether our patients, clients, staff or families — that we neglect to care for ourselves. The fact that you saw your physician is a huge first step, and I commend you for it. Now, let’s talk about moving forward without feeling overwhelmed.
My best advice is to focus on daily, accessible, sustainable changes you can implement easily and immediately. Start by prioritizing your mental health, as stress is often the root of many health issues, especially in our demanding field. Set aside time each day — whether five minutes or 50 — for activities that help you decompress. They could be meditation, deep breathing, journaling or taking a walk. Begin each day with a brief gratitude practice, and set daily reminders to pause, reflect, appreciate, and refine your actions and attitude. In addition, consider working with a therapist or joining a gym. The opportunities to improve your well-being are limited only by your imagination and discipline.
As for your physical health, don’t try to overhaul your entire lifestyle overnight. Start with simple changes. For example, swap sugary drinks for water, add one or two servings of vegetables to your meals, and find an activity you enjoy, even if it’s just walking your dog. Consistency is more important than duration or intensity at this stage. Consider these the first steps in a lifelong journey. The most critical thing is to start.
Next, schedule a follow-up visit with your doctor and consider consulting a nutritionist. Stay current on your lab tests, and if you haven’t done so already, schedule your annual mammography.
If you’re prediabetic, remember that it’s an early warning sign. You can often reverse the trend by making small adjustments now. Again, don’t focus on drastic diets or intense exercise regimens because they rarely work long term. Focus on incremental progress and track your results. Adjust and adapt as needed.
Finally, be kind to yourself. At 35, you have plenty of time to make positive changes. Prioritize self-care just as you do caring for patients.
You’ve got this!