The Jarrettsville Veterinary Center Policy For Clients With Financial Constraints. 2016 Version.

Seems that my professional life on the case by case basis is going very well. I have clients and patients that I absolutely adore and look forward to seeing every working day. Truly, I love veterinary medicine and helping pets and their people. I am lucky and grateful to be one of those veterinarians who can say that with genuine gusto.

The trick however is that I also have to run a business. Too often those two facts can be at odds with each other. In order to practice medicine I have to have a building, trained staff, and stuff,, lots of expensive delicate highly fragile technologically advanced (did I say, expensive?) stuff.

The sign of a successful practice is most commonly considered to based on a spread sheet of elaborate charts, data, and numbers. But for me the sign of a successful practice is walking out each  night knowing that everyone who walked in the front door was treated with love, respect and compassion. The challenge is finding a balance between sharing that and keeping the lights on.

If I can't figure out a way to keep paying clients walking in the door I can't take care of  all the patients who come to me in need.. and to be totally honest I want to take care of the non-paying patients as much (sometimes even more.. see Weasely and Dunkin) as the well funded cases.

Dunkin

At Jarrettsville Veterinary Center we promise the following;

1. We are here to help our clients and our patients whenever they need us.
2. We do not deny care to anyone.
3. We are transparent. Prices are posted online and provided for all goods and services.
4. We are available 7 days a week. 
5. We are accessible through Facebook, my blog, and all JVC clients are given my email.
6. We provide options so that economic euthanasia is not a part of any patients treatment plan.

To do this we had to come up with a plan.

Clarke

Here is the Jarrettsville Veterinary Center protocol for any client or patient with financial hardship.

Every patient should be treated the same. We do not assume how much someone cares for their pet, how much that bond is worth, and what to provide based on those two egregious assumptions.

We provide an examination and an assessment for each case. We ask that the client pay for this. Our appointment fee is  $50. If they cannot afford this I will see them pro bono. (Disclaimer to pessimistic critics who think I'm looney about now. This doesn't happen. In four years I have given away maybe two exams).

Financial concerns can be discussed after this. We are assuming that people can’t or won’t pay. We need to stop expecting that people can’t or won’t pay and start treating everyone equally. Assumptions have no place here. Prepare for every option and adjust as they are accepted or declined. Every pet is given the same care, the best options for optimal outcome and everything stems from this. Our primary obligation is to superior pet care. 

Any client who has financial constraints should be given all options to allow us to help them with the care of their pet. To assist our clients in caring for their pets, and to remain aligned with our clinics mission of never denying care, we are enacting the follow new policies;

Every client is asked and expected to pay the initial $50 exam fee. We state this at the first contact point. This is where we start and this is what we relay to clients calling in seeking an appointment for their pet. IF, they state that they cannot afford this, it is at the veterinarian’s discretion as to whether they are willing to waive the exam fee. If the vet declines to waive the fee we can reach out to the rescues. If no one is willing to help with this call me and I will take the case over. (I will either see the pet pro bono, or authorize the JVC donation fund to pay for the exam).

Crocket and his million dollar smile!

After the exam the diagnostics need to be discussed. Every vet should become comfortable providing care with limited diagnostics. There is, in some cases, no other option. My goal for JVC is to provide care to our patients and to never turn away anyone in need. But, I am also most obligated to you, the staff. I will never ask you to do something you are not comfortable with, nor will I ask you to compromise or participate in something you don’t feel is right. If you feel caught in between call me and I will gladly help.

Our goal is to help our clients and their pets and we must do whatever we can to achieve this. We do not allow convenience euthanasia’s, walk-in euthanasia’s without prior DVM consent based on the vet knowing the case AND the prognosis being grave with death eminent, and we should not allow them internally due to lack of resources.

If CareCredit is declined VetBilling.com can be offered. To be eligible for Vet Billing the client must leave a 30% deposit for the estimate. If the client does not have the 30% to leave as a deposit they must either leave collateral OR go to a local pawn shop and provide the deposit. I am no longer going to accept no deposits left. A client invested in their pet will find a way. We will be creative and both place trust in each other with some form of collateral. Those that cannot leave a deposit and will not discuss collateral either don't have the emotional investment in their pet to ask for our help, OR, may be unable to provide adequate care for the pet. If you have a problem call me, or the Hospital Administrator and we will resolve it.

Estimates must be accurate and must be given as a range. The client should ask for CareCredit at the high end, and will be given an a  Vet Billing payment plan for the high estimate. If the bill is lower we will shorten the payment period. All estimates need to be in writing and submitted in the chart. The client needs to sign the estimate and be given a copy.

If the client cannot afford the care needed or recommended for their pet, their options are as follows;

1.  If the client wants care for their pet and to stay with us and are unable to leave a deposit for the entire estimate, they are required to apply for CareCredit. CareCredit is the most expensive plan we offer, but, it guarantees us payment. I ask for this because in many cases the client is not calling and is just telling us that they did not get approved. To use a VetBilling.com payment plan the client is charged a set-up and a per transaction fee.  To provide this option we must make sure that the estimate is accurate. Also, please notify the client that they need to ask for the amount at the high end of the estimate. They are welcome to use our phone and we are happy to help them should they have any questions or concerns. 
2. Seek care elsewhere if they choose to euthanize and we are unwilling to oblige. Euthanasia is based solely on what is best for the pet. We do not provide this based on client request. It must be consensual AFTER the pet is examined and the vet determines whether the condition is treatable and request ethical. 
3. Seek pro bono care elsewhere. We have a list of local rescues and clinics who might be able to help.  
4. Continue services at JVC without financial obligation by signing over the pet to one of our affiliated rescue groups. From here the pet will be treated and cared for and adopted to a home via the rescue.

Weasely. Our newest Good Samaritan case.

I am persistently trying to offer assistance and run the fine line between taking care of pets and the staff. If any staff members feel compelled to assist a client and/or a patient they are welcome to donate their time and services. I appreciate the generous compassionate dedication of all of the JVC team but we are consistently helping people who do not pay us back and do so at the expense of us collectively.

Every client needs to be given a daily update of their bill and every hospitalized patient is required to be paid in advance at the beginning of the time of services.

Lastly, no pet will be euthanized or allowed to be privately cremated without the bill being paid. If a bill is not paid, or transferred to me the vet who provided the services will be held responsible for the invoice. (I never ever want this to happen! I will gladly shoulder the responsibility so that no one else has to cover someone else’s bill!!)

For all clients leaving with any outstanding balance a written plan for repayment, a copy of a valid driver’s license and a signed copy of the repayment schedule plan with a witness signature must be done. All paperwork needs to be kept and included in the file or kept by the hospital administrator.

The intention of the policy is to provide assistance to the pets at risk of surrender to shelters due to lack of resources for medical issues, economic euthanasia due to inability to pay up front for needed veterinary care, or abandonment.

In short JVC will offer every single conceivable option to help a pet in need. We will take custody of the pet and find a home after the pet is well and we will never turn our back on a pet. I cannot provide all the care to all of the pets in the world who need us, But I can do so to those pets in our care.

This policy has been in place for almost 5 years. We have done miraculous life saving medicine  and built relationships based on  exactly what vet  med is intended for. If you follow our Facebook page you will see the faces of those we are able to alter the fate of.

Even with this policy I still have clients who want for JVC to pay for their pets care and refuse to sign a payment plan.. I also have clients who ask for us to pay for the care and then want to adopt the pet back. No one ever said it would be easy, but for us  it is the right  thing to do, and I can leave work everyday saying that I  did everything I could for my patients. If they walk into JVC they are my patient and I will never turn and walk away from them.

Related Blogs;

Shelter Medicine Meets Private Practitioner. Finding An Answer with An Agenda.

Dunkin, The Story of The Littlest Life, And  All That Matters.

Open Admission Shelters Are NOT Safe Houses.

Wellness Plans, Savings Plans and Surprises. Why your vet NEEDS to be your best friend.

The Jarrettsville Veterinary Center Price List for 2016.

As always JVC, and I, are here to help you and your pet. If you would like to meet the amazing staff and hear more about the ways that we can help you and your pet live longer happier and healthier lives we would be happy to show you how the face of veterinary medicine and the care we provide can ext end past the traditional options of hope and luck.

If you would like to learn more about pet care or ask a free pet related question please visit Pawbly.com. It is free to use and open to all of those who love pets.

If you want to help others and you have experience with pet care please join us on Pawbly.com. Pet care is about helping others and we are built on this alone. I also have educational videos on YouTube, or @FreePetAdvice.

And of course we hope that you will Please always Be Kind.

Making Vet Care More Accessible. How comfortable are you thinking AND acting outside of the box?

I think that one of the biggest complaints we hear about in veterinary medicine is that it is too expensive. A hard complaint to dismiss. I would never balk at the gripe of $1,000 being trivial. If you end up at the ER and need an emergency exploratory surgery you should expect to pay about $3,000. Most of us don't have this cash hanging out in our back pockets. BUT, should you find yourself in a similar predicament you should expect to add another zero to that estimate. And, we are talking about the same diagnosis, the same surgery, and the same treatment care. Not a bad deal when you compare it that way, is it?

This babies story..

As a follow up to my previous blog,"Taking A Stand And Facing Consequences," I thought I would share my attempt at putting my money where my mouth is.. So, I am including our written Jarrettsville Vet Financial Constraints Policy with everyone. Why am I doing this? Well, beside the persistent nagging yearning for transparency, I also feel that the existing system is met with great bitter frustration from people desperate to take care of their pets in need of immediate care they cannot afford to provide.

In our efforts to provide help to more people, AND never turn away a pet in need, Jarrettsville Vet has adopted the following payment protocol;

It is important to remember that when discussing a treatment plan with a client that every patient and every client should be treated the same. We provide an examination and an assessment for each case. Do not make any assumptions about any pet or client without discussing all possible options. One of the worst mistakes we can make is to deny care because we assume the client cannot, or will not pay for it.

Financial concerns can be discussed after the options are provided. We are assuming that people can’t or won’t pay and yet too many people internally/staff are complaining (or departing) because they are not paid enough. We need to stop expecting that people can’t or won’t pay and start treating everyone equally. Assumptions have no place here. Prepare for every option and adjust as they are accepted or declined.

Any client who has financial constraints should be given all options to allow us to help them with the care of their pet. To assist our clients in caring for their pets, and to remain aligned with our clinics mission of never denying care, we are enacting the follow new policies;

Every client is expected to pay the initial $50 exam fee. This is where we start and this is what we relay to clients calling in seeking an appointment for their pet. IF, they state that they cannot afford this, it is at the veterinarian’s discretion as to whether they are willing to waive the exam fee. If the vet declines to waive the fee we can reach out to the rescues. If no one is willing to help with this call me and I will take the case over. I will either see the pet pro bono, or authorize the JVC donation fund to pay for the exam.

After the exam the diagnostics need to be discussed. Every vet should become comfortable providing care with limited diagnostics. There is, in some cases, no other option. My goal for JVC is to provide care to our patients and to never turn away anyone in need. But, I am also most obligated to you, the staff. I will never ask you to do something you are not comfortable with, nor will I ask you to compromise or participate in something you don’t feel is right. If you feel caught in between call me and I will gladly help.

Our goal is to help our clients and their pets and we must do whatever we can to achieve this. We do not allow convenience euthanasia’s, walk-in euthanasia’s without prior DVM consent, and we should not allow them internally due to lack of resources.

If the client cannot afford the care needed or recommended for their pet, their options are as follows;
1. Seek care elsewhere if they choose to euthanize and we are unwilling to oblige.
2. Seek pro bono care elsewhere.
3. Continue services at JVC.

If they choose to stay with us and are unable to leave a deposit for the entire estimate, they are required to apply for CareCredit. CareCredit is the most expensive plan we offer, BUT, it guarantees payment to us. I ask for this because in many cases the client is not calling and is just telling us that they did not get approved. To provide this option we must make sure that the estimate is accurate. Also, please notify the client that they need to ask for the amount at the high end of the estimate. They are welcome to use our phone and we are happy to help them should they have any questions or concerns. A declined CareCredit fax must be submitted via fax to the clinic for us to offer the EBCS payment plan.

If CareCredit is declined EBCS can be offered. To be eligible for EBCS the client must leave a 30% deposit for the estimate.

Estimates must be accurate and must be given as a range. The client should ask for CareCredit at the high end, and will be given an EBCS payment plan for the high estimate. If the bill is lower we will shorten the payment period. All estimates need to be in writing and submitted in the chart. The client needs to sign the estimate and be given a copy.

If the client does not have the 30% to leave as a deposit they must either leave collateral OR go to a local pawn shop and provide the deposit. I am no longer going to accept no deposits being left. And, there are no exceptions. If you have a problem call me, or the hospital administrator and we will resolve it.

I am persistently trying to offer assistance and run the fine line between taking care of pets and the staff. If any staff members feel compelled to assist a client and/or a patient they are welcome to donate their time and services. I appreciate the generous compassionate dedication of all of the JVC team but we are consistently helping people who do not pay us back and do so at the expense of us collectively.

Every client needs to be given a daily update of their bill and every hospitalized patient is required to be paid in advance at the beginning of the time of services.

Lastly, no pet will be euthanized or allowed to be privately cremated without the bill being paid. If a bill is not paid, or transferred to me the vet who provided the services will be held responsible for the invoice. (I never ever want this to happen! I will gladly shoulder the responsibility so that no one else has to cover someone else’s bill!!)

I am including a list of pawn shops. I am also including their hours of operation. I feel very strongly that we are offering to help, willing to put our necks on the line to help them and they in turn need to also put a little skin in the game. Anyone who is unwilling, or unable to, provide a deposit can sign their pet over to a rescue and we will help that rescue get the care that pet needs. I know this might not always be fair, and I apologize for this, but that is life. I can offer to help care for your pet, I just have to expect that you will put your pets needs first and do what they need.

There are other options that I am exploring and hope to be able to offer soon. I have spoken with the founder of PetChance.org. A crowd funding site that helps people raise the needed funds to care for their pet in the darkest of hours and most desperate of times.

PetChance.org is a 501(c)(3) non-profit organization based in Massachusetts. The mission is to remove obstacles for pet owners so they have more opportunity to provide excellent medical care for their pets.

So, where do you stand?

What can you do?

Do you put your money where your mouth is?

Do you think, and act, and make miracles happen?

And when do you dare to live and think outside of the box?

I am a small animal practitioner in Northern Maryland. My goal is to help more pets. It is the reason I went to vet school and the reason I get up every morning to try again. I believe that miracles happen everyday, that amazing things are possible if you just dream, believe, and work to make them a reality.

If you have a pet question, seek better care for your pets and want to help other pet people, please join me at Pawbly.com. Pawbly is a free online social media platform built by pet people to help other pet people. It is free for everyone to use.

You can also find me at the clinic, Jarrettsville Vet, in Harford County Maryland. I am also on Twitter @FreePetAdvice.

Related Blogs;

What Can We Do To Help More Pets?

Burnt Out From Being Burned.