Good Commercials Are Sold With A Smile You Never See

 Did you know the secret to selling something with only audio is to be smiling as you record?

Did you know that a smile can be heard?

Have you tried it? That smile is transcendent. It influences. Motivates. Sells.

Don't we all have to pitch ourselves every single day to someone?

Veterinary medicine is no different.

Simba. One of the 54 cats we helped last year from one home.

My job is to understand and translate my mute patient and sell their needs to their parents. Smiling while I sell, albeit the way a ventriloquist does, is the art behind the successful veterinary care sell.

I more appropriately I call it the 'building of trust to the point where the pitch is simplified to a permission versus a negotiation'. 

Basil One of 5 cats we took after the owners were evicted from a motel.,
He is safe with us now, but looking for a home.

I am a terrible salesperson. All that nonsense of fluff, fake veneers, and smoky mirrors is exhausting. I am a failure as a phony. I know this. I have had to rely on my genuine compassion to build a clientele willing to entrust their pets care in my hands. Just be me and try to remember to smile every so often. Not too much teeth or arm twisting. Keep the common goal in mind. We all have to be here with the same agenda and the same endpoint. Not an easy task or small hopeful wish.

It's not just lip service. I back it up with skin in the game. I make deals. If needed I will make deals that the house loses on.

Sadie. The most influential patient in my career.
She was my defining moment. My pivot point.

I give stuff away daily. It's the glitter in my vanilla day. It is the thing I love, take greatest delight in, every single day.

Sound crazy? Counter intuitive? Maybe its the easiest way to sell my genuine belief in always putting the patient first.

Saffie. Clinic cat.
Adopted and returned 3 times.
And still loved.

Here's an example.

Miss Phillips was elderly. Small, demure, crumpled and lacking any color in her dense weighty coat. Grey stringy hair, grey overstuffed winter coat, and grey sweatpants. She was seated on the long wide wooden bench in the exam room. Composed, quiet and clutching her coat sleeves enveloping her oversized market bag I think she used as a purse. She was quiet, withdrawn and weathered. She struggled with the weight of the 7 decades she had been alive. She needed help getting into our building. The staff led her into the exam room as they carried her petite dog-sized cat carrier for her. She was soft spoken and easily overlooked. She was a new client with a cat to be seen for a spay. This is the information I am given as I walk into the exam room. "New client, new patient. Cat needs to be spayed." No other information available. Blank slate. Not my favorite place to begin.

Seraphina.
Queen of everything

I say "hello" and start collecting pieces to finish the canvas. "This is Lilly. She is about a year old. She is not spayed." That's all I have. I look up at Ms Phillips. She has no emotion. She doesn't move an inch on the bench. Nestled into her winter coat seemingly swallowing her in its over abundant quilting.

"So, she has never been to the vet before?" I ask.

"No." Volley and serve and still no emotion to guide me on where this is going to end up.

"She is here to start her vaccines and be spayed. Correct?" I repeat. Ms Phillips is not giving me any information willingly. This is going to be a Q&A discussion. I slow down. Mirror her pace and attitude as much as I am able. 

I take a minute to look at her again. Switch gears from Lilly to her. "Did you drive here?"

"No, I don't drive." 

"Oh," I reply. A sigh of relief washes over me. "Who brought you?"

"My friend drives me."

"Do you have other pets?"

"No."

"No other cats?" Part of my job is sizing people up. Finding common ground whilst understanding the degree to which they invite these pets into their lives. That, and I just had a sense of "cat lady" lingering. Building a relationship to help a pet for their entire life and not this one and done visit. I try to remember to smile inside my inquiries. Add a smile, slow my pace, she seems very nice. I can see myself, someday, in her.

"There is a cat. (long pause).... She is not mine. I let her inside when it is cold. I just had her at the ER over the weekend. She had a respiratory infection. It cost me $300, so now I cannot afford to much for todays exam. I am not allowed to have more than one cat."

And there it was. The shell was cracked. She spilled the beans in just a few sentences and a change of perspective. 

We spoke for a few more minutes. She told me that she was renting her house. She was not allowed pets, but her landlords were going to let her keep Lilly as long as she was spayed and vetted. She was here, at my clinic, because we were the most affordable outside of the rescues and non-profits that had a 6 month plus spay/neuter wait time. 

"You let this other cat into your home where she sleeps at night. You feed her and now you pay for her to go to a vet clinic, and yet she isn't yours?"

All of a sudden one cat that she couldn't afford was two.

"What is going to happen when she has kittens?"

And with this question the look on Ms. Phillips face fell to the ground. It hadn't occurred to her. This reality where her good deeds put her in a predicament she couldn't manage.

We decided together that she would leave Lilly with us at the clinic. Her friend graciously ok'd bringing her back tomorrow with the other cat, Kitty. I would spay both the next day, and she could pay me back as she could. To save financial resources that she truly didn't have we would cut out the optional items like pre-op blood work. The exchange and change of plans had taken almost 20 minutes of our allotted 30. It had included being honest with who we are. It also included asking for help from the driving friend via a flip phone she dialed to her friend parked in the lot outside, too far for Ms. Phillips to walk again.

The next day I met Kitty. Small, slender, matted and peppered with grit in her coat from the flea dirt. Underweight, under muscled, overlooked and discarded like soo many cats in our community. She was gentle, confident, and melted with any small inkling of affection. She was so grateful for a warm place and a kind heart that she surrendered and collapsed into your arms soaking it all in.

Ms Phillips called later in the day checking on how the two cats did with their spay surgeries. "Fine," I replied. I had estimated Kitty to be about 4-6 years old. She was too sweet to be overlooked anymore. I asked her if she would like us to try to find her a home of her own. I never know if I can persuade others to see the kindness in an all black cat who isn't a kitten, but, she was not a feral cat and she needed a break. Ms. Phillips agreed once again that she couldn't have two cats at her home.

Over the phone (no car to drive and sign papers, remember), she authorized Kitty to stay with us as we tried to find her a home.

You know what happened? Another miracle. Seems so crazy the way miracles find us when we give more than we have to, and offer more than the house makes money on. Ms. Phillips got brave! She went to her landlords and put her cards on the table. She told them that she loved these two cats! That with a little help she was going to take care of them and she asked for permission to have TWO!

They said YES!

She called us back. Told us she wanted her Kitty back. 

Turns out happy endings just need a little faith and genuine compassion to make miracles happen.

....and with a smile we made the ending meet the intentions of everyone a reality everyone benefits from.

Wren. Night time ritual.
I tell her she is the most beautiful girl in the world and she reaffirms it.

Related blogs;

Wren: The Sickest Kitten Of Them All

Seraphina; The Futility of it ALL and Meet Seraphina

Sadie; Sadie's Story.

The Hardest Part Of This Job

Give Back. 

Why the Spay Price Isn't Fixed.

Three reproductive tracts of the three spays I did a few days ago. They are an excellent explanation as to why there is not a flat fee for spay surgeries (at least at my clinic).

Could you guess which reproductive tract belong to which patient?

Patient Number 1;

A 7 month old domestic short haired cat.

Patient Number 2;
An 8 month old 38 pound Cattle Dog.

Patient Number 3;
An 8 month old Labradoodle who is 55 pounds.

At my clinic I try to do everything I can to treat every case independently and be fair to each. Therefore, providing a "one  size fits all" approach doesn't work in many surgery cases. With the exception of routine cat and dog neuters, every other surgery has a price range and every other surgery is based on the patient. 

Historically vets have put themselves in the predicament of dismissing spays as a "basic" surgery done so often that it has been diminished to "routine" status. This perception has understandably caused clients to price shop and balk at spay costs of anything over $100. High volume low cost spay and neuter clinics have popped up to meet demand and only reinforced the perception.

For all of the knee surgeries that I do weekly with a $1200 price tag, that clients are more than happy to pay based on the specialists average going rate of upwards of $3,000, I have to argue and justify a spay price of $200 plus. Ridiculously that spay has a much higher chance of causing a life threatening post operative complication than my knee surgery does. I will take a bad knee to correct over a fat dog in heat to spay any day of the week.. and I make 5 times the amount of money doing it. 

Why does "one size not fit all"? Because some dog spays are ridiculously difficult to do. And some patients need more time, more pre-op consideration and more peri-op care, not to mention post-op goods and services. All of these cost more time and more money. Wouldn't you want your vet to tailor and customize your pets care to their needs. Isn't it fair to pay for that?

The three uteruses (probably grammatically correct to say 'uteri' but that just sounds snooty scholarly, which I am not, so I'll move on).. belong to the pets above and listed in their perspective order. (Note; I did not use the actual patients for this,, they are in fact my cat Wren, and my dear friends Madeleine and Maizie.. but they represent the actual patients very well.). The top uterus is an early pregnancy in a feral cat. Middle is an 8 month old who is 38 pounds and in heat, and the last is also an 8 month old who is 55 pounds and not in heat.

The costs of a spay should vary based on the patient. If your dog is in heat, pregnant, or has a uterine infection it is going to be more difficult to perform the procedure. It will take more anesthetic time, require more equipment and suture and should also be followed up with post operative medications to include analgesics and antibiotics.

As I  discuss why spay surgeries are each entitled to their own charges I will admit that I never charge a different price for cats. A pyometra cat is the same cost as a pregnant cat is the same cost as a regular cat spay. In truth there is not enough of an additional degree of difficulty to warrant the extra fee. The only exception to this is the post operative care and medications. I challenge other vets to argue differently. I especially challenge the emergency clinics who give estimates of cat pyometras in the thousands of dollars. 

The cat below is also pregnant. Although no one wants to be stuck in the middle of this moral and ethical argument it is Spring here and the kittens are blooming as fast as the flowers. Sadly, many of the cats in our rural area are also feral. Feral cats having kittens perpetuates more feral cats having kittens and many of these are eaten, killed, or die of infection. When a feral cat  is caught and brought to us for a spay or neuter we can't touch them, examine them, or even know if they are pregnant. Once they are sedated they are all spayed and neutered regardless of their condition. It is the only way the cats can be released responsibly and spared their life. But a cat is a cat and a cat uterus is easily surgically removed regardless of uterus size. If your cat is given a thousand dollar estimate (or anything near close to that call me. I will do it for a fraction of that.

If you asked me to spay your dog as I would my own dog here's what I would do;

1. Have the vet who is performing the spay on your dog do a physical examination while you are present. Can you imagine going in for surgery and never meeting your surgeon, OR, having never met them and they never examined you? That's plain neglectful.

2. Every human patient has pre-operative blood work done to check basic organ function. I now want to check clotting function too.

3. Your pet should be free of internal and external parasites. Having fleas walk through the surgery site is not maintaining an acceptable sterile field. People with invasive surgeries these days have to use a special surgical soap and shower with it every day.

4. Every spay should be intubated and maintained on inhalant general anesthesia. The best way to maintain an open airway is to have one. The best way to maintain an acceptable anesthetic plane is to use gas.

5. Intravenous fluids via an indwelling iv catheter. I use it for every spay these days. Why risk it for $80?

6. Every spay gets and goes home with analgesics. For the cats most of these are injectable. or the dogs a 24 hour dose of an NSAID is given pre-op and oral meds go home for the next 4 days.

7. Suture material. The glue that holds the tissue together and keeps your pet from bleeding internally or opening up their incision. You get what you pay for in this department and no one ever asks what this vital material is. There is still debate in the veterinary field about what  is and is not considered acceptable standard of care. For many experienced vets I will not argue that using what works for you is fine, but, the rules of engagement are shifting and clients have the right to know what we use and why we use it. If a surgery fails they also have the right to their pets records and challenge us on our choices.

There is a terribly fragile line between low cost and affordable and borderline substandard care.

Chloe who needed an emergency pyometra surgery and couldn't afford the ER price.
Her story below.

We all like to have an idea of what something will cost. It allows us to plan, budget, and bargain shop. Medicine allows for only so much planning and presuming.. the rest is decided on luck, fate and preparedness for worst case scenario.

If you are price shopping for a spay you are asking for more cut corners than I would ever be comfortable with. If your pet has a problem while being spayed or neutered your vet has a much better chance at your pets survival if they are intubated, under inhalant anesthesia, with iv  fluids, and a full sterile surgical suite. Wouldn't you expect the same for yourself?

There are a few brave clinics who provide set prices for a service and rely on the law of averages to make the bad cases dilute out the overwhelmingly easy cases. It allows for clients to not be side swiped by sticker shock when those inevitable outlier surgeries are their pets surgery.

I much prefer the open and honest approach. I treat each case as their own and each is priced fairly based on their own merit. I also care far more about every pet walking out of surgery happy, comfortable and safe. If you cannot provide optimal care due to financial struggles we will work with you,, it is the reason we maintain a fund for hardship cases at the clinic. Good patient care should not be  about bottom lines, budgets, and unacceptable risks.

Related Blogs;
The Ode of My Obligation. Why does the ER charge so much?

Chloe's Emergency Pyometra. Saving Your Pets Life When Optimal Options Aren't Possible.

Jarrettsville Vet Price List 2016 Edition.

Pyometra. Finding a Happy Ending With A Preventable Disease.

If you would like to discuss your pets medical or behavioral condition with me you can find me on Pawbly.com. Pawbly is a free online community dedicated to helping people who love their pets. If you are a pet lover please join us in and share your experience and expertise. Together we can shape the destiny to provide more happy endings to those who need them.

If you would like help and you are in the northern Maryland area come visit me at the clinic, Jarrettsville Veterinary Center in Harford County.

Or find me on Twitter @FreePetAdvice.