A Very Fictional Exchange
By Mike Falconer
Dr. Try Ingtodomybest: Good afternoon Ms. Dis Satisfied what seems to be the problem?
Ms. Dis Satisfied: Problem? I’ll tell you what the problem is. I’ve been waiting to see you for 45 minutes and then when I do see you it is only for 10 minutes!
Dr. T: I’m sorry, we’ve been rather busy today and we we have had other cases that have taken longer than we would have liked – I’m so sorry for the delay.
Ms. D: You are just too busy, you don’t allow enough time for each appointment. You just try to pack us all in so you can charge as much as you can per hour. Oh and by the way you charge too much – been here 10 minutes and you want to charge me almost $200!
Dr. T: To be perfectly honest there is a certain amount of truth in what you say. We have to schedule based on the best use of our time with the most optimistic length of each visit. If we didn’t, your visit would be even more expensive.
Ms. D: Nonsense. My 10 minute visit should cost the same regardless of what else is going on in this hospital. I am only using 10 minutes of your and the staff’s time.
Dr. T: If only that were the case. You see you also pay for the down time; well actually to be more precise all clients do, just like you all pay for the overhead of the building.
Ms. D: Why should I pay for you doing nothing?
Dr. T: Believe me I don’t want you to, I want you to only pay for the time that you use, but in order for that to happen we need to keep as busy as possible. The busier we are the more efficient use of our labor which is 50% of our cost of your visit.
Ms. D: So what you are telling me is that your time is more valuable than mine?
Dr. T: Only in as much as you value it in that way. In order to make care for your pet accessible there is a balance to be struck between the average waiting time / length of appointment and the cost of that appointment. Let me put it this way, Would you be willing to pay more to guarentee less of a wait time and a longer, on average appointment?
Ms. D: That would be depend on the value of the appointment?
Dr. T: I am assuming that is value as you see it as opposed to how I see it?
Ms. D: Surely they are the same thing?
Dr. T: The value of a heartworm test to me is, other than it being good medicine and the best thing for your pet of course, is what you pay for it and the potential for finding other conditions. If we catch a condition early we can then treat with the better chance of a good outcome because we caught them early. The value for you of a heartworm test is piece of mind and it allows you to receive heartworm preventive which is what is the best thing for the health of your pet. Those points of view both have value, but if our view of value is too out of sync then you won’t get the heartworm test for your dog, neither of us has piece of mind and although your visit will be shorter and I can see another patient more quickly, I will not receive the fee for the test or the medication.
Ms. D: So what you are telling me is that if I want to have a longer appointment with you and less waiting time I would have to pay more?
Dr. T: Well of course. The basic rule of veterinary medicine as things currently stand is the whatever walks through the doors pays the bills. If not enough walks through the doors one of three things happens. We raise our prices, we lower our costs (wages are 50% of our costs remember), or we close.
Ms. D: You could always get more people to come through your doors?
Dr. T: Absolutely, but these are the other side of the coin of raising prices and lowering costs. Getting people through the door when they are not already coming in means lowering prices or raising costs – in other words marketing. If successful it solves the problem if it fails it, course just makes the problem worse.
Ms. D: But this just sounds like all you care about is the money?
Dr. T: The flip side of that is that all you care about is the money! Everyone in the building spends their days with pets and most have made it their career and for less money than they could get in other professions.
Ms. D: I’m tired of that argument – there is value in spending your day with pets most people would love a job like that.
Dr. T: Touche! However the reality does not always live up to the public perception. Hence the high burn out rate and other serious ills of the profession. I’ll give your visit today for free if you can name a television portrayal which matches what actually happens inside a real hospital.
Ms. D: ……
Dr. T: Do you like flying?
Ms. D: No I hate it, packed in like sardines, air travel used to be so stylish.
Dr. T: Why don’t you fly business class or first class?
Ms. D: Because I am not made of money – I come here too often.
Dr. T: A business class seat costs anywhere from 2 – 4 times the price of an economy priced seat because it uses the 2 – 4 times the resources of an economy seat. The most precious of which is, of course, space. Your hankering for the good old days of air travel was when all seats were business class. Lowering the barriers to air travel has meant we can now travel like never before; however, it also means that we do not value it in the same way.
Ms. D: So if I am understanding you correctly, you are telling me that as a Doctor you have to bring in a certain amount of money every hour like a quota. How can I trust you if you are doing this?
Dr. T: That is one way of looking at it. I would rather look at it as I have to carry my share of costs of having a facility like this so it can be open. As long as we charge appropriately the unwritten contract that we have where we charge based on our costs and in return we will make every effort to be cognizant of not taking you for granted and at the same time not letting you take us for granted, will mean that conversations like this will never have to happen in the real world.
Ms. D: Well thank you for your time and for your insights – can I get a payment plan for todays visit please?