Episode 33

full
Published on:

16th Nov 2023

VetBilling: Payment Plans for Veterinary Care with guest Suzanne Cannon

The lack of financial access to veterinary care creates a ripple of negative effects. It poses challenges such as delayed or foregone medical treatment for pets, compromising their health and undermining the broader objectives of the One Health approach. This issue is exacerbated by credit inequality, where individuals with limited financial resources may struggle to afford veterinary services, potentially rupturing the human-animal bond due to economic euthanasia or owner surrenders. Surrenders due to owner financial constraints then contribute to the overcrowding of shelters, the need for more adopters, and the cycle begins all over again.

Addressing this problem requires a multifaceted approach, including the expansion of more accessible payment options at the point of care, which is where VetBilling hopes to fill the gap for pet owners who can’t access conventional financing. Ou guest, Suzanne Cannon, is the co-founder of VetBilling and we will discuss the problem pet owners face as well as how their company helps both the pet owner and veterinary clinic with payment plan solutions.

Mentioned in this episode:

Keep it Humane Podcast Network

The Animal Welfare Junction is part of the Keep It Humane Podcast Network. Visit keepithumane.com/podcastnetwork to find us and our amazing animal welfare podcast partners.

Transcript
DrG:

Hi and welcome to the Animal Welfare Junction.

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This is your host Dr.

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G and our music is written

and produced by Mike Sullivan.

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Today we have Suzanne Cannon with

us, the co founder of Vet Billing.

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So welcome Susanne and thank

you for coming to the Junction.

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Suzanne Cannon: Thank you

for inviting me to be on.

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DrG: So how about to start you let us

know about what got you started, your

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background and where you are today.

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Suzanne Cannon: Sure.

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Um, let me try to make a long story short,

um, because my journey to get where I am

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today was unplanned and it's surprising.

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So my prior professional background

is in pastoral counseling.

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I have a graduate degree and pastoral

counseling, and I have worked in the

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past as a hospital chaplain and a hospice

chaplain and a pastoral counselor.

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in an AIDS clinic, um,

and in a methadone clinic.

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So, um, clearly I didn't start out with

the idea of, of being in veterinary,

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but I've always had dogs and horses.

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So, veterinarians figure prominently

in my life, um, because we're there

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a lot when you have multiple animals.

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So I've always had a super close

relationship with my, my vets, um,

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because I rely on them so much.

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So the seeds for the idea of vet billing

were actually planted nearly 20 years

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ago when I was going through a divorce.

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Um, so I had to move back in with

my mom and I was in my early 40s.

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So that's not something like

you plan on happening to you.

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And during this time, I, one of my dogs

got pancreatitis, one of my schnauzers.

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And schnauzers are prone to pancreatitis,

which I knew, so they were on prescription

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diet food, they didn't get table scraps.

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I mean, I was very conscientious about,

you know, preventing pancreatitis,

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but sometimes you just can't.

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So, of course she got sick on a

Saturday night, late, and I had

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to take her to the emergency vet.

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And it turned out that she had, you know,

quite a severe case of pancreatitis.

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And, um, she ended up having to stay

at the emergency vet for a couple of

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days, as opposed to transferring her

back to my regular vet because they

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didn't feel she was stable enough.

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So, um, that meant that when she

was finally okay, for which I was

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enormously grateful, um, I then

had a vet bill of about 4, 000.

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Now, when I say 4, 000 now, that

sounds like, like a bargain compared

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to some of the emergency prices that

I, that I see working at vet billing

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and what they've become in the last

couple of years since the pandemic.

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But nonetheless, 4, 000 was an

enormous amount for me at the time.

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Um, previously been married to a

physician, so I didn't have, um, the

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financial constraints then that I found

myself in at this particular time.

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The other thing I think is important

to say here that had a lot to do with

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the creation of vet billing also is

that I had pet insurance at the time.

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Um, I had had a pet insurance

policy for both of my dogs

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for close to 10 years by then.

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And what I came to find out was

that the fact that Insurance is

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mostly a reimbursement model.

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Um, meant that I didn't have any

help to cover that 4, 000 upfront.

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Like I was still responsible for

coming up with that money in advance.

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And then I would have had to file a claim.

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And this was back when there was.

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Only two insurance companies.

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Mine was VPI, which then eventually

got rolled into Nationwide.

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It was the very first pet

insurance company out there.

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It was founded by Dr.

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Jack Stephens.

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And the only other one then

was Trupanion, I think.

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And, um, so, I, I thought, well,

I can't rely on my pet insurance

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to help me pay this 4, 000.

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I didn't have the money

in my bank account.

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Um, I didn't have a credit card

with enough of a limit on it that

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I could put the 4, 000 on that.

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And so the receptionist, seeing my

distress and worry, said, Oh, don't worry.

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She said, we have this thing

called Care Credit, and you can

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apply for that, and then you can

make payments over six months.

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And I was so relieved,

my knees almost buckled.

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I was like, Oh, thank goodness.

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Okay, everything will be okay.

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And back then, The vet office actually

processed the care credit application.

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It wasn't like today with the smartphones

and everything um So she went in the back

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or something and and did my application

and she came back and she said i'm

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so sorry But you were declined So in

that moment, I had a lot of feelings.

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I felt embarrassed.

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I felt ashamed.

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I felt confused.

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I was like, why, why was I declined?

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And so they're going, do I have credit?

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I'm trying to think if there were

bills I hadn't paid and I didn't

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really, I didn't really use credit.

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Um, so at the time I was completely

confused and then I was scared.

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Like, what am I going to do?

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I felt very helpless and very vulnerable.

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And, um, of course as many pet owners

do in a similar situation, I asked about

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making payments because I was working

and I could have made payments and I

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would have willingly made payments.

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I even sat there thinking to myself,

okay, if I need to take on a couple

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of other jobs in order to manage

this expense, I will gladly do that.

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And then I realized, well, even if

I do that, I'm not going to have

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the money right now, you know,

that's going to take me time.

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So ultimately I was saved by my mom

who paid the 4, 000 on a credit card.

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Then I paid my mom back over the next

couple of years while I was getting

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back on my feet after the divorce.

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And.

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When I left with my dog that day,

I remember thinking, I cannot be

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the only pet owner that has faced

this situation where you've tried

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to really do everything right, and

you've tried to be very responsible,

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and you suddenly find yourself

facing an unexpectedly large expense.

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Um, and my dog was eight at the time and

otherwise very healthy and a schnauzer.

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I mean, we're going to expect

her to live for another five or

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six years, which, which she did.

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So the idea of euthanasia over money.

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Was untenable to me.

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Like I, I couldn't even, I could

not imagine making that decision.

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And I thought to myself, what do

people do if they don't have a mom

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to turn to or a relative, a dad, you

know, somebody in their family or a,

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a very close friend that can help them

overcome that upfront expense and,

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you know, be able to move forward.

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So.

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That happened, like I

said, many years ago.

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And then later I met my partner who is

my life partner and business partner now.

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And he had spent the last few decades

building a professional accounts

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receivable management firm and doing

electronic processing of payments.

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Starting back when electronic

transactions were still kind of new.

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So when we met, I said.

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I wonder if we can adapt what you're

doing to veterinary and give people an

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alternative to if they're declined for

credit, but not because they have a poor

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payment history or anything like that.

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I wonder if we can apply that

to, um, to helping fill the gap

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for people that aren't helped

by traditional credit solutions.

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DrG: I worked at an emergency practice

and I saw that quite a bit and we have

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always had an affordable model, right?

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So we try to keep all of our costs

low so that we can help the majority

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of people and affordability is

something that it means different

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things to different people, right?

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So we would get individuals that

went to an emergency, a regular

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emergency clinic first, they would

be given like a 5, 000 estimate.

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They come to us and.

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It was a 1, 200 estimate.

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So it was a lot cheaper and they were

really happy and pleased to see it.

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But that 1, 200 would be a lot

for some other individuals.

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And there, you know, to your point,

there is that, that feeling of shame of

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guilt of not being able to help your pet

because you feel inadequate financially.

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And then having somebody look into

your, Finances and then it automatically

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judge you like you have no credit.

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So you must be a piece of dirt, right?

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Because they don't know what's what's

happening I as a business owner my credit

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has gone Really really low because of

business expenses and business things and

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and different things and I can afford my

payments but credit worthy wise I may not

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be credit worthy and The credit system

is so flawed that it just goes up and

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down, up and down for no reason sometimes.

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So it's really, , we're making

decisions for people based on

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things that are somewhat arbitrary.

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How does your company, well, actually

let's start with what are the different

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reasons why people may not get approved

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for credit?

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Suzanne Cannon: I love this topic

because um, it's something that

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I wasn't aware of until I started

researching this when I was contemplating

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launching VetBilling, which at

that time didn't even have a name.

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Like I didn't know what

I was going to call it.

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, and I wanted to understand to begin

with, like, why was I declined?

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And, um, So, what I found out by

my research is that I fell into a

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category called credit invisible.

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And I learned about how much credit

inequality there is in our country.

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I had never heard of

credit invisibility before.

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It has a companion called

credit unscorability, um,

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they're slightly different.

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But when you're credit invisible,

it means basically you haven't

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established a credit footprint.

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So why would that have been

the case for me since I was

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in my early forties by then?

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Well, what I now know is that all

the credit that I ever used during

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my marriage was connected to my

husband as the primary account holder.

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When I applied for care credit

that night at the emergency

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vet, I applied in my own name.

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Essentially, I had no credit

footprint, only in my own name.

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So that meant that I was credit invisible.

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Um, a company like your credit or any

sort of financing company is gonna,

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make an inquiry of the credit bureaus

and they're not going to find a lot of

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data to tell them anything about you.

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And as a result, they'll say

their algorithm will say, you

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know, this is too much of a risk.

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This is an unknown.

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Like we don't know the degree

of risk involved with extending

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credit to this person.

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So essentially, that doesn't have

anything to do with whether you would

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honor your financial obligations or

it's, it's not a personal decision.

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It's a decision that is made by

an algorithm that has been created

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by underwriters who determine

risk at a large financial company.

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So, essentially, it's kind of, it's

taking it out of the hands of the vet,

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who knows the client, who knows the

patient, who knows the case, and knows the

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situation, and kind of going, okay, um,

we're not going to help this client pay.

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The third party company is saying

we're not going to help the client pay.

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And now the vet feels like, oh.

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Well, we can't help you either.

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So, credit Invisibility is something

that impacts, um, people of color

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much more often than whites.

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It's about double the rate

of credit invisibles among

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minority groups in our country.

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And there's various reasons for

that that have, again, nothing to

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do with actual credit worthiness.

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Um, different cultures

perceive credit differently.

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Um, a lot of African Americans are

not very trusting of the entire U.

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S.

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credit system because they know

about redlining and they know about

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reasons why they haven't been able

to access credit in, in the past.

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Um, and same with other groups.

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So they're actually penalized when

they suddenly need to access credit in

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an emergency, like for their animal.

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In order to get credit,

you have to have credit.

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It reminds me of that old thing,

like when you're first out of school

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and you're trying to get a job and

no one wants to hire you cause you

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have no experience experience, right?

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Well, how do I get experience, you

know, and you know, unless you give

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me a chance and it's kind of the same

thing with credit, like, okay, well.

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I haven't established credit

yet, so what am I going to do?

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And these people are really left in the

cold, and there is a very large number

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of Americans that are credit invisible or

credit unscorable, and they're the ones

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that are falling into that black hole.

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At the same time, they probably don't need

charitable funds because they probably

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earn enough that they can make payments.

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And my other thought with creating vet

billing was, why are, if, if people are

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declined for a tool like care credit.

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Why are we then tapping into the

nonprofits that already have limited

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resources and those resources

should be reserved for people who

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are truly like insolvent, like

they have no other way to pay.

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But what about all the middle

income earners out here who

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live paycheck to paycheck, not

because they're irresponsible,

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but because life is expensive.

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And they, you know, they need

to be able to bridge that gap.

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So, I mean, that was.

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A lot of the goal of what vet billing

wanted to alleviate was to help provide

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a safety net for people that found

themselves in kind of that gray area

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between the ability to access traditional

financing versus having to seek charitable

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funds, which is a lengthy arduous

process, and it takes a lot of time.

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So if you're in an emergency, it's not

ideal to be trying to apply for grants.

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And the average award amount

for grants is about 500.

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So, if you have a 5, 000 bill, you're

gonna have to tap into multiple funds

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to try to get together enough money.

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DrG: I had a client that, when

I was working in an emergency,

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that came to us with her dog.

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Her dog was very sick.

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And she was kind of middle income.

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She had a good job.

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She was living paycheck to paycheck.

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And she did not qualify for financial

assistance because she made enough money,

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but she was living paycheck to paycheck.

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And she was trying to find help.

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But of course, there is limited help

for individuals that are, that do

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not qualify for financial assistance.

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So our hospital was

open to everyone, right?

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So our prices were the

same to anyone, regardless.

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Like we did not have, uh,

People did not have to qualify.

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So it was.

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It was really sad to be dealing with

somebody that's doing the best that she

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can to not have to go into government

assistance because she feels that she can

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work hard and she can still produce and

everything else, but she'll still did not

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have enough money to take care of her dog

and this was around the time of covid.

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So she had been making really good

money and all of a sudden she was

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struggling and there wasn't anything

really to help her with with that

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and she could not get credit.

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So, you know, it's like people like that.

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And in her case, because we were

open, we were able to help her out

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and get the diagnostics and stuff

for the things that she needed.

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But I have met so many people that

have had to make the really difficult

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decisions of euthanizing their

pet or surrendering their pet to a

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shelter just because they don't have

enough money to take care of it.

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Suzanne Cannon: Right.

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And that, that breaks my heart.

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That was another big motivation

for VetBilling is I hate hearing

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those stories because I can imagine

myself in, in that situation.

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And I don't want anyone to have to make

that sort of terrible choice because it

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causes a great rupture before the human

animal bond, it ruptures the family bonds.

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It is.

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painful for the veterinarian, um, who

suffers moral distress from having

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to be in these situations where

you have a treatable animal with.

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Potentially a good prognosis.

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Um, I mean, it's one thing to euthanize

for financial constraints if the

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animal has a very poor prognosis.

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Like one of my veterinary friends,

her name is Kate Boatwright.

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She writes a lot on

spectrum of care issues.

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And, um, you know, she mentioned

to me that there are cases

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that fall in a gray area.

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Like she had, um, a client whose

dog had a septic abdomen and that

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There, the prognosis wasn't very

good, and the animal was going to

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require some additional surgeries.

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There was no guarantee that the

surgeries were going to, you

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know, prolong the animal's life.

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And the clients were very

financially constrained.

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And in that situation, they made the

decision to go ahead and euthanize.

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Um, but I said that to me is different

than purely economic euthanasia, where

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it is a treatable animal and you can

treat that animal and expect to continue

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seeing that animal in your clinic for

the rest of its lifetime, which also

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represents All of your downstream

revenue from the life of that animal.

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So if you want to look at it

from a business perspective,

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it makes more sense to treat.

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Um, but you know, there are always

cases where You know, euthanasia

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due to finances combined with a poor

prognosis would, would make sense.

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Um, it's still painful, but, um, I

just, I hate hearing that for lack

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of, um, the ability to come up with

all of the upfront money today that

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an animal is put down or surrendered

because a lot of these pet owners.

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Um, can pay over time, the obstacle

they're facing is, there is kind of

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what I refer to as a legacy payment

model among veterinary clinics, which

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is still that, you know, your entire

amount is due up front, um, and, or

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you can't proceed with treatment unless

you come up with 50 percent of the

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high end of the estimate or something,

that's insurmountable for people.

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And then treatment can't begin.

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And that creates anguish

for the pet owner, and it

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creates anguish for the team.

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Um, although I certainly feel that

veterinarians, in order to survive, um,

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the pain of that, the ethical and the

moral distress, have had to, um, move

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to a place where they protect themselves

by telling them it's the owner's fault.

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Um, you know, if only the owner

were more prepared, if only they had

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insurance, I hear the thing about

having pet insurance all the time

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and it drives me crazy because one of

the reasons we only have 3 percent of

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pets insured in the United States is

that the vets aren't paid directly.

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So the owner pays premiums, but they're

still on the hook for that upfront cost.

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And if you don't have 4, 000.

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You don't have 4, 000 tomorrow.

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I mean, I look at pet insurance as kind

of being more like asset protection for

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people that can already afford the bill.

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Um, they can pay the 4, 000.

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They can wait to get it back.

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Um, so they are recouping their loss,

but The one exception to this is

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Troupanion, which will do direct payments

to the vet, but they have to, the

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vet has to have the claims processing

software in order for that to happen.

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And I have Troupanion policy, so despite

my frustrations with the pet insurance

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model, I still have a policy for my dogs.

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, But neither vet that I go to has

that claims processing software.

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So I'm still in the reimbursement

model situation for any

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bills that I have as well.

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I still have to pay up front

and wait to be paid back.

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And I, I just hear pet insurance discussed

so often as if it's a panacea and it's

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the ultimate solution to access to care.

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And now you have complete peace of mind.

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You'll never have to worry

about treatment costs again.

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That's not accurate.

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And I, I just want us to talk more

candidly about that as well, and

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that we need other options out

there, um, apart from pet insurance.

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DrG: And some people fail to read

the, the small print, because I know

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I have a, I have a friend who has a

Dachshund and the Dachshund had back

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problems and he went ahead and you know,

he had all his stuff up to date and

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he submitted his claim and they said,

sorry, but Dachshunds with disc problems

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are not covered in this insurance.

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And he was like completely like, and

this was years and years ago, I believe

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that the insurance that he's used that

he was using then is now covering it.

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But at the time they didn't because a

lot of insurances will not cover certain

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genetic predispositions for, for diseases.

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So dachshunds with disc problems, Maine

Coon cats with heart problems, uh, you

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know, Dobermans with heart problems.

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So they will not cover things that they.

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kind of know are going to happen.

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So, you know, you, you

have people that they don't

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necessarily read that fine print.

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They just see, okay, you know, you get

80 percent of the, of the reimbursement

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and, and that kind of stuff.

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And then when you have the emergency,

then you're just, you know, shocked

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to find out that you have planned,

you have tried, and then you have

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not, you're still not able to, to

afford the care that your pet needs.

352

:

Last, last week I interviewed Dr.

353

:

Michael Blackwell on One Health.

354

:

And one of the, the case that he

said kind of turned him was having

355

:

to euthanize a dog of a veteran

that had a treatable condition that

356

:

could not be treated because of

costs and it had to be euthanized.

357

:

And he said that it felt wrong.

358

:

And I have been in that position of

feeling wrong about having to euthanize.

359

:

A patient that, you know, it, I don't

know if it can make it or not, but

360

:

there is not that option because

of, you know, funds and I have been

361

:

very, very lucky to have owned my

own practice and be able to, to offer

362

:

affordable care so that euthanasia due

to financial reasons is not necessarily

363

:

a thing that we had to do, but it's so,

it's so hard to know that it happens.

364

:

And I think that it is a huge

cause of compassion fatigue.

365

:

You know, we're losing so many

veterinarians and technicians

366

:

that are just leaving the field

because they went into this

367

:

business wanting to help animals.

368

:

Uh, plus minus wanting to help

people because so many animal people

369

:

don't necessarily like people, but

you know, we go into this field to

370

:

help animals and then it literally

is, we can't help this animal.

371

:

Not because we can't not because

we don't have the, the ability or

372

:

the education, just because this

person doesn't have the funds.

373

:

Suzanne Cannon: Yes, and I knowing like

my personality and temperament if I were a

374

:

veterinarian and I were in that position.

375

:

I.

376

:

I don't know how long I would

last, you know, um, facing that.

377

:

There is, um, a wonderful

YouTube video out there from a

378

:

TED Talk that you probably might

know of, um, by Melanie Bowden.

379

:

She's a veterinarian.

380

:

I think she's currently working with veg.

381

:

But she made this, um, she did

this TED Talk a few years ago.

382

:

And it's called, What it Really Takes

to be a Veterinarian, and she sort

383

:

of busts all the myths for people out

there who assume that it's all playing

384

:

with puppies and kittens all day and,

oh, this must be the happiest job ever.

385

:

And one of the things she talks about

is the inability to treat animals

386

:

because of owner financial constraints.

387

:

And the way that she described

it, the term she used, Is soul

388

:

crushing and I thought that that

was such an apt description of it.

389

:

I think it over time it literally

has to do something to your insides

390

:

to be able to cope with that.

391

:

Um, you can't go to work and,

you know, function if your

392

:

soul is crushed every day.

393

:

So you have to develop some sort of

internal defense mechanism against that.

394

:

And, um, and that is what sometimes

I think can turn into resentment of

395

:

clients or, or client bashing, because

where, where does that blame go?

396

:

Where do all those feelings go?

397

:

Um, when we have them, it's,

it's It's really very painful.

398

:

So, and by the way, Melanie, um,

Bowden wrote a book that came out

399

:

a year or two ago that I love.

400

:

I highly recommend.

401

:

It's called, What the F Is This Vet Med?

402

:

It's about sort of her baptism by

fire into like leaving vet school

403

:

and then going into the actual field.

404

:

And, and as you're saying, you know,

veterinarians don't go into this.

405

:

With any idea when you're dreaming of

being a veterinarian, you're not also

406

:

dreaming of client financial limitations,

like nobody starts thinking of being a

407

:

vet if they're eight years old or 10 years

old and they're like, Oh, I'm going to

408

:

treat all these animals, but there's going

to be a lot of people that can't pay.

409

:

I mean, nobody is thinking that.

410

:

And so, you know, I think that she

touches on that and in her book

411

:

of her experiences with that and.

412

:

what she has done to try to cope

with that, um, so that she can have

413

:

a sense of wellbeing and make sure

that she cares for herself properly.

414

:

DrG: I'm going to have to check that

book out because yeah, it's when we go

415

:

to vet school, we're, we don't go through

business management classes, right?

416

:

We go through classes on how to

identify diseases and how to treat

417

:

conditions and that kind of stuff.

418

:

Realistically, we don't even get

like human resources type classes.

419

:

And I know that some of the

universities are kind of.

420

:

Reworking the way that their curriculums

are because they are recognizing

421

:

the need for spectrum of care.

422

:

But even so, I mean, we we

don't graduate knowing how to

423

:

how to be a business person.

424

:

And you have to be a business person

to to be in any kind of business.

425

:

So it's really difficult.

426

:

And you get into into that point

of whose responsibility is it to

427

:

take care of any individual animal.

428

:

And clearly, yes, the responsibility

lies on that, on that pet's owner

429

:

or caretaker, because they took on

the responsibility of their care.

430

:

But I also feel that as veterinarians,

like we take an oath to help animals

431

:

in society and animal welfare.

432

:

And it doesn't say that we have

to take care of affluent society.

433

:

It just says society, right?

434

:

So we, we kind of have to figure out.

435

:

Ways outside the box.

436

:

And I'm not saying this to, to tell

people, you know, we, we should

437

:

do everything for free because

things can not be done for free.

438

:

We have to be compensated for what

we're doing, but we also have to

439

:

recognize the fact that the cost

of veterinary care has increased

440

:

exponentially in the last several years.

441

:

So you can have people who got their

animals back when, you know, you could

442

:

go and get your yearly examinations and

everything for 75, a hundred dollars.

443

:

five years ago or even eight years ago

and the same dog going to the vet right

444

:

now would be five eight hundred dollars

so yes the cost of care has increased

445

:

it doesn't mean that these people are

bad owners like you can't plan for

446

:

for things like that and then the cost

of emergency care has also gone up

447

:

exponentially and the veterinary field has

increased, like, leaps and bounds, right?

448

:

From when it used to be.

449

:

When I started 24 years ago, it

was a stethoscope and a microscope,

450

:

and that's what we had, like,

stethoscope, microscope in our hands.

451

:

And now we have CTs, and we have x

rays, and we have MRIs, and we have

452

:

all of these amazing advantages.

453

:

And with those come with increased

costs, but we have not allowed

454

:

enough time for people to kind of

be able to adjust to those changes.

455

:

Right.

456

:

So all of these expenses

are are literally unexpected

457

:

Suzanne Cannon: Yes, they are.

458

:

And a friend of mine who has worked

in various, um, companies over the

459

:

years, developing new diagnostic

systems for for veterinarians.

460

:

He said to me once very thoughtfully,

he said, you know, it occurred to

461

:

me at one time that, you know, here

we are like happily creating all

462

:

these advanced diagnostics and stuff.

463

:

But we haven't stopped to

think about whether the cost

464

:

of putting those in practice is

pricing pet owners out of care.

465

:

And I said, yeah, that's, you know, that's

a really interesting thing to think about.

466

:

And I think about, you know,

the kind of veterinary care.

467

:

That was available when I was growing

up as a kid, which was really a long

468

:

time ago, really a long time ago.

469

:

But, you know, I feel

like what I remember is...

470

:

You know, seeing the vet maybe once

or twice a year for vaccines, like

471

:

the core vaccines, and I'm sure that

back then we didn't even have some

472

:

of the vaccines that we have today.

473

:

And I, I don't even really

remember my dog that I grew up

474

:

with getting sick very much.

475

:

Maybe we didn't pay as much

attention to her, but I mean, like

476

:

if she was throwing up or she had

diarrhea, it's like, oh, she's sick.

477

:

But I also remember that a lot of

times we, she would get over it.

478

:

So I wonder if as.

479

:

Um, you know, we've brought pets

more and more into our families as

480

:

full fledged members of the family.

481

:

Um, we've increasingly sort of

medicalized, um, what they're going

482

:

through, and we go to the vet a lot more.

483

:

We notice things a lot more.

484

:

But, I mean, the dog I grew up

with lived a long, healthy life.

485

:

And I think, you know, you go into

PetSmart now, I am overwhelmed when

486

:

I walk down the dog food aisle.

487

:

There's too many choices.

488

:

Um, pet owners get very confused about

all of this and then there's social

489

:

media telling you what you should feed

your animal and one post that I saw

490

:

saying you should use this green juice.

491

:

Literally, it was green juice to

treat something in your animal.

492

:

And then of course, those same people

that see that walk into the vet clinic

493

:

and say, Oh, I'm using the green juice

for my pet and veterinarians are just.

494

:

DrG: That's great.

495

:

I know from Dr.

496

:

Google.

497

:

We, the veterinarians hate Dr.

498

:

Google.

499

:

Suzanne Cannon: Right.

500

:

I know.

501

:

I mean, I, I kind of hate Dr.

502

:

Google too.

503

:

I kind of wish it would go away because,

um, well not go away, but for, for

504

:

some reasons, because before we were

so much reliant on Google for things,

505

:

my veterinarian was the absolute

authority on anything about my animals.

506

:

Like I didn't.

507

:

second guess anything

that I was told by my vet.

508

:

Um, and now it's too easy

for people to do that.

509

:

So there are times when I've gone to

the vet and, um, she might suspect, she

510

:

might tell me a couple of , differential

diagnosis about what's going on.

511

:

And I tell myself, do not

go home and look that up.

512

:

Like, don't, don't look it up because

I'm going to focus on the scariest

513

:

words, and also you have to be very

careful about the source from where

514

:

you're getting your information.

515

:

And I think I'm lucky because I

work with veterinarians, I kind

516

:

of know what the reliable sources

are, but a lot of people don't.

517

:

So, you know, if I put in the name of a

disease or something, and the first result

518

:

that comes up is from a website called Wag

Walking, I'm probably not gonna read that,

519

:

even if it was, they say it was, Approved

by a veterinarian or, you know, something,

520

:

but I just, I just don't want to go there

because I don't want to scare myself and

521

:

I don't want to second guess my, my vet,

I mean, there's nothing that can take

522

:

the place of actual clinical practice.

523

:

Things do not go the way that

they are written out in Google.

524

:

You know, you have this richness of

experience that you can never get by

525

:

looking up something on the internet.

526

:

DrG: Yeah, people get

confirmation bias, right?

527

:

So they get something in their head

and they want to believe that their

528

:

pet has or doesn't have something.

529

:

So they look, and if you look hard

enough anywhere, you're going to

530

:

find something that agrees with

what your, what your thought is.

531

:

And, uh, I have a family member that

used to post kind of funny things.

532

:

He would get a symptom and say, I had

a, I had a blinding headache today.

533

:

I checked out.

534

:

One of the medical websites.

535

:

So I may even have a migraine

or a tumor in my brain, right?

536

:

So it's kind of like all these

extremes that can happen just thinking.

537

:

And when we have an

ailment, we can think about.

538

:

Okay, do I feel chills?

539

:

Do I feel hot?

540

:

Do I feel tired?

541

:

Do I feel achy?

542

:

But our pets depend on us to,

to know things without them

543

:

saying, without expressing.

544

:

And animals, especially like cats,

they're great at hiding things.

545

:

So it is really important to have

that education, to be able to examine

546

:

the pet and be able to do things.

547

:

But yeah, we, we have We have gone

from one extreme to the other,

548

:

from zero diagnostics to all the

diagnostics, and the in between has

549

:

kind of gotten a little bit lost.

550

:

So I do agree that, you know, if If,

as, as a veterinarian, me personally,

551

:

if a patient, if a client comes in with

their patient and I give them my, my

552

:

opinions, my diagnosis and everything

else, I'm okay with them, you know, going

553

:

to a second opinion, getting, going to a

specialist or going to somebody else or

554

:

thinking about it, especially when it's

something very difficult, I don't take

555

:

offense to it because it's something that

I would do myself if somebody told me that

556

:

myself or my child has something serious.

557

:

Thank I want to, you know, I want

to, I want to find out about it.

558

:

So as veterinarians, nobody

should really be offended about

559

:

getting that second opinion.

560

:

And then, and getting,

getting something done.

561

:

Suzanne Cannon: That's true.

562

:

Although circling back around to the

issue of financial access, sometimes

563

:

Going to a specialist is out of the

question for some people, which is another

564

:

complicating factor and something that Dr.

565

:

Blackwell said in the interview that

you did with him on your previous

566

:

podcast was He said something along

the lines of veterinary medicine is

567

:

not equipped with a system for dealing

with these financial Challenges and

568

:

I think he's really right about that.

569

:

I mean there has only been sort

of one system for 25 years, which

570

:

has basically been care credits.

571

:

And I don't want to like pick on care

credit, but they are the most predominant

572

:

financing option offered by most vets.

573

:

Um, I mean, there are other options

that operate similarly to care

574

:

credit, like Wells Fargo, all of them.

575

:

DrG: And we used a scratch pay as well.

576

:

Yeah, it was something similar,

but, but the same as care credit,

577

:

it's all dependent on, on credit.

578

:

Suzanne Cannon: It is.

579

:

And then I will say though, scratch

pay differs from credit and that

580

:

it's a short term installment loan.

581

:

It's not revolving credit.

582

:

And I think one of the nice things

about scratch pay is that clients

583

:

aren't dealing with that promotional,

um, that promotional window of

584

:

deferred interest where if you pay

off your bill within six months, Um,

585

:

you don't have to pay any interest.

586

:

So a lot of people say,

Oh, it's zero interest.

587

:

Not technically, not really deferred.

588

:

So if you miss one payment or you

are late with one payment by a

589

:

day, that's going to throw that

deferred interest out the window.

590

:

And what it's going to trigger

is retroactive interest on

591

:

your entire original balance.

592

:

And that APR on that is like 28.

593

:

99%.

594

:

So what happens to people sometimes.

595

:

Um, is they end up owing more

than their original invoice was.

596

:

And this is by a lot.

597

:

Yes, by a lot.

598

:

And it's called getting

into a debt death spiral.

599

:

Like you, you just cannot get ahead of it.

600

:

So you have to be very, um, conscientious

about using those, um, type of

601

:

financing products and that, you know.

602

:

The vet staff would make sure to make

it clear to your clients that you make

603

:

sure that you make all of your payments

on time and that you pay off your

604

:

balance by six months and that making

the minimum payment is usually not going

605

:

to be enough to pay off your balance,

you're going to have to pay more so

606

:

that you're, you don't have that risk.

607

:

So that was another thing

that we did with vet billing.

608

:

Um, vet billing basically

is a tool that allows.

609

:

Veterinary clinics to extend their own

credit and make their own approvals

610

:

based on the client, the patient, the

situation so their hands aren't tied when

611

:

something like care credit doesn't work.

612

:

And, , even though most vets are,

are terrified of payment plans and

613

:

extending in house credit, it, that's

basically because they have done it

614

:

for years, but they haven't done it

well because there isn't a system.

615

:

Um, there's always a lot of, uh,

sort of patchwork approach to this.

616

:

Like you use a promissory note,

one vet uses promissory notes.

617

:

Another vet is holding postdated checks.

618

:

So the client's writing six checks that

they have to hold and deposit one a month.

619

:

You get to check number

three and it bounces.

620

:

And then, you know, the vet staff is

like, okay, what are we going to do?

621

:

They're not trained to

do all that follow up.

622

:

Um, another thing that's common is

simply sending monthly statements.

623

:

through the client hoping they're

gonna pay off their bill, which leaves

624

:

a lot of, um, too much control in the

hands of the pet owner over whether

625

:

and when they're going to pay that.

626

:

So what we did with vet billing

was create a system where all the

627

:

payments are automatically drafted.

628

:

We provide the clinic with the contract.

629

:

You just set it up by logging

into our online platform.

630

:

So you have a standardized contract,

you set up the payments, , they're

631

:

automatically drafted, and then if

anything happens with those payments,

632

:

if there is a payment failure,

a transaction failure, Then it's

633

:

our team that follows up on that.

634

:

So we have software that reprocesses

payments, but we also have a team

635

:

of humans that reach out to pet

owners because the goal is to keep

636

:

them on track with their payments.

637

:

The idea was to give vets, um,

sort of a backup system that was

638

:

going to mitigate any financial

risk that they were taking on.

639

:

By us handling the entire plan for them.

640

:

And that's why we have about

a 90 to 95 percent repayment

641

:

rate on all of our plans.

642

:

It's kind of like if you give clients an

easy way to comply, um, they do comply.

643

:

And, um.

644

:

And then that way we can support vets as

well because that's equally important to

645

:

us is, , reducing some of that moral and

ethical distress that they're feeling that

646

:

their hands are tied like, oh, we can't

move forward with this case because they

647

:

were, they were declined for care credit.

648

:

DrG: I can completely understand

where vets are coming from because we

649

:

had in our hospital, we would extend

credit and people would burn us.

650

:

And, and some people would pay like

once or twice and then that was it.

651

:

They will leave a credit card and then

they would cancel the credit card.

652

:

So it is, it's really

difficult as a veterinarian.

653

:

And then you don't want to get

into that whole, ordeal of having

654

:

to go after people in small claims

court and that kind of stuff.

655

:

First, it's expensive, it's time

consuming, and it doesn't look good to be

656

:

going after somebody for money after, you

know, it was to, to help their patient.

657

:

So it's not a good public relations thing.

658

:

So I think that, that something

like this sounds great for

659

:

especially emergency stuff.

660

:

Most people can potentially You know,

you have a whole year in between wellness

661

:

visits to come up with however much

money you need for a wellness visit.

662

:

But the problem really comes when

your dog all of a sudden is vomiting

663

:

or it, you know, it ate a sock.

664

:

It, it accidentally got out of

the house, got hit by a car.

665

:

Now it has a broken leg or whatever.

666

:

And you have this, this

emergency and you can't afford it.

667

:

And you have the money to pay it.

668

:

You just don't have the

money to pay it now.

669

:

And, it is really hard as a veterinarian

to, again, we didn't go to business

670

:

school to kind of figure out what the

best way to manage those things are.

671

:

Suzanne Cannon: No, that's true.

672

:

And then like what you said about most

veterinarians have experience with

673

:

being burned when they've extended

payments to clients, that's really true.

674

:

Um, and we want to prevent that, but it's

really hard, um, to sort of convince.

675

:

Veterinarians who are understandably

skeptical about the system we offer

676

:

that this doesn't function like any

payment plans They have probably done

677

:

in the past at your clinic Do you know

what so you said people would like

678

:

leave a credit card number to run?

679

:

Did you guys do anything else

as far as all the payments?

680

:

DrG: No, like, so all that we would

do is get information like from the

681

:

owner, like a driver's license, some

kind of government identification.

682

:

And then, yes, they would leave,

uh, usually a credit card because

683

:

we tried doing the checks things and

then the checks would not go through.

684

:

Um, so we would try doing a

credit card and then having

685

:

somebody run the credit card.

686

:

And yeah, so that, that was basically it.

687

:

Suzanne Cannon: Yeah.

688

:

Yeah.

689

:

And what we have built into our system as

well is that when you set up a contract.

690

:

Um, the owner has to provide

a primary payment method and

691

:

a secondary payment method.

692

:

So if the first one You know doesn't go

through then we can automatically Withdraw

693

:

from the secondary payment method.

694

:

Not everybody has two payment methods.

695

:

It depends on the client.

696

:

It depends on the demographic

but um if There are two payment

697

:

methods that protects against, you

know, any additional risk as well.

698

:

So there's a lot of things that are

built in to our system, like address

699

:

verification, bank card verification.

700

:

So people can't put in a

fraudulent address, they can't

701

:

put in a fraudulent bank card.

702

:

The system will pick it up

and say that it isn't valid.

703

:

Providing a, a soft credit check is

an option that you can do, which

704

:

basically is there for the veterinarian

just to have an idea of the degree of

705

:

financial risk involved in extending a

payment plan to this particular client.

706

:

So it's not like a pass fail

system, like your credit is, like

707

:

you're approved or you're not.

708

:

This comes back with a series of

letter grades from A through F.

709

:

And a recommendation for the minimum down

payment you should get from the client

710

:

and the optimal payback period so you're

not waiting, you know, too long to get

711

:

your money, like, overall, our average

payback period across all payment plans

712

:

is about seven months, six to seven

months, so it's not anything crazy.

713

:

The average finance

amount is 800 to 1, 000.

714

:

So people need a lot of help in that

area between like 500 and 2, 000.

715

:

Um, we do work with a lot of emergencies

as well, and they have much bigger bills.

716

:

So they may extend payments to 18

months for some of those clients,

717

:

but generally they do 12 months.

718

:

And, um, we have.

719

:

Very, they have very

good payment compliance.

720

:

We have a emergency in the Dallas area

that we've worked with for several

721

:

years and they send us tons of payment

plans and they have about a 97%.

722

:

Repayment rate, um, but they have really

created protocols in a system around

723

:

it, like up to invoices up to 500.

724

:

You can get a maximum of a 6

month payment payback period.

725

:

A thousand dollars you

can extend to 12 months.

726

:

So they created policies and then.

727

:

They will make exceptions on a case

by case basis, in collaboration

728

:

with the doctor and the team.

729

:

So, that works really well.

730

:

So we try to, you know, guide the clinics

we work with in helping them set up

731

:

protocols around offering payment plans.

732

:

You're not just offering them willy nilly.

733

:

Like, we want you to have a policy in

place and Then, if there's a case that is

734

:

really pulling on your heartstrings, you

really want, you know, you can always make

735

:

an exception, but have protocols in place

and then it's gonna work better for you.

736

:

DrG: Yeah.

737

:

As a business owner, I, I always

thought of, let's say that it's an

738

:

emergency and it's a thousand dollars.

739

:

I'd rather make a thousand dollars

over six months than make zero dollars.

740

:

and not help this patient

as a veterinarian, right?

741

:

Because we have, again, to

think about both sides of it,

742

:

we have to Keep the doors open.

743

:

We have to, to pay our bills

because we can't, we can't tell

744

:

our electric company, sorry, you

know, I didn't charge these people.

745

:

So I want to pay you in, in like

the, the love that I gave this

746

:

animal, but you know, like it

doesn't, it doesn't work like that.

747

:

Like we have to pay, we

have to pay our bills.

748

:

And unfortunately as

veterinarians, we have.

749

:

A lot of loans and a lot of, a

lot of payments, our supplies,

750

:

everything is, is really expensive.

751

:

So there are, there are costs,

but being able to help the

752

:

owners afford their, their pets.

753

:

realistically is good

business sense, right?

754

:

Like we don't, we don't make money

out of not treating our patients.

755

:

So if we can, if we can help our

patients, you know, taking away the,

756

:

the emotional part of it, treating

our patients is good business.

757

:

And then again, as veterinarians

and helping our staff deal with

758

:

compassion fatigue, being able to tell

a staff member, Hey, you know what?

759

:

Fifi's going to be able to get treated

for the bladder stones, even though Mrs.

760

:

Smith doesn't have the

money right this second.

761

:

And that staff member that has been

the one primarily, because, I mean,

762

:

as veterinarians, we're not the ones

dealing with the owners primarily, right?

763

:

It's the receptionist, the technician,

the assistants, they're the ones

764

:

that are spending all this time

and bonding with these people.

765

:

We go in the room, we see them for

five, 10 minutes, we do our diagnostics,

766

:

our medical stuff, and we leave.

767

:

And then the staff is left with having to

tell the owner, this is the cost, this is

768

:

the estimate, this is what's happening.

769

:

No, there's no, there's no options.

770

:

Like, you know, you

got to make a decision.

771

:

So it's really, really difficult

on, on the veterinary staff.

772

:

And then when that owner has

to make a difficult decision or

773

:

when that owner gets irate and

says you don't care about my pet.

774

:

That's all going on that, you

know, veterinary staff, not

775

:

as much on the veterinarian.

776

:

So I think that, you know, being able to

find creative ways to help pet owners.

777

:

with their, with their pet care

is also a way for us to help as

778

:

veterinarians to help our staff deal

with the difficulties of our job.

779

:

Suzanne Cannon: Yes, and one of the

most gratifying things that, that

780

:

I hear from a lot of our partner

clinics, which tells me that vet

781

:

billing is working exactly as I hoped.

782

:

Um, in the beginning is that they say

it reduces a lot of stress for their

783

:

staff, um, and really contributes to

their emotional well being because

784

:

they no longer feel helpless and

powerless, like they don't have

785

:

another solution to fall back on.

786

:

I had one hospital administrator tell me

that prior to using vet billing, she said

787

:

some of her staff would get so upset and

they would come to her crying and say

788

:

that they felt personally responsible

for euthanasia or the surrender of

789

:

that animal because they couldn't.

790

:

Give them an option yet.

791

:

It wasn't up to them, but it still

was a very personal experience.

792

:

And I think that's because almost

I would say 100 percent of vet

793

:

staff all have animals themselves.

794

:

Um, many of them have multiple

animals, you know, and They can

795

:

empathize with what it would, would

feel like to be in that situation.

796

:

I think all of us that love animals, our

heart immediately goes out to someone

797

:

that is struggling to pay for care.

798

:

And we want to be able to fix that.

799

:

Um, you know, we, we don't want to

have to say no, we don't want to

800

:

equate money with the value of a life.

801

:

On the flip side, though, what I have

also heard from veterinary staff from

802

:

time to time is, I think, I think

you might have talked about this, Dr.

803

:

Blackwell, this, this saying about, if you

can't afford your vet bill, you shouldn't

804

:

have a pet, and pets are a luxury, not

a right, , and another thing I've heard

805

:

is, oh, well, you wouldn't go to the

grocery store and ask to make installment

806

:

payments, or you wouldn't go get your car

repaired, and And ask to make installment

807

:

payments, although financing is on the

rise and car repair businesses, but what

808

:

I will say, I don't think that those

are good comparison because groceries

809

:

and your car are inanimate objects.

810

:

They're not like members of your family.

811

:

I mean, they're, they're necessary

things are the same thing with

812

:

furniture, like being able to.

813

:

The finance furniture as opposed

to paying in full for it.

814

:

But when you're talking about an

animal, you are in most cases talking

815

:

about a family member that is loved.

816

:

And that intersection of emotions

and finances is like a powder keg.

817

:

It's very volatile.

818

:

So, um, so we have to remember

that there's an extreme emotional

819

:

investment in that animal when

we're talking about money.

820

:

So you, you can't, it's

really not the same.

821

:

Like my, I could have a, a

car accident tomorrow, heaven

822

:

forbid, and my car is totaled.

823

:

And, um, am I going to be upset?

824

:

Yeah, I'm going to be upset.

825

:

I'm probably going to be mad because

of the inconvenience and worried

826

:

about the expense and the cost.

827

:

Am I going to be grieving for my car?

828

:

No.

829

:

But if it was my animal that I had

to put down over money, you better

830

:

believe I'm going to be grieving.

831

:

So, you know, that's really

kind of the difference.

832

:

DrG: And we have to, to understand

and respect the human animal bond,

833

:

especially in people that are underserved

because they need those animals, right?

834

:

And animals live in these

underserved communities, too.

835

:

So we cannot be judgmental of people

that have no resources to affordable

836

:

and accessible care when there

are animals in their community.

837

:

Where are these animals going to go?

838

:

And the, the other thing that I,

that I see a lot is the, the problem

839

:

that shelters are having with shelter

overpopulation and people dumping animals.

840

:

And there are people that dump

animals because they're irresponsible

841

:

and they didn't know what they were

getting into and that's on them.

842

:

But there are quite a few people

that surrender animals because of

843

:

medical conditions, because they

couldn't afford it, because they, they

844

:

have to move because of evictions.

845

:

I mean, life situations that they

don't want to part with this, with this

846

:

animal, this animal is their family,

but they have to give them away.

847

:

And we have, on one hand, somebody that

doesn't want to Get rid of their pet.

848

:

And on the other side, the shelter that

is so oversaturated with animals that

849

:

they're having to euthanize animals.

850

:

And the solution, like I spoke with Dr.

851

:

Blackwell, is a difficult

solution because so many

852

:

people have to come together.

853

:

We have to figure out a way to keep

those animals home with their owners.

854

:

And then we are helping the

shelter population as well by

855

:

decreasing the intake number.

856

:

I mean, how amazing is that for the

person that gets to keep their pet and

857

:

for the shelter that doesn't have to

euthanize the dog because of space?

858

:

Suzanne Cannon: Yes, absolutely.

859

:

I mean, one of, one of my favorite

quotes is, um, it's often attributed

860

:

to Desmond Tutu, but I think it's

potentially at Various sources.

861

:

It doesn't matter.

862

:

But the quote is at some point we

have to stop pulling people out of the

863

:

river and go upstream and find out why

they're falling in in the first place.

864

:

So there are a lot of antecedents

or upstream ways that we can

865

:

address this problem instead of on

the back end where we're reactive.

866

:

The animal is being surrendered.

867

:

Then, you know, it already had a loving

family and now it's going to go in the

868

:

shelter Now it's going to potentially be

adopted by a new family And then there's

869

:

no guarantee that the new family won't

be faced with this situation themselves

870

:

of an unexpected vet bill And that

animal could end up back in the system

871

:

again like because we're not addressing

the initial problem or we're not coming

872

:

up with Um, enough effective solutions

for managing that problem to keep it

873

:

from happening in the first place.

874

:

It's like what I call a vicious.

875

:

circle, just going around and around

again and that I think we have a choice

876

:

about whether we want to continue

to perpetuate that circle or not.

877

:

When it's better to keep

that pet in his loving home.

878

:

I have a, I have a veterinarian friend.

879

:

Who also said once she, she hurt her

ankle, she broke her ankle or something.

880

:

And she said, the problem with

financial obstacles for clients and then

881

:

surrendering an animal over money, she

said, that would be like, for me, if I

882

:

went to the hospital and I couldn't pay,

you know, for the cost of having my.

883

:

Ankle set and repaired and whatever.

884

:

And they said to me, oh, well if

you can't afford to pay, would you

885

:

like to go and live with this other

family, ? Who can, who can pay your bill?

886

:

And she said, honestly, no, . She said,

I would rather have my broken ankle.

887

:

I'll just walk around with a limp

and you know, crutches or whatever.

888

:

'cause I don't wanna go to another family.

889

:

And when we sort of.

890

:

flip the script and we think about

these things in a different way.

891

:

It's like, what if this

was happening to a human?

892

:

It's like laughable, but also sad.

893

:

It's like, gosh, yeah.

894

:

Why, why are we doing this this way?

895

:

DrG: If, if there are any veterinarians

or veterinary managers listening to

896

:

this episode and they want to get

more information about vet billing,

897

:

how does the process work for them?

898

:

Suzanne Cannon: Oh, it's really easy.

899

:

The first thing I can do is

find our website is vet billing.

900

:

com.

901

:

So it's really easy to remember.

902

:

And you can explore the website.

903

:

We work with non profits as

well as for profit clinics, too.

904

:

So they can explore the website.

905

:

There's a form that they can

submit, request more information.

906

:

They can schedule a demo so they can

actually see how the platform works

907

:

and what it looks like to set up

contracts and, and things like that.

908

:

And then we're also

active on social media.

909

:

So we have accounts on Facebook,

Instagram, and LinkedIn.

910

:

And we do a lot of, like, educational type

of content, for example, things about

911

:

credit invisibility, credit inequality,

the value of financial triage, putting

912

:

some kind of financial triage system in

place so that you can match clients with

913

:

the payment solution that is going to

be most appropriate for them in whatever

914

:

financial situation they're, they're, In,

um, human hospitals do this, do financial

915

:

triage, and it helps them know from sort

of the get go where this client is likely

916

:

going to be and whether they can use, um,

they can pay in full, whether they are

917

:

going to need support from a traditional

financing system, whether they're going to

918

:

need an in house option or whether they're

going to need charitable assistance.

919

:

So it just sort of helps

you conceptualize that.

920

:

One of the things we have talked about

on our social media is whether or not

921

:

your clinic has clients like ALICE.

922

:

Do you know about ALICE?

923

:

Have you met ALICE?

924

:

I have not.

925

:

So ALICE is actually an acronym for Asset

Limited Income Constrained and Employed.

926

:

Asset Limited Income

Constrained and EmpLoyed.

927

:

So an Alice client, we'll

just call her Alice.

928

:

So I created an Alice icon on

one of our social media posts.

929

:

So Alice earns income that exceeds

federal poverty level, but she still

930

:

struggles to meet basic expenses.

931

:

Um, Alice and clients that are

like Alice come from all races,

932

:

ages, ethnicities, and abilities.

933

:

But...

934

:

Households of color are

disproportionately A.

935

:

L.

936

:

I.

937

:

C.

938

:

E.

939

:

clients, if you are A.

940

:

L.

941

:

I.

942

:

C.

943

:

E., you most likely live paycheck to

paycheck, you probably work two or more

944

:

jobs, and it's likely that you have a

family member or members that need care

945

:

and assistance that you're providing.

946

:

And the other thing for really bringing

this home is that we all probably know

947

:

an Alice, whether we realize it or not.

948

:

They're in our lives or we work with them,

we know them, maybe they're our friends.

949

:

So, when Alice comes into your clinic,

she's going to be the one that's most

950

:

likely to need an accessible option for

paying over time for veterinary care.

951

:

And she's not likely to qualify

for traditional financing,

952

:

, because of her situation.

953

:

, but what we like to tell people

is that you can help Alice.

954

:

without giving away services or sending

her off with a list of charities and

955

:

saying, you know, here, you know, go find

this, that vet billing is ideally suited

956

:

for helping clients like Alice that fall

in that area where charitable assistance

957

:

isn't really ideal, but they're not going

to qualify for traditional financing.

958

:

I learned about Alice actually from

Another veterinarian that wrote

959

:

about this and the acronym ALICE was

developed by United Way of New Jersey.

960

:

So I went and looked into the

information they had on Alice.

961

:

So they have all sorts of

programs to help Alice clients.

962

:

So again, asset limited income

constrained, but employed, and

963

:

that describes a lot of people.

964

:

So that was one thing I really wanted

to mention because I'm sure you

965

:

work with a lot of Alice clients.

966

:

DrG: Yeah, I do.

967

:

And I mean, just

listening to that, I know.

968

:

times in my life where I

have been Alice, right?

969

:

Even when I was in school and I had

a job, but I was in school, so it

970

:

was difficult to, to make ends meet.

971

:

And I had a cat, so I was very lucky that

my cat never needed any emergency care,

972

:

but had my cat needed emergency care at

that time, it would have been, it would

973

:

have been very difficult for me to, to

have given him the care that he needed.

974

:

So, but, but I would have

been able to arrange something

975

:

because I did have a job.

976

:

So I would have been able to pay.

977

:

I just would not have been

able to pay everything at once.

978

:

And I think about even, veterinary

personnel, like veterinary

979

:

technicians, they're professionals.

980

:

And they make decent money, but I

know a lot of veterinary technicians

981

:

that could not afford bills at the

veterinary clinics that they work at.

982

:

And I don't think that any

veterinarian is going to say that

983

:

their veterinary technician should

not have a dog or a cat, right?

984

:

That they're, you know, if you

can't afford it, you can't have it.

985

:

Uh, but yet we do have some veterinary

technicians and assistants, uh,

986

:

that come to our clinic because

we are, more affordable, even with

987

:

their discounts and everything else.

988

:

Unfortunately, they can't,

they can't afford it.

989

:

So, and the concept of affordability

is a little bit different from one

990

:

place to another, and we just have

to eliminate that judgmental idea

991

:

that if somebody can't afford an

animal, they shouldn't have it.

992

:

Also, there are the vast majority

of animals go through life without

993

:

needing emergency care, without needing

thousands and thousands of dollars.

994

:

So are we going to tell everybody

that cannot afford an emergency bill

995

:

that they shouldn't have an animal

just in the case that they would have

996

:

to, need that that emergency money?

997

:

Suzanne Cannon: I agree.

998

:

I mean, that's like saying, um, you know.

999

:

You manage to take good care

of your animal until they're

:

01:03:24,774 --> 01:03:26,134

five or six years old.

:

01:03:26,494 --> 01:03:30,374

And then at five or six, this really

happened to a family that I worked with.

:

01:03:30,864 --> 01:03:34,484

Um, you notice one day that

suddenly your dog can't pee.

:

01:03:35,663 --> 01:03:36,694

Okay, what's going on?

:

01:03:36,704 --> 01:03:39,934

And that she seems lethargic

and like she doesn't feel well.

:

01:03:40,534 --> 01:03:41,464

And it's a Sunday.

:

01:03:42,024 --> 01:03:45,704

So the only option you have is you're

very worried because this is an emotional

:

01:03:45,704 --> 01:03:50,434

support animal, say for you, you're on

SSDI, your husband has a traumatic brain

:

01:03:50,434 --> 01:03:52,894

injury, again, this comes from real life.

:

01:03:53,614 --> 01:03:58,934

You go to the emergency, and you spend

nearly 1, 000 in diagnostics to find out

:

01:03:58,944 --> 01:04:03,254

that the dog has bladder stones and that

there's a stone blocking the urethra.

:

01:04:04,264 --> 01:04:12,214

And then the second estimate that you

get to treat that Is 7, 000 and there

:

01:04:12,214 --> 01:04:14,984

is just no way, , that you can do that.

:

01:04:15,604 --> 01:04:19,764

So I, this was a family that I actually

guided through getting charitable

:

01:04:19,804 --> 01:04:26,504

assistance, but should we have told that

family, you shouldn't have had that dog

:

01:04:26,514 --> 01:04:32,184

all along, even though he's so important

to your, your husband who was a veteran

:

01:04:32,184 --> 01:04:34,144

and had a traumatic brain injury.

:

01:04:34,529 --> 01:04:36,209

Um, and so important to your family.

:

01:04:36,469 --> 01:04:40,799

She's been receiving veterinary care,

preventive veterinary care all along.

:

01:04:41,189 --> 01:04:46,169

We all know that bladder stones can not

have any symptoms until there's a bladder

:

01:04:46,169 --> 01:04:50,239

infection or until there's a blockage

and it just, like, kind of happens.

:

01:04:50,839 --> 01:04:54,159

And, you know, if you're going to

your regular exams, you're not getting

:

01:04:54,529 --> 01:04:57,549

radiographs of the bladder to see

if there's stones and you're not

:

01:04:57,549 --> 01:05:00,169

gonna, you know, if there's not a

problem, you're not gonna bring it up.

:

01:05:00,934 --> 01:05:02,194

So it suddenly happened.

:

01:05:02,194 --> 01:05:06,474

So all along this dog has been

well cared for and well loved, but

:

01:05:06,534 --> 01:05:10,834

because of a 7, 000 estimate, we

want to tell them you shouldn't have

:

01:05:10,834 --> 01:05:12,654

had that dog in the first place.

:

01:05:13,194 --> 01:05:15,844

Like you're saying, it

doesn't make any sense.

:

01:05:15,844 --> 01:05:22,714

It's very reductionist and very short

sighted and There's no nuance in that

:

01:05:22,714 --> 01:05:26,674

sort of statement, and every situation

is different, and I would hate to see

:

01:05:26,694 --> 01:05:31,904

people deprived of the companionship

of animals because of that reason.

:

01:05:32,394 --> 01:05:33,788

Yeah, because of the what if.

:

01:05:34,579 --> 01:05:38,409

Yes, because we don't know, we don't

know what we're signing on for when we

:

01:05:38,999 --> 01:05:42,589

bring them home as an eight week old

puppy, like when I got my miniature

:

01:05:42,589 --> 01:05:46,949

Schnauzer Finch, but I have ever imagined

my wildest dreams that he would end up

:

01:05:46,949 --> 01:05:49,079

suddenly paralyzed at the age of five.

:

01:05:49,899 --> 01:05:52,209

There was no, that was

not even on my radar.

:

01:05:52,494 --> 01:05:56,644

Even with all the things I've learned

from working with vets for 10 years and

:

01:05:56,944 --> 01:06:00,944

all the journals that come to my house,

even though I'm not a veterinarian, and

:

01:06:00,954 --> 01:06:05,274

all of these horrible cases that I read

out of curiosity and then go, Oh, stop it.

:

01:06:05,274 --> 01:06:09,324

Now, now, now your dog has any symptom

you're gonna think it's this weird case.

:

01:06:10,024 --> 01:06:13,834

But even with knowing all that,

I, I had no, I had never heard

:

01:06:13,834 --> 01:06:15,384

of a Schnauzer that had this.

:

01:06:15,574 --> 01:06:18,124

I now know that there are others, but...

:

01:06:19,194 --> 01:06:20,744

Not totally unexpected.

:

01:06:20,754 --> 01:06:23,104

You don't get that puppy and go,

Oh, I wonder what will happen if

:

01:06:23,104 --> 01:06:25,924

in five years they're paralyzed and

they need a wheelchair and I need

:

01:06:25,924 --> 01:06:27,714

to learn how to express a bladder.

:

01:06:28,904 --> 01:06:33,694

You, you sign on for what it is,

you know, that's what commitment is.

:

01:06:34,468 --> 01:06:38,948

DrG: So for pet owners, , is there a way

for pet owners to find out if there are

:

01:06:38,978 --> 01:06:41,758

clinics that are, uh, with vet billing?

:

01:06:42,708 --> 01:06:45,708

Suzanne Cannon: Yeah, we do have

a directory page on our website.

:

01:06:45,968 --> 01:06:50,498

So you could just type in to

Google, uh, vet billing, find a vet.

:

01:06:51,013 --> 01:06:54,823

Um, or go straight to our website and

there's a participating veterinarians

:

01:06:54,843 --> 01:07:00,193

page so you can search by city and

state or zip code to see if there are

:

01:07:00,193 --> 01:07:05,333

vets like within 50 miles or 100 miles

or, you know, however far from you.

:

01:07:05,823 --> 01:07:09,443

And if you, if your vet isn't on

there, there's a form that you can

:

01:07:09,443 --> 01:07:15,263

submit to us to recommend that your

vet consider a partnership and then

:

01:07:15,263 --> 01:07:20,763

we will certainly reach out to them and

provide information and we do actually

:

01:07:20,783 --> 01:07:22,483

on board a number of clinics that way.

:

01:07:22,483 --> 01:07:25,053

It comes from a recommendation

from their own client that

:

01:07:25,053 --> 01:07:26,243

would like them to participate.

:

01:07:27,173 --> 01:07:33,123

So, um, they can of course always call

us, um, there's an 800 number on our

:

01:07:33,123 --> 01:07:37,333

website and you can call and talk to our

team because we'll have the most updated

:

01:07:37,333 --> 01:07:43,083

information about, um, who participates as

a vet billing partner because we're adding

:

01:07:43,103 --> 01:07:48,513

new clinics all the time and sometimes

there's a lag between when we add them

:

01:07:48,513 --> 01:07:50,323

and when they show up on our website.

:

01:07:51,326 --> 01:07:53,146

DrG: This has been

really great information.

:

01:07:53,146 --> 01:07:57,096

It ties into the topics that we have

talked about the last few weeks, as

:

01:07:57,096 --> 01:08:00,876

far as the importance of One Health,

affordable and accessible care, decreasing

:

01:08:01,136 --> 01:08:03,666

shelter euthanasias by decreasing intake.

:

01:08:03,976 --> 01:08:06,946

So anybody that's listening, vetbilling.

:

01:08:06,946 --> 01:08:10,836

com, you know, if you're a veterinarian,

part of the veterinary team.

:

01:08:11,171 --> 01:08:13,981

Look into it because I think

it's going to help your, your

:

01:08:13,991 --> 01:08:15,381

practice and help your clients.

:

01:08:15,381 --> 01:08:19,411

If you're a client, then, you know,

you can, you can mention it to your

:

01:08:19,411 --> 01:08:24,671

veterinarian so that hopefully they

can give more options for people to, to

:

01:08:24,671 --> 01:08:31,551

afford care because it's pet ownership

should not rely on people's financials.

:

01:08:31,631 --> 01:08:35,201

It should rely on the ability to give

an animal a good home, especially

:

01:08:35,201 --> 01:08:37,031

with the overpopulation and the.

:

01:08:37,551 --> 01:08:41,931

And the great value that animals have

to people, the human animal bond . So

:

01:08:41,991 --> 01:08:45,201

thank you, Suzanne, so much for being

part of this conversation for taking

:

01:08:45,201 --> 01:08:49,381

the time to go over your guys's history

and why your company and thank you

:

01:08:49,381 --> 01:08:53,091

so much for having a company that

offers the services to individuals.

:

01:08:53,091 --> 01:08:53,810

Suzanne Cannon: Thank you.

:

01:08:54,291 --> 01:08:55,441

Thank you for inviting me on.

:

01:08:55,470 --> 01:08:57,381

I can talk to you for probably four

:

01:08:57,381 --> 01:08:57,600

hours.

:

01:08:58,640 --> 01:08:58,711

Yeah,

:

01:08:59,390 --> 01:09:01,691

DrG: this is, this is a

never ending conversation.

:

01:09:01,691 --> 01:09:04,661

I'm sure that we'll probably

have other, other topics to talk

:

01:09:04,661 --> 01:09:06,481

to as we, as we move forward.

:

01:09:06,890 --> 01:09:10,850

So thank you so much for being part

of this and to everybody out there.

:

01:09:10,861 --> 01:09:12,591

Thanks for listening

and thanks for caring.

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About the Podcast

The Animal Welfare Junction
Veterinary Forensics
The Animal Welfare Junction is a podcast developed to bring awareness to different topics in animal welfare. The host, Michelle Gonzalez (Dr. G) is a veterinarian who provides affordable veterinary care in the State of Ohio, and also a Forensic Veterinarian helping with the investigation and prosecution of cases of animal cruelty and neglect.
The topics presented are based on the experiences of Dr. G and our guests and include discussions about real cases, humane projects, and legal issues that affect animals and the community. Due to the nature of the discussion, listener discretion is advised as some topics may be too strong for some listeners.

About your host

Profile picture for Alba Gonzalez

Alba Gonzalez

Michelle González (DrG) was born and raised in Puerto Rico. Her passion growing up was to become a veterinarian. She obtained a B.S. in Zoology at Michigan State University and the Doctor of Veterinary Medicine degree at The Ohio State University, followed by a 1-yr Internship in Medicine, Surgery, Emergency and Critical Care at the University of Missouri-Columbia. In 2006 she founded the Rascal Unit, a mobile clinic offering accesible and affordable sterilization, and wellness services throughout the State of Ohio.
Dr. G is involved in many aspects of companion veterinary medicine including education, shelter assistance and help to animals that are victims of cruelty and neglect.
DrG completed a Master’s degree in Veterinary Forensics from the University of Florida and a Master’s in Forensic Psychology from Southern New Hampshire University. She is currently enrolled at the University of Florida Forensic Science program. She assists Humane organizations and animal control officers in the investigation, evaluation, and prosecution of cases of animal cruelty and neglect.