“How much is a ___________?” Creating relational vs. transactional interactions


Frequently, when answering phone calls veterinary teams are asked:

“How much do you charge for…?” The caller can be asking for something as routine as pricing for vaccinations, or they may be inquiring about a procedure, like dentistry or declawing, which opens the door for a much deeper conversation. How do you or your staff respond? What answer best conveys the value of the services you provide or opens a dialogue to educate on a controversial topic? Two clear solutions exist: evaluation of services offered and how those services are presented by your team to clients/prospective clients.

Does Your Hospital Routinely Evaluate the Services It Offers?

As a practice owner, I critically examined how and why I offered services on an annual basis. There were procedures that were “purposefully abandoned” when they failed to meet the criteria listed below:

  • Does the service offered fit with our culture? In other words, do we feel good about performing this service?
  • Does the service offered provide a clear benefit to the client and the patient?
  • Is the service offered in a manner that meets or exceeds best practices medicine?
  • Does the service offered make good financial sense?

The result of this exercise allowed my hospital to focus on meeting client needs as well as allowing my team to be true to their collective values. Due to the positive outcomes that my hospital experienced, I routinely undertake this exercise with my consulting clients.

How Does Your Team Convey the Value of the Services You Offer?

One of the services that I offer as part of my consulting practice is a competitive market analysis. This in part involves calling practices that are either geographically or philosophically similar to my client’s hospital. While most hospitals score very well on their initial phone greeting, the quality of the dialog quickly deteriorates. The primary challenge is that the customer service representative (CSR) works to establish a transactional as opposed to a relational interaction.

A transactional interaction is devoid of a personal connection and is characterized by the caller asking a question, and the CSR replying with the price of the services. There is no attempt to establish common ground with the caller and typically no attempt to schedule an appointment. The caller is left feeling underwhelmed and unimpressed.

A relational interaction is one in which the CSR works to establish rapport with the caller. The caller feels that the CSR and by extension the hospital, truly cares about them and their pet. They feel validated in their decision to call this hospital and experience a sense of connection. They are motivated to schedule an appointment. 

A Relational Interaction About Dentistry

The CSR asks for the caller’s name and uses it in the conversation:

“Mrs. Smith, thanks for calling ABC Animal Hospital today. How may I help you?”

The CSR asks about the pet and further personalizes the conversation using the pet’s name:

“Mrs. Smith, we love cats and Leo sounds like a character. I look forward to meeting both of you.”

The CSR explains services in terms of the value that they bring to the client and the pet, not what they cost:

“Mrs. Smith, I am happy that you called today asking about dental services for Leo. At ABC Animal Hospital our dental treatments are comprehensive in nature. The dental procedure starts with a complete blood panel evaluation, so that our doctors can individually tailor the anesthesia to Leo’s needs. It includes a complete pre-anesthetic physical examination as well as a veterinary technician dedicated to Leo for the entire day, including monitoring him while he is anesthetized and during the recovery period and personalized anesthetic protocols. A second veterinary technician will act as his dental hygienist, cleaning and polishing his teeth and taking x-rays of all of his teeth. She will also record any abnormalities seen on a dental chart. The doctor will evaluate the x-rays and examine Leo’s mouth. If there are any concerns about problems with his teeth or gums, the doctor will call and discuss recommendations with you.

Leo will go home later in the day during a scheduled discharge appointment, where we will review the dental chart and x-rays with you. We will also discuss any special care Leo needs. What questions do you have for me, Mrs. Smith?”

The CSR asks for a commitment:

“Mrs. Smith, we would love to help Leo live a long and healthy life. We can schedule Leo for a new patient examination today at 3:00 PM. How does that sound?”

As veterinary professionals, we face increasing competition for our client’s attention and resources. I believe that the most important position, and most difficult, is that of your front desk team.

They are the gatekeepers of your practice and their communication skills and style are the first impression of your hospital that a prospective client will form. Invest in their training by providing guidelines and tools, and continue to train your entire health care team to interact with clients in a relational manner. When teams are taught to interact with clients in a relational manner, outcomes include increased client satisfaction and client bonding as well as enhanced workplace happiness.

A Relational Interaction About Declawing

The practice of surgically declawing cats has become a controversial topic. Veterinarians are faced with clients that threaten relinquishment or abandonment of cats if the surgery is not performed. An opposing viewpoint is offered by anti-declawing activists who feel the procedure causes mutilation of the cat and is inhumane. In some instances, these activists, passionate about their cause, have become very aggressive toward veterinary hospitals that provide declawing services.

As an example, in August, 2015 the AVMF’s “America’s Favorite Veterinarian” contest was abruptly cancelled due to cyberbullying of competition finalists by some anti-declawing activists. The cyberbullying included “the circulation of fraudulent negative advertisements, negative reviews, and threatening phone calls” according to a press release by the American Veterinary Medical Foundation. More recently, veterinarians in the Salt Lake City area have had their hospitals actively picketed by some anti-declawing activists. These hospitals were targeted after activists called to price shop declaw services; when a price was quoted, the activists appeared the next day to picket at the hospital locations.

How do hospitals avoid becoming the target of unwanted and unwelcome publicity? Relational interactions are a key strategy in this type of situation. By training your front desk team to promote the value of the service, as opposed to quoting a price, you can move the focus of the conversation from controversy to education. Formulate a scripted statement and train every team member that answers the phone about the importance of following the protocol. Here’s an example.

The CSR asks for the caller’s name and uses it in the conversation:

“Mrs. Brown, thanks for calling ABC Animal Hospital today. I understand that you are interested in having your cat, Puzzles, declawed because your husband is on blood thinners and you are afraid that Puzzles will scratch him and cause problems for your husband. The decision to declaw Puzzles is a complex one and will require a frank discussion with one of our doctors. May I schedule an appointment for you and Puzzles?”

If the caller has behavioral concerns, a relational statement should utilize some effective communication tools, bolded in the example below:

“Wow, Mrs. Brown, it must be distressing to have Puzzles scratch your new sofa (empathy statement). I understand that you are calling today to schedule an appointment for a declaw surgery for Puzzles (reflective listening statement). The decision to declaw Puzzles is a complex one and will require a frank discussion with one of our doctors. May I schedule an appointment for you and Puzzles?”

If Mrs. Brown then asks why it is a complex conversation, the CSR could reply:

“Mrs. Brown, there are risks and benefits to any surgical procedure. Additionally, there are alternatives to declawing surgery. May I schedule an appointment for you to fully explore all options for Puzzles with the doctor?”

If there is continued pressure for a price quote:

“Mrs. Brown, I am sorry that I am unable to quote a price for you. As I have explained, this is a complicated discussion and is one that the doctors have requested to have with clients.”

A possible outcome might be the direct question “So you do perform declaws at your hospital?” In this case, a reply could be:

“Mrs. Brown, that decision is between the veterinarian and the client and is based on the medical needs of the patient. May I schedule an appointment for you and Puzzles?”