NURSE CLINICS CHARGE FEE!

RE: NURSE CLINICS CHARGE FEE!

ellynoonoo — Mon, 02 Sep 2019 18:25:18 GMT

I work for a corporate and we charge a lower fee for anal glands nail clip etc, I am a consult nurse and I dont charge for advice as per practice protocol but any tests/procedures I do are chargeable. Our Rvns administer 2nd and 3rd vaccines which are charged at 1st vacc with vet. we are curently running geriatric clinics which are £50+ these are done by Rvn. We Also do hpc checks for clients who are on the plan and these are included as part of the package.

RE: NURSE CLINICS CHARGE FEE!

Robyn — Mon, 26 Aug 2019 16:54:38 GMT

We don't charge unless I do something - i.e. my time for an advice consult is free, but I charge for nail clipping, anal glands, giving medication etc, anywhere from £5-15 depending on the thing. Puppy and kitten wormings are free except for the medication. I don't do medical consults (diabetes or senior checks) so this works just fine for us, as any health checks are automatically booked for the vet, and we have 3 vets to my one nurse so consult balances aren't so bad either!

I think the big thing is really to have a very strict protocol in place. If the receptionists aren't sure what does and doesn't get charged for, that where things get difficult and you lose client trust - and since I really focus my consults on building that relationship since I have the time to do so, that's a big thing for me! Make sure any pricing structure you put in place is really easy to understand, really concrete, and that owners are made aware at the phonecall - even just a top end cost for any consult you could do if they're not 100% on what needs done.

That definitely goes back to what you're saying Alison - I don't focus my consults on generating revenue in themselves so much as really building that relationship with my clients, but that does help build revenue in itself when something does happen!

RE: NURSE CLINICS CHARGE FEE!

Alison Clare Hickman — Sat, 24 Aug 2019 00:30:30 GMT

apache

I agree £20 really only covered equipment/materials used, with a small contribution for my time. However a 'bigger picture' of overall practice income was taken. The consults were seen as a gateway to VS referrals where the greater income was generated from fees for consulting/tests/meds and so on...

Overall the practice benefitted financially and, moreover, the nurse consult attracted more owners with senior pets to come forward than seen before. A 'focussed feeder' introduction if you will.

Importantly, those pets identified as of concern got a referral for a VS DX and given TX earlier. Sometimes this was just as a result of the answers to my Questionnaire... straight VS referral without any more time spent or tests undergone at nurse consult.

We know that owners can be unaware that their pet's symptoms are signalling a disease process... So...a reasonably priced nurse consult encouraged the owner to bring their companion in for a Senior 'MOT'. We might not like it but owners do want value for money, (I'm in Yorkshire and that's a given!!). Particularly if they don't think there's anything much wrong with their pet ("just getting old").

Fur example (haha, a typo but I'll leave it as it fits!) a cat described as "a grumpy old man" was DX with chronic arthritic changes. The patient was in pain and dealing with it as only a cat knows how... one vet referral later (with the tests etc as appropriate) and we had cat on supportive meds and a very much more comfortable life. Plus a happier owner pleased they'd got a "kitten-like pal" back...

I should love it if was an accepted normal in every practice that nurse consulting generated income on a stand alone basis, as do vet consults currently. However, that's going to take time to evolve. In the meanwhile, and potentially as a rule of thumb, I do believe that a team effort (sharing is caring ) can be beneficial to a practice - both financially and for career satisfaction purposes. Yes?

Hope this helps!!

RE: NURSE CLINICS CHARGE FEE!

Sal the 1st — Fri, 23 Aug 2019 23:00:50 GMT

appointments for nurse eag and nail clips were purposely priced less than the vets to encourage clients to use the nurse for these as the vet hated doing them and ' didn't spend 6 years qualifying so he could squeeze a dogs arse'. Truth was I didn't like them either but that was the deal when I asked if I could start charging for nurse appointments everything he didn't like doing including microchips that a nurse was capable of came in my direction because I was always a few quid cheaper and his time was more valuable than mine - at least this way I got to make a charge for what I was doing (not just bums and nails) and could prove my worth with a visible financial income. I don't know about anybody else but I used to find it pretty demoralising that my time wasn't worth anything.

The biggest plus point for me was that now I was charging for my time people valued it more and I got less of the 'can you just trim a bit of chewing gum out of my labradoodles coat the woman at the groomers wants to charge me - but do it careful I don't want it to look horrible , oh and he nips a bit when you get the scissors near him' or 'the rabbit is a bit mucky underneath and i'm worried about maggots can you give him a quick clean' and they learnt how to keep their rabbit clean and discovered that actually the groomer was cheaper than I was.

From that I was able to develop my own clinics for diabetes, golden oldies, mobility,weight etc and took on most of the routine recheck bloods (thyroid, diabetic, kidney cats, epileptics etc) BP checks, STT and my job suddenly became much more interesting and worthwhile. I never diagnosed I always passed to the vet anything that needed to be sent down the corridor, and I did pick up a few . I felt that I had a little respect from the vet at last (I probably didn't but sometimes you have to kid yourself ) and we did seem to work together better.

RE: NURSE CLINICS CHARGE FEE!

apache — Fri, 23 Aug 2019 21:49:06 GMT

I'm not sure I have very much useful information to contribute but if I can make a couple of points?

1. Sal the 1st there is no way in my practice I will charge the same procedure at a lesser amount because it's done by a nurse. The tricky bit is getting the client in front of the right professional.

2. Alison Clare Hickman I love the idea of your senior clinics, but that is SO MUCH work for £20. Massively underselling yourself.

I don't know the solution but I'm sure it's not doing stuff for free. Whilst I agree a nurse consultation maybe should be less than a vet consult (as nurses can't do as much), is it likely to be a longer appointment? The cost of providing a nurse is very similar to a new grad so it can't be that much less. We have 1st, 2nd and subsequent consult fees for vets, I think the same fee as a vet subsequent would be fair. Fixed price procedures (EAG, clip nails, microchip) would cost the same whoever did them.

RE: NURSE CLINICS CHARGE FEE!

Sal the 1st — Fri, 23 Aug 2019 19:10:58 GMT

I used to work for one of the corporates and nurse appointments were always free.

The problem with that was appointments that really should have been booked for a vet were often booked for a nurse. It became ridiculous in that nurse appointments were rammed full every 5 minutes whilst the vet appointments were half empty and many times what was brought into me I had to go find a vet anyway - which then resulted in moaning clients who didn't want to pay a consult fee because they had booked in for a free appointment.

So we started charging for some of the nurse appointments at a reduced cost compared to that of a vet appointment ie eag with vet £18 , eag with nurse £12 nail clip with vet £15 and with nurse £12. Result was the appointments diary was now a bit more equal and people who needed to see a vet did book into see one. The other thing it highlighted was that nurses are actually pretty good at earning their keep from consults

RE: NURSE CLINICS CHARGE FEE!

Alison Clare Hickman — Fri, 23 Aug 2019 15:54:39 GMT

Yes success. I set up a Senior Health Clinic and charged £20 - this included a urine test (dog and cat - (uripet or Katkor), and was a.dipstick and microscopy tests, blood test (skin prick for glucose), schirmer tear test(dog) and BP (cats). A full hx.taken (pre consult questionnaire issued). Referral to vet on findings to a separate vet consult with standard fees and for further tests at full price.

I've still got the paperwork if you're interested in any of it?

I also set up behavioural and desensitisation clinics where the first 5 sessions were fee free but thereafter if more work was required, a consult fee was expected. I initially thought the clients would disappear after the first 5... not so. They were bonded to the practice and the support provided. So long as it was made absolutely clear from the start what the plan was for payment, no problems. If I was setting them up now I'd charge from the start and refer upwards sooner to specialised practitioners.

I say a definite yes to charging for our work!!