See Your Client As You

Clients should be first, staff second, owners third, and communities fourth, so says Robert Waterman who with Tom Peters authored the 1981 management bible, In Search of Excellence. It has been over a quarter century since this book's research was done, but most of the principles remain valid today, as well as copied by many of our "current experts" speaking from the podium. Organizations that stay close to their consumers stay focused on what is important.

The Shrinking Caddy

In 1984, General Motors listened to their engineers and Congress, then shrank the Cadillac by two feet. The sales stalled, forcing GM to rethink their car design program. They met with five groups of Caddy owners, 500 owners per group, over a three-year period. They put these people behind the wheel of prototypes and let them play. The result was the 1988 Cadillac DeVille and Fleetwood which cruised into showrooms with subtle tail fins, nine extra inches, fender skirts, and a 36 percent sales growth over a year earlier. The Caddy "gunboat" was back and overall volume had grown for the first time in five years.

The tough lesson was driven home: pay great attention to the consumer and know their real desires. The auto industry focused on gasoline prices early in this millennium, and decided the American consumer wanted a smaller, more fuel effective, vehicle; sorry Charlie, they still wanted an SUV, just make it more fuel efficient. In Australia where they pay $1.40 a liter for gasoline, the small ute (Ranchero style) is popular, as is smaller SUVs, and you see more station wagons instead of the larger SUVs. Forum Corporation, a Boston-based consulting firm that specializes in consumer service, has shown that keeping a customer typically costs only one-fifth as much as acquiring a new one.

Staying Close

As veterinarians, we have learned what is best for the animal. We care, but often we do not listen. I have spoken often of patient advocacy, the concept of speaking to the client on behalf of the pet's welfare. This carries with it the obligation to listen to the replies. We must think of ourselves as the client if we want to communicate.

The art of communication, and staying close to the client, is an art of caring. There are a few basic rules to follow to make it happen:

 Always remember, they were never 'our clients', we are 'their veterinarian'. Clients are the appreciating assets of our business model.

 The fact in most communities is that clients are not dependent upon a single practice -- we are dependent on building the client bond to our practice.

 Respond quickly and directly. Answer their concern/question first. Be ready to acknowledge 'perceived bad service' did occur.

 Match their rate of speech in a language they understand. Ensure your body language and voice tone match the message you are stating.

 Make every staff member aware of your practice dream and ensure everyone sends the same message. There is no client worse than no clients.

 Monitor service internally to see that your staff treats one another like you want clients treated. You can't afford any on the practice team to have a bad day.

 Listen to everyone in your client contact chain and respect internal thinking. You can't respond until you know the perceived message.

 Reduce the barrier of professional detachment so clients feel free to talk to you. Learn to act rather than react.

 Stay in touch after the healthcare episode. Caring should not stop with the "cure."

Checks and Balance

Northwestern Mutual Insurance relies on their clients to "calibrate" the company headquarters annually. Since 1907, five policy owners, recommended by field agents, are brought in annually to be demanding, no-nonsense parents and tell the staff what it is they are doing right and wrong. They spend five days interviewing officers, examining documents, snooping for problems, and watching the bureaucracy. Nothing and no one is off limits. The company prints the group's review unedited in its annual report. Would you be willing to put your practice up to that level of review? If you saw your clients as you, it should be a welcomed service.

Northwestern has a 95 percent renewal rate, the industry's highest retention rate. One of the key reasons is the annual on-site review by the policy holder group. Tom Moraghan of Domino's Pizza has been getting close to his customers by paying 10,000 families to be "mystery customers." Each family agrees to buy 23 pizzas from Domino's throughout the year to evaluate quality and service. A manager's bonus compensation is partly based on those scores. The regional offices rate the corporate Domino's staff monthly on the quality of service they receive, and the monthly bonuses paid to every full-time home office worker is based in part on the evaluations.

Some veterinary practices use client surveys (sample follows) and become discouraged by the unremarkable replies. This is due in part to the sample group. Our clients like us and don't want to hurt our feelings. They "understand" our long hours and harried appearance. They know mistakes happen and forgive us our errors without our having to ask. But what of our new clients or the clients picking up their records because they are leaving? If we really cared, we would interview these two populations of clients for their opinions. Review the list of potential target questions of the survey to develop ideas for your own practice. We need to believe what they tell us since perceptions are "fact" for those that hold them.

Sample New Client Questions

Departing Client Questions:

 What one thing/service/person encountered at this hospital was important enough to you that you'll look for it at your next veterinarian's practice?
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 What one thing did you encounter at this practice that you never what to experience again?
__________________________________________________________________________
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Please prioritize the reasons you initially selected this practice, then list your current reason(s) for leaving (1 most, 5 least concern):

The text, Building The Successful Veterinary Practice: Innovation & Creativity (Volume 3), Blackwell Publishing, we promote the concept of 20 second surveys, looking at one area of the practice each month. Long surveys are counterproductive and have far less response validity. Other questions samples are provided in that same reference.

The alternative to the written client survey is the "Council of Clients" approach. This group is comprised of those who paid the most in the previous quarter. If building an improved cat position in your community, you may want to build a Council of Clients who are multiple cat owners. Councils can change each quarter, or there may be multiple Councils targeting various aspects of the practice initiatives, maybe even one a month, but never repeating a Council member invite within a 90 day period. You need at least ten households represented, preferably twelve, at an after-dinner dessert function, so you need to invite about double what you expect to attend. The reason: to improve the community support by this practice. There only needs to be two or three from the practice attending, all with thick skin, allowing the clients to out number the team. Ask positive questions before any negative questions; never react to a client comment/response with an excuse! There is no defense against perceptions, so please do not justify at this "council of clients" survey time. You can ask for their opinion on how to convey the information. For example, with dentals:

Client - "The dental prices are too high, they are twice what I pay for my kids!"

Practice - "You are right. Children do not require anesthesia but pets do, for their safety as well as ours. As an anesthetic patient, we must do pre-anesthetic laboratory screens and physical examinations, and post anesthetic recovery concerns. For the entry level, early dental cleaning patient, our prices are very close to what you pay your dentist, and for those with pet insurance with wellness riders, after reimbursement, our cost is less than your dental rates. What would be the best way to let clients know of the care we do provide in the process of a dental procedure?"

The "Council of Clients" is an indicator, not the final word. If the same problem comes up two quarters in a row, it should be addressed quickly. Actions stemming from the "council of clients" input should be published in some form so they and your other clients can see what you are doing to better serve the community. The concept of asking a client how your practice is doing is very scary, but it has worked for many industries. They are the purchasers of your services. This way, you can really meet their needs, especially if you ask, "What else should we be offering you as a pet owner or us as a healthcare facility?"

In the short run, client perceptions can harm the ego, but in the long run they can improve the practice. A practice that responds to the client will grow and develop as a service to the community. A practice that makes excuses and "explains away" the perceptions of the clients is doomed to stagnation. The choice in the next decade is yours. Bloom or stagnate. You decide which end of the olfactory spectrum you would like to be on.