Relationship-Centered Care: Connecting with Clients to Meet the Needs of Their Pets
World Small Animal Veterinary Association World Congress Proceedings, 2013
Richard M. DeBowes, DVM, MS, DACVS
Inner Compass Leaders, Pullman, WA, USA

Veterinary practice today presents an interesting landscape. It is now extremely clear that veterinary medicine is a service business and that we must engage our clients in a way that promotes a level of trust, so that clients will be open and receptive to medical recommendations, offered to advance the wellbeing of their pet (or production animals).

The economic challenges of the past four years have circled the globe and presented new and additional business pressures for many veterinarians relative to the fiscally sound operation of their practices. Many veterinarians blame the economic downturn and slow recovery for the flat returns or declines in their business revenues during these interesting times. The Bayer Veterinary Care Usage study conducted in 2010 and 2011 lends credence to this view noting that 51% of practice report fewer visits and 42% of practice report reduced revenues. Several key elements were identified in this study including: the economic downturn, fragmentation of veterinary services, resistance by the feline sector (to seek veterinary services), use of the Internet to gain information, the perception that health care visits are unnecessary and the high (real or perceived) cost of healthcare. It's interesting to note that amongst the challenges enumerated, all but the economic downturn and fragmentation of service are issues that can be addressed through client education.

The veterinary profession across the United States and perhaps elsewhere, has not done a good job of educating our clients about the need for regular, thorough preventative health care for their animals, animals that they consider to be family members and in some cases, child surrogates. It is essential that veterinary health care teams engage in relationship centered, compliance driven care, designed to enhance the wellbeing and longevity of pets. That requires that we demonstrate (explain) the value of preventative health care to our clients so that their pets will live comfortably into their full genetic potential.

The truth is that there are many practices that are doing great medicine, harvesting great profits and enjoying the practice of medicine while others languish and even decline.

How can this be? I believe it all comes down to attitude. Attitude controls our thinking and our actions. By extension, attitude controls our commitment to a successful future, our focus, energy, and actions. My hope is to share with you, a series of ideas for you to consider implementing in your hospital so that you too, can have that "ideal" practice. There is however, a catch...you must be open to new ideas and willing to change what you do?

Most folks who are dissatisfied with the results of their practice efforts are inclined to continue focusing on the same goals, using the same methods, pursuing the same tasks and working harder than ever to achieve their desired end. The thinking is that "if I just work a little harder, this will all turn around". It's been said that doing the same thing over and over and expecting different results is the working definition of insanity.

This is paradigm paralysis in its most obvious form. It occurs when we allow our paradigm to become THE paradigm. As we become deeply vested in a given paradigm, our resistance to change increases. In fact, we are so vested in our current paradigm that we can't even envision a different paradigm. Folks stay locked on their known and comfortable but generally underwhelming operational track and as a result, their businesses languish.

The paradigm shift that must occur is that the appointment becomes a client-centered experience. Practices must shift from simply delivering a service or a product (many of which are available over the internet and large retail outlets) and deliver an experience. Health care teams must adopt an approach of under-promising and over-delivering on opportunities for "best care" in the most relational and bonded way possible.

It's easy to blame the economy but at the end of the day, it is patently true that the patient's health care needs do not wax and wane with the economy. Many will respond to suggestions of new approaches saying, "Yes... but you don't know my clients."... "My clients are different."..."My clients won't pay for that!" Those are common and completely understandable responses and they are offered by veterinarians around the world. However, where proactive approaches are undertaken to create a high value, high-bonding experience for the clients, practices are thriving. Given that so few veterinarians have actually surveyed their clients, employed focus groups and thoroughly explored what their clients truly want, practice owners and managers are left to draw conclusions from their daily (and largely paradigm constrained) interactions in their exam rooms and at their reception desks. All it takes to move to the next level, is a paradigm shift.

Consider how most clients feel about their pets? Have you ever asked a client how long they would like their pet to live? What do you suppose the answer would be? Forever! I get that answer 7 out of 10 times when I ask the question. Of course they know it's not possible. What the clients are telling us is that they love their pets and would like to keep them as integral, healthy, pain-free members of their families for as long as possible.

Knowing this (and believing it) is key. Appreciating that clients want your help, advice and recommendation on how to keep their pet as healthy as possible is central to future success. For this reason, it will be important to ensure that your practice focuses on keeping pets well instead of patching them up when they are sick or injured. I am not suggesting that we abandon interventional medicine ... I am after all, a surgeon! I am however, suggesting that your clients are not any different than you when it comes to health care. When you go to your physician, you want to hear that you are well and you want to hear what you need to be doing to remain well. There is not one of us who wants to hear that we have an incredibly interesting case of a hemo-lymphatic cancer, a most unusual form of cardiomyopathy or a very atypical demyelinating disease! Your clients will have the same perspective regarding their four legged, scaled or winged family member. They want to hear that their pets are well and they will be receptive to your informed recommendation on how to keep their pet well if it is delivered in a cogent, effective and relational way.

So what are some of the ways you can create an experience instead of an appointment?

First you have to begin to create a positive experience before the client arrives. How do clients hear about you and WHAT is it that they hear? Do you have a website? Is it easy to find and is it current? Is it easy to navigate (have you had folks test it for you)? Does it have pictures and clearly outline your services, core policies and allow for client feedback? Can clients schedule on-line appointments at your hospital through your site? Does it have answers to frequently asked medical questions, first aid tips and clearly explain how to get assistance with emergencies when your hospital practice is closed? Is it linked to social media so that folks can "like" you on Facebook, follow you on Twitter, and comment about your practice on YELP. Do you offer links to other key services such as trusted information sites, respected pet husbandry vendors, trainers, groomers, spas, and pet sitting/walking services? Are you making it easy for people to get what they need and want for their pet through their relationship with you?

Do you have a practice brochure? Is it current? As with your website, it should be assembled by a professional. Does it have lots of photos and clearly depict a warm, friendly, welcoming and highly competent practice? Does it truly project the image you wish to project? Have you had it evaluated by focus groups who will tell you what they think and feel after reviewing your materials?

Prior to my visit, would I receive a reminder call, an e-mail, a text message or a tweet reminding me that you look forward to seeing me at my 2PM appointment tomorrow? Why not? My dentist texted me three times about my last appointment, two weeks out, one week out, and the day before.

When I visit your practice, what will I see...litter in the car park? Dead or dying landscape features? Is the signage visible, current and eye catching? Is the signage accurate? Are there posted hours of operations and an emergency phone number or information on where to get help after hours? Are the currently employed principals listed on the sign? Is the facility well maintained or is it in need of repair, painting etc?

When I enter your hospital, is it neat, clean, uncluttered, quiet and odor free? Are the reception personnel friendly, engaging, and welcoming? Am I greeted by name? How about my pet... is s/he greeted by name? Is the seating comfortable and are the reading materials current? Are there educational materials or media available for me to review? Am I offered refreshments? Is there adequate space for people to spread out and reduce pet stress? Is there a cat reception area or adequate examination space to allow a feline client and patient to be shown to a room away from the canine clients?

As I interact with team members, how am I greeted, reassured, and updated? Would I know who does what in the hospital? How would I know that? Do you have a concierge service...someone I meet who could answer all my questions and with whom I may liaise after my appointment. Would everyone in the hospital (including the kennel staff who bring my pet out to me have a business card with their work contact information so that I can follow up if I have questions? Nothing in your hospital is more valuable than your people... celebrate their value, creativity and talent through acknowledgements including business cards and awards.

Does your practice have programs that target ideal weight maintenance, optimal dental health maintenance, parasite control, etc? Do you offer pre-purchase consultations for people seeking a pet but unsure of what sort of pet best meet their family situation and home environment?

Does your practice have a clean, quiet comfort room for those challenging discussions about serious diagnoses and prognoses, end of life issues where client may face those challenges in a more comfortable and supportive (less clinical) environment? Do you have healthy, trim clinic animals that greet clients and perhaps help soothe clients who are engaged in contemplating those difficult conversations?

Does your practice have a lending library for books on pets? Consider having a set of books about pets, pet care and husbandry. Include books such as those written that show the connection between people and pets and how our lives are enriched by our four footed friends. Consider giving every new pet owner a book as part of the VALUE of their first appointment with you. Sign it with a message of well wishes from your practice on their entry into pet parenthood! You will be shocked at the positive response. Remember to concentrate on providing VALUE to convert the traditional medical care appointment into a healthcare experience.

What sort of ongoing connection do you nurture amongst your client base? Do you have regular client education meetings, perhaps specifically targeted at your new clients or new pet owners? That could be a quarterly evening presentation at your practice or a local hotel or school on a subject of interest to them (behavior, nutrition, dental care, exercise, socialization) with refreshments and an opportunity for questions. Do you have an annual "open house" to promote your practice with tours, brochures, refreshments, and gifts or novelties that promote your practice? Most of your clients don't realize that your surgical suite is little different to that used by their physician. This is a wonderful opportunity to partner with your animal health industry representatives for support (to drive your business and theirs). Many times there may be samples or other promotional materials that your reps can provide.

Does your health care team make routine visits to the elementary schools in the region to promote veterinary medicine, pet safety and where appropriate veterinary careers as as well as biomedical research, food safety and public health? School visits provide an opportunity to promote our profession and safe interactions with animals while promoting your practice.

Do you have rewards for referrals, a welcoming packet for new clients, new puppy or kitty owner kits or any ways to engage clients and thank them for entrusting you with the care of their furry family member? Do you reward (perhaps a gift card from a store/coffee shop) for the referral of a client?

The aforementioned ideas are just that... ideas. However, they are employed by successful practices around the world where veterinarians recognize that veterinary medicine is a people business. Those veterinarians choose to exceed the expectations of their clients and actively work with their health care teams to practice exceptionally good relationship centered care.

References

1.  Bayer Veterinary Care Usage Study. Bayer Animal Health; 2011.

2.  Barker J. TheBusiness of Paradigms

  

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Richard M. DeBowes, DVM, MS, DACVS
Inner Compass Leaders
Pullman, WA, USA


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