The Practice Success Prescription: Team-Based Veterinary Healthcare Delivery by Drs. Leak. Morris Humphries
Thomas E. Catanzaro, DVM, MHA, FACHE, DACHE
The environment of the reception room is a mood setter.
Are there bonding pictures of people caring about animals, or are there hunting pictures reflecting non-bonding activities?
Does the practice keep Better Homes and Gardens, People, or Time magazines in the reception area, so they can be bought as tax deductions, or are there client bond builders like the Delta Society Journal, Pet Health News, and Latham Letter?
Does the practice keep a scrapbook in the waiting area and consultation rooms, with the pictures that have been sent by clients of your patients? Has the effort been made to label the scrapbook pictures with a little information about the pet, client, and the location/situation where the picture was taken?
Is there a pictorial available concerning the activities that occur in "the back room"? Our clients wonder about that mysterious place where they never go, and a collage or scrapbook, or even individually framed pictures help take the mystery out and bond the client to your concern about their pet.
Does the client relations specialist (receptionist), nursing staff (technician), and other staff address the client and patient by name at every opportunity?
Other matters to consider, during the client's visit to the practice:
When a provider discusses the "needs" of the companion animal, is the word "need" clearly stated, or is it disguised in terms like "recommend", "you should consider", "it might be nice if --", or other softening phrases that confuse the urgency of the message?
Does the staff address the patient needs as an advocate of the animal's well-being, or is the practice philosophy one where we try to keep a superior or professional position?
Does the veterinarian tell the client what the pet "needs" for proper health maintenance, or what the practice "needs" to do for comprehensive health care. Do we allow the client to "waive" or "defer" these services, rather than make the decision for them? You'll find the pet advocate gets much more support and cooperation in the healthcare delivery process, not to mention a larger per patient transaction fee.
Does the veterinarian take time to explain the "philosophy of practice" or does the practice cop-out with cold "clinic policies"?
Quality Medical Records = Standards of Care = Continuity of Care
Medical records are how we communicate with a team-based veterinary healthcare delivery system. If it is not in the medical records, it was never done. More so, if it is not in the medical records, it was never needed, or offered as a need to the client. If the client's response to the stated "need" is not in the medical records, it was never heard or discussed with the client, etc., etc., etc.
The VCI® Signature Series Monograph Medical Records for Quality and Profit describes the documentation needs, The monograph also has a CD, which contains all the forms most practices will ever need, and can be tailored to practice-specific standards of care. That means the patient data cover sheet, in pink (♀) or blue (♂), has a wellness item list on the left side column of the "checkerboard square", while the master problem list and medication refill list continue onto the back of the form, using head to foot printing, so you only have to fold up the page, not un-prong and flip it. |
Does the practice "reach out and touch someone" by mail, even using e-mail as an option, or in person? How many follow-ups, recalls, or reminders are done by mail versus using the telephone. When following up a surgery case or an extended medication treatment plan, such as a twenty-one-day cystitis therapy, it isn't hard to teach the receptionist or technician to say, "Mrs.____, this is Judi from the ____Veterinary Hospital. We know you are due back in about a week, but the doctor and I just wanted to ensure you haven't had any questions arise now that you've been home for a couple of days."
When calling a new client, something like, "We know you're coming back for the next puppy shots in three weeks, but wanted to say we enjoyed your first visit and just wanted to be sure there aren't any new questions", can close the "doctor and I" telephone introduction.
A bond-centered practice tracks pet parent awareness, instead of just "reminder effectiveness", as discussed, using search and sort techniques of the veterinary software computer systems. By calculating rates of compliance monthly, a practice better understands the perceived "importance" of their protection messages. If you run the same dates this month as last month, the difference between the same period two months in a row is the number of companion animals that have come in during that period. Reminders can be done for dentals, fecals, ECGs, sequential laboratory screening, surveillance ultrasounds or vet scopes, vaccines, socialization behavior, nutritional advisor, and a host of other nursing surveillance functions. If this is being attempted, ensure the postage budget is eight-tenths to one percent of gross, which will allow for the quarterly newsletter, plus any infomercial, advertorial, or seasonal pre-sensitization notices before postcards.
In sending reminders, the client relations specialists change the system to start at the eleventh month, have the second reminder at the beginning of the twelfth month, and do a telephone follow-up for expired protection at the end of the twelfth month. Veterinary Consulting International® have helped many practices develop very clean narratives for these reminder cards. Here are just two samples:
Eleventh month: "This is the last month Fluffy will be fully protected from the diseases of our community. For Fluffy's welfare, please make an appointment before the end of the month."
OR
"Dear Fluffy, you went on vacation and we need a fecal sample to ensure you did not catch anything while traveling. Please drop off a sample soon"
End of eleventh month: "This month is when Fluffy's protection expires without booster vaccinations. Please, make an appointment immediately to let us help protect Fluffy's health."
OR
"Last month we sent Fluffy a protection reminder about his vacation travels; he must have lost it (or eaten it). Please help Fluffy remember to drop off a fecal sample soon so we can help protect Fluffy's health."
Within seventy-two hours of expiration: Telephone call by OPNT or receptionist, with message, to the effect of: "The doctor and I missed you and Fluffy this past week. Is everything okay at your house?"
OR
Telephone call by OPNT or client relations specialist, with message, to the effect of: "The doctor and I missed Fluffy's fecal sample this past week. Is everything okay at your house?"
The front desk team concurrently starts call-backs for all missed companion animal appointments, using a simple narrative, such as, "The doctor and I missed you and Fluffy yesterday. Is everything okay at your house?". This is an essential element of the recovered client program. For more details, see the VCI® Signature Series Monograph Client Relations Zone Operations.
Cowboy says, "You're bound to succeed if you have ignorance and confidence."
Consultant says, "Do not pre-judge any client or any patient's needs. Just do it!"
Remember, the doctors are now routinely using a box to annotate each patient need. The front team technicians will do likewise. For instance, "recommend rabies" will become "RV [ ]";" "needs parvo shot" will become "PV [ ]"; "traveled to Lyme area and needs Lyme test" becomes "L-tst [ ]"; etc. Regardless of who writes the box, each doctor will complete the "needs" annotations by entering the client response to needed patient care. Remember, any box without annotation will be referred by the front team back to the doctor for completion before the client is allowed to depart the facility!
When an appointment is missed, wouldn't it be a nice touch to show concern for the pet and client, rather than the appointment log? Teach the receptionist to pick up the phone and say something like, "Mrs. Jones, this is Suzie at XYZ Veterinary Hospital. We noticed that we didn't see you as expected yesterday, and the doctor and I just wanted to call and see if everything was okay at your house?"
Do not continue talking after this opening statement. The first person to talk now will have to "explain." Just let the client talk and listen carefully. If rescheduling is wanted, the client will say so. If the client is ducking the appointment, a caring, "That's fine, we just wanted to make sure your family and Fluffy were healthy and didn't need any assistance", will get a better bond established than trying to force the making of another appointment.
These "scripts" must be practiced before they are used. The words must seem real .If you are not willing to take the time and sit together as a team to rehearse the practice narratives, then do not expect someone on staff to take the time to listen to clients.
There are many communication techniques that convey the caring and concern of a practice, but a preprinted postcard is not usually one of them. The first reminder by postcard is great, but let the practice concern show through on follow-ups. A letter or a phone call will usually result in greater bonding results than that second postcard. A possible exception to the telephone call follow-up is in communities that are saturated with telemarketing programs that keep the family phone ringing off the hook from 6:00 p.m. to 8:30 p.m. In this case, the letter that appears personally written will be the best follow-up to make that client feel like a member of your "practice family".
Cowboy says, "Life ain't in holdin' a good hand, but in playin' a poor one well."
Consultant says, "Every staff member is a gem., Use them to show off their best facets!"