"He who knows much about others may be learned, but he who knows
himself is more intelligent. He who controls others may be more
powerful, but he who has mastered himself is mightier still." Lao Tsu

Image

Many have talked about a practice's image, a professional image, an image of caring. What are you doing, on a daily basis, to improve that image? In the 1990s management literature, a new "buzz phrase" emerged: "moments of truth." It was coined by the CEO of Scandinavian Airlines System (Mr. Carlzon), and means simply "an opportunity to influence a customer, to create an appropriate image." In every encounter with every person, at least one moment of truth occurs. Generally, more than a single moment occurs in each encounter to make an impression. In each instance, impressions and values are established based on impressions and perceptions. In a veterinary practice, these moments of truth are often the difference between a client becoming a four-times-per-year friend or a once-in-three-years visitor.

In a brainstorming session with other consultants, we looked at the average veterinary practice client cycle and counted the moments of truth that any practice could possibly influence. While all the ideas listed here will not fit every practice, the majority should. The challenge is to get the staff members to accept the responsibility to improve the image in each area they touch. They need to have pride in what they do, moment by moment, to affect these moments of truth. To establish that pride in performance is the challenge of leadership, but that is a different book! Look at these opportunities, and discuss them with your team:

Finding the Practice

 Yellow page ad

 Web page search for service or location

 Referral by client

 Newspaper ad

 Community literature source

 Referral by out-of-state veterinarian

 Outdoor signage

 Ancillary pet supply referral

 Staff community service

 Community activities/Rotary/Scouting/women's clubs/government

The Initial Contact

 Web site inquiry with rapid response

 Phone for a price quote

 Phone for a service quote

 Phone for an appointment

 Response to a perceived emergency

 Directions to the practice

 Stopping in for a tour

 Pet boarding during move-in at new home

 Meeting a staff member out in the community

 Meeting the veterinarian at a community function

 Actual appointment hours offered

Arriving With the Pet

 Practice identification

 Direction signage for parking and entrance

 Parking lot appearance/tidiness/potholes/debris/droppings

 Access to the front door

 Entry ease and protection of pet from other patients

 Lighting/security

 Initial waiting room impression (sight, smell, sound)

 Access to the front desk

 Staff appearance

 Decor/odor/noise/cleanliness

Reception Staff (Client Relations Specialists)

 Courtesy/attentiveness

 Name tags for easy I.D. (First name and title only, for personal safety)

 Personal business card presentation

 Friendly/smiles

 Responsiveness/caring

 Remembering client concern from when appointment was made

 Pace/professional approach

 Phone techniques (behind the scenes is better to reduce distractions)

 Gossip level (never let clients hear staff talking about other clients)

 Talk about pets/clients by name rather than condition

 Waiting time (less than 7 minutes maximum)

 Amenities available

 Other clients entering and exiting (satisfaction)

Initial Client/Patient Movement Methods

 Appearance/uniforms/shoes/personal composure of Nurse Technician

 Personal hygiene/makeup/hair/breath/facial hair of Nurse Technician

 Escort to consultation room

 Name tags for easy I.D. (First name and title only, for personal safety)

 Personal business card presentation

 Initial interview techniques (knowing client concern)

 Hands on pet within 17 seconds

 Consult room appearance

 Body language/voice tone

 Staff competency Paraprofessional rapport

 Asymmetry (wellness) examination (3-5 minutes)

 Diplomas on wall

 Odor/cleanliness/noise

Veterinarian Initial Impact

 Appearance/personal composure

 Treatment of staff

 Self-introduction

 Touching the animal

 Awareness of client concern (never called client complaint)

 Listening technique

 Body language/voice tone/rate of speech

 Terminology

 Explanation of examination/findings

 Patient advocacy/speaks of pet's needs/ensures client decides

 Empathy/concern for client's position (feelings and fiscal)

 Clearly prioritizing needed care

 Transfer of husbandry issues to Nurse technician for follow-up

Consultation Room Exit

 Summary of findings

 Training to administer treatments

 Client Education for current needs

 Explanation of value of services (thus charges are understood)

 Pre-qualify each departure with the three Rs (recheck, recall, reminders)

 Escort to discharge (or discharge from consult room)

 Protection of animal during transit through hall/reception area

Discharge Actions

 Attentiveness at discharge/waiting time

 Discharge desk clutter/appearance

 Cleanliness/odor/noise

 Presentation of invoice/bill [consistency with healthcare plan (estimate)]

 Collection of fees

 Dispensing medication

 Concern for client understanding

 Establishing the three Rs compliance expectations/methodology

 Privacy/courtesy/caring Literature offered to ensure family understanding

Post-Discharge

 Follow-up telephone call/newsletters

 Sympathy cards/memorials for deceased pets

 Thank you" correspondence

 Satisfaction surveys

 Reminders

Over one hundred moments of truth were listed above and the ability of the veterinarian to directly alter them accounted for only about ten percent of the total. The amount of concern (training and rehearsal) exhibited by most veterinary practice teams does not equal the importance of these client impression opportunities.

Consider the moments of truth from the client's perspective. If they have come by word of mouth referral, they are usually more forgiving for small stumbles in services, but if they came by web site or signage, they are less forgiving; client relations must catch these "vibrations" before the client departs the facility. How many times can your staff, facility or practice methods 'offend' the new client's initial impressions of your practice before they are no longer a client? Conversely, every moment of truth is an opportunity to cement the doctor-client-patient bond.

In fact, as proven in most every service industry, how the operational managers and supervisors treat the staff will determine how the staff members treat the clients. When Carlzon asked the Scandinavian Airlines System (SAS) headquarters staff what their "mission" was, it took three weeks for the team to decide it was "the movement of people." They closed the headquarters for about six months and took the client-centered service to the field and impressed every one of the 40,000 employees with their importance in the moments of truth. In two years, SAS went from a failing airline to one of the top three income producers in Europe. But they rested on their 1988-89 performance and forgot to reinforce the client-centered programs. They forgot to look into the future and make the SAS employees responsible for change in the future. SAS lost money.

The successful practice empowers its staff to react and change to meet the client's needs. To have the freedom to commit resources without additional line item permission and to make the client perceive a caring staff and a quality healthcare facility. In human healthcare this concept is called Continuous Quality Improvement (CQI). In industry and corporate America it has been called Total Quality Management (TQM). Authors like Juran, Deming, and Crosby have made their consulting fame by basing their approaches on reintroducing employee-based quality and pride factors to American corporations. They believe that when the employee puts pride into their daily effort, when they are empowered to make changes for the betterment of the team without first climbing the supervisory ladder for permission, the output will be perceived as quality.

Assigning outcome accountability to an employee (empowerment) must be accompanied by the needed authority, and these must be supported by job/task ownership. The staff member must think of the practice as "our practice/our hospital" at every decision point in the process. In the consulting business, we find that practice "luck" is usually directly related to the preparation of the staff to grab opportunity as it comes knocking. Where does your practice approach sit in the scheme of things when it comes to preparing your staff to grab the moment of truth and turn it to the practice's advantage?

The trend in the United States during the last quarter of the last century had been away from client service. However, the 1990s rediscovered the importance of service to the client. American examples do exist, like Marriott, Nordstrom, Worthington Steel, Federal Express, and American Airlines, but they are the exception rather than the rule. The new millennium must bring an increase in client service!

The practice that best controls its respective moments of truth will become different from other practices in the mind of their community. These astute veterinary practices will succeed where others have floundered because practice quality and client impressions are communicated during the moments of truth and have very little bearing on the professional facts. They will become the leaders in the veterinary marketplace during this decade.