Thomas E. Catanzaro, DVM, MHA, FACHE, Diplomate American College of Healthcare Executives
All veterinarians work in one way or another to educate their clients. They try to educate them about preventive needs, wellness needs, and curative needs. Here is the first real challenge - research has shown that only three new items can be introduced effectively by a healthcare provider during a single consult, as well as that being received by the patient/client. After three issues, everything falls of the client's mental plate. The staff must get involved for internal referrals to effectively raise the client's veterinary I.Q, in a reasonable period of time. They discuss the common problems and what veterinary medicine can do for their pets. Some practitioners rely solely on the spoken word, but that information deteriorates before the sun sets. This is why most successful practices have progressed to some form of literature.
Every client deserves the courtesy of having something educational
in hand when they leave the practice to read after they get home when
they can relax from the stress of the visit.
As previously discussed, there are many forms of literature that can be acquired from pharmaceutical and feed companies, publishers, veterinary associations, and other vendors which support our industry. These support agencies spend hundreds and thousands of dollars on sophisticated written, illustrated, and audio-visual promotions every year. Those practices who want to be different, or desire to customize their approach to their own community, develop personalized pieces to supplement the professionally produced pieces from national organizations. There is general agreement that client education materials, at the very least, save time and money while ensuring a comprehensive delivery of information. Some assert that the additional effort expended on personalized practice brochures, newsletters, and handouts is repaid many times over by the growth of the practice and the public recognition of veterinary medicine as a healthcare profession. Regardless, the trend is to more information, not less. The client's desire is for more information, not less. The caring practice will deliver more information, not less, in a client friendly manner which does not overwhelm the animal owner.
In the Blackwell Publishing text, Building The Successful Veterinary Practice: Programs & Procedures (Volume 2), chapter two discussed bonding clients while chapter 5 discussed internal marketing; many practice owners have forgotten these are two different issues. In the next volume of the trilogy, Building The Successful Veterinary Practice: Innovation & Creativity (Volume 3), we discussed health alerts, new client newsletters, and other less common marketing concepts. In the Blackwell Publishing 2000 text, Veterinary Healthcare Services: Options in Delivery, Chapter 5 discusses "persuasion marketing"; a new concept that experienced veterinarians intuitively understand but newer staff and doctors think is revolutionary. All these tools are targeted at educating a practice staff to educate the client through caring veterinary healthcare programs and services, and strong practice leadership must focus on staff training before client marketing.
We have operated consulting firm dedicated to "taking our clients to the next level", whatever that may be. We built the largest team and published the most books of any veterinary exclusive consulting firm. We have provided a very diverse selection of do it yourself management aids at our web site (www.drtomcat.com), including a free safety newsletter and a free management newsletter. All this, and yet I had to personally take control of the healthcare delivery of our Maine Coon Cat, Merlin (see dedication).
When Merlin reached middle age, I had to require the veterinarian who tended to Merlin when I was on the road to do a full blood chemistry; her reply to my wife was, "Yes, I should have recommended it, but most of my clients do not accept it, so I have quit mentioning it." Her belief level was lower than I ever expected.
With a bit of extra knowledge on biochemical/physiological trends, we adjusted his diet, and treated his joints; his quality of life was pretty good. When I came home, he greeted me with his "silent meows", and waited until I sat down before the head-butted me and had his ears "scratched"; he would sit next to me for hours, never invading my space, just sharing the closeness. At bed time, when I retired to the bed room, he would follow, jump up on the bed, walk across my body, and head-butted until I scratched his ears as he lay at a comfortable arm's length; when I started to doze, he went back to his nightly household rounds, those things important to cats of his age and dominance.
In the spring of his last year, while I was traveling, Merlin's urine turned red, and I directed by phone that he be taken to the same veterinarian for an immediate urinalysis and evaluation. The results were negative, the doctor told my wife, and I was called on the road; like a normal client, I know red urine is bad, so I asked about the blood chemistry and radiology. My wife asked the veterinarian and the response was, "Yes, I should have recommended it, but most of my clients do not accept it, so I have quit mentioning it." The results were negative, the doctor told my wife, and I was called on the road.
We all know that red urine is not good, so I asked about the contrast study or ultrasound recommendations. My wife asked the veterinarian and the response was, "Yes, I should have recommended it, but most of my clients do not accept it, so I have quit mentioning it." An ultrasound with a specialist was scheduled, and tumors were in the bladder, spread throughout the colon, and Merlin's liver was very cystic; we started pain management.
Now the veterinarian thought she was ready for the full-blown program, so she offered chemotherapy and exploratory surgery; I explained that a 17-year-old Maine Coon Cat with this extensive a metastasis was not a great candidate for heroic treatments, and we would closely manage his pain and quality of life.
In July of Merlin's last year, I came home from the AVMA annual meeting, and as I walked in the door, Merlin did his "silent meow", took a few steps towards me, and lay down; he was in pain. I asked how long he had been in pain, and my family said he had not eaten in 36 hours, and had not moved much. Each member of my family is trained in some aspect of healthcare, yet they had missed his "pain" movement.
I laid down on the floor next to Merlin, scratched his ears, and made the decision that we were at the end of pain management and he was now suffering. He was too important to me for anything less, so the decision was made to allow him to cross to the rainbow bridge.
If I was an average client, I would probably be denying Merlin's pain like my family had been, maybe I would be blaming the veterinarian, or even start bargaining with the Lord for some extra time with this long-time friend and comrade. But I was not an average client, I am a veterinarian. I have been given the responsibility for the life of others, a covenant to tend to the animals of the land, and granted the privilege of offering a humane death in cases of undue suffering.
Every member of my family now knows how to identify pain in animals, and every client we consult with has been asked to accept pain scoring as a standard of practice. I have always been strong on patient advocacy, and my belief in this profession is strong; I never want a client to encounter what my wife did when she took Merlin in for veterinary assistance. This book, and the support of the friends who have contributed portions to this text, is one step towards that goal.
Good clients do not follow discounts and do not want short-cuts in healthcare for their animals; they are stewards of the life of a trusted friend, and will follow a caring provider. Clients deserve caring veterinary staffs, and patients deserve to have an advocate who speaks for their well being. Caring staff members do not follow the dictator, they follow the doctor with the vision and a caring heart. The appendices of this text provide concepts and ideas, they are not to be followed by rote; they require a caring leader to caress the ideas and make them their own. The focus must always be on the client, they are the stewards who need to be informed and nurtured. The informed client will want to purchase the needed care and will resist being drawn away from a practice which has conveyed its caring and concern with an integrated client education program. Clients may change veterinarians when they don't know the difference, but they don't leave a veterinary practice that cares! As you embrace the bond, and as your practice becomes known for the "caring heart" approach to veterinary healthcare delivery, never lose the dream, never lose the caring that caused you to select this profession; I can hope no more for any colleague or staff.