C. Kolthoff, Cand.med.vet, E-MBA, IAF cert. facilitator
We can calculate that a Scandinavian small animal veterinarian performs up to 100.000 consultations during their professional carrier. From an AAHA study, we know that pet owners carry out less than half of our recommendations. On top of this, I have experienced that clients choose their veterinarian, not based on veterinary professional skills, but based on communication skills. This calls for making an effort in improving what veterinarian does every day. Let us aim to make every consultation the perfect consultation. In this talk, I will explain how I have implemented a focus on the perfect consultation for all vets in two of my practices.
The Basic Concept
The basis of The Perfect Consultation consists of three things: The consultation model based on The Calgary-Cambridge guide by Kurz & Silverman, the use of video recordings in the consulting room, a workshop in the clinic to get started, and last but not least, the willingness to do regular video films with practice in group gatherings.
The Expected Outcome
It has to make sense for the veterinarians in the practice to implement The Perfect Consultation. Otherwise, they will be reluctant to do it. Here are the most important benefits of the program:
- Happier, healthier animals receiving the agreed treatment.
- Potential for higher salary due to increased personal turnover.
- Happier clients based on improved relations and interactions.
- More effective consultations and better cooperation with the support staff.
How to Measure
Facebook reviews are a good indicator of the veterinarians' ability to communicate with clients. Another good measure I use is the Net Promoter Score (Google this for more info). Some use sending text messages after the visit with a quick questionnaire, but I find that it annoys the Scandinavian customers.
Financially, I would follow Average Clinical Transaction Value and monthly turnover and monitor the development over time. I would look at individual results as well as team result.
In the consulting room, you would experience a higher rate of clients following your recommendations, but this is hard to measure. What you can measure is numbers of dentals (or other procedures) as a percentage of clients seen.
How to Make Video Recordings in the Consulting Room
I recommend using a cheap and easy-to-use action camera like the Go Pro Hero Session. You just press the button to start and then press again to stop. I recommend doing it manually as the different Bluetooth apps and connections tend to confuse the veterinarians. Choose at least a 128-GB memory card, as the recordings take up a lot of space. Place the camera about 1.5 meters above the floor as this gives the best recording angle. When the videos are shot, you upload it to a folder in the server or onto a laptop computer. I have experimented with uploading to YouTube (as hidden files), but for many reasons I do not recommend this.
We need to be aware of different legal issues for different countries and I can only speak for Denmark and Norway. Here I recommend that you put a sign in the reception, noting that you might be filming in order to continually improve the customer experience and that it is for internal use only. If we put more emphasis on informing the clients by talking about it in the reception, we experience that there is excessively much focus on the video in the consulting room.
The Calgary-Cambridge Consulting Model
I have researched many different consultation and communication models. Based on their proper research and years of experience, I ended up voting for the Calgary-Cambridge model by Kurtz and Silverman. I hosted some workshops in order to make adaptations to the model, but we ended up deciding that it works as it is. The model looks like this.
Instead of going through the model here, I recommend that you Google it. Look for the model, but also the 5 pages PDF that goes more in depth with each of the phases.
If you want to go more in depth at the practice, then I recommend that you buy "Skills for Communicating with Patients" for the vets and "Teaching and Learning Communication Skills in Medicine" for the "teacher." Both titles are by Kurtz and Silverman.
How to Start in Practice
Start introducing the project and the video recording slowly. Find a veterinarian that does not mind and start shooting some film. Show them to the rest of the team and explain the expected outcome of the project. When the team watches the film, they understand the huge learning potential.
Ask the rest of the veterinarians in the clinic to start shooting 1–2 videos and have them watching it. I recommend appointing a veterinary nurse as technical support and to be in charge of gathering and labeling all the videos on the server or on one laptop.
Then you make a workshop in your clinic, where you go through the Calgary-Cambridge model and work your way through the model and start getting inspired by each other's videos. There is a million way of performing this workshop, so I will not go into details here. However, the key is that we have to base it on what problems the veterinarians experience in the consulting rooms, watching each other's video, role-play and proper feedback.
After the workshop, you have to follow up with a system, where each veterinarian shoots videos each month, and where you have gathering with focus on making The Perfect Consultation.
Veterinarians That Do Not Want To Be On Camera
It has to be a good experience to all the veterinarians. Otherwise, you do not end up with the right learning environment. For all veterinarians the rules are that you can always delete a video that you do not like and all communication has to be positive.
Here is what I do with very reluctant veterinarians: 1) Invite them to take an active part in the workshop and the following gatherings and accept that they do not shoot videos yet. 2) Ask them to start shooting videos that no one else but themselves will see. 3) Have them appoint a mentor that can watch and provide feedback on a one-to-one basis. This should lead to that they will get into the program. If not, they have to find another place to work if video is practice policy.
ALOBA Feedback Model
Giving constructive feedback is an art form in itself. When you watch the film in groups, I advise using the feedback method called "Agenda-led outcome-based analyses." The steps in the model are as follows:
Before showing the video, you ask the vet to set the scene. Let him or her describe prior knowledge that is useful for the common understanding. Then you ask the group to note down specific words and action as well as the time, to aid feedback. Ask one in the group to watch as if the patient.
After showing the film, you allow the group several minutes to collect their thoughts and note down the one or two most important points. Acknowledge any feelings of the vet showing the film, if necessary.
When you give feedback, you start with the vet on the film. What went well and what could be better? Then you turn to the group and ask them the same questions, always starting with the positive first. After the feedback, you can go back and watch small sessions on the film to get into further details. Close the session with concluding what was the common learning.
Key to feedback is to stay loyal to the feedback model and always keep make sure that it is on a positive note.