Why Do Clients Come???
Promoting the Human-animal Bond in Veterinary Practice
Thomas E. Catanzaro, DVM, MHA, FACHE, Diplomate American College of Healthcare Executives

"If you build it, they will come." from Field of Dreams

In the movie, Field of Dreams, "If you build it, they will come" was spoken by a voice, and a corn field was plowed under, a ball field was built, and by the end of the movie, it looked like every car in the State had lined up on the road to visit the ball field. Those days of veterinary medicine are over. No longer will the client lines appear and wait for the average practice to offer average veterinary care. The days of competitive practices and substitute sources are upon the profession.

Sources of New Clients

There are not many options for new clients in any quantity in most communities. A new client is one of three categories: a new pet owner who has never accessed veterinary care before; someone who has just moved to town with a pet; or someone who is not fully satisfied with the last veterinary encounter. When they call your practice, they want to be assured that your practice will provide the appropriate care in a timely manner, with empathy for them and their pet, while charging only an appropriate fee.

Before looking at the effectiveness of the available methods, we first must understand how clients pick practices by location. Repeated surveys report about 60 percent of all new clients look at location first when seeking a veterinary practice; 60 percent of those selecting by location select the final choice by word of mouth referral. Again there are only a few options available for discussion when exploring the how:

 Word of Mouth

 Outside Signage

 Yellow Pages

 Professional Referral

 Internet Linkages

 Paid Media

 Unpaid Media

The Balance of Attraction

Some practices do not invest in their outside signage. It looks like an afterthought. A sign that is perpendicular to the street is 85 percent more effective than a sign which is attached to the front of the building. In an average practice in an average community, less than ten percent of the new clients now come from the signage, but there are communities/locations where this "sign draw" exceeds 30 percent. A feline practice in Georgia developed a very special sign to easily denote their "feline exclusive" services and tripled their sign impact on drawing new clients. The sign must be easily read and understood in about three seconds to the passing driver. Don't overload it with information and small elements or a complicated logo. In Australia and New Zealand, most of the signs simply state "VET". A smart practice also understands that the facility appearance and parking lot are part of their signage. An unkempt parking lot or poorly maintained exterior facade tends to make the client perceive a disorganized or unkempt practice, and might cause the client to drive by and seek the next practice.

When assessing the telephone book (Yellow Page) marketing effort, the community standards play a major part in the initial decision for entry level. The impact is a practice query responsibility. To judge the appropriate column space (cost), remember, a five to one ratio is needed on the money made versus money expended due to the media effort. Most practices operate on less than a 20 percent net before ROI, which is why the five to one ratio. When someone says they came in because of the telephone book listing, a practice must ask why. Sometimes it is due to services, other times it may be due to a doctor's reputation, but often it is because someone has referred them to the doctor, practice or location. This someone needs to be thanked, so the aware practice asks who!

In the 2007 surveys, 86 percent of the households have Internet access, and the yellow pages have not gotten easier to read. Many people just do a web search, so your Web Page listing is important. There are many people selling web pages at prices from very economical to very expensive. Some web sites tie an umbilical to the practice and you most contact a remote web master to make changes......then there is eVetSite Systems, linked to VIN....... economical, small maintenance fees, easy to tailor and maintain, and best of all user friendly and responsive. In many practices we work with, client relations now simply asks, "Do you want to be contacted by e-mail for text message?", and they do snail mail only by exception at the client's special request.

The satisfied client who refers a friend or neighbor to a practice accounts for about 60 percent of the new clients in a quality veterinary facility. The referring client deserves to be recognized because, as most mothers know, "Behavior rewarded is behavior repeated." This recognition should be at least a thank you note in the mail.

If you provide an additional value-added benefit, such as movie or zoo tickets or a practice credit, supplemental reinforcement will occur. This new client will forgive more "bad day errors" than the other sign or yellow page derived new clients.

A special type of "word of mouth" is the professional referral This includes pet stores, breeders, and feed stores, as well as other veterinary facilities if you have a special interest capability or special equipment. As before, "behavior rewarded is behavior repeated" and some form of appreciation should be forthcoming following the referral. Some practices believe in this enough to have a special party for the best referral sources every six months, just to celebrate and say thanks. Sometimes they even share the new program introductions during this party, but that is another story.

One method sweeping the United States is to use the media to find the practice clients. Sometimes this is a newspaper ad or a radio spot, and in some other situations, it is coupons and special offers. Again, like telephone book marketing, the trend of the community is married with the practice philosophy to establish the appropriate level. Regardless, like with telephone book advertising, a four to one ratio is needed on the money made versus money expended due to the media effort. The real problem with the paid media and coupon system is that the clients are very low net (if any) which violates the five to one ratio, and they also show a very low return rate to the practice (less than 20 percent). This area must be tracked for effectiveness.

The area of most fun, to me, is the unpaid media exposure. There is one practice which sponsors a "Meals on Wheels" for pets whose owners are unable to feed them (in the hospital, shut-ins without income, etc.). This practice gets a lot of free media coverage just for the human interest of the subject. There are veterinarians who sponsor (at cost) the Scouts (or 4-H, or FFA, etc.) in offering a fall "rabies clinic" for the community, at some central location arranged and advertised by the Scouts. This is very cheap goodwill and it gets great, no cost, media coverage. There are many other ways, including a "pet column" in a local newspaper or a local "pet radio hour" on a Saturday or Sunday morning, to get free media coverage. All it takes is innovation and an awareness of the community needs and desires.

The Best Program

There is no best program. In veterinary practice, like in the stock market, another famous gambling arena, the mix-and-match always exceeds the single investment. It is a combination of the lateral actions of other practices, practice philosophy, community substitutes, and pet owner perceptions. It is also dynamic, changing frequently, often quarterly, often by the season of the year. The practice must adopt whatever programs it needs to keep about 10 to 15 percent of all transactions new clients. Most communities in America average about 20 percent pet owner movement each year, lending to the validation of three yardstick premises:

 When the new client access rates are higher than 15 percent, it tends to make me look for clients who fail to return.

 When the new client rate is less than 9 percent, it often indicates a low new client access rate.

 When a new client rate is less than 5 percent, it usually means the practice is dying, but it is seldom seen from inside the practice - excuses abound!

There is no great science to the method or madness associated with gathering new client information. If you want to know what attracted them to your practice, ask them. It is amazing what you can learn when you ask a question and then just listen. The choice for your practice is yours. Make it an overt decision.

An appointment is a contract, and must be kept - on time!

In these days of tight budgets and a demanding economy, the veterinarian's responsibility to the community must be balanced with a commitment to family, friends, and a personal quality of life. In the United States, this has led to tighter appointment schedule policies and less catering to the walk-in client. It has spawned emergency clinics which operate evenings and weekends and that are supported by multiple practices. In many metroplex veterinary practices, the simple addition of "walk-ins welcomed" to the yellow page ad increases the client access rate by 25 percent; with high density schedules (shown later), this workload demand increase can be absorbed. But we will focus on only one element: the veterinary practice's office hours.

During the past decade, the average work week decreased from about 80 hours to 49 hours for most veterinarians (many new graduates complain rightly about being required to perform a 40-hour work week). We see this as a healthy trend, but it requires a change in attitude and operational habits. The majority of practicing veterinarians continually report they do not have enough leisure time. Yet we see many practitioners open earlier, stay later, and expand to weekend appointment hours. The six-day work week is still the norm for doctor-centered practices.

Doctor-centered practices are linear in nature, with the doctor in the eye of a hurricane. Most all events revolve around the doctor and where they are physically located, causing portions of the hospital to "go dark" when the doctor moves to another zone. It does not happen in the dentist office, nor in human healthcare hospitals. My cardiologist has me seeing a nurse practitioner three times for every one time I see him, and my physician does not do needles - that is a nursing function - so he works 4 to 5 consult rooms concurrently (and they all have one door, since he uses staff to load and unload the consult rooms). A team-centered practice continues to operate all zones, no matter where the doctor goes. The VIN text, The Veterinary Success Factor: Team-based Healthcare Delivery, published early in 2008, defines and describes the zone and team processes to leverage doctor time and increase the practice's liquidity.

Speaker Information
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Thomas E. Catanzaro, DVM, MHA, FACHE, Diplomate American College of Healthcare Executives

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