Ever wondered what the heck the vet is trying to tell you? Don’t be shy! Ask those questions until you get answers that don’t sound like gibberish. Your pet’s health is too important!
[tweetthis]Is your vet speaking jibberish? Speak up![/tweetthis]
Life With Clients
Your Appointment On Time… Or It’s Free
By Peter Weinstein DVM, MBA
Post offices, banks, doctor’s offices, motor vehicle departments, restaurants, veterinary clinics… They all have a similar reputation—they never seem to run on time.
Does your practice belong on the above list? If so, do any of these situations sound familiar?
- The first client arrived late and things just snowballed from there
- The client was such a Chatty Cathy that we couldn’t get her into or out of the room
- The cat was sooooo fractious that it took a while for us to get our hands on it
- That last patient was much sicker than we thought.
And where are you in this mix? Is lateness ever the doctor’s fault. Do any of these phrases ever describe you?
- On the phone instead of in the exam room
- On the internet instead of in the exam room
- Distracted, disorganized, and unfocused while in the exam room
- Never in a rush, because you know people will wait for you.
If you want to claim that you are a client-centered practice, you need to change your approach to client waiting. It is disrespectful and just bad client service to keep people waiting. On the other hand, if you want to continue in the old model of a doctor-centered practice … take your time!
[tweetthis]If you are a client-centered practice, change your approach to client waiting. [/tweetthis]
Instead, what if you guaranteed your clients that if they arrive on time, they will be seen within ten minutes of their appointed time OR the appointment is FREE!!
Now, your first reaction is likely, “I can’t do that, I’ll be giving away FREE EXAMS all day!” But keep in mind, you are probably already doing that due to appointments that last longer than they should. If you DID make this promise to your clients, though, wouldn’t it differentiate you from other practices in your area? Think about it this way: “If I’m on time every time, then maybe I’ll be done on time at the end of the day, too!” Wouldn’t that be nice?
So, let’s see how we could accomplish this.
First, make being “On Time, Every Time” a goal for the entire practice team.
Second, take a month to identify WHY your practice runs behind. For each appointment over the next month, note when the client is late arriving, the time the client gets into the exam room, the time that the veterinary nurse or doctor enters the room, the time the doctor leaves the room, and, if the doctor is late leaving the room, note the reason why.
After you have completed a month or more assessment of your exam room operations, determine the most frequent causes for why you fall behind. What percentage were client caused? Staff caused? Doctor caused?
For those things that you can control—staff and doctor—what changes are needed to get the team to stay on time? For the things you can’t control—clients or pets—what can you do?
Armed with your research and your ideas, make the necessary changes in your practice workflow to keep the doctor and staff on time. For example, it might be as simple as cutting out phone calls and Facebook time between appointments, or developing a system to let the doctor know that time is up. With your changes implemented, repeat the tracking for another month. Were you on time more often this month? Did you go from 60% late appointments to 30% late? Of the 30%, were they doctor/staff or client/patient caused?
Once you have implemented enough changes so that 85% to 90% of your appointments are on time, issue the challenge to your staff to be an “On Time, Every Time Practice” and make this promise to your clients. Reward your staff for staying on time, and promote the heck out of your promise to the world at large. Tell clients they can leave War and Peace or Harry Potter at home when they come to see you, because you will be seeing them on time, every time or their visit is FREE.
If this seems simple, that’s because it is! The more significant aspect of this change is to challenge the veterinary profession to repair one aspect of its image that can be controlled – late appointments.
Being on time shows respect for the client, sends a message to the staff, and is good for business.
Stop making excuses. Start making changes.
[tweetthis]Being on time shows respect for the client. We need to change our approach.[/tweetthis]
Dr Peter Weinstein sees himself as a cheerleader and advocate for the veterinary profession. From his current job as Executive Director of the SCVMA to his speaking and writing, he likes to help veterinarians and their teams enjoy what they do everyday. Feel free to reach out to him at peterw2@aol.com
Tips to Help Vets Lose Their Minds
Looking for new ways to drive your veterinarian over the edge? Take a look at this short video so you can be “that client.”
[tweetthis]Want to *really* annoy your #veterinarian? @Vetstreet #vetpractice [/tweetthis]
Coping With Vet Shaming
One of the hardest things about being a doctor is constantly being told you are wrong. Our clients tell us that Dr. Google, the breeder or their mother says so. Our colleagues debate online as to whether allowing clients to decline presurgical bloodwork makes you a bad doctor. If you do shelter or spay/neuter clinic work, you are constantly shamed for all the horrors you must be committing. I am envious of my veterinary brethren who can let this go. I am not one of those people. I try not to take things personally, but sometimes the negativity is overwhelming.
Here’s the thing: none of those people have to sleep on your pillow at night. None of them have a care in the world about the protection of your license. None of them is technically able to “cast the first stone”. There will always be someone practicing better medicine than you. Someone, some where will also be practicing far worse medicine than you.
I’ve had clients try to shame me for refusing them a prescription without an examination or for refusing to prescribe inappropriate treatment. I explained that I don’t do those things for my mother, so I’m certainly not going to do them for someone I barely know. Some vets would do both of those things with no problem. If you are one of them, you won’t find any shaming here. I don’t worry about what everyone else is doing.
Ultimately, peer pressure isn’t going to be an acceptable excuse if my license comes under scrutiny. I told the University of Florida Vet School class of 2015, “If the explanation for what you are about to do starts with ‘Against my better judgment, I………’ – DON’T DO IT”.
As veterinarians, we seem to spend an inordinate amount of time trying to please people and trying to keep people from taking things away from us. I was always taught to act from a position of power. Neither of these stances are powerful. Instead, spend your time trying to be happy and achieve your goals – it’s a whole lot healthier.
My mentor has never once complained to me about shelters offering vaccines, low-cost practices, online pharmacies or new clinics opening down the street. Do you know why? Because she only worries about her practice and how to make it better. She participates in clinical trials (you wouldn’t believe what a benefit these are to vets and clients alike), practices higher and higher standards of care and is always looking for ways to make her clinic stand out as excellent. She doesn’t waste her time trying to figure out how to make other veterinarians look bad. Tearing others down doesn’t make you look better. Standing confidently no matter what everyone else is doing DOES.
We should all strive to be better doctors, but remember that there is no one out there practicing perfect medicine. There are a whole lot of things that get in the way of practicing “ideal medicine”. Vet school is like a self defense class – you can learn how to do it perfectly in theory, but when it happens in real life, things get ugly. I think that being a really terrific doctor hinges not on how you execute the perfect workup of a case but on how you handle the cases where you must act without all the information. If I could always run every test I wanted, medicine would be easier. If all my patients and clients did what I told them, medicine would be easier. If medicine were easier, everyone would do it.
If you are watching everything your nearby clinics are doing – stop. If you are struggling constantly to satisfy difficult clients – stop. If you are staying up at night worrying how you are going to keep the specialty practice, corporate practice or clinic down the street from stealing your clients – STOP. Instead, try one or more of these:
1. Fire clients that make everyone’s life miserable. Ask your staff – are there clients that make you not want to come to work? Here’s a hint – if their name on the caller ID causes a clinic-wide groan and coin-flipping for who answers the phone, that’s your target. Decide who gives you the biggest headaches, and let them go. Focus on spoiling your good clients rotten. Your staff can’t concentrate on retaining clients with excellent customer service if they are required to be abused.
2. If you aren’t recommending lab work with every annual examination – start. Many clients are happy to do what’s best for their pet, but you have to let them know what’s best. This improves your medicine, increases revenue and protects pets by catching problems early.
3. Recommend that pets with chronic disease (kidney failure, thyroid problems, diabetes, etc) come in a minimum of every three months for a recheck and labs. Call to remind their owners – your software can probably link a reminder to the “Kidney Recheck” exam so you don’t have to remember. Even if they decline the kidney recheck, blood pressure and urine sample and only come in for the labs (they should be weighed as well) – that’s more information than you would have had on that patient otherwise.
4. Get involved with clinical trials. This is time consuming and best for a detail-oriented team. It’s a way to draw patients to your practice and to help people with financial issues get free services without giving them away yourself. In addition, you can be part of getting new medications approved and know what’s ahead for the veterinary profession!
5. Weigh all of your patients at every visit. If the elderly cat is losing weight at her nail trim, that should trigger your staff to ask if the owner is trying to get the cat to lose weight. If not, they should recommend a workup.
6. You look over records from other veterinarians all the time. As you’re reading – see if there’s anything they have been doing that would be a good idea for your practice. If you hire a relief vet – look over the record of every patient they saw – any habits there that you could adopt? Search for ways to make yourself more successful as a doctor and a business person, and the clinic down the street just won’t matter.
The rule for athletes applies to us as well: You have no competition. Don’t compare yourself to others or try to be better than anyone except the doctor you were yesterday.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.
Why Your New Puppy Might Need A Joint Supplement
This week, Dr. Roark talks joint supplements in puppies of breeds at risk for hip dysplasia, arthritis, and joint problems. Is there any benefit to getting young dogs on joint supplements when they show no signs of problems?
[tweetthis]Why Your Puppy Might Need A Joint Supplement[/tweetthis]
If you’re interested in learning more about joint supplements, why some of them work and others don’t, and/or how to pick a brand, you can check out this hilarious Cone of Shame episode as well!
Why We Fail Pets When We Judge Pet Owners
Years ago, I worked for a small animal clinic in Fleming Island, Florida. The area was becoming more developed, but there was still a lot of rural area around, with a majority of old country folks living there. Our clinic saw mostly dogs and cats, with birds and exotics making up the balance.
One day, an older lady showed up without an appointment. To all appearances, this lady didn’t have two pennies to rub together. Mrs. Strange was thin, with much-worn clothes and the sallow complexion of a lifelong smoker. The dog with her wasn’t much better off. The older black pit bull, Coal, was emaciated but with a swollen, pendulous belly and a wicked cough. It was clear, however, that she loved this dog with all her heart.
Coal was Mrs. Strange’s companion and protector while her husband drove a long-haul tractor trailer for days or even weeks at a time. The dog had even kept Mr. Strange from entering his own home one late night when he returned home from a run a few days early. Not until he reassured the dog, ‘Coal, it’s Daddy,” was the gentleman of the house allowed in.
Coal was somewhere around ten years old, and had never been on heartworm preventative. As a matter of fact, he hadn’t been seen by a vet since he was a puppy.
Certain that most of the diagnostics I offered would be refused, I was mildly surprised when Mrs. Strange agreed to blood work and a heartworm test. Unfortunately, we didn’t get as far as the ELISA test; a direct smear revealed more microfilaria (heartworm larvae) than red blood cells. And, just in case there was any doubt, Coal coughed up an adult heartworm onto the exam room floor. Clearly, the prognosis was bad.
Dr. Mike Ricker explained everything to Mrs. Strange and she opted to take him home and think about what to do. In as poor a condition as this dog was, treatment might even prove fatal. We offered to refer them to the University for a modified treatment that might be less stressful thinking anything we could do to help this poor, sick dog should be discussed.
Mrs. Strange’s husband was due home; She wanted him to be a part of the decision. We sent her home with medication to make Coal more comfortable, and she paid her bill in full with cash. We honestly didn’t expect to hear from them again, except perhaps to be told that Coal had died on his own.
The next day they called and scheduled euthanasia. Mrs. Strange and her husband came at midday with Coal. Mr Strange looked much like one would expect a long-haul trucker to look; long grey hair, ball cap, worn and faded jeans and a t-shirt advertising a far-away truck stop. We spent a surprising lunch hour laughing and crying along with them while they said goodbye to their Coal. Once again, they paid their bill in cash and took Coal to bury him at the only home he’d known.
Once more, we never expected to see them again.
In areas with rural residents who are used to doing for themselves, it’s not uncommon to have pets brought in at death’s door. The owners often hope we can work some kind of miracle to snatch their pet from the brink. They feed their dogs table scraps and Old Roy, get their vaccines from the feed store, and do their doctoring at home. Only when something is beyond their abilities do they seek help. Educating these people out of their self-sufficient mindset seems practically impossible.
Two days after Coal’s passing, Mr. and Mrs. Strange called to make an appointment for a new puppy. They came that very afternoon with the most beautiful red-nosed pit bull puppy I’d ever seen. Her name was Ruby and we all fell in love with her. No one was more smitten than her proud new parents.
We were told they wanted to do everything right by this dog. Ruby wanted for nothing; she was fully vaccinated and promptly started on heartworm preventative. Ruby’s owners followed our instructions to the letter, always grateful and appreciative of our help.
Over the next year, they presented us with two more red-nosed additions to their family. Both of them were accorded the same complete and loving care as Ruby. Mr. and Mrs. Strange became some of our favorite clients, and I looked forward to their visits.
Most of all, these people taught me a valuable lesson. Appearances are deceiving, sometimes in a good way. If we had all assumed that they were (and treated them like) uncaring pet caretakers because of their first dog’s condition, I’m willing to bet they never would have come back.
Never assume you know someone’s story just because of how they look or act. Coal may have been a medical nightmare, but he was loved. The feelings his owners had for him ensured his successors were the most pampered, healthiest and happiest dogs I’ve ever known. I was, and still am, grateful for the lesson.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.
Debi Matlack is that rarest of creatures, a native-born Floridian. She still lives there with her husband, another Native Floridian, and four cats. She hopes that someday her writing might prove popular enough to support her in the manner to which she would like to become accustomed, probably becoming a crazy cat lady (but a well-financed one).
You can find Debi’s recent novel Old Dogs for sale here.