Karen E. Felsted, DVM, MS, CPA, CVPM
This article is the second in a series by Dr. Karen Felsted discussing what sets growing, successful veterinary practices apart from their competitors and how you can implement their business models in order to benefit your practice.
Much of the information presented in this series is based on the results of a recent study—the Bayer Veterinary Care Usage Study—that investigated veterinary practice performance from both the veterinary professional and pet owner viewpoints.
To learn more about this study and read the first article in this series, Practices That Continue To Grow: What Are They Doing Right? (January/February 2012), go to todaysveterinarypractice.com and select Article Lists.
One of the truly unique features of the recently released Bayer Veterinary Care Usage Study (bayer-ah.com/nr/45.pdf) is how actionable it is. The study was done in two parts: one focused on pet owners and the other on veterinarians and their practices.
In the pet owner survey, clients were clear about what they liked and disliked about veterinary practices and what would encourage more frequent visits. In the veterinarian survey, the activities, attributes, and practice philosophies of practice owners were studied. Both sets of participants provided clear insights into ways to meet client expectations and grow veterinary practices.
Building Stronger Relationships: Veterinarians & Clients
Same Veterinarian: Each Client, Every Visit
One of the most interesting findings from the Bayer study was that practices that assigned clients to the same veterinarian every visit had seen an increase in visits over the past 2 years.
However, only 29% of practice owners agreed with the statement that clients were assigned the same veterinarian for nearly every visit. Another 19% of practice owners somewhat agreed with this statement, but most practice owners did not appear to encourage this in their practices.
I’ve asked, “Would you or your children prefer to see the same doctor every visit?” multiple times in seminars. The answer? About 95% of the attendees want to see the same doctor when they or their children need medical attention.
So why isn’t this done in our own practices? Do practice owners and managers think pet owners don’t care whether they see the same veterinarian? Have they just not thought about it? Or is it discouraged in the name of convenience?
Assessing the Benefits
The benefits of pet owners seeing the same veterinarian each time they visit are clear:
- Knowledge: The veterinarian has a better understanding of the pet’s medical history and problems. No matter how well documented the records, it’s not the same as the knowledgeable relationship created when the veterinarian has seen the pet before.
- Trust: Each time the veterinarian sees the client, he/she is building a bond with the pet owner, leading to trust. Pet owners are more likely to accept recommendations from veterinarians they trust. This relationship also makes it more likely that the client will refer his/her friends and colleagues to the veterinarian and/or recommend the veterinarian online.
- Value: Treating veterinarians as interchangeable cogs in the relationship between the practice and the pet/pet owner devalues the importance of the veterinarian to the owner.
Of course, just being in the same room with someone doesn’t mean a bond is being built. It’s important to provide communication training to everyone in the practice and stress the value of building a trusting relationship between the pet owner and the practice.
Why Doesn’t It Happen?
Practice owners who have intentionally set up a system where pet owners don’t see the same veterinarian often do it for two reasons:
- To fit the scheduling system in place in the practice
- Discourage bond-building with associates in case they leave the practice, preventing clients from following them to a new practice.
While those are both legitimate concerns, there are better ways to address them than discouraging relationship building with practice team members.
What To Do When It Can’t Happen
It’s not possible for clients to always see the same veterinarian—veterinarians will be off when clients need to come in and emergencies happen requiring that other veterinarians step into appointments. But instead of the receptionist booking any veterinarian, he/she should review the pet’s records to see if the pet has been previously seen by another veterinarian in the practice and schedule the appointment with that person.
Backup systems should also be in place—well written medical records, standard protocols for treating common cases, and good communication between veterinarians jointly handling cases—to increase the client’s confidence and trust no matter who is seeing the pet.
Improving Relationships with Clients & Patients: Key Points
Veterinarians, Clients, & Patients
- Assign the same veterinarian to a client for every visit if possible.
- Book a veterinarian who has seen the pet before if the patient’s regular veterinarian is not available.
- A system of well-written records, standard treatment protocols, and good communication between veterinarians jointly handling cases increases the client’s confidence and trust.
Practice Team, Clients, & Patients
- Provide communication training to everyone in the practice, stressing the value of building trust between the practice, client, and patient.
- Pair technicians and doctors together, allowing the client to build a relationship with both individuals.
- Assign callbacks or technician’s appointments to technicians who know the clients.
Practice Team, Cats, & Owners
- Educate cat owners about implementing routines that allow cat-friendly transport.
- Emphasize cat-friendly transport tips by talking to clients; providing handouts; and using media, such as the practice website, newsletters, emails, videos, and social media.
- Make the clinic comfortable for cats by:
- Reorganizing the waiting room to keep cats and dogs separate
- Bringing cats directly into the examination room
- Keeping examination room lights dim and noise low
- Checking out the client with the cat in the examination room or car (weather permitting)
- Assigning hours or days just for cat appointments.
Bilding Stronger Relationships: Veterinary Teams & Clients
It’s Takes a Village
Naturally, the benefits of building a relationship aren’t confined to veterinarians. The more strongly bonded the clients are to everyone in the practice; the more likely they will (1) keep coming back even if a key person leaves and (2) the more they will trust recommendations made by anyone on the practice team.
In general, clients can’t judge the quality of medical care; however, relationship building with the entire team—from the veterinarian to veterinary technician to receptionist—reassures the client that his/her pet is receiving the highest quality of care.
Begin With These Steps
Encourage team members to build these bonds with the following techniques:
- Pair technicians and veterinarians together so the client not only builds a relationship with the veterinarian but also the technician.
- Continue by assigning callbacks or technician’s appointments to technicians who know the clients.
- Encourage younger or shyer team members to open up and build relationships with clients. One of the best and easiest ways to do this is by telling the client everything being done to the pet; for example:
- “I’m taking Fluffy’s temperature now; it’s normal.”
- “Fluffy weights 10 pounds now; that’s a little less than before. I’ll mention this to Dr. Felsted so she can talk to you about it.”
How Does It Make A Difference?
The number and type of veterinary practices have increased greatly in the last 10 years, providing clients with many more options for veterinary care. Relationships with the veterinary team are an important consideration when clients are making these decisions and it is worth spending time creating long-lasting relationship between the veterinary team and pet owners.
Continuing Education for Your Clients
Educating pet owners on preventive care and routine procedures is an integral part of providing better medicine in your practice. Regular communication between visits helps owners feel like they are part of their pets’ health care team and can be used as reminders to schedule appointments.Communication with pet owners can be carried out in the following ways:
- Provide handouts to clients in the clinic—especially handouts that provide information about routine wellness care, preventive care, and recommended therapy.
- Put together a library of handouts and brochures and keep them accessible to clients in the practice.
- Add a section with educational resources to your practice website, including educational clinical information, links to educational resources, handouts in a printable format, and videos depicting step-by-step procedures (eg, how to medicate your cat at home).
- Distribute the information above and additional educational information by:
- Newsletters (mail or email)
- Social media (blogs, Facebook, Twitter)
- Prompt practice team members to give clients handouts and/or provide the practice website address by adding a reminder to in-clinic, internal examination checklists.
The Feline Friendly Practice
Rebuilding the Relationship
Felines Fading Away
We all know that cats don’t want to go to the veterinarian—it’s a process that’s stressful for both the cat and owner. Information from the 2007 American Veterinary Medical Association U.S. Pet Ownership & Demographics Sourcebook indicated a significant decline in cat visits at a time when dog visits were increasing. This decline was significant enough to bring down the total number of veterinary visits.
Reversing the Trend
It is not fully understood why this issue is getting worse but information from the Bayer Veterinary Care Usage Study clearly indicates the areas that need to be focused on to reverse the trend.
Cat owners interviewed during the Bayer study were eloquent about the difficulties they encountered in trying to take their cats to veterinary clinics. Cats:
- Hid when they saw the carrier
- Scratched and bit their owners
- Cried all the way to the clinic
- Went ballistic when a dog nosed up to the carrier in the reception area.
Results of the related online survey reiterated the findings from these one-on-one interviews; 58.2% of cat owners said their pet hated going to the veterinary clinic as opposed to 37.5% of dog owners. And 37.6% of cat owners said just thinking about taking their cats to veterinary clinics was stressful.
Transportation to the Clinic
One way to reduce this stress is to help the cat owners in your practice learn about cat-friendly transport. Some recommendations include:
- Start habituating the cat to the carrier early by leaving the carrier out in the house on a regular basis.
- Put soothing synthetic pheromones or clothing the cat associates with a favorite person in the carrier.
- Cover the carrier—some cats like that better than being able to see out.
- Withhold food before a car trip or consider motion sickness medications for cats that get carsick.
- Take the cat on little mini-trips around the neighborhood to habituate it to car rides.
Knowing what these recommendations are, of course, is just the starting point. They need to be communicated to cat owners via the following ways:
- Receptionists should talk to cat owners about cat transport every time they make an appointment.
- Provide a cat transport handout to clients when they are in the clinic.
- Send (mail/email) the handout to clients after making appointments.
- Recommend that cat owners watch the excellent video from CATalyst about acclimating cats to carriers at catalyst.org.
- Distribute the information above (advice, handouts, video link) through:
- Newsletters (mail or email)
- Practice website
- Links added to other feline handouts
- Social media (blogs, Facebook, Twitter)
- Prompt practice team members to educate clients about cat transport by adding a reminder to any internal annual examination or kitten examination checklists used.
Maintain the Educational Process
Start this educational process at the kitten stage and keep with it even as the cats get older. Only 8% of practice owners in the Bayer study completely agreed with the statement, “I provide each cat owner with instructions on how to make travel to the clinic less stressful for them and their cat,” and another 25% somewhat agreed with the statement.
The majority of cats will never love going out and about like dogs do but the above recommendations can at least reduce the stress and terror to a more manageable level. Cat owners as well as cats will thank you for making this task easier!
Making the Clinic Comfortable for Cats
The effort to keep cats’ experiences less stressful doesn’t end when they arrive at the practice. Most clinics aren’t designed for cat comfort but there are many things practices can do to make this part of the visit more inviting to cats and owners.
Waiting Room Experience
Only 28% of practice owners completely agreed with the statement, “We go to great lengths to ensure the waiting room experience for cats and cat owners causes as little stress as possible.” Another 42% somewhat agreed with the statement, but it’s clear many practices could be doing more.
The following are suggestions to make the waiting room experience more pleasant for cats:
- Create a separate waiting area for cats using a screen, bookcase, or some other barrier that clearly demarcates the two parts of the reception area. Signage and directions from the receptionists about who should sit where will at least keep dogs and cats from being too close.
- If this isn’t an option, move cats into an examination room as soon as they arrive. Some practices instruct cat owners to call when they pull into the parking lot and a team member goes out to assist with bringing the cat and its owner straight through the waiting room.
- Another option is to group cat appointments together by assigning certain hours or days as “cat only.” One creative designation is “Feline Fridays.”
Examination Room Experience
Cats don’t like noise or bright lights; examination rooms regularly used by cats and their owners should:
- Be away from the primary noise of the hospital or, even better, sound-proofed
- Have softer lighting.
When it’s time for the client to leave, there are several ways to handle check out:
- Check clients out in the examination room
- Put the cat in the car prior to check out (weather permitting)
- Leave the cat in the examination room during check-out.
Reducing cat stress goes a long to reducing cat owner stress, which makes the veterinary visit experience more pleasant and ultimately results in an increase in feline patient visits.
Karen E. Felsted, DVM, MS, CPA, CVPM, is the Chief Executive Officer for the National Commission of Veterinary Economics Issues (NCVEI, ncvei.org). She is also a founding director and current member of VetPartners (avpmca.org), the treasurer for the CATalyst Council (catalystcouncil.org), and a past member of the Veterinary Economics Editorial Advisory Board. Dr. Felsted has written an extensive number of articles for a wide range of veterinary publications and speaks regularly at national and international veterinary meetings. In addition, for the last 10 years, she has provided financial and operational consulting services to veterinarians, most recently with Brakke Consulting and Gatto McFerson CPAs. Dr. Felsted received her degree in marketing from University of Texas–Austin and spent 12 years in accounting and business management, including 6 years with Ernst & Young. During this time, she also earned both her CPA and MS degree in management and administrative science from University of Texas–Dallas. In 1996, Dr. Felsted received her DVM from Texas A&M University; she practiced small animal and emergency medicine for 3 years.