Tell, Don’t Ask to Fix Compliance Blunders
By Wendy S. Myers, CVJ, President, Communication Solutions for Veterinarians
Wishy-washy conversations may cause clients to dismiss necessary follow-up care and to refill medications, putting patient care and practice revenue at risk. Pet owners expect clear, specific guidance from your veterinary team. Here are common compliance blunders and how to correct them:
Compliance blunder: “Do you need any refills today?”
Veterinarians sell 62 percent of pet medications, reports the market research firm Packaged Facts. Eight out of 10 clients trust what their veterinarians say about pet drugs. (*1) Compliance starts at check-in. Receptionists should view drug-purchase history when clients visit for appointments, boarding or to pick up food and medications. The AAHA compliance study found only 55 percent of dogs get year-round heartworm preventatives. Only 30 percent of practices send reminders to refill chronic medications. (*2)
How to fix:
Tell, don’t ask. See when preventatives were last purchased and how many doses were sold. Some clients also may share medication between pets. If only a few doses remain, prompt the client to refill the prescription now. If the client visited five months ago and bought a six pack of heartworm prevention, one dose is left. Tell the pet owner, “I see that Max has one dose left of his heartworm preventatives. Let me tell you about our rebates so you may save the most.”
Check all pets in the family to see which need refills for preventatives and chronic drugs. The average American family has two pets (1.6 dogs and 2.1 cats), according to the American Veterinary Medical Association U.S. Pet Ownership & Demographics Sourcebook. (*3) I may be visiting for my cat Alex’s checkup, but my second cat, Caymus, needs his medication for cardiomyopathy refilled. My veterinarian is 15 minutes from my home, which turns into 30 to 45 minutes each way during rush-hour traffic. Ensure timely refills, help me avoid road rage and improve your refill compliance.
If your hospital has an online store, guide clients to set up accounts and auto refills during today’s visit. Tell the pet owner, “You can pick up future refills at our hospital, or I can help you set up auto refills through our online store now. Your pet’s preventatives will be automatically shipped each month until the next heartworm test is due. Do you prefer to get medication now or have it delivered to you with free shipping?”
Compliance blunder: “Do you want to schedule a recheck?”
Medical progress and pediatric exams have specific follow-up timelines. Clients may perceive a “recheck” as free and optional. About 75 percent of practices “always” or “most of the time” forward book patients’ progress exams, according to a Veterinary Hospital Managers Association survey. (*4)
How to fix:
Lead the client to book now because the appointment reminder will print on today’s receipt. Your busy hospital also may be booking exams one to two weeks in advance. If the client doesn’t book now, an appointment may not be available when follow-up care is due. Use the term “medical progress exam” to stress the urgency and importance of follow-up care. Tell the pet owner, “Dr. Patten needs to see Max for a progress exam for his skin infection in two weeks. Let’s book the appointment now so you get your first choice of time and day. Two weeks from today would be Thursday, Nov. 15. Does this same time, 9 a.m., work for you?” If the client is here at 9 a.m. on a Thursday, she may be able to return at a similar time and weekday. Book the appointment with the same veterinarian, ensuring continuity of care and efficient use of exam time.
Because you follow specific timing of vaccines, diagnostics and deworming for pediatric patients, book the next puppy or kitten exam today. Tell the pet owner, “Dr. Jeff needs to see your kitten again in three weeks, which would be Nov. 15. Does this same time, 1 p.m., work for you?”
Every practice has a mind-erase hallway that connects exam rooms to the front desk. Clients may forget to schedule follow-up care on the way to the checkout counter. To bridge this gap, choose from three strategies:
- If you have computers in exam rooms, the technician or veterinarian should book the next exam now. Nervous about a doctor using the appointment scheduler? Train to trust!
- Use a travel sheet or alert in your practice-management software. Hospitals with paper or paper-light records could use laminated travel sheets to note charges, reminders and follow-up care to be entered.
- Walk the client to the checkout desk for a verbal handoff. The technician or veterinarian would tell the receptionist, “<Client name> needs to schedule a progress exam for an ear infection for <pet name> on <date>.”
Create Level 1 and Level 2 progress exams,
depending on the amount of exam time needed for follow-up care. Level 1 progress exams would be 10-minute appointments for conditions such as ear infections, while Level 2 progress exams are more complex cases such as diabetes and would be 20 minutes. When scheduling follow-up exams, strive for same day, same time and same doctor.
Compliance blunder: “Do you want to book the dental procedure that the doctor recommended?”
The patient’s dental disease will get worse, and the price of treatment will significantly increase over time. Replace the wiggle word of “recommend” with the action word of “need.”
How to fix:
Schedule the procedure on the day of diagnosis. To guide the pet owner to book now, offer the doctor’s next two surgical/dental days. Schedule the procedure with the same veterinarian who diagnosed the condition because he will be familiar with the case and enjoy production pay. Booking with the same doctor also increases clients’ confidence.
If the client will check out at the front desk, the receptionist should schedule the procedure first, and then collect payment for today’s services. Lead the client with the two-yes-options technique. Tell the pet owner, “Dr. Lavallee diagnosed Caymus with Grade 1 dental disease. Let’s schedule his procedure first, and then I will get you checked out for today’s services. We can perform the dental treatment next Monday or Wednesday. Which fits your schedule?” Provide fasting instructions and let the client know you will call, email or text to confirm one day before the procedure. An appointment reminder for the procedure will print on today’s receipt.
When you confidently explain needed follow-up care and refills, you will guide clients’ decisions. The result is healthier patients and practice revenue. Get more training in my online CE class on “Are Your Wiggle Words Killing Compliance?” Enroll at here.
*1 – Niedziela, K. Veterinarians Sell 62% of Pet Drugs. Today’s Veterinary Business. Published September 2017. Accessed Sept. 17, 2018 at https://todaysveterinarybusiness.com/veterinarians-sell-62-pet-drugs/.
*2 – Compliance: Taking Quality Care to the Next Level. American Animal Hospital Association, 2009, pp. 11, 19.
*3 – 2012 American Veterinary Medical Association U.S. Pet Ownership & Demographics Sourcebook. Accessed Sept. 17, 2018 at www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership.aspx.
*4 – DVM360.com staff. VHMA Files: Forward Thinking, How to Use Forward Booking for Your Practice. Published Jan. 22, 2015. Accessed Sept. 17, 20158 at http://veterinaryteam.dvm360.com/vhma-files-forward-thinking.