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What to tell clients to win back refills

What to tell clients to win back refills

What to tell clients to win back refills

By Wendy S. Myers, CVJ, Communication Solutions for Veterinarians

Question: We get a dozen refill requests from outside pharmacies every day. I’m frustrated with the amount of time my team spends giving away our pharmacy income. What can we say to persuade clients to get refills from our hospital?

Answer: First, evaluate your prices on preventives and long-term drugs for chronic health conditions. Strategically price these drugs so you’re competitive, especially parasiticides because they comprise 59% of pharmacy sales.[1] Smart prices combined with rebate and reward programs will give your hospital an advantage. 

When you get a heartworm preventive request from an outside pharmacy, check the medical record to confirm the patient has had an exam and negative heartworm test within 12 months. Call the client to share benefits of buying preventives from your hospital.

SAY THIS: “We received a request from <outside pharmacy> for Max’s heartworm preventives. Dr. <Name> checked your dog’s medical record and confirmed that he has had an exam and negative heartworm test within 12 months, which is necessary to safely take preventives. You can pick up a refill at our hospital or order it through our online pharmacy if you prefer home delivery. Our hospital has competitive prices and offers safe, guaranteed drugs that we buy directly from pharmaceutical companies. <Drug name> has a $__ instant rebate when you buy it from us. You can pick up a refill at our hospital, or I can help you place your first order through our online pharmacy. Which do you prefer?” 

Let me highlight key words in this script. Use the doctor’s name to reinforce the veterinary-client-patient relationship. Explain your standard of care that dogs must have exams and heartworm tests within 12 months for you to prescribe preventives. Share prices and benefits of buying medications from your hospital, including rebates or rewards. “Online pharmacy” has a medical focus compared to the retail sound of “online store.” “Instant rebate” lets clients know they don’t have to wait for checks or vouchers in the mail. Use the yes-or-yes technique to lead clients to refill now through your hospital or online pharmacy.

If leave a voicemail message, send a backup text. TEXT THIS: “We left you a voicemail about <pet name>’s refill of <drug name>. Order now through our online pharmacy with home delivery or reply Y to pick up at our hospital. Get $__ instant rebate when you buy 12 doses of <drug name> from us. Text or call with questions.”

Invest 5 minutes to call clients because pharmacy represents 25% to 30% of revenue.[2] Pet owners will appreciate hearing from you, and you’ll win their trust and loyalty. 

WANT TO LEARN MORE? 

Enroll your team in the course: how to compete with online pharmacies.

About the Author: Best known as the “Queen of Scripts,” Wendy S. Myers, CVJ, has taught communication and client service skills for more than two decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Wendy was a partner in a specialty and emergency practice. Visit CsvetsCourses.com to learn more.

References:

1. Palacious Rubio D. Trends in Online Sales of Pet Products. Available at: https://globalpetindustry.com/article/trends-online-sales-pet-products#:~:text=Amazon%20leads%20online%20sales%20of,%25)%20and%20Walmart%20(33%25). Accessed Jan. 30, 2024.

2. Gavzer K. How to Profit on a Hospital Pharmacy. Available at: https://todaysveterinarybusiness.com/profit-hospital-pharmacy/. Accessed Jan. 30, 2024.

Scheduling Weeks Out? Implement Forward Booking

Scheduling Weeks Out? Implement Forward Booking

Scheduling Weeks Out? Implement Forward Booking

By Wendy S. Myers, CVJ, Communication Solutions for Veterinarians

A practice manager told me her hospital doesn’t have any checkups available for four months. Clients feel frustrated and patients aren’t getting timely preventive care. If your practice is booking checkups two or more weeks out, you need to implement forward booking as a long-term solution.

Have clients schedule pets’ next checkups during today’s appointments. While dental practices aim to schedule 75% of patients in advance, only 11% of veterinary hospitals forward book six- or 12-month checkups.[1],[2] When clients schedule months in advance, you will have ample appointments available. Here are four success factors to implement forward booking: 

1. Pre-block checkups in your schedule template.

Build your schedule 12 months out. Pre-block four checkups in each doctor’s daily schedule:

  • First appointment of the day: Doctors are confident about preventive care, which creates a positive mindset for the day.
  • Appointment before lunch: Because checkups are predictable and more likely to finish on time, the outpatient team can enjoy well-timed lunch breaks.
  • Appointment after lunch: A checkup after lunch starts the afternoon on time.
  • Last appointment of the day: Wrapping up the day with a checkup ensures the outpatient team goes home on time. 

Don’t worry if veterinarians’ schedules change. Doctors will request time off in advance for vacation and conferences, especially if booking travel. Simply contact clients whose appointments need to be moved.

2. have the outpatient team personally schedule future appointments.

In dental practices, hygienists have greater success with pre-appointing patients than scheduling coordinators at checkout.[1} By the time patients reach the checkout counter, they want to leave and may dismiss staff’s attempts to schedule. 

Here’s how to apply this strategy to checkups, pediatric exams, and progress exams:

Checkups: Having technicians and assistants initiate conversations about future checkups emphasizes the importance of preventive medicine. Compare the pre-appointment strategy to dentists’ offices, which clients already experience. Use the yes-or-yes technique to lead pet owners to commit. Say, “Just as your dentist has you schedule your next appointment at checkout, we do the same to proactively manage your pet’s health. By scheduling today, you will get your first choice of doctor, day, and time. Do you prefer <date, time 1> or <date, time 2>?” The first choice is the same day of the week and time as today’s appointment. The second choice is a different day of the week and time of day (morning vs. afternoon).

When procrastinators won’t commit, use benefit statements. Say, “I understand you don’t know your schedule 12 months from today. By scheduling now, you will get your first choice of doctor, day, and time. You will get a confirmation today and reminders as the date nears. If you need to change the appointment, just reply to the text/email. Does this same time and day typically work for you?” If the client agrees, recite the time and date out loud to reaffirm the decision. Say, “Fantastic, let’s schedule you for this same time on <date>.”

If your hospital has computers in exam rooms, having outpatient teams schedule future appointments and collect payments is the most efficient. If clients will pay at the front desk, client service representatives (CSRs) can use these same scripts. Always guide clients to pre-appoint before paying for today’s services because appointment reminders will print on receipts and trigger confirmations. Follow the best practice of “Schedule First, Pay Last.”

Pediatric exams: If you’re booking three weeks out, puppies and kittens risk missing timely immunizations. During the first pediatric exam, forward book the remaining series of appointments. If a client visits today with an 8-week-old puppy, say, “Your puppy will need exams and vaccinations at 12 and 16 weeks of age. We need to provide timely exams to monitor <pet name>’s growth and development and vaccines for ongoing protection. We will schedule your puppy’s next two appointments today, so you will get your first choice of time, day, and doctor. Let’s set the next appointment when your puppy will be 12 weeks old. Do you prefer <date, time 1> or <date, time 2>?” Once the client agrees, say, “Great, we will see <pet name> on <date, time> for the 12-week-old appointment. Now let’s book the 16-week visit. Do you prefer <date, time 1> or <date, time 2>?” Let the client know to expect confirmations.

Progress exams: If patients need progress exams, schedule today to ensure timely follow-up care. Seeing the same veterinarian builds client confidence that the medical problem will be resolved and supports exam efficiency. A different doctor will need more time to review the medical record to learn the previous veterinarian’s diagnosis and treatment.

Use words that work. Replace the wiggle word of “recommend” with the action word of “needs.” “Progress exam” communicates that follow-up care is medically necessary, and you are moving forward in resolving the health concern. “Recheck” may be perceived as free and optional. Say, “Dr. <Name> needs to see <pet name> in two weeks for a progress exam for the ear infection. Do you prefer <date, time 1> or <date, time 2>?”

3. implement a confirmation protocol.

Dentist found that patients who leave with appointments are statically more likely to show up.[3] Only 10% of dental patients cancel or no-show, while two-thirds skipped booking because they don’t want scheduling hassles.

Likewise, you can save clients future tasks and make preventive care easier when you forward book. Veterinary hospitals experience 11% no-shows.[4] Text and email confirmations significantly lessen cancellations and no-shows. 

In my online course on Everything You Need to Know About Scheduling, I advise sending four confirmations with actions that improve practice efficiency (https://csvets.info/scheduling). Confirmations should include hyperlinks to online forms based on the reason for visit. Use emojis to increase open rates and clients’ understanding of appointment instructions. A pile of poo will grab clients’ attention and boost compliance for intestinal parasite testing. Here is the series of text confirmations:

Immediately upon booking: <Pet name> has an appointment at <time, date>. Complete patient history form at least 24 hours ahead, which is required to guarantee your appointment. Bring a stool sample 💩 that is fresh within __ hours. Download our app to pay after the exam. Reply C to confirm or RS to reschedule. 

Two weeks prior: <Pet name> has an appointment at <time, date>. Please confirm this still works for you. Complete patient history form at least 24 hours ahead, which is required. Reply C to confirm or RS to reschedule. 

Four days prior: This is a friendly reminder that <pet name> has an appointment at <time, date>. Remember to complete patient history form at least 24 hours ahead, which is required. Reply C to confirm or RS to reschedule. 

Two days prior: We will see <pet name> for an appointment at <time, date>. Complete patient history form, which is due TODAY by X p.m. and is required to keep your appointment. Bring a stool sample 💩 that is fresh within __ hours. Download our app to pay after the exam. See you soon! 

If clients have not confirmed or submitted online forms two days prior, call them. Say, “We have reserved an appointment for <pet name> at <time, date>. We are experiencing increased appointment requests and have other patients on a waiting list. We need your confirmation and online form submitted by X p.m. today or <pet name>’s appointment will be released to another patient in need. Please text/email/call us with questions.” 

When clients fail to respond, call them after your deadline and send backup texts or emails to inform them that their appointments have been cancelled. Text: “We regret that we have not received your confirmation and/or online form, which is required to guarantee your pet’s exam. Your appointment on < date, time> has been released to another patient in need. Book online or download our app to reschedule.

4. make having future appointments the norm, not optional.

Dentists don’t give patients a choice. Their pre-appointing strategy has been successful for decades. Veterinary practices can implement forward booking to ensure timely preventive care, future hospital revenue, and fewer scheduling phone calls.

WANT TO LEARN MORE? 

Enroll your team in the COURSE: HOW TO MASTER FORWARD BOOKING.

About the Author: Best known as the “Queen of Scripts,” Wendy S. Myers, CVJ, has taught communication and client service skills for more than two decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Wendy was a partner in an AAHA-accredited specialty and emergency practice. Visit CsvetsCourses.com to learn more.

References:

1. Faustino A. How to Improve Dental Recall with These Tips. Available at: https://capforge.com/how-to-improve-dental-recall-with-these-tips/. Accessed Feb 6, 2024.

2. Forward Booking: How Forward Booking Leads to Better Patient Care. AAHA and Partners for Healthy Pets. Available at: https://www.aaha.org/globalassets/04-practice-resources/Forward-booking. Accessed Feb 6, 2024.

3. 6 Metrics That Determine the Success of Your Dental Practice. ThriveCloud. Available at: https://mythrivecloud.com/6-metrics-that-determine-success-dental-practice/. Accessed Feb 6, 2024.

4. What Pesky No-Shows Actually Cost Your Veterinary Practice. PetDesk. Available at: https://petdesk.com/blog/what-pesky-no-shows-actually-cost-your-veterinary-practice/. Accessed Feb 6, 2024.

8 Ways to Find Time for Training

8 Ways to Find Time for Training

8 Ways to Find Time for Training

By Wendy S. Myers, CVJ, Communication Solutions for Veterinarians

While attending a conference, a veterinarian got a text from his hospital manager that a client service representative (CSR) had just resigned. More than half of veterinary front-office staff last under two years in their jobs.[1] The doctor asked me, “My manager already posted the job opening online. How can we train a new CSR to quickly get up to speed?” 

With practices’ current busyness, finding time for training can be challenging. Here are eight ways to ensure training happens:

1. Create onboarding checklists.

On their first day of employment, new hires get a checklist of skills to learn, training resources, and deadlines for completion. Set them up for success because the cost of turnover is 16 percent to 20 percent of an employee’s salary.[2]

In Jump-Start Your New Receptionist: 6 Courses, I share an onboarding checklist and six hours of online courses to achieve fundamental skills in phone techniques, scheduling, difficult clients, and client service (https://csvets.info/jumpstart). Assign mentors to teach skills and sign off on testing. At the end of each week, the CSR team leader checks in with the new hire to confirm progress and answer questions.

2. have staff create practice-specific training.

If you don’t have standard operating procedures (SOPs) in writing, start creating them with the help of new hires and their mentors.

Let’s say a mentor is teaching a new CSR how to create an electronic medical record in your practice-management software. Have the new hire write down each step while learning the process. Turn the document into a SOP for others to follow. While the mentor demonstrates step-by-step clicks, make a screen recording to accompany written instructions. Upload videos on your hospital’s private YouTube channel where employees can access tutorials that answer, “How do I…?”

3. identify training resources.

Gather internal and external sources that employees and managers can use such as:

4. block learning time in work schedules.

This may seem obvious, but you’ll guarantee that employees have dedicated time to learn. New hires will have lots of lesson time blocked in daily schedules while seasoned employees may get two hours a month. Supervisors can coordinate training dates and times so teams continue to work efficiently. For example, a surgery technician might have training time set aside from 2 to 3 p.m. after morning procedures finish and a lunch break. Putting training on staff schedules makes it official, like meetings that employees can’t miss.

You also will get better results when employees complete training at work. Too many interruptions happen at home. A manager told me her CSR submitted three hours of payroll to watch a one-hour course at home. Distractions of kids, dinner, laundry, and homework also may cause employees to retain less of what they learn. Expecting employees to put in extra time to learn at home tells them you don’t value their personal time or them. Have staff learn at work where you control the surroundings.

5. create a positive learning environment.

Provide a quiet nook such as a desk in the employee break room, conference room, phone cubby, or shared office. Place a basket of snacks, fruit, water, notepads, and pens next to the computer or tablet. Have headphones so employees can listen without distracting background noises.
 

6. make training part of your culture.

After new hires complete their 90-day introductory period, keep growth going. Identify which skills they need to learn and become proficient in performing. Set expectations and learning goals with deadlines during performance reviews.

7. set a ce requirement for all staff.

Veterinarians and credentialed technicians must complete a certain number of RACE-approved CE credits to remain licensed or certified throughout their careers. In Florida, veterinarians need 30 credits every two years while certified veterinary technicians need 15 credits every two years.[3] Set a CE requirement for CSRs and veterinary assistants employed at your practice such as eight credits every two years, which is half the number of CE credits required for technicians. Consider accepting a mix of RACE-approved CE credits as well as participation in lunch-n-learn sessions from vendors and certificates of completion for online courses.

Employees should submit training requests that require funding. At Mount Laurel Animal Hospital in Mount Laurel, N.J., every employee gets $350 per year for education and can request additional funds. Employees may use educational funds for dues, conferences, online courses, books, college, and other training. Certified veterinary technicians (CVTs) get annual CE allowances of $1,000. The National Association of Veterinary Technicians in America (NAVTA) offers Veterinary Technician Specialty (VTS) certificates in more than 16 specialties from dentistry to behavior (https://navta.net/veterinary-technician-specialties/). Mount Laurel Animal Hospital’s technicians with a VTS certification get $1,500 for CE annually.

8. tie training to job advancement.

Create job levels with skill checklists. Adobe Veterinary Center in Tucson, Arizona, has four job tiers for CSR positions. Level 1 CSRs learn 55 skills, ranging from appointment scheduling to creating and maintaining electronic medical records. Employees get training through online courses, SOP manuals, mentors, and hands-on instructions. Tests confirm they have become competent in skills. Wages increase as employees move up through job tiers. Once CSRs reach Level 4, they have become proficient in 94 skills. Discover how to create job structure in my course on Career Paths: A Guide to Implementing Job Levels (https://csvets.info/careerpaths). Employees who see clear upward opportunities with your practice are more likely to stick with you longer. 

Companies that offer ongoing skill development are seven times more likely to retain their employees.[4] Teammates who spend time learning at work also are less stressed and more productive. Finding time for training will get your employees and practice growing.

WANT TO LEARN MORE? 

Enroll your team in the training bundle: jump-start your new receptionist: 6 Courses.

About the Author: Best known as the “Queen of Scripts,” Wendy S. Myers, CVJ, has taught communication and client service skills for more than two decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Wendy was a partner in an AAHA-accredited specialty and emergency practice. Visit CsvetsCourses.com to learn more.

References:

1. How to Help Your Veterinary Front-Desk Team with Burnout. Available at: https://whiskercloud.com/blog/help-your-veterinary-front-desk-burnout#:~:text=How%20bad%20is%20reception%20turnover,two%20years%20in%20their%20role.&text=According%20to%20the%20AAHA%27s%202020,was%2023%20percent%20on%20average. Accessed March 18, 2024.

2. Hansen M. How to Get Employees Excited About Training: 10 Ways to Motivate Them. Available at: https://www.edgepointlearning.com/blog/get-employees-excited-about-training/. Accessed March 18, 2024.

3. Frequently Asked Questions About Continuing Education. Florida Veterinary Medical Association. Available at: https://fvma.org/continuing-education/about-continuing-education-ce/. Accessed March 18, 2024.

4. Hilgers L. How to Help Employees Make Time for Learning at Work. Available at: https://www.linkedin.com/business/talent/blog/learning-and-development/how-to-help-employees-make-time-for-learning-at-work. Accessed March 18, 2024.

4 Mistakes Conference Goers Make

4 Mistakes Conference Goers Make

4 Mistakes Conference Goers Make

By Wendy S. Myers, CVJ, Communication Solutions for Veterinarians

You earned continuing-education credits, shopped the exhibit hall, met new friends, and reconnected with classmates while attending conferences. Now you’re back to the daily grind. Your investment of the registration fee, travel, meals, and time away from your practice could be costly if you make these four post-conference mistakes.

1. Filing and forgetting conference notes

You picked up new medical knowledge, efficiency ideas, and revenue growth strategies at the event. Without implementation, these gems are worthless. Before you leave the conference, dedicate 20 minutes in the quiet of your hotel room or on your return flight to write the top three ideas you will implement when you return to your practice.

When determining goals, ask these questions to prioritize which choices will have the greatest impact on your practice:

  • How will this idea improve client experiences?
  • How will this idea enhance employee productivity and job satisfaction?
  • How will this idea improve patient care?
  • How will this idea increase hospital revenue?

Let’s say you attended my session on how to use technicians as physician assistants. If you follow my advice on shifting up to 20% of appointments from veterinarians to technicians, you will increase appointment availability, which makes clients happy. Technicians will work at the top of their licenses and skillsets, which makes employees happy. Delivering more technician appointments will improve patient care and generate revenue, which makes practice owners and managers happy. All four criteria are in sync, so this goal is a winner.

Michael Hyatt, founder and chairman of Full Focus and bestselling author, advises to make your goals SMARTER:[1]

  • Specific: Identify exactly what you want to accomplish.
  • Measurable: Quantify the result so you know whether you hit the goal.
  • Actionable: Start with action verbs of “increase,” “grow,” or “improve” instead of dreamy to-be verbs of “be” or “have.” A weak goal is “Be better at recommending early detection screens,” while a strong goal is “Increase compliance for early detection screens by 20%.”
  • Risky: A goal should make you stretch to the edge of your comfort zone but not be impossible. You’re not thinking big enough if you want to increase compliance 5%.
  • Time-keyed: Assign a date to every goal. A goal without a deadline is just a dream. Your goal would be to “increase compliance for early detection screens by 20% by June 30.”
  • Exciting: You need to be excited about achieving the goal. Otherwise, you won’t have the motivation necessary to keep pursuing the goal when you encounter unexpected challenges.
  • Relevant: Goals should be aligned with your practice and personal values and other goals. As a hospital manager, don’t aim to earn your certified veterinary practice manager credential and get a master’s degree in business administration the same year. It’s too much, and you risk failing at both. Do one or the other.

When writing goals, Hyatt advises to review them regularly. He does this weekly. Ask, “What’s the next step I need to take to move toward this goal?” When you review goals, they should inspire you to populate your daily task list with action steps.

2. not following up with new connections

You sat next to a hospital manager in a session about onboarding new hires. During the break, you talked about your phase-training checklists, exchanged business cards, and promised to email each other. Six months later, you discover a handful of business cards buried in the bottom of your backpack. You sort through the cards but don’t remember which manager had the awesome onboarding checklist you desired.

Write notes on business cards about your conversations and follow-up actions. At the end of each day, put a note on your calendar or digital planner with a reminder to follow up on a specific date. Send follow-up emails when most conference goers will have been back at work for two days. Your email should include who you are, what you discussed at the convention, and suggest next steps such as setting up a meeting, connecting with a colleague, or buying a service or product.

If your follow-up conversation merits a call or virtual meeting, book a date and time with your colleague before leaving the conference. Let’s say you’re a practice owner and meet an associate veterinarian candidate during seminars. Grab dinner together at the conference or schedule a post-event video call for a job interview. Because many practices are hiring, quality prospects may get snatched up quickly.

3. missing deadlines on show specials

You’ve been yearning for another dental unit and find the equipment you want in the exhibit hall. Better yet, a show special offers exceptional savings. You tuck the flyer inside your backpack and head down the next aisle of vendor booths. When you return to work, you discover that you missed the deadline and will now pay full price. 

Be decisive at the conference. If you’ve got the funds and tingle with excitement over the equipment purchase, buy it today in the exhibit hall. If you need to check with your accountant or corporate practice office, send an email today with the information and upcoming deadline. Purposefully deciding before the deadline will let you enjoy savings and delight your team when you return and explain, “I bought a new dental unit at the conference, and it will arrive Friday!”

4. Not sharing what you learned

You’re the practice owner and have four associate veterinarians. You attended sessions on internal medicine and orthopedic techniques and are excited to use your new knowledge. Besides benefiting patients, this know-how could help your associates. Schedule a doctors’ meeting to discuss your favorite pearls. Upload conference proceedings along with your notes on a shared drive or practice server where other doctors, technicians, and assistants can study the information, too. 

If doctors decide to update a protocol or introduce a new service based on what they learned at conferences, schedule a staff meeting to discuss details with employees. Explain the “why” behind the protocol change, share a written standard operating procedure, and create scripts of what to tell clients. Getting everyone on the same page before you roll out a new service or protocol will ensure its success. Whether you attended sessions on medicine, management, or client service, knowledge gained needs to be shared. 

Your practice invests thousands every time a doctor, manager, or support staff member attends a conference. Set aside time to write goals and engage your team in understanding and implementing ideas. Your strategic approach will pay rich dividends on continuing education.

WANT TO LEARN MORE? 

Enroll your team: ALL ACCESS PASS 100+ Courses

About the Author: Best known as the “Queen of Scripts,” Wendy S. Myers, CVJ, has taught communication and client service skills for more than two decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Wendy was a partner in an AAHA-accredited specialty and emergency practice. Visit CsvetsCourses.com and YouTube.com/csvets to learn more.

Reference:

1. Hyatt M. The Beginner’s Guide to Goal Setting. Available at: https://fullfocus.co/goal-setting/. Accessed Jan. 8, 2024.

HOW TO CHARGE FOR TECHNICIAN APPOINTMENTS

HOW TO CHARGE FOR TECHNICIAN APPOINTMENTS

HOW TO CHARGE FOR TECHNICIAN APPOINTMENTS

By Wendy S. Myers, CVJ, Communication Solutions for Veterinarians

is your practice struggling with doctor shortages?

Using technicians as physician assistants is a solution. Your practice could shift up to 20% of appointments from veterinarians to technicians. Better yet, you can charge for technician appointments.

which appointments to reallocate to technicians

Consult your state’s guidelines on technician and veterinary assistant duties and whether veterinary supervision must be direct or indirect (https://www.avma.org/advocacy/state-and-local-advocacy/veterinary-state-board-websites).  

After reviewing your state’s policies, identify types of appointment that technicians and assistants may see. Create scheduling guidelines with appointment lengths and reasons for visit for client service representatives to follow. Consider a standard of care that patients must have a veterinary-client-patient relationship and a physical exam from a veterinarian within 12 months to be eligible for technician appointments.[1]

Shift four appointment types from veterinarians to technicians and assistants:

1. Preventive appointments. Let’s say a veterinarian examined an adult dog today and gave the first Leptospirosis vaccination. When the dog needs a Leptospirosis booster in a few weeks, schedule an appointment with a technician rather than a doctor. Forward book the technician appointment today to ensure timely immunization. Schedule recurring technician appointments for patients on weight-management programs so technicians and assistants may assess patients’ progress and provide nutrition counseling to clients.

2. Diagnostic appointments. Technicians and assistants can collect samples and perform lab tests for drug monitoring, early detection screens, preanesthetic testing, blood pressure checks, glucose curves, and more.

3. Treatment appointments. Technicians and assistants can change bandages, administer subcutaneous fluids, perform laser therapy, trim nails, clean ears, and more.

4. Instructional appointments. Teach clients about home care such as giving insulin injections and subcutaneous fluids. Have clients record videos on their smartphones of patient care that they will need to do at home.

Let’s say the client schedules a technician appointment to get her dog’s ears cleaned. Ask the client to record a video on his smartphone as you clean the right ear and verbalize instructions. After you finish cleaning the right ear, have the client clean the left ear while you coach him. Clients will better understand homecare instructions after watching, doing, and recording videos for future reference.

use distinct terms

To help clients understand the difference between duties performed by a veterinarian and technician, choose different service names. Use “exam” when a veterinarian performs a physical exam. Used in the human nursing profession, the term “health assessment” is when a technician or assistant evaluates patient health.[2] Download my history questions for checkups at https://csvets.com/historyquestions/.

A health assessment performed by a technician or assistant includes three activities:

  1. Get patient’s vital signs (i.e., temperature, pulse, respiration, weight)
  2. Ask history questions
  3. Update medical record 

Veterinarians should define which patients will need health assessments during technician and assistant appointments. Here are services that may merit health assessments:

  • Change bandages
  • Clean ears
  • Express anal glands
  • Administer subcutaneous fluids
  • Provide laser therapy
  • Administer vaccines
  • Check weight and provide counseling
  • Remove sutures

A health assessment may not be medically necessary for certain services such as:

  • Trim nails
  • Collect urine or blood for lab tests
  • Place microchip

how to set health assessment fees

Clients will pay for services and health assessments performed by technicians and assistants. Let’s say a client books a technician appointment for a nail trim. Charge for the nail trim service but a health assessment is not medically necessary. Another client schedules a technician appointment for her dog’s bandage change. Charge fees for bandage change services and a health assessment, which is medically necessary.

When setting fees for health assessments that technicians and assistants will perform, consider two options:

Option 1: Percentage of doctor’s exam. Let’s say your veterinarian’s exam fee is $60. Charge half the doctor’s rate if a credentialed technician provides the health assessment or $30. If an assistant does it, charge a third of the doctor’s rate or $20. 

Option 2: Create a per-minute rate. Identify three figures:

  • Average hourly wage: Calculate the average hourly wage for your credential technicians and veterinary assistants. The 2022 average hourly pay for a technician was $19.60, according to the U.S. Bureau of Labor Statistics.[3] Veterinary assistants averaged $16.58 per hour.[4]
  • Benefits: Benefits are typically 32% of an employee’s wage.[5] Benefit expenses include all costs associated with health, dental, worker’s compensation, and other insurances; retirement benefits; the owner’s portion of employment taxes; uniform reimbursement; continuing education; discounts or allowances for veterinary services; and paid vacation, holidays, and personal days.
  • Staff costs as a percentage of revenue: Total staff expense with benefits in a financially healthy hospital is kept below 23% to 25% of revenue.[6] Support staff includes all non-veterinary employees, managers, and custodial personnel. About 16% to 19% of income is allocated to staff wages while 5% to 8% is for benefits. 

Here’s the per-minute formula: Take the average wage per hour with benefits ($19.60 technician hourly wage + 32% for benefits = $25.87 per hour) and divide by 23% staff costs as a percentage of revenue. A technician will need to generate income of $112.48 per hour to meet profit goals. Divide $112.48 income per hour by 60 minutes for a per-minute billable rate of $1.87 for technician time. Use a similar calculation to determine a per-minute rate for services that veterinary assistants will deliver.

Rather than the tedious task of setting a stopwatch every time a technician sees an appointment, set fees in blocks of 10, 20, 30, and 40 minutes with a minimum amount charged. For example, a 10-minute technician appointment is $18.70 plus fees for additional services delivered. If the task only takes 5 minutes, still charge the 10-minute technician fee because it’s the minimum amount and starting point for fees.

Here are examples of technician appointment fees based on blocks of time:

Length of technician appointment

Health assessment fee

10 minutes

$18.70

20 minutes

$37.40

30 minutes

$56.10

40 minutes

$74.80

communicate value to clients

If you don’t charge for technicians’ time now and will implement a health assessment fee, host a staff meeting to explain the “why” behind the fee to your team. Technicians and assistants will appreciate that you value their time and expertise and want to charge clients for services they deliver.

Write a script of what to tell clients. You want employees to answer clients’ questions confidently and consistently about the new fee.

Say this, “Our veterinarians have determined which patient treatments need health assessments from technicians and veterinary assistants. Our health assessment includes getting your pet’s vital signs of temperature, pulse, respiration, and weight, along with asking you history questions and updating your pet’s medical record with this information. For this nursing care, we charge a health assessment fee of $XX and fees for additional services provided during the technician appointment. For example, an appointment to change a pet’s bandage would include a health assessment to check that the wound is healing properly along with fees for the bandage change service. I am confident that you will find value in the nursing care that our technicians and assistants provide.”

Doctors need to transfer trust. When veterinarians perform exams and give immunizations, tell clients what to expect for the next booster vaccinations. Say, “<Pet name> will need a booster vaccine on <date>. You will schedule an appointment with my technician, who will conduct a health assessment, give the booster vaccine, answer your questions, and update your pet’s medical record. We take a team approach to preventive care. I value the contributions of our nursing team.”

Communicate value at the start of technician appointments. Set client expectations upfront. The technician or assistant will explain, “I’m <name>, the certified veterinary technician who will perform <pet name>’s health assessment and give the Leptospirosis booster vaccine. I will get <pet name>’s vital signs, including temperature, pulse, respiration, and weight. I will ask questions about your pet’s health and update <pet name>’s medical record with the vital signs and information we discuss. What questions may I answer before we get started?”

When your practice utilizes technicians like physician assistants, technicians will work at the top of their licenses, improving job satisfaction and employee retention. You will increase appointment availability for clients, which is advantageous with today’s overloaded schedules.

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About the Author: Best known as the “Queen of Scripts,” Wendy S. Myers, CVJ, has taught communication and client service skills for more than two decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Wendy was a partner in a specialty and emergency practice. Visit CsvetsCourses.com and YouTube.com/csvets to learn more.

References:

1. The Veterinarian-Client-Patient Relationship (VCPR). American Veterinary Medical Association. Available at: https://www.avma.org/resources-tools/pet-owners/petcare/veterinarian-client-patient-relationship-vcpr. Accessed Jan. 3, 2024.

2. Guide to Good Nursing Practice Health Assessment. Available at: https://www.nchk.org.hk/filemanager/en/pdf/health_assessment_e.pdf. Accessed Jan. 3, 2024.

3. Occupational Outlook Handbook, May 2022. Veterinary Technologists and Technicians. U.S. Bureau of Labor Statistics. Available at: https://www.bls.gov/oes/current/oes292056.htm. Accessed Jan. 3, 2024.

4. Occupational Employment and Wages, May 2022. Veterinary assistants and laboratory animal caretakers. U.S. Bureau of Labor Statistics. Available at: https://www.bls.gov/oes/current/oes319096.htm. Accessed Jan. 3, 2024.

5. Woodruff J. Benefits as a Percentage of Wages. Chron. Available at: https://smallbusiness.chron.com/benefits-percentage-wages-14587.html. Accessed Jan 3, 2024.

6. Tips to Help You Manage Veterinary Staffing. Simmons & Associates Inc. Available at: https://simmonsinc.com/can-you-manage-veterinary-practice-staff-expenses/#:~:text=The%20total%20support%20staff%20expense,23%2D25%25%20of%20revenues. Accessed Jan. 3, 2024.