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create efficient dental schedules

create efficient dental schedules

create efficient dental schedules

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

A distraught technician explained that her hospital schedules 14 dental procedures per day, and she’s worried about her health. After four procedures in a row, her arm goes numb. The technician sought advice from conference speaker Mary L. Berg, BS, LATG, RVT, VTS (Dentistry) of Beyond the Crown Veterinary Education in Lawrence, Kan., and author of Dental Radiographs Made Easy and Companion Animal Dentistry for Veterinary Technicians.

Avoid overcrowding dental schedules, which can put patient and technician health at risk. “If a practice wants to embrace dentistry, they can’t schedule eight or more per day because they will do poor procedures,” advises Berg. “Take time to look for disease, take radiographs, and address problems.”

Teams can be more efficient with smart scheduling and setting clients’ expectations. Here’s expert advice:

budget enough time

Rushing to complete procedures can leave some disease untreated, Berg warns. The 2019 AAHA Dental Care Guidelines for Dogs and Cats provide a 12-step protocol for oral health assessment, dental cleaning, and periodontal therapy.

Create scheduling guidelines for client service representatives (CSRs) and other employees who book procedures. Berg shares estimated procedure times based on the stage of periodontal disease. Procedure times are “table time” from induction to the start of recovery and include taking radiographs and performing some extractions. Patient preparation and recovery time are additional. Multiple and/or difficult extractions also will increase times.
  • Stage 1 procedure: 1 hour
  • Stage 2 procedure: 1 to 1 ½ hours
  • Stage 3 procedure: 2 to 2 ½ hours
  • Stage 4 procedure: 3 hours

Let’s say the dental team will perform procedures from 9 a.m. to 1 p.m. for four hours of procedure time. The team could do four Stage 1 procedures, two Stage 2 procedures, or one Stage 1 and one Stage 4 procedure. Berg advises limiting to two Stage 3 or 4 procedures per day.

If the procedure will require more than three hours, consider staging care, Berg suggests. The first procedure is a dental cleaning while the second is oral surgery about a week later. Debra Bohnke, DVM and medical director of Cimarron Animal Hospital in Tucson, Ariz., explains in her blog that staging dental treatments also spreads out expenses for clients.

“Seventy-five percent of dogs and cats have more dental disease than can be detected when pets are wake because they don’t let anyone do a thorough 360-degree tooth-by-tooth examination while they are awake,” Dr. Bohnke writes. During the first procedure, Dr. Bohnke calls the client to explain any additional treatments and extractions. She discusses doing everything at once or delaying care along with an appropriate timeline based on the severity of disease. If staged care is performed within the time specified, Cimarron Animal Hospital offers an $85 credit toward the second anesthesia.

ASSIGN A DENTAL TEAM

Use two to three technicians and assistants based on your staffing levels, Berg advises. An anesthesia technician does hands-on patient monitoring and watches electronic monitoring equipment. “Don’t rely on electronic monitors only,” Berg warns. Periodically use a stethoscope as a doublecheck. The second teammate is a dental technician who completes an oral examination, takes full mouth dental radiographs, and performs the procedure. An optional third member is a veterinary assistant who available to assist the dental technician with charting and radiographs.

SET THE ORDER OF PROCEDURES FOR DOCTOR AVAILABILITY

Don’t schedule an orthopedic surgery at the same time as a Stage 4 dental procedure, which will require the doctor’s time simultaneously. Veterinarians will perform most oral surgeries. Consult your state board of veterinary medicine on which duties technicians and veterinary assistants may or may not perform, including extractions.

A smart scheduling approach is to have the doctor performing a spay, neuter, or shorter surgery while the dental team is doing Stage 3 and 4 procedures.
 

SET clients’ expectations when booking procedures

Clients at VCA Sheridan Animal Hospital & Veterinary Specialists of Western New York in Buffalo, N.Y., get an admission process sheet upon scheduling. Instructions explain what to do or not do 10 days before the pet’s procedure, the day before, what to bring, and what to expect on procedure day. Download the form.

The admission process sheet tells clients they will get preadmission calls the day prior, which will last 10 minutes. Hospital Manager Holly Monroe says a triage technician calls clients with CSRs as backup. Questions are prepopulated in electronic medical records based on the type of procedure and patient history. All clients are asked if pets have taken any medication within 24 hours, including NSAIDs, fish oil, or aspirin; any issues to be aware of before procedures; who will bring the pet; confirm vaccines are up to date; and discuss any additional services. A client with a diabetic pet will be asked about the brand of insulin, how much is given, when the last dose was administered, when the pet will eat, and when the next insulin dose will be due. Clients receive individual treatment plans and anesthetic consents by email or through the MyVCA App, which allows digital signatures.


The admission process sheet and preadmission calls have cut surgical and dental check-in times in half. “This has helped the admission process in so many ways,” says Monroe. “We can admit six to seven clients smoothly and quickly. Medical records are more thorough. Every staff member is asking consistent questions. We have fewer no-shows. It’s been a huge deal for us. The more communication you have with your clients, the better.”

Clients also pay 75% of the treatment plan upon booking. Watch my video on “Stop Saying Deposit! Say This.”

HAVE PREOPERATIVE APPOINTMENTS

Suffolk Veterinary Group Animal Wellness & Laser Surgery Center in Selden, N.Y. created preoperative appointments to avoid surprises on surgery days. “Our veterinarian was tired of not knowing what type of surgery he was walking into that day,” explains Practice Manager Nicole Carucci-Winkler, LVT. New clients would call, schedule surgery, and drop off patients. “We’d have no idea who these people were, who patients were, and what, if any, contraindications to surgery there might be,” says Carucci-Winkler. “A canine neuter could be a 5-pound Yorkie with a portal-systemic liver shunt. You want to know about the shunt prior to surgery, not the morning of surgery. No human doctor would do surgery on a patient without a preoperative appointment. Why should a veterinarian be required to?”


Preoperative appointments are with a veterinarian and licensed veterinary technician (LVT). Before the preoperative appointment, the LVT contacts the referring or previous veterinarian for medical records, reviews and audits patient history, checks vaccination status, and writes a case summary for the veterinarian. The doctor examines the patient to establish a veterinary-client-patient relationship (VCPR), which is required by state law and the AVMA.

“Introducing the LVT as part of the surgical team helps build clients’ trust and educates the public about who an LVT is and the importance of his or her role in veterinary medicine,” Carucci-Winkler says.

During the preoperative appointment 10 to 14 days before the procedure, the doctor and technician explain the procedure, fees, third-party financing, and expected outcomes along with possible complications and post-operative care. The technician collects blood and urine samples to send to its reference lab.

You don’t want abnormal results the morning of the procedure such as the patient with a portal-systemic shunt, Carucci-Winkler explains. “You don’t want to call the client while she’s at work or otherwise occupied and tell her you’re cancelling surgery because blood work indicates the patient needs additional diagnostics before you would put it under anesthesia,” she says.

Preoperative appointments let the team choose appropriate dates and times based on the type of procedure. Clients sign treatment plans and anesthetic consents in advance. When patients are admitted for procedures, clients just sign to acknowledge they are admitting the patient and confirm contact information for today.

Talk with your team about ways to streamline admissions, budget procedure time, and set clear expectations for clients. You and your clients deserve smooth, efficient check-ins.

WANT TO LEARN MORE? 

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Stop Leaving Voicemails For Clients

Stop Leaving Voicemails For Clients

Stop Leaving Voicemails For Clients

STOP LEAVING VOICEMAILS FOR CLIENTS

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

You call a client about her cat’s lab results and leave a detailed voicemail, explaining that you need to discuss the diagnosis and treatment. After two days with no response, you leave a second voicemail. 

Even if clients have your hospital’s phone number saved in their contacts, research shows 67 percent don’t listen to voicemails.[1] I understand why. Clients can’t skim voicemails. They must listen to the entire message, call back, wait on hold, and leave a message because the veterinarian isn’t available. 

Text is a better choice. Text dialogue can happen asynchronously. Both parties don’t have to be on their phones at the same time. Veterinarians and clients can reply when they’re available. Up to 80 percent of callers choose texting over voicemail. Millennials are the largest pet-owning segment and 60 percent prefer to communicate with businesses via text.[2],[3] 

Let’s end your frustration with unreturned calls and phone tag. Turn your callbacks into “textbacks.” Texts rarely go unread or unanswered. Ditch the 10-minute task of calling and leaving a voicemail. Replace it with a 2-minute text. Create templates in your texting platform for these common responses:

TEXT AFTER DISCHARGE

After each hospitalized patient is discharged from surgery, dentistry, or treatment for an illness, your medical team follows up with clients. Set expectations for a textback during the discharge appointment. 

Say this: “You will get a text/app message from us tomorrow to confirm that <pet name> is eating, drinking, and taking medications. If you have questions or concerns, reply to the text, or call us at 555-555-5555.” 

The next day, text this: We are checking on <pet name> after surgery yesterday. Is <pet name> eating, drinking, and taking medications? Reply Y or N. Reply with questions. 

If the client replies “Y” for yes, document the communication in the electronic medical record and reply to thank the client. If a client replies “N” for no, call to discuss the pet’s symptoms and next steps. The client’s answers may prompt an appointment for a progress exam or telemedicine consult. 

Create a series of text templates when patients require multiple follow-up messages. Text campaigns should notify, educate, support, and steer pet owners. In your texting platform, link the series to trigger in sequential order. 

Let’s say you perform a dental treatment with several extractions. Send this series of texts after the dental discharge appointment:

  • 1 day later: We are checking on <pet name> after oral surgery yesterday. Feed a soft food, no hard treats or chews, and refrain from brushing teeth for X days. Is <pet name> eating, drinking, and taking medications? Reply Y or N. Reply with questions.
  • 4 days later: <Pet name> may eat regular food now. No hard treats or chews for X days after oral surgery. Reply with questions.
  • 7 days later: You may gently brush <pet name>’s teeth with pet toothpaste and a soft toothbrush now. Click here <link> to watch our video on how to brush your pet’s teeth. Reply with questions.
  • 14 days later or based on next appointment date: <Pet name> has a progress exam to check on healing from oral surgery on <date, time>. Reply C to confirm or RS to reschedule. 

TEXT AFTER SICK OUTPATIENT EXAMS

Let’s say you saw an urgent care patient for loose and watery stools. You determine the gastrointestinal upset was due to high-fat table scraps at the family barbeque, and radiographs confirm no bones were ingested. You prescribe medication and instruct the client to feed a bland diet for several days. The outpatient technician who assisted the veterinarian with the exam will be responsible for follow-up communication. 

Text this: We are checking to see if <pet name> is feeling better. Feed a bland diet for X days. Is <pet name> having normal stools and a good appetite? Reply Y or N. Reply with questions. 

The client already has a relationship with this technician, who is familiar with details of the case. If the health concern has not resolved, schedule a progress exam.

TEXT PREVENTIVE LAB RESULTS

Share lab results for intestinal parasite screens that you send to your reference lab. I provided consulting and onsite training for a 10-doctor hospital where the medical team told clients “No news is good news” for intestinal parasite test results. Being busy isn’t a good excuse and may harm compliance for preventive diagnostics. Pet owners are paying to learn results. Clients will be more likely to accept screening in the future if they understand today’s results. 

Text clients about negative results and reinforce timely dosing of preventatives. Call clients about positive results so you may discuss treatment and medication. 

Text this: <Pet name>’s intestinal parasite screen was negative with no egg cells or parasites seen. Give <brand> each month for heartworm and intestinal parasite prevention. Click here to view lab results <link to patient portal on your website>. Reply with questions.

TEXT AS BACKUP TO VOICEMAILS

A client calls and tells your client service representative, “Someone from your hospital just called me. What do you need?” While you might find the answer in the electronic medical record, the staff member may not be available. 

Whenever you leave a voicemail, send a backup text to lead the client to listen and promptly call back. Your text should include the best time to return the call based on the staff member’s availability. 

Text this: “Dr. <Name> left you a voicemail about <pet name>’s lab test. Please listen, and then call 555-555-5555 to discuss the diagnosis and treatment. Dr. <Name> will be available between 2:00 and 2:20 p.m.” 

Veterinarians need administrative time blocked in their schedules to review lab results, update medical records, approve prescriptions, and call/text/email clients and vendors. Learn how to add doctor-client communication blocks so veterinarians can batch tasks. Read my blog on “Overwhelmed With Callbacks and Emails?”

Clients will get cranky if they leave multiple messages without returned calls. Watch my 2-minute video on  “I need to talk to the doctor now!” Find out what to say when a client demands to talk with the veterinarian, but he isn’t available.

Have a doctor and technician list the top callback scenarios at your hospital. Identify which callbacks could be converted to textbacks, which will improve your team’s productivity and increase response rates from clients. Write templates for your texting platform to save time and have consistent messaging from your hospital.

WANT TO LEARN MORE?

Enroll your team in the 1-hour course: Technology Tools Every Practice Needs.

References:

[1] 22 Business Phone Statistics. Numa. Available at: https://www.numa.com/blog/22-business-phone-statistics. Accessed Aug. 11, 2022.

[2] Share of Pet Ownership in the United States in 2021-2022 by Generation. Statista. Available at: https://www.statista.com/statistics/1130651/pet-ownership-by-generation-us/. Accessed Aug. 11, 2022.

[3] Svyrydenko A. Why Millennials Love Texting. TextMagic. Available at: https://www.textmagic.com/blog/why-millenials-love-texting-infographic/. Accessed Aug. 11, 2022.

 

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Overwhelmed With Callbacks, Texts, and Emails?

Overwhelmed With Callbacks, Texts, and Emails?

Overwhelmed With Callbacks, Texts, and Emails?

OVERWHELMED WITH CALLBACKS, TEXTS, AND EMAILS?

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

A client called three times today, following up on the message she left for a doctor this morning. Busy with back-to-back exams and two emergencies, the veterinarian hasn’t returned the call. Worse yet, the client service representative (CSR) spent 20 minutes taking three extra messages and making excuses for the doctor.

Job stressed has jumped to 80% as doctors deal with excessive caseloads and staff shortages.[1] Veterinarians work through lunch, stay after hours, and go home exhausted. The cycle will start over again tomorrow. One in six veterinarians has considered suicide, according to the Centers for Disease Control and Prevention.[2]

The reality: Veterinarians need administrative time blocked in their schedules to review lab results, update medical records, approve prescriptions, and call/text/email clients and vendors. Without dedicated time for administrative tasks, veterinarians risk job burnout and mental health.

The solution: Pre-block doctor-client communication slots in daily schedules just as you do appointments. Choose from two options: 1) Three 20-minute doctor-client communication blocks at mid-morning, mid-afternoon, and the second to last appointment of the day such as 10:30 a.m., 2:30 p.m., and 4:00 p.m., or 2) Six 10-minute doctor-client communication blocks every 90 minutes such as 9:00 a.m., 10:30 a.m., 12:00 p.m., 1:30 p.m., 3:00 p.m. and 4:30 p.m. Both options allocate 60 minutes per day for doctors to complete administrative tasks.

Here are tips to help doctors maximize the payoff of doctor-client communication blocks:

HAVE CSRS SCREEN DOCTORS’ CALLS.

Explain, “The doctor is currently seeing patients in appointments/performing surgery. What is your specific question for the doctor? A technician may be able to help you now.” The caller says she can’t get her cat to swallow a pill. Because a technician can give medication administration instructions, the CSR will connect the caller to a technician rather than take a message for the veterinarian.

SET EXPECTATIONS FOR WHEN CALLS WILL BE RETURNED.

Let’s say the client leaves a message at 9 a.m. in reply to the doctor’s voicemail about her pet’s lab results. The CSR will explain, “Dr. <Name> is seeing patient appointments now and needs to speak with you. The doctor will be available at 10:30 a.m. and 2:30 p.m. to return calls. What is the best number to reach you during those times, and can the doctor also text you at that number?” You’ll avoid a barrage of repeat messages from the same client. 

If the caller doesn’t answer when the veterinarian returns her call, he can leave a detailed voicemail about the lab results. Send a text as backup communication. Text this: Dr. <Name> left you a voicemail about <pet name>’s lab results. The doctor can speak with you at 2:30 p.m. Please reply C to confirm you are available or RS to reschedule another call time.

ASK TECHNICIANS TO HELP WITH RESPONSES.

The doctor will review texts, emails, and voicemails and choose whether he or a technician should respond. This can improve response times. A veterinarian will call a client to discuss abnormal lab results and his diagnosis of kidney disease, while a technician will return a call about a positive intestinal parasite screen and treatment. 

The technician will say, “I am <technician name>. Dr. <Name> asked me to call you about your dog’s intestinal parasite screen. Your dog is positive for hookworms. Dr. <Name> has prescribed oral medication for two to three weeks of treatment, which you can pick up today before 6 p.m. We will review medication instructions with you when you arrive. Because the dog’s environment can be infested with hookworm eggs and larvae, you need to remove any stool from your yard promptly.[3] Use gloves to put feces in plastic bags and discard in your trash. You will want to remove feces from your yard daily and have your pet on monthly preventatives. What questions can I answer about Dr. <Name>’s diagnosis?” Repeating the doctor’s name will instill trust. Invite questions with the phrase of “What questions can I answer…?” rather than the close-ended question of, “Do you have any questions?”

FUNNEL EMAILS TO SPECIFIC DEPARTMENTS.

Rather than have every email dump into the general hospital inbox, set up emails that get to the right person the first time. Create email accounts such as pharmacy@vethospital.com and records@vethospital.com. Technicians and assistants will manage refill requests at pharmacy@vethospital.com, while CSRs will handle incoming and outgoing medical record requests at records@vethospital.com.

USE FOLDERS TO MOVE THE PROCESS FORWARD.

When a refill request lands in the pharmacy@vethospital.com inbox, the technician will confirm the pet has had an exam within 12 months and is up to date on any drug-monitoring tests. The technician moves the request to a “Ready for doctor approval” folder, which the veterinarian can access. Once the doctor okays the refill, he updates the medical record and moves the message to the “Approved to refill” folder. The technician fills the medication, enters the charge, texts pickup instructions to the client, and moves the request to the “Completed refills” folder.

CREATE TEXT AND EMAIL TEMPLATES FOR COMMON RESPONSES.

Based on options from your email provider, you can set up and select templates when composing replies. Just personalize a few fields rather than retyping the same paragraph 20 times today.

Here’s an email template for a prescription request: Thank you for requesting a refill of <drug name> for <pet name>. Our medical staff is reviewing the prescription request and will email you when it’s ready for pick up or if they have questions. Prescription requests submitted by 2 p.m. will be filled the same day and available for pickup after 4 p.m. If your request is submitted after 2 p.m., we will email you when it is ready on the following business day. You will get an email with a link to pay, park in our curbside pickup parking spot, and text us when you arrive. Thank you for using our hospital’s pharmacy and supporting small businesses in your community!

Once a technician fills the medication, text the client a link to pay and pickup instructions. Here’s a text template for refill pickups: We have filled <brand name> for <pet name>’s heartworm prevention. You received an instant rebate of $XX for purchasing 12 doses. Use this link to pay and get an immediate receipt. Park in our curbside pickup spot and text us when you arrive.

When you add doctor-client communication blocks, veterinarians will batch administrative tasks, provide timely responses, and create loyal clients. Busyness is not an excuse for poor client service. High appointment demands and staff shortages require doctors to work smarter, not harder, longer hours.

WANT TO LEARN MORE?

Enroll your team in the 1-hour course: Be the Boss of Your Schedule.

References:

[1] Halow B. Alarming Results from National Survey on Veterinary Stress. Available at: https://www.bashhalow.com/alarming-results-from-national-survey-on-veterinary-stress/. Accessed May 23, 2022.

[2] Dembosky A. It’s Not Just Doctors and Nurses. Veterinarians Are Burning Out, Too. National Public Radio. Available at https://www.npr.org/sections/health-shots/2022/04/08/1086091339/its-not-just-doctors-and-nurses-veterinarians-are-burning-out-too. Accessed May 23, 2022.

[3] Ward E. Hookworm Infection in Dogs. VCA Animal Hospitals. Available at: https://vcahospitals.com/know-your-pet/hookworm-infection-in-dogs. Accessed May 23, 2022.

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what to tell clients when you raise prices

what to tell clients when you raise prices

what to tell clients when you raise prices

What to Tell Clients When You Raise Prices

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

A practice owner told me he hasn’t raised prices in two years and worries how clients will react. While he knew procrastinating was a mistake, the situation is quickly getting worse. The U.S. inflation rate rose to 7.5 percent in January 2022, reaching a 40 year high.[1] The cost-of-living surge has been the biggest since 1982, when Michael Jackson released his groundbreaking album “Thriller” and gas was 91 cents a gallon.[2]

Economic changes have triggered laboratory and vendor price increases as high as 12 percent in the veterinary profession.[3] Costs are rising everywhere, from gas to groceries. If your hospital hasn’t raised prices yet, do it now. But what should you tell clients?

tell employees before you tell clients.

Your team needs to understand the “why” behind fee changes. You don’t want employees to stumble when responding to clients. Have a consistent message, which will make it easier for employees to explain price increases and for clients to accept them. Your message should be concise and empathetic. Don’t apologize because raising prices is a normal aspect of running a business. Your products and services provide excellent value, and you should charge accordingly.

create a script of what employees should say.

If clients question fee increases, you want frontline workers to be able to answer. Never say, “You’ll have to talk to the manager or doctor about prices.” You risk creating angry clients if the manager and doctor aren’t immediately available. Every employee must share a concise, confident response. Watch my YouTube video on “Raising Prices? What to Tell Clients” at https://www.youtube.com/watch?v=gev5cwb1ni8&t=11s.

Your script should include four points:

1) Express Empathy: “I understand that you’re concerned about the cost of veterinary care for your pet.” The word “concerned” shows empathy.

2) Be transparent and state reasons for fee changes. Like many businesses, our hospital has had price increases in the products and services we buy from vendors. We also invest in our employees’ ongoing education, so they learn about medical advances to improve patients’ comfort and treatment outcomes.” These two statements about vendor price increases and investing in staff training concisely state specific reasons for fee changes. The statements also show you are transparent about prices.

3) Explain how the price increase will benefit the client and pet. We strive to keep fees affordable while sourcing the best products and supplies to ensure we deliver the high-quality veterinary care that you and your pet deserve.” Emphasizing high-quality care explains how the price increase will benefit the client and pet.

4) Show appreciation for the client’s loyalty. “Thank you for your feedback. I will share it with the doctor and manager. You’re welcome to reach out to Dr. Smith or our manager, Amy, with further questions. We appreciate the opportunity to care for Max.”

Your team also can share information about preventive care plans, third-party financing, and pet insurance to help pet owners manage the cost of care.

how should you answer, “why is your hospital more expensive?”

Every employee needs smart responses when clients or phone shoppers question your fees. 

Say this (See key words in bold): “Our hospital offers affordable fees. Our surgical fee may be higher than another hospital that you contacted because we have the latest monitoring equipment, include preanesthetic testing and pain-relief drugs with the surgery, and have an experienced staff with ongoing continuing education. I’m confident you will see value in the quality of care that our team provides. Let’s schedule a presurgical exam so you can meet our doctor. The veterinarian also will share our surgical protocols and answer your questions. When can we meet you and Charlie? I have an appointment available at 9 a.m. Monday or 2 p.m. Tuesday. Which do you prefer?” 

The client service representative (CSR) explained how the quality of care will benefit the pet. She used positive phrases such as “Our hospital offers affordable fees” and “I’m confident you will see value.” The CSR had an inviting approach of “When can we meet you and Charlie?” instead of the yes-or-no choice of “Do you want to book an appointment?” She offered the next two available exams, which leads the caller to schedule now.

position your hospital as a premium provider.

You get different service and quality from a steakhouse compared to a fast-food drive thru. We all dine out and may choose a restaurant based on convenience, price, experience, and quality. Likewise, your community has low-cost veterinary care providers, shelters, private and corporate practices, and emergency and specialty hospitals. Each serves a need and niche.

A premium practice would include preanesthetic testing and pain medication in procedures while a low-cost provider might offer these services as options. A premium practice blocks urgent care slots in its daily schedule to see sick patients while another provider might tell clients its schedule is full and advise seeking care at an emergency hospital.

raise prices whenever products or vendor fees go up.

While this seems obvious, it can happen without processes in place. A technician unpacks products, updates the quantity in the inventory module of the practice-management software, stocks shelves, and passes the invoice to the bookkeeper. The bookkeeper pays and files the invoice. No one confirmed whether the unit cost on the vendor invoice matched the unit cost in the inventory module.

Let’s say a vendor increased an item from $10 to $11. The practice incurred a 10 percent increase that didn’t get passed along to clients and cut into profits.

To prevent this error, use the purchase order feature in your practice-management software. In AVImark, this lets you “receipt the order,” specifying which items were received, any price change, which vendor sent the products, and apply shipping and taxes that were charged.[4]

make small increases to professional services quarterly.

While it’s smart to raise prices when vendors charge you more, when was the last time you raised professional fees for exams and procedures? 

Owen McCafferty, CPA, CVPM, and founder of Owen E. McCafferty CPA Inc. in Ponte Vedra Beach, Fla., advises hospital leaders to stay ahead of inflation with quarterly fee increases and to monitor staffing. Let’s say your exam fee is $55, and you want to raise it 12 percent. Increase the fee 3 percent or $1.65 each quarter to $56.65, $58.30, $59.95, and $61.60 respectively. Clients are less likely to notice small increments compared to an escalation from $55 to $61.60. 

Many practices are operating short-staffed and want to reward loyal employees with raises. Because employee wages and benefits average 48 percent to 52 percent of costs, you can’t give raises without upping prices, advises McCafferty. Take care of core employees who stick with you when times get tough, he says. Good wages and benefits will help you retain and recruit employees.

be competitive on shopped items.

Consumers shop prices on three veterinary drug categories: 1) Flea and tick preventatives, 2) Heartworm preventatives, and 3) Long-term drugs for chronic conditions such as arthritis and allergies. Parasiticides represent the largest market share of pet medications with 42 percent of sales.[5] Most of your prescription approval requests from internet pharmacies are flea/tick and heartworm preventatives. 

The Veterinary Fee Reference, 11th ed., reports a 65 percent average markup on flea/tick and heartworm preventatives compared to 107 percent on other prescription medications.[6] If you markup preventatives 107 percent, you will lose sales to third-party pharmacies and other area hospitals. 

Don’t procrastinate to review and raise prices regularly. Available from the American Animal Hospital Association, The Veterinary Fee Reference is a resource to benchmark your fees against national averages (https://ams.aaha.org/eweb/DynamicPage.aspx?site=store&Action=Add&ObjectKeyFrom=1A83491A-9853-4C87-86A4-F7D95601C2E2&WebCode=ProdDetailAdd&DoNotSave=yes&ParentObject=CentralizedOrderEntry&ParentDataObject=Invoice%20Detail&ivd_formkey=69202792-63d7-4ba2-bf4e-a0da41270555&ivd_cst_key=00000000-0000-0000-0000-000000000000&ivd_cst_ship_key=00000000-0000-0000-0000-000000000000&ivd_prc_prd_key=7F0F61F6-5D44-4BDE-A54C-C38CF8066FFA).

Clients will be more comfortable with small, steady increments instead of large fee hikes. Most pet owners will anticipate increased costs in the future. They know costs are rising everywhere, from gas to groceries. You need to keep your practice financially healthy, too.

want to learn more?

Enroll your team in the 1-hour course: What to Say When You Raise Prices.

References:

[1] Bartash J. U.S. Inflation Rate Climbs to 7.5% After Another Sharp Increase in Consumer Prices. MarketWatch. Available at: https://www.marketwatch.com/story/coming-up-consumer-price-index-11644498273. Accessed Feb. 15, 2022.

[2] List of 1982 Significant News Events in History. The People History Home. Available at: https://www.thepeoplehistory.com/1982.html. Accessed Feb. 15, 2022.

[3] McReynolds T. Inflation Hitting Veterinary Practices. AAHA News Stat. Published Jan. 12, 2022. Available at: https://www.aaha.org/publications/newstat/articles/2022-01/inflation-hitting-veterinary-practices/?utm_medium=email&utm_source=rasa_io. Accessed Feb. 15, 2022.

[4] AVImark User Manual. Inventory List: pp. 86.  Available at: https://softwareservices.covetrus.com/wp-content/uploads/2019/09/AVImark-user-manual.pdf. Accessed Jan. 14, 2022.

[5] McReynolds T. Veterinarians Outselling Online Retailers When It Comes to Pet Meds—But Not For Long. AAHA NEWStat. August 2019. Available at: https://www.aaha.org/publications/newstat/articles/2019-08/veterinarians-outselling-online-retailers-when-it-comes-to-pet-medsbut-not-for-long/. Accessed March 29, 2021.

[6] The Veterinary Fee Reference, 11th ed., AAHA Press: 2020;229,230,228.

 

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How to Handle Late Clients

How to Handle Late Clients

How to Handle Late Clients

How to Handle Late Clients

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

You’ve heard the excuses: “I got stuck in traffic.” “I had to crawl under the bed to catch my cat and wrestle to get him in the carrier.” “I was in a meeting at work that ran late.” Whatever!

When one client runs late, it causes a domino of late starts for the remaining appointments. Multiple consequences happen: 1) Your team looks disorganized, 2) Late arrivals increase wait times for on-time clients, and 3) Your medical team feels rushed.

With current out-of-control appointment demands, you must be the boss of your schedule. You want to be able to give each client and patient the full amount of time set aside for their appointments. Let me share options to handle clients who are late for appointments.

CREATE A LATE POLICY.

While clients may occasionally show up late, habitually tardy clients disrespect your time and services. You can prevent this bad behavior.

Just as your hospital has a financial policy, have a late and no-show policy that holds clients accountable and sets expectations in a professional, respectful way. Add the policy to your new client registration, online patient history forms, and online or app scheduling tools.

Here is a sample late policy: “We ask you to arrive before your scheduled appointment time so you may benefit from your full exam time. New client and patient history forms should be completed in advance to help our medical team prepare for your pet’s visit. A grace period of __ minutes will be granted for unforeseen delays that you may encounter while traveling to our hospital. If you arrive more than __ minutes late for an appointment, we will offer options of being seen as a work-in, day admission, or rescheduled if our schedule permits. We strive to ensure clients and patients are seen in a timely manner and appreciate your on-time arrival. Clients who have three or more late arrivals for appointments cannot schedule future appointments and will only be seen as emergencies or day admissions. Additional fees will apply.”

Start with a warning on the first offense.

Explain, “I understand that you were 15 minutes late to your appointment today. We want you and your pet to benefit from the full exam time with our medical team. To best serve you, please be on time for future appointments. We send confirmations upon booking and reminders two weeks, four days, and two days before your exam. Let me confirm that we have your correct cell number for texts and your email. We appreciate your timeliness so we can give all patients the time they need.”

put alerts in your practice-management software.

Track the number of times that a client is tardy to identify when a one-time occurrence becomes a chronic behavior. I follow a “three strikes and you’re out” policy. Forgive a first offense. You’ve been unexpectedly delayed in traffic, too. When you see three late arrivals within one year, decide whether to keep or end the client relationship. Allowing the chronic behavior to continue is your fault.

text clients when they are 5 to 10 minutes late.

This puts you in control and lets you determine options for the late arriving client. If you see appointments every 15 minutes, send the text when the client is 5 minutes late. For 30-minute exams, reach out when the client is 10 minutes overdue. Send this text: “We expected to see you at 3 p.m. for Max’s appointment. Reply YES and your expected arrival time if you’re on the way here, or RS to reschedule.” Obviously, clients should follow laws about not texting while driving.

show appreciation when clients call ahead to explain, “hey, i’m running late.”

This is honest and conscientious behavior. Reply, “Thanks for calling to let us know. What time will you arrive?” If you get a vague response of “I’m leaving my house now,” ask again, “What time will you arrive at our hospital?” Reply with, “Thanks for letting us know. Please drive carefully. We look forward to seeing you soon.”

Don’t make promises over the phone. If the client is 25 minutes away and has a 30-minute appointment, only 5 minutes of exam time will remain. Explain, “Once you get here, I will let you know options for us to see your pet today.” Never punish on-time clients by letting a late client cut in front of them.

Once the client arrives, look at your options.

Option 1: If the client arrives a few minutes late with three-fourths of the appointment time remaining, go ahead and see the patient (20 minutes of the 30-minute appointment remain). Alert a technician or assistant who can start the appointment now and help get the schedule back on track.

Option 2: See another doctor if one is available. Explain, “Dr. Jones has started his next appointment. Dr. Smith can see you now. Let me take you to Exam Room 3.” Unfortunately, every veterinarian at your hospital is likely fully booked with the current appointment demand. This option may be a rare choice.

Option 3: Ask if the client can wait and be seen as a work-in. Explain, “Dr. Jones has started his next appointment. We want Max to get the care he needs. We will see Max as soon as the first doctor becomes available, which may be 45 or more minutes. Are you able to wait, or do you prefer to reschedule?”

Option 4: Offer to reschedule. Use the yes-or-yes technique, focusing on what you can do. Say, “My next available appointment is <date, time 1> or <date, time 2.. Which do you prefer?”

Option 5: Offer a day admission. Never use the term “drop-off,” which is tacky and unprofessional. Explain, “We can see your pet as a day admission. For 10 to 15 minutes, you will meet with a technician who will get your pet’s vital signs, ask questions about your pet’s symptoms to share with the doctor, set a pickup time, and provide the expected cost of care. Because your pet will stay with us throughout the day and receive nursing care, there is a day admission fee of $XX. Shall we admit your pet to the hospital, and have you talk with the technician?”

I advise charging a 1- to 12-hour hospitalization or boarding fee to cover the cost of nursing care. The Veterinary Fee Reference, 11th ed., reports an average fee of $48.94 for hospitalization without an IV and no overnight stay (day hospitalization) for a 25-pound dog, $49.97 for a 60-pound dog, and $47.28 for a cat. [1] Boarding fees for 30- to 60-pound dog in a medium run average $27.29 while cat boarding is $21.07. For consistency and simplicity, I suggest creating a flat rate for day admissions such as $50. This day admission fee is charged in addition to the exam fee and other services delivered.

Options to see late-arriving clients will vary based on your schedule in that moment. You may only have one option or all five available. When a late client arrives at your hospital, your goal is to be a problem solver. You’ll hear words of thanks from the client for making care happen.

When you set clear expectations and follow your late policy, you will stand up for your time, your schedule, and your employees’ mental health. Remember, you train your clients how to treat you.

WANT TO LEARN MORE?

Enroll your team in the 1-hour course: Secrets to Keep Exams on Time.

Reference:

[1] The Veterinary Fee Reference, 11th, AAHA Press:2020; 245, 264, 248, 104, 105.

 

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When Curbside Care Takes Too Long: Do This

When Curbside Care Takes Too Long: Do This

When Curbside Care Takes Too Long: Do This

WHEN CURBSIDE CARE TAKES TOO LONG: DO THIS 

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

It’s freezing outside and getting dark earlier. Curbside appointments are taking 45 to 60 minutes. How can your team be more efficient? 

1. Get A TEXTING SERVICE OR APP WITH MESSAGING.

A veterinarian sees an average of 30 patients per day. The average healthcare call takes 8 minutes, which can include 3 minutes of hold time (1). 

If clients call you to announce their arrivals for curbside care, 30 calls total 4 hours of talk time. At a three-doctor practice, talk time jumps to 12 hours spread among the client care team. 

Post signs with instructions to text rather than call you for curbside care: “Curbside appointment? Text this: ARRIVED, your name, your pet’s name, parking spot #.” If you want clients to download an app for text and video chat during curbside care, include a QR code on signs. Clients will scan the QR with their smartphones and download and install the app upon arrival. Create response templates for frequently sent messages such as arrivals for curbside care and medication pickups. 

TEXT THIS: “Welcome to our hospital’s curbside check-in. To prepare for your appointment, please connect to our Wi-Fi. The network name is <your network> and password is <your password>. A nurse will call/video chat with you shortly to get your pet’s history and then get your pet from your car. Please remain in the same parking spot for the duration of your curbside care appointment so our medical team may quickly reach you.” 

The last instruction is critical. Many teams are frustrated with clients who leave during curbside care to run errands and then don’t answer their phones. 

Time savings: 4 hours of phone time per number of doctors scheduled

2. use online forms.

Go digital with histories and treatment plans. The team at Lake Road Animal Hospital in Horseheads, New York, uses an online curbside care form for checkups. Include links to your form in email and text confirmations. Ask clients to complete the form before the day of their appointments. If they haven’t returned it in advance, resend the link during curbside check-in. Create text templates for common messages so you’re not retyping instructions all day.

When you need to prepare treatment plans for hospitalization, surgery, or dentistry, create templates in your practice-management software. For example, you will have a template for a Grade 2 dental procedure and would add the number of anticipated extractions. Doing a light edit is faster than recreating the treatment plan every time. Text the client that you’ve emailed the treatment plan and anesthetic consent, and then initiate a video chat to discuss it. After answering the client’s questions, explain, “To schedule Rex’s dental procedure, please check your email at <client email>. You may digitally sign the treatment plan and anesthetic consent form and reply to our email.” Ask your software provider about digital signature capture tools or use services such as https://www.docusign.com or https://www.hellosign.com

Time savings: 2 ½ hours of phone time (average of 15 treatments per doctor per day at 10 minutes each)

3. get an app with video chat and telemedicine capabilities.

Psychologists’ research shows 55% of communication is body language (2). 

Video chat lets you better engage clients, which is especially important when clients have sick pets. You can express empathy through words plus body language to show your compassion. 

When doctors perform physical exams, they check 12 systems, which can take 10 minutes. Before COVID, clients saw and heard everything in exam rooms. Now during curbside care, the doctor performs the exam, calls to regurgitate findings, and answers the client’s questions. This can add another 10 minutes, doubling the doctor’s time. 

At Russell Ridge Animal Hospital in Lawrenceville, Georgia, Dr. Brad Miller and his team have clients download its PetPro Connect app to video chat during curbside care. They can watch Dr. Miller perform the exam, explain findings, and discuss necessary treatments. I will share a video on how the team uses messaging and video chat in my course on Cut Curbside Care Time in Half

Video chat lets clients see, hear, and understand. If a dog needs cruciate ligament surgery, hold a knee model and medical illustrations to show how you will repair the injury. Video chat lets you project confidence when explaining diagnoses and treatments. Shaving 10 minutes off every curbside appointment could save you 3 hours per day. A bonus: Higher client compliance and revenue. 

Time savings: 3 hours of phone time per veterinarian 

Despite all of COVID’s inconveniences, it has forced veterinary teams to rethink workflow and embrace technology. Like curbside grocery and restaurant pickup, veterinary curbside care will continue. Even when you can welcome clients back inside, some may prefer curbside care. A client undergoing cancer treatments or who cares for a high-risk elderly parent will want the safety and convenience of curbside appointments. Make sure the client experience is as amazing outside as it is inside your facility. 

 

WANT TO LEARN MORE?

Get more training in Master Curbside Care: 3 Courses, which includes End the Phone Frenzy, Cut Curbside Care Time in Half, and Deliver 5-Star Curbside Care Experiences. This training package includes team enrollment with unlimited replay, handouts, online testing, and three hours of CE credit.

References:

1.  Insight Driven Health: Why First Impressions Matter, Accenture, May 2013. Available at: http://www.accenture.com/us-en/~/media/Accenture/Conversion-Assets/DotCom/Documents/Global/PDF/Industries_11/Accenture-Why-First-Impressions-Matter-Healthcare-Providers-Scheduling.pdf. Accessed Feb. 8, 2021.

2. Psychologist Albert Mehrabian. Wikipedia. Available at: http://en.wikipedia.org/wiki/Albert_Mehrabian. Accessed Feb. 8, 2021.

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