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Enough! When to Fire Clients

Enough! When to Fire Clients

by | Aug 23, 2023 | Client Experience, Difficult Clients, Hospital Management

Enough! When to Fire Clients

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

After firing eight clients for crabby behavior in one month, a hospital manager hung a poster in the lobby notifying clients, “We have zero tolerance for aggressive and abusive behavior.” Fed up with entitled jerks, more managers are initiating “kindness policies” and notifying clients through mass emails, social media, and new client registration forms. Managers don’t want employees to fear for their safety or psychological well-being.

Define which behaviors merit firing

Hospital leaders should define reasons to fire clients such as:

  • Threatening or aggressive behavior and/or language
  • Physical violence
  • Discriminatory behavior
  • Failure to honor hospital policies
  • Refusing to pay for services and/or having outstanding balances
  • Three or more no-shows for appointments and/or procedures

Schedule a staff meeting to learn and practice conflict-resolution techniques so employees can react appropriately when situations arise. Professional in-the-moment responses may correct clients’ bad behavior and set expectations for future interactions.

correct bad behavior the first time

In my course on What to Say When Clients Challenge You, I teach how to change behavior from combative to collaborative. Let’s say Mr. Friendly mutates into Mr. F-Bomb. Explain the expected behavior and how it will result in a solution. Isolate the client by taking him to a private area such as an exam room, doctor or manager’s office, or employee break room. Reducing his contact with an audience of other clients will de-escalate the situation and communicate your desire for immediate resolution. Stand up so you and the angry client are on the same eye level. If you are seated and the client is standing, he is in the dominate position. Walk and talk as you guide the client to a private area for further discussion.

SAY THIS: “So you may have my complete attention and we can find a solution together, let’s step into an exam room.”

To correct foul language, state benefits of respectful behavior.

SAY THIS: “If I hear that language again, I won’t be able to help you and your pet. We need to find a better way to communicate so we may find a solution together.”

The word “language” is neutral compared to “If you don’t quit cursing,” which may be perceived as confrontational and lead to more negative words. Use “we” to show collaboration rather than “you,” which blames the client. “Solution” communicates you want to resolve the issue. If bad language continues, ask the client to leave the building or explain you will hang up if it is a phone conversation.

how to eject bullies

Don’t be bullied by clients who shout expletives. If unruly behavior continues, follow five steps to eject a bully from your hospital:[1,2]

1. Assess the potential danger of the confrontation. Employees should seek support from a manager or veterinarian when a client becomes verbally abusive. The right words instruct the client to immediately correct the behavior. 

SAY THIS: “I understand that you are frustrated. We both need to be calm and work together to resolve this situation.”

If a client appears to be under the influence of alcohol or drugs, offer to call a taxi. If the client is with others, ask a sober person to drive the offender home. If the impaired client insists on driving, get a description and/or photo of the car and license plate and call police with that information. You also may have security cameras that record the incident.

2. Explain why you’re asking the client to leave. Abusive behavior will not be tolerated. 

SAY THIS:

  • “While you have a right to voice your concerns, you do not have the right to be abusive to our staff.”
  • “As a manager/veterinarian, it’s my responsibility to protect my team, other clients, and patients so I must ask you to leave the hospital now.”
  • “If you don’t leave our hospital voluntarily, I will call the police to protect my staff, other clients, and patients.

3. Escort the client out of the hospital. Use body language to reinforce your ejection of the client. Walk toward the exit and ask the client to follow you. Keep walking towards the door, even if the client doesn’t initially follow you. Remain at the door. This firm body language communicates your request to leave is final and non-negotiable. Watch the client drive out of your parking lot. If the client sees you immediately leave the door, he or she may return inside.

4. Don’t put your hands on the client. Touching an irritated person could get a violent reaction.

5. Call the police if necessary. Call the police if the client is threatening physical harm to you or others, breaking a law, or damaging hospital property.[3] Don’t be timid. Look the client in the eye and explain, “Please leave the hospital immediately, or I will call the police.” You are telling—not requesting—that the client must leave now.

Because clients will always challenge you, teach your team what to do before situations occur. Like any good relationship, open communication and clear expectations will build trust and respect.

sample “You’re Fired” Client Letter

If you decide to end a client relationship, send a “You’re Fired” postal letter by a traceable method to confirm delivery and receipt. A client may easily delete or overlook an email or text. 

Terminate the use of all services, from veterinary care to boarding. If you let the client continue to use ancillary services, you suggest the behavior was acceptable. 

Enclose medical records for all pets in the household. You don’t want the troublesome client returning to pick up records and causing another scene in your lobby.

Use firm statements such as “This letter severs our business relationship.” You are done communicating. Period. 

Have a doctor or manager sign the termination letter. The client needs to know this decision is final and comes from the top. 

The day you send the postal letter, immediately inactivate the client’s record to stop future reminders and prescription refills. Put an alert in your practice-management software so all employees know the fired status in case of future contact. 

Notify employees the same day you fire a client. Send an email, call a huddle in the treatment area, or post the letter with the client’s address blacked out on an employee bulletin board. Employees need to know when client relationships have been terminated. You’ll likely get high-fives and respect from staff who appreciate when leaders stand up for them. 

Dear <Client Name>: 

<Your Veterinary Hospital> takes pride in its compassionate, professional staff. We expect mutually respectful relationships with our clients. You’ve indicated displeasure with either our services or our healthcare team <list specific instance sticking to facts>. 

Because of your interactions with our team, <Your Veterinary Hospital> will no longer provide veterinary, boarding, or grooming services for your pets. OR Because we are unable to provide you with satisfactory service, we can no longer retain you as a client. 

For your convenience, I have enclosed medical records for <pet name> so you may seek services elsewhere. We are confident you will find another veterinarian who can accommodate your requests. 

This letter severs our business relationship. Any future communication to <Your Veterinary Hospital> should be directed to me.

Sincerely,
<signature>
Doctor or manager name 

Enclosures: Medical records for <pet name> 

WANT TO LEARN MORE? 

Enroll your team in the online course:  What to Say When Clients Challenge You

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 YouTube.com/csvets and Csvets.com for more.

References:

1. Patrick M. How to Deal with a Client Who Is a Bully. Chron. Available at: https://smallbusiness.chron.com/deal-client-bully-25567.html. Accessed Dec. 12, 2022.

2. Ejecting a Customer. WikiHow. Available at: https://www.wikihow.com/Deal-With-Aggressive-Customers. Accessed Dec. 12, 2022.

3. At What Point Do You Need to Call the Police? Angry Retail Banker. Available at: http://www.angryretailbanker.com/2015/05/11/at-what-point-do-you-need-to-call-the-police/. Accessed Dec. 12, 2022.

 

Is remote work the secret to keep staff?

Is remote work the secret to keep staff?

by | Aug 8, 2023 | Hospital Management, Leadership Skills, Personnel Management

Is remote work the secret to keep staff?

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

When a rockstar client service representative moved out of state, a Montana practice had the employee work remotely to answer phones, enter inventory, and manage equine travel health certificates. A New York hospital manager works from home one day a week to review financials, set doctor and staff schedules, and prepare performance reviews.

Remote work is a dominant trend in 2023, with 13 percent of full-time employees working from home and 28 percent blending a hybrid model of home and in-office work.[1]

While veterinarians, technicians, and assistants need to deliver onsite patient care, hospital managers and client service representatives (CSRs) can do all or part of their work remotely. CSRs can answer phones, manage clinic emails and texts, schedule appointments, and call clients about overdue services and prescriptions. Managers can plan budgets, order inventory, create marketing initiatives, conduct virtual hiring interviews, write performance reviews, and complete tasks that benefit from focused, uninterrupted work. Remote workers can give your practice multiple advantages.

attract and keep top talent.

Millennials are the largest generation of the veterinary workforce, with women accounting for 78 percent.[2] Remote work aligns with millennials’ affinity for flexibility, autonomy, and work-life balance.

“Everyone has wants, needs, and reasons to work from home. For me, it was the ability to stay home with my young children when the uncertainty of the pandemic was still lingering, and I could remain in my career field. The stars truly aligned,” explains Aimee Brulatour, who works from home in Port Saint Lucie, Fla., as practice manager of HomeVets, a mobile, in-home veterinary service in Baltimore, Md.

Brulatour values the flexibility, level of privacy you do not get in a clinic setting, as well as the savings on gas and commute time.

A recent study found 82 percent of respondents are trying to hire at least one employee and are experiencing difficulties filling jobs at their practices.[3] Candidates now consider work-life balance and flexibility as the most important factors when evaluating job offers, with 81 percent saying they would be more loyal if they hadflexible work options.[4] Hybrid and fully remote jobs may help hospitals recruit and retain employees in competitive job markets.

When hiring a remote CSR, Brulatour sought candidates who are well-spoken because their voices are the face of the practice. “Veterinary experience is a must for us since training can have its challenges,” she says. “We use Google Meets for practice information management software training.”

HomeVets started completely decentralized and mobile in 2020 but recently bought a brick-and-mortar practice from two retiring doctors. Rebranded as HomeVets at Patapsco Valley in Ellicott City, Md., the practice is being remodeled and will reopen in October. The practice has four veterinarians and will give mobile HomeVets a facility to perform surgeries. Jordan Klaff, RVT, works as a mobile technician and remote CSR for HomeVets. Klaff manages calls for the mobile and brick-and-mortar practices, where an auto attendant menu routes calls to the remote CSR for scheduling and other inquires or to onsite staff if checking on hospitalized patients.

increase productivity.

When working fully remote, 35 percent of employees feel more productive.[1] They have fewer in-person distractions, the ability to design their own work environments, and reduced commute time.

“An employee who isn’t client-facing can be far more productive, have a better sense of well-being both personally and professionally, and have increased morale and retention when they are able to work outside of the clinic,” says Brulatour. “Although you are not onsite, you are more available to your team. Technology allows for document sharing and group edits, app communication, and virtual meetings. I can work late and still get dinner ready for my family or take an hour lunch and play outside.”

Working 100 percent remote, Brulatour’s hospital manager duties include staff schedules, payroll, benefits, budget and expenditure planning, social media and marketing, recruiting, staff training and meetings, performance reviews, biannual price audits, employee handbook, standard operating procedures, and employee events.

“If I have my laptop and phone, I can work from anywhere,” says Brulatour. “I don’t even need a printer! I use Google apps such as Sheets, Docs, Forms, and Calendar.”

reduce costs and reallocate space.

The average real estate savings with full-time teleworkers is $10,000 per employee per year.[5] With a hybrid model, a practice that has four CSRs could have two work onsite and two offsite. Remodel your lobby, converting a large front desk into a smaller workstation and repurposing the space for one or more exam rooms. The annual average revenue per exam room is $342,312 or $361 per square foot, according to AAHA’s Financial Productivity Pulsepoints.[6] In larger practices with three or more full-time veterinarians, the average revenue per square foot for exam rooms increases to $514.

A manager with a hybrid work schedule could work from home four days a week and one day onsite, sharing workspace in doctors’ offices when it is an associate veterinarian’s day off. The manager’s office could be repurposed as a revenue-generating exam room. A shared workspace also reduces computer and phone expenses.

embrace technology tools.

When Kaitlyn McMorran moved from California to Arkansas, she wanted to continue her job as hospital manager of Jeronimo Pet Clinic in Mission Viejo, Calif. She worked remotely for more than a year. McMorran used Splashtop for remote access to the practice-management software and RingCentral, a cloud-based phone and fax app that works on a desktop computer and mobile phone. Remote work let McMorran focus on computerizing the practice after Dr. Barbara Weintraub bought it from a retiring doctor. McMorran helped convert paper charts into electronic medical records, create a website and social media presence, enter financial records in accounting software, set up a client communication app, and add an online pharmacy.

“I wrote a job description for the remote practice manager position and talked with Dr. Weintraub about it,” she says. McMorran traveled to the practice several times during the year for onsite meetings.

Now McMorran has moved backed to California and has a hybrid schedule, mostly working onsite but does a workday from home as needed. While working onsite at Jeronimo Pet Clinic, she serves as a veterinary assistant and hospital manager. McMorran also is attending school to become a registered technician. She values the job flexibility and plans to do more remote work during her maternity leave in December.

Weekly virtual meetings help Brulatour collaborate with HomeVet owners Drs. Shawn Budge and Brittany Wolfe. Each year, she travels to Maryland to spend a week working with the HomeVets team and recently attended the VMX conference with its doctors. Brulatour also created a private Facebook group called Mobile In-Home Veterinary Network where more than 200 remote veterinary staff exchange resources.

“Embrace the future and all that technology has to offer,” Brulatour advises. “Start slow. Work on a hybrid model first and figure it out one step at a time. Never stop growing.”

WANT TO LEARN MORE? 

Enroll your team in the online course: Survival Tips When You’re Short-Staffed.

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 YouTube.com/csvets and Csvets.com for more.

References:

1. Haan K. Remote Work Statistics and Trends in 2023. Forbes Advisor. Available at: https://www.forbes.com/advisor/business/remote-work-statistics/#:~:text=As%20of%202023%2C%2012.7%25%20of,to%20a%20hybrid%20work%20model. Accessed July 24, 2023.

2. Practice Inefficiencies Compound Veterinary Stress. JAVMA News. Available at: https://www.avma.org/javma-news/2021-12-01/practice-inefficiencies-compound-veterinary-stress. Accessed July 24, 2023.

3. Groundbreaking IDEXX Study Reveals Opportunities to Increase Veterinary Practice Productivity. PR Newswire. Available at: https://www.prnewswire.com/news-releases/groundbreaking-idexx-study-reveals-opportunities-to-increase-veterinary-practice-productivity-301750165.html. Accessed July 24, 2023.

4. Managing Flexible Work Arrangements. Available at: https://www.shrm.org/resourcesandtools/tools-and-samples/toolkits/pages/managingflexibleworkarrangements.aspx#:~:text=Many%20U.S.%20workers%20now%20consider,a%202020%20survey%20by%20FlexJobs. Accessed July 24, 2023.

5. Hussain A. 4 Reasons Why a Remote Workforce Is Better for Business. Forbes. Available at: https://www.forbes.com/sites/amarhussaineurope/2019/03/29/4-reasons-why-a-remote-workforce-is-better-for-business/?sh=48a8fbe41a64. Accessed July 24, 2023.

6. Hawn R. Hospital Considerations: Expand or Build New? Available at: https://www.mwiah.com/our-insights/hospital-considerations. Accessed July 24, 2023.

 

5 Ways to Improve Email Reminders

5 Ways to Improve Email Reminders

by | Mar 9, 2023 | Hospital Management, Revenue Growth

5 Ways to Improve Email Reminders

WITHOUT A MARKETING STRATEGY, YOUR EMAILS MAY BE UNDERPERFORMING.

By Wendy S. Myers, CVJ, Communication Solutions for Veterinarians
 
Your hospital relies on email reminders as a highly effective and inexpensive tool to reach thousands of clients. Email benchmarks for healthcare services show average open rates of 24% and click-to-open rates of 13%.[1] The click-to-open rate indicates how effective the email message, design, and content performed, as well as whether the message caused the client to act.[2]The click-to-open rate is the number of clicks out of the number of opens (instead of the number of delivered emails). If 100 clients opened your email and 13 clicked through to book appointments, your click-to-open rate is 13%.
 
Email can be a powerful communication tool that ensures timely patient care and improves hospital revenue. Here are best practices to make your email reminders successful:
 

1. use a compelling subject line and call to action.

Because 62% of emails are opened on mobile devices, you need a short and captivating subject line.[3] To fit the subject line on a mobile device, you have 30 to 40 characters. Emoji can save space and increase open rates by 56%.[4] Find emoji on GetEmoji.com, CopyPasteCharacter.com, MegaEmoji.com, and fSymbols.com.

Use a data field to put the pet’s name in the subject line. Personalization will make your reminders stand out in clients’ inboxes.

Your call to action should tell clients what to do next. Give them a deadline to respond. This is not a skim and delete email.

As clients progress through your email series, increase the urgency of messages if they have not booked appointments. Here are email subject lines with the three strategies of personalization, emoji, and call to action:

  • Checkup reminder 1: <Pet name> needs a checkup by <date> 🐾 Book Now
  • Checkup reminder 2: Don’t miss <pet name>’s next checkup 🩺 Book Now
  • Checkup reminder 3: <Pet name> is overdue for a checkup ❤️ Book Immediately

2. keep email messages short.

Email messages between 50 and 125 words have the best response rates of 50% or higher.[5] People are skimming and scrolling, often not reading.

Use bullets or numbered lists to improve readability. Include hyperlinks to your online booking webpage, download your app with scheduling tool, and phone number. Hyperlinks let clients click and act. Research shows 70% of consumers prefer to schedule appointments by text or app.[6] You’ll reduce incoming phone calls, and clients can book 24/7. Most of the appointment and refill requests in the VitusVet app are between 8 p.m. and 7 a.m. with 5 a.m. as the busiest time.[7]

3. use a call to action button.

A button will stand out to email skimmers who may overlook a text hyperlink. The button should be larger than the text to be eye-catching. Color will make the button stand out from text. A big button can be easier to click on a mobile device. Ask your practice-management software or third-party reminder service to create customized buttons that work across all devices.

4. promote preventive care plans and financial solutions.

If you offer preventive care plans, include a brief description with a link that lets clients learn more such as “View our preventive care plans with monthly payments <link>. We can answer questions during your pet’s exam, or you may enroll online now.” 

Let clients know you can help with payment options for veterinary care. More than half of pet owners would use a credit card dedicated to financing care for their pets, according to the Synchrony Lifetime of Care study.[8] Dog owners can spend $534 to $1,285 annually on medications, parasite control, vaccinations, checkups, and dental care. Cat owners can spend $374 to $965 for yearly health expenses. If you offer third-party financing, include a one-liner such as “Learn about financing options through <link to provider>.”

5. use benefit statements to encourage foward booking.

Many practices have full schedules several weeks in advance. Traditionally, hospitals have sent checkup reminders 30 days ahead. If you are booking three weeks out and send reminders 30 days ahead, you only have one week of appointments available. With current appointment demands, send reminders 60 days ahead because you will have more openings. Your hospital may not have open appointments three weeks from today, but you will have openings eight weeks out. In May, send reminders for patients who will be due in July.

See the graphic at the top of this blog for a sample email with these effective marketing strategies.

Sending effective reminders is the first step in getting clients to schedule. Continue your communication with a series of confirmations that set expectations and prevent no-shows. 

Customize your series of scheduling and medication refill reminders to drive future business. Get how-to instructions with text and email templates in my free eBook on Everything You Need to Know About Reminders at https://csvets.com/reminders/.

Monitor your response rates monthly and test the wording and design of messages to identify which strategies get the best results.

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 YouTube.com/csvets and Csvets.com for more.

References:

[1] Ultimate Email Marketing Benchmarks for 2022: By Industry and Day. Campaign Monitor. Available at: https://www.campaignmonitor.com/resources/guides/email-marketing-benchmarks/. Accessed March 1, 2023.

[2] Email Marketing Terms. Campaign Monitor. Available at: https://www.campaignmonitor.com/resources/glossary/click-to-open-rate-ctor/. Accessed March 1, 2023.

[3] Infographic: The Ultimate Mobile Email Open Statistics. EasySendy. Available at: https://easysendy.com/blog/mobile-email-open-statistics/. Accessed March 1, 2023.

[4] The Real Scoop on Email Emoji in Subject Lines. Campaign Monitor. Available at: https://www.campaignmonitor.com/blog/email-marketing/the-real-scoop-on-email-emoji-in-subject-lines/. Accessed March 1, 2023.

[5] Renahan M. The Ideal Length of a Sales Email, Based on 40 Million Emails. HubSpot. Available at: https://blog.hubspot.com/sales/ideal-length-sales-email. Accessed March 1, 2023.

[6] Park A. 70% of consumers prefer to schedule appointments via text: 5 tips for safe, effective patient texting. Available at: https://www.beckershospitalreview.com/healthcare-information-technology/70-of-consumers-prefer-to-schedule-appointments-via-text-5-tips-for-safe-effective-patient-texting.html?oly_enc_id=3257D1848212C3H. Accessed March 1, 2023.

[7] Olcott M. Postcard Reminders: 3 Reasons You’re Kidding Yourself. Available at: https://vitusvet.com/blog/postcard-reminders-3-reasons-youre-kidding-yourself/. Accessed March 1, 2023.

[8] Pet Lifetime of Care Study, August 2021. Synchrony. Available at: http://petlifetimeofcare.com/#page=1. Accessed March 1, 2023.

 

The Death of Dental Month Discounts

The Death of Dental Month Discounts

by | Dec 21, 2022 | Hospital Management

Could this be the year that dental discounts die?

When National Pet Dental Health Month began in February two decades ago, its goal was to educate pet owners and fill seasonal downturns for practices. Deliberate discounts have mutated into marketing monsters for hospitals. Many practices have jampacked dental schedules from January to March to accommodate the demand.

With current staff shortages and overloaded schedules, many hospital managers and owners are ditching the 10% to 20% price cut. Others may quit discounting because dental procedures are forward booked two to three months out.

Let us end dental month discounts and make treatment part of everyday exam conversations. Use these educational approaches to get clients to accept preventive dentistry year-round:

ditch the term “dental.”

This catchall word does not accurately define a particular procedure, according to the 2019 American Animal Hospital Association (AAHA) Dental Care Guidelines for Dogs and Cats (1). Teams should use specific terminology such as complete oral health assessment, orthodontics, periodontal surgery, and advanced oral surgery. AAHA’s guidelines include a chart of dental term definitions such as: “Oral surgery is the practical manipulation and incising of epithelium of hard and soft tissue for the purpose of improving or restoring oral health and comfort.”

focus on the benefits of treatment.

Jason Coe, DVM, PhD, a professor at University of Guelph’s Ontario Veterinary College and an expert in veterinary clinical communication, suggests considering clients’ perspectives (2). Pet owners want to know:

  • What treatment options are available along with the cost?
  • What will my pet experience based on the treatment we choose?
  • What is the prognosis or outlook?
  • If I accept treatment, what will be the outcome for my pet’s health?

avoid the wiggle word of “recommend.”

Clients may assume they can wait because the procedure is just a recommendation and is not urgent nor medically necessary. Instead, use the action word of “need.”

USE photos to increase client understanding.

Research shows 65% of people are visual learners (2). They understand best when shown an image, model, or graphic demonstrating the problem or treatment. Use photos two ways:

1) Document and share your diagnosis. Use a smartphone to take dental photos that help clients see problem areas. Markup, enlarge, and crop images to show clients what you see. Save images in patients’ electronic medical records to visually document the diagnosis and share photos with clients by text or email.

2) Explain procedures with slideshows. Take photos of your team performing preanesthetic testing, taking dental radiographs, using surgical monitoring equipment, and other steps of procedures. Build a PowerPoint presentation branded with your logo. Write captions for each photo. Export the presentation as a slideshow to play on exam room computers or digital photo frames. Share the slideshow on your website and social media, too.

provide treatment plans on the day of diagnosis.

After hearing diagnoses, pet owners want to know their next steps. Give clients information to help them decide and schedule today. A treatment plan serves four purposes:

  1. Gives you legal permission to treat
  2. Lists services and products in the procedure
  3. Shares expected cost of care
  4. States payment policies

Treatment plans will have a high and low range. Do not call it an “estimate” or you risk making the conversation “all about the money.”

WANT TO LEARN MORE? 

address cost head-on.

For one out of four pet owners, an unexpected expense of $250 or less is a financial issue (3). The average dental case is $499.64, including preanesthetic exam, CBC with differential, chemistry panel with eight chemistries, dental radiographs, preoperative pain medication, 30 minutes of anesthesia, IV catheter and placement, IV fluids, dental scaling and polishing, subgingival curettage, fluoride application, electronic monitoring, post-procedure pain medication, post-procedure injectable antibiotics, hospitalization, and one-week supply of antibiotics (4).

Say, “We can help you with financing options to pay for veterinary care,” advises the eBook, Language That Works: Changing the Way We Talk About Veterinary Care, from the American Veterinary Medical Association (5).

Update your hospital’s treatment plan templates with links where clients can learn about third-party financing. The last line item on a treatment plan is: “Learn about financing options at <link>.” Embedding the description in templates will ensure financial solutions are consistently communicated to clients. Circle or highlight the link so clients know where to learn more. In addition to treatment plans, share financing links in email and text confirmations, QR codes, website banners and buttons, and social media posts.

set dental fees by grade to incentivize early treatment.

Increase prices 25% or more between each grade. A Grade 1 dental procedure might include one 30-minute unit of anesthesia while a Grade 2 procedure would have 1.5 units or 45 minutes. Using the average of $500 for a 30-minute Grade 1 dental procedure from AAHA Veterinary Fee Reference, from Grades 1 to 4, the cost of care nearly doubles (see chart). Reward the behavior you want, which is early treatment. Extractions would be additional based on the number and difficulty of oral surgery.

Dental treatment         Average fee

Grade 1                       $500

Grade 2                       $625

Grade 3                       $781

Grade 4                       $976

ask for a commitment to treat.

Offer the veterinarian’s next two procedure days. Book the dental treatment with the same doctor who diagnosed the condition because he or she will be familiar with the case and enjoy production pay. Scheduling with the same doctor also increases clients’ confidence.

Use the yes-or-yes technique to lead clients to book now: “Dr. <Name> diagnosed <pet name> with Grade 3 dental disease. We can perform the procedure on <date 1> or <date 2>. Which do you prefer?”

Let’s stop cramming too many procedures into one month, running our technicians ragged, and disappointing clients who can’t get the discount when patient capacity overflows. Celebrate the end of discounts during National Pet Dental Health Month like the death of the Yellow Pages!

WANT TO LEARN MORE? 

References:

1 –  Bellows J,  Berg L, Dennis S, Harvey R, Lobprise L, Snyder C, Stone A, and Van de Wetering. 2019 AAHA Dental Care Guidelines for Dogs and Cats. Available at: https://www.aaha.org/globalassets/02-guidelines/dental/aaha_dental_guidelines.pdf. Accessed Dec. 19, 2022.

2 – Klingbord J. Exam Room Communication for Veterinarians. AAHA Press, 2011:27,29,160-162,34-35.

3 – Pet Lifetime of Care Study, August 2021:13. Synchrony. Available at: http://petlifetimeofcare.com/#page=1. Accessed Dec. 19, 2022.

4 – AAHA Veterinary Fee Reference, 11th edition, AAHA Press, 2021;120.

5 – Language That Works: Changing the Way We Talk About Veterinary

Care, American Veterinary Medical Association. September 2021:22. Available at: https://www.avma.org/blog/new-ebook-reveals-best-language-use-clients. Accessed Nov. 29, 2022.

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create efficient dental schedules

create efficient dental schedules

by | Sep 7, 2022 | Client Service Skills, Hospital Management, Scheduling Secrets

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.

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Stop Leaving Voicemails For Clients

Stop Leaving Voicemails For Clients

by | Aug 12, 2022 | Client Experience, Client Service Skills, Exam Communication Skills, Hospital Management, Phone Skills

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.

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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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