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How to Keep Employees Safe When You Reopen

How to Keep Employees Safe When You Reopen

How to Keep Employees Safe When You Reopen

In mid-May 2020, more than half of states have started to reopen their economies under restrictions, including allowing fewer customers, requiring workers and customers to wear masks, and enforcing social distancing.[1] In uncertain times, your practice team needs to create systems that will make employees and clients feel comfortable with the delivery of veterinary care. Let’s get your practice ready to safely reopen:

Consider assessing employees’ health at the start of each shift.

When employees arrive, a supervisor would use an infrared non-contact thermometer to take temperatures. CDC’s definition of a fever is 100.4 degrees.[2] Managers should maintain a temperature and self-assessment log. Each employee will answer a short list of self-assessment health questions, which could be incorporated into your electronic time clock software. Consult with your employment attorney and send employees with fevers home. Equal Employment Opportunity Commission (EEOC) guidelines give employers the right to take employee temperatures and advise having a plan on how the process will occur, confidentiality of information, handling employee refusals, and actions if fevers are detected.[3] Download EEOC guidelines at https://www.eeoc.gov/laws/guidance/pandemic-preparedness-workplace-and-americans-disabilities-act.

The Colorado Department of Public Health and Environment created an online symptom checker for health-care businesses (https://intake-app-dot-cdphe-erm.appspot.com/intake-form). Questions ask the presence of symptoms including fever, chills, cough, difficulty breathing/shortness of breath, sore throat, headache, body aches, vomiting, and diarrhea. The questionnaire asks whether the employee has been in contact with someone who had COVID-19 symptoms but was not tested or with someone who tested positive. 

Have employees immediately wash their hands upon arrival.

Staff shouldn’t clock in or put personal items in lockers until they’ve washed their hands with soap and water for at least 20 seconds. Set hygiene standards such as having employees wash their hands after providing care to every patient, using the restroom, sneezing, blowing the nose, cleaning, sweeping, mopping, smoking, eating, drinking, taking a break, and before or after starting a shift.

Encourage safe distancing.

Co-workers should stay at least six feet apart. If you have two receptionists at the front desk, shift workstations to be farther apart or move the second employee to a phone cubby or an office. Employees should wear cloth masks (PPE for procedures), even if you’re not allowing clients in the building. Wearing a mask is not a substitute for social distancing—employees must do both. 

Adapt your break room.

If you have a small space, schedule individual employee breaks and mealtimes so only one employee is in the break room at a time. Provide sanitizing spray to wipe down the counter, microwave, sink, table, and chair after each use. COVID-19 can live on cardboard for 24 hours and on plastic and stainless steel for up to 72 hours. The virus can be spread from infected objects if you then touch your mouth, nose, or eyes. Encourage employees to bring their own coffee mugs, dishes, and utensils from home, avoiding shared kitchen utensils, dishes, and supplies. 

For larger teams, reduce the number of chairs at tables, spacing them six feet apart and using colored tape on table surfaces to indicate separate seating. At Capital Area Veterinary Emergency Service in Concord, N.H., Hospital Director Joshua Jasper moved its break room to a larger conference room, marked table surfaces for distancing, and set up a team appreciation station with complimentary snacks and drinks (https://www.linkedin.com/posts/jjosh21_vetlife-veterinarymedicine-caves2020-activity-6655803991835967488-96ze).[4] 

Sanitize workspaces.

Doctors and managers should sanitize and clean personal workspaces at the beginning and end of each shift. Shared workspaces such as reception and nursing stations should be cleaned between client interactions and when another co-worker will use the same equipment or computer.

Go to single-table surgical suites.

Chapel advises that some two-table surgical suites can be converted to a single-table room, providing more space for medical teams working in a confined space.

Talk with veterinary colleagues and associations to share resources and tips on what’s working in practices. Safety protocols will help your team deliver the care that clients and patients are counting on.

References: 

[1] Mervosh S, Lee J, Gamil L, and Popovich, N. See Which States Are Reopening and Which Are Still Shut Down. New York Times. Available at: https://www.nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html. Accessed May 11, 2020.

[2] Definitions of Signs, Symptoms, and Conditions of Ill Travelers. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/quarantine/maritime/definitions-signs-symptoms-conditions-ill-travelers.html. Accessed May 4, 2020. 

[3] Pandemic Preparedness in the Workplace and the Americans with Disabilities Act. Equal Employment Opportunity Commission. Available at: https://www.eeoc.gov/laws/guidance/pandemic-preparedness-workplace-and-americans-disabilities-act. Accessed May 5, 2020.

[4] Jasper J. Capital Area Veterinary Emergency Service. LinkedIn post. Available at: https://www.linkedin.com/posts/jjosh21_vetlife-veterinarymedicine-caves2020-activity-6655803991835967488-96ze. Accessed May 4, 2020. 

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5 Ways Your Practice Can Recover From COVID-19

5 Ways Your Practice Can Recover From COVID-19

5 ways your practice can recover from covid-19 

Some veterinary hospitals have gone to urgent and emergency care only, cancelling all non-essential appointments and elective surgical and dental procedures. The American Veterinary Medical Association (AVMA) advocates for veterinary hospitals and ambulatory practices to be considered essential businesses in situations where non-essential businesses are asked to close for COVID-19 risk mitigation.[1] As you adjust plans day by day, look at how your small business can recover from this crisis. Here are five strategies you should implement now:

1. provide curbside concierge service.

To maintain social distancing and keep clients and employees safe, go curbside and restrict pet owners from entering your building.

When clients call to book appointments, explain the process: “Please call us from your car when you arrive for your pet’s appointment. A veterinary nurse will meet you to ask you questions about your pet and to explain the services we will deliver. We will take your pet inside the hospital and perform care while you wait in your car. A doctor will call you on your cell phone to explain exam findings, treatments, and medications. A receptionist will review your pet’s services and fees over the phone and get your credit-card information for payment. The veterinary nurse will bring your pet, medications, and paid receipt to you in our parking lot. We appreciate the opportunity to care for your pet and have a safe environment for everyone.” 

2. get an online store.  

Clients will need to refill preventatives and long-term medications. You can’t afford to miss this recurring revenue. In addition to curbside pickup of foods and medications, talk with your veterinary distributor about setting up and promoting your online store. If you already have an online store, drastically increase your sales. Send email blasts to clients, share social media posts, update on-hold messages, and tell every caller. 

Encourage clients to sign up for auto shipments, which improves compliance and helps you avoid seasonal declines. The American Animal Hospital Association (AAHA) compliance study found only 55 percent of dogs get year-round heartworm preventatives.[2] Let’s say a client buys six months of heartworm preventatives. Set up one auto-ship refill in five months when one dose will remain. Because a heartworm test and exam will be due at the completion of one automatic refill, you will send reminders for the exam, heartworm test, prescription renewal, and other services included in the checkup.

An over-the-counter flea/tick product also could be set up on auto shipments. When one dose remains, you would alert the client via text, app, or email: “Your auto refill of <brand name> to protect your pet from fleas and ticks has been filled and is on the way.” 

Auto-ship single doses. Distributors offer monthly delivery of single doses of preventatives with free shipping. Receiving monthly doses in the mail will help clients on limited budgets as well as multi-pet families where the client may not be able to buy 12-packs of preventatives for six dogs at the same time. (This also breaks the habit of sharing a box of preventatives between multiple pets.) Get more training in my online CE course “Quit Losing to Internet Pharmacies: How to Sell More Preventatives” (https://shop.csvets.com/new-releases/quit-losing-to-internet-pharmacies-how-to-sell-more-preventatives/).

3. offer telemedicine services.

Get an app for your hospital with telemedicine capabilities. Live video consultations with a messaging tool that allows pictures, videos, and other attachments will let you share information back and forth with clients. Many telemedicine apps integrate with practice-management software for medical record-keeping and invoicing. Use telehealth for initial consultations as well as follow-up care, setting your own prices and hours.

Define types of cases you can see using telemedicine. Dr. Lori Teller, DABVP (canine/feline), CV, at Meyerland Animal Clinic in Houston used telemedicine for an orthopedic patient with intermittent lameness. The client said her dog limped at home but acted normally at the hospital. Telemedicine let Dr. Teller see the problem happening and combine the client’s video with her earlier hands-on exam.[3]

Besides helping you see patients virtually during the COVID-19 crisis, telemedicine lets you fix low compliance for follow-up exams and post-surgical assessments. AAHA and AVMA have published a digital guide on The Real-Life Rewards of Virtual Care: How to turn your hospital into a digitally connected practice with telehealth. Download at https://www.avma.org/sites/default/files/resources/Telehealth-Virtual-Care-Brochure.pdf.

4. audit your reminders.

Make a list of every vaccine, medication, diagnostic test, and treatment that needs to be repeated. Let’s say your hospital performs a drug-monitoring test for dogs on non-steroidal anti-inflammatory drugs (NSAID) every six months. Send a reminder one month before the test is due so the client has ample time to schedule an appointment. You’ll also prevent the confrontational conversation when a receptionist has to tell the client her dog’s NSAID can’t be refilled until the test is done. Likewise, send reminders for senior pets that get early detection screens, blood pressure checks, and other recurring diagnostics.

When you send medication refill reminders, you’ll eliminate the frustration of last-minute calls from clients who wait until the last pill is gone. Refill reminders can be app notices, emails, or texts that link to your online store.

5. increase callbacks. 

Electronic medical records make it easy to search patients by diagnostic codes. Check the exam and diagnostic status of patients with your top 10 chronic health problems such as arthritis, cardiomyopathy, allergies, diabetes, and others. 

Let’s say your standard of care is to see diabetic patients every three months to monitor glucose levels, check weight loss or gain, and assess overall health. Run a report on diabetic patients, sorting by the date of the last visit. 

Have receptionists call clients with diabetic patients that have not been seen in longer than three months. Explain, “Dr. <Name> asked me to call you about <pet name>. He/she noticed that <pet name> is overdue for an exam and blood test to monitor glucose levels so we may manage your pet’s diabetes. Dr. <Name> can see <pet name> on Monday at 11 a.m. or Thursday at 4 p.m. Which do you prefer?” Lead the client to schedule with the yes-or-yes technique, which gets stronger compliance than the yes-or-no choice of “Do you want to schedule an appointment?” 

COVID-19 is an opportunity for your veterinary practice to examine the way you serve clients and patients. The initiatives you start today will help you get through this crisis and establish ongoing revenue streams. Use this pandemic as a reason to work “on” your business rather than just “in” your business.

References:

[1] COVID-19 Updates. AVMA email to members. Available at: https://echo4.bluehornet.com/hostedemail/email.htm?CID=41754840731&ch=0B4C3F8FC25BADF3C7E8514E62BDCDCD&h=4bedb94f04ecc3a8b8746c6d022f84b0&ei=7mKQI-lNW&st=15-MAR-20. Accessed March 23, 2020.

[2] Compliance: Taking Quality Care to the Next Level. American Animal Hospital Association, 2009:11,19.

[3] The Real-Life Rewards of Virtual Care: How to turn your hospital into a digitally connected practice with telehealth. Available at: https://www.avma.org/sites/default/files/resources/Telehealth-Virtual-Care-Brochure.pdf. Accessed March 23, 2020. 

 

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How to Prevent No-Shows

How to Prevent No-Shows

How to Prevent No-Shows

How to Prevent no-shows

His frustration had reached the boiling point. After three no-shows this week, a veterinarian asked me if he should start asking clients to prepay for surgeries. While I empathize with his angst, don’t punish 99.9 percent of good clients for a few bad apples. Imagine you are a client of 12 years who now has to pay before services get delivered. You might get so mad that you leave the practice. Instead, use these proactive techniques to prevent no-shows:

Text or email appointment confirmations immediately after booking.

A client schedules a spay one month from today during her puppy’s last checkup. If you wait until the day before the procedure to remind her of the surgery and fasting instructions, you chance that she may forget or need to reschedule. When she books today, immediately text or email an appointment confirmation that she may add to her calendar. Set up appointment confirmations in your practice-management software or third-party apps. Text: “<Pet name> has a surgical admission appt on <date> at <time>. Reply C to confirm or RS to reschedule.” If a client replies RS, call to have her select a new time and date.  

This double confirmation at the time of booking reiterates the importance of the exam or procedure. My dentist does this. When I booked my next hygiene appointment, I got a text on the elevator ride to the parking garage. I added the appointment to my calendar before I unlocked my car.

Confirm earlier and multiple times. 

Don’t wait until the day before appointments or procedures to remind clients. Set up a series of confirmations and reminders: 1) Upon booking, 2) Four days before the appointment or procedure, 3) Two days ahead, and 4) The day of the appointment, reminding of fasting instructions for procedures or bringing stool samples for checkups. 

Gather new client information during scheduling calls. 

Go beyond collecting a name and phone number. When scheduling, take 2 minutes to enter the client and patient names, address, email, cell number, and patient breed and birthdate. You’ll avoid the negative experience of “clip-boarding” a new client when you hand her a registration form at check-in while she struggles with her Jack Russell terrorist on a retractable leash. You’ll suck away valuable exam time with busy paperwork. Because you have gathered the majority of client contact information during the scheduling call, you’ve established a “know, like, and trust” relationship. 

Perform preanesthetic testing when clients book procedures. 

If you diagnose my cat with dental disease on Wednesday and I schedule treatment for Friday, collect blood and urine samples for preanesthetic screening today. This lets you choose the most cost-effective diagnostics from the reference lab or in-house testing. The client pays for lab tests today, reassuring she will show up two days later for the procedure. Your nursing team also will appreciate one less task to perform the morning of the dental treatment. 

Have clients sign anesthetic and surgical consents before booking. 

Let’s say you diagnose dental disease and explain the need for treatment. The client agrees. Get signatures on the treatment plan and anesthetic consent form today. You’ll dodge the time-suck of paperwork and get written commitment to show up. 

An alternative is use text and email together. When you confirm the surgery two days in advance, text the client: “See you Friday at 8 a.m. for <pet name>’s surgical admission. No food after 10 p.m. Water is OK. We emailed surgical forms to <email>. Reply with questions.” The text prompts the client to check her email, where you can provide detailed fasting instructions and attach consent forms and treatment plans.

Your email message would say, “We will see <pet name> for surgery on Friday at <Your Veterinary Hospital>. Please withhold food after 10 p.m. tonight. Water is OK to drink to prevent dehydration. Your surgical admission begins at 8 a.m. with a nurse, who will spend 15 minutes reviewing the consent form, answering your questions, and getting phone numbers where we may reach you the day of the procedure. I’ve attached your treatment plan and anesthesia consent forms. To speed your admission, please bring these signed forms with you, or we are happy to answer questions during check-in. Please allow at least 15 minutes for <pet name>’s admission to our hospital. If you have questions, call or text 555-555-5555.” 

Text driving directions to new clients. 

When you confirm exams two days in advance, text: “We’re excited to meet you and <pet name> on Friday at 4 p.m. Bring a stool sample that’s fresh within 4 hours. Get driving directions at <link>.” When new clients click the link on their smartphones, map apps will give them estimated travel time along with turn-by-turn directions. You’ll enjoy on-time arrivals and create “wow” first impressions. 

Send a final text or email confirmation the day before appointments and procedures. 

Text the client: “We will see <pet name> tomorrow for an appt with Dr. <Name> beginning at 9 a.m.” The word “beginning” trains the client to be in your lobby at exam time, not down the street at Starbucks (unless she’s fetching you a pumpkin spice latte!). 

Mail thank-you cards after the first visit. 

This is the first date that starts a lifetime relationship. Don’t default to a templated email or text that will get scanned and deleted. People receive hand-written greeting cards in the mail on birthdays, holidays, or anniversaries. Make the new client appointment a standout occasion. Have the doctor and hospital manager sign the card and add a personal message such as “We loved meeting your kitten, <pet name>, and look forward to watching him grow up!”

Start no-show strategies today.

A dog owner may spend nearly $700 for a checkup that includes an exam, vaccines, diagnostics, and 12 months of flea/tick and heartworm preventatives. Surgical and dental procedures may have even higher dollar values to your practice. Stop the anxiety of whether clients will show up as promised. Reclaim the confidence that you’ll have long-term, loyal relationships with these approaches.

Author: Wendy S. Myers, CVJ, Communication Solutions for Veterinarians

 

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Avoid a Meltdown When Dr. Popular Isn’t Available

Avoid a Meltdown When Dr. Popular Isn’t Available

Avoid a Meltdown When Dr. Popular Isn’t Available

A longtime client calls and requests an appointment with Dr. Popular. While this veterinarian is blessed to be busy, you don’t want clients to have meltdowns when they can’t see their preferred doctor. What should you do? 

 

focus on what you can do.

Don’t tell the pet owner that the doctor is booked three weeks out because it will create a negative impression and could incite an argument. Say, “Dr. Popular’s next available appointment is Aug. 30 at 9 a.m. If your pet needs to be seen sooner, Dr. Next could see you tomorrow at 4 p.m. Which do you prefer?” 

practice forward booking.

When clients want their first choice of time, day, and doctor, have them book the next appointment during today’s exam. Use forward booking for progress exams, checkups, and disease-management exams for pets with chronic health conditions.  

When wrapping up today’s exam, Dr. Popular should introduce the concept of forward booking. If you have computers in exams rooms, he should schedule it now (Yes, the veterinarian needs to know how to use the scheduling tool in your practice-management software). Here are two examples of client conversations: 

For a disease-management exam, explain the “why” behind the change in the frequency of exams and use benefit statements. Dr. Popular would say, “Because Molly was diagnosed with arthritis today and will begin long-term medication, I will need to see her every six months to manage her arthritis and check blood work in case we need to adjust medication dosages. Booking her next exam now will let you get your first choice of a time and date with me. Six months from today would be Jan. 9. I could see Molly at 10 a.m. or 4 p.m. Which do you prefer?” 

For a checkup, lead the client to book the next six- or 12-month exam. If the receptionist is scheduling the exam during checkout, she would say, “Just as your dentist has you schedule your next appointment at checkout, we do the same to proactively manage your pet’s health. Let’s book your pet’s next checkup for this same day and time next year. We will confirm two weeks before the exam, so if you need to change the appointment it will be easy. By scheduling today, you will get your first choice with Dr. Popular. He could see your pet at 10 a.m. on Wednesday, Aug. 12 or 3 p.m. on Friday, Aug. 14. Which do you prefer?” The first choice is the same day of the week and time as today’s appointment. The second choice is a different day of the week and time of day (morning vs. afternoon). Get scheduling techniques in my article on “Four Ways to Use Forward Booking” (https://www.veterinarypracticenews.com/four-ways-to-use-forward-booking/).   

be persistent when pets require progress exams.

Because Dr. Popular is booking weeks in advance, the entire healthcare team must be dogged and communicate the importance of scheduling follow-up care today. After explaining how to clean a dog’s ears and apply ointment for an ear infection, the nurse would say, “Dr. Popular needs to perform a follow-up exam in two weeks for your dog’s ear infection. We strive to book follow-up care with the same doctor because Dr. Popular wants to see the condition successfully resolved. This will be a 15-minute appointment to examine your dog’s ears and determine if additional treatment will be needed. Dr. Popular could see your dog on Thursday, Aug. 28 at 10 a.m. or Friday, Aug. 29 at 2 p.m. Which do you prefer?” 

If the client procrastinates and waits to call your hospital in two weeks when care is due, Dr. Popular won’t be available. Booking with the same veterinarian helps you achieve exam efficiency. If Dr. Next will see Dr. Popular’s patient for follow-up care, he will need to spend more time reviewing the medical record to get up-to-date on the diagnosis, treatment, and prescribed medications. The follow-up visit may take twice as long if a different doctor sees the patient.  

add more urgent care slots to dr. popular’s schedule.  

I advise receptionists to block three urgent-care slots per doctor per day for same-day sick patients. Because clients will call every morning with sick patients that must be seen today, plan for them in your daily schedule. You may need more urgent care slots on Mondays, Fridays, and Saturdays, when hospitals typically see higher volumes of sick patients.  

To determine how many urgent care slots Dr. Popular will need, create a spreadsheet that totals the number of exams he sees by day of the week. Let’s say he saw 22 patients on Thursday. Approximately 20 percent of patients are same-day sick appointments. Based on this formula, Dr. Popular would need seven urgent-care slots on Thursdays. Block an urgent-care slot at the top of each hour in Dr. Popular’s schedule on Thursdays. Get more insight in my YouTube video on “Overbooked and Can’t See Sick Pets? Here’s the Solution” at https://www.youtube.com/watch?v=j_oWxml2qyc&t=9s.  

Talk up other doctors.  

You want clients to feel confident and comfortable with every doctor in your practice. Dr. Popular, nurses, and the client-care team need to praise the skills and knowledge of other veterinarians in your hospital. When a client sighs after hearing Dr. Popular isn’t immediately available, promote Dr. Next. The receptionist would say, “Dr. Popular’s next availability is Aug. 30 at 9 a.m. I could schedule you with Dr. Next. He has a special interest in feline medicine and would love to meet Alex. I’m confident you’ll be satisfied with the quality of his medicine. Dr. Next could see Alex tomorrow at 4 p.m. Shall I schedule this exam?”

During his appointments, Dr. Popular also can share praises of his colleague, Dr. Next. Afterall, Dr. Popular may be the practice owner and hired Dr. Next. To transfer the client’s trust to another veterinarian, Dr. Popular might say, “Dr. Next has been part of my medical team for five years. We went to the same veterinary college and share similar medical interests and philosophies. If I’m unable to promptly see your pet, I’m confident that Dr. Next will do an exceptional job.” 

Because Dr. Popular will take vacations or may sell the practice one day, you must build trust in every veterinarian. Have your team discuss ways to equally distribute appointments amongst all doctors because the hospital’s goal is to have every veterinarian fully booked every day.

 

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Stop Clients’ Bad Habits of Emergency Refills

Stop Clients’ Bad Habits of Emergency Refills

Stop Clients’ Bad Habits of Emergency Refills

The habit is predictable. Every day, multiple clients call your veterinary clinic within minutes of closing time to request prescription refills. “My dog took his last pill this morning, and I need a refill today. I’m on the way to your hospital now. Could you wait for me?” pleads the pet owner.

You both want the dog to get timely medication, but why did the client wait until the last dose was gone before contacting you? To avoid the stress of urgent refills, take a preventive approach with these strategies:

Alert clients when refills are coming due.

My cat, Caymus, takes benazepril daily. I refill his medication every three months. When you dispense his next prescription, create a refill reminder for 11 weeks, when one week of doses would remain. Alerts could be phone calls, emails, texts or app messages. Send alerts through your practice-management software or third-party providers.

At Blue Sky Animal Clinic in Loveland, Colo., Practice Manager Chrystal Bell wanted to be able to call and text from the same phone number her clients knew. Zipwhip lets you use your existing business phone number to send and receive texts. Now clients text refill requests to Blue Sky Animal Clinic’s main phone number. Employees reply when messages pop up on the desktop screen.

Push notifications also let you tell clients when they need to repurchase. A VitusVet call study found the average client service representative (CSR) answers 600 calls per week at a veterinary hospital.1 While more than 60 percent of calls generate revenue through appointments and prescription refills, the average veterinary hospital is missing $123,000 of gross revenue due to inefficiencies in phone-based customer service. (*1)

Links in your emails, texts or app can let clients request prescription refills electronically. Clients will enjoy the satisfaction of one-click refills, while your client service team will be overjoyed when you reduce call volume by 20 or more calls each day.

 

Enter the number of refills available.

If the veterinarian wants to perform a blood test every six months and the technician is filling a one-month supply, five refills of 30 tablets would remain. The number of refills will print on each prescription label, letting the client see the countdown of 5, 4, 3, 2 and 1 refill left.

While I agree that veterinarians will need to approve each prescription refill, don’t punish clients with long hold times on the phone. Note the number of refills that are available in medical records, avoiding the find-the-doctor game each time clients call with refill requests. Tell the pet owner, “<Client name>, I see that you have five refills available. What time would you like to pick up your pet’s medication? I will have the doctor confirm the refill. I will only call you if the doctor has any questions or concerns. Otherwise, we will see you at <time>.” After speaking with the caller, the CSR could ask the veterinarian to approve the prescription and note the requested pickup time for the technician who will fill the medication.

 

Set up reminders for drug-monitoring tests.

Clients may become outraged when you decline their emergency refill request because blood work is due. To avoid confrontation, your medical team needs to proactively remind clients when future testing will be due. Veterinarians should set protocols for the frequency of blood tests for long-term drugs such as phenobarbital, non-steroidal anti-inflammatories (NSAIDs), thyroid medication and others.

When a technician fills a long-term prescription, enter two reminders: 1) drug-monitoring test and 2) Prescription refill. Let’s say your veterinarians want to perform blood work every six months for dogs taking NSAIDs. Set the reminder for 30 days before testing is due, which will trigger postal, email, text and/or app notices to the client. Your reminder should explain the reason for testing and lead the client to schedule now. The reminder would state, “Drug monitoring is necessary for <pet name> to continue to safely take medication and is required before the next refill. Please schedule your pet’s blood test before <date> so we may provide prompt refills.” If an exam also is due, schedule the appointment with a veterinarian. If the blood test is the only service due, make a technician appointment for the blood draw.

If clients haven’t responded to reminders, technicians would call one week before testing is due. Say, “This is <technician name> from <Your Veterinary Hospital>. We saw <pet name> six months ago, and Dr. <Name> needs to monitor his thyroid level. During a technician appointment, we’ll collect a blood sample and run the thyroid test. Drug monitoring is necessary for <pet name> to continue to safely take his thyroid medicine and is required before the next refill. <Pet name> will be out of thyroid medication next week. We could see you Monday at 10 a.m. or Tuesday at 5 p.m. Which choice is convenient for you?” Use the two-yes-options technique to guide pet owners to schedule.

 

Place a sticker on the vial when one refill remains.

When blood work will be due before the next refill, put a label on the prescription vial such as “Blood test required before next refill.” The prescription label also will note that zero refills remain. Use a bright-colored sticker rather than typing “Blood test required before next refill” on the label. Few clients re-read labels for chronic medications when dosing instructions remain the same.

The sticker alerts both clients and employees. When the client arrives to pick up medication, the CSR would see the sticker and say, “I see that this is your last refill before blood work is due. Let’s schedule a 15-minute technician appointment for the blood draw. We could see your pet next Tuesday at 1 p.m. or Wednesday at 11 a.m. Which choice works for you?” Schedule first before collecting payment for the medication because an appointment reminder will print on today’s receipt. In addition to using stickers on chronic medications, also put the “Blood test required before next refill” sticker on heartworm preventatives when a heartworm test will be due.

 

Set up auto refills.

Retail pharmacies such as grocery stores, Walgreens and CVS Health use text alerts when prescriptions are ready. Research conducted by the CVS Health Research Institute found that pharmacy customers enrolled in digital and online programs have better medication adherence and reduced healthcare costs. (*2)

Your veterinary hospital could use an auto-refill strategy for over-the-counter and prescription drugs. If a client buys six months of heartworm preventatives, set up one auto refill in five months when one dose will remain. Alert the client when the medication has been refilled with calls, emails, texts or app messages such as “Your pet’s heartworm preventative has been refilled and is ready for pickup. One dose remains, and we want to provide ongoing protection from deadly heartworms.” An auto-refill strategy would increase compliance for 12-month dispensing. Because a heartworm test would be due at the completion of one automatic refill, you would send reminders for the physical exam, heartworm test, prescription renewal and other services included in a preventive checkup.

An over-the-counter flea/tick product also could be set up on auto refill. Let’s say the brand has a “buy six, get two free” promotion. At month 7 when one dose remains, you would alert the client, “Your auto refill of <brand name> to protect your pet from fleas and ticks has been filled and is ready for pick up. Your purchase is eligible for two free doses, a value of $___, which we have included with your refill.”

Midwest Veterinary Supply’s partnership with MyVetStoreOnline.com lets clients set up recurring orders of any product, from food to medication (www.midwestvet.net/practice-solutions/home-delivery-solutions/mvso.html). The “Easy Dose It!” program sends clients a single preventative dose in the mail each month with free shipping.

 

Send dosing alerts.

During exams, show clients how to set up alerts on the day of the month that they need to give flea, tick and heartworm preventatives. Provide instructions through email blasts, e-newsletters and social media posts, too.

 

Offer refills through your online store.

When clients get refill notices, offer the convenience of online or app ordering. Ask your veterinary distributor about setting up your own online store. Clients get home delivery of medications and diets with auto-ship benefits and reminder emails. You set the price of all products. Clients pay your hospital’s retail price plus shipping, handling and applicable taxes.

Make this a hassle-free year of managing prescriptions. These strategies can graduate beyond prescription drugs. Think of every consumable product your hospital sells—diets, dental chews, preventatives, pet toothpaste—and create refill push notifications. You’ll improve client loyalty, patient care and the financial health of your pharmacy.

Reference:

*1 – DiFazio M. Veterinary front desk workers are heroes too and here are the numbers to prove it. Published June 28, 2016. Accessed December 20, 2016 at http://content.vitusvet.com/blog/veterinary-front-desk-workers-are-heros-too-and-here-are-the-numbers-to-prove-it.

*2 – CVS Health introduces new digital pharmacy tools to help make medication adherence easier and more convenient. CVS Health, Nov. 18, 2015. Accessed Dec. 19, 2016 at https://cvshealth.com/newsroom/press-releases/cvs-health-introduces-new-digital-pharmacy-tools-help-make-medication.

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How to See More Patients

How to See More Patients

How to See More Patients

Seeing patients every 30 minutes doesn’t work. If Dr. Smith has outpatient exams from 8 a.m. to 5 p.m. with an hour for lunch, he will see 16 patients. His daily production will be $3,072 to $3,360 based on a $60 exam fee and average doctor transaction of 3.2 to 3.5 times the exam fee.  (*1) Tweaking scheduling techniques will let Dr. Smith see eight more patients each day, increasing income $4,608 to $5,040. Let’s start making more money:

Step 1: Schedule exam time based on the reason for the visit.

Don’t put every appointment in a 30-minute slot because a progress exam will take less time while a sick-patient visit may take longer.

Veterinarians and receptionists will work together to create scheduling guidelines. Don’t force this significant change on employees without their input—or it’s guaranteed to fail. Talk about what works and doesn’t work with your current schedule, how nurses support doctors in exams, and which scheduling tweaks will have the greatest impact. When making any change in your hospital, answer:

  1. How will this change improve client experiences?
  2. How will this change improve patient care?
  3. How will this change grow revenue?

Teamwork will help everyone understand the “why” behind scheduling renovations and get buy-in to follow guidelines consistently. Receptionists and doctors will need to define appointment lengths such as:

  • 10 minutes: Booster vaccines without exams, Level 1 progress exams for minor problems such as ear infections, and surgical discharges when a doctor needs to provide instructions.
  • 20 minutes: Adult preventive checkups, complicated medical/surgical discharges, Level 2 progress exams for complex problems, disease-management exams for chronic conditions, and second, third, and fourth puppy/kitten exams.
  • 30 minutes: Sick and urgent care exams, senior preventive exams, new clients, limping or symptoms that may require radiographs, skin cases, ophthalmic exams, second opinions, quality of life consults, and unattended euthanasia.
  • 40 minutes: Patients with vomiting and/or diarrhea, first puppy/kitten exams, attended euthanasia, and exotic pets.

Expand this list based on the types of appointments you see. Keep the quick-reference chart of scheduling guidelines on reception computers or laminated cards so tips become habit-forming. Your practice-management software also lets you designate appointment types, which would automatically block the correct length based on the exam type.

 

Step 2: Think in 60-minute blocks.

Your goal is to book every minute of each hour, avoiding gaps in the schedule. A 60-minute block could include a 10-minute progress exam, a 20-minute preventive checkup, and a 30-minute sick-patient exam. The next 60 minutes might consist of a new client appointment followed by a disease-management exam. Both choices had you successfully fill each hour.

 

Step 3: Book sick-patient exams next to checkups.

If you schedule three sick patients in a row, you risk running behind and creating an avalanche of late exams. Preventive checkups are more predictable and likely to stay on time. If you sandwich a sick-patient exam between two checkups, your schedule could stay on track.

 

Step 4: Leverage nurses.

Evaluate which appointments could shift from the schedule of veterinarians to nurses, such as giving booster vaccines that don’t require an exam, expressing anal glands, changing bandages, administering fluids, trimming nails, collecting samples for drug monitoring, and more.

 

Step 5: Evaluate as you go.

You’ll need two to four weeks to transition to the new scheduling system because you may have forward-booked appointments for progress exams. Everyone will need training on how the new scheduling system will work and what their roles are in executing it. Set a transition date to switch from the old to new scheduling method. The transition is best made quickly and completely.

During the first 90 days of implementation, have a doctor and receptionist supervisor meet weekly to see what worked well in the schedule’s flow and identify tweaks to make. Fine-tuning during the first 90 days will help you define your perfect exam flow.

 

Step 6: Track results.

Measure before-and-after progress. Create a spreadsheet on the number of appointments and revenue for 30 days before changes were implemented, and then 30, 60, and 90 days after the new schedule began. You should see up to 33 percent growth.

 

Share results.

During staff meetings and invite employees to share feedback. When employees see results and know they were part of making it happen, your practice will thrive.

References:

*1 – Tumblin D. Problem: Your Average Doctor Transition Is Low. Veterinary Team Brief, January/February 2018. Available at: www.veterinaryteambrief.com/article/problem-your-average-doctor-transaction-low. Accessed on March 10, 2019.

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