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Overwhelmed With Callbacks, Texts, and Emails?

Overwhelmed With Callbacks, Texts, and Emails?

by | Aug 12, 2022 | Client Experience, Hospital Management

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

by | Aug 8, 2022 | Exam Communication Skills, Hospital Management, Leadership Skills, Revenue Growth

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

by | Aug 8, 2022 | Client Experience, Client Service Skills, Hospital Management, Scheduling Secrets

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.

 

How to Prevent No-Shows

How to Prevent No-Shows

by | Oct 15, 2019 | Client Service Skills, Hospital Management, Scheduling Secrets

How to Prevent No-Shows

How to Prevent no-shows

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

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

by | Sep 27, 2019 | Client Experience, Client Service Skills, Hospital Management, Scheduling Secrets

Avoid a Meltdown When Dr. Popular Isn’t Available

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

A longtime client calls and requests and 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

by | Apr 3, 2019 | Client Service Skills, Exam Communication Skills, Hospital Management, Revenue Growth

Stop Clients’ Bad Habits of Emergency Refills

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

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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