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what to tell clients when you raise prices

what to tell clients when you raise prices

what to tell clients when you raise prices

What to Tell Clients When You Raise Prices

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

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

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

tell employees before you tell clients.

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

create a script of what employees should say.

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

Your script should include four points:

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

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

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

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

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

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

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

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

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

position your hospital as a premium provider.

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

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

raise prices whenever products or vendor fees go up.

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

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

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

make small increases to professional services quarterly.

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

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

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

be competitive on shopped items.

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

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

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

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

want to learn more?

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

References:

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

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

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

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

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

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

 

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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 

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

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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Tell, Don’t Ask to Fix Compliance Blunders

Tell, Don’t Ask to Fix Compliance Blunders

Tell, Don’t Ask to Fix Compliance Blunders

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

Wishy-washy conversations may cause clients to dismiss necessary follow-up care and to refill medications, putting patient care and practice revenue at risk. Pet owners expect clear, specific guidance from your veterinary team. Here are common compliance blunders and how to correct them:

 

Compliance blunder: “Do you need any refills today?”

Veterinarians sell 62 percent of pet medications, reports the market research firm Packaged Facts. Eight out of 10 clients trust what their veterinarians say about pet drugs. (*1) Compliance starts at check-in. Receptionists should view drug-purchase history when clients visit for appointments, boarding or to pick up food and medications. The AAHA compliance study found only 55 percent of dogs get year-round heartworm preventatives. Only 30 percent of practices send reminders to refill chronic medications. (*2)

 

How to fix:

Tell, don’t ask. See when preventatives were last purchased and how many doses were sold. Some clients also may share medication between pets. If only a few doses remain, prompt the client to refill the prescription now. If the client visited five months ago and bought a six pack of heartworm prevention, one dose is left. Tell the pet owner, “I see that Max has one dose left of his heartworm preventatives. Let me tell you about our rebates so you may save the most.”

Check all pets in the family to see which need refills for preventatives and chronic drugs. The average American family has two pets (1.6 dogs and 2.1 cats), according to the American Veterinary Medical Association U.S. Pet Ownership & Demographics Sourcebook. (*3) I may be visiting for my cat Alex’s checkup, but my second cat, Caymus, needs his medication for cardiomyopathy refilled. My veterinarian is 15 minutes from my home, which turns into 30 to 45 minutes each way during rush-hour traffic. Ensure timely refills, help me avoid road rage and improve your refill compliance.

If your hospital has an online store, guide clients to set up accounts and auto refills during today’s visit. Tell the pet owner, “You can pick up future refills at our hospital, or I can help you set up auto refills through our online store now. Your pet’s preventatives will be automatically shipped each month until the next heartworm test is due. Do you prefer to get medication now or have it delivered to you with free shipping?”

 

Compliance blunder: “Do you want to schedule a recheck?”

Medical progress and pediatric exams have specific follow-up timelines. Clients may perceive a “recheck” as free and optional. About 75 percent of practices “always” or “most of the time” forward book patients’ progress exams, according to a Veterinary Hospital Managers Association survey. (*4)

 

How to fix:

Lead the client to book now because the appointment reminder will print on today’s receipt. Your busy hospital also may be booking exams one to two weeks in advance. If the client doesn’t book now, an appointment may not be available when follow-up care is due. Use the term “medical progress exam” to stress the urgency and importance of follow-up care. Tell the pet owner, “Dr. Patten needs to see Max for a progress exam for his skin infection in two weeks. Let’s book the appointment now so you get your first choice of time and day. Two weeks from today would be Thursday, Nov. 15. Does this same time, 9 a.m., work for you?” If the client is here at 9 a.m. on a Thursday, she may be able to return at a similar time and weekday. Book the appointment with the same veterinarian, ensuring continuity of care and efficient use of exam time.

Because you follow specific timing of vaccines, diagnostics and deworming for pediatric patients, book the next puppy or kitten exam today. Tell the pet owner, “Dr. Jeff needs to see your kitten again in three weeks, which would be Nov. 15. Does this same time, 1 p.m., work for you?”

Every practice has a mind-erase hallway that connects exam rooms to the front desk. Clients may forget to schedule follow-up care on the way to the checkout counter. To bridge this gap, choose from three strategies:

  1. If you have computers in exam rooms, the technician or veterinarian should book the next exam now. Nervous about a doctor using the appointment scheduler? Train to trust!
  2. Use a travel sheet or alert in your practice-management software. Hospitals with paper or paper-light records could use laminated travel sheets to note charges, reminders and follow-up care to be entered.
  3. Walk the client to the checkout desk for a verbal handoff. The technician or veterinarian would tell the receptionist, “<Client name> needs to schedule a progress exam for an ear infection for <pet name> on <date>.”

Create Level 1 and Level 2 progress exams,

depending on the amount of exam time needed for follow-up care. Level 1 progress exams would be 10-minute appointments for conditions such as ear infections, while Level 2 progress exams are more complex cases such as diabetes and would be 20 minutes. When scheduling follow-up exams, strive for same day, same time and same doctor.

 

Compliance blunder: “Do you want to book the dental procedure that the doctor recommended?”

The patient’s dental disease will get worse, and the price of treatment will significantly increase over time. Replace the wiggle word of “recommend” with the action word of “need.”

 

How to fix:

Schedule the procedure on the day of diagnosis. To guide the pet owner to book now, offer the doctor’s next two surgical/dental days. Schedule the procedure with the same veterinarian who diagnosed the condition because he will be familiar with the case and enjoy production pay. Booking with the same doctor also increases clients’ confidence.

If the client will check out at the front desk, the receptionist should schedule the procedure first, and then collect payment for today’s services. Lead the client with the two-yes-options technique. Tell the pet owner, “Dr. Lavallee diagnosed Caymus with Grade 1 dental disease. Let’s schedule his procedure first, and then I will get you checked out for today’s services. We can perform the dental treatment next Monday or Wednesday. Which fits your schedule?” Provide fasting instructions and let the client know you will call, email or text to confirm one day before the procedure. An appointment reminder for the procedure will print on today’s receipt.

 

When you confidently explain needed follow-up care and refills, you will guide clients’ decisions. The result is healthier patients and practice revenue. Get more training in my online CE class on “Are Your Wiggle Words Killing Compliance?” Enroll at here.

References:

*1 –  Niedziela, K. Veterinarians Sell 62% of Pet Drugs. Today’s Veterinary Business. Published September 2017. Accessed Sept. 17, 2018 at https://todaysveterinarybusiness.com/veterinarians-sell-62-pet-drugs/.

*2 – Compliance: Taking Quality Care to the Next Level. American Animal Hospital Association, 2009, pp. 11, 19.

*3 – 2012 American Veterinary Medical Association U.S. Pet Ownership & Demographics Sourcebook. Accessed Sept. 17, 2018 at www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership.aspx.

*4 – DVM360.com staff. VHMA Files: Forward Thinking, How to Use Forward Booking for Your Practice. Published Jan. 22, 2015. Accessed Sept. 17, 20158 at http://veterinaryteam.dvm360.com/vhma-files-forward-thinking.

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Stop Hiding Patient Care “In the Back”

Stop Hiding Patient Care “In the Back”

Stop Hiding Patient Care “In the Back”

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

While consulting a practice, I observed client after client challenge receptionists over fees for exams and other professional services. The high-volume hospital performed exams, gave vaccines and delivered other services in the treatment area in the interest of efficiency. Conducting professional services behind closed doors left pet owners questioning charges. Some wondered whether their pets were really vaccinated.

To create perception of value and improve client education, I persuaded doctors to deliver services in front of clients in exam rooms. Client complaints immediately stopped. Because 65% of people are visual learners, deliver veterinary care that engages pet owners. (*1) Here are ways to stop hiding patient care “in the back”:

 

Verbalize your physical exam.

Once you begin the nose-to-tail exam, describe every step, giving clients play-by-play details as you cover each body system. If you engage in small talk during the physical exam, pet owners may assume you’re just petting their animals rather than assessing their overall health. Tell the client, “For your pet’s physical exam, I will assess 12 areas, including eyes, ears, nose and throat, teeth and gums, coat and skin, heart, abdomen, limbs and paws, urogenital system, lungs, gastrointestinal system and weight.” Then give them guided tours of their pets.

Let children listen to their pets’ hearts through your stethoscope. You’ll show kids the cool science of veterinary medicine while inspiring future responsible pet owners.

 

Explain diseases you’re protecting against as you vaccinate.

When vaccinating a dog for leptospirosis, ask risk-assessment questions and explain how the bacterial infection is spread. This shows clients you tailor vaccines for every patient.

 

Use teaching tools.

The exam room is your classroom. When you’re an effective communicator, you can increase acceptance for professional services and products. Replace artwork of dogs and cats with framed posters on frequently discussed topics of heartworms, age analogy charts and parasite prevalence maps. Use models, websites, dry-erase boards, x-rays, handouts, exam report cards, and videos as teaching tools.

Let’s say you advise a pet owner to give subcutaneous fluids to her cat to treat its kidney disease. Rather than administering fluids in the treatment area, demonstrate it in the exam room. Tell the pet owner, “Let’s give your cat fluids together today, so you will know how to do it at home. You’re welcome to record a video on your smartphone for reference. I also will text you a link to our hospital’s YouTube video on how to give fluids. Giving your cat fluids three times per week will keep her hydrated and let us better manage her kidney disease together.”

 

Invite clients to look in your microscope.

Your ear cytology reveals a cat’s ear mites. Rather than returning to the exam room to explain your diagnosis, tell the client, “Come with me. You’ve got to see these ear mites.” When she peers into your microscope, the pet owner exclaims, “Those look like monsters! No wonder our cat was scratching his ears.” You’ve shared behind-the-scenes magic while guaranteeing compliance for treatment.

 

Show pet owners where procedures will happen.

From discussing dental treatments to orthopedic surgeries, boost clients’ confidence in your procedures with a quick tour. Walk clients through your in-house laboratory, treatment area and surgical suite. Also post a virtual tour on your website. Half of the family may be present for today’s exam and other caretakers can see the same tour online.

Seeing where procedures will be performed may comfort clients who have a fear of anesthesia. Clients will be impressed with the cleanliness and sophistication of your surgical suite. Many may tell you, “Wow, this looks just like a human hospital.”

After presenting the treatment plan and completing the tour, ask, “What questions can I answer about your pet’s dental procedure and our anesthetic protocols?” The phrase of “what questions” invites pet owners to share concerns or get more information. This wording is more effective than the yes-or-no choice of “Do you have any questions?” Once you’ve provided answers, ask clients for commitments to treat. Say, “Do you need more information, or have I explained enough for you to decide?”

If emergency care is being delivered in the treatment area and you can’t do a tour now, have photo books or digital slideshows of procedures. Take a photo of each professional service listed on your treatment plans, from your in-house lab to patients receiving nursing care during recovery.

 

Let clients watch care being delivered.

Laser therapy can be performed in exam rooms with clients present. Seeing treatments helps them understand its benefits and book ongoing therapy.

Clients may be able to observe certain workups. My cat, Caymus, has cardiomyopathy. Dr. Jennifer Lavallee, owner of The Cat Specialist in Castle Rock, Colo., lets me watch when she performs his cardiac ultrasound. She discusses findings and shares ultrasound images. As a result, I’m a compliant client. Consider which procedures and treatments would be appropriate for your clients to witness. Obviously, you don’t want bystanders hovering in your surgical suite or interrupting emergencies.

 

Banish the phrase “in the back.”

You can see clients’ tense reactions when they hear these words. Pet owners may become anxious about what will happen to their animals behind closed doors. Explain where and why patient care will happen such as “I’m going to take your cat to the treatment area where another technician will assist me in collecting his urine sample. We’ll return in about 5 minutes and start the urinalysis, so you have results during today’s exam.” Replace the negative words of “in the back” with “treatment area,” which is more professional and accurately describes your facility.

 

Demonstrating the quality and compassion of your care in front of clients will develop trusting relationships while increasing compliance. Get more training in my online CE class on “Creating the 5-Star Experience in the Exam Room”.

Reference:

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

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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

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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How to See More Patients

How to See More Patients

How to See More Patients

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

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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