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Stop Clients’ Bad Habits of Emergency Refills

Client Service Skills, Exam Communication Skills, Hospital Management, Revenue Growth

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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