A clean bill of health is a reason to celebrate
I advocate for more early-detection diagnostics, as I think they make sense for pet health, for client peace of mind and practices bottom line.
Adding more and better preventive care protocols in your veterinary practice can seem daunting: What exactly counts as preventive care? How do you price the services? Will clients accept it? Don't worry-I know from experience that implementing preventive care protocols can work well for your patients, your clients and your practice.
The first step on this journey is reminding yourself that veterinary medicine is about providing our clients' four-legged family members with the best quality and longevity of life possible. In other words, it covers much of the work you already do: annual or twice-a-year physical exams, early-detection diagnostics and vaccines, as well as prevention of disease from fleas, ticks and heartworms. Every veterinary team, yours included, already has a written or unwritten standard of care that applies to how you treat pets for their annual healthy pet exam, whether your practice calls it a “wellness exam” or “preventive care visit” or some other name. The point is that all practices are already in some way heading down the preventive care path, and the protocols outlined here can help your practice make further progress in a way that's right for your team.
Recommend diagnostics consistently
I argue that the standard of care for a practice must ensure that you aren't missing early signs of disease that should be monitored or treated. To do that, a preventive care appointment that includes early-detection diagnostics provides the best value for patients and the highest probability of catching potential concerns as early as possible to address them.
Research from AAHA clearly supports the importance for otherwise “healthy pets” of conducting internal parasite exams, vector-borne disease testing, a complete blood count (CBC) and a serum chemistry profile.1 One in four adult and senior dogs that present for a healthy pet exam will have diagnostic markers that require follow-up, making it critical that we consistently recommend these diagnostics.
Price preventive services strategically
How can a typical practice price preventive care services to maximize value for clients? In our practices, we've seen success with pricing preventive care appointments lower than sick patient appointments. We know that preventive care appointments are price-shopped, and being competitive in pricing for these exams-while remaining profitable-can bring new clients in the door.
After all, no practice-no matter how good it is-can wow a client who doesn't come in. A preventive care appointment is an opportunity to create lasting bonds, so a pet owner returns when the dog eats a tennis ball or the cat's chronic kidney disease needs management. We need to respect the lifetime value that a satisfied and bonded client brings to the practice directly as well as through word-of-mouth referrals to our practice for family and friends.
Here's a successful case study example: Our practices established a baseline protocol for early detection that made sense in our region. And we priced it aggressively to gain compliance and increase revenue per patient visit. Our practices are in tick country, and we see many tick-borne diseases that we need to test for annually. As a result, our early-detection diagnostic panel includes an internal parasite test (comprehensive fecal analysis), testing for tick-borne disease and heartworm disease, CBC, serum chemistry profile and SDMA test.
We price our early-detection diagnostic panel (including CBC, serum chemistry profile and SDMA test) about 30% higher than the comprehensive fecal analysis and SNAP 4Dx Plus Test (IDEXX) combination, which generates additional revenue per preventive care visit. Clients find it affordable, and we're able to incorporate diagnostics into more preventive care visits. Some clients may say, “Not at this time,” but they'll never say yes unless we ask them.
Most of the time, early-detection diagnostic results will be within normal limits, so veterinarians and team members need to celebrate this good news with clients. Teams can help clients understand that these tests matter in helping their pets live the best life they can. All too often in veterinary medicine, we become excited about the unusual and are blasé about the “normal.” We sometimes forget that for our clients, the news that their pet is healthy and doing well can be exciting to them.
When your team members see the value being placed on “normal,” they're more likely to feel confident in recommending early-detection diagnostics as well. We need to emphasize the value of preventive care for our patients and clients to our teams within the practice.
Another crucial moment with early-detection diagnostics is when we find problems in otherwise healthy-appearing pets and find opportunities to intervene earlier. When we see markers that concern us, we can talk to clients about the appropriate strategy right away, whether it's treatment or monitoring. Clients appreciate the value of detecting potential disease early, and we're ultimately hoping for better outcomes if we catch something before the pet becomes ill.
Appreciate the work of preventive care
Practice managers and owners would all prefer to generate more income during a 20-minute visit, because all of our fixed costs are the same whether we earn $75 or $250. Additional diagnostics is a way practices can earn more revenue during a patient visit.
And because the research indicates that we're likely to find problems when we actually look for them, early intervention not only helps the patient but also provides additional revenue for the practice through the diagnostics themselves as well as additional follow-up activity that may arise. Our practices have seen an increase in dentistry and minor surgeries, such as lump removals, because a more comprehensive panel can be used for most of our preanesthetic protocols.
Ultimately, practice managers and owners need to design the standard of care and protocols for what makes sense for that practice and that location. Educate clients on the benefits of early detection, and make sure that it's part of your preventive care process. Develop an early-detection diagnostic panel that meets your needs and workflow, and price it aggressively to provide value to all of the stakeholders in your practice.
1. American Animal Hospital Association. Promoting preventive care protocols: Evidence, enactment and economics. Indianapolis, IN: American Animal Hospital Association; 2018.
Nancy Drumm is general manager of four AAHA-accredited hospitals in the Capital District of New York and blogs on one of IDEXX's veterinary-facing websites at practicelife.com.