Dr. Joe

9:15 a.m.

Missy answered the phone on the second ring.

"Hello, this is the animal clinic," she chimed.

"Who is this?" a cynical voiced boomed.

"Sorry, this is Missy. How can I help you?"

The voice boomed once more, "Chubs is sick again for the third time in two years, and I need to come in this morning."

David M. Lane, DVM, MS

Missy paused, "Who am I speaking to?"

"You must be new. This is Maggie Jamison. I pay rent on a quarter of your building. Dr. Joe also sent his daughter to college on my account. Where have you been girlie?"

Missy had actually recognized the cynical voice on the other end but wanted to make sure. She now needed to move the phone call into a more positive direction.

"Dr. Joe is pretty open this afternoon. When can you come in?

"I have a doctor's appointment myself this afternoon and that may take some time. Tell Joe I need to come in this morning."

"I have some time between two surgeries at 10:30."

"Put me down," Maggie boomed and the phone fell silent.

10:38 a.m.

Missy takes another call-this time from Frank Goodson. Frank had gotten a card in the mail several months ago about "Jimmy's shots and wanted to make an appointment."

"Mr. Goodson, Dr. Hamilton doesn't have anything until after 4 p.m. Can you come in at that time?"

"I'll be there after work," Mr. Goodson said.

Meanwhile, Dr. Joe Hamilton peered into the cage at his second surgery. This surgery was a seemingly straightforward neuter surgery on "Pepper" Johnson. He needed to start surgery on Pepper at 10:45 if he had any chance of seeing his 11:30 appointment with "Brandy" Issel. Brandy had cancer and the owners were considering euthanasia. Mrs. Jamison was nowhere to be seen.

Dr. Hamilton adjusted the isoflurane gas on Pepper and thought he would wait five more minutes.

10:50 a.m.

Dr. Hamilton had just gowned and gloved for the second surgery when Missy appeared. Mrs. Jamison had walked right into an exam room with Chubs and was waiting impatiently for Joe to examine her pet. Missy padded into the prep area and stated that Mrs. Jamison had arrived and thinks all of our clocks are fast. Joe now panics a bit. Mrs. Jamison is a long-standing and demanding client. He removes his sterile garb and heads to the examination room. Pepper is now in a 'holding pattern' on the surgical table.

Maggie quickly jumps on the issue. Chubs is once again dragging her rump on the rug. This time it is a newly purchased carpet from a high-end dealer in town. She wants to know why Joe can't seem to cure her of this condition. Maggie stated that she had spent considerable time on the Internet and found out that is this a common and easily treated issue. Maggie demanded a cure today or she might seek help at Elsewhere Animal Center down the street. Dr. Hamilton asked for her forbearance and discussed her options as he momentarily thinks about Pepper under isoflurane in the back. The clock ticked on. Joe was now sweating.

Just then, Dr. Hamilton could see Brandy coming through the front door lying limply in the arms of her owners. Brandy's owners see Dr. Joe through the open door as he is talking to Maggie about Chubs and Dr. Hamilton could see by their pleading eyes that they expect to talk to him ASAP.

Maggie frowns as Joe excuses himself and walks through the waiting room toward the Issels'.

Just then an obviously shaken tech appears from the back and asks Dr. Joe in a loud whisper to hurry back to surgery. The tech stated that suddenly he could not detect a heartbeat on Pepper.

The disaster in progress at the "Animal Clinic" is for the most part preventable.

Scheduling 101

However, the dysfunctional scene at Dr. Hamilton's office is more often true than many of us would want to admit. Although breakdowns occur in other professional offices, I would be willing to bet that clients who go to see our human counterparts are a little bit better behaved than those who see us on a regular basis. Please re-read Dr. Hamilton's story and see how many errors in scheduling that you can pick up. By the way, answering on the second ring or better is appropriate-anything longer deduct points from your scorecard.

Let us analyze the problems with Missy's scheduling approach:

• Identify yourself, your place of business and your willingness to help up front. Missy does not identify herself, which as can be seen, ultimately wastes a lot of her time. Clients like to know to whom they are talking to and if they have reached the correct phone number.

• Get to client's name and problem up front. If the client forgets or intentionally fails to provide his or her name, keep calm and cool, and don't throw an "attitude" back the other way. Missy did pretty well here but could have been a little less blunt. If a receptionist does recognize a voice, acknowledge it right away. This will even soothe an "old crank" like Maggie. But be careful. If you make an identity mistake prepare to pay.

• You are in control of the appointment book. A growing percentage of clients are making scheduling demands on veterinarians that they would never dream of imposing on other medical professionals. In fact, veterinarians are so unique in society that many clients would pause before correctly identifying veterinarians as medical professionals. It is time for a real change. Our time and our patients deserve full professional recognition and respect. Therefore, receptionists need to schedule for the sake of patient care and the practice management first. Missy has made the classic mistake of assuming that since a time is available that putting a patient in a given time slot will be suitable.

• Carte blanche: Missy has allowed both Mrs. Jamison and Mr. Goodson to dictate the terms of their appointments. Veterinary hospitals need to evaluate and block portions of the day for various events and stick to the plan. If Dr. Hamilton needs to see patients from 2 p.m. to 5 p.m., a client should be offered a specific time according to the management needs of the hospital. Even if a veterinarian has not one single client scheduled for an afternoon, the patient should be given a specific time to start framing the afternoon around. This allows time for the urgent call-ins that inevitably appear during the "red zone" (see sidebar, p. 24).

• Mr. Nice Guy: Dr. Hamilton, a.k.a. the "Good Humor Man," wants to please everyone at once. He is of the school that doting and fawning score the maximum points in the game of veterinary medicine. This also allows him to spend the least amount of money in the Yellow Pages. He also keeps prices fairly low for good measure. He is a "good" veterinarian with a growing duodenal ulcer and a receding hairline. Joe is "just Joe" and usually lets people call him by his first name. He has allowed Missy to schedule according to the needs of his clients and works six days a week. He complains that in spite of being busy all the time he seems to get very little done during any given practice day. He stays late at night to do paperwork because the days are so chaotic.

Dr. Hamilton needs to sit down with his staff and block his appointment schedule to best suit his needs and the needs of his patients. Unfortunately, Dr. Hamilton is of the "fly by the seat of your drawers" school and does absolutely no training at all.

Solution

We suffer a bit from the "Dr. Nice Guy" image. Surveys nationwide always rank veterinarians up at the top of most admired and well-liked professionals. With that logic, I would suppose that the neighborhood "ice cream man" is also very well liked-primarily due to convenience and a short waiting line. And if convenience and a short waiting line have high priority for a medical office in the eyes of a client, it is no wonder that clients like their veterinarian. Unfortunately that does not usually equate to superior patient care. Ultimately, the patient matters more than our popularity as professionals. In the end, the respect we earn as professionals is a reflection of care for the patient. A lot of veterinarians seem to have self-esteem issues. It even can lead to scheduling errors like those at Dr. Hamilton's office. But as you can see what goes on in the front affects everything and everybody. In the end patient care suffers.

A nationwide professional issue

Training your staff to properly schedule a doctor's time is a balance between professionalism and compassion. Regardless of whether your practice has one doctor or 12, scheduling professional time properly and professionally is crucial to the success of the practice.

By the way, Pepper was just fine. It seems that the technician wasn't properly trained to insert and manage the esophageal stethoscope. However, Dr. Hamilton's hairline and ulcer suffered major setbacks.

Epilogue