Fear Free, high value continuing education? #skeptical
Kyle Palmer, CVT
Long-time dvm360 magazine and Firstline contributor Kyle Palmer, CVT, is hospital manager for VCA Salem in Salem, Oregon, as well as a practice management consultant for a number of other hospitals.
shutterstock.com As a member of the veterinary field for 26 years, I've been fortunate to attend some terrific regional continuing education conferences, and in many cases I've been able to enact small b
shutterstock.com As a member of the veterinary field for 26 years, I've been fortunate to attend some terrific regional continuing education conferences, and in many cases I've been able to enact small but meaningful changes that have helped move our practice forward. The same is true of our veterinarians and other key team members. But recently our assistant manager Julie and I accompanied one of our veterinarians to the CVC Conference, and the "take away" has created a major change in our practice culture that none of us saw coming. And many of us are still amazed at the immediate success.
When we send multiple team members to the same meeting, we try to avoid joining each other in a given class. The more education we can each be exposed to, the better. Our assistant manager elected to attend the "Low-Stress, Pet-Friendly Practice" track presented by Drs. Marty Becker and Jonathan Bloom-mostly because she didn't see anything else that interested her more than the classes I'd already called dibs on that day.
After a few of her classes, I listened intently while she started to describe how becoming certified in the Fear Free program might be a good fit for our practice. To say I was skeptical would be an understatement. It's not that I wouldn't embrace a more welcoming environment for our patients. But after 26 years, I'd been hardened with the idea that most of our patients just fundamentally don't like being poked and prodded when they'd rather be home instead, and there's not much we can do about that.
Boy was I wrong ...
Once back at work, Julie started the Fear Free certification process and started laying the groundwork for some sweeping changes in the practice. It turns out that we'd inadvertently already put a few helpful things in place. Last year we revamped an exam room to resemble a room in anyone's house and also debuted a brand new exam room solely for cats. Client response to both of those changes was very positive. And while we couldn't measure the direct effect on patients in the cat only room, we made note of several dogs who-despite a track record of deep anxiety-were now very relaxed in the "comfort room" that looked like home.
A couple of our new veterinarians had some experience with the Ceva line of pheromone products (Feliway and Adaptil), so when Julie outlined how they would play a role in the new approach, these veterinarians were quick to show support. I can't stress how important it is to have your veterinarians on board with changes in the practice. And every one of our six doctors are great patient advocates and always concerned about patient comfort.
Remodeling down time
Two days a week, we have four doctors practicing in a space that badly needs expansion, and we essentially bring our schedule to a standstill from noon to 2 p.m. to shift out everyone to lunch, provide a time to catch up on phone calls and medical records and accommodate our morning surgeries, which can frequently run over.
I'd been pushing to expand our at-home care services (when your building is too small, why not use clients' living rooms as an exam room?) on those two days. Then Julie pitched part of her Fear Free strategy: She wanted to shift one doctor and technician to lunch at 11 a.m. instead of noon and start scheduling them for a two-hour block of cat-only appointments during the two hours that we're usually down. Not only did it start immediately, taking some pressure off our already full schedule by freeing up two hours somewhere else-she took the cat-only theory even further.
During those hours our reception lights are off. We have plenty of natural light to continue doing business, and the lighting in our cat exam room is limited to a residential style lamp, unless our team members need more light for something specific. The room is equipped with a Feliway diffuser at all times, our team members spray themselves with Feliway before entering and the exam table is covered with a heating blanket and clean towel. Specific cat friendly music is playing in the room at just the right volume.
The results? Nothing short of incredible. Nine out of 10 cats (and 10 out of 10 owners) are immediately relaxed. Many cats literally lie on their back and allow a physical exam. The best part? We've added at-home care hours on those days too. And though it wasn't the reason initially, we now consider it a part of the Fear Free philosophy, as many patients are simply less stressed in their own home.
Not to short change our canine patients, we are also using Adaptil collars if clients request them during their dog's stay with us, and we are automatically placing a bandana sprayed with Adaptil around every dog's neck at the reception counter. It's removed on their way out and laundered. I have literally witnessed barking anxious dogs relax the second the bandana is placed on them.
Using the same approach, cats in the hospital for surgery wake up with a "Snuggle Buddy" (it is with great resistance that I use that term), which is a stuffed animal/soft blanket that can be sprayed with Feliway.
One of our veterinarians noted this week that she was able help trim a dog's nails with no resistance, despite a history of struggling during that procedure-all because of our new approach. (See nail trim treating in action here) The entire team is seeing the benefits of this program, which has completely changed how we approach our patients. And every team member is now "all-in."
Additionally, we've implemented a broad policy of treat aids to ease the anxiety of various procedures, including when pets need to stay with us. Fish flakes and "meowijuana" (a catnip product) are having a significant effect on our cats while Vegemite, peanut butter, chicken jerky chunks and “Lickity Sticks” have helped distract our canine patients. One word of caution: Don't overlook your patients' or clients' food allergies in using these products!
Looking back, we wouldn't know about this program had it not been featured at a very good conference, and we probably wouldn't have adopted it had we not sent multiple team members to the meeting gaining a better overview of different topics. Our patients' experiences in our practice will never be the same.
Kyle Palmer, CVT, is a Firstline Editorial Advisory Board member and a practice manager at Silver Creek Animal Clinic in Silverton, Ore.