How Can Veterinarians Do More in the Time They Have with Patients?

August 25, 2016
American Veterinarian Editorial Staff

E’Lise Christensen, DVM, DACVB, veterinary behaviorist at Veterinary Behavior Consultations of Colorado & New York City, discusses how veterinarians can make the most of the time that they have with their patients.

E’Lise Christensen, DVM, DACVB, veterinary behaviorist at Veterinary Behavior Consultations of Colorado & New York City, discusses how veterinarians can make the most of the time that they have with their patients.

Interview Transcript (slightly modified for readability).

“It’s actually really difficult to get everything done. We are putting so much pressure on ourselves in these shorter appointments and I realize that’s just a philosophy of practice; how your practice works versus another may be quite different. Some people [schedule] longer [appointments] for things like puppy visits because they know there’s going to be a lot more to talk about, or a geriatric visit or a sick visit; a behavior visit is no different.

So, if you are in a situation where your receptionist takes an appointment and the main concern is cats urinating out of the litter box, that’s a time where you might say, 'Well, the first appointment for urinating out of a litter box is not long, because I’m going to do a urinalysis, a culture insensitivity and maybe some abdominal imaging, [such as] X-rays or ultrasound.' That would be a gold standard first step, well, gold standard would also include [complete blood count and chemistry profile (CBC Chem)]. But if you’re going to do that in that first visit, take a physical exam, make sure our patient doesn’t have pyelonephritis or some other infection; get some data.

Now, on the re-check, that’s where I think veterinarians run into trouble, because mostly what would happen or what often happens, is the technician might call [the client] back with those results or the veterinarian may call instead of scheduling a re-check appointment. You can schedule that re-check appointment with only the client if you want to, but I strongly encourage you to bring that client back into the office so that they can see that you’re taking the problem very seriously. If you present it [in a certain] way for many clients, [such as], 'Hey, you know what? Let’s schedule a re-check. We’re going to talk about the results and we’re going to create a new plan,' [then] you’re not going to get as much pushback as you think because, especially for this problem, [and] for all behavioral problems, these owners are often very motivated to solve the problem.

Even if you know as a clinician that if you give [the clients] recommendations they might not do them, what these clients need to feel better about the problem is more information and your support, and you can’t do that as well over the phone. Furthermore, you’ll become emotionally bankrupt if you keep trying to do it because you won’t be paid for it. Have that client come back in so you can give them support in person and you can bill them for your expertise, because it does take expertise to have these conversations."