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Putting it all together for the patient (Proceedings)

April 1, 2010
Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CCRP, CVA, MS

Recent studies consistently report that 75 - 80% of pet owners think of their pets as children.

Irving Townsend - - "We who choose to surround ourselves with lives even more temporary than our own live within a fragile circle, easily and often breached. Yet, we still would live no other way."

Recent studies consistently report that 75 - 80% of pet owners think of their pets as children.

      Where dogs stand in the household

          • Member of the family - - 76%

          • Dog is one of most important things in life - - 67%

          • Dog is better companion than other family members - - 53%

          • Health of dog equal to own - - 49%

          • Dog's death equal to that of friend or relative - - 60%

Recognize opportunities for raising the standard of medical care

          • Improve patient quality of life, and enhancing the family-pet relationship

          • Remember C=R+A+FT (more later)

          • Get over complacency (if you keep doing what you've always done, you'll keep getting what you've always had)

          • Common excuses:

                - "They didn't do what I told them to do..."

                - "They didn't listen..."

                - "It's not my pet..."

                - "We're busy..."

                - "If they (the clients) don't care, why should we?..."

                - "They said 'no' once..."

Veterinarians and practice teams have much more influence than they think

          • Advocate on behalf of a being who cannot advocate for itself - - for what it "needs and deserves"

          • Help "parcel" client education to prevent information overload

          • Stop overestimating client concerns about money

          • Shrink the "recommendation gap" by training the entire team always to make the recommendations that reflect the best healthcare options for every single patient.

          • What gets measured gets done

          • Better medicine IS better business

          • Clinic culture permeates the practice

Compassionate care and advocacy are guiding values that influence a practice's mission. What are the implications when everyone on the practice team pays attention to his or her role in communicating culture to the client?

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8 Steps to Improved Compliance:

      1. Begin at the beginning

           a. Recent studies consistently report that 80 - 90% of pet owners think of their pets as children

           b. Don't fail to plan

           c. Avoid "Ready, Fire, Aim"

      2. Make a decision and act on it

           a. You can practice high quality medicine or low cost medicine - - not both

           b. Warren Bennis - -"Managers do things right. Leaders do the right things."

           c. This is really about doing the right things right!

      3. Train, train, train

           a. Internal communication is as important as communication with clients

           b. Answer the questions: "How do we do things here?" and "How do we talk to clients about how we do things here?"

      c. Training Options

      d. Multiple resources for in-house use

                - ACT, LifeLearn, Care Credit CDs & DVDs

                - AAHA webinars

                - Most are cached on the site

                - www.VetMedTeam.com

                - Free courses from CAPC, Merial, VPI, etc

                - www.IdexxLearningCenter.com

                - www.CETUniversity.com

                - www.VirbacUniversity.com

                - www.AbbottAnimalHealthCE.com

                - VIN

                - www.DVM360.com

                - Search for cached webinars

      4. Train some more

           a. Protocols create consistency of experience - - for the team, for the client, and for the patient

      5. Get over your reluctance to ask clients for money

           a. Earl Nightingale - - "All the money you will ever have is currently in the hands of someone else"

           b. Fewer than 10% of clients object to cost

           c. Don't forget the 80/20 rule...

           d. Earl Nightingale - -

           e. "Have fun doing what you do and others will have fun spending their money with you."

      6. Track your compliance efforts

           a. What gets measured gets done

           b. Track your efforts

           c. How many canine wellness examinations?

           d. How many heartworm tests performed?

           e. Should be 100% - - what is your practice's success rate?

           f. Repeat this exercise for all essential services

      7. Get everyone involved

           a. Make compliance and improved patient care fun

           b. Get everyone involved

           c. Attitude is everything

           d. Bob Boylan - - "Weed out the non-believers - - they are neither wrong nor dumb if they don't agree with you. They're just on the wrong boat going in the wrong direction."

      8. Commit to advocacy on behalf of a being who cannot advocate for itself

           a. Your clients want what's best for their pets

           b. Schedule follow-ups, rechecks, recalls, and reminders

           c. Advocacy on behalf of a being that cannot advocate for itself sustains momentum

           d. Just as consumers purchase from emotion, focusing on improving patient care empowers team members to advocate from their emotional connection with those patients. The revenue side of this is taking care of itself.

Christine Longaker - - "Pain is inevitable. Suffering is optional." Join the International Veterinary Academy of Pain Management (www.ivapm.org)

Client Call Scripting - -

          • "We're doing a comprehensive review of our medical records and we notice that we have not seen 'Butch' for ___ months.

          • "I'm sorry that we have allowed this to slip through the cracks. We'd like to get 'Butch' back on track with his healthcare. Could we please schedule an examination for him this week?"

Lao Tse - - "The journey of 10,000 miles begins with a single step."

CBA - - What you can conceive and believe, you can achieve!

      Improving compliance is an investment. Accept responsibility for your role in creating and fueling the "advocacy cycle"

Advocacy Cycle:

          • Pet is member of the family

          • Complete veterinary evaluation

          • Diagnosis leading to improved wellness or illness management

          • Recommendations to clients with conviction

          • Client acceptance

          • Team follow-up and reinforcement

          • Further encourages acceptance

          • Reinforces benefits to pets

          • Follow-up to check on progress

          • Further reinforcing and scheduling of appropriate rechecks

          • Starts the cycle over to practice better medicine

Compliance is a process not an event

      Improving compliance relies on a cascade of events

      Improving compliance hinges on clarity... (avoid vague statements...)

      Remember, clients are not the primary impediment to good compliance

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