Stop the perpetual otitis resurgence

April 21, 2017

When in one ear and out the other becomes a nonstop annoyance. (Shutterstock)James Noxon, DVM, DACVIM, knows ears and the problems that can erupt.

When in one ear and out the other becomes a nonstop annoyance. (Shutterstock)James Noxon, DVM, DACVIM, knows ears and the problems that can erupt. He spent three hours on the subject at the CVC last year. We've turned our ears toward his advice and are amplifying two client communication tips to help you best help veterinary clients and patients fear the ear no more.

Tip 1: It's the whats and the whys, not either/or.

This comes down to aligning your goals, says Dr. Noxon.

> Client's goal: Treat the clinical signs once, it's gone for good, right?

> Your goal: Treat the signs now and then find the underlying cause so you have a chance at preventing recurrence.

Dr. Noxon's script to get clients on the same page: “There's a what, and there's a why. The what is what's happening right now. If you treat the what and fail to address the why, the whats come back. If you try to treat the why without treating the whats, it appears you have treatment failure, because you still have all that stuff on top that covers things up.”

Next, reinforce the importance of the whys and whats: “Today we're going to address the whats. You will come back for a recheck appointment in X amount of time. At that time, we'll start talking more about why.”

At this point, Dr. Noxon gives clients a little information about underlying causes of otitis such as allergies. “The reality is if they don't come back and they don't address those issues, everything you do is wasted," says Noxon. That means a waste of your time but also your clients' money. He says not to shrink from telling clients this straightforward fact.

Tip 2: Make sure clients will do follow-up care.

After explaining to veterinary clients how to clean their pets' ears, Dr. Noxon always asks, “Can you do this?” The critical next question after the high likelihood that they say yes: “While you're watching their eyes, you ask, 'Will you?' Those are different things,” says Dr. Noxon. “If they won't, I'm not going to be judgmental about that, but I need to find something else to do.”

In case you're concerned that clients will think the second question is rude, remember this, says Dr. Noxon: "My reputation is going to be based on whether they do what I asked them to do. If it fails, who do you think they blame?"

You can take proactive measures to make sure compliance isn't such a pain, says Dr. Noxon. For example, instead of expecting clients to count out 20 drops a day, he says you can find adapters to fit most containers.