Think small: Companion-animal lessons for equine veterinarians
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.
Open your mind! Equine practitioners can learn a lot about clients and business from small animal veterinarians.
Shutterstock.comAs the equine practice model drifts further away from an extension of livestock work and closer to working for clients who also own pets, it's time to examine some of the similarities between (and differences from) companion animal practice. I recently asked a few simple questions of doctors and veterinary technicians in my area. Their answers can give us all a quick refresher on what should be a narrowing gap between the ways equine practitioners and small animal practitioners treat their clients. Here's what I learned.
1. Equine clients have different expectations from companion animal clients.
According to many veterinarians I talked to, horse owners place a great deal of urgency on medical needs, with the possible exception being vaccinations and other preventive care. That said, is it the nature of caring for a horse or the nature of the horse-owning client that defines this trait? Possibly a little of both.
While many pet owners now consider their dog or cat to be part of the family and include pet healthcare in their discretionary spending budget, they aren't often directly affected when they delay a pet's treatment. Horse owners, on the other hand, tend to have a symbiotic relationship with their animal. When a condition prevents a horse or horse owner from participating in the normal routine-riding, training or just being active-horse owners seem more likely to press for an immediate resolution.
Horses' sheer physical size may also result in a higher level of sympathy or concern from owners for the conditions that ail them. In other words, clients may be willing to ignore their Chihuahua's limp for a week or so, but they feel differently when a 1,200-pound animal can't make the trip from stall to water trough to feeder.
What this means for you: As an equine practitioner, you really have only two choices-structure your schedule in a way that allows you to cater to those clients who need you on short notice, or educate them about the realities of common equine conditions so they'll be a little more patient. For example, it's not unusual for some horse owners to assume that non-weight-bearing lameness is an emergency, so alleviate their anxiety by explaining the difference between a broken leg and a hoof abscess. Of course, it's not always easy to know what's going on before a physical exam, but a detailed history taken over the phone can often point you in the right direction and buy you the time to schedule the appointment.
2. Companion animal clients will wait longer for an appointment than equine clients.
Dr. Tim Phillips of Desert Valley Equine Center in Redmond, Oregon, says most of his equine clients are reluctant to wait for an appointment. “In this market,” he says, clients are likely to wait “maybe one or two days.” He also added that, if asked to wait, many horse owners are likely to call another veterinarian.
The uncertainty of each day's appointment schedule and call volume has encouraged equine veterinarians to squeeze in anything that can be done, regardless of its effect on the practitioner's hours or exhaustion level. As a result, instead of a series of consistently scheduled days, many equine veterinarians experience peaks and valleys in their schedule.
Days that become too busy in order to accommodate every client are often followed by days that are only partially full. On those extra-busy days, your clients may opt for your competitors with partially scheduled days who can see them immediately.
What this means for you: Training clients to operate according to your wishes is always a slow process, while inadvertently training them not to is often quick and hard to reverse. Sometimes, the perception that you'll respond immediately in cases that aren't really emergencies has a negative long-term effect. The solution? Offer a “no wait time” appointment by telling clients they're in luck as you just had a cancellation. Do this during the slowest times of the year.
While it's tempting to rush right out the door, happy to be busy, encouraging clients to think that you're perpetually busy will lead to a greater appreciation of your time. And when a client does demand an appointment immediately, your first question should be, “How long has the condition existed?” More often than not, the answer is several days, and it's harder for them to be demanding when they've just admitted to waiting until the last minute to call you.
3. Small animal clients bond to the practice while equine clients bond to a doctor.
In the era of multidoctor practices, small animal clients seem more willing to place their trust in a practice rather than expect to see a specific veterinarian. In mixed or equine-only practices, however, clients still value the relationship they form with “their” veterinarian and prefer to schedule with that doctor. Oddly, that hasn't stopped many horse owners from maintaining relationships with more than one veterinary practice-presumably to leverage their ability to be seen promptly.
Julie Hannan, assistant manager and head equine technician at my practice, Silver Creek Animal Clinic in Silverton, Oregon, has worked for more than 20 years at a mixed practice and sees a significant difference between small animal and equine clients. Most dog and cat owners don't mind seeing any of the six Silver Creek veterinarians. Equine clients, on the other hand, expect to be scheduled with their regular veterinarian. “Not doing so can create a lot of turmoil for all of us,” Hannan says.
Of course, identifying the differences between equine and small animal clients is one thing. Figuring out why they're different is something else. Here's one possibility for why horse owners prefer to see “their” veterinarian: Equine practitioners have unconsciously created a different kind of bond with their clients. Horse owners have less exposure to other team members when their horses are seen on an ambulatory basis. If an equine veterinarian doesn't regularly bring a staff member along on calls, clients may not be familiar with anyone else from the practice.
The dynamics of ambulatory practice versus multidoctor small animal practice can also shed some light. Two or more small animal veterinarians who work side by side in the same building with the same staff members will naturally begin to practice in a more consistent fashion. Holding onto different medical and procedural philosophies is counterproductive. It sends mixed signals to clients, can confuse team members and may lower overall compliance. In the field, of course, an appointment is often a one-on-one experience, so differences among doctors aren't as readily apparent or problematic.
What this means for you: It's important to encourage consistency in how you and other doctors practice. This means creating a strong mentoring program for younger veterinarians and being willing to open your own mind to new ways of doing things. Consistency leads to clients being more likely to accept an appointment with one of your peers when need be, which is best for your practice and for your own schedule. Whenever the opportunity arises, take the time to “talk up” your fellow practitioners in front of clients. Clients may continue to request appointments with you, but those comments could make the difference in the future when circumstance forces them to see another veterinarian in your practice.
4. We trust our small animal patients to emergency clinics but rarely our equine patients.
In urban areas, many small animal veterinarians hand over emergency cases to practices that are open after hours or on weekends. The relationship depends on trust between general and emergency practitioners and has proven critical to satisfying younger veterinarians who aren't keen on spending their evenings taking emergency calls. However, the same trust between general and emergency practitioner has not been widely developed in the equine field.
Dr. Phillips notes that, as in many other locations, there are no equine emergency practitioners in central Oregon. He would consider a relationship with one, he says, if he “was assured of getting clients back.”
But retention of clients is not the only factor holding back the development of equine emergency practice. A majority of veterinarians polled indicated that they've used-or considered creating-a “call group” of local veterinarians to rotate emergency and after-hours calls. This would be a great first step toward the establishment of a full-time emergency veterinarian working after hours.
What this means for you: The jury is already in: Newer veterinary school graduates will not accept after-hours work the same way previous generations did, and if they do at first, they typically come to loathe it after a few years. Like it or not, adapting to these changes will be critical to practice survival, and that means working together in the industry to encourage emergency-only practice or a large group emergency rotation. Younger practitioners will continue to leave the equine field and switch to companion animal practice if they see that they're guaranteed to miss most important family events because Mrs. Smith works all day and doesn't mind paying extra to have her horse seen at 7 p.m.
In my opinion, small animal hospitals get some important things right. Equine veterinarians should consider moving toward a practice-oriented approach to avoid losing impatient clients who may have a relationship with another practice but not one with their primary practice's own associates.
The new generation of veterinary graduates is also prioritizing personal time at a level unseen in the past. Financial compensation and benefits are still important to them, but quality-of-life concerns have risen significantly-and nothing in practice affects that more than after-hours emergency work. Equine veterinarians who consider using (or encouraging) emergency-only practitioners will find themselves with associates who are happier in their positions.
We may only be able to change our relationship with clients slowly, but it has to begin with changing our way of doing business. Equine practice, however attractive it may be to those of us who love horses, must evolve, and practice owners and managers must realize that there is no escape from the comparison to companion animal practice-both by clients and by potential associates.
Kyle Palmer, CVT, is a frequent contributor to dvm360, a Firstline Editorial Advisory Board member and a practice manager at Silver Creek Animal Clinic in Silverton, Oregon.