Veterinarians offer tips to improve compliance

Client compliance is a thorny issue for many veterinary clinics. More often than not, once the client exits the clinic, any discharge instructions were left behind in the exam room. To compound matters, many veterinarians don't realize lack of compliance has reached such epidemic proportions, instead choosing to believe - without evidence - they service obedient pet owners.

Whether offering tuna- and liver-flavored medicinal options per clients'request, as one clinic does, is a potential solution to this escalatingissue, the pet only knows. Following is a sampling of other veterinarians'tricks to trigger higher rates of compliance.

Dr. Kathleen Neuhoff,

president, AAHA, Mishawaka, Indiana

Neuhoff, the outgoing president of the American Animal Hospital Association(AAHA), was privy to results of AAHA's recently completed compliance study.She says her hospital has taken the findings to heart and is in the processof instituting a plan to hire a specialized compliance monitor.

Magrane Pet Medical Center will create a new job description, what likelywill be called a client service and compliance specialist, according toNeuhoff, hospital co-director. That person would be dedicated to increasingclient compliance. As an example, that person would review all charts atday's end and make sure doctors have made recommendations.

"(The idea is) so we can get an idea of what our recommendationsactually are. You can't figure out what your compliance is if you don'tknow the recommendations," she says.

Dr. Peter Glassman,

Washington, D.C.

Glassman, director and chief of surgery of Friendship Hospital for Animals,operates an online marketing company called VetInsite, which produces petportals or private Web pages for pet owners. Veterinarians can purchasethe pet portals from VetInsite. The company then provides resources fora veterinarian to outsource initiatives such as reminder programs or dentalor wellness programs, and the company then tracks compliance for the programs.

Based on his experiences within the profession, Glassman says that complianceis "pretty bad."

"There needs to be an automated way, because veterinarians are notoriouslylax in their marketing. It's hard enough to get a veterinarian to do a dentalpromotion or a wellness promotion much less take the next step and trackthe effectiveness of the program," says Glassman.

Dr. Jessica Heard,

Peachtree City, Ga.

At Braelinn Village Animal Hospital, doctors and staff implemented asystem in which any client who leaves the clinic with medication gets aphone call from one of the technicians.

"Our system is very low tech, but it works very well," saysHeard. Although the hospital is technologically adept, the staff has optedto use different colored Post-it notes, which represent various levels ofpriority, as part of its reminder system. If it's a yellow Post-it for example,it goes in the callback file and the doctor writes a date on when they wantclients to be called.

"Every day at some point, if we get a slow moment, the techniciansget the charts and make calls," says Heard. "They ask how themedication is working, if the client needs the doctor to call, if they feelthere's any improvement. That helps in terms of follow-up because a lotof times we'll find out ­ well it wasn't working as well as I thought."

Dr. Christen Skaer,

Wichita, Kan.

To keep their clientele well-informed, the staff at Skaer VeterinaryClinic provides clients with reading material as they enter an exam room.

"The assistant or technician who greets them and takes a historytalks about the importance of bloodwork (for example, senior or wellness),"explains Skaer. "The doctor will then reiterate what the technicianhas explained first. It helps for a client to hear things several timesand to be able to read information."

On another front, Skaer Animal Clinic is in a transition period, movingtoward recommending twice-yearly physical exams on all patients.

"To facilitate this, each person in the chain (reception, assistant/techand doctor) talks about the importance (of twice-yearly exams)," saysSkaer. Each client also receives a handout that begins, 'you go to the dentistevery six months, you go on vacation once a year, you get your oil changedevery 3000 miles...so, why do you only take your pets to the doctor everyseven years?'

Dr. Ellie Shelburne,

Northampton, Mass.

Sometimes it's not that clients forget about or simply won't bother withmedications, Northampton Veterinary Clinic has found that sometimes clientsare frustrated with trying to medicate unaccommodating animals.

To ease the burden, circumstances permitting, Shelburne's clinic hasbegun offering transdermal medications with some success. Otherwise, theclinic says it does everything in its care to enhance client communications.

"It's imperative for us to be sure we're providing compliance informationin the most accessible way possible ­ with very clear instructions,"says Shelburne.

Dr. Margaret Rucker,

Lebanon, Va.

Dr. Margaret Rucker, past president of AAHA who served on its board whenthe association first identified the compliance issue as one to study, recommendstalking to clients before they visit your clinic.

"Try to give them an insight as to what will be done prior to thevisit," says Rucker, owner of Southwest Virginia Veterinary Services.

Once clients visit her clinic, her staff has compliance down to a system.All discharges are written in detail. A copy of instructions goes into theclient record. Using a computer, the clinic divides clientele into threecategories: reminder, recall (called by technician who assisted doctor withcase) and recheck (rescheduled if they don't show up).

"This creates a chain of communication ­ not doctor-dependent,but hospital team-dependent," says Rucker. "Hopefully compliancedoesn't fall on the doctor."