Today's Veterinary Business

DEC 2018

Today’s Veterinary Business provides information and resources designed to help veterinarians and office management improve the financial performance of their practices, allowing them to increase the level of patient care and client service.

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34 Today's Veterinary Business Business Business INNOVATION STATION The American Association of Veterinary State Boards recently voted on a new model act of prac- tice — visit http://bit.ly/2Dce0mo — that might change when and how a veterinarian-client-patient relationship can be established. In the meantime, an opportunity exists today for practices to use telehealth tools that are within existing VCPR requirements. Using an after-hours triage service can help veterinarians maintain an appropriate work-life balance, retain clients who do not need to visit an ER or specialty ser- vice at that moment, and provide peace of mind to pet owners. The public's desire for "service on demand" raises a number of inter- esting questions: • Is there an unmet need in the veterinary profession to pro- vide after-hours triage care? • If such a need exists, what solutions exist and how are they different than telemedicine? • How can after-hours care be monetized, and what would be the economic impact on a practice that provided it? • Would the practice be better or worse off if these activities were done in-house? • Who should be allowed to practice triage without the existence of a VCPR? • What other non-financial ben- efits could a practice generate by providing the service? Let's tackle each question. Is there an unmet need in the veterinary profession to provide after-hours triage care? Today, most veterinary clinics when closed use an answering machine to refer clients to a nearby emergency facility or prompt the caller to leave a message. In many cases, measuring how many clients hear the automatic response and hang up versus how many leave a message is difficult. It's also hard to know how many clients never call because they don't think their situation is an emergency. Pet owners without medical training often cannot accurately judge the level of care that is neces- sary. They can only judge the client service they received. Dr. Philippe Moreau, in a presentation to the World Small Animal Veterinary As- sociation World Congress, asserted that clients' No. 1 expectation of veterinarians was kindness and compassion, followed by availability. Many practices are not aware they typically receive up to 15 after-hours calls per doctor per month. Assuming a four-DVM prac- tice, that would mean clients tried 60 times to reach out and poten- tially were sent elsewhere. I believe the use of answering machines to refer questions to an emergency facility can lead to suboptimal outcomes for general practices and emergency facili- ties alike. General practices lose a valuable opportunity to engage in client service while emergency hospitals are frequently burdened with non-urgent issues that might impact their standard of care. By John Dillon While the telehealth conversation has largely centered on telemedicine and whether a veterinarian can diagnose a case through digital tools, after-hours triage care — nights, weekends and holidays — is an important but often overlooked consideration for practicing veterinarians. 1 2 What solutions exist and how are they different than telemedicine? In the absence of a VCPR, general advice and emergency triage are the only options that can be pro- vided to a pet owner. The practice of emergency triage involves a spectrum of providers — from Pet Poison Hotline to dedicated after-hours triage providers. In every situation, important fac- tors should be considered, such as: • What are the limitations to the advice being dispensed? • Does this create additional liability for my practice? • What criteria should I use to evaluate after-hours options? How can after-hours care be monetized, and what would be the economic impact on a practice that provided it? The economics of providing after-hours client care using a third party is nuanced due to VCPR limitations and limitations on what information can be provided. Because of this, the monetization of triage care is best achieved indi- rectly rather than upfront. Best results are achieved by: • Offering the service for free to existing clients and tracking the number of new appoint- ments generated by being available after hours. • Using the service to attract and convert new clients. • Raising exam fees. Clients are often willing to spend $2 to $5 more on an exam fee if they get free after-hours support in return. • Incorporating the service into a wellness plan. A four-DVM practice grossing $1.5 million to $2 million a year from 6,000 active clients might see upward of 60 clients reach out with questions after hours each month. Based on my experience, we can assume the following: • 60 percent of the calls are non-emergent. 3 The economics of telehealth Do you know who your clients are calling after hours? You can concede the business to someone else or you can take an active role in meeting their needs.

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