Today's Veterinary Business

JUN 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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51 June/July 2018 • TODAYSVETERINARYBUSINESS.COM again, how do we know if the exam room assistant or nurse has reviewed all preventive proce- dures with the client and done so in an effective manner? I like to use pre-exam checklists during annual wellness visits. (Canine and feline forms can be found at column/practice-smarter.) Pre-exam checklists list all the preventive procedures necessary for a pet's optimum wellness. Exam room assistants use checklists to review with clients the services that are needed for their dog or cat. As this is done, the assistant will note any services that are due in the future, recommended or declined. The checklists include a brief description of each service so the completed form can be given to the client at the end of the visit as a further source of education. Anytime the practice recom- mends a service, we note it on the pre-exam checklist. As an example, suppose the doctor recommended a dental cleaning but the client wanted to think about it. We would note the dental cleaning as a recom- mended service and a service code would be entered into the com- puter. This would cause a line to be added to the invoice stating that a dental cleaning was recommended, and it would prompt a follow-up call to the client in seven to 10 days. A declined service is a little dif- ferent. Suppose a doctor, nurse or exam room assistant recommends a service, such as a feline leukemia test or vaccination, and the client declines. We will note that the ser- vice was declined on the pre-exam checklist, and a service code would then be entered so that the invoice contains the line, "Declined Feline Leukemia Vaccination." No fol- low-up will be done by the prac- tice, but don't be surprised if the client returns a day or two later and asks for the service to be rendered. Perhaps another family member saw the notation on the invoice and, knowing someone whose cat had the disease, approved the vaccination after all. Once the nurse or assistant is done in the exam room, the next step is to evaluate the effective- ness of the hand-off information to the doctor. Once again, having a template in the computer or a checklist can help to make sure all the information gathered by the team member is communicated to the doctor. Clients don't appre- ciate having to tell an assistant something and then having the doctor come along and ask the same question. It is one thing to say, "Susan said Casey has been vomiting" versus someone asking, "So, why is Casey here today?" Effective communication between the nurse, exam room assistant and doctor is necessary. Difference Makers If a client sees one doctor during one visit and a different doctor during another visit to your prac- tice, will the experience be the same or very different? What is it that makes one doctor more effective than another in the exam room? I would love to think it is their medical knowledge, but I have found that it is normally their communication skills and the rela- tionship they form with the client that makes the difference. Some veterinarians can tell a client to do almost anything and she will, while other doctors have a hard time getting compliance. I coach doctors in the exam room almost every day, and I will tell you that most of them are able to drastically improve their com- munication and bedside manner, and thus, the bonding with their clients. Many times, it is the little things: how one enters the room, greets and interacts with the client and pet, conducts and verbalizes the physical exam, and makes recommendations. One doctor will say, "You might want to consider having Fluffy's teeth cleaned," while another doctor might say, "Mrs. Jones, take a look at all this tartar on Fluffy's teeth. We really need to get these teeth cleaned. Let's get that set up before you leave today." As you can imagine, the results are night and day different. Sometimes it is not what you say, but how you say it. The results will impact patients, who will hopefully receive excellent preven- tive care, but it also can affect the financial aspects of the practice. If a veterinarian can increase each professional transaction by $20, that can equate to over $60,000 in increased income by year's end. Video Evidence Once again, I will plead my case for video evaluation in the exam room. I have looked at hundreds of videos and can tell you that every one of them allowed me to help the vet- erinarian improve the exam room experience. I am lucky enough to teach at many veterinary schools every year. Many, if not most, of these schools are videotaping stu- dents in clinics during their senior year. Boy, how I wish veterinary practices would continue to do this once the students graduate. If you could give me a tool that is guaranteed to help make me better at what I do, I would jump at it. Well, that is exactly what videotaping is: a tool that will help you and your associate doctors to become more effective in the exam room, enhance your verbal and non-verbal communication skills, and, more than likely, improve your professional transaction and client bonding rate. The question of the day is: What is your exam room experi- ence from the client's perspective and what can we do to improve it? We cannot treat the exam room as an inner sanctum where no one is allowed to see what happens. This is where we make it or break it in our hospitals, so let's evaluate, coach, train and improve upon this most important aspect of your practice. Practice Smarter columnist Mark Opperman is president and founder of Veterinary Management Consultation Inc. and co-author of "The Art of Veterinary Practice Management, Second Edition." I coach doctors in the exam room almost every day, and I will tell you that most of them are able to drastically improve their communication and bedside manner, and thus, the bonding with their clients.

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