Wendy Hauser
DVM
Dr. Wendy Hauser is the founder of Peak Veterinary Consulting. She writes extensively and speaks frequently about hospital culture, communications, leadership, client relations and operations. She is a member of the AVMA Veterinary Economic Strategy Committee.
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Imagine a clinic where pet owners can communicate with a veterinarian around the clock by phone or email, where same-day or next-day appointments are the norm, where the doctors routinely spend extra time with clients and pets, and where the hospital focuses on preventive care and provides myriad payment options. Clients want all that. A fall 2021 Packaged Facts report found that concierge veterinary care, long a staple of human medicine, is in high demand.
Concierge medicine emerged on the human side 25 years ago when physicians looked for ways to deal with overwhelming caseloads and high levels of career dissatisfaction. Also called “retainer-based,” “highly attentive” and “boutique medicine,” concierge care allows physicians to limit their patient numbers and offer exclusive services in exchange for an annual fee. Patients get unlimited office visits, in-office diagnostics and procedures at no extra charge but are responsible for the cost of hospitalization, specialist visits and tests performed outside the practice.
Where Veterinary Medicine Stands
The human model of concierge practice has not translated fully into veterinary medicine. Instead, two components of concierge medicine are available to pet owners: memberships and subscriptions.
The membership model leverages the lower caseloads of concierge medicine and improves access to doctors by restricting the number of clients. Some providers — New York City’s Small Door Veterinary, for example — charge a monthly fee and give the option to upgrade to preventive care services. Others, such as Modern Animal in Los Angeles, confer membership and unlimited physical examinations. The model typically provides clients with access to a pet’s medical records via a custom mobile app and unlimited 24/7 telemedicine consultations.
In contrast, subscription care features inclusive care and monthly payments. Often called bundled care or a wellness plan, this model isn’t new to veterinary hospitals. The services are typically not portable from one hospital to another unless they are part of a corporate wellness plan, such as those offered by the Banfield and National Veterinary Associates networks.
Several providers, such as Premier Pet Plans, GoFetch, VCP and Petly Plans, market customizable wellness programs to independent practices. The benefits of in-hospital wellness plans include more comprehensive preventive care through geographic and age-appropriate lifestyle recommendations.
In addition, many pet health insurance companies offer wellness endorsements on their policies, allowing for fee-schedule reimbursement. For the pet owner, the benefit is the plan’s portability and the bundling of the payment with the insurance premium.
A recent development is the standalone, direct-to-consumer plan. Some platforms, such as AirVet and Vetted, provide 24/7 telemedicine in addition to scheduled reimbursements for preventive care services. Others, like Wagmo and Pawprint, offer scheduled reimbursements for veterinary care.
Meanwhile, a business model that expands the subscription concept to provide preventive and illness care is emerging. This model addresses pet owner concerns about affordability and covers preventive services, preventive medications, diagnostics and in-hospital illness care. Clients pay a monthly fee based on the pet’s life stage. Two examples are U.K.-based Animor and Hannah Pet Hospital in Oregon, which advertise comprehensive care for less than $100 a month.
What Practice Owners Can Do
Veterinary hospitals can adopt highly attentive medicine and subscription-based care to satisfy rising client expectations. Here are four ways to achieve a boutique medicine feel:
1. Create relational interactions.
A vital component of the personalized experience is treating each client and patient as an individual. The interaction begins with a team member building rapport with a pet owner. Once their needs are identified, clients feel that the team member, and by extension the hospital, truly care about them and their cats or dogs. They sense a connection, which is critical when creating a customized experience. (See “How to Set the Tone” below.)
2. Personalize each pet’s care.
An essential element of personalized care is understanding a client’s goals for the pet. I never met clients who didn’t want their cats or dogs to live forever. While I couldn’t guarantee forever, I could educate and partner with pet owners to provide a level of care that aligned with their values and beliefs. “What are your goals for today’s visit?” and “What are your goals for this stage of your pet’s life?” are questions a veterinarian can ask. Additionally, health care recommendations should be based on a pet’s age, breed and lifestyle. At each visit, have clients fill out a questionnaire about their pets’ environment and the risk of exposure to infectious diseases.
Surveys have found that some pet owners define preventive care as what they feed a pet, how much exercise the animal receives, and how much love and attention it gets. As a result, they tend to minimize the medical aspects of preventive care. By asking a client what and how much a pet eats and how much exercise it gets, a veterinarian can make specific recommendations that align with the owner’s perceptions of preventive medicine. This approach empowers the owner to provide optimum care.
3. Promote wellness plans and bundled chronic disease care.
Wellness plans create predictability around the cost of preventive care. One benefit to veterinary hospitals is the ability for clients to subscribe to bundled preventive care services and pay for them in monthly installments. Because a relatively low number of veterinary hospitals offer wellness plans, competitors that promote such programs can stand out in the marketplace.
Bundled chronic disease care builds upon wellness plans by covering pets diagnosed with a non-curable condition. The package includes all the examinations, medications and diagnostics needed to manage a specific long-term disease. Because the cost is dispersed over a year, rather than charged each time a pet’s disease state is regulated, the approach is more affordable and predictable for the pet owner.
4. Partner with a 24/7 telemedicine service.
Pet owners want their veterinarians to respond promptly in an emergency. But are they asking for 24-hour access to the individual veterinarian, or do they want a safety net that helps them identify an emergency and learn what to do? I suspect it is the latter. They want a trusted, reliable, vetted source that is an extension of the veterinary hospital. The advent of independent, 24/7 telemedicine services fills the need. Most of the services send reports to the clinic the next day so that the continuity of care and follow-up by the primary veterinarian remains intact. In highly attentive models, follow-up is a client expectation.
Any veterinary practice can implement key elements of concierge medicine. When client expectations and the hospital’s offerings align, the outcome is a pet owner more bonded to the hospital. Building deeper, more trusting relationships enhances team members’ perceptions of doing meaningful, enjoyable work. That’s a critical step in lessening employee burnout and retaining valuable team members.
HOW TO SET THE TONE
Relational interactions begin with the use of the client’s and pet’s names and is supported by good communication techniques. Think about which words help build a relationship in this hypothetical phone conversation:
Caller: I’d like to find out about scheduling an appointment for my puppy.
Team member: That’s great! We love puppies. What is your name and your puppy’s name?
Caller: I am Jack, and my puppy is Cappy.
Team member: Jack, I am Ashley. How can I help you and Cappy?
Jack: I just picked up Cappy from the rescue, and someone there recommended that he have an examination. He might be due for a shot, too.
Ashley: Jack, I am so glad you called. It is a great idea to have Cappy checked out. How old is Cappy, and what type of a dog is he?
Jack: They think he is about 12 weeks old, and he is a Lab mix.
Ashley: Oh, he must be adorable. Besides a thorough physical examination and reviewing his medical records to see if he is due for shots, what additional concerns do you have?
Jack: He seems very hungry, and his stools are a little loose. He is also biting my hands a lot and is itchy.
Ashley: Thanks, Jack. We will discuss dog foods and amounts to feed him during your first visit. Then, the doctor will examine Cappy’s skin carefully. Many things can cause puppies to itch, from dry skin to fleas. We also will discuss basic behavior tips to help redirect Cappy toward more appropriate chew toys than your hands. How does that sound?
Jack: It sounds great.
Ashley: Great! Jack, we can see you and Cappy at 2 or 5 p.m. tomorrow. What works best?
Jack: 5 p.m. is better.
Ashley: Perfect. Jack, I will send a link for the new-client and patient paperwork. The directions will ask you to submit a picture or scan of his rescue group health records. Would you please complete it by the end of today? Doing this allows us to be fully prepared to greet you and Cappy. We also request that you bring a marble-sized piece of stool, no older than 12 hours, in a plastic bag so that we can check Cappy for intestinal parasites. That could be one reason he has loose stools. What are a good phone number and email address?
Jack: It’s …
Ashley: I just sent the link. Any other questions?
Jack: Yes, I just got it, Ashley. I can’t think of any other questions now.
Ashley: Jack, we look forward to meeting you and Cappy tomorrow at 5 p.m. Have a great evening!
Here’s what worked to build the relationship:
- Ashley asked for the client and patient names early in the conversation, and she used them frequently. The initial question began to create a personal experience for the caller, and it was enhanced when Ashley introduced herself.
- She was enthusiastic about his call — “That’s great! We love puppies.” Her response validated Jack’s decision to call.
- Ashley’s asking open-ended questions allowed Jack to state his concerns fully.
- She signposted what would happen during the examination, combining Jack’s concerns about food, itching and behavior with an explanation of how the issues would be addressed during the first visit.
- She proposed two appointment times.
- She explained her request for online medical records and how providing them early would benefit Jack and Cappy.
BY THE NUMBERS
A Packaged Facts study found:
- 49% of cat owners and 50% of dog owners agreed “It’s especially important to me that my vet focuses on preventive care.”
- 26% of millennials and Gen Zers agreed “It’s especially important to me that my vet provide wellness plans to help manage costs.” That segment of the population makes up the largest percentage of pet owners.