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.Read Articles Written by Wendy Hauser
Working as a relief emergency veterinarian pre-pandemic, I was alarmed that more than 50% of the pets I saw had no primary care veterinarian. However, my observation was not unique. A 2021 American Veterinary Medical Association study found that 24% of dogs and 35% of cats had not seen a veterinarian in the past year. Also that year, Petco Love reported after distributing 1 million vaccinations to animal welfare groups that 63% of the patients had no prior vaccinations. So, how do pets fall through the cracks, and what should practices do about it?
The primary drivers for why patients don’t get needed veterinary care are:
- Client economic limitations.
- The owner’s inability to access care.
- A lack of communication.
When it comes to communication and scheduling routine care, most pet owners rely on reminders about services due. Ask yourself these three questions:
1. Does our computer log reminders for every patient?
As a practice consultant, I am dismayed to see how many pets don’t have service reminders in the practice management software system. This issue is often due to a new client not bringing patient records to the first visit or the previous practice not sending requested documents. The result is a pet with no service reminders in place.
Here’s how to fix the problem:
Run a monthly PIMS report to identify who in your patient base is missing reminders. Depending on your software system, you might produce a standard list or a custom report. Many PIMS Facebook user groups can show you how to run the reports.
Once you have the information, request medical histories from the pet owners or prior practices. You can delegate the task to a remote worker (either a team member or a veterinary-specific virtual assistant hired through companies like Saiber Vet, GuardianVets and Chronos).
Discuss your findings during a team meeting and ask for ideas about solving the problem. For example, consider breaking staff members into teams and starting a competition to see which group can recover the most missing data. Incentives could include a catered lunch for the winning team when 25% of missing reminders are completed, chair massages upon 50% success and a $50 Amazon gift card for 75%.
Check patient reminders at each visit. For example, an exam room team member should ask a new client about the pet’s last veterinarian and have the owner sign a release form authorizing the records to be sent from that practice. When new pets have no medical history, enter a placeholder reminder in the computer system. This step usually occurs when a pet is seen for preventive care but rarely during sick visits.
2. Are reminders turned off?
Many practices halted reminders during the pandemic, and some forgot to turn them back on. Are you certain that your hospital sends reminders to clients?
Now is also an excellent time to check the cadence of reminders. For example, given the lack of available appointments at some hospitals, should you send preventive care reminders well in advance to ensure the pet arrives closer to the due date?
3. Do clients receive email, text, mail and phone reminders?
Communicate with clients in various ways. For example, ask pet owners about their preferred method of receiving reminders and then do it that way. Alternatively, your practice can send reminders by text the first time, email the second notice and mail the third one.
With overdue clients, have a team member call the pet owner and make multiple attempts if needed. Some consultants advise that you keep trying until a client requests no additional contact. You can outsource the calls through the virtual assistant options mentioned above or with automated systems such as the VetSource Retriever program.
Improving Access to Care
The AVMA’s 2022 Pet Ownership and Demographics Sourcebook found that fewer than 10% of the respondents said a lack of convenience and access, such as a practice’s location and hours, were barriers to regular veterinary care. Instead, a more likely contributor to the increasing number of pets not seeing veterinarians is the lack of available appointments, often driven by workforce shortages and workplace inefficiencies.
How can your practice improve efficiency and create more capacity? Here’s how.
BEFORE THE VISIT
For preventive care visits, practices should “prescribe” client education videos on topics relevant to a pet’s life stage. You can share videos posted on YouTube by the AVMA, the American Animal Hospital Association, the American Association of Feline Practitioners and other organizations. Your practice also can record videos and post them to your hospital’s social media channel. The advantage of hospital-created videos is the personalization, both in the content and relational interaction. Additionally, you enhance search engine optimization when your website hosts custom content.
The videos should be less than two minutes long and address specific topics. Link to the videos by text or email when you schedule an appointment and ask the client to watch them before the visit and be prepared to ask questions. The exam room team member who verifies the pet’s history during the visit can answer questions about the prescribed education or share them with the doctor.
For new clients, I recommend that they complete an online medical history form. You can set up the file using Jotform or Google Forms. Then, send a link to the document by text or email when an appointment is scheduled or a few days before it. Some client management platforms can sync the information with your practice management software. (I like automated systems such as TeleVet and AllyDVM.)
DURING THE VISIT
Make sure to review any submitted documents with the client. The exam room team member can verify the information and ask about new concerns.
Upon a patient’s arrival, you can enhance efficiency in two main ways:
1. Examination room scribes
In human studies, for every hour that inpatient physicians spend with clients, they spend two hours on medical records and patient management. However, when they used dedicated exam room scribes, charting time decreased, physician satisfaction improved, and efficiency increased, leading to more appointment availability and higher revenue.
In veterinary practices, consider using a virtual assistant, many of whom are veterinary professionals, or train a team member. Another option involves voice-to-text tools.
2. Patient record templates
Efficiency improves when all veterinarians in a hospital use standardized examination templates created within the practice management software system. Team members know what to look for and where to enter patient information.
AFTER THE VISIT
Create a safety net by implementing these two strategies:
- Forward-book the next appointment: Clients leaving your hospital should know when to return. At the conclusion of every visit, tell them about service due dates and the reasons. It might sound like this: “Mrs. Smith, we are committed to keeping Applesauce healthy and happy. Because she is now a senior, Dr. Hauser believes seeing her twice a year is important. This allows us to detect and manage any health changes early. We have found that our patients live longer and healthier lives, which is what we want for Applesauce. Six months from today would be Oct. 27. Would that work?”
- Communicate between visits: You could email health alerts, announce new products or services, and introduce new team members. An alternative is to post news blogs, and then text or email the links. Companies such as Astuvet and Belle Pet send curated content based on a pet’s species, age and chronic medical condition. Additional tailored content can include exam report cards and copies of diagnostic tests.
Dealing With the Cost of Care
The 2022 AVMA survey identified two primary reasons that pet owners don’t schedule annual examinations for dogs and cats: affordability and a lack of perceived value of the exam. Here are four solutions to help prepare clients for the cost of veterinary care.
1. Wellness Plans
Surveys show that pet owners, particularly those in generations X and Z, desire wellness plans to help manage veterinary costs. Unfortunately, wellness plans remain an underutilized tool for helping pets receive preventive care through budgeted monthly payments. Such plans are embraced by corporate practices but largely ignored by privately owned hospitals. In addition to meeting the expectations of clients and helping them care for their pets, wellness plans serve as market differentiators.
2. Bundled Chronic Care
The advantages of health care bundles for managing a pet’s chronic illness include:
- Empowering owners to pursue treatment by dividing hefty upfront costs into monthly payments.
- Improving the consistency of disease management.
- Giving hospitals increased control over medication and diet dispensing and revenues.
3. Client Education
Educated clients are empowered pet owners. Informing clients about the future cost of veterinary care and how to pay for it is critical to client education. Sadly, we often overlook this step. A client’s ability to adhere to recommendations often rests on education. Industry partners such as Synchrony Financial’s Lifetime of Care Study and ASPCA Pet Health Insurance’s Cost of Care platform contain tools designed to help veterinary teams engage in conversations with pet owners.
4. The Value Proposition
The pandemic had two unforeseen consequences: an increased need for pet care and reduced client education. For two years, pet owners missed out on hearing about preventive care and how it improves an animal’s quality of life and longevity. The net result was a lack of perceived value in preventive care and more willingness to forgo regular care.
Here’s how veterinary teams can shift the perception so that pet owners see regular care as essential.
- Focus recommendations on the pet and owner: Too often, veterinary teams think about the tangibles of a service, like the time it takes and the extra training that goes into it. Instead, clients want to hear how the information they receive or the service you perform will benefit the pet’s life and well-being.
- Respect the client’s beliefs and values: This approach tailors veterinary care to the pet’s lifestyle and incorporates the client’s perspective into your recommendations.
- Proactively discuss costs: According to the AVMA’s Language of Veterinary Care Initiative, clients want to engage in cost-of-care conversations early in the visit. Specifically, they want the veterinarian (and the doctor’s expertise) more involved in the discussions.
It’s Up to You
The definition of “Falling through the cracks” includes phrases like “Failing to be noticed” and “Something being overlooked.” Those are apt descriptions of factors causing an increasing number of pets to miss vital regular health care. Veterinary practices cannot afford to ignore fewer patient visits.
Fortunately, veterinary practices can follow many strategies for recapturing missed pets and reversing the downward trend. By examining reminder processes, creating workplace efficiencies and having transparent conversations about the cost of care, you can fill in the gaps and create a seamless client experience.
DID YOU KNOW?
Vetsource Data and Insights defines lapsed patients as those without a veterinary transaction in the past 14 to 18 months. Month-over-month increases of 20% or more have been tracked since May 2022. According to the data, the average veterinary practice has 621 lapsed patients.