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Chapter 11: Tales from the COVID-19 front lines

“What actions are we going to take that will help propel us into a new normal that includes more compassion, more collaboration and more kindness?”

Chapter 11: Tales from the COVID-19 front lines
June is LGBTQ+ Pride Month. Above, veterinary professionals from across the nation participated in the World Pride 2019 march in New York City.

This week: Dr. Mia Cary on diversity, Dr. Peter Weinstein on leadership and much more.

Read other installments in this series:
Chapter 1   Chapter 2   Chapter 3   Chapter 4   Chapter 5  Chapter 6
Chapter 7   Chapter 8   Chapter 9   Chapter 10  Chapter 12  Chapter 13  Chapter 14  Chapter 15

Cary Consulting CEO and change agent Mia Cary, DVM

There is so much weighing on us all — from the impacts of an ongoing pandemic, to the loss of loved ones, to horrifying acts that shine new light on pervasive racism. While we are still trying to get by day to day and triage the most urgent matters, we must also carve out time to think about what we want our new normal to look like. What actions are we going to take that will help propel us into a new normal that includes more compassion, more collaboration and more kindness? How will we leverage the benefits of diversity because it’s both the right thing to do and good business? I’ve asked this of many veterinary professionals over the past week and these are some of the responses I’ve received:

  • “All practice members have committed to replacing ‘the girls’ with ‘team members’ or their names.”
  • “We invited staff members to include relevant, helpful facts such as ‘I speak Spanish’ or ‘I speak ASL’ on their name badges.”
  • “We allow staff members to utilize professional development funds to take a second language course.”
  • “We are celebrating LGBTQ+ Pride Month in June by decorating the practice, including the curbside pickup area, in Pride rainbow colors.”
  • “We are inviting staff members to include their personal pronouns on their name badges.”
  • “We are creating a year-round buildup to Black History Month in February by highlighting black veterinary professionals on the practice social media channels.”
  • “This fall we are planning for Asian Pacific American Heritage Month in May by gathering facts about influential Asian-Americans to post around the practice.”
  • “We have started inviting staff members to select a topic of their choice to present at monthly staff meetings.”
  • “We are starting each staff meeting with team members sharing one challenging and one positive thing that happened in the last 24 hours.”
  • “We enrolled all team members in the AVMA Workplace Wellbeing program and created a place on our dry-erase board to share key learnings as we progress through the modules.”

What about you? Is there an activity on the list you will share with colleagues? Or perhaps the list sparked a creative idea that was already forming. Today is a good day to take one step toward a more diverse, collaborative and kind world.

Veterinary industry consultant and Southern California Veterinary Medical Association executive director Peter Weinstein, DVM, MBA

As we just passed Memorial Day weekend and remembered those who fought for our freedom, it’s a good time to also think about those we lost in the past three months to the coronavirus pandemic. And as we can’t forget the past, it is your job as a leader to help set the direction for the future. Your patients, clients, staff and family depend on you to make the right decisions.

This is the perfect time to speak less and listen more. Take into consideration the guidelines for your state, county and city. And then have some candid conversations with your team. As a leader, providing them safety and peace of mind should be paramount. In his book “Leaders Eat Last,” Simon Sinek says, “The true price of leadership is the willingness to place the needs of others above your own.” With the lingering fears of the virus still omnipresent, talk to your team about their comfort as you move from curbside to tableside, from essential to available, from limited to “back to (new) normal.”

You have to take into consideration a multitude of variables as a leader at this time — financial, human resource, regulatory, etc. Balancing all these variables might seem daunting, so use the resources around you. These include the various international and federal websites (WHO and CDC, for example), association websites (AVMA and state VMAs), and small business websites (SHRM, SBA, etc.). Talk to your accountant, your financial planner and your attorneys to map the future of your practice, your team and yourself.

Many practices have had record-breaking days, weeks and months. That is record-breaking on both sides of the curve. If you are busier than you can handle, what changes are you going to make for the next phase? Ask your team members for guidance in this as they are handling the front line. Make smart decisions on safety using personal protective equipment, hospital disinfection and, most importantly, what to do when (not if) you have a known infected staff member or client. Set up the guidelines and systems now so that you aren’t scrambling to react. Before you start molting into the new normal, create a phased-in plan. Be proactive instead of reactive.

On the other hand, if the past few months have been really trying financially, it is more important than ever to ask questions, evaluate data and seek guidance to help you get back your mojo (luck, charm, skill). Which of the variables that impacted your practice were internal and which were external? Which can you impact and which are here to stay?

You and your team’s mental health have been put through a wringer the past 90 days. Some paid time off for the team could be just what the veterinarian ordered. Some paid time off for the leadership is mandated as well. The next wave will be a combination of viral and economics. You need to be ready. Having your head on straight and ducks in a row — wow, two trite phrases back to back — is required.

A final thought from Simon Sinek: “Inside our organizations, the dangers we face are not a constant. They are a variable. And they are the decisions of leadership as to how safe they make us feel when we go to work. This is the job of leaders.”

That is your job now!

Crum & Forster Pet Insurance Group assistant vice president of veterinary relations Wendy Hauser, DVM

Over the past two weeks, the majority of the country has begun easing business restrictions, allowing veterinary hospitals to offer more comprehensive services, including preventive care and elective procedures. At the same time, there is increasing concern about a second wave of COVID-19 in the late fall and winter. What should you do now to be prepared for this possibility?

1. Actively review what worked well for your hospital during the past three months.

If a second wave occurs, what are best practices that you can repeat? Curbside check-ins, contactless payments, history forms completed and returned to the hospital before the appointment, off-site client communication management teams, and creating cohort health care teams are examples of business practices that worked well for many hospitals.

2. What technological solutions should you implement now to be prepared for the future?

This is the time to investigate and invest in new technologies, such as telemedicine platforms, client communication options including platforms that virtually place clients in the examination room, voice-to-text integration with medical records, and integration of client-completed history forms into practice management software systems. What needs to be done to upgrade your phone systems to be more efficient? Solutions might include off-site employees to answer phones and triage calls, as well as chat, softphones or VoIP technology rather than adding dedicated phone lines. By identifying inefficiencies now, you can identify solutions and refine their utilization when your hospital is not in crisis mode.

3. Encourage all employees to get influenza vaccinations.

According to the Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel, veterinary team members should receive annual influenza vaccines because of to their extensive contact with animals and pet owners. Given the timing of the possible second wave of COVID, it is possible that both illnesses may coincide. What’s even more critical is that employees be vaccinated against influenza this year to minimize the risk of co-infections as well as reduce the impact of influenza on co-workers.

4. Build up cash reserves.

Early indications are that the economy will stabilize and grow minimally over the final six months of the year. What can’t be predicted is the impact of a second COVID-19 wave on the economy. It would be prudent to have three to six months of cash reserves in the event of another economic downturn.

Beyond Indigo Pets president and Today’s Veterinary Business editorial adviser Kelly Baltzell, MA

There is life before March 1, 2020, and life after March 1, 2020. What applied in the previous world may or may not be working in today’s world. Now that a couple of months have gone by, what has worked for digital marketing in the veterinary space?

Blogs: The numbers speak for themselves. Traffic on my clients’ blogs is up 156% over 2019 and accounts for 30% of their website traffic. An example of a blog that is gaining thousands of views a month is this one from Animal Kind Veterinary Hospital: bit.ly/3clmNzl.

Social media engagement and ads: Besides sharing content, engagement also is working for digital marketing. On Facebook, people want light things to do, share and interact with. For example, an engagement ad that is colorful, fun and light can gather five to 10 times better engagement. This bright pink engagement ad, for example, generated typically 50 submissions of pictures. Facebook ads in general are “on sale” and producing great results. It’s time to leap on lower-cost opportunities.

Google Ads: Google is offering a fire sale, just like Facebook. If your marketing goal indicates that a Google Ad is needed, embrace it. Google Ads are now budget-friendly and are working. For example, one of my client’s Google Ad campaigns had a 72% decrease in cost and 71% decrease in cost/conversion compared with last year. Other clients’ ads are working so well that we had to throttle back or turn off the ads altogether because the hospitals are booked. The bottom line is that if your marketing budget has the funds, use Google Ads.

Forms: Out of the marketing wild has emerged forms as a strong new tool. In the madness of March, many hospitals switched to utilizing online forms more to streamline the curbside process or telehealth consults.

Remember to lean into your marketing now, not out of it. More than ever, people need to see your brand and know that you are in business.

Creative Disruption columnist and WellHaven Pet Health chief medical officer Bob Lester, DVM

Three months into COVID and our profession has once again proven its economic resilience. We took the worst a pandemic has to offer and we are still standing. Standing stronger than before, I believe.

So, what will the next three months, 12 months, three years bring? Are we in for a prolonged recession or a brief one? A V-shaped recovery, W-shaped, L-shaped, perhaps a Nike swoosh? Who knows? In any case, we are in a recession. Regardless, I submit, the bull case for the veterinary profession is stronger than ever. As the COVID winners and losers are tallied, the veterinary profession is clearly among the winners.

COVID losers? How about brick-and-mortar retail, airlines, hotels, restaurants, in-person entertainment and pants.

COVID winners? How about Amazon, Netflix, Target, Zoom and veterinary medicine.

Why vet med? Prior to COVID, our profession was enjoying substantial tail winds, including increasing pet numbers, increasing pet spending, increasing pet lifespans, decreasing euthanasias and the continuing respect our society has for veterinary professionals.

Post-COVID, veterinary practice will have gained even more momentum, including record pet adoptions, more pet owners expressing plans to adopt additional pets, an increased recognition of the importance of preventive care and zoonoses, lower interest rates, cheaper rents, an easier hiring environment, more clients working from home and recognizing their pets’ health needs, increasing practice adoption of technology in support of better veterinary care, and perhaps best of all, pet owners acknowledging that by spending more time with their pets their household happiness is up and anxiety is down. Veterinary practice benefits in all cases.

Veterinary medicine has weathered storms before and emerged stronger for it. This storm is no different. I remain bullish on veterinary medicine, but maybe not on pants.

Getting Technical columnist, practice management consultant and Patterson Veterinary University instructor Sandy Walsh, RVT, CVPM

We have seen some changes over the past couple of weeks. Veterinary teams have mastered the art of curbside, but the clients are starting to show signs of weariness. They are losing patience with the process, especially with the warm weather and stay-at-home restrictions being loosened. They want back in. Those picking up food or medications are still good with the concept, however. I can see this concierge service becoming more of the norm going forward.

Practices are slowly beginning to allow clients back inside the practice. We’re learning what it really means to clean and sanitize for client and employee safety. I had the opportunity to preview Patterson Veterinary University’s online course “Disinfection Keys to Success.” It’s great content for the whole team. Stay tuned for this one and check out www.pattersonvetuniversity.com for more COVID-related resources.

Practice owners are starting to stress a bit about using all of their Paycheck Protection Program loan money within the current eight-week period to receive complete loan forgiveness. We might soon see changes here. Last week, the U.S. House passed a bill that would change the forgiveness process, making it more favorable to borrowers, and the Senate is expected to pass something similar soon. Many of our business colleagues are making information available to help clarify the rules. The Veterinary Hospital Managers Association and VetPartners have hosted several informative webinars and town-hall discussions specific to the financial implications of the pandemic. The latest from the accounting firm Gatto McFerson is at www.gattomcferson.com.

The best news is that practices continue to stay busy. Wellness services and elective surgeries are back. The light at the end of the tunnel is no longer a flicker; it’s getting brighter every day.

The Vet Recruiter founder and CEO Stacy Pursell, CPC, CERS

On the recruiting front, my firm has seen an increase in activity in the past two weeks. The majority of my clients who were interviewing and hiring pre-COVID are interviewing and hiring again. We still have plenty of practices doing video interviews, but more are becoming comfortable allowing veterinarians back into the clinics for in-person interviews.

People continue to be more positive, especially in the Southern states. Most practices I talk with are trending back closer to normal with revenue, and some are saying their revenue is better than last year at this time.

Veterinary industry consultant Debbie Boone, CVPM

Now is a very good time to be in the plexiglass business as companies erect safety shields between the staff and the public. One plexiglass company owner reported a 60% increase in sales over last year but said it made him sad because his products were putting barriers between people, which is an unnatural state for humans.

Even so, as states loosen restrictions, most of the practices I work with and the manager groups I follow are planning to wait to reopen to the public. The few that are jumping in will open by escorting clients into the exam room from the parking lot and allowing no more than two family members to accompany the pet. One staff member at a time will interact with the clients to allow for physical distancing. Rooms will be disinfected between appointments, and personal protective equipment will continued to be used.

Last week I previewed a new free course launched by Patterson Veterinary Supply and Virox on proper cleaning, sanitizing and disinfecting protocols. I learned that hospitals might not be disinfecting well enough to kill fungi and viruses on surfaces because the practices do not allow the products to sit or stay wet long enough to do their job. When clients return to our buildings, teams must follow proper protocols to protect themselves and others.

As promised, I am sharing the results of my Veterinary Team Member COVID-19 Exposure Survey. More than 130 people, most of them practice managers answering for their teams, responded this way:

  • “I have had a fellow team member or myself infected with COVID from client exposure.” Yes: 3.
  • “I have had a fellow team member or myself infected with COVID from friends or family.” Yes: 11.
  • “I have had myself or team member become infected with COVID from an unknown source.” Yes: 12.
  • “I have not been infected nor have had an infected team member.” Yes: 112.
  • “My area is considered a hot spot.” Yes: 45.5%. No, 54.5%.

It appears that teams are doing a good job protecting themselves at work and that the greatest risk to us is friends, family and unknown sources. I was glad to get replies from both hot-spot and non-hot-spot areas for balanced data. I ran the survey to satisfy my curiosity and to hopefully offer comfort to the most fearful among us. Thank you to all who responded.

A new danger lurks with the civil unrest in many major cities. Managers and owners concerned that looters will damage their practices are planning for team and property safety. Many emergency practices are shortening hours in response to curfews.

As a child growing up in the ’60s, I can say these scenes are sadly too familiar. My hope is that with great disruption comes change for the good. These are challenging times, for sure. We must listen and keep the lines of communication open as we battle both a pandemic and injustice.

Today’s Veterinary Nurse editor-in-chief and NAVC director of veterinary nursing Kara Burns, MS, MEd, LVT, VTS (Nutrition)

As we enter June 2020, much is different in our profession. Veterinary protocols have changed and become the new norm for patient care. Curbside protocols along with history taking and discharge instructions via telephone have become standard, as has home delivery. Veterinary nurses are experiencing increased utilization of their skills as veterinarians begin to delegate certain tasks — a positive sign that needed change in the profession is occurring, although we did not expect it to happen because of a pandemic.

One thing that has been observed is increased frustration and a lack of kindness from pet owners. This is not true of all clients, but my colleagues are definitely seeing an increase and are turning to colleagues and veterinary nurse social media community groups to share their frustrations and pain regarding clients who inappropriately project anxiety and fear onto veterinary teams. People are scared and nervous, and the result is a change in how people react, respond and treat other people.

Thankfully, this is not true of all clients, actually very few at this time, but it is increasing. I still see pet owners appreciative of the fact that their pet will be examined and treated as efficiently as possible while we maintain safe social distancing. Fear, anxiety and future unknowns are leading to these client reactions. Veterinary teams are working in new situations and trying to provide the best care possible.

As restrictions across the U.S. begin to ease, elective procedures and wellness visits have increased, all within the protocol we associate with the new normal. Time will tell how and when we get back to “normal” or what “normal” will look like. But I do know that veterinary teams are working hard to ensure that pets are given the best care in a new world and that owners are protected and communicated with in the safest and most efficient way possible.

We are all in this together. Be kind to one another.

We want to hear from you: How has the COVID-19 emergency affected you, your practice or your veterinary business? Email editor Ken Niedziela at [email protected].

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