Sandy Walsh
RVT, CVPM
Getting Technical columnist Sandy Walsh is a veterinary practice management consultant, speaker and adviser. She is an instructor for Patterson Veterinary Management University and continues to work in a small animal practice. She has over 35 years of experience in the veterinary field and brings her in-the-trenches experience directly to readers.
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The veterinary nurse and every other team member has an important role in client compliance. But first, what is compliance?
By our definition, compliance is the extent to which pets receive the services and treatments that have been recommended by the veterinary team, from preventive care to more complex medical treatments and procedures. Adherence, on the other hand, is the extent to which patients receive the medications or at-home treatments prescribed. This includes the pet owner filling and refilling the prescriptions, correctly administering the appropriate dose or treatment, and then completing the prescribed course of treatment.
Compliance and adherence go hand in hand with our patients receiving the continued care and treatment they need. If our patients are not receiving prescribed medications, they won’t get better. Clients will not see positive treatment results and might not accept future recommendations, so your compliance rates will decline.
Choose the Right Words
The veterinary team has little direct control over whether a pet owner accepts the veterinarian’s recommendations or adheres to a course of prescribed treatment. However, tangible actions can be taken to influence client behavior.
Start with your delivery of the treatment plan. Once the veterinarian has outlined the best course of treatment, now is the time to communicate to the client what is needed. How recommendations and treatment plans are communicated often can make the difference between a client who is agreeable and one who leaves without optimal treatment or, in some cases, opts for no treatment.
The veterinary nurse often has the responsibility of presenting treatment plans to the client. Several steps can be taken to enhance this communication and improve acceptance rates. Start by changing some of the words used.
For example:
- “Treatment plan” instead of “estimate.” This shifts the focus to the medical rather than the financial. Communicate the medical needs first and then the financial aspect.
- “Need” instead of “recommend.” “Monty needs preanesthetic bloodwork” has a different impact than “We recommend preanesthetic bloodwork for Monty.” This approach conveys a sense of importance or urgency. When treatment plans align with the practice’s defined patient-care models and best medical approach, they will speak to the patient need as well as the client need.
- “Preventive care” instead of “wellness.” Shift the focus to what can be done with regard to prevention and early detection while maintaining wellness. Rather than calling them wellness plans, let’s say preventive care plans.
Be a Master Communicator
Recommending a treatment plan must be restricted to those capable of conveying the need and addressing client concerns without guilt or exerting pressure to accept. Communicate your treatment plans in a confident, straightforward manner. Clients will not accept what they do not understand or believe necessary. Allow them the opportunity to express concerns, ask questions and gain understanding.
Effectively dealing with resistance is an important part of the communication process. If adequate time is taken in the treatment plan’s preparation and presentation, clients will have a better understanding of their options for treating the pet and will be less likely to decline treatment. Once the treatment plan has been accepted, the team must continue to work with the client and keep the communication open and active. When the pet is hospitalized for a treatment or procedure, keep the client informed as to what is happening and what she can expect when her pet is discharged and sent home.
We make too many assumptions about a client’s ability to treat her own pet, especially when administering medication. The best communication process is more than simply affixing a label to a vial and handing it to the client as she checks out at the front desk. Veterinary nurses need to actively ensure that the client leaves with a complete understanding of what the pet needs at home and how to make it happen. Do it this way:
Demonstration
- Pet owners do not instinctively understand how to properly give a pill or instill eye or ear meds. All new prescriptions should be demonstrated. Show the client how to administer the medication being sent home. Give the first treatment while the client is in the exam room, and demonstrate the best way to restrain and treat the pet at home.
- All treatment protocols should be demonstrated, from how to clean the ears before administering medication to applying a hot compress to flushing a drain or brushing teeth. The exam room nurse is in the perfect position to make sure that proper communication happens each time a pet is discharged. Build the time into your discharge appointments.
Show and Tell
- Use visual aids such as anatomical models and photos, and teach restraint techniques.
- How-to videos can be shown in the exam room, sent to the client by email, or viewed through links on the practice website or YouTube channel.
Written Instructions
- Provide written discharge and treatment instructions, including what to expect over the first few days. Treating the pet at home is frequently a family affair, so the information should be in a format that can be shared with people who were not present during the discharge appointment.
Regimen Aids
- Provide pill concealers for pets that are difficult to treat.
- Consider daily pill boxes, treatment calendars and automated medication reminders.
- Suggest strategies such as placing medications in a visible place at home or giving them at mealtimes.
- Make sure the prescription refill process is easy.
The Follow-Up
- Check in with pet owners the day after the visit to make sure they were able to treat the pet and that the medication was issue-free.
- Confirm the pet’s medical progress exam has been scheduled.
What happens in your practice when a client does not accept a treatment recommendation? Understand that finances often are not the main reason a client will decline a treatment plan. Inadequate communication, not understanding the pet’s needs and a fear of anesthesia generally top the list.
If the whole team gets on board with enhanced communication throughout the process, we can help clients make informed decisions. In some cases, “no” just means “not now.” Follow up with those clients in a timely and appropriate manner. Share important resources and continue to address their concerns.
There is no better patient advocate than the veterinary nurse. It’s what we do best.