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Client Expectations For Veterinary Care In The Future
by Mary Ann Vande Linde, DVM
VMC, Inc. Evergreen, CO 80439
Technology is changing all our lives at a breakneck pace. We are virtually connected
to the world by the press of a button. We can email, converse and research anytime,
anywhere. Every year, we have more sophisticated diagnostic tools and techniques and
increasingly efficient means to manage client and practice data. We are also faced with
clients that are better educated than ever and have access to a scope of
information that is unprecedented.
As we consider this world of faster, slicker, snappier and more elegant solutions,
it is critical to remember - the client is a human being and that connecting with
that being is the most vital step to filling the client's expectations - today
and in the future.
Before we see into the future, it is worthwhile to consider what clients expect of
Veterinary Care in the Present. A telling indicator of expectations is understanding why clients
make a move away from a hospital or clinic. The top six reasons clients stop doing
business with a veterinary office are:
6. Death of their pet
5. Client moves from area or is deceased
4. Price
3. Mistakes / Malpractice
2. Referral to another hospital
AND the Number 1 reason -
1. Indifference or poor attitude
People want to believe that the professionals who are treating their pet really
care about that animal. And the client wants to observe, hear, and feel that the
staff in the office care about doing their jobs professionally, efficiently,
cheerfully, conscientiously and with integrity. No one wants to patronize a
business that is lackluster, condescending, disorganized, surly, inflexible or inconsistent.
Many of the expectations for the veterinary care provided in the future are
amplifications of the wishes of today's client. These wants include:
- Complete medical services with preventative and "well care" as a priority.
- A long term relationship with a practice that demonstrates a caring attitude
for their pet and which will be their advocate if treatment with a specialist must be sought.
- An office operation that is efficient and organized
- Minimal waiting time
- A consistent message throughout the process - from the receptionist
to the technician to the veterinarian.
- Most importantly, clients want you to communicate to them with respect, clarity,
and consistency. They want to be spoken to in language they understand. Medical
jargon is distancing.
- The diagnosis or likely outcome articulated in terms the client can understand
- Exams conducted thoroughly and without a sense of being rushed. Use your tools
and instruments every time. Include the client in the exam by providing a
running narrative. Do not examine in silence and inundate them with
information at the end.
Changes in how we communicate as a society will modify the tools we use to deliver information.
- Increasingly, people expect communication to be visual, quick and on-demand (e.g., Pet Portal)
- Key words - Ease of Use, Simplicity
- And with the changing cultural demographic, materials will often need
to be available in more than one language.
- However, before we reach the point of slick, versatile information delivery
systems, we must assure that the human communication can meet the test of
consistency, clarity, completeness, and meaning.
- Just as we teach our veterinary students to read a radiograph or examine
a skin disorder, we must provide them with a system, a framework to communicate
effectively with their clients. An example of this is:
Communication Model
1. Preparation
- 1 minute of preparation saves 3 minutes in the exam room
- Review the client history and ask Technician or Assistant
for bullet points from history and prescreen
- Set specific objectives for the visit - Identify the 3-5 concerns.
How will you confirm or raise awareness of these? List them on the record
before you walk in
- Develop a plan of action
- SMART Objectives:
- Specific
- Measurable
- Action Oriented (client's actions)
- Realistic
- Time Bound
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2. Approach
- (Say it with a smile!) Hello, I'm Dr. ________"
- Welcome everyone to the exam room - pet parent, pet, children
- Attitude is everything
- The Three R's
- Rapport
- Eye contact
- Body posture
- Voice tone and level
- Use owner and pet's names
- Touch the pet
- Reason
- Restate or re-ask the reason for the client's visit
- Ask what the client really wants
- Response
- Bridge to what you can do to satisfy the client's concern or need
- Ask, "...how does that sound?"
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3. Diagnosis
- Give a thorough exam, Head to Tail
- Use all your tools - stethoscope, otoscope and ophthalmoscope
- At this stage, effective questioning and listening is vital to help
you know how much the pet parent understands about their pet's needs and to
help focus the pet parent on your area of concern. You should spend about
60% of the time talking at this stage.
- An effective question is like a FUNNEL
- Types of Effective Questions:
- Open Questions
- Determine thoughts, feelings, attitudes of clients
- How, what, why
- Closed Questions
- Confirm information or direct conversation
- Yes or no answers
- Brief response
- Listening Effectively:
- Improves understanding of needs
- Helps to empathize
- Encourages clients to "open up"
- Makes others more willing to listen
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4. Recommendations: Compliance
- This is the step when you take the pet parent's concerns and connect
them to a product, service or program and the answers to your open questions
- Use the exam room report card to list your recommendations. Also,
provide clients with a timeline for when services are to be performed.
Use mind maps to simplify treatments for clients
- Pictures are worth a thousand words, so never tell what you can
show. People remember less than 10% of what they hear, but 90% of
what they see, hear and do themselves
- Features & Benefits
- Features - Products, Programs & Services
- Benefits - the SO WHAT's
Remember - Clients do things for THEIR reasons not OURS
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5. Addressing Concerns:
- The 5 step approach
- Acknowledge
- Clarify
- Answer
- Verify
- Close
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6. Commitment & Follow-up
- When to complete the visit:
- Receiving positive responses
- Time is running out
- Client Closes
- In completing, always
- Summarize the key points
- Request their commitment
- Make sure a plan is created and entered in the computer.
Complete your record.
- Make sure you give them a timeline so they know
when they are to return.
- First visit = Treatment
Second visit = Prevention Plan
- Reminders, Recheck, Recall (R3)
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Let's look at an example of a real life situation that demonstrates that consistent,
careful communication is as important to meeting the client's needs as the level of
care provided to their pet...
Background:
- A cat presented with an acute respiratory problem. After 2 days, the local vet
referred the client to the University.
- The admittance was done through Emergency Services to expedite the process,
yet as a result, the client had no clear point of contact.
- The admitting doctor (intern) was convinced that the cat had cancer and
ordered lots of tests - CAT scan, blood tests which did not reveal anything.
- By this time, the cat was quite stressed and the owner was advised that they
must wait until the respiratory specialist returned from vacation. The owner
called to find out the status of her pet and was told she may not visit.
- After 24 hours, it was discovered that the respiratory specialist was not
returning for at least another day, and had no record of receiving a message.
- The doctor talked to the client and received authorization for surgery.
- No cost estimate was provided the client.
- The cat did not survive the surgery. There was no acknowledgement of the
loss from the University.
- Three months later, the client received the bill.
- The pet's ashes still cannot be located. The client has major issues
with the bill and is challenging the majority of the charges.
This case is extreme, yet it does offer several points where attention to
communication could have helped the client be accepting and satisfied with the process...
- Initially, the admitting doctor needed to take the time to review the records
from the referring veterinary clinic and talk to the client about the situation
before ordering a battery of tests
- More questioning should have been done to determine the client's priority -
was it for the pet to be cured, made comfortable or ….?
- Steps should have been taken to provide the client with peace of mind -
allow visits, give a contact for questions and on-going reports.
- A cost estimate should have been given for surgery so there would be no surprises
- The client's loss should have been acknowledged.
The importance of effective communication skills and superior client services
cannot be overstated. Client service is the ability to meet client requirements.
Often, client's requirements, expectations or wants are implicit or unstated,
yet my work with numerous clinics has shown time and time again that:
- Clients want to have their pets treated with compassion and kindness
- Clients want to be listened to and to have their questions addressed in
language they can understand.
- Clients want their time and intelligence respected.
- Clients want the medical staff to be professional and skilled
The Client's satisfaction or the fulfillment of the client's expectations is
expressed by David Maister's First Law of Service -
Satisfaction = Perception - Expectation.
That is, if a client perceives services as being better than expected, then
their satisfaction level is high.
The top client expectation for Veterinary Care in the Future is to be communicated
to clearly, consistently and with respect.
- One of the most significant steps we can take to prepare our students
for this reality is to teach them to communicate systematically, with varied
modalities and (very importantly) with caring and compassion.
- Having a communication framework in place will provide our profession with
the center required to adapt to the changing profile of the
diversity of our client needs and population.
Reference List:
Moreau, Phillippe. "Client's Needs and Client's Expectations" 28th World
Congress of the World Small Animal Veterinary Association, 2003.
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6641&O=Generic
Milani, Myrna. "Practitioner-client communication: When Goals Conflict" The
Canadian Veterinary Journal, v44(8) 675-678. 2003.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=340246
Veterinary Practitioners Registration Board of Victoria, Guideline 7.
"Employer/Employee Relations - The Employment of Inexperienced Registered
Veterinary Practitioners", July 2006.
http://www.vetboard.vic.gov.au/guidelines.html
http://www.vetboard.vic.gov.au/docs/gl7.pdf
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| © 2007 Veterinary Management Consultation |
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