By Dr Pere Mercader (DVM, MBA, DEA)
According to some, the consultation is the temple of veterinary medicine. The client’s perception of our service will largely depend on what happens during the consultation and on the manner in which it is conducted. That is why it is very important to develop a client and patient care protocol for the consultation. This will help our clients to have a consistent experience in our consultations, regardless of the day of the week they come or the vet on our team who sees them. It is disturbing to see the lack of consistency in both the physical examination of patients and the treatment given to clients in many veterinary practices. It is therefore highly significant that one of the most prestigious medical textbooks1 devotes its first chapter to the proposition of a detailed protocol to follow during the consultation, including very specific recommendations about how to address the client. What is also significant is the large number of vets who quietly skip over this chapter in order to focus directly on those chapters that they perceive to be properly clinical.
In our case we propose the following customer care protocol during consultations:
Present a professional appearance
Remember that our client is unable to judge the quality of our medical procedures and therefore seeks external signs to reassure themselves. A clean uniform with the appropriate identification and an immaculate, discrete and smart appearance all project a professional image in a medical environment.
Greet the client in a professional but friendly manner
Introduce yourself, giving your name and position at the practice. Smile and shake hands with the client.
Interact with the pet from the start
Greet the pet by name, establish physical contact with it and make a friendly comment to relax the owner.
Apologize if we are running late
Praise clients that arrive on time. As well as a gesture of courtesy, these practices send a clear message both to the client and the rest of the team regarding the value of their time and ours. In the same vein, it is also advisable to call those clients who have not turned up for their appointment 20 minutes after the time agreed. The call must be polite and friendly, but it will help us to remind the client that a vet at our practice has spent several minutes waiting for them.
Use the name of the owner and the pet at least once during the consultation
This will improve interaction and demonstrate a service orientation. Even the most skeptical clients who think we pulled their name from the clinical record a few minutes before they arrived will positively appreciate our efforts as a sign of professionalism.
Perform a thorough physical examination, always explaining to the owner what we are doing and what our findings are
We often forget that what seems obvious to us is a mystery to our clients, especially if we do not exteriorise it. Half a minute spent in silence inspecting the inner ear of the pet can be an eternal wait for an apprehensive client.
Always provide some written information
This improves customer understanding, makes sure clients remember our veterinary practice and, in short, increases the perception of value regarding the service received. The consultation report (figure 1) is an excellent educational tool for clients. Furthermore, the report’s use has a valuable secondary purpose: to provide standard and systematic guidelines for all the vets at the practice when carrying out physical examinations of patients.
Make eye contact with the client, especially when we are delivering an important message
It is important to avoid writing or staring at the computer when we are making a health recommendation to a client.
Combine verbal explanations with visual media whenever possible
It has been demonstrated that the use of drawings, illustrated atlases, articulated models, videos, etc. significantly improves levels of client understanding (and therefore the likelihood that they will accept and remember what is being said). Nowadays there are a number of high quality communication tools accessible to those vets who want to use them.
Use layman’s terms but without lapsing into trivialities or inaccuracies
A common mistake among younger vets is to try to impress clients with sophisticated terminology in the false belief that this will reflect positively on their professional image. On many occasions however, the result is that the client clams up, feels intimidated and remote from the vet and, with luck, will end up asking the nurse or the receptionist to repeat “the vet´s explanation”.
Summarise key information for the client and ensure they have understood everything
The prestigious English veterinary consultant John Sheridan (www.veterinarybusinessbriefing.com) uses a methodology that shows to what extent client communication is a challenging task for many vets. The method consists of the following: over a period of three or four consecutive days, a questionnaire with three questions will be handed out after each appointment to both vets and clients for each to fill in figure 2.
As the reader will probably guess, the vets had a great surprise when checking what their clients had understood…
An effective technique to minimise this problem is to summarise the most important points at the end of each consultation:
What have we found out?
- What does the veterinary practice have to do from now on?
- What should the pet owner do from now on?
- When should the patient return to the practice?
Also, it is advisable to close the conversation with the pet owner with a twofold question:
“Mr. Jones, have we made everything clear? Would you like us to go over any of the information again?”
These two questions will clear up many misunderstandings, avoid clients calling with queries and will significantly improve compliance and ability to follow our health recommendations.
Nurturing the relationship:
The follow-up after the consultation
It is not uncommon to find veterinary practices that lose between 20 and 40% of their patients from one year to the next. This means a real “hemorrhaging” for any business and severely limits growth potential, putting even its very survival at risk.
What are the most common causes of patient (client) loss for a veterinary practice?
Figure 3 below ranks these causes according to the ability of the practice to influence them with their management systems:
Reasons outside the practice’s control
Patient deaths (between 8 and 12% annually)
Clients moving house (change of address) 1-2 % annually
Losing a pet, donating it to someone else or to a rescue center (2-3 % annually.)
Reasons within the practice’s control
Customer dissatisfaction, resulting in an intentional change to another veterinary practice (from 2 % to 5 %)
Lost clients due to poor communication by the practice (up to 20% annually)
These figures are approximate and are based both on the author´s personal experience as a veterinary practice consultant and on several published studies2. The practices that have been concerned enough to ring those clients that had stopped coming to their veterinary practice for more than a year have discovered, to their surprise, that a significant percentage of them were not aware that they “were no longer clients”.
Bearing this in mind, it is highly recommended that a sequencial protocol for vaccination reminders is routinely followed. The following procedure is recommended:
1. First letter (or email or text message to a mobile) 11 months after the last vaccination.
2. Second communication (by letter, email or text message to a mobile) to those clients who received the first communication a month ago and who have neither turned up at the practice or asked for an appointment.
3. Telephone call. For those clients who have also not responded to the second communication. This call ought to follow a structured protocol and always begin by showing interest and concern for the health of the pet. The purpose of the call must be to gather information about the status of the pet and, whenever possible, generate an appointment for its return to the veterinary practice.
“Good morning (afternoon), Mr/Mrs. (client name), my name is (name of the caller) and I´m calling from the ABC Veterinary Hospital. Following a review of our patient records we have realised that (name of the pet) has not been to the practice for the last 12 months and so we are calling, firstly to confirm that (name of pet) is well and secondly –just in case you had forgotten– to remind you that the last vaccination (name of the pet) had has already expired and unless it has been given again over the past 12 months…”
A thoughtful touch, surgical follow-up calls
Various studies have been carried out on the marketing activities of veterinary practices3 and it has been discovered that one of the actions that had the most positive impact on clients was an unexpected call from the veterinary practice to find out how the pet was recovering after surgery.
The veterinary practice should establish a specific policy for these types of calls, clearly defining the following issues:
For which kinds of procedures (it is suggested that they are limited to surgery).
When (it is suggested they are made 48 hours after the surgery was done).
What is said (show interest in the recovery of the patient and anticipate any possible concerns the owner might have, take advantage of the call to remind the owner of the date of the follow-up visit).
These calls can (and should) be made by non-veterinary practice staff. They provide an excellent public relations exercise that most clients do not expect and also help to identify and proactively resolve any possible concerns or worries. In the event that any of these calls result in concerns of a medical nature that require discussion with a vet, the person in charge of making the calls will take the responsibility to gather together all the relevant information and call the client back. It is advisable to create a monitoring report where the person in charge of making the calls systematically records the calls made, the calls to be made, the comments received from clients and any action required.