Don't blame ailing revenue on recession

Don't blame ailing revenue on recession

Jun 01, 2003

Recently, our office has received an increased volume of calls asking the universal, paranoid practice owner question: "How are other practices doing this quarter?" The query reflects the doctor's concern that perhaps something is afoot other than external factors such as couch-potato clients watching the war in Iraq on Fox television; or, perhaps, the fact that multiple layoffs at local industries could be impacting; or, perhaps, fear of SARS is keeping clients at home.

The fact of the matter is, most practice owners are reluctant to point a finger at some uncontrollable outside force threatening practice revenues.

Rather, most become suspicious that practice internal controllable factors are at play. As one practice manager said: "I am worried we are doing something wrong."

Many times, this fear of doing something wrong is related to fee schedules. Maybe the practice's fees are too high. Maybe clients are seeking services elsewhere. Maybe veterinarians have priced themselves out of the market.

Fee structures to blame?

Wait a minute. There are many other issues you should consider before jumping to the conclusion that fee structure is the internal issue at play. Most practices have extraordinarily reasonable fee structures, compared to the expertise and quality veterinary care provided. Most evidence suggests that tremendous elasticity in veterinary fee structures exists and that most practices have quite a bit of latitude for judicious fee increases on various services before complaints will arise.

Beyond failure of the reminder system, because someone forgot to print them, post them or the computer software failed to print all of the reminders truly due, what else should you be thinking?

The answer is clear: Who is answering the practice's telephone? If business is down, perhaps the message potential clients hear when they call is a complete turnoff. Is someone turning them away before they even have a chance to see you at the exam room table?

Some practitioners have reported the worst possible situation: a surly, unhappy receptionist or technician picks up the phone and slams it down without even finding out who is calling. This person is so busy and overwrought that she cannot bear the thought of making another appointment. When the phone rings, they choose to ignore it or simply hang up on the caller.

Are you listening?

Usually, the situation is not quite that bad, but have you really listened to what your employees say when a call comes in? Perhaps a bit of phone espionage would be in order.

Recently, we had the opportunity to secretly conduct staff reviews via phone espionage for several clients. What we found astounded us, especially given the high standards to which these practices aspire. Staff training and continuing education is ongoing. Regular meetings ensure everyone is up to speed on client queries that may arise.

Some of these practices have trained practice managers at the helm who really take it personally when an employee does not do as good a job as she thought the individual was trained for.

In one practice, income for the first quarter of 2003 has been significantly down from last year. When calling, my assistant, Sue, posed as a pet-owner inquiring about services for two of her cats. One had blood in the stool. The other was a kitten requiring vaccines, spay and a declaw. The mistakes made by the receptionist included:

· She did not inquire as to whether the caller was a new or existing client.

· At no time was any effort made to establish an appointment, for one cat or the other.

· The correct fees for various procedures on the kitten were incorrectly quoted.

· The receptionist expressed a strong opinion that the surgical procedures were "very expensive".

· The receptionist expressed no interest in nor did she ask any questions about the ill kitten.

· The receptionist did not ask for the caller's name, telephone number or any other information that would potentially lead to an appointment.

More calls

In another espionage call to a different hospital in a different state, Sue posed as a pet owner seeking information about vaccinations and spay/neuter. Although the hospital employee was cheerful and pleasant, just as in the other consults we performed, the following problems were noted:

· Too much scientific information was provided that flew over the head of the caller.

· Confusing and misleading information was given that was not in accord with hospital policy.

· The technician vowed with absolute authority that vaccine procedures would cause no harm whatsoever to the pet.

· No effort was extended to obtain any information about the caller, or offer to establish an appointment.

· We observed mediocre presentation skills about the various quality support care services provided at the point of surgical procedure, such as pain management, pre-anesthetic laboratory testing, and comprehensive physical examination.

Make it happen

We could give you a few more examples, but let's move to suggestions and solutions. First, please ensure every employee who might be answering the telephone understands this message: Any caller who has taken the time to find the practice's telephone number and make the call has a problem that he/she wants solved. It is your duty to help that client get the information and professional attention needed through an established appointment.

The second issue is to make sure your employees understand that there is no way they can fail when dealing with a telephone call. One reason appointments might not be made for callers is because the employee is afraid to make a mistake. All of us deal, from time to time, with questions we cannot answer. Each employee needs to understand that an excellent phrase to state with confidence and authority is this: "That is a good question. I don't know the answer, but I will find out for you. Please give me a phone number to call you, and I will get back to you promptly."

Or, alternatively: "That's a good question. Let's schedule an appointment so you can speak to the doctor who can resolve the issue for you. Is 2:00 tomorrow afternoon a good time for you?"

Practice makes perfect

Here are a few standard questions your employees should be practiced at using:

If the caller is not known or the name is not recognized, the receptionist should ask: "Are you an existing client, or are you new to our practice?"

If an existing client, the staff member should politely ask for the client's full name and name of pet.

If the caller is a potential new client, then at some point, the receptionist may want to say at an appropriate point in the conversation: "Since you have not been to our practice before, let me tell you a little bit about us."

When issues of fee-shopping occur, use this phrase as suggested by Dr. Wayne North, consultant: "For all of these services, we charge only $______."

Each employee with phone answering responsibilities should clearly understand at what point a caller problem indicates urgent or non-urgent care. For an excellent training reference and flow chart to assist in a variety of called-in medical dilemmas, consider "The Veterinary Receptionist's Training Manual" by Drs. Jim Wilson and Carol McCormick, AAHA Press (phone: 800-252-2242).

If a caller refuses to schedule an appointment, but has been looking for information, try the following: "May I send you some additional information about our practice?" Or, if your practice maintains a current and active Web site, "If you would like more information about the services we provide and also access to excellent articles about pet care, you can visit our Web site at ___________."

Don't take employees' effective response to incoming calls for granted. Many employees have not had adequate training that allow them to "close the sale". Many employees need booster shots to practice through role-playing effective phone techniques. For every telephone call a practice receives, there is an opportunity to establish a long-lasting relationship with a client.

No employee should ever lose sight of the responsibility for giving the client the opportunity to establish a bond with the practice. This responsibility to the client and pet can only be met by making the appointment at the point the individual calls.