Don't underestimate good, old-fashioned human contact
John Price calls the clinic and is complaining.
He thinks that his cat, Nellie, is long overdue for her leukemia vaccination and no one called or sent a reminder. He also said that Dr. Kent wanted to do some blood tests and X-rays this spring.
He seems to remember that the last time Nellie got her "shots" she had a reaction and almost died. Now, on the other hand, his dog Riley was hit by a car last year and died. He was sure that he told Dr. Kent this fact when he saw him at the convenience store last fall. Yet, he states that he keeps getting reminders from the clinic urging him to bring Riley in for a heartworm test. Your receptionist Karen has mined the database and found that all of Mr. Smiths' reminders are in the computer and were sent with all the other reminders last month-unfortunately including Riley's. Nothing is noted in the computer about blood tests of radiology or reaction to shots for Nellie. She naturally finds that Riley is still "alive" in the computer. Karen pulls the chart and finds that Mrs. Price brought Nellie in this past June for itching and was given a steroid injection. Nothing else has been written down except that the technician discovered that Riley had gotten her leukemia shot at another vet office which was offering discount flea baths. Dr. Kent, a solo practitioner is on vacation.
Karen's options are:
·1. Schedule all the requested items with Dr. Susan Barnes, the relief vet, and note that Dr. Kent is on vacation.
·2. Ask another vet across town what he or she would do and ask if there are any positions opening soon.
·3. Board the cat until Dr. Kent returns and begin your vacation.
·4. Ask the technician or the relief vet what to do.
·5. Schedule an appointment for the client to see Dr. Barnes and write a full summary of the conversation. Then go explain everything to Dr. Barnes.
The answer is number 5.
Dr. Barnes needs every advantage possible in dealing with this client-especially the client needs and perceptions. Karen should convey every confidence in Dr. Barnes and try to resolve all issues that concern the client in a friendly and professional way. Since Dr. Barnes is likely on overload, Karen needs to talk about this issue with Dr. Barnes between clients and/or procedures so they can both focus on the issue.
Welcome to the world of over-reliance on technology and under-reliance on normal human communication.
Communication Problem #1
The Deer in the Headlights
It is quite common for a veterinarian to meet clients away from the office and away from the pet and be clueless as the actual names attached to the faces they indeed recognize but can't place. It is easy for the client to say, "Hey, Doc" without recalling the veterinarian's actual name, but almost impossible for the vet to have total recall concerning the owner and pets let alone the specifics and plans for all their maladies.
Yet clients somehow have great confidence in all this and relay information that is expected to be hard-wired forever in the veterinarian's noggin.
Communications Problem #2
The Write Stuff
Veterinarians are busy people. If they are too busy to write medical/surgical plans in the chart or into the computer, then client and staff misunderstandings will be standard fare in the hospital.
Solo practitioners are often independent people and will modify patient planning as the need arises, i.e. without written plans.
This is a problem waiting to happen when the "Doc" is out of town or out of gingko biloba.
Communications Problem #3
You cannot really blame people for shopping around. We all do. Client loyalty is fast becoming a thing of the past. We live in a convenience-oriented society and bringing a pet to a veterinarian can be quite an inconvenience.
Also there are times when spouse A will not talk to spouse B about an assortment of things-including emergency trips to the vet for the flea baths. This, of course, spreads our patient's history records around. The chain of communication is inevitably broken and blind spots present themselves to the next veterinarian who sees the pet.
Communication Problem # 4
Over-Reliance on the Computer
Naturally, the computer cannot phone a client and discern their intentions and straighten recall issues out (at least not yet). This is the reason we have human beings. Unfortunately, we have become blinded by the computer's amazing ability to sort and prepare information for us to use.
It is important that we know the limitations of this technology. Therefore, if you are just blindly letting your computer generate reminders without some oversight, office predicaments will be inevitable and medical care will suffer.
Some solutions are available.
1. Make an effort to memorize names. Everyone remembers a face. This is because the face is the overwhelming visual image related to a time and place. Most people when meeting someone for the first time will let the visual images overwhelm the abstract portions of their brain-thus when a name is offered, it quickly (often immediately) is forgotten. Make a conscious effort to connect the abstract name with the visual image of the person. If you are overwhelmingly visually oriented you will be surprised that you can actually recall the name by concentrating on the medical chart itself recalling the name just by bringing the visual image of the medical chart into your head. I have found it helpful to write the person's name down somewhere for future reference when I first meet them.
2. Carry a crutch. This can be a 3x5 card or a Personal Digital Assistant. When you make recommendations to or receive information from a client who has "caught you off guard" and away from you database or medical record-write it down and later inform your staff to update your database and/or make an entry in your pre-appointment book. (see sidebar)
3. Write everything down in the hospital record. Try to follow a communication pattern that works for your hospital. The doctors must be encouraged to write therapy plans that are legible and ensure that their intentions are clear to anyone reading the chart or computer.
4. Make some phone calls. If an obvious vaccination or history gap appears in the record in spite of protestations to the contrary by the owner, call your colleagues and inquire about visits to their hospitals that your client (or their family) may have made on behalf of a pet. It is common for clients who use multiple hospitals for their own convenience to have memory lapses concerning the location of Fluffy's last shots. This can be time consuming, but you will be rewarded with information that you will need to proceed.
4. Use Post-It® notes: Truly an invention right up there with sliced bread. Notes can be placed in strategic places in the veterinary hospital where the unwary can be sufficiently trapped and moved to action.
5. Use old-fashioned human contact. You may not know it but as we have become more computer reliant in our culture the messages themselves are getting lost. More and more things in our culture work to keep your clients "off message". Computer generated reminders from all sources have lost their freshness in our homes as we increasingly are deluged by every sort and variety of messages from e-mail, FAX, video and print to TV. More and more of these messages are being received from a torrent of constantly evolving technological gadgets. Your attractively imprinted reminder card, which previously was reverently placed under a refrigerator magnet, now is simply lost in the deluge. We should use an old technology in a new way-our telephones. (See sidebar). You would be surprised at how many of our clients, in addition to the usual updates we give them on a pet's blood tests and hospital status, really appreciate telephone reminders for their pet's anticipated needs as they arise.
Dr. Lane is a 1975 veterinary graduate of the University of Illinois. After graduation he practiced as an associate in California before moving to Carbondale, Illinois and establishing Lakeside Veterinary Hospital in 1978. Dr. Lane completed a master's degree in agricultural economics in 1996. He is the author of numerous practice management and economics articles.