This is a story about Mrs. Dunn, her dog, Tootsie, and their visit to the veterinarian. It is a fictional account, but it
could just as easily have happened at any veterinary practice on any day of the week, according to the American Animal Hospital
Association's (AAHA) newly published Compliance Study.
Mrs. Dunn and Tootsie, her sweet-natured brown Dachshund, had just finished Tootsie's annual exam, and they were at the front
counter to settle their account. Mrs. Dunn wrote her check for the day's examination. Upon concluding the transaction, she
smiled and said goodbye to the receptionist. She picked up Tootsie and waved the dog's paw in a good-bye gesture, too, and
they left. The visit went well. The client left happy. Tootsie received the medical attention she needed ... or did she?
How patient careis unintentionally compromised
Tootsie is a 9-year-old, spayed Dachshund. In the examination room, the veterinarian had mentioned that it might be a good
idea to set Tootsie up for a dental prophylaxis and take blood for a senior laboratory panel. The doctor commented that Tootsie's
weight had been creeping up for the last couple of years and that it might be a good idea to put her on a reduction diet.
Mrs. Dunn nodded her head in agreement with these suggestions and seemed to pay attention to everything the veterinarian said.
The doctor vaccinated Tootsie and as he was leaving, said he would like to start seeing her every six months. Mrs. Dunn again
nodded in agreement. After the doctor left, the technician came in and took a blood sample for Tootsie's annual heartworm
check. She said she would let Mrs. Dunn know if there was a problem, but that the doctor said they should take Tootsie's heartworm
preventive home today.
Upon checkout, the receptionist generated an invoice that listed the health examination, the vaccines, the heartworm test
and a six-month supply of heartworm preventive medication.
Did Tootsie get the care she needed? What was missed?
Did you identify:
- Scheduling the dental prophylaxis?
- A weight-reduction diet to take home?
- Scheduling Tootsie's new six-month senior exam?
- Setting up the refill reminder for Tootsie's heartworm preventive?
- Taking blood for the senior panel?
- Client literature and someone to talk to about the new services recommended for Tootsie?
Missed patient care opportunities are more common than veterinarians believe, according to the AAHA Compliance Study. The
study reports that patient care opportunities, like those listed previously, are among the most common that occur in companion
animal practices in North America. (For more information on the AAHA Compliance Study, visit the AAHA Web site at AAHAnet.org.)
Three barriers to compliance
The AAHA Compliance Study identified three barriers that veterinarians need to overcome to ensure that patients consistently
receive the quality care they need.
The barriers are:
1. Convincing themselves and their staffs that compliance is a problem. Veterinarians and their staffs do not believe it is
a problem in their hospitals. Most veterinarians "guess-timate" their hospital's compliance levels, but according to the AAHA
Compliance Study, compliance levels are almost never as high as they think they are.
2. Many veterinarians and their staffs believe that the clients are the problem and that there is nothing they can do about
it. Veterinarians may say:
"Clients won't pay for it."
"Clients will think I'm only recommending things to make more money."
In either case, the recommendations aren't made.
3. Clients' perceptions are that recommendations and follow-through are lacking. This may be a reality, and it could also
be a communications problem. Nonetheless, it appears to be a serious barrier to improving hospital compliance scores.
The AAHA Compliance Study directly addresses veterinarians' misperceptions with new data about actual compliance levels for
core vaccinations, pre-anesthesia panels and other routine veterinary services. It shows that compliance is a serious, but
unrecognized problem in most veterinary hospitals.