While clients offer untold excuses as to why they fail to comply with heartworm recommendations and senior screenings, the
blame sometimes belongs to the one giving - or not giving - the recommendation.
An often-overlooked barrier to client compliance is the veterinary practice itself, according to the American Animal Hospital
Association (AAHA), and much noncompliance occurs because no recommendation is made. These findings and a spate of other compliance
shortcomings were highlights from a study on client compliance presented at the recent AAHA conference in Phoenix.
Compliance - defined by AAHA as the sum of the recommendation gap, follow through and client acceptance - directly influences
the level of care that practices can afford. "We all strive to provide the best patient care, but it's impossible for practices
to accomplish this mission if they do not closely monitor compliance," says Dr. John Albers, AAHA executive director, who
spoke at the session.
Dr. John Albers
Dr. Earl Cornprobst admits he's "as bad as anybody else" about providing good recommendations. Although he relies on a semi-annual
printout of compliance records for tracking purposes, he says he's now aware of areas, such as dentals and senior screenings,
that he should track more closely.
"Compliance depends on the individual staff and is based on the ability of the hospital to market its services. We must educate
clients first," he says.
Dr. Richard Coe admits AAHA's findings were "shocking." "I just hope veterinarians return to their offices now, share the
findings with others, and check their own records for compliance," he says.
The findings are part of a larger study not yet published by AAHA. As previously reported in the April issue of DVM Newsmagazine,
the study explored compliance related to heartworm, dentistry, therapeutic diets, canine and feline core vaccines, senior
screening and pre-anesthetic testing.
"Client compliance is definitely not the sexiest subject at this meeting," says Melinda Boehringer, practice manager of Fremont
Animal Hospital in California. However, she says her proactive practice has witnessed the payoffs of client compliance. Noting
recent figures on vaccines, Boehringer found 85 percent in compliance.
But she credits the client as much as the clinic. "We have an affluent client base, which has an influence. For that reason,
compliance is rarely a problem because of financial reasons."
Tallying it up
Medical records from more than 1,400 cats and dogs from 240 practices were gathered to quantify compliance. An additional
1,003 pet owners were surveyed. Key findings include:
- Heartworm. In endemic areas, 83 percent of dogs are in compliance for testing, but only 48 percent comply with preventive
- Dentistry. Of dogs and cats with grade 2 or higher dental disease, 35 percent have had a dental prophylactic. Out of the 60
percent of dogs and cats that needed dental work, only 34 percent of clients received recommendations; 17 percent of those
- Therapeutic diets. Only 19 percent of dogs and 18 percent of cats are in compliance with appropriate therapeutic diets for
six specific diagnoses.
- Core vaccines. The area with highest compliance found a whopping 87 percent of dogs and cats are in compliance with veterinarians'
recommended vaccine protocols. Changing protocols were factored in.
- Senior screenings. Although no hard data was available, the study found that senior screenings achieved low compliance most
likely due to low frequency of recommendations.
Complete results of "The Path to High-Quality Care: Practical Tips for Improving Compliance" will be published this spring
and will include a CD-ROM that runs on MS Excel. The software tool will enable practices to measure their protocols and will
offer suggestions to alleviate gaps in recommendations and client compliance. The resource set will be available for $10 for
AAHA members; $50 for nonmembers. To order, call (800) 883-6301.