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Healthier patients are an annual visit away

DVM Best Practices

Step 6: Offer general recommendations. Give the client a recommendations handout (Figure 3) with these lists: 1) 12 steps to keep your cat healthy, and 2) 18 early signs of disease. This handout should include instructions to bring the cat in for an exam if the client notices any signs of disease.

Step 7: Give the appropriate vaccinations. The cat receives appropriate vaccinations based on risk assessment. Doing this last sends clients a message that, although vaccinations are important, they aren't the most important part of this visit. My goal is to emphasize healthcare. Having a technician give the vaccines further emphasizes this point, if your state board permits it.

Figure 2. Annual Exam Report
Tips to make it work Once you've established your program, you'll need to take steps to reinforce your message. For example, I use fees to emphasize the importance of the annual visit. I charge $4 more for an annual exam than for a routine exam. But I charge minimal fees for the vaccines—I only charge $5 for feline rhinotracheitis-caliciviruspanleukopenia vaccination. Ironically, the bottom line cost for the visit is about double what I used to charge when I priced vaccines higher and didn't charge for the exam. Another important point: Giving fewer vaccines doesn't significantly alter the total bill.

Initially, I priced the annual visit the same as my routine exam. I increased the fee after about 18 months. Some clients said they didn't want the exam, they only wanted the vaccines. After checking with my state board, I found that a rabies vaccine could only be administered to a healthy animal, which required an examination by a veterinarian. If clients complained, I agreed to a brief exam, which omitted steps 1, 2, 4, 5, and 6. If they further insisted on no exam, I told them they would need to find another veterinarian. I lost very few clients, and those who left were not missed.

I handle the initial puppy or kitten series a bit differently. I omit steps 1 and 2, and I charge my routine exam fee for the first visit with the same vaccine fees. On the second and third visits, I charge a recheck exam plus vaccines, unless I spend excessive time examining the pet or talking with the client. In this case, I'll charge the higher exam fee.

Figure 3. Recommendations for cat owners
Everyone wins We see enormous benefits from our annual wellness program every day. For example, we're now more efficient because a technician precedes me and completes the first two steps before I enter the room. This saves time and allows my practice to care for clients and patients more efficiently. And clients feel better served—several have told me that we give their cats better exams than the clients receive from their own physicians. Our client numbers continue to grow from referrals. And my annual visit compliance has skyrocketed to 94% within 18 months of sending out reminder cards.

My practice is literally fueled with findings from annual visits. We perform an average of more than 50 ECGs per week, including those performed during annual visits, on cats with cardiac disease, and for preanesthetic screenings. Because we aggressively evaluate and treat cats for cardiac disease, we also average more than 10 echocardiograms per week. This means additional income from radiographs, laboratory tests, hospitalization, drugs dispensed, and therapeutic diets.

Today, my patients are healthier—and so is my practice. Sure, my current approach isn't the way I practiced for the first 25 years of practice. But it's one of the best changes I've made.

Reference 1.Norsworthy G.D.; Another perspective on the vaccination controversy: Redefining the annual visit. Vet. Med. 94 (8):736-742; 1998


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