Achieving client compliance-start early
Client compliance is directly proportional to client knowledge. Clients must be educated by the veterinary staff for success
to occur. Senior education is first discussed well before pets reach their senior years. If possible, begin discussing preventative
blood profiling during the first puppy visit and relate that puppies, adult dogs and senior dogs have different medical needs
and therefore require care depending on their life stage. For example, puppies have different nutritional requirements compared
to older dogs. Review the overall plan for "wellness" during the first puppy visit including mention of preanesthetic testing
and yearly blood profiling when the patient reaches the senior years. Use the age analogy chart during each yearly visit to
help clients understand the aging changes occurring and to emphasize the importance of preventative health and nutritional
Achieving client compliance-continue educating
Pre-anesthetic testing makes the transition to yearly blood profiling more logical as patient's age. Baseline results obtained
during pre-anesthetic testing for neutering, dentals, lumpectomies or other anesthetic events provide valuable comparison
data for interpretation later in life, plus owners become familiar with the procedure increasing compliance for future profiling.
Yearly profiling should begin when the patient reaches the senior age threshold - veterinarians may understand the recommendation
but how about our clients? Educational materials are critical if we expect clients to comply with our recommendations. Report
cards summarizing physical exam findings and our medical recommendations are helpful in increasing compliance. Define the
senior pet by including age charts on your report card to help educate owners on what pets are seniors. Specific brochures
explaining the benefits, components and costs of the senior program allow owners and other interested parties to continue
the education process at home. Senior wall charts a poster form of the age analogy chart, defines which pets are senior or
geriatric and therefore educate owners in the exam room.
Achieving client compliance - it's the teeth!
Achieving increased client compliance can best be realistically accomplished by combining senior and geriatric blood profiling
with ultrasonic dental scaling. Using the senior health profile as a pre-anesthetic test for dentistry increases anesthetic
safety and increases owner compliance by decreasing owner anxiety. Most owners understand the need for dental scaling yet
owners of older pets may not comply with your recommendations because they fear anesthesia. A complete senior testing program
helps decrease anxiety by increasing safety thus increasing the number of dental procedures and initiating the concept of
yearly testing. Furthermore, the majority of older patients require yearly dental scaling setting the stage for yearly testing.
Annual reminder cards help remind clients about vaccines, heartworm testing and other recommended procedures - why not health
screenings? Clients are familiar with reminder cards so use them once the senior program has been initiated.
The Metzger Animal Hospital Five-Step Program
Step 1: Front office stage
Our front office team members are instrumental in the success of any new program and senior care is no exception. Receptionists
actually play two important roles in the senior and geriatric program - as initiators and closers. Receptionists start the
senior care experience by identifying which patients will potentially participate in the program. Patients are greeted then
weighed on scales in the reception area thereby allowing the front office team member to determine the appropriate age group
using the age analogy chart. Clients with senior or geriatric pets are given a copy of the age analogy chart on a clipboard
and asked to complete the form in the examination room. Step one completed.
Step 2: Technician/assistant stage
Technicians and assistants initiate step two by assisting clients in completing the age analogy form (if necessary) and reinforcing
the concept that the pet is senior or geriatric. If possible, examine the teeth to determine if a dental is required - most
older pets have dental disease. Our practice uses dental photographs to increase client compliance by providing visual reinforcement
for the doctor's recommendation. Technicians or assistants usually produce the dental pictures with the clients in the exam
room or in the procedure area when trimming nails, cleaning ears, etc. Technicians and assistants end their senior assignment
by informing the doctor about the patient's age and dental status and providing the dental photograph for the continuing education
in step three.
Step 3: Veterinarian stage
Doctors continue the education process by emphasizing the importance of dental health. Let clients grade their pet's dental
health by comparing the dental photograph with a dental wall chart or dental pamphlet available through companies selling
take home dental products. Clients must understand that dental disease can contribute to serious medical problems especially
in older pets. Acknowledge the owner's fear of anesthetizing older pets then help dismiss those fears by explaining the benefits
of your senior program! Your senior program not only helps improve anesthetic safety but also allows the early detection of
laboratory abnormalities-early detection is the basis of the program! Give written recommendations using client dental education
handouts then end the appointment. Hand the client completed age analogy chart, the doctor completed recommendation form with
dental photo to your front office staff and let them do the rest!
Step 4: Schedule, schedule, schedule!
Your front office staff is the most important component for senior success - they start it and they end it. Receptionists
must ask to schedule the senior/geriatric dental or it just won't happen. If clients need more time or are not interested,
simply send a reminder card in one or two months. It is our duty to educate clients about senior care and dental disease -
Step 5: Rewards
Successful teams share their rewards - so start sharing. Top performers deserve the top rewards so measure and motivate. Metzger
Animal Hospital currently uses the "Gold Star" reward program to measure team member individual and group (receptionist, technician,
and doctor) performance. Each team member involved in the scheduling of a senior or geriatric profile is awarded one gold
star; consequently, the receptionist, technician and doctor are individually and instantly rewarded for their efforts. Rewarding
the team immediately reinforces the practice goals and provides for friendly competition. Start giving stars to your stars!
Interestingly enough, no one has yet to ask me what the stars are worth.
Financial benefits of the senior health program
Senior testing is better medically for our patients because it allows earlier detection of diseases. Senior pets represent
25-35 percent of our patients and this number will most likely increase as technology progresses. Senior medicine will become
an increasingly important profit center for veterinarians. Increased income results from increased laboratory testing, reflex
testing, increased use of veterinary recommended diets, increased number of dental procedures, increased pharmaceutical income
from diseases diagnosed, not to mention the income (vaccine, heartworm testing and preventative, flea products, etc.) derived
simply from patients living longer through better medicine. Follow the Metzger Five Steps to Senior Success and join me in
the most exciting development in veterinary medicine's new millennium!
- Senior Care: Case by Case ; Proceedings from the 1999 North American Veterinary Conference The Gloyd Group 2000.
- Reinventing Senior Care; Dawn Grubb Vet Economics Special Fall Edition 1999.
- Starting a Senior Care Program; Fred Metzger DVM, ABVP Vet Economics June 1999.
- Senior Care 2001: The Impact of Aging on Everyday Cases; The Gloyd Group 2000.