For example, let's return to scenario two. Dr. Methodical has just completed his recommended laboratory evaluation and begins
discussing the findings, face-to-face, with the owner. Dr. Methodical uses the initial lab report as a work sheet to outline
the differential diagnosis and develop a rule-out plan for each item on the differential. By visualizing the doctor's thought
process and recognizing the importance of each step, the client is far more likely to accept the necessary additional recommendations
for proceeding with the diagnostic plan. The client will accept additional laboratory tests, radiographs or ultrasound or
other necessary diagnostics. Building value to these follow-up tests by client education will usually help in gaining the
necessary compliance. This same philosophy applies to recommendations for surgical, dental and other procedures.
Table 2. The 5 steps to gaining compliance.
Reflect on the latest challenge - that of maintaining the "annual visit" without the "annual vaccination." Practitioners will
need to use every morsel of credibility and client trust they have hopefully built over the years in facing this new compliance
challenge. Getting clients to bring in their pets for annual exams when they may not need an annual vaccination will be the
supreme test of the practitioner's compliance skills. See this month's DVM Newsmagazine's InFocus supplement for ideas.
Common obstacles to educating clients
- 1. Insufficient appointment times.
All too often practitioners become frustrated about getting a client to accept a particular recommendation. The problem
often starts with scheduling appointments. The allotted times are often not sufficient for spending the necessary time to
make a client aware of the need for complying with a recommendation. Without adequate time the client doesn't have the time
to ask questions and gain the necessary knowledge to comfortably make a decision.
- 2. Lack of sufficient visual aids.
Special effort must go into creating a visual image. A drawing, picture, model, live animal, computer or video monitor is
extremely helpful in educating a client. In my practice, we use an LCD screen attached to a camera on a microscope to help
the client gain knowledge and build trust in the recommendation in prolonged treatment necessary for a difficult mange case.
By seeing the organism on the scope it creates a strong mental image that will greatly enhance owner compliance.
- 3. Lack of sufficient exam room help.
Taking time to vividly demonstrate periodontal disease to a client will convince an owner to comply with a dental prophylaxis
recommendation. But this cannot be accomplished if owners are expected to restrain their own pet during the examination. A
major shortcoming in demonstrating dental disease in many practices is simply due to the inability of the owner to visualize
inflamed gums while they are struggling to restrain their pet.
- 4. Not building an adequate case for compliance.
Many times the busy practitioner fails to build an adequate case for compliance with the recommendation. A concerted effort
must be taken. Being in a hurry and skipping key educational steps will lessen compliance or may cause buyer's remorse later
on. Time spent in this area will also improve client acceptance of higher fees that often result from complex workups or procedures.
The ability to acquire compliance with recommendations is usually related to paying attention to many issues over time. It
is important to have created the proper groundwork for client compliance by building a solid connection based on trust and
credibility. Assessing individual client's preconceptions and spending effort addressing them is very important. Spending
adequate time and energy, using visual aids, charts, drawings and worksheets to engage the client is indispensable. Most of
all, building an adequate case for compliance with recommendations by thoroughly educating and engaging the client will boost
client value perception and usually result in compliance. The practitioner's ultimate goal should be to educate the client
so well that the client can only arrive at one logical conclusion, that of compliance with his or her recommendations.
Dr. Irwin has been a small animal practitioner for 31 years. He has owned and managed three practices in suburban St. Louis
for more than 20 years. He has spoken on topics including practical hematology, diagnostic testing, wellness screening, using
high technology equipment such as a CO2 laser and other in-house diagnostic equipment to enhance the quality of practice.
He has lectured to veterinary groups throughout the United States, Canada, Australia, New Zealand, South Korea, England, France
and Germany. He has written and published more than 30 articles in veterinary books and journals. His topics include the use
and marketing of in-house laboratory diagnostics, CO2 laser and other higher technology equipment to improve the level of
practice. He received his veterinary degree from Purdue University in 1971.