The technician peered at the screen. Someone noted "rotten teeth," and she recommended an ultrasound and ordered an assortment
of blood tests, cytology and blood cultures. There were no notations concerning the physical exam other than dental problems.
There was no nindication of vaccinations or a fecal test.
"Did they test Freddie for worms" Karen queried.
"Not that I see." The tech thought for a moment and then said, "It's getting late. We'll do that next time. The doctor has
recommended these procedures to find out what's wrong. Yes, that must be the case."
The technician was doing her best to decipher the doctor's notes, knowing that he had already left and wouldn't be back until
tomorrow. There was another veterinarian in the office, but the two had missed each other. There was no chance they would
Karen looked at the laundry list of recommendations and then at the total estimate: $950.
"Can I talk to the doctor about all this and about Freddie before I leave?" she asked.
"He's gone for the day," the technician said. "I can leave a note for him to call you tomorrow."
Karen was in shock. Her cat was still sick and all she had was a piece of paper.
At this point, all Karen could think about was getting her precious cat and leaving. She grabbed Freddie's pills knowing she
had no idea in the world how she would get the cat to swallow them. All she knew was that she didn't want to spend any more
time at the veterinary office. She paid her bill and left.
Later that evening Karen tried to Freddie a pill. She wrapped it in cheese. She tried hiding it in a cat toy. She tried slipping
it between his clenched back teeth. Finally, she gave up.
Two hours passed. Freddie took a stroll to his water bowl and collapsed. He died a few minutes later.
We are failing
Not all stories end well in veterinary medicine. This one certainly did not. Each of us has an opinion and a tentative diagnosis
about Freddie. One thing is for sure, we will never know whether Freddie could have been saved because the hospital failed
to perform his work-up in a timely manner. As a profession, we must strive to do better.
What are the chances that Karen will ever return to this veterinary hospital? What are the chances she'll want another pet?
At best, they are diminished.
This scenario is more than a story about the tragedy of a lost pet. Unfortunately, it represents issues facing hospitals across
the country. In the past few years, our profession has grown more akin to human medical practice, a trend that does not bode
well for client satisfaction. (See "The Satisfaction Matrix" for a comparison between physicians and veterinarians today.)
Client Satisfaction Matrix
Client satisfaction is declining
Clients of both veterinary and human medical practices are increasingly dissatisfied with the care they receive. For us, decreased
satisfaction has likely led to decreased patient visits over the past few years. Why are customers less satisfied now?
Two trends have emerged in the last two decades. One is the need to demonstrate profitability as a business (beyond providing
a living for an individual owner). The other is the growth of the multi-doctor business model. These trends are not inherently
bad but can lead to poor practice models that decrease client satisfaction.
The pressure to improve profitability is real. The costs to deliver quality medicine are high. Practice management advisers
have harped about the need for fee increases for years, but we may have reached a tipping point. When are prices too high?
We may have just found out. We must keep our clients satisfied in all aspects of service delivery, including perceived fee
Higher prices have increased profitability but have taxed our best clients and reduced visits from the remainder. The second
trend, toward multi-doctor practices, has reduced client satisfaction as well. Multi-doctor practices reduce the ability of
clients to see same doctor and often create therapy conflicts if more than one doctor is involved in a patient's treatment
Client satisfaction is down. Veterinary office visits are down. The scenario presented in this column offers telltale clues
to the top reasons client satisfaction is declining.