How to maintain sanity, schedule with new client

How to maintain sanity, schedule with new client

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Sep 01, 2001

You open the door to the exam room. On the other side of the table and occupying what seems to be half the room sits John Smith, 20 minutes late and weighing 350 pounds. Beside him is his similarly obese Saint Bernard, Ranger- restless and salivating onto all flat surfaces.

At the sound of your voice, Ranger emits a low growl and urinates freely on the floor. In John's arms, present for moral support, is "Pixie," a 4-pound Yorkie terrier. In the corner sits 5-year-old nephew, Jason. Your seemingly simple job is now daunting: In 15 minutes you are to give Ranger's annual vaccinations, annual lab tests and a physical examination for lumps, bumps and constant scratching. Suddenly, John's cell phone rings.

Veterinarians are presented daily with similar situations. How you handle them affects your professional reputation, income and, ultimately, your emotional health.

If you and your staff don't have a game plan it will ultimately lead to burnout.

Avoiding burnout

Over the past several years clients have complicated our patient examinations by bringing with them a second pet (along only for the ride), cell phones, beepers and assorted gadgets, children, and physical limitations.

The landscape has changed forever. Bottom line: the owners are overburdened and preoccupied.

Asking them to lift the pet and restrain it on the exam table for even a small period of time is problematic and unsafe-for both you and the client.

In addition, educating a distracted client under these circumstances is challenging. Since clients often bring multiple problems and circumstances to us, the traditional 15-minute office visit is out the window.

An unorganized visit by Mr. Smith and his dogs can cost your clinic both time and money. Several questions need to be addressed.

* Can you maintain your emotional balance?

* Will this client and pet have a positive experience at your office?

* Will you be able to manage all the needs of this patient in a timely and efficient manner?

* Does this pet present a safety issue for the client and staff while in your clinic?

Short answer

While this article does not address staffing issues directly, the short answer to these questions begins with proper staffing.

If you are still practicing by yourself with only a receptionist and a kennel worker because you cannot afford to hire more staff-think again. The economics long term are against you. There is no substitute in today's fast-paced world for properly trained staff-especially exam room assistants. Whether you are a solo practitioner or have multiple associates, staffing for the exam room is essential.

Can you maintain your emotional balance?

Before meeting John Smith and Ranger, you had just left your other exam room where Mrs. Brown had brought "Jake" to have a nail trim.

According to Mrs. Brown, only the veterinarian appears qualified to trim his nails. Jake had never been on a leash before today and was full of smelly hair-mats. In addition, he was dripping with mud from the morning rainfall.

Much of your staff's time was spent mopping the floor and changing smocks. While we wrestled with Jake, Mrs. Brown tries to balance her checkbook and groused that she was late for her daughter's soccer tournament.

After your encounter with Mrs. Brown, you try to recoup your composure as you enter to work with Ranger.

Having reviewed the scene, you wait as John Smith finally clicks his cell phone shut. He seems agitated that he had to wait an extra few minutes. How do you react?

The battle now is to retain your professional deportment. As difficult as your day may get, you must maintain your composure. Otherwise, you will lash out at the people who are there to support you and your patients-the staff. Here are some tips.

* Take a deep breath-it works

* Avoid petty arguments with clients. Instead, be supportive and understanding of their point of view. Never play the 'bad guy'.

* Always thank your employees for working through difficult situations.

* Maintain an exercise program. This helps balance your physical and emotional body chemistry.

* Never degrade or talk about a difficult client after they leave. This type of behavior is self-defeating and is the hardest thing of all to do. It sets a negative tone for your whole hospital environment. Once you start, your employees will follow your lead.

A positive experience

Your reputation may hinge on a positive or negative experience people will have in an examination room.

Bad news spreads quickly. People will gauge your competence not on your knowledge but on our compassion and care for their pet. Remember that this is the owner's baby. An animal's negative behaviors such as biting, scratching and elimination behaviors will likely be attributed to the veterinarian and not the animal itself. In other words, the patient doesn't "like" the veterinarian.

Unfortunately, an owner often tends to harbor lifetime attitudes and biases based on a single experience. Things that can improve your chances of creating a positive experience:

* A lowered and softer voice

* Calling the pet by its name and using "baby talk."

* Lowering your position or first examining the animal while you sit on the floor.

* Avoiding eye contact with aggressive animals.

* Gently separating the animal from the owner.

* An assistant for restraint during the exam.

* A professional and friendly attitude in the exam room and at the front desk.

Time efficiency

For Ranger's annual visit to be handled efficiently, the needs of the client and the needs of the patient should be organized in such a way that they are crystal clear to all staff members. These issues should be arranged in such a way as to reduce the total time your client spends in your office.

First things first

Certain procedures should usually be attended to first.

If the owner needs medicine refilled, find this out up front so these can be done in the background while the owner is waiting to get into the exam room or while the pet is being examined. Your goal should be to handle Ranger's visit with the greatest time efficiency possible while attending to the total needs of the client and patient.

Exam room

* Weight and temperature recorded

* History and concern of the client should be written into the chart.

* Lab tests should be taken and running before the veterinarian enters the exam room.

Three golden needs

There are three basic needs that should be addressed during each office visit.

Remember that client needs and patient needs are separate issues. Remembering them will save you and your client a lot of time.

Have you met the owner's needs? No matter how appropriate the therapy, if it does not address the owner's chief complaint you have achieved nothing in the eyes of the client. You must address the problem as perceived by the client with either appropriate therapy or be prepared to justify your reasoning for not treating the owner's chief complaint.

Not addressing the chief complaint is one of the worst time wasters in veterinary medicine because it creates unnecessary recalls and frustration for the client. Education of the client is the key.

Have you met all the current real medical needs? The pet has certain current needs. Have you addressed them all? Have you recorded these needs on the medical record?

Have you made proper provision for future needs? Do you have a written future therapy plan for the pet that has a guaranteed follow though? This issue is critical to the health of your patient and practice. This is best done with a three-pronged approach: appointment cards and confirmed appointments for the next visit, postcard reminders for annual exam and vaccinations, phone calls for future surgeries and procedures, and written instructions for the client in the exam room.

If you cannot connect the patient with the next visit, you will delay or miss 50 percent of the work needed for the pet. This is not good medicine.