7 howl-worthy strategies from top-performing veterinary hospitals

Most veterinary practices, like most small businesses, are eager to leave 2011 behind. The profession spent a lot of time discussing why client visits have been declining over the last 10 years, a necessary but not always encouraging subject. The Bayer Veterinary Care Usage Study of pet owner behaviors and motivations brought to light a number of useful factors and potential solutions (see the May, June, and July 2011 issues of Veterinary Economics for more details).

(LUIS CARLOS TORRES/GETTY IMAGES)

What has been less well-publicized is the second phase of that research, which focused on veterinary practices—particularly those that have seen increased veterinary visits over the last 10 years, the same time period when the trend has gone the other way for most practices. What have those practices done to drive demand for their services? What do they have in common? That's what the researchers proposed to find out—and what this article lays out. As we enter 2012, it's time to find something to celebrate.

So, without further ado, here are the seven things you can do to increase demand for your services, based on evidence from practices that are already doing them. Make these strategies an everyday part of your practice and soon your clients—and you—will be howling with newfound enthusiasm.

1 BUILD INDIVIDUAL RELATIONSHIPS

In practices we studied that were seeing increased patient visits, the No. 1 thing they did—the top driver of demand for their services—was ensuring that clients saw the same veterinarian every time they visited. Pet owners want a personal physician for themselves and also for their pets. Plus, when you see the same client every time he or she visits, it fosters familiarity and builds confidence in your skills and advice, creating a high degree of trust. And when you see the same patients routinely, you know what care they've received and notice if they haven't been in for a while, allowing you to be proactive in scheduling a visit.

Another important driver of demand for veterinary services is believing that wellness exams are one of the most important services you provide. If you believe this to be true and have a longstanding relationship with clients built on trust, they're going to believe in it too. Keep in mind that clients want to please you as much as you want to please them.

2 MEASURE CLIENT SATISFACTION

Although it's commonly known that veterinarians want to please their clients, our research shows that only one out of five practices conducts client satisfaction surveys. You really don't know how good of a job you're doing unless you measure success.

Make new friends: How to network

In 2005, the AVMA/Pfizer Business Practices Study found that measuring client satisfaction was one of the top drivers of veterinary income. But since then we haven't made any progress as a profession in measuring client satisfaction.

There are lots of ways you can measure satisfaction, including new client surveys, after-service surveys, and annual customer satisfaction surveys. And surveying is incredibly easy to do. Many practice management systems include surveying as a feature, or there's inexpensive software you can purchase separately. I recommend conducting your surveys electronically, because that's the way people are used to receiving and responding to surveys these days.

I often have veterinarians tell me they don't survey clients because they don't have time. Or they don't get that many responses. Or they don't know what to ask. But as of 2011, more than 30 percent of appointment slots are open in the average practice. Use that extra time to launch a survey. While it's true that you may not get many responses, just asking people for feedback fosters satisfaction and loyalty. Clients view the survey as an indication that you really care what they think. And it doesn't take that many responses for you to identify trends and potential problems you may need to address.

If you don't know what to ask, use sample surveys and adapt them to your situation (see "Web resources" for tools from http://dvm360.com). Be sure to ask about the clarity and completeness of your communication. In our research, we found that veterinarians think they do a great job at communicating, but clients aren't always quite so clear on what you're trying to tell them.

Also ask about the value-for-money of your services, the ease of doing business with you, the quality of your customer service, and whether clients feel they're important to the practice. Finally, remember to ask about your practice's appearance, cleanliness, convenience, and so forth.

3 FIND AND BEFRIEND THE CAT

When I talk to veterinarians, I often hear that a dog is worth about two cats or that cats are worth half as much as dogs. But actually, data from VCA shows that the lifetime value of a cat is closer to 80 percent that of a dog because cats live longer and typically receive substantial care in the last few years of life. And there are more cats than dogs in the pet population. The fact is that most of the growth potential in small animal practice is in serving more cats.

Cats are significantly underrepresented in the patient base. When I interview veterinarians, they usually tell me that about 40 percent of their patients are cats and 60 percent dogs. But when I ask them to go check their records, we usually find that they're overestimating the number of cats they're seeing. It's more like 30 percent cats or even 20 percent.

One reason for this shortfall is that cat owners are more negative about veterinary visits than dog owners. Forty-one percent of cat owners say they wouldn't take their pet to the veterinarian if a vaccination wasn't needed, versus about a third of dog owners. And 58 percent of cat owners say their pet hates going to the veterinarian.

To cats, the carrier is like a medieval torture device. One of the biggest obstacles for cat owners is simply finding the cat and getting it into the carrier, so they don't bother unless the cat is showing signs of illness or injury. Yet only a third of practices instruct cat owners on how to make travel to the clinic less stressful.

Change clients' mindset by teaching them about cat-friendly transport. When you send them reminders, include information about how to acclimate cats to a carrier. When you see a kitten, show its owners how to train it to a carrier. Your goal is for cat owners to think of you as a feline practice that also sees dogs, not the other way around.

I was amazed when research showed that many conscientious veterinary clients who own both dogs and cats bring their dogs in once or twice a year while their cats haven't visited in three or four years. The kicker? Their veterinarian never asks them about their cats.

The easiest step is to ask about other pets in the household during every client visit. You'll find that many of your clients have cats you haven't seen—or haven't seen recently. When you do discover these cats, ask clients to schedule an appointment for them.

I know of a practice in Texas that was slow on Wednesdays. The team began offering a significant discount on wellness exams for cats only on Wednesdays. Now Wednesdays are one of the busiest days in the clinic.

You can also work to create a cat-friendly facility. Cat owners hate to have dogs sniff their cats in the waiting room. Allow plenty of space to keep dogs and cats separate, and move cats into the exam room as quickly as possible. (See "Web tools," for feline-friendly resources.)

4 MAKE COST OF CARE PREDICTABLE

Our research shows that pet owners fear the bill they'll get at the veterinary clinic. More than 50 percent say costs are usually much higher than expected. What's worse, they don't see the value of preventive checkups, making it more likely they'll face a large bill down the road—which will reinforce the sticker shock problem. When we asked pet owners to complete this statement, "I would take my pet to the veterinarian more often if ... ," here's what they said:

> I knew I could prevent problems and expensive treatment later.

> I was convinced that it would help the pet live longer.

> Each visit was less expensive.

> I really believed that pets needed exams more often.

The bottom line: Veterinarians must do a better job of helping pet owners understand the role of preventive medicine and routine checkups. How? First, talk about the recently published guidelines from AVMA and AAHA that recommend wellness exams at least annually to maintain proper preventive care for dogs and cats. Second, provide a complete report card at the end of each exam. No matter how well you communicate in the exam room, pet owners don't remember most of it when they get home. Almost every practice management system features built-in report cards, and sample report cards are also available online (see "Web tools"). Give pet owners a written report card to take home and they'll then remember what you did and what you found.

The third thing that really resonated with pet owners in the research was a full-year health program that outlines what the pet needs, when it should come in to visit the veterinarian, what things to look for, and how to keep the pet healthy. Thirty-nine percent of pet owners said they would visit the veterinarian more often if they had such a plan. And if it's breed-specific, it's more valuable, because then they understand that it's really tailored to their pet.

Next, make the sticker less shocking. First, avoid automatic fee increases. I believe that veterinarians are highly skilled professionals who offer a very valuable service. But increasing fees 5 percent or 10 percent every year is not the way to price your services. All it does is tell pet owners that it's going to be more expensive every time they visit. Instead, raise fees when you need to and selectively, not across the board. You can raise fees on treatment much more easily than on routine visits and exams, because pet owners are far more likely to pay anything to treat a sick or injured pet.

Sticker shock isn't just about price. It's also about surprise at receiving a high bill, along with worry about how to pay. So provide estimates for all principal exams and treatments. And provide more payment options, such as third-party payment plans and internal installment plans. Promote pet insurance and offer wellness plans the clients can pay for monthly.

5 BE HARD TO AVOID

Most pet owners know they should be bringing their pets in for a visit, but they just don't get around to it. There are ways you can influence their behavior, primarily by making it easy for them to schedule and keep appointments.

First, schedule the next appointment before the patient leaves the hospital. Also, continue sending postcard reminders. Pet owners love to put these on the refrigerator. But they also want e-mail reminders for their smartphones and electronic calendars. And if they're under 30, they probably want a text message. Call clients one or two days before the appointment, and follow up with non-responding clients at least three times, with a staff incentive if the client ends up scheduling.

6 NETWORK

The number of practicing veterinarians has risen faster than the number of pets over the last 10 years. And there's an average of 15 practices in your trade area. So pet owners have many choices. The most effective way to compete is to be highly visible in your community and build referral relationships. You do that by networking.

Sadly, almost two-thirds of practices have no programs in place to encourage clients to refer other people. Your existing clients are your best source of new business. Mutual referral relationships with groomers, dog walkers, and pet daycare providers are also a great resource. Usually there's no money involved. You just walk into a place of business and say, "We want you to refer people to our practice. And if clients need a dog walker, groomer, or daycare provider, then we'll refer them to you." (Of course, you need to do due diligence on these businesses so you know you're recommending someone who's reliable to your clients.)

7 STAKE A CLAIM ON THE INTERNET

Pet owners, especially cat owners, are heavy users of the Internet—heavier than the typical person. Cat owners are 75 percent more likely to use social media sites as a first place for news than average Internet users. They're 12 percent more likely to check these sites before purchasing products. And both cat and dog owners are more likely to use social networking sites every day. You need to be on the Internet because that's where your clients are. For a long time we've recognized that word-of-mouth is the best source of new clients. Today, word-of-mouth takes place in social media. If you're not part of the conversation, you're not top of mind.

So how do you leverage the Internet? Communicate with clients via e-mail, let them schedule appointments and ask questions via e-mail, and have a receptionist monitor the clinic's e-mail account all the time, feeding messages to the right people. Build and maintain a high-quality website—clients expect it of the businesses they use. Provide online appointment scheduling. Write a blog or send an electronic newsletter with links to the website. If you keep your blog posts or newsletters short—no more than one or two computer screens—people will read them.

Next, maintain an active Facebook page. If you have more than two people in your practice, one of them is a fanatic on Facebook. So take your most active user and make this person your Facebook correspondent.

Remember, the key to making these seven strategies work for you is to employ all of them. Choose one or two to implement immediately, but don't stop there. Continue transforming your practice using these strategies until you're through the list. The practices that are managing to increase client visits use all of these strategies to build their business. And if you follow these steps, you can see increased visits as well. Time to crack open the champagne!

*This article was adapted from Volk's CVC Power Hour presentation at the 2011 CVC San Diego, "New study results: 7 ways to build demand for your services."

John Volk is a senior consultant with Brakke Consulting. Post questions and comments at http://dvm360.com/comment.

Web tools

Visit http://dvm360.com for these resources to help you implement the strategies in this article:

> http://dvm360.com/catresources. A list of tips to make your practice more feline-friendly, including links to videos that demonstrate how to help clients train their cats to carriers

> http://dvm360.com/receivablespolicy. A payment and billing policy for your staff and clients

> http://dvm360.com/newclientsurvey. A questionnaire to hand out to new clients

> http://dvm360.com/clientsatisfaction. Another client survey

> http://dvm360.com/reportcard. A pet wellness report card.