Bringing clients back--communicating the value of care (Proceedings)

Veterinarians and their team members have been working for years to educate pet owners about the care their pets need in order for them to stay happy and healthy.  Undoubtedly we've made some progress, but results from the recently released Bayer Veterinary Care Usage Study indicate we have a long way to go; many pet owners simply don't understand the need for what is generally accepted as routine care. 

More than a few reports have shown that the economic recession of 2007 to 2009 had a negative impact on the number of patients seen at many companion animal veterinary practices in the United States. There is also substantial evidence that the erosion in the number of patient visits began well before the start of the recession.  The prospect that the number of dog and cat visits to veterinary clinics was decreasing at a time when the pet population was increasing raised concerns about whether pets were getting adequate veterinary care, as well as what impact this decrease might have on the economic state of the veterinary profession, and whether the trend toward fewer veterinary visits was reversible.

The Bayer Veterinary Care Usage Study was designed to confirm the decrease in the number of patient visits that has occurred over time, to identify factors responsible for this decrease, and to identify specific actions that companion animal practitioners could take to encourage more frequent veterinary visits for dogs and cats in order to reverse the trend.   The study was a collaborative effort between Bayer Animal Health, the National Commission on Veterinary Economic Issues and Brakke Consulting, Inc. and included in-depth interviews with companion animal practice owners, qualitative interviews with pet owners and a robust, statistically valid national online quantitative survey of pet owners.

The study identified six factors that have contributed to the decrease in visit numbers:

·         2007 to 2009 US recession--The recession and resulting unemployment had negative impacts on spending for veterinary services, exacerbating the decline in visits that had already been occurring

·         Fragmentation of veterinary services--There were more points of care and a wider variety of veterinary services available to pet owners; while this didn't contribute to the total decrease in veterinary visits; it meant that pet visit were spread out amongst more practices

·         Proliferation of Web usage--Pet owners frequently consulted Web sources regarding pet health issues, rather than calling or visiting their veterinarians

·         Inadequate understanding of the need for routine care, particularly examinations--Many pet owners primarily associated veterinary care with vaccinations (i.e., shots) and because their pets did not require vaccinations as frequently, visited their veterinarian less often

·         Cost of veterinary care--Many pet owners expressed shock at the size and frequency of price increases at their veterinary clinics and did not find value for the price paid

·         Feline resistance--Because many cats aggressively resist being put in carriers and transported to the veterinary clinic and show signs of stress during veterinary visits, many cat owners deferred taking their animal to the veterinarian

Veterinarians and their team members spend so much time immersed in pet care that it is easy to forget not every pet owner knows what we know.  The lack of knowledge is truly alarming and because of it, many pets aren't getting even the minimum level of care they need.  In the Bayer study, 36% of pet owners agreed that were it not for shots, they would not take their pet to the veterinarian. Similarly, 24% agreed with the statement that routine checkups were unnecessary.  These pet owners do not recognize the many types of illnesses their pets may have that would not be visible to an untrained eye and that could have serious consequences if left untreated. 

Heartworm disease and intestinal parasites are just two of the common conditions that come to mind.   And they don't recognize the value of the physical exam and the opportunity that an appointment with a veterinarian gives them to learn more about what they can do to take better care of their pet at home; for example, what kinds of food would be best for their particular pet, the need for heartworm preventative, and the kinds of symptoms to look for that would indicate a more serious medical problem.

Survey respondents in the Bayer study who owned pets that lived primarily indoors were less likely to have taken their animal to the veterinarian in the past year.   These owners don't appear to understand that while an indoor pet is less likely to be hit by a car or to get involved with a fight with another animal, they are just as likely as outdoor pets to get cancer, diabetes, kidney disease and many other ailments.  Likewise, pet owners with older animals were less likely to have taken their animal to the veterinarian in the past year. The idea that older animals need less care than younger ones obviously makes no sense; yet many pet owners appear to believe that.

The study also indicated that both dog and cat owners want this information and that it would make a difference in the care they provide their pets.  A large percentage of dog and cat owners said they would take their pet to the veterinarian more often if they really believed the pet needed exams more often, if it would help their pet live longer and if they knew they could prevent problems and expensive treatment later.  

It's clear that we need to increase our efforts to educate pet owners about the level of veterinary care needed.  How do we do this?  First of all, as a profession, we need a mantra similar to “twice a year dental cleaning” or the USDA “Five a Day” fruit and vegetable campaign.  Pet owners need to be as convinced of the need for regular pet care as they are about the need for regular dental care.  In order for them to be convinced, WE have to be convinced about what that care looks like and we have to communicate it constantly, both at the profession-wide level and at the practice level.

What can you do at your practice to help pet owners better understand the importance of veterinary care?

First of all, develop standards for care within your practice and turn them into a mantra similar to the twice a year dental cleaning campaign.  Make sure everyone in the practice is on the same page and understands not only what the recommendations are but why they are important.  It only confuses team members and clients if one doctor recommends annual visits and another says to come in twice a year.  Decide what your practice thinks is the best care and include this information in your staff training so everyone gets it. 

Set up systems to communicate this information to every client that walks in the door-assign roles to individual staff members and use checklists, posters, and handouts to further illustrate the points.  For example, your annual exam discussion checklist may include twelve key points ranging from dental care to nutrition to exercise to flea and tick preventatives.  Decide which topics will be covered by the doctors and which by the technicians and make sure the technicians have the information they need to give good recommendations and thoroughly answer clients' questions. 

Be sure these discussions take place where any related learning aids are located; for example, the discussion about dental disease loses impact if it occurs in the reception area instead of in the exam room where illustrative models and posters are located.  Require each doctor or staff member to sign off on the annual exam checklist to indicate they have talked about the recommendations with the client and schedule your appointments so there is time for these discussions.  Don't forget that clients regularly ask receptionists about medical matters as well so give them they information they need to provide good quality answers or decide when they need to bring in a doctor or technician for a broader explanation.

Train doctors and staff members to talk in a pet-owner friendly manner-not everyone naturally has good communication skills but these can be learned with just a little effort.  In addition to talking to clients, remember that they need information in other formats as well.  Develop client friendly communication materials in multiple types of media--people take in information differently (hearing, reading, seeing) so provide information in different formats--brochures, your website, podcasts, and through the use of posters and pictures.

Communicate regularly with your clients through reminders and newsletters.  All practices use reminders to some extent but expand your system to include more clients and more types of reminders.  Use language that conveys the benefits and value of your recommendations, not just the recommendation itself.  Consider multiple formats for reminders:  email, texts, phone calls, as well as the more traditional mailings.  Email is an inexpensive and useful way to send newsletters or health alerts to your clients.  Collect and update email addresses regularly so your clients get the information they need; every time a client comes in, the receptionists should confirm their current email address along with other contact information.

Its just as important to educate clients about WHY exams and wellness care are so important as to make the recommendation; talk about the benefits--prevention of future problems, a longer life for the pet, and having happier/healthier pet now.  Also educate clients about WHAT the exam includes and how this helps you help their pet-many clients don't realize a veterinarian or technician is actually examining the pet, not just holding or petting it.  One of the best ways to do this is through communication of everything you do-“I'm taking Fluffy's temperature now; its normal” or “I'm looking at Fluffy's teeth-they have some plaque on them-let's set up an appointment to clean those so her breath will smell good and an infection in her mouth won't lead to other problems”

And don't forget the internet; 39% of the pet owners in the Bayer Veterinary Care Usage Study said that they look online first if their pet gets sick or injured.  20% say they check out the Internet after they visit their veterinarian.  Anyone who has worked in a practice for very long knows that this is true and that clients often can't distinguish good Internet information from bad.  So what can practices do to communicate better with clients via the Web and make sure clients go to reliable sources?  Listed below are some key tactics:

·         Establish your own internet presence via your website, Facebook and other places where pet owners go

·         Provide interesting, updated content about the regular care pets need and common accidents and illnesses

·         Provide your clients with a list of veterinary websites you trust for good quality information

·         Link to these sites from your own website

·         Set up a system to monitor postings about your practice on the internet and learn how to appropriately deal with negative information

A very significant part of communicating value is what we have discussed above-communicating the need and importance of care.  However, clients must also find value in how the care is provided; i.e. in the client service experience.    

Communicating value is particularly important now because:

·         Clients continue to be nervous spenders

·         Veterinary medicine, even referral medicine, is an increasingly competitive marketplace

·         Veterinary care is complicated and difficult to understand

·         Hospital visits can be frightening

·         People take in information in different ways

In clients' minds, veterinary care is no different from any other complicated service that people buy.  Many people don't understand how their car works; they assume the repair place will properly fix the problem but they can't really judge whether or not that happens.  So they judge the car place on things they can understand such as whether the car is ready to be picked up when it was promised, whether the costs were within the estimated range, whether there was a comfortable place to sit while waiting for the oil change and whether the repair people were condescending about the lack of car knowledge the consumer had.

A very interesting article ("Clueing in Customers"-Berry & Bendapudi-2003) in the Harvard Business Review about the Mayo Clinic reiterates this point. The authors said:   “When a company's offerings are hard to judge, customers look for subtle indicators of quality.”  The Mayo Clinic is probably the most recognized brand in the world for quality medicine with very little spent on traditional marketing and advertising and they got there not only by providing great medicine but also by focusing on the client, not just the medicine. 

They recognize that medical care is frightening and complicated and do everything they can to ease the patients concerns.    Scheduling is done around the client's needs, not the hospital's needs, the hospitals are attractive and soothing in design and decor, everyone (janitors, nurses, receptionists, etc.) are trained to understand how the smallest thing they do impacts the patient.  It is this kind of experience that allows a business of any kind to communicate value and attract more clients.

Most practices are already doing at least some of the things discussed above.  What has become so clear, however, from the Bayer Veterinary Care Usage Study is that we still have a ways to go before pet owners are as educated about veterinary care as they need to be to provide the best care for their pets.  Review the educational efforts you have in place in your practice and see if there are ways to improve them.  And remember that implementation is key; we can't just educate pet owners when we have time; it needs to be “every client, every patient, every record, every time.”