Caught on camera: 5 profit-sucking mistakes veterinary clinics make

Recently I've asked several practices to place wireless cameras in their exam rooms. After much cajoling and harassment (just kidding), the doctors finally agreed, and soon we were able to review them and their staffs in action. The resulting videos are enlightening. For one, you wouldn't believe what some clients do when we're not in the exam room. In one instance a client searched all the drawers and helped himself to a handful of syringes. In another video clip, a couple became amorous and barely escaped discovery in a compromising position. But enough of my voyeuristic fun. The real reason for these video sessions is to provide valuable clues to improving clients' and patients' experiences in ways that directly affect your bottom line.

Most people have no idea how their exam room behavior impacts clients and sometimes even patients. Little changes in body language and communication can dramatically influence client satisfaction, compliance, and, of course, the average client transaction. One practice showed a $23 increase in the average client transaction within two weeks of videotaping sessions. After reviewing countless exam room videos, I can tell you that some mistakes are universal. Here are the top five faux pas caught on camera.

BLOOPER 1: Doubling up on duties

One common problem these video clips have brought to light is something I call repetitive communication. The exam room assistant asks the client a series of questions at the beginning of the visit. Later, when the doctor comes in, he or she asks all the same questions. The result? Clients become frustrated and wonder why they spent all that time talking to the assistant when they have to repeat themselves to the doctor.

In addition, the more time an assistant takes from the appointment, the less time the doctor has to provide the necessary care. In one video, the exam room assistant spent 17 minutes of a 20-minute appointment obtaining information on a sick pet. This technically left the doctor only three minutes to finish the appointment and move on to her next patient.

Of course, I'm in favor of using exam room assistants. I just think it's important to decide what these individuals should do and how much time they should spend in the exam room. The doctor needs more time in a sick pet visit. Therefore, the assistants should spend less time on those visits. Assistants should obtain basic information—for example, the patient has been vomiting and having diarrhea. The doctor can then ask what the diarrhea looked and smelled like and how many times the patient has vomited.

BLOOPER 2: Coming off cold—or too casual

Another common exam room problem is a lack of common courtesy coupled with inappropriate body language and appearance. In many practices I reviewed, doctors and assistants would enter an exam room without acknowledging the client or pet. Veterinary professionals should always introduce themselves to clients and acknowledge the pet.

Poor body language is also common. I've seen many doctors who stand in the corner of the exam room with arms crossed as if they were afraid of the client or patient. I've seen exam room assistants avoid eye contact or even talk to clients with their backs turned.

And don't even get me started on dress. Some team members look like they just rolled out of bed, with messy hair and wrinkled clothes. Some doctors look like they're heading to the gym instead of the exam room.

BLOOPER 3: Failing to go the distance

Many times when I review exam room videos, I also ask to see the corresponding medical records of the patient visits. I do this to see if the practice is implementing a full-service approach. That is, if a client brings in a pet for an annual comprehensive wellness exam and distemper vaccination, are they also checking to see if that pet had a fecal done in the past year? Do they know the status of vaccinations and preventive procedures? Have they done a heartworm check and feline leukemia test?

I've found that too many practices deal only with the admitting complaint or the client's request, failing to offer that full-service approach. In addition, one team member may do an excellent job, while another does little or nothing. Remember the management rule that states, "Don't expect what you don't inspect." Videos are an excellent tool to help you achieve consistency and know what's actually happening inside your exam rooms.

BLOOPER 4: Missing marketing opportunities

Marketing, by definition, is the process of informing your client of the various services and products your practice offers. How well do you market your practice in the exam room? Again, this varies not only among hospitals, but also among doctors within a hospital.

In one video I reviewed, the veterinarian impressed me. She was examining a patient and, as she looked into the dog's mouth, asked the client, "Have you noticed Casey's breath lately?" The client replied, "Yes, it's pretty foul." The veterinarian said, "Let me show you why. Take a look at these teeth."

She showed the client the red gum line and the tartar on the teeth. Then she took out a dental grading chart and asked the client how she would grade her dog's teeth. The client looked at the chart, looked at the teeth, and graded them at a three. The veterinarian agreed and told the client, "We need to get those teeth cleaned before they become a grade four."

The doctor instructed the assistant (who was standing right there) to review with the client what was involved in a dental cleaning and to prepare a medical care plan (estimate) for the pet's treatement. The assistant scheduled the appointment before the client left the building. Now that's marketing.

Visit dvm360.com/passivemarketing for step-by-step tips on how to effectively market the products your patients need.

BLOOPER 5: Forgetting to ask the client

I've seen many veterinarians, technicians, and exam room assistants do a great job educating clients about a specific problem or preventive procedure but then fail to close the deal. They forget one of the most important and simplest steps—to ask if the client would like to do what they've recommended. In a recent video I watched, the exam room assistant did an awesome job educating the client about microchipping. The assistant explained how the chip worked and how easy it was to insert, especially since the pet was having a dental procedure done that day and was going to be under anesthesia. Problem was, she never asked the client, "Would you like for us to take care of that today?" I'm sure the client would have said yes.

In some cases, of course, we provide the client with a medical care plan before asking if he or she would like the service or not, but we always have to ask. The worst-case scenario is that the client says no, in which case you enter a declined code in the computer. But you can't get to yes without asking.

After watching countless exam room videos, I can tell you one thing is for sure: They're eye-opening and a lot of fun to watch. If you haven't taken the plunge, I urge you to do so. What you'll learn will astound you. And if you have any good videos, send them to me.

Mark Opperman, CVPM, Veterinary Economics' Hospital Management Editor, owns veterinary consulting firm VMC Inc., in Evergreen, Colo. Please send questions and comments to ve@advanstar.com.