Don't underestimate good, old-fashioned human contact

John Price calls the clinic and is complaining.

He thinks that his cat, Nellie, is long overdue for her leukemia vaccinationand no one called or sent a reminder. He also said that Dr. Kent wantedto do some blood tests and X-rays this spring.

He seems to remember that the last time Nellie got her "shots"she had a reaction and almost died. Now, on the other hand, his dog Rileywas hit by a car last year and died. He was sure that he told Dr. Kentthis fact when he saw him at the convenience store last fall. Yet, he statesthat he keeps getting reminders from the clinic urging him to bring Rileyin for a heartworm test. Your receptionist Karen has mined the databaseand found that all of Mr. Smiths' reminders are in the computer and weresent with all the other reminders last month-unfortunately including Riley's. Nothing is noted in the computer about blood tests of radiology or reactionto shots for Nellie. She naturally finds that Riley is still "alive"in the computer. Karen pulls the chart and finds that Mrs. Price broughtNellie in this past June for itching and was given a steroid injection. Nothing else has been written down except that the technician discoveredthat Riley had gotten her leukemia shot at another vet office which wasoffering discount flea baths. Dr. Kent, a solo practitioner is on vacation.

Karen's options are:

·1. Schedule all the requested items with Dr. Susan Barnes,the relief vet, and note that Dr. Kent is on vacation.

·2. Ask another vet across town what he or she would doand ask if there are any positions opening soon.

·3. Board the cat until Dr. Kent returns and begin yourvacation.

·4. Ask the technician or the relief vet what to do.

·5. Schedule an appointment for the client to see Dr. Barnesand write a full summary of the conversation. Then go explain everythingto Dr. Barnes.

The answer is number 5.

Dr. Barnes needs every advantage possible in dealing with this client-especiallythe client needs and perceptions. Karen should convey every confidencein Dr. Barnes and try to resolve all issues that concern the client in afriendly and professional way. Since Dr. Barnes is likely on overload,Karen needs to talk about this issue with Dr. Barnes between clients and/orprocedures so they can both focus on the issue.

Welcome to the world of over-reliance on technology and under-relianceon normal human communication.

Communication Problem #1

The Deer in the Headlights

It is quite common for a veterinarian to meet clients away from the officeand away from the pet and be clueless as the actual names attached to thefaces they indeed recognize but can't place. It is easy for the clientto say, "Hey, Doc" without recalling the veterinarian's actualname, but almost impossible for the vet to have total recall concerningthe owner and pets let alone the specifics and plans for all their maladies.

Yet clients somehow have great confidence in all this and relay informationthat is expected to be hard-wired forever in the veterinarian's noggin.

Communications Problem #2

The Write Stuff

Veterinarians are busy people. If they are too busy to write medical/surgicalplans in the chart or into the computer, then client and staff misunderstandingswill be standard fare in the hospital.

Solo practitioners are often independent people and will modify patientplanning as the need arises, i.e. without written plans.

This is a problem waiting to happen when the "Doc" is out oftown or out of gingko biloba.

Communications Problem #3

Vet Hopping

You cannot really blame people for shopping around. We all do. Clientloyalty is fast becoming a thing of the past. We live in a convenience-orientedsociety and bringing a pet to a veterinarian can be quite an inconvenience.

Also there are times when spouse A will not talk to spouse B about anassortment of things-including emergency trips to the vet for the flea baths. This, of course, spreads our patient's history records around. The chainof communication is inevitably broken and blind spots present themselvesto the next veterinarian who sees the pet.

Communication Problem # 4

Over-Reliance on the Computer

Naturally, the computer cannot phone a client and discern their intentionsand straighten recall issues out (at least not yet). This is the reasonwe have human beings. Unfortunately, we have become blinded by the computer'samazing ability to sort and prepare information for us to use.

It is important that we know the limitations of this technology. Therefore,if you are just blindly letting your computer generate reminders withoutsome oversight, office predicaments will be inevitable and medical carewill suffer.

Some solutions are available.

1. Make an effort to memorize names. Everyone remembers a face. This is because the face is the overwhelming visual image related to atime and place. Most people when meeting someone for the first time willlet the visual images overwhelm the abstract portions of their brain-thuswhen a name is offered, it quickly (often immediately) is forgotten. Makea conscious effort to connect the abstract name with the visual image ofthe person. If you are overwhelmingly visually oriented you will be surprisedthat you can actually recall the name by concentrating on the medical chartitself recalling the name just by bringing the visual image of the medicalchart into your head. I have found it helpful to write the person's namedown somewhere for future reference when I first meet them.

2. Carry a crutch. This can be a 3x5 card or a Personal DigitalAssistant. When you make recommendations to or receive information froma client who has "caught you off guard" and away from you databaseor medical record-write it down and later inform your staff to update yourdatabase and/or make an entry in your pre-appointment book. (see sidebar)

3. Write everything down in the hospital record. Try to followa communication pattern that works for your hospital. The doctors must beencouraged to write therapy plans that are legible and ensure that theirintentions are clear to anyone reading the chart or computer.

4. Make some phone calls. If an obvious vaccination or historygap appears in the record in spite of protestations to the contrary by theowner, call your colleagues and inquire about visits to their hospitalsthat your client (or their family) may have made on behalf of a pet. Itis common for clients who use multiple hospitals for their own convenienceto have memory lapses concerning the location of Fluffy's last shots. Thiscan be time consuming, but you will be rewarded with information that youwill need to proceed.

4. Use Post-It® notes: Truly an invention right up there withsliced bread. Notes can be placed in strategic places in the veterinaryhospital where the unwary can be sufficiently trapped and moved to action.

5. Use old-fashioned human contact. You may not know it but aswe have become more computer reliant in our culture the messages themselvesare getting lost. More and more things in our culture work to keep yourclients "off message". Computer generated reminders from all sourceshave lost their freshness in our homes as we increasingly are deluged byevery sort and variety of messages from e-mail, FAX, video and print toTV. More and more of these messages are being received from a torrent ofconstantly evolving technological gadgets. Your attractively imprinted remindercard, which previously was reverently placed under a refrigerator magnet,now is simply lost in the deluge. We should use an old technology in a newway-our telephones. (See sidebar). You would be surprised at how many ofour clients, in addition to the usual updates we give them on a pet's bloodtests and hospital status, really appreciate telephone reminders for theirpet's anticipated needs as they arise.

Dr. Lane is a 1975 veterinary graduate of the Universityof Illinois. After graduation he practiced as an associate in Californiabefore moving to Carbondale, Illinois and establishing Lakeside VeterinaryHospital in 1978. Dr. Lane completed a master's degree in agricultural economicsin 1996. He is the author of numerous practice management and economicsarticles.