Implementing a feline preventive medicine program

Now that you have decided what to include in your feline preventive medicine program, how do you implement your ideas? The implementation process begins where everything else begins in a typical veterinary hospital - at the front desk.

Successful implementation of a feline preventive medicine program begins at the front desk. The receptionist introduces the concept to the client.

Educating staff members is the key to any successful clinic program. The receptionists, technicians and kennel workers should all be informed about basic hospital policy. Together, they form a client education team with the veterinarian as the leader of the hospital team and principal educator.

Taking the first steps

Staff education is best accomplished when guidelines and hospital policies are specifically delineated. A clinic text of routine protocols provides an easy reference for employees who are trying to hold volumes of information in their memory banks. Remember, you had years of training to learn this information, so make it as easy as possible for your staff to learn about clinic health care policies. Supply all employees with a clinic manual to ensure a completely educated team.

Start your manual with the basics and include the hours of clinic operation and a mission statement. A mission statement solidifies a clinic's practice philosophy and should be prominently positioned in the manual. Display framed mission statements in exam rooms and waiting rooms for clients to read. Clients need to know how you feel about veterinary practice and what your goals are concerning good client/patient care.

The technician educates the client on the key elements of a preventive medicine plan using brochures and handouts to facilitate understanding and compliance.

Outlining protocols

To gather the preventive medicine information for your manual, outline what you usually discuss with clients on the first feline visit: nutrition, immunizations, parasite control, behavior and reproduction. Basically write down your examination room spiel. Keep the text simple enough for lay staff to understand, but detailed enough that they are adequately informed.

The text should be a complete guide to general health care for cats. Begin with the basic requirements for life - food and water. Cover proper nutrition for kittens, adults and senior cats. Prescription diets and the diseases that warrant their use should be explained. List all of the diets you sell in your practice so that your staff may readily answer client questions. With the numerous diets carried by most clinics, a chart may simplify the dietary dilemma and serve as a quick reference for staff. If multiple brands are sold, list foods by reason for use.

Immunization programs should be summarized as well. Each illness and its associated vaccine should be explained. Include a brief description of clinical signs so that your staff may inform clients of "what to look for." Diagram the ages that vaccines are usually administered in an easy-to-read chart. Also include exclusion criteria stating when a vaccine should not be given, i.e. during pregnancy.

Table 1: Topics for Staff Training Seminars

Include information on reproduction in your preventive medicine booklet. Staff members should be able to explain the estrous cycle as well as the benefits of spaying and neutering. Make sure that staff members know your clinic's opinion on the optimum age for spaying and neutering. Personnel should understand basic pre-operative laboratory workups, anesthetic protocols, recovery procedures, pain management protocols and length of hospital stays for routine surgeries.

Wellness plans

Many clinics laud the benefit of kitten wellness plans, which encourage client compliance and increase practice profit margins. The kitten wellness plan should be outlined on a client handout that lists vaccinations recommended and suggested dates of administration. A copy of the signed agreement may be included in the patient's medical record. The cost for the entire kitten series of immunizations is totaled and a pre-determined percentage (15-20 percent) is deducted from the total when the client signs up for the plan and pays for all immunizations in advance. Enrolling in the kitten wellness plan may also allow for a discount on future ovariohysterectomies and castrations. The plan educates the client about the immunizations series and reproduction guidelines at one time. Knowing in advance what is expected and paying for it up front increases client return rate, renders healthier kittens, decreases pet overpopulation, and may very well increase the clinic's bottom line. It's a winning proposal on all fronts.

Regular in-hospital seminars on topics such as clinical techniques, medical equipment, infectious diseases and parasites keep staff up-to-date on important information and maintains enthusiasm for preventive medicine programs.

A list of parasites prevalent in your practice area should also be included in the employee's preventive medicine guide. Describe the parasite, how it is acquired, how it affects the patient, how it is treated, and how it is prevented. Staff members should be familiar with the parasite control medications used in the practice. With the plethora of internal and external parasite products on the market, a list of products is helpful and again serves as a quick reference.

Survey your drug inventory and categorize parasite control products according to use, i.e. intestinal parasite medications, heartworm preventives, flea control products. Make sure staff members are aware of potential adverse events and appropriate ages for use. Most pharmaceutical companies provide good visual aids for staff education on parasites.

Routine diagnostics play an important role in keeping cats healthy. Technicians are the most knowledgeable regarding in-house testing procedures, but all staff members should be able to discuss which tests are deemed routine at your practice. They should know what tests are performed in conjunction with annual examinations (fecal exam, FeLV/FIV test, feline heartworm tests). They should also know that certain tests are recommended as the cat ages. Develop a senior care program and include the laboratory tests to be discussed during visits with feline patients more than 7 years of age, such as CBC, chemistry panel, urinalysis, thyroid function tests, etc.

Communicating with clients

Well-informed, organized clients make better cat owners. Providing clients with health record folders allows them to keep all of the cat's pertinent medical information in one place. Many clients bring these folders with them for each veterinary visit. Clients also appreciate wellness forms completed during the physical exam. These forms can be organized by body systems and the veterinarian or technician can simply check "normal" or "abnormal" under each category, then briefly comment on each abnormal finding. Clients will remember exam room discussions more accurately with this helpful prompt. Moreover, in the frenzy of drop-offs and pick-ups, the person who brings the animal in may not be the actual caregiver. Wellness forms provide crucial information for absentee pet owners.

Getting staff on board

Present your new feline healthcare program to the staff with an initial overview to introduce the concept to them. Let them know that they do not have to "know it all" after the first session and that there will be regular meetings to discuss each item in the preventive medicine protocol in detail. Make these seminars comfortable with an open invitation for questions. It also helps to provide lunch or a snack. Staff members, like their veterinary employees, learn better on a full stomach, and the staff will appreciate the added consideration of a treat.

Keep interruptions to minimum during the training sessions. We all have a practice to run and do not want to ignore clients, so schedule seminars during the slower part of the day, perhaps over lunchtime. Assign one employee to "run the clinic" while the rest of the staff is in session and educate this staff member individually. Some doctors prefer after hours sessions at night to avoid interruptions, but often personnel are anxious to get home. If seminars are conducted after the clinic closes, remember to compensate your staff for their time.

Stagger educational meetings to give the staff members time to absorb the material and think of questions. Time between meetings allows employees to become adept at implementing each portion of the program before embarking on a new area. Make sure that the team is comfortable with each new "play" in the game plan before introducing a new one. Make regular meetings a priority in your practice to emphasize your commitment to the plan.

In multi-doctor practices, alternating speakers keeps the meetings interesting and gives colleagues ownership in the preventive medicine plan. Technicians and receptionists may assist in discussing certain aspects of the program, too, especially as it relates to their individual duties. For example, technicians may lead the discussion of parasite testing, while the receptionist may cover the topic of parasiticide sales. It helps when staff members speak from experience. Clients appreciate hearing what products or services staff members consider useful on their own cats.

Ask all staff members for suggestions that may improve the overall health maintenance protocol. Most people appreciate being a contributor and will often present a new angle on the subject. The staff may also have good ideas on how to actually present the information to clients. They know what techniques work for them, so allow them to make the most of their personal experiences with the clients.

Strong delivery system

Provide the staff with the tools they need to do a good job of client education. Handouts provide the client with written information to take home, but also serve as a good discussion guide for the staff member while in the examination room. And remember, a picture is worth a thousand words. Show pet owners what roundworms look like and they will surely want the preventive medication you prescribe.

Clients are frequently linked to the information highway, so provide them with pertinent Web sites. Perhaps they could benefit from the AAFP Web site or the sites provided by pharmaceutical and diagnostic companies. Providing Web sites that you have personally reviewed may decrease the client's tendency to access less dependable Internet sources for information.

Staff members are usually quite dedicated to the protection of animal health and will attend employee seminars and educate the clients without external motivation, but a little incentive never hurts. Have the staff keep a tally of each time they discuss the preventive health plan with clients and reward them when they reach a designated goal. Perhaps they would enjoy a lunch outing or movie passes or video rental certificates after they reach their goal. Once a goal is reached, set a new one and start the tally over, so the staff remains enthusiastic about the wellness program.

Group praise is great. Complement your staff on their team effort, but do not hesitate to individually recognize members who truly stand out. Rewarding individual accomplishments may encourage excellence in the rest of the staff members. When an employee does an exceptionally good job, tell him so.

Being a good doctor is rewarding, but we all know that the smartest veterinarian in the world cannot have a thriving practice without a good staff. From the front desk to the exam room to the kennel area, we depend on the people who work with us to keep the clinic running smoothly. An informed staff certainly makes a veterinarian's job easier and frees up the veterinarian's time to truly "practice medicine."

Team approach

The doctors and staff must work together enthusiastically on the preventive medicine program because it is a win-win situation. A good feline preventive medicine program is an essential part of a successful practice; a successful practice financially supports doctors and lay staff alike; and informed doctors, technicians, receptionists, and kennel assistants are the foundation of a good feline preventive medicine program. Most importantly, the feline patient is the ultimate beneficiary due to the excellent quality of care it receives in the process.

Suggested Reading

Dr. Buzhardt is a companion animal practitioner and along with her husband, is co-owner of The Animal Center, Inc., in Zachary, Louisiana. A native of Louisiana, she graduated from Louisiana State University School of Veterinary Medicine in 1980.

Buzhardt has more than 20 years of experience in conducting pharmaceutical field trials. She has served as a spokesperson for several animal health companies on key issues of concern to pet owners and lectures to fellow veterinarians on medical topics as well. As an advocate of the human-companion animal bond, Buzhardt has been recognized by the human medical community for her seminars that focus on integrating infants into pet-owning households. She also coordinates pet therapy programs for the elderly and pet education programs in elementary schools.