Making every client feel like #1 (Parts 1 and 2) (Proceedings)

• Pet owners view and communicate about their pets and animals from the right side of their brains (emotion). Veterinarians view the same pet from the left side of their brain (logic). We need to use both sides of our brains when we view the precious family members who're brought to our door, the 4-H animal we treat or the horses who're treated like Golden Retrievers with hooves!

• Communication is the key to success.

o Remember them warmly

o Know personal details about pets and pet owners

o Take a personal interest in them

o Only sell them things their pet needs (based on a thorough understanding of needs)

o Do an excellent job interacting with their pets

o Do a good job communicating with them. How well veterinarians explain the reasons for their recommendations drives clients' perception of value (owner wins) and quality of care (pet wins). Survey results show the strong positive impact communication and pet interaction have in clients following recommendations made by their veterinarian. In fact, 71% follow recommendations when they receive a thorough explanation of the veterinarian's treatment plan.

• Ideal veterinarian in a survey had these qualities:

o Answers your questions

o Articulates diagnosis

o Articulates likely outcomes

o Explains available alternatives

o Explains what is done to your pet

These speak nothing of your skill as a veterinarian but speak volumes as to your skill at a caring, competent communicator.

• Researchers at the Mayo Clinic identified seven "ideal physician behaviors." Patients want their doctors to be "confident, empathetic, humane, personal, forthright, respectful and thorough." How, in the course of the 15 minutes that the typical patient gets to spend with a doctor, can all this happen? In the book "Only 10 seconds to Care: Help and Hope for Busy Clinicians the author (an internist and cancer patient) shows how simple actions and well-chosen words on the part of medical professionals can make an enormous difference in a patient's emotional and physical well-being.

• Begin with the end in mind. What do you want the first contact (typically phone) to be like? What should happen when they walk in the door and are greeted? What kind of magic should happen in the exam room, during the callback, and what could facilitate a referral or repeat visits?

• Moses was a 10-year-old St. Bernard. The Dunnicks spent almost $10,000 on a hip-replacement and aftercare, but the dog still died. Despite the extreme cost and the unfortunate outcome, the reason why the Dunnicks refer people to North Idaho Animal Hospital, and why they brought their two newest pets to us was because Moses was offered a bumblebee plush toy when he was hospitalized. They were also touched by the photos of the dog as a puppy, the condolence card and the donation to the veterinary school in Moses' memory.

• Smile on the phone

• All team members speak with a calming, interested and sincere tone in everything they do.

• All Treat vs. All Pain Hospital

• Greet pet owner and pet by name

• My first client after not practicing for over a decade.

• Dr. Harris and Drake the Lab – Story

• The exam room is the high temple of veterinary medicine. Before surgery, we scrub, dress in special clothes, use special tools, etc. Why don't we have the same level of preparation before we go into the exam room to see clients? For example, studies have shown that a white lab coat and a stethoscope increase the client's perception of value by over 17%!

• Secrets of exam room superstars:

o An appointment is a social contract, respect that.

o If you're late for an appointment say, "I'm terribly sorry I kept you waiting so long. I had ______ (explanation)." People don't mind waiting for exceptional service.

o Stand up straight. Confident posture conveys authority. Train yourself to lift your head and drop your shoulders every time you enter the exam room and soon it will be a habit.

o Speak first and look clients in the eye about 70% of the time. It's scientifically proven that this strategy makes you more credible and likeable.

o Create a bond in the first 15-20 seconds of the visit by demonstrating friendliness with: smile, eyebrow flash, nod

o Ask them to describe why they're in to see you and then listen without interruption (about 1 minute)

o Don't discourage clients from gathering information before they come into the veterinary hospital, but not to oversearch. Too many statistics and case histories can be overwhelming and all that information is useful only to a point: each case is different and each patient is different.

o To make the most of each visit, veterinarians should first focus a pet owner's concerns and then focus on just one or two of their pet's most pressing medical problems, saving others for later visits.

o Look for clues indicating a client's clear understanding: why you are performing the exam – Nodding, smiling

o Ask the client, "What were you hoping I could do for _____?" Accurate diagnosis, alleviation of pain, cure?

o Three expressions of empathy. For example you could say, "I can only imagine how worried you must be for Sparky, but I'll do all I can to help him...and you."

o Face the person you're talking to. You may not realize it, but when you discuss something that makes you uncomfortable (such as the cost of a diagnostic procedure), your feet and body will start pointing towards the door. Counteract this tendency by turning your whole body toward your client.

o Limit the fidget. Scratching an imaginary itch, fiddling with your hair, or covering your mouth with your hand makes it seem like you're lying. Not a good thing when you're telling a client her cat needs a $200 test. Can't go wrong with stroking the pet!

o Match a client's mood. Is she sad because her dog might have a tumor? Thrilled because his liver values are stabilized? Match this emotion with a supportive comment, vocal tone, and facial expression and you communicate, "We're on the same team here."

o Exude confidence and the fact that you'll take care of the problem, take away the worry.

o Don't try to "fix" the emotion when bad news upsets a pet owner. Rather, empathize and align with the client and say something like: "I can see you weren't expecting this news. I understand that you're upset by it. I'm disappointed too that we didn't get a better response to the treatment."

o There's a world of difference between "if" an "when" when discussing the chance a disease like cancer, will reoccur. or a condition, like kidney failure, will persist. The word "when" is a prediction of doom that can make it difficult or impossible for pet owners to find hope that their pet will be okay." In contrast, a prognosis preceded by "if" introduces uncertainty. This hint of possibility encourages pet owners to strive for a balance of hope and acceptance that helps them continue to work and play, laugh and love in the face of a fragile future for The Bond. For pet owners to be free to find the balance that helps them live, or eventually let go, the door must be left open for them to find hope.

o Rather than focus solely on the expected outcome when a prognosis is dismal, share both your expectations and your hope with patients. Pet owners can "expect one thing" and "hope for another." HEALTH PROFESSIONALS ARE OBLIGATED TO NEVER EXTINGUISH HOPE.

o Personalized pet health protocols – Based on breed, age, current health status, lifestyle, emerging risks.

o Foreshadow future care. For example, change food 5 times, dental care, joint or ear problems, breed predilection for certain diseases.

o Use the word "need" all the time; forget options. Either the patient needs or the vet needs.

o Ask, "Have I answered all of your questions?"

o Encourage patients to be honest and forthright. Too often, pet owners withhold critical information or lie because the truth is embarrassing or because they don't want to disappoint the veterinarian by admitting they did not follow the advice or precise treatment plan.

o Make the dog's tail wag or the cat purr

• Ask them the genesis of their pet's/horse's name; then use their name and the name of their animal often. Clients love this chance to illuminate why their pet is special.

o Twice

o Cinco de Meow

o Shebang (as in she's the "whole shebang")

o M.C. Hamster

o Laptop

o 11:30

• I saw a client go into a veterinary hospital with a very sick dog that was going to require an extensive workup and treatment. I asked her what the dog's name was and she said, "Riley." "How did you come up with the name?" I asked the frightened lady. "Oh, we got him from the pound and when he first came home, he fell over onto his back, paddling the air with his feet, wanting his belly scratched." We said, "Boy this dog is going to live a life of, you guessed it, Riley!"

• Keep an open mind. Don't make preconceived assumptions - Perform SOAP on your clients to gain a better understanding of their wants and needs for their pet. We do this for our patients (Subjective, Objective, Assessment, Plan) and we need to do this on our clients. On first impression we might think this is just an animal and not important to them; or that cost is a primary concern. But by looking at subjective information (did their last pet receive excellent care, is this an expensive designer dog) and gathering objective information (where does pet sleep, is dog wearing a sweater, bling around the collar, are they hugging the pet) we can get concrete facts that will allow us to assess this client's true relationship with their pet, answer all of their questions, and together we can come up with a treatment plan.

• Really listen to what client's are telling you – Valerie Cox, Delta flight attendant making toast for Siamese lynx points "Nique" and "Squeak."

• Touch before you teach, teach before you reach, reach before you treat

• Make exam room a mixture of classroom and theatre

o Not just a spay. Perhaps the only major surgery your pet will ever have!

o "I don't think she'd have made it."

o "One of the worst fractures I've ever seen."

o "She was in a lot of pain, it's a good thing you brought her in."

• Learn how to do the "two yes" option sequence for responding to requests. Take for example, a client who asks to change an appointment:

o Tuesday or Wednesday?

o Wednesday is doable, morning or afternoon?

o Morning is doable, which is better for you, 9:15 or 9:55 a.m.?

o We now have you and Smokey scheduled at 9:55 Wednesday with Dr. Becker, would you like the reminder by phone or email?

• When a client purchases a new product or service, the team member responds with "That is a great product/service. Many of our clients have reported they appreciated getting it and that their pet has benefited from it." In addition, the team member can give a personal testimonial about how they use the product on their own pets. This is called comforting the buying decision.

• Make an assumptive close – "Mrs. Smith, based on what you've told me and my physical exam, here is what we're going to do." Then you outline the personalized pet healthcare protocol and end with silence. If the client says "Yes!," give her an estimate or quote and get started. If the client says "maybe" or "no," don't immediately acquiesce and offer an inferior Plan B. Instead, fight for Plan A. Say something like, "I must not have communicated to you clearly enough how important these tests are if I am to know what's wrong with Sparky and be able to make her well. If the client still says no to some or most of your recommendations you can say, "I know that you care deeply for Sparky but that your budget is a concern today." Let me prioritize my recommendations and let's see what we can postpone until a later visit that will cause the least pain or risk to Sparky. In this way, you haven't backed away from your professional recommendations but have only deferred them to a future date.

• Understand that what you are selling is piece of mind. Those clients opting for "no" or "later" should feel comfortable with their decisions, not guilty. The consequences of deferred or waived care are explained, and a "next visit" expectation is communicated to clients and put into the records before they leave the hospital. In a nutshell, you foreshadow future health care protocols.

• Comfort the buying decision – MDs are terrible at this, DVMs are better, but neither is good enough. Every time somebody buys a product or service they want to know that they made the right choice, that it was a sound decision, that they received value. There are several ways to do this: Have the team tell clients the same message: "It's a good thing you brought Sparky in. She was in a lot of pain, but she'll be feeling better in no time!"

• What if you don't find anything wrong with the pet? Celebrate normal results and good health! And make the clients feel good about their actions. You might say, "Even thought we didn't find anything wrong with Sparky, it's a good thing you brought him in. I saw a similar case a month ago that turned out to be very serious. So we're lucky. Plus, we have the results of laboratory tests that will serve as a good baseline in the future if something does go wrong."

• Two reasons why people don't come back (perceived indifference or hurting their pet). If the pet cries out, trembles, pulls back, winces...DON'T continue with exam; rather, tell the owner "It's obvious that this is uncomfortable for ___ and I don't want to cause her any unnecessary discomfort of pain. So I'll wait and examine that area carefully under sedation or anesthesia."

• Monday morning "cages are empty" medicine vs. Saturday morning "cages are full."

• Make a client feel like they're the most important appointment you have that day, and same for the next one, and the next one.

• The value of the physical exam

o The quickest way to improve overall practice quality is to improve the physical examination process. Heads you win...tails you win. Tip of nose to tippy toes.

o Seek more detail while investigating the patient's history. GMA executive with Bernese Mountain Dog – Lameness after exercise, vacationed in CT.

o Stethoscope, ophthalmoscope and otoscope have WOW factor.

o Additional information will often lead to a more detailed physical examination (intraocular pressure, eye stain)

o A more complete physical will produce a higher level of diagnostic procedures (swollen joints...joint tap...C&S)

o The greatest opportunity to increase practice quality is through the use of diagnostic tests. Laboratory tests often uncover hidden conditions that would otherwise go undetected by even the most talented clinician at the top veterinary hospital in the world. Example would be feline cardiomyopathy which is dramatically under-diagnosed (only way to tell is by ultrasound).When these conditions are found, early treatment and preventive measures can be provided. Speaking of breaking patterns:

• Seeing is believing! So is feeling, smelling, hearing. Flip the lip, flip the flap, etc.

• Use props: people learn much better by seeing what you're talking about. So use visual props such as arthritic hip model, bladder stones, heartworms.

• Communicate in words people understand. Doctor jargon is great for school, or talk between colleagues, but clients want, no, make that need to understand what is being said. Most clients don't know –itis from –osis, -ectomy from –otomy, or even benign from malignant.

• Young veterinarian said to owner who had stepped on dog's leg, "The radiographs show that the leg isn't broken. The dog is limping because of soft tissue damage." The owner was confused so I explained it as a severe sprain. Another owner came in because their Shih-Tzu was gasping for air (collapsing trachea or inhaling the soft palate). She was in her late 40's, and this, her first pet, was her child and she thought it was dying. She had already talked to other pet owners, breeders and had looked on the internet for answers. Medically, this wasn't a big deal for the young dog...but for the concerned pet owner...this was a REALLY BIG DEAL! What she was buying, wasn't a cure, it was a definitive diagnosis and peace of mind knowing a) her dog wasn't going to die, and b) it wasn't in pain.

• Become a pet advocate for the best quality of care. Can be a client advocate before and after the exam room.

o Eliminate any biases or preconceived impressions with clients (address up the Yak River).

o Every single case, every single animal that enters your exam room warrants an objective, non-prejudging approach.

o If you could give away veterinary services, what recommendations would you make for every patient? This specific patient?

o Sometimes we justify our position as empathy. What makes veterinarians feel we have special insights regarding client's desires? Clairvoyance 101 wasn't taught as part of my veterinary school curriculum, was it yours?

o The difference between "OK care" and "The Best Care" is just tens-of-dollars, not hundreds or thousands of dollars.

o The one thing you can't be accused of is _____? You can be accused of charging too much, have a client wait too long, or missing a diagnosis. But the one thing you can never be accused of is doing anything that isn't in the pet's best interests.

• Example of great scripts:

o "I'd like to give your pet a $50 disease, but that's just not possible with this case. It is much more serious than that and warrants this level of diagnostic work-up and care."

o Tell a client who is in a hurry for a diagnosis – "Mrs. Beck, this is a very complicated puzzle. I have several parts of the puzzle put together, but I still need a few critical pieces. I hope to get these from some additional tests, from consultations with my colleagues, etc."

o You'll never have the same amount of money as Bill Gates, but you can feed your dog exactly the same food he feeds his dog."

o Call Prescription Diet t/d "edible toothbrushes"

o Call loose teeth "piano keys"

o Routine blood tests are like a picture-window on the body" allowing us an expansive view of your pet's current health status.

o Bring in a stool sample the size of a Milk Dud. Don't clean up the whole yard and bring it in.

o Because pets cannot talk or communicate their needs, we must use advanced diagnostic methods to determine their state of health.

o Many pets mask or hide their illness from their owner and the veterinarian, so these tests can help us identify disease signs early, while there is still a good chance for a cure.

o Nutrition - Nutrition affects your pet's life more than any other single factor.

o Chronic Medications - We recommend blood tests, radiographs and ultrasounds on a routine basis to make sure the medications are effective and given at the proper dose.

• When a client seems distant or disturbed, the team member will ask, "You don't seem as comfortable right now, is there something I can do to help?"

• When a client shares disappointment with any service, product or communication, the team member will ask, "We really want you to be pleased with our service. What can we do to make it right for you?"

• Make the visit a positive memory. Don't just say something mundane or knee-jerk things like "Have a nice day" or "Thanks for coming in." Jolt the consciousness with something personalized and unique like, "You're a loving, responsible pet owner and someone it's an honor and joy to serve. Sparky's so lucky to have a mom like you!"

• Using the phrases "My pleasure" or "Here to help" or "Thank you for choosing our practice" need to be in a cheerful, sincere, non-parrot fashion in a wanting-to-help tone.

• What clients said in nominating their veterinarian for Morris Animal Foundation Veterinarian of the Year contest:

o Dr. Sitzman knows I consider my pets my children and not only doesn't question that bond, he celebrates it!

o Dr. Kennedy maintains an open mind on homeopathic techniques, yet proceeds with caution and integrity.

o Dr. Wahl always makes us feel like his favorite clients. My friends say the same thing so we know it's real!

o Dr. Bainbridge always makes you feel like your "furry baby" is the only patient he has at the moment, when you know he's swamped.

o Dr. Walter always takes the time to take care of the animal and their human, never making you feel silly about any health concern. She and her staff always ask about all the pets in the house when you call and always call to follow up after any treatment.

o For Dr. King, his compassion for his patients and their owners is more than just words, it is the love and concern in his eyes, voice and hands. It is his willingness to not give up in seemingly hopeless situations while exhibiting the same compassion, love and dedication to patiently explain recommendations the owners may not want to hear. He has never stepped back from a complicated problem, but has no hesitancy in recommending a specialist.

o Dr. Weeks always remembers my pet Mambo's nickname "Big Guy." She has always included me in his care as a partner. When he died she gave me the greatest gift by telling me "I was a good mommy."

o Dr. Fuller knows that the extra mile is never crowded. He communicates what he's finding as he does his exam and emphasizes that recovery and cure often takes a while and the human half of the bond needs to be patient and let nature restore the patient to health. Animals relax with Dr. Fuller's quiet demeanor and compassionate interaction.

o Our rescue organization has taken over 600 animals to see Dr. Boltz during the past four years and she has treated every one with the same professionalism and thoroughness. Tough cases are no match for Dr. Boltz---she will leave work, go home, and spend as many hours as it takes to figure out the diagnosis and treatment plan. I have received calls on her days off and late at night, with assessment results and treatment plans.

o Dr. Byam brainstorms and researches when we bring her odd cases and treats every homeless animal we bring her as if it belongs to the most important person in the world. In each animal that comes to her practice, she sees a precious life that has a right to be loved and to share that love, and it is her passion to keep each one as healthy and happy as possible.

o Dr. Prouix has a genuine gift of compassion and sensitivity that I had never seen before in a vet. He has a voice and touch that comforts and heals in tandem with the best of science and knowledge. When we lose a pet, our raw emotions were appreciated and understood and we never felt embarrassed by our many questions or the tears we shed.

o Dr. Harr's love of animals shows through the peacefully decorated room dedicated to the critically ill where she softly comforts them as they take their last breath. I watched a big tear roll down her face as she gently stroked my little boy's hair and whispered goodbye.

o Dr. Johnston was highly recommended by several friends because of her dedication, compassion and kindness, keystones of her wonderful reputation and our experience.

o I have been a neonatal nurse for 29 years and I have never witnessed the level of enthusiasm, devotion, compassion, skill and knowledge displayed by Dr. Kempt. He sets the standard for excellence through his personalized care of animals and their families.

• There's only one greatest pet in the world and every family has it! Story of Teresa undergoing anesthesia.