Stop getting burned by ear infections

Welcome to the team meeting on canine otitis externa and ear infections. Get ready to teach your team how to manage these tough common conditions-and avoid ruining client bonds and dogs' well-being. The four meeting parts below will help you teach your team why otitis externa and ear infections happen, as well as teach clients how to keep their pets' ears healthy. 

You'll find a trainer's script and team activities in each section. We recommend beginning with part No. 1 then progressing through part No. 4 to give your team the most complete understanding of the topic. Do this, and your team will emerge as experts on how to keep the hurt out of dogs' ears.

Press the links below to access the meeting tools. 

Expert contributors

Thank you to the following experts for their contributions to the material for this meeting:

Paul Bloom, DVM, DACVD, DABVP, DABVP, Canine and Feline Specialty

Allergy and Dermatology Clinic for Animals, Livonia, Michigan

Assistant Adjunct Professor, Department of Small Animal Clinical Sciences, Department of Dermatology, Michigan State University

Stephen Waisglass, BSc, DVM, CertSAD, DACVD

Adjunct Professor, Ontario Veterinary College

Dermatology Consultant, Veterinary Information Network

Dermatology Referral Service

Veterinary Emergency Clinic

Toronto, Ontario

Lisa Petty, BS, RVT

Animal Dermatology Clinic, Indianapolis, Indiana

Amanda Friedeck, BS, CVA

Texas A&M University Small Animal Clinic, dermatology, College Station, Texas

Part 1: Team knowledge

In order to create a successful team-wide approach to ear problems, every single team member needs to understand the ear, how infection affects it, and why both identifying underlying issues and preventing recurrent inflammation and infections are crucial. This 15-minute meeting section gives you a pretest to assess your team's knowledge. Then you'll get data to drive home the importance of managing otitis externa, as well as a detailed illustration to help you teach team members the anatomy of a dog's ear. View Part 1.

Part 2: Implementation

Now it's time to put your team's background knowledge to work. The handouts and activities in this 15-minute meeting part will help you ensure everyone in your practice understands how to perform ear cleanings. They'll also help your team decide which ear-related questions to ask while taking pets' histories. By the end of this meeting, each team member will know the signs of otitis externa and ear infections and understand why recheck visits are so crucial for affected pets. View Part 2.

Part 3: Client communication

Background information and know-how are only worthwhile if team members understand how to use their knowledge with clients. This 15-minute meeting part will help you teach team members how to talk to clients about otitis externa and ear infections. Interactive activities walk them through demonstrating ear cleanings and overcoming common compliance barriers. View Part 3.

Part 4: Marketing and follow-through

Your meetings culminate in this 15-minute meeting part. Your goal: Talk about strategies and tools for making pet owners your partners in treating and preventing otitis externa and ear infections. To help, you'll find an activity for busting client myths and discussion guides for ensuring your appointments and reminder systems are effective. You'll also get tips for tracking your team's success. View Part 4.

Part 1 resources

Download these handouts and tools before your team meeting:

• Part 1: Meeting guide: Explains the thinking behind the meeting and activities

• Part 1: Trainer's script: Step-by-step meeting dialogue

• Pretest: Ear problems: Assess team members' knowledge of canine ear problems

• Trainer's key: Ear problems pretest: Trainer's answer key with background information

• Team handout: Ear structures: Map of canine ear structure with labels

Part 1: Team knowledge

In order to create a successful team-wide approach to ear problems, every single team member needs to understand the ear, how infection affects it, and why both identifying underlying issues and preventing recurrent infections are crucial. (Click here for a script that walks you through exactly how to hold a meeting on this topic.)

Before continuing, it's important to clarify terminology. The general term otitis refers to inflammation of the ear. The ear consists of three regions: the outer ear, the middle ear, and the inner ear. Inflammation of these specific areas is termed otitis externa, otitis media, andotitis interna respectively. Of these three, otitis externa is by far the most common and treatable, so this training focuses on it.

Inflammation of any of the regions (otitis) can cause a decrease in normal defenses of the immune system and can predispose a pet to developing an ear infection, another focus of this training. The outer ear is also the most commonly infected region of the ear. The ear canal can become colonized and infected with bacteria, yeast, or both. This infection, in turn, can increase inflammation and the clinical signs of otitis. This vicious cycle, if left untreated, can lead to significant pain, scarring, and loss of the normal ear canal anatomy and hearing.

3-minute activity: Ear problems pretest

With those clarifications made, it's time to get a feeling for your team members' knowledge. To do so, give them a pretest (Pretest: Ear Problems). Erase any test anxiety by explaining that, while you will collect the tests, the purpose isn't to grade team members. Instead, you want to gauge how much background information trainers need to offer.

Hand out the test and ask team members to go quickly-they either know the answers or they don't. After about two minutes, ask team members to stop. Then call out the correct answers, asking team members to place an “x” next to incorrect answers. Next, explain that you'll collect these tests at the end of the meeting to assess how much background information trainers need to provide. Go on to say that today you'll be offering some background information that relates to the test. You'll add additional information as necessary in future meetings. Then ask team members to keep their pretests out and encourage them to take notes in the margins. After the meeting, you'll collect the tests; however, you'll return the tests at the next team meeting so team members can keep them as a reference tool.

Option-Play ear-related jeopardy

If you'd like to organize a more interactive pretest of sorts, plan a game-show style pop quiz to start your meeting. To play, adjust the pretest questions to be Jeopardy-style answers. For example: Answer: An underlying condition but not swimming or hair in the ears. Question: What is a cause of ear infections.

This activity is more interactive than a pencil-and-paper quiz and might get your team members more excited about the topic. However, it will not provide you with as much insight into what each team member knows about otitis externa and ear infections. Choose whichever option-pretest or game show-suits your goals and your team best.

Dish out data

After collecting the pretests, explain to the team that the ear's major functions include receiving auditory signals and maintaining balance. Let them know that these functions can be impaired if pets' ears become infected or get lesions in them.

To drive home the point of just how much otitis externa can affect pets and their owners, share some data from Banfield Pet Hospital. Banfield analyzed 2.5 million health records (2.1 million dogs and 450,000 cats) to document disease trends. The study results showed these key trends:

Inflammation of the outer ear canal, or otitis externa, ranked as the second most common disease affecting dogs and cats.

Since 2006, otitis externa increased 34 percent in cats and 9.4 percent in dogs

Last year, 15.8 percent of dogs and 7.4 percent of cats were diagnosed with otitis externa.

Some purebred dogs predisposed to the disease include the basset hound, beagle, American and English bulldog, golden retriever, Labrador retriever, Lhasa apso, all sizes of poodle, pug, Shar-Pei, and English springer spaniel.

5-minute activity: Why do dogs get ear infections?

Now that you've caught team members' attention, it's time to move on to more scientific work-specifically, explaining ear anatomy. It might be best to ask an experienced technician or a veterinarian to lead this part of the meeting. Regardless of who's presenting, use the "Team Handout: Ear Structures" form to aid in the explanation.

Give each team member a copy of the handout to refer to while you walk through the anatomy. Let team members know that some dog breeds are more likely to get otitis externa and ear infections because of the way their ears are structured or because of other characteristics of their ear canals. For example, explain that narrow ear canals (also called stenotic ear canals) may not allow for good air circulation. The resulting moist environment can increase a pet's risk for developing otitis externa and ear infections. Also share other risk factors, such as long pendulous ears. These items are considered predisposing factors, which means they make developing otitis externa and ear infections more likely.

Many cases of otitis externa and ear infections occur as a consequence of another condition, such as an allergy. Explain that veterinarians examine dogs' ear flaps to look for redness on the inner section, which may be a sign of allergy. Also mention that a significant percentage of dogs with food allergies present with ear problems as the only sign.

For all these reasons, it's important to tell team members that they all must look out for ear problems. For example, when receptionists check in dogs at increased risk for otitis externa and infection (being of a specific breed, for example), they can mention that risk to pet owners to set the stage for the technician and veterinarian. Also teach team members the following signs that a pet may be suffering from otitis externa and an ear infection: odor coming from the ears (experts advise against sniffing a dog's ears to avoid transmission of infections like methicillin-resistant Staphylococcus aureus), shaking the head, scratching at the ears, rubbing the face on the carpet, crying when they touch their ears, or shying away. If clients call and mention these signs, receptionists can bring up the possibility of otitis externa and an ear infection. Every team member plays a key role in helping clients manage the disease in their pets; this will be further discussed in Part 2: Implementation.

1-minute activity

Ask your veterinarian to spend a minute discussing the medications and ear cleansers you use in your practice. Ask the doctor to explain why it's important for him or her to examine the eardrum (also called tympanum or tympanic membrane) to see whether it's intact. Then remind team members that each case of otitis externa and each ear infection is different, and the doctor will need to examine the pet for each new complaint. Why? Because a medication that was safe or appropriate for one infection might not be right the next time.

Continue to Part 2: Implementation

Part 2 resources

Download these handouts and tools before your team meeting:

• Part 2: Trainer's script: Step-by-step meeting dialogue

• Team handout: Clean dogs' ears: Step-by-step guide to cleaning dogs' ears with teaching notes

• For clients: Clean dogs' ears: Step-by-step guide to cleaning dogs' ears

• Activity: Lock in rechecks: Practice scheduling recheck appointments with sample scenarios

• Sample: Ear history: Example questions to ask when taking a dog's history

Part 2: Implementation

In part 1 of this meeting series, you gave team members background knowledge about canine otitis externa and ear infections. Now it's time to put that knowledge to work. This part of the meeting will help you ensure everyone in your practice understands how to perform ear cleanings and understands the importance of being advocates for client compliance. By the end, each team member should be able to recite the signs of otitis externa and ear infection and guide a client through the process of cleaning a pet's ears. (Click here for a script that outlines exactly what to say to get to this point.)

2-minute activity: Clean thinking

When done correctly, cleaning dogs' ears with an ear cleanser can help treat and prevent otitis externa and ear infections. Regular cleaning with an ear cleanser also may help manage infection-prone ears. Veterinarians often recommend cleaning ears with a cleanser to remove debris before administering ear medications to treat inflammation and infection.

But many clients, despite their good intentions, just aren't very good ear cleaners. For this reason, veterinarians may recommend cleaning only for some patients. So ask your veterinarian to take a couple minutes to explain when and why he or she recommends ear cleanings to clients. The doctor might also want to discuss that it's possible for clients to clean ears too frequently. Then he or she can touch on how a cleaning scheduled is devised for each pet. For example, it might be based on how much wax the dog's ears produce.

7-minute activity: Cleaning demonstration

Now you can transition into teaching team members how to properly clean a dog's ears. Before beginning this meeting part, ask an experienced technician or a veterinarian to be prepared to demonstrate an ear cleaning. Start the demonstration by giving team members this handout, which describes how to clean a dog's ears. They can use the handout to follow along during the cleaning demonstration. (Encourage team members to use the client version of this handout to educate pet owners. This will be discussed further in Part 3: Client communication.)

Ideally, the technician or veterinarian will demonstrate a step-by-step cleaning on a canine patient due for the treatment. (If no such patient is available, it's acceptable to demonstrate on a stuffed animal.) Ask the technician or doctor to narrate the cleaning process, explaining what a team member would say throughout in order to teach clients to clean their dog's ears at home.

The demonstrator should note that some dogs might be aggressive or resist cleaning because their ears are painful. Ask the trainer to provide some strategies to help technicians or assistants work with these pets.

Take the teaching a step further: Many dogs will need ear mediciation as part of their otitis externa treatment. So, for part of this meeting, ask the technician or veterinarian to demonstrate medication administration on a canine patient, if possible. Then make a “no exceptions” client-education policy for pet owners whose dogs need drops. The policy would say that no client should leave your practice without getting a demonstration of how to properly administer ear medication.

Otitis externa and ear infections, role-by-role

Now that your team members understand how to clean dogs' ears and administer drops, it's time for them to learn how to put this knowledge to use. Technicians, assistants, and receptionists all play a crucial part in helping clients manage canine otitis externa and ear infections. In a perfect practice world, every team member will understand all other team members' roles. This builds respect among employees and helps ensure all the proper steps are taken with every patient. However, in order to keep this part of the meeting to 15 minutes, you'll need to train team members separately, breaking them into two groups: those who work in the back (usually technicians and assistants) and those who work in the front (usually receptionists). If you have additional time to spend during your meeting, it's best to complete all the training as one team-wide group so all employees are cross-trained on each others' roles.

7-minute activity: Tech talk (concurrent with below)

One of technicians' and assistants' main jobs is to ask otitis-related questions when they take a pet's history. To ensure they collect the right information, spend a few minutes talking about the exact questions you want technicians to ask. Also discuss why-such as why there would be allergy-related questions on the list. You might elect to ask an experienced technician or a veterinarian to lead the discussion about why these questions are important. (This will free you up to lead the receptionists' discussion outlined below.) The same medical leader also should discuss what technicians and assistants should do with the information they learn. For example, should they take client-education steps immediately, relay the information to the doctor, and so on.

7-minute activity: Receptionists and rechecks (concurrent with above)

Recheck appointments are critical to managing canine otitis externa and ear infections. Tell receptionists they play a key role in locking in these follow-up visits before clients leave the building. It's also a good idea to assign them the job of issuing client reminders for these appointments.

Why make such a big deal out of rechecks? If a dog's ear is infected, without a follow-up appointment, the veterinarian has no way of knowing whether the infection resolved. If the pet comes back six months or a year later with an ear infection, the doctor won't be able to tell whether the infection is new. This makes setting the treatment plan more difficult. Remind receptionists that recheck visits give the veterinarian the opportunity to identify whether the client has been properly complying with treatment recommendations. If they have been, a new treatment might be necessary if the infection is not clearing.

Share this example to illustrate the significance of rechecks: A veterinarian sees a pet on a follow-up visit with an ear infection that's not getting better. The doctor asks the client to demonstrate how he applies the prescribed ear medication. The client administers the medication appropriately, but when the veterinarian examines the ear, she sees that the medication is not going deep enough. By identifying this problem, the veterinarian can now offer advice to ensure the medicine penetrates enough to solve the pet's infection. Without this recheck visit, the client may have assumed his pet would be cured because he was administering the recommended treatment. Now the veterinarian will recommend another follow-up visit to ensure the new strategies prove effective.

Some clients might initially decline receptionists' recommendations to schedule a follow-up appointment. To help prepare receptionists to persist in encouraging a recheck visit, give each of them a copy of the worksheet “Locking in Recheck Visits.” Allow about three minutes for them to complete the worksheet. Then discuss their responses as a group. (If you're short on time, you could complete the worksheet as a group, discussing responses as you go.)

Continue to Part 3: Client communication

Part 3 resources

Download these handouts and tools before your team meeting:

• Part 3: Meeting guide: Explains the thinking behind the meeting and activities

• Part 3: Trainer's script: Step-by-step meeting dialogue

• Activity: Difficult client situations: Four difficult client situations to discuss

• Trainer's key: Difficult client situations: Trainer's answer key with sample responses

Part 3: Client communication

The information and strategies you presented in part 1 and part 2 of this meeting are only worthwhile if team members understand how to use their knowledge with clients. This part of the meeting will help you teach team members how to talk to clients about otitis externa and ear infections and overcome common compliance barriers. (Click here for a script that walks you through the meeting dialogue.)

Begin the meeting by explaining that one of the most common reasons clients leave a veterinary practice is because their dog's ear problem wasn't cured-at least, that's what clients think. What really happens most of the time is that the veterinary team didn't manage clients' expectations for handling the dog's particular ear problem. This usually means a client didn't understand that treating and managing their dog's ear problems often involves dedicated, long-term management.

To help avoid this scenario in your practice, your team members must be prepared to educate clients about otitis externa and ear infections. Team members are on the frontlines of education, answering pet owners' questions in the waiting area, in the exam rooms, and on the phone. They'll be a large part of helping clients understand otitis externa and ear infections. So tell your team members it's ideal for them to spend a little time talking with each dog owner about otitis externa and ear infections. This is especially true if the dog has risk factors, such as long ears.

Of course, if the client's dog already has an ear infection, then your team must step up client communications. Part of team members' main role in otitis externa cases is imparting to clients that the goal will be to successfully manage rather than cure the problem. Then team members must help clients understand why management is so important and teach them what to do.

Teach ear cleaning

The first step is training pet owners how to clean ears and administer ear medications before they leave your practice. Your team members are fresh off learning how to clean a dog's ears themselves, thanks to part 2 of this meeting. Before they demonstrate cleaning and administering medication, they should explain the importance of the demonstration to clients.

First off, tell team members to avoid asking clients if they know how to clean their pet's ears. This can put clients on the spot, and they may say yes even if they don't know how. So team members should let the client know they'd like to clean the dog's ears and administer the medication while the client watches. Explain that the demonstration is important because improper cleanings and improperly administered medications won't work. This means the pet's ears won't improve, resulting in more discomfort for the dog and more visits to the veterinarian. Following your instructions will improve the chance of decreasing inflammation and clearing infection quickly. What's more, if your team knows the client has effectively handled cleaning and treatment, you'll know a new approach might be needed if the ear infection isn't clearing.

Let team members know that, after giving an introduction like the one above, they're ready to show clients how to clean ears and administer medication. Suggest that team members give clients this form so they can follow along during the demonstration. After a team member cleans one ear, it's a good idea for the team member to ask the client to clean the other ear while the team member watches. This practice run helps team members see where the client might need help and ensures the client learned correctly.

Talk about cleaning tools

Another important portion of client education is addressing the right and wrong tools for ear cleaning. What's right: A veterinary ear cleanser. The veterinarian will recommend a safe cleanser for each pet. Using the recommended cleanser will help decrease inflammation, help clear infection clear more quickly, and help prevent recurring infections. Cotton balls and gauze squares are the best for wiping the dog's ears clean.

After talking about what's right to use, tell clients what to avoid. Most veterinarians recommend against putting anything inside the ear. Tell clients they should not insert cotton swabs into their dog's ears. Tell clients that using a cotton swab may push earwax down into the ear, creating more problems. In addition, talk about how cotton swabs could potentially become stuck in the ear. Finally, talk about how even a soft cotton tip can cause injury and create soreness in a pet's ears if they're already inflamed. Even technicians need to be aware of this potential sensitivity when they use swabs to collect samples for cytologic examination.

Manage client expectations

Now spend a few minutes talking about difficult cases. For example, some pet owners won't clean their pet's ears. Others will resist recheck visits. Tell your team members you'll give them strategies to overcome these obstacles. This is especially important because, if your team doesn't manage these cases and set realistic expectations for clients, you'll lose clients. Worse yet, you'll fail to help dogs with otitis externa and infected ears.

Start the difficult-case discussion by reminding team members that clients dealing with painful pets might face a particularly tough time cleaning and treating their pets' ears. Experts say it's important to remind clients to avoid holding their pets down to administer ear cleansers or medications. Doing so may make the pet head shy, which will make it more difficult to treat the pet in the future. To help, the veterinarian may opt to use oral medications to make the pet's ear feel better before asking the client to attempt any treatment.

There may be a medical solution to helping clients whose dogs are in pain. For the other cases, the solution is communications-based. One of the most effective ways to overcome client resistance to managing otitis externa and ear infections is to encourage your team to relate the pet's situation to a person's situation. For example, team members could relate the pain people feel from ear infections to the pain a pet feels.

Another important tip is to speak using client-friendly terms. For example, when talking to clients, team members should say ear inflammation instead of otitis externa and they should say ear infection regardless of whether the infection is due to a bacteria or yeast. This will help clients understand the information.

You've already discussed the importance of scheduling recheck visits with clients whose dogs have otitis externa and ear infections. Remind receptionists that they should set up the recheck appointment before clients leave the building. Also tell technicians that they should explain the reason for the recheck visit before clients head to the front desk for checkout. Technicians should also let clients know that the doctor might recommend more ear smears or tests to ensure the pet is improving. It's important to tell clients that if the dog's ears aren't healing, the veterinarian may recommend a different treatment.

Perhaps the most important part of managing clients' expectations has to do with explaining the difference between controlling the symptoms and curing an underlying condition. As discussed in meeting part 1, the greatest number of ear infections stem from an allergy that can't be cured. This is similar to handling hay fever in people. The symptoms-stuffy nose, itchy eyes-can be controlled but the allergy isn't cured. The same is true for allergies in dogs. There's no cure for pets' allergies, so they need to be identified and addresses. And if they're causing ear infections, the infections must be treated.

10-minute Activity: 4 difficult cases

After sharing these tidbits with team members, they're ready to handle difficult client situations relating to otitis externa and ear infections. To practice, download this “Difficult Situations” form and print it on cardstock or paper. Cut the page into four cards as indicated. Divide team members into four groups, giving each group a card. Provide paper and pencils so team members can write down their responses. Introduce the activity like this: “Each group will look at a difficult situation we might face with pet owners whose dogs have otitis externa or an ear infection. Each group will write down how they'd respond to resolve the situation.

After giving team members about three minutes to write down their responses, ask each group to share. Then discuss as a team what was great about their responses. Most importantly, discuss which statements would encourage resolution of the situation why. The “why” is actually the most important part, because when team members grasp why certain statements work, they'll be more likely to use them. If possible, offer a small reward, like a $5 coffee gift card, for the team members who come up with the best responses. End the meeting by explaining that, next time, you'll look at how to track client compliance and measure the team's success at handling cases of otitis externa and ear infection.

Continue to Part 4: Marketing and follow-through

Part 4 resources

Download these handouts and tools before your team meeting:

• Part 4: Meeting guide: Explains the thinking behind the meeting and activities

• Part 4: Trainer's script: Step-by-step meeting dialogue

• Activity: Debunking client myths: Common client misconceptions about ear infections

• Trainer's key: Debunking client myths: Trainer's answer key with facts about ear infections

• Sample for clients: Ear cleaning checklist: Information from your veterinarian

Part 4: Marketing and follow-through

All the previous meeting parts (part 1, part 2, and part 3) culminate here. The goal for this meeting part: Discussing strategies and tools for making pet owners your partners in treating and preventing otitis externa and ear infections.

Begin with wellness

Start the discussion by talking about how regular wellness exams offer an opportunity to discuss ears. Remind technicians that they need to be asking ear-related questions as part of their history taking, as you discussed in meeting part 2. All team members should be on the lookout for dog breeds at high risk for otitis externa and ear infections. Some veterinarians recommend regular ear cleaning as a way to encourage pet owners to look at their pets' ears about once a week. Before this meeting begins, ask your veterinarian whether he or she recommends preventive ear cleaning in high-risk dogs. If so, emphasize that team members must show these clients how to properly clean their pets' ears with the recommended ear cleanser.

8-minute activity: Client mythbusting

A good way to ensure your team is prepared to talk about otitis externa and ear infections with all clients is to address common client myths. Download the “Client Myths Worksheet” and answer key to reinforce your team's knowledge and help them assist clients. Pass out this handout to every team member. Then discuss the facts as a group, asking team members to write down the correct responses. Writing down the facts will help team members remember them. Finally, ask whether there are other misconceptions or questions team members hear from clients. Address them as needed.

Compliance hurdles

One of the toughest myths to handle is that, once treated, a dog's ears will be healed forever. Some infections may recur because they're caused by underlying allergies or the structure of the dog's ears. In these cases, there's always a high risk for developing new or recurrent infections. Some infections and cases of otitis externa can appear to recur but the truth may be they weren't resolved in the first place. In these cases, it's important for the veterinarian to determine whether an infection truly is recurrent or whether it's an unresolved infection that wasn't completely treated. Clearing up ear infections only happens when the ears are treated long enough. In fact, experts say one of the biggest reasons ears infections are such a problem for clients is because treatment stops too early.

So the real issue here is following up with clients to ensure they're complying with preventive cleanings and treatment, which can include cleanings. Experts say one of the biggest reasons clients fail to administer ear medications and clean their pets' ears is because they've never been taught how. Remind team members the importance of teaching every client at every appointment. Also remind them to make sure the client is leaving with appropriate handouts and instructions.

Group discussion: Handling uncooperative clients-and pets

Next, talk about noncompliant clients. Tell team members to encourage clients to be honest about whether they're cleaning their pets' ears. Assure pet owners they won't be judged. Rather their honesty will help you offer solutions. For example, if a painful pet makes cleaning difficult, the veterinarian and technicians might treat the pet for a while so the ears are less tender. Then the client can begin ear cleanings. Or the veterinarian may sedate or anesthetize the pet and flush its ears if the client wasn't able to make ear cleanings happen at home. Other clients might be too busy or have uncooperative pets. Take a minute to brainstorm the solutions your practice could offer them.

Making time

Another challenge with client compliance and satisfaction is lack of time-yours, not the client's. Veterinary referral doctors and staff members say the clients they see are usually frustrated because they don't feel their regular veterinary team communicated with them. Most often, they say this happens because of short appointment times. Client communication is a critical tool to manage clients' frustrations and prepare them to offer the treatment their pets need. Consider the length of your appointment time for these visits and plan for the technician to spend some extra time in the exam room educating clients about their pet's condition. Part of this would include teaching clients how to administer medication and clean the pet's ears, depending on the veterinarian's recommendations.

Group discussion: Effective and efficient

Talk about how you can make your appointments most efficient. Discuss which parts of the exam the technician can take over, including taking the pet's history, performing the cytologic examination of the ear smear, and educating the pet owner. And remember, you don't want the client to feel rushed. Discuss how you can encourage clients to call you with problems and make them feel like you're partners in treating pets. Address who will be available to field these phone calls. Consider offering clients the technician's business card so pet owners can call when they have questions. Also consider reaching out to your clients, calling them proactively to ask how they're doing with their dog's ear care. Making these connections with clients will strengthen their bonds to your practice and help improve compliance.

Group discussion: Tracking compliance

It's important for team members to track compliance to ensure clients don't end up frustrated and the ear inflammation unmanaged or the infection untreated. One idea for measuring compliance is using your inventory software to track how many bottles of ear cleanser the client has purchased. If the doctor has recommended weekly ear cleanings for a pet, the owner should purchase roughly six to eight bottles a year. You could even check monthly statistics for clients whose pets are newly diagnosed with otitis externa or ear infections. In your meeting, discuss who could be in charge of tracking these numbers. Then devise a plan for how the person will report the findings. (If you're short on time for your group meeting, schedule a follow-up meeting with the necessary people to prepare a plan.) For example, the person might let the practice manager know a client is under the numbers. Then the practice manager could work with the appropriate team members to devise a reminder system or follow-up calls. Be careful not to judge clients. They may be purchasing their ear cleanser elsewhere, so avoid being accusatory if you try using this system.

You may also use your practice management software to identify how often clients return for rechecks and set a goal to improve this number. Also review your practice's reminder system. Do you send out reminder cards? Do you call or e-mail clients 48 hours before appointments to remind them about the upcoming visit?

Finally, and perhaps most importantly, when clients do come in for rechecks, make sure your team members congratulate them on being excellent pet owners. For example, when the pet comes in for a recheck and the infection has cleared, the technician might say, “It's so good that we cleared up that ear infection, because I'm certain those ears were hurting. Good job staying with it!”

3-minute activity: Ear problems post-test

A great way to end your meeting is to ask team members to take the same test they took at the beginning of part 1. They will undoubtedly get more answers correct. This is a tangible way to show them their progress. It also helps you decide whether there are areas related to otitis externa or ear infections that you need to revisit.

Conclusion

To close your meeting, have everyone give each other a round of applause. You've made a lot of recommendations in four short meetings. And your clients-and patients-are going to benefit from your new approach.