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April 2023
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Successful preventive care requires a team effort
Successful Preventive Care Requires a Team Effort
Does your veterinary practice have standard protocols for preventive care recommendations? If not, this is the first step you should embrace to promote preventive care in your practice. These protocols ensure that all clients are receiving consistent recommendations no matter which veterinarian or team member they see during their appointment. Having different recommendations for frequency of examinations, laboratory testing, vaccinations, and parasite prevention can lead to client confusion and decrease compliance.
Preventive care protocols can be developed in several ways and can vary in their level of detail. At a minimum, they should include recommendations for examination frequency, vaccinations, parasite prevention, and diagnostic testing. Additional preventive care protocols may include many additional items, such as standard spay/neuter and nutritional, behavioral, and oral health recommendations.
The 2011 AAHA Preventive Healthcare Guidelines provide an overview of what might be included in a clinic’s protocols. Specific components, such as vaccination and diagnostic testing recommendations are supported by additional AAHA guidelines. (See aaha.org/guidelines for the entire list.)
Once preventive care protocols have been developed, all team members should receive education on the new guidelines. It is essential that team members not only understand what the recommendations are but the reason behind each recommendation and how best to communicate it to pet owners.
Implementing Preventive Care Protocols
When first implementing a preventive care protocol or adding a new recommendation to existing protocols, hold a team meeting to review and discuss. Create opportunities for team members to actively engage with the ideas during the meeting, such as:
“Once the protocols are introduced, it is helpful to provide written copies of the protocols to team members and have them easily accessible around the clinic for reference.”
- Have a veterinarian or veterinary technician give a short presentation with an overview on the medical topic and the new recommendation, such as parvovirus vaccination, feline leukemia testing, or heartworm disease prevention. These presentations could be collected and put into a booklet that can be reviewed as needed by team members.
- Allow team members to ask questions to clarify why certain recommendations are being made or discuss what they see as potential barriers to client compliance. They may bring up items that will be common client concerns, allowing your whole team to prepare a response together.
- Consider opportunities for role playing to allow for communication practice about specific recommendations. This could be combined with general communication skills training for employees.
- Ask team members to break into small groups to create client education materials like a bulletin board display or social media post, to highlight specific recommendations.
Once the protocols are introduced, it is helpful to provide written copies of the protocols to team members and have them easily accessible around the clinic for reference. It can take time for new recommendations to become routine. Providing written scripts that individuals can utilize when first introducing the recommendation can help to increase their comfort levels. The amount of detail an individual team member will communicate to clients will vary by their level of training and position in the clinic. Over time, they can adapt the script to fit their own style and experiences, personalizing the recommendations for individual clients.
Another powerful tool to improve client compliance is to encourage team members to follow the same preventive care recommendations for their pets so they can share first-hand experience. When every team member can explain why the recommendations are in place, the perceived value of the exam, vaccination, test, or preventive product will increase.
Communicating Preventive Care Recommendations to Clients
Clients are more likely to follow recommendations that are made consistently by all team members, and most clients will need to hear recommendations multiple times before agreeing, especially if it is something new for their pet. Having different team members explain the recommendation before and throughout the visit can help to improve compliance.
Preventive care recommendations can start before the client ever arrives for their appointment. For example, when the client schedules their examination, the client service representative (CSR) can say, “I’ll be happy to schedule Fluffy’s appointment. She is due for her annual preventive care examination, the following vaccinations, and parasite screening, which includes a stool sample and blood test. Based on Fluffy’s age, her healthcare team will discuss additional recommendations for blood testing that will help to ensure she isn’t hiding any signs of disease. Do you have any questions about this?”
At check in, the recommendations can be reiterated by the CSR. The veterinary assistant or technician who takes the patient history can review in more detail the reasoning for specific recommendations, especially if the client is unsure about certain vaccinations or testing recommendations. This means that before the veterinarian even enters the examination room, the client has heard the recommendations at least three times.
The Essential Role of the Veterinary Technician
Veterinary technicians should be entrusted to use their knowledge and training to provide detailed client education. According to the 2018 AAHA/AVMA white paper, “The Opportunity,” clients often do not fully understand what happens during a preventive care visit. One way to overcome this gap is to spend time building a relationship with the client and communicating the value of the physical examination and any testing performed. Veterinary technicians are valuable assets when it comes to building relationships with clients. (You can view the white paper here; The Opportunity)
Veterinary team members should be equipped to answer common questions from pet owners about preventive care recommendations.
When taking a history, technicians can ask specific questions to evaluate for lifestyle risk factors that may affect recommendations for the specific patient. They can have an initial discussion about patient nutrition, behavior, mobility, and ask questions that might elicit subtle signs of pain, such as “What is your cat’s favorite place to spend time and has that changed?” These professionals can answer many client questions and start to elicit the client’s concerns, goals, and limitations that can help guide the veterinarian in developing patient-specific recommendations.
A thorough history and introductory conversation with a veterinary technician will allow the veterinarian to focus their attention on the items of highest concern to the client, which can improve the perceived value of the appointment. They can answer additional questions and reiterate recommendations the technician made based on the standard clinic protocols as well as any patient-specific concerns that have arisen during the client communication or physical examination.
Allowing veterinary technicians to use their full knowledge base to engage in client education is one part of improving technician utilization and job satisfaction. Additionally, clients are more likely to be engaged in the decision-making process for their pets when both a veterinary technician and veterinarian are involved, according to a 2022 JAVMA study of shared decision making in veterinary medicine. Creating a patient care team that includes the client, veterinarian, veterinary technicians, and other team members will ultimately improve compliance with recommendations and outcomes for patients.
Barriers to Preventive Care Compliance
Two common barriers that may be faced in achieving high compliance with recommendations include financial concerns and not understanding the value and benefit to the pet. Most pet owners consider their pets to be a family member. They want to maximize their pet’s quality of life for as long as possible, and many are eager to pursue medical care that will help to achieve this.
Client education is essential to overcoming many barriers to preventive care compliance. I have often had clients accept a recommendation and then tell me that no one ever told them the reason behind year-round heartworm prevention or screening blood work before. Spending an extra minute or two in the examination room engaging in client education can maximize outcomes for patient health and the veterinary business.
When it comes to financial barriers, determining the client’s budget is an important first step. Consider spreading vaccinations over multiple visits, selling smaller quantities of preventative products, or scheduling a follow-up visit with a veterinary technician to perform recommended diagnostic testing. Another key component of client education is that an investment in preventive care can save money long term. For example, when discussing recommendations for spay, informing owners of the risk of pyometra in intact females and the cost of emergency treatment compared to a routine spay can help to strengthen the recommendation.
Talking Points for Veterinary Team Members
Veterinary team members should be equipped to answer common questions from pet owners about preventive care recommendations. Here are some common questions you may hear from clients about preventive care recommendations and considerations for how to respond.
Does my pet really need a yearly (or twice yearly) examination?
A key part of preventive care involves getting the patient, client, and veterinary care team together, whether that is in a traditional clinic or a home visit with a mobile veterinarian. These visits should happen at least annually but may be needed more frequently depending on patient life stage.
Some clients are reluctant to come to the veterinary office regularly for examinations, especially if vaccinations or other diagnostic tests are not currently due. One strategy to overcome this is to use the well-known comparison of a single year in a pet’s life being equivalent to several years of human life: “We know that our pets age faster than we do as humans. We need to see Fluffy once a year to track her weight, mobility, dental health, heart function, and more. Seeing her only once a year is like you going to your own doctor only every few years.”
Owners of pets who are highly stressed by veterinary clinic visits may be even more resistant to regular examinations. Discussing ways to prepare their pet for the visit to reduce stress and use of previsit pharmaceuticals can help to minimize stress and ensure the pet receives appropriate care with lower stress for all involved.
A key part of preventive care involves getting the patient, client, and veterinary care team together, whether that is in a traditional clinic or a home visit with a mobile veterinarian.
Why are we giving so many vaccinations?
Vaccinations are divided into core vaccinations and lifestyle-based vaccinations in the AAHA vaccination guidelines. Veterinary technicians should be familiar with the vaccinations carried in the clinic and trained to evaluate risk factors to help determine the appropriate vaccinations for individual patients. The entire team should also be familiar with the frequency of vaccinations, especially booster schedules and how to approach pets who are overdue for vaccination.
Some pet owners may express vaccine hesitancy for all vaccines or concern for the number of vaccines their pet is receiving. This can be especially true for pet owners who have experienced a vaccine reaction in the past. Creating an individualized vaccination schedule that spreads out vaccines can be one approach to address this concern.
My pet seems fine, so why should we do lab work?
Routine screening blood work is recommended for pets of all ages, though the specific tests and frequency vary by life stage. Data from IDEXX shows the value of screening lab work in detecting subclinical disease, allowing veterinary teams to intervene earlier and lengthen quality and quantity of life for patients.
Remind pet owners that pets are masters of hiding illness, and catching early disease will benefit their pet’s health in the long term. As a veterinarian, I will often tell pet owners, “While everything feels normal on examination, my hands can’t tell me how Fluffy’s organs are functioning. Blood work will allow me to evaluate this and check for early signs of disease.” For young pets, lab work helps to determine individual normal values and track trends over time, which can be a valuable asset as pets age.
Education Beyond the Exam Room
Veterinary teams should also take advantage of opportunities to educate clients on preventive care recommendations outside of their visit to the clinic. Technicians or other team members who enjoy social media could be given extra responsibilities to promote preventive care through this avenue. Consider sharing not only recommendations but stories of patients who have benefitted from following preventive care recommendations.
Veterinary professionals know the benefit of preventive care to improving patient health and maximizing both quantity and quality of life. Providing education in and out of the exam room will help clients develop the same appreciation for the importance of preventive care in helping their pet to live their best life.
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