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October 2023
Technician Utilization in Dermatology
Using a credentialed technician in the role they were designed for increases the number of cases the team can see, and it can increase overall revenue. In this article, we will cover some of the many ways that trained technicians can contribute to dermatology appointments.
How Techs Can Contribute—and the Support They Need to Succeed
The use of technicians in veterinary medicine varies greatly: Some practices utilize their technicians to the fullest—others do not. Using a credentialed technician in the role they were designed for increases the number of cases the team can see, and it can increase overall revenue. In this article, we will cover some of the many ways that trained technicians can contribute to dermatology appointments.
Collect Dermatology History
A well-trained, proficient technician can assist in many aspects of a dermatology appointment, as the technical staff are usually the first faces a client sees in the exam room. Among other things, they can collect a complete dermatology history, conduct a basic physical exam, and open the line of communication with clients. A simple history questionnaire with questions on food, past health issues, and behavior can be used to help direct the technician on what questions to ask while in the exam room.
Certain questions beyond the normal history should include: “What are your goals and expectations for the appointment today?” If the patient is in for a recheck appointment, the client should be asked: “If this is as good as your pet will ever look, will you be happy?”
The answers to these questions will guide the veterinarian toward the type of discussion to have with the owner—whether that includes future therapies or reasonable expectations of treatment for skin disease.
Obtain Cytology Samples
A well-trained, proficient technician can assist in many aspects of a dermatology appointment.
Once the patient’s history and physical exam are done, basic cytology samples can be collected, processed, and interpreted by a trained technician. It will take time to train a technician in cytology interpretation, but once the training is completed, there are great benefits to the practice. For example:
- The tech will be able to analyze the slides very quickly;
- A single technician who is proficient in cytology can train the rest of the staff;
- Other diagnostics can be collected and processed by the technical staff at the request of the veterinarian.
Set Up Before and Clean Up After Procedures
It’s usually the technician’s job to set up for procedures and clean up after them. Technicians can be trained in how to do many procedures depending on state regulations.
- Many procedures, such as skin testing and biopsies, can be prepped by the technician with the veterinarian only needing to read the skin test or perform the biopsy while the technician handles all other aspects of the procedure.
- A well-trained technician can make the procedures run smoothly and be as efficient as possible with minimal involvement of the veterinarian.
Discharge Patients
Discharging a patient can easily be done by technical staff. However, there will often be multiple types of therapy going home with the owner, so before they leave, it is vital to make sure they understand their role in their pet’s health. If an owner doesn’t understand how to do a treatment, they usually won’t call the clinic to ask—they just won’t do it.
Spending a few extra minutes reviewing the pet’s meds increases client compliance and can save the owners and veterinary staff some frustration. A well-trained tech can perform this task and answer most of the questions an owner may have, which can free up the veterinarian to move on to the next client.
For example, a trained technician can:
- Go over the treatment plan and give the clients relevant handouts to take home with them.
- Discuss realistic expectations, explaining that it’s expected that a well-managed allergic dog will flare at some point in time. This does not mean the treatments are not working, just that they are having a flare.
- Remind the owner that treatments for skin disease usually take weeks to show visible improvement.
Provide Hands-On Client Education
Client education is a huge area in which the technical staff play an important role.
The technician can:
- Make sure clear and concise directions are on the medications being sent home, including a written document with directions on intended therapies.
- Show owners how to administer treatments. Demonstrating how to do the treatments appropriately, whether it be ear cleaning or topical treatments, is a necessity in dermatology.
- Review proper cleaning techniques: Never assume the owner knows how to clean an ear or bathe their pet; it should be discussed every time.
Workflow is more efficient overall when the technical staff are trained and allowed to do what they were trained to do.
Field Phone Calls and Emails
Many phone calls can be taken care of by technicians without unnecessarily involving the veterinarian. Technicians can be trained to make and recognize if and when a recheck appointment is necessary. Sometimes clients can be advised to try a topical therapy that they have at home or that can be dispensed without a prescription. Or, if necessary, they can schedule a recheck. Veterinarians can provide a list of emergent symptoms for techs to have readily available when speaking to owners on the phone so the technician knows when a patient should be seen immediately. Techs can also:
- Make day-after calls to check on the patient and ensure all treatments can be completed as directed.
- Document what was discussed with the owner in the medical record. Legally, notes need to be more descriptive than “spoke with owner,” to help protect the veterinary team in case questions arise.
Know State Regulations—Then Train and Delegate to Technicians
Technicians can be utilized in many areas of the clinic starting with the basic dermatologic history, physical exam, and establishing expectations of the visit. So why don’t more technicians do these things? A technician’s role within the clinic is only limited by two things: state regulations and the veterinarian’s willingness to relinquish their job duties.
Regulations of what technicians can and can’t do vary by state and it is ultimately the responsibility of the technician to know what their state regulations are. But the biggest restriction to technicians within the clinic is the willingness of the veterinarian to relinquish certain job duties and trusting technicians to complete them adequately.
To help build this trust and alleviate potential problems, veterinarians need to train technicians on how they want things completed.
Training Techs to Be All They Can Be in Dermatology Appointments
Here are some specific things that veterinarians can do to improve technician utilization.
- Spend the time to train your lead technician on diagnostic tests and procedures based on your state regulations. Once that training is complete, they will be able to train the rest of your staff.
- Provide a teaching set of cytologic samples for training purposes. Videos are helpful, as long as your technicians have access to the videos when they need them.
- Send your technicians to local continuing education (CE) events on topics that will benefit the clinic. Veterinarians or hospital managers can contact company reps about in-house CE or ask if they are sponsoring any local CE events.
- Encourage technicians to speak to their veterinarians about taking on more responsibility (as allowed by state regulations) within the clinic setting. Remember, it is the technician’s responsibility to know their state regulations and restrictions.
- Encourage technicians to search for local CE opportunities that are of interest to them and would be beneficial to the clinic and present that to the veterinarian. There are many online CE events and portals that can be utilized.
- Practices can provide financial assistance for technician CE, knowing it will benefit the staff and increase the quality of patient care.
A technician’s role within the clinic is only limited by two things: state regulations and the veterinarian’s willingness to relinquish their job duties.
Example of a Workflow with Multiple Technicians per Doctor
Workflow is more efficient overall when the technical staff are trained and allowed to do what they were trained to do. In my opinion, a clinic with two or three techs per doctor can see many more patients than a clinic with a higher doctor-to-staff ratio. Here’s an example of how this workflow can play out with properly trained technicians:
Technician 1 meets with Client A, collecting the basic and dermatologic history of the patient and doing a quick physical exam.
Technician 1 takes any cytologic samples or collects further diagnostics if the veterinarian has put a plan in place prior to the appointment. These diagnostics can be basic blood work or a scheduled urinalysis.
Once all this is completed, the veterinarian can do their exam, ask any follow-up questions, and start discussing further diagnostic tests if needed. During the veterinarian’s exam, Technician 1 processes the slides and documents their findings. (An additional technician or assistant may be needed to help the veterinarian in the exam room.)
Technician 1 takes the cytology findings to the veterinarian while they are still speaking to Client A
to form a final plan.
Meanwhile, Technician 2 meets with Client B, obtaining the basic dermatologic history and doing a physical exam on the next patient. The process begins again.
Once a plan has been finalized for Client A, the veterinarian can move on and Technician 1 can:
- Gather up the prescribed treatment therapy or set up for the diagnostics.
- Show Client A how to do the therapy as instructed.
- Go over any side effects that may be possible with the prescribed therapy.
- Set expectations that therapy could take a week or two for the skin to start looking better.
- Discharge the patient.
Working this way, a diagnostic plan can be developed for multiple patients in the time it could have taken to see only one patient.
Amanda L. Friedeck, LVT, VTS (Dermatology), started working for Texas A&M University Small Animal Clinic in 1995, as a student worker. In 2007 she graduated with a bachelor’s degree in animal science with a business minor. Amanda received her LVT credentials in the summer of 2014, and in 2018, she became one of the first technicians to pass the Dermatology specialty boards and obtained her VTS (Dermatology). She wrote a book chapter for a published veterinary technician dermatologic textbook and enjoys speaking to technicians on dermatologic conditions and sample collection. |
Photo credits: fstop123/E+ via Getty Images, SeventyFour/iStock via Getty Images Plus, ©AAHA/Kimberly Lamb, SDI Productions/E+ via Getty Images