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Establishing Protocols Paves The Way To Success
By Tracy Dowdy, CVPM
When I was in high school I had a part time job as a veterinary assistant in my father’s practice. After working for him for couple of years, I could predict what he was planning to say and do with his clients and patients regarding the common cases such as ear infections, skin problems, routine surgeries and wellness visits. Today in the veterinary practice, most patients are healthy and receiving services for preventative healthcare and common maladies. Do you have written medical protocols grouped in your computer system for easy retrieval? If not, why? Standard medical protocols create consistency with the quality of care, it allows the doctor to empower the healthcare team and it improves the efficiency in the daily workflow.
Consistency in the Quality of Care
When a practice has multiple doctors, many times we see inconsistency in the quality of care with the patients. This creates conflict in the level of client service and the utilization of the healthcare team to educate clients regarding the common issues in the practice. Do you have clients who want to see a specific doctor because they treat cases symptomatically versus recommending diagnostics as the first option before treating the problem? Many veterinarians we talk to about this issue of creating standards in their practices are concerned about dictating how to practice medicine to their colleagues. However, the medical protocols are not meant to be a rigid rule to follow. Rather, they should be a guideline for the entire professional team to follow so there is consistency in what is being recommended to their clients. It also creates improvement in fee capture and helps veterinarians to offer the best treatment plans to your clients. Sometimes veterinarians are so busy during appointments and surgery throughout their workday that they leave themselves open to cut corners to save time versus utilizing the medical protocols preloaded into the computer system. Medical protocols also help recent graduates with their cases as a guideline for high quality of care.
Empowering the Healthcare Team
By having standard medical protocols in your practice, you are able to leverage your team in a variety of facets. For example, the receptionists are able to give information to clients about possible testing and treatments options to clients over the phone before they come in to the practice. Keep in mind; receptionists are not diagnosing the problem. They are educating your clients about the standard of care your routinely provided in your practice.
Here is a likely scenario your receptionist may face on a daily basis: A client calls your practice because his dog has been scratching his ears constantly for three days. The client wants to know what could be the problem and how much it is going to cost to cure it. Your receptionist is empowered to say one of the following statements:
Scenario A: “Mrs. Jones, I can’t give you any information other than you need to schedule an appointment for Fido and our office visit is $45.00.”
Scenario B: “Mrs. Jones, based on what you are describing to me, typically our doctors like to run some tests to identify what is causing Fido’s ears to itch. I would be happy to give you an estimate for the standard testing and treatments options we recommend. Again, this is just an estimate but it will give you some idea of what may take place when you and Fido come for your appointment.” “Dr. Smith will want to do a physical exam, ear cytology and an ear mite swab to identify if there is any infection, bacteria or parasites. Based on the results of those tests, we will know how to better treat Fido’s ears. In addition, Fido may need to have his ears cleaned and flushed to get all of the debris out of his ears in order for the medication to be more effective. Typically we will send home some medication and ear cleanser for you to apply to treat the ears. The cost for the services I just mentioned ranges between $125 to $175.” Again, Mrs. Jones this is just an estimate since Dr. Smith hasn’t seen Fido to know exactly what could be the problem. However, this gives you an idea of the costs associated with Fido’s symptoms. We have an opening for 1:00pm today. Would you like to come in at that time?”
As you read over both scenarios, it becomes clear that empowering the receptionists and the technicians in your practice to educate clients can be a huge time saver, increase client compliance and excellent client service. Some practices I have consulted have a notebook with approximately one hundred estimates for quick access when educating clients on the phone or in person. Most pet owners want to do what is best for the pet if they understand the value of the service being provided. By having standard medical protocols in place, your team is able to educate clients and pave the way for the veterinarian to practice medicine effectively.
Efficiency of the Workflow
Written medical protocols are the templates for estimates. Taking medical standards and converting them into efficient estimates improves the workflow by becoming a work order for the healthcare team. Consider how much time it takes for the doctor to dictate every test, treatment, and medications to the support staff for every case he/she sees. After the technician has taken a thorough history from the client during an appointment, he/she can recommend and perform baseline testing based on the medical standards your practice has adopted. Then the veterinarian is able to know the results of the test before entering the exam room for the physical exam. As the exam is completed and the veterinarian is consulting the client about treatment, the technician can anticipate and prepare the estimate to present to the client. After the client has agreed to the treatment plan the technical team is empowered to start the plan without having to get instructions from the veterinarian. This streamlines the efficiency in your daily workflow and it allows the practice to see more clients and patients. Many practices who have this system in place are able to implement high density scheduling because the doctor is doing only the work that requires a veterinary license (20%) and the healthcare team is doing everything else (80%).
Get started today with implementing standard medical protocols in your practice. All it takes is meeting with your team and discussing the best level of care for the common things you treat in your practice. Document it in your computer system by creating groupings or bundles. Also, train your team to the standards and the reasons for providing that level of care in your practice.
© Vetzmagazine Winter 2005
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