The appointment book is already filled when the practice opens its doors. The phones are ringing. The receptionists are squeezing in double-booked appointments and referring others. The practice and its veterinarians are in high demand. Sounds like a good problem to have, doesn’t it?
However, at the end of the day, after the double-booked appointments, after the angry call from a client who was referred elsewhere and after working through the dinner break just to see all the appointments, the team’s physical and mental health has taken a beating. Wouldn’t it be nice to have “a village” to deliver patient care and release some of the pressure?
The idea of having a village may not be as far-fetched as it sounds. Primary care veterinarians cannot do everything. Yes, moving the tech from being a restrainer of patients to a leveraged technician takes time, but it has its merits. Utilizing specialists and referral practices also has its merits in helping the veterinarian to handle the increased demand for treating complex medical conditions.
Take a moment to study our human counterparts. Not everything on the human medicine side is worthy of copying, but some aspects may prove advantageous to the veterinary profession. Nurses and nurse practitioners who are capable of handling routine care of complex medical conditions have enabled physicians to expand the number of cases they oversee. Telemedicine, although not replacing in-person visits, has leveraged the medical team more effectively. Moreover, with the development of wearable medical devices and smartphone apps, some monitoring and diagnostics can be conducted in a virtual atmosphere.
Your Village
Take a moment to dream of your ideal village. This will be different for every practice because of the location, size, services, client demands and status of the current team. Many practices started the village when agreements were made with specialists, emergency practices and referral practices in areas such as oncology, dermatology and ophthalmology. However, do not stop there.
Does your village need someone for behavior? Perhaps someone concentrating on nutrition should be included. What about a rehabilitation therapist? Pet trainer? The list goes on. In some instances, the veterinary practice has added in-clinic people to cover some of these services. In other practices, clients are referred to the nearest provider.
The caveat to referring outside the practice walls is the problem with communication and compliance. It is not always a seamless referral. Communication between the practice and an outside entity can be rocky — a patient is seen, referred and then lost. Client compliance might be rocky, too. The referral is made, but the follow-up visits fall off due to distance or expenses.
In the ideal village, communication is seamless and connected. Compliance is made easier with the use of technology. This may be the perfect time to explore some options for developing both in-clinic personnel and expanded telehealth services to create a village that will provide for your patients.
Partners in the Village
Take a moment to construct a dream team for the veterinary practice. For instance, a team member is interested in dog training. Is it feasible to budget training for this person so she that can become the in-clinic trainer? Would it be feasible to dedicate space for behavior and other training sessions? After training and certification of the person, the veterinarian can refer the patient in need of training to the in-clinic trainer. This person has her own appointment column, and clients are scheduled to come receive the additional service.
Not feasible to train and devote clinic space? What about setting up teleconsulting with a trainer or behaviorist? With the proper equipment, the patient can be assessed via video feed from the practice or from the patient’s home to the partner trainer or behaviorist. The village may be the exam room next door or the technology that brings together the pet and the partner.
Perhaps having a dedicated area to connect to partners via video conferencing is a reasonable way to expand the village. Now, this is not to take away from the veterinarian-client-patient relationship, but it is a way to increase compliance by connecting the primary care veterinarian, client and specialist and creating a relationship whereby ongoing care is handled through video conferencing from the primary care practice or the patient’s home. Fido is having a medical condition requiring the services of a specialist. After initial exams, a telemedicine protocol is established and all three caregivers — the specialist, referring veterinarian and client — can view the patient at the same time. Treatment plans can be discussed and implemented in real time, rather than losing time by emailing reports and traveling back and forth.
Finally, consider wearable technology as a village partner. Remote monitoring and video-enabled engagement will enable veterinarians to assess critical health issues and communicate faster and easier with clients. Not all villagers need to be humans; there may be merit to adding technology to enhance the level of care you provide patients.
A New Village Structure
On the human side of health care, dream teams of nutritionists, occupational therapists, social workers and wearable technology are used to improve patient engagement, leverage team members to do what they do best, and foster more seamless interactions with professionals and specialists. Is it possible for veterinary care to do the same thing?
Our human counterparts are seeing value in changing their business models. The Health Research Institute’s “ROI for Primary Care: Building the Dream Team” report stated: “Today’s primary care doctors are not being deployed effectively. HRI’s 2015 clinician survey found that they spend more than one-third of their time on administrative work, discussing behavioral health issues with patients and addressing patients’ social barriers.”
Sound familiar? How many of today’s veterinarians are spending time on administrative work to keep the business successful, troubleshooting behavioral issues of the four-legged patient, and addressing clients’ financial and social barriers? The same report noted that 75 percent of consumers were comfortable seeing a nurse practitioner, physician assistant or pharmacist instead of the physician for certain services. If our clients were comfortable with this structure for their own health care, would they be comfortable with it for their pet’s health care?
Now is the time to look at your practice village and restructure it to best serve the needs of the patients, the clients and the business. A team is needed to share in the care of pets. This team, or village, may contain any number of professionals and use technology to provide exceptional patient care, meet client demands and improve the team’s efficiency.