Vet Practice Practices: Blending the Old With the New

Regardless of new innovations being introduced into the market, the veterinarian-client-patient relationship should be the essential basis for interaction.

As we head into the summer months, business is booming for most veterinary clinics, judging by industry numbers. “You’ve likely seen reporting on the boom in pet ownership in the wake of the pandemic,” said Link Welborn, DVM, chief veterinary officer of Covetrus. On the adoption side alone there has been a 15% increase from 2020 versus the previous year, according to Shelter Animals Count. “People spending more time at home (and likely seeking out a four-legged companion) are big contributors here, as well as pet parents working at home having more time to observe their pet’s problems.”

In addition, disposable income has been redirected to veterinary care with consumers spending less money on travel and entertainment.

“This is leading to many practices, especially smaller, local clinics, having a hard time keeping up with appointments and sometimes leading to overworked veterinarians and practice team members,” Welborn said.

Making adjustments

The COVID-19 pandemic caused most veterinary practices to quickly adjust to seeing pet patients and their owners in new ways, with many moving to curbside and drop-off appointments.

Yet there’s an inefficiency associated with curbside service. The client pulls up into a parking spot, calls to say they’ve arrived, the clinic must identify an individual staff member to go out and get the pet, the staff member chats with the client, brings the pet in, an exam is performed inside, a tech or the veterinarian call the client to discuss what they found, an estimate may need to be presented for care, test results may need to be shared, treatment needs to be discussed as a result of the tests … there are a lot of extra steps added in. “There’s just a lot of inefficiency associated with it, as opposed to a client coming into an exam room,” Welborn said

Welborn and most veterinarians he’s talked to are looking forward to getting back to face-to-face appointments as soon as possible “provided we can do it safely.” Many animal hospitals, including Welborn’s, were offering the option of an in-hospital visit as of early May, and a certain number of clients were taking advantage of it. But others were not. “Not everybody’s comfortable with it,” he said. “Frankly, I think curbside service is going to continue to be part of what we do. If nothing else because it’s convenient for some clients.” For instance, clients may not want to come into the hospital for a prescription or a bag of pet food and would rather have it brought out to them curbside.

But as new ways of interacting with clients take hold, Welborn said it’s important for veterinarians to continue to emphasize the importance of in-person examinations.

“It’s very simple,” he said. “A hands-on examination is very often essential to making the right diagnosis, from the start. Without it, some veterinarians may make a diagnosis and prescribe medications when a physical examination would have altered the diagnosis and care.” This could result in a delay in the pet receiving appropriate care while the pet parent and veterinarian wait to see if medications work or fail. In turn, this could cause unnecessary pain, suffering, and in the worst cases, tragic consequences for our animal companions.

Additionally, while some may argue that using telemedicine to establish a patient relationship has worked well for human healthcare, Welborn said that it’s important to remember that we, as humans, benefit from the ability to speak with our care providers, allowing us to share our specific issues and have a constructive dialogue. “Clearly, animals do not have this same ability. Therefore, assessing pain and other sensations that pets feel through audiovisual means is extremely challenging for veterinarians.”

Veterinarians are very trusted by pet owners, “who recognize we’re trying to do the right thing for the right reasons. So we’re still quite successful at being able to develop those relationships, it’s just a little bit more of a challenge [within the pandemic environment] than it used to be.”

A disconnect can lead to lost revenue for a practice, but also missed opportunities in a pet’s care. Veterinary care is best provided by a team that includes the client, veterinarian, the practice team, and other trusted sources of services and products including specialists and outside pharmacies, Welborn said. Whenever the veterinary practice doesn’t provide medications, either directly or through a trusted home delivery pharmacy, there is a greater chance for error, incomplete medical records, and associated diminished quality of care. “It’s also well-documented that traditional brick and mortar stores and e-commerce retailers are getting into the prescription and specialty pet foods space in a big way,” he said. “Yet these retailers largely compete on cost, and they don’t have the same understanding of a pet’s individual care needs as their veterinarian, who traditionally provided these services. These large retailers are threatening to cut out veterinarians entirely, which will lead to detrimental health outcomes.”

Supporting local veterinary practices is more important now than ever by purchasing medications within the practice since pharmacy sales still represent about 25% of practice revenue, he said. “Just like all small businesses, consumers moving to online purchases was a challenge for your neighborhood veterinary practice – and with the increase in the need for care due to that influx in pet purchases, pet owners will need these practices to be left standing strong.”

Mixing new methods with traditional practices

There is a significant opportunity to pair innovative, new ways of delivering care with more traditional practices that elevate the standard of care. Welborn cited the launch of Covetrus Script Assist as an example he’s seen. Script Assist leverages machine learning and practice management records to quickly identify where gaps in medical care reside, particularly in areas like preventative medications. “Ultimately, it’s our goal to ensure that veterinarians stay at the center of a pet’s care – no matter in what way it manifests.”

New technologies are great for the profession, Welborn said. And his clinic has certainly taken advantage of implementing them. “Telemedicine is great,” he said. “It’s just really important that we have that hands-on physical exam initially to establish the veterinarian-client-patient relationship (VCPR) so we can have a baseline and that relationship with the client. Then we can leverage telemedicine in some cases for convenience.”

Photo credit: istockphoto.com/yacobchuk

Reps as a resource

Particularly when practices are so busy, being able to get answers to questions about product availability, the best products to purchase, what’s coming off backorder, etc., is more important than ever. “That kind of information has always been vitally important,” said Welborn. “And now we have less resources to do some of that work on our own. So we have to rely more heavily on sales representatives to help us with some of those issues.”

Summertime wellness

Wellness visits have traditionally increased in the summer as clients get booster vaccinations for their pets in anticipation of their pet staying in a kennel or pet resort while they are on vacation. This was diminished last summer with a reduction in travel due to the pandemic, Welborn said. A rebound in leisure travel will likely result in an increase in wellness visits.

“Unfortunately, this will be challenging for many veterinary practices that are already at or beyond capacity. In response, some practices are designating special times for wellness appointments to cluster the visits and improve efficiency.”

Balancing act

While increased patient volume is a good sign, Welborn said the biggest issue facing the profession right now is a workforce shortage. “We don’t have as many veterinarians as we need to provide the service,” he said. “I don’t know any veterinary practice that has more staff members and more veterinarians than they need. Everybody is trying to hire. Not only veterinarians but also those experienced, credentialed technicians.”

It’s a balancing act to try and meet the needs of clients and patients with not quite as many people on staff. Veterinarians also don’t want their team members to burn out. Personal well-being is a major topic in the profession with higher levels of burnout and depression, and even suicide, “and the workload associated with the pandemic has likely made those issues worse,” Welborn said. “So it’s a balance for the leaders of practices to try and meet the needs of clients and patients while trying to protect the team as much as we can.”