If you want to see first-hand one of the problems our profession faces, spend a couple of hours on a clinic stakeout. Park your car outside a couple of veterinary hospitals and watch pet owners enter the practice. You’ll witness them trying to coax dogs to enter or carry them inside. Then park outside at a few local pet stores and watch dog and after dog tow their owners into the shop with enough power to pull them on water skis. The Bayer Veterinary Healthcare Usage Study tells us that pet owners have been avoiding taking their pets to the vet while pet store trips have increased dramatically. This trend poses huge problems for our profession for four reasons: Pet store employees are viewed as the true pet health experts. Pet owners fall out of the habit of seeing us as part of their buying pattern. We risk losing relevance, which, once lost, is almost impossible to regain. Our practices lose income. It’s like being a highly trained and educated DVM in a boxing ring with the “pet store DVM” and getting hit with two jabs, a hook, and a potentially knockout uppercut. All is not lost, however. We have the tools to fight back, reclaim our authority, and be busier than ever. We can compete to win. The strategy is straightforward: We must put science and sizzle in place to make a trip to the veterinary hospital a better, higher-value experience for pet and owner than a trip to the pet store. To do this we must first look at what we can do to eliminate or decrease the fear, anxiety, and stress triggers that act as barriers to entry. In this case, I mean literal barriers. I’m talking about the parking area and entrance to your practice, which can present a number of powerful deterrents to a positive experience before the pet even gets inside. Here are five to consider. Make removing No. 2 a No. 1 priority Did you know that feces from dogs experiencing stress contain fear pheromones (anal gland secretions on the feces) that alert other dogs of danger? If you don’t want the steaming equivalent of flashing red lights lining the sidewalk on the way into your practice, you must search out and pick up feces several times a day and seal them shut in a disposal bag—don’t just toss them into the trash. Thoroughly clean up anal gland expressions in the exam room. The outside vertical surface makes dogs fear the inside Did you also know that the vertical surface just outside your front door, portico, or building corner probably has thousands of invisible signs that scream danger to dogs as they stop, sniff, and check “pee-mail” before entering the clinic? Clean vertical surfaces with a solution like Rescue (accelerated hydrogen peroxide) at least once daily, and pressure wash/steam clean monthly. Spritz the area with pheromones several times a day—doing so can turn a negative into a positive. If a new or particularly sensitive dog is scheduled to visit, instruct the pet owner to call you once she arrives so you can go outside and place a trail of treats leading to the front door. It’s even more powerful for the pet owner to place the treat trail from Point O (outside) to Point I (inside) to Point E (exam room), according to Lisa Radosta, DVM, DACVB. Try it—it will make a tentative dog run inside like a sled dog moving from Anchorage to Nome to deliver vaccine. Face the front door challenge For many owners, it would be easier to crack a safe than work the combination of moves it takes to get inside a vet practice. The typical swinging door of a veterinary hospital, whether singly or as a double set, with an enclosed entryway, is very difficult for pet and pet owner to navigate. This can be even worse for elderly or infirm clients who are trying to handle a scared dog, have multiple pets, or are holding a carrier. Hold the door (or the carrier) for clients entering the practice. Better yet, also keep a treat pouch close and start giving visiting pets tasty tidbits as the first step toward putting the “treat” into treatment. Go for the greeting That first hello might mean the final goodbye if it turns into a source of fear or stress for the pet. And unfortunately, we have a tendency to get right down to business without first establishing connections among the pet, the pet owner, and the practice team member. Wherever the first contact with a patient and client happens, and if the pet desires closer contact, ensure the team member knows these dos and don’ts, according to Dr. Radosta: Don’t make direct eye contact with the pet (it’s a threat). Don’t face the pet when saying hello. Don’t reach down to touch the pet. Don’t put out your hand for the pet to smell. Don’t touch the pet on top of the head. Do turn sideways when greeting a pet. Do crouch down if you can (decreases our perceived size and threat level). Do toss down treats so that the pet can get closer if she wants to. If she doesn’t, don’t force it. Maybe try higher-value treats. Do touch the pet on the sides of the neck/chest and the base of the tail (for dogs), and under the chin, the hairless areas above the eyes, and the base of the tail (for cats). Ban the waiting area If a veterinary behaviorist were tasked with designing the most stressful place possible for pets, it would be what already exists in about 22,000 veterinary clinics across the U.S.—the waiting area. Think about it—harsh smells upon entry, phones ringing, doors swinging, doorbell chiming, intercom squawking, voices and laughter, people in motion, fluorescent lights buzzing, dogs barking, sounds of distress, and unhappy pets. Now think about the participants—dogs who don’t like other dogs, cats who don’t like other cats, cats who don’t like dogs, people who don’t like cats or dogs, people who don’t like other people, all waiting together, worried about their pet and the cost of treatment, and wondering when they can leave. Do what thousands of veterinary practices have done and usher pets and owners directly into the exam room to be checked in (and out), or have owners check in and then return to and wait in their vehicle with their pet, who is isolated and smelling familiar smells, entering the practice only when the exam room is ready. “For those times when animals absolutely must spend some time waiting in your lobby, visual barriers can help reduce stress,” said Heather Lewis, AIA, principal of Animal Arts and co-author of the Practical Guide to Veterinary Hospital Design: From Renovations to New Builds. “Arrange seating in groupings that can allow separation of cats and dogs, and use temporary visual barriers such as screens and other furnishings to help prevent cats and dogs from seeing one another.” In short, the check-in area should be calm, quiet, and welcoming for pets and people. Don’t use bleach to clean; use accelerated hydrogen peroxide. Silence the door buzzer/bell and use another method to alert to someone entering. Turn down the volume on voices and the phone, and play calming music. First impressions are lasting, and that’s even truer for pets who have little control over their fate once they’re on the way to our hospitals. Once they arrive, make sure the sights, sounds, and smells they encounter communicate healing and reassurance and not fear, anxiety, and stress. That’s an impression that can last a lifetime! Dr. Marty Becker writes every other month for Veterinary Practice News. He is a Sandpoint, Idaho, practitioner and founder of the Fear Free initiative. For more information about Fear Free or to register for certification, go to fearfreepets.com.