By Wendy S. Myers, CVJ

A client says, "I'm just here for the rabies shot, Doc," a client says. When a pet owner chooses services below your standard of care, the patient risks exposure to diseases and parasites. Practice health also suffers. An IDEXX study found the cost of meeting the gold standard of preventive care is $17,700 for a dog over a 12-year lifespan, including exams, vaccines, parasiticides, dental cleanings, and nutrition counseling.¹

A client with an adult dog may spend $731 on preventive services and products annually, while a cat owner invests $723 (see Tables 1 and 2). Vaccines represent eight percent of income and feed other preventive revenue including laboratory, pharmacy, exams, and dentistry.²

Here are seven strategies to grow vaccine compliance:

1) Send reminders 60 days ahead

With current appointment demands, many hospitals are booking three to six weeks out. Most send reminders 30 days ahead. If clients call and cannot get timely appointments, they may decide not to schedule. You will have more appointment availability if you send checkup reminders in August for patients due in October.

Your reminder should explain the "why" behind forward booking 60 days in advance. Text this: "<Pet name> will be due for a checkup <date>. We are experiencing increased appointment requests. Book now to ensure your first choice of time, day, and doctor. Click here to book online or download our app."

The benefit statement of "book now to ensure your first choice" will motivate clients to schedule early. Lead clients to use online or app scheduling tools because 70 percent of consumers prefer to schedule appointments via text/app.³ You will also reduce call volume and improve efficiency. The average scheduling call takes eight minutes compared to half the time to reply to text or email appointment requests.^4,5

2) Set expectations during scheduling calls

Client service representatives (CSR) should open the patient's electronic medical record to see which services and products are due, allowing them to choose the right appointment type and length. Summarize which services and products are due during the scheduling call. Say this, "Max is due for an exam, vaccines, heartworm/tick test, intestinal parasite screen, and refills of flea/tick and heartworm preventives. Does Max have any health or behavior concerns you want to discuss with the doctor"? <Client responds.> "The next available checkup is <time, date 1> or <time, date 2>. Which do you prefer?"

Summarizing preventive services and products promotes your gold standard of care. Asking about health or behavior concerns is the most important question in this script. Too often, veterinarians get blindsided at the end of exams with, "While I'm here, could you also check…?" If the client explains her cat has been peeing outside the litterbox, the exam might run 20 minutes late to collect the urine sample, perform urinalysis, and discuss test results. If the client shares the health concern during the scheduling call, the CSR would have chosen a longer sick patient exam rather than a checkup appointment.

Use the yes-or-yes technique to offer the next two available exams. This leads the client to book now. You'll avoid the negative reaction to, "We don't have any appointments available for three weeks."

3) Preview services when starting exams

At the beginning of appointments, technicians or assistants should explain their roles and summarize services again. An American Animal Hospital Association (AAHA) study found repetition of the message increases compliance.⁶

The technician will explain, "I am <technician name>, who will assist Dr. <Name>. <Pet name> is due for an exam and vaccines for distemper/parvo, rabies, Bordetella, and leptospirosis. We will test for intestinal parasites and heartworm/tick diseases. Max is due for refills of flea/tick and heartworm preventatives. I will tell you about rebates so you may save the most. What questions may I answer before we get started?"

If the pet owner doesn't understand or declines leptospirosis, the technician will explain, "Leptospirosis is spread through the urine of wildlife. The bacteria can be in water and soil. Symptoms may include fever, increased thirst, loss of appetite, vomiting, diarrhea, lethargy, and pain. The disease can cause kidney and liver failure. Leptospirosis also can be spread from animals to people. Two boosters are given several weeks apart the first time your dog is vaccinated, and then it is given annually. Shall we vaccinate your dog for leptospirosis, or do you want to talk with the doctor?"⁷

This yes-or-yes question has the client choose the vaccine or get more information from the veterinarian. With further education, the client may accept vaccination.

4) Have doctors reinforce protocols

Before the doctor enters the exam room, the technician will say if a client questions or declines a vaccine. The veterinarian can explain area prevalence, health consequences, and cost of treatment.

This additional information from an expert may persuade the pet owner. If the client still declines, note the decision in the medical record. Revisit the need for vaccination during the next exam as persistence may get results.

5) Send five reminders

Texts have the highest open rate at 99 percent while healthcare emails average 33 percent.^8,9 

6) Call clients when patients become overdue

CSRs will call because scheduling is a primary job duty. Pick a consistent weekday such as Wednesdays. Avoid your busiest days of Mondays, Fridays, and Saturdays.

If you talk to the client, say: "This is <name> calling for the doctors at <Hospital Name>. <Pet name> is overdue for an exam, vaccines, diagnostic tests, and preventatives. We're concerned about his/her health. The next available checkup is <date, time 1> or <date, time 2>. Which do you prefer?"

The phrase "calling for the doctors" communicates your veterinarians are aware of the pet's overdue status and are genuinely concerned. Lead the client to book now with the two-yes-options technique, offering the next two available checkups.

When describing overdue preventive care, focus on four categories: 1) Exam, 2) vaccines, 3) diagnostic tests, and 4) preventives. If you describe too many details, the list may intimidate the client and she will not schedule. For example, simply say the pet is overdue for diagnostic tests rather than specifics of an intestinal parasite screen, heartworm/tick test, and senior early detection screen.

If you get voicemail, leave this message: "This is <name> calling for the doctors at <Hospital Name>. We are worried <pet name> is overdue for an exam, vaccines, diagnostic tests, and preventatives. Your pet may be unprotected. Will you please call or text us at (555) 555-5555 to schedule a checkup?"

7) Measure your vaccine compliance

Use a core annual vaccine such as distemper/parvo. Run a report to determine how many distemper/parvo vaccines you gave in a 12-month period and the number of active adult dogs during that same time (exclude puppy vaccines and exams). Let's say you saw 2,160 adult dogs and gave 1,663 distemper/parvo vaccines during a one-year period. Your vaccine compliance is 77 percent.

Engage your entire team in improving vaccine compliance from calls to exam room conversations. You will ensure timely vaccinations and increase revenue for preventive services and products.

Wendy S. Myers, CVJ, has been training veterinary teams for 22 years as owner of Communication Solutions for Veterinarians. She teaches teams to become confident communicators, so more pet owners say yes to medical care. Wendy shares her expertise through conferences, online courses, and monthly live CE credit webinars. She is a certified veterinary journalist and author of five books. Her passion is to help practices like yours thrive and grow through effective communication skills. You may reach her at wmyers@csvets.com or www.csvets.com.

References

1. Dicks M, Maddux M. The Market for Veterinary Services: Cracks in the Foundation. Available at: https://news.vin.com/default.aspx?pid=210&Id=9063711. Accessed June 13, 2022.
2. Promoting Preventive Care Protocols: Evidence, Enactment, and Economics. American Animal Hospital Association 2018:12.
3. Park, A. 70 percent of consumers prefer to schedule appointments via text: 5 tips for safe, effective patient texting. Published May 4, 2020. Available at: https://www.beckershospitalreview.com/consumerism/70-of-consumers-prefer-to-schedule-appointments-via-text-5-tips-for-safe-effective-patient-texting.html. Accessed Aug. 18, 2020.
4. Insight Driven Health: Why First Impressions Matter, Accenture, May 2013. Available at: https://www.slideshare.net/AdamBurke5/accenturewhyfirstimpressionsmatterhealthcareprovidersscheduling/. Accessed Jan. 19, 2022.
5. Study by PetPro Connect. March 2021. Data on file at PetPro Connect.
6. Six Steps to Higher-Quality Patient Care, American Animal Hospital Association, 2009:20.
7. Leptospirosis. American Veterinary Medical Association. Available at: https://www.avma.org/resources/pet-owners/petcare/leptospirosis. Accessed June 14, 2022.
8. Burke K. 107 texting statistics that answer all your questions. Published May 24, 2016. Available at: www.textrequest.com/blog/texting-statistics-answer-questions/. Accessed Feb. 6, 2020.
9. Brudner E. Email Open Rates by Industry: See How You Stack Up. Published June 14, 2019. Available at: https://blog.hubspot.com/sales/average-email-open-rate-benchmark. Accessed Jan. 19, 2022.
10. AAHA Veterinary Fee Reference, 10^th ed., 2018. AAHA Press:59, 146, 140, 130, 150, 82, 81, 82, 83.
11. AAHA Veterinary Fee Reference, 10^th ed., 2018. AAHA Press:60, 140, 130, 150, 171, 84, 84, 81.