Although your team recommends the best medical care for pets, sticker shock may prevent some clients from accepting dental treatments. The average dental case is $427, according to AAHA Veterinary Fee Reference, 8th edition (see Average Dental Case Bills).To get more clients to accept dentistry, we must communicate its value. "Clients want optimal dental care—a higher quality service,” says Ed Eisner, DVM, Dipl. AVDC, at Animal Hospital Specialty Center in Highlands Ranch, Colo. "We must offer competence, service and value for dentistry. When we communicate value, clients will appreciate our dental services, pay their bills, tell friends and return for annual or semiannual dental care.” Here’s how you can create a great experience for dentistry that makes clients smile. Create photo books or slideshows. Most pet owners have never seen an animal’s dental procedure from start to finish. Create dental photo books using websites such as Shutterfly, Walgreens or Costco. Place photo books in each exam room and your lobby. The American Animal Hospital Association (AAHA) offers a book to use in exam room conversations, "Healthy Mouth, Healthy Pet: Why Dental Care Matters” (www.aahanet.org). Jan Bellows, DVM, Dipl. AVDC, of All Pets Dental Clinic in Weston, Fla., has a series of five smile books that can be viewed on his website at www.dentalvet.com. Digital For a digital option, create slideshows on digital photo frames, tablets or exam room computers. When computers hibernate, your slideshow becomes the screen saver. Describe anesthesia safety protocols. "Once an animal reaches age 10, more clients are afraid of anesthesia,” says Kathy Pershing, CVT, a dental technician at Animal Hospital Specialty Center. "I explain that three people are actively involved in the pet’s dental procedure: two certified veterinary technicians and Dr. Eisner. We also use sevoflurane, monitoring equipment and warming blankets.” Average dental case bills The average dental case charge is $427, according to AAHA Veterinary Fee Reference, 8th edition.1 This includes a preanesthetic exam, CBC with differential, chemistry panel with eight chemistries, dental X-rays, 30 minutes of anesthesia, IV catheter and placement, IV fluids, dental scaling and polishing, subgingival curettage, fluoride application, electronic monitoring, postprocedure pain medication, postprocedure injectable antibiotics, hospitalization and one-week supply of antibiotics. Present service first, price last. When recommending dental treatments, avoid saying "estimate,” which centers on price. "Treatment plan” emphasizes needed medical care. Stand at the end of the exam table, forming L-shaped body language, or position yourself shoulder-to-shoulder with the client. This is collaborative body language, compared to a confrontational posture of talking across the table with a physical barrier between you and the client. Because clients need to understand service first, cover prices with an educational brochure such as Virbac’s dental report card (brochure #VP028) or preanesthetic testing brochure. Explain each item, pointing to the left column that lists medical services. After you’ve shared photos and discussed medical services, reveal the price. Educating clients before showing prices helps them make informed decisions. Clients may jump to judgment if they see the price first without understanding the comprehensiveness of professional dental care. The Admission Process Schedule admission appointments. Avoid using the term "drop off,” which implies the admission process takes seconds. Schedule a 15-minute admission appointment with a technician or veterinarian. In the privacy of an exam room, you can have the client sign consent forms, collect contact phone numbers, answer questions and explain when you will call following the procedure. If technicians admit patients, make sure a veterinarian is available in case the client has additional questions. When client care coordinators make confirmation calls, they would explain fasting instructions and then tell clients, "Your dental admission appointment is scheduled for 7:45 to 8 a.m. with a technician, who will spend 15 minutes reviewing the consent form, answering your questions and getting phone numbers where we can reach you on the day of the procedure. Please allow at least 15 minutes for your pet’s admission to the hospital. If you have questions, please call us at 555-555-5555.” Give clients your business card. During the admission appointment, give clients business cards of the veterinarian and technician who will perform the procedure. This instills confidence and communicates your professionalism. After Care A technician would say, "We will call you after 1 p.m. when we have finished your pet’s dental procedure. If you have questions before then, here’s my business card and the doctor’s.” Clients also may use the business card if they have questions about home-care instructions after the patient is discharged. Watch my video on using business cards at www.YouTube.com/csvets. Use a dental consent form. Once the pet is under anesthesia, a comprehensive oral exam and dental X-rays may reveal the need for additional care. In addition to the anesthesia consent form, have clients sign to authorize additional dental services if necessary. Always call to update the client on any additional services and prices. If you can’t reach the pet owner, this consent form tells you whether to perform all necessary dental procedures, add services up to a specific dollar amount, or if the client declines any unforeseen dental procedures. Text clients after dental patients are awake. Add this statement to your anesthesia consent form: "How would you like to hear from us when your pet wakes from the procedure?” Then list text, email or phone call. If a complication occurs, always call the client. Expect up to half of clients to choose text notification. Never use a practice cell phone to text clients because you can’t print the text to document it in medical records. Another danger: Clients may expect you to answer the practice’s cell phone 24/7. DENTAL REMINDER BOX Dental reminder intervals Service Reminder cycle Grade 1 dental treatment 12 months Grade 2 dental treatment 09 months Grade 3 dental treatment 06 months Google Voice and Gmail Chat offer free texting services that time and date stamp conversations, which you could print for paper medical records or save as PDFs in electronic medical records. Gmail Chat also allows you to attach photos. Dental technicians would log into Google Voice or Gmail Chat as patients are recovered to update clients and remind them about discharge appointments (see photo above). Show and Tell Take before-and-after dental photos. Few clients look at the back of their pets’ mouths. Photos often show dramatic improvements and communicate value for dental services. Incorporate photos and X-ray images into discharge instructions. Provide a dental report card. "Write a pictorial case summary report with photos and X-rays,” advises Dr. Eisner. "Create a template in Word so it’s easy to format and revise.” In addition to showing value, a dental report card helps family members who were not present understand the procedure. See my book, "The Veterinary Practice Management Resource Book & CD,” for a dental report card (www.csvets.com/books/). Share dental X-rays. The 2013 AAHA Dental Care Guidelines for Dogs and Cats recommends taking radiographs of the entire mouth, which are necessary for accurate evaluation and diagnosis. Intraoral radiographs revealed clinically important pathology in 28 percent of dogs and 42 percent of cats when no abnormal findings were noted during initial exams.2 AAHA also offers a dental radiology poster to help educate clients about the importance of dental X-rays (www.aahanet.org). Discharge first, pay last. Clients need to understand all the services that were performed before they see the final bill. During discharge, explain the procedure and potential complications such as vocalization, bleeding, coughing or signs of pain to watch for at home. Discuss any prescribed antibiotics and medication for inflammation and pain. Also demonstrate home-care products. When you offer a product in the exam room, it’s medicine. When it’s sold at the front desk, it’s retail. Because a dental diet may be part of ongoing therapy, bring the therapeutic diet into the exam room. Tell the client, "Because your pet was treated for dental disease today, he needs to eat this therapeutic diet to maintain his oral health. Let me explain how to transition to the new food and also tell you how much to feed.” Put a prescription label on the diet, which has the pet’s name, how much to feed and where to get refills. "Release consults can be delegated to well-trained staff, but clients are even more impressed if the doctor takes time to explain what was done,” Dr. Eisner advises. Call clients after dental patients have been discharged. Depending upon the discharge time, call the pet owner later that evening or the next morning. Ask about the pet’s condition, ability to give dispensed medications, use of home-care products, and answer questions. In dental group codes in your practice-management software, automatically turn on a callback for one day later. Whenever this service is invoiced, a callback will be generated. Have the technician who performed the procedure call the client. The employee already has a face-to-face relationship with the client, knows details of the procedure and can answer questions the client may have. Just as you use doctor ID codes to track production, create staff ID codes so each employee who delivered care for a specific patient is linked to that medical record. This will keep callbacks organized and give staff accountable. Send dental reminders. Whenever an invoice is generated, a reminder for a follow-up oral assessment will automatically follow. Link reminders to dental group codes. Get dental reminders in my book, referenced above. Because optimal service doesn’t just happen, plan a staff meeting to develop a strategy of how your team will deliver A+ dental services and increase client understanding and perception of value. "Don’t think 'My clients won’t pay more,'" advises Dr. Eisner. "You need to show more value." Next issue: Have front-office staff speak with confidence. Wendy S. Myers owns Communication Solutions for Veterinarians and is a partner in Animal Hospital Specialty Center, a 10-doctor AAHA-accredited referral practice in Highlands Ranch, Colo. She helps teams improve compliance and client service through consulting, seminars and webinars. You can reach her at wmyers@csvets.com or www.csvets.com. REFERENCES 1. AAHA Veterinary Fee Reference, 8th edition, AAHA Press 2013; p. 115. 2. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in cats. Am J Vet Res 1998;59(6):692–5.
