Mouths dropped at a practice health summit in Chicago when hospital manager Alexandra Wright shared Ellisville Veterinary Hospital in Ellisville, Mo., averages 10.14 preventative doses per patient per year. The reality for most practices is 68 percent of dog owners leave the clinic without heartworm disease preventatives, and those who purchase only buy 8.1 doses per year.1

Intrigued by Ellisville Veterinary Hospital's benchmark-breaking compliance, I asked Wright to share how the team does it. These are their techniques:
1) Streamline the number of preventatives
Ellisville Veterinary Hospital used to stock five brands in-clinic. Wright explains inventory management, overhead costs, and staff training on five parasiticides was overwhelming. Multiple products also confused clients. Now, the hospital offers one preferred brand in-clinic.
"Having continuity across the board has improved compliance," says Wright. "Our online pharmacy gives us access to other brands if needed."
2) Start discussing refills at check-in
Client service representatives (CSRs) review purchase history when clients arrive for appointments. As the first touchpoint, they initiate conversations about refills of diets, medications, and products. If clients decline refills at check-in, CSRs put notes on check-in forms technicians and assistants refer to during appointments.

3) Revisit purchase history
Technicians explain why flea/tick and heartworm disease prevention is medically necessary and discuss the last date and brand of previous purchase. They say, "You purchased for flea/tick and heartworm disease prevention 18 months ago and got 12 doses. Did your dog miss six doses, or are you buying preventatives elsewhere?"
If pet owners purchase from outside pharmacies, technicians explain the hospital's competitive prices, instant rebates, product safety and guarantees, and the convenience of leaving with preventatives today or getting home delivery through its online pharmacy.
4) Bring authority to conversations
"Veterinarians discuss the importance and necessity of these medications," says Wright. "By the time the appointment is over, the client has had three touchpoints." Most clients walk out with preventatives due to repetition of the message from CSRs, technicians, and veterinarians.
5) Only stock six- and 12-dose packages
Team members offer clients 12 doses first and go to six doses if clients cannot meet the expense of a year's supply. The staff explains the cost per dose and savings from instant rebates. "It's best for compliance to just offer 12 and six doses," says Wright.
Single doses are only sold through the hospital's online pharmacy. Staff dispenses free single doses from its pharmaceutical partner for puppies and kittens with changing weights.
6) Automate refill reminders
When clients buy six doses in-clinic, they get refill reminders when it is time to buy the next six doses. They get a series of three refill reminders at 90, 60, and 30 days before their preventatives are empty. When clients purchase 12 doses, refills coincide with annual wellness appointments. Conversations about preventatives are equally as important as discussions about vaccines during checkups.
7) Send emails to non-compliant clients
If clients leave appointments without preventatives, CSRs send emails and texts as part of the checkout process. The approved digital prescription is sent to the hospital's online pharmacy, puts the product in the client's cart, and sends an email for the pet owner to complete checkout. Because Ellisville Veterinary Hospital's online pharmacy syncs with its practice information management software (PIMS), clients' emails, addresses, phone numbers, and pets are automatically included in their profiles for its online pharmacy. When placing their first orders, clients create passwords. Returning clients log in to select their shipping and payment preferences (Figure 1). This proactive approach makes buying from the hospital easier and takes just a few clicks.
CSRs use an email template to customize the message with the brand, dose, quantity, and pet name. Here's what it says: "Hello ! This is Ellisville Veterinary Hospital letting you know that we have emailed you a digital prescription for your 's monthly preventative for direct purchase and shipment to your home through our online pharmacy. This will come as a separate email with a direct link to order the item. We prescribed and authorized refills for <brand, dose, quantity>. If you have questions or want to discuss your pet's prescription, please reply or call us at . Our team will be pleased to assist you!"
CSRs send backup texts with a similar message to prompt clients to check their emails. Half of clients buy from post-visit emails. "Our clients are extremely involved and proactive in their pets' care," says Wright.

8) Support clients who need help placing their first online orders
CSRs can log into the hospital's online pharmacy and view the site as clients, walking them through where to click and what to do to buy online.
9) Use what you prescribe
Employees use the hospital's preferred brand of preventatives on their own pets through its pharmaceutical partner's staff dosing program. This lets team members experience products firsthand and have a "Here's what I do for my pets" testimonial for client conversations.
10) Regularly refresh the team's knowledge
Wright schedules staff training on parasiticides twice a year with its pharmaceutical representative. "I am passionate about team education. We stay diligent as a practice and continually educate our clients and team about the importance of preventatives," says Wright. "I've been in the industry 15 years and still need to keep my mind fresh."
Combining consistent messages, having a preferred brand, and following up when clients don't leave with 12 doses gets results higher than industry benchmarks. Wright hopes other practices will adopt their dispensing strategies.
"The ability to help other hospitals in their success is extremely rewarding," says Wright.
VPN Plus+ members can read "When summer ends, heartworm doesn't" to help sway clients who might think heartworm preventatives aren't needed in cooler months. Not a member? Sign up today at the VPN Plus+ website. |
Wendy S. Myers, CVJ, knows the right words will lead clients to accept your medical advice, driving patient and practice health. As founder of Communication Solutions for Veterinarians, Myers teaches practical skills through online courses, conferences, and onsite consulting. Her experience as a partner in a specialty and emergency hospital helped her understand issues that owners and managers face. Learn how Myers can train your team at csvetscourses.com.
Reference
- Jones S. The Invisible Threat You Can Help Prevent: Heartworm Disease. https://docs.boehringer-ingelheim.com/Heartworm_Flip_Book.pdf. Accessed Oct. 25, 2024.