Originally published in the December 2014 issue of Veterinary Practice News Let’s say the veterinarian diagnoses my 5-year-old cat, Opus, with Grade 1 dental disease during his preventive care exam. After explaining the diagnosis and answering my questions, the doctor asks the technician to present the dental treatment plan. Here’s how to prepare clients for surgical and dental admissions. Explain service first, price last. Use the term “treatment plan,” which emphasizes needed medical care. Avoid saying “estimate,” which centers on price. 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. Educating clients before showing prices helps them make informed decisions. Cover prices with a dental report card or preanesthetic testing brochure. Explain each item, pointing to the left column of medical services. After you’ve shared step-by-step photos and discussed medical services, reveal the price. Clients may jump to judgment if they see prices first without understanding the comprehensiveness of professional dental care. Schedule the procedure at the time of diagnosis. If you have computers in exam rooms, the technician can book the surgical or dental procedure now. If the client will check out at the front desk, the receptionist should schedule the procedure first, and then collect payment for today’s services. Today’s bill may cause the client to hesitate to schedule a follow-up procedure. Say, “I see that the veterinarian diagnosed Grade 1 dental disease. Let’s schedule your pet’s dental treatment first, and then I will get you checked out for today’s services.” The appointment reminder will print on today’s receipt. Make admission appointments. Set admissions for every 15 minutes, with complex cases checking in first. This allows time for preanesthetic testing as well as longer recovery. Let’s say you have five surgical and dental procedures scheduled today with admission appointments from 7 to 8 a.m. See Figure 1 for a sample admission schedule. Figure 1: ADMISSION TIME PATIENT 7:00 a.m. Declaw with spay, Jessie, 5-month-old Persian cat 7:15 a.m. Grade 4 with extractions, Buttons, 14-year-old poodle 7:30 a.m. Grade 3 with extractions, Rocky, 7-year-old golden retriever 7:45 a.m. Neuter, Caymus, 4-month-old black cat 8:00 a.m. Grade 1, Opus, 5-year-old ragdoll cat In the privacy of exam rooms, you can have clients sign consent forms, collect their phone numbers, answer questions and explain when you will call following the procedures. Use a surgical and dental point system to schedule procedures. So employees know how many procedures to schedule each day, create a point system as a guide (see Figure 2). Let’s say one doctor does surgery each morning. Surgery starts by 9 a.m. and ends by 1 p.m. for five hours of surgery time including breaks. Each doctor’s daily maximum points are 25 (see Figure 3). Figure 2: PROCEDURE POINTS Declaw with spay or neuter 6 Grade 4 dental treatment with extractions 5 Spay, older than 6 months 5 Declaw only 4 Grade 3 dental treatment with extractions 4 Lump removal, senior pet 4 Grade 2 dental treatment 3 Neuter, older than 6 months 3 Spay, 6 months old or younger 3 Grade 1 dental treatment 2 Neuter, 6 months old or younger 2 Figure 3: PROCEDURE POINTS MINUTES Declaw with spay or neuter 6 60 Grade 4 dental treatment with extractions 5 50 Spay, older than 6 months 5 50 Grade 3 dental treatment with extractions 4 40 Neuter, 6 months old or younger 2 20 Spay, 6 months old or younger 3 30 TOTAL 25 250 Each point equals 10 minutes. You may need to adjust the point value based on the efficiency of your surgical team, speed of the doctor and experience level of doctors and technicians. Have veterinarians make a list of common surgical and dental procedures and assign point values. Provide the guidelines to employees who will book procedures. Using a point system will help you avoid booking too many procedures. If you have a lighter surgery schedule, you could begin exams earlier. Let’s say you have one neuter surgery, one lump removal and a Grade 1 dental treatment, which totals 8 points or 80 minutes. Procedures begin at 9 a.m. and finish by 10:30 a.m. The veterinarian could begin exams at 11:30 a.m., giving him one hour to call clients with updates, prepare home-care instructions and take a break before appointments start. Make surgical and dental confirmation calls. Call clients the day before procedures to remind them of fasting instructions and to allow ample time for check-in. Remove “drop off” from your vocabulary and hospital forms. “Drop off” implies the admission process will take seconds—hand you the leash or cat carrier and go. Instead of “drop off,” use the term “surgical/dental admission,” which is more professional and communicates that there will be a check-in process. Set expectations during confirmation calls so clients know how much time to plan for patients’ admissions. If you have a specific admission time, say, “This is [your name] calling from [Your Veterinary Hospital] to remind you of [pet name]’s surgical/dental procedure tomorrow. Please withhold food after [time] tonight. Your surgical/dental admission is scheduled for [time] with a technician, who will spend 15 minutes reviewing the consent form, answering your questions, and getting phone numbers where we can reach you the day of the procedure. Please allow at least 15 minutes for [pet name]’s admission to the hospital. If you have questions, please call us at [telephone number].” If you have a window of time when patients check in for procedures, say, “This is [your name] calling from [Your Veterinary Hospital] to remind you of [pet name]’s surgical/dental procedure tomorrow. Please withhold food after tonight. Your surgical/dental admission is between [time] and [time] with a technician, who will spend 15 minutes reviewing the consent form, answering your questions, and getting phone numbers where we can reach you the day of the procedure. Please allow at least 15 minutes for [pet name]’s admission to the hospital. If you have questions, please call us at [telephone number].” Have technicians admit patients in exam rooms. Don’t have receptionists handle surgical and dental paperwork at the front desk. Distractions of ringing phones and other arriving pet owners will prove challenging. Clients also may feel uncomfortable asking medical or financial questions in a public lobby. A rushed client may decline additional services because “decline and sign” is the fastest choice. Surgical and dental patients will be admitted before morning exams begin, so receptionists can escort clients into exam rooms where technicians will complete the admission process. Bringing structure to your surgical and dental admissions will elevate patient care and enhance client experiences. Talk with your team about which ideas you could apply in your hospital. For additional training on scheduling exams and procedures, see my webinar on “Secrets of Effective Scheduling” here. Make surgical and dental admissions an efficient and stress-free experience for clients—and your health care team.
