I recently called a veterinary hospital as a mystery shopper to ask what a 15-week-old puppy would need. The receptionist accurately described an exam and vaccines, but she missed the need for an intestinal parasite screen, deworming and preventatives—items that would add $88 to the visit, resulting in better patient care and revenue. When auditing compliance for practices, I find half of dogs and cats are getting screened annually. The Companion Animal Parasite Council (CAPC) guidelines advise testing dogs and cats by fecal flotation with centrifugation. Puppies and kittens need to be tested at least four times during the first year of life; adult pets need to be tested twice a year, depending on patient health and lifestyle.1 While most practices have standards of care for routine testing, few have strategies to ensure strong compliance. If a two-doctor hospital has 3,600 active patients, increasing testing from 50 percent to 70 percent would generate $26,654.44 in revenue (additional 720 patients at $37.02 per test2). If you prescribe annual heartworm preventatives with intestinal parasite control to 720 patients, you’d add another $216,000 (average of $25 per dose x 12 months x 720 patients). A passion for poop generates impressive income and protects pets and people from zoonotic diseases. Remind clients to bring stool samples during scheduling calls. Summarize appointment details at the end of calls, and plant seeds for good compliance. Say, “Dr. <Name> will see <pet name> at __ a.m./p.m. on <date> for his preventive checkup. We will confirm your appointment two days before and remind you to bring a teaspoon-sized stool sample for your pet’s intestinal parasite screen.” Remind pet owners again when confirming exams. Phone call, email and text reminders about upcoming appointments also should instruct clients to bring in pets’ stool samples. Having clients bring samples eliminates pets’ stress from sample collection and can lead to more fear-free visits. Send home collection containers if samples aren’t available. If clients forget or you’re unable to collect samples, provide a container with instructions. Many lab companies offer free or low-cost containers that are air tight with a scoop. Place a basket of collection containers in your lobby. Let clients know that containers are air tight so they can put them in the refrigerator or a designer purse with no worries of stinky odors. Create prepaid intestinal parasite screens. If you’re unable to perform testing during the checkup, tell the client, “Because we were unable to collect your pet’s stool sample today, I am sending you home with a collection container. Just drop off your pet’s stool sample within the next week. We will perform the test and call you with results. Today’s receipt will include your prepaid intestinal parasite screen. We will call you as a courtesy reminder in seven days if you haven’t brought us the sample.” In your practice-management software, set up a code for a prepaid intestinal parasite screen with a callback for seven days. If the sample is not returned within seven days, the exam technician who saw that appointment would call the client as a courtesy reminder. If a client drops off the sample within seven days, have the lab technician satisfy the reminder in your software. Post prevalence maps for your area. Get maps for hookworms, roundworms and whipworms by state and county from CAPC at capcvet.org. Display maps on bulletin boards in exam rooms and your lobby, and post them on social media. Send reminders for testing, dosing and refills. Use client-friendly terminology of “intestinal parasite screen” instead of medical jargon of “fecal examination.” Testing reminders are as equally important as vaccines. Preventatives are a consumable item, and clients must be reminded to repurchase them. Remind clients to repurchase when one dose remains. Your email reminder could include a link to your online pharmacy for refills. Clients who buy singles can least afford the expense of heartworm treatment. The client-service team should call single-dose users every 20 days, because clients will need to repurchase and give the next dose within 10 days. In your software, link your single dose code to automatically trigger a callback 20 days later. When receptionists access the daily call report, they will see which clients to phone as courtesy reminders. Say, “This is <your name> calling from <Your Veterinary Hospital>. We appreciate your commitment to protect <pet name> from deadly heartworms. This is a courtesy reminder that <pet name> will need her/his next dose of <product name> on <date> to protect from heartworms, roundworms and hookworms. When you pick up your refill, we will tell you about rebates for additional savings. We are open <describe hours and days> and look forward to seeing you!” Through your practice-management software or third-party providers, send dosing reminders when each dose needs to be administered. Push notifications to give doses can come through app, email and text alerts. Use waivers when pet owners decline testing. Every client needs to be educated about the zoonotic risk of intestinal parasites. “Liability for the transmission of zoonotic diseases can be a disaster waiting to happen,” warns Charlotte Lacroix, DVM, JD of Veterinary Business Advisors in Whitehouse Station, N.J., on the CAPC website. “When a toddler playing with his puppy results in his being blinded due to Toxocara larva migrans infection, our litigious society will likely put the responsibility on you.” Have clients sign waivers that release your practice from liability and confirm they understand the risks of refusing testing. Get consent forms in English and Spanish in “Legal Consents for Veterinary Practices” by James F. Wilson, DVM, JD, through aaha.org. Even when clients decline testing, keep reminders active. Your persistent, consistent message could be persuasive. Spread the word on social media. Share posts about intestinal parasites from trusted sources such as CAPC, American Veterinary Medical Association, Centers for Disease Control and Prevention, IDEXX Pet Health Network and Vetstreet. Get creative. Visit your local dog park and pick up stools that have been left behind. Return to your clinic to run intestinal parasite screens and post the results. You’ll encourage responsible pet ownership habits while educating the public. Also make a video of a technician performing a test and show the results through the microscope lens. Once your team determines which strategies you’ll implement, set monthly goals for testing. Have the practice manager run a report to determine your clinic’s current compliance for intestinal parasite screens in dogs and cats. Aim for 20 percent improvement. The practice manager can post goals and results each month so the team knows when to celebrate or hustle. Have fun—affix an emoji poop sticker on the chart each time an intestinal parasite screen is performed. You’ll be smiling about the improved patient care and hospital revenue. References Companion Animal Parasite Council intestinal parasite recommendations. Reviewed October 2016. Accessed 03-13-17 at www.capcvet.org/capc- recommendations/hookworms/. AAHA Veterinary Fee Reference, 9th edition, 2015, p. 158. Wendy S. Myers owns Communication Solutions for Veterinarians in Castle Pines, Colo. She is a certified veterinary journalist and the author of “101 Communication Skills for Veterinary Teams.” Reach her at wmyers@csvets.com or csvets.com. Originally published in the May 2017 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today!
