Laboratory testing, when combined with a thorough history and proper physical examination, contributes to forming a correct diagnosis. This improves medical care for the patient as we are treating a known (proper diagnosis) versus an unknown (suspected diagnosis or simply clinical signs and symptoms,) and easily increases practice profitability without the need to simply try to find ways to "increase the bill."
Below I will address some of the commonly performed laboratory tests, as well as those not commonly performed but likely should become commonplace in our practices. I will also share some ways the entire staff can and should become involved in the proper utilization of lab testing. Note: I cover only those tests I personally believe should be commonly performed in our practices, and not those less commonly needed or specialty testing.
Blood profile
Most veterinarians complete a basic blood profile at least annually. Since pets age quicker than people, we have been doing a biannual visit for many years and included a blood profile plus other testing, as well. We all know waiting 12 months, especially for older pets more likely to show abnormalities, can be a death sentence for some.
Evaluating pets every six months makes more sense and allows diseases to be caught earlier, which can save lives and save your clients money. While you have a choice of which blood profile should be run, most owners can afford a basic mini-profile at least every six to 12 months, and this is fine for younger animals. For older animals I prefer a complete "senior" profile including, at a minimum, a TT4 and preferably also a FT4.
Microscopic fecal examination
A microscopic fecal exam can identify parasites in asymptomatic pets, as well as pets with GI signs. Your techs can perform these tests while helping the client and get an immediate answer allowing treatment while the pet is in the office. The test is of minimal cost to you and is a high profit item to the practice.
Since some parasites are zoonotic, I recommend this test every six months. Remember to have your staff (typically your receptionist) remind owners to bring in a fresh fecal sample for the visit. I have found even when reminded via the phone and a follow-up email or text, many owners still say they were never told to bring in a fecal or urine sample—hence the importance of a fecal loop and taking all dogs outside to try to get a urine sample!
The receptionist does not need to know all of the medical details of which tests will be done or why, but can simply share that the visit typically involves some type of lab testing (blood, urine, fecal, etc.) and remind callers to do their best to bring in a fecal sample and urine sample (they need to know how these samples, especially the urine sample, will be collected; it's still amazing the typical owner doesn't know how to collect and store these samples, especially the urine sample!)
While I mentioned the first contact with the practice is the receptionist, this is not technically true. Often, the very first contact is with the practice website (the receptionist is typically the first personal contact with the practice.) Therefore, it is critical your website describe in some detail what to expect on the first visit if you feel that the caller may not be open to your level of lab testing that is typically done on the first visit (especially if you are unique in your practice area in performing lab testing.)
Handouts
I am a big believer in handouts for two reasons:
- They provide a written explanation of what the pet needs, which reinforces your words during your discussion with the pet owner.
- They can be taken home so the owner does not forget anything that occurred during the visit, which is especially helpful when they want to explain to the family why testing was done during the pet's checkup.
I think it is important to approach writing the handout with the idea of explaining why a test is needed, and, when possible, relating it to our own doctor visits (how we give blood and urine during our checkups to allow for early disease diagnosis, and how we want this same level of care for our pets.)
In our practice, disease-specific handouts are given to the owner after I have already explained what needs to be done for the pet following my examination and before the tech presents the treatment plan (which includes estimated costs) so the owner is prepared to agree to our plan. The handouts explain what testing we may need to do that day and makes it easier for the owner to say "Yes" to our treatment plan.
I want to share a final thought about costs to the pet owner for all this testing. First, I strongly encourage you to seriously considering offering wellness plans for your practice. These plans, tailored to your needs and those of your patients and clients, can reduce the cost of testing by bundling services. Second, I strongly recommend suggesting one or two pet insurance companies to your clients.
If you are doing a lot of lab testing, it is almost guaranteed problems will be found on the tests. Owners who already have pet insurance can continue monitoring their pets at minimal costs due to the insurance. Finally, while in theory I am not big on professionals discounting their work, in reality we all expect and often ask for discounts and your clients are no different. Do not be afraid to market specials throughout the year on your lab tests to encourage usage by those who might not be able to afford your regular pricing.
Also, remember, even if you don't markup your lab tests as much as you would like to encourage more clients to utilize them, offering them at a slightly lower cost can be beneficial because you are likely to uncover problems you will be treating. This means these pets will need treatment and further follow-up testing, which will typically make up for any lost profit on the pricing of the initial testing.
As an example, most practices would agree that at least 50 percent (if not more) of pets tested with blood and urine tests will uncover some abnormality that requires treatment, further investigation, and follow-up testing. This is beneficial to the patient as disease is discovered before clinical illness, and beneficial to the practice by increasing profit through the practice of high-quality medical care, which benefits everyone!
Shawn Messonnier, DVM, opened Paws & Claws Animal Hospital and Holistic Pet Center in Plano, Tex., in 1991. His special interests include holistic and functional medicine, exotic pets, dermatology, cancer, and internal medicine. In addition to serving clients, he has written for numerous veterinary and pet publications, and is also the author of several books, including the award-winning The Natural Health Bible for Dogs & Cats.
