Building Bonds To Improve Patient Care

If there is one thing we can all agree on, it is that the ability to build strong relationships with clients and their pets is one of the most defining characteristics of a successful veterinary practice.

If there is one thing we can all agree on, it is that the ability to build strong relationships with clients and their pets is one of the most defining characteristics of a successful veterinary practice. It’s not rocket science—we live and breathe the importance of this bond.

We train our staff to master it, keep our eyes and ears open for new ways to enhance it, and recognize that a practice’s greatest strength can be found in how well it becomes an integral third party in the relationship between owners and their pets.

Similarly, could there potentially be additional benefit for a practice that chooses to emphasize building a bonding between individual veterinarians and clients? According to the 2011 Bayer Study, the answer is a “yes,” and the data from the study actually point to this one-to-one relationship between a practitioner and client as a key driver of increased visits.

The study found that practices that encourage clients to bring their pets to the same veterinarian for every visit are the same practices that experience increased compliance and acceptance of recommended treatment protocols. It appears that the apparent disconnect between what veterinarians think they are communicating and what pet owners are hearing is greatly minimized when it comes from a single voice.

It is natural that pet owners who understand and trust in their veterinarians’ recommendations and believe that they always have their pets’ best interests at heart will be more likely to act in accordance with these recommendations.

Emphasizing individual relationships has associated risks, especially when the success of a practice becomes overly dependent on bonding, which is never more apparent than when a well-liked doctor leaves to practice elsewhere, followed by half of the active client base.

Many owners have experienced such an exodus in the past, and are understandably hesitant to promote a policy that would allow them to become that vulnerable again. The interests of the practice must always be primary, and a good way to ensure this is through a system in which there are at least two veterinarians with whom each client is familiar and comfortable.

When facilitated by the primary doctor, this secondary relationship is usually well received and minimizes the likelihood that doctor-client bonding will result in negative repercussions for a practice at some time in the future.

A somewhat more difficult risk to handle is a situation in which the loyalty a specific doctor engenders among clients is both extreme and/or based on elements that fall outside the scope of best medicine. In worst case scenarios, clients who have formed these relationships with a certain doctor often express overt distrust of other associates, team members and even the practice entity itself.

“On one level, it can be such a positive for the practice when clients bond with a specific doctor,” explains Jessie Merritt, practice administrator of Oswego Veterinary Hospital in Lake Oswego, Ore. “But there must be consistent standards of care in place and a culture where doctors, and the entire staff for that matter, always support one another and show solidarity.

“When clients sense or experience disagreement or contradiction among colleagues, it can become toxic on so many levels,” Merritt continues. “In that situation the client may not only form a positive bond with one doctor, but harbor negative opinions regarding the others.”

These situations can lead to a debilitating rift not only among practice employees, but also between a practice and a portion of its client base.

Tips for Encouraging a Continuous Client-Practice Bond

The preferred doctor should always provide the name of a secondary doctor for times when she is unavailable (this should also be added to a computer alert) and whenever possible should facilitate this relationship via a face-to-face introduction.

“Train receptionists to use the word ‘and’ instead of ‘but’ when a client calls and their primary vet is unavailable,” says practice consultant Shelley Johnson, CVPM. “Saying something like, ‘But Dr. B is available’ has negative connotation and sounds like giving permission not to bring in their pets. Simply changing the approach by saying ‘And Dr. B is available at 2 p.m. or 5 p.m.,’ greatly increases scheduling success.”

With chronically ill pets, the primary veterinarian should contact the owner not only to let her know he will be gone for a period of time, but to let her know that her pets’ cases have been discussed in detail with another doctor(s).
This outreach goes a long way to easing a client’s mind, initiating trust in the secondary doctor’s recommendations, and fostering a culture that values collaboration among doctors.

Get It in Writing

If a practice does not have written standards of care, then the first step is relatively simple—divide the work, develop consensus and get them done! Often, though, the medical standards have already been developed and it is more delicate issues, such as generational differences and the tenure of a veterinarian, from which problems might stem.

In some cases, client loyalty is founded on recommendations that require less compliance than the hospital’s standards, and it is not uncommon to hear stories of pets that did not receive necessary and/or timely care because their owners refused to make appointments based solely on the fact that their veterinarian of choice was unavailable.

While surely the doctor never intended for clients to react this way, when their clients are presented with more stringent standards or policies it can often escalate into a situation where the practice and other associates are forced to deal with unfounded accusations of over-charging or over-treating. This can be frustrating and detrimental to the development of collegiality and collaboration among a team of doctors, both of which are the foundation of a successful multi-doctor practice.

Often, a doctor truly believes in the practice’s care standards and even helped develop them, but the fear of angering and alienating clients makes it too difficult and uncomfortable to change recommendations or enforce new protocols. And while it’s a great feeling to be the most popular, encouraging “exclusive” client loyalty often comes with a personal price tag that can include excessive client phone calls, lack of respect for a doctor’s personal time and longer hours spent trying to keep everyone happy.

In short, veterinarians who enable this type of client behavior, even if unintentionally, are their own worst enemies.

Points to Think About

Lack of communication and accountability are very often culprits in these situations. Far too often,  “favorite” doctors have never been educated on the financial ramifications of their actions, nor are they fully aware of the toll it is taking on their teams. If no one has said anything to them and clients are happy, what is the incentive for doing things differently?

In best-case scenarios, once communication is initiated and the ramifications of their actions are fully understood, these doctors will get on board. On the other hand, if left alone to continue practicing as a non-team player, it can take reaching the point of burnout to recognize the personal price they have paid for doing so, and only then is there a strong enough incentive to change.

For multi-doctor practices where the above risks have been assessed and managed, and the entire medical team is committed to documented standards of care and agree to stand behind these protocols with every patient every time, individual client-veterinarian bonding is truly one of the best ways to increase patient visits and client compliance.

Perhaps some uncomfortable internal discussions need to take place to ensure this level of commitment from the entire team, but the value to the practice is well worth the minor discomfort.

And what about the value to our patients?

If forming individual veterinarian-client relationships leads to greater compliance with health care recommendations, then they are the ultimate winners. And at the end of the day, isn’t that truly what it’s all about?


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