Revitalize Reminders And Watch Income Rise

Since adding reminders for lab work, diagnostics have increased to 26 percent of income at Park Hills Animal Hospital in Park Hills, Ky.

Since adding reminders for lab work, diagnostics have increased to 26 percent of income at Park Hills Animal Hospital in Park Hills, Ky.

That’s higher than the industry benchmark of 18 percent found in a 2012 State of the Profession study.1 Veterinarians target pets ages 2 to 7, offering clients a $105 screen that includes a complete blood count, chemistry panel, heartworm/tick screen, urinalysis and thyroid screen.

"Doing early detection has been one of our greatest successes,” says owner Mark Collett, DVM. "It’s important to check the pets that aren’t sick.”

While you can’t predict when pets will become sick or injured, you can anticipate when they’ll need preventive care. Exams, diagnostics, vaccines, therapeutic diets and parasite preventives are renewable services that generate 38 percent of revenue.2 Reminders drive future visits.

As a practice consultant, I frequently overhaul reminders as the top business growth strategy. Too many hospitals approach it as "that’s the way we’ve always done it” and aren’t adapting reminder methods based on today’s trends.

Here are proven strategies to revitalize your reminders and watch income soar.

Reflect your standards of care.

In 2008 when Courtney Anders, DVM, founded Pearl Animal Hospital in Portland, Ore., she established written standards of care. "Then we set up reminders in Cornerstone that would be mirrored in Vetstreet,” says Office Manager Cheryl Latta.

The American Veterinary Medical Association and American Animal Hospital Association have preventive care guidelines at

Go beyond postcards.

Four years ago, Park Hills Animal Hospital sent only postal reminders. Now they use Vetstreet ( and expanded into emails and texts.

"I’ve seen an increase in people coming through the door,” says Dr. Collett. "My doors are swinging, and I think Vetstreet has been a big help with that.”

Repetition of the message gets results, so use both postal and email reminders. A reminder compliance study found responses increased up to 31 percent when sending a combination of postal and email reminders compared to postal reminders alone.3

"We’re constantly working to find better ways to keep in touch with our clients,” says MaryBeth Soto, CVPM, practice manager at Main Street Veterinary Hospital in Flower Mound, Texas, who uses Idexx’s Pet Health Network Pro ( "We want to keep in touch with clients after they leave whether it is by email, postcards or callbacks.”

Collect more emails.

Half of Americans own smartphones, with 82 percent checking and sending email on their devices.4 While viewing email reminders on smartphones, clients can touch your phone number to call your clinic or link to your website.

At Pearl Animal Hospital, employees have collected 98 percent of clients’ emails. Latta credits requesting clients’ emails each visit and employee incentives. At the end of every exam, clients are emailed report cards and also receive lab results and appointment confirmations via email.
"We started as a paperless practice, so we collected emails from the get-go,” says Latta. "Once we explain to clients how we’ll use their emails, they’re eager to share them.”

At monthly staff meetings, employees are entered into drawings for collecting emails and client-service activities. Each entry ups their chance of winning a monthly gift card.

Easier client communication motivates employees at Main Street Veterinary Hospital, where they’ve collected 80 percent of clients’ emails.

"Our staff knows that if they get clients’ emails, their jobs will get a little bit easier,” says Soto. Each visit, the client reviews a client update form with his address, phone, and email. "We also ask if can we text them and post their pets’ pictures on social media,” she says.

After three years, most practices have captured 60 percent to 70 percent of clients’ emails. Strive to get 70 percent or higher. Each month, monitor the number of emails you’ve collected and share results with your team.

How you ask for clients’ emails matters. Don’t say, "Can I get your email?” Instead, use benefit statements. Say, "Our hospital is going green and sending more email reminders. We want to be able to quickly notify you about pet health alerts such as a pet food recall or a rabies outbreak in our area. You also can access Jake’s reminders and request prescription refills and appointments through our website. Which email would be the best for you to receive Jake’s reminders?”

Send reminders weekly.

Abandon once or twice monthly schedules. When you send reminders once a month, responding clients typically make appointments within a week. You have a tsunami of pet owners booking exams for 10 business days, and then the schedule dries up like a drought.

Rather than high and low tides, you want a steady stream of clients booking appointments. Weekly reminders will produce even scheduling and cash flow, and ensure less stress on staff and doctors.

Here’s an effective reminder schedule:
* First reminder: Postcard and email sent three weeks before due date
* Second reminder: Postcard and email with urgent message sent two weeks after due date
* Third reminder: Phone call and email three weeks after due date

Monitor response rates monthly.

Correct any short-term decline before it becomes a long-term problem. Each month, review reports in your practice-management software or from third-party providers. Once clients have received first, second and third reminders, you should achieve an overall response rate of 70 percent.

Let’s say 1,477 reminders were sent this month and 1,003 services were delivered for a response rate of 68 percent. You’re close to the goal of 70 percent.

Your team needs to schedule 30 additional exams to reach its monthly goal. If you have five client-service representatives, each needs to book six exams for overdue patients. If your clinic is open six days a week, you will need to schedule just one overdue patient per day.

Besides improving patient care, overdue reminder calls can have immediate financial benefits. According to the AAHA Veterinary Fee Reference, 7th edition, the average feline wellness visit generates $158, while a canine wellness visit averages $168. If your team schedules 30 additional exams with 60 percent dogs (18 exams x $168) and 40 percent cats (12 exams x $158), the income potential is $4,920 for the month or $59,040 annually.

Make overdue reminder calls.

For the greatest success of booking exams, call clients when patients are newly overdue and have just fallen into the third reminder cycle.

Because you’ll need to speak with clients to make appointments, always call their cell phones first.

Etiquette is to call between 8 a.m. and 8 p.m. If calling home phone numbers, dial between 5 to 7 p.m. on weekdays and 9 to 11 a.m. on Saturdays. You’re more likely to catch clients arriving home during the workweek or on Saturday mornings before weekend errands.

If you get voicemail, leave this message: "This is <your name> calling for the doctors at <Your Veterinary Hospital>. We’re worried that Opus is past due for his preventive care exam, vaccines, diagnostic testing, and heartworm and flea/tick preventatives, and might now be unprotected. Will you please call us this week at 555-555-5555 to schedule his exam?”

If you talk with the client, say: "This is <your name> calling for the doctors at <Your Veterinary Hospital>. Opus is now overdue for his preventive care exam, vaccines, diagnostic testing, and heartworm and flea/tick preventives. We’re worried about his health. When is a convenient time for you to come in for an appointment this week? The doctor can see you at 6 p.m. Thursday or 9 a.m. Saturday. Which is more convenient for you?”

The phrase "calling for the doctors” communicates that your veterinarians are aware of the pet’s overdue status and are genuinely concerned.

The warning "may now be unprotected” is a call to action. Offer the next two available appointment times, which is known as the two-yes-options technique. This phrase is stronger than "Do you want to make an appointment?” which is a yes-or-no answer. I offer a webinar on "Callbacks That Get Clients to Come Back” at

At Main Street Veterinary Hospital, every technician and client-service representative is required to call four clients per day with overdue reminders. They turn in completed call sheets daily to a technician who oversees the program. Main Street Veterinary Hospital also pays employees $5 for every overdue preventive care visit that gets scheduled.

"Some staff earn $75 to $80 extra per paycheck, so it’s a big incentive for them,” Soto says.

1. State of the Profession: Veterinary practices still facing financial challenges. DVM Newsmagazine. Oct. 2012. Accessed 04-09-13 at  /redirect.aspx?
2. Myers, WS. How to Conduct Effective Reminder Calls & Callbacks. Communication Solutions for Veterinarians Inc. 2009: Chapter 1, page 9.
3. Data on file, VetInsite Analytics, 2011
4. Mobile email usage statistics. Accessed on 10-05-12 at /redirect.aspx?

Create distinct reminders.

Have computer codes that separate preventive screens from sick-patient diagnostics. Distinguish the reason for testing because it influences future reminders and impacts the accuracy of compliance results.

Let’s say your hospital is located in South Carolina, where 1 out of 66 dogs is testing positive for Ehrlichiosis in 2013, according to the Companion Animal Parasite Council ( You perform an annual heartworm/tick test as a preventive screen, but use the same test when a sick patient visits with symptoms of tick-borne disease.

When you run compliance reports, results may be inflated because preventive and sick-patient testing are muddled in the same code. Instead, create distinct codes such as "heartworm/tick preventive screen” and "tick-borne disease test.”

The word "preventive” in the first code shows it’s for annual screening, not a sick-patient workup. When you run compliance reports, search only "heartworm/tick preventive screen” to get accurate compliance results. You also could use the term "screen” for preventive care and "test” for sick-patient diagnostics.

"We’re a lab-oriented practice,” says Soto. "We could have a general profile with four different reminders on it. We include the reminder in the invoice item’s name such as General Health Profile—2 month reminder.”

Outsource reminders to a third party.

"Don’t do reminders yourself,” advises Soto. "They’re too time consuming, and your biggest expense is staff. A third-party won’t forget to do it and get sloppy. <HOME>


8/22/2013 4:36 PM

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