What’s Best for Patients Is Best for Practices

Standardizing care improves patient health and your bottom line

Older couple with Pomeranian walking into practice

Did you know that doing what’s best for your patients is the best way to yield bottom-line results for your practice? You can start by getting your entire practice—veterinarians and staff—to establish and implement practice-wide standards of care at every stage of a pet’s life. Focusing on new areas of diagnostics at Chuckanut Valley Veterinary Clinic is improving patient health and increasing practice revenue

When veterinarians and staff use personalized approaches to managing patient health rather than agreed-upon standards of care, clients get mixed messages and patients receive inconsistent care depending on who they see in the practice at each visit. The results can be detrimental to patients and erode client trust and compliance.

From personalized to practice-wide standards of care

Establishing agreed-upon standards of care within a practice eliminates confusing and conflicting messages from staff and creates a consistent experience for clients. Making diagnostic testing part of those standards allows practices to take advantage of their best opportunity for new revenue.

Diagnostics has been and is predicted to be the fastest growing source of income in veterinary medicine.1 While a typical veterinary hospital may generate 16% to 18% of its revenue from diagnostic testing, at Chuckanut Valley Veterinary Clinic, diagnostics are responsible for a far greater share of practice revenue—and it didn’t happen by accident.

Since 2010, we've implemented a succession of standardized protocols at Chuckanut. And we’ve seen a jump in revenue every time we focus on a new area of diagnostics. We started with real-time care, running diagnostics and sharing the results with clients during their visits, and roughly 18 months later, we began working on long-term medication monitoring. When that was successfully implemented, we initiated our senior care protocol.

Top-notch care improves bottom-line revenues

Each of our standards of care is rooted in current AAHA preventive care guidelines.2 And every detail has been discussed, negotiated and agreed upon by all veterinary associates in the practice. Not surprisingly, these protocols have increased the practice’s total diagnostic revenue. But we’ve also seen increases in every profit center within the practice, including pharmacy, surgery and professional services. What we’re finding is that the more we adhere to our practice protocols, the more we learn about our patients’ health needs, and the better we are at addressing those needs. Once we agree on a practice standard of care, we build the standard into our software to make adhering to it not only easy, but automatic.

Chuckanut has experienced year-over-year increases in total diagnostic revenues ranging from 18% to 34% since implementing standardized protocols. A closer look at these increases shows that the revenue generated from each visit has increased more than $20, indicating that veterinarians and staff are succeeding in gaining client compliance.

Sustained Diagnostic Revenue Growth

Year-over-year increases in diagnostic revenue at Chuckanut Valley Veterinary Clinic. The practice implemented a real-time care protocol in 2010, a long-term medication monitoring protocol at the end of 2011 and a senior care protocol in 2013

 
Transitioning from a client visit to a client experience

At Chuckanut, we also use technology to engage clients and encourage them to adhere to recommendations. We don’t just take x-rays and perform diagnostic tests, we pull up the results on- screen and review those results with the client at our side. Involving clients in their pets’ cases creates experiences that help build trust and drive future compliance. With IDEXX VetConnect PLUS, we have an automatic, visual record of our patients’ diagnostic results. So when we monitor NSAID therapy, we’re able to see changes in ALT, for example, and use graphs that help clients understand why we recommend blood work every 6 months. And when working through a diagnosis, we’re able to show clients the trend of declining ALB, for example, which helps them agree to next steps.

Calculating the potential of a lifetime

Diagnostics represent a tremendous opportunity for veterinary practices to provide patients with the highest standards of care and increase practice revenue, but we’ve only just scratched the surface. According to AVMA practice data, pet owners currently spend about $3,600 on veterinary care during the course of a pet’s lifetime.3 As a comparison, we calculated the potential veterinary expenses for a typical dog with an owner who was 100% compliant with AAHA preventive care guidelines. Assuming a 12-year life expectancy and an unremarkable medical history—some arthritis, dental work, nothing dramatic—this dog’s veterinary expenses would have been $17,700.4 Even when compliance drops, if diagnostics are regularly used, the lifetime veterinary expenses for this dog would have been $13,600.4 Essentially, today’s pets are receiving only a fraction of the veterinary care that our industry recommends is best for their health and well-being. Clearly, practice revenue also suffers when we don’t employ standards and strongly encourage clients to adhere to preventive care guidelines.

Estimated lifetime expenses for a 12-year-old dog

A comparison between total veterinary expenses for a 12-year old dog estimated from AVMA pet owner statistics and the potential lifetime total for veterinary expenses, assuming an unremarkable medical history and varying levels of compliance with AAHA-AVMA preventive care guidelines. Lifetime expenses at 100% compliance (light blue line) and high diagnostic utilization (dark blue line) were calculated using prices from Chuckanut Valley Veterinary Clinic.2-4

 
How to get started with your standards of care today

Implementing standards of care in your practice may seem daunting, so start small. First, calculate the percentage of revenue you currently generate from in-house and reference laboratory diagnostics. Establishing a baseline will give you a marker against which you can measure success. Then choose an area that you feel represents an untapped growth opportunity based on your existing clients and patients.

The whole team has to be involved, aligned and trained on the standards to motivate clients to follow recommendations. If a client doesn’t agree to veterinary recommendations, we can’t do what’s best for the pet. So we make sure every staff member understands how the standards benefit the patients. Empowering staff members to perform tasks that don’t require a veterinarian can be highly motivating to them and also benefit the bottom line. The more staff members learn, the better skilled they become at communicating the standards to clients with conviction because they believe in it, too.

In your practice it might make the most sense to start by establishing standards of care for senior patients, dental exams or long-term medication monitoring. Pick one. Once you’ve agreed on the standards, integrate them into your software and train your staff thoroughly. Challenge your team to start with those clients who are most likely to comply. In no time, your efforts will pay off for your patients and your practice.

View the following videos to learn more about preventive care from Mr. Wood and Dr. Brown.


Fritz Wood, CPA, CFP
Role of Diagnostics in Practice Health

Peter Brown, DVM
Dr. Peter Brown Talks about Preventive Care

Register for Dr. Brown and Fritz Wood’s upcoming webinar: Medical Standards Deliver Bottom-line Results.

Peter Brown, DVM, and Fritz Wood, CPA, CFP

Dr. Brown earned his DVM at Washington State University in 1991. He began working at Chuckanut Valley Veterinary Clinic for Dr. Greg Ingman. In 1994, he became a partner in the clinic, and in November 1996 they built a new facility. Dr. Brown has become a sought-after speaker on client relationships and customer experience.

Fritz owns H. F. Wood Consulting, where his clients include many animal health companies. For more than 20 years, he has conducted research examining veterinary productivity and personal finance. He teaches at numerous U.S. veterinary schools and speaks extensively. A founding member of VetPartners, Fritz also serves on the advisory board of Veterinary Team Brief.

 
References
  1. How diagnostics drive success in veterinary practice. Available at: http://diagnosticpricing.com/wp-content/uploads/2013/04/Diagnostics-Summary.pdf. Accessed March 8, 2015.
  2. AAHA-AVMA Canine preventive care guidelines. Available at: https://www.avma.org/KB/Resources/Documents/caninepreventiveguidelines_ppph.pdf. Accessed March 8, 2015.
  3. U.S. pet ownership statistics. Available at: https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership.aspx. Accessed March 8, 2015.
  4. Data on file at IDEXX Laboratories, Inc. Westbrook, Maine USA.