Posts Tagged ‘Client expectations’

Reasonable Expectations X: Saving the Best for Last!

February 18, 2011

This will be my tenth and final blog post describing reasonable expectations as they pertain to delivery of veterinary care (parts one through nine can be found at www.speakingforspot.com/blog).  This time, however, the tables will be turned- rather than describing what is reasonable for you to expect of your veterinarian, I am going to discuss what is reasonable for your veterinarian to expect of you!      

© Juli Dell'Era

Here are a dozen reasonable expectations.  By complying with as many as possible, not only will your vet and the hospital staff sing your praises, your efforts will directly benefit your pet’s health- and nothing is more important than that.       

  1. Arrive on time for your appointment. This means being present in the waiting room, not hanging out in the car finishing up your cell phone conversation or meandering with your dog outside the building (please read below about the importance of arriving with a full bladder, your dog’s that is). When you arrive late, not only will you and your pet be shortchanged on time spent with the vet, there’s a chance the staff will remain behind schedule for the rest of the day.  If you and your pet are new to the practice plan on arriving 10 to 15 minutes early to fill out necessary paperwork and be sure to bring all prior medical records including X-rays, ultrasound reports, and laboratory test results. (Old invoices are no substitute for the medical record). If you are tempted to arrive late because your vet consistently runs late, call ahead and chat with a front office staff member who will know if it’s “safe” to arrive after the scheduled appointment time. 
  2. If you suspect your pet has a contagious disease such as an upper respiratory infection, forewarn the staff.  For the sake of other patients in the waiting room, they may recommend that your little snookums remain in the car until it is time for the doc to see you.
  3. Unless instructed otherwise, do your best to bring your pet in with an empty stomach and a full bladder. This means taking the litter box away a couple hours ahead of time and foregoing the popular doggie p-mail spots outside the clinic.  Your vet may want a urine sample for testing and if procedures are recommended, better that breakfast was skipped.  Don’t worry, your dog or cat is unlikely to urinate on the hospital floor and if it does happen, guaranteed there’s a mop in every hospital!
  4. Please turn off your cell phone.  Not only is the ringing phone a distraction, answering it while in the midst of conversation with your vet conjures up adjectives I’d best not mention.
  5. Come prepared to provide a thorough history.  Believe it or not, your observations may provide more clues for a correct diagnosis than the actual physical examination.  In fact a solid history can make the difference between having to run one diagnostic test or five. Do some sleuthing around the home front to make sure there’s nothing unusual your dog or cat may have been exposed to. Your vet will want to know if you’ve observed any vomiting, abnormal stools, coughing, sneezing, decrease in stamina, or change in bladder or bowel habits.  If you don’t deal with “poop patrol” talk to the family member who does!
  6. Bring along all of your pet’s current medications (including supplements, flea control products, and heartworm preventive) so your vet can confirm that everything is as it should be.  At a minimum bring along a written list of what you are giving your pet including the name, strength and frequency of any medications- not just a visual description of the tablet. (Many medications come in the form of small, round blue pills!). Yes, the information is in the medical record, but, you’d be surprised by how often discrepancies are discovered.
  7. Know the name(s) of what you are feeding; in fact bring along a label just in case.  It’s remarkable how often clients can describe the appearance of the bag or wrapper “to a tee”, but for the life of them, cannot remember the name of the product. If the diet is homemade, bring along a copy of the recipe.
  8. Do your best to directly answer the questions asked by your veterinarian, without a lot of embellishment.  For example, if your vet asks if you have been filling the water bowl any more or less than usual, your answer should begin with “Yes,” “No,” or, “I don’t know.” “I give her only bottled water.” or “She absolutely adores water.” is not the answer your vet is looking for.
  9. If your pet is sick, try to have all the decision-makers present at the time of the office visit.  If this is difficult to arrange, the person present should take notes, and even consider audio-recording the conversation.  This is useful since details inevitably get lost in translation, especially when traveling from spouse to spouse!
  10. By all means, let the staff know if your pet is aggressive.  All animals are capable of unpredictable behavior.  A savvy veterinary staff can usually peg aggressive dogs and kitties within seconds of meeting them.  Occasionally one surprises us and bites or scratches- either a staff member or the client.  Everyone feels terrible but it’s made far worse when we learn that the client knew it could happen, but failed to warn us.
  11. Yes, I know it can be awkward, but I strongly encourage you to discuss your financial concerns before services are provided. When it comes to ways to pay your bill, there is no standard veterinary clinic menu, though most accept cash, credit/debit cards, and checks.  Do your homework to find out which ones apply to your facility. What receptionist hasn’t heard, “What do you mean, you don’t take Discover?” 
  12. Treat the entire staff well.  I get really peeved when I learn that a client, who has been sweet as can be with me, has been abrupt, condescending, or rude to one of my staff.  Keep in mind that everyone who works in the veterinary clinic plays an important role in keeping your pets healthy.   They all deserve to be treated with equal respect and without a doubt, the entire staff will know if this has not been the case. 

There, I’ve done it!  I’ve said what all vets long to tell their clients, and I sure as heck hope you’re not offended! Do you think these are reasonable expectations?  Are there others worthy of adding to the list?      

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook      

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Reasonable Expectations Part II: Access to “The Back” of the Hospital

September 4, 2010

This is the second part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets.  Part one can be found at www.speakingforspot.com/blog

Care to tag along next time your pet is whisked to “the back” of the veterinary clinic for an injection, a diagnostic test, or a nail trim? Perhaps you are curious about what actually goes on “back” there. Maybe you believe that your best buddy will feel more secure if you are present.  Whatever the reason, know that  if you desire to go where your pet goes and see what your pet sees, this is a perfectly reasonable expectation in most circumstances.   Your request might be denied if: 

-Your pet is better behaved without you there (all vets have experienced aggressive patients in the exam room who become gentle as lambs when separated from their humans).

-There is something going on that is private (for example, a grieving client) or too graphic for you to see (trust your vet on this one).

-Your dog or cat will be in an area of the hospital that is off limits to humans. For example, in my hospital, in order to avoid radiation exposure, no one other than the patient is allowed in the room where X-rays are taken.  Gentle sand bags are used for restraint along with mild sedation if needed.

– The staff is aware that you have a lot to say and no one will be able to get anything done because they will be too busy responding to your questions. 

Admittedly, some vets simply don’t like having clients tag along.  If your doc falls into this camp, some patient persuading on your part may be necessary.  Provide reassurances that you will be on your best behavior and remind him or her that large animal vets do practically all of their work in front of their clients.  I happen to love when my clients wish to accompany me into the bowels of the hospital.  In fact, I find myself inviting them to follow more often than they think to ask.  I prefer they get a first hand look at what I am doing and seeing, rather than simply listening to my after-the-fact verbal description.  Admittedly, I’m proud of my facility and feel great when clients see our bustling staff, content patients in clean, comfy cages, and state of the art diagnostic and patient monitoring equipment. 

Before my clients step foot beyond the exam room, I gently coach them on the art of being unobtrusive- avoiding instructing nurses on how to restrain their pet and asking a bazillion questions while I am performing a procedure.  I always reserve the right to send clients back to the exam room if I perceive that their anxiety level is becoming contagious, and I describe in advance what they will be seeing.  This deters some, which is a good thing- nothing like a fainting or vomiting client to get the day off to an exciting start! 

Have you ever accompanied your dog or cat to “the back” of the hospital?  Was it a good experience for you?  How about for your pet?

Now, here’s wishing you and your four-legged family members abundant good health!

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com  to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Reasonable Expectations

August 28, 2010

Never before, during my almost 30 years as a veterinarian, have I encountered such rapid and profound changes in client expectations. We’ve entered what I like to refer to as “The Age of the Empowered Client”. I’d love to believe that this is a result of so many people reading my book, Speaking for Spot. Alas, I must give credit where credit is due- namely, the worldwide web. Discuss a symptom with my clients and I’m no longer surprised when they pull out their printed list of the diseases Dr. Google feels might be responsible. Render a diagnosis and my client can surf the net to quickly find a plethora of others who have “been there, done that” and are willing to provide advice about how best to navigate any possible medical minefield.

Do I believe these changes in client expectations are a good thing? You betcha! As I convey in Speaking for Spot, my belief is that every animal needs an empowered, adept medical advocate by its side. Of course I want veterinarians to remain essential members of the health care team, but I love it when those at the other end of the leash (or monkey-wrenching their backs schlepping cat carriers) become the team captains!

Over the next several weeks I will write about several previously uncommon client expectations that are now becoming mainstream. They are reasonable expectations in that they ultimately serve what clients and veterinarians hold as common ground- namely, the best interest of the patient. Remember, change is not for everyone- not all veterinarians necessarily “embrace” these changing expectations. Some gentle patience and persistence on your part may be needed. If you find your vet isn’t willing to budge, for your pets’ sake, I encourage you to find a new teammate.

I’m going to describe my favorite client expectation first because, once this expectation is fulfilled, satisfaction of most others will naturally follow. So here we go.  It is perfectly reasonable for you to expect “relationship centered care” from your veterinarian. This is a style of communication in which your vet holds your opinions and feelings in high regard and enough time is allowed during the office visit to hear them. He or she recognizes the unique role your pet plays in your life and is a willing source of empathy and support. Rather than telling you what to do, vets who practice relationship centered care discuss the pros and cons of all options before making a recommendation. They believe in collaborative decision making. Compare this to “paternalistic care” in which the vet maintains an emotional distance and recommends only what they believe is best without consideration of the patient’s or client’s unique situation. There are no significant opportunities for discussion or collaboration.

Relationship centered care is not for everyone- some people truly prefer to be told what to do (certainly the way I feel when my car is in need of repair!). However, if you desire relationship centered care from your vet (or for that matter your own physician), please know that this is a completely reasonable expectation. How do you find a veterinarian who employs this style of communication? At the risk of tooting my own horn, the chapter called “Finding Dr. Wonderful and Your Mutt’s Mayo Clinic” in Speaking for Spot will tell you everything you need to know to fulfill this expectation.

Do you work with a vet who provides relationship centered care? What do you like about his or her communication style?

Now, here’s wishing you and your four-legged best friend abundant good health!

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com  to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.