Are We REALLY Educating our Clients?

After decades of client interactions with those that have provided expensive dentistry for their pets, I began to notice a pattern in statements made by these clients.  When they came in for their post extraction rechecks, they were asking the same thing; "How did this happen?  How did Diogee's mouth get so bad that he required 12 extractions?" I would then explain periodontal disease and the care necessary to keep oral health in check, and their eyes often glaze over.  That look says it all; "I can't brush my pet's teeth and it is so expensive."  Frustration ensues!

A light went on for me and I realized they do not know how to train their pets to have their teeth brushed and they do not know what products to purchase.  I have also come to know that our clients do not know how to properly choose a chew toy, how often dentistry is required, the importance of dentistry, what a dental diet is and most have no idea that animals do not overtly demonstrate pain unless it is acute, but that they experience it the same as we do none-the-less.  

That made me ask, what else do they not know?  Do they know that halitosis is NOT normal?  Do they know that often a fractured tooth is painful even if they are wagging their tails or purring?  Do they know what steps the practice takes to safe guard their pet during anesthesia?  Do they know that we will only continue the procedure if the anesthetist feels it is safe?

I then understood why the clients are all saying the same thing.  They have not been educated and they feel like it is all out of their control.  It is sort of how I feel when I pick my car up from the service station.  I write a big check.  I don't really understand what was done and I thought by changing my oil and getting my transmission checked, I had done what I was supposed to do to make sure my transportation is reliable. Frustration ensues!  And, does that experience make me apt to swing by for wiper blades or will I stop by Walmart for them?  Walmart!  And, if a friend shared that they got service elsewhere cheaper, am I apt to switch?  Unfortunately, YES! And, aren't these experiences similar?

What are you doing in practice to make sure all of these questions are addressed? Are you using brochures? Do you actually hand them out?  Have you developed your website enough?  And, if you have, have you tracked the success or does it just cost money and make you feel better?  Do you brush your own pet's teeth everyday and if not, how can you teach a client how to do so?

Very commonly, practices today use the word wellness on their websites, but are we providing wellness if we are not educating our clients?  Is it even possible to provide all of that information within the confines of a 20 minute appointment?  I have found that it is not, especially since most clients do not bring their pets in specifically for oral assessments.  Dentistry needs are most commonly discovered during the examination for some unrelated problem that needs to be addressed first!

So, a challenge for you all out there:  If you believe your clients deserve oral health education, maybe it is time for you or one of your staff members step up and create an educational experience for your clients.  This is something that I have done at the practice at which I work clinically.  Once a month, I stay to provide a FREE dentistry seminar for our client base.  The clients are invited by staff members for a variety of reasons; new puppy or kitten owners, owners that are reticent to provide recommended care, or owners that presented to the practice for an unrelated issue but dentistry needs were identified.

Has this been successful?  Absolutely.  For me, this experience takes about an hour and a half.  I schedule the event at 7 pm on varying weeknights.  My initial expectation was as I am sure yours is; they would be antsy and eager to get out the door.  But, that is not my experience.  With questions, the clients keep me an additional hour.  They are thirsty for this knowledge and any animal knowledge. It is no coincidence that the Animal Planet is one of the most popular cable stations available.

I have found it helps your attendance to provide a 10% off discount for attending. The discount is the initial motivator!  And, make no mistake, I do understand that there is NOT a wide profit margin on dental services.  But, what the practice gets in return is an educated owner.  That owner understands the wisdom of providing home care and the financial and medical benefit of frequent professional care and shorter, safer anesthetic experiences.  That discount is recouped many times over by the increased care that the owner now provides.  

There are so many benefits to this program:

• owners get the "tools" to maintain health and comfort for their pets
• owners provide more frequent care
• actual prophys are added to the dentistry schedule more frequently
• the increased numbers of prophys means less stressful dental/anesthetic experiences for the staff
• it gives the client a "behind the scenes" understanding of the support provided by the dentistry/anesthetic staff
• it bonds the client to the practice in a huge way

Finally, for me personally, I know that the practice has provided a system of education and ultimately we supported wellness when it comes to dentistry.

Is this tried and true?  I have provided this seminar once a month for over 5 years.  I also have been subcontracted to provide this seminar for another practice monthly for about 3 years now.  I have had attendance numbers ranking anywhere from 12-40 clients per month.

For me this program is a win-win.  The practice wins in many ways; a booked dentistry schedule, less stressful cases, better practice health and ultimately we rest knowing we are providing wellness services for our patients.

The client wins by understanding their pet's needs, their dentistry bills are more manageable and the pet wins by having better overall health and comfort.   Isn't that what we all went into this profession anyway, to help  pets because they can not help themselves.  This is an awesome opportunity to fulfill that mission!

If you would like to create an experience like this for your practice, feel free to email me (Gr8vettek@aol.com) for an outline of topics you can use.  All you have to add is your own energy, passion and love.

To the Heart of the Matter

To me this is the saddest of cases!

A very nice man brought his 8 year old, female spayed, King Charles Spaniel to our practice. The history was that he previously lost a King Charles to cardiac issues, a problem that commonly effects this breed.  That experienced devastated him and he vowed to do everything in his power to avoid cardiac issues in this next dog if at all possible.

We had been providing care for this dog for a number of years and early on the veterinarian heard an innocent systolic click when listening to the heart.  It was mentioned and this client  sought a cardiac consult and an echocardiogram immediately and spend upwards of $400 on that evaluation annually by a cardiologist.  All was well.  He wanted the best for his baby and he went to any lengths to provide that.

We recommended dentistry for his dog and this brought up a whole host of fears about anesthesia. He was afraid he may lose his dog.  We tried to assure him that with frequent professional care, we could provide the shortest and ultimately safest anesthetic experiences for his sweet baby.  We showed him how we have state-of-the-art monitors and that we have a dedicated anesthetist for the procedure.

He said he would consider this carefully.  

What he did, in an attempt to safe guard his beloved was to seek a second opinion.  He went to another practice.  They witnessed his concern and they offered to provide anesthesia-free dentistry and told him that that would be ultimately safest.  He provided this level of care for his dog twice.  The second time, they told him that they got most of the work done but that Nala was not allowing all of it.

Fast forward to a couple weeks ago.  This client came in for his annual exam.  He related to our veterinarian that his baby was dropping food and was eating very carefully.  This very compliant, gentle dog allowed us to show him that there were multiple mobile teeth and that his baby needed to have a deep cleaning and full mouth radiographs.  

Once we anesthetized this patient and obtained a full set of diagnostic X-rays, we identified 27 teeth that we needed to be extracted because of either greater than 50% bone loss or tooth root abscessation.  This man was horrified.  The work was provided and the pet is doing wonderfully.

What breaks my heart is that this man wanted the best for his dog.  He was not stingy with his money in relation to this dog.  He was misled that providing anesthesia-free dentistry would provide the same care for the dog as we would provide with the aid and expense of anesthesia.  In the long run, this King Charles Spaniel experienced long term periodontal infection and we know that that can negatively affect the heart...the organ he was so worried about in the first place.

Good morning!  I woke up this morning and there was a notification on my PetED Facebook page.  The notification was informing me that someone that I have not met, "liked" the page.  Such a nice feeling. So, I was having my cup of "wake-the-heck up" and found myself staring at PetED's logo and day dreaming.

While in Las Vegas at the Western States Veterinary Conference, I gave a technician one of my cards after we chatted for a bit about dentistry and X-rays at the Technician Fair.  She politely took the card and innocently asked; "If you teach dentistry, why didn't you design a logo around that and why the briefcase?"  So, I thought I would share how I responded about the PetED logo.

First of all, the name of the company; PetED.  It is true that at this point, most of the business is centered around veterinary dentistry.  I am the president and that is my clinical specialty and main focus.  However, I envision a company that has a much larger scope. Having been invited into almost 50 practices to teach dentistry, I am aware that some practices have areas other than dentistry that they would appreciate help expanding or further developing.  One of the common issues that comes up whenever I teach dentistry is anesthesia.  Once practices start doing full mouth radiographs and finding additional pathology, the patients are under general anesthesia longer.  That often necessitates a good look at the practices' anesthetic protocols and practices.  

That led me to know that I wanted the company to be the resource for any of their educational and training needs.  I can't be an expert in all disciplines. Fully embracing that fact, PetED has technicians that I have had the honor and pleasure of getting to know, that are considered experts in other disciplines that can be scheduled to consult for the company.

Why the briefcase?  Well, that is to show that PetED trainers come with materials for you to keep as references when we leave your practice.  If I train technicians how to perform regional nerve blocks, I leave you with pre-calculated dosage charts.  If I teach intraoral radiographs, I leave the practice with a CD of images that show the proper position for each image.  

The briefcase also shows that we are mobile.  We pack up and come to you (although we do have a wet lab site).  The practice could be in our geographic area or we frequently travel to other states as needed.  PetED is not limited to any geographic area. As a matter of fact, I am scheduled to speak to a group in Modesto, California in a few weeks.

The paw prints are pretty self-explanatory.  This is a small animal veterinary resource (although PetED does have access to one of the leading equine technicians in the country).  

The colors?  I wanted to be memorable and that yellow jumps out at you, hopefully catching your attention.  I want you to think of PetED and our trainers when you see that yellow and blue.

And why cartoon-type imaging?  I intentionally chose images and a font that invokes a feeling of fun!  Practice life can get intense but the educational experience does not have to be.  PetED is serious about the materials and the information shared but the trainers PetED has chosen are intentionally ones that are respected but share the information in comfortable and relaxed way.  When a PetED experience is schedule, I want the staff to want to be present that day.  Education should be something to look forward to instead of something to avoid.

Well, as I look out the window and see the very early March buds on some of the trees, I marvel at the miracle of Spring.  This is a time of hope and rebirth.  The seed of PetED was planted in the fall and through the darkness of winter there was a lot of underground work done in preparation for its birth.  My hope is that the PetED trainers will be able to plant the seeds of understanding and inspiration to revitalize how you experience this profession you so passionately sought.

Have a spectacular day!

Vickie

"I didn't say they could extract THAT MANY TEETH!"

Sorry it has taken me a while to post the next blog.  Right after I posted the first, I was in the midst of a whirl wind pet sitting for a dear friend, speaking to a class of sophomore and junior high school students, speaking at Rau Animal Hospital's  client education seminar and preparing to travel to Las Vegas to present at the Western States Veterinary Conference.  The wind has settled and I have poured a cup of coffee to sit and catch up with you.  Can I refill your cup before we chat?

I had the opportunity to speak to a large group of technicians while in Las Vegas about developing a thriving dentistry department.  One of the discussions we had concerned dentistry admissions processes and consent forms.  I shared that when I visit practices often I see that the consent form has three selections from which to sign off:

Some look like this:

If further problems are detected while my pet is under anesthesia (initial all that apply)
__________ Do whatever is needed to give my pet a healthy oral cavity, but not limited to tooth extractions.
__________ Do only what is authorized
__________ Please contact me before doing any additional procedures.  if I can not be reached while my pet is under anesthesia then:
                         ___________ Perform whatever procedures are needed
                         ___________ Do only what I have authorized

I would like to challenge this form of consent.  I understand that this is an attempt to handle problems that occur every day in practices across the country.  Our patient is under anesthesia, the mouth is cleaned, charted and all X-rays have been taken.  We now know that there is much more pathology than originally expected.  A call is placed to the pet's guardian and they can not be reached.  This leaves the veterinarian in a quandary and a state of frustration.  Do we do whatever is needed or not?  With this form of consent many feel they have "informed consent" to proceed with therapy and surgery or at least it gives them guidelines and client expectations under which to proceed. 

I also know from having talked to many employing this type of consent, that clients are still disappointed with the bill.  They feel they did not give consent to spend "that much money" and they are shocked at the number of teeth extracted.   And, unfortunately, it is common practice for the receptionist to present the client with the total bill and it is often she/he that has to take the initial heat...in front of all of the other clients.  So, in many cases, the person that has the least amount of dentistry training on staff, the person that was probably not involved at all, the person that has no power to amend the bill, often bears the brunt of the client's disappointment.  And we wonder why practices find it hard to keep wonderful customer service representatives and why some our front line staff members can get surly with our clients!

So, my question is, if we asked these clients; did we meet your expectations, do you think they would say "YES!"  Do you think they are going to be apt to provide the same services next year?  Do you think these clients are going to recommend this experience?