Preventive Care Protocols — Are Your Doctors On Board?

Why is preventive care important to pets, clients, and practices? Look no further than recent studies, data, AAHA, AVMA, and the experiences of most practices for scientific evidence and ethical recommendations. The purpose of preventive care is to help our patients have longer and healthier lives. Veterinary medicine is a noble practice, and vets want their patients to be well. Even though they may like surgery and complicated cases, not one veterinarian would ever wish a problem on a pet. So, why is it difficult to talk about prevention in practice?

Know Your Goals and Make Them Your Mission

Change management is a complicated process. The first step is always an honest assessment of your practice culture. If you feel like the practice is ready for change, conduct a checkup to tune the process for your practice. Be specific about what you want to achieve — it always helps to tie goals into the practice mission.

Our mission is very simple: We want to do our best for every pet, every time. In reality, it becomes very easy to short shrift healthy pet visits when sandwiched between sick patient visits and catch-up time. We miss too many opportunities when we don't keep that mission in mind. Prevention, detection, and treatment is what veterinary practice is all about — when we make these priorities, we help our patients and clients move closer to achieving that longer, healthier life. Therefore, your goals should reflect your mission.

Begin With the Veterinarians

Preventive care is a team process and the veterinarians are the captains of the team. Protocol change starts with them. When the veterinarians define the standard for your healthy pet visits, the team has a consistent message for clients, who can lose trust when the message is muddled. If your practice has everyone on a different page, client retention will be an issue — many practices cannot expect organic growth from adding new clients. We have to retain our clients and do more for the ones that we have; a clear plan for keeping pets healthy goes a long way towards developing lifelong bonds.

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Drafting the Standard of Care

You need a standard of care (SOC) to identify basic recommendations so the team can be an active partner in delivering exceptional care to patients and clients. Since veterinarians are trusted to use their education, experience, and judgment in complex situations, the SOC is not meant to be an all-encompassing opus that covers every contingency and dictates procedure. The SOC is a simple written expression of your veterinarians' basic beliefs. Here are some pointers:

Write it down: This process begins with your veterinarians documenting what they would recommend to the best clients in the practice — not to their family and friends. The doctors should jot notes individually at first and then meet as a team. If they're not sure how to write an SOC, there are examples at AAHA and AVMA.

Find your besties: For the SOC, identify your best clients. These should be the clients everyone loves, who trust you with their pets' care, and believe in your advice. The doctors need to write their recommendations considering these clients. Give them the faces of clients and patients to have in mind as they sit down to begin.

Keep it simple: Make the SOC simple and straightforward so every team member can understand it. It should include what your practice recommends for patient history, physical exams, internal exams (like early detection diagnostics), and followup preventive care (like year-round flea and tick prevention).

If your doctors are stumped as to the current recommendations based on scientific evidence, the AAHA has great resources available. And don't forget to pat yourself on the back when you finally have a written SOC that you can build a program from!

Devote Plenty of Time

How long should this part of the process take? At least three to four times longer than you expect, even with a single-doctor practice. Everyone is busy, they disagree on language, and getting all the doctors to sit down together at the same time is just about impossible considering their schedules, walk-in emergencies, etc. But it is critical to take this time to lay the groundwork with your doctors — they need to own the SOC and drive the medicine in the practice. Implementing change is never easy, but you can't shortcut the process. Getting this in writing will provide you with a reference document for the entire team and for clients.

What Does Success Look Like?

Getting the doctors on board is crucial to implement change. Consistent messages are how we build trust. Team members are gratified when the doctors confirm the recommendations that they have made to help educate the clients about a physical exam, early detection bloodwork, vaccination, a fecal exam, and prevention of heartworm and tick-borne disease. Otherwise, it can be demoralizing when the team has discussed the importance of a fecal exam, and the veterinarian dismisses its importance to the client. Would you trust a practice that does not seem to have their act together?

It's critical to think of change management as a cyclical process — we're never done with improving the quality of care we deliver to our patients and clients. Preventive care will continue to evolve as we improve at making prevention and early detection priorities. Think of yourself as an agent of change. Success can be measured by doctors making consistent recommendations, team members who feel like their words and client education are important, and clients who trust the practice to give them the right information for mitigating their pets' care.

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Nancy Drumm
General Manager, Capital Vets

Nancy Drumm is the daughter of a veterinarian and the granddaughter of a dairy farmer. She started working at the family practice at the age of 8, helping her father see patients after dinner, and the practice has been part of her entire life. She has been a farmer for many years as well. She has a burning interest in how things work and enjoys the challenges of running a business. She combines that curiosity and a willingness to try new things with a desire to use data to help us all make better decisions for our lives and practices.

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