Worldwide medical and scientific journal for animal health professionals
Veterinary Focus

Issue number 1 Marketing & Sales

How to offer a great experience - Part 1

Published 10/05/2021

Written by Philippe Baralon , Antje Blättner , Pere Mercader and Susie Samuel

Also available in Français , Deutsch , Italiano , Español and ภาษาไทย

Based on studies on a human hospital, this chapter will outline the different steps in the pet owner journey in your practice, including the consultation that should be a “golden moment” for your client. The veterinarian and the staff play a crucial role in the “pet owner experience” but process and physical aspects should never be underestimated. 

Example of a professional-looking waiting room. ​ All the mistakes above were fixed and the following facilities were added: 1. Separated waiting areas for dogs and cats with cat carrier trees.

Key points

It is strongly recommended to work with appointments to reduce waiting time.


Having a dedicated space for cats in the waiting area is highly appreciated by cat owners.


The consultation should follow a clear structure and be client-oriented.


The rule of the 3 Ps

Lessons from the best human medicine hospital

In 2003, Professor Leonard Berry (Texas A&M), one of the world’s top experts in health services management, carried out an in-depth study on the internal operations of the Mayo Clinic at its three main campuses in Arizona, Florida and Minnesota 1. The Mayo Clinic is probably the most recognised hospital brand in the world and its prestige is legendary. During his research, L. Berry and his team interviewed over 1,000 doctors, patients, nurses and managers of the group. They attended and were present at over 250 medical appointment interactions between patients and doctors and they analysed the operation of 14 different medical departments (including neurology, oncology, orthopaedics, gastroenterology and urology, among others). In the conclusions of their study, the authors of this research identified three pillars on which the exceptional level of service provided by the Mayo clinics are based and the resulting exceptional patient experience: the People, the Process and what they call the Physical Evidence. This is the rule of the 3 Ps.
 

People (Box 1). The creed of the Mayo Clinic’s founder (“the best interest of the patient is the only interest to be considered”) pervades all staff actions. The clients who were interviewed explained how “My doctor calls me personally at home to find out how I am” or “When I had a colonoscopy, the doctor personally explained to me that I had a polyp, as she remembered that my husband had died from cancer of the small intestine and she knew that I was scared that the same was happening to me” or “My oncologist is the kindest person I have ever spoken to. I was much more than a medical problem to him. He talked to me about his personal life. He treated me like a person”.

Box 1
 💡 How to improve the client experience through people
  1. Don’t pay income production-related variable incentives, as these can lead to inappropriate behaviour that does not prioritise the interest of the client/patient.
  2. Measure client satisfaction and track the results back to the staff who attended to that client. Share the results individually and acknowledge those who obtained the best metrics (i.e., NPS).
  3. Train, train, train!
  4. Encourage not only technical training, but also client service-related skills. Film/observe young vets during appointments and work with them to identify areas that could be improved.
  5. Select staff not only according to their clinical skills and credentials, but also according to their communication and client-focus abilities.
  6. Formalise the clothing worn and greeting made by veterinarians during appointments.
  7. In the context of complex, life-threatening cases handled in large units where the client interacts with more than one vet, identify a “veterinarian in charge of the case” who can take care of the key interactions with the pet owner.
  8. Select veterinarians and support staff who own and like cats or at least are accustomed to handling them.
  9. Make sure that clinic owners lead by the example every day: the points above are of no use if the team does not see their bosses practice what they preach.
  10. Incorporate client communication skills in veterinarians’ performance appraisals.

 

Process (Box 2). As far back as 1910, Dr. William Mayo said, “for the sick to benefit from scientific advances, it has become necessary to develop medicine as a cooperative science”. This foundational vision translates into an integrative medicine approach to cases: Mayo Clinic patients never feel that they are being passed around among a series of disconnected doctors who exercise their specialities in a standalone manner. Much to the contrary, all of the clinic’s systems and processes promote teamwork among professionals: for example, all doctors receive fixed salaries to prevent personal interests in dealing with specific cases and, therefore, invoicing higher amounts that could result in commissions.

Box 2
  💡 How to improve the client experience through process
  1. Work with scheduled appointments whenever possible. If managed correctly, appointments result in a reduction of waiting times and enable vets to prepare proactively for the consultations, clearly improving client experience.
  2. Define telephone standards and measure them regularly (i.e., with a mystery caller service), correcting areas of improvement through training activities.
  3. Schedule in feline patients at certain times of the day and with longer time frames. Teaching our clients how to bring their cats to our centre in the least stressful way possible.
  4. Regularly call the owners of hospitalised patients to explain any change to the treatment plan and/or estimate.
  5. Systematically call all clients the day after patients have undergone surgery (even if they have a follow-up scheduled soon), to show interest and answer any queries.
  6. Always provide a written consultation report summarising the most relevant events during the visit.
  7. In complex cases involving the work of more than one vet at the centre, appoint a head veterinarian who gathers all key information relating to the case for the owner.
  8. Encourage your staff to use the services and products offered by the clinic (such as wellness plans, food, anti-parasitic drugs): what is best known is best sold.
  9. Ask your clients for their preferred contact method for vaccination and de-worming reminders (none, email, telephone, SMS, letter) and comply with this.
  10. Define a formal discount policy in the clinic: whom you can give a discount to, which clients and under which circumstances. Few things confuse and frustrate a client more than sometimes receiving a discount and other time not, depending on who serves them or without a clear reason.

 

Physical evidence (Box 3). The Mayo Clinic’s facilities are designed to minimise stress, to provide a welcoming and professional environment, designed for families… This is appreciated not only by patients and their families, but also by workers. And the 2,800 medical staff — unless they are in operating theatre or performing specific medical procedures — dress in business attire, in order to convey competence, respect and professionalism.

Box 3
 💡 How to improve the client experience through premises and physical evidence
  1. Parking (own or agreement with a nearby parking area)
  2. The toilets should be kept clean at all times.
  3. Consultation rooms should always be cleaned after every visit
  4. Whenever possible, the switchboard should be separated from the reception desk, to enable undivided client attention
  5. Clear- and professional-looking signage in all areas of the clinic
  6. Directory of practice services and staff placed in a visible location in the reception area
  7. Presence of furniture and relaxing decoration in non-medical areas of the clinic (sofas, coffee maker, relaxing images of happy pets)
  8. Dedicated consultation room for cats
  9. Separate reception (or, at least, a dedicated area) for cats, with spaces and furnishings designed for them
  10.  Separate hospitalisation (or, at least, a dedicated area) for cats

 

Most veterinary clinics worldwide can certainly learn lessons and gain ideas from this example in order to improve their clients’ experience… Below are some ideas in this regard.


The first moment of truth

After the client has selected a veterinary practice through various channels, the moment comes when they arrive at the clinic. If pet owners have had a positive experience thanks to a well-designed homepage and a professional telephone reception and are able to find a parking spot without any problem, they tend to be in a good mood on arrival.

Of course, clients are always a bit stressed when visiting a vet, even if they assume that their pet is healthy and that “their” practice will provide the best possible care for their companion. However, if the client had a choice they would most likely not be going to a vet but playing with the pet or taking it for a walk. This is the reason why excellent design is so essential — welcoming the client and relaxing pet and owner.

Exterior design

The exterior of the practice makes a major contribution to a client´s sense of wellbeing and transforms their visit into a positive event. As employees tend to gradually become blind to the workplace appearance over the years, staff can sometimes be neglectful to the outward “face” of the practice. Employees are also frequently in a hurry when they enter or leave the practice to get to their workplace in time or they have a fully separate entrance and just don´t get the client´s viewpoint. This important area with such an impact on the pet owner´s impression of the practice needs to have an independent “task force” to check the exterior at least once a day and fix any problems immediately.
 
An awesome exterior should be designed and maintained as follows:
 
  • Complete cleanliness and maintenance for the practice surroundings, i.e., plants, pavements, entrance, outdoor seating;
  • Easily visible and well-maintained entrance signs and car park with a logo and best possible lighting;
  • Attractive design of window surfaces, e.g., with adhesive foils highlighting the practice logo and enhancing corporate design;
  • Protected (sun/rain) seating, wastebaskets, bags for animal waste and fixtures to temporarily “park” nervous dogs so that the owner can check in at reception quietly.

The exterior is the first part of the practice that the client experiences when they come with their animals to see you. Treat them like a welcome guest and show them your best side — at any time of the day and night!
 

Reception

From the carefully designed exterior, we move to the interior of the practice and this area also needs to have a continuous client-friendly design that is supplemented with a great reception team. The combination of a pleasant and interesting ambience and attentive, highly specialized employees trained for this important job are what make a practice unique and impresses clients deeply. This includes greeting clients immediately when they enter the practice — a smile, eye contact and a nod may be sufficient if applied properly (e.g., when the receptionist is on the phone). The next most important factor is having the practice staff take care of the pet owner, listen to their requests, provide them with sufficient information (about waiting time, the upcoming consultation, appropriate offers or innovations for the pet) and accompany them to a seating area. Even if doing so is not possible 100% of the time in a busy practice, the team still needs to be aware that a client’s reception sets the path for the entire relationship and is essential for establishing a good relationship and creating a long-term loyalty. Always remember that the client is the basis for our business — no client, no revenue, no profit and no growth!

The style of reception in the practice has a strong impact on client relations. Upon entering the practice area, the client should be approached as quickly and professionally as possible, helping him feel secure, acknowledged and respected.

Interior design

In order to make sure a client feels comfortable (besides an enthusiastic and personal greeting), the facilities must have a convenient and client-oriented ambience (Figure 1) — meaning the furniture and design needs to focus on the client’s and pet needs. Specific tips for a successful basic design include:
 
  • A bright, pleasant smelling and air-conditioned reception area
  • Comfortable seating (recommendation: test your seats by sitting down for ten minutes!)
  • Interesting and up-to-date reading material about animal health and related issues
  • Racks and small tables for transport containers (cats, small mammals, birds)
  • Information about the practice services, i.e., veterinary services and other services such as examination techniques, check-ups and nutritional counselling
  • A select range of animal food and sensible accessories (e.g., transport baskets, toys)
  • Presentation of the practice team with professional photos, skill sets and special interests
 

Figure 1. Waiting room set-up: what was wrong!

Here are the errors the clinic made:
1. Unpleasant smell
2. Plants in bad shape
3. Messy advertising board
4. Posters on the wall are not related to pets
5. Out-of-date magazines
6. Untidy display racks (bags lying flat, best places are empty, etc.)
7. Unsorted bags lying on the floor
8. Grocery-like promotions
9. Nothing for cats nor cat owners

© Royal Canin SAS

If you want to do something more for your clients’ comfort and emphasize your client-friendly image, we recommend the following items:

  • Drinks for people and their pets, i.e., water taps and bowls or coffee machines and mineral water
  • Information about seasonal topics such as parasite prevention in spring and autumn, joint health in winter, travel prophylaxis (medicine, food) in summer
  • A “children’s corner” with smaller furniture, animal books, crayons and paper
  • Waiting room television with informative videos for various animal species and interesting practice services — always including and presenting the practice team


More for cats!

Cats are becoming more and more popular as pets — increasing numbers of them around the globe are evidence for this. The good news is that these cats also need veterinary care. We as service providers need to do more to meet the needs of our feline clients and adapt to these needs in terms of our communication strategy (see “Telephoning” section) and practice design.
 
Cat owners are particularly sensitive when it comes to practice visits as seen in various studies (e.g., Bayer Veterinary Care Usage Study, 2011) and many cat owners see a visit to the vet as pure stress, causing them to avoid going causing poor levels of veterinary care for cats. However, these clients are extremely thankful for every step the practice team takes to make them feel more comfortable.
 
1. Designated cat waiting area
 
Whenever possible the practice should either have a separate cat waiting room or an area specifically designated for cat owners (Figure 2). The area can easily be separated from the dog area and reception through a partition (shelves, coat racks, displays etc.). Hereby a special and secluded space is created, which cats appreciate as they like to hide. The area can also be labelled with (wall/floor) stickers and images, making it easy for clients to find.
 

Figure 2. Example of a professional-looking waiting room.
 
All the mistakes above were fixed and the following facilities were added: 1. Separated waiting areas for dogs and cats with cat carrier trees (cats prefer to be in high places) 2. Pheromone dispensers  3. Accessories meeting cats’ behavioural needs.
 
© Royal Canin SAS
 

2. Special furniture

The cat area needs to have racks or small tables for cat carriers (Figure 3). The colours of the “cat space” should be soft and the lighting mild and indirect, as cats prefer things a bit “cosy”. Pleasant photos of cats and the practice’s “cat team” on the wall add an extra personal touch.

 

Figure 3. Royal Canin developed a cat carrier tree to avoid putting the cat on the floor. © Royal Canin SAS

3. Special service

The cat area is also the ideal place to promote services and products the practice offers for cats, such as special health checks, care programs, nutrition and accessories. Do not go for all you can show at the same time, but rotate the focus using posters and brochures. If you have enough space, a food display with a small, select range of premium cat food, sensible toys and “good” cat transport containers is a big plus. The client can then use the waiting time to find out more about the practice´s services in pleasant surroundings (Figure 4).

The reception and waiting area need to make the client feel at home immediately, so that stress and worry about their pet slips away. They need a comfortable seat in interesting surroundings where they can wait to visit the vet — with attentive support from the practice team.

Figure 4. The 7 rules for an effective food display.

1. Prefer a display rather than a showcase. The pet owner enjoys being able to take the bag in hand.
2. Don’t leave it empty. Especially at eye level (notion of “golden diamond” — see picture).
3. Put bags on their facing, not on the side or lying down (except big bags).
4. Put the wet formula next to the dry, as it will remind the pet owner and the nurse about it.
5. Put the price and — even better — the cost per day.
6. Fill the shelves according to space and in relation to the turn over of each product.
7. Of course, keep it clean and respect the “first-in, first-out” concept.

 

The practice team

A practice is only as good as its team! Even though optimum design of the practice space is essential to a good image, without a caring, attentive and client-oriented practice team that actively cares for clients, even the most perfect design will be ineffective. But when an awesome interior design meets extraordinary employees, the combination of these two elements has a tremendous impact on the client.

Defining the difference

What is the difference between an average and an extraordinary practice team? What makes a client so loyal that they will not even consider visiting some other practice, never mind switch vets?

The answer is both simple and complicated: communication! Simple because everyone knows communication is important and plays a crucial role. Difficult, because there is still not enough training and expertise for the implementation of client-oriented communication in veterinary practices. Examples of important characteristics to look for in front desk staff enabling extraordinary client care include:

  • Natural friendliness and enjoyment of being around people and animals
  • Stress resistance and the ability to maintain a clear head in difficult situations
  • Commitment to do more than “just” complete tasks
  • Client-focus or the capability to see the world through a client’s eyes and provide the best possible service to owners and their pets
  • Being able to communicate, inform and counsel in a clear and simple language, so that the client understands every word
 
These are the ideal characteristics of a dream team, rarely found in this combination in real life — but they should be kept in mind when searching for a “5-star” reception team.
 
An exceptional reception team makes all the difference — it bonds clients and keep them coming back again and again. But: it has to be found, trained and maintained every day!
 
Creating an extraordinary performance
 
Now, what is the perfect interaction between the reception team and clients? Let’s assume the team meets all the necessary requirements, an optimum interaction involving a new client with a cat and an appointment arranged on the telephone beforehand may appear as follows: The receptionist greets the client, approaches her, introduces herself and asks what her wishes are:


Receptionist:
Hello, welcome to our practice, my name is Anne Roberts. How can I help you?

Client: I have an appointment for Kitty’s vaccination.

The receptionist opens the appointment calendar in the computer and sees that, thanks to an excellent telephone interaction, the appointment for Kitty and other details have already been included in the client´s file. She can now use this information to address owner and pet by name and thus help immediately create a personal bond, e.g., by asking about transportation — knowing that this is often a problem for cat clients.

Receptionist: Then you must be Mrs Green, we are happy to meet you. Were our transport tips for Kitty helpful?

Client: They were great. It was a huge help.

The client’s positive reaction illustrates that mentioning transport was a good move, and allows the team to highlight once again the special service in the form of transport tips.

Receptionist: Wonderful! I just need you to fill out this intake form. Would you like to take a seat in our cat waiting area to complete it?

(In this case with a new client the receptionist waits for the pet owner to complete the intake form to check and update the data in the computer. When serving a regular client the data should actively be checked at least twice a year at reception upon arrival.)

Client: That´s a good idea!

Receptionist: Then please follow me, I’ll show you around.

Here the receptionist is combining the necessary bureaucracy with highlighting the special cat waiting space and personally accompanies the client — the client feels like a VIP. With the intake form she also checks the client´s data (email and phone), so that the practice has an accurate and updated client database.

Client: It´s nice and comfortable here and I can keep an eye on Kitty.

Receptionist: Thank you Mrs Green, I will come right back to you to pick up the form and I am happy to answer all your questions.

Client: Wonderful, thank you so much!

Once the formalities are done, the receptionist collects the form and tells the client about the expected waiting time, offers a drink and asks if the client needs anything else. With this style of interaction the practice creates a positive impression at the first personal contact. The pet owner experiences first hand that they are a VIP and that service and client focus are not just words but are being “lived”. This is the best way to gain and keep clients.


The consultation

Meeting the vet should be the highlight of the client’s visit to the practice; positive impressions that were created on the phone and at reception can now be reinforced. Clear, structured and client-oriented communication during consultation is absolutely vital to understand and be understood. Studies have shown that doctors often make a great effort to provide patients with suitable diagnostic and therapeutic explanations but that the patients sometimes fail to understand. Misunderstandings between vets and pet owners often occur because the scientific world of vets has very little overlap with the client´s world and vets are often poorly trained in client communications. But nowadays a veterinary qualification is not enough to satisfy the client´s needs, pet owners want more!
 

Build structure to support communication

If vets and practice teams use a specific structure for their dialogue with clients it helps to establish a good relationship, to create an effective understanding and it even saves time while securing a high quality of communication. The structure we propose can´t be applied to every situation, but in general, helps forming a strong bond with your clients:
 
1. Preparation: Preparation is vital to a consultation! A vet should review the client´s file (Figure 5) and make a quick update about the last 2-3 visits before the client is invited into the consultation room: What were the reasons for the last visits? What were the examination results and therapy, which products were prescribed and purchased? What notes did the vet make about the consultation, such as pet owner and animal preferences, circumstances etc.? Using this information, the doctor can prepare individually for a client before he enters the examination room. This process has 2 advantages:
 
  • The client realizes he is not merely just any customer but he and his animal have the vet´s full attention
  • Prior to the consultation, the vet can think about how he can make a link to the previous visit with (further) diagnostics, products, recommendations or information, which were not applied in the previous visit.

 

 

Figure 5. A quick client file review before the appointment is highly advisable because it slows down the hectic pace of certain days, helps the vet prepare for the consultation and allows for better communication. © Shutterstock

2. Opening the consultation: Once the client has entered the room and is fully concentrating on the vet, the consultation can start. The vet should initially keep the cat in the basket and the dog on the floor to ensure the client’s full concentration. Having a vet multi-task by asking about the medical history and examining the animal at the same time is not ideal. The client deserves full attention, because this is what they are paying for. If we as vets attempt to perform multiple tasks at the same time, we miss important signs clients give us and — even worse — we create the impression that we are doing something completely mundane because we can do it “on the side”, hereby dramatically reducing the value of our services. How can we expect the pet owner to pay a suitable price at the end of the consultation if we act as if the task is nothing special?

To start the consultation after greeting client and pet the following phrases are ideal:

  • How can I help you today? This question works if the vet does not have enough information, e.g., with new clients, or to check on details obtained from a phone call (discrepancies often occur).
  • How has Max been since the last treatment?
  • How does Toby like the new diet?
  • How was your holiday in Spain with Milo?

These questions link to consultations and information from the past and signal interest in the pet’s health and client needs — they send the message, “I want to provide the best possible service for you!” They also connect to the consultations that have already taken place and refresh the client´s memory.

3. Listening: It is important to really listen to the client, only ask questions, when something is not clear and to take notes to make sure that no information is lost. Once the client has finished with his description, the vet can and should ask targeted questions about the symptoms shown by the pet and if there are other things that the pet owner has recognized which are important to the overall picture. This way the vet usually gets much more information on the pet´s actual health status than if they simply start by examining the pet — this information often leads to further consultation and diagnostics.

4. Sorting and prioritising: During the next part of the consultation vet and client should collaboratively decide, which symptoms or diseases need to be  addressed immediately and which findings can sensibly be postponed to another appointment. Doing so helps to use the assigned and available time in the best possible way rather than adding pressure by exceeding the allocated timeframe and keeping other clients waiting.

5. Comprehensive physical examination with comments, summary, prescriptions and agreements regarding therapy and diagnostics (Figure 6): Vets should always first perform an examination starting at the tip of the nose and working to the tip of the tail and then move on to special examinations of individual organs. While doing so the vet should take the client on a journey in which they explain the findings on individual body regions and organs to the client, so the pet owner always knows what the vet is doing. At the end of the examination the vet should summarise the findings, present a diagnosis and explain the planned therapy and/or further diagnostic procedures to the client. When explaining it´s vital to use media such as leaflets, posters and models to create a picture in the client´s mind that will help them to understand the facts. In the event of further diagnostics and complex therapy, it makes sense to talk clearly with the pet owner about the price and the possible outcomes. In this case, agreement from the client for suggested therapy and diagnostics should be obtained by asking: “What do you think? Can I schedule an appointment for the X-ray?” Should the pet owner hesitate or have objections, a Plan B can be worked out with options better suited to the client.

Figure 6. Comprehensive examination will include comments, summary prescriptions and agreements regarding therapy and diagnostics. It should always be performed starting at the tip of the nose and working to the tip of the tail and the move on to special examinations of individual organ. © Shutterstock

 

6. Linking one consultation to the next consultation (or contact): If vet and pet owner agree and therapy or diagnostics are to be carried out, it is a good idea to end the consultation by linking the “now” to the next contact. Possibilities include a follow-up consultation, the appointment for the next check-up or noting the next endoparasitic or ectoparasitic treatment. Maintaining contact with the client is vital, reminders for specific consultations can be sent per email, text message or via post. Regular reminders for checks on chronic diseases such as atopy, renal, cardiac or joint disorders help assure compliance and illustrate to the client that the practice takes care of both client and pet!

7. Check out: The final stage in a consultation involves repeating the arrangements briefly, bidding the client farewell and then directing him to the reception for billing and scheduling the next appointment.

Working with appointments

As everybody today has less and less time and life moves quickly, working a practice by appointments only has clear advantages over an “open hours” set-up:

  • The client´s time is valuable and by giving and keeping an appointment the practice shows respect for the pet owner´s situation. Nobody likes to wait and sit around not knowing, when (or if) something is going to happen.
  • The vet´s time can be planned more precisely so that the calendar is never too full and never too empty.
  • Vets can prepare for the client´s visit — they know who is coming and when. This way, they can already think about the best possible offers for pet and owner before they are in the consultation room.
  • Appointments keep the stress of daily vet practice at bay, because there are not so many pets and clients waiting, moving in and out, and the noise level is reduced greatly.
 

References

  1. Leonard L. Berry & Neeli Bendapudi. Clueing In Customers. Harvard Business Review, February 2003.
Philippe Baralon

Philippe Baralon

Dr. Baralon graduated from the École Nationale Vétérinaire of Toulouse, France in 1984 and went on to study Economics (Master of Economics, Toulouse, 1985) and Business Administration (MBA, HEC-Paris 1990). Read more

Antje Blättner

Antje Blättner

Dr. Blaettner grew up in South Africa and Germany and graduated in 1988 after studying Veterinary Medicine in Berlin and Munich. Read more

Pere Mercader

Pere Mercader

Dr. Mercader established himself as a practice management consultant to veterinary clinics in 2001 and since then has developed this role in Spain, Portugal and some Latin-American countries. Read more

Susie Samuel

Susie Samuel

Dr. Samuel graduated from Cambridge University in 2001 and spent ten years working in both mixed and small animal practices. Read more

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By Philippe Baralon , Antje Blättner , Pere Mercader and Susie Samuel