ImproMed, LLC. Logo
Issue: 58 - Oct 15, 2013
Selling the Value of Diagnostics
By: Wendy S. Myers
IDEXX

Since 2007, Ellie has taken NSAIDs to manage her arthritis following two knee surgeries. The 11-year-old Labrador retriever gets drug-monitoring tests every six months. When Dr. Peter Brown of Chuckanut Valley Veterinary Clinic in Burlington, Wash., reviewed Ellie’s latest results, he used IDEXX’s VetConnect® PLUS to see trends over time. Ellie’s liver values had been steadily increasing and were now at the top of the normal range. Dr. Brown sat next to the client, showing her graphs of Ellie’s changing liver values on his iPad. He discussed adding a liver supplement and plans to recheck blood work next month. From his iPad, Dr. Brown shared lab results to the client’s PetlyTM online pet health page through IDEXX’s Pet Health Network Pro.

“While she was still at our clinic, an alert on her phone indicated she had new lab results shared,” says Dr. Brown. “Now she can share results with the rest of the family at home.”

A 2012 State of the Profession study found diagnostics make up 18% of practice income with growth to 20% anticipated in three years.1 “Diagnostics is where our profession is going to grow,” says Dr. Brown. At his mixed-animal practice with six veterinarians, 24% of revenue comes from diagnostics.

With persuasive conversations, Infinity’s technology tools and effective reminders, you can get more patients the preventive diagnostics they need. Here’s how:

Use repetition of the message to gain acceptance. Awareness starts when clients call to schedule exams. When a client schedules a senior pet exam at Chuckanut Valley Veterinary Clinic, an alert prompts the receptionist to explain senior testing. “Always prepare your clients for what to expect before they walk through the door,” Dr. Brown advises.

Replace “Do you want?” with “Your pet needs” when discussing diagnostics. Before the veterinarian enters the exam room, a technician informs the client of what diagnostic testing is needed, gets approval and collects samples. Test results are available during the exam. “Clients get a high perception of value when you share results in face-to-face conversations,” says Dr. Brown.

Use trending to provide solutions. When her diabetic dog began drinking more water, a client returned to Golden Triangle Animal Hospital in Southlake, Texas, for help. “I played Joe Detective using the VetConnect® PLUS tool with trending, which created a stronger perception of value,” he says. Diagnostics revealed Cushing’s disease, and Dr. Steve Ruffner shared a graph of previous tests with the client.

Use benefit statements. Help clients understand the medical and economic benefits of screening. Compare preventive screening to an “internal physical exam.”

Here’s a script for senior screening: “Because pets age faster than people, changes can happen quickly. Just like people in their golden years, senior pets have an increased risk of diabetes, heart and endocrine disease, and cancer. Because these diseases show few signs in early stages, preventive screening is important. Senior preventive screening helps us establish a baseline of what is normal for your pet as well as to detect any changes early. Catching changes early often means they will be easier and less expensive to treat. Think of preventive blood work as the internal physical exam that lets us check the health of organs and thyroid function. Thyroid disease is common in older pets. Urinalysis lets us determine hydration, kidney function, and whether there is any inflammation or infection in the urinary tract. We will collect blood and urine samples now, and then will discuss results with you today.”

Share facts on prevalence in your area. The Companion Animal Parasite Council offers prevalence maps for heartworms, tick-borne diseases and intestinal parasites in dogs and cats (www.capcvet.org). Enter your postal code to get U.S. or Canadian data on heartworms and tick-borne diseases from IDEXX’s www.dogsandticks.com. At www.kittytest.com, you can find U.S. data by state and county for Feline Immunodeficiency Virus, Feline Leukemia Virus and feline heartworms.

Look to in-house lab reports for insightful statistics. When Dr. Robert Tope of Electric City Animal Clinic in Anderson, S.C., ran a report on his in-house SNAPshot Dx® Analyzer, he found 80 positives out of 960 heartworm tests last year. Telling clients that 12% of patients tested positive in 2012 reinforces the need for annual screening and year-round preventatives.

Offer affordable prices on preventive screening. As a veterinary consultant, I advise practice owners to price preventive diagnostics 25% less than sick-patient testing. A 2013 study of 7,827 dogs found 31% of dogs of all ages had abnormalities, including diabetes, renal disease, hepatic disease and anemia when undergoing preventive screening. Almost half of dogs age 13 and older had abnormal test results.2 Sharing good news takes less time. A higher fee for sick-patient testing covers additional doctor time to diagnose the problem and discuss treatment.

At Electric City Animal Clinic, 90% of clients accept its $70 preventive diagnostic package that includes blood work, heartworm/tick test and intestinal parasite screen. The senior diagnostic bundle priced at $100 gets 75% compliance.

Create distinct codes to designate preventive screening from sick-patient testing. Distinguish the reason for testing because it influences future reminders and impacts the accuracy of compliance results. Let’s say your hospital is in Virginia, where 1 out of 13 dogs is testing positive for Lyme disease, according to the Companion Animal Parasite Council. You perform an annual heartworm/tick test as a preventive screen, but use the same test when a sick patient presents with tick-borne disease symptoms. If you run compliance reports to see what percentage of active dogs have received heartworm/tick tests, results may be inflated because preventive and sick-patient testing are muddled in the same code.

Instead, create distinct codes such as “heartworm/tick preventive screen” and “heartworm/tick test.” When you run compliance reports, search only “heartworm/tick preventive screen” to get accurate results. You could use the term “screen” for preventive care and “test” in sick-patient diagnostics.

Send reminders for preventive testing. Use postal and email reminders to let clients know when testing is due for heartworms/tick-borne diseases, intestinal parasites, retroviruses, blood pressure, adult and senior preventive screens, and drug monitoring. Compliance jumped 20% when Chuckanut Valley Veterinary Clinic added diagnostics to its reminder list.

“You need to get clients to say yes every year. If a dog will live to age 15, you need eight years of yes to senior screens,” says Dr. Brown. “If the first time that clients hear about blood work is from the doctor, it’s too overwhelming.”

When your team promotes the benefits of preventive diagnostics, the success you have with one patient can magnify. Cat owners often own multiple cats – 2.1 per household – compared to dog owners, who average 1.6 dogs per home, according to the American Veterinary Medical Association’s 2012 U.S. Pet Ownership & Demographics Sourcebook.3

“Compliance trickles down to other pets because most of our clients have multiple pets,” says Dr. Brown. “When a client with an older dog gets a puppy, she already knows about the lifetime of testing ahead.”

References:

1. State of the Profession: Veterinary practices still facing financial challenges. DVM Newsmagazine. Oct. 2012. Accessed 04-09-13 at http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=793509&pageID=1.

2. Pet Wellness Report: Canine Health Risk Assessment, A review of 7,827 Cases, May 2013, Zoetis.

3. Dog owners spend more on veterinary care, according to AVMA. AAHA NewSTAT e-newsletter, August 24, 2012.

SNAP is a registered trademark of IDEXX Laboratories, Inc. or its affiliates in the United States and/or other countries.

Author bio

Wendy S. Myers owns Communication Solutions for Veterinarians and is a partner in Animal Hospital Specialty Center, a 10-doctor AAHA-accredited referral practice in Highlands Ranch, Colorado. She helps teams improve compliance and client service through consulting, seminars, and webinars. You can reach her at wmyers@csvets.com or www.csvets.com.