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CASE STUDY · July 15th, 2019

Putting Prompt Care into Practice

by John Paulson, DVM

MANAGING VETERINARIAN

A few years ago, while serving as MDVM at Ridgetop Animal Hospital, we found our practice slightly overrun with urgent calls from clients. Most weren’t actual emergencies, but they wanted to see a doctor immediately. When they tried to make an appointment, we were booked – sometimes for weeks. If we were booked, they’d walk in.

There are other hospitals in the area, but clients wanted to see us. It warmed our hearts to know how much they loved our hospital and staff, and so we found it difficult to turn them away. Under pressure, we tried to accommodate more, but it only led to longer waits, rushed visits, and added stress on doctors and staff who were stretched thin.

As the hospital leader, I felt I was letting them all down. I knew this was not sustainable, and there had to be a better way.

That’s when we decided to launch prompt care.

Why Prompt Care?

Most general practices have some system in place to address urgent care or requests, generally through referrals. At Ridgetop, we weren’t looking to establish a 24/7 emergency unit; we’d continue to refer patients to ER when appropriate. Rather, our goal with prompt care was to embrace and welcome every patient we could treat within our operating hours.

We believed the service would allow us to treat more of our patients more consistently, but also increase our client base over time, as we earned a reputation in our community for delivering quality care to every animal who came to our practice. And we were right.

How We Implemented Prompt Care

Implementing prompt care was no easy feat. It required a lot of planning, piloting, and communicating. But in the end, adding the service helped Ridgetop Animal Hospital treat many more patients and earn more revenue. Here are some of the critical steps we took:

1. Creating Space

More often than realized, many practices have space that’s not being utilized efficiently. At Ridgetop, we had an 800 square foot area dedicated to short-term boarding and grooming. The service had produced only marginal revenue for quite some time. After a careful review, we discontinued the offering and converted the space our new prompt care exam room.

Of course, not every hospital needs a designated room to ensure prompt care’s success. Initially, as we ramped up the service, the room doubled as a dental station until about a year later when it was clear the service could stand on its own. Even today, the dental equipment remains in the room for emergency procedures. And when not filled, we also use the treatment space for smaller tasks or non-sterile procedures such as wound and hematoma repairs.

The prompt care space at Ridgetop Animal Hospital.

2. Allocating Doctors and Staff

At first, we did not hire new staff. One of our associate doctors moved out of the appointment rotation to become our full-time prompt care veterinarian. Once the caseload built up, we added staff and rotated in other doctors who wanted to participate.

At Ridgetop, all calls and same-day appointments were allocated to prompt care. The assigned doctor began her morning with a completely open schedule that filled in as the day progressed. Most days were extremely busy, few were slow, but the staff always had to be prepared. Ultimately, we found prompt care doctors worked similar rates to appointment or surgery days.

We also discovered through trial and error that not all staff were suited to support prompt care. The doctor on schedule had to perform urgent care medicine and needed experience working in a fast-paced environment. Our techs had to discern between urgent situations we could accommodate in-clinic versus an ER, and facilitate the DVM’s ever-changing schedule. Attending relevant CE as well as visiting other urgent care facilities helped.

Our front desk handled all the booking. To compensate for the growth in business, we eventually brought on more staff, but overall implementing prompt care reduced phone and scheduling time significantly, and created less stress across the board.

3. Establishing Prices

We kept pricing simple. We did not want to make it too complicated for staff to process, or for clients to understand. Our surcharge for prompt care was $13. All other treatment charges remained equivalent to that of a scheduled office visit.

Clients who paid for prompt care got the convenience of same-day “urgent care” without paying the higher fees associated with emergency clinics. Additionally, the nominal cost helped filter out clients who truly didn’t require immediate care without financially deterring those who needed the service.

4. Educating Clients

The entire staff played a crucial role in making prompt care a success at Ridgetop. The front desk ensured clients were aware of the service and set expectations. Techs and doctors helped communicate the value during scheduled visits to help build word of mouth. And promotional efforts, including in-clinic signage, social media posts, website updates, and email blasts, helped build awareness before launch.

It took some time, but clients began to understand on their own when it made sense make an appointment or come in for prompt care.

The Results

For Ridgetop, implementing prompt care was a clear win. Clients love the convenience, and our staff loves delivering quality care for everyone who seeks it. Plus, doctors and technicians gain experience with cases that would typically be referred elsewhere.

Prompt care also helped generate more revenue than initially expected. It brought in many new clients over the years because it enabled us to take on more cases. And the grooming service it replaced is not missed. Revenue for one day of prompt care often approximated one month of grooming earnings without the challenges of maintaining that service.

Of course, prompt care isn’t for everyone. The best candidates for prompt care are busy hospitals that have:

  • A strong client base
  • At least three full-time DVMs on staff
  • Strong support staff and good departmental leads
  • Full schedules with good hours
  • Willingness to commit to the idea and patience to see it through

For practices who do not meet most of these criteria, working with your leadership team to increase your clientele may likely be your first order of business.

Recently, I joined the team at Shoreline Animal Hospital, where I now serve as the managing doctor. We are currently developing our own strategy to implement prompt care. Unlike Ridgetop, Shoreline already operates as a walk-in clinic so we will have some unique challenges. Still, we are up for the task.

If you have any questions about prompt care, or if your team or division would be interested in hearing a presentation on the topic, email me at JPaulson@NVAnet.com.

You can also watch my presentation from the 2018 NVA Community Gathering below. I share more details about my experience with prompt care and why it’s so important to me professionally and personally.

John Paulson, DVM

MANAGING VETERINARIAN

Shoreline Central Animal Hospital | Shoreline, WA

Dr. Paulson graduated from Oregon State University in 1991. He practiced in Cottage Grove, OR and Redmond, WA before coming to Silverdale in 1996. His veterinary interest lies in Orthopedic and Soft Tissue Surgery. Dr. Paulson is certified for orthopedic bone plating and Tibial Plateau Leveling Osteotomy (TPLO) Surgery.

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