Practice E.R. – Seven Vital Signs for a Successful Practice

Practice E.R. – Seven Vital Signs for a Successful Practice

The practice consultation follow-up rate (C2:C1 Ratio) is one of the 7 primary drivers of practice performance.


Do you send your clients off with a vague reminder to ‘come back in three weeks’ or to call ‘if fluffy seems worse’ or worse still ‘If Fido isn’t better in five days, call me’.

What we don’t realize is that when we use these phrases, we are doing our patients and our clients a grave injustice. How? By making the client the vet, and thus delegating to him or her our responsibility for evaluating the pet’s health. The results can, at the very least, cost you the client’s trust.

Just to be clear – There are really only 2 types of consultation despite how many you have on the computer.

1) The Primary Consultation (C1) that the client makes – they instigate it, they are aware of the cost and generally they are happy to pay the fee if they get 15 minutes of veterinary attention i.e. they bring the value with them. Value is inherent in the clients’ request. For the vet – no real issues.

2) The Subsequent Consultation (C2) that the vet requests in the pursuit of good medicine and professional obligation. This is the tough one for us. Where is the value that equates to another consultation fee (albeit reduced – why?). The point is it is entirely up to the vet to create the value for the client. The client is asking why do I need to bring it back and why do I need to pay another fee? To be successful and to be a good vet – you had better have an answer. When you figure that out you can actually charge the same for both consultations – what’s that worth to the bottom line?

The C2:C1 Ratio

Measure the rate your vets create repeat or subsequent consultations from an initial consultation. In clinical cases, if practicing good medical protocols, animals should be seen at more frequent intervals if the case is being managed pro-actively. Avoid “We’ll try this and call me in a week if no better! “ In most practices the repeat consultation rate (number of subsequent consultations to primary consultations) is often less than 50% The reality is that it could easily be 100% -150% by practicing improved compliance protocols and practicing better medicine – better patient care and extra revenue from the same number of clients. Ideally we recommend that the C2:C1 should be at least 100%.

Here’s a practice that ran a series of Vetdynamics Invoice Workshops starting with a C2:C1 ratio of 30% and increasing to 83% and more over a few months and sustaining and growing

This resulted in more consultations with no more clients, patients or caseload and more opportunities to practice great medicine.

Client spend per consultation also increased due to better consultation technique and communication i.e. better perceived value for the client.

As a result total practice turnover increased from £40,000 per month to £50,000 per month with no more clients, patients or caseload. Over 12 months this was worth an extra £120,000, most of which went to profit.


Encourage your vets to adopt this seven-step recheck protocol

1. Educate the Client – explain what you find, what you are doing and the need to monitor the outcome

2. Establish a convenient day of the week for scheduling the recheck

3. Offer two choices – day and time – agree and record the client’s choice

4. Accompany the client to reception; confer with the receptionist in the client’s presence

5. Schedule the date and time and complete an appointment card

6. Send a reminder – If the scheduled appointment is more than 3 weeks ahead, ask the client whether they would prefer a reminder by mail or e-mail. Record their wishes and ensure that the reminder is sent on time.

7. Make a reminder telephone call – 24 hours prior to the recheck appointment



To find out more come along the Vetdynamics Lunch Time Bonus 12.30 – 1.30 in the Business Theatre

LUNCH TIME BONUS: “Practice ER 7 Vital Signs for a Successful Practice

Alan Robinson BVSC MRCVS DMS

Vet Dynamics UK Ltd

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