End the 10 minute consult?
Consults frequently last longer than 10 minutes. If an owner is 2 minutes late, or elderly and slow to get in the room, you’re quite often left with 7 or 8 minutes to read the previous history, get an updated version from the owner, examine the animal, discuss all the diagnostic and treatment options, administer or put up the drugs, explain how to give medication and discuss follow up. It doesn’t give clients or patients the best care, because we simply HAVE to rush… then we’re running behind for the entire day, leading to the inevitable missed tea and lunch breaks.
Increasingly, vets are aware that there is a good BUSINESS case for longer consults – having more time to discuss more treatments and workups in theory leads to increased uptake of these and increased client satisfaction and retention. In such an immediate society, clients are expecting more bang for their buck, and we can give them that if we have more time. And, with the rapid advances in medicine and surgery there is simply MORE to discuss than there was 10 years ago.
Click here for a Vet Record Open article about consult length, showing that it exceeded the 10 minutes allocated in 48.4 per cent of consultations.
This is an incredibly complex debate; different models will fit different practice circumstances. One thing is certain; taking the bull by the horns and thinking of innovative ways to address the trend of increasing client expectation will future-proof your practice. Examples include 20 minute consults with the nurse having the first 10 minutes to gain a history and TPR, followed by 10 minutes with the vet while the nurse assists with giving of medicines and writing up. The vet moves between two staggered nurse consult rooms. Clients feel they get more value for money and time, while the nurses have more frontline responsibility and the vet has time to do a more thorough job.
The following blog is reproduced with kind permission from Recruit4Vets on timing consultations:
“How long do your consults last?
Timing consults is one of the most significant differences between competing veterinary practices, yet it receives surprisingly little discussion in the public arena.
If you think about it, the simple consultation is one of the main sources of income for a vet clinic. If you have five-minute consults, you can see twelve people an hour. If consults last fifteen minutes, you can only see four people an hour. So on the face of it, a clinic could triple its consultation income by reducing the duration of its standard consultations.
But is it as simple as that?
I have the privilege of running my own vet clinic, so I have had the liberty of deciding how long my consults should last. When I started the business, I tried various different approaches, from a standard five minutes to a universal 15 minutes, to a mix of the two.
We found the five minute consults pressurised, and sometimes that can be helpful. There was no time for idle, non-productive chit chat: it was straight into the work, finding the problem, organising treatment, and moving on to the next client. At first, this seemed highly efficient.
In practice, this brought a number of problems…
First, short consults were less fun: part of the joy of veterinary consultations is the engagement with our clients, getting to know them, and them getting to know us. There is an intangible value to the idle chit chat, and there isn’t time for it, something is lost.
Second, it was rarely possible to complete the consult inside five minutes. Yes, there were the simple suture removals, routine vaccines and others that could be neatly fitted into a short space of time. But then there were the behavioural consults, the itchy skins and the dogs with several small problems that the owner wanted to discuss. It was impossible to condense these into the allotted time space, and so the consultations nearly always ran over. We noticed that the time spent waiting to see the vet increased from an average 10 minutes (acceptable to most people) to an average 20 minutes (and some people started to complain about this).
After this trial period, we decided on a different approach: having a selection of short five minute consults for predictably simple tasks, plus longer 15-minute slots for others. This was an improvement, and the waiting time for clients came down to 12 minutes, but it still had its problems. Vets were struggling to write up their cases in the shorter time period, and there were more cases of incomplete or brief case notes making it hard for other vets to work out what had been going on. It also made it difficult for reception staff, having to decide on what length of consult for the client on the phone, and making sure that every free slot was filled.
After this, we decided to go straight for the universal fifteen-minute consultation. We know that this reduces our throughput, but we also know that it’s the right amount of time to deal with the average case in a comprehensive manner. This extra time allows us to be sure that we cover every aspect of the pet’s problem, in detail, and it allows enough time to ensure that the details of the consultation are carefully recorded at the end.
There is also an economic argument that the thorough attention to detail during a longer consultation means that the animal may receive a more comprehensive treatment plan, to include subtleties that may have been missed during a shorter consult. And arguably, this more comprehensive treatment may mean more income for the clinic which reduces the effect of the lower throughput of cases.
It’s interesting that in some parts of the world – such as the USA – it’s common to have routine consults lasting 30 or 45 minutes. Consultation length is subject to a surprising degree of local variation.
‘In the USA, routine consults last around 30-45 minutes’
We have debated the possibility of moving to ten-minute consults, which are common in the United Kingdom. On balance, we have decided against this: we like to be able to fit in occasional extras, such as the walk-in client or the interrupting phone call. This would not be possible with the ten-minute consult, and we believe that our overall service to the customer would be adversely affected if we tried to do it.
Fifteen minute consults are ideal
The difference between five minutes and fifteen-minute consults is like the difference between sprinting and jogging. Just as you can sprint for up to a kilometre, you may be able to do five-minute consultations successfully for an hour or so. But if you are doing a long run – like a half marathon – (or a full day’s consults), it’s impossible to keep sprinting: you need a slower, regular pace, like a steady jog. In the veterinary consultation world, that means fifteen minutes is ideal for us.”