宠物医师与宠物主人的有效沟通.doc

宠物医师与宠物主人的有效沟通
介绍：根据在美国从事20年咨询服务工作的经验，笔者意识到，成功运营动物医院最重要的工具就是有效的沟通。有效的沟通能够让客户更愿意接受服务，让客户对医院更加信任，从而接受医生的建议，放心地把宠物留在医院进行治疗。
方法：促进与客户更有效的沟通，有以下3点主要方法
1. 我们需要了解的是，沟通是一种双向的路径，需要有演讲者（医院员工）与听众（客户）。演讲者需要经过培训，才能让听众了解医院工作流程的重要性。
2. 有效的沟通应有一种固定的模式，每位员工都需要遵循该模式。预防兽医学的5个步骤是促进沟通有用的工具。
3. 同时，所有的沟通都应建立在同情心与高质量服务的基础上。
沟通的基础是员工教育：有效沟通的基础来源于员工与医生们丰富的知识和高度的自信。没有足够的知识与经验，无法让客户了解医院为什么需要进行如此复杂的工作流程。提高员工的自信，方法就是让他们在医院里通过学习、培训、接触各种不同的病例，从而增强他们的经验和知识。员工教育对于医院的成功至关重要，因为大部分的沟通都是从员工开始，又从员工结束。如果计算一下，动物医院中非专业员工与客户相处的时间是临床兽医与客户相处时间的两倍。当客户第一次打电话或者拜访医院，员工首先与客户交谈并邀请他来医院。此时正是员工开始对客户进行教育的时机，早于医生对客户的宠物进行检查的时候。在检查室时，医生来之前，员工还可以进行体温、脉搏的检测。这是一个很好的机会，员工可以向客户解释该宠物现在的状况以及医生可能会给出怎样的建议等等。所以，员工的知识与教育程度非常重要，员工的参与能提高医生诊断的价值。当医生的诊断结束后，员工可再次安慰客户，让客户放心。医生检查和诊断的结果，对宠物的护理会有一系列的建议和计划。这也是员工进行客户教育的重要时机。ADDS（该治疗方案的好处、不执行该治疗方案的后果、医生所提建议的关键点、整个故事）是我的医生们通常使用的促进医患有效沟通的方法。因为沟通是双向的，那么听取客户的意见，记录客户的需求就是沟通非常重要的组成部分。需要告之客户、需要客户同意的内容，也都是应该记录在案。当客户决定是否在这所医院治疗他们的宠物时，他们想要知道以下3件事情，当然医生可以向客户进行解释，但是值得信赖的员工也可以承担这项任务：
1.我将会付费多少？
2.我的宠物怎么了，你们将要做些什么？
3.多久能恢复，以后会复发吗？
当解释明白后，客户就会同意医生的建议，同时签署医疗合同。医疗合同中除了医疗方案外，应当包括医疗费用、支付方式以及宠物送诊时间。当然还应留下客户电话，以便当医生想对医疗方案进行修改时，能随时联系到客户。除了急诊以外，在没有签署医疗合同之前，不采取诊疗措施。所有这些对客户进行沟通教育的行为，都要求员工自身的水平非常高。每月拨出特定的时间进行一次的室内员工培训，是医院向员工表示院方非常重视员工的教育与培训。员工会议是拨出特定的时间，员工与医生一起讨论病例和客户，也是员工学习的过程。有一个原则：教育让人更有责任感。同理，通过员工来对客户进行教育的重要性可见一斑。
制度化标准化的沟通技巧：当双方进行沟通时，我们总是希望说有意思的事情。在一个忙碌的动物医院里，每天会同时发生太多的事情，电话铃声、犬吠声、客户在前台咨询，正在给宠物做术前准备，准备迎接送诊的动物，客户在等待治疗评价等等，所有这些营造出一个压力环境。当客户匆匆忙忙时，我们与客户交谈，往往也会漏掉或忽略我们应当对他们解释或建议的内容。如果每个员工都有一个自检目录，就能提醒我们自己不会忽略该向客户交代的所有要素。 在过去的20年中，笔者在多家动物医院推广预防兽医学5步自检目录，获得了很大成功。该自检目录适用于所有动物医院，同时也可因地制宜，根据每家医院不同的需要作调整。该自检目录最重要的价值在于，医院的每一位员工都可以统一地对客户进行教育、解释和建议。自检目录也是病例的一部分，能够显示在医生提出建议之后，最终客户选择了那种医疗方案，又放弃了哪些方案。面向客户进行制度化标准化的沟通、教育与建议，对于医院经营的成功与否非常重要。
自检目录样本如下：
客户姓名 日期
宠物名 就诊目的： 新宠物 检查 注射疫苗 其他
六个月体检，每年CBC/GP与免疫效价
疫苗佐剂 疫苗效价 每年基本血常规 Q6M检查
建议
1、 营养健康食品供应商来源
iVet食谱 i Vet食疗 O3O6 FA/Zn食品 Rx食谱
建议
2、 体内和体外寄生虫预防，人畜共患病
Q3M粪便检查 跳蚤/心丝虫预防 涡虫疫苗
建议
3、 口腔卫生对于健康的重要性
牙胶 牙齿印模材料 洗牙 抗生素
建议
4、 动物行为学，人与动物的交流
一般咨询 处方 行为学家咨询
建议
5、 该诊所特有的选项
卵巢切除/去势手术 肛门腺 通便化毛膏 宠物美容
建议
富有同情心的沟通是建立在人与动物情感纽带（Human Animal Bond）的基础上。只要HAB成为员工沟通的一部分员工就能与客户进行富有同情心的沟通。HAB不仅仅是你向客户说了些什么，而是从你的身体语言就能感觉到。抚摸宠物的头、脖子、尾巴，轻搓宠物的腹部，这些身体语言都能在与交谈时表现出与宠物的亲密。与宠物坐在同高度的地板上，能让它们有回到家的感觉。如果医生和医院其他员工能这样做，会给客户留下非常深刻的印象。在给宠物检查完毕提出医疗方案时，就又能与宠物建立另一种HAB，同时让客户感受到员工的同情心。带领客户参观处置室与住院处，让客户放心地把宠物留下来进行治疗。关于拥有宠物与人们生活的关系，一直以来的研究与事例数不胜数。在美国有很多监狱用宠物充当犯人在狱中的“室友”。很多残障人士，每天都接受宠物治疗或陪伴对于很多情绪紊乱或精神失常的病人，与宠物共同生活也是一种先进的治疗方式。人们从最自然的层面了解宠物，同时，自己也回到了自然的状态。拥有宠物就像拥有了自然。所有这些知识，都应该通过医院的员工传达给我们的客户。当客户理解了医院所有的工作程序都是源自对动物的同情，他们就更能理解了这些医疗程序的必要性。当客户明白宠物更大的价值时，他们也会对宠物更加照顾，就像对家人一样。
结论：我们已经知道通过教育促进沟通的重要性、预防兽医学、HAB这三个要素。通过教育提高员工的知识，严格的制度化的预防医学检查，员工对HAB的知识，这三者是促进有效沟通，说服客户的基础。有效的沟通能让医院、客户、宠物三方都得到最好的结果。
Successful Client Communication in Veterinary Hospitals in the USA
Introduction: Through 20 years experience as a consultant in the US, I have recognized the most important tools that practitioners need to polish to make their practice successful. These are COMMUNICATION tools that are used for better service rendered to the CLIENTS. Through the optimum communication clients build high level trust and confidence in the clinician. As a result of the trust their pets are left for the services and treatment that were recommended by the clinician.
Method: I would like to point out 3 important ways that the communication becomes successful.
1. We need to understand the communication is definitely two way street. It means there are the speaker and the listener ( staff and clients). Speaker should be highly educated for the listener to be able to understand the importance of the procedures.
2. It also takes a form of structure and every one need to follow this formality as part of the system. 5 Steps of Preventive Medicine is highly effective tools for communication.
3. Also, all above action for commutation should be based on compassion and Quality to the eyes of clients. Otherwise client might perceive the value of the treatment and recommendation as part of merchandizing.

Communication based on Staff Education: Effective communication starts from the knowledge and confidence of the staff and doctors. Without knowledge and experience no one can speak up for the pets medical need and why it is important to get the procedures done. Only way to experience the staff confidence is to have them learn and experience through education, training and exposure to many different scenario within the hospital. Staff education is so vital for the success of the hospital since most communication is going to be initiated by the staff and most communication is finished by the staff also. If calculate the percentage of time that a clinician spends with the clients it will be less than 30% compared to the para-professional encounter is more than double of doctors. When clients calls the clinic or visits initially, staff first talks and invited them to the hospital. Even in walk-in cases, the communication starts with questions on the condition of pets and how the problems started. In a wellness care cases also, staff can communicate about preventive medical elements. This is the moment that the staff (receptionist) can plant the seeds to educate the clients before their pets are examined by the doctor. During the examination room also, staff can do TPR( temperature, Pulse and Respiration check) before doctor comes in for examination. This is also a great opportunity to speak to clients about the conditions of the pets and what doctor may speak to them pertaining to the condition of the pets. So, staff knowledge and their education can be so valuable since their participation enhances the value of the doctor’s time at the time doctor evaluate the cases and make diagnosis. Once the diagnosis is finished staff can revisit to comfort the clients also with words of assurance. As a result of doctor’s examination and diagnosis there will be recommendations and plan for the care of the pets. This is when the technicians and para-professionals can participate in the act of client education. ADDS ( Advantages of the treatment process, Disadvantages what the treatment is not followed through, Distinction of the particular process that doctor is proposing, and Storytelling ) is one of the tools that many of my doctors are using to make the communication more effective. As the communication is two-way-street listening to what clients say and putting in record on what they request are such a vital part of communication. The component the clients should be told and what they agreed should be all in record also. When clients leave the pets at the clinic for treatment there are 3 things they wants to know and it should be clearly explained before and/or during the treatment. Although it might be best that doctors explain about these items, depending on the level of trust staff may be able to do it effectively.
1. How much it will cost when I return?
2. What is wrong with my pet and what will be done about it?
3. How soon will it get better and will it happen again?
Once these are fully explained Client leave a notation that they agreed to the proposal through a paper trail. Agreement should be formulated as part of the written record regarding cost of the treatment, method of payment and time of discharge of the patients. Client’s contact phone member is essential in an event that doctor might change the course of treatment for the best care of the pet. No treatment should be performed unless it is an emergency so that the contact number is so crucial for the approval of additional treatment. All these act of communication and education of the client requires high level education of staff. Once of month in-house training by setting aside a designated time is a good example to show the staff the hospital is serious about staff training and education. Staff meeting set aside in advance will be a good tool for the staff and doctors communicate to discuss about the patients and clients as part of the learning process. Knowing the principle that “Educated person becomes more responsible and responsive”, the importance of client education through staff knowledge should be further emphasized.
Structured Skills on Communication: We all want to say impressive things to the other party when we communicate. In a busy veterinary practice, there are so many things happening simultaneously. Ringing of the phone, dogs barking, clients asking for the medication at the front desk. Surgical patient being prepared, getting it ready for the discharge animals, clients waiting for treatment estimates: all these put us in a pressure cooker leading us to a stressful environment. Speaking to clients when they are in such a hurry even makes us to forget and/or neglect what we need to explain and recommend. Having a formulated check list for recommendation is a good way not to skip routine and regular steps of preventive medical procedures as well as elective elements when patients are in the examination room. Author has used 5 Steps of Preventive Medicine Check list over the last 20 years to many different practices with total success. This check list is for a general practice although it can be altered in such a way that fits the practice’s needs. Most important thing of this list is that the staff can uniformly can educate, explain and recommend the procedures. This is also becomes part of the medical record showing what was recommended and what procedures are not followed through after recommendation. This structured process of communication through education and recommendation is a vital part of the practice success since fundamental foundation of preventive medicine is placed in the practice at the same time.
I have inserted example of 5 Steps. of Preventive Medicine. Check List.
Client Name_______________________ Date________
Pet’s Name________Visit for : New Pet □, Check Up□, Vaccine □ others □
Invitation □ Validation □ Processing □
1. Six-month examination, Annual CBC/GP and vaccination titer □
Booster Vacc. □, Vacc. Titer □ Baseline/annual Blood □ Q6M exam □
Remarks: ______________________________________________________
2. Wellness Nutrition through iVet foods, Treats and Diet Supplements □
iVet Diet □ iVet Treat □, O3O6 FA/Zn □ Rx Diet □
Remarks:________________________________________________________
3. Ecto and Endo parasite prevention; zoonotic considerations □
Q3M Fecal □ , Flea/Heartworm Prevention □ Girardia Vacc □
Remarks:__________________________________
4. Dental hygiene importance to good health □
Dental Gel □, Aqua Dent □, Dental Cleaning □ Antibiotics □
Remarks:_________________________________________________________
5. Behavior Medicine and Human Animal Bonding □
General Consult □, Rx □, Behaviorist consult □
Remarks:_________________________________________________________
6. Others Optional Steps specific to the practice (i.e. elective surgery, grooming, feline specifics)
Spay/neut □, AnalGland □, Laxatone □, Groom/Boarding □, TNT □
Remarks:_________________________________________________________