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Veterinary Forum June 2007 (Vol 24, No 6)

Implementing extended vaccination protocols

by Michael Andress, DVM

    Concerns about lost revenue may be the leading factor preventing veterinarians from changing to extended vaccination protocols. In a companion article, "Winning the revenue battle with extended vaccination protocols" (May 2007, Issues in Practice), I discussed how practice revenues can actually increase by changing to a 3-year vaccination schedule.

    The importance of pets receiving an annual physical examination cannot be overemphasized. In addition to a physical examination, basic blood and urine tests, heartworm antigen tests and intestinal parasite evaluations are recommended. In the past, clients have sometimes declined these procedures because they had to pay for yearly vaccinations. By redirecting the focus of annual visits from vaccinations to preventive measures, clients may become more willing to comply with recommended routine testing. Not only can practitioners practice a higher standard of care, but the quality of life for their patients can improve and practice revenues can grow.

    There is evidence supporting the new 3-year vaccination protocols for some vaccines.1-5 All of us have seen the studies from organizations, including the American Animal Hospital Association (AAHA) and the American College of Veterinary Internal Medicine (ACVIM), which have encouraged adaptation of extended vaccination protocols.

    However, practitioners who want to implement these recommendations may be concerned about a perceived drop in practice revenue. The question is: How can I successfully integrate extended protocols into my practice?

    Start by educating your staff

    All of the doctors in your practice need to agree on a vaccination and preventive care protocol. Clients need to hear the same information from all team members. Receptionists, technicians and assistants typically are the first team members who will be addressing vaccination protocols with clients, and your staff's understanding and acceptance are crucial to realizing a smooth transition. Devote at least two regular staff training sessions for discussing why the protocol is being changed and how, as a team, staff can implement the new recommendations. The sessions should focus on explaining the science behind extended vaccination protocols, developing a detailed vaccination schedule and offering tips on how to educate clients.

    During the first training session, you should talk about the new protocols and the reasons behind them, including information on research, safety and efficacy. Simple handouts demonstrating how the protocol will work for puppies, kittens and adults can help the entire staff feel comfortable about explaining to owners what to anticipate.

    For the second staff training session, develop a list of potential client questions and objections. Examples include: "Is this new protocol safe for my pet?" "I don't want my pet to receive any vaccines." "We've done annual vaccinations for years. Why are you changing now?" Have your staff role-play answers to these questions to prepare them for providing appropriate responses. An example response to why the practice is changing its protocol could be: "Our doctors have reviewed recent national data on vaccinations and have determined that a 3-year protocol is in the best interest of your pet. Studies have shown that vaccines can last longer than 1 year. This new protocol is based on recommendations from the American College of Veterinary Internal Medicine and the American Animal Hospital Association."

    Many hospitals have adopted a senior program, including analysis of blood and urine samples on, at minimum, an annual basis. For these practitioners, adopting a policy of recommending annual physical examinations and testing for all pets can be based on their senior program. For practitioners who do not offer a senior program, this is a good time to start.

    Once staff has been trained and feel prepared, it is time to communicate with clients. If you already have developed a monthly newsletter, this is a perfect vehicle for announcing your new protocol. If not, a single-page client mailing should explain why your hospital is changing its protocols. You can indicate that recent research completed by reputable organizations and board-certified veterinarians reflect the need for updated vaccination schedules, but clients also should be reminded that science is constantly changing and you will remain current in all areas of veterinary medicine in order to provide the best care possible for their pets. As rein­forcement, when clients present their pets, your staff can remind them that the change reflects current knowledge, and staff should be willing to devote sufficient time to discuss the different types of vaccines and when it is recommended that pets be vaccinated.

    During the annual visit, performing a thorough examination is essential, along with making appropriate recommendations based on examination findings, such as ear cytology, dental care or age-appropriate blood work and urinalysis. This also is an ideal time to discuss pet obesity, osteoarthritis and the importance of blood monitoring when pets are on long-term medications.

    Your annual reminder system can be adjusted to accommodate annual physical examination and testing procedures by updating your practice management software. Vaccination reminders can be programmed for 3-year follow-up, or in the case of state regulations, continuation of annual rabies vaccination.

    Although email reminders often enjoy a better compliance rate, you should consider having a team member also call clients to reaffirm the hospital's vaccination recommendations and personally answer any questions the client might have about them.

    Making the right choice

    Changing to a 3-year vaccination protocol can be rewarding. Our entire veterinary team worked together and gained a sense of pride in knowing that they were affiliated with a progressive hospital.

    Implementation of an extended policy does not have to be an overwhelming change. The key is to involve your staff and provide adequate training on why and how to successfully make this change. We owe it to our staff, colleagues and, most important, clients to consider and implement recommendations if they work well for our practice. Clients and staff will be receptive to these changes if they are properly explained as being beneficial for the pet.

    1. Paul MA, et al: Report of AAHA canine task force: executive summary and 2003 canine vaccine guidelines and recommendations. JAAHA 2003;39:119-131.

    2. Richards JR, et al: AAFP feline vaccine advisory report. JAVMA 2006; 229(9):1405-1441.

    3. WSAVA Monthly News 2004. ACVIM Board endorses use of the AAHA 2003 canine vaccine guidelines; www.wsava.org/monthlyNews2004. htm. Accessed December 18, 2006.

    4. Mouzin DE, Lorenzen MJ, Haworth JD, et al: Duration of immunity in dogs after vaccination or naturally acquired infections. JAVMA 2004; 224:55-60.

    5. Paul MA, et al: 2006 AAHA canine vaccine guidelines, revised. www.aahanet.org/About.AAHA/About_Guidelines_Canine06.html, p.3. Accessed December 19, 2006.

    References »

    NEXT: James R. Richards, DVM, dies after motorcycle crash

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