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Let’s face it, most decisions we make in life come down to a cost:benefit analysis. Do I brave the cold to walk downstairs and shove my scrub top in the dryer to get wrinkles out or do I skip it? Do I grab a granola bar because it’s quick or do I take the time to scramble up some eggs for longer lasting energy? Do I ligate those ovarian pedicles once because I’m that good or twice because you can’t be too careful?
The same applies to the veterinary teletriage question. Is it worth it to pay for a teletriage service when you’ve gotten by just fine with an answering machine, outgoing voice mail, or generic answering service? Aside from a strict monetary breakdown (which is discussed in The Profitability of Veterinary Teletriage), I make the case here that veterinary teletriage is worth its weight in more than gold.
I give you one client, three scenarios.
She is an inexperienced, budget-conscious, new puppy owner. She calls your clinic because her puppy didn’t eat dinner and has now vomited once. She is afraid, anxious about not pursuing care if it is needed but also worried about how expensive it will be.
A GuardianVets triager answers the call, takes down the signalment and history, and asks stability questions. If this puppy is a 12-week-old Labrador with 3 DHPPs so far, a negative fecal last visit, happy-slinky-dog-wiggle hyperactivity, and a penchant for chasing bugs, the triager will tell the client to monitor the pup closely for change through the night and call back if the pup’s condition worsens. Meanwhile, a request for a next-day appointment will be submitted to the clinic. Based on the conversation the client has with the clinic the following morning, an updated course of action can be determined.
If, however, this pup is a 6-week-old Yorkie who can barely lift his head, the triager will direct the caller immediately to the on-call doc or local ER and explain the reason for the urgency.
In both cases, the client has been heard and appropriately advised after hours by a veterinary practice that clearly values personalized, high quality care.
The client calls the clinic and hears the outgoing message, "We are currently closed. If you believe your pet is experiencing an emergency, please call the ACME Emergency Clinic at 123-4567."
Our client is now frustrated on top of being scared for the puppy and worried about finances. Because who is she to know if this is an emergency or not? It’s not like she went to vet school for umpteen hundred years to get trained up, for pity’s sake. She feels utterly abandoned. So she goes to the local ER with her squirrelly lab pup who won’t stay still for a temp and gets slapped with a $300 emergency bill, 3 cans of I/D for…(uh, she has no idea for what), and ill-will toward her daytime clinic.
The client calls your clinic and hears the same outgoing message. She gets frustrated, angry, and doubly scared about finances when it seems like no one wants to help her except those, in her view, money-grabbing emergency clinics. So she decides not to go to the ER for her hypoglycemic, hypothermic, PSS Yorkie who won’t survive the night.
The consequences of that decision are on the client. I’m not questioning that. But can’t we do better?
The Other Ugly:
On the flip side, an answering service will pose the question to the client, "Do you want me to contact the on-call doctor for you?" The client is once again forced to decide if they should take the next step, but if phone consults are free, that’s a no-brainer.
The answering service then connects the Lab-owning and Yorkie-owning client alike to the on-call veterinarian at 3 AM. Now the client is happy because she is talking to a veterinarian (Yay), but the DVM is grumpy indeed that he’s been woken up for the sixth time that night for a happy, wiggly Lab pup.
The Human Equation
Clearly, after-hours triaging is not just about emergency patient care. It is about human psychology, perceived value, and peace of mind, both for the client and practitioner. In the course of my own career, I’ve worked on call and I’ve slept blissfully through the night, relying on the answering machine. I’ve also worked shifts at the local emergency clinic to know what shows up at the most ridiculous times.
I’ve been lambasted by my day clients who felt the emergency clinic had taken advantage of them when their pet didn’t need to be there; I’ve been castigated by clients who blamed me for not being available when their pet needed me and they didn’t know what to do.
We’ve all experienced this. In the same way, the hypothetical client above is real in every sense. I’ve seen her, and without my veterinary training, I would be her. Is it worth it to meet her in her moment of greatest need with skill and kindness, even in the wee hours of the night?
I hope you can agree with me, the answer is yes. Only then can everyone sleep easier…except for the brilliant triager who is hard at work on your behalf.