Smile! You're on clinic camera!

Smile! You're on clinic camera!

Sep 01, 2007

Mark Opperman, CVPM
You have no idea how much you and your team can learn from videotaping and reviewing exam room visits. I closely watched a veterinary student as she saw her exam room work on videotape. We watched the entire visit from the moment the client entered the exam room to the time she walked out, about 90 minutes. While she watched the video, I snuck glances at her. She was startled by what she saw.

In the video, she leaned back against the exam room counter with her hands in her pockets and almost never made eye contact with the client. She came across as unsure and indecisive. She would say things like, "Well, I think you should ... " or "It might be ... " or "You might want to consider ... ." To make matters worse, she said "uh" 37 times.

Her professor was kind and really didn't have to point out any of these things; she noted them all on her own. She was embarrassed but thankful. She had no idea she was communicating so poorly. She worked really hard to improve her communication skills and went on to become an exceptional veterinarian.

The fact is, you probably escaped from veterinary school with little or no training in exam room communication. Fortunately, this is changing. Many schools now teach communication skills. Some even videotape students during clinic rotations and review the tapes with the student to talk about body language and tone of voice, and to share other insights about how to present healthcare information effectively.

I've worked with students during this process, and the results are impressive. The students are initially apprehensive, but after they've done it once, they positively beg to be videotaped again to see if they've improved and to receive constructive feedback. After all, where else are they going to learn these skills if not in veterinary school?

Well ... maybe in your clinic.

Watch and learn

The bottom line
Videotaping in the exam room is not a covert operation. The owner or manager informs all hospital employees in writing and asks them to sign a release form acknowledging that outpatient office visits may be recorded for educational purposes. Your team posts a sign in the exam room to inform clients of this as well. And only then do you install cameras. No one knows when the switch will be turned on—but they do know it'll happen.

When I've helped practices do this, I sit down separately with the doctor and the team member after the visit to review the tape. I'm still surprised at how effective it is. For example, one assistant repeated herself nine times during an outpatient office visit, but had no idea she did it.

During this review, you'll look for ways to cover the same information more efficiently and communicate more clearly with the client. Besides looking at what you and your team members say, you'll look at your body language and tone. Often, what you say is not as important as how you say it. And it doesn't take a lot of videotape reviews to see big changes.

When doctors don't wanna

Now, veterinarians, you tend to be more hostile to videotaping than technicians or exam room assistants, but the results you can see are just as startling. One associate I worked with was having trouble increasing her average client transaction. We had talked about making sure she offered all the products and services the pet needed, working effectively with her exam room assistants, improving her communication skills, and using passive marketing. Nothing seemed to work.

Prove you are not Big Brother
Finally, we videotaped several of her exam room visits. We then sat down together and watched the tapes. She wasn't doing anything we had talked about. In the visit, she made noncommittal statements instead of direct recommendations. I didn't have to say a word to her when the tape was done. She just sat there looking at the monitor. Finally she asked, "Who was that?"