True or false: If your veterinary practice schedules 30-minute appointments, you should spend that amount of time in the exam room with the client and pet.
If you answered “True,” I’m about to rock your world.
Exam room efficiency is a big challenge for new graduates and early career vets, and one that can have far-reaching consequences that affect your day, remaining patients, mental health, and—ultimately—your future in veterinary medicine.
Knowing how to conduct a concise but thorough examination that addresses both pet and client needs AND keeps you on schedule is truly the key to vet med happiness. Let’s take a look at the challenges and solutions for transitioning from time-suck to time-saver.
Why are you taking so long? Common efficiency barriers for new grads
Exam room procedure is deceptively simple, but transferring your practiced patient assessment skills to the exam room with the client present poses new and unfamiliar challenges such as:
- Chatty clients — In an attempt to remain friendly, new grads become a captive audience to every story, anecdote, and question.
- Distractions — Additional pets in the room, children, arguing clients, and loud client devices can make it difficult to focus—especially when you’re learning.
- Unruly pets — Examining or wrangling a moving target can be comical, but it affects your diagnostic accuracy and efficiency.
- Staffing shortages — Technicians and assistants may not be available to help restrain the pet or prepare your treatment plan, forcing you to fly solo or fall further behind.
- Multitasking — Attempting to do too many things at once (e.g., examining, charting, and listening to the client) reduces your proficiency and can make you appear distracted or disinterested, which damages client trust.
- Fear or lack of knowledge — Finally, being a new veterinarian is nerve-wracking. Worries about client perception or whether or not you can answer every question can create doubt and slow your entire process.
If you’ve experienced any of these challenges, take a deep breath and relax—they’re all completely normal. And unfortunately, some of them never go away!
Here’s how you can streamline your exam room processes and bypass the ones within your control.
The ideal appointment—how you should be spending your time
First, let’s revisit the pop quiz from earlier. For a standard wellness exam—and many straightforward sick pet exams—there is no reason to spend 30 minutes in the exam room. Doing so is a recipe for disaster—and many late nights at your desk.
Instead, break that 30 minutes into three separate time blocks, in which you’ll tackle everything that pet and client needs. This includes:
- The history and exam — The first 10 minutes is for the patient history and your physical examination. This period includes greeting the owner and pet, reviewing the presenting complaint, and performing the pet’s physical exam. Narrate your exam so that owners can follow along and better understand your recommendations.
- Thoughts and treatment plan — Use the next 10 minutes to summarize your thoughts and findings, and create, present, and implement your treatment plan. Note—most of this should be taking place outside the room.
- Charting and notes — Finally, if you didn’t take notes during the exam, spend the last 10 minutes of the appointment writing up the patient record and completing any other pertinent tasks (e.g., gathering take-home resources for the client). Timely charting increases thoroughness and helps you avoid staying late or taking your work home.
Using this structure, you’ll complete all the necessary tasks for each patient within the allotted time period and be prepared, focused, and on-time for your next appointment.
Fast forward—how to improve your in-room efficiency
Adopting this rule-of-thirds approach to appointments can seem like it requires militant precision, but with a few simple strategies and lots of practice you’ll find a balance that allows you to be thorough and concise while still honoring the client’s need to be seen, heard, and understood.
Here are some tips for making the rule of thirds work for you.
- Find your baseline — Use a stopwatch, smartwatch, or phone app to time a routine appointment from start to finish. Then clock how much time you spend in the room. Use these numbers as a starting point.
- Time yourself — Set goals to reduce your total in-room time. If it helps, use an interval timer—set to vibrate—to send five or seven minute warnings. These unobtrusive reminders can help you stay on track or remind you to wrap things up.
- Maximize the patient history — Detailed patient histories save precious time and prevent repetitive questioning. If you find yourself frequently asking clients about medications or diet, ask the technician to incorporate these questions into the patient history.
- Anticipate client questions whenever possible — Efficiency is all about having a plan. When prepping for your appointments, consider what questions the client may ask. You can get a general sense for what these might be by reviewing the presenting complaint, pet signalment, and medical history. Although it’s impossible to predict exactly what will unfold during an appointment, preparation can help boost your confidence and reduce your time in the room.
- Present your own treatment plans — Reviewing treatment plans with clients can help you improve the way you summarize your exam findings and recommendations. If your client still has questions when you present the estimate, this indicates gaps or lack of clarity in your summary. Such extra questions create unnecessary and time-consuming back-and-forth when you eventually delegate this task to a veterinary technician.
Ideally, by the time the treatment plan is presented the client should have a thorough understanding of “Why” and simply be reviewing and approving the associated costs.
Efficiency and confidence grow together
Learning is not a linear process, and when you first attempt to improve your exam room efficiency you may find the rule-of-thirds structure confining or restrictive. You may fail to plan or anticipate the patient’s needs, or you may have a “routine” appointment in which you fall down a rabbit hole and 30 minutes becomes an hour. These things happen. But as you steadily work to improve your exam room efficiency you’ll enjoy a corresponding confidence boost. And, as you gain confidence, previously time-consuming tasks will become streamlined, and you’ll find your rhythm—which results in greater efficiency!
When you’re starting out, the standard appointment can feel impossibly brief—but with practice, a clear plan, a well-tuned focus, and a client-friendly demeanor you can accomplish all the necessary tasks and more.
Speaking of accomplishing more, Ready, Vet, Go Veterinary Mentorship provides the practical support and guidance you—or your new associates—need to navigate the most common early career challenges. Our six-month online training program helps new and early career veterinarians become valuable contributors to their practices and enjoy long and rewarding careers.