The Future of Veterinary Telemedicine
By Roger Redman DVM
We continue to hear the term “new normal” as if it is a destination that we’re going to reach, or have already reached and are now all trying to acclimate to. In reality, I don’t think we’re going to “land” in a new normal in that sense, but rather, it will be a constantly evolving and tested set of behaviors, expectations, and standards that will be based on the comfort levels and expectations of individuals, communities, and families. This road may take months or even years and will likely vary from one city to the next. One thing is all but certain already, however, which is that the sharp adoption of telemedicine we are seeing during our pandemic is here to stay and is going to become a far more substantial part of our industry. The question is how.
For starters, it’s important for us all to realize that telemedicine is not in any way a threat to our profession. It is not a sinister plot to steal office visits from us and cannibalize our business. In fact, many who are utilizing it heavily now are actually generating more touchpoints with their power clients as well as activating previously dormant clients, which is leading to tighter client bonds, more visits, less client churn, and for many, substantial revenue growth. With that said, what should we expect once our doors fully open?
I think we’ll be seeing some interesting new trends well into the future that all involve telemedicine. My first take is a bit of a cheat, as it’s not technically telemedicine, but does leverage a telemedicine platform to function so I’m going to throw it in. We’re going to see curbside become a standard offering for many practices well after the pandemic. It sounds like many practices are already planning to continue curbside services indefinitely. Somewhat surprisingly, clients seem to really like the ease of the experience, which feels somewhat concierge or VIP. They get to stay in their cars and join the exam via live video to feel like they’re in the room with their veterinarian. This is, of course, not considered telemedicine as the veterinarian and pet are together in-person and it is the owner who is virtual. Yet it all still runs through the same platform that practices would use for their virtual visits so I’m including it here because as usage of that experience grows, both clients and doctors will become more and more comfortable using it for more typical virtual exams.
Another thing we’re going to see is an increase in breadth of care, as practices are catching onto the face that they’re going to be able to re-activate a large set of their previously dormant clients. We’ve all heard the statistic that roughly 80% of our revenue comes from 20% of our clients. This seems to ring true with the majority of hospitals I know, including my own. For the other 80% of clients we hardly get the chance to talk to or see them in person. For that group, studies suggest the barriers to getting care, i.e. time, transportation, cost, perceived value, etc., will become significantly diminished as telemedicine becomes a viable option for many of them. This is a massive opportunity for practices to drive up the lifetime value, or LTV, of their clients. Pairing this with the fact that the average vet only sees each client face to face for an average of 16 minutes each year, practices who take this opportunity seriously and lead the pack will reap the rewards.
As we slowly re-open (or plan to re-open) our doors, many veterinarians are finding themselves busier than ever somehow. Many of us are understaffed and booked out solid for 2-3 weeks with more appointments than we can handle. As telemedicine works its way into those workflows, we’re going to see it get leveraged by those forward thinking practice owners to help lighten that load. Many of these visits, like medical progress exams, re-checks/post-ops, common dermatology issues, etc. will move to a virtual format so that clinics can see more of those clients in less time and with less overhead, making more time in the day to see clients in person who really do need to be seen physically. Data suggests the average telemedicine appointment lasts between six and ten minutes, and without staff check-in and check-out time involved. Now suddenly you're able to handle between six and ten patients in an hour all while sitting at your desk. All of the sudden, hospitals will feel less busy but will be making more money and working less. This one will take time as it will require us all to break old habits but I believe will be well worth the learning curve and investment as it will have huge impacts on quality of life for the entire staff.
Another trend I’m already hearing buzz about is practices hiring a specific veterinarian to be designated for telemedicine, with scheduled appointment time slots. And with more women in our profession it may allow a stay at home mom-DVM the flexibility to see appointments, gather income for her and the practice, reduce practice caseload, and perhaps most importantly, keep that DVM connected to your practice while she is away to care for children, all while linking with cloud based medical records. As veterinarians we’re all different in our ability to adopt new technologies and break old habits. The pandemic is going to allow us opportunities well beyond our normal day to day routines.
What about veterinary regulation in your state? What does it say about telemedicine? Always check with your state's veterinary licensing board to determine what is permitted. At least 16 states have created pandemic-allowances for some level of telemedicine in veterinary practice. The largest variant from state to state is whether a VCPR can be established via telemedicine versus only practicing telemedicine (which may include diagnosing and prescribing) on patients that have already had an in-person exam. I feel certain that the demand by pet owners and by practicing veterinarians currently utilizing it will cause licensing boards to create some level of permanent telemedicine language in their practice acts post-pandemic. The American Association of Veterinary State Boards has tirelessly created model language that can be utilized by state boards for their respective regulations.
Finally, in saving the best for last, I believe telemedicine isn’t just a part of our future, but also guarantees that our profession has one. The veterinarian used to be the first line of defense for all things pet health. We were the go-to resource for care for pet owners. Unfortunately, things have changed and Dr Google and the internet have surpassed us. Over 70% of pet owners go to Google or social media to get answers to their pet ailments before even attempting to talk to a veterinarian. With improved access to care and less barriers surrounding it, we’re going to see large segments of pet owners develop and prioritize relationships with veterinarians. Many of those will come from the dormant 80% of your current clients mentioned earlier, while others will come from the millions of pet owners who don’t have a primary veterinarian at all. In the future, telemedicine won’t stop people from googling symptoms, of course, but with improved access to care it can help bring the veterinarian back front and center as the trusted source for pet care.
We’re all taking things day by day, just trying to survive and make it to tomorrow unscathed. The future is uncertain and that can be frightening, yet I firmly believe it can also be exciting. There is a bright and inspiring future ahead of us and we as an industry will be stronger than ever before. It will certainly look different from what we’re used to, and perhaps what we had expected it to, but different opens up doors to new and unexpected opportunities…..and telemedicine is going to be one platform to get us there.
Roger Redman DVM is President of American Association of Veterinary State Boards, has owned and managed several veterinary hospitals, and is Strategic Advisor to Airvet