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Friday, June 26, 2009

What Is Quality?

For the past week I have been in meetings to help improve the quality of service, medicine, and performance of my clinic. Having managed veterinary hospitals for the last 9 years, there wasn't anything earth-shattering that I learned. Definitely a few confirmations of what I believed, as well as some new hints and tweaks to my methods, and for that I am pleased. But another thought began to occur to me. How do we define quality veterinary medicine?

In reality, quality is pretty subjective. What might be good quality to one person may not be the same to another. "Quality" is a word that we think we all can understand, but really we need to define it. Is someone a high-quality doctor because they use all of the latest and best equipment? Does a vet give you quality service because they charge less than others in the area? Would someone who is a highly skilled clinician but has poor bedside manner be considered a quality veterinarian? What exactly does quality mean to each person? That's a hard thing to determine, and I have seen my clients vary in these opinions. One may see my need to run numerous diagnostic tests as a sign that I am thorough and consider every possibility to get to the bottom of what is wrong with their pet. The next person may see the same situation as an attempt to drain their wallet.

Since in the end I have to first and foremost answer to myself, I have to be comfortable with how I practice medicine. So here's what I see as "quality". A high-quality veterinarian is someone who puts the concerns and the needs of the pet as the highest priority, even over the needs of the client. This is someone who recommends the best medical care possible, even if the client can't afford it. However, that once the recommendation is made, that quality vet must then listen to and consider the client's desires and abilities (both financially and emotionally). He or she must be compassionate to the humans and animals, but also reserve a bit of detached clinical judgment, looking at a case as objectively as possible. A high-quality doctor is extremely knowledgeable about current medical diagnostics and therapy, and is not hesitant to go through the diagnostic process. Yet they are also very aware of their personal limitations and weaknesses, and will not attempt a surgery or case that would be better served by being referred to a specialist or someone else more skilled in that area. The high-quality vet charges for their services at an appropriate rate, realizing their own personal worth, and not trying to discount and be the cheapest. At the same time, they do not look at finances as the end goal, only a means to accomplish their medical efforts. In short, a high-quality vet is compassionate, knowledgeable, and skilled in modern medicine, considers the health and needs of the pet as their highest priority, and isn't afraid to stand by their diagnostic plans and charges in the face of some resistant clients.

Does that sound like your vet, or someone you would want to take your pet to? If not, why not? As I study ways to improve managing my own clinic, I have to worry about these issues and how clients will perceive them. Once I was told that clients have a choice. Their medical services can be fast, high quality, or cheap. The client can have two of those three choices, but not all three. Which would you choose?

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