State of the Art Meets State of the Heart

• State of the Art Meets State of the Heart (210.5 KB)

“Pet owners assume that every practice is good. But in fact, all practices are not the same, procedures are not all the same. We are a small practice, and a tight team. Our culture is to be the other family doctor… Every once in awhile, I stumble upon a dog that’s just a dog. But until I’m told otherwise, every pet is a member of the family.”— Robin Downing, DVM

Front row: Robin Downing, DVM, hospital director, with Tommy, clinic mascot; Sharon DeNayer, practice manager; Brent Morris, DVM, veterinarian. Back Row: Melissa King, veterinary assistant; Michael Hernandez, technical services director; Rachel Greve, CVT, veterinary nurse; Jocelyn Axelson, CVT, veterinary nurse; Ilona Green, client care specialist.

Dr. Robin Downing’s commitment to her patients and team is evident as she talks about Windsor Veterinary Clinic and The Downing Center for Animal Pain Management, co-located practices she owns in Windsor, Colorado. “We treat our clients the same way we would want to be treated, that’s our North Star,” Dr. Downing explains. “Owners are greeted by name when they arrive. When a new client arrives, our client service specialist volunteers to give a tour of the practice. We have a complete open-door policy, except during necropsy. New clients meet our clinic dogs, meet the team, and see them working. This is basic communication—components of our overall atmosphere.”

Educate, Comfort, & Inspire
Before stepping foot into Dr. Downing’s clinics, potential clients can view every part of the hospital on the website, which also offers comprehensive information on services and pet health. She says, “One of our goals is to anticipate the questions we know clients will ask. Instructions are delivered verbally and in writing, and we all engage in follow-up in an active fashion.”

“Our goal,” Dr. Downing continues, “is to marry state of the art with state of the heart. You can be a really nice person, but if you’re practicing 30-year-old medicine, you’re a quack. And without heart, your state-of-the-art facility will stand idle.”

A prime example of state-of-the-heart care that, as Dr. Downing puts it, “seduces” clients to bring their animals to her practice, is a TLC nurse. Evelyn Stickler is a retired human health care nurse who volunteers to comfort recovering surgical patients by wrapping them in fleeces warm from the dryer. “The ones who are too big to sit in her lap just put their heads down and take a nap,” Dr. Downing relates. Another example is the Comfort Room, a space furnished like a cozy living room. During this interview, a cat in kidney failure received IV fluids in the Comfort Room while his “mother” sat nearby, working on her laptop. Dr. Downing says, “This cat is her life. He can make her comfortable while I can give him the care he needs.”

Dr. Downing’s passion for providing gilt-edge service impacts the practice’s balance sheet. That the impact is positive—very positive—can inspire any veterinary health care team in today’s economy. Dr. Downing’s philosophy: “You can’t serve two masters. You can provide quality medicine, or you can provide low-cost medicine.

Compliance
Regarding client compliance, Dr. Downing says, “I hold my team up to any other practice, whether it’s wellness care or caring for pets when they’re sick.” The team devised a form (see page 16) to track data based on every patient’s visit. Information is updated when an appointment is scheduled. “The nurse and doctor can see the patient’s status at a glance and have a chance to make a preemptive strike,” Dr. Downing says.

Windsor Veterinary Clinic boasts an enviable compliance rate in parasite prevention. “The national average is about 48%, ours is about 95%.” One secret? A parasite courtesy call. Dr. Downing explains: “We have a population of clients, often older people, who want to be called when it’s time for treatment or to buy preventatives. We also ask if there is anything else they need, like scheduling a nail trim. I’m shocked how many people want to be called—they say it’s like getting a call from a friend.”

Windsor Veterinary Team
“The culture at this practice,” Dr. Downing notes, “is to keep client and pet in the center of the care-giving circle. We don’t play the blame game or the shame game; we’re not interested in making the client feel guilty.” While not expected to have all the answers, “I have no idea, I’ll have to go ask my boss” is not in their vocabulary.

When hiring a new team member, Dr. Downing recommends “finding talent and training skills.” The hospitals’ interview process involves a 2-day working (paid) interview, giving everyone a chance to “kick the tires.” Once on board, education is an ongoing process, involving weekly staff meetings and monthly technical training meetings. Dr. Downing also takes “shameless advantage” of Internet-based opportunities. “Web-driven training is an excellent jumping off point for discussion.”

Walt Disney said, “You can build the most wonderful place in the world, but it takes people to make the dream a reality.” The reality that Robin Downing and her team have built would undoubtedly meet with Walt’s approval.

Many Happy Returns (on Investment)
How can Robin Downing’s self-described “small, country practice” afford an impressive complement of state-of-the-art equipment? According to Dr. Downing, “Return on investment is very important. We have to take responsibility for weaving the cost into what the client will pay. Our equipment pays for itself, usually with 6 to 12 months.”

Following are 2 examples:

Blood Pressure Monitor: “Monitoring blood pressure is critical in managing a patient during general anesthesia and an excellent blood pressure monitor costs only about $1000,” Dr. Downing says. “A small practice might perform surgeries 2 days a week, 5 procedures a day, which is 10 a week. When we charge $25 per procedure, the monitor becomes self-sustaining in about a month ($25 x 10 procedures x 4 weeks). After that, it becomes an income generator. At the end of the first year, we will have earned $11,000.”

Precision IV Fluid Pump: “I use Heska’s precision IV fluid pump, [Heska.com] because it can deliver between 0.1 mL/H to 999 mL/H in precision flow fashion. That means we can use the same pump to deliver IV fluids in surgery or for treatment, chemotherapy for oncology patients, or to deliver parenteral nutrition.” By charging $30 per “pump day,” the equipment quickly becomes part of a practice’s profit center.

More About Dr. Robin Downing
• Practice owner, Windsor Veterinary Clinic, PC (windsorvet.com) and The Downing Center for Animal Pain Management, LLC (downingcenter.com)
• DVM, University of Illinois, 1986
• Founder and past president, International Veterinary Academy of Pain Management
• Diplomate, American Academy of Pain Management
• Certified in veterinary acupuncture, canine rehabilitation, and pain education; currently pursuing certification in animal chiropractic