One of the most important jobs for a veterinary receptionist — or any member of the veterinary team who happens to answer the phone — is to determine how to handle calls from concerned pet owners.
Does the pet need to be seen by the doctor? If so, how soon? Is it an emergency? All these questions must be answered in a single phone conversation.
Recognizing emergencies in veterinary triage
There may be days that the practice is slow, with several empty appointment slots. On these days, any client with a medical concern can be given an appointment to have their pet evaluated and treated. On other days, however, the schedule may be fully booked.
If the next available appointment is not until later in the week, how can a veterinary receptionist determine whether the pet should wait until that appointment or be seen as an emergency? Being able to make this assessment accurately is an essential skill from both a medical quality and a client service standpoint.
Client-perceived emergencies may be nothing more than mild illnesses, while cases that clients find only minimally concerning may be a life-threatening situation. Therefore, determining whether a case is an emergency may require some detective work.
First, find out the patient’s signalment. The patient’s age, sex, reproductive status, species, and breed can help suggest how likely a particular concern is urgent. For example, a female cat straining in the litterbox is far less likely to be an emergency than a male cat straining in the litterbox. A 5-year-old German Shepherd that has gone 24 hours without eating is far less likely to be an emergency than a 5-week-old Toy Poodle that has gone 24 hours without eating.
After learning the patient’s signalment, find out the client’s concerns. Ask open-ended questions in order to gather as much information as possible. Examples include:
- When did the problem start?
- What symptoms are you seeing at home?
- How long has this problem been going on?
Although it can be tempting to ask closed-ended questions, these may influence the client’s responses and decrease the chances of you rapidly understanding the situation. Inversely, many clients will want to provide extensive backstory on their pet’s medical history in an effort to be helpful. In these cases, it can be helpful to ask “What changed that prompted you to call us today?” This simple question can help the client narrow their focus to their pet’s most pressing issue.
Veterinary triage lists: urgent and non-urgent issues
If the client mentions any of the following issues, the case is likely to be a true emergency and should be seen as soon as possible:
- Bleeding that will not stop
- Difficulty breathing
- Severe vomiting/diarrhea
- Known toxin exposure
- Persistent seizures or changes in mental status
- Unsuccessful attempts to urinate
- Severe pain
Other concerns may be perceived as emergencies by the client, but are not true emergencies. These conditions include itching, limping, ear infections, and other chronic conditions.
In general, conditions that have been going on for some time are less likely to be an emergency than issues that have developed or worsened acutely, although even chronic conditions can have acute, emergent exacerbations.
It’s not an emergency, but the client thinks it is — now what?
Inevitably, there will be days that a pet owner calls with an apparently non-emergent concern, requesting immediate attention. It is up to each practice to decide how they wish to handle these cases.
Ideally, the receptionist can alleviate the owner’s concerns and schedule an appointment for the next available opening. This must be done carefully, however. It is important to never tell a client that their pet will “be okay” or that it’s “safe to wait until tomorrow.” This could place the practice at liability if the pet’s condition deteriorates overnight.
Instead, the receptionist may want to offer assurances such as “It sounds like Fluffy is stable enough to wait until tomorrow to be seen, as long as nothing changes. If you notice any deterioration in her condition between now and then, though, please call us or take her to the emergency clinic.”
If the owner does not feel that the pet can wait to be seen, the veterinary practice should have an established, consistent approach for how to proceed. There are four common options in such cases. You may wish to use the same approach for all situations, or have separate approaches for existing vs. new clients:
- Work in any case that is perceived as an emergency by the client
This may lead to fewer client complaints and a decreased risk of “missing” a true emergency during phone triage, but can increase wait times for clients with scheduled appointments.
- Work in client-perceived emergencies, with an additional fee
In theory, charging an additional fee will encourage the pet owners to more accurately assess whether their pet’s condition is truly an emergency.
- Do not work in client-perceived emergencies
Client-perceived emergencies are offered the option of waiting for the next available appointment or taking their pet to an emergency clinic.
- Drop-off appointments for client-perceived emergencies
In some clinics, patients who want to be seen without an appointment are dropped off for the veterinarian to examine between scheduled appointments.
Handling severe emergencies
If a client calls with a pet that is having a severe emergency (hit by car, dogfight with severe life-threatening injuries, etc.) and they are on their way to the clinic, alert the doctors and/or veterinary technicians so that they can be prepared for the patient’s arrival. This allows veterinary supplies and equipment to be gathered in the treatment area so that treatment can be started immediately.
In some cases, clients may call regarding severe emergences that your clinic is not equipped to handle, due to staffing, equipment availability, or other factors. In these situations, it may be in the pet’s best interests to direct the client to the nearest emergency clinic.
For example, if a client calls regarding a dog that has been hit by a car and is minimally responsive while your practice’s only veterinarian and technician are involved in a lengthy surgery on another patient, it may be best to direct the patient to a nearby emergency clinic in order to ensure that the patient receives the best possible care.
Addressing client questions and concerns
In some cases, pet owners do not want to come to the veterinarian but instead call for advice on how to handle an emergency at home. This can be a challenging situation, especially if it seems to be a true emergency, because you genuinely want to help the pet. Despite this desire, it is important to avoid making recommendations over the phone.
Even though it may seem simple and harmless to provide a dose of Benadryl for an allergic reaction or hydrogen peroxide to induce vomiting, this can be construed as prescribing treatment without a veterinarian-client-patient relationship. If a pet becomes ill after receiving home treatments, a veterinarian could be held liable and could be found guilty of violating the practice act.
If a client calls regarding a potential toxin ingestion and does not want to bring the pet into the clinic, their best resource is to contact poison control. There are two pet poison control hotlines in the United States:
- ASPCA Poison Control Center: 1-888-426-4435 (https://www.aspca.org/pet-care/animal-poison-control)
- Pet Poison Helpline: 1-800-213-6680 (https://www.petpoisonhelpline.com/)
For a small fee, these poison control hotlines will work with clients to determine whether veterinary care is needed and, if necessary, work with veterinarians to determine appropriate treatment for toxicity cases.
In any other cases, encourage the client to see veterinary care for their pet, either at your hospital or elsewhere.
Sources and additional reading
- Helewa, B. 2017. Calling All GPs! Phone Triaging in Veterinary Practices. Presented at Southwest Veterinary Symposium.
- Frederick, C. 2014. The Art of Telephone Triage. Veterinary Team Brief. Accessed at: https://www.veterinaryteambrief.com/article/art-telephone-triage