Written by Marilyn Iturri

(Article in PULSE, publication of the Southern California Veterinary Medical Association, in December 2022) View full article →

“Where is Susie? I love her so much,” she announced. “I need to give her a hug! She was so kind when we talked on the phone.”

The compliment would be welcome in any veterinary clinic, but there was a minor hitch to her particular request. Susie is a veterinary technician hired through a company that hires, trains, and pays remote help for veterinary clinics, and she had never been in the office. Ever. She works for Chronos, a remote veterinary-team building company based in Pennsylvania that employs virtual receptionists, nurses, administrators, and managers. Co-founder Phil Zeltzman, DVM, DACVS, Fear Free certified, said the company began in September 2019. “We were looking for solutions in our general practice,” said Dr. Zeltzman, a veterinary surgeon. Dr. Zeltzman and company co-founder Jeremy Wentz, VMD, Fear Free certified, were trying to lessen the stress on staff members at their Brodheadsville Veterinary
Clinic in Brodheadsville, Pennsylvania.

“We didn’t start out to become a separate company,” he said. “We did it to lower the stress at the front desk because we care about the wellness of our team.When we saw the benefits, we decided to share with our colleagues.

“By trial and error, we came up with the right tech- nology, a training program and protocols.”

In their own practice, Dr. Zeltzman said, they quickly discovered that with the virtual help came better customer service, both in person and over the telephone; less stress at the front desk and in the back; and they landed more new clients because calls were never missed.

In time, the veterinarians found that production had increased and they had less turnover in the in-house staff. Traditionally, when the front desk needs help, technicians and assistants are often drafted, meaning they can’t do their primary jobs: working with the doctors.

Then the COVID-19 pandemic hit, exacerbating staff shortages felt throughout the veterinary industry.

“When ‘remote’ became cool if not necessary, we already had all that in place when everybody else was scrambling to replicate what we developed during quieter times, ”Dr.Zeltzmansaid.

“We were able to make a huge difference in the practices who trusted us. When their teams got decimated by COVID, we were there to help keep their doors open, so to speak since we were all curbside.”

John Dillon heads a similar remote-staffing company, GuardianVets Inc., established in 2017. He is its founder and CEO.

His background is in finance, and his family has run small businesses in the past. He was looking to form a startup and said he was drawn to the veterinary industry.

“From the consumer’s side, continuity of care after hours can be a huge problem,” he said. “As a pet owner, I trust my veterinarian the most. The problem is they’re not there when I really need them, as in nights and weekends. Most people work weekdays and can’t get to their vet when they’re open.”

Initially, Dillon said, GuardianVet wanted to help practices extend their hours of care.
“When they were closed, their [telephone] traffic came to us. We offered triage support. If the technician determined there was a true emergency, they would follow the particular clinic’s protocol. This enhanced their customer service.”
As the company grew, Dillon said, he realized there was a huge need during the day as well.
“There aren’t enough veterinary professionals out in the market,” he noted. “We offload demand during the day, for emergency rooms, too, not just general practice. We help triage out non-emergent cases, helping the practice enhance care and reduce the burden.”

Dillon said his company has seen steady if not meteoric growth.“Every year we get bigger and better,” he said.

Both Chronos and GuardianVets frequently field questions about how a remote technician works.
“First, we triage non-urgent issues,” Dillon said. “In the context of telemedicine, techs can do re-checks and follow-ups virtually. They can handle vaccine requests and refills.

“A lot that the technicians and assistants do support the doctor gets sidetracked when they help the front desk. That disrupts the continuum between the front desk, technicians, and veterinarians. They can’t support the doctor. Then the veterinarian’s work slows down, and that has a real business impact.”

Chronos is open to brainstorming a clinic’s needs, but so far has had no requests that surprised the founders.

“It’s rather the other way around,” Dr. Zeltzman said.

“We tend to surprise practice owners and managers when we tell them they can have a remote manager. We had proof of concept because we had worked with a remote manager in our own practice—likely the best one we’ve had in our six years—and we knew how well it worked.”
He said potential clients often ask what certified technicians can do remotely because it seems like a hands-on role.

Chronos Adds a New Service

Chronos is adding a new service to its offerings, virtual vet- erinary scribes. At Pulse’s press deadline, it had not yet been added to the company’s website, chronosvet.com. But this is the company’s explanation of the service:

“Our scribes are trained to take the history and write up your medical record.That saves your in-house team and your doctors’ time and energy. Doctors can focus 100% on patients and clients, which increases the bond with your practice.
“We hire trained veterinary scribes specifically dedicated to your practice.They can take a history virtually.Then they type directly in your medical record while your doctors focus solely on the client and the patient.

“All your doctors have to do is proofread. They don’t need to remember, hours after the exam, if the issue was in the left leg or the right leg. Or if the broken tooth was 104 or 204. Or if they said the next follow up should be in 2 or 4 weeks.
“In turn, your doctors can help more patients in less time, which increases revenue.

“Medical records are much more thorough.

“Less time writing records up during lunch and after hours. Less burnout.

“More efficiency. More happiness.”

A View from the Remote Trenches

Alex Stocker has worked in the veterinary industry for 15 years, serving as a kennel assistant, veterinary assistant, customer service representative, shift lead, lead assistant, officer manager and practice manager. She also helped open a new practice from the ground up.
In short, she’s just about done it all.

Stocker, 36, now leads a team of 17 working for an 18-doctor animal hospital on the West Coast. But she works from home in Richmond, Kentucky.

Her employer is Chronos, a remote veterinary-team building company that hires, trains and pays virtual employees to supplement in-house staffing at animal hospitals across the country.

“I am responsible for the Chronos team that works with this specific hospital,” Stocker said. “I have 17 employees, including two department leads that report directly to me.”The in-house clinic staff comprises about 50 employees.

“I am responsible for ensuring that the tasks we help our hospital with are completed at a high standard and in a timely manner. I ensure all training material has been updated with the most recent information. I do employee evaluations, employee schedules, meet with the in-house team, and facilitate Chronos meetings—among other things.”

She has been with Chronos since January 2021 and has been a lead location supervisor since May of that year.

Stocker said working remotely has provided much more flexibility in her day-to-day life.

“I no longer have to commute to the clinic each day. I am able to work more efficiently and productively in my home, with fewer distractions.

“Our remote team is the most communicative team I have had the privilege of working with in my career,” she said. “We are in constant contact with each other throughout the day, so we definitely still have a very ‘team,’ feeling. I never feel alone or isolated as a remote employee.”

While Chronos declines to provide specific salary information and client fees, Stocker said, “I am being compensated much better working remotely than I was when working in-clinic.”

Her team helps with surgery and dental scheduling, pharmacy refills and authorizations, doctor messages and relaying those messages to clients, answering chats about questions, sending and receiving medical records, scheduling appointments, communicating with clients, taking

“I would say that there is definitely less drama working remotely!”
– Alex Stocker, lead location supervisor, Chronos 12 payments virtually and operating as a virtual client service representative at the front desk of the hospital.

Stocker, who holds an associate degree in veterinary technology, said it took a while to develop a rapport with the in-clinic staff from a distance.

“Gaining their trust and assuring them that we are well educated took time,” she noted. “They wanted to make sure their clients and patients were well taken care of and that the level of care that they provide would also be provided by us.

“We assured them from the get-go that we were all there to accomplish the same goal: to help their clients and patients as if we were in the hospital.
“The in-house team has been nothing but warm and welcoming to the remote team and we truly operate as one large team now. It is amazing to see how well we have integrated remote work with in-house work to provide the most outstanding care for clients and patients.

“The in-house team is very appreciative of the workload we take off them each day,” she added. “This allows them to focus more on the in-person client and patient care since we can take care of the majority of the behind-the-scenes duties,” she said.

Stocker said her Chronos training consisted of expected etiquette with client interactions and ensuring she had a sufficient base of medical knowledge.

“I then received training for the particular hospital that I work with on all of the tasks that Chronos was to help them with. We frequently add new tasks and are growing our team, so we are all still learning new things and being trained in different areas all the time.”

Has there been an unexpected bonus to the job?
“I would say that there is definitely less drama working remotely! Chronos, as a company, has a very high standard for not tolerating drama or negativity. This has been a breath of fresh air in the veterinary community.

“Not having to worry about cattiness, gossip, or general drama in the workplace has been phenomenal,” she said.“We are truly a team working toward the same goal. I do miss working in practice at times, mostly for the interaction with patients. However, the remote work that we do is so fulfilling that it makes missing that patient interaction worth it.”

“There is much more for a nurse to do than hands-on things,” Dr. Zeltzman said.

“At one large practice, the surgery schedule was a complete mess. Keep in mind, this was in the midst of the pandemic chaos. If a client called to schedule surgery, it would take a week for someone to call back. We identified this major pain point during a brainstorming session. Chronos was tasked with getting the surgery schedule back under control.

“Within a week, everything had been straightened out. If a client called, a nurse would pick up the phone instantly to book the appointment.
“There’s no need to be on-site for that.

“At other practices, nurses are in charge of the pharmacy. Clients call all day long for refills, either in-house or at third-party pharmacies. At most practices, this means listening to 874 voicemails or grabbing 234,778 phone messages taken by the front desk, typically at the end of the day, the end of the shift, then figuring out if each call is legit, if the Rx is legit, if the Rx can be filled, how long it has been since the last Rx authorization, possibly chase down the doctor in charge to confirm a refill is OK, and more.

“Chronos can take care of these calls in real-time. No need to be on-site for that.

“At yet other practices, our nurses can filter through countless calls in real-time, so that [in-house] nurses and doctors don’t have to deal with them, again often at the end of their workday. No need to be on-site for that.”

Both companies hire, train, and pay the staff. Both declined to offer specifics on pay for staffers or costs to clinics, but say wages are competitive.

Dillon said GuardianVets has 250 client clinics. Dr. Zeltzman said Chronos’ client count is confidential but said it has practices in every time zone.

“Our anticipation was that our most eager practices would be on the coasts,” he said. “For example, in some areas real estate is so expensive that receptionists and nurses simply can’t afford to live there. So these practices have a really hard time functioning.We can help those practices, and sometimes we save them money on every Chronos team member they hire.

“In other situations, practices are in areas that are less dense, so there is a paucity of local talent. So again, these practices can’t function without receptionists and nurses, and we can help them stay in business.

“Our benefits to the clinic involve increasing compliance and increasing revenue,” he said. “Since there are no more missed calls, we can schedule more appointments and take the time to educate owners on the services needed for their pet.”

Dillon noted that some veterinarians offer medical advice online without a valid veterinarian-client-patient relationship.

“We are staunch defenders of the VCPR,” he said. “We don’t want to change it; it protects patient welfare. We aim to innovate within the guardrails of the existing framework. We don’t diagnose or prescribe; it’s just not what we do.”

Dr. Zeltzman says Chronos staff is also aware of the importance of the VCPR.

“Our team members know very well not to play doctors,” he said.

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