Practice Management News and Views from around the World – December 2008


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UK Small Animal Practice for the period to July 2008

data adapted from MAI consolidated data report



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Leading pet insurer first to sign up to use revolutionary communications hub

PetPlan has become the first insurance company to sign up to use the new ‘smart’ communication ub VetEnvoy.

The platform, which is run by LiveTime 24/7 Ltd, has been built specifically to handle the Vet-XML data format, created by the SPVS-led Vet-XML Consortium, which allows data to be easily, reliably and securely transferred between different Practice Management Systems (PMS), lab and insurance companies as well as microchip databases.

Another insurer Pet Protect, also looks set to sign up to use VetEnvoy and the Consortium is currently in talks with others such as AXA, Norwich Union and Direct Line.

“Receiving claims electronically has to be the future,” said Simon Wheeler, Head of Marketing and Partnerships at Petplan. “Although our existing paper-based process is very slick – it has to be given the tremendous number of claims received and processed each day – VetEnvoy will make processing more efficient. Claims will be delivered immediately and an electronic audit trail means that vets can be certain of receipt by Petplan. And the resulting reduction in settlement time offers significant client benefit.”

Mike Fletcher, Director of LiveTime 24/7, added: “We are delighted that Petplan has signed up to use VetEnvoy. The current power of VetEnvoy lies in its ability to simplify and speed up the processing of insurance claims. This means that the current average cost of processing a claim could be cut by at least half. Also, by utilising the information that vets already hold within their PMS, it is also helps reduce the chances of mistakes being introduced when compiling the information.”

As well as speeding up the processing of insurance claims, another eventual key benefit of VetEnvoy will lie in its ability to provide a more straightforward and efficient way of transferring medical records, including digital images such as radiographs, ultrasound and hotographs.

Richard Hillman, SPVS President, explained: “VetEnvoy is truly revolutionary and the Society is proud to be a leading partner in bringing the system to fruition. Research among veterinary practices revealed that — unlike medical practices – most still do not store case referrals and lab reports in an electronic format.

“While many PMS systems can store and retrieve financial records, the efficient electronic management of clinical records, which is the core function of practices, had previously been neglected. An electronic system focusing on medical records will give practices the ability to access medical notes from any location with Internet access as well as speeding up insurance claims and making the process more secure and less prone to error.”

The official announcement from Petplan came at the SPVS IT Day where LiveTime also presented a cheque for £2000 to the Society’s Educational Trust.

Veterinary practices can currently benefit from a free 90-day trial of VetEnvoy by signing up via the VetEnvoy website. SPVS members will also receive a 20% reduction in costs per claim if they choose to continue using VetEnvoy after the trial.

You can click here sign up via the Vetenvoy website

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Common Beliefs Lead To Mediocrity

In a recent newsletter Peter Weinstein and Steve Kornfeld report that ‘what most of us tend to do when we get out of school is look around to see what everybody else is doing and then do the same as everybody else does. Do you agree? If everybody is doing what everybody else is doing, that inevitably leads to mediocrity and stagnation.’

Some do what everybody else does, but better. They thus become more successful, but only marginally so. Yet, as the cost of doing business is growing in leaps and bounds and as competition steadily grows as well, stagnation or just slow growth don’t really cut it anymore.

Do you feel crunched in your practice? Do you feel you have to work harder and longer every year just to stay afloat? If the answer is yes, you are working hard at copying what everybody else is doing. Why not work smarter instead? If you want to be a true veterinary professional,
you need to start thinking outside the box and do things “unconventionally”. Then you might find yourself needing to work less hard and having better results.

So let’s begin by looking at some of the entrenched beliefs in our profession that keep many of its members from getting greater results:

  • You can be a compassionate veterinarian or a financially successful veterinarian, but you cannot be both
  • An offshoot of that-if you focus on what’s good for you financially, you can’t focus on what’s good for the patient; the two cannot coexist
  • Your clients cannot afford your services
  • Your clients choose to work with you because of location and cost of service, so you better be cheap
  • If you raise your fees to how much you really deserve, your clients will leave you and your colleagues will think you are in this profession to get rich
  • You can be everything to all your clients
  • You should strive to know everything about veterinary medicine so you can deal with every case you get
  • If you own a practice, someday you will be able to find a great buyer and retire in comfort
  • If you are an associate, someday you will be able to afford a practice and be successful in it
  • You are a licensed veterinarian and that qualifies you to be knowledgeable at running your practice as a business and at making it grow
  • Business in veterinary medicine is cyclical; some months are slow and others are busy and this can never change. In other words, it is unthinkable to be equally busy year around

If you want to be a true professional, you need to stop buying into these beliefs. You also need to look beyond the limits of our profession to what professionals in other industries are doing and take what’s working there and adopt it into your own practice. There is no need
to reinvent the wheel time and time again; it’s all there. All you have to do is identify it, adapt it to your specific needs and then adopt it.

You can click here to visit Peter Weinstein and Steve Kornfeld website

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Pet ID Cards Prove Popular

Pet ID Card completes pilots and publishes research results.

  • Launched via pilots across four sites in Scotland
  • Research shows clinic clients are impressed and praise the card and system as useful
  • Clients use email for prescription renewal and appointment enquiry
  • Councils approve for proof of vaccination for boarding

Pet ID Cards were introduced earlier this year to 4 Scotland sites in pilots to adapt software to the UK market.

Following four months of card delivery, a cross section of clinic clients was researched to determine receptivity to the card and the supporting system. Overwhelmingly respondents were in favour of the card and identified key areas of benefit including convenience of having all details on one card, as well as being able to log in to review information, 24/7 communication for appointments, prescriptions and general enquiries. The latter in particular is significant as a number of clinic staff were cynical of client use of email when the program was launched, believing most prefer and are able to contact the clinic during surgery hours. Email contact has been confirmed by clinic front office staff as having increased significantly since cards were introduced.

The Pet ID Card, which displays the pet’s photo and holds important pet health information, vaccination status and veterinary clinic contact information, is issued following a pet’s annual vaccination and is generally sent directly to practice clients along with a clinic welcom letter. A new card is triggered and issued each year to ensure core information is current. The durable, easy-to-store and carry card can be used by the client as evidence of vaccination status for boarding and grooming facilities and also carries pet identification microchip numbers and, if applicable, rabies tag information.

Specific information contained on the card includes:

  • Pet name and photo
  • Client name and contact information
  • Veterinary clinic contact information
  • Emergency service/after-hours information
  • Client and patient information, including annual wellness exam date, vaccination status, allergies and special medical conditions
  • Any current reminders such as worming, dental, weight check etc
  • Rabies tag and microchip numbers
  • Login information for secure Internet services — provides a way for clients, kennels and emergency clinics to check on pet health and vaccination status in addition to any current prescribed medication.

Apart from reducing the volume of printed reminders a clinic needs to produce each month, the Pet ID Card system generates significant additional client goodwill and loyalty. Currently annual vaccination compliance in the UK after 2 years pet ownership is believed to be 55%/45% dogs and cats respectively. The Pet ID Card system aims to improve that by a further 10% to 60% and 50% respectively. In an average practice with some 350 vaccinations per month, that represents 420 additional vaccinations per year. The additional revenue from those retained clients is more than enough to pay for the cost of the system, though the UK owner, Vetgate Systems advises that costs are recovered from a combination of increased vaccination fees (if they have not been adjusted in the last 24 months) and increased visits/sales per client. The net result is claimed to be improved revenue and profitability for the clinic.

The system provides additional services apart from the card and client portal, including newsletters, or content for existing newsletters and websites from a range of templates all at no additional cost.

A further option is for the introduction of online purchasing for those clinics seeking to develop the product sales side of their business.

The Pet ID Card has been approved as acceptable evidence of vaccination status in the catchments of all clinics involved in the pilot. The councils were consistent in their observations of convenience for clinic, client and kennel in accessing information and providing a communication channel for those parties. They also consistently noted there was a potential application for stray animal recovery with information on the Pet ID Card system being more current than some microchip data bases.

Kennels reinforced that praise, noting that having online access to ‘guest’ information 24/7 meant they could immediately determine any allergies and medication an animal may be on before needing to contact a vet.

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What Client Complaints Are Not Saying

by Katherine Dobbs, RVT and published in Veterinary Practice News Oct 2008

We have all heard clients complain. Some of the most common complaints concern long waits and unexpected fees.

You have probably developed routine responses for these complaints, citing policy and price ustification. Yet at times we miss the point completely and send the client away even angrier. The client leaves in a huff while we go to “the back” to vent to our co-workers about the high maintenance client who just left.

We hear what the client says, but we often don’t stop to think what the client really means. If we evaluate the emotions behind the gripe, we have a better chance of addressing the problem. Let’s work through some common client complaints and explore how you can rethink your response.

How Much Longer?When a client complains about how long they are waiting, is it really the minutes ticking away that causes their frustration? If you ask, you may discover that the wait seems long because of something that isn’t immediately obvious: They are worried about their pet in the back (being admitted or treated); they have a baby who is about to explode because nap time is approaching; they are worried about getting out on time to meet their child’s school bus; or they’re not sure how they are going to pay for the visit now that they noticed the “Payment due upon service” sign.

These circumstances are aggravated by the wait; the wait itself is not always the issue. Sometimes all it takes is for a team member to update the client, let him know how long he can expect to wait, and ask how the team can make him more comfortable.

It might be as simple as dipping into the “client refreshment fund” to buy the hungry toddler a snack or a drink.

When clients complain about the long wait, what they are saying is: “I need someone to help me if I’m going to be sitting here for any extended period of time … like 15 minutes!”

Am I Going to See the Doctor? You may hear, “I didn’t get to see the doctor when … .” This problem is not always as obvious as it seems.

Does the client have a strong desire to see a particular doctor? Perhaps. But more often than not, she just wants to be sure she is getting the right advice and information from someone who knows her pet. This doesn’t necessarily have to be the doctor every time, for every client.

Other members of the team should be trained to know the patient, the information that needs to be delivered and how to provide personalized service.

This will free up the doctor. It also will give the client more points of contact.

In this case, what the client is really saying is: “Who are you? And do you know my pet and have the right information for me?”

Why Is My Pet Filthy?

There is no excuse for sending a pet home dirty, whether it is blood on an incision or fecal matter on the behind. But it happens, particularly if a patient came in with symptoms of diarrhea or vomiting.

A weak, timid or aggressive patient can’t always withstand a complete bath. But every effort should be made to spot-clean the pet.

If a pet cannot receive a full cleansing bath, someone should address that with the client before the pet is brought out for a visitation or release.

Acknowledge that you are aware the pet is dirty, but for “X” reasons it is not in the pet’s best interest to give it a complete bath at this time.

The client will want what is best for the pet and will appreciate that you noticed and cared enough to explain. Otherwise, the client will go home, then notice the filth. The next call he makes will be to your doctor or manager.

It Costs HOW Much?

This is the complaint that makes us all cringe. There is often no good reply.

You can explain the care given, the lab charges incurred, the equipment cost, the medication fee increase, but none of it makes the client feel any better. By this point, it is too late.

Being proactive is the only way to avoid this complaint. Because what the client is not saying is, “I didn’t expect this total, and I have no idea how I’m going to pay for this.”

The only way to avoid fee complaints is to communicate. Post clear information about payment options and expectations, obtain permission in advance for all services, and provide an estimate for continued daily care for hospitalization.

What happens if there is a surprise discovered–missed charges that have been applied to the invoice or a procedure that was performed without permission? Tell the client as soon as the discrepancy is noticed.

If this occurs when the pet is being released, do not set up the receptionist for a battle by having her present an unexpected invoice to a client at the front desk. Instead, have someone who knows the family escort them into a room and discuss the invoice before the pet is brought up. This eliminates the embarrassment at the front desk as the client tries to figure out how to pay the bill and allows the practice time to work with the client, if necessary, on explanations and payment options.

4-Letter Word: Policy

Regardless of the type of complaint, the one thing you want to avoid is the P-word. Clients do not care about your hospital’s policy. They care only about their pets.

Your practice cares about their pets, too.

So when you find yourself butting heads with a client over policy, step back mentally and think of why the policy is in the best interest of all the patients. That is what you tell the client.

An example is the client who wants to stay with her pet for a long time or overnight. The reason she cannot stay isn’t “policy.” Instead, it is that all patients need to be continually monitored by the staff. The patients need to rest, the staff needs to be able to provide medication and nursing care, and therefore the visits are limited in the best interest of all the patients.

You can apply this “pet-centered policy” logic to nearly every policy affecting clients. You may not make every client happy, but every client will know that you have the best interest of his pet at heart, even if he continues complaining.

You can click here to visit the Veterinary Practice News website

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How to have a busy lobby, right now

by Ben Cummings

Ben Cummings is the publisher of a website devoted to the business development of chiropractor services in the USA. Chiropracter and veterinary services are very different in many respects. However practice success in both professions depends on the delivery of
high quality professional services for clients/patients who demand, and are prepared to pay for them. Maybe there are some lessons here for veterinary practice owners.

Success breeds success. A busy lobby stimulates more business, and often significantly more. Here’s a tip used by my clients to look busy, even when you’re not!

There’s an Italian restaurant near my home. When I drive past it the parking lot is usually empty. I have never eaten there and I’ve concluded that..If no one else is eating there, how good can the food really be?

I will admit this is completely unfair. Perhaps the chef there is the best in the city! However humans look at popularity to judge the value of products and services. I bet you the biggest steak in Texas that you would not had read a Harry Potter book were it not for its popularity with others. On a recent trip to St. Thomas I counted at least a dozen people on the beach reading the Da Vinci Code. Finally, I broke down and purchased it to see what “made it such a good read.” We look to see what others are doing to make judgments about products and services.

This powerful psychological factor is known by social psychologists as social proof. Social proof explains much of our behavior. It explains the reason I purchased the Da Vinci code and Harry Potter… but have yet to eat at the Italian restaurant.

Why a busy lobby stimulates more business We want to go where others go. We want to wear what others wear. We want to be part of a successful, busy looking progressive practice.

If the lobby is packed…

If the parking lot looks busy…

The doctor must be good.

When the lobby looks busy, patients feel that their decision to select your service has been validated. When patients see the demand for your services to be great, they are more likely to tell others about their “great doctor.” I have seen a busy lobby single handedly grow some practices.

In practices that are slow, the slow lobby compounds the problem. The patients feel like the patrons to the slow restaurant. “What’s wrong? Where is everyone?” The doctor often confirms these suspicions by exhibiting desperate behavior. They start doing things they shouldn’t do. Such as…

  • Using pressure in the case presentation
  • Talking too much to educate the patient, since they might be afraid to lose the new case
  • Using sales tactics

These actions reduce the doctors results significantly making the lobby emptier. And on it goes…

The first thing I do when taking on a new clients is I make sure they have a busy looking lobby. If they don’t already have a busy lobby, here’s one of the fastest ways to accomplish this…

The 3 day a week practiceIf your lobby looks slow, the first thing to do is reduce your operating hours… immediately!

One client’s practice was open five days a week. His lobby generally appeared slow. From experience we know that 80% of practice revenue is made during just 20% of the hours a practice is open. I urged him to stay open during the “golden hours” and close his two slowest days. He decided he needed to do something, so he tried it out. We call this the “3 day a week” strategy. Thus far it has worked wonders in all the situations to which it’s been applied. I’ve never had this strategy fail to produce a positive immediate result, to my knowledge.

Patient flow increased 20%, with zero investment

His practice was now open 3 days a week. When his patients came in now, they saw a lobby that looked extremely busy. The positive benefits were seen immediately. The busy lobby…

  • Made patients feel better about his service
  • Increased energy in the office
  • Morale of office staff improved
  • Doctor and staff delivered services faster, which increased patient satisfaction
  • Forced the doctor to quit delivering long boring case presentations. He delivered his case presentation briskly. (Not surprisingly this improved his case acceptance results)
  • Within a few months of patients seeing a busy lobby, his office visits increased by 20%.

This 20% increase represented a substantial improvement in income. We’re talking thousands of dollars. It was easy to do. A simple change to make. He’s working less hours than before, making more income. Patient satisfaction has improved. His patients feel better about going to a busy doctor. This one’s a no-brainer.

If your lobby looks slow, it can have a dramatic negative effect. Close during slow days which enhances the appearance of your lobby. We have found the average improvement to patient flow is a 10-20% improvement. Without having to spend more money. Nothing validates a patient choice to be your patient, like the busy lobby!

You can click here to visit the Ben Cummings website.

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