Practice Management News and Views from around the World – February 2013

Fork-Lift Truck, a coin and a bottle

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What’s happening in small animal practice in the UK

Selected data from the MAI consolidated report to October 2012



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“Negative Employees Are Hurting Our Practice…”

from an article by Dr Kathleen Ruby and published online in the My Exceptional Veterinary Team website

Dear Dr. Ruby, I’ve learned a lot from EVT since recently becoming a DVM. I could use your advice now…

I work in a clinic with some employees who are angry, bitter, unproductive, and downright rude. I’ve brought this to the attention of the management and pleaded for the company to hire a professional to help us get to the bottom of this bad behavior. I’ve been told that these employees are essentially untouchable because of their age. I’ve also been told that we’d never be able to find replacements because of the low pay of the position.

I’ve been unsuccessful in trying to talk with these people on my own. Where do I go from here? I know my time is limited at this clinic–I just need some guidance to help me while I look for another job. I want to make sure that the company realizes I made an earnest effort before giving up.

Dear New Doctor, First of all, this is a global practice issue, not merely the result of a few employees who have decided it’s acceptable to misbehave. Unfortunately, by not addressing this problem, it becomes bigger and more destructive. Let’s examine the bigger dilemma in your situation and then we’ll talk about ways you might still intervene. The culture of the practice, and the resulting environment, has been left to define itself. It is important to understand that the law of entropy, or the inevitable and steady deterioration of a system or an organization, applies to veterinary practices.

If leadership does not actively seek to build, nurture, and develop a beneficial practice culture, it will not happen. People, when left in a vacuum, develop poor work habits, negative attitudes, and destructive behaviors. Without a team consensus of acceptable behaviors, a practice culture deteriorates, and a few negative individuals can hold the rest of you hostage to their poor behavior. In the same way health deteriorates if preventive action is not taken, the health of a medical team deteriorates through neglect. Sadly, the manager sounds as though she has just thrown up her hands.

Laissez-Faire Leadership

This style of leadership, called laissez-faire, is typified by a leader who lets the office environment and work team develop as they will, based on the philosophy that people know what to do, and if left alone, will do it well. This can work if a strong positive vision has been embedded into the culture so everyone has a clear sense of how to self-manage and fulfill expectations.

Unfortunately, it often is used by leaders who can’t or won’t make the effort to build a healthy team. Your manager, by sharing excuses (untouchable because of age; irreplaceable because of low salaries), is taking the “victim” role, saying, “I have no power to manage my employees or to impact the way this practice runs.”

Victim mentality pervades the management realm; many managers who don’t know how to make things better abdicate responsibility. Unfortunately, this creates a negative cascade of difficulties, such as new associates leaving in frustration, new employees becoming indoctrinated with a negative attitude, and a general disintegration of both the quality of service and the quality of care.

The argument that these employees come “cheaper” and therefore can’t be replaced is a poor business model to embrace. How do we gauge the dollars spent hiring and training employees and veterinarians who then flee a toxic work environment? How do we justify the dollars that leave the practice because clients go elsewhere? How do we measure the impact of stress on the staff as this type of behavior is allowed to continue unchecked?

Laissez-faire leadership can cost a practice untold dollars. Managers and leaders owe it to their practice, their colleagues, their clients, and their patients to address, thoughtfully and consistently, poor and destructive behavior in the employee group. Practice health depends on it.

This points out the importance of skilled and proactive leadership, as well as consistent coaching and follow-up of troubled or ineffective employees. Just as we can’t “fix” a long-neglected patient overnight, this type of management culture can’t be rectified immediately.

Blueprint for Change

If this manager truly wanted to improve the situation you describe, she would:

  • Call a team meeting to lay out expected behavioral guidelines in your practice, letting people know that these expectations will now become the bar against which performance will be evaluated.
  • Talk to each person individually to develop an initial evaluation.
  • Coach each individual on areas of improvement needed. Areas of strength should also be discussed and noted.
  • Work with each person to determine how these areas will be monitored and measured. The employee must be helped to understand that destructive or negative behaviors must be addressed, and be apprised of the consequences that will occur should the changes not happen.
  • Set a timeframe for reevaluation (3 to 6 months).
  • Hold brief weekly coaching meetings to review progress and set new goals when needed.
  • Document and initial the process weekly.

In this way, a roadmap for necessary change is defined, set, and monitored. Difficult employees, who may not be aware their behavior is destructive, are brought to the realization that what has been tolerated must change or a job will be lost. This puts the responsibility where it belongs: on the shoulders of the difficult employee.

Action Plan

As a new associate, it appears you don’t have the power to change the culture or instill the impetus for change in these employees. Working with your manager, the person in charge of the office climate and employee retention, is imperative. Since this is THE most important job the manager holds, I would hope that you could enlist your partners in asking for this issue to become her top priority.

Is it possible to present a suggested action plan to your partners, and to ask for their support in putting this issue forward to your manager?

As a new associate, it is important for you to remain both positive and proactive. Approaching this issue empathetically and assertively, with helpful ideas in hand, will demonstrate your value as a team member. If, after all of this attention, the practice leaders appear unwilling to address this issue, you will have to face that the practice is not a good match for you and seek a more compatible work environment.

Good luck bringing these new ideas to your managers!

You can click here to visit the My Exceptional Veterinary Team website

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Carve your niche in a competitive market

from an article by Bob Levoy published online in the website

Recent studies have revealed there’s no shortage of veterinarians these days. So in the midst of a surplus of veterinary care, how does one stand out and distinguish his or her services from those of others?

My solution: Develop a niche practice. Don’t try to be all things to all people in today’s ultra-competitive, cost-conscious environment. Target a specific population of clients or patients, identify their needs, and address those needs more competently than anyone else. Could you answer a need in your area for a veterinarian who does house calls or who focuses on a specialty such as ophthalmology, behavior counseling, or holistic medicine?

A prime example of a veterinarian doing just that is Dr. Laurie Hess, owner of Veterinary Center for Birds & Exotics in Bedford Hills, N.Y. Dr. Hess is one of only 150 diplomates of the American Board of Veterinary Practitioners in Avian Medicine, and her thriving practice is one of only three AAHA-accredited bird and exotics specialty referral hospitals in the United States.

Dr. Hess has earned a reputation as the go-to practitioner for exotic pets, in part because of her impressive public relations efforts. Here’s how she carved out a niche in her market:

Hit the streets. When she first started, Dr Hess went to more than 60 pet stores in a 50-mile radius. If the pet-store owners recommended her hospital, she would refer clients to their stores for products and food. Share your knowledge. Dr. Hess speaks to local exotic pet clubs and also lectures at schools and conducts tours of her clinic for Boy and Girl Scout groups.

Get in the public eye. Dr. Hess has sent original press materials to more than 200 media outlets and has been a guest on TV’s The Martha Stewart Show and The Doctors.

Take advantage of social media. Dr. Hess has an extensive ad campaign on Google, Bing, and Yahoo and maintains an active Facebook page, Twitter feed, and website. In addition, she employs a marketing team at a cost of $1,500 per month to promote veterinary care for exotic pets and birds.

Despite the languishing economy, Dr. Hess says business is good. “The practice benefits from a strong referral base and relationships with nearby veterinarians,” she says. “And the added publicity is icing on the cake.”

You can click here to visit the DVM360 website

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‘Tyred’ of Average Service??

from an article published online in the OnSwitch Blog

Car tyres — not the most exciting things to spend a couple of hundred pounds on, but quite important as routine expenditure goes. Even more important than haircuts apparently.

So when the Onswitch car passed its recent MOT with an urgent advisory comment to replace the two front tyres very soon (“are you going on any long journeys? Ah.”), we couldn’t really ignore the necessity of imminent spend. As usual, the car went for its MOT at our favourite garage. Not our nearest garage by the way, but the best — thanks to the friendly service, free advice and regular help in reducing bills by offering alternatives that are cheaper, but just as good. And they don’t look at us like idiots when we don’t know what engine coils are or what they do. Which is nice.

Now they really should have called whilst the car was in, so the tyres could have been fitted there and then. Because we would have said yes, of course fit two new tyres if you say that it needs them. *winces slightly at unexpected extra cost*. Instead, when the car was picked up, we said we’d book it in for new tyres after the very long journey we had to do the next day. Ah.

Now, we thought it might just be easier and cheaper to go to a High Street tyre emporium, after all ‘they’re the boys to trust’. Not knowing much about tyres, we typed our registration number into the chain’s website, and booked an appointment for two days hence for the tyres to be fitted in the city. But when the site crashed repeatedly on inputting payment details, a phone call was required. The rather bored-sounding young lady advised me that the booking had not in fact been made, but because the system had locked out that slot for 20 minutes, she could not do anything. The best thing to do would be to ring back in 20 minutes and book over the phone. The best thing for who? So, rather begrudgingly, we did ring back. This time a different(and slightly more switched on) girl made the booking, and then uttered the immortal words “oh, hang on.” Seemingly our local centre can’t actually get hold of two of the most commonly fitted tyres for three days — the day after we want to go. So we huff a bit and cancel the whole thing.

Feeling rather sheepish, we ring our friendly garage. No problem, they say. We’re fully booked but if you can drop the car in tomorrow we’ll fit you in in and amongst. Courtesy car at short notice? Yes of course. Total price? 10% less than the High Street ‘specialist’. Oh and by the way, the tyres the ‘specialist’s’ website said you needed were the wrong ones, but we realised straight away and ordered the right ones in.

New tyres fitted, and lesson well and truly learned.

(And when the car spectacularly loses power pulling out of a junction and has to be towed away a couple of weeks later, guess where we insist the tow truck takes us? And they fix it the same day for £95! Love those guys!)

You can click here to visit the website

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7 Things You Will Smile About When You’re Older

from an article published in the MarcandAngel website

The most splendid achievement of all is the constant striving to surpass yourself and to be worthy of your own approval. This is how happiness blooms.

So don’t wait for someone to bring you roses; plant your own garden and decorate your own soul with ideas and passions that bring you joy. You do not exist to impress the world; you exist to live your life in a way that makes you and your loved ones smile.

Stay true to your path, stay positive, and someday you will catch yourself smiling about…

1.Memories of working on a life passion.

Passion is the key, and it’s worth making sacrifices for. It’s the secret ingredient that has kept me going through some of the most painful times of my life. Because at some point, especially when the going gets tough, you have to wonder what you’re doing and why. Over the years, I’ve questioned myself and given myself a thousand little reasons to keep working on this site, but it always comes back to where it started. It comes down to my core passion to explore life’s challenges and write about them.

What distinguishes many of us who are actively pursuing our dreams from those of us on the couch is that some of us have learned the hard way — perhaps through a severe loss — that life is short, and that we must capitalize on the opportunities each day gives us, on the raw potential our minds and bodies are capable of, and on every once willpower we can muster to make our journeys worthwhile.

2.The little moments.

True wealth is the ability to experience each moment of life to the fullest. The subtle things are often the most powerful, but sometimes we get so busy that we don’t pay attention to them. So my challenge to you is this: Open your eyes. Wake up. Be attentive. Acknowledge each wonderful gift you have. See today as another day to enjoy the sights, sounds, smells, and sensations life has to offer. Bottom line: Enjoy the little things, because one day you may look back and discover they were the big things.

3.The happiness you helped create.

Attitudes are catchy. Whether they’re positive or negative, they’re rubbing off on you and those around you. So be positive. Let your intentions bleed with goodness — embodied in positive thoughts, cheerful words, and unselfish deeds — and the world will be to you a bright and happy place in which to work, play, and serve the greater good.

4.Relationships that weathered the storms with you.

No relationship is all sunshine, but two people can share one umbrella and survive the storm together. In fact, the best relationships are not always the best because they have been consistently the happiest; sometimes they are that way because they have survived and strengthened through unhappy times.

5.Feeling beautiful on the inside.

As you get older, what you look like on the outside becomes less and less of an issue, and who you are on the inside becomes the primary point of interest. You eventually realize that beauty has almost nothing to do with looks; it’s who you are as a person, how you make others feel about themselves, and most importantly, how you feel about yourself.

6.Knowing that you did your best.

Don’t be afraid of death; be afraid of a life unlived. You don’t have to live forever; you just have to live right now while you have a chance. Keep in mind that life doesn’t always give you second chances, so when an opportunity arises, take it. And never give up on a dream just because of the time that’s required to accomplish it. The time will pass anyway. Do what you need to do so that, at the very least, you can look back on your life someday and say, “I gave it my best shot.”

7.The peace in your heart.

Life is short. So focus on what matters to YOU and let go of what does not. Remember, it is the strength of your conviction that determines your level of success, not the number of people who agree with every little thing you do. In the end, you will know that you’ve made the right decisions and followed the proper path when there is peace in your heart.

You can click here to visit the MarcandAngel website

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