Practice Management News and Views from around the World – January 2009


purchase Soma COD Best wishes for a peaceful and profitable New Year

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buying soma News from Veterinary Success Services

by Steve Kornfeld and Peter Weinstein D’sVM

Here’s something we would like you to tell your clients.

Tell them, “quality of care, quality of service, or price; you only get to choose two”. We bet you will be very surprised with their answers. You know, a true veterinary professional would have no doubt what his/her clients prefer so if this comes to you as a surprise, maybe you are still a veterinary hobbyist.

Interestingly though, anyone can become a true professional. It basically takes three things to become one:

  • Creating a plan for a professionally run practice.
  • Getting into action.
  • Never giving up.

In this e-mail course (see the Veterinary Success Services website for details) we will cover all aspects of becoming a true professional in your practice and career. We are confident you can master the strategies and techniques that will allow you to succeed in all your endeavors. After all, you went through veterinary school. If you are working too hard, you’re trying to make by volume what you lack in price.

Working on volume is much more expensive than working on price as providing service costs you money. This undercuts your profits and forces you to push even more services in a given time. This makes providing high quality service even harder, thus having to lower prices even further to “stay competitive”. This is a negative vicious circle, do you agree?

Your clients actually tell you when your prices are low; they ask you how much your service is before they accept its value. In other words, they are trained to focus on cost as the primary determinant for their selection of your services. On the other hand, if you focus on profit as a main indicator of success, you can lose volume and still have far more money in your bank account, have fewer and more efficient staff and associates who are dedicating their time to improving their skills and attracting and keeping high paying clients.

With this strategy you will also have more time to relax and recharge and you can be more productive per unit of time. Having the time to create rapport with your clients and build value in their mind, are crucial strategies to being able to charge appropriately for your services. This however takes time to master and deliver. If you have severe time constraints, you won’t be able to do this with mastery.

Running on empty doesn’t fill up your tank.

Today we are going to touch on the main barrier to success in practice and how to overcome it. The secret is by becoming a true veterinary professional.

It is a known fact that veterinary practices are… well, veterinary practices and this is the biggest problem we have in our profession. The right attitude instead is that we are businesses that provide veterinary care. See the difference? So let’s go to work on turning you in shining veterinary professional.

“Becoming a true veterinary professional”

Here is another important attribute of true veterinary professionals; they put being successful at the top of their agenda. Getting through the day unscathed is not equivalent to being successful, unless your goal is to get through the day unscathed.

Dedicating a large percentage of your day to putting out fires or worrying about issues, does not get you any closer to goals, unless your goal is to do everything yourself. The best way to be professionally successful is to focus on the functions in your practice that give you the
best results. Financial results are only one part of that.

Here is an exercise we suggest you do to start becoming a true professional. For the next week go to work with a stopwatch and measure how much time you are really dedicating to highly productive activities in your practice. You will be amazed when you realize how much of your time is wasted on low yielding activities every day.

So what did you come up with? How many hours do you truly produce and how many hours do you spend staying put?

You know, life pays you by what you produce, not by your intentions and wishes. A tiger doesn’t get to eat if it doesn’t catch its food. Sitting on its rear thinking about catching something is only going to make sure it stays hungry. If you are a veterinary associate, your salary no doubt, is decided based on your production. If you waste precious time thinking about being productive, you will probably be left behind when the time comes for a raise. No point in complaining about how hard you’re working and how little you are making. Instead, if you focus more (much more) of your day on highly productive tasks, you will be able to negotiate more from your employer and from life.

The same goes for you, the practice owner. You may call the shots in your practice but if you don’t produce, your clients are not likely to give you what you want. If you handle your clients like a hobbyist, your clients are calling the shots in your practice and they dictate your lifestyle. Do you want your clients to dictate your lifestyle or do you want to do it yourself?

You can click here to visit the Veterinary Success Services website

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Avoiding the dangers of tearoom talk

Retail expert, Jurek Leon has vast experience in the area of customer service. Jurek adheres to the slogan that ‘loose lips sink ships’ and recently discussed the dangers of what he calls ‘tearoom talk’.

According to Jurek, tearoom talk occurs when a member of the team has had a bad experience with a customer whether it is over the phone or face to face. As we all have a need to release stress, it is natural that the team member concerned would want to discuss the incident. The person concerned gets into the tearoom and typically will start a conversation with something like:’You wouldn’t believe the customer I just had.’

The team member will then proceed to discuss how rude and arrogant the customer was, complaining about how hard done by they feel etc.

Usually they don’t get any further before one of the other people in the tearoom cuts in and says something like “Oh, that’s nothing, you should have heard the woman I had on the phone yesterday…”

This person will go through an account of what had taken place the day before, before a third person in the tearoom interrupts. This person’s story will begin with “You guys…that’s nothing…”

It then becomes a case of who can come up with the worst customer of the month scenario. This invariably means that somebody who is sitting there quietly, having a cup of tea and relaxing, recovering their spirits to get back into the fray, suddenly becomes de-motivated by this talk. This type of talk effectively undoes all positive customer service sessions that the team has been involved in and creates an ‘us’ versus ‘them’ mentality at work.

The question is how do we then get a negative customer experience out of our system without creating a negative morale at work?

Jurek says that it’s OK to discuss the experience but recommends referring to the customer by name and ending on a positive note. By ending the story with something like “You know I’m really pleased. I didn’t let that person upset me, I’m really proud of myself” will create a different atmosphere in the tearoom.

It’s all about getting on side with our customers.

You can click here to visit Jurek Leons website

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Telling people nicely

Unattended or misbehaving kids cause retailers grief continually. How to handle them and get parents to control them is something every retailers thinks about constantly.

Here’s a nice effort.


Did it work? Would it be appropriate in a veterinary practice? Who knows? You might have noticed that parents never think that their child is a problem

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Pet Insurance Rising In Down Economy

Extracts from an article by Brian Hutchins about pet insurance in the USA – originally published in Veterinary Practice News

Much as the economic crisis loomed large in the election of Barack Obama as president, it also has sparked a heightened interest in pet healh insurance from pet owners and veterinarians.

Concerns about the economy, from Wall Street to Main Street, flared in September and October, and have brought to the forefront the idea of pet health insurance as a way to manage health costs.

A central issue is whether pet health insurance in general is a cost-effective way to manage veterinary costs during tough economic times.

Overall industry policy sales are continuing to grow, fueled both by an interest in managing those risks and a growing number of companies, including new players such as AIG-underwritten PurinaCare and Trupanion, marketing the concept and their policies.

Although more consumers are now willing to buy insurance policies, the number of insured U.S. pets is still less than 1 percent of all pets by most accounts.

The precise number of insured pets in the U.S. is not known–several companies do not report numbers due to proprietary concerns–but a couple of members of the North American Pet Health Insurance Assn. estimate that 750,000 to 800,000 pets are insured and that the North American pet insurance market would grow annually between 25 and 35 percent for the next five years, to a $1.1 billion market by 2012.

Good Renewal Rates

Still, the economy’s effects on pet health insurance sales varies by insurance provider, with the more established players staying relatively stable despite the onslaught of new players and the newer players reporting the more rapid sales growth that would be expected from a fledgling business.

Perhaps most promising for the industry is strong and improving renewal rates, which providers say means that consumers are seeing value in pet health insurance and that companies are delivering that value.

“We’re seeing a slight slowing in new policies sales, but our retention rate has actually increased,” said Curtis Steinhoff, senior director of corporate communications at Veterinary Pet Insurance in Brea, Calif. “People who have a policy now are saying, ‘Now is the worst time for me to get a $3,000 or $4,000 vet bill,’ so they’re holding onto their policies in greater numbers.”

Potential new customers, however, may be viewing insurance as a luxury and are choosing not to add another expense given the uncertain economy, he said.

VPI is still growing and insured about 465,000 pets as of late October, Steinhoff said. He declined to provide more specific numbers for competitive reasons. Also factoring into the slowdown of new policy sales is a more competitive marketplace, with at least 15 providers now in the market.

Similarly, Hartville Group Inc.’s sales were softer in the third quarter than the first half of the year, but not as soft as the company expected, said Dennis Rushovich, chief executive officer of the Canton, Ohio-based company. Hartville typically sees its strongest sales in the beginning of the year.

Even with the sales slowdown, Rushovich said, the company insures more than 80,000 pets, up from 79,079 pets at the end of the second quarter.

Rushovich said the economy has been in a downturn for almost five quarters by his calculations, and the company’s first-half sales were very strong and above expectations. Insurance sales typically pick up during down times, he said, because people tend to think more about what would happen if they lost a job or faced other financial challenges. Pet health insurance sales should act similarly, he said, depending on whether a pet owner sees the expenditure as discretionary spending or a necessity.

Also, the down economy’s full effect on pet health insurance will be difficult to fully understand until the current troubles are over, he said.

Fall Downturn

Although its sales are up year over year, Pets Best Insurance of Boise, Idaho, acknowledges a difference. “Every month had been record-breaking until September and October,” said founder Jack Stephens,DVM. “People are just unsure. We are seeing some declines.”

In short, people were not making new financial commitments but the company’s retention rate went up, he said.

Those declines were month over month for September and October and possibly a temporary glitch. Dr. Stephens noted that preliminary figures indicated the company had two record sales days through the first five days of November and was back on a “rapid growth curve.”

The company insures more than 30,000 pets, he said. With his long history in pet health insurance, Stephens, who also founded Veterinary Pet Insurance, has been through recessions. The pet insurance market leveled off then but came back quickly as people thought about how important their pets were to them, he said.

Other Options Available

Pets Best has seen an uptick in policy cancellations as consumers look to save money, Stephens said, but the company saved many accounts by switching them to its lower-premium insurance programs. If the customer’s complaint is about Pets Best specifically rather than general money concerns, the company’s policy is to refer customers to the North American Pet Health Insurance Assn’s website to find another provider, such as Trupanion of Lynnwood, Wash.

“I’ve been doing this for eight years and I’ve never seen a bigger urgency to get pet health insurance than now,” said Darryl Rawlings, chief executive officer of Trupanion, which began selling policies in the U.S. this year and is still getting state approvals. The company has been active in Canada for eight years as Vetinsurance.

Although Trupanion’s programs are new to the U.S. and offer unique features compared to other companies’ offerings, Rawlings attributes the good reception to the economy. Most significantly, Rawlings said, MasterCard and Visa are his main competitors and are becoming less of an option for pet owners as credit lines shrink and consumers max out. Increasing numbers of consumers no longer have the option to put that unexpected veterinary bill on their credit card.

Also, with investments off sharply, retired pet owners living on a fixed income based on 401(k)s or home equity are finding their investment base and discretionary income down significantly, Rawlings said. This leaves those pet owners less able to handle unexpected veterinary bills and, presumably, more interested in financial products that would help manage those costs.

Rawlings said that with only 1 percent of pets insured in the U.S., he wasn’t worried about pet owners who might balk at adding a pet health insurance premium due to economic uncertainty slowing industry growth.

Anecdotally, Rawlings said that veterinarians, recognizing that pet owners are struggling, are talking more to their clients about pet health insurance in recent months. Veterinarians also are asking Trupanion about how to use its marketing tools more effectively. Practices are now more likely to hand insurance brochures to clients rather than merely put the brochures on a counter, he said.

While Rawlings said he couldn’t provide meaningful growth figures for the U.S. since the company is new to the market, its most recent quarter in Canada was its biggest ever. The Canadian economy has been relatively immune to the U.S. troubles, he said.

As of late October, Trupanion was approved in 30 states that represented about 80 percent of U.S. pets. Rawlings expected to earn approval in all states by the second quarter of next year.

Benefits of Marketing

With gasoline prices high and 401(k) plans falling, business is booming at Petplan USA, administered by Fetch Insurance Services Inc. of Philadelphia, with month-to-month double-digit growth through October, said founder, president and CEO Chris Ashton. Citing proprietary concerns, he declined to reveal specific sales figures. Fetch licensed the Petplan brand and program and began marketing it in the U.S. in July 2006.

“People are not asking if they can afford pet health insurance, but how they can afford not,” Ashton said. In response to the economy, Ashton said, the company is doing more marketing, including on the Internet and to the veterinary profession. He also said the company is conducting, and getting more requests for, its lunch-and-learn programs for veterinary practices.

He acknowledged that some veterinarians don’t support pet health insurance, but he said the time has never been better for veterinarians to promote it.

“We know people are putting off veterinary visits” in an effort to save money, he said. He also said that he has data, based on Petplan’s 25-year history in the United Kingdom and other markets, to show that insured pets are taken to the veterinarian more often, their owners become more bonded to the veterinary practice and the owners spend more money on more services than non-insured pet owners.

Likewise, VPI recently shifted its marketing to emphasize an economic message. To pet owners, that message is about how pet insurance can help them manage veterinary bills.

To veterinarians, the message is about how insurance can boost practice revenues. VPI is encouraging veterinarians to promote veterinary pet health insurance, Steinhoff said, noting the company has data showing that insured pet owners visited the veterinarian more often, were inclined to spend more once there and were more likely to follow veterinary recommendations than non-insured pet owners.

Well-Informed Owners

PetPartners Inc. of Raleigh, N.C., has been “surprised by just how consistent people have been” in their insurance purchasing amid the economic challenges of recent months, said Linda Bell, the company’s chief marketing officer. The company, whose brands include the American Kennel Club Pet Healthcare Plan and the Cat Fanciers Assn. Pet Healthcare, has seen a consistent level of new sales and renewals and an upward trend in claims costs.

Anecdotally, Bell said the company perceived an uptick in interest at its booth at a couple of recent dog shows.

It also has noticed consistency of use among its various plans, ranging from wellness plans to accident-only policies, and various deductible options, Bell said. The company’s retention rates remain strong, she said.

Bell said people are now more aware of pet health insurance because of the additional players in the market and a related increase in overall promotional activity, especially on the Internet, where online shopping for pet insurance is relatively simple.

People also are more aware of veterinary medical advances available for their pets, and the higher costs of those procedures, because of television programs, Bell said. She said the company is seeing strong sales in California and Florida–markets where home price declines have been the sharpest in the nation and consumers presumably under more pressure.

You can click here to visit the North American Pet Health Insurance Association website

You can click here to visit the Veterinary Practice News website

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3 Ways to reduce those frustrating practice management headaches, that you hate!

by Ben Cummings

Ben Cummings is the publisher of a website devoted to the development of chiropractor practices in the USA

A study showed doctors wasting on average 30% of their work time trying to fix reoccurring management headaches. Here are 3 tips for eliminating common practice hassles so you can focus on treating and generating practice income

In my opinion, the ideal practice is one where a Doctor is free to focus on creating practice revenue. When he shows up to work he can focus mainly on delivering care and case presentations. The two most important income producing areas in practice!

The problem is so much of a doctors time is consumed putting out management fires. Here are three tips for reducing these common management frustrations:

1. Systems are the answer

Doctors get drawn into battles they shouldn’t be drawn into. Doctors spend about one-third of their work time dealing with the same problems over and over. The solution is to take a systems-thinking approach. Systematize problem areas, and let the systems do the work.

I’ve observed that 20% of the problem areas cause 80% of the trouble. Doctors waste enormous time on things like:

  • Having to make sure a staff person is doing what they’re supposed to be doing
  • Spending too much time on the telephone, and not enough time on practice development
  • Chasing insurance payment
  • Making sure calls are being returned, instead of having reliable staff
  • Trying to do everything yourself

Wasting time on these things, means less time spent on practice development. You get caught up just putting out fires. Nothing significant seems to get accomplished. What are the 20% problems that cause you 80% of the trouble? Rather than base your practice around unpredictable human behavior, center it around systems. Let the systems you create solve the problems before they occur again.

When the doctor reduces the majority of time wasting hassles, we find income improves. The practice grows! The doctor has more time for practice development. When things are systematized practice capacity improves also. These are things that grow practice income.

2. Get rid of the belief “no one can do it better than me!”

We get that a lot from doctors! “No one can do it better than me” means why hire someone to help grow a practice if no one can do it as well as the doctor can?

When a doctor believes “no one can do it better than me” they don’t hire needed staff. Even when it can make them more money. When a doctor tries to do everything themselves they hit an income ceiling. They can’t make any more income because they’re unable to see patients when the demand to get into the practice is greatest. This is frequently known as a capacity problem.

Today’s patients will not except slow apathetic health care. They’ll just go elsewhere. If you can’t get patients in when they want to be seen they will often chose to leave. The age of hyper-availability is already upon us. Those doctors who refuse to staff up or expand their capacity to accept patients when they most desire to come in will find future growth a challenge.

If one has the belief that hiring anyone else into the practice will lead to incompetence in that area, than the doctor will not hire even if it’s desperately needed. New staff can be used to expand the numbers of patients that can be processed. Since doctors earn money based on the number of treatments and visits delivered, expanding patient processing capacity can frequently expand income immediately. Doctors with the belief “no one can do it better than me” frequently hit the income ceiling.

3. Doctors are reluctant to delegate mundane practice tasks to others

Doctors hold onto tasks! There are dozens of mundane tasks that consume a doctors time, yet generate no value. Doctors find it hard to give these up.

Doing mundane tasks can waste dozens of valuable work hours. As many of these should be delegated as possible, to free up time for practice development. Of course, I sometimes think doctors hold onto these mundane tasks as an excuse for inaction with regards to practice development. After all it’s easier to waste time doing your own insurance coding than it is thinking about a patient flow strategy that could drive in 20 new patients a month.

When a doctor is reluctant to give things up that waste their time and produce little value, it
can impact the practice negatively in a number of ways such as:

  • Stress of running the practice increase as the practice grows
  • Growth slows
  • Hard to focus on practice improvement
  • No time for practice development
  • Feel they’re so busy that they don’t have the time to even hire someone else

Shirley McClain said, “The problem with the rat race is, even if you win you’re still a rat!” The goal of starting your practice was not so you could work like a dog for 30 years and retire when you’re too old to enjoy it.

If you think about these three concepts and correct the most common areas of the practice that are wasting enormous amounts of your time, you will find income improves and being in practice becomes more enjoyable!

You can click here to visit the Ben Cummings website.

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