Practice Management News and Views from around the World – July 2011

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What’s happening in small animal practice in the UK

Selected data from the MAI consolidated report to April 2011

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Shoestring Budgets

from an article by Tracy Dowdy CVPM

Budgets are a foreign concept in many small general practices. However, if you want to take your practice from good to great, you need to know the heartbeat of your practice. What profit centers generate the most income in your practice? What areas in your practice are the least profitable? How do you benchmark your practice’s financial condition to other practices throughout the country? You need to be asking and answering these questions in a systematic way to forecast and proactively plan for your practice’s future financial success.

Most practices dread monitoring this data. But the process can be simple and the value great. First, remember that budgets and goals aren’t monsters — rather, they help you reach the practice’s goal of financial health. Next, tackle common problems using the solutions outlined below.

  • Accept the learning curve. Living with a budget is an education. Trimming expenses, knowing what to allocate for each line item or how much cash reserve to keep . . . these skills take time to hone. Learn to adjust a budget as you go, and what was once a shot in the dark gradually will become a more predictable, useful tool.
  • Be prepared to miss your budget estimates. Rule No. 1 in setting up a budget is that projections are best guesses and nothing more. You’re going to miss your estimates occasionally. If the practice is achieving 100% of its targets, you’re not being aggressive enough in setting goals. It’s okay to miss targets so long as you act quickly and intelligently to correct matters. For example, if you budgeted $500 a month for imaging supplies and your bill consistently tops $650 for three months running, adjust your
    imaging-supplies allocation to $550. By the same token, if the bill is only running an average of $400, trim your supply expense. Then reallocate among profit centers for these adjustments to ensure you achieve your overall practice goal.
  • Work flexibly. Being willing to stay flexible is the key to staying on budget. For instance, if your actual revenue doesn’t match forecasts, trim your expenses to compensate for the lost profits. By the same token, if you’re earning more than anticipated, it might be time to invest in better equipment, labor or additional inventory.
  • Watch your cash flow. You’ve heard the phrase “cash is king.” Cash-flow problems are what kill most small businesses. Monitor your income closely to make sure you have the funds to pay your bills. Keep checking that your revenues equal or outweigh expenses each month.
  • Be conservative. When you first set up your budget, it’s a good idea to overstate your expenses and lowball your expected revenue. In addition, use this approach to make sure your cash flow holds up.
  • Nurture a cash cushion. The uncertainty of budgeting — both in terms of income as well as expenses — is one of the biggest threats to the survival and success of any veterinary practice. While trimming expenses to the bare minimum is always a good idea, it’s also prudent to set aside income whenever possible. If you can afford it, earmark a portion of every month’s excess income and sock those funds away in a money market account. These funds may come in handy for predictable expenses such as year-end taxes, but
    they will be absolute lifesavers if unexpected expenses crop up suddenly.
  • Check your budget every month. This is a point that I can’t stress enough. Go over your budget every month and examine your cash flow so available funds are sufficient to meet your liabilities. If you follow point No. 2 and adjust your budget as you go, you’ll have an emergency fund to take care of monthly overruns. Use it when things cost more than you thought, and put money into the contingency fund if net revenues exceed expectations.
  • Use your budget as a form of restraint, not constraint. Setting up and sticking to a solid budget is the most effective teacher of fiscal discipline there is. But don’t be shy about busting your budget on occasion if it’s truly warranted. It’s often impossible to budget for a valuable lastminute seminar or a trip to a trade show to make valuable contacts. If you are too rigid with your budget, you’ll refuse to spend when you have the opportunity to make a valuable investment in your practice.
  • Identify the low-hanging fruit. By setting income and expense goals for each profit center, the entire team can be involved in improving client compliance. Set or raise medical standards for your practice, then train your entire health care team to educate clients on the importance of why the services are essential to the overall health of their pets.

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Seeing Is Believing

from an article by Henry Moore published in the My Exceptional Veterinary Team newsletter

Client’s View: Kristi was eager to take her new pup Jake to the Ark Veterinary Hospital. She’d heard great things about their focus on wellness and preventive care. As a new pet owner, Kristi wanted to do everything she could to make sure Jake had a long, healthy life, and she wanted a veterinarian she could connect with.

Kristi spent an enjoyable few minutes with Kara, Dr. Conrad’s tech, who seemed suitably impressed with the friendly Jake. In fact, Kristi felt that she’d found her practice of choice … until Dr. Conrad walked through the door. She appeared distracted and preoccupied. Even when answering questions, Dr. Conrad seemed more focused on getting information in the records than getting to know Kristi and Jake. Kristi wasn’t sure after all that Dr. Conrad’s clinic was the place for her … or Jake.

Veterinarian’s View: Dr. Conrad had had a terrible morning. With two sick children and a reluctant sitter, she’d been late getting to the office. She was starting her day already tired; her call night had been rough and she’d had to come into the hospital twice for a dog in the ICU. She’d started her day overbooked and knew she had one of her favorite clients coming in at noon for her beloved Yorkie’s euthanasia. Dr. Conrad was doing her best to catch up.

Clients want information, education, diagnostics, and compassion. They want to feel like their pet’s well-being is the only thing on the mind of everyone they encounter during an office visit. And yet, everyone on the veterinary team is only human; we have lives and problems, and we get short on time. Sometimes, our need to buckle down and push through our day conflicts with what our clients hope to receive from us.

How to Communicate Care

Make sure that clients see–and believe–your care and concern by following these tips.

  • If you’ve got several life problems brewing, imagine them remaining “outside” of the building as you walk into your clinic.
  • On days when you’re feeling stressed, give yourself a few moments of quiet contemplation to center yourself before you begin your work day.
  • As you leave one exam room, take a deep, slow breath and expel it, calming yourself before entering the next room. Let each visit go before you start the next one.
  • When you enter an exam room, make a point to shake your client’s hand or meet their eyes and smile hello. Greet the pet by name.
  • Remind yourself to periodically make eye contact with your client as you do your physical and update your notes.
  • If you are using electronic medical records, remember to periodically stop and look directly at your client when he/she is speaking.
  • Remember that even though you see many clients a day, they only see you once. Make that one time count!

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

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Managers: 5 reasons receptionists hate you

from an article by Debbie Boone BS published in the dvm360.com website

Managers listen up: Your receptionists have spoken and they have a lot to say about your management style. Check out this list of management failures–created by attendees in continuing education courses on reception skills–and see if you fall into any one of these five categories. Then study the solutions so you can better serve your team.

Managers who resist change. This seems to be veterinary receptionists’ most common frustration. The receptionists I work with learn about not just the nuts and bolts of their position but also how to be a team player and how to excel in customer care and relationship building. They leave excited and enthusiastic to implement what they have learned. Many go back to managers who will embrace the changes. However, I do hear, “I’m just the receptionist, no one will listen to me and nothing will improve.”

Solution: Managers need to be open and constantly looking for things to improve. Team members have good ideas and we should use every brain on our team. Encourage team members who attend continuing education to educate the group when they return. One or two good ideas can really improve customer care in your practice.

Managers who don’t lead. These are the comments I hear privately: “What would you do when your manager is the problem?” “She doesn’t discipline or dismiss poor quality workers. She hides in her office and doesn’t know what’s going on with staff.”

Solution: After more than 30 years of management, I firmly believe in terminating employees that tear down the fabric of the team. It’s better to work with someone wonderful for one year than someone terrible for 10. Document poor employee performance and dismiss the problem employees.

Managers who don’t protect team members. This is sad. Allowing abusive clients to verbally or even physically attack your team is inexcusable. One receptionist told me of an incident where a client threw a toy from the retail counter at her and the practice manager did nothing.

Solution: I am very proud of one practice owner who took action after he overheard a client berating his receptionist. The owner followed the angry client out to the parking lot and “fired” her. This receptionist was glowing when she told the story–she felt truly valued as an employee. Staff members should be treated as well as your best client. It’s our job as managers to protect and care for our team.

Managers who don’t motivate. A manager’s job isn’t to do the work but to see that the work gets done. That’s why receptionists get frustrated by lack of delegation. If you don’t trust your staff to do the work then you hired the wrong people.

Solutions: Good receptionists want to do more, get more responsibility, and use their brains to bring ideas for improvement to the workplace. Turn loose and let them.

Managers who don’t train their employees. I ask receptionists, “Who has a job description or a formal training program?” Out of nearly 700 attendees, maybe 50 raise their hands. Not surprising, but disappointing not the less–when receptionists are given little to no direction they don’t know whether they should keep doing what they’re doing or step up their game.

Solutions: Try this exercise: ask your team members to write down traits they would choose in their perfect teammate–someone they would be working with for the next five years. Keep these suggestions in mind when managing your practice and use them as a guide when you train and motivate your staff.

You can click here to visit the DVM360 website

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More Practice Management CPD

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You can click here to visit the PetsVetSpace website

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