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

This months Video clip – Saving Money on Veterinary Care — a message to adapt for your own clients

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The Restaurant Manager

I came across the following anecdote in a website devoted to the business of running a restaurant — and felt that the message could equally apply to veterinary practice:

“When I was a restaurant manager, the most difficult part of my job was dealing with underachieving, problem employees.

Although it never became easy, I started doing a better job handling them after my boss pulled me aside one day and shared a few words of wisdom.

He said that before taking action with anyone who was performing below par, he would always try to find out the underlying reason for it. He explained that there are usually three primary caus of poor performance.

  • The employee doesn’t know HOW to do a good job. Make sure the employee has been properly trained and knows exactly what’s expected of them. It’s possible that some remedial training and clear communication of your expectations is all that’s needed.
  • The employee doesn’t have the ABILITY to do a good job. After they’ve been trained, are they “capable” of doing the job up to your standards? If not, could they handle a less demanding position? If that’s not possible, it would be in everyone’s best interest to get them started on a new career somewhere else.
  • The employee doesn’t have the DESIRE to do a good job. If they know HOW to do a good job and have the ABILITY to do it, poor performance is probably due to attitude. A bad attitude can be very difficult to change. If an employee can’t turn their attitude & performance around in a reasonable time, they really leave you with no alternative but to let them go.

Meet with the employee and get a sense of what’s causing the poor performance. It should then be much easier to determine what form of corrective action is appropriate.

Having underperforming employees is never fun, but dealing with the situation quickly, fairly and decisively will be make your job easier, your business run better and will be appreciated by the good performers on your staff.

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Adding value when asking for payment

Caroline Johnson says that nowadays, there’s no such thing as a free service, yet why do so many veterinary practices find it difficult to ask for payment? In this article she offers her advice on adding value in the practice and explains how payment needn’t be such a grey area.

1.Talk through the bill

When giving the client the bill, talk through every item listed before presenting the total.That way, the client gets to see exactly what is involved in every procedure so that the pounds charged then appear good value for money. For example, many clients will not understand that ‘running tests’ may consist of a general anaesthetic, X-ray, blood sampling and analysis, painkillers and so on. In talking through an itemised bill you will demonstrate the value of all you have done.

2.When you’ve given something extra, tell them

When talking through the bill, give brief explanations where necessary. For example,”we’ve used a special anaesthetic to give added safety owing to Fido’s heart problems, hence the additional charge here on the bill” or “he may feel a little pain after the procedure, so to reduce his discomfort we have given him the latest painkillers” or “when dematting Charlie,we found a tick attached to him, so we’ve applied the latest in flea and tick control, which should keep him clear of parasites for the next month”.

3. Invest in training

From a clients’ perspective, the most important area of the practice is the bit they see and the people they meet. Ensure that reception staff are fully trained, comfortable with presenting bills and with taking a client through an itemised invoice in a way which demonstrates the value of your service. Role-plays with reception staff can be used to build confidence where appropriate.

4.An invoice speaks a thousand words

I once used a garage that had the slogan ‘big enough to cope, small enough to care’, and which was used on every piece of literature they produced. Succinctly summarise what your practice is about or what it offers and capture this is in a simple slogan and print your logo and your slogan on the bottom of every invoice. This means that the invoice will say more about you than what you charge! For an example of a slogan closer to home, the British Veterinary Association’s strap line is ‘Giving Vets a Voice’; short, sweet and brilliant.

5. Follow up

A visit to the hairdresser, dentist or chiropractor would not be complete without a request to book another appointment.The benefit to the business is clear, but since uptake is usually high, then there must also be benefits for those of us who make future bookings.Organise your practice so that you can book future appointments wherever posssible. Cats and dogs need to be wormed several times a year and, therefore, if you offer a ‘pill popping’ service then you could book the animal in with a nurse for the next wormer to be administered. What about the next health check and vaccination? The opportunitie are endless. Select key services and take future appointment bookings.

You can click here to visit Caroline and Jeremy Johnsons website

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Learn how to run your own practice at SPVS Business Day!

SPVS is holding a special event for anyone interested in setting up their own practice.

The event, which will be presented by Hazlewoods LLP and held on November 19th at the Aztec Hotel in Bristol, will cover areas such as benchmarking, understanding financial information, practice valuation, liability partnerships and tax.

Delegates will also be guided through the key steps they would need to take when buying into an established veterinary business.

Jacqui Molyneux, SPVS Junior Vice President, said: “The event will be a fantastic opportunity for practitioners interested in moving to that next level in their careers by setting up their own practices.

“We’re delighted to have Hazlewoods LLP present the seminar, as they have a wealth of hands-on business experience and expertise in the veterinary world, and can provide crucial advice and guidance to ensure that prospective practice owners make the right choices. This seminar will be the first in a series that Hazlewoods will present for SPVS, and each will be presented at several venues around the country over the next two years.”

Costs for the one-day course are £150 + VAT for the first delegate and £130 + VAT for the second delegate from the same practice.

The Business Day will be held at the Aztec Hotel in Bristol.

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Veterinary Business Briefing member announces launch of new buying group

Giving large group buying power to independents – by Wayne and Ruth Gray

As two veterinary surgeons who have many years experience of running our own veterinary group of practices, we have often thought about joining a buying group but there was always something that didn’t feel quite right. Sometimes there were purchasing restrictions that would have cramped our style, sometimes we were asked to pay our wholesaler though the buying group which made us feel insecure, and sometimes the high management fee left us questioning the benefit of joining at all!

Working as a small group we had already developed a good rapport with other companies, and so decided to form VetShare and develop that further. We hope you will agree that VetShare is designed to be different.

In VetShare you will continue to pay your wholesaler direct by the deadline date so that your cash flow remains unaffected, and you can rest assured that we pass on all the drug discounts that we negotiate on your behalf, back to you. What you see is what you get. Setting up this group has taken a considerable amount of time, and will continue to do so if we want our members to continue reaping the benefits from it, and so there is a modest management fee. Yet we are so confident in VetShare that we have decided not to charge a member anything if we think they have not gained from being with us, and we hope to be able to reduce that fee further in the future for longer standing members. There is everything to gain and nothing to lose with VetShare and it comes with many extra benefits. Make the effort to join now, and find out what they are.

You can click here see visit the VetShare website

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Self-Awareness and the Effective Leader

by Jeff Thoren, DVM, ACC

Organizations benefit more from leaders who take responsibility for what they don’t know than fromleaders who pretend to know it all.

Although it is probably one of the least discussed leadership competencies, self-awareness is possibly one of the most valuable. Self-awareness is being conscious of what you’re good at while acknowledging what you still have yet to learn.

In our highly competitive culture, admitting when you don’t have the answer and owning up to mistakes can seem counterintuitive. In fact, many of us operate on the belief that we must appear as though we know everything all the time or else people will question our abilities, diminishing our effectiveness as leaders.

In reality, whether you acknowledge your weaknesses or not, everyone still sees them. So rather than conceal them, the person who tries to hide weaknesses actually highlights them, creating the perception of a lack of integrity and self-awareness.

A recent article by Chris Musselwhite of the Leadership Resource Center, suggests that:

  • On an interpersonal level, self-awareness of your strengths and weaknesses can net you the trust of others and increase your credibility – both of which will increase your leadership effectiveness.
  • On an organizational level, the benefits are even greater. When you acknowledge what you have yet to learn, you’re modeling that in your organization it’s okay to admit you don’t have all the answers, to make mistakes and most importantly, to ask for help. These are all characteristics of an organization that is constantly learning and springboards to innovation and agility – two hallmarks of high performing organizations.
  • Acknowledging the need to become better at anything is only the beginning, and it’s often the most difficult step in the whole process. This difficulty to see in yourself what others see so easily is what makes the path to self-awareness so challenging.
  • One way to get started is by soliciting and listening to feedback from those who work with you. Once you’ve solicited feedback it’s crucial that you listen without justifying your actions or people will stop giving you feedback.
  • The skill of asking good questions can be invaluable to you and your organization. When the question is about your own performance however, it can be harder to be objective about negative feedback. When you show that you are equally open to all types of feedback, you demonstrate self-awareness and the willingness to learn.
  • Asking questions models a solid, transparent approach to problem-solving and decision-making that benefits everyone in an organization. But perhaps most importantly, it models that it’s okay not to know everything, which encourages everyone that it’s okay to be constantly learning.
  • By modeling habits of good self-awareness you help to create a more self-aware organization. An organization that is self-aware is open to learning and better equipped to adjust quickly to changes as the marketplace dictates. This ability is the defining characteristic of a learning organization and possibly the most compelling reason all managers at all levels should include self-awareness in their development goals.
  • You can click here to read the original article

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    Prescription Fees for UK Practices. SPVS offers some advice

    Practitioners will be aware that on the 31st October 2008, the three year period of issuing a prescription free of charge will end. From 1st November, vets will be permitted to resume charging for writing and producing a prescription. The DTI has stated that it will monitor the situation to ensure that the profession is not using the price of the prescription as a barrier to the client in obtaining competitive prices for medicines. If this is found to be the case then legislation allows for the DTI to determine a fee themselves.

    Practitioners will be aware that the “free prescription” was one of the recommendations of the Competition Commission Enquiry into the monopoly vets were found to hold on medicine supply . The CC committee felt that the writing and supplying of a prescription was a mechanical act and as such had a very small cost element . SPVS took issue with this during the investigation and we remain of the opinion that a prescription is a legal document, enshrining a considerable degree of responsibility. It is not possible to issue a prescription without consulting a patient’s records; to do so would be unsafe and irresponsible. The GMC provides guidance on prescribing for doctors that echo these responsibilities.

    Whilst the DTI indicated that a “Medicines Determination Fee” could cover these acts and create a separate entity to the prescription; SPVS holds the view that creating a separate fee not only creates confusion for the client, but also devalues the prescription itself. Preparing and providing a prescription is a professional act and as such, it should attract a professional fee. Most practices would agree that they are the best place for clients to purchase medicines from as they are ideally positioned to give the client full and accurate information.

    There has been some discussion within council and comparisons for prescription fees have been sought. Figures of £10 – £15 have been quoted for a private prescription from a medical practitioner. BUPA has a fee of £12 for repeat prescriptions . The VMD has a figure of £15 for an Import certificate for using a product authorised in another member state . Although comparisons are useful, SPVS maintains that any fee should be calculated rationally, reflecting true business costs.

    Example of Calculation

    The Society has looked at the time taken to issue a prescription and approximately 5 minutes is typical from reading the client’s request to signing the document.

    For example. Practice A7 has a consultation fee of £20 for 10 minutes or £120 per hour.

    5 minutes of professional time = £10 +VAT = £11.75

    Practice B7 (a practice in which a SPVS Council member is a partner) has hourly farm time of £110 per hour.

    5 minutes of professional time =£9.15 +VAT = £10.75

    Mixed practices may well choose to have a single aggregate value to reduce confusion to clients who have both farm and companion animals. In the above example this might be £11.00.

    If a prescription has more than one item listed, it would be reasonable to charge a lower fee per additional item. This is more difficult to predict, but a fee of half the single item fee might be appropriate.

    The figures used above are for illustrative purposes only and are not to be taken as a “SPVS recommended fee”. Individual practices have different costs bases and so must calculate this figure for themselves.

    Practices should be aware that the free prescription is the only aspect of the regulations to change. All the other recommendations of the Competition Commission that were accepted by the DTI, remain in force. This includes keeping a list of the top ten POM-V products used within the practice.

    Practices must also be aware that it is still a requirement of the Order that practices do not discriminate between those who request prescriptions and those who collect medication from the practice. The above method of calculating an appropriate fee accounts for the extra time and responsibility that the written prescription requires and as such is not discriminatory.

    Good communication is at the heart of any business and SPVS would recommend alerting clients to this change to their terms of business in advance of the 1st November.

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