Practice Management News and Views from around the World – September 2012

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Equine Veterinary Business is changing

From an article by Mike Pownall DVM

One of the most profound things I have learned in business is that no business sector is truly unique and that there are lessons to be learned from other industries. The light went on for me about this while I was attending the Equine Business Management Strategies Course a few years ago. One of the presenters challenged us to identify business challenges we had in equine vet practice, and to look at other industries to see if we could find similar issues and, better yet, solutions to these challenges.

Until then, I thought, like many equine vets do, that our business was unique and that we were the only ones to face the challenges we do. My opinion on that changed forever about 15 minutes later. Our group identified seasonality as a concern in equine vet practice. Our business is in the North, so we are busy 3 seasons of the year, and at that time we died during the winter. When we looked at other industries we, indeed, found businesses facing similar situations. Better yet, we also were able to find ideas for solutions to these challenges. For example, Bombardier, used to only manufacture Ski-Dos. That was great for the winter but what could they sell in the summer? That business challenge led to the creation of the Sea-Doo. Anyone who spends time on a lake in the summer now yearns for the days of yore, when we never had to hear the incessant buzz, of the this now ubiquitous summer recreation vehicle.

Great success for Bombardier, bad for quiet days on the lake. This led us to think of the owners of ski hills. Once the snow was gone what next? Now, most progressive ski hills offer summer recreation, like mountain biking. I have used that lesson in our own business to make the peaks and valleys of our business year less abrupt. We are much more busy in the winter than we used to be. The ability to think outside of our own constraints led to many opportunities.

Last year we purchased a companion animal practice. At first I was overwhelmed by the apparent differences between an equine vet business and our new endevour, but I soon realized there were numerous similarities. A vet performing an exam and then taking a dog or cat to the back room for diagnostics or treatments is no different than the work flow in an equine hospital. I also learned that there were things we did in our equine ambulatory practice that can be useful in a companion animal practice. Equine vets know
a lot about working on the road, so we can offer a wealth of knowledge about running a mobile companion animal practice, which is a growing area in companion animal practice.

Our small animal business has a busy retail section and a high level of compliance with preventative health programs. I think most equine vet businesses could use some help in those areas.

When I looked at the Equine Vet Business blog with the point of view that lessons can be learned from other industries, I knew I had to change the focus of the blog. I had to try to bridge the usual gap between vets who think what they do is so special to asking what can equine vets learn from small animal vets. Conversely, what business lessons are there for companion animal vets from the equine vet industry. Indeed. what can these 2 learn from large scale food production veterinarians? I don’t know yet, but I am looking forward to finding out.

You can click here to visit Dr Pownalls Veterinary Business Matters website

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VNs with SQP qualification earn higher salary

A veterinary nurse with an SQP (suitably qualified person) qualification is likely to be paid more than a standard qualified VN, according to new statistics from the British Veterinary Nursing Association (BVNA), the Society of Practising Veterinary Surgeons (SPVS) and the Veterinary Practice Management Association.

The finding comes from the 2012 edition of the Salaries Survey, a collation of salary data collected between March and May of this year from veterinary surgeons, veterinary nurses, managers, administrators and receptionists.

The aim of the survey, said SPVS, is to “give some indication of what is being paid as the ‘going rate’ to act as a starting point in salary negotiations between practice and employee”.

435 responses were received for the survey. The respondent breakdown was as follows:

  • 75% qualified VNs;
  • 9% have a veterinary nursing degree;
  • 6% have a veterinary nursing diploma;
  • 3% have advanced veterinary nursing diplomas;
  • 11% student VNs;
  • 1% studying for a non-VN nursing qualification;
  • 3% qualified veterinary care assistants; and
  • 9% have an SQP qualification.

For the 290 full-time respondents, it was found that the average salary for a qualified VN was £19,881, with the minimum and maximum wages reported as £11,700 and £33,700, respectively.

However, those with an SQP qualification reported an average wage of £20,280, 2% higher than a qualified VN. However, the minimum wage reported for an SQP was far lower, at £8,800, while the highest wage reported was the same (£33,700).

In other findings, it was found that respondents from greater London received the highest average salary (£24,753), while those based in the Midlands and Merseyside received the lowest (£17,873)

It was also found that salaries paid to VN degree holders tended to be lower (£19,160) than those without degrees (£19,902). However, SPVS believe the smaller amount of years since qualification (3 for degree holders, 7 for non-degree holders) could explain the difference, as there is a definite correlation between the years of experience earned and the amount of wage paid.

You can click here to visit the BVNA website for the full report

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U.S. pet ownership declines from 2006 to 2011

from an article by Kristi Reimer in the DVM360 news magazine

Dog ownership down a little; cat ownership down more, according to AVMA demographic study

The percentage of pet-owning households declined 2.4 percent over the last five years, according to a study of 50,000 pet owners conducted by the American Veterinary Medical Association (AVMA). An Aug. 4 preview of the 2012 U.S. Pet Ownership and Demographics Sourcebook, to be released this fall, revealed that the percentage of households owning dogs decreased 1.9 percent, while households owning cats declined 6.2 percent, although cats still outnumber dogs as pets.

“Obviously the recession is probably a big reason for this decline,” says Karen Felsted, DVM, MS, CPA, CVPM, president of Felsted Veterinary Consultants and presenter of the data. “But there may be other reasons as well, and we need to find out what those are.”

The study did find that veterinary visits for dogs were up 9.2 percent, but the feline decline has continued, with cat visits down 4.4 percent since 2006. The average number of veterinary visits per dog was 1.6 times per year, while the number of visits per cat was 0.7 times per year. “What I find particularly disturbing is that 45 percent of cat-owning households never visited a veterinary clinic in 2011,” Felsted says. “That’s up dramatically from 35 percent in 2001 and 36 percent in 2011.”

Here are some other study findings presented by Karen Felsted:

  • Pet owners spent $28 billion on veterinary care in 2011, with about two-thirds of that spent on dog care, a quarter going toward cat care and the rest spent on other types of pets.
  • While there was an increase in expenditures for both dogs and cats from 2006 to 2011, Felsted says mean expenditures per pet were flat with inflation taken into account. Plus, 51 percent of dog owners and 74 percent of cat owners spent less than $200 per year on veterinary care, which Felsted considers the minimum for basic preventive care.
  • Six percent of dog owners and 3 percent of cat owners reported that they had insurance for their pets. “I thought this was interesting because it’s higher than the 1 to 2 percent you usually hear quoted,” Felsted says.
  • Eighty-six percent and 78 percent of dog owners said their pet was average weight. “Now do you think they’re right?” Felsted asked the audience. “We know from the Banfield State of Pet Health Report that there’s been a 37 percent increase in overweight dogs and and a 90 percent increase in overweight cats. I think their perception may be skewed.”

“So what does all this data mean?” Felsted says. “It means that with fewer potential clients, we need to provide more extensive care. We need to look at our marketing, perception of value and pricing. Plus we need to get back to basics. We’ve talked about the ‘wow’ factor a lot, but a bandana on a dog doesn’t mean much if the client had to wait for 45 minutes in the waiting room.”

You can click here to visit the DVM360 website

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Consumer confidence, the economic situation and veterinary practice

From an article by Mark Stallwood published in the Stallwood Consulting Services blog

According to the media, small business is suffering in the current economic climate and suffering badly. There are stories every day in regard to share market fluctuations, the US political and economic crisis, the European sovereign debt crisis and more. It is easy to become overwhelmed and despondent about the future of your practice, however it is not all doom and gloom.

Let’s look at some of the economic commentary surrounding each of these areas. The US is going through a major economic restructure with a shift from a manufacturing base to a predominately service base, the economy is also still adjusting to the fallout from the sub- prime crisis. These two factors will have effects for some time to come, but corporate profits in the USA are actually quite strong, but this is not being transferred into jobs growth, at the moment. Overall the gloomy picture is effecting consumer confidence in Australia and causing wild fluctuations on the share market.

The European situation is different; here we are talking about the likelihood of Governments defaulting on their debts. While it is unlikely that this will occur, the pain felt by the Eurozone in bailing out some of the weaker economies will restrict the cash that governments have to spend on other areas. There is likely to be cutbacks particularly in public service areas that will also impact on employment.

Asia is the standout economic region at the moment, with continued solid growth in China, albeit at a slower pace than a year or two ago.

So what does all of this mean for Australia, and in particular veterinary practice?

Overall, consumers have become more cautious in their spending. Those retailers involved in the end of the market where discounting is common are reporting a slowdown in sales, irrespective of the size of the discount. It would seem that consumers may have realised that if they wait then things maybe even cheaper. Similarly we are seeing more people move to purchase online; while this is not as sudden a phenomena as some retailers would have us believe, it has now reached a critical size that is impacting on most businesses.

Interestingly top end retailers, those that provide high level service and customised products are reporting strong sales growth. In general the Australian economy is strong, but businesses are being impacted by the crisis in confidence i.e. from a consumer perspective will I have a job and can I pay my bills?

So …..for veterinary practice the story seems to be, if you have focused on a low cost or discount market then your customer base maybe holding back on their spending to wait and see how things change. They may even start to look for greater levels of discounting. If you have focused on high end service and provided good value for the dollars that clients spend (note this is real value not just providing lots of service for a low or no price), and have built a customer base that is loyal then business should still be growing although maybe not as fast as it was 3 years ago.

When will all of this end? Well the pundits are divided. Some say that the current business environment should now be accepted as the new normal and things will never go back to how they were; others are saying that things will improve, but that it will be slow and could take up to 5 years to get back to the booming business days that we all remember.

Not being an economist, just an interested observer I would always bow to greater knowledge but it seems to me that we have forgotten that business is cyclical, and that a significant number of the consumers we deal with in veterinary practice are not driven by purely economic factors. Most practices see a large percentage of pets that are family members; people want the best possible care for them. We need to present the treatment options and let people decide.

If you start to discount prices to attempt to drive business, then you had better start to look at your expenses and even the overall structure of your business. This is a downward spiral that you don’t want to get into, because it is difficult to pull up before disaster.

Business conditions will improve. Good clients are still spending money on high quality service. Look beyond the next newspaper headline of doom and gloom.

Where do you want your practice to be in 5 years from now and how will that influence your decisions now?

You can click here to visit the Stallwood Consulting Services website

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Be the business

from an article by Andrew Roark DVM MS in the website

Veterinarians, generally speaking, are not self-centered people. Focusing on others helps us to build relationships with our clients, empathize more deeply with our patients and create stronger teams with our staff. This tendency to avoid a selfish outlook does not, however, make us the best veterinarians that we can be. To grow as doctors, make ourselves maximally valuable to our patients and our employers and achieve true job satisfaction, we need to pay attention to ourselves. We need to understand what our career options are; how we want to grow; what our strengths, weaknesses and passions are; and what success looks like for us as individuals. The best method I have found for achieving this mindset is trying to view myself as my own business. (I think Andy, Inc. has a nice ring to it.)

Before you skip to the next article, let me say that I know that thinking about business is probably not your favorite thing to do. Most veterinarians would probably rank strategic business planning right up there with watching C-SPAN and getting a flu vaccine in the list of awesome things to do on your day off. Career planning is not sexy, but you know it is important. And this method is a quick and easy way to wrap your head around what you are doing and where you are going as a veterinarian.

Now, let’s pretend that you are your own business and you work for no one else. Are you doing the following things well?

Setting your price

For most associates, figuring out what to ask for in an employment contract is like playing basketball with small children. You worry about being humiliated and taken advantage of in a way that even your close friends will never let you live down. You also fear being perceived as an egotistical jerk who treats poor, good-hearted practice owners mercilessly for your own pleasure. But if you think of yourself as a business, you can escape that feeling by asking yourself: “Are my prices fair? Do they reflect my value to the consumer (practice owner)? Will they keep me in business?”

If the answer to any of these questions is no, then you need to negotiate. And it offers some direction on what you should ask for. Remember, asking an outrageous price for your services or nickel and diming your client (practice owner) is not how you want to run your business. However, you also can’t survive if your costs to live are greater than what you are able to bring in. You need to know what your overhead expenses are (your personal living expenses including debt), and what value you can bring to the hospital (both financially and culturally). If you have these key pieces of information, you can take an educated stand on your salary and benefits.

Sometimes your potential client (practice owner) will not be willing or able to pay the price that you are asking. You have the power to try to negotiate further, to accept the arrangement your client is proposing or to find a different client. Remember that money isn’t everything, and sometimes it’s better to make less money and work for a client that fits your style. Just never forget that you always have to be able to pay the bills.

Protecting your reputation

When you go to a Ritz-Carlton Hotel, you know what you are going to get. The people at the front desk will be available, the cleaning crew will have the room ready, you won’t see any emotional meltdowns from the staff and management will not be caught yelling or throwing things. This dependable, committed approach to service exemplifies professionalism, and it is the easiest way to build and protect your reputation.

Consistently behaving professionally will increase your value to the practice, protect your reputation in the veterinary community and ultimately provide you with credibility and career options. You have to do it every single day–even when the urge to go “Jersey Shore” on certain staff members is overwhelming–but it will pay off in the end.

Building your brand

How do you want your clients, your peers and the staff to think of you? Are you the gifted surgeon, the local expert on avian medicine or the compassionate guardian of underprivileged animals? When you share your interests with clients in person or on your website, when you consider taking a different job or when you research CE opportunities, never forget who you want to be. If you tell people what your interests are and you actively seek opportunities to build skills in those areas, then you are guiding your career toward your dream job, even if you aren’t 100 percent sure what that dream job is. Keep focusing on the areas that you are passionate about, and people will seek you out with opportunities to do what you love most.

Thinking of yourself as a business, especially when your work schedule and conditions are largely dictated by your employer, probably feels a bit odd. However, this mental exercise can empower you to make your career what you want it to be. So, Dr. CEO, what do you want to be, and how are you going to get there?

You can click here to visit the DVM360 website

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Whole Practice Success Alignment

by Demian Dressler DVM

Aligned. Congruent. Consistent. When a group of people are working together, these traits create results. Things happen. We go places.

But when a group of people are working together but are misaligned, incongruent, and inconsistent, we don’t move. Or we may go backwards.

Your veterinary practice is made of different people with different ideas, thoughts and motivations. Consider the front staff alone. How many different people are there? How about the back staff? The Doctors? Management?

The truth is that a veterinary practice is a complex mix up of many different flavors of people.

How aligned are these different people? Are they really moving in the same direction?

If we toss these ingredients together and see what happens, our dish will probably not be very appetizing. But, if we use a certain amount of this one, prepare it just so, and combine it with that one, also prepared properly…magic happens!

What is the thing that allows us to get where we want to go? What is the dish we are going for?

To cut to the chase, the dish we are going for is the practice vision. This is the desired outcome of the practice, in how it benefits those who work in it or on it.

Veterinary practices can create stress, fatigue and burnout. However, they can also create excitement, fulfillment, and prosperity.

How well does the practice support the needs and preferences of the owners? The Doctors? The staff? What does the practice do to help their lives be better? Can things be changed so the practice supports the people within the operational system? Can the organizational processes be altered to better suit life happiness?

Notice that the Cornerman use of the word “vision” is not about the work product. In other words, it is not about the work of the practice in helping pets and people. In Cornerman training we call this the “mission”.

The difference quickly points to some interesting beliefs that we carry concerning the two roles the practice plays.

The vision is the desired outcome of the practice for those who it is supposed to be supporting (owners and staff).

The mission is the desired outcome for those the practice is serving (patients and clients).

Outcome oriented work processes bring the practice closer to what we want, when viewed from a wide angle lens. Does the orientation of the practice produce stress, fatigue and burnout? Or does it create excitement, fulfillment, and prosperity? The outcome orientation is deeply rooted in the practice culture.

How Does Your Practice Culture Stack Up?

What is the effect of your practice culture? Does it move towards a certain outcome?

Vertical integration of the vision is when each level of the organization gets us closer to the desired outcome. From the kennel staff to the owner or partners, everyone is moving, with each task, towards a clearly defined outcome that everyone prefers.

Is the leadership connected with the remainder of the practice? Is there a clear channel of communication? Is everyone on the same page and is the page a good one? Sometimes there are nests of disconnect, conflicting values, and lack of synergy in veterinary practices. No vertical integration means activity with limited productivity.

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