Practice Management News and Views from around the World – December 2018

Hiring a Millennial

With acknowledgment to

Vet practices face axe under Pets at Home shake-up

From an article by John-Paul Ford Rojas published online by SkyNews

Hundreds of Pets at Home workers are facing uncertainty after the retailer announced an overhaul involving dozens of its vet practices.

The company has earmarked 30 sites, employing up to 300 people, for possible closure - though it hopes to redeploy workers nearby where possible.
It is shaking up its vet practice business after a review of the division identified many sites were under pressure from salary costs - and the fees charged by the Pets at Home parent company.

One analyst said a decline in the number of EU vets in the UK was putting pressure on pay.

The changes were announced as the group reported an 80% fall in pre-tax profits to £8m for the 28 weeks to 11 October, largely thanks to a £29m hit from the vet practice changes.

Stripping this out, profits were still 9% lower at £38m.

Chief executive Peter Pritchard, who joined in May, announced the overhaul of the vet practice business after a recent rapid expansion in the division.

He said: "I recognise we have grown at pace and, more recently, have seen the pressure that rising costs are placing on this young business. "We will need to recalibrate the business to deliver more measured growth whilst maintaining our plan to generate significant cash profits."

Pets at Home operates 471 sites through its First Opinion vet business.

It now plans to buy back 55 of the practices that it operates through joint ventures with vets. "Around 25 of these will be operated as company-managed practices, whilst we consider the options for the remainder, which may result in us proposing to close them," the company said.

Nicholas Hyett, equity analyst at Hargreaves Lansdown stockbrokers, said it represented a major shake-up "as the vets' partners struggle to make sufficient money to pay Pets' fees and still take home a decent wage themselves".

"That's partly due to factors outside Pets' control," Mr Hyett added.

"A decline in the number of EU vets in the UK is putting pressure on salaries and also making it more difficult to find new partners."

Selected Tips for Improving Productivity Among Small Business Owners

From an article by by Annie Pilon published online in the

As a small business owner, you only have a finite amount of time each day to get things done. But you likely have an almost endless amount of things that you’d like to accomplish. So you need to find ways to make the most of the little time you have to work with.

If you’d like to get more done in less time, you need to find small ways to improve productivity for both you and your team. Here are some tips you can use for improving productivity at your small business.

Tips for Improving Productivity

Identify and Do the Most Important Tasks, Delegate the Rest

Delegating tasks to your team members can give you more time to focus on the really important items on your to-do list. But first, you need to determine what those important items are. Go through your to-do list and identify the items that only you can do or that are essential to your operations. Then find team members or contractors who can handle the items that don’t fall into those categories

Prioritize the Items on Your To-Do List

You should also go through your list to find which items are the most urgent. The tasks that have to get done right away should go at the top. And more long-term projects can go on a separate list so that they don’t cause overwhelm or distract you from those more urgent items.

Get the Least Desirable Tasks Out of the Way Before Lunch

On every to-do list, there are items that you just don’t want to do. Anything that you’re dreading is going to cause you more stress than other tasks. So it’s best to get those things out of the way early. Pledge to complete those pesky items before lunch so that you can take a break as a reward for completing them.

Stick With One Task at a Time

Multitasking might seem like a great way to get more done. But studies have shown that trying to do two things at once can actually slow you down. So instead, stick with one task until it’s completed, then move onto the next item on your list.

Set a Timer for Lengthier Tasks

If you have items on your to-do list that need to be broken up throughout the day because they take too long to do at once, outline exactly how much time you plan to spend on those items per day. Then set a timer when you start those items so you don’t get caught up and forget to look at the other items on your list.

Finish Quick Tasks Right Away

On the other end of the spectrum, when you have small tasks like quick phone calls or emails that are cluttering up your to-do list, it can help your productivity to get those things out of the way early. Then you can focus all of your energy on just one or two major projects throughout the rest of the day.

Find the Right Collaboration Tool for Your Team

When working with a team, you need to be able to communicate with them quickly and efficiently. That means you need an actual system that everyone can use to update their progress on different projects, instead of relying on emails or meetings where you need to go out of your way to ask them about those items. Project management tools like Google Docs can help your team collaborate and share information quickly and easily.

Make Sure All Meetings Have Clear Agendas and Cut Out Those That Don’t

Meetings can be absolutely necessary for keeping your team on track and your clients happy. But they can also be huge time wasters. To avoid getting trapped in unproductive meetings, make sure that every one you host or attend has a set agenda.

Not only should every meeting have a purpose, but it should also have a strict schedule that outlines which items to discuss when. That way, you can be sure you’re only attending meetings that will make you more productive instead of those that will simply waste your time.

Schedule Breaks and Exercise

You also need regular breaks throughout the day to keep your mind sharp. Instead of getting caught up in your to-do list and just mindlessly working the day away, schedule a few quick breaks throughout the day to get up and walk or stretch. You can even set an alarm or timer so that you don’t forget.

Stay Off Social Media During the Day

In fact, it can also be beneficial for you to stay off of social media throughout the workday if at all possible, at least for your personal accounts. And for any business related accounts, you should set aside time to schedule posts and respond to inquiries on social media rather than checking those items constantly.

Give Your Team a Clear Direction From the Start

As a small business owner, you can only get so much done on your own. But your team can help you accomplish much more, if you let them. However, if your employees need to constantly come to you to ask questions or get the okay to move ahead on projects, it can halt your productivity and theirs. Instead, give them clear instructions for their specific duties and projects so that they can work more independently and only come to you or other managers when it’s absolutely necessary.

You can click here to visit the SmallBizTrends website

Combine These 2 Ingredients to Enhance Client Compliance

From an article by Amada Donnelly published in her newsletter

For as long as I can remember our profession has discussed client communications that enhance client compliance. So, what have we learned and what’s changed? Well, the competitive landscape and profession has changed dramatically since I was a kid working in my dad’s small animal practice. But what hasn’t changed is that clients still value the relationship they have with the veterinary team when making decisions about care for their beloved pets.

When this relationship is based on trust and a sense of family, pet owners are more likely to come in, agree to services and refer their friends. Unfortunately, gaining the trust of clients is harder now because of competing distractions clients face (think Internet, low cost alternatives, less discretionary income). Moreover, clients often feel overwhelmed with all our recommendations for high quality care and think “does Chloe really need this?”

As I reflect on my 15 years in clinical practice and my observations working with practice teams, I believe the 2 secret ingredients to successful client communications and enhanced compliance are Authenticity and Confidence. Confidence without authenticity leads to pet owner mistrust and skepticism. Authenticity without confidence may result in confusion and inaction.

Look at the following aspects of your communications and consider how authentic and confident you are when making recommendations.

  • 1.Do you give clear recommendations or use vague, indecisive language such as “It might be a good idea… ” or “We could do…”?
  • 2.Do you clearly explain medical options when appropriate and convey the risks and benefits of each along with a recommendation for which course of treatment you think is best for the pet.?
  • 3.Do you give clients facts and accurate information? There’s a difference between using lay terms clients can understand and “dumbing it down”. Likewise, using scare tactics or judgmental phrases to motivate clients is never a good idea. 
  • 4.Do you ask clients open-ended questions about their knowledge and viewpoints so they become a partner in making decisions about their pet’s care? Examples include “Tell me what you know about senior laboratory testing?” and “What concerns do you have about the treatment plan I’ve outlined for Belle?” 
  • 5.When tracking compliance and setting target goals for the team, do you focus on patient advocacy rather than hitting a number? Make sure employees know any target goals are in place to help pets get the care they deserve so they can live longer, happier lives. Clients would surely be put off if they thought a recommendation was made just so the hospital could hit a revenue goal.

You can click here to visit Amanda Donnelly’s website

Telehealth: Opportunities abound

From an article by Edward Blach published on the IsMyPracticeHealthy website

There has been much discussion and even consternation about telehealth in veterinary medicine for the past several years. The word 'telehealth' conjures up many different visions of what it means, how it might impact veterinary medicine, and how it could impact veterinary practices.

Let's start by first defining the terms, 'telehealth' and 'telemedicine'. The AVMA defines them as:

  • Telehealth: the overarching term that encompasses all uses of technology geared to remotely deliver health information or education.
  • Telemedicine: the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.

The distinction between these two terms involves the delivery of information or education (telehealth) versus the delivery of medicine (telemedicine). The Veterinary Client Patient Relationship (VCPR) limits telemedicine from being used to establish new client relationships, but it is important for practices to understand how technology can help them serve clients and even reach new clients.

Animal owners want to use technology to receive simple answers and animal care services similar to how they recieve services to meet their daily needs. If practices want to remain relevant to their clients, they should identify those telehealth services that meet client needs and also allow them to deliver appropriate care.

Many practices will not answer simple questions over the phone. This process puts questions in clients' minds regarding motives for not answering questions via phone. Clients have gotten suspicious that veterinarians only want them to come in so that they can charge them big fees. It's not a positive situation when the incentives between service provider and the service recipient are not aligned. If veterinarians make clients come in to the practice to get questions answered, then the incentives are not aligned. Veterinarians should get paid for helping clients not have to come in to the practice, which is known as 'wellness'. Clients don't like coming to the practice when it's not absolutely required. It's inconvenient and expensive.

Telehealth technologies actually help align the incentives by providing a way to screen patients to reduce unnecessary visits. Telehealth also helps clients connect with their veterinarian earlier and more frequently in their cycle of need. Therefore, it will drive valuable clinic visits, and reduce wasted use of staff and facility resources when a visit isn't necessary.

These are just a few reasons to explore optimal use of telehealth. Use telehealth to optimize the care you provide. There are many opportunities to improve customer and patient care through the use of these modalities. Find those that are a fit for you and use them to provide exemplary care and to stay relevant in a changing world.

You can click here to visit the IsMyPracticeHealthy website

Growth Opportunities amid Corporate Consolidation

From an article by Kristen Coppock published in the Veterinarians Money Digest

The evolving landscape of veterinary practice ownership doesn't have to mean the end of independent ownership. Here's how to thrive in the face of increasing corporate consolidation.

In a practice ownership landscape that is increasingly corporate, independent veterinary practices can continue to thrive, accordng to Michael Dicks, MS, PhD, chief economic adviser for VSOP Solutions-Calico. At the 2018 NY Vet conference in New York City Dr. Dicks recognized the ownership challenges independent practices face and outlined ways to help ensure a sound future.

There has been significant growth in the number of corporate veterinary practices in the United States, from 2126 corporate practices in 2016 to about 35,000 today. “This is corporate consolidation,” Dr. Dicks said. “We’re losing a lot of independent practices.”

He noted that while corporate businesses represented only 20% of practices in 2016, those practices provided half of all services to pet owners. Meanwhile, larger practices are growing at a faster rate than smaller practices, which are typically owned independently. Between 2015 and 2017, Dr. Dicks said, tier 1 practices, the largest businesses, grew 16.6% compared with 10.7% growth for tier 4, or the smallest practices.

In a landscape where corporate consolidation and faster growth of larger practices is common, Dr. Dicks said that practice owners have opportunities that can help them better compete in the market.

One way to grow an independent business is to look at providing lower-cost services at a higher volume. Dr. Dicks said there is potential in this type of business model that many owners have not considered. Lowering the cost of some services can help independent practices better compete against corporate practices, which can offer lower prices through bulk purchasing. “Typically, we focus on how we can raise prices to increase profit,” he said. “Low- to middle-income people are 50% of the population. They have pets, too.” A higher volume of services provided to more clients would help keep practices profitable.

Independent owners can also increase the value of their practice—making it less desirable to corporations—by reinvesting in their business, including their employees. “Production benefits profits,” Dr. Dicks said. “Don’t go it alone. You have to find someone to run your business who you trust.”

For some independent owners, hiring a skilled employee to manage the business would help keep it running smoothly. Having administrative help also affords veterinarian owners more time with clients and patients. Investing in practice assets, such as land ownership, also adds value and potential profits to an independent practice.

Dr. Dicks also recommended developing a succession plan that will give associates some ownership of the business. A veterinary stock option plan may be a viable solution, he said.

Overall, independent veterinary practice owners can emulate private equity firms to remain profitable and competitive with corporate practices. Dr. Dicks suggested a focus on making money by building balance sheets and taking stock of where profits and losses are coming from. Private equity firms also rely on what their clients are telling them, as well as examining the competition. According to Dr. Dicks, they are looking at target markets and where there might be opportunities to capitalize, such as where the market can support price increases, cost cutting, and sales growth.

You can click here to visit the Veterinarians Money Digest