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

If I could talk

There are things in business much more important than numbers.

From an article by Colin Bielckus published on the Ian Dickson website

I’m not the average, typical accountant I have to say. Numbers are a part of what I do but numbers are not the be all and end all of my life – there are things in business much more important than numbers.

Don’t get me wrong – it’s infinitely more useful to have them than not have them but they are a tool – and just one of the tools in your armoury if you are running a business.

Numbers tell you what you’ve done and (if you’re forward looking) you can see what you actually did against what you expected to do but, if they’re a few £s out, does that affect your decision making process? – Hopefully not.

I’m not going to tell you how to run your business – not in a few hundred words anyway – but I would just like to mention a few things I’ve found out on the way through my business life.


For good decision making it’s better to have something up-to-date, even if some of the numbers are best estimates. Just make sure they are indeed your best – and be realistic.

Co-operation vs. competitive working

I’ve been out of kilter with the business world for years over this but it looks as if everything is changing in my favour – life’s much nicer if you get on with everybody, even in your own industry and there are loads of people who might not be my ideal client but would be a perfect fit for someone else. Following on from the above, be generous. Give with no expectation of return and you will be surprised how life has a habit of making it up to you from some other source.


Having an adversarial relation with your staff does no one any good. If I had a £ for every time I’ve said “if it wasn’t for person X this job would be straightforward”, I’d be a very rich man indeed. But – if you and your staff have a common goal (or at least overlapping ones) your business will do better than one where they do not – and it’ll be a nicer place to be. By the way, I frequently (always?) add clients/customers and HMRC to the above quote…

Hard work

If hard work and lots of it made you successful, teachers and janitors would be the best paid people in the country. Doesn’t happen does it? Life’s just not fair – live with it!. My daughter Penelope runs my Instagram account and I pay her to do so – inspirational quotes and some narrative to go with it – she finds it easy, I don’t. So give it to someone who actually likes to do the things you find hard and give yourself time to do what you do best.

Lovely story I read about a software engineer (publication upon request) who was earning $250k and was considered to be the firm’s best engineer. It was later discovered he spent his entire working days looking at social media and had outsourced all his coding to a firm in China at a cost of $50k!

Needless to say the firm fired him. Nowadays I think I’d probably promote him (as does the author) if he was working for me. Get him to set up a department to do it properly! “Question is – What would you do?”

You can click here to visit Ian Dicksons website

Top 5 Reasons Your Practice Has No-Shows (and What You Can Do About It)

From an article published on the DVMelite website

At last check, the industry-wide veterinary no-show rate averaged between 9-11%. That means that even on the lower end, most clinics experience a no-show rate of about one out of every 10 appointments. That adds up to anywhere between 23 and 29 missed appointments per year.

What all of this really boils down to is lost revenue. In order to reduce this risk, it’s important to first understand what’s actually causing these no-shows to occur in the first place. Only then can you take the appropriate measures to avoid them down the road. Let’s take a look.

Reason #1 – They forget.

Life gets hectic. Keeping up with appointments can be tough, which is why client forgetfulness is the number one reason for no-shows. Admit it – it’s happened to the best of us. Thankfully, there’s a pretty straightforward solution to this, and that is scheduling reminders.

Providing a courtesy confirmation call a few days prior to a scheduled appointment can be enough to keep the majority of your forgetful clients on track and cut down on costly no-shows. Beyond just phoning, however, text confirmations or push notifications can be even more effective, as they eliminate the risk of a missed voicemail message.

Reason #2 – Last minute issues or emergencies crop up.

Unexpected situations arise for everyone, including your clients. In fact, last minute problems or emergencies are the second most common reason for veterinary visit no-shows. Unfortunately, there’s not a ton you can do to prevent these scenarios from occurring in the first place. You can, however, make an effort to drive home the importance of calling ahead to cancel (whenever feasible).

You should also have a plan in place for managing those unavoidable situations when a client simply can’t keep their appointment. Be understanding and flexible, and do your best to reschedule them as soon as possible.

Reason #3 – Their sick pet gets better.

When a sick pet takes a turn for the better and his or her health appears to improve, a client may feel that their scheduled appointment is no longer necessary. Ideally, your clients will be courteous enough to pick up the phone and call in to cancel in advance, but we all know this isn’t always the case.

You and your team can reduce the chances of no-shows by specifically requesting that they call if anything changes. For instance, when your receptionist is on the phone scheduling the appointment, a simple reminder to call in and update if the pet starts to feel better can do wonders.

Reason #4 – Financial constraints.

Like it or not, keeping a pet healthy costs money, and for clients struggling with finances, this looming expense can be enough to result in a no-show. For instance, a client may simply no longer have the funds today to cover the appointment he or she booked six months earlier.

There are a few different strategies for addressing this no-show reason, and the approach you take will ultimately depend on your preferences and your practice policies. One option is to offer payment plans to accommodate those who may be experiencing financial difficulties. You could also promote the use of pet insurance to help defray some of the costs and make your care more affordable. At the very least, try to be understanding.

Reason #5 – Bad weather.

Depending on where your practice is located, inclement weather can have an impact on whether or not your clients will keep their appointments. Like emergencies, there isn’t a whole lot you can do to avoid a weather situation, but thanks to the increasing accuracy of meteorologists, you can prepare for such an event in advance.

When bad weather is in the forecast, plan ahead by sending out a notice to all of the clients who are scheduled for visits. Politely request that they call ahead if they are not going to make their appointments and then use the available slots to handle last minute emergencies. While there’s no way to prevent no-shows entirely, there are certain practices that you can implement to help keep them at a minimum. Remember that communication is the most important factor. If you take a proactive approach and treat your clients with respect, they’ll be much more likely to return the favor by calling ahead when they can’t make it in to the clinic.

You can click here to visit the DVMelite website

Conference Helps To Improve Your Business Performance – 3 Great Tips

From an article by Jerry Crick published on his VetBizBlog

Did you go to the SPVS / VPMA(VMG) Congress? I hope so, it was a grand event with lots of people and great ideas. In case you are not aware, VPMA is now VMG – Veterinary Management Group. The new name is an effort to communicate that all managers are included in the VMG domain – not just ‘practice managers’.

Please, if you did not make it this year, do add the event to your calendar for next year – it is truly great value, just one new idea can easily pay for the conference in a month or two. As you might imagine I spent most of my time there debating the pros and cons of business ideas/choices with practice owners and managers and key people from suppliers across the UK.

Two things became clear: first, independent practice needs more tools to combat the competition from corporate owners; second, delegates are seeking high quality management advice across all aspects of veterinary practice. Just what this blog is all about!

Here are three tips I picked up over the weekend.

Pet Health Clubs

Many practices now run PHCs. We had such a club in our practice. In fact it worked quite well and we had over 1,000 members. But, we could never get much more than that, maybe we didn’t try hard enough with clients or it just wasn’t uite as attractive as we thought. Hey-ho.

This weekend maybe I have found out why. I spoke with a practice manager where they have a PHC with free consults. Now, I don’t mean two free consults per year, I mean all consults are free. Scary huh! Maybe not. Their practice is not dissimilar in size to our own, but they have 5 (five) times the number of PHC members. Free consults is a really great benefit to customers, even if they are paying a bit more per month for the PHC. And vets love to get clients back for a quick re-check knowing it won’t cost them a penny. So they come back. Time after time each time spending money in the practice.

Remember too that my figures for PHC members indicates that they spend 70% more than non-members.

Client loyalty must be huge. The loyalty and the extra visits gives every practice a massive opportunity to communicate more often – clients will not object to weekly emails plus specific emails about their pets..

The take away from this is:

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    If you don’t have a PHC get one soon – Recommendation:
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    If you do have a PHC consider changing to include all free consults or have a new ‘Platinum’ tier which has all free consults.

CT Scanning

I have long advocated independent practices should consider acquiring CT not only for their own patients but also to offer to other local practices as an outpatient referral service. The numbers really do stack up.

With a scan charge of between £600 and £800 and the ability to do 10 per week and the likely cost of running this being in the order of £2000 per week it is relatively easy to make the numbers work to generate a healthy profit over a 5 year period.

You will need space, a high voltage three phase electrical supply, a building which does not vibrate too much, relevant safety screening etc. If you have the space it is a no-brainer. If you can acquire the space at reasonable cost – still a no-brainer.

Go on, check it out.

Holiday Management

Several people have commented on the difficulty of managing holidays, especially when you have 10+ people and/or multiple sites. There are some unusual systems out there including one where they use photographs of a calendar to send round each branch and as you can imagine it is always out of date. Some of the problems people have experienced with their holiday systems include:

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    Lack of transparency – this is very frustrating for staff as they can never know the current picture and it makes it hard to work out holiday is still remaining.
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    Paper trail failures – this is one I suffered badly – lost pieces of paper and staff claiming they had sent in holiday requests even if they had not.
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    Tracking actual taken against allowance – the simple way round this is to keep a spreadsheet with all holidays and allowances and keep a tally – but it still takes time.
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    Difficulty in controlling how many people are off at one time – especially in multi branch practices.
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    Over booking locums because of poor holiday control.

The takeaway: find a way to manage holidays with an online holiday system which provides the ability for staff to request holidays, managers to accept or reject, and reports to keep you up to date with statistics etc.

You can click here to visit Jerry Crick’s website

6 Steps for Responding to Client Complaints

From an article by Greg Kelly published on the Veterinarians Money Digest website

Client complaints are inevitable, but they don’t have to cause monumental problems. Just follow these six steps to diffuse client grievances.
All veterinary practices are bound to receive complaints. Some may be factual, while others may be based purely on emotions. Some will be large, and others relatively small. Regardless of the size or scope of the grievance, Charlotte Lacroix, DVM, JD, CEO of Veterinary Business Advisors, says it’s always best to take complaints seriously and respond quickly.

This approach will mitigate damage and prevent issues from spiraling out of control. Generally, clients sue or complain in an official capacity if they think the veterinarian was either unresponsive or negligent. It’s often the unheard client who escalates a complaint to higher authorities or pursues litigation.

Dr. Lacroix suggests taking a six-step approach after receiving a complaint to improve client satisfaction and stop a potential malpractice suit in its tracks.

Step 1: Listen First

Above all else, let them be heard. Give the client filing a complaint your undivided attention and don’t interrupt them. Many times the client just wants to vent, and the mere act of listening and documenting the talk can improve the situation immensely. Allowing the client to fully offer his or her own point of view can work wonders.

Step 2: Be Objective and Calm

To avoid reinforcing the client’s perception of careless or inappropriate acts, put defensive or emotional responses aside. Keep in mind that unhappy clients mostly want to be heard whether they are right or wrong. You also need to realize that even reasonable complaints don’t necessarily mean your practice was careless.

Step 3: Make Your Points, Too

Failing to adequately communicate with a client is the source of many lawsuits. It’s highly unlikely that you will over communicate to the client. Don’t leave things unsaid because the client may have had unrealistic care expectations or may not have fully comprehended a diagnosis or course of treatment. To best deliver the message, get informed consent, offer free estimates, encourage questions, explain services with handouts and speak without any medical jargon, which often confuses and intimidates clients.

Step 4: Display Empathy and Concern

The loss of a beloved pet often brings out sadness in a client, as well as the need to blame someone — namely the veterinarian. Practitioners are more likely to manage a client’s feelings about a pet’s death if they act with empathy and courtesy. Clients who may be having coping difficulties should always be directed toward a grief counselor or pet loss support group.

Step 5: Train the Team

Since veterinary staff plays a key role in managing client complaints, they require the proper training in how to handle these tricky situations. They must always act professionally and seek to sidestep any contentious conversations with clients. Additionally, many clients are more intimidated by the veterinarian as compared to other staff members, which can make for less hostile conversations.

Step 6: Never Admit to Mistakes

It’s only human to want to apologize when things go wrong, but flat out apologizing or taking responsibility should be avoided. The problem with doing so comes when a client files a lawsuit. With more complicated cases where a malpractice charge is made, veterinarians should quickly reach out to their lawyer and/or insurance company before admitting any fault or considering a settlement with the client.

You can click here to visit the Veterinarians Money Digest website

How Improving Employee 'Experience' Can Boost Your ROI

From an article by Jennifer Post published in the Business News Daily website

No company could be successful without its employees. Even the best product in the world needs to be backed by a company full of people who care about that product or service, work to make it accessible, and strive to keep it going. Yet, so many companies don't emphasize employee experience inside the workplace. Some business owners and CEOs may not see how spending money on a program to boost employee experience can be a strong investment.

Employee experience is a holistic environment that organizations purposefully design to enable employees to thrive, according to Rachel Ernst, head of human resources at Reflektive.  "It is the sweet spot where the employees' and the organization's needs, wants, and expectations intersect to ensure that both sides are successful and satisfied," Ernst said.

A 2017 Global Human Capital Trends report explains how employees look at everything that happens at work as a whole, and how all of those experiences impact the daily life of an employee. The report also stated that organizations focused on improving employee experience go beyond talking about employee engagement and culture, instead focusing on the overall experience, from HR to management to workplace practices.
Here are some tips to integrate and boost employee experience at your company.

1. Ask questions.

Start by asking employees what you can do to give them the kind of environment they need to be successful in their jobs. The best way to understand how to improve is going straight to the source for feedback. Ernst said to ask, listen and then act.

"Many organizations try to 'develop' people versus focusing on how to coach them to grow themselves," she said. "Create workshops to help employees understand what motivates them, what their key strengths are and their most important skills."

2. Give feedback.

Giving the type of feedback employees need is crucial. Ernst said that this means frequent, specific and relevant feedback. Require managers to check in regularly with employees and discuss progress toward goals, roadblocks and areas that are lacking.

"Make sure that managers are asking what their employees need in terms of training, coaching and resources or support," Ernst said. "Last, help managers to articulate how their employees' work and goals align with the company's overall goals and purpose-driven mission."

3. Track progress.

"No great employee success program is complete without some way to measure and continuously improve," Ernst said. "People analytics tools can help you take the experiential temperature of employees and quantifiably measure their satisfaction and engagement."

She added that this can help you to identify what works and what doesn't, and to adjust quickly before it starts affecting employee performance and satisfaction.
Marc Solow, managing director of Deloitte Consulting LLP's Human Capital practice, noted the importance of implementing a program to boost employee experience.

"A disengaged employee is one who will likely be less loyal, passionate and even less productive than an employee that is engaged," he said. "A workforce with an unsatisfactory experience can drag down performance and hinder efforts to drive change within an organization."

If employees are having positive experiences at their workplace, they are more likely to stay at that company. Then, once word gets out about this company's culture and emphasis on creating a positive and powerful employee experience, more people are going to want to be a part of your company.

"Employee experience is paramount to successful recruitment and retention," Solow said. "Unhappy or unsatisfied employees will likely share their experiences, and word will get out that an organization is not one where people want to work. As demand for skilled talent grows more competitive than ever, positive employee experiences will be a huge factor in winning this talent."

Unemployment is at a 17-year low, and Ernst noted that employees have plenty of choice in where they work. Companies are doing everything they can to attract the kind of talent that best represents their company missions and values. If your company isn't providing the kind of experience that employees are looking for, there are other companies out there that will.

"In today's world of digital, tech-savvy, in-demand resources, employees simply will not stay with an organization if they do not feel their demands and expectations are being met," Solow said. "As technology continues to explode and become more advanced, so too will the demand for technologically skilled, high-performing workers."

You can click here to visit the Business News Daily website