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

Dancing with 100 people

Why Do You Keep Problem Employees?

From an article by Amanda Donnelly published on her website

Every practice leader I know has experience with problem employees (either present or in the past). Problem employees are team members who create some type of disruption in the work place. They demonstrate negative behaviors such as mood swings, tardiness, lack of accountability, gossip, complaining, resistance to change, playing the victim, lack of initiative, rudeness, or a sense of entitlement. Sound familiar? Despite the bad behavior, leaders are often reluctant to terminate these employees even after multiple reprimands. Why is that?

Here are the most common reasons:

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    They have valuable skills
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    We can’t find a replacement
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    Clients love them
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    They’ve worked here so long
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    We like them as a person

And here are significant barriers I see:

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    Lack of documentation
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    Fear of confrontation
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    They improve for a period of time before falling back into old habits

Here's how to overcome barriers that keep you from getting rid of problem employees:

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    Document poor job performance. Be sure to focus on observed behaviors.
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    Meet with employees to review a performance improvement plan. Don’t forget to provide assistance as appropriate. This may include training, coaching or referral to your employee assistance program (EAP).
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    Don’t let fear guide your actions. It’s reasonable to give someone multiple chances to improve but ultimately there has to be consequences for under performers. Otherwise, you'll never have the positive culture you desire.
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    Consider the consequences of negative behaviors and poor job performance. This may include inconsistencies in patient or client care, low morale, hurt feelings, turnover, decreased productivity and increased stress on the team. As a leader, you owe it to your clients, patients, the team and your business to let go of problem employees as soon as it becomes clear they won’t change. I’ve yet to see a practice that wasn’t better off after letting go of team members with bad behaviors.t

You can click here to visit Amanda Donnelly's website

Pricing: it’s more than a numbers game

From an article by the Small Business Heroes team

Deciding on what to charge a customer can be a dilemma for a small business when they are struggling to balance what they think the market can bear with what they need to turn a profit. David Johnson is Head of Programme at Cause4, and advises small businesses and charities on strategies for growth. He feels that the real magic is in the margins.

Getting the pricing right isn’t easy. Whilst on paper you can plot out your operating costs, calculate a suitable profit and decide that’s what you want to charge for your products or services, you could find yourself struggling if your competition is undercutting you or the clients you’ve earmarked just can’t justify the expense. You need to understand the margins in which you’re operating. Market research isn’t just something you do when drafting your first business plan, it should be an ongoing process. It’s important to keep an eye on what your competition is charging and the specifics of how they price their services. You need to make sure you are comparable. Do a mystery shop before you go to market and build in the time to revisit your findings as the years go by.

You don’t have to offer a like-for-like product or service to justify your expense. Having a social purpose as part of your strategy can appeal to customers who share your vision and those who need to show their own stakeholders that the suppliers they are working with fit their values. Founder of TOMS, Blake Mycoskie, has built a company that matches every pair of shoes purchased with a pair of new shoes given to a child in need. TOMS aren’t the cheapest canvas shoes on the market but they’re certainly popular and their customers are prepared to pay a few extra quid for the feel-good factor that they’re making a difference.

Think about your advantages over your competition. Are these something your customers can experience? Will they pay more because of something different you’re bringing to the market? Sometimes bundling items can give the impression of adding value and help you differentiate from other businesses in your field. Offering consultancy and training courses on top of your service product is one way to increase customer spend and build a more long-term relationship. Alternatively you could think about partnering with businesses with similar ethos to deliver a joint offer.

It’s important to consider where you are in the life of your business. You may initially want to use more competitive pricing to gain advocates for your work or build a market share. You’ve also always got the option of staggered pricing where your prospective clients have varying levels of turnover. And, if you find that you don’t win a client in a competitive tender, ask for feedback. The more information you can get at this stage means you are able to make adjustments and correct for next time.

Pricing shouldn’t be a race to the bottom and it is ok to make the decision that you can’t afford to work with someone as to take them on would lose you money. Be thorough with your assessment of how much it’s going to cost to deliver this business, there may be hidden costs, such as additional training, increased insurance premiums or the need to bring in extra manpower than could turn your celebrations over a new business contract into a cross you have to bear.

You’ll need to review your pricing strategy regularly to incorporate changing costs, market demands and competition. And the old adage: “revenue is vanity, profit is sanity, cash flow is reality” should work like a mantra for any growing business. Having a client that signs up to a big-ticket service or item only to prove unreliable about paying their invoices can cause you heartache, putting a stress on your ability to deliver to them and to your other clients.

You want to offer a service or product that your client thinks has value. But value is a subjective term. Get to know your customers and you’ll better understand their motivations for making a purchase. How is your product or service impacting their daily lives, their own businesses, their health and wellbeing? A customer understands that you will be incurring costs to deliver but their decision to buy is based on their own needs not your business operation.

Finally, it’s worth thinking about offering some options. Showing customers that there’s a ‘way in’ by offering a cost-effective paired-down product or service can secure their interest. Once they get to know you and the quality of your work they might be happy to pay more for more features.

Many SMEs, especially, start-ups struggle with their pricing strategy and run out of money because they just haven’t got the numbers right. Pricing is the difference between success and failure so take the time to do your research and stay aware of what you’re spending versus what you’re charging. It’s not just about the monetary value, it’s about the value your customers feel they are getting, the experience of working with you. Know your value and charge for it.

You can click here to visit the Small Business Heroes website

Mind Over Miller: A little more conversation, a lot more loyalty

From an article by Robert Miller published in the DVM360.com website
Want to build your veterinary practice? Dr. Robert Miller says just talk to your clients.

Because I began practice in 1957 in a rural community that had never before had a local practicing veterinarian, I had to let the local (small) human population (who owned a huge animal population) know of my availability. The professional ethical code of that era forbade any advertising other than one local newspaper publication of the professional’s business card. Advertising, coupons, signs or other sales techniques were forbidden.

So, in order to let the public know of my existence, I did several things: I joined the local Lion’s Club and a couple of other groups in town. I visited local ranches to ask if they could board my wife’s horse. This inevitably led to conversations that included the question, “What do you do?”

I explained that I was opening a mixed-animal and house- and farm-call veterinary practice. This invariably produced a joyful response such as, “Oh great! We really need a vet out here. We use Dr. _____, but he’s 35 miles away and sometimes not available, so we’re glad to know someone else is here if we can’t get him.”

When we reached a staff of eight doctors, we were told that we were the largest general practice group in the United States. Of course, that was almost half a century ago, and large group practices are now commonplace.

One reason our practice grew so rapidly and so successfully is because, although I never violated our strict ethical code, I found a very effective method of recruiting loyal clients—the telephone.

Today, unsolicited telephone advertising is a plague, but that isn’t what I did. What I did do:

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    Even when my entire practice was ambulatory (large and small), if I was late I would telephone the client, explain why I was late, apologize, and tell them when I expected to arrive. People almost invariably were understanding and appreciative.
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    The year after I began my practice, our team got its first telephone answering service. At first, the owner of the business did all the answering herself, and she was excellent. Eventually, as our community and her business grew, she hired other operators. I asked the owner to allow me to personally train each operator as to how I wanted the telephone answered:
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    Not “Veterinary service!” But “Dr. Robert Miller’s answering service, how may I help you?”
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    Not “Is this an emergency?” But “Dr. Miller is off duty now, but he is available if you need to speak to him.”

I told them that it does not need to be an emergency for me to speak to the caller, at any time, if they were concerned or had a question.

The above became a permanent practice policy even after I opened an office and even after we had grown into a large group.

After I established a clinic, whenever I completed a surgical procedure, I personally phoned the client to reassure them that the patient was doing well (if it was).

This usually elicited words of relief and gratitude.

Often, long after caring for a patient, I would call a client to say something like, “This is Dr. Miller. It’s been three weeks since we treated Brownie’s ears. Is he still comfortable?” Or, “Several months ago, we removed Pal’s tumor. I have an identical case and I thought I’d call and find out if Pal is still doing well.”

The surprise and appreciation expressed by clients after such calls was so common and so effusive that it invariably built our practice. A common response was, “I wish you were my doctor.”

When, inevitably, our practice grew to the point where the doctor did not always have time to make such calls consistently, the calls were assigned to practice employees who were polite, friendly, patient and understanding.

In human and veterinary medicine, such a call is a rarity. This is unfortunate.

You say you are too busy? I was never too busy to make such calls. The result? A practice that grew and grew and grew.

Today, the automatic answering machine and recorded messages are available to “relieve” the busy doctor from making such calls. But remember that the client who calls about their animal is usually concerned. A response acknowledging that concern reflects the doctor’s sympathy, compassion and understanding.

Unanswered phone calls, brusqueness, indifference, impatience and forcing callers to leave messages are not practice builders. Importantly, such “call backs” are informative to us as to the efficacy of our treatments.

What I don’t want to hear is, “Oh! Dr. Miller? Oh! Pal died the day after you sent him home.”

You can click here to visit Robert Millers website 

You can click here to visit the DVM360.com website 

How veterinary practices can deliver a ‘red carpet’ customer experience

From an article by Stephanie Vaughan-Jones of Moneypenny published in the VetDynamics website

At Moneypenny, we often talk about rolling out the ‘red carpet’ for our customers. What we mean is delivering the kind of service that makes everyone feel like your biggest and most important client. A VIP. It’s this experience that wows customers, and not only keeps them coming back but will ultimately grow a business and its reputation too.

Stephanie Vaughan-Jones, Commercial Manager at telephone answering specialist Moneypenny, identifies five key ways that veterinary practices can deliver a ‘red carpet’ experience for their clients…

Take a walk in your clients’ shoes

With owners and their pets at the front desk, staff in and out of appointments and the phone ringing before you even open the doors – it can be difficult to stay on top of it all in a busy veterinary practice.

Competition, however, is on the rise and clients both deserve and expect the very best experience. So, if you do just one thing, make it this: step into your clients’ shoes. Mystery shop your own practice, look at everything objectively and become your own client. Call your reception, send an email, use your website, get in touch on Twitter, send a friend into your practice in person. Think of every possible touchpoint there is for your practice and see how it works and how it feels.

Take note of any areas you were proud of and any areas that could be improved. What impressed you? What would you think if you were a new or existing client? However busy you are, the insights that you’ll gain from taking time to do this will be worth their weight in gold.

The little things are the big things

Long after people have forgotten what’s been said or done, they will remember how they were made to feel. In the veterinary sector – where emotions can often run high – this is particularly true. That’s why the little things can so easily become the big things. Remembering a patient’s name, for example, and that of their pet can make a huge difference. Or using their preferred method of communication and taking the time and care to listen and address any concerns they may have.

Customers want to be nurtured, to feel special so aim to surprise and delight clients at every opportunity. These small touches of expertise, understanding, kindness and consideration make a huge difference and more often than not are the very things that inspire customers to share their experience with others. By going above and beyond, you aren’t just impressing one person, but an infinite number of people in the future too.

Consistency is King

As with many things in life, good things come to those who wait. That includes winning the trust of your clients. It may take a number of positive encounters with a practice before a consumer begins to trust them. Successful practices understand this. They know that customer service is a long game; that the benefits won’t always be apparent overnight, but that building loyalty and strong client relations is the key to long-term success. They also appreciate that relationships like these are built through steady and consistent service at every point of contact.

So, think of your own practice and how it’s run on a daily basis; and then consider the following. Is the level of service you offer the same at every interaction?

How does this represent your practice as a brand? Is every patient greeted at the front desk like they are your most important client? Is there someone available to always answer the telephone, with a warm and caring manner? Do you respond to clients’ queries when you say you will?

If the answer to the above isn’t yes, then it may be time to consider ways you can improve each of these elements. Consistency and reliability fosters trust and helps to build that all important bond between a client and business. This is equally important when it comes to existing customers as well. A client should never hang up the phone or leave your practice thinking ‘that wasn’t my usual standard of service’. It takes a long time to earn a person’s hard-won loyalty and a few minutes to lose it, so treasure their confidence and do everything you can to keep it.

Listen, listen, listen

Any practice, no matter how big it has grown or how busy it is, will soon stop if they fail to put their customers first. This, can, of course, be a challenge with other demands around you, but listening – and I mean, really listening – to clients is the key to ensuring this doesn’t happen.

We’ve all been guilty of not fully paying attention at some point; nodding and making all the right noises but sticking with our original preconceived ideas without opening our minds to the alternative. The most successful practices though will listen to their clients at every opportunity and gather as much honest feedback as possible. Yes, it might be painful to hear at times but also hugely beneficial. Never assume that you know what your clients want. What worked well last week or even today may not work tomorrow or in two months time, so listen, recognise when things need to change, and act on it.

Exceed industry standards

In today’s customer-centric world, simply meeting expectations isn’t enough; you need to ‘wow’. So, if you haven’t done so already, take a look at your competitors and compare how you measure up.

What services do they offer? Can you book an appointment online, for instance? Is there anyone to pick up phone calls once the doors close at 5.30pm? No? Herein lies your opportunity to exceed the ‘norm’. In today’s market, the onus is on the business to win the client over – not the other way around. And the rewards of this are there to be reaped.

Word quickly spreads about extraordinary service, and those recommendations are priceless. Practices that raise the bar are inevitably the ones that rise to the top. Not only do they surpass their own expectations of what constitutes good service, but also the industry’s standard. This can be enormously powerful.

You can click here to visit the VetDynamics website

You can click here to visit the MoneyPenny website

Staff Performance Issues

From a blog published on the NewVetBoss website

When managing staff performance, most of our staff members fall into four categories. Identifying which category a staff member falls into can help you figure out how to improve their performance.

The first category is the employee that knows their job and does it well.

These are your ideal employees! But just because they do their job well doesn’t mean they don’t deserve some of your attention. These employees really need to know you appreciate them and to provide support for any concerns or requests they may have. Want to go to CE? Sign them up! Need another scrub top? Give it to them!

This group of employees needs your support and then get out of their way so they can do their jobs!

The second category is the employee that doesn’t know their job but wants to be doing it.

These could be new employees or existing ones that are moving into new roles or taking on new responsibilities in the practice. This group needs training. Lots of training!

We often forget how tough it can be to be a new employee in a new job. As a manager, you must make time on a regular basis to check in with these employees. Set up a regular meeting time, often weekly to meet with them and see how they are doing.

Checklists are helpful to ensure that these employees are trained in all areas of their job. Make sure employees know they can come to you for additional help. This category of employee can easily move into the first category with the additional training they need.

The third category is the employee that knows their job but isn’t doing it.

I think most of our “problem” employees fall into this category.

These are the frustrating ones. Employees in this category may have been one of your best employees at one point. Over time, for various reasons they have stopped performing in their position.

It is easy to be angry at these employees. They know their job so why don’t they just do it ?!?

You might find yourself thinking that these employees should leave the practice, they need to leave the practice. We may be looking for reasons or incidents that would lead to their termination. Good riddance- right?

Not so fast, because these employees know their jobs there is great opportunity to turn these employees around. There could be lots of reasons why they aren’t performing.

Lack of job satisfaction and burnout occur frequently in veterinary medicine. The key to managing this category of employee is relationship. Yes, relationship. Relationship is defined as “the way two or more people are connected”. Like it or not you are connected to your employees.

You have a shared goal to be productive and contribute to the success of the practice. This doesn’t mean that you become this employee’s “friend” or lunch buddy. This means that you have some honest conversations with this employee and their performance issues. You are also connected to them by the shared goal of improving their performance.

These employees need to know that you value them but that they need to be doing their job. The expectations for improving their performance need to be shared with them and a performance improvement plan setup. This should be an interactive process that the employee participates in. Meet with them and ask them to come up with solutions.

Create timelines to achieve solutions and then hold them accountable to those timelines. Let them know from the beginning they will be accountable for both the solutions and meeting the timelines. Once the plan is in place, you need to support them. Meet with them regularly to discuss the progress being made to improve performance. The goal is to move these employees into the first category when they know their jobs and are doing it.

The last category is the employee that doesn’t know their job and doesn’t want to do it. 

Two words. Bye-bye. Do you have employees in this category in your practice? These employees are demotivating to all your other employees. Why should your other employees work when this person doesn’t and no one is doing anything about it? In my experience these are not usually your long term employees.

Employees in this category are usually recent hires and they never really make it. It could be lack of training, however most people that want to do their job will learn even in the absence of formalized training. Employees in this category need to leave and leave quickly- before their bad attitude rubs off on the other team members.

I think staff development and improving staff performance is a huge part of practice success. I’m a firm believer that if you take care of your employees they take care of the business.

You can click here to visit the NewVetBoss website