Practice Management News and Views from around the World – December 2016

Santa's Elves Making Toys

Look at Everything with Squid Eyes

From an article by Natasha Wilkes published in her High Performance Vets Blog

Have you ever walked away from a business, thinking what a terrible service and experience?

You asked yourself ‘How can they not see how bad they are?

Reading Susan Scott’s book, Fierce Leadership, she discusses having squid eye. Being able to see things that others can’t. It’s a skill that squid hunters develop to find squid while they are blending in to their natural environment.

I have noticed this when interviewing for a position.

Your first experience is memorable. You notice things about the environment, the team and how they interact with you and with others.

  • Are they friendly?
  • Does it smell?
  • Does it look outdated and therefore, what else is?

This can leave you wanting to become part of the team or not. After ignoring my gut feeling previously, to my detriment, I now trust my instincts.

What I do know is that you don’t notice things after a while. The smells fade, the outdated decor becomes normal, the rude team member is just how they are.

Some people don’t even notice how dissatisfied they have become as they have forgotten what joy feels like in their lives.

I have seen people go down the slippery slope of compassion fatigue and they didn’t realise we all could see it.

They thought they could hide it.

We all have blind spots about ourselves and others.

We either:

  • don’t see it and aren’t aware of it
  • are aware of it and don’t know what to do
  • are aware of it and don’t want to do anything

That is why is it so important to ask for and listen to feedback, either from yourself or others.

If you begin to feel ill or anxious before going into practice, when dealing with a certain client or before a procedure, what is your body trying to tell you?

What are you choosing not to see or ignore? If you are given feedback in a performance review or from a client, you must listen even if you don’t want to hear it.

I am usually called in when there is a major crisis such as a relationship breakdown, flame out, sacking, high staff turnover, disengagement or a very unhappy team.

This didn’t occur overnight. It’s been brewing for a while but either is wasn’t seen or it was ignored.

Look at your life and your career with squid eyes.

Sit down today and for all the areas of your life and your career, write down what you like and dislike and what you would like to change.

We promote preventative health for our patients, so do the same for yourself. Don’t wait for the crisis to occur before seeking help or advice

You can click here to visit Natasha Wilkes website​

Vet Nurses: are yours motivated or de-motivated?

From an article by Kay Irvine and published in the VetDynamics.co.uk newsletter

According to 90% of surgeries polled by the British Veterinary Association (BVA) earlier this year, over half of pet owners do not understand what registered veterinary nurses do.

Alongside this research, the British Veterinary Nursing Association (BVNA) says ‘vet nurses provide skilled supportive care for sick animals as well as undertaking minor surgery, monitoring during anaesthesia, medical treatments and diagnostic tests under veterinary supervision.

Vet nurses also play an important role in the education of owners on good standards of animal care.’A typical veterinary nurse goes to college, studies hard and achieves a qualification, of which he or she can be proud – yet the title ‘Veterinary Nurse (VN)’ is not protected by law, so pretty much anyone, it appears, can call themselves a Vet Nurse, which is somewhat concerning.

What frequently comes to light when our Vet Dynamics coaches investigate the pricing and charging structure of our clients’ practices, is that many nurses are often under-utilised, their services are rarely charged for, they feel devalued and think that their capabilities aren’t perceived by vets and practice owners as highly as they deserve.

It’s no wonder they can become de-motivated and some even opt to leave the profession! Think about it…Veterinary practices charge a consult fee for clients to bring their pets to see the vet, who is highly qualified with letters after his or her name and maybe ‘Dr’ in front. They are perceived as THE professional in the practice.

Yet many practices still give away ‘FREE nurse clinics’ – simply charging for any products used or given, which is fine if it’s part of a marketing strategy or wellness scheme.

These clever, qualified (they have letters after their names too!) hard-working, caring people’s professional time is given away for free! It just doesn’t make sense.

Time to rethink the way you work…

Here at Vet Dynamics, we strongly encourage veterinary practice owners to completely rethink the way they structure their pricing, charging and service offering. Sticking with ‘the way it’s always been done’ when there are massive changes happening in the veterinary sector is resulting in independents having an uphill struggle to stand out against the corporate vet groups who tempt and tease price-conscious pet owners away.

Practices who find themselves in a ‘plateau’ situation are either merging, selling to the corporates or plodding along bravely trying to keeps their heads above water, yet caught in what we call ‘The Busy Trap’ and not able to find the time to work ON the business and less IN it.

We find the majority of our new clients are, on average, discounting 48% of their consults AND giving away free nurse consultations as well. That’s over half of their consult revenue being given away.

Why? Who decided that random discounting was the way to grow a successful practice?

It’s ‘nice’ but, from a business point of view, completely crazy!

It’s a whole new world…

It is time to embrace the future of veterinary medicine and stop charging by pet type or treatment.

How often do you chase a hamster around the consult room and end up with a bleeding finger?

Yet a Labrador might just lie there, take the injection and then lick you to say thanks.

In my experience, the little creatures are often the most complicated and difficult to work with, yet get a ‘small furry’ discount! Instead, consider pricing your fees this way: 15 minutes of vet time = X, whilst 15 minutes of nurse time = 1/2 X. That’s it.

Value your nurses and ensure that they are paid for what they do. Simplify your pricing and get rid of discounted consults.

Anything ‘free’ should be built into your Pet Health Club, if not, charge for your nurses’ time.

Val Belbin RVN Cert Ed is joint head of Myerscough-Lynwood School of Veterinary Nursing and coordinator for all the veterinary nursing programmes. She says “The vet nurse training is getting more and more difficult and although the entry requirements haven’t changed the academic level expected of them in their training is much higher. Also,” she added, “vet nurses are now more answerable for their actions following the requirement to become registered and it is really critical that they are recognised as the knowledgeable professionals they are and more than ‘just a nurse’.

Value your nursing team – they could be doing so much more for your business and, if you open your mind to the possibilities, you may just have a stronger, more motivated and loyal team working alongside you and a practice that flies to new heights!

You can click here to visit the VetDynamics website

The Key to Meaningful Productivity: Being Receptive

From an article by Patrik Ward published in the Entrepreneur.com website

Being receptive effectively means receiving knowledge, ideas and inspiration from a variety of sources and inputs.

We all want to be more productive and fulfilled in our day-to-day.

Even the words that we use to describe productive people and actions are filled with aspiration: ship, create, code, get things done, make things happen.

A quick search of Google for the phrase "increasing productivity" returns nearly half a million results.There are countless books, blog posts, tips and tools designed to help us maximize our ability to get things done.

There's also a real danger of becoming unbalanced .I've recently seen some people suggest taking this to the extreme, focusing on productivity to the exclusion of everything else in life -- no reading, no fun, no conversations, no games, no inspiration.

When we focus too deeply on our productivity, it becomes easy to see ourselves as a collection of outputs. But we are more than just the sum of what we've accomplished. We're also the sum of what we've learned, heard, read, watched, reflected on, believed in and listened to.

As strange as it sounds, the pressure to be productive has made it easier than ever to feel unproductive.But another word for unproductive can be: receptive.

Receptivity: the key to learning, improving and observing the world

Being receptive effectively means receiving knowledge, ideas and inspiration from a variety of sources and inputs. It acknowledges all of the work that we do every day to process and make sense out of the signals that are around us all the time.

Over the past few years I've challenged myself to spend more time improving this aspect of my life. I'm definitely still early in my journey of exploring this, but I wanted to share some learnings I've had along the way and what's worked for me.

This doesn't necessarily mean that these things will be right for everyone.What I am excited by, though, is starting more of a discussion around how we can be better readers, listeners and observers of the world around us.

How we can be generous, healthy participants as well as contributors.

5 Practical ways to be more receptive

If productivity asks the question, "How can I create more effectively?" then receptivity poses the question, "How can I receive more effectively?"

Here are some practical tips I've implemented in my own life. This definitely doesn't mean that I'm against "productivity" in the traditional sense, but I do think there is a lot of value in balancing what we create with how we receive the things that are all around us.

1. Default to disabling all notifications.

Being receptive doesn't mean opening yourself up to all the noise of the world.Sometimes it means saying no to distractions so that you can focus on the things that matter.

At the moment I only receive notifications for phone calls and text messages (and I'm debating removing text notifications altogether, too).

I've been amazed by how present I've been able to be without my phone or computer regularly demanding my attention.

2. Observe one new thing each day.

We have a limited amount of receptivity in any given moment. To test this, try listening to 20 different songs playing at once -- it sounds like chaos, and it's impossible to appreciate any of them.Life is a lot being surrounded by infinite harmonies, with each one competing for our attention.

What I've started to do is pick one thing each day -- a lamp, a song, a specific plant in the garden -- and take the time to deeply and truly observe it.I

I'm still very much a beginner at this but I've already felt it begin to develop my ability to focus, which is a crucial muscle for being more receptive.

3. Practice minimalism.

Minimalism is the practice of cutting out the extraneous and being intentional with your space, possessions and time.

How can we apply these principles to be more receptive in our own lives? One quick way to become more receptive is to reduce the number of things that compete for my attention.This is as true for many of the things we interact with as it is for notifications.

  • If I only owned one book at a time, I imagine I'd read it more deeply than if I had a stack of books waiting for me.
  • If I limited myself to one browser tab at a time, I'd pay far more attention to what I'm reading than if I had 15 tabs open.

4. Write in the margins.

My grandfather used to tell me, "You haven't truly read a book until you've argued with it in the margins."Over the years he built up a collection of hundreds of books, each filled with his thoughts, reactions and questions.

5. Ask better questions.

While there may not be any bad questions, I do believe that there are better questions.The more I find myself thinking about improving the way I ask questions, the more I realize that it's a powerful way of being more receptive.

While there may not be any bad questions, I do believe that there are better questions.The more I find myself thinking about improving the way I ask questions, the more I realize that it's a powerful way of being more receptive.

Open questions like, "Why do you think that might be true?" invite us to listen to someone else's perspective more fully.

Over to you!

As you read through this, you might notice that some of this advice sounds like it could apply to productivity, too.

This is why I think the two ideas are inextricably linked: The more receptive we are, the more energy and inspiration we have to be truly productive. The more productive we are, the more important it is for us to become better at receiving and processing signals.

You can click here to visit the Entrepreneur.com website

How to Better Educate Clients Who Don’t Know What They Don’t Know

From an article by Amanda Donnelly published on her website

Last month I had the good fortunate to have a speaking engagement in the home town of my brother and sister-in-law. How nice to be able to stay with family instead of in a hotel.

They have 2 dogs – Zoey, a Yorkie and Malone, a Schnauzer.

It’s not unusual for my sister-in-law, Tami, to ask me pet healthcare questions. On this visit, we talked about Zoey’s dental care. Tami has always been concerned about Zoey’s oral care in part because she is a Practice Manager for a dentist.

I volunteered to examine Zoey’s mouth and found advanced periodontal disease.

Tami was surprised. She had no idea the disease was so progressive or that Zoey likely had pain associated with her bad teeth.

It struck me that even with her significant knowledge about human dentistry, Tami didn’t know to routinely examine Zoey’s mouth and what to look for.

She didn’t know what she didn’t know.

How well educated are your clients about the need for regular dental cleanings? Statistics show that pet owners need more in-depth education about dental care and a stronger call to action to schedule dental cleanings.

The latest data from AAHA’s Financial & Productivity PulsePoints reports the average income for dentistry in 2013 was 4% of total revenues and this number didn’t change substantially from data for 2011.

I routinely see dentistry income at 2-4% of total revenues for my clients. Given the large number of pets with dental disease, these statistics reveal a majority of pets aren’t getting the care they need.

Now I know what you’re thinking: “Our team members always make dentistry recommendations but pet owners don’t say yes.” The problem isn’t that teams don’t make recommendations, but rather that clients don’t always hear a strong enough call to action.

Let’s take a look at what your team could do differently to better educate clients about the value of dentistry for their pet.

Improving Client Education About Periodontal Disease And The Value Of Dental Care

In my observations, team members routinely give only brief explanations about dental disease quickly followed by a recommendation for a dental cleaning.

It sounds like this:“Chloe has gingivitis and some periodontal disease. Left untreated this can lead to loss of teeth and damage to other organs. We recommend a dental cleaning and we can get you an estimate if you need it.”

Notice there are limited details about the disease and instead a greater focus on the recommendation and cost of care.

Unless your clients are saying “Yes, let’s do it. I can’t wait to spend $XXX on dental care” then I suggest the following step by step client education process.

1.Give clients details about dental disease.

Here’s an example:“I’ve examined Chloe’s oral cavity and I want to review some relevant findings. She has gingivitis along all her gum lines and advanced periodontal disease as well particularly on the left side of her mouth.

Let me show you what I’m seeing. [at this point-show the client areas of concern and explain dental grading]. It is also helpful to use visual aids to augment verbal client education. This may include brochures or Veterinary apps with photos of periodontal disease.

No, the next step is not a recommendation!

2.Involve pet owners in a discussion of their pet’s health.

Don’t rush to tell clients what they need to do. Instead pause and give them time to absorb the education you’ve offered. This will likely result in the client asking questions to gain more information.

These questions lead to further dialogue about pain and the progression of periodontal disease. They also serve to uncover any owner misconceptions such as thinking that bad breath is normal and dental cleanings aren’t really important to overall health and comfort.

3. Make a clear recommendation.

Avoid ambiguous language and give the client a strong call to action.

Here’s an example that combines need recognition and establishes the value of the service:“The best way to treat Chloe is to schedule her for a complete oral cavity evaluation and teeth cleaning. Let me explain the entire procedure. [at this point, go into further details about radiographs, anesthesia, dental cleaning, pre-anesthesia labwork]

No, you’re still not done!

4. Close with an open-ended question.

Unless the client immediately requests an appointment, ask an open-ended question to uncover any concerns. Here are examples:

"What questions do you have about the treatment plan for Chloe?"

”What concerns do you have about Chloe’s treatment plan?”

“Tell me your thoughts about scheduling Chloe’s dentistry procedure.”

5. Schedule the appointment NOW.

Try to schedule the dentistry procedure while the client is still in the exam room. This improves compliance because it conveys to the client a sense of urgency. It also saves time at the front desk.

If the client does check out at the front desk, alert the reception team to make an appointment for Chloe or put in a call back if the client doesn’t schedule.

Clients need more information and a stronger call to action to agree to expensive dentistry recommendations.

People will do something different if you do something different.

Case in point: For years, the dental hygienist and dentist at several dental offices always recommended flossing to me but I never followed the recommendation till this year.

The reason I finally committed to flossing is because my current dental office focused on the long-term value.

They used visual aids to explain dental homecare and explained that flossing really could make a difference in avoiding progression of disease and tooth loss.

Take steps now to improve client education about dentistry. If your team follows the above protocol for client education you can increase compliance for dentistry at your practice.

After my conversation with Tami, she immediately got on the phone to schedule an appointment for Zoey!

You can click here to visit Amanda Donnelly's website