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

People are Awesome – but so are their pets

Feeling squeezed by corporate competition?

From an article by Jeff Rothstein published on the dvm360.com website

Running a single veterinary hospital can be a challenge for managers and practice owners, so how do the ever-growing corporate groups manage to successfully run 20, 50 or even 100 practices? Although it’s tempting to spend your time gnashing your teeth with anger or blaming them for everything under the sun, I think you can learn a lot from corporate-owned practices. And it’s not all bad.

Team and client education

Group practices often have their own online training, and these courses are a great way to ensure that everyone is well versed on all aspects of their job—covering topics ranging from OSHA compliance to pet restraint and anesthetic protocols. Any noncorporate stand-alone hospital can and should develop a training program, and there’s a plethora of training modules available. Some are free from vendors, consultants or education companies.

When it comes to client education, the big groups typically have handouts and online information on major disorders. 

Marketing, philanthropy and statistic reporting

Corporations are masters in these areas. You can be too. Spend time on your marketing plan. Align with adoption and shelter groups or get involved in charity events and fundraising efforts. These things get your clinic involved in the community and are just as easy for you to do as it is for that big group practice

It’s also important to share your practice numbers, goals and expectations with your team. They know you want to be successful—but they need to know what that looks like.

Benefits

Finding and keeping key team members is a big challenge facing all practices, but because of their bigger employee pools, corporate practices sometimes have an easier time offering more attractive benefits. Highlights include better vacation time and paid holidays, matching 401(k) plans, better health insurance and often dental and vision coverage. These benefits don’t come cheap, but attracting and retaining good team members is worth the investment.

Quality control

Managing multiple locations successfully requires good quality control protocols. You can develop those too.On the medical end, review all medical and surgical cases that have had adverse events. Instead of being defensive and taking everything personally, realize that mistakes happen. Taking the time to learn from these cases is important so we don’t let them happen again.

To better maintain pet owner satisfaction, it’s also a good idea to survey clients on a regular basis. Doing so allows us to get a pulse of client satisfaction and we can respond to areas that we are weak on.

Facility maintenance and appearance

Keeping facilities in tip-top shape and reinvesting in the latest equipment is an important and expensive commitment that corporations make. It’s easy for an individual hospital to be short-sighted in this manner. In the long run though, the investment pays off in terms of growing the business and providing the best care.

Purchasing power

Want the purchasing power—and the discounts that come with it—that practice groups enjoy? Join a buying group. I belong to a local management group that buys together, and we do much better than if we were all on our own. Savings on medical and office supplies, medical equipment and laboratory services can be substantial, so make sure you don’t lose out on this.

Nearly 10 percent of veterinary hospitals are now a part of corporations, and that number will likely continue to grow. This shows that the business of veterinary medicine is alive and well and can be reasonably profitable if managed well. Yes, there are advantages to independent ownership over group practice. For one, having a vested owner on site is always powerful, with that personal touch. On the other hand, mimicking what corporate practices do well can only help your practice be more successful, and it will help you compete nicely against the big guys.

You can  click here to visit the DVM360.com website

“This is my dream – but it’s impossible in vet practice, isn’t it?”

From a blog by Diederik Gelderman published in the Turbocharge Your Practice Blog

A subscriber (let’s call her ‘Judy’), emailed me this question this week….

“What do I have to do to have a successful, profitable practice, be able to give my staff fair wages, not work crazy hours, have a fair work environment which encourages a good work/life balance, which supports my staff and does not promote ‘burnout’ and mental health issues?”

You know what Judy – it’s NOT a dream and it’s totally possible and simple to do. Mind you, simple and easy are not the same thing…..The simple fact is that good veterinary medicine can be very profitable! So when you;

  • define your market niche and practice model
  • determine who is your ideal client and patient and treat them appropriately
  • act as the pet advocate within that niche and
  • charge a ‘fair’ fee for what you do,

  - you’ll be successful, profitable (which means you can do all those things in that question above and most importantly, you’ll smile a lot!

 ..you’ll be successful, profitable (which means you can do all those things in that question above and most importantly, you’ll smile a lot!

Let’s examine those four items…..

Determine your market niche and practice model

Most Veterinarians never work out their market niche. Practices with a narrow and a deep niche are the most profitable and the happiest.There are seven different practice models that you could use. They range from high-touch, high-tech through to low-touch, low-tech.

Most practice owners never think through what their preferred practice model should be and therefore 80% of practices compete on or in the ‘middle-ground’ of moderate-touch, moderate-tech.

This middle ground is where ALL the competition is and so there is a fierce pressure on price here.

Most practices (85% is the number shown in recent surveys) perceive that their (unique) differentiator is ‘Better Service’.

Just do the maths on that one! To the pet owner, consumer, all these middle-ground practices look the same, do the same, service the same, answer the phone the same, in fact are the same.

So what do you do when there is no differentiation from your service provider (irrespective of whether that provider is a hair-dresser, nails salon, bottle shop, retailer, motor mechanic or Veterinarian) – YEP that’s right, you shop on PRICE – whether that be in a bricks and mortar sense or an on-line/internet sense.

Note: that of these 7 different practice models, there is no wrong model no ‘incorrect’ one. Each model is valid in its own right and there is client demand for each of them.However, some models are more or less profitable than others and have far more or less competition.

The models that are by far and away the most profitable and in which there is far less competition are the models at the two extremes; high-touch high-tech and low-touch low-tech. My personal preferred model is high-touch high-tech or moderate-tech model.

There is not much competition in these arenas either. Most practitioners reading this will think that they have a high-touch model and therefore will be wondering why they are not more profitable than they are.

The fact is that what we think is high-touch is plain downright ‘average’ or in fact low-touch in most other service industries.

Veterinary practice one of the poorest customer service industries there is – especially in Australia. This isn’t just my opinion, it’s well recorded in studies done by companies like Ibis World.

This leads us to the next point – which melds in with the idea of ‘niching’ your practice

Determine who your ideal client (and patient) is and treat them appropriately

As you know, practice is always the most fun and rewarding when you are working with those specific clients and patients that you truly love.

However, most start-up practices, in order to grow as quickly as possible, try to attract any and all clients/patients and try to be everything to everyone to make this initial growth happen. And that model never gets revisited and never changes. So ultimately those clients that we love only ever form a small proportion of the clients we see on a daily basis.

This philosophy is a great way of growing the practice – initially – but it’s not a good long-term strategy for a healthy, happy and profitable practice and lifestyle

Some practices may eventually shed their breeder clients or their exotic or bird clients or their greyhound clients, etc. However, if truth be told, they continue to do a little bit of everything for everyone and really get known for nothing by all of them. And continue to work with many different clients, some of whom they would rather not deal with.

It doesn’t have to be like that….Working with the clients (and patients) that you love will have you jumping out of bed every morning, rather than reluctantly dragging yourself out of bed to go to work.

Act as the pet advocate within that niche

When you are the pet advocate and act as the pet advocate – within the ‘restraints’ (budget, time, beliefs, etc.) as determined by your client, then you’ll achieve the best outcomes for your patient, client and ultimately yourself and your practice.

Acting as the patient advocate is firstly all about developing/having standards of care around; pain management, senior care, wellness, dental disease, arthritis, pet insurance, etc. and even client service. And then secondly about ‘seeing’ what’s in-front of you, then treating what’s in front of you and communicating that need (to treat what’s there) to your client.

When you are in ‘that’ niche, when you are working with your ‘ideal’ client, then this process is simple and easy.

When you are not working within your niche and when you’re not working with your ideal client, then this conversation (and subsequent actioning) can be difficult and sometimes impossible.

Charge a ‘fair’ fee for what you do

Let’s face it – 30% of Veterinary clients want the cheapest price – have always wanted it and always will!

Studies supporting this go back to the BSAVA study of 1972. But are these clients your clients (or rather – are they your ideal client)?

The good news is that this means that 70% of clients do not want the cheapest price – they want value.

‘Value’ is a mix of; service, quality, convenience, care, price and many other things. When you are working with your ideal client in your niche, then you’ll easily be able to supply them with the value that they want and at a price that’s ‘fair’.

By ‘fair’, I mean fair to them, to the pet, to the employees in your practice and to you.

‘Fair’ doesn’t mean cheap and it doesn’t mean expensive. ‘Fair’ means different things to different people.

People who buy Armani, Gucci, Omega (watches), BMW, Mercedes-Benz, Dolce & Gabanna, Louis Vuitton, etc., don’t feel ‘ripped-off’ or that these prices are ‘unfair’. They believe that they are receiving true value with and for their purchase.

However people that do not see the value in these brands, do not buy them, they buy what seems of ‘value’ to them.

Charging this fair fee to your client, will allow you and your practice to become truly profitable and for you to have the lifestyle that you seek and deserve.

So Judy – that’s your answer!

Is this easy to achieve?

NO – not at all. It takes gumption and determination to step away from the paradigm, the model that’s used by 80% of the veterinary practices on the planet.

But then Warren Buffet, Steve Jobs, Bill Gates, Elon Musk, etc. didn’t become successful by doing what the majority did – they became successful by doing something different to the norm. As Warren Buffett says – “To become successful, you need to find out what everyone else is doing and then do the opposite.

”There are 20% of practices out there that have this level of success that you are after. Is it simple to do? Yes it is!

Is it easy? No – it is not!  

Is it do-able? Yes – absolutely!! Bite the bullet, makes the changes you need to, hold your course and success will come – what’s important also – it’ll happen sooner than you think.

You can click here to visit the Turbocharge Your Practice website

Are You in Control of Your Practice? – or does it Control You?

From a blog by Joel Parker and published on his Veterinary Practice Solutions website

Good question, right?

As private practice owners we all paid the price of admission and signed up for success. Or so we thought.

Many times stress, burn out, low morale, not enough business, too much business, working too many hours, low profit etc… quickly moved in . These are all signs of poor control.

The problem (and solution) comes down to this seemingly simple law: Control is the ability to either speed something up, keep it the same, or slow it down.

It’s proactive in it’s approach.

With this in mind, get the idea that you either control something (like driving a car), or like a passenger it controls you.

So how does this relate to your practice?

For starters, very few of us really know how to first compile objective data to diagnose the condition of any area in our practice and then use this data to pro-actively speed an area up or slow it down. For example, early on I kept going to my accountant with the monthly statements and asking “This data is interesting but what can I do with it?”.

He had no practical solutions. But as clinicians we naturally think this way, right? We compile subjective and objective patient data, make an assessment (diagnosis or tentative diagnosis) and then proceed to make a proactive treatment plan to improve the condition of the patient.

He had no practical solutions. But as clinicians we naturally think this way, right? We compile subjective and objective patient data, make an assessment (diagnosis or tentative diagnosis) and then proceed to make a proactive treatment plan to improve the condition of the patient.

So how about doing this with your practice? Here’s a place to start:

1. Pick some basic objective things to track over time - monthly New Patients and Client Visits are good ones to start with (Note: just like your patients, a practice has different systems that work together. Each can and should be monitored like you monitor the heart rate, the white count etc… of a patient).

2. Graph these out to develop your Management Dashboard - just like in your car - so you can visually see the direction these areas are heading.

3. Keep it up to date and develop your external and internal marketing plans as tools to use to pro-actively influence the areas you are tracking. Over time you should feel more and more in control.

This is the foundation of good practice management.

You can click here to visit the Veterinary Practice Solutions website

What About Me? A Client’s Perspective

From an Article by Lee Robinson and published on the VetDynamics website

I am amazed at how often I have attended practices to work with the team, to discover how surprised and even horrified they are in some cases, when I tell them what it is like to be a “pet owner” visiting a practice.

I describe to the team the emotions that I, as a client and a pet owner experienced. (This is before coming to the UK and being involved and gaining an understanding of the Veterinary profession).

I relay a story of one instance where my dog was clearly not herself so I called a vet practice (let’s call it Practice “A”). I had not been to this practice before as I had recently moved to the area. After the phone had rang to the point where I was about to hang up, a grumpy voice answered. I gave the receptionist my name and the name of the pet and explained my concern.

She hardly appeared to care and I had to tell her that I was bringing the pet in for the vet to check her out. The point was I was not invited to bring the pet in but rather had to insist.

So my first impression was ‘can I trust this practice to care for my pet’.

About one hour later I arrived at the practice, very concerned not only for my pet’s health but also whether this vet could provide the right diagnosis and treatment.

I looked around the car park and as I was already on edge and feeling very unsure, I was able to identify many things to confirm my suspicion that this practice was not good enough for me and my pet. Dog poop in the car park, some litter and some weeds. Not a lot, but again, enough to justify my doubt.

You see, by this time I was subconsciously looking for anything to confirm my belief that this practice could not care for my pet. I walked into the practice and stood unacknowledged for some time.

Again, I was looking about the reception area to find anything that would confirm my doubting beliefs. I nervously walked up to the counter and told the receptionist that I had called an hour before regarding my dog’s health. When she spoke I knew it was the same person I had spoken to on the phone.

This lady proceeded to question me asking my name and the pet’s name. Now, hang on!.….. I had told her this already on the phone, why didn’t she write this down?

It was as if she didn’t even remember me calling less than one hour earlier.

By this stage I “knew” that they didn’t care about me or my dog. Should I go on?

Long story short, the Vet pushed and shoved my dog around, while I stood and watched the Vet stick an object into my dogs rear after which I was told to give my pet some tablets. I instantly panicked as I know I can never get my dog to swallow pills.

After parting with my money, I went home feeling sick with nerves and frustration.

Once home I decided to call another practice (practice B) at which time I was invited by an empathetic receptionist to see the Vet as soon as possible. I drove to this second practice and when I walked into the practice the receptionist got up from her chair and came out into the reception area, said “Hello Mr. Robinson, this must be Sally” (my dog).

Then she said the magic words, “Don’t worry Mr Robinson, we will take good care of Sally”

Well… suddenly I had full and utter faith that this practice and the Vet would do everything in their power to care for my pet.

The Vet gave Sally a thorough examination and explained what he was doing throughout the whole consultation. I happily paid the account and arranged for Sally to come back in a few days’ time.

So which practice did I return to time and time again and which practice will I never go to again?

Which practice do I recommend to my family and friends? Of course it’s practice B.

However, the point here is that it’s important for the team to put themselves in the client’s shoes and understand the emotions, the fears, frustrations, nervousness as well as the pride, relief and even the feelings of being a good pet owner.

We live our lives within the vet practice and within the veterinary profession; we must step outside these walls and look at the world from a client’s perspective, which is hard to do when we are “in it” all day and everyday.

Teams need to often and regularly get together to explore and discuss the world from a client’s perspective.

Follow the client’s journey and discuss each step in detail.

Explore how the client feels, their emotion, throughout each step of this journey. It is only when we do this that we can provide a wonderful and memorable experience for our clients so they keep coming back and they get real value for money.

You can click here to visit the Vet Dynamics website

How Do You Respond to Change?

From an article adapted from content in Shawn McVey's presentation titled, "Managing Change and Growth" and "Manager's Guide to Implementing Change."

Your environment is constantly changing: the people you work with, your clients, who gets elected to public office, and your teenager's taste in friends. You can choose to interpret change in one of two ways: pessimistically or optimistically.

Pessimistic Interpretive Style

Are you filled with panic at the mention of an impending change? Are you unable to concentrate, impulsive, and apt to complain? Do you resort to sitting on the couch, sucking your proverbial thumb? Does finding alternate ways of doing things give you a headache? Do you long for the good old days? If you find yourself nodding and answering, "Yes!" to these questions, you are a pessimist when it comes to change.

Even positive changes involve loss, uncertainty, and some degree of emotional turmoil. But you will not be successful at work if you typically interpret change as:

  • Permanent,
  • Universal
  • Internal, or
  • Scary.

Optimistic Interpretive Style

Do your ears perk up when there's talk of change? Do you meet the challenge head on? Do you take initiative instead of waiting for others to address the problem? Do you spend your energy on solutions rather than emotions? Do you take risks, use your imagination, and keep learning? If these statements describe you, you are an optimist when it comes to change.

Change initiatives succeed because people adapt their attitudes and behaviors as fast as the practice needs them to. You will be successful at work if you typically interpret change as:

  • Temporary
  • Specific
  • External, and
  • Exciting.

When Making a Change

Dealing with change doesn't have to be overwhelming. Here are some ways to make it easier:

  • Break down the process. Look at each step of the change, and identify exactly where you need to make improvements.
  • Estimate implementation costs.Factor in training, lost productivity, and unexpected challenges.
  • Evaluate your plan.Do you need to write new procedures before you can implement the change? What can you address before beforehand to circumvent potential obstacles?
  • Share information.Constantly communicate and educate. Your team should understand what the change is about, and what it's not about. Help people see the "why" of the change. Relate it to the vision, mission, and core values of the practice. The transition won't begin until they understand the change.
  • Encourage participation.Help employees see how they, the clients, the patients, and the clinic will benefit. Emphasize teamwork. You'll get buy-in through participation; people don't argue with what they help create.
  • Get going.Get in the trenches with front-line employees. Roll up your sleeves, improvise, and learn.

You can click here to visit Shawn McVeys website