Practice Management News and Views from around the World – March 2017

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How do we keep veterinary medicine fun?

From an article by Dave Nicol published in his Hamster Wheel blog

I just got finished up with my first interview for a new podcast I’m hosting (due later this month) with Dr Diederik Gelderman, We had a great, wide ranging chat about his very successful and unusual career.

Nothing was off limits and we covered a lot of ground from his fascinating life. But this wasn't a "softball" question, rosy tinted love-in. We talked about the bad stuff too, including how a combination of poor decisions, lack of training and workplace stress plus a large dose of financial burden led to a well publicised (and, had it not been for his daughter finding him, likely successful) suicide attempt.

One of the things that really jumped out from the conversation was how much Dr Gelderman really loved his early “James Herriot” style career. And it is equally obvious just how much passion he has for what he is doing now.

So he started with fun, but built, or perhaps allowed, a version of reality to slowly drain his enthusiasm and rob him of everything he held dear - his family, wealth and (very nearly) life itself. Then, through his suicide attempt and the support he received during his subsequent recovery, Diederik courageously found a way through his pain and was, in a way, reborn into 'Life 2.0'. His second chance.

As we talked I wrote a question down for later use, "How do we keep modern veterinary medicine fun?”

It was the wrong time to ask the question because I didn’t want to steer him off the course he was on, and in the end we talked about so many other fascinating things we just ran out of time. (Perhaps Diederik will be up for a round two in the future?)

But this is an important question. I think I’ll pitch it at every podcast guest moving forward, because fun seems to be missing from a lot of people’s life who work in the veterinary sector. There are burdens and pressure stacked up everywhere: debt, knowledge, time… It’s sometimes hard to imagine why people choose this pathway anymore, but to quote War of the Worlds, "yet still, they come”.

If this resonates with you, then perhaps take some time of your day and let your brain chew on these questions:

  • Why did you get into veterinary medicine?
  • What drew you to it and what early experiences gave you joy?
  • Are you still having fun?
  • If so, why?
  • If not, why not?
  • What hypothetical changes would need to occur in order for you to be having enough fun to be enjoying yourself?
  • How do you start to create a daily life where you are having fun?

Once you have these answered honestly (which may be a hard, emotional job), write your thoughts down and you will have in your hand a crude roadmap to a better place. A simple piece of paper upon which may well be scrawled the most important 'to do' list your ever write.

We are all fully in charge of our life choices and, unless we tell ourselves otherwise, anything is possible. So all that is required is the courage to take the first step towards your new goals. What do you have to do now to begin to move, or (just as importantly) maintain, your version of reality such that fun is an integral part of your day?

We are all collectively responsible for the creation of fun in our day. In doing so we'll automatically reduce the space available in our heads for darker thoughts and actions.

So what’s your first move?

You can click here to visit Dave Nicols website

The Very Basics of percentage-based associate compensation

From an article by staff

CVC educator Denise Tumblin, CPA, explained to practice owners, practice managers and associates what they needed to know on percentage-based compensation.

You have the money, but knowing exactly how to divvy it out could be a ruff process. Denise Tumblin, CPA, knows how hard it is to figure out what to pay and what benefits to offer to team members and associates. She showed off her sympathy and knowledge at CVC San Diego and went into detail about what works and what doesn’t when it comes to percentage-based compensation. Here are a few of the things she touched on.

What do the other practices do?

According to Tumblin’s work in Benchmarks 2015: A Study of Well-Managed Practices the majority of these high-functioning hospitals at the end of 2014 now pay doctors some form of incentive-based compensation.

  • 26% pay purely based on production
  • 50% pay doctors a guaranteed base, plus a percentage of production over a required minimum
  • 24% pay doctors a fixed salary.

Blended-rate practices

When one percentage applies to all medical service and product production, a practice has a blended rate. Well-Managed Practices typically pay doctors between 16 and 21 percent. Where they fall in that range is dependent on the practice’s staff-to-doctor ratio. In other words, the more staff the practice provides to assist the doctors, the lower the percentage paid to the doctors.

The additional staff members, according to Tumblin, allow the doctors to produce at a higher level, which in turn increases doctor compensation.

Keep in mind…

According to Tumblin, to make any percentage-based compensation work—blended-rate or split-rate—every team member must understand what is and isn’t credited to the doctor’s individual production. Doctors receive credit for all medical service revenue provided during an outpatient appointment, in-hospital treatment or dental and surgical procedures. Doctors also receive credit for medications and therapeutic foods dispensed during an outpatient appointment, during in-hospital treatment or at the end of a patient’s hospital stay. Such items as prescription refills and additional food or product purchases that don’t involve a doctor are credited to a hospital provider. The doctor receives credit for the refill only if it requires his or her time to review the record, assess whether the medication or dosage needs to change, and give direction to the staff member who will fill the prescription. Doctors never receive credit for boarding, grooming or retail purchases.

What do you do if multiple doctors touch a case? When multiple doctors collaborate to treat a patient, the doctor who provides each point of care receives credit. For example, if Doctor A examines and admits a patient to the hospital on Day 1, and Doctor B provides or supervises the hospital treatment on Day 2, Doctor A gets credit for everything on Day 1 and Doctor B gets credit for Day 2.

And last, but certainly not least, Tumblin says production-based pay only ever works well when doctors lead with what is in the best interest of the patient. And what does that lead to, in almost all cases? Tumblin says doctors earn more.

Tumblin urges practice owners, practice managers and associates to maintain that patient-first mentality to always, always remembers it’s about the medicine, not the money. With a patient-first approach, the money follows the medicine.

You can click here to visit the website

How to Increase Patient Visits with Forward Booking

From an article by Amanda Donnelly, published in her website newsletter

How often does your team schedule follow-up appointments for pets before the client leaves your practice? If you're not sure or it's less than 75% of the time, then you have a tremendous opportunity to increase patient visits (and revenue) for your business.

We all know the benefit of follow-up appointments. For healthy pets, forward booking improves client compliance and ensures pets get the care they deserve.

For medical conditions, progress exams help ensure the pet is responding to treatment leading to improved medical outcomes for the pet. So, if we agree that follow-up visits are beneficial, why don't they happen? Here's the 2 biggest reasons as well as guidance on how to implement change in your practice.

Reason #1: Not having a clearly defined protocol for the team to schedule next appointments for pets.

Talking about the value of scheduling progress exams at a staff meeting or asking team members to do forward booking isn't enough. Instead put a written protocol in place that includes the following:

  • All pets need to have their next visit scheduled before the client leaves.
  • The veterinarian must tell the client when their pet needs to be seen next and convey the value of that appointment. For medical progress exams, this means making sure clients understand why they need to come back to have their pet re-evaluated.
  • Ideally, a team member schedules the next appointment before the client leaves the exam room. If this isn't possible, the appointment is scheduled at the front desk during check-out before the client pays.
  • The protocol must include how the doctor will communicate to team members when the next visit is due. For example, he or she may tell the technician in the room or walk the client to the front desk and inform the client service representative.

Reason #2: Lack of staff training on how to communicate with clients about the their next visit.

Even if employees have been instructed to do forward booking, clients don't tend to schedule the appointment if the team hasn't been properly trained on how to ask for the appointment. Train your team to:

  • Avoid asking clients "if" they want to book their next appointment. Instead always use the doctor's name and reiterate the need for the appointment. They can say "Dr. Taylor wants to do a medical progress exam on Chloe in 2 weeks to be sure she is responding to the antibiotics."
  • Offer a specific date and time for the next appointment by saying, "That will be March 15th, does 2pm work again for you?"
  • If the client is reluctant to schedule, encourage then to book an appointment so they will receive reminders and then can reschedule if necessary. This is especially important if the next visit is months or a year away.

You can click here to visit Amanda Donnelly's website

My Veterinarian - Why our relationship is a success

From a blog by Diederik Gelderman posted on his website

This is personal account of how Jonathon West came to his Veterinarian and why the relationship became a highly successful one.  It's a valuable lesson for us all in our work, no matter what our role. It also speaks volumes about what people - all of us - expect from a professional service provider.In other words – What Our Clients Expect From Us

Jonathon’s Story

One of the effects of my job (as someone who works in advertising and marketing) is that I place great faith in a Veterinary doctor who communicates well with me and my family.

Because my job entails marketing in the medical, dental and Veterinary professions and improving communication between the profession and the community, I tend to become impatient with a doctor who cannot communicate well with me.

I do not respect any doctor or practice which is not marketing well to me. I feel frustrated and I want to complain. And when I complain, I want service. I want answers. I want satisfaction.

Otherwise I will go home and say to my wife: "I'm paying a lot of money to that guy. I don't see why I have to be treated like that."

Let's be honest. We've all done it. We all expect service for our money.

With a Veterinary practice, there are added complications. When our precious pet is sick, as dedicated pet owners, we will put up with anything for their relief or treatment. We almost feel at the mercy of the receptionist and the doctor and we don't want to do anything that might jeopardise the care they need.

But we are really no different from the client or customer in the supermarket or the bank. If anything, we expect a Veterinary practice to be even more professional.

Although my particular job makes me more aware of why I am expecting a service, I am feeling the same way that any client feels. I want service. As a pet owner with a pet needing treatment, what do I expect from the doctor and the practice?

I am a client who has to visit the doctor at least once every six weeks for some form of pet challenge.

I have a dog that needs a monthly injection and a check-up. I have another dog who is fairly healthy and only needs to go in once a year. And then we have two asthmatic cats who have had all the normal ailments that go with asthma.

It’s quite a tribe with lots of problems.

My aged mother-in-law has come to live with us. She is Greek and speaks very little English (I will resist the temptation to launch into a mother-in-law joke.) She also has an elderly dog that needs a lot of care.

What do I expect for my patronage?

I expect that I should be recognised as a loyal client both on the phone and when I enter the practice. I feel the receptionist would realise that I would not ask for an urgent appointment if my pet didn't need it.

As the receptionist knows I am in a busy job, I would expect a phone call explaining that the doctor is running late, asking if I would like to leave it for half an hour before I come in. By the same token, I phone or I’ll ask my secretary to phone if I am running late for my appointment

I like to be greeted by name when I enter.

When there is something wrong with one of my pets, I appreciate the diagrams the doctor draws to help explain the problem. He does the same for my mother-in-law, with the added bonus of writing down instructions about her dog’s medication so we know what she requires.

My doctor lets clients know what to do if they need attention during the night. This is very important.He is from a Greek background, so he can speak to my mother-in-law (to some degree) in her own tongue, but he has also recently started to learn Russian because his practice is in an area which has a high number of aged people who speak only Russian.

When one of our pets has tests, he always tells us when to ring back and is always available to discuss the results briefly over the phone. If you phone during the day and he is busy, he always phones back.

Quite often he will ring or let me know on my next visit what he has read or researched about my pet’s illnesses, or what new developments have occurred.

This is our doctor. We all love him, and we love to recommend him to friends.

We found him by accident when we first came to the city. One of our asthmatic cats had a bad attack on a Friday night. Saturday morning we took him to a doctor close by. He prescribed a new drug and on Sunday morning, he rang to check if the medication was working and if ‘Sammy’ had slept well.

He had well and truly won our patronage.I know that many of you know of similar practices. What my doctor is doing adds to his workload, but it follows good marketing and communication principles and therefore bonds clients more tightly to the doctor and the practice.

Clients expect much more

All clients, all over the world are being educated to expect much more as clients and customers of all businesses. Communication and marketing skills are important skills for any owner or manager of a small business – including Veterinary business.

And not just the manager and the owner – in fact, ALL Team members need to be excellent communicators.

As with any other small business, 80% of your business comes from just 20% of your clients. It’s up to you to develop that top 20% of clients to be the ones that you really enjoy working with. And then you need to charge them a ‘fair’ (HIGH-END) fee for the type of service that you provide.

With Veterinary practice, your clients are pet owners and that ratio still applies. It is just as important to develop your marketing and communication as it is to become more efficient in your administration of your practice. Remember – I’m your client….’

You can click here to visit Diederik Gelderman's website

6 Ways to Foster Healthy Competition at Work

From an article by Rieva Lesonsky published on the SmallBizTrends website

Workplace competition can help make your staff more productive, more engaged and more energized. However, it can also stress them out, crush their confidence and lead to lasting resentment. Some people are naturally competitive and thrive in competitions, while others aren’t and will cringe at the mere idea of a contest.

How can you create healthy competition at work while avoiding any potentially harmful effects? Here are some tips.

Creating Healthy Competition at Work

Make it Fun

Work is naturally competitive: Everyone wants to do well in his or her job, be recognized and get promoted. Don’t add to this stress by making your workplace competitions deadly serious. Keep a lighthearted and fun element to the contest.

Monitor the Effects

Pay close attention to how your workplace competitions unfold — not just in business results, but also in human terms. Are tempers flaring? Are people snapping at each other or becoming uncooperative? If a competition starts to go off the rails, call a halt to discuss the problems and, if you have to, end the competition.

Compete in Teams

Competition among individuals has the most potential to go wrong. It can lead to a dog-eat-dog environment where everyone is out for number one. In general, team competitions are healthier, and also encourage collaboration, which is vital in today’s workplace. Try to balance the teams as much as possible by choosing team members with different strengths. Not only will this create more effective teams, it will also give the members opportunities to learn from each other while competing.

Encourage Competing with Yourself

Competitions that focus on achieving a “personal best” instead of beating others can be highly motivating, while avoiding the downsides of one-on-one competition. Individuals can compete with themselves, such as sales reps trying to raise their sales numbers each month. Teams can compete with themselves, too: For instance, you could measure your shipping department’s average time per package and see if they can get faster every month.

Stay Focused on the End Goal

It’s great when employees get excited about the competition, but sometimes they get so excited they forget about the ultimate goal. For example, if your contest measures how many calls your customer service reps handle in a day, they might get so focused on speed that they start rushing through calls — and service quality declines.

Provide a Reasonable Reward

The reward for workplace competitions can vary depending on the nature of the competition, your business and your people. For example, at some workplaces, the winning team might be content to receive a silly trophy and recognition at the weekly meeting. Others may be motivated by something more tangible, like getting to leave early on Friday afternoons. Still others will need larger rewards to motivate competition — such as salespeople, who are often rewarded with bonuses or vacation packages for bringing in big sales.

How do you encourage competition at work (or do you)?

You can click here to visit the SmallBizTrends website