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

RTSF 2017 - Tanya & Sondre

Should you fear the corporatization of veterinary medicine?

From an article by staff

The editors analysed data, mined our shared market knowledge and had many long (really long) meetings about how we should address the issue of corporate medicine in our coverage, especially in light of recent events

In the end, we decided it was best to ask our “brain trust” for their real-life experiences and perspectives. We created a panel made up of regular contributors, new faces and industry veterans, who together create a spectrum of voices that represent the many angles of this issue. Here are some highlights.

Is more corporate ownership of veterinary practices a good or a bad thing? Why or why not?

In general, corporate ownership forces private practices to step up their game, bring more structure to their businesses, learn to lead more effectively, and reach for novel business models and decisions. Consolidation in general means that larger groups can trim expenses, lean down their administration costs, and provide team members access to high-quality continuing education and other benefits. In general, consolidated practices can be more competitive in many, many ways.

But consolidation also has a down side. Larger organizations may not be as agile in responding to market changes, allowing smaller, leaner organizations a chance to jump on opportunities more swiftly. Corporations also have a more difficult time humanizing their presence on social media, an effective pipeline to clients that private practices can more easily and affordably leverage to their benefit. — Bash Halow, LVT, CVPM

I think it’s probably a good thing on an individual basis. There will probably be better managed practices that will afford employees better schedules, pay and/or benefits than a more poorly run independent hospital. It will be good for practice owners getting ready for retirement, as the corporations are paying a premium on practices. In the long run, though, I worry that it may not be in the best interest of the veterinary profession to be mostly owned by corporations—corporations that are primarily about business. Yes, the business of veterinary medicine will likely improve via efficiency and economy of scale, but at the loss of the small, local, community practice. — Greg Nutt, DVM

I have always seen corporations as “the evil empire” and would never consider working for one. However, I know how our profession has changed over the years, and I can see how it might be a good thing. As our new graduates accrue more and more debt to become veterinarians, I’m not sure how any of them could ever become practice owners. This I find very sad. So, maybe it’s more of a necessary thing than a good thing. Also, I think more and more corporate ownership might turn our profession into more of a service industry—like going to work for a glorified McDonald’s. — Elizabeth Noyes, DVM, MS, PHhD

More corporate ownership is good from the standpoint of providing a viable exit strategy for practice owners when associates are unable or unwilling to take on the financial and emotional challenges of ownership. But it’s bad in that it reflects the ongoing economic challenge of rising veterinary student indebtedness versus earnings potential. According to a New York Times article, the ratio of debt to income for the average new veterinary school graduate is practically double that of a medical doctor’s burden. One consequence of these economic pressures has been the emergence of large corporate-owned practices to take advantage of economies of scale. Given this, it appears that this trend will likely continue. — David Bruyette, DVM, DACVIM

I am an associate emergency and critical care specialist at the Veterinary Specialty and Emergency Center (VSEC) in Levittown, Pennsylvania. About two years ago, VSEC was purchased by BluePearl Veterinary Partners. BluePearl was subsequently acquired by Mars Petcare. I believe that a larger group of veterinary hospitals and corporate ownership is not a disservice to the pet owner nor the veterinary team member. One advantage is lower overhead and greater purchasing power providing that practice a higher profit margin. This allows the practice to purchase additional medications to stock for the clients, new diagnostic tools, cheaper in-house blood work, in-house ultrasound machines, or new CT or MRI machines. These savings allow for better medical care for our clients and their pets. Corporate practice also allows veterinarians to focus on the medicine rather than the burden of management responsibilities.
— Garret Pachtinger, VMD, DACVECC

In my opinion, private and corporate veterinary practices are both good because they give practitioners and pet owners choice. I can only speak to my experience at Banfield—personally, I view corporate ownership as a good thing because we gain the skillsets of each individual entity, ultimately making us well-rounded. At Banfield, we all bring different backgrounds and expertise, and it’s those varying experiences that enable corporate practices like ours to impact more pets’ lives—and offer even greater workplace environments for associates. I see firsthand all the time how Banfield leverages its size for good. In corporate practice, our scale enables us to give back to communities (whether through charitable donations or paid volunteer time), offer our associates great benefits and get involved in the causes that matter to them (student-debt reduction, for example), and more generally help increase their well-being and lifestyle on work and personal levels. — Kimberly-Ann Therrien, DVM, vice president of veterinary quality, Banfield Pet Hospital

More ownership may not be a bad thing, but the profession as a whole will benefit from the public having choices in their communities. Some folks want what corporate has to offer; others loathe corporate and want the feel that an independent practice can provide. With the graduate debt situation as it is and the apparent trend of newer veterinarians being less interested in practice ownership, the golden generation of veterinarian practice owners will be looking to sell their practices for retirement, and I’m concerned that corporate buyers will be the most profitable option. Should this play out, communities will see their choices in animal health care reduced.— Ryan Gates, DVM, Cuyahoga Falls Veterinary Clinic

I’ve worked at both corporate and independently owned practices, and ultimately I left corporate because I did not feel like my voice mattered. On the other hand, corporate practices did offer good benefits and there are certainly many privately owned practices that have toxic owners as well. I was lucky that I found a great one! But if I had to choose an answer on corperate ownership being a good thing or bad thing, I’d say it’s a bad thing.— Kat Hodes, DVM

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The 5 Big Waves affecting the veterinary profession

From an article by Alan Robinson published in the VetDynamics website

Let me tell you a story….At 01:00 hours on Boxing Day 2004 there was a massive earthquake in the Eastern Indian Ocean. This created a huge displacement wave on the ocean floor, which resulted in a tidal surge moving east and west across the Indian Ocean at 150 mph.

This is relatively harmless in the deep ocean, but once it hits shallow water it creates a tsunami of devastating speed and size. We’ve all seen the video footage of the widespread devastation and loss of life it caused in coastal communities from Japan to Africa.

The Maldives; an isolated community of around 400,000 people was one particular area that was affected. Courtesy of hundreds of coral atolls in the Mid-Indian Ocean, the Maldives community actually felt the earthquake as it occurred. However, they didn’t pay much attention at the time and could not have known they needed to prepare for what was yet to come.

At 9.30am the tsunami hit causing huge damage to the islands – leaving 82 dead and 24 missing, presumed dead.The Maldives is the lowest lying country in the world, on average 1.8m above sea level and nowhere more than a few hundred metres from the sea.

So why wasn’t the damage so much worse? Fortunately, the inhabited areas lie within protected coral atolls surrounded by reefs, which took the brunt of the tsunami force and reduced the size and speed to a much smaller, but still devastating tidal surge.Since then some of the islands have rebuilt their infrastructure and community to a thriving tourist economy – not in the least due to the resilience and persistence of the people that live there.

However, some islands are still abandoned and sadly have never recovered.

Now, I don’t want to diminish or trivialise the damage suffered in the 2004 tsunami but I do want to borrow the metaphor of the devastation major unexpected events can have on communities and industries and also reflect upon the resilience of the people, their businesses and those affected by these changes.

The question I want to ask is:

Do you, your business and your team have the personal resilience, the professional business skills and the purposefulness to withstand the changes to come?

At Vet Dynamics, we work to improve veterinary practice performance, leadership and teams, to continually enhance animal welfare and the lives of vets and their teams all around the world. At the Vet Dynamics Business Bootcamp I would like to share with you, my thoughts and concerns about the 5 major waves of change due to affect our profession and the impact that is going to have on you, your business and your team.

Well, you might say, there’s always been change – so what’s new? Yes, waves of change of various intensity have come and gone – and we’ve survived. What is happening this time is unprecedented and of a scale never seen before. AND the 5 waves I will be talking about are converging into the ‘Perfect Storm’ of change that is going to be either a profound threat to many OR a profound opportunity for others.

Which of these applies to you will depend on whether you have a ring-fenced buffer – like the coral atolls, and the elevation and a place of safety you can maintain above the coming change.

The 5 waves are not discrete. They will mix and merge as one giant tsunami of change. There are essentially 3 external merge-trends and 2 seismic internal trends.

Wave 1: is the Economy – what is it going to do over the next 5 years?

We have seen the volatility of Dot Com, Global Financial Meltdown and the current mega boom. Add to this the current Geo-political cycle of Brexit, Trump, ISIS, Syria, Egypt and the EU – something has to give.

So what does this mean to you and your business?

Wave 2: is closer to home as a significant inflection point in world demographics.

The moving out of the post-war Baby Boom generation; the largest, most influential, most consumptive generation ever – ‘the pig moving through the python’.

Transitioning into their legacy phase – what will that be? They are being replaced as clients and employees by the GenerationX – the ‘lost’ generation and the Millennials, the ‘I don’t want that’ generation. What does this mean as a fundamental shift in world view and human needs? Personally, commercially and as communities?

Wave 3: is a duo of changes within our professional infrastructure.

They are Corporatisation and Commoditisation. No one really knows what these changes will mean however they will have an impact on

  • Employment
  • Career paths
  • The division of clinical and management
  • Skill levels and polarisation
  • Consumer choice

There is a feeling that this will suppress the intrinsic motivators of entrepreneurial spirit that has up to now, driven vets and vet businesses to build quality clinical care, client experience, financial success and team performance.

Are we actually now driving business models that are swapping purpose for profit – and people for processes?

Wave 4: with the above comes the fear of perceived competition.

Is this just corporates or are there other things to worry about?  Is it the new practice, corporate or otherwise, the internet, lack of vets, regulation or bureaucracy that is going to be the competitive threat?

There are three key principles to bear in mind:

  • Practices fail from the inside – out (not because of competition)
  • Most practices are too busy:- to practice good medicine, to deliver excellent customer service and to increase and sustain profitability
  • You do not need more clients – you need better relationships with your  existing clients to be profitable. The solution to this challenge lies in identity and positioning.

Wave 5: is advancements in technology - including

  • Artificial Intelligence
  • Robotics
  • Biological Nano-technology
  • Communication
  • Education and
  • The actual value information

As vets, we are no longer the purveyors of veterinary knowledge – all this is freely available – we need to become the curators of information. To remain significant and relevant as a profession, we need to let go of the certainty and authority of ‘the white coat’ and instead become curators of wisdom within our community.

You can click here to visit the VetDynamics website 

The key to delivering excellent customer service in your veterinary practice

From a blog by Deb Render published on the website

Veterinary receptionists are the frontline troops of the veterinary practice. They are seen as, and are responsible for, the image that your practice portrays to current and potential clients.

They provide the first point of interaction, deliver the first example of your customer service standards and are your products sales team all rolled into one.They perform the role of marketer, merchandiser, counsellor and relationship manager.

So how much value do you place on those out on the front line? What training are they armed with to excel, and in turn, increase profits for the practice? The world is changing and so is the customer’s ‘service experience’ – being just satisfied is no longer good enough.

Consider these areas as part of the role of a highly-effective veterinary receptionist…

1. Image Management Specialist

There’s no doubt about it – your reception team are your image management specialists. They are usually the first point of contact on the phone, when a client walks through the door and when they communicate with organisations and associations in the industry. They are also usually the interior designers and decorators and cleaners for the waiting room.

Veterinary receptionists need to know how much of an impression they make on their clients.

Walk through your practice together as if you were a new client. What do you see? The receptionist, as the image management specialist should ensure that the overall impression is that of a professional, clean and inviting environment. The reception area should be tidy, and the receptionist in neat attire preferably with a name badge.

A good receptionist should also take the time to regularly come out from behind the counter to take note of cleanliness, smell and the client’s perspective. You may not see under merchandising stands from the reception area but a seated client can.

Overall, the receptionist should be aware of the ambience and decoration in the waiting room. It’s not just about whether posters are tatty or products dusty, but what posters, pictures and charts do you have on the wall … do they need to be there?

Think about a room in your house you can relax in. What does it look like? Why do you find it relaxing? Considering clients entering our practices are often under a great deal of stress, why not apply these principles to your own practice and let your receptionist manage the image you choose to portray.

2. Communication and Relationship Specialist

Your receptionist should be your communication and relationship specialist. Aside from the impression they make on new clients, they should also be firmly committed to maintaining and building on relationships with existing clients.

A huge part of marketing is about building and extending relationships we have with our clients. Let’s get smarter about our clients. Get out there and talk to them, establish ongoing feedback systems that have a variety of methodologies. Let’s get smarter about our relationships. Make sure our relationship with our clients is part of our whole customer service system.

Clients are people, they are human, and they want a connection where things like trust, respect and caring matter. Whether is it by phone, email or in person, they want to feel good about doing business with us. They want to trust that you and your reception team will deliver on what you promise.

A good receptionist should maintain a flawless communication style, and be able to adapt their body language, tone, pitch and daily timetable to make each client feel they are the most important person in that moment. A good receptionist will take the time to find out the client’s story and regularly stop each day and ensure they are ‘engaging’ in meaningful interactions and truly listening.

3. Marketing and Merchandising Specialist

Have you ever thought about what type of clients you would like to attract to your practice, and therefore what products, services and marketing systems will stimulate their interest?

Have you shared your business or marketing plan with those who will implement your objectives through front of house sales and interactions?

Involving receptionists in the planning and direction of the practice is an excellent way of communicating the priorities of day to day routines. A receptionist will often provide invaluable information as to what products are sold most regularly, what items clients regularly ask after and what trends are appearing in pet ownership.

Similarly, when you decide on new products or services (such as puppy preschool), your receptionist should be able to competently plan, demonstrate and display this product and information. A thorough understanding of merchandising principles goes a long way in achieving sales.

Additional skills, training and responsibilities can empower receptionists to make a real difference to the long term achievements of your veterinary practice.

You can click here to access the website

Creating Staff Incentives for Small Businesses

From an article by Paul Edge published in the Small Business Heroes website

Offering staff something extra along with their paycheck each month can have a huge impact on motivation and performance at work. While offering a quarterly bonus is a draw for many employees, there are other personal touches which can make a difference to those looking to get something more out of work than just money. Introducing staff incentives is one such way to reward employees for achieving goals.

Although it may seem like a no-brainer of a prize, money isn’t always the best incentive. Opting for incentives which are more personal and creative not only make the team more excited; it can really show your creativity as a business and make it a more desirable place to work for.

One of the joys of a small business is knowing your staff and having that more personable approach. Using that familiarity to create an incentive which people genuinely care about can produce better results, boost team morale and create a positive working environment.

Whether you’re planning a group incentive or one for all individuals to get involved in, here are some points to consider.

You Don’t Need to Focus on Profit

Naturally, the aim of any business is to make money, but an incentive which focuses on making more profit isn’t necessarily something that employees value. If a company makes more profit, employees may never see this money, so creating a profit-related incentive won’t always create maximum motivation and enthusiasm.

Creating an incentive which focuses on service or working as a team can be much more efficient and engaging. For example, if you’re a small hairdressing business, don’t ask the team to sell the most expensive products and haircuts. Why not see if they can get two new clients each per month?

It means they have to be creative and it’s not just about the money; it’s about getting new clients and new people through the door.

Time Off Can be Much More Rewarding

A recent survey discovered that holidays and time off are both incentives which motivate employees. With this in mind, combining both of these as an incentive prize is a sure-fire way to boost performance and engage employees in hitting their targets.The incentive reward could be two extra days off (creating a long weekend) and a holiday booked and ready to take.

A long weekend holiday could involve a gorgeous log cabin at a secluded forest retreat, a city break, or even a last-minute cruise deal.

Personal Vouchers

Amazon vouchers as rewards are great, because you can buy pretty much anything on Amazon. However, demonstrating that you know your employees and giving them a prize which is personal can work much better. Is a team member or their other half pregnant? How about getting them a voucher for a child care store? Does somebody love beauty? Give them a voucher for a makeover.

Adding a personal prize is the right way to incentivise staff; it shows that the business listens, cares and can offer employees things that genuinely benefit them.

Being Paid to Stay Fit

Exercise is something which many employees aim to fit into their day, but it can often be a struggle. This is why some companies are paying their employees to work out. This kind of incentive works for both the employer and the employee. The employee gets regular exercise and doesn’t have to worry about fees or time lost. In return, the employer gets a healthy member of staff who will come to work feeling active and refreshed.

Creating incentives that employees actually want is a great way to boost performance and motivation. For small businesses, it can even be worthwhile sitting down with your staff and discussing with them what motivates them most to work. Once you have their answers, you can create incentives to boost their performance and establish a great working environment.

You can click here to visit the Small Business Heroes website