Practice Management News and Views from around the World – February 2014

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What’s happening in small animal practice in the UK

Selected data from the MAI consolidated report to October 2013

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Combine These 2 Ingredients to Enhance Client Compliance

From an article by Amanda Donnelly published in the Catalyst Vets blog

For as long as I can remember our profession has discussed client communications that enhance client compliance. So, what have we learned and what’s changed? Well, the competitive landscape and profession has changed dramatically since I was a kid working in my dad’s small animal practice. But what hasn’t changed is that clients still make decisions about care for their beloved pets in large part on the relationship they have with the veterinary team. When this relationship is based on trust and a sense of family, pet owners are more likely to come in, agree to services and refer their friends. Unfortunately, gaining the trust of clients is harder now because of competing distractions (think Internet, low cost alternatives, less discretionary income) clients face. Moreover, clients often feel overwhelmed with all our recommendations for high quality care and think “does Chloe really need this?” And it certainly doesn’t help when television shows like the recent 20/20 episode air negative claims about veterinarians making unnecessary recommendations.

As I reflect on my 15 years in clinical practice and consider my observations working with clients, I believe there are 2 secret ingredients to successful client communications and enhanced compliance with treatment recommendations. They are Authenticity and Confidence. Confidence without authenticity leads to pet owner mistrust and skepticism. Authenticity without confidence may result in confusion and inaction. Look at the following aspects of your communication and consider how authentic and confident you and your team are when making recommendations.

  • Give clear recommendations for the best treatment. Eliminate vague, indecisive language such as “It might be a good idea… ” or “We could do…” and instead identify the pet’s need followed by a specific recommendation.
  • Explain medical options when appropriate and convey the risks and benefits of each along with a recommendation for which course of treatment you think is best for the pet.
  • Give clients facts and accurate information. There’s a difference between using lay terms clients can understand and “dumbing it down”. Likewise, never use scare tactics or judgmental phrases.
  • Ask clients open-ended questions about their knowledge and viewpoints so they become a partner with you in making decisions about their pet’s care. These include questions such as “Tell me what you know about senior laboratory testing?” and “What concerns do you have about the treatment plan I’ve outlined for Belle?” By asking questions you create a dialogue with clients and avoid being seen as a “salesperson”.
  • Consider how you track compliance for wellness services and what messages you use with your team. Focus on patient advocacy rather than hitting a number. Make sure team members know that any target goals are in place to help pets get the care they deserve so they can live longer, happier lives. Clients would surely be put off if they thought a recommendation was made just so the hospital could hit a revenue goal.

You can click here to visit the Catalyst Vets website

You can click here to visit Amanda Donnelly’s website

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3 bad spending habits of veterinary practice owners and managers

from an article by Denise Tumblin and Christina Materni published in the dvm360 online magazine

New Year’s is a time for reflecting and planning for resolutions–even in business. So, set a resolution to drop the following three bad spending habits and replace them with new ones to help you stress less about the bottom line in 2014.

Bad habit – 1: Bring on every special offer from suppliers

It’s difficult to walk away from a deal on drugs and medical supplies, but don’t accept one that puts an extra item in inventory that you don’t need. Sure, veterinarians like to try new products. But when the decision is made to take on something new, what is it replacing? Here’s a target to aim for: $10,000 to $16,000 on-hand drugs and medical supplies per full-time equivalent doctor. That number includes heartworm, flea and tick products but excludes diets.

Also, beware of purchasing increased quantities if it will lower your inventory turnover rate below six. An easy back-of-the-envelope calculation for inventory turnover rate is the number of times you refill your inventory of a product in a year. As a general rule, only take advantage of special offers if the purchase keeps your inventory turnover in the six to 12 range.

Bad habit – 2: Not investing in your staff

If your staff turnover is on the high side, taking a look at these areas may help zero in on why:

Structured evaluation process. Employees should receive evaluations at least once a year. Good times are an employee’s anniversary hiring date or sometime in the first quarter.

Train your staff. Time is money and training takes time. If you constantly find yourself short-staffed, if you experience high staff turnover or if your staff isn’t quite up to par, perhaps it’s time to examine your pay scales to be sure they’re competitive.

Staff compensation budget. Not having a budget for staff compensation may leave you scratching your head when it comes to staffing and paying appropriately. Target staff costs (wages, payroll tax and retirement contributions) between 22 and 25 percent of gross revenue, which includes cost-of-living and merit increases for current team members. (Editors note Staff costs here include all the nursing, reception and other support staff but exclude the cost of employee and employer veterinarians) Depending on the economics of your community, you’ll need to plan a cost-of-living increase of 2 to 4 percent and a 1 to 5 percent merit increase for a total increase of between 3 and 9 percent./p

When Dr. Elizabeth Callahan, owner of Veterinary Medical Center in Easton, Md., looked at her clinic’s staff costs last year, they were out of control. She sat down with her clinic’s leaders and found a better way to staff.

“If a doctor wasn’t coming in until 10 a.m., we didn’t need his support team there at 8 a.m.,” Dr. Callahan says. “We scheduled smarter. Now, a team member might have to take a two-hour lunch or stay later than usual, but we kept them in the loop from the beginning so they’ve all been nice about it.”

Small changes like this helped Dr. Callahan’s practice reduce their staff costs by 3 percent so staff members are seeing bonuses and raises this year.

Bad habit – 3: Letting client information lie

In this digital age, updating not only an individual’s contact information, but how they wish to be contacted is essential. Granted, doing so will require diligence and a consistent message, but try to keep the process as simple as possible and be sure to explain why you are asking for an update. Try saying, “We value our relationship with you and your pet and keeping accurate contact information is just one of our many standards of care. Can you please answer a few questions?”

There are multiple opportunities to update information when clients visit your practice—when you greet them, when they wait in the reception area, when you work with them in the exam room or when they wait for prescriptions.

Just because you’ve been doing something one way for years doesn’t mean it’s best practice. If you can break these bad habits, you’ll be in great shape for the new year.

You can click here to visit the Wutchiett Tumblin and Associates website

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VPMA helps managers get to grips with performance reviews


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Performance reviews are often dreaded, and not just by the staff being assessed! Managers looking to develop an effective review programme without the headache are urged to attend the Veterinary Practice Management Association’s afternoon meeting on the 11th March in Kilmington, Devon. Practice Manager of Pelyn Vet Group and VPMA Regional Co-ordinator, Renay Rickard, will discuss how to develop an engaging and robust appraisal system, including induction processes, use and development of job descriptions, goal-setting and key performance criteria. Renay will emphasise how to engage the practice team into the review process, so that it becomes something that staff actively look forward to. The seminar also includes Health & Safety updates from Mike Woolnough from Peninsula Business Services.

The seminar is part of the VPMA’s programme of regional meetings, which are open to both members and non-members. The meeting starts from 1.30pm with networking (and cake!) at the Hitchcock Cricket Pavilion in Kilmington. Talks commence at 2pm and will finish at 4.30pm. The rate for members is just £12 and £18 for non-members.

You can click here to download the Registration Form

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Do you have the ‘Meetings from Hell’ in your veterinary practice?

From an article by Judy Gillespie published in her VetAnswers blog

Meetings , meetings, meetings….

On one hand I firmly believe you can’t have a successful veterinary business without regular staff meetings. On the other, there is nothing worse than lengthy, unnecessary, boring meetings.

I recently read Live from CVC! Q & A: How long should veterinary team meetings last? and was reminded of a job in my previous life as a Human Resources Manager at a resort in Queensland. For quite some time the General Manager insisted on having an Executive Manager’s meeting every Friday morning. “Yes well that’s not so unusual” I hear you say, “it’s what every good Manager should be doing, isn’t it?”

Well yes, except the meeting went anywhere from five to eight hours.. every …single.. week, and not surprisingly, every single Friday I ended up with a thumping headache. Why the headache?

  • There was NO agenda
  • No minutes from previous meeting
  • AND they were usually a complete waste of time

Anywhere from 5 to 8 hours were spent on a talk fest usually about golf. Honestly – for most of the meeting we would listen to one of the Senior Execs talk about his long and interesting life playing (almost professional) golf and as the General Manager was a golfing fanatic and in awe of the other Manager’s golfing prowess he was frequently the one encouraging the conversation. One more thing… this occurred during the 90’s when smoking was all the go in the workplace so not only was my brain being poisoned by stories of golfing glory days, my body was being poisoned by second hand cigarette smoke.

So how did I escape this private hell?

One day I sat down and added up the hourly rate of the eight senior executives in the meeting, I then multiplied the figure by five hours as well as eight hours. Remembering it was nearly 20 years ago (I was very, very, young!) I worked out that each week, the Friday Gab Fests were costing the Resort anywhere between $900.00 and $1,400.00 – and achieving absolutely nothing! I wish I had a camera to take a photo of the General Manager’s face when I showed him those figures – ahh priceless!

From then on, the meetings were reduced to one hour every Friday morning AND we started having an agenda AND minutes taken! But best of all? There were no more interminable golfing stories!

You can click here to visit Vetanswers website ‘Management Resource’ to help to escape from your own ‘Meetings from Hell’

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10 Things your patients are saying behind your back

From an article by Renee Knight published in the Dental Practice Management website

Editors note: Fear not! – this isn’t a nightmare development of George Orwells novel but simply an article from the Dental Practice Management website. Read ‘vet’ for ‘dentist’ and ‘client’ for ‘patient’ – then judge whether there are lessons to be learned by your practice

Patients are going to talk. After they leave your practice, they’re going to tell family and friends about the experience they had—whether it’s good or bad.

You might be surprised to learn what many patients talk about when you’re not around, from judgments about how you handle your time to complaints about that awful team member you hired. Here’s a breakdown of some of the most common things patients say behind your back, and how you can change those comments from positive to negative.

“My dentist never starts or ends my appointment on time.”

This is a big one. Your patients are busy people, and no one wants to spend a lot of time in the reception area waiting for their appointment to begin.

Yes, dental offices get behind but there are steps you can take to make sure this doesn’t happen on a daily basis at your practice, said Kathleen O’Donnell, Executive VP of Coaching for Jameson Management. Make sure you time your procedures accurately and never double book. Be smart about scheduling patients, or you may lose some to the dentist down the street who doesn’t make their patients wait.

And don’t think you can squeeze in an emergency patient and your other patients won’t notice—if you have a full schedule this will throw off your day and leave your other patients wondering where you are.

“My dentist is always in a hurry.”

Yes, you have a busy practice and a lot of patients to see, but that doesn’t mean you should rush in and out of every operatory without spending time getting to know your patients and their dental goals, said Penny Reed Limoli of Limoli and Associates. Take the time to educate your patients on their condition and treatment options and answer any questions they may have. Let them know you do have time for them and want to help them reach optimal oral health.

“A lot of patients say their dentist seems like he’s in a rush and doesn’t spend much time with them,” Reed Limoli said. “What I really think they’re saying is when the dentist is in the room he’s not really interacting with them. He just came in and said ‘How are you doing? OK, now open up.’ Be sure that you’re connecting with patients when you’re in the room.”

“Wow, my dentist’s fees are so high.”

If patients don’t understand the value of the care they’re receiving, then they’re likely going to think your fees are too high. Take the time to educate your patients about the value of optimal oral health, and how not going forward with treatment may cost them more money down the road.

If a patient questions your fees or complains that prices always seem to be going up, don’t get defensive, O’Donnell said. Instead, take the opportunity to educate the patient. Let the patient know you want to provide the best care for your patients and are dedicated to providing outstanding services.

And remember, if you truly are providing that outstanding service, your patients are less likely to question how much they pay for it.

“When the doctor or doctors in a practice perform excellent clinical dentistry and have outstanding customer service, then patients don’t question their fees,” O’Donnell said. “They will feel it’s a fair price for the wonderful experience they had.”

“He never told me treatment would cost that much.”

Patients never should be surprised with how much treatment cost. They should know up front exactly what to expect when it comes time to pay the bills, yet this is an all-too-common complaint that leaves patients angry and confused.

This one is easy to avoid. Establish a protocol in your practice that requires you to have a written financial agreement before you start any procedure, O’Donnell said. That way, patients know exactly what to expect before they even agree to treatment.

“My dentist has the worst staff!”

This is a touchy one but one you really need to handle right away if it becomes a problem in your dental practice. You have to make sure your team members offer friendly service to your patients, and that they’re knowledgeable enough to answer questions patients may not feel comfortable asking you.

If a patient truly doesn’t like a team member for whatever reason, chances are that patient is going to seek their dental treatment elsewhere. Send out a patient survey to give patients the opportunity to tell you what they like and what they don’t like about your practice, O’Donnell said.

Take their comments and concerns seriously, and talk with any team members about issues that come up in the survey. You want patients to feel comfortable at your practice, and your team plays a large role in making that happen.

“I don’t understand why I need a new crown.”

This all comes back to patient education. Just because a patient tells you he understands why he needs the recommended treatment doesn’t mean he really does.

When you’re talking to patients about treatment options, make sure the financial coordinator is with you, or maybe a hygienist or dental assistant depending on the situation. That way you have another set of eyes and ears watching the patient for body language, O’Donnell said. When the doctor leaves the room, the team member can answer any questions the patient may not feel comfortable asking you.

It’s also a good idea to ask patients to tell you what they understand about the treatment options you’re proposing, O’Donnell said. Let the patient know you want to make sure he understands the importance of the treatment before he leaves the office, and that you and your team members are happy to answer any questions to help make that happen. Talk with the patient about his goals and show him how the treatment you’re recommending aligns with those goals.

“Too often dentists focus too much on the whole treatment acceptance process or the case acceptance process,” O’Donnell said. “We want to make sure not just the doctor but the entire team is focused on how we can best educate our patients.”

“My dentist never listens to me.”

Before you can talk to a patient about treatment options, you have to know what his goals are and you have to be flexible. Maybe your patient doesn’t really want a crown right now, or simply isn’t interested in any of the cosmetic fixes you keep talking about. Don’t argue with that patient, Reed Limoli said. Find out what his goals are and find a way you can meet those goals without suggesting treatment he simply doesn’t want.

“All my dentist cares about is money.”

Adding new technology to your practice is great, but if your patients don’t see the value in that technology, they may think all you care about is fancy gadgets and what they can do for your bottom line—especially if you’ve recently raised your fees, Reed Limoli said.

Again, this all comes back to patient education. Educate your patients about any new technologies you add to your office, and make sure your team members do the same. If they see the value in new technology, they won’t question your motives for adding expensive equipment to your practice.

“My dentist has a horrible temper.”

This is not a reputation you want to have in your community. Sure, we all get angry sometimes but that doesn’t mean it’s OK to take it out on a patient or a team member.

The next time a late patient makes you angry, resist the urge to let that patient know about it, Reed Limoli said. Instead take the opportunity to remind the patient how important it is to keep their appointments and to arrive on time, and have your office manager talk to them about scheduling a time that works best for their schedule. Address the issue, whatever it is, rather than blowing up and making your patients and your team members uncomfortable.

“My dentist flirted with me!”

You want to take the time to get to know your patients, but you also don’t want to take it too far. You may think you’re just being friendly, but your patient may see it as inappropriate flirting, Reed Limoli said.

When chatting with patients, don’t get too personal. Don’t ask who they’re dating or what they’re doing Friday night. Keep any jokes you tell clean, and avoid bringing up politics. You don’t want to offend your patients; that’s a good way to ensure they end up at the practice down the street.

You want them to talk

Patients are the lifeblood of your practice. Without them, there is no practice. You have to make sure they’re happy when they leave your practice, and ready to tell their family and friends about the great experience they had. If your patients are talking behind your back, that’s not necessarily a bad thing—you just want to make sure they’re focusing on the positives. If they are, you not only have patients who are sure to remain loyal, but patients who will refer new patients, and that can only mean good things for your practice.

You can click here to visit the Dental Practice Management website

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