Greetings Fellow Bloggers,
Please be kind as this is my first blog of any kind! This past Saturday we held an Open House to celebrate and showcase our new facility. The entire team really went above and beyond prior, during, and post Open House. We had facility tours, refreshments, give-aways, and educational stations planned along our designated tour path. The shear turnout was unbelievable, I would estimate upwards of 500-600 people over the course of three hours. Overall, it was considered a great success on many levels.
However, I am hoping to get ideas and opinions on how to show our appreciation to our clients and community for their continued support as we forge ahead into a bigger and brighter future. We can reach out via e-mail, our facebook page, and/or newspaper. Prior to the Open House I did arrange for a industry supported eight-page insert which included photos and articles about our practice, so our older client-base is familiar with us using such an antiquated form of communication (haha). If any of you are contemplating doing something of this nature, don't be afraid to use the future health of your industry relationships to bludgeon them into supporting your endeavor!
I know that there were numerous clients that wanted to stop by and see us but were turned off by the parking and the overall size of the crowd. Perhaps, providing several more informal shorter meet and greets would suffice? In retrospect, I should have asked for advice prior to the Open House, especially in terms of projecting the number of guests! That would have been too easy though.....
Thanks for your consideration,
That is an awesome term isn’t it-energy vampires. I had never heard that before until I was reading “The Energy Bus” by Jon Gordon and he describes energy vampires as those people who are gifted at being miserable and seemingly try their hardest to make those around them miserable too.
I bet you could name an energy vampire or two in your hospital. Who are the ones that you think about after you leave work? The ones who “if they only would…. Why do they…?”
The point is that though most of you like to fix things and make things better (or you probably would not be in veterinary medicine,) you cannot fix energy vampires! But they will suck away your energy! Some people just like to be miserable and it is not our job to FIX people-only animals. People have to fix themselves.
I was talking to a supervising technician earlier this week and she was telling me that one of her doctors had printed out a previous post I had written about crazy being hard to see when you are living in it. After, reading the post she knew she had to let someone on her staff go.
This technician was completely an energy vampire and becoming a huge drain on the supervising technician as well as the rest of the team. The supervisor finally realized that trying to fix this person was never going to work and she would not let this energy vampire destroy the morale of the rest of her team any longer.
I have never been so happy to hear about someone losing a job-knowing that the team would be much happier without this miserable person, even if it meant they would be short staffed for awhile. It is better to be tired from having to work a bit harder than to be emotionally drained from working with a toxic person.
Energy vampires will suck the life out of you and the rest of your team if you allow it to happen. They can’t help themselves. You have probably talked to them many times about their bad attitude and lack being a team player. You come into work, just hoping they will have changed but odds are it will not happen.
The energy vampire must leave your hospital-it is time to free their future and let them go far away from you and your team. If they are mad, just tell them I made you do it!
Have you ever had to work with an energy vampire? How did it feel when they finally left?
You can read even more posts at www.catalystvets.com
A Lullaby To My Ears
What was I thinking when I overstaffed my practice?
For one thing, I was listening to and misinterpreting the mantra repeated by countless practice consultants through the years of my career, a mantra often reprinted (in better times) on the pages of this company’s magazines: The most successful practices have the highest lay staff:doctor ratios.
This observation, of course, has its basis in truth. A doctor cleaning cages and signing checks is not making the most profitable use of his time. Having a lot of employees would no doubt keep me from doing work that my staff could do for me, leaving me free to diagnose, prescribe and cut, right? After all, these are the activities of a veterinarian which actually generate income.
As you might guess, there were two problems with this staffing strategy that, in 2008, soon had measurable financial ramifications. First, the strategy of a high staff to doctor ratio is only sound if the doctor is working at or near his peak capacity – which I was prior to the onset of the recession. If that is the case, more lay staff can, indeed, allow a doctor to more successfully leverage his available time. If, however, a once-in-a-lifetime recession hits your already-stagnating local economy, this strategy can backfire badly.
Second, speaking honestly, I can say that I was not clear on the distinction between association and causation. In other words, I did not realize that having a large number of employees per doctor was only a characteristic of, and not necessarily a cause of practice success. Extra staff can not increase office visits if there are no potential office visits available to be increased.
My real problem though, was that this mantra was like a lullaby to my ears. The truth is that I had hired many well-paid people to take care of me by protecting from tasks that caused me stress. My office manager dealt with the daily financial challenges that a solo practitioner must face even in good times, just so I would not have to face that reality. My technicians performed the tedious, sometimes frustrating chores of nursing care on inpatients in my hospital so I could avoid the aggravation. My receptionists were there to shield me from my clients, minimizing the amount of face-to-face interaction I was required to have with them, and thereby, reducing the amount of pressure they could place on me to meet their needs. Finally, the truth is that even my associate (though she didn’t count as lay staff) was there, ready and waiting - usually just waiting - just so we would never have to tell a client. “No, I’m sorry. We can’t see you right at this very moment.”
I guess it’s obvious that I was dealing with a combination of small business burnout and compassion fatigue. The truth is though that there are much more effective and efficient (as well as less expensive) ways to deal with burnout and fatigue than hiring additional employees.
One thing I’ve noticed: as a grown up, most of the major decisions you make have more than one layer to them, more than one motivation. Like a two-edged sword, they can cut both ways. Take, for example, my staffing decisions. The motivation to free up my time for more income production sounds healthy, logical and inarguable. The other motive - to excuse myself from job duties that made me anxious or frustrated - though is unhealthy, and is one that is doomed to failure. Life has a way of eventually sorting out which motive is the real one. And if the motivation is to avoid some set of circumstances in an effort to avoid negative emotions (such as frustration or anxiety), the circumstances tend to keep recurring until the negative emotions are acknowledged and faced.
Now that I've answered the initial "What was I thinking?" question, a better question to consider – in fact, the most important question to consider – is "Why did these aspects of practice cause me so much stress?"
More on that later – that’s another topic for another post. I’m still not done delineating the full extent of my dysfunctional staffing decisions.
Okay, so when the recession hit in 2008, my practice was overstaffed in every way imaginable. I had a well paid, full time office manager. I had just hired a full-time associate veterinarian who, while she was not over-paid, was definitely not generating enough revenue to justify her salary. I had two full time technicians and one full time receptionist.
While this may seem like a reasonable level of staffing for a full service practice open six days each week and providing after hours emergency service in a rural area, it proved disastrous when the bad economic news started rolling in that year.
Those who know me best would howl with laughter at the suggestion that I am an optimist. As the recession lingered on, however, I made the mistake of remaining far too optimistic for far too long. I kept thinking that if I could hang on just another month, things would turn around.
The financial hole that I one-more-monthed myself into was serious. The sad truth is, it took me three years to stop digging myself in deeper. Of course, once I stopped digging, things began to improve immediately. In reality though, it has taken me another two years to recover from the consequences of the staffing decisions I had made in 2008.
Last month I wrote about a chain of events that lead to a client being very upset with us due to a string of misinformation. It was Friday morning and she had just euthanized her puppy for what she believed was because we had prescribed heartworm prevention that poisoned her dog. For two days her puppy had been unsuccessfully treated at another veterinary hospital and all we had to go on was what she told us. We were told his kidney values were high, he was doing worse so she had to euthanize and it was our fault.
Certainly understanding of the sudden, terrible situation of having a puppy get acutely sick and then euthanizing we gave our condolences. We asked what we could do for the owner. Her response was we could do whatever we would like but no matter what she would be suing us. Our relationship to that point was vaccinating and prescribing a healthy puppy a FDA approved heartworm prevention, we were confidant this owner did not have a case. At that point I’m sure a lawyer would recommend ending the relationship right then and there with the client.
But, when our practice manager brought the owner’s conversation to my attention I still wanted to know what happened? A young puppy that was perfectly healthy a week before gets acute azotemia and is euthanized within 2 days is all I had to go on. Certainly many possibilities existed but the one that gave me considerable concern was the possibility of a leptospirosis infection (which is endemic in our area). My thoughts then turned to the one year old child that was in the exam room with that puppy the week before.
The puppy was lost and by the clients unrealistic reaction our interest in this case should have been over. But being a veterinarian I had to think of the human health aspect, especially with a young child’s health at stake. So I discussed my concern with my practice manager. Given the lack of credible information the client had been given by other doctors to this point I was concerned this possibility was not going to be thoroughly followed up with. He had the same concerns and against legal advice we felt we needed to get answers on this case, if for any other reason the potential health of a child.
We could have done a gross necropsy ourselves and sent the appropriate samples to reference laboratories for testing but the owner had lost total trust in us. We told the owner the best option would be to get an independent, board certified analysis and take the puppy to the nearest university diagnostic lab which is about an hour and a half away. Unfortunately due to the price the owner balked some more. So my practice manager had a good idea and contacted the company that produced the heartworm prevention in question. As unlikely as both the company and we felt the prevention was the problem they agreed to pay for the necropsy since they were still in the middle of some damage control due to the erroneous Atlanta news report.
Unfortunately due to the drive the owner still balked at taking her puppy to the diagnostic laboratory. So my practice manager for the sake of ensuring this child’s well being went himself a half hour in the wrong direction to pick the puppy up, and then drove him to the university to have the necropsy performed. He literally spent that entire Friday dealing with this case.
Luckily the leptospirosis tests were negative. All toxin screens for the heartworm prevention were negative as well. The puppy had an acute renal and brain infection from an Enterococcus infection. The results took about 6 weeks until all results were in. After each report I would call the owner to follow-up (she had us sign for her to get the results directly from the university so we did not have an opportunity to tamper with them). Only once did she pick up the phone once the initial gross results were in but the leptospirosis and toxin tests were still pending. By now she had done some reading and was concerned about leptospirosis as well. We discussed the results and the possible implications of leptospirosis, but I advised the owner to talk with her pediatrician and to get infectious disease specialists on board if the results were positive. Luckily they were not and each time I called the owner she did not pick up the phone or call me back. During our conversation I could tell she was more concerned about her family then about litigation, but I could still tell that she had distrust for us because of that initial misplaced information.
In the end we lost a puppy. We went through a lot of trouble for a client we were not going to keep. But as unlikely as it was I am proud of the way our hospital handled the case and looked into something that could have had broader implications for a human, a young child none the less. Our diligence did not make good business or legal sense, but I truly believe that even though this owner did not appreciate it, we were the only ones truly looking out for her family and sometimes beyond better judgment you just have to do the right thing.
A very disturbing study was just released addressing the financial status of the profession and as you may have expected, the results are not good. You can view the white paper that was just presented at NAVC here.
There were many disturbing trends they found but these are the some of the findings that should be very concerning to all of us.
“There is widespread concern over personal financial condition. Less than half of the veterinarians who are owners, and less than a third of associates, rated their personal financial condition “well”. “
“22% of the practice owners carried student loan debt, with an average balance of $66,110. 49% of associate veterinarians are carrying student loan debt, with an average balance of $112,082.”
“For some associates debt servicing requires nearly 40% of their monthly income.”
“A very large number of veterinarians, especially those not doing well financially, are not at all confident in their ability to manage finances.”
These statements should have all of us very concerned. The problem is most people have been sitting around with their head in the sand (which seems to be something our profession is very good at doing) or waiting on the veterinary schools or the AVMA to change what is happening to our beloved profession.
The only one that can change your future is YOU. If you are waiting for the “powers that be” to make positive change-good luck!
Luckily changing your future is simple. Simple BUT not easy! You MUST learn about personal finance and you MUST get out of debt as quickly as possible. I know you are thinking that is impossible BUT it is not. Being debt free is the only thing that is going to give you options and freedom.
Coming out of veterinary school, I knew absolutely nothing about finances. I made plenty of mistakes, but I was so fortunate to have learned about Dave Ramsey from a veterinarian who I worked with. Listening to Dave’s radio show made me realize that there was a different way to handle my finances and shockingly enough it was not what the “financial experts” would have you believe.
New graduates are coming out of veterinary school with an average of $150,000 in student loans. I was fortunate to have very little student debt, BUT thanks to APPLYING the principles Dave Ramsey teaches, my husband and I were able to pay off our $300K home mortgage in 7 years. I also run my business debt-free. I am not telling you this to be bragging, but instead I want you to understand that YOU too can get out of debt.
Getting out of debt quickly is not easy and you will have to sacrifice some things now in order to get it done, but taking 30 years to pay off your debt is honestly just plain stupid. As a wise man once said, the borrower is slave to the lender, and I bet you feel just like that when you are paying all those loans every month.
If you are serious about changing your financial well being then leave me a comment below and you will be entered to win a copy of Dave Ramsey’s “Total Money Makeover” which we will give away on March 15th.
If you are a practice owner, I strongly recommend his CORE Financial Wellness program that you can offer to your entire team. This program will benefit not only you and your doctors, but also your support staff who often are struggling just to get the bills paid each month.
I obviously don’t receive anything from Dave or his team for recommending his products, but if you take what he offers and APPLY it- you too can be free from the mountain of debt AND change your family tree!
You can read more of my posts at www.catalystvets.com
One of my favorite writers is Anne Lamott. Check her out. She writes grace-filled, hilarious, encouraging stuff that points us in the direction of self-acceptance. Recently she posted that she intended to entitle her autobiography, “It Seemed Like a Good Idea At The Time.”
If I was gonna write a practice management blog, the only type of practice management blog I would be qualified to write is one like that…“It Seemed Like A Good Idea At the Time.” I certainly could not write one from an authoritative position of financial success, giving you the three steps to follow in order to match my success. I’m more like singer/songwriter Todd Snider (again, check him out), who refers to himself in one of his songs as, “a walking financial mistake.” If I was gonna write a practice management blog, it would have to be more along the lines of exposing you to what notto do.
If I was gonna write a practice management blog though, that’s about the only type that I could think of that might be interesting, or that stood a chance at being beneficial to someone else. More specifically, the blog would be about considering why It Seemed Like A Good Idea At The Time - in other words, analyzing the motivations, beliefs and internal dialogue that fueled my questionable decisions.
The blog would be like a T-shirt I saw just before the holidays, “Dear Santa, Let Me Explain…” My blog would be called “Hidden Expenses” because these whys and motivations can cost us money without ever showing up in a standard chart of accounts.
If I was gonna write a practice management blog though, I’d have to do it under a pseudonym…not because I’m ashamed to own my mistakes or my motivations for making those mistakes, but rather, because I don’t want to give my frenemies - uh, I mean my local colleagues - any advantage that could adversely affect the value of my practice. You see, in spite of my mistakes, I have managed to own and operate the same veterinary practice for thirty years. That gives you some idea of my age; doing a quick bit of math, you can see that there is more sand is in the bottom half of the hour glass of my career than there is in the top. Consequently, I think about the value of my practice. A lot. So…in order to protect that value – such as it is - I would change my name in accordance with my constitutional right to avoid self-incrimination…if I was gonna write a practice management blog.
Don’t worry though, I’m real. Brendan Michael Howard of Veterinary Economics knows who I am and could put you in contact with me should you feel compelled to invalidate me. By way of credibility, I have previously written personal growth articles for Veterinary Economics under my real name. Also, if you look around the internet a little for my pen name, you can find an e-novel I’ve written set against the backdrop of our profession.
I suppose the real question is…if I was gonna write a practice management blog, would anyone read it? I guess we'll see...
There are so many skills you need to be a good manager. There are also many courses, workshops, webinars you could attend and books you could read all about how to be the best manager. But none of them will be much help if you don’t have skills in one particular area..... the ability to recruitment and selection the RIGHT people for your veterinary practice.
Just imagine if a client or a friend came to you and asked you to get them a pet. And so you did – a cute little puppy from the local shelter that was just begging for a new home. When your client/friend arrived to pick up their new pet rather than the expected reaction of “Aww he’s so cute & exactly what I wanted” you got “A dog??? But I’m allergic to dog hair, live in a unit that doesn’t allow dogs or cats AND I work long hours and frequently travel. I was thinking more of some fish or maybe a bird!”
Now it’s not the puppies fault but there’s no way he’s going to fit into the life of someone who is allergic to pet hair, lives in a unit and isn’t home very often – no matter how brilliant a dog he is.
Now you’re probably thinking “How ridiculous! Of course I would never just go and choose a pet for someone without finding out exactly what they wanted.” And I know you understand that choosing the right pet is an incredibly important decision. So you might make a list of all the attributes the pet would need to match the lifestyle of your client/friend just to make sure you find the perfect fit. You might even discuss a few suggestions with your client/friend and get them to consider some ideas before you made any final decision or purchase.
We all shake our heads when we hear about people who purchase a pet on the spur of the moment and then realise they can’t afford it, it doesn’t fit their lifestyle and they have no idea what to do with it. When the cute puppy starts barking all day, digging up the garden and the neighbours start to complain the owner may try some training to change the puppy's behaviour but ultimately most dogs need company and no amount of training is likely to work (although changing the behaviours of the owners is another story!). And so unfortunately the dog is blamed and is the one to suffer.
Well now my question is, why would you employ someone for your business without going through a similar process?
(NB: there’s no way I’m comparing employees to pets btw – I just like analogies!)
It can be quite a time consuming and frustrating process and sometimes the pressures of everyday work (and from existing team members) means that it may seem easier to just choose the first person that looks to have the right skills and experience – well according to their resume anyway. But just like the ‘spur of the moment’ pet purchaser you may also find yourself stuck with an employee that just isn’t suited to the environment and culture of your veterinary business. It won’t be the fault of the employee either, they are who they are and just as a dog can’t change into a bird, a person can’t change their inherent personality traits and work environment preferences.
The next time you’re faced with recruiting a new staff member there are three important things you need to do:
1. Consider what the needs of the business are;
2. Make a list of the attributes that the new employee would need to meet those needs;
3. DON’T employ someone until you find the RIGHT person that meets those needs.
The journey from point 2 to point 3 is the challenge. If you don’t already have a recruitment and selection system set up or you have no idea how to set one up then investing in some training is the most valuable investment you can make.
There are some 1 day workshops coming up around Australia being run by ‘Recruit Right for Vets’ –Recruitment Bootcamp for Vets. No I’m not receiving any monetary (or otherwise) reward for mentioning these workshops, I just know that a hands-on practical workshop is the best way to learn the skills you’ll need to implement the right recruitment & selection system for your business. And $395 seems like a pretty reasonable price to pay considering the cost of employing the WRONG staff!
So in the comments section below, tell me the what you think is the most difficult part of recruitment and selection of new staff? What’s gone wrong in the past for you?
By Guest Blogger: Tim Alberts, Managing Director, Standard Practice
Have you ever looked up the definition of a Document Management System (DMS)? NB: We won’t confuse issue more by adding that definition here... But it wouldn’t be amiss of me to say most people, after around the second line of the definition, lose their place and start to wonder just what it is they’ve gotten themselves into!
The thing is – when it comes to managing documents, a system can track and store and be as capable as you need; however, if you don’t know what you don’t know – about DMS’s ... then it can all appear just a teeny bit too confusing....
For most businesses, Windows Explorer is their default ‘document management’ system. So what’s wrong with this? Isn’t that good enough?
Certainly it’s generally better than paper-based systems, particularly those dust-gathering, almost always out-of-date manuals that we used to have to contend with.
But let’s look at a few issues and limitations around this approach.
For starters, it means your staff must know how to navigate your network. That’s not so bad if you have a really well organised file system, and staff who are well trained in using it. In a busy clinical environment, this is often not the case.
How do you provide limited access to your documents?
For most clinics and small businesses, using Windows Explorer means there is little to no control over duplicate documents being created, or documents being moved, edited or deleted (inadvertently or otherwise).
Without good skills in Windows, permissions and security (which most of us either don’t have, or don't have a budget for) it’s hard to limit who gets to see what. This means staff have access to many documents that are either irrelevant to them or not appropriate for them to view.
How do you currently backup all your documents?
Without a good file-system backup in place, it’s pretty hard to know that you have a secure backup of your documents when they are spread over a (possibly not-so-well-organised) network. Often clinics will pay great attention to backing up their patient management systems (e.g. RxWorks), but don’t have great systems in place for backing up their documents and other files.
How does your current ‘document management’ system (i.e. probably Windows Explorer) help you with making external resources available to your staff? Things like websites, YouTube clips, Material Safety Datasheets etc.
How do you catalogue those things and ensure your staff won’t have to remember complex URLs or rely on Google searches (that might yield different results on different days)?
We all know that wading through a Manual is not the most effective or time efficient way to get to a piece of information.
HOWEVER… there are times when you want groups of documents collated into ‘a manual’ – e.g. an Induction Manual, a Workplace Health & Safety Manual (or heaven-forbid, a Policy & Procedures Manual for the purposes of meeting accreditation requirements).
Usually, this means a whole lot of copy-and-paste, or print-and-collate.
A good DMS should offer you much more than Windows Explorer (or the horrible old dust-gathering thing on the shelf). Consider:
So what do you think? Is it time to consider implementing a (good) document management system? It really could be a lifesaver for your veterinary practice.
Tim Alberts is the Managing Director of Standard Practice and one of the people responsible for the development of the system. The team at Standard Practice are experts at document management and their software allows you to store, manage, organise and reference all your policies, procedures, forms, training resources etc. in one central database.
Tim has worked with veterinary practices all around Australia and New Zealand since 2005 to help them implement the Standard Practice™ system and improve their efficiency & communication.
Back about 6 years ago, I did not have a pre-anesthetic checklist in place. Typing that sentence about makes me sick to my stomach because looking back that was so naïve, yet I had never really thought about it and it certainly was not commonplace.
Not having that checklist got me in a pretty bad situation when I was at a hospital operating on a dog who had bilateral CCL disease. I had done an orthopedic exam on the dog a week earlier, so I made the mistake of not repeating the exam the day of surgery. My assistants both had asked the technician helping us which leg we were operating on and were told the right leg.
Once we got into surgery, I was surprised because there was a partial CCL tear instead of what I had suspected was going to be complete CCL tear. In the OR, I asked again about which leg we were supposed to be doing and was again told the right leg. We proceeded on with the TPLO, which thankfully was uneventful.
All was good until the evening when the owner came in to visit the dog and she told the attending veterinarian we were supposed to do the LEFT leg. The veterinarian called me and I almost became physically ill. How could I have made such a stupid mistake?
It was really quite easy because the first time the pet came into the hospital the receptionist entered the right leg as being the worse leg NOT the left. I am not remotely placing the blame on the hospital though because if we had a pre-anesthetic checklist in place this would not have happened. I would have repeated my exam even though I had done one the week before because that is a box my assistants have to check off as completed EVERY time.
The good news is the dog recovered well from the first TPLO and went on the have the other leg fixed as well and is doing fine.
I tell you that story, not because I want to admit that I made such a huge mistake but instead to remind you of the importance of the checklist and a team that follows it. Immediately, I created a pre-anesthetic checklist that MUST be completed on every patient. How it works is once the patient is down, my assistants do the initial exam and then I double-check them EVERY time.
Yesterday, we arrived at a hospital to correct a medial patella luxation on a young crazy pit bull. I actually snuck away to wolf down my lunch while Kadie and Nicole were getting the patient ready for surgery. While I was eating, Nicole came to tell me that Kadie had actually palpated a CCL tear in the right leg even though we were there to do a patella surgery on the left leg.
I immediately got up to do my exam and sure enough that was exactly what was going on and thankfully my “on the ball” team and a pre-anesthetic checklist keep us from making a huge mistake for our patient!
Dr. Atul Gawande, a human surgeon, wrote “The Checklist Manifesto” about the importance of a checklist for keeping us focused on not forgetting the simple things-like doing an exam or giving pre-operative antibiotics. Interestingly, he found that many doctors (and I would bet veterinarians too) resist checklists because they feel that medicine is as much an art as a science. Though, doctors are not keen on being required to use a checklist, he found that 93% of them would want one used if they were having an operation.
I hope my bad experience can save you from making a similar mistake and I would challenge you to create a pre-anesthetic checklist if you do not already have one in place.
Do you have a story of a team member saving you from making a stupid mistake that you would like to share?
You can read more posts at www.catalystvets.com
I’m a relatively intelligent person. I can understand most issues that relate to my two dogs. And when you’re explaining my dog’s condition and then outlining your recommendations, I’ll nod my head, look intelligent and probably agree with you.
“Do you have any questions?” you may ask. “No, I think I’ve got it all” I might say.
And then by the time I’ve arrived home (a massive 5 minute drive away) it’s quite likely I will have forgotten at least 60% of what you’ve told me. Don’t take it personally; I do the same thing with information from the physio, plumber, dentist ..anyone really who verbally gives me information or instructions.
As I’ve already mentioned – I’m a relatively intelligent person AND I’m also a mum with 2 very busy kids and a husband. I manage our household and my own business – I have so many balls in the air that I should be the star of the next Cirque du Soleil show. So while you were talking to me I may or may not have also been thinking about whether my kids have a fork in their lunchbox to eat their pasta salad with, reminding myself to stop in at the butcher’s to get something for dinner and remembering that I haven’t paid my Telstra bill. Or I may have been listening to you with 100% of my attention. The problem is that you won’t know either way. After being involved in literally hundreds of hours of interviews in my previous life as an HR Manager I’ve perfected the art of appearing to give you 100% of my attention when I’m not – tricky hey! (Don’t get me started on the implications of not listening with 100% attention during an interview)
I should mention that I’m also a highly visual & kinaesthetic learner. This means I learn by reading and doing. My auditory learning skills? Not so good. However I’m not alone, as a large percentage of the population are also visual learners (at least 65%, probably more).
So if you really want to help me provide the best care for my two dogs it’s pretty simple. Don’t just ‘tell’ me, you need to also ‘show’ me:
If you haven’t already, check out the iConsult – the Australian designed app for the veterinary consult room, it ticks all the boxes! (Yes they have a page in the Vetanswers Business Directory but their App is awesome!)
So now you’ve worked out you need to SHOW me what you’re talking about AND follow it up with a handout and preferably an eBook, you also need to consider those clients that are not only visual learners but who also may have little experience in the veterinary world. These are the clients who may not understand your explanations. I know it can be tricky – if you explain something too simplistically the more knowledgeable client may feel you’re being condescending. Explain something using too much technical jargon and your client may feel you’re talking over their head.
Again, you can explain something to me and I’ll appear to be understanding every single word (I may even be giving you 100% of my attention!) but I also don’t want to feel like an idiot by admitting I don’t understand a word you’ve just said.
This is where a helpful blog post from dvm360 can help you out ‘Veterinary clients’ biggest doctor complaints revealed’. The author Bob Levoy, suggests that one way to deal with this type of communication gap is to use the ‘Teach-Back Technique’. Check out the blog post for more details but basically the aim is to get the client to repeat back to you in their own words what you have just explained. Ah hah! There’s no hiding behind me wisely nodding my head as you talk now!
I can see this technique will require a little bit of practice so that you don’t come across as condescending and you’ll need to find the right language but I think the suggested scripts offer a great place to start.
So in summary if you want to be sure that your clients have understood what you’ve explained AND also understand exactly what they have to do when they get home, you need to do a few things:
So from your understanding, what’s the most important thing you need to do when communicating with clients? ;-) You can tell me in the comments section below.
By Guest Blogger Connie Stewart, Vet Edge Ltd
This blog post was originally posted on the Vet Edge website on 3/9/13 & has been reproduced in its entirety with permission.
While August was Dental Month for many veterinary practices, your canine and feline patients suffer from dental disease all year round. According to Kyllar & Witter (2005), 60% of over 400 adult dogs in their study had periodontitis. Hence every second dog who presents to your clinic for an annual health check potentially requires a dental treatment. But are you performing half as many dental procedures as you are conducting canine annual health checks? I suspect not.
I remember from my days in practice as a veterinarian what it is like. Day after day you recommend a dental procedure and client after client say "I want to think about it" and you don't see them again until next year. There is a better way. To follow are 6 steps to help you get more of your clients to say "yes" to your veterinary dental procedure recommendations.
I'm sure you are looking at every mouth, but are you pointing out the dental disease by showing the owners on their pet.? If your patient is a little "mouth shy", you could always use a dental model that has dental disease on one side and a healthy mouth on the other. While this might seem a little unnecessary, remember that your clients have not had all your years of veterinary training and experience and they don't see dental disease every day like you do.
Make sure you tell the owner all the benefits they will receive when "Fluffy" undergoes a veterinary dental procedure. A note here is to explain using language the owner understands, not 'veterinary speak'. Another great tip is to consider the benefits from the owner’s perspective. For example, you might say: "Have you noticed Fluffy's breath isn't that pleasant? Well this is because of the dental disease and our treatments will remove all the disease causing the bad smells."
I find most vets are happy to discuss the endocarditis potential and other negative consequences of dental disease.
Owners are left to assume that the procedure you will perform is much the same as what happens to them in the dental chair unless you explain otherwise. Include elements that will put your clients mind at ease. Examples include use of blood screening and fluids to improve anaesthetic safety and nurse monitoring throughout the procedure. The more detail you include here, the more value the owners understand they are getting before you get to how much it will cost.
It is tempting to print out an estimate and run through all the technical elements of their future bill. The problem with doing this is that all the value you explained to the owner in Steps 1-4 have now gone out the window. Instead, all they are thinking about is how much this bill is eventually going to come to (doing maths in their head). They also naturally start to think about what else they could do with that money. It is ideal to keep step 5 super short and it could go something like this: "We can do all of this for Fluffy and it will cost between $350-500 (insert your owner prices here)".
The range is to allow for differences in severity of disease, if the procedure goes longer than expected, requires more teeth extractions and/or additional medications to be administered. This can be explained to owners if they ask.
Again, nice and simple: "Would you like to go ahead with booking in Fluffy", or "How is next Thursday to book in Fluffy?"
Now while you won't get a "yes" every time, you will hopefully get more than you do now. In a future post, I'll give you some tips on how to overcome the dreaded "I'll think about it" response. If you don't have a process around dental recommendations in your practice, check out this post on 9 Key Benefits of Establishing Systems and Process for your Veterinary Practice.
How are you getting more clients to say "Yes" to your dental treatment recommendations?
What tips or pitfalls have you discovered to get more clients to say YES?
Connie is a veterinarian, veterinary business consultant, coach and director of Vet Edge Limited with over 10 years’ experience in the veterinary industry. She has a Bachelor of Science and a Bachelor of Veterinary Science graduate from Queensland University and has recently completed a Post Graduate Diploma of Business from the University of Auckland.
She is passionate about helping veterinary business owners and their clinic teams to create their vision, set goals, maintain execution strategies that drive results and improved profitability.
Connie is an experience trainer who has a particular passion for helping veterinarians improve their consultation room effectiveness and is currently developing a training program for vets called Better Veterinary Recommendation, which will be available online in October 2013.
For more veterinary business tips, sign up at www.vet-edge.com to receive a free weekly e-newsletter.
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This past week at work has been a little off kilter. We have been busy, but little things have not been flowing as well as they usually do. Initially, I could not pin point exactly what the problem was.
After thinking through things, I realized that the problem was not my team-it was me. I was “off “this week, mainly because I have had a lot of stuff going on away from work. It has affected my ability to be the leader I need to be for my team.
Now to be completely vulnerable, I just finished writing in my journal about how I need to let go of trying to take on ownership of other people’s choices because I do this way too much in my life and I need to be done with that.
The easy way out for me as the “boss lady” would have been to start blaming my team for the little mistakes that were happening. Again, nothing was major but little things do drive me crazy (ask anyone who knows me well.)
The irony is a few weeks ago we were at a hospital (that we rarely work at) and while we were there, they were having a staff meeting. In the meeting, the practice manager was talking about the poor morale and how it had to improve.
Now honestly, I do not know the specifics of what the issues were but what I do know is that you cannot mandate an improved morale. This is not a new policy you can implement and think morale will improve. If any of you are parents, you have probably tried this at home without much success either!
If they asked my opinion (which they didn’t) I would tell the leaders in the hospital to take a good look at themselves. What behaviors are they engaging in or not engaging in that is likely causing this low morale?
What I know as the leader in my business is my attitude matters most. I am not saying that you are responsible for other people’s attitudes because if you are like me, then you already take on too much ownership of other people’s feelings.
BUT as the leader, your attitude, good or bad, does set the tone for everyone else on your team. To be honest, I wish my attitude did not matter so much, but it does, and THAT is a responsibility that I, as the leader, must accept.
Leave a comment below: Do you think the leader’s attitude (good or bad) sets the tone in your hospital?
You can read more of my posts at www.catalystvets.com
Last week I had the pleasure of attending an IVMA conference in Indianapolis. Speaker Brenda Tassava CVPM, CVJ shared her advice and tips with the small gathering of veterinary professionals. Her experiences working in and with veterinary clinics had well equipped her to offer a wealth of knowledge in such areas as; workplace communication, developing a team vision and preventative care plans.
As it should be, I left the conference excited and charged, inspired to pass along a ton of new ideas.
Back at the office... life goes on. Day after day we drudge through our familiar routines. The spark fades away and all those great ideas end up in the pile of things we’ll get to when we have time.
But does it have to be that way? What if we could harness that positive energy and keep the flames burning bright?
Trying to implement too many new concepts at once may be overwhelming. Instead focus on just one or two small things at a time, otherwise you’ll easily feel defeated and never accomplish your goal. Be as specific as you can about how you plan to present and finalize the change you are trying to bring on.
For example if you’re striving to improve patient care and offer exceptional service to your clients, begin with something easy that the whole team is willing to perform.
Make a commitment that for the next week you’ll; offer an additional service such as nail trims or ear cleaning even if the client doesn’t ask for it, take a few extra minutes to help them tote their carrier out to the car or provide some other courtesy that makes your clinic stand out.
I know it seems like such a small and simple task, but when you’re too afraid to take a big leap, it’s the small steps that will get you moving in the right direction.
So why is change so hard?
My theory and short answer is, people are naturally creatures of habit. We find a method that somewhat works for us and we repeat that method. As much as we want and even need change at times, we are equally afraid of what the change will require as well as what it will yield. Most people continue to repeat even a broken method until change becomes absolutely necessary. However it’s only through choosing a different method that we can grow and succeed.
If you get the chance to attend a local veterinary conference, it’s my hope you’ll walk away with some great ideas and a renewed passion for what you do. Keep that flame burning and be ready for change when you bring it home.
You can find more information about Brenda Tassava and HTC veterinary consulting services at http://www.halowtassava.com/htc-team/brenda-tassava-cvpm-cvj/
Though many of you have been shy about the “one thing” you are going to be working on in the comments section; we did get a good response over in our Facebook group (if you would like to be part of that let us know). People were working on a variety of things including giving up soft drinks, staying off of technology for a certain time in the evening, and training for a half marathon.
As you may remember, my one thing was to stay off of the Internet from the time I get home until the kids go to bed. This has always been a real issue for me especially when I am stressed!
I have done a lot of reading on habit formation and one of the best things I picked up was determining what trigger was standing in my way of accomplishing a particular goal. For me, probably like many of you, when I see my ™ or my iPad™- I immediately want to pick it up and see what I may have missed.
The best and easiest way to stay off my devices was to just keep them out of my sight. This may not be the same trigger for you, but it worked for me.
The simplest way for me to keep it out of my sight was to just leave all those devices in the truck until the kids go to bed. It is amazing how well changing one thing enabled me to create a GOOD habit. My “one thing” was not 100% success though. Last night, I was not thinking and accidentally brought my phone and iPad™ in the house and guess what- I was on my iPad™ before I even realized it!
A few years ago, I decided I had to give up Diet Coke™. This was the hardest thing I ever did! It probably took me a good year to lose the cravings for that addicting substance. I knew replacing Diet Coke™ with water would never work. I needed something similar but a lot healthier, which turned out to be unsweetened, iced tea.
We all have different triggers and the key is figuring those out. My Diet Coke™ addiction was more about the ritual of drinking a big drink every morning and afternoon rather than what it was that I was drinking. Once I replaced those Diet Cokes™ with unsweetened iced tea, replacing Diet Coke™ at any other time a day became much easier. Now the taste of Diet Coke™ repulses me.
I recently stumbled on to www.jamesclear.com. James publishes two articles a week and most of them are about creating better habits. I would strongly encourage you to check him out. Also, the book “The Power of a Habit” by Charles Duhigg is another great resource if you want to create lasting positive change in your life.
What you will learn from both of these authors (and what might actually surprise you) is with a few little tweaks, how easy it can be to shift a bad habit to a good habit or to create a new habit all together!
Have you figured out any triggers that are helping or hurting you?
You can find more of my blogs at www.catalystvets.com
By Guest Blogger Dr Gary Turnbull, East Port Veterinary Hospital, New South Wales, Australia
It's time to start a dental “program”. Before you let loose on the general public (your clientele) there are a few important boxes that need to be ticked. This holds true for any program that you care to consider, and in fact for every single change you wish to make within your practice.
To help illustrate the salient points I’ll share with you some wisdom from learning the hard way.
My first attempt to initiate a new approach to dentistry took shape in 2008. As I reflect on my own experience, I realise that I broke every fundamental rule in the Leadership playbook. At the time I thought it was pretty straight forward and it looked something like this:
Over the past 4 years I have significantly refined the program. Only through the implementation of sound Leadership principles has it become a success. So successful in fact I was invited to present “Goldmine Dentistry” to Banfield Petcare in Portland Oregon November last year. And to put some numbers to it, we now perform 600 dental cases per year, accounting for approximately 8% of our total turnover.
Looking back, there were two critical errors in judgement and execution on my part; a failure to recognise and articulate the true purpose of the program and a system of motivation that was inherently flawed.
At the inception of any new program, a logical starting point is to motivate the team. Let’s face it, whether you’re the practice owner, manager, gun practitioner or head nurse, you can’t do it on your own. As tempting as it may be to offer a reward, provide an incentive for great measurable results (as I did)....don’t do it! Research has demonstrated many times over that apart from the most basic non-cognitive functions, financial incentives do not enhance performance. To the contrary, they actually worsen results.
This concept pops up time and again and it’s all about inspiring people. We are inherently adept at articulating what we want done and how to do it. We put our logical, analytical brain (neocortex) into gear and provide all facts and figures, features and benefits. Our team members digest this information which is great but unfortunately it just doesn’t move them. Why not? We’re talking to the wrong part of their brain. You see, we actually make decisions with our limbic brain, the part that controls emotions and is responsible for decision making and in fact all human behaviour. The way to tap into people emotionally is to start not with what we are doing but rather why we are doing it.
Now when it comes to dentistry this is a no-brainer. Speaking with veterinary professionals all over the country about their mission, invariably I hear people committed to promoting and practising ‘Gold Standards’. When it comes to companion animal dentistry, those standards are developed and published by the American Animal Hospital Association (AAHA). AAHA guidelines provide us with comprehensive recommendations for dental care including the need for annual oral examinations for all patients performed under general anaesthesia (the only way a thorough examination can be performed!). So the “why” box is ticked for us. The only way to uphold Gold Standards is to rethink our dentistry and start giving it a lot more attention from a preventative perspective.
I should add at this point, the why is never about money. Profit is a result of what we do, but never the reason why we do it.
I know I’ve been guilty in the past of telling my team what I want done, and then proceeded to tell them exactly how to do it. There’s a few flaws with this approach. First of all, I’m not the smartest and definitely not the most creative person in the room when our team gets together. In fact, the more I take a back seat and keep my mouth shut, the faster the magic happens. Secondly, I’m not a receptionist, or a nurse, or a manager, so who am I to tell them how to do their job? Doesn’t mean I don’t have control. Autonomy is all about clearly defining the outcome you desire and then letting the team decide how they will get there. It gives them ownership of the situation and immediately starts to create accountability as well.
Finally, to be able to hold our team accountable for executing and maintaining a dental program, we must first ensure they are adequately resourced by way of education, training, equipment and time. I recall my undergraduate dental training consisted of 2 lectures given by the head of surgery!! Although things have improved considerably, I find many practitioners don’t like dentistry simply because they are not confident in what they are doing. The AVA conference dental wet labs are a great place to start if this is an issue. Personally I have found the veterinary dental community to be extremely generous in sharing their wisdom and expertise.
If you haven’t already, you will also need to invest in a veterinary dental suite, comprehensive range of hand instruments (sharpened daily!) and yes intraoral radiography. Without dental radiographs you are sabotaging your purpose of practicing Gold Standards.
Once you start routinely radiographing your patients and appreciate all the pathology you’ve been missing for years your workflow patterns will change. We frequently find dental cases take 1 – 1 ½ hours to complete. You will need to ensure you have adequate human resources and enough hours in the day to cope with this.
It is beyond the scope of this article to address all of the Leadership principles that need to be applied for success with your dental program…….I could write for days! However getting the team motivated and creating some accountability is a great place to start.
It is beyond the scope of this article to address all of the Leadership principles that need to be applied for success with your dental program…….I could write for days! However getting the team motivated and creating some accountability is a great place to start.
Dr Gary Turnbull is a veterinary surgeon situated on the mid-north coast of NSW. He is the director of the East Port Veterinary Hospital, a multi-award winning and Australian Small Animal Veterinary Association accredited Hospital of Excellence. Gary is a first class honours graduate from the University of Sydney and a Chartered Member of the Australian Veterinary Association. He is also a member of the Australian Veterinary Business Association, Australian and American Veterinary Dental Associations and Australia’s first Veterinary Mastermind Group.
In addition to clinical practice, Gary is a recognised and respected presenter in veterinary practice management, business models and life-balance strategies. He is also a graduate of the Lincoln Institute’s Executive Leadership program and co-founder of Vetintell, a company specialising in Leadership training to the Veterinary Industry.
Before defining the core values in my own practice, I did not understand how critical they were in helping me sort through all the potential new hires. What I can tell you is hiring people who do not share your core values will never work. They will always be a square peg in a round hole.
Before I knew better, I had hired people who did not embrace the core values of TVSS and it was not pretty. They never “got it” and ultimately they left or I had to let them go. Without compatible core values, they will never be a true fit for your team which is not good for you or them.
The challenge I see is that a lot of hospital leaders have not truly defined their core values or the core values are vague ideas written in a manual somewhere that no one reads.
So then, is it any wonder that many animal hospitals have the turnover they do?
Turnover is expensive.
It is estimated that the average cost to replace an employee is about 20% of the person’s annual salary. That means if you lose a technician who is making $16/hour then it will cost you $6144 off of your bottom line to replace him/her. Multiple $6144 by 2 or 3 and see how quickly that number escalates. That is money YOU are losing each year by not making better decisions on the front end.
Want to increase your profit margin? Then take time NOW to define your core values clearly and begin articulating them in your hospital. Define exactly the type individual you need and what core values must be important to them.
You may be surprised..…. How much easier it is to bring on the “great” new hire instead of just a warm body to fill a void.
Do you currently have Core Values, and if so, are you using them in the Hiring Process?
You can read more posts at www.catalystvets.com
I watched the NFL championship game last night and was just disgusted by the behavior of Richard Sherman. My son is visiting me. He is 22 and a sports fan. We had this heated debate today about this as he felt it was just "the adrenaline after the game" and other what I would call, ridiculous excuses. My point was if he was my employee he wouldn't be playing in the Superbowl. In my opinion, evaluating his behavior as a person as well as a manager, I feel he took away from all the hard work of his team. They won a great game and instead of being able to celebrate and talk about the game, the team, the efforts of a long season all we are talking about and hearing about today is Richard Sherman. He took that moment and made it all about him. He is "the best" (his own self administered title). Another player on the opposing team, "mediocre" according to him. He ranted, raved, yelled and just made an a** of himself (in my humble opinion). My son again came to his defense listing out several other sports figures who misbehaved, acted poorly at levels much worse. As mother and manager I felt the need to teach him a life lesson here. There will always be someone worse who does something worse. That doesn't make it OK. Using the business approach I tried to explain to him how I would handle this. Yes, I would sit his butt on the bench and yes, I know that will NEVER happen. A team is a team and we can't function without a team who is supportive of each other. If my team achieves something we celebrate as a team. It isn't one person's time to shine or embarrass as in this case. If my team member called someone mediocre we would have a talk. if they stood on the surgery table screaming, somewhat like a psycho, that they are the BEST - we would have a more serious talk. I would love your input on this. I will use your ideas to share with my son as well. If a team member of yours acted in that manner would you allow it without any consequence or opportunity to coach?
If you don't know what I am talking about here is the video. This Seattle Seahawks player acted this way right after the game ended.
Things are always changing on Facebook - rarely with any warning or explanation. There has been some weird stuff going on with the algorithms – Vetanswers posts are now being seen nowhere near as much as they used to be and I hope that won’t stay the same for long.
At some stage Facebook also appears to have removed the opportunity for users to request that posts from certain Pages always appear in their Newsfeed. You used to be able to visit a Business Page & click on the 'Settings' to ensure you were receiving 'All Updates' in your Personal Newsfeed.
I’ve recently come across another setting that I think could work as a replacement option although it is a little more complicated – of course!
Open your personal Facebook page & click ‘Home’.
On the left hand side at the very bottom you’ll see the heading: ‘Interests’
Now in the ‘Search Bar’ at the top of your personal page type in Vetanswers & click on the link to visit the Vetanswers Page (oh ok – you could type in any Business Page I suppose!)
On Vetanswers' Page you should see that the ‘Liked’ box is ticked (if not then tick it!). Click on the little grey wheel and you’ll see the following drop down list. Click on ‘Add to Interest List’:
I already have an Interest List called ‘Veterinary Business’ so I can just click there & the Page is added to the List.
BUT if you’ve never used ‘Interest Lists’ before you’ll need to create a List. To do this click on ‘+ New List....’.
On the left hand side of the new screen that has just opened, you’ll see a list of suggested List Headings. If none of these suit just click ‘Next’ in the bottom right hand corner.
Now you get to choose:
3. Now click ‘Done’
To make sure you receive all the Posts from the ‘Awesome Businesses’ on your list, click on the blue ‘Manage List’ on the right hand side & make sure all the Update choices are ticked, or remove those you’re not interested in seeing e.g. Games!
Now all you need to do to keep up with all the Posts from your favourite (awesome) businesses is open up this list.
As you may have noticed, your ‘Interest Lists’ are right down the bottom of the left hand side menu which means you’re quite likely to forget that the Lists even exist. To ensure this is less likely to happen, scroll down to your favourite Interest List (the one with Vetanswers in it!) and click on the little blue pencil.
Click on ‘Add to Favorites’ and you’ll see that your ‘Awesome Businesses’ Interest list has disappeared. Until that is, you scroll to the top on the left hand side menu & under ‘Favourites’ you’ll now see your ‘Awesome Businesses’ Interest List – tah dah!
You can also work with your ‘Interest Lists’ by clicking on ‘Interests’ heading on the bottom of the left hand side menu
Then click on the little blue pencil next to each of your ‘Interest’ Lists and you can ‘Add/Remove from Favourites’ or ‘Delete List’
So this is the only way I can come up with to ensure I get to see all the Posts from the Businesses I have chosen to follow on Facebook. It’s not perfect, as it still requires me to click on the List to view the Posts but it’s better than nothing....at least until Facebook changes it again that is!
I'd love to hear in the Comments section below if you have any other suggestions for making sure you see all your favourite Business Page Posts in your Newsfeed.
If you'd like to see more veterinary business blog posts, visit our website: www.vetanswers.com.au. To keep up to date with all the great veterinary business information we share you can also join our community - it's FREE - just click here
Ok - so you've got a Facebook Page, maybe a Twitter account, what about Pinterest? Instagram? You Tube? Google+?
No, I'm not suggesting you get them all, but maybe you've got one or two on the go.
So who posts information to them?
How often do they do it?
What sort of information do they post?
If your answer was a vague.."Errr...don't know...but it seems to be going ok?" then I've got the resource for you!
I've put together a super basic 'Social media posting calendar'
So this is what it looks like.. click on the image below to visit the original blog post & then download an excel version.
Although I appreciate control and planning I also love flexibility. The idea behind the Calendar is to help you approach the very powerful tool that is social media with a level of professionalism AND help you get the most out of it. But you don't have to record every post and update. The power of the Calendar is in the planning stage - planning the monthly focus, planning the general topics and associated promotions, etc.
This also fits neatly in with the 'Vetanswers Blog Posting Calendar' - put the two together and you'll have total control over all your social media AND you'll find you'll save heaps of time by planning before hand what you'll be posting and blogging about!
So what do you think? Will it be useful for you? Tell me what you think in the comments section below - or tell me if there is another resource you'd like me to put together.
If you'd like to see more blog posts or download FREE resources just visit Vetanswers - www.vetanswers.com.au. While you're there feel free to sign up to join our online veterinary community - it's FREE and you'll receive our weekly eNewsletter too