With barking dogs, yowling cats and the everyday chaos that accompanies veterinary medicine, you probably figure your veterinary practice sees&#8232;plenty of disruption already. However, &#8232;there is another type of disruption — and&#8232; one you should welcome: disruptive innovation and marketing.

As one of the top buzzwords for 2018,&#8232; “disruptive marketing” is taking the&#8232; world by storm. The concept began with “disruptive innovation,” a term coined in the 1990s by Harvard professor Clayton Christensen, MBA, DBA, to define a business model that appeals to a fringe market and then expands to the mainstream.

In theory, disruptive innovation fills a need not met by existing products or services. Initially, the product or service is marketed to people who are not current customers or clients. After gaining traction in this very small market, it evolves until it appeals to the masses, taking over the industry and thereby disrupting the status quo.

Of course, being different does not alone guarantee success. In fact, most attempts to think outside the box and defy conventional wisdom prove spectacularly unsuccessful. Why? Often, it happens because the primary goal was simply to be different rather than to fill a need in a unique way.

One example of disruptive innovation: the pet food industry.

 Not long ago, it was dominated by big brands and generics, all offering very similar products. Then, along came a few small startups offering organic, human-grade, raw and other types of “pet health food.” These companies gained traction with a small, niche market, then aligned with the broad cultural movement of healthy and environmentally conscious living. Soon, these small companies began posing a threat to big corporations, leading to more natural&#8232;and healthier product lines from mainstream brands. Essentially, the entire pet food industry was disrupted.

Disruptive marketing is similar. It involves going beyond the tried-and-true techniques, taking risks and reshaping the status quo. Early digital marketing was a highly disruptive trend, not only delivering advertisements in new ways, but also fundamentally changing the relationship between veterinarians and clients, as well as the general public. A decade ago, the mere concept of email or social media was foreign to most people.

Today, these are not&#8232; only staples of effective marketing, they are what clients expect.

To know what is coming for the veterinary industry, we can take a cue from something&#8232;that has already disrupted human medical care: telehealth. A few years ago, it was generally assumed that a patient needed to see a doctor in person. Today, real-time video conversations and other interactive forms of communication are making more and more doctor visits virtual. The same trend is set to sweep veterinary medicine, likely with even greater success.

For example, a pet owner might be unsure whether an animal’s small wound requires medical attention. If the wound really is minor, an unnecessary office visit consumes your time and costs the client money — but a serious infection that looks mild to the owner’s untrained eye might not get the immediate treatment it needs.

Using telehealth, the owner could send you photos via email and then discuss any clinical signs over Skype. The entire process would take less of your time than a physical examination, alleviate crowding in your reception area and reduce the use of practice resources. Because your cost is much lower, you can charge an affordable fee without reducing profit. On the other hand, if you note signs of a potentially serious problem, you can arrange an appointment right away.

Veterinary telehealth is gaining popularity among a small segment of the market. It offers a new level of convenience and the potential to reduce the cost of care, but many veterinarians and pet owners hesitate to embrace it. Like most disruptive innovations, however, telehealth is set to take over the mainstream market and usurp the status quo.

What can be accomplished with today’s technology is nothing compared with what will be possible tomorrow. From glucose monitoring systems to wearable activity trackers, at-home consumer diagnostic technology has become the standard for humans. Expect the pet health industry to follow. In the not too distant future, you might conduct a urinalysis generated by a smart litterbox or monitor a pet’s surgical recovery with real-time data transmitted by its collar.

Perhaps you think longingly back to the days of pens, paper and corded phones. However,&#8232;social and business trends are racing forward at breakneck speed. One of the best ways to position your practice for success is to embrace rather than fight the high-tech era.

Becoming an early adopter of emerging changes in veterinary medicine is one way to use disruptive theory to your advantage. Another involves developing your own disruptive strategy. You might not be planning to revolutionize the entire industry, but you can certainly disrupt your local market. How?

In the words of one disruptive marketer, it is about developing something that “people didn’t know they needed.”

 However, that won’t work unless people actually do need (or want) the product or service you offer. An ideal disruptive model follows these steps:

Identify an unmet need in a specific market segment — before your competitors or even your clients are aware of the need.

Find a creative and unique way to fill that need.&#8232;

Expand and improve your offering until it meets the needs of the masses yet still serves the original niche market.

Think about the specific needs of your clients and the demographics of your location. For example, in a city where most people rely on public transportation, taking a pet to the veterinarian&#8232;can be challenging. Most veterinarians don’t make house calls, which leaves an unmet need for a mobile service. In a high-end market where most people take their pets to the groomer regularly and give them premium foods, there may be an unmet need for a one-stop shop offering veterinary services, grooming, custom-fitted pet clothing and retail sales of boutique food brands.

If you want your practice to survive, rely on proven techniques and stick to what has always worked. However, if you want it to thrive in today’s highly competitive market, set yourself apart from the competition and position your practice as an industry leader. Be a trendsetter rather than a follower.

Naren Arulrajah is president and CEO of Ekwa Marketing, a complete internet marketing company that focuses on SEO, social media, marketing education and the online reputations of veterinari- ans/practice owners. With a team of 180+ full-time marketers, ekwa.com helps practice owners who know where they want to go, get there by dominating their market and growing their business signi cantly year after year. If you have questions about market- ing your practice online, call 855-598-3320 to speak one-on-one with Naren. 

Goodson S. Pet food brands woo new customers with disruptive marketing. Huffington Post website. 

huffingtonpost.com/scott-goodson/pet-food-brands-woo-new-consumers-with-disruptive-marketing_b_6961580.html

. Published April 1, 2015. Updated December 6, 2017. Accessed December 20, 2017.

Parr S. Disruptive innovation, dog-food edition. Fast Company website. 

https://www.fastcompany.com/1808050/disruptive-innovation-dog-food-edition

. Published January 13, 2012. Accessed December 20, 2017.

Articles

Managing Your Practice

To thrive in today’s highly competitive veterinary marketplace, you need to set yourself apart from the competition and position your practice as an industry leader.

Disruptive by Design

In veterinary school, Bill Van Bonn, DVM, aspired to be an equine surgeon, a dream he followed into practice. But after a few years, another interest called to him — aquatic medicine &mdash; sparked by his years growing up on the Great Lakes. Dr. Van Bonn pursued training in aquatic animal health&#8232;and worked for several years with the Navy Marine Mammal Program in San Diego. In 2005, collaboration with a colleague at Chicago’s Shedd Aquarium led to a job offer, which Dr. Van Bonn accepted. Aside from a sabbatical in 2009, he has worked at the aquarium ever since.

Dr. Van Bonn’s indirect route to his current position as vice president of animal health at the Shedd Aquarium is not unusual in the world of aquarium medicine. Greg Bossart, VMD, PhD, senior vice president of animal health, research and conservation at the Georgia Aquarium in Atlanta, started out in small animal practice before embarking on&#8232;a career path that included stints at the University of Miami Miller School of Medicine, Miami Seaquarium and Florida Atlantic University’s Harbor Branch Oceanographic Institute in Fort Pierce. Leigh Clayton, DVM, director of animal health and welfare at the National Aquarium in Baltimore, also started in small animal medicine before moving on to zoo medicine. Her experience in avian medicine secured her current position.

VIDEO: Oceans are a Good Indication of World Health

As Dr. Clayton’s story well illustrates, aquarium medicine involves much more than fish. Most large aquariums also feature birds such as penguins&#8232;and puffins, various reptiles and amphibians, and mammals ranging from otters and sea lions to beluga whales. Many exhibit terrestrial mammals, as well. “There are so many opportunities to learn new things and work with new animals and apply our knowledge in new and different ways,” Dr. Clayton said. “That always keeps our job interesting.”

The scope of aquarium medicine can be almost overwhelming, considering the species diversity as well as the sheer number of animals on exhibit. “We have about 1,500 different species at Shedd Aquarium,” Dr. Van Bonn said, “and the ballpark total number of animals is around 32,000 — although the reality is, we really don’t know. I could come in tomorrow and there could be 600 new seahorse babies.”

Most aquarium veterinarians spend little time interacting directly with their facility’s collections. That is left to the husbandry departments, which oversee specific animal populations and act as the medical staff’s eyes and ears, notifying them when an animal appears ill.

In certain circumstances, the husbandry staff at Shedd Aquarium train animals to be willing participants in their own health care. “We definitely&#8232;rely on the cooperation of the animals,” Dr. Van Bonn said. “Come over and say ‘ah,’ come over and give us your fluke so we can take a blood sample — that sort of thing. And it’s not limited to marine mammals. We have sea turtles that are trained&#8232;to get on a scale every month so we can check their weight, and we even have octopuses that are trained to let us inspect their tentacles.”

Training also allows curators and veterinary staff to better understand the animals, Dr. Van Bonn added. Whales, for example, sometimes exhale forcefully — a coughlike behavior known as chuffing. Veterinarians can learn much about a whale’s health and physiology by collecting the chuff and measuring hormone levels and other vital functions.

An aquarium veterinarian’s daily responsibilities are both similar to and very different from those of a community veterinarian, say those in the field. Routine examinations and general animal care take up much of their time but by no means all of it. “Common problems range from vomiting and diarrhea to seizing animals to nutritional problems — issues you would see in a general practice,” Lance Adams, DVM, staff veterinarian at the Aquarium of the Pacific in Long Beach, California, said. “We see a lot of reproduction problems, because trying to manage reproductive issues in a managed population&#8232;is a little difficult. We might not have the right sex ratios or the right water quality or the seasonal changes that the animals need to reproduce normally, and that can lead to problems. We try to stay on top of that and be selective with the animals that we acquire.”

Injuries resulting from interactions&#8232;in mixed-animal exhibits are another&#8232;common issue, according to Dr. Adams.&#8232;“During encounters, they sometimes&#8232;injure themselves or each other,” he&#8232;said, “so we deal often with scrapes,&#8232;infections, eye damage — things like&#8232;that.” In 2007, a shark almost snapped&#8232;off a sawfish’s rostrum at the Aquarium&#8232;of the Pacific, requiring the veterinary staff to suture the bite wounds and splint the rostrum until it healed. “It turned out really well,” Dr. Adams said. “That was an exciting case.”

Aquarium veterinarians, like community practitioners, deal with geriatric issues, a happy result of quality care. “In captivity, fish and other animals are protected from food shortages, predation and disease, so we see geriatric problems that we would never see in the wild,” Dr. Adams explained. “For example, animals with arthritis that can’t swim as well are not going to survive very long in the wild, but in captivity, they do. So we deal with issues ranging from arthritis to vision problems to tooth wear.”

Emergent issues are also in a day’s work at the nation’s public aquariums, and some cases become memorable. Dr. Van Bonn once performed complicated knee surgery on a bullfrog (the patient recovered nicely), and Dr. Clayton recalls performing exploratory thyroid surgery on a knob-tailed gecko that resulted in removing a large cyst. The patient was then placed on a thyroid supplement, with the dosage determined by heart rate and shedding frequency because the animal was too small to provide a relevant blood sample.

Among Dr. Bossart’s most memorable experiences: the time his staff worked on an electric eel. “That was interesting because it required considerable care in handling the

animal and putting it under anesthesia,” he said. “Our patients could electrocute us — that was a fascinating concept.”

Indeed, aquarium medicine can be perilous. “Our animals are quite challenging to work with,” Dr. Adams said. “Some of them can be big; some can be strong; some can be dangerous because they are venomous.”

Because little may be known about their patients’ health and physiology, aquarium veterinarians frequently find themselves extrapolating and innovating on the spot. Entire books cover the subject specific to dogs, cats and birds, but no textbooks exist for treating beluga whales, manta rays or electric eels. As a result, aquarium veterinarians commonly confer, sharing information within their small community as it becomes available.

The unusual physiology of the varied species found at most aquariums also requires specialized equipment. For example, a drug called tricaine methanesulfonate, or MS-222, is commonly used to anesthetize fish and amphibians so they can be examined. “This is a critical component to our daily practice and something that most community veterinarians aren’t going to have,” Dr. Clayton said. “In addition, we borrow liberally from all the technology that is used in human and veterinary medicine, and modify it so we can use it on really small creatures and really large creatures.”&#8232;

Because patients can weigh hundreds or even thousands of pounds, special equipment must be devised for hoisting and transport. At the other end of the spectrum, veterinarians use magnifying devices to examine and work on their smallest patients. Darting equipment, commonly known as jab sticks, is sometimes used to administer medication to species that are difficult to catch or would be too stressed by the attempt.

To promote innovation, Shedd Aquarium partners with the Northwestern University McCormick School of Engineering in Evanston, Illinois, challenging students to create custom equipment that would benefit its animals, such as an enrichment device for otters. When a trainer tosses in a special hollow ball stuffed with shrimp, the otter learns to slide the ball through the plexiglass maze to an opening at the bottom.

Unsurprisingly, research is an integral component at most aquariums, with vast areas of study. Shedd Aquarium’s micro- biome laboratory, for example, has a DNA sequencer that promises to shine new light on unseen organisms, such as bacteria and fungi, that share space with the aquarium’s collections. The National Aquarium received a grant from the American Association of Zoo Veterinarian’s Wild Animal Health Fund to provide the first systemic description of

the blood of horseshoe crabs, an important project because almost nothing is known about the health of these living fossils. The Aquarium of the Pacific is working to help save the severely endangered Guam kingfisher, as well as exploring ways to promote shark reproduction in captivity.

Opportunities for veterinarians with an interest&#8232;in aquatic medicine are broad, including large public aquariums, state fish and wildlife agencies, and community veterinary practices that provide services to fish enthusiasts. Interested students and practitioners are encouraged to attend meetings and conferences that emphasize aquatic medicine, and explore opportunities to shadow working aquarium veterinarians.

“This is a great time to become involved in aquatic medicine because there are more and more opportunities,” Dr. Van Bonn said. “It’s a very exciting area of practice.”

Lifelines

Welcome to a unique field in veterinary medicine, where the work is never dull and practitioners interact with a host of diverse &mdash; and sometimes dangerous &mdash; creatures.

Aquarium Medicine: An Ocean of Possibilities

Practice owners who wish to sell their business face a tough challenge: To whom should they sell? In some cases, an associate veterinarian may be ready to purchase the practice, but is that person as financially qualified as a corporation might be? Which entity is likely to pay more for the practice, and how important is it for the seller to obtain the highest price possible?

To get a better handle on which buyer is the better choice, the seller must compare the common expectations and needs of an associate or private buyer with those of a corporate buyer. It’s also important to determine expected earnings from the sale.

Both buyers and sellers should consider these three common factors.

The common mantra “location, location, location” applies in veterinary medicine, too. We have been in the midst of a veterinarian shortage for nearly two years. Some older practice owners are selling because they are unable to find an associate and the workload has become too much for them. Practices that are most likely to attract new associates or private buyers are those that offer locale, livability and/or a family member already in the area.

Video: Should You Sell Your Practice Privately or Corporately?

Location is less significant when considering corporate buyers because they are likely to have associates who can transfer easily&#8232;to a new location. Corporations care more about access to a regional management team and the presence of a demographic that will support the minimum size and growth required.

Private buyers want colleagues with whom they can collaborate on medical cases, but they usually do not have a minimum requirement for the number of associates employed at the practice. For corporate buyers, however, this matters. Corporations look for economy of size and efficiency, which typically translates to three veterinarians and a gross annual revenue of more than $1 million. Some corporate buyers have even raised their minimum revenue requirement to $2 million per year. Private buyers who are aware of the efficiencies and economies required to turn a profit usually want a practice that brings in at least $500,000 in annual revenue.

Fair market value (FMV) is an important consideration for private buyers, whereas investment value is critical for corporate buyers.

This is where sellers face big decisions. Practices purchased by private buyers are typically sold for FMV. Corporate buyers, on the other hand, are often willing to pay up to 25 percent over FMV for a small animal practice that meets their criteria.

Often, private buyers face the heartbreak of&#8232;not being able to satisfy the financing required&#8232;to match a corporate buyer’s offer. Practice sale price, as calculated by veterinary practice valuators, is based on historical performance and profit- and-loss statement analysis, which is verified by tax returns, and concludes with an adjusted net cash flow — also known as adjusted earnings before taxes, depreciation and amortization (EBITDA). This financial result is then capitalized at a market rate generally resulting in a multiple of 4 to 5.2 for FMV, after consideration of specific subjective factors and the cost of capital.

If a corporate buyer offers more than 25 percent above FMV, the only way the seller can help an associate buyer reach the sale price is to help with financing secondary to a bank loan and extend the payback period beyond the common bank term of 10 to 15 years. Even then, banks may decline to lend if the practice’s total debt exceeds FMV.

Profitability (defined as excess cash earnings on a normalized cash accounting or an adjusted EBITDA basis) is not the only value that helps establish a sale price. Cash flow also determines the buyer’s financing payment plan and the corporate buyer’s needed return on investment. In an FMV sale to a private buyer, the buyer is generally not as concerned about whether the normalized cash profitability is in the 5, 10 or 15 percent range, as long as the practice will provide a reasonable wage to the buyer and sufficient cash for payments. Corporate buyers commonly will not consider purchasing a practice with less than a 12 to 15 percent adjusted cash flow or adjusted EBITDA.

Seller financing is a&#8232;common requirement&#8232;for a private buyer&#8232;depending on the sale&#8232;price and the buyer’s&#8232;financial condition.&#8232;Most corporate buyers&#8232;do not require any&#8232;financing. Some&#8232;sellers prefer to carry&#8232;a portion of it to&#8232;maintain a source of income and reduce sales tax by using the installment sale rules provided by the Internal Revenue Service.

Partial sale — when a seller wants to remain in control or is willing to become an equal or minority owner over a determined period of years &mdash; initially works for some sellers and private buyers. Very few corporate buyers agree to a partial practice purchase, but, in my experience, those that do consider it will demand majority ownership status and a controlling interest purchase.

Continued employment of the seller is a common condition of sale for both private and corporate buyers. To help transfer the goodwill of the practice, most private buyers want a seller to continue working in the practice after the acquisition, and most sellers are willing and able to do so for up to three years. Corporate buyers usually demand at least one to three years of seller commitment following the closing.

Including real estate in the sale is common among private buyers; similarly, lenders like to lend on both a practice and its associated real estate when economically feasible. Corporate buyers generally prefer not to purchase any real estate. If the current owner requires that it be included in the sale, some corporate buyers will have an independent party purchase the real estate and lease it to them.

Some sellers want to choose a successor who will take on the practice’s clients. Of course, selling to a current associate automatically achieves this goal. Likewise, selling to a local veterinarian provides a higher likelihood of meeting client desires.

When selling to a corporate buyer, many owners enlist the assistance of a practice sales broker who can bring more than one soliciting corporate buyer to the offer point. Corporate buyers often keep current associates in place, at least for the short term, to maintain consistent relationships with the seller’s clients.

Will management and leadership skills training be available?

It’s common for sellers to request skills training to help reduce stress on themselves and their current staff. With a private sale, outside training may not be possible, but corporate buyers have the economies and contacts to provide it, which could tip the scales in their favor.

Although some associate buyers provide outside management, most tend to rely on the continuance of current managers, if any. Corporate buyers vary as to whether they will keep current employees or bring in pretrained staff from other clinics.

Staff benefits typically include medical, dental and vision insurance, as well as supplemental expense reimbursements. An associate or private buyer usually keeps these as is, but corporate buyers, which may have access to larger group plans, might increase the coverage choices.

Similarly, retirement benefits usually do not change — and may even decrease &mdash; when a practice is acquired by a private buyer. A corporate buyer commonly can provide more retirement and/or disability benefits.

It typically takes much longer to close with a private buyer than with a corporation, largely because corporate buyers have the cash on hand to fund major purchases. Private buyers often need to obtain financing, so the sale may take up to six months to close. Corporate sales may close in as few as 45 days.

What is the sale process and documentation?

Most buyers prefer to use a nonbinding letter of intent for basic terms like price and payback plans. After some due diligence, the letter of intent is followed by a purchase and sale agreement — also known as an asset purchase agreement &mdash; that becomes binding after certain contingencies are met.

Private buyers also typically pay an earnest money deposit to the seller. As investment value buyers paying a higher purchase price, corporations often can get sellers to waive this deposit.

Selling or buying a veterinary practice involves a major financial and emotional commitment&#8232;for all involved. It should not be taken lightly or done without help and consultation from experts. Sellers usually obtain a higher sale price when they use a practice broker, even if an offer to purchase has already been made.

Likewise, to prevent overpaying, private buyers should work with a buyer representative — perhaps a consultant with experience in the field or someone who understands veterinary practice valuations. Representatives should possess a certified valuation analyst or a similar qualification.

Dr. Salzsieder owns two multidoctor small animal practices, a law of ce and a veterinary practice brokerage, with his son as a partner, doing valuations and practice sales in nine western states for Total Practice Solutions Group. He is a founding member and distinguished life member award recipient of VetPartners and a founding member of the American Veterinary Law Association. 

Practice Finance  - Journal

Veterinarians looking to sell their practice must weigh the needs and expectations of potential buyers against their own financial situation and desires.

The Seller's Dilemma: Private or Corporate Buyer?

Hiring and retaining an exceptional veterinary team involves more than posting a job opening and interviewing potential employees. As discussed in the first three parts of this series, this involved yet rewarding process begins with creating and maintaining accurate job descriptions (

), progresses with developing benefits packages and reward programs (

), and requires continued communication with team members (

These strategies must be implemented to halt the high turnover that many practices face. The benefits of viewing employee retention as an ongoing process far outweigh the extra time and training required. The final component in building a solid veterinary team with staying power centers on recruitment and the myriad ways to influence public perception about your clinic.

Branding encompasses your practice’s values, culture and community presence, as well as how you conduct yourself. In many ways, branding boils down to perception and is unique to every potential employee. One of the best ways for a practice&#8232;to influence and shape its brand is by monitoring current perceptions.

Remember, a job interview isn’t one-sided; candidates are evaluating you, too. Job seekers have researched your practice, looked at your website, tapped into social media and scoured&#8232;the internet for bits of information they can&#8232;gather about your team, your community presence and your business activities. Job seekers today are more connected than in years past. They form a perception about your practice before applying for the job or arriving for an interview. What are they seeing? What do employer review websites such as Glassdoor or Indeed say about your practice?

Numerous management-based websites say that one of the best ways to attract the right job candidate is to have current employees refer their friends. What do your employees tell others about their workplace? As you may recall from Part 3 of this series, conducting stay and exit interviews offers a wonderful way to learn what team members value about the work environment and what should be fixed (February 2018). This same information will help establish your brand and uncover whether your employees are serving as brand ambassadors or your biggest critics.

Whether job seekers learn about your practice online or by word of mouth, consistency is key. When a job posting’s description of the workplace differs greatly from public perception, it creates a disconnect that will make it more difficult to attract qualified candidates.

You’ve done your research to ascertain what a candidate will learn about your practice from an initial search. But branding doesn’t stop there.&#8232;You have to ensure that every step of the process enhances the experience you want the candidate to associate with your brand. Consider the application process:

Do callers receive a positive message? &#8232;

Is the reception staff aware of the job posting and its details?

Make sure you’ve covered all your bases by simplifying the application process as best you can and providing necessary staff with the job description or a script for potential inquiries. A positive application experience may garner additional positive reviews about your practice and, in turn, attract more candidates. &#8232;

Consider who will be interviewing the top candidates. These interviews will likely be among the first in-person interactions job seekers have with your practice, but all too often, the management team is forgotten in the recruiting process. Take the time to educate managers on how to listen, how to ask the right questions, what questions are illegal and should be avoided, and how to use the job description and skills list to really dig in to what each candidate has to offer.

It is not uncommon for a candidate to arrive&#8232;for an interview, be held up in the waiting room (perhaps the front desk was unaware of the scheduled interview) and then get handed off to someone — anyone &mdash; who is available. Perhaps unforeseen events, such as a patient emergency, tied up the person who intended to conduct the interview,&#8232;but this situation doesn’t lend itself to the kind of “wow” experience you wanted to deliver &mdash; not to mention that a poor candidate experience can hurt your brand.

One of the best ways to ensure a smooth and successful hiring experience is to fine-tune your recruiting process before you need to use it. Institute a protocol, and train your management team. Consider these steps:

Provide samples of what the post should include, know what job boards to use, update your website’s career page, create an employee referral program and use your established social media presence.

Provide easy-to-access applications, outline the steps in the process and inform the team who will conduct interviews.

Provide alternative &#8232;processes, allowing candidates to either complete a paper form you keep on file or submit an online profile. &#8232;

Establish&#8232;a list of questions and plan a tour of the practice. &#8232;

Plan how the final candidate will be determined, and prepare an offer letter.

Create a schedule for the onboarding process, and prepare all necessary paperwork to be completed. &#8232;

Your recruiting team should be involved in creating the steps and documents and familiarize them- selves with the process so it can be implemented at a moment’s notice. Why at a moment’s notice? &#8232;

Some of your best hires may be passive candidates — people who are not actively searching for a job but stumble upon your practice. A passive candidate might be a current client or a friend of an employee. Your recruiting team needs to be ready to conduct an unscheduled interview.

Notice that the focus of this article is preparation: preparing your brand, preparing the recruiting team, preparing for the candidate experience. Do not leave the recruiting process to chance. Your practice needs to be ready for both passive candidates and active job seekers.

If your goal is to hire the most qualified, professional candidate, why would you present an unprofessional, unprepared business and recruiting team? Devote some time to managing your brand and establishing a recruitment process that is always ready, and you will be rewarded with new hires who are in it for the long haul.

Ms. Dunn is an award-winning speaker, writer and consultant who brings over 40 years of in-the- trenches experience and business education to veterinary management. She is founder and CEO of 

Snowgoose Veterinary Management Consulting

, which helps veterinarians devel- op strategic plans that consistently produce results.

Establishing and maintaining a positive brand for your practice are essential when recruiting new talent.

Shut the Revolving Door - Part 4: Recruiting

It seems the fitness tracker craze isn’t reserved for people. America’s seemingly endless love and fascination with pets has sparked a new trend: wearables. What impact this increasingly popular animal-centric technology will have on the practice of veterinary medicine remains to be seen.

The crux of the industry’s growth is the smart- product area of wearables, including fitness trackers, training systems, activity monitors, GPS trackers, cameras, smart vests and collars, emotion sensors, and health monitors. Electronic and Wi-Fi- enabled collars and cameras can monitor a pet’s location, its activity level and even its emotional state. Here we explore the growth and potential uses of activity monitors and trackers for dogs and cats.

The decision to equip pets with their own activity monitors is in line with the national trend of Americans treating pets like family members and thus outfitting them with similar comforts. Currently, 68 percent of American households

 have at least one pet and 77 percent of Americans own a smartphone

According to research by Global Market Insights, the pet wearable market is poised to surpass $8 billion by 2024, largely as a result of increasing disposable income and adoption of pets.

 A company press release states, “Owners are increasing their spending on smart products that can be controlled remotely and monitor their pet’s health and fitness.”

22 of the Pet Industry's Most Innovative Products

Millennials Are Driving Growth of Holistic Pet Care

The market is merely responding to the expansion of wearable devices for people (e.g., Fitbit and Apple Watch) and turning toward pets and the profit potential they represent in the U.S. economy. Because 59 percent of cats and 54 percent of dogs in the United States are overweight or obese,

Addressing the issue in its 2017 pets edition, the Los Angeles Times reported that in the $66 billion pet industry, emerging pet technology represents a growing segment.

“What started out as simple gadgets such as light-up collars have now evolved to high-quality GPS collars and wearable health-monitoring devices,” according to Tierra Bonaldi, an American Pet Products Association spokeswoman. “We have seen more and more traditional human companies get involved in pet products because they see to what lengths pet owners will go to care for their pets.”

Aaron Massecar, PhD, program manager for veterinary innovation and entrepreneurship at &#8232;the Texas A&M College of Veterinary Medicine&#8232;& Biomedical Sciences in College Station, said&#8232; that while the pet wearable market “is still in its nascency,” many new players are emerging “as sensors become more ubiquitous and their use becomes more generally accepted. At the current time, it still seems to be a consumer-driven market as the clear application to the medical benefit of the animal has not been established yet for most veterinarians." 

The main use for pet wearables, according to Dr. Massecar, continues to be GPS for tracking. “This solves the immediate consumer need of finding a lost pet and does so at a continually reduced cost to the owner,” he said.

Although this application has no immediate impact on the practice of veterinary medicine, “other companies are showing the relationship between activity level and nutritional requirements,” Dr. Massecar said. “This kind of information can help a veterinarian better understand the presence of possible allergens in a pet’s food.”

Although acceptance rates have not met expectations for these technologies, Dr. Massecar said he believes that “part of the reason for this could simply be because veterinarians are not trained to think about remote diagnostics as part of the treatment plan.”

As more pet owners look to preventive wellness as a means to avoid detrimental health conditions for their animals, “an increase in the desire to track activity and correlate that with animal health is foreseeable,” Dr. Massecar said. “As this trend grows, the veterinary profession must look at ways of incorporating these technologies into practice. At the same time, wearable companies will have to continue to demonstrate the efficacy of their products to veterinarians.”

Chad E. Dodd, DVM, CEO of Animatas Consulting and a member of the 

 Editorial Advisory Board, said that one advantageous way veterinarians can use the data collected from these&#8232;monitors is as a component&#8232;for follow-up assessments,&#8232;which are often traditionally skewed by the&#8232;patient being examined&#8232;in the unfamiliar, sterile&#8232;environment of a veterinary hospital. “Monitoring&#8232;a pet’s chronic medical&#8232;conditions in its routine&#8232;environment will inevitably provide more accurate measures,” he said. “This allows veterinarians to create individualized treatment plans that will lead to better outcomes.”

The long-term potential, according to Dr. Massecar: “If veterinarians and wearable companies can come together and begin providing 360-degree, 24/7&#8232;and real-time validated information about our pets, then we will not only be able to provide actionable insights for our pet’s care, but also increase the ability to predict the development of diseases.”

Increasing professional participation in the field depends on veterinarians’ curiosity about wearable technology, Dr. Massecar said: “Simply typing ‘pet wearable’ into Google produces a lot of information, from companies to market insights. If veterinarians are able to develop a healthy curiosity about the kinds of companies that are working in this space and think about how the information that wearables provide could help to deepen the understanding of a particular condition — with electrocardiographic monitoring, for example &mdash; then that curiosity will send them on a pathway that will likely make an early adopter out of the veterinarian.”

Even though most wearable technology companies focus their marketing efforts on consumers, they are not blind to the potential revenue stream — and collaboration &mdash; the veterinary industry presents. In fact, according to Dr. Massecar, wear- able companies are interested in veterinarians’ perspectives. “As veterinarians reach out to these companies, more robust products that better define use and enhance animal health will come,” he said.

One such company is FitBark, which has developed professional portals for veterinary schools, practitioners, boarding providers, trainers and dog walkers. Though geared predominantly toward pet owners, the sales force remains engaged with researchers on how activity monitoring could play a role in veterinary medicine, particularly with regard to mobility, nutrition, anxiety and skin conditions.

Davide Rossi, FitBark’s CEO, said that for veterinarians, wearable devices can serve as monitoring tools to collect longitudinal data and track patients’ progress. Although he did not have precise figures on how many veterinarians currently use the FitBark dashboard, the company promotes its data usage as an objective source of information to identify changes in activity and mobility levels, create exercise plans with activity targets, audit postsurgical compliance and monitor recovery from orthopedic surgery.

Vetrax, a monitoring system developed by AGL, takes a different approach. The company’s sensors, which are marketed as able to detect pet behaviors beyond running and rest — think shaking and scratching &mdash; are available only through the recommendation and oversight of&#8232;a veterinarian. The associated portal also acts as a client management system for veterinary practices by storing the contact information and billing history of the clients whose pets are outfitted with one of the sensors.

Even without overwhelming public support from the nation’s veterinary professionals, the data collected by these technology companies likely will find their way into veterinary medicine through alternate routes. Not only do pet owners relay information about their own pets, but researchers, food manufacturers, insurance providers and pharmaceutical companies have used data collected from activity trackers and health monitors to refine their products and support claims. The University of Cambridge in England recently released its findings from a 2017 One Health study that used FitBark to monitor the activity levels of sheep in preclinical orthopedic experiments.

 It is believed that the data collected from the monitors have the potential to improve treatment outcomes in humans and animals with orthopedic diseases.

For its part, Burlington, Massachusetts—based PetPace is taking the lead on exploring how pet monitors can recognize seizures in animals with the launch of its Canine Epilepsy Study. Its goal: develop the capability to detect and possibly predict seizures in dogs. “Understanding the&#8232; true prevalence of seizure activity is invaluable&#8232;in our attempts to effectively manage epilepsy in dogs,” said Bob Murtaugh, DVM, MS, DACVIM, DACVECC, FCCM, lead investigator of the study. “The introduction of the PetPace technology will allow us, for the first time in veterinary medicine, to attempt just that &mdash; know exactly when, in real time and for how long, each patient has a seizure.”

By measuring seizures in real time, veterinarians “can now tailor treatment plans to the individual patients’ needs and provide pet parents with peace of mind through round-the-clock monitoring,” Dr. Dodd added.

Rossi predicts that it will soon become increasingly normal for pets to wear some form of a smart collar. “It’s going to become very easy to create a digital identity for pets, and that digital identity is going to make pet ownership a little easier, a little more efficient and a little more coordinated between family members and members of the veterinary community,” he said.

“It’s an exciting time for the animal health industry,” Dr. Dodd said. “Whether it’s the pioneers or the followers, the teams that pay heed to consumers’ needs and wants, help solve everyday problems, and deliver a great customer experience are going to be the ones that get rewarded. And hopefully, through their offerings, we can achieve better health outcomes for the animals in our care.”

Greg Kelly is a long-time health care writer and editor. He has written for the Physician’s Money Digest, Dentist’s Money Digest and Veterinarian’s Money Digest websites. He lives at the Jersey Shore and welcomes comments at gregkelly@monmouthbeachlife.com.

Springer J. 2017-2018 APPA National Pet Owners Survey. American Pet Products Association website. 

americanpetproducts.org/Uploads/MemServices/GPE2017_NPOS_Seminar.pdf

. Published 2017. Accessed January 4, 2018.

Rainie L, Perrin L. 10 facts about smartphones as the iPhone turns 10. PEW Research Center website. 

pewresearch.org/fact-tank/2017/06/28/10-facts-about-smartphones/

. Published June 28, 2017. Accessed January 5, 2018.

Pet wearable market worth over $8bn by 2024 [press release]. Selbyville, DE: Global Market Insights, Inc; August 21, 2017. 

gminsights.com/pressrelease/pet-wearable-market

2016 Pet obesity survey results. Association for Pet Obesity Prevention website. 

. Published February 21, 2017. Accessed January 4, 2018.

D’Angelo A. You won’t believe the tech toys we found for you and your pet. 

latimes.com/style/pets/la-hm-pets-tech-20170827-story.html

6.   Newell K, Chitty J, Henson FM. “Patient reported outcomes” following experimental surgery-using telemetry to assess movement in experimental ovine models [published online October 31, 2017]. 

Feature

We take a look at the potential impact of pet wearables on the veterinary practice of the future.

Beyond Gadgets and Gizmos

I was disappointed to find that “Tapping the Talents of Millennials” (February 2018) was just another case of libel against my generation. After a brief disclaimer about the “danger of hasty generalizations,” the article transitioned into a litany of generalizations based on “expert” opinions and dubious research findings. As a group of scientific professionals, I would hope that the editorial board’s standards are higher than those of the general press, particularly when publishing negative stereotypes about fellow colleagues. In one example, the article cited a far-fetched study when it claimed that millennials “want to stay home and play video games all day instead of working.” Drawing on statistics from 2000 to 2015, the referenced publication downplayed the Great Recession and massive advances in automated manufacturing to reach the conclusion that many millennial men, such as myself, were just lazy video game addicts. Such a poorly supported opinion in an article about young veterinarians isn’t just disrespectful, it’s delusional. Phew! I’m glad to get that out of my system. Now, back to Super Mario.

Thank you for taking the time to respond to our article. We appreciate the fact that some of the observations we reported — be they myths, stereotypes or unique experiences &mdash; don’t fit your self-image. Clearly, most millennial men are not lazy video-game addicts, as Erik Hurst reported. We were jolted when we read that comment and can appreciate your reaction. We included it to illustrate how varied the views of this generation are.

We recently heard a comedian talking about his young teenage daughter. He said, “She’s a strong young woman; she came through surgery well. We had to remove the cellphone from her hand. Now we’re hoping for eye contact.” The audience roared with laughter. With your feedback in mind, however, I wondered whether such tales are not taken as jokes by those who rely on their cellphones as a part of life.

Your taking the time to write (and get it “out of your system”) was the right thing to do. You’ve increased our sensitivity and we thank you.

Letters to the Editor

A letter from one reader regarding a previous article on millennials in the workplace. 

Mailbag (April 2018)

Research proves the importance of encouraging words for employees&#8232;in hospitals and on hospital teams, says Wendy Hauser, DVM, vice president of veterinary relations for Crum & Forster Pet Insurance Group. “One study showed that 67 percent of employees whose managers provided positive feedback were highly engaged in their jobs, whereas only 31 percent of employees whose managers gave only negative or corrective feedback were engaged,” she says. “If all [they] hear about is what’s not working well and [they] never get those pats on the back, it’s amazing that 31 percent persevered through that.”

To give great positive feedback, watch your body language. “Be very aware of your eye contact, your facial expressions, the tone and pitch of your voice, how loud your voice is, and how rapidly you’re speaking,” Dr. Hauser says. Make sure you convey an upbeat message in a manner that matches your words.

It’s also important to catch employees when they’re at their best. “Seek the things we take for granted in their daily performance, and look for opportunities to give positive feedback in the moment and in front of everyone else, depending on the employee’s preference,” she says.

Missed charges are a huge issue for veterinary practices, averaging $64,000 per doctor per year, according to Joy Fuhrman, DVM, MBA, director of finance and operations for Shepherd Software. “If you have two veterinarians in your practice, you could hire a third just by capturing all that additional revenue,” she says. Other data show that, on average, 10 percent of charges are missed. “If your average transaction charge is $130 and your technician misses that $13 nail trim, then 10 percent of your revenue for that patient is walking straight out the door,” she says.

To ensure that charges don’t slip through the cracks, Dr. Fuhrman advises using appropriate software and training the entire team — not just the technicians and front desk staff&#8232;but also the veterinarians. “These are important ways to drive revenue and grow your practice,” she says, “because that’s money that goes straight to the bottom line.”

“Our typical veterinary culture is&#8232;very stale and study,” says Heather Romano, managing director of human resources and training at iVET360, “and millennials don’t really respond very well to that.” Millennials tend to focus less on making money than older generations do and more on making a positive impact, according to Romano, who suggests altering management style accordingly.

“We can change the way we talk to our employees to help them understand how they are making a difference in our hospitals,” she says. “We can be more like coaches instead of bosses to all our employees.” Millennials respond well to that approach because it helps them understand the reasons behind systems and procedures. And baby boomers and Gen Xers feel respected, which is important to them, she says.

boarding to your practice, you have some real built-in advantages,” says Greg Taylor, CEO of the Mason Company. “You already have a referral network, which is huge, and practices that add boarding usually see a bump in routine services such as teeth cleaning and vaccinations, because you will have customers showing up on a routine basis.”

A fixed-cost business, boarding is expensive at the outset, depending on the number of runs added, Taylor says. “It could easily cost you $1 million to house your first animal, but it’s going to cost only a few bucks to house the second, third and so on,” he says. “You want to make sure you have the revenue stream to wash over those fixed costs, and veterinarians already have that with their patient base.”

Try to make the most of your building’s footprint, which is both the biggest cost and the biggest constraint. “Make sure you have as much capacity as possible by using things like stacked run systems, specific runs for small versus large dogs and even true two-story systems,” he says.

Finally, although a full grooming operation isn’t necessary, you must at least offer baths for the dogs, Taylor says. “You’ll need to incorporate that into your design, as well as purchase the appropriate equipment.”

The top of an attention-grabbing resume goes beyond the basics (name, cellphone and email contact information, and your city and state) with specifics tailored to the position being sought, says Stacy Pursell, founder and CEO of The VET Recruiter and a Certified Employee Retention Specialist.

“That means replacing an objective or mission statement, which might not line up perfectly with the organization’s needs and current openings, with a professional summary that aligns more closely with the hiring company’s expectations,” she says. Other tips: List your work history in reverse chronological order, making it as relevant as possible to your job search, and limit your resume to two pages.

Advice Unleashed

Tips and insight from business, financial and practice management experts.

Advice Unleashed (April 2018)

Most people would rather pass a kidney stone than learn about personal finance, much less put their financial house in order.&#8232; Yet choosing a basic fiscal tracking system can enhance your peace of mind, quality of life and retirement plans.

With the understanding &#8232;that people have varying&#8232; levels of financial &#8232;literacy — and limited time &#8232;to balance their income-&#8232;to-expense ratio &mdash; I’ve&#8232; searched for general strategies that veterinarians can implement with relative ease. I’ve found three concepts to be particularly powerful despite their apparent simplicity.

This system is based on the notion of separating your after-tax income into three broad categories: needs (50 percent), wants (30 percent) and savings (20 percent).

Your needs include everything required to live, such as food and shelter (housing and utilities), plus transportation, &#8232;insurance (health, disability, life, home,&#8232;car), child care and other necessities. Notice that cellphone and internet expenses are absent from this group. These are considered wants because, believe it or not, you can survive without them.

7 Personal Finance Tips for Veterinarians

Wants improve your overall quality of life but are not essential, such as a gym membership, a cellphone plan, entertainment, vacations, gifts and beauty products. These are considered luxuries.

A primitive way to decipher between needs and wants is to determine whether you can delay spending money on something without severe consequences, such as going to 

jail, losing your property or paying a fine. If you cannot delay the expense (alimony, credit card bill, car payment), then the item is a need. However, if you can put off the purchase (designer clothes, vacation, cellphone upgrade), then the product or service is a want.

The final category, savings, represents the remaining 20 percent of your net income. You could split this amount into two equal portions, setting aside 10 percent for short-term savings or an emergency fund and 10 percent for retirement investing.

You can keep track of expenses &mdash; and live well &mdash; without spending hours agonizing over every cent spent.

April 2018