Just like this institution, your veterinary practice can be a well-oiled machine.
If you're looking to help your veterinary practice grow, expand and thrive, take a few cues from the Mayo Clinic in Rochester, Minn. The Mayo Clinic is doing all three—it has upwards of 60,000 employees (including doctors), grosses more than $8 billion and sees about 1 million patients per year. Despite its size, the Mayo Clinic enjoys the best reputation in the world for human medical care and is categorized as one of the best places to work in the United States.
Compare that to an average veterinary practice that has fewer than 10 employees and fewer than three veterinarians, each of whom sees about 15 patients per day. Most veterinary clinics have cash-flow problems, staff turnover at a two-year rate, and employees who receive few (if any) benefits such as healthcare, dental, vision and retirement. Although most veterinary clinics can't compare to the size and scale of the Mayo Clinic, there are plenty of nuggets to glean from the way it operates.
The Mayo Clinic trustees have a clear idea of what they're doing and where they're headed, and they constantly seek data and input from others about the best ways to get there. Everything that everyone at the Mayo Clinic does revolves around the current and morphing state of healthcare. This vision incorporates bedside medicine, government activities, insurance dynamics, current and emerging patient needs and the state of evolving technology.
More than 100 years ago, the Mayo brothers created a simple mantra that became a mission statement: "The best interest of the patient is the only interest to be considered." Outcome tracking, a Mayo Clinic principle I was introduced to more than 40 years ago, still guides me today in my practice.
Take a minute to chat with Mayo Clinic employees and you'll notice that everyone, from janitors and volunteers to doctors and nurses, understands his or her contribution to the vision and mission. Veterinary practice owners most frequently ask me how to keep their staff members motivated. With the Mayo Clinic model, it's simple. Give your team a mission and vision to believe in, and then make it happen, every day.
A central feature of the Mayo Clinic system is the compensation dynamic. Doctors are paid well, but on salary. Production is not an issue. Locker-room shop talk is about cases, not money. When my wife was being considered for a liver transplant, we met the head of the transplant team, Dr. David C. Mulligan. He walked in and said, "Mrs. Riegger, you do not need a liver transplant—your condition is benign." Our one-and-a-half hour appointment turned into a three-hour education session, courtesy of Dr. Mulligan. We left smiling. It's expected that new hires for the Mayo Clinic doctor team need five years to get up to speed. To help them succeed, the clinic sets up an educational training track.
Cooperation is central to the Mayo Clinic's activities. Employees work in teams within their departments, and they work with other institutions and small practices throughout the world with one goal—help each patient, one at a time. Everything is centered on a team: medical teams, surgical teams and training teams.
Everything at Mayo revolves around training. And on the fourth floor of the Mayo Clinic Phoenix Campus is a $20 million simulation center. When an issue or problem is identified, it's off to the simulation center to address it.
The facility plays a huge role in the healing of its patients. From the parking lot to the foyers, to the rooms and the healing garden—every space is carefully created, cultivated and fine-tuned to assure that patients and their families are comfortable and inspired to heal. Even the nurses' stations are carefully planned. Each room is no more than 20 steps away from a station.
8. Bill of rights and responsibilities
You can access this three-page document at the Mayo Clinic website, mayoclinic.org. There are two specific items in it that caught my attention. The patient has the right to choose the level of care he or she desires—including declining recommendations and the responsibility to understand the consequences of these decisions. When I had two trauma injuries in 2011, a ski accident and a horse accident, I was fully apprised of my options and the potential outcomes of each one. Then I made my decisions. Nobody pushed, pressed or guilted me into anything; they just gave me the facts.
9. Adherence to schedule
Dang, it's impressive. A patient has an appointment at 10 a.m., and it is actually at 10 a.m. I asked how they do it and the Reader's Digest answer is, "It's hard work."
10. Client education
The clinic's newsletters, website and other materials all have a clear purpose: education. And you don't get a sense they're trying to sell you something. It's clear they believe an educated medical consumer makes for good relationships.
11. Follow-up excellence
Excellent follow-up care and tracking helps determine outcomes. The flow at the Mayo Clinic is: admission, appointment and then arrival at the scheduling desk. This desk is separate from admission and the cashiers—it's the scheduling desk only. So as a patient leaves each appointment, new appointments are made and if adjustments are needed to a string of appointments, the new appointment is entered and the string is adjusted.
This is a physician-run organization. And an excellent clinician may ascend to a leadership role, but only for a time. Then he or she goes back to his or her clinical specialty. And while there are non-physicians within the flow chart of leadership, they're in support roles. An MBA or a CPA is not making decisions that affect patients.
While this is a lot to take in, your first step in emulating the success of the Mayo Clinic is to develop a mission statement that everyone in your practice will believe in. Once that's in place, you can set up policies and programs that empower employees to follow and live by the mission.
Dr. Riegger is the chief medical officer at Northwest Animal Clinic Hospital and Specialty Practice. Contact him at (505) 898-0407, firstname.lastname@example.org or www.northwestanimalclinic.com. Find him on AVMA's NOAH as the practice management moderator.