Adding value to a practice - immediately

Business-savvy veterinary students are learning that practice owners appreciate the fresh view they bring to their work. Students' understanding of the business and medical sides of practice allows them to quickly add value and help improve their work-life balance.

5 ways a new association can add value

This story is a composite picture of what happens in veterinary medicine as students embrace the importance of sound business management to support good medicine. It is not based on an actual person or practice.

New graduate Dr. Keri Black stepped into her associate veterinarian role with ease in her first practice. It was hard to be new, but she felt confident she could meet the expectations of the owner and clients at Berry Hill Animal Hospital. Not all graduates are so fortunate. What made things different for Keri?

It began during Keri's third year of veterinary school when she discovered a new student organization called the Veterinary Business Management Association (VBMA). VBMA is a growing, national student-managed organization, dedicated to the belief that business management knowledge is integral to the education of a well-rounded veterinarian and that business knowledge will allow DVMs to practice better medicine.

Keri thought it was important to understand how a veterinary practice worked and how an associate veterinarian fit into the mix. VBMA had a chapter on her campus. She was surprised to find so many other like-minded students eager to learn about the business side of the profession they soon would enter.

At VBMA meetings, Keri learned that the average annual compensation new graduates could expect, depending on what part of the country they practiced in, ranged from $40,000 to $54,000 a year. She also learned that to produce value sufficient to justify that level of compensation, she would need to generate approximately $223,000 to $300,000 in gross revenue. Her gross revenue, or production, would be based on how many patients she examined, the healthcare services she provided and the fees that the practice charged.

Standards of care

Keri also heard a talk about the American Animal Hospital Association's (AAHA) compliance study and its implications for improving the quality of patient care and practice finances. Compliance, she learned, was about setting standards of care that you believed in for patients. The standards of care should address pet wellness and preventive healthcare needs. The AAHA study also encouraged practitioners to set goals and track how well they were meeting the standards they set.

Keri wrote down the six areas that the AAHA study covered (vaccinations, heartworm testing and prevention, dental prophylaxis, pre-anesthesia testing, nutritional support and senior care) and took the list with her to her summer job at a small companion animal practice. She wanted to talk to the practice owner about them and get his opinion.

Implementation

The practice owner was impressed Keri put so much thought and effort into her job. He thought establishing standards of care was an excellent idea. He and Keri held several follow-up meetings to establish written standards to share with the rest of the hospital team. They followed the AAHA compliance model and created standards for the six preventive healthcare areas addressed in the study and added an additional standard of their own to cover fecal testing.

Their next step was to share the new standards with the practice team. The practice owner touted the importance of the standards and shared his belief that they would help them to take better care of patients.

The practice owner asked his team to consider how they could support the new standards in their roles: What ideas did they have for implementing the standards to ensure consistency of care and make the workload manageable for all team members? What training would they need?

The team members had plenty of ideas, and Keri was assigned to a cross-department team composed of the head receptionist, a technician and the practice manager to think through the intra-department implications of improving compliance. The team was charged with coming up with a practical plan to implement, track and measure its compliance success.

Keri enjoyed working with the team; they came up with better ideas than she could have alone. She also gained valuable perspectives from each team member that deepened her appreciation for the contribution everyone made to patient care.

The practice owner was happy Keri had initiated standards of care compliance and appreciated the fresh energy and enthusiasm she brought to the project. Keri searched online for the most current pet care guidelines from the American Heartworm Society, the Companion Animal Parasite Council, AAHA and American Association of Feline Practitioners to provide up-to-date information for their discussions.

Next level

Working on the standards of care made the owner realize how long it had been since he had reviewed and updated the practice's preventive healthcare services. He also appreciated the organized and systematic approach the AAHA compliance format provided to help organize his thinking.

Keri grew enormously from this experience. She recognized the importance of involving the entire practice team and the members' unique roles in compliance and patient care. She also saw how having clear standards helped improve patient care. Basic healthcare standards were things that she, as a new veterinarian, would be able to do immediately and that, in turn, would favorably impact her financial contribution to the practice and show her value.

With the practice owner's encouragement, Keri led a staff-training program on the hospital's new fecal policy. To make it fun, she gained the help of the technicians. The goal was to show everyone how a fecal flotation was done, the parasites they could discover through this testing method and the zoonotic implications to the human members of a pet's family. They invited staff members to bring in fecal specimens from their own pets, and they let them run the tests themselves so the hospital team members could talk to clients based on their own experiences.

Work pays off

The staff welcomed the clarity the standards of care provided. Having standards bolstered their confidence in discussing routine preventive healthcare procedures with clients; they knew exactly what they should be talking about and how to explain the benefits.

The standards of care helped the doctor and hospital team become more consistent in making and reinforcing wellness recommendations. This led to increased client acceptance, improved patient care and better financial results.

Continuing education

Even after Keri left the practice to return to school, the doctors and staff found more ways to use the care standards she helped create. When they hired a new hospital team member later that year, they used the standards to help ensure a good match with their hospital's patient care values.

Following graduation, Keri joined a larger practice. Buoyed by the success of her summer experience, Keri asked the practice owners she interviewed with about their care standards and spoke of her previous experience.

Based on what Keri had learned at VBMA meetings and her practice experience, she thought to ask about the hospital's standards of care, how many patients she could expect to see during an average day, the hospital's fee structure, the production expectations the owner had for new graduates and how the different departments worked together.

All of the practice owners Keri spoke with were surprised and impressed with the questions she asked and her compliance experience. She received employment offers from all four of them. The three-doctor suburban practice Keri joined did not have written standards of care when she interviewed with them. They decided to put them in writing after talking with her, and this ended up as the deciding factor in her decision to join the hospital.

On the job

In her first few months at the new hospital, Keri focused on improving her client communication skills. She found that the other doctors and staff members were pleased to help her and freely shared ideas. They seemed to like that she asked for their advice, and she always made sure to thank them and let them know how she was doing.

Keri created a care standards checklist for herself so when she reviewed patient records she could check off the things she needed to relay to clients. She made a point of learning the best way to work with the technicians and assistants to smoothly hand over patients and clients to them. She brought the hospital owner a suggestion to improve the hospital's travel sheet to show when a dental prophylaxis was recommended and the client's response so the receptionists would know when they should schedule the procedure.

About six months after she joined the new hospital, the practice owner asked if she could develop a plan for improving its senior pet health compliance. The practice enjoyed little success in this area. The owner, however, felt it was an important health concern because of the large percentage of older patients that they were seeing. He felt a good senior wellness program could help delay or prevent problems and detect diseases at an early stage, when they would be most treatable.

Keri was flattered, but remembering her previous experience, she knew she would need help to accomplish the goal. She wants to form a cross-functional team to address senior pet health compliance. Keri plans on asking a technician, receptionist and the practice manager to participate on the team. She is looking forward to another valuable learning experience and expects to make a great contribution to improving the healthcare of senior pets, the practice and her own job satisfaction in the process.

Gavzer is a board member of the Association of Veterinary Practice Managers and Consultants and an independent veterinary business consultant focused on education, staff training and marketing. Owner of KG Marketing & Training Inc., Gavzer is a speaker and writer based in Springboro, Ohio.