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Are you taking readings from the complaint barometer?
Just ask a client which part of the anesthetic monitoring or pain relieving medications you should leave out to save them money at the expense of their pet's health.
There was a time, not a generation ago, when most veterinarians in the good ole' USA showed a net profit before veterinary salaries of 40-plus percent. Some even broke the 50-percent mark. Of course, those were simpler times. It was before the first oil embargo of the '70s and 15 percent inflation. There was a now-forbidden "combination injection" available that was penicillin and streptomycin combined. There was even a penicillin/ streptomycin/cortisone combination. There was a product called Diathal(tm) that cured diarrhea of any type with one or two injections and a magical injection called miketamide that could just about revive the dead in less than five seconds after injection. Some old timers managed to get one bottle of each to last a month and with a large bottle of prednisone tablets represented almost their total pharmacy expense.
They might not be considered "progressive vets", but their expenses were few, and many saw 55 percent of their revenues fall to the bottom line. Many had radiographic equipment recycled from the Korean War that might have cost them $500 and when boosted to 220 volts, it could produce 60 milliamps at a roaring speed of one-tenth of a second. Staff training included saving money by drying out wet paper towels for reuse. Surgical gloves were washed, dried and re-powdered to last for at least a month of surgeries.
Laboratory equipment consisted of a centrifuge for hematocrit and urine sediments and little strips of paper that could be dipped in serum to approximate a BUN or glucose. Without the $40,000 laboratory equipment, the $50,000 plus digital X-Ray equipment ultrasound, endoscope and the $7,000 dollars of drugs sitting in the pharmacy, most practitioners earned a great living even with an office visit of $5 and selling a case of prescription diet for $8.
In those days, you could take your date to two movies and a bunch of cartoons, have a couple of soft drinks and all the popcorn in the world for a buck! A cup of coffee was a nickel, gasoline was 20 cents a gallon, a carton of cigarettes was $2 and often came with green stamps that could be accumulated for fabulous household goods, and first-class postage was 5 cents!
Thankfully, times have changed. Sort of.
Now, our postal service upped the price of a first-class postage stamp to 39 cents. I don't much care how much a carton of cancer sticks sells for today, but gasoline is a whole lot more than 20 cents a gallon.
Sure, inflation is hell! So is trying to net 50 percent. Somehow or other, the message has gotten lost that clients can and do provide the profits. Somehow, in the last couple of decades, veterinarians started settling for 25-30 percent net. Costs of practice have skyrocketed but our profession has failed to keep the fees appropriate to our costs of doing business.
In our on-site consultations for many practices over the years, we solicit suggestions from staff. One prize-winning reply was; "I think our fees should be lower. Not that our clients can't afford these fees, but they are cheap and complain at every opportunity."
Two maxims of life are: It is the squeaky wheel that gets the grease, and, of course, the biblical admonition "Ask and ye shall receive."
Complaints get action, and most veterinary professionals would rather quit than fight, concede than debate, and they might adhere to the concept that vows of poverty are not limited to the clergy.
Here's the reality check: Two fee complaints per day from clients for each veterinarian in the practice are just normal! These fee gripes are just part and parcel of normal human interactions.
P.S. If you are not getting two complaints per day, maybe your fees are too low!
You can try to please everybody, or you will lose your shirt! Please notice that your best clients seldom complain about any fee where the perception of your services is good or better. (Hint! Hint!) Please also notice that if shoppers actually make and keep their appointments, you lost twice! You lost because you were the low bidder, and you lost because 87 percent will be in one time only, have driven 30 miles to get your one-time low fee service, declining any or all recommendations for their pet's needs but the basic service, never to return.
Of course, if, in this day and age, you make "rabies-only" appointments for new clients, you may be certifiably the second-worst businessperson in your town. If you were the worst, you would have immense value serving as a bad example!
There has never been any law forcing you to accept the huge waste and inconvenience of providing a thorough examination of the pet of the client who only wants the least service required by law. Unfortunately, no argument for dental health or sound nutrition will move this pet owner to responsibility. These clients should be immediately referred to the practice across town you have the least admiration for.
The examination fees in some states seem to still center on $15 today, while others are approaching $60-$65. While we can prove that 54 percent of any veterinarian's clients earn more than their veterinarian, professional ears are not open to those facts but rather to the communities' unrealistic woes. While it is true that average family incomes in some counties of Montana and the Dakotas average below the poverty levels at $13,500 or so, 50 percent are, by definition, above average and can afford quality services.
However, 75-95 percent of clients do not complain and just go for the service. The complainers often take no action that would indicate that they are leaving the practice; they just like to complain.
For years now, I have proved to myself the value of fee complaint by buying gifts from major department stores at 80-90 percent of their tagged price. All you have to do is ask for the store manager or buyer and tell him or her that you would like the product for less. I do it for fun and to prove a point. Whole cultures are set up to haggle on everything being sold. It is part of the game!
You cannot afford to play this game in your professional practice. Just ask a client which part of the anesthetic monitoring or pain relieving medications you should leave out to save them money at the expense of their pet's health.
I'm not entirely certain what makes me tick, but I certainly do know what makes me ticked off. That is seeing net revenues less than 40 percent of gross. Unless you picked an area oversaturated with "colleagues," the only reason for nets less than 40 percent are iatrogenic in nature.
Dr. Snyder, a well-known consultant, publishes Veterinary Productivity, a newsletter for practice productivityand is available for in-practice consultation. He can be reached at PO Box 189, Hebron, KY 41048-0189; (800) 292-7995; firstname.lastname@example.org; Fax: (772) 220-4355.