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Could departmentalizing work for your veterinary hospital?


I dont like cross-training. Heres why specializing is working better at our hospital.

This was written by one of 10 finalists for the Veterinary Economics Practice Manager of the Year award, sponsored by VPI. For more from each finalist and a slideshow of the nominees, visit dvm360.com/PMOY.

Should everyone do everything in an average veterinary hospital? Or should team members be deployed into specific clinical departments? That's what my practice's department heads and team members and myself have been discussing over the past seven years. I can say today that departmentalizing has worked for us.

Obviously, one of the big advantages to departmentalizing is that you're better able to put team members in just the right areas where they'll be most successful and best serve clients and patients. But there's a risk too: You can make it easy for them to get rusty in other areas.

As we considered departmentalizing our staff, we also worried that team members would get bored without the variety. That concern held us back three times from trying out departmentalizing-but this fourth time, we did it. The bottom line was, if we wanted to maximize our level of patient and client care while remaining efficient, some specialization was required.

Sinking our teeth into departmentalizing

The final factor for us that pushed us into team member specializing was the desire to offer a higher level of dental services. In the final quarter of 2012, we identified a doctor and a technician who had particular interest in this area. We delivered the CE and equipment they needed to offer high-end dental care for pets: digital imaging, new or specialty dental instruments and several wet labs and seminars. At the same time, we rolled out a marketing campaign emphasizing dental care for the whole year, not just February's National Dental Health Month. We offered discounts to clients who scheduled recommended dental prophylaxes or procedures in a certain time period. We made sure to note in the records when dental procedures were recommended and scheduled our software to automatically create informative letters and reminders so clients saw that dental procedures and prophylaxes were important and learned what was involved. 

To make this dental focus possible, we also figured out what areas would be covered by other technicians: other surgeries, exam room visits, drop-offs, etc. It was awesome to see how willing the team was to work together to identify who best fit where and then make sure those team members thrived in their own areas.

Departmentalizing wasn't more than we could chew

It's been almost a year and a half now, and things have continued to work with this layout. There's just enough rotation to keep things fresh for the technicians and no one seems to be in a rut.

Our goal for this dental specialization for the first year or two was to see the same number of dentals per year spread out beyond February and producing more income per procedure. We also focused our dental procedures on just two days a week so we could be more focused with less equipment setup.

In 2013, we did 210 dental ATPs-roughly the same as 2012-but produced $23,000 more with the same number of procedures using the same materials and relatively similar staffing. We did buy a new digital imaging system, but that cost less than half of the extra gross production. New digital imaging led to more procedures done when issues where found.

This year, we're focus even more on following up on recommendations. Our doctors are consistently noting dental recommendations on client invoices, as this automates most of the client communications and reminders about the need for dental care and the discount we offer for scheduling in a timely manner.  Depending on our progress, we may send out targeted marketing (email or mail) to those who received a recommendation but didn't schedule a procedure. We extend another opportunity for them to book with the discount, which can be upwards of $100 on major dentals. We hope to continue this trend of growth in that area.

We didn't brush off other departments

Departmentalizing stretches father than just dental, of course. To see if it's working in other areas, such as surgery, we look to see that our surgery technician's production stays on par with general surgery production. Our software allows us to track those points independently. This way we can assure that departmentalizing is working from a labor costs standpoint.

By placing technicians who either already thrived in exam-room appointments or possess that exceptional personality for client interactions, we've seen great success in preventive care and wellness plan promotions. In late spring/early summer of 2013, we increased revenue from preventives by 49 percent.

We've found that technicians, and other staff, who can confidently educate clients have a profound effect on the success of such promotions.

Another great example was our wellness package promotion at the beginning of this year. We negotiated with our reference lab to get the best price possible on a particular wellness panel and coupled that with an exam bundled at a great price-while maintaining our normal margins. It was our goal over a two-month period to double the number of these panels we had done during the same time in 2013.  We ended up increasing the number of panels 177 percent, from 63 to 175.

We usually set sales goals for these promotions and post graphs on the wall so the entire staff can see our progress. When we hit those goals, as we did for the wellness program, we celebrate with a dinner outing, lunch or some other treat for the staff to remind them that they are the ones who made it happen.

We also use departmentalizing with our reception and assistant staff. In those cases, it's less about clinical specialties and more about special duties or responsibilities. Whether it's being in charge of new-client letters, reminder calls or their departments' schedule, we try to empower team members to bring out their best. We see the staff embrace departmentalizing in just how much care and thought they put into their work. If people really care, there's no substitute for that!

Shawn Gatesman is practice manager at Heartland Veterinary Clinic in Harrisonburg, Virginia.

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