Double identity: When youre veterinarian and practice manager
Kyle Palmer, CVT
Long-time dvm360 magazine and Firstline contributor Kyle Palmer, CVT, is hospital manager for VCA Salem in Salem, Oregon, as well as a practice management consultant for a number of other hospitals.
Are you a high-flying veterinarian by day and a reluctant veterinary practice manager by night? I dont want to take the wind out of your cape, but your neglected alter ego may need a boost.
Having an alter ego is tiring, which is why it's best to hire a practice manager if you can. But if you can't right now, make sure you're paying attention to the areas below. (Shutterstock.com)In the past 10 years or so, having a practice manager has become the rule rather than the exception. Yet, there are still many solo (and even small) veterinary hospitals that just can't take that step for financial or logistical reasons (or both). So who's managing these practices? You are, Doc. But how you are managing that role is a harder question to answer.
It's rare for practitioners to set aside time to focus on administrative tasks, so let's assume you don't either. Don't feel bad. You spent eight years in school learning to save lives, and if you're like most veterinarians, the last thing you want to do is “push paper.” However, whether you notice it or not, managing is happening every day. So if you're not managing your practice, it's absolutely managing you.
Finances: Don't dilly-dally
Taking care of a practice's financial resources requires more than just writing checks periodically, and treating this task like something you can put off until the last minute isn't wise. Several supply vendors still offer a discount for paying early, so if you manage cash flow wisely, taking advantage of that offer is a little like getting free money. And on the flip side, many of your utilities and recurring service providers will start adding late charges if you let bills sit around too long.
Employing a bookkeeper is an option, as is using a bookkeeping service or training someone on your staff. Writing checks and putting them in envelopes is busywork, but regardless of who does it, make it a priority to hold onto signing authority and take the time to look at every bill. Keeping an eye on the expense trends in your practice is a valuable and informative exercise. You need to know when your garbage service goes up, and you need to know how much power your building is using now compared to the same period in the past as well as a hundred other measurements.
It's easy to look at your gross daily receipts as an indicator of how your practice is doing, but that number is meaningless without factoring in expenses. Using a yearly budget is a terrific tool, but if you go that route, be sure to include accounts designed to build up funds for future capital needs. Expanding your facility, replacing a vehicle or buying radiography equipment should be contemplated well in advance to minimize cash flow disruption. Include a capital fund for the unexpected too, as we all know unanticipated needs will arise despite thorough planning.
Human resources: Do your homework
I can't stress enough how important it is for practitioners without a manager to become semi-experts in the area of human resources. If you employ one or more staff members, handling their employment properly is not only the most important job you have but also represents an avenue of huge liability if you fail to do it. Employees have rights, and every state has a department that helps protect those rights and helps you understand and respect them. It just requires a little homework.
Understanding payroll laws, meal break rules and how to handle the administration of a new employee-not to mention how to handle the processing of a terminated employee-are some areas you need to become familiar with. Learn about holiday pay, sick leave pay, vacation pay, workplace harassment and discrimination, and make sure you're on the right side of your responsibilities as an employer. You'll never feel like the time you invest in becoming proficient in these areas has been a waste. A “good” employee can go bad in a heartbeat, especially if his or her rights aren't being respected.
Special offers and generics: Play the field
I cringe when I hear a practice say that all their supplies come from a single vendor. Our industry is fortunate to have several large distributors, and they all do a terrific job. But despite what these distributors may say, they don't work for you. They work for themselves. It's not a matter of honesty but of complacency. If they own your entire supply business, what incentive do they have to deliver you the most competitive pricing?
Make no mistake: All distributors offer deals based on your buying volume and your relationship with them. Buying groups are becoming more mainstream, but I'll simply never feel comfortable with a single distributor knowing I'm not continuously shopping around. It may be unreasonable to ask for an advance price for every order, but you should be checking them periodically and comparing them to previous prices. Everyone makes mistakes, and if you don't look you'll never know.
Another thing that makes me shudder (cover your ears, manufacturers) is failing to take advantage of generic medications. Veterinary manufacturers of nongenerics are certainly important players in our industry and make things like continuing education meetings, industry magazines and many important studies possible. I'm not advocating that you leave them cold, but do pay attention to what you're buying from them.
They all have proprietary, effective-and in some cases revolutionary-products that either have no peer or no equally efficacious peer. These companies also all sell products that have long been available in generic form for a fraction of the cost. If you want your services to have the widest and deepest reach, you may want to include lower-cost medications in the equation (when possible) to allow Mrs. Jones on a fixed income to spend more of her resources on your services. Veterinary industry experts have been ringing that bell for over 15 years-generate more revenue from professional services and less from inventory sales.
In this day and age of major chains competing for your medication revenue, this is your one really good tool for staying “in the game.” In addition to being able to deliver medications more inexpensively, competing with online or big-box retailers can also help to slowly heal the black eye our industry had for many years due to unreasonable product markups.
Technology: Your smartphone is your friend
Of course, the newest technology makes ultrasound, radiology and diagnostic testing more informative and often ensures that answers are delivered more swiftly, but I'd argue that those aren't the most important technology aides in your world. If you don't have a smartphone (I'd really be happy if no one raised their hand), it's well past time to make the jump. Accessing emails, managing your schedule, communicating via text messaging and using the internet as a productive tool are all ways this amazing device can help you run your practice.
If you have a brick-and-mortar facility, make sure your phone is connected to your schedule (Microsoft Outlook and Google calendars work great and sync automatically). Employ mainstream practice management software to invoice clients, maintain medical records and keep your fee schedule from being guesswork in the field. Software can easily run on a laptop and even many tablet devices. I've been in this industry long enough to remember when handwritten carbon invoices were standard, and I can only imagine how many of them were lost, damaged or destroyed, and with them, all evidence of charges that had been paid (or worse, still needed to be paid). Missed charges fall straight to the bottom line.
Either find the time ... or find the money
While it may seem like this list of things to help you manage your practice is relatively small and easily attended to, it only seems that way. In fact, these things (collectively, at least) will take 10 percent of your practice time away or will require you to spend 10 percent more time in the evenings or on weekends just to keep up.
If you must continue into the future owning a veterinary practice that lacks a dedicated manager, you need to at least find the time to take care of these areas. That being said, if your practice does flourish and grow stronger, I would argue that there's no more important business expense than hiring someone who can address the above issues and tasks. Find someone you trust and make sure they have the correct skillset. You won't be sorry.
Kyle Palmer, CVT, is a frequent contributor to dvm360.com and dvm360 magazine, a Firstline Editorial Advisory Board member and a practice manager at Silver Creek Animal Clinic in Silverton, Oregon. Send your questions or comments to email@example.com.