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Brendan Howard oversees veterinary business, practice management and life-balance content for dvm360.com, dvm360 magazine, Firstline and Vetted, and plans the Practice Management track at all three Fetch dvm360 conferences.Brendan has proudly served under the Veterinary Economics and dvm360 banners for more than 10 years. Before that, he worked as a journalist, writer and editor at Entrepreneur magazine and a top filmed entertainment magazine in Southern California. Brendan received a Masters in English Literature from University of California, Riverside, in 1999.
At Fetch dvm360 in Kansas City, these 10 practice managers were announced as finalists in the dvm360/VHMA Practice Manager of the Year competition. Know anybody?
KANSAS CITY, MO-Certified veterinary practice managers, practice-owning managers, and a woman who keeps a humane society's veterinary team running smoothly are among the finalists for 2019 dvm360/VHMA Practice Manager of the Year. The 10 finalists were announced during Fetch dvm360 in Kansas City this weekend.
These finalists are “enhancing the image of the profession,” says Jim Nash, MHA, CVPM, president of the Veterinary Hospital Managers Association (VHMA), the collaborators who help make the contest happen and provide membership perks and educational opportunities to the winner. “They're helping their practices thrive by demonstrating best practices and outstanding problem-solving skills. These managers are ushering in positive changes and deserve to be applauded for their hard work, persistence and professionalism.”
The association's executive director, Christine Shupe, CAE, offers congratulations and good luck: “The VHMA is proud to collaborate with dvm360 to identify and recognize the movers and shakers in the field of veterinary practice management. The narratives presented by each finalist reinforce the pivotal role a manager plays in a practice's success.”
Without further ado, here are the finalists, with comments that grabbed our attention from their contest entry forms.
Practice manager and co-owner at Paw Patch Veterinary Hospital in Indianapolis, Indiana
“In between the initial contact and the final sale of the practice, I was able to share with our hospital's potential buyer what I wanted for the practice: sustainability, pay raises and benefits for staff. I also asked about the possibility for myself and one of our long-term RVTs to buy in to the practice during the sale. I was told they'd done that with associates but never other employees, but it could likely be done.
“While we'd talked about the sale during leadership meetings, we weren't talking with staff just yet. As things progressed, I felt we needed to. I wanted to give them the big picture: that the sale of the practice could be happening, that the practice owner had good reasons to sell now, that no one would lose their job, that we'd be able to offer raises and insurance benefits within a year and that we'd give team members the opportunity to ask questions and voice their opinions.
“The final outcome was that the practice was sold. Our main doctor still owns a percentage, and an associate, an RVT and myself all own a percentage.”
“One thing I took away from the VHMA Management Exchange in Indianapolis was the wealth and breadth of knowledge that was in that room. I have to be honest: I came away feeling a bit inadequate as a manager after attending that meeting. It reminded me of my daughter. Every year, my family attends some large national and international cycling events. My 15-year-old daughter is racing among the best cyclists in the nation or world. She can come away from those races feeling inadequate if things didn't turn out the way she expected, but after a couple of days, she realizes the opportunity she had racing with these elite cyclists, and she starts to implement the things she learned. When she goes to the next event, she can take what she learned and use it. That's how I see my experience at the VHMA Management Exchange.”
Practice manager at Annville-Cleona Vet Associates in Annville, Pennsylvania
“As a practice manager of a growing clinic, I knew I needed to up my game. I did a lot of research on how to become a better manager and realized I needed my CVPM. I joined the VHMA and many Facebook groups, attended seminars and classes on management and enrolled at Penn Foster College to get my Veterinary Practice Management Certificate. Then I enrolled in the VHMA prep course for the CVPM and bought all of the recommended reading material from VHMA. Podcasts and Audible books on what it takes to be a good leader took the place of me reading feel-good love stories. In November 2018, I committed and signed up to take my test the next April. I dedicated myself to spending an hour before work every day studying. I studied during my lunch hour, three hours every evening and six hours every Saturday and Sunday. I was determined to pass, and I did!”
“We approach online pharmacies from a different perspective. If a client requests an online prescription, we fill it within 24 hours, and the next time the client comes in we educate them about why we recommend buying these products from a veterinarian or a veterinarian's online pharmacy. We try to help pet owners understand the value of that. We explain it is the safest place to buy food, prescriptions and medications. We can provide immediate support with potential alternatives and offer information about potential issues that is not available online.
“It's been challenging to get staff members to buy in to the idea of educating clients about products. The staff complained that they always get ‘shut down.' If convenience is what the clients are looking for, we inform them of our online store. To address increasing confidence levels in the staff related to client education, I role-play with them to increase knowledge and help them sound more confident when clients ask questions. In doing so, it's given the power back to our employees, and they feel more confident in having the tough conversations with clients in all areas.”
Interim CEO and director of veterinary services at Humane Society of Boulder Valley in Boulder, Colorado
“Our seven-DVM practice is a busy, full-service, full-price public clinic serving clients of all income levels and caring for thousands of animals through our robust shelter medicine program. With growing popularity, our appointment books were full for weeks at a time. Even a basic preventive visit for vaccinations required a three-to-four-week wait. Our full-pay clients were looking (and booking) elsewhere for service, and our low-income clients were waiting critically long periods before their pets could be seen.
“This is when we decided to try walk-in appointments. It was a huge hit. Within the first few weeks, we were overflowing. But our clinic is less than 3,000 square feet, and walk-in patients quickly filled every available exam room, kennel and cage. We buckled down, maintaining a once-weekly walk-in event for about a year, monitoring client wait times and revenue impacts. Financially, it was a huge boon, but the toll it took on my team in terms of workload eventually led me to to stop these events. I think a good business leader understands when to say ‘yes' to a wonderful idea and when to say ‘no' when it's clear things aren't going as planned.
“Since stopping walk-ins, we've made budgetary adjustments, revisited our general appointment schedule and made changes to mitigate the backlog we still experience. The flow of animals through the shelter still keeps us exceptionally busy, but our clients are seen at a much more even flow.”
“When I first learned about the Fear Free initiative, I knew the philosophy would complement the positive reinforcement training and behavior methods employed in other parts of our organization. Our crowded clinic environment was definitely stressful for patients-particularly the shelter animals, which were already experiencing apprehension in the veterinary environment. With more than 30 staff members in our nonprofit clinic, this was a big educational investment. We enrolled our entire team and set aside time for each person to complete the training.
“But completing the coursework and earning Level 1 Fear Free certification was only the beginning. We needed to adjust how we handled patients, what we offered clients and how we scheduled appointments. Change is never easy, but employees began suggesting additional ways to improve, and the lift to morale was an unexpected bonus. Our next goal is Fear Free practice certification!”
Practice manager at Minnehaha Animal Hospital and Pet Doctors Animal Clinic in Minneapolis, Minnesota
“I've been implementing wellness plans and loyalty rewards programs at both clinics. The CSRs were key in helping create the various plans we ended up with. I made the decision based on the cost vs. benefit calculations: Would these increase compliance with wellness care? Would the potential volume make up for revenue ‘lost' by offering a small discount for the package? Would clients be incentivized to stay with our clinics based on the reward they could earn? What's our actual cost? The end result is that one hospital definitely saw an increase in wellness care-the hospital with the demographics I expected would be most open to the program. The other hospital has different demographics and enrolled fewer patients in the wellness plans but more in the loyalty rewards program. These two programs have set us apart from other independently owned veterinary clinics in the area, because we're the first to offer them.”
“As the second location has grown substantially, I've transitioned to splitting my time between the two. Initially, the teams at each location were unhappy that I wasn't on site all the time, but I've since worked to train and empower team leads to step in and take care of many issues. I've seen it increase job satisfaction and engagement.”
Practice manager at Cheat Lake Animal Hospital in Morgantown, West Virginia
“I'd been hoping to transition our clinic to paperless for years. I eventually convinced the practice owners to give it a try. I formed and worked closely with a small committee (myself, one RVT, and two of our doctors) for six months to plan out how we would make our clinic paperless. Using IntraVet, we walked through every step of an appointment, surgery, hospitalization and office visit to figure out how we would perform these services with as little paper as possible. After meeting for a year and a half and composing a thorough paper-lite manual, we were ready to make the transition.
“We met in small groups with each of our 50-plus staff and trained them on the process. I scheduled a small IntraVet support team to be at our clinic for a few days while we made the transition, and our paper-lite team offered support for our staff members as well. Overall, the transition to paper-lite went smoothly and the processes still work very well today. It's improved our workflow tremendously and saved a few trees in the process.”
“Our ownership expanded (we had an associate buy in), and net profit was the highest it had been in years. Then our practice owner suddenly announced that she had purchased a building with hopes of opening a cat-only satellite clinic. Since I'd never been involved in starting a clinic from scratch, I used many resources that were right at my fingertips. Our drug representatives helped me a lot with planning checklists and general advice. We began ordering equipment as the renovations of the building began. I contacted a long-time resident tattoo artist to commission our logo. She and I worked together over several months to come up with the cutest cat logo.
“Feline Veterinary Care of Morgantown opened in December 2018, and I'm happy to report that first-quarter results were not disappointing. We've had a lot of positive feedback from our clients and community about our area's first cat-only clinic. The staff feel proud that they can offer focused feline care with Fear Free practices. Best of all, the cats appreciate feeling extra special!”
Practice manager at Creekside Animal Hospital in Macomb, Michigan. (not pictured)
“Recently we lost an associate veterinarian who was beloved by clients. We parted on good terms, but with her leaving we lost some staff as well. Being short-handed is always cumbersome for remaining staff. I had two remaining LVTs. I filled in as needed. In the process, we did gain a brilliant new-graduate veterinarian and new-graduate veterinary technicians. The training involved is time-consuming while you try to maintain managerial duties, client issues and all aspects of a normal day-to-day job. This is just a blip that I know we'll get through together.”
“We've taken on online pharmacies. First of all, we don't feel we should make things harder on our clients. What that means is, we're not going to make our clients come in for a written prescription or charge for one to mail into the online pharmacy of their choice. We educate them on the dangers of counterfeit product and how products bought from us are guaranteed. In an effort to help protect our clients' pets, we have a special stamp we put on all of our outside prescriptions stating that the product has to be made in the United States, not expire before a certain date, be in its original packaging and allowing for no substitutions. As an online option, we provide Vetsource for clients if that's more convenient for them, and we let them know the product is the same as if they picked it up from our hospital. Guaranteed.”
Practice manager at Garden Oaks Veterinary Clinic in Houston, Texas
“Taking on the daunting task of earning AAHA accreditation can be overwhelming, and it's impossible to do it solo. Having the commitment and enthusiasm of every team member is absolutely crucial, because there are more than 900 standards to review in 21 different categories of hospital management. Getting everyone on board for a task like this isn't always easy, but our team shared a desire to have a higher standard of care for our patients and clients, so I created a ‘Road to AAHA' plan to get us prepared.
“I recognized that all of our team members had different interests in the practice, and I invited them to each take ownership for the sections they were passionate about. This allowed us to divide and conquer while also letting team members become experts on their area of the hospital. Each person created a checklist for their section to ensure we were meeting all mandatory standards, making sure standard operating protocols were written, and confirming that any needs for supplies or equipment were communicated to the practice owner, who was in charge of overall supervision and completing to-do lists that each group provided. I met with each person regularly to follow up and offer my support throughout the process.”
“One day I asked the practice owner to go to breakfast with me. I reminded him that my role as practice manager is to make wellbeing a priority and to establish a foundation of psychological safety. If there are systems that need to be changed to improve the environment that contributes to burnout, I'll take care of that. But what I needed from him was to apply his oxygen mask first. By taking steps to show that he's committed to his own wellbeing, others will feel empowered to do the same. I challenged him to bring me suggestions for what he needed to regain control of his life and combat the stressors he couldn't control-not the solutions he thought the business needed. His list included being able to physically separate the hospital, being outdoors, participating in fitness activities and having more time to ‘catch up' in the hospital. I took his list, and I got to work finding ways to accommodate his needs in conjunction with the business needs.”
Hospital administrator at Lee Veterinary in Atmore, Alabama
“To solve a scheduling problem, I recommended stepping away from surgical procedure appointments and providing each veterinarian with their own surgery day. However, this meant I needed an LVT who was experienced and highly skilled in client education, treatment plan facilitation, calculations, anesthesia and dentistry (including radiography). Finding such a candidate in our area can be quite a challenge. Much to my surprise, this individual had actually been employed by the company up until about seven months prior to my arrival.
“I asked permission from the practice owners to perform a much-overdue exit interview with the former technician to understand what contributed to her exit and what feedback or perspective she could share that could aid me in staff management and continuous improvement. Upon returning to the clinic, I provided the owners with the details of our meeting and my thoughts, which included the need to have this employee back with the clinic, in this challenging surgical technician role that she would certainly find rewarding. Fast-forward almost a year later, and this was the best decision for the clinic. She has played a vital role in surgical consistency for our doctors and patients, made a significant impact on the growth of our dentistry category, and provided technical leadership to our medical support staff and students.”
“There is something that the Avengers, Batman and Robin, the X-Men, the Justice League and the Teenage Mutant Ninja Turtles all have in common. They each have unique strengths and weaknesses, but their success is best accomplished by leveraging their individual unique skill sets in a team. However, there's another superhero: ‘Luckily I.' These heroes do their best, but tend to work alone because they set high and often unreasonable expectations for others, finding fault and highlighting others' weaknesses. This superhero is quick to point out, ‘Luckily, I fixed the problem' or ‘Luckily, I was there to intervene.'
“When I saw this problem in my own team, I developed a Superhero Academy. The staff was brought together to openly share their feelings about the culture and to then go around the room and describe the desirable culture. We made note of these descriptions, as they played an instrumental role in the development of our clinic's cultural vision. Pledges were made to be the type of superhero who works with others for the greater good-providing support to others so they reach their potential and capitalizing on their strengths and preserving the integrity of the team.”
Practice manager at Cicero Animal Clinic in Brewerton, New York
“I am an active member of the VHMA and am frequently on the discussion boards, either asking colleagues for advice or offering my own, if I can. Through the VHMA, I've been fortunate enough to develop a network of professionals I can lean on for advice at the drop of a hat and am available for the same help in return. The VHMA is an endless resource for everything veterinary-related, from practice management to business management and all that lies in between. This year, I completed the CVPM prep course and am preparing to sit for the test.”
“Not a single clinic in our area was offering wellness plans. Clearly, this was a potential area of growth for us. In 2013, I started researching the various plans available to clinics. I called AVImark, our practice software provider, and found out they'd just released an update that allowed a user to build and manage their own wellness plans in AVImark. Jackpot! They also offered a merchant processor program that would work in AVImark and allow us to store client credit cards safely and successfully for monthly payments while also being PCI-compliant.
“The next step was to anticipate and avoid problems. I posted on the VHMA boards telling everyone my plan and asking for advice. To my surprise (at this point, I was new to the VHMA), lots of good advice poured in from managers all over the country. I spent hours on the phone with several of them, talking about their successes and failures with wellness plans. This was an incredible resource, especially learning from other people's failures.
“When everything was in place to start, I held a two-hour training session with the entire team. We practiced discussing plans with each other as if we were clients. Staff confidence was mixed when it came to the change, but I did my best to combat any hesitation with education and support. We met two weeks later to review what we learned from the first meeting and discuss some of the hangups we'd had. After that, staff started to buy in to the plans. We eventually added wellness plan mentions to every level of advertising we have, including our on-hold phone recordings. They did so well that in 2014 I designed and implemented puppy and kitten plans.”
Practice owner and medical manager at Cat Care of Fayette in Fayetteville, Georgia
“I've been a technician for years at Cat Care of Fayette. I've been promoted from technician to lead technician to office manager and now owner/practice manager. I purchased Cat Care of Fayette last year from the doctor I've worked closely with for 12 years. On busy days, when we're unexpectedly short-staffed, I believe it's vital to step up and hop right into technician/receptionist mode no matter what position you hold in the clinic. We have a different dynamic from some other clinics, because we've all grown into one team instead of separating the departments. Everyone pitches in where they can when it's needed without arguing about ‘not my job.'”
“When I purchased the clinic as a nonveterinarian, I'm not going to lie-I was apprehensive about how I'd be accepted in the veterinary community and by clients and staff. My fear was far worse than the outward surprise, respect and enthusiasm I actually received. What I work hard to prove every day is that an individual doesn't need to be stuck in place. They can always achieve more with hard work and dedication.”