"I save the owner 25 hours a week-and then some."


Practice managers lower turnover, free up the doctors' time so they can focus more on patients and clients, and improve the owners' sanity. Could you use one of these gems in your practice?

SINCE JOYCE BLAIR JOINED SOUTHPOINTE Veterinary Hospital in Allen Park, Mich., as its hospital manager 12 years ago, she estimates she has saved the owner at least 25 hours a week. Dr. Carol McKee, owner of the six-doctor, 22-staff member practice, says Blair saves her "every minute she's here," so really that's more like 40 hours a week.

"I'd say my biggest contribution to the practice is the owner's peace of mind," says Blair. "I've freed up her time by handling staff and client issues. I certainly try to run the practice day to day in a way that's in line with her thinking and philosophy."

With more time, owners with practice managers can focus more on client and patient care. In fact, more time means they can see more patients. Since Jan Diffin took over as the clinic manager of Escanaba Veterinary Clinic in Escanaba, Mich., the three-doctor practice has seen about 30 additional clients per week. Calculated at an average doctor transaction of $112, that works out to an extra $3,360 per month—or more than $40,000 a year.

Figure 1. Covering all the management duties

In all fairness, Diffin says, the hospital added another doctor last year, too. Diffin's humble when she talks about her contributions to the practice, but the numbers don't lie. And she'll admit that her position saves the practice money. "We increased our profits by having a clinic manager because the doctors can practice medicine; they don't have to worry about staff problems, scheduling, and ordering inventory," she says. But more important, says Diffin, are her contributions to the clinic team by facilitating monthly staff meetings, continuing education, and open communication for the 15 staff members.

These benefits—the ability to delegate employee development, an improvement in the owners' quality of life, and the ability to focus on medicine and strategic planning—are the top reasons that owners hire or want to hire a hospital administrator or manager, according to results from Benchmarks 2006: A Study of Well-Managed Practices. There's no surprise then that 71 percent of the 100 top-notch practices participating in the study currently employ a hospital administrator or manager. Of those without, 50 percent plan to hire one in the next two years. Knowing what they know now, 57 percent would have hired a manager sooner.

Figure 2. Taking care of your manager

Overall, study participants that employ a manager say their managers have saved them an average of 15 hours a week. They report lower overall staff cost as a percentage of revenue (by about 1 percent), and per doctor production averages that are $46,000 higher than in practices without a manager. "I think my doctor's relieved that she can practice medicine now," says Diffin. "She doesn't need to worry about the small stuff."

That small stuff is really more like a mountain of responsibility. Hospital administrators and practice managers lead employee development for the client and patient care teams. They consistently support the practice's mission; inspire others' commitment to the mission; and mentor and educate the nondoctor staff members in client relations, management, and leadership to ensure continued growth for staff both personally and professionally. And they represent the owner within the practice and in the community. (See "Covering All the Management Duties" for a look at how these positions affect the whole team.) The first step: Find a manager who's right for you.

Hiring right

Success in hiring the right manager begins with determining what you're seeking. Too often we encounter owners who aren't satisfied with their manager. Yet when prompted, the owner can't describe his or her vision for or expectations of the manager. Nor do they have written job descriptions.

Behind the study

This year's study results confirm the importance of defining expectations upfront. We asked owners to identify one thing that they and their manager could do to improve their effectiveness as a team. "Clarify responsibilities" was the most frequently cited response.

Neglecting to think about what you need in a manager before the interview process makes it very difficult to know when you've found the right person. It's also a recipe for dissatisfaction (and perhaps disaster!) once the manager is hired. Based on your needs, make a list of the qualities that you'd like to see in a candidate. Separate your list into qualities that are must-have and nice-to-have. (See "Winning Traits" for more.)

No applicant will have all the ideal talents and competencies you identify. So, as you review candidates, keep your must-have list in mind, and don't compromise. For other qualities, make a conscious decision about which skills you're willing to help your manager develop over time.

The benefits of investing in your practice

Once you've defined the qualities successful candidates will possess, establish a hiring protocol that outlines each step you'll take—from recruitment through hiring—to find a manager. Then create a position description that defines the responsibilities and expectations of the position. (See a sample position description at www.vetecon.com.)

Investing in training

You've hired your ideal candidate for the manager position. Great, but that doesn't mean you're done. The work to develop a cohesive, productive team member has just begun. Well-Managed Practices estimate the learning curve is six to seven months for managers with more than two years of management experience and longer for managers with less experience.

Set the tone for a successful, long-term relationship the first day by beginning with a balanced orientation program. During this initial training period, you'll want to communicate your expectations clearly and develop the manager's understanding of hospital protocols. Doing so helps the manager become more efficient and productive as quickly as possible.

Words of wisdom from long-time managers

While you're pushing for progress on some fronts, keep your new manager motivated by building on his or her strengths. And as your manager becomes more accomplished, continue to look for opportunities to keep him or her enthused and moving forward. Provide ongoing options for growth and professional development so he or she doesn't grow restless.

Well-Managed Practices use a variety of resources to develop their managers. These resources include national and regional veterinary management conferences, the Veterinary Hospital Managers Association, AAHA's Veterinary Management School, the Veterinary Management Institute at Purdue University, and Veterinary Economics Managers' Retreat. Also encourage your managers to read practice-management journals and publications including Veterinary Economics, Firstline, Trends, and The Harvard Business Review.

Figure 3. Winning traits

Remember to get feedback from your manager. Employees are often your best source of information about their development needs. And to feel vested in the process, the manager must share responsibility for identifying areas in which he or she needs additional training.

Handing over the reigns

Of course, all the training in the world is useless if you don't empower your managers. You must trust them. "Don't hold back," says Diffin. "Let your mangers do their jobs. You've got to let go of a few things. That's very hard for owners, especially ones who have been doing these duties for years and years."

Owners and managers tell us that to build a successful, long-term relationship the owner must communicate well; nurture the relationship; value and respect the manager's contributions; recognize and reward effort; and be fair, honest, and consistent. In return, the manager will bond clients and staff members to the practice, be productive and efficient, bring new ideas to the table, share knowledge, and help keep the practice moving forward.

As you can see, accomplishing this list of goals takes cooperation. And Blair says it's important that the manager and owner share the same philosophy about how you treat employees and patients. "You want to discuss and make sure you understand the issues that are important to you," she says, "and share an understanding about where the practice is going over the next few years."

Taking the plunge

What advice would owners in Well-Managed Practices offer to a colleague who was considering whether his or her practice would benefit from hiring a manager? Dr. JoAnne Roesner of Loving Hands Animal Clinic in Alpharetta, Ga., says, "Bite the bullet and do it. I hurt my practice, efficacy, profitability, and my own sanity waiting!"

Drs. George Seier and Belinda Hataway of Cobbs Ford Pet Health Center in Prattville, Ala., agree, "You may think you can't afford a manager, but actually you can't afford not to hire one. A manager can make you money, control staff issues, and improve your quality of life."

Denise L. Tumblin

Denise L. Tumblin is president and owner of Wutchiett Tumblin and Associates in Columbus, Ohio. She led a team of management analysts to develop Benchmarks 2006: A Study of Well-Managed Practices. Send questions or comments to ve@advanstar.com.

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