Make your practice run like clockwork


Does the daily grind cause tasks to fall by the wayside? Follow these tips to put the gears back in motion.

As the clock ticks down to the end of each workday, there are a few questions you should be asking yourself. Have you accomplished the day's tasks? Are your clients pleased with your services? How's your bottom line? If you've had problems in any of these areas, better efficiency may be the solution. By improving a few key areas, you'll see increased revenue, a more motivated staff, and happier clients—who wouldn't want that? So grease the wheels by improving your entire team's productivity and effectiveness. Here's how:

Use your cogs better

Some estimates say veterinarians spend as much as 50 percent of their time doing non-DVM-related activities. That's too much time for work that produces less practice revenue than medical tasks would bring in. Most practice owners should aim to cut their time doing non-DVM-related activities in half. Think about how much time you spend doing the work of technicians, receptionists, and managers. Even better, keep a log of your activities for one week, noting each task and the amount of time you spend on it.

At the end of the week, evaluate your log, highlighting all the jobs that could or should have been done by others. Then note who could have performed each highlighted task—like an exam room assistant or surgical technician—and see if these team members are scheduled when they need to be. Have each team member complete the same exercise. For example, your technicians might be doing work better handled by receptionists or veterinary assistants. Many times operational efficiency can be greatly improved with proper delegation from the top down.

Set your clock properly

I know, I know. You'd rather express anal glands all day than work on your team's schedule. But here's the thing: If you're willing to put in the time and effort, scheduling can be a rewarding challenge. When you have the right people scheduled at the right time, your day will go more smoothly and your practice will profit.

Your team schedule is derived from your doctor schedule, so first write down your doctors' office hours and surgery schedules. Next, in place of employee names, list job positions (receptionist, technician, veterinary assistant, kennel assistant, and so on) needed to support the doctor time you've recorded. If you schedule a doctor for surgery from 8 a.m. to Noon, you'll need a technician from 7 a.m. to 1 p.m., a veterinary assistant to help the technician during the same hours, and a receptionist from 7 a.m. to Noon.

Let's say you have another veterinarian scheduled for office hours from 9 a.m. to Noon the same day. You'll need an exam room assistant during those hours and perhaps another receptionist. Got the idea? Once this schedule has been in place for a month or so, you can re-evaluate it to see if you should adjust your staffing.

Practices that leverage their doctors well—meaning they schedule them for doctor stuff and nothing more, as much as possible—might have a higher staff-to-doctor ratio and use more team members at any given time to support the veterinarians' activities. This approach is great, as long as it results in more income. Simply placing more bodies on the schedule will not improve efficiency or profitability. Those bodies need to be trained.

Grease the wheels with knowledge

One of the best ways to improve operational efficiency is to train your healthcare team, then train them some more. The learning curve can be steep if you expect these employees to learn on their own. But if you invest in effective training, you'll see improved efficiency, profitability, employee retention, and motivation in your workplace, along with less stress and fewer mistakes.

So how do you educate your employees? Here's what doesn't work: throwing them into the deep end to see how they swim. It's much better to develop a well-thought-out training plan for each position in your practice. I like to use a phased program that spans three to four weeks. This program lists all the duties an employee will be responsible for, along with the time allotted for learning each task and the employee who will handle that aspect of the training. Once the new employee has completed the program, the practice manager or owner evaluates his or her performance to see if any fine-tuning is necessary. Search "phased training program" at the page to find a guide for efficiently training receptionists.

CE is a vital part of team training. The more your team members know, the more effective they'll be in their jobs. Can you imagine a receptionist who's never learned about customer service or a veterinary assistant who's never been taught about preventive medicine?

Maybe you don't have to imagine—the reality is out there in your practice right now! Get those team members into a class or send them to a conference. Your education didn't stop when you graduated from veterinary school; mine didn't stop when I became a certified practice manager. We all need to be continually updated in our fields, and so do veterinary team members. Actively promoting CE both in the hospital and at meetings and conferences goes a long way in improving operational efficiency. Plus, it lets your employees know you care about them and their professional growth.

Buy a better machine

Are you still handwriting checks or manually scheduling appointments? If so, you're not alone. Some practices still don't use computers. And many more are using the same software they bought when they first installed computers 20 years ago. Remember that old DOS platform? It's no longer supported by any software company, but it lives on in many veterinary hospitals. The same is true of hardware. Old, slow computers are laboring on long past their effective life. If this sounds familiar, it's time for you to upgrade to newer, faster technology. Today, a computer system needs upgrading every three to five years.

Take a look at your other technology as well. Updating your phone system, accounting software, or employee scheduling system might free up hours in your team's weekly schedule. And medical technology can also boost efficiency and productivity. It's possible to integrate an in-house lab, digital radiography system, and practice management system to minimize redundancy and duplication of efforts. Perhaps a laser surgery unit would allow you to do more surgeries in a day. Obviously you can't invest in all these new technologies at once, but it might be time to look at one or two of them.

Get the paper out of your machine

My partner, Sheila Grosdidier, and I recently visited a practice in California and counted 27 places a record could legitimately be stored in that practice—the bathroom was about the only room that didn't make the list. That means that if a record went missing, a team member would need to look in 27 places, and he or she still might not find it.

I believe paper records are the biggest time wasters in the veterinary industry. What if there were no more paper records in your practice and that all your medical records were electronic? Scary, I know. But every paperless practice I've consulted with says it's one of the best things they've ever done.

Suppose that each doctor in your practice carried around a wireless computer or, better yet, a convertible notebook that allows you to either type on the keyboard or write on the screen. At your fingertips you'd have access to patient records, lab results, the appointment schedule, and even e-mail. You could instant message team members on the other side of the building and get an instant reply. If all of this seems intimidating, don't let it be. You can start small with a paperless system. Opt for a "scan as you go" process where your team scans, in advance, the records for patients you'll see tomorrow or next week. By the end of the year, all active records will be scanned into the system.

Find someone else to grease the wheels

Another way to improve efficiency is to outsource, and a prime candidate for outsourcing is payroll. I rarely suggest a practice do its payroll in house. Payroll services will do this for you, and the cost is very reasonable for what you get: These companies set up direct deposit for employees, prepare your quarterly state and federal reports, and deposit taxes. They can also keep track of personal time usage and calculate payroll deductions. Some companies do even more. You probably can't process your own payroll less expensively in house.

Many other practice functions can also be outsourced. You can find a company to create your Web site, send patient reminders, and implement targeted marketing. You can also affordably outsource accounting and bookkeeping services. Hopefully your practice is using a collection agency or lawyer to assist with past-due payments. On the medical side, you can send patient samples to an outside lab, which in many cases is more cost-effective than testing in house, and you can either hire a traveling ultrasound technician or refer patients to a specialty facility. With any outsourcing you do, be sure you are getting a cost benefit and improved response.

Once you've determined which areas need your attention, get started on improving your operational efficiency. Even if you're happy with the way things are going, there's always room for improvement. So work smarter and maximize your team's productivity. You'll be amazed by the improvement to your practice's bottom line. But don't wait—the clock's ticking.

The bottom line

It's time for a change

To help keep your profits ticking, take these steps to improve your operational efficiency:

Leverage your team. Free up some of your time by delegating appropriate tasks to team members.

Schedule smart. An efficient office is one that has the correct amount of staff members working at any time.

Train like a champion. Informed team members can perform their jobs more effectively.

Update your technology. Updating old pieces of equipment might save you hours each week.

Go paperless. You'll save unbelievable amounts of time.

Outsource. Payroll services, Web site design, and lab testing can all be done by outside professionals, saving you time.

Mark Opperman, CVPM, is a Veterinary Economics Editorial Advisory Board member and owner of VMC Inc. in Evergreen, Colo. Send questions or comments to

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