Management lesson: Know what not to do


Think back to the last few times you had complications in surgery; painful thought, but it is usually your fault isn't it?

Think back to the last few times you had complications in surgery; painful thought, but it is usually your fault isn't it?

The skin suture line could just maybe use an extra suture which just happened to take a bite out of the aorta or something close, as measured by the blood on your face mask. Rip all those nice, neat sutures, find that gusher and start all over again. Then curse yourself for putting in that last suture that you really didn't need anyway.

It's like that anytime you try to over-manage a situation or try for perfection when perfection just wasn't needed.

It's the same with managing your practice. You constantly search for that magic bullet, making changes without really sitting down with yourself to argue out the alternatives and long term implications and possible down-side damage.

Name of progress

How many times have you damaged your practice in the name of progress?

Just like the football game is won by the team that makes the fewest mistakes, you'd better be as good at avoiding mistakes in your management as you are in your medicine.

There are, though, a half dozen or so management mistakes that most practitioners almost always make. Seasoned veterans of these errors can laugh now, but perhaps some of you can avoid boo-booing (not the word I would have liked to use) your practice by being forewarned.

Mistake #1: Changing what seems to work for what may be better without having a way to measure what works best.

At lunch at the last C.E. meeting, one of the practitioners in the next town mentioned that they stopped calling clients the day before their appointments to confirm. He said it was an absolute total waste of his staff's time. You go back to your practice and make your receptionist happy in that she has one less task to do. Six months later, she complains about the increased number of no-shows. You blew this one because the other practitioner has a successful practice and he sounded like he knew what he was doing. Besides, it made it easier on his staff.

If you circled the no-shows in blood-colored ink at the end of each day, you could determine how many you had per month by adding up all the blood spots. Then you could know that you had 4 percent with reminder calls. The next month, the number might have been 12 percent and you would know that the change was bad for your practice.

Meanwhile, you are out of pocket an extra 8 percent of your monthly productivity for six months or essentially two week's income defenestrated itself. (Great word. Look it up!)

I know you make these mistakes all the time. How many more new clients did you get when the phone company talked you into increasing the size of your ad? How many fewer new clients did you have when you shrunk your ad? What? Cat got your tongue? (Interesting expression yy�y�y�yy�y�y� anyone know where it came from?)

Mistake #2: You bought the super-duper computer practice management program and used the training offered with purchase. You did not contract for additional training.

Chances are, at least one person working with the program today was not on your staff when training was given.

Therefore, they were trained second, third or fourth hand depending on how many staff have come and gone since you installed the computer. Sure they know the invoicing module, but do they know how to tweak the most information out for you so you can manage? You are managing to get along, but are a "fur piece" from really managing. By far, the most productive and least used management tool is your computer and its vast store of management information. I hope that you at least take time to really analyze the information on the end-of-month summary, perhaps entering that information into a database program (may be included from the software manufacturer) for graphing to note changes from month-to-month, season-to-season and year-to-year.

Mistake #3: Waiting until January to see how you did last year. O.K. you were down $14,000- $634,000 to $620,000 Not too bad! Pretty close! Nope! Not O.K.! You raised your fees 5 percent last February. You should have been up to $665,000. You are effectively down $45,000 at a time when inflation took about a 10 percent bite in your cost of drugs, supplies and labor. You haven't been tracking your monthly and year-to-year transaction numbers have you?

Transactions in veterinary practices nationwide in non-high growth areas are down 5-15 percent. Why not? We graduate 3 percent more veterinarians than we really need every year. Eighty percent of those are moving to your zip code, but don't worry; you just keep on truckin'.

Mistake #4: You give your clients interest-free loans. Do an aged accounts receivables report and look at all the yy�y�y�yy�y�y�"Oh-she's-O.K.-she-can send-in-a-check-later" people on that list.

Why should they pay you before they pay their credit card debt? That's 22 percent interest and at most, you only have a $5 billing and service fee. (Increase to $6.80 now!)

Mistake #5: Hiring an associate instead of an experienced office manager and an extra technician.

The same veterinarians who think the word "restraint" means five bodies piling on the patient to get a radiograph (they never heard the other word "sedation") thinks that delegation is a group sent to China on a fact-finding (read sightseeing) tour. Veterinarians should be handcuffed before they are allowed to do anything that does not require a license to perform.

Most of the management they do-four to eight hours a week-could be done by another staff member. Most of the strategic planning they don't do could be done by another staff member. As for the associate, give me two more good technicians and I'll get as many patients seen and treated well as most practices that only hire associates to get more time off for themselves. (Controversial yy�y�y�yy�y�y� you bet! But the grist for another month.)

Mistakes #6, 7, and 8 are major staff errors; hiring without testing, hiring and not training and having no method of measuring employee performance.

Hiring without testing. You aren't going to hire that nice receptionist applicant before finding out if she can spell, are you? Just ask her to hand write out one experience that was interesting from her last two positions. Then ask her what percentage your revenues are up if you took in $37,456 this month compared to $35,111 the same month last year.

Tell her you want to increase the fees for five services (give her the services and current fees) by 4.2 percent. What will the new fees be?

Who is going to train your staff after they've signed on? Your other receptionist? All she is going to be able to pass on in the few minutes that can be spared while she is doing the rest of her short-handed duties is a quick and sketchy review of the 80 percent or less that she understood from the employee who originally trained her. Why not call the training companies? AVLS (800-444-3634) can provide a program on CD called Staff Training Step by Step, as well as videos on Exam Room Tech Training and a dozen others. ACT (800-357-3182) can provide video training for kennel staff, dental prophylaxis as well as many others. There are many other sources. See the ads in this publication.

Don't believe you are training if you don't have tools to help.

And then there is the mistake of having no way to gauge employee performance. Do you give raises just because 12 months have elapsed? Shame, shame! You need a game plan for measuring staff performance against job specifications and performance. Make it clear to your staff that increases in compensation from this day forward will always be tied to performance. You can find performance evaluation forms on my Web site,

These are only eight of the many, many mistakes we see when consulting in practices; mistakes that cause more terror and havoc than a Steven King novel, but it is our hope that for many readers, four warned is four armed or four legged ? heck! You figure it out!

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