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The technician's role in improving practice profitability (Proceedings)

August 1, 2008
Gary I. Glassman, CPA

The veterinary team is a most influential element of practice management ensuring a well run and efficient hospital.

The veterinary team is a most influential element of practice management ensuring a well run and efficient hospital. They can play a significant role in making sure clients receive the best of care and attention. Good teams are lead by those who have developed systems for training and then making sure those systems are working properly.

• An area where veterinary teams need to have developed good systems is with compliance issues. The areas of concern are: 1) Heartworm testing and preventive 2) Dental procedures, 3) Therapeutic diets, 4) Senior screening, 5) Canine & feline core vaccines and 6) Pre-Anesthetic testing.

• With heartworm, the gap between those tested and those taking adequate amounts of medication needs to be filled. Consider use of the reminder system to make sure the proper amounts of medication are dispensed.

• With dental procedures, consider grading teeth during the office visit to gain client compliance. Also use dental report cards.

• Client education should be considered for the improvement of therapeutic diet sales. Appoint a staff member as the hospital's nutritional consultant to provide that client education. Look to the food companies for support.

• Develop a senior screening protocol for the hospital that the staff can promote. An example of a well defined program might include twice a year office visits, blood work, fecal exams, and a chest x ray. Thirty five to forty eight percent of the average hospital pet population is defined as senior creating a huge opportunity for additional service.

• Core vaccines score high with compliance because of the use of the reminder system. Make sure all client records are complete. Make sure the record is complete with the client's address, telephone number, e mail address, animal's name and the animal's weight. You can also run search and sort criteria reports to determine which client records might be incomplete. This should be done yearly in all practices so records can always be up to date and complete.

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• Use the team and facility to enhance practice financial results. Look at hospital hours. How convenient are you for your clients? Do you take early morning drop offs? What time do you start appointment? How many evenings are you open? What are Saturday and Sunday hours? Do you book technician appointments so you can leverage your time with the staff? Technician appointments can be booked for nail trims, SQ fluids, anal gland expressions, blood draws, suture removals and micro chipping.

• How do you book appointments? Ten minute flex schedules tend to work best but require staff training. Appointments can be booked for 10, 20 or 30 minutes depending upon the clients request for the appointment. This flexibility allows you maximum efficiency to book appointments with little wasted time.

• How does your practice delegate job responsibilities? With limited DVM time, leveraging is a great revenue enhancer. A doctor's time is finite and a scarce commodity. Our ability to drive service revenue is a factor of time and efficiency. All practices must find a balance of time and efficiency that is perceived to be fair and equitable to the client. To maximize the efficient use of a doctor's time, delegate and leverage the practice staff. Make staff a resource not a cost. Ask what tasks and activities that are currently performed by the doctor can be delegated to members of the veterinary care support team? All hospitals should invest in continuing education. Today's hospital should budget .6% of gross revenue for continuing education and this should be for all staff and not just for the doctors.

• How should technicians be used in the exam room? The following is an exam room protocol for technicians:

• The receptionist greets the client and takes basic client and patient information.

o Receptionist passes information to technician

o Technician reviews the client record, obtains needed 9information and walks client to the exam room

o Technician performs pre-exam checklist and obtains temperature

o Technician informs doctor of the visit and why patient is here

o Technician stays in the exam room and assists doctor

o Once all treatments and procedures are complete, the technician is released

o Technician does routine lab work and prepares necessary medicine

o Technician re-enters the exam room with lab results and medications for the doctor

o Technician escorts client to reception area

o Technician receives next patient information to begin process again

• Waiting clients need to be informed is their wait time will be more than 5 minutes

• All doctors and assistants should have their own business cards

• Good exam room habits should be developed. Use pet report cards. Also use educational handouts to reinforce recommendations. Develop a list of good reputable web sites where clients can find information. Use newsletters to target market and reinforce recommendations. Repeat recommendations several times to clients. Keep exam rooms neat and clean and develop a uniform policy requiring name badges for all staff.

• How do you deal with hospital inefficiencies? These can be identified as inconsistent charges, healthcare plan vs. estimate, incomplete records, lack of follow up plans, overbooking and inadequate work space.

• In 1999, a Brakke Consulting did a management and behavior study that indicated good business practices and value based pricing can have a dramatic, positive impact on income. What have you done in your practice to ensure good business practices?

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