True confession of a consultant


The time has come for a consultant to come clean.

The time has come for a consultant to come clean.

But first let us talk about some other industries.

Consider the movie business: After a 20-minute wait in the concessions line at a local movie house, we finally gave up and went in to see the film without buying anything. It's well known that virtually all theater profits come from concessions, so it doesn't take a consultant to point out that movie houses would sell a whole lot more popcorn and colas by keeping lines to less than five minutes. That is common sense.

In road construction, engineers create beautiful designs, but if one were to ask them how to raise or lower a manhole cover so it doesn't become a traffic obstacle, many of them would have no idea how to accomplish it. For that, one must turn to the on-the-job foreman, who has street smarts.

In the banking business, underwriters can look at all kinds of numbers to pass judgment on a requested business loan. They will say what can be accomplished with a business plan, but if one were to ask them how to go about running a new enterprise day-to-day, they wouldn't have a clue. Again, one needs the front-line, experienced entrepreneur to get the details – the one with street smarts.

In the fast-food industry, one can go through all the gyrations to get a franchise financed, built and opened. But if one were to ask a Burger X "consultant" how to go about making it profitable, smooth-running and a fun place to work, they would have no idea. One would need to hang out with a successful franchisee to understand what success "energy" means – someone with street smarts.

In former times, trades, skills and careers were learned through a mentoring system; today, apprentice positions mostly have gone by the wayside. Still, a good farrier will have learned from a skilled farrier, and a new surgeon still learns from a master.

So it is that, even today, we need teachers, advocates and mentors. That relates to the role of veterinary-practice consultants.

The inspiration for this column is the recent discussions in Web-page threads on AVMA's Network of Animal Health (NOAH). Some there expressed a "certain disappointment" with practice consultants.

The criticism likely is based on the sound rationale that the root of the issue is misplaced expectations of the consultant, and a mismatch with those seeking his/her services.

Three issues have converged to challenge practices:

  • Diversification of workplace staff.

  • Diversification of business niches.

  • Diversification in the balance in life and work.

Why seek a consultant?

Any help we can get to mitigate these stressors and make lemonade is a blessing but, as it is, a magic pill (through consultation) is not available.

There are three types who seek management-consulting services:

  • Those who really want to change and will do so.

  • Those who wish to change but will not.

  • Those who just want the ego gratification of, "Yes, you are doing a nice job, doctor."

The usual trigger for hiring a consultant is too much stress within a practice's current business template.

Perhaps a new business model is needed. Practices stop growing from within, so it is realistic to believe some outgrow their roots and need internal change.

Some clinicians tend to focus on clinical issues so much that the personnel and business sides of practice management go into the tank.

A common reason for consultants to be summoned is the need for infrastructure adjustment within a practice. Every practice has unique and distinct needs. They don't fit a cookie-cutter pattern.

We do know that McVeterinarians exist and have their niche, but they fail to meet the needs of most pet and practice owners.

Three types of consultants

Comprehensive consultants know the industry inside and out.

Segmental consultants have a pretty good grip on certain specific aspects of the industry.

Want-to-be consultants have a limited viewpoint.

A comprehensive consultant is likely to be a "been-there-done-that" individual. The resume will have it all. Enough said.

The segmental consultant is likely to have a particularly strong background in a specific area. The most obvious segmental consultant is the certified public accountant, the one who can get the general ledger in order, the chart of accounts in order and offer templates for the monthly, quarterly and annual business templates for budget and expense targets.

The want-to-be consultants must have excellent listening skills and be problem solvers in order to provide good solutions for practice problems.

When we match the three types of consultants with the three types of veterinarians seeking consulting services, it is easy to see that mismatches can occur. Therein lies the source of the failure of expectations.

In which group does each of us belong? Answering that takes some soul searching.

3 basic needs of veterinarians

  • One wants to improve cash flow.

  • One wants a balance of life with work, or a work-pattern change.

  • One wants to reinvent himself or herself, the practice, or both.

Cash-flow needs and issues are pretty simple: Just do it.

But when one wants to merge all of the above, things get tricky.

Criticism of a consultant's advice, and the outcome from following it, usually comes from one of the following:

  • Those who got the right information, but failed to act with discipline and commitment.

  • Those who got the wrong (or right) information and failed to act.

  • Those who have false expectations – enough said.

What, then, is a practitioner to do?

Forget the instant fix

Instant fixes work nicely with rice and potatoes, and fee increases. But when it comes to workplace issues, be prepared to do an internal investigation, question yourself and take pause: Change likely is needed.

A magical solution will come only from within and with effort. No single person can help another until all parties are listening and committed.

Set a realistic timetable. When one drops in new ideas, new templates and an updated business plan, even a three-year timeline is pretty optimistic.

Rejoice with each baby step. A little victory here and there, coupled with a long-term goal and vision, provide positive reinforcement on the journey.

In each practice and with each business model, those on the front line know what really is happening in a practice. Start the troubleshooting with a focus group of staff and one with clients.

Review our column, "Secrets of success," in last month's DVM newsmagazine, and begin problem-solving with assessments from the front lines.

Then, make a list of the 10 things you dream about having, doing or achieving. Set out to get there.

Make a list of the 10 things that frustrate you daily and weekly. Set out to eliminate them.

Set up a network of colleagues, friends and other professionals to help you address your issues.

After all that, if you still believe you need to hire a consultant, make sure that individual's skills match your needs.

The single greatest frustration for me has been the failure of a practice and consultant to set up a three-year set of goals. An annual schedule of visits, telephone conferences and "homework" is central to "getting there."

But now, the bad news:

When hiring a consultant, remember it is buyer beware.

Dr. Riegger, dipl. ABVP, is the chief medical officer at Northwest Animal Clinic Hospital and Specialty Practice. Contact him by telephone or fax (505) 898-0407,, or Find him on AVMA's NOAH as the practice management moderator. Order his books "Management for Results" and "More Management for Results" by calling (505) 898-1491.

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