From veterinarian to betterinarian: How I improved my production
Jeremy Keen, DVM
Paying your bills and chipping away at your student loans as a veterinary associate? These strategies can help you build your incomeand practice top-notch medicine.
Shutterstock.comBeing an associate veterinarian can be stressful at times, especially if you're a recent graduate. You may think you're not efficient enough, you spend too much time on surgeries, you don't communicate well enough with clients-and on and on. Plus, practicing veterinary medicine on your own for the first time is downright scary. “Please don't let me kill this patient” has become your mantra-am I right?
As if all this weren't enough, you're also concerned about paying off school loans. You need enough money not only to survive but to chip away at that mountain. What you need to do is increase your gross production and therefore your income. I'm here to tell you it can be done-and the good news is that it's as simple as practicing great medicine. Here are a few ways I've increased my gross production. They'll work for you too.
An ear cytology should be performed on every patient that's shaking its head, has red and inflamed ears, or just has a lot of dirt in its ears. This test is simple to perform and requires just a few minutes. It tells you if you're dealing with a yeast or bacterial infection and also guides you to the best treatment.
The average price for an ear cytology is $18, and ear problems are rampant in veterinary medicine. So if you see just five ear cases per day and perform five ear cytologies, this creates $20,700 in gross production if you're working 4.5 days per week. Ear cytologies help us practice good medicine and at the same time build income both for practitioner and practice.
A fecal exam is in order for every newly acquired pet and then annually as a good preventive measure. Vomiting, diarrhea and weight loss also signal the need for a fecal exam. It requires only a few minutes and supplies a large amount of information about the pet's gastrointestinal health. If you diagnose intestinal parasitism, the fecal examination will point you to the best deworming agent.
On average, I see 15 cases per day in which I perform a fecal exam, and the cost for this test is $16. This creates $55,200 in gross production for a 4.5-day workweek. It's much more satisfying to explain to a client exactly what we're treating (intestinal parasites, bacteria, etc.) after performing a fecal exam than just placing the patient on an antibiotic and hoping for the best. It's money well spent and clients respect us much more if we can give them a diagnosis.
Annual wellness bloodwork
We should be performing annual wellness bloodwork in all of our middle-aged to geriatric patients and recommending it for all patients. It's so much easier to diagnose a chronic condition such as liver or kidney disease if we closely monitor the numbers and initiate treatment at the ideal time. Clients love us when we diagnose their pet's condition before it's too late to do anything about. Also, if we perform bloodwork at a young age we obtain a good baseline to compare to in the future.
I see an average of five senior pets per day and the wellness bloodwork costs $75. By doing this every workday, once again assuming a 4.5-day workweek, you'll create $87,750 in gross production for the year. Annual wellness bloodwork is a great practice builder, very good income producer and, once again, great medicine.
Chronic medication bloodwork
Any patient that's on a long-term medication such as an NSAID, corticosteroid, immunotherapy or seizure medication should have bloodwork performed every six to 12 months.
Supplements designed to support patient health-glucosamine-chondroitin sulfate, omega-3 fatty acids, SAMe, silybin and many others-are a great option in practice today. There's some controversy over how well they work, but I personally am a great believer in these products and think they have the potential to increase the health and longevity of our furry friends. I find that when I present research findings for these supplements to my clients, coupled with my own experience with long-term results, they're very appreciative.
My clinic sells glucosamine-chondroitin by the bottle. A bottle lasts five months for most patients and we sell it for $61 per bottle. I recommend this supplement for all of my patients, but especially for large-breed dogs, small-breed dogs with orthopedic abnormalities, and middle-aged cats that hide their arthritic pains so well. I don't have an exact number of patients for you, but if you have 1,000 patients on this supplement daily, you'll be selling each one 2.5 bottles per year at $61 per bottle. This creates $152,500 in gross production for the year.
Having said this, I don't recommend marking up supplements very much since they're a long-term product and not a medication. My clinic routinely increases the client cost by 30 percent over clinic cost.
Weight loss plans
If you're like me, 60 to 70 percent of the patients you see are either overweight or obese. This is becoming a huge (no pun intended) trend and it doesn't seem to be slowing down. So I've begun formulating personal weight loss plans for my overweight patients. I discuss the pet's current weight, its ideal weight, and the number of daily calories to feed in order to obtain the ideal weight. I break the plan down on a monthly basis and set weight loss goals for each month. I have the clients bring the pet in every month for a weight check.
Handouts are your friend
One of the most important things a veterinarian or staff member can do is hand a pet owner an educational handout. These handouts can be downloaded from dvm360.com (check out this list of nutrition and weight loss handouts), created by your practice or sourced from your veterinary software provider. They offer owners the key information they need to remember without forcing them to commit everything you're saying to memory instantly. They also help save you time and remain efficient in the exam room.
During the initial visit I discuss the pet's body condition score. I ask the client how he or she feels about the pet's weight (underweight, ideal, overweight, or obese), and then give my professional opinion. This is the best way to spark the conversation before diving into the details of the plan itself. It's wonderful to see the smiles on clients' faces when their pet comes in wagging its tail, at its ideal weight and happy as can be. I have found weight loss to be a great practice niche for me and an excellent production driver. If I take that extra step to formulate a plan, my clients tend to become clients for life.
Client communication will make or break a practice-or a veterinarian. If you're not a good communicator, you'll never be seen as a good veterinarian in your clients' eyes, no matter your skill level. This especially applies to surgery patients.
On a routine day, most of us perform a number of surgeries that we consider routine. However, no surgery is routine to our clients-they're on pins and needles waiting for the results. Want to build your clientele as a young veterinarian? Call the client after every surgical procedure. Take a few minutes to put pet owners at ease and let them know that all went well before, during and after the procedure. This signals that you're concerned about the pet's well-being and safety-and the owner's peace of mind.
On a similar note, hospitalization and drop-off appointments may be routine for us, but again, they're not routine for our clients. We need to update clients on their pet's status at least once or twice daily. The easiest way to remember this is to treat every patient as if it were our own. A simple phone call takes just a few minutes for us, but it means the world to our clients.
These tips will help any veterinarian increase his or her gross production (the numbers speak for themselves) and build loyal clientele. If you just remember that practicing great medicine and possessing good communication skills equals healthy income production, you'll be successful.
Dr. Jeremy Keen is an associate veterinarian at Desoto County Animal Clinic and Precious Paws Animal Hospital, both in Southaven, Mississippi, and a frequent speaker at the CVC veterinary conferences.