Switching on to practice profit - Veterinary Practice
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Switching on to practice profit

Veterinary Practice joined delegates at an all-day workshop focused on ‘strategic performance management’

IF the relevance of urban chickens, twitter, practice facebook and England football jerseys for dogs is not clear to anyone involved with small animal veterinary practice, then you will not be alone.

For more than 250 veterinary surgeons and practice managers who attended the series of 13 Practice+ workshops, arranged by Merial and delivered by Onswitch, there were many aspects presented that made them think, question and also laugh.

The gathering of 30-plus people in the last of the series at Exeter was presided over by an enthusiastic team from Onswitch, led by Alison Lambert, with a presentation from Mark Beaney of Hazelwoods accountants.

Paul Jeffries from Merial introduced the seven hours of CPD by use of a Dogs for the Disabled video and announced that donations for the charity from the attendees at all the workshops had reached £20,000. It takes £5,000 to train an assistance dog and there are over 80,000 people in the UK who would benefit from a trained animal to open doors and drawers, fetch shoes and clothes and, as the video showed, put something in a rubbish bin as well as acting as guide and companion.

The group was then introduced to the balanced scorecard, which is used by various businesses to allocate actions and intentions to finance, staffing, clients and operations.

Each delegate received a scribble board and as topics were discussed particular items of relevance to their practice were entered. The idea is that the scorecard should be hung up in the practice office, reviewed, referred to and updated monthly.

In preparation beforehand, delegates had collected information about their practice. In discussion some of the items were easily available and others much more difficult.

Part of the preparation was a photo-journey around the practice. This included car parking, entrance, reception, office, consulting rooms, kennels, pieces of equipment, or whatever seemed relevant.

It was interesting that two vets from the same practice were looking at their pictures of the entrance when they realised that the practice sign actually showed the wrong opening hours! One can imagine the client who ’phones to come in at four because it suits them only to be told that the surgery doesn’t open until five.

The whole topic of responses to clients, particularly new clients, in relation to availability of the practice was highlighted time and again by Alison as one of the weaknesses of the small animal veterinary world.

Clients choose a veterinary practice for vaccination, when the animal is sick and because out-of-hours help is available. In an urban situation the same practice may not match these three needs. Some veterinary practices are open from 8 ’til 8 with routine consults seven days a week at normal rates. The busiest two days are Saturday and Sunday.

If the opening hours are limited, “people think you are closed”, Alison said. Consulting is the “engine” of the practice and the number of hours open multiplied by the number of consulting rooms provides the maximum consulting hours. Measure consulting hours and increase them, she urged.

Pet food sales

It was pointed out that women are key decision makers and pets have to share the overall household spend. A pet owner who is new to pet ownership is likely to obtain information from large retail store outlets. It is a fact that 97% of pet food is bought from non-veterinary outlets but the minimum target should be £1,000 of pet food sold per month per vet, Alison said.

The average is 5% of practice turnover and more time should be spent on veterinary specialist items. Only half of pets are vaccinated or have regular preventive treatments. Love and attention is the requirement, not disease prevention, and this led to a discussion about pet pamperers.

Pet pamperers are 21% of the pet-owning public. Easter eggs were sold for dogs this year. How many vets and nurses buy coats for their dogs? Gifting for dogs at Christmas is a booming business.

It was drawn out from the participants, with some reluctance, that some had coats for their pets. One vet had a pink and a white one. Fleeces, Superman outfits, England jerseys, Father Christmas get-ups and waterproofs were a surprise to many but the typical spend is over £60. Pet ownership is greatest among the less affluent and rescue centres are an important source of new pets. The role of children as a prompt for pet ownership is diminishing and older people are worried about what will happen to their pet if they have to go into a home. Urban chickens are on the up.

Shared plans

Business plans set the goals for the next year, said Mark Beaney. If there is no shared plan then staff will interpret on behalf of the practice. There is more likely to be positive growth from recently established practices, where there are fewer partners, an optimistic attitude and a demonstrated commitment to staff.

The average turnover per veterinary surgeon in practice is £206,000 with 1.4 nurses per vet, and the higher the fees, in relation to drugs, the greater the practice profitability.

Information for clients is best handled in small parcels with nurse consults supporting initial vet consults for new pet owners.

Estimates for the cost of operations allow the client to take informed decisions on cost and a simple templated system allows accurate estimations.

Staff costs are around 40% of sales. Calculated as a percentage of turnover, a veterinary surgeon remuneration package average is 20%. A useful exercise is for the vets in the practice to each diagnose the same condition and cost it up. This approach is a possible activity for partners’ meetings.

Nurses give the second vaccination to new owners at 15% of practices. The nurses are good at it, give a check-up, take temperature, discuss microchipping and insurance and the owners like it because the nurse “puts the love back into the consult”.

Text reminders for vaccinations are used by 6% of practices but the younger generation respond well to texts. A measure of telephone calls to the practice compared to consults per month may not directly relate, but receptionists should aim to convert a call to an appointment. People asking for information about pet ownership should be seen for free and this should be viewed as an investment by the practice.

Practice reputations

Veterinary practices have a reputation among veterinary surgeons, nurses and other staff. The reasons why people join a practice and why they leave should be actively assessed. Reasons for leaving are rarely due to money, Alison said.

A structured induction for a week is advised for all new employees, with observation by nurses of what takes place in the consulting room a must. Younger vets and nurses expect to observe but senior partners tend to resist this opportunity to share practice activity.

New practice clients are a measure of the health of the business and need to be monitored and given the “warm gorgeous”. Twenty per cent of practices achieve 20 new client households per vet per month. Active clients have been seen in the last 15 months and 1,000 active clients per vet is the target. Free advice to new owners should not be given on the ’phone but in the consulting room.

Delegates brought in information from the practice website and a consistency of branding of logos and colour with other literature was considered important. As well as the usual dog and cat information, a section on chickens will attract new clients, who may have other pets. The final pitch was that clients “need to hear that we are caring”.

Individual discussions of confidential practice information also took place and pieces of video of pet owners talking about their aspirations and disappointments with practices emphasised many realities.

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