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Crunching the Numbers

Posted By Christine Shupe, Monday, February 27, 2017

When you own a veterinary practice, handling the practice finances may be the most significant and perhaps the most perplexing responsibility. Ensuring that records are up-to-date and preparing and completing required financial forms are essential, but can the practice afford a full-time bookkeeper? VHMA tackled this issue in a recent Insiders’ Insight survey and respondents were asked about who handled the practice’s bookkeeping and accounting. The survey was completed by 404 practice managers.


The bookkeeper is in the house (or not)!


Managers responded to the age-old question: Is the practice’s bookkeeper and “innie” or an “outie.” Overwhelmingly (77%), respondents reported that bookkeeping is handled in-house. However, of those respondents, fewer than half (42%), said the bookkeeper had been formally trained!


Most practices use the services of an accountant to supplement the work of the bookkeeper. The frequency of accountant interactions ranged from “as needed” to weekly. Thirty-three percent reported that the practice uses accounting services monthly. A mere 2% reported that the practice NEVER uses accounting services.


That thing that you do


So, why do practices hire accountants? Sixteen percent said that the accountant is hired to handle taxes only. It is more common for accountants to provide a range of services, the most popular being review, followed by tax preparation, financial consultation and audits.


Respondents were asked to indicate whether the practice use the industry standard Chart of Accounts. Sixty-four percent reported that they do and 23% do not. Of those using the COA, 55% report it is sourced with the AAHA and 12% describe the source as modified AAHA. Other sourcing responses include: my accountant (34%), Quickbooks (16%) and previous owner (3%).


Effectively handling financial aspects of a practice is best left to qualified professionals who operate under a system of checks and balances. Although bookkeepers do not require degrees or licenses, the more training and credentials one has, the better for the practice. A properly trained bookkeeper and a relationship with an accountant will go a long way to enhance a practice’s financial standing.


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Client Loyalty: Are You Feeling Their Love?

Posted By Christine Shupe, Monday, January 30, 2017

Here’s something to consider: Some experts maintain that it costs between four and ten times more to acquire a new customer than it does to keep an existing one. Some suggest that it costs 30 times more to attract a new client than it does to retain an existing one.


And, while experts may not agree on the costs of attracting new clients, they agree that nurturing client loyalty makes good business sense.


In that spirit, VHMA asked survey respondents about their strategy for nurturing client loyalty.  Do they ramp up the bells and whistles or is it simply enough to offer courteous, respectful and quality care?


The survey, which was completed by 107 veterinary professionals, did not define client loyalty, but rather, asked respondents to describe how their clients demonstrate loyalty.  Approximately half of the respondents described loyal clients as those who comply with the recommendations and treatment proposed by staff.


Approximately 25 percent believe that clients who refer friends and family to the practice are demonstrating loyalty. Respondents also consider clients who are “brand loyal” and use a practice’s services exclusively to be loyal.


More than 50 percent of respondents stated that between 51 and 75 percent of their clients are loyal.


Asked to isolate the attributes most likely to influence a client’s loyalty to a practice, respondents identified trust in the veterinarian and clinic staff (33 percent), caring and attentive customer service (24 percent) and having established a personal connection with a staff member (21 percent).


How do practices know how many clients are leaving and how many remain loyal? Slightly more than 50 percent track attrition. Forty-four percent do not and five percent do not know.


Of those practices tracking attrition, 34 percent track monthly, 28 percent do it quarterly and 21 percent annually. Less than 50 percent of practices tracking attrition contact clients who do not return.


Respondents did speculate about the reason clients do not return and 38 percent attributed it to the cost of care. Others cited disappointing customer service (19 percent), inconvenient location (15 percent) and a small number blamed hours, trust, quality of care, wait time for appointments and continuity of care.


Client loyalty can make or break a business. Getting clients in the door is a first step but long term success is dependent on return customers. Our survey respondents value loyalty, but creating loyalty requires effort. Sometimes a client immediately clicks with a practice and returns again and again. It is more difficult to follow-up with those who have not returned and ask them about their experiences with the practice. Practices that track, follow-up and consider client evaluations are more likely to have a strong following.


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2016 dvm360/VHMA Practice Manager of the Year Announced

Posted By Christine Shupe, Friday, December 9, 2016
Updated: Tuesday, November 15, 2016

The VHMA and committed to helping practice managers grow and flourish in their careers---recently announced that Judi Bailey, CVPM, is the 2016 dvm360/VHMA Practice Manager of the Year. The award celebrates practice managers who are the backbone of financially sound, well-led and inspired veterinary hospitals and practices.


The program application process opened in early 2016 and 10 finalists were identified in the spring. Each finalist had expertly incorporated the skills and knowledge that are hallmarks of effective practice management into their toolset and applied them to lead, collaborate, problem solve, innovate and motivate. Given the high level of skill and expertise shown by the finalists, selecting one award recipient was challenging.


Judi, a hospital administrator at Loving Hands Animal Clinic, Alpharetta, Georgia, did an outstanding job of detailing her experience and demonstrated strong leadership, decision-making, team and management skills. She also established her commitment to lifelong learning and a proven ability to adapt to change.


Highlights of Judi’s accomplishments follow.


Leadership and Decision-Making

Shortly after joining Loving Hands as a Practice Manager, Judi recognized the need to convert to a paperless system. The hospital was more than 10,000 square feet and the amount of time needed to hunt down medical records was incredibly inefficient. Years earlier, Judi had successfully helped her emergency practice convert to paperless. Prior to Judi’s arrival at Loving Hands, the owner had tried unsuccessfully to go paperless. Judi did however receive the owner’s approval to move forward.


She began by researching software options and considering cost, training, yearly support fees and the cost to make the shift.  Working through the financial details was not half as challenging as convincing staff of the merits of the new system.


Initially the decision to go paperless launched an onslaught of concerns, questions, fears and hostility. Despite the owners early backing of the project, she waivered when staff expressed concern. Grumbling among staff continued for several weeks and Judi finally scheduled a staff meeting to halt the spread of gossip and allow the team to voice to speak openly about their reservations.


At times Judi questioned her decision to usher in change, but stayed strong and committed to her decision. She communicated with staff and explained the importance of adapting to change and its impact on moving the practice forward. She also outlined her plan and involved the team in developing new protocols.


Her efforts helped to establish a modern, more efficient, much more cost effective means of managing patients. The team saw that Judi was committed to her decision and did not back down when challenged.


Team Motivation and Management


Judi stepped into her position and was leading a team that was unmotivated and in some cases hostile to events that occurred prior to her arrival. The damage was so deep that the team was betting on how long Judi would last. Undeterred, Judi drew on her experience and addressed the issue immediately in a team meeting, as well as individually. Her goal was to listen and help the practice carry out its vision by adhering to the practice’s core values and mission.


She identified expectations for each staff member and introduced an open door policy to voice concerns. She made it clear that she expected employees to adhere to policies and procedures and that she would not tolerate insubordination.


Unfortunately, it was necessary to “liberate" several employees who were causing discontent and disharmony among the team. A candid discussion with the owner about how her actions were negatively affecting the clinic’s culture was necessary, but difficult, and led to an agreement that put Judi in charge of hiring and firing and the owner returned to practicing veterinary medicine. Judi was committed to hiring kind, friendly, motivated and trainable staff whose personalities contributed to a more positive clinic culture.


With Judi managing, the clinic weathered employee turnover and assembled a happy and functional team. In a matter of just a few months, the atmosphere changed for the better. Judi continues to encourage staff, including the doctors and the owner, to strive for excellence and use all of the tools and resources available to become better people and better at their jobs.


Judi is committed to bettering herself both professionally and personally and encourages employees to be the best they can be.


Lifelong Learning


Judi is a long-time member of VHMA, AAHA and SHRM. She earned the CVPM (Certified Veterinary Practice Manager) credential in 2014. She is an advocate of continuing education and, along with her owner, budgets to allow continuing education for the entire clinic team.


She is passionate about sharing her knowledge with others. A decade ago, she founded and served as president of the Georgia Veterinary Managers Association (GAVMA). She submits articles to industry newsletters and is a strong believer in conference education.


Adapting to Change


Change is a constant challenge in Judi’s clinic. Recently, the number of new clients declined due to the opening of two area clinics and Judi strategized to turn the trend around.


To address this issue she outlined two strategies with the reluctant support of the owner. First, she reintroduced the free initial examination for new clients. Second, to ensure high compliance for routine care with existing clients, she introduced the Community Wellness Clinic, a four-hour block in the morning of the slowest revenue day, which entitled clients who purchased a wellness examination to a 50%discount on vaccines.


The promotions were rolled out with email blasts to existing clients, promoted during past due callbacks and announced on reminder cards. Judi also created a protocol and trained doctors and staff on how to make it work. Five weeks after the plan was implemented appointments were completely booked two weeks out, revenues jumped 68 percent on the slowest day of the week, clients were appreciative of the discount and compliance from past-due patients increased by 38 percent.


Judi recommends examining hospital numbers and trends to identify ideas that will not compromise a clinic’s culture, vision and mission, but will entice clients and potential clients.


VHMA’s Executive Director Christine Shupe congratulated Judi on her award and said, “I am super excited that this year’s Practice Manager of the Year Award goes to Judi Bailey, CVPM. As a certified CVPM manager, she helps to raise the standard for management professionals in the industry. As a long-time active VHMA member she is paving the way for the next generation of manager to continue to provide exceptional leadership in practice.”



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Vetting the Vet Tech Shortage

Posted By Christine Shupe, Wednesday, November 30, 2016

Who’s on your veterinary team? Do you have a full roster or are some players or positions more difficult to fill? If you are down a veterinary technician your practice is not alone. TheVHMA’s October 2016 Insiders’ Insight report tackles the issue of hiring and retaining veterinary technicians.


VHMA surveyed 283 managers to discern whether their practices are struggling to fill technician positions. Respondent were also invited to share their perspectives on the shortage and how technician training programs may impact the shortage.


Of the 283 managers who responded to the survey, 41 percent said that the number of available technicians is insufficient to satisfy current demand. The shortage, according to 20 percent, is exacerbated by competition among area hospitals and clinics that are trying to attract qualified candidate.


Roughly 10 percent believe that the practice is challenged because the facility does not pay competitive salaries and three percent report that their practice does not offer competitive benefits.


About 11 percent provide reasons for the shortage that go beyond the responses offered in the survey. The most common explanation is that technician salaries industry-wide are low---too low to maintain an adequate standard of living for those in the field.


For example, Hospital A may be offer a salary that is competitive with salaries paid by Hospitals B, C and D, but that salary is still insufficient to provide the technician with a living wage.


Despite salary concerns, 58 percent report that they successfully retain their technicians.  Only four percent said that turnover in their facility is high.


Training Technicians


Respondents were also asked to comment on the programs that are training the next generation of veterinary technicians. Overall, reviews are mixed.  Sixty –eight percent say that some technicians coming through these programs as well qualified and others are disappointing.


When asked to describe the ideal training program candidate, 48 percent would like technicians in training to have some college or foundational work---an interesting requirement in light of the historically low salaries technicians are paid.


Asked to write-in suggestions for improving these programs, more than 50 percent indicated that more hands-on training is critical. Ten percent advised that these programs should promote a culture of professionalism and several other respondents implied that students lack a strong work ethic.


Improving technician communication skills is also a priority for respondents. Nine percent are seeking employees who are capable of communicating effectively with clients and are willing to interact with people. Several respondents mentioned that technicians seem more interested in animals than enhancing their people skills.


Nine percent suggested that training programs should do a better job of managing student expectations before they enter the workforce. Several respondents are concerned that student salary expectations are not aligned to what the market will pay.


Program Issues


When asked to speculate about the issues veterinary technician programs are facing, 27 percent had no opinion. Twenty-six percent believe that programs struggle with a number of issues, which include: lowered enrollment, expanded regulation and higher cost of living for students. Additional insights were gained from those who summarized their feelings under ‘other’ and 19 respondents explained that the poor ROI made it difficult for schools to attract students, knowing that upon graduation they will be saddled with debt and the prospect of dismal earnings potential. An additional 12 respondents believe that schools are not discerning and do not vet students.


Despite the shortage of technicians, practices are doing their best to attract the most qualified technicians.  Asked about the secret to hiring and retaining qualified technicians, 30 percent report that the clinic’s friendly, supportive atmosphere attracts and retains employees. Others describe the facility as inclusive and respectful---attributes employees find appealing. Twenty-three percent said that by integrating the technician into the team, the clinic is increases employee satisfaction. Competitive salaries were mentioned by 13 percent.


Practices should recognize that there is more to attracting and retaining technicians than salaries and benefits. In a competitive market, often overlooked and just as important, is ensuring that the technician is a valuable member of the team and is given opportunities to grow, advance and contribute to the practice.


Don't miss VHMA's December 8, 2016 educational webinar - Attracting Strong Veterinary Technician Applicants in a Hot job Market. A free webinar.


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Telecommuting: More Than a Remote Possibility

Posted By Christine Shupe, Friday, August 26, 2016

With more than 30 million workers in the U.S. telecommuting daily, telecommuting is an out of office experience that is becoming the norm. Although widely accepted, is it an option that works for all workers? VHMA recently posted a member survey and polled veterinary practice managers about their experiences with telecommuting. The survey elicited responses from 256 managers.


The results suggest that telecommuting---in one form or another---is a viable option for practice managers. Close to half the respondents (42 percent) report that they spend either some or all of their time working remotely. An additional 33 percent expressed interest in telecommuting, although they currently do not telecommute.


But not all managers find working remotely appealing, approximately 25 percent said that they do not telecommute and are not interested in telecommuting in the future.


The majority of telecommuters (48 percent) spend less than 11 percent of their time away from the office. A miniscule percentage (3 percent) work at home more than 80 percent of the time and 36 percent spend between 11 and 30 percent of their time working in a location other than the practice office.


Although telecommuting is somewhat common in the veterinary industry, most practice managers report that their practice has not adopted a formal telecommuting policy: only 13 percent said the practice has a telecommuting policy.


Employer-sanctioned telecommuting is more likely to evolve in response to a worker’s personal situation (44 percent) or in response to a request made by the employee (10 percent). Responses to personal situations such as maternity leave seem to be more long term. Employee requests appear to be more episodic and short term, such as weather-related requests to work at home.


Thirty-three percent cited “other” reasons for telecommuting but these responses can be divided into four categories:

  • To complete assignments due to job demands that exceed the time available to accomplish the task in the office
  • To meet a deadline and complete the task without interruptions
  • To reduce travel time when a practice has multiple locations
  • In response to unanticipated events


When working off-site, 47 percent said that they are not required to record their time. Employees required to track their off-site time, most often use the practice time clock (29 percent).


Silence is golden

What is the primary reason for telecommuting…peace and quiet!


Fifty-six percent report that they can complete their work without being distracted when working remotely and 47 percent enjoy the flexibility that telecommuting affords.


Thirty-one percent detailed their reasons for telecommuting in the open-ended “other” response category and their responses reveled a common theme: telecommuting allows these managers to complete assignments even though conditions may prevent them from travelling to the office. These situations occur when a child is ill, a babysitter is unavailable, the employee is under the weather or the cat is about to give birth to kittens! Only twenty percent telecommuted to save time and commuting expenses.


Doing it all…outside the office


Based on the responses, managers believe that they can perform many of their job responsibilities as effectively off-site as they do in the office. While working remotely, respondents report working on many tasks effectively: 90 percent handle financial administrative tasks, 69 percent address Human Resource administrative tasks, 66 percent conduct marketing management, 55 percent prepare Benchmark reporting, 40 percent perform inventory management and 38 percent complete client administrative tasks. Clearly, manager respondents are capable of working as effectively in a remote location as they do on-site.


Managers were also asked to identify difficulties they encountered in completing assignments while working off-site. Forty-six percent said that they do not struggle to perform any job-related tasks when working outside the office. The tasks most often mentioned as challenging to complete off-site are: inventory management (34 percent), client administrative tasks (28 percent) and Human Resources administrative tasks (20 percent).


Weighing the pros and cons


As with most decisions, it is important to consider the advantages and disadvantages. When asked to weigh the pros and cons of telecommuting, respondents appreciate that they are more productive when working remotely (76 percent) and enjoy the flexibility telecommuting affords (54 percent). The downside of fewer interruptions is that 52 percent miss the regular face-to-face contact with coworkers and others. Moreover, when the home is also the office, 49 percent said it is difficult to separate work and the lines between personal and professional life are blurred.


When choosing sides, 78 percent cast their vote in favor of telecommuting and would recommend it to their colleagues.

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