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Taking a Strategic View of Practice Success

Posted By Christinee Shupie, Thursday, September 21, 2017

Growing a business is a lot like treating a patient: A proper diagnosis and a treatment plan can have a positive impact on the patient’s health and well-being. For veterinary practices, the strategic plan can help to diagnose the state of the practice and identify goals and objectives that will ensure future success.


To determine whether practices rely on strategic planning, the Veterinary Hospital Managers Association (VHMA) released a survey that was completed by 170 veterinary professionals.


The majority of respondents (67%), report that their practice relies on a strategic plan and 32% do not. Respondents whose practices have not adopted strategic plans speculate that it is because supervisors lack interest or follow through in planning activities (50%), owners do not support strategic planning (46%), time constraints make planning difficult (34%) and leadership lacks the skills and/or resources to spearhead the planning process (24%).


Of the practices in which a strategic plan is used, 73% of respondents describe the plan as informal, while 27% report that the plan is a formal document.


When creating a strategic plan, identifying strengths, weaknesses, opportunities, and threats (SWOT) is an important exercise to develop the strategies that can help a practice improve and grow. The SWOT analysis helps to create the roadmap for success. It is not surprising that 60% of respondents with formal strategic plans have been involved in a SWOT analysis planning session. Sixty percent of respondents whose plans are characterized as informal have participated in a practice-led SWOT planning session.


All respondents with formal strategic plans say that the plan is documented or written compared to 30% of those with informal plans.


Based on the overall results, the practice owner and manager (45%) and leadership team (41%) are the staff members most often involved with developing the strategic plan. When the responses of respondents with formal plans are analyzed, the results reveal that all staff members (37%) participate in creating the plan. Among this subset, practice owner and manager (35%) and leadership team (30%) are also involved in the planning process.


Once the planning document is created, 60% of all respondents share it with the entire staff.


Forty-two percent of respondents report that the strategic plan is designed to cover a combination of time periods, including: short-term (2 years or less); mid-term (2-5 years); and long-term (5 plus years). Twenty-six percent indicate that their plan focuses on the mid-term, 25% say the plan emphasizes the short term and 6% have adopted long-term plans.


The issues that are addressed in the plans tend to be the same across the board and include facility growth (85%), staffing (78%), equipment and/or technology (75%), and product and service pricing (70%).


A critical step in any planning process is monitoring and evaluating progress toward goals. By neglecting this step, the document is relegated to a back shelf to gather dust. How frequently the plan is evaluated is often tied to the rate of change within the organization. Among respondents, 41% evaluate and monitor the plan annually and 39% schedule quarterly reviews. A much smaller percentage monitor monthly (17%) or weekly (4%).


Strategic planning, whether formal or informal, is not a one-time event. It is an ongoing process that must be evaluated and adjusted if an organization is committed to effectively confronting and adapting to future challenges.







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Presenting Finance Options is Not Standard Practice

Posted By Christinee Shupie, Thursday, August 31, 2017

In collaboration with our Platinum Business Alliance Partners CareCredit, Henry Schein/Vetstreet and Nationwide VHMA created a survey to elicit information from veterinary staff about the strategies, issues and challenges of helping clients pay for pet healthcare, communication and practice challenges. The results of the survey---completed by 216 respondents ---are presented below.


Discussing fees with pet owners can be uncomfortable and frustrating for veterinary team members. The conversation is even more difficult when it is clear that the client cannot afford the recommended treatment. In these situations, sharing information about financing alternatives and insurance options may increase the likelihood that the patients receives appropriate care.


Starting the conversation


According to the majority of respondents, the staff members most likely to discuss fees with clients are receptionists (87%) and veterinary technicians (78%).

The staff members least likely to engage in fee discussions with clients are veterinarians (52%) and other staff (62%). Please note, “other” does not include veterinarians, receptionists, managers and technicians.


Examining the options


Although the cost of veterinary care can be significant, discussing financing options with clients does not appear to be standard procedure in the practices surveyed. A scant nine percent indicate that options are included with the treatment plan. According to 67%, payment options are most often discussed only when the client voices concern about the cost of treatment. Nineteen percent defer talking about financing entirely until the client specifically inquiries about it.


Respondents (57%) prefer that when clients apply for financing they complete the application at home. Twenty-eight percent, however, would rather that clients apply in the office with the assistance of staff person.  A small number (14%) favor asking the client to complete the application on their own in the office.


Assisting the conversation


When payment options such as CareCredit are presented to clients, respondents indicate that conversations about these products can be improved with resources that clearly explain financing to clients (49%), scripts for staff that outline how CareCredit works (45%), a payment calculator (44%) that can be used to show clients their monthly payments and scripts that guide staff in discussing payment and costs in general with clients (42%). Fifteen percent believe that it would be beneficial for CareCredit to meet with and train veterinary staff.

Practices that offer CareCredit report that the most challenging aspect of promoting the credit card is informing clients that credit has been declined (75%). Other problematic areas include: discussing payment options (27%), answering client questions about CareCredit (24%), processing a CareCredit application (20%), getting help when needed (17%) and training staff to use CareCredit (15%).


Understanding the options


In the month prior to completing the survey, 70% of respondents report having first-hand knowledge of at least one staff member recommending an insurance plan to a client. The health insurance or finance companies most often mentioned are: Trupanion (61%), CareCredit (53%), Nationwide (44%), Embrace (21%), Pet Plan (18%) and ASPCA (15%). A small percentage identified a smattering of additional plans, which include 24PetWatch, Figo, Pet First and Healthy Paws.


When asked to list resources that might better equip staff  to knowledgably recommend pet insurance, the open-ended questioned yielded 66 responses that sorted into the following categories: approximately 30% report that a comparison chart with unbiased evaluations of an array of plans would provide consumers with information necessary to make good decisions; 10% requested training videos and webinars that staff could view to learn about the plans at their convenience; and several respondents requested lunch and learns and/or informational meetings with plan representatives.


Attracting clients


In response to the statement, “I believe that a pet insurance plan that includes wellness is important to a pet’s optimal health,” 40% of respondents agreed and 33% strongly agreed. Only 4% disagreed and 15% had no opinion. Forty-seven percent report that 50% or fewer of the visits to the practice are wellness visits and 43% said that more that 50% of visit are wellness visits.


Communicating effectively plays a significant role in attracting and retaining clients. The top three methods of communicating with clients are reminders sent via email (60%), reminders that are texted (45%) and assessing services and performance through client satisfaction surveys (31%). Respondents are least like to rely on phone reminders (6%) and email newsletters (4%) to keep in touch with clients.


The most important attribute of a Communication Solutions Strategy, as identified by respondents, is to improve client compliance, identified as very or most important by 71% of respondents. Forty-three percent indicated that the strategy is important to grow revenue. Fifty-six percent said that a less important aspect of communication is attract new clients and 50% felt that it was not as important to use communication to educate clients about the importance of preventive care (56%).


Responding to challenges in the practice


The quality of the staff often dictates the success of a practice. Recruiting and hiring staff is one of the greatest challenges respondents face (57%). Related to the importance of staff is the challenge of offering effective staff training and development (50%). Other areas that test practice administrators include: identifying lost revenue and capturing missing charges (43%), providing client education and ensuring compliance (40%) and increasing patient visits (40%).


Respondents do not seem to struggle as much with implementing new technology (12%), managing the practice’s reputation (11%) and complying with laws and regulations (11%).


Respondents are tuned in to what their clients are saying about the practice and most practices (94%) monitor online reviews.


An open ended question pertaining to Client Communication Solutions allowed respondent s to suggest enhancements and improvements. Those most often mentioned include:  lower cost, better integration with PMS, more opportunities for clients to communicate with the practice, improved customer support and the ability to schedule appointments online.







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The Meeting Will Come to Order!

Posted By Christinee Shupie, Wednesday, June 28, 2017

Staff meetings…supervisors may see them as vital to the success of the practice and employees may view them as time wasters. Regardless of whether you love them, hate them or are blasé about them, they are standard fixtures in many veterinary practices.


VHMA surveyed 332 hospital administrators, practice managers, office managers, veterinarians and technicians and 91% are affiliated with a practice that holds staff meetings at regularly scheduled intervals. Fifteen percent report that meetings are held weekly, although 12% meet biweekly. A small number of respondents define “regular” as daily, quarterly or annually.


Approximately half of the respondents hold “all staff” meetings as well as meetings that are organized by position or department. Only a few offices schedule department only meetings (2%) or position only meetings (5%).


How critical is staff meeting attendance? It is so important that 57% said that even employees who are not scheduled to be in the office the day of the meeting are required to attend. Eleven percent report that, while the practice expects all employees to attend, those not scheduled to work are allowed to participate by phone. Thirty-three percent say that administrators do not expect employees who are not working the day of a staff meeting to participate. Those employees are later briefed on meeting discussions. Eighty-six percent of the practices surveyed distribute notes and minutes after the meeting. Fourteen percent post notes to the practice’s message board.


In the majority of cases (57%), an agenda is not circulated to staff prior to the meeting. Seventy percent designate someone to take notes, which are shared with staff.


The most common agenda topics are: customer service (96%), client communication and education (92%), medical protocols (92%), staff training (88%), products and services (84%) and management and leadership topics (70%). At the other end of the spectrum are topics that do not seem to receive much attention at these meetings, including: industry trends (36%), interesting cases (27%) and discipline issues (27%).


Meetings tend to run 31-60 minutes (40%) and 61-90 minutes (36%). Four percent report that staff meetings last less than 30 minutes and 19% attend meetings that are in excess of 90 minutes!


To ensure staff meetings are productive, 59% close the office while the meeting is in progress. Eight percent will close the office on occasion and 33% do not close the office for a meeting…ever!


According to respondents, the one strategy that influences how productive the meeting is, is having an agenda (57%). Other strategies for success identified by respondents are: required participation (18%), assigned duties/tasks (9%), short, time-limited meetings (9%) and required attendance (8%). Several respondents serve food and have introduced fun activities to make meetings more palatable.


Holding regularly scheduled staff meetings can enhance communication among employees. For these meetings to be effective, there should be an agenda and follow-up with employees who did not attend to ensure they are aware of issues discussed. And never underestimate the power of some tasty snacks and few fun activities!



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Information Integration in the Practice

Posted By Christinee Shupie, Tuesday, May 30, 2017

Is your practice data trapped within multiple silos? Silos are created when information is maintained in distinct systems and is not automatically shared or communicated from system to system. Silos can hamper operations because the flow of information is inhibited, resulting in redundancy of data entry, lost information and breakdowns in communication.


VHMA took a look at how practices share critical information in the practice in its April Insider’s Insight survey.  With 299 individuals responding, the results reveal that the survey population is more likely to be information integrators than separatists.


Most respondents (80 percent) have integrated their practice management software with in-house laboratory equipment. Nine percent reported that the practice has not integrated these systems. Of the nine percent, 34 percent explained that current software does not allow integration. Fifteen percent said that laboratory equipment does not support it and 11 percent do not know why.


Respondents believe that integration of software and laboratory equipment is either important or very important (95 percent). A small percentage said it is not very important (three percent) or not at all important (two percent).


In response to a question about whether practice management software is integrated with reference lab equipment, 83 percent said that it is. Fifteen percent report no integration. The top reasons for not integrating the two is due to software that does not support integration (45 percent), 21 percent have not integrated for security reasons and 12 percent said that they did not know integration is possible. Seventy-seven percent of respondent felt it was very important to integrate project management software with the reference lab.


When asked to describe how integration between software and labs impacts customer service, the answers most commonly provided are that integration saves times, provides quick results to clients and allows staff to spend time on other tasks. Some respondents focused on the ease of getting information to clients because all records are readily accessible. Respondents also reported that it improved efficiency in the practice and allowed the practice to streamline operations creating a better client experience. Others noted that integration decreased human error and eliminated the potential for missed charges. A small number believed that there are no advantages to integration.


When asked to comment on the overall advantages of integration, respondents listed responses similar to those identified in the previous question.


Responding to a question about integration with reference labs and the impact on quality of care, respondents highlighted the timeliness of the information and improved accuracy of information, which ultimately results in better patient care. Another common response was that integration allowed professionals to identify and track trends in patient records.


If you want to eliminate data silos, it is highly recommended that order diagnostics from within your practice management software. By doing this your test requests and results will flow back and forth automatically. Talk with your in-house and reference laboratory companies to understand the latest integrations available based on your current software version. Many of these software integrations can be installed by diagnostic field technicians who can set them up for you at no charge.


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Is Data Driving Your Practice?

Posted By Christinee Shupie, Thursday, April 27, 2017

Veterinary managers interested in improving the practice’s bottom line have put data in the driver’s seat. Data can provide a wealth of information about new clients, client opinions, return visits and more. All of this information can be used to run a practice more effectively.


VHMA’s March 2017 Insider’s Insight survey focused on tracking clients and data collection---specifically, how information is collected and the ways in which practices are using the information. The survey was completed by 227 respondents.


To track or not to track


There are many reasons to track clients, including: to determine whether marketing efforts are working, to gauge client loyalty and to receive feedback. Among survey respondents, the majority are most likely to capture information about new clients at monthly intervals.

Approximately 49 percent of the respondents keep tabs on deceased patients and 51 percent do not track or collect this information. Fifty-seven percent also do not follow reactivated patients, but 65 percent do engage and monitor inactive patients.


Inactive v. former


When asked to define “inactive,” respondents do not agree on a universal definition. Forty-one percent say that a patient/client who has not had a transaction with the practice in 18 months is considered inactive. Another 40 percent identify the period of time without contact as 24 months. Write-in responses reveal that 15 percent agree that patients/clients who go without practice contact for 36 months should are considered inactive.


Keeping tabs on patients who have not returned to the practice for preventive care can be time consuming, but 67 percent report that they use some type of practice software to generate reports that makes the task manageable. Once the inactive clients are identified, most practices use phone or email messages to encourage them to schedule a visit. The message, very often, is an appeal to the client about the importance of preventive pet care. Practices also use empathy and concern about the pet’s health to motivate clients to schedule a visit.

Practices also use strategies such as product promotions (32 percent) and discounts (21 percent) to get clients back in the office.


Fifty-nine percent apply subtle pressure on clients to return. They reach out once…possibly twice and then disengage. Thirty-four percent are more persistent and will reach out three or four times. Very few (five percent) exceed five attempts.


Seven percent do not record information about inactive patients or those who have not maintained a preventive care schedule and therefore have not introduced outreach effort to persuade them to return to the practice.

Most practices (73 percent) do not have a formal reengagement program. Of the respondent who have implemented these programs, Demand Force and Vet Success were listed most often.


Of the 48 respondents with a re-engagement program, 40 percent saw a patient return of between one and three percent and 22 percent reported a four to five percent patient return. Respondents speculated that there are three primary reasons that patients do not return: the patient moved out of the area (70 percent), the client has a concern about the cost of care (57 percent) or the pet passed away (43 percent).


To ensure the practice is receiving feedback from clients about the patient experience, half of the respondents survey clients after every visit and 21 percent survey clients about select topics. Sixteen percent never survey.


Data collection and analysis can yield essential information that can have an impact on a practice’s success.

However, for the information to be effective, it should be the catalyst for outlining strategies, taking action and changing the status quo.



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