Design Your Practice With Patients In MindApril 17, 2009 Veterinary practice construction has come a long way, from cold, stainless steel bars and concrete floors to welcoming places of comfort and compassion. Regardless of the species or special focus, veterinarians and staff can work more efficiently and patients can rest more comfortably with some guidance by those with years of experience in the veterinary and design-architecture fields. Specialty practices, from cat-only to equine-only, or procedure-specific clinics such as surgical or emergency practices, share common issues that can be improved in any animal facility, as long as the entire staff and a willing designer are allowed to voice their opinions. The blunt dissection of architecture and veterinary facilities can be separated into designing new or remodeling current (and usually in-use) structures. The difference ends there. A more finite dissection determines the specific needs and uses the future practice will have. Consider Consumers A smart practice owner asks consumers and staff (the staff including the veterinarian as well as the client) what they would like to see in a practice. Often, those in the veterinary field forget that there is another world at the reception desk, or outside the front door. In addition, patient care is …
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Prep Your Staff For Critical CareApril 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. For your staff members, emergency medicine is a fragile blend of critical care and client care. With every case, they must balance the immediate medical needs of the pet with the strong emotional needs of the pet owner. From the location of certain drugs or equipment to the protocols that are followed, it is essential that emergency procedures are consistent, almost second nature, so that your staff can handle the unpredictable character of a distraught client. Assign Roles and Responsibilities "What works best for us is to assign a certain job to each person involved in an emergency," said Allison Gross, DVM, an emergency and surgery clinician at Friendship Hospital for Animals in Washington, D.C. "For example, I try to have one person in charge of intubating and breathing for a patient, one person in charge of getting venous access, one person getting the drugs and fluids we will need, and one person recording everything." Dr. Gross said the team tries to schedule these positions at the beginning of a shift, but often they are assigned on the spot as an emergency comes in. Off-the-cuff …
When Corporate Practice CallsApril 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. When Brian Harpster, VMD, MS, owned a practice, his wife claimed he worked 90 hours a week, though he says it was actually 60 to 70. His West Shore Veterinary Hospital in New Cumberland, Pa., had a staff of 30 and grossed $1.7 million annually. At 51, he wanted to reduce his hours and still practice while eliminating “the headaches and hassles” of management. In a decision he says was “50 percent lifestyle and 50 percent financial,” he and two partners sold the practice to VCA Antech in December 2002. They sold for 11 times the hospital’s original cost in 1984, retaining ownership of the building and land with VCA agreeing to pay for future renovations. Carrying low debt, they could use VCA’s rent payments to defray the mortgage, which will be paid off next January. After the sale, Dr. Harpster’s income was about the same, but his work week dropped to 40 to 45 hours. He now works 3 1⁄2 days a week, 32 to 34 hours, at what is called VCA West Shore Animal Hospital. VCA, based in Los Angeles, operates …
Do You Need A Sabbatical?April 17, 2009 We live in a world that continues to become more demanding and stressful. The expectation is to be more efficient and more organized through the use of electronic support, thereby reducing stress and providing more free time. However, are we really able to reduce our level of stress and free up time through technology alone? The answer is an obvious "No!" Most workers in the United States are now working more hours than they did l0 years ago. The projected reduction in the work week has not occurred even though great advances have been made with the Internet, as well as satellite and cellular communications. Communication media now allow us to be in constant contact with our business, family, colleagues and friends. This technology makes communications much easier and efficient, but does not provide more free time. In fact, most people are experiencing less free time because we cannot really get away from work. We are now becoming a nation that takes working weekends and working vacations rather than real "get-away" vacations. As the pressure of competition continues to push us faster and faster down the road to "being successful," we are becoming more stressed and subject …
Balancing Life, Work Requires 6 Key SkillsApril 17, 2009 Is it possible to have it all? Can you really have a full career in veterinary medicine and have a family and a personal life? Eight female veterinarians discussed this topic at the Southwest Veterinary Symposium in Dallas. They represented public health, private practice, corporate practice, industry, academia, research and extension veterinary medicine. Balance-of-life issues dominated the discussion. Can there ever be a balance between family, career and self? The answer is yes and no. Some days or periods are better than others. Life is a journey that continues to evolve and change, and as a result requires different coping skills at each stage. Participants said the stages appeared to be divided into five post-education areas: job selection and transition into the working world; marriage/family development; career development; career expansion/modification; and career exit strategy. As the panelists discussed their histories and experiences, six common themes or skills emerged as necessary to maintain a semblance of balance: Time management. Asking for and accepting help. Delegation. Prioritizing. Following your heart. Releasing the guilt. These six areas were utilized by most of the panelists at one time or another. The areas were not mentioned in any order, …
Bad Habits Breed Germs, ResistanceApril 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. Reducing the spread of infection is a two-tiered strategy requiring proper hygiene and accurate diagnosis. While every practice needs an infection control plan, experts say management of those protocols is too often lax. “Antibiotic resistance is a big topic and hygiene is a huge issue that needs to be improved on,” says Joshua Daniels, DVM, Ph.D, a clinical microbiologist at Ohio State University. “Proper hand washing and disinfection of surfaces along with other measures can’t be assumed as known and must be discussed.” The U.S. Centers for Disease Control and Prevention and the American Veterinary Medical Assn. periodically survey veterinarians about infection control practices within the clinic. These surveys help authorities better understand practices routinely used by veterinarians. “CDC infection control policies and those made by the National Assn. of State Public Health Veterinarians (NASPHV) detail proper hand-washing procedures, the use of gloves, cleaning and precautions in general,” Dr. Daniels says. “These may seem obvious, but it’s clear that employee education and reminders are necessary.” Click here for NASPHV recommendations. (Click on “What’s New.”) They cover respiratory protection, protective …
What Client Complaints Are Not SayingApril 17, 2009 We have all heard clients complain. Some of the most common complaints concern long waits and unexpected fees. You have probably developed routine responses for these complaints, citing policy and price justification. Yet at times we miss the point completely and send the client away even angrier. The client leaves in a huff while we go to “the back” to vent to our co-workers about the high maintenance client who just left. We hear what the client says, but we often don’t stop to think what the client really means. If we evaluate the emotions behind the gripe, we have a better chance of addressing the problem. Let’s work through some common client complaints and explore how you can rethink your response. How Much Longer? When clients complains about how long they are waiting, is it really the minutes ticking away that causes their frustration? If you ask, you may discover that the wait seems long because of something that isn’t immediately obvious: They are worried about their pet in the back (being admitted or treated); they have a baby who is about to explode because nap time is approaching; they are worried about getting out …
Cutting Costs To Cope With The Economic DownturnApril 17, 2009 During the first half of 2008, we in the U.S. struggled through very difficult economic times. This year started out after a slow Christmas retail season and talk of recession. We’ve recently seen oil rocket to over $140 a barrel and the stock market fall by over 15 percent, both as of this writing. The discussion about “if” the United States is in a recession became a moot point to most Americans. As the price of oil has risen, the cost of everything associated with transportation has also increased--food, automobiles, appliances, raw materials, etc. The effect has been less disposable income to spend on non-essential items such as vacations, restaurants, electronics, etc. As we all know, the companion-animal veterinarian relies on the available disposable income of our clients. Fortunately, many of our clients place the value of their pets above that of most other disposable income items. But how much longer will they do this as more and more of their paychecks go toward food and fuel? Where is the veterinary economy heading in the next year or two? No one knows. If we did know, we all could make brilliant investments and turn …
Offering A Variety Of Payment Options Can Help Clients CopeApril 17, 2009 Follow Veterinary Practice News on Twitter at @vetpetnews. For most veterinarians, health care is a heartfelt calling. But medicine is also a business, and a hospital must make a profit to succeed. Vital to that success, financial experts say, is a periodic assessment of available payment options for clients and incorporating that analysis into your practice management. “Payment is not something that dominates the day-to-day thought processes of many veterinarians because they have so many things going on,” said Howard Rubin, chief executive officer of the National Commission on Veterinary Economic Issues. “It’s easy for them to just assume that it will take care of itself. “We have found that veterinarians need to analyze this part of their business just as they analyze other parts of it.” A common mistake made by practitioners is failing to set payment option standards and policies. “Many times [veterinarians] just wing it,” Rubin said. Equally unwise is extending credit without first obtaining a client’s credit history. The result is a possible default that costs your clinic money. Post-dated checks are another no-no, said Tom A. McFerson, CPA, a partner in the …
What’s Your Diagnosis? Mediastinal AbnormalityApril 17, 2009 Signalment: Eight-year-old male castrated standard poodle History: Two-month history of decreased appetite and weight loss. Questions: 1. What are the primary findings? 2. What do you think is the primary reason for the clinical signs? Radiographic interpretation: A soft tissue mass effect is causing a silhouette sign with the cranial border of the heart. The mass runs in a oblique right-cranial to left-caudal direction, indicating that it is in the ventral mediastinum. The mass is seen better on the right lateral recumbent view due to the aerated lung highlighting the mass (recumbent atelectasis partially silhouettes the mass on the left lateral view). The heart and lungs are normal. The mass in the cranial ventral mediastinum is most consistent with a neoplasm. Thymoma or lymphoma are the most common mediastinal neoplasia. Ultrasound of the cranial mediastinum with guided aspiration is often used to help differentiate these possibilities. Normal anatomy: The mediastinum is the central portion of the pleural space and is composed of the left and right pleural sacs. Mediastinal disease usually …
