How a fixer-upper practice might be just what the veterinarian orderedMay 2, 2019It's tough out there for buyers of veterinary practices and it seems to be getting worse. Every year, a few new investors and/or corporate consolidators call me looking to spend way too much money on two-plus doctor practices. So how can you, the young, ambitious associate, compete for one of these? You can't, unless you get lucky enough to find a seller morally opposed to corporate veterinary medicine, or who likes you well enough to give up $500,000 to $1,000,000-plus on the asking price. Thankfully, there's another way. If you're willing to live in a smaller town, you could find a true gem of a clinic with little competition from other buyers. Alternatively, if you start thinking like an investor and look for a poorly performing clinic, you could build it into your dream practice. The marketplace is flooded with underperforming clinics, their owners anxious to find a buyer like you, particularly if they are retiring and want to solidify a succession plan. In this article, I'll focus on what you need to know when buying a fixer-upper with real upside potential. I'll also offer tools on how to spot and fix the most common issues that can drain …
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10 tools every superachiever needsMay 2, 2019Without battle-tested systems, healthy habits, and proven strategies, it's difficult to grow beyond a certain plateau. To get better, superachievers typically use the following 10 tools, at the very least. Let's see how they can apply to our profession. 1) An idea-capturing device You have a brilliant idea. It's so amazing you're certain you'll remember it. After all, it's going to change lives! Five minutes later, you are wracking your brain and retracing your steps to remember it. Ideas often come at the most inconvenient time, which means you should have a way to capture them in real time as they come to you. Keep a small notebook on your nightstand or in your pocket. Surely you can download all kinds of apps, although any smartphone or tablet has a "note" function where you can jot down ideas. What about a waterproof marker in your shower? The idea is to avoid walking around with all kinds of mental clutter. Write things down so you can focus on other stuff. 2) Keep a calendar Many people have multiple calendars: one on the wall, one on their desk, an organizer, and a digital calendar. Some may even have a personal calendar …
Fire employees and hire stakeholdersApril 12, 2019Which one of the following scenarios is more likely to take place at your practice? Scenario 1 John needed to makes copies of the anesthesia log. He placed the document in the copier, pressed the "start" button and… nothing happened. He walked away, cussing at the stupid piece of (junk), and ended up using the last copy of the anesthesia sheet. "Somebody should finally do her job and get us a new copier," he mumbled. Scenario 2 At a different clinic, Joy wanted to make copies of a consent form. She positioned the master copy in the machine, pushed the "copy" button and… nothing happened. She went to the practice manager and reminded her that, according to the repairman, it was time to get a new copier. Two days later, a new copier was installed. The good news: it was on sale. The bad news: it was a terrible choice. Receptionists hated it. Technicians hated it. Doctors hated it. People complained about it for years. But the practice manager felt good about doing her job. Scenario 3 At yet another hospital, Mary had to photocopy the travel sheet. She put the document in the copier, pressed the green button …
Digital cytology: The future of clinical pathologyApril 12, 2019It's Friday afternoon and Mr. Rush is in your practice again with Smoosh, his nine-year-old boxer who has been lethargic for the past month. Last week's blood work revealed mild lymphocytosis, mild non-regenerative anemia, and high-normal calcium. During today's follow-up, you palpate bilaterally enlarged submandibular lymph nodes. Not surprisingly, Mr. Rush is short of time and patience. You collect lymph node aspirates, tell him you'd like to take a look under the microscope, and return to the treatment area to stain the slides. Looking through the scope, you see the cells are relatively homogeneous. Most of the lymphocytes appear smaller than normal and are darkly stained; however, a fair amount of plasma cells and neutrophils are present. The blood work, breed, and lethargy are worrisome for lymphoma, but Smoosh is getting older and he is long overdue for a dental. Should you push for flow cytometry or a lymph node biopsy? Or are you overreacting, just like the lymph nodes? The cytology doesn't seem normal, but it's a tough call. It looks as though you have two choices: one, push for a bigger workup, or two, send the slides to a pathologist. You wonder what Mr. Rush will say when …
Must you pay your staff for being on call?March 19, 2019Suppose you operate a 24-hour emergency hospital. In this tight labor market for veterinary technicians, you are faced with a staffing shortage for the night and overnight shifts. It occurs to you that requiring existing technicians to be on call from time to time may be a way to help solve the staffing dilemma. But how would this affect your budget? More specifically, would you be required to pay your staff for being on-call even if they are not actually called in to work? What is considered compensable? Well, that depends. Under the federal Fair Labor Standards Act (FLSA), employees in on-call status must be paid if they are "engaged to wait," but not if they are "waiting to be engaged." Hmmm. How does this obtuse rule of thumb work in the real world? The key is whether the on-call time is predominantly for the practice's benefit. The more the employee is under the practice's control, the more likely it is the on-call period will be viewed as benefiting the practice and, in turn, as being compensable. Requiring technicians to remain on the premises during their on-call time will almost certainly render this time "hours worked" under FLSA. In …
Seven secrets for spring cleaning your practice and your lifeMarch 14, 2019Whether out of fear of missing out (aka loss aversion), getting in trouble, or that it might be useful someday, we accumulate an extravagant amount of stuff, both physical and virtual. We've all read articles about the importance of spring cleaning and how to declutter your life. Unfortunately, most articles usually focus on physical objects, rather than the multiple facets that make up your every day. Imagine how much better you would feel knowing you are free of all types of clutter, well beyond your secret junk drawer. We are going to help you do just. All you have to do is commit the desire and the time to do it. 1) Spring cleaning in your personal life Spring is a perfect opportunity to rid your life of toxic relationships (or any relationship) that infects it with negativity and bad influence. How much better would you feel if you got rid of them? In some cases, you may not be able to cut the ties completely. So stretch them! Make the necessary changes to get away from soul-sucking individuals and get closer to positive, happy, and compassionate people. 2) Spring cleaning in your home Remember this mantra of spring …
How therapeutic home-delivery programs can benefit your practiceMarch 11, 2019This is an exciting, but challenging time for small-animal veterinarians, as we help clients manage their pets' health in ways that were unavailable when I started practicing more than 30 years ago. Take nutrition, for example. New therapeutic diets are enabling us to manage a much broader spectrum of disorders than ever before. But advances don't stop there. Our multiple-location dermatology practice has found success using e-commerce to deliver therapeutic diets directly to pet owners' homes. This convenient and efficient system benefits our clinic, our clients, and the patients in our care. Why sign up for a home-delivery program? While I'm not an expert regarding such programs, I will share my experience with home delivery of therapeutic pet diets in the hope other veterinarians can benefit. It's no secret online pet food sales have grown dramatically in the last few years, especially as more people use e-tailers for their shopping needs. According to a 2017 article, e-commerce accounted for more than 18 percent of dog food sales and close to 13 percent of cat food sales. Further, Amazon's pet food sales increased 34 percent in the first half of 2018 compared to the first half of 2017, and retail …
Leveraging your team to its maxMarch 4, 2019If you always do what you have always done, you always get where you have always gone. This is a slight variation of Einstein's definition of insanity. Let's explore how this unfolds within the realm of veterinary team utilization. Your veterinary team is made up of people with various passions and talents. Each team member brings great depth and breadth to the services provided to the client and patient. Clearly defining their roles, expertise, and scope of practice improves the delivery of veterinary care. You may recall the 1999 Mega Study1 commissioned by the American Veterinary Medical Association (AVMA), Association of American Veterinary Medical Colleges (AAVMC), and American Animal Hospital Association (AAHA) entitled "The Current and Future Market for Veterinarians and Veterinary Medical Services in the United States." The study defined six critical issues to be addressed for veterinary medicine to succeed moving into the next millennium: 1) Veterinarian's income 2) Economic impact of large numbers of women in the profession 3) Global demand for all categories of veterinary services 4) Inefficiency of the delivery system 5) Supply of veterinarians 6) Skills, knowledge, aptitude, and attitude of veterinarians and veterinary students Let's briefly address the other categories before delving …
What veterinarians can learn from the Sears bankruptcyFebruary 20, 2019Sears, one of America's longest standing household names, recently raised the white flag and filed for bankruptcy. Started by Robert Sears in 1886, the company bearing his name clearly struggled in the past few years. The reasons are important and somewhat universal lessons to be applied. So how can veterinarians avoid mistakes that brought a 133-year-old iconic business to its knees? Adapt or die Sears was a pioneer in catalog sales, but slow to change with the times. More recently, it struggled to compete with Walmart and other big box stores. Similarly, veterinary practices face competition from multiple "players," including low-cost vaccine businesses (e.g. farm stores, feed stores, human pharmacies, pet stores), spay and neuter clinics, and even local family practices. This has profoundly affected the profitability of practices that relied heavily on "yearly shots," instead of focusing on the importance of (bi)yearly physical exams. Sadly, this philosophy made vaccines look like commodities, which means clients are likely to gravitate to the cheaper provider. Another factor that has historically affected revenue is the development of three-year vaccines. Again, those of us who didn't stress the value and importance of a (bi)annual exam are now facing clients who feel they …
Building trust with pet parents through digital marketingFebruary 5, 2019Pet parents come in all shapes and sizes, ages and genders, backgrounds and income levels. Yet, they all share a few common concerns that guide them as they choose a veterinarian. In addition to a convenient location and budget considerations, such as pricing and the availability of financing, pet parents put a high premium on finding a veterinarian they can trust. Why is trust so important to today's pet parents? Today's pet owners live in a world that tells them they shouldn't trust anybody. The combination of claims of "fake news," well-loved celebrities and politicians acting badly, or major corporations indulging in unethical behavior results in a public wary to take anything on faith. The benefit of the doubt has evaporated, leaving veterinarians forced to market themselves in an environment where customers do research before committing to even the smallest purchase. (Think sports drinks and snack foods.) Choosing to get health care for a pet is a high-consequence decision. Seventy-eight percent of pet owners agree a pet is a member of the family.1 In July 2018, a survey conducted by Pew Internet and American Life found more than one in five people research specific physicians and hospitals before seeking …
