Small changes make a big difference to your bottom line (Proceedings)
Small changes in how you practice, or in how you run your business, can have a dramatic impact on your earnings over a lifetime and in keeping you and the profession economically strong.
Most practicing veterinarians want to be compensated at a higher level of income. The only way to really generate more revenue is to increase the number of patients we see per day and/or increase the average charge per patient. The AVMA-Pfizer study (JAVMA, Jan 15, 2005) reported the most common way veterinarians have increased their income over the past 5 years was to raise fees and increase the average charge per case seen. If the typical small animal veterinarian were able to increase the number of transactions per year (increase efficiency) from 4,000 to 4,500 and to increase the average doctor charge per case seen (increase quality of services) from $117 to $125 the net result would be an increase of gross revenue from $468,000 to $562,500. You may now be asking how can I see more cases? How can I increase the quality of my services?
For each of us to see more cases, we need to increase the number of cases per day by increasing revisits and new cases. This is possible through a good marketing plan and through increasing efficiency. More cases may be available through expanding hours slightly to allow an earlier drop-off time and staying open until 6:30 p.m. to allow a later pick-up time. Drop-off cases allow you to work on these cases when time is available during the middle of the day. Increasing the revisit rate is possible by increasing the follow-up on cases that need to be re-evaluated by making the re-visit appointment prior to the client leaving the practice. Most cases should have a re-appointment, recall, or recheck put into the database before the client leaves.Allowing clients to make appointments on Saturday will also increase visits as most clients work 8-5 Monday-Friday. The important factor in scheduling is to limit the number of scheduled hours for each veterinarian to 45 per week. If the practice has 3 or more DVMs, the length of the work week can be kept reasonable. If the practice has 2 or less DVMs, then adding hours may only make a longer work week. In this case, the practice owner(s) should consider how the practice might be able to merge with another area practice to obtain at least 3 DVMs in the practice.
Banfield has been evaluating efficiency in their 750 practices and has found that 4 veterinarians in a practice allows a reasonable 40-45 hour work week and quality of life while covering a 7 day work schedule. Quality of life for the veterinarian usually involves the following 4 areas: practicing high quality medicine, receiving an income that is commensurate with other similarly trained professionals, having a work schedule that allows a life outside of work (40-45 hours per work week) and developing a healthy investment/retirement program.
All of these goals can be met if the practice owner can become efficient in his/her practice life. The length of the work week must be reasonable and the practitioner must work efficiently for both quality and income requirements to be met. Too many practitioners are still working too many hours and spend too much time doing work that can be delegated to a high quality staff.
The areas that should be considered to improve efficiency include: multitasking (seeing more than 1 patient at a time); delegating duties to qualified staff; using incentives to pay people; encouraging the use of pet insurance and wellness programs; recommending at least 2 visits per year for each pet; using electronic communications effectively; organizing the pharmacy so prescriptions of commonly used drugs are prepackaged/precounted; restricting the work week to 45 hours and keeping medically current through seminars, on-line programs, printed material and interactive labs.
Let's briefly review each of these areas to improve efficiency. The first area is being multitask oriented. To really use multitasking to the fullest, a minimum of 2 examination rooms per receiving veterinarian must be available. To be able to increase the quality of service and still see more cases, one must be able to move between 2 exam rooms and spend a quality 10-15 minutes with each client/patient. The only way to do this is to be able to delegate to well trained and knowledgeable staff. To delegate one must be willing to allow staff to do those things they do well (other than diagnose, prescribe, make a prognosis, or perform surgery).