Practice Smarter columnist Mark Opperman is the president and founder of Veterinary Management Consultation Inc., director of veterinary practice management at Mission Veterinary Partners, and founder of the Veterinary Hospital Managers Association. His column won first place in the Florida Magazine Association’s 2020 Charlie Awards.Read Articles Written by Mark Opperman
Many businesses and just about every veterinary practice are dealing with employee shortages. Shops and restaurants everywhere have posted help-wanted signs. According to the American Animal Hospital Association, 81% of veterinary professionals said their practice wants to hire people to fill new positions, and 73% said they expect to hire replacement team members because of employee turnover. Unfortunately, the hiring problem isn’t going away anytime soon. So, what can you do to help your practice survive and thrive amid staffing shortages? Here are four strategies.
1. Leverage Your Doctors
Leveraging is the ratio of full-time team members to full-time veterinarians. The normal ratio is 3-to-1 but 5-to-1 in a highly leveraged practice. If your clinic is fortunate to have a healthy number of support staff, consider leveraging your doctors. What do I mean? Think of what the staff can do rather than the doctors. Naturally, this depends on team members’ competencies, such as whether they are licensed technicians or veterinary assistants or received extensive on-the-job training.
Let’s start in the exam room. Before the doctor enters, a team member can obtain the patient’s history and educate the client about recommended preventive procedures. Many assistants can weigh a patient and check its vital signs. The assistant can stay in the room while the doctor does the physical exam, hold the patient and help in other ways. Many practices have the assistant enter information into a computer while the doctor does the exam or speaks with the client. Depending on what happens next, the assistant or technician can prepare the prescription or run routine laboratory work.
Many practices send tests to an outside laboratory, which frees team members to do other things. In addition, clinics have found that clients are amenable to learning test results the next day, which might be more profitable for the practice.
After the doctor concludes the exam and discusses the findings with the client, the assistant can take over and share discharge instructions and educate about any prescribed medications. The assistant then can escort the client to the reception desk for checkout.
So, during a 20-minute wellness visit, how much time did the doctor need to spend with the client? The answer varies in every practice and probably with every visit, but it’s about 10 minutes on average. That’s leveraging your doctors.
2. Use Flexible Scheduling
My next recommendation is to consider using 10-minute flex scheduling. That means dividing the appointment schedule into 10-minute increments, giving you the flexibility to schedule slots of 10, 20, 30 or even 40 minutes. Not every appointment fits into a 20- or 30-minute time frame, and you can waste a great deal of doctors’ precious time by not scheduling them correctly. For example, does a medical progress exam require 30 minutes? I don’t think so.
See the table below for how some practices use flex scheduling. Note the column for technician appointments, which is another excellent way to leverage a team. You can decide which services fit into the technician category, but remember to schedule them. For example, some practices might have technician appointments every day, while others schedule them three times a week. Assign a specific technician to the appointments, and make sure the person is available at the set times. I advocate charging for a technician appointment and for whatever procedure or lab test is performed.
3. Hire a Contractor
Now is a great time to consider outsourcing. Which business activities are a practice owner, manager or team member doing that could be outsourced? For example, many practices hire a vendor to handle client reminders and marketing. Quite a few companies offer such services, so do your due diligence. In most cases, practices report that the outsourcing improved the effectiveness of reminders and freed up team members’ time.
Employee payroll also can be outsourced. The companies can handle direct deposits, year-end W-2s and payroll reports. Most payroll companies are very cost-effective, I’ve found.
Now, who does your bookkeeping? I know many practice owners who spend a long day at work and then go home to post invoices and pay bills until all hours of the night. Consider using a bookkeeping service instead. You can hire someone to come into the practice a few days a week, or you can use an off-site service that electronically obtains your data. Some larger software companies, such as QuickBooks, offer bookkeeping services.
Finally, who oversees your social media? Does a team member monitor online reviews and respond to them? Do you have someone who routinely posts on Facebook and other platforms? Those tasks are essential, but must they take up a team member’s time? Once again, vendors provide such services. I suggest you check to ensure the company does what it claims to do, and call references.
4. Alter Office Hours and Surgery Times
Given the shortage of veterinarians and other team members, many practices modified their office hours and surgery schedules. Some discontinued Saturday hours or reduced their hours on other days. Doing that can be a double-edged sword because it puts more demands on the practice when it is open. This is where effective scheduling comes in.
For example, can you reduce the number of surgery days if your surgery schedule isn’t full? (Granted, this is wishful thinking in most cases.) If you have two hours allotted to lunch, can you cut to one hour and add appointment times? Could you adjust the times your practice opens or closes to utilize your team better? Striking a balance can be difficult. Some practices stopped accepting new clients and discontinued services such as boarding or grooming because they didn’t have enough staff.
We are in challenging times. Hopefully, things will get better soon, but practice owners should rethink how they do business until then. Now is the time to take a serious look at how to practice smarter, not harder.