Dr. Peter Weinstein owns PAW Consulting and is the former executive director of the Southern California Veterinary Medical Association and the former chair of the American Veterinary Medical Association’s Veterinary Economics Strategy Committee. He teaches a business and finance course at the Western University of Health Sciences College of Veterinary Medicine.Read Articles Written by Peter Weinstein
Nearly two years into it, the COVID-19 crisis has been a rollercoaster ride for veterinary medicine. As everyone pondered what the profession needed to do to survive and hopefully thrive during this truly once-in-a-lifetime experience, the one recommendation heard most often was the mandate for change. Three of our past articles — “12 Ways to Sustain Your Practice,” “What Now?” and “Six Growing Issues” — addressed the industry’s pandemic challenges and what we believed were some of the answers. Let’s look at how our thoughts played out.
We wrote that more and better leadership was essential for surviving and thriving during the pandemic. Early on, survival required veterinary medicine at all levels to activate its leadership superpowers and provide direction. From the beginning, the American Veterinary Medical Association led the way with best practices for preserving the health and safety of the practice team. Concurrently, the AVMA’s Veterinary Economics Division kept its finger on the pulse of the profession’s financial aspects. In addition, AVMA emails and online articles served as guideposts for clinic leaders.
Looking at clinics that emerged from the 2007-2009 recession relatively unscathed, we noted that their leaders focused on people’s needs, which is what great leaders do best. More than a decade ago, they found ways to keep their teams employed and give team members the peace of mind of continuing to earn an income. Fast-forward to the present and practice leaders did the same thing while protecting everyone’s health. Phase two required more changes because of the insanity of being busier than ever. When the floodgates open, how do leaders support teams that are exhausted, short-staffed and bombarded by dissatisfied clients? The same leaders who guided employees through recessionary uncertainty now had to keep their teams together during the chaos. Metaphorically, like cars, the engines at many veterinary practices were running in the red zone, putting team members at a greater risk of burnout.
Practice owners, managers and leaders have learned to commiserate with all generations of employees. They listened and tried to understand the needs of others. Their willingness to heed suggestions on solving issues strengthened the camaraderie that frequently fractures during difficult periods.
The bottom line is this: Practice leaders focused on the needs of their teams during the pandemic, ultimately putting people before profits. And as a result, their profits were sustained and even grew in the face of great tumult.
What was the secret sauce that practice leaders used to make a difference since early 2020? Communication. Clear, concise and compassionate communication. With their teams and clients.
During periods of uncertainty, we said, leaders must create a feeling of certainty. Using live and virtual modalities, leaders truly overcommunicated that they were “there” for their teams. And they advised clients that clinics were open for business, albeit in a different way.
Early in the pandemic, one survey indicated that only 25% of pet owners knew that their veterinarian was providing curbside service. Why the disconnect? It was because of a failure to share the protocols properly on websites, in emails and even over the phone. As a result, some clients were surprised to arrive for an appointment and find locked doors and a sign reading, “Please call us from your car.”
In the end, communicating the changes going on in a practice, a clinic’s busyness and better ways to connect clinics with clients was a point of great success for leaders who understood the need for certainty. Pet owners rewarded them with business and, for the most part, empathy. Client communication is a long-term tool for practice success.
Effective staff communication is a long-term tool for practice success, too. Whether you call it a huddle, timeout or staff meeting, or you use Slack or another digital messaging app, a daily pep talk and update helps build confidence within a team. And during the eye of the storm like COVID-19, taking a moment to say thanks, enforce breaks and recognize the challenges helps temper some of the angst. Veterinary teams needed to be heard, understood and supported. That is what great leaders do well.
Practices that led the way and connected with their clients and staffs became models for dealing with any crisis — pandemic, fire, flood, earthquake, tornado, hurricane.
Maintaining the pre-pandemic status quo was next to impossible for clinics. According to the Veterinary Hospital Managers Association’s “Insiders’ Insights” report from July 2021, only 4% of practices made no operational changes during the pandemic. Overall, clinics did well during trying times to find creative ways to serve clients while keeping everyone (pet owners and staffs) safe.
From tableside to curbside was the first major tectonic shift. In a profession where the delivery model was already inefficient, the shift only added to the inefficiency as direct communication became more difficult. The pivot and the lessons learned slowly pushed the industry in a positive direction. As we suggested, veterinary practices must move to a greater team-based health care delivery model whereby all staff members are more involved with the client experience and the doctors focus on the clinical aspects of patient care. The client service team and the technical team spent more time speaking with pet owners. Besides taking a patient’s history, the team was often the communicator of the findings and treatment plan.
The pandemic challenged the client experience like never before. Many pet owners have an intense attachment to their pets, so they are conflicted when they have to drop off a pet or watch it being “taken to the back.” With no window into what was going on and less direct contact with a veterinarian, clients were pushed to the psychological edge. What could practices do to enhance the client experience and mollify pet owners? The greater use of audio and visual technology and better communication proved a difference-maker. Practices that live-streamed visits provided a satisfying view into the pet’s experience.
Because of the safety protocols erected between pet owners and practices, another significant unmet need was client education. Practices responded with YouTube videos, digital handouts, enhanced websites and text messages for the sharing of medical information. Clients could de-stress by accessing the information from their car or home.
One prediction of ours that proved correct was that many practices would add options for picking up and delivering pet food and medications. Some clinics opened drive-through or walk-up windows, and others handed food and meds to clients in their cars. Home-delivery models included the greater use of a practice’s online pharmacy and assigning team members to drive to clients’ homes.
Another operational change we predicted was the greater use of technology. Once practices moved to curbside service, a reliance on technology was a given. Technology can mean many things, ranging from more phone calls to text messages, online forms, remote checkouts and telemedicine. Virtually every practice introduced some or all of those options.
Probably the pandemic’s most unexpected consequence was the increased caseload in many hospitals. In the spring of 2020, the chief concern was that practice revenue would drop significantly and that many clinics would lay off staff. We recommended a “focus on survival.” Turns out that while some hospitals were severely challenged during the early months of the pandemic, most saw revenue stay steady or grow dramatically.
Operational changes meant to keep clients and employees safe can be at odds with the increased demand for veterinary care, and this continues to be a challenge. The request for more services pressured practices to demand more from their doctors and non-doctors, which, in turn, caused increased levels of mental and physical fatigue.
Sixteen months ago, we warned about a brewing recession and how veterinary medicine needed to prepare. For most practices, we admit, the recession was a non-issue. The National Bureau of Economic Research announced in early June 2020 that the U.S. economy had peaked in February and was officially in a recession. Although some industries — airlines and hotels, for starters — suffered greatly during the pandemic, veterinary medicine wasn’t one of them. The government’s designation of veterinary medicine as an essential industry allowed clinics to stay open. While many hospitals saw declines in revenue and caseloads during the early months of the pandemic, they largely made up for it.
A lot of pandemic trends worked in the industry’s favor. Among them:
- Clients worked from home and noticed more pet medical issues.
- Clients didn’t spend much money on personal outings — no mani-pedis, dinners out or movie-going — so they spent it on veterinary care.
- Pet owners who worked from home had an easier time sneaking over to a veterinary practice.
- The Small Business Administration’s Paycheck Protection Program kept some employers afloat.
- Unemployment money kept some pet owners solvent.
- The growth in pet ownership meant a growing need for veterinary care.
The recession lasted only a couple of months, the National Bureau of Economic Research acknowledged. Still, the astronomical growth seen at many practices won’t continue forever.
Corporate Consolidators and Practice Sales
Veterinary practice sales were going strong entering 2020, we wrote a few months later. “Both corporate consolidators and private individuals were eager to invest in veterinary hospitals,” we said. “Multiples were high.”
Some consolidators shut down acquisitions or paused pending deals because of the pandemic, we reported. Others moved forward cautiously.
All that was short-lived. What happened? Within a couple of months, observers realized that clinics would continue serving clients and pets and that veterinary medicine would remain an attractive market for corporate buyers and individuals. Wouldn’t you rather have owned a veterinary practice than a restaurant back then?
Corporate acquisitions skyrocketed in 2021, and individual practice purchases have held up, too. The prices paid by corporate groups are very strong. No question that some practice owners considered selling earlier than they might have otherwise.
The experts knew early on that a zoonotic disease was at the root of the pandemic. There was no doubt that the veterinary profession needed to be an integral part of the discussions going on at all levels of government. The concept of One Health is not new. More than at any time in recent memory, this current period points to the veterinary profession’s importance in food safety, the human-animal bond and human health itself.
“The interconnection between people and animals,” we wrote in December 2020, “offers huge opportunities for the veterinary profession.”
We stand by that statement.
The pandemic continues two years after the emergence of COVID-19. Some of what we advised readers was spot-on and some less so. We still see a need for:
- Consistent and persistent financial caution within veterinary practices.
- A renewed and continuous focus on the mental health of team members.
- A focus on the mental health of clients during difficult times.
- A focus on the mental health of patients.
- Being proactive about making changes to veterinary business models.
- A better understanding of how to provide a great client, patient and team experience and accomplish it effectively, efficiently and profitably.