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
Karen E. Felsted
CPA, MS, DVM, CVPM, CVA
Take Charge columnist Dr. Karen E. Felsted is the founder of PantheraT Veterinary Management Consulting. She spent three years as CEO of the National Commission on Veterinary Economic Issues.Read Articles Written by Karen E. Felsted
Before the COVID-19 pandemic arrived, what caused insomnia in practice owners, managers, veterinarians and staff members ranged from the cost of patient care to online bullying. (See the sidebar “What Worried Us Then.”) Since March 2020, however, more challenges arose, and they didn’t make the old issues go away; they just added to the list. Identifying the recent problems is easy, but finding the solutions is much harder. Let’s look at four issues identified in an Insiders’ Insights survey and how veterinary leaders can best respond.
Staff Mental and Physical Fatigue and Declining Morale
Unless you live in a cave, you’re well aware of the concerns about the mental health and well-being of veterinary team members over the past few years. Unfortunately, the problem has gotten only worse during the pandemic.
The two years put tremendous pressure on people. Clinic teams were asked to change quickly and dramatically at the pandemic’s start. Change is not easy and is even more challenging when done quickly. The pressures mounted as we went from tableside to curbside, unmasked to masked, and scrubs to personal protective equipment.
The 2020 Merck Animal Health Veterinarian Wellbeing Study reported, “Serious psychological distress remains high in younger vets” and “Suicidal thoughts and attempts continue to remain higher in veterinarians than the general public.” Some of the reasons included long hours, stress and high student debt. Unfortunately, many people struggling with such issues don’t know how to help themselves. Moreover, many work colleagues or supervisors are not trained to help.
What can your practice do? Start by:
- Reviewing Merck’s 2020 study and one from 2017 here: bit.ly/3fbXq70.
- Reading the American Veterinary Medical Association’s “5-Minute Wellness Quick Start for Veterinary Workplaces” at bit.ly/3nbtmwE.
- Providing an employee assistance program to your entire team. An EAP is often available as part of your practice’s health insurance plan or can be procured independently.
- Learning to recognize the signs that someone might need professional help and then appropriately steer the person to a therapist, substance abuse care or a suicide hotline.
- Showing that you care by listening, empathizing and putting the team’s ideas into action.
Client Irritability and Demands
As the door slowed its swinging, why did clients start swinging their tongues, fists and keyboards? The virus seemed to affect how people behaved, not just in veterinary hospitals but also in stores, hotels, takeout lines and airplanes. As a result, the human race lost some of its civility.
The veterinary profession, which had been loved and respected for eons, became the center of the bull’s-eye for clients seeking to extract a pound of flesh because they had to wear a mask, couldn’t be present during a pet’s examination, didn’t realize the cost of care because they were new pet owners, or were existing clients who couldn’t be seen by who they wanted “Today!”
COVID brought out the worst in people, which, combined with the added stresses of PPE and busyness, frayed the nerve endings of veterinary hospital staff. How you handled the irritability and demands ultimately determined whether your practice resembled an action-adventure movie or a romantic comedy.
One of the underused communication tools in a practice is the art and science of listening. The COVID era demanded both superhuman patience and compassion to the point of exhaustion as clients dealt with a pet’s health, their fears of the virus, and the loss of jobs and, in some cases, family members. When you didn’t listen, demonstrated impatience or showed too little compassion, an already irritable client acted out.
So, what can a veterinary practice do?
- Get rid of truly horrible, unreasonable clients. It’s an easy solution that should be applied in appropriate cases. You don’t need every client. If by responding professionally and with dignity you encourage a client to seek care elsewhere, you might remove a great source of stress. Firing a client can be the greatest present you give your staff.
- Don’t be too quick to judge clients. Many aren’t getting the service and communication they are used to. The situation isn’t necessarily the practice’s fault, nor is it the clients’ fault. Everyone is short-tempered these days. Acknowledge that mistakes occur, apologize and try not to let them happen again.
- Overcommunicate sooner rather than later. People handle change better if they know about it in advance and understand why.
- Train your staff to reply to a verbal attack and not worsen a situation. With difficult clients, try to isolate them from an audience. Don’t use the parking lot, lobby or internet as a place to address irritated pet owners. Find a quiet, non-public platform for communication. Let them vent, listen and take notes, repeat what you heard, and identify a solution that both of you can live with. Don’t try to win an argument. Instead, try to retain a client.
- Respond, don’t react. Whether the catalyst is a Yelp, Facebook or Twitter post, an email, a phone call or a personal one-on-one, going ballistic by phone or keyboard is easy, but it’s not a good idea. Instead, take time to formulate a response. Do some due diligence to support your position or better understand the protagonists.
- Focus your staff meetings on the issues that pet owners deal with so that you can better meet their needs. The problems might include the pandemic, first-time pet owners, the cost of care, client service and wait times.
- Be compassionate with pet owners — something that can’t be overdone. Many instances of client irritability come from feelings of uncertainty, fear and not being heard. Many clients think the clinic staff is rushing and not listening. So, use staff meetings or other training opportunities to improve listening skills.
We’re in one of the tightest labor markets we’ve seen in years, but especially for veterinarians and credentialed technicians. Unfortunately, the situation will not get better anytime soon — think years! — so, what can a veterinary practice do?
- Look critically at your practice’s culture. Is this a place where people want to work? One that regularly expresses appreciation for the work people do and sees them as valued contributors? A practice that offers opportunities to learn and grow? A practice where people are nice to each other? Does the hospital understand the need for and promote a work-life balance and offer flexibility in scheduling, compensation and benefits? If any answer is “no,” understand that applicants have many opportunities to go elsewhere. In addition, your employees might not be as strongly bonded to your practice as you’d like.
- Compare your compensation and benefits to what’s available in the market. If your practice doesn’t stack up, you’re going to have trouble competing against all the other clinics looking for employees.
- Review your help-wanted ads and where you place them. If your ad looks like everyone else’s and uses the same tired phrases — “We practice great medicine!” — then why would a job seeker contact you? Make sure you clearly describe what is unique and desirable about working at your hospital. Get help with the ad writing if needed. Don’t limit your job postings to the cheapest site you find. Reach out.
A veterinary practice’s first response to not having enough team members is to try to hire more. However, the results might be slow in coming. In the meantime, also focus on what you can control internally. For example, revamp your workflow and training programs to increase productivity and efficiency. That can significantly reduce the need for additional employees and deliver faster results when compared with bringing on new employees.
Fewer Veterinary Visits
Did the door keep swinging at your practice during the height of the pandemic? Statistics from many sources indicated that the number of transactions did not grow at the same pace as practice revenue and, in some cases, shrank. Although practices felt busier in the face of COVID-related inefficiencies, the number of pets seen in many hospitals did not reflect that busyness.
When people hunkered down in the early stages of the pandemic, the door didn’t swing because people were too scared to cross paths with other living beings. And then when the floodgates opened and everybody wanted an appointment, who were the consumers of veterinary services? New pet owners? Were they first-time pet owners or perhaps long-time owners who were new to your practice because they couldn’t get into their usual clinic? Were they your best clients, and their pets were quite ill? They knew you’d be there for them. Or were they current clients working from home who were more observant of their pets’ needs and who had extra cash in the bank since they weren’t flying or driving or going out?
We don’t have the studies yet on who comprised the vast majority of practice visitors during COVID. However, we know that people waited longer than ever to get an appointment, that they waited longer than ever after they arrived at a clinic and that many of the pets were sicker than ever.
For many practices, increasing the number of visits isn’t an area they want to focus on now because they need the breathing room. Whether your practice needs more clients now or later, what can you do to get more visitors?
- Develop a marketing plan to keep the front door swinging and the phone ringing in the face of unpredictable client compliance. You should market when you are busy and especially when you are not.
- Maintain a regular presence on Facebook, Instagram and other social media platforms. Focus not just on cute puppy and kitten pictures but also client education. The message should be, “We have the answers to all your pet care questions.”: A social media advocate who monitors and updates your platforms and watches for nasty reviews puts you ahead of the biggest pain points. Social media is your pipeline to educate people, so use it correctly.
- Create a retention program. Choose a portion of your database to contact monthly about a particular medical concern — for example, dental care, obesity, travel or flea control. Use various marketing tools, such as email, text messages and snail mail.
- Pick up the phone and call your best clients with this simple message: “It’s been a tough couple of years, so we wanted to check in and see how you and your pet are faring.”
- Forward-book appointments. With so many practices having a multiweek waitlist, encourage all pet owners to book rechecks and other appointments farther into the future to make sure they are seen when they want.
- Renew your focus on client service. Now might be the time to review topics such as how to encourage callers to actually make an appointment. Isn’t it amazing how many client service representatives wait for a client to ask for an appointment when they instead could offer a few open slots proactively?
- Upgrade your website. When was the last time you did it?
- Emphasize convenience. Can clients make appointments online or text to find out how their pet is doing? Can they order prescription renewals through your online pharmacy? Can they communicate with you through telemedicine?
- Get to know your clients. Given the increasing number of millennials and their willingness to spend lots of money on pets, have you created a millennial friendly practice? Make communication technology a friend, not an enemy. Your team probably has millennials who would be more than happy to be your outreach to their cohort. Have them try out technology options and let you know what they like.
Finally, remember that veterinary professionals don’t live on an island. Big things are going on in the world that affect everyone. Getting our house in order will make dealing with societal issues easier.
WHAT WORRIED US THEN
A survey published in DVM360 more than five years ago showed that practice teams were most concerned with:
- Rising costs and the affordability of veterinary care.
- Competition from nontraditional service providers such as big-box retailers and online pharmacies.
- Client (non)compliance.
- Student debt and the cost of veterinary school.
- An oversupply of veterinarians.
- Google and other sources of misinformation.
- Government regulations, fees and taxes.
- A slippage in the strong reputation of veterinarians.
- Corporate veterinary practices.
- Maintaining pet wellness and preventive care.
- The poor abilities and attitudes of associate veterinarians.
- Emotional stresses caused by online bullying, a poor work-life balance, compassion fatigue and burnout.
THE VALUE OF LEADERSHIP
A veterinary practice’s strong foundation is built upon leadership. And with leadership comes a vision statement, mission statement and core values. Great leaders prevent headaches before they have a chance to start. One way they do it is by having a strong vision statement laying out what they want the practice to look like and deliver. A strong mission statement defines why a practice does everything it does. And finally, a practice with a robust core values system defines how people will act within the business.