This week: Exhaustion and stress have become commonplace as veterinary practices adapt to the new normal. At some hospitals, business is fine; at others, it’s not so good. Read other installments in this series: Chapter 1 Chapter 2 Chapter 3 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15
Chapter 4: Tales from the COVID-19 front lines
“I try to remind anyone in this profession that we should be so proud to be veterinarians now more than ever.”
Nova Scotia, Canada, veterinary nurse Ashlyne McRae, RVT These last few days have been so mentally exhausting and emotionally tiring. For three days now, several times per day, I have had to take pets away from their humans. We are only allowed five people in our building due to the COVID-19 pandemic — one vet, two techs and two reception. So, when it comes to euthanasias and owners saying their final goodbyes, I have had to take pets away from their owners on the sidewalk. We can allow only one family member in the building. The rest must remain outside, leaving the other family members crying at the doors ... men, woman and kids who don’t understand. This has literally killed me. Every. Single. Time. I cry doing it. I try and hide this from my colleagues as we are already stressed as it is. Being in Canada with colder weather and climates that restrict us from doing outside tents hinder and hurt us deeply. My eyes are so puffy and I am mentally and physically exhausted. Because of the social distancing, I can’t even hug the owners but leave them crying on the sidewalk outside our door. I tell the owners I will hug their pet, hold them and kiss them till their final breath. Please remember, this pandemic is just as hard on veterinary staff as it is our human counterparts. Veterinary medicine and staff may not be essential to COVID-19 patients, but we are still essential during this global pandemic. Please share. We suffer too.
Fearless columnist and Chicago practice co-owner Natalie Marks, DVM We have just completed three weeks of shelter in place in Illinois and remain grateful to be considered an essential business. As we continue to weather the storm as two separate teams working three 12-hour days, we can feel the weight of this new normal becoming heavier. We miss our other teammates, we miss our clients, we miss giving each other hugs after a tough euthanasia, we miss the feeling of focusing solely on our patients and not worrying about our own health, and we miss our life pre-COVID-19. Many psychologists around the country speak of this feeling so many of us have as a feeling of grief, and I see that in some of our team members. We try to focus on learning, on case success, on taking the day a minute at a time, and being flexible and supportive and patient. Everyone needs this now, whether they visibly show it or not. I try to remind anyone in this profession that we should be so proud to be veterinarians now more than ever. We will be called upon to bridge this gap between animal and human health, and we also make sure to continue to provide care so that the ever important human-animal bond can continue to comfort so many pet parents in need right now. The hardest part of last week had nothing to do with 12-hour days, uncertain financials or even home schooling three very stir-crazy children. We lost a colleague, a professor, a friend, a mentor and one of the most respected veterinarians in exotic and avian medicine. Dr. Peter Sakas of Niles Animal Hospital passed away from complications from COVID-19 and, with his loss, this pandemic instantly became very real and terrifying to the Chicago veterinary community. My 10-year-old heard this news and now begs me not to go to work. The mind starts to race and not only contemplate the ongoing safety of your team and hospital, but your own mortality. And, I have to admit, I made sure to review my will and have all of my documents in order just in case. I’m saying “just in case” a lot more now, telling friends and family what they mean to me, hugging my children even tighter, taking longer looks at them when they are sleeping and holding my breath every time I hear a sneeze or cough. While this pandemic has been a massive shock to the system, I certainly hope that the we all continue to be this much kinder and prioritize the important people and things in life more when this all ends.
White House, Tennessee, hospital managing partner Whit Cothern, DVM Monday, April 6 begins our third week of the social-distancing restrictions many others have implemented. While in many ways it’s beginning to feel routine, as I write this on Sunday morning I can’t help but wonder what else new and unexpected will arise this week. Among the new and unexpected we’ve encountered along the way are:
- The increased demand on our telephones and customer service team. This seems obvious in hindsight, but our first instinct when reducing staffing levels was to begin here. We’ve since better recognized what happens when almost every client interaction occurs via phone. We have adjusted accordingly.
- An area phone and internet outage lasted approximately four hours one day. The only thing more challenging than almost every client interaction occurring over the phone is not having a phone with which to interact. We do have a business cell phone set up as a redundancy for such an event, but like many other things, who knew we’d need it during a global pandemic?
- The more that pet owners are directed to stay at home, the more they seem to discover that their pets need a nail trim. Good luck trying to surmise from the pet owner if said nail trim is really medically necessary, because that answer will undoubtedly be “yes.”
- The need to provide our team with a letter prepared by our attorney to keep in their vehicles stating “as they are employed in veterinary health, they are deemed part of the Essential Critical Infrastructure Workforce by the Cybersecurity and Infrastructure Security Agency (CISA) division of the Department of Homeland Security published March 19, 2020.”
- The decision late in the day last Friday to provide a face mask to every team member in case of further directives requiring they be worn in public. We asked them to put their name on it, use it judiciously and assume it’s the only one they’ll be getting, because it very well could be the only one for the foreseeable future. The handful we have remaining are now under lock and key, putting face masks in the same league as fentanyl and phenobarbital.
Veterinary industry consultant Debbie Boone, CVPM Decision exhaustion. I certainly feel it, and I see the posts on all my social media pages. Owners and managers are mentally fatigued with all the instantaneous changes they face, the risk to staff and personal health, and the decisions on furloughs and layoffs they are being forced to make. The Payroll Protection Program (PPP) will certainly buy time, but the question is how soon will funds be available? I am hopeful that practices were proactive and prepared to make these applications. Those hospitals further into this pandemic, particularly on the West Coast, have had to begin staffing cuts long before the CARES Act was an option. Will practices bring back staff with PPP funds? I believe they will. But the caseload will remain reduced, so what will these staff members do? One of the most consistent things I hear when I discuss training, writing protocols, and developing mission and core values statements is “I don’t have time.” With a decrease in cases and staff being paid from PPP funds, we now have the time. Let’s use this gift to be ready when the world returns to the new normal. Use this time to reach out to clients who are sheltering in place and check in with them. Make a short video every day to keep in touch with pet parents. They need your connection, communication and education more than ever. New research from Diggo, an animal health marketing company, surveying pet owners shows that 73% of our clients will consider getting services at Walmart veterinary practices when they are available. If veterinary hospitals plan to maintain their clients, according to the latest Diggo newsletter, we must be more transparent with fees, build solid relationships by listening, be convenient by using telehealth tools like two-way texting, record sharing and online stores, and be available 24/7 by engaging with services who do teletriage on our off times. Now is the time to act on these pet owner messages and be ready to fly when the cage door opens. In history, one thing is consistent: In times of great disruption, there is always something better that comes out on the other side. Veterinary practices must be ready to serve with the better tools and ride a positive wave into the future.
San Francisco veterinarian and Pride Veterinary Medical Community President Dane Whitaker, DVM, MPVM I am a small animal/marine wildlife relief veterinarian practicing in the San Francisco Bay area for over 25 years. I completed a master’s in preventive veterinary medicine in 2017. I had no idea then how my training in epidemiology and One Health would be so poignant today. San Francisco was one of the first major U.S. cities to implement shelter-in-place orders. Back in early March, friends, family and coworkers were asking for my opinion as an epidemiologist on the wisdom of social distancing and canceling gatherings. As I realized that veterinarians were considered essential services, I then began to make the difficult day-to-day decisions on where if felt safe for me to work. Traveling to different practices, exposing myself to various staffs and them to me, was something that I had to think long and hard about. I made the choice to not travel out of the county for work and to only go to practices I had an established relationship with. Fortunately, most of these practices were instituting curbside service, so at the least I could eliminate direct contact with clients. My marine mammal rehab relief work continues at a much-reduced level as decision makers in this field grappling with the ethics and wisdom of what constitutes essential services when sick and injured wildlife is involved. I recognize that marine mammals are an important sentinel species and that monitoring their health is essential as an indicator of ocean and human health. How much of this can we put on hold while the pandemic rages on? These are decisions that we are making on a day-to-day basis. I am also the president of Pride Veterinary Medical Community. We provide advocacy, education and outreach for our national and international LGBTQ+ veterinary professionals. This pandemic has been difficult for all of us, and our organization has been addressing compounding layers of stress potentially added to the lives of many that are already struggling. Every day brings a new change and a new challenge. The resilience and dedication among the staff and volunteers dedicated to this profession is astounding. This gives me hope.
VetCT Vice President Matt Winter, DVM, DACVR The COVID-19 pandemic has without a doubt brought many serious challenges to us all. During this time, health care delivery is certainly essential. I thank the health care professionals who are putting their lives at risk each and every day. They are heroes and heroines all. Delivering veterinary patient care is wrought with challenges because of restricted travel, social distancing and financial constraints brought upon by economic contraction. This has brought tremendous stress and emotional strain on caring and compassionate veterinarians and veterinary professionals. As the days stretch to weeks, and weeks to months, it seems we are adjusting to a new normal. The challenges of maintaining the personal safety of staff and clients while providing the best in veterinary care are gargantuan. Telehealth and telemedicine, while not new, will evolve rapidly in this uncertain environment as a means to deliver veterinary care while maintaining personal safety. At Veterinary Consultants in Telemedicine we recognize this. We believe strongly in delivering the best in patient-focused veterinary care and improved outcomes through continuous education, collaboration and innovation. In an effort to help, we have quickly put together a team of specialists in internal medicine, surgery, critical care, ophthalmology and neurology to provide free specialty consultations during the COVID-19 pandemic. This is meant only to add service where none may exist or be accessible, and not to supplant any existing relationships. Physical referral to a local specialist is always preferred. #vetsforvets We know that this does not place us on the front lines with the clinicians and their staff who are managing the stress and dangers of seeing patients in parking lots and risking their lives for their patients’ care. But we hope we can help provide a service that can ease the strain just a bit and support the veterinary health care heroes and heroines during this difficult time. Stay healthy and safe, everyone. [Veterinarians interested in VetCT’s free instant advice from veterinary specialists should visit vet-ct.com or email [email protected]. The offer is good through April 30.]
Veterinary nurse and National Association of Veterinary Technicians in America President Kenichiro Yagi, MS, RVT, VTS (ECC) (SAIM) “Heroes work here” say the signs placed on display outside of essential businesses and services that continue to operate through COVID-19, including some veterinary practices. These words are nothing but the truth as veterinary teams continue to work through the COVID-19 pandemic. As more states issue orders for non-essential services to close while maintaining veterinary businesses as essential, veterinary technicians and nurses courageously provide the care needed by patients. The necessary diversion of personal protection equipment to human health care make personal protection within veterinary practices ever more challenging. Veterinary professionals are supporting each other whether it be shipping supplies to each other or sharing resources to create non-commercial versions of PPE. Medical equipment such as ventilators being drafted to human health care is a common occurrence now. In addition, more areas are asking medical professionals, including veterinary professionals, to enlist in helping during the COVID-19 crisis. In the midst of this, colleagues are frustrated as it seems our profession is forgotten to exist or not given consideration to the difficulties we are facing. Seeing “veterinary technician” missing from licensed medical professional signup lists for COVID-19 health care efforts has been like salt to our wounds. All we want to do is help. For those of us who belong to practices that have chosen to close or reduce hours, choosing between no pay and unemployment is a real choice. As we brace ourselves to weather COVID-19, it is too easy to focus heavily on the negatives. Members of our profession are still expressing gratitude, providing support and finding humor through these times. And we’ll want to keep rallying toward the positive and checking in with each other. Positivity in these unprecedented times is important because our next pandemic could be a mental health pandemic without it. [Visit the NAVTA Facebook page at https://bit.ly/39To280.]
Beyond Indigo Pets CEO and Today’s Veterinary Business editorial adviser Kelly Baltzell, MA Time has gone slow and fast simultaneously. As we are moving into Week 4 of this event, we are seeing hospitals adapting to the new normal. What we are witnessing from the Beyond Indigo perch to the crisis is:
- Most staffing adjustments have been made. 99% of Beyond Indigo client hospitals are staying open and doing curbside in-and-out care.
- Some of our hospitals are absolutely crushed with business. The hospital and our team theorize it is due to the fact that they a) stayed open and their competitors did not, b) people have time now to actually take care of their pets and can bring them in and address health concerns, and c) they are marketing like crazy to let the world know they are open and can care for their pet.
- More and more of our hospitals are moving to telehealth care and onboarding that service to connect with pet owners.
Veterinarian Tyra B. COVID-19 came crashing down like a noisy gong. Never did I imagine I would be writing about how this new pandemic is affecting not only me but the entire veterinary community. The stress of potentially having to close your business and knowing that financially, it may not be a good idea. The stress of impatient clients and their demands, which you may not be able to accommodate. The stress of understanding what is essential versus non-essential care and communicating that cohesively across the community. The stress of an employee whose family member is ill and not being informed until the test is positive. This is what life is like on the front lines, not to mention the risk of not having any symptoms but potentially passing the virus to someone at home. You press on, wearing a mask, washing your hands and cleaning any surface possible every chance you get. I’ve always prided myself on my ability to handle stress, though my body would say otherwise. I’ve been lucky enough to dodge the flu and nasty stomach bugs, but what if I can’t dodge this? How will it affect my daily life, my business, my family? I have two elderly parents and a diabetic child. What if? I won’t mention it, but the thought of the possibility of contacting this virus and not being able to be there for my loved ones is dauting to say the least. I have found far more sleepless nights, chest pains and teeth clinching. There have been moments of deep reflection, times where I’m filled with gratitude and times of “WTF!” My therapist suggests for health care workers and any essential worker to take short mental breaks throughout the day and between appointments. I color and listen to audiobooks to help deal with work-related stress. At home, I’ve found joy in cooking new things for my son and having a glass of wine. I am finally exploring cable channels I hadn’t, and I’ve learned that I like “Log Cabin Living.” Most importantly, I’ve allowed myself to rest, something I have a hard time doing. I think most veterinary professionals have a hard time with this because we think it’s wasting valuable time. I try to limit news programming and doomsday attitudes. Because I am generally optimistic, it is my hope that we all come out of this stronger than before. Just like any storm, the sun is guaranteed to shine again. Stay strong everyone. This too shall pass.
Saint Francis Veterinary Center of South Jersey area business manager Mark Magazu, JD, MPA Saint Francis remains open, offering all specialty, emergency and wellness services. I’d like to share some of the simple and inexpensive innovations we’re using that are easily implemented at minimum cost.
- We’re using an inexpensive cloud software called Waitwhile, which is commonly used in restaurants to shepherd the curbside experience of clients. It allows clients to sign in from their car once they arrive. After they sign in, a series of automated text messages are triggered through the app, preventing staff from having to text from their personal devices. Clients can monitor their place in line in real time. The dashboard lets our team see exactly who’s in the parking lot, how long they’ve been waiting, what car they’re in and what service their pet needs. The text-chat threads are downloadable into our PIMS.
- We’re using a WordPress plugin called Formidable to adapt our website to facilitate check-in and authorizations in a stepped approach with adaptive forms. For example, if a client selects “surgery” as the needed service, the form automatically adapts to ask specific questions. This way, we receive tailored information and clients appreciate the relevance of the questions asked versus having to fill out longer, more generic forms.
- We’re implementing Fur Baby Tracker, an app that gives our team the ability to update owners throughout their pet’s stay, including video and photos, with simple taps in the app.
- We’re using TeleVet, a very simple telemedicine platform. This technology allows us to talk to clients virtually whether they are sitting in our parking lot or at home. We’re still evolving our protocols for telemedicine, but this will definitely be one of the innovations that lives on after COVID-19, so now is an excellent time to experiment with it.
Cary Consulting CEO and change agent Mia Cary, DVM On Friday, I received a call from my eldest bonus son, Dakota, who lives in Raleigh, North Carolina. Our granddog, Russell, had a partial obstruction in his throat and anxiety was rising. I encouraged Dakota to go to his local veterinarian immediately. Dakota rushed over to CityVet, jumped out of the car and ran to the front door, which he was surprised to find locked. I had failed to prepare him for the new COVID-19 curbside services that most practices have instituted. Upon seeing Dakota and Russell at the door, the staff member inside the reception area swiftly came to the door, ascertained the situation, and explained calmly and succinctly that they would take Russell to the back to help him and that Dakota should wait outside of the hospital. It wasn’t long before a staff member returned a happy Russell to a relieved Dakota, with the bone dislodged. This scenario mirrors the scene in veterinary practices across the globe. As I connect with clients and keep up to date via veterinary listservs and online communities, I continue to see a wide variety of operational responses to COVID-19. Proximity to coronavirus epicenters, practice culture and local leadership all play a role in how practices and individuals are responding to the pandemic. Last week, the CityVet team was not wearing masks when interacting with clients, but I suspect by now they are. Many practices report staff layoffs and shortened hours. While the majority of practices I’ve connected with over the last week are busy with compromised, sick pets, there is also a growing number that are seeing more downtime between curbside client appointments and emergency walk-ins. Some practices continue to welcome gifts of gratitude from clients in the form of home-baked goods. Others instruct their teams to thank the client and accept the gift, “But the food must be tossed.” Veterinary telemedicine continues to increase thanks to many states loosening regulations and out of necessity. More and more veterinary professionals realize the many benefits of virtual veterinary care — from the obvious, such as the ability to care for patients while practicing physical distancing, to the less obvious realization that clients appreciate it. Loyalty often increases due to these digital interactions. The teams faring the best during this crisis continue to be the ones with the strongest leadership, the most effective communication, and a culture based on trust, community and collaboration. Research suggests that it takes 21 days of repeated, intentional activity to form a new habit. It will be interesting to see what new habits we all create during these unusual, unprecedented times.
The Vet Recruiter founder and CEO Stacy Pursell, CPC, CERS What I saw last week was practices still interviewing and hiring veterinarians. I received multiple new calls from practice owners or managers asking me to find them a veterinarian or veterinarians. Most of my clients are doing video interviews. A few clients did in-person interviews last week. I had a client want to make an offer to a veterinarian after doing a video interview and not seeing her in person. I have clients recording videos of their practices and emailing them to candidates so that they can see inside the practice if an onsite interview isn’t possible. Some of these videos are really cute. An observation I made is that some of the videos don’t have anyone in the practice talking on camera. Hearing people talking gives a better feel for the personality or culture of the practice. I’ve heard from relief veterinarians who want to stop doing relief work because their shifts are being reduced. They want to find a full-time position with benefits. I received more resumes from employed veterinarians than I have during any week in the past year. They are reaching out, saying they want to see what else is out there. Several have stated that they don’t like how their current employer is handling things with COVID-19 and that it has caused them to look elsewhere. Some practices have told me they are primarily seeing emergencies right now. I’ve had some practices tell me their revenues are down. Some have said their business is good. One veterinarian told me his practice is up 25% right now because another practice had reduced its hours.
Creative Disruption columnist and WellHaven Pet Health chief medical officer Bob Lester, DVM We already knew that our profession was made up of the smartest, most dedicated and caring people on the planet. During this crisis, our profession’s role as a leader in both public and animal health protection has never been more important. This challenging time has reinforced the enormous power of pets as the antidote to depression, the cure for loneliness, the provider of unconditional love, the alleviator of stress, the stimulus to physical activity and the solution to social isolation. Our partners in human resources really came through last week. Generally taken for granted, HR professionals showed up big time. In a matter of just a few short days, they labored tirelessly to understand and translate hundreds of pages of rescue legislation, simplify it, explain it and execute on it. Consider the alphabet soup of confusing acronyms: FFCRA, FMLA, EPSL, PPP, CARES, e-FMLA. In normal times, such directives would be rolled out over months and years, but our partners in HR made them happen in a matter of days. Brilliant and hard-working hospital support specialists spent many long hours administering the new programs and connecting with teams to answer questions and determine who qualifies for new state and federal assistance programs. Another in a long line of veterinary profession hero leaders emerged. My thanks for all they do in support of our caring profession. I continue to be amazed and proud of all that we do. Together we will emerge from this crisis stronger than ever.
North Carolina veterinarian, speaker, consultant and Today’s Veterinary Business editorial adviser Ernie Ward, DVM, CVFT Last week, we definitely observed veterinary practice revenues take a beating as pet parents hunkered down in most of the country. While some clinics reported that service demand remained high, most expressed that revenue and transactions suffered due to decreased appointment requests and limited staff resources. Many clinics have reduced staff hours by 20% to 50% and often only have one veterinarian on active duty at a time. Curbside care has become the norm as clients are allowed inside the clinic only for procedures such as euthanasia. It’s no surprise that online shopping for pet medications and preventives, food and supplies continues to boom. I believe many of these stay-at-home purchase habits will persist beyond the pandemic, indicating a potential softening of veterinary pharmaceutical sales in the future. I’m hearing many veterinary technicians and support staff complain that they’re being put at undue risk during nail trims, anal gland expressions and past-due distemper vaccines. Staff stress seems to be escalating. Topping the list are worries about contracting COVID-19 at work, job security, and an overall lack of concern from management and owners. This is the time for management and owners to focus on the needs and worries of their staff and treat them with utmost respect and appreciation. The practices that truly make their staff a priority during this crisis will be rewarded with incredible loyalty and improved productivity once business returns to normal. The practices that rule by fear (“You’ve got to come to work or we’ll go out of business!”) or shame (“Are you afraid of getting sick? You’ve got to be kidding! You’ve got nothing to worry about.”) will see a continued deterioration of staff morale and will likely see decreases in efficiency and productivity as resentment grows. These are the times to build a legacy. Will you be known as a leader who puts people first, innovates veterinary care and supported others during the crisis, or will you be remembered as uncaring, unempathetic and focused only on money? Crises bring out our best and worst traits. Be sure to focus on bringing your best each day in the coming weeks. Stay safe and give your pets a hug from me.
Crum & Forster Pet Insurance Group assistant vice president of veterinary relations Wendy Hauser, DVM Last week was spent touching base with friends and acquaintances who serve many different areas of veterinary medicine. From a call with a boarded small animal internist that I mentor, I learned that the private-practice specialty hospitals are facing a deluge of patients in need as both teaching hospitals and generalists leverage them for their skills and availability. On a call with my group of veterinary-focused friends, I heard opinions from two veterinary attorneys about the impact already seen on consolidator purchases, speculation about new multiples paid, and talk about the strong early performance of veterinary hospitals in the investor space. I heard worry about the lack of planning for pets whose owners might become incapacitated from COVID-19; who will care for the pets? Also explored were concerns for how the economic crisis is impacting veterinary hospitals, from decreased revenues to balancing client needs with team safety to the challenges of figuring out how to access the federal business aid packages. Most of all, I was reminded during each of these conversations about the importance of finding humor in each day. As we have heard, this week is predicted to be very hard and sad, with an escalating loss of human life. This is the perfect time to inject a little humor and some gratitude in each day. Here are a few ideas:
- Reach out to your clients by social media or phone to share a funny video. I strongly recommend a YouTube video about COVID-19 from our pets’ perspective. [View the video at https://bit.ly/2JJ4lVF.] Please don’t blame me if the tune sticks in your head.
- Last week, I talked about the value of team huddles to share what each person is feeling at the beginning of the day. This week, continue to take the emotional temperature of your team and add the following question: “What one thing brought you joy in the past 24 hours?” It is a good way to remember the good when we are being deluged with sad and scary news.
- Have a one-minute dance party. Choose a silly song and see who has the goofiest moves. This will encourage breathing and laughter — two great ways to relieve stress.
- Have team members choose individual theme songs, and take turns sharing the songs. Mine is “Ride of the Valkyries” by Wagner.
Today’s Veterinary Nurse editor-in-chief and NAVC director of veterinary nursing Kara Burns, MS, MEd, LVT, VTS (Nutrition) I am seeing and hearing the anxiety from my veterinary practice colleagues. Every member of the veterinary health care team is dealing with uncertainty and unpredictability. Every minute of every day things are changing. Veterinary team members are balancing competing demands, caring for patients, caring for pet owners, caring for our families and caring for ourselves. So, how can our teams help each other? And how can we attempt to destress when anxiety is at an all-time high and the nation and the world is shifting by the minute?
- Take action. Communicate your concerns with co-workers and problem-solve with colleagues to plan coping processes.
- Pace yourself. Watch for disturbed sleep, excessive fatigue, irritability and poor focus.
- Breathing helps calm us and enhances our focus. Take intentional, slow breaths.
- Prioritize good health habits. Maximize healthy eating by bringing your meals to work. Practice good sleep habits — put that phone down — and go outside.
- Take breaks. Incorporate breaks into the practice protocols. Even minibreaks will help. A 10-minute walk during your workday is calming and enhances energy and focus.
- Be a team player. If you have children or relatives who need care, let your hospital team leadership know ASAP and be willing to cover for co-workers who have the same concerns.
- Be kind. Everyone is stressed and trying their best to cope with the everchanging world events. Smile, be encouraging and help one another.
Thrive Affordable Vet Care director of learning and development Claire Pickens, CVPM, SHRM-CP, CSSGB In a time of constant and unforeseen change, two traits will carry people through: relentless optimism and courage. A month has passed since most of us have had to dramatically change our processes and mentalities about client interaction. We’ve historically put so much value on the in-person interaction that allows us to build strong relationships. And now we are faced with building strong relationships via video or phone. Throughout this, many of us are probably wondering if this month and the months to come will forever change how we interact with our clients. The good and bad news is that it might. Relentlessly optimistic people will see these changes and know that there will be a light at the end of the tunnel. Their positive outlook is contagious to team members and clients. Relentlessly optimistic people will embrace the innovative spirit of having to invent changes to adapt to a rapidly evolving environment. And a relentless optimistic person will be an influence to everyone around them. This doesn’t mean turning a blind eye to the struggles or glossing over the hardships. What it means is understanding that we are in a moment of time that is going to pass and that we will come out stronger on the other side. I’m hopeful that we, as a veterinary community, can be relentlessly optimistic about what lies ahead for our hospitals and for our relationships with clients and patients. A courageous person exudes the kind of strength that gives others hope, whether this is the creator of a new process, the champion of a new process or the person always looking for a way to be inventive and think outside the box. The courage to approach these new challenges with confidence is highly contagious. Being courageous doesn’t mean doing things out of blind faith or haphazardly. It doesn’t mean you turn a blind eye to risk. Being courageous means being a champion for your hospital and helping to build the culture of strength and unity needed to weather a storm together. As we move forward into a second month, I’m hopeful that teams are becoming more united. That people are embracing the opportunity to learn new ways to communicate with clients. That we are optimistically supporting each other and infusing a courageous spirit into our environments. This too shall pass.
VetSuccess CEO and founder Martin Traub-Werner Veterinary practices experienced a similar year-over-year decline in revenue and invoices this past week as compared with the week prior. While hardly good news, this suggests that, at least last week, the numbers were not dramatically lower than the previous week. Forecasts of a more profound impact on the economy across the country continue to be concerning, and enforcement of stay-at-home orders in larger states like Florida and Texas may adversely affect these numbers in the coming weeks. For the week of Monday, March 30 through Saturday, April 4, VetSuccess data from more than 2,500 U.S. practices again showed a drop in both revenue and invoices each day from the same day the prior year. Year-over-year daily average revenue per practice was down 14% nationwide, compared to being down 17% the previous week. It’s interesting to note that larger practices were down 17% compared to smaller practices, which were down 10%. Not including home-delivery data, pharmacy revenue was up 6%, whereas over-the-counter and diet revenue was down 8% and professional services revenue was down 16%. Turning attention to invoices, year-over-year daily average invoices per practice were down 16.5% nationwide, compared with being down 19% the previous week. Larger practices were down 17.5% compared with being down 20% the previous week. Smaller practices were down 12.5%, compared with being down 14% the previous week. The top three states with the most significant change in invoices year over year were Massachusetts, down 29%; Washington, down 25%; and Colorado, down 25%. [For additional data, check out the VetSuccess Veterinary Industry Impact Tracker at https://bit.ly/3afxUd0.]
Getting Technical columnist, practice management consultant and Patterson Veterinary University instructor Sandy Walsh, RVT, CVPM Things on the surface are looking much the same. Veterinary teams are still doing whatever they can to serve sick and injured pets. Many practices are not allowing clients to come inside at all, except for euthanasias. All communication is being done by phone, and the only contact is a technician wearing protective gear who transfers the pet into the hospital and then back out. All payments are taken by credit card over the phone. Clients are, for the most part, understanding, and most are compliant. Stress is starting to wear on teams. Most are following the recommendation to wear a face mask at all times, which heightens the concern of exposure. More and more employees are opting to stay home, which is leading to short staffing. Hospital hours are being reduced further as a result. Practice owners are stressed about steadily declining revenue but are hopeful that financial relief will come with the CARES Act and the Paycheck Protection Program, and many are getting their applications in. I’m still seeing teams working together under solid leadership from the managers and practice owners. Thankfully, I have not seen any confirmed cases of COVID within our practice teams. Fingers crossed that this continues.
Veterinary industry consultant and Southern California Veterinary Medical Association executive director Peter Weinstein, DVM, MBA The last week went by very quickly and with less tumult than the prior weeks. It seems as if the curbside, no clients in the building, social distancing, split shift, layoff, furlough, stressed, concerned veterinary model is holding its own for this nanosecond. In speaking to veterinarians all over the country, I’ve found that the only consistent thing is the inconsistency of how business is doing. One practice I spoke to experienced a March that was 20% better than the March of last year. On the other hand, a non-scientific study indicates the more than 50% of practices are down from a revenue standpoint. I am guessing that the new delivery model is much more inefficient in some ways and thus prevents practices from seeing as many clients. One variable that might impact practices more and more are the state mandates associated with veterinary practices being essential businesses. Some states issued edicts defining which services a veterinarian may provide. Others trust veterinary practices to use their best judgment as health care providers to choose between what needs to be done versus what would be nice to do when it comes to a presenting complaint or a concern or need. Talking about confusion, some states have encouraged and liberalized telemedicine to allow for practices to use it as much as possible. Please recognize that in most states, your licensing board defines what you can and cannot do as a veterinarian. What is permitted in one state might not be permitted in another. Some of the news reports make it feel as if there is a national standard. There isn’t. This topic, more than any other, has caused my email box to beep and my phone to ring. Yes, you can integrate telemedicine into your practice. There are a gazillion options. Do your due diligence, ask questions and charge clients for your time. But most of all, know understand the laws in your state regarding telemedicine. The major focus for many managers and owners is getting loans and grants and access to cash as we head deeper and deeper into the malaise. The Paycheck Protection Program grants and Small Business Administration loans have eaten up a lot of time as practices get ready to head into this for the long haul. Every practice should apply for every opportunity that they can with the full understanding that we truly don’t know how long we will be impacted by the COVID-19 crisis. We don’t truly know how deeply impacted unemployment will be, and with unemployment, how impacted the economy will be. Given all the unknowns, an extra store of cash at low or zero interest rates is a good thing to have. With cash being king, don’t forget to see about getting deferred rent and extended terms from vendors. Minimize your inventory and increase cash flow from your online store. One final soap box concerns your people. Now more than ever, the way you respect and communicate with your team, focus on their needs, and license to their concerns will have a huge long-term impact on the success of your practice. The new abnormal has been tough on them as not only the disease but the threat of unemployment looms. Morale, which in most practices even before COVID-19 was a roller coaster, is even more like ventricular tachycardia. Your practice culture of caring and concern for patients and clients must fully and completely extend to all members of your health care team. Take care of them now and they will be there for you tomorrow. Off the soap box. Mic drop.
We want to hear from you: How has the COVID-19 emergency affected you, your practice or your veterinary business? Email editor Ken Niedziela at [email protected].
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