Ready, set, grow!
Elevating your hospital from the status quo to something really fabulous requires an honest assessment of where you stand and then formulation of a detailed action plan.
Is the time right to expand your veterinary practice? Here’s what some hospital owners are doing:
- Hiring another veterinarian.
- Making home visits to older clients and to clients who want a more compassionate euthanasia experience.
- Purchasing an expensive, yet medically valuable, piece of equipment to fill an unmet need.
- Installing a drive-through window for pharmacy pickups.
- Adding a pet pickup and drop-off option.
- Providing hospitalized pets with a nighttime attendant.
- Employing a multilingual staff member.
What’s important is to be proactive, savvy and strategic about growth. Change is inevitable. Growth is optional. Whatever you decide should enrich the client bond, improve the patient experience and reduce the chance that a pet owner will choose another clinic because of issues with your prices, services or customer relations.
Here’s what to consider when deciding how and when to grow.
Where Are You Now?
What’s your readiness for change quotient? Brainstorm with staff to assess your practice’s strengths, weaknesses and opportunities. Fine-tune whatever needs attention.
You have only so much time, money and energy to spare. Focus on expanding your practice in areas that will impact the highest percentage of your patient and client population. Should you install a specialized piece of equipment that might be used once a week, or should you add a diagnostic imaging tool that would be used frequently? Compare how each investment would change your practice’s quality of care and the bottom line.
Also do this:
- Ask yourself, “How can I attract more new clients or offer more high-value services that will lead to additional revenue?” Think about new communications and marketing ideas, such as building relationships with real estate agents, groomers, boarding staff and pet sitters in your area.
- Ask yourself, “How can I leverage existing clients?” Finding new business from existing clients is easier than trying to attract new clients.
- Listen to what clients ask for. Factor in their feedback, such as a desire for more predictability in the cost of veterinary care, more payment options and estimates of the cost of annual care. Your clients might expect competitive prices on products like pet food and nutritional supplements that are available through other channels. Perhaps they would welcome the convenience of a practice that opens earlier or closes later. Also, communicate with clients in the medium they prefer, such as email, text messages or Facebook posts.
- Compute how often you refer a patient to another clinic for special treatments. Would investing in equipment to keep those clients in-house be a smart move?
- Determine whether a significant number of clients are using online sources of pet health information instead of calling or visiting you. What can you do to make your hospital the first place that pet owners turn to?
- Understand the economic forecast for your community or state. Is a recession brewing that could reduce spending on veterinary services?
What Do Your Numbers Say?
Stith Keiser, CEO of Blue Heron Consulting, has this advice: “As a business owner, I can be as guilty as the next owner of sometimes making decisions based on my gut or on trends I think I’m observing. Sometimes this pans out, but at other times it backfires. Innovation and adding services and staff can all be a boon to business, but not if we add them to a practice that has a shaky foundation.”
When you gauge your practice’s business foundation, Keiser recommends monthly reviews of your profit and loss (P&L) statement, balance sheet and practice information management system’s totals for the period. Together, these reports will help you assess:
YOUR PROFIT MARGIN
- The average U.S. veterinary hospital has a profit margin, after fair market owner compensation, of around 10%. Healthy practices should be closer to 14% to 16%. Exceptionally well-run hospitals can exceed, and maintain, a margin above 20%. If your margin is lower, cash flow is an issue. When that’s the case, the two primary culprits are insufficient revenue and excessive management expenses. (Payroll and cost of goods sold tend to be the two highest expense categories for any hospital.)
- If your well-established business is running at a loss because of declining revenue, quickly determine the reasons and address them. Do your prices on products and services cover the costs? Do you have a lot of open appointment slots? Do you routinely send annual appointment reminders to clients? Do you dedicate time to attracting new clients, or do you simply raise prices in an attempt to increase revenue?
- If your practice is profitable, can you do better? Do you know which products and services are most profitable? Do you factor in all costs when determining your profit margin?
Many practice owners miss an opportunity to leverage the information on their balance sheets. Not only does a balance sheet list assets and liabilities, but it also helps you to analyze the return on your assets.
Keiser recommends these steps:
- Ask yourself, “Do I have the necessary capital to finance my practice’s growth?” Consider cash in the bank and tangible assets you might be able to sell, such as that dust-covered ultrasound unit sitting in the closet. (Before jumping to sell it, maybe you should train yourself to truly use it.) Keiser has seen some practice owners use personal assets or a personal loan or line of credit to fund business expansion. He generally cautions against this course because the business should cover such financing needs if it’s being run properly and has a healthy profit margin.
- Examine key performance indicators (KPIs). To help determine whether you need to launch a service or buy an expensive piece of equipment, review your KPIs to measure your financial operation and client compliance with your offerings. Specifically, look at the average doctor transaction (ADT), average client transaction (ACT), gross revenue production per full-time equivalent doctor, client bonding rate and the number of transactions. Instead of focusing only on how your numbers compare with national benchmarks, which is a valuable habit, look for the story behind your numbers. KPIs will reflect the level of medicine you’re practicing, how well you’re leveraging your team and how often clients comply with your recommendations, to name just a few.
- Be realistic about how much time will pass before revenue catches up to costs after you launch a service, buy an expensive piece of equipment or add an employee.
YOUR BUSINESS APPROACH
Is your practice running as efficiently and effectively as it could be? The secret to this is to hire qualified, quality staff members and pay them a competitive salary. You want your team to care about animals and people. The bond between your staff and pet owners is an important part of client retention.
You should do this:
- At check-in, ask every client whether she needs medication or food refills not only for the pet that arrived but for other pets at home.
- Remind clients of an appointment two days beforehand. Call no-shows to reschedule.
- Look at your costs of labor, materials and overhead, and then benchmark them against industry norms. If your costs are above average, perhaps your practice isn’t as efficient as your competitors’. Also, evaluate whether you are using a low-price strategy to gain a competitive advantage. It can backfire.
- Explore the latest information technology tools. They can provide user-friendly and affordable ways to improve productivity in the areas of inventory control, operations, accounting, human resources and client relations.
- Sit down with your team to define preventive care. This prevents confusion between team members and clients. Then, encourage your staff to recommend preventive products and services. Educate clients about the need for routine examinations by using posters, stickers, checklists and other resources to make sure the information is consistently communicated.
What Is Your Growth Strategy?
Envision where you want to be and the services you want to offer over the next three to five years. A simple, disciplined approach to growth will lead to fewer mistakes. Create an action plan that includes specific assignments of who will do what and by when. Set dates for assessing your progress and potentially tweaking the plan. Will more space or additional equipment and staff be needed? What skills will they need? When should they be hired? Consult all the stakeholders. Being smart about planning for growth should translate to increased revenue and better client satisfaction. Make sure any new services will deliver at least the same profit margins as you earn now.
Immediately after you develop an action plan, solve existing problems to help your practice prepare for growth.
You should evaluate:
- Your appearance: View your clinic as though you are a new client. Start at the front door. Is the lobby clean and attractive? Is the furniture comfortable? How is the smell? Is the signage and artwork of professional quality? Do you have the space to accommodate the variety of pets and owners you serve? Is the medical equipment and technology up to date? Upgrading the look and feel of your practice can improve customer satisfaction and leave a better impression of your staff’s level of professionalism.
- Your team: Do you have the right staff? Can employees who aren’t quite up to par become more effective through better training? How do you deal with unprofessional behavior? Is everyone still passionate about your practice’s mission? Consider terminating anyone who does not measure up to your standards and fill those vacancies with employees who bring value to everything they touch. Most employees want to do well in their job, but they might not know or understand how.
- Your resources: How much money do you need to finance growth? If you need working capital through debt consolidation or a loan, consult a lending expert. If you’re buying another practice or opening another location, talk with a lawyer. A financial adviser can raise your comfort level regarding investments and the financial return.
- Your virtual image: Check your online reputation. An internet search can lead potential clients to unflattering social media pages and review websites. Make sure your website is designed logically and provides high-quality, timely information about your services and staff. Encourage happy clients to leave online reviews. Get comfortable with marketing your practice through your website and other sources. Some veterinarians think that advertising undermines credibility, but the difference between marketing and pet owner communication is a fine line. If you are uncomfortable promoting your practice, you will miss opportunities to help pet owners understand the need for veterinary care, which ultimately will result in a lack of practice growth.
- Your visibility: Give back to the community. You can build your hospital’s reputation while doing something good for the benefit of others. Schedule a charitable event or become the primary partner of one. Share photos on your Facebook page to show your community service. For example, Potwin Pet Clinic in Topeka, Kansas, honors deceased pets by planting a tree in the pet’s name through a program offered by the Arbor Day Foundation.
Let’s Go! Grow!
Maximize success by getting serious about promoting new services. After all changes and building additions are complete, hold an open house. Or send an email or letter advising clients about what’s new. Update your office phone message to promote new products, services and doctors.
With new clients, send thank-you cards and perhaps have the attending veterinarian write a brief, personal note. Enclose a business card, refrigerator magnet and brochure so that new clients have your contact information at their fingertips and can share it with friends.
In his best-selling book “Winning,” former General Electric CEO Jack Welch says that planning for long-term growth doesn’t have to be scary. He advises looking at it as having a breakthrough idea and investing the resources to make it work. Welch urges readers to “not be satisfied with the status quo.”
“Be relentless in seeking out the best ways to achieve your goal and bring your idea to fruition,” he writes. “But don’t stop there. Surround yourself with team members who love to learn. Embrace change, adapt your plan and continually make improvements over time.”
Periodically, open your strategic action plan and ask yourself and your team, “How’s it going? Is our revenue and client base increasing according to plan? What things do we need to stop or start? What have we learned?”
Here’s a checklist of points to contemplate:
- Understand why and how you are growing. If your practice is thriving, you’re doing something right. Identify exactly what is making a difference in profits, services, sales, assets, inventory control and receivables. Make sure that your core values and mission aren’t being compromised.
- Evaluate how your clients are reacting. Regardless of your hospital’s stage of growth, be sure to listen to your clients and meet their needs. They enrich and sustain the practice, so delight them. Good ways to get customer feedback are through social media, surveys and face to face during office visits.
- Were your staffing projections correct? What’s obvious, and what needs a second look? What do your employees say about how the changes affected their work? Are new hires progressing as expected? Is more training or team building needed? Review your current staffing and whether responsibilities have been optimized to meet increasing workloads.
- Be flexible. The ability to adjust your business, regularly revisit the master plan and test different strategies are strong, smart ways to approach the growth stage. Your confident leadership will set the tone because growth brings challenges that will require your entire staff to adapt. Be vigilant in paying attention, and welcome feedback.
On behalf of those you serve, be the consistent champion for the benefits of change.
Judy Gray is president of CEOonCall in Tallahassee, Florida. She served as interim CEO of the North American Veterinary Community, publisher of Today’s Veterinary Business, in 2012-13.