Defeating complacency: The practice killer

Complacency is a terrible disease.

It contributed to the demise of the Roman Empire.

It has killed, destroyed or wounded many businesses, organizations and human relationships. It continues to thwart the success of many of our most prominent industries.

Complacency can infect any business or organization, be it nonprofit or for-profit.

What about our veterinary business, where we strive to deliver quality medicine and care?

We must remind ourselves that our success today is because of what we did yesterday, as well as last month and last year.

Current market forces have triggered busy days in the typical veterinary clinic. We see increasing consumer desire for better care, while there is a shortage of full-time veterinarians. And the production-pay trend actually compounds this issue.

Complacency can infect any veterinary business, because current growth is market-demographic driven and not quality-of-service driven.

We can discover and head off complacency with specific, active steps, such as these:

• We must have input from the consumer.

• We must not take our clients for granted.

• We must attend to the facility.

• We must read enough each week to stay current.

• We must attend to the needs of the staff.

• We must learn new skills.

• We can learn more about the human side of pet owners.

• We can avoid becoming the human equal of the medical-doctor generalist, who has become, pretty much, a traffic cop.

• We can have fun and work to make the veterinary clinic a fun place to visit.

15 monthly steps to keep complacency asleep

1. Review records

Randomly review at least 20 medical records per month from top to bottom. Specifically address the following: written home-care instructions, the differential, specific diagnosis, support for diagnosis, treatment and response to therapy. Make notes on clinic and staff patterns. Then make adjustments.

2. Outside pathology check-up

This month, send 10 paired specimens of chemistries — fine-needle aspirates, biopsies, heartworm tests, thyroids and fecals — to different places. Expect some interesting results.

3. Inside pathology check-up

Send 10 paired specimens from the in-house laboratory chemistries — fine-needle aspirates, heartworm tests, thyroids and fecals — to your favorite laboratory this month. Expect interesting results.

4. Radiology check-up

Send radiographs to an AVMA-boarded radiologist this month. Have them read for substance, but also ask what steps might be taken to improve the quality of the films. Expect to be pleased.

5. Anesthesia check-up

Look at the logs for deaths, recovery times, cardiac irregularities, oxygen saturation rates, blood-pressure swings. Consider and compare those with open lines vs. those without.

6. Nosocomial check-up

Look at the kennel history for contagious respiratory history, gastrointestinal problems and vermin, including fleas. Clients hate fleas coming home, even if they have them at home. Improved ventilation can help. Bathe every pet with a flea shampoo before it is discharged. Inspect patients going home for dirt and debris. Clients hate taking home stinky pets. We can't find problems if we don't look.

7. Seek answers from departing clients

We need to know why clients leave, but many never tell us. A simple one-page summary letter to departed clients asking basic questions about their perception of the practice can provide illumination. To improve the reply rate, provide a self-addressed, unmarked envelope to ensure anonymity. And, of course, $1. Take each comment seriously and make changes if you can.

8. Review on-the-spot survey

On the flip side, your existing clients can offer valuable input, too. A simple one-page summary letter to this week's clients, asking basic questions of their perceptions of the practice, can help identify problems. To improve the reply rate, provide a self-addressed, unmarked envelope for anonymity — and again $1.

9. Review the telephone log

A review of the incoming telephone log finds tidbits of great information. Practices that do keep a log of all incoming calls find this list contains a wealth of information. Why are folks calling? Are all messages getting to the appropriate people? Expect some surprises.

10. Review all in-house worksheets

By now, most growing, thriving practices use some sort of accounting system to track daily duties. A specific review of each completed duty shows who who is doing what — and who is not doing what. If you monitor the uncompleted duties, you can find what types of staff members need to be added to assure that all duties are handled. What is monitored is completed.

11. Design sense

This month bring in an ASID-certified interior designer. These professionals bring expertise and suggest ideas to make a hospital less clinical, warmer and more functional. Next month, try a landscape architect and do the same for the clinic grounds. For a reality wake-up call, bring in the housekeeping supervisor from a local hotel chain to critique the cleaning and maintenance of your facility. Expect to be surprised.

12. Self-assessment questions

Before reading the articles in the various periodicals that have quizzes, take the quizzes to see how you're doing. Then read the article.

13. Plan a reverse sabbatical

Invite a respected friend and colleague to visit your practice. Ask the colleague for input on the facility, dress, records, cleanliness, equipment and patient care. Prepare for constructive input. No one likes criticism, but this will be well-intentioned. One might not like all the ideas, but even a couple of ideas might help. Try them.

14. Plan a sabbatical

It can be stimulating to visit another practice, one that serves a niche similar to yours. Also try some different venues, visit a veterinary school, a referral practice, an AAHA practice, an ABVP practice, a spay clinic and an emergency clinic. If you're a small-animal practitioner, spend a day at an equine practice. Spend a day with a human dentist. Expect to learn a lot.

15. Read 100 pages of Ettinger's Textbook of Veterinary Internal Medicine this month

Next month: Part 2 of the complacency topic — numbers to monitor.

Dr. Riegger, dipl. ABVP, is the chief medical officer at Northwest Animal Clinic Hospital and Specialty Practice. Contact him by telephone or fax (505) 898-0407, Riegger@aol.com or www.northwestanimalclinic.com. Find him on AVMA's NOAH as the practice management moderator. Order his books "Management for Results" and "More Management for Results" by calling (505) 898-1491.