Give up the one-man band

Equine practitioners who spend most of their time in a hospital setting have a small army of assistants, technicians, and administrative staff members assigned to each step of the patient's visit, freeing the doctor from tasks such as taking blood or issuing the bill.

But equine practitioners who devote most of their time to ambulatory services usually maintain an army of two: themselves and either a licensed technician or a trained assistant who functions as the horse handler.

Are you an isolated road warrior? If so, it's time to get more help, says Dr. Mark Rick, senior associate veterinarian at Alamo Pintado Equine Medical Center Inc. in Los Olivos, Calif.

Some of your colleagues have managed it, ceding tasks that once fell under their purview to their assistants. On the mundane side, your assistant can drive and answer the cell phone. More technical tasks include taking radiographs or performing ultrasound.

Dr. Rick acknowledges that it can be difficult to get into the habit of delegating. But, he says, there's a big payoff if you do. "Giving away other tasks gives you time to devote to better communication and lets you see more patients—and you'll be more sane at the end of the day," he says.

And if you don't delegate, you may be hurting your practice's bottom line, says Susan Werner of Werner Equine Practice Management in North Granby, Conn. Clients will pay for quality service and medical care, Werner says, but they want to be able to talk to the veterinarian. And spending that extra time with a client is difficult if you're also breaking down the equipment, preparing lab samples, and putting together the bill.

Log your jobs-and pass some on

Give up scheduling, driving, and billing

Dr. Andy Clark, MBA, CEO of Hagyard Equine Medical Institute in Lexington, Ky., says you should aspire to do only tasks that require a veterinary license. "As soon as you find a task that doesn't require a veterinary license, find another team member to take that job on," he says.

Sure, that's easier said than done. So Dr. Clark recommends starting by giving up scheduling and turning your cell phone over to your assistant. Here's how to tackle these first two steps—and then two more:

1. Let someone else schedule. Convinced they're the only ones who can allocate their time efficiently, equine practitioners often cling doggedly to doing their own scheduling, Dr. Clark says. But it's a task often done better by someone else. He suggests designating a "scheduler."

Work with this person to develop a scheduling protocol, listing how much time you like to spend on each procedure. With this written protocol in hand, someone else can schedule for you, he says.

2. Turn over your cell phone. "The advent of the cell phone has turned many equine practitioners into receptionists," Dr. Clark says. "They think they're giving their number to an inner-circle of clients and friends, but soon they're slaves to a ringing phone."

His tip: Ask your assistant to answer the phone. Dr. Clark says he had a fabulous technician who took all his calls, talked to everyone, and then gave him a list of people to call back. "I could continue working as a doctor while she handled those incoming calls," he says.

3. Put someone else behind the wheel. Equine practitioners who haven't given up driving the vehicle are losing precious time, Werner says. She says they can take advantage of the drive time to enter patient histories into the laptop, return client calls, or catch up on reading journals.

4. Give up the billing. Werner also suggests dealing with billing in the office. Your assistant can give the caretaker an after-care sheet detailing what the doctor did and how they should proceed, she says, but then turn the task of creating the invoice over to someone designated to handle accounts receivable in the office.

That person can compare the patient history the practitioner entered with the list of services provided and check for discrepancies or missed charges. Once the bill is issued, that in-office person can follow up to make sure it's paid within 30 days. And if clients have questions about the bill, they can talk to the accounts receivable person, leaving you with more time for patient care.

Dr. Rick agrees that it's a good idea to hand over billing. "It gets rid of the awkwardness of providing professional services and then presenting the bill. And the job gets done better and more fairly," he says.

Get more ideas from your team members

Clearly, these aren't the only tasks your team members could take on. And chances are they'll be excited to grow their responsibilities and make a bigger contribution to the success of the practice. So be sure you don't shut your eager employees down.

"It's important to be responsive to team members who ask for more responsibility," says Dr. Rick. "Giving responsibility enables and empowers key employees to spread their wings and not only contribute to the process of running the hospital but also to feel good about it."

In his own practice, Dr. Rick admits his technicians and assistants light-heartedly get on his case when he's doing tasks they could be doing. "They push me out of the way and say, 'Dr. Rick, don't be such a micromanager.'" Most times, he says, he does get out of the way and let them do the work.

Dr. Clark says team members have good insights on how to improve practice efficiency. So his advice is to ask team members what tasks they could take over to make the practice run more smoothly. "You just have to brainstorm," he says.

Sheri Miller, LVT, and president-elect of the American Association of Equine Veterinary Technicians, agrees that equine practitioners can empower technicians by turning over the tasks they know their technicians are trained to do. "Everybody enjoys the benefits of a smoother-running practice if you give away some of the work and the responsibility that goes with it," Miller says.

You'll keep some things

Still, Dr. Rick says, there's a balance. Even if you really commit to leveraging your team members' talents, you may decide to keep certain tasks, even if they don't require a veterinarian's license. "The buck stops here, and I'm the one who has to talk to the client, so I want to be the one to perform the task," he says.

For example, he likes to change the first cast after an involved surgery, so he can see what's underneath. "I want to see how the incision looks and whether the leg is swollen, and to decide whether the stitches should be removed," Dr. Rick says. "Other tasks I like to personally stay in charge of include scoping a stomach looking for an ulcer or monitoring the healing of a previously documented ulcer, scoping a horse following a surgery, and looking at a culture plate to decide whether it should be sent to the lab for identification and sensitivity."

Of course these tasks might change for each doctor. "All doctors have a sense of what they must stay in charge of and what they can delegate," says Dr. Rick. "The decision of whether or not to delegate a task really comes down to your confidence in your team members' abilities. If a team member always gives accurate feedback—due most likely to excellent training—then you'll gradually shift more and more tasks to him or her."

Those who do strike the right balance, Dr. Clark says, will reap numerous rewards: less staff turnover, an increase in collections and business, better customer service, better medical records, and happier clients. "A whole lot of things improved when I started delegating better," he says.

The bottom line

If you're used to doing it all, it can be tough to give up nondoctor responsibilities. So start with delegating the small things. For example, ask your assistant to drive, answer the cell phone, and set up and put away equipment.

Kimberly Rubenstein is a freelance writer and editor in Overland Park, Kan. Please send your questions or comments to: ve@advanstar.com