Bonuses give team members a strong incentive to succeed.
You are, I trust, aware of the benefits of production-based compensation for associates: Higher earning potential almost always equals better performance. And when you combine a guaranteed base salary with a percentage of production—a system I call ProSal—it's truly a win-win situation. The associate can't be paid any less than the guaranteed base but has a strong incentive to offer a full-service approach—generating more income and providing a higher level of care.
Mark Opperman, CVPM
Well, why not apply this principle to your entire healthcare team? Everyone would be vested in the success of the practice, and everyone would share in the economic rewards of that success.
One of the biggest challenges facing the veterinary profession is appropriate compensation for the support team. How can we expect to recruit and retain these most-important assets when we pay them such a paltry salary? Part of the problem is the fees we charge—they're too low and often discounted—but what motivation do team members have to make sure fees get charged? None! However, if you involve employees in the financial success of the practice, you enhance their compensation as well as yours.
Most employee incentive programs I've seen over the years have some flaw. Take bonuses, for example—even bonuses based on increased gross revenue. Were all employees equally involved in achieving this increase? Probably not. So if you pay everyone the same amount, you're rewarding some team members who don't deserve it. This naturally leads to disharmony and discontentment.
To get an incentive program for the nondoctor team to work, you must:
This is a tall order, but such an incentive program has been successfully incorporated in many practices. Let's take a look at it—first the financial side, then the performance side.
First, you must establish exactly what team members will receive as their bonus. I like to use a percentage of the increase in gross revenue: If the practice sees financial gain, so do team members. Normally this percentage is 10 percent of the increase in gross from one quarter compared with the same quarter of the previous year. In a mature practice, 10 percent of the increase is very fair. If a practice is growing, if a new associate is hired, or if a new building is constructed, the percentage might be reduced. Remember, this is 10 percent of the increase in gross, not the gross itself.
Why gross? Because you have to base the program on what employees can influence. They can affect gross revenue, but they can't control net. If you buy a new piece of equipment or hire a new doctor, it may decrease the net even though your team members have been working hard to offer services and provide excellent client care. So stick with gross, and you'll see employees shine.
On the performance side, each team member must know what he or she needs to do to improve the practice's gross revenue.
• Receptionists must know that it's critical to convert phone shoppers to clients, remind clients to bring in stool samples, and review the medical record so they can ask clients about purchasing food or other items they normally buy from the practice.
• Technicians must know that it's critical to offer a full-service approach. If a client comes in for a wellness visit, the technician needs to review the lifetime-of-wellness checklist with him or her to make sure your team is offering optimum healthcare. Surgical technicians must record all the services you performed in the computer record, time surgery and anesthesia, make medical recalls, and fill out discharge order forms.
• Veterinary assistants need to discharge patients promptly and assist clients to the car.
Once the team knows exactly what you expect of them, those criteria become part of the evaluation process. Here's how it works: Each employee is evaluated each quarter—receptionists, technicians, veterinary assistants, and even practice managers. You'll need separate evaluation forms for each position and you'll include individual goals as well as position expectations. You'll give team members the evaluation forms at the beginning of the quarter so they know exactly how they'll be assessed.
At the end of the quarter, each employee evaluates himself or herself. The practice manager completes the same form after obtaining input from the practice owners and associate veterinarians. The team member and practice manager then sit down and discuss the evaluation, addressing any differences and determining the team member's future goals.
This conversation is very important. Employees want to know how well they're doing and what they can do to improve—and they sense it if they're being rubber-stamped. At the end of the evaluation process, the employee receives a score between 0 and 100. I suggest you set no more than 20 criteria, worth five points each.
Now for the tricky part. Once you score the evaluations, you need to adjust the score based on the number of hours the employee worked to make the incentive fair. For example, if an employee receives an 80 on her evaluation but worked an average of 20 hours a week during the evaluation period, the score would be adjusted to 40 (half a full-time employee's hours).
Total the adjusted score and divide each score by the total to calculate the percentage of the fund the employee receives. The entire fund is divided according to employees' evaluation scores and hours worked (see "Using an Employee Incentive Program").
Using an employee incentive program
The beauty of this program is that there's no discrimination. The veterinary assistant can receive as much as the office manager or technician—it all depends on whether she did her job and helped the practice excel.
Many practices require employees to achieve a minimum pre-adjusted score—a 60 or 70, for example—on their evaluation form to receive anything from the incentive fund. This rewards your top employees and makes more money available to those who are truly making the practice more successful. It also sends a strong message to those who are not.
Another note: A team member must be employed during the entire incentive period; if she comes in during the quarter or leaves before the end of it, she won't receive anything from the incentive fund.
You'll also need to revise the evaluations periodically. If an employee receives a score of 90 or 100, raise the bar. Take some criteria out of the evaluation and insert new objectives to enhance the employee's performance. You don't want your team members feeling they're in dead-end jobs; show them there are new challenges ahead.
If there's no increase of gross, you still need to evaluate your employees. In fact, I think team members will be even more interested in learning what they can do to help the practice during the next quarter to receive their bonus.
Now a warning: You cannot cut corners with this program. If you're not willing or able to incorporate it entirely, don't do it at all. If you don't do the evaluations or don't do them effectively, the program won't work. You can't do the evaluations every six months or every four months—I've tried, and the momentum doesn't build enough. You must do them quarterly. The criteria used in the evaluation must be objective, not subjective, and the evaluation process must be fair.
In addition, your team needs to know the "score." Create and post a chart that lets employees know the practice income last February compared with this February. Income should be posted daily or weekly and benchmarked to the same period of the previous year. Employees shouldn't be surprised at the end of the quarter to learn there was—or wasn't—an
increase and therefore a bonus.
Your employees are an asset; they're on your side; they want to help you offer the best possible care and service to your clients and patients. They also want to help you be more financially successful. Provide the tools and incentives that will help them do that. Remember, Together Everyone Accomplishes More.
Veterinary Economics Hospital Management Editor Mark Opperman, CVPM, is owner of VMC Inc., a veterinary consulting firm based in Evergreen, Colo. He'll be speaking to team members at Firstline Live Aug. 24 in Kansas City, Mo., and to veterinarians and practice managers at CVC Central Aug. 26, also in Kansas City.
For more, visit thecvc.com.