How an old veterinary hospital learned new tricks

When The Animal Medical Center, a renowned nonprofit teaching hospital in New York City, celebrated its 100th anniversary in 2010, business was not at its strongest. Although the hospital had more than 38,000 patient visits that year and had trained upwards of 30 percent of the country's veterinary specialists, business was down due to a weak economy, declining caseloads, competition from many new for-profit specialty hospitals and a reputation for not being customer friendly.

That's when Kate Coyne stepped in and turned things around. Coyne had 30 years' experience in human medicine, starting as a respiratory therapist and working her way up to CEO at of one of the Saint Barnabas Health Care System hospitals in Livingston, N.J.

After retiring from Saint Barnabas, Coyne was offered the chance to turn around The Animal Medical Center (AMC). Within four years, Coyne and her team gave AMC the boost and direction it needed. Using the research company CalPro in a program initiated by Zoetis, Coyne was able to obtain a baseline of how their clients and referring veterinarians thought they were doing.

Through changes she implemented, AMC's caseload increased by 19 percent, and the hospital's financial picture improved substantially. Revenue has increased 26 percent since 2010 and client satisfaction is up by 25 percent.

While every hospital is different—small animal vs. large animal, small-town vs. big city, one doctor vs. a corporation—some strategies work for everyone. Human and animal medicine are amazingly similar in terms of basic business principles, Coyne says. Here, she shares some tips she used to turn AMC around, and she says these tips can help you improve your practice, too.

1. Offer a great product with a passion for service.

"Our business is service, and our product is veterinary medicine and care," Coyne says. By reiterating that mantra time and again, she helped change her team's mindset. But in every team, there's bound to be one person who says the pet is their focus, not the people.

"There's a person at the end of every leash," says Coyne. "The pet can't go out and say what great care you gave—the owner does that. We have to serve the client, not just the pet."

To help make the adjustment with her team, Coyne spent much of her time on the client floor modeling proper behavior. Staff members watched her interact with clients and pets, and soon they were imitating her positive attitude with patients and clients.

2. Provide training—and make it fun

To address the perception that AMC wasn't customer friendly, Coyne put mandatory customer service training programs in place for all staff members—doctors included.

"Anyone who received a paycheck had to attend," she says. "We had to improve our service level to remain in business."

Role-playing played a big part in training staff members and doctors to focus on service. "It's up to the front-office staff as well as our veterinarians to learn what clients need, to hold their hands and guide them through the process. It makes a huge difference in clients' impressions of your level of care."

3. Reward superior care and service.

It's not enough to teach people to do their jobs well—you also have to reward them for it. "Everyone likes to know that what they do is seen and appreciated," says Coyne.

At AMC's regular department meetings, administrators read positive client letters then post them for all to see. Team members also benefit from a reward at each quarterly staff meeting.

"Don't ever be afraid to say thank you, with your words and in the form of a reward. We give $25 gift cards or boxes of candy to those who offered outstanding service or who were mentioned in client letters. It's their job, but I can thank them for doing it so well."

4. Focus on finances

Tightening purse strings is never fun and it's rarely easy. But setting a budget is essential to maintaining a well-run business. "When I arrived, our financial picture was dire. We had to stop the bleeding. That required a 'right-sizing' of the organization, including personnel and salary reductions. We needed to reduce expenses by $7 million. This had to be done with surgical precision. We had to know where to cut and how deep."

In four years, she cut operational costs by half, all the while improving the quality of care. Her No. 1 trick? Determining the cost-effectiveness of specific diagnoses and the value of standardization of products, supplies and equipment. The cost savings for these initiatives are substantial and improve quality and efficiency, she says.

Her tip: Know your costs per case. "We researched every procedure to see where standards of care differed and what each procedure cost," Coyne says. "Was one dog sicker than the other? Were the cases different in any way? It's not about the cost to clients, but what it costs us directly and indirectly to provide the care."

Once they analyzed the services and compared them among the doctors, the team set a standard of care to follow. This allows them to cut costs where possible and creates a consistent way of providing a service that best serves the patient, the client and the hospital.

Next, Coyne suggests looking for services you provide that lose money. Are there services that cost the practice money and aren't altogether necessary? If so, she says consider scrapping them from your care menu.

"Just because you've always offered it doesn't mean you have to continue," she says. "Some high-cost services are necessary. And some services are loss leaders. Developing specific care plans by diagnosis can reduce costs and often improve quality."

5. Schedule with your client in mind

One of AMC's missions is education. With more than 50 interns and residents, the team needs to build teaching opportunities into appointment times—which is no easy task.

To determine which times best fit client demand, AMC surveyed clients who called for appointments. Each time a client requested an appointment, the scheduler would ask the caller how satisfied he or she was with the time slots given.

"Ask your receptionists to track how often clients ask if you're open late or whether you have weekend appointments," she says. "If they say, 'Oh, never mind' after you offer a time that doesn't fit their needs, take note. If this happens frequently, consider shifting your schedule to accommodate them."

Sarah Moser is a freelance writer and editor based in Lenexa, Kan.