Owning your mistakes as a veterinary practice owner

We all start out as practitioners with a universal anthem: "I'm never going to make the same mistakes that my first employer made. I'm going to manage my own staff and run my practice like a real business, make a better than decent profit, spend time with my family and retire at a reasonably young age." So what the hell happens to all of us?

Everything was all so organized at the beginning. Yes, the construction did take two months longer and required $10,000 more than planned. The 69-page business plan, so carefully crafted, so detailed, simply failed to keep with reality despite incessant labor. Staffing was well planned but few wanted anything to do with their job descriptions. The staff that cost 20 percent in the ideal practice ended up costing 55 percent of revenues in the first quarter when staff outnumbered clients almost every day. The greatest task was to find tasks for underbusy staff, relieving them of their favorite pastime of following the big hand of the clock in its revolutions.

But no fear, there is a way back. Here are my tips for correcting the mistakes we all swore we'd never make.

Transparency

One of the greatest manpower-savers of all time is glass. Nothing assists our efficient manpower more than being able to find staff when they are needed. Also, staff members who are aware that you can see them tend to stay more productively occupied. Excepting the lavatory, every room in the hospital should have a window—and the larger the better. And as your practice grows, you will soon fall out of the habit of giving escorted tours to new clients, but your windows can display your hospital to every passerby—no better advertising exists!

In my own self-designed hospital, a full laboratory, radiology, surgery and treatment areas were revealed to clients just a few steps away from their assigned examination room. Referrals soared after their first visit. Never was the question "Do you do the surgery here?' asked. I was surprised that, in my 29-year tenure at this hospital, not one client seriously asked whether they could watch their pet's surgery through the four-by-eight-foot window. Just having seen the immaculate, well-equipped surgery suite was a remarkable confidence builder.

Nepotism, numbers and needs

As far as staff goes, there are rules that work. The first (and best) rule is to make sure you never hire a close friend or anyone possibly related to you, and never, ever hire someone because they remind you of yourself at their age. You will come to regret it severely!

There is an ideal ratio of receptionists to technicians to kennel workers, which is 8:9:4. Your staff budget will work best when the outlay for receptionists is 38 percent, technicians 43 percent, and kennel workers 19 percent. These numbers are most important after two years of practice. Before that, chaos reigns—receptionists are excercising patients, kennel workers are answering phones, doctors clean cages and all job descriptions are rendered meaningless.

The next question is, "What about an office manager?" That answer is simple. A new and growing practice has no need of an official office manager until revenues approach $1 million. At that time, a salary of $40,000 with a productivity bonus based on increased efficiencies and profits will be very successful.

Hiring and firing

The practice that does not perform staff performance reviews is destined for staff mediocrity, which is itself a precurser to overstaffing. Here, Snyder's "Rule of 48" prevails. When rating staff performance on a scale of one to 10, six staff members rating at an eight will invariably outproduce the eight staff members who are rated at a six. Note that fewer, more productive staff can each get a greater share of the paraprofessional payroll.

Furthermore, one rule that has never failed me is to never retain a marginal employee. Either a person is motivated to prideful employment or he is not. Don't waste time on this person. It is insanity itself to maintain an underproductive employee for fear that your unemployment tax rate will increase.

Another good rule is that only veterinarians should hire veterinarians. Applicants for a reception position should interview with the existing reception staff. Applicants for technician positions should interview with current technical staff. Your staff should then present the top candidates to you with reasons why any applicant should prevail. This helps ensure that major staff personality clashes do not occur. Staff members also want help to get the job done, not competition to see who can do the least work. All staff should be hired on a probation basis with performance standards strictly maintained and reviewed at 30 days' time.

Yes, I've laid out rules and more rules, but the key to successful management is mutual respect. One of the greatest pleasures is that no staff member leaves for the day without coming to wish you a good night and you feeling able to sincerely thank him or her for helping make the day successful.

A great staff knows what needs to be done and needs no supervision. Employees care that their areas of responsibility are well maintained and take pride in their work. They arrive on time and stay when needed. Successful management means that the practice runs well without the manager. If all team members do what they signed on to do and do it well, then everybody is happy, including clients.

Just remember—no practice runs smoothly all the time, so you're just going to have to get used to it!

Dr. Gerald Snyder publishes Veterinary Productivity, a newsletter for practice productivity. He can be reached at 217 Clinton St., Hoboken NJ 07030; (800) 292-7995; or vethelp2@optimum.net.