Providing client convenience: It's no small matter

Friday morning

Dr. James Brooks turned over in bed and looked at the clock. It was 8:05 a.m. He was a little late but thought he could make it to the clinic on time. He quickly headed to the bathroom to wash up and brush his teeth. He looked in the mirror — same face, different day. He laughed nervously because it really wasn't the same face. It was a suddenly aging facade marred by the daily stress of being a solo practitioner in a changing veterinary world. He had never married. His apartment usually was a mess — cleaned only when circumstances dictated.

After a quick shower, he hastily shut the front door and jumped into a 5-year-old sedan.

Heading down Elm Street, he shook his head and said aloud to himself, "What is going wrong down at the hospital? We were busy last year but it's a little down this year, and I am doing everything I can to bring it up to speed."

His mind wandered to the veterinary meeting he was to attend this weekend. Jim had fallen behind in continuing education and needed the hours to maintain his license. He knew he'd enjoy the conference but wondered if being absent another weekend would present problems. He was away the previous weekend to attend his sister's birthday party; it had been a great time with family and friends.

Dr. Brooks had started closing on Saturdays out of self-preservation. He still came to the hospital twice daily to check on animals when he was in town.

He turned into the parking lot at 1555 West Park — the Springdale Animal Clinic.

Kendra met him at the door. She was the clinic's "gal Friday," an over-achiever who was on top of every situation. She never seemed to get sick and was very efficient.

Susan, his other full-time employee, mostly worked in surgery.

"Susan called in sick this morning. It's just you, me and the cat," Kendra said.

The feline in question was Fred, a feckless 18-pound clinic cat that James was not always proud of. Fred often would show up unannounced in an exam room while Dr. Brooks was delivering a rousing exhortation on feline obesity to some "food-enabling" client. Forthwith, things would not go well.

Dr. Brooks was in another bind. His best client, Wayne Battle, had called just after closing last night and wanted to board Willie and Wanda, his two nervous German Shepherds, over the weekend.

Wanda was diabetic and needed insulin twice daily. Willie had bouts of bloody diarrhea when boarded and needed oversight. He couldn't be separated from Wanda or the diarrhea became unmanageable.

Wayne was told that Dr. Brooks would be gone for the weekend but that Jenny should be able to treat his pets. Kendra said she would double-check with Dr. Brooks in the morning.

The morning conversations

"Any calls I need to know about?" Jim asked.

Kendra frowned slightly.

"Wayne Battle called. He was very nervous about you being gone over the weekend and was asking whether Jenny 'knew' his dogs' situation."

Jenny, the kennel attendant, was somewhat new to the practice and Mr. Battle had never met her.

"Did he say he was going to bring Willie and Wanda in?

"Didn't really say, but will call back later."

"Anybody else?"

"Two others. Sandra Bramlett called to ask if there is a different heart medication for 'Samson' that she could use. She wants something chewable and asked whether she could bring his heart pills back for a refund."

"Drat," Jim intoned, "we just bought a ton of that medication last week. There is no chewable, and a liquid medication is not available yet."

"Sheldon Whistleton called, asking about a Saturday appointment. I, of course, told him you would be gone tomorrow and that we have been closed on Saturdays now for a year. He was shocked and said he always has come on Saturday. He says he has to drive 15 miles to get here, but works all week and can't come in any other time."

"Any other good news?" Jim asked with unmasked sarcasm.

"Well, I guess the good news is that everyone wants to see you this morning. Word must have gone out on the 'war drum' that you were leaving town. Everyone wants in and we are now full of appointments," she beamed.

Just then the phone rang and Jim retired to the back to look over the hospital patients.

"Springdale Animal Clinic," Kendra announced.

"Hello, this is Gladys Nelson (a moment of hesitation). Scruffy is vomiting and I would like to see Dr. Brooks immediately."

"I certainly understand your situation. Dr. Brooks is full this morning, but you can come in and we should be able to work you in within the next hour or so."

"I don't think this can possibly wait. Besides I have a hair appointment at 10:30. It was her only opening in the next three weeks and I had to take it."

"Would you like to drop Scruffy off and pick him up later this afternoon?" offered Kendra.

"Well, the problem with that is that after my hair appointment I am having lunch with the Red Hat Ladies. Then my husband is picking me up and we are leaving for Las Vegas," she sniffed.

"You could leave Scruffy here for the weekend." Kendra tendered.

"Oh, we want to take her with us to Las Vegas. We have a standing reservation with "Doggie Land Spa and Resort." It is sort of a condominium and we need to use up all our 'Doggie minutes'. Each condo run has a lotto number assigned to it. If your run shows up in the lobby TV when you return, you get a bazillion free 'doggie minutes' for the next trip."

Kendra had heard enough.

"I'm sorry but the doctor is full this morning."

Kendra heard a click on the other end. She stood and looked at the waiting room. It was rapidly filling.

She started wheeling clients into rooms, answering phones and processing pharmacy requests. It was going to be a busy day — for a change. Business had been very slow in recent months.

Meanwhile, Dr. Brooks was acting as both doctor and assistant both in and out of the exam room. Kendra did her best to fill the rest of the work duties as lunchtime neared.

Then more calls started to flood in.

They included:

• Gladys Nelson calling back, asking that her records be faxed to St. Elsewhere Animal Hospital.

• Wayne Battle wanted the "shot records" called over to St. Elsewhere, where he was told that an intern stayed overnight on weekends in the kennel ward.

• Sandra Bramlett left a message while Kendra was in an exam room. She said she had found a chewable heart medication on the Internet. It mentioned something about heartworms. She wanted to know if that would work instead. Could they call her back tomorrow (Saturday), since she would be out the rest of the day?

• Another caller asked, "Do you now have $4 prescriptions for amoxicillin like Wal-mart?" She wanted to bring her amoxicillin back from last year. The pharmacist had told her it was the same thing.

The weekend

Dr. Brooks managed to escape and have a weekend with his colleagues. Most were in solo practice as well. The question on all their minds was this: "Client numbers are down, but we are busy. Why?" No one really knew, but they agreed there were a lot of terrific new toys in the exhibit hall.

Monday morning, Springdale Animal Clinic

"Morning, Kendra. What are we doing today?"

"Well, Doc, we are dead in the water. Susan called and is coming in to talk with you." Every vet knows what "wants to talk with you" means, coming from an employee. It means that extra time will be spent looking for and training a new employee while overworking the current staff (including the owner).

Susan appeared from the front and nervously asked for a bit of privacy. Dr. Brooks offered the exam room in resignation —knowing full well the solemn nature of the impending conversation.

Susan began quietly.

"Dr. Brooks, I have been offered a job at St. Elsewhere. It is so convenient. I just can't afford the gas to drive across town anymore."

"Can you give us two weeks' notice? I have several surgeries scheduled in the next few weeks."

"I-I am s-sorry," Susan stuttered. "I start there tomorrow."

He frowned and thought to himself, "How convenient."

Solo practice challenges

Although it may be a little premature to declare an end to solo practice, it is on its way out eventually for a number of reasons. Among the leading reasons is life-balance issues for the practitioners themselves.

Solo practice made sense in those areas (suburbia) where clients can avail themselves of many convenient choices: emergency and critical-care centers, modern boarding facilities, specialists and an array of generalists.

Solo doctors there have enjoyed the convenience of emergency centers and specialists as well, and this has worked to their advantage for a number of years now. Remember the mantra — location, location, location? It is still true today and likely will always be true.

In places where specialists and emergency clinics are further away, it is difficult for young veterinarians to get started and still maintain any semblance of a balanced life. There it makes more sense to have multiple veterinarians in one location and for practices to share emergency duties.

Another strike against solo practice is the overall ability to hire and retain key employees. Today's employees are looking for flexibility (convenience) and the possibility of promotion and stability. All that is in short supply in a solo practice. Certified technicians naturally gravitate to the bigger, multi-vet practices.

Clients have changed as well. They are much less practice-oriented and much more convenience-oriented. Multi-vet hospitals can offer the convenience orientation so much in evidence by the current customer base because they can spread client demand (convenience) over many people and hours.

Client retention

For years it has been known that customer retention was a cheaper option than acquisition. Early research suggested it cost 10 times more to acquire a new customer (than to retain a current customer).

Most practices, and thus owners, are looking for new clients. This is especially evident when a client appears with paperwork in hand from a nearby colleague and the client is unhappy with your colleague's approach for whatever reason.

All of a sudden the veterinarian becomes super-vet and is willing to bend over backwards and explain each little nuance of the patient's condition — all in an attempt to welcome these nomads into the practice and justify their new choice in veterinary care. But this is not a particularly good business model.

A better approach is retention of current customers. Our clients can be very loyal but more often than not the majority are looking for convenience and fast and efficient service.

How else can you explain the kind of morning our fictitious Dr. Brooks experienced (and that each of us has experienced from time to time)?

Our customers are just like us. When we leave our practices, we are looking for the shortest line at the fast-food store and someone who will quickly and efficiently answer our questions when we are in a hurry (which is most of the time). We are they.

Is the client always right? Of course not, but they are still the client. They still pay the bills.

The best approach is to try to create client satisfaction and retain your sanity.

Client satisfaction can only come by meeting their needs. In today's world you meet client needs by being available and providing as many services as you can ethically provide. This means being open, having product and services when the client needs them.

High-quality, 24-hour veterinary care is beyond the ability of almost every soloist. Therein lies the rub. In other words, your good clients want you to take as much time off from your practice as you need.

Just don't do it when their pet is sick.

Takeaway lesson for the 21 st Century

In the long run, to have a long run you must hire an associate and create systems. Then you will be able to create more convenience for your clients. Otherwise you will just watch it all die a slow death.

Dr. Lane is a graduate of the University of Illinois. He owns and manages two practices in southern Illinois. Dr. Lane completed a master's degree in agricultural economics in 1996. He is a speaker and author of numerous practice-management articles. He also offers a broad range of consulting services. Dr. Lane can be reached at david.lane@mchsi.com