Simple tips for your 10 greatest management challenges

Here are the top 10 toughest parts of your job, in order, with advice for solving them from our Editorial Advisory Board.

Trouble keeping good team members? Don't be afraid to fire bad ones. Faced with clients who won't comply? Build personal connections with them. Not enough time in the day to handle business? Create your own all-star team of advisors. Every frustration you told us about in our most recent Veterinary Economics Reader Assessment has a solution. Enjoy the answers from these top-notch practitioners and consultants.

1 Managing employees

Your top challenge in practice is dealing with your team: hiring and training them, paying and motivating them, communicating effectively, and handling conflict.

You said:"How am I supposed to raise the morale of 30-odd technicians on my own?"

Solutions: Shawn McVey, CEO of consulting firm Innovative Management Solutions, offers these team-building strategies:

> Be slow to hire and quick to fire. "Until we stop hiring anyone who's breathing and quit rewarding team members for seniority rather than skill, teams will suffer," McVey says. Devote the time you'd spend trying to get a nonproductive team member up to snuff in hiring a better one.

> Don't burden good employees with mediocre ones. When responsible team members have to work with others who aren't doing a good job, it sends a message that management doesn't value quality and accountability.

2 Client compliance

Winning the silver medal for daily practice frustrations is client compliance. It can be hard to stand up for your medical recommendations when everybody seems to be turning them down.

You said:"It's hard dealing with clients who don't want to follow my recommendations but want me to make their pet better."

Solutions: Dr. Fred Metzger, DABVP, owner of Metzger Animal Hospital in State College, Pa., says you can't fix everything by creating a good relationship with clients, but it definitely helps.

> Introduce yourself as Dr. X then tell clients to feel free to call you by your first name. If they've been referred to you, ask them some casual questions, even just occupation. Noting what you have in common and showing an interest in the client will make him or her more comfortable.

> Don't take difficult clients personally. Everyone has bad days, and pet owners have problems just like you. Also, having a sick pet can put anybody in a bad mood.

3 Running the business

The third-most challenging aspect of veterinary practice is business management. If you have little or no training in the financial aspects of owning or working in a practice, you're not alone.

You said:"My exposure to business in veterinary school was minimal. I feel unprepared to handle the business side of things."

Solutions: Mark Opperman, CVPM, owner of veterinary consulting firm VMC Inc. in Evergreen, Colo., says you don't have to be a business genius. Just surround yourself with a good team:

> An accountant can follow your financial progress, help reduce your tax liability, make sure you're following all the applicable state and federal financial regulations, and help with personal finances.

> A lawyer can handle contracts and any veterinary and workplace legal questions.

> A practice manager can tackle staff scheduling, evaluations, and implementing new business ideas.

> A business consultant can help ensure your practice's profitability, operations, and efficiency.

4 Managing time

Your fellow doctors told us they're struggling to find the time to run their practices and achieve work-life balance.

You said:"I never have enough time to take care of payroll, taxes, bookkeeping, financial planning, and so on."

Solutions: Understand your priorities, says Dr. Ernest Ward Jr., owner of Seaside Animal Clinic in Calabash, N.C. There's no gimmick in the world that can magically get you extra hours in the day. But knowing what you value can make all the difference. Staying healthy with exercise and good nutrition, working regular hours (barring emergencies), and making time for loved ones will happen if you schedule for these things and recognize the consequences. If you want to get out of work at 6 p.m., you'll have to say no to the client who wants their vaccination at 6:15 p.m. Think hard about your ultimate objectives, and let them guide you.

5 Life as an associate

Associates sometimes feel they get no respect. It's hard to talk to their bosses, and clients only want to see "the owner." It's enough to give some young doctors the blues.

You said: "I lack confidence to be a leader in the practice. I have the knowledge but not the social skills."

Solutions: Dr. W. Andrew Rollo, an associate at Madison Veterinary Hospital in Madison Heights, Mich., says you're not alone. Confidence leads to self-respect, and owners and team members pick up on that. But confidence only comes with experience. If you feel like you've been thrown into the water to see if you can swim, make sure you have a buoy within reach: a classmate, a mentor, or a trusted colleague. If you're shy, take command of the exam room: Know the names of the client and pet, and share what you're thinking with clients. Talk like an expert—you are one!

6 Keeping up with change

The sixth-most challenging part of veterinary practice for you was staying on top of new workplace laws and innovations in medicine.

You said:"How do I keep up with all this reading?"

Solutions: When Dr. Jim Kramer, CVPM, owner of Columbus Animal Hospital in Columbus, Neb., sees that something isn't working in his practice or he needs information on a topic, he turns first to the Web. It's easy and instant. Next, he checks professional journals or calls one of his veterinary colleagues or meets up with them at a conference. He often returns from these events with so many great new ideas that his staff and partners "cringe" when he walks in the door. "Change is never easy," he says. And finally, when he needs to brush up on workplace safety and OSHA compliance, Dr. Kramer checks with AAHA, the OSHA Web site, other online resources, and safety consultants.

7 Charging appropriately

Setting fees is a big headache for many veterinarians.

You said: "How do I keep prices down for the client but high enough to make a living for myself, my associates, and my team?"

Solutions: First, charge for everything you do, says Denise Tumblin, CPA, owner of Wutchiett Tumblin and Associates in Columbus, Ohio. That way there's less pressure on you to raise fees to grow your practice. Use published resources for guidelines in pricing your services. You can get data in Benchmarks 2008: A Study of Well-Managed Practices, from Veterinary Economics and Wutchiett Tumblin and Associates (available in late August). Other notable resources include AAHA's Veterinary Fee Reference and the data collected at NCVEI's Web site (ncvei.org).

8 The recession

This economic downturn has many of you worried. You ranked this is as the eighth-most challenging aspect of practice today.

You said: "Clients' financial frustrations and the unfortunate economic reality today dictate the quality of medicine I can practice."

Solutions: Don't panic, says Gary Glassman, CPA, a partner with Burzenski and Co. in East Haven, Conn. His advice is to build strong bonds with your clients and sock away a little extra cash for slower months. Prepare a practice budget and use it to plan expenditures. And make sure your reminder system is working. If not, maybe you need to try calling, sending postcards, or e-mailing— anything you haven't tried yet. Follow up with clients and educate them even more about why it's still important for their pets to see you at least yearly.

9 Cash flow

The cash comes in, the cash goes out. Where does it all go? Veterinarians want to know.

You said:"It's always a challenge to make ends meet."

Solutions: If this is you, then Dr. Karen Felsted, CPA, CVPM, the new CEO of the NCVEI, says you need something important from your accountant: a cash-flow statement. It shows the sources and uses of cash in your practice. Very profitable companies can be cash-poor. Another important tool is a cash-flow budget, which shows your projected cash inflow and future usage. It lets you plan for times when you'll be short and need a line of credit to pull through.

10 Attracting clients

Businesses of all stripes regularly lose clients to competitors or relocations. The tenth-biggest challenge for veterinarians is finding new ones to replace them—and grow their practices.

You said:"I need more clients willing to pay for quality medical care."

Solutions: You need a multimodal approach, says Dr. Jeff Rothstein, MBA, president of The Progressive Pet Animal Hospitals and Management Group in Michigan. Knock-their-socks-off service, which creates word-of-mouth referrals, is most important. Extended hours, community activities, advertising, and partnerships with high-quality pet stores can also help to grow your practice.