Why is management scary?
Humans are instinctively afraid of the unknown, and after spending five or six years learning clinical skills, we are released into a small business world. It’s something we were never trained for, and we are expected to learn it on the job.
Which is the same as giving your accountant a surgery kit, and asking them to spay a cat, and to figure it out with on-the-job training. It’s a crazy example, of course, but that’s what we are expecting veterinarians to do after graduating.
What is management, anyway?
“Management is the process of: getting the things you need, delivering it to the people you employ, so they can do the stuff you need them to do, at the time it needs to be done.”
What does that mean to a veterinarian?
The purpose of a veterinary practice: is to get the pet, the vet, and the owner into the same room at the same time, with the tools and skills to perform veterinary medicine. (The Veterinary Trinity)
Everything we do in a veterinary practice needs to be aimed at making this happen.
If management is so simple, why is it so hard? The fundamental challenge in veterinary management is that we are scientific doctors who are working in a very emotional world. Our end goals are usually animal welfare, pain relief, and the emotional bond between humans and animals, and most of us received NO formal training in how to organize work to make this happen in an efficient, low-stress way.
So we do things the way they’ve always been done, and there’s a feeling that something’s just not working right. And that’s a subjective feeling, which we are investigating with objective methods! Like pain, it’s hard to know exactly how much something hurts, but we can feel when it hurts less!
Our job as clinical managers is to diagnose and treat our veterinary practices, just like if they were one of our patients. You can’t yell at a fever, and working harder won’t make the white blood cells kill more bacteria.
Symptoms and Clinical Assessment:
Clinics have symptoms, just like patients. Low profit, high stress, lots of people quitting, clients complaining – these are symptoms of an unwell clinic. Sometimes it’s not even a definite symptom – it’s a feeling that „something is not right”. So as a business owner, you need to take the history, examine the patient, assess the clinical parameters, and decide on the diagnosis, or treatment. Sound familiar?
Clinical Parameters:
Clinical parameters in a veterinary practice are called KPIs.
Note: Everything CAN be a KPI, but not everything SHOULD be a KPI! Make sure you are picky about what you measure, otherwise you are spending all your time measuring things instead of running the practice. Good KPIs include active client numbers, daily appointment numbers, the amount of money your clients spend it with you, patient numbers – but outside of these, you can have your own KPIs, if they are helpful for your business. Measure parameters that mean good things or bad things are happening to your business.
When clinical parameters are bad for a long time, you start developing symptoms in an animal patient. When KPIs are bad for a long time, you start developing symptoms in your workplace. We measure KPIs for the same reason we measure clinical parameters – we want to fix things before the symptoms develop.
Systems – just what are they good for, anyway?
A successful veterinary practice is systems based. What does this mean? It means that most of the decisions are pre-made. You and your colleagues have made a plan to predict most of the decisions in the daily work. Your daily routine should never be a surprise. You don’t have to worry about what problem will crop up, because you’ve made a plan to make sure that people know what to do when they happen.
Definition: A system is an organized, pre-planned way of working, that is intended to get something done. A good system is sustainable, repeatable, and should be focused on the outcome, not the system.
Impossible? Let’s look at the physiology of an animal. There are no creatures that decide how fast their heart should beat, or how wide their pupils are. Sustainable, reliable systems run things, so they can concentrate on the daily priorities, like eating, drinking, and thriving.
Think of the organ systems – our lungs bring in air, our kidneys excrete, our gut absorbs nutrients. Our muscles contract, to move our arms and legs. We don’t think about the individual organs, but we know when they don’t work! (just like our systems in our veterinary clinic.)
If you have no systems, or you have systems that aren’t working well, you have symptoms. (Just like in our patients!)
Business Goals: The end purpose of a clinical system.
One giant goal is hard. Lots of small goals are easier to accomplish. You walk a kilometer, one step at a time.
Break down your big plans into small steps. How do you eat an elephant? One bite at a time.
Big goal: Lambert’s Law – A veterinarian needs to generate 5 times their annual salary in fees to be a consistently profitable business. (Alison Lambert MRCVS)
(It is possible to exceed this over the short term, but it is not sustainable.)
This may be a very big number, if you want to be paid well, and you need to split this up between 600-800 active clients, over a single year. How many clients will you need to see every day to make this number happen? How much will they need to spend? How do we make this happen, as smoothly and seamlessly as possible? We can answer these questions – it won’t be easy, but the payoff is definitely worth it!
Your goal as a clinical manager – because that is what we are – is to develop a sustainable, productive, and healthy veterinary practice, producing a good living for you, and good veterinary medicine for your patients: because a well-run clinic means better medicine for our animal companions – and isn’t that what it’s all about?