Blackwell's Five-Minute Veterinary Practice Management Consult, 3rd Edition

Editor-in-Chief and Consulting Editors

Contributors

Preface

About the Companion Website

Section 1 - Marketplace

1.1 Models of Veterinary Practice

1.2 Challenges to the Profession

1.3 Trends in Companion Animal Veterinary Practices

1.4 Veterinary Trade Areas

1.5 Today’s Pet Owner

1.6 Today’s Veterinarian

1.7 Today’s Veterinary Students

1.8 Internships and Residencies

1.9 Today’s Veterinary Paraprofessionals

1.10 Veterinary Staff

1.11 Functioning as a Healthcare Team

1.12 The Differing Perspectives of Practice Teammates

1.13 Generational Differences

1.14 Gender Issues

1.15 Personality Profiling

1.16 Value Disciplines

1.17 Practice Management Support Professionals

1.18 Stakeholders and Strategic Partners

1.19 Importance of the Human-Animal Bond

1.20 Mergers and Acquisitions

1.21 Corporate Veterinary Practices

1.22 Not-for-Profit Veterinary Hospitals

1.23 Housecall and Mobile Practices

1.24 Hospice and Palliative Care

1.25 Specialty and Emergency Centers

1.26 Equine Practice Management

1.27 Food Animal Practice Management

1.28 Mixed Animal Practice Management

Section 2 - Administrative Management

2.1 Workplace Management

2.2 Organizational Charts

2.3 Managing People

2.4 Working in Teams

2.5 Motivating the Healthcare Team

2.6 Accountability

2.7 Change Management

2.8 Compassion Fatigue and Burnout

2.9 Moral distress and ethics exhaustion

2.10 Compromise fatigue

2.11 Making Meetings work

2.12 Leadership

2.13 Leadership fatigue

2.14 Implementation: Getting it done

2.15 Emotional Intelligence

2.16 Finding the right fit

2.17 Negotiating 101

2.18 When to hire an office manager/administrator

2.19 Staff performance planning (proactive goal setting)

2.20 Staffing Budgets

2.21 Operations Manuals

2.22 Procedure Manuals

2.23 Enhancing Doctor Productivity

2.24 Enhancing Team Productivity

2.25 Appropriate handling of medical errors

2.26 Changing organizational culture

2.27 Practice Insurance Needs

2.28 Employee Benefit Programs

2.29 Not-for-profit foundations

Section 3 - Human Resources

3.1 Compensation

3.2 Benefits

3.3 Wage and Benefit summaries: the whole package

3.4 Employee Bonus Criteria Design

3.5 Employee-related costs

3.6 Continuing education benefits

3.7 Effective Staff Recruitment

3.8 Screening potential hires

3.9 Staff Orientation (Onboarding and Integration)

3.10 Staff Training

3.11 Structured on-the-job training

3.12 It’s Not Your Job…It’s your responsibility

3.13 Leveraging Staff

3.14 Staff development

3.15 Engaging Staff

3.16 Effective coaching for the exam room

3.17 Mentoring

3.18 Staff scheduling options

3.19 Staff performance evaluations

3.20 Staff Turnover and Retention

3.21 Employee Manuals

3.22 Measuring your HR performance

3.23 Office Politics

3.24 Conflict Resolution

3.25 Dealing with difficult employees

3.26 Effective disciplinary protocols

3.27 Personnel Records

3.28 Terminating Staff

Section 4 - Client Relationship Management

4.1 The Basics of Client Service

4.2 Client Service Strategies

4.3 Exceptional client service

4.4 What clients expect from their veterinarian

4.5 Meeting the needs of pet parents

4.6 Client perception and learning

4.7 The Client’s Buying Journey

4.8 Pet-Specific Care (Personalized Medicine)

4.9 Lifelong Excellence in Health Care

4.10 Personalized Pet Profiles

4.11 Compliance and Adherence

4.12 Creating a client-centered hospital

4.13 Creating a feline-friendly focus and facility

4.14 Developing a fear-free hospital

4.15 Client appointment scheduling

4.16 Client Reminder Systems

4.17 Maintaining regular client contact

4.18 Telephone Service Management

4.19 Measuring Client Satisfaction

4.20 Client Rewards Programs

4.21 Client Retention

4.22 High touch and high tech customer service

4.23 The extended hospital team - making referrals work

4.24 Telehealth

Section 5 - Communication

5.1 Effective client communication

5.2 Identifying client communication styles

5.3 Speaking as a professional

5.4 Making clear client recommendations

5.5 Translating medicalese

5.6 Shared decision making

5.7 Posing client questions effectively (Open-ended inquiry)

5.8 Reflective Listening

5.9 Non-verbal communication

5.10 Empathy

5.11 Harnessing the power of negativity

5.12 Discussing pet-specific care

5.13 Discussing finances

5.14 Discussing behavior

5.15 Discussing diet and nutrition

5.16 Discussing oral health

5.17 Discussing pain management

5.18 Discussing anesthetic risk

5.19 Giving and receiving feedback

5.20 Delivering bad news

5.21 Dealing with an angry client

5.22 Discussing quality of life and end of life issues

5.23 Dealing with a grieving client

5.24 Dealing with a crisis

Section 6 - Marketing Management

6.1 The Big Picture: Marketing, Advertising, Promotion and PR

6.2 Giving Clients what they want most

6.3 Better meeting the needs of existing clients (Internal Marketing)

6.4 Attracting new clients (External marketing)

6.5 Defining marketplace opportunities

6.6 Marketing Plan

6.7 Basic tools of marketing

6.8 Demographic Assessment

6.9 Client and Patient Segmentation

6.10 Target Marketing and Targeted Client Outreach

6.11 Push versus Pull Marketing

6.12 Practice Positioning

6.13 Branding

6.14 Emotional Branding

6.15 Practice Differentiation

6.16 Internal Team Marketing

6.17 Professional Promotion and Publicity

6.18 Client Education Tools

6.19 Paid Advertising

6.20 Personalized marketing

6.21 Client Focus Groups

6.22 Outbound Telephone calls

6.23 Measuring marketing performance

6.24 Dealing with the media

Section 7 - Financial Management

7.1 Time Value of Money

7.2 Financial Statements

7.3 Measures of Liquidity, Solvency, and Profitability

7.4 Getting the most out of your accounting professional

7.5 Analyzing client transactions

7.6 Benchmarking

7.7 Data you should be reviewing regularly

7.8 Key Performance Indicators (KPIs)

7.9 Making valid comparisons between practices and services

7.10 Compensating Owners in Multi-Owner Practices

7.11 Understanding Practice Profitability

7.12 Pricing strategies (Markup versus Margin)

7.13 Breakeven Analysis

7.14 Activity-based costing and cost allocation

7.15 Internal Accounting Controls

7.16 Return on investment from Practice Ownership

7.17 Perquisites (Perks) of Practice Ownership

7.18 Forgotten costs of doing business in a veterinary hospital

7.19 Capitalization and Depreciation

7.20 Accounting closing processes

7.21 Tax planning

7.22 Employee Stock Ownership Plan (ESOP)

7.23 Buying a Practice

7.24 Buying into a practice, as a partner

7.25 Practice sales: Planning, Structure, and methods to minimize taxes

7.26 Planning for the sale of a Practice

7.27 Selling to a corporate entity

Section 8 - Cash Management

8.1 Revenue streams in veterinary practice

8.2 Revenue Budgets and Forecasts

8.3 Increasing the top line in practice

8.4 Expenses in veterinary practice

8.5 Managing General and Administrative Expenses

8.6 Improving the bottom line (profit) in practice

8.7 Payroll Management

8.8 Ordering Inventory Economically

8.9 Accounts Receivable issues

8.10 Getting paid for services rendered

8.11 Pet Health Insurance

8.12 Payment (Wellness) Plans

8.13 Third-party Financing

8.14 Digital Wallets

8.15 Cryptocurrencies

8.16 Credit and Collections

8.17 Discounting

8.18 Practice Reinvestment

8.19 Borrowing Money

8.20 Buying versus Leasing

8.21 Controlling Cash flow - Budgeting

8.22 The EFT Payment Process

8.23 Value-add Tax (VAT) and Goods and Services Tax (GST)

8.24 Cash Control: Preventing Embezzlement

Section 9 - Operations Management

9.1 Medical Records and patient documentation

9.2 Patient and Procedure Logs

9.3 Standards of Care and Care Pathways

9.4 Continuity of Care

9.5 Profit Centers

9.6 Value-added analysis

9.7 Continuous Quality Improvement

9.8 Digial Imaging Systems

9.9 Laboratory considerations

9.10 Medical Equipment and fixtures

9.11 Effective Inventory Management

9.12 Inventory Management - Nutritional Products

9.13 Medication Dispensing, Compounding, and Prescribing Practices

9.14 Medication Dispensing, Compounding, and Prescribing -Legal Considerations

9.15 Pharmacy management (as a profit center)

9.16 Retail Sales - The Art and the Science

9.17 Veterinary feed directives

9.18 Adding Emergency Services

9.19 Integration of hospice care into practice

9.20 Kennel Management(as a profit center)

9.21 Waste Management

Section 10 - Information Technology (IT)

10.1 Information technology in Veterinary Medicine

10.2 Selecting Computer hardware

10.3 Selecting Computer Software

10.4 Selecting financial/Accounting Software

10.5 Cloud-based solutions

10.6 Keeping technology in perspective

10.7 Information Security: Backing up and archiving your system

10.8 Cybersecurity and Network Security

10.9 Blockchain

10.10 Paperless Practice

10.11 Electronic Communication - email and texting

10.12 Digital Marketing Strategies

10.13 Web Sites

10.14 Search Engine Optimization (SEO)

10.15 Paid online advertising

10.16 Social Media

10.17 Mobile Applications

10.18 Patient Portals

10.19 Protecting and defending your online reputation

10.20 Measuring performance of digital media campaigns

10.21 Technology: Redefining the Client Visit

10.22 Online retail - Making it work

10.23 Virtual team training

10.24 Internet Use Policy

10.25 Digital communication policies for staff

Section 11 - Facility Management, Design and Construction

11.1 Contemplating practice ownership - Getting started

11.2 Building, buying or Leasing?

11.3 Asset Ownership (RE, building, equipment, etc.)

11.4 Financing Basics

11.5 Selecting a site

11.6 How large should a clinic be?

11.7 The construction process and working with architects

11.8 Zoning and Permitting

11.9 Managing Construction Costs

11.10 Practice renovations

11.11 Leasehold improvements

11.12 Designing with the Patient in mind

11.13 Client/Patient Flow

11.14 Integrating technology

11.15 Noise and odor control

11.16 Heating, Ventilation and Air Conditioning (HVAC)

11.17 Flooring

11.18 Sustainable Design for Veterinary Practices

11.19 Referral and Emergency Facilities

11.20 Pet boarding and luxury accommodations

11.21 Large Animal Facilities

Section 12 - Practice Safety

12.1 Basics of Meeting Practice Safety Requirements

12.2 Practice Safety Needs

12.3 Client Safety

12.4 Animal-related injuries at the workplace

12.5 Security issues for hospital and staff

12.6 Developing and Implementing a Safety Plan

12.7 Hospital Safety Manual

12.8 Radiation Safety

12.9 Work-related accidents and Worker’s Compensation

12.10 Emergency Preparedness for Veterinary Professionals

12.11 Emergency Plans

12.12 Controlled Substances

12.13 Adverse drug event reporting and pharmacovigilance

12.14 Suicide in the Veterinary Profession

Section 13 - Legal Issues

13.1 Veterinary Practice Legal Needs and Dealing with Attorneys

13.2 Informed Consent

13.3 Malpractice

13.4 Unprofessional Conduct

13.5 Privacy Policy and Confidentiality

13.6 Identity Theft prevention programs (red flag rules)

13.7 Employment contracts

13.8 Partnership agreements

13.9 Buy/Sell Agreements

13.10 Employees versus Independent Contractors

13.11 Non-competition

13.12 Legal duty to refer

13.13 Extralabel drug use

13.14 Disability Law

13.15 Workplace Harassment

13.16 Fair Labor Standards

13.17 Employment legalities - Bias

13.18 Accommodating Employees with Disabilities

13.19 Ownership versus Guardianship

13.20 Pet Trusts and Wills

13.21 Animal Abandonment

13.22 Animal Cruelty

Section 14 - Planning and Decision Making

14.1 Career Planning

14.2 Professional Development Plans

14.3 Resume + Cover letter (+ sample in appendix)

14.4 Curriculum vitae (+sample in appendix)

14.5 Strategic Planning and Implementation

14.6 Identifying and Solving Problems

14.7 Time Management

14.8 Keeping up with the pace of change

14.9 Mission and Vision Statements

14.10 Business Plans

14.11 Business Entity Structures

14.12 Fractional Practice Ownership

14.13 Determining a practice’s worth

14.14 The Valuation Process

14.15 Practice Value Rules of Thumb

14.16 From associate to owner

14.17 Managers as practice owners

14.18 Risk Management Issues

14.19 Debt Management

14.20 Business contigency planning

14.21 Succession Planning

14.22 Gifting practice ownership

14.23 Retirement Planning

14.24 Your next career

Section 15 - Appendices

15.1 Finding more information on practice management topics

15.2 Sample resume and cover letter

15.3 Curriculum vitae

15.4 Business Plan

15.5 Marketing Plan

15.6 Abbreviations

15.7 Glossary

Index

Lowell Ackerman, DVM, DACVD, MBA, MPA, CVA, MRCVS, is a global consultant, author, and lecturer based in Westborough, Massachusetts, USA.