Efficiencies Can Improve Bottom Line

Running an efficient practice can often help raise the bottom line of income.

Rachael Brugger

Most practicing veterinarians want to be compensated at a higher level of income. The only way to generate more revenue is to increase the number of patients we see per day or increase the average charge per patient. 

The AVMAPfizer study (JAVMA, Jan. 15, 2005) reported the most common way veterinarians increased their income over the past five years was to raise fees and increase the average charge per case seen.

The average doctor charge per case seen is $117, according to the National Commission on Veterinary Economic Issues.  The average number of transactions per full-time-equivalent veterinarian per year is 4,000.

This would translate to a gross revenue of $468,000, the NCVEI reported.

If the typical small-animal veterinarian were able to increase annual transactions to 4,500 and raise the average doctor charge per case seen (increase quality of services) from $117 to $125,  gross revenue would jump from $468,000 to $562,500.

How It Can Be Done

You may be asking, “How can I see more cases? How can I increase the quality of my services?”

To see more cases, we need to increase revisits and new cases. This is possible through a good marketing plan and greater efficiency. 

For example, expand your office hours slightly to allow earlier drop-offs and stay open until 6:30 p.m. to allow later pickups. You can work on drop-offs as time allows during the day. Also make re-visit appointments before the client leaves. 

Allowing clients to make Saturday appointments also will increase visits. Remember to limit the number of scheduled veterinarian hours to 45 per week. 

If the practice has three or more DVMs, the length of the work week can be kept reasonable. If only one or two FTE DVMs are present, adding hours may make a longer work week. 

In this case, the practice owner should consider merging with another practice to obtain at least three DVMs.

Banfield has been evaluating efficiency in its 630 practices and found that having four veterinarians in a practice allows a reasonable 40- to 45-hour work week and a quality of life while covering a seven-day work schedule. 

Quality of life usually involves practicing high-quality medicine, receiving an income commensurate with other similarly trained professionals, having a life outside of work and developing a healthy investment or retirement program.

Other things to consider

To boost efficiency, consider:

  • Seeing more than one patient at a time.
  • Delegating duties to qualified staff.
  • Offering pay incentives.
  • Encouraging the use of pet insurance and wellness programs.
  • Recommending at least two visits a year for each pet.
  • Prepackaging and precouting commonly used drugs.
  • Limiting the work week to 45 hours.
  • Keeping medically current through seminars, online programs, printed material and interactive labs.

It’s Not That Hard

To multitask to the fullest, a minimum of two examination rooms per veterinarian must be available. To increase the quality of service and still see more cases, one must be able to move between two exam rooms and spend a quality 10 to 15 minutes with each client and patient.

The only way to do this is to be able to delegate to well-trained and knowledgeable staff. To delegate, one must be willing to allow staff to do those things they do well (other than diagnose, prescribe, make a prognosis or perform surgery).

By delegating, the client and patient receive your undivided attention during the diagnoses, prognosis and prescribing phases. The staff can get involved in the documentation, treatment, education, etc., while you move to the next room.

Using an incentive plan to compensate both professional and support staff can be beneficial. But incentives can be a negative when not administered correctly. 

Accounting for the specific services provided by each person is sometimes a challenge. and everyone needs to know which services are exempt (i.e. boarding, pet food, non-doctor-ordered refills). It is common to pay veterinarians 18 percent to 25 percent of the gross and pay each technician a competitive salary plus 0.5 percent of the practice’s gross income. 

Incentives in industry work well in most applications and will improve efficiency and quality in veterinary practice.

Semi-Annual Exams

Promoting fee discounts is probably not a wise way to go, as our net profit is usually in the 28 percent to 38 percent range, and providing a discount to the client usually makes us work harder for less money. 

However, the use of pet insurance allows a higher level of care when the client’s policy is paying for 80 percent of some of the services.

Recommending semi-annual physical exams will increase the quality of service and revisit rate. If clients understand that pets age seven to nine times faster than people, the frequency will make sense.

Improving the pharmacy will allow prescriptions to be filled faster and more accurately. The use of precounted vials of commonly dispensed items will speed the dismissal process. 

Restricting the work week to 45 hours and keeping current through continuing education are important efficiencies. 
We make better decisions more quickly when we are rested. We can all work 14- hour days when necessary, but constantly working those hours can lead to burnout. 

Keeping up with the ever-changing veterinary field requires planning and scheduling, too. Continuing education is available on about any day of the week and in any location.

The most efficient form of CE is on the Internet, where you don’t have to leave your practice or home. But hands-on CE has become more popular and requires a trip to a national, regional or local site. Possessing the most current information is a moral, ethical, and legal requirement.

More veterinarians everyday are learning how to get the job done easier and more efficiently while earning a better income. We have raised the level of service to our patients and clients, and now we are learning how to improve our delivery of service to improve our own well-being.

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