The Wagging Tail

Often times when asked what I do for a living, I respond by saying, “I am a veterinarian.”  Then I wonder, What does a veterinarian look like? So I qualify my response with, “I work as a veterinarian.”  Either way, the revelation of my career inevitably invokes wonderful stories of beloved Pets. Most people are so happy to talk to a veterinarian!  They hold us in high esteem. They smile with pleasure as they share their stories. Who smiles when talking about visiting a doctor? Our clients!

I am proud to be part of such a well thought of profession.  I often call myself “The Good Doctor” when I tell people that I AM a veterinarian.  And I realize that with my chosen career path comes a certain responsibility to be a part of local, regional, state and national VMAs.
It’s easier as a student. SAVMA is a visible part of our curriculum, and many of us attend the AVMA meetings annually as students. Let’s not forget to do that as graduates! The helm of the associations must eventually pass onto the next generation of veterinarians. YOU are that next generation of bright young veterinarians, and I can’t encourage you enough to become a member of our professional associations after graduation.

Become involved in your local VMA and AVMA. Become a spokesperson in your association that the media can contact for Pet health expertise. Be ready to lobby for veterinary related topics with your local politicos and VMAs. The profession needs you!

Each year, the Georgia VMA hosts a ‘Veterinarian on the Capital Day’ in Atlanta where all GVMA members are invited to the state capital for networking and recognition. On that day, we attend sessions of the state senate and house of representatives, and we receive recognition from each legislative body. When they call us to stand and be recognized as the caretakers of Georgia’s animals, there is palpable pride of self and profession in the air. The governor of Georgia is a veterinarian. He comes down to meet us and takes a photo with the group. It’s pretty cool to be a part of the Georgia State VMA and know that our state values our contribution.

Before you shrug off joining a VMA, think of how you can be a part of representing your profession just by being there. Paying your dues to support your local/state VMA actions will help support our profession in Washington.
 
When attending AVMA there is such a sense of collectiveness. You look around and though everyone doesn’t look like you, they are you. Those other veterinarians share with you a common thread of education, long nights of study, sweat, tears – and most importantly – a common passion. I not only work as a veterinarian, I am a veterinarian. And WE are our profession.

I have provided financing for the purchase of over 150 veterinary practices and millions of dollars of equipment.  I have reviewed easily five times that number of transactions that never got completed.  As I read through these loan applications, I often ask myself whether the applicants really understand the economics of owning and running a veterinary practice.

There is no real “magic” to understanding the basic economic principles that rule the business side of practicing veterinary medicine.  At its core, you need to be able to generate enough cash to service both your fixed and variable expenses plus provide a return on your investment (the purchase price of an existing practice or cost to set up your own practice). 

Fixed expenses are those that occur weekly, monthly and annually and are not related to changes in revenue.  This includes expenses such as rent or the mortgage payment.  It includes other general expenses such as insurance, utilities, office supplies, repairs and maintenance.

Variable expenses are those expenses tied to revenue.  For example pharmaceuticals, medical supplies, support staff labor and veterinary salaries (including that of the owner for their clinical services while working in the practice). 

After accounting for both fixed and variable expenses, the “net profit” is what remains.  There are more expenses, however, that drain on net profit.  The most prominent are interest, depreciation, and paying off long-term debt. For an intriguing article about today’s Veterinary Economic Reality, click here

As I review loan applications, one of the first things I review is the applicant’s personal financial situation.  I apply the same criteria to them that I do to the practice they want to purchase.  What are the applicant’s fixed and variable expenses and will the practice they want to purchase generate enough cash to meet those expenses?  What I find to be most troubling is that many veterinarians applying for practice ownership have piled on fixed expenses to the level that it becomes nearly impossible for a practice to support such a cash load. 

Take, for example, student debt.  I have seen some students graduate with upwards of $200,000 in loans.  If you see 15 Pets per day, five days per week, for the next 20 years, $5.00 of your Average Patient Charge (APC) is going to have to go to paying off just your student loans!  Add in the home loan (or rent), car loan (or lease), insurance, utilities, food and other expenses and generating a true profit from the practice (a return on your original investment) starts looking more difficult.

There are only two things one can do to control the economics of veterinary medicine.  Either control costs or increase prices (margin).  The idea of personal fiscal responsibility needs to be addressed with students and new veterinarians if they have practice ownership as a goal.  They need to understand that it will take sacrificing the things they want today in order to accomplish the goal of practice ownership in the future.  

Did you know that when you open up to your team members, associates and staff at the practice, it actually helps reduce anxiety and stress, along with boosting your well-being? It’s true. Studies have shown it including one from the University of Michigan that appeared in the Science Daily.  The study focused on women specifically. Although the majority of veterinarians entering the field are female these days, I think this theory applies to both genders and is valuable information to know.

There was also an article posted on dvm360.com addressing the same thing. Gabbing, as they referred to it (or bonding) can make you happier and healthier.  The article also mentions gossip but no one condones spreading rumors or that type of behavior in the workplace.

You know, every year at this time, probably like you, I have the same problem. I struggle to keep it together and not bite someone’s head off. Interestingly enough, it was only a few months back, pre-summer, around April/May, that I remember looking forward to the lazy days of summer. But here I am, near the end of August, counting down the days to Labor Day and the stress of the kids returning back to school. I bet that you and a few of your veterinary staff surely can relate to this, having children of your own. Schedules are going to change, rides will be needed, conferences will need attending and so on. When I feel this familiar end-of-the-summer anxiousness hit, I know exactly what to do. I do what I always do when I’m about to lose it. I phone a friend. It always helps. You obviously wouldn’t do this at the hospital but I think conversing about these “common” or shared feelings during a down time, at lunch or between patients is a good way to build stronger, better relationships at the practice. It’s also another opportunity to connect by getting to know your team members on a more personal level.

Think about it. Sometimes the best stress-reducer is simply sharing your stress with someone else. Maybe it’s a complex case or a non-compliant client who is frustrating you, or just merely the day-to-day scramble of running a practice. The act of talking it out – and getting support and empathy from someone else – is a great way of blowing off steam and reducing stress.

It’s never too late to cultivate these important relationships. 

Last week I talked about doctors, whether they are the owner or not, having to balance their role as leader in the team with their role as a member of the team.  This week, I’m continuing the blog on the same subject and am offering some more friendly advice.

Support the hospital’s mission, protocols, standards, policies, etc.  If you’re the owner and the one who sets the policies, this is very easy to do.  If you’re new to the practice and you don’t understand a policy, have the owners explain it again so that you understand the idea behind it and don’t start a “war.”  There’s nothing more frustrating than a grudge between the “new” and the “old” or the “front” and the “back.”  We’re all on the same team, and very early on I banned the use of the phrases “front” and “back.”  I can’t remember the last time I heard such divisive talk.  I also try to get all of my team members to be at least partially cross-trained so that they appreciate the hard job that the “other side” has to do.

Never say “that’s not my job!”  That phrase is demeaning and belittles the employee to whom it’s directed.  Are you really too good to clean a cage or wipe a table?  Everyone who works at the hospital is there for the purpose of helping Pets.  We all need to do whatever is necessary to chip in and get the day’s tasks done so we can enjoy helping Pets while we’re at work and leave at an appropriate time to enjoy our families when we get home.  If you’re constantly busy, your team will want to be constantly busy.

Ask the team members about their weekend or their family.  Let them know that you respect them as individuals and not just as someone to sweep the floors.  Share quick stories about yourself, your Pets, family, etc.  What are your hobbies?  What are their hobbies?  One of my team members bakes cakes as a hobby.  How great is that?  I’ve bought birthday cakes and even an occasional “I love you” cake for no particular reason for my wife.  I think my whole team knows that in my spare time I’m a video game/computer geek.  Obviously there’s a balance to strike between sharing and “too much information” but don’t miss out on the human side of our profession.

If you’re new to the team and an associate doesn’t respect you, make sure to address it quickly, firmly, and respectfully.  Let everyone know that you’re interested in working as a team to take care of the Pets and provide great customer services and not in “bossing” people around.  Also, let them know that ultimately you have the legal and ethical responsibility to provide care for the Pets, so it’s important to find a way for them to respect your position within the hospital as team leader.

You want to be friendly and feel like part of the team, but you don’t want to spend your whole time cutting up and telling jokes.  You want to work efficiently and accurately and friendly.  Joke, tell stories, laugh, listen, live, but don’t forget to work.  Don’t work so hard at becoming part of the team that you forget to lead the team to the finish line.