A Clear Road To A Bright Future - With Dr. Peter Weinstein
The veterinary field has had turbulent years that seemed to buck the trends in other industries. Where other fields had to scramble to attract business, the pandemic caused an unexpected surge in veterinary call volume, packed schedules, and appointments booked out for months. That's a good thing, right? Not necessarily. In fact, the veterinary field is in crisis and has been for years. With independent practices being swallowed up by big corporations, a lack of qualified veterinary candidates, and a host of mental health issues that perpetually hit this field particularly hard (high suicide rates, compassion fatigue, and more), it's time to take a closer look at how we can make some impactful changes.
After seeing Dr. Peter Weinstein, speak on "Reimagining Veterinary Medicine," we were struck by some of his simple yet profound solutions to many things plaguing this industry. We sat down with him and broke down some of these challenges and the innovative ideas he has to shake things up a bit and, in doing so, help the veterinary industry reemerge stronger on the other side.
What the Veterinary Field Learned in 2020
To say that the transition during the pandemic was seamless for veterinarians and their staff is patently false and understandably so. Curbside service was initially clunky, calls were inevitably missed, and clients and staff alike were left feeling overwhelmed. Call it a come-from-behind story, but all of these changes that needed to be made on a dime forced the hand of those in the industry to use technology that they had been reluctant to embrace in the past.
"The unfortunate thing," Dr. Weinstein notes, "is integrating technology in the face of chaos only adds another variable to the chaos. Whereas, if they had accepted technology before the pandemic, it would have been much easier to accelerate the use rather than just a combination of integration and acceleration."
The other thing that last year taught the veterinary industry is that more doctors aren't always a good thing—and this is no offense to veterinarians! As Dr. Weinstein points out, getting away from doctor-centric practices and leveraging other staff members is the wave of the future. Let doctors do what they do and vet techs, for example, do what they do. This goes hand in hand with the acronym Dr. Weinstein refers to - WONJI - which stands for "Work ON, not just IN, your practice." It means that veterinary practice owners need to get away from the chaos of daily veterinary life occasionally to zoom out.
"WONJI is going out to a mountain top and looking out over the ocean, or looking out over a lake and looking at the big picture, long-term sustainable change, more of a planning base change than a reactionary change. It's about taking time to look at where you are, look at where you were, and figure out where you want to be short-term, intermediate-term, and long-term."
Getting back to the vet techs, Dr. Weinstein even suggests that practices should consider letting vet techs bill for their hours to log this progression. You also have to pay vet techs a livable wage for the area where they live to show them that you value and are investing in them.
"Now, a living wage in Orange County and San Diego may be different from the living wage in Merced and Modesto," Dr. Weinstein points out. "But your veterinary nurses, your veterinary technicians are a valuable contributor to the success of your practice. It really pains me that I was paying employees more in 2000 than some employees were making in 2021. If you invest in an asset, it gives you a return on investment. If you don't, it becomes a liability. We should treat people with respect. We should pay them for the skills that they have and the skills that they may develop. We should pay them for the contributions that they make to the ultimate success of the practice. And we should look to do everything we can to retain them as part of the practice team and give them a career and not just a short-term job."
Don't Fight the Old; Build the New
This is a very timely message from Dr. Weinstein, as we are most definitely at a crossroads. Veterinarians and their staff can return to the old ways of doing things, like handwriting notes and shunning telemedicine. Or we can embrace things like having a transcription nurse in the exam rooms taking notes for the doctor for expediency and telehealth as a means of triage.
Here's Dr. Weinstein's take on building the new:
"There's a quote I love to use: ' What's the difference between a grave and a rut? The depth and the length of time you're in it.' A great many veterinarians coming into the pandemic had just been continuously hastening and deepening their rut. For whatever reason, many of them had to climb out of that rut to survive the pandemic, whether it was scheduling changes, whether it was PPE, whether it was curbside. Now that we have seen that we can make a change going back is not an option. Going forward is a necessity. Way too many practices spend time repairing broken systems instead of preparing for working systems.
One of the other quotes was, 'Prepare, don't repair.' We should be planning what we have done that's worked and how we can integrate that going forward. What we didn't do that didn't work that we continue to do, that we need to get rid of. And how do we really want to see ourselves as an individual practice and then, ultimately, as a profession 5, 10, 20 years down the road?"
Use or Lose Your Space
Not enough veterinarians put enough weight and thought into the layout of their facility and the use of the rooms within that facility. The example that Dr. Weinstein gives is that if a veterinarian opens a practice knowing they don't like surgery, instead of opening a facility with surgery rooms that will ultimately gather dust, consider pairing with a local hospital with plenty of surgery rooms and refer cases there.
As Dr. Weinstein puts it, "Your generalist is not going to do brain surgery on you. Your surgeon is not going to pop a pimple. We could very easily create practices that allow the doctor to focus on those things that they're passionate about and build a physical plan to do so."
It's much more challenging to be profitable when your floor plan isn't optimally utilized. For example, Dr. Weinstein points out that the veterinarian uses ninety percent of hospitals to generate income. As such, when they're in surgery, 90% of the hospital isn't used by the doctor to generate income. Until you have enough doctors to be one doctor in an exam room, another doctor in surgery, and maybe a third doctor in the treatment room so that the x-ray unit and lab equipment are getting used more often, you're paying for assets that are not giving you an immediate return.
Consider a Specialty
As Dr. Weinstein points out, cat-only practices are highly optimized, as there is no larger equipment for dogs or other large animals. You don't need the giant double cages, runs for large dogs, and you can likely even get by with one size of the various cat medications. Focusing on pets that are 20 pounds or less, for example, will significantly lower your inventory.
"So it's just thinking differently," Dr. Weinstein notes. "Whether it's a breed, whether it's a species, whatever the case may be, it's just we don't have to do it the way we've always done it."
20% of Clients Generate 80% of Profits - So Where Do You Focus?
That wasn't a trick question. Of course, you should focus on that 20 percent. But what does that mean exactly?
Here's Dr. Weinstein's take on client focus:
"I am talking about the same way American Airlines treats me because I'm an executive platinum flyer. During the pandemic, many practices had to turn their best clients away because their appointment book was filled. Now, how do you feel about that practice if you're a best client and you have to wait two weeks? You just gave them $10,000 last year in veterinary services, and you've been told you have to wait two weeks. Why don't practices think about that 20% of the clients and make sure they have slots available for them the same day? We used to offer first dibs on our boarding to preferred clients over the holidays. If your clients want to book over the holidays, we ensure that there is room for them because they're the ones who got you where you are. Go with the ones that got you where you are because they will be there when you need them."
You Can't Manage What You Don't Measure
This is something that Dr. Weinstein mentioned during his conference and something that we try to impart to our clients. We know metrics aren't at the forefront of your veterinary-oriented minds like pets or human interaction is, but analyzing them and using them to your advantage are critical to running your practice. As Dr. Weinstein notes, "If you have 10, 12, 15 metrics to look at on a regular basis, you can look for trends. You can use those metrics for goal setting."
As an independent practice owner, you want to examine metrics like:
- Gross Revenue
- The number of daily, weekly, and monthly transactions
- Average client transaction
- The number of specific procedures (dental cleanings, radiographs, lab profiles, etc.)
- Money spent on staff
- Money spent on doctors
- Money spent on inventory
Embrace Telemedicine...To a Certain Extent
Telemedicine didn't just pop up during the pandemic, although it became beneficial during that time. It's been a concept that veterinarians have used or considered using for years. Others, however, dig their heels while maintaining there's nothing that can ever replace putting your hands on a pet.
Dr. Weinstein's take on telemedicine falls somewhere in between:
"Telemedicine is a useful adjunct to the practice of veterinary medicine. In the right situations and with the right clients and patients, it can make a visit quicker, less scary, and still profitable for the practice. You can never replace a physical examination when it can be done; however, a virtual examination may be worthwhile considering certain re-evaluations of conditions, behavioral cases, exotic husbandry questions, and as a tool to determine the severity of a condition (triage)."
Schedule Structured Training For New Employees
This isn't a new concept, but it is one that far too many veterinary practices have discounted and paid the price. They try to train on the fly, and not only does this not work, but the staff members trying to do this training feel overworked and resentful. Dr. Weinstein says, "If training is not planned, scheduled, organized, and maintained, it is haphazard. And if haphazard, it is not structured. Training must be structured and scheduled starting on day one, and training NEVER ends. Have a 30, 60, 90, and 120-day training plan for new hires and an annual training and education schedule for all hires."
And Dr. Weinstein fully admits that there is a lack of people who have previously worked in the field, but he says there's no problem with that, noting that people are like "clay." With a formal, structured training program, you can mold your new hires into the employees you want them to be and continue to coach them to be successful.
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The veterinary field is currently in a bit of crisis, but, as Dr. Weinstein conveys, all is not lost. If you stop returning to what wasn't working and reimagine ways to take the industry into the future, you will make it. Want advice on how to do so? Schedule a GeniusVets demo today.