Happy New Year! I’m guessing that many of us in the veterinary community have resolutions regarding our careers, our finances and our businesses — or the businesses we hope to own someday. That’s why I’m starting 2016 with a “Three Questions for …” feature on Mark Opperman, CVPM, founder of VMC Inc., the well-regarded veterinary practice management consulting firm. I am sure most in the veterinary community know of Mark Opperman already, and many have gleaned helpful knowledge from his work. But if you don’t know of him, here is some information from his website:
In 1983 Mark Opperman answered the call to guide veterinary practices to a higher level of management. […] In 25 years, he has consulted with more than 1,500 veterinary hospitals throughout North America, providing timely, practical assistance in such matters as hiring associate veterinarians, establishing partnerships, developing exit strategies, addressing employee issues, and focusing on profitability and efficiency.
Mark is in demand as a consultant, as an author and as a popular speaker at veterinary conferences and meetings. He is also a frequent contributor to the veterinary media, such as DVM360. I am proud of Nationwide’s work with Mark to help members of the veterinary community make good decisions for themselves and their practices.
Now on to those questions:
Through your years as a consultant, you have been able to make profound changes to the way veterinary practices run their businesses. What is the most important change that you have advised a practice to implement that has resulted in a significant increase in practice performance?
There was one practice that I consulted with where the owner was really burned out. Although he had only been a practice owner for less than 10 years, the practice he purchased was not well managed, so he had bought a lot of problems along with the practice. At the time, he was working 80 hour weeks, was married, and had three children. Two of his children were under 10 years of age and the other was a teenager. I can remember talking with the teenager while I was on-site at the practice. Let’s call her Sarah.
Well, Sarah was bitter. She was a cheerleader, and her dad never attended any of her school’s games. In fact, she said she almost never saw her dad, unless she came to the veterinary clinic. I also interviewed the employees in the practice and the practice owner’s wife. No one was happy, least of all the practice owner. At that point, he just wanted to sell the practice and “get the hell out of veterinary medicine.” Unfortunately, the practice had little value, and he needed some kind of income from the practice or from the sale of the practice.
After doing a comprehensive operational audit of the practice, I developed a business plan for the practice owner. It consisted of some pretty drastic actions, such as terminating several long-term employees (in my opinion, these individuals were like cancers on the practice). I also updated their fee schedule, revised the office hour and surgery schedule, and helped them implement employee job descriptions, training programs and about 18 other changes that I felt to be critical for the practice. The practice owner and I had some very long conversations. I assured him that there was a way out, but he would need to commit to the plan and follow through. He agreed to give it 12 months and, if things were not better, we would attempt to sell the practice.
The first three months were not easy. During that time, we had a 100% employee turnover and some rough months financially. Also, there were some clients who were upset because “this isn’t the way Dr.___ used to do it.” The practice owner and I stayed in contact, and I offered him support and reinforcement as well as guidance and answers to his questions.
Then, about three months into the process, he called me and seemed upbeat, which was unusual. He said, “The most amazing thing had happened to me this morning.” I asked him what it was and he replied, “I got up this morning and really wanted to go to work.”
I spoke to this practice owner again a few months ago. He now has three other full-time associates, one of which is in the process of buying into the practice. His daughter is applying to veterinary school, and he is doing well and happy. When I think of how far this practice owner has come, I feel truly grateful that I was able to make such a difference and to positively impact so many lives. It is what I live for.
What would you recommend to a recent veterinary college graduate regarding tactics to pay student loan debt? Is buying a practice still a good route on the path towards financial stability for young practitioners?
For many, student loan debt has really gotten out of control.
Through the generous sponsorship of Nationwide, I am able to teach at many of the veterinary schools each year. Last year I was at the University of Pennsylvania and, at the conclusion of class on the first day, a young woman came up to me. She informed me that she was a junior and would be graduating next year, but she anticipated she would have loans totaling more than $200,000. She also told me she was married, and her husband would be graduating from dental school with loans of around $175,000. Both she and her husband wanted to own their own practices, and they would like to start a family in the next few years. She wanted to know if I could help her figure out how she could pay off all these loans as well as purchase the practices and start the family they wanted.
She was not kidding; she was serious. Dr. Jim Wilson was with me during this conversation, and both of us just looked at each other, speechless.
I think the first thing I would recommend to a veterinary school student is to be proactive. You need to think about all this debt and how you are going to pay it off before you incur it, not after. I am not sure if the lending institutions are making it easy or not to borrow money for education, but I am certain very few are talking about what it will take to pay it off. Students need to learn to budget and understand what they are getting into, before, not after, the fact.
I think that ownership is a good path for many, but not all. I would not get into owning a practice because you want to make more money. I would get into ownership because you want to own and manage a practice. Owning a practice is the easy part; managing it successfully is the hard part. I would hope that veterinarians who move into an ownership position are well informed and have a mentor who will guide them into the position of ownership.
I always tell associates who are interested in ownership to look at owning a practice as if it were a marriage. You will spend more time with your partner than with your spouse. Make sure you work three to five years with someone before you buy into a practice. Learn about the management of the practice and make sure it fits with the practice you envision yourself owning. You can’t change the culture of the practice, so make sure it is what you want to be a part of.
What is the most important topic to focus on when training veterinary staff, and why?
It is really hard to just pick one thing that is important when training your team, but if I had to choose, I would say consistency and time. I find that most practices do not really set aside time for training. They just throw new employees into the fray and hope they will come out well trained.
I have been a long-time believer in phase training programs. These are documents that outline every step in training. Most of our phase training programs are four weeks in duration. They start off with, literally, where the employee is to park their car and end with everything the employee needs to know being trained and reviewed with them. Making this commitment to training has great rewards to the practice. We find that turnover is greatly reduced, mistakes minimized and productivity greatly enhanced.
I will give you one example of how costly the lack of training can be. I consulted with a specialty practice about a year ago. During one of the days I was there, a client came to pick up her dog who had just had a TPLO done. The receptionist seemed a little flustered, but hit some keys on the computer and announced to the client that the total bill was $423. The client acted surprised and said she thought it would be a lot more, but the receptionist assured her that was the total bill. I was standing there watching all this and had to use all the restraint I had to keep out of it and just watch. The transaction was completed and the patient was discharged.
Later that evening I recounted the story to one of the practice owners, and we both agreed that this was impossible. The next day the mystery was solved. The “total bill” was only the initial services rendered when the patient first came in — none of the surgery or hospitalization charges had been entered. This receptionist had been a kennel assistant the previous day and was only promoted to the reception position when a receptionist had quit. And, of course, she entered the new position without any training. How would you like to call a client and say, “oh, by the way, you still owe $3,200”?
So making sure we realize that proper training takes time and that we must have a well thought out training program would be one, if not two, of the things I think most important to focus on when doing team training.
Thanks Mark! You’ve given everyone a lot to think about going forward into 2016!