The Mercedes Benz factory in Tuscaloosa, Alabama uses the “just in time” inventory method to make SUVs. The vendor delivers the right part to the assembly line exactly where it will be added. The part is then added to the vehicle and re-ordered every 2-3 hours. According to the company, this method focuses employees on the importance of teamwork and communication. Everyone must work together, doing specialized tasks so that everything comes together to make a quality vehicle.
A veterinary practice is not a car factory, but running a profitable practice also requires the right mix of functions, done by the right people at the right time. Examining the roles in your practice can help enhance teamwork, efficiency, and ultimately, revenue.
I recently returned from a VetPartners practice valuation conference in Dallas. In speaking with industry leaders, owners, and managers, the conversation kept returning to veterinary technicians. At many practices, they are underutilized.
Appropriate use of technicians is an issue in every aspect of medical, dental, and veterinary health care. As a paramedic, I observed doctors routinely performing physical skills such as starting IV or doing ultrasounds for patients. Yes, this is part of the standard of care, but it is not necessary for a physician to do these tasks when there is someone who can do it on their behalf, maybe better, faster, and cheaper. This is common in veterinary hospitals all over the country.
Examining the roles in your practice can help enhance teamwork, efficiency, and ultimately, revenue.
Why does this happen? There are several reasons why veterinary technicians might not be doing the tasks they would like to do, or are trained to do. The veterinarian is the person who writes the paycheck and does the reviews. For this reason, the technician may feel the need to defer to the DVMs, and may be uncomfortable about making suggestions or asking for increased responsibilities.
Or, a practice might just be too busy to consider how the technician’s role might be expanded or changed to increase job satisfaction, and yes, practice profitability. Some veterinarians may think they can do it better, or “they have always done it this way,” or they may feel that they need to deliver the whole package to be a good doctor. Technicians specialize in these skills. If the veterinarians in your practice are doing them, why?
Work Satisfaction and the Technician’s Role
In a 2011 study, veterinarians reported that their average appointment is 20 to 30 minutes. Some appointments may need 30 minutes, but if the practitioner is trying to do everything, and the technician has only a limited role, then it pays to ask some questions: “What am I doing in 30 minutes?” “Have I delegated as much as I can?” If you are doing physical skills, such as vaccination, or charting in the electronic medical records system, then maybe you have taken on too much. Your technicians can manage inventory, bond with clients, improve client communications, help with electronic records management, and many other patient care tasks depending on state law.
Vaccinations are a good example of a task that can be done by technicians. It takes time to go to the refrigerator to get a vial, get a needle, get a syringe, draw up the vial, make sure it’s the right dose, hold the animal, give the vaccination. It seems like this would be an inconsequential task, but do this twenty, or thirty times a day and it adds up to a lot of time. A doctor can’t afford to do this.
Recently, one of my clients purchased a practice. On the first day, the new doctors walked into the hospital and saw a technician standing outside the room with the door closed. When asked why the tech was standing outside the room, the technician said, “we bring the patient to the room, then wait outside until the doctor calls us to hold the patient, but otherwise, we aren’t really allowed in the room.”
“Just in Time” Thinking
Think about that SUV plant. When it is time to put the doors on the SUV, only the doors are delivered and installed. When the practitioner does it all, it’s like a factory worker driving to the vendor, getting a door, installing the door on the SUV and then driving to the vendor to get another part for the next vehicle. It is very inefficient!
This is an extreme example, but most people don’t see inefficiencies because they are immersed in them. It’s not a matter of minimizing the doctor’s role; it’s making sure he or she is doing the right job. The waiting technicians could have taken the history, prepared the patient, discussed the client’s concerns and notified the doctor of any changes since the last visit. In an efficient appointment, the technician could also do any physical tasks within the scope of their license or certification. With those essential tasks done, the doctor can enter the room, make a diagnosis and outline a treatment plan. Likely, the client will feel that it has been a quality interaction.
Most people don’t see inefficiencies because they are immersed in them.
Starting the Conversation
Job dissatisfaction and burnout is widely reported among veterinary technicians. Insufficient pay is a large reason for technician job dissatisfaction. Money is a great motivator for veterinary technicians, but feeling useful to the practice is just as important in motivating good people. Technicians are taught a lot of skills in school with the expectation that they will be using these skills and then they get out in a practice and they are limited in their scope.
Cynthia Maro, DVM, CVA, CAC, VMRT, and Connie Glavan, LVT suggest some ways to get started:
- Review the roles and tasks of each person in the practice. Decide which tasks you can delegate to technicians to keep them working “at the top of their license”.
- Start a dialog with technicians. Instead of making assumptions about technician preferences, do a survey with specific questions that may bring out unexpressed thoughts and opinions.
- Hold a meeting immediately following the survey to discuss the responses.
- Repeat the survey and meeting twice a year to get staff to think about personal and professional goals and objectives.
Examining the roles in your practice with the aim of expanding technician involvement is a win-win activity for everyone. With some focus on goals and objectives and team effectiveness and tasks, veterinary practices can make sure the right skills are done at the right time by the right people – it’s like getting the SUV door onto the vehicle at the right time, by the right worker. You can boost profitability, and your techs can get the job satisfaction they need to remain committed, high performing members of your team.
Mark J. McGaunn, CPA/PFS, CFP® leads the veterinary/financial planning divisions at McGaunn & Schwadron, CPA’s, LLC and can be reached via email@example.com or (781) 489-6651.