Thomas E. Catanzaro, DVM, MHA, FACHE, Diplomate American College of Healthcare Executives
Service is an Obligation
Veterinarians are a caring lot and go out of their way to tend to the needs of their clients and patients. The same fact is true of most every member of a practice staff. That is why we all entered the profession. I don't know of anyone who entered veterinary medicine primarily to become a millionaire. The expanding clinical hours in the veterinary practice community has been a response to the public demand, and a method to increase the income compared to a semi-fixed expense category (facility overhead). With most urban and suburban families being dual wage earners, or single parent, the need for evening and weekend convenience is evident. When located in a metroplex, the morning "drop-off" service is a market niche based on service.
There is legislation in some states, and more pending in others, to address the staffing of veterinary facilities "after hours." This will be a financial challenge in the future of our profession. The use of an appointment system is still evolving. The walk-in system generally gave way to 15-30 minute appointments a decade ago, and the 20-minute appointment became commonplace by the end of the 1980s. Now the flexible 10-minute appointment log has been reintroduced to allow tailoring of the practice's appointment times (10 minute for suture removals and nurse technician vaccine appointments, 20 minutes for routine sick call and Life Cycle consultations, 30 minutes for exotics and new clients, etc.). There are still a few walk-in practices, and some appointment-only practices have adopted a friendlier stand for walk-ins, using their inpatient team to handle this client need. But that is another story of better staff utilization, better held for another time.
To highlight some of the benefits of the 10-minute flexible scheduling, as shown at the end of this chapter, and discussed more fully in the Signature Series Monograph, Zoned Systems & Schedules: 10 minutes for recheck or suture removal, 20 minutes for outpatient sick call, an extra 10 minutes for new clients to discuss practice philosophy, an extra 10 minutes for a second animal, an extra 10 minutes to discuss husbandry for an exotic patient, an extra ten minutes for a senior citizen "benefit" in lieu of a discount, or even, the extra time needed for a new graduate to do anything. Using these general guidelines to develop the practice's appointment program is essential, but the real secret lies in "high density scheduling" for the doctor.