Some will say, "This is all emotional stuff. Where is the task list?" The reality is that most all people come into veterinary medicine for emotional reasons, and when we leave that aspect behind, things like "burn-out", "resistance", and "frustration" raise their ugly heads in daily operation. Mission focus becomes the first casualty in this type of practice environment. People who are "just doing their job" feel unfulfilled, and their careers are cut short, because we are not meeting their emotional needs.

From a different perspective, on-going training is an emotional need, people want to contribute to the welfare of animals, and to that, their skill set must regularly improve. People that become "credentialed to do more" exhibit more pride in their performance, have a feeling of greater self-image, and with clients, let the pride show. The mission focus is never lost. Clients perceive this pride as quality, and the reputation of the practice grows faster through word of mouth.

Beware of Fads

What have you done lately to improve? The answers are abundant, and often redundant, and most sound like: "We have adopted (practiced) (been trained in...):

 ...participative management."

 ...team-building."

 ...change management."

 ...human-animal bond."

 ...empowerment."

 ...conflict resolution."

 ...leadership principles."

 ...one-minute management."

 ...personality profiling."

 ...incentive compensation."

 ...competency/productivity."

 ...statistical assessments."

 ...self-directed teams."

 ...guest relations training."

 ...behavior profiling."

 ...total quality management (TQM)."

 ...decentralization."

 ...goal-setting."

 ...overcoming resistance.

 ...delegation."

 ...restructuring."

 ...client-centered service training."

 ...Japanese management."

 ...attitude surveys."

 ...quality circles."

 ...patient advocacy."

 ...strategic planning."

 ...management by objective."

 ...zero defects."

 ...flex-time."

 ...job enrichment."

 ...re-engineering"

 ...the "E" myth."

 And so on....

No doubt any or each of these programs can help most any veterinary practice, most can improve performance in the right atmosphere, and some can even excite the staff. Some practice managers and practice owners, though, may simply be hooked on grabbing the latest bell or whistle that promises to lead them to glory. In fact, I know from experience that there is more than one manager in more than one veterinary practice who has become enchanted with keeping up with the latest consultant's invention, package, or program -- some say "fad". The basic fact is, with the "gimmick of the day", that he/she has derailed the veterinary practice from its true mission focus.

Organizational behavior has many theories. Improvement programs come and go. But success, I believe, depends on three fundamental truths:

1.  Successful veterinary practices offer products and services that pet owners want to buy, at a fee they feel they can afford, and are willing to pay. What the practice sells is, in most simple terms, peace of mind, or reduction of fears.

2.  Managers in successful veterinary practices know their numbers, that is, the details, to two decimal places maximum, of such items as costs, volume, values, rates, space, dimensions, and speed. And they know how the numbers relate, such as mg. per ml., costs of drugs sold, diagnostic service sales to pharmacy resale income per doctor, overhead as a percentage of gross, average staff hours per transaction, and the like.

3.  Leaders know people make the program a success They develop people through a series of ever-increasing levels of competency and productivity to instill pride in performance. Triumphant leaders, like outstanding coaches, recruit outstanding people, those staff members who possess ability, desire, and a team commitment.

Ability is the easiest trait to identify. The desire, or attitude, is the hardest to measure. Team commitment is very hard to discern without time, tenacity, and technique.

Veterinary practices need an annual plan that embraces these truths, so every member of the practice team knows where the practice is going, and where they are going. The annual plan is part of the three-year to five-year plan for strategic assessment and response to the community needs and changes. The annual plan has quarterly performance planning for all members, which include doctors, all practice staff, and even the administrative specialists, during the last month of every quarter. A team-leader, or "coordinator", as introduced in Chapter Five, has a quarterly budget meeting during the first month of every quarter. There is an annual budget meeting with all coordinators and doctors, since the budget is a short-term vision. It is only an outcome from the healthcare provider's commitment to programs and mission focus.

Yes ma'am and sir, you read it correctly. The budget is only an "outcome" from the healthcare provider's "commitments" to each practice program and the mission focus of the business. The budget is an emotional device, which can make or break the staff morale, as well as the owner's sanity.

In Chapter 4, "Program-Based Budgeting", in the text Building the Successful Veterinary Practice: Programs & Procedures, I placed the program-based budget discussions between "Chapter 3, "Medical Records", and Chapter 5, "Internal Promotion". Yet, few people have ever grasped the importance of the sequence. The medical records reflect the standards of care and continuity of care of all providers, the healthcare delivery outcomes are summarized by the veterinary-specific software, and then we share it with our clients and community as a special service, as internal promotion of specific programs at specific times.

There are two separate VCI® Signature Series Monographs to support this process. Fundamentals of Money Management provides the starting points, from internal controls to an expanded AAHA Veterinary Chart of Accounts, which includes mixed animal practices. Profit Center Management provides a spreadsheet budget on the accompanying CD, which drives the management charts and graphs needed for timely monthly decision making, based on the commitments being shown in the data accumulated off your own practice's veterinary software. The quarterly budget meeting is a time to look at what is planned, and get a firm commitment by each healthcare provider and the level of commitment. We want to hear positive, "I can do that" responses at this meeting, and pass it on to the respective practice zone teams. Chapter Eight of this text discusses this aspect.

The "Cano" attitude is based on knowing what is coming, what is staying, and what is going. Let your vision set the course for others to follow. Inability to meet any of these three truths, in my opinion, ensures a veterinary practice of community failure, regardless of their "fad pursuit" efforts.