In the August 2007 issue, Dennis M. McCurnin, DVM, wrote on an article titled, “A Comparison of Veterinary Practices in the United States and Holland.” The article discussed single practitioners, diagnostic fees, cat services and client education. Here is the continuation of the article that appeared in print:
Several issues could be considered by both U.S. and Dutch veterinarians to increase and improve efficiency.
First, we all must learn to do more multitasking; that is to handle more cases per day, by using more than one exam room at a time per DVM. Many practices have only one consultation or exam room per DVM. This limits the number of cases that can be seen each day.
If two consultation rooms were available per FTE DVM receiving cases, then larger numbers of cases could be serviced. To make full use of two consultation rooms per DVM, the art of delegation must be perfected. Delegation also requires a well-trained staff to be able to delegate to.
We must develop quality staff to allow delegation to improve efficiency. We also need to develop more consultation rooms in most practices by converting office space, storage space or other areas that could be developed into examination rooms.
Other steps to improve practices’ efficiency include use of paperless medical records, use of prepackaged pharmacy items and accepting appointments made by the client through the practices’ website.
Incentives will also promote efficiency. Paying veterinarians through an incentive plan (18 percent to 25 percent of individual gross income) results in increased income for both the individual and the practice.
In the U.S., the percentage of associates paid on production has increased from 33 percent in 2003 to 51 percent in 2006.
Dutch practices are paying 14 percent of associates on a production basis in 2006. The scheduling of DVMs for 40- to 45-hour work weeks will also increase efficiency by having everyone more rested.
The final part of the survey dealt with the specific source of gross revenue by categories. The Dutch generate a higher percentage of their revenue than U.S. veterinarians in the areas of immunization, pharmacy, prescription diets, surgery, product sales and feed (pet foods other than prescription diets). Except for surgery and immunization, these revenue sources are mostly retail items that have a much lower percentage of markup than professional services.
When we evaluate U.S. veterinarians’ revenue sources, we see revenue higher in outpatient, laboratory, radiology, dentistry, anesthesia, boarding, and grooming services. All of these revenue sources are professional services except for boarding and grooming and they have a higher percentage of markup compared to retail services.
Therefore, both U.S. and Dutch veterinarians would be financially better off to focus on providing professional services which have a markup of 100 percent to 500 percent compared to retail, which has a 50 percent to 150 percent markup.
Wen comparing the Dutch study to the U.S., specific opportunities become evident. We both need to improve efficiency to improve our revenue and net income while controlling the length of our work week to improve quality of life.
We must learn to multitask through better delegation to our trained staff. We need to focus on providing the level of diagnostics necessary to provide the highest quality of medicine for each patient. Areas of diagnostics to consider include CBCs, chemistry panels, urinalysis, cytology, fecals, radiography, ultrasound and endoscopy.
Another area of opportunity is to direct our major efforts toward providing more professional services.
This can be accomplished through a targeted communication plan for our clients. The more information we provide to clients, the better prepared they are to follow our recommendations.
Retail services are a convenience to our clients but should not be the major source of our revenue. Some retail items are necessary in most practices (prescription diet, flea/tick control, medicated shampoos, etc). But our focus should be on providing a higher level of professional services.
Boarding has become more popular in the U.S. as we have learned that clients will pay a premium for veterinary-supervised boarding.
Finally, we must consider the opportunities we have to improve professional services to cats. The cat population in both countries is growing and currently outnumbers dogs (in the U.S., there are 90 million cats compared to 74 million dogs; AVPMCA, 2006). We need to improve communications about cats’ needs with clients, the general public, animal shelters and anyone who will listen. Education about what cats need to remain healthy will help us all.
What have we learned from the NCVEI Dutch information?
The closer we look at each other the more we look alike.
We all can learn and improve our quality of practice and life by sharing information.
For more information about how the 38 tools at NCVEI can help your practice, go to www.NCVEI.org. The information available there will surprise you.