How To Ensure A Successful BuildMay 1, 2012 Before any successful commercial construction project begins, an “A Team” must be assembled: lender, architect, contractor and, of course, the owner. The team will work together to ensure a successful project and support the owner in decision-making. Some critical elements of all construction financings include sufficient capitalization and budget, timelines of the build-out, and the quality and strength of the contractor and architect. When the lender “builds” the project, a number of questions must be answered. Is the contract inclusive? An experienced lender checks contingency, permits, scope of work. What is and is not included as part of the project? Landscaping, security systems and phone generally are not included in the contract. Is the property properly zoned or does it need to be subdivided? What are the timelines on zoning and permits? What fees must be paid? Many municipalities require monies up front to review drawings, go through the planning process and issue permits. What is the deadline for closing on the land or building? Many times, a lender will provide a “bridge” loan to carry the project until the permit is issued. How many months will construction take? An experienced lender will add additional …
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Change Is Inevitable; Profitability Is OptionalMay 1, 2012 The only constant in life is change; witness the veterinary profession over the past 50 years. Change has involved all facets of practice from species to quality and scope of medications and available treatment modalities. Reluctance to stay abreast of changes results in an increased chance of becoming obsolete in today’s competitive environment. This is especially true with the relative stagnation generated by an increased number of practices vying for the same limited pet population. To understand today’s problems, one must look back to the inception of veterinary medicine in the United States. Initially the profession’s minds and hands were not emphasized when price was placed on veterinary services. Most pets relax during laser therapy. Often, there was no charge for the diagnosis, only for the treatment. Compounding this problem, there was no charge for the treatment except for the medication. In other words, the profession was saying our time and expertise are worthless but the medication is worth far more than a reasonable markup. In essence, we became a store from the onset. Back in the early ’90s, we emphasized the sale of products. We marketed the practice as “one stop …
Helping Clients Afford To Say ‘Yes’April 5, 2012 No one better understands the value of the human-animal bond than veterinarians. But as small-business owners with considerable overhead invested, veterinarians know that good practice management calls for responsible fee collection. Technological improvements increase pet owners’ expectations for good outcomes, though advanced procedures and care demand additional equipment and training, which also add to costs. This is where third-party financing can help boost a veterinarian’s bottom line. Practices can make financing available so that patients who don’t have insurance, cash or credit lines, or choose not to use them, can select and pay for the optimal treatment. “The ability of veterinarians to care for pets has grown exponentially with the advancement and availability of technology,” says Mary Beth Leininger, DVM. “We can fix things we couldn’t fix before.” Dr. Leininger is vice president of veterinary relations for ASPCA Pet Health Insurance, a subsidiary of the Hartville Group, with headquarters in Canton, Ohio. “People have a strong connection to their pets,” she says. “They consider them members of the family. So when the pet needs treatment, it is not so much that we have to talk them into the procedure and the cost. …
Digital Radiography Is Becoming NormApril 5, 2012 Remember when Caparsolate was used to treat heartworms? When halothane was the most common inhalant anesthesia? Or when X-ray film was developed by hand-dipping a metal frame into tanks of solution in a darkroom, then hanging it to dry? New veterinary graduates may have to Google “Caparsolate” and “halothane,” and in the near future they may have a hard time finding a veterinary practice that still develops X-ray film. Digital radiography, which eliminates the darkroom, chemicals and manually filed plastic film, moseyed into veterinary medicine in the early 2000s, hit its stride around 2004, and today is galloping full-tilt into mainstream use. “The technology has gotten better, the software has gotten better and the prices on the client side have gotten better,” said Seth Wallack, DVM, Dipl. ACVR, who practices in San Diego. “The time of the early-adopter of digital is over, and now it’s more mainstream. It’s becoming the norm.” Digital technology is much faster than conventional radiography, and the software allows adjustment of brightness, contrast, zoom and pan on a single exposure. As long as the patient is positioned correctly, most everything else can be fixed by the machine’s controls. “Digital radiography …
Is This Town Too Small?March 30, 2012 Remember the old westerns, where the good guy (or bad guy) would say, “This town ain’t big enough for the two of us.” Something similar is happening in veterinary medicine. The “guys” are boarded specialists versus non-boarded but highly experienced generalists, and I’m not sure which one is the bad guy and which is the good guy. Actually, I’m not convinced that the town is too small for the two of them. Recently at American Animal Hospital Association in Denver, I hosted a table called “Building Referral Relationships,” where up to 10 people who registered in advance got the opportunity to come brainstorm, share and learn from each other about a topic they selected. As people gathered at our table, silly me thought that I needed to find out whose camp they were in, the referrers or the referring. Turns out most of them wore both hats. Several were generalists who may refer a patient on to a specialist in some instances, but they were also highly experienced (particularly orthopedic surgeons) so they received referrals from the community based on their reputation. Quite an interesting discussion took place. It actually reminds me of the struggle the …
The Pitfalls Of A Practical ProfessionMarch 28, 2012 My parents are both educated as architects. However, neither one of them practices architecture except when the stray job materializes or when willing-to-impose daughters like me ask them to design their new house. It’s not that they’re not impressively talented with awards and accolades to show for their progressively green brand of minimalist architecture. Neither have they lapsed into early retirement. Rather, it’s more to do with how the rug’s been pulled out from under their profession’s foundation over the past 30 years. Let that be a lesson to our profession. Indulge me as I explain how: In the ’80s, the architecture profession underwent a transformation with the rise of the technical, specialized architect. This new breed was distinct from the traditional architect, formerly schooled in overseeing the conception and construction of a structure from start to finish in a holistic sort of way (think Antoni Gaudí, Frank Lloyd Wright and Louis Kahn, among other 20th century luminaries). The advent of this highly specialized architect, fueled in part by the computerization of the profession via AutoCAD, was attended by a concurrent decline in the perceived need to educate architects broadly as artists, craftsmen, theoreticians, engineers …
Lucrative Tools For Boosting BusinessMarch 27, 2012 It’s time to rethink the way we conduct business in our veterinary practices. Times have changed and practice owners and managers must seek new ways to meet the needs of pet owners, while at the same time ensuring that their businesses remain profitable. One of the most critical elements of this change is the creation and active dissemination of a written financial policy that defines a practice’s payment options. Only 52 percent of veterinarians report actually having a written financial policy1, and we have done ourselves no favors by making the discussion of payment as difficult and uncomfortable as possible—in most cases leaving our front desk people the miserable job of trying to obtain a payment or deposit from a pet owner with little or no funds. They must then scurry off to get someone “higher up” to handle the situation, which eats up time and energy. Even if that policy has been written, many employees and clients have no idea what it is, although they know it has been disregarded often enough to realize it has little meaning. Consider how much simpler things would be if payment options and expectations were …
Surgical Lasers Aren’t Just For Teaching HospitalsMarch 22, 2012 Fourteen years ago, when cell phones resembled barbells and personal computers were still an option, Kenneth Bartels was hunkered down in the heart of Oklahoma State University’s veterinary teaching hospital, becoming an expert on an extraordinary technology that now literally is veterinary surgery’s cutting edge: carbon dioxide and diode lasers. “Laser surgery is noted for an ability to minimize hemorrhage and seal nerves and lymphatics through photothermal activity,” said Bartels, DVM, director of the Surgical Laser Laboratory at OSU’s Center for Veterinary Health Sciences. “This implies there is decreased inflammation and less pain. The surgical laser is a tool that can be used to great advantage with the appropriate understanding and training.” And the education is out there: Dr. Bartels said laser theory is now incorporated into Oklahoma State University's veterinary clinical curriculum, along with wet labs for student chapters of the American Animal Hospital Association and American Association of Feline Practitioners. For small-animal surgery, carbon dioxide lasers are used in cat onychectomies, several phases of brachycephalic airway syndrome surgeries, spays and neuters, tumor removals and surface incisions. In equine medicine, the fiber-delivered diode laser is used with …
Good Marriage...Good MedicineMarch 16, 2012 Kristen Lawmaster, DVM, never wanted to open her own clinic. So when she and her husband, Todd Lawmaster, also a DVM, acquired the Parkview Veterinary Hospital in Monterey, Calif., two years ago, she had no plans to actually work there. Not only did she not share her husband's entrepreneurial passion, she also assumed it would be a disaster. "Everyone warned against us working together," Dr. Lawmaster said. "I was still in my other job and I kept thinking to myself that there was no way I was going to work with him because everyone said how awful it is for spouses to work together." It wasn't long, however, before she changed her mind. "The draw became too much because he was getting all this brand new equipment and I was working in an old, decrepit hospital," she said. She now shares her husband's love of a more progressive, preventive form of veterinary medicine--if not his be-your-own-boss mentality--and has been working side-by-side with him ever since. They join a number of spouses who successfully manage a two-veterinarian household. "It's is a fairly common thing." said Amy Carr, DVM, Dipl. ACVECC. "About 10 percent of my …
Short Sales And Finding Future FinancingMarch 6, 2012 One of the lasting effects of the real estate bubble and Great Recession is the growing number of professionals caught in the real estate devaluation of residential properties. In the past, home appreciation seemed to make any home mortgage safe for both the bank and owner, but the last few years have led to instances where the borrower can find herself 50 percent underwater on her home loan. In some instances, this has led a borrower to decide that the best option is to a sell the home, with the bank’s permission, for less than what is owed. The amount of loan left after the sale is commonly known as a “deficiency balance,” which may or may not be forgiven by the bank. A Look at Short Sales To understand how a short sale is perceived by a bank, a borrower must first understand that a typical bank considers a mortgage loan a contractual commitment by the borrower to repay the debt borrowed, regardless of what the house is worth. Even if circumstances make this nearly impossible for the borrower, the first reaction of a banker is to look upon a short sale as a …
