VHMA • PO Box 2280, Alachua, FL 32616 • 518-433-8911 • admin@vhma.org • www.vhma.org

The Agile ClinicDonald A. Thompson, J.D., CVPM Veterinary Center at Fishhawk (Lithia, FL) donkate@verizon.net

PO Box 2280Alachua, FL 32616-2280admin@vhma.org • www.vhma.org

4 • VHMA • April 2012

About 10 years ago, a group of software developers wrote the ‘Agile Manifesto’ for software development as a result of frustration about developing software for

both government and private companies. Within this manifesto there is real value for the veterinary industry, as we all seek to flourish in an uncertain economic world. The software manifesto simply states:

Through this work we have come to value:

Individuals and interactions over processes and tools,Working software over comprehensive documentation,

Customer collaboration over contract negotiation,Responding to change over following a plan.

That is, while there is value in the items on the right,we value the items on the left more.

For the veterinary profession, we might re-state (slightly) the above to read:

We have come to value:Individuals and interactions over speed and process,

Quality medicine over retail and preventatives,Client education over treatment plan negotiation,

Responding to change over following a plan.

While there is value to the right, we more highly regard the left!

First, what matters are individuals and interactions. More than anything else, we must value individuals. Our clients pay our bills (!!!), they are our best source of subjective information, and they are the best source of new clients. They plainly deserve time and attention. We can’t be so busy thinking about our own agenda that we miss the individual in front of us. Concurrently, it is essential that our entire team understands that we do tasks one at a time, and we do that one job well! In our profession mistakes can kill; so it is vital that we slow down and value each individual task we confront. That starts with the front desk and ends when the client walks out the door. While speed and process are necessary, we can’t ignore the importance of slowing down and valuing each individual, and each interaction.

(Continued on page 3)

The o�cial newsletter of the Veterinary Hospital Managers Association May 2012

VeterinaryHospital

ManagersAssociation

Business Alliance Partners

®

List Serve DiscussionJune 21: Key Practice Metrics: What You Really Need to be Watching

Webinar June 13: Blog Your Practice’s Way to the Top

Meeting and ConferencesLegal Symposium: October 18, Vancouver, BC

Annual Meeting and Conference: October 18-21, Vancouver, BC

October 18, 2012, Vancouver, BCRenaissance Vancouver

Harbourside Hotel, Vancouver, BC

Hiring, Firing& The LawA VHMA Human Resource Legal

Symposium for US and Canadian Practices

CHAMPIONINGTHE CHALLENGE

The VHMA Annual Conference

October 18-21, 2012, Vancouver, BCRenaissance Vancouver

Harbourside Hotel, Vancouver, BC

Save the Datefor TWO important events.

I'm Your VHMA Member Benefit . . .Are you Using Me?

Did you know that VHMA offers two reports which play an invaluable role in helping you see how your practice compares to similar ones!

The VHMA Fee Guide reflects two decades of research into veterinary fees, incomes, and client feedback. By combining and coordinating information from three areas of study, VHMA has created a simple tool that allows practices to quickly and easily develop a new Fee Guide for the practice, which will help to maximize profits. All you need to provide is your current fee schedule.

Member cost is $125 per survey. The Fee Guide is only available to small animal practices at this time.

The VHMA Practice Diagnostic Report provides useful and unique management statistics about your business in key areas of practice management: scheduling, client statistics, human resources, expenses, and fees.

If you are among the first 400 members to return the Practice Diagnostic Survey, the report is FREE. After the first 400 the cost is $200.

For more information about the Benchmarking Reports, or to order, go to VHMA.org.

VHMA Benchmarking Reports

Second, quality medicine is first and foremost. In today’s highly competitive environment, depending on the fickle whims of the consumer is dangerous. A client can purchase preventatives at Costco and the Internet, but neither of those can diagnose pancreatitis. Be a doctor, and think like a hospital. Look for occasions to practice medicine, because a doctor isn’t something that can be purchased online. Don’t’ race through an exam and miss the ear infection that is just starting, or simply give a shot of Prednisone and not know why the dog is limping. Practice quality medicine! However, applying this principle hardly means ignoring retail and preventative opportunities. In fact, when seeking improvement in retail sales, be mindful of the powerful benefits of principle one and three. Spending a bit more time with the client, in part educating and in part bonding, will pay major dividends as they consider where to spend their consumer dollars.

Third, client education is critical to our long term success. By constantly engaging in educational opportunities with our clients, we ultimately spend less time negotiating over treatment plans. Before we display any treatment plan, we need to explain the medical procedures we believe are appropriate, and what the benefits are of the tests and procedures recommended. Use visuals at every opportunity. Too often in a busy day, we simply don’t take the time needed to educate. In the long run, we are not really saving any time (because the nurse shuttles back and forth from the exam room asking for three variations of the treatment plan as the client haggles over price), and certainly we are not optimizing revenue. An extra minute or two of real education with a client will pay major dividends.

Finally, we must adapt and change, or get run over. I have always hated the term “best practice” as I truly believe there is no ‘best’ practice. There is only better, and striving to get better is the ‘best’ we can do! The notion of being nimble on our business feet, so to speak, is born of many thousands of years of wisdom that applies to everything from the boardroom to the battlefield. Sun Tzu, the famous Chinese general, in The Art of War, writes, “Only a general who is flexible and knows how to adapt his strategy to changing circumstances can command victorious troops.” “We have always done it that way” is slow death. Your Sun Tzu competition will destroy you. Enough said.

2 • VHMA • May 2012 VHMA • May 2012 • 3

President’s Message

The Dawg Days of Summer

Ah, summertime. Bring on the hot, lazy days by the pool, the smell of a

fresh cut lawn, and cool lemonade in a frosty glass.

With students out of school, many companies including veterinary hospitals will be gearing up to bring on extra staff either in paid or volunteer positions and we need to be ready. As with any other staff member, temporary staff need to be thoroughly screened. Unfortunately summer hires and volunteers often slip through with no screening whatsoever. I’ve heard all the reasons: they won’t be here long, they were referred by another employee, screening is perceived as too costly for such a short term employee, and screening is not required for temporary employees.

As business managers we need to protect a safe working environment, our clients, pets, and our reputation. As employers we need to realize that a screening policy does not begin and end with permanent staff. Simple steps can minimize the chance of a dishonest or dangerous person from derailing your practice:

1. Establish a policy for screening summer hires and volunteers.

2. Become familiar with the laws. Find out what is allowed in your State/Province.

3. Obtain the applicant’s authorization. Every applicant should authorize a background check.

4. Utilize relevant screening tools. (i.e., pre-employment drug screening).

A thoughtful, written out plan should be a top priority when we hire temporary staff or recruit volunteers. As we all know bringing on the right people can greatly

minimize risk to the workplace, reduce the chance of litigation, and protect the company’s reputation.

Not sure where to start, VHMA’s MemberConnect community is a great resource for sample policies, application samples, and job descriptions. It is a great time saver and your colleagues are willing to share their “tried and true” testimonials.

I am looking forward to traveling to Vancouver in October for the VHMA Annual Meeting and Conference. The Legal Symposium will be offered as a single-day event immediately before the Annual Meeting and Conference this year, a great way to get in two meetings with limited time away from the office and reduced travel expenses. Start making your travel plans now to take advantage of the lower prices.

Remember to stimulate the mind and enhance your environment!

Tom MacDonald, CVPM

The Agile Clinic (Continued from page 1)

MATTERSLEGAL

Question: We have a client that has requested a copy of their records. They have a very large outstanding balance. We would like to know if we are required to give them the copy of their records before they pay off that balance?

Legal Advice: “Many jurisdictions permit the retention of an animal as a possessory lien as a remedy for ensuring that your account is paid full; I’m not aware that such a lien extends to the medical records which, typically, are required to be forwarded to another veterinarian upon the receipt of a request - this is based upon the need to ensure that there is continuity of care. My view is that, while you may charge a reasonable fee for the reproduction of the medical records, you are not permitted, in most states, to refuse to provide the records pending payment of your account (regardless if the pet is alive or deceased).”

Douglas C. Jack, Esq.

Posted 05/14/2012. Please note the date of this post. The law changes frequently and as a result this may not reflect the current state of the law.

VHMA Legal Matters is a collection of legal advice posts that relate to common cases or situations that many practice managers encounter daily. Advice presented here is not intended to replace the need for your own attorney, but simply to help provide general advice as guidance. VHMA does not accept liability due to errors or omissions.

VHMA Legal Matters is free to VHMA members - scroll through our current posts or submit your own question.

WelcomeNew Members

Adam Sidney Ainspan, DVMRichard John Albrecht, M.S. Ed

Greg Andrews, DVMAmy M. ArnoneJanet Clare Ayres

Mij Lynn Baker, MBAKen Bixel, VMD

Cindy BonoClaudia Lenk Bradbury

Patricia Bruner, PHRGail Buckler, PHR

Liz CaicoLynn Anne Castleberry

Lisa Jo CirottoSusan Lynn ClarkeRebecca Mae Cody

Jason CollinsJennifer Douglas

Paul EcclesBrian D. EmdenPatti Ferguson

Tammy FoyJanice L. Garvin

Angela GerretsenAllison Green

Johanne Hamel, DMVChad Hargon, MBA

Summer Holmstrand, MBAStephen M. John

Victoria Kee, BSc.Rita M. Krzyminski, CVT

George MaleskyJulia Marlin

Kristin Mick, BAS-CVTRuthann O. Norman

Kathryn Lynn Osborne, BS, RVTCandi PisanoNancy PoppeErin Punshon

Karen Regan, DVMSteven Michael Roberts, DVM, MS

Andria D. Saxon, CVT, CVPMGinger SchellFran St. Fleur

Chad Carter StevensNatalie Sweeney

Adrienne SwisherMeLitta Terry

Kathleen Elizabeth TollisonMaranda Susan Weathermon

Patrick WillardDonna Zappone

Second, quality medicine is first and foremost. In today’s highly competitive environment, depending on the fickle whims of the consumer is dangerous. A client can purchase preventatives at Costco and the Internet, but neither of those can diagnose pancreatitis. Be a doctor, and think like a hospital. Look for occasions to practice medicine, because a doctor isn’t something that can be purchased online. Don’t’ race through an exam and miss the ear infection that is just starting, or simply give a shot of Prednisone and not know why the dog is limping. Practice quality medicine! However, applying this principle hardly means ignoring retail and preventative opportunities. In fact, when seeking improvement in retail sales, be mindful of the powerful benefits of principle one and three. Spending a bit more time with the client, in part educating and in part bonding, will pay major dividends as they consider where to spend their consumer dollars.

Third, client education is critical to our long term success. By constantly engaging in educational opportunities with our clients, we ultimately spend less time negotiating over treatment plans. Before we display any treatment plan, we need to explain the medical procedures we believe are appropriate, and what the benefits are of the tests and procedures recommended. Use visuals at every opportunity. Too often in a busy day, we simply don’t take the time needed to educate. In the long run, we are not really saving any time (because the nurse shuttles back and forth from the exam room asking for three variations of the treatment plan as the client haggles over price), and certainly we are not optimizing revenue. An extra minute or two of real education with a client will pay major dividends.

Finally, we must adapt and change, or get run over. I have always hated the term “best practice” as I truly believe there is no ‘best’ practice. There is only better, and striving to get better is the ‘best’ we can do! The notion of being nimble on our business feet, so to speak, is born of many thousands of years of wisdom that applies to everything from the boardroom to the battlefield. Sun Tzu, the famous Chinese general, in The Art of War, writes, “Only a general who is flexible and knows how to adapt his strategy to changing circumstances can command victorious troops.” “We have always done it that way” is slow death. Your Sun Tzu competition will destroy you. Enough said.

2 • VHMA • May 2012 VHMA • May 2012 • 3

President’s Message

The Dawg Days of Summer

Ah, summertime. Bring on the hot, lazy days by the pool, the smell of a

fresh cut lawn, and cool lemonade in a frosty glass.

With students out of school, many companies including veterinary hospitals will be gearing up to bring on extra staff either in paid or volunteer positions and we need to be ready. As with any other staff member, temporary staff need to be thoroughly screened. Unfortunately summer hires and volunteers often slip through with no screening whatsoever. I’ve heard all the reasons: they won’t be here long, they were referred by another employee, screening is perceived as too costly for such a short term employee, and screening is not required for temporary employees.

As business managers we need to protect a safe working environment, our clients, pets, and our reputation. As employers we need to realize that a screening policy does not begin and end with permanent staff. Simple steps can minimize the chance of a dishonest or dangerous person from derailing your practice:

1. Establish a policy for screening summer hires and volunteers.

2. Become familiar with the laws. Find out what is allowed in your State/Province.

3. Obtain the applicant’s authorization. Every applicant should authorize a background check.

4. Utilize relevant screening tools. (i.e., pre-employment drug screening).

A thoughtful, written out plan should be a top priority when we hire temporary staff or recruit volunteers. As we all know bringing on the right people can greatly

minimize risk to the workplace, reduce the chance of litigation, and protect the company’s reputation.

Not sure where to start, VHMA’s MemberConnect community is a great resource for sample policies, application samples, and job descriptions. It is a great time saver and your colleagues are willing to share their “tried and true” testimonials.

I am looking forward to traveling to Vancouver in October for the VHMA Annual Meeting and Conference. The Legal Symposium will be offered as a single-day event immediately before the Annual Meeting and Conference this year, a great way to get in two meetings with limited time away from the office and reduced travel expenses. Start making your travel plans now to take advantage of the lower prices.

Remember to stimulate the mind and enhance your environment!

Tom MacDonald, CVPM

The Agile Clinic (Continued from page 1)

MATTERSLEGAL

Question: We have a client that has requested a copy of their records. They have a very large outstanding balance. We would like to know if we are required to give them the copy of their records before they pay off that balance?

Legal Advice: “Many jurisdictions permit the retention of an animal as a possessory lien as a remedy for ensuring that your account is paid full; I’m not aware that such a lien extends to the medical records which, typically, are required to be forwarded to another veterinarian upon the receipt of a request - this is based upon the need to ensure that there is continuity of care. My view is that, while you may charge a reasonable fee for the reproduction of the medical records, you are not permitted, in most states, to refuse to provide the records pending payment of your account (regardless if the pet is alive or deceased).”

Douglas C. Jack, Esq.

Posted 05/14/2012. Please note the date of this post. The law changes frequently and as a result this may not reflect the current state of the law.

VHMA Legal Matters is a collection of legal advice posts that relate to common cases or situations that many practice managers encounter daily. Advice presented here is not intended to replace the need for your own attorney, but simply to help provide general advice as guidance. VHMA does not accept liability due to errors or omissions.

VHMA Legal Matters is free to VHMA members - scroll through our current posts or submit your own question.

WelcomeNew Members

Adam Sidney Ainspan, DVMRichard John Albrecht, M.S. Ed

Greg Andrews, DVMAmy M. ArnoneJanet Clare Ayres

Mij Lynn Baker, MBAKen Bixel, VMD

Cindy BonoClaudia Lenk Bradbury

Patricia Bruner, PHRGail Buckler, PHR

Liz CaicoLynn Anne Castleberry

Lisa Jo CirottoSusan Lynn ClarkeRebecca Mae Cody

Jason CollinsJennifer Douglas

Paul EcclesBrian D. EmdenPatti Ferguson

Tammy FoyJanice L. Garvin

Angela GerretsenAllison Green

Johanne Hamel, DMVChad Hargon, MBA

Summer Holmstrand, MBAStephen M. John

Victoria Kee, BSc.Rita M. Krzyminski, CVT

George MaleskyJulia Marlin

Kristin Mick, BAS-CVTRuthann O. Norman

Kathryn Lynn Osborne, BS, RVTCandi PisanoNancy PoppeErin Punshon

Karen Regan, DVMSteven Michael Roberts, DVM, MS

Andria D. Saxon, CVT, CVPMGinger SchellFran St. Fleur

Chad Carter StevensNatalie Sweeney

Adrienne SwisherMeLitta Terry

Kathleen Elizabeth TollisonMaranda Susan Weathermon

Patrick WillardDonna Zappone

VHMA • PO Box 2280, Alachua, FL 32616 • 518-433-8911 • admin@vhma.org • www.vhma.org

The Agile Clinic

PO Box 2280Alachua, FL 32616-2280admin@vhma.org • www.vhma.org

4 • VHMA • April 2012

About 10 years ago, a group of software developers wrote the ‘Agile Manifesto’ for software development as a result of frustration about developing software for

both government and private companies. Within this manifesto there is real value for the veterinary industry, as we all seek to flourish in an uncertain economic world. The software manifesto simply states:

Through this work we have come to value:

Individuals and interactions over processes and tools,Working software over comprehensive documentation,

Customer collaboration over contract negotiation,Responding to change over following a plan.

That is, while there is value in the items on the right,we value the items on the left more.

For the veterinary profession, we might re-state (slightly) the above to read:

We have come to value:Individuals and interactions over speed and process,

Quality medicine over retail and preventatives,Client education over treatment plan negotiation,

Responding to change over following a plan.

While there is value to the right, we more highly regard the left!

First, what matters are individuals and interactions. More than anything else, we must value individuals. Our clients pay our bills (!!!), they are our best source of subjective information, and they are the best source of new clients. They plainly deserve time and attention. We can’t be so busy thinking about our own agenda that we miss the individual in front of us. Concurrently, it is essential that our entire team understands that we do tasks one at a time, and we do that one job well! In our profession mistakes can kill; so it is vital that we slow down and value each individual task we confront. That starts with the front desk and ends when the client walks out the door. While speed and process are necessary, we can’t ignore the importance of slowing down and valuing each individual, and each interaction.

(Continued on page 3)

The o�cial newsletter of the Veterinary Hospital Managers Association May 2012

VeterinaryHospital

ManagersAssociation

Business Alliance Partners

®

List Serve DiscussionJune 21: Key Practice Metrics: What You Really Need to be Watching

Webinar June 13: Blog Your Practice’s Way to the Top

Meeting and ConferencesLegal Symposium: October 18, Vancouver, BC

Annual Meeting and Conference: October 18-21, Vancouver, BC

October 18, 2012, Vancouver, BCRenaissance Vancouver

Harbourside Hotel, Vancouver, BC

Hiring, Firing& The LawA VHMA Human Resource Legal

Symposium for US and Canadian Practices

CHAMPIONINGTHE CHALLENGE

The VHMA Annual Conference

October 18-21, 2012, Vancouver, BCRenaissance Vancouver

Harbourside Hotel, Vancouver, BC

Save the Datefor TWO important events.

I'm Your VHMA Member Benefit . . .Are you Using Me?

Did you know that VHMA offers two reports which play an invaluable role in helping you see how your practice compares to similar ones!

The VHMA Fee Guide reflects two decades of research into veterinary fees, incomes, and client feedback. By combining and coordinating information from three areas of study, VHMA has created a simple tool that allows practices to quickly and easily develop a new Fee Guide for the practice, which will help to maximize profits. All you need to provide is your current fee schedule.

Member cost is $125 per survey. The Fee Guide is only available to small animal practices at this time.

The VHMA Practice Diagnostic Report provides useful and unique management statistics about your business in key areas of practice management: scheduling, client statistics, human resources, expenses, and fees.

If you are among the first 400 members to return the Practice Diagnostic Survey, the report is FREE. After the first 400 the cost is $200.

For more information about the Benchmarking Reports, or to order, go to VHMA.org.

VHMA Benchmarking Reports