The business effect of snow and the Xmas break

Re: The business effect of snow and the Xmas break

Gillian Mostyn — Wed, 20 Jan 2010 10:22:04 GMT

[quote user="Ian Mostyn"]That's a bit personal isn't it?? You will have to look at our webcam later www.vetcouples.com [/quote]

erm....news to me....

Re: The business effect of snow and the Xmas break

Gillian Mostyn — Wed, 20 Jan 2010 10:21:35 GMT

[quote user="Hanna Bennett"]

[quote user="Ian Mostyn"]I really hate it when assistants charge half of a consultation, that to me is the worst way to charge. Full price or nothing.[/quote]

hmmm i see a husband and wife 'discussion' here....

[/quote]

hehe - no, we actually agree on this one. I always charge one of the fixed costs on the price list, or nothing at all (I don't do this very often I have to add!) Just doing 0.5 x something makes a mockery of the pricing structure and is likely to come back and bite you on the a**e when 2 clients compare their bills one day.....

Re: The business effect of snow and the Xmas break

Ian Mostyn — Tue, 19 Jan 2010 21:28:23 GMT

That's a bit personal isn't it?? You will have to look at our webcam later www.vetcouples.com

I am quite happy to charge a nail clip for a broken dew claw but that is our cheapest charge out of three levels and I don't like assistants to go below that.

Ian

Re: The business effect of snow and the Xmas break

Julian Earl — Tue, 19 Jan 2010 21:25:52 GMT

[quote user="Gillian Mostyn"]

I may have been to uni for 5 years but that doesn't qualify me to pull a broken dew claw and charge someone what may be 4 hours pay to them. I am very happy to charge people for my services - I worked very hard to get what we've got - but a blanket policy never works.

[/quote]

This is at the very core of all these discussions about fees, over-charging, vets' salaries and all the rest.

What we perceive is a need to cover our costs and earn £x,000 per year so that we can justify our five years training to ourselve and indeed to our clients. However, when they come in and spend, say, £40 for a fifteen minute consultation and an injection and a week's worth of tablets, they don't give a hoot about whether we earn the same as a GP. All they care about is that that consultation has just cost them the same as a week's shopping or a night out at the local pub restaurant. That is why we are discussing whether to charge a full consultation for a torn dew claw - to us it takes the same time (maybe) as diagnosing an intussuscetion and therefore needs to cover the same time-costs as a full consultation; to them it's just a quick manicure.

I'm not suggesting that I know the right answer, if there is one, but standing back and realising that we look at the question of fees from opposite end of the spectrum to our clients can be enlightening.

Re: The business effect of snow and the Xmas break

Hanna Bennett — Tue, 19 Jan 2010 20:45:55 GMT

[quote user="Ian Mostyn"]I really hate it when assistants charge half of a consultation, that to me is the worst way to charge. Full price or nothing.[/quote]

hmmm i see a husband and wife 'discussion' here....

Re: The business effect of snow and the Xmas break

Ian Mostyn — Tue, 19 Jan 2010 13:00:36 GMT

I will include a free post-op check in the price of a procedure if that check is a required & expected part of the surgery. I don't feel it is fair to charge separately to remove stitches from a bitch spay when there is no choice about it. I will charge for check ups for more complicated follow ups or on-going medical care post-surgery.

As a rule, we do not offer discounts for anything. We didn't offer a discount for microchips in microchip month, dentals in pet Smile month or if the local paper wants to do a pet promotion. Our prices are the same for students and pensioners although we will work with local charities and take PDSA Pet Aid etc. I do find the judicial use of an occasional free consultation improves client loyalty but only usually to the better clients and for quick check ups. I feel that discounts devalues your service but an odd freebie is appreciated more. I really hate it when assistants charge half of a consultation, that to me is the worst way to charge. Full price or nothing.

Ian

Re: The business effect of snow and the Xmas break

Laurence Webb — Sat, 16 Jan 2010 14:53:38 GMT

Mr Wray

[quote user="Jonathan Wray"]

Dear Mr Webb,

[quote user="Laurence Webb"]I understand the logic of not wanting to give away consults FOC, but how do you interpret the ratio of 1st and 2nd consultations?[/quote]

I, please remember this is a singular response, look at both 1st/2nd consult ratio along with FOC and compare with practice average. If a vet is charging FOC instead of a 2nd consult when they have indicated the need for a revisit, there is something to be discussed.

[/quote]

Thank you, I misinterpreted your post to mean that you looked at the number of free consults (sensible) then seperately compared the proportion of 1st and 2nd consults (which could vary for good or bad reasons), not that they were examined as a whole.

[quote user="Jonathan Wray"]If you're having a problem charging then get out of general practice[/quote]I never said that I had a problem charging. The only free consults that I give away are those that are already included in the price of a procedure, such as post op checks. Did my question suggest that I did otherwise?

Laurence

Re: The business effect of snow and the Xmas break

Hannah Wynne Richards — Sat, 16 Jan 2010 09:48:12 GMT

Beldather I own a practice , sometimes give discounts, and when I employed an assistant, was very angry if the assistant did so WITHOUT PRIOR CONSENT The reason is obvious, I have a legal right to give away my own money. No one else has a right to take it from me. I was as angry as I would be at any other form of theft (FOR THIS IS WHAT IT REALLY IS )

When I was an assistant, I had a simple way of dealing with requests for discounts I would tell the owners that "I'm only an employee I have'nt the right to give discounts-you'll have to ask the boss " It didn't bother me in the slightest whether the request was granted or refused, as I felt it was purely something between animal and practice owner, and none of my business

Jonathan If you have a big problem with a succession of undercharging assistants, it may be worth while checking you don't have a nurse who is influencing them

Wynne

Re: The business effect of snow and the Xmas break

J G Wray — Sat, 16 Jan 2010 08:49:32 GMT

Dear Mr Webb,

[quote user="Laurence Webb"]I understand the logic of not wanting to give away consults FOC, but how do you interpret the ratio of 1st and 2nd consultations?[/quote]

Assistants also find ways around the system. Some that I have encountered include charging 1/2 consultations or using the ad hoc charging feature on a PMS to charge a reduced consultation charge or simply "forgetting" to charge a professional service fee. This isn't terribly common but 1st/2nd consult ratios make you look a litle harder. There's not much of a discussion on these occasions because this is on the deliberate side of contrived.

If you're having a problem charging then get out of general practice

Another colleague made reference to bosses and their preferential treatment of certain clients. This happens for all sorts of reasons and if an assistant feels hard done by, because they are being compared to an average which includes the bosses peculiarities, then they can decide whether to take it up with the boss and learn the reason, or suck it up and get on with life.

I did this once, over a pint in a pub and was told by my boss "ex-girlfriend, I'm working off the guilt." which was considerably more than I wanted to know.

Regs

JGW

Re: The business effect of snow and the Xmas break

Laurence Webb — Sat, 16 Jan 2010 00:01:28 GMT

[quote user="Jonathan Wray"]my "favourites" are number of free consultations and ratio of first to second consultations.

[/quote]

I understand the logic of not wanting to give away consults FOC, but how do you interpret the ratio of 1st and 2nd consultations?

Should an vet be doing a higher ratio (therefore charging more per consultation slot) or a lower ratio because they recommend rechecks or have a loyal following of clients whose pets have chronic conditions? A bad vet may be only doing 1st consults because no-one will go back to see them again. An undercharging vet may be doing more 2nd consults to make the cost to the client less.

Re: The business effect of snow and the Xmas break

beldather — Fri, 15 Jan 2010 23:30:02 GMT

As an aside to this discussion, one of the things that really annoy me as an associate, has been bosses who ban associates from discounting but who do it regularly themselves, often for the same client and/or service.
Now while I understand that is their practice and they can do what they like, it can only be detrimental to the practice (and the associate for that matter) to have the boss as the preferential doctor to see ''because he is cheaper''.

Sometimes it aint just the associate.

Blair

Re: The business effect of snow and the Xmas break

Gillian Mostyn — Fri, 15 Jan 2010 14:49:18 GMT

Phipps

I'll have to agree to disagree - that just isn't how we run the practice. We have very healthy profit margins and are growing year on year (the first 3 years we were open we grew 35% each year.) Our practice reputation is excellent, especially for 'not ripping people off'. Our staff are happy and proud of the practice. I may have been to uni for 5 years but that doesn't qualify me to pull a broken dew claw and charge someone what may be 4 hours pay to them. I am very happy to charge people for my services - I worked very hard to get what we've got - but a blanket policy never works.

None of the clients in question have ever complained - and I wouldn't undermine my assistants by reducing their fees without their consent. I'm just saying that sitting back and saying 'I've earned it' isn't necessarily the best way to gain a loyal client base. As someone else has said, it is probably a corporate vs small private practice split of opinion.

Re: The business effect of snow and the Xmas break

Martin Jones — Fri, 15 Jan 2010 13:24:02 GMT

Dear Mr JGW

OHow about the self-important vet with poor people skills who, after reducing an old lady's dog to a screaming heap with an injection, said 'Now that didn't hurt - it was only a prick with a needle'

To which the old lady replied, 'Yes dear, but it was what you were doing with the needle that caused the problem'

Jonesy

Re: The business effect of snow and the Xmas break

J G Wray — Fri, 15 Jan 2010 13:11:04 GMT

Time for a tedious homespun apocryphal tale

Salvador Dali was sitting in a cafe on the boardwalk in Biarritz when he was approached by an admiring American:

"Senor Dali, I am an admirer of your work, would you do me the honour of drawing on this napkin?" said the tourist

Dali penned a cartoon, offered it to the American and said:

"That will be $100."

"But," replied the tourist " It only took you a moment!"

"No sir," replied Dali "It took a lifetime and a moment - $100"

Boom boom

Regs

JGW

Re: The business effect of snow and the Xmas break

Glen McIntosh — Fri, 15 Jan 2010 10:44:49 GMT

[quote user="Gillian Mostyn"]dog with broken dew claw, takes 2 minutes to pull it and send them on their way - a full consult fee is excessive[/quote]

I disagree. This client, no matter how much of a "good" client they may be, is bringing their animal to you for your or your assistants expertise. The client does not know how to deal with the broken dew claw otherwise they would have done this at home. To you, me, and your assistant, the treatment of a dew claw injury is relatively straight forward, but that is because of our training and experience. This is valuable and should be charged for appropriately. Not only that, sometimes treatment of dew claws do not go to plan. Part of your charge covers the professional risk you will always run when ever you treat any animal for any condition, or provide veterinary advice.

Unless otherwise expressly directed by you - the practice owner, your assistant would have been in the wrong not to charge a full consultation fee, even for a really good client. Maintaining good client relationships should not involve providing discounts. It is the service that you provide and the way that you provide it that keeps good clients coming back. If it is the discount then they are not good clients and they will eventually move on to the next sucker who gives them a bigger discount.

Assistants should be given absolutely minimal discretion about providing discounts/foc consults - ie very clear guidelines, or, preferably, prohibit the giving of discounts under any circumstances unless directed or approved by the practice owner/manager. Discretion in this area will inevitably lead to larger and more frequent discounting by assistants - it is human nature. And practice managers/owners should lead by example in this regard and they should back assistants to the hilt, both in word and in deed, when they charge appropriately and without fear or favour.

Re: The business effect of snow and the Xmas break

J G Wray — Fri, 15 Jan 2010 10:12:14 GMT

Dear Mrs Mostyn,

[quote user="Gillian Mostyn"]Isn't it generally better to just look at total turnover instead of individual indices? Maybe ATV as well....[/quote]

These are also part of the KPI - incidentally these come from bespoke reports using Crystal/Business Objects i.e. SQL query via ODBC - I just mentioned my "favourites", because these are easier to discuss and alter.

[quote user="Gillian Mostyn"]I have had a few instances where I have been annoyed at overcharging by assistants[/quote]

Are your Terms and Conditions clear to your clients? If so, then you should have no difficulty with this. After all, I charge the same for cat speys whether an experienced vet takes 15 mins or a newbie take 20.

[quote user="Gillian Mostyn"]I suppose it all comes down to whether the fees are reasonable and they can look the client in the eye, happy to charge them[/quote]

I'm not sure I've ever charged what I thought clients will be happy with - which may be FOC. It's more to do with what profit I need to generate to pay myself and invest back into the practice. Mr Sheridan and his ilk will still tell you how poorly vets achieve even a standard return on their practice investment, even with this aspiration.

This will no doubt be discussed more post Panorama.

The VPMA, management consultants in the vet world and SPVS are strong on this stuff. The PMS suppliers are confused, trying to be all things to all their clients.

Regs

JGW

Re: The business effect of snow and the Xmas break

Wally — Fri, 15 Jan 2010 10:07:05 GMT

I think this line of debate highlights the deterioration in the service we offer - the difference between large multi-branch practices and corporates making money out of offering a service compared to the traditional approach of offering a service to make money. Is the emphasis on making money or offering a service?

What owners often fail to realise is that if the owner feels they get poor value for money or that they pay for 'nothing' they will either go elsewhere next time or not come for advice as readily.

I agree with Gillian - you can easily upset good clients by overcharging and the most successful business is created by building a good relationship with your clients - not making sure they always pay for something. Judicious use of free consultations can definitely benefit a practice.

Re: The business effect of snow and the Xmas break

Gillian Mostyn — Fri, 15 Jan 2010 09:39:38 GMT

Isn't it generally better to just look at total turnover instead of individual indices? Maybe ATV as well....

I have had a few instances where I have been annoyed at overcharging by assistants - eg. really good client, dog with broken dew claw, takes 2 minutes to pull it and send them on their way - a full consult fee is excessive. The are occasional times that there is some give in the system. On the whole my assistants understand that wages have to be paid, and are happy to charge for their expertise. I suppose it all comes down to whether the fees are reasonable and they can look the client in the eye, happy to charge them. I guess I've been lucky.

Re: The business effect of snow and the Xmas break

Hannah Wynne Richards — Fri, 15 Jan 2010 09:06:54 GMT

I'm with Jonathan on this one Assistants should NEVER give free or discounted consults without prior authority. It's not their money that they are giving away

Wynne

Re: The business effect of snow and the Xmas break

J G Wray — Fri, 15 Jan 2010 09:02:08 GMT

Dear Mr Barbour-Hill,

In turn and as I've also made clear I shall give you my answers as unequivocally as possible and make no assumptions.

[quote user="Evelyn Barbour-Hill"]What do you find so important about the number of free consultations?[/quote]

When they are outside agreed protocol, they mean lost income, with all the consequences. We have opportunities to charge nothing for our time which we can justify and budget for within our own ethic and others will have theirs. Another colleague has mentioned free-of-charge (FOC) consultations in association with a dental package. That is their practice's choice.

We have KPI which are discussed and "benchmarked" against practice averages. If an assistant has more FOCs they can be asked to justify this. This is a perfectly reasonable approach by a boss. A boss can also require/coach/reproach that assistant. This is also perfectly reasonable. We are talking specifically about FOCs here and assistant are contracted to earn fees for the practice owners. Theyt are not contracted not to earn fees for the practice owners.

Howzat?

Regs

JGW

Re: The business effect of snow and the Xmas break

beldather — Fri, 15 Jan 2010 02:49:56 GMT

I'm going to ask the same question.
In my previous job I did alot, and I mean alot of dentals. All were associated with free consults usually prior to dental (other vet seen it, so rebooked with me so could see what was dealing with prior to the dental) and then 1-2 rechecks afterwards.
My free consults were probably 3x times the other vets, but with big production attached to it.
I didnt appreciate the accusations of giving away services the first few times they were assessed.

Indices are nice but you have to be very careful about how they are interpreted.

Regards

Blair

Re: The business effect of snow and the Xmas break

Evelyn Barbour-Hill — Thu, 14 Jan 2010 23:40:01 GMT

Dear Mr. Wray

As ever on this forum I had better point out that I am not criticising, I am asking a genuine question because I am interested in the answer.

[quote user="Jonathan Wray"]"favourites" are number of free consultations and ratio of first to second consultations.[/quote]

What do you find so important about the number of free consultations?

Once when I was a salaried assistant (a long long time ago) I got a telling-off on this very point. The boss did not explain why. It puzzled me then and it puzzles me now.

Re: The business effect of snow and the Xmas break

J G Wray — Thu, 14 Jan 2010 15:54:11 GMT

Dear Ms Johnson,

[quote user="salome2001"] Many associate vets don't understand business[/quote]

No argument there

[quote user="salome2001"]and it might help build a less resistant team if they were let in on why some decisions are made.[/quote]

I don't quite understand what you mean by "resistant". "Resistant" to what? Is it "resistant" to understanding stark financial facts or is it "resistant" to accepting a role in producing those financial facts?

We also have Key Performance Indices (KPI), of my choosing, for our fee earners. I look for a headline figure of turnover based on 1.5-2 times true cost of assistant, and analyse work undertaken monthly. I look at about a dozen parameters, but my "favourites" are number of free consultations and ratio of first to second consultations. I then publish them to the fee earner with a guide of the practice averages.

This provides us with some talking points with the fee earners, but isn't for the support staff. Did you experience anything like this?

Regs

JGW

Re: The business effect of snow and the Xmas break

salome2001 — Thu, 14 Jan 2010 12:30:05 GMT

when I managed a branch for a corporate we were sent monthly figures and basically told either we were doing well (ie made more money than last month) or not (in which case it was always my fault). There was never any explanation of why and the figures I was shown never tallied with the takings, so it was a waste of time, and in my opinion, an exercise in bullying.

Never shared with support staff.

I think that had it been done correctly (with explanations and a longer term outlook) it would have been a very helpful exercise. Many associate vets don't understand business (I taught myself reading the VBJ and going to practice management lectures at congresses) and it might help build a less resistant team if they were let in on why some decisions are made.

Re: The business effect of snow and the Xmas break

Hannah Wynne Richards — Thu, 14 Jan 2010 11:10:04 GMT

Yes

I tend to calculate turnover on the basis of a 51 week year Christmas and New Yr fortnight = 1 ordinary week. The weather was pretty good here until this week, but everything ground to a halt Tues pm. Turnover this week is approx 50% the level this time last week, and would have been even lower if a big insurence cheque had not come in on Tues

Wynne