Low cost clinics.

Re: Low cost clinics.

Bob Russell — Sat, 16 Oct 2010 11:55:40 GMT

Sorry - a lot of the terminology is easily 'misunderstood'!!!

At the moment I have a degree of isolation from the bigger chains just because of our position. I did put 'corporates' in inverted commas because it is a fairly meaningless term in itself.

Our practice totally depends on loyalty and we work very hard to earn it. We cannot compete on price alone and do not try to. I look at what is a fair return for me and work everything backwards as best I can so I charge what I need to.

Larger practices get considerable economies of scale (nothing wrong with that) but we are a member of a buying group so get some benefits from that. This helps to reduce our costs and keeps our fees that bit lower than they otherwise would be.

Loss leaders are a perfectly acceptable commercial practice that we have to live with. What worries me is the practice that charges £120 for a 'routine' spay and £1200 for a 'routine' pyometra! A client that thinks the advertised prices reflect the true cost of veterinary care may be lulled into a false sense of security and perhaps not take out insurance for example.

It is always a problem balancing the books but some of the extremes look decidedly unethical to me!

Maybe I am getting a bit long in the tooth for the cut and thrust of modern competitive practice but hopefully a slightly old fashioned approach to general practice will allow me to survive until I retire.

I will try to avoid using 'corporate' in future as a term!!!

Re: Low cost clinics.

Cat Henstridge — Sat, 16 Oct 2010 10:22:46 GMT

I have locumed for the Pet Vaccination Clinics, the low cost chain in Birmingham which Judy Walker origially set up, and it was one of the best, most enjoyable and stress free places I have been to!

They mainly operate on a walk-in system and they always had enough vets on to cope with the demand, so it never got too fraught and if you needed to spend a bit longer than average with a client the rest of the team could pick up the slack. They run a safari system with the vaccines where a nurse does most of the consult and generally went out with the flea/worm/dental products they really needed because someone had the time to discuss it with them. Also, because they were cheaper and people knew that, there was hardly ever any problem (in my experience) of wragling over bills and quotes.

Cat

Re: Low cost clinics.

Vikki Halliday LLB — Wed, 13 Oct 2010 21:35:00 GMT

[quote user="Bob Russell"]

Some practices (dare I say 'corporates') are very good at appearing like they are Aldi or Lidl but how many of them are genuinely cheap? How much of this is eye-catching headlines to lure people in and make up the difference elsewhere?

[/quote]

What is a corporate? Many people would consider my practice to be one, but I can assure you it is not, nor does it try to offer loss leading neutering and vaccination with pricey non-routine treatments to make up the loss.

Perhaps, people should look beyond the branding, and try to understand the philosophy of each practice without pre-judging.

I know of several "independant" local practices who offer "loss leading" routines at a far lower price than I am able to, and that is taking into account the generous discount I benefit from as part of a buying group. They also offer lower priced services as a whole, and I am unable to see how they do it, other than in volume.

Please don't tar us all with the same brush, as some " independant" practice owners are just as guilty, if not more so, of perpetuating the myth of cheap veterinary care.................

Re: Low cost clinics.

Bob Russell — Wed, 13 Oct 2010 15:45:44 GMT

For a practice to be genuinely cheap they must be extremely efficient - use all the facilities as much of the time as possible to get throughput.

Most so called cheap practices use loss leaders (as do many of the pet-shop chains). Fortunately people get wise to this in the end.

Our practice ranges from rushed off our feet to quiet as the grave, with little or no logic or warning!!!

The march of the so-called corporates seems quite relentless though. We did a quick count and in our part of the world (population of over 250,000 within 20 miles or so) there are probably considerably less than a dozen independent practices - scary!!!

Re: Low cost clinics.

salome2001 — Wed, 13 Oct 2010 15:17:21 GMT

[quote user="Julian Earl"]

Re. the step change in business: if you listen to Alison Lambert of OnSwitch then we are all trying to be Marks and Spencers vets, or maybe even Harrods whereas the practices that are booming are the Lidls and Aldis - the corporates going for the cheap and cheerful service. True or not?

[/quote]

It would appear from some TV programmes that "corporates" (sic) are hardly going for the Aldi end of the market...

Re: Low cost clinics.

Mark Holmes — Fri, 08 Oct 2010 11:02:35 GMT

One other approach particularly for those clinics which seem to be feast or famine. We are often quiet for about 3 months between Jan and March/April when the weather is bad and all the animals are safely indoors. If you have months that are quiet and summer months where you could really do to employ another set of hands what about offering cheaper neutering and routine work for those months to reduce the work load in the summer? What would it be worth for cash flow? 20%?

Re: Low cost clinics.

Hannah Wynne Richards — Fri, 08 Oct 2010 10:01:25 GMT

Mark Which thread was it in which I said you were trying to take us back to the 80s ? I can't remember although I remember the "bad old days " only too well, so I can't say whether it will be relevant to this thread

Certainly, I think there will always be a place for the single-handed, and well-equiped practice (like mine and Martin's ) which can offer a combination of individual service, and quality facilities to the limited number of clients who are prepared to pay a premium-I don't even pretend to be cheap. I think it's the average-sized practice in the middle who will be most hurt by the low cost clinics

Wynne

Re: Low cost clinics.

Julian Earl — Thu, 07 Oct 2010 19:19:35 GMT

[quote user="Mark Holmes"]

[quote user="Martin Atkinson"]I long ago understood the adage that if you double your prices (in reality charge realistically) you won't lose half your clients but you'll lose most of the poor value customers and make as much profit for half the work.[/quote]

... There is however likely to be a step change in the business environment over the next few years. I cannot see any of us being immune to it. The percentage of our clients' disposable incomes which could be lost is going to be huge. Look at child beneits paymwnts £2000 a year loss in income is alot to start with but when considered as a percentage of disposable income it could be staggering. I think we all need to look at how low cost clinics compete because in 5 years we may be emulating them.

[/quote]

To be honest, I get a bit fed up hearing this "double your fees, lose half [or some other percentage] of your clients and you'll be less hard-worked and better off for it" over and over again for the past X years. When I've heard it spouted, it's always been a friend of a friend, or something similar. It's a veterinary urban myth as far as I am concerned.

For a start, it depends where you're coming from - if you are a rock-bottom, no frills practice with clients queueing down the street, then maybe it would work - but how many practices are like that nowadays, even spey and vaccination clinics? And since the latter depend on high volume turnover, why would they want to do that anyway? Likewise, if you're a top-rate referral centre, maybe it would work at least until the insurance limits were reached. But if you're a middle-of-the-range, average practice with average fees in an averagely wealthy area, then doubling your fees would drive away way more than half of your clients. I am sure that we would lose eighty, ninety per cent of clients. We would certainly be less busy, but what the heck would we do all day?

Yep, I could sack two or three assistants, because they would be twiddling thumbs all day. So who would then want to do the resulting one-in-two night duties? Nobody, that's who. Nope, double your fees and put yourself out of business is the situation for most practices in my experience.

Re: Low cost clinics.

jamie winstone — Thu, 07 Oct 2010 18:20:06 GMT

The question is what would your practice do if a very lo-cost practice started up in a part of town near you. One answer would be to do nothing and see a considerable amount of your vaccine business go elsewhere. The good news would be that you would be considerably quieter but also substantially poorer.

Truthfully i can think of nothing worse than an easyvet clinic opening up in my vicinity.

Re: Low cost clinics.

Mark Holmes — Thu, 07 Oct 2010 17:02:04 GMT

[quote user="Martin Atkinson"]

Perhaps those who are on too low (or no) income to keep pets might suddenly realise the sense of not doing so. And those who only go looking for cheap deals because they don't know true good value when they fall over it will learn that they have to pay a fair price if they want caring professional service. On the other hand pigs may learn to fly.

[/quote]

Or what is more likely to happen is those who have never been able to afford pets will still not be able to afford pets but keep them anyway and those who have been happy with a caring professional service will be less worried about it as long as they have a reasonable chance of success at a price they can afford. Someone (Wynne) suggested I was trying to take to profession back to the 80's, I'm not, but we might have to look at 80's practice for 80's economics.

Again I'm only postulating, I don't like being a busy idiot anymore than anyone else.

Re: Low cost clinics.

Martin Atkinson — Thu, 07 Oct 2010 16:44:28 GMT

[quote user="Mark Holmes"]

I meet too many people who seem to believe they are "entitled" to an income of X complaining about a cut price clinics does not make you competitive and scoffing about them doesn't encourage people to take them seriously.

[/quote]

Re: Low cost clinics.

Mark Holmes — Thu, 07 Oct 2010 16:19:04 GMT

I don't diagree, I'm quite familiar with the term "busy idiot" but my point is these clinics actually fulfill a function. I meet too many people who seem to believe they are "entitled" to an income of X complaining about a cut price clinics does not make you competitive and scoffing about them doesn't encourage people to take them seriously.

There is however likely to be a step change in the business environment over the next few years. I cannot see any of us being immune to it. The percentage of our clients' disposable incomes which could be lost is going to be huge. Look at child beneits paymwnts £2000 a year loss in income is alot to start with but when considered as a percentage of disposable income it could be staggering. I think we all need to look at how low cost clinics compete because in 5 years we may be emulating them.

Re: Low cost clinics.

Hannah Wynne Richards — Thu, 07 Oct 2010 16:01:08 GMT

Hear hear Martin

Wynne

Re: Low cost clinics.

Martin Atkinson — Thu, 07 Oct 2010 15:56:32 GMT

I once again reflect on how lucky I've been over the years and can only feel sorry for those who will have to make the bulk of their living working in this competitive environment not just cut price clinics of course but on-line pharmacies etc. I could retire tomorrow if I wanted, but I don't want, I still love my job and get excited about CPD, and the thought of doing the gardening, playing golf and going on cruises for the next 30 years does not fill me with joy (even though endless skiing and cycling holidays may persuade me)! However I'm now in a position that I can select the clients I want, be philanthropic with charities but give 2 fingers to those who know the cost of everything but the value of nothing and laugh at the 'poor vet' up the road who has set up a cut-price clinic and is moaning about being stressed because he's overworked. I long ago understood the adage that if you double your prices (in reality charge realistically) you won't lose half your clients but you'll lose most of the poor value customers and make as much profit for half the work.

Re: Low cost clinics.

Bob Russell — Thu, 07 Oct 2010 14:16:55 GMT

I cannot comment on this particular practice as I have no experience of how it works. I am sure more efficient use of facilities will cut costs and I have no argument with this.

This type of practice can do well and I am sure be very profitable.They can, however only work in areas with relatively high populations and the existing practices should have benefited already from this large pool of clients. If they have not catered to this market good luck to anyone starting such a venture as long as suitable standards are maintained.

My concerns relate to 'ordinary' practices that advertise loss leaders and then charge astronomical prices when non-standard procedures are carried out.

A pyo is not a routine procedure but is not 3 or more times as difficult, time consuming etc than a standard spay.

Cheap clinics are fine but not if the true costs are 'subsidised' by the likes of £80 blood pressure monitoring or massive loading of emergency surgical procedures.

Re: Low cost clinics.

Mark Holmes — Thu, 07 Oct 2010 13:52:55 GMT

[quote user="Bob Russell"]

Routine procedures as loss leaders, uneconomical vaccination rates all devalue what we do. I assume this leads to the £1200 pyometra (plus £80 to monitor blood pressure during surgery!) some members have talked about.

[/quote]

They do but whilst we all talk about charging the need to charge more what do we do if the money just isn't there? Certainly when I worked for PVC we were in inner city Birmingham and Coventry. There is quite a large market segment out there which sits between PDSA and normal commercial practice. Non insured and poorly resourced clients, this market segment is only going to get bigger over the next few years as government spending bites. Bites not just into the public sector but into the private sector which relys on selling to public sector employees. If we don't have a strategy which is based upon more than taking more from the client, I do not see where some practices have a future.

We can scoff a little but she is (or was) very successful at what she does. The practices were all very tidy and presentable (better that some more traditionally priced practices I have worked at) She used to stagger vets and nurses starting times so some vets would start late and work through into the evening, the building was then earning a return on the invested capital for perhaps 25% longer than many practices. Not only is the building working longer but the vets are fresh in the afternoon and evening (I am thinking about my tea rather than about turnover between 5 and 6 in an evening)

We currently have alot of floor space and facilites which are only used for perhaps 3 hours a day for operating. If these could be worked for 5-6 hours then the fees required to keep them would be lower.

When referring to surgical norms, which norms are we referring? Operating on 2-3 dogs in the same room at one time? Avoiding dentals on surgical cases? (For example an animal has a bleeding mammary mass and advanced periodontitis Sometimes the only opportunity to get the teeth sorted is at the same time or it will not get done) One nurse to two anaesthetics? In poor socioeconomic circumstances is it better to have lots of entire bitches roaming around (loose) or to neuter bitches in less than ideal circumstances and deal with the (few) problems that arise. (Plenty of people treat their dogs like cats and let them out in the morning and in at night) When the money isn't there surely accepting a sliightly greater complication rate and keeping fees lower can be justified.

My recollection of other fees is that they were also not unreasonably high. (Gareth am I just remembering the place though several years of fogginess or am I about right in my recollection)

Mark

Re: Low cost clinics.

Bob Russell — Thu, 07 Oct 2010 11:39:21 GMT

[quote user="Malcolm Ness"]

Knowing what it costs to buy the necessary consumables, fund the necessary equipment, pay the necessary staff and provide the necessary premises and also knowing a little about the appropriate surgical technique, can anyone explain to me how it is possible to spay a bitch for less than £120=00 without either underpaying staff, working unprofitably or seriously straying from accepted norms of good surgical practice?

[/quote]

You can't!

Income must be recovered elsewhere or perhaps you use one of the many new-graduates at an unfair low rates of pay. Alternatively you expect a very rapid throughput i.e you rush them!

This is my big worry for the future of the profession - pay rates will remain artificially low. Routine procedures as loss leaders, uneconomical vaccination rates all devalue what we do. I assume this leads to the £1200 pyometra (plus £80 to monitor blood pressure during surgery!) some members have talked about.

Re: Low cost clinics.

Malcolm Ness — Thu, 07 Oct 2010 10:05:45 GMT

Re: Low cost clinics.

Bob Russell — Tue, 05 Oct 2010 16:08:16 GMT

Re: Low cost clinics.

Hannah Wynne Richards — Tue, 05 Oct 2010 15:45:41 GMT

Bob You're risking it

May cause offence !!!!!!!!!!!!!!!

Wynne

Re: Low cost clinics.

Bob Russell — Tue, 05 Oct 2010 15:23:48 GMT

[quote user="bob lehner"]

[quote user="Martin Jones"]

It is relentlessly cheerful, isn't it?

[/quote]

Sorry - but just couldn't help a (schoolboy) snigger at the receptionists' descriptions.....

Zara - Here to give you service with a smile
Beryl - Here to make you feel special time after time
Vicky - Here to give you real value and quality of service every time

[/quote]

Missed that bit - sounds decidedly dubious to me! Are they Eastern European by any chance?

Re: Low cost clinics.

bob lehner — Tue, 05 Oct 2010 15:05:29 GMT

[quote user="Martin Jones"]

It is relentlessly cheerful, isn't it?

[/quote]

Sorry - but just couldn't help a (schoolboy) snigger at the receptionists' descriptions.....

Zara - Here to give you service with a smile
Beryl - Here to make you feel special time after time
Vicky - Here to give you real value and quality of service every time

Re: Low cost clinics.

Bob Russell — Tue, 05 Oct 2010 15:00:48 GMT

[quote user="Hannah Wynne Richards"]

Cross ref to Malsezzia thread That's the sort of client they'll attract

[/quote]

Not for long when they find they only have five minutes with the vet!!

Re: Low cost clinics.

Hannah Wynne Richards — Tue, 05 Oct 2010 14:42:05 GMT

Cross ref to Malsezzia thread That's the sort of client they'll attract

Re: Low cost clinics.

Martin Atkinson — Tue, 05 Oct 2010 13:19:58 GMT

The sad thing with low-cost clinics is that they pretend to be philanthropic in helping keep costs down but they are in reality cherry picking and lower the value and prestige of us who are doing a genuine job at a sustainable cost. We have a similar set-up near us so there are some sour grapes here I'll admit but what really pisses me off is when my clients who have drifted off there to get a cheap deal think its all right to just turn up as large as life when a) the cut cost clinic can't treat a complicated problem or want to charge a fortune to compensate for their low routine fees and b) want to be seen out of hours because the cut price bod's OOH provider is a million miles away but expect me to be happy about it and still charge my usual fees despite the fact I've lost my income from routine stuff. Bah humbug.