Financial monitoring

Re: Financial monitoring

Bob Russell — Tue, 10 May 2011 12:31:07 GMT

[quote user="Evelyn Barbour-Hill"]

So it's an advertising thing?

The difference between that and Ryanair is that Ryanair's hidden extras are harmless, not unnecessary medications.

Possibly Anon's employer has been to too many management seminars.

[/quote]

Ryanairs business model also involves a supplementary income from the airports/towns they use (I understand). For a small regional airport the flights bring in extra business so local businesses chip in to support the viability of the flights. Sounds a bit like a veterinary practice attached to a pet shop!

Re: Financial monitoring

Tim Mainland — Mon, 09 May 2011 17:45:00 GMT

Anthony's story reminds me of a farm client many years back. I treated a few cows for him and he requested a bottle of Ceporex inj. I pointed out that the Ceporex was much more expensive than my total bill for visit and treatments. He replied "Ah yes, but long after you've driven down that lane and disappeared that bottle of Ceporex will still be here!"

Re: Financial monitoring

Hannah Wynne Richards — Mon, 09 May 2011 17:40:39 GMT

I agree Amanda-nightmareish-the money has to come from somewhere-you do offers to get the bargain hunters through the door,and they then get aggressive when they get hit with a large bill Everyone is pulling in opposite directions-the practice owner has to keep the bank manager happy, so is pushing for "added value " to every consult, rather than just doing a good job, the client is trying to get away with spending the minimum , and the assistant is pig in the middle-if the assistant also has issues about charging then it's just about "pistols at dawn "all round So much easier to just dothe very best job you can, don't scrimp if the animal will benefit from the treatment, but don't treat for the sake of revenue only, and have high basic charges so you don't need todo so

Wynne

Re: Financial monitoring

Anthony Todd — Mon, 09 May 2011 17:31:10 GMT

[quote user="Hannah Wynne Richards"]Why are people ashamed to charge prpperly for their clinical ability ?[/quote]

Round we go again.

'cos clients think the injection is what they're paying for and is what's valuable, not the diagnosis or advice.

eg when you buy a paintbrush to paint the roof and the storeman says "you need a four inch brush", you pay for the brush not the advice.

Which brings me to the teacher asking the class to make a sentence using the word "contagious".

After a couple of illuminating sentences from others Johny said "My dad says the bloke next door is painting his roof but he's only got a 2" brush and it's going to take the contagious"

Sorry, just came to mind.

Re: Financial monitoring

Amanda Nicholls — Mon, 09 May 2011 17:28:10 GMT

[quote user="Hannah Wynne Richards"]

Tim I have the most expensive basic consultation fee in Swansea-I don't have the biggest practice, but I have nice clients, and quite frankly I can't be bothered with the hassle of trying to get assistants to do things my way-I expect An Ons boss is as disgruntled as he/she is

Wynne

[/quote]

I couldn't agree more, I have set my practice up to focus on service rather than price and it is such a nice way to work compared to other practices I have worked for. There is a large group practice in my area i locumed for with cheap vaccines and neuters, they were even offering the first consultation free to all new clients!! you can imagine how much fun it was giving the client a bill for £400 for a stitch up on a dog you spayed a few weeks previously for £99!

Re: Financial monitoring

Hannah Wynne Richards — Mon, 09 May 2011 17:21:51 GMT

You're probably right An On and his/her boss seem tobe pulling in different directions-the boss wanting the practice to be financially viable AnOn disliking charging, clients ringing round and going tothe practice with the lowest consultation fee , then being upset when the total bill is far higher

I far prefer my type of practice Firstly I feel more honest,and therefore more comfortable with a high initial consultation fee, as opposed to aggressive marketing, and secondly as (or possibly because ) of this 80% of my clients are insured, we can all work together for the good of the animal, so I neither push anything so as to make money,or fail to offer it to save charging Far less stress and agro all round

Wynne

Re: Financial monitoring

Tim Mainland — Mon, 09 May 2011 16:45:35 GMT

Exactly Wynne- you are in your chosen comfort zone. And we are in ours which is how all practices like to be - whatever their size. Problem for Anon is that he and his practice push each other outside their own comfort zones. You all seem to think there is an easy compromise but I don't think its that easy for them - otherwise they'd probably have done it already. Hey ho...

Re: Financial monitoring

Evelyn Barbour-Hill — Mon, 09 May 2011 16:38:05 GMT

So it's an advertising thing?

The difference between that and Ryanair is that Ryanair's hidden extras are harmless, not unnecessary medications.

Possibly Anon's employer has been to too many management seminars.

Re: Financial monitoring

Hannah Wynne Richards — Mon, 09 May 2011 16:34:43 GMT

Wynne

Re: Financial monitoring

Tim Mainland — Mon, 09 May 2011 16:32:24 GMT

Same reason as Ryanair I guess! People may or may not see through it but Ryanair have found no reason to change. For Anon's practice you'd need to ask them but I suspect Ryanair is a close analogy.

Re: Financial monitoring

Evelyn Barbour-Hill — Mon, 09 May 2011 16:23:11 GMT

[quote user="Tim Mainland"]Anon's practice is dealing with a local situation to keep their up front consultation fee competitive. [/quote]

You mean he is heavily advertising or quoting this supposed consultation fee, but invariably adds the price of two injections when it comes to it. What's the point? People see through it just as they see through Ryanair. So why bother? Why not just add four or five quid to the consultation fee and stop insisting on unnecessary injections?

[quote user="Tim Mainland"]Anon's practice is dealing with a local situation to keep their up front consultation fee competitive. And so are the rest of you - [/quote]

Afraid not.

Re: Financial monitoring

Tim Mainland — Mon, 09 May 2011 15:59:29 GMT

Oh let's get off our high horses! Which of us hasn't bought a loss leader/BOGOF/mega discounted product heavily advertised by a leading supermarket? We respond as does Joe Public. And spays/vaccines/consultation fees are our lead in, ring around prices that the punter responds to. Anon's practice is dealing with a local situation to keep their up front consultation fee competitive. And so are the rest of you - otherwise you wouldn't be urging us all to "charge properly"-you'd just do it! Nobody is stopping you. Locums please ignore- I do realise you are stuck with what you get in your chosen lifestyle.

Re: Financial monitoring

Hannah Wynne Richards — Mon, 09 May 2011 15:20:55 GMT

Why are people ashamed to charge prpperly for their clinical ability ?

I just don't understand it !

Wynne

Re: Financial monitoring

Clive Ansell — Mon, 09 May 2011 15:13:32 GMT

[quote user="Hannah Wynne Richards"]

Hear hear Evelyn It's the basic consultation fee that needs to go upto a more realistic professional level

Wynne

[/quote]

Therein lies the problem

The profession seems not to value and not to charge for its professionalism and professional time, to the point some practices have to rely on "add ons" to bump up revenue; such as the 2 injections whether they are needed or not with each consult, or pre op bloods and intravenous fluids for cat castrates etc.

The worst example I have seen was while working in a corporate in 2002; Client phoned and was quoted/estimated £29 for a cat spey - cat brought in and had op next day - client collected cat and bill was "well with the full blood profile and nsaid and ab injections that will be >£100 sir" - client dischuffed.

Re: Financial monitoring

Hannah Wynne Richards — Mon, 09 May 2011 15:00:56 GMT

PS to above-as most of these cats probably have kidney problems, a bit of B12 will probably do them some good-so An On can give it with a clear conscience

Wynne

Re: Financial monitoring

Hannah Wynne Richards — Mon, 09 May 2011 14:59:09 GMT

Hear hear Evelyn It's the basic consultation fee that needs to go upto a more realistic professional level

Wynne

Re: Financial monitoring

Evelyn Barbour-Hill — Mon, 09 May 2011 13:55:07 GMT

[quote user="Tim Mainland"] I think I covered that point but to add a little, injection costs are perceived as far less price sensitive than consultation fees by Joe Publ$ic. So changing them may push both staff and clients out of their comfort zone.[/quote]

That's what I don't understand. The bloke is charging every client for two injections at a consultation so in effect he's just charging that much for the consultation and it's the total that matters to the client. Why not just admit it, then Anon can give an injection or not as he judges medically best.

The alternative way out for Anon would be to give two tiny injections of something innocuous like vitamin B12.

Re: Financial monitoring

Tim Mainland — Mon, 09 May 2011 07:54:14 GMT

[quote user="James Laidlaw"]

I resent the fact that a locum that isn't part of a "team" is suddenly not thinking in the patient's best intrest. I do what I can, with the time I have and for the clients I have without regard for the money the business I work for makes or the bank manager I have to impress. I work for the patients' best interests. Whether any other colleagues or vets do is up to them. But this is the reason I had a massive go at a client who had the balls to ask me how much commission I got on selling petfood the other day.

I work in the best intrest of my patients. I think if I didn't - I would be looking for another job.

[/quote]

Locums are absolutely part of the team - IMHO. If only for a day. If you choose not to be, then I find that very sad. And I think the other staff members would find that awkward. If they don't, then I suspect that actually you might be part of that team!

Re: Financial monitoring

Tim Mainland — Mon, 09 May 2011 07:41:10 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="An On MRCVS"]

Tim , I agree regarding financial end . However , the original query related to the fact that each customer needs to get 2 shots . The individual animals which incited the edict were all elderly cats which were 16 years plus . I am reluctant to use NSAIDs in these guys if there are no recent bloods . I follow a little known maxim "First do no harm " Anon

[/quote]

I just don't get it. Why doesn't the bloke Anon works for just increase the consultation charge by four or five quid?

[/quote] I think I covered that point but to add a little, injection costs are perceived as far less price sensitive than consultation fees by Joe Publ$ic. So changing them may push both staff and clients out of their comfort zone. As it stands it sounds like Anon is alone in being uncomfortable in that particular practice. At least, that's how it looks to me...

Re: Financial monitoring

Evelyn Barbour-Hill — Sun, 08 May 2011 23:58:15 GMT

[quote user="An On MRCVS"]

[/quote]

I just don't get it. Why doesn't the bloke Anon works for just increase the consultation charge by four or five quid?

Re: Financial monitoring

James Laidlaw — Sun, 08 May 2011 23:29:47 GMT

I work in the best intrest of my patients. I think if I didn't - I would be looking for another job.

Re: Financial monitoring

Tim Mainland — Sun, 08 May 2011 21:55:24 GMT

Point taken Anon, but the scenario pointed to a much bigger issue which I hope that I've highlighted.

Re: Financial monitoring

An On MRCVS — Sun, 08 May 2011 19:30:36 GMT

Re: Financial monitoring

Tim Mainland — Sun, 08 May 2011 13:37:09 GMT

Wow, this is some thread - and I've only just seen it, as it draws to a close.

So, just to add a final twist....I sometimes ask my staff to take a list of external institutions & personalities involved with veterinary practice and put them into "football leagues". We have clients, wholesalers, HMRC, VAT man, RCVS, Bank manager, pharmaceutical companies, H&S, Employment lawyers, BVA etc etc. And we'd have the Premier league, Championship,Football League Divs 1 & 2. The league I'm most interested in is the Premier League and who is in it. IMHO there is only one member- THE BANK MANAGER. He is the only one capable of closing down a practice today and forever in the absence of any clinical failings whatsoever. You may well choose to disagree but that is my summary.

This thread started over a practice insisting on giving 2 injections per consult for financial reasons and it's been discussed ad nauseam. But not the finances behind the protocol. The impression has been given that this approach was used to achieve excessive dosh. Though it may also have been just to keep head above water. Who can say. We live in tough times, but have yet to see few if any vet practices go to the wall. In an era with so many other businesses going belly up, who knows how long our privileged success will continue. Little can be known of true vet practice viability on an individual basis. Over the years I've have been involved with two particular practices - one was a 2 vet set up where the proprietor paid the assistant much more than the proprietor earned in profits; the second was a solovet where the proprietor earned much less than an average assistant at that time. Just anecdotal I know, but how many other practices are actually close to the edge - we assume we work in profitable practices - but are they really?

There are many approaches to practice profitability and viability and it comes down to local management. One may prioritise "2 injections"; another may go for ensuring clients are happy and come back again; others may go for cut price cheap n cheerful; yet others for working up to the hilt every case that comes their way. There are so many ways to bake the cake of SA vet practice. But one thing is common in my experience - that is that whenever an assistant VS relinquishes the role of employee and becomes self employed, then behaviour in the consulting room suddenly changes! Clinical rationalisations suddenly find totally reasonable ways to shift. And I suggest it is because the individual has come under the influence of the Premier League Bank Manager. There is no getting away from it - this guy bites, and he cares nowt for ethics of any sort. And the concurrent fact is, that if the self emploiyed vet doesn't work to the tune of the Bank Manager, then there will be no practice.

This is turn creates an evolved scenario. An ethos develops in practice, under the guidance of its proprietor(s), whereby clinical attitudes and approaches develop which match the needs of the patients, with the comfort zones of the proprietor and clients, and the financial parameters imposed by the Bank Manager. And all is happy until ANother VS comes into the practice, and wishes to bake the cake of veterinary practice in a different way. Suddenly the practice which gives 2 injections is a. Facing a shortfall in income b. Facing client dissatisfaction as things ain't what they used to be c. Getting laystaff discontent as clients aint happy, boss aint happy and new vet is "stirring it". d. Bank Manager aint happy. Should they change their pricing structure? Their clinical approach?? Who knows. But this is just one scenario. It can happen just the same in a high end or low end practice where ANother vet wants to do things differently. There is always a logical clinical reason for a different clinical approach, but the financial structure will shudder if you change things.

How to deal with it? Our profession is built on teams. It's not about 2 injections; or giving options or not giving options. It's about recognising the team that you are in or joining and deciding to fit in. Or to move on. Vets are strong individuals but we are nowt without our team.

And if you don't fit in, then the Bank Manager is lurking, even if he isn't your Bank Manager.

Hey ho......

Re: Financial monitoring

Evelyn Barbour-Hill — Sat, 07 May 2011 22:12:19 GMT

Seriously, could nobody palpate that Yale key?