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Practice Management

Numbers Down? Turn Them Around!

by Mark Opperman, CVPM

    Is your practice experiencing a decrease in the number of transactions and/or clients you see? You are not alone. Many practices are experiencing the same phenomena. To offset the decrease in transaction numbers, most practices try to better market their products and services and thereby increase their average client transaction fee. Although this is definitely a good thing, and I support taking a full-service approach and educating clients about everything their pets need to maintain a healthy life, there is a limit to how much a client will do, especially in one visit. So let’s look at what you can do to increase the number of transactions and client visits in your practice.

    Evaluate Your Client Service

    The first thing you must do is evaluate your customer service. I have consulted with more than 1500 practices over the years, and I always ask practice owners about how they perceive the quality of their customer service. It is very rare for someone to admit a problem with their customer service. Most people think they provide great customer service. The truth is that it really doesn’t matter what you think about your customer service—what’s important is what your clients think. So, have you asked your clients? Do you survey clients on a regular basis to get their opinions regarding the quality of your customer service? Do you know how well your receptionists communicate over the telephone? What do clients experience when they come into your practice? If your answers to these questions are “no” or “I don’t know,” then you have some work to do. Few successful businesses continue to be successful if they do not keep a finger on the pulse of their clients.

    New Client Questionnaire

    I suggest that you send a questionnaire to your new clients. Remember, these clients are deciding whether they like you and if they will come back to the practice. Established clients have already made their decision about you. They have returned and will continue to do so, unless you do something to upset them. So concentrate your questionnaires on your new clients. You can use the U.S. Postal Service or e-mail, however, if you send questionnaires via regular mail, be sure to include a self-addressed, stamped envelope. Expect an average of 50% of the surveys to come back, telling you the good—along with the bad. Use a well-designed client questionnaire so that you get information that can guide you in identifying specific problems and planning any necessary changes. (Click here for a questionnaire that was professionally designed for my company.)

    Mystery Phone Shopper

    Another fairly easy way to evaluate your customer service is to use a mystery phone shopper. This is exactly what it sounds like. You have someone call your practice as a client and ask a series of questions, and then you evaluate the response. The caller can be a friend or family member, or you can hire a company that provides this service. At VMC, we offer a mystery phone shopper service in which a certified veterinary practice manager calls your practice posing as a client and records the conversation for evaluation. To this day, we are amazed at what we encounter. One practice put us on hold for more than 17 minutes. At another, the receptionist gave us inaccurate information. I can’t tell you how many times we hear, “ABC Veterinary Hospital—can you hold?” and—click!— we’re on hold. Your telephones and how they are answered are your first point of contact with your clients. Doesn’t it make sense that you need to periodically evaluate how well your team is doing in this area?

    Mystery Shopper

    A mystery shopper is a little different. With a mystery shopper, you actually send someone into the practice to evaluate the client experience. Again, this person can be a friend or relative (as long as no one in the practice knows him or her), or you can hire a professional company. VMC has worked with several mystery shopper companies, and again, we are always astonished at what they find. Sometimes the results are very good. Often, however, there are huge gaffes in customer service. As you might imagine, some of the most common problems are team members not greeting clients as they enter the hospital, not making eye contact with clients, and not knowing pets’ names or the reason for their visit. But mystery shopping has turned up some other interesting revelations. Often, these have nothing to do with the team but instead involve the doctors. Some impressions of doctors noted by mystery shoppers have included “did not seem to care,” “are more interested in money than my pet,” and “did not seem to know what they were doing.” The fact of the matter is that most veterinarians never get any feedback on their exam room communications skills—which can make or break a doctor and a practice.

    Mystery shoppers can open everyone’s eyes to problems that exist in the hospital. I think they are a great way to evaluate your practice, so I suggest that you use them on a routine basis. You might be surprised how many companies offer this service and how cost effective they can be. Search the Internet for “mystery shopper companies” and see what comes up.

    Check Your Bonding Rate

    Okay, so you are seeing a decrease in the number of transactions or client visits. But is that because clients are coming in less often, or is it because you are losing clients? One of the things you need to look at is your practice’s bonding rate. Bonding is defined as the return rate of clients within the past 18 months. This should be a relatively easy number to determine, either by running a report within your third-party communications service or by doing a criteria search and sort in your veterinary practice management system.

    The normal bonding rate in a veterinary hospital is about 60%, which I personally feel is low. Most of VMC’s practices have a 70% to 80% bonding rate, unless they are located in a college or military town. Take a look at your bonding rate and see how it stacks up. If it is low, then you need to do some investigation to determine the reason. You should also compare your bonding rate to the number of new clients coming into your practice. If you are losing 30 clients a month and only generating 20 new clients a month, you have a decreasing client base and a real problem. The industry average for new clients is about 25 new clients per full-time equivalent (FTE) doctor per month, but what is really important is how many of these clients you retain.

    Evaluate Your Reminder System

    If your number of transactions is down, another area you need to review is your reminder system. I recently consulted at a veterinary practice that was struggling with a decrease in transactions. While I was there, I asked who was doing the reminders. The receptionist I asked replied that she thought it had been “Julie,” but Julie had left the hospital a few months earlier, so she wasn’t sure who was doing them. Guess what—no one was doing them! This is one reason I like to outsource reminders—so that the practice can be sure they are being done, and in a timely manner.

    You should also review which products and services you have linked to reminders in your practice management system. Naturally, wellness exams, vaccinations, and fecal and heartworm tests should generate reminders, but what about dentistry, blood work (especially for senior pets), electrocardiograms, and senior wellness exams? One category for which many practices fail to use their reminder system is products. You can link reminders to flea control, heartworm, and thyroid medications, or any other medication or product you wish. You can also offer to automatically send (and bill) these products to your clients. If you use e-mail reminders, this service becomes very cost effective and a great one for your clients.

    So, if your number of client visits is down or if your number of transactions has decreased, don’t automatically blame it all on the economy. The recession is an easy culprit, but not necessarily the right one. 2012 has been a banner year for many veterinary practices that have seen awesome growth in both number of visits and average transaction amount. If your practice is not one of these, maybe it is time to find out why.


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