Today's Veterinary Business

DEC 2018

Today’s Veterinary Business provides information and resources designed to help veterinarians and office management improve the financial performance of their practices, allowing them to increase the level of patient care and client service.

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• 80 percent of the appointment requests later walk in the door. • 5 percent of after-hours calls are from potential clients. • The average transaction size per client visit is $125. • The lifetime customer value is $1,250 per new client. This typical practice would see 28 new appointments in the course of a month, two new clients and $7,500 in new monthly revenue, leading to $90,000 in additional income over a year's time. What if a practice wanted to offer telemedicine on top of providing an after-hours triage ser- vice? Assuming the chosen platform allows the practice to charge clients directly for services rendered, the formula to understand the bottom-line impact is: Total practice profit equals [the number of remote consults multiplied by the marginal rev- enue per consult] minus the flat fee per month. Therefore, suppose the following: • Platform A has a flat monthly fee of $75 per month. • Platform A charges a 10 percent transaction fee for every consultation. • Practice B charges $50 per telemedicine consultation. • Practice B sees an average of 10 clients a week remotely (40 a month). We can determine the total practice profit this way: [40 consults multiplied by $50 per consult] minus [40 consults multiplied by a $5 consult fee] minus a $75 flat fee per month. We can therefore see the practice would generate an additional $1,725 in profit if it saw 40 clients through a telemedicine platform over one month. We also can see the practice needs to do at least one consultation a month or else it would lose money given the flat fee structure. Would the practice be better or worse o if these activities were done in-house? Many practices that try to take calls after hours use a rotating staff schedule. In this case, they should factor in the cost of providing the care internally — How much do I have to pay my DVMs and veterinary nurses to be available after hours? — and assess whether nighttime work can affect daytime performance. It is important to note that an in-house ap- proach cannot be done low tech at scale. Tech- nology needs to be developed to track, monitor and record every call, integrate with medical records, and allow for appointment scheduling. Furthermore, consideration needs to be given to caller time zones and for variations in how other hospitals want triage practiced for clients if the practice is part of a larger group. Who should be allowed to practice tri- age without the existence of a VCPR? I believe only licensed DVMs or licensed veterinary nurses under the supervision of a veterinarian should be allowed to practice emergency triage. What other non-nancial benets could a practice generate by providing the service? Asides from the economic imperative to provide after-hours triage care, practices typically benefit in two intangible ways: • Improved client service. This builds trust, loyalty and awareness. Retaining clients is cheaper than acquiring them. • Improved team morale and job attractive- ness. Remember that burnout is a real issue and that turnover is expensive. In summary, veterinarians have to balance many interests when running a practice, including: • Providing the best medical care possible for patients. • Providing the best client service possible. • Ensuring the practice generates a profit. I hope I have shown that these interests don't necessarily have to compete with each other, that after-hours triage is distinct from tele- medicine and that telehealth can be a useful tool for improving how client service is delivered. Innovation Station guest columnist John Dillon is founder of GuardianVets, a provider of after-hours telehealth consults on behalf of veterinary practices. Innovation Station columnist Dr. Aaron Massecar contributed to this article. CHOOSE TERUMO. Quality. Commitment. Savings. 800-888-3786 PM-00335 4 5 6 Number Economic value Monthly impact Annualized impact New appointments 28 $125 $3,500 $42,000 New clients (non-emergent) 2 $1,250 $2,500 $30,000 Exam fee upcharge 6,000 clients $3 increase $1,500 $18,000 Total value - - $7,500 $90,000

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