How We Operate Our Veterinary Clinic

Welcome to another episode of Questions With Crocker! This week Dr. Crocker and Shane discuss seven things they use to operate their veterinary clinic efficiently with little to no hiccups.

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TIMESTAMPS
Intro 00:00
How We Operate Our Vet Clinic (@doggydoctors) 05:59
You Always Need An Organizational Chart 06:41
Letting Go Of Control 12:04
Job Descriptions Are Important 15:37
Hone In On Your Policies & Processes
Understanding The Bigger Picture 20:41
Meetings Are Effective When Done Right 21:01
Create A 5 Year Plan 24:40

Transcript

0:00

[MUSIC]>> Welcome back to another episode of Questions with Crocker with me, Dr. Crocker, and my husband Shane.>> Yes, I'm here.>> Why are you revving your face?>> You just said we need to come up with a secret handshake.>> I did. We did a little like, I want to give you a high five prior to starting, and you did a fist bump and I did a high five, and it felt like awkward.>> As it should.>> I feel like we need a podcast secret handshake.>> We do not.>> Are you sure? All right, you guys let me know. If you want to write in and let us know if we do or don't need a secret handshake for the podcast, that would be amazing. Speaking of people giving us feedback, I am excited to be here and talk to you guys today about owning a practice. We had some good questions come in and we're going to go more in-depth on a couple things. This is going to be more of a business oriented podcast this time. Just a general informational about us, I'm an emergency veterinarian, and I also own a small and old general practice in Texas. Shane is my partner in life and my partner in the practice. He's an entrepreneur, owns multiple businesses and helps run and manage them. We like to talk about that med behind the scenes, everything that you want to know about being practice owners, and about other random things. We've been stirring the pot recently on social media with some of our podcast clips. It's been interesting.>> Nobody's blowing my page up.>> People really didn't like the fact that I said that veterinarians should get paid decently. Some people were frustrated that I didn't also loop veterinary technicians into that.>> We did talk about technicians.>> We talked a little bit about them, but not I don't think as much as somebody.>> Maybe people just saw clips and it listened to the whole episode.>> That is very likely.>> I will often ask people when they start really coming at me in comments on things, if they actually listen to the episode. The clips from this podcast are 30 seconds on social media, which you can follow us on social media channels at questions with Crocker. But if you actually want to hear the whole thing in context and not just the sound bites, definitely you want to listen to the whole thing. It's only, so they're like 25 to 30 minutes, so not too bad of a listen overall. If you want to watch us, you can watch us on Apple or Spotify.>> You can't watch us on Apple or Spotify.>> Oh, sorry. You can listen to us on there. You can watch us on YouTube. I actually don't watch much on YouTube. I'm not like a podcast watcher. I'm a podcast listener. You, however, are an avid YouTube fan.>> Yes.>> But not for podcasts.>> Usually watching golf.>> You watch golf, like, crazy on YouTube. And the interesting thing to me, and if you could just explain this little I would appreciate it, you don't actually watch professionals on YouTube. Like you don't watch people that are practicing.>> Start to become more prevalent on on. There's been a place now that some of the younger up and coming stars are doing more stuff all mom on YouTube.>> But I don't know if you'd get as much enjoyment out of that as you do out of these random groups of guys that just like to have a good time and go golf together. And pretty much just give each other heck the whole time.>> That's what golf is.>> It's not actually about the game. It's about who you're with and what you can do. What is the craziest bet that you ever had on the golf course? Was there ever anything ridiculous that you've ever done?>> No, yeah.>> Is it not anything you can say on here?>> Probably the most surprising was right out of college. I went on a business trip and I got suckered into a bet game that I had no idea what I was betting on. And when we got done, I owed a lot of money.>> Like you didn't know how fun.>> Which is not fun.>> I'm surprised because you're usually like tight with the money. So I'm surprised you would bet something. This is the man that when we go to Vegas, we literally each get like a hundred bucks in cash. And then once that's gone, it's gone.>> This is girl, Matt.>> Because it's not true.>> I'm sure you gamble more than a hundred bucks.>> Okay, but usually it's like this is our cash. Use this for the night and that's it. And then we go with other people and I'm like shocked because they're just putting out a ton of money. But they also win a lot more. So I guess that's why they call it gambling overall. Speaking of Vegas, so a couple big things coming up this month, I actually am going to go out to BMX. I'll be leaving next week for that in Florida. It's in Orlando. So if anyone's going to be there, happy to meet up. Would love to meet people in person and just get to know them. I'm going to be on some podcasts. There is a guest, which is great. And do some interviews. And so that will be a good conference. And then the next one that we're both going to is Western and Vegas. So again, if anyone wants to meet up in Vegas and hang out, I feel like that conference is, it's a long conference. But I feel like you just don't even know what time it is because you're in like a dark building and a dark casino the whole time. So there's a lot of things going on, a lot of events and a lot of ways to connect at both those conferences. So definitely let us know. I think that one next week is on our calendar. I'll be honest. So it's just added. Like last week. I need to go check this out. I added it. So I'm pretty sure... Well, I was going back and forth on whether I was going to go or not. I'm pretty sure that doesn't exist in my calendar. Because Izzy has club volleyball. And I want to watch her. So I'm actually going to skip the first two days of the conference. Go to her matches. And then I'm going to go out there just for a couple days to do some business meetings and do some networking. We need to podcast about how you're supposed to update in your own calendar. I know what's going on. We do have a joint calendar which helps us keep a little bit in line. But I am telling you now, and there's record of it. So here you go. Congratulations. You're rubbing your face more. So speaking of our kids and sports and activities, our sons started basketball. He did start basketball, yes. It was possibly the most fun and most hilarious game I've ever seen. First grade basketball is something else. It's chaos. It was pure chaos. They didn't know what basket they were going to have the time. They didn't hurt and catch. We really know how to guard each other. Kind of steal the ball from each other. He did great on defense. I mean, great for his first game ever. And didn't shoot the ball that much. That it was actually effective. But it was fun. And I think basketball is definitely going to be more his sport than baseball. Baseball was a little slow for him. Eight to four game. That score scored a bucket of quarter. Eight to four. I know. And like every score all of the parents were like,"Yeah!" I mean, like freaking out. And it's only like eight to four. But it was really fun. So it is fun when your kids start getting into sports more. Except do you remember when we were dating? What did we say about our kids' sports and weekends? I'm sure we were very naive as to what reality was going to be like. A hundred percent. We were like,"We won't spend every weekend going to sporting events and like split up." And look at us now. A hundred percent. That's our lives right now. So, but that's okay. Your parents grew up following your own baseball. Mine grew up following me around horses. So it is what it is. Anyways, let's get into this question today. So this podcast is based around questions that people submit to us. Usually on social media, sometimes via email. And we had a good one that I thought would allow us to expand a little bit more on some things we've talked about in the past. So at Doggie Doctors, who is super sweet, she's a veterinarian. I really enjoy. I wanted to know a little bit more just in general about us purchasing and running a clinic. So what I thought would be nice is if I shared some things that you taught me when we first bought and started to think about how we were going to run the practice. And then you share something that I did that maybe wasn't your typical business oriented thing or an approach that I had to something. So do you want me to go first? So you have a second to process. Process everything. Okay, so the number one thing that you taught me that honestly, standard like the most boring thing ever, was that you have to make an organizational chart. Do you remember that? I'm sure we talked about that, yes. So you were pretty strong on the fact that you felt like we had to make an organization chart. And honestly, my thing was we had like five employees and I'm like, why do I need an organizational chart? Like I literally can walk in the room and say something to everyone. But your thought process behind it made sense. So share why you should have an organizational chart, even if you don't have a ton of employees starting out. I think it's probably twofold. One is you want to build an org chart that you can kind of grow into. Oh, work. An org chart. An org chart, yes. So something that you can grow into. So what does the five of your plan look like with an org chart? And then you can break that down to today's environment. But everything that you, person that you plug in is to be plugged in for a reason that, in that reason should resonate for something coming out of the line. So you're looking at the growth potential. Not just we seem busy, let's plug somebody in to, you need to make sure everybody A has the ability to make decisions. And no, they're specific roles and who their direct report is. The last thing you want to do is an owner is that everybody coming to you with a problem and you become a bottleneck for decision making. They need to follow a appropriate channel that maybe you ultimately have a say-so-and, but they've got to follow that channel or you can't really grow. And I think that was the point that really hit home with me because I have been in a practice before and been like the associate veterinarian that every single person came to with their problems, with their questions, with their concerns. And honestly, one, it felt like I didn't have the ability to really do anything about it. And two, I should have given them more ownership over trying to fix those things themselves. And I really became a bottleneck for change because I was kind of like door open on everything. And so what I learned to do was say, did you talk to your manager about that yet or have you talked to that person directly? And that did help start to kind of weed out just everyone coming to me directly. But you definitely made a point to say, you don't want to be the person that everyone talks to and everyone comes to with every little thing. You want it to be that there's a process and there's a layer of leadership, at least one or two between you and that because you will slow down everything if they need you to sign off or they need you to approve it. And I'll be honest, there's been some things that maybe decisions have been made, you know, when I haven't been there or haven't been consulted with that might not have been done exactly like I would. But I think if you're on the same page with how you want to practice to run, what you really value and what your culture is for the most part, you have to trust your team. And I do agree that thinking, okay, five, ten years down the road, what position will these people be in? Who am I hiring for? Like where am I looking to plug people in? Is extremely helpful. We don't just want bodies. We want people that are going to help build something that's really valuable. So we have an organizational chart that has me and then has you and you zone top in the, in the, we chart, I think a look at this picture. So technically I'm on top just because you need like one ultimate decision maker and it's mainly because of like medical and cultural things. So I am the chief medical officer, also the owner, you are the chief operating officer and we have a chief technical officer. So those are kind of the top three layers. And then I am the apex of the mountain, I would say. But we each have under that like our zones of what we're in charge of in the hospital, which I think speaks to the other question that a lot of people ask us is how do we work together and still get along. And it's because I literally can look at that chart and say, okay, this is person's having an issue or this area of the hospital's having an issue that falls under shame and this person. So like they're going to organize that or they're going to deal with that. And I have like my little area that I'm in charge of and I try really hard to stay in that area. How do you think I do a majority of the time? I need to add general contractor to my lane and you need to stay out of my swim lane over there. You do. You do. What do you? What are your primary responsibilities as chief operating officer? I was just more chief financial officer. Okay, sorry. I think you actually put you as both. I think you and our technical manager slash practice manager probably do more of the operation stuff. Okay, more in charge of finances, margins, balancing accounts, making sure we could pay bills, all the receivables, payables, all that one stuff. Also, I mean, I would say management of the building and things like that, which is why I felt like you were more operations, making sure the phones work, making sure like the internet was updated, all that you're in charge of the renovation, like all that has been under you. And then I'm in charge of the medical side of things. So the medical our cat wants out. So the medical standards, the way that we do things are different. Anything to do with people? That's you. Yes, I'm HR. I'm in charge of social media. So I'm in charge of marketing and hiring and also firing. So I'm in charge of that for the doctor group and then for the team as a whole. And then we have people who are in charge of the technical side of the team and the CSR side of the team. So definitely trying to have layers of leadership, I think is really important, even if you're in a really small practice. I have seen practice in the past where the owner was the leader and they would literally walk through a room and say like, oh, we need to do this and then keep walking. But there was no person that was in charge of that. There was no understanding of what they really wanted. And so then they would be mad a month later because whatever they had mentioned randomly in the room didn't get implemented. Yeah, I think you'd get a lot of blowback too from people that are actually doing the work when that happens. So you've hired people to make decisions and take ownership and do things. And then next thing you know you're walking through and point out something that you would do different. And it kind of undermines their authority a little bit and tends to backfire because it just takes these people almost takes the authority away from them. So 100% and that is that's where you have to let go of control a little bit. I am very much, I would say a type A type personality. And that has been a maturity just in my leadership journey to realize that not everyone is going to do things exactly the way you would do them. And you have to kind of step back a little bit and let them figure it out. And sometimes it works out. Sometimes it doesn't. Sometimes you do have to come in and maybe clean something up a little bit. But I agree with you 100%. I used to be that person that would walk through the hospital. And they still joke a little bit and say like tornadoed tenacious coming in. But I would walk through the hospital and just find like all these little things that I'd have to comment on or I'd say we need to work on that or we need to do. And I think that can be frustrating to the people that are there every day and are really working hard. It's easy to see things sometimes when you step back and you're not in it. And so I have an easier ability to look at inefficiencies or look at the way things are going that maybe aren't going exactly the way I had envisioned them. But just because of these are different than the way that you saw it happening doesn't mean it's wrong. And that was a hard thing for me to get and be okay with the fact that I might have a vision in my head and that might not be exactly the way it's carried out. But it doesn't mean that the client's not having a good experience. It doesn't mean my team's not happy. It doesn't mean we're not providing like excellent medical care. So need to be open to kind of feedback in them telling me the way that they want things to go or telling their manager about it and then when we come together and then talking to us. So in regards to that we have kind of a management or leadership meeting where all of us that are in charge of the direct reports meet and then our job is then to kind of talk to the different people under us about things that we need to work on. And then we do also have a team meeting where we go over things as a whole a lot of times it is decision making about things that we want to see happen because I really think it's important to get feedback. Another misstep people who are really enthusiastic can take is saying I want to do all these things and change them and not really knowing the best way to change them and maybe making everyone's job dramatically harder. And sometimes you're going to make people's jobs harder. Yeah, I see that a lot. Where you, not you, but in general people will take and try to fix a problem that they don't really know the problem of fixing. And it takes a while sometimes to have everything kind of be digested and understand where is the true problem that we're trying to solve for without going in and just throwing a dart at a dart board and say okay, we're fixing this and next thing you know you screwed up 10 other things. So sometimes it's better to slow down and make sure you truly understand the problem and then work through different solutions that will ultimately fix the problem the right way. I actually did that not because I meant to, but we have templates that are set for our rabies certificates and every dog that gets a rabies, like they automatically get the certificate printed off or email to the owners. And we had someone who was traveling overseas and they needed the microchip number on there. And so I'm like I can fix that for them, you know, I'll get it done. And so I just like pulled up the template, changed it, put the microchip number in and apparently I messed the template up for like two months. And every time they went to try to do it, they had to like do all these things to and I made their job dramatically harder. And so my practice manager told me you're not allowed to touch templates. If you want something changed on a template, you need to tell me and I will change it or you make a copy and change it, don't change your original. And it was something that seemed really small, but it did make their jobs dramatically worse. When all I was trying to do was help or fix something else. So 100% that's the case. And again, I'm a doer and I'm a fixer. So I want to do it, but you need to do it by making sure you're checking it with the people who are in charge of those different things and not just saying like I'm the owner. Let me change it. Let me do it. I wonder if I've ever done that to you. I'm sure. Major like little harder by trying to example, but I'm sure if we dig deeper up in the chest, we could punch them. I'm glad that you don't have a ton of examples of it. That's probably a good sign. Okay, so organizational chart is important, something you should definitely hash out, you and your leadership team. The other big one was job descriptions, which to me, you hear they're important, you know, they're important, but they are so not fun to do. And the good thing was you said like why create the wheel and we actually found some great templates that we were able to adjust, but I know it's important. Explain why it's so important to have a job description. I don't think early on a thought job description is really where I guess I thought like you like it's just a bunch of words on the piece of paper. Nobody really follows. I was interviewing some people one time for some different positions and we had a ton of people a candidate to look at. One person email me said you months sending over a copy of the job description. So we sent that to him and it made me pause for a second and realized that if those are written correctly, it really does define what people are doing, which you're paying them to do. So if you don't have the job description built correctly, how do you really hold that person accountable for the job? Right? So they have to know very specifically what they're responsible for. And if you want to tie incentives to that or whatever it has to be measurable. So having a job description that actually fits the role for that person carries a lot of weight. It really does. And I think a lot of us think that we know what a veterinarian does, we know what a technician is doing, we know what a management position is doing. But really when you get into it and you look like you could pull up five technician job descriptions and they could all say different things because some are going to be in charge of some admin duties. Some are not going to be in charge of that. Some technicians are allowed to do a lot more than other technicians are allowed to do. And so kind of knowing what that expectation does sets everybody on the team up for success versus someone may be thinking they get to do more than they actually get to do in a job or being able to like grow into position more, right? So we did that and then to kind of expand on it more. We also did a level one, two and three technical duty list. And basically that is a part of our salaries. So the salaries are based on what level you are. So it's very transparent. Like these are the things that you need to be really good at and we need to check off that you can do and you can move up and salary based on what level you are. And so that was another thing that we found some examples online and we adjusted them and moved some things. And there was some things that we specifically really wanted. I want my level three technicians to be able to do full abdominal ultrasounds and be able to send them off to a radiologist and be certified in that. But that's something we added specifically to our practice. But I think it's really nice. It also takes away from just like paying people random amounts of money. You can explain why you're paying them what you're paying them and what they need you to make more money in your practice. So job descriptions and specific like further descriptions based on levels, I think are extremely valuable. And then in that with the managers, it talks about who the direct reports are, who they're in charge of. And I think that also gives them ownership over who you really need to be overseeing. And honestly, who you're going to be held accountable for. Like if I have a technical team that's a mess, I'm going to look to my manager first. Why are they such a mess? What have you been doing to try to help them? What have you been doing to make this culture better? Because really that's where it's going to be the point that I'm going to talk to you. And so it kind of helps to have that really defined. Was there anything else that you can think of around job descriptions or levels? No, I would also lump in into the same kind of category as policies and processes. And again, we can talk, you know, long time on this. But if you don't have processes for stuff, things are going to get dropped and, you know, missed. So and that's something we probably need to get better at is creating processes. Not just because everybody knows this is the process, but where it's written out and you really have a clear vision of what the process is. So you have the job description for this person. These are the things that they do. Here's how they do them, right? So I think sometimes processors overlook ordered food the other day and they had to make something and I waited for like 15 minutes to watch over the counter nest. The guy where my food was and he had cleared me out of the ticket before we actually gave me the food. So we skipped one little step in a process, but they just the downhill effect of that is, you know, have a customer that had another food, maybe they didn't have the best experience, you know, now the food's cold. Now we had to throw that out and make new stuff. So I mean, just one little miss step in a process can really mess up the entire workflow for not careful. And some of that you can again find if you are a part of like some of these groups like BMG uncharted, you actually can get like hospital manuals that are going to have a lot of things, but there's some that are still very specific to your hospital, the way you wanted to run the workflow and only you can really go through and adapt those things. And it's nice to have a template to work off of, right? Because it may actually trigger thoughts of things that maybe you didn't think of or ways that you may want things to work and you just hadn't really thought it through. So having a template to start with and then working through that to create your own process, I think it's a very well valuable. It's actually funny. We're about to have like the three cold days that we haven't texted for the whole year coming up and so we're working on what is our cold weather policy. And last year we kind of had one loosely based, but I want something that's like written out that I can send to the team and let them know, okay, if it's this, we're doing this, if it's this, we're doing that and obviously get feedback on it. So we were just talking about we got to get that finalized because we have those cold three days coming that we had to prepare for. So, but I do think those things are really important. So those are the big things that I took away from you that I think were important steps with buying a practice and really trying to start out like with a strong foundation for your team and a lot of transparency for them of like what you expect and what's going to happen. What have you come up with anything that I did specifically that you maybe haven't done with other businesses you've owned or anything that I kind of thought about? Yeah, if there's a lot of stuff, I think the one thing that probably at the top of my head would be I'm so black and white with figures and numbers that that's how I base, you know, knives and my decisions off of. I think you're much better at understanding what is the global picture, right? I don't care what it cost. If we do this, we're going to get returns off of it. So looking at stuff maybe outside of just a normal figures is very helpful, but then to like the management style of having the the huddles and the stat meetings and the the manager meetings. I hate meetings, but I understand the value if they're ran correctly, how to make sure we pass that information down appropriately. And we we have tried really hard like I do like Google forms a lot to get feedback on things before you even have a meeting. So that we're going into the meeting saying, okay, this is what we needed to decide. This is what you guys came up with any other feedback. So I try to limit, I guess, the meeting time and make it a very efficient time if everyone's going to be there. And for the most part, I think that people don't absolutely hate the team meeting. So that's always a good thing. But it's also good just to at times you have to level set, right? Okay, guys, we've been doing this. We're getting great feedback. It's positive. Keep it up. We're also doing this and it's causing, you know, extra weight times or whatever. Let's make these changes. So like you said, be able to step back and see the overall vision that maybe people that are in the day to next don't see in it being able to level set and regroup I think makes a lot of sense. Well, and even today we made some changes to the schedule recently. And I had noticed a couple, I guess, consistent things that weren't really what my vision was for the schedule. And so today I went to the different teams and I talked to the technicians and I talked to front and I was like, you know, why is it getting scheduled like this? And do we think we could do A, B or C? And I got really great feedback and I was able to kind of take all that and then come back to everyone and say, okay, this is what I want to see. And this is how I want us to do it. And then we'll talk again in a couple weeks and we'll see like how that's going. And so that's the process we're in, especially having added a new doctor recently to just figure out what workflow works best for someone and what schedule works best for everyone. But overall, we are busy and we're making more money and the team is what? I'm not sure we're making money, but we're not making money. We're spending a lot of money. Well, we're spending a lot of money because we're doing a huge renovation right now. I haven't bought the tonopin I want to buy and I know what that is. It's not only 2024 capital budget. Okay, so tonopin is the smallest thing ever and it measures the pressure in the eye. And it is very important because if a pet has got come where they have something like you need to know because that is an emergency. There's this one thing that can measure that, right? And so I was looking into how much this like little itty bitty thing is, just guess how much it is. 800 dollars. So the cheapest I could find was $6,000. For this ety bitty, eye measurement, eye pressure tool. Now I did talk to all of this is going to be business for about 40 plus years. How many times have they needed this? So that's the crazy thing is in the past years and owner, we have not needed it. But it's one of those things if you don't have it, like I would say that you have to have one in the hospital. I would say that that's one of those pets that you say. Unfortunately, we need to send you over to the ophthalmologist or, you know, the. So I did, I talked to an ophthalmologist and I actually found one that is significantly less and they said it works really well. And so I'm going to look at the conference I'm going to and see because at the conferences, they will have specials and deals on equipment and 24 or a couple of budget is already being closed. There's no more expenses. So you're just started. We can't change the budget yet. We did just buy an x-ray. So that's a decent chunk of change right there. So we're just slow rolling it. There was something the team asked me about the other day. I was like shh, a shain around. We don't want to talk about that in front of him. So okay. So hopefully that is helpful to someone. Some of the things you need to think about that are very specific things. I've actually shared. We can provide examples to people. Yes. I mean, again, they can find much better ones out there. I'm sure, but we're happy to provide what we've built. I just said our job descriptions and tech levels to somebody today who asked if they had if we had one and they could use it as a basis. So always happy to share that information. Again, we had someone else's template that we worked off of. So the information's out there, but if you want to reach out to us, we are happy to give you what we've come up with so far. So hopefully that is helpful. If you guys have additional questions about practice ownership, about veterinary medicine, make sure to hit us up at questions with Crocker. You can always leave a review on Apple. I would say build a plan to just quickly. Like a five year plan. I was in my wrap up. This is important because you've already hit me up for things that are on the plan way in advance of when they're supposed to be on the top. Oh, and this man pulled out a picture of the two and five year plan and was like, that is not to this year. We need to find that picture actually. I actually have it in my phone. So for all you partners of owners that are married to create a plan to take a picture of it. It's very important. Evidence of when you said something was going to happen. All right, wrap it up. Sorry. All right, no problem. So you can listen to us on Spotify or Apple. You can leave us a review there. We would love it if you wanted to give us some feedback on the podcast. And you also can watch us on YouTube. We appreciate you guys listening. Make sure to get those organizational charts done and let us know how it goes. Thanks so much and have a great day.