How To Become An Efficient Veterinarian

Welcome to another episode of Questions With Crocker! This week Dr. Crocker and Shane discuss the many efficiencies and inefficiencies in veterinary medicine, how to incorporate different elements of efficiency into your workflow as a veterinarian, and more.

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TIMESTAMPS
Intro 00:00
The Importance of Disability Insurance In Vet Med 04:32
How To Become An Efficient Veterinarian 09:12
Why It Matters To Be An Efficient Veterinarian 09:23
The Things That Take Up The Most Time 10:18
How To Measure Efficiency 13:02
How Dr. Crocker Does Appointments 14:13
Technology Is Underutilized 18:47
Billing Efficiency 29:47
Outro 32:27

Transcript

0:00

[MUSIC] Welcome back to another episode of Questions with Crocker. With me, Dr. Crocker, an emergency veterinarian and practice owner in Texas, and my husband, Shane.>> Hey.>> What's happening?>> I'm showing my microphone straight.>> Why are you messing with it?>> It looks great from here. I'm sure it's great. I'm sure you sound good. We are podcasting. We're excited to be here. You were not on the last podcast because I was at VMX in Orlando, and I was podcasting with some people live on site, which we're going to do again at Western Veterinary Conference coming up. We're going to bring all our podcasting equipment, and we are going to just talk to people. I'm excited about it because I actually have a couple other couples that are in Veterinary Medicine that you and I are going to interview together.>> Sounds like a blast.[LAUGHTER]>> In general, you don't come to very many vet conferences with me, but you've been to Vegas before. What are your thoughts on vet conferences? Because you used to go to large conferences when you were in sales and working in health care.>> Yeah, I think they're a little bit smaller than human health care conferences.>> That's wild to me. Because it seems so big when I go to it. How is it smaller?>> I feel like there's, I suppose the big health care conferences, there's some like there's more people, and more vendors and booths and stuff.>> You said the booths are epic in human health care.>> A lot of them are, yeah, like budget two store booths and everything else.>> So big.>> It seems like a waste of money to be honest.>> I was about to say that. I'm so glad that our money in health care is going in good resources. But there was a couple cool booths at Western last year. Do you remember what we went and did at one of the booths? What do we do?>> The one where we saw what's his name?>> Grunk.>> Yeah.>> Yeah. So we saw the football player. And then we also, there was bull riding there. And I of course had to ride the bull and how'd I do?>> Wonderful.>> I would say that they were actually a little easy on me. It was a little weak. I've written better mechanical bulls and->> A couple of you still in business?>> I don't know. We're going to see this year. They actually were not at BMX in Orlando, which is like the largest vet conference there is. And so I was kind of wondering that. Like, are they going to make a big showing again at Vegas? Is that just going to be like, they're conference? Because they did it at pretty big.>> Yeah.>> It was a pretty big deal. And I do enjoy going to conferences because there's always new things coming out that you hear about. Right now, there's a big stir because there's a new parvo medication that is a one injection. It's not a cheap injection, but it's still a lot cheaper than hospitalizing parvo dogs for many days in a row. And we've used it in our ER a couple times, but it's still really new. And so hearing the data on being able to treat some of these dogs that really could die from the disease and having them bounce back within 24 hours is pretty incredible. So learning about just all the new inventions, there's a lot of technology. A lot of new things coming out in that realm. And I think that it kind of speaks to what we're talking about today and the question that we have. Just in case you're new to the podcast.>> It's not a word.>> That's just. In case you're new to the podcast, listen, I just got off a three overnight in the ER. And I am not as young as I used to be in case you hadn't noticed, which neither of us are as young as we used to be. There was actually a picture of us the other day when we were dating. And I showed it to Corbin and he's like, who's that pointing at you? And I was like, that's dad. And he's like, he's like his hair looks a lot different.>> A lot different.>> So anyways, I don't even know what I would say. You got me so off track. But the premise of our podcast is questions with Crocker, because a lot of people ask us questions about veterinary medicine, about being a pet owner, what they experience, what we experience as a veterinary. And so we like to pull back the curtain and talk about some of those things. And this question comes from someone younger in the industry. And I think we can give them some good information.>> We'll give them information.>> That can be the judge of the quality of it.>> So we do always like to preface that anything we say and share is not professional information. We are sharing our experiences. We're sharing the things we've learned through all the years of working. But let's give credit where credit is due. How many businesses are you currently running, Shane Crocker?>> Oh no.>> A few.>> A few.>> I got more employees.>> More than one.>> There's a lot that don't have employees. So it's a little bit different, I guess.>> What, name one that doesn't have an employee?>> A bunch. Our real estate company that owns the vet hospital. There's a technical pay its own company, but there's no employees.>> I mean, we're the owners, so we're kind of employees, right?>> Not of that company.>> No.>> Is this the company you own that my name is not mine?>> Actually, I think I'm the owner of that company.>> So, so now we know the truth that you're hiding assets.>> There's several like that that require tax returns, but no employees.>> Why are you hiding assets from me?>> I promise you this, not the biggest question. We now need to address.>> You also have a lot of life insurance now.>> Oh, okay, good to know. Good to know. Actually, so that's one thing that people were talking about a lot at this conference. They were talking about disability and life insurance. And I think it's interesting because a lot of people said, you know, you being able to work is where your value is as a vet, like being able to use your hands, being able to do surgery, being able to use your brains. If you have a traumatic injury, that's all gone. So, they were talking about how disability insurance is so, so important in our profession, because it is such a physical profession. But I wanted to know your thoughts on that, because I feel like you are more aware of all the insurance, dos and don'ts in general.>> I would agree. I think especially for veterinarians, you'd have to use your hands, especially for surgery. Now, the reality is if you can't use surgeries and the more you can still do other things in the profession, so I don't think it's, you know, if you can't practice medicine, doing surgery that you just go sit on the couch. So, yes, disability insurance is probably important, probably more so for somebody that's specialized, like a surgeon or something like that, but I think there's other things you could do if you needed to.>> With your degree. Yeah, and we talk a lot about that, about the variety. That's one of the best things about the veterinary degree is it is so versatile, and you can kind of pivot and rotate whenever you need to. And I do know people that were practitioners a long time, and, you know, physically couldn't do it anymore, and so they moved into a different role in the industry role or a teaching role. And so, I think that does work. Now, I will say, I am aware of a veterinarian that does not have full use of her hands, and she does surgery still, and she actually speaks, and is a motivational speaker in her industry, and it's pretty amazing how she's been able to adapt and like still do those things. And so, I'm not going to say that that, you know, wouldn't be something like changing for somebody, but there is a lot of ways that you can, I guess, grow and still be able to hopefully do something. There's other coverages for disability that could be very important. I would consult with the insurance agent. With an insurance agent? Yeah, well, it's good to know that you have life insurance on me with all my travel and all the other things that I have going on. Actually, we had an interesting case in the ER that made me wonder a little bit how good my insurance was currently. So, we had a dog come in, and the dog was bitten and attacked by a coyote about five days before it came into the emergency room. And these owners had been treating at home the wounds. There was puncture and bite wounds kind of all over this dog, and it was about a 40-pound dog. She was pretty cute and adorable, but she came in and was lateral, which means she couldn't get up. All of her wounds smelled horrific, and were like seeping fluid. But the biggest thing was that she was very neurologic. So, her eyes, she didn't have a blink response. She was tremoring a lot. We had to give her medication to stop her from tremoring. She was just very dull. And, you know, when you have an animal that's been attacked by another animal, it's really not that common for coyotes to attack larger dogs like that. You do hear about them, you know, taking smaller dogs, but 40-pound dog is pretty decent size. And so, immediately on our list, had to be the possibility of rabies, because the time frame of being bitten and showing signs and there's different forms of rabies. Everyone kind of thinks of like, "Cujo." But there's actually like a furious form, which is the Cujo form, but then there's also a dull form when they're just really quiet. So, we handled her with gloves, and only those of us that were rabies vaccinated, handled her because we were really worried that it was potentially something like that. And rabies is transmitted by, like, saliva, and so, you know, you have to look in their mouth, check their gum color, so we just made sure to wear gloves, and obviously not get bitten. Because nobody wants to go through rabies' prophylactics. But I was thinking, like, what would happen if I needed to be treated for rabies? Because... I was trying to figure out that an entire time. How do you were going to relate that back to life insurance? I don't know if you were, like, scared. You were going to get attacked by a coyote or... I know. So, I don't know if that it was if I got rabies and, like, died because rabies... No, almost anything. rabies is fatal. Like, what would you do? I mean, obviously, you would, you know, not survive and never get married again. And, you know, spend your days and morning. Exactly what I was thinking. I always joke that I would haunt you forever if you. Anyways, totally, totally a tangent here. But... That was not on our questions. That was not on the questions. But, yes, that was an interesting case. And it was not a fun case to deal with, because of the concern for rabies, which is fatal in people. So, vaccinate your dogs, please. Did you put the dog down? Yes, we did. We actually talked to animal control, because of the exposure and, like, how neurologic she was and how many people she had been in contact with, especially in the household with, like, all these children and people we needed to know if she had babies. And so, made that decision and submitted the samples to find out. So, we'll find out in the next couple days, actually. And if she is positive, we all get to get lots of shots as a prophylactic, which is not very much fun. But, we'll see. We'll see. At least there's something that we can take just in case. So, back to our question. So, I thought that this was a good one and one you could kind of speak to with all the, I guess, balls that you juggle and I could speak to it too. But, at Shuni Vajohana, and I don't know if I said that right, wants to know, how can you... What? Don't give me that face. Show Hiotani. Shuni Vajohana. That's what it looks like. I don't know. You can reach out to me if that's your... I'll go with Shuhi Yotana. You do not know. And who was? Is that her? Guarantee. It's definitely not a baseball player. But, wanting to know, how can you become an efficient vet? So, I think this is a great question. It's a great question that younger vets ask a lot. And, I think it's an important question. So, first, let's just talk in general about, why does it matter and why is it valuable to be efficient in our field? What is your thoughts? I think it's important in any field to be efficient because you get more done and typically getting more done, allows you to potentially make more money, allows you to see more patients. There's probably a lot of reasons to be efficient. I agree. I think even further, if you're an efficient veterinarian, that means hopefully you're getting your records done in a timely manner. You don't have a lot of things hanging over your head. Like, when you leave at the end of the day, you have good time management. You are able to just not be as stressed. I think the more efficient you are in the more processes you have in place and you use the resources you have, then the better you'll be as a veterinarian to your pet patients, but also the better you'll be to yourself because you'll have a little bit more availability to rest, relax, take time off mentally, when you don't have as much hanging over your head. And a lot of that means getting things done in the time you have to get them done and being able to go home and just rest. So, a couple of things came to mind right away. And I think for me, it started with, what are the things that take up like the most time that really are a time suck when you're a young veterinarian and you're just starting out? And at the top of that list, which I don't think a lot of people think about, but is veterinarians doing technician duties? So, I am a firm believer that a great veterinarian will have quite a few technicians at their disposal and they will do the things that they have to do as a doctor and the technicians will do all the other things that they are able to do and to the utmost that they possibly can, that their license and their state allows. And I think that is one way that you can be really efficient. Now, the struggle is a lot of young vets, when they get out, they don't trust people to do things for them. They're worried constantly and so they, which honestly some of those technicians probably know more than they know, 100%, 100%, especially on the technical side of things. And I actually tell the young vets all the time, like you will learn just as much from the rest of the team as you will from this senior veterinarian who worked with it, and if not even more, right? And so I think that they often want to be the one to place the catheter or intubate or do this surgery. And when I start working with people, sometimes they're shocked that all I do with this surgery is examine the pet, make sure nothing major is changed. They're in a good condition for anesthesia. I do the drug calculations or actually a double check the drug calculations that they have done to make sure everything's good. And then I say, great, and they put that pet under anesthesia, they intubate, they prep, they clip, they do everything they need to do. And then they call me and say, "Hey, they're ready for surgery." And I go in there and I do the surgery. Then after surgery, I say, "Thanks so much, y'all were great. I leave and they recover the patient." And so my time with that surgery patient is much less because I let other people do the job that I know that they are able to do. Now, a lot of it is also, I've worked with a lot of these people a while. I know their capability. I trust them. There are certain cases that are more critical that maybe I'm a little closer by, right? But I really do know that they can handle like what I give them. And when you're starting out especially, you're nervous because your license is what's on the line. And if something goes wrong, you know, that's on you. So I get why it's hard to trust, but I really think to be sustainable in this career, you have to kind of trust your team to do the things that they're supposed to do. Do you feel that way is just like an owner of a business that that is a hard thing to do? Or are you really good at delegating and letting people do their jobs? I think I'm pretty good at it, but I learned watching other business owners growing up, my dad always said, "There's the right way. There's the wrong way. There's my way." And I understand his point, understand why it does what he does, but you also become a bottleneck to being able to grow if you have to touch and oversee every little thing. So I think I learned a long time ago that sometimes you have to rely on the team you put in place, allow them to do their job. And like you said, oversee just to make sure the results are what they're supposed to be. Yeah, and there's always opportunity to, you know, test and see like how well people can do and how much you can give them. And then to take back some of that if you need to. The first thing you can do, Mom, when you said about efficiency is,"Mom, I went to, well, how do you measure efficiency?" So for me, it would be like on a day, how many patients can I see and how many surgeries can I do? The previous practice I worked at that had a group of technicians that just rocked it out. I could do three, four procedures in two hours, like surgical procedures. And that's because I basically, you know, would help start the dental and then I would go do a spay or a neuter and then I would come back and extract teeth and then I would go do another spay or neuter or grow through removal and then, you know, they'd have the second dental down and I'd come out. So I could bounce around while other people were doing all the things that they are very capable of doing. And so it's really for me, like, I know my ability to do multiple things. I know how long it takes me to do these procedures and it really shouldn't slow me down having other people do their job, right? And then the other thing I think about is, where else can my time be spent? So instead of spending 20 minutes helping get a surgery patient ready when I really shouldn't be the one that needs to be doing that, I'm just been 20 minutes working on records or maybe seeing a room and seeing a whole another patient and a whole another appointment. So I consider things to be efficient when I think about how quickly I can get things done with a good team and with the right support. I will say I can't hold everyone to that standard because I think I work a little differently and communicate a little differently. So I wanted to walk a little bit through like how I would do appointments because I also think that's something that has helped make me more efficient. So one of the biggest things that I think is important is a lot of times in the traditional setting, you know, a technician gets the pet, they get the weight, they take the history, they come and tell you this is what's going on, then you go in the room and you do your thing and then you say, okay, this is what I need you to do and it's like this back and forth right between you and the technician. I certainly prefer, and this is partially from working in open concept DR, but I've been able to take some of this to GP. I prefer to be faster in the room. I prefer to be a part of the history taking. I'm doing my exam while they're taking a history. We're talking at the same time. I'm asking questions. They're typing for me. So they're typing up a history. They're making sure it's thorough. Sometimes they can even type up the exam findings as if I'm talking through them like what I'm finding and what I'm seeing. And so I think having you guys work together as a team in a room versus having the your turn, now my turn, your turn really makes things more efficient. Yeah, I could see that also lead to more questions from the pet owner, right? So the technician gets all those information and then you come in and that leads to more questions, which actually drags that entire point out even longer. Yes. And it's so funny because a technician will tell you this all day long. They will go in there. Oh, you're here for vaccines. Okay, anything on it? No, fluffy is totally healthy. Everything's great. Okay, so no issues. No, fluffy is awesome. We're good. And then literally I'll go in there and look, be like, well, there's actually, you know, they've been limping for about three days and there's this lump on them. And then it turns into, okay, well, now you got to look at all these things. And I'm not saying you can cut that out completely, but I do think by being part of the conversation, if you're able and getting in that room faster and seeing why they're there and asking the questions you really want to know and doing your exam while the tech is taking a history can be really, really helpful. So that's something that helps me. I also really like it when, you know, I'm in a room and I like for certain cases, especially sick ones for a technician to be in there with me. And you know, if I say, you know, I really recommend we do lab work or I recommend we take X-rays. And then there's those, yeah, I think so. They'll actually take the pet and start getting those diagnostics done while I'm answering like any additional questions. And so that is helpful just to keep the appointment rolling. And I'm going to probably go see another room while the blood works running while the X-rays are being done. And then I can look at them and pop back in there, right? But it's trying to get those things done quickly so that I can move on to the next room and the next thing. So utilizing them in that way is really helpful. The other way you utilize them is you train your team to communicate for you. And you train your pet owners to trust your team. So callbacks. It's another thing that's kind of a pain in the butt, but it is really important. It helps create like trust and a relationship with pet owners. And yes, we do email sometimes like healthy young dog blood work looks great heart, um, test is negative. We'll email that, but anything else or anything where they were sick and we were checking something, I really want to call them just to answer those questions, but I don't really want to call them. I want my team to call them. And so training them how to communicate, you know, those things that might be abnormal, what the next steps would be answer questions will keep you off the phone and being in those long conversations. Yeah, I think even sitting at groundwork with the customer while you're in the room, hey, um, you know, so and so technicians going to even call back, so we have the findings, you know, kind of sitting at that framework where they know it's not going to be you making that call is probably huge. It is it, um, it helps to set the expectation. And then I am really big on if an owner wants to talk to me or if an owner calls during the day, unless it's something I really do have like the time to really talk to them. I am big on like, hey, have some email with their questions and I'll email them back or have them send a picture of what's going on. So using technology in that way to communicate as much as I can, which is a lot faster and easier than getting kind of stuck on the phone. I'm also pretty good at not getting stuck in conversations. I think that people want to talk and they want to be heard, but I think learning how to figure out like why are they really there really addressing that and then making sure you can move on to the other thing is a little bit of an art. We all know talkers that are just hard to shut down, but I'm pretty good at kind of saying like, okay, and we need to make sure that we get this done on fluffy. So I'm going to go and check on C like where they're at with everything. I'm good at turning the conversation around and kind of getting out and I don't get feedback that like I don't spend enough time with people or they don't feel like I'm engaged because I think when we're talking, I'm very much eye contact, very much asking the questions I need to and answering the main reason they're there, right? But small talk, I make a little bit of it, but it's not a long drawn out process. So utilizing your team in that way to have them do the skills that you know they can do so you can be doing just doctor things, having them communicate as much as possible, I think is hard as a young veterinarian to trust people to do that, but it's all part of the training process and if you don't feel like your team can do that, then really you have to start with training them to do those things and you know what's the thing everyone says like I don't have time to train, well you don't have time to not train, right? Because it's going to make you slower and make you make it worse. I think that technology is also something that's underutilized in veterinary medicine. So can you think of any technology pieces that would would probably help or practice to be more efficient and help with veterinary and to be more efficient? Yeah, I was going to back up and step further and say how you create your day is going to help with your efficiency. Let's talk about that. I like that. So having a practice management system that you set up your appointments appropriately and those appointments are scheduled appropriately is going to allow you to flow through the day better. Okay, so I'm going to say something controversial. There are veterinarians that especially when they're coming out of school, they are requesting to have like hour long appointments. That's what they're starting as. And I, so just with the way I work in the way I... There's only eight hours in the work day. I know, I know. But the way I work in the way I do things, I don't understand it. Like I don't understand what would take an hour. And I work emergency. Like I work really tough cases, right? And I also work GP and I see second opinions and I see tough cases. But the longest appointment I schedule is 30 minutes. And that's for second opinions that are going to be going through old records and like, well, you know, that may do more diagnostics. And even then, I tell my team like, really don't schedule me 30 minute, like schedule me 20 because I can take five minutes from this one and 10 minutes from this one and I can like get the time I need and I'm I can balance multiple rooms. But I have a hard time with people needing an hour for an appointment. And this is... Like people being your clients need to feel like they need an hour? No, no, like the veterinarian. Feel like they need an hour for an appointment? And I don't know. I mean, I need honestly, if like people out there have hour appointments, I would love to hear... Yeah, I like to know what that flow is. And also I'd love to know what they're... And compensated for that Tom. I would love to know what their ACT is, like average client transaction because I couldn't only see people a day and like pay the bills, but I think that part of it is they spend time communicating and I think a lot of it is they spend some time maybe talking to the other vets about their plan and their things. And then I also think a lot of it is like getting their records done. So they're they're trying to make sure like all that is done before they move on to the next patient. And I think it's great that people feel empowered to ask for that, right? And I know practices that are like we start a new grads off with hour long appointments. I know practices that do 45-minute appointments for like all their veterinarians no matter who. So I think different practices are just structured differently and they probably charge... I mean yeah you got to you got to increase the prices to more, right? But I don't know what I would do with an hour with each client and... I mean if you're a specialty center and you're dealing with a lot of... Oh 100% 100% no sick medical cases I can see that maybe, but I don't know. So I think that that's interesting and honestly I would love to hear from people who like require an hour or their practices set up that way because I would like to know more about that. And I'd like to know more about the financial model like what they what they have to charge to make that work. Yeah my meat gut is wild but I'd like to know more just a broad say. Yeah but my the way I work the idea of it is like... I'm not saying it. I'm saying my good reaction is to call it stupid but okay okay. I will hold back my judgment until I get more permission and then I might call it. I would like more we would like more information please so if you do that but I do think I mean I think that people if that's what they need then it's good that they're able to ask for that and if people can give people that and slowly work them in... Is it what they need or what they want right? I mean there's a lot of things in life I won't but I'm necessarily need. It could be both and the way that people work it's just might be the pace is different and honestly if they're still making the practice money or if maybe they are making more money for a permit because they spend more time with them like... But it would be on that like you're doing it injustice to your other clients now you have to push appointments out further because they can get as many people seeing during the I don't know there's a lot of a lot of questions about this. We have a lot of questions in general. We're not saying it's the wrong way to do it. We're not saying it stupid. We are not saying it's stupid. No like I'm not saying it's stupid but I just I don't understand it right. So but I do think a lot of that part of that is records. So I wanted to talk about records. That's what I was going to actually technology in general. I mean if you can have your notes be filled faster because you have templates built and everything else and there's a lot of technology things you can utilize to expedite your records and your prescriptions and get your x-rays into one place where you can see them and there's a lot of things you can use your practice management forward. I create efficiencies throughout the day. I agree and I think like you said how you schedule so just setting yourself up for success that your front desk is not booking you like all sick appointments in a row you know and things that are like going to take more time that there's you know wellness sprinkled in there with sick appointments. You know I like to know if there's some AI around this. I mean right now if you think about it we utilize our customer service reps and their knowledge to say this needs to go here because of whatever right there's got to be some AI around being able to plug in keywords and it automatically schedules even more efficiently. So I actually think that's an amazing idea and if someone knows of something like that that'd be great because we were even talking. And if it's not existing we trademark. We're trademarking it now. Copyright trademark it's our idea we get paid for. But we were talking about that because we were having a little bit of an issue with scheduling surgeries because all of us have separate surgery times and then also you know a catanuter takes significantly less time than a you know dog spay and an older dog takes more time than a younger and for dentals depending on the grade of the dental you can actually do like more less denials in a day right. So we were talking about that and I was trying to come up with like time frames for how much time you needed for kind of each one. But honestly if there's a way that a software would just do it for me. I mean there's there's enough smart people out there working on AI like if it's not already creating existing today it's got to be pretty close. Someone's working on it. So I do think that you know having them schedule for you the right way is extremely helpful and also will help you get out of there on time. Like I don't want my last appointment today to be a sick one. I wanted to be a wellness and I wanted to be something that's healthy and so that record is easy to get done and it's easy to just be done for the day. But technology and utilizing it is great. So there's some things that I heard about recently that I think would make people more efficient with record record keeping a lot of that revolve around using AI to do your records for you. So there's actually apps now where you can take your phone in and you can set it on the counter and tell the owner like hey this is going to take my notes for me it scribes for me and it will actually listen to you talk to the owner listen to the history you'll talk about your physical exam which I already do in the emergency room because I'm in front of owners. So I'll say like I'm just going to listen to the heart now that sounds great. You know their body condition is good. Okay I see we have a little bit of tartar so you're saying these things anyways and then the app is picking up on it and then you can go and it you can teach it to have a template for like what you want your physical exam to say and everything and it will just auto fill everything for you. To me that's a no-brainer right and then it's in your PM system you read the real quick mix and quick adjustments that you know is based on something that may have been missed or with your needs and then you move on. Well and then there's also things like I think it's called the talk of two and talk of two is where your keyboard actually listens to your voice and like types for you and so it's kind of like a dictation software but you can teach it and it has veterinary words in it so if you're saying things that are words that usually you know wouldn't be on there like eosinophil or mass cell like those things always get changed when I try to like captions in social media it actually knows those words and so you can say it and it would just you know fill it out for you. Chat GBT has a whole thing where you can have templates and you can just type in like it was a cushing's dog and I you know found the basic things and it'll auto fill a physical exam. The key though is it's got to get in your PM system right so if you're using like chat GBT you have to copy paste probably something like that so ideally you want a software technology that's auto scripting directly into PM system. So ones like talk to are integrated and I do think it's like a third party integration right but it's integrated and you can still use it and any keyboard that can hear you basically can use it so any keyboard like set up in your practice and it's based on your voice like it knows your voice specifically and so I think it's interesting I haven't used it but I've been looking at those different softwares because I will be honest. This is a plug for talkative. No I made for who wants some people to give us some stuff. Oh yeah I already know them they're great those guys would probably let me try it out but I do think that thinking through like ways like this that would help you do these things faster and make small changes. Now absolutely for records templates are key and every practice management software is going to have templates and then you can go in and adjust it for what you want. One of the biggest issues I see young veterinarians do is they spend way too much time on their notes and records and yes it is a medical record yes it is something that at some point could be legal you know issue so you need to be thorough but use your templates and do not write paragraphs like you wrote in vet school like let's be honest what we had to write in vet school was ridiculous like the amount of information that we had to write you have to learn to simplify your findings. There's been precedent set where like shorthand or something like that is considered you know okay. Yes so I actually was on ethics and grievance and committee for the Texas Veterinary Medical Association when I was a student and we actually got to see like different board complaints and ethics complaints and some people got in trouble because nothing was documented. Yeah what makes sense right? You can't do a record yeah and not document anything and not document like what you gave a pet or you know sometimes you do have to put like I don't put owner decline things but I'll say like discuss hospitalization versus outpatient treatment like owner like cell patient treatment or recommended radiographs owner elects to wait and see if pet improves. I don't really say declines but I kind of say like no they went a different direction right but I make sure I put in there like what my recommendation was and so there's definitely that but I do think I found apparently you can put in there like routine neuter was performed and as long as you can say like this is my routine neuter yes and you can explain like what you mean and it is something that you're privy to you're fine and you're covered but with templates being in there really you can auto fill out that stuff and your neuters are done the same use the same suture and you do it the same technique so you really don't have to change that much so setting templates up correctly using templates if you have paper records which sorry if you still have paper records if you want to be efficient get rid of paper records get rid of paper records but there are stickers you can actually put on a paper record and you can mark abnormal or normal if you want to be efficient get rid of paper records not shame crackers saying that but but that is something I think utilizing your technicians within the room with you to scribe is also huge I don't want to be on a computer typing while I'm talking to an owner absolutely not but I would love it every time they start typing and they start putting stuff in for me it's very helpful and even if it's a little reminders of things I said are things that I found abnormal it's great to be able to go back and work on that the business suddenly says don't do scrubs go with a I mean even if there's some upfront calls to get this stuff integrated the long term of AI is it's got to be significantly better than going to scribe everyone I know that has utilized AI says it does take a little bit to set it up and train it basically like for what you want but is much easier than that let me say thing going from paper records to electronic record right it's a big pain yeah it's gonna be huge pain it's gonna slow you down for six months until you get it figured out but once you get it figured out you're good to go yeah I personally will tell I will be honest I want to be honest I do not get my records done every day at the end of the day completely definitely things that are really sick or things I know will need to follow up or I need to send records elsewhere I do but if it's like a routine puppy visit and the puppy was perfectly healthy and I'm pretty much gonna auto fill that sometimes I just am going in the next room and then I am a person that at the end of the day can just sit and like zoom through everything but I like to do it from home that's why we have cod-based software like I want to come home I might spend time with you guys and the kids and get everybody down and then I'll sit and like go through records but really that's my choice because I like to walk around and talk to people I like to spend time with everybody even if I don't have something else I have to do records are not my priority what about on the billing side I could see where that can create some inefficiencies from veterinarians trying to figure out what to charge for who's taking care of that how's everything can put into those so I'll be honest I have seen data that says that it's actually better if your support team bills for you because things aren't missed and we're more likely to give discounts or to write stuff off when we see the cost of things and so especially if you have like a very open book way of leading where people know like when we make money it helps everybody as a whole like you can have more raises you can pay people more or there's bonus systems in place like they are inclined to want to build things and build correctly and so I like it when my team does the invoicing they do a majority of it and then I'll just double check things we have templates for all our surgeries and all that surgery invoicing gets done usually while we're in the procedure and they're monitoring anesthesia they can just put that template in and request meds so we have a lot of that streamline and I think that causes us to miss less things when it's being built and I come out of a room and it's already built and I just can glance at it real quick or say let me add these three medications bottoming bottoming it's done approved and the owner can get checked out faster one of the things that makes me the most frustrated in the world is if we had a great appointment with someone great experience and they go up front and it takes forever to check them out I was I was just going with that efficiency is better for the veterinarians better for the technicians but it's also better for the customer experience yes so I would agree completely that you got to get the customer in and out of it can you stand there forever yeah trying to check out I mean we have a couple of adorable cute like older customers that want to talk because they don't have a lot of people talk to and so they'll sit and banter but I don't want them to have to wait because we don't have the build on yet because we don't have the meds ready yet like I want everybody doing this person's not clicking the right button or standing there looking at the screen trying to figure out what to click next yes and how to build for it or how to do the care credit or how to do the scratch pay so those are all things that we continue to work on because I want that to be seamless seamless experience 100% is there any other inefficiencies that you can think of my biggest thing are the things that are the time sucks and so I really want to be you know being efficient with records being efficient in the room with the clients making sure that everyone else is doing the things they can do with the pets and I can do the minimal amount that I need to do is there any other inefficiencies you can think of now I was just going to say I think this is completely parallel with almost any industry and any type of business right you have to utilize your employees and allow them to maximize everything that they can do you have to utilize technology to the best of your abilities and whatever you can afford maybe take care of both of those that's going to make you significantly more efficient right there it's going to and it's also been proven by numerous studies it's going to make this profession more sustainable and cause less burnout for you and your team if you allow people to work to like they're a most ability and they feel valued and they feel trusted they are going to want to be there longer and so I think overall being efficient helps everyone so I think that's a good place to stop I hope that we gave some good tips and tricks talk to you you can reach out to me whenever that's right whenever you're ready to allow us to do some stuff we're looking to check podcast sponsors so yeah but thank you guys so much for listening you can always go on apple or Spotify listen to us and leave a review we love hearing your feedback I love seeing your 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