*Blackwell’s 5 Min Vet Practice Manual Flashcards
What is an item that is interchangeable and the price is reflected by supply and demand?
Commodity
What is the reduction in cost per unit that results with increased production?
Economy of Scale
Define: Full Time Equivalent
method of comparing practices based on a full time schedule of 40hrs/wk
Define: Mom and Pop
term for small business where owners also run the business
What is the term for a vet practice affiliated with a retail entity?
Retail Anchored Practice
What part of the hospital tends to be the profit-driver?
Exam rooms
Define: Information Glutted, Knowledge Starved
knowledge of vets has been battered by the internet
the internet tends to provide lots of info while muddying the waters for clients
Define: Debt:Income Ratio
Total debt / annual income
Measure of financial stability
Tends to be extremely high for veterarians
Define: Cost-Value Disconnect
disconnect between perceived value and services/products and the cost to the client
Vets require ___ staff compared to human doctors and oftentimes ___ get to utilize their skills
More, Don’t
What are the top two highest costs to running a practice?
Payroll
Inventory
What are some of the challenges in maintaining a profitable inventory?
Storage, shrinkage, online pharmacies, unsold product, duplicate products
What portion of vet school grads pursue specialties?
40%
Term for process of 2+ businesses fighting for the same market?
Competition
Define: Consolidation
Acquisition of smaller company into larger company
Define: Differentiation
creating competitive advantage by offering unique product/service
Define: Disintermediation
giving client direct access they’d otherwise need a mediator for
Term for: Offering a new product/services to gain increased sales
Diversification
Define: Generational Wealth
development of financial stability which can be passed down to future generations
Define: Humanization of Pets
society trend of treating pets like human family members
Term for: helps investors establish goals for investments and measures success
Investment Thesis
What do mature markets include?
Competition, differentiation, and diversification
Define: Recurring Revenue
portion of company’s revenue that is highly likely to continue in the future
Define: Roll Up Merger
occurs when company buys another company in the same market and merges them together
Define: Contracted Management
management company manages business operation for a fee
Term for: Management structure that allows for benefits of economies of scale in purchasing decisions
Group Purchasing Organizations (GPOs)
Define: Peer Groups
helps with general business knowledge for owner
may operate as GPO
focus on collaboration between practices
Define: Cooperatively Owned
Group of local vets own and operate practices
Define: Condo Model
Multiple practices operate under same roof
Term for: Management structure where group of separate practices are located in close proximity to create medical campus affect
Clustered Model
Define: Trade Area
geographic area where company gets most of clients from and also where penetration market is highest
What are three ways to determine trade area?
Zip Code Counts
Drive Time
Address Mapping
Define: Medicalization
% of animals seen by vet at least once in 12 month period
Define: Psychographics
research that explains people’s behavior
Define: Adoptive Learning
Memorizing facts rather than applying concepts
Today’s client expects ______-centered care where client has voice in decision making
Relationship
Define: VIRMP
Veterinary Internship and Residency Matching Program
established by AAVC to pair interns with programs
Define: Internship
one-year postgrad education program
Define: Residency
2-3 year training to qualify for specialty
What does NAVTA stand for?
National Association of Veterinary Technicians in America
Define: CVTS
Committee on Veterinary Technician Specialties
Provides guidance to vet tech organizations for form specialty organizations
Define: AVECCT
Academy of Veterinary Emergency and Critical Care Techs
First specialty to gain recognition
Define: Skill-based Compensation
System of wages and raises based on achievement in different skill blocks
Term for: Written protocols regarding patient care, customer service, and team professionalism
Standards of Performance
Define: Total Quality Management
Consistent performance, expectations, and consequences
What are the 5 traits of Emotional Intelligence?
Self awareness
Self regulation
Self motivation
Empathy
Effective relationships
Define: Stay Interview
interview team member to see what keeps them at your practice
Define: Exit Interview
interview terminated team member to learn why they’re leaving
What are the 9 golden rules for effective team meetings?
Schedule meetings in advance with posted agendas
Rotate meeting leader and note taker to develop ownership
Prep meeting room in advance (include refreshments)
Prepare audio/visual aids in advance
Start and end on time
Create relaxed environment
End with consensus, conclusion, and summary
Provide clear follow up action plans in writing
Start and end with motivating message
Define: Absenteeism
Regularly missing work without good reason
Define: Presenteeism
Be present at work but not fully functioning because of illness or other medical condition
Define: Onboarding
teaching new hire skills they need
What type of leader adjusts their leadership style to the person?
Adaptive Leader
What is the most reliable method of personality profiling?
Myers-Briggs Personality Types
Term for: paths a manager might take to satisfy their clients
Value Disciplines
What are the three types of Value Disciplines?
Operational Excellence
Product Leadership
Customer Intimacy
Define: Operational Excellence
highly efficient workflow
pleases the masses
Define: Product Leadership
value discipline where there is constant innovation
Define: Customer Intimacy
Type of value discipline where there are strong relationships with clients, focuses on the individual
Name three stakeholders in vet med
Pharmaceutical companies
Manufacturers
Distributors
Labs
Referral and emergency practices
Breeders
Groomers
Boarding facilities
Pet stores
Term for: relationships between businesses in which parties work cooperatively in a business effort with a shared goal
Strategic Partnership and Alliances
Define: Compassion Fatigue
AKA Secondary Traumatic Stress Disorder
gradual loss of compassion by people who work with individuals thar are ill, suffering, or victims of trauma
What are the two factors that affect the HAB?
owner attachment
owner commitment
When is the HAB most commonly hurt?
When the owner has certain expectations of the relationship with their pet but the pet shows undesirable behaviors
What are some ways to enable the HAB in the vet clinic?
staff training
encourage staff to interact with pets
photos of new pets to the clinic
photos of staff with their own pets
client education about pets’ needs
puppy/kitten classes
What are some ways to enable the HAB in the exam room?
give pet time to become familiar with the exam room
fear free handling
match your level of care to the level of attachment the owner has with the pet
ask about behavior at every consult
minimize stress in euthanasia procedures
palliative/pain-relief care
Define: Aquisition
act of one entity gaining control of another
Term for: Difference between asset’s purchase price and selling price
Capital Gains
Define: Merger
several practices combining
What practice valuation method looks at net cash flow over last 3-5 years with greater emphasis on the current year?
Single Period Capitalization
What practice valuation method takes into account the company’s asset values as well as discounts expected cash flow?
Excess Earnings Method
Define: Equity Sale
owner sells their share of the practice and buyer assumes asset and liability
Specialty and emergency practices reflect the importance of ___ because they are a true reflection of a pet owner’s desire for 24-hour access to high-quality medicine and surgery.
HAB
Specialty and emergency practice are fed by what two factors?
general practice referrals
public’s desire for advanced care
Define: After Hours Emergency Practice
Practice that is open outside of GP practice normal business hours
Define: Central Hospital
combination of multiple specialty hospitals
Term for: a facility that is open 24/7 and can handle emergencies
Critical Care Facility
It typically takes a minimum of ___ GP vets within 30-45 minutes for an emergency practice to have enough client base.
25
What does SWOT stand for?
Strengths, weaknesses, opportunities, threats
What two committees need to be formed to support an emergency hospital?
Operational
Facility
In emergency hospitals, a deposit of ___-___% should be collected prior to services rendered.
50-75
Term for: Specialty practice that…
- more common in smaller markets
- “beta testing” for the referral industry
Single Specialist Standalone Practices
What kind of specialty practice houses multiple specialties under one roof and owned by a few individuals?
Mega Practice
What production rate do specialists typically make?
21-23%
What are the two types of equine practices?
ambulatory & hospital
What’s another term for a hospital equine practice?
Haul-in practice
Define: Accounts Receivable
money owed to the business by the client
Define: Associate Vet
employed vet who doesn’t have ownership in company
Term for: rate of return needed to attract capital to the practice
AKA the rate of return a buyer would expect for investing in the practice
Capitalization Rate
Term for: written document outlining amount owed, dates, amounts for expected payments, consequences of failing to make payments on time, and client signature
Deferred Payment Plan
Define: Finance charges
amount of money charged for payments that extend beyond an agreed-upon time limit
Define: Inventory Turns
frequency that you use inventory items
How is Net Cash Flow calculated?
revenue minus expenses plus non-cash expenses
What are the three ways to compensate an associate dvm?
flat salary
pro-sal
production
What are the five most common benefits offered to associate dvms?
CE expenses
annual leave
health insurance
liability insurance
CE leave
What are the five business entity models?
Sole proprietorship
Partnership
C Corp
S Corp
LLC
What is the fundamental difference in food animal practices?
They must be economical
What federal law allows vets with a VCPR to prescribe and dispense meds in an extra-label manner to food animals
Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA)
Define: Veterinary Medicine Mobility Act
federal law that allows ambulatory vets with DEA registration to transport controlled drugs to treat patients in the field
T/F: Food vets are often compensated better than other vets.
true
Food vets have increased ethical responsibilities due to the role they play in ___.
Food safety
What does ELDU mean?
Extra-Label Drug Use
Term for: The reduction in cost per unit that results when operational efficiencies allow increased production
Economy of Scale
Term for: The reduction in costs of operations when a company enters two or more markets where the operations in one market can be used to make operations in another more efficient
Economy of Scope
Define: Holacracy
Flat organization structure where decision making is done by teams rather than a management hierarchy
Define: Open Book Management
Transparency of business success to employees better understand the efforts that impact success
Define: Profit Center
Area of practice that can be assessed by it’s revenue and expenses
What is the current business model in the U.S.?
Many small practices serving the community with similar services
Term for: Collective ownership or overseers of the practice
Board of Directors
Define: Floor Workers
Team members who do the hands-on work
Hierarchy charts should be shared with the team. What is something you can do when presenting the chart so as not to appear to dictate who is “over/under” who?
Flip the chart to be horizontal
Term for: A collection of documents outlining hospital protocol
Standard Operating Procedure
AKA SOP
What are the three components of a spoken message?
Verbal, paraverbal, and nonverbal
Term for: When members are uncertain about rules, roles, and expectations
Forming
What is the difference between horizontal vs vertical organization?
Vertical: nonteam environment
Horizontal: team environment
Define: Norming
Phase of team development where working styles are agreed to and system are in place
What phase of team development is when teams work positively, creatively, and productively together
Performing
Define: Outer Leadership Qualities and give some examples
outer qualities a leader must have to show they can be a good leader
communication skills, visibility, teamwork, attentiveness, commitment
Define: Storming
stage of team development where team members disagree on goals/personalities
What is the difference between Task Objective and Team Objective?
What are the stages of team development?
Forming
Storming
Norming
Performing
Define: Engaged Employee
Employee who is actively involved in their work and highly committed to duties
Term for: Theory that motivation is increased when employees believe that increased effort leads to desired results
Expectancy Theory
Define: Herzberg’s Motivator-Hygiene Theory
The theory that meeting basic needs results in motivation and increased performance
Term form: Pyramid of needs. When a lower tier is met, the next level is the motivating factor.
Maslow’s Hierachy of Needs
What are some ways to provide the physiological needs of your team?
Equipment, training, manpower
What are some ways to provide the safety needs of your team?
Meet OSHA requirements, job security, open-book management, regular feedback
What are some ways to provide the relationship needs of your team?
Community involvement, acknowledge great work, team-building exercises
What are some ways to provide the esteem needs of your team?
Consider your team’s ideas
What are some ways to provide the self-actualization needs of your team?
Support certification programs, introduce career mapping
Define: Talent Management
process of attracting, selecting, training, developing, and promoting employees
Term for: the obligation to be responsible and act in the best interest of the organization and it’s mission
Accountability
Define: Apathy
lack of feeling
Term for: exhaustion due to stress, the demands of being empathetic to others who are suffering
Compassion Fatigue
Define: Compassion Satisfaction
derived pleasure from helping others
Term for: Ability to share another person’s emotions
Empathy
Term for: Particular stress that derives from working in a certain occupation
Occupational Stress
Term for: An indirect exposure to trauma through firsthand account or narrative of a traumatic event
Secondary Traumatic Stress
Define: Vicarious Trauma
disturbances that result from helping trauma survivors often resulting from using controlled empathy
List three symptoms of Compassion Fatigue.
bottled-up emotions
impulsively rescuing animals
isolation from others
sadness and apathy
excessive complaining
lack of interest in self-care practices
reoccurring nightmares and flashbacks
persistent physical illness
difficulty concentrating
metal fatigue
proneness to accidents
What are the four A’s related to moral stress?
Ask
Affirm
Assess
Act
What is the American Association of Critical-Care Nurses?
nonprofit organization that offer professional and personal support with goal of best patient care
Define: Ethics Exhaustion
fatigue, emotional distress, and lack of will to behave in a way that is in line with your ethical beliefs
Term for: When you know the ethical action to take but are unable to act on it, and you on in a manner contrary to your professional/personal values which undermines integrity and authenticity.
Moral Distress
What is the first A in the four A’s of Moral Distress?
“Ask”
Ask yourself if you feel moral distress.
What is the second A in the four A’s of Moral Distress?
“Affirm”
Commit to addressing your moral distress.
What is the third A in the four A’s of Moral Distress?
“Assess”
Evaluate your moral distress.
What is the fourth A in the four A’s of Moral Distress?
“Act”
Take action to resolve your moral distress
Define: Compromise Fatigue
Sense of stress associated with repeated compromising of patient’s medical care
Term for: tendency if individual to return to a stable level of happiness despite major position/negative life events
Often leads to shift in expectations
Example: DVM becomes so accustomed to clients refusing their first recommendation due to finances - DVM stops recommending based on best medicine and instead based on what they think the client can afford
Hedonic Adaptation
Term for: sense of stress associated with managing expectations regarding policy/procedure
Leadership Fatigue
What are the top three stressors for DVMs?
Time management
Difficult clients
Clients’ inability to pay
Define: Agenda
List of meeting topics to be covered
How do you calculate the cost of a meeting?
(attendees’ hourly wage x length of meeting in hours) + cost of any food/drinks provided + lost revenue
T/F: Meeting should not start until all participants are present.
False
What are the five commitments of leaders?
challenge the process
inspire a shared vision
enable others to act
set the example
celebrate accomplishments
What are the four areas of focus in regards to achieving a practice’s vision?
Finances
Client
Workflow
Growth
Term for: ability to recognize one’s own and others emotions, to discriminate between them and label them, and use this info to guide thinking and behavior
Emotional Intelligence
Define: Human Capital
Value of skills, knowledge, and experience a person has
Term for: the collective standard of behavior that is understood and appreciated by everyone in a team
Teamship
Define: The Action Centered Leadership Theory
Leader accomplished goals through actions of the team
What three elements do leaders need to create to motivate employees?
Autonomy (allow team members to take action without micromanaging)
Mastery (give tools for growth and learning)
Purpose
Define: Critical Path
Succession of connected tasks in a project that will take the longest
What are the four areas of a project that must be planned for and managed?
Scope
Resources
Time
Cost
Term for: Scheduled progression of responsibilities that help an employee achieve a higher position.
Career Pathing
Define: Job Enlargement
Assigning new tasks that build off tasks an employee already knows
Term for: Unanticipated harm that was induced by appropriate care
Adverse Outcome
Define: Cognitive Limitations
Mistakes that happen from being absent-minded or distracted
Term for: unintentional harm caused by inappropriate care
Veterinary Medical Error
Define: Change Agent
Individual who works to create change in organization
Term for: the values and behaviors that contribute to the unique social environment within and organization
Organizational Behavior
What are the six momentum points? Describe them.
Interest - all parties are interested in creating change
Novelty Momentum - lots of excitement about the change
Effort Awareness - the realization that change is hard; momentum starts to fade
Decision Point - when we decide to move forward with change or abandon it
True Change - when we start seeing successful change
Sustainable Momentum - when we’ve created a new normal
Define: Salary and Benefit Summary Statement
Breaks down dollar value of salary and all provided benefits
What are the four C’s of Onboarding?
Compliance
Clarification
Culture
Connection
How much of the hospital’s annual revenue should be budgeted for new hire training?
1-2%
Define: Expectancy Theory
employee behavior is based on the outcomes that they value
Define: National Labor Relations Act (NLRA)
federal law that gives employee’s rights to organize and bargain collectively with employers (unionize)
What federal law protects employees over 40 years old from discrimination in employment practices based on an employee’s age?
Age Discrimination in Employment Act
What federal law prohibits discrimination in employment practices based on an employee’s disability?
Americans with Disabilities Act
What federal law established minimum wage, overtime pay, record keeping, and child labor standards?
Fair Labor Standards Act
Define: Title VII of the 1964 Civil Rights Act
federal law that prohibits discrimination in the workplace
Define: Defections
Clients who leave a practice during a certain time period
Define: Autonomic Shift
physical reaction due to emotion (i.e. blushing)
Define: Kinesics
communications through body language
Define: Proxemics
spatial relationship between individuals in conversation
Define: Paralanguage
tone and rhythm of voice
Define: Marketing
matching product to consumer needs
Term for: Developing effective involvement in public activity and guiding an organization on public expectations
Public Affairs
What are the five components of marketing?
product/service attributes
marketing communications
market research
customer service
sales management
What are the 6 C’s of client relationship management?
consistency
compassion
client service
convenience
competence
cost
If you are to increase prices on services OR products, which should you do and why?
Services - purchasing products from the vet hospital is about convenience, so theses prices should stay competitive with other sources. Services are a professional service that can be charged at a premium.
Term for: splitting up of audience for marketing purposes
Segmentation
Define: prospect
Potential client that can be targeted for business
Define: attrition rate
rate of loss of clients
Term for: a piece or part of the overall market that shares similarities in its demographic traits, attitudes, or views that lead it to experience similar needs or desires
market segment
What are the four P’s of marketing?
product
price
promotion
place
term for: promoting new products to new markets
diversification
term for: promoting existing products to new markets
market development
term for: the extent of sales of existing products and services to existing clients
market penetration
Your trade area is the area in which what percentage of your clients is located?
80%
What are the 6 steps to perform a market potential analysis?
- define the practice’s market
- collect data on the area
- estimate the demand for services
- estimate the current supply within the trade area
- calculate market potential
- final assessment
What is the formula for estimating the demand for your services?
population / 2.53 people/household x % of households with pet
% of households with pets can be found in U.S. Pet Ownership and Demographic Sourcebook
How do you calculate the current supply within a trade area (or Effective Influence)?
- compile list of all practices in and around a trade area
- define each practice’s trade area and see what overlaps with yours
- estimate amount of overlap
- for each practice, # of FTE DVMs * % overlap = Effective Influence
Formula for Share of Aggregate Household Income
= aggregate household income/trade area FTE DVMs
Formula for Potential Clients per DVM
= # of pet households/trade area FTE DVMs
Formula for Potential Revenue per DVM
= # of pet households/trade area FTE DVMs * % clients seen * ave. client sales
Formula for Potential Revenue per DVM
household pets/ trade area FTE DVM x % clients seen x average client sales
Pull vs Push Marketing
push marketing uses strong ads, pull marketing reaches to specific needs of clients with hope of engagement
Define: Omnichannel consumer
someone looking for consistent marketing message
What % of revenue should be allocated to marketing?
3-6%
Term for: monetary value if some defined investment at some point in the future given a specified rate of return
Future value
Term for: calculated rate of return given the cost and future value of investment
Internal rate of return
Term for: net return on a project given all costs and revenues
Net present value
Term for: current monetary value of some defined investment return given a specific rate of return
Present value
Term for: amount an investment appreciates or depreciates over time
Rate of return
Term for: method used to estimate time it would take for investment to double in value
Rule of 72
Formula for: net present value
= pv of all revenue - pv of all costs
Formula for: future value
= pv x (1+r)^t
Formula for: rule of 72
=72/interest rate
What are the three methods of accounting?
Cash
Accrual
Hybrid
What is the cash method of accounting?
Income recorded when received, not when earned
What is the accrual method of accounting?
Income recorded when earned, not even received
What is the hybrid method of accounting?
Combo of cash and accrual methods
What does a P&L using the accrual method have that the cash method doesn’t?
AR and AP info
What is the basic accounting equation that all accounting systems are based on?
Assets = liabilities + owner’s equity
Formula for: AR Turnover
sales on account / average net AR
Formula for: Acid Test Ratio
(Cash + receivables + marketable securities) / liabilities
Define: Horizontal analysis
comparison of a measure within two different periods
Define: Vertical Analysis
comparison of a specific account in a period to the total within that period
What is the difference between Current Ratio and Acid Test Ratio?
Current ratio is total assets and liabilities
Acid test ratio is just quickly liquid assets to respond to sudden demands
Formula for: Lost clients per year
active clients last year + new clients this year - active clients this year
What are the five steps of benchmarking?
identify areas to benchmark
collect data
analyze data
implement change
evaluate results
What are the four stages of the business life cycle?
startup
growth
plateau
decline
Term form: process of seeking small improvements to improve efficiency and quality
Continuous Quality Improvement
What is VTE and how does it apply to support staff?
Veterinary Time Equivalent = # of veterinary hours
Support staff VTE = support staff pay/vet pay
It it takes an RVT and vet assistant 5 minutes to place an IVC, how much should be charged for labor if the following is true:
RVT pay = 1/3 vet pay
VA pay = 1/4 vet pay
Vet must produce $5 per minute to meet salary
(for RVT) … $5 * 1/3 VTE = $1.67 * 5 = $8.35
(for VA) … $5 * 1/4 VTE = $1.25 * 5 = $6.25
$8.35 + $6.25 = $14.60 to place an IVC
Define: pro forma
projection of income and expenses based on a set of assumptions
