Over the past few days, I have talked to many veterinarians and the media about how veterinary practices should respond now to COVID-19. The situation is different from previous crises but learning from those situations can be helpful.
A Story from the Past
In 2007, our multispecialty and emergency veterinary hospital was booming. We couldn’t hire either doctors or staff fast enough to keep up with the demand for our services. We had opened in late 2003, had been profitable from the first month and grew faster than we could keep up with.
But then three things happened in a short period. We parted ways with one of our profitable specialists, a new competitor opened, and the recession hit. It was like running up hill as hard and fast as you can thinking you’ll just keep climbing and then instead falling off a cliff into an abyss.
Because we were young and inexperienced, we didn’t have a big cash reserve. We weren’t as profitable as everyone told us to be. And when the revenue fell, we were in trouble.
Echoes to Today
I don’t currently own a veterinary business but I empathize with all of those who do. I remember the pit in my stomach nausea looking at the financials and desperately trying to figure out what to do. While the recession was bad, I know that the COVID pandemic has the potential to be much worse, depending on what happens in the next few weeks.
There is Absolutely Hope
However, I want everyone out there to know that you can get through this. Veterinarians are incredibly valuable part of our society and our businesses are amazingly resilient. Although 2008 was horrible, my business made it through and by 2013, my partner and I had not one, but two successful large hospitals.
In this crisis, there is going to be government help. Congress just passed and Trump signed the largest stimulus bill in history which does have useful provisions specifically to help small business survival.
How veterinary practices should respond now to COVID-19
While I do believe it is all going to work out, there are action items that all veterinarians need to do today.
1) Maximize social distancing
If you haven’t stopped seeing non-essential cases, you need to do that now. Curently, COVID-19 might not be as impactful in your area as in Seattle or New York. However, the faster your local community responds, the less cases there will be. It is crucial to decrease the number of the contacts each of us has everyday in order to decrease the spread of the virus. The impact of social distancing on total case numbers of COVID-19 can be seen in the below diagram of case numbers in the provinces of Lodi, which put had shelter in place February 26, and Bergamo, which did not act until March 9th:
The other reason we need to limit elective procedures is to manage PPE. Until the supply is better, we need to make sure PPE is there for the nurses and doctors on the frontline.
2) Manage cash flow
The stimulus funding is coming but is not going to help instantly. If you have a current bank loan, call the bank today and see if you can push off payments for a few months or set up a line of credit. You can also discuss with your landlord whether you can put off rent or pay less rent now for a few months and then have some larger payments later in the year. You can also talk to your 401K company and see if you can change or adjust matching. SBA disaster loans are available for small businesses in certain states and have low interest rates. It is worth talking to your accountant about your best options.
3) Use technology
The veterinarians who had already started using telemedicine had a head start when COVID-19 hit, but now is the time for all veterinarians to learn to use this technology. As one veterinarian stated, this may be the time we finally start charging for all the time we spend on the phone! The AVMA has put together a great resource on options. Until you find a platform you like, it is worth trying Facetime, Zoom, or Google Hangout. The FDA has now issued guidance that during this time they are relaxing requirements on setting up a VCPR. Remember to document in your medical record that it was during COVID-19, if you had no option but to establish a VCPR virtually.
This is also the time to investigate ways you can text your clients and have those texts feed into your medical record or to investigate all those things your EMR can do that you never had time to learn.
4) Over communicate
Clients are stuck at home and spending more time than ever on the internet. Is your website up to date? Do you have a facebook page or Instagram you haven’t had time to use? Now is the time to use those tools to reach out to your clients with information about your hours, what you are seeing, new protocols, and solid information about COVID-19. I really like this blog post on marketing during this period of time.
Although this is not the time to do non urgent annual exams, it is a great time to look at who is going to need medication or preventatives refilled and call clients proactively. This is refill revenue you can make safely while also assuring your patients get the medication need.
5) Streamline and look for efficiencies
It is hard to work ON your business when you are super busy working IN your business. When your caseload slows down during this period, use the time to figure out how you will best “catch up” on those elective procedures and non-urgent visits when it is safer to see patients again. If you were only doing 2-3 dentals a day before, what would you need to do in your practice to do 1-2 more a day when you re-open. What steps could you take to provide quality care for more cases but still get home on time? What slows you down and how can you remove time sucks?
Your staff is an amazing resource when trying to streamline. ASK them to help you make a preparation and efficiency plan.
6) Keep track of what is due
If you are going to miss a lot of procedures, blood work or vaccines for 6-12 weeks, how are you going to make sure you can keep track of these so you can reschedule? This will be crucial for how you bounce back. Your staff may have great ideas on how to do this if you ask.
7) Use the slow time to strategically plan for the future
The best decision we made during the recession was to learn as much as we could about economic cycles and be ready for when things bounced back. Despite the financial scariness, we realized the best way to grow going forward was to diversify and have two locations. We spent the recession investigating demographics, looking for buildings, playing with floor plans, and planning how we would run two locations. We opened our second location with a great lease deal due to the recession and were ready with trained staff when the economy bounced back.
This is going to be a different kind of period that may have cyclical stops and openings. Think strategically about how to make through not just 2 weeks but going forward.
8) Avoid layoffs if all possible
The hardest decision my partner and I made during the last recession was to lay off a portion of our staff. Our staff costs had always been too high and as we looked at all our options, it seemed to be the only thing that could get us through. However, the layoffs both felt terrible and impacted us later. The folks we let go were our kennel staff, as we thought they were the least trained, best able to easily find other jobs, and the easiest to replace at a later date. However, our kennel team, had been our “bench,” from which we had promoted to train into veterinary assistants. We realized two years after the layoffs that we were suffering in part because we had lost the depth that we really needed for growth.
Other hospitals took a different tack and instead spoke to all their employees and everyone took a voluntary cut in hours to keep the team together. The decrease in hours and costs was the same but team was prepared for growth when the economy restarted. If you are decreasing your hours, talk with your staff about decreasing everyone some number of hours rather than losing people you may need when you can get back to business.
9) Train
This is the time to build your training resources and to help your team be better prepared for when you get busy in the future. Can you develop training checklists for each area of your hospital? Can your more experienced staff spend more time teaching your newer employees?
10) Ask for and give help
This is not the time to try to go it alone. Use your advisors such as your attorney, accountant, and banker. VIN has put together some amazing resources that you can access even if you are not a member. The member discussion boards on VIN have been a wealth of information and brainstorming. If you live in Washington, the WSVMA has a great site with state specific financial resources for surviving this crisis. This is also the time to connect with and learn from other veterinarians in your community.
At the same time, this is truly a time to be a giver. The more you help and support your staff, the more they will be bonded to you and your practice. Your clients will see and appreciate if you are active in supporting your community in other ways. I am proud of the emergency and critical care hospitals that have loaned needed ventilators to our human counterparts.
The above actions will help make your business more resilient, focus the energy of your staff in productive ways, and create hope for the future.
Do you have other suggestions for how veterinary practices should respond now to COVID-19? Please comment and share – we are all in this together.
1 comment
If you know your cost per minute you can capture the market that cannot pay in full but can make a down payment on a treatment plan to cover your operating cost, rent, payroll, etc instead of saying “if you cannot pay in full sorry we cannot help you.” At least you are creating cash flow to keep the doors open and you will be generating a recurring revenue stream from your A/R. Practices need to be ready now and in the future when third party financing companies will be approving fewer clients because credit scores will be dropping.