Busy days, rising costs, price increases, staff shortages, and burnout — what a good time for veterinary practices! In reality, none of these factors have shifted much, if at all, in my New York practice but my overall outlook certainly has, along with the state of the U.S. economy. As a CVPM, part of my job entails looking at metrics and I have only recently started to see decreasing trends in new clients that put us more in line with “pre-Covid” growth. Revenue is of course higher as prices have increased but also because of a focus on compliance. Patient visits and total invoices remain roughly the same.
A recent VHMA Insiders’ Insight KPI report indicates that new client growth as a whole has been trending down for some time. I am not an economist, nor do I pretend to be, but I do have concerns about what the rest of the year and beyond will bring. There is talk of recession but also talk of the economy stabilizing — it is up to you how you interpret talk and trends and how you will proceed.
For me, I am treating this current time and the foreseeable future as though the recession is coming. That means I will not be purchasing any major equipment or incurring any large debt from intentional choices. Costs on supplies, drugs, and everything else continues to rise and I will adjust accordingly. In addition to this purchasing freeze, below are other areas that I’ll be keeping an eye on.
Although I have already instituted a price increase this year, I believe I will need to do it again as the costs continue to rise. There is a very real concern that floats around my head every time price increases come up. Several years ago, I had a conversation with my favorite veterinary financial guru in which she discussed the concern that if the cost of veterinary medicine continues to rise disproportionally to household income, we may see a time when people can no longer afford veterinary care or elect to do so.
I don’t know where exactly that limit is for clients, but when I raise our prices, I am very aware of the local economy. The prices are set appropriately to achieve our goals and enable us to be profitable but that doesn’t mean I don’t make every effort to make them affordable to our clients. We do not offer a discount, but we do offer alternative ways to pay for care, especially preventative care. We are also very focused on controlling our expenses to keep that profit.
Whatever happens, we will adjust and make informed decisions to do the best we can. We have been through financial hard times before.
Staff shortages continue to be a problem, not just for me or the veterinary industry, but for every industry. Since 2020, several restaurants and small businesses in my area have decreased hours or even shut their doors due to worker shortages. There was once a time when I was overwhelmed with resumes when I posted a job. Now I am lucky if I get a handful of people who actually show up for a scheduled interview and really lucky if there is a qualified candidate at all.
In the midst of this, I have improved my talent screening skills with recommendations from other managers. One example is that I now send a survey to those applicants I am interested in to help gather more information such as availability. This helps both parties not waste time interviewing if there are deal-breakers from the start. I have managed to get a few more great team members but would not call us “fully staffed” by pre-Covid terms. That might be the kicker too, because somehow we managed to make being short-staffed “the norm” while still providing a high level of care and customer service without working our staff to the bone.
“Bringing in more technology, automating tasks, and taking a hard look at efficiency have helped ease our staffing issues.”
We have adapted the best we can and our improvement in the face of great challenges is something to be proud of. Don’t get me wrong, I am still trying to hire more staff — I just haven’t found them yet!
Burnout is a topic that hits home for me. I am burned out from hearing the term burnout. I don’t want to hear about burnout and compassion fatigue anymore. I want us to find a solution to the problem that prevents us from using the terms which we now talk about nonstop. Yes, it is great to put a name to it, acknowledge it, raise awareness, and treat it. But I don’t want to treat it, I want to prevent it. Not possible you say? Perhaps.
There are of course factors from people’s outside lives that play a role in burnout and compassion fatigue, but there has to be a way to control our environment or provide training in such a way that it makes it much less likely, as opposed to half the staff in the clinic suffering. I think there are many parts to this formula including repairing client-staff relationships, strengthening clinic culture, setting and maintaining boundaries, and most importantly, building resilience.
I have made many changes over the past two years within the culture aspect of our clinic. Prior to Covid, I would say it was a great culture. Not without its problems, small ones here and there like any other clinic, but overall, pretty good. It held up well during the first year of Covid, considering the trauma of it all, but now I can see that we need more emphasis on overcoming difficulties and not letting them affect us so deeply. Above all, my greatest focus is the ability to handle challenges without excessive emotional or physical tolls, and the bounce back from those events that truly do affect us.
A lot of the problems and stressors we face currently are not going to completely go away or resolve. Some of them have always been there but have been magnified by the stress of the past two years.
I can’t control the economy or the cost of supplies but I can make sure I am doing all I can to ensure that clients see the value in their dollars spent with us. I can try to make care more affordable by offering things like monthly wellness plans. I can also control our costs as best as I can to keep us as safe as possible in the face of a financial threat. I can’t make more appointments or fully trained and qualified staff appear out of thin air, but I can set limits on booking appointments and taking new clients that will find a balance to keep both clients AND staff functionally happy. I say “functionally” happy because clients may never be 100% happy, and I am ok with that as opposed to booking us so far beyond capacity that the staff and the quality of care suffers. Will some clients be upset and go elsewhere? Yes, but it’s the best I can do. I can’t choose client behavior but I can set boundaries on what is appropriate and put a stop to inappropriate behavior. I can also empower and train my staff to handle it with empathy, but more importantly resiliency and to remember that a difficult client is NOT an abusive client.
We need to find peace in not just what we CAN do, but in what we CAN’T do. We are human and we have limits. I can already hear someone saying “well tell the clients that.” I do and you probably do too. “They don’t listen and they don’t care,” one might reply. Well, that may be true of some, but certainly not all. We will never make everyone happy and that is ok. There is a part to be played by the general public about their own behavior and demands but again, I can’t control that. I can only control what we will and will not tolerate. If we are all consistent in not tolerating abuse and terminating those clients, one would hope they would get the hint and choose to act differently.
I can, however, change how negative comments and accusations from unhappy clients affect me, particularly by learning to NOT let them affect me. Solidifying my self-value, increasing my threshold for stress and grief, and focusing on meaningful pursuits shifts the stress of not being able to please someone away from me and I can continue through my day knowing I am doing my best and doing right by the clients and patients we serve. I can face the next curveball the world throws at our industry, including a recession, because I know that we will adapt and do our best.
We can handle it
After the hell of 2020, I have made a conscious decision to find and be the change that the challenge presents and not the stressed-out effect of it. I have done this by rewiring myself to handle stress in a way that is not detrimental to me. I am doing all I can to help our team in stress management and resilience and I am seeing a change for the better. Staff shortages, rising costs, and busy days aren’t going anywhere soon and when they do, they’ll be replaced by new problems. When that happens, we will handle it. These industry struggles are an obstacle, but resilience is the way forward.