Note: Dr. Erin Keiser co-wrote the following piece with her husband Stith Keiser.
I knew I would be on the receiving end of a little (okay, a lot) of skepticism as a new grad. Especially as an obviously young, not-from-around-here-girl, practicing in a rural part of Kentucky. In each exam room I walked into, I made sure to do what I’d been advised to prevent any confusion about my role. I’d wear my white coat, stethoscope around my neck, and always introduce myself as Dr. Keiser (with an emphasis on the doctor). I was prepared to have to explain some of the more in-depth diagnostics and treatment recommendations before clients would trust that I had their and their pets’ best interests at heart.
I was not prepared, however, for some of the pushback I would get around the seemingly simple recommendations, such as annual bloodwork on a geriatric dog. I’d hear “What for, doc? He’s eating, drinking, and acting completely fine, why do we need all that other stuff?” As veterinary professionals, we forget that our knowledge was hard-earned and took 8+ years of training to learn what seems like basics now. It also takes seeing a lot of worst-case scenarios to be comfortable with recommending the routine stuff.
It wasn’t until I diagnosed my own 10-year-old lab, Charly (my heart dog, for those familiar with the term) with a liver tumor using routine bloodwork that I could convey the significance to my clients. Because we had been diligent in monitoring her bloodwork annually when she was healthy starting at a young age, the moment her ALT and ALP started to creep up without any outward clinical signs, it was a red flag.
Thanks to a lot of great veterinary professionals that took care of her, she still enjoys bounding around like a puppy on our family farm three years later. If I had waited until her liver tumor was causing outward symptoms, it may have been too late for her.
Charly is just one example. We all know prevention is the best medicine—there are countless medical emergencies to be prevented and lives to be saved by proactively looking for signs of illness in an otherwise “asymptomatic” animal.
Metrics in a business are no different.
If we wait until there is already a “symptom” to start investigating, whether its bloodwork or a key performance indicator (KPI), we are already at a disadvantage working against the clock to find a solution before the problem worsens or becomes life-threatening to our patient, or, in the case of a business, our livelihood and the livelihoods of our team.
Choosing the right veterinary KPIs
So, what is the equivalent of running annual bloodwork for a veterinary practice? A quick Google search will provide hundreds of different business metrics you can track.
“Before you can decide what metrics to monitor, you need to determine what you are trying to achieve.”
In other words, what does success look like for you and your team?
- Are we just monitoring the situation and trying to get a baseline, like annual bloodwork in an asymptomatic pet? In a business setting, the equivalent of monitoring our cashflow and general financial health?
- Are we looking to improve something specific, such as kidney values after administering IV fluids? Or the impact of pricing on revenue or decreased client compliance?
- Are we hoping to identify the root cause of a problem, like when a dog comes in ADR or when unintended staff turnover suddenly increases?
Let’s start with some of the basics, the equivalent of running annual bloodwork.
What are the metrics you should be paying attention to that will help identify a potential problem before there are any symptoms, regardless of patient signalment? It doesn’t matter the number of FTE (full-time equivalent) doctors you have, type of practice, or geographical location, we suggest starting with the following KPIs.
Two types of veterinary KPIs
You can break them down into two categories, productivity (revenue) and expenses.
- Productivity KPIs include DVM production, average doctor transaction (ADT), number of new clients per year, active clients per year, lapsed clients, year-over-year (YOY) growth, average revenue per unique patient visit, and client and staff discounts.
- Expense KPIs include Cost of Goods Sold (COGS), Payroll, Rent, and EBITDA, all as a percentage of gross revenue.
Putting it all together
Regardless of what we are trying to achieve as veterinarians, practice owners, and veterinary professionals, we must get an idea of where we are currently. Once we have our baseline and our goals in mind, metrics can be used to determine that we’ve met, exceeded, or fallen short of our goals. And when we fall short, we can use those same metrics to identify where we went wrong and redirect to reach our desired outcome.
Put simply, metrics help us make the best decisions possible for our hospitals—pets, people, and financial health.