What procedures and services are most profitable?

Discussion in 'Veterinary' started by cody123, Jan 7, 2009.

  1. cody123

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    Hi Everyone,

    I'm killing some time today and I got to thinking about the future of being a vet. I love animals and that's what got me here but I get worried about running a practice someday and being vulnerable to the economy.

    I guess what I want to know is what are the best profits centers for a vet practice. And...what are the service and procedures that I should concentrate on to be profitable.

    I've heard the stories of getting sick of looking at "ears and rears" all day ;)

    So any insights?

    Cody
     
  2. twelvetigers

    twelvetigers stabby cat
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    If you're only interested in making more income, perhaps you should look into a different branch of medicine? Lol.

    You'd make the most money as a vet by getting a board certification, I'd imagine. As for procedures in a clinical setting, well, I'd say you would b better off looking for a more "posh" clinic to work at rather than trying to focus on specific procedures. I mean, what if euthanasia offers the best profit margin? Does it matter?
     
  3. Poochlover11

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    Ya, I would have to second that. If you are looking for income I would say become a human doctor. They make more money for the same amount of time vets go to school.
     
  4. WhtsThFrequency

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    Vets with board certifications/specialties make the most. Emergency medicine makes a lot, but the hours and lifestyle can really get to you after a while. Surgery is big of course, and pathology pays very well also.

    And keep in mind all certifications/specialities need probably a 1-2 year internship (average $23,000/yr - terrible) and definitely about 3 years of residency (average $32,00/yr - terrible as well)....it's awful that with a four year medical degree residents get paid such low salaries.
     
  5. K12

    K12

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    #5 K12, Jan 8, 2009
    Last edited: Jan 8, 2009
  6. cody123

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    You know...making money is not evil. My goal is to have my own practice and if I'm financially successful then I'll be able to help a lot more animals.

    A struggling vet practice isn't going to do anyone good. The vet will be stressed as well as the staff. And you know what? The clients will sense that and start to look elsewhere causing even more financial woes.

    And no...if euthanasia just happened to be the most profitable, I would not go there. I simply want to know where I should start to focus my skills and experience in order to eventually run a thriving practice.

    I've been to way too many vet practices with my own animals that stunk. I think one can run a compassionate, honest AND profitable practice. If I work smarter, not harder then I'll never have to be in a situation where I have to nickle and dime my clients.

    I find it offensive that some tell me to look to another field. Why is being success minded somehow bad? More vets should learn how to run a business before they go and open one.

    Cody
     
  7. cody123

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    I'm so sorry for your bad experience. I've had a similar one.

    I had a little Shih Tzu/Terrier mix who had a grapefruit-sized tumor off of his spleen.

    We found it because one night out of the blue he collapsed. We eventually ended up at the local specialty clinic. They quoted me $2500 for the surgery. I told them I couldn't afford it. They said then Randy would probably die.

    I took him out of there in tears...I was a total wreck.

    I went to another vet who would charge me a mere $2000.

    Then I found Dr. Bob. He had his own practice and was highly recommended. He removed Randy's tumor for $500 and saved his life. Because of Dr. Bob, I had Randy for another 5 years.

    That taught me a huge lesson and has made a permanent impact on me.

    But if Dr. Bob's practice had been struggling. If he really needed a big case to make ends meet that month, maybe he would of charged me more.

    I can't say but again...a struggling practice is no good for anyone.

    Cody
     
  8. lailanni

    lailanni c/o 2012
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    Being a financially successful vet vs. being in a profession just to make money = two different things.

    You want to be a financially successful vet? We all do!

    You want to be a vet just to make lots of money? Sorry. Vets typicially don't make as much money as human doctors, dentists, etc. You're better off there if you're only going to look at your pocketbook. :rolleyes:

    If you are a vet student, your school may have a VBMA chapter. Go look that up for money/practice management.
     
  9. cody123

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    Who ever said I was ONLY looking at my pocketbook? I never did. I also never said I'm in the profession to make a lot of money. Being profitable doesn't equate getting rich. And I'm sure there are vets out there who make a decent living because they know how to run their business the smart way.

    Look, the reality is there are broke vets and there are vets who know how to run a profitable business. Getting to do what I love is first. But then why wouldn't I be interested in running a profitable business as opposed to running my practice into the ground or barely making it?

    I don't appreciate being told to look toward my school for suggestions. If you don't have an answer to my question...why would you even respond?

    Trust me, there are more people out there who are interested in a concrete answer. Being a vet is not like becoming a priest...we don't take a vow of poverty :).

    Cody
     
  10. Bill59

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    K12, the purpose of this forum is not to defame specific veterinarians or veterinary hospitals, which is exactly what you have done in your 2 posts so far.
     
  11. almostglue

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    I think Cody's question brings up a valid issue facing new grads and established vets (not necessarily the original question, but the responses to it). I'm a 3rd year at Georgia, and we're currently taking a class called Veterinary Practice Management that's teaching us (hopefully) how to run a successful practice. I don't think it's evil to talk about how to make money. If you can't make money you can't keep your doors open to help animals. That's not to say you should charge ridiculous prices to your clients, but you need to make a living and you need to charge for your knowledge – you’re worth it. We learned earlier this week that most veterinarians are undercharging on their exam fees and they're losing money because of it. We go to school for 4 years to learn veterinary medicine and I for darn sure better be able to charge my clients a fair price for me giving them my knowledge. If they think that price is too high, then it's my responsibility to show them why I'm worth that price.

    My only problem with the question is that I don't think you should tailor your education solely to areas that will be profitable, but learn how to run a profitable well rounded veterinary practice. Perhaps the question wasn't intended to mean that you only want to learn/do things that will make you money, but I'm thinking maybe that's where some of the conflict is coming from? I don't know. I think the procedures that draw the most profit will vary in every practice and between communities. It depends on your particular skill set (such as if you have a particular interest in dentistry, that section of your practice could bring you increased income). I do know that 'money' shouldn't be a dirty word. I’m kind of getting tired of everyone saying “don’t become a vet if you want to make money”. Yeah, that shouldn’t be your main reason, otherwise you’ll be miserable. But to me that sounds like people are saying that veterinarians can’t make money unless they specialize, and that is certainly not the case. Of course I’ll never make as much as a human neurosurgeon (and that’s even if I do specialize), but I certainly have the ability to be doing what I love (veterinary medicine) and making a very decent living at it.

    I didn't really answer your question either (but do think a checking out your school's VBMA (veterinary business management association) is a great suggestion), so maybe I shouldn't be replying, but I think a discussion of sound veterinary business practice would be a great one to have. I’m sure if you talked to some of your professors who have been in private practice or just called up your state’s VMA they would more than happy to refer you to someone to discuss successful veterinary business management. If there’s one thing we could use more of in this field, it’s a knowledge of business.

    Sorry this turned into a novel, but I’m getting pretty fired up about business stuff since I’m taking this class. :D
     
  12. StealthDog

    StealthDog U of MN 2010
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    I third the suggestion to check out VBMA- my school's chapter has made me feel far more prepared to handle the economic challenges after graduation! Veterinary Economics magazine is good too, although it's geared towards practitioners so it's super applicable to us as students.
     
  13. cody123

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    Thanks for the reply.

    I am talking to my VMA but I was just interested in other people's opinions. Hence posting the question on the forum. I do appreciate you backing me up a little. I don't know why everyone had to jump on me so harshly.

    I really don't know where this attitude comes from regarding earning profits in one's practice. I mean, the better I do as a vet, the better my staff will do financially. Isn't that a good thing? Isn't it good to be able to offer help to low income clients like heavily discounted spay/neutering programs?

    Come on, making money isn't evil as long as you earn it through honest work. And I know for a fact that vets can earn a very nice living if they know how to run their practice.

    Peace,

    Cody
     
  14. fargeese

    fargeese VMRCVM Class of 2012
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    The vet I worked for said that his 25,000 dollar IDEXX blood machine had paid for itself many fold in profits. He did not do any extra tests because he owned the machine, but rather did the ones he would have referred out in the past himself. He said the same about his urinalysis machine. I would say that the equipment thing can be a slippery slope (i.e. new vets taking on more debt for machinery at the outset than they should) but if the practice is healthy, and you can find a service that is needed often enough that could be done in-house with a machine, it would be something to consider.
     
  15. Poochlover11

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    Cody,

    First of all (I can't speak for everyone), I didn't intend to attack. I guess the reality is (sad but true) that human doctor's get paid better then animal doctor's. And if you are looking at it from a purely financial stand point then become a human doctor. I realize though that you are set on becoming an animal doctor, so go for it. It's just that from what you are saying above I don't see how you can afford to perform cheap spays/neuters if you want to be successful (and hey, correct me if I am wrong-I am willing to hear your game plan). In my mind, people who perform cheap services like that usually get a lot of financial aid from donations (ex. SPCA?). A lot of large, successful vet clinincs do pay quite a bit more for procedures then do smaller, less successful clinincs. How can you be financially successful if you don't charge quite a bit for your services?

    My point is that if you are really in it to help animals (I am not saying you are not-I am not attacking, just being diplomatic), then there will be times when you will not get a lot of money for a procedure because not everyone can afford that. Even in an ER setting-you are charging lots of money, and it's usually people with lots of money who will come to you-not middle class people. Does that make sense?

    I guess since my purpose is to help people and help pets, and I am willing to sacrifice some of my financial success if that means I can help someone out. I don't criticize you for wanting financial security, it's just if that is what you are looking for overall, then I guess it makes more sense to become a human doctor. They get paid more then vets for the same amount of school.
     
  16. Poochlover11

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    You seem like a decent guy. I actually went through something very similar. Thank goodness for vets who don't charge a ton! I guess that is why I assumed in your first post that you may be in it purely for financial success-because a lot of vets with good hearts won't charge a ton for a procedure if they know that someone really loves and cares for that pet and can't afford an extremely expensive procedure.
     
  17. fargeese

    fargeese VMRCVM Class of 2012
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    I don't see why everyone seems to be missing the point. The OP did not ask how to be rich, he just wanted to know what the most profitable aspects of a practice could be. It's like a bookstore owner asking which titles sell best so he can stock more of them. Choosing to do more procedures that have a greater profit margin is just good business, if making money is a goal. Even if making a lot of money is not the goal, making enough to support a business and it's employees still means making some profit, and identifying what will make you one is just good business practice.

    Also, to be blunt, I think we are going into this with the wrong attitude. What happens when we go for our job interviews and are offered salaries that will not support paying off our school debt? Do we just say, "Well, we are always going to be poor, underpaid martyrs" and suffer? Or do we try to negotiate for more money? We cannot, as a profession, expect to get paid what we deserve if we devalue what we do even to ourselves.

    As for low cost spays and neuters, the operation itself may not be that profitable (even with funds from the SPCA etc.) but it may generate a client who will return for vax, exams, etc. for their new pet. I think that question would be better answered by a practicing vet though, that is just conjecture on my part.
     
    Disclosure likes this.
  18. Poochlover11

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    Okay, that is great. I don't think Cody123 is wrong for posting. But in my experience (and hearing from other vets), sometimes you have to have a heart and help someone who can't afford an expensive procedure. I am NOT devaluing what I am studying to become. I am working my BUTT OFF to become a vet and will be very proud when I finally have made it through. I want to pay off my loans too and will charge accordingly. But if I have to choose between having an extremely large, high priced clinic or a clinic that provides a fairly comfortable life for me and affordable procedures for my clients-I will always choose the latter.
     
  19. fargeese

    fargeese VMRCVM Class of 2012
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    Would you consider identifying procedures that generate good profits, implementing them, and then consequently having the liquidity to do some low cost procedures for needy clients an acceptable compromise?
     
  20. Poochlover11

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    I think that is a good idea. I am not opposed to that at all fargeese. I am not trying to start any fights. I just took offense specifically to your comment about not having pride in the profession.

    I am in this business to help others-I realize you need finances to do that. So no, I am not opposed to that.
     
  21. fargeese

    fargeese VMRCVM Class of 2012
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    I am sorry if you took offense, I was not trying to attack you personally. I just get frustrated in general with the notion that we have to expect to get less than we deserve for our work. There is nothing we can do about some things (our high debt load, emergency procedures we probably won't get paid for, etc.) but something we can do as a profession is to operate more as a business and less as a charitable foundation. Human doctors take the same oath to serve as we do and as such have the same commitment to save lives. So how do we reconcile the vastly disparate salaries between the two professions? What also interests me is that doctors price their services quite high with the expectation, usually borne out, to get paid. Why do we not expect the same for our services? You can argue that people won't pay those kinds of prices for pets, but we might be surprised. Maybe the pet insurance industry would skyrocket like the human health insurance did?

    Again, nothing personal, just a friendly debate :)
     
  22. cody123

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    This is exactly what I was getting at when I mentioned performing low cost spay/neuters for folks. Thanks!

    And to Poochlover11:

    Listen, if I can run my practice profitably because I understand where the true profit centers are (and this doesn't mean I'm taking advantage of clients...it could be stuff like previously mentioned like doing labs in-house) then I'll have the extra funds to help those who are in a jam and just want to help the pet they love and cherish.

    I find it odd that because you read the story of my dog, Randy, you now think I may be a decent person. I think you jumped to conclusions when you read my original post.

    I am a decent person, I just don't buy into the notion that becoming a vet means having to scrape by in life. There are lots of ways to increase business profits, you just have to understand how.

    Cody
     
  23. david594

    david594 The-OSU CVM c/o 2013
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    I think you got that backwards, where doctors price their services quite high with the expectation of not actually getting paid. (either in whole, or not the full amount they actually request for their services). What a doctor bills for and what an insurance company actually pays have little to do with each other.
     
  24. david594

    david594 The-OSU CVM c/o 2013
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    I think it also helps to look at where being a loss leader might be beneficial. The area where I am now $50 is kind of the norm for exam fee's, but where I work we only charge $38 making us one of the cheapest exams in the area.

    The differences tend to be made up in different areas though. We charge $20 for fecals and do them in house, while other clinics in the area will send them out charging the same $20, but then having to pay the lab $8 to read the fecal. Same thing with urinalysis, dipstick takes no time at all, but with a few well trained techs you can also do your sediments in house as opposed to paying the lab.

    A big part of the economics really relies solely on getting clients in the door.
     
  25. Poochlover11

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    The reason it SEEMS like you are a decent person is because based on your story it appears you have a heart for animals. I was just trying to be kind and apologize for being not so nice before. No need to get defensive.
     
    #25 Poochlover11, Jan 9, 2009
    Last edited: Jan 9, 2009
  26. QuarterHorseGal

    QuarterHorseGal UFCVM 2012
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    Geez, that seems like a pretty harsh personal attack. I don't see what Cody said that would necessitate a reason to prove he's a decent person. I think it would be safe to assume he has a "heart for animals," he is a veterinary student and future colleague of all of ours. When the reality of being in over $100,000 in debt settles in, coupled with starting salaries that will make balancing one's budget a struggle, it would be ignorant to not think the way he is. As for the OP topic, an internship and residency is probably the way I'm going to go. But some other random ideas... If you had a partner that you went into practice with, that could be a way to share expenses on equipment and gain more clients. A vet I worked for bought most her equipment used and saved some money that way too. As for specific procedures, the small animal clinic I work for makes a lot of profit off of dentals and ear flushes, and basically nothing off of neuters. For equine medicine, surgery was the most profitable at a large clinic where I externed.
     
  27. twelvetigers

    twelvetigers stabby cat
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    All I read from your first post was something along the lines of, "I want to make as much money as possible. What should I focus on to make lots of money?" I suppose the sentence regarding the economy hinted at deeper and more honorable motives, but I didn't catch that.

    So, that's why I responded the way I did. I think I understand now what you meant. I apologize for that. Along the same note, though, I would try to make sure that your posts don't have too much of a (for lack of a better word) pretentious undertone, whether intentional or not - it tends to set people on edge.

    $0.02...
     
  28. BR549

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    A well run kennel can be profitable. At the hospital I work at, most clients board (baths as well) their animals at some point in time. Policies state that the animals have to be current on vaccinations, so we update them as needed. I am not sure how profitable this is, but it helps. There is also at least a 100% mark up on medications. Most are marked up even higher. A bag of lactated ringers is purchased for a dollar and some change. When an animal is given fluids, it costs the client about $32. I used to think this was outrageous, but I have come to terms with it as I get closer to becoming a professional. Vets need to be paid for their time and services. Everything costs something. If you don't get paid for your services, then you will run your practice into the ground. Who will you be able to help then?
     
  29. Poochlover11

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    I am sorry for my last post. I was a little dramatic. I just felt attacked and hurt. I didn't intend to be mean. I think there was just miscommunication on both sides. Cody I am sorry and I hope you will forgive me for being judgemental.
     
    #29 Poochlover11, Jan 9, 2009
    Last edited: Jan 9, 2009
  30. cody123

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    Thanks for the apology! I really appreciate it.

    But I still wonder why making money AND helping animals have to be mutually exlusive desires? I love animals. I come from a long line of animal lovers. My grandfather actually had a pet chicken!

    But I also come from a family where I am the first to graduate college. One of my goals is to have a better life than my parents AND to give my children a better life than mine.

    I want to be able to retire comfortably without being a burden to my children. I want to have nice things.

    If that makes me pretentious or a bad person, so be it.

    But I'm not going to invest all this time and money in school to sit back and let things happen how they happen. I'm going to be proactive and seek out ways to be successful. And while I'm enjoying success, I'll also find happiness because I'll be doing what I love: helping animals.

    Cody
     
  31. twelvetigers

    twelvetigers stabby cat
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    Well, that seemed 100% genuine and not pretentious at all. :) Good luck! As far as what to do, just do whatever you like best and make the most of it. That's all anyone can do, really.
     
  32. Bill59

    Bill59 Member
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    I reconcile it by the cold hard fact that most people will pay more to save their own or their child's life than they will pay to save their pet's life. Ultimately, the price of a service is set not by how much it costs to provide that service but by how much someone is willing to pay for that service. You could set your price for a cruciate repair at $10,000 for example (roughly what it costs for a human). But you will find damn little demand for that service at that price. It doesn't matter that the skill and training required are similar.

    This discrepancy has actually decreased a lot during the past 50 years or so (at least for small animal) as dogs and cats have become more like family members to many people. And this will probably continue to some extent. Also the human health care in the US is soon going to have to find ways to restrain their cost increases or the government is going to force them. They're going to have to start doing what veterinarians have done all along.
     
  33. Fairyblastt

    Fairyblastt UC Davis class of 2013
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    I second the kennel aspect as something that'll make money. The first clinic (a 1 vet practice) I did kennel work in was an old-style converted shelter of sorts... we had enough space (and 3 separate inside wards of kennels and a covered outside ward with larger runs) for a lot of dogs and cats. I counted up to 65 dogs and 15 cats over christmas one year... a lot of work (!!) but the vast majority of it isn't vet-centered, so it was definitely profitable for the clinic. Esp. as clients with dogs or cats with special medical needs (or complicated med schedules) were extremely loyal customers. We also did lots and lots of bathes, hygiene clips, nail trim ect. Of course, that clinic had a lot of space (both inside the hosipital and outside), so a lot of places wouldn't have the room to do boarding on that level. I suppose we would have also been more limited if we were in an area that didn't have very mild california weather. And it takes tons of organization and a dedicated (and well-trained) kennel staff.

    Basically, I think that any procedure that doesn't need the vet directly involved (maybe just on site) can be very profitable and still honest. The second vet clinic I worked at did a lot of exotics boarding... esp. for parrots. Can't even say how many new clients we got because they liked the way their parrots were treated when they came in for boarding the first time (beats a pet store :laugh: for sure).

    Moreover, having a profitable business means that you can pay your staff better. This is directly connected to less staff turnover, better trained and more cohesive staff, better customer service, and a better relationship between the staff and the clients. Clients will be more loyal to and trust a clinic where they develop a relationship with the entire staff (not just the vets, but also the receptionists, techs, etc). I don't believe any of this is possible without paying (and treating!!!) your staff well, and you need a well-run and profitable business to be able to do that. Vets that like to cut corners and have low staff wages, shoot themselves in the foot, bc you get what you pay for.
     
  34. LVT2DVM

    LVT2DVM UGA-CVM c/o 2013
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    Cody123, I think you question is both valid and necessary if you plan on starting and managing you own veterinary practice.

    To start off, I have to say a big NO! to boarding. Boarding may seem like a easy way to make a buck, but for vets its full of pitfalls and problems. For example (I have a ton more, dont feel up to including all here):
    -it takes up precious, expensive floorspace
    -requires extra staff and supplies
    -unless you offer something special like exclusive suites, grooming (another headache, just try and find a good groomer) or special exercise packages your "prison-like" cages may sit unoccupied
    Boarding just isnt the money maker it use to be.

    My philosophy, corny it may be, is your best profit centers are you and your staff. As you mature as a vet, you will develop specific interests within vet medicine. Could be surgery, dentistry, internal medicine, feline only medicine, whatever. This could lead to an interest in board certification, but it doesnt have too.

    You need to define within your practice which of those areas really set you apart from you local competition and then utilize those to your advantage. Your interest will be specfic to you so sorry if my examples dont fit any of your interest, there just known, proven options.

    Example 1, you like ortho so you go to a special class and learn to perform CCLRs. While its great if your client can go to a BCVS, some just cannot afford it. There is absolutely no reason why a regular DVM cannot perform a TPLO or other approved cruciate repair. Your the only one in your area that can, so BAMM! Market yourself.

    Example 2. Your head LVT absolutely loves dentistry (this would be me). Given the opportunity she can perfom 2-3 dental per day under limited supervision (after preop exam, while your seeing appts) at 200-400 a dental plus aftercare products (most of my dental go home with 50 worth of dental aftercare). You immediately get that girl a dental suite, an IM3 dental machine, a dental xray machine and let her Show-You The-MONEY! But you need to make sure you are recommending dentistry to your clients/patients when appropriate (encouraging to come early, not waiting until teeth are flapping in the breeze, ect.) This is one of those areas where you both need to work together for the common practice good. One of the techniques we use is to stage and price our dentals based on periodontal disease (1-4) and therefore its more advantageous to get a dental at stage 1-2 verses waiting and then their gonna have the dental price plus extractions. It helps our docs and tech be on the same page when making reccs which is stage1-2 need to get in within 30 days and stage 3-4 get scheduled ASAP.

    Some other examples including offering office hours when your competitors are closed, encouraging staff to help market product and services and offering incentives for meeting goals, and I think the number one, profit center unsuccessful vets overlook is GOLD STANDARD CUSTOMER SERVICE. Somewhere during your vetschool education (hopefully)someone will talk to you about the analogy that 3% of your clientele bring in 75% of your profits (or something like that). The truth is clients who are happy come back, WITH FRIENDS. Your will not be able to satisfy 100% of the clients you see, just impossible. But if you practice outstanding customer service and offer unique services, you will establish a client base with loyalty that will continue to utilize your practice and those are the clients you want to make happy and keep happy.

    If your really interested in learning more of this stuff, make sure you check out veterinary economics and DVM360. If you have a geographic location in mind, start talking to vets in the area about what services they are offering and what they feel is working and what isnt. But dont forget to talk to the techs, they sometimes see things the doc doesnt.
     
  35. fargeese

    fargeese VMRCVM Class of 2012
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    You are right, and I thought some of the things you said at the time I wrote it, but I just wanted to make the point (by overstatement, perhaps) that human doctors and vets seem to approach business with different expectations. I thank you though for your correction.

    Now that there is an actual vet present, do you have any opinions on the suggestions offered so far as profit centers? I am as curious as Cody by this point.
     
  36. david594

    david594 The-OSU CVM c/o 2013
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    For the TPLO you mean other than the fact that you need to Certified by the company thats sells the necessary hardware in order for them to sell it to you? ;)

    I think LVT2DVM hit the nail on the head with these though. The TPLO is a great procedure but it can run upwards of $4500 a knee at a specialty hospital(or atleast it does at the one I work at). On the other hand I work during the week at a wellness clinic where the doc we will do lateral fabellar cruciate repair for well under $2000 all told(maybe not as ideal, but a more affordable option for clients). So we actually have had cases that we have referred to the specialty clinic only to have them come back afterwards asking us to do it only because we are more affordable. Generally the pricing trend is pretty consistent across the board for all our surgeries.

    Having good connections with other vets in the area can help with this as we have other wellness clinics that will refer clients to us for the surgeries they know we preform because we are a more affordable option.
     
  37. Pandacinny

    Pandacinny VMRCVM c/o 2013
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    I agree with LVT2DVM that customer service is one of the most important things. I stopped seeing a great vet in my area because her staff were horrible. Techs and assistants would visibly roll their eyes and sigh like a 15 year old when clients had overactive puppies, or asked them a question, or, you know, made them leave the break area to come help at an appointment. Also, the front desk staff mis-scheduled me twice, causing me to lose time at work for nothing, which is pretty annoying. Having done front desk and tech work, I understand how stressful it can be and that mistakes can happen. When they happen over and over again, though, you lose clients and those clients tell their friends not to try your practice. Your staff are the first and last people clients see at at your clinic - make sure you hire good ones and make your appreciation known to them so they stick around.
     
  38. Bill59

    Bill59 Member
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    Regarding a veterinary student concentrating on areas that are most profitable, I think you're better off focusing on learning medicine and surgery, interpersonal skills and the basics of business management.

    Some keys to running a profitable practice are to understand where the money goes, increase the top line (revenue), leverage staff, set reasonable fees, utilize benchmarking and develop strategic plans. But this is all secondary to being a good veterinarian -- practice quality medicine and surgery and have an excellent tableside manner. If you can't diagnose your way out of a paper bad and clients think you're a jerk, it doesn't matter if you're a management genius.

    As for specific areas of revenue, AAHA has a lot of info on this. Here's some averages from their data:

    vaccinations: 10% revenue, low profit margin

    diagnostics: 20-25%, good margins

    product sales: pharmacy, food, OTC: 20%, very low profit

    boarding and grooming: 10%, low profit and such a pain in the ass some vets don't get involved

    surgery: 10%

    dentistry: 2%
     
  39. IvyLynx

    IvyLynx NCSU CVM c/o 2013
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    I was going to suggest rehabilitation. I worked at a rehab clinic for a few months and they make tons of money (though the business is suffering a little because of the owners horrible management skills). People bring dogs mostly, and the treatments and evals alone would probably bring in decent cash. I was going to suggest boarding as well (our clients could bring in a patient, healed or no, for boarding whenever...which really upset the vet, but anyways...), but LVT brings up good points.

    Housing the patients took up tons of space because they weren't usually in cages. Some of them had their own rooms, and they all had egg crates and blankets and sheets and pillows and etc. We had a couple of newfoundlands not too long before we left and they got a room practically the size of my smaller classrooms.
     
  40. Nexx

    Nexx 2 weeks and counting
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    Which makes sense when you think about it, after initial investment you are looking at a service which costs you very little money to provide and has minimal time investment as opposed to surgery or other services.
     
  41. cody123

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    Awesome suggestions everyone!

    You know...speaking of customer service, I'll bet many vets would be surprised to know how many patients they lose due to staff issues.

    I've dropped vets and personal docs due to rude, uncaring and incompetent staff.

    Vets need to really impose on their staff that EVERYONE is in sales. Meaning that every single staff member who comes into contact with a client must have the mindset that they are a salesperson for that practice.

    I don't mean they are selling products but they are selling the practice. They are selling the experience, therefore creating strong relationships with the clients.

    Clients' requests and questions shouldn't be seen as a burden but as an opportunity to delight the client and keep them coming back.

    Cody
     
  42. KKibo

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    I have mixed feelings about offering boarding.

    On the one hand, it does take up a lot of space. On the other...boarding "spa's" without a vet on hand leads to some scary thoughts.

    Perhaps, if you have the gumption and the willingness to really put yourself in more debt, a seperate business in addition to the hospital owned by yourself that which its sole purpose is boarding might be profitable (after quite some time, more than likely).

    From what I've seen in my area the upscale animal hotels and boarding facilities do -really- well. Whereas the vets who just have small metal cages and crates seem to feel they are more of a hassle than a profitable service. We continually have clients spend upwards of $500 to over $1,000 when they go on vacation to have there many pets boarded. We even have clients who just drop their animal off for the day.

    However, it does seem that location has more to do with boarding being profitable than anything.
     
  43. No Imagination

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    The vet I worked for closed down her 3 doctor hospital of 12 years to do 4 days of clinic work (vaccs, spays/neuters, and euthanasia's (no other surgeries)).

    Says she is making more net than ever. Also works per diem 2 days a week.

    But... I know 3 very well to do vets who own 2-3 doctor hospitals as well. I think there is a hump in terms of business vs. doctors a hospital has to overcome before you can start bringing in big money, as few single doctor hospitals seem to last very long or grow very profitable (in my experience).

    As far as board certifications? Still a bit confused as to what that brings to your hospital.

    Surgeons for instance. The line seems quite fuzzy as that what a cert. surgeon can do vs. a skilled non-cert. vet (assuming you've learned and are competent doing the procedure).

    Not a vet(student), so who knows, but if private practice is what you're looking for, not sure if board cert is the way to go.
     
  44. Bill59

    Bill59 Member
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    That's a good question. From a legal/sate practice act standpoint it doesn't matter. If you're a licensed veterinarian you can practice veterinary medicine with no restrictions. You can do brain surgery if you want.

    But ethically you shouldn't do something you aren't competent to do and the vast majority of veterinarians understand and practice this.

    From a business standpoint, board-certified specialists depend on referrals from other veterinarians. A dog needs brain surgery for example, so the general practitioner refers the patient to a specialists that's competent to treat the patient. And most veterinarians only refer to specialists they are comfortable with -- they want what's best for their patients and clients. And being board-certified is part of that assurance, although not the only part.

    But you're right that in many cases it's unclear on who should do what. For example many GPs are comfortable doing a cystotomy. Some are comfortable repairing a cruciate. But a communuted humerus fracture in a 120 pound rottweiller is likely going to get referred to an orthopod. Many GPs are comfortable treating corneal ulcer but everybody refers a cataract surgery to an ophthalmologist.

    Part of your education and experience is learning when to refer.
     
  45. No Imagination

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    Bill, I've brought this topic up at least 2 times previously, and you were the first to explain it to me.

    Its funny the 2 examples you used,

    "For example many GPs are comfortable doing a cystotomy. Some are comfortable repairing a cruciate."

    That was the case with the vet I worked for, she was referred many cruciates despite not be Board Cert. simply because she had a local rep. for being good at them, and more importantly, refusing to follow-up on those clients (non-surgical I mean).

    Thanks.
     
  46. david594

    david594 The-OSU CVM c/o 2013
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    But was she doing lateral fabeller(suture) technique for the cruciates? Or was she doing newer TPLO and TTA techniques also?

    I am in the same type of smaller clinic where we get a fair number of referrals for surgery. But the reality of it is that for the clients we are the "best option financially" as opposed to simply the "best option." Our $1500 to the board certified surgeons $4000 is a big factor for clients.
     
  47. Bill59

    Bill59 Member
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    That's pretty common. A lot of GPs get interested in a certain area and through CE and practice develop a local reputation such that they will get referrals. In addition to orthopedic surgery (some do TPLOs), dentistry, ultrasound and endoscopy seem to be common examples.

    This is usually not a problem as long as the GP doesn't advertise or imply that they are a specialist (the AVMA actually doesn't like for anyone to use the term specialist, even real specialists). As you mention, it's important to send the client back to the referring veterinarian -- start "stealing" referred clients and pretty soon you won't have any referrals.

    Also it's important for everyone to realize which cases are really best treated by a boarded specialist/referral hospital and to make that recommendation. Whether or not the client is willing and able to comply with that recommendation is another matter, but at least you've made the best recommendation.
     
  48. VeganChick

    VeganChick Tufts University V'13
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    I would think that where you set up your practice is also an important factor. If you set up in a poor area where clients can only afford routine vaccinations (if that), you might make less than in a more affluent area where the clients will do "anything" to make their pet better. Both demographics need vet care but the money invested in this care by clients will be different.
     
  49. johncronejr

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    What makes it possible for people like Dr. Bob to do what he did, is because Dr. Bob likely has a different view of what kind of financial lifestyle he needs. Many people go into business with dreams of having the nicest building, the nicest house, cars, paying for their kids complete college costs, etc... These things require a greater profit margin to achieve. Without Dr. Bobs financial statements it's hard to say if he just didn't require as much money as others for his lifestyle or if he had such a high profit margin with other patients that he was able to give you an affordable surgery cost.

    My bet is that he just didn't require as much personal income to live the life he wanted to live.
     
  50. guppy73

    guppy73 Tufts V'13!
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    One other thought & question to the OP: Does your school have a HSVMA (Humane Society Vet Med Assoc.) chapter? I attended the following presentation this past semester, & it sounds as though it might be helpful in your case as well:

    Doing Well Because You're Doing Good: How Helping Animals Can Help Your Bottom Line
    A growing concern for animal welfare and increasing public appreciation for positive social impact by veterinarians means that involvement in community animal welfare activities and the operation of a profitable practice need not be mutually exclusive.
    This presentation provides case studies of veterinarians who have sustained profitable practices while focusing on essential therapeutic services, such as low-cost sterilization, declining to perform cosmetic surgeries, and working with rescue groups and shelters.


    It was a terrific presentation, & I'd highly recommend it! Here's their link, & best wishes!


    http://www.hsvma.org/about_us/

    :)
     

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