Driving Veterinary Practice Profitability and Client Loyalty Through Financial Strategy, Communication, and Marketing

Good evening everyone, and welcome to the Veterinary Business Institute's monthly webinar series. At the Veterinary Business Institute, we are dedicated to empowering practice owners build sustainable, high-performing clinics that deliver exceptional care without the sacrifice of profitability. Now, tonight's event, "Driving Veterinary Practice Profitability and Client Loyalty," tackles the three hidden drains that limit your practice's growth: outdated accounting, fragmented communication, and invisible marketing. I'm your host, Dan Adisha, and alongside our three experts, we'll uncover the actionable strategies that you need to stop reacting to operational fires and start proactively building the efficient, profitable practice you deserve. Now, just a few quick housekeeping notes to help you get the most of this hour.

First, yes, we are recording. You will receive a replay link in your email after the event so that you can re-watch and share with your partners. However, do not let that make you passive. The real value is happening right now, live. And to make the best use of your time, engage with us. Use the Q&A button bottom of your screen for specific questions you may want me to ask the panelists. Or else use the chat to share your thoughts with your colleagues here. I'll have my eye on both the feeds and will do my best to weave your questions into the conversation as we go along. Or else, we'll tackle them during the Q&A session, the live Q&A session midway through our event.

Now, the strategies we are covering tonight are game changers, absolutely. But the conversation does not have to end in an hour. It continues weekly on the Veterinary Business Podcast, every Thursday, 6:00 AM Eastern. Industry titans like Naren Arulrajah, Dr. Manda, and our co-hosts break down the exact steps you need to drive growth, retain patients, and optimize your operations. It's the perfect listen for your morning commute. Be sure to search for Veterinary Business Podcast on your favorite app and hit that subscribe button so you don't miss an episode. Now, we'd like to give a massive shout-out and a thank you to our platinum sponsor and growth partner, Ekko Marketing, founded by Naren Arulrajah, the very same founder of the Veterinary Business Institute.

Now, for nearly 20 years, Ekko has helped vets across the globe stop being the best-kept secret in their town. And they believe that great care deserves great visibility. And as a thank you for joining us tonight, we are offering a complimentary one-on-one marketing strategy meeting with our event sponsor, Ekko Marketing. If you want to stop reacting to operational fires and start proactively building your wealth, this is your chance to align your digital marketing with your financial goals so that you can attract your ideal loyal clients who will drive your profits upward. Now, there are only 10 spots available tonight, so be sure to reserve yours now as we go along. That being said, let's take a quick look at the roadmap of what we are going to cover tonight. We're going to first break down the three core pillars of a profitable clinic. First, we are going to dive into accounting, showing you how to identify those hidden revenue opportunities and get costs under control.

Next, we'll tackle communication, so giving you the strategies to align your team and boost that client retention. Thirdly, we're going to look at your marketing approaches that will attract those high-value loyal clients and of course, but the real magic will happen in that last point, understanding how these three pieces, the numbers, the people, the outreach, all work together to drive your long-term growth. Now, let's meet the experts who will guide us through this conversation. First up is Dr. Rebecca Maher. She's a veterinary surgeon and consumer psychologist who helps clinic teams decode animal health communication so that they can build unshakable client trust and boost treatment acceptance. Dr.

Maher, great to have you here on the panel. Thank you. Great to be here. Thanks for having me. Absolutely. And next up is Kamala Bailey. She's a CPA and certified valuation analyst who helps veterinary practice owners uncover hidden financial leaks so that they can maximize their net margins and finally achieve true financial peace of mind. Kamala, welcome to the panel. Thank you. And of course, rounding out our panel is Lester De Alwis. He's the marketing manager at Ekko Marketing, and he helps veterinary organizations build powerful online visibility so that they can attract high-quality clients effortlessly and outpace the corporately-owned competition.

Welcome, Lester, to the panel. Thank you, Dan. Pleasure to be here. Great to have you here. All right then. Hmm. Let's dive into the conversation here. So my first question is to you, Dr. Maher. When a client hesitates at a treatment estimate and a team member immediately discounts, which staff skill gap caused that moment to fail? And I think if you unravel what's happening in that moment, really, that hesitation's created a feeling of discomfort, and so the team member is going to a shortcut to try and ease that discomfort. So it's not like a strategic discount that they're putting in place. It's a short-cutting move to alleviate the pressure that they're feeling.

So I would say that there are three really key skill gaps there that are sort of creating that sense of pressure. The first one is around handling hesitation in the first place. As humans, we tend to feel pretty uncomfortable when there's a silence or a gap in the conversation, and we rush to fill it. So helping teams understand that sometimes we need to let that gap breathe. Maybe the client isn't hesitating because of the finances. Maybe they're hesitating because they're having to think about the decision or think about the logistics around how they might make this work at home. So giving people the tools to understand it's okay to let a hesitation breathe. I think the second one is around overcoming objections. So giving teams the tools to be able to understand what to do in that moment where they're feeling the pushback from the client. They've got a flow of a conversation they can move into, so they know what the first step needs to be. That can really help to give people confidence to actually lean into it rather than feeling like they need to step away and ease the pressure.

Mm-hmm. And then the final of the three would be around communicating value and price. So it's hard sometimes to be able to really get that value across clearly to clients, and there are some really specific skills that we can put into place around how we describe what's in it for them, how we explain what the benefits of a decision or a procedure are to them to make sure it lands with them. And similarly with money, it's tempting to feel like the number is the thing that's causing the problem, but actually often it's the way that we've described it, the way we've presented it, because we can make numbers feel bigger or smaller to people depending on how we talk about them.

So I would say that those are the key three skill gaps that I would want to look into if that was a problem in a clinic. That's right. Thank you very much, Dr. Mayer. So let that hesitation breathe and for that pushback, always have flow ready in hand. Of course, communicating value and the price is an art form. So- It is ... let's figure out how we can definitely fix those skill gaps as we go along the conversation. Thank you, Dr. Mayer. Absolutely. Now, Lester, what are you seeing right now with independent veterinary practices that rely heavily on word of mouth? Where are they losing visibility to larger groups or consolidators? That's a great question. So, to be honest about this, it's a big shift happening right now.

I know word of mouth is not a bad thing. If people are talking about your clinic, that means you're doing something good. You're doing some great work. It means clients trust you, that trust is earned, and nobody's saying word of mouth is dead. But here's the truth. Word of mouth alone is not enough anymore to keep your practice growing. The reason why it is because client behavior has changed. Even when a friend recommends your clinic, the next thing that the person is doing is going to pull up the phone and search you on Google. And they read your reviews, they look at your website, they compare you, two or three with other clinics nearby, and then they decide or then they take the decision. So this is where independent practices start losing ground, and 92% of people in the North America, they start on Google, when they're looking for a vet, and Google handles over 30 billion searches a day. If you're not showing up in those searches, clearly, strongly enough, with good reviews, you're really already at a disadvantage.

So because there are bigger groups, like the bigger practices if you go and search, they are spending the real money to show up there on the top three results of Google, having good reviews. They're now waiting to be found, and they're making sure they get found first. So there are three places we see independent practices falling behind. First is search visibility, second is the message clarity that they put out there, and third is active client acquisition. But I will touch a bit on the search visibility. So when someone Googles vet near me or vet near my town or who comes up, who shows up in that Google search? So if it's not you in the top five results of Google, you're losing that client or patient.

So the top five Google results get almost all the free traffic, and everything below that barely gets seen. So that is something you need to fix if you are not being able to see yourself in the top five results of Google. So the good news is independent practices are not doing anything wrong with word of mouth. Of course, you need to take a step forward and look at the new areas. So the environment has changed and the practices that are growing today are the ones that stop waiting to be found and starting to show up on purpose. So visibility is no longer optional. It is the foundation in marketing. Check. Thank you very much, Lester, for that very comprehensive answer.

Of course, that comparison factor is playing a big role in when, as you mentioned, 92% of people who are searching for a vetSo let's figure out as we go along how to really solve for that as well. Thank you, Lester. Now, Kamala, most practice owners trained clinically report net margins below 15%. What financial blind spot must, well, most consistently explain that gap? What have you been seeing? Typically, what I see, it's managing their expenses effectively. They're great at medicine, and they have the top-line revenue typically, but often they haven't had any business training, or they don't have an understanding of how to manage a business, and particularly expenses.

And the expenses that they struggle with the most are cost of goods sold. Mm-hmm. Those are treated as unavoidable expenses rather than what they really are, which is actually highly controllable expenses. So managing inventory and cost of goods sold is crucial. And what that includes is carrying the appropriate products. If there's a multi-doctor practice, getting the doctors together and having them decide on one drug instead of multiple drugs that do the same thing is crucial. Along with tracking your expiring or slow-moving inventory, and being consistent in your reordering controls, that's very important. And the last thing is, do not have cash sitting on your shelves. That's what inventory is.

The ideal inventory should be between 13,000 and 18,000 per full-time equivalent vet. So most practices with sub 15% margins are not necessarily underpricing- Okay ... or they may not be overstaffed. They are really leaking profit through their unmanaged cost of goods sold. Think about this, just a 3% to 5% improvement will move your margins dramatically. The bottom line is not that the profit comes from doing more, it comes from- Mm ... managing the economics of what you actually are doing. Hmm. And that economics being efficient seems to be the key, is it? Yes. Managing your expenses. Now that's the problem practice. Can you give us from your experience what does it look like when the practice is doing this correctly, when they're managing it efficiently?

The cost of goods sold really should run between about 18% and up to at most 24% of your gross revenue. The practices that I work with, with the highest profitability, manage it between those numbers, and if they're able to do that, they'll hit even up to 20% on the bottom line. That's amazing. Dr. Maher, I know you're in the UK side of things. Have you seen these numbers before? Yeah, the numbers are very familiar actually. So yeah, typically we'll see practices with profitability anywhere from kind of 10% to 20% would be a kind of a good window to find themselves in. But yeah, it's very variable across our market, but the numbers are similar and the challenges are similar too.

Now, I would like to ask you a question, Dr. Maher, regarding this, because Kamala just mentioned getting the associate doctors, veterinarians together and then deciding one drug of choice. How- Mm ... how easy is that conversation or how can we make that conversation easy? I think it depends, doesn't it? It depends on the kind of therapy area you're talking about, how much choice there is, whether the drugs are really directly comparable or whether there's a perception of there being a slight difference between them. But yeah, certainly it's something that it makes sense to come together and think about what's the ideal selection, and perhaps there's a minimum selection that you want to have on the shelf from a clinical perspective.

And then, if you need those other medications that perhaps you perceive to be slightly different, maybe some of them could be ordered in on an as required basis rather than having a big stock on the shelf. But yeah, it does make sense to sort of bring the team together, and I think the key thing from a communication perspective is for it to be a real co-creation of the plan rather than somebody sitting in the room and telling everybody that this is how it's going to be. It's about bringing the team on board, making sure everybody's voice is heard because different people have different perspectives. Right. And all of those perspectives are really important.

So bringing people together and co-creating it together. Love that communication and clinical perspective on it. Kamala, from your accounting perspective, how would you structure that conversation for it to go as smooth as possible? Of course, it's all about the profitability. So, as clinics are able to increase their profitability, they're able to share that in their payroll. So the way that I would term it would be, the more efficient we are, the more there is available to share. Absolutely, and that's something we all want to be part of. Right. Right. Dr. Maher, my next question is to you. How do you determine whether to standardize client communication scripts or preserve the individual relationship styles each clinician has built over time?

That's a great question, and it's one that comes up a lot in the training that we deliver. So for me, it's not an either/or. It's probably a bit of a false binary in that I think you probably want to be somewhere in the middle of those two things. So for me, the things which I would want to look to standardize would include the structure of a conversation, so the flow of where you start and where you move through. So we have frameworks which we coach people to use for consults, for example, and for phone calls, for incoming client calls, so that you create that sense of consistent communication. It's a communication that feels really good to the receiver of it, and it's simply through the flow.

But that's not the same as having a script. These are sort of steps you move through, but you can use your own natural language to move through those steps. So that would be the first thing that I would want to standardize. The second thing I think it's really important to understand is that there are really key moments in the client communication experience which have a disproportionately big impact on how things feel to the client. So identifying those moments, like for example, the start of any communication. Literally those first seconds where somebody is making up their mind about us, because really we do make judgments subconsciously about people, literally in milliseconds sometimes. So thinking about how we show up in those first few moments, how we introduce ourselves, how we welcome them, how we have eye contact and so on. Is the room ready?

Is it clean and does it smell nice? All those things that create that first impression. It's a really key moment to think about standardizing, not in terms of the words that you use, but maybe a bit of a checklist of the things that you're going to make sure are in place at that start of the communication. So there are other key moments, like the moment you make a recommendation, the moment you're trying to communicate value, and the closing, the kind of final moments in any communication, because that's the sort of memory that we take away from it. Mm-hmm. So I think helping teams understand what are those key moments and what can we do in those moments which help the communication feel really good, but allow them to use their own language to bring that to life.

Okay, check. Now, you mentioned a couple of times over here the flow of conversation, right? And these key moments as well. I'm just wondering what is the ideal flow you're really talking about? What does that look like? So it depends a little bit what situation you're thinking about. But for example, if we're talking about an incoming phone call coming into the clinic, we use a framework called CLASS. So the C stands for connect. So in those first few moments, we are looking for behaviors that really help to sort of create rapport and connect the client with the team, with the practice early on. Then we look at listening, that's the L in CLASS.

So, making sure that we are actively listening. We're not just kind of listening with a view to then speaking. We're actually really trying to ask questions and understand and reflect back what we're hearing. Then the A would be to acknowledge, so acknowledging maybe the client's concern if they've phoned in with a concern or just acknowledging that maybe we're just validating that you've done the right thing calling us. We're sort of giving that kind of validation or acknowledgement for the reason for the call. Then we move to the two S's at the end. So the first one is to solve the problem. So maybe it's a appointment booking that's required. Maybe there's some information they need, but we're looking to make sure that we solve whatever they've called in for.

And then secure at the end is about making sure that everything is sort of secure in place. So reiterating things like the plan or key steps or what to expect next so that people leave with that really clear understanding of like, "Yep, I'm booked in for 2:00 tomorrow afternoon, and they're looking forward to seeing me." Great. Happy days. So, that would be an example of one of the frameworks we use. We use different ones for consulting and for dealing with objections from clients as well. Okay, great. Thank you very much for giving us insight on that framework, Dr. Maher, and of course, showing us some of the things needs to be standardized, but how it's executed can be left up to the individual.

Exactly. Check. Now, Lester, a lot of clinics feel busy but not as profitable as they should be. How do you help practices grow without overwhelming their teams? Very good question. So, this is something we hear all the time. When I go to the meetings with the practice owners, they tell, "We're busy. We're not making the money we thought we'd be making." And the first instinct is always, "We need more patients," or, "We need more clients." But more clients is usually not the answer. More clients often means burnout, longer wait times, and a drop in the client experience, and that drop hurts profit more than it helps. So the real issue is that growth and efficiency aren't working together.

So when we work with practices, we don't chase volume, we focus on smarter growth. So the first thing we look at is the quality of your growth, not just quantity. So are you attracting the right patients or the clients? As you know, marketing is about getting the patients to find you and giving them a reason to choose you.So the ones who value what you do, the ones who follow through on the treatment plans, the ones who stay with you long-term, because when you bring in better fit clients, you don't need as many to grow your profit. Mm-hmm. Ten great clients or 10 good patients who are not price shoppers every time will be your go-to choice. So, and the second thing is getting more out of what you already have. So most practices already have a strong client base and steady demand, but services aren't being communicated well enough.

So recommendations aren't being enforced, reinforced consistently, so follow-ups aren't structured. So I would say make sure your follow-up systems are well-structured in a way that these follow-throughs with the patients are working and communicated effectively. So instead of making the team work harder, make them to work smarter. So we help practices get more value from that work that is already happening. So and the third piece is reducing the friction for the team. So growth should not mean more stress. It should actually mean a better systems, clearer communication, everyone on the same page, front desk, technicians, doctors. When the whole team is aligned, the practice runs smoother and not harder. And I think there's this great analogy where if someone rows the boat on the opposite direction, and the doctor basically looks at a different direction, and basically what happens is your boat is not going to go anywhere.

So and the last piece is good marketing actually makes operations easier. And so when marketing sets the right expectations before a client walks in, that means the website, the reviews, the messaging, or what kind of clinic you are, about your website. The client arrives already understanding your value by just looking at all what you mentioned online and on your digital marketing presence. So that means the conversations about price and is you don't need to actually create or basically put it or plant it into their head. That trust is already built on that first look on the website and it's easier, yes, on treatment plans. So the shift really is stop asking how do we handle more and start asking, how do we make what we're already doing work better?

So when you do that, of course, the profit goes up, and then team feels more in control and the client experience actually improves, and that is what matters. Very interesting take there, Lester. More is not always better. That seems to be the underlying theme there. But of course, making what is already working a bit better, that's the way to go about it. And Camilla, I think I have a great question. Just, it's a great segue to this one. So how do you decide between reducing fees to retain a price-sensitive client versus holding your fee schedule and risking that client leaving? Camilla? Well, it's not all about the revenue. You actually need to look at the contribution margin, and that is the difference between the revenue and what it costs you to perform the service.

So does that differential contribute meaningfully to your overhead, your payroll, and other expenses? If the client accepts discount pricing but still produces a positive contribution margin, then it's possibly they're worth keeping, right? But if they require discounts every time they come in, and they push and push, and they get your services are near or below the cost- Mm-hmm ... then you really are subsidizing them, and they aren't necessarily worth keeping. So you need to look beyond the revenue and analyze their contribution. Another thing to consider, and this kind of goes along with Lester's marketing, is your capacity. If you're busy and you're giving discounts to clients that don't generate what others might, that kind of gives you answer right there, right?

You'd rather have those that don't want the discounts or don't ask for the discounts. So you should consider routinely that if you do discount, you're training your clients to question the value as well as really truly commoditizing your services. And this practice will attract price-sensitive clients over time. Whereas if you hold your fees and you are aligned in reinforcing your medical value, like Dr. Mayer talked about, show the value, you will attract the clients that are used to those standards and want those standards and are willing to pay for those standards. So don't be afraid to let clients leave. It can often be a financially healthy decision.

And shift from "We can't afford to lose clients" to "We can't afford to keep unprofitable clients." There we go. Is it okay for me to- Of course ... to add to that, if that's okay? Absolutely. And certainly one of the things that I see a lot in UK vet practices and it'd be interesting to know whether it's similar in the US, but one of the things I see a lot is that teams often don't understand the profitability of the practice that they're working in, and it's the perception of how profitable it is often way out of kilter with the reality. So, if you've got a practice that's operating with a profit margin of, I don't know, 10 to 15%You don't have to give very much away before you're having to do a lot of work in order to just recoup what you've just given away.

And I think a lot of teams who are giving these sort of minor discounts or what feels like a minor discount at the time don't understand the real financial impact of that discount. And actually what I see time and time again is that if we can help them understand that, many more people in the practice will feel much more reluctant to actually give a discount away. And if we can help them understand the pricing policy within the business, they can understand how the pricing has been set, and they can see that it's fair and that it's as it should be in order for the business to be able to run. And that it's not excessively profitable as a result of that pricing strategy. Again, a lot of teams will then feel much more comfortable with it and feel much more confident to then lean into those conversations with the client as well. So I think often there's a knowledge piece missing for the veterinary teams who aren't involved in the business management side of things.

I believe in open book and letting people, maybe not dollar-wise, but percentage-wise, letting them see that, hey, it is only a 10% profit. Yeah. And as an owner, maybe, that isn't enough really. There's a lot of work- Exactly ... as an owner. Yeah. So sharing with the team is not a bad thing. Absolutely. I agree. Right. That's great. Kamala, I'm just curious. Now, well, Dr. Mayer also mentioned it, showing the value, right? Holding your fees. There's a little bit of a faith or rather trust in the process factor there. What's your advice to our practice owners who want to change that mindset? Well, I think retaining clients is very important, and I do tell... We do them every once in a while.

About every 18 months or so, we'll see what the retainage is. And if it goes down, it's not the end of the world. We also have to track the profitability. So, it's like a two-edged sword, really. It's hard to be right where you need to be, I guess. Yeah. It's hard. So, is there a way to make that easy? That's a good question. I think sharing the profitability with the team is not a bad way to go and holding people responsible, especially when it comes to cost of goods sold. Oftentimes people don't realize if they just accidentally ruin a surgery pack or something, what the cost to the clinic really is of that. So if you hold people responsible and explain the importance of tracking inventory and cost of goods sold and how it affects profitability, and when it affects profitability, and there's more on the bottom line, again, we go back to the fact that we can share that with the team if that's the case. So that's what I think is very important.

That's great. I think that's a great point. There's a lot of education going on, not just to the clients, but also for the team side- Yes ... for teams, for us to all align better on the mission to profitability. Right. Before we continue on to the next question as planned, we have a very exciting segment here where we are going to do a bit of a live Q&A session. Give me one second. Oops. Here we go. Right. So, for our attendees, this is a great moment for you to really get involved and make sure that you are not leaving the conversation with a thought like, "Oh, I really wish I had asked that question." So, don't lose sleep over that question.

Go ahead and ask it away here right now. Just to get things warmed up, I do have a couple of questions that I had selected from our community, the Veterinary Business Institute community. We have a fantastic community on Facebook, and LinkedIn as well. So we got a few questions that aligned with our topic tonight. So let me pull one up here. Okay, here we go. This one. Yeah. We have a lead tech who says something along the lines of, "My doctor spends about 20 minutes in the exam room talking about the surgery, but they never mention the price. Then they hand the client to me at front desk, and I get to deal with the sticker shock." How do we get the doctors to actually own the cost of medicine before the client hits the lobby?

This is open free for all. Please, go ahead. We'll start with perhaps Dr. Mayer. Would you like to take a stab at this? Sure. And, I would say this is one of my soapboxes. So I feel very firmly that no client should ever leave the consult room without a clear idea of the cost that they are soon to be paying or soon to agree to. Because if there's an affordability issue there, firstly, if a decision has been taken within the consult room, andthey've needed to decide whether or not they're going to go with a procedure or a plan. If they don't know the cost of that, they can't make an informed decision about whether or not this is a good idea for them.

And if there is a genuine affordability issue there, the conversation needs to continue in the consult room to assess what other options do we have available to us, which maybe don't involve this procedure or this approach. And you can't have that conversation once they've gone to the desk. So, I feel very firmly that conversation does live within the consult room. And the way that I find most helpful to encourage that to happen is to, again, go with a bit of a co-creation approach where we bring the whole team together and we talk about-- So this is what we do in our workshops. We talk about the money discussions that are going on within the clinic and what's challenging about them, what's difficult about them, and we get the different team members to discuss what makes things difficult.

And sometimes hearing each other's perspective enables people to understand the impact that they're having on other members of the team by avoiding those conversations or pushing them into a different part of the team. So for me, it's about getting people together, getting them to talk about it, and then kind of working through, I think with a facilitator helps to be able to work through, so what can we do collectively as a team to help this work through more smoothly? And often it's not as simple as just deciding, let's have the conversation in the consult room, because the reason the vet's not having that conversation is often because they lack the confidence or the skills to be able to lean into that conversation. They're worried about the pushback they might have.

And so sometimes we then need to support with give them the skills and the tools they need to be able to do it. That's right. Kamala, would you have anything to add on to that by any chance? This is a very interesting conversation because in the US, we always leave it up to the techs to go over the estimates. And I see where you're coming from, Dr. Maher, because if there is some pushback, the veterinarian is going to be able to explain probably better than the techs might. But the training here is the vets do medicine and leave the money to others. Yeah. So. Yeah. I guess there's a divide there in terms of the approach, because certainly in the UK, you wouldn't just hand over normally.

Sometimes we will hand over to talk through an estimate in detail, but we would've talked about the big number first and yeah, had a discussion about whether that worked for them. Yeah. Interesting. Normally. Interesting. Yeah. Right. Oh, this question has been asked even by one of our registrants, but I think we just answered it. And then there's a question that goes, well, implementing CMA including discussing variability in estimates. So, I would imagine this has come from the UK because we've recently- Yes ... been through a process where the Competition and Market Authority have come to a ruling in terms of the communications that UK vet clinics or small animal vet clinics now need to put out into the market.

But sorry, could you repeat that question again? I wasn't really clear. Yeah. It's not a very well-structured question, but it's implementing CMA, including discussing variability in estimates. Okay. So, one of the things that has come out of the CMA process is that vet practices will need to give written estimates for anything that's expected to exceed, I think it's 500 pounds in cost. And I think the key for me, this is another one of my soapboxes, is that giving clients information on its own is not true transparency. It doesn't help them make decisions because what they need is understanding. So I think we need to be really careful that when we're implementing the outputs from the CMA process, that we're not just ticking the box and saying, "Here you go, there's the information. I've done my job." That we're making sure that we're actually helping the client understand that information, we're giving it them in a way that makes sense to them, and that is going to enable them to make a better decision as a result of it. And so that means having good value-led discussions where we're talking about what it means for them, what it means for their pet, what they will get or avoid as a result of going down this route, and what the various upsides and downsides are.

And I think that's the piece that if we implement the CMA outputs just by the book and we don't think about it too deeply, we run the risk of just giving information but not helping them understand. Check. Now, we have another interesting question here, from Dr. Greg. Where from? I can't seem to find from where. But this is a bit of a marketing question. "Word of mouth kept my clinic full for 20 years. But now, due to corporate opening up down the street, they're eating my lunch. I absolutely hate social media. Do I really have to start dancing on TikTok to survive?" This is a very passionate question. Lester, we really need an answer here. Well The trend is that, right? You see everyone going on the trend where you see someone who's an influencer in TikTok or in Instagram, and you want to basically-- You see that they are getting a lot of traction through social media. Well, it depends.

Of course, you don't have to do all of that because there are some practices that are very good at doing social media, because their way of approaching marketing is through that lens of showing that story. So you can always put your story in different ways. Of course, there are experts in, or there are really good personalities where they can show a good picture on TikTok, Instagram, and create that sense of belonging to that patient to come to your practice. But that itself is not enough. So, I would say you need to just get your basics. Of course, social media is something that if you feel very passionate about it, you can do it. But in fundamentals of getting patients to visit your practice, you should focus on the basics.

And that is your website, creating a good website, creating a good Google business profile, making sure you get good reviews, good love letter reviews. Reviews is what makes things very important to anyone to choose your practice. No, it's not the social media. Even if you do really good on TikTok or on Instagram, I would just go on Google business profile and check who you are, how many reviews, what people say about you. Because you might be dancing really good on TikTok, but if you're not giving the good care on your practice, that doesn't make any sense. So, yeah, I would say just focus on the fundamentals, that is making sure you have all the things checked in terms of your website, your reviews, your culture about your practice on your website, about your team, your team is very important, and also what you do and the services you offer.

So if those things are very clear on your website and everything is crystal clear without no duplicate content, meaning you will be penalized from Google, and to the fact I was talking about earlier, if you have duplicate content, you will not be ranking. Can I say something? Go ahead, please, Kamala. Because I deal with this a lot, actually. And what I tell my clients who are local is really play up the fact that you're local and in the community and have been in the community and love your community. And that's what I think is important, especially when corporate comes. Yeah. Exactly. Right. And I just wanted to add on there, just so that Dr. Greg finds this completely appreciative. How do we get those reviews? Is there a quick way to do it, Lester?

What's the shortcut here? The thing is, if your quality of care is up, if you are really giving your 100% to the patient, getting a Google review is not that hard. And getting that review is basically, you don't need extra sys-- Of course, there are systems to get reviews. We do have something called Grow My Reviews at Equa Marketing that we have implemented for our clients. However, in basic terms, if you do your care to the level that the patient is very satisfied, if you ask a review and they will just write a love letter review in your Google business profile. And that basically is how you can do it. It's just making sure you do the fundamentals of the first few touchpoints perfectly and, of course, your patient will write something really good about you and how the exact experience. I have seen some Google business profile- Right ... reviews where they explain the entire experience from the start of entering your practice until they left the- Right ... until they leave the practice.

So that's how I think it all depends how you get reviews. Of course, you should be asking for reviews if you do want to know your feedback about your practice. Right. Thank you very much, Lester. And absolutely, Kamala. Just doubling down on how much you are involved in your community will really resonate much more better with those patients that are coming in. And when they are even asked for a review, perhaps they might feel that connection more so to support a local business. Perhaps that's the side you were mentioning there, Kamala. But definitely double down on what makes you unique. So Dr. Greg, we really hope that you don't have to dance on TikTok to survive.

Right. Let's keep moving on here. Thank you very much, panelists, for really joining in on that very engaging conversation to answer some of our registrant questions. Now, Dr. Maher, during the discharge appointment, a client leaves without scheduling a follow-up care. Who missed what, and at which point did that conversation go wrong? That's a really interesting one because the temptation in that scenario is to look to the last person, the person who discharged the patient and kind of apply blame, apportion blame to them. The reality is, though, that if we look across the timeline that the client's had, the contact timeline, there will have been lots of opportunities. And in factEssential moments where we should have been talking to them about that follow-up.

So, if we think about the consult, when we're talking to them about the procedure, we can frame follow-up as an essential part of this procedure, so that the client isn't left with this feeling that it's, "Oh, that's been introduced at the end, so maybe that's optional. I don't need to worry about it." So if we can explain to them the rationale for the follow-up, "We will see you back at this timeline after the procedure because..." and we can explain why, that's going to help build their mental model, build their expectation that follow-up is something I should do. Mm. So then, we also have a moment where the patient's admitted. That's another opportunity for us to really embed that feeling that follow-up is essential. And in fact, we could be booking that follow-up at that point as well. We don't have to wait till the end to book the appointment.

And then at discharge, again, that final opportunity to either book the appointment, reinforce why follow-up is really important, or if it's already booked, just reinforce that, "We're going to see you on this day and here's your appointment. Don't forget, this is why we need to see you back." So there are lots of moments along the way, so we can't say that one person has let the whole thing down. It would be a system error that we haven't got in place the right conversations happening at the right time. And actually, we could just build it in as default that when the client books the procedure, "Here's your booking for your follow-up appointment." And they can change the appointment if it doesn't suit them.

But the fact that it's given to them as a default, that they haven't got to arrange it themselves, that kind of reinforces that this is important and that it should be followed through. Are there any particular moments when a follow-up isn't required? Yeah, I think that there are some, from a clinical perspective, there might be some scenarios where you've reached the end of that process. But I think generally speaking, for a pet that's been admitted, they've had some sort of procedure which requires healing normally, and the client can't be expected to understand whether or not the patient has healed fully. And so there does need to be a process whereby we check that, and we make sure that things are as they should be.

So, I guess the scenarios where I would say maybe follow-up is less necessary would be somewhere, a situation where there hasn't been any kind of surgical procedure perhaps. Or, it's harder to kind of ascertain what those moments would be. I think in the vast majority of cases, we do need follow-up, but the key thing is that when they come back for follow-up, we also need to add value in that moment. So it needs to not just be a quick glance where we're like, "Oh yeah, everything looks good. Thanks for coming in. Goodbye." We're actually taking time, and we're talking through how have they been at home. We're going to say, "Right, we're going to give him a full checkover and make sure everything's okay." We talk them through that clinical exam, and then maybe we're having ongoing conversation about long-term management or the things to look for at home so that the client leaves feeling like, "That was really worthwhile. I got a lot from that.

It was worth me coming back in." The problems that I see with follow-up is when it's a quick glance. The client walks out and thinks, "Well, I've just paid for that," or, "It's been included in my procedure cost, and I didn't get anything from it. What was the point?" And that's what we want to avoid. Check. So when a client leaves without scheduling a follow-up, let's not blame the last person on the rung there- Definitely ... but rather the system that- Mm-hmm ... caused it, and ensure that we check these things- Absolutely ... before we point any fingers at anyone. So, Kamala, my next question is to you. What is the earliest number a practice owner can track weekly to confirm that charge capture improvements are actually reaching net profit?

Well, it'll probably show up first in revenue, but not revenue alone. The best way to track it, I think, is through your ACT or your average charge per transaction. This tells you that you are capturing more value with the same work. Mm. Or it can tell you that you are actually charging for what the team is already doing. Mm-hmm. So you should see your revenue tick up, sure, while your transaction counts probably stay relatively stable, and there really shouldn't be a change in your payroll or overhead. There should be little to no additional costs because you're capturing the charges you should've been capturing before, and your contribution margin should increase.

So if you add $5 per visit with 2,000 visits in a month, your revenue should really truly increase $10,000. There shouldn't be a differential. So I suggest tracking your revenue per visit and the number of visits that you have, and consider looking at your top five mischarge categories and track those manually. And that will tell you if you're doing what you should. Hmm. How would you identify those mischarge categories? You have to do audits of your medical records and make-- That's how you do it. You check through and make sure that things are being charged when they should be, and if they're being missed, that will tell you what's being missed.

What's the frequency that you would really recommend to our practice owners? That's a good question.I guess if you think that there are issues, you should be looking at it. But I would say at least once a year, looking at your... I don't know, Dr. Mayer. I'm not a vet, I'm an accountant. So do you have a suggestion on that? Well, I certainly know that there are practices in the UK that would track that on an ongoing basis in some cases. So they may be looking at it monthly or quarterly, for example. But I guess to a certain extent, you don't want to overburden yourself with the sort of admin tasks, but if it's something that is really key, then the more often you track it, the more data points you've got, the more you're able to then intervene and actually change things, and you see the trends and so on. So I would be inclined to monitor as often as is feasible, really.

We include ACTs in our financial statements every month. So we do track the ACTs. As to how often you would do an audit on your charges, that I- Oh, yeah Yeah. The practices that I know that are tracking that on a more regular basis don't do it through audit. They do it simply through a sort of tracking mechanism in their PMS. So it's data that's more easily findable. Yeah. That's right. So I guess if the ACT started to take a trend down, that was when you might want to do an audit. Perfect. Thank you very much, Kamala, for helping us really identify the signal that we're looking for to ensure that it's time for a little bit of an audit into the practice. Now, Lester, I think my next question is to you. Many practice owners aren't marketing experts, so if someone is unsure whether their marketing is really working, where should they start looking first?

All right. So a very good question again. I'd like to make this with maybe an analogy to explain how this works. So think of your marketing like a bucket of water you're filling. So the water is the new pet owners, and the bucket is your practice. So now ask three simple things. Is the water going into the bucket? That means this is people finding you online. And is the bucket holding the water? That is, is your website, reviews, and bookings working properly? Are people staying and taking the action? And the third question is, is the water staying over time? And that is repeat visits, loyalty, and long-term patients. So most clinics have a problem somewhere.

There is no water going in, that means no visibility. There's holes in the bucket, that means people leave without booking or even scheduling an appointment. And then patients don't come back, which is they don't stay over time. So, yeah. So to bring it to the whole picture, we see practice owners talk about this problem, and that's totally normal because they're running a practice. You're leading a team. You're caring for patients. Marketing often feels like money going out the door without a clear picture of what's coming back in. So it's totally normal. I think the best place for you to start if you want to take action is, one, is making sure if you can figure out are those new pet owners actually finding you online, and then when someone Googles a vet in your area. And the second thing is when people find you, do they actually take action?

Meaning, does it give them the urge to actually call and book through your website? So that tells you whether your website or your reviews are doing the job. And the third thing is when someone becomes a patient, are you building that long-term value from that relationship? Are they coming back? Are they hearing about all your services? Are they staying loyal? So those things, you need to focus. So most practices are doing one or two of these well, and very few are doing all three consistently. So, and that's where the leaks are, how we're seeing when we talk to practices and that's what we've exactly built something called a marketing strategy meeting.

We step outside your practice, and we look at your marketing, the way a new client or a new patient would. We show you what's working, what's not working, and then we show you what's been missed, what your competition is doing, and give you a clear, specific plan on what to fix. And the thing is, that will make the biggest difference because, of course, when you see your practice from an outside perspective, you see all the hidden leaks, and you see, you understand this is where things are not working. This is why things are not working. So this is again, as a token of appreciation in partnership with Veterinary Business Institute, and Equi Marketing, we're offering you a complimentary marketing strategy meeting.

And each session includes our team researching four to six hours about your practice and share a custom growth plan during that meeting, and we can offer these two very limited spots. So for this week, we only have five to... Yeah, I think five spots left because we do speak to a lot of practices, and we do want to give them all our attention. So the spots are very limited. So take your time and make sure you grab that opportunity. And if you're thinking, "I'm not really sure how our marketing is performing," this is the best step to take, and understand where your practice visibility is. Again, if you don't decide to work with us, that's totally fine.

You can still take this plan and apply it with your practice, and we will make sure that part will stay with you. Check. So, if patients in your city are searching for the services you offer, make sure you're the one that they find, trust, and choose. QR's on the screen, links in the chat. Go ahead, book your session now. And really appreciate that, Lester. And now we are almost at the end over here. I would love to get a final golden nugget, key takeaway from each of our panelists. Hold on. Yeah. So what is the number one thing our attendee can do tomorrow, right? The first step they can do tomorrow morning to really drive their profitability and loyalty forward.

What would that one step be? Kamala, can we start with you? Mine might not be so simple, but I think utilizing the AHA VMG chart of accounts for their financial statements is absolutely crucial. That would be the number one thing I would tell any practice. If they have good financial information, they can make the right financial decisions, and the only way to do that is using the AHA VMG chart of accounts. Check. Dr. Maher? I would say that from a communication perspective, one of the single most powerful things they could do would be to analyze incoming phone calls and consults to start to unpick where are the moments where they could make these really tiny changes that would have really big impacts. So I realize that doing that in and of itself is not one small thing, but I think it would help you identify which are the really small things which the team can then put into place really easily.

That's right. And, Lester? Yeah, I think, before you spend on marketing, spend on ads and everything. I know you want to go and get into the trends, even TikTok and do all of that. I would say fix the leaks in your practice, what you already have, understand where you are at in terms of your online visibility and then once you have a clear understanding, then you can put on your finance or put on your money to invest on marketing. So, don't rush to spend more on marketing. First check if people can find you and if they are booking, and if they're coming back, then if your marketing is already doing good, then just keep doing what you're doing.

But if you see there is something that's not working, you need to first analyze and then get to work on it. Thank you very much. Right. Lester, Kamala, and of course, Dr. Maher, thank you so much for your time. You've given us an absolute blueprint today on how to really stop revenue leaks, fix your client communications, and of course, build that digital presence, driving your high-value growth. As we close out, a brief feedback survey will pop up on your screen. Please take 30 seconds to fill it out. It'll help us ensure we continue to bring you the exact topics that you need. To everyone attending, thank you so much for dedicating this hour to your business instead of...

Of course, investing in your business is the key. So have a wonderful night, everyone, and keep on building those thriving practices. And we will see you at the next Veterinary Business Institute's event. Take care. Dan Adisha signing off.