The Resurgence of Independent Veterinary Practice: Balancing Autonomy with Efficient Business Models

Good evening, everyone. Welcome to the Veterinary Business Institute's monthly webinar series. I'm thrilled you have joined us for a conversation that promises to be both practical and inspiring. So tonight, we turn our attention to a powerful movement reshaping the profession, the resurgence of independent veterinary practice. Across the industry, more veterinarians are choosing to build and sustain practices on their own terms, seeking the freedom to define their culture, care standards, and business vision. So it's a timely conversation about reclaiming autonomy and reimagining what success looks like in veterinary medicine today. We extend our deepest gratitude to-- Let me share the screen. All right.

We extend our deepest gratitude to our esteemed sponsor, Equa Marketing, founded by visionary leader Naren Arulrajah, who also established the renowned Veterinary Business Institute. For nearly two decades, Equa has been at the forefront of delivering cutting-edge digital marketing solutions tailored exclusively for veterinary practices. Their unparalleled expertise reflects a profound understanding of the unique challenges and opportunities within the veterinary industry. Equa Marketing offers a comprehensive suite of services, including expertly crafted websites, design and maintenance, precise call tracking, advanced SEO optimization, and strategic paid advertising campaigns. Their commitment to excellence is evident in their remarkable 95% client retention rate, which is a testament to their ability to deliver measurable results and foster lasting partnership. Thank you, Equa Marketing, for your unwavering commitment and partnership.

And let me just also take a moment to introduce you, to perhaps remind you of the "Veterinary Business Podcast," which is streaming every Thursday, 5:00 AM Eastern Standard Time. As you can see from this slide, the "Veterinary Business Podcast" covers a wide range of topics in discussion with industry leaders, experts, and practice owners. You can find this podcast at veterinarybusinessinstitutes.com, and I just encourage you, it's a great source of best practices, innovative ideas, inspiration, and great thought leadership as well. So make sure you check those out as well. All right. So the topic that we will be exploring today is the resurgence of independent veterinary practice, balancing autonomy with efficient business models.

We'll explore what's driving this trend, the opportunities it creates, and how independent practices can stay both profitable and true to their vision in an evolving market. All right. So I will be your host for today's event, and I'm Shahara Bandara. At the Veterinary Business Institute, I manage live event summits designed to create engaging and practical learning experience for veterinary professionals. My background is in psychology and human resource management, and what truly drives me is bringing people together, sparking conversations, building connections, and creating opportunities that make a real impact on our profession and on society.

So that passion is what brings me here tonight, and I couldn't be more excited to share this space with all of you. Now, let's meet the incredible panelists who will be sharing their wisdom with us tonight. We are thrilled to welcome Esteban Sotomayor, a veterinary business consultant, practice leader, and operations strategist, transforming veterinary clinics across Latin America into high-performing, sustainable businesses. He's the CEO of All Pets Hospital Veterinario, which is Ecuador's first 24/7 emergency veterinary hospital, and also the CEO of VetFlex SA, which is a veterinary equipment distribution company. With all this, he blends real-world leadership with deep business expertise. A recipient of 2024-25 VHMA Emerging Leader Award, he helps clinics elevate leadership, financial performance, and client experience while staying on the cutting edge of veterinary technology and growth.

So please join me in welcoming Esteban Sotomayor. Thank you so much for that introduction. I appreciate being here. It's a pleasure to be here. All right. Thank you so much for joining with us. Our next panelist is Adishia Peemananda, senior executive and expert facilitator at Equa Marketing and a trusted veterinary marketing consultant. Adishia is a digital strategist who turns online engagement into measurable revenue, designing client acquisition systems that consistently delivering over 300% ROI. By combining data-driven strategy with expert facilitation, he helps practices uncover market opportunities and build marketing frameworks that are powerful, profitable, and sustainable.

Please join me in welcoming Adishia Peemananda. Thank you. Thank you very much for having me here, Shahara. All right. Wonderful. Thank you for joining us tonight. All right. Next, we're delighted to welcome Natalie Moore, Director of Operations at Peak Pet Urgent Care and a dedicated veterinary leadership and HR specialist. Raised in Colorado with a lifelong love for animals, Natalie combines hands-on clinical experience as a veterinary assistant with a business and HR degree from the University of Nevada, Reno. She now focuses on building strong collaborative teams and creating workplace culture where veterinary professionals feel supported and empowered to deliver exceptional care. Please join me in welcoming Natalie Moore Thank you.

All right. Our final panelist is Erin Preston, a veterinary practice growth strategist and leadership and team alignment specialist, and the founder of Inside Business Advisor. With over 20 years of veterinary business leadership, Erin previously owned and grew a nine-doctor small animal hospital, expanding it from 2,000 to 6,000 square feet, scaling the team from 15 to 40 employees, and achieving steady 9% annual revenue growth before a successful corporate transition. Today, she helps veterinary hospitals across the US optimize operations, boost profitability, and build engaged, high-performing teams. So please join me in welcoming Erin Preston.

Thank you for the introduction. Thank you for joining with us. All right. So here are the key areas that we will be exploring in today's discussion. We will discuss why independent veterinary practices are thriving again and how you can leverage this resurgence. We will look at the balance between professional autonomy and market realities, share proven business models that keep practices profitable and efficient, and offer strategies to boost revenue and team performance without sacrificing quality care. Finally, we will focus on future-proofing your practice, building resilience, staying competitive, and creating a sustainable model for long-term growth and fulfillment.

So I encourage you to take notes as you listen to this discussion, because there will be plenty of practical insights you will want to capture. Also, a quick reminder, the chat will be open throughout tonight's session, so if you'd like to pose a question, just drop it in the chat. I'll make sure it gets to our panelists. If for some reason we don't get to your question live, don't worry. We'll make sure it's answered and circled back to you after the session. All right. Let me stop sharing my screen. All right. Before we jump in, I have a little teaser for you. If you stick around until the very end of the panel, there's a surprise waiting, something you will really want to hear.

I can't spill all the details right now, but what I can tell you is this: It has the power to make a real difference for your practice and for you personally. And here's the best part. It won't cost you a thing. Yes. Consider it a gift, something truly special, and I promise you will be glad to stayed to find out what it is. Having said all of that, let's go ahead and get started. I would like to turn to you, Esteban, for the first question. You've had the unique experience of guiding veterinary practices across Latin America through significant growth and transformation. So from what you have seen in those markets, what key lessons or fresh opportunities do you think independent practice owners here in North America could learn from- I think- All of you?

... I think that's one of a really good questions that I get a lot. It's like, "Okay, what we can take from Latin America?" We were talking a little bit about some of the difference. Yeah. We have a lot more of competition between hospitals. You will have cities in Latin America where you're going to have a lot, a lot of clinics and hospitals in just one spot. So we need to be a lot more conscious on the experience and the type of customer experience that we provide to clients. So we don't have to be just really good in medicine, but we also have to be really good on the way that we deliver that experience to our clients. Right now, the customers are asking for much more touch with the doctor and be able to take more time with them, and that's something that we had to do here, too, in Latin America, because we don't have technicians, and doctors have to do pretty much everything. So that give us the time, or gives the doctors enough time to chat with the clients, trying to really get to know the pet owners, too, and the pet that they're treating. So I think that's one of the biggest difference that we're seeing, that we're learning how to be, or we're using a lot more the customer experience than what there's been used in the States.

That's very true. Not only the medicine. Experience matters, right? Exactly. It's a whole package. Exactly. All right. The second question to you is, running a thriving practice means balancing two demanding worlds, providing clinical excellence and ensuring strong business performance, as you mentioned earlier. So from your perspective, how can they begin to think more like entrepreneurs while still staying true to the deeper mission and why that inspired them to open their practice in the first place? I would like to start that question by asking also the people that it's willing or they want to be an open, like their hospital, what type of business they want to own. If they want to own a lifestyle business, or they want to own this huge hospital that will need a lot of them, and will demand a lot of them on work and stuff like that. As bigger the hospital, the bigger the demand from the owner.

So that's something that we also need to figure it out at first, what type of business you want to be running. And I think that's one of the hardest things to balance whenever you're entrepreneur. You think, "Yeah, I want big, big, big." But then, yeah, you want bigger, you have more problems, more employees, more clients, and there's just a whole lot on your plate. So you need to start thinking about how you want to run your business. And then I'll ask them, of course, like- If you want to be an entrepreneur right now, it's a lot of things that you need to manage in your plate. So you really need to focus on all the business aspects. You cannot just be good in medicine. You need to know a little bit of everything so you can control the team you're building.

Yeah, you can have somebody and outsource your accounting, but still you need to grasp a little bit of the basic concepts so you know what they're doing. The same with finance, the same with marketing. So you need to try to study a lot of the different fields, not just the medical part, but also the other fields that the business will be involved in. All right. Amazing. Right. I have another question for you. So you have seen firsthand how operational systems can make or break a practice over time. As you look forward to the next decade, is there one operational strategy or management practice that you believe every independent veterinary clinic should adopt now to stay competitive, efficient, and sustainable for the long haul?

Yes, and I will have to go back and circle back to the building human relations. Right now, we're getting into all the AI situation. Everything is, yeah, we're going to have to automatize our communication with our clients. We're going to have all these medical records. We have these AI voice recording softwares that are just going to make our lives much easier, and we become a lot more dependent on machines, and we stop listening that human contact that the client is looking for. So right now, if I can tell, everything is going to move to machines, and we need to find ways to keep up that and keep the human touch. And that's why I think that any thriving hospital should be thinking that if they want to be competitive and different and have a competitive advantage here in 10 years, it's not going to be with more software or more machines.

It's going to be with better human contact. That's amazing. That's very true. You might have the best technology, the best equipments, the best treatments, but find a way to keep that human touch. That is more important. All right. I would like to get back to Adhish now. Adhish, in today's world, digital marketing can make or break veterinary practices' growth. So why has it become such a critical factor for independent clinics, and what common mistakes do you most often see practice owners making when trying to build or manage their online presence? Would like to hear from you. Okay. Thank you. Thank you, Shehar, for this opportunity. I am, first of all, humbled to be here among such a great esteemed panel. And, of course, to answer your question, I would have to go into looking at the past decade, right? How has digital marketing or even marketing changed over the years, right?

Earlier, two decades ago, it was you can set up your practice and have a banner, right? Sign up, and then people will find you, right? And the practice had that leverage with regards to how people will get to find it. But now, today's world, the power has completely shifted to that smartphone in your pocket, right? So the power is with the people. And even before they get to your practice, they're going to check your reviews, they're going to check your social media, judge your website, take the time to really dig deep into your digital presence. Because what they are dealing with here is they're trying to figure out, do I trust this person with my family member, right?

That is the key factor that they want to figure out right before they even step in to the clinic. So, with regards to the mistakes we see that practice owner makes, like Mr. Esteban just said, a practice owner nowadays can't just be a veterinarian, doing what they love, taking care of the animal and the pets, but they have to be a business owner. They have to be a marketer. They have to be an accountant. They have to do all these things at once, and that's a real tough thing. And also, of course, dealing with the other things that comes from being in the industry itself. So some simple mistakes that we come across usually is when it comes to marketing efforts is delegating without directing. So like Esteban said earlier, what is the goal, right? In a lot of these things, we are not, for example, when a person wants to do marketing, the business owner says, "Okay, we need marketing." And they get usually someone who's good with social media in the staff, and they just hand it over. "So do the marketing," right?

But if it's not tied back to a metric that drives revenue, then that is just vanity at the end of the day, right? So they need to really tie back into metrics that tie with revenue when it comes to giving out these tasks to someone else. And then another mistake that we see commonly made is with regards to How not taking it so seriously to understand that currently, digital marketing is not just about promotion. It's also about education. And as Esteban also mentioned previously, we are getting into the whole AI, AI this, AI that, even in marketing. It's whole flip industry at this point with AI. But at the same time, that allows the doctor, the veterinarian, and the vet techs more time to deal with the patients and give that human touch.

But that needs to be communicated well and much more better into their digital presence. So what I'm talking about is a well-established digital integration. Your clinic might be the best. But in a competitive landscape, like perhaps in South America, they need to differentiate, and that is with that human experience, that customer experience part. That experience part has to start all the way from their website, their social media profiles, perhaps even nowadays, we are checking things out on AI. Whether you're using Gemini, ChatGPT, whatever your agent is, we're checking them out and seeing what comes up. So, just getting that knowhow into how to really translate all that experience, all that knowledge, all that emotion that is behind the person, that is behind the clinic, into a digital platform.

How to get that integration done needs to be taken much more seriously. Because otherwise, people are just losing out before even they get the chance to prove themselves. So those are some mistakes that I'm seeing with regards to the veterinary industry, making mistakes on the digital platform. That is very true. As you mentioned, people are going to be so judgy with what you show out there. With your website, your social media presence, and all of that. So as you mentioned, I like those two key points. You need to delegate your team with more direction. That reminds me of one of the short clips that Esteban shared on team doesn't need more rules, they need more direction.

Something that you shared on your LinkedIn. And the other thing is you need to focus on education, educating people rather than marketing what you do. Then people will gradually get to know what you are expert in. All right, Adhishit. The next question for you is, many practice owners are short on time and resources. Yeah. They can often ask where to focus their energy first. If you had to narrow it down to just two or three digital strategies that consistently bring in the most new clients, which ones would you recommend, and why are those so impactful? You just need two or three digital strategies that consistently bring in the most new clients.

How would you- Right. So, of course, this is a high key point in the veterinary industry when compared to the other industry that we're working with, like especially healthcare professionals. There is a huge shortage of staff. That is, everyone knows this. There's a huge burnout rate as well. So it's really important for veterinary business owners to really make the best use of the resources they have. And time is their utmost important resource. So with regards to that and the ease of accessibility to these tactics, which I'm about to say, I would say number one, really first, you have to shift your mindset. from thinking marketing as like a microphone to more of a magnet.

Because as Esteban previously said, he has said such great points in the short time he has spoken because I keep referring back. But definitely, you need to understand what kind of practice you are. Are you a big practice? Are you a very boutique, small, catering to a certain type of treatment specialist? So you have to take those into consideration, and then consider also the fact, who are going to be my ideal clients? Because that's important. It's not just about quantity, it's also very much about the quality, especially with regards to the time management part. So in that case, thinking of your marketing tool as a magnet, two things that are really important. One is your reputation, your online reputation.

Of course, everyone knows that reputation precedes your presence. But online reputation these days with everyone being so socially proof driven is key. So we're just talking about Google reviews. I'm sure everyone here already does it, is aware of it, how important Google reviews are. But we underestimate it. We see it happening over and over again. We underestimate it because perhaps you're so overwhelmed with dealing with the pets that need the treatment immediately. We don't really have time to think about, "Oh, I should have asked them for a Google review." If they had a great experience, I should have asked them to, "If you don't mind, just drop a five-star review," or just, "Rate your experience." That's it. That's all you need to ask.

But you don't even have that moment to lose to even ask that kind of thing. So Streamlining by maybe having a QR code or just in the whole process, this whole digital process where you get the first call, right? And they book the appointment, they come in there, and then even afterwards, like the aftercare, how are you going to do it with the calls and follow-ups? During that time, you can perhaps have your front desk person to ask, "Oh, if you had a good experience, we would really appreciate it if you could just review us on Google." That's it. That's one. So that will build your reputation online. That's great, fantastic. And the other thing is, well, your expertise, right? Not everyone can be everyone. I mean, you can, but then again, you will be looking at what you are, right?

So some practices might be focusing on a specific type of treatment, whereas some other practices might be interested in showing their boarding facilities, right? So you really have to decide in a way, right, which one is more important to you at this given moment. Are you searching for really high-quality clients who are in need of dental treatment, or are you searching for that best vet tech in town? Depending on these answers, you have to build the content up, right, on your digital platforms, your website, your social media. And when you do these things, what you're going to build is almost like a trust flywheel per se, right? So you have, on one hand, your expertise and on the other hand, your reputation. These two things work together to build that magnet to attract the people that you want, whether it be your new hires, right, or your really ideal patient.

So those are the two things or two areas, well, three, one being the mindset, that I would think for veterinarians to really take into consideration. This is amazing. I assume the audience is taking notes and learning from our expertise. All right. The third question for you is, this is the most important question because once a practice is investing in digital marketing, the next big question is how to know if it's truly working, right? From your perspective, what are the key signs or metrics that show a strategy is effective, and what's the very first step you would suggest to any practice looking to strengthen its online presence and measure real results?

How do we know that? Okay. This is a fantastic question, and a question that is always asked a bit too late, when the lines are in red. So let's ask before we get to red, let's ask from the planning day itself, what are we going to look at, right? What are the KPIs we're going to measure in terms of our marketing? And then just two things. One, leading and lagging metrics. So lagging means basically your revenue, like what happened at the end of the month, the profits generated, the new patients that came in. And then the other one, leading, is basically how you're predicting these results, right? What are you going to do to get those new patients?

What are you going to do to generate that new revenue? So, one of the most simplest things is to ask: how did you hear about us? How did you hear about us? That's it. Okay. Why I'm saying this is because this will help you differentiate and figure out where you are at with your digital marketing performance, right? If it's a drive-by, then we're still 20 years ago is the same thing. They had an emergency, they wanted to get to the nearest veterinary, and they were just driving by and they saw, and they walked in and they seek treatment. Or did they use Google to figure out, did they search at 10:00 PM, for example, they searched, "What should I do if my dog ate a grape?"

Right? And we all know how devastating that is and how much of a panic that can cause in a person, right? 10:00 PM, how are you going to get to the nearest veterinary clinic, right? So first thing, they're going to search up for that, and then what if your content that addresses this situation in your area pops up and you give the step-by-step, the first aid, the emergency treatments that you can do perhaps at home to a limited degree, and what are the next steps that you need to do, right? So when you have that kind of content already available for a person, they will see it and they will find you. This way, you can really figure out where they're coming from and also figure out how that article, perhaps, okay, let's say an article that is about how to care for your elderly pet dog. Okay, how is that article converting into the month and treatments that came through for more senior dog care, like the five new treatments that came in.

How are you going to connect those two things together, right? This is why it's important to figure out a single source Of information for each. Because when you do this tracking through the use of unique UTMs, you can figure out, okay, they came through this article. They then made this phone call, which, of course, phone call tracking is a whole another subject and is absolutely vital if you want to figure out where you're at, how you're missing leads, or even the quality, as Esteban said, the experience you're giving, that human experience over the phone. Perhaps that's the first-time person who's going to get that over-the-phone call experience. So how are you doing?

So that's a very key vital part, tracking your phone calls. To the phone call, booking the appointment, coming to the clinic, receiving the treatment, and then the aftercare. All of these points can be tracked and should be tracked, because if you're not tracking, you can't improve on it. So it's absolutely imperative that you track these things. And, yeah. So with all that said, what is the first thing that you can do, really? Perhaps you can just open up Google on an incognito window and just type in, "nearest vet around me." And then see who comes up to the top. Is it your clinic? Is it your competitors? So figure that out, first step, and even try other search engines, Bing, or even the next step. Nowadays, we are on AI.

So check that out as well. See how you're faring in that regards, because with AI overviews, some of these rankings might not be even considered because that's a whole another topic, and one we are currently really actively staying on top of as well. So just see where you're at to get an idea and an understanding of how you are doing, your digital presence and digital marketing, and from there on- All right, Alisha. I think we have a surprise for the audience as well. Would you like to mention that as well? Okay. So yes, once you do have gotten your understanding of where you're at, perhaps you can book a complimentary marketing strategy meeting with us at ECWAH.

So this is on behalf of ECWAH to all the audience members here. It's completely complimentary, and it's going to be this one-on-one session with one of our experts who will do a background research before the meeting on where you're at digitally. So one of those ways was, as I mentioned, just typing in Google through an incognito window, and there are many other ways. Google Lighthouse, just to test your website score, checking your social media, how you're doing, and also looking at the bigger picture of how many veterinarians are there in your region. How much website traffic they're getting, and the more nuanced marketing figures. So our expert does all this background check, and then we'll have a nice chat with you for 30 to 40 minutes, seeing where you're at, and provide you with a roadmap as to where you can go. So please, if you can, this is real valuable time invested into your marketing efforts, and it's completely free, too.

So- Yes ... I encourage you all to book the session. All right. Thank you so much for that. Alisha, thanks for your expertise, sharing your expertise. All right, yes. Grab the opportunity. It's completely free. All right. I would like to turn to you, Natalie. Hi. Natalie, you bring a rare perspective having worked hands-on in the clinic, as well as in leadership and operations. So from that vantage point, how do you see team culture shaping the long-term sustainability of an independent veterinary practice? What aspects of culture most directly determine whether a clinic thrives or struggles over time? We'd like to hear from you. Yeah, absolutely. So, independent practices definitely have a unique advantage to more closely invest and develop in their culture in other ways that maybe a larger or a corporate-owned clinic might not be able to.

And they can do that in multiple ways, such as what you mentioned in terms of my position. So really starting with closing the gap between the team and leadership, and then ultimately that leadership pipeline. So ultimately, my goal with my transition from being in clinic as a vet assistant for about five years, and then, as you said at the beginning of the meeting, going to UNR, getting my business degree, moving into this role. That was definitely an area that I saw was struggling in a lot of clinics, of course, is that culture aspect. So again, it's about bridging that gap between the leadership and the team that we see that unfortunately happens in some of these larger clinics.

So as a team member, I can even speak for myself, a lot of something that I deem as respectful and is very important is when you can see a leader in your clinic that truly understands not only what you're doing as a support staff member, but also just the ins and outs of all the positions in the clinic. It makes it so that you can also make the best decisions to balance the needs of the staff, but also balance the needs, of course, operationally for the clinic. So developing the culture Excuse me, with a foundation of truly what I would say is very important is just making a huge difference for the team in the long run is that culture. So, additionally, independent practices have a special niche where we can more closely encourage and engage these team members in leadership and mentorship as well.

So, with an independent practice, you have the ability to invest in their growth in this aspect over time so that eventually you can almost have kind of leaders throughout the entire hospital as opposed to in a larger clinic that might be struggling to find and fill these different leadership gaps that you might have throughout the hospital. Secondly, I would say, of course, that's going to be very hand-in-hand culture with the staff retention and growth, which I know that a lot of clinics struggle with. So, in reality, as an independent clinic, it is going to be difficult for us to compete with some of these larger corporate-owned hospitals that have that ability to offer good salaries, big benefits, things like that. As we grow as independent practices, maybe we can grow that aspect of our clinics over time.

But certainly as a startup independent practice, I can speak for us, you kind of start somewhere and add as you go, for sure. So, that's definitely going to be something that is a huge contributor. But again, what is so important about that culture aspect of that, we can differentiate ourselves from the corporate-owned practice. So, building a community within the team with shared goals and values truly makes a huge difference within the staff. And it'll be a couple of things I have down here below. But unfortunately, culture is a huge contributor to turnover. So, this is an area where independent practices, again, can definitely invest in this area.

And then, of course, that's going to be patient and client experience. So, truly a team that feels supported, feels heard, and communicates well, that in turn trickles down to the clients that we see, the patients that we see. So, how a team member feels about their hospital, about their work environment definitely reflects in their attitude towards the community. So, investing in your culture isn't even just an investment in the culture itself, it's an investment, of course, in how the community views your hospital, and your customer service, of course. And then, of course, reputation within the community. So, although, again, we might not have a large advertising budget that maybe a large clinic could have, something that we've found that works really well for us is centering our advertising. Yes, we do Google and stuff like that, social media, et cetera. But something that we've found that has worked really well for us is centering a lot of our advertising around what we deem as our four pillars of Peak, and I will go over that here a little bit later.

So, it's really about encouraging that involvement from the team, asking them what's important to them. So, and one of the ways that we've done that for advertising for the hospital is we've asked the team, "What causes, what things are important to you?" So, as a result, we've sponsored some Little League teams, 4H, FFA. Some of these places that you don't necessarily have to post on your social media like, "Hey, guess who we're sponsoring?" Or things like that. It's just little ways to, number one, give back to the community so that it makes that, and communicates that feeling of this is truly a community hospital where we're here to support our clients and our patients. But then inadvertently, we're also supporting and sponsoring some of our Little League teams of our staff members and their kids.

So, just showing that support for their family is another way that we've definitely gone about it, for sure, to invest in that culture. So, and that's how we've used a way of advertising to develop a reputation in the community, and then in turn, of course, like I said, show support for the team as well. So, yeah. That's amazing. We all talk about, I think, with technology and with AI and everything, how do we keep that human touch with the clients? As you mentioned, strengthening the relationship with clients. But I loved when you talk about how to strengthen the relationship within your team, right? So you need to eliminate that gap between leadership and team and have a culture with the shared goals and values. And also not only leadership, but with mentorship as well. So, I loved it.

All right, Natalie, your next question is, you often speak about the importance of empowering veterinary teams, as I mentioned, so they feel supported and valued. So, from your experience, what does true team empowerment really looks like day to day? Right. How can practice leaders build that environment while avoiding common pitfalls like burnout and high turnover? Absolutely. And I have a couple things jotted down here to address that, but I want to start off by saying that every clinic is always going to go through ebbs and flows. There is going to be busy seasons, as we all can agree and understand on, but there's going to be busier seasons.

So, it's really just about creating that baseline for your staff of what I'm about to kind of talk about, that's investing into that culture that will in turn prevent some of that burnout and turnover that we see. So, number one, I think one of the most important aspects is, exactly like you said, was just that shared purpose. So, we've been really lucky with the team that we've had here at Peak, but it's definitely about finding the right people that exemplify the core values of the hospital. So, one of the things that we did that is a nod back to the pillars that we've deduced for Peak Pet, was we sent out a survey to the team and asked them, "What are three words that you think represent Peak Pet?" So, we kind of got their answers, compiled them all, and came together with the four pillars of Peak Pet, and then that is what we built our mission statement off of.

Because we really wanted the team to be a part of what our mission was. So again, it's that shared purpose. And it's going to be that North Star that you oftentimes, when you have those busier seasons, when you maybe are feeling some of that burnout from the team, it's very busy, to again, point us back to that North Star and bring us back down to zero and talk about our why. Why are we here? Why are we doing this at the end of the day? So, for example, one of the pillars at Pete Pet-- a lot of Ps in there-- is education. So, that means that every staff meeting, for example, we incorporate some type of education in all of our staff meetings for at least 30 minutes or so.

And that could be a game, a slideshow. Our doctors do little presentations. We did educational Jeopardy with our doctors, and they hosted it, and it was really fun. But, I also use these four pillars in our biannual review. So, I do reviews with our staff every six months. So they're consistently getting that feedback. So, in that instance, say, for education. So, if I'm consistently seeing a team member that I'm feeling I'm having to push really hard to get their CE credits, or is just generally not showing an interest in wanting to grow their skills, they're just kind of happy being where they are. Ultimately, I know that team member doesn't align with the goals that we have as a hospital and as a team. And eventually, those team members do weed themselves out. So having an entire team on the same page with what we want to accomplish as a clinic is truly step number one. And a clinic that doesn't have a strong mission, and quite frankly, doesn't talk about it often, because I know a lot of times, hospitals might have a mission statement, but we don't talk about it a lot.

So again, we just don't have that North Star as a clinic. So, my best recommendation in terms of that is talk about your mission statement a lot. Talk about what grounds you guys as a clinic every single staff meeting so that we can keep that constantly in our minds. Because ultimately, a team that doesn't talk about their mission, doesn't have those shared and common goals, you lose them over time. The next part of that is going to be definitely your team having a voice. For sure. I know that we all want our teams to always feel heard, but it doesn't always just come from a place of just hearing what they say. Of course, as managers, we have to walk that line between meeting the needs of the staff and then, of course, the needs of the clinic as a whole.

But what's really crucial about that is implementing a process for the team to give ideas, their thoughts and their opinions. And taking their suggestions so that we, as the leadership team, the owners of the hospitals, the owning DVMs, can make the best educated decisions we can for the entire hospital. So then it means more when that staff member is like, "Oh, I made that suggestion for that workflow," and it was ultimately implemented. And so they feel more a part of that decision-making in the hospital. And then two, also on top of that as well, something that I find very admirable in a lot of leaders that I've seen is when they get asked a question, they instantly shoot back, "Well, what do you think?" to that staff member.

"What are your thoughts on this?" And it's always key to be curious and ask them what their thoughts are. Truly collaborate, not dominate those decisions, and include the team in those decision-making processes. Next is definitely going to be recognition, too. I do know from experience that one of the biggest killers of someone's drive in a clinic could be just simply not being thanked. Appreciating the staff is truly a key element to preventing that burnout turnover and can be done in so many different ways. So, for example, something that I do for our onboarding process is that I will actually have them fill out a page where they select what their languages of appreciation are.

So I have them pick an area where they feel represents them the most, and that's going to be words of affirmation, gifts, quality time, acts of service. And surprisingly, most of our team prefers quality time. So, something that we do for our team is about every quarter or twice a year or something like that, we'll shut down the clinic early and do a little team event where we all get to spend time together. On the other hand, of course, if a team member says that words of affirmation is their way that they feel appreciated, I know and I keep that in my mind that I'm always going to, when I see them going that extra mile, I'm going to pull them aside privately and look them in the eye and say, "Thank you so much. I see how hard you're working." And that definitely makes a difference, I think, over time with the team.

And then lastly, of course, is the leadership aspect. Another important thing to note on this is preventing burnout of the leadership team. So that's our managers, our lead technicians, lead assistants, things like that. But sometimes managers oftentimes get kind of left out of this conversation. But a large part of, of course, being a manager is wearing so many hats within the hospital, doing your best to lead the team while sometimes being kind of the loneliest area in the hospital. So, I'm in no way an expert in this area. I'm still growing in this area myself. But some of my recommendations of this are going to be proper balance of that workload. So, for example, if I have a marketing event over the weekend, kind of balancing that by taking one of your work days off during the week.

Modeling vulnerability and boundaries with your team. Just being real with them. So, as managers, sometimes we're never expected to have a bad day. But what I found is communicating with the team when I'm not necessarily having the best day, they understand and support me, and I, of course, do the same thing for them. That also means Of course, setting boundaries for yourself when you're outside of the clinic. Same thing goes for the staff. Definitely, another one is going to be consistent, not reactive. So this means being consistent with your protocols, your expectations for the team, and having steady communication so that it reduces the confusion and miscommunications that sometimes happen in the clinic.

And then lastly, I would say is addressing conflict early. Of course, something that I know can eat away at a lot of managers and practice owners is just knowing that there's an issue that you need to deal with. So my advice here is always to do your homework, do your due diligence, but confront issues promptly. And then this also shows, of course, to your team that their concerns are genuinely being addressed promptly and not getting pushed down the line. And I say all that too just because leadership and the owners of the hospital are truly a huge aspect of that burnout turnover rate, so it's important to kind of mention those people as well.

All right. Amazing. Thank you so much, Natalie. Yeah. You should have a shared purpose, educate your team, connect with your team, brainstorm with your team. So there are a lot of things that you can take into practice from tomorrow onwards from what Natalie said. All right. I will get back to you if the time permits, but for now, I would like to turn to you, Erin. Erin, you took your own practice from a small team to thriving 40-person hospital and ultimately transitioned it successfully to corporate ownership. So looking back, what were the defining decisions or mindset shifts that made that kind of sustainable growth possible, both for the business and for you as a leader?

Would like to hear from you. Yes. Thank you. So the defining decisions are based around are you ready for growth? As Esteban had mentioned, what size business do you want? Are you ready to expand and grow, and what exactly do you need? So in my hospital, we were bursting at the seams. Our community was asking for larger capacity to serve. We were limited for the amount of new clients that we could accommodate in our appointment schedule. So we had to start thinking outside the box. How can we develop strategies and actionable items with our team in order to pursue a future growth of the hospital? So we sat down, we looked at our mission, we looked at our vision and core values with our entire team, and ultimately, the outcome was, well, we wanted a larger facility where we weren't on top of each other, better visibility, better client parking. We needed more exam room space, dedicated suites such as a dental suite, an OR, and ultrasound and radiology. We wanted to expand our services. We were looking for the capability of hiring a doctor that could come and do house calls for us.

Telemedicine was a priority. We wanted to have specialists come in and do orthopedic surgeries. We were interested in providing echocardiograms. So we wanted to take our hospital from being a smaller private practice to still a private practice that was privately owned, but also to incorporate some specialty in there as well. So we had to start thinking outside the box and develop a strategic plan of how are we going to get there. And the one important thing that I keep hearing throughout this discussion is focusing on a client-centered practice. What do your clients want? And so that was really important. We needed to also be looking at financial growth targets. Well, how are we going to get there?

How's our team going to support us in that way? Assessing staff needs. Well, how many doctors do we need to have six exam rooms, and how many support staff do we need for every doctor? And then start developing a marketing plan, revamping our website and our social media presence so that our clients could actually see the reason behind why we were growing, because change is challenging for not only your team, but also your clientele. And the interesting thing was, as soon as we were moved into our new facility, the pandemic hit, and I was so thankful that we had the capacity to serve our community. We had much other smaller veterinary hospitals around us that were really struggling, and so it became a huge opportunity for us to turn the corner and open a much larger facility.

That's amazing. You need to know what you really want to do, and you need to have a proper plan with what you want to do. Right. All right. The next question is, when you are called in to help a struggling veterinary practice today, you bring decades of leadership and operational insights. So what's the first thing you look for that immediately tells you whether the team is truly aligned or misaligned with the owner's vision and goals? So that would be through direct observations of behavior. How well are they communicating with each other? Is everyone sharing their ideas collectively? Are you providing feedback in a timely manner, whether it be constructive or positive feedback?

That's just so important to your team. You need to be discussing concerns on a regular basis. That means departmental meetings, full staff meetings. Doctors need to have regular rounds. What does your patient care look like? Does the team actually really genuinely care about their purpose and what they're doing in this veterinary medicine role? And how are your clients being treated? That goes back to the client-centered practice. They want to have a warm, inviting, comfortable exposure to your hospital, because then that helps them feel comfortable that when you're admitting their pet for the day, they're going to have a similar experience, even though they're not actually present.

So I would strive within a setting like that to create a collaborative culture where we're sharing our knowledge with each other. And it's important, as others have mentioned, that when you're hiring your team, you start looking for personality and also values that match what the business is looking for, because that's going to help your organization just continue to thrive and grow, and obviously with employee retention, that's huge as well. So, everyone's heard the terminology of "teamwork makes the dream work," so that's essential. That's very true. I think it reminds us how important it is, our behavior, our personality, because everything depends on how you communicate, how you treat your staff, how you treat your clients.

So that's very important. And finally, Erin, you have distilled years of experience in leadership, operations, and strategy into actionable advice for independent owners. So if you had to share just one guiding principle for those who want to achieve both profitability and long-term sustainability, what would that single piece of wisdom be? We've already mentioned it today. That's empower and invest in your team. Your highest performing workforce is going to be those that you invest in. So that's the biggest takeaway that I would give to everyone is make sure that you're providing continuing education. If people want to take university-level courses to improve themselves within your hospital, make sure that's a priority.

All right. Amazing. I think what a session this has been. Let me share my screen. All right. There you go. All right. A huge thank to our phenomenal panelists. Thank you so much, Esteban Sotomayor, Adisha Pemanand, Natalie Mull, and Erin Preston. You have shared so generously, blending best practices with passion and authenticity. And finally, to all of you who tuned in, thank you so much. You are the reason we do this. Without you, there's no learning, no growth, no community. So stay connected and keep the conversation live. And remember, leadership is not about surviving. It's about creating a future worth leading into. So I would like to remind you about this.

I would like to remind you of the complimentary gift that you are getting from our main sponsor, courtesy of Equa Marketing. Remember, this is not just a chat, it's hours of research, tailored insights, and a roadmap designed specifically for your practice. So scan the QR code, grab your spot. It's an opportunity you'll be glad to say yes to. So thank you so much. Thanks again, Esteban, Natalie, Erin, and Adisha. Thanks a lot for joining with us. Thank you for sharing your expertise, sharing your wisdom. And I'm Shahara Bandar, and it's been an honor to host today's session with all of you, and we'll see you at the next Veterinary Business Institute event. Until then, take care and good night.