An Interview with a Veterinary Leader From Down Under (Part 2)

by Guest Blogger on September 14, 2014

dave nicholDr Dave Nicol is a Scottish born veterinarian who lives in Sydney, Australia. There he is the sole owner of a two hospital practice that has more than doubled in revenue since he took over in September 2011. Before moving to Australia he was head vet and group business development director with Parkvets Ltd (UK) and has worked as a consultant to some of the United Kingdom’s largest veterinary practices.

Dr Dave is an internet marketing expert, publishing his first book in 2011 called The Yellow Pages Area Dead – marketing your practice in the digital the result of ten years of researching and experimenting with what works for vets when using the Internet to market our services.

In addition to his in practice work, Dr Dave is the co-founder of Recruit Right for Vets, an online recruitment service that saves vets time and money when finding the right people for their practices. And if all of that wasn’t enough then he writes business articles for Vet Team Brief, DVM360, Vet Economics and The Veterinary Business Journal.

If you all interested in building a successful veterinary businesses then you can follow Dr Dave on Twitter at www.twitter.com/drdavenicol or read his management blog at www.davenicol.com/blog.

Rebecca: What is one piece of advice you would give to a practice owner?

Dave: Get off your hamster wheel.

Rebecca: [laughs] Amen.

Dave: What else am I going to say there? That’s the whole thing for the hamster wheel.  Do yourself a favor and learn how to hire good people. Learn how to attract the right customers, not just every customer. And when you have good people in your business and you give them opportunities, your life transforms. When you get really good people in, life is just pretty sweet.

Suddenly it’s like you’ve got a time machine. I’m just a crazy Dr. Who fan. Dr. Who is a character from British TV. He has a Tardis, a time machine, he can zoom around in.  It’s like you’ve got a Tardis. Suddenly you have time, because suddenly it’s like “I went into work on Tuesday, and I didn’t do anything clinical.  I sat around and I wrote some stuff and I thought about some stuff, and I made some decisions. And I looked at the takings at the end of the day, I was like, How did we do that?  I didn’t do anything. That was amazing!”.

You know, I actually felt a little guilty. God’s own truth. I thought if I could do that every day and not be here, how many more customers could I have? How many more hours could I spend training these guys to be better at what they do?  It’s like this exponential curve of awesome that you can get if you get those good people. So, get off the hamster wheel, and stop doing everything yourself. Start delegating stuff out to your team, but get good people.

Rebecca: No kidding.  I finally got to that point in my business, and I’m a different person than I was two years ago. With the right team, it’s amazing.  I was so stressed out all the time, not realizing how bad things were.

Dave: Yeah. Sometimes you don’t know exactly how bad things are until you take a big, bold step and change something. Then you think, “Why did I not do that x number of years ago?”.  If it’s six months ago, that’s not too sad.  But if it’s 20 years ago, that’s pretty sad to hear stuff like that. We don’t have time to waste.

Rebecca: What about advice for associates?

Dave: Get over yourself if you think you’re not selling stuff.

Rebecca: Oh, thank goodness for saying that. Everything we do every day is selling. I sell TPLOs.  Do I believe in them?  Yes.  But am I selling them?  Yes.  And that’s fine, because I believe in them. It drives me crazy, vets are like, “I don’t want to be a salesperson.”  We’re all salespeople.

Dave: Yeah. We are. And if you have to do it through the lens of “I solve problems,” then that’s fair enough.  Do it.  But you can’t solve problems unless people follow your action, and we call that selling.  As long as you’re selling the right thing, for the right reason, there should be no problem. It’s got to fit your values, and that’s where a lot of people go wrong because they end up in a practice that doesn’t fit their values.

So if you’re not comfortable following a procedure or schematic template way to do something, then don’t go work at Banfield. You’ve got a real conflict in your values. I’m not saying it’s the right or wrong way to do it, but find a place where you are comfortable in your skin and they’re comfortable with you and your skin.  It’s got to work both ways. If those values connect, there’s really no conflict there. That took me a long time to work out. Sometimes I was getting stressed in the clinic, and I’d say the times I get stressed are when there’s a conflict of values.

Rebecca: Absolutely. I was talking to a veterinary associate in a practice today and he was asking about hiring. He asked me “Where do I start?”. I said, “You better have your hospital’s values straight because you will never find people who you want if you don’t even know what your hospital values are or what your purpose is behind what you do.”

I said, “Don’t even think about hiring. Take a step back and see who you guys are and what you’re all about. Otherwise, you’ll never find the right people unless you just stumble upon them.”

Dave: Exactly. I’m doing a recruitment boot camp for CVC this year. I’ve probably talked about recruitment more than anything else because it’s such a big deal. I try something out in my own business. If it works, then I go talk about it. I also build products that help others replicate what I’ve done in my business.

So the Recruit Right for Vets side of my business gives people that process to follow with the recruitment, just like your friend who was starting out.  “How do I go here?”  So you’re dead right. The values are just left, right, and center of everything you’re doing in recruitment and, indeed, in your business.

We recorded this fun webinar called The Top Five Mistakes Most Vets Make and How to Avoid Them” that your readers should check out.They can get that right from recruitrightforvets.com.  There’s a webinar right there that people can listen to, and it’s free. If they just listen to that, I bet you there’ll be a ton of people have light bulbs going off above their head and going, “Huh.” It has made a huge difference in my business.

Rebecca: We will definitely have links for that.

I’ve been thinking about the role of medical insurance for pets.  It has not really taken off yet in the United States, but I know it has been in Australia and Europe for a long time. What is your experience with medical insurance for pets?

Dave: I don’t know if we’ve had it for longer, but we just did more with it. I always find that the weirdest situation. In the UK, we have the National Health Service, so health care is free at the point of delivery.  You’re taxed for it, of course, so it’s not really free, but the US is all about private health insurance.  As a concept, we always felt hamstrung in veterinary practice, because our clients never saw their own health bills.

And so, it was always harder to convince them there was value in our bills.  And it always felt like we were pushing up against a wall, and maybe that provided us with motivation to do something a bit more proactive with health insurance.  Well, after 20-odd years of selling insurance, we’ve gotten the market penetration somewhere to maybe 20 to 30%, depending on what studies you would believe.  But high 20s was where the UK pet insurance market penetration got.

Honestly, we didn’t feel like we were doing a good job; after 20 years, that’s all we penetrated.  And then the global financial crisis hit, and everyone’s like, “Actually, 30% was really pretty good.”  It transformed a lot of the UK, because a lot of specialty practices were built on the back of that pet insurance.  They were able to really push forward in terms of technological advancement.

I was always amazed that in the US, where you guys are comfortable with insurance as a product for yourselves, very few pets have medical insurance.  Insurance in Australia is starting to get a little bit more of a toehold because people are waking up to the benefits of it. I have a hard time believing that the insurance level isn’t better in the US.

All I can say is, it’s such an enormous opportunity, not just for practices but for pet owners as well. It helps maintain their cash flow, and it’s amazing that more people haven’t taken that up. Maybe you need less resistance from customers actually wanting to pay their bills, so maybe there was less motivation to sell at the first instance.

But pet-insured clients, they come in more often. They spend more with your clinic. They say yes to everything you want to do, whether it’s the TPLO or the ear flush, whereas you might have a client who just goes for some eardrops.  Now they’re going to come in and have the sedation and the cytology. You can do your job the way you were trained. There’s nothing better than knowing that you’ve got an insured client.

Now, I’m not saying that that suddenly changes your treatment plans. They’re always the same, but just when people say yes, that’s a good feeling. You have your core – like the 80/20 thing, right?  You know, 80% of your revenue’s coming from 20% of your clients.  Well, if those 20% of clients are insured clients, they’re going to spend more. There’s just no question it’s a good business decision.  And for those clients who have bigger bills, they love insurance.

If I were opening a clinic in US, insurance would be right in the heart of what we’d do. I would be on pet medical insurance company’s doorstep going, “Guys, come in and tell me how we can work together and do this, and build both of our businesses together.” I think that would be a smart play for US practitioners to be making.  Heck, we were kind of getting a bit doom and gloom earlier. If you’re looking for something that is a bright light in a dark sky, pet medical insurance is there.

And we’ve shown in UK how far penetration can go, ten times further than it is in the US at the minute. It just needs a joined-up approach in the clinic. I know that my clinic here in Australia, our pet insurance level is climbing way faster than the national average, and we have got a lot of insured clients now. It makes a big difference to the work we’re able to do, and our growth is phenomenal.  I’ve opened a second hospital, and having insurance there has been part of that growth. I would strongly encourage people to go for it. I think it’s a very smart idea.

Rebecca: That’s great. Yeah, I really do. I think it’s the way to go in the future, for sure. Many moons ago, I used to be an equine surgeon. It completely took the stress off the management of cases, because it took money out of the equation, and we treated them the way they needed to be treated. We didn’t have to worry about, “Oh, can I afford to run this CBC, or do I wait three more days?”

As a clinician, it’s hard to articulate to people how freeing it is to be able to actually treat the patient absolutely the way it needs to be treated without having to make every decision based on finances.

Dave: Completely agree. There’s one other thing I would say though. The insurance is a finely balanced equation, and there definitely needs to be a coherent relationship, a symbiosis between insurer and practice and pet owner.

Rebecca: Absolutely! We certainly do not want to go down the path of doing needless tests just to make a buck!

Dave: There is over-servicing potential there. It doesn’t have to be like that. It is a carefully balanced thing. Everybody needs to realize that. It needs to be fair for everybody. And so, insurance shouldn’t be seen as just the goose that laid the golden egg that’s just going to get run dry. It needs a coherent. You know, all your puppies and kittens coming in at the base of the pyramid in order to support the top.

And then, having a fair fee schedule that works for you but and the insurer.  I’m always surprised. I am very open to talk to insurers and say, “Let’s talk about fee schedules here that we work to.”  Maybe my clients are going to get an insurance policy that is affordable for them over life, affordable for you as the company, and affordable for us as a business to make the profits that we need and we’re comfortable making. I think that would be a really interesting conversation for the three groups of people to actually have.

If I have one comment about the insurance industry, I think probably that conversation hasn’t happened enough in the past. Certainly in the UK, insurance has probably gone through a bumpy time because there’s a lot of claiming and not necessarily a whole lot more selling going on when you hit saturation. And so, the equation needs to be thought through very carefully.  Otherwise, you wind up with insurance hikes of like 50, 60% renewal for animals that haven’t been making claims. It can get ugly.

I would certainly advocate and encourage conversations among veterinary leadership, insurers, and pet owners to make sure that balance is right for everybody.

Rebecca: That’s a good point, for sure. What do you think veterinary medicine’s going to be like in about ten years?

Dave: I would like to say it’s probably different. However, the world around us changes a lot, and we are really good at ignoring that and trying really hard not to share.  It’s impossible not to think that corporatization is going to be one of the biggest drivers and shapers of our profession. The work-life balance thing is going to continue to be something us vets wish more of. Unfortunately, there will be pressure upon a lot more vets now to actually make their repayments on the debt they’ve accrued.

That’s going to shape the profession in fairly profound ways. That hasn’t necessarily been thought through, and we’ve not seen just yet. I do think life’s going to get harder, not easier. There’ll be an ongoing requirement … it won’t be a luxury.  It won’t be something that, “Oh, yeah. You can get ahead in the market with good business skills.”  It’ll simply be a case of if you don’t have them, you’re going to be gone. I think ultimately, that’s probably be quite good news for the customer.

I think they’re going to be getting good deals as standards improve.  We’ve seen technology have a wonderful impact on the level of care we can give.  It’s the macroeconomic changes now that are going to really shape our profession in the future. Wherever there is the strengthened bond between pet owner and pet that exists in the US, in the UK, in Australia, there will always be an amazing opportunity for people who get it right. Those who get their ducks in a row and have well-run businesses with good people – they’ll thrive.

What’s happening now is a weeding out of the weak. Corporatization is preventing some practices from going bust by buying them for market share and running them more effectively. I’m not saying corporate is all bad, because I don’t believe they are.

Obviously, my blog has been written from the slant for people who don’t have the business experience, that’s necessarily the small independents. I think small independents are going to thrive as well, because they’re going to offer something different. The USP for corporate is going to be standardized services, slick, cost-efficient, and the USP for the independents is going to be customer service, customer service and customer love.

The corporates aren’t going to be able to live with that, because we vets are like herded cats and hate to be told what to do. There’s always going to be turnover there, whereas the little independents are never going to be able to compete on price. I think there’ll be an equilibrium that comes to the market.

The only thing where I would hate to be is right in the middle, because the middle always gets squished. We have to be great. One thing’s for sure – it will all change. It will get harder, not easier. However, there will be great opportunities for us.

Rebecca: Anything else you’d like to add?

Dave: It’s tempting to get stuck in the melancholy of change, and the doom and gloom of it. However, I really think this is a wonderful profession.  I’ve never thought, “This was a dumb call.  I wish I had never done this.”

Rebecca: Right, me neither.  I love what I do.

Dave: Even though I have a focus on business, that doesn’t mean it’s a focus on money.  The older I get, the more I realize: no money makes me really unhappy but having money doesn’t make me happy. Having great relationships with people around me; building something I feel is of value to the world and other people feel is a value to the world; and helping others around me make me very, very happy.

I think that’s part of the human condition, and there are a lot of people like me out there. Otherwise, we probably wouldn’t be in this profession.  My number one thing is to have fun and enjoy what you’re doing. If you don’t enjoy what you’re doing, please don’t do it. Find somebody else to do it. Do everyone a favor. [laughs]

Rebecca: [laughs] That’s awesome. Great stuff. I really appreciate you taking time out of your schedule. I know our readers will get a ton of value out of your insight.

 

 

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