This week on the podcast…
Leslie Mamalis, Senior Consultant at Summit Veterinary Advisors, joins Dr. Andy Roark to walk through how she advises veterinary clinic owners or leaders on how and when to consider closing on Saturdays.
ABOUT OUR GUEST:
Leslie is the Senior Consultant with Summit Veterinary Advisors, a nationally recognized business consulting firm. Leslie’s specialties include practice valuations, profitability assessments, feasibility analyses, and transition planning for veterinarians across the country.
Leslie has an MBA and an MS in Information Technology and became a Certified Valuation Analyst in 2013. She worked for the American Animal Hospital Association (AAHA) for seven years, beginning with management education seminars and then becoming involved with the accreditation program. She is a member of the National Association of Certified Valuators and Analysts, the Veterinary Hospital Managers Association, VetPartners, and the VetPartners Valuation Council.
Ms. Mamalis is an author and frequent speaker on practice value, profitability, and owner transition. She is an original columnist in Today’s Veterinary Business. Leslie has extensive experience helping veterinarians and managers understand financial reports so they can use that information to increase practice profitability and value.
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Episode Resources
Summit Veterinary Advisors – https://summitveterinaryadvisors.com/
Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/
Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/
Dr. Andy Roark Swag: drandyroark.com/shop
All Links: linktr.ee/DrAndyRoark
Episode Transcript
Dr. Andy Roark:
Welcome, everybody to the Uncharted Veterinary Podcast. I'm your host, Dr. Andy Roark. I actually, I made this podcast, guys, the one you're listening to right now with my friend, Leslie Mamalis, and I was going to put it out through my Cone of Shame Veterinary Podcast. It's a podcast I talk about what's going on in medicine and I tend to have guests on and do interviews, and I really liked this interview with Leslie a lot, and I was talking to Stephanie Goss about the case for and against Saturdays, and she said, “That's an Uncharted podcast, Andy.
These are the types of management decisions that we work on and weighing the pros and cons and looking into how to make decisions about when we're open and what we do with our hours, I think that's a great Uncharted episode,” and so she really, she twisted my arm and so I'm going to put this out as an Uncharted podcast. Guys, I hope that you'll love it. It's a little bit shorter than our regular Uncharted podcast, but I think it's a really, really good one. Leslie's amazing. She is a senior consultant at Summit Veterinary Advisors, and I give her more of an introduction when we get into the episode. Guys, let's get into this.
Speaker 2:
And now, the Uncharted Podcast.
Dr. Andy Roark:
Welcome to the podcast, Leslie Mamalis. How are you?
Leslie Mamalis:
I'm doing great, Andy. Thank you so much for having me.
Dr. Andy Roark:
It's my pleasure. So I was checking and confirming your title before you came on, and it is Queen of the Universe.
Leslie Mamalis:
It is, yes.
Dr. Andy Roark:
Okay, good. Boy, I got to tell you, the quality of guests I'm getting on this podcast just keeps going up. It's amazing.
Leslie Mamalis:
You're moving up in the world.
Dr. Andy Roark:
Really pulling them in. As a queen of the universe, Leslie Mamalis, you are also, when just have free time, you are senior consultant at Summit Veterinary Advisors.
Leslie Mamalis:
That's right. That's right. Summit just celebrated 25 years too so it's tradition.
Dr. Andy Roark:
You and I have known each other for a long time. We've been on the speaking circuit together doing practice management stuff and things like that. You write a column that I really enjoy in Today's Veterinary Business. I like to read your stuff on practice and practice management, and you had a column not long ago, that was The Case for and Against Saturdays, and I enjoyed it. I think that there's a lot of value in coming with a balance of saying, well, sometimes this makes sense and sometimes it doesn't.
I think a lot of people have really felt shoehorned into Saturdays. I think the pandemic was a really interesting shakeup time when people started to really question, wait a second, what are we doing and how much do we have to do and what do people really want, and so I wanted just to go through the exercise with you of evaluating the case for and against Saturdays if you're a small animal medical practice. Is that okay?
Leslie Mamalis:
Absolutely. Absolutely. And just as you're saying, there's been pretty significant social changes over the past few years that are making veterinarians reconsider Saturdays and office hours in general.
Dr. Andy Roark:
Well, talk to me about that. Let's just start at a high level. Why are we having this conversation? What are the social changes you're referring to?
Leslie Mamalis:
Well, for forever, veterinary practices were open six days a week or five full days, plus Saturday mornings at least, sometimes later, and that has been the expectation for eons because you needed to be available for clients who needed to come in on Saturdays because they were working. Well, with the pandemic, oh my gosh, things changed so much because for one thing, some practices weren't open at all for a period of time and then there had to be so much caution taken with segregating staff, making sure that the employees were safe and healthy so that you could continue to have the practice open, and Saturdays just were not feasible. It was so hard to staff Monday through Friday, and frankly, clients weren't going anywhere. There weren't going into the office frequently, kids weren't at school, there weren't after school activities.
Social life really got very quiet for a long time, and so veterinary practices who closed on Saturdays because of the pandemic now have come out of that and wondered, should we reopen, and honestly, during the pandemic, I think a lot of people got back to what really matters in their life and they enjoyed having a little slower pace, and Saturdays became family time or personal time and not time to run around doing errands or working, and the value that comes from having two consecutive days off is tremendous. If you have just one day off a week or you have one day off and not the following day, you're spending that day doing errands, doing chores. You're not getting any time to relax and refresh. By having two days in a row though, you can accomplish all of those must-dos and also have time for yourself and your family.
Dr. Andy Roark:
Do you see a labor shortage in veterinary medicine and do you think that contributes to the idea to either not do Saturdays or to continue, or to either drop Saturdays or to continue not doing Saturdays? So I don't want to make too many assumptions. When you're shorthanded, I feel like people look for reasons. One is how do we make it go with the staff that we have, but then I also, I can go from there into recruiting people and is that a perk that people like is not having to work on Saturdays, and so is that hooey? Is that made up, or do you think that's real?
Leslie Mamalis:
I think it's real. I think maybe we're taking it a little farther than reality truly suggests, but is there a labor shortage? I think there's a labor shortage in almost every industry right now, and it's not that there aren't enough people. It's that people don't want to work as much as they used to because they're not seeing the value. The money isn't as important for whatever reason, and that's true even now that so many of the government incentives and extended unemployment, et cetera, those benefits have ended, but we're not seeing a rush of people back to, especially some of the less skilled jobs.
And I'm not seeing that there are many unskilled jobs in veterinary medicine, but if you look at fast food or retail, something like that where you don't have to undergo a lot of training in order to do work, there's still not a rush to go back to those jobs. So I also believe that it can be a shortage of people who want to work for what you're paying, and that certainly has changed somewhat in veterinary medicine because practices have had to pay more to keep people, and honestly, high time. It's time that veterinary medicine wasn't the underpaid profession, especially for veterinary nurses, for receptionists, for veterinary assistance. People should be able to make… I'm sorry, I'm really going off on a tangent here.
Dr. Andy Roark:
No, no, go ahead. I love it.
Leslie Mamalis:
So people need to be able to work at a veterinary practice and support themselves and their families. So it was important and a very necessary change that wages have increased. They needed to, absolutely, because I'm tired of seeing good people leave the profession because they can make more money doing something else.
Dr. Andy Roark:
Sure. I think all that makes sense. Let's go with this a little bit and let's just say that I am the owner of a three doctor practice and I have increased wages for my staff, so I've got a bigger payroll than I've had before, you know what I mean? I'm able to retain people the way that I've wanted to, and the staff has brought me this idea that maybe we don't need to be open on Saturdays, and so maybe my kids are young and then I would like to have two consecutive days off as much as anybody.
Walk me through how you would advise me here. So Leslie, I brought you in and I say, “I'm looking at this. I don't really know where to start. It's a scary thing. I know that Saturday is my busiest day. I know that people show up. The idea of not being here is scary, and at the same time, I would really like to not be here and people are telling me, ‘oh, don't worry. The clients will come on other days,' and I don't know if that's true. I've got at least a couple of people who have told me they're not coming if I'm not open on Saturdays.” How do you walk me through a decision making process?
Leslie Mamalis:
Absolutely. Absolutely. So we need to start from where are you located because if you're in Denver like I am, it's a different decision than if you're in Lander, Wyoming where I grew up and it's about 10,000 people and there are two veterinary practices. So if closing on Saturday is not going to impact your clients or your community in a negative way such that it outweighs the benefit that your practice will get, then that's one decision, and I'll talk a little bit more about that. So if you're in a metropolitan area and there are emergency clinics that are open on weekends, open during the evening, it's less of an issue for you to close your practice on Saturdays.
So yes, there are absolutely clients who need to come in on Saturday, whether it's because they just prefer to come in on Saturday or they cannot get in because they cannot get time off work or they've got little kids at home, or there's some reason why they can't come in. So there are so many things that go into a decision related to closing on Saturdays. So certainly, there's the doctors and staff at your practice, there's your clients and what their needs are, and then there's the community needs, and we need to consider all of those together.
Speaker 4:
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She's a CVPM and if you've not met Maria before, you are in for a spicy treat. She is amazing and she is super excited to kick off the conversation, talking about team meetings with her take on making them effective and efficient. That's right. It's called Effective and Efficient Team Meetings. It's $99 to register, but it's free for our Uncharted members. Now, if you've never been to an Uncharted workshop before, this is not your traditional webinar where the presenter or the speaker sits there and talks at you for an hour. The goal for our community workshops is to make them live.
We don't want you to sit silently in front of your screen. We want you to be engaged and interacting for the one to two hours that you're meeting with our speakers to have the chance to ask your questions, to talk to your peers, and interact with other rockstar veterinary professionals because that's what you are, and we want to see you there. So head on over to unchartedvet.com/events to sign up for this workshop and check out what's coming because we've got a bunch of stuff coming up in the future that you don't want to miss, and now, back to the podcast.
Leslie Mamalis:
Saturdays so often are a pain in the butt to schedule, not for the clients, but for the staff. Doctors don't want to work Saturdays, staff don't want to work Saturdays, and too often, the Saturday shifts end up with people calling out for whatever reason, and so the people who are left working, they're overburdened, and after a while, that becomes to feel really unfair. The other thing is if for those clients who have Saturday appointments, if they're coming into a practice that's now understaffed, their experience is not going to be nearly as positive as it might be during the week, and Saturdays can absolutely become crazy.
Some Saturdays are nice and everything works really well, and staff show up, clients are on time, nobody has an issue, but those Saturdays are so few and far between. It's much more likely that Saturdays are going to be crazy. There's going to be a mob scene because you're going to have clients who have to come in today, can't possibly wait until Monday, refuse to go to the emergency clinic for whatever reason. Perhaps it's because it's really not an emergency. So often, the stress level in the practice goes up, the quality of client communication and client care goes down.
Patient care, I'm going to hope is always good. May not be absolutely what you wanted it to be, but it's always good care. It's the client that gets the raw end of that deal, either through needing to wait much longer than they expected for their appointment or they're not getting the attention they expected, they're not getting the full explanation maybe from the receptionist, et cetera. So that can be difficult. For staff, I never minded working Saturdays when I knew that I was going to go in and come out and at the time I expected, but I would work my shift and go home.
So often, that doesn't work though because you've got to stay late to finish appointments, deal with that emergency or transfer the case to the emergency clinic. You've got to clean like crazy and you're there for two or three hours later than you expected to be. Once in a while, that comes with the territory of working in veterinary medicine. Once in a while, that's not a big deal. Every time, that becomes a big deal and so you start getting dissatisfaction and disgruntlement with staff. People start resenting working on Saturdays and which makes it even harder to schedule them.
Dr. Andy Roark:
Okay, this is not the argument I thought you were going to make, which is interesting. I think all this makes sense and I have 100%, I was lamenting recently, I was working in the clinic on a Saturday and we were really busy and I had some people who went up to the front desk and they were like, “Is Dr. Roark always so rushed? We didn't feel like we got to ask him these questions,” and they had a pet with allergies and they had transferred from another vet, and it was just interesting in that I was doing my best to try to keep up with the flow of patients coming in and I didn't have time to sit down and do the whole allergy talk with them.
And so I tried to specifically answer their questions and then I was onto the next room, and it bothered me because I thought their critique was valid. I really did, and at the same time, I don't know what I would do differently because I had other sick patients and so I was really pinched, and it was one of those ones where I rolled around and I go, I see their criticism. I see its validity. I don't know what I would do differently if I was back in that position, and that always bothers me as systemically, it feels broken, and so it's interesting to me that you say, well, all these things happen.
And I see them all, you're exactly right, the staying in the afternoon, the people calling out, and then we're shorthanded and we're still dealing with this, the dump truckload of stress, but they're all tied around this being a really popular day, and so I have a hard time teasing those two things apart. If I was this practice owner, I'm looking at you and saying, wow, but these are all problems of popularity and people wanting the service. Are there things that you can do to help assuage my fears that the biggest day of the year, if I just stop doing it, that all that revenue's going to go away? How do you help people not grab onto that idea and just cling to it?
Leslie Mamalis:
Sure, and that can be difficult. So my recommendation would be start by closing every other Saturday. If you're really worried about losing a lot of revenue because you're not open on Saturdays, start by closing every other Saturday and look at other times during the week when you may be able to expand hours. So could you stay open until 7:00 or 8:00 one night a week? Could you open a little bit earlier? Could you do more to encourage people to use drop-off appointments? Are there other ways that you can move cases during the week, but allow your clients to still have the flexibility of dropping that pet off and not needing to take time off of work or to still get their kids to school on time?
So certainly, looking for other places during the week where perhaps you could expand hours. Many of the practices we work with work half days on Wednesdays. Could you open Wednesday afternoons, and again, just adding even if you stayed open until 6:00 or 7:00, assuming that you… I'm surprised by the number of clients I work with that are open 9:00 to 5:00. I kind of wonder, when would I take my pet then, but if you're open 9:00 to 6:00, could you stay open until 7:00 twice a week and just stagger employees. If you're not doing telemedicine, so many practices had an immediate turn to telemedicine during the pandemic and a lot of them have stopped.
It's like, why, because if you can do telemedicine, now I don't have to worry about juggling my three cranky cats and trying to get them into the practice during the week right after work, right before work. So finding ways to use telemedicine, finding ways to use more technician appointments, finding ways to just expand the ability of the practice to serve clients with existing staff and also in existing office hours. Now some people are going to leave, absolutely, and unfortunately, a couple of those people are going to be people that really surprise you. They're the ones that you've really enjoyed working with, but for whatever reason, they just can't fit into your hours. That's okay. We have to let it be okay for clients to choose to go somewhere else and not take it as a crushing blow to our egos.
Dr. Andy Roark:
Easier said than done.
Leslie Mamalis:
Absolutely. Absolutely.
Dr. Andy Roark:
But yes, you're right, but oh boy, that hurts.
Leslie Mamalis:
It does.
Dr. Andy Roark:
Oh, man.
Leslie Mamalis:
It absolutely does, but if you can have a calmer environment, happier staff who are more engaging with clients, it will be easier to replace the clients that you lost by not being open on Saturdays. So by starting to just taper Saturday hours so that you're open every other week instead of every week. Gosh, look back to what people were doing prior to easy access to emergency care. Veterinary practices, you rotated. It's like you got together with a group of your colleagues and everybody picked a weekend and you were on call that weekend and it worked. So sometimes it's okay to go back to what worked long before you were a veterinarian, just because if people really need access on Saturdays, they can still get that care.
Dr. Andy Roark:
I think this really speaks to a fundamental philosophic shift that I think a lot of people have gone through, and I think you put your finger on the very beginning of going back to the pandemic and people spending some time at home and starting to think about what they wanted their lives to be like and things like that. I always thought in my thirties especially, I was pretty darn convinced that bigger was better. You wanted to have more doctors, you wanted to be open more days, more hours, see more patients.
And that's what success was, was this escalation of service capabilities and service providing to the public and that was where the success path went, and I remember I was running strategic planning for this veterinary practice owner and I was talking to her about where she saw herself in 10 years, and I was like, “What's your big plan? Where does this look in 10 years,” and she said, “Andy, I have a three vet practice and I love it, and I don't want any more vets and I don't want any more clients. I want to do what I'm doing now and I would like that to be simpler. I would like it to be easier for me to do what I'm doing now,” and that absolutely broke my brain at the time.
Leslie Mamalis:
Absolutely, absolutely. Because we've all been taught that bigger is better and if you're not moving, if you're not growing, you're in trouble, right?
Dr. Andy Roark:
Yeah, exactly. And this is a conscious movement away from that. This is consolidation to say, no, we're going to see a little bit less. We're going to ratchet this down. We're going to have more time away from the business, and I really do think that's a very modern idea and I think it's probably a really healthy one. Leslie, thanks so much for being here and thanks for talking through this with me. I really appreciate your time. Where can people find you online? Where can they read more of your stuff? Where can they learn more?
Leslie Mamalis:
Sure. Summitveterinaryadvisors.com is our website. We're on Facebook and the Insta, and you can find my articles on Today's Veterinary Business. I write the Money Matters column.
Dr. Andy Roark:
Excellent. Well, guys, thanks so much for tuning in. Leslie, thanks so much for being here. Take care of yourselves, everybody. And that's it, guys. That's the episode. That's what I got for you guys. I hope you enjoyed Leslie. Again, I really appreciate her. She's wonderful to work with. She's so insightful and so, gang, anyway, Stephanie Goss and I will be back for you next week doing our regular thing. Can't wait to talk to you then. All right. Take care of yourselves. Be well. Bye.
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