This Week on the Uncharted Podcast…
Are we still talking about needing an online pharmacy this far into the pandemic? Apparently, we are and for a different reason than you might think. This week on the podcast, Stephanie Goss is joined by Jenn Galvin, Practice Manager/Practice Owner to discuss a fun topic that came into the mailbag. A manager of a corporate practice wrote in and asked about our take on the “encouragement” they are receiving from their corporate leadership to begin outsourcing a lot of products off their shelves into their online pharmacy for home delivery. This is a lively one, let’s get into this…
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Episode Transcript
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Stephanie Goss:
Hey, everybody. I am Stephanie Goss, and this is another episode of the Uncharted podcast.
Stephanie Goss:
This week on the podcast, Andy's taking a bit of a break, but I have got my partner in crime Jenn Galvin here with me today. For those of you who don't know Jenn, she is a practice manager and practice owner of a multi-doctor practice in Arizona. She is so much fun. And when I saw this letter come through the mailbag, I thought there's no better person to talk through this challenge with than my friend, Jenn.
Stephanie Goss:
So we are going to talk through a mailbag letter about some inventory questions and I want to thank our friends at Vetsource for bringing you this week's episode ad free. Let's get into it.
Meg:
And now The Uncharted podcast.
Stephanie Goss:
And we are back. It's me, Stephanie Goss. And this week I am without my partner in crime, Dr. Andy Roark, but I have a fantastic guest host here with me today.
Stephanie Goss:
I have my friend and wingman and partner in crime, Jenn Galvin. And for those of you who have never met Jenn, she is an Uncharted member. She is super, super funny. She is smart and sassy and she is a practice manager like myself and she is also a practice owner. She manages her practice in Arizona with her partner, Erika Cartwright who is the DVM. And how long have you guys been in practice together, Jenn?
Jenn Galvin:
It is going to be 10 years next month.
Stephanie Goss:
My gosh. That is awesome.
Stephanie Goss:
Well, thank you for being here with me today. I am excited to have you.
Jenn Galvin:
Yeah, I'm super excited to be here.
Stephanie Goss:
I am excited for more people to get to know you. Our community obviously knows you really well. And you and I have done a bunch of workshops through Uncharted together now at this point over the last five years. And we have done some about this topic or pieces of this topic because you and I have traditionally tackled some of the more business heavy content that we have done for Uncharted. So talking about KPIs and inventory and the business side of things.
Stephanie Goss:
And so we got a letter in the mailbag recently and when I looked at it, I thought, “Okay, I would love to talk through this with Jenn,” because this is the kind of stuff that you and I both nerd out about. So I thought… No offense to Andy, I love him so much, but this will be a much more fun conversation with Jenn.
Jenn Galvin:
Now, without him here, do I have to give you a funny middle name or…
Stephanie Goss:
I mean…
Jenn Galvin:
Do you just… We skip that.
Stephanie Goss:
I think you could probably make one up, but we also can just skip that ride along.
Jenn Galvin:
Okay.
Stephanie Goss:
But this week is going to be a fun one, you guys. We have a letter from the mailbag we got from a manager who is working at a practice that is corporately owned and they are feeling a lot of “pressure” to outsource medications and preventatives to their online pharmacy or home delivery service. And so they were saying that their practice is having a lot of reservations about online pharmacy in general but specifically this manager is really concerned about the reduction in income to the clinic as well as feeling like isn't this going to make pet care less convenient for our clients.
Stephanie Goss:
And so this manager had three or four really specific questions. They want to know how do we explain to our clients that we're no longer carrying their favorite products, is this the direction that the industry as a whole is headed in, and do the pros outweigh the cons in the long run. And they said, “I would love some help as we grapple with this issue and prioritize what we keep on the shelves and whether we should fight for a bigger budget for our products.”
Stephanie Goss:
And I just thought this was such a great conversation to have. And so I am super excited to have you here and nerd out on this with you because I think you and I both have… I think this is going to be a very fun soap boxy episode.
Jenn Galvin:
I was just going to use that word like this is a soapbox topic for me. I know it's one for you. If we could both just have megaphones and scream from the hills.
Jenn Galvin:
Yeah, yeah. And this comes up all the time. In our classes that we've done, in people that we talk to at conferences like pharmacy is a huge topic and people are always worried about it and they're afraid and I understand why they're afraid-
Stephanie Goss:
True stories.
Jenn Galvin:
… to let it go.
Stephanie Goss:
I think let's start-
Jenn Galvin:
Yeah.
Stephanie Goss:
… as Andy and I always do with the headspace on this. And so when I sat down to think about how are we going to talk about this topic, for me, the headspace really was we've got to start with the why. That is the be all end all in this conversation, I think.
Stephanie Goss:
And so this manager actually asked a great question because they didn't put it as one of their question but they said they were feeling pressure from their corporate partner to outsource medications and preventatives to their online pharmacy and so that's where I would start the why honestly.
Stephanie Goss:
And the questions for me are why are you being asked to outsource things because understanding why they are asking you to do it is key to planning how you approach it, not only with your team, but also with your clients because there's a whole bunch of different reasons why you might want to outsource more of your pharmacy from your brick and mortar location to an online pharmacy.
Stephanie Goss:
So some of the things that immediately come to mind for me are, are you over budget in your cost of goods? That's a really easy place that a lot of people start when we look at the cost that it has to the clinic to carry product and have it sitting on our shelves.
Stephanie Goss:
You and I talk about this extensively when we talk about inventory and we talk about practice financials. It is often a place where practices struggle and it is not uncommon for you and I to hear from a practice when we start digging into their budget and looking at numbers. They're like, “We're at 24% of our revenue as being carried in cost of goods or 25%.”
Stephanie Goss:
And then when you and I talk about where our practices have been or are and it's a significantly lower percent, they're just like, “I don't understand how-
Jenn Galvin:
[crosstalk 00:06:36].
Stephanie Goss:
… you get to that lower number.”
Jenn Galvin:
If people come out and they're at a super high COGS, the first thing that I ask them to do is look at the amount of money on your shelves and that starts with actually recording your inventory correct which is a whole another ball wax. But if you look at what is the money sitting on your shelves, oftentimes in most practices, it's so big, it's such a big number.
Jenn Galvin:
I know that you have to have products. There are some things you have to have on your shelf, but if you could liberate half of that amount of money and put it in your bank account, what could you do with that? It's huge. It's a huge number. And I have practices that… It's a couple doctors, it's nothing huge and they're coming back with 40,000, 50,000, $60,000 of inventory at their hospital. What could you do with $30,000 back in your pocket?
Stephanie Goss:
Yeah, I think that is definitely a piece of it and I want to talk a little bit about some of the things that we could do with that money because I think that that goes to the last question that this practice manager asked us about whether we fight for bigger budget for products.
Stephanie Goss:
But I think the other things they ask for me when it comes to the why and trying to understand. And so if you are in a practice where you're looking at pressure outside of yourself whether it's coming from your practice owner or your corporate partner in this case or even from your vendor, if you have a home delivery service or if you don't have one and you have sales reps coming into your practice asking you why don't you have an online pharmacy, there are good reasons why you're getting some of that pressure.
Stephanie Goss:
And so I want to talk about some of those things that we should all be examining for ourselves and we should be able to have a concrete answer on the why. So are you over on your cost of goods? The other really, really common one that we see is when practices have a lot of duplicates of medications.
Stephanie Goss:
I think I have shared this story on the podcast before, but maybe not, maybe just in our inventory sessions that you and I have done, but when I started at my most recent practice, I came in and I remember when I went for my interview and the hospital has a beautiful, big, giant lobby. We're very blessed with space but you walk in to the right of the front door are these floor to ceiling shelving units and they're pretty built in.
Stephanie Goss:
You walk in and there's literally full floor to ceiling of pet food and they had Hill's, they had Royal Canin, and they had Purina and they had one of everything, all of the common diets. And then on the opposite side, it is full, shelves are full of parasiticide products and they had chewables, they had topicals, they had flea, they had tick, they had flea and tick. They had all of the combos.
Stephanie Goss:
And I remember standing in the lobby waiting for the people who were interviewing me to come out and get me. I remember just thinking, “Oh my God, I want to know so bad,” just for my own curiosity “what their cost of goods is.” And it was so funny because we went into the interview and I bit my tongue and made myself sit on my hands so that I didn't just immediately blurt out for the love of God please tell me what your COGS are. That was all I could think of when I was standing there staring at shelves.
Stephanie Goss:
It looked beautiful and robust and full and all of the good things that we want to consider when it comes to product marketing in our practices and at the same time, I was horrified by what I knew must be the dollar volume sitting on those shelves. And I also wanted to know why.
Stephanie Goss:
Why are you having every option under the sun? Because we also know that when we offer everything to our clients, we're not actually offering them anything. Our clients are more likely to say yes to a recommendation when we give them a clear recommendation and maybe one alternative as option whether it's medication like an antibiotic or a parasiticide, it doesn't really matter. The clients are looking to the veterinarians and to the hospital team to say, “This is what I want to use for Fluffy and here's why.”
Stephanie Goss:
And so when we have all of those options on the shelves, we think about it in terms of feeling good about trying to offer our clients options and convenience. And that's how a lot of my friends that our managers have looked at it, they're like, “Well, I carry everything on the shelf because we want the clients to be able to get whatever it is that they want.” And I can totally understand that.
Stephanie Goss:
And that was actually honestly part of the answer from the practice was like, “We want the clients to be able to have choices.” And so I said, “I can appreciate that.” And to your point, I knew thousands, tens of thousands of dollars that were sitting on those shelves. And I was looking around and just thinking, what else could you do with that money?
Jenn Galvin:
Right, right. Well, and so many practices, and I get the mindset, I do. But you're not a big-box store. You're a veterinarian. You're not trying to be a Walmart or a Costco or… That's not our job. Our job is to pick something to feel really confident about and whatever that product may be, it is, and that's fine and that's the beauty of having an online pharmacy versus carrying all that stuff in your practice because you get the positives of being a big-box store or if you have that client that comes in and says, “Hey, I've used this particular product for 10 years. It's what I like. I'm not switching.” You can say, “Great. We have that over here where it's not sitting on our shelf, collecting dust-
Stephanie Goss:
Let me have that delivered to your house.
Jenn Galvin:
… eating up [inaudible 00:13:13] and I can bring it right to your door.” It's such a better way to do that.
Jenn Galvin:
The other horrifying thing when you said that I was like, “I wonder how much people are taking off their shelves [crosstalk 00:13:24].”
Stephanie Goss:
That was a hundred percent. I was standing there thinking, “Mm, I wonder how much of that inventory is walking off,” because it's out. It's out. And it's in the open. And I'm like, “If you have that much product…” You and I both know when it comes to managing inventory, when you have that much product sitting on the shelves, if you are not doing daily counts of that stuff, stuff is walking off every single time.
Stephanie Goss:
Everybody likes to think that it's not and then it's not going to happen in their practice and, “Oh, we know our clients, we know our team,” but the reality is it happens. It walks off the shelf every day. And so that was the other part of it for me.
Stephanie Goss:
And so it was funny. I did finally get to the point and I asked the medical director and the regional manager who were interviewing me. I asked him, “Tell me about the products that are on the shelf and tell me about why you guys have the volume in stock that you do.”
Stephanie Goss:
And it was interesting because the practice had been… They were like, “Well, we want to be able to offer convenience to our clients and the closest store that carries stuff like this is a little bit of a drive and so we want them to be able to access stuff.” And I was like, “Oh, okay.” And I was like, “Is that the only reason?” They were like, “Well…” I said, “Well, tell me about the parasiticide for example.”
Stephanie Goss:
And what it came down to was that this practice had been largely managing for a good period of time with one regular doctor and a lot of relief help. And so it turns out that they had started ordering things because someone would be doing relief and they'd be like, “This is what I'm used to using. I'm going to prescribe it for the client. Can you get it?” And instead of… They didn't have an inventory manager or anybody who was in charge of that at the time and so they just asked whoever was on that day and they were like, “Yeah, sure. We'll get it ordered for the client.”
Stephanie Goss:
So instead of looking at how do I have one single order sent to this particular client or even the five clients that associate vet saw that day, it was like, “Sure, let me buy a whole carton and have it delivered to the clinic. And then the other eight boxes in that carton are going to just sit on the shelf until the end of time.”
Stephanie Goss:
That's the next piece of the why for me that I would ask you when trying to unearth why are you being asked to do this is, are you overstocked? So we know that duplicates and overstock can cause massive chaos when it comes to inventory.
Stephanie Goss:
And so that would be something else I would look at is, do you have the duplicates but also even if you only have one product, let's say I walked in and they were only carrying one of the parasiticides, if every single one of those shelves is full with multiple cartons of backstock sitting there, the next question in my mind is like, “How often are we actually turning over that product? How often is that product sitting on those shelves?” Because that also contributes to the problem just as much as carrying all of those duplicates?
Jenn Galvin:
Oh, for sure. And you can get caught in the trap. I love my vendors. They're fabulous people, all of my reps are wonderful and they've gotten to know me and the kind of manager I am over time so they know when to give me a deal and when not to give me a deal?
Stephanie Goss:
Right.
Jenn Galvin:
But you have a lot of these vendors that will come and it's their job to sell you product. That's what they do. And so they'll come in and say, “Hey, we have this special on X parasiticide. And so if you buy 45 million cartons, we'll give you three for free.” And so you think, “Oh, man, three? It's 350 bucks a carton. Who would pass up over a thousand dollars in savings? Give me the 45 million cartons.” And then before you know it, you're sending back expired product and you're eating a ton of money and it totally wasn't worth it. And I see so many places fall into that trap and then they've got all this extra stock that it just eats your wallet.
Stephanie Goss:
And then I think the last piece of maybe the why that I could think of would be one of the benefits to having been in corporate practice is that we often had access to data that was greater than what I might have had access to in private practice.
Stephanie Goss:
And so one of the questions I would ask is, are we looking at data that is showing that my specific hospital, my specific clients are already shopping elsewhere.
Stephanie Goss:
And that is something that all of us should be looking at whether we're corporate or private practices doesn't matter and I used to have a spreadsheet in my private practice where every time we got an online pharmacy request for another pharmacy, didn't matter whether it was 1-800-Petmeds or Chewy or the Costco down the street when we got an outside pharmacy that was something that got logged on the spreadsheet so that we could see where our clients were shopping, what they were shopping for in other places, and be able to make decisions for ourselves.
Stephanie Goss:
That occurred because I'm super freaking nerdy. And I love spreadsheets.
Jenn Galvin:
No.
Stephanie Goss:
Big surprise. Big shocker to anybody who listens to the podcast. You guys should all know this about me by now.
Stephanie Goss:
And because I grew up in a practice where one of my practice owners was a CPA and so numbers and data mattered and that was how I was trained and that was what I did. And yet I think that was one of the things that I appreciated when I worked in corporate practice was that I often had access to correlated data like that that was telling me specific narrative about my own clients and my own practice. And so that would be another question that I would want this manager to ask.
Stephanie Goss:
But I think all of those questions aside, I think the number one thing from a headspace is I would start with why. Get curious and not in a, “I'm going to tell you no because I don't agree with you,” way but in a, “Tell me why. Why here? Why now? Why is this important?” Because understanding the why I think is where we should always start when it comes to making decisions in our practice.
Jenn Galvin:
Yeah. And I think you have to feel good about it too.
Stephanie Goss:
Yes.
Jenn Galvin:
If you're going to do this, if you're going to start to outsource, if you're just doing it because your mom told you to, it's that same thing as when we were children like, “My mom says I have to clean my room before I can go sleep over at Stephanie's house. It's really stupid.”
Jenn Galvin:
If corporate is telling you or if your practice owner is telling you like you have to clean your room, you have to outsource your stuff. If you're just going to go into it with like it's because I have to, that's… Really why though? What is the true reason? And find something that you can embrace.
Stephanie Goss:
And so I think the embracing it is big. I think the acceptance and the embracing are two separate steps because when your mom tells you to go clean your room, I love that analogy, there's always the like, “I'm going to fight against it,” and then at some point comes the acceptance, which is usually done with a pout and an irritated face and attitude. And then eventually some of us get around to the embracing part, not all of us, but some of us get around to the embracing part.
Stephanie Goss:
And I think Jenn and I are hoping that by the end of this conversation that we have encouraged and cajoled and supported and loved on you guys enough to get around to the embracing part of it because both of us are going to shout loud and clear about our love for online pharmacies.
Jenn Galvin:
Well, you do like to hug people so I think the embracing thing…
Stephanie Goss:
I do. I do. That is a true story. That is a true story.
Jenn Galvin:
Yeah.
Stephanie Goss:
So headspace, we are going to start with why and then I think actually this episode is going to be less about the plan of attack and a little bit more about headspace. And so I think there were three other questions that our listener asked that I think are important to unpack in terms of headspace.
Stephanie Goss:
And so the first one is they asked, “Is this the direction that the industry as a whole is headed in?” I think what they were specifically asking is maybe not just about online pharmacies because I got the feeling that they were on the fence there but most specifically about outsourcing “a lot” of our medications and preventatives. And so my question there is picking things apart.
Stephanie Goss:
But the reality is, are you being asked to outsource your pharmacy as a whole by and large? Or are you being asked to outsource a lot of medication or preventatives because of some of the reasons that we just talked about?
Stephanie Goss:
Because how you feel about that and your response to it are probably going to be different. If someone came in and said, “I want you to stop carrying all products in house and send everything out to an online pharmacy.” And there are practices that run that model now that has shifted to the doctor's office where you don't carry anything in house and you send them to the pharmacy just like they do in human medicine.
Stephanie Goss:
But the most of us are still living in that hybrid space where we're trying to adopt the model of we carry the necessary things in house and the things where, to your point, we want to be able to provide clients with multiple options or we want to reduce some of the duplicates that are on our shelves or we want to be able to carry a variety of sizes and choice, like we want to give clients choices, I think that's the bottom line behind online shopping.
Stephanie Goss:
When you or I go flip open to Amazon to find something, part of why I'm doing that is because I know I'm going to have a variety of choices and a variety of price points at my fingertips and I'm not going to have to think about that.
Stephanie Goss:
And so I think a lot of us approach what we carry in our own practice with that same rule of thumb. And that certainly was the case in my practice because one of the things that I looked at in horror when I was standing in that lobby is that they had single doses, they had three packs, they had six packs, they had 12 packs, and I was like, “Oh my God.” Stop it. Just slow, stop.
Jenn Galvin:
Slow your roll. Slow your roll. Yeah. And that was something like immediately, it's the light bulb moment where you're like, “You can just carry six months packs,” and that's how people buy it from you. And that's okay. And that's really-
Stephanie Goss:
[crosstalk 00:24:28]. Changes heart.
Jenn Galvin:
Mm-hmm (affirmative).
Stephanie Goss:
And the funny part about that is I guarantee that most practices did not start with all of those options on their shelf. They started with a couple and then slowly over time something got added and then it was like, “Well, if we're going to add that we might as well this and then let's have this option for clients as well.”
Stephanie Goss:
And so that change doesn't occur overnight either which is the funny part to me is that we all dig in our heels when it comes to eliminating that change. But most of us are really willing to embrace that change on the front end in terms of adding things. It's the taking away where we're just like, “Let's dig in our heels and scream about this.”
Stephanie Goss:
So I think is this direction that the industry is headed in a whole? Hell yes. Right.
Jenn Galvin:
Yeah. We're just so far behind on that train. The ship has sailed.
Jenn Galvin:
I know we were talking earlier about… Look at the pandemic. If that was not a reason to jump on the online pharmacy ship it to people train, that was fireworks in your face like get on the boat of getting that done. And we were talking about how much ecommerce has grown time and yeah, this is definitely where we're going.
Stephanie Goss:
Yeah. So it's funny because when we looked at that question you and I both emphatically said yes and we're laughing because both of us have been on board with home delivery.
Stephanie Goss:
My prior practice was one of the very first practices with MWI's proxy program. Do you remember that? Like way back when?
Jenn Galvin:
Oh, that's old.
Stephanie Goss:
Right? I'm dating my-
Jenn Galvin:
We're very young. Okay. We're both very young, beautiful women. But yes, that's old.
Stephanie Goss:
I'm dating myself with that. I've been on board for a long time.
Stephanie Goss:
And I think your point is really valid which is that the world shifted radically under all of our feet in the last couple of years. And so I have seen a lot more practices make the leap which is amazing and exciting and at the same time, it never ceases to amaze me how many practices I talk to who are like, “Eh, we haven't. We're not really into it. We haven't. We don't see the value in it. We don't understand why. We don't want to give up the profitability.”
Stephanie Goss:
And so I think those are all things that you and I want to get into, but it was interesting because when you and I were having the conversation about setting this episode up to your point about the pandemic, we know…
Stephanie Goss:
So there was a white paper done on why online pharmacies and why now and had a lot of statistical information from completely outside the online pharmacies themselves within veterinary medicine. And so there was a statistic that came out of that from the American Pet Products Association and they did a bunch of studying during COVID and their estimate was that 11.4 million, million, households got a new pet during the pandemic and those numbers were significantly higher amongst millennials and Gen Z.
Stephanie Goss:
You and I were looking at that and for me, my first thought was I don't know a single millennial or Gen Z who doesn't shop online. I shop online. I'm not a millennial, but I shop online. You shop online. My freaking grandma who's 96 years old shops online now and has groceries delivered and things sent from Amazon. This is not just…
Stephanie Goss:
And I think that's one of the things that drives me crazy is often we get so laser focused on, “Well, it's just the young people. It's the millennials, it's the Gen Z, they're driving this,” and they are because statistically numerically they're way more of them that are doing it at a faster time speed than a lot of the other generations, but it's not a generational discussion anymore and it hasn't been for quite some time. And so I think we need to look at our own behaviors.
Stephanie Goss:
It's amazing to me. I have watched Andy asked this question and in lectures and our friend, Eric Garcia, has some lectures that he has been doing recently about ecommerce and I watched recently when we were in Florida him asked the question of the audience. Who here has shopped on Amazon in the last week? And almost every single hand in that room went up and it was a big room, a lot of people in it.
Stephanie Goss:
The reality is we are all used to the ecommerce model now and there's tons of statistics and we can drop some of them in the show notes because I think they're actually really, really interesting but I think the reality is the pandemic has forced ecommerce growth to explode. And I think veterinary medicine, like we do, has done some serious digging in of our heels and folding of our hands over our chest like, “Yeah. We're not into this.”
Jenn Galvin:
And you know what this reminds me of? Do you remember… And this is going to age me a little bit, but way back in the day, it was all about print ads in the phone book.
Stephanie Goss:
Yes. Yeah.
Jenn Galvin:
Computers, they were not our thing. We were not actually going to use computers. This was back in the nineties. And computers are not here to stay so let's just keep print ads. People were spending crazy amounts of money there.
Jenn Galvin:
And it took forever to get vets to stop paying for these huge color page ads. It's like I'm talking to my practice owner like, “Please, for the love of God, stop paying for print ads in the phone book.”
Jenn Galvin:
I feel like we're kind of there where life went on. Computers are… That's what we do now. Who has a phone book? And they come. They come to your house and you're like, “Do I sit on this? What is this for?”
Jenn Galvin:
It's only computers. That's where we are. That's reality. And that's where ecommerce is. I don't go to the store anymore. Stuff's delivered. That's real life.
Stephanie Goss:
It's so funny that you say that because when I moved here to Washington… You guys, I've been living here seven years, so that's math that's too hard to do this early in the morning, but whatever seven years ago was 2016?
Jenn Galvin:
15.
Stephanie Goss:
In the teens, right? In the 20 teens. I'm not kidding, my practice still had ads in the phone book and were pay… And I looked at when I first started it and I dug it and I looked at the budget and not $1,000 plus a month expense to have these giant ads in the phone book and I was like, “Oh my God. Why? Why are we doing this?” And the conversation was…
Stephanie Goss:
I understood why they were thinking this way for a little bit. I could have some understanding. We are actually the second most concentrated place in the entire United States for retirees other than somewhere in Florida. And so they were older people want their phone book and they don't have cell phones and they're not looking at information that way. And I was like, “Ooh, I beg to differ.” I'm going to push the buttons here.
Stephanie Goss:
We looked at that but it's so true and I think a lot of us in veterinary medicine have looked at online pharmacy in that way like we're just going to fight it and we're just going to fight it and dig in our heels and dig in our heels. And it irritates the hell out of me because I'm just like, “We are so far behind the curve.”
Stephanie Goss:
I think when we looked at the question is this direction that the industry in a whole is heading, it was a resounding heck yes from both of us. And I really feel strongly and this is where Jenn and I both get on the soapbox on this. If you are running your practice and you do not have a home delivery option for your clients, you are failing to serve your clients. Fight me on that one.
Stephanie Goss:
Because we do a disservice to our clients when we cannot provide them with options and to your point, when you have those clients who come in, who are like, “I've been using this product for years and it works for me and I would like to continue it,” there may be some validity and some updating of the medicine that has been done and we should be educating them if we have a newer product or a better product that could serve their patient.
Stephanie Goss:
I'm not saying not to have those conversations and I would rather be able to serve that client and meet their needs and meet them where they're at than have them walk away and buy from someone else and we know that is exactly what is happening because hello, have you checked your fax machine lately, how many faxes do you have sitting on it from Chewy or 1-800-Petmeds. The reality is… Or even Amazon. We know that clients are shopping other places now.
Stephanie Goss:
And again, this is where I really meant it when I said, this is not a generational problem, this is not millennials. It's not just the Gen Zs that are shopping online. It's all of our clients. And often when you start to dig into the data about your specific clinics' clients, it's some of your best clients that are probably shopping online.
Stephanie Goss:
And so I think it's really important to start with that headspace of even if you don't think that this is the right fit for your practice, I'm going to really push you or your practice owner, whoever is providing the resistance and the drag on this because the reality is we're here. The ship has…
Stephanie Goss:
I loved how you said that Jenn, the ship has already sailed. The rest of us have been on the ship for a while and we're waving it at you from out in the ocean and there are still colleagues of ours who are standing back on the shoreline going, “I don't know,” but you are losing out. If that is you, you are losing out on the opportunity to serve your clients. And so I would challenge you to think about it in a different way.
Stephanie Goss:
For me, that is often a lot of the conversation you and I have had with our colleagues when we're talking about this. It is about reframing the way we think about it because we are so concerned in veterinary medicine about losing. Losing clients, losing profit, losing margins.
Stephanie Goss:
And when the conversation is often had about home delivery, the number one thing that comes up is, “Well, they're going to take all the profits and what's the point if I'm only going to get a couple of dollars out of that prescription. I could sell that in my clinic and mark it up 75, a hundred percent.” Because a lot of times the conversation is about parasiticide which is a loss leader.
Stephanie Goss:
And for a lot of us, we do charge lesser markups on that because it is something we're providing because it's good quality medicine and we want all of our patients to be on it. And I would rather sell the higher volume of it at a lower cost and generate the same amount of revenue than have the markup be higher and have clients buy it from other sources online.
Stephanie Goss:
That's one of those ones that's really common and the argument is, “Well, I don't want to lose that money because if I'm already selling it at a lower markup and then I move it to my home delivery or my online pharmacy, then I'm going to lose even more money because they're going to take fees and credit card fees and all of that kind of stuff. And so at the end of the day, if I'm only getting $2,” let's just pick a round number out of there, ” for that NexGard prescription, it's not worth it to me.”
Stephanie Goss:
I think that's one of the things that I have always been most puzzled by that line of thinking because-
Jenn Galvin:
It was like, “I will arm wrestle you to fight you on that one.”
Stephanie Goss:
And because… Yes, and more it's hard for me because I'm like, “I would rather have $2 10 times a day than $0 10 times a day.” That argument, I have really struggled with that and I've had the conversation with people and I've never really heard an actual explanation that has made logical sense.
Stephanie Goss:
I think the drive for that conversation comes from a place of fear. I can understand that because for the first probably 10 years that I was in practice and you and I have both been in practice about the same amount of time, we had raging markups on our pharmacy.
Stephanie Goss:
I remember a time where a lot of products had multiple hundreds of time percent markup on them, right?
Jenn Galvin:
Yeah.
Stephanie Goss:
And those days are gone as things have shifted and people are buying online and they're shopping around. They're doing all of the same things that we all do in our personal lives. They're doing that for their pets as well. Those days are gone.
Stephanie Goss:
And so for me, I have never understood that rationale of I'm just going to keep fighting and keep fighting and keep fighting. I think you and I are both solidly in the yes camp.
Jenn Galvin:
Yeah. And the bummer is the battle's lost. And I hate to say that. I do. Because the battle, we fought it for a long time. We really did. And we did well for a long time, but it's gone, it's lost. And a lot of people forget the time and energy you have to put into carrying everything that you want to, paying somebody to order it, paying somebody to put it on the shelf, paying somebody to sell it. I see a lot of practices paying production on these products. And so really by the time you do all of the things, you're making 15 cents on a product.
Stephanie Goss:
If you're not actually-
Jenn Galvin:
[inaudible 00:38:44].
Stephanie Goss:
If you're not actually losing money because how often do you and I talk to practices where we dig into that and we ask them how their pricing is set up and then we ask them what their average staff hourly wages and we calculate out what it costs to order to carry, to do all of those things and then we ask them about production and that's where my horrified…
Stephanie Goss:
I always have to struggle. I struggle, you guys, to control the horrified look on my face because when somebody tells me that then they're paying production and we actually do the white board math with them. So many practices are actually losing money on those products when we do the full math because there are so many practices out there where the price that gets put into the computer and their inventory setup is what is my hard cost and that's all that's being looked at and all of those other associated soft costs are not.
Stephanie Goss:
If you are listening and you're like, “This is all stuff that I didn't know,” or “Well, maybe that's us.” You are not alone and it is something that you can help change for your practice by getting some education and support and there are a lot of places now in veterinary medicine where you can get that support.
Stephanie Goss:
We both are huge advocates of our friend, Nicole Clausen, who's actually doing a podcast with me that is coming up as well. She is an inventory super nerd and she's got a whole community on Facebook for the Inventory Nation and a place where people in veterinary medicine.
Stephanie Goss:
Because a lot of times the person who gets put in charge of inventory for the clinic is an assistant or a technician or somebody who just got handed this thing. They don't actually have any formal training. There hasn't been a whole lot of thought put into how do I train them, what do they need to know, why they need to know it.
Stephanie Goss:
And I can't tell you how many times every single practice that I have personally worked in where I have gone into and I have looked at those numbers where it hasn't been the case that there are charges that are not included and how those prices are factored and when you actually do the math where there are things where you're losing money.
Stephanie Goss:
And so I think that's a super important point. And I think not to look at it in a negative perspective but it's time to stop having the conversation about should we because the answer is hell yes. We should have 10 years ago.
Stephanie Goss:
And the question in my mind is how do we. And so you and I, when we have had these conversations before we both are very strong proponents of I don't care which pharmacy you use, you just need to have one because the answer there is that look, it needs to be the path of least resistance.
Stephanie Goss:
And every clinic is unique. You have different team members, you have a different team makeup, you have a different workflow from the practice down the street, you have different clients from the practice down the street. And at the end of the day, the way that you go about choosing your partner should include thought into all of those things and then you should be looking at what product out there because there are a lot of them now which is great.
Stephanie Goss:
When I started, literally proxy was the only option. We had one and you worked with what you had, and now there are a multitude of home delivery options for veterinary practices.
Stephanie Goss:
And so I think what you and I both try and encourage people to do is look at what is your workflow, what are your problems… Going back to the why. Why are you trying to do this? And what option out there is going to be the best fit for your practice? And the answer's going to be different in every clinic, and that's okay. That's why we're so glad that there are multiple options that work.
Stephanie Goss:
And then I think the other big question in caveat that you and I both encourage people to ask is what partner matches your values as a business? What partner do you feel like you get excellent customer service from that feels like an extension of your practice?
Stephanie Goss:
Because if I'm going to work with a third party partner, I want my clients to have the same kind of experience when they have to call customer support for a question, their pet won't eat the food or the product caused a reaction. Or they're trying to do a return because… whatever the reason is. I want whoever they get on the phone to feel like an extension of my own practice. I want there to be a similar experience.
Stephanie Goss:
And so again, because we all run our practices differently, each of the options out there for third party partners are going to have a different experience and feel. And so that should be part of the decision making process, for me, is what is going to be a natural extension of that process.
Stephanie Goss:
But this is where you go back to the why. Why are you trying to partner with somebody? Are you trying to outsource some of the duplicates? Are you trying to provide clients with additional options? What is the why and how does the partner that you choose serve that why I think is really important.
Jenn Galvin:
Yeah. When we looked into ours, I remember, there's a lot of options that will integrate with your software, of course. And we actually wound up picking something that didn't because we like the company better, they did a better job with customer service. We just felt like they would get a better client experience and we are trying to convince these people don't buy from these other places. We can have the stuff delivered to you and you're going to get great customer service and that's what drove us to pick the pharmacy that we ultimately went with.
Stephanie Goss:
Yeah. Yeah. I think the next question that was asked after that is do the pros outweigh the cons in the long run and I think we've talked a little bit about that. And again, I think our answer is a resounding heck yes.
Jenn Galvin:
Absolutely.
Stephanie Goss:
I think that's where we are and I think you bring up such a valid point. We need to be able to provide for our clients because if they're not going to get it from us, they're going to get it from somewhere else. And so we can control that. We can control that narrative but so many of us don't do a great job of self-promotion in this regard.
Stephanie Goss:
I see so many clinics who say that they have an online pharmacy when I ask them, “Well, how are you using it?” And they're like, “Oh, well, when a client asks us for something we don't have, then we fill it through our online pharmacy.” And I'm like, “Wow, you guys are missing a big opportunity here in a whole variety of different ways.”
Stephanie Goss:
I think it's interesting this email from this listener was they're getting pressure to outsource a lot of medications and I know that's a scary thought for a lot of practices.
Stephanie Goss:
I certainly had anxiety myself when I shifted probably about seven or eight years ago now the practice that I was in. We started shifting more of our product to our home delivery service because I was really trying to free up capital in the practice and I was trying to free up capital that was sitting on the shelf.
Stephanie Goss:
And so we as a doctor team and myself sat down and looked at what were we carrying and why we were carrying it and really tried to pare down some of what we had on the shelves because part of our why was we wanted to bring on more team members and as much as we all wish…
Stephanie Goss:
And I'm going to soapbox for a hot second here. I talk to my friends and colleagues in private practice and so many times I have knowing full well that I worked in a corporate practice, people would look at me and say, “Well, corporate just gives you the money to do things. You can pay the signing bonuses. You can pay your team more because you're a corporate practice.”
Stephanie Goss:
And I can't tell you guys how many times I looked at people and had to have the conversation about there is no magic NBA money tree that I went and shook or magic [inaudible 00:47:06] money tree that goes and gets shook and the money just falls out and the things happen.
Stephanie Goss:
The way that my budget worked in corporate practice was the exact same way that it works in private practice which is that it's a pie. And I decide as the practice administrator or my medical director and I decide together or my practice owner and I decide together how that pie gets divided up and it's no different in private practice than it is in corporate practice.
Stephanie Goss:
And so I think when we think about shifting that for online pharmacy, part of the goal with my doctor team and I was we wanted to hire more team members and we were at a place where we were really squeezed for that extra money and so we decided to take a hard look at what were we carrying and why were we carrying it and try and free up some of that capital because we were facing a state minimum wage increase.
Stephanie Goss:
I was looking at our team and I knew we wanted to add more team members and I also wanted to be able to increase the wages of the team that I already had. I calculated out what that was going to cost us and we were looking at $43,000 that we were going to have to shake out of a money tree and I knew that there was no money tree that I was just going to go shake. And so I was like, “How are we going to do this?”
Stephanie Goss:
And so one of the options I looked at is look, do we have stuff that we can eliminate and can we get this number down because if we can get this number down, then it's going to free up capital in other pieces of the pie that I can then reallocate to paying the team. That for me is a really, really strong example of a pro that far outweighs the con.
Stephanie Goss:
And I think the other big one for both of us is the understanding that not every single one of our clients is going to be able to take our recommendations at face value. We have done an incredible job in veterinary medicine I think over the last 16 years that I have been in practice elevating this standard of care and shifting and we've got more pets on preventative and we're doing more preventative education and we're addressing whole patient care and wellness care in ways that we never had before. And I think it's amazing.
Stephanie Goss:
I think that there needs to be room in the conversation for not every client that we work with is going to be able to, for a variety of reasons, not all of them that have to do with money is going to be able to take our recommendations. And so I think it's really important that we start to have a really serious conversation about how do we meet our clients where they're at.
Stephanie Goss:
This is where I feel like home delivery and online pharmacy for your practice absolutely makes sense and support that because now I have the capacity for my client who is a snowbird who now is in Alaska for the summer and needs their prescription. Well, I can let them go be seen at another practice locally and get the medicine from somebody else or I can let them order from an online pharmacy that is not mine, or I can say, “Yeah, no problem. Let me have it shipped to you and it'll show up where you're vacationing for the summer and not a problem. We'll see you when you're back in town for the winter,” because we've got the reverse snowbirds.
Stephanie Goss:
And same for you. You get the clients who come down for the winter and are in Arizona and enjoying the sunshine and you have the option to… You know that they might see a vet where they live the rest of the year or you might be their primary vet and you're providing services while they're there and you want the ability to continue giving them those products and services that they need when they're back home here in Washington for the spring and summer.
Stephanie Goss:
I think it creates an opportunity for us to start to have some of those conversations about how do we meet clients where they're at whether they need a lesser expensive option or a product that they started on when they lived in the South that covers things that… Parasites and things that they have there endemically year round that we don't have here on the West Coast or… Those are just some examples and they're easy ones. But I think that it's part of the bigger conversation about the pros outweighing the cons here.
Jenn Galvin:
I think part of that, too, and something that was very eye opening for me, number one, you get to be there for your client all year round from a pharmacy standpoint which is great, and we do. Our population goes up by like,000 people when we have snowbirds here so it's crazy.
Jenn Galvin:
But number two, I had a client and this was, I don't know, year two, I think that we were open and we were trying to sell her I think it was HEARTGARD and we sell it in either we have six-month boxes. That's how we sell it. So you can either get six months or you can get 12 months. That's what we have. And she said, “I can't afford that.”
Jenn Galvin:
I had this light bulb moment where it was like, “Oh, our online pharmacy offers a remind me where they just send a monthly dose to that client,” and that's such a more affordable option for that person where they're not having to shell out a 12-month fee of HEARTGARD spending over a hundred bucks. This lady couldn't do it. But once we sat down and I said, “Oh, you know what? Our online pharmacy, this comes right to your house, you give it to your pet so you're not forgetting to do that, which is a great feature of that. So the pet is getting better standard of care. And on top of that, you have to pay for it monthly instead of all out at one time.” And the lady was so ecstatic about it.
Jenn Galvin:
And so it's just a win-win and now we're not denying that pet a needed product because that client couldn't afford it. It's just something I never thought because for me, I'm like, “Yeah, you just buy six months and you do this thing.”
Stephanie Goss:
And it's so funny. I love that you use that as an example because I will tell you guys, I am that client, but in a different way.
Stephanie Goss:
My problem is not that I couldn't or wouldn't spend the money to buy a six-month or 12-month box. I am your stereotypical non-compliant preventative client because I, for the love of all that is holy, cannot remember with all the chaos in my life to give the dose when it's supposed to be given. I'll buy the box. I'll give like the first two doses and then the rest of that six or 12 packs will sit in the cabinet in my house and will not get given because life is a thing.
Stephanie Goss:
And I will tell you that very early on, I made the transition to similarly getting the remind me dose. It shows up once a month in the mailbox. I would go walk. I lost my dog in this last year but [Bird 00:53:53] and I would take a walk down to the mailbox and we would go get her dose and literally standing at the mailbox I would give her monthly dose because that was the only way that I could guarantee that it would go into her because otherwise forget it.
Stephanie Goss:
It was a game changer for me in terms of feeling like now I'm not lying to clients when I tell them I give my pet preventative monthly because it's actually a thing that's happening.
Stephanie Goss:
That's where I think I challenge us as colleagues to start to open our minds beyond the first thing that comes to mind which is we need to offer options because it's not affordable. I think that's a fantastic reason because we need to meet people where they're at and recognize that there are other reasons why people want things shipped to their home that don't just relate to the cheapest possible option.
Stephanie Goss:
I think unfortunately, there are a lot of us where that is the lens we have narrowed down and viewed home delivery and online shopping through is that we're just talking about the clients who want the bargain basement pricing and that's why they're shopping online.
Stephanie Goss:
I think we know that the reality is, look, we all get on Amazon and order stuff because I don't want to have to leave my house. I want to be able to at 11:00 PM when I remember, “Oh crap, I'm out of toilet paper.” I want to be able to order it and have it show up at my house. That's where we live now.
Jenn Galvin:
Yeah.
Stephanie Goss:
I think it's the same for our clients when it comes to what are they ordering and why are they ordering it.
Stephanie Goss:
I think the last question was do we fight for a bigger budget for our products. I think you and I talked already like don't you want to put that money towards something else and I think the first thing that came to both of our minds is let's put that money towards our team.
Stephanie Goss:
We're having these bigger conversations about wages and wage equality and how do we do more for our teams and how do we support people who stick with us and are there for us. A guy would way rather take some of that money that's sitting on the shelf in terms of inventory and buy things for my team, pay them more, buy new equipment, do those things. And when you start to look at your pharmacy as capital sitting on the shelf, it's fun to do some hallucinating and think about what else you could do with that money.
Jenn Galvin:
It sounds super nerdy, but for me, that's such a fun thing to think of if I had like X amount of money. If I got rid of some of these meds and I had the ability to still carry them on an online pharmacy, you're not taking anything out of your hospital that you can't give back to your clients. So it's not like you're like, “Eh, we're going to get rid of x-ray.” This is something that it's easy to figure that out.
Jenn Galvin:
But what you can do with that money? I've seen practices that they have actually been able to free up enough space getting rid of products to put in another exam room. You want to talk about profitability.
Stephanie Goss:
Yes, absolutely.
Jenn Galvin:
What could you do with that space? It's not even always about the money, but it's how much space is that stuff taking up.
Jenn Galvin:
When you're talking about a full shelf up front of pet food and preventatives and what could you do with that space.
Stephanie Goss:
I will-
Jenn Galvin:
Let alone, what's getting stolen [crosstalk 00:57:00].
Stephanie Goss:
I will tell you that although I'm not at the practice because I am not in full-time practice anymore but they are putting two exam rooms in the lobby in that space that previously had inventory just sitting on it and to your point, those exam rooms are going to generate revenue now for the practice in a capacity that far exceeds the $50 box of heartworm preventative or a hundred dollars box of heartworm preventative when we're generating an ACT of 250 or 300 bucks every time a client walks in that exam room. That's super smart.
Jenn Galvin:
And I think trying to figure out what are your team's pain points and trying to turn that into why are we making this shift can really be beneficial.
Jenn Galvin:
I think if it's, “We need more team members,” you can spin, moving product out to be able to generate the revenue to do that and free up that money, if it's, “Man, we don't have enough exam rooms. Our wait times are forever. Our doctors are sitting on their hands because they don't have another exam room to go into,” if you free up the space, maybe you can get another exam room.
Jenn Galvin:
If you can think of things that are a problem for your team and then turning that into the solution is exporting that stuff out of your practice, putting that on an online pharmacy, that's a great way to motivate them to be part of that transition, which is, I'm not saying…
Jenn Galvin:
It's scary, guys. We did it out the gate starting our practice and it was still hard because we had so many professionals that came from the dig in your heels, you don't migrate that stuff out of practice kind of places and it's hard. It's a hard transition. I'm not saying it's… Yeah. You just tell them, be excited about it and they're going to do it and it's going to be great. It's hard, but you can do it and you just have to find the reason why.
Stephanie Goss:
Yeah. Yeah. I think… As usually occurs with you and I, we get to talking and the conversation is so good and we could talk about this forever and I think we're at the wrapping point for today because I think we answered all the questions with yes, yes, and yes. And-
Jenn Galvin:
Let's just do it.
Stephanie Goss:
Let's start with the why and that's a big part of it. And I love the point that you just ended us on which is it's not only about why you're being asked to make the change and why would you want to make the change, but also what is the why in the practice, what are the pain points for the team, what are the pain points for the clients, what do you want to have more money for, why do you want to have more money in the practice, what could you do with it if you free it up, I think all of those things are great reasons to take a look at shifting to an online pharmacy if you don't have one.
Stephanie Goss:
And yet I also can see… I would love it for us to do a part two on this and talk about… You brought up the team and it's hard and change is hard. I think the plan of attack when I sat down and looked at this because usually Andy and I talk about headspace and then we talk about, “Okay, how do we actually tackle this problem?”
Stephanie Goss:
And for me, the tackling of it comes down to clients really don't care. At the end of the day, they really don't care what you carry or why you're carrying it. They just want you to tell them what they need and how they get it. And so that is a training issue all day long and we need to teach our people what to say and how to say it.
Stephanie Goss:
I could totally see you and I jumping on and doing a part two of this and really diving into that because that is its whole own separate thing. But the why, I feel like this has been really fun going back and forth and talking about some of the reasons why we need to do this. But I think the answer to all of the questions from Jenn and I is a resounding yes and I have had so much fun talking through all of this with you.
Stephanie Goss:
Jenn, thanks for being here with me today and for talking this through. This was fun.
Jenn Galvin:
Yeah. Oh, man. I love chatting with you any chance I get, so thanks for having me.
Stephanie Goss:
Of course.
Jenn Galvin:
And yeah, I'll be back if you want to discuss how to get your team to do this, I'll be back. You just have to say the word.
Stephanie Goss:
Sounds good.
Stephanie Goss:
Take care, everybody. Have a fantastic week and we will talk to you guys again soon.
Stephanie Goss:
Well, gang, that's a wrap on another episode of the podcast and as always this was so fun to dive into the mailbag and answer this question.
Stephanie Goss:
And I would really love to see more things like this come through the mailbag. If there is something that you would love to have us talk about on the podcast or a question that you are hoping that we might be able to help with, feel free to reach out and send us a message. You can always find the mailbag at the website. The address is an unchartedvet.com/mailbag or you can email us at podcast@unchartedvet.com.
Stephanie Goss:
Take care, everybody, and have a great week. We'll see you again next time.
