{"id":1104,"date":"2014-01-01T15:57:03","date_gmt":"2014-01-01T15:57:03","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=1104"},"modified":"2022-02-16T19:19:36","modified_gmt":"2022-02-16T19:19:36","slug":"practice-building-moving-forward-investing-in-the-future-of-your-practice","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/practice-management\/practice-building-moving-forward-investing-in-the-future-of-your-practice\/","title":{"rendered":"Moving Forward: Investing in the Future of Your Practice"},"content":{"rendered":"<p class=\"p1\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2016\/06\/T1401C05.pdf\"><img decoding=\"async\" class=\"alignnone size-full wp-image-9886\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2011\/07\/pdf_button.png\" alt=\"pdf_button\" width=\"110\" height=\"27\" \/><\/a><\/p>\n<hr \/>\n<p class=\"p1\"><em><span class=\"s1\">Travis Meredith, DVM, MBA, Diplomate ACT<\/span><\/em><\/p>\n<p align=\"LEFT\"><em>Affinity Veterinary Center of Malvern, Malvern, Pennsylvania<\/em><\/p>\n<p><em>Axxiom\u2014The Practice Impact Group, Philadelphia, Pennsylvania<\/em><\/p>\n<p class=\"p1\"><span class=\"s1\">Dr. Meredith explores proactive, strategic investment decisions for practices committed to generating additional income, offering the highest quality of medicine, providing an optimum patient experience, and creating a productive work environment.<\/span><\/p>\n<hr \/>\n<div class=\"orange-box\">\n<p class=\"p1\"><span class=\"s1\">This year\u2019s Practice Development series is dedicated to building today\u2019s veterinary practice. The goal of this series is to describe the many elements that impact the growth and success of your veterinary practice. This first installment examines the broader thought process of investing.<\/span><\/p>\n<\/div>\n<p class=\"p1\"><em><span class=\"s2\"><b>Dr. Smith<\/b><\/span><span class=\"s1\"> graduated from veterinary school 10 years ago. A mother of 2 school-age children, she has worked as an associate veterinarian since graduation, and has reached a point where she finds herself wanting more out of her career. While Dr. Smith has spoken with her current employer about her desire to be an owner, the reality of a partnership is a long shot at best. After months of casually exploring options, Dr. Smith has come across a location outside of her existing non-compete agreement, with a landlord who is excited to have a veterinary hospital as a tenant.<\/span><\/em><\/p>\n<p class=\"p1\"><em><span class=\"s2\"><b>Dr. Jones<\/b><\/span><span class=\"s1\"> is the sole owner of a busy 3-doctor practice in a suburb of a major metropolitan city. He purchased the business as a single-doctor practice 15 years ago, and it has grown steadily most years. His practice is built on the foundation of good medicine, and although he has many of the latest clinical tools, Dr. Jones acknowledges that his current facility looks very much the same as it did the day he purchased it. His team constantly reminds him of the challenges of working in a cramped space\u2014he knows a facility expansion is long overdue.<\/span><\/em><\/p>\n<p class=\"p1\"><span class=\"s1\">While these 2 veterinarians are very different individuals at different stages of their careers, they are remarkably similar in one way. Both of these capable professionals have reached a decision point in their professional lives\u2014to remain in the relative stability of the known or to invest in an opportunity to find greater professional success. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Both of these scenarios demonstrate the influential role strategic investments play in many veterinarians\u2019 lives. <\/span><\/p>\n<h2 class=\"p3\"><span class=\"s3\"><b>DEFINING <\/b><\/span><span class=\"s1\"><b>INVESTMENT<\/b><\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">In finance, <\/span><span class=\"s2\"><b>investment<\/b><\/span><span class=\"s1\"> is the purchase of an asset with the hope that it will generate income or appreciate in the future to sell at a higher price. The term is typically used in reference to a long-term outlook, and is associated with taking some kind of risk. Investing is not just the process of committing money, but the factors associated with that commitment.<\/span><\/p>\n<ul class=\"ul1\">\n<li class=\"li1\"><span class=\"s1\">Research<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Assessment of risks<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">The decision-making process.<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">In veterinary medicine, we often loosely use the term <em>investing<\/em> to justify any expenditure. Similar to many other business processes, many decisions to invest in our practices are reactive to situations, such as broken equipment or end-of-year tax shelters, rather than <em>proactive<\/em>, strategic decisions with a stated goal.<\/span><\/p>\n<h2 class=\"p1\"><span class=\"s4\"><b>STRATEGIC <\/b><\/span><span class=\"s5\"><b>INVESTING<\/b><\/span><\/h2>\n<p class=\"p1\"><span class=\"s2\"><b>Strategic investing<\/b><\/span><span class=\"s1\"> is the process of:<\/span><\/p>\n<ul class=\"ul1\">\n<li class=\"li1\"><span class=\"s1\">Identifying a need or desire to grow your practice<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Evaluating the opportunities to create improvements<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Considering the costs, risks, and possible rewards<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Intelligently making financial decisions to commit resources to projects and initiatives that create the greatest financial, clinical, and\/or operational value for your practice.<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">We invest in our practices for several different reasons, or a combination of reasons:<\/span><\/p>\n<ol class=\"ol1\">\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Create something of value.<\/b><\/span><span class=\"s1\"> Whether buying your first practice or moving an existing practice into a new building, you want to build a business that has value. While you may not anticipate selling soon, eventually you will look to sell your business and be fairly compensated for the years you have committed to its growth.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Revenue.<\/b><\/span><span class=\"s1\"> We invest to create a new business, a larger building, or more examination rooms. All of these goals are centered on growing our practices, which ultimately leads to further financial success for the practice.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Control of your own destiny.<\/b><\/span><span class=\"s1\"> For many practitioners, the decision to transition from an employee to an owner is based on a desire to create a more stable life. As a practice owner, you may inherit more tasks, more chores, and occasionally more headaches, but one thing is certain\u2014every day you wake up knowing your job is secure.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Quality of life.<\/b><\/span><span class=\"s1\"> Many improvements in our practices are intended to make our professional lives easier. Increased working space, shortened radiograph processing time, and more efficient patient flow are all results of investments designed to improve the quality of our professional lives.<\/span><\/li>\n<\/ol>\n<p class=\"p1\"><span class=\"s1\">Regardless of the reason, investing in our practices is about moving forward medically, technologically, and professionally.<\/span><\/p>\n<div class=\"orange-box\">\n<p align=\"LEFT\">As you invest in your practice, <strong>engagement in strategic thinking <\/strong>is one of the most important exercises for the practice team. The decision to commit resources and\/or borrow money to expand, add, or renovate is a decision that will financially impact the practice for years to come.<\/p>\n<\/div>\n<h2 class=\"p3\"><span class=\"s3\"><b>TYPES OF<\/b><\/span> <span class=\"s1\"><b>STRATEGIC INVESTMENTS<\/b><\/span><\/h2>\n<p class=\"p1\"><span class=\"s2\"><b>Strategic investments<\/b><\/span><span class=\"s1\"> take many forms, ranging from a simple equipment purchase to multi-million dollar renovations. Depending on the stage of your career, professional goals, and operational needs, most projects are investments in one or more of the following:<\/span><\/p>\n<ol class=\"ol1\">\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>New business.<\/b><\/span><span class=\"s1\"> The first investment for many veterinarians is business ownership. Whether a startup practice, a partner buy in, or purchase of an existing practice, every practice owner was once an associate who identified an opportunity to create his or her own business.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Personnel.<\/b><\/span><span class=\"s1\"> The most common investment in personnel is the hiring of an associate doctor. Many practices in today\u2019s environment do not have the immediate client demand to keep a new full-time associate productive from day one; therefore, the addition of a new associate is more uncertain than 5 years ago. That said, personnel growth still remains one of the most significant drivers of revenue growth.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Equipment.<\/b><\/span><span class=\"s1\"> As practices compete with the many external competitors to core elements of their business, many are investing in new equipment in order to provide the next level of service for their customers.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Facilities.<\/b><\/span><span class=\"s1\"> Facility investments are often the most complex projects, with the highest financial consequences when executed without a clear strategy and purpose. Often, incorporating loans of thousands to millions of dollars, facility expansion projects require careful coordination of designers, builders, and contractors, as well as a real world perspective of which improvements create the most value.<\/span><\/li>\n<\/ol>\n<div class=\"orange-box\">\n<p align=\"LEFT\">Despite the broader economic challenges and the prevalence of student debt among young professionals, funding for veterinary practice purchases and improvements is readily obtained\u2014opportunities that are not available to small business owners in other industries.<\/p>\n<\/div>\n<h2><span class=\"s3\"><b>RETURN ON INVESTMENT<\/b><\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">So how does one determine what creates value? While many practices commit money and time to improvements, and many more incur significant debt for larger projects, very few begin a project with a clear understanding of its benefits.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">If you look around at your practice:<\/span><\/p>\n<ul class=\"ul1\">\n<li class=\"li1\"><span class=\"s1\">How often do you use your equipment? How does its current use compare to your expectations the day it was purchased?<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Are you taking more images with your new digital radiology machine?<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">How many times do you use your ultrasound machine?<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Are you ahead or behind your expectations? Did you have expectations?<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">In finance, the term <\/span><strong><em><span class=\"s2\">return on investment<\/span><\/em><\/strong><span class=\"s1\"> (ROI) is a principle that governs how and when a business spends money. ROI is a measure used to: <\/span><\/p>\n<ul class=\"ul1\">\n<li class=\"li1\"><span class=\"s1\">Evaluate the efficiency of an investment or<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Compare the efficiency of a number of different investments. <\/span><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">To calculate ROI, the benefit (return) of an investment is divided by the cost of the investment; the result is expressed as a percentage or a ratio.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">In veterinary medicine, many practices do not utilize revenue or profit margins as a sole decision driver. ROI can be measured objectively when adopted for clinical metrics, including number of new patients, improved patient compliance, reductions in client complaints, or greater efficiency per doctor. See <\/span><span class=\"s8\"><b>To Add or Not to Add<\/b><\/span><span class=\"s1\"> for an example of ROI use in practice.<\/span><\/p>\n<div class=\"orange-box\">\n<h2 align=\"LEFT\">To Add or Not to Add<\/h2>\n<p align=\"LEFT\">A busy 3-doctor practice is considering adding a third examination room to accommodate more patients, reduce waiting times, and allow more time spent with clients.<\/p>\n<ul>\n<li>Each examination room is currently utilized at its maximum capacity, accommodating 10 patient visits per day.<\/li>\n<li>A third examination room would accommodate 5 extra patients per day without requiring an increase in personnel and only slightly reducing use of existing rooms.<\/li>\n<\/ul>\n<p align=\"LEFT\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-table.png\"><img decoding=\"async\" class=\"alignnone wp-image-8922 size-medium\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-table-e1455920574844-300x150.png\" alt=\"010214 pb table\" width=\"300\" height=\"150\" \/><\/a><\/p>\n<p align=\"LEFT\">The <strong>Table<\/strong> evaluates the clinical ROI related to adding a third examination room. Based on its information, adding a third examination room will:<\/p>\n<ul>\n<li>Increase patient visits by 15%<\/li>\n<li>Accommodate up to 50% of future growth before requiring facility improvements.<\/li>\n<\/ul>\n<p align=\"LEFT\">This efficiency can be converted to a financial value by assigning a dollar amount to each patient visit. At an average client transaction of $100, a 15% increase in patient visits is worth $1500 per week or $78,000 per year.<\/p>\n<\/div>\n<h2 class=\"p4\"><span class=\"s1\"><b>PRACTICE INVESTMENT<\/b><\/span> <span class=\"s9\"><b>MISTAKES<\/b><\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">Every day, <i>very smart<\/i> veterinarians make <em>very bad<\/em> decisions regarding their businesses. While there are many factors that result in bad experiences, the most frequent errors in practice investments are the following:<\/span><\/p>\n<ol class=\"ol1\">\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Delaying strategic investments.<\/b><\/span><span class=\"s1\"> We can look around our practice and identify improvements that have been pushed off for years, sometimes decades. However, delaying an improvement project does not make the problem go away. In fact, by failing to stay up to date, practices cannot offer the highest quality of medicine, an optimum patient experience, or a productive work environment.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Lacking clarity in reasoning.<\/b><\/span><span class=\"s1\"> We are human, and even objective medical professionals can find themselves justifying personal perks as valuable to the business. If you make the decision to build oversized personal office space for yourself because you have worked in a closet for 25 years, that\u2019s fine. Understand, though, that this expense will need to be funded by revenue created elsewhere in the practice. Be honest with yourself in the process.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Identifying needs versus wants. <\/b><\/span><span class=\"s1\">In planning for future growth, it is critical to separate needs from wants. I may want the outside regulation sized basketball court for lunchtime exercise, but I really need 2 new examination rooms. The selection of one project doesn\u2019t necessarily preclude the other, but it will create a decision hierarchy when determining a budget.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s2\"><b>Building the Taj Mahal. <\/b><\/span><span class=\"s1\">Many practitioners have spent years in cramped quarters and inefficient facilities. Once they have made the decision to invest in renovations or a new building, they build a facility far beyond their needs, assuming that \u201cwe\u2019ll grow into it.\u201d The end result? All too often these practitioners become overwhelmed by high debt payments and facility costs the practice cannot support.<\/span><\/li>\n<li class=\"li5\"><b><\/b><span class=\"s1\"><b>Embracing the \u201cfield of dreams\u201d strategy\u2014if you build it, they will come. <\/b><\/span><span class=\"s10\">You are adding a new laser machine and ultrasound. How&#8230; <\/span>\n<ul class=\"ul2\">\n<li class=\"li1\"><span class=\"s1\">Are you going to let your clients know about it?<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Are you going to train your staff?<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">Can you ensure it gets utilized to the fullest potential? <\/span><\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<p class=\"p1\"><span class=\"s1\">Too many practices have very expensive pieces of medical equipment sitting dormant because of a failure to properly implement them into daily practice.<\/span><\/p>\n<div class=\"orange-box\">\n<h2 align=\"LEFT\">HERE IN THE REAL WORLD: A CASE STUDY<\/h2>\n<p align=\"LEFT\">Like many veterinarians in our area, my wife\u2014who is also a veterinarian\u2014and I had been looking for our next practice ownership opportunity for several years. We understood\u2014similar to other veterinary families\u2014that our best opportunity to create personal financial success was practice ownership.<\/p>\n<p align=\"LEFT\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-image.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignright size-medium wp-image-8923\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-image-300x241.png\" alt=\"010214 pb image\" width=\"300\" height=\"241\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-image-300x241.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-image-1024x824.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-image-768x618.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/01\/010214-pb-image.png 1061w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p align=\"LEFT\">For us, the decision to open a new practice was influenced by several factors:<\/p>\n<ol>\n<li><strong>Experience. <\/strong>My wife and I have been practice owners before; therefore, the premise of starting a new practice was much less daunting to us than to a first-time practice owner. We had existing processes, templates, and protocols that we were able to implement from day one.<\/li>\n<li><strong>Local market knowledge. <\/strong>We selected a local area that was familiar and well known. Over the previous 5 years, my wife had built a very busy relief practice, often working in and around this region. This allowed us to develop a very high comfort level with the standards of medicine, client expectations, and general pricing dynamics of the area.<\/li>\n<li><strong>Limitation of choice. <\/strong>We live in a very popular part of the country, and practices are sold less readily than in other markets. Corporate practice expansion has made purchasing quality practices a very competitive process.<\/li>\n<li><strong>The diamond in the rough. <\/strong>We did not embark on new construction but found an opportunity that best fit our strengths:\n<ul>\n<li>We decided to lease a facility that was previously a veterinary practice (opposed to, for example, a strip mall location that had been a different business).<\/li>\n<li>The building had dated, but existing, examination rooms, treatment area, and surgery suite, which enabled us to focus on client-centered cosmetic improvements.<\/li>\n<li>Building from the ground up would have concentrated our energy and resources on months of design, zoning approvals, and construction.<\/li>\n<li>Our approach kept the time between beginning renovations and seeing clients to a matter of weeks versus months.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<p align=\"LEFT\">The right opportunity for us won\u2019t be right for everyone, but we were able to match our strengths and goals with the right investment opportunity. As this series continues, we\u2019ll continue sharing our insights into the practice \u201cbuilding\u201d process.<\/p>\n<\/div>\n<h2 class=\"p3\"><span class=\"s3\"><b>SMART<\/b><\/span>\u00a0<span class=\"s1\"><b>DECISIONS <\/b><\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">There are no certainties in life, but it is important that the financial investments we commit to new or existing practices move our practices forward. Every dollar we commit is a dollar that\u2019s not given to our families, our practice team, or ourselves; each dollar should be committed based on strategic investing. This process puts you in a position to make the most informed, appropriate improvements, ultimately maximizing the performance of your practice.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">ROI = return on investment<\/span><\/p>\n<p><span class=\"author-bio\"><strong><a class=\"fancybox\" href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2015\/07\/T1507C07_Author.jpg\" rel=\"gallery\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-5287\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2015\/07\/T1507C07_Author.jpg\" alt=\"Travis Meredith\" width=\"100\" height=\"129\" \/><\/a>Travis Meredith<\/strong>, DVM, MBA, Diplomate ACT, is Contributing Medical Editor of <em>Today\u2019s Veterinary Practice<\/em> and Vice President of Member Services for Calico Financial. He received his DVM from Texas A&amp;M University, completed his residency in theriogenology at University of Pennsylvania, and received his MBA from University of North Carolina\u2014Chapel Hill.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u00a0<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Travis Meredith, DVM, MBA, Diplomate ACT Affinity Veterinary Center of Malvern, Malvern, Pennsylvania Axxiom\u2014The Practice Impact Group, Philadelphia, Pennsylvania Dr.<\/p>\n","protected":false},"author":1,"featured_media":2827,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":54,"footnotes":""},"categories":[364],"tags":[],"class_list":["post-1104","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-january-february-2014","clinical_topics-practice-management"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Moving Forward: Investing in the Future of Your Practice | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" 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