Mon 2.2 THEAKSTONE

7/31/2019 Mon 2.2 THEAKSTONE

1/6

Theakstone, Terry, Increasing profit by incorporating behaviour into practiceProceedings of the AVA Annual Conference, Canberra 2012 Page B1.2.1

INCREASING PROFIT BY INCORPORATING BEHAVIOUR INTO PRACTICE

Dr Terry TheakstonePositive Pet Solutions

PO Box 395Epping NSW 1710

IntroductionBehaviour is often an underutilized and neglected profit centre within veterinarypractice. While Puppy Preschools have become a popular component of somepractices, behaviour advice and recommendations are frequently poorly handled withinthe general practice setting and business opportunities and patient welfareopportunities are lost. Why and how to change this will be presented.This paper willalso explore the change and effect of starting this process within a practice.

Why change?Behavioural problems are the most common concern for pets and veterinary clients.

Overall (2003) and behaviour is an integral part of the veterinary consultation. It is, afterall, frequently the clinical sign recognized and acted upon by the owner. Unfortunately,within practice, behaviour without clinical illness is ignored or receives minor attention.These are multiple lost opportunities to benefit the patient, the owner and the practice.Behaviour counselling represents less than 1% of veterinary visits while only 25% ofveterinarians routinely enquire about behaviour issues and 15% of veterinarians neverenquire. Hetts, Heinke Estep (2004).

Mature veterinary practices have problems maintaining client numbers. Patient visitnumbers are decreasing or stable and there is a tendency to maintain income byincreasing the number of services provided to each patient and hence the dollar valueof each patient presentation. Practices now introduce compliance and wellness

programmes as a means of maintaining contact with clients.

Incorporating behavioural services within the practice makes good business sense inthat it potentially increases pet ownership and pet retention allowing an expansion ofservices offered. Ideally, this will result in a more harmonious relationship between petand owner leading to stronger bond between pet and owner, longer pet ownership andpet replacement after loss.

Pet NumbersThe number of dogs in Australia peaked in 1997 at 4.0008 million (Baldock 2004) andhave declined to 3.405 million in 2010. (ACAC 2010) The number of cats peaked at anestimated 3.4 million in 1988 and declined to an estimated 2.35 million 2010. These are

a 15% decrease in dogs and a 27% decrease in cats.

Perhaps even more concerning is that the decline in both cats and dogs is greater thanthe projected figures in Baldocks modelling. This has occurred at a time when thereare an increasing number of veterinary graduates and veterinary facilities attempting toservice a declining client base.


2/6


Along with declining numbers pet retention by owners is a client base issue. Weakowner/ pet attachment has been shown to be a major reason for relinquishment ofpets. Amalgamating the ACAC (2010) figures and RSPCA national statistics gives thefollowing table.

DOGS CATSNumber % of sold

dogsNumber % of sold

catsSold 2009 450,000 164,500Surrendered RSPCA 2009 69,383 15.4% 66,205 40.2%Euthanised RSPCA 2009 22,085 31.8% 39,495 59.6%Behaviour reason for euthanasia 11,406 16.4% 13,185 19.9%

This suggests that 51.6% of dogs and 33.4% of cats that were euthanized by theRSPCA were euthanized because of behavioural issues. There is a major wastage ofanimals within the pet care industry and behaviour is a major contributing factor to thiswastage.

This rate of loss is not improving. The RSPCA 2009-2010 figures have 53.5% dogs and33.00% of cats euthanised for behaviour problems. Veterinarians have the ability tohave a major impact on this wastage. Most animals surrendered to a shelter have beenseen a veterinarian within the previous 12 months. Scarlett et al (2002)Preventing our patients early surrender and potential euthanasia can have a significanteffect on practice income because the longer the retention of clients and their pets themore they spend in the practice.

$ spent per annum on Pet % increaseYear 1 $248.00Year 2 $360.00 45.2Year 3 $440.00 22.2

Wood (2010)

Profit centresBehaviour is a neglected profit centre within practice. Although Puppy Preschools andKitty Kindergarden have been promoted for years and the benefits for the pets andtheir owners recognised not all practices run these programmes.

Those practices that run these programmes rarely offer other behaviour services andyet an active promotion of behaviour can provide an income that matches otherimportant profit centres within veterinary practice.

Profit Centre % Gross IncomeHeartworm 4.95%Boarding 4.75%Hospital services 4.36%Other services 4.04%Anaesthesia 4.01%Radiology & Imaging 3.83%

National Commission on Veterinary Economic Issues


3/6


Within the authors practice direct income from behaviour work was within the 4.0% -5.0% level and growing. Apart from an additional income stream the major benefit wasthat clients started to view the clinic as a source of behaviour information and madecontact with issues as they arose.

OShea (2011) similarly found that the graduates of Puppy Preshool provided apatient and client base that contributed more to the practice than non graduates.

HowA benefit of behaviour is that significant parts of a behaviour programme can beprovided as a passive income stream without veterinary involvement. It is essentialthat the people delivering the advice be appropriately trained. Too often it is passed onto the clinics nurse to run with minimal training and support or passed to an outsidetrainer without consideration of the methodology used.

StaffDevelopment of behaviour as a profit stream within practice needs the practice

members to be committed to promoting this area and for the veterinarian, nurse andtrainer to work as a team. All have important parts to play and to achieve results theyall need appropriate training. Nurse / Trainer selection is as important as any other staffselection and should be selected with care.

Nurses need more than the component found within the Cert IV nurses course andtrainers should be similarly qualified. The DELTA Cert IV course in Companion AnimalServices provides a solid base for nurses and trainers. They should follow theprinciples outlined in the AVBIG Reward Based Training Brochure. Errors in staffselection at this crucial stage can be harmful to both the pets and to the practice.

As the staff was trained every mention of behaviour within the practice was tagged for

a follow up by a behaviour nurse. This meant that phone calls, front desk enquiries ordiscussions and consultations were all tagged for a follow up call. These calls weremade when the behaviour nurse could deal with them without intervention. Triage ofthese issues occurred with some being referred back to the veterinarians for attention,some entering training programmes and some recommended a referral. Thecommonest reason cited for not promoting behaviour within a practice is the timecommitment required. Triage helped solved some of this issue.

Attendance at Puppy School was considered essential and promoted at receptionbefore and after consultations as well as during any consultation. Pups were frequentlytaught to sit on a hand signal as the consultation proceeded and then requested to sitin the reception area. Some clients even were asked to take their pups elsewhere if

they would not attend.

As behaviour is promoted in this fashion it is essential that all staff members of thepractice follow the same protocols and have the same approach. Our behaviour nursebecame important as a resource for educating other staff members.

Concepts of dominance and punishment as motivation for and a means of correctionbehaviour need to be resolved before this process starts. One veterinarian referring todominance or using punishment to stop behaviour undermines the whole process.


4/6


SiteAlthough there is a temptation to hold the school within the surgery it is more importantto have an appropriately sized site to allow adequate separation of the various pupsand to allow the whole family to attend. As the reason for the school is to preventsocialisation problems it is essential that people and pets are not overcrowded. Thismay require separation of the school from the practice site. Failure to have adequatespace may actively promote problems in attendees rather than resolve them.

DevelopmentLindeman (2006) suggested that to prevent being overwhelmed start small with one ortwo ideas and then to gradually expand the services and products. Well run puppyclasses soon progress into juvenile classes, adult classes, one on one training andproblem resolution. Promotion of the staffs ability to deal with behaviour problemsquickly expands the client expectations and the practices workload.

Not all practices will progress to problem resolution because of the technical difficultiesand time constraints. Most practices do have the capacity to incorporate behaviour

consultations. The Bayer Veterinary Care Usage Study (2011) found that only 61.7% ofappointments are currently filled. How often does the veterinarian with a 15 minuteconsultation spend extra time with clients and not charge?

The only ways to increase the number of consultations and fill the appointment book isto increase the frequency of visits of existing clients or to attract new clients.Compliance and wellness programmes such as geriatric programmes, dentalprogrammes and weight loss programmes all aim to increase the frequency of visits.

It is suggested that behaviour wellness programs outlined above will be even moreproductive for the practice because behaviour wellness programs act to maintain theclient base at the puppy and juvenile life stage rather than later in the life cycle.

Client educationThe development of a behaviour wellness program is closely amalgamated with clienteducation where appropriate pet selection is encouraged, realistic expectations of theowner toward the pet, behavioural needs of the pet, responsibilities of pet ownershipand pet care are emphasized. (Hetts, Heinke, Estep 2004) It is important for theveterinary clinic to promote education within their client base because of the amount oferroneous material in the public domain and the effect that this may have on thewelfare of their patients.

In a survey of cat marking behaviour Bergman, Hart, Bain et al (2002) found that 93%of owners sought advice from non veterinary sources as well as or in addition to their

veterinarian while 26% who did not contact their veterinarian failed to do so becausethey did not believe they could assist. Actively educating clients promotes the clinic asthe primary source of veterinary information.


5/6


Practice BenefitsThe tangible benefits of a behaviour program can be significant and equivalent to otherimportant profit centres as has been discussed above. However, the intangible benefitsrelate significantly to the health of the veterinary practice.

A strong human animal bond is essential for clients to maintain strong relationshipswith a veterinary practice. Behaviour as an emphasis within the practice strengthensnot only the client pet relationship but more importantly the client practice relationship.it is suggested that an emphasis on animal welfare creates business opportunities thatresult in your business welfare.

McDowell (2010) a human pediatrician, described how his career started treatingchildhood diseases but because the needs of the child has changed and his work isnow primarily spent treating behaviour disorders.

Our patients needs are changing as their management and control has changed andas veterinarians we should give a similar emphasis to our patients if we wish to

maintain healthy veterinary practices.It is not the strongest of the species that survives, nor the most intelligent thatsurvives. It is the most adaptable to change.

Charles Darwin


6/6


ReferencesACAC (2010) Contribution of the Pet Care industry to the Australian economy 7thedition. Animal Health Alliance

Baldock, C., (2004) Australias declining pet populations- a shared challenge. Adiscussion paper prepared for the Australian Veterinary Association

Bayer Veterinary Care Usage Study Part II American Veterinary Medical AssociationConvention St. Louis 2011

Bergman, L., Hart, B. L., Bain, M. et al (2002) cited in Seibert L M, Landsberg GM,(2008) Vet Clin Small Anim 38 937-950

Hetts, S. Heinke, M.L., Estep, D.Q. (2004) Behaviour wellness concepts for generalveterinary practice. JAVMA 225 No 4 506-512

McDowell, M., (2010) Behaviour in the pre-language child Proceedings of Animal

Behaviour Chapter and Animal Welfare Chapter Australian College of VeterinaryScientists

National Commission on Veterinary Economic Issues cited Wood, F., (2010) AustralianVeterinary Practice Managers Association Conference Proceedings

Overall, K., (2003) Medical Differentials with potential behavioural manifestations. VetClin Small Anim 33 213-229

RSPCA Annual statistics 2008-2009

RSPCA Annual statistics 2009-2010

Scarlett,J.M. , Salman MD, New JG et al J. Vet Med Assoc 2002; 220; 306-311

Wood, F., (2010) Australian Veterinary Practice Managers Association ConferenceProceedings

Documents

Mon 2.2 THEAKSTONE