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Issue: 74 - Feb 16, 2015
A System is the Solution
By: Peter Weinstein, DVM, MBA
Veterinary Success Services

~~AUTHOR’S NOTE—In May 14, 2010, Impromed published an article with the same name in this newsletter.  This article contains some of the same information updated to support the release of, “The E-Myth Veterinarian”, co-authored by Michael Gerber and Peter Weinstein, DVM, MBA.  You can purchase the book at http://michaelegerbercompanies.com/web/the-e-myth-expert-series/#veterinarian.  Happy reading.  But more importantly, happy taking action.

 

THE VETERINARY MODEL

For decades the veterinary model went something like this:

  •  Work extremely hard to get into vet school; get into vet school and
  •  Work extremely hard to get through vet school; graduate from vet school and
  •  Work extremely hard as an associate for a few years; think that you can make more money by opening your own practice or by buying a practice and then
  •  Work extremely hard as an owner to try to attain the veterinary dream; and then
  •  Work extremely hard to find someone who wants to work extremely hard and will buy your practice.

The veterinary model mimics beautifully the model reproduced thousands of times each day as entrepreneurs all over the world take on the world of small business.

The V-Myth

In 1986, Michael Gerber wrote his first book entitled, “The E-Myth”.  With apologies to Mr. Gerber, I have applied his concepts to veterinary medicine into something that I call “The V-Myth”. 

In his book, Mr. Gerber discusses the E-Myth Point of View.  Here it is:
“The E-Myth is the entrepreneurial myth.  The E-myth says that most businesses fail because they are not founded by entrepreneurs, but by technicians, suffering from an ‘entrepreneurial seizure.”  The E-Myth says that all technicians, anyone who does technical work of whatever kind, make the same fatal assumption: that because they understand how to do the technical work of their business, they understand how to build a business that does that work.”

The technician goes to work IN his business!
The entrepreneur goes to work ON his business!
Understanding and acknowledging this difference, the difference between working on your business and not in your business, is what will determine what you will do everyday at “WORK”.

So, what is the V-Myth?  Well, looking at the discussion of the Model Veterinarian, we are propagating in many cases the E-myth legend.  The associate veterinarian, working, working, working, working, everyday doing it, doing it, doing it suddenly has an epiphany.  Why should I make money for Dr. Dolittle, I would be better off taking what I learned and doing it for myself.  They have their own ‘vetrepreneurial’ seizure and either buy Dr. Dolittle’s practice or go a few miles down the road and build their own practice.  They thought they were working for a lunatic before….Now look at the lunatic they are working for!!  (A mirror works well to answer this question!)

What we need to learn is what it takes to create a ‘world class organization’ that meets our needs as entrepreneurs, technicians and managers.  If we look at Starbucks, McDonalds, Home Depot, Staples, Subway, they all have a replicable system.  It is consistent no matter where the store is.  I am suggesting that we need to model their consistency by developing systems within our practice that work without our having to work on them daily. 


How is this going to help?
If you ever want to stop working IN your business and start to work ON your business you need a system that will work without you being there.  Of course this can be a quite the challenge since we love to name our practices after ourselves, “Dr. Smith’s Animal Hospital” “Young Animal Hospital”

Working on your practice is developing systems that operate effortlessly, mindlessly, systematically, repetitively, predictably, consistently, and uniformly.  No matter who is there working the system.  No matter who the client is.  No matter the situation.  Every single time.

Working in your practice is spaying cats, removing fractured carnassials, hiring animal caretakers, filling out deposit slips, filing radiographs, etc.

The entrepreneur works on their practice.  The vetrepreneur works in their practice.  Everyday.  Day after day. Until one day, they either lose it, sell it, or have the big one while squeezing anal glands. 

So, who is it you want to be?

ACTION ITEM: when you get back into your practice, make a list of the things that you do everyday.  Everything.  Put a “T” next to those things that are you acting as a technician.  Put an “M” next to those things that are you acting as a manager.  Put an “E” next to those things that are you acting as an entrepreneur.

Enough already, tell me about the systems I need and how to develop them!
I’m glad you asked.  A system is a set of things, actions, ideas, and information that interact with each other, and in so doing, alter other systems.  Almost matches the way a body works.  It is basically a recipe.

But what is a SYSTEM?  The system is a clearly defined manner in which a business works, or basically HOW it is done!  How everything is done!  The system dependent or process dependent business creates replicability in the way EVERYTHING is done.  If your business depends upon YOU, you can’t replicate it twice with any assurance that it will work.  However, with a system in place, the business doesn’t need YOU, it has the system. Thus, you can work ON your business system (model) and not IN your business. 

In each of these points, the goal is document, document, document and train, train, train to a level where habits and consistency reign.

VISIONING
What do you want for your life?  Both your business life and your personal life.  Your business is a tool to accomplish those things that you want for your personal life.  You have to know what you want for your personal life so you can get your business to do it for you.  Your business is a means to an end!! Or it’s just a job! 

As a team member working for a veterinarian, if you know the direction of the ‘vetrepreneur’s’ primary aim, you will better be able to develop the system and thus contribute to the success of the system and the business.

ACTION ITEM: Create a personal vision.  Think about it, Visualize it. Now, write it down!!  Share your aim with those around you-family, friends, team.

OBJECTIVES
Can you envision the size, the amount of income, profits, the number of staff, the products sold, the services provided, the hours of operation, etc.  What will it feel like, look like, act like for the customer/client?  How will it differentiate itself from other veterinary hospitals? 

If you have already started your practice it is NOT too late to create this vision and then work ON your practice to achieve it.  Meet with your practice leadership to get their thoughts, insights, and experiences.  They will have details on areas that you might have never thought of.  Take all this information and develop the systems to achieve your objective.  Focus on every detail.

If you are thinking of starting a new practice from scratch or buying an existing practice, you should try to shape your strategic objective before you start your business.  Visit other practices, tap into the various resources that are available: architects and designers, attorneys, accountants, consultants, colleagues, etc.  Focus on every detail.  It is the details that will differentiate your business from all the others.

THOUGHT:  If you DON’T know what your business is going to look like when you’re finally done, how will you know when you get there?

ACTION ITEM: Picture the final product that you will call ABC Animal Hospital.  Envision every detail from dress code to fees.  Think about it. Visualize it.  Now, write it down! 

ORGANIZATIONAL DEVELOPMENT
If you aren’t going to be the one to do all the work, you will need an organization to help you achieve your vision.  In the beginning, you might be the one that is in charge of operations, finance, marketing, human resources, etc.  As the practice gets bigger, others will fill in these roles as you change from wearing all the hats to just wearing the entrepreneurial hat.  However, you MUST think of the role as a function of the hospital NOT as the person who is doing the job.  Create the roles and the associated job description, job expectations, etc. so that ANYBODY who is qualified or who can be trained could step in and perform the functions. 

If you want to think of this as a corporate organization chart, you will start your business as CEO, CFO, COO, Chief of Marketing, Chief of Sales, Janitorial Supervisor, etc.  Each of the ‘corporate roles’ or ‘boxes’ must be filled in.  And more, each box MUST have clear expectations.  In practice, the people working IN the boxes would be the receptionists while the people working ON the boxes would be the managers or supervisors or owner/entrepreneurs. 

Your goal as veterinarian/owner is to define the box, fill the box, and get out of the box.  Your objective is to delegate NOT abdicate.  By creating a system for each box or role, you change from a people dependent organization to a process dependent organization.  Your Organizational Strategy must flow from your Strategic Objective that of course, flowed from your primary aim. 

Action Item:  Think of the organization of your practice when it is mature/completed.  Are you filling in all the boxes?  Do you even have clearly defined boxes?  Even if you are the ONLY one to fill in all the boxes, make a list of all the roles that need to be filled for your practice.  E.g. CFO/Bookkeeer/Accountant; Chief of Marketing; COO/Hospital Administrator; Chief of Service; etc.  For each box/role that you created, define the job description and expectations, the commitment and accountability, not just for you but also for the replacement that you are going to hire.  SOON!

One more thing, start at the bottom and work up.  Create the positions at the bottom, those that do the tactical work and work up the chart to the manager’s roles, the strategic workers.  If you don’t have the tactical people, you are doing the tactical work.  And then who is doing the strategic work?

Finally, the rules that you create for each box MUST be lived by everybody. If the owner doesn’t obey, extol, honor and follow the rules, how do you expect anyone else to take them seriously? 

MANAGEMENT DEVELOPMENT
The success of a Management Strategy should NOT have to depend upon the people.  The success comes from the development of a management system that ANYBODY can oversee.  The management system eliminates the unpredictability of people by orchestrating the process by which management decisions are made by eliminating the decisions whenever possible.  Huh? 

The goal is to create a system that produces the results you want automatically.  The goal is to create an effective and efficient model that runs automatically.  This system is what keeps and finds clients. 

The answer is found in an OPERATIONS MANUAL.  A series of checklists that are used to train, teach, educate, and monitor the day to day workings of the hospital.  The checklists itemize the specific steps needed for a person to do his or her job.  Each ‘box’ has its checklist.  The checklist is used to confirm accountability to the defined standards.  By signing at the bottom, the team member indicates that they did their job.  If you sign and don’t do the work, it is grounds for dismissal. 

Each line item on the checklist has been described and delineated in the manual.  Each line item on the checklist has been trained and the trainer is accountable for ‘signing off’ on the completed training.  It becomes very easy for the manager then to just spot check the checklists.  The checklist is the system.  The people perform the system.  EVERYTHING that you do in the hospital can have a checklist and an accountable person.  The AM receptionist will have checklist that is different than the PM receptionist.  IF you have more than one receptionist on at a time, each will have their checklist and accountabilities.  And of course this can vary every day.  The goal of the checklist is predictability.  The little things on the checklists that are routinely forgotten won’t be forgotten.  The small things are what make a difference. 

As a consultant, I have always felt that checklists were great for training but were demeaning when used as a whip to beat people into action or when used to look for failure to perform rather than quality performance.  It is in the way that the checklists are used that are the difference here.  And of course, it is the people using the checklists that make the greatest difference.

ACTION ITEM: Get cracking on your Operations Manual.  Create the checklists (skeleton).  Flesh out the checklists (add the meat).  Review, monitor, update.  Now delegate the checklist monitoring to your managers.  Let them oversee the system. 

PEOPLE DEVELOPMENT
If you have gotten this far into this discussion, you are asking yourself: “And how the heck am I going to get my people to do this?”  You’re not!  You can’t get people to do anything they don’t want to do anyhow.  You need to create a work environment where your people WANT to do it.  People like games, so create a game that they want to play.  Create the environment where doing the work is more important to your people than NOT doing it.  Doing it then becomes a way of life. 

To do this, start by treating your people as if they are important.  Take the operation of the hospital seriously and let everybody know it.  The hospital is a reflection of your primary aim and an expression of the owner.  Your people will appreciate this. 

Stop looking just for employees but more for players of your game.  Start hiring people who want more than just a job.  Stop the current approach of hiring, welcoming and sending off to work all within the first five minutes of a new hire coming in the door.  Take the time to introduce your new hires to the culture of the hospital.  This will develop a new level of respect.  Team performance comes from respect for the ownership and management.  Communicate your vision and primary aim well before you ask anybody to work on the necessary tasks.  Emphasize that the level of the work that somebody does reflects who you are.  Sloppy work says you’re sloppy. 

Work with your people on the concept that the idea (why) behind the work is more important then the work itself (what).  If you get the ‘why’ across the ‘what’ will follow!  Your people strategy is how well you communicate the ‘game’ to them BEFORE you hire them NOT after they are already working.  What is your game?  What are the rules? 

Of course, your people strategy is an extension of your management strategy and its Operating Manual and the Organizational Strategy that reflects your Strategic Objective and Primary Aim.  Communicating the expectations of the business, the standards that have been established for performance and accountability and the vision will motivate both New people as well as current team members.  And of course, it is always how leadership acts! 

Above, we have talked about systems for every facet of the hospitals operations.  This is where you create the system that you will use to recruit, hire and train new team members.  Starting with communicating the hospital’s vision and continuing through a scripted process to ensure you end up hiring the best people for your system.  Remember, the system produces the results.  The people manage the system.  And it’s the system that differentiates your business.

ACTION ITEM: Create a script describing why you do what you do and how.  Meet with the best applicants to discuss their feelings about YOUR business and how they see their role in working towards the vision.  Script follow up calls and letters of acceptance and rejection.  Create a scripted training program that lasts sufficiently long to ensure a skilled team member with confidence to perform and NOT just a warm body.  What’s the rush?


SUMMARY:
Consistency comes from systems!

After reading the above, it must seem like a daunting task to systematize your practice.  How much time will it take to develop operation manuals?  How long will it take to script every client interaction?  How can I possibly figure out what to measure to determine the success of my business?  I don’t have time to hire people with a formal system, there aren’t enough good people out there, I just need a warm body anyhow.   There is NO way that I am going to trust anybody to do the things that need to be done, I am the only one who can do it. 

Now, think about it.  If you continue to do what you have been doing are you not just burying yourself deeper and deeper into your practice?  Isn’t your practice becoming more and more dependent upon YOU to be the one to do everything?  What will happen in your absence?  How can you ever take even a day off?  Would I want to buy something that is so dependent upon ONE individual?  Aren’t you working yourself to death and your business too?

The minute you bought or built your practice you started to work for somebody else.  Who?  Your buyer!!  If you have built a practice based upon a system, your buyer will be purchasing a world class, turnkey operation, that will readily allow her to be profitable and focus on working on the business rather than just in it.  On the other hand, if your practice is YOU, are YOU for sale?

Think about it, the system is really the solution!!

References:
Gerber, Michael.  The E-Myth
Gerber, Michael.  The E-Myth Revisited
Gerber, Michael and Weinstein, Peter, DVM, MBA.  The E-Myth Veterinarian