Cascade Veterinary Practice: changing times

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Cascade Veterinary Practice


changing times




CHAPTER OVERVIEW


This case study explores the impact of poor management and changing demographics on Cascade Veterinary Practice, a mixed practice based in rural Australia. The veterinary partnership, owned by husband and wife team Tim and Mary Blake, is in serious difficulties as a result of their personal problems taking priority over the business, and there are no contingencies in place. The case shows how key performance indicators, as contained in the practice’s extensive computer system, were ignored, and as a consequence the practice is in serious financial difficulty. The practice’s issues are considered in light of both its internal and external operating environments. Although fictitious, this case scenario offers a valuable platform for identification and consideration of the opportunities for reinvigorating a floundering practice.




Introduction


Veterinarians Drs Tim and Mary Blake, husband and wife, own a rural veterinary practice in Cascade, rural Australia, and a small branch holding at Mandow, 25 km north. Both Tim and Mary are tiring of veterinary practice and need a new lease of life, professionally and personally. Staff are concerned and at a loss as to what to do. Dr Dean Bletchley and Dr Tamara Savorio are veterinarians employed within the practice. Dean and Tamara have discussed the issue between themselves and have arranged to meet with the principal veterinarians to see if they can contribute to a solution. Tim and Mary have been great bosses for Dean and Tamara, and they really appreciate the support they have been given as new graduates. A preferred outcome would be that Tim and Mary would allow Dean and Tamara to get involved in the running of the practice and then they could take a well-earned break. Dean and Tamara feel up for the challenge; it could well open up opportunities for both of them, either by way of partnership or providing them with valuable experience for their own career paths.


Together, the four of them decided to meet on the Monday morning of the long weekend. Mary arranged with Kristy, a previous associate, to act as ‘locum’ that day so the full-time vets of the practice could get together. Kristy was fantastic like that, able to work from time to time as needed.



Background


Cascade Veterinary Practice is located in a rural area, although the town is undergoing urbanization. Small animal consultations are increasing and large animal call outs are decreasing. There are currently the two partner veterinarians (Drs Tim and Mary Blake), the two associate veterinarians (Drs Dean Bletchley and Tamara Savorio) and four nurses. Seven years previously, the practice employed three veterinary associates and six nurses.


Tim and Mary met at veterinary school, married and graduated 25 years ago. After graduation, both Tim and Mary were keen to move chiefly into large-animal work but retain some small-animal work. They obtained their first veterinary positions in competing practices. After 3 years, they decided to purchase a large-animal practice of their own in a different area. The practice had been in existence for 24 years at the time Tim and Mary purchased it. It was a one-man practice and the veterinarian was looking forward to retirement. The practice, as a whole, was a ‘good buy’ back then, selling for $35 000 on ‘goodwill’ plus the Cascade building, which they purchased from the previous principal 6 months later. Tim and Mary struggled in the early days to make ends meet, with three young children and a sizeable loan with which they had financed the business and land purchase. Over the ensuing years, Tim and Mary made some improvements to the main clinic, which was originally a renovated bungalow. The changes were fairly minor, comprised of a new coat of paint, linoleum flooring, installation of office equipment and renewal of X-ray and anaesthetic machines.


To add to their main clinic in Cascade, Tim and Mary had purchased another building 15 years ago: a large shop (a former auction house) in the small town of Mandow, 25 km away. The practice only used rooms at the rear of the shop because the front parts of the building were tenanted. However, both tenants have recently vacated, leaving the main street frontage section empty.


Over the last 22 years, Tim and Mary grew the practice to five veterinarians (including themselves), four full-time nurses and two part-time nurses (all local people). However, now, the practice has just four full-time veterinarians: the partners and the two associate veterinarians, Dean and Tamara. These are supported by three full-time nurses and one part-time nurse. The full-time vets are each allocated a day a week to service the Mandow area, with Wednesdays covered according to booking demand. The Cascade clinic is open from 8.30 a.m. to 6 p.m. Mondays to Fridays, and from 9 a.m. to 12 noon on Saturday mornings. All the nurses work at Cascade. The Mandow premises are only open when the veterinarian is actually there, between calls or to take appointments; the Mandow clinic functions chiefly as a base for the veterinarian. Mandow, 25 km away, is serviced by a gently undulating, fairly straight and good bitumen road, such that the veterinarians can generally drive to Mandow in 25 minutes.


Dean, the older of the two full-time veterinary associates, has been in mixed practice for 4½ years and is quite ‘comfortable’ in his current work place. Dean spends his free time working in community groups and is planning to volunteer for a dog desexing programme overseas in the near future.


Tamara, who graduated 2 years ago, is developing into a very competent mixed-practice veterinarian, keeping herself busy studying for her membership of the Australian College of Veterinary Surgeons in Reproduction. She is very interested in reproduction in all common domestic species, and is particularly enjoying the work she is involved in with Tim, especially ultrasound pregnancy testing of horses, alpacas and goats.



The external environment



The profession


In the 1980s, Australian large-animal veterinary practices certainly ‘rode on the back of the cow and the sheep’, as did the Australian economy in general. With the Brucellosis and Tuberculosis Eradication Campaign (BTEC) and wool floor price schemes for the farmers around 1970–1990, cash flow was good for veterinary practices and wool producers, respectively. With the BTEC work, which was paid by the government, veterinarians regularly visited all cattle properties, so they knew their farm clients well. Cascade Veterinary Practice was a typical large-animal practice, which originated in the farming environment described above. Like many others, it had a generally casual approach to appointment scheduling, drug handling and providing free advice. Antibiotic resistance was virtually unheard of. Similarly, resistance to anthelmintic drenches was not yet recognized.


By the mid 1980s, brucellosis and tuberculosis were close to eradication in the more intensive livestock areas, so the need for private veterinarians to be harnessed into government paid work decreased. Then, around 1991, the wool ‘floor price’ was removed, and purchasing by the Australian Wool Corporation (AWC) for the stockpile was discontinued. This caused incomes to plummet for wool enterprises, the effects of which flowed on to businesses serving the farming community, including veterinarians.


Over the last decade or so, cattle and sheep prices have stayed relatively static, while costs of doing business have risen annually by at least the Consumer Price Index. Farming profits have narrowed, and farmers’ core business now includes being ‘land caretakers’. Farming enterprises are being sold to neighbours, so farming units are becoming much larger while still retaining the same level of management and labour units, thus becoming more efficient. In addition, for the last 2 years, eastern Australia has suffered several years of drought from a prolonged El Niño effect in the Pacific Ocean. As such, the local population of cattle and sheep has reduced to about 60% of previous levels. Now, in 2013, the Cascade and Mandow areas are entering a third year of drought.

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  4. Ellie Prior: starting out in practice

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Oct 9, 2016 | Posted by in GENERAL | Comments Off on Cascade Veterinary Practice: changing times

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