Mandatory Bundled Wellness Plans

Veterinary
Hospital
Managers
Association
PO Box 2280
Alachua, FL 32616-2280
admin@vhma.org • www.vhma.org
The official newsletter of the Veterinary Hospital Managers Association
October 2012
Mandatory Bundled Wellness Plans
This article was previously run in the OVMA Focus, July/August 2012. Reprinted with permission.
Webinar
November 14: Collaborate: Shared
Success through a Charitable Foundation
Meeting and Conferences
Management Exchange:
February 8-10, San Diego, CA
Annual Meeting and Conference:
September 26-29, Charlotte, NC
What Insights Await YOU at the
VHMA Management Exchange?
VHMA
Business Alliance Partners
Topics Covered
February 8-10, 2013
Catamaran Resort Hotel & Spa
San Diego, CA
Every professional working in veterinary practice management
has a unique perspective to share, an invaluable piece of advice,
a strategy for performing his or her job better.
The Veterinary Hospital Managers Association’s “Insight Through
Interaction” Management Exchange brings these personal
experiences to life through a series of dynamic, peer-led
presentations. Organized panel discussions, workshops and
group activities strengthen friendships and maximize the
learning experience. The setting is informal, and the educational
impact is outstanding.
r*nnovative ways to improve client
communications
r4USBUFHJFTGPSSFEVDJOHXPSLQMBDFDPOóJDU
r0QQPTJOHQFSTQFDUJWFTPOIPUUPQJDT
r*NQMFNFOUBUJPOUSJVNQITBOECMVOEFST
r4IBSL5BOLQSFTFOUBUJPOT
r#MPHHJOHBTBNBSLFUJOHUPPM
r&UIJDTQBOFMEJTDVTTJPOT
r*EFBFYDIBOHFTBOETPNVDINPSF
M
ost veterinarians are reluctant to enforce clinical protocols on their clients. For
a clinic to enforce wellness plans was a radical departure in a profession that is
known for dipping its toes in the water long before it ever wades in.
The Collierville Animal Clinic’s annual wellness plan includes:
• Annual physical examination
• All vaccines required (based on individual patient risk factors)
• Blood panel including heartworm test
• Fecal test
• Weight recording along with nutritional counseling
• Complimentary nail trim
According to Mr. Gerard Gervasi, hospital administrator at Collierville Animal Clinic,
rolling out the bundled wellness plan was a lot easier than doctors and staff predicted.
Expecting the worst, staff and doctors developed contingency plans to use if clients
resisted the new protocol.
Eight months before the mandatory wellness plans were introduced, staff and doctors
took time to explain to each client that a new wellness plan was going to be introduced
the next year. The staff handed out fact sheets explaining what tests would be done and
why, showing the baseline values for a healthy pet and how certain values can predict the
onset of disease.
When he was developing the pricing, Mr. Gervasi first went to the reference lab to
negotiate a better price based on the projected increase in the quantity of blood panels.
“We were not diagnostic heavy, we were sending them one or two tests per day; now we
were poised to send them several thousand per year. They came back with a really good
price and this was passed on to the client.” Gervasi did not see any need to discount
professional services to clients; he only passed on the lab savings.
When mandatory annual wellness plans were introduced, average revenue per
transaction jumped by $35 and total revenues in the hospital went up 15%. The testing
protocol was so effective, hospitalized cases went down 33% after the first year because
the new blood testing protocol was catching things before they became critical.
®
5IJTQSPHSBNPíFST$POUJOVJOH&EVDBUJPO)PVST
Why don’t you join us this year? To register, visit www.vhma.org
4 • VHMA • October 2012
(Continued on page 3)
VHMA • PO Box 2280, Alachua, FL 32616 • 518-433-8911 • admin@vhma.org • www.vhma.org
Welcome
New Members
Mary F. Allen
Diane Beebe
Sabine Gisela Blomberg
Ashley Brown
Kathleen Ann Buchanan
Annie Chevrier
Carol Ann Coffey
Stacey Connell
Sylvia Elizabeth Daniels
James M. Doleski
Dani Fried
Shayne Taylor Gardner, CVT
Alexandra Faye Gill
Sallye Gregg, DVM
Robert T. Heidecker, DVM
Jennifer Heidecker
Lisa Heiting
Heather Heitz
Jamie Lynn Horning, BSBA
Sara Elizabeth Hurd
Cathy Innes
Tracey Johnson
Pinky V. Lanier, BS. HRI Mgmt.
Darrell Ogden
Donna Oster
Jessica Paige Pritchett
Mark Ransom
Dana Rhoden, CMP, CMM
Amanda Roper
Daniel Smith
Amanda Stadler
Nicole Emily Welkener
The Practice Pulse is the official
publication of the Veterinary
Hospital Managers Association
(VHMA). All rights reserved. No
part of this document may be
reproduced in any form without the permission of VHMA.
Opinons expressed in articles
and editorials of this newsletter are those of the author and
not of VHMA. Comments can
be directed to Christine Quinn
Shupe, CAE, executive director,
at christine@vhma.org.
2 • VHMA • October 2012
President’s Message
An Event To Remember
W
e’re back! I just returned from
the VHMA Annual Meeting and
Conference that was held in Vancouver,
BC. It was four days of excellence,
opportunity, and networking with
colleagues. I can honestly say that the
Annual Meeting and Conference is one
of the Association’s highlights.
I was thrilled to meet new members and
reconnect with old friends. This year we
honored our CVPMs who celebrated
the certification’s 20th anniversary.
The celebration culminated with a
pinning ceremony and dinner cruise.
Congratulations to all who have earned
the CVPM!
Another twist this year was to host the
Legal Symposium at the front end of the
Annual Meeting and Conference. The
human resources issues addressed during
the symposium equipped participants
with topical and essential information
about hiring and firing issues. It was
exciting to see the reactions from first
time attendees who loved the format of
this program.
This year’s Annual Conference program
was outstanding. I spoke with many
members who are excited to put the
insights and practices gleaned from the
session to work in their offices as soon as
they return to their practices.
But even when we weren’t learning in
formal sessions, we were learning from
each other. The great thing about the
VHMA is that we care deeply about the
profession and each other. We puzzle out
issues and ask for feedback as we network
between sessions, we share advice as we
wait in line, and we are always ready to
provide input to help a colleague along.
The hotel was perfectly situated on the
Vancouver’s Coal Harbour. The view
from the meeting rooms was outstanding
and had us all transfixed as we watched
the float planes comes and go. What an
unforgetable city!
We all lead busy lives and at times
communicating with one another
through different forms of social media
seems so easy and attractive. But I
believe you cannot underestimate the
value of meeting face-to-face with other
professionals to cultivate and nurture
relationships. What may begin as a
professional relationship often evolves
into a friendship.
Remember to stimulate the mind and
enhance your environment!
Tom MacDonald, CVPM
LEGAL
MATTERS
Mandatory Bundled Wellness Plans
Question:
Mandatory annual wellness testing at Collierville has been responsible for an increase
in diagnoses of diabetes, thyroid disease, Cushing’s disease, and even heartworm disease
well before clinical signs become apparent in the pet.
One of our receptionists came in
with dreadlock hair extensions, part
of which was dyed bright blue. Our
Uniform and Appearance Policy
states, “A neat, clean and professional
appearance is required...” with no
specific mention of grooming or hair
style in the rest of the policy. This
person did talk with me about two
months prior, saying that they had
thought about getting dreadlocks.
I was very clear at that time when I
told this person that dreadlocks were
unacceptable.
1) Is it legal for the practice to specify
or forbid a hairstyle in an effort to
maintain our professional atmosphere?
2) Can I proceed with disciplinary
action? We have a very clear policy on
progressive disciplinary procedures
- verbal, written, suspension/probation
then termination. My plan was to apply
the next stage of discipline for each day
this person chooses to come in with
this hairstyle.
Legal Advice:
“My sense is that while your policy
statement may be ambiguous, the
hairstyle selected by the employee
is legitimately problematic for
the employer both in terms of
“professionalism” and, in my view,
safety. Having longer hair in a
veterinary clinic can obviously
present some safety issues in terms
of entanglement with devices and
ensuring clear sight lines. The fact that
you had voiced your concerns at an
early stage is also helpful. In my view,
unless the employee can raise some
form of argument based upon ethnicity
or religion, then dictating, within
appropriate limits, the hairstyle to be
worn by clinic staff is fully within the
lawful range of directions that can be
provided by an employer.”
Douglas C. Jack, Esq.
(Continued from page 1)
With the new wellness testing protocol, heartworm testing was transferred from exam
room SNAP testing to a reference lab. Moving heartworm testing to the reference lab
caused an immediate increase in heartworm positive results. “This was interesting for
us when this happened,” Mr. Gervasi explained. “When we moved all of the heartworm
testing to the reference lab, they were able to pick up more because of their more
sensitive equipment. We even took positive samples from the reference lab and tried
SNAP tests on them. In some cases there was the hint of a line (indicating a positive) but
we had to admit that we could have easily missed a lot of them if it was done in the exam
room.”
Like most practices, there are fewer cats coming into Collierville Animal Clinic than
dogs. Clients only bring them when they are sick and many clients will readily bring
in their dog every year but hold off on bringing in the cat for a number of reasons.
“Last time I brought him here he was mad at me for a week,” is what they often hear.
To educate their cat clients, Gervasi introduced blood pressure monitoring for cats
and added it to the wellness plan. This has helped them pick up on more cases of
hypertension.
After a decade with mandatory annual wellness plans, Gervasi is convinced that the
annual wellness test is more reliable than the client for identifying changes in the pet. Pet
owners may notice a change in their pet, but not realize it’s the onset of a problem.
Pressing the point I asked, “Suppose I have a three year old dog with no clinical signs
and I want everything but the blood test?” ‘Well,” Gervasi responded, “for starters, how
do you know there are no clinical signs? Just the other day we had a case in here of a dog
that looked perfectly healthy but when we did a blood panel we found out the dog had
Cushing’s disease.”
“OK,” I responded, “then let’s say I can’t afford the blood test.” “You know,” Gervasi
responded not breaking stride, “you can’t afford not to do the blood test. You need the
heartworm test right? Well the increased cost of the whole blood panel is only a couple
of bucks more than heartworm alone and if you price out all the services separately it
will cost you $140 more. This is a good deal.”
‘We might have to work a little harder with new clients who come from a hospital that
does not offer mandatory annual wellness testing and plans but this program makes
sense to them when we explain it,” says Gervasi. While many hospitals across North
America are struggling with increased client reluctance to go to their veterinarian,
Collierville Animal Clinic is well ahead of the curve with clients who are happy to come
in every year because they see the value and the health benefits of the wellness plan.
In these tough economic times Gervasi has advice for his clients who are trying to save
money: “The bare minimum veterinary service might look good right now, but down
the road it might cost you a lot more.”
Posted 09/06/2012. Please note the date of
this post. The law changes frequently and
as a result this may not reflect the current
state of the law.
VHMA • October 2012 • 3
Welcome
New Members
Mary F. Allen
Diane Beebe
Sabine Gisela Blomberg
Ashley Brown
Kathleen Ann Buchanan
Annie Chevrier
Carol Ann Coffey
Stacey Connell
Sylvia Elizabeth Daniels
James M. Doleski
Dani Fried
Shayne Taylor Gardner, CVT
Alexandra Faye Gill
Sallye Gregg, DVM
Robert T. Heidecker, DVM
Jennifer Heidecker
Lisa Heiting
Heather Heitz
Jamie Lynn Horning, BSBA
Sara Elizabeth Hurd
Cathy Innes
Tracey Johnson
Pinky V. Lanier, BS. HRI Mgmt.
Darrell Ogden
Donna Oster
Jessica Paige Pritchett
Mark Ransom
Dana Rhoden, CMP, CMM
Amanda Roper
Daniel Smith
Amanda Stadler
Nicole Emily Welkener
The Practice Pulse is the official
publication of the Veterinary
Hospital Managers Association
(VHMA). All rights reserved. No
part of this document may be
reproduced in any form without the permission of VHMA.
Opinons expressed in articles
and editorials of this newsletter are those of the author and
not of VHMA. Comments can
be directed to Christine Quinn
Shupe, CAE, executive director,
at christine@vhma.org.
2 • VHMA • October 2012
President’s Message
An Event To Remember
W
e’re back! I just returned from
the VHMA Annual Meeting and
Conference that was held in Vancouver,
BC. It was four days of excellence,
opportunity, and networking with
colleagues. I can honestly say that the
Annual Meeting and Conference is one
of the Association’s highlights.
I was thrilled to meet new members and
reconnect with old friends. This year we
honored our CVPMs who celebrated
the certification’s 20th anniversary.
The celebration culminated with a
pinning ceremony and dinner cruise.
Congratulations to all who have earned
the CVPM!
Another twist this year was to host the
Legal Symposium at the front end of the
Annual Meeting and Conference. The
human resources issues addressed during
the symposium equipped participants
with topical and essential information
about hiring and firing issues. It was
exciting to see the reactions from first
time attendees who loved the format of
this program.
This year’s Annual Conference program
was outstanding. I spoke with many
members who are excited to put the
insights and practices gleaned from the
session to work in their offices as soon as
they return to their practices.
But even when we weren’t learning in
formal sessions, we were learning from
each other. The great thing about the
VHMA is that we care deeply about the
profession and each other. We puzzle out
issues and ask for feedback as we network
between sessions, we share advice as we
wait in line, and we are always ready to
provide input to help a colleague along.
The hotel was perfectly situated on the
Vancouver’s Coal Harbour. The view
from the meeting rooms was outstanding
and had us all transfixed as we watched
the float planes comes and go. What an
unforgetable city!
We all lead busy lives and at times
communicating with one another
through different forms of social media
seems so easy and attractive. But I
believe you cannot underestimate the
value of meeting face-to-face with other
professionals to cultivate and nurture
relationships. What may begin as a
professional relationship often evolves
into a friendship.
Remember to stimulate the mind and
enhance your environment!
Tom MacDonald, CVPM
LEGAL
MATTERS
Mandatory Bundled Wellness Plans
Question:
Mandatory annual wellness testing at Collierville has been responsible for an increase
in diagnoses of diabetes, thyroid disease, Cushing’s disease, and even heartworm disease
well before clinical signs become apparent in the pet.
One of our receptionists came in
with dreadlock hair extensions, part
of which was dyed bright blue. Our
Uniform and Appearance Policy
states, “A neat, clean and professional
appearance is required...” with no
specific mention of grooming or hair
style in the rest of the policy. This
person did talk with me about two
months prior, saying that they had
thought about getting dreadlocks.
I was very clear at that time when I
told this person that dreadlocks were
unacceptable.
1) Is it legal for the practice to specify
or forbid a hairstyle in an effort to
maintain our professional atmosphere?
2) Can I proceed with disciplinary
action? We have a very clear policy on
progressive disciplinary procedures
- verbal, written, suspension/probation
then termination. My plan was to apply
the next stage of discipline for each day
this person chooses to come in with
this hairstyle.
Legal Advice:
“My sense is that while your policy
statement may be ambiguous, the
hairstyle selected by the employee
is legitimately problematic for
the employer both in terms of
“professionalism” and, in my view,
safety. Having longer hair in a
veterinary clinic can obviously
present some safety issues in terms
of entanglement with devices and
ensuring clear sight lines. The fact that
you had voiced your concerns at an
early stage is also helpful. In my view,
unless the employee can raise some
form of argument based upon ethnicity
or religion, then dictating, within
appropriate limits, the hairstyle to be
worn by clinic staff is fully within the
lawful range of directions that can be
provided by an employer.”
Douglas C. Jack, Esq.
(Continued from page 1)
With the new wellness testing protocol, heartworm testing was transferred from exam
room SNAP testing to a reference lab. Moving heartworm testing to the reference lab
caused an immediate increase in heartworm positive results. “This was interesting for
us when this happened,” Mr. Gervasi explained. “When we moved all of the heartworm
testing to the reference lab, they were able to pick up more because of their more
sensitive equipment. We even took positive samples from the reference lab and tried
SNAP tests on them. In some cases there was the hint of a line (indicating a positive) but
we had to admit that we could have easily missed a lot of them if it was done in the exam
room.”
Like most practices, there are fewer cats coming into Collierville Animal Clinic than
dogs. Clients only bring them when they are sick and many clients will readily bring
in their dog every year but hold off on bringing in the cat for a number of reasons.
“Last time I brought him here he was mad at me for a week,” is what they often hear.
To educate their cat clients, Gervasi introduced blood pressure monitoring for cats
and added it to the wellness plan. This has helped them pick up on more cases of
hypertension.
After a decade with mandatory annual wellness plans, Gervasi is convinced that the
annual wellness test is more reliable than the client for identifying changes in the pet. Pet
owners may notice a change in their pet, but not realize it’s the onset of a problem.
Pressing the point I asked, “Suppose I have a three year old dog with no clinical signs
and I want everything but the blood test?” ‘Well,” Gervasi responded, “for starters, how
do you know there are no clinical signs? Just the other day we had a case in here of a dog
that looked perfectly healthy but when we did a blood panel we found out the dog had
Cushing’s disease.”
“OK,” I responded, “then let’s say I can’t afford the blood test.” “You know,” Gervasi
responded not breaking stride, “you can’t afford not to do the blood test. You need the
heartworm test right? Well the increased cost of the whole blood panel is only a couple
of bucks more than heartworm alone and if you price out all the services separately it
will cost you $140 more. This is a good deal.”
‘We might have to work a little harder with new clients who come from a hospital that
does not offer mandatory annual wellness testing and plans but this program makes
sense to them when we explain it,” says Gervasi. While many hospitals across North
America are struggling with increased client reluctance to go to their veterinarian,
Collierville Animal Clinic is well ahead of the curve with clients who are happy to come
in every year because they see the value and the health benefits of the wellness plan.
In these tough economic times Gervasi has advice for his clients who are trying to save
money: “The bare minimum veterinary service might look good right now, but down
the road it might cost you a lot more.”
Posted 09/06/2012. Please note the date of
this post. The law changes frequently and
as a result this may not reflect the current
state of the law.
VHMA • October 2012 • 3
Veterinary
Hospital
Managers
Association
PO Box 2280
Alachua, FL 32616-2280
admin@vhma.org • www.vhma.org
The official newsletter of the Veterinary Hospital Managers Association
October 2012
Mandatory Bundled Wellness Plans
This article was previously run in the OVMA Focus, July/August 2012. Reprinted with permission.
Webinar
November 14: Collaborate: Shared
Success through a Charitable Foundation
Meeting and Conferences
Management Exchange:
February 8-10, San Diego, CA
Annual Meeting and Conference:
September 26-29, Charlotte, NC
What Insights Await YOU at the
VHMA Management Exchange?
VHMA
Business Alliance Partners
Topics Covered
February 8-10, 2013
Catamaran Resort Hotel & Spa
San Diego, CA
Every professional working in veterinary practice management
has a unique perspective to share, an invaluable piece of advice,
a strategy for performing his or her job better.
The Veterinary Hospital Managers Association’s “Insight Through
Interaction” Management Exchange brings these personal
experiences to life through a series of dynamic, peer-led
presentations. Organized panel discussions, workshops and
group activities strengthen friendships and maximize the
learning experience. The setting is informal, and the educational
impact is outstanding.
r*nnovative ways to improve client
communications
r4USBUFHJFTGPSSFEVDJOHXPSLQMBDFDPOóJDU
r0QQPTJOHQFSTQFDUJWFTPOIPUUPQJDT
r*NQMFNFOUBUJPOUSJVNQITBOECMVOEFST
r4IBSL5BOLQSFTFOUBUJPOT
r#MPHHJOHBTBNBSLFUJOHUPPM
r&UIJDTQBOFMEJTDVTTJPOT
r*EFBFYDIBOHFTBOETPNVDINPSF
M
ost veterinarians are reluctant to enforce clinical protocols on their clients. For
a clinic to enforce wellness plans was a radical departure in a profession that is
known for dipping its toes in the water long before it ever wades in.
The Collierville Animal Clinic’s annual wellness plan includes:
• Annual physical examination
• All vaccines required (based on individual patient risk factors)
• Blood panel including heartworm test
• Fecal test
• Weight recording along with nutritional counseling
• Complimentary nail trim
According to Mr. Gerard Gervasi, hospital administrator at Collierville Animal Clinic,
rolling out the bundled wellness plan was a lot easier than doctors and staff predicted.
Expecting the worst, staff and doctors developed contingency plans to use if clients
resisted the new protocol.
Eight months before the mandatory wellness plans were introduced, staff and doctors
took time to explain to each client that a new wellness plan was going to be introduced
the next year. The staff handed out fact sheets explaining what tests would be done and
why, showing the baseline values for a healthy pet and how certain values can predict the
onset of disease.
When he was developing the pricing, Mr. Gervasi first went to the reference lab to
negotiate a better price based on the projected increase in the quantity of blood panels.
“We were not diagnostic heavy, we were sending them one or two tests per day; now we
were poised to send them several thousand per year. They came back with a really good
price and this was passed on to the client.” Gervasi did not see any need to discount
professional services to clients; he only passed on the lab savings.
When mandatory annual wellness plans were introduced, average revenue per
transaction jumped by $35 and total revenues in the hospital went up 15%. The testing
protocol was so effective, hospitalized cases went down 33% after the first year because
the new blood testing protocol was catching things before they became critical.
®
5IJTQSPHSBNPíFST$POUJOVJOH&EVDBUJPO)PVST
Why don’t you join us this year? To register, visit www.vhma.org
4 • VHMA • October 2012
(Continued on page 3)
VHMA • PO Box 2280, Alachua, FL 32616 • 518-433-8911 • admin@vhma.org • www.vhma.org