A healthier bottom line (Sponsored by Intervet/Schering-Plough Animal Health)

You know it's good for you, but it just isn't palatable. Maybe you can't make it a habit. Or maybe it never even occurred to you. No, I'm not talking about spinach or lifting weights. I'm talking about underutilized services and business practices that benefit your bottom line. The following recommendations from industry experts will demonstrate how to reform your thinking and implement underutilized services to enhance your practice's financial health.

1. The missed exam

Elise Lacher, CPA, with Lacher McDonald Consulting in Seminole, Fla., says that equine practitioners skip brief medical examinations so frequently that adding them to your routine is practically found money. James Guenther, DVM, MBA, MHA, CVPM, a consultant with Brakke Veterinary Practice Management Group in Asheville, N.C., says it's easy to slip into the habit of performing the requested service and then moving on to the next thing. "Many practitioners still operate with a firefighter mentality," says Dr. Guenther. "They dash from emergency to emergency, rarely stopping to squeeze in routine care." But providing your patients with 10- to 15-minute examinations anytime you're onsite is good medicine—and good business.

Why are brief examinations on their way to extinction? Lacher believes that many equine veterinarians know their clients can go elsewhere for vaccinations and Coggins tests. They're compelled to demonstrate gratitude for loyalty by being affordable. "But don't think of medical examinations as an added cost. They're an added service," Lacher says.

Missed charges also undermine your ability to demonstrate value and generate income. Maybe you performed the examination or dispensed the drug, but you forgot to bill for it. "Don't wait until the 20th of the month to write invoices," warns Dr. Guenther. If you can't afford the time to bill at the point of service, ask a technician to do it.

Andrew Clark, DVM, MBA, and CEO of Hagyard Equine Medical Institute in Lexington, Ky., says capturing fees—and charging appropriately for what you do—holds the biggest potential for revenue growth. "It's harvesting the low-hanging fruit," Clark says.

2. Diagnostics in the field

It may constitute changing your protocol, but another ticket to enhanced revenue and preventive medicine is your imaging equipment. Your technician already rides shotgun (see Oldies but goodies), but the equipment acts as your third business partner. With the advent of portable laboratory equipment, ultrasonography, and radiography machines, diagnostics don't need to reside in a brick-and-mortar building. "Many practitioners buy the equipment, but some don't use it because they think it slows them down," Dr. Guenther says. But the technician takes care of the time issue, Dr. Clark says. "You take the pictures and discuss them with the client while the technician cleans and loads the unit, starts the invoice, and enters the charges," he says.

Oldies but goodies

Lacher says that pricing for onsite imaging can be difficult to pin down. Prices will vary depending on your practice and demographics. And it's not always easy to sell diagnostic testing to the owners of seemingly healthy horses. But Lacher says this is a critical opportunity where many equine practitioners fall behind.

Are you UP on your hourly rates?

The 2001 National Fee and Market Study conducted by the American Veterinary Medical Association and American Association of Equine Practitioners claims that as much as 15% of small-animal clinics' revenue comes from diagnostic testing. Equine practices barely achieve 1%. Horses require just as many routine tests as cats and dogs, but few equine practitioners place the appropriate emphasis on testing. Explain to clients how diagnostics can make horse healthcare more affordable in the long run. Once you've determined your fees and polished your pitch, it's simply a matter of dusting off your equipment and using it in the field.

3. Enhanced reproductive services

This is an arena where practitioners can take a hint from larger reproductive farms: Add well-mare pregnancy examinations to your menu of services. In addition to the two customary reproductive ultrasounds (to learn if the mare is ready for breeding and a few days after insemination), Lacher recommends a six-month prenatal progress examination that includes an ultrasound. Ultrasound images provide tangible evidence that the pregnancy is progressing as it should and gives peace of mind to clients during this high-stakes endeavor. The key is becoming an advocate for your patients. "Determine the best standard of reproductive care for your client base," says Dr. Guenther, "whether you're breeding, working with cooled or frozen semen, or monitoring cycles."

The terminology you choose plays a pivotal role in getting clients on board. Dr. Clark suggests that practitioners do away with the word recheck. Because you may not explain the recheck's importance or give it away for free, it conveys no value. Instead, call it a medical progress examination. "You'll feel better about charging for it, and clients will feel better about paying for it," he says. Instead of performing insurance examinations on newborns, bundle it with other procedures and call it a neonatal wellness program.

4. Proactive scheduling

Do you wait by the phone for clients to call you? If the answer is "Yes," then it's time to take scheduling into your own hands. While this isn't a medical service to add to your roster, it's a valuable client service that saves you time, money, and headaches. Calling clients ahead of time and booking appointments based on where you will be on a given day translates into less time behind the wheel and greater earning potential. With your increased efficiency, you can bill at the time of service, which helps prevent missed charges. Another perk? Proactive scheduling requires no new equipment or training. Once you witness the benefits, it will seem silly that you ever handled your calendar any other way.

Why is this simple tactic so underutilized? Initially issues with client acceptance may arise. "Proactive scheduling may mean that clients no longer choose the doctor that visits them; services are provided by the veterinarian who is in their area on the given day," says Dr. Clark.

Calling clients in advance would be a considerable detour from the way some veterinarians run their businesses. Many doctors feel that calling clients with the goal of securing appointments is pushy or intrusive. But everyone leads busy, hectic lives nowadays. Most clients welcome friendly reminders. They will appreciate the fact that you took the initiative; it's one less thing they need to remember. And it shows that you care for their horses' health and well-being. You're not only making your precious time go further, you're providing superior patient and client care. If only eating more vegetables and jogging were just as easy. ?

MIchelle O'Neal is a freelance writer and editor in Shawnee, Kan.