Shown below is the updated graphic we’ve been sharing each month; this includes the January 2022 VetSuccess revenue metrics shown on the Insiders’ Insights KPI dashboard (https://www.vhma.org/resources/insider-insights) as well as placeholders for other related metrics that should also be reviewed regularly in order to get a full picture of what’s going on in a practice.
In order to put this in perspective, here is some of the same information for the last few months showing the overall trends:
Revenue, patient visit, and new client growth fell in January 2022 compared to January 2021 with January in each year having the same number of workdays. Revenue and visit numbers have fallen steadily since November 2021; prior to then, these numbers bounced around a bit, and there wasn’t a clear trend. New client figures have decreased each month since May. The enormous growth seen during some of the pandemic appears to be slacking off, and practices are returning to a new version of pre-pandemic times.
Of course, these are averages, and what is going on in other practices may not be going on in yours.
Last month, we discussed new client analysis in depth; this month, we’ll dive into a related topic--patient visits.
Before starting your own analysis, it’s important to understand what exactly the term “patient visits” means. Unlike some others, this is not a metric that is consistently defined in our profession.
In my mind, a patient visit means the pet actually came to the practice and had something done to it, such as an exam, a surgery, etc. Patient visits are different from invoices (also referred to as transactions.) Invoices often include services provided as part of a patient visit but can also be solely for the sale of products at a time in which the pet is not present, and nothing is “done” to it. The total number of patient visits for a particular time frame will almost always be less than the number of invoices for the same time frame due to these product sales. Patient visit and invoice figures generally trend similarly, and there is often a steady correlation between the numbers of each. Analyzing either metric can be useful, but it’s important to understand what you are really looking at when pulling information from a Practice Information Management System (PIMS) report or using the information in a published source. Not all PIMS reports provide visit numbers in their reports, and definitions vary in those that do. For example, one well-known PIMS includes the sale of products in its visit definition. If the practice generated an invoice for a client that included charges for dental services for one pet as well as a heartworm preventive refill for a second pet; this PIMS would call this particular transaction “1” invoice but “2” visits even though the second pet didn’t actually have a service done for it at the time of this invoice; it simply had a medical refill purchased for it.
Should telehealth transactions be included? To me, these should be handled similarly to in-person visits. If the pet is a part of the virtual appointment (for example, via video) and the client is charged for this appointment, or there is an extensive recheck-type discussion where the client shows the doctor photos of the pet’s skin and again, is charged for the appointment, then I would consider it a patient visit. If the client just calls to ask a routine question, it’s not. Determining what telehealth activities to include as a patient visit and what not to is obviously going to include some judgment; the most important thing is to be consistent in how it is done so comparisons over time are useful.
The starting point in patient visit analysis is to review the growth or decline in visits in your own practice for the last five years.
This growth calculation is straight forward:
The above analysis looks at the total number of patient visits in the practice but it is also important to review the patient visit numbers on a per FTE doctor basis, particularly if your FTE numbers have been fluctuating. Obviously, the more FTE doctors you have, the more patient visits the hospital should have. Your practice’s patient visit numbers can then be compared year over year and to published sources.
Patient visits are influenced by a number of factors; some of these include:
- Number of new clients
- Frequency with which each patient visits the practice
- Doctor productivity
- General efficiency in the practice (ability to see more patients)
- Doctor communication abilities (i.e., client acceptance of recommendations)
One of the first questions to be asked is: do you want or need more patient visits in your practice at this time? As we said when discussing new clients last month, if the practice is still swamped and struggling with staff shortages, the answer may be no. In this case, the practice should focus on keeping the clients and team members you do have happy and offering each of them the best experience you can.
If you do have open appointments and want to see some growth, then two areas to focus on would be increasing the frequency with which current clients visit and attracting more new clients.
In order to increase the frequency with which current clients visit, the practice needs to focus on offering all clients the best possible medical recommendations. This of course, means the practice team needs to first determine what those recommendations will be for wellness care and common medical conditions. Just making the recommendation isn’t enough; however,
how these recommendations are offered is critical. This often comes down to communication skills. The practice also has to provide a good experience and be a place clients want to come back to and price their services to match the value given.
Another area to focus on when trying to increase patient visits is attracting more new clients. We talked about this
last month.
If your PIMS doesn’t provide patient visit info, the number of doctor transactions can be used instead for a similar analysis (typically, these include a service of some kind performed for the pet.) Total invoices can be used as well, although there are some differences in what the analysis will tell you when using this figure. Of course, be careful; any comparison between your numbers and published sources are an “apples to apples” comparison. Remember, too, that none of these metrics replace a profitability calculation. A practice can have very high visit numbers and still be unprofitable.
➤ Download Insiders' Insights - KPI, February 2022 Report➤ VHMA Members can access the dashboard to drill down by region, species, and practice size filters, access the interactive KPI dashboard
Data review and commentary is provided by Karen E. Felsted, CPA, MS, DVM, CVPM, CVA of PantheraT Veterinary Management Consulting, www.PantheraT.com.
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