寵物養(yǎng)護與美容第四章寵物美容7課件

FutureofVeterinaryTeachingHospitalsVeterinaryTeachingHospitalMissionsTheuniquechallengeoftheVeterinaryTeachingHospitalisto:Remainfinanciallyviablewhileenablingteachingandresearch,allthewhileprovidingveterinarymedicalservicestothepublic.

JimLloydHistoryInternshipsbeganin1950-60’s,residenciesin1960-70’s.Boardcertificationbecamethenormforentrylevelclinicalfacultypositionsinthe1970-80’sClinicalDepartmentsbegantodivideresponsibilitiesintoacademic&hospital,andHospitalDirectorsbegantobehiredinthe1980-90’sVeterinaryCollegesbecamemoredependentonhospitalincomein1990-2000’s.ProblemsIdentifiedDifficultyinfacultystaffingofVTHsduetoattractionofprivatepracticeFundingofVTHs–revenueandgiftswereprobablythebestfuturesourceoffundingsinceanincreaseincentralcorefundingwasnotlikely,Decreasingofstatesubsidies,andanincreaseinthecompetitionforcasesandfacultyToomuchred-tapeinuniversityformanyspecialistsResearch,teaching,andservice–hardtobegoodatallthree,canbeindirectconflictwitheachother.Somethinkthereisa4thmission–toteachbusinessaspectofveterinarymedicine Increasedrelianceontuitionandfees,stagnantVTHrevenuesinsomeareasStaterevenueasa%oftotalrevenueforvetschoolsdecreasedfrom55%to33%Average#ofstate-fundedfacultypositionshasbeenstatic,someincreaseinnon-statefundedpositions,atsametimeasincreasein#ofstudentsDecreasingtostaticapplicantpoolforvetstudents,suboptimaldistributionofcaseload(needmoreprimarycasesforteaching,toomanytertiarycases)Doallthestudentsgetenoughhandsonexperience?Inprivatepractice,avetearning$65,000shouldproduce$300,000inrevenue,buttheVTHisnotatypicalpracticePracticeownerswantfromgraduates:knowledge,communicationskills,peopleskills,businessskills,howtomanageworkloadSpecialistsarefindingthatVTHshavealackofmoney,lackofequipment,lackofnewspace,lackofcontroloverworkday,toomanygoals,longdaysandweekends,notefficient,poorlocation,andthattheycandoteachinginotherplacesPresentfacultycanbepoorrolemodelsforinternsandresidents–showunhappinessandfrustration.AdequatecaseloadisnotalwaysthereinacademiaforteachingandresearchneedsTheNeedtoChangeSVMsandVTHsmustbewillingtochangetoaccommodatetheaboveissues,prioritizemissionsofclinicalprogram.Univ.ofMinnesota–Triedsomenewideas:clinicalspecialistmodelandincentiveplan;replacedstudentlaborwithtechsResults–increasedcaseload,increasedrevenue,tenuretrackfacultycouldfocusmoreonresearch,andteachingimprovedRecruitment/retentionofClinicalFacultyLookfordonorsfornewequipment/facilitiesandtoaugmentfacultysalariesLooktosharespecialistswithprivatespecialtypracticesNeedtoofferpart-timeorfull-timeclinicaltrackpositionstospecialists,butmustnotbea2ndclassposition–needlongertermcontracts,sabbaticals,votingprivilegesWorkwithUniversitytogetmorecompetitivesalariesforspecialists,signingbonusesDevelopIncentivePlan–partofrevenuebacktofacultyorsectionofhospitalfortheiruseDevelopsatellitepracticesoastoaugmentmoneygeneratedandimprovesecondarytypecasesOfferconsultingtimetofacultyImprovecultureinVTH/SVMsoarereasonstoattractorretainfaculty,marketacademiclifestyleinternallysofacultyunderstandandsellthebenefitsAugmentaresident’ssalaryifthatpersonwillcommitforcertainnumberofyearsasafacultymemberSelectresidentsthatwanttostayinacademiaClientandRDVMsurveys-topointoutareaswhereimprovementisneeded,likecommunicationMakecliniciansandstaffrealizetheyarecompetingagainstprivatespecialtypracticesforcaseload,mustgivebetterserviceBringinoutsideconsultanttohelpmakeVTHmoreefficientNewfacultyneedtointroducethemselvesorbeintroducedtoRDVMpopulation,alsogiveCEseminarsEnhancingOperationsofVTHWorkonalleviatingbottlenecksinVTHHireDevelopmentOfficerwhoisassigneddirectlytoVTHHavetreatmentsofhospitalizedcasescarriedoutbytechnicians,notstudents–mightimproveefficiencyandletstudentslearnmoreVTHsneedtohireaHospitalAdministrator/Director–MBA,MHA,orsimilartraining.IfnotaDVM,mustreporttoaDVM(AVMAaccreditationrules)VTHsneedstohaveastrategicplan,establishbenchmarks,havegoodfinancialreportingsystem.ClinicalTrackfaculty–goodmovetohirethembutwhoshouldpayforthem?VTH,Clinicaldepts.?PartnerwithprivatespecialtypracticestohirespecialistsShouldresidentsbetrainedatprivatespecialtypractices?Orshoulditbeajointendeavorwithuniversities?Specialtycollegeshavetobecarefulthattoomanyrestrictionsfortrainingresidentsarenotplacedonspecialists/collegesNextStepsHelpfacultyunderstandtheproblemsandembraceabusinessplan,createaVTHTaskforce(AAVMC,AAVC,NAVCA)in2004thatwillworktopreparea“whitepaper”addressingconcernsforfutureofVTHs–useforlocalsupport,consultantbackgrounding,andaccreditationstandardsDevelopbenchmarksthatallVTH’scancompleteannuallyandusetodetermineefficiencyoftheirmodel–createdBenchmarkingTaskforceforthis–AAVMC,AAVC,NAVCA.BenchmarkingTaskForcemeeting–Aug.24,2005TaskforcemetinSchaumburgwithHowardRubin,developerofNCVEIbenchmarksforprivatepractices.ThisgroupstartedworkingwithhimtodevelopsomethingsimilarforVTHsthatwouldbemorehelpfulthanAAVMCannualinfothatiscollected.Utilizebenchmarkingforinternalandexternalcomparisons.Dr.Hubbell’sWhitePaper–PresentandFutureProblemsforVTHsThevastmajorityoftheadvancesinveterinarymedicalcaretodatehaveoccurredbecauseoftheexistenceofVeterinaryTeachingHospitals.TheconvenienceandhighqualityofprivatespecialtypracticesimpactsthecaseloadsoftheVTHsandhasthepotentialtocompromisetheeducationofveterinarystudentsandpostgraduateveterinariansandthegenerationofknowledgethroughclinicalinvestigation.Dr.Hubbell’sWhitePaperTheresolutionofthiscrisiswillrequirebroadparticipationandcooperation.Newalliancesmustbeformedtofosterclinicaleducationandinvestigationattheprofessionalandpost-professionallevels.Theprofessionmustbeengagedbecausethesolutionwillinvolveuniversities,specialtycollegesandpractices,privatepractitioners,veterinarystudents,andorganizedveterinarymedicine.FutureofVTHs–Conference,Nov.10-11,2006,KansasCityDr.MaryAnnVandeLinde–VeterinaryManagementConsultingspokeon“ClientExpectationsforVeterinaryCare”Topreasonwhyaclientleavesavethospital–indifferenceorpoorattitudeofstafforDVMsMinimalwaitingtimeConsistentmessagefromoneareatoanotherWanttobetreatedwithrespect,clarity,andconsistencyFutureofVTHs–Conference,Nov.10-11,2006,KansasCityWanttobecommunicatedwithontermstheycanunderstandWanttheexamstobethoroughbyaDVMandnotrushedAllinteractionwithclientmustbeimproved–fromreceptiondesktostudenttostaffandfacultyFutureofVTHs–Conference,Nov.10-11,2006,KansasCityDr.ColinBurrows,SADept.headatUniv.ofFloridaspokeon“MeetingtheExpectationsofReferringVets”WhyRDVMsrefer–uncomfortablewithcase,lackskillsorequipment,lackoftime,liability,goodexperiencewithreferralhospital,knowspecialist,cannothandlediagnosisoremergencyFutureofVTHs–Conference,Nov.10-11,2006,KansasCityWhyDVMsdon’trefer–Geography(toofar),cost,thinktheycandoitall,previousbadexperiencewithreferralhospital,poorfeedbackfromclients,don’tpersonallyknowspecialistFutureofVTHs–Conference,Nov.10-11,2006,KansasCityWhatRDVMsexpect–knowledgeofservicesbeingoffered,goodquickresponseto1stphonecall,efficientcommunicationfromstaff,protectrelationshipbetweenclientandRDVM,timelycommunicationduringandafteranimalisreferred,donottreatotherdisordersthanwhatanimalhasbeenreferredinfor,follow-upwithRDVMwhenanimaldiesoriseuthanized.FutureofVTHs–Conference,Nov.10-11,2006,KansasCityRDVMsareourmostimportantclientsandweallneedtorealizethat.Needtoperhapsdomoremarketingtoincreaseourreferralbase.Floridahasdone:RDVMAppreciationDayHospitalNewsletterPracticevisitstolocalpracticesLocalassociationvisitsFutureofVTHs–Conference,Nov.10-11,2006,KansasCityClientandRDVMsurveyHospitalAdvisoryboardWebSiteforRDVMsHospitalToursforClientsandRDVMsPressreleasesReferralfaxcovers–newsornewclinicalstudiesaddedtofaxcoverClientsadvocates-volunteersFutureofVTHs–Conference,Nov.10-11,2006,KansasCityEducatecliniciansonbusinessissuesRemindcliniciansofreferralprotocolandifdonothaveone,createone(howandwhentocommunicatewithRDVMs,whatisexpected)ClinicianincentiveplanTakecliniciansoutofthechargingbusinessTollfreenumberFutureofVTHs–Conference,Nov.10-11,2006,KansasCityDr.JohnAlbersfromAAHAspokeon“FutureofSpecialtyPractice”1996–18%ofnewvetgraduatesweredoingadvancedstudies(internships/residencies)2006–increasedto33%withmostofthosewantingtopursueboardcertificationWhyspecialtypracticeswillcontinuetogrow?Insurveydone,74%ofclientswouldpay>$500totreataseriousdiseaseintheirpet52%wouldpay>$1000,15%wouldpay>$5000FutureofVTHs–Conference,Nov.10-11,2006,KansasCity61%ofthosepetownersthatthoughtoftheirpetasamemberofthefamilywouldgotoaspecialistiftheirvetrecommendedit.RecentgraduateshaveahigherpropensitytoreferthanvetsthathavebeenoutforawhileLenderswilllendmoneytostartaspecialtypracticeatagoodrateManufacturersofexpensiveequipmentofferthesepracticesgoodratesFutureofVTHs–Conference,Nov.10-11,2006,KansasCityDr.DavidLee,HospitalDirectoratMinnesotaspokeonthe“VTHasaProfitCenter”anddiscussedtheuseofaprofessionalcallcenter,theuseofareferralcoordinator,dischargeinstructionsfaxedimmediatelytoRDVM,havingaCasemanager/section,hiringaHospitalist(aDVMthatwouldhelptomovecasesthroughthehospital)FutureofVTHs–Conference,Nov.10-11,2006,KansasCityDr.CharlesMacAllisterfromOklahomaState,spokeonCooperativeArrangementsforTrainingSpecialists82%oftheresidencyprogramsareinuniversitiesasof2006Needtorecruitresidentsinterestedinacademiaasacareer.Plentyofapplicantsforpositionsinallspecialtiesexceptforanesthesia.FutureofVTHs–Conference,Nov.10-11,2006,KansasCityOklahoma–growingownfacultybypayingotherinstitutionstotakethemonasanextraresident(payfortheirsalaryandbenefitstotheinstitutiontrainingthem).MustcompleteaMSdegreeandworkforatleast3yearsatOklahomavetschoolafterfinishresidency.Costof$140,000/residenttohomeinstitutionforaresidenttobetrainedelsewhereFutureofVTHs–Conference,Nov.10-11,2006,KansasCityDr.RubenMeredith,anophthalmologistinahugemulti-locationprivatespecialtypracticespokeon“OphthalmologistinPrivatePractice.”6locationspresentlywherehavepracticesandresidents,have12activeresidentsonboardrightnowandtendtokeepmostofthemonascliniciansaftertheyfinish(self-trainthem)AllschoolsshoulddoaSWOPTanalysisonceayear.FutureofVTHs–Conference,Nov.10-11,2006,KansasCitySWOPTanalysis–strengths,weaknesses,opportunities,andproblemsandthreats.PrivateSpecialtypractice(PSP)Strengths–residencytraining,largecaseload,commitmenttoresearch,board-certifiedstaffMultiplecentersenvisioned.Weakness–internalcommunication,stafftraining,inventorycontrol,employeeaccountable,communicationwithclientsandRDVMs,lackofuniformoperatingsystem,lackoftrainedtechs,inefficientfacilities.FutureofVTHs–Conference,Nov.10-11,2006,KansasCityVTHsStrengths-Vetstudents,faculty,benchresearchfacilities,universityresources,fundingforresearchWeaknesses-abilitytopaycompetitivesalaries($200,000forophthalmologist),budgetarycontrol,universityrestrictions,etc.FutureofVTHs–Conference,Nov.10-11,2006,KansasCityPrivateSpecialtyPractice’s(PSP)strengthsareourweaknesses–location,salaries,flexibility,budgetPSP’sweaknessesareourstrengths–researchpossibilities,futureclinicians(students,internsandresidents)VTHsandPSPsmustworktogetherandcooperate,formdirectpartnershipswithPSPsFutureofVTHs–Conference,Nov.10-11,2006,KansasCityDr.RichardValachovicfromtheAmericanDentalEducationAssociationspokeonthesimilaritiesbetweenwhatthedentalprofessionandtheveterinaryprofessionarefacingThereare56dentalschoolsintheU.S.andthereare400openfacultypositions,themeanageofthefacultyis52yrs,faculty<30yrsoldmakeuponly3%ofthetotalfaculty,averageof5vacantpositionsperdentalschool,and10newschoolsinthepipeline.FutureofVTHs–Conference,Nov.10-11,2006,KansasCitySalarydiscrepancyisthebiggestreasonforopenpositionsinthedentalprofessionanditisoneofthemainreasonsforthesameproblemintheveterinaryprofession.TheyhavereachedouttostudentsindentalschoolsandalsotodentistsinprivatepracticetopullthemintoacademiaAcademicDentalCareers