In This Episode
There’s about a 10% no-show rate in the veterinary industry; that’s 10% less revenue clinics are making than they could be. Missed appointments seem like a fact of life, but is there some way to alleviate them? This week on the Veterinary Innovation Podcast, Shawn and Ivan chat with Nick Kurgansky, the co-founder and CEO of Next In Line, about how clinics can fill that gap, some of the challenges that come with creating a standalone product, and why it’s easier to configure a product to help meet customer needs than building a whole feature suite from scratch.
Mr. Kurgansky recommends Pitch Anything by Oren Klaff.
- Efficiency in Scheduling
- Early-Stage Startups
- Manual vs. Digital Processes
Shawn Wilkie: You’re listening to the veterinary Innovation podcast, you’re listening to the veterinary Innovation podcast. My name is Shawn Wilkie, and I’m excited to be here with my co-host Ivan Zak. Wanted to introduce today’s guests.
Meet our guest – Nick Kurgansky of Next In Line
Ivan Zak: Hi, I’m Ivan Zak and I’m introducing you Nick Kurgansky, he is a founder of next in line and Russian friend of mine. I guess. He’s a he’s a Russian background judging by his last name. The used to work as a business analyst for the US federal government degree in finance from Georgetown University. He has also a bachelor in French from the University of Maryland loves outdoors and music and he had a hand in the creation of a culinary arts club and he’s private school. Tell us about that. What did you do there?
Nick Kurgansky: Yeah. So pleasure to talk to you Ivan Zak and Shawn. Thanks for having me on the podcast love what you all are doing back in high school. Actually, I was at an audition. A boys school. We had to do these clubs as kind of a free time after school activity. I didn’t really enjoy any of the ones that were currently offered at the school and a few friends, and I decided that we wanted to create our own we found a common interest in cooking and exploring flavors from different cultures different states countries Etc. So we decided to build a cooking and we explored areas around the world every week.
Shawn Wilkie: You’re like the ultimate Bachelor at guy. You’re like Master degrees and finance the CEO and I can cook. This is perfect. I like to be a diversely skilled Nick Kurgansky. What was the Genesis behind next to mine? Your father’s doctor. I knew that from knowing you personally. So you like to hit some first-hand experience with the efficiencies in human medicine, but just curious how you came up with the idea of where it all came from if you could give us a little bit of background of the awesome. Yes, no happy to do so Sean.
Efficiency in Scheduling
Nick Kurgansky: Thanks for the question. It’s kind of similar to my experience with the culinary arts Club back in high school. As you mentioned. My dad is a dermatologist and one night. We were just talking about his practice where he was booked for three to four months at a time and patience would call his staff every morning looking a sooner appointment or any sort of open appointment which takes up time for his staff. There have the same refrain. No, we don’t have anything available call back tomorrow call back tomorrow. So Steph just needed to keep saying the same thing and it became a very inefficient process for him. His staff is patience. And what we decided to do was find a way to leverage technology to make this more efficient more automated and that’s really where we came up with next in line in its infancy. It was a virtual wait. List where his patients could go on it and then whenever he had a last-minute cancellation or last-minute opening it would blast out text and email alerts to those patients and they could book it on a first come first serve basis.
Ivan Zak: So were they were the calling back to book the appointments or they had an actually access to their calendar. How did that work through the message?
Nick Kurgansky: They could actually booked the appointment. They could either respond to the message or click on the URL which would then notify the practice staff and they could just expect that patient and not have to do anything themselves
Ivan Zak: Okay, cool. So let me ask you this, you know, you finished the the Master’s in finance and then all of a sudden during the dinner conversation at home with your dad, you’re like yeah not going to do anything with that. I’m just going to build an app for that and just continue with that and I assume would not whole lot of return investment in the first year, so
Nick Kurgansky: This is correct, and I didn’t pitch it to that way I like to think that I am using it occasion. My parents spent money on through my 25 years, but I pitched it as a way to help him generate more money if we could perfect it for his practice, then we could Market it to others but to your point no in the early going for startups. You’ve been there in your past. You but that first year, we really focused on perfecting the product getting feedback from his patients from his staff and then from their kind of build it into what it’s turned into today and kind of Market it that way and monetize it after the fact.
Ivan Zak: All right, so you pitched it to your dad and raise the first classic round of friends family and fools, and as I know in a lot of instances your family then thinks where they fools are not to do so so a shift in those together. Batteries so you started with that and then now you’re in veterinary medicine. So I assume that your dad is not in veterinary medicine or your mom. So, how did you transition to that? And how did you just say? Hey, let’s just shift completely pivot and all their
Nick Kurgansky: Great question and we did build it and Market it to other doctors here in the Baltimore area where we’re located Where he breeds horses has chickens. He had goats dogs cats, you know as a functional farm and he constantly had vets coming out to his farm to treat the animals he knew other vets just from his experience. He’s been doing this for 30 years and in meeting them conversing with them because our office was on his farm initially and so I would see the Vets on a weekly or monthly basis one thing led to another and we realized that there was a need for more efficient technology in the veterinary space. So we thought that taking what we had applied in the human field, which is sometimes five to ten years ahead in terms of tech bring it over to the vet space Market it and really help them be more efficient, especially with the huge growth in pet ownership and especially everyone knows the younger there is a way to bridge the gap between the vets and the rising number of pet parents and that’s kind of where we started going.
Shawn Wilkie: All right, Nick Kurgansky. So I got a question for you. And it’s is this a feature? Where is this a product because there’s all of these Veterinary management practice Management Systems out there and I know what you do, but it to me feels like should be a feature of these practice management software’s.
Nick Kurgansky: Yes, we get that a lot and initially it did start as a friendship. Feature, but what we do now is it’s more than just online booking and a virtual waitlist. We have booking we have reminders we have client communication. We have reporting we have a whole bunch of other features. So it’s turned into a platform that works very well with their practice management system and their practice management system is at managing their clients the medical records prescriptions and things like that, but more often than not they don’t focus on the client side of things in terms of communication booking efficiently and helping the staff do what they do best internally and treating the clients in the patient. So that’s kind of where next in line fits in and we’re trying to compliment what they already have. Do you love that when you’re doing a demo and someone says well, that’s just a feature should be mine. My practice management system. I heard a lot of that one when I was involved with smart flow and then and then the only thing you can say to that is se but it isn’t simple if it’s if it was it would have built it already but exactly no it’s exactly what it is. And you know what I was after for the last probably five six years. He gave us the same statement that people gave to me they were like, oh a white board while it should be a part. I like well it isn’t so and that we do so we probably do it well and then you know, when you start expanding you grow your team by the end of it smartphone will think 60 around 60 people and people like, oh, it’s just a feature. I like and it’s just 60 people working on that feature for you. So I think we kind of know what we’re doing. But now I totally get that. So in your journey, you know, I seen a guy Kawasaki that’s the guy who was evangelist for apple. He was talking about being a CEO of a startup company and he said that if anybody would offer him to be a the CEO of startup company he would say hello that’s too hard. But he is mature, you know, businessperson and evangelists right now looking back at you’ve been at it for what two years now about two two-and-a-half year.
Shawn Wilkie: Yep. Okay. So know what you know today roll back two years if I told you do you want to do this, would you still say absolutely or would you be like hello, it’s too hard I would still do it.
Nick Kurgansky: I love what I do. I love that every day is different and that you can build something from scratch. I will caveat that by saying you always hear if I knew then what I knew now, I would look at things differently. I would build our team differently because again, my dad’s a doctor or co-founder owns animals and Farms, but I think who you surround yourself with is very important and from the get-go if we had brought on veterinarian. Orion team members, I think we could have done a lot more a lot faster but to your point and guys point it definitely is a challenge it is not for everybody but I don’t think I would not do it. It’s enjoyable and rewarding except for those days when it’s not in you deal with people that are asking if it’s just a feature. It sounds very much like you have the disease that I like to call entrepreneurship.
Nick Kurgansky: Yes. I have been if that I’m trying not to spread it to everybody else’s I know some people don’t want it but looking for a I don’t see a cure but looking to keep it inside internal with me as my lawyer says that what do you say to me last time? He said I think you caught a bug called startup. So it is a very dangerous game where you might get stuck in the hamster wheel, if you do it once you might not be able to get out of it and then your family and your spouse’s might not like it because you’re spending more time with your startup then with him or her but for now, it’s okay.
Shawn Wilkie: We can relate figured so Nick Kurgansky another question for you. So the lean startups one of my favorite startup books, you know, you’re in technology and event space. What was the first and most meaningful thing that you learn from your customers once you actually had customers have been a lot of learning lessons, I think both of you can attest to with startups and growing businesses. There are a lot of things that you don’t know and you kind of figure it out as you go in terms of what your clients are looking for. One thing I’ve learned is you can’t be everything to everyone. So in the early going when we were a startup we were just saying yes to everything because we wanted clients we wanted revenue and so that kind of how does bolting on different things and it led to less stable releases and less thought out things we were rushing through them just to get it out and get people on board. But what I’ve learned is clients don’t always know how to say what they want. This is what they’re saying, but here’s what they actually mean and here’s what they want. And so it’s translating what they’re saying into what they want. Giving it to them in a way that exceeds those expectations and really gives them what they didn’t realize that they were asking.
Shawn Wilkie: For all the veterinarian is listening to the podcast. You know, what’s the one thing that you would say your product really revolutionizes when it comes to scheduling when it comes to the practice. Why should they give your product a real hard look?
Nick Kurgansky: Yeah. So what I would tell the veterinarians listening Sean is that we are an extension of their staff a lot of practices. Not have the desire or funds to hire software developers or build things to fit their needs. So what we do is we work as are software development team where if they need something customized or configured we don’t sit there and build things from scratch, but we have different features that we can turn on turn off for them. We can in different ways and this really helps them ensure that what they’re getting meets their needs. It helps automate the registration the booking and reminder processes so that way they can go focus on pet care because at the end of the day, they went to vet school to treat patients to take care of sick pets and they don’t have to worry about administrative tasks and managing the the front office duties.
Shawn Wilkie: So I love with you. You said about selecting the right features in a descending the customer because I’ve been a victim of that too and just kind of when you were early startup. You have an idea and something catches on and then you start doing features for everybody and then you know, there’s two instances one as they describe one thing you build another thing, but they just said something and you spend weeks and weeks on developing in the other one is that they expressed their interest and then interested when you made it there like Okay cool. So that also happened. So I think that the key there is that to understand the business case to articulate it well and then also to prioritize so so what do you do in your product roadmap, once you’re talking in the more customers you have the more features you have flowing. What do you use to filter through that and to select what is strategic do you what is you know the next best feature for the customer? Is there a process we do you guys kind of brainstorm together about it? How do you arrive to the right features? Has to develop.
Nick Kurgansky: Yes, that is also another challenge. We’re following all the requests to one area and then filtering through them because some are going to be very specific to use cases where others will be more broadly applicable to different practices. So in our business, I would say we have three avenues for features one is coming from the client one is in my mind but it going and then we have our developers to have their own strategies and priorities for what they want in the back end and make things better in their mind since they’re in the coded day-to-day. So to your question we try to get everything in a running list there some software’s out there to do that where you can kind of put in feature requests bugs and other options and then you can kind of write them in terms of how many people have requested them then as we’re looking at that internally we’re trying to figure out of these features and enhancements which are going to be applicable to the most amount of people which ones are going to be valuable and turn into something that we can monetize versus some that might just be a one or two person use case or something. That’s yeah, it’s cool to have but no one’s really going to pay for it. So there are a lot of things internally, we have meetings to go through this externally kind of talk with clients. And as I said, right then depending on how many people are asking for them and getting their feedback on what that could look like on a bigger scale cool. There’s so much lost Revenue associated with canceled appointments. How do you guys help with that problem and you have any statistics that you can share for our listeners to understand the magnitude of the problem?
Nick Kurgansky: Yes Shawn, so I saw something from a how where They said that there’s about a 10% no-show rate in the industry and no-shows are the worst especially no call. No show. You’re very rarely going to be able to get someone into that opening because it is so last-minute on the other hand. If someone gives you notice and cancels the night before or even six hours ahead of time, then that’s where you can leverage something like we’re next in line started where you’ve got that are interested in coming and sooner or who might have been interested in Services as your hospital, but maybe price was a concern or they’re so busy that they can actually make time and then you can use next and lines wait list to send a message to these clients to say. Hey Sean. Hey Ivan Zak, we now have an opening today at 3 p.m. For grooming if you want to bring fluffy in we welcome to have you and the practice could even offer a five or ten percent discount at the last minute just to try to incentivize devise someone or again if price was a concern going off of that 10% no-show rate with cancellations. It’s going to be a little bit higher and then if you have a practice that seeing 20 or 30 appointments a day, you’re looking at somewhere between three to four or five cancellations and no-shows and that adds up very very quickly as you’re looking at the price per appointment and then the Yeah, that’s that’s certainly a significant problem. And one of the one of the kpis that the organizations are looking at in the veterinary clinics or the consolidators is actually the fill rate of the calendar because you’re paying people per hour and then you want to fill you want to be efficient. So you want to see a decent amount of appointments per hour, but you also want to make sure that they’re all filled.
Ivan Zak: So I certainly can see the main point there and I think that even without you know, if you’re calculating every listener, I think who owns the business can basically say, that’s the ten percent off. Of total revenue, whatever you put a revenues and see the impact of the problem which you’re solving so that that sounds significant.
Nick Kurgansky: Yes. It definitely is and especially with the number of appointments coming through there if Eve it’s a 10 or 15 minute appointment. That’s now open. That’s someone sitting around for 15 minutes twiddling their thumbs or yes, they could be doing follow-up calls. But again the Vets the Anu and that’s kind of where the focus is Shawn Wilkie: So a little anecdotal story to share from my experience this morning, it’s Election Day in Canada the 21st of October when we’re recording this podcast, so I went to vote and I walked in and they had a table filled with paper no computers just paper and it’s so incredible to think about processes like scheduling like voting that are dictated by these paper processes. Has so the question, I guess that relates to all of this process this paper process or yesterday’s way is how simple is it to use your software neck. So say your clinic that’s listen to our podcast in the thinking geez, you know, we do have a lot of scheduling issues. Is it is it an easy product to use is it simple talk a little bit about the interface and what you need to know what kind of basic skills you need to have in order to implement this software in your practice.
Nick Kurgansky: We see a lot Tron is people ask, you know, how to clients access it how easy is it? Is it mobile-friendly. So what I tell people is our application, it’s all web based. So it’s very easy to access via the clients website. If they have any sort of pet owner app, it can be embedded in their the clients can access it via mobile tablet computer Smart TV, basically anything that connects to the Internet, so it’s very responsive and easy to use that way. We’ve done it in an easy way such that whether you are a novice and never use technology before or you’re someone that uses it day in Day Out you can do it very quickly and then we’re working with practices now that don’t even schedule appointments, but they’re still using our system because it integrates with practice Management Systems where it can act as like a new client registration form and instead of having paper forms that then the staff has to copy in or manually enter in there’s just a digital form it automatically creates those client and patient records and does away with a lot of those manual processes that you and I have been mentioned and have seen throughout your careers.
Ivan Zak: So with with the integration and I have some questions so with smart flow I’ve struggled a lot connecting with the major practice management. System and it’s been a long time couple months, but I’m just wondering in your experience. It just seems to me that the systems are locked and even though some of these bigger organizations with you know, with a number of pins in them saying we’re totally open. How is the process of integration? Is it more open market? They all automated easy easy to just say hey, I want to work Let you in and then everybody is happy or is there still a struggle
Nick Kurgansky: It is still very much a struggle because as you said a lot of them are closed whether it’s because they’re not web-based or because they’re owned by someone who has five or six of them. It’s not as open and intuitive as it could be. So there’s a lot of back and forth both from an administrative and legal perspective trying to figure out what data is. Miscible or permitted to go back and forth what access is external Parts can have but then from a technical perspective because everybody uses different technology different languages different databases. So it’s trying to figure out how to align all of that so that when you do integrate it to whatever capacity the company will allow you or there’s the functionality to do overriding data or breaking data deleting data because you have it labeled differently than in their system. So it is still a very long process. It could take months and months to make Headway with a company just from an overarching standpoint. And then once you actually get access if you get access it then takes time to build out the technical integration work through bugs missing capabilities. So it’s a very lengthy process.
Shawn Wilkie: Thanks so much. Much for listening to the veterinary Innovation podcast. We’re pretty social people. So you’ll find us on every social media channel.