In This Episode
Business metrics are often thought to be in direct opposition to the purpose of a veterinary clinic. While providing great care is top of mind, clinics are ultimately businesses, and that comes with measurements and data that can be used to optimize and improve systems, creating efficiencies and keeping employees engaged.
This week on the Veterinary Innovation Podcast, Shawn and Ivan are joined by Dr. William Griffin, formerly of Pathway Vet Alliance, as they explore ways that defined processes and KPIs can scale to help clinics of any size.
Dr. Griffin recommends The Leadership Gap: What Gets Between You and Your Greatness by Lolly Daskal.
- Growth Systems and Processes
- Business Metrics and Benchmarks
- Net Promoter Score
Shawn Wilkie: You’re listening to the veterinary innovation Podcast, You’re listening to the veterinary innovation Podcast, my name is Shawn Wilkie and along with my somewhat awesome co-host, we interview innovators in this space – every week. Ivan why don’t you go ahead and introduce today’s guest.
Meet our guest – Dr. William Griffin
Ivan Zak: Hi, I’m Ivan Zak and I’m introducing a friend of mine. Dr. William Griffin and we’re going to talk about Innovation and people management platforms. What we dug up on Bill is that he’s most recently Chief Support Officer of pathway vet Alliance the fastest-growing Visionary consolidator group before that. He was a Founder CEO and the medical director of regional Veterinary emergency and Specialty Center known as Regional vet and he graduated with honors from pennsylvania vet school and had a special interest in radiology and Diagnostic Imaging welcome to the show Bill and thank you for joining us.
Shawn Wilkie: It was great to talk to you just as we kind of caught up before the podcast we’ve been trying to do this for several weeks now Super duper happy to have you here build. We’ve had lots of conversations about the work that you did a pathway and I think in my notes here, it says you guys went from 13 hospitals to over 200 in the time that you spent there. What kind of processes what kind of systems did you put in place to help facilitate that growth?
Dr. Griffin: Well first start by saying that the time frame that we achieve that was was really unexpected. You know, the original plan was A Five-Year Plan and we really weren’t sure how quickly we could acquire practices and really how many practices would be interested in joining the pathway team. We quickly found out that there was a lot of interest and that the acquisition side of it obviously pose challenges, but the rate limiting step was truly the integration as well as the operation of the practices
Ivan Zak: So when you say integration, I mean to some folks and before I get more familiar with the consolidation world or before I exited smart flow into idex integration is the process when something is acquired and then integrated into existing system and I assume that you refer to integration of the hospitals after acquisition into the pathway system. Is that correct?
Growth Systems and Processes
Dr. Griffin: Yeah, exactly. You know that the pathway model was unique at the time, you know, the big consolidators then you know was certainly DCA and loop Purl and NBA as well as a few others halfway was unique in the fact that really we were looking to partner with practices and leaders that were interested in retaining their vision their brands and creating a legacy Go see for their teams to continue on versus some of the other consolidators were basically when you were purchase you have very little say in how things continued post-acquisition. So with that some challenges that I heard about the consolidators is that as soon as the acquisition happens the practice owners are quickly losing interest in participating in the day-to-day activities, is that the experience that you’ve had through pathway or the vision was supporting more of the previous owner participation. Well it varied and exciting part was when you when you partnered with a group or owner and the model really resonated with them and they were able to unload or unpack some elements of their responsibilities that they felt they may be were no longer the best person to do but they were still super passionate about the profession about their team about, you know delivering care as also now with an opportunity to work with a larger group, you know, it was it was something that many of them were excited. It was the next phase of their career those those practices were great because it was local ownership and then as a consolidator, we could offer them tools and resources that they would have otherwise had others were the alignment wasn’t as strong created challenges where maybe they were looking to truly exit retire and their team then was left without you know, a true north or leader that was on sites to then provide the vision and understand the why behind what they were doing day-to-day,
Ivan Zak: You know the growth to four hundred and fifty percent over three years is just something that’s unheard of in the industry and with that. I’m sure that that was all celebrated is a big success but it comes with it significant pains and if it was never done previously what was sort of the key factor or factors that allowed you to such a significant growth over a short period of time.
Dr. Griffin: Well, I think again from the am a model it was really attractive to people, you know, because it was such that your brand your legacy was gonna be left intact it also allowed you as the seller to basically have equity in pathway. So you’ve benefited from the consolidation that’s occurring in the industry. So, you know as a single owner you really can benefit from that Arbitrage as part of a group then you get the upside of Arbitrage as well. So that was really enticing to many people and it was unique at the time and attracted a lot of lot of interests the challenge then was what was the operating system. What was the operating model and how could that scale and pathway was unique, you know led by Sean McVeigh who was the CEO at the time and Jason trout line is the founder, you know, a lot of it was was really focused on the human element. You know, how do you really Empower and capitalize your Frontline teams that resonated a lot with me because I was really passionate about the value of the nursing team this from Healthcare delivery point of view. And in order to scale that Sean took traction, which is a management tool and modified it into a pathway methodology of allowing practices to self manage.
Ivan Zak: This is very interesting because at some point as I left, idex I had a lot of people reach out and ask about what technology should we use and then every time I talk to someone like that I’m saying. Well, what are you trying to achieve and the and I think that technology is one piece, but what I’m hearing is that there was a there was a people management operating system that is outside of technology that combined with technology produced such a result. Is that right?
Dr. Griffin: Yeah, but you know Wickman wrote a book called Traction and it really is it’s a relatively simple methodology of how to empower teams to lead themselves based upon core values and you know, Sean modified that and that became pathway planning and pathway planning was distributed across the entire organization down to the individual practices in the practices. They Define their core values their Vision their mission and that was used to then create a framework and a structure that people would hold themselves accountable. It was their vision. It was the pathway system and it really allowed teams to suddenly take take responsibility and ownership and be able to start self-managing in a way that again in the right hands and the right practice was pretty transformational incredible.
Ivan Zak: And the traction is something that I you know, that that book is very dear to me because smartphone has managed the same way and then part of it was implemented when I was at idexx as well. It really is around that people operating system, but also with the significant metrics, so is that something that you were able to develop at pathway? And is there sort of kpis? I don’t want anything proprietary to be shared of course. It’s a you know, it’s an organization but is there are industry standard Corporation sort of metrics that you can share with the listeners that are maybe preparing their practices for sale in and getting ready to have those metrics and and how really are they available to plug into the whole traction system to be successful in the day-to-day management.
Dr. Griffin: Well you touch on an interesting topic, you know benchmarks metrics standards those words in the veterinary lexicon don’t always communicate something positive, even at the individual practice level talking about standards can be challenging now when you take that at an Enterprise level where you’re working with, you know, General practices ER practices hybrid practices specialty practices practices that have boarding grooming, you know, and then alternative medicine. It’s extremely challenging to come up with benchmarks that basically cross all of those different practice types. So the honest answer is that was probably one of the biggest challenges of being able to get actionable data and have some benchmark to judge. You know how that practice was to that data point. I heard the sort of something that I feel is in every business is the key point is the actionable metrics because so many times you, you know, you go to lectures and you listen to you know, you should be measuring this you should be measuring that but I think that the most important part is what do you do with it and we have this great podcast that we thought we were recording with our friend Joel Parker, but someone fucked up and didn’t but we I’m sure we’ll repeat the episode recording with him
Shawn Wilkie: And just to be clear. That was you right?
Yes. Now I have to admit that I’ve shout but but yes, we know am I talkin again?
Dr. Griffin: Yeah. I’m sure he wouldn’t mind talking again.
Ivan Zak: He was very engaging conversation right around that topic because his philosophy and he’s more involved in with the day-to-day practice of the individual that’s exactly the same problem that his philosophy introducing metrics that are actionable and helping organizations to produce the numbers of them when they change you can actually act on them and I think that the, you know the challenge it sounds like the challenge is the same at the corporate level, but then there’s also you know our our common problem of getting the data. So so are there any any sort of easy shortcuts or anything like that to access the data in the industry, are there any vendors that provide analytics that help you to understand that so yeah, there’s a lot of vendors. I don’t think is any shortcuts some of the challenge with the vendors is the data is the kpis are only as good as the accuracy of the data.
Dr. Griffin: So that was one of the challenges with the you know, multitude of disparate practice Management Systems the practices have and then on top of it. Obviously the fact that there are no standards as far as the service and inventory codes. It’s very challenging to make sure that you have the data that is accurate that then you can then start to communicate with practice leaders or Regional leaders and try to determine a Cause. So one of the things that halfway did that really was also very bold and addition to the rapid acquisition the model I think was bold of leaving ownership and control in the practices hands was to say well in order to try to get some standard data and to be able to accelerate practices their clinical growth is to standardize the practice management system. And so pathway researched all the practice Management systems that were available and looked for one that really was robust enough to support everything from a general practice to a multi specialty practice at the same time that had a standard centralized structure that would allow for standards to these develop internally. So the benchmarking you’re asking about if practice is All Worked on the same system and use the same codes then you would really be able to then start having some clean data that you would then be able to report on that must have caused. So a lot of pain pill well, yeah, especially to find pain right some people’s pain other people’s pleasure and you know, honestly overall it was extremely challenging but it was also satisfying because there are very few practices that are really happy with their practice management system. And so to be honest with you out of the about a hundred practices that we converted to a standard system while I was there, I would say that 90% of of them were happy with the concept of moving to a standard system that provided better functionality. And so there really wasn’t a lot of lot of communication needed. Once you articulated why it was being done everything everyone from the owner to the managers was saying wow, we really need this.
Business Metrics and Benchmarks
Ivan Zak: This is great when we were talking about metrics. I recently went to John Hopkins Medical Emergency Department Baltimore, and and I was talking to them about the metrics that they are measuring and it sounds like when we are talking about consolidator, there’s for the most part people are worried about the numbers the productivity. They Revenue are their metrics that you are familiar with or you were following then go outside of that because I feel that when you are measuring revenue or how many appointments have you booked or things like that that all drives the business, but I I don’t really think that receptionist OR technician or driven by the passion and a love of animals really give a shit about so are there, you know metrics that you measured or you envision that at the hospital level should be measured to drive other Behavior rather than Revenue generation because I think they’re related but we don’t look enough at them.
Dr. Griffin: Yeah. So he one of the ones that was powerful was an NPS score or clients satisfaction. We well I was they weren’t really able to scale that it was done in some practices and not others but there was a system that was being implemented that would scale it and that was really the practices that used. It was a real eye-opener because it allowed them to understand what their clients were thinking and saying about them and provided some real time feedback for people to evaluate, you know, their communication potentially their systems and it’s done properly. It really allowed people to optimize and pivot based upon what their clients were saying about them, you know,
Net Promoter Score
Shawn Wilkie: you mean the net promoter score right just for our listeners that might not be familiar with that.
Ivan Zak: Yes, you know just to shift gears a little bit. The consolidator world is now more and more familiar to us. And from what I know there’s about 20% of practices and at least North America are Consolidated and are put on one or another system. There’s you know certain Visions there. He’s there in the last, you know, 15 20 years of this process. Do you think there’s any sort of certainly pathway stood out as innovative model? Where do you see the future of the consolidators go is this going to be 5050 Consolidated not is there a new opportunity and how we manage these practices or consolidators manage these practices and what is the next new thing for them? Because it seems like there is just a repeatable model. And then it’s just isn’t just buying practices and we’re going to wait until it dilutes or what’s going to happen.
Dr. Griffin: Yeah, it’s a great question. You know, I think the model is changing, you know based upon the experience that the profession has with consolidation, you know, I mean sellers now right there in the market and thinking about selling and five years have the benefit of now looking back and saying well what’s happened in the market over the last five to ten years when pathway started it was still pretty early. So that was good because you know, people only really had a VC a and envy a model to look at so pathway was very different and therefore, you know, it was neither of those two entities. Therefore pathway was was A lines pretty well, however, you know last three years or so. I mean, there’s a large number of consolidators many of them have a very similar message about people caring and compassion and they’re not talking about even though and Arbitrage and multiples. However, having said that you know, it’s some point all of the high-performing practices are going to be consolidated because we know that you know veterinarians don’t want to take on the responsibility or the financial debt to purchase these practices. So the good ones they’re either has to be a transition process where the ownership is transitioned from the current owner to Associates, which is challenging or it’s going to have to be to consolidate of so in the near future many of those practices are going to be no longer available. So the next level are going to be practices that have a lot of opportunity and m&a loves opportunity, right because now you can expand margin through processes and so you You can buy lower. You can buy at a lower cost lower multiple. And then you can expand the margin by implementing system across the protocol and buying power. However, that requires a lot of change change is difficult as we all know and what we’ve seen so far is that there really is no good operational platform to effectively and efficiently improve operating performance in the veterinary space. We proved that we could acquire them improve and we can manage them. We haven’t proven that we can improve their performance at an Enterprise level at scale.
Shawn Wilkie: It’s so interesting. I think we’ve had at least a few guests on our show, you know, the Innovation lead from PCA Brendan and and I think that that’s a topic where we could literally put two or three you guys in the room and I think there’ll be a lot of engaging debate, the one of the things that I wanted to do is just shift the direction a little bit kind of keeping in mind that we’ve got a lot of that practice owners that are listening to our show and as a business owner as a technology guy, you know, one of the things that I’ve always not necessarily always struggle with but you know often have struggled with is getting everybody that’s in the boat. That is the business rowing in the same direction and you guys went from you know, a small group that was sizable to this colossal group. And would you attribute a lot of that getting your team on side and getting the external practices on side with the traction book? It was or other specific things that you can put your finger on that may help get their team going in the right direction. I mean, it’s obvious that you’ve got a wealth of experience and just want to ask you that question.
Dr. Griffin: It’s a great question and it’s you know, it’s a point of passion. So say what started with the idea that there is a better way and there is a better way became one of the key themes to the brand and it resonated on every level it resonated with compassion fatigue burnout with suicide with the limited growth opportunities for the support staff and many people had spent, you know, a lot of their adult life in the veterinary profession and we’re very passionate about trying to figure out, you know, how to deliver care in a better more consistent way that created opportunity for the practice teams. And so that passion is I think what really fueled the growth of happening.
Shawn Wilkie: Thanks so much for listening to the veterinary Innovation podcast. We’re Pretty social people. So you’ll find us in every social media channel. Also, you can check out our website at the veterinary Innovation podcast.com. Thanks so much for listening.