Managing a Veterinary Clinic Chain

in Finland

Veikko TuovinenPhD, DVM, MSChief Development OfficerThree Plus Group Ltd.

Carrier• Mixed practice, 5 years• Disease prevention, 14 years• Research, 6 years• CEO, Tuhatjalka Clinics 2008-2015• Chief Development Manager, TPG, 2015-• DVM 1982 (Helsinki)• MSc epid. 1990 (Cornell), PhD 1994 (Helsinki)

– Control of Swine Diseases by Slaughterhouse Activities• Dipl. ECVPH 2003, Dipl. ECPHM 2004• Honours (Finnish Vet Union)

– Golden Medal of Honour, 1998– Vet of the Year, 2001

Helsinki – Brno = 1600 km

Finland?• 5.5 million people• 338,435 km²• 70 % forest• 10 % water

• 187,888 lakes• Independent 1917• EU member 1995 Capital: Helsinki

What is Management?“Management is the function thatcoordinates the efforts of people

to accomplish goals and objectives by using available resources

efficiently and effectively”Wikipedia

Management - POCCCPlanning

OrganizingCoordinatingCommanding

Controlling

• Plan: • what needs to happen in the future• how to generate plans for action

• Organize: • Make sure the human and nonhuman

resources are put into place

Plan and organize

• Coordinate: • Create a structure through which an

organization's goals can be accomplished

• Commande: • Determine what must be done

and get people do it

• Control: • Check progress against plans

CCC

Management via our Story• Three Plus Group was established in 2007

(Parent company)

Small animals (Verkavet)

IT technology(Finnish Net Solutions)

Values”The most valuable assets

of the company are its values”

TPG’s valuesHonesty

TransparencyAppreciation of the othersGrowth and Development

Homework• Which are your values?

– Not nice sounding, but real ones

• Do you share the same values with yourpossible business partners?– Challenge each others

Vision”How the company looks like

after 5-10 years”

Turnover is >7,5 million euros in 2015

The company is solid and profitable

Good quality pet health care for customer’s needs

Verkavet’s Vision in 2007

Strategy

“High level plan to achieve the goals under uncertainty”

Background for Strategy• Market size• Trends• Demand / supply• Competitors• Consumers’ needs

Market 2007• 100-130 million euros• annual growth 7 %• >600,000 dogs• >500,000 cats• >700,000 vet visits• lack of vets, evening, night and weekend

services

Vets 2007• 1843 vets

– 1400 active– About 850 practitioners

• 440 pet vets– 180 small clinics

POSITION* N %Municipal and Governmental 703 50.2Private sector 444 31.7Substitutes 207 14.8Others 47 3.4TOTAL OF ACTIVE VETS 1401 100.0

Students 290

Retired 293

*Finnish Veterinary Association’s members 2007

Four ”views”Customers’ viewPersonnel’s view

Process viewOwners’ view

Customers• Who are our customers?• What services they need?• What is the trend in needs?• Why customers choose / don’t choose us?• What could we do better than competitors?

Customers’ needs 2007– evening, night, and

weekend services– basic and emergency services– better phone service– internet services

Personnel 2007• No existing employees

• Must find vets, nurses and clinic managers• Must find ”winner teams”• We must offer an attractive choice

Process view• How processes are planned to work?• How processes work?• Continuous iteration

CEO and clinic managers must have skills to recognize all processes!

• We had no existing processes- A huge challenge- Possibilities

Owners’ view• A company

• Must produce profit• Must follow the company values

• Has the company a winning team?• Skills, motivation

• Does the company have strength to grow?• Good vision, investment money

TPG’s Strategy 2007

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Quick growth!- turnover from 0,3 to 7,5 million e in 2015

TPG’s Strategy 2007– Basic and emergency services

• Evening, night, and weekend services• Cooperation with specialized vets

– Small animals only – a chain of clinics

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TPG’s Strategy 2007– Utilisation of internet

• Practice Management Software (Provet Net)• web pages (www.tuhatjalka.fi), facebook (https://www.facebook.com/tuhatjalka?fref=ts),

google…

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How to grow quickly?Buy clinics (carefully…)• customers, location, future market, staff…

clear vision• analyze the balance sheet with care• don’t take unnecessary risks

How to grow quickly?TPG bought two clinics in 2008

– Bank loan, biggest risk in our history

– First clinic (Tuhatjalka) was a succesName for the whole chainExperiences from night and weekend service

– The other • Too small (one vet + nurse)• Closed 3 years later

How to grow quickly?Build clinics (carefully…)

– Analyze market possibilities– Location, location, location… - very important– Layout – Operation mode– Tuhatjalka built six clinics

• one flopped, closed in one year

How to grow quickly?Personnel• Manager, vets• Nurses, other• A Winning Team• one person can change the whole clinic

How to grow quickly?Advertise• Web pages, social media• Mobile (http://tuhatjalka.fi/mobiili)

• Google• Text messages, calls• Street • (phonebooks, magazines, radio, taxi windows, road signs, sponsoring,

tv (https://www.facebook.com/tuhatjalka/videos/146829552095125), calendar (https://www.facebook.com/media/set/?set=a.254165527963440.63154.147004062012921&type=3)....

How to grow quickly?Answer the phone - quickly• Phone center

– professional phone service• Tuhatjalka answers 24/365• Phone connected to Provet

– recognizes the customer– opens the patient card

How to grow quickly?Web Pages

– connected to Provet– time reservation– treatment history – reminders, messages– chat, pictures, stories– anamnesis, check in…

• let the customer do the work

How to grow quickly?Mobile

– Popularity increases– Interactive– Tuhatjalka was the

first company in Finland offeringmobile services

How to grow quickly?Cost Effective Quality Service

– What ever you do, do it well• Professional• Customer Service• Documentation

– Price is important in basic services, less in special

Cat Friendly Clinic- Tuhatjalka Turku was the first Gold Certificate Cat Friendly Clinic in Finland(http://icatcare.org/cat-campaigns-cat-friendly-clinic/accredited-clinics)

Quality

Chains?

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• Save money– medicines, supply… better discounts– adverts, management…

• Common procedures– bencmarking, quality control, prices, …

• More together, synergy advantages– contracts, salaries, accounting, management

Tuhatjalka Clinics 2015

Turku

Tampere

Jyväskylä

Kuopio

VirkkalaHelsinki

Savonlinna

Tuhatjalka personnel

0

10

20

30

40

50

60

70

13

18

45 45

53

6360

2008 2009 2010 2011 2012 2013 2014

2008 2009 2010 2011 2012 2013 2014 20150

5000

10000

15000

20000

25000

30000

35000

40000

6734

16305

24535

34111 33232

3787734997

32824

Client visits

Estimate

Turnover

2008 2009 2010 2011 2012 2013 20140

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

8,000,000

9,000,000

935,748

2,295,371

3,241,146

5,196,3225,791,874

7,699,6127 210 419

Euros

Change in market• Long economic depression• More vets supply>demand

– we, too, have lost customers• Capital investors two big chains

– Animagi 37 clinics, Univet 17 clinics• merged in 2015• 54 clinics (about 35 % market share)

Change in market• Contract prices of 24/7-services down• Competitors use Provet, too• Digital marketing common• Hard competition

Future• Back to basics

– market size– trends– demand / supply– competitors– consumers’ needs– our strenghs– SWOT

• Values

Market 2015

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• about 200-250 million euros• annual growth 5-10 % (?)• 2450 vets, about 1800 in working life• approx. 1 - 1.2 million vet visits

Finnish vets 2015

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POSITION N %Municipal 414 22,9Governmental 204 11,3Private: employees 268 14,8Private: entrepreneurs 259 14,3Substitutes 462 25,5Others 204 11,3TOTAL 1811 100,0

Our strengths• Second biggest chain in finland

– About 3 % market share– 7 clinics, own phone center– Biggest in 24/7-services (4 clinics)

• Qualified, international personnel• Solid financial standing• Full Provet utilisation• Ten multidisciplinary owners

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Economic depression=

a great possibility to strong companies!

Depression

Tuhatjalka decided?

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Secret, but guess

Managerial skills

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What skills does a manager need?

Managerial skills• Political

– Connections– Power

• Conceptual– Ability to analyze complex situations

• Critical thinking

• Interpersonal– Ability to communicate, motivate, mentor and delegate

Managerial skills• Diagnostic

– Ability to visualize most appropriate response to a situation

• Leadership– Ability to lead and provide guidance to a specific group

• Technical– Expertise in one's particular functional area

• How many vets, nurses, other• Working hours, shift cycle• Required skills• Salaries

– Per hour / provisional / bonuses– Shift differentials– Staff benefits

Example: Human Resources

• Motivation, basic and further training• Staff benefits (Tuhatjalka examples)

– Sports and culture voucher (400 e/y)– Discounts of pet feed and treatment– Relaxation evenings and trips– Free time health ensurance, etc.

• Occupational health care and wellbeing• Participation on decision making

Human Resources Policy

• Trust / control • How to handle problems

– Violation of company values– Violations of privacy protection– Avoiding duties, negligent to superior advices– Recurrent mistakes– Bad customer service– Stealing, narcotics, alcohol, smoking at

work...– Etc.

Human Resources Policy

• Basic principles• Location

– Good parking spots /better location

• Hardware• Services and products• Pricing

Building clinics

• Independent / chain / francising• Small / big• Hospital / clinic / (alone)• Many small clinics / one big• Close to / far away from the other clinics• Services and products• Shop / only vet work• Etc.01.05.2023 Veikko Tuovinen 58

Consepts

Concepts• Similar or different clinics?

Laboratory (every clinic)• VetABC• VetScan, etc.

Half Digital X-ray (every clinic)• GeR• Agfa

Savonlinna’s reception

Operation room, TuhatjalkaJyväskylä

• Partners (devices, pet feed, supply…)• Cooperation (other clinics, experts…)• Contracts• Media• Social media• Etc…

Other examples

Services and products• Shop / webshop• Treating / Preventive• Services:

– All possible / short list– Basic / specialised

Services and products• Which animals you treat• Basic /special• Specialists

– own / contracts • Prices and paying

– Cash, card, invoice, installments, in advance– Per service / time, even monthly payments

• Do you recognize your competitors?– Other clinics– Clinic chains, also foreign chains– Capital investors– Insurance companies– Pet accessory shops– Department stores– You?

Possible competitors

Conclusions• Management is taking care of everything

in the company– Lead doing– Delegate and trust your team members

• Control by key economic figures, quality work and customer satisfaction– Utilize Clinic Management Program’s reports

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Managing is full of intresting challenges

Thank you!