On Thursday, May 17, 2012, 12 noon, I had a meeting with my associate vets, both facing me with serious faces across the consultation table. A client came but I asked her to wait.  My management meetings do get interrupted and the train of thoughts get de-railed and so I ask some clients to wait a while and keep my talk short and sharp. Walking the talk to make Toa Payoh Vets the top 3 veterinary surgery in Singapore is an uphill task, requiring frequent checks and balances on the staff performances.

For this meeting, I got a big book and recorded down the meeting points.

1. Strategy.  Being the top 3 veterinary surgery in Singapore. I said: "It is easy to talk about my vision of Toa Payoh Vets being the top 3, especially in veterinary surgery. Talk is cheap. Talk is easy. I have implemented certain checks on your work and you may not like my frankness in pointing out deficiencies. But this is part of management and part of continuing education."

2. "Keeping meticulous records is part of this vision. How can Toa Payoh Vets be the top 3 if its vets don't keep meticulous records?"  I illustrated a case of a vet's sedation of a Beagle with the bladder tumour which was a "trust and audit" case done by me to check on the standard of care.

The injection given was 30% of Dom and Ket as instructed by me and was injected. The dog was old, had fits, low red blood cell count and was dribbling bloodied urine. The figure written was 50% as no amendment was made when there was a change to 30%.  "Meticulous records in anaesthesia and surgery provide a strong defence in the case of litigation," I said. "There will be more litigation and complaints as Singaporeans get more educated and demanding. So, meticulous recording by the vet provides a strong defence. I will be printing serial number record books soon and the operating vet will be personally responsible."  All corporations have similar stories of having to motivate staff to be meticulous in their work and so the "trust and audit" model of checking their work is necessary. 

3. Keeping associate vets happy so that they will stay with Toa Payoh Vets. The vet is the prime mover but that does not mean that he or she can order any drug he or she likes and not be aware of the high costs. "Keeping the associate vet happy does not guarantee his or her loyalty to Toa Payoh Vets," I had said privately to Dr Daniel. "With sufficient clientele and easy access to money from parents or joint start ups with another vet, I don't expect associate vets to stay long and be loyal to Toa Payoh Vets." 

"We have several cases where the rich parents finance the start up of new vet practices. No sweat for the younger vets as regards the need to earn sufficiently before opening because the money is already provided by the parents."

4. Leaving a legacy for the 2nd generation. I have stated to my associate vets that I do not build up Toa Payoh Vets for the second generation. I will just sell off the practice and retire when I am unable to practise. I don't worry about legacy. If the 2nd generation can't perform, so be it. In any case, the Toa Payoh Vets will just decline as there will be more intense competition over the years. The practice will die off as excellent performance counts a lot in a vet practice as referrals come in from other parts of Singapore.

"The Beagle with the bladder tumour (Trust & Audit in a Case of an old dog with fits and bladder cancer) was from Pasir Ris and the Shih Tzu with the crusty scabies ears  (No Smoke Without Fire - No Scabies Without Mites) was from Jurong East. So, there must be some reasons they come to Toa Payoh Vets when there are other vet practices conveniently nearby." I said to my associate vets as these two cases were handled by me.

There are around 50 vet practices in Singapore in 2013 and there will be at least one near Pasir Ris and Jurong East and the majority of Singaporean pet owners will go to the vet based on proximity.  

5. USP. "One Unique Selling Proposition" of Toa Payoh Vets is that there is no need to come back for stitch removal," I said. "Yet one associate vet asks clients of spayed and neutered dogs to come back in 14 days' time." There is a need to be consistent in veterinary surgery amongst the vets here." I said.

6. There were other issues such as vet cost and the vets gave their feedback. "Ultimately, in a corporate world, associate vets have to take instructions from the superior or boss. If not, they better open their own practice, order expensive drugs they like and do consultations of half an hour per average case." There is a need to provide affordable vet costs and reduce waiting time. Obviously if the associate vet spends half an hour per case and keep the others waiting 2 hours, there will be much dissatisfaction in many others as Singaporeans are time-pressed. Associate vets need to learn how to be productive, efficient and manage their time well after graduation as service is time-based and long waiting times are not appreciated by the Singapore clientele.  

In conclusion, real world business needs to be profitable. Otherwise, associate vets will get lesser pay and will just go to another practice. As simple as that. A happy working environment with poor profits will not retain any associate vet even if the management makes them happy at work.

There is the bottom line and the need to recover a decent return on investment for the founder too. Many vets don't know how to do the financial analysis. "A high revenue with high expenses does not mean that the business is making money!" I said to the associate vets. "It is the net profit that is important."  Much management is still required to execute the clinical governance and expertise in 2013 and beyond if the vision of being the top 3 veterinary surgery in Singapore is to be realised

Update: As at March 18, 2013, one associate vet and the vet assistant of 2012 have resigned to join other practices. Resignations and changes are part and parcel of practice and life. More efforts on my part are needed to focus on providing a high quality of service.