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Managing a Veterinary Clinic Chain
in Finland
Veikko TuovinenPhD, DVM, MSChief Development OfficerThree Plus Group Ltd.
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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
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Helsinki – Brno = 1600 km
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Finland?• 5.5 million people• 338,435 km²• 70 % forest• 10 % water
• 187,888 lakes• Independent 1917• EU member 1995 Capital: Helsinki
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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
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Management - POCCCPlanning
OrganizingCoordinatingCommanding
Controlling
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• 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
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• 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
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Management via our Story• Three Plus Group was established in 2007
(Parent company)
Small animals (Verkavet)
IT technology(Finnish Net Solutions)
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Values”The most valuable assets
of the company are its values”
TPG’s valuesHonesty
TransparencyAppreciation of the othersGrowth and Development
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Homework• Which are your values?
– Not nice sounding, but real ones
• Do you share the same values with yourpossible business partners?– Challenge each others
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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
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Strategy
“High level plan to achieve the goals under uncertainty”
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Background for Strategy• Market size• Trends• Demand / supply• Competitors• Consumers’ needs
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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
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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
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Four ”views”Customers’ viewPersonnel’s view
Process viewOwners’ view
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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?
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Customers’ needs 2007– evening, night, and
weekend services– basic and emergency services– better phone service– internet services
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Personnel 2007• No existing employees
• Must find vets, nurses and clinic managers• Must find ”winner teams”• We must offer an attractive choice
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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
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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
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TPG’s Strategy 2007
01.05.2023 Veikko Tuovinen 24
Quick growth!- turnover from 0,3 to 7,5 million e in 2015
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TPG’s Strategy 2007– Basic and emergency services
• Evening, night, and weekend services• Cooperation with specialized vets
– Small animals only – a chain of clinics
01.05.2023 Veikko Tuovinen 25
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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…
01.05.2023 Veikko Tuovinen 26
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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
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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
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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
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How to grow quickly?Personnel• Manager, vets• Nurses, other• A Winning Team• one person can change the whole clinic
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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)....
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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
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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
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How to grow quickly?Mobile
– Popularity increases– Interactive– Tuhatjalka was the
first company in Finland offeringmobile services
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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
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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
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Chains?
01.05.2023 Veikko Tuovinen 38
• Save money– medicines, supply… better discounts– adverts, management…
• Common procedures– bencmarking, quality control, prices, …
• More together, synergy advantages– contracts, salaries, accounting, management
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Tuhatjalka Clinics 2015
Turku
Tampere
Jyväskylä
Kuopio
VirkkalaHelsinki
Savonlinna
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Tuhatjalka personnel
0
10
20
30
40
50
60
70
13
18
45 45
53
6360
2008 2009 2010 2011 2012 2013 2014
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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
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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
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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)
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Change in market• Contract prices of 24/7-services down• Competitors use Provet, too• Digital marketing common• Hard competition
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Future• Back to basics
– market size– trends– demand / supply– competitors– consumers’ needs– our strenghs– SWOT
• Values
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Market 2015
01.05.2023 Veikko Tuovinen 46
• about 200-250 million euros• annual growth 5-10 % (?)• 2450 vets, about 1800 in working life• approx. 1 - 1.2 million vet visits
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Finnish vets 2015
01.05.2023 Veikko Tuovinen 47
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
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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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01.05.2023 Veikko Tuovinen 49
Economic depression=
a great possibility to strong companies!
Depression
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Tuhatjalka decided?
01.05.2023 Veikko Tuovinen 50
Secret, but guess
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Managerial skills
01.05.2023 Veikko Tuovinen 51
What skills does a manager need?
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Managerial skills• Political
– Connections– Power
• Conceptual– Ability to analyze complex situations
• Critical thinking
• Interpersonal– Ability to communicate, motivate, mentor and delegate
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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
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• How many vets, nurses, other• Working hours, shift cycle• Required skills• Salaries
– Per hour / provisional / bonuses– Shift differentials– Staff benefits
Example: Human Resources
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• 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
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• 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
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• Basic principles• Location
– Good parking spots /better location
• Hardware• Services and products• Pricing
Building clinics
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• 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
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Concepts• Similar or different clinics?
Laboratory (every clinic)• VetABC• VetScan, etc.
Half Digital X-ray (every clinic)• GeR• Agfa
Savonlinna’s reception
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Operation room, TuhatjalkaJyväskylä
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• Partners (devices, pet feed, supply…)• Cooperation (other clinics, experts…)• Contracts• Media• Social media• Etc…
Other examples
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Services and products• Shop / webshop• Treating / Preventive• Services:
– All possible / short list– Basic / specialised
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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
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• Do you recognize your competitors?– Other clinics– Clinic chains, also foreign chains– Capital investors– Insurance companies– Pet accessory shops– Department stores– You?
Possible competitors
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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
01.05.2023 Veikko Tuovinen 65
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Managing is full of intresting challenges
Thank you!