Introduction to Knowledge Management in Veterinary Consolidation

In the dynamic world of veterinary healthcare consolidation, two distinguished voices come together to shed light on the pivotal role of knowledge management. Kateryna Shelest and William J Griffin, VMD, engage in an insightful dialogue to explore the challenges and solutions within this evolving landscape.

Kateryna Shelest (KS), an expert in customer support and the Founder and CEO of KATICO, has been a driving force in enhancing operational efficiency and transparency in veterinary consolidations. With a customer support career spanning nearly a decade, she boasts a track record of transformative change across diverse business sectors. KS’s leadership shines through her notable achievements, including the successful launch of multiple Knowledge Hub Projects serving consolidators with over 1,500 personnel, and the innovation of frameworks for software selection, proactive knowledge accumulation, and operational process enhancement.

On the other side of the conversation, is William J Griffin, VMD (WG) a creative entrepreneur with over 25 years of experience in the veterinary industry. As a co-founder of one of the fastest-growing consolidators and industry consultant, he brings a unique understanding of the complexities involved in advancing teams and technology to improve clinical and business performance.

KS and WG’s paths first crossed during their collaborative work for a prominent consolidator long before the inception of KATICO. Today, they come together for an insightful interview to discuss the challenges and opportunities surrounding knowledge management in veterinary consolidation. With KS’s exceptional achievements in operational excellence and WG’s deep industry knowledge, this dialogue provides valuable insights into the evolving landscape of veterinary healthcare. Join us as we explore their perspectives and seek solutions to the complexities of veterinary consolidation in the modern age.

Role of Knowledge Management in Veterinary Consolidation

Kateryna Shelest (KS): Is there any role that the knowledge base plays in veterinary consolidation?

William J Griffin, VMD (WG): Without a doubt, there’s a place for it. However, the challenge lies in the business and medical sides when it comes to applying operational structure.

I think that’s where the pushback comes in when you talk about Knowledge Base or Standard Operating Procedures (SOPs). The business side is offering structure to the medical side in terms of how they think they could operate. The medical side is pushing back on the business side, saying, “You don’t understand the actual business of medicine.” So, while everyone acknowledges the need for a knowledge base, its execution has been lacking so far.

KS: What do you think contributes to this challenge?

Challenges of Implementing Standardization

WG: Many of these younger consolidators in the last 10 years gained traction by assuring veterinarians they’d enhance collaboration without disrupting established success. The promise usually includes retaining medical leadership, brand, and existing practices, while gaining support in areas like insurance, payroll, recruitment, and marketing.

Veterinarians initially welcome this assistance, saying, “Great! I could use help.” as long as their autonomy in business, client interactions, and medical practice remains untouched. This is because veterinarians are known for their independent thinking. However, reality hits when consolidators attempt to scale. Changes in payroll, processes, and tools follow. With varying state laws and consolidator practices, even minor details like lunch policies impact clinics. The intended SOP standard seeks risk mitigation, yet practices perceive this change negatively.

KS: How can practices be encouraged to recognize the value of standardization?

WG: Certainly, there’s an opportunity here. If you market something unreal to stand out and then the post-sale reality disappoints, trust is eroded. While the Knowledge Base serves as a tool, the core issue revolves around trust and transparency. Consolidators, often young and inexperienced, lack robust knowledge structures. Veterinarians often have a better grasp of the day-to-day operations with all the nuances and complexities of their business as a single entity. However, consolidator is hundreds of units and has requirements to grow and scale their business. Therefore, the SOPs introduced by consolidators compound distrust, misalignment, and friction.

KS: So, is there a lack of a partnership?

WG: Ideally, there should be a partnership. Incentives and a structured approach are crucial for fostering an efficient, effective business. Both sides should be accountable to key metrics, with compensation — whether emotional or financial — linked to these metrics. However, the current reality falls short of this ideal.

KS: Based on our interactions with consolidators, we’ve noticed a common struggle in defining key success metrics.

WG: You’re absolutely correct. The challenge lies in the complexity and inherent difficulties within the industry. With numerous issues that may not currently have solutions, it’s not that straightforward to efficiently develop Standard Operating Procedures (SOPs) and a Knowledge Base to train and transfer knowledge to the veterinary team. Furthermore, even if they do invest time in developing SOPs, how long do these standards remain static before the change takes place? Another underlying issue is alignment within the consolidator. Are all departments — finance, marketing, operations, legal — aligned with these SOPs? Is there unified support? If not, they undermine their own standards before attempting to train the veterinary team.

Training, Change Management, and Private Equity

KS: Our observations when working with consolidators on implementing the Knowledge Hub highlight the challenges of adapting to rapid changes and aligning parties during SOP releases.

WG: Training is another aspect to consider. The resources allocated for training are quite minimal. Let’s imagine metrics are sound, departments aligned, and SOPs effective. However, how do you translate this knowledge to clinical teams? A mere email won’t suffice.

KS: Unfortunately, that’s often the case.

WG: Indeed, the training of teams is often neglected, alongside the concept of change management. Before training, a change framework must exist. This harks back to my earlier point — veterinarians resist change, having been promised minimal changes post-sale. The foundation is shaky, making effective knowledge transfer a challenge.

KS: Frequent changes often demand rewriting and consequently, retraining, consuming resources. Why do you think consolidators don’t invest much in change management and training?

WG: Having private equity as a partner means a short window to create shareholder value — typically 5 years. This short timeframe limits investment in training and change management. Costs are also significant — establishing training and change management departments, alongside core business departments, requires substantial funding. Private equity seeks returns within this 5-year span. The entire operation structure of consolidation is extremely lean.

KS: Typically, a one-time cost seems appealing to investors. Wouldn’t it be simpler to enlist change management experts and enhance communication and information flow? A singular project could transfer knowledge or ensure ongoing maintenance. Rather than entire departments, a consolidated approach of involving experts for the task could be effective.

WG: Yes. But that has to be then part of the mission and core values and budget for that consolidator to commit to change management, and change leadership.

Shift in Mindset and Future of Consolidation

WG: In fact, an interesting evolution is underway. A shift from rapid acquisition to effective operation is evident. The growth pace slows, allowing more attention to existing clinics. The need for rapid system growth diminishes as doubling size annually becomes less common, unlike the initial years where early consolidators doubled yearly. The industry’s rapid growth through acquisitions has hit a plateau, prompting a focus on delivering better care within existing practices and establishing effective systems and processes to empower staff. This shift mirrors a typical business curve, moving from rapid expansion to a period of stabilization and optimization.

Moreover, many initial sellers who sought to maintain their practice’s status retire within the first 3 consolidation years. This carries both pros and cons. While losing the practice’s leader is a downside, it might be advantageous if their vision doesn’t align with the organization’s future. Elevating individuals in tune with the consolidator’s goals is crucial. These individuals should embrace protocols and standards, focusing on clinical aspects and avoiding excessive business involvement.

Without structure, individuals tend to operate at will, making effective business management and quality clinical care challenging. As consolidators mature and original sellers exit, a more structured and systematic approach will likely emerge.

KS: But it takes time.

WG: Bingo! Time is the key.

KS: Could practice team members be missing that sense of structure and connection to data? Perhaps they lack a holistic view of how their work contributes to hospital success.

WG: You’re absolutely right. Teams inherently desire structure, even if they don’t directly express it. Human nature craves a sense of place within a hierarchy. If every workday is unpredictable — lacking expectations and impact — it leads to disengagement.

Having a well-defined, measurable, and reinforced structure, supported at the team level, can foster powerful teams. When teams are actively involved, they contribute their frontline knowledge to shape the structure. This can lead to remarkable engagement. When frontline teams help modify SOPs to improve them, they become invested in the process and embrace it wholeheartedly.

KS: Absolutely, which leads me to my next question. Could consolidators potentially involve hospital teams and leverage their experience, rather than solely guiding actions?

WG: Indeed, many consolidators begin this way. They acquire effective practices and integrate their systems, processes, and even leaders. This approach is logical until rapid expansion occurs — doubling, tripling, and quadrupling the initial group within a short span. What worked for a smaller group isn’t scalable to a larger one. Leaders of the initial 10-practice group remain in their comfort zones, unaware of the scalability challenges. This is where change management and strong leadership come into play. Without these, the original 10-practice leaders may become disengaged and negative, rather than the positive force they were meant to be.

It’s a challenging scenario. Without the right knowledge and understanding, this approach leads to friction. Some groups are now adopting a different strategy. Instead of trying to acquire diverse practices of various types — general, emergency, specialty, equine, and mobile — they’re focusing on sub-specialization or building practices from scratch. These groups take a narrow segment of veterinary care and become experts in it. Unlike legacy practices, these new practices attract individuals who want to excel in that specific segment. This approach allows for streamlined optimization of processes, systems, culture, training, and change management.

With a focused business model, these groups are likely to produce better data on care consistency, employee experience, and operational costs. While this approach might take longer than the typical 3 to 5 years, the results tend to be superior. As this becomes the industry standard, consolidated practices may eventually shift their mindset and narrow their scope to improve the overall quality of care.

Role of Knowledge Hub and Future Solutions

KS: Can we at KATICO contribute to organizing information and structuring knowledge?

WG: Absolutely. There are significant opportunities to support the Knowledge Hub concept in a more effective way than in the past 5 years. The demand for structure remains, but the approach and delivery can be improved. It’s crucial to be thoughtful about implementation, as multiple attempts to introduce standard operating procedures might lead to decreased trust and engagement.

Quality SOPs can have a transformative effect, empowering teams to take charge, lead, and feel proud of their work. It’s incredibly satisfying to witness the passion and dedication that frontline teams bring. While written SOPs are just a part of the equation, they play a pivotal role in unlocking the potential of individuals and enabling them to take direct responsibility for the care and service they provide.

Conclusion and Preview of Solutions

In this discussion, we’ve unveiled the intricate challenges of veterinary consolidation, from knowledge transfer hurdles to the impact of private equity partnerships. While the path forward may seem complex, it’s not insurmountable. As we navigate the evolving landscape of veterinary care, the next part of our conversation will delve into potential solutions and strategies that can enhance the consolidation process. Stay tuned as we explore practical ways to bridge the gap, empower veterinary teams, and optimize the delivery of exceptional care.