文章详细
美国宠物医院的管理
Henry K. Yoo
从商业模式角度，兽医学管理与其他行业一样，成功的管理模式需要必不可少的要素。在此，笔者阐述一些商业运作的原则要素，期望能给听众切实有效的帮助。通过结构化管理程序，这些要素可应用于动物医院的管理维护与其进一步发展。当团队中的每一个成员都能训练有素地在实践中运用这些要素，就会诞生新的企业文化。
当我们谈到商业模式的组成，一般会想到以下这些要素：知识、资金、信息、员工以及工作场所。尽管在过去以上这些因素都很重要，而在当今社会，因为知识、资金与信息这类资源比过去更易获得，所以商业模式真正需要的要素发生了转变。转变为：在早期商业模式的基础上，最大限度地开发人力资源（people）、工作流程（process）和商业产品（products）。当它们之间有一个系统的联系网络，最大限度地发挥每个要素的作用，这三个要素也可产生协同效应。
三个要素：人力资源是一个组织的重要力量。勤奋的员工是企业成功的核心要素，而且，员工将不断为企业创造更高效的工作流程。“勤奋的员工”与“高效的工作流程”在商业运作中几乎是同义词，因为勤奋的员工总会在工作中探索如何让系统更高效地运行。勤奋的员工在工作流程中按部就班地工作，就会生产出高质量的产品。
在人力资源管理中，为了达到更好的效率，我想提出以下几点以供参考
人才选拔：根据职位的需要，了解如何面试、选拨应聘人员非常重要。应聘简历中最重要的部分为应聘者曾经的工作经验和成绩，以及未来的工作潜力。应聘者的工作经历应该与现应聘的职位相一致，除非应聘者想要开辟一条新的职业路径。在让应聘者自我陈述以后，还应向他们进行适当的提问。
一套实用的测试系统非常重要，测试应聘者语法、词汇量以及数学能力，因为这些都是职位要求的关键要素，关系到日后与客户的沟通。给应聘者一页纸，让其写出“为什么应该雇佣我？”的理由，将显示其文字表达能力、语法、词汇量以及思维能力。注意尽量向应聘者提出开放式的问题（而不是封闭式的）。多注意聆听应聘者的回答，更能洞察其能力。如果应聘者被选中，其面试过程的记录应该保留，作为其员工资料的一部分。
退出过程：大多数时候，当工作关系结束时，雇主与员工一般都沉默无语。笔者建议大家在此刻，双方开诚布公地向对方提出建议或意见，对未来的工作给出一个明确的参考。对雇主来说，应该问问诸如“你觉得我们应该如何改进我们的管理技巧？”“在你工作期间，你觉得最吃力的地方在哪里？”之类的问题，从而了解卸任员工的想法。或者问“未来如有可能，还会来此工作吗？”与该员工保持好良好关系，时机成熟时可重新雇佣。
培训与教育：教育员工反应更快，更有责任感。员工教育应该是雇主在经营中最重要的投资，尤其是在兽医学领域。员工是第一线的工作人员，是他们每天向客户（病人）提供建议与指导，给予客户（病人）关怀。员工自信而又热情地向客户提供指导，有助于建立客户对医院团队的信任感。由此，也可展开高水平的客户教育，进一步巩固员工与客户之间紧密的信任关系。员工教育与客户教育，是企业走向成功的重中之重。
激励与授权：这是上段所述“教育与培训”的延伸。通过教育培训、知识分享、团队支持这些方式激励员工，同时也是授权机制的组成部分。当员工犯错时，对他们的鼓励非常重要，当他们干得不错是，应该及时表扬。同时建立一套机制，让员工在团队中自行考查自己的表现。
领导力：领导力不一定按等级划分，应该采取扁平式管理。为了达到更好的效果采取的自发式的行为，以及对产品进行改进，都是领导力的表现。提供一个良好的气氛，让员工们敢于冒险因为冒险可能是学习新东西的过程。在所有的员工中，公开地讨论错误，让大家都能从中学到经验。员工大会是一个主要的方式，大家各抒己见，交流自己的想法和遇到的问题。
奖励制度：这是一把双刃剑。如果使用得当，这是一个很好的工具。否则，对企业将会产生损失。在建立员工和团队的奖励制度之前，需要做详细的研究，证明该制度合理并且可以让大家共赢。金钱也许并不是最好的奖励方法。
流程管理：如果没有一个完善的员工行为准则/规范，员工在工作时就会按照自己工作方便的原则开发出一套自己的方法。职位协议与工作要义是制定流程管理的一种很好的模式。诊所每个部门都配备一个检查册，可以防止人为错误的发生。特别是接待员、动物健康技术员、手术室员工都应该有一个检查册，以便他们在结束工作前检查自己的工作是否符合要求。这些检查册中的职位协议与工作要义，可以保持员工表现的统一性，并且具有长期连续的效果。如果没有这样的指南手册，员工工作起来就像一盘散沙。以下是管理价值链：
投入（最初的投资）l
运营操作（生产产品）l
产出（不明确的产品）l
教育（市场营销）l
最终产品（更高附加值的产品）
投入资金、员工时间、知识、技能等投入运营过程，开始得到的产品非常不成熟。这是一种价值定位不明确的低端产品，只有进行消费者教育（或者市场影响），提供产品更丰富的使用性，产品的价值才能被更好地挖掘出来。也就是说，通过教育消费者的方式，可以提高产品在消费者心目中的价值。所以可能是同样的产品，但是经过不同的消费者教育过程，其对消费者产生的价值就是不一样的。
产品管理：我们兽医诊所所能提供的有以下两组产品
1. 有形产品：处方、检查结果、诊断影像，这些都直接关系病畜的健康与其所得到的服务。
2. 无形产品：以上服务过程中所给予的情感关怀、对所提供的服务消费者认识到的价值、同情心。有形产品易于认识，因为它们直观地体现在客户的账单上，为服务付费很容易理解。尽管无形产品增加了有形产品的产品价值，但由于无形产品并不体现在客户的账单上，所以客户很难愿意为此类产品付费。为了提高服务水平，提供服务的一方需要明白：产品的价值如何被客户理解这一过程。这并不仅是客户看到、摸到了什么，而是客户感受到了什么。
客户的不满：作为管理咨询师，常常有人问我如何在诊所环境中解决矛盾。通常涉及以下3个方面：
意料之外的高收费—财务方面
之前没有告之此项收费
没有向客户解释，没有与客户讨论过的额外费用l
要求客户做太多检查项目
不了解客户的需要
在电话里或诊疗时对客户的咨询回复很含糊l
在服务时滔滔不绝地讲话，却没对给客户进行相关的解释l
服务时表现冷漠或者不友好
医学不足
检查结果尚未出来l
预后不明确l
没有提供其他可供选择的解决方式l
诊断过程中的利与弊没有解释清楚
结论：有效的管理能够提高服务质量，同时能促进与客户沟通时情感的交流。管理是指一群人合作，合作时形式的工作流程能够生产质量统一的产品。尽管追求利益不是动物医院的宗旨，但所有的商业模式都是在其投资的基础上追求利润的最大化。良好的收入来自高质量的服务和给予客户的同情心。
作者：Henry K. Yoo 兽医学士MBA硕士为英菲尼迪医疗咨询公司高级顾问。Yoo博士是一位医疗战略者，向医药公司提供咨询服务，如先灵葆雅公司、艾维特营养公司等。任教于King Charles University 大学和S. Baylor University大学。他在众多机构做过演讲，并作为演讲嘉宾参加过多次国际性会议。邮箱地址为henryyoo@gmail.com
Principles of Veterinary Hospital Management
Henry K. Yoo
(Executive Consultant Infinity Management Consulting & Co.)
Introduction: Veterinary Management is not any different from other business in terms of the essential components that leads the business to a success. The author wants to express some fundamental and principle matters that the audience can use when they go back to their work almost immediately. And these elements can be used and maintained for the progress of the operation of the hospital through a structured management process. Once the maintained elements are practiced repeatedly and duplicated by each members of the team, a new culture will be established as part of organizational philosophy.
Principles Successful Business: If we take a brief look at the factors that makes a business, we used to consider the factors like knowledge, money, information, employee and building where the business should be placed at. Although these were important in the past, now the needs are shifting since money, knowledge and information are much more available than ever before. So, the might be considered as negotiable items. The needs are shifting from these negotiable elements to the maximum use of People, Process and Products based on early stage of Business Planning. Also these 3Ps can be synergistically responding when there is a professional network that can maximize the presence of 3Ps. The reason why I call them as non-negotiable is in the fact that these are original and cannot be replaced with other factors.
3Ps: People Factor is the beginning of an organization. The team of dedicated People is central part of a successful unity and the People will continuously build process that is efficient system that controls work-flow. Dedicated People and Efficient Process are almost synonymous terminology when it comes to the operation of business since dedicated inpiduals always look for the way to make the system work more efficiently. Once the efficient Process is put in place by the dedicated People, it is almost natural for the people to yield quality Product from which the end-users experience the value since Product is only the outcome of the joint effort of People and Process. Amongst People, Process and Product, the most important element is People since it is the one that starts Process then onto the act of making products. The act of managing, navigating with and motivating People starts with People. This is why the author considers People is determining factor in the success of an organization.
People Management: Amongst the Management skills of People, I would like to point out the items that need to be considered for the effective results.
Selection Process: It is so important to know how to screen and interview to determine the fitness of the applicant to the job posted. Job application file should contain extensive process to reveal the past history on works and potential hiding elements. Work history of the applicants should in line with the present job unless the applicant is considering a new path. It is also important to ask right questions with open end while giving much more opportunity to the applicants to speak. A System to check the grammar, vocabulary and the ability in mathematics are all crucial elements that comes with job and communication with clients. Giving a while sheet of paper asking the applicant to write for the subject like “ Why should I be hired?” will reveal his/her ability to write, grammar, vocabulary and way of thinking. Important things are not to ask closed questions. Also listening more than speaking is a better way to explore more about the applicants’ ability. The record generated during the interview should be part of the file for the applicants if she/he is hired for verification in the future during and after job is awarded.
Exiting Process: Most of time, many employer and employees are not in speaking terms when the job terminates. Author educated the clients to use this opportunity to be the most honest time for each to give an advice and yield a clear reference since there is no attachments any more. It is also important for the employer to ask like “How do you see that we need to improve our management skill?” or “What was the most hard things for you during your employment?” to know the opinion of the exiting staff. Asking “Would like to come back to apply for a job in the future?” might be a way to continue the connectivity with the staff if condition improves when the times are better. I would also suggest to pay for the exiting interview since it might be a good gesture and money spent well as she/he leave the post.
Training & Education: Educated person becomes “More Responsive and Responsible”. Education is one of the best investments that the employer should pay attention in running a business especially in medical field. Staff is always in a position to give an advice and instruction for the better care of patients. Guiding clients with confidence and compassion will be the way to have the clients builds trust with the hospital group. As a result higher level of clients education will take place and close and trusting relationship between staff and clients are built as a result. Educating both Staff and Clients are one of the key to the success of an organization.
Motivation and Empowerment: Although this might be an extension of the upper mentioned Education and Training, motivating the staff through education/training, knowledge sharing and team support are part of the empowering mechanism. It is always important to encourage staff even after their crucial mistakes and to praise them for their jobs well done. Make a system that they can monitor their performance themselves as a team.
Leadership: Leadership does not have to hierarchical but at the level of flat organization. Voluntary act of performing for the better result and improvement of the products are always a sign of leadership. Make an environment where they take risks since it might be part of the learning process. Mistakes can be openly discussed for all staff to learn from it. Staff meeting (truly by the staff) is a democratic way of bringing up a discussion for all staff for their inquiry and personal opinion. This is a way to build leadership.
Incentive System: This is double edge sward. If it is used efficiently it will be a best tool. If not it can bring a disaster to the group also. Before setting a program to reward the staff and the team, a careful study should be made so that it is fair and making a sense so that all involved is happy. Money is not always the best motivator or element of incentive system.
Process Management: When there is no staff guidelines established as a line of reference the staff invent their own rules that might satisfies their needs best depending on their convenience of the day. Job protocols and Job discretion will be good examples of the system management. Check list for the opening and closing for each department of the clinic should prevent a lot of mistakes and/or human errors. Especially receptionist and technicians, surgical room staff should have their own check-list before they sign out. These protocols and job discretion will maintain uniformity of performance through the consistent expectations in quality outcomes. When these guide lines are not present, the staff and system may take their own path just like driving around without a map that the driver might have to refer to. As it shows on the value chain pathway below,
Input ( Initial Investment )
Operations ( Product Manufacturing )
Output (ill defined Product)
Education( Marketing and Sales)
Final Product (at higher value)
the process of input with capital, staff time, knowledge and skills with soft and hardware will go through the operational chamber only to yield the output that is very raw in its nature. This is undefined product that may retain only basic value until the process of educating (or marketing) end-users and up grading the usefulness. As a result the perceived value of the product might be enhanced by the educational efforts. At this point the subject product is at much higher value although it might be the similar or same product as it was originally manufactured.
Product Management: There are two groups of Product that we manufacture the service items. These are :
Tangible Items: Rx, Tx, Sx, that directly related to patients for the better care of their wellbeing.
Intangible Items: Emotions generated throughout the process of above, Feeling of Appreciation, Perceived value of the service rendered as well as feeling of Compassion
Tangible items are easily recognizable since these are directly shown on the bills to the clients. As a result the payment is expected upon the rendered service. Intangible items are not shown on the bill nor expected to be paid although the Intangible Items tend to booster the value of the Tangible Items. To accomplish a successful level of service, the care givers should have a full understanding on how the value of a product is perceived. It is not only from “what the Clients see and touch” but also from” how the Clients feel”.
Clients’ Dissatisfaction: As a consultant in management, a lot questions are asked to resolve conflicts that occurs in clinical settings. Usually there are three areas that are pointed out. As I have projected on Power Point, these are generalized areas of client dissatisfaction although the management can minimize the frequencies of these happening once the management understand the cause of the clients confrontation.
Unexpected Financial Charge
- not being informed at the beginning
- additional bills that was not explained or discussed
- asking to do too many procedures
Not knowing the need of the clients
- unclear response to inquiry on the phone or/and during examination
- taking too much time in service without due explanation
- being indifferent or not being friendly
Medically Incompetent
- under-delivered outcomes
- prognosis was not clear
- options were not explained
- advantages and disadvantages of diagnostic procedures were not explained
Conclusion: Successful management develops a Process that promotes quality service and compassion driven communication with clients. Management is a collective body of People and this People body will generate a system focusing on the compassion and quality. As a result the Product (which is the outcome of People and Process) will be generated at higher level quality. All business are driving for the financial return on their investment although only finance should not be the object of the organization. As I projected in the slide, The Financial Outcomes should be the Result of Compassion and Quality. We want to put a Horse before Carriage.
The End.
Author: Henry K. Yoo DVM MSc MBA is an Executive Consultant at Infinity Medical Consulting & Co. located in Santa Monica, CA. Dr. Yoo, as a medical strategist, consults pharmaceutical companies like Shering-Plough, iVet Nutrition and ENVY Medical Co. He also has assignments with colleges and universities as faculty at SNU, W. University and S. Baylor University. The topics of his consulting and education at many institutions have been expanded to international conferences and conventions. You may be able to reach him at his email address henryyoo@gmail.com.