Veterinary Practice Types

Veterinary Practice Types

Estimated reading time: 13 min

This section gives a general overview of the traditional choices about options and setup made by different types of practices. No two practices are the same, of course, so we expect that you may differ in one or more ways from the average.
We recommend that you look at other types of Practices and how they use RxWorks Options and Setups. You may find that your practice has some of the traits of a different type of veterinary practice and may find some of the solutions used in that arena good for your business too.
A qualified RxWorks trainer can help you with the customization and tailoring of your RxWorks software. It is advised that your team stay abreast of new developments by reading the release notes and schedule regular training and maintenance.

Learning from others

Veterinarians in Equine and Large Animal Practices spend a lot of time visiting clients have long been used to managing inventory in their vehicles. If you want to add house-calls as a service in your Small Animal Practice, your RxWorks Trainer will be able to give you some of the tips and tricks we have picked up working with Equine and Large Animal Practices over the years.
Similarly, as an Equine Practice Manager, you might be interested in looking into some of the clipboard functionality many Small Animal clinics make use of to streamline waiting room and in-clinic workflow.

Animal Shelters

Though there many different types and sizes of Animal Shelter, they do have much in common.

Setting Up

  • In most cases, Animal Shelters setup RxWorks as for a typical small animal practice
  • The standard appointment system is suitable for most cases. You can setup reminders and make good use of HealthCare Manager.
  • You may have veterinary specialists and will be interested in the referral system, referral response letters and so on.
  • Appointment clipboards may also require two extra fields:
    • Referring Client
    • Referring Vet
    • These fields will allow referrals to be tracked at the time of booking.
  • You can setup generic clients such as Admissions, Assessment, Re-HOME.
  • You might use extra custom fields on each species. Examples are Admission Date, Admission Reason, Where found, Resolution Date, Resolution.
  • These fields will allow you to get admission and resolution reports each month using Reports G Queries.

Emergency Centres

We understand that practices run exclusively as emergency centers are quite different to general practice. However the options and setup are usually the same as a standard small animal practice.

Setting Up

  • Clipboards will be similar to general practice, although the hours will be different.
  • Appointment clipboards may also require two extra fields: Referring Client and Referring Vet. These fields will allow referrals to be tracked at the time of booking.
  • You may wish to regard the client’s normal practice as a referring practice. Therefore you will need to configure some referral response letters.
  • Referral Clients and vets can be setup on the Client > Category > Other tab.
  • You will need to know how to use the referral reports to focus on where patients have come from and the results provided.
  • A Referral Practice e-learning video is available on the RxWorks website. This can demonstrate the full functionality of the referrals system.

Equine Practice – Descriptive Overview

Overview

  • In many equine practices it is the administration staff, not the veterinarian who enter visit records. This dynamic often changes slightly with the introduction of RxWorks as it becomes quicker and easier for you to input data on the spot. RxWorks procedure templates provide a more powerful medium for a veterinarian to communicate directly with their clients.
  • The average invoice value is much higher in equine practice and many are not paid on the day of the visit. Consequently, the setup and management of accounts is a major issue and can be quite complex. To counterbalance this, most equine practices have a very capable accounts manager whose primary focus is on the financial side of the business, rather than simply a veterinarian or nurse who is good with the books.
  • Most equine practices do a considerable amount of work for horse trainers, studs and so on. These people usually do not actually own the horses. This raises special issues with setup, accounting and client communication.
  • Equine practice usually involves a lot of outside calls. The vehicles used tend to carry rather large inventory and tracking stock may be a concern. Some equine practices setup each vehicle as a clinic for the purpose of stock control.
  • Many Equine clinics tend to use Cost Centers to enable reporting on different areas of the business, eg Field Service, Hospital, Outpatient
  • You may round prices to the nearest 5 or 10.
  • Setting Up

  • Clipboards and Appointments will be similar to General Practices, but are likely to be a little simpler due to the reduced number of species.
  • As there are generally less time slots in clipboards for EQ, set the clipboard display to 2 lines – to see more information for each appointment without having to hover.
  • Appointment colours may be used for geographic area (for example, North, South, East and West) meaning you need to setup appointment types for each area. Alternatively you may want to use different colours for different users.
  • You will almost certainly make use of the Travel Multiple function. Client > Categories > Number tab. Before making use of it, make sure it is tested to a) use the clients travel multiple when invoicing and b) automatically prompt you to update the client’s travel multiple if you charge for a different distance.
  • To charge clients shared traveling, it is best to have fees such as Shared Travel 33% priced at 1/3 of the normal rate rather than having just one traveling fee and manually changing the distance in the charge out dialog.
  • You will want to take advantage of 2 extra patient custom fields. Patient Alternative Name 1 and Patient Alternative Name 2 that can be used to store and search on a stable name, racing or nick name. These fields can be renamed to whatever you like.
  • Considerable effort should be given o the client communication in RxWorks procedures. Effective use of invoice notes will allow information to show on handouts given to a trainer as well as invoices mailed to the owners.
  • You can enter the map directions to the client in the Client Notes. These can be chosen to be included when printing clipboards.
  • Horse Trainers and Studs

    As you may have clients such as horse trainers and studs with large numbers of horses. The horses are usually owned by other people or groups of people yet it is the trainer or stud that is the client. This creates some special problems.

  • Some equine practices attach the patients in these cases to the stud or trainer but may want the billing details set to the actual owner(s).
  • The alternative is to attach the patient to the owner and set the stud/trainer as the location.
  • Unfortunately, mistakes with horse identity and ownership occur fairly regularly. At the stud the stable hand may tell the vet that the horses name is Name-X and it is owned by the ZZZ Syndicate. However this may be incorrect. Consequently visits recorded on incorrect patients and invoices made to incorrect owners are quite common. In these cases it is helpful to know you can always transfer a visit to another patient.
  • Accounts

    The large amount of work done on credit in Equine practices means a greater reliance on the RxWorks accounting system. It is advised that a qualified RxWorks trainer assist you in the accounts set up.

  • In a large Equine practice a months worth of overdue accounts (current debtors) may be a six figure sum. You might decide to run some accounts fortnightly, or all of them in the first day or two of the new month.
  • You understand the costs involved in chasing a delinquent debtor and the value of money, so you might be interested in the Settlement Discount process. Settlement instructions can be printed on account notes from Reports B > Accounts > Setup > Settlement discount.
  • You will want to use accounts that include invoices in patient order and set the New Page per Patient option. Reports B > Accounts > Setup > Styles and Selection Criteria
  • Tracking payments from studs and trainers can be a problem. It is common for the stud or trainer to pass on the invoices to the owners and then to pay the practice when the owner pays them. This results in numerous payments being made through the month that relate to this horse or that, last month, the month before and so on. The simplest solution is to use the standard RxWorks accounting but to enter the invoice number into the payment notes when payments are made. This does not automatically track which invoices are paid but is very useful if there is a later argument about which invoices are outstanding.
  • Another solution which may be of interest is to attach patients to the stud or trainer and set the billing details to the owner. Then set the owners Account Address to be C/o the stud/trainer.
  • Because of the number of errors that occur with ownership and so on, your accountant needs to understand the Reverse Account process as well as how to transfer patients between owners and visits between patients.
  • When transferring patients, you need to understand the significance of including or excluding invoices and the need to transfer receipts manually if invoices have been included.
  • Because of the number of accounts which will probably be reversed each month it is a good idea to re-run accounts for the previous month, without actually printing them, before running accounts for the current month. This will “tidy-up” any accounts that have been left reversed and thus prevent past month invoices appearing on the current statement.
  • Equine Veterinarians will be particularly interested in the facilities of RxWorks Mobile Veterinarian 2.0.
  • Because of the requirements of Equine practice, and keeping in mind how you have setup the practice, elected to run accounts and so on, the following functions are particularly important to the general office staff:

  • Using Billing Details / Syndication
  • Using multiple address types including setting a particular address for accounts.
  • Using patient Location
  • Finding a patient by Racing Name or Stable Name
  • Transferring a patient from one client to another
  • Transferring visits to another patient
  • Transferring invoices to another client
  • Reversing accounts
  • Mixed and Large Animal Practices – Descriptive Overview

    Very few practices are exclusively Large Animal-oriented. The term Large Animal is not really completely correct (after all, Great Danes are about as big as sheep), but it is synonymous with Farm Animal or Production Animal. Large Animal Practices would usually treat species such as sheep, goats, pigs, cattle and horses.
    Many practices will find the RxWorks Prescription Module particularly useful as it is now a legislative requirement in some countries to prescribe the amount of bulk medications, drugs such as mastitis treatments and so on, for each farm 12 months in advance. At the end of the year they will need to print the Prescription reports. This practice may become more common in other countries and various States of the US in coming years.

    For mixed practice in general:

  • The average invoice value is much higher in large animal practice and many are not paid on the day of the visit. Consequently, the setup and management of accounts is a major issue and can be quite complex.
  • To counterbalance this, most large animal practices have a very capable accounts manager whose primary focus is on the financial side of the business, rather than simply a veterinarian or nurse who is good with the books.
  • Large Animal practice usually involves a lot of outside calls. The vehicles used tend to carry rather large inventory and tracking stock may be a concern. Some large animal practices setup each vehicle as a clinic for the purpose of stock control.
  • As large animal practices generally deal with herd management. i.e. you might have a patient for Cattle Beef herd, Sheep Herd rather than individual patients.
  • Often you will have a default Farm Sales patient (independent of the herd) you can use to track prescriptions, run healthcare indicators and reminders.
  • You may round prices to the nearest 5 or 10.
  • Typical Setup for a Large Animal Practice

  • Clipboards and Appointments will be similar to small animal practice but will need to make allowances for outside call appointments.
  • Appointment colours may be used for geographic area (for example, North, South, East and West) meaning you need to setup appointment types for each area. Alternatively, different colours may apply to different users.
  • You will almost certainly make use of the Travel Multiple function. Client > Categories > Number tab. Before making use of it, make sure it is tested to a) use the clients travel multiple when invoicing and b) automatically prompt you to update the client’s travel multiple if you charge for a different distance.
  • To charge clients shared traveling, it is best to have fees such as Shared Travel 33% priced at 1/3 of the normal rate rather than having just one traveling fee and manually changing the distance in the charge out dialog.
  • You will want to take advantage of 2 extra patient custom fields. Patient Alternative Name 1 and Patient Alternative Name 2 that can be used to store and search on a stable name, racing or nick name. These fields can be renamed to whatever you like.
  • Considerable effort should be given to the client communication in RxWorks procedures. Effective use of invoice notes will allow information to show on handouts given to a trainer as well as invoices mailed to the owners.
  • You may want to use the option to Filter Fees By Category, rather than species for Mixed Practices. This will allow large animal vets to view fees that are >Al Species> and >Large Animal>. Any >Small Animal> fees will be ignored.

  • You can enter the map directions to the client in the Client Notes. These can be chosen to be included when printing clipboards.
  • Multi-Site Practices

    This is not a practice type as such, but it is a situation with special requirements.
    RxWorks has a number of features specifically designed for multi-site practices. The RxWorks trainer and the Practice Management team will discuss this during the set-up.

    These features are:

  • Clipboard sharing
  • Inventory for each site
  • Prices varied for each site
  • Graphic letterheads and footers can be customized for each site
  • Restricting users access to particular sites
  • Different background color for the RxWorks screen at each site.
  • Personalized Page Styles will automatically select the correct printer
  • Client Preferred Clinic is automatically set for new clients to the currently logged in clinic. Preferred clinic can be used to restrict Reminder and Account Statement printing and is a restriction option in many reports.
  • Use “Clinic Short Name” to give a short easy reference for each clinic. This is used in Clipboards, Client Page, Visit List etc
  • Setting up different branches in the database

    The RxWorks program installs with a single clinic. This is Clinic 1 and it is usual to make this the main clinic. Your implementer will need to add the extra clinics directly into the database.
    After you have added a new Clinic all other customisation should be done in Task Panel > Options & Setup > Clinic.

    Clipboard Sharing

    There are three different ways clipboards can be setup in multi-site practices.
    You can set up a group for Appointments for each clinic and then set clinic clipboard security. This means that 1 user may be able to view clinic 1 and 2, but excluded from clinic 3.
    Patient status clipboards such as Waiting Room etc. remain shared so that structure and functionality are easy to manage.

    Inventory and Process

    Usually an individual clinic will want to track their own inventory levels. This means Clinic 1 should be set to use Clinic 1’s stock, Clinic 2 to use Clinic 2’s stock and so on.
    Some will want to set different prices at different clinics or they may wish to use price bands where, say, Clinics 1, 2 and 3 are to share the same prices while Clinics 4 and 5 are to share different prices.
    You will find in Task Panel > Options and Setup > Clinic > General Options that Clinic 1 is locked into using Clinic 1 Stock and Clinic 1 Prices.
    All other clinics will be defaulted to use Clinic 1’s Stock and Prices.
    As you set up each of the other clinics to use their own stock there will be a delay while RxWorks duplicates Clinic 1’s stock into the new clinic.
    If you set up a clinic to use their own Prices you will be asked if you wish to duplicate Clinic 1’s Prices. If you choose No then the new clinic will have all its prices set to zero. It is usually far better to choose Yes as they immediately have a working price structure. The prices can be modified later using the Item Pricing Wizard.
    If using item wizards for multiple practices, you must be logged into the clinic you wish to manipulate.
    If using electronic stock control you should talk to your Wholesaler about having different accounts for each clinic – this means stock orders can be created automatically for each clinic and Goods Receipts downloaded to the correct clinic.

    Graphic Letterheads and Footers

    Each site can have its own customised graphic letterheads and footers. This will allow for a different clinic name, address, phone number and so on to be included on printed documents including invoices, accounts and even reminders.
    RxWorks attaches graphic headers and footers to documents using Page Style settings. The actual graphic files reside in RxWorksTemplatesLogos.
    To individualise the graphics the same file names are used but the files are saved into a subdirectory named by the Clinic Code.
    Whenever you print a document requiring a graphic, RxWorks will look for the file first in the clinic folder. If it is not there RxWorks looks in the Logos directory.

    Restricting Users to particular sites

    By default all users have access to all clinics. However, it can be useful to restrict some users from clinics they have no need to open, mainly because it reduces the chance of them logging in to the wrong clinic. You can do this by manipulating the settings in ‘User Security at Options & Setup I’.

    Different background colour for RxWorks screens

    Use different background colours for RxWorks screens to help prevent people working while logged into the incorrect clinic. This needs to be set up directly in the database, so you will need the help of a qualified RxWorks implementer.

    Referral Practices

    Specialist veterinarians are referred difficult cases by general practitioners. When a practice consists entirely of specialists it is called a Referral Practice.
    Because they depend on the good will of general practice they need to guarantee they will only do work referred to them and they will not compete in any way for routine work.

    As such most Referral Practices will not be interested in things such as:

  • De-sexing
  • Vaccination
  • Healthcare
  • Counter sales of food, accessories, flea and worm treatments and so on (in most cases, the only counter sales they would make would be for repeat medications).
  • On the other hand, Referral Practices will be particularly interested in:

  • The RxWorks system of recording referral practice details
  • Attaching referral vet to patients
  • Letters of response to the referring vet
  • Referral reports
  • Attaching images to patients
  • Typical Setup for a Referral Practice

  • Clipboards will probably be the same as general practice. Referral Clinics normally set up clipboards with Veterinarian Names at the top of each column. Since referral clinics often have visiting specialists who re not full-time, it is important to know how to use Miscellaneous Entries to block out days that are unavailable. In large referral clinics, having a clipboard group for each specialty may make things less complex – eg Dermatology Appointments, Ophthalmology Appointments
  • There will probably be little interest in the usual patient custom fields. These should be removed as appropriate.
  • There may be some special customs fields you would like setup for patients. Custom fields to record Insurance Company and Insurance Policy Number may be useful.
  • Reminders will probably be limited to recalls for specific treatments and you will probably want to remove the normal general practice reminders.
  • There will be little interest in de-sexing, de-sexing certificates and vaccination certificates. These should be removed as appropriate.
  • There will probably be relatively few monthly accounts and therefore little interest in having complex Account Types.
  • There will probably be little use for the Client Category, Text and Number fields.
  • Referring Clinics should be entered as Clients and marked as Referring Clients.
  • Small Animal Practice

    The majority of practices established around the world are small animal clinics. No practice is alike, and each business requires unique invoicing and communication that suits the location and demographic of clients.
    While RxWorks is configured with default certificates, letters and handouts, these should be tailored to suit the practice.

    Typical Setup for a Small Animal Practice

  • Clipboards will probably show as consult 1, 2, 3 or by vet name. Appointments are usually set by colour for each type.
  • Patient custom fields will require detailed consideration. What fields are updated when a fee is sold. There may be some special custom fields you would like setup for exotic species.
  • Reminders will be needed for a broad range of wellness treatments and post surgery recalls.
  • Strong requirement for de-sexing, de-sexing certificates and vaccination certificates. These should be edited as appropriate.
  • There will often be basic Account Types. Cash Only, Bad Debtor, Approved Credit
  • Client Category, Text and Number fields will require detailed consideration.
  • You can make good use of HealthCare Manager and wellness plans.
  • You may have veterinary specialists and might be interested in the referral system, referral response letters and so on.
  • User customization and security is important.
  • Visiting Specialist

    It is not uncommon to find general practices where there is a specialist on staff or a specialist that visits their practice on a regular basis.
    This does not affect setup to a great degree, but staff should be trained on the RxWorks Referral system.
    Practices with Visiting Specialists may wish to separate income generated by the specialist using the Cost Centre facility. Task Panel > Options & Setup > Finance > Cost Centers.

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