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Unlocking the Hidden Value of Veterinary Nurses: A Revenue Revolution - ep 207
Unlocking the Hidden Value of Veterinary Nurses: A Revenue …
Send us a text Discover how to maximise the value of your clinic's Veterinary Nurses and boost your clinic's revenue in this ideas-packed e…
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Oct. 15, 2024

Unlocking the Hidden Value of Veterinary Nurses: A Revenue Revolution - ep 207

Unlocking the Hidden Value of Veterinary Nurses: A Revenue Revolution - ep 207

Send us a text

Discover how to maximise the value of your clinic's Veterinary Nurses and boost your clinic's revenue in this ideas-packed episode of Veterinary Voices.

Julie South catches up with Michelle Cameron, a New Zealand Registered Veterinary Nurse with extensive experience in emergency and critical care (ECC), and an Executive Member of the New Zealand Vet Nurse Association (NZVNA).  

Michelle shares valuable insights on leveraging the skills of veterinary nursing professionals.

Key topics covered:

  1. Implementing nurse fees: Discover about charging for services such as overnight patient care and surgical preparation, which are often provided by nurses but not billed separately.
  2. Overcoming resistance: Understand the challenges of introducing new billing practices and how to address concerns from both staff and management.
  3. Improving clinic culture and profitability: Explore how recognising and valuing nurses' professional skills can positively impact both team morale and the clinic's bottom line.
  4. Practical examples: Gain specific ideas for billable nursing services, including hospitalisation fees, surgical prep, and nurse-led consultations.

This episode offers valuable insights for Veterinary Nurses looking to increase their professional value, Practice Managers seeking to optimise clinic operations, and Veterinarians interested in maximising team efficiency. 

This episode can seriously be revolutionary in regards to how you approach veterinary nursing and clinic billing practices!

Contemplating your next career move?
Tania Bruce - VetStaff's passionate kiwi recruiter - would welcome the opportunity to have a 100% confidential chat with you. Tania's a former Ortho Head Vet Nurse so speaks your language!

How to get more bang for your recruitment advertising buck
This is what VetStaff is really good at so if you'd like to stretch your recruitment dollar, please get in touch with Julie because this is something VetStaff can help you with.

Committed to DIY-ing your own recruitment?
If so, then shining online as a good employer is essential to attracting the types of veterinary professionals who're a perfect cultural fit for your clinic.

The VetClinicJobs job board is the place to post your next job vacancy - to find out more get in touch with Lizzie at VetClinicJobs

Revive Your Drive - daily 2-minute videos for veterinary employers and employees to help revive their drives at work and at home.

Transcript
WEBVTT

00:00:04.927 --> 00:00:08.634
Welcome to Veterinary Voices Episode 207.

00:00:08.634 --> 00:00:12.711
I'm your host, julie South, with a bit of a croaky voice.

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With listeners in 1,400 cities around the world, veterinary Voices celebrates all that's great about working in New Zealand's veterinary industry.

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You can find back copies at veterinaryvoicesnz.

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Veterinary Voices is brought to you by VetStaff, new Zealand's only recruitment agency specialising in helping veterinary professionals find jobs that they're excited about going to on Monday mornings in Kiwi Vet Clinics, vetstaffconz.

00:00:46.540 --> 00:00:54.215
This episode goes to air the week after Veterinary Nurse Awareness Week in New Zealand.

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By the time you're listening to this, the NZ VNA will have announced this year's Vet Nurse of the Year.

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Whoever you are, congratulations.

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I look forward to having you as a guest on this show in the not too distant future.

00:01:09.385 --> 00:01:15.162
Today, I'm really excited to share the chat I had with Michelle Cameron.

00:01:15.162 --> 00:01:36.828
Michelle's an executive member of the NZVNA, the New Zealand Vet Nurse Association, and because she talks about something close to my heart and to the two vet nurses on my team, which is how vet nurses can up the ante and raise the perception of their professionalism by including their fees and clinic invoices.

00:01:36.828 --> 00:01:40.820
I'm really excited to bring this show to you, vet nurses.

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Stay tuned, because if you want ideas on how you can earn more for you and your clinic.

00:01:47.713 --> 00:01:51.870
This is one of the episodes that tells you how to do that.

00:01:52.379 --> 00:01:54.509
So who is Michelle Cameron?

00:01:54.509 --> 00:02:04.087
She's a registered veterinary nurse who graduated from Massey University with a diploma in veterinary Nursing in 2002.

00:02:04.087 --> 00:02:15.531
In 2016, she gained her VN CERT, ecc, which is the Veterinary Nursing Certificate in Emergency and Critical Care in the UK.

00:02:15.531 --> 00:02:25.569
Michelle worked in New Zealand for a few years before heading off on her OE to the UK and Europe, where she ended up spending most of her time in Glasgow, scotland.

00:02:25.569 --> 00:02:27.402
As a veterinary nurse.

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She locummed in many different clinics across the UK the RSPCA, an orthopedic specialist clinic and an after-hours emergency clinic.

00:02:38.050 --> 00:02:47.043
Michelle undertook assessor training whilst in the UK, which is now a clinical coaching which the New Zealand version is based on.

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Michelle currently works in a busy as in busy mixed practice in New Zealand's rural North Island under the job description of clinical operations and administration.

00:02:59.311 --> 00:03:08.504
As well as being a registered veterinary nurse working in a four clinic practice, michelle is also an executive member of the NZVNA.

00:03:08.504 --> 00:03:12.873
When she's not busy at work, she's busy at home, being a mum and a wife.

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Her family consists of two human children, three feline fur babies, as well as Michelle and her husband.

00:03:21.260 --> 00:03:29.585
Stay tuned, because Michelle delivers heaps as in heaps of value, both this week and next week.

00:03:29.585 --> 00:03:48.888
She talks about ways that nurses can start including their time on bills, about how they can help pay for some new kit, new gear in their clinic, how to overcome resistance when they're sometimes seen as being perhaps a little bit less than the highly skilled veterinary professional that they really are.

00:03:49.569 --> 00:03:52.558
This is part one of two Heads up.

00:03:52.558 --> 00:03:56.768
You'll notice that the audio isn't as good as it usually is.

00:03:56.768 --> 00:04:10.604
Unfortunately, michelle and I had heaps of technical issues getting this episode recorded, which was a little while back, and the 200 plus episodes that I've recorded of this podcast.

00:04:10.604 --> 00:04:15.054
I've never had a show with the issues that we experienced here.

00:04:15.054 --> 00:04:26.333
It was pretty obvious to me that when we had those experience that Michelle had worked in ECC, emergency and Critical Care, because she didn't get flustered once.

00:04:26.333 --> 00:04:35.891
Even when the first recording platform developed attitude, we failed on Zoom, ended up on Teams, which failed a few times as well.

00:04:35.891 --> 00:04:39.470
All through that, michelle maintained her cool and calm.

00:04:40.060 --> 00:04:47.074
We joined the conversation here where I asked Michelle about how vet nurses can earn their keep in clinic.

00:04:47.074 --> 00:04:48.262
And oh, quickly.

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If the term VOI is a new one to you.

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It stands for Veterinary Operating Instructions.

00:04:54.694 --> 00:05:00.221
Michelle.

00:05:00.221 --> 00:05:08.401
We are talking about, to put it pretty crudely, pretty bluntly, nurses earning their keep.

00:05:08.401 --> 00:05:11.869
Now, we all know that they do that.

00:05:11.869 --> 00:05:28.295
I hope I hope listeners have that same respect as well, and we all appreciate that there is lots of potential, lots of untapped potential in clinic with veterinary nursing skills.

00:05:28.295 --> 00:05:40.564
What do you think could be the first step in a clinic where nothing that a nurse does is being charged for?

00:05:40.564 --> 00:05:42.310
Where do you think they could start?

00:05:47.240 --> 00:05:48.362
for where do you think they could start?

00:05:48.362 --> 00:05:51.829
Where they can start is depending on what their skill sets are and where the nurses are being utilized.

00:05:51.829 --> 00:06:12.192
In the beginning you will have a nurse that's interested in surgery or a nurse that's interested in consulting, and those are two completely different areas in which fees can be associated with the nurses under that kind of umbrella, where they are pulling in those fees or fees associated with them as well.

00:06:12.192 --> 00:06:22.985
So I would say likely it's going to be in clinic, out the back, where they've got their prep room and the hospital and we have patients that stay overnight.

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The patients that stay overnight will generally have a fee associated with a hospitalisation stay and this is where often in the past is a charge or a price that is removed when people don't feel that their invoice is correct with the estimations and they take off that hospital overnight stay.

00:06:46.839 --> 00:06:59.026
That hospital overnight stay in my experience is used for the person that gets up in the morning, goes in first thing before everybody else goes in in the morning.

00:06:59.026 --> 00:07:02.822
They check all the animals, make sure everyone's okay.

00:07:02.822 --> 00:07:06.211
They will take the dogs out and walk them.

00:07:06.211 --> 00:07:08.367
They'll clean out those kennels that they've been in.

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They'll take the beds out.

00:07:09.524 --> 00:07:17.365
They'll wash them, remove all the bowls, clean them all up and then they'll start with their medications and their feeding and that sort of thing.

00:07:17.365 --> 00:07:24.490
And that's also sort of during the day that hospital care walking the dogs, feeding, toileting, et cetera.

00:07:24.490 --> 00:07:29.985
Cats again litter trays and all that kind of thing as well.

00:07:29.985 --> 00:07:34.694
And that fee is not a vet fee is that that's all done by a nurse.

00:07:34.694 --> 00:07:57.127
At this stage, and in the past I suppose this has always been a job associated with someone that doesn't have any qualifications or skills, and now we do have those qualifications available for the nurses or veterinary nurses, I should say that they can be bringing in those fees for them as well.

00:07:57.127 --> 00:08:10.603
So when the charge is removed from that hospitalisation, it means that basically you're saying that all that time that that person has spent on that patient means nothing, means absolutely nothing that could be.

00:08:10.603 --> 00:08:19.552
You know there's lots of different ways, prices and charges and numbers and you know money value to that and it means something different to each practice as well.

00:08:19.552 --> 00:08:35.856
So I'm not going to go into exact money, but just the fact that it is time and it is money, creating fees where that can be taken away from the veterinary nursing sort of side under that umbrella bracket of the fees that they can create as well.

00:08:36.197 --> 00:08:44.131
So a starting point is making sure that we're invoicing that hospital stay for that patient, because that's the be all and end all At the beginning.

00:08:44.131 --> 00:08:58.062
We have patients that stay overnight, we have patients that stay during the day Again, hospital stays often will get removed as well for that and that's that person again walking, feeding, medicating, recording all the things that they do as well.

00:08:58.062 --> 00:09:00.138
That would be one of the things that I would start with.

00:09:00.138 --> 00:09:20.331
And also the other thing that we're doing in all of our practices is, generally patients will come in and have surgery and the surgery you have a vet that will do all the veterinary kind of things with regards to operating, making decisions on what medications they're using, etc.

00:09:20.331 --> 00:09:41.192
And then you'll have a nurse who's going to be monitoring the anaesthetic, gathering everything ready, preparing that patient, preparing that surgery ready, and that can also be created into a fee for the nursing side, a nurse preparation fee for surgery, or it could be a nurse preparation fee for a procedure as well.

00:09:41.192 --> 00:09:44.821
So usually the fee can be associated with time.

00:09:44.821 --> 00:09:51.480
So 10 minute units is a good way to start and depending on how long that procedure takes.

00:09:51.480 --> 00:09:55.356
You know they can increase that time component with it as well.

00:09:55.417 --> 00:10:11.148
Associated with the other things that we're doing is that I've always said the um, you know the when you're doing a bandage on a conscious patient, sometimes the nurses will do it in pairs a nurse will hold the patient and then the nurse.

00:10:11.148 --> 00:10:16.971
The other nurse will put the bandage on, or you're the nurse is holding the patient and then the vet's putting the bandage on.

00:10:16.971 --> 00:10:24.477
The time associated with that procedure would always go to the vet, so the vet time would always be associated with that bandage.

00:10:24.477 --> 00:10:33.639
Putting that on it could take 20 minutes, depending on if they're doing a splint and waiting for it to dry and things, but you always need a nurse to hold that patient.

00:10:33.639 --> 00:10:35.817
Sometimes you need two as well.

00:10:35.817 --> 00:10:43.897
So wherever there's vet time there should always be a corresponding nurse time as well, and that is associated in the fees.

00:10:44.158 --> 00:10:47.077
With regards to in the background fees, I suppose, as well.

00:10:47.077 --> 00:11:15.785
Those are the main ones that I would start with and then, depending on if people are doing consulting and allowing their nurses to do consults, that's a whole nother bracket of fees where they are actually doing their own consulting with the VOI training under the direction of a vet and being able to start doing their vaccinations, or pen stands, cytopoint injections, those repeat ones, not the initial ones, where the vet needs to prescribe them initially as well.

00:11:15.785 --> 00:11:19.139
So that's probably where I would start.

00:11:19.438 --> 00:11:24.432
Begin with, julie, you raise some great points there as I was listening to you.

00:11:24.432 --> 00:11:37.160
To downplay, to not include work that a vet nurse does is almost insulting for him or her and it's not a great way to build great culture.

00:11:40.889 --> 00:11:47.504
No, not at all, and that's why we fight so hard to make sure that the nurses are having their time valued as well as a professional.

00:11:47.504 --> 00:11:50.817
All of the nurses that I work with are registered vet nurses.

00:11:50.817 --> 00:11:54.732
They're not just people off the street, as they were in the past.

00:11:54.732 --> 00:12:13.592
I've been a nurse for a very long time and the stigma that still comes from way back 20 years ago plus is still with us today with regards to nurses not being recognised with their professional titles, not being recognised with their qualifications and things like that as well.

00:12:13.592 --> 00:12:16.659
So it's something that we feel quite strongly about that.

00:12:16.659 --> 00:12:22.239
You know we can help, and in ways that is beneficial to everyone, to the practice.

00:12:22.239 --> 00:12:23.481
They're part of it.

00:12:23.481 --> 00:12:24.182
They, you know.

00:12:24.182 --> 00:12:28.318
Often we hear people saying that we'd fall down without them.

00:12:28.318 --> 00:12:30.551
You know you don't have a vet and a nurse.

00:12:30.551 --> 00:12:31.673
You know it's not.

00:12:31.913 --> 00:12:32.875
It's not going to last.

00:12:32.875 --> 00:12:42.183
When you've introduced this, what kind of resistance or obstacles have you had to overcome in clinic and how did you get over them?

00:12:42.549 --> 00:12:45.399
I think the main resistance is worked through.

00:12:45.399 --> 00:12:49.395
Sometimes we've had within clinic we may have.

00:12:49.395 --> 00:12:56.225
For instance, we have different admin teams, we have small animal teams, large animal teams, etc.

00:12:56.225 --> 00:13:02.254
We have small animal teams, large animal teams, etc.

00:13:02.254 --> 00:13:08.955
We are looking at resistance within teams with regard to something that we've never charged for before, but did the consult or something like that and now we're charging.

00:13:08.955 --> 00:13:16.378
There's always a question raised about why we're doing that now, and the response generally is because why shouldn't we?

00:13:16.378 --> 00:13:23.717
Why are we doing a consultation with a patient and a client without having a fee associated with it?

00:13:23.717 --> 00:13:42.995
With a consultation fee With the nursing sort of consults versus a vet consult, it's a lot less, but it's still a fee that we can use for the nurses in valuing their time, I suppose as well, and their skills, which then frees up the vet to do other things.

00:13:43.236 --> 00:13:52.379
Also with that though and I'm wearing my former business coaching hat here there is a cost.

00:13:52.379 --> 00:13:56.815
There's a direct cost to the clinic to provide that service.

00:13:56.815 --> 00:14:09.697
Yeah, there's all the overheads that go with turning on the lights and opening the doors in a clinic, and then there's the overheads of what it actually costs to staff the clinic.

00:14:09.697 --> 00:14:32.461
So it's got to be good for the clinic to start recouping some of these costs, and also it's good for the clinic because it, I believe, live according to Julie, it improves the morale and shows respect for the professionally qualified people that work out the back.

00:14:33.124 --> 00:14:33.784
Absolutely.

00:14:33.784 --> 00:14:52.043
We have had many times throughout the years where we've had different you know how you have your wellness webinars and things where they will show us on our screens various people talking, and usually it's some sort of American one.

00:14:52.043 --> 00:15:17.139
It was talking about fees and showing value for your fees, and this wasn't just for vets, it was for nurses, it was for the admin staff at reception, because if they don't believe what we're doing and they can't explain to the client that's standing on the other side of the counter why we have charged what we have charged, then it's falling apart.

00:15:17.139 --> 00:15:28.240
If they can understand where that total amount comes from and they can have that explained to them right at the start, before they get that big bill, as they put it.

00:15:28.240 --> 00:15:33.702
If we can explain that to them, then the client is always much happier.

00:15:33.702 --> 00:15:35.355
They're well informed.

00:15:35.355 --> 00:15:37.697
That communication has happened really well.

00:15:37.697 --> 00:15:48.659
The estimation at the beginning has happened and then the fees are able to be included in that as well and it can be explained why that's there.

00:15:49.302 --> 00:15:56.259
Why is there a nurse fee associated with my surgery for my dog that had, I don't know, a toe removal, something?

00:15:56.259 --> 00:15:58.283
There's also a bandage fee there.

00:15:58.283 --> 00:16:04.538
That can be explained because the nurse is there holding that dog, putting that bandage on or using their skills.

00:16:04.538 --> 00:16:09.561
The nurse was there monitoring your patient the whole time for the anesthetic.

00:16:09.561 --> 00:16:10.423
What would happen?

00:16:10.423 --> 00:16:11.032
What do you think?

00:16:11.032 --> 00:16:14.057
When you're talking to people, how else can you explain it?

00:16:14.057 --> 00:16:18.259
Would you rather them not have somebody there watching them?

00:16:18.259 --> 00:16:19.042
I'm not sure.

00:16:19.042 --> 00:16:24.038
I think that we all know what that answer is, but they don't understand because they don't go out there.

00:16:24.038 --> 00:16:26.298
They don't see it as well.

00:16:26.298 --> 00:16:44.775
So using that tool, I suppose for people is that making the entire clinic understand where these fees are coming from, is a big thing before you can start putting it on people as well, on the on the clients end and things as well, I would say Julie.

00:16:49.365 --> 00:16:58.860
I just want to interrupt this chat for a very brief moment to share something important for clinics doing their own recruitment vetclinicjobscom.

00:16:58.860 --> 00:17:10.640
You probably already know and agree that well, traditional recruitment methods just aren't cutting it anymore, which means a new and a different approach is necessary.

00:17:10.640 --> 00:17:14.144
New and a different approach is necessary.

00:17:14.144 --> 00:17:18.560
This means that you need to differentiate and showcase what makes your clinic a great place to work.

00:17:18.560 --> 00:17:38.230
Vet Clinic Jobs is all about boosting your clinic's employer brand not to be confused with your clinic's client brand and VetClinicJobscom is totally affordable brand and vetclinicjobscom is totally affordable.

00:17:38.230 --> 00:17:42.663
Give your recruitment marketing the oomph it needs through vetclinicjobscom.

00:17:42.682 --> 00:17:43.365
Now let's get back to today's show.

00:17:43.365 --> 00:18:06.587
I would just like to say something quite, I think, provocative here, and this is something that I have been saying for the last five years and I honestly believe, hand on hearts, that hand on my heart that clinics will function a lot better and they will be a lot more profitable.

00:18:06.587 --> 00:18:22.729
Even though it doesn't sound like it, it If and when clinics have dedicated receptionists who are not nurses, and the reason I say that is I could be a receptionist.

00:18:22.729 --> 00:18:26.194
I would be a really good receptionist.

00:18:26.194 --> 00:18:28.538
I believe I can do that job.

00:18:28.538 --> 00:18:30.929
I cannot do your job.

00:18:30.929 --> 00:18:34.055
The skill set is completely different.

00:18:34.055 --> 00:19:01.419
I don't have the training, and yet I think that when clinics put highly qualified, highly skilled nurses at the front of house which is great because they've usually got the people skills house which is great because they've usually got the people skills but they're putting them front of house, the clients that come in kind of discount the skills, the medical skills.

00:19:01.419 --> 00:19:12.252
If you go to your doctor, your doctor is not going to put one of his highly skilled registered nurses manning the phones on the front desk, absolutely.

00:19:12.252 --> 00:19:15.726
And yet that's what happens in a veterinary clinic.

00:19:16.467 --> 00:19:46.657
When Tanya and I are working with clinics in a consultancy type capacity, one of the first things that we try really hard to get them to do is to look at how they can get their receptionist as a dedicated, non-nurse receptionist Unless it's a nurse who might be returning to the workforce.

00:19:46.657 --> 00:19:59.300
Perhaps they are one of those 20 years ago nurses that pre-diploma, pre-certificate and they are absolutely happy to be on the front desk.

00:19:59.300 --> 00:20:01.932
They don't want to do surgical nursing again.

00:20:01.932 --> 00:20:07.005
That's different, but I do think it's a total waste of skills.

00:20:07.005 --> 00:20:15.599
I'm not discounting the skills that receptionists have, because it's a skilled job as well.

00:20:16.605 --> 00:20:20.773
I had a conversation a few years ago with a principal.

00:20:20.773 --> 00:20:23.038
It was a small, independent.

00:20:23.038 --> 00:20:25.355
Well, it wasn't so small, but it was an independent clinic.

00:20:25.355 --> 00:20:32.931
I was talking with one of the directors and I was saying to him that you need to start charging for your nurses.

00:20:32.931 --> 00:20:35.673
It was almost insulting to him.

00:20:35.673 --> 00:20:41.681
He could not get his head around the fact that nurses are valuable.

00:20:41.681 --> 00:20:49.817
How do you suggest if there's a nurse listening here or a practice manager and wants to put it to their principal?

00:20:49.817 --> 00:20:51.949
How do you suggest that they broach that?

00:20:51.969 --> 00:20:54.034
it to their principal.

00:20:54.034 --> 00:20:56.239
How do you suggest that they broach that?

00:20:56.239 --> 00:21:04.931
Well, I would first of all come up with a list of things that you could bring to the clinic.

00:21:04.931 --> 00:21:07.215
First of all, there's lots of different ideas up on you know, I suppose, the NZVNA website.

00:21:07.215 --> 00:21:10.671
There's lots of things on social media and things that people are doing as well.

00:21:11.271 --> 00:21:18.375
People are talking quite a lot with regards to nurses and them feeling that they're not being well utilised.

00:21:18.516 --> 00:21:29.251
So there's lots of different ideas that you can bring to the table, sound them out, and if you are able and competent to be able to do these things, then why shouldn't you?

00:21:29.251 --> 00:21:41.257
We have these veterinary nurses as professionals in their own right, basically, and they have a fee earning potential so you can bring revenue into the clinic.

00:21:41.257 --> 00:21:42.465
So how can that be bad?

00:21:42.465 --> 00:21:57.571
At the end of the day, we can have nurse fees under that umbrella, where it can cover their entire wage or even supersede it, depending on how many nurses you've got in the clinic that works with you.

00:21:57.571 --> 00:22:10.471
So I would say, get your list ready, see what you can do, even if it's if they're not going to give you consulting time, maybe out the back, you know things where you can be monitoring anesthetics and things like that as well.

00:22:10.471 --> 00:22:15.511
That can all go under a nurse umbrella kind of fee and you can build.

00:22:15.511 --> 00:22:19.036
It doesn't have to start with 50 different fees as well.

00:22:19.036 --> 00:22:20.569
Start with two or three.

00:22:20.569 --> 00:22:21.855
See what happens.

00:22:25.626 --> 00:22:28.035
I hope you found this really helpful.

00:22:28.035 --> 00:22:38.732
Regardless of whatever role you have in your veterinary clinic, there's something in this episode, I believe, for everyone, and the same for next week as well.

00:22:38.732 --> 00:22:56.936
So make sure you tune in next week as well, because Michelle talks about different invoice line items that not only make a difference to a veterinary nurse's self-esteem because they're being recognized as adding value, but also make a positive difference to a vet clinic's bottom line.

00:22:56.936 --> 00:23:02.291
So stay tuned for that Until next week.

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This is Julie South signing off and inviting you to go out there and be the most fantabulous, resilient version of you.

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You can be Kakiti Ano.