30. Ready to expand? How to grow your veterinary hospital into multiple locations, with Mike Robinson, VMD
With Dr. Mike Robinson
Building relationships with patients can be one of the most rewarding parts of owning a healthcare practice. (Or, for veterinarians, also building relationships with the patients' owners.)
What happens when you decide you want to expand your practice into multiple locations? Will you still have the time to dedicate to connecting with patients? How will you foster the kind of culture you want in your new locations?
Meet our guest
Dr. Mike Robinson, VMD has learned the answers to these questions and more on his road to becoming the owner of multiple animal hospitals in North Carolina.
He began working as an associate at Cabarrus animal hospital in North Carolina in 2011, and a few short years later, he found himself in a position to purchase the hospital. Then in 2019, he opened a startup clinic in Harrisburg and in 2022 bought a third clinic in the same area. He’s currently in the process of completing a ground-up construction project which will be the future home of both Harrisburg hospitals.
In this episode
- How to know when it's time to open a second location?
- What challenges can doctors expect when deciding to expand?
- How is managing multiple hospitals different from managing just one?
- How do you maintain a company culture across multiple locations?
- How to structure your workforce to thrive in different locations?
A lot of vets get into it because they love working with people and the animals. And the reality of going into a second practice is you probably can’t do both excellent. You need to have a partner who’s willing to do that side of it, or do you hire a manager who’s willing to do that side of it?
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Ever wonder what it’s like to go from being an associate, to hospital owner, to owning multiple locations? Today, we are joined by Dr. Mike Robinson who is going to tell us all about it! Mike graduated from the University of Pennsylvania’s Veterinary Medicine program and began working as an associate at Cabarrus animal hospital in North Carolina in 2011. A few short years later, he found himself in the position to purchase the hospital. In 2019 he opened a startup clinic in Harrisburg and in 2022 bought a third clinic in the same area. He’s currently in the process of completing a ground-up construction project which will be the future home of both Harrisburg hospitals. He is passionate about providing progressive veterinary medicine while providing an unparalleled customer experience. Cabarrus and Harrisburg Animal Hospitals pride themselves on creating a positive, family-forward work culture with the goal of exceeding the expectations of all pet owners they encounter.
Mike, it's so nice to meet you. Thank you so much for joining us. We're happy to have you on the show today.
You know, I've heard a lot about you. I've gone to my team asking for veterinarians that they think would be great candidates for the show and your name came up first from a couple different people. And I know that you've had kind of a really interesting road to become the veterinarian you are today. So do you just mind sharing a little bit of your story with us?
You know, the idea of removing eyes and doing surgery and critical cases was all very new to me. So I was back and forth for about a week and became pretty good friends with the veterinarian that was seeing him at that time. And he just kind of said, you ever thought about being a veterinarian? And I said, well, no. He said, well, my dad was a human physician as well. He's like, why don't you just come check it out and work with us for the summer? So I did, I went and worked in the kennels was my first job at the clinic and just really found a different perspective on veterinary medicine. I remember sitting there studying for the MCAT and the six month old dog completely blind had just lost an eye. I'm miserable. People are saying, well, do you put the dog down? You know, what do you do? What kind of quality of life is that going to be?
And this dog is jumping and bouncing around and could not have been more happy and less concerned with what had just happened to him. And it just kind of showed me, like, if that was me, I'd be feeling miserable and sorry for myself. And here's this dog who is like nothing ever happened and ready to move on. And it gave me a new perspective on animals, let alone the industry. And so from that point on, I was like, OK, I think this might be my calling. And so from there I had to go back and start taking some classes in order to get into veterinary school, do some things to kind of set myself apart from all the people who grew up always wanting to be a veterinarian.
And so I went and trained dogs in Texas for a while and went and did some veterinary trips in Costa Rica and Nicaragua and then ultimately ended up getting into veterinary school at the University of Pennsylvania. From there I went on and did an internship at veterinary specialty hospital in Cary and then came back to Cabarrus Animal Hospital where I'd taken my dog from the very beginning, started working there as an associate and a couple years later I had the opportunity to buy the practice with a partner.
That's an amazing story. How did you go from, being associate to deciding that you wanted to become an owner? What did that thought process feel like?
Yeah, and we don't hear that from most hospital owners. They usually don't have as much of a business background, right? It's just like, can you go to school to be a veterinarian? Then all of a sudden you are told you should own a hospital. So I think that's amazing that you had that background and it's probably very helpful. But can you tell us what that was like going from an associate to practice owner all within the same hospital?
So I think one of the biggest struggles that I had with it, though, was a lot of these people were my contemporaries and my friends that I went out with on the weekends and hung out with differently at work events. And now I'm kind of having to take a different step and separate. So that was a struggle for both my partner and I, is like, okay, how do we separate ourselves and have that respect, but also still have that relationship and draw those boundaries. So I won't say it was easy by any stretch, but I think having grown up and kind of moved through the different departments and kind of earning their respect with each transition in the hospital made it a little bit easier when it came time. And at the end of the day, I never acted like I was better than them. I was always part of the team. And even to this day, I don't ever talk about any of them being my employees. They're people that I work with. And I think having that mentality has also served us well along the way. We're all here to do the same thing, whether it's owner or kennel person, we're all here to support one another. And I think that's paid big dividends for us as well.
Yeah, thanks for sharing that. Now that you've been an owner for several years, and today's episode, we're kind of really focusing on the idea of owning multiple locations. So in your opinion, do many healthcare providers know going in that they want to be a multi-hospital owner, or is that something they kind of discover after a few years of ownership?
Yeah, we've heard it time and time again on the show about the power of a great mentor, right, and what they can do for your future.
So I think you hit the nail on the head. What would you say the motivation, or maybe your motivation for wanting to own multiple hospitals is?
What sort of niche did you guys build? Because I think that's really important to think about when you're talking about owning a hospital. What specific type of thing do you bring that's different from the competition?
I'd say we're more urgent care emergency day practice from the standpoint of you come in with something that needs to be cut, we're gonna cut it. You come in with something that needs to be hospitalized, we can hospitalize it. We're always gonna offer you to go to the specialist, but we can perform high level procedures. We can do high level medicine in our four walls with the staff that we've got and that we've trained. And so that's kind of become our niche in the areas. You can't afford to go to the specialist or logistically you can't get to the specialist like we can't do it here but go to Cabarrus Animal Hospital. They can do those things, they'll get you in today.
I'm sure your pet owner patients really love that too, not having to go to multiple different locations and all over, right?
Yeah, that's fantastic. Let's say that we're determined and we've done our research, that we're ready to open this second location, let's say. Where do you start?
What's your role going to look like when you open that second location? Because things have to change. When we started this, my partner and I, we were the guys. We were the people that the clients came to see. We were the ones that were producing 75, 80, 90% of the revenue and clients came to see us. And so there was a transition as we started getting bigger where I had to kind of step back a little bit and clients weren't necessarily thrilled with the idea that I wasn't gonna be there. And so for me, I knew long-term, my goal wasn't to be the guy in the room seeing all the patients. That just wasn't where my love was. I knew I wanted to be more involved in the ownership and the management of the hospital. My partner, polar opposite. He wants nothing to do with it. He'll tell you himself, he wouldn't even know how to log in our bank accounts if you asked him. Because he's a fabulous surgeon, he's a fabulous clinician, and people love and adore him, and that's where he is a rock star. And so, I knew that's what I wanted to change, and in order for us to be successful and grow, number one, I had to step out and start working on the business and not just in or at the business, and for number two to happen, it was even that much more important that I wasn't in the practice all day, working in the practice, but I was working at both practices trying to make sure that systems were in place, management was in place, that we were hiring, we were doing everything we needed to grow. And so I think that's really important because a lot of vets get into it because they love working with people and the animals. And the reality of going into a second practice is you probably can't do both excellent. You can probably do both okay, but something's gonna suffer, whether it's your home life, whether it's the practice management, whether it's the callbacks to those owners. You can't do everything excellent all the time when you start getting to that kind of scale. That would be the last thing I would tell people is like, hey, why do you want to do this? Like why the second practice? And are you willing to change who you are in the practice? Or do you need to have a partner that's willing to do that side of it? Or do you hire a manager who's willing to do that side of it? Because you just simply can't do everything all the time really, really well. And it really comes apparent when you get into that second location and it's not just right there in four walls.
Yeah, and sounds like you found the perfect partner, by the way, between you two.
You know, we’ve discussed how you know when you're ready to open additional locations, but when we come back, I'd like to get into more of what it's actually like to manage multiple hospitals. More with Dr. Mike Robinson right after this.
I'm Corey Brown and this is Provide’s the Path to Owning It podcast. We're back with Dr. Mike Robinson, owner of multiple animal hospitals in North Carolina to discuss what it's really like to manage multiple hospital locations. Mike, you've hit on this a little bit, but I think our audience listening would really just like to hear from someone who's done it, how is managing a single hospital different from managing multiple locations?
So I think I needed to come to terms with the fact that I couldn't be that guy anymore as much as that kind of hurt to not be the one that everybody was so excited to come see. But I had to plan for that so that they had somebody to go to this. They didn't think that I was just leaving them to go off and manage the business. They had to have somebody that they knew they could be with and that they trusted and that they liked just like they liked me. And so that was a big part of the transition for me was just realizing, okay, I can't do both. Let me make sure my clients are taken care of because that's the most important thing. And then that'll give me more time to focus on the things that I need, which 90% of my days are probably dealing with human resource issues. I think we're over 100 staff between the two hospitals and we're just over 20 doctors. So most of my time is making sure that our people are taken care of, that they're happy being here that our protocols are in place, that our systems are in place. And so that's what my focus has to be. And if I were to try to do that half the time, things would fall apart and staff would leave us because there's no way I could do that in a way that would really benefit them if I was just doing it half the time.
Yeah, I think it's so important that you realize that early on too, and had that handoff like you said. I think that is great advice. You've mentioned employees and staff and multiple doctors, so I think our audience would like to know what kind of office structure do you have that works well for you? Is there like one management group that's managing both practices? Are they run independently? Can you talk a little bit about that?
So all along with growth, whether it was in hospital number one or number two, we've always tried to stay a little bit overstaffed when we're in that growth phase. So from a management or a structure standpoint, we've had to do the same thing. We started off with no practice manager when we first took over the practice, and I was kind of in that role to having a practice manager to morphing into needing two practice managers in our larger practice. And then under them we had numerous different lead positions or management positions in the hospital. None of them happened day one, but as we were growing, we could see the need for it as we got further along. And again, we didn't want to be reactive, we wanted to be proactive in those situations. So I think the same thing goes for that second hospital. Once you realize, okay, we're gonna do this, you can't put those people in place after the building's already there and the doors are already open. You kind of need to know what that's gonna look like and have those people in place and have them understand how things work at number one so that they can easily go over to number two and recreate that situation. And by doing it early, they were able to work with our managers at number one and really understand how the hierarchy worked and the systems worked at number one so that they were just going over and recreating the management at number two.
So the way that we run things are, Yes, there's kind of a central management team. My original practice managers have kind of grown to a place where we have people under them that are handling some of the day-to-day that they used to do so that they can focus on some of the larger picture things for both hospitals like inventory, scheduling being two of the bigger things, they kind of view those things for both hospitals. But then I've got a practice manager at number one who's an absolute rock star as well. And she just does everything that my practice managers at number one do and they are constantly in communication. We text, call, have meetings. And so I think you have to build that management team before number two opens and then be able to plug them in and just have more people in place than you probably need on day one so that when people do come in the door, you look like you know what you're doing and you've got the staff there prepared to meet their needs. We do run them kind of as one, but at the same time, and this is one of the things we had to learn, as much as we have these systems that are in place across the two hospitals, they're two separate hospitals. They're two totally different staffs. The clients, even though we're in a similar area, are different, and I think that's something we've kind of learned along the way, is we thought, okay, it's just a couple exam rooms down the road, this'll be the same deal, we'll just run things the exact same way, and to some extent, yes, but no, it's like when you have kids, like yeah, both kids are from the same mom and dad. But they're different. They have their own personalities and they have their own interests. And that's what's kind of happened between the hospitals. And that's something that's been really fun and exciting to deal with. But it's been something that I don't think we anticipated the differences that would happen in some of the decisions and the way we would have to handle things differently between the two hospitals, even though they couldn't be run more similarly. So I think that would be the other thing that I would tell people is like, you got to be nimble and understand that as much as you want it to be like number one it's going to be its own hospital. It's going to have its own personality, and you're going to have to make decisions and changes based on what's happening at number two that just were different than number one. That's been a challenge, but it's been fun. And I think we probably recognize it a little later in the process than we should have. But it's neat kind of seeing the second hospital grow and become its own person, just like your children when they grow up and kind of become their own adult.
Can you share one thing that was unexpected at number two that you didn't anticipate?
Do you mind sharing what you've kind of learned about managing such a large staff and attempting to keep that office culture fun and positive like you had mentioned?
And it's like, oh my gosh, where's all this coming from? And there was this kind of underlying sense of there was a disconnect between the employees and management and ownership. And we wanted to sit there and be like, oh no, we've been doing all these things, we've been taking care of these people. But when we really stepped back and started talking to our management team, we realized like, yeah, there's a personal side of this that we've always managed to maintain that we've lost. And some of that was the employees that we'd had for 20 years, 30 years, maybe some had retired, maybe some during COVID decided they didn't want to come back. Maybe we just added a lot of people that weren't here before, but they didn't have a history with us. They didn't have this history of these guys always take care of us, or this is a big family.
And so when the going got tough, there wasn't that same trust that we had historically had. And so for the first time in a long time, we really had to take a look in the mirror and say, OK, like, We've got to get back, even though our staff has gotten this big and we're this busy, we've got to get back to a place where these people feel comfortable coming and expressing their concerns, coming to us when they have issues. One of the things we kept hearing was like, I'm scared to come talk to you guys, right? I don't know you well enough to say these things. And that was a real gut punch because for the first time in our careers, somebody wasn't comfortable coming to us. And that was on us. I mean, we had to fix that.
And so we've taken some steps recently to really kind of close that gap between them and management and them and ownership. And I think that was probably the first time as we've scaled, we had lost touch a little bit with what was happening as we had added so many new people. And I'd like to think if COVID hadn't happened and the scaling hadn't happened so quick, maybe we would have been more in touch with it and it wouldn't have happened the way that it had. But you know, we're learning from it and we're learning that we have to kind of manage a newer generation a little differently than we did before. We have to manage people who don't have a 10, 15 year history with us a little differently than we do somebody that just walked in and has never worked in the vet industry. And so it's been a good learning curve for us. But it's definitely something we had never experienced on a much smaller scale.
Yeah, I mean as someone who has worked for doctors for many years in the past, I think it's so important that you listen to your managers and really take that in. I think that's probably the biggest piece of advice I could give an owner.
You've given so much great advice today. I'm not sure if we can narrow it down, but is there one piece of advice that you could give our associate veterinarians and our single hospital owners listening today who have dreams of owning multiple locations?
Mike, that's great advice. Thank you for sharing. You know, for those who may be interested in joining your team now, I'm not sure if you're hiring, but what's the best way for them to reach out to you?
Awesome. Well, Mike, thank you for being with us today. It's clear we found the right person to discuss how to grow from one hospital to multiples. And being able to hear it from someone who's done it so successfully is just really valuable to our audience. So we appreciate you taking the time.
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