Company Profile: Guardian Vets



Tell us about how your company got started. 
My former life was as an investment banker and project finance professional. I had no background in the pet space or the veterinary industry.
Everything changed when I adopted my puppy Patrick.
As a first-time pet owner, I had numerous instances where I would have a medical question at night or on weekends: for example, my puppy might seem lethargic, would make an unfamiliar noise, would ingest something potentially problematic or would throw up and I didn’t know why.
My only options were to take him to the ER or to try and Google it myself.
I never knew if the issue was an emergency and the ER would offer no support other than saying “if you think it is an emergency you should come in”.
After a few instances of going to the ER unnecessarily, wasting money, and being extremely upset about both of those things, I thought, there has to be a better way.
I spent lot of time speaking to other veterinary professionals and began to understand the economics of the business, and why it was that after-hours care was not something commonly offered by private practices.
I came to realize two things about the industry:
1)     Many practice owners did not understand how often their clients had issues after hours (this sounds so obvious but there’s the old saying “you can’t manage what you can’t measure”. The reality is most veterinarians simply have no idea how many calls they get after hours and some hardly even track voicemails; and
2)     Many practice owners were older and were used to referring all of their after-hours business to the ER because that was just “how things were always done”. That may have been OK in the past when many ERs were locally owned so the profits would eventually trickle back and when consumers didn’t have other options as to where to get their information. But times had changed: ER’s are now mostly corporate owned or standalone entities and consumers can simply search for information themselves on the internet.
I also saw that there were other companies trying to solve this issue (or similar issues).
The most prevalent solutions (at the time) seemed to be:
·       “Call Center Companies”;
·       “Other Companies that Connected Pet Owners to a Random Remote Veterinarian”; and
·       “Companies that allowed remote consultations through an existing VCPR”
When evaluating these solutions, I saw more problems:
·       “Call Center Companies” don’t offer any medical support and literally connect you with a random person who can only “take a message”. As a pet owner, I had dealt with this already and knew nothing is more infuriating then being connected to a person who can offer no help whatsoever. Might as well just put on the answering machine!
·       “Other Companies that Connected Pet Owners to a Random Remote Veterinarian” indicated a massive lost opportunity from the practice’s point of view. Why would a practice support or endorse a company who is sending their clients elsewhere? Moreover, why is the practice turning its own clients away when they need the support the most? The ideal solution for a client would be to go through their primary veterinarian who they trust. Also another big problem is that many of these companies proport to minimize the need for physical appointments. That is potentially dangerous, shows a deep lack of understanding of the veterinary profession and flat out violates VCPR
·       “Companies that allowed remote consultations through an existing VCPR” were not really a new concept. For decades, there already have been veterinarians that are available for their clients remotely through their phones. Then, came communication between doctors and specialists (e.g. X rays, cardiologists, dermatologists, etc.) that sent faxes to each other, emails to each other, etc.  Then, came web cams and the ability to Facetime and the wave of huge corporations where you may often see different doctors for the same pet. Now you can mashup technologies like Stripe and Twilio and charge for your time through an app. These are all helpful tools, but they didn’t solve the problem I had experienced. My problem was with the lack of afterhours care. As a veterinarian, do you really want to be “on call” all the time? Mine didn’t. What sort of work-life balance will you have if you are personally available at night and on weekends? What if you’re not dressed professionally at night and a client wants to video? Suppose you as a practice owner or manager decide to rotate who is on call and rotate staff to take turns, have you considered how much it will cost to pay your staff? How will your clients react if they have to pay once to talk remotely and then again to be seen in person? How will the information be captured? How will calls be recorded? How will appointments be set? How will records be updated? How will this information stay secured? We have had practices that had tried to handle afterhours in-house and rotate shifts come to us specifically because they were fed up with these (and other) issues and on top of it were suffering from staff burnout.
So after studying the landscape and remembering our focus towards improving afterhours care, I realized that triage support, when appropriately practiced and when integrated through the primary veterinary practice, could help bridge the gap for both pet owners and veterinary practices, while helping strengthen the centrality of VCPR.
With this realization, an incredible initial team was formed and we made a deliberate choice not to go the telemedicine route.
As we saw it, this problem needed business model innovation first, technology second. We had to figure out a way to make it a “win-win” for both the practices and the pet owners and then build the technology infrastructure to support that solution.
Thankfully, we did.
Our model works because we help practices generate more appointments, improve customer service and attracts new clients.
Pet owners (i.e. the clients), in turn, love the service and the resulting message to them from the practice is clear: we are here for you when you need it most.
To be clear: we do not provide treatment and we do not provide diagnoses. We simply provide support afterhours so the client would be better informed as to whether this really needed to be seen immediately by the ER, or whether we should just schedule an appointment to be seen by the primary veterinarian.
In our view, in the absence of a VCPR it isn’t a matter of whether you need to be seen or not seen… it is a matter of how soon do you need to be seen.
That has been a key distinction in how we got started and how we approach the business.



How many interactions with clients/consumers have you had?
Although we only launched the company in February 2017, we have already processed thousands of calls.
How many repeat interactions have you had?
Sometimes that recommendation from our team will be to “schedule an appointment with your veterinarian but monitor for X,Y,Z”. In those cases, we encourage the client to call back and follow up with their observations if they have any remaining questions or are unsure about anything. 
We also have repeat users that call for different issues that come up with their pets.
As a practice, you want your clients calling you for any medical related question instead of turning elsewhere for their information. That makes your practice more “sticky” and in turn translates into more appointments and greater client loyalty.
Do you employ veterinarians or do you provide a service to them?
Both. We basically act as an extension of a practice afterhours for triage care when they are normally closed.
Does using your service result in in-clinic visits?
Yes. We have one hospital that has generated 70 new appointment requests in a month from existing clients and has gotten over 10 new clients in that same time span through the afterhours service.
That is a very real, tangible benefit to the practice’s bottom line.
Our first few clients were crucial in understanding exactly how many calls practices do typically get afterhours, how many of those result in consultations, and how much actual business we can drive from that (asides from client goodwill).
Now if you call us, we can reasonably estimate what the bottom line impact will be to your business given a few key metrics, by relying on these datasets.
Beyond the financial ROI, think about the message you are sending your clients by saying “our practice offers our clients the ability to speak with a veterinary professional, for free, afterhours”.
What kinds of patient outcomes have you experienced? Do you have any stories you can tell us?
The biggest outcome, by far, is relief and then appreciation from the pet owners.
We have had calls ranging from foreign body ingestions, to hit and runs, to breathing issues, to fleas, to itching, to seizures, diarrhea, to issues with skunks and porcupines in rural areas. Very rarely are the questions related to behavioral issues like food aggression, and we filter a lot of the “what hours are you open”/ “can we request another prescription” questions through the voicemail ability and intelligent answering systems.
Of course, some consultations result in an ER recommendation while others result in a “monitor for XYZ and lets schedule an appointment for you tomorrow”.
In the absence of a VCPR we are very, very wary of anyone that says that their consultations result in appointments being avoided. That is at best negligent and at worst extremely dangerous. Again, to reiterate: for us, it isn’t a matter of whether you need to be seen or not seen… it is a matter of how soon do you need to be seen.
One important point to note though: even if when we refer a pet owner to the ER, clients appreciate the fact that their veterinarian provided this service. We are able to educate the client on the potential costs of the ER visit ahead of time so “sticker shock” isn’t so much of an issue and the focus from the ER can be on providing the best care possible for the pet.

Veterinary Preparation

What does the ideal client look like for you? What kinds of problems do they have?
Our best clients are owners and practice managers that have a growing practice and that care about providing the best service. We also only currently work with companion animal practices.  If your clinics service pocket pets and exotics, we can assist with those clients as well.
Typically, these practices understand the need to be there for their clients’ afterhours but they want their staff to maintain work-life-balance or are worried about overworking their team/ staff burnout.
What can veterinarians do to incorporate your technology?
Call us! We will set up your phone systems to integrate with our technology and have a program in place to get the word out to your clients.
We do need to know specifics about your practice so we can customize to your requirements but the first step is to call. At the very least visit!
What kinds of questions do they have?
Common questions include:
·       Is after hours care really a big issue for us? (the answer is yes and the fact that you’re asking indicates that you’re likely not actively tracking the single most important lifeline for your business – your phones!).
·       Will we face additional liability? (no and we are happy to explain how our business model was developed to protect you)
·       How much do you cost? (It depends. But think for a second: how much do you value your current front of house staff during their job well during the day? What would happen to your business if those phones rang and rang and no one picked up? If it’s a top priority for you during the day, why isn’t it a top priority for you at night? How big is your practice? What is your average transaction size? How much is a potential new client worth to you? We can talk about cost after we understand your practice and your needs.)
Perhaps my favorite commonly asked question is “How do I know I can trust your team?”
I love this because our team is the single thing I am most proud of. We have an exceptional team of veterinarians and veterinary technicians/nurses (they are all licensed and actively practicing in both general practices and emergency practices as well, by the way) and we have a deep list of referrals from current clients to back them up.
On top of our exceptional team, we have a deep set of triage protocols in place already, the technological infrastructure built in a secure environment to recognize where calls are coming from, document/record everything, provide summary reports, request appointments, customize for your practice’s preferences and give you robust analytics so you can see in real time the bottom line impact to your business.

What onboarding strategies do you have?
If you think it is as simple as “hand the phone systems over to GuardianVets and it’s done”… you’re mistaken!
We take care of everything on the backend to make sure the technology integration is seamless but there is a lot of customization and client outreach that is also involved to make sure this is a success.
We only succeed if you succeed! Part of the strategy involves making sure your clients are aware of this.
What suggestions would you have for clinics interested in using your tools?
Call us! We first need to understand your needs before we can tell you how to use our tools.
Regardless of whether you’re reading this at 6am on a Tuesday getting ready to go to work or at 10pm on a Saturday… feel free to call.
Our motto is “good customer service is good business” and we live by that standard.
What suggestions do you have for vets interested in telehealth but don't know where to start?
Before jumping into anything, I’d recommend taking a step back and thinking: “why am I considering telehealth?”
What is your root problem and what is your end goal?
Is your problem really that your clients are all demanding the ability to Facetime you?
Or is it that you realize the need to always be there for your client but don’t want to work 12+ hour days and be “on call” nonstop for clients at night, weekends and holidays and were attracted to the potential of technology to help you? 
In our view, the marketplace has evolved from a “doctor centric” model focused solely on quality of care where the doctors were the gatekeepers of all the information to a more “client centric” model focused on perceived value where the client has many options on where to get their information (rightfully or wrongfully).  
In this new marketplace, customer service is increasingly important. As a practice, you have to be there for your clients when they need the help. But likewise, for most veterinarians, you also need balance.
GuardianVets can help you achieve that balance. We can help you provide the best service to your clients and also generate additional revenue in the process.

Business Model

What does the business model for the veterinarian look like?
Hospitals can elect to pay us on a “Pro Sal” basis (i.e. depending on how many consultations are provided and new clients we bring them), or, can pay us a fixed monthly fee.
Regardless, we make sure to stay impartial as to whether clients are referred to the ER or to the primary veterinarian so as to make sure the pet receives the best care possible.  Even with an ER referral, our service allows the clinic to touch base the following morning with the pet owner after an emergency, which further bonds the client to the practice.
What kinds of revenue do veterinarians tend to generate using your product?
Suppose, for example, you are a 3 FTE veterinarian practice with 3,000 Active Clients and after hours you receive, per week:

  • 20 calls
  • 10 actual afterhours consultations which result in 6 appointments
  • 5 voicemails
  • 1 new potential client with a question

Voicemails aside, that is 4 new potential clients and 24 appointments from existing clients per month.
Suppose further your Average Transaction Size (ATS) is $120/appointment and a new Client’s Lifetime Value (CLTV) is $1,500 (this number can vary hugely but for the sake of argument).
Further suppose only half of the new potential clients that had questions and called afterhours actually come in the door and stick around.
24 appointments X $120 = $2,880
4 clients X $1,500 CLTV x 50% = $3,000
Total Practice Monthly Value= $5,880
In this hypothetical example, the hospital generated $5,880 in value in one month.
In reality, we have had one 3 FTE veterinarian hospital generate 70 appointments afterhours and over 10 new clients in one month alone.
That is a very real, tangible benefit to the practice’s bottom line.
When vets use your tool, how are they charging the client? Is it part of an overall package, a one-time fee, an option to be part of a package? What have you found to be the easiest, most effective, revenue generating?
Lets take a step back and think about another industry: airlines.
·       Some airlines want to charge you directly extra fees for carry-on luggage, extra fees for food and beverage, extra fees for Wi-Fi, etc.
·       Some airlines bake the cost of luggage, food, entertainment etc. into the cost of your ticket and offer different packages for economy, business and 1st class.
·       Some airlines cater only to the super exclusive clients and offer private flights.
How you charge your clients says a lot about how you position yourself in the market place. 
Asides from the revenue from new appointments and new clients, we have worked with hospitals who have used things like “Wellness Plans” to make additional revenue off our service.
However, we ask that you first think about what message you want to convey to your clients. Then, we can work out different ways to maximize your ROI.
It’s not just about making the quickest buck.
Your practice has a brand and we’re here to help you build a long-term sustainable business around that.
Is there greater or lesser revenue for veterinarians as a result of using your service (we have found that people who use telehealth services first and then go into veterinarians afterwards are more likely to go into the vet and spend more money while there)?
We want to clarify a few things we believe generally about telehealth before addressing the revenue potential again.
We believe:
·       Telehealth should always be linked to a practice, otherwise pet owners are more likely to try to use it as a substitute for a physical visit;
·       The impetus for telehealth on the consumer side is driven by pet owners looking for answers afterhours who are not sure whether an issue is an emergency or not (there are many other applications between doctors and specialists of course but this really isn’t as contested);
·       GuardianVets after-hours triage solution is the best option for veterinarians who want to provide the best service to their clients but want to maintain work life balance;
·       Telehealth should only be practiced by licensed professionals; and
·       Telemedicine is only one component of telehealth and can only be practiced within an existing VCPR and even then, it needs to be adopted carefully
GuardianVets does not provide telemedicine, we only provide only after-hours triage through an existing veterinary practice.
Our aim is to bond your clients more closely to your practice. In the process, your practice will provide better service and make more revenue.
That all said, it seems like there is a very real problem right now with rising student debt and salaries not being very attractive.  So while GuardianVets can make practices more money, if you are a veterinarian you may be thinking: “that’s great for my boss but I want to supplement my own income too!”
If that’s your concern, I encourage you to apply to work for us (do note our interview process is very competitive) and help us sign up your practice!
Being a technology company, we offer perks (work from home, competitive pay, flexible hours, etc.) that many traditional brick and mortar service providers physically cannot.  
So yes, we can both help practices make more revenue and also enhance the incomes of veterinary professionals. But beyond that, we are seeking to enhance and improve the industry.
We believe afterhours triage can enhance the client experience, improve the bottom line for veterinary professionals and make sure the pets always receive the best care possible.