I am the owner of a small animal practice that has been AAHA-Certified for 41 years and was the first practice in Minnesota to become Fear Free Certified two years ago. While it does take a great deal of work to maintain these certifications, I strongly believe the effort is well worth it.
As part of a practice owners' group on Facebook, I recently observed a conversation string regarding the benefit of AAHA Accreditation. The overwhelming majority of practice owners opined that they felt certification was NOT worth the effort. The reasons stated were primarily that it took too much effort and cost too much when weighed against the perceived returns. In other words... they just didn't feel they got enough in return for the time and money they invested in the process.
Over the years, I often have heard practice owners state that "I already have high standards, so why pay all the money for the certification?" or conversely, "I know practices that are AAHA certified, but don't have as high of standards as we do at our practice, so what's the point?".
Yes, it is true that certification of any kind does not guarantee that the certified party will live up to the standards of certification. That is true of individuals as well as practices. Being certified and accredited as a veterinarian does not guarantee that all veterinarians practice to the ethical standards set forth by our profession. I wish it did, but it doesn't. Does that mean, however, that it is not important to have standards at all?
Practice certification of any type provides a foundation of standards to which a practice can aspire. Take AAHA, for instance. As of 2020, there are 982 standards, of which 87 are mandatory and you must obtain a passing grade in each of the 19 categories of standards in order to successfully obtain accreditation. The process of going through these standards and assessing your hospital, even if it is only once every three years, assures that you are at least exposed to "best practices" in each area of your hospital. Without this type of roadmap, how will you keep up and know what the appropriate standard of care is in each area?
As veterinarians, we are proud of our diverse education. We are simultaneously ophthalmologists, dermatologists, internists, etc., across a variety of species. There is no possible way that we can maintain expertise in all of these areas without extensive ongoing education. What we learned in school years ago is not necessarily the current standard, so we need to keep up with our continuing education in order to be effective practitioners.
The standards that AAHA publishes serve as a similar form of Continuing Education for all of the different areas of practice. Without these, how will you know what the current standards of care for your practice are? Are you meeting current standards for OSHA, for controlled drugs, for record keeping or patient care, for instance? Your practice might maintain standards of care, but will you be progressing and keeping up with changes in our profession, without being pushed to do so? We learn best practices and improve our systems every time we go through re-accreditation!
With Fear Free Certification, Low-Stress Handling Certification, and Cat-Friendly Certification, your hospital is required to meet certain standards, which include specific ongoing education for your staff. These hospital-wide certifications lead to culture changes and a source of practice identity and pride that individual certifications do not. This culture change creates a better workplace with higher staff satisfaction, more loyalty and reduced staff turnover.
Many people argue that these certifications/accreditations do not provide a good return on investment. If you are only looking at financial returns, then I think you are missing a big part of the picture. A Fear-Free Certified Practice, for instance, leads to a delivery of care that is tangibly different than what most practices provide. This difference is recognized by clients because it creates an entirely different (and better) client and patient experience. This type of experience can lead to a well-defined brand image for your practice and more brand loyalty for your clients.
As a practice appraiser, I must also mention how much these certifications can impact practice value. Practices that take accreditation seriously, that involve their staff and change their culture are more valuable to potential buyers because these practices have a foundation for continued success after a sale. When the success of a hospital is derived from the entire staff and from clients who are loyal to your practice and not just to you as a practice owner, this leads to the type of Goodwill that can be successfully transferred to a new owner. The result is a decrease in potential risk, which translates to higher multiples and higher practice value.
Don't just take my word for it. I have studied corporate practice sales over the past few years. I have individually reviewed websites for over 3,300 corporately owned practices and have found that 32.4% of these practices are AAHA-accredited. This compares to a national average of around 12% of all practices that have achieved this accreditation. With Cat-Friendly practices, approximately 3% of all practices are certified, while 8.8% of corporate-owned practices have this designation. It is too early to do this analysis for Fear Free, but it is clear that corporate buying groups see some advantage to practices with these designations, as the practices they purchase are accredited at a rate that is almost 3x higher than the national average.
The bottom line is the value of practice certification is obtained in many ways beyond financial return. Accreditation can provide a road map to constant improvement and maintain current standards of care. Accreditation can also lead to a more well-defined practice culture and source of pride for your team and this is often correlated with increased staff satisfaction and decreased turnover. And finally, accreditation can often lead to more sustainable goodwill and a higher practice value when it comes time to sell.
