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Episode #1 with Matthew Fletcher of Patterson Veterinary

In this first episode of the Veterinary Start-Up Practice Podcast, attorney Rob Montgomery connects with Matthew Fletcher, a highly experienced veterinary equipment specialist with Patterson Veterinary.

Matt Headshot

Rob and Matt touch on misconceptions that  veterinarians may have when it comes to doing a start-up veterinary practice. They also discuss the importance of reaching out to specialists like Matt and Rob early on in the start-up process, as well as the importance of having a vision for a future veterinary practice and how using that vision can help guide the practice owner through a smoother (and less stressful) veterinary start-up experience. 

Over the past decade, Matt has assisted over 500 veterinarians open, expand, relocate, and remodel their practices. Drawing on his vast experience in the veterinary business world, Matt helps to guide veterinarians through specific workflow designs, provide technician support for installations and repairs along with contributing to the equipment and cabinetry options that may best fit the space.

Listeners who want to connect with Matt can do so at (410) 259-5283 or at and they can connect with Rob at or through his law firm’s website at

See the full transcription below:

Bumper  0:00  

Welcome to the veterinary startup practice podcast with Attorney Rob Montgomery, where Rob and his veterinary industry guests seek to demystify the process of starting up a veterinary practice. Since Rob is a lawyer, we need to tell you that this podcast is for informational purposes only, and shouldn't be considered legal advice. listening to this podcast does not and will not create an attorney client relationship. As is always the case, you should formally consult with legal counsel before proceeding with any legal matter. And now, here's Rob Montgomery.

Rob Montgomery  0:34  

Hello, everyone. I'm attorney Rob Montgomery and welcome to the veterinary startup practice podcast where as we like to say, we are seeking to demystify the process of starting a vet practice by bringing in experts and thought leaders from the veterinary world to talk about the startup process, what to do and sometimes even more importantly, what not to do. And today, we are joined by Matt Fletcher, of Paterson veterinary. Matt is an equipment specialist there and he's been with Patterson for over 10 years. He presently covers the Maryland, Virginia, Pennsylvania, Delaware, New Jersey territory for Paterson and Matt has personally opened or expanded or helped vets relocate and remodel over 500 veterinary practices during his career. And Matt, like the other folks at Patterson help their vet clients with vet specific office workflow designs, they help with equipment specs, architecture, contract contractor, or Ruffin field support. They help obviously with equipment and cabinetry. And then they also help to provide technician support for installations and repairs and all that stuff. So obviously an integral part of the vet startup process. So we're happy to have Matt with us today. And thanks, man, for being on the podcast and welcome. You welcome, Rob, thanks for making me sound extremely important. I do appreciate that. Well, you are an important guy here in the process. I mean, it's, you know, so like the vets have gone out, they, they've talked to their rail, or they found these spaces that they like, and now you know, it's like, well, I got to put something in them, right. And so you serve a very, very key role for for a lot of a lot of respects. And I'm excited to chat with you today and really provide some good information for our listeners, about some things that they need to think about when it comes to the design and equipment and the layout of their, of their office. So let's go just kick it off with a question that you were asking all of our guests on on the podcast, Matt, which is, what are some misconceptions that veterinarians have about startup practices that you see out there?

Matt Fletcher  3:08  

Got it. I think the first main misconception, particularly with veterinarians looking at startups, as opposed to say, purchasing a practice is is the cash flow of it, you know, obviously, a lot of it's kind of vacillate between the two and worry that, you know, when you're starting a practice with essentially no customers, that the cash flow, you know, for yourself as a veterinarian, and as a family, family member, and so on, can be tricky. Obviously, it's one of those things whereby, you know, in this particular industry right now, more so than it's been in the 10 years, I've been doing it, the industry is so healthy right now, there's no shortage of pets, there's no shortage of owners of pets, the different outlook of people spending money on their pets has changed over the 10 years. And it's purely and simply there's not enough there to see the pets and owners that are out there in a reasonable amount of time ahead of an appointment. So a lot of the practices I've seen open in just you know, the last three or four years, you know, before COVID, and during COVID. And after COVID, as I think amazed themselves how fast they've needed to, you know, hire a second associate, or think about even expanding so quickly, you know, so I think a big misconception is, I'm going to struggle, I'm going to be you know, trying to make ends meet. Really, that's much, much less of a concern than it was 10 years ago with the industry as it is, you know, so that's one of the biggest misconceptions and worries that that's how they think about starting up their own practice brand new. Yeah. And I think obviously, it's reasonable to be concerned and to think about that I think would be reckless for people not to at least, you know,

Rob Montgomery  4:59  

Think about that. But and that's really why we're doing this podcast too, is to really get the word out. And for people to start thinking about that, you know, a startup is a viable option to an acquisition. And I feel like we're talking to a lot of folks about this, that in the end of that profession, the proliferation of corporate owned practices, and big groups, purchasing practices has made it difficult for the owner operator that to purchase a practice, that's, that's a, quote unquote, good practice. And while you know, I feel like, you know, cash flow of an existing practice, yeah, that can be a good thing. But sometimes it's not realistic for a for a veterinarian to be able to buy a practice with good cash flow. And what we oftentimes see is, people make concessions with that, and they ended up buying practices that are cheaper, and sometimes cheaper, in our perspective isn't less risky, you know, like, if you buy a practice, that's not really thriving and hasn't been a successful practice, that might be a cheap practice, that might also be a practice that has a very low ceiling, you know, so that you're not able to grow it or make it more successful. Whereas if you're looking at a startup, you have the ability to pick your location, build out a brand new office, start from scratch with the marketing your vision for what you want that practice to be, and really put something in the community that the community of pet owners is excited about, and they want to come see you, as opposed to that practice that's been out there for 30 years, and really isn't isn't firing on all cylinders? So that's right, yeah, it's kind of interesting, when you look at it, mostly, you know, yourself, you know, Rob, buying a practice, you know, not only costs more than a startup, but as so many wrinkles, to buying the business, the land, the building, you know, all manner of different things.

Matt Fletcher  7:04  

And then still, you know, a lot of these practices for purchase, as you mentioned, can be not quite the, the top practice that maybe somebody has worked in and wants to buy. So you're buying an older practice and all the building. Older equipments are in the end, you know, pretty quickly, if you do a good job, and you expand that ceiling, right? You put your building can't match what you want to do, you know, you're stuck, having having bought it. Same thing with regards to, you know, the equipment itself, it's suddenly, you know, there's equipment that, you know, is 789 10, whatever it is years old, well outside of warranty coming to the end of its life, and suddenly got to buy new equipment as well, during that particular, maybe first couple of years of owning that existing practice. So it comes with a lot more wrinkles. And I think there's a lot more complicated, shall we say, than a startup? We really can make it exactly what you want to make it from day one.

Rob Montgomery  8:05  

Yeah, yeah, absolutely. And I think, as you said, you know, through COVID, we've seen the vet professionals really grow their practices they've thrived through, through COVID. And from an economy standpoint, it's a strong opportunity, a lot of cases for, for people to go that route. And I think, you know, when you see pet owners, especially new pet owners, which have really increased over the last few years, for them, you know, if you have a new pet, you know, you're not necessarily tied to who the quote unquote old vet is, you know, like, it's, it's almost like it's a new relationship for everybody. It's a new relationship for the pet owner, and their, their animal and the vet. So I don't think you know, unlike some other healthcare industries, where people kind of get in that rut, so to speak, of always going to see the same person, I think there's a lot of opportunities because there are new relationships and opportunities for new relationships to be forged, which are really unique, I think, to, to the vet industry.

Matt Fletcher  9:14  

For sure, I think and I think the nice thing about that is Rob, that, you know, when you start up your own practice, you as the vet set your own standard of medical care, customer expectations of you and your staff and your practice. Everything is a fresh if you want it to be you know, buying a practice. You know, as you said, it's always been, you know, warm and fuzzy animal hospital or whatever it may be right. It's always been Dr. Jones. They've been there for 20 years. Sometimes changing the mindset of staff and customers is its own challenge. You know, when you buy an existing practice rather than creating their own way, when you do a start up, you know, yeah,

Rob Montgomery  9:59  

Oh, yeah, Echo. I mean, when you buy a practice, you are buying the baggage as well. There's there's no doubt, I think. And I think as you said, you know, when you have an older practice where equipment is failing, or there may be issues with a facility, I think sometimes people have this sort of false sense of optimism of what it takes to, you know, sort of buy a fixer upper and fix it up. I think a lot of people are kind of warped by their experience and observation of these, like, TV show, like fixer upper things that you bring the crew in, you take something that's not so nice, and you turn into something great. You know, that's not so easy. And it doesn't always work out that way.

Matt Fletcher  10:40  

That's right, you would be amazed at how many, how many vets we come into that just purchase an existing practice. And so quickly, they realize, you know, the challenges that they have with that existing practice. And obviously, the upside was, it's an existing business's cash flow, you know, it's a bit more of a, maybe maybe less worrisome in that regard, right? Because there is no cash flow running through the business as it is. But suddenly, those obstacles really jumped to mind. And you do sometimes see the regret of why did I buy this one, you know, and look at what I've got to do, I might as well do my own thing, you know, from day one, and because now I've got to relocate this practice. And Blimey, that's, that's what they're doing with a startup, right? Go get a new space. So, you know, it's kind of interesting to see how people how people, you know, go with it, you know, so, yeah,

Rob Montgomery  11:32  

it's kind of like, you know, if you see something and you want to make so many changes to it, then is it really something that you wanted to purchase in the first place? It's like, right, it's like getting married, saying, like, I'm gonna marry this person, I'm gonna make, you know, I'm gonna change them. It's not that easy, you know? And if there are too many changes you want to make, you probably shouldn't have gone that direction in the first place. Right? That's right. That is right. So it's funny that because of misconceptions, you know, I think a lot of it stems from worry, right. You know, of course, if that's not under practice before, then then they don't know what they don't know. Right. And as they, you know, unless they've worked in a particular practice that they're going to buy, you know, for the last five years, where they know all the ins and outs of it.

Matt Fletcher  12:14  

You know, it can be a very worrying, cloudy, fuzzy experience as to which way to go. It's kind of the same thing with, you know, when when, when they're looking at, say, a new practice, and they look at a location, you know, some of the misconceptions of Africa, I've got a, I've got to stay, you know, just outside of my five mile noncompete, but within six miles of the practice that I work out, because everybody's going to follow me. And that kind of really restricts where they, they look, you know, that that misconception, it's, it's obviously useful to have people come and follow you right? Out of the non compete zone, but with the industry being as it is, I think the misconception is also don't, you don't need to stay exactly, you know, close to where your current practice is, you know, if you look at the demographics properly, you look at where you want to commute to, you know, within your your everyday commute from your home address. There's lots of areas and locations, you know, where you can set up where people don't know you, but you know what, people right now neither that they need to be seen. Now they're struggling to get appointments with their existing practices, existing practices, and not taking on new clients in certain areas. They don't have the scope to do it. You know, the shortage of vets in its own way drives that also. So that location can quite often be a misconception that you don't need to be right up the street outside of your non compete of the current practice you work with to you know, so yeah, yeah.

Rob Montgomery  13:45  

And I think two things I take away with that. And one, I have to say, first off is these non competes, obviously, I'm a lawyer, we counsel that's an irregular basis, and on a regular basis as well, people come to us with these horrible non competes, you know, and let me take this opportunity which I have continuously taken the opportunity on this issue during this podcast to talk about Be careful of what you agree to when you sign these associate agreements, you know, because these covenants Not to Compete can potentially come back to haunt you down the road when you are looking to purchase a practice or do a start up so, you know, beware, understand what you're agreeing to in these contracts, and guard your ability to practice your profession. You've spent a lot of time and money to get the degree and your license to be a veterinarian, don't willy nilly give it up to go work for some corporate group and agree to not work within 20 miles of the location where you work perhaps or the place where you work and live you know, it's you have to be careful about that. These are problems or mistakes that are made by that's yours before they're ready to make this onto

Per Nouriel step, and it has the ability to be able to stymie their entrepreneurial desires. And so be careful with this stuff, you know, don't just sign what is put in front of you understand it, try to negotiate it to the best, the best that you can. It's funny you say that, Robert, in this current, I say, I haven't done this for 10 years, you know, again, I sort of hark back to how it was 10 years ago, and how it is now

Matt Fletcher  15:27  

10 years ago, you know, when a vet approached me and said, hey, you know, I'm looking to open my own practice, you know, can you help me? What do you do so on?

My first question was usually, where do you work now, so that I don't walk in the door and find you there by complete accident, because you didn't tell me where you work.

And we talk about the non compete. And, you know, the, the interesting element is, you know, 10 years ago, that was a big concern people like I, if my employer finds out, I just know, they're going to fire me.

You know, even if I'm not doing anything wrong, the fact that I'm looking to start up my own place, they're going to get worried, you know, that I'm going to take their business, they're going to fire me, in the current climate, blind me a veterinarian can go work wherever they want, there's so many practices, looking for veterinarians, you know, to see appointments, I don't think a veterinarian needs to sign a non compete, I think a veterinarian can find work anywhere they choose to work at the moment, there's just no reason to sign a non compete, in my opinion. Now, I'm not a lawyer, of course. So that's your gig. Rob, right. So everyone has to do that. But, you know, I have not had anybody and I've had a few, you know, that have been discovered during the process of, of, you know, going through opening their own practice, and have been let go by their employer, it didn't make any difference, they picked up six days a week work very quickly, you know, in the local area, you know, whilst they continue to open their own place, so it's interesting, you know, the industry and what you might send the vet market for the vet has changed over the years, well, that that really shouldn't be a worrying noncompetes.

I don't know if any vet or maybe even a corporate would

Rob Montgomery  17:09  

fight of that deciding not to not to sign that there's so much work out there, I think they would just be cutting off their own nose to spite their face, you know, yeah. But you know, the thing is that those things are in these agreements. And if you don't know, to ask to take it out, or you don't try to negotiate it, and just sign it, you get stuck with that stuff. And, you know, I agree, I mean, there's there's enough demand for for associate vets, and there are opportunities that they should be able to find where it doesn't have a non compete, or it has a reasonable non compete. I mean, there's nothing wrong with something that's, you know, a few miles where the practice owner wants to protect their their patients so that they don't go across the go across the street. I mean, that's reasonable. But once you start getting into some of these more expansive noncompetes, especially with some of the specialists, we see they're working with groups, man, it's just, it's a shame. But you know, and we're going to talk in detail about that in some of the other episodes, especially with a lender. And I think one of the misconceptions that people have is, oh, don't worry about these things. If you've signed it, and you've agreed to a non compete, you know, courts never going to enforce it, or will the group ever go after you for that. And the reality is, it doesn't matter, because the bank is not going to give you money for the startup, if it's within the restrictive covenant area. So you know, and and even if you are able to, quote unquote, win the litigation, to get that covenant reduced or knocked out the cost of doing that, and the time that it does, it makes it prohibitive. So you know, the better, better practice is just, you know, be wary about these things at the outset, and understand what they are, what you're signing yourself up for, and be skeptical. And you know, be careful, because this is going to impact your ability down the road to practice the profession. The other thing too, that I want to get back on that we were talking about. Some things you said while the demographics and there are other things to think about where you're located. And you know, I think there's a lot of things that generally are counterintuitive to somebody who hasn't gone through this process. And so for vets, they're doing a startup, this is what I would refer to as a one transaction. A lot of times people will do one startup in their career. So it's not like, Hey, I've done this 10 times I know what to look for. If you're doing something one time, the stakes, get that much hire to surround yourself with a good team of experienced people, professionals, consultants, who can help you guide you in the right place to make the right decisions to be successful. I'd feel like you know, I see people that work with good teams, and I see people who don't work with good teams. The people that don't work with good teams are definitely it's a riskier proposition for sure, than the people that stack the deck and surround themselves with good advisors that help

helped them to pick out the location to equip it properly, to make sure that they have a good lease in place, like you can, you know, as we talked about the difference between a startup or an acquisition, and we say, well, there's no cash flow with a startup, you know, so therefore, it's riskier. Not necessarily, and that's obviously the theme of this podcast. But, you know, knowing that you can mitigate that risk by doing things right. You know, and I think, looking at doing a startup, right, and finding the right place, right, demographics, right budget, all that stuff, can really set yourself up for success. It doesn't have to be this crazy, wild, risky thing. If you you surround yourself with the right people. It's funny, isn't it? Yeah, that when you talk about the the question of misconceptions that that have about startups, and the misconception that I can't possibly do that there's just so much to do, and I don't even know half of what there is to do, right? The old the old comment of you don't know what you don't know, right? So it can be overwhelming for a vet, even before the process engages to begin starting up their own practice, that that kind of goodness gracious, how do I how do I even start? Where do I even start, and it's surround yourself with that team really is the key because like all of us, right, Rob? We don't know what we don't know. Right? So we find somebody we ask around you ask for a referral from from me and neighbors, if it's if it's buying a buying a know a snowplow, you know, whatever that may be

Matt Fletcher  21:40  

a lawn mower for your house, you ask her out what have you got, you know, do you use should you buy it from

and you kind of gather information to make a good decision for yourself. And that's, that's really the key to making what is an overwhelming process far less overwhelming, because you surround yourself with people that know what they're doing. I mean, I use the old term before Al's loan, lease layout and law, usually, you need all four things going on roughly around the same time, the start of your process,

you know, to kind of move the ball down the field or several balls down the field, you know, at the same time, so you're building that team, you know, for example, you know, the bank, right? Like, you're going to want to talk to some of that specific banks, that specific programs, but also your own local bank, because you know, what, they may have some really flexible programs, or not, right? The realtor, the real estate guy, you know, somebody was very experienced, knowing what kind of space that event needs, from a perspective of truly dimensions can make a big difference for that practice, you know, wider versus deeper, right? Narrower versus, it's so interesting, you know, when you come across realtors that don't do a lot of that, that they're throwing spaces in front of, of doctors, that just aren't going to be desirable for workflow for that. The same thing on the real estate side, you know, with with the negotiation of a good lease with good ti money, tenant improvement money, you know, the length of free rent, or reduced rent or staggered rent is super important to, you know, making it much more easy, experienced opening,

you know, with a good realtor that knows what they're doing. It's kind of interesting, right, that a lot of the time you don't pay the realtor, you know, depending on who the group is. So, you know, getting the right one, there is a no brainer.

designers, architects, contractors, you know, looking at looking at a space that the realtors put in front of you, before you even go and see it, you know, that that's something I do a lot with, with my practitioners is I'm like, Hey, if you kind of see a few that you fancy, somebody over the detailers, I have a quick look, you know, see if there's any that jumps out to me as being very difficult for designing of that.

You know, and in the end, if we, if it looks good, and the lease terms look good, you know, have have a designer, you know, a contract, come in and have a walk around in that space. Because, you know, holy moly, you see these spaces where, you know, it's a leased space, but, you know, the HVAC will need to be brought up to code in, you know, before anything can be built there. It's like, okay, well, it's a leased space. The doctor doesn't want to be paying for that, right? Because you're not going to take the HVAC with you if you ever move. So, you know, that's something that needs to be negotiated by the realtor.

And all of that ties back into what the banks willing to lend you for the real estate space in a certain area. And all of that comes all the way down to them. yourself. Rob Right as a lawyer, real estate leases have their own clauses and elements that you yourself would would maybe advise against or negotiating differently.

A, which is you talking to you as a realtor talking to the landlord, right,

Rob Montgomery  25:06  

all the way through and including, you know, setting up the business, LLC, or whichever way is best for a customer doing personnel contracts. But, you know, that's that for hours. That's the key, as you said before, you know, the the team upfront. The loan, the lease the layout and the law, that really is the key, I would say, for everybody to take away, you know, to take away the misconception that it's impossible to do this, it's too much work. It's a lot of work. Sure. But if you get the right people around you, then it makes it a whole lot easier. I find Yeah, yeah. And look, I feel like the decision to be made is, do you want to be a practice owner? And if the answer is yes, then you should consider a start. I'm not saying you have to do a start, or should I start, but you should consider a startup. And you don't need to know all these things, you just need to put the right team in place to execute on this stuff. So you know, it's kind of think of yourself as being the CEO of your startup, you know, you're not, you're not expected to DIY each of these elements. But as a CEO, you engage all these people to provide those services to coordinate to work with each other, to recommend the people that they've worked with before that they've had success with or that their clients have had success with. And that's really how you, you build the team. And that's the recipe, I feel like for success with a startup. And that's the difference between doing a good startup versus a as I said, a few minutes ago, the riskier startup where you're trying to figure this stuff out yourself. For the first time you're doing it. And like everything else, the first time you do most things, you don't do it well, or you screw it up. So

I have to tell you what, it's a whole lot more stressful, doing a difficult startups and doing a smooth startup. Right. So I mean, who who wants the extra stress? Yeah, well, it was stress. And it equates to dollars to you know, like, this is not a contest to do the cheapest startup, like, I've never seen the award, Matt, for the cheapest startup. Nobody cares about how cheap your startup was, and what the stat that does matters, you know, what's your revenue look like? A year, 235 years in, that's what matters, you know, and sometimes you have to spend a few bucks to be able to make a few bucks, you know, it's return on investment ROI, as they like to say, in the, you know, in the, in the financial planning world, you know, and, and this is one of those instances that, yeah, you can you can do it, you can do it cheap, and do it wrong, and save tons of money and be waiting for, you know, for for patients and clients to walk in the front door and waiting for the phone to ring or you could spend a few bucks, do it right, and set yourself up for success. That's right. There's a reason, Rob, why most of the banks are more than happy to lend money to veterinarians to start up a practice, right. And banks don't give away money for free, right. It's a safe industry for banks to invest in. veterinarians are usually pretty realistic people. I mean, what they deal with day in day out, I think makes veterinarians realistic people. It really is, it's there, and the money is there. The key is just to spend it in the right way, sensibly, you know, to get your job done, get you open and guarantee yourself a return on investment on all the money you spend. Right and sensibles, right? I mean, we're not saying here, folks, that I'm not saying go out and spend money with reckless abandon right now you spend money wisely, as Matt said, you know, and we're ways that it's going to turn into it's a good investment, and you're going to have return on that. So, you another question, Matt, that we're asking all of our guests. What is a mistake or two that you see veterinarians make when they do startups? Right. It probably tying into what we just talked about Rob?

Matt Fletcher  28:51  

Vets who don't seek or don't take advice from knowledgeable people,

or facts, or at least,

I mean, if they seek it, and listen to it, seek it don't listen to it. Find advice. Talk to people in the industry. Listen to people, you don't have to take all the advice right? But if you arm yourself with information,

provided don't paralyze yourself with analysis, right?

I've seen I've seen a few veterinary Excel spreadsheets. Holy moly, you do wonder how they sleep at night, but to the curse, the curse? Oh my god. It's the curse of the perfectionist mat. Right? So we're dealing with bright people. That's the key. Yeah, with the advice you seek advice. Think about it again. Same as anything else. Consider the source right? You know, look and listen beside what you want to take as good advice what you don't. And you know what if that advice prevents an error, one error in your process.

Then Happy Days, right? We've had a good moment. But you know, if you have good advice, then there's usually some great ideas for success, you know, within the process of opening your practice, and maybe even after you've opened your practice that you can, you can arm yourself with and use, you know, to your own advantage of that. So that's the biggest thing I would, I would say is, you know, people just plowing ahead and not at least seeking and considering advice at very least. Yeah. So on that note, in terms what we were talking about before with the team like, Matt, when is when's the best time? For somebody who's considering doing a start up practice to engage with you or somebody like you? I would say yesterday, I'm kind of

ballsy to say that, I would suggest but so the reason I say that is, you know, I don't do everything, right. I'm not a contractor. I'm not a real estate agent, I'm definitely not a lawyer, not intelligent enough to do that. Rob, you're wiser than I am.

You're probably actually smarter. Talking about that. There's a few people who've not told me that. So. But I would say, you know, early on, because, you know, if somebody doesn't know anything, they're like, how do I start? So, you know, I work with numerous banks, veteran, if specific, and otherwise, I worked with numerous real estate agents, you know, some who specialize in that some who do all have medical, and, you know, usually,

I've worked with multiple different contractors in different areas, some, I would recommend some I wouldn't, you know, and so what I usually say to people is, you know, come talk to me, let's have a chit chat. Let's see what your vision is, let's see where you're at, let's see where you want to be. And wherever they are in the process, if they talk to a bank of a God alone, no problem, we can move to the next stage. But I can kind of introduce people to the team, you know, and that I work with a lot of people I recommend that will help them move that project forward.

And eventually, you know, then it comes to the stuff that I actually do, but I try and be a, you know, really a consultant in a way. I mean, the veterinarians don't pay me for any of this. I just hope they buy their equipment from me and their cabinets from me in the end, right. So, but but in reality, I'm happy to recommend and link and grease the wheels, so they can actually go find the right people need to speak to to get the good ideas and, and seek the advice, take the advice and move that project forward. So the earlier the better. Really, yeah, we kind of feel the same way too. It's like, we may not be doing the actual work yet, like you said, but it's about making sure they're doing the right things. And you're working with the right people. And they're the sequences, right, and you know, you want to see them, it's easier and better to work with somebody that's done it right by the time they get to you and need your actual services, then to try to put the genie back in the bottle, so to speak.

So give me an example of that. It's kind of like,

you know, they get a loan, and they sign a lease. And then they say, Hey, Matt, can you come in and look at design in my practice, here's my space. And you walk into the station go, oh, goodness, gracious, oh, my way design a functional workflow in this space? It's, it's, you know, it's got a ton of load bearing columns, you know, the things I can't move a lot of in flexibility, you know, to kind of arrange in a flow. And, you know, I wish they caught me about four months ago. Yeah, but man, let me put my head in, right, and look and go, Oh, think about this before you sign this one. Yeah, for sure. Yeah, but you've been matched across the street from a Starbucks, right? You know, it's like, so wide, right? They'll just kind of get they focus sometimes on the wrong things. And you know, and worry about all these things that don't matter. And then the things that you're talking about, that are really crucial. They don't even know to look for it, you know, and that's, that's part of not starting the process. And listen, yeah, I mean, opposite Starbucks is not going to get any more money from the bank, and they're probably going to worry that you buy new Mocha Lattes, for $22.50. And they're going to start worrying about your right. Definitely, definitely avoid the sort of book. Yeah, or the rent might be more too.

Rob Montgomery  34:20  

So So with that, how about what's the thing or two math that you see veterinarians do with their startups that are they're good, you know, that that have really turned out to be successful decisions or how they've handled themselves? It's kind of funny. So a lot of different things really, I mean,

Matt Fletcher  34:39  

you know, with the, with the space itself, is what I would say. And obviously this is dependent on the loan as well, right? So how much money you can get from a load and what the rent is on the space but going too small on the space itself.

It's a mistake but going larger on the space

So long as it's affordable, it is a good thing to do because especially with the industry as is right now, which is booming,

you know, the ability to, you know, have six exam rooms, whether that's now or later, right? Whether you can only afford to build a practice of, say, 2500 square feet, or 3000 square feet, and you get a three for whatever exam rooms into that.

The ability to add more exam rooms, and finish out a little bit more with that space later is super important. Because what you don't want to get stuck with is a space that you've outgrown after two years.

And you can't, you can't pay off your loan any earlier. And you're just stuck. And you're like, Man, I can't see any more appointments, I haven't got enough space to see new customers,

I'm stuck in a space is too small, like I said to you know, the loan itself, of course, dictates some of the brands. But I see this people go in too small, but other people go in large. And again, like I say, with the design process, you know, Rob, spaces can be designed, leaving, you know, less, for example, let's say it takes 3500 square foot space, but with construction costs, you can only afford with your loan to finish out 2500 square feet, well, spaces can be designed where, you know, if we're gonna have say, three more exam rooms in 234 years time, you know, we can we can design a space out where that space is ready to go.

placed in the correct flow and location to be easily finished out in two, three years time to give you those three more exam rooms, but then also, you know, hey, well, I forgot three more exam rooms in 234 years time that I'm going to need some more treatment space, and I'm going to need some more holding space for the test whilst they're recovering, and after they've recovered. So you know that the taking that extra space that doesn't necessarily need to be fitted out finished out. In initial construction, if the budget doesn't allow, it is I think a good thing to consider. Because it just allows you more more scope to grow the business within the existing lease space, you know, and a good real estate agent might be able to get you some kind of, you know, rent adjustment or whatnot, based on that plan, because I think people don't know this. But you know, that's great tenants for landlords that practices stick. They're not like yogurt shops that come and go.

Rob Montgomery  37:39  

They stick and a good real estate agent will make a landlord understand that. So that's one of those big things I say is definitely go bigger than as big as you can go affordably. Whether you finish out or not. Yeah, a couple of things to unpack there. So the last part yeah, really working with a realtor that understands the profession and can advocate for the profession is key because you know, to get the benefits of being a favorite tenant, you know, that's as a as an industry should be a favorite tenant, that's you know, you're only going to get the the nod on that or get the break on that if the landlord understands what they have. And if they don't, then they need to be educated. And the person educate them is the realtor that understands the profession understands the business and can really, you know, sell you as a tenant to them. And if the better tenant you are, the better terms you get the more tenant improvement allowance and all that stuff, which we were talking about on on some other episodes. Let me just go drill down a little bit more to with that to Matt, when you said, you know, hey, we're going to leave, get a bigger space, and we're going to expand in the future. So what we're saying is in part, maybe you're going to have some rooms that you haven't finished or you haven't equipped, but you're going to put plumbing in them and have everything that's set up and ready to go. So that when you do want to expand, you don't have to start trenching the floors and doing all that heavy construction, like that's been done at a time that it's efficient, and more affordable. And then it's just a matter of kind of like lay going, you know, adding these pieces as you go and you need it. That's exactly right. Yeah, it's just setting yourself up for future success. And it's, it's kind of one of those things where when people say that, you know, again, the question, what are good things that you see that do and start up you know, that size of space, but like thinking about that vision? Not just as I want to get open

Matt Fletcher  39:34  

the vision of five years 10 years down the line? What do I want to be as a practice you know, like, where do I want to be am I going to be here am I going to relocate is my aim to go big and bigger and bigger again, is my aim to stay with this particular location and just make it a two three Doctor practice because that I enjoy that experience. Now that's what I want to be as an owner

Unknown Speaker  39:59  


Matt Fletcher  40:00  

also, you know, that medium long term thought of, you know, hey, what do I want to do in the future in terms of services? You know, I may start in as a GP, do I want to be eventually GP plus where I served, you know, GP plus being? I do, maybe I do a couple of surgeries that specialty centers do but their basic specialty surgeries? Whether it's basic orthopedics, yeah, not all orthopedics, right. But things where I can slightly differentiate for myself.

And if so, well, then maybe do I need a bigger surgery suite for this? So that's something that we sort of plan for in the design, but that's maybe a maybe a short term goal, but maybe it's a medium term goal, or long term goal? You know, do I want to be GP plus plus, right? So what's GP plus? Plus? Maybe I want to add

additional services such as scoping or therapy, maybe even hydrotherapy?

Do I want to go down the line of doing more advanced imaging, whether that is you know, endoscopy laparoscopy. Getting into in the end, sounds a bit crazy, typically about a startup practice, but in the NCT because the price of equipment usually comes down, right, unless it's a brand new modality.

Rob Montgomery  41:22  

And they're really looking, you know, medium and long term from day one. And a lot of that plays into picking that size of location, and designing it out so that they are super ready to go. In year three, in year four, whatever that year is where they go. Look at look at the cash flow, I'm doing great, now's the time to expand, I've got the money to expand, I've got the money to add new things and new services. That medium long term it is vision is really I think essential for a practitioner from day one, considering what they want to do, where they want to be what cyberspace they're looking at, you know, in that particular business model, you just nailed it. And that's used the word that I just wrote down in my notes with an exclamation point right before you said it said, we're totally on the same page vision, you know, and that's, that's the exciting thing. And like hearing you talk about that, I think just takes us back to what we were talking about the outset, are you going to do a startup or an acquisition, if you buy somebody else's practice, it's very hard to imprint your vision on their practice, it's hard, it takes time, it takes money, and you probably never fully are able to do that. And this is the beautiful thing about a startup of a professional practice, is this is the opportunity for you to build something exactly what you want, that's custom tailored to you. And so hearing you talk about all these things, Matt just gets me excited for people that are considering this because, you know, this is this is what this is all about is having your own practice, putting, you know, that's custom for what what you see your goals and your vision for practicing your profession. And I think this is something that people need to take away. I think as much as anything from this episode, that if you're considering this, and considering doing a startup, a major part of the process is doing some soul searching and some planning and brainstorming as to what do you want your practice to be? Because that's, that's where that's where all this stuff begins, you know, all the planning that you just talked about, it all derives from how to support the veterinarians vision and dream for their practice. And it's not their colleagues practice, it's not their employer's practice. It's not the sellers practice, it's their practice and, and thinking about that, and what you want to do, what type of, of patients you want to treat, and the equipment and the culture of the practice and the vibe of the practice and what it looks like and what it feels like, that's all up to you. And it's something that you need to sit down and do some planning before you start talking to people and get that help to help you build that vision. But it's your vision, you know, people can't say like, okay, Matt, Rob, do what you know, we're supposed to do, you know, and I think I know the answer this question. If somebody comes to you and says, Well, that tells me what I should do with this. You know, you want to know what they want, right? To be able to tell them how to achieve that goal in that vision. Yeah, it's interesting. I mean, many moons ago in my faraway youth. I professionally coached soccer so it was it was interesting phrase we had when we were planning a lesson right planning a session it was the phrase was begin with the end in mind. And the end in mind in say the coaching session was how do I want my kids to play in the in the scrimmage at the end, in larger sided form? And then we would work backwards with that end in mind, right, that very end goal, which for the vet practice, should probably at least be you know,

Matt Fletcher  45:00  

10 years, right? If say your loan is right, in 10 years time, what do I want to be, you know, and then start to work backwards and go, alright, well, if I want to be doing more advanced imaging, but I really love surgeries, but I realized that from day one, I might not be able to afford all the equipment I need, or the size of practice, I need to do the surgeries that I really love that my passion, so I've got to grow my GP business, you know, up and up and up to to get to that point. Okay, great. So, with that in mind, what size space? Would I need to be what I want to be? And is it affordable? And if it isn't, okay, how can I set myself up to find a space that I can develop initially, and then make into that space, or we talked about again, right, getting the biggest space, but designing all of it, but finishing it right, and leaving the rest of it follow for later. Planning with the end in mind is really the key that I think helps a lot of vets, you know, think about their vision, and then work backward from that moment and go, Okay, what do I need to be in seven years time to get to where I am in 10, five years time to get to be at what I am seven, and kind of worked through that process from day one. And it's interesting, because when you have that, and when people tell me, I want to be this in 10 years, okay, great. Well, we can talk to, you know, we talk to the bank about that, let's talk to the bank about how that works. Like, what what cash flow, you're gonna need to show in five years of your existing practice to be able to move on to that next level to afford that next level, you know, the banks are more than happy to rescue people money, right? Happy Days for them. So it's a big kind of thing. I try and talk to all my practitioners about when they're like, hey, I want to open a practice and like, what's your vision now? But what's your vision in 10 years? What do you want to be? You know, where do you want to be, you want to be retired in 10 years, good for you, we'd all love to be retired. Let's make that plan. It's the same as planning your 401 K, right, or your kids college fund and the investments for that, Rob, you're planning with the end in mind. And I think that really helps with that. coalesce their vision into something that they can then discuss with the team. And the team can help them map out that roadmap to getting their short term, medium term, and in the end, in the long term, to get to where they want to be.

Rob Montgomery  47:21  

That's powerful stuff, Matt. And I think we're going to do this in reverse. I was going to ask you what one piece of advice you would give to a veterinarian considering a startup? And you just answered the question before I asked. It's so it's awesome stuff. And I think it's important for people to really, really take that advice to heart. And know too, that this is about what your vision is, as a practice, enter what you want. And it doesn't have to be with somebody else's vision is. And you know, this is why it's just such a neat and exciting and powerful thing to be able to pick your way of doing your your practice. And I think yeah, I think probably the same as chatting back and forth with you. There's been, you know, there's no need to be afraid of it.

Matt Fletcher  48:06  

If you surround yourself with people who know what they're doing, and give you good advice, and introduce you to the right people, so that you're armed with the information to make the right decision for you, then you're going to be fine. You know, it's as simple as that. There's no need to be afraid of it. You just as a team available. If you ask around and you look for it.

Rob Montgomery  48:29  

Yeah. Now. That's great. That's awesome stuff. And so Matt, thank you so much for for taking the time and being on the podcast, if people want to reach you or get in touch with you. How can they do that? And we'll put it in the show notes too. But if you could just tell our audience to that's the best way to contact you.

Matt Fletcher  48:49  

Sure, yeah. So cell phones, usually the best way because I'm usually running around. So for 1025952 a few years, my cell phone, my email address at Patterson has my name. So it's Matthew with two T's, a period. And then my last name, which is Fletcher, as in Fletcher lives in Chevy Chase. At Patterson vet, which is all one So Matthew dot Fletcher at partisan is how to reach me, that's awesome. And then that'll be up in the in the show notes too.

Rob Montgomery  49:19  

So if people want to refer to that, though, they'll say it but you know, thanks again for for taking the time, man. It's You're certainly a leader in the industry. And it's just valuable advice for anybody that's thinking about doing a start up. And it's good stuff and thanks again for the time.

Bumper  49:36  

Thanks for listening to another great podcast with Attorney Rob Montgomery. And don't forget to tune in next time to have the process of starting up a veterinary practice demystified. For more information about today's podcast, or to contact Rob's firm, go to www dot your vet

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