Up until the point our practice hit £750k - £1m turnover, our path to growth was ‘simple’ - work harder, see more patients, hire another vet, repeat. But, eventually, there was this ‘busyness’ hamster wheel - we needed more time to plan and grow the business but were too busy just doing the day-to-day 'running the practice' things... so we just kept going, which made us busier, so we had less time… and repeat … forever.

Today, we're a £2.5 million turnover practice and running an emergency practice and a daytime GP vet practice that runs 24/7.

Getting here required learning an entirely different skill set—one they definitely didn't teach us at vet school. If you're currently at that 2-3 vet, practice level, working flat out and wondering how to break through to the next level, here's what I didn’t know, and was shown and taught by others who had been there before me.

1. The skills that got you here, won’t get you there

This was a painful lesson. I think that for a lot of new 'business' vets, particularly if you’re an omnicompetent clinician, doing everything is one of your superpowers. We do medicine, surgery, euthanasias, vaccinations, fix the plumbing, change the lights, update the website , write the newsletter and post it all on social media (often all on the same day). This is what gets you started cost-effectively. But eventually, you realise that you only have two hands, and even without sleep, there are only 24 hours in a day, and once you get to the point where there are 25 hours worth of jobs in your 24-hour-day, something has to change (or burnout hits you with a hammer).

So, those omnicompetent skills will no longer serve you, and it is now time to take the scary financial decision to pay someone to do those jobs. (Note -it is still great to have a basic understanding, so you can talk to plumbers, electricians, web designers, and copywriters). But start small, pay someone part time, contract out to someone here or abroad for a few hours per week, and watch what they can do while you are working on the business (or spaying a dog… your call).

As a diplomatic person who genuinely wants to please others, I preferred to avoid difficult conversations, I'd hope that underperformance would magically improve and that people would get better by the sheer willpower of my ‘nicer bossness’ (spoiler alert - It didn’t) – so I had to learn the new skills of how to walk head on into those difficult conversations.

My mentor also introduced me to the "bus journey" concept. Your practice is a bus, and you're driving it. Some people will be with you for a few stops, others for hours. Both are okay. Neither of you are good or bad—you're just traveling different distances together. Some team members are perfect for a specific season or task as you grow, but not the whole journey.

Learning to walk into those awkward conversations about performance—and accepting that not everyone will be with you for the entire ride—was powerful. It's also essential. At our size now, trying to avoid one difficult conversation can derail the entire team.

2. You must become data-obsessed (and not just about turnover)

When you're growing, each month naturally beats the last, so this feels sufficient, and after that breakeven point, there is more money in the bank than last month, so for the first few years I measured our success with two numbers: monthly turnover and the bank balance.

Cashflow measurement is life-threateningly crucial, and you read about it and think “yes, yes, I understand”, until VAT, payroll and the first Corporation Tax bill all hits you at the same time.

The real revelation in assessing the practice numbers was the principle of lead indicators vs lag indicators. Lag indicators are the ones that are the end result of lots of things, eg. Turnover – you can’t just increase turnover. … you can increase the number of new clients, and the amount they spend (the lead indicators), but you can’t alter a lag indicator on it’s own, so they are less useful in making decisions about your business. We started tracking metrics like number of phone calls, online Petsapp chats, consultations performed, number of hospitalisations, number of dentals, how many newsletters we sent out, etc. And looking at these numbers helped us spot weird variations that affected the business.

As an example, one number we tracked for our emergency business had a huge impact: the number of emergency consultations as a percentage of incoming phone calls.

It varied dramatically—sometimes wildly—depending on who answered the phone, how new they were to the practice, and how much training they'd received. This wasn't just a customer service issue - animals that should have been seen immediately were told "they'll probably be OK until Monday." Some weren't okay. In addition to the clinical concern, this single metric meant that turnover varied by £10,000 per month for no logical reason.

Once we measured it, we could train on it. Once we trained on it, we improved it.

Make a dashboard with all your numbers, initially with an excel spreadsheet and manually enter the data from your PMS, and then as you want more data, you can use separate 3^rd party programs or apps that will extract data automatically from your csv reports, social media pages etc.

If you're not tracking your lead indicators, you're flying blind.

3. You need to build your practice playbook (yes, "systems/processes," but not as boring)

Think about any successful sports team. They have a playbook. What we do when X happens. Who is responsible for Y. When we do this thing, then Z happens. Every player knows their role, the sequence, the standards. Your business needs exactly the same thing once your practice gets bigger and isn’t all about you.

When you're small and everyone sees everyone daily, things work through osmosis. "The way we do things" lives in people's heads. That stops working at scale.

We run 24/7 now. Some team members don't see each other for weeks at a time. What happens when two people do the same job on different days, in their own ways? Chaos.

Post-op visit protocols differ by vet. Banking gets done... sometimes. Invoices get paid... eventually, or twice. Client reminders become inconsistent.

You need people in your business who are good at creating these playbooks—documenting how things should work—and then pressure-testing them to ensure everyone actually follows them (and understands why). It doesn’t have to be about boring SOPs that live in the dusty folder in the office, it can be simple things like a 30 second video on how to use the blood machine, with a QR code stuck to the machine and linked to your video.

This isn't about bureaucracy. It's about creating consistency so your clients get the same excellent experience whether they see Sarah on Tuesday or James on Thursday. Without this, your business is whatever your most recent employee decided to do when you had a day off.

4. You need a CEO mindset, not a "head vet" mindset

This one hurt my soul initially.

At some point—for us it was around £1-£1.5 million—you need to start working ON your business rather than IN it. Initially, just one afternoon per month where you think about where you actually want the practice to go (and where you don't want it to go).

Up until now, it's been "hold on tight everyone, we're building a vet practice!" But now you need to consider what the practice has become. Is that what you intended?

This time also lets you plan bigger strategic moves. Some of these ideas will add £100,000 to your turnover. That's time better spent than neutering dogs—and I say this as someone who loves clinical work.

The mindset shift is profound: you start realizing that running a vet practice is fundamentally the same as running a dental practice, a shop, or a software business. Different names, same fundamentals: customers, payroll, finance, operations, marketing.

You're not just a vet anymore. You're a business leader who happens to be in veterinary medicine.

5. Get a mentor or coach (someone who's already made your mistakes)

I resisted this for too long, thinking I could figure it out myself and, well, coaches and mentors cost money. I wish I had done it years ago.

My mentor and business mastermind taught me to "trust the process." I'd set up newsletters or Facebook ads and get frustrated within a month when there weren't instant results validating my decisions. They taught me these things take 6+ months to show real return. Obvious now. But knowing this helped my sanity and saved me from killing multiple initiatives too early.

They also explained something that really frustrated me: how difficult it is to grow AND increase profit simultaneously. You typically don't have both at the same time. You invest in technology and team to grow, your profit dips, then it grows. Sounds "duh" now, but understanding this pattern saved me from panic and assuming I had made poor decisions that hadn’t come to fruition.

A mentor in the vet space is great because they know your industry.

A mentor outside the vet space is great because they open your eyes to the outside world, and show you that all businesses have similar problems and you learn how non-vets solve problems.

A good mentor has already paid for the lessons you're about to learn. Why pay for them twice?

The uncomfortable truth

If you're reading this and thinking "I haven't got time for this," and “I can’t afford this”, I understand completely. I felt the same way, and I didn’t do most of these things until years after they would have benefitted me.

But here's the truth: if you're too busy to work ON your business, you'll stay too busy forever. The harder you work IN the business, the more you're needed IN the business. It's a trap.

Eventually, growth doesn't come from personally vaccinating more animals, because “clients like to only see the boss”, it comes from developing new capabilities—management, data literacy, strategic thinking—that feel uncomfortable precisely because they're unfamiliar.

The skills that got you to where you are won't get you to where you want to be. That's not a criticism—it's just the reality of scaling anything worth building.

Start with one afternoon per month to work ON your business.

Start tracking your lead indicators on an excel spreadsheet.

Get a mentor.

Your future self will thank you.