Epicur Advisory Council Member, Nicole Clausen, CSSGB, CCFP, leverages her deep understanding of veterinary operations, gained through her 16 years in the industry, to empower veterinary practices. After working her way from receptionist to Inventory Manager, Nicole gained a unique perspective on the intricacies of successful clinics and now uses that experience to champion inventory management excellence through her business, Veterinary Care Logistics.
We’re excited to have Nicole on our Advisory Council! We asked her to share her expertise on the importance of a robust inventory management system and best practices for finding a pharmacy partner, ordering and restocking, and care team communication.
For those who don’t know you, Nicole, can you share more about your background and how you ended up in this line of work?
I’ve been in vet med for over 16 years now. I started in high school as a receptionist at a veterinary practice. During college, I got a job at a vet clinic. I thought I was going to pursue human nursing, but I realized that it wasn’t for me, so I landed on animal science. I thought it kind of fit with the work I had done in the veterinary industry previously. I ended up starting work at a new veterinary office and was supposed to be a receptionist there, but they said, “Hey, do you want to manage inventory also?” I thought it sounded fun, so I said sure!
My only training was – to shake a bottle, and if it felt low, I ordered it. In the beginning, I struggled. I did not really know what I was doing. It was challenging for me, not only completing my job but also from an emotional and mental perspective, because I knew I wasn’t doing a good job. But I had no idea how to do it better. So, I eventually started learning everything I could from human health care. I learned about inventory management and supply chain management and began developing systems and processes to set up my inventory. It started going smoothly and I felt like I cracked the code on inventory.
Other clinics started asking questions about how I had set up my inventory and I was then asked to give a talk on inventory management. I spoke in front of this group of people, and it was an experience that lit my soul on fire. It was an “ah ha” moment of, this is what I’m supposed to be doing. My role grew from there. I thought I would be more of a traditional consultant, but now I have courses, consulting, and a podcast. I love doing different things all the time. And it’s coming up on seven years since I started Veterinary Care Logistics in April.
Is that role how you first got introduced to Epicur?
So, when I was an inventory manager, I purchased from Stokes. When I was at a VetPartners meeting, I spoke about DEA regulations and met Branson and Emily there. We got talking, and that’s how I connected with Stokes/Epicur.
There were no certifications or pre-existing courses to be an Inventory manager?
Before I started my work in inventory management, there was no certification or anything. So, I actually started a certification program for inventory managers. The education and training on inventory were extremely limited before some of the programs I implemented. However, I did get several certifications from outside the industry in human health care and other supply chain logistics, but not anything veterinary-specific.
Were you surprised that you were managing all of this important inventory without any rules or instructions?
I was shocked. It was hard for me to wrap my brain around. I wasn’t given a budget, so I just purchased stuff based on what I was told. There were no guidelines or clarity, so I took on the role of defining and putting these guidelines in place for myself.
I find that’s true with many practices or inventory managers, where they have taken on this role that they learn and put guidelines in place for themselves as they go. They’re rarely given ordering guidelines besides “Just don’t run out.”
Inventory management is often a topic that is not taught in veterinary school. We often talk about continuing education in many areas of the field, but for inventory, we are just doing the education. We’re not even continuing education because we are at a starting point.
Download our Inventory Management Guide to learn how to improve your practice’s inventory processes. We’ll share important considerations for software tools and key reminders for your team!
Do you see any differences in inventory management guidelines depending on the veterinary practice – a large hospital vs a smaller private practice?
I would say so, yes. And I would say the difference that I have seen in the last couple of years is that a lot more attention is being put on the importance of inventory. I see more practices with guidelines and policies around them. When I first started, it was not as common, and everyone was trying to figure it out together. But now it’s more common.
A practice that has a well-trained inventory manager and has passed it along typically has guidelines. But many practices are just trying to find their footing. However, with inventory being the second largest expense in a veterinary practice, especially with the fluctuating economy in the last several years, it has definitely come to the forefront. It’s a part of the business that practices need to manage and pay attention to.
What is your experience with 503Bs as an inventory manager?
I am in Montana, and back when I was an inventory manager, Montana deferred to human regulations. That meant we actually had to purchase from a 503B pharmacy for office use, so I have been familiar with 503Bs for a while. But what was interesting was that I didn’t understand the “why.” I did not know why it was important and why it mattered. I just thought it was more of a burden rather than the actual reasoning behind it. But it is so important for everyone to know about 503Bs because it’s really about the safety of the patients, and I did not understand that as an inventory manager.
In continuing education, we talk about the differences between a 503A and a 503B because I think that knowledge and education are power. Learning about it is not meant to burden or complicate your life. It really is there for patient care and safety.
I have found the same thing with the beyond-use dates and expiration dates. People have asked – how long do you keep this beyond the beyond-use date or past the expiration date. They try to find a workaround for it. But we shouldn’t and can’t be doing that. Regulations are put in place for a reason.
I think that’s where there is so much room for education, not only on the difference between 503A and 503B, but the difference between traditional manufacturing and compounding.
Continuing Education for Veterinary Professionals
At Epicur, we are committed to continuing education which is why we partner with industry leaders to develop opportunities for learning, growth, and understanding of regulatory standards, trends and insights in patient care, veterinary hospital best practices, and more.
As a 503B facility manufacturing medications, a lot of our focus is on education and making sure practices are ordering from qualified partners. How do you approach educating inventory managers on where to order and processes to follow?
I think that a lot of times, practices look at compounded meds and consider them regular pharmaceuticals. It’s the train of thought that Gabapentin is Gabapentin, and I think that translates into thinking that all compounded medications are created equal. And so a lot of times when you’re looking at other products, you’re just trying to find the cheapest cost. But I talk about it with folks, and when it comes to compounding, there’s so much more than just the cost.
I think there is a significant educational aspect to that, and it’s not realized what goes into compounding, what’s involved with it, and what it really means for the end product. Everything else, outside of compounding, takes price into consideration, but you should really care about the quality and the process behind it. For example, 503B facilities must follow current Good Manufacturing Practices, cGMP. These are the same regulations that commercial manufacturers must follow. As an owner of quite a few creatures, I’d rather pay more for something I know is of higher quality.
However, from the inventory purchasing perspective it’s so ingrained to find the cheaper one, find the cheaper one, find the cheaper one. But cheaper is not always better. Having a restrictive budget and knowing where to give and take can be a challenge.
Like you said, education is so important. How do you help inventory managers and even veterinary professionals stay up to date with changes and their impact?
A big philosophy of mine is just to make it simple. When we talk about these things, it’s important to not overcomplicate them because I feel like they’re overcomplicated enough. I always try to explain it simply and in a way that matters to them to understand. Making sure they know why it is important, how it impacts them, and ultimately, what they need to do about it and what kind of support they need for that to happen.
A lot of times, I might do a podcast episode and have guests on. I’ll often do webinars, but a lot of times I just post in the community. Getting the scoop out to people and disseminating the information.
Adopting a structured process is important, especially regarding adjustments in formulations or strengths due to GFI. Rather than abruptly changing, consider prepping staff for the change, getting feedback, seeing what they need, and going through a communication process so everyone can feel more comfortable with the change. It’s important that everyone feel supported because change is scary and can be jarring. So, if we can help and support through a feedback loop, I find that to be beneficial.
You mentioned a few of the challenges that you initially faced as an inventory manager. What are the other major challenges for inventory managers or just for a veterinary practice in inventory management in general?
There are a lot of challenges. One of the biggest ones in the last couple of years has been backordered products and supply chain disruptions. With a lot of back ordered products and supply chain disruptions, we are not able to get the products and the medications needed. For critical medications like controlled substances, it becomes a scramble to find something.
The lack of education and training is also a challenge and feeds into many more challenges. If you have an inventory manager who is trying to do well but doesn’t know what to do, they feel really discouraged and disheartened. Then, their team is also frustrated because they might be running out of medication or not have what they need, so patient care might struggle. So, when you have a challenging inventory, it’s a challenge not only for the purchaser and the inventory manager but also for the team and team morale. And then it’s also a trust issue with your clients. Because if you’re constantly out of things and it seems chaotic to your clients, they are going to start to question the practice and why medication is always out of stock.
Prices or costs for medications and lab work have been rising so much every year that it has put a lot of practices in a conundrum of “how do we actually price this so it’s reasonable for clients, but also so that we can be profitable and stay open.” Online pharmacies really force practices and clinics to become more strategic in how they price their products and what they carry. It’s not feasible to have every single option on the shelf now because it’s so expensive.
Often, inventory management has this perception or reputation for being really challenging. Which it certainly can be, so a lot of people in the practice don’t want to take it on. It often becomes a vet tech, a vet assistant, or a receptionist who is doing double duty; they’re trying to take care of their patients and manage inventory at the same time. Similarly, inventory managers tend to wear all the hats, doing equipment maintenance and inventory, and the job turns into saying yes to helping out in many areas of the practice.
Turnover for veterinary staff is a critical issue. Do you find similar high turnover in inventory management?
No, not as much. I tend to find that once somebody discovers that they love inventory, that’s the role they stay in and works with their brain. It tends to be longer lasting. Most of the turnover I see often is when they get promoted.
I think a lot of times, that’s because they took a system that was not working, transformed it into a well-oiled machine, and want to stick with it. I recently ran a poll in one of my inventory management communities, asking if they’d rather only manage inventory or never manage it again. Over 90% of the people said they would only manage inventory.
