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Key Performance Indicator: Maintaining a Net Growth of Active Patients

Lisa A. Yackel, CVPM, PHR, SHRM-CP, VetSupport, Richmond Hill, Georgia

June 2018

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Monitoring new client acquisition as a monthly KPI is standard in many veterinary practices. Certainly, it is one of the best indicators of marketing strategy effectiveness and a good return on investment. Taking the exercise one step deeper to gather data on patient versus client acquisition will provide more specific numbers because clients may bring in multiple patients. This month, we look at net growth of active patients.

If existing lapsing patients (ie, those who have not received practice services in the last 14 to 36 months1) are “bleeding” out, the marketing strategy is not sustainable. Giving an infusion of “new blood” while discovering the source of the “bleed” and stopping the hemorrhage is a better plan.


Net growth of active patients is the number of active patients at the end of the month compared with the number of active patients at the beginning of the month.

To Improve Patient Base

  • Audit and analyze the practice reminder system.
  • Actively pursue lapsing (ie, 14-18 months without services) and lapsed (ie, 19-36 months without services) patients. 
  • Develop strategic marketing plans to attract new patients.
  • Provide team members with CE that promotes the importance of preventive care.


Ensure a balanced emphasis is placed on retaining existing patients while still marketing strategically to obtain new clients and patients. Acquiring new clients costs significantly more than retaining an existing client. A general goal is 30 new clients per full-time equivalent veterinarian per month.2


Set a goal of maintaining a positive net growth of patients each month. The goal will depend on various factors (eg, new or established practice, transient area [ie, military town, college town]); the author recommends a 1% to 1.5% increase as a middle-range goal.

The Numbers

Use these formulas to calculate the net change in active patients: 

Active patients 

=    New patients

        +  Returned patients

        –  Deceased patients

        –  Inactivated patients

        –  Lapsed patients

Net change in active patients

=    Active patients(at the end of the month)

        –    Active patients(at the start of the month) 


The net change in active patients is not the only number your practice success depends upon, but it is an important KPI because it reflects the practice’s true growth and can also serve as a warning of an ineffective reminder system and poor customer service and bonding rates.3

A certified veterinary practice manager can help a practice understand KPIs and so much more. Visit the Veterinary Hospital Managers Association at for information, resources, and certification.

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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