Scaling Truss Vet: Lessons from Expanding an Urgent Care Practice to Three Locations and Beyond

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THIS WEEK’S GUEST
CJ Casselli - Founder & CEO, Truss Vet

In this edition, we sit down with CJ, the co-founder of Truss Vet, to uncover the actionable lessons he’s learned from launching and scaling an urgent care-focused veterinary practice. CJ offers deep insights into the challenges of building a business from scratch, educating clients about a new service model, and the strategic decisions that have driven Truss Vet’s success. Whether you're a veterinary practice owner or manager, this Q&A delivers practical strategies and industry insights that can help you refine and grow your own business. In our conversation, we discuss:

• The unique challenges of scaling from 1 location to 3 and beyond

• His personal and company-wide tech-stack

• Effective strategies for managing and motivating teams across multiple locations

• Key metrics to track when scaling a veterinary practice

Let’s dive in 👇🏼

ENTERING THE VETERINARY INDUSTRY
Background on CJ and Truss Vet

CJ started his career in traditional advertising, working with a diverse array of clients, including a large pet insurance business. After realizing his passion for business leadership, CJ pursued an MBA from Duke University. He spent two years searching for a company to buy but eventually decided to start something from scratch. This decision led to the founding of Truss Vet, a company focused on filling the gap between primary care vets and emergency rooms by offering urgent care for pets.

Q: What led you to choose the veterinary industry over other fields?

CJ: As a pet owner, I noticed gaps in the client experience at veterinary clinics. My co-founder, who is a veterinarian, shared similar concerns. Together, we saw an opportunity in a growing industry with strong consumer demand. Pets are a joy to work with, and the industry’s resilience, even during tough times, made it an appealing business choice. We also wanted to build something that could have a broad impact in a big industry.

Key Takeaway: Identify and address gaps in client experience within a growing industry. This approach not only taps into market demand but also ensures that your business can have a lasting impact.

THE NICHE OF URGENT CARE IN VETERINARY MEDICINE
Urgent care bridges the gap between regular vet visits and emergency rooms.

Q: Why did you decide to focus on urgent care instead of traditional veterinary services or emergency care?

CJ: Urgent care is a relatively untapped market in veterinary medicine. It fills a crucial gap between general practice and emergency services, similar to how urgent care operates in human healthcare. During COVID, we saw that many non-emergency cases were clogging up ERs, leading to long waits and high costs. By focusing on urgent care, we can provide faster, more affordable care for less severe issues, which benefits both pet owners and the overall healthcare system.

Key Takeaway: Specializing in a niche, such as urgent care, allows you to provide a targeted solution to existing gaps in the market, creating value for both clients and the broader industry.

Q: How challenging has it been to educate clients about the urgent care model?

CJ: Educating clients has been one of our biggest challenges. Many pet owners don’t realize that urgent care is an option, and they default to either waiting for their regular vet or rushing to the ER. We rely heavily on referrals from other clinics and a strong online presence to inform clients about our services. While it’s been a hurdle, we believe that as more people experience the benefits of urgent care, awareness will grow.

Key Takeaway: Client education is crucial for introducing new service models. Leveraging professional referrals and building a strong online presence are effective strategies to enhance awareness and drive adoption.

STRATEGIC DECISIONS IN BUILDING & SCALING
Serving 1 Million Pets in 10 Years Through Strategic Expansion

Q: What strategies do you use to acquire and nurture clients given the unique use-case of an urgent care?

CJ: We acquire clients primarily through referrals from other vets and our online visibility. We focus on being available when clients need us, which is crucial in urgent care. We don’t invest heavily in long-term nurturing because our service is need-based—clients come to us when they have an urgent problem. However, we do engage in general awareness marketing and SEO and PPC efforts to stay top-of-mind when the need arises.

Key Takeaway: In a need-based service like urgent care, being accessible at the right moment is key. Invest in SEO and PPC to ensure visibility when clients search for immediate solutions.

Q: You mentioned you’ve built your locations from scratch. What was the decision-making process behind choosing to build versus buy existing practices?

CJ: When we launched, acquisition multiples in the veterinary industry were extremely high, making acquisitions less attractive. Building from scratch allowed us to control costs and tailor our clinics to our specific urgent care model. Although building from scratch is challenging and comes with its own risks, the long-term ROI can be more favorable if you execute well.

Key Takeaway: Building from scratch can offer more control and better alignment with your business model, especially when acquisition costs are prohibitive. This approach may yield better long-term returns if carefully managed.

Q: How did you fund your first location, and how has your funding strategy evolved?

CJ: We initially raised money from a single angel investor, who is a passive partner in the business. This approach allowed us to retain control and grow at a manageable pace. For subsequent locations, we’ve used a combination of debt and earnings from our clinics to fund expansion. We’re cautious about taking on too much capital too quickly, as we want to maintain control and avoid overextending ourselves.

Key Takeaway: Start with strategic funding that allows for control and sustainable growth. Gradually mix debt and reinvested earnings as you expand to maintain financial stability and ownership.

OVERCOMING CHALLENGES & SUSTAINING GROWTH
Location, Location, Location

Q: How do you decide when it’s the right time to open a new location, and what’s holding you back from rapid expansion?

CJ: Timing is everything. We’re mindful of growing too fast because rapid expansion can amplify existing problems. Right now, our focus is on refining our model and ensuring we have the infrastructure and capital to support multiple locations. The two biggest constraints are capital and building a scalable infrastructure. We want to go slow to go fast—laying a solid foundation before expanding rapidly.

Key Takeaway: Prioritize building a strong foundation before scaling. Ensure your infrastructure and capital are in place to support sustainable growth rather than rushing into expansion.

Q: How does scaling from one location to three differ from starting at zero?

CJ: Going from zero to one is all about proving the concept—validating the market and making sure the model works. Scaling to three locations is a different challenge; it involves building the infrastructure to manage multiple clinics and replicating success without being physically present at each location. As you scale, it’s crucial to implement systems and processes that ensure consistency and quality across all locations.

Key Takeaway: Scaling requires a shift from hands-on management to implementing robust systems and processes that can maintain consistency and quality across multiple locations.

Q: What have been some of the biggest challenges you’ve faced in scaling, and how have you overcome them?

CJ: One of the biggest challenges has been site selection. It’s critical to find the right locations, and we’ve learned a lot by talking to experts in related fields, like retail and human urgent care.

Another challenge has been managing multiple locations without being present. We’ve had to focus on hiring the right people, implementing robust systems, and continuously refining our processes. Finally, educating clients about urgent care has been tough, and we’re still experimenting with different marketing strategies to get the word out.

Key Takeaway: Location is critical when scaling. Combine strategic site selection with strong hiring and process management to overcome the challenges of expanding a multi-location business.

Q: How do you measure your team’s productivity and know when it’s time to hire or fire?

CJ: We use weekly scorecards to track key metrics like revenue, number of visits, average transaction value, and how late the team stays after hours. These indicators help us assess workload and determine when we need to expand the team. We also have regular one-on-one meetings to review performance, set expectations, and provide coaching or support as needed. We try to avoid micromanaging by focusing on building a strong team and efficient workflows.

Key Takeaway: Use data-driven metrics and regular performance reviews to manage team productivity. Avoid micromanagement by focusing on building a strong, autonomous team.

Q: How do you keep your staff motivated and aligned with Truss Vet’s vision?

CJ: It’s all about communication and culture. We articulate our mission clearly—bridging gaps in care and improving pet health outcomes—and make sure our team understands how their work contributes to this larger goal. We also invest in building strong teams at the clinic level, with leaders who embody our values and can foster a positive work environment. Keeping the vision alive and ensuring everyone feels part of a bigger mission is key to maintaining motivation.

Key Takeaway: Clear communication of your mission and values is essential for keeping your team motivated and aligned with your business goals. Strong leadership at every level fosters a positive and cohesive work environment.

Q: What is your current tech stack, both at the practice level and personally?

CJ: At the practice level, we use Slack for communication, Google Workspace for documents, Instinct as our practice management system, and Notion for our company wiki and SOPs. We’re also exploring analytics tools to better understand our data. We use Waitwhile as our queue management and appointment management system.

On a personal level, I’m a big fan of David Allen’s Getting Things Done (GTD) methodology, which I manage using Todoist. I timebox tasks in Google Calendar and do weekly reviews to stay on top of everything. Delegating effectively and using tools like Texts for organizing non-email messages are also part of my productivity strategy.

Key Takeaway: Leveraging the right technology and productivity tools can streamline both practice management and personal workflow, leading to greater efficiency and better decision-making.

Q: How do you handle client complaints and negative feedback?

CJ: We try to capture negative feedback before it goes public by sending follow-up emails and texts, offering clients an opportunity to share their concerns directly with us. If it’s a business issue, our practice manager will reach out to the client; if it’s a medical issue, a doctor will get involved. We don’t typically offer discounts unless there was a clear mistake on our part. The goal is to address concerns promptly and keep the relationship