I was speaking with a colleague recently and she told me about some problems that were occurring at her practice.  A few years ago the practice began compensating all of its doctors on 100% production.  At first things were fine, but slowly some new trends started to arise that were troubling.  Some doctors began skipping cases in line and taking sick ones that could lead to a higher transaction.  Then some of the doctors demanded being compensated for consulting on another doctor’s case.  Doctors would only scrub into another’s surgery if they knew they were being compensated as well.

            This is a very busy practice and the technicians and veterinary assistants were the ones responsible for invoicing all the care a patient received and giving the proper doctor credit.  Some of the doctors felt they were not given the appropriate credit and began invoicing all the charges themselves.  It did not take too long before everyone felt like they were getting the short end of the deal and everyone became distrustful.  At the end of the day the manager had to print a list of the day’s invoices to see who was given credit for what.  Then each doctor would look over the printout to make sure they got his or her rightful share.  In a busy practice who has time for this?

            The production model is suppose to encourage doctors taking on challenges, providing the best care and possibly putting in a little extra time at the end of the day to be available to those clients in need.  You can be in a production system and still help another doctor out with a difficult surgery or give an interpretation on a x-ray, by doing so that doctor will certainly return the favor when you are stuck on a case.  In an every vet for herself model that sharing of ideas and consultation will not occur.  During a difficult splenectomy the doctor may need some help from a colleague, but may be reluctant to ask for fear of losing production.  The veterinarian standing right next to you might have a new idea or have seen a similar case before that would be greatly beneficial to help a patient.  Make sure to promote a system where everyone feels welcome to help and share.

            You also have to wonder when the doctors are consumed by their own production what standard that sets for the rest of the staff?  It is not a secret that veterinary technicians and support staff are not breaking the bank with their pay.  They are there for a higher reason; to help loved ones of families.  When the support staff sees the doctors competing for the better case and making sure they got credit for that flea preventative are they going to be motivated to maintain that higher level of care?

            Don’t get me wrong, I believe in production.  I think it is a good way to compensate doctors.  But at most you should only worry about it once a month; to see how you did and what you can improve on.  The daily motivation at work should be upholding the oath we all took upon graduation.  In my estimation all of this penny counting and case hawking may make one particular doctor a few extra thousand dollars at the end of the year.  However by doing so making for a miserable work environment, is it worth it?  For those veterinarians that need to count every dollar regardless of the poor work environment they are setting I think you missed your calling.  There is always room for more lawyers.