It really isn’t. Most animal hospital mission (purpose) statements are insanely long. In fact, they are too long for the people who created them to remember, let alone new people joining the team.
Because of the length of most mission statements, there is an immediate disconnect between what you have posted on the wall and what actually goes on between the walls in your hospital.
Coming up with a short and sticky statement is not an easy process, but it is so powerful when you do.
A few years ago, I struggled to create a mission statement that encapsulated what we were trying to do with TVSS. It took a lot of brain- storming, but finally our mission statement was crafted.
We exist to provide the surgical excellence and compassionate service we would want for our own pets
At the end of the day, what mattered to us was providing surgical excellence and compassionate service. But what was most important to us, was providing to other pets what we would want for our own pets.
Every day, our team knows this is the goal. At the end of the day if we have done these two things, then we have accomplished what we set out to do. It is short, and it is sticky. It is NOT complicated and NOT hard to remember.
A short and sticky mission statement helps us make tough decisions when needed.
The other day we had a dog, already under anesthesia, who was going to have an FHO. After reviewing the radiographs of the dog, I concluded there was no way I would do an FHO on this dog if he were mine (the radiographs revealed no significant DJD.) I called the owner and explained to her that there was no way I could perform the FHO. For all I know, she went down the road and had another veterinarian perform the surgery (she really wanted this surgery for some reason) but it was not going to be me doing an unnecessary surgery.
Not only can your team actually remember what you collectively are trying to accomplish when your mission statement is short and sticky, but it will also resonate with your clients.
We recently added a video to our website and most owners have told me that the reason they selected us to do their pet’s surgery was because we treated their pet like he/she was our own- how awesome is that? So not only is it resonating with my team and me, but also clients who chose us to perform their pet’s surgery.
I challenge each of you, to take some time at your next leadership team meeting and start crafting a short and sticky mission statement-one that will actually help your team know why they are there and what you are trying to accomplish!
Do you have a short and sticky mission (purpose) statement you would like to share?
You can read more of my posts at www.catalystvets.com
When employees say “I am burned out”, they are really recognizing, feeling, and expressing Compassion Fatigue. The problem is that technicians do not know about compassion fatigue…as a result of the general widespread use of the term, burnout. ~Figley & Roop, 2006
When compassion fatigue affects our employees, our entire practice suffers. Our practice then becomes afflicted with organizational compassion fatigue. According to Patricia Smith, “when management, workers, volunteers, clients and patients suffer varying levels of Compassion Fatigue, they incorporate their symptoms into the “corporate culture” of the organization. Eventually, the productive mission of the organization is replaced by policies, procedures and goals that reflect high levels of dysfunction…when compassion fatigue among employees hits critical mass, the organization itself suffers.”
We all want our practices to be a place where our clients are treated with compassion, our patients receive the best quality medical care, and our team can pursue personal and professional goals in a supportive environment. This type of positive work environment will result in a team that displays some basic traits, including:
Yet when compassion fatigue is affecting our workplace and our team, then this is when the work environment has become “toxic”: (~Figley and Roop, 2006)
Just as with individual compassion fatigue, there are both personal and professional reasons to minimize compassion fatigue. It is difficult for each individual to reach their potential in this toxic environment, and it is also difficult for the organization as a business to survive and grow. Profitability of the practice is definitely affected. Service organizations must recognize that addressing [compassion fatigue] is part of a reasonable standard of practice for any profession that entails direct service to traumatized “clients”. The cost of not doing so is immeasurable. ~Saakvitne & Pearlman, 1996
What does organizational compassion fatigue look like, so we can recognize these symptoms in our own practice and make necessary changes?
Symptoms of organizational compassion fatigue: (~Smith, 2008)
When left unaided, stress levels rise. Employees, particularly the line staff and middle management, feel helpless, then hopeless. Resentment, hostility and blame surface… ~Smith, 2009
In an article by Paul B. Hofmann appearing in the Healthcare Executive in Sep/Oct 2009, there are many factors that lead to compassion fatigue among healthcare workers. These include inadequate professional training, poor mentoring, low staffing, and an organizational culture that does not encourage, value and recognize exemplary displays of compassion. Hofmann goes further in saying that if employees do not believe they are respected and appreciated for their efforts, and if they do not feel cared about by those who have responsibility for them, it will be more difficult for them to establish and maintain a truly caring environment for patients. “Inevitably, compassion fatigue will have an adverse impact on staff recruitment, retention, morale and performance,” says Hofmann.
If we agree with Hofmann as to the factors leading to compassion fatigue among healthcare workers, we recognize that there are plenty of places to help our employees move through and out of the fog of compassion fatigue. We need to provide professional training from their first day, and never stop encouraging them to continue their learning and growing. Mentoring is perhaps the most important task that a manager performs, yet it requires sensitivity to know which employees need mentoring and how they can be best served. It also requires time, to create personal bonds, set professional boundaries, and develop trust so that employees are open and responsive to being mentored by their management team. Low staffing is a reality for many of our practices, as we struggle with each unexpected loss of an employee and try to fill in that space using the “warm body” technique. This is avoidable if our management team continually accepts resumes and applications for all positions even when there is no opening, and conducts ongoing interviews to line up the best candidates for when an opening occurs. If the management has established open communication with each team member, they are also better prepared to know when an employee may be reaching a personal or professional goal that will take them from the practice (i.e. graduating school, completing certification, etc.), or realize when an employee is struggling and thus involuntary termination is unavoidable. Employee loss should never be a surprise, in most cases. If it is, then the management is not projecting employee needs very far into the future.
Organizational culture is so important to minimizing organizational compassion fatigue. As Hofmann stated, our management team (including practice owners and all levels of supervision) must encourage, value and recognize exemplary displays of compassion by the employees. This could be extra time spent with a grieving client, staying late to provide patient care that is necessary, or an employee supporting their teammate through a difficult case. We must be careful not to assume this is unprofitable “down time” or just someone “riding the clock”, when instead it may be the extension of compassion that you really want and need from your team members. Feel free to use the word “compassion” as often as possible when describing activities that you are praising, as this will help them make the connection that it is this display of compassion that is being recognized. As managers in general, it is easy to focus on the problem or trouble employees that constantly need guidance and counseling. However, those employees who probably deserve the support of management the most are those who need to see real examples of how much they are respected and appreciated. This goes beyond tangible rewards and “employee of the month” plagues to words and actions that provide them the feeling that they are cared about. This is where that personal bond is so important.
We can create healthy work places, and here are some guidelines to help us reach that goal:
Eight Laws Governing A Healthy Workplace
1. Provide a respite for the team.
2. Provide continuing education for team.
3. Provide acceptable benefits to aid staff in practicing beneficial self care.
4. Provide management and team with tools to accomplish their tasks.
5. Provide direct management to monitor workloads.
6. Provide positive, team-building activities to promote strong social relationships between colleagues.
7. Encourage “open door” policies to promote good communication between team members.
8. Have grief processes in place when traumatic events occur onsite.
As we conclude the last of our five post series, we would love to hear hear your thoughts regarding compassion fatigue, so if you leave a comment on this blog, your name will be put into a drawing for your own copy of Overcoming Secondary Stress in Medical and Nursing Practice by Robert J. Wicks, which I will mail to you. All comments must be received by November 9. Be sure to include your email address so I can let you know on November 10th, if you were the winner! - Rebecca
Other posts written by Katherine are:
Mark Opperman, CVPM, says five-star service is about exceeding expectations. In this video he delivers easy tips to push your veterinary clinic over the top in clients' eyes.
By Rachel Cunningham
Creating online videos is a great opportunity for veterinarians to get new clients and increase brand awareness in the local market. The online video sharing site YouTube is the second largest search engine worldwide, right behind Google. This means that when people aren’t searching on Google, they are often searching for videos on YouTube. In addition to being popular with online consumers, video has a range of uses and benefits for local veterinary practices.
Online video is a great tool for veterinary practices as it creates trust in viewers. After a consumer views a video about a local business, they feel like they “know” the practice and have a personal connection to that business. Additionally, video is a fantastic way to communicate a large chunk of information in a relatively short span of time. Recent studies have shown that only one minute of video has the same value as almost 1.8 million words (Video Brewery, 2012). Consider how much information just one minute of video can relay to the viewer.
Video marketing offers variety and flexibility as well. You have the option to choose whether to create videos in-house or through the use of a professional videographer. The best option would be to incorporate both professional and in-house videos to take advantage of what each option has to offer. When creating video for your practice, you can select from four main types of video to produce: patient testimonials, service demonstrations, documercials, and behind-the-scenes. Each of these styles enables your practice to meet a different goal.
Video Testimonials: Increasing Website Conversions
If you are just starting out with video for your practice, patient testimonials are the ideal place to begin. While written online testimonials on review sites are great for search engine optimization (SEO), client video testimonials are often more convincing and tend to increase website conversions. Online consumers are very good at identifying fake reviews, but video testimonials are inherently more trustworthy because they are hard to fake. Online reviews about a veterinarian carry a lot of weight with pet owners, so video testimonials increase the likelihood that a pet owner will become a new client.
Demonstration Videos Educate Pet Owners
A demonstration video showcases your services (a pet exam, dental cleaning, etc.) and provides pet owners with a good idea of what it is like to bring their pet to your practice. Service demo videos educate pet owners about your offerings, make viewers comfortable, establish your credibility as a veterinarian, and increase awareness of your veterinary practice. Create videos about your most popular services and continue to add more videos as your services expand. Upload the videos to YouTube to get them in front of a wider audience and become an authority in veterinary care.
Professional Documercials Market Your Practice
Investing in a professional, HD video of your veterinary practice is a way to reach several goals at once. A documercial not only highlights your services, but it showcases client testimonials and provides pet owners with a peek at what happens behind-the-scenes. Documercials enable you to market your veterinary practice, reach a wider audience, educate pet owners, and build your reputation as an authority on veterinary care. Using a professional videographer enables you to continue seeing pet patients while getting a high quality video filmed, edited, published and syndicated.
Behind-the-Scenes Provide a Personal Experience
Behind-the-scenes videos give pet owners a glimpse of what happens at your practice. These types of videos are good for humanizing your practice while informally showcasing your services. Pet owners and online consumers enjoy these videos because they provide a personal experience. Behind-the-scenes videos also enable you to engage with existing clients and improve return rates. It can be tough to have a relaxed demeanor while keeping a professional manner with clients. This kind of video allows you to retain your professional demeanor and authority while letting patients know that you are human and approachable. This style of video is a little tricky to implement, so hold off on jumping into this type of video until you have created the other three types of videos.
Shooting Video: Quick Tips for Veterinarians
Getting started with video does not need to be a complicated process. We’ve compiled several easy tips to help you start shooting video for your practice.
1. Always use either a HD video camera or a smartphone that has good audio and video capabilities.
2. Adjust lighting, sound, and the setting so that it translates well in the video. Any setting should be properly lit and look clean. Only shoot video inside.
3. Be ready to film client video testimonials at anytime. When a client is ready to share their testimonial on film, being ready makes it convenient for them.
4. Keep the videos short, between 1 - 2 minutes.
5. When on camera, smile. A smile makes you look approachable and makes the viewer comfortable.
6. Publish your videos on YouTube and share them on your website and social media.
Video is an effective and popular medium that enables your practice to accomplish a variety of goals. The versatility of video enables you to change your goals to match the changing needs of your practice. Using resources like YouTube and recent advancements in smartphone capabilities make it easy to create videos. Once you get comfortable with shooting and sharing videos, you can streamline the process for efficiency.
Katherine Dobbs, RVT, CVPM, PHR, began her career in veterinary medicine by becoming a registered veterinary technician in 1992. Her career includes technician positions within private practice and surgical training and research. She joined Gulf Coast Veterinary Internists and Critical Care (GCVI) in Houston, Texas, in 1996. During her 10 years at GCVI, she became the first full-time manager in the practice by accepting the position of Director of Client Services. In September 2006 she became a Certified Veterinary Practice Manager (CVPM) through the Veterinary Hospital Managers Association (VHMA). Driven by a growing desire to consult with managers in other emergency and specialty practices, she founded the Veterinary Emergency and Specialty Practice Association (VESPA at www.VESPAssociation.org) in June 2006. (Please read more about Katherine Dobbs below post.)
Compassion fatigue is not a new topic in veterinary medicine; it has been talked about before. Yet how many of us today would admit that we suffer from compassion fatigue? Whether you are the family veterinarian who is now saying goodbye to puppies and kittens you first met ten or fifteen years earlier when you entered the profession, or you are the emergency clinic technician who must say goodbye to many patients all in one day after barely getting to know their families, or you are the front office team member at a specialty practice who faces the brunt of emotional eruptions from clients day in and day out, we are all susceptible.
Experts agree that the more you know about compassion fatigue, the better prepared you are to recognize it and cope with its effects. Compassion is defined as a deep awareness of the suffering of another, coupled with the wish to relieve it (Figley & Roop, 2006). Fatigue is defined as the mental weariness resulting from exertion that is associated with attending to the emotional and physical pain of others (Figley & Roop, 2006). Combined together, compassion fatigue has been called thehurt of the heart (Ogilvie, 2006), something all of us in the veterinary profession are susceptible to, and many of us today suffer from this condition.
So what is burnout, a term we hear more often from our team and possibly ourselves? Burnout is the general feeling of exhaustion that develops when a person simultaneously experiences too much pressure and has too few sources of satisfaction (Figley & Roop, 2006). Then there is also the day to day stress inherent in our jobs; how does that fit into this discussion?A good way to remember the difference between Stress and Burnout is that Stress is “too much” (pressure, work, expectations) and Burnout is “not enough” (depletion, emptiness, apathy). If Stress is drowning, Burnout is being dried up! (Smith, 2008)
Regardless of their meanings, however, it is apparent that we as a profession suffer from stress, burnout, and compassion fatigue. When we examine the symptoms produced by these conditions, it’s apparent that they affect our professional lives, and also our personal lives. Let’s look at symptoms of compassion fatigue in particular:
When you clock out at the end of the day or shift, your compassion fatigue isn’t left behind in your locker. It follows you home, and affects your relationships with your spouse or partner, children, friends, and ultimately decreases your overall quality of life. These are just a few of the ways that compassion fatigue causes us to act at home:
We choose this career because we are compassionate, caring people. Unfortunately that also makes us more susceptible to compassion fatigue. If we had no compassion, we would not have to worry about the fatigue. The first step is to understand and accept the emotional strain that is part of our career. We must recognize the toll it takes on us daily, yet also recognize our great potential to overcome or minimize its effects.
We understand and accept that sadness and pain are a part of our job…We begin to understand that our feelings of anger, depression, and sadness are best dealt with if we recognize them and allow them to wash over and past us…We recognize our incredible potential to help animals. We ARE changing the world! Fakkema, 1991
So what can we do about compassion fatigue, aside from leaving the profession and giving up the careers we love? We have to fight back, on a personal level, and an organizational level. We can make a difference, in our lives as well as the lives of pets and families.
(Katherine Dobbs bio Continued from above)
In January 2007, Katherine accepted a position with Horizon Veterinary Services, Inc., as interim hospital manager of their flagship hospital, FoxValleyAnimalReferralCenter in Appleton, Wisconsin. In 2008, she created InterFace Veterinary HR Systems, LLC. Katherine focuses on providing human resource information and building customized tools for performance management within general and emergency/specialty practices. Katherine became a Professional in Human Resources (PHR) in June 2008, and a compassion fatigue specialist in 2009. Katherine has also been published in various industry journals including AAHA Trends, Firstline, Veterinary Economics, Veterinary Practice News, and the Veterinary Technician journal where she was a member of the editorial board and the featured author of the monthly Management Matters column. She has published two books with AAHA Press, and writes for several technician journals in Canada and a veterinary publication in the UK. She is an invited blogger for Veterinary Practice News and My Exceptional Veterinary Team. She has also self-published two books for pet owners on end-of-life and pet loss. Her public speaking experience includes various state, regional, and national conferences in the United States and Canada, for managers, veterinarians, and veterinary technicians. Katherine was voted the 82nd Annual Western Veterinary Conference Practice Management Continuing Educator of the Year in 2010. (updated 2/12)
You can contact Katherine at:
Katherine Dobbs, RVT, CVPM, PHR
interFace Veterinary HR Systems, LLC
3825 E. Calumet St., Ste. 400-187
Appleton, WI 54915
You can follow Rebecca's blog at www.catalystvets.com
Mr. McVey completed his graduate studies in 1991 in political social work and behavioral science. He then pursued a career as a psychotherapist and program director in psychiatric facilities, followed by a transition to administration of veterinary practices. In 2001, Shawn founded McVey Management Solutions, a consulting business that specializes in improving health care delivery systems and improving workplace culture.
Mr. McVey is also the founder of Veterinary Specialists in Private Practice (VSIPP), an annual conference that provides continuing education for veterinarians and administrators in specialty practice. Mr. McVey is a graduate of Purdue’s Veterinary Management Institute, and is the first non-veterinarian to be named to the Board of Directors of the American Animal Hospital Association.
Shawn is a member of the Editorial Advisory Board of Veterinary Economics and FirstLine Live magazines. He has been named Speaker of the Year at both the North American Veterinary Conference and the Western Veterinary Conference. Shawn trains and consults with veterinary practice teams approximately 50 times per year.
Rebecca: What concerns you most about the state of the profession right now?
Shawn: Well, I thought about that question, and I think externally and internally are the answers. Externally, what concerns me about the state of the profession is the constant struggle of the value proposition, the constant struggle of being able to sell value, and the fact that if we want to get—if we want to have the lifestyles that we want and need, we want our staff members to be elevated to the professionals that they aspire to be, then we’re constantly going to have to be charging what we’re worth. And so, that means that we’re not going to be able to be there for every person who might want what we have to offer.
Shawn: So that concerns me about the profession externally. But internally—and then the second thing is I think the universities are so woefully out of touch with what the current markets are. And they’re so driven … I think there’s going to be too many specialists, and I think the specialists are going to basically do hybrid, mixed practices.
I have a lot of concerns for the single veterinarian who is general practice-trained, and their ability to make a living in this profession. I think it’s going to be very hard.
Rebecca: Yes, I know, I agree.
Shawn: Especially when they’re coming out with $200,000 worth of debt.
Shawn: I look at Great Britain and Australia and other places where they come out of high school and go into a five-year program and graduate with a Bachelor of Science degree in Veterinary Surgery. And then they get out and they make the exact same amount of money relative that the general practice veterinarians do in the United States and Canada.
Only they’ve got one third of the debt. And so I think we’re going to have to come up with a different model of training veterinarians that doesn’t cost so much.
Shawn: And internally, what really concerns me about the profession is the denial that current veterinarians are in about their need to be better businesspeople.
It’s almost disdain for any kind of business practice or discipline in business is viewed as getting all corporate.
So my concern internally is that veterinarians are not going to rise to the demand, and we will be completely corporate taken over because that’s the only people who know how to do it.
Rebecca: I know.
Shawn: And it’s happening. I mean we’re going to go the way of human medicine. The country doctors are no more, and it’s all corporate medicine basically, unless you have a few boutique kind of … you know, from high-end sports medicine clinics to plastic surgery, to rehab therapy … So I really think that the handwriting is kind of already on the wall.
Rebecca: I agree.
Shawn: I want veterinarians to be proactive and to decide their fate, rather than to be reactive and they seem to love to be reactive.
Rebecca: We need to be focused on thriving instead of just surviving.
Shawn: Yes, the attitude of scarcity …
Shawn: And veterinarians act like, in my opinion, like they’re the only ones that have to go through this.
I mean every other successful business, from realtors to restaurants to auto dealers to hotels, they’ve all—they get it, that they got to figure out who their market is, make a product that goes to that market, not try to be everything to everyone and everybody—you can have a car, but not everybody buys a Mercedes, not everybody buys a used Chevy, but there is a place in the market for all of it.
Rebecca: Yes there is.
Shawn: Veterinarians want to be all things to all people and just don’t want to do any conflict, which is why I teach what I teach.
Rebecca: What do you think is the best thing about veterinary medicine?
Shawn: Well, the best thing about veterinarian medicine, other than the obvious answer of the work environment, working for animals and with animal which is cool to people who love animals.
But the global best thing about it is, I still think it’s one of the few professions where an entrepreneurialism can really be celebrated, like I think of all those people that, to be an entrepreneur, they go out and pay a franchise fee to Subway and own a Subway, and they’re not in love with sandwiches, they’re love with the idea of being businesspeople.
And the veterinarian gets to be the best of both worlds.
You can live your passion, and literally, if you have enough chutzpah, you can create a world that you live in that expresses your values, that expresses your spirituality, that expresses your passion, and choose people that are like you, or at least share your vision, to work around you. And honestly, you can make a really decent living if you do it right. It is hard to kill a veterinary practice. If you just get the right location that’s not too saturated and you have a modicum of business checks and balances in place, you and your team can enjoy a healthy business for as long as you’re a member of the community.
So the opportunity … I know I’m talking about the demise of the business, but the opportunities that are still there in veterinary medicine are very exciting to me.
Rebecca: One piece of advice you would give to a PRACTICE OWNER or somebody that—let’s say somebody that’s just recently bought a practice or started a practice?
Shawn: I think my biggest piece of advice for a practice owner is to work with a plan.
Be intentional about what the business looks like financially, culturally, clients … so rather than waiting for the business to just happen, which is I think a lot of business owners do that. They open up the business and five-to-seven years later they wake up because of some crisis and the lightening bulb for them is: “Oh, my God, I can change the direction of the business!”
So start out that way, with a plan and intention in mind of “I want to make this amount of money, I want these kinds of people around me, I want these kinds of clients, and here’s how I am going to get there.” And along with that goes: build into your budget of opening the idea that you’re going to use professionals to help you, whether it’s consultants or AAHA or whomever, but get some help.
Rebecca: Yes, we all need wisdom.
Shawn: Because they don’t teach you what you need to know in veterinary school about running a business.
Rebecca: [laughs] No, not so much, not so much at all.
Shawn: And my advice for NEW GRADUATES would be to really, really choose your first practice very carefully because the first practice that you end up being in as an associate tends to be the one that really shapes how you feel, live, and believe about veterinarian medicine. So you take on … It’s really like the same thing as a child being parented.
You really do end up taking on the personality of that original practice owner, the medical habits of that original practice owner, and the disciplines or lack thereof of the practice owner. It’s like another marriage.
So choose very carefully your first practice, because once the person makes the move of getting out of a practice and going into their own practice or another practice, then it’s easier for them to do. But for a lot of veterinarians, that very first practice is the one that’s hard for them to get out of if it’s not a good fit.
Shawn: My advice for ASSOCIATES is get a voice, have a voice, and use it.
Rebecca: Yes I second that!
Shawn: Too many associates, I think, sit back and sheepishly accept whatever’s happening in the practice, and well, they believe – they falsely believe – that the owner knows what’s going on and the owner has control over the business. What they don’t know is the owner is oftentimes running just as blind as they are, but they’re not talking about it.
And so, sometimes your best ideas as an associate, if you raise your hand and say, “Hey owner, I think we should do this,” they’re actually going to be receptive to it.
Like, “Hey owner, I have this idea. Would you let me take this project and run with it?”
Rebecca: So ten years from now – what do you think veterinary medicine’s going to be like?
Shawn: Well, I think we are … there’ll be an acceleration of consolidation, and so there will be very few one-doctor, mom-and-pop clinics left …
Shawn: Because nobody wants to buy them, and there’s that more … if they do, like VCA, they’ll buy three or four of them, close them all down and have one mother-ship in the area.
So I think we’re going to see the end of the era of the kind of … just like we saw in the ’70s and the ’80s the end of the Marcus Welby, MD kinds of practices of just the local doc who everybody loves …
Shawn: …we’re going to see that going by the wayside, except for agrarian or kind of low population environments. That’s going to be a massive shift. I think we are going to see—so there’ll be a lot more consolidation and a lot more corporatization, not just VCA, but people like myself who are consolidating businesses and there are going to be a lot of people that have regional, 25 to 100 practice little kingdoms, if you will. So that’s going to happen.
And the other transformation that I think will be dramatic in veterinary hospitals is that we are going to see many more hybrid practices. So we’re going to see practices that have a specialist, general practitioners, and urgent care onboard. So one-stop shopping for the consumer that will put the squeeze on traditional emergency clinics, and also put the squeeze on some specialty hospitals, to be quite honest with you. So I think those are going to be the two biggest things.
And then finally, last biggest thing is I think we’re going to see a lot more professional management. People who are technicians, client service representatives, and even doctors, who thought that, well one option could end up to become a manger – I don’t think that’s going to be—there is not going to be as many options, because people are going to hire professional managers.
Rebecca: Right. As they should.
I can not thank Shawn enough for spending some of his valuable time allowing me the opportunity to interview him for our CatalystVETS community! Make the time to attend his workshops-they are game changers and truly can get you started on your own journey to excellence! – Rebecca
What insight did you take away from our interview with Shawn?
You can follow Rebecca weekly at www.catalystvets.com
I absolutely love impressing my friends and family with my stories about working in the veterinary clinic. Aside from the ever popular tales from the surgical suite and gruesome accounts of neglect, I relish most the chance to brag on our clients.
Pet owners who regularly visit their veterinarian are among the most intriguing and fascinating people I've met. Even the difficult to please and down right ornery, tend to grow on you when you get to know their pets.
Before I joined the veterinary community I have to admit I had no idea how generous folks could be when it comes to their furry friends. Nearly every day we receive tokens of gratitude from our clients.
Donuts and cookies are the most popular, but over the years we've also collected countless flower arrangements, fruit trays, gift baskets and various home made goods ranging from knitted scarves and earrings to buckets of spaghetti. One sweet lady even makes us home made chicken & noodles.
Yet as much as I love the food, and believe me I LOVE the food, nothing touches my heart and makes it all worth while more than a hand written thank you note. It means something to me when a client recognizes the personal care and dedication we put into treating their pet. And more than that, they actually take the time to write out their appreciation and deliver it. Today as I looked over the words written by a satisfied client, I was suddenly very impressed with this act of kindness.
I guess I never thought about it before, but it occurred to me that this is such an effortless and seemingly small gesture.
Why hadn't I been writing thank you notes to professionals that service me and my life?
The truth is I've spent a good deal of my life grumbling about what I'm not happy with and very little time recognizing anyone's extra effort.
School Security Officers
Child Care Providers
Hair Stylists etc. etc.
I could easily name several people that deserve thanking at the very least, if not a bucket of spaghetti as well.
In a few weeks Yankee’s closer Mariano Rivera will be ending a hall of fame career as the best closer of all time. It is impressive that he had such nerves of steel to perform such a high stress task and that we was so dominant when it mattered most in the playoffs (with the exception of game 7 of the 2001 World Series). But what is most impressive of all is that he accomplished so much with basically just one pitch. For most Major League pitchers to be successful and have staying power they need an arsenal of pitches. A pitcher that has a 99 mile per hour fastball will get a good look, but to make the team needs an unidentifiable change-up or sharp slider to go along. Then there is the occasional great story of a pitcher that flounders in and out of the league for years and then when left for dead is able to perfect a new pitch, such as the story of R.A. Dickey having his best success in his late 30s after finding the knuckleball.
There are probably some general practitioners out there that may find some similarities to the floundering pitcher. They look at their monthly statements and see an underwhelming gross and average client transaction. General practitioners don’t have one dominant skill set that they can count on bringing in revenue day after day. They are not cardiologists that can perform echocardiograms all day or surgeons that pump out TPLOs like Fords rolling off the line. General practitioners need to have an array of skill sets to help increase revenue; they basically need to fine that fourth and fifth pitch.
There are ample continuing education opportunities available for general doctors to add to their repertoire and offer more services to clients. General doctors are not board certified surgeons and when faced with a dog with a broken humerus or luxating patella should offer the owner that referral. But many pet owners trust the veterinarian they know and if given the option would like to stay in house, provided that veterinarian is competent in a particular service.
In the Spring I attended a weekend CE on echocardiogram. It was a great opportunity to sharpen my understanding of the cardiovascular system. But it was also an opportunity to put to use a diagnostic tool we already had sitting at the practice. After the weekend I did not feel confident to begin doing and charging for echocardiograms that Monday. I don’t think R.A. Dickey was in the 5th inning of a tied game and all of sudden decided, ‘I think I’ll try and throw a knuckleball for the first time right now.’ I tried to make room in my day to do one echocardiogram per day for one month. Usually on healthy pets that were admitted for other reasons or boarders. When I finally felt I was getting consistent results on the healthy hearts I felt it was time to offer my service to clients, at a lesser but what I felt appropriate fee.
Anytime an echocardiogram is discussed we tell owners about the option of a cardiologist. That they are board certified trained, have more education on the topic, better equipment and can do more measurements. Some take option A, but there are many more that would rather stick with what and who they know and have the echocardiogram done with me. It has been a process and with each one I perform I think I am getting better, I think I will be more proficient in a year than I am today. The information and growth that I am making is invaluable, the extra gross adds a little more value to the bottom line. Doing echocardiograms will not make me rich, but it helps add to the monthly reports. Eventually it will be time to add another skill to my arsenal and to further my growth as a doctor. So if you are looking at your monthly gross and wondering where the growth is, it may be time to develop your own knuckleball.
The terminology associated with unconventional therapies has shifted a bit over the last 40 or so years. Initially, such therapies were often described as “alternative.” This fit well with the still widespread philosophical position that new or different ways of looking at health and disease which are not part of the scientific tradition are necessary or valuable. But it wasn’t the most effective marketing for these practices since it suggests substituting these therapies for conventional medicine. The dramatic effectiveness of science-based medicine is hard to ignore, and most people aren’t willing to give it up for the promises of unproven alternatives.
The term “complementary and alternative medicine” (CAM) emerged to suggest a more flexible approach in which unconventional therapies could add benefits along with, not only in place of, conventional medicine. This is still a popular term, but some advocates of CAM therapies dislike the implication it carries that science-based medicine is the mainstay of treatment and CAM simply “complements” it. And it can be quite clumsy to say.
So the latest term that seems to be gaining ground quickly is “integrative medicine.” This suggests a seamless merging of the best of conventional and unconventional medicine. Integrative medicine advocates often present this approach as focused only on the welfare of the patient and willing to use whatever tools are appropriate without any prejudice regarding their origins. What could be wrong with that?
Well, to begin with, there is a hidden and untrue assumption behind this approach; that individual practices from both CAM and scientific medicine are equivalent, equally likely to be useful regardless of the philosophies behind them. The problem with this assumption is that there is, in fact, good reason to believe that therapies based in science and validated by scientific research are far more likely to be safe and effective than therapies based on implausible or pseudoscientific theories and validated by historical use, individual anecdotes, and little to no controlled scientific research.
Among some skeptics, integrative medicine programs in academic medical centers have been labeled quackademic medicine. This is the integration of implausible and unproven alternative therapies into academic medical practice not, as is often claimed, with the intent of investigating whether or not such therapies are safe and effective but with a pre-existing faith in their benefits. Such integrative medicine programs are founded on a desire to use the platform of an academic institution to give an aura of legitimacy to such practices, and to use the authority of a faculty position to convince veterinary students these are legitimate medical therapies regardless of the evidence for or against them.
There are a number of problems with such programs. As Mark Crislip from the Science-based Medicine blog has put it, “If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.” In other words, integrating unproven therapies or outright ineffective nonsense with conventional medicine doesn’t improve patient care or outcomes, it makes them worse. And there is growing evidence of the harm this can cause, both directly and indirectly (e.g. 1, 2).
Such integrative medicine programs are also, alas, quite successful at conveying the impression that the therapies they promote are evidence-based or widely accepted as legitimate in the medical community even when they are not. And they tend to create this impression among doctors and medical students as well as the public, despite the lack of compelling evidence of effectiveness for most of these therapies. They are very successful public relations efforts.
These programs are not, however, very successful at stimulating the research needed to make truly evidence-based judgments about CAM therapies. The clinicians involved in these programs are themselves already convinced their practices are effective, so they tend to produce research at high risk for bias. And when research results are not supportive, they are ignored or rationalized away since the self-reinforcing clinical experiences and anecdotes most doctors rely on do seem to support what they are doing, and this has more psychological impact than less influential, but more reliable, objective research. Rarely do integrative medicine programs discourage even the most obviously useless of CAM therapies, such as homeopathy, but they tend to encourage acceptance of the whole mélange of unrelated and ideologically affiliated practices within the CAM family.
The folks at Science-Based Medicine and the James Randi Educational Foundation have recently published an e-book with a number of essays discussing the problems with the infiltration of unproven or bogus CAM therapies into academic medicine, which I highly recommend: Quackademic Medicine
The marketing and PR campaign under the label of “integrative medicine” have begun to appear in veterinary medicine in the last several years, thanks largely to the recent availability of significant funding from proponents of alternative medical practices. For example, I recently wrote about a grant of $10,000 the American Holistic Veterinary Medical Foundation gave to the veterinary school at the University of Tennessee (UT) to promote alternative veterinary medicine. Based on the fundraising and marketing materials of the AHVMF, this organization certainly seems to share the typical marketing and PR goals of most integrative medicine programs. There is some talk of research, but always with the emphasis of demonstrating to the skeptical mainstream that CAVM practices are safe and effective, which is already taken as a given. And there is much talk of widening the appeal and availability of CAVM therapies, regardless of whether the evidence supports their use.
And based on the blog post written for the AHVMF by the grant recipient at UT, this certainly seems to be the agenda for the leadership of the integrative medicine programs the AHVMF is supporting there. Dr. Donna Raditic, who runs the integrative medicine service, made it clear in a blog post on the AHVMF site that she has no doubts about the effectiveness of CAVM and seeks to make alternative therapies more popular and acceptable not by conducting objective research but by providing “hand-on” exposure and the opportunity for generation of anecdote and personal experiences that are, despite their unreliability, so persuasive for most of us.
The AHVMF has also given a total of $110,000 to the Integrative Medicine program at Louisiana State University’s (LSU) School of Veterinary Medicine. The LSU integrative medicine folks have, of course, been actively promoting the AHVMF fundraising efforts, and they have hosted as speakers a number of prominent advocates of a variety of alternative therapies. The web site for this integrative medicine division, which was apparently made possible initially by a substantial private grant, also talks considerably more about promoting alternative therapies than about researching their safety and efficacy. The grant comes from individuals with a strong interest in promoting alternative therapies, and it has been used, in part, to send staff and students for training at the Chi Institute and the annual convention of the American Holistic Veterinary Medical Association, two of the biggest promoters of unproven and even clearly ineffective and pseudoscientific alternative practices.
Despite the numerous connections between these integrative centers and prominent advocates of unproven and pseudoscientific therapies, and the clear bias evident in the promotional materials which talk not about testing CAVM practices but promoting them, it is possible these centers could be useful if they have a commitment to rigorous scientific research and if they are willing to openly rejecting therapies which fail to prove their value in such research. I would like to think that the academics involved in these centers understand the indispensability of evidence-based medicine and scientific validation of claims for any therapy. However, starting from a position of embracing alternative therapies, talking about promoting rather than investigating them, and exposing students to the pseudoscientific rationalizations of homeopaths and other CAVM extremists from the AHVMA all suggest that these centers are more of a marketing and PR effort on the part of true believers than a genuine academic endeavor to find out the truth about these therapies.
So what sorts of services are these programs offering and promoting? The LSU center advertising a variety of therapies, including so-called Traditional Chinese Veterinary Medicine, which includes acupuncture and herbal therapies. I have written extensively about TCVM and acupuncture before. TCVM is a hodgepodge of pre-scientific and pseudoscientific vitalist myths used to identify not disease as it is understood in science-based medicine but “imbalances” in energies and other metaphorical entities which cannot even be proven to exist, much less to play a vital role in health and illness. These mythic concepts are then used to guide the application of therapies which undoubtedly have real physiological effects but which have not been demonstrated to be safe or effective in maintaining or restoring health. Herbal therapies, for example, are among the most promising CAVM treatments because they contain pharmacologically active chemicals. However very few have been consistently shown to be truly effective for any disorder in any species, and there is ample evidence that they, or contaminates they contain, can be very harmful.
Acupuncture is the most popular form of CAM after chiropractic (though still not as widely used as proponents would make it seem). Despite extensive research over decades, it has not been convincingly shown to be anything more than an elaborate and rather potent placebo. To be clear, that doesn’t mean it heals disease through the power of the mind. It means that it can cause us to believe we are better, and even to feel better, when our disease actually hasn’t changed, and it is no more effective than randomly poking us with needles or even toothpicks.
Such a placebo might have a meaningful benefit in treating subjective symptoms such as nausea or pain in humans, so long as it was not substituted for therapies that actually affect the disease directly. However, there are serious doubts about how effective such a placebo ritual and non-specific irritant might be in animals, particularly since they cannot report how they feel and must rely on us to judge their comfort, and it is clear that we experience a significant placebo effect on their behalf. I have seen patients in obvious and serious pain whose owners felt they were fine thanks to acupuncture treatment.
The LSU integrative service offers a few other therapies, some of which are a bit of a bait-and-switch in that they are frequently claimed as CAM even though they are widely used by conventional veterinarians (such as physical therapy and nutritional therapy). The most egregiously ridiculous kinds of therapies, such as homeopathy, flower essences, energy healing, and so on, are not listed and, I hope, not offered by the LSU integrative medicine service. And the folks at LSU are careful to emphasize that they do not restrict the use of established, science-based therapies. So while the hazards of direct harm to patients from unproven therapies are probably quite small (both acupuncture and herbal products can be dangerous), the bigger problem is that pseudoscientific practices such as TCVM are offered and presented to students and clients as if they were just as reasonable as science-based practices, despite the many reasons they are not.
There is less readily accessible information on the services offered in the integrative medicine department at UT. Dr. Raditic is certified in acupuncture (not, of course, a recognized medical specialty in human or veterinary medicine) and is apparently pursuing a board certification in nutrition (which is a recognized specialty area). As a member of the AHVMA, she is at least to some extent affiliated with proponents of other, less reasonable CAVM practices, but I have no way of knowing what her views are on these or the extent to which she practices, teaches, and promotes them.
The UT Facebook page recently promoted an “educational” event in which the “National Acupuncture Detoxification Association” will be teaching “ear acupuncture” Both the concept of detoxification, through acupuncture or other means, and the various systems of ear acupuncture are pseudoscientific and unproven concepts that certainly shouldn’t be promoted at a veterinary medical college. Dr. Raditic is also reported to offerchiropractic, cold laser, and herbal/dietary supplement therapies. These are all fairly typical CAVM therapies with mixed, but generally poor, evidence concerning their effects. Cold laser and some herbal or supplement therapies are at least plausible and might have benefits in some cases. Chiropractic, however, has little claim to any legitimate veterinary use based of the bogus theory behind it (the “vertebral subluxation complex”) and the lack of reliable evidence of safety or benefit.
Reportedly, the University of Florida College of Veterinary Medicine has also received $10,000 from the AHVMF for its acupuncture program. Some of the faculty members associated with the integrative medicine program at UF are also affiliated with the Chi Institute, the largest organization teaching TCVM and acupuncture in the U.S., and other organizations promoting all aspects of TCVM, not merely acupuncture. Educational materials provided by the UF integrative medicine web site promulgate some of the common myths about veterinary acupuncture (that it is an ancient practice validated by this history, that there are identifiable specific points along “energetic channels” that can be stimulated to achieve specific therapeutic effects, that it has been validated for specific indications, such as pain, by controlled research, etc). This does not suggest an open, evidence-based approach to TCVM but a pre-existing belief that it is effective despite the lack of compelling research evidence to that effect.
So the efforts of proponents of integrative veterinary medicine appear directed at the same goal as such programs in human medical centers. They are not so much concerned with finding out if these therapies are safe and effective since they already believe this to be true based on their underlying theories, personal experiences, historical use, and other non-scientific sources of evidence. Instead, they wish to make such therapies comfortable and familiar to students and practitioners of scientific medicine so they will be more readily accepted, regardless of the state of the evidence. And while for now they are avoiding promotion of the most egregious nonsense, such as homeopathy, energy healing, dowsing, they do not appear to be making any effort to distance themselves from such practices or those who do promote them. TCMV and acupuncture share much philosophical and ideological ground with these sorts of practices, in particular a feeling that validation through scientific research is a nice extra with PR value but not essential to judging the value of a therapeutic practice. It is difficult, then, to see how these centers can be anything other than marketing efforts or contribute the kind of rigorous data and unbiased evaluation needed to separate those CAVM therapies that may have real value from the useless nonsense.
The University of Tennessee School of Veterinary Medicine is one of the most noticeable academic institutions that appears to have been co-opted for the promotion of pseudoscientific veterinary medicine (along with Louisiana State and the University of Florida). I have written previously about the Integrative Medicine program at UT and the $10,000 grant the college received from the American Holistic Veterinary Medical Foundation (AHVMF) explicitly for promoting (not studying) alternative therapies. Now, the university has presented its Distinguished Alumni award to two self-proclaimed “holistic” veterinarians. And these doctors were not honored despite their promotion of mystical pseudoscience but specifically because of it:
Dr. Marc Smith of Natchez Trace Veterinary Services and Dr. Casey Damron of White Oak Animal Hospital were recently honored with the “2012 Distinguished Alumni” Award at UT College of Veterinary Medicine in Knoxville, TN, for the creation of Pet-Tao Pet Foods and their service in the field of Alternative Veterinary Medicine.
Curious as to what about the creation of a pet food company might have merited such an award, I took a look at the Pet-Tao Foods web site. It is unashamedly dedicated to an approach to veterinary nutrition and health founded in the mystical nonsense of so-called Traditional Chinese Veterinary Medicine (TCVM).
Our diets are truly “holistic” because each and every ingredient is chosen according to two Eastern theories that define the term “holistic” – Yin/ Yang and The Five element theory. No other pet food company has this unique perspective, experience, or credibility.
The theory [of TCVM] states that all naturally occurring events in the universe have two opposite aspects: male & female, up & down, hot & cold, dark & light. These opposing aspects are interdependent, dynamic and constantly struggling to maintain balance with each other…Food is a powerful determinant in the body’s struggle to maintain health and the balance of Yin and Yang.
In Traditional Chinese Veterinary Medicine, the five element theory explains the intricate relationships between the five naturally occurring elements in the environment: Metal, Water, Wood, Fire and Earth…When using this theory in regard to foods, one can control how organs function in the body. For example, a geriatric dog with increased liver enzymes should be fed LIVER according to the 5 element theory. Feeding liver promotes liver function and healing while re-establishing balance of the liver with respect to other organs.
In keeping with this fanciful and completely unscientific approach to nutrition, the company does not produce foods for specific nutritional needs or medical conditions as understood in scientific medicine, but for balancing Yin & Yang and the Five Elements. This allows them to recommend a limited set of diets for any medical conditions regardless of the cause or the specific nutritional composition of the diet based entirely on their assessment of the degree of imbalance in these mystical principles identified in a TCVM evaluation (which is itself a complex and completely subjective evaluation of the tongue, the pulse, and other physical and historical factors according to rules based entirely on tradition and trial-and-error). The company’s diets include:
It is probably unnecessary to point out that there is no scientific evidence to support the practice of selecting food ingredients to balance Yin/Yang or the Five Elements. This is an entirely mythological folk model similar, and likely historically related, to the Greek system of Humoral Medicine that led to the now mostly abandoned practices of bloodletting, purging, and other methods of “balancing” the vital humours to manage health and disease.
The fact that veterinarians who are thoroughly trained in scientific medicine and who are often, at least in my experience, practicing perfectly competent science-based medicine, are able to believe in such nonsense and use it in their clinical work is a bit of an embarrassment to the profession. However, the fact that a mainstream university research and teaching institution sees the promotion of such mystical anachronisms as worthy of lauding with an award for “excellence” is much worse. This lends a thoroughly undeserved aura of legitimacy to ideas that belong on the rubbish heap of medical history along with the treatment of infection by bloodletting and of epilepsy by application of leeches.
Dawn* and I didn't always work so well together. When I first came to work at the veterinary office I have to admit I was intimidated. Not only nervous about moving in on this already close knit group of comrades, but Dawn in particular had an overbearing and aggressive nature I wasn't use to. We were about as opposite as we could be. While she was loud and outspoken I’m an introvert. I take the reserved and passive approach, and she could be down right bossy. Still I resolved to focus on my work in the treatment area and as long as she stayed at the reception desk we surely wouldn't have a face off. I could tell right from the start that wasn't going to be easy.
Just when I was getting the knack for dodging Dawn, there was a shift in our office structure. One of the technicians abruptly quit and the position she left open had to be filled. Dawn, being the most flexible and seasoned employee was obviously most suited for the job. I became aware that I’d soon be working right along side my nemesis I literally felt queasy and sick. How could I possibly trust this woman? I didn't even like her and what's worse was, she didn't like me either. All I could think of were negative possibilities.
Determined not to let this situation destroy my love for working with animals, I tried my best to keep it professional and stay detached from Dawn and her personal attacks. I'm not going to lie, at first it was awful. She set the thermostat set to arctic chill and turned all the fans on high. I would silently back the a/c down and shut the fans off when she wasn't looking. I would get so frustrated when she left empty shelves before my shift and she hated the way I tied the trash liners so tightly around the rim. Dawn held a flare for delegation. I didn't want to follow her orders. I’d balk defiantly at her attempts to recruit my help. I felt if she needed help with something all she had to do was "ask". This petty squabbling went back and forth for a long while.
Last winter we were saddened by the loss of a loyal and regular boarding dog. Dawn suggested we memorialize him by making a clay paw print for his owner. She personally created and hand painted it. The grieved client was overwhelmed with gratitude at such a thoughtful gesture. We decided to offer this service to all pet euthanasias. We purchased a small clay baking oven, clay and several colors of paint and stains. Dawn took on the responsibility of crafting each paw print. I remember one day watching her struggle with which color would be best for a certain print. It was important to her that it be special and unique.
Facing this tender side of Dawn, I realized, we were actually both there for the same reason. We loved our jobs. We wanted to be there for the pets and their people. Keeping myself at a safe distance only created a bigger gap between us. It wasn't until I perceived Dawn in a more personal light, that I understood her. We actually had a lot more in common than we thought. As I learned to accept our differences, she learned to respect my boundaries. Dawn and I still have the occasional run-in, but now we have both developed a tolerance and a deeper respect for each other.
We're all made differently and sometimes those differences can even seem extreme, but that's okay. We can each be ourselves and still be exactly what this world needs.
*name is changed
Do you hear this? "We were too busy" - that is why we didn't do X, Y and Z
I know veterinary medicine and the days and how they go. There are days when you are lucky to grab one bite of a sandwich and others where there seems to be enough time to repaint the entire practice. Time management is a skill. One needs to learn to prioritize the importance of the tasks that need to get done and then do them in that order. For example client call backs are important but on a crazy day I wouldn't suggest doing those before filling out lab work to be sent out that night. It isn't difficult to manage time if you look at the things that need to be done and then prioritize them in the order of importance Also, be ready to change their ranking. Maybe something that was a 5 suddenly becomes a 1 because of pure need. Make lists! We are human and we will forget things, especially if we are running around like chickens with our heads cut off. Lists serve as great reminders and also hold staff accountable for tasks that they are responsible for completing. Share the work load - DELEGATION!
Q: Our practice is so slow right now there just isn't enough work to keep our doctors and staff busy.
A: There will always be those days wen there just aren't clients coming in the door but that doesn't mean there isn't anything to do. Have a down time to do list handy for these times. Some things you could do when it is slow:
1. Deep clean the practice
2. Make up puppy and kitten kits
3. Make new client packets
4. Call clients for patient updates and ask about their experience at your practice
5. Count inventory
6. work on community events like wriging an article for a local paper or magazine. Post intersting articles on social media. go out in the community and pseak to school children.
7. Call clients with overdue items
8. Call accounts receivable clients
The list goes on an on. You all know those things you say you never have time for? Those are the things you do on slow days. If there is staff standing around claiming to have nothing to do and you have a down time to do list.....send them home! I don't pay for holding up walls. Now if this is a problem that is more then a day or so then you need to evaluate what is going on in your practice to make it so slow. Call in past dues and try to schedule appointments. Evaluate your level of service to see if that is having an affect on your appointment fill rate. Look at your staff to DVM ratio and see if maybe you have too many staff for the amount of work your practice has.n Check out your new client numbers and existing client return rates. Call clients who stopped seeing you and ask them why. Long bouts of slow periods may indicate a problem and you need to find out what has caused it and fix it ASAP.
Well in the perfect situation you want both and though sometimes it is seemingly impossible to find the right candidate is out there. I find that skills are something I can teach to anyone that has the willingness to learn so I am lean more towards hiring for team fit and training the skills. I also find that attitude can affect both skills and the team fit. When it comes to attitude I don't find you can train someone to have the right attitude. First of all if their attitude is poor they will not have what it takes to learn the skills needed to perform the job. They won't take the initiative to learn. No matter how well you make your training program and job descriptions if the person you hired does not have the proper attitude to take pride in their position it won't matter. On the other side of that coin a bad attitude makes for terrible team fit. It often brings down morale of other team members. It certainly comes across in te level of client service you offer to your clients and the level of care you offer to your patients and that is something that can directly hurt the practice both in reputation, working environment and financially. Any employee with a poor attitude will start to infect your entire team in several ways:
1. Other team members will not want to work with them and when they do you will feel the tension in the air of the practice (your clients feel it too)
2. The teamwork needed to make a practice run effectively and efficiently will be damaged and ultimately mistakes will be made and the team won't support each other making these mistakes more noticeable to other staff and clients. Your goal is to have a team that functions well together and can catch each others mistakes and keep the flow of the day going
3. You will see your "good" staff going toward the dark side. When a hard working staff member sees someone who is not pulling their weight or that has a bad attitude, unfortunately that becomes contagious. Their feeling is well if they can get by doing it wrong, doing little or being grumpy then why should I put forth all this effort?
Rebekah Brown is a veterinarian from Melbourne, Australia. After graduating from Melbourne University, she worked in private and university practice for 5 years, including 6 months at The Ohio State University, Following an interest in technology-enhanced teaching and learning, she moved into creating computer-based teaching materials, which she has done for both DVM and VT students. She is passionate about playing an active role in the profession and its future directions.
As befits a conference themed ‘Into the Future’, the future of the veterinary industry and profession was front and centre at the 2013 Australian Veterinary Association conference held in Cairns, Queensland. Canadian Dr Jim Stowe, an invited speaker, wrote about the future of the veterinary profession in the Canadian Veterinary Journal 15 years ago and clearly to an extent, the more things change, the more they stay the same. Since that time, Jim has remained passionate about the profession and a deep thinker about its future. On this basis, I was very interested in his views on the current position and future of the veterinary industry. Although I don’t concur with all of his comments, one of his recommendations I thoroughly support is that we need to start a dialogue within the profession about its future course. This post is my attempt to contribute to that discussion. All ideas below are taken from my notes taken in Jim’s sessions, the conference proceedings, and Jim’s slide decks.
‘The veterinary dilemma: Picture a leaking life raft surrounded by sharks; too many in the boat, too little food to survive. Is this our future – or present?’
Major current concerns for veterinary practices: (note all the lists below include only some of the points covered over the 8 sessions)
- rising unemployment within the profession due largely to the great increase in graduate numbers
- financial unsustainability of large animal practice
- fewer practice visits
- poor remuneration
- increasing corporate ownership of practices eg Greencross in Australia, Banfield in the US
- effects of global financial conditions
Predictions for the future of veterinary practice:
- The end of vaccines due to the development of personalised medicine
- Ratings of every veterinarian, every practice and every University – online
- Retail and pharmacy vanish from practice shelves due to online retailing
- Practice resale value becoming worthless
- Decline in the number of pets due to an aging population and a continued decline in large animal practice due to the corporatisation of farms.
- Pet insurance rates either soar or completely fall by the wayside.
Ideas for positive change to current veterinary practice:
Recommendations for the future of the veterinary profession, including changes to veterinary education:
Jim’s prediction: The veterinary profession as we know it will not exist twenty years from now. It will either degenerate into a relatively unprofessional cheap service for pet owners as a cute cottage industry, or it will become a varied and enviable profession dedicated to the care of every animal species on the planet.
Create a Social Media dialogue on this issue to get feedback from the rest of the profession and to connect those with resources.
I just returned from the VetPartners 2013 Mid-Year Meeting in Chicago. It’s usually the only time during the year that I get to meet a good friend and fellow Crimson Tide fan, CPA Scott Huner of Birmingham, AL, as tax season wipes out any chance of attending the annual Florida meeting at the NAVC in January. VetPartners colleagues like David McCormick, Lou Gatto, Philip Homsey, Kelly Baltzell, Bete Johnson and others from across the world have helped grow our firm’s veterinary client base through referrals, education on timely industry issues, and introductions to veterinary luminaries at networking events far from home.
I usually get some ideas to write about from my travels and have good intentions of typing on the plane back from wherever I have been. This is one of those times. I could blog about DOMA tax law changes, health care exchanges, or eking out extra profitability by buying cheap copier paper to print patient invoices versus using recycled “green” laser paper (our choice despite the cost). But what hit me on my trip was breakfast customer service as a leading indicator for hotel guest happiness. If the first meal of the day goes wrong, the rest of that day’s experience could be a potential disaster.
We stayed at the Hyatt Regency Chicago as our base of operations and I noticed that it wasn’t your typical downtown hotel. For one thing, the restaurants in the hotel were great. What made them great were both the food and the service. Both at Stetsons Modern Steak + Sushi and American Craft Kitchen & Bar located in the hotel, the wait staff (notably our upbeat server Patricia at ACK&B) were very well-educated in all facets of food ingredients, pairings, and I could tell that they liked their jobs, and not just for the paycheck. Breakfast is my “bellwether” event to see how an entire hotel succeeds. And based on that, the hotel was top notch.
Breakfast at the restaurant Wildberry Pancakes & Café, located 3 blocks down from the Hyatt, was really the highlight of the trip. I went there three times out of four morning slots. Wait time was either nothing to 45 minutes without complaint. Breakfast is my favorite meal and the food was fantastic. My wife Kathy and Scott and Sherry Huner had the famous Bliss Berry Crepes, while I had boring less-sweet alternatives. One of our servers, Will, was just exceptionally fabulous as he came in at the right times, apprised us of food ETA, filled our coffee at the perfect time, and just had a super chipper attitude. You would have thought he was serving a seven course dinner with wine pairings at a Sonoma Vineyard instead of breakfast. Our meal could have been mediocre had the food been fantastic and the service subpar or just par, but he took it up a notch. I noticed there was no idle staff chitchat; everyone had a task and did it well. Even the table busboys were hustling. We experienced a waitress in training on our first visit. A lot was expected from her supervisor, who stood right by with an on the spot performance evaluation.
Many people don’t come to a service establishment with any expectations, that way they don’t get disappointed. In my case, I always expect the best, and when I get it, the experience is truly memorable. That’s why I remembered Patricia and Will without even writing down their names 5 days ago, a great feat for me. Both Patricia and Will could have even worked for Chef Ming Tsai at Blue Ginger without interviewing.
Training can help employees learn tasks, but positive attitude is hard-wired. It’s either there or it’s not. It would pay for veterinary practices to hire employees that pet owners remember not for what they didn’t do, but where everything they actually did just made the experience that much better. And in those instances where a veterinary visit produces some sad results, the right staff attitude could be just what the doctor ordered.