Summary From Part 1:
Happiness = Reality - Expectation
Veterinary Medicine has a large % of veterinarians that are dissatisfied and unhappy with their profession. This is in part due to their expectations exceeding the reality of the career. This 4 part blog addresses common disconnects in the profession between expectations and reality, and hopes to improve happiness by closing this expectation-reality gap, and by providing recommendations to improve reality.
Chess board with White King knocked down
Part 3 of this Blog Series will focus on Veterinarians vs. The Boss
Expectation: BOSS KNOWS BEST
You expect your boss will know and teach you best practice. You expect that they are up to date, that you can trust and learn from them, and be performing appropriate medicine.
1. As a new grad you will lack experience and pattern recognition, but you will excel in the latest medicine and the newest use of diagnostics tools. YOU are in the forefront of the field and sometimes you know better than your boss. Having a new grad in the clinic is valuable to the practice as it infuses the latest tools and knowledge, and keeps the clinic up to date.
2. Some of you will have great bosses/mentors that are interested in being up to date and want your new ideas, these are the good ones! However, some of you will have bosses that have no interest in learning, or are resistant to change/updates. You may be pressured or taught to perform sub-par medicine, stating 'this is the real life'. Your boss may also try to push certain practices as money makers (prescribing meds, doing surgeries that should be referred, etc.)
1. PICK THE RIGHT CLINIC: In your interview discuss freedom of case management, referral practices, and about particular case management topics important to you (ex. antibiotic use), and see how your boss responds. If your boss gets defensive, angry and refuses to be open to new medicine in a hypothetical conversation, how do you think they will respond in a real life situation?
2. YOUR CASE IS YOUR CASE: Your licence is YOUR licence. Stand your ground respectfully. Manage your cases how you feel is best. If you don’t agree with your boss stand up to them and explain WHY. Also, you need to 'Cover your Ass' legally. A recent study showed that the #1 complaint to the board was veterinarians not referring early enough. If you think a case warrants referral, OFFER IT EARLY.
3. BUSINESS IS BUSINESS: Understand that your boss needs to make money. If you are not prescribing drugs that they feel are money makers, try to replace this with something else (ex. Probiotics or running a fecal test vs. antibiotics for diarrhea)
4. CHANGE YOUR SITUATION: If you are continually having issues with your boss or colleagues regarding patient care or treatment plans, address this. Ask for a private meeting and respectfully display the Evidence Based Medicine to support your medical decisions. Discuss your need for freedom to manage your own cases. If your boss is unwilling to let you perform appropriate medicine or is making you perform medicine or pushing practices you are uncomfortable with, start looking for a new job.
5. MENTORSHIP PLAN: Determine what level of 'mentorship' is important to you and get a detailed 'mentorship plan' in writing. Determine in your interview if your mentorship needs can be met at that clinic (are there senior vets available to help/mentor, is there time or is the clinic too understaff? etc.)
Your boss may not be performing medicine that is up to par, and as a new grad you are important to the field because you are the ones infusing the profession with the most up-to-date practices. Without new graduates coming through the profession would not progress, so being a new grad gives value to a clinic! It is important to pick a clinic that embraces up to date medicine, and a clinic that will give you the freedom to perform good medicine.
Let's Get Personal
When I graduated I worked in a practice with a boss that hadn’t done CE in 10-15 years. He performed great medicine in terms of when he graduated but some of his practices were very out of date.
Falling into the ‘this is real life’ trap, I spent the first year of my practice treating blocked cats by putting in rigid plastic tom-cat catheters and leaving them open to drain without a closed collection system. I cringe thinking about how much those poor little kitties suffered from pain, discomfort and UTIs because I didn’t stick to my guns about what I was taught in school about soft catheters and closed collection systems.
My boss didn’t do this on purpose, he just wasn’t up to date. As a new grad I should have been educating him and progressing his practice. I failed in that situation to up-hold my end of that bargain.
Your boss thinks you won’t charge appropriately. This is employers #1 problem with new grads!
Similarily, you expect your boss should ‘care’ and therefore be OK when you don’t charge appropriately.
1. Your boss is probably right! and not just about new grads. Imposter Syndrome is very real in the veterinary world, and makes us feel that we don’t belong and aren’t good enough, and therefore we don’t value ourselves. This results in us not charging clients appropriately. This isn’t fair to your boss because they need that income in order to run their business, and pay you that appropriate salary you negotiated.
2. We are to blame when we complain to colleagues/clients/etc. that the costs of our clinic are too much. Your boss, the business owner, set the prices according to what they feel is appropriate and fair and what is required to run their business and pay wages. When we undermine our bosses, or are upset our bosses make us charge, we are worse than the clients that come in and say that we ‘don’t care’.
3. We often feel inadequate for not knowing the answer to a case without diagnostics or work up, and therefore either want to perform tests for free to ‘compensate for our deficiency’ or we assume clients won’t want to spend the money on their pet. We don’t value ourselves, so we assume clients don’t value us, our services, or our role in society. Also, the public perception is that vets perform unnecessary diagnostics/treatments just to make money, so we are primed to defend ourselves from this stereotype and often are hesitant to come across as ‘selling’ diagnostics or treatments.
1. VALUE YOURSELF: Until you value yourself, you won’t be able to charge appropriately. And if you don’t value yourself, how can your boss value you? If they can’t value you, how can they pay you appropriately. Do your part in this relationship with your boss!
2. CHARGE APPROPRIATELY: Charge appropriately for everything you do! Make sure you ask your boss how to charge, and ask for a review on your billing to ensure you are charging appropriately. By doing this you will also show your boss your confidence and value, and will make you more valuable to the clinic.
3. RESPECT THE BUSINESS: Your boss has the risk and reward of owning the clinic, therefore it is up to them to decide on costs and charges. If you feel that particular items cost too much, or the fee structure for certain procedures/diagnostics are cost prohibitive and preventing you from doing your job, talk to your boss about it. Be specific about what exactly you feel costs too much, why you think it is too much, and come up with possible solutions.
4. EMBRACE ‘SELLING’: ‘Selling’ is just effectively communicating best medicine to pet owners.
A recent study showed that an average dog, over 12 years, would require $17, 000 USD (= $22,000 AUD) of veterinary care. On average, people are only spending $3,600 USD (=$4,500 AUD). That is about 20%. That means that 80% of care that animals medically require isn’t be performed. Therefore, you aren’t ‘selling’ veterinary care, you are just explaining what is actually required, and then the owner can decide what they want to do. A large part of your job depends on your ability to effectively communicate or ‘sell’. The more you can ‘sell’, the more financially valuable you will be for your boss, but more importantly, you will be able to provide more of the care your patients NEED.
Statistics support that you aren’t over-servicing. So go ‘sell’ your butt off!
You can’t demand appropriate compensation if you don’t do your part to support the business part of the profession. If you undermine the costs of care to the client, then you are doing the same thing as the clients that argue we charge too much and that we ‘don’t care’ about the pets. Veterinary medicine has advanced and clients have come to expect high standards of care, and this comes at a cost. Value yourself and charge appropriately, you are worth it!
Many bosses feel new grads lack technical skills, lack ‘real world experience’, and that they are doing you a favour by giving you a job.
1. If a clinic didn’t need a vet, they wouldn’t be hiring one. Every job is a symbiotic relationship, but bosses often look at new grads as parasites.
2. Bosses often think new grads can’t be left alone and need babysitting and help with every case, however despite thinking this they often are not present or supportive when needed. There is a huge disconnect between what bosses ‘think’ they do, and what they actually do.
3. New grads often do need some support initially, and their technical skills often are lacking upon graduation, however they often very quickly up to speed and are working alone.
4. ‘Real World’ is often equated to Anecdotal/Opinion Based Medicine and NOT Evidence Based Medicine. Your new fresh ‘Gold Standard View' is very important to infuse into the clinics to help keep the profession progressing!
1. VALUE YOURSELF: Value yourself and your degree! Just by having a DVM degree, you have immense value. Also, value your new and recent knowledge. Contribute to cases and show you are part of the team.
2. IMPROVE YOUR SKILLS: While in vet school (or before), get a part-time job, or do job shadowing where you can improve your skills. While you are on rotations in 4th year, ask your supervising vet or nurse to let you try to take blood, put in catheters, hold animals, do surgeries, etc. You are there to learn, be an active learner!
3. WORKING INTERVIEW: Prove to your boss how awesome you are, how good you are with both the technical and medical aspect of the career. That week or two is your time to show that clinic that you can jump in and work!
4. RECORD YOUR PROGRESS: Monitor the number of consults you are doing each day, and how many require ‘help’. Track this progress. This will help you see how AWESOME you are doing, will help push you to work independently, and will be proof to your boss that you are independent when you ask for that raise in 6 months!
5. REMOVE THE TRAINING WHEELS: For each case, pretend like your boss/mentor isn’t there. Make a plan of what you would do, and then check this plan with your mentor/boss, instead of just saying ‘help’ with no direction. It helps to have resources that you can use, like a VIN account, or specific textbooks. This approach will not only speed your path to working independently, but will also show confidence, independence and value to your boss! It will also progress the profession!
Beautiful river in the forest
Be part of the PROGRESSION of the veterinary field by infusing your new knowledge into your clinics. Keep the profession flowing forward instead of relying on your bosses' 'real world medicine' that causes the profession to stagnate.
As a new graduate your technical skills will increase rapidly, and very soon you will be working on your own. Also, often the amount of ‘mentorship’ employers feel they are providing you is more than is actually being provided. As a new grad, prove your worth to your boss with a working interview, actively pinpoint skills that need improving and practice, record your progress and actively try to become independent. This will not only increase your independence and skills more quickly, but your medicine will be more ‘up to date’ as you won’t be relying on your bosses older ‘real world’ medicine. You will be actively progressing the profession instead of keeping it stagnant!
You expect that your boss will support you and care about you. You think that if a case goes badly, or if you have a change in your personal life situation, your boss will be there for you and wants what is best for you.
1. Some bosses are amazing and will support you with hard cases, difficult clients, and does truly want you to take advantage of new opportunities. However, some bosses will make comments like ‘oh well I’m glad I didn’t get that case’, or ‘I’m glad I wasn’t there that day’, when you have a difficult client or case. They may not support your medical decisions to clients, or if you are sued/have a complaint some will completely side-step the issue and leave you on your own.
2. Some bosses get very angry when you want to leave a clinic. They will make you feel guilty about taking advantage of other opportunities in life. Millennials are all about experiences and growing their knowledge and experiences, so the concept of staying in one job forever isn’t part of this ‘Gig Economy’ that we are currently in. Your boss may be mad that you are leaving, even if it is for ‘good reasons’, and may not pay you, may ‘fire you’ early to try to sting you back, or may pull support on previous issues that are pending, etc.
3. You can’t predict who will be supportive and who won’t. Remember, at the end of the day, this is a business, and very few bosses will put their employees before their own livelihood or business. You should be looking out for yourself #1 as well!
1. LIABILITY INSURANCE: Get your own liability insurance (aka professional indemnity insurance). I have always held my own liability insurance despite having it covered through employers, just in case. It is a minimal cost that gives large peace of mind.
2. YOUR CASE IS YOUR CASE: make sure you don’t do ‘what your boss wants/pushes’ if you feel uncomfortable. It is your name on the file, and therefore your license at risk.
3. CALL THE EMERGENCY CLINIC: If you need help, advice or another opinion right away, call your local emergency clinic. Most emergency centres are used to vets calling for advice, and are happy to help in whatever way they can.
4. CHANGE YOUR SITUATION: If your boss is undermining you, not supporting your clinical decisions, or you aren’t getting the level of support you need, consider changing jobs. Also, humans are humans. There will be bosses that are inappropriate (bullies, sexually inappropriate, etc.). If you are in an abusive work relationship, find a new job.
It is important for you to protect yourself and look out for yourself. You are a professional and that means that all of your professional decisions are a reflection of your own license. Ensure you are comfortable with all of the medicine you perform, ensure your cases are looked after in the way you feel appropriate (ethically and legally). Try to pick a clinic where your boss will support the level of medicine you wish to perform, and if that isn’t occurring consider changing your work situation. You are the only one looking out for your best interests, so make sure you protect yourself!
Your Boss expects you to work long hours and nights/weekends because “that’s what they did”. They expect you to work as hard as they PERCIEVE they worked.
1. Often our perceptions of how hard we worked are skewed from hard we actually worked. This is true of your boss as well. So they will likely THINK they worked harder than you are working.
2. With the changing market to large companies owning clinics from the previous system of each vet owning their own independent clinic, statistically your boss probably was working hard to build their own business. Therefore the financial gain of working weekends, holidays, etc was directly related to their input. This is compared to today’s market, where this ‘fanatical work ethic’ is expected despite being an associate with no view to own, and therefore with no financial gain. Your boss likely wouldn’t have worked that hard for a clinic that wasn’t their own business.
3. Student debt, mortgages/rent, insurances, etc. All of these financial strains are much higher than when your boss was going through school. Today, we need higher salaries to pay for ‘life’. Also, today we have a higher expectation for Quality of Life. Just because your boss may have been abused/overworked, doesn’t mean that we should be perpetuating this process. Veterinary medicine has drastically changed, so the job dynamic will have to as well.
1. CONTRACT TERMS: Be clear about the schedule and details when you are signing a contract. Have disclaimers about weekends, nights, on call, holidays, etc. If you are willing to work these, then make sure you have appropriate compensation in your contact for this!
2. EFFICIENCY: Learn to be efficient and create processes in your clinic so that you are not staying late unless the caseload demands. If the caseload demands you stay late, ensure you are paid appropriately.
3. VALUE YOURSELF: Value yourself, your time, your financial investment of your degree, and your worth ethic. At KICK ASS VETS we recommend and push people to work hard while they are work, but we also recommend and push people to be appropriately compensated for this work. If you are working weekends and holidays, push for a higher salary!
People will always feel ‘they had it harder’. Your boss will likely think you are not working as hard as they did, and not understand that when you are not working for your own business the drive to work every weekend and holiday is different. It is important to push appropriate compensation for today’s market, which includes today’s trials and tribulations including higher student debt, higher cost of living, etc. Value yourself and work hard so you can be proud of your day’s work, but also value yourself to be paid appropriately for that work!
Please continue to Part 4/4 'Expectations vs. Reality: Vet vs. Client...'
Written by Dr. Ann Herbst BSc, DVM

Published July 10th, 2019

Advocate for yourself, you are the only one that will!

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