Leslie A. Mamalis
MBA, MSIT, CVA (Emeritus)
Leslie A. Mamalis is the senior consultant at Summit Veterinary Advisors and the firm’s former owner. She provides practice valuations, profitability assessments, feasibility analyses, and financial consulting to veterinary specialists and general practices. She is co-chair of the VetPartners Valuation Council. Learn more at summitveterinaryadvisors.comRead Articles Written by Leslie A. Mamalis
How do you know when your hospital is ready to bring on another veterinarian? Maybe your current doctors are working more hours than they want. Or perhaps an associate veterinarian is planning a life change such as semiretirement or the birth of a child. Possibly, you want to spend less time on the medicine and take a more active role in the business side. Or maybe you want to work less, spend time with your grandkids or mentor residents. If any of these situations apply to you or your practice, hiring another doctor is a critical step.
Other reasons to hire an additional doctor include:
- The practice is growing.
- The appointment schedule is full.
- The practice is increasing the hours or days it’s open.
- Patient services are being expanded.
When it comes to doctor staffing, determine whether your team of veterinarians is willing to fill in for colleagues who are on vacation or attending conferences. Are requests to cover additional shifts met with resentment? If your doctors dislike picking up shifts, the reason might be that they aren’t getting the time off they need and expect. If you don’t hire another doctor, consider whether you will lose associates because they didn’t receive promised mentoring or because they couldn’t achieve a work-life balance.
Hiring another veterinarian takes time and money, but look beyond the recruiting costs. Most practices can afford the expense, especially when a productive veterinarian is brought on board. The ongoing costs of supporting another doctor include his or her pay and benefits, including continuing education and licensure expenses, and potentially hiring additional support staff. Cost savings might be realized if, for example, you don’t rely as heavily on relief veterinarians to fill holes in the schedule.
Ideally, when you hire another doctor, the practice is growing and cash flow is stable. If you own a practice with one or two veterinarians, you should be prepared to give up some of your compensation or take smaller profit distributions or draws while the new doctor gets up to speed. New veterinarians won’t generate a lot of profit until their schedules are full. New hires should pay for themselves within a few months, but their contributions to the bottom line could take some time. The loss of a little of your personal income in the short term is well worth the cost if a new doctor can help you build the business and allow you to take some well-earned time off or pursue other professional goals.
In addition to the financial costs of hiring, a time commitment is required. Do you have time to mentor a new doctor? Even when you hire an experienced veterinarian, you or someone else will need to properly onboard and mentor the doctor. If you hired a new graduate and promised to mentor the person but were too busy or too mentally or physically exhausted to provide it, you lose the opportunity to help that doctor strengthen his or her skills. New grads are eager to apply their skills, but most want some degree of mentoring. If you can’t do it, can another doctor? If the mentor is another associate, determine how that veterinarian can be compensated for the responsibility.
The Opportunity Cost
Instead of asking, “Can I afford another veterinarian?” the better question might be, “Can I afford not to hire one?” As your business grows, you will come to the point where not hiring a doctor will be detrimental to the practice. We often dwell on what an associate veterinarian will cost, but a better perspective is what another doctor will allow you to do. Having more doctors does not automatically guarantee more success, but it might allow you to improve morale and reduce stress in all employees.
When the front desk always needs to squeeze in “just one more” appointment, doctors go home worried that they missed something because they were rushing. Veterinarians and veterinary nurses have told me they fear compromising the quality of patient care because of how busy the practice is. If four “squeeze ins” occur during the last two hours of the day, everyone in the practice hurries, rushing through the check-in, the patient history, the exam and the testing. All this rushing reduces your ability to provide quality patient care and client service.
While wellness and vaccination appointments can be booked weeks out, a sick or injured pet needs to be seen before the condition worsens. If your hospital can’t see the pet that day or the next morning because you’re understaffed, you risk permanently losing a client to a competitor who can see the patient sooner. And when the appointment schedule is full of sick pets, your doctors can’t do as much preventive care or intervention. Neither the doctors nor nurses have time to educate clients about topics like nutrition or dental health.
Leveraging Veterinary Nurses
Are your doctors doing what only a veterinarian can do — diagnose, prescribe and perform surgery — or are they spending time on tasks like blood draws, catheter placements, nail trims or client education? Your practice would be better off hiring additional nurses and letting your doctors be doctors. Adding more nurses to the roster is an excellent way to help veterinarians see more patients.
A recent article published in JAVMA News stated that the ideal number of certified nurses per doctor is four. Credentialed nurses should be used to the full extent allowed by your state’s practice act.
We have long known that veterinarians become frustrated and disillusioned and leave when they are not allowed to practice the way they wish. The same is true of credentialed veterinary nurses. When these highly skilled, well-educated team members spend most of their time cleaning and doing scut work, they, too, become frustrated and resentful, and they leave for better-paying jobs. If these nurses were encouraged to do more, they could earn better pay, remain in the profession and take the pressure off of a practice’s veterinarians.