Ivan “Zak” Zakharenkov, DVM, MBA, is the CEO of Galaxy Vets. He is the co-founder of Veterinary Integration Solutions and the creator of Smart Flow, a workflow optimization system later acquired by Idexx Laboratories. His master of business administration degree focused on international health care management and his dissertation on “Lean Methodologies in Veterinary Consolidation While Preserving the Experience of Veterinary Staff.” He earned his DVM at Atlantic Veterinary College and his MBA from the University of Cumbria.Read Articles Written by Ivan Zak
With 12 years of emergency medicine experience spread across 35 veterinary hospitals, I’ve witnessed firsthand every stage of veterinary job satisfaction and burnout. How to confront this problem threatening our industry? Is there any way to combat growing discontent? With an open mind and drawing on the best management practices available, I determined that my MBA dissertation would begin the search for answers.
Burnout: Veterinary Medicine’s Chronic Problem
Whether human or veterinary, the health services experience higher than average suicide rates compared to the general population and other high-stress professions. The increased prevalence of mental disorders, occupational stress, and an unwillingness to speak up contribute to our towering numbers. That Sword of Damocles swings over the head of every veterinary employee — one link in the burnout chain.
Loss of control over their work, low job satisfaction, and dwindling mental and physical capabilities have piled up, prompting employee burnout scores to climb. All those links break. Regardless of whether a person works in reception or as a doctor, more pressure rests on their shoulders. And that pressing weight has grown during the COVID-19 pandemic as new pet visits soar and social-distancing protocols are imposed. More and more veterinary employees drag themselves to and from the office.
Older and Wiser?
Despite what I and many other people might expect, those succumbing to the most burnout pressure are younger than 30. A full 27% of the 1,457 respondents to a survey I conducted fell into the youthful category. They showed less enthusiasm for their work and higher signs of physical exhaustion than their older counterparts. That finding runs counter to the expected result of burnout targeting the most senior employees.
While startling at first, all this is not such a surprise. The veterinary industry as a whole shows an increase in the younger employee demographic. With these fresh-faced graduates taking on the brunt of the work, I understand why they’re achieving burnout at a faster pace.
Veterinary Technicians: Lost in the Shuffle
Veterinary technicians shoulder much of our field’s work burdens. Utilizing a Professional Fulfillment Index (PFI) to determine job satisfaction, I asked for survey responses on a scale of zero to four. A response of “2” indicated a reasonable level of contentment. Veterinary support personnel, including technicians, averaged 1.9 — not even a happy minimum.
Concerned, I worked with Stephen Cital on a poll for Veterinary Anesthesia Nerds, hoping to clarify the picture. Our results were astounding: 78% of technicians feel increased stress since the COVD-19 pandemic began.
Around 20% of U.S. veterinary practices are owned by corporate consolidations, with more clinics selling to consolidators every day. The takeover theory works for the corporation, but the stress of worrying about layoffs, integrating new practice management styles, and deciphering corporate policies leaves employees wondering whether they’re coming or going.
Balancing the complications of mergers and acquisitions presents unique challenges. Currently, veterinary employees below the management level have little decision-making input. This leads to higher uncertainty levels, more questions, and the potential for creeping stresses. These consolidated practices stand to benefit the most from a changed management structure.
Enter Lean Thinking
Lean thinking arose from manufacturing companies. However, by focusing on engaging employees and turning to them for suggestions on improving company value, I saw the lean thinking approach’s potential to turn around poor job satisfaction and burnout in the veterinary field. I strove to apply the lean thinking concepts to our dilemma, seeking a way to correct the downward spiral.
As a starting point for my study, I used principles developed by John Toussaint, one of the foremost figures in the adoption of organizational excellence principles in health care. John provides six principles that can be used to implement lean thinking in health care:
- Care providers should think of lean management as an attitude of continuous improvement.
- Lean thinking is a value-creation tool.
- Lean thinking is a method to foster unity of purpose.
- Health care providers should view lean thinking as respect for the people who do the actual work.
- Care providers ought to think of lean management as a visual. This leads to the mounting of displays in staff areas to increase understanding of the application of lean methods.
- Hospital staff should consider lean thinking as a flexible regimentation.
Having considered a correlation between veterinary and human health care industries, I concluded that implementing lean thinking methodology might help support veterinary employees’ mental well-being.
I highly advise this strategy for consolidated settings as mergers usually cause stress and anxiety among employees due to changes in policy, practice and workflow. Lean thinking will help to facilitate the consolidation of the veterinary domain, improve the experiences of employees after the acquisition or merger, and avoid high staff turnover post-acquisition. Veterinary consolidators, as complex corporate structures, would be able to apply lean strategy at scale.
As many corporate entities adopt lean thinking and focus on specific pillars, most of them aim to increase revenue, improve the health of the organization, and become more productive. However, the lean concept is not only about improving metrics, but also changing the organizational culture. Lean organization encourages a bottom-up leadership model. Management in such organizations ensures creative conditions for their employees to become successful and efficient on their own. Lean thinking is about empowering employees, giving them more freedom to make decisions, cultivating the feeling of being in control, and focusing on results rather than micromanagement.
Further study of this topic will have a significant impact on the enterprise management and well-being of the industry altogether.
Lean thinking returns independent thought and participation to the hands of the employees at every level. Clear standards of procedure clarify everyone’s role in the practice, allowing for a smoother workflow, particularly in emergency and specialty practices. This clarity will buoy the individual spirits of veterinary staff, encourage their participation in staff meetings, and lower compassion fatigue rates.
Human hospitals utilizing lean thinking principles find themselves falling into predictable patterns. They know the lines of communication, the available inventory, and their place within the system. With less uncertainty, they have time for themselves to explore continuing education and other self-development. I fully believe the same benefits await technicians and other support staff — to say nothing of my fellow doctors.
Consolidated practices trim the most redundant positions as their first acts. This uncertainty and anticipation add stress and panic within the staff, increasing burnout. Lean thinking addresses such redundancies and waste more fluidly. As a whole, the new practice sits down and outlines the steps needed to achieve the agreed-upon goal. With every employee’s input, the unwanted waste falls away in an organic manner that satisfies everyone; no fear, no uncertainty. Instead of a faceless conglomerate of executives dismissing positions or even procedures, the practice as an entity has the opportunity to apply lean thinking to the redundancies.
I feel this approach will lower the stress level in such mergers. United under a shared value or core statement, employees receive an active role in “trimming the fat.” Practices can see where excess product inventory might present problems, reroute procedures to cut unnecessary steps, and refine positions to allow employees to shine. When presented in this manner, the veterinary staff won’t find removing redundancies objectionable.
The Consolidated Veterinary Field
While my survey results revealed a higher percentage of private hospital workers than consolidated employees, times are changing. Mergers and acquisitions allow veterinary hospitals to pool finances, maximize the full benefit of human resources, reduce operating costs, increase efficiencies, and expand market shares. The future will likely hold more consolidated practices. But without a plan to handle inefficiency, such practices will continue to struggle.
Unless we work toward decreasing the high level of burnout among veterinary employees, such mergers might fail. The inherent stress of consolidation without lean thinking yields confusion, anxiety, and even anger. Job satisfaction falls away, and compassion fatigue piles up. Havoc reigns. Lean thinking provides the best solution.
Retain Quality, Contented Employees
Lean thinking divides the core value and concern of a practice among the entirety of the staff. Everyone’s voice gets heard and valued. When people feel integral to their practice, their self-worth automatically increases. I strongly feel this sense of self holds the key to breaking down those burnout numbers.
Even among consolidated companies, as employees speak up without repercussions, they’ll engage in the lean thinking process. A person wants to feel valued and valuable. Lean thinking promises to grant that possibility to our field and all of our employees. It’s a unique opportunity we’ve yet to explore. Moving forward, we have nothing to lose.
I’m sharing the full Burnout Survey analysis workbook. Feel free to slice and dice the dataset at links.vetintegrations.com/djuk4o and drill down into the segments you care about the most.