Ernie Ward
DVM, CVFT
Opening Shots columnist Dr. Ernie Ward is an award-winning veterinarian, impact entrepreneur, book author and media personality. When he’s not with family or pet patients, Dr. Ward can be found contemplating solutions during endurance athletics and meditation and on his weekly podcast, “Veterinary Viewfinder.” Learn more at drernieward.com
If you have a question about practice life, personal well-being, leadership or veterinary careers, email openingshotstvb@gmail.com
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Q: We’re super busy and probably understaffed. I’m OK that we never get to eat lunch, but my boss gets frustrated when I sit down to grab water and snacks in between appointments. What can I do?
A: I feel your pain and hunger. Tell your boss that I’m frustrated by the number of veterinarians and practice managers complaining about poor staff performance and morale, yet they can’t find a way to let the staff eat lunch.
Production, attitude and resilience begin with basic self-care. Unless leaders make fortifying our bodies, minds and spirits a priority in an already stressful workplace, expect continued burnout, dissatisfaction and attrition. Allowing your staff 30 to 60 minutes off-site to refuel and recompose is simply good business. As far as sitting down to snack, that’s a no-brainer, but be careful that snacktime doesn’t replace a proper lunch break.
You identified several potential problems you need to address: improper appointment scheduling, inadequate staffing or improper training, and poor leadership communication. Start tackling those tough issues after lunch.
Q: I’m a veterinary technician in a small, one-doctor practice with a problem veterinary assistant. This person has a very abrupt way of speaking that many clients say is condescending and offensive. We get complaints every couple of months and have lost several clients. Others ask not to see her. Our employer apologizes for her behavior and then takes her off phone duty or appointments for a few days, putting more work on the rest of us. Aside from her attitude, this person is a very dedicated and hard worker, and some clients like her. My boss is very loyal to her for personal reasons, so firing is not an option. Everyone is extremely frustrated but at a complete loss for what should be done. Any suggestions?
A: This situation calls for a game called “Slow the Bleeding!” Whenever workplaces consciously keep employees who are bad for business, the objective is to find a job that reduces their damage. The only reasons I can imagine you’d ever dare play this are:
- The person is in a close relationship with the boss.
- She possesses a rare skill or talent.
- I can’t think of anything else.
A bright spot in your question is she doesn’t appear to be offensive or harmful to co-workers. If she is, the game is forfeited. You can’t slow that much bleeding.
But back to our current contest. Has your employer told her that she’s losing the game? Sometimes we presume that people know an issue exists, so make sure your boss communicates truthfully and directly. Simply pointing out the problem can propel positive change.
Let’s keep playing. Can she take a role that would minimize contact with clients? Can you create a position that leans on her strengths? Will she be happy?
The problem with these games is that our good staff and clients often lose. While we’re working out the rules and moves, complaints continue and morale plummets. I understand the situation might be hard for your boss, but making difficult decisions is your boss’s job.
Q: I hired a new receptionist who has done well during curbside service. As we’ve started seeing patients inside again, she’s struggled. She struggles to keep up with checkouts, asks team members a lot of questions and seems overwhelmed. When I approached her, she complained that she needs more training. Is she a keeper, or is this a glimpse of what’s to come?
A: You might have heard me say, “Complaints are camouflaged constructive criticisms.” In this case, I’m impressed that the new hire feels confident enough to ask for help. The transition from curbside isolation to lobby chaos can be rocky for rookie receptionists. The fact she did well during curbside is encouraging, but it doesn’t mean she has the skills needed to succeed in regular practice.
That’s where training comes in. To date, she’s been trained in an unusual workflow. If she’s otherwise a positive member of your team, I advise investing in more structured instruction. Assign a staff mentor to spend a few minutes each day fielding her questions and reviewing processes. I call this “one-minute training” and advocate for leaders to conduct brief coaching sessions throughout the day.
Give the employee ample support and feedback and see how things stand in a couple of weeks. If her performance continues to flag or the complaints amplify into personal attacks, the time might be right to cut your losses. Chances are she’ll soar, have even better questions, and hopefully improve your culture. I’ve always been grateful for employees who are willing to push back to make things better and know when to ask for help instead of going it alone.
Q: I’m in a rural, two-veterinarian practice that barely pays its bills some months. We do the best we can, but we serve a clientele who can’t afford the best veterinary medicine. A video CE speaker showed a list of expensive equipment like ultrasound and digital radiography and said it was the standard of care. I felt embarrassed and inferior reading her list of things I doubt we will ever have. Am I practicing substandard medicine if I don’t have all the modern high-tech tools?
A: I can relate. When I opened my first clinic in 1993, fresh out of veterinary school, my wife and I chose a small town in one of the poorest regions. Money was tight, and many pets paid the price of poor home care. Like you, we learned the art of compromise and how to stretch a dollar into 10. We had a World War II-era X-ray machine, and I thought we were big-time when I purchased a used ECG. We focused on providing the best care within a client’s budget, stellar communication and service, and a heaping dose of kindness and compassion. We grew that tiny clinic into a world-class facility that eventually enjoyed all the high-tech toys. I learned two valuable lessons:
- Optimize what you have and can control.
- Good veterinarians don’t blame their tools.
As for that “list,” each state veterinary practice act lists minimum facility and practice standards. I’m not aware of any that require ultrasound or digital radiography. Standard of care is determined by much more than the equipment you do or don’t have. It’s founded in your knowledge, interpretive and analytical abilities, and communication skills, and it’s constrained by client permission.
I might be a bit old school these days, but I’ve found you can diagnose a lot through a thorough physical examination, basic blood and urine tests, and radiographs. I’m sure we’ve both MacGyvered a fair share of creative diagnostic solutions. Surgery and medicine then become a bargain between what you can afford to offer and what your clients can afford.
Bottom line: Refer patients when needed or wanted. Don’t feel inferior when you’re doing the best with what you’ve got. And keep pushing for better.