The Wagging Tail

In this day and age with “YouTube” and countless reality television shows, the attraction of fame has become a part of our daily lives. We probably know the names and faces of more people today than we have ever known as a society before. So I wonder, was the desire for fame and adoration in any way a factor in my choice to become a veterinarian? Was it part of yours? I must say in all of my conversations with my colleagues, even the few who have obtained some type of notoriety, the desire to be “famous” was never a part of their dream. 

Many of us decided to become veterinarians at a young age because we love animals. I often ask the new doctors I interact with, “When did you decide to become a veterinarian?” The response is often something like: “When I was 9-years-old!” And  when I ask “Why?” it’s usually: “Because I love animals.” In no other profession do we decide so definitively to become a part at such a young age.
 
As we struggle with all the hardships of studying hard in high school and college, volunteering to get experience, the rigorous process of acceptance to veterinary school and the difficulty of getting through veterinary school itself, do we need to be encouraged to keep going because “you will have fame and fortune in the end?”

I had to push myself hard to become a veterinarian, but I’m okay if fame and fortune are not part of the package. And I’m willing to bet you feel the same way too. It’s my mission to care for the sick, to be a voice for the voiceless – and I find great joy day-to-day interacting with our non-human friends. The rewards far outweigh any notoriety. What motivates and sustains you as you practice veterinary medicine?

Maybe our young people who dream of being a reality television star or the next “Idol” need a different kind of hero to admire. I nominate an individual whom represents hard work in academics, continues to develop skills throughout his/her lifetime, and who cares for the little creatures who can’t speak up for themselves. But whether or not I am ever sprinkled with fame and fortune for my contribution to society, I will still consider veterinary medicine the most rewarding profession in the world.

When dealing with clients, each of us brings our personal experience and background to the exam room.  My most successful classmates were those who could adjust their mannerisms, word choice and overall style of communication to fit the client’s comfort level, rather than expecting the clients to somehow adjust their level of understanding. 

I am very much of an introvert at heart, and early on I had to force myself to look up, smile, make eye contact, etc.  If the clients understand the message that we’re trying to communicate, then we’re more likely to be successful at providing high quality medical care to our patients and feel rewarded by having clients who understand and appreciate us. 

By practicing three methods – courtesy, concern and active listening, I dramatically increase my success when dealing with clients. 

Common courtesy begins as soon as the client enters our facility.  We acknowledge the client with a smile and eye contact.  If we’re busy helping other clients, we let them know that we’re aware of them and will get to them as soon as we can.  When possible, we try to call clients by their name, address their Pets, ask about their family, etc.  Every client is a VIP client. 

Showing genuine concern for a client makes them more likely to trust my recommendations.  In the exam room, I always try to relate a quick personal story to my clients to let them know that I can identify with them.  If they have a boxer, I let them know that I have two boxer puppies right now “and boy do they keep me busy!”  If they have a cat with diabetes I tell them about my cat Jon Tom who lived to the ripe old age of 22 – who by the way, also happened to have diabetes.  It really helps to build a bond when they know that I’ve been in their shoes.  It only takes a minute or two to make this connection, but this connection can last for years.

Actively listening can prevent the misunderstandings that often lead to client complaints. Active listening involves observing body language, facial expressions and tone of voice.  To ensure that I understand the client, I repeat what they’ve said.  For example, “Fluffy has been vomiting once a day for the last week, is that correct?” When I address the client, I speak slowly and clearly in terms that they can understand.

I recently saw a Pet on recheck whose owners went to “their regular vet” for an ear infection, walked out the door with a full set of vaccinations, heartworm prevention, flea prevention and home dental care – but their Pet still had an ear infection.  To avoid these kinds of misunderstandings, I always end each visit with, “Is there anything else you wanted me to check on the physical exam?”  or “Is there anything else that you wanted to talk about?”  I remind them to call us if they think of anything else when they get home.
Effective client communication is a learned skill, but one that I know is extremely important to the success of my practice.  I remind myself each day to be courteous, find a common connection, and really listen to my clients. After all, practice makes perfect.

In this unfortunate economy, many owners are choosing to lay off valuable staff in an effort to save money and you may be wondering if you should too.  And while you never want to be overstaffed – particularly during difficult economic times – you can ill afford to lose experienced and talented staffers now more than ever.

In fact, most practices are understaffed. Ironically and counter intuitively, high-performing veterinary practices actually spend a greater percentage of gross income on staff salaries and wages. This fact is supported by at least three studies:

• Dynamics of a Successful Practice Study (Arthur Andersen)
• The Well-Managed Practice Study (Advanstar/Wutchiett-Tumblin & Associates) (http://www.wellmp.com/PracticeStudy.html)
• KMPG Mega Study (http://www.ncvei.org/kpmg.aspx)

How is this so? Having an adequate number of competent, capable, well-trained staffers allows two important things to happen: Doctors can spend more time with each client and patient and doctors can see more clients and patients in the course of a day.

Compelling evidence from other health care professions also supports keeping your staff.  In the 1980’s, optometrists nearly doubled their staff to doctor ratio. The result? Each doctor enjoyed an additional 50% patient visits. The additional staff per doctor created enormous capacity for optometrists.

Dentists with hygienists see 23 more patients each week than those without a hygienist. More food for thought: All human health care professions have roughly double the staff to doctor ratios seen in veterinary medicine, allowing the doctor to see two to three times the number of patients. In fact, the Medical Group Management Association (www.mgma.com) has discovered that mid-level providers produce a 200% return each year. A nurse paid $90,000 is likely to increase practice production by $180,000.

It’s also important to note that employee satisfaction plays a large role in business success. The Harvard Business School Service-Profit Chain (http://hbr.harvardbusiness.org/2008/07/putting-the-service-profit-chain-to-work/ar/1) . pointedly depicts how profit is achieved in a service business:

• Profit results from client retention
• Client retention results from client satisfaction
• Client satisfaction results from outstanding client service
• Outstanding client service results from employee retention
• Employee retention results from employee satisfaction

Before making any layoff decisions, it’s wise to determine how staff layoffs would impact employee satisfaction.

Ultimately, avoiding layoffs and keeping your practice fully-staffed should positively impact your practice. You’ll be able to spend more time seeing clients while your staff continues to provide outstanding client service.

If you’ve got kids in school – whether they’re big, small or in-between – I’d wager you’re feeling more stressed and overwhelmed right now than most other times of the year…except maybe the holidays.  Even if you don’t have children, it’s inevitable that you’ll see clients who are struggling with the stress that comes with this time of year. 
Back-to-school time creates an additional “whammy”  into what already feels like a hectic lifestyle. And what is it about June, July and August that makes them sail by so effortlessly, then only to meet their ending with such an abrupt exit?

It’s funny because just as soon as you figure out your summer routine and things seem like they’re clicking along, bam! It’s time to once again, re-adjust to a new school year and all that it entails. And when you’re a professional trying to balance two worlds…new bus routes, new teachers with new sets of rules and expectations, homework, daycare and the unexpected minutia that comes-up in the hospital, it can all take a toll on your mental state. 

How do you get through this time without making it hard on yourself, your family, your clients, patients, staff and the guy who just passed you without using his blinker?  I think it begins with a change in perspective.   

It’s important to first recognize that everyone is struggling, trying to make it all work.  Consider that frazzled client in front of you in the exam room…  What could you do to let him/her know that you understand what they are going through?  Even just a knowing smile can help ease tension they may be feeling. 

This time of year, it’s also helpful to remember the old saying, “This too shall pass”.  There’s a lot of wisdom in those few words. And although school season will always be busy, back-to-school really only lasts a few weeks or so. Taking yourself out of the moment and realizing that this time is short-lived can help you gain a gentler perspective on where you (or your clients) are at this point. 

Does anyone remember the story of how penicillin was discovered?  Alexander Fleming was discarding some contaminated Petri dishes in his lab and he observed that a plate culture of Staphylococcus had been contaminated by a blue-green mold and that colonies of bacteria adjacent to the mold were being dissolved. Curious, Alexander Fleming grew the mold in a pure culture and found that it produced a substance that killed a number of disease-causing bacteria. Naming the substance penicillin, Dr. Fleming in 1929 published the results of his investigations, noting that his discovery “might” have therapeutic value if it could be produced in quantity.  Wow, pretty neat stuff when you consider he could have just said, “Hmmm,” and thrown them away. 

So you are at work, and you have lots of appointments scheduled, drop off patients and procedures.   A few are having routine survey radiographs taken.  Many are having fecal exams and blood work. You take a look at a blood smear slide, everything looks o.k.  What’s that little spot there?  Probably nothing and we move on. Could we have missed something new?   Have many of us have been seeing the same thing and disregarding it as an artifact?

There are discoveries waiting to be found everywhere.  Whether it be a new drug, a disease or some as of yet unknown species of parasite, we will never find it if we don’t let ourselves be open to discovery.  A mindset of “opportunity vs. monotony” can change the way we see each day and how we practice veterinary medicine. 

So many of us can get into a rut that leads to professional burn out.  How can we keep our practice exciting?  Try not to look at each day as a day full of the “routine” vaccination appointments or the “typical” surgery.   Look at each case for its unique nature and not its sameness to the rest.   An attitude of discovery and opportunity can change our entire perspective in veterinary medicine.  

Just when we think everything is “known under the sun,” someone finds a whole new animal species or family of bacteria, even in impossible places like boiling geysers – that discovery lead to the polymerase chain reaction!  Try to find the opportunity in each day, in each case and you may be shocked at what you find.