The Wagging Tail

If you haven’t actually started an official gift list, you’ve more then likely begun thinking about what you want to do to show your friends, family and co-workers that you care for and appreciate them this holiday season. But loved ones aren’t always the only ones on our minds this time of year. Many of us feel a tug at our hearts, a heightened sense of awareness for the less fortunate, including “the forgotten ones,” the well-deserved Pets who have no one to take care of them. Given this, I thought it would be appropriate to share some great ways to give back to the Pet community this Yuletide season.

Consider volunteering a few hours at your local animal shelter. 

I know you already spend a ton of time with animals, but volunteering at an animal shelter can do a lot to brighten an animal’s day, not to mention provide well-deserved relief for a weary kennel worker. And if you have a niece, nephew or children of your own, bring them along!  Giving back will give you the satisfaction that only comes from helping others, (not to mention get you in the holiday spirit) and will set a philanthropic example for our rising citizens.

 Be a part of the Season of Suppers Campaign.

Banfield Charitable Trust (BCT) and Meals On Wheels Association of America (MOWAA) are teaming up this holiday season to help homebound seniors feed their pets.   Helping keep companion Pets well fed, healthy and part of the family for as long as possible is the primary focus of this initiative.  You can donate Pet food or money at your local Banfield hospital.  You may even want to support a Season of Suppers fundraising event in your community. All proceeds will be donated to the Season of Suppers Campaign.

Give to your favorite Pet-focused charity. 

There are tons of them out there, so I did a little research and came up with six well-deserving and reputable organizations worth considering:

• The American Society for the Prevention of Cruelty to Animals
• Humane Society of the United States
• World Wildlife Federation
• Dogs for Deaf and Disabled Americans
• Delta Society
• National Association for Search and Rescue

Hope this information is helpful. Remember, even the smallest of efforts can bring about a measurable difference in quality of life. If you have a few minutes, I would love to know how you plan to give back this holiday season.

“There’s only so much I can do!”  How many times have you wrestled with the feeling that you didn’t accomplish enough?   At the end of the day, you think about the patients and clients you interacted with, reflecting on whether or not you did everything you could to measure-up to your standard.  Your mind then shifts to a conversation you had with a team member that morning, and you question the way you handled the exchange. 

Dealing with sick animals, bereaved clients, newly hired team members, managing the practice and trying to be the family person you want to be is a tall bill.  Being a veterinarian is rewarding and yet, absolutely taxing – physically and emotionally at times.  You love, and are devoted to, your family and your job, but the demands of both get to you, maybe more often than you’d like to admit, even to yourself.

Renee Rucinsky, DVM, DABVP, and contributing writer for dvm360.com, refers to the feeling of emotional overload in her article, Compassion Fatigue. What is compassion fatigue?  We know that compassion is about feeling for others while fatigue is related to a lack of energy. Dr. Rucinsky believes that compassion fatigue is a state of complete exhaustion that leaves a person feeling physically and mentally overwhelmed.

No doubt, we’ve all experienced extreme stress at times, but veterinarians are more likely to suffer from compassion fatigue for a number of reasons: 1) the profession inherently calls upon vets to deal with many intense emotions on a daily basis 2) vets are innately caring people which means they feel for others on a very deep level, and 3) vets tend to be perfectionists, which causes them to expect too much from themselves. 

What can you do to combat compassion fatigue? First, know the symptoms. In Dr. Rucinsky’s article, her list includes, “excessive complaining, isolation, compulsive behaviors (excessive spending, eating or other addictions), poor sleep habits, poor hygiene, apathy, difficulty concentrating, recurrent infections or chronic aches and pains.” Using a few of Dr. Rucinsky’s techniques as a guide in fighting compassion fatigue, start by saying “No” to stepping out of the exam room to answer that non-emergency client call, and reduce your stress by empowering your team to handle any issues that arise.

There are steps you can take to change things – and that might even include seeking professional help. We all know what’s good for us. Dr. Rucinsky touches upon the usual such as regular exercise (taking a brisk walk during your lunch hour), making healthy food choices (brown bagging it instead of heading for fast food), surrounding yourself with positive people (the vet tech who’s always willing to jump in and help wherever needed), for example.

If you start from within, you can consciously change your attitude – and that’s a good first step to a better outlook on life that will ultimately help you combat compassion fatigue.

Most of us came to this profession as a calling, not as a result of a measured analytical decision process. Veterinary professionals share a sincere, idealistic, and passionate desire to give back by helping Pets and families.  We are excited by the opportunity to participate in that magic bond between Pets and their Pet parents.  It turns out that our choice of profession was not only a sound emotional decision, but also a good rational choice given today’s uncertain and changing economy.

Since 1972, the U.S. economy has suffered through six major recessions.  Through the previous five the overall gross domestic product (GDP) shrank while the veterinary profession grew.  The current sixth recession is once again proving to be kind to our profession.  According to Fritz Wood CPA, CFP and noted veterinary accountant, eighty percent of small animal veterinary practices are continuing to grow despite the current economic climate.

The Pet care industry (of which veterinary medicine makes up the lion’s share) accounted for $23 billion in 2008.  This is projected to grow to $34 billion by 2013.  Currently the second fastest growing segment of consumer spending is Pet care (second only to consumer electronics).

The Bureau of Labor Statistics reports Certified Veterinary Technician as the second fastest growing profession and Veterinarian as the ninth fastest growing profession.  New graduate veterinarians and technicians continue to entertain multiple job offers.

Veterinarians continue to be ranked as one of the most admired professions. In fact, Money Magazine (November 2009) just listed veterinarian as one of the top 25 “Best Jobs” in America. Veterinarians were ranked as an “A” in benefiting society and scored near the top of all careers in job security, personal satisfaction and future growth. 

And it just keeps getting better!  The bond between Pets and families continues to grow stronger.  Technology is allowing us to do things we couldn’t even imagine a generation ago, and a huge number of Pets remain in need of quality veterinary care.

The economy will rise and fall, recessions will come and go, but the bond between Pets and families continues to grow, and the need for great veterinary care is stronger than ever.  There has never been a better time to be a veterinary professional!

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. 

Often times when asked what I do for a living, I respond by saying, “I am a veterinarian.”  Then I wonder, What does a veterinarian look like? So I qualify my response with, “I work as a veterinarian.”  Either way, the revelation of my career inevitably invokes wonderful stories of beloved Pets. Most people are so happy to talk to a veterinarian!  They hold us in high esteem. They smile with pleasure as they share their stories. Who smiles when talking about visiting a doctor? Our clients!

I am proud to be part of such a well thought of profession.  I often call myself “The Good Doctor” when I tell people that I AM a veterinarian.  And I realize that with my chosen career path comes a certain responsibility to be a part of local, regional, state and national VMAs.
It’s easier as a student. SAVMA is a visible part of our curriculum, and many of us attend the AVMA meetings annually as students. Let’s not forget to do that as graduates! The helm of the associations must eventually pass onto the next generation of veterinarians. YOU are that next generation of bright young veterinarians, and I can’t encourage you enough to become a member of our professional associations after graduation.

Become involved in your local VMA and AVMA. Become a spokesperson in your association that the media can contact for Pet health expertise. Be ready to lobby for veterinary related topics with your local politicos and VMAs. The profession needs you!

Each year, the Georgia VMA hosts a ‘Veterinarian on the Capital Day’ in Atlanta where all GVMA members are invited to the state capital for networking and recognition. On that day, we attend sessions of the state senate and house of representatives, and we receive recognition from each legislative body. When they call us to stand and be recognized as the caretakers of Georgia’s animals, there is palpable pride of self and profession in the air. The governor of Georgia is a veterinarian. He comes down to meet us and takes a photo with the group. It’s pretty cool to be a part of the Georgia State VMA and know that our state values our contribution.

Before you shrug off joining a VMA, think of how you can be a part of representing your profession just by being there. Paying your dues to support your local/state VMA actions will help support our profession in Washington.
 
When attending AVMA there is such a sense of collectiveness. You look around and though everyone doesn’t look like you, they are you. Those other veterinarians share with you a common thread of education, long nights of study, sweat, tears – and most importantly – a common passion. I not only work as a veterinarian, I am a veterinarian. And WE are our profession.

I have provided financing for the purchase of over 150 veterinary practices and millions of dollars of equipment.  I have reviewed easily five times that number of transactions that never got completed.  As I read through these loan applications, I often ask myself whether the applicants really understand the economics of owning and running a veterinary practice.

There is no real “magic” to understanding the basic economic principles that rule the business side of practicing veterinary medicine.  At its core, you need to be able to generate enough cash to service both your fixed and variable expenses plus provide a return on your investment (the purchase price of an existing practice or cost to set up your own practice). 

Fixed expenses are those that occur weekly, monthly and annually and are not related to changes in revenue.  This includes expenses such as rent or the mortgage payment.  It includes other general expenses such as insurance, utilities, office supplies, repairs and maintenance.

Variable expenses are those expenses tied to revenue.  For example pharmaceuticals, medical supplies, support staff labor and veterinary salaries (including that of the owner for their clinical services while working in the practice). 

After accounting for both fixed and variable expenses, the “net profit” is what remains.  There are more expenses, however, that drain on net profit.  The most prominent are interest, depreciation, and paying off long-term debt. For an intriguing article about today’s Veterinary Economic Reality, click here

As I review loan applications, one of the first things I review is the applicant’s personal financial situation.  I apply the same criteria to them that I do to the practice they want to purchase.  What are the applicant’s fixed and variable expenses and will the practice they want to purchase generate enough cash to meet those expenses?  What I find to be most troubling is that many veterinarians applying for practice ownership have piled on fixed expenses to the level that it becomes nearly impossible for a practice to support such a cash load. 

Take, for example, student debt.  I have seen some students graduate with upwards of $200,000 in loans.  If you see 15 Pets per day, five days per week, for the next 20 years, $5.00 of your Average Patient Charge (APC) is going to have to go to paying off just your student loans!  Add in the home loan (or rent), car loan (or lease), insurance, utilities, food and other expenses and generating a true profit from the practice (a return on your original investment) starts looking more difficult.

There are only two things one can do to control the economics of veterinary medicine.  Either control costs or increase prices (margin).  The idea of personal fiscal responsibility needs to be addressed with students and new veterinarians if they have practice ownership as a goal.  They need to understand that it will take sacrificing the things they want today in order to accomplish the goal of practice ownership in the future.  

Did you know that when you open up to your team members, associates and staff at the practice, it actually helps reduce anxiety and stress, along with boosting your well-being? It’s true. Studies have shown it including one from the University of Michigan that appeared in the Science Daily.  The study focused on women specifically. Although the majority of veterinarians entering the field are female these days, I think this theory applies to both genders and is valuable information to know.

There was also an article posted on dvm360.com addressing the same thing. Gabbing, as they referred to it (or bonding) can make you happier and healthier.  The article also mentions gossip but no one condones spreading rumors or that type of behavior in the workplace.

You know, every year at this time, probably like you, I have the same problem. I struggle to keep it together and not bite someone’s head off. Interestingly enough, it was only a few months back, pre-summer, around April/May, that I remember looking forward to the lazy days of summer. But here I am, near the end of August, counting down the days to Labor Day and the stress of the kids returning back to school. I bet that you and a few of your veterinary staff surely can relate to this, having children of your own. Schedules are going to change, rides will be needed, conferences will need attending and so on. When I feel this familiar end-of-the-summer anxiousness hit, I know exactly what to do. I do what I always do when I’m about to lose it. I phone a friend. It always helps. You obviously wouldn’t do this at the hospital but I think conversing about these “common” or shared feelings during a down time, at lunch or between patients is a good way to build stronger, better relationships at the practice. It’s also another opportunity to connect by getting to know your team members on a more personal level.

Think about it. Sometimes the best stress-reducer is simply sharing your stress with someone else. Maybe it’s a complex case or a non-compliant client who is frustrating you, or just merely the day-to-day scramble of running a practice. The act of talking it out – and getting support and empathy from someone else – is a great way of blowing off steam and reducing stress.

It’s never too late to cultivate these important relationships. 

Last week I talked about doctors, whether they are the owner or not, having to balance their role as leader in the team with their role as a member of the team.  This week, I’m continuing the blog on the same subject and am offering some more friendly advice.

Support the hospital’s mission, protocols, standards, policies, etc.  If you’re the owner and the one who sets the policies, this is very easy to do.  If you’re new to the practice and you don’t understand a policy, have the owners explain it again so that you understand the idea behind it and don’t start a “war.”  There’s nothing more frustrating than a grudge between the “new” and the “old” or the “front” and the “back.”  We’re all on the same team, and very early on I banned the use of the phrases “front” and “back.”  I can’t remember the last time I heard such divisive talk.  I also try to get all of my team members to be at least partially cross-trained so that they appreciate the hard job that the “other side” has to do.

Never say “that’s not my job!”  That phrase is demeaning and belittles the employee to whom it’s directed.  Are you really too good to clean a cage or wipe a table?  Everyone who works at the hospital is there for the purpose of helping Pets.  We all need to do whatever is necessary to chip in and get the day’s tasks done so we can enjoy helping Pets while we’re at work and leave at an appropriate time to enjoy our families when we get home.  If you’re constantly busy, your team will want to be constantly busy.

Ask the team members about their weekend or their family.  Let them know that you respect them as individuals and not just as someone to sweep the floors.  Share quick stories about yourself, your Pets, family, etc.  What are your hobbies?  What are their hobbies?  One of my team members bakes cakes as a hobby.  How great is that?  I’ve bought birthday cakes and even an occasional “I love you” cake for no particular reason for my wife.  I think my whole team knows that in my spare time I’m a video game/computer geek.  Obviously there’s a balance to strike between sharing and “too much information” but don’t miss out on the human side of our profession.

If you’re new to the team and an associate doesn’t respect you, make sure to address it quickly, firmly, and respectfully.  Let everyone know that you’re interested in working as a team to take care of the Pets and provide great customer services and not in “bossing” people around.  Also, let them know that ultimately you have the legal and ethical responsibility to provide care for the Pets, so it’s important to find a way for them to respect your position within the hospital as team leader.

You want to be friendly and feel like part of the team, but you don’t want to spend your whole time cutting up and telling jokes.  You want to work efficiently and accurately and friendly.  Joke, tell stories, laugh, listen, live, but don’t forget to work.  Don’t work so hard at becoming part of the team that you forget to lead the team to the finish line.

Doctors have to strike a balance between being the leader and being a member of the team because if they spend too much time “leading” then they might be resented or looked at as a tyrant, and if they spend too much time being “just one of the guys” then the team might not work efficiently or truly respect the doctor’s position within the hospital. This is an especially delicate balance for young doctors and for doctors who recently joined a new team.

The doctor sets the tone for the entire hospital, so make sure you behave how you want the team members to behave. If you are on time, they will respect and understand why you expect them to be on time. If you adhere to the dress standards, then they will understand why they have to do the same. At my hospital, I always make sure to wear clean dress shoes, slacks and a nice shirt. When it was our policy for the male doctors to wear a tie, I always wore a tie. When the policy changed due to the risk of spreading germs, I stopped wearing ties. When a team member showed up with open toe shoes and I asked her to change them, she understood that I respected the hospital’s dress code.

Set a positive, friendly tone. Don’t let negativity take over. If you’re upset about a client, then take a quick break — walk outside, use the restroom, get a drink from the water fountain. Collect yourself and return to the team. I don’t try to hide the fact that I get upset, because everyone gets upset. But, I let the team know that I have the tools to handle it appropriately. For example, sometimes I take a deep breath and slowly count to ten. I do it quietly, but not necessarily in private. Let the team know, “Gosh, that was a difficult situation, but now it’s time to move on…” The team will learn by example how to do the same thing. I’ve seen team members close their eyes and take deep breaths or ask to step outside for a quick break. It makes me proud to know that they can handle difficult situations.

Don’t engage in gossip or make negative comments about other team members. It’s OK to say things like, “Hey, let’s be nice.” I have learned to immediately stop talking when I hear myself say or think something like, “I probably shouldn’t say this…but…” You never know who might overhear what you’re saying or how what you’re saying might hurt someone’s feelings, etc. You might think all you needed to do was “vent” and then move on, but the people who heard it may be deeply hurt.

I hope I’ve given you a little insight on balancing your role as leader in the team as well as participating as a member of the team. Part II of this blog will run next week. Look for tips on a few things like supporting your hospital’s mission, setting policies, pitching in to help no matter where it’s needed and taking an interest in your associates on a personal level while still getting their respect as team leader.

Seriously.  It is. 

Why do I always see shame on the faces of people who’ve not been able to stay on their diet?  I used to be perplexed by this, and then one day, the light bulb went on. 

We all think it’s our fault. Believing the diet plan is full-proof, most people blame weight-loss failure on either a lack of willpower or personal strength, never pointing a finger at the blueprint. 

But food is neither the enemy nor your BFF.  It’s fuel, plain and simple.  Eating food is physiologically necessary (especially if you want to keep up with the pace at your practice) and here’s where I make the comparison between food and urine.

Food.  The desire to eat is an internal indicator just like the urge to go. It has nothing to do with willpower, internal fortitude or character.  A message starts in your stomach and tells your brain Hey, I’m hungry.  Do something about it.  You either respond to the request by eating, or you ignore it. If you’re trying to lose weight, like many others, you’ll likely try to suppress the desire to eat and disregard the message. But ignoring it doesn’t make it go away.  And no good can come from not eating. Besides, how can you properly handle your patients without energy that comes from food?

Urine.  The same thing happens when your bladder is full.  A message goes up to the brain saying, Hey, I gotta go, which, of course, prompts you to begin looking around for a bathroom.  At your earliest convenience (maybe after you finish with your next client), you address the situation without giving it another thought and move on with your day.

An interesting thought to ponder: What would happen if you didn’t have a built-in monitoring system that notifies you when it’s time to go? Now I’m no urologist, but I know that if we didn’t eliminate the toxins in our bodies on a regular basis, there’d be a lot of sick people walking around, not to mention the mental torment and physical discomfort that goes along with holding it.  Not an enjoyable experience.  And really how effective would you be at work, at home, in life, if you suppressed the urge for an extended period of time?  Talk about unpleasant, distracting and absolutely pointless. 

No, I’d wager you’ve never thought about waiting as long as you can to and I also bet you’ve never connected this sensation with a flaw in your personality and yet that’s what people do, everyday, when it comes to eating. 

Are you guilty of going for long periods of time without eating, all in the name of I’m too busy? The practice needs me?  Do you think ahead by planning, preparing and bringing food with you to the hospital, in case you get too busy to take an official lunch break?  If you take the time to get rid of what you don’t need, you can stop long enough to take in what you do.

Basic principle of human existence: Hunger = empty tank.  Food = the fuel needed to fill the empty tank.  We need to make peace with our only source of energy, stop blaming ourselves for feeling hunger and take the time to give our bodies what they need.