DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Nicole Palumbo, DVM

Tips to Make Your Day Less Stressful and More Productive

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We are all living through practicing during COVID. It’s an adjustment and we are all a little extra stressed throughout the day. But there has been a growing trend of burnout, negativity, and overall unhappiness seen in the veterinary clinic and it definitely is having a huge effect on everyone. To me, every day is a new day for something good to happen. I try to remain positive at work, which then impacts my team and the work they do daily. Here are some of my daily tips that can lead to a less stressful day and might help you become more productive.

1. Arrive early!

Nothing makes a day more stressful and irritating than arriving to work and already having several rooms waiting for you. You pretty much have already started your day in the mindset that you are behind and will always be behind. Continuing this pattern leads to burnout and an unhappy work environment. Setting your morning alarm an extra 15-30 minutes early will allow you time to get to work before appointments have started and give you the opportunity to get ready for the day. You can assess the appointments coming in, look over your messages and respond as needed, and review any lab work that you may have sent out. This leads to less stress at the end of the day as well since you will have taken care of most of your messages and calls to owners.

2. Pack your lunch the night before.

It sounds so simple but honestly, this can make or break your lunchtime.  Having an already packed lunch means you don’t have to waste time looking at menus, ordering food, waiting for the food to arrive and stressing about the delivery potentially being late. You will also feel better with a self-packed lunch versus spending unnecessary money on greasy takeout. Obviously, you may want to treat yourself from time to time but in general, having a pre-packed lunch means less stress for you.

3. Learn how to multi-task efficiently. 

You are a veterinarian which means you already know how to multi-task. You have done it throughout your entire schooling and continue to do it to this day. But there is a difference between multi-tasking and efficiently multi-tasking.  Trying to see three rooms at once only helps if you can switch your focus easily.  If room 1 needs blood work then have your technician get it running, write down your notes and switch to room 2. While your technician is discharging room 2 you can write your notes and then move onto room 3 while still remembering that lab work is running on room 1. But if all three rooms require large workups it’s not efficient to try to take on all three at once. Pick your battles and learn that trying to do it all can actually slow down your efficiency.

4. Leave your home life at the door.

One of my technicians states that her child tells her to take off her work coat when she gets home. It’s a cute way of saying, mommy separate your work life from your home life. I know it’s hard – your staff is like your second family. But if you continue to come into work upset about what may be going on in your home life, you are just going to spread that negativity throughout the day. Spending 15 minutes complaining about how you have so much laundry to do at home means you just wasted 15 minutes that could have been used to write notes, call owners, or finish an exam. We all need a little time to vent but if that negatively continues to make your day worse, then it really isn’t helping you decompress.

5. Utilize your technicians and staff. 

Your staff is the lifeblood of the clinic. You need to trust them and trust in them to help you with tasks.  Don’t be the doctor that refuses to allow their technicians to get blood or urine themselves. If you are worried they will miss something on ultrasound when obtaining urine then teach them what to look for to sharpen their skills. If you have technicians that monitor your hospitalized patients, trust in their skills of observation and let them guide you to change or keep certain treatment plans. Train your staff to feel comfortable going over lab results with owners and discussing the doctor’s plans. The more you use them the less stress on your plate.

6. Breathe

Take a few moments to just breathe, decompress and assess the situation. You are the doctor, you are the rock. If three emergencies come through the door and you have frozen, then the rest of the staff will panic. Know that if you push through with a positive attitude it will be easier to get through those unexpected rough moments. Yelling at the staff, blaming the staff, or getting mad at the circumstances of the emergency will never help you in a time of crisis.

I’m not an expert but I know what has helped me the most over the last several years of practice. Walk into work happy and ready for the day and likely you will leave work a happier person as well.

There I Said It: What Happened to Common Courtesy?

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Courtesy: The showing of politeness in one’s attitude and behavior toward others.

I am only one person. The world does not revolve around me. I am a small part of this universe. I was raised to be polite and respect others’ time and schedules. My mom taught me that it’s better to show up a little early than to show up late. I get so embarrassed when I am late and will profusely apologize and dwell on how my actions may have impacted someone else. I showed up an hour late to a dress fitting and didn’t admit my mistake until I left. I sent several apology emails because I felt so bad that I wasted the shop owner’s time.  

Lately, I have noticed a lot of people have no respect for other people’s time and frankly don’t care. They honestly don’t care. They will show up late for appointments and demand to be seen. They will make excuses to blame the business for them being late and not take personal responsibility for their own actions. They will threaten to go to social media if we refuse to see them. They will threaten to obtain their records and go somewhere else. They will scream at our staff, call them stupid, swear profusely and literally act like they are the only person in the world who needs help. 

It has, unfortunately, gotten worse with the recent pandemic. Everyone is already on edge but these people are even more ramped up. We are dealing with real-life and death emergencies and some clients will actually tell us their dogs ear infection is more important than a pet that was hit by a car. They refuse to reschedule. They refuse to pay ER fees to be worked in. They refuse to care about the veterinary staff that has been working 12+ hours without any breaks. They honestly don’t care about anyone except themselves and it needs to stop.

Common courtesy – that is all I am asking for when it comes to how you treat my staff. If you are late, own up to it and realize that you may need to reschedule. If you have a sick animal and the clinic is booked, you are likely to pay ER fees so we can work you in. If you messed up and didn’t call in your refill of medication soon enough, don’t yell at our staff for not having it ready in 5 minutes… own up to it and be courteous to your fellow man. We all need a little kindness right now.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Becoming a Manager During a Pandemic

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In February of this year, I was chosen to become the new managing DVM of the hospital where I currently work. I was to take over the role April 1st, 2020. At the time I had been out of school for almost 8 years. I was excited. I had so many ideas. I wanted to change so much. I wanted the clinic to become loved by all. I wanted us to grow and become like a family. And then… COVID-19 hit. 

A few weeks before I was to take over as MDVM, the news was spreading in regards to veterinary clinics potentially having to shut down due to the pandemic. This was mid-March so it had not really affected our area but all of the doctors were getting news from the AVMA and local representatives that we need to have a plan in place. Even though I wasn’t officially the managing DVM, everyone kept looking to me to create a plan of attack. With the help of another colleague and the support of corporate, I put out a message for the clinic and our clients regarding what changes may need to be incorporated during this time. We wanted people to be prepared if we had to go curbside or limit entry into the clinic. Unfortunately, a few days later I was told I was overreacting and overstepping my boundaries. I was defeated. I was just trying to make the staff feel safe during an uncertain time. I’d rather be over-prepared than underprepared. But I was told to hold my horses and not take the virus too seriously. 

A day later, our office manager put herself in quarantine due to recent travel out of state. Three days later, our state went into non-essential business lockdown. A day later, twelve members of our staff went on furlough due to having young children, sick/immune-compromised parents, and lack of resources for their kids during the school shutdown. The next day, the current managing DVM became sick and went on quarantine for two weeks. It wasn’t even April, but I was pushed to handle what was going on. I was asked to step up during this unprecedented time. 

April 1st came and went. I still haven’t fully received any major training for the job. With the lockdown, most of the corporate staff were forced to work from home, which meant no “in person” training for me. The weekend MDVM training courses were canceled. I couldn’t even rely on the former MDVM to help out because they had gone down to part-time and we had opposite schedules. I can’t blame corporate either – they were giving me weekly updates and holding phone conferences to help with any issues that were occurring. My main goal was to keep the staff from quitting and setting the clinic on fire. It was tough. The sheer amount of angry clients and non-clients was outrageous. I can’t even count the number of times my staff was verbally abused over flea medication. We all felt mistreated every day, and sometimes it was hard to get through the day. 

It is now almost June. The county is partially reopening. Most of our staff is back in action. We are still faced with a lot of angry clients and non-clients daily. I am still figuring out how to run a hospital. But I think if I can make it through a pandemic then when things get back to normal (or as close to normal as we can get) this job will be a piece of cake. Who am I kidding? It is going to be rough, but I am stronger because of the crisis and the help of all of my staff during this difficult time. You never know what you can achieve when you are put in the hot seat. I think one pandemic is enough for me though.  

Stay safe everyone!

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

No, We Don’t Offer a Money-Back Guarantee

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“I wasn’t satisfied with my visit, I want a refund.”

“The bloodwork was normal, so I can get my money back, right?”

“The treatment didn’t help. I want my money back.”

For anyone in the veterinary field, we hear this a lot. It seems like owners believe that if they complain enough they will get money back. I can understand why. With the current trends, many companies offer money-back guarantees on their products. Didn’t like the food? Here is a coupon for a free meal. Product was defective? Here is your money back and a discount on your next purchase. We are used to getting it our way but owners sometimes forget that medicine is not an exact science and there isn’t going to be a money-back guarantee.  

Examinations and laboratory work take time and money to complete. When the results are not favorable people tend to demand their money back. They forgot that they aren’t paying for a good outcome but they are paying for an expert to help them get to the bottom of their pet’s issue. This can be as easy as one appointment or as difficult as a long-term ailment. Sometimes it’s a bit of a trial and error concept when treating certain diseases. It doesn’t mean that if one treatment doesn’t work you get a refund though. Yet unfortunately, a lot of people will demand money back or a discount because they are frustrated.

A few examples of this are exploratory surgeries. Veterinarians are often faced with the decision to urge an owner into exploring an abdomen or waiting to see how they do on fluids. An exploratory surgery can give us a quick answer but it can also be an expensive answer if there is a negative explore. I have had owners ask if we will give them money back if the explore turns out to be negative when in fact it was a diagnostic test giving us a lot of information. The same goes for cases of parvovirus.  We can put an animal on every treatment imaginable but in the end, if the dog’s own immune system doesn’t respond we are going to recommend euthanasia or the patient may also pass away on its own. In those cases, I have had people complain they spent 2000 dollars for nothing. We understand the situation is frustrating but medicine is not black and white. 

Sometimes client frustration leads to blackmail. Yes, daily veterinarians deal with clients blackmailing them into discounts, payment plans, and writing off a balance because they threaten us with bad reviews. Many of those bad reviews aren’t valid – see my prior article on how to decode them. But unfortunately, people are so used to complaining to get their way that they use it to blackmail veterinarians into cutting corners or the bill. This doesn’t help the pet and leads to more frustration and anger.

There is a reason we don’t offer money-back guarantees. We aren’t god. Some animals don’t play by the book. Some animals respond adversely to medications. Some animals don’t show symptoms until its too late. Sometimes we can do everything correctly and the outcome is poor. Medicine is not an exact science. As clients, we hope that you understand this and realize we are doing our best to help you. We aren’t a restaurant where you can complain about the cut of meat or lack of salt in the sauce. 

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

They Just Want To Be Paid

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I’m unsure what workshop has instilled the notion of “perks” to keep employees happy but I have to respectfully disagree with it. I will admit, knowing there is going to be a free lunch after a rough day is nice but I can’t help think of better uses for that money. It seems as though there is always enough money for free treats or lunches but when it comes time to discuss raises or 401k matching the money magically disappears. 

I know running a business is not an easy task but I can tell you as a person who started at the bottom it is easy to feel discouraged regarding job security and respect when you are barely paid slightly above minimum wage. In the veterinary clinic, the veterinarians are ultimately the ones who make the decisions and the money to keep the practice open but without the support staff, we could never be as successful. We ask so much of our support staff daily but a lot of the time their pay does not reflect that. Technicians are burning out. They are seeing jobs at grocery stores and fast-food restaurants that are offering higher hourly wages and frankly less stress than their current jobs. A love of animals sometimes isn’t strong enough to keep them in the business. Some of them are getting stolen away by corporate practices that can offer higher wages. Some are just leaving the field altogether. 

Recently I created a survey for technicians and shared it with some other clinics to gather data. It was anonymous and had simple questions so I was able to gather this information without bias. The questions ranged from how long have you worked at your current practice, to hourly pay range, and the affordability of living on their own. Out of all of the responses, even with seniority and higher pay, not one technician could afford to live on their own. Most technicians’ pay ranged from $11 an hour to the highest and most senior at $17 an hour. Many technicians admitted to having side jobs, despite working 40 plus hours a week as a technician. All technicians felt severely underpaid for the type of work they are required to do. The majority, but not all, went to veterinary tech school and have acquired sometimes up to $40,000 in student loan debt. Let’s do some math to get the full picture. 

Say I am one of those technicians that are paid $11 an hour. With taxes and potential healthcare taken out, I am making roughly $1300 monthly if I am lucky to work a full 40 hours a week. With my student loans at about $300 per month on standard repayment, I have about $1000 dollars left over for rent, utilities, phone, weekly gas and food, and clothing – not including emergencies. In most cities- even rural areas- rent alone can cost between $550-800 for a studio apartment. If you want to save money and find a roommate most two-bedroom apartments can be as much as $1000-1400 depending on the city- not including utilities. If you do the math – every month that person is in debt. For a lot of the younger veterinary technicians, unless you are married or have help from family, you cannot afford to be on your own. Even when you look at the math on the technicians making slightly more, they still are barely scraping by if they want to enjoy their jobs and life. 

We complain about not having good help or people who are willing to work the hours we do but we forget how little these people are paid. The lives of many of our patients are in their hands and technicians deserve better. We cut costs with generic medications and discount services for our best clients but when it comes to our own staff we undercut their worth. As with any company, the workers may be replaceable but the people themselves truly are not. Maybe this means we increase everyone’s base hourly or maybe we start treating them like the crucial part of the hospital and start them on a salary? Either way, we need to pay them better and hopefully stop the burnout and loss of good employees. Remember, the business may rely on the veterinarian but without the support staff, we cannot truly function.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Stop Dumping On Your Receptionists

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“The job isn’t hard, why can’t they do it right?”

I’ve heard it time and time again. Receptionists get dumped on by veterinarians, managers and sometimes by one of their own. We take our frustrations out on them because of poor scheduling, client messages and even the inability to decipher what a client meant on the phone versus what was really happening. For those of you who haven’t worked reception in a busy animal hospital, you truly don’t understand how trying and difficult the job can be at times – especially if you haven’t trained your staff appropriately.

I remember several major screw-ups when I was a receptionist that could have been prevented if I had a better knowledge of simple medical issues. I almost let a hypoglycemic puppy wait in the lobby until their appointment time because I didn’t recognize what was happening. I scheduled a blocked cat for a regular appointment instead of them rushing in immediately. It happens to the best of us but that doesn’t mean we don’t know what we are doing. Receptionists play a huge role at the clinic and instead of continuing to reprimand them for the same things over and over again, maybe we need to start retraining them and listen to them when mistakes have been made. As a former receptionist and now veterinarian, here are a couple of tips for both receptionists and for training receptionists that can help create a better environment for all.

1. Carry a small notebook with you at all times.

When in doubt always write down information that has been given to you by clients or staff. It’s not easy to remember everything after you put a client on hold and when presenting information to a technician or veterinarian it’s best to have it all on paper so you can give accurate details. 

2. Follow a script in your mind when obtaining details.

When getting information from owners always remember to ask, are they a client, their name and pet name so you can look up the account and any other details you can get out of them. Too many times I’ve seen veterinarians get frustrated when a receptionist asks them a medical question, but then doesn’t know if they are a client or not. We cannot give accurate medical information if we don’t have the full picture. 

3. Set boundaries and rules regarding callbacks.

If someone calls demanding to speak with a doctor about an animal your clinic hasn’t seen in two years, putting a message in for the doctor is going to cause a little bit of an uproar. Many clinics just deal with these calls and pass it on to a technician, but in all honesty, they shouldn’t make it past the front desk. Receptionists, you are the guardians of the telephone. The floodgates open and close because of you. Even having a protocol for difficult clients unwilling to make an appointment without speaking with a doctor will save you a lot of annoyance. 

4. Set boundaries for work-in appointments.

No one likes working through lunch but sometimes we blame the wrong person and take it out on the receptionists. No one wants to disappoint clients but setting up a plan for when you are booked is going to stop a lot of headaches. Be upfront with your receptionists and create a game plan. It may be as simple as, no more appointments unless dire emergencies. It may be, we cannot see anything else right now, please tell them to go to the local ER. Either way allows your receptionists to work for you, not against you. They are not mind readers and need direction when it comes to overbooking. 

5. Make sure your trainer isn’t the one creating poor habits of the rest of your receptionists.

This is a big problem I see. We have someone in charge of training but they don’t follow the rules either. It’s not the fault of the trainee if the trainer isn’t doing their job. Poor habits like overbooking one vet more “because they can keep up” or ignoring clients in the lobby to chat about other clients will continue to get passed on if you do not set up protocols. If your head receptionist won’t follow the rules then it’s time to do some rearranging. 

6. Have simple medical training for all receptionists.

I am not talking about a full education on every medical issue that can pass through the clinic, but basic knowledge can be key. If your clinic has monthly meetings you can take this time to discuss a new subject. You can also create a “cheat sheet” for receptionists to refer to when getting client information. We still want receptionists to come to the doctor with medical questions but giving them some medical knowledge will make them realize how dire a situation might be. 

Please, don’t belittle your staff. They aren’t stupid. They aren’t doing things on purpose. Possibly they weren’t trained properly and you are likely the one at fault. Take some time to re-educate them and you will have better communication for those involved. 

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.