A note for anyone who is, or who pays, a relief vet
I have come to understand recently that if you want to “go viral” as the kids say, you need to write things that divide the audience, scorch some earth, and elicit strong emotions. It also helps if you can “beef” with somebody like when Drake made Kendrick Lamar angry. So, I’ve decided to give going viral a try by disagreeing with someone on a topic that is sure to set the internet on fire: how relief veterinarians should get paid. Here goes.
In this month’s Today’s Veterinary Business journal (See? You can feel the viral coming already!) there’s an article called Should Relief Veterinarians Receive Production Pay? Relief veterinarians, for those unfamiliar, are the equivalent of substitute teachers in the vet world. They roll in when Dr. Thompkins throws his back out or Dr. Ashcroft goes on a honeymoon and keep the magic happening. Anyway, the basic idea in this article is that paying relief veterinarians based on how much revenue they generate instead of a flat daily rate might be a better, more motivating way to compensate them.
I want to be very clear here and say the article does not advocate that all relief vets should be paid on production. It primarily suggests that providing relief veterinarians with a productivity bonus could be an effective incentive, potentially making clinics that couldn’t otherwise afford them a viable option. I think this is actually a nice idea and don’t see a lot of downside to it if a clinic wants to give it a try.
I also want to say that I worked for many years as a relief veterinarian and … I was happily paid on production. (More on that later). There’s not a wrong way to work with relief veterinarians as long as everyone understands what the agreement is and goes into it with eyes wide open.
My concern with the article is simply that I don’t think it paints a fair picture of why relief veterinarians are not likely to want to be paid this way. I imagine practices showing the piece to relief vets who work for them and saying “See? It’s totally reasonable for you to get paid some or all of your fee based on how much revenue you produce when you are here.” I imagine the relief vet not having a journal article to hold up, and thus feeling like they must be missing something when they still think this is a bad idea.
I’m here to weigh in for the relief vet and say, in most cases, it makes a ton of sense to NOT get paid on production. Here’s why:
[Note for readers who are still wrestling with the whole concept that vets sometimes get paid based on the revenue they generate for the clinic – I am going to skip the debate about production-based compensation in general for veterinarians because it’s a whole separate can of worms. It’s interesting, no doubt, but it’s beyond what fits here so we’ll let it lie for today.]
When you are a veterinarian, the amount of revenue that you produce in a practice comes from three places.
- Your clientele – In general practice, highly productive veterinarians typically have an established client base that specifically requests them. This loyal clientele trusts the vet and is familiar with their recommendations, which saves time and raises the chances that the pet owner will agree to the services the vet is recommending. An established client base also ensures a consistent workload, reducing idle time at the clinic.
- Your ability to work efficiently – At an individual level, this means being able to move quickly because you know where drugs and equipment are located and are proficient with software. At the team level, this involves working seamlessly with your trained support staff. It’s really hard to be efficient when you’re learning the practice software, don’t know where anything is, don’t know who your trained technicians are or how they are used to working, and the people helping you don’t know your practice philosophy, preferences, or expectations.
- Your caseload – You can only take care of the patients who are put on the schedule for you to see. If you are scheduled to see a lot of cases, then you have the potential to generate more revenue than if you are scheduled to see very few. Also, if you are provided cases that will require diagnostic workups, medical procedures, or packs of preventatives for multiple pets, then you are probably going to generate a lot of revenue. If you are doing recheck appointments all day, then you are probably not. Caseload is an area where, if you don’t have a clientele, you are at the mercy of the person doing the scheduling.
Now, if you buy this idea that these are the three drivers of revenue for veterinarians, then you already understand why I’m going to say that production based pay rarely makes sense for relief veterinarians. A relief vet walking into a brand new hospital (1) does not have an established clientele and will be starting fresh with every client they see, (2) will not know where anything is or how best to leverage the support staff (or even how well trained the support staff is), and (3) will have no control over the cases that are handed to them. These realities make production-based pay highly risky for a relief veterinarian whose livelihood depends on this work. This arrangement minimizes risk for the clinic but shifts that risk to a veterinarian who typically lacks sufficient control to manage it fairly.
Again, I didn’t get the impression from the article that the author was saying “all relief vets should be paid on production!” I basically agreed with the points he made and the possibilities of rethinking how we use compensation. (Is this how online beefs work? Am I doing this right? Is this a lean beef?). After all, the idea of offering a bonus if a relief vet stays particularly busy seems to have few downsides.
Also, when I was working as a relief vet, I happily got paid this way. My primary objective at the time was to get work when I wanted it (and not to earn a living this way), so allowing clinics to just pay me on production made sense. The clinics didn’t have to worry too much about if they would have the caseload to justify me being there for a day, and I was fine if I just saw five or six appointments because it gave me time to work on other projects in the doctor’s office. I also recognize that often relief vets fall in with a small number of clinics and get to know the people, protocols, and clients to the point that production based pay might make sense for them. Finally, there are clinics that have fantastically trained support staff members ready to go and are more than willing to load relief vets up with cases that will allow them to generate revenue, potentially making this system work for everyone.
Ultimately, there’s no single “right” way for veterinarians and clinics to collaborate. As long as both parties enter the agreement with clear understanding and good faith, embracing innovative approaches to meet everyone’s needs should be encouraged. However, for most relief veterinarians, a production-based compensation model rarely makes sense given the inherent unpredictability of clientele, efficiency, and caseload in new environments. (This post is totally going viral!)
