One of my most crushing failures as a vet came one Friday when I was scheduled to work at a tiny satellite clinic with only a single young veterinary technician. It was my first year in practice and I dreamed of being a great doctor to patients, a great champion for staff, and a great investment for the people who hired me. I was going to do it all, and make it fun and easy for those around me.
The satellite clinic was attached to a large boarding facility, and on the Friday in question I found myself and my technician caught in a perfect storm of appointments, procedures, walk-ins, boarding pets that needed wellness updates, and the first local canine influenza outbreak.
As the work piled up, I did what most veterinarians do. I put my head down and sailed into the storm. “Just get it done,” I thought.
When lunch came, I asked my technician if she was ready to take a break. She looked at the pile of work we had and said she’d rather work through lunch to get out on time. In my naivety and inexperience, I agreed.
We did not get out on time. We worked well past closing and into the night. We worked hard; nearly frantically at some points. When it was done, I was hangry and tired. My tech was silent. Both of our Friday nights were shot.
The next day though, I was pleased with the amount of work we’d done. I thought I’d showed grit in pushing us on, and I was proud of my technician and how we’d pulled together to get it all done.
On Monday, my technician, with another technician for moral support, went to my bosses to complain about working with me. She said the work didn’t stop and there were no breaks and we didn’t go home until hours after closing and it was terrible.
I was devastated. Being a good person to work with and work for is my highest aspiration. Pleasing the practice owners who had given me my first job was also right at the top of my priority list. And worst of all, I was KILLING myself working hard just to be chewed out. I was truly hurt and resentful.
Fortunately, time and experience have a way of changing our perspective. The truth is, my technician was right to complain. If I hadn’t been the one in charge, I would have complained. That awful Friday taught me a painful lesson, one I’m reminded of from time to time, and one so many of my colleagues have learned at some point, too. At least I know I’m not alone.
Right now, veterinary clinics across the country are struggling to hire doctors and support staff that they desperately need. The work is pouring in and the “help wanted” ads go unanswered. In many of these practices that face more work than they can accomplish in a day (emergencies on top of walk-ins on top of appointments), the approach set by management is the one I employed all those years ago: “just get it done.” It’s the default solution whenever there’s not a conscious effort to stop and figure out a better, more sustainable one. Work comes in, so we do it. We do it all.
Don’t get me wrong here, some days, putting our heads down and powering through the workload is the only possible way to approach the chaos. Sometimes this is even the best solution for a string of rough days or even a couple of weeks at a time. But this has to be the exception, not the rule. It’s no way to live, and there will be consequences if we try.
The hard truth that many of us do not want to accept is that we have limits. There is an optimal workload that our practice, with its current staff, can handle that will allow us to feel very busy, but not distressed — that might make us tired, even exhausted, but not depressed. If we exceed this workload, stress levels increase, the quality of care we provide decreases, and the client experience suffers.
When you’re swamped to the point that you feel constantly pressured to skip your lunch or breaks, you throw medications at patients because you don’t have time to work them up. You walk into every appointment knowing the pet owner has waited a half hour past her appointment time to see you. And worst of all, you wake up knowing it’s going to be that way again today, tomorrow, next week, and for as many months as you can imagine.
So, what are the alternatives to working ourselves to death? That’s easy: accept that we are overwhelmed and manage to our optimal capacity.
“But clients will leave!” practice owners scream. “We won’t be able to pay our bills!” they moan. “I need to see those cases to pay my student debt!” the vets shout.
If you can’t support a 3-doctor practice seeing a reasonable 3-doctor case load, then you have a flaw in your business model. Period. If your business depends on people working an unreasonable amount, then your business is destined to fail. The employees you have are not infinitely stretchable. At some point, they will break or quit. (And guess what? The best people leave first because they have the most opportunities elsewhere.)
If my original scenario at the satellite clinic presented itself these days, here’s what I’d do: I would politely send walk-ins to our main clinic, insist we take breaks, call the main clinic to ask for another technician to be sent over, and/or leave some of the wellness work on boarding pets to be done the next day (with a heads-up call to the next vet so she would know what was up). I’d remind myself that we always have options. We don’t have to take walk-ins after a certain time. We were in a position to stabilize, then transfer, emergencies. We can decline to take new clients just like practices do in human medicine.
Make no mistake, even if I got a do-over, that wouldn’t have been “an easy day.” We would have worked hard, but we would have had a reasonable load for the two of us to do and do well. Sometimes discretion truly is the better part of valor.
So please remember: you don’t have to make the same mistake I did. Figure out what your optimal case load looks like, train your staff on how to schedule so it (or something like it) happens, and charge appropriately for your services. Draw the line, and play for the long term. It’s within your power to give your practice the gift of boundaries.
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.
