Bullying and Shaming in Veterinary Medicine – The VBM Podcast with Dr. Betsy Charles

bullying

About a year ago I began hearing more and more stories from students and young colleagues about some of the miserable ways they were treated at school, and in their first jobs. Meanwhile, for the longest time I have been disappointed by the way veterinary professionals treat each other on veterinary Listservs, and even at CE meetings; there is an obvious undertone of snarkiness, and sometimes disdain when colleagues share experiences about how they diagnose, and treat cases. This is not a new thing in the profession, because when I started thinking about it I realized that this tone has been present all through by vet school years and my veterinary career. I just finally recognized it!

Cue a meeting I attended this past summer where Dr. Betsy Charles,  was a guest speaker. She is the executive Director of the Veterinary Leadership Institute, which is a non-profit organization dedicated to the development of veterinary leaders. During one of her presentations she discussed an undercurrent of bullying, and shaming within the profession. The light bulb went on and I knew I needed to have Dr. Charles on this podcast to discuss this subject.

This is a fascinating podcast with Dr. Charles because this is a complex topic. I must admit that by the end of our chat Dr. Charles brought up a concept that gave me a profound sense of optimism about our profession. It was almost the missing link that joins the challenges we have as a profession, and a solution to help steer us past these challenges. I won’t say anything more about it, you will have to listen to the end to find out.

This is a discussion we need to start and the profession needs to address.

Some of our conversation may be very controversial to some people so please leave a comment here, or on our Facebook Page. The more we discuss this the better we will be able to find a solution.

You can find our more about the Veterinary Business Institute at their website, and on their Facebook Page.

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The Struggle Between New and Senior Veterinarians

A couple of weeks ago I was chatting with one of our veterinarians, Dr. Jenna Donaldson, about some of the challenges facing our profession. What started at as a casual discussion turned into a lengthy conversation on the reasons so many new equine veterinarians leave the profession within a few years  after graduation. I challenged Dr. Donaldson to start a discussion on the problem with the goal of starting a conversation between new and senior vets on how we can resolve the problem. I have posted a blog from her on the subject. We are planing on following up with a podcast with her and some of her graduating peers and other vets who have been in the profession for a while. There is a solution out there and we won’t get to it unless we start talking about it collectively.

During veterinary school and my internship years, I had the privilege of meeting many new equine practitioners. Luckily for me, they were always happy to talk to an overly-chatty student, maybe in part because they remembered being in my shoes! By and large, these individuals were intelligent and hard-working. I was amazed at the vast amount of experience and ambition these individuals possessed. They were personable, respectful, and good with horses. I felt certain that the majority of them would surely be successful in equine practice. However, a number of them have chosen to move on to different areas of veterinary medicine within three to give years of graduation. This is becoming increasingly common in this industry and it is unfortunate given the amount of time and money that these individuals dedicate to their education. Many of them could also have gone on to be leaders or successful business owners in the profession. Why is this happening?

The reasons cited by practitioners who have chosen to move on from equine practice are varied and complex. Some graduates started out in a practice where mentorship and/or support was limited. This causes significant tension while climbing the steep learning curve post-internship. Most of us have extremely high expectations for ourselves, and we take failure personally. It is impossible to be perfect all the time, and new veterinarians WILL make mistakes. Having strong backup available can help prevent major errors and provide emotional support for the inevitable issues that arise. When this is lacking, the stress that develops can be overwhelming. For individuals in this situation, the tension they face can affect their view of equine practice as a whole, prompting a switch to a different area of veterinary medicine or even a new industry. This aspect is what I find most concerning, and this is where I think the profession could improve the most.

It must be acknowledged that a certain percentage of recent graduates did not fully understand the unique demands of equine practice and decided that the career was not for them. Without a doubt, equine practice demands a commitment over and above what is generally required in other areas of the profession. Some veterinarians have decided to move on to a career with a more predictable, regular schedule which would allow them more time for other life priorities (most commonly family). From a financial perspective, some recent graduates are simply unable to balance their large student loans and other financial obligations with the low starting salaries of equine practice. This group of individuals has decided to pursue another option which would help them to improve their financial situation.

In some ways, this attrition may actually be beneficial and necessary. Anecdotally, not enough jobs exist for all of the graduates who would like work in equine practice. Additionally, for some individuals, negative experiences in equine practice have affected their lives far beyond the limits of their job. Maintaining mental, physical, and emotional health can be exceptionally difficult for all veterinarians and potentially even more so for equine practitioners. Recognizing this in oneself and taking steps to prioritize one’s own health is something that is often stigmatized in this industry. I believe that individuals who have stepped away from equine medicine for this reason should be commended for their courage in making such a difficult decision.

It is worthwhile to acknowledge that this issue is extremely complex and multi-faceted. There are many stakeholders with varying viewpoints and concerns. Considering the perspectives of both recent graduates and more experienced practitioners (many of whom are practice owners) is valuable.

Recent graduates like myself have worked hard to be admitted to veterinary school, competed for internships, and fought for one of the limited positions available in equine practice. In general, they are not afraid to work hard. They acknowledge the commitment that equine practice requires. They want to be appropriately compensated, mentored, and allowed to develop their skills. They also desire sufficient time away from work to develop or maintain strong relationships, friendships, and hobbies. They want to be treated respectfully by their clients, colleagues, mentors, and practice owners.

Seasoned veterinarians have worked hard to get where they are now. They have sacrificed many things such as vacations, time with family, hobbies, etc. To them, these sacrifices are what is required to be successful and are simply part of the career. To many of them, equine practice is far more than just a job. They are often frustrated by the perceived lack of motivation of more recent graduates. They want to be recognized for their experience and their contributions to equine practice. They want to be treated respectfully by their clients, colleagues, and associates.

I would also like to discuss some potential solutions. First and foremost, we must remember that we all share the same goal. We all work to promote the wellbeing of horses of all demographics with the acknowledgement that all veterinarians are also professionals in a highly competitive service industry. A good place to begin would be to initiate an industry-wide dialogue between recent graduates and more experienced practitioners. We need to openly share viewpoints, frustrations, experiences, and expectations. This requires a willingness to treat others with respect, as well as an openness to facilitate discussion without defensiveness or hostility.

Within practices, I feel that it is essential to develop a system whereby new associates can be mentored and supported. Each graduate comes to their first associate position with a different level of experience. No one is going to be entirely prepared for everything they will have to face. It is in the best interests of the practice owner to ensure that their associate has support available so they can provide the best possible client and patient care. I am extremely grateful to know that if I have a question about a horse, I have many people I can call, including the 10 other veterinarians in my practice. Everyone is always more than willing to help me at any time of day or night. I wish that all recent graduates could have the same level of support. On an industry level, collaboration both between and within practices should be encouraged. This may include call-sharing groups, collaboration with nearby referral centres, merging single-vet practices to form a larger business, seeking ways to promote teamwork within a larger practice, etc. No specific idea will fulfill the requirements for every situation, but a willingness to interact professionally with perceived ‘competitors’ is a starting point for everyone. Additionally, practitioners could share ideas that are working well to attract/maintain the best associates, preserve mental/physical/emotional health, encourage teamwork, and promote a positive working environment.

In conclusion, attrition of recent graduates from the equine veterinary profession is a complicated issue without an easy solution. However, if the industry chooses to view this as an opportunity rather than an overwhelming challenge, there is the potential to change the way the profession is viewed in a way that will continue to make it relevant and valued in the changing dynamics of the world. We could once again be considered leaders and be respected for our professional integrity in our interactions. I strongly believe that we could be role models for the trainers, owners, and riders as well.

If you have anything to add on this topic please add a comment.

Are you interested in increasing your business skills or knowledge? The Veterinary Business School could be the solution for you. Click here to find out more about this business education program geared towards veterinarians.

Veterinary Business Matters Podcast- Perspectives From Vet School

We have been fortunate in our various equine and companion animal hospitals to have had some excellent summer students working for us over the years. For the past two summers we  had 3 students in the same class at the Ontario Veterinary College. In this podcast I speak with Michelle DaCosta, Marisa Markey and Samantha Molson. All are entering 3rd year. I have known Michelle and Samantha for two years and close to five for Marisa so I have noticed a change in them over time in their knowledge of the veterinary profession, and what it will be like in 2 years when they graduate. It’s a pretty sobering discussion for them, yet all of them have excellent ideas on how vet colleges can better prepare students for the profession, and what the three of them will do to seek employment.

Veterinary Business Matters Podcast #26 – Optimal Client Communications with Dr. Colleen Best

I was moderating a session at the AAEP Business Education meeting in August when I heard a line from a presenter that made me sit up straight and grab a pen to write the line down – Client communication should be a core competency for a veterinarian. Wow, how true! The person presenting was Dr. Colleen Best of the Ontario Veterinary College. Dr. Best is doing research on client communications between equine veterinarians and horse owners. If you are a small animal vet about to leave now, don’t worry her supervisor, Dr. Jason Coe, is doing similar research in small animals. I asked Colleen if she would join the Veterinary Business Matters Podcast to share what she and Dr. Coe have learned.

I think you will find the perspective that Colleen brings is refreshing and exciting. It is one thing to qualify the effect of client communications but now we are able to have quantifiable evidence of the importance of excellent client communication. You can download the podcast here or go to iTunes and subscribe to the podcast.

Dr. Best can be reached at cbest.dvm@gmail.com if you would like more information on her research.

Mentoring the New Veterinarian – Veterinary Business Matters Podcast #24

A few weeks ago we chatted with Kristin Britton, a soon to be graduated veterinarian and Dr. Scott Spaulding of Badger Veterinary Hospital about the challenges facing new veterinarians. One of the subjects we touched upon was mentoring. After our first conversation we thought that the topic of mentoring was so big that it deserved a discussion of its own. The subject of the new vet transitioning is very relevant at this time of year since Kristin will be graduating from WSU this weekend and is about to start a new job! Congratulations Dr. Britton and good luck. We hope to keep in touch to see how she does as a new veterinary.

Follow this link to the podcast  Veterinary Business Matters on iTunes 

The Fate of the New Vet Grad – Veterinary Business Matters Podcast

In this 1st episode of a 2 part series we talk to Kristen Britton, fourth year veterinary student and Dr. Scott Spaulding, DVM, CEO of the Badger Veterinary Hospital about challenges facing veterinary students seeking employment and practices hiring new associates. Kristen is the past president of the Veterinary Business Management Association, a vet student driven organization that works to educate veterinary business students on the business of veterinary medicine. Her involvement with the VBMA gives her a unique insight into the challenges facing the soon to be veterinarians graduating this spring in North America. Dr. Spaulding has been a guest on this podcast last year. I always learn something new to bring back to my practice whenever Scott and I chat.

I recorded this episode earlier this year and recorded the 2nd part on the subject of mentoring recently so I thought I would release them close together. In the next couple of weeks we will talk about the sometimes thorny subject of mentoring the recently graduated veterinarian. The sound quality is not the best in the first couple of minutes in this episode but it improves soon so please be patient.

Enjoy the discussion

5 Ways to Get Hired as a Veterinarian

Earlier this week I tweeted about the new private veterinary school opening up in East Tennessee. To paraphrase my tweet, now that I have more than 140 characters to work with, I commented that we need another vet school in North America like we need more lay dentists. There are hardly any jobs for new grads in vet med regardless of the species. I think most of us are  aware by now that there is not a shortage of vets in rural practice, instead there is a shortage of clients in these regions that can afford vet care, let alone the case load to justify a full time vet. This was my explanation to a vet student on Twitter who wondered why I was so negative about this new school. His next question asked what should a vet student or new grad do to make themselves more attractive to job opportunities. Here is my response.

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The New Veterinarian as Solo Practice Owner

With the class of 2011 graduating new vets are facing challenges that no recent grad has ever faced. By recent I mean in the last 30 years. There may have been the same paucity of jobs in the early 80s when we were in another long recession but nothing like there is now. Consider this! There are 32 jobs available for 720 applications on the AAEP web site. That means there are 23 resumes for every job.  It is now easier to get into vet school than it is to get a job as an equine vet upon graduation. For those of you who are practice owners do you see yourself needing to hire a new associate within the next year or two? To really make a new grad, or retiring vet who wants to retire cry, keep in mind that the average vet student graduates with $133,000 in debt. Whether students are borrowing and spending wisely for their education is a discussion for another day. What is a new grad going to do with this mountain of debt and no prospect of a job going to do?

More and more I am seeing new vets start their own practices following an internship. To do so immediately after graduating would doom the endeavor to failure but after an internship it might be a necessity in spite of the challenges. There are 2 reasons why a post intern grad might start their own practice.

If a new associate is going to work very hard they might as well work for themselves.

  • There are no jobs. If you want to be a vet and nobody is hiring what are you going to do?
  • Cultural disconnect between older practice owners and new grads. Older vets have a work ethic unique to them. Many want their associates to work as hard as they do regardless of the strain this puts on family life or outside interests. If a new associate is going to work very hard they might as well work for themselves. As for the work life balance typically they are not very busy as they start out so there is plenty of time to be involved with family or hobbies.

It would be nice to view this progression with a chuckle and shake of the head as we wish them good luck but I worry that there may be some unintended consequences for the equine veterinary industry.

  • Poor business decisions made by the new practice owner may create a new level of expectations amongst horse owners. A new business may cut prices with the hope of getting new customers. A new vet will not have the appreciation of the difficulties or challenges of the job and likely won’t value their skill and education. All they care about is getting work.
  • These new vets might have a better sense of customer service and a willingness to try newer medical techniques. I know when we started our practice that we rejected many of the conventional attitudes of older practices that we had spent time in and tried to show our clients extra attention along with a willingness to try new things. This was a differentiating factor between us and other vets and allowed us to grow a practice very quickly.

So where does this leave the older and established practices and the young bucks starting out? This might sound counter intuitive but I would suggest taking the high road and arranging an introductory meeting. Encouraging professionalism will benefit everyone the most. The older vet can explain why they price the way they do. The younger vet can discuss newer techniques. The end result should be mutual respect. I have been spending some time recently with companion animal vets and I am amazed at how much they collaborate and refer to specialists unlike the “I can do everything” equine vet. Who knows if this new vet may be in a position to buy the practice of the older vets in time or if the established practice can cover on call for the new kid in town?

At the end of the day it is in the best interest of everyone if our profession is conducted with integrity that does not diminish the value of veterinarians in the eyes of our clients.

Have you had a new vet open a practice in your area recently? If so how did you respond?

Equine Vet Business. Practice Tip #2. Veterinary Student Wet Labs

Every semester our veterinary clinic hosts a group of veterinary students from our local veterinary college for a hands on wet lab. It has been beneficial to us in many ways as you will find out on this video. I can’t recommend enough the win-win scenario of reaching out to your local community to show the value of your veterinary practice. With all of the threats facing our industry the more face time we can have with potential horse industry participants the better. Have a look at the video by clicking here

What other outreaches have people done to highlight their veterinary practice in their areas?

YouTube Video of Equine Vet Business Practice Tip #2

Life After Vet School – Tough Choices for Senior Vet Students

This past weekend I was asked to speak to 107 senior vet students from all across North America on the future of equine veterinary practice. This was part of the Purina Equine Veterinary Conference held every year. I have never seen so many downcast students after I revealed what the current veterinary job market is like in North America. I felt like someone who has just told a kindergarten class that Santa Claus does not exist. Hopefully, it was the isolation of academia that has kept them in the dark. In any case I tried to stress that it was not all doom and gloom and that there are opportunities for new grads. Take a peek at my presentation to see what opportunities are out there. I am eager to hear what others think that new equine vets can do to find a job after graduation.

www.slideshare.net/mpownall

Vet Colleges: change is needed. A Response!

We received a great response to our last blog on the broken business model of the typical veterinary college from Dr. Joop Loomans of Utrecht University. I thought that Dr. Loomans prepared such an eloquent response that it was worthy of a blog of its own. Thank you Joop.

As equine veterinarian you “get the customers you deserve”. This is what I tell students when I educate them on equine business management and it’s a statement that I really believe in. It refers to the colour theory of Léon de Caluwé on change management and is also related to internal branding. There are many different kinds of equine customers; those who find it important their horse is treated by a well known and respected vet, those who think it’s important to have vet a close personal relation with their vet, others only think about value for money or just want the cheapest and again others feel safe in a scientific and learning environment with their horses and those who go for vets who always have the newest/fancy “experimental” treatments available. To make it even more difficult to comprehend, it may even differ per case. Therefore I don’t believe equine teaching hospitals and private practices are really competitors. The equine industry needs the total spectrum of veterinary care. 

At Utrecht University we have a long tradition of a university ambulatory clinic in the vicinity of the faculty clinic in a radius of about 25 kilometres around Utrecht. This goes back to the beginning of the twentieth century and has been in equilibrium with the growing numbers of private practices around Utrecht (by veterinarians the university educated!). Nowadays we live in perfect harmony with these practices and we all “get the customers we deserve”. Our customers are those who love to know more about their horses and their health, they don’t mind if a student is working with their horse as long as they get “added value” by learning with the students and of course the horse isn’t suffering. They don’t mind if the consultation and treatment of their horse takes longer, as long as it is not an emergency situation and they will pay a normal fee for these services (we calculate the time an experienced vet would need for a particular consultation and treatment). Therefore we do not compete on price and use the money we get for educating students to pay for the extra time we spend while educating. We find this a very good and simple way of pricing and we even find practice around us being cheaper than we are. 
The situation might be a little more complicated for referral hospitals since, as Mike Pownall stated, Universities are often able to build larger facilities using public money. I remember Mike walking through our premises, wondering how much this would have cost (and how much the tax payer had invested). One should however bear in mind that teaching in a clinical setting with real patients requires a safe environment for patients, clients, students and teachers especially when the university education philosophy is to have an increased responsibility for students in patient care during their curriculum. We want students to learn by doing in a safe environment, starting in our clinic with our own horses, but this is quickly extended to real patient care in our hospital (both intra and extra mural). Later, in the final year (sixth year) students have eight weeks of clinical work in one of the five private equine practices in the Netherlands we work with. 
Teaching veterinary medicine, educating young adults to become an equine veterinarian is a beautiful job. Together with the veterinary profession we have set standards by writing “Programme Outcomes of the Veterinary Curriculum”. This ensures the involvement of the veterinary profession in the education and the educational goals and makes us all responsible for the future of our profession. Therefore we should not loose ourselves in discussions about fair or unfair competition but join forces and work on a sustainable future of both your practices and our teaching hospitals. 

Joop Loomans, PhD, DVM, Faculty of Veterinary Medicine, Department of Equine Health, Utrecht University, the Netherlands.

Veterinary Colleges: change is needed!!

In my last post I touched on many similarities between NA equine vets and our counterparts in Europe. I omitted one particular topic because it deserves a post of it’s own: vet colleges are now trying to compete with private practitioner. We were attending a presentation from the dean of the School of Veterinary Medicine in Utrecht, The Netherlands. His talk was on the changes he is instituting in his college to help increase the caseload. I realized that he was trying to do with his institution is what the deans of so many vet schools in North America have been doing; building a state of the art facility in hopes that it’s mere presence will flood the teaching hospital with cases. Most of us are aware that vet schools are facing significantly decreased caseloads due to the presence of private practices that can offer faster and more efficient appointments, better client service, and continuity of patient care, among many reasons. The vet school business model is broken, and instead of examining why it is broken and developing realistic strategies to maintain the quality of the education they offer, institutions think that building bigger state-of-the-art teaching hospitals or buying up local private practices will regain the lost caseload. I knew this had been going on in North America but I was surprised that the same scenario is playing out throughout Europe.

In discussions later on, the group of private practitioners at the conference had the same litany of concerns. Tax money is being used to compete against private practitioners. The culture of vet colleges is such that they can never offer great service and the clients are choosing to use private clinics where these needs are begin met. Frustration over the shrinking caseload has led to clinicians openly criticizing private practitioners in front of students and clients. When local vets have approached the state or provincial college about working together, their concerns are ignored. I will give credit to the dean of the college in Utrecht on this last point. He seemed genuinely concerned about finding a relationship with local vets that was mutually beneficial.

Is there a solution to this problem? As private practitioners we can ignore it. It can be a competitive advantage to be located near a vet college, since the level of service there is usually so poor that it is easy to look good next to them. That is a cynical and myopic view though. We need well-trained future vets that have an appreciation of private practice, and not the book smart but clinically naïve graduates with a suspicious attitude of private practice that many of us are encountering now.

What is the mandate of most vet colleges? Education? Of course. Research? Absolutely. Operating a competitive veterinary hospital? Not so sure about the last one. Can clinical education for students be contracted out to private practitioners who meet the standards of the teaching institutions? This is being done at the newer vet colleges accredited in North America and it can certainly be adapted to the older schools as well. The students would get a structured clinical education in their junior and/or senior years that would offer varied and practical experiences, the money losing expense of a vet hospital would be eliminated, and there would be more collegiality between the schools and private practitioners. Programs for internships and residencies could also fit in this new paradigm. Vet schools will argue that there would be a lack of consistency in the clinical education with this model. Can they honestly say this consistency exists now? We have all experienced the frustration of being taught by a tenured professor who obviously hates their job or is so far removed from what is going outside of their field of research that they become a liability to patient care let alone the education of a student. At our local vet college many female students interested in large animal practice have been dismayed to encounter openly misogynist senior clinicians who belittle their desire to work in this field. I am sure that with a little effort, minimum standards for participating private vet clinics could be implemented. What is in this for the private practitioner? While the arrangement is not for everyone there are numerous potential benefits. They would be paid to host the students and they would have a ready pipeline for new associates. The students would be bring with them current knowledge on a variety of subjects that would be beneficial to seasoned practitioners in the field.

Something has to change within the vet colleges themselves and also in their relationships with private practitioners. My solution is not for everyone but I would love to hear thoughts from other people. Lets see if we can get a dialogue going and hopefully some ideas can come out of it that might foster a needed change.

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