Even before COVID-19, it could be challenging for veterinarians to manage the workload. Now, we hear from associates and practice owners alike that they are buried and need additional help to serve clients and patients. Veterinarians are as stressed as they have ever been, and it continues to be challenging to find doctors to hire. That isn’t going to change any time soon.
So if you can’t find a doctor to hire, what can you do instead? Make full use of the rest of your team. What are your doctors doing that your nurses[1], assistants, or client service staff can do? How often are your doctors placing catheters, holding patients for radiographs, or doing dental prophylaxis? More importantly, how many more appointments could your practice schedule if your doctors did none of this?
If you aren’t using high-density scheduling, where the doctor sees four to six appointments per hour, seriously consider adopting it in full or in part. By using skilled nurses, the doctor can spend less time with each patient without compromising patient care or client service. Nurses take patient histories and TPR’s, then brief the doctor who examines the patient and prepares a treatment plan. Nurses communicate the plan to the client, and get the treatment plan underway while the doctor moves on to the next appointment in another exam room.
For high-density scheduling to succeed, you need enough nurses as well as enough exam rooms to accommodate multiple simultaneous appointments per doctor. The doctors also need to trust the team to do their jobs well. Too often, a doctor won’t delegate because they don’t trust team members to do a task correctly. If this happens at your hospital, identify the cause. Has the doctor experienced poor results when delegating? Is trust lacking because they have seen mistakes happen or because they don’t know the team well enough to have developed that trust? Are the doctor’s expectations reasonable?
If you aren’t interested in high-density scheduling, what elements could you incorporate? Discuss the workflow around specific tasks such as patient restraint, monitoring, or client communication. Other than diagnosing, prescribing, and performing surgery, what activities must fall to your veterinarians? Another team member can do almost everything else. Your veterinary nurses are professionals capable of providing patient monitoring and care, educating clients, assisting in surgery, taking diagnostic quality images, and medical recordkeeping. Let them do what they are trained to do and get out of their way.
A great deal of job satisfaction comes from performing at the highest level of what we are trained to do. Yes, veterinarians can fold laundry or schedule appointments, but other team members have the time to do those things and may do them better and faster. Veterinarians should be in the exams rooms, treatment, or surgery. If everyone in your practice is able to do what they are best at, engagement increases, morale improves, and the practice operates more smoothly.
When you expect more from your team, your team can expect more from you – more training, more authority, and yes – more money. While job satisfaction goes a long way toward keeping employees at your hospital, they can’t be successful if they aren’t paid a reasonable wage. You may need to pay at the high end of the scale in your area to attract and keep the best candidates. If they can take work off your doctors’ shoulders, it’s well worth your money.
The 9th edition of AAHA’s Compensation and Benefits[2] lists annual veterinary staff turnover at 23% compared to the national average of 15%. Among non-owner veterinarians, annual turnover was 16%. The turnover rates for other positions were: managers – 10.3%, nurses – 24.3%, reception – 32.5%. If a hospital loses nearly one-quarter of its employees every year, it is spending a tremendous amount of time recruiting, interviewing, hiring, and training people who won’t stay.
While we could all do a better job at employee retention, remember that while fair wages are important, money is not the only critical factor in job satisfaction. Survey after survey reveals that recognition, appreciation, and the opportunity to contribute are essential to long-term job satisfaction and engagement. People leave well-paying jobs all the time because they aren’t fulfilled. They may even be bored.
No one should be bored in a veterinary hospital! Nor should any single position be overburdened. Train, trust, and utilize every team member to the fullest. If other team members can take work off the doctors’ plates and do an excellent job in those functions, everyone wins.
[1] This article uses the terms “veterinary nurse” and “nurse” to refer to credentialled veterinary technicians.
[2] American Animal Hospital Association. Compensation & benefits. 9th ed. Lakewood, Colo: AAHA Press, 2020.
