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Drug Testing in Veterinary Practice
Drug and alcohol abuse is a serious problem in workplaces across the United States, including in some veterinary practices, with significant financial implications. According to the National Drug-Free Workplace Alliance, U.S. Department of Labor statistics indicate the following:
- Alcohol and drug abuse cost American businesses $81 billion in lost productivity in just one year
- Substance abusers are absent ten times as often as non-abusers
- Substance abusers are three times as likely to be late to work than non-abusers
- Substance abusers use medical benefits 300% more often than non-abusers
- Substance abusers file 30% to 50% of all workers compensation claims
One method to control the damage inflicted upon a business's bottom line is drug testing, but this is a controversial topic among veterinary practice owners. Controversy arises, in part, because of the sometimes confusing federal and state laws that dictate what a business can or cannot do in regards to testing, and in part because there is a risk of discrimination when policies are not effectively created and/or implemented.
Although no federal law specifically prohibits drug testing, the American with Disabilities Act (ADA) does restrict the scope and timing of the testing. Some states prohibit or restrict certain types of testing, so be sure to be familiar with your state's laws before creating your policies.
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Communication Breakdown, Now What?
The article "How to Recover after a Communication Breakdown" by Charlie Powell shares how to respond when a communication breakdown occurs. This includes how to determine what went wrong; how to rebuild after a breakdown; and how to prevent breakdowns in the future. In what he calls the "anatomy of communication," he shares five major aspects of communication as well as the questions to ask when something goes wrong.
- Sender: this is the person/organization trying to deliver a message. When something goes wrong, it's important to review whether the message was sent to all relevant parties and whether the message was appropriately shared.
- Coding: this is the language of the communication. If there is a breakdown in communication, review the clarity of the message and double-check the details provided.
- Channel: the medium by which the message was sent. When there is a problem, ask the following questions about the channel: How many mediums were used? Were there reminders? Or were there too many reminders?
- Decoding: the translation of the message. When determining if decoding is the problem in a communication breakdown, review whether the receivers understood the message you intended. If not, what caused the block? Are they uninterested? Distracted?
- Feedback: this is how each receiver responds. If there is no response, then you know there was a breakdown at some point. This could range from disinterest to a critical event happening that prevented attendance.
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Practical Solutions for Effectively Managing Your Greatest Asset - Your People
There is no greater challenge in veterinary medicine today than recruiting, hiring, managing, and retaining talented people. Now you can find answers to your most pressing human resources questions and get a people management resources guide, all in one complete kit.
The Human Resources Tool Kit simplifies the overall approach to people management in your practice, by providing you with the most up-to-date and comprehensive tools, tips, and practical tactics to managing employees of all levels.
Developed by Charlotte Lacroix, DVM, JD, The Human Resources Tool Kit offers simple, actionable strategies, plans, and forms you can start using right away - along with a wealth of information to guide you. The Kit provides a broad overview of various laws and regulations governing the employee/employer relationship. With an indexed listing of the most common workplace challenges and solutions, you'll learn "best practices" in dealing with:
- Recruitment/Hiring
- Orientation
- Employee Records
- Compensation
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- Performance Management
- Discipline/Termination
- HR Compliance Audit
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Recruit, Retain, Realize, Relax! Order today.
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HR Questions?
Ask Kellie:
Question:
I've heard speakers talk ab
out different types of audits. Do they matter?
Answer:
Policies and procedures should never be on the "set it up and then forget about it" plan. Important systems need audited. Audits should take place in the following areas, among others:
- Ethics
- Finances
- Human resource policies
- Medical protocol/standard of care
The term "audit" is closely associated with financial reviews, and with good reason. It's very important to ensure that your financial records are pristine, following all tax laws and requirements, and to make sure that proper checks and balances are in place. There are internal and external audits. Internal audits should take place frequently, with regular external audits also taking place, with the external auditor providing an objective statement on the accuracy of financial statements of the practice. These audits can be used by tax authorities who need verification of tax return accuracy; financial institutions who are lending money to the practice; and practice management who are assessing risk factors and modifying policies and procedures for improved fiscal responsibility.
Ethical audits, meanwhile, take your practice beyond what it legally right into what is morally right. From a risk management perspective, one lapse in judgement by a member of the practice can have devastating effects. Consider creating a formal written code of ethics, distributing it to employees, where you share your zero tolerance of ethical infractions. Regularly review this code, updating when necessary, and strictly enforce the code. Provide ethics trainings to all practice employees, hourly and management alike - and encourage ethical behavior, even when it comes in the form of an employee questioning the ethics of a policy or behavior.
Human resource audits should be regularly conducted to keep up with the ever-changing federal, state and local statutes. When practices fail to comply with one of these - even inadvertently - and an employee files a complaint, this can result in significant financial consequences, and even criminal penalties. Note that it's not uncommon for state laws to create employee rights that differ from the federal laws from which they were devised. Plus, policies and procedures that made perfect sense last year might cause you to be out of compliance today, and a human resources audit with a compliance specialist will help to identify potential areas of trouble. Even if something is missed, or changes after the audit, courts tend to respond more favorably to practices that can show good faith efforts to comply.
One of the best ways to reduce potential liability of your practice is through keeping complete documentation, both of medical information of your patients and your communications with clients. Veterinary state board sanctions are largely due to a practice failing to keep complete and accurate records. And, while there are many benefits to paperless records, know that computerized records may not be as helpful as written ones in, say, a malpractice suit defense because they can be tampered with too easily. To protect yourself, ensure that you have excellent record-keeping procedures; follow them precisely; and conduct audits of them to improve processes and further protect yourself.
Finally, don't forget about clinical protocol audits. This quality improvement audit focuses on standards of care and how they can be improved. As the US National Library of Medicine points out, this has become standard by some national governing bodies in human medicine, and this has led to measurable improvements in care. Conversely, the absence of this evaluation has led to more failures of appropriate levels of care. As of yet, these audits are not required by national veterinary governing bodies, but their implementation is a key element of reducing practice risk.
When establishing standards of care, the baseline level is that a veterinarian must perform duties with the amount of skill, care and diligence that colleagues would practice in similar situations. Although this is admittedly vague, it is good practice to consult with practice staff, colleagues and insurance carriers to remain aware of the latest preventative care measures used by other veterinarians.
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