The 2016 AVMA AAEP Equine Economic Study revealed that 16% of practices had no employees. A more recent study conducted by this author for EquiManagement in November 2021 had similar results, with 17% of the 312 respondents reporting that the practice where they worked had hired no other employees. Many of these practices are undoubtedly solo practices, with the veterinarian performing all tasks necessary to provide services.
Reasons vary for not having any staff to help with tasks that do not require a veterinary degree. Some doctors explained that they cherish their freedom to make “on-the-fly” decisions about their schedules without worrying about the time considerations of an employee. Others fear they will lose precious time alone in the truck. Some feel they will not be able to afford the wages, or they fear the responsibility of having someone depending on them for a living. For a few, the hassle of payroll tax obligations, workers’ compensation insurance and managing an employee just seem like too much trouble. However, there are very good reasons to consider hiring help.
Hiring an Ambulatory Assistant
Often, the best first employee for a practice to add is an ambulatory assistant. An assistant can increase the safety of the veterinarian by more effectively restraining patients and thereby decreasing the risk of injuries. Equipment is often better maintained by an employee than by an exhausted and overwhelmed veterinarian. Assistants can drive, allowing the veterinarians to write invoices or medical records during travel between calls, as well as make client callbacks. Alternatively, if the veterinarian prefers to drive, a well-trained ambulatory team member can do these tasks.
Assistants also allow patients to be seen when clients are at work, increasing customer satisfaction and often improving efficiency. Having a second set of eyes on invoices can prevent most missed charges for services and dispensed items. This increases revenue and profit for the practice, as well as decreasing stress for the veterinarians. Assistants allow doctors to stick to doing “doctor things” while they take responsibility for keeping the truck stocked, laboratory submissions prepared and equipment maintained.
You might be wondering whether you can afford to hire an assistant. It is important to know that benefits, overtime, payroll taxes and workers’ compensation will typically increase the hourly wage by 50%-100%. A $15/hour wage really costs the practice $22.50 to $30 per hour. If we assume minimal benefits, at $22.50/hour for five 10-hour days
per week, that assistant could cost the practice $1,125 per week for 52 weeks, or $58,500. To afford that assistant, the practice needs an additional $58,500 in profit, or the owner needs to be financially able to take less in distributions. If taking home less money is not possible for the owner, then increased revenue will be needed. If the practice is making 20% profit, that’s up to an additional $292,500 in revenue to afford the assistant’s costs.
Ways To Afford an Assistant
Before giving up on the idea of an assistant as unaffordable, remember that the increased efficiency that assistants bring to the practice will allow the doctor to have a higher percentage of billable hours in each working day, so revenue will naturally rise. In addition, not having several hours of administrative tasks at the end of the workday will mean that the veterinarian starts each day better rested and able to tackle a new set of diagnostic challenges with more enthusiasm.
Hiring a Part-Time Employee
Hiring a part-time assistant to minimize benefits and eliminate overtime might be the best approach to start. At $15/hour for 20 hours/week ($300) plus 9% payroll taxes ($27) for 52 weeks and $200 in workers’ compensation costs, the assistant then costs just $17,204 per year. At 20% profit, only $86,020 in additional revenue is required if the owner cannot afford to take less of a distribution. This seems doable to most veterinarians, and typically what they find is that their lives are vastly improved, along with their efficiency and revenue production.
With someone else to set up and pack up the DR and/or ultrasound, suddenly the doctor is much more eager to offer those services even when pressed for time or at the end of a long day. Patient care and customer service typically improve.
With two extra hands, the work of the day is lightened considerably. Simply having the companionship of another team member can brighten the mood. Consider raising your prices 10% in order to fund an assistant’s wages—you deserve the help!
“Being too busy” is a reason to consider hiring, but the business owner must create a job description and have repetitive daily and weekly tasks that can be delegated to an employee. In the ambulatory setting, this generally isn’t difficult! Here is a resource for hiring: https://www.sba.gov/business-guide/manage-your-business/hire-manage-employees.
Get Ready To Hire an Employee
Before hiring that first employee, take these steps:
- Step 1: List your employee’s tasks in a job description.
- Step 2: Standardize the work this employee will do; create policies and procedures.
- Step 3: Document procedures in writing, videos or podcasts (or have your new employee help you produce these as you train that person).
- Step 4: Figure out the financials—can you afford to pay this new employee?
- Step 5: Advertise the position and interview candidates.
- Step 6: Make the hire.
- Step 7: Plan the new employee’s first two weeks of orientation and training. You must follow tax and legal requirements before hiring and retaining employees.
Be sure that your business is compliant with state, local and federal regulations by doing the following tasks:
1. Get an Employer Identification
An EIN is a nine-digit number assigned by the IRS that identifies you as a business entity and allows you to legally hire employees. Start by visiting the IRS website, since the IRS encourages companies to apply for employer ID numbers online.
2. Verify Employee Work Eligibility
Although you don’t have to submit this form to the federal government, U.S. Citizenship and Immigration Services (USCIS) requires that all employers verify an individual’s eligibility to work in the United States by completing IRS Form I-9. The last page of Form I-9 specifies the documentation new hires must present to employers to attest to their employment authorization, whether they are citizens or non-citizens. Use I-9 Central at https://www.uscis.gov/i-9-central if you need assistance with electronically verifying employees’ identity and employment authorization.
3. Satisfy Federal and State Tax Reporting and Wage Requirements
To be compliant with federal and state regulations, you must properly classify your workers as employees or independent contractors. Because of the strict rules regarding independent contractors, it is unlikely any of your employees will qualify. Whether you decide to employees, contractors or both, your decision will determine the amount of unemployment and payroll taxes you pay. If you hire an independent contractor, freelancer or consultant, the individual will be responsible for reporting and paying their own Social Security, Medicare and income taxes. You’ll need to file a Form 1099 for any independent contractors you hire.
You cannot pay assistants a salary in an attempt to avoid overtime. The Department of Labor Fact Sheet No. 170 states: “Technologists and technicians, such as engineering technicians, ultrasound technologists, licensed veterinary technicians, avionics technicians and other similar employees, are not exempt under Section 13(a)(1) from the minimum wage and overtime requirements of the FLSA because they generally do not meet the requirements for the learned professional exemption. Technologists and technicians do not meet these requirements for the learned professional exemption because they do not work in occupations that have attained recognized professional status, which requires that an advanced, specialized academic degree is a standard prerequisite for entrance into the profession.” (See https://www.doi.gov/whd/overtime/fs17o_technicians.pdf.)
If you decide to hire either part-time and/or full-time employees, each employee must fill out IRS Form W-4, Employee’s Withholding Allowance Certificate, to indicate the number of allowances he or she is claiming for tax purposes. As an employer, you’re responsible for withholding certain taxes—based on the number of allowances the employee claims on their Form W-4—from your employee’s paycheck. These include federal income, Social Security and Medicare taxes, as well as Federal Unemployment Taxes. You might also be required to withhold state and local income taxes, depending on your state’s laws. As an employer, you’re also responsible for reporting the amount of wage paid and taxes withheld for each employee using a Form W-2. Many employers choose to use a payroll service to do this important work.
4. Report New Hires to your State Directory
Federal law requires that all employers report new employees to their state’s directory within 20 days after the date of hire. See the Small Business Administration’s website (www.sba.gov) for a list of New Hire Reporting Centers in each state.
5. Obtain Workers’ Compensation Insurance
As an employer, you are required to obtain workers’ compensation insurance (www.dol.gov.topic/workcomp/) for employees who might get injured on the job. Workers’ compensation laws across states differ slightly in details, such as benefit rates and the procedural rules governing employers, employees and insurance firms.
6. Post Required Notes on Worker Rights
With the exception of Texas, every U.S. state requires most employers to display up-to-date posters highlighting federal and state workers’ rights in a conspicuous area in the workplace. These workers’ rights are constantly evolving, meaning you need to update the posters regularly.
The Employee Hiring Process
Once you have received several applications that are favorable, you will interview candidates you feel are qualified for the position. Interview questions should be uniform for all applicants in each interview cycle. Make notes about each applicant. Keep those records for all applicants, not just those you hire. Make sure your notes do not include descriptions of appearance.
Interview questions are best when they are open-ended rather than eliciting “Yes” or “No” responses. Some suggested questions/requests are: “What are your greatest strengths?” “What are your greatest weaknesses?” “What is the reason you have applied for a position at ABC Equine?” and “Give me an example of a time when you have handled a conflict in the workplace.”
You should always call references. Do not skip this step. Confirm the dates of employment and the wage, if possible. Ask “Would you employ this individual again, if given the opportunity?” and “Is there anything else you would like to tell me about the applicant?”
After you choose your new staff member, make sure to introduce him or her to your software, billing, pharmacy and equipment use. Introduce your new hire to as many clients as possible over the first few weeks, perhaps by making a website, Facebook or Instagram post to welcome that person to your practice. Make sure you are always available to answer questions or address concerns. Go over your employee manual with your new hire to ensure that they understand your policies. Make sure that person receives mandated controlled substance and safety training in the first week of employment. You should have written acknowledgments in the new hire’s personnel file of receipt and understanding of all three of these aspects of their responsibilities.
Take-Home Message About Hiring Employees
Employees can make many contributions in a small vet practice. Increased revenue and profit often follow staff additions as doctors are freed from tasks that decrease their efficiency.