Equine practitioners work approximately 50 hours per week compared to their small animal colleagues, who clock about 43 hours a week, according to the National Commission on Veterinary Economic Issues (NCVEI) and an AVMA-Pifzer study.
My personal experience in solo practice found me working 70-90 hours a week for too many years to count. I imagine this is true for many of our colleagues, especially at certain times of the year.
I worked as an equine veterinarian for 33 years, most of it spent as a solo practitioner. It was hard to see any way of deviating from the standard method of practice employed by so many colleagues. Simply put, horse-owing clients demand round-the-clock availability. My well-developed sense of responsibility fit nicely into their needs. This meant being ready to jump into action whenever a call came in, no matter how intrusive on family and personal life, and no matter the hour or the weather. Saying “no” did not seem to be an option.
Looking back after having shed those idealistic blinders, it is no wonder that working under those parameters was a sure recipe for burnout.
There are not many solutions to dealing with the demands of being a solo equine practitioner, particularly in a highly competitive market. One could hire an associate with all the related costs that would likely obviate a reasonable income for the practice owner. Another option is to forego a position of business ownership by joining another practice. Alternatively, one could eliminate emergency calls and restrict availability to regular business hours, no longer being available 24 x 7. Or one could elect to leave veterinary practice altogether.
This introduction probably strums a chord with many of you reading it. You might feel completely blocked in by the unrelenting hours of servicing equine clients who have been spoiled for a very long time by full-time accessibility to their equine practitioners. If you’re not available due to conflicts, it is possible that a client whose needs you’ve addressed for years will switch permanently to the person who runs to his or her aid that one time. That is a bitter pill to swallow. The lack of loyalty and appreciation by those we work hard to help adds to burnout.
So what sort of options might you pursue to introduce creative work schedules into your practice that maximize client loyalty as well as your own career satisfaction?
Many companies (not necessarily veterinary related) have suggested creative options in work scheduling, such as unlimited vacation time; a results-only work environment; remote work and distributed teams; flexible schedules (not 9 to 5); or job sharing. Of these choices, the last two are the options that have the most reasonable chance of fitting in with a hands-on job of being an equine practitioner.
With more than one practitioner servicing the business, your options become many and varied. On-call emergency duty staggered between practitioners frees up personal time for everyone. Job sharing has become a popular strategy, and it is one that works particularly well for parents raising young children or veterinarians caring for elderly family members.
The American Association of Retired Persons has determined that 50% of people caretaking an elderly family member have to balance this responsibility with full-time work. More sobering is the finding that within the next five years, it is speculated that half of today’s workforce will be providing care for elder family members. This is yet another motivating reason to consider implementing creative work schedules.
Building creative work schedules is also a means of attracting competent employees. The newer generation of graduates is well aware of a need for work-life balance, and they no longer wish to work in a fashion that older practitioners might consider normal. The younger set might have a passion for the profession, but not to the point of total immersion that allows veterinary medicine to dominate their lives.
No matter what type of work schedule you decide upon, an important element to making it work is educating your clients about what they can expect. They might want only Dr. A but have to make do with Dr. B or C. It is important to them that there is continuity in the practice, with each doctor communicating to the primary care doctor about cases seen on his or her behalf.
Job sharing can be highly useful and can cut the number of hours worked each week to 30-40. Schedules can even be flexible if all participants are willing to negotiate days in attendance in the practice. Time off might also be modified in the event that something comes up, such as unplanned family happenings, illness, the need for a mental reset or the desire to attend an interesting continuing education seminar.
You might even consider sending out a survey to horse owners to ask them what hours are particularly useful to them for scheduling appointments. If most are free in the afternoons, then practitioners’ work can be scheduled to coincide with those hours. If it’s the morning or the evening hours, then schedules can be tailored appropriately, with the veterinarian given some time off in the middle of the day.
Some practitioners in a multi-doctor practice might consider a compressed work schedule format similar to shifts that nurses follow—three or four 12- hour days—to be more attractive than eight-hour days scheduled five days a week. This gives more concentrated down time. It might seem like the vet has an amplified work schedule during those three or four days, but in truth, he or she is likely to end up working 12 or more hours a day even with a five- or six-day a week schedule. That is just the nature of a busy equine veterinary practice, particularly at certain times of the year. Scheduling the practitioner for a three- or four-day work week ensures that each individual has some quality time off to rest, regroup and pursue family and personal life needs.
For practices with dedicated interns or residents, the practice owner and associate veterinarians might field emergency calls from home without having to go into the clinic and still participate in case assessment. They can advise interns and residents on a course of action and continually check in while remaining in the comfort of home or participating in family events. With the ability to relay digital information such as video and diagnostic images via email or Skype, there are infinite ways of communicating medical information among practitioners from a distance.
There is some evidence that providing practitioners with options to balance work obligations and personal life leads to improved productivity and job satisfaction. For a practice owner, this means greater retention of veterinarians with better profitability and client satisfaction.
The Solo Practitioner
Generating a creative work schedule for a solo practitioner requires some creative thinking and openness to novel ideas.
One logical plan is to collaborate with other solo practitioners to figure out how to share emergency duty while also retaining your own clients.
Sharing emergency duty is a satisfying solution if each practitioner honors a philosophy of not stealing his or her colleagues’ clients. After the emergency event, the case is turned back over to the primary care doctor and both vets discuss the details, so the client knows there is communication and continuity of care for the horse.
In my own experience of working too many hours 24/7, I elected to turn over emergency calls on nights and weekends to a willing and eager new graduate who desired a jump start for her own solo ambulatory equine veterinary practice.
If you are a solo practitioner, establishing a good working relationship with one or more solo practitioners can have other benefits. For example, you might collaborate on the purchase and use of expensive equipment. This relieves each solo practitioner of an expensive Financial burden that could otherwise be shared.
In addition, it frees up capital to help with hiring a vet to cover emergencies—or a relief vet for part-time work during busy periods or vacation times.
The other thing I deemed important included conducting several educational seminars for my clients, so they could understand through photos and explanations what does and does not constitute an emergency. They understand that no matter what, it is important to call even just to discuss a concern so nothing serious slips through the cracks. Yet they received advice about taking care of simple problems that are safely put off for veterinary attention until the next day or so.
Just like in a group practice, solo practices will have times of year when they are less busy. A solo practitioner can follow the lead of the multi-doctor group by scheduling around clients’ preferences. It is important to send out queries to your clients asking about optimal times they’d like to see you for their horses’ needs.
Making this altered schedule work for you and your clients depends on you educating your clients about what to expect during such a flex-hour arrangement.
Each practice develops a specific “culture” along with a philosophy of ethics and approach to veterinary medicine. To maximize positive attitudes and strong work ethics, it could be worthwhile to provide a clinic’s veterinarians with creative schedules.
Part-time work, shared job positions, flex hours, compressed work schedules— these are just a few examples of ways to obtain the best productivity with the greatest job satisfaction for veterinarians and staff.
Don’t be afraid to talk about flexible or alternative work schedules with your associates. You might find it helps them want to stay in your practice.