The Business of Practice From the 2019 AAEP Convention

There were many outstanding business presentations at the 2019 AAEP Convention. Here are synopses of a few of those talks.
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At the 2019 AAEP Convention, an early-morning session was set aside to discuss ethical issues in equine practice.

The annual AAEP Convention is not only the world’s largest educational gathering of equine veterinarians, it also provides some of the best equine business presentations. The 2019 AAEP Convention offered many pertinent and applicable business topics. In this article we summarize some of the presentations from the Convention.

Genderspeak: Working Together Successfully

In response to the changing demographics of gender among veterinarians, the keynote speaker of the AAEP convention was Tammy Hughes, a nationally renowned speaker on communication. For the last 20 years, Hughes has explored the research on how women and men relate and how they evaluate situations differently. Her presentation was geared toward helping the audience understand what is typical in both gender cultures, allowing listeners to read people more accurately and evaluate their conduct more fairly. Hughes addressed the issue of communication differences with humor and sensitivity.

Hughes explained that “People do things for reasons that make sense to them. They learn appropriate adult behavior through their childhood experiences. It’s not about good or bad, right or wrong—it is about differences!”

She stated that diversity is about much more than gender; it includes race, generation, sexual orientation, ethnicity, physical qualities, nationality and culture. While there are some differences due to biology (“nature”), she said, many of the observable differences in communication come from nurture. In addition, she said it is important to recognize that all populations have a bell curve, so in each cohort there will be some who behave differently than the “norm.” By becoming aware of these behaviors, we can become more agile in understanding each other as human beings, she said.

Much research has been conducted about innate gender differences, Hughes said. Some of this research is performed with infants in their first 24 hours of life. Interestingly, male babies choose to focus visually on blinking lights and machinery, while female babies focus on faces primarily. Toy companies have done a great deal of research on children’s preferences for toys over the last 50 years. By watching children play in rooms filled with all different types of toys, they have repeatedly observed that boys’ play generally revolves around power, speed and noise, while girls’ play involves caring and relationships. Although boys might interact with dolls, they create very different scenarios than girls in their play.

The speaker mentioned the differences in acceptable behavior that exist for each gender in different times of life. In the early years, the acceptable range of behavior for females is much wider than for males, she said, but this flips in adulthood. While girls are readily accepted in childhood as “tomboys,” boys with softness are labelled “sissy” or “pansy” and receive strong negative messages. As adults, society has much stronger limits on acceptable behavior for women, often narrowly defining what is feminine, while giving men a broad range of allowable conduct.

In defining the differences between males’ and females’ views of the work world, Hughes shared that men see power as hierarchical, while women are more comfortable with a flat structure. She described a meeting where older male physicians were to answer questions at a conference for younger doctors. They set up the room with a table on the stage that visually demonstrated their superiority. When young female doctors were added to the group answering questions, they wanted to set up the room with chairs in a circle on the same level. Neither understood the choices of the other. In the female culture, a flat structure minimizes individual power and increases cooperation. In the male culture, scuffling for position and power is a way of life.

When a woman is the boss, she needs to do “relationship work” in order to maximize her team’s performance. Because power is not seen as acceptable in females, she cannot toss a folder on a subordinate’s desk and say, “I need this done by 3 p.m.” as a man could do, said Hughes. Instead, she must have a conversation that strengthens the relationship and ask nicely for performance of the task.

When a team has a success, crowing loudly will be seen as arrogant and distasteful from a woman, but will be expected or at least accepted from a man.

Hughes shared that men and women focus on different things in their communication—goals versus process. Often women want to talk a situation or problem out with a colleague to process the circumstances and brainstorm possible solutions. By contrast, she said, men are goal oriented in their communication—they will want to suggest a solution because they process internally, while most women process externally. This leads to frustration where a man thinks, “Why did you ask me in the first place if you weren’t going to take my advice!” However, by giving prior notice that she is just looking to brainstorm, a woman can still have those conversations with a male colleague, the speaker added.

Another difference the speaker outlined between the genders is with having a linear focus versus multiple foci. Males tend to work in single “boxes” at a time, while women multi-task in multiple, simultaneous “boxes.” This gender difference is brain based, with females excelling at rapid task switching compared with males. When this disparity is not recognized, a boss will feel the employee of the opposite sex is under-performing and might deny them promotions, raises or good reviews, she said.

In describing different “rules of talk,” Hughes relayed that there are distinct gender differences in risk-taking versus honesty, use of linguistic devices, attribution of success versus failure, and non-verbal communication. For instance, comfort with risk-taking allows males to typically “say they can do it (whatever it is), then figure it out,” while females are honest and say what they think could work after confessing their lack of experience with the issue. In keeping with this difference, a study showed that men will apply for a promotion or job if they have six of 10 “required” qualities, while women will only apply if they possess all 10 qualities, she said. Because of this, females can fail to advance in the workplace.

Regarding the disparity in use of linguistic devices between the sexes, the speaker reported that women frequently use hedges, disclaimers and tag phrases to flatten out the power structure, a method that is very successful in female culture, but falls flat in the male power hierarchy. In contrast, males jockey for position and build relationships with each other through rough verbal bantering that can sound aggressive to females. These differences can be hard to overcome in the workplace, Hughes said.

Hughes explained that results of studies on attribution theory show clear gender differences. When study subjects took a test and were then given fake test results and asked why they performed in such a manner, there was marked variation between the sexes. When the results indicated the test went well, females attributed their success to luck, effort or task ease, while males chalked their success up to their superior talents. When the fake results indicated poor performance, the females said they tried hard but couldn’t succeed, while the males blamed an external factor. In a humorous example, the speaker suggested that when a woman’s pants are too tight, she will say “I need a diet” and the man will say “There’s something wrong with these pants!”

Non-verbal communication is powerful, and women are subject to unwittingly mis-communicating with men in this manner. Of particular trouble is nodding. According to the speaker, women nod frequently to indicate “Yes, I am listening; I am paying attention to what you are saying,” but men translate these nods as agreement with their ideas. As a result, men often feel blindsided when the women later disagree or offer amendments to the proposal.

In summary, Hughes suggested that research overwhelmingly shows that mixed-gender teams always outperform homogeneous, single-gender work groups. However, the ability to interpret others’ communications through multiple lenses will elevate results even further and help create a more harmonious and level playing field at work.

Business New Hour

Mary Beth Whitcomb, DVM, MBA, ECVDI (Large Animal Associate), and Ernie Martinez, DVM, MBA, headed up this popular kick-off to the Business Education sessions at the AAEP Convention on Sunday afternoon.

A recent study performed in the U.K. and published in the Veterinary Record revealed that although women are increasingly the dominant gender by numbers in the veterinary profession, gender discrimination remains a serious issue. Researchers found that many female veterinarians deal with blatantly sexist clients who insist that males treat their animals. Even worse, practices are failing to address these gender discrimination issues, and practices promote female veterinarians at much lower rates than males. Women respondents, especially recent graduates, reported that they were assumed to have limited competence and high potential for careers cut short by maternity. Female veterinarians with children (but not males) were considered to have lower commitment to the profession.

The study also suggested that those who don’t think women face discrimination are often the ones who discriminate the most.

ACVS Study: Next reported was a study published in JAVMA titled “Demographics, measures of professional achievement, and gender differences for diplomates of the American College of Veterinary Surgeons in 2015.”

Results showed that hours per week worked and full-time versus part-time status did not differ by gender. Respondents in equine or large animal private practice worked the most hours (50-59 hours/week) and had the most emergency on-call responsibility. Women were more likely than men to be employed in academia. In both private practice and academia, respondents in small animal practice earned substantially more ($228,000) than did those in equine or large animal practice ($130,000), and men earned 18% more than women, even after relevant adjustment.

Females were less likely than males to be practice owners or to hold a prestigious academic title or rank. Results also showed that perceptions about the effect of gender in the workplace differed between men and women.

A partner study titled “The intersection of personal and professional lives for male and female diplomates of the American College of Veterinary Surgeons in 2015” was also reviewed. This paper revealed that men were more likely than women to be married or in a domestic partnership (88% vs 68%, respectively) and to have children (77% vs 47%).

Among women, but not men, respondents in large animal practice were less likely than were those in small animal practice to be married or have children.

Respondents with children worked significantly fewer hours (6.0 less for women vs 3.1 hours less for men) than did those without children. Females were more likely than males to report that having children had negatively impacted their professional lives.

EquiManagement Article: The winter 2019 EquiManagement cover story “Leaving Equine Practice” was highlighted during the Business News Hour. In the article, the recent attrition of equine veterinarians in their first five years of practice was discussed. Survey results indicated that the primary driving forces behind this exodus are the lifestyle, long work hours, emergency duty and low compensation. The presenters said that recent numbers of jobs on the AAEP Job Site numbered 359.

Veterinarian Health and Welfare: Wellness is a topic currently at the forefront of veterinary medicine, Whitcomb shared. National Public Radio (NPR) recently had a program on the Facebook group Not One More Veterinarian (NOMV), which is a non-profit organization with 21,400 members. Moderators of the site are trained in suicide prevention, and a “Bad Day” phone list has NOMV members ready to talk to any veterinarian who need someone to listen. By partnering with BetterHelp, NOMV now also offers one month of free online counseling. Whitcomb added that the AAEP Healthy Practice program has a plethora of wellness resources available and suggested that afsp.org is also a good site for more information.

Cyber Security: Rounding out the hour-long session, Martinez reported on the growing threat of cyber attacks in veterinary hospitals, with 19 of 400 NVA hospitals affected in 2019.

Measures to increase cybersecurity include having your Windows operating system on auto-update, utilizing anti-virus software, being careful not to open e-mails from addresses that are unfamiliar, and having a back-up system that you use daily.

Sidebar: Ethics Session Proves Popular

At the 2019 AAEP Convention, an early-morning session was set aside to discuss ethical issues in equine practice. Emma Adam, BVetMed, PhD, DACVIM, DACVS, from the Gluck Equine Research Center, moderated an ethics case-based panel discussion. She noted that veterinarians often serve as ethical gatekeepers.

The overriding premise that dictates ethical guidelines is referred to as the “social license to operate (SLO).” This means that society and communities have given their approval for certain activities. Because of that overriding premise, the session began with a presentation on “Social License to Operate” by Camie Heleski, PhD, of the University of Kentucky.

Legitimacy, consent and trust are prerequisites for an effective social license to operate, along with transparency, accountability, honesty and credibility. While an SLO is difficult to quantify, it must be earned rather than granted, and if lost, it is tricky to regain. Questions that were asked:

  • Do veterinarians have an automatic social license to operate?
  • Have public attitudes toward veterinarians changed over the years?

Many horse owners see a value in veterinarians, but clients also have tremendous access to information, media and “Dr. Google.” Because of this, an automatic social license to operate for vets is not implicit, as it used to be.

Veterinarians usually lose public trust through objectionable actions. One audience member suggested that when posting on social media, it is smarter to offer evidence-based information rather than opinions and feelings, which can be damaging. It is also always appropriate to say, “I don’t know.”

As public trust of veterinarians is chipped away, this might be a wake-up call for practitioners to become more proactive. One person asked, “If we don’t speak up, should we expect the public to trust us?”

As pertains to private equine practice, when a practitioner feels that there is an ethical “red flag,” it is important to discuss those concerns with the client. One hypothetical example provided in the seminar depicted a client asking her veterinarian to inject a horse’s coffin joints for a horse show that is going on for the next few days. Just flatly saying, “No, you need a four-day withdrawal period prior to showing, so I won’t do that” leaves a bad taste in the client’s mouth and makes the veterinarian uncomfortable.

Rather than leaving it at that, it could work better for both client and vet if there is a discussion about other possible solutions. Clients don’t always know about the array of options for managing a horse’s chronic lameness conditions. Another proactive step to consider is to be involved with clients’ needs before an event is upon them. This could be accomplished using a computer- driven reminder to have the client contact you well in advance of an event.

Poor ethical standards and bad press have caused many industries to lose this social license to operate privilege— the mining industry, sows in gestational crates, greyhound racing, elephants in circuses and bullfighting in Spain, to name a few.

Heleski related that videos of negative things often go viral in a matter of hours, citing the video of a barrel horse being trained with a shocking device, which was shared 6,900 times in 90 minutes.

Although social license to operate is difficult to measure and quantify, she said that often “public emotion may not be recoverable.”

The intense scrutiny on 37 deaths in 2019 from catastrophic breakdowns of racehorses at Santa Anita is one of the situations that might put the sport of racing at risk of losing its social license to operate. There are practices deemed acceptable at U.S. racetracks that are not acceptable elsewhere, including the use of whips and race-day medication. It was suggested that the best way to handle the greater scrutiny of the racehorse industry is by responding to public opinion. 

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