Abstract:: Points from the practice management seminars (Opperman, Wood) at NAVC 2001 are included as two cases are discussed. Case 1-the short staffed practice manager playing pick up all the loose ends and Case 2 - Staff member in prominent spot is returning to school for further education and is offered a new position at a substantial decrease in pay, but the new position is in what she's going to school for. Chat includes hints on ad placement, salary/benefits, delegation, staff unification, and motivation.

Summary:

Staff Motivation:
1. REWARD SYSTEM: Use a reward system of "gold stars". Use a chart in the staff lounge area that lists everyone's name and a spot to write in what the person did or have several suggestions of ways a staffer can make the practice better. Anytime a staff member goes out of his/her way to benefit the practice, that person receives a gold star. Each quarter the staff is evaluated by the practice manager and practice owner and based on the gold stars (i.e. you can set a goal of three per quarter). Those that achieve the goal receive a reward such as movie passes, gift certificates to restaurants, free lunch, passes to events, etc. Opperman and Wood suggested that the rewards be "pamper awards", that is ones that force the person to go out and enjoy him/herself. Money, free clinic goodies don't qualify.
2. MONEY FOR NOTHING? DVM's always thinking of money (i.e. can't do this [give benefits], can't implement this [rewards system], can't pay you this because [better wages]...). This may require outside help (i.e. practice management consultant). Just looking at daily statements or even monthly printouts doesn't give you a real grasp on what is the true income/expense of the practice. DVM's and practice managers need to evaluate where the money is going.
A. REAL SALARY = hourly wage + hospital paid insurance (medical, dental, eye) + 401K matching + services and goods discounts within the practice + uniform allowance + paid days off, etc. Many staff and veterinarians forget what's included. Staff forget and see only the dollars on their checks (the net not the gross); veterinarians see the total amount (gross) that goes out for the entire employee (their real salary). So there is a huge misperception of how much someone really makes. What it boils down to is the take home to the staff who have to in turn pay for their life expenses. For staff, make sure they know what their real pay is if they are griping and also to give them knowledge enough to make solid raise requests (i.e. not just in hourly wage, but increased benefits where there are none, etc.). For the veterinarians, this knowledge give them leverage for offers to staff. The most important thing to remember here is for the practice owner to realistically think about cost of living and how much happy staff is worth when he/she factors in hiring/firing costs, training time and cost, and the veterinarians ability to address and do his/her licensed tasks only (diagnose, prognose, prescribe, perform surgery) and utilize staff enough to cover the rest.
B. HOW TO GET GOOD APPLICANTS: Classified ads are the least productive way to get good applicants. If you must use them, spend a little extra to be specific about whom you are seeking (Opperman). Example ad: Certified Veterinary Technician wanted for an AAHA small animal/exotic 2 doctor practice in....Must be a team player, be interested in continuing education, client education, and have excellent organizational skills, motivation, and be able to multitask. Salary is DOE on years in the field, licensure, and will be adjusted after a 90 day probationary period. (Note, CVT is spelled out and the salary change is not denoted as being raised or lowered). NOTE: Untapped resources include seniors, flex time part timers (parents with school children); ads in VetQuest on VIN and in VSPN, at your local VT/VA programs, in state/local VTAs or staff support groups (VHMA), local colleges job boards or placement services/job links.
3. IMPORTANCE OF STAFF: All staff is important. All staff should be treated with respect. There is a difference between licensed and unlicensed personnel, however, time in the profession and ability to learn also play an important role in each persons abilities and future abilities.
4. LICENSED STAFF: There is an ongoing issue of whether or not licensure of technicians makes a difference. It does, but sometimes there is a person, who just doesn't make the grade in real life even tho' he or she made it through school and passed a licensing exam. This happens in all professions, (just think about some of the veterinarians that fit this bill); this is not an excuse. In the case of veterinary technicians, to improve future veterinary technicians, contact the veterinary technology program and offer them advice on what they might do better to ensure quality graduates. For example, more hands on animal care in school. Then get involved with the advisory board of the program and get involved. HINT: this gives you a heads up on upcoming graduates that you can snap up before they hit the interview trail.
5. SALARIES: other than hourly...be very cautious. If you are paid to work 40 hours, only work 40 hours (or as close as possible). Veterinary medicine is notorious for people working way past their "time". Yes, it's needed in cases of emergency, but it should NOT be the norm.
6. KEEPING THINGS LIGHT: monthly staff meetings (Opperman) should be used as mini CE events, wages should be paid, and attendance should be mandatory. Use these meetings to go over new procedures and policies, stage mock situations and role play. Make the meetings FUN, have FOOD, and keep it short (minimal/no b****ing)

Case 1: This practice manager is in charge of several tasks in the clinic. Determine what duties actually fall under the title practice manager and what duties should be delegated. You can spread yourself too thin.
Duties: accounts receivable, payroll, employee compensation, health insurance, receptionist, technician, DVM's personal financial, 401K, hiring/firing, employee scheduling, maintenance of two practices (repairs, signs, etc.), employee conflicts/resolutions, client conflicts.
Ask yourself, is this person overburdened? How many job titles is this person performing in this clinic? (answers are yes! and at least 4!)
Breakdown: Manager: payroll, employee compensation, 401K, maintenance of two practices, client conflicts, and everything is as an overseer (deal with it only when the supervisor in charge can not). Office Manager: accounts receivable, health insurance, supervising receptionists and their hiring/firing and conflicts/resolutions. Head Technician: supervises medical staff, trains/hires/fires, schedules, and deals with conflicts/resolutions. Personal accountant: DVM's financial affairs outside (and maybe inside the practice). NOTE: some of these can be delegated further to specific office personnel or other staff.
Steps for success:
1. Start identifying people you can delegate tasks to. Start with minor tasks to "test them out". Make sure the person(s) is(are) willing to accept responsibility.
2. Start delegating. Even the little delegations can help you better manage your time and concentration on other issues. You have to let go.
3. They will make mistakes, no one is perfect, not even you. Identify, teach, watch, reteach if necessary, reassess choice for task if necessary and reassign as needed.
4. Continue to delegate until you get down to what your real job is.
5. NOTE here...the veterinarian saw potential and DELEGATED so he/she could do his/her job (diagnose, prognose, prescribe, and perform surgery).

Case 2: Staff member working in one area of the hospital and is going to tech school. DVM wants to make staffer a tech rather than the current job and significantly reduce wages in doing so. In a nutshell, never accept a reduction in wages if you are transferring fields (unless you have a huge amount of time in at the original position, are a supervisor/head person in that position, or the position you are going to you have absolutely NO knowledge).
1. DVM is not losing any money placing ads/interviewing or necessarily having a probationary period.
2. Training in routine clinic policies and procedures is almost nil (except the duties and tasks specific to the new position.
3. Staffer can consider counter offer of slight reduction in wages (taking in to account #1 and #2 above), but put a stipulation on a wage increase upon completion of tech school and then again on successful passage of the licensing exam(s).
4. Staffer needs to remember to include pros about having a licensed technician in the practice and the increase in quality animal care that will ultimately occur once school, licensing, and experience come into play.
5. The entire staff can sit down and have a heart to heart, well thought out, hard fact evidence to back up discussion with the practice owner and practice manager to discuss attitude, utilization, etc. Basically, anything that the entire staff is in agreement with that they would like to see change. The common/ultimate goal is to voice your concerns that you all want to provide the best medicine and practice for the clients possible. (see the ultimate take home lesson below). NOTE: We all have "hard times"; this phrase should NOT be a constant fall back for anyone in the practice. It is a cop out and it's negative. Think positive, think future.
6. Staffer needs to assess just how badly you want to stay with the practice and practice owner that provides constant issues and reluctance to compensate staff. There are too many available positions for qualified personnel in veterinary medicine to allow yourself to suffer (mentally or financially).

ULTIMATE TAKE HOME LESSON:

Happy Employees = happy clients = longevity of employees = less new trainees, less turnover, etc.

Happy Employees = well paid + well compensated + well utilized + well respected individuals

The two most important words you can use in every day life = "Thank You"

Attendees: Nanette (host), Kelly, Cheryl