For love or money?

I'm gonna let you all in on a secret. A lot of veterinarians are paid at least partially based on commission, for lack of a better term. Many places use a "pro sal" compensation scheme, where "pro" stands for "production" (i.e. the gross income you make for the practice) and "sal" stands for "salary" (i.e. a base amount of pay that the veterinarian gets no matter what).

That part doesn't bother me. Most base salaries are decent (not nearly as high as MDs or even RNs, but that's another issue), and my personal philosophy is that if you consistently try to do right by the pet and the client, the money will follow.

However ... not every veterinarian thinks that way. Unfortunately there are also places (like the corporation I work for) who go report-happy and publish and track production statistics on a VERY frequent basis. Couple that with regional managers who don't have a veterinary background, and let's just say you get what you reward.

On paper (money-wise), I look like a crappier veterinarian than Dr. Relief. Their average income per patient is around $130 and mine is more like $110. However, Dr. Relief does things like prescribe antibiotics in about 80% of the cases that they see - even if it's something minor like the animal sneezed twice or has a localized hotspot. Oh, and had the techs not caught a couple of MAJOR medication errors, Dr. Relief may have killed a couple of animals (not kidding). So the company keeps people like Dr. Relief on staff and nags doctors like me to increase their production*. Nice, eh?

*I should note that no one has bugged me about my production - yet. Apparently after you've been there a year then they start nagging you if you're not hitting their targets. I should also mention that I'm very close to hitting their targets without practicing scheisty medicine.

On the hunt

I've been checking the classified ads in several places and have applied for 3 other positions so far. I've heard back from one who said that particular clinic needed someone with more experience but would I be interested in this other one? You betcha.

This week I've felt like the grim reaper. Thursday - euthanasia. Friday - euthanasia (of a young cat with a horrible tumor). Today - told someone their beloved dog has a mid-abdominal mass, probably in the spleen. Ugh. Keep in mind that I don't work emergency so this string of events is very atypical for us. Aside from that I'm managing fairly well at work. Unfortunately the doctor who covers a lot of my days off:
- Says they don't know how to do spays
- Nearly overdoses about 1-2 patients per day (except the techs catch the mistakes)
- Takes about 2 extra hours per day to see 2/3 the number of patients I do
- Prescribes antibiotics like they're candy (I'll write another post about that soon)
- Doesn't write ANY notes in the record on about half the patients they see so I have no clue what to do if I get stuck with the recheck
So when I come back to work I get to deal with pissed off clients and pissed off techs. Yes, we have ALL discussed this with management. The harsh reality is that there aren't enough vets to cover all the clinics so rather than close one for a day they keep a warm body around. Especially when that warm body makes a lot of revenue by prescribing unnecessary medications.

Too much.

I spent Sunday volunteering at a Crossfit competition held at our box (gym), which basically involved setting up for the different workouts and keeping score/judging teams as they went through the workouts. The competitors had to meet certain standards in order for their reps to count. It was a lot of fun, and I almost lost my voice from yelling out rep counts through the day!

The rest of this week has been rough. Tuesday I went to the shelter and got to do several spay/neuter surgeries and help with an FHO (cool!) Wednesday and yesterday at work were very busy and full of difficult cases and difficult clients, and yesterday I had a migraine and stomach pain all day – not good when you have several loud dogs as day cases.

Unfortunately on Tuesday I also found out that my sister and her family are no longer coming to the wedding. My sister was going to be my only bridesmaid and my niece was going to do a reading in the ceremony. I am still processing the whole thing. The reasons have nothing to do with me but I’m still pretty devastated.

Between that and all the crap with work I’m calling shenanigans on the whole “God doesn’t give you more than you can handle” thing. I'm totally overloaded and just praying I can make it through the next 3 weeks until I can get some time off.

Mass exodus?

Yesterday we got the news that one of our long-time (and, I might add, pretty darned good) techs is leaving too.
She's headed to my previous hospital where I worked as a tech. You know, the dream one.

So here's the tally of who's missing now:
- 1 veterinarian
- a practice manager
- 1 RVT/LVT
- 2 receptionists (one on maternity leave, the other on disability ... did I mention that we only had 2 receptionists in the first place?)

Awesome.

D said something very profound yesterday:
"It's hard to be onboard when everyone is jumping ship; worse yet when you don't have anywhere to jump to."

At least I have tomorrow (Sunday) off. Yeahhhh!!

Insomnia

I've been having a lot of trouble staying asleep lately. I wake up in the middle of the night and then can't go back to sleep because I'm either worried about something (usually work) or have just had a nightmare.
The other night was the worst because I had a nightmare that my friend, a tech at my old clinic, told me that my old clinic would never hire me because "They think you're like 12 and will never be able to catch up with the type of medicine practiced here." I was completely devastated. D says the dream is a sign that it is something I really want badly (true) and not a premonition (I hope not).
As a result, I've resorted to taking an OTC sleep medication and it's been working wonderfully. I fall asleep quickly and - more importantly - I STAY asleep all night. Even though tons of people I know take prescription sleep pills or antihistamines I still somehow feel guilty for having to resort to this kind of help.

Friday was a bit of a cluster - I ended up driving 1 1/2 hours each way to cover a clinic that had no doctor onsite and only being at that clinic for 3 1/2 hours worth of work. Hey, if they want to pay me to drive all day (and reimburse my mileage), whatever. I've got tomorrow and Tuesday off!

Don't know how to feel about this

Dr. X resigned. Their last day is Friday.

On the one hand ...
- I don't have to worry about tiptoeing around them and maybe whoever replaces them will be easier to work with
- I'll now get to work 5 shorter days (we are keeping the clinic open fewer hours in the interim and I'll switch to a 5x9 schedule instead of 4x11*)

On the other hand ...
- What will happen to the handful of ridiculously difficult clients they managed? (I don't want them - have some of my own, thankyouverymuch)
- With our practice manager also leaving soon, there's a gap in who will manage client escalations, tech scheduling, and other admin tasks. I guess a PM from a different clinic will pinch-hit for ours in the interim, but still.

This is gonna be a sh!t show, I fear.



*Why not 5 x 8 or 4 x 10? Supposedly those 9 or 11 hours include a 1 hour lunch break. I think there was one day where I got to take a 30 minute lunch. Of course the techs were calling me during that time about something or other.

Holiday cheer (not)

According to the techs at work December usually has a higher-than-average number of a-hole clients. The techs' theory is that people are stressed out over the holidays because clients have limited funds and have to deal with various family things, so they (the clients) take it out on us. Based on last week I believe it. We had a handful of clients who were told that they were more than welcome to take their pets elsewhere. Believe me, this is a BIG DEAL at a clinic where the culture is to bend over backwards to accommodate clients. Hopefully that gives you an idea of how out of line the people were. I won't go into details, but let's just say that screaming obscenities is not okay.

Yesterday Dr. X apparently called in sick and work was trying frantically to reach me to come in. I wasn't available (and if I was, I probably still would not have agreed to come in because I was completely fried). Hopefully they got someone to cover so that they didn't have to close the clinic, but if that was the case - well, then the company needs to do a better job of scheduling and getting a pool of relief vets. There isn't really any incentive to come in on your day off, either. Yes, you could earn more toward your production. No, that's not a sufficient reason for ANY vet I know to come in on their day off. I guess if Dr. X and I got along better I'd feel more team spirit or whatever and might be more inclined to help, but that's not the case.

Bit by bit the wedding is coming together. Although I'm excited for it, I will also be soooo relieved when it is over! We're doing a fairly low key event with few guests and a coordinator and I'm still super stressed over it.