For 18 years, Dr. Ray Ramirez made a career out of filling in when other veterinarians were absent or needed an extra hand. He prided himself on being the kind of worker any practice owner would want to hire permanently.
Now Ramirez is a practice owner himself. This is what he has to say about hiring relief help:
“Just wish I could clone myself to do relief work for myself.”
The wish is expressed with a smile but he’s not really kidding. Ask clinic owners for their ideas on what makes a good relief veterinarian, and the answers are as varied and individual as the owners themselves.
That was the result when Dr. Valeri Devaney floated the question, “What do YOU want in a relief vet?” in a message-board post of the Veterinary Information Network (VIN), an online community for the profession.
Devaney, a relief veterinarian in Houston, said she asked the question in hopes of picking up ideas and insight. “I am always interested in improving myself,” she said in an interview. “Especially in an economy that makes a relief vet an expensive venture for a solo vet, I want to provide a good value.”
At the same time, she wasn’t surprised when responses ran the gamut. “Everyone’s idea of ideal medical care varies,” Devaney observed.
Most respondents agreed on the basics: Be on time. Be friendly. Treat staff well. Take good notes. But some expressed seemingly contradictory concerns.
“I worry that a relief vet might not be aggressive enough in diagnostics to get to the bottom of the problem (not to run the bill up. I’m just worried that a lot of people will skip diagnostics if it is the end of the day or worry about the client’s ability to pay, etc.),” wrote Dr. Kathy Jordan, a practitioner in Townville, S.C.
Conversely, Dr. Katie Linderman in Chattanooga, Tenn., posted that she values a relief veterinarian whom clients really like, someone with a good bedside manner. “It is stressful to hear that the relief vet made clients feel like bad pet owners just because they can’t afford a huge work-up,” she said.
The lesson is that the relief veterinarians most likely to survive the multifaceted and sometimes conflicting demands of clinic owners are those who are adaptable, flexible and good communicators.
“I definitely agree that different owners will have different expectations of their relief vets,” said Jordan in an interview by e-mail.
“It’s hard to find a good fit,” agreed Dr. Lisa Bennett, a solo practice owner in Issaquah, Wash. “It’s just like finding a good employee — it’s hard to find a good employee who matches your style.”
The professional credentials and training are just a start, Bennett said. “There are all these other variables that go along with it: Personality, commitment to the patients, commitment to pain management, commitment to making the clients happy, commitment to making the patients happy.”
The number of veterinarians working relief at any given time is relatively modest. The American Veterinary Medical Association (AVMA) counts roughly 2,000 practitioners as relief veterinarians based on information in the profiles of the association’s 81,500 members. How those numbers compare with the past is unknown. The AVMA has not tracked the sector over the years.
Anecdotally, it appears that the population is fluid. In addition to a core of practitioners who make a career of relief work, veterinarians may serve as fill-ins while looking for a permanent position in a clinic, while between jobs, part-time while raising a family or after retiring from ownership, for example.
To that extent, the concerns of relief veterinarians likely interest and affect many more in the profession than those serving as relief at any given time. Still, resources devoted to their issues are scant. There are no national professional or support organizations. Existing resources include a message board folder on VIN and the book “FlexVet: How to Be One, How to Hire One. The Comprehensive Practice Guide for Relief and Part-time Veterinarians” by Dr. Carin Smith, a one-time relief veterinarian now working as a consultant and writer in Peshastin, Wash.
(The guide originally was published in 1990 under the title “The Relief Veterinarian’s Manual” and has been updated and revised several times since then.)
In an interview by e-mail, Smith identified one of the top challenges facing relief veterinarians as “Adapting to many different practice styles, cultures, policies and medical approaches, as well as working with a variety of people and varying numbers of staff members with varying abilities.”
On the owners’ side, the challenge is “finding someone who will be comfortable working in your practice given your culture, style, policies, etc.,” she said. “It is all about a ‘match’ ... ”
For that reason, veterinarians and clinic owners alike recommend face-to-face meetings ahead of time to discuss practice styles. “That would allow the relief vet to tailor their work to the owners’ expectations/desires,” said Jordan, the practice owner in South Carolina. “Not that they should do the exact same thing the clinic owner would do in a given situation, but that they could learn what the clientele typically expect and adjust accordingly.”
She offered this example: “If the clinic caters to clients who typically want extensive diagnostics for a dog who vomited once, the relief vet would know to offer very complete work-ups to everyone. If the clinic caters to clients who typically want very low cost, the relief doc should still offer diagnostics, but would know not to push too hard for tests on a case that would usually respond to symptomatic management.”
In short, Jordan said, “The more communication between the relief doctor and the clinic owner, the better.”
While that might seem like common sense, many a practice owner has stories about minimally communicative and generally unimpressive relief help.
“The biggest problem I’ve had with relief vets in general is them not communicating with me,” Linderman, the practice owner in Tennessee, recounted in an interview. “Just leaving notes that are kind of ambiguous and not really going into detail on what the client’s attitude was and how the client was really stressed and they’re expecting me to get results right away — things like that where I’ve walked in and didn’t (know to) call the client back right away and the client was nearly hysterical by the time I figured out it was a big deal.”
Other problems clinic owners have had include relief help being habitually late; making telephone calls to set up other jobs while leaving clients waiting; having lengthy conversations with clients well past closing time, then charging the owner for the extra time and requiring the owner to pay staff to stay late; and disrespecting staff.
So disappointed and frustrated are some owners that they are reluctant to hire relief veterinarians in the future. Ramirez, for example, said he is considering simply closing his clinic in East Peoria, Ill., while he takes a week’s vacation this summer.
Ramirez noted that he knows one very good relief veterinarian, but she lives three hours away. Having to reimburse her travel and lodging as well as paying for her services makes bringing her in prohibitively expensive, he said.
Bennett, the solo practitioner in Washington, said that owing to the slowed economy, it makes more sense to close than to hire relief help while she’s away. “When I was gone for two weeks in November, I just had staff in to sell food and make appointments,” she said. “It just wasn’t worth paying (a doctor) to come in.”
If practice owners have had disappointing experiences with relief veterinarians, so have relief veterinarians with some practices.
Devaney, the relief practitioner in Houston, told of swearing off one clinic after she learned that a technician had neutered a cat while she was serving as the only doctor on duty. She reported the incident to the veterinary medical board.
For Dr. Chiara Switzer, a relief veterinarian based in Toronto, an ethical dilemma arose when she learned that the owner of a clinic where she was serving gave only partial doses of vaccine to a small dog. The information came out as she was drawing up the shot and the dog’s owner piped up, “Oh you’re giving him the whole thing?”
Switzer finessed the situation by saying something about the dog being big enough to take the whole thing now. That seemed to satisfy the client.
“I never imply that the clinic owner is doing something wrong,” Switzer said. “Part of my job is to maintain the trust that the client has in the clinic, so I will never say anything to disturb that trust.”
Why the clinic owner was cutting the dose isn’t clear — whether out of ignorance because the dog was small, or something else. Switzer, new to relief work at the time, didn’t pursue it. She did, however, vow not to work for the clinic in the future.
A relief veterinarian for more than eight years now, Switzer said she enjoys being her own boss without the obligations and responsibilities of owning a clinic. But because of her independent streak, she is in some ways not the person whom some clinic owners would describe as the perfect substitute.
Dr. Richard Headley, a practice owner in Mishawaka, Ind., summarized his ideal relief veterinarian this way in a post on VIN: “I like to have a relief who I would like to have as an associate.”
Switzer said she understands the wish but believes it’s not easily fulfilled. “The personality that it takes to be a good relief vet is not the personality that it takes to be a good employee,” she said.
On the other hand, the personality that makes for a good relief veterinarian may well make for a good clinic owner. And there’s the rub.
“I had one (relief veterinarian) that was really, really, really, really, really great,” said Bennett, “... but then she went and bought her own practice, and that blew that.”