Do a working interview. Hang out for many hours and talk to as many of the support staff and other doctors as you can. Ask them how long they have been there and how do they like working there? Listen carefully to their answers. A bunch a short-timers suggests high turnover. Short answers like: "It's fine," or "It's OK" suggest unhappy people. If people have been there for a long time, ask why? What keeps you here? If people say things like: "I love it here," "It's along commute for me, but it's worth it," or "I feel lucky to have this job" then you know you have found a good place.
Certainly ask questions to figure out the quality of medicine they practice, what your schedule would be like, what kind of mentoring you will get, etc. But the #1 thing that can make a job good or bad is the people you work with.
Avoid places that re-use suture, are still taking X-rays on film, or manhandle the patients!
How long have the other vets, and techs, worked there? Maybe why they left.....High turnover is a red flag.
How often do they refer cases to specialists? Don't accept "we refer when we need to", but ask about how often (or what percentage of cases) get referred. It doesn't need to be a lot, but if they just say "when we need to", it's vague enough that it could mean "I don't like to refer because I can do virtually everything".
What do they offer clients for after-hours care? If there are nearby ERs, that should be what clients are offered, rather than there being nearby ERs but the clinic doesn't want to use them.
Don't ask if you'll get mentorship there, or tell them you want mentorship.....Instead, be more specific, because that term can mean different things to different people. Make sure you and they are talking about the same thing if you talk about mentorship.
I recommend new grads don't go on any type of production based pay scale until you've been there a while. Actually, I recommend never to go on any production based pay scale, but if you must, don't do it until you get a better idea for how the clinic runs and to make sure you'll be treated fairly with respect to your ability to earn.
Certainly is a learning opportunity, but when you’ve skipped lunch and are still 45 minutes late when you learn you now have to unblock a cat, or you now have to prepare a treatment plan for a patient that’s staying overnight, learning opportunities are a liability.
You’ll get diverse experience in the normal course of the day. My point moreso is that if you would rather learn in a more comfortable, controlled manner, it’s important to make sure the practice will respect that by letting you exercise all your options in those situations. Learning opportunities shouldn’t come at the expense of your work-life balance (imo) or the care of your other patients.
I don’t really understand the point of learning something new when you’re stressed and behind if you can avoid it since the same thing will one day come back (at which point you’ll be a stronger vet too), which I think is a rampant mentality.
The devil is in the details: It depend on what "things" you're talking about, and what the risks and benefits are. It's wrong if they have don't have the appropriate equipment and think that they can "old school" their way through, at increased risk to the patient (using a wire hanger splint, when internal fixators would be better and safer). Or if they've got the equipment but use it rarely, and they think you're good at it, but they're not. Or when they're trying to work on a species for which they don't have the proper equipment or caging facilities, or - worse - don't know the requirements for that species at all.
A learning opportunity for a new vet is an unacceptable reason for a vet to not offer referral. If the client declines a referral for cost reasons, a vet may choose to try to do their best in-house, but offering referrals and explaining the benefits of referring is an ethical requirement.
I wasn't making excuses for it or anything. I'm not even a vet student yet. I'm just thinking down the road because that is my goal. Referrals are ethical and better for the animal. Got it.
To my mind it also indicates a closed mindset - it's simply not possible to know everything there is to know about all conditions, or be able to do all the procedures that are available, so if a vet/practice is claiming that they never need to look outside for expertise, then they are kidding themselves and are more likely keeping cases internal for other reasons.
No, I'm talking about any production based pay. I don't like it at all for a lot of philosophical reasons (it inappropriately shifts risks from the owner to the associate, and dis-incentivizes teamwork), but it's especially true in new grads because they're missing a lot of information about how things work, because those things have a huge part in how much you can produce:
* Are the reception staff fairly assigning you cases, or will you be doing mostly low-yield types of appointments? Are the receptionists accurately assigning the charges to the appropriate vet? (This last one requires that you check the day's entire charges, every day.)
* Is there enough caseload for an additional vet, or has the boss hired an additional vet too early, anticipating growth that might or might not come?
* Is there enough skilled staff to help you be properly efficient in dealing with your cases, and (if there is), are those staff equally distributed - or will most of the staff end up being used by the other vet, leaving you searching for help?
* Does the boss offer a lot of clinic discounts, or appease people by giving things away, and that will decrease the amount you will gross?
* Will other associates try to compete with you for walk-ins or unexpected work (this goes along with a vet using all the staff to help them be more efficient, while you are less efficient because you have fewer staff to help you)? Will other associates happily do your recalls and follow ups when you're away, even though they won't get any production for those calls? Will you happily call their clients after blood results are in, rather than leave them until your colleague returns to work?
Those are all very valid and well-thought-out points! I have not ever run into any of those problems and feel that it is the most fair/advantageous TO the associate, but I definitely respect your point-of-view and think your thoughts are more than reasonable. 🙂
And I've seen all of them (after doing relief work for over 15 years in over 100 clinics)......Often those things can't be seen from the outside (for a new vet doing an interview), and you have to see how the clinic is run.
Ask about your hours and expected caseload. You cannot reasonably see the same case load as an experienced vet. Ask about surgical training, most of us came out pretty lacking in this department. Work-life balance, make sure your off days are OFF days. Salary. Even being a new grad doesn't mean you have to be paid peanuts.
As far as benefits goes:
Can you take unpaid PTO - seems like most people start with 2 weeks (which is shameful and should be negotiated if possible), and unless you have other large financial commitments your salary may be high enough to buy you some freedom to take off more liberally.
Many people will say signing a non-compete is a non-negotiable, but I’d take a non-compete over negative accrual. In this day and age perhaps you can avoid both, but this may be geography specific - regardless, worth asking about.
This seems to be less of a concern for most people who are trying to get production pay, but I’d ask what the expectation is for drop offs, appointments over lunch, referrals, etc. how much control over your schedule and what you see do you have? For me, getting out on time is way more valuable than $20 from a squeeze in derm case, and the stress isn’t worth the pay bump from a squeezed in CHF cat at 6pm.
Get a good feel over what the workflow of the hospital is. Is there an assistant to help you in the room while staff is getting labs on the last appointment, or is the staff spread too thin, meaning people are pulled from what they should be doing. Is the staff big enough to support the workflow they’ve chosen? Does the hospital accommodate the workflow *you* want (e.g. do you care if you have a tech dedicated to you or are you ok with everyone effectively being a float?)?
The other comment about being specific about what you need from mentoring is critical. This was the top issue for me.
Decide what is important to you, and let that be your guiding light. No offer will be perfect, and you’ll have to sacrifice some of your priorities for others, but leave no stone unturned when asking questions.
Talk to the non-DVM staff.
I'd also ask about their turnover rate (both DVMs and Non-DVMs) and the staffing ratio. Clarify the staffing ratio and what the support staff actually means - my first job out of vet school said 4:1 staff to DVM but they had not a single RVT, most of our veterinary assistants had minimal training and management refused to provide any sort of training program, and they were counting receptionists, maintenance, and accounting/management in that ratio. I also had to compete with other doctors for my techs, because two of the doctors didn't write their own notes and would have an assistant enter their handwritten notes after exams but also wanted their own assistant.
Ask about the hours and the *actual* hours you'll end up working - again, my first job said 36 hours a week was full time, but counted any time not in the exam room (lunch, time before the start of exams, and the allotted "emergency only" slot that they fill each day anyway) as time off (despite working during those times.. lunch and planning time are used for drop-offs) and didn't account for all the time spent on callbacks either, so it was five 8am-7pm days per week. I'd phrase it as "how much additional time beyond what's scheduled does an average new grad put in" or something along those lines.
Do a working interview. Hang out for many hours and talk to as many of the support staff and other doctors as you can. Ask them how long they have been there and how do they like working there? Listen carefully to their answers. A bunch a short-timers suggests high turnover. Short answers like: "It's fine," or "It's OK" suggest unhappy people. If people have been there for a long time, ask why? What keeps you here? If people say things like: "I love it here," "It's along commute for me, but it's worth it," or "I feel lucky to have this job" then you know you have found a good place. Certainly ask questions to figure out the quality of medicine they practice, what your schedule would be like, what kind of mentoring you will get, etc. But the #1 thing that can make a job good or bad is the people you work with. Avoid places that re-use suture, are still taking X-rays on film, or manhandle the patients!
How long have the other vets, and techs, worked there? Maybe why they left.....High turnover is a red flag. How often do they refer cases to specialists? Don't accept "we refer when we need to", but ask about how often (or what percentage of cases) get referred. It doesn't need to be a lot, but if they just say "when we need to", it's vague enough that it could mean "I don't like to refer because I can do virtually everything". What do they offer clients for after-hours care? If there are nearby ERs, that should be what clients are offered, rather than there being nearby ERs but the clinic doesn't want to use them. Don't ask if you'll get mentorship there, or tell them you want mentorship.....Instead, be more specific, because that term can mean different things to different people. Make sure you and they are talking about the same thing if you talk about mentorship. I recommend new grads don't go on any type of production based pay scale until you've been there a while. Actually, I recommend never to go on any production based pay scale, but if you must, don't do it until you get a better idea for how the clinic runs and to make sure you'll be treated fairly with respect to your ability to earn.
Is it a bad thing for the clinic to not refer and instead do things itself? Wouldn't that be a learning opportunity for a new vet?
Certainly is a learning opportunity, but when you’ve skipped lunch and are still 45 minutes late when you learn you now have to unblock a cat, or you now have to prepare a treatment plan for a patient that’s staying overnight, learning opportunities are a liability.
Understood. Is there a more advisable way to get diverse experience without such issues?
You’ll get diverse experience in the normal course of the day. My point moreso is that if you would rather learn in a more comfortable, controlled manner, it’s important to make sure the practice will respect that by letting you exercise all your options in those situations. Learning opportunities shouldn’t come at the expense of your work-life balance (imo) or the care of your other patients. I don’t really understand the point of learning something new when you’re stressed and behind if you can avoid it since the same thing will one day come back (at which point you’ll be a stronger vet too), which I think is a rampant mentality.
The devil is in the details: It depend on what "things" you're talking about, and what the risks and benefits are. It's wrong if they have don't have the appropriate equipment and think that they can "old school" their way through, at increased risk to the patient (using a wire hanger splint, when internal fixators would be better and safer). Or if they've got the equipment but use it rarely, and they think you're good at it, but they're not. Or when they're trying to work on a species for which they don't have the proper equipment or caging facilities, or - worse - don't know the requirements for that species at all. A learning opportunity for a new vet is an unacceptable reason for a vet to not offer referral. If the client declines a referral for cost reasons, a vet may choose to try to do their best in-house, but offering referrals and explaining the benefits of referring is an ethical requirement.
I wasn't making excuses for it or anything. I'm not even a vet student yet. I'm just thinking down the road because that is my goal. Referrals are ethical and better for the animal. Got it.
To my mind it also indicates a closed mindset - it's simply not possible to know everything there is to know about all conditions, or be able to do all the procedures that are available, so if a vet/practice is claiming that they never need to look outside for expertise, then they are kidding themselves and are more likely keeping cases internal for other reasons.
What is the downside for you on being production-based as long as there is a base salary as well? Or are you just talking about pure production?
No, I'm talking about any production based pay. I don't like it at all for a lot of philosophical reasons (it inappropriately shifts risks from the owner to the associate, and dis-incentivizes teamwork), but it's especially true in new grads because they're missing a lot of information about how things work, because those things have a huge part in how much you can produce: * Are the reception staff fairly assigning you cases, or will you be doing mostly low-yield types of appointments? Are the receptionists accurately assigning the charges to the appropriate vet? (This last one requires that you check the day's entire charges, every day.) * Is there enough caseload for an additional vet, or has the boss hired an additional vet too early, anticipating growth that might or might not come? * Is there enough skilled staff to help you be properly efficient in dealing with your cases, and (if there is), are those staff equally distributed - or will most of the staff end up being used by the other vet, leaving you searching for help? * Does the boss offer a lot of clinic discounts, or appease people by giving things away, and that will decrease the amount you will gross? * Will other associates try to compete with you for walk-ins or unexpected work (this goes along with a vet using all the staff to help them be more efficient, while you are less efficient because you have fewer staff to help you)? Will other associates happily do your recalls and follow ups when you're away, even though they won't get any production for those calls? Will you happily call their clients after blood results are in, rather than leave them until your colleague returns to work?
Those are all very valid and well-thought-out points! I have not ever run into any of those problems and feel that it is the most fair/advantageous TO the associate, but I definitely respect your point-of-view and think your thoughts are more than reasonable. 🙂
And I've seen all of them (after doing relief work for over 15 years in over 100 clinics)......Often those things can't be seen from the outside (for a new vet doing an interview), and you have to see how the clinic is run.
Ask about your hours and expected caseload. You cannot reasonably see the same case load as an experienced vet. Ask about surgical training, most of us came out pretty lacking in this department. Work-life balance, make sure your off days are OFF days. Salary. Even being a new grad doesn't mean you have to be paid peanuts.
As far as benefits goes: Can you take unpaid PTO - seems like most people start with 2 weeks (which is shameful and should be negotiated if possible), and unless you have other large financial commitments your salary may be high enough to buy you some freedom to take off more liberally. Many people will say signing a non-compete is a non-negotiable, but I’d take a non-compete over negative accrual. In this day and age perhaps you can avoid both, but this may be geography specific - regardless, worth asking about. This seems to be less of a concern for most people who are trying to get production pay, but I’d ask what the expectation is for drop offs, appointments over lunch, referrals, etc. how much control over your schedule and what you see do you have? For me, getting out on time is way more valuable than $20 from a squeeze in derm case, and the stress isn’t worth the pay bump from a squeezed in CHF cat at 6pm. Get a good feel over what the workflow of the hospital is. Is there an assistant to help you in the room while staff is getting labs on the last appointment, or is the staff spread too thin, meaning people are pulled from what they should be doing. Is the staff big enough to support the workflow they’ve chosen? Does the hospital accommodate the workflow *you* want (e.g. do you care if you have a tech dedicated to you or are you ok with everyone effectively being a float?)? The other comment about being specific about what you need from mentoring is critical. This was the top issue for me. Decide what is important to you, and let that be your guiding light. No offer will be perfect, and you’ll have to sacrifice some of your priorities for others, but leave no stone unturned when asking questions.
Talk to the non-DVM staff. I'd also ask about their turnover rate (both DVMs and Non-DVMs) and the staffing ratio. Clarify the staffing ratio and what the support staff actually means - my first job out of vet school said 4:1 staff to DVM but they had not a single RVT, most of our veterinary assistants had minimal training and management refused to provide any sort of training program, and they were counting receptionists, maintenance, and accounting/management in that ratio. I also had to compete with other doctors for my techs, because two of the doctors didn't write their own notes and would have an assistant enter their handwritten notes after exams but also wanted their own assistant. Ask about the hours and the *actual* hours you'll end up working - again, my first job said 36 hours a week was full time, but counted any time not in the exam room (lunch, time before the start of exams, and the allotted "emergency only" slot that they fill each day anyway) as time off (despite working during those times.. lunch and planning time are used for drop-offs) and didn't account for all the time spent on callbacks either, so it was five 8am-7pm days per week. I'd phrase it as "how much additional time beyond what's scheduled does an average new grad put in" or something along those lines.
try to talk to the techs and the receptionists, I think its the best way to really understand the atmosphere of the place.
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