Here’s what we learned – WSVMA event dives into the state of the industry and team attrition
On February 25, concerned WSVMA members attended a day of lectures and exercises on the state of labor in today’s veterinary practice. Experts were brought in to speak on issues such as staff retention, training, the impact of corporate ownership, labor laws and the possibility of labor unions.
First to speak was Rebecca Rose, CVT, certified veterinary technician, practice manager, and founder of CATALYST Veterinary Practice Consultants. Ms. Rose has authored many books on practice management and lectures annually on veterinary team development and topics of practice management. Her first topic of the day was “Should I Stay or Should I Go?”, speaking about what team members value about a position beyond just the money.
Statistics from a 2016 NAVTA survey of veterinary technicians showed that money enough to support a family paled in comparison to a sense of appreciation and fulfillment. Technicians want to know that their career is making a difference. They care deeply about their patients and their families. But, most important is recognition of their efforts, so much so that 50% would change their jobs to one where they were recognized. “People quit their bosses, not their jobs,” says Rose. This leads to an industry turnover rate of 29%—twice that of other industries where job changeover is closer to 15%. When technicians were asked their reasons for changing jobs, 38% cited low pay followed by 20% stating lack of respect and 14% specifying burnout. Rose defines burnout as being associated with problems at the work site, such as long hours or poor communication. When team members leave, they may not stay in our industry—about 45% go to human healthcare jobs, where the pay is greater. On average, veterinary technicians make about $38,805 per year: about $20 per hour in Seattle. Compared to $60,000/year for a medical lab technician, or $68,000/year for a registered nurse, and it can be easy to understand why veterinary practices have difficulty attracting and retaining team members.
Next up was Scott Spaulding, DVM, speaking on Corporate and Private Practice Approaches to Team Management. Dr. Spaulding is the CEO of Badger Veterinary Hospital, and the President of the Mixed Animal Veterinary Associates of North America (MAVANA), a corporate entity of mixed animal practices in 10 states, spanning from Washington and Oregon to Texas and Florida north to Michigan and Wisconsin. He started his lecture summarizing the past, present and future of business management in North American veterinary practice, using data gathered by the AVMA while he was chair for the Veterinary Economic Strategy Committee.
We haven’t really changed our business practices since the 60’s, according to Spaulding, yet the customer has changed. Clients want better communication and flexible hours, and veterinary practices need to step up. As for where we are today, as millennials form a larger portion of the pet owner population, one social factor is that they came of age during the largest recession since the Great Depression. Like their Greatest Generation grandparents, Millennials have had to be frugal with their spending habits, including with their choices in veterinary care. While in the 1990’s, veterinary practices were told to increase their prices to improve the incomes of veterinarians and support our practices, now the Veterinary Service Price Index has greatly outstripped the Consumer Price Index, making veterinary services very expensive to the consumer, and making it difficult for clients to do business with us. We are now seeing a reduction in demand for veterinary services, making business more challenging.
So, can corporatization change the equation? Today’s practices are corporations, although we generally term them “partnerships.” VCA only holds about 4% of the market, Banfield only 3%, and NVA 2%–the vast majority of the market is still under private ownerships. 50% of the market is held by large practices with five or more veterinarians—but still private.
How do private practices and corporate practices compare? Large corporate practices offer collaboration of ideas, talent, positions and finances. They have the benefit of professional management with dedicated HR, often with increased confidentiality. They can strategize and plan marketing and hiring, and offer career opportunities and advancement that a smaller structure cannot offer. That large structure may come with a price, though: employees may feel that they have no say in matters, or that their concerns are not heard. Smaller practices are homegrown, with personal attention to staff, rather than detached HR offsite. They can be more flexible and connected to the local community, with a family culture. Associates often have the ability to buy-in and invest in the practice, rather than just be an employee, and may be more flexible in terms of benefits, insurance, and paid time-off. But, management may be more haphazard, with less training, and personal conflicts may make for tough resolution of HR issues.
Next to speak was Dr. Kent McClure, the AVMA’s Chief of Governmental Relations. His topic was on what the National Labor Relations Act (NLRA) covers, and the role of the National Labor Relations Board (NLRB) in labor negotiations. The NLRA Was enacted in 1935 to ensure the ability for employees to organize and collectively bargain, without obstruction by employers. It is neutral as to outcome, merely ensuring that a fair process in negotiation is given to employees, and that they have the right to choose their own representatives, assemble, and negotiate with management. Not everyone is covered by the NLRA, including independent contractors, supervisors, governmental employees, whether local, state or federal, domestic workers, air and rail workers, or agricultural workers. The NLRB’s role is to provide a neutral process to allow employees to organize. The first step is for employees to signal intent to unionize, by having at least 30% of the employees sign Authorization Cards. The employees form a Bargaining Unit, usually defined as a group sharing common interests in terms of employment and bargaining, and may consider type of work and classification of job or location. Once sufficient showing of interest is present, the NLRB will facilitate an election. The election is won by a simple majority of those voting—no quorum or percentage. During the attempt to unionize, the NLRB prevents employers from threatening, interrogating, engaging in surveillance, promising employees better terms, or soliciting grievances in an attempt to block unionizing efforts. Once a union is formed, the NLRB is responsible for overseeing collective bargaining, and for ensuring that both employer and union observe the rules of conduct.
After Dr. McClure’s discussion on how unions can form and how they work, Dr. David Gill spoke on behalf of the employees looking to form the National Veterinary Professionals Union (NVPU). The NVPU seeks to represent associate veterinarians, technicians, assistants, and unlicensed assistive personnel. According to Gill, employees feel that they need to have a collective voice to be heard by the industry, especially those who work for large corporate entities. Four areas of concern need to be improved, he says, and the employees seek collective bargaining rights to promote negotiations in these areas. Preservation of quality of care for patients needs to be addressed, as short staffing and coverage when employees call in sick has been a persistent unresolved issue. Another issue Gill raised is that employees feel collective bargaining can improve workplace safety, including improvement in safety equipment. Wages are also under scrutiny, as the average support staff employee makes $20/hour, which is not a living wage in Seattle. Wages have been stagnant in veterinary medicine in all forms of employment, and collective bargaining is necessary to make employers take notice in both the corporate and the private sector, according to Gill. Finally, benefits need to be addressed. Well-qualified employees are leaving the field for better benefits, sometimes even taking a pay cut to achieve those better benefits.
Unionization will take time and has challenges. The NLRB is appointed by the President, and the current administration is engaged in rolling back policies that allow smaller unions to organize. The efforts to unionize will require funds and lawyers, but until the first collective bargaining effort is signed, no union dues may be collected, which means that so far everything is voluntary. And, as a society, we have not been supportive of unionized labor: wages have stagnated overall since the Reagan era. Therefore, it may be some time before the NVPU is a reality.
The last part of the afternoon was devoted to discussing skills that could help WSVMA members master the problem of labor. In “To Attract and Retain Qualified Team Members,” Rebecca Rose combined lecture on strategies to attract team members with break-out sessions and discussion on team culture and sharing ways to retain team members. Is your doctor to team ratio efficient? Can you leverage team members and utilize their skills, creating greater satisfaction among the team? Team members that have spent years acquiring expertise will feel more engaged with their job if all their skills are utilized. Hospital managers should identify roles that need to be filled, and hiring should be focused towards those skills, with specific job descriptions to help direct hiring. To attract like-minded people, your advertisement needs to promote your team culture, the values of the clinic and goals. Wages and benefits should be competitive to ensure that qualified staff are compensated enough to stay.
Once people have been hired with those skills, empower them to use all their skills. “Micro-managing kills morale,” says Rose. But, the best team cannot function without excellent communication. Since communication was not taught in veterinary school or veterinary technician programs, the savvy hospital manager will create opportunities for team members to improve their communication skills. The audience was broken into smaller discussion groups, and each group was tasked with identifying three ways to retain team members. Here are the ideas they shared:
- Staff leverage – allow LVT’s to do the duties they are trained and allowed to perform
- Allow team to have a sense of ownership within their duties
- Provide mentorship, support and opportunities for personal development
- Staff training: formal and cross training
- Foster open and team-centered communication
- Create a safe and respectful environment
- Coach vs. dictate
- Show employees you care about them and their growth as professionals
- Recognize team for good work, say thank you
- Open book management
- Transparent pay scale
- Cash incentives for exceeding daily revenue goals
- Establish referral rewards
- Rewards for volunteering e.g. earning ½ hour for every 2 hours of volunteering
- Foster a fun and collaborative environment
- Empower employees by implementing their suggestions
- Hire slowly, fire fast
- Allow employees some control of their own work environment e.g. staff defines scheduling requirements and what works for the flow
- One-on-one meetings with active listening, take notes and share with the employee
- Host team building hospital events
- Celebrating non-work-related events e.g. birthday, work anniversaries, etc.
WSVMA wants to empower all its members to improve their management skills and create stable, engaged teams. Rebecca Rose will lecture again at the 2018 Pacific Northwest Veterinary Conference in Tacoma. A summary of this VetMed Matters Conference will also be presented. Join us in Tacoma September 28 – 30, 2018!
By Dr. Diane Pinkers, Secretary, WSVMA Board of Directors
Posted March 30, 2018