autonomy

[gracietiger]

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I am wondering if anyone has any thoughts on which areas of vet medicine have the most autonomy. I have about 400 hours or more in each of a general practice, shelter, zoo and referral center. I have only been exposed to one of each, however, so I my exposure to the various fields of vet med is very limited (given that organizations and businesses can vary so greatly).

As I mentioned in another post recently, I really want to engage in welfare advocacy or education in my career. Well, all vets do that so I should specify that I am interested in things like serving on an advisory board for a non-profit or welfare committee, consulting, being an expert witness for animal cruelty cases, and so on.

I am attracted to private practice, and eventually owning my own practice, because I believe it may best allow for me to pursue outside advocacy work. But I wonder if it is realistic for the owner of a private practice to have the time/freedom to volunteer for a shelter or other non-profit, advocate, engage in animal rescue (ie, up and leave to respond to Hurricane Katrina), etc?

I also find shelter work to be incredibly fulfilling. I appreciate that shelters can give veterinarians opportunities to practice some really neat medicine, while engaging in animal welfare issues. However, I wonder if the politics within a shelter could end up making a vet feel stifled, and if a vet's opportunities to participate in welfare issues depend on the vision of the director. I also think I would find spaying/neutering for the majority of my career to become mundane, and wonder if most shelter vets spend most of their time spaying/neutering (which was the case at the shelter where I volunteered). (For the record, I am not unwilling to spay/neuter, I am just not sure I could do 50 a day, four or five days a week).

On a totally other hand, based on my experiences at a referral center, I really loved internal medicine. I become bored with routine easily, and enjoyed the variety. However, I am not sure I would much enjoy working for a large hospital or referral center. I also wonder if hospitals or specialty centers are less inclined to support their doctors taking on advocacy causes or voicing animal welfare concerns. Something else I am wondering is if most specialists work for a hospital or specialty center? Could a specialist join or start a small private practice?

These are really, really broad thoughts and questions, and I am just looking for some perspective since there are so many people on this forum with their own experiences and interests. I am interested in what you guys consider to be the areas of vet med that allow for the most autonomy, and what it is about the area or specialty of vet med that you are interested in that attracts you?

 

[HopefulAg]

What do you mean autonomy?


You don't work with other people?

You don't answer to other people?

You work mainly on your own time?

You're the boss?

 

[gracietiger]

Haha, that's a good question. I'm so used to hearing about "autonomy" in academia that I never really stopped to consider its meaning. I suppose the way that everyone interprets this probably varies hugely on an individual basis. To me, autonomy means having some freedom to go about doing your job the way that you see fit.

For example, in academia, my boss did not show up from 9-5 everyday. Though we had specific hours for vacation and sick time, no one was breathing down his throat, calculating his hours, demanding to know where he was and when. He was also able to voice his personal opinions to the media and in presentations on topics related to his research quite a bit without worrying about the security of his job. My perception, in academia, is that this is the "autonomy" that is so sought after by professors.

To me, "autonomy" would mean, like I said in my post, having the freedom to pursue opportunities outside of medicine, like advocacy or rescue. I do not think that I would feel like I was thriving if I was required to follow very strict protocols or if I feared that I would lose my job if I publicly spoke about something that a higher-up disagreed with. I love working with people, and have no qualms working for people, but I do believe that my colleagues and/or boss would need to be cool with me wanting to pursue some of the things that I find personally rewarding on the side. For example, the private practice vet whom I worked with (and whom owned her own clinic) travels the world doing disaster relief. When the earthquake in Haiti occurred, she was able to hire a relief vet while she volunteered for an animal rescue organization. I also liked that she had a great deal of creative freedom in how she opted to run her clinic and practice medicine. She had some progressive philosophies that not everyone, including myself, always agreed with, but she had a really loyal and strong client base that supported her in following her passions.

I think the most important thing for me is finding a way to incorporate advocacy into the practice of medicine, and I'm interested in hearing more about the opportunities and limiting factors in doing this. But I'm also just curious what is important to other people in selecting a specialty or type of environment to work in (ie, why do you prefer a hospital over a small clinic? why do people want to pursue shelter work? what is attractive about running your own clinic?)

 

[HopefulAg]

Then I suppose you have two options as far as I see it, to become the most autonomous:

A) Own your own clinic so you answer to no one except your clients.

B) Be so kickass that no one really wants to fire you (think 'House').

 

[Lab Rat83]

B) Be so kickass that no one really wants to fire you (think 'House').

Haha I love it! I've always wanted to be more like Dr. House but I'm just not mean enough. I also could never work for or with a "Dr. House".

 

[gracietiger]

HAHAHa, does anyone really get away with being House?? Even if they do, unfortunately I'll never be as good of a doctor as he is!

 

[Bill59]

Just off the top of my head ...

1. Academics. Specifically a full professor with tenure has a lot of autonomy. The problem is you don't start out as a full professor, you start as an instructor or Assistant Professor, usually after doing a residency/board certification and/or PhD -- this position has much less autonomy. Then after 5-7 years you either get promoted with tenure or fired. Then after another 5-10 years you may or may not get promoted to Professor.

2. Practice owner. If you own a successful, well-established practice with some associates you have a good bit of autonomy. But as with the academic route, when you first start you have very little autonomy and are accountable to your clients, your employees, the bank and about everybody else.

3. Industry, military, government. You have a boss and well-defined responsibilities and expectations. In some case this includes things like where you live. On the other hand, you usually have well-defined, limited hours and freedom to do what you want in your off time.

4. Associate. You're basically susceptible to the whims of the owner. This means you may have a lot of autonomy or very little. Boss man/woman makes that decision.

Could a specialist join or start a small private practice?

Sure. Don't confuse private practice with general practice; they aren't synonymous.

 

[HopefulAg]

Could a specialist join or start a small private practice?

I missed this the first time I guess.

It seems to me that a lot of private places, especially the large ones, are looking for specialists to join their practice. It's another service they can market to their clients. So yes, definitely a possibility.

Also anyone can start a private practice as long as they have the money. I've heard of at least one (and I"m sure there's more) clinic that's owned by someone who's not even involved with vet med (aside from owning the clinic). Drugs are bought through the vets he hires and the clinic is managed by a manager.

 

[sumstorm]

Also anyone can start a private practice as long as they have the money. I've heard of at least one (and I"m sure there's more) clinic that's owned by someone who's not even involved with vet med (aside from owning the clinic). Drugs are bought through the vets he hires and the clinic is managed by a manager.

Actually, that isn't quite universally true. Many states have a restriction that requires a vet to be at least a partial owner. There was an article on VIN about this not too long ago.

But I know quite a few specialists who own/operate private practices. The derm I use has 2 private practices in 2 major cities...he travels between them. And some own private practices that aren't brick & mortar, such as the surgeon who practices out of GP's ORs.

 

[gracietiger]

Good points!

I am definitely intermingling general practice and private practice. I suppose when I think of private practice, I automatically conjure up an image of my local GP veterinarian - typically a small office with a small staff. I do enjoy working with a small team of people, which is why I am not interested in an academic position, nor one in a hospital or large specialty clinic. I have not come across specialists (like an internist, oncologist, derm, etc) who work at a small, few doctor practice. I like to scan veterinary jobs on the internet to see what's out there, and when I search for jobs for a specialist, I almost never (perhaps never) have seen one that is not at a hospital or specialty clinic. But what you guys are saying is that there are opportunities for a specialist to own a small clinic? Would it be difficult in a more urban area to gain referrals if a GP is more connected to the larger multi-doctor referral center or specialty clinic?

I am also curious if anyone has any thoughts on freedom in a shelter environment. I know shelters vary tremendously so I realize there is no textbook definition of what it means to be a shelter vet. But it seems there are many people here interested in shelter medicine, so I am curious about your thoughts on creative freedom in a shelter environment.

 

[NStarz]

I am also curious if anyone has any thoughts on freedom in a shelter environment. I know shelters vary tremendously so I realize there is no textbook definition of what it means to be a shelter vet. But it seems there are many people here interested in shelter medicine, so I am curious about your thoughts on creative freedom in a shelter environment.

I think, as part of the definition of an "animal shelter" that a shelter vet almost has rescue/welfare issues built right into the job description. I've only worked at a progressive shelter, so I can't really tell you how it works in many other shelters out there (super high euth rates, cat that gets URI gets put down without a second thought), which are issues I don't encounter in my shelter. Many shelters do not have the funds to support a vet's salary and those that do probably don't pay all that well. There are a lot of shelter politics that come into play which may dictate your medical decisions as well. It's also a lot of spay/neuter!