As someone who left my hooooorrrible first job by Thanksgiving, I opened up this thread ready to say, “same dude, same. Don’t hesitate to leave the first horrible job. Get out!”
But honestly I didn’t see anything in your first post that made me say this is a horrible job. Though I agree there are concerns. I really don’t think 14-15 appts per day is unreasonable at this point, if that is what you are seeing total (not just what you are scheduled for in addition to things that get added on). Unless your salary is low and/or you are working a ton of shifts per week or your average transaction is super high, 8-10 appts per day is likely not earning your keep. So I do think some readjustment of expectations are due on your part.
That being said. There are issues, and what came up in your later posts are worse than in your original post imho.
1.) re: waking sx patients. Who is coming up with the anesthesia protocols? What is it? I think some adjustments might be in order, and you should be able to do that (if not, that is a problem). Who is monitoring anesthesia, how qualified are they, and what is being monitored? What are the parameters that the anesthetist feel comfortable interpreting, and what anesthesia decisions are they qualified to be making without further input? I think it would be beneficial for you to not scrub in until the patient is prepped. It might delay you cutting for 5 minutes, but I would go through one round of monitoring with the anesthetist together just prior to scrubbing in so that you can both be on the same page about where the patient is starting and discuss the plan moving forward after you scrub in - start that communication and have a plan to keep it open throughout the procedure. I often keep my dental patients pretty light (they often still have swallow reflex) and they don’t pop awake. So something is not right there. If you wanted to talk through what is happening with anesthesia because you are not confident about it, I’m happy to do so. Feel free to DM me.
2.) Lack of efficiency overall - partly it is you, but hugely it is the staff. A really good team can prop up a fairly incompetent doctor (I’m not saying this is you) and keep them moving. In my second job barely 6 mos out scarred from a truly ****ty situation, I had an incredible team that made me perform like a kickass vet. They directed me from one place to the next, and took care of all nondoctor things. As soon as I would come out of a room, I wrote down my orders for the patient and let the staff know if I needed to talk to the client again or if they could complete the appt, and off they went after telling me, “you’re in room 2 next, short synopsis is X, hx is written in records otherwise. Right ear was nasty, TNTC rods, left ear 2+ rods, occ yeast. Do you have an ear med you want me to make up or wait until exam? O wants apoquel and ear cleaner refill, so i put that in the invoice already. After that, so and so is just checking in your euthanasia 18 year old cat so I figured she could go ahead and go over aftercare and check client out as you’re finishing this case, is that ok?” True teamwork where amazing techs really helped me out while allowing me to still be the doctor in charge. And we got through a lot of cases, no thanks to me.
So you’re right. You’re not getting the support you need, and neither is your support staff. There sounds to be a management issue (which unfortunately is rampant in this profession). This is a tough one, because finding another job is easy, but with a severe tech shortage, it’s hard to find a clinic with a well oiled support team with excellent management that isn’t occupied already with doctors who want to stay there and in a place to mentor a new grad. And given the huge cost to you for leaving, I’m not sure hopping will solve your problems. Does not hurt to start looking, but I wouldn’t hop until you know the next clinic will not have the same issues. And know it’s easy to have rose colored glasses and want to believe the next management that tells you how “everyone is like family” (honestly those words are red flags - heed with caution).
You said everyone is nice enough, which is huge. This means that you have some capacity to work together with your team to make some improvements (knowing that you are constrained in what changes you can make as a low man on the totem pole). But with the team you are working with, you can discuss ways that will help efficiency when working specifically with you. Think about all the steps involved in turning over an appointment from check in to check out. Knowing you cannot add staff, assess which staff members including yourself and front desk staff are responsible for what? Where is the bottleneck? Where can some of that shift (order of execution and also who is performing it) to ensure efficiency. If the inefficiency is that you are sitting around waiting for hx to be taken and then waiting around again for cytology… then you have the power to change that. And so many ways to do so. Can the assistant ask for permission to obtain cytology samples prior to getting full history and hand them to you for know skin/ear patients, and you can read previous hx and stain/read cytology slides and start putting together some meds while assistant completes hx before you actually go in the room?
It sucks the morale is bad and the management is awful to staff. But until you and/or staff find greener pastures (or if it’s corporate sometimes the management will get purged and hopefully you get a better one), you have each other to prop up. You are both stuck there until you do, so you might as well make the best of it. And both you and staff are inexperienced so the more you grow now, the better if will be for you moving forward whether it be at this clinic or the next. Again, happy to brainstorm if you would like someone to talk through your situation with.
3.) my biggest deal breaker with your situation is actually the dentistry. I can assure you that you will never be performing quality dentistry if the model is that you are seeing appointments while your dental patient is under. Yes there can be downtime during a dental procedure if your staff is good, but certainly not long enough for you to see appointments (especially at the rate you’re seeing appointments). A full mouth cat rad and full cleaning without any noted pathology needing treatment (i.e. the parts the tech will be taking care of) takes half an hour. You should be able to use that time to do callbacks, rx refills and other DVM tasks, write records etc… but not see appointments. Typically clinics that have techs “do dentals” while the DVM sees cases are not appropriately diagnosing and treating oral disease, nor will they ever support a DVM who wants to. And you need appropriate training to perform adequate dentistry. Honestly, dentistry is like the steepest learning curve in general practice. This isn’t a figure out how to pull teeth on your own situation. You can do that with a tail amp or cystotomy, but not a dental. Can they send you to CE? Even if you can’t change the shoddy dentistry program in your clinic, you can at least grow so that you can develop those skills to either implement when something changes at this clinic or you leave. But there’s no reason that you can’t start learning and improving what you can do.
I’m sorry this is rough. I hate to say it but I think I do need to be a bit of a downer and tell you that what you are experiencing is mostly garden variety frustrations of associate vets that leave them disillusioned. This is the crap that leaves vets to leave the profession prematurely. Are there greener pastures? Yes absolutely. Are there amazing clinics? Yes absolutely. But this is like that dog aggressive hyper excitable can’t walk on a leash but super sweet and happy pit bull with horrible skin that needs to be rehomed because it doesn’t mesh well in the current household situation. It needs that perfect home, that we all know exists somewhere but is hard to find. Start looking, but don’t jump into the next available home that isn’t going to work out. But in the meantime, change what you can to make things better for you in the current situation. Be clear about what you can change and what you can’t, and concentrate on the former. Don’t dwell on the latter. That’s how you end up in a dark place. Unfortunately you are shackled with financial debt to the company for another 20 months or so… so you have a lot of skin in the game should you decide to leave for an opportunity that isn’t 100% worth it.
I know I sound like a Debbie downer. But I’ve walked in your shoes, and one thing I wish someone had done sooner was slapped me in the face and told me this is just a job and a way to earn a living first and foremost. It cannot be where I depend on finding fulfillment in life. That is what results in misery and resentment and depression due to the job. My advice to you is to define what is “good enough” for what you need from your job, and determine if current situation is already or can become “good enough” as a place you earn your living (not where you fulfill your soul). If not, what makes it not good enough? And how easy/hard is it for you to find that elsewhere? If it’s attainable, start looking. If it’s not, dig deep and figure out why it is a dealbreaker for you and if that is a fair expectation to hinge your happiness on. Yes, a lot of us came into his profession because it was our calling, and we have this incredible passion for what this career can be. It is immensely hurtful when workplace mismanagement impinges on your ability to realize this vision. Yes you deserve to try and find that unicorn clinic that fulfills you, and it is out there. But it is equally, if not more important, to define and attain “good enough” for your sanity in the meantime. Another really hard lesson I learned along the way is that I am the easiest part to change in this… as much as that is incredibly hard to admit and then actually make happen. But the less I rely on my job for my happiness (let’s be real, I still do… it is incredibly hard to let go for someone who’s life is defined largely by their career… but I’ve gotten better), the more enjoyable my job becomes ironically.
