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Discussion in 'Veterinary' started by Pet vet, Jan 30, 2018.
Perfect. Thanks. Great explanation.
Fair enough. Not what I meant, but I can see how it could be interpreted that way. Sorry, gang. No offense intended.
Also remember that not only is the daunting aspect of being the doctor weighing on grads, but for many it is also their first job period. I think those of us with some age and job experience in which we are used to making decisions and being in charge is something forgotten when considering our younger colleagues. haha
Maybe this horse is beat, but why are you "concerned that new grads are entering the workforce expecting their first job to be like additional 'school'"? Do you think practices hiring new grads don't realize they're, well, new grads?
Obviously, this was a poor choice of words. In my career prior to vet med, there was no such thing as mentorship in jobs. I applied for a job, was hired to perform a specific set of functions, and was compensated monetarily for my contributions. That was it. There was no formal expectation of 'mentorship' highlighted at the outset when I negotiated my contract. There was a task laid out in front of me, and I was expected to meet the stated goal in the time frame allocated. That was it- very simple. It's not like I was an expert in every task I performed from day 1. I learned on the job, and asked other folks for input when I felt I was out of my depths. It was all very informal. To me, that's not mentorship- that's a collaborative workforce (no matter what industry you're in). I'm surprised folks were so offended by this. I'm not sure what else I'm supposed to say.
Also, from your posts, it sounds as if you're heading more towards lab animal and not so much GP or "clinical" work. I've never worked lab animal but I could see how just that makes a difference in wanting/not wanting mentorship. But I could definitely be wrong. They are two very different aspects of vet med and what you might be looking for in a job is likely going to be much different than someone going into GP.
I don't want to give the impression that I don't need/want the advice of my seniors. That's hardly the case. Of course I need their input. Otherwise, I'd already be a qualified lab animal vet. I guess the degree to which a new grad wants this is what differs between individuals. Also, I'd imagine that the style of delivery differs considerably among mentors/supervisors. Internships and residencies by their very nature are a lot like 'school.' There are didactic requirements (independent of CE), and some programs even require graded exams to mark a participant's progress in mastering the material (not to mention the board exam administered at the conclusion of training). There is also a very significant pay cut associated with the receipt of that training. By my own choice, I'll be making half (or even less than that) of of new grad in his/her first practice job, should I be successful in securing a residency slot. When I inquired about mentorship (and what the term means to different people), I just wanted to be clear how that differed from formal training. I have a better idea now, and I appreciate the responses to my question. ff I were hiring a new grad for a job, I would want to be sure that this prospective employee and myself were on the same page when it came to mentorship. There's nothing worse than misplaced expectations. When I was in grad school, the definition of mentorship varied WIDELY between PIs and laboratories. My adviser's idea of mentorship was the provision of funds, a lab to do the work, and review of scientific writing. Other PIs were far more hands on with their students, physically conducting experiments with these folks in the lab, troubleshooting equipment malfunctions, etc. My experience didn't come close to that. Neither approach was right/wrong, but I can see a student asking for mentorship in a job and being disappointed in what was actually offered- not because the employer didn't want to give it, but because the employee's expectation wasn't clear. Or, perhaps the employer isn't willing to provide the degree of mentorship requested, and the employee ends up being frustrated because he/she feels hung out to dry without support in his/her first job. A ton of hypotheticals here- I have no idea how common they are, but I can see them happening.
Yet again, no I didn't. I said that particular attitude I outlined was the wrong motivation for a vet to have, but no where did I ever say that those who prefer ProSal have the wrong motivation for being a vet......I'm not sure why you claim that I said that quote, because those are your words you're quoting, not mine. I do believe that those who prioritize income-generating transactions over many other things are motivated by the wrong thing, but that's not at all the disparaging comment on the people who prefer ProSal that you keep thinking I said. You are creating a causation between two ideas that I never even said. And I do believe that choosing ProSal is a wrong choice but, again, you're pretending that my opinion on that means anything about someone's motivations for being a vet, which is nothing I ever commented on.
You've taken a comment I made about motivations of a (hypothetical) vet, and somehow made it about motivation (of you) for being a vet. Go on, read the thread again, and see what I actually said.
I quoted exactly what you said just without the box showing your name. But I'm at work and I'm not going to go back just to place it in the box.
If you wish to go read your post, you'll see it there. Otherwise, you won't.
But I wish to move on. I'm not going to keep beating this horse.
Remember when we've cried/yelled about the lack of peer support in vet med?
Remember when we complained about vets tearing each other down?
Remember when we picked a difficult, emotionally draining job, that generally doesn't compensate us as well as it should?
How about we take the nit-picking at each other down a notch and try and be understanding/supportive. Every time I log on this forum all I read is one vet tearing at another. Let's try to demonstrate some more warmth, empathy, and understanding.
I think much of the motivation underlying communication gets lost over the internet. For the most part, I believe people mean well when posting in these forums. Occasionally, a topic gets started that lights a fire under a few people, and the conversation becomes less than generous on both sides. I don't, however, believe that folks deliberately post here to tear each other apart (I know I don't, although it has been perceived that way in the past). I would bet that many of these conversations would progress quite differently, face to face. I've inadvertently offended people on SDN before- certainly wasn't my intention. All I can do is apologize. I tend to give people the benefit of the doubt. If someone makes a comment that fires me up (first, it's their right to disagree), I try to put the statement in context and wonder how the same conversation would have gone had they been standing in front of me. Plus, people ave bad days- this can spill over into online posting as well. Not my goal to defend poor behavior, but I really do think that the majority of people who post on here have their colleagues best interests at heart. Sometimes, it just gets out of hand.
FWIW, I hate pro-sal because I saw it abused at a corporate practice. I didn't want to feel like my colleagues would stoop to putting their names on my cases in order to make more money, but it happened.
Since I own my clinic now, we do profit sharing. Everyone gets a percentage of the hospital production as a whole. Techs, too. Though they get less than DVMs.
Everyone wants the hospital to perform well when they are invested. Nobody feels like a salesman
I agree with this.
But I also think there are pros to ProSal - it isn’t all bad. If I want to bump my income, for instance, all I have to do is pick up a few extra shifts and that translates into direct income to me.
Profit sharing carries the risk of one hard-working employee feeling discouraged when a less hard-working employee is perceived to reap the same benefit for less effort.
Not disagreeing - just saying there are plusses and minuses either way.
At my old job (granted, this clinic wasn't great for many reasons), selling selling selling was always part of our meetings. Always offer a nail trim, ear clean, products, etc. because "The more we sell, the more likely you we are to be able to give bonuses at the end of the year." I know it's all about how you spin it, but at the end of the day, the main idea is the same. The more the hospital makes, the more you can make too. Less of a direct incentive than pro-sal, sure. I just think to some degree, staff have to have an element of sales to their job.
It's much less pressure when it doesn't directly impact your salary
it also means your pay isn't hurt by taking time off
And so do vets! I am frequently selling when I work, but what I sell are my ideas and advice, and I sell them for the benefit of the patient, not for the income of the practice. The fact that the clinic makes money from my recommendations is an afterthought (good medicine means good money), not my motivator (i.e. your quote "The more the hospital makes, the more you can make too").
I feel like the person's core being/virtues is what determines their behavior/motivation, not so much the mode of pay.
I mean, the same person who picks and chooses cases based on how much money it will likely generate because they're paid on production, is likely the person who is not a team player and won't see the walk-in at the end of the shift because they're paid salary. The vets who act based on their compensation rather than as a professional who just takes on their responsibilities to the best of their abilities, will show their habits no matter what.
I've been paid both ways, and there are annoyances with both. At the end of the day though, as long as I feel like I'm getting compensated enough money to live comfortably, I don't really care either way. I've never worried about my pay on production since I'm usually productive, and I script out just as much stuff, still recommend cheaper alternatives, and only advise diagnostics as indicated. I just bring up the options and let the owners choose. I always try to find the cheapest way to achieve the same goal for the owner. If I want more money, I just go and do a relief shift somewhere since that's super lucrative. Just a couple shifts a month, and I get an extra $1200-1400 after taxes.
After all is said and done, even if you're paid salary, most people renegotiate based on how productive they are anyway. So for me, it doesn't matter all that much.
As for mentorship, I do think that word gets thrown around a lot by new grads as an important factor, when many graduates don't really understand what it should be and its relative importance.
I talk to 4th years often about what they're looking for in a contract, and many tell me they want mentoring written in there. And I'm not sure that's necessarily the right move.
I think it's important to have another doctor in the building to bounce ideas off of, and to help bail you out if you're stuck or running into complications. I don't think you need to have dr. Boss set time for you every week to go over your performance, do case reviews, etc...
The old doc that does "all sorts of orthopedic things" and never refers anything and promises to turn you into his/her protégée isn't necessarily going to teach you more than the collective wisdom of a progressive multidoctor practice, where there isn't any one doctor who is committed to mentoring you. I've had a number of people tell me they chose the former over the latter.
As for the original question, the things that matter for me.
*Location - I will commute up to 40 minutes, but no more. I am geographically restricted.
*4 day work week. I will work every weekend, and I don't mind night shifts. I will work long shifts. But I will only go in for 4 shifts per week. The schedule MUST be set. I will never work again for a hospital that makes a schedule for the next month the month before.
*I need a surgery day, and it needs to be a full day. I will not do half day surgery days. I also must be given full control of what gets booked on my surgery day. I won't allow others to tell me how many dentals I should be able to do in a day.
*full mouth intraoral rads for every dental
*safe anesthesia with a person monitoring at all times with appropriate monitoring equipment and warming equipment.
*adequate well leveraged staff
*overall compensation package
Nice to see you again @Minnerbelle hope you are doing well.
I agree with everything Minner said on mentoring (can't comment on sal/prod yet but I do agree that personality does play a big part in it).
I define mentoring as having someone(s) to bounce ideas off of, to help you out if you're stuck on a case, that will pull you in on (/discuss with you) cases that have aspects that would be good learning experiences. Hand-holding doesn't equal mentoring, but having someone to help guide you when you're first starting out is something to consider looking for.
Some responses in blue. But definitely agree that these are all important things for new grads to be looking at.
And it seems as if previous experience also plays a giant part. I was abused on a salary based pay, plain and simple. So I have a distaste for it. Whereas, dyachei and Calliope had bad experiences with production so they have a distaste for it.
Both definitely have pro's and con's and dyachei's comment above about having to worry about taking time off on production pay is true. You could be penalized for simply taking vacation or taking a sick day, which super sucks and definitely needs to be fixed in the pro-sal set-up.
Thanks! Doing well overall. Can't decide what exactly I want to do long term with my career, but am currently coasting and getting settled with the rest of my life (bought a house, got married, actively paying off my student loans). How are you?
Doing ok. In my second job now since graduation. Having thoughts of leaving general practice but also can't really find anything else that isn't general practice. I just bought a house so getting it all set up and should be moved in by the end of the month/beginning of March.
I agree, those are valid points.
I don't know if this is region specific, but at least around here, it's a job seeker's market. Even the newbie new grads are getting killer deals, to the point where a sign on bonus is fairly common to sweeten the deal. Everyone's hiring, and there's like never enough relief doctors to ever go around. So I can't imagine at this point not being able to get everything on my wishlist. I get contacted periodically with job offers, and I know at least a few practices that would kill to have me and would be willing to provide everything on the list.
The other two things I'll add on to my dealbreakers:
*No on call after hours. I won't answer phones overnight, and I won't come in. There are plenty of ERs nearby
*I won't see exotics. I don't think I know enough about them to do right by them, and there are enough people around me who will see them.
Oh same around here. Definitely a job seeker's market. The only issue is 95% of clinics around here are corporate owned. So you get to deal with all the corporate bureaucracy. It is a bit like picking which poison is going to have the least side effects.
Banfield's $30k sign on bonus is pretty tempting, and it seems like every location is hiring DVMs right now. And that's if you didn't do the SJP...I heard SJP alumni are being offered insane sign on bonuses. My friend did two and she said they are offering her like $80-90k.
Sure, if you want to work for Banfield. I mean, corporate is corporate, you'll get to practice good medicine and if lucky you'll have good upper management. I hear good but I also hear a lot of bad. I interviewed with Banfield was offered just south of 90k salary with production but ended up taking something else.
Oh and those sign on bonuses sound great until you get to the fine print that includes how many years you need to work there to keep it all. If you leave before that many years, you have to pay it back. How much you have to pay back depends on how long you were there and how many years were in that original contract. Sounds great, until you hear the details/read the fine print.
True true...I think I would bite the bullet if I were in the position of being offered a higher salary plus what my friend was supposedly offered. I mean, potentially getting a $80-90k bonus on top of a decent salary already...
I don't intend on working for Banfield, but they also have so many locations by my fiance that are always hiring (probs a red flag tbh).
The good medicine part depends on location tbqh.
For instance, at the one banfield I was encouraged to practice medicine to the best of my ability and recommend things that needed recommending. At the next, I was yelled at for not recommending extras that weren't necessary or for scripting out an antibiotic due to cost limitations when we had a similar one for $50. There are positives and negatives to corporate (and to private) practices to keep in mind. My biggest issue was our lack of leadership when there were problems. We did have a doctor "stealing" cases (he'd put his name on it after someone else actually saw it, etc). And if there was a case he thought was good money, he'd push people out of the way to see it.
He is the only vet I know that still does FIP vaccine regularly, and Banfield allowed it because it made them more money. Otherwise, I did fine with production and made a lot of money that way. It was just frustrating that leadership did nothing about the issues. So I wouldn't say that's a "production" issue as you stated, DVMD.
I prefer doing it this way (profit sharing) because there isn't direct competition for cases/production and the vacation thing is huge. I don't want a vet to feel like they can't take time off because they'll lose money. you need your time away to recharge. I can't afford to give everyone the amount of vacation I'd love to (4 weeks a year would be great, but can only realistically do 2).
Minner's set of must haves are going to be different from many people's. While it's great to want a set schedule (and who doesn't?) it's a hard demand to meet in practice. If a vet is taking a vacation, or get injured, there needs to be some flexibility to coverage. We can usually work around that here. I give my current associate a 4 day weekend every other week and a 4 day work week. There are some exceptions to this of course. And if I need to be out for any reason, she is given the option to cover or we will call relief. If she covers, she gets paid a daily rate. However, her contract stated an expectation of 4-5 days/week. So she gets it if she works 6 days in a week, for instance. It's up to her (and she typically wants the extra pay).
the 80-90k is probably accurate. But if the location is slow, it won't matter, because they will adjust downward - I liked the first practice I was at with Banfield, but it became clear that the central team talks a big game, but it hasn't trickled down to their field management yet. It would be great if it did.
Sorry, didn't mean for it to come off that producing enough was the issue, I didn't think it did. I meant all the little issues production based pay may cause...hence why I stated I was "abused on salary and you had issues with a production based pay" it wasn't intended to mean you couldn't hit production. Since you had already mentioned the issues, I didn't go back and list them out again, people are smart and can read back on what you had already said.
And the bad management/leadership I would toss into the production category since it was all based on $$ and case stealing. But that's just me. You could probably find that in salary too. I don't really have issues with case stealing or being pushed to offer unnecessary things. I did have case dodgers and a push to recommend unnecessary things on salary.
Yeah, I just think if management had done their job, it wouldn't have been an issue. Case dodging is a problem on salary, for sure, but again, management should be able to handle it. So I don't think it was a problem with the production so much as weak leadership.
I don't think it's a given you'll get to practice good medicine. At least, not from what I see over on the referral side of care.
Interesting about the signing bonus. How long do you have to stay to keep the full $30k? That would definitely be an enticing bonus.
Huge red flag, yeah. I'd keep coming back to that if it were me.
Some people do love their Banfield job. What really strikes me isn't how many people leave after a year (so common for new grads to do that regardless of where they go), but the stories you hear from people leaving. A classmate of mine went there (and left after 9 months); we meet for beer once in a while and I'm just astounded by the practices his Banfield hospital had - clearly providing an questionable level of care while at the same time asking too much of their doctors. And the things he tells me line up with the transfers I see from them.
Seems like it might be pretty location dependent.
The other thing that bothers me from the heresay I've picked up is there seems to be a disconnect between what they told my classmates it would be versus what it really turns out to be (in terms of caseload, flexibility in practice, things like that).
It's certainly not a place I would want to work based on what I hear from my classmates who went there. I guess it's one of those "not for everyone" things?
What would you leave GP to do if the ideal job were available?
(I'm not sure my answer would be. I like ER. I just want the ideal ER position, maybe.)
ETA: What I think I'd really enjoy would be a 50% GP, 50% ER job where I worked a reasonable schedule that wasn't killing me. As best I know, that job doesn't exist. I don't want two part-time jobs.
Honestly, this is my biggest problem, I don't know what I'd do. I've had two full fledged emergencies appear in the last two shifts and I get excited dealing with those, figuring them out, but I can't do much at my clinic. Heck film rads are **** for seeing anything. I don't have an ultrasound to check for free fluid. I can run some bw in house but it is very basic. At the same time, I don't think I could do ER 100% of the time.
I'm just a bit exhausted by GP always being about seeing more patients in less time, making more money, doing more, more more but without the staffing or the equipment. I'm also a bit tired of the follow up. Repeat clients are nice but they get exhausting too. I dunno, I really have no idea what I'd do.
Well, minus become a traveling bum, but it doesn't pay enough.
Right? I mean, I can think of alllll sorts of things I'd like to do. None of them really fit into the 'reality' box. In my perfect world, I work ER 5-6 days/month because I somehow became wealthy and am only working for fun, and the rest of the time I spend sailing, traveling, and playing with my kids.
Having trouble making that a realistic plan, though.
Not sure what you mean by traveling bum...but I just saw a posting on AVMA for a traveling house-call vet that had a really good salary (in MI). apparently decent equipment and everything.
Close enough to a bum?
No, no. I was thinking zero vet med. Get paid to travel the world and bum it up in hotels....
Why can't we just have what we want??????
@Lab Vet - to answer your question re: mentorship. I didn't expect hand-holding or another year of watching-over like fourth year. I did want someone experienced in-house that I could discuss a tough case with or look at a weird eyeball with or scrub in with me when I spayed a 120lb 1yr old St. Bernard. The first few weeks to months, I wanted the sense of security of someone who'd been at it longer than I had in the same building, absolutely. But as time went on and I grew more confident, I still wanted a group of people that were willing to discuss cases or be a second set of eyes on a weird case. When I accepted my current job, "mentorship" was still on my list of things to consider, just lower down.
Now a lot of veterinarians are creating their own unique paths after vet school. I have interviewed many vets who tried working at a practice but have since created niches that are unique to them. One vet decided to write books on helping students cope in vet school, another coaches vets on how to be happy, another has a vet comedy podcast, and another started her own animal hospice practice which is now nationwide. So more and more vets are not going the traditional route.
And not to derail the thread again, but I wanted to add my $0.02 on pro-sal.
Small animal GP is a business. I provide a service: examine patients, perform diagnostics and configure treatment plans. I was hired to generate income by providing these services. We expect people to pay for these services because it is a business.
I am NEVER going to recommend a test or a treatment or a procedure that is not in the best interest of my patient because I am an ethical practitioner. If I am an unethical practitioner, I could recommend unnecessary services; I could also steal controlled substances and sell them on the street. There are many things an unethical person could or would do that an ethical person would not, regardless of how they're compensated. It seems as though you've worked with unethical people who benefited from pro-sal, and I'm sorry that has been your only experience with it. I've been fortunate in that both practices I've been in with pro-sal have been nothing but awesome; I get extra compensation for staying late, seeing an emergency instead of going home to have a timely dinner with my family, working up a difficult case or performing a complex surgery that requires me to do some extra reading the night before. I benefit by getting to pay down my loans faster. My practice benefits from the income I generate from these services that allows us to continue to upgrade our equipment and services; my patients benefit from my educating their owners. Both practices have a wonderful team-work atmosphere where people are always happy to help each other out.
As for "Why take time out in the day to read up on a problem or practice a new knot technique when it might take away time that you could be using to earn more money?" - simply because I do not practice with my compensation in mind. Again, ethical practitioner. I am reading every.single.day on new treatments, medications, procedures, etc...because I want to give my patients the very best possible care and outcomes. I treat every client equally, whether or not they can afford my recommendations or not. Just last week I saw a dog that I wanted to send on one particular medication but the owners couldn't afford it...so I sent them on a medication I think isn't quite as effective as the first but that has a chance of helping the problem for much less money. I never once thought, "Ugh, there goes my production on that case!" I'm sure there are people out there that think that way, which is sad, but to lump us all together...please don't
Everything TR said. Just because I'm on production doesn't mean I'm unethical and I'm insulted by that insinuation. I recommend things that I feel are necessary according to the case, the patient, the client and the budget. I don't practice any differently than when I was on straight salary, except now I don't mind a busy schedule and staying late occasionally and covering for other vets. I frequently script out drugs and tell clients when they can probably get them cheaper at a pharmacy. I do estimates and discuss what I feel is 100% necessary and what isn't (ie the vomiting/diarrhea 2 year old dumb lab that's well hydrated and happy and eating can probably be treated conservatively and symptomatically but some owners WANT bloodwork and rads to know 100% everything is fine). I often tell clients "I don't think we need to do x today", which helps down the road when I REALLY think they need to do y on that day and they believe me.
Can pro-sal create competition? Sure. But straight salary can create a lot of animosity if some people feel they're pulling more than their share. I am lucky to be in a fairly collaborative environment where the other two vets don't mind sharing cases and helping out. Likewise, why do I learn new stuff when I could be making revenue? Because the schedule isn't always full. Our receptionists do their best, but sometimes there's just nothing in the book (especially this time of year). That's your time to advance your knowledge. Plus CE time. Poke around on other vet's cases if you can when you have time. It's not all or nothing. It's "Let me get through my day of ear infections and maybe browse some journals tomorrow when the schedule book is lighter".
Perhaps you misunderstood what I said when I talked about ProSal or production compensation promoting selfishness rather than working as a team.......I mean that literally, not figuratively. I'm not lumping any associates together as unethical based on whether or not they are paid in that way, and I agree that any method of compensation won't turn an ethical person into an unethical one......but it does illustrate to me what owners/managers value by paying in that way. It's a statement about what management values and what management promotes by their choice of compensation methods; they are saying "this is what I value in you and this is the only reason you're here. This is what's going to make you more important to the clinic".
Another way to look at it though, having been way underpaid at my first job on salary.
At least on production, you aren't as likely to be cheated on pay. If you are paid "a fair pay" including paid vacation, then it doesn't matter at all I guess, as long as your full compensation package is comperable to what you would have gotten paid on production.
But how is "fair pay" determined? Most employers are not going to knowingly "overpay" you a salary that is below what you justify based on your production. Which means that you're more likely to be underpaid on salary than what you would have earned on production. If you get raises based on your production figures... you still have the same incentive to produce in order to get paid more. But by the time you've gotten a raise because your production says you deserve more, it means you were already underpaid.
It's demoralizing and sad to have to worry about taking vacation if you're paid straight production, or if you're on a negative accrual system. Because it really means you don't get a true paid vacation. But if you come to terms with that, and just think of yourself as essentially working as an independent contractor of sorts, at least you know you're getting paid what you're worth. And at least where I've been, it's very easy to find out how much you're producing at any given time.
I don't really care which way I get paid as long as I'm getting a good package out of the deal overall. If I'm getting paid $120k now on production with essentially 0 vacation, I'm okay with a salary of $100k as long as I get $20k worth of vacation/maternity leave, as long as there is a chance for some sort of profit sharing tied to growth. As long as the overall package is comparable, it's fine. I wouldn't go on salary though, unless I really trusted my employer and things are transparent.
I feel like contract reading/negotiations should be a mandatory seminar for veterinary students. I've learned more in this thread than I have in the last 3 years of school (about jobs)