5 things that worry a new doctor

We know the first year in practice brings special challenges. It's a major life transition to move from school to the workforce no matter what your profession. And in veterinary medicine, associates hold the lives of pets in their hands almost from Day 1, which gives the experience even more intensity.

To learn more about recent graduates' experiences in the workforce —and how owners can make them feel more comfortable and help them hit the ground running—we asked Dr. Philip VanVranken, a 33-year veteran of veterinary medicine and owner of Dickman Road Veterinary Clinic in Battle Creek, Mich., to act as a mentor to recent graduate and Veterinary Economics Editorial Advisory Board member Dr. W. Andrew Rollo, who's an associate at Gibraltar Veterinary Hospital, a five doctor, small animal practice in Gibraltar, Mich. The two doctors exchanged regular e-mails over the course of a year and discussed everything from basketball to making mistakes.

We're planning to run four articles this year that share portions of their conversations, which we hope will stimulate discussion and help both associates and owners understand each other better and learn to work together more effectively.

Near the beginning of their discussion, Dr. VanVranken asked Dr. Rollo what his top worries were as he made the transition to practice. Here we share his responses and Dr. VanVranken's advice.

Concern #1: Do I know enough?

Dr. Rollo: I think I can speak for 90 percent of my classmates (and the other 10 percent are in research) when I say that I was concerned about whether I knew enough. Confidence as a doctor is something they can't teach at school and something everyone has to figure out on their own in the real world.

In the first couple weeks, I found myself running out of the exam room into the office and looking up what I had just told a client about a certain disease or condition. One time I suggested Addison's disease as a possible diagnosis. The owner began asking many questions about the condition such as treatment and prognosis. I'd never dealt with an actual patient with hypoadrenocorticism and probably slept through the lecture years ago. To my surprise, when I opened the closest reference I could find, I learned that what I told the owner was right.

Dr. VanVranken: I understand feeling concerned about your confidence. But, not to worry, clients have confidence in doctors who work hard for their patients. Think of it this way: Every pro baseball team has a fan-favorite, and it's usually not the 10-year veteran with the big salary. Instead, it's the rookie making the league minimum salary. He runs out every ground ball, is remorseful when committing a fielding error, and makes himself available to fans and reporters. The moral of the story is you can bat 245 and still win fans' admiration. Everyone pulls for the individual who strives to please.

Concern #2: Making mistakes

Dr. Rollo: To be human is to err, and I'm aware that I'll make mistakes. Sometimes it's in the exam room; a few weeks in, I told a client that she could get Demodex from her dog. Hours later I realized that I'd mixed up Demodex with scabies. Needless to say, I had to make a humbling phone call later that day to re-educate the client. Luckily I have a great team around me for help and support along the way.

Dr. VanVranken: We all make mistakes, even after 30 years of experience. Granted the mistakes aren't as frequent, but they still happen. Get used to them and learn from them. There's a lot of dung out there and the challenge is to step in as little as possible. Your experienced team will help you in that regard.

Another thing that will help is to spend a few minutes each night at home reading about one difficult case you saw that day. After a couple of years, you'll have read about almost every disease.

Concern #3: I look too young

Dr. Rollo: Since I still get carded at a bar, I worry my looks could affect clients' confidence in me. Sometimes I feel like I should walk into an exam room with glasses on to add some years to my face. On the other hand, I've been surprised with the confidence clients show in me. The "DVM" certainly adds something to the name.

Backgrounder: New grad

I guess it's not surprising, but every now and then a client will make a remark about how young I look. I usually respond with, "Well, thank you. I'll take that as a compliment."

Dr. VanVranken: As far as looking too young, I remember that feeling. I imagine after a few more 12-hour days, you'll look like the rest of us grizzled veterans. So enjoy your youthful looks while you've got them.

Concern #4: How can I gain team members' respect?

Dr. Rollo: As a new graduate, I worry that staff members won't respect me. With any group of co-workers it takes a while for each person to get used to another's personality. I think by now the staff has learned that I like to have fun, but there are other times we need to be at our professional best.

Transition tips: Break the worry habit

I have some really experienced team members around me who help me a lot. And I've been able to learn from them and am always open to their suggestions. Yet I know the final decision and responsibility lies with me.

Dr. VanVranken: Your technicians will be your guardian angels. They're probably already battle-tested so don't be timid; ask for their advice. Experience is a powerful ally to have on your team. Moreover, asking for their help will make them feel that you value their contributions. Nurture your relationship with your technicians carefully!

I'm also glad to hear you like to have fun—that's very important. Sometimes we refer to practice as "organized chaos." Humor helps keep everyone's spirits up.

Concern #5: Did I make the right choice?

Dr. Rollo: My last concern was whether all the school, time, and money were worth it. That was an easy one to answer—all I have to do is send home a recovering pancreatitis dog or deliver some healthy puppies through cesarean section to know the answer is "yes."

Dr. VanVranken: In this day of personal coaches, it's healthy to find someone who knows how they want to negotiate life's hairpin turns. You could look at it like this: As you go through life you can either drive or be chauffeured. Those who are chauffeured, though, don't know where they are or how they got there. Myself, I've always preferred to drive. That way I can repeat trips I've taken in the past. Over the years, I've been lost a few times, but I've either stopped and asked directions or depended on my experience on previously traveled roads. And I agree, the turn to veterinary medicine was a good one, at least for me.

The bottom line

As many as 45 percent of respondents to the 2005 Veterinary Economics Student Study estimated they would have $100,000 or more debt when they graduated. In addition to the stress of a heavy debt load, new grads face other stresses. They worry about knowing enough and winning team members' respect, just to name few. Dr. Philip VanVranken tackles new-doctor W. Andrew Rollo's biggest concerns and provides solutions and insights into the issues that plague beginners.