Are you an underearner?

Asking whether you're an underearner may seem insulting—a personal attack on your abilities and business sense. After all, you work hard. In fact, it feels like you work all the time. You're a good doctor, too. You attend conferences and keep up with the journals. Sure, you could make more money if you wanted to, but you're just not willing to put in more hours than you already do. Besides, you didn't get into veterinary medicine for the money. Anyone in this profession who doesn't have money worries must be cutting corners, overcharging, or letting some corporation dictate how they practice medicine.

But still—it would be nice to put more away for retirement, wouldn't it? And don't you wish you had more to show for your prime working years? If so, welcome to the club of underearners.

iStockphoto.com/Elena Elisseva; Zone Creative

Don't despair. Underearning is not the same as underachieving and definitely not a reflection of how hard you work. Underearning isn't associated with a low income either. In fact, underearning isn't really about money at all. It's about your relationship with money.

Underearning is earning less than your education and experience would suggest—despite a desire to do otherwise. Underearning is about the choices you make and the value you put on your talent. Undervaluing yourself can be costly, and the effects compound over time.

Take the quiz to find out where you fall on the underearning spectrum, then read the advice that follows. It is possible to do what you love and be paid well for it.

Self-assessment

You might be an underearner if ...

1 When it comes to financial goals, I:

a. Wish I could magically shrink my bills or receive some financial windfall.

b. Have a vague idea of what I should be making but seldom hit that number.

c. Identify what I want, make a realistic plan to achieve it, and actively work the plan.

2 My compensation is:

a. Pathetic, but I can't work longer hours without alienating the last friends and family members who still talk to me.

b. OK. I'm not getting rich, but I make enough to get by.

c. Excellent. My income is more than enough for all of my present and future needs.

3 Discounts and free care are:

a. Part of the job. There's no way I can say no to a needy client or patient.

b. Not great for me or the practice, but unavoidable once in a while.

c. Unacceptable. I spent time and money to become a veterinarian, and my talent is valuable to clients and patients.

4 When I experience conflict with other doctors and employees, I:

a. Use a duck-and-weave technique to avoid any confrontation.

b. Do what's needed to keep the peace, even if it means giving in during a discussion.

c. Don't seek conflict but do address problems and disagreements through timely and direct face-to-face discussion.

5 My general approach to ordering supplies is:

a. To spread my orders around so everyone gets some of my business.

b. To accept a good price if a sales representative offers me a deal.

c. To negotiate the best deal by researching prices, bargaining, and consolidating orders with a few vendors.

6 When I have more patients than I can handle or a management muddle I can't fix, I:

a. Figure it out myself; everyone else is just as busy and stressed-out as I am.

b. Ask for assistance when absolutely necessary but apologize for intruding on someone else's schedule.

c. Call in reinforcements as soon as things start to get out of hand.

7 If a colleague appears to be making lots of money as a veterinarian:

a. She probably overcharges or has a spouse who makes a lot of money.

b. Good for her; I wish I knew her secret.

c. She's charging appropriately for her costly equipment, talented team, and years of experience.

If you answered mostly with A's and B's, it's time to face facts: You may be your own worst financial enemy. But the situation isn't hopeless. Reversing a pattern of underearning is possible by looking at the thoughts and feelings influencing your business behavior. Here's a detailed look at the typical underearner characteristics as reflected in the quiz.

Bad habits that die hard

1. Underearners have wishes instead of goals. Wishes are thoughts you hope will come true; goals are things you identify, make a plan to achieve, and actively work toward. It's unlikely that you'll be bailed out of your financial crunch by winning the lottery or receiving an inheritance from a long-lost uncle, so buckle down and face reality.

Solution: Twenty-five years of experience in human and animal healthcare management consulting has shown me this undeniable fact: Your operating budget is the single most powerful management tool at your disposal. Long-range planning with a road map for how to achieve those plans is as important to your business

as daily operations.

2. Underearners tolerate poor compensation. Many underearners believe that in order to earn more, they must work harder or longer. The reality is that most underearners are already working harder than their colleagues. Underearning can be as much about what you don't do as what you do.

Solution: Underearners are great at playing the blame game. Resigning oneself to an unacceptable level of income because "this neighborhood isn't growing" or "economic conditions are poor" or "if I raise my fees my clients will all go to my competitor" are all examples of relinquishing responsibility for securing your own financial future. First, you need to determine if what you fear is real or if it's more about your own insecurities. Try out a few things: raise a couple of key fees in small increments over the course of a year, be more assertive about compliance, or add a new service. Then, measure revenue, compliance, and complaints before, during, and after the test period.

3. Underearners underestimate their worth. Underearners spend a lot of time volunteering their services and providing free care. They discount or write off charges because they feel guilty, embarrassed, or ashamed. If you've felt that way, your feelings are not about money—they're about your sense of self-worth.

Solution: Valuing your time is the same thing as valuing yourself. Think back to how money was handled in your family when you were growing up. Was it a source of stress? Was there conflict in school between the haves and have-nots? If you don't think those experiences still affect us today, consider how you felt just before you walked into your last high school reunion. In a profession where your product is your expertise, the only way to give yourself a raise is to increase your fees and/or decrease your expenses.

4. Underearners are excellent avoiders. Many underearners experience chronic interpersonal problems in their practices because they avoid confronting people or take the path of least resistance even if it's not in the best interest of the business. They often have a strong need to be liked so they're careful not to make anyone angry or create conflict.

Solution: Create systems that speak for themselves so you don't have to be "the decider" in common conflict areas such as schedules, attendance, time off, and duties. Develop a manual that outlines policies in clear and unambiguous language. Write thorough job descriptions with clear reporting relationships. Review and update these often and apply them to everyone. Record minutes at staff meetings and post them.

Also make sure new employees sign a letter of understanding. This isn't a contract; it explains to new staff members what was discussed in the job offer: salary, schedule, benefit eligibility info, supervisors' names, and any other things agreed to at the time. Place a copy in the employee's personnel file.

5. Underearners are poor negotiators. Underearners spread their supply ordering around to several vendors because they're afraid to hurt a sales representative's feelings, even though they may be able to reduce costs by consolidating. Or they don't evaluate the quality and cost of all services on a regular basis.

Solution: If this is difficult for you, be objective. Look at the pros and cons of working with each vendor, including pricing, quality of service, ease of resolving billing errors, and more. Ask vendors to give you their best pricing based on your total volume and the current partial volume and tell them you are going to do this every year. Evaluate areas like merchant services on a regular basis by sending potential providers a copy of a typical bill and let them calculate what your fees would have been with them.

And don't stop with supplies. Your financial vendors deserve the same scrutiny. Start by calling your credit card company and asking them to reduce your interest rate. If they won't, look for a better deal.

6. Underearners are afraid to ask for help. Underearners suffer in silence. They don't want others to know they feel underappreciated and overwhelmed, and they don't know what to do to resolve those feelings.

Solution: Undervaluing yourself is a compounding problem. The longer you let thoughts of unworthiness guide you, the less likely you are to change. If you think that just maybe you're an underearner, ask for help sooner rather than later. Talk to a colleague who's doing well (not another underearner), look at industry benchmarks and other financial resources, or call a consultant. You'll never recover lost revenue from years of avoiding the issue, but you can realize improvements. And the effects of the change start compounding on the first day you implement new behaviors.

7. Underearners are reverse money snobs. They often believe that anyone in their profession who makes a comfortable living must be cutting corners, providing poor-quality care, or somehow acting unethically. If you believe that a colleague can get wealthy only by selling out or exploiting others, or that being poor is a virtue, you are definitely an underearner.

Solution: It's time again to examine the role money played when you were growing up. Did your family resent rich people? Is there someone in your life who has always played the victim in every job they've held? Was there a lot of comparing of lifestyles? Is it a source of pride for you to provide care for free or to discount frequently because "someone has to"? If you're truly earning what you need to support yourself today and provide for a secure future, that's perfect. If you're not, consider what issues from your past influence your behaviors today. If some are holding you back, work at letting them go. Ask for help if you need to.

If you're an underearner, the situation isn't hopeless. Reversing the pattern is possible, but it takes introspection to understand feelings and thoughts influencing your behaviors. Remember, it's not about money; it's about self-worth. Your team, clients, and patients value you. It's time for you to start, too.

Jan Miller is president of Veterinary Best Practice in Hillsboro, Ore. Send questions or comments to ve@advanstar.com