Choose wisely, Practice in the real world

Jane: Late 20s and has worked for Dr. Taylor as an assistant since the beginning for five years. She is not a certified technician. She shows dogs and has no previous medical training. Pay: $12 per hour. She feels she is the leader of the hospital. A lot of Jane's friends are clients of the practice.

Alice: Early 20s. Has worked in a previous veterinary hospital for one year. Has worked for six months for Dr. Taylor. She has a BS in agricultural science. Pay: $11 per hour. She is devoted to the mission of the hospital.

Look for the red flags

Dr. Jeff Taylor: Is in his mid-30s and very interested in the medical side of his practice. Started practice five years ago after dissatisfaction with his income. Originally hired staff at minimum wage and has had high turnover rate until last year. Jane is the only original staff survivor. Money is tight, and the practice is not growing anymore. He has yet to equal his income from his first job. Avoids conflict.

Sylvia: 20 years old and has worked for three months as a receptionist. She is the only receptionist. Dr. Taylor's wife substitutes for Sylvia when needed. Sylvia is involved with Greyhound rescue.

Scene One

Jane Meyer is a bossy sort and somewhat loud at times. She watches out of the corner of her eye as Alice washes some slides. Dr. Taylor re-uses the slides used to perform fecal tests, and Alice has just finished rinsing and drying several. Alice now places them against the side of the sink and walks away.

Jane calls her over and bluntly tells her that she likes to use a different soap and that the propping angle for those slides is too low. She states that it will cause spotting of the slides. Jane smiles as Alice adjusts the slides. Alice smiles back weakly. She returns in 30 minutes to inspect, clean, polish and put them away.

Later that day, Alice prepares the examination room for the next patient — an obese Maine Coon cat named Killer owned by Janet Spiller. Alice weighs Killer at 28 pounds. Janet had bought Killer from a breeder a few years ago.

Just then, Jane appears from the back.

"You know, Janet, that Dr. Taylor will try to be nice and tell you that Killer is a little overweight. You should know that he is totally obese, and you need to put him on a diet." Jane opined.

Janet Spiller was shocked and immediately came to Killer's defense.

"Main Coon's are supposed to be "big boned," and he hardly eats a thing. He may be a little overweight, but I can't really see how," she replied.

Dr. Taylor enters the room and begins his examination while Jane and Alice exit. Alice starts to prepare the vaccinations for Killer behind the exam room when suddenly Jane blurts out in a loud whisper.

"You know that fat cat is really not a Maine Coon at all. It is just a big fat cat that some local breeder is passing off as a Maine Coon?"

Alice tries not to listen.

Dr. Taylor cringes in the next room as he can hear every word that Jane had just "whispered".

Janet had been stroking Killer during the examination and had hesitated briefly as Jane's whispers floated into the room.

Dr. Taylor hates it when Jane goes into her speeches about show-quality animals. It is apparent to everyone in the hospital that, according to Jane, purebred character is as important as any health issue. She has preached this dogma to clients for years during spay and neuter discussion before every puppy and kitten exam. He had never talked to Jane about toning down her rhetoric, and it seems to be too late now. Although desperate to talk to her about it, he seems powerless at this point. Jane has just about taken over the life and destiny of the hospital. She is in control.

Scene Two

It is 7 p.m. and the parking lot has three cars parked at odd angles. Dr. Taylor has come to check out a few glitches that occurred earlier in the day in the computer. He recognizes only one vehicle.

Dr. Taylor places the key in the back door and notices that it is already open. He walks in the back of the clinic and sees lights on everywhere. Once inside, he finds Jane and Judy Pinkston working feverishly over a Bull Mastiff that Dr. Taylor has never seen before. A gastric tube lies on the counter, and the animal is in obvious distress.

"Hi, doc," Jane cries. Judy brought Goliath in at 6 p.m. right after you left. He is trying to die as we speak. I was about to call you."

Dr. Taylor moves swiftly to the animal's side in time to watch Goliath move into the initial stages of agonal breathing that every veterinarian hates to see. The aftermath is predictable — the crying, the guilt and finally the awful mess that seems to be cleaned up in a numbing silence.

In the end, Dr. Taylor knows that no money will change hands. After all, Jane came in on her own time and Dr. Taylor has arrived too late to claim involvement. Dr. Taylor had suspected Jane had been doing this type of moonlighting for her friends for some time but had never actually walked in on it. Many of her friends belong to local dog clubs, and some come to Dr. Taylor. He had tried to appease some of the strong personalities within the local club with discounts and special favors. In spite of this, a lot of members were attracted to other veterinarians in the area who would spend their personal time dealing with breed-related issues. Dr. Taylor was cordial but really never had time to buy into the show scene.

Scene three

Dr. Taylor walks into the hospital in a little early on Monday morning. He can hear the phone ringing over and over. Suddenly, the phone goes silent. In the back Dr. Taylor finds that his two morning assistants are helping Sylvia with a "ropy" looking Greyhound. This is the second such animal in a week that has mysteriously appeared from the back of the kennel. There is always an extra kennel or two in the back, so Sylvia has brought many of her charges in for check ups and processing. Sylvia apologizes for the phone issue noting that this particular Greyhound is a little "hard to handle". She makes no apology for tying up the rest of the morning staff.

Dr. Taylor begins to acclimate to the situation and now can hear resonant barking from the back. He walks by the knot of activity and decides to investigate. In the kennel, he finds a familiar face — a Greyhound named Charlie. Charlie is one of Sylvia's projects from last year. In the adjacent run is an unfamiliar Greyhound cut from the same cloth as the other new patient currently in process. In the next kennel is the lone paying customer for the practice. Her name is Jamie. She is a small Rat Terrier with a heart problem. Jamie shivers and coughs with nervous confusion as Dr. Taylor walks by.

As Dr. Taylor re-enters the treatment area, he frowns a bit as he moves past the scene of activity. He attacks the notes and charts that remain undone from the day before but cannot ignore the ensuing conversation that is about to unfold.

Jane enters the room from the front and for some reason, everyone bolts to attention and waits for her reaction. She looks at the Greyhound.

"Sylvia, if that's a Greyhound, I am a monkey's uncle."

Sylvia holds her tongue. The others are confused by Jane's statement.

Dr. Jeff Taylor is happy to have retreated to the periphery. He dislikes the caustic banter but has decided to stay above the fray. He mentally shifts gears and once again devotes his attention to the pile of charts before him.

The pile would get bigger as the day wore on.

Then the phone rang. Since everyone else was busy; Dr. Taylor answered. He recognized the booming voice of his accountant right away.

"Jeff (there was a pause in the bass profundo). Jeff, do you realize that you are three months behind on your payroll taxes?"

Managing in a vacuum

Avoiding conflict has cost Dr. Taylor both respect and the control he needs to manage his practice.

He will not only lose control of his practice and its ability to perform financially; he will also lose Alice, who has been true to the mission of the practice. Alice cannot long survive in the hostile leadership exhibited from Jane. When Alice leaves, Jane solidifies her power position within the practice. This has been going on for five years. Dr. Taylor also fails to see or be able to cope with the financial leaks in the back of the hospital.

Hiring people with the "wrong stuff"

There are some constants in veterinary medicine. One constant is that there always will be an army of unqualified people looking for a chance to work in an animal-related environment. Another constant is that there is a subgroup of animal lovers out there that I will classify as members of the "animal community."

This community involves itself in animal issues far beyond what would be the normal activity of a pet owner. These individuals have elevated their animal activities to that of a hobby and, for some, an obsession. Many in this community eventually seek employment in veterinary offices as a natural extension of their other animal-related activities.

Veterinarians are susceptible to hiring these individuals. After all, it would seem natural to bring people into a veterinary clinic that both love animals and are for some reason are willing to work without quibbling a lot over salary. This would appear to be plus in that a lot of veterinary clinics find it hard to find qualified people. Therefore, the logic goes that training people from this animal community to work in the veterinary environment reduces payroll costs and may even attract clientele.

This is certainly not always the case. Let me first state that there are many very good workers in practices across the country that come from the animal community and are unselfishly devoted to the practices and their work. Unfortunately, in most practices, staff typical of those illustrated in the story of this fictitious practice infiltrates an otherwise healthy work environment from time to time.

Veterinarians are caught between a rock and a hard place. They need qualified help, but often, it is not available when needed. The key management advice is to look for that tunnel vision in prospective employees when it comes to animals. Remember there are animal collectors and may even be seeking employment in your office simply to find a way to afford to keep the burgeoning menagerie at home (see "Look for red flags").

What's with Jane?

So, what's with the fictitious character Jane in this story? Well, Jane is a typical control freak that will take your practice hostage if you let her. Her personality will gladly fill the management void left open by Dr. Taylor. In other words, if a management vacuum occurs in the practice, someone will fill it. In this case, it was Jane. Unfortunately there are a lot of veterinarians out there with tremendous veterinary skills and poor human resource skills.

It is common for many divisive and deceitful individuals to perform the basic duties of their employment beautifully. In a sense, employers forgive their bad behaviors because job performance is at a high level. The problem is that the bad behaviors start to win, and it can hold your practice hostage.

Many years ago, I had an individual in my practice like this. She referred to the practice as if she were the owner and made many decisions beyond her capacity as a receptionist, including the practice of veterinary medicine without a license. She routinely bossed people around, but she was so good at her job that it was hard to fire her. She (and I) also treated a constant stream of her cats for nominal fees. In other words, I was being held hostage. I admit that I let her run all over me — I was a being a mouse.

In another sad and extreme incident, I had a member of the animal community that happened to show dogs on weekends. She worked in our practice for about a year and brought her animals and her young son frequently with her to work. In about a year, she left but returned a month later in an unusual manner. She and one of my clients that she had befriended burglarized the practice and removed some lab equipment, euthanasia solution and other controlled substances.

Unbelievably, she later was caught trespassing on property owned by her show competitors in the act of euthanizing their animals.

Bottom line?

It is your practice. Hire individuals that will promote and increase the professional appeal of your practice. Avoid those that come to work based on their own self-interests.