Maintaining the mix

As veterinary medicine continues to evolve, I can't help but wonder if the future of mixed practice is doomed. Sure, plenty of successful mixed practices are flourishing across the country, and new graduates are still signing on as associates, ready to be multi-focused. But there appears to be a shift among recent graduates that threatens the future of small animal/equine practices everywhere. These trends won't surprise you, but they may account for why you're finding it harder and harder to hire dedicated mixed animal associates.

WHAT NEW GRADUATES WANT

For several years we've seen a slow evolution in new graduates' priorities. Years ago associates were mostly male, had designs on becoming a partner at the earliest opportunity, and expected to "pay their dues" when first employed. According to many practice owners and managers, that's no longer the case. Most new graduates are women, neither gender seems as concerned with partnership, and employment terms are centered around the benefits available now rather than later.

In an industry known for sending new graduates into practice with the heavy weight of school loans, salary has always been a concern. Several years ago, that may have been the principal concern, along with how the new doctor would "fit" into a specific practice. Today, while salary remains a top concern, there are many others—some that make mixed practice less attractive.

Flex and family time. A growing concern among new veterinarians is the balance between home and work. The older generation of veterinarians (especially equine doctors) would expect to arrive at home after the work was finished. Period. There were fewer multi-doctor practices, and veterinarians enjoyed an extremely personal relationship with their clients—some doctors practicing out of their homes. While members of the younger generation also pride themselves on their client relationships, there is more separation from work and a greater expectation of home time.

It's easy to point to the changing gender demographic among graduates to explain this dynamic, but many men are just as likely as women to prioritize their time at home.

In increasing numbers, new veterinarians are looking for employment at a practice that will allow unscripted changes in schedule, the flexibility to leave early or come in late if family needs arise, or simply fewer hours worked in the week. Unfortunately, new associates don't always equate fewer hours with less pay. Dr. Don Howard of Twin Oaks Veterinary Hospital, a mixed animal practice in Salem, Ore., agrees. Many new associates "want more benefits, fewer hours of work per week, and an increase in pay to compensate for the time they're not working," he says.

While many practice owners are adapting their job offers accordingly—whether they like it or not—the reduction of work hours can lead to other practice challenges. Dr. Howard says that becoming a better-than-average veterinarian is tied to the caseload and intensive learning curve that's typical of an associate's first year or two. Slowing down that natural development makes it more difficult to "achieve success, respect from clients and peers, and the ability to practice quality medicine for the patients," Dr. Howard says. While an associate will still get to the necessary level of expertise, it may take longer, which becomes a financial consideration when negotiating a contract.

No emergencies. Because of their commitment to equine clients, many mixed practices provide emergency services for both horses and small animals. While large population centers typically offer viable alternatives for after-hours companion animal care, the same can't be said for horses.

Addressing the issue of after-hours work is vital when negotiating the terms of employment, and it is one of the biggest threats to mixed practice.

Graduates who are focused on equine work will usually handle the emergency load without complaint and understand the necessity of providing after-hours care. New associates who are split between companion animal and equine practice, or those focused primarily on dogs and cats in a mixed practice, are more likely to consider emergency work an obstacle. At my hospital, Silver Creek Animal Clinic in Silverton, Ore., three associates hired in the past six years left the practice primarily because of emergency work. They simply decided that giving up their time outside of the regular workday wasn't justifiable. All three relocated to companion animal practices that refer emergencies.

For associates not fully committed to equine practice, this single issue can be a catalyst for career decisions and, as a result, poses a threat to the future of mixed practice.

Species focus. True mixed practitioners are out there, but in this economy, a new mixed practice veterinarian is more likely described in one of two ways: an equine practitioner who is willing to compromise and work on companion animals, or vice versa. Neither are good long-term prospects for professional fulfillment.

Dr. Howard says it's more difficult than ever to find quality associates who can move easily between large and small animal patients. One reason, he says, is that we know so much more about each species than we did 20 years ago, making mixed practice more daunting to a new graduate.

According to his experience, most practitioners look for equine or companion animal practice. He also noted that if one group was willing to compromise, it tends to be an equine practitioner willing to join a mixed practice rather than the other way around. The reasons can be twofold: People who are not horse savvy (including veterinarians) may be intimidated by their size and strength, and in this economy, equine practitioners have been forced to expand their focus.

In addition to the three associates who left Silver Creek because of emergency work, at least one other doctor moved on in an effort to find a heavier equine caseload. Our last two recruiting cycles turned up nearly 50 resumes each, but few candidates were actual mixed practitioners.

While writing this article, I tried to explore the topic with new doctors, but was met with some resistance. One prospective graduate and two associates, all of whom graduated in 2011, declined to be quoted for the same reason: due to concern that a public statement about their preferred area of practice might limit their future job opportunities.

MOVING FORWARD

Mixed practices will survive—if only because they're necessary in some areas, still profitable, and still a preference for some veterinarians. However, employers will need to be ready to compromise in some areas if they wish to hire and retain quality associates. Creating flex-time options, reducing emergencies with the creation of a regional call group, and allowing Dr. Jones to come in late so he can see his daughter's play at school are ways in which practice owners should be willing to concede some ground.

Kyle Palmer, CVT, is practice manager at Silver Creek Animal Clinic in Silverton, Ore. To comment, e-mail ve@advanstar.com.