Weigh your needs before signing contracts

Consider three factors before signing on the dotted line. If your core values, standards of care and educational expectations fail to mesh with a practice, the working relationship won't succeed. Don't assume your standards and the practice's protocols interconnect. Successful working relationships depend on matching your personal needs to the following criteria:

• Core values: It is critical that the new veterinarian understands and accepts the practice's vision and core values; if the core values do not match, walk away.

• Standards of care: It is critical that the new veterinarian understands and accepts the practice's standard of care, including the formulary. If disconnect exists with the practice's healthcare delivery protocols at this point, then neither the employer nor prospective hire should want to continue discussions.

• Education, training subsidies: It is critical that the practice is willing to subsidize a new hire's education and training, continuous quality improvement and personal development. Concurrently, the new hire must be willing to accept a lower base wage during general practice training for a "no ceiling" productivity as his or her skills develop.

Using a decision tree

With these three assumptions, survey of the practice by the potential hire is indicated and should be compared to other prospective practices. While the sample lists duty hours and standards of care high on the decision tree (Table 1), they might not be your criteria. Practice location or compensation might be of greater concern for some new graduates, and in most cases, they are mutually exclusive factors. Location preference causes reduced selection criteria and therefore lower compensation leverage, while compensation levels are higher in certain metropolitan areas, which might not be locations desired for a first job. Within a geo graphic area, new doctors with school-age children must assess the home site for quality of education and family safety. Equipment, team harmony and cleanliness easily can be seen during a one-day practice visitation, while management philosophy and staff quality usually take a bit longer to assess. Emergency duty is balanced against emergency pay because the extra income often is a great way to retire school debts but is a real distraction from quality family time. Extra demands also relate to quality of life. This process comes with four basic premises for the practice and prospective employee.

Table 1 Sample Weighted Employment Evaluation Decision Tree: RankIng the pros and cons of potential employers

Goal assessment

The sample Goal Statement Criteria chart (Table 2) continues the decision-making process by reflecting the type of explanations that might be provided to a prospective employer. Prospective employers should address these explanations before the interview process to ensure the potential employee understands what is being offered and/or expected as terms of employment.

Table 2 Sample Goal Statement Criteria: know what you want, what to expect

The employer and prospective hire need not agree on the weighting, but the prospective employee must be honest and share the criteria of selection with the prospective employer so there is an equitable playing field for negotiations.

The user of the decision tree must use a single set of standards when assessing multiple job locations or offers if a true selection process is desired. The decision tree offers the user high flexibility in assigning criteria and weighting each factor; in some cases, certain criteria can become deal breakers and must be elevated before use of the Weighted Employment Evaluation Decision Tree.

The challenge of acceptance

The economic value of a potential employee is in the eyes of the person paying for his or her services. In some cases, relief from the daily grind gives the practice owner a higher incentive to hire and set aside the initial economic value for better quality of life, as well as the potential of increasing the economic value with in-house development. The largest stumbling block in most negotiations will be the salary expectations: The prospective hire wants significant income guarantees without proving what he or she is worth, while the prospective employer wants some form of a guarantee of personal production before compensation is determined.

Indicators predict harmony

In some cases, a new veterinarian will want buy-in guarantees, and while that is unrealistic, it is a perception, so it is part of negotiations. A "professional fit" between providers must be established before any form of partnership or co-owning arrangement is reached. Key indicators must be addressed:

• Division of existing case load,

• Expected duty hours,

• Outpatient standards of wellness care,

• Formulary agreement (pharmacy stock),

• Day admission expectations for patient diagnostics,

• Inpatient standards of diagnostic care,

• Equitable credit policy for all clients,

• Staff leadership and team harmony,

• Professional development.

We find these criteria are best discussed in a quiet, out-of-practice environment, often across a kitchen table with a yellow pad of paper. Many of these go back to the Goal Statement Criteria chart or the Weighted Employment Evaluation Decision Tree, and compromises should be expected by both parties. Practice harmony hinges on agreement on these factors; they are not the domain of accountants or attorneys. The smart practice will have an attorney draft the final agreement in accordance with state regulations, and a smart new graduate will have a financial advisor to help develop a cash-flow plan to retire debt and establish an investment program.

The bottom line

As you can see, negotiating that first win-win employment contract is as difficult as finding the right significant other to share a life with. In fact, it's harder. New graduates generally do not have the privilege of "dating" a practice; they need to find an employment position soon after graduation. This is one primary reason why so few new graduates stay with their first practices. They did not have the experience to effectively identify the selection criteria or measure the practice for a long-term fit.