Why do technicians leave? A roundtable discussion

Marnette Falley: Our discussion begins with a letter submitted to Firstline. The reader writes:

"A veterinarian recently asked me, 'What do we need to pay our veterinary technicians to keep them with us? And what do we need to offer to get more educated technicians in the field?' I explained that there's not a dollar amount associated with retention and recruitment—technicians want to feel respected and need a chance to use their skills as well as receiving fair compensation. Here are the tough questions I'm struggling with. How can we get more people interested in attending school for a degree in veterinary technology? What are recently graduated registered technicians looking for in terms of wages, benefits, and so on? How do we keep registered technicians from leaving the field?"

Here's my question: If fair compensation and fair benefits are a given, what else do we need to do to make veterinary technology a career and help technicians want to stay in the profession?

Debbie Gair: Compensation is the obvious answer, but it's not the only answer. We know people aren't driven only by compensation. And the most common complaint I hear from technicians is that they aren't being utilized. Sometimes doctors know that, and they don't want to use them. Sometimes doctors just don't know how to better tap technicians' skills. They don't know how great it could be to have a really excellent technician in their practice.

Denise Tumblin: Maybe there should be a course for teaching doctors to use technicians.

Karen Felsted: That's a good idea. Sometimes part of the issue stems from the doctor's level of experience. Brand new doctors may still need to put in catheters because they don't know how to do it. And some of it comes down to general management. I'm not sure the traits that make you a good veterinarian and make you driven enough to go through vet school and borrow a million bucks to start or buy a practice are the same traits that make you an instinctively good human resources person.

Falley: Sheila, how long did you practice as a technician?

Sheila Grosdidier: Nine years.

Falley: And what were your experiences?

Grosdidier: I think veterinarians' approach depends on the experiences they have during college. If you look at graduates from the University of Pennsylvania School of Veterinary Medicine their uses of technicians' skills and their pay for technicians are significantly higher than doctors from some other schools.

At that veterinary school, veterinary students learn early about the value of technicians, and they realize that they don't want to practice without them. But at some schools there are six technicians in the entire building.

I think we need to take a close look at what keeps people in practice. If you take benefits and fair pay off the table —let's assume for a second that we can achieve that—team members need to feel enriched by what they're doing. Are they feeling challenged? Are they learning new things? Are they being recognized for what they do?

I think in most cases the answer is no. So practices are drastically underutilizing technicians.

Felsted: I think variation in certification and licensure also complicates the picture. There's a huge difference in how states feel about technicians and what they require. Some states clearly value technicians and recognize this value in their licensing requirements, and others don't. And I see the same inconsistency among veterinarians. It seems pretty clear that not all veterinarians think they need to employ licensed technicians or that delegating all the medical care that the law allows to technicians is a good thing.

Moderator, Marnette Denell Falley Editor, Veterinary Economics

Grosdidier: We often talk about suffering a shortage of credentialed technicians and about retention issues, but I think these are symptoms of underlying diseases. We're seeing the culmination of other problems.

If you build your job descriptions so that people see how they can elevate their skills and drive their income by improving their performance, you have the right benefit package. If you provide clear job descriptions and regular performance evaluations, team member retention rises significantly.

Participant, Karen Felsted, CPA, MS, DVM, CVPM Veterinary Economics Editorial Advisory Board member and consultant with Gatto McFerson in Santa Monica, Calif.

If a clinic employs several technicians, we find those technicians will stay longer. And in time, they'll also delegate the work they don't have to do to assistants. When that happens, assistants become more valuable to the practice and more satisfied. Everyone has a valuable role.

Why they leave

Falley: When you look at how many people graduate from veterinary technology programs and then how many credentialed technicians are working in a practice today, you have to ask, "Where did they all go?" This is a group of team members who've received specific training and have invested in a career and still they don't stick around.

Tumblin: One thing that's important is continuing to add layers of responsibility. Technicians are motivated. They're bright people, they went to school to learn about this profession, and interest in learning doesn't stop. Yes, you learn every day in practice, but maybe they need more. For example, maybe a practice could keep a technician excited about the profession by giving him or her management responsibilities. Or teaching responsibilities, so they can help other team members learn and grow.

Grosdidier: Plus, the message that those responsibilities gives is that we're confident in you. We know you can do this. We feel that you're a tremendously valuable person on the team.

Dentists have a model that they use to grow and keep their dental hygienists. It's called the Three Es: enrichment, encouragement, and enlightenment.

So enrichment means you make sure their compensation and benefits are right. You're asking for and getting feedback from them on their level of job satisfaction.

Participant, Sheila Grosdidier, BS, RVT Firstline Editorial Advisory Board member and consultant with VMC Inc. in Evergreen, Colo.

Encouragement means that you constantly talk about their performance and what they can do to grow and to develop. You build annual training plans for each person on your team. This is what you're going to learn this year. This is how you're going to grow and develop.

The enlightenment part means technicians get to share their knowledge with others in practice. They provide training for veterinary assistants or kennel executives—whomever needs assistance. They get to see the whole picture. That gives them that sense of empowerment. They feel like they're choosing the direction they want to go.

Felsted: Just getting back to the utilization issue. It's a rare clinic that has truly passed down every single thing they can to a technician. What do you think?

Gair: Those that do have much longer retention.

Felsted: Exactly.

Gair: When that does happen they really have people who buy in and they stay for much longer.

Felsted: And they have the financial wherewithal then to pay those people too. If you're utilizing the team, the doctors can see more appointments and you're making more money and offering better pet care.

Gair: Many places use their technicians the very same way they use their veterinary assistants or exam-room assistants. I don't blame those technicians for not wanting to be working at those practices. Especially if we have people coming from a technician school that really focuses on what they can do and how they can be useful in practice.

Grosdidier: I also worry that sometimes we're telling veterinary assistants, "You're not worthy. Your only career path is to somehow get to a point where we can call you a technician." That isn't right or true.

There are lots of jobs and roles in a practice and they're all valuable. Why can't there be a separate career path and a development path for veterinary assistants? There are plenty of responsibilities in practice that aren't specifically what a technician can do.

What if you divide those out. And then you'd develop pay scales that relate to their performance and not on the idea that they've worked there a certain length of time so they will be in a certain category. I think we need to find ways for technicians and veterinary assistants to grow alongside one another and build with one another and truly be a team instead of saying, "We need to shove you out of the lane you're in and put you over here in the technician track because that's the only way you're going to get anywhere." That doesn't suit either side of the equation.

Participant, Denise Tumblin, CPA Owner and president of Wutchiett Tumblin and Associates in Columbus, Ohio.

I don't see job descriptions as being limited. I see them as being dynamic and evolving with the individuals. There are such big areas where we haven't even thought about using our team members to their full potential. Yes, a lot of clinics say, "Oh, I use them in the exam room." Ninety percent of them do not. Technicians are used as a restraint device or to hand out a brochure. There are plenty of jobs in the clinic for everybody to be able to develop their skills and abilities. I think sometimes we spend too much time thinking about what we want to call people instead of what we want them to do and how we want them to work with one another.

Why doctors don't delegate

Falley: What's the biggest stumbling block that keeps doctors from delegating more to their technicians?

Tumblin: If doctors have never employed a licensed technician they may not know everything a licensed technician is capable of doing. I think that's one issue. I think for many it's a trust issue. Again, maybe that's because they haven't worked with technicians before.

Grosdidier: I think it's a management 101 mistake that's commonly made. They say, "We had Becky the technician back in the 1980s and she was a disaster, so we don't want a licensed technician."

The University of Pennsylvania does a nice job of helping veterinary students learn to work with technicians. For example, when students learn to place catheters, veterinary nurses show them how to do it.

Tumblin: That's interesting. Maybe it's a question you can pose to doctors: "Hey, what are you going to learn from your technician during your career?"

Falley: I asked why doctors aren't delegating more, and one issue you all raised is that they're not used to working with technicians in that way so they don't know they're missing the opportunity. Some may respond, "Hey, I am using my technician." How could we help them determine whether they're using all of their technicians' skills?

Grosdidier: The Veterinary Technician Educators Association developed a list that identifies the tasks credentialed veterinary technicians can do. In some clinics I give that list to the technicians. Then I give the list to the associates. I tell them to check off everything on the list that they regularly do. And then we usually sit everyone down and slide those lists next to one another. We say, "According to your technicians they haven't done those things. According to them, you do that." This opens conversation. You think one thing and your team thinks another thing. Where is the middle ground?

Falley: What is the most common objection to handing over more responsibilities? Do doctors believe their technicians don't have the training?

Grosdidier: Doctors do often go back to the training. At that point, I try to work with the doctors to build a training plan. First you say, here are eight things you want technicians to learn. Then let's talk about what we can do to prepare them better for those responsibilities. Will you make the commitment to relinquish those tasks? What's the value to your practice? If technicians take on those additional responsibilities, what are you willing to pay for that?

Solutions for the team

Falley: If you were going to make three recommendations to doctors on how to keep team members in general and technicians specifically around longer, what would they be?

Tumblin: Communicate.

Felsted: Understand what motivates them and try to provide those motivating experiences.

Grosdidier: And it's OK to ask them what they find important.

Gair: You have to respect their wishes, needs, and abilities.

Grosdidier: And you need to offer continuing education.

Tumblin: They need fair compensation and benefits.

Gair: If you push people to be the best they can be and if you encourage them and provide them with a motivating environment, they want to participate. They want to buy into the practice emotionally and behave as if it's their own.

Falley: Let's say you're one of the technicians in one of the hundreds of hospitals where you aren't doing what you think you could be doing. What are the three things you should do to address this problem in your practice?

Tumblin: I think you should tactfully go to the owners and offer suggestions. Tell them you can do these tasks. Remember, you can't have this conversation in front of a client. But, in the treatment area, you could ask the doctor if she'd like you to perform a task so she could go do something else. It's challenging, I think, for some people to speak up and say, "I can do that for you." It has to be handled tactfully.

Gair: Depending on the doctor, it could be as simple as a short, weekly strategic planning meeting. Try to plan these meetings away from the practice. It deserves your full, undivided attention away from distractions. The technician might say, "I've been thinking about my role at the practice and I want to be ..." Speak the doctor's language. "I want to be able to offer better service to our pets. I want to make the practice more money. I'm thinking of some ways I could do that. Would you be open to that?" Maybe you could get permission to try a few ideas for three weeks or for 90 days to see how it goes?

Tumblin: That shows that you have the initiative. Sometimes all of this gets put on the managers. Part of the problem is the manager doesn't have the time to do all of this. The technicians say, "You tell me how to utilize me better." The manager is like, "Yes, let me put this on my endless list of things to do. I'll get back to you in a year and a half."

Participant, Debbie Allaben Gair, CVPM Firstline Editorial Advisory Board member and owner of Bridging the Gap in Sparta, Mich.

Grosdidier: Every time we go into a clinic that has a team or a productivity issue, the technicians will say, "You know, I don't know what's going on. I don't feel in on things. They don't communicate with me. They don't tell me where we're headed or what my role is in making things effective." These things cost you nothing. Why aren't we giving feedback to our teams like, "Do you know what you need to do to get a raise?" They haven't a clue because it's been three years. It is like the flip of a coin. Win the lottery and get a performance review.

Falley: And the excuse is always time. We don't have time.

Grosdidier: It's that time that you save when you're not interviewing new team members.

Gair: Absolutely. When you build an enriched environment and encourage each other, team members are empowered. That's a motivating environment. It's a career for them. That's the difference. They're valued. They're respected.

Tumblin: I visited a practice not long ago and this doctor demonstrated a good example of offering a motivating environment. The doctor had some new staff members who'd started the day before, and he already knew all of their names. He didn't say, "I'm not going to bother learning their names because they won't be here in six months." He called them by name. It was wonderful. What a great example of how to build a stronger team.