The pandemic created an impossible personal situation where I began instantly balancing a full-time job in practice and virtually homeschooling three grade-school children. Our city had strict quarantines with long periods of social isolation. My father had a severe stroke where I was left with no ability to be in the hospital or talk easily with his medical team. And, most recently, my immediate family was faced with chronic illness. Life was not OK, and suddenly, neither was I.

First, let me say, I’m not seeking sympathy. I know so many others carry much more weight every day on their backs and in their hearts. I share my life struggles here because, while your lived experiences may look different, the emotions and mental health concerns might feel almost the same. 

We gain strength in community; we find solace in relatability, and that’s what we all need right now. We need to not feel alone because so many in this profession still struggle in silence and in the shadows and with no support. Unfortunately, there is still a significant stigma around asking for help and, even more so, being open about mental health therapy. And that’s despite the fact that we, as medical professionals with education and training, constantly work to improve the physical and emotional health of our patients. 

I wouldn’t hesitate to recommend the need to prescribe an anti-anxiety medication or a pre-visit pharmaceutical to reduce fear and stress in my patients. I don’t bat an eye in that discussion with clients. So why do we often feel embarrassed, nervous and even ashamed if the tables were turned and placed us as that patient?

I wish I was writing this article with the solution for fixing everything, because that’s what we do. Healers fix things. But I can’t, and what’s even harder is admitting that, especially when it looks from the outside that you can, that you have everything together; that you’re tougher and braver than most.  

What I can do, however, is encourage you to become the patient, even just for a day. Step outside of yourself and commit to a period of uninterrupted, selfish time to ask yourself the question, “Am I OK?” That sounds so simple and trite, but it’s a serious question that requires you to be vulnerable and self-aware. Honesty is imperative; that’s where bravery comes in.

I want all of my colleagues, even if you think this article doesn’t apply to you, to take an essential and important step towards self-care. Go to the website avma.org/resources-tools/wellbeing/assess-your-wellbeing and openly and honestly take the 30-question Professional Quality of Life (ProQOL) Assessment. 

This tool is frequently used and widely respected as a resource to “measure the negative and positive effects of helping others who are experiencing suffering and trauma.” It was developed originally by Beth Hudnall Stamm, PhD for use in human health care, but now is also applied to the veterinary profession. The goal is to help you understand where you stand in relation to three areas crucial to mental wellbeing: compassion satisfaction, compassion stress and compassion fatigue.

This may not be easy. The first step in anything is always the hardest. And the results of this assessment may be shocking, saddening, maddening or even scary to read. But we need to face this. We owe it to our families, our children, our colleagues, our friends, our clients, our patients and ourselves. 

Just like in practice, we can’t treat without the right diagnostics, and while this assessment doesn’t give a specific diagnosis, it’s the screening tool to suggest diagnostics are necessary. Without acknowledgement, support and proper treatment, we end up with burnout.  

Burnout is defined as a psychological syndrome that involves prolonged response to chronic interpersonal stressors on the job. It looks like emotional exhaustion, cynicism, personal inefficiency and ineffectiveness at work. 

Reread that. 

Does that sound like you? Does that sound like a colleague? Did you look away or exhale deeply or get a little queasy in your stomach? It’s hard to admit, isn’t it? Veterinarians are perfectionists. We don’t like to fail. So don’t. 

It’s OK to not be OK. It’s OK to ask for help. It’s OK to say no. It’s OK to streamline your kids’ activities and not go to every single virtual birthday party and not answer every email within 10 minutes. It’s OK to be selfish here. Stop judging yourself and be brave and kind to yourself. You deserve it. +

The post It’s Ok to Not Be Ok (I’m Not) appeared first on PetVet Magazine.

I know that with anything in life, failing to prepare is preparing to fail—even if it’s for a pandemic that is making us feel as if we live in controlled chaos at all times.

However, as we all do our best, here are my five steps for surviving the school year ahead:

Stay in Front

Most moms I know always want to be prepared. But how do you prepare for something that has upended your life in every possible way? I think by now we’ve all learned to expect the unexpected, so now we need to turn that thinking into a plan of action.

First, let’s set expectations. I cannot expect the same level of ability for remote learning from my second grader as compared to my fifth grader. Not only are they different ages, but my care-free and fearless seven-year-old is really nothing like my serious and sensitive eleven-year-old. But they both need to be able to make it possible for me to help them get through their school days without taking too much away from the rest of the household. 

The week before school started (we are all remote learning here in Chicago), we started going over what every day was expected to be like. Not only how they would get on their Zoom calls and handle themselves, but when they would get their work done, how they would keep tabs on everything, and how they would help me take inventory of what they need and what they have accomplished during their day.

We can all look at our current life situation and bemoan all that our kids are losing, including the in-person interaction with their teachers and the social skills they would be developing alongside the other children. Even my friends who have kids learning in-person have said that school is nothing like it was before COVID-19. Social distancing, constant mask-wearing, no recess or lunchroom, and the lack of athletics and other social clubs has made everything very different from what we were accustomed to in the most recent past. And, is it absolutely ok to be unhappy about all of this. It isn’t fair to our kids; it isn’t fair to us. But all of us in this profession know from our years in practice that life takes unexpected turns. 

We’re stuck in this situation now, but there is good that can come from this. Our kids will be raised to be resilient. They are learning to handle adversity in many forms. They are dealing with being scared about the unknown. These are all building blocks for their life that will make them stronger adults—as long as we are strong for them right now. Life is a challenge we need to meet head-on.

Ask for Help

However, meeting life head-on does not mean everything has to be done completely on your own. My husband and I, who both work full-time, know that we have to come together to find the best solutions for our family to keep us all moving forward. Whether with your partner or on your own, figure out who within your family and friends can be of help. Establish your village! 

I find all too often in life we don’t want to ask other people for help, thinking we are just being a burden, when those very same people could probably use our help, too. I’ve made this mistake too many times in life, not realizing that it actually shows strength and bravery asking for help, not weakness or inability to manage. 

I have a good friend who watches our school-update Zoom calls for me (while I’m practicing) and takes notes for me so I can be up to speed on what’s going on at school. In turn, when I’m home, I have her daughter over for socially distanced play dates whenever she has anything for work that takes her away from home. 

Helping with school work, technology or just letting a friend vent are just some of the ways we can all help each other take some of the stress off of our shoulders. 

Take Time for Yourself

Speaking of stress…yes, it’s building up. We can all feel it. We are so busy worrying about work, our kids, our parents, and anyone and everyone in our lives who has been affected by this. But, especially in our profession already riddled with compassion fatigue and daily mental health challenges, we need to take care of ourselves. 

Don’t Beat Yourself Up

Speaking of taking time for ourselves, a huge component of that is forgiving ourselves. I have days where I drink more coffee than I would like (If my Starbucks closes down again, I will quit this pandemic!), eat the chocolate I swore I would forsake or never quite get my workout clothes on. And that’s okay. Not every day is going to work right. Some days are going to be really, really awful. Some days we are going to cry. (Okay, many days we might cry!) Accepting that fact will make this a lot easier. 

If you do the best you can to incorporate the three points above, then you are providing a loving and smart environment for you and your family, and you are getting through this as best as anyone can. Some days that means everything goes wrong. I can’t tell you how many times I’ve been at practice trying to put out a fire at home via FaceTime in between appointments.

Whether it is setting an exercise routine and sticking to it, finding ways to make sure you can eat healthy, pulling out an adult coloring book or just setting aside some time for yourself every single day to take a relaxing bath, we can’t be good for everyone else if we aren’t being good to ourselves. Yes, a glass of wine is a great way to end the day, don’t get me wrong, but we need more than that for ourselves. Make time for yourself to rest and recharge and feed your passions.

This Too Shall Pass

At the end of the day, we need to remember that these days won’t last forever. Yes, they may last way longer than we first thought, but they will end. We will find a new normal that works, even if we can’t get back to our old normal. There will be a year soon when your kids are back in school for the whole year. And those kids will be formed by all of the experiences and trials they went through during this time. 

At the end of the day (yes, often with a glass of wine), I like to look at my three little ones and capture this moment in time and think about their kids someday. (Can you imagine the lecture our grandkids will get from our kids when they complain that they are bored!?) We didn’t choose to have this chapter in our lives, but we can do our best to keep the narrative flowing in a positive direction. +

The post The Veterinary Parent’s Survival Guide to Virtual Learning appeared first on PetVet Magazine.

Natalie Marks, DVM,
Medical director, Blum Animal Hospital and Gold Paw Veterinarian of the Year 2017. 

The post Veterinarian Life Advice appeared first on PetVet Magazine.

The original impetus for more females in the profession started with Title IX which abolished gender discrimination in federally funded education. When this ground–breaking law passed in 1972, the original societal thought was that, even though women would apply to these programs, they would soon get married and drop out to stay home and raise children. But that myth was quickly dispelled and a new trend in the face of the veterinary industry slowly began. Besides the legal change, there was also a shift in cultural thought about women becoming physicians and veterinarians, and this has become the “norm” for acceptance ever since.

Theories Behind The Gender Shift

The American Council on Education states that since 2000, women have represented about 57% of enrollment at US colleges, and more females are seeking additional education as compared to men in the same position. This statistic itself could explain the increasing number of applicants at veterinary schools.

According to the Association of American Veterinary Medical Colleges, the number of women entering the profession surpassed men in 2007, and now, approximately 78% of veterinary students are female. A current study out of the Department of Sociology at Southern Methodist University suggests that male applicants may even be deterred after seeing the number of women applying and enrolling.

Another theory speculated that females would be more willing to secure a lower salary as men target other medical professions, such as human medicine or surgery. According to the AVMA, Female graduates have historically been paid $2,406.97 less than male graduates in all areas of the industry. However, statistics quickly prove that ALL professional universities, such as law school, dentistry and pharmacy, are experiencing higher numbers of female applicants.

The Paradigm is Shifting

While we see an absolute increase in the number of females graduating and applying to veterinary schools, perhaps the area of clinical practice is becoming more appealing to the working mother. Many business owners are understanding the change in the workforce paradigm.

Female graduates want a stronger work/life balance and creativity or flexibility in their hours or schedule. They also want to consider positions that support and work well with employees through maternity leave and support working mothers through having space for nursing demands at work, childcare emergencies and health insurance options for families.

Rather than overlooking a prospective candidate for one with more traditional concerns, owners and managers are now investing in these women, recognizing that establishment of family allows veterinarians to be more connected to the community and to grow “roots” in the practice. These women cannot be successful in their role without better support within and outside of the clinic with childcare and home management—and creativity in three–day work weeks or nontraditional hours can be incredibly helpful. Additionally, there can also be a unique camaraderie to clientele; we know that over 80% of clients at small animal practices are women themselves, and this relatability can help to grow a business and client base.

In food animal medicine, still a traditionally male–dominated focused area of practice, chemical interventions have allowed women (and men) to work more efficiently and safely around patients with tremendous physical strength. This is a very important area of advancement, not only regarding the safety of all professionals, but also for the emotional health of these animals. Being able to take care of these animals without significant physical demands or even limitations has opened more opportunities for women to work in all areas of the industry.

Perhaps the biggest change has been in the leadership presence within the US veterinary schools. According to Veterinarian’s Money Digest, in 2012, only 28% of the administration in leadership roles were women. When measured recently in 2017, that number was up to 42%, and climbing. However, we still have work to do in trying to reach gender equality within organized veterinary medicine. Currently, leadership roles within this genre are only about 25% women. Additionally, leadership roles within organized veterinary medicine groups such as the AVMA, WVC, NAVC and AAHA still are predominantly men.

The Future

So, what does the future hold for female veterinarians? While there have been significant advances in recent years, we still face many challenges including the growing concern of suicide among women of this profession and the decreasing number of female students graduating with aspiration of ownership. The continued and imperative need for mentorship within the profession will need to be an important focus.

Organized, female–focused programs such as the Women’s Veterinary Leadership Development Initiative (WVLDI) are helping women to do just that. Through this group, women are being given tools to overcome their own personal barriers to advancement and creating strategies to help bridge the salary gap between genders. Other larger platforms like Fear Free© have an executive council with over 50% women and have large industry partners like Zoetis with female CEO’s who are trying to share knowledge and wealth in different arenas to inspire and encourage women to follow similar paths.

It will be exciting to see what changes occur in this next generation and even more exciting to be part of the wave.+

The post The Future Is Female: The Upsurge of Women in the Veterinary Industry appeared first on PetVet Magazine.

But, after allowing myself a five–minute pity party, I had to remind myself that “old” can mean “experienced” and “with perspective”—which is a great thing! However, all of the other “seasoned” colleagues reading this have to remember something else of equal importance: we have to stay relevant in medicine, but we also have to adapt and flex with the new generation of clients coming through our door.

Client expectations and services are very different for the millennial client and, if your practice does not meet and/or exceed these in the desired format, you will drive clients away instead of building loyalty.

Let’s look at a few specific areas of client communication that can improve client service in your practice:

Client Expectations Surround the Client “Experience”

It’s common knowledge in the veterinary industry that millennials have surpassed baby boomers as pet parents. This is very significant to how veterinary practices approach the needs of this client. This is a generation of ease and efficiency; they want knowledge at their fingertips and immediately available. This translates into the essential need of having an accurate, up–to–date and very accessible (especially mobile) version of the hospital website, along with credible sources of continuing education and client handouts.

Many of our millennial clients are searching our website or the most recent diagnosis for information on their smartphones in the lobby as they wait to be checked out. Rather than carrying a negative tone about searching Google or other sites, we must embrace the web and steer our clients in the direction we find most helpful. This includes the hospital’s own social media presence, its content and reinforcing engagement by being interactive and responsive to client feedback.

In addition, millennials are seeking out an experience when interacting in areas of service. This means certain desired services are incredibly helpful to promote or add into veterinary hospitals, including but not limited to individualized vaccine counseling, delivery services, price matching for prescriptions or written prescriptions.

The Trap of “Over Promising & Under Delivering”

Client loyalty is influenced by many variables, but this tried and true tenet encompasses many of the failures I see in this area of service. Nothing will upset a client of any generation more than telling them to expect a call with lab work that night and failing to call, being given the wrong prescription or food, or miscommunication between veterinarians or the veterinary team.

While we want to always strive for excellence in both medicine and client communication every day, we also have to set reasonable expectations for team members on what is absolutely expected in client and patient interactions where we commonly fall short. There are small ways that we can exceed or “over deliver” on service to build trust and loyalty.

Customer service representatives (CSR’s) have the incredibly challenging job of dealing with client demands and/or complaints, and these typically stem from not being able to easily and efficiently resolve their issue without escalation. We should empower our team to become solution seekers for clients and try to resolve their typically small issue in the moment, rather than transferring the client to a manager and having to re-explain the situation again with increasing frustration.

In these scenarios, it also helps to train team members on how to use positive customer-support phrases that are genuine and open-ended to encourage client feedback and validation.  We work in an emotional profession and recognition of the emotional state of the client should help direct the phrasing used to either calm or encourage rational and respectful communication headed towards resolution.

The Changing Role of Pets in the Family

I don’t think this final point is breaking news to anyone in the industry. But the reason I mention it again with such emphasis is because, while we all have seen the significant increase in dogs traveling with owners, becoming emotional service animals and serving the role of “children” of the pet parent, our messaging to clients has not changed. Discussions in exam rooms regarding workups, treatment plans and, most importantly, pet parent goals for the future of that patient HAVE to include the role of that pet in the pet parent’s life.

Do not forget about the more recent advances in veterinary behavioral medicine, appetite stimulation, pain control, physical therapy and earlier diagnostics for many chronic diseases.  Clients WANT to know about these options, and the veterinary hospital should be the FIRST source for this information. The trust between a veterinarian and a client can be weakened when new advances are not discussed in the appointment, but instead found online, from a friend or even another animal hospital.

Keeping these points in the forefront of all team members’ minds and implementing appropriate training in communication to address the changing demographics will help your practice stay current and growing while exceeding expectations! +

The post How to Successfully Ride the New Wave of Client Expectations appeared first on PetVet Magazine.

When I talk to other practitioners about why, in a busy practice with multiple associates and a strong medical focus, ultrasound has not been added, I typically hear the same three concerns:

1. Some feel that there is not enough time in the day to learn a new technology.
2. The practice won’t be able to pay off the machine.
3. Clients will find the cost too expensive.

I actually believe the exact opposite on all three of the above reasons.

No Time To Learn New Technology

Yes, learning a new skill takes time and an open mind.  However, I can tell you from firsthand experience that these machines have become incredibly user–friendly since I was in veterinary school 20 years ago. Companies with ultrasound technology understand the time constraints most small animal practicing veterinarians are under and want to guide you on how to apply the machine instantly, as such, most offer online or on–site support to help integrate the machine into your practice.

Additionally, having credentialed veterinary technicians learn to use this tool helps elevate these staff members and makes them feel a more integral part of the team, while saving valuable veterinary time.

Example: One of the fastest ways to start implementing ultrasound into daily practice is the utilization of ultrasound for cystocentesis. This is an introductory skill that can be quickly taught to all veterinarians and credentialed veterinary technicians in a short time period. Not only is this a great revenue stream for a profit center, it is most importantly better medicine. A quick, cursory scan of a canine or feline bladder with a standard probe can diagnose bladder stones, polypoid cystitis, a thickened bladder wall and even suspect bladder tumors (and a very valid reason to NOT obtain urine by cystocentesis.)

This additional knowledge helps reach a diagnosis faster and potentially drives the need for additional diagnostics. It is also a great addition to any breed–specific screening programs, e.g. screening breeds that are high risk bladder stone formers or Westies with a higher risk of transitional cell carcinoma.

Not Able to Pay off Machine

While cystocentesis will slowly help pay off the investment of an ultrasound machine, it is a large capital investment for all practices and, in today’s uncertain financial climate, this debt can create worry and anxiety. However, there are a number of companies offering this technology, and this means they have competition for your dollar and will get creative to make you their client.

Talk to these companies about leasing programs, payment options and other ways they can help you make sure this investment makes financial sense for your practice. This discussion should also include the type of medical workups being performed at the practice, the space available for the machine(s) and the current knowledge base at the practice. This will help define and tailor the best “starting” machine, what probes are needed, what training is essential and necessary for implementation of additional uses of the ultrasound machine and allow for budgeting and predicting of cost and eventual payment of the machine.

Cost to Clients

We must also keep in mind that we, as veterinarians, are not the only part of the veterinary–client–patient relationship that must see value in this machine. It is imperative to educate clients on the benefits (and limitations) of an ultrasound, the non-invasive nature, the speed of diagnosis and the wealth of knowledge derived from full ultrasound studies. To be successful, we need to remember a few important tenets of the veterinary industry today.

The new generation of pet parents (the millennials) have some specific character traits. As a group, they tend to come to exams with more questions, a desire for more details and previous online research they’ve done prior to the appointment. They want information quickly and in an easily accessible format. In addition, they tend to be more cost conscious with the same expectations for excellent medical care and successful outcomes. However, they also want the best medical care possible for their pets.

Once you see all of the different ways you can use ultrasound on an everyday basis to provide better medical care, you will easily be able to explain to clients (especially millennials) that you can keep the cost relatively low while still providing superior and rapid diagnostics and medical care.

A perfect example of how to use this technology for best medicine with financial value is the use of ultrasound for the F.A.S.T exam—otherwise known as the Focused Assessment with Sonography for Trauma. The ultrasound probe is placed on four different quadrants of the abdomen (or thorax) and is used as a rapid screening test for free blood or urine in the abdomen (usually secondary to a ruptured splenic tumor or urinary bladder) or free blood around the heart (pericardial effusion). This also can be taught to many members of the veterinary team.

This timely screening test is one of the most helpful, but unfortunately one of the most underutilized tests in veterinary medicine today. It is noninvasive, can be performed quickly as the patient enters the hospital (median study time was 6 minutes), requires only a very small and portable machine and requires only minimal sonography skills.

The JAVMA 2004 veterinary F.A.S.T study also found that one third of the patients in the study that had trauma secondary to contact with a motor vehicle also had a hemoabdomen. This is a much higher incidence than previous studies and that speaks to the specificity of the test. This test also has a high sensitivity, meaning that it is very accurate if NO free fluid is found during the F.A.S.T exam. The outcome being that the veterinarian will look outside of the abdomen to other parts of the animal when suspecting internal bleeding.

Ultrasound can be a very efficient and cost effective addition to any practice. It screens and diagnoses medical and surgical conditions from a non invasive perspective AND generates revenue.  While there is a learning curve with any new technology, it truly will elevate both medicine and financial growth within any small animal practice. +

The post Ultrasound Machines & Their Importance in the Small Animal Practice appeared first on PetVet Magazine.