If you are like most veterinarians, you started your practice with few staff and even fewer clients.  The challenge and excitement of starting a business can be all consuming.  Perhaps you find yourself wondering where the time has gone, suddenly you are celebrating a clinic or personal milestone.   Like many health professionals, in order to take a vacation you may need to enlist the help of a locum tenens.

Locums help keep a veterinary clinic running smoothly

While finding a locum is stressful, the stress is compounded with staff and client concerns.  Finding the right person to fit into your practice can be difficult, then arranging logistics such as accommodation, travel, vehicle, especially if your practice is outside of a major centre, can seem overwhelming.

Here are things you can do to mitigate the stress of hiring a locum:

1. Use a checklist of required skills and clinic procedures when doing a preliminary interview with a locum.  Ask your staff for input on this checklist, they may know things about your practice and your style that you don’t realize.

2. Understand that the locum may not generate the same revenues as you.  Losing revenue is more manageable than losing clients or valuable staff members if the locum is not suitable.   A loss of a few thousand dollars for a vacation is recoverable.  You will never recover the time you are gifting yourself to relax or spend time with family and loved ones.

3. Give yourself plenty of time to find a locum through advertising, local veterinary associations, word of mouth or locum agencies.   Start looking for a locum up to a year in advance, sometimes longer for busy times such as summer or holidays.

4. Allow a generous budget and be honest with what you can afford.  If you hesitate on a locum that seems perfect because of their fees, likely someone else will see their potential and book them up.

5. Prepare your clients for alocum.  Many veterinarians do not think to prepare their clients for a locum’s arrival. In my experience, some practice owners seem to just hope their clients won’t notice!

I recommend that your approach to preparing clients for a locum should depend on the situation.  Some of your clients, with healthy animals, will be in your clinic for annual wellness examinations.  For these clients, ensuring that they are aware that they will be seeing a locum may be enough.  Other clients, with pets with ongoing health issues, may need more preparation for their vet’s absence.  Direct your reception staff to reinforce the locum’s positive attributes when booking appointments.  If a client prefers to wait to see their regular veterinarian, I believe that it is important to respect that wish.

If a client email list is available, a short bio with a picture of the locum will help with an introduction.  Clients with anxiety about seeing a new vet may be comforted in knowing the locum’s background, skills, years of experience, and that locums will rarely drastically change existing protocols for chronic illnesses.

Advance preparation for the veterinarian’s absence and building expectations is helpful.  Throughout the year, the staff and veterinarians can mention past or upcoming vacations, and refer specifically to good experiences they have had with locums.

You may wish to display a copy of the bio of the locum with picture, and a brief description of what a locum means, on display at the front desk for a few weeks before the new veterinarian comes to take over.  Your reception staff can hand them out to clients in the waiting room, or at earlier appointments before their regular vet leaves.

In a clinic where locums are a frequent occurrence, the locum bio may be all that is required to give clients a sense of ease to know about the veterinarian they will be seeing.

With the tips above, hopefully hiring a locum will not seem as daunting.   There will be some work initially to prepare for the locum’s arrival, but time well invested to keep clients and staff happy.

We all claim to want “feedback”. But who really wants to hear that people hated their service/opinion/essay or whatever. I have struggled at times with constructive criticism, as it is delivered thinking various “what does he know” or “that was taken out of context” thoughts. Then there is the “yes, but” comment that bubbles up as feedback is given, sitting at the tip of the tongue waiting for the other person to finish telling all that feedback stuff, so that I can finally get my say!
I am taking a management communications course. I had been dreading it, because I’m not much for the touchy-feely fluffy type courses. It was challenging at first, especially with an instructor change halfway through. Did you know that there is a word for how you judge a person based on when they show up (chronetics) and if they are a close (or far) talker (proxinetics). Terminology aside, one thing I heard that resonated with me was when the instructor told us that feeback is a gift. I mulled that over for a little while, and that little sentence has truly shifted my perception of feedback. Although it is always hard to take criticism, how often do people really go all out to give you negative OR positive feedback? How many times have you just thought “I won’t go back there again” instead of telling them why the service fell short? Or how often you finished a conversation thinking “wow that was awesome service” but didn’t bother to mention it?
Feedback is a gift, whether in personal or professional life, but unfortunately difficult to give and receive. I have learned at least one thing in this course: there is a skill to receiving feedback. And I plan on working very hard on that skill, among others, because it is so important.
So, if you are trying to think of what to get me for Christmas now you know — and it’s free!

I went on a trip recently and had the opportunity to do some rare shopping across the border in Grand Forks ND (without kids). When I get the opportunity to do shopping I try to avoid the kids stores that seem to draw me for some unknown reason.
While shopping in TJ Maxx, a store like Winners, I gravitated towards the pet area. Clients will often tell me about this product or the other they bought at a department store, and since I recommend and use veterinary line products I often wish I could be more knowledgeable on the products that clients can find over the counter.
On this day I ruminated over a shampoo product for dog, with tea tree oil and pyrethrins, for ‘itchy skin’. It made me think carefully as I would imagine there would be some concern using this product in a cat. I tried to think like an owner and wondered if I were a cat owner and saw this product would I use it on my cat, even though it is labelled for dogs? My conclusion was yes, that if I were a client with little advanced medical or veterinary training that I would consider using this on my cat, with potential toxic effects.
I often try to put myself in my client’s shoes, seeing things from their point of view, and I hope that makes me a more empathetic person. What do you think? Are there ways you manage to develop your empathy?

I am excited to be a first time exhibitor at, well, anywhere, and I am very proud to start with the CanWest conference in Banff October 15-18 http://www.canwestconference.ca/
I am looking for input on what I can do to draw people in to my booth get to know me and Canada Locum. I’m looking for feedback and votes on best ideas (you can pick more than one)
1. Home baked cookies iced with Canada Locum logo
2. Laptop available to take an online personality test that tells you what “animal” you are
3. Free draw for prizes (tote bag, mug, candies, etc)
4. Notepads/pens/other various swag
5. Megaphone
6. Blaring techno music videos (they seem to think this works in markets in Asia?)
7. Dunk tank
8. I can dress up in some kind of costume? Dog? Zebra?
9. Free budgie with purchase of an organ (if you are born after 1980 you might not get this SCTV reference)
10. Any other ideas?

I would love to hear from anyone who is going to CanWest, as a result of this business I don’t always get to meet the wonderful people that I speak with on the phone. I would love to be able to place a face with a name.
So please vote for your best gimmick, and look out for me at CanWest!

I just took a cool personality test, took a while but worth a try – not sure what I’ll do with the results but I’m happy to share!

Personality testing may be helpful to find a good match when seeking employees, but there are so many tests out there it is hard to pick the perfect one.  I have found a good review site of many different personality tests for you to peruse to see if something seems to resonate with you.  http://www.top10tag.com/200910top-10-personality-tests-online-2/
I tried Personal DNA, it was a bit lengthy, but interesting to do with a variety of question types.  I like my result, but I’m not sure if it would spit out “raging lunatic” or “dark brooding jerk” anyway.

When you have finally found a veterinarian that gets you, who loves your pet, and who you feel comfortable with, you may feel a huge sense of relief.  If your pet has chronic health issues, it may have involved years of hard work with your vet to find an effective treatment regime.   Unfortunately, vets need vacations too, but when your vet goes away, there is no reason to panic.    

Veterinarians, like physicians and many other health professionals, often seek the services of a “locum tenens” (locum for short), or, in the US, a “relief vet”.  This is a common way for small business owners in healthcare to fill short term job needs, while ensuring patient care is maintained.

Here are four things to keep in mind if you have to see a substitute (or a “locum”).

1.  Your vet trusts this person in their practice.  Keep an open mind and ask questions.
2. Locum vets are typically experienced veterinarians, able to adapt to different situations.
3. For pets with a long medical history, the locum vet cannot read the whole “book”.  Be ready to give them a condensed version of the issues and approximate timeline – then they can look up the pertinent parts of the medical record.
4. Sometimes a pair of fresh eyes can identify new treatments or techniques that may work well for your pet

 As a locum tenens for 14 years, I know what you might be feeling when I walk unexpectedly into an examination room, it is written all over your face.  I don’t take it personally, because I know that I am working for a caring and thoughtful vet who has a great bond with his or her clients.

When you see a locum veterinarian, they will have the detailed medical record, but it helps to be familiar with your pet’s history.  Remember that an appointment is only 15-30 minutes long ,so it is hard for a locum to read the entire file in that time.   Don’t be scared, most locums do not drastically change protocols set up by your regular veterinarian, unless they have a good reason.   Also, many locum veterinarians will offer alternatives to the existing treatment, but usually only if there is a need or they feel the animal will really benefit from a change.  In most cases, locum vets are aware of your relationship with your vet, and do not want to “rock the boat”.  As everything in life, communication is essential, and also the worst thing to do well.  You may experience feelings like; “who does this guy think he is” or “does this vet think I’m not taking care of my pet?”  or “they are just trying to make money for the clinic”.  I would almost guarantee that none of these things are happening.  The locum is probably thinking of some tweak or additional test that may benefit your pet,  by looking at the case with fresh eyes.  The locum is genuinely trying to offer sincere help and value to you, but also your regular vet, by providing the best care they can.  Locum veterinarians work in many hospitals and see a wide variety of cases, so they pick up little tricks and tips along the way.   Oftentimes, the locum vet, more unfamiliar with you or your pet, may recommend some further testing for your pet’s condition.   

If you are finding yourself hesitant about the locum’s advice, ask them how they came to their recommendations.  Ask specific questions about the drug or test they are promoting.    How urgent is their recommendation, and can it wait until you can speak with your regular vet.  A warning sign that you may want a second opinion, is if a locum vet becomes aggressive, defensive or cannot back up their recommendations with logical purpose.  In that case, either seek a second opinion or wait until your vet returns from vacation.  In an emergency, however, if your pet’s life is at risk, it is best to keep questions as short as possible,  so the vet can concentrate on resuscitating your pet.

So, don’t be scared of your vet’s replacement, armed with the tips above and some common sense, you might just learn something new.

Let me guess. You need a vacation, you are a busy practice owner, with only one or two vets, and you are terrified at the prospect of hiring a locum or relief vet to run your business for one or two weeks. Your staff is equally terrified about the idea of a new vet strolling in and changing the way they do everything. Instead, you just keep working, or close the clinic except for pet food sales while you are away. That is a great strategy if you can convince your tech to paint the exam rooms, but not for continuity of care for your clients and their pets.
Canada Locum strives to minimize this stress by using years of experience to ask the questions you haven’t thought of, and provide you with resources to feel better about your decision. Whether it is hiking up Mount Everest or sipping multicoloured drinks on the beach, the point is to enjoy your vacation.

Read on for my take on things to consider when you hire a locum for your practice. Feel free to call or email me with any questions (info@canadalocum.com, (403) 467-3767)

Here you will find some points to consider, that I have learned as a locum, and through conversations with locums and practice owners. My biggest tip is to have a checklist (contact me for a sample) of things that should be discussed with your locum in advance. Read on to learn questions that you might not even think to ask!

Summary

1. Get your staff and clients excited about your locum, focus on the locum‘s positive attributes and the new ideas they will bring to the practice.
2. Find a locum that makes you think about your vacation and not the practice.
3. Use your checklist to discuss how your practice works.
4. Make sure you have a detailed contract – and verify their license status.
5. Consider any profit a bonus.
6. Hire a locum for a day if possible in advance of a large block of time to iron out any conflicts.
7. Have a checklist of issues to review before you go to minimize any misunderstandings – Did you read the title? I know I said this already – are you getting the picture? You can get a sample by contacting me at info@canadalocum.com. Give a copy to the locum, so you both know what you have discussed before you go on vacation. Give a copy to the support staff so they know how to book appointments.
8. Enjoy your time off!

Billing

Your first task with your newly appointed locum is to get a contract. If the locum does not provide you with one you should ask for one. This should outline at a minimum; dates and times of work, arranged payment and any extras like accommodation or on call duties.

Make sure that your billing policies are clear. You may think it obvious that you give a 10% discount to Peter and his Pomeranians, or that you charge extra for a nail trim if it takes three people. The locum should be billing according to your written fee guide. In addition, the locum should not be responsible for determining fees, discounts or payment. Have these in writing, or, if available, delegate this responsibility to a trustworthy senior staff member who knows your client relationships.

A locum is not necessarily going to make you money. If you accept this before your vacation you may be less stressed on your return. Profits should be considered an added bonus to your vacation. Your job is to relax, the locum’s job is to hold down the fort and see the work presented to them. You can’t force your clients to see a locum, and some clients will wait for your return for routine appointments. Good news, they are still your client. If a loyal client shows up expecting to see you, but sees a locum, they will be seriously ticked-who wouldn’t?

Appointments

Scheduling a day for a new locum can be challenging. The locum does not know the clinic, the staff, the clients or the clinic layout. Be honest about how you book your appointments. Locums are also usually very meticulous about records, to avoid miscommunication, which takes some time. Most locums charge a fee for time out of hours.

At all costs, avoid the client surprise! It is crucial that clients know they are seeing a locum. Many clinics are worried that they will lose money on a locum day (see note in Billing). An unfortunate experience for everyone is when the locum walks in the room, and the client exclaims “Where is Dr. X today?!?” with an accompanying horrified expression. Here’s what I suggest; when a client books an appointment, the receptionist will say “Thank you Mrs. Jones, your appointment is on Tuesday at 4pm with Dr. Smith”. In this case, a client who wants to see Dr. X will say that they would prefer to see Dr. X, which can then be arranged if possible. A client who is willing to see a locum will not comment and come to the appointment. Certainly this is a great opportunity to promote the locum, for example; “Dr. Smith is a great veterinarian with 8 years experience, and she cares very much about the animals in her care. Dr X trusts her and other clients are really happy with her”

Technical skills

During the first few days with a locum there will be an adjustment period to find out where the locum’s skill sets fit in with your practice. The locum should be informed whether an AHT is on staff. If there is no AHT then the locum has the right to dictate what procedures are acceptable. Avoid booking a solo new or locum AHT with a solo locum veterinarian, a recipe for potential disaster. A locum will also likely not know how to use your x-ray machine, so have staff on site that are trained, or have a contingency plan for cases requiring radiology, such as a neighbouring clinic or referral centre.

Don’t micromanage! Or worse, delegate a staff member to micromanage for you! A good locum tries to fit in with the practice philosophy but will do things the way they see fit. Locums will not necessarily use your first choice of antibiotic, suture pattern or type, etc. Locums must be given the flexibility to work within their comfort zone. By having a discussion about case management styles, using a checklist, and your very specific requirements in an interview ahead of time, an understanding is possible.

Euthanasia, in my experience, is a source of potential conflict. If you are particular about your euthanasia method, use your checklist to discuss with the locum (i.e. whether an IV catheter is placed, whether the animal is sedated, owners present, whether the locum will agree to “convenience” euthanasia).

We all know vets with different comfort levels with surgery. Get a list of acceptable surgeries from the locum. Do not book a locum a cruciate surgery without confirming that they do this procedure, and their experience – is it their second or seventieth time doing a cruciate? Some locums may not do cosmetic surgeries such as tails, ears, declaws, and debarking, if you expect your locum to do these procedures use your checklist to discuss them.

Be honest about your caseload; use your checklist to review with the locum. Do you see birds sometimes for beak and wing trims? No big deal? A locum might feel completely overwhelmed. Do you book 10 minute or 30 minute appointments? How many surgeries do you perform in a morning? Make sure your locum comes prepared for the pace at your clinic.

Case Management

Most locums enjoy their job because they love learning new things; however the locum should have the flexibility to do things their own way. Your staff may feel like they are protecting your interests by telling the locum how you do things, but this can make a stressful experience for staff and locum if not delivered delicately. Discuss with your staff in advance how they should deal with these situations.

What do you do with emergency cases? A locum might not feel comfortable hospitalizing a patient overnight with no staff in attendance. If a locum stays to see an emergency they will likely charge extra. Use your checklist to discuss! Also, what should the locum do with a referral? Discuss your referral policies with the locum in advance, but respect the locum’s comfort zones. What are your routine protocols like vaccines? Heartworm and deworming protocols? Do you vaccinate for Feline Leukemia? All cats? Only indoor cats? Do you require a blood test prior? Do you vaccinate with a three year or one year vaccine? Iron out any issues with routine procedures before the locum comes to the clinic. Use your checklist and make sure the locum is getting the correct information directly from you, to avoid confusion during the locum term.

Checklist

If a checklist sounds like a lot of work, I guarantee it is a lot easier than dealing with a mutiny from your support staff because the locum went horribly wrong (I see you grimacing because we have all been there!). Ask your staff for help designing or editing your checklist. If you have specific policies, some idiosyncrasies, or you like to tap your feet three times before you spay a cat, your support staff certainly know it – probably better than you do!

The dreaded spam.  Hopefully if you subscribe to my newsletter you don’t have the same reaction as I do to many of my blog comments.  I am a newbie to this blog thing.  The first few comments I got were so exciting, one commentator wrote that they were from Italy and they found my topic very interesting – WOW!  A few days later I get a different comment from the same person.  As I look closer at the addresses of the people that are sending me comments the lightbulb goes on.  It seems that blog spammers write the same thing “thanks for that awesome posting it saved MUCH time”.  Sometimes they personalize with an emoticon or something.  I have been feeling a bit like a dinosaur since playing hockey with the UCVM vetmed team, but this was the icing on the cake, making me feel a bit conned, taking so long to realize I was being spammed. I even replied to one comment that wanted to know the theme for my blog.

So for all of you “real” people out there, post a comment, let’s get some discussions going about being in the veterinary industry in Canada.  Whatever you do don’t write “thanks for that awesome posting it saved MUCH time” because those go straight to SPAM.

Maybe you have been working as an employee veterinarian at the same job for years and you are ready for a change.  Or you have been out of the workforce for a while and are ready to go back part time, but can’t find a place to set down roots.   Do you have a bit of the wanderlust and want to work and travel, and be able to set your own schedule?   Maybe (like me) you have a short attention span and simply love new challenges and new experiences. Many people choose to become a veterinary locum for a variety of reasons.  Here are 10 traits that I think might indicate to you that becoming a locum is a good choice:

1.  “Go with the flow”.  You like learning new ways of doing things, although you may have preferred techniques, you can adapt to situations that necessitate doing things differently.  For instance, you are unlikely to completely change a stable diabetic cat’s insulin brand just because you don’t really like the one he is on.

2.  Personable.  You like working with new people and appreciate that everyone on a clinic team has something to contribute. 

3.  Confident.  You trust in your abilities and experience to do a good job, including knowing when (if possible) to refer when your abilities are outmatched by the case (or the client!).

4.  Financially stable.  Becoming a locum can be lucrative as a full time endeavour, however there can be slow periods where money won’t be flowing.  If you live paycheck to paycheck then think about how you would handle erratic work.

5.  Unflappable.  Weird things will happen when you are a locum.  If you panic or rage about changes in your routine or unexpected hiccups, becoming a locum will be stressful.

6.  Competent.  You should be confident doing most things a routine practice will see in a day.  If you hate surgery and won’t do it,  you may find it challenging to find regular work.  However, if you do hate surgery, or at least feel incompetent in one area (i.e. large dog spays) you need to be honest and communicate this to the practitioner who may be hiring you.

7.  Organized.  Locums are usually independent contractors, and must keep track of all their expenses, income and submit GST payments and probably quarterly tax installments.  You also will (hopefully) be managing all your written contracts, invoices and payments.  Let’s not mention if you ever make a mistake on your schedule and show up at the wrong practice – in a different town (ouch!  It’s happened, but not to me thank goodness!)  As an aside here I did have a panic attack one day, as I was driving up to the ski hill at Lake Louise (2hrs from where I live).  I thought for some reason I had made a mistake and I was supposed to work that day.  I called the clinic, which was still closed, then to locum colleagues to make a contingency plan – it ended up being a false alarm, I was due to work the following Saturday.  I never forgot that feeling and was careful to put checks in place to prevent it from ever becoming a reality.

8.  Time Manager extraordinaire.  This trait goes along with #7 above, but I wanted to emphasize the importance of good time management.  You will manage your time effectively from the way you handle appointments and surgeries at a new clinic, to scheduling your locum time efficiently, making sure you book yourself some time off, and managing your paperwork.

9.  Thick skin.  You don’t mind when people wax on about how great their regular vet is – and how disappointed they are to see you.  Most people prefer their regular vet or they wouldn’t keep coming back to their practice.  Your job is to “woo” them and let them feel comfortable with your recommendations. 

10.  Leggo my Ego!  You may be the best thing since sliced bread to veterinary medicine, but remember you are trying to get work.  If the support staff and clients think you are obnoxious, condescending, or worse yet criticise the regular vet’s approach or clinic management – you won’t get asked back.  Find positive ways to communicate what you need, and why you might need to do things differently than what they are used to. Engage and empower the staff and clients to work together as a team.  After all,  is a locum out of work really a locum?  Or just unemployed?  And word travels fast among the veterinary community – good or bad.

If you think becoming a locum sounds appealing, contact me for more details and exclusive resources to help with the transition.   Fill out my form to get on my mailing list for jobs and locum tips.  info@canadalocum.com, (403) 467-3767