Ernie Ward
DVM, CVFT
Opening Shots columnist Dr. Ernie Ward is an award-winning veterinarian, impact entrepreneur, book author and media personality. When he’s not with family or pet patients, Dr. Ward can be found contemplating solutions during endurance athletics and meditation and on his weekly podcast, “Veterinary Viewfinder.” Learn more at drernieward.com
If you have a question about practice life, personal well-being, leadership or veterinary careers, email openingshotstvb@gmail.com
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Q: We have a newish doctor who wanted more flexibility with her kids, so we started offering telemedicine appointments for our established clients. The issue is that a longtime client sent me a screenshot of the veterinarian in a sweatshirt and messy ponytail, and I could see an unmade bed and clutter in the background. The client was disappointed and asked for a discount. Should I say something to the doctor or see if it happens again?
A: I applaud your practice for embracing telemedicine. It’s a powerful tool that can enhance client convenience, improve patient care and offer your team much-needed flexibility. The fact that you’re adapting to the evolving needs of your staff — like accommodating a doctor’s desire for a work-life balance — is a testament to your leadership. Growing pains come with any innovation, and in this case, the pain point is professionalism — or the perceived lack thereof.
Your description is a classic example of how good intentions can go awry. While telemedicine offers flexibility, it doesn’t exempt us from maintaining the same level of professionalism that clients expect during in-person visits.
Let’s examine this further.
Over two decades ago, I wrote about the importance of professional appearance in veterinary medicine. Back then, it sparked heated debates. Some argued that a veterinarian’s skills and knowledge were all that mattered, while others (myself included) maintained that how we present ourselves significantly influences client trust and perceptions. Fast-forward to today, and the same principles apply, even in the virtual world.
When clients log into a telemedicine appointment, they evaluate the doctor’s medical expertise and the experience. A messy background or overly casual attire can unintentionally signal disorganization, disinterest or a lack of respect for the client’s time. In your case, the client’s request for a discount speaks volumes.
On one hand, telemedicine allows veterinarians to work from home, providing the flexibility that can improve job satisfaction and retention. On the other hand, it requires us to adapt our professionalism to a new medium. This means paying attention to details we might not consider in the clinic, such as lighting, background, attire and a reliable internet connection.
Your new doctor’s desire for flexibility is valid, but it shouldn’t compromise the client experience. The good news is that this is an easy fix.
Yes, you must say something to her. But how you approach the conversation is critical. Start by acknowledging her value to the team and the importance of her work-life balance. Then, gently explain that telemedicine appointments are an extension of your practice’s brand and reputation.
Offer practical solutions like these:
- Dress the part: A clean, collared shirt or clinic scrub top can help convey professionalism.
- Set the scene: Encourage her to use a neutral, clutter-free background for appointments. A blank wall or a tidy home office works well.
- Lighting and angles: Ensure her face is well-lit and the camera is at eye level. This creates a more engaging and professional interaction.
Frame the suggestions as ways to enhance her telemedicine presence, not as a criticism of her current approach. Most importantly, emphasize that this is about building and maintaining client trust, not vanity.
Additionally, take the opportunity to educate your clients. Let them know that telemedicine appointments are a valuable service designed to provide convenience without compromising care. If they understand the effort your team is making to accommodate their needs, they might be more forgiving of the occasional hiccup.
Q: Our practice manager has been with us since we opened in 2000. She earns $27 an hour — she started at $20 — and she has about $15,000 in health benefits. After 24 years, she feels underappreciated, and recent health issues have impacted her performance. My partner-husband suggests a significant raise, but I’m considering cost-effective options, like hiring a less expensive manager. How do we balance acknowledging her dedication with our $2.4 million practice’s financial realities?
A: Your practice manager has been your clinic’s backbone for over two decades, but now, health challenges and feelings of underappreciation are affecting her performance. Let’s tackle this with a clear-eyed, numbers-based approach while honoring her contributions.
Generally speaking, a veterinary practice manager’s salary should not exceed 5% of gross revenue, depending on location, practice size and responsibilities. For your $2.4 million practice, that’s roughly a $120,000 cap. Your manager’s current compensation totals around $79,000, well within that range. However, her wage raises over the years averaged only 29 cents an hour annually, far below cost-of-living adjustments. That stagnation likely fueled her sense of being undervalued.
Your husband’s instinct to reward her loyalty is commendable, but your concern for financial sustainability is equally valid. Here’s how to strike a balance:
- Evaluate her role: If she handles all management duties — human resources, inventory, scheduling, training, reviews, complaints and more — her compensation is on the lower end for those responsibilities. If her role is more limited, her pay might already be fair.
- Set performance goals: If her health issues are resolved, establish clear performance metrics tied to practice growth. Consider bonuses for achieving these goals, aligning her success with the practice.
- Consider phased raises: A significant raise might strain your budget, but incremental increases can show appreciation without overwhelming your finances.
- Streamline her role: If her workload is unsustainable, delegate tasks to other team members to reduce her burden and prepare your team for potential transitions.
Your manager’s health challenges complicate the situation. If she’s still recovering, her performance fluctuations might not reflect her capabilities or potential. Support her through this period with flexibility and understanding. If the health issues are ongoing, consider a coordinated exit plan that preserves her dignity and your relationship, such as reducing her responsibilities while training others to take over.
A manager’s role is often a pinnacle unless the person becomes a shareholder. If your manager plateaued, explore ways to challenge her, such as leadership or ownership opportunities or involvement in strategic planning. If she is no longer growing the practice, it might be time to reassess her role.
This isn’t just about money. Use metrics to guide your decisions, and don’t lose sight of the human element. By balancing financial realities with heartfelt appreciation, you can honor her contributions and ensure your practice’s success.