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New Graduate Survival Manual
February 8, 2010 (published)
Stephen R. McDonald, DVM; Aurora Villarroel, DVM, MPVM, PhD, DACVPM;
Lana Kaiser, MD, DVM; Reneé D. Dewell, DVM, MS

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 http://www.vin.com/Link.plx?ID=5423161 


 

Academy of Rural Veterinarians
(518) 694-0056
arv@caphill.com
http://www.ruralvets.org/

New Graduate Survival Manual or "preparing to negotiate manure of all kinds with a smile on your face"
Basic Information about adjusting to life in private practice and other things you didn't know that you should be aware of
Choosing a first job
What about a contract?
Other things to consider
This is a great career, but you have to make a living
Now you are ready!

New Graduate Survival Manual or "preparing to negotiate manure of all kinds with a smile on your face"

You have either graduated or will graduate soon from veterinary college. You are joining one of the greatest professions there is or ever was. We are held in high regard by the general public, even MDs think highly of our abilities. Their patients can tell them where it hurts, while ours cannot. We in large measure rely on our five senses to begin our examination of a patient; we must engage the animal's owner to get some sort of history and symptoms the owner has observed. By necessity we converse with the owner more thoroughly and longer than perhaps their family doctor does. Diagnostics and treatment occur after the initial hands-on exam of the animal and person-to-person interview. This approach is often perceived by the owner as an interaction with a very caring and concerned veterinarian. In most instances this is indeed the case, and many young veterinarians cite the family vet as a major influence in their decision to become a veterinarian. Veterinarians, just like all others of our species, come in all shapes and sizes, but make no mistake; most are really extraordinary individuals who are one cut or more above the general population.

Young graduates have been in school most of their lives, with their 1st DVM job often being their first "real" job. They have spent most --if not all-- their adult lives preparing themselves for a career in veterinary medicine. It is accurate to say the level of sophistication and standard of care for animals in North America, Western Europe, Australia and New Zealand equals or surpasses standards for humans in many developing nations. Newly graduated veterinarians possess a knowledge base that represents the leading edge in the newest diagnostic advances and treatment protocols.

Too often, however, these bright young people are thrown to the wolves; that is, they are faced with social, economic, and ethical dilemmas post-graduation that they have not been exposed to before. While highly trained in the science of veterinary medicine, often times they find themselves in unanticipated situations that can be unpleasant, unethical, or downright illegal. This guide is meant to inform new graduates of some of the issues they may be confronted with early in their careers. It can also serve as a map through the mine field of an early career to help avoid common and not so common mistakes.

Before your first interview, focus your search by listing your career and life goals, making a budget you can live by, reviewing the topics presented in this manual, and getting ready to join the most exciting and rewarding profession you could have chosen.

There is an excellent, must-read resource written by John McCarthy, DVM, MBA on the Veterinary Information Network (VIN) that deals with your first job as a veterinarian. It is "Preparing For Your First Job".

Basic Information about adjusting to life in private practice and other things you didn't know that you should be aware of

When you walk across that stage and collect your diploma, you are beginning day one of a new life. This is both exciting and a little intimidating. You are embarking on a life of learning and service to both humankind and his/her animal wards. At first the responsibility seems daunting, but you have a very good baseline of knowledge and while your practical skills may need honing, you know how to think and how to get answers. Don't sell yourself short. New graduates bring several very important things with them to their first job:

1.  Up-to-date knowledge of the very latest breakthroughs and innovations. The astute practice owner will mine your knowledge base; it is vital to a practice to remain up to date medically, and your walk-around knowledge is a convenient source. Often times a new grad will be more adept at technological activities, such as ultrasound and computer operation than the seasoned practitioner.

2.  Enthusiasm. Most new grads have the enthusiasm of those that have worked hard to reach a goal and are ready to enjoy it. They are also keen to learn and try new things. This is a positive attitude than can be contagious to other staff members. This job is supposed to be fun, and a new grad can remind everyone that it really is.

3.  Help! The most important reason to hire you is because they need help to deal with the work they have and they want to grow the practice. Hiring you will enable these things to happen without overloading any single member - not you, the new graduate, and not your new boss.

Item 1 and 2, above, might be considered innate; they are "perks" the new grad brings to enhance the practice. Item 3 is where the trouble starts. These are management issues for which the owner is prepared to pay the veterinary employee in exchange for time spent and services rendered. We will discuss this later when we write about choosing your first job and contract negotiation.

As you go through this, be aware that in many cases, the practice owner you are thinking of working for is as clueless about how to work with, mentor and treat a new graduate as you feel about being a practicing veterinarian or employee. Things are easier to work out if all parties admit that they are "making it up as they go" and agree to be open and honest about how it is going without taking it personally.

What is expected and required of a new graduate?

There are basic expectations of an employee such as being punctual, assuming responsibility of your work (e.g. treatments for hospitalized animals), looking presentable to clients and so on, which the new graduate should be informed of and have an understanding of prior to signing their contracts.

Nearly every practice owner recognizes that the new hire needs time to transition from student to doctor. However, not all realize that the new grad should be supervised and mentored through this period.

Within a "reasonable time", new grads are expected to take on their fair share of the caseload and produce sufficient income through services rendered to at least cover their own salaries. Private practice is a "for profit" enterprise and cannot exist very long if expenses are greater than income. However, misunderstandings may occur when the term "reasonable time" is not properly defined. The practice may consider 2 months to be reasonable to them, while the new grad may expect more time.

New grads must realize that the diagnostic and treatment regimens, as well as all salaries and expenses of the entire clinic are funded in total from fees paid by clients. This is why some practices lack the support of technicians. The ability to perform unlimited diagnostic tests and have unlimited support personnel paid by University funds are a thing of the past. Permission to do tests must be granted by the client, whose resources are likely limited. Therefore, new graduates need to learn to prioritize which tests provide the best information for their cost.

The new graduate must learn to practice "Sutton's Law"; Willie Sutton was a British bank robber. When he was caught, he was asked "Why do you rob banks?" to which he replied "Because that's where the money is". Sutton's law tells us that we should order the tests that give the most information first.

This is a common frustration among new veterinarians, who must learn how to selectively choose and convince clients to allow them to pursue tests and treatment regimens that will increase the likelihood of a favorable outcome.

The Culture of a Veterinary Practice

The staff and doctors of a veterinary practice are members of an established society or family. The new veterinarian needs to find his/her way into this group with respect and courtesy. The new veterinarian, while outranking many of the other employees in terms of education and responsibility, is near the bottom of the practice's social order. Many employees have been there for years and know the way of the clinic. They can be an excellent source of help and advice. Most staff will respond favorably to simple courtesy and will appreciate requests for advice and help as well as a "thank you" for a job well done. This can be challenging to a young graduate who insists on being treated with deference by the support staff. A DVM degree does not gain you instant credibility and respect. Respect must be earned by being courteous and proving one is worthy of it.

Clients, for the most part, will be respectful of your degree, but it must be remembered that many are long-term clients who have what they feel is a personal relationship with a senior veterinarian. They may insist on having another vet on staff see their animal, and this can be hurtful to a new graduate. An even more unpleasant occurrence is if they repeat everything you have told them to a senior vet or technician, making it obvious they didn't believe or understand anything you told them. Grow some thick skin and ignore this; they may be just talking to an "old friend" or they may want some assurance from the people they know. They don't know what you know, but they want the best for their animal. You are new, and they trust the old guy. In short order, they will be asking for you, especially if you are attentive and do your best. A fellow veterinarian suggested: "make sure the clients know you as a person, then they are more apt to treat you like one." Additionally, a handshake upon meeting the client and a sincere compliment about their pet will help cement the bond between veterinarian and client.

Jealousies and personality conflicts can arise and lead to a miserable working environment. It is best to avoid these situations by being friendly but neutral and staying out of work conflicts unless you are directly involved. If you perceive that a staff member has some animosity toward you, confront the situation politely and try to understand what you might be doing to cause these feelings and how you might work together to correct the problem. Be accountable and willing to accept any responsibility you may have for the conflict. If, after showing your willingness to "work it out", you cannot correct the problem then avoid all but necessary interaction with the antagonist or ask for mediation from your boss.

Mentoring

Everyone needs a little guidance, especially during the early days of a new job. The nature and degree of mentoring needs to be discussed and agreed upon both by the employer and the prospective employee ahead of time. Some new grads want to be able to seek help on every case they see, others only want help if they ask for it, and want to be allowed freedom in their approach to their cases. There can be a great deal of variation in the amount and quality of mentoring a practice owner is willing or able to provide. However, new grads need to understand that senior veterinarians cannot "hover" over them because that would prevent them from seeing their own cases during that time, committing two veterinarians to a single patient. Unfortunately this topic is often overlooked when negotiating for a job, but inadequate mentoring is a leading cause of veterinarians leaving a practice.

Senior veterinarians have an obligation to intervene if the new grad is misdiagnosing or inappropriately treating an animal; after all, the practice owner is responsible for negative outcomes due to avoidable errors, regardless of who commits them. New grads should expect this, but should also expect the senior veterinarian to be their advocate when they are challenged by a client over some differences of opinion.

In some cases, it can be advantageous to seek a second or third mentor outside of the community of the practice itself, at least in matters that don't require immediate attention. This should be done openly with no question as to loyalty to the practice that "butters your bread."

For a more thorough discussion of mentoring, The American Animal Hospital Association has a very good paper on mentoring at http://www.aahanet.org/PublicDocuments/MentoringGuidelines.pdf

The Vanishing Boss

Your initial interview is a good time to ask the owner what his/her plans are in regard to their own vacation time. Ask specific questions such as when they are leaving, how long they'll be gone, whether they can be reached, and if there is another vet available to help you. Before you get all revved up about this, realize that the owner may have worked literally years without a vacation. They may be very tired and probably waiting for someone to "help them out". However, if you are uncomfortable being left alone you must tell them. They should be willing to stay available for a while until you get your bearings, agree to be in contact by phone, or to have another vet available. If you suspect you will be left an orphan, that is, the owner is out the back door when you enter the front, you are taking this job at your own peril.

Gender

There remains a gender issue that female veterinarians must address (especially those in large animal practice), though progress has been made.

Physical strength is often an issue brought up by some clients and even some veterinarians. The perfect large animal vet would have arms long as a basketball player's, with the diameter of a five-year-old child's, but with the strength of Arnold Schwarzenegger. Such physical attributes belong to extra terrestrials. We all have physical limitations, which we must compensate for. Remember that as a veterinarian, you are supposed to be smart, and therefore be able to use brainpower to overcome a lack of horsepower. Bring or ask for help if you need it. Most clients will be glad to follow your direction, but if you'd rather bring a stout kid hired as a tech to do the heavy lifting and prolapse stuffing, In short, be prepared. Obstinately refusing help when you obviously could use some doesn't further your cause and it doesn't make you look very smart.

Many old clients feel that women aren't supposed to be in dirty, hazardous situations. Your first goal in gaining their acceptance, and ultimately earning their respect, is to make them comfortable with the idea that you don't mind getting dirty. Think of some opening statements to relieve both your and their discomfort. In the hypothetical instance of a prolapse, if its July, say something like "At least she didn't fall through the ice", or something equally absurd, which shows you are not only OK with doing it, but you are optimistic enough to realize it can always be worse. Do not complain about being dirty, in fact you should enjoy being dirty, or it will be one of the last times you are on that farm, and probably neighboring farms.

You will doubtlessly encounter some unabashed gender bias; if you are female working with large animals, and if you are male working with small animals, some clients just naturally prefer one gender over another. Just show them you can do your job and you know what you are doing. It may take some time, but they will eventually accept your abilities. A sincere effort to adapt as much as possible to "the way things are done around here" will also go a long ways.

The following is from a female vet with the "right stuff":

"In 1995, I was hired as the first female veterinarian in a mixed/large animal clinic serving a rural area. There were 8 other male vets in this well established practice that included 3 practice locations. I rode with the other vets for two weeks then they turned me loose. My approach was to look the clients in the eye, shake their hand, then diagnose and treat their animal the best I could all while keeping up a conversation about the high school football/basketball teams. I may not have known what was wrong with the animal (or the name of the football team) but did my best, told them if I didn't know, and looked up the symptoms in the book I had hidden in my truck. I found that clients really just wanted to know if you would talk to them or talk down to them, if you were willing to get dirty when need be or were a princess from the ivory vet school. Every other male chauvinistic comment that was made to me, I ignored and proceeded to prove them wrong either at that visit or the next.

I went to a new client early on. That client mentioned that I had been to his neighbor's farm the week before. He said that his neighbor told him that the new female vet "acted like she knew what she was doing and the animal didn't die". For me, 2 months out of school, that was high praise indeed and I took it as so. At that point, I knew things were going to be OK."

Emergency duty

Similarly, you should have a clear understanding about emergency duty. If your clinic does emergencies, you will have to do your share. Complaining about emergency duty will not put you in a positive light within the practice. However, the sharing should be fair; you should not be expected or forced to take all of the emergencies, and you should not expect senior veterinarians to have an equal amount of emergency duty. They have had their years of emergencies, and you have a job because of them; it is only fair that they get a little better schedule. Some practices will allow the attending veterinarian to keep the full emergency fee as an incentive for those veterinarians who can use the extra income (especially new graduates). Get your agreement in writing.

The following experience of a colleague illustrates some of the bad experiences of other new graduates:

"Ask what the motivation for having an associate is. If it is to be able to take more time off, see the red flags. Most likely, you are going to find yourself alone and thrown to the wolves within a very short period of time. I'd been out of school about 2 months when my boss left for 2 weeks to go hunting in CO. I lost what I believe was a savable cow attempting a c-section on my own because there was no one within 3 counties that I could get hold of to come help me, and I'd only seen a slide show presentation about how to do one while in vet school. I ran into trouble and didn't know how to get myself out of it. He left with no other veterinarians on call to help me out if I had a problem, but I should have expected that considering his favorite phrase when I'd have a difficult case that I'd ask him about was "You're a graduate veterinarian. YOU figure it out". He would take off an average 8 weeks per year but pitch a fit if I wanted to take a single vacation day, especially if it was a Friday or Monday around my weekend off."

If you are uneasy about emergency duty, arrange to have another veterinarian in the practice as backup (at least by phone) and make sure you understand the practice's policies on emergency service payment beforehand. The night you are faced with a C-section is not the time to discover that the practice does not bill clients. Also, make sure you know what level of technical support you will have and what the arrangements are for compensation before your first emergency shift. Get all of your ducks in a row before they start pooping on your head!

Attitude

A positive, can-do attitude will get you through many situations and will do more to win respect and credibility than all the academic preparation you have endured. When dealing with clients, remember they have come to you with a problem they cannot solve, and you should spare no effort in helping them. This includes asking for advice from any member of the practice, your former faculty acquaintances, veterinarians at the diagnostic lab, internet resources such as VIN, and so on. No one expects you to know everything, but your efforts to help solve the problem will be your legacy. "I don't know" is an honest and perfectly acceptable answer that should always be followed by, "but I'll find out and get right back to you."

Humor and "Small Talk"

It's only serious if someone is actively trying to kill you. Humor is a very effective tool when used to relax an anxious client and lower the tension level in both yourself and whoever you are dealing with. This is a major role player in large animal practice and should not be disregarded or diminished; for some people it is part of their culture. Not playing along implies to them you are an elitist. If you don't know any jokes, learn some and be able to tell a few well. It helps! In addition, take a few minutes to read what is going on locally so that you can discuss sports and community events intelligently. Be able to laugh at yourself and be okay with others laughing with/at you if you make a silly mistake.

I once took a female extern on a rather large palpation job. The cowboys found out she was from Arkansas and immediately began to tease her about being a "Redneck". She quipped "Just because I'm from Arkansas and met my boyfriend at a family reunion doesn't mean I'm a redneck. Everyone back home knows the REAL rednecks are from Mississippi." She had no trouble at all after that. If she had reacted negatively, it would not have worked out as well.

Mistakes

Mistakes are unavoidable, we all make them. The trick is to be accountable for them, learn from them, and not repeat the same error in the future. Tell the client and tell your boss when they happen. The difference between school and practice is simple: In school you learn the lesson, and then take the test. In practice it's the opposite, you take the test, then learn the lesson. Don't beat yourself up when you learn a painful lesson; you will remember these incidents for future reference. Sooner or later most small animal vets will spay a tom cat, equine vets will tear a mare's rectum, and bovine vets will deliver a calf and not check for a twin. Hopefully it doesn't happen twice to the same vet.

Choosing a first job

Now that we have discussed some reality-based practice situations, how on earth do you decide where to begin your veterinary career?

Write your Goals to remind yourself what you really want

After you have read this article, sit down and consider your goals. Make short term (what you want for the first year out of school) and long term goals (how you want your career and life to unfold). Your goals may change at some point in time, then you just have to change your plan to fit.

The important thing is serious thought and WRITE IT DOWN. Make a list of what you really, really, really, want. You have to do this individually, as each of us has different passions, priorities and interests. One person might want a busy practice with a large caseload to learn as quickly as possible, another may want work time to be compatible with family interests, yet another may want a fast track to making a lot of money. With a DVM degree, all of these goals and more are possible, and all of these can have unforeseen consequences. I know of a young vet who took a high paying job right out of school in a very high-end clinic in a large city. She made lots of money, but had many threats of lawsuits and even several death threats.

Are you married or have a significant other who will likely accompany you to your new position? If so, consider options that are important to you, but by all means keep their preferences at the forefront: "If Momma's (or Daddy's) unhappy, ain't NOBODY happy." They are the most important people in your life. An isolated unhappy spouse/partner is a stressor that you can avoid by considering their wants and needs as well as your own. Don't fail to include them in assessing your career goals.

Here is a basic list of points to consider to get you started:

1.  Salary and benefits

2.  Level of mentorship

3.  Time off and emergency duty

4.  Schedule

5.  Animal species seen

6.  Case load

7.  Cultural and recreational amenities in the community

8.  Job for spouses/significant others

9.  Schools for children

10.  Culture, philosophy and 'feel' of the practice

11.  Facilities and technology at the practice

12.  Support staff at the practice

13.  Continuing Education Support

Add to this basic list as needed. After making a list of what you really want, start looking for a place where such a position is possible.

Do your homework!

Schedule interviews at clinics that interest you and even a few that may not interest you. . Don't arrive at your first day of work without ever having visited the practice that hired you. Some say they can't afford the time or money to do face-to-face interviews at every practice they are interested in. The truth is you can't afford not to. There's a chance that taking a position without interviewing in person can work out. But to roll the dice like that and leave to fate the outcome of the most critical year in your professional development is foolhardy.

While at the practice, talk to associates and employees. See if you can discern if they are relaxed and whether they seem to enjoy their work. Remember that in interviews everyone is on their best behavior and things may be very different after you work there for a while. Temper tantrums and bad mouthing associates to clients are BIG red flags. Is the boss a good mentor? How are cases assigned? Ask your potential boss how he handles office conflicts. Does he handle them in a healthy manner or just avoid them? If he runs away from handling conflict, you should consider running, too.

Contact previous associates of the practice and find out what the work environment is really like and why they left. If there is a turnover of associates every few months to a year, look elsewhere. If the practice will not give you the names of former associates, you can ask the placement office at the veterinary school whether the clinic in question interviews each year. Another source of information is drug company salespersons that call on practices. You can contact them by searching the companies' web sites for the name of the rep for a specific area. These reps usually can tell you a lot about the inner workings and atmosphere in a given practice. Remember that you are also interviewing them!

When you are making your decision, there are many things you need to know about the practice and the people who work there. You can ask specific questions, like "How is night call divided?" or more general, open ended questions like "What do you like best about the practice?" Be sure to pay as much attention to what isn't said as to what is said. Some sample questions are listed below.

1.  What do you like most about your job?

2.  In your opinion, what is the most important attribute that a new DVM should have?

3.  Ask your potential boss what the characteristics he appreciates the most in his favorite employees are? It will give you a good idea of what he/she values in an associate.

4.  What are your clinics' strengths? Weaknesses?

5.  What would clients say is top notch about the clinic?

6.  Are there written job descriptions for employees?

7.  Do you hold regular staff meetings?

8.  How are employees evaluated and how often?

9.  How long have support staff been employed? Lot of turn over?

10.  What is the relationship between this clinic and the neighboring practices?

11.  Are there plans in place for upgrading/purchasing new equipment/facilities/vehicles (looking for how they plan for future)?

12.  Ask why they want to hire another veterinarian.

The bad experience of this fellow veterinarian may have been preventable:

"My first boss never told anyone that they had done a good job, even if a client came in praising the person. He accused everyone of stealing from him-money, hoof picks, q-tips, whatever. He constantly told people how worthless they were and how he really should just fire them, but then he'd have to hire someone else and that person would probably be just as bad. He'd complain about how nobody could do anything, but he wouldn't train anyone to do anything saying they'd just screw it up and he'd have to fix it anyway. He would scream at whomever happened to be present anytime he was upset without regard to if clients were in the building, if the person on the receiving end of his fit had anything to do with the problem, or just because he was in a bad mood and wanted to take it out on someone. When I had clients that started requesting me, he would get mad and find a reason that he had to see them. I became the competition. Whenever I did something different from him, it was wrong, even if it worked. If I used a medication he didn't usually use, I was chastised, even when I'd tell him that it had been proven to be superior to the stuff he used and was what we'd been taught to use. He wouldn't teach me how to do surgeries that we weren't taught in school, because he didn't want me to be able to do everything he could, but then he'd scream and pitch a fit when I'd have to call him in to do something at night or on the weekend when he was supposed to not be on call. He wouldn't come in on or help with surgeries that I wasn't confident with because any idiot should be able to do that just from looking in a book. After talking to a couple of vets who'd worked for him before, I found out that he'd been every bit as difficult to work for with them and that the problems seemed to be intensified with each subsequent associate. I don't know of any associates that stayed more than 6-12 months after me."

This is an extreme example, but it illustrates that had this veterinarian contacted former associates before signing on, he/she would have been less likely to take the job.

Communication Skills

The single most important tool at your disposal is your ability to communicate. The most important reason for problems reported by new graduates is that they didn't think they had agreed to something that their boss thinks they did agree on. In other words: misunderstandings. Good communication skills will minimize the chance of these misunderstandings to happen, and when they do, resolution is more likely due to decreased confrontation.

Follow the link to read this article: "The Art of Successful Communication in Veterinary Practice for a New Graduate", courtesy of John McCarthy, DVM MBA.

This work is short but comprehensive. This entire paper should be read as the very first step in preparing yourself to seek a job. The following section about Situational Use of Communication Principles is from that article. It helps illustrate how important communication skills are.

"These situations all illustrate the importance of being a competent communicator, in fact your future success as veterinarian, depends largely on your ability to communicate successfully to a variety of audiences in many situations. Again, PLEASE read the entire paper at the link above.

 The art of negotiation techniques and skills - Negotiation will play a major role in your communications with your clients and other staff members. Successful negotiations require proper timing and developing trust and rapport with the other parties. Being honest and trusting others helps reduce unnecessary conflict and increases the potential for collaboration and agreement.

 Problem solving - Whether your practice utilizes a team or individual approach will determine what your role will be.

 Conflict resolution and/or management - Resolving conflict will be a major test of your communication skills. Conflict is part of life. Avoiding it can cause further conflict that is unnecessary and painful. Conflict is healthy when you engage in it to reach a collaborative agreement or new alternative. It becomes unhealthy only when it is used to vent frustrations and fears or to control others or the situation.

 Facilitating the decision-making process

 Facilitating the learning process

 Giving and receiving criticism

 Job search communication - Resume writing, interviewing, preparation and follow-up.

 Record-keeping -Understanding the importance of and use of medical records for business, diagnostic, and legal defense reasons, research records, financial records.

 Seeking funding for research and entrepreneurial activities - the art of grant writing

 Marketing materials - Writing and publishing practice newsletters, client info sheets and other publications.

 Private practice applications - Grief counseling, communicating in emotionally charged settings, discussing money matters with clients are all special situations requiring communication skills (See next section.).

 Education - Either as a presenter or learner, you will continue you education forever. As presenter or author, you will need communication skills to make your audience understand what your message is. As a continuing education student, the value of what is being presented to you will depend on your ability to read or listen to the message being presented and understand its meaning."

What about a contract?

The following is from a chapter in Dr. John McCarthy's article, "Preparing for Your First Job".

"A contract is a legal obligation between the parties and may be either oral or written. However, written contracts would be more easily enforceable if a misunderstanding took place. Contracts between a veterinary employer and an employed veterinarian would be considered to be a personal service contract and is generally written and not oral. Many veterinary employers do not utilize employment contracts for several reasons among which are:

 They feel that they are time consuming and expensive.

 They want the flexibility to decide employment issues as the need arises.

 They have functioned for years without them and don't want to start now.

In spite of this, I suggest that you strongly insist on a contract. If the word contract becomes a stumbling block, making a "Statement of Understanding" or "An Employment Agreement" between you and your new employer may be more agreeable terminology and will essentially be the same. As was stated earlier, the major reason for concern by new graduates was employment agreement misunderstandings.24 Contracts, under any name, will serve as written understandings between the two parties and will serve, in most cases, to settle disputes before they become serious.

In most cases, if things are working out, neither you, nor your employer will ever look at the contract after you sign it. You will work things out as you go and not worry about the letter of the contract as long as both of you are happy with the outcome of the ongoing relationship. The contract will come out of the drawer only if you are unsure of what you agreed to, are not entirely happy with what is happening, or worst case of all - find yourself being asked to leave or wanting to leave."

Contracts will not protect you if you are not producing as expected or if you and your employer are totally incompatible, but they might protect you from being fired without cause, which can happen if you don't have one.

Recognize that in many states, employment is "at will" and your employer doesn't need a reason to fire you and you don't need a reason to leave. Check the labor laws in your state. Do not sign thinking no one will ever enforce a clause that makes you uncomfortable. The fact that the clause is there is a RED FLAG and needs to be discussed. Consider hiring a lawyer to look over the contract and translate from the legalese.

If you feel your contract has been broken and your employer is unwilling to discuss the situation or negotiate, weigh your options carefully before taking or threatening legal action. Sometimes the best thing for you is to ultimately just walk away and minimize your losses. A legal battle is always very expensive and emotionally draining.

What Should the Contract Contain?

According to Dr. McCarthy:

"Any item that was included in your previous conversations with your new employer, that either you or the employer feel should be included can be as long as it is legal.

For example, a requirement that you act outside of the limits of your state license would be illegal and, hence, likely make the entire contract illegal. You might want to, however, include an agreement that you would not be asked to perform convenience euthanasia."

Covenant Not to Compete

"An enforceable covenant-not-to-compete included in the contract would restrict the employee from practicing the same type of veterinary medicine that they were hired for within a certain distance and for a certain period of time after they left this employment even if the term of the contract had expired. In order to be enforceable, non-compete covenants must be legal in the state in which the contract is written. At present, California, Montana, Oklahoma, North Dakota and Alabama prohibit the enforcement of restrictive covenants associated with employment contracts26. Most other states will enforce them if they are reasonable but you should be aware of the law as it exists in your state. Reasonability of the restrictive covenant depends on three parameters:27

 The first is location. The covenant will restrict the individual from working in or starting a similar practice in a certain distance from the original practice. This distance must be considered "reasonable". If the covenant was to be challenged, or defended in the courts, it would be the judge that made this decision. A reasonable distance would generally be considered the area from which the practice drew the majority of its clients. This could change drastically if one was referring to a city practice where blocks could be the measure or a very rural practice where several miles might be the measure.

 The second is time. The covenant will restrict the individual from this same activity for a certain period of time after leaving the employment where the contract was held. To be reasonable, the courts, if required, would determine how long the individual who left the practice could have a negative impact on the old practice. A time limit of more than one year would be unusual.

 The third parameter is the scope of activities in the new practice situation. For example if the contract holder's practice was entirely small animal, the covenant could not restrict the employee from practicing equine medicine in a close vicinity to the original practice."

Basic Guidelines

"Mr. Madden's articlelists the following six guidelines to avoid problems with a contract. These guidelines are applicable to both the employee and employer.

1.  The wording in the contract should be clear and unambiguous. If there is ambiguous wording, the contract will be interpreted against the party who drafted the language.

2.  Always read all of the language of a contract before signing it.

3.  Understand that if you sign a contract that contains wording you don't like, you're nevertheless agreeing to abide by that wording.

4.  Understand that if a contract does not include wording that you want, you may not be able to enforce that wording later.

5.  Never disregard wording in a contract because someone tells you "it's boilerplate" or "doesn't mean anything" or is "routine". If it doesn't need to be there, ask that it be removed.

6.   If a contract is complicated, or if you have any questions, seek independent advice.

It is good advice in any case to seek legal advice before signing any contract and this contract will be no less important than the many that you will be asked to sign throughout your career. Another real life anecdote. Remember, the devil is in the details:

"Beware of "buy in for the right person". I worked overtime with no compensation for 5 years to prove how "right" I was for buy in only to be told that it was off the table. This was after being told I was great and wouldn't I like to buy in for the first two years. At the time I thought it was because I was a woman (and that might be the case), but time and numerous other discarded associates lead me to the conclusion that the "right" person is tall, blond, male, and shares my boss's surname. Yep, his son graduated vet school last year. I met him for the first time when he was 7. Beware of paying dues that are too high. Oh, and if you don't get it in writing, it's not worth the paper it isn't written on." Name withheld."

Other things to consider

Ethical and regulatory drug use

Much discussion is devoted to wages, hours, CE, perks, etc. Grads pick the job of their dreams based on whatever criteria they feel is significant only to discover during the course of the first day on the new job that the practice engages in activities that are unethical or even illegal. A moral dilemma is encountered in which (after signing a contract and committing to a 6 or 12-month lease on a house) new grads must decide whether they concede in their principles or they break out of their job contract. Besides the breach of contract, they may possibly have to break out of their lease agreement (often with severe financial penalty) to move to another location. Also, needless to say, a two-week stint at the first job really doesn't add much shine to your work history.

The following is a checklist of many but not all-ethical and regulatory issues that you should be aware of as you interview with a prospective employer. Spend some time at the practice and try to check as many items as possible from this list:

 Look at their books: (Some practices are reluctant to do this, but ask anyway.)

 What percentage is dispensing vs. service work? (Dispensing is OK if done correctly.)

 See how they handle client-patient relationships, extra-label drug use, etc.

 Walk through their pharmacy. Are the drugs properly labeled/ stored? Are controlled substances logged in when added to the inventory and logged out as they are dispensed? Are there compounded or bulk products present? If the pharmacy inventory is not handled correctly, this is a problem that can result in disciplinary action, which can have a very negative effect on your career.

 Make sure you are comfortable with the practice's philosophy of drug usage, especially in food producing animals.

 How do they handle prescriptions? Must document a valid client-patient relationship, record all prescriptions, label prescriptions correctly.

 How do they handle requests for performance and appearance enhancing drugs for show and competitive animals?

Regulatory medicine

USDA Accreditation procedures are diagnostic tests, vaccination and inspection procedures mandated by the USDA to control and eradicate diseases that may present a risk to public health. They should be performed correctly as required by directives issued by USDA (federal) and state animal health authorities.

Make yourself aware of these issues if you haven't thought about them before. Veterinarians deal with these issues daily, and you should be aware that point of view and personal perceptions can affect how a person deals with these and other topics. Most prospective employers should be willing to openly discuss these matters with you. The notion of "doing the right thing" should govern everyone's philosophy. The bottom line is that a practitioner should have policies to deal with these matters that you understand and are comfortable with, and in no case should you be expected to violate either the law or your own ethical values.

This is a great career, but you have to make a living

There is a reason for putting salary near the end. You should have a good idea how much money you need to make to satisfy your needs, service your debt, and start your life. You should be aware of what the average salary is for a given region and practice type. Compensation for your time and knowledge is always a big issue, especially because there has to be someone willing to pay for it: your clients.

Ironically, money or the lack thereof is seldom the chief reason cited for leaving a practice. It is likely that salary is a number and when a number is agreed upon, everyone involved understands and there is little confusion. However, there are other things less tangible that are part of the veterinarian's "compensation" and are more likely to cause problems. For example hours worked, emergency duties, not being mentored or accepted into the community in general or the society of the practice. A salary of $60,000 does not mean the same to a veterinarian working 40 hours a week than to one working 80 hours a week. Perks, such as CE, insurance, vehicle lease, dues payments and so on are all negotiable, and should be in your contract; but keep in mind these are in lieu of money. Be aware that a high salary may be an attempt to distract you regarding some "hidden cost". For example, you may get a very high wage, but you have to do emergencies with no relief. Never the less, you must have an idea how much money you need to make. Your base salary must be enough to at least cover your monthly expenses. MAKE A BUDGET BEFORE YOU LOOK FOR A JOB.

Buy-in potential

There are all sorts of buy-in plans and payment by commission strategies, but initially the primary goal is to find a practice to call home where you can learn the art of veterinary practice in a low stress and enjoyable environment. Once you have done that, consider in future negotiations how to increase your income. If you are doing well, you will be more productive and therefore more valuable to keep in the practice. In my opinion, money follows happiness, but money sure can't buy happiness.

Now you are ready!

This article is meant to offer some insight into avoiding common pitfalls among recent grads. Like Eleanor Roosevelt said: "Learn from the mistakes of others, you can't live long enough to make them all yourself." While comprehensive, this list of pitfalls is not exhaustive. Additionally, we are sure you will bring your own experiences and priorities into your decision making as you find the right employment position. The art and practice of veterinary medicine is stimulating, engaging, diverse, and rewarding.

Once again, welcome to veterinary practice, colleague!

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