SOLUTIONS TO SUPPORT EARLY-CAREER VETERINARIANS

BY CARA WRIGHT, DVM, MS, IVCA

Integrating a new graduate into your practice is an exciting and rewarding, yet challenging, prospect. All doctors, regardless of experience level, face challenges when starting at a new clinic.

These challenges are compounded for new graduates adjusting to workflow and interpersonal dynamics outside a university setting.

The following approaches will help you support new doctors growing in your practice and their careers.

Technicians

Pairing an experienced technician with a new graduate speeds the processes of finding medications and supplies in the practice vehicle, setting up and using equipment, and navigating practice software. What’s more, when faced with a stressful situation, an experienced assistant can offer reminders like, “Dr. Wright, would you like me to clip this wound for you?”

Asking a senior clinician to check medical records and billing upon case completion helps the new graduate learn your practice’s policies and medical-record style, which is likely more abbreviated than the university setting. It also allows the doctors to discuss the case and appointment outside of clients’ earshot.

Implementing a graduated appointment schedule helps the new doctor, as well as the staff who schedule appointments. Allotting about 15 extra minutes for routine appointments at the start of employment allows the new graduates to sharpen their exam routine, basic technical skills, and client communication skills. With this background, they’ll be more likely to succeed on future “fire-engine days.” It also decreases the likelihood that new grads run late to scheduled appointments.

Feel free to modify this example graduated schedule to best suit your practice: º A senior clinician double-checks records/billing for completeness. º Add emergency coverage once all parties feel comfortable and the new doctor has appropriate backup if needed. º Real-life example: New doctors in my former practice accompanied senior clinicians on emergencies for four months. Then they began to take primary emergency coverage, with a senior clinician always available by phone and to meet on the farm if needed. º A senior clinician provides final review of medical records. º The newer doctor takes charge in appointments when possible with the senior clinician present for support.

• Phase 1: Shadow other doctors for both routine and emergency cases, meet clients, learn farm locations, practice using software, write medical records and billing for cases seen with senior clinician; senior clinician to revise/edit for completeness of record and accuracy of charges.

• Phase 2: Schedule solo basic wellness and simple appointments, such as vaccines, routine dentals, bandage changes, lasers and shock waves.

• Phase 3: Schedule complex cases (lameness, gastroscope, etc.) with senior clinicians, while increasing the frequency of solo appointments.

Start new doctors talking to clients by allowing them to communicate during callbacks on routine cases. This way they can speak with clients without the pressure of communicating a diagnosis and treatment plan. When working with senior clinicians, ensure new doctors are present for the entire appointment rather than cleaning or putting away equipment. Remember, a new doctor is not a technician. Witnessing another clinician’s client conversations is the best way to pick up case-related communication skills.

Triaging ER phone calls takes time and practice and is often stressful for new doctors. Answering daytime emergency calls lets new doctors engage with clients while staff and other clinicians are available for assistance.

Case workups.

Limitations of equipment in the field, client budget and practicality of treatments are all topics that can cause insecurity in a new graduate. Discussing the available on-farm options helps create confidence. Directing new doctors to medical records of similar cases is a low-effort way to compare notes. Holding weekly or bi-weekly case rounds allows for case discussion and questions that may arise once off the farm.

Providing constructive and timely feedback is the cornerstone of growth and improvement. Although varying personality types will respond to feedback differently, following general guidelines is helpful for mentors. First, ask if the doctor is open to hearing some feedback. This ensures an open mindset for constructive thoughts. Then provide feedback with a structure that reinforces the good while providing suggestions for improvement. To help the new doctor see areas of strength, use affirmative statements such as “patient assessments were accurate” or “identified appropriate treatments for likely diagnosis.” When debriefing, ask questions such as “What did you do well?” “What do you wish you had done differently?” and “What did you learn?”

By using the solutions outlined above, you can successfully integrate a new graduate into your practice. The new doctor will become an integral part of your practice sooner rather than later—and hopefully for many years to come.