 readers are in the accumulation phase of their investment lives, others, like me, are planning to retire sometime during the next decade. We need the continued growth of some of our investments in retirement to outpace inflation, but the goal of investing for and in retirement is to produce enough cash flow to sustain your standard of living.

I have many mentors in the investing space, but by no means am I a financial planner, nor do I have all the answers (hence the need for mentors). However, I do see the results of my learning as I watch my cash flow increase, and I am confident that my needs in retirement will be met. My goal in writing this article is to provide fodder for your next discussion with your financial planner. (If you do not have a financial planner, you should consider getting one.)

Cash flow in retirement can come from a variety of sources. The 2 discussed in this article—dividend-paying stocks and closed-end funds (CEFs)—are suitable for investors of any age.

A stock is an investment that represents partial ownership in a company (see 

 sidebar). Dividend stocks pay cash—usually monthly, quarterly, biannually, or annually—in the form of dividends. These companies tend to be profitable and share their profits with all of their stockholders.

Although it fluctuates daily, the average dividend for companies in the S&P 500 Index is about 2%.

 This means that for every $100,000 invested in an S&P 500 mutual fund, the investor will earn $2000 annually in dividends. (Capital gains, or the profits from shares of a stock or other asset, are a different type of return and averaged 13.99% during the last decade; over 20 years they have averaged 6.41% and are “expected” to range from 6% to 8% for the next 10 years.) If you do not want to do a lot of work investigating individual stocks, then investing in mutual funds (especially those of dividend payers) or CEFs is the way to go.

However, you can also invest in individual stocks. Choosing the best stocks can rely on timing and is often a hit or miss, even among experts. Increasing the number of dividend stocks in which you invest to 50 to 100 in a variety of industries/sectors minimizes both the risk of losing principal and the chance that too many of your stocks will suffer dividend cuts or suspensions, as we have seen with the coronavirus disease 2019 pandemic.

Regardless of how you choose to invest in dividend stocks, the returns serve as a source of reliable (although not guaranteed) cash flow. There are no guarantees when it comes to cash flow, but dividend stocks tend to bring greater cash flow than cash, certificates of deposit, or bonds—although bonds and bond funds can also provide cash flow and help balance the risk of a retirement portfolio.

A CEF—also known as a closed-end investment or closed-end mutual fund—is a portfolio of pooled assets that raises capital only once, through an initial public offering, and then lists shares for trade on a stock exchange. As with many mutual funds, a professional fund manager oversees CEFs but they do not issue or redeem shares daily as is the case with mutual funds. A CEF portfolio is typically focused on a narrower subset of securities, such as a specific industry or market sector, which makes them more subject to volatility.

A CEF trades like a stock—on a stock exchange or over the counter—whereas an open-end mutual fund is bought and sold directly with the fund company or a brokerage firm.

Cash is earned by the CEF investor in 2 ways: cash flow (represented as yield on the fund, paid monthly, quarterly, biannually, or annually) and growth of the share price (capital gains similar to stocks and mutual funds). The yield is what makes these funds so appealing to retirement investors and averages 6.73%, quite a bit higher than the S&P 500.

 So, for every $100,000 invested, you would receive $6730 in cash flow annually. In general, CEFs are chosen as investments by those who want regular (but not guaranteed) cash flow, such as retirees.

Unlike open-ended mutual funds, CEFs usually trade at a discount or premium to the value of the assets in the fund (called the net asset value). In general, investors try to buy CEFs when the discount to the net asset value is larger than average, and extra money is made as the discount narrows and the share price increases. (Note that this gain is only realized if shares are sold as their value increases, similar to an open-end mutual fund or individual stock.)

A second feature of CEFs is debt, because many CEFs borrow money to buy holdings in the fund. Debt can boost the yield by adding to the number of holdings in a CEF that are paying dividends, interest, or capital gains income. But it can also magnify losses because securities can lose value if interest rates rise—especially securities sensitive to interest rates, such as bonds.

One final feature to remember is that part of the income of some CEFs consists of “return of principal (capital)” rather than earnings. A CEF may return principal if, for example, it is unable to meet periodic distribution levels that shareholders have come to expect. Depleting capital can erode the CEF’s share price over time. This is usually not a problem for well-run funds and can be advantageous when taxes are due.

Although all of this may appear complicated, it really is not. CEFs may be a way to assist cash flow in retirement, but consulting with your adviser is the best option to help determine your level of comfort, safety, and financial needs.

Dividend stocks and CEFs can be helpful investment vehicles for those who want regular cash flow in retirement. Starting to invest in these vehicles at any age, but especially in the several years before retirement, can help ensure that you have enough income to make retirement enjoyable. Discuss this information with your retirement specialist so you can make the best choices.

Here is what I am doing, as I sit a few years away from retirement. After much research (see 

 sidebar), I have moved some of my mutual fund investments into dividend-paying stocks, and purchased several CEFs to add to my portfolio (most are equity or stock funds, but some are municipal bond funds that produce tax-free income, important for me in retirement). All of the dividends and cash yields from these investments are reinvested each month so that I can purchase more shares of the dividend stocks and CEFs, just like I do with my mutual funds. The nice thing about doing this now—a few years before retirement—is that I can see roughly how much income my investments will throw off for retirement (the exact amount will change as I make investment changes and add more cash to these accounts). So I know that if I were to retire today, I would have enough cash to fund my monthly expenses. Of course, I do not plan on retiring now because I thoroughly enjoy working and wish to continue growing my investments to ensure even more security for when I do decide to retire (which is important because of inflation and if my expenses increase in retirement).

Shawn P. Messonnier, DVM, owns Paws & Claws Animal Hospital and Holistic Pet Center in Plano, Texas, and serves on the 

 Editorial Advisory Board. He has written multiple books on marketing as well as holistic veterinary medicine.

1. Ross S. a history of the S&P 500 dividend yield. Investopedia. Updated May 5, 2020. accessed January 18, 2021. 

www.investopedia.com/articles/markets/071616/history-sp-500-dividend-yield.asp

2. Foster M. What is a closed-end fund? The ABCs of CEFs. December 31, 2020. accessed January 25, 2021. 

www.kiplinger.com/investing/602012/what-is-a-closed-end-fund-abcs-of-cefs

Articles

Dividend stocks and closed-end funds can help ensure a financially secure retirement. Here are the basics on these investment types.

Investing 101—Cash flow in retirement

Periodontal disease is easy to treat and prevent, but it is among the most common infectious conditions we see in our clinic. While many of our clients equate periodontal disease with dirty teeth or bad breath, we know that this infectious and inflammatory condition can contribute to serious problems including heart disease, diabetes, and immune disorders. There are multiple options for managing periodontal disease, but I will focus on 2 approaches: standard and platinum treatment.

*The progress examination is up to the veterinarian and can be done by a technician or doctor to review home treatment and evaluate the pet’s dental health if needed.

The basic approach is straightforward—clean the teeth and hope for the best. In my opinion, unless it is not economically feasible for your clients, preanesthetic evaluations such as examinations, labs, and ECGs are 

optional. (When did good health and common sense become optional?) If your patient expires under anesthesia, even with the owner opting out of preanesthesia evaluation, you are still liable for what happens to that patient. Unfortunately, defending your position legally in this scenario is rather challenging.

The basic approach addresses what is seen in the mouth but ignores deeper issues such as pain relief following a dental scaling. Although the teeth are technically cleaned, the disease remains present and has not been adequately treated.

The platinum approach involves much more than cleaning teeth. Following a supra- and subgingival scaling, teeth are polished to smooth microscopic indentations in the enamel to help reduce immediate tartar accumulation. Because a dental procedure is at the very least uncomfortable, when the pet awakens, topical lidocaine gel applied to the gingiva provides relief. OraVet and Clindoral are products that aid in periodontal healing by slowing tartar buildup. If a disease is severe enough to cause more pain, or if extractions are performed, additional analgesia such as nonsteroidal anti-inflammatory drugs, opioids, and local nerve blocks should be administered for patient comfort and safety. Additionally, dental radiographs can reveal deeper pathology that is not obvious during a visual examination of the oral cavity. Choosing the platinum approach or something similar allows proper systemic treatment of the disease.

More practices should treat periodontal disease better than they currently do with the basic approach. If a patient had a serious source of infection or inflammation anywhere else in the body, we would be extremely aggressive in explaining to clients why certain tests and treatments were necessary. I think we hesitate with proactively managing periodontal disease because we underestimate its impact on our patients’ health. I fell into this trap many years ago, wondering why I could not convince pet owners to clean their pets’ teeth. If I believe I am simply cleaning their teeth rather than treating disease, I cannot convince an owner to spend a lot of money just so their cat or dog can have a pretty smile. When I attended a cardiology seminar and heard the speaker say that the most important thing to do for a pet with heart disease is to treat that pet’s periodontal infection, it finally clicked for me.

Once I gained this understanding, I was able to adjust my approach to managing periodontal disease. If you opt for the platinum approach, you must get your team to agree that cleaning teeth helps to end pain and save lives. Market your platinum approach to your clients with handouts, videos, and email newsletters. Replace terms like “teeth cleaning” or “dental” with “periodontal treatment" or "therapy,” thus improving client acceptance. Additionally, start discussing dental health at the first veterinary visit, even for puppies and kittens. Make sure you educate your clients about the seriousness of periodontal disease.

The platinum approach shows that there is more to assisting a sick pet than just hospitalization and fluids. To determine the best treatment approach for your patient, consider the potential nature of the illness, severity/chronicity, age of the pet, and the ability of the owner to afford the treatment.

Finally, the platinum approach includes items that are also incorporated in human hospitalizations. For example, technicians are provided to patients and clients are charged for their services. Pet owners are also charged for medical waste removal. For critical cases, sick pets may require ongoing monitoring (ECG, SpO2, etc).

In addition to fluid therapy, I have found it extremely beneficial to include vitamins, injectable herbs, and other homeopathic remedies to support the immune system, detoxify the pet, and hasten healing and well-being.

As a holistic veterinarian, I rarely use conventional medications indiscriminately. However, there are certain circumstances when antibiotics are needed. Additionally, believing that no pet should die without the benefit of steroids, I often use injectable dexamethasone to enhance recovery and support pets with undiagnosed Addison disease. A daily fee for the doctor exam is included, and a pet’s condition should be assessed daily during hospitalization.

Two options for managing this condition, plus how to help your clients determine which plan is best for their pet.

Better medicine, better business: Periodontal disease

Veterinary clinics dramatically shifted their protocols during the coronavirus disease 2019 pandemic, most notably with the implementation of curbside care, according to Mary Lopez, hospital manager at Hendricks Veterinary Hospital in Boise, Idaho.

Although a 2020 survey showed that most people prefer curbside service,

Lopez says that in veterinary medicine, this sudden shift in protocols presented unique challenges. Appointment times are staggered , services are limited, and cleaning protocols have increased, resulting in more frustrated clients, she told attendees at a recent Fetch dvm360® virtual conference.

Additionally, there has been a spike in pet adoptions, significantly increasing clientele. With an ongoing shortage of veterinary staff across the nation, many clinics are struggling to meet these new demands, says Lopez.

To help improve patient care, enhance client experience, and reduce burnout and compassion fatigue among staff members, Lopez and her team made adjustments to curbside protocols.

Here are 5 strategies Lopez implemented at her clinic that you can incorporate in your practice to provide a gold standard for curbside care.

Paper forms are tedious and time consuming for clients and veterinary team members. To reduce check-in times, try converting to digital forms. At Lopez’s hospital, clients complete forms digitally using SnoutID (a pet health app) before the appointment, saving her team 30 minutes during the check-in process. SnoutID also allows clients to review payment estimates, limiting the sharing of pens and direct contact with paperwork. Other digital signature platforms include JotForm and DocuSign, says Lopez.

2. Collect medical history prior to appointment

During the pandemic, phone lines and email inboxes have been jammed, delaying communication with clients, says Lopez. To help facilitate prompt communication with pet owners, Lopez and her team decided to collect medical history before appointments, using SnoutID. This app has its own staff of veterinarians and technicians who handle data consents for records transfer, she says. The platform also helps retrieve health records throughout the United States, she adds.

Busy phone lines have made it difficult for clients to alert staff to their arrival, says Lopez. Trying to locate cars in a packed parking lot is challenging without proper labeling. “Sometimes, we would get clients that would call to check in and they would say, ‘I’m in the silver car.’ How many times have you been out and looked for silver cars? That can be a little confusing,” says Lopez.

To help standardize arrival, Lopez has clients click the “I’m here” button or send a message on the Snout ID app, and the team is immediately notified of the client’s arrival. Lopez also recommends labeling parking stalls. She says a staffer’s husband built labeled parking signs to help locate clients.

Collecting payments over the phone can present security concerns, including credit card fraud, and clients can easily dispute charges without the backup of a signature. “It was very vital that we created a secure payment system for our clients, to make their safety and ours,” says Lopez, who recommends the following secure payment options:

Use card readers like Clover or Square. Make sure you have strong Wi-Fi because you must go to your client’s vehicle.

Utilize digital invoicing systems such as PayPal, for example.

Collect payments ahead of time using an app like SnoutID.

“It’s so important to effectively communicate with your clients. You need to explain the new process to them because if you don’t communicate, it’s going to be very difficult for you and your staff,” says Lopez, adding that you should regularly update all of your communication platforms.

Be sure to send a mass email to all clients and update them once a month. You can also utilize 2-way texting to keep pet owners informed. Additionally, make sure your latest updates are pinned at the top of your social media pages. To accommodate your less tech-savvy clients, add signage to your practice door. Put up banners to let clients know you are offering curbside service, including contact information. Make the text large and use an easy-to-read font style and color.

Finally, educate your customer service representatives and your technicians about all new protocols and how to best discuss them with clients.

“Clients were anxious at first. We had to deal with a lot of emotion. So, I had to create these talking points or scripts for my team so that they have a professional way to respond to these clients,” Lopez says.

COVID-19 & the future of commerce: a look at the dramatic shifts in consumer shopping behavior. Medallia Zingle. Accessed January 19, 2021. https://cdn2.hubspot.net/hubfs/393073/2020%20Consumer%20Report/MedZing2020-Future-Of-Commerce-Report-FNL.pdf

One veterinary hospital manager shares key strategies for enhancing curbside protocols at your practice.

5 ways to establish a gold standard for curbside care 

Years ago, I took a hiatus from clinic ownership. I sold my practices to spend more time with my young family. I did not want to exit clinical work entirely but wanted to regain control of my schedule in hopes of seeing more kid baseball games and planning trips to amusement parks. So, I became a relief veterinarian. Was I in for a surprise. I placed a small classified ad in the state veterinary society magazine and, before I knew it, I had more relief gigs than I could handle. I soon discovered that relief veterinary work is a great way to earn a living. But to prosper and avoid big problems, you must be smart.

The significance of a relief service contract

Plenty of relief veterinarians think gig worker status is based on a simple arrangement between the veterinarian offering occasional services and the clinic that responds. Legally, 4 parties are involved, and each has its own interest. Of course, there are the relief veterinarian and the clinic owner—the former wanting the highest price per shift, and the latter the lowest possible cost per day for the services.

But 2 other partners—the Internal Revenue Service (IRS) and state government—have perpetual needs that must be recognized and satisfied. Both want the same thing from the relief doctor and the clinic owner: regulatory compliance.

I quickly recognized during my brief gig career that perhaps the only way to satisfy all 4 parties was to have a written contract between the relief provider and the clinic for which the veterinary work would be done. Consider these risks of not formalizing the relief services relationship in this way.

Unless the relief practitioner requests and receives payment at the end of each shift, there is an underlying risk that a clinic may later neglect or refuse to pay for past services. This is particularly likely if there has been a misunderstanding (unintentional or not) about work schedule, pay rate, or whether lunchtime is compensated. Sometimes, the practice owner runs short on money. Without a written service agreement, such disputes end up in court, possibly leaving the gig veterinarian on the losing side.

In the absence of a written agreement, unanticipated disputes can arise regarding whether commuting time is included in the provider’s hourly rate calculation and whether a fee will be charged for mileage (and the amount per mile). Does the relief veterinarian get paid hourly to make phone calls at the end of a shift, or does payment cease at the end of the final appointment? All these questions can be resolved in advance with a well-crafted relief contract.

Relief veterinarians play a vital role in clinic scheduling. They enable owners to take personal time, and they soften the blow when an associate is on family leave or exits the hospital unexpectedly. No clinic owner wants to sour a relationship with a good, reliable relief veterinarian. But in the absence of a clear contract, the relief doctor/clinic owner relationship can suffer as unanticipated disagreements arise.

Sometimes hourly per diem veterinarians linger long after office appointments end, making more and longer phone calls on the clock than the practice owner feels are necessary. Occasionally the owner or medical director can attempt to micromanage cases being handled by the fill-in veterinarian. I have seen instances where a practice and per diem doctors clash over dress (too casual?), footwear (slip and fall/Occupational Safety and Health Administration violation risk?), and even inappropriate lunch hour sunbathing between morning and afternoon appointments. Relief contracts can address any such issues from the outset of the worker-owner relationship.

The IRS is interested in your contract—or lack thereof

The IRS loves employees—independent contractors, not so much. In fact, the agency considers everybody not an owner to be an employee until proved otherwise. If a relief veterinarian wants to carry out services as an independent contractor, it means an obligation to demonstrate that they are not an employee under law. With a solid written relief services contract that fully describes the business relationship, this obligation is much easier to satisfy.

The contract terms help clarify reasons relief veterinarians may appropriately consider themselves nonemployees. The IRS prefers individuals to be considered employees because the agency tends to get its withholding money from each paycheck right away, before the worker ever gets paid. The same goes for the worker’s required Federal Insurance Contributions Act (FICA) and Medicare contributions.

Independent contractors, on the other hand, generally receive payment for services in lump sums without any immediate withholding. Rather, they are charged with meeting several tax compliance obligations, including making estimated tax payments. The federal government doesn’t like having to risk chasing down independent contractors who sometimes spend funds owed to Treasury or Social Security Administration.

Therefore, if a relief veterinarian pursues a gig career without strictly adhering to the characteristics of an independent contractor, the federal government may and can impose financial penalties against him and any clinic that inappropriately failed to withhold and remit taxes, FICA contributions, and Medicare payments from the relief veterinarian’s earnings.

However, clarifying language can be included in a relief contract to reinforce the notion that the occasional worker is indeed an independent contractor. This includes clear statements explaining how the job was obtained, whether the worker is paid commission (aka production), whether services are provided on the same schedule each week, and whether the worker provides their own instruments and equipment. (For more detailed information about the characteristics of an “independent contractor,” refer to 

 per www.irs.gov/pub/irs-pdf/fss8.pdf to provide guidance.)

The existence of a written agreement between a per diem or shift veterinarian and a clinic is persuasive if IRS seeks details of the relief client/contractor relationship.

Naturally, state tax authorities are interested in the “contractor or employee” nature of a relief veterinarian in states that have an income tax. But even states like Florida and Texas, which do not have income tax, want to know who in the work relationship is tasked with providing regulatory compliance over the worker/owner arrangement.

If you are an employee, your boss is charged with making sure you are covered by a workers’ compensation policy. In the absence of a relief contract, that issue may be neglected, with the owner later discovering that failure to cover the per diem doctor constituted a violation of the law.

The same problem exists regarding statutory unemployment insurance filing and remittance laws. And don’t forget about legally required disability insurance payments.

Written relief contracts are good insurance

The general rule I recommend that relief veterinarians follow is this: If you are doing a limited amount of relief work, request that your employer pay you according to a written contract, but as an employee, not an independent contractor. The contract will cover the items that could otherwise result in a disagreement, but the W-2 worker status will keep everyone paying and reporting to the federal, state, and municipal governments as they should.

I suggest that for veterinarians making gig work a primary occupation, a contract also be used, but that it additionally include as much detail as possible to support the argument that independent contractor status—if sought—is firmly supported in writing and with formality.

Christopher J. Allen, DVM, JD, is the president of Associates in Veterinary Law, PC, which provides legal and consulting services exclusively to veterinarians. He can be reached at info@veterinarylaw.com. Allen serves on the dvm360® Editorial Advisory Board.

One veterinarian shares the ins and outs of relief work, plus what to look for in your contract agreement.

Relief veterinary work: What you need to know

Being a veterinarian can seem like an impossible job most days. Who else juggles being a dentist, dermatologist, orthopedic specialist, cardiologist, surgeon, oncologist, radiologist, and mind reader to a patient that can’t talk?

Veterinarians tend to be honest, caring, selfless, hardworking, and creative problem solvers (think James Herriot), but many of us have sky-high debt and constantly face pushback from clients about the costs of specialized care. Pet owners want it all, but they do not want it to cost too much.

Although the coronavirus disease 2019 (COVID-19) pandemic has only added to these challenges, it presents a unique opportunity for us to improve our boundary setting and our people-pleasing natures, gain perspective on what we can and cannot control, and take care of ourselves so we can take care of others.

With people spending more time at home with their pets, the human-animal bond is stronger than ever, making the service we provide essential. The work we do benefits the mental health of our human clients just as much as it does the physical health of our patients.

If you or your team members are suffering from compassion fatigue during these unprecedented times, tap these 5 useful strategies to help everyone come out on top.

Investing in your well-being has never been more crucial. Try to find an activity that refreshes you. I have found a 2- to 5-minute meditation first thing in the morning very helpful (the Calm app is great). If meditation does not appeal, I have also found leisure reading (not the internet, and not about COVID-19) calming. Online exercise classes or even a morning walk or jog can be incredibly mind-clearing. Whatever you choose, make sure it is something you can maintain. Create a routine and follow it daily. Remember, you have to put the oxygen mask on yourself before you can help others. Self-care is not selfish; it is necessary.

Compassion fatigue may look different during the pandemic. For example, your team may be manifesting it in new ways such as making mistakes, being more withdrawn, or having problems focusing and staying on task. Pay attention to all signs of isolation, anxiety, and stress. 

As leaders, veterinarians should regularly check on their teams and maintain open communication. A simple “Hey, are you having a rough day?” goes a long way.

COVID-19 significantly affects our clients as well. Many are experiencing financial strain, hindering their ability to pay for veterinary care. Some clients are delaying elective items and other less urgent services. Acknowledging that clients are coping with their own anxiety and stress helps us not to absorb all the responsibility for things beyond our control.

. Telehealth has become an increasingly popular platform during the pandemic. Not only did it allow us to continue providing quality care to patients, but it has increased client loyalty. I like to think of telemedicine as a client gratitude builder during COVID-19 and suspect the trend will continue far beyond the pandemic. It is also important to note that placing value on our services and receiving income for client-driven telemedicine consults is beneficial to our profession. Telemedicine helps us set appropriate boundaries with clients and to stop giving away our time and expertise for free.

Additionally, clients love participating in their pets’ appointments and are so appreciative when they are able to watch the examination.

 We have fully transitioned to inpatient drop-off and curbside protocols, and it appears we will not be doing otherwise anytime soon. Many veterinarians are discussing ways to maintain curbside protocols beyond the pandemic.

Although curbside care has inconveniences, such as a lot of walking between the office and parking lot, it can also streamline workflow and reduce stress. Using telemedicine to connect with clients during curbside appointments has been exceedingly helpful. Utilizing a videoconference app (my practice uses 

) to take a history, ask questions, and perform an examination in front of the client is far more efficient and less time-consuming than going back and forth on the phone throughout the curbside appointment. It has also helped our new clients to feel connected to the appointment, even though they are parked outside.

 I have developed the following internal mantra during COVID-19: I can do anything for a short time. That needs repeating. I can do anything for a short time. This mantra reminds me that the pandemic will eventually pass, and when it does, I believe our teams and practices will be stronger and more committed than ever.

Amy C. Garrou, DVM, is Medical Director at Washington Heights Veterinary Clinic in Houston, TX. Her areas of interest include internal medicine, endocrinology, soft tissue surgery, cardiology, and telemedicine. She is a member of the American Veterinary Medical Association, the Texas Veterinary Medical Association, the Harris County Veterinary Medical Association, the Veterinary Information Network, and the International Association of Veterinary Pain Management. She serves on the board of the Houston Zoo, YPO (formerly Young Presidents’ Organization), Gulf States Chapter, and the Harris County Veterinary Medical Association.

One veterinarian offers advice on coping with pandemic pressures while strengthening well-being among team members.

5 strategies to help avoid compassion fatigue during COVID-19

A new year can mean a new you and a better team, but I challenge you to take a long hard look in the mirror at the biggest roadblock and the biggest opportunity: you. That’s right, it’s 

 who can get the most out of your team. Here are five things to get you pumped for a great year as a veterinary practice manager and, more important, empower your staff to have their best year, too.

Your perspective on everything from normal, everyday stuff to big yearlong plans really sets the tone for the rest of the team. I am far from perfect, but I try to start every day with a fresh outlook and an “I can conquer anything” approach. This rubs off on the team and before you know it’s New Year’s Eve again and everyone’s exhausted from a crazy holiday season but still laughing and having a good time. Hang onto your hopeful perspective—you’ll help keep everyone else excited to try their best to break records.

Step 2: Give team members the tools they need

Each person on your team marches to the beat of their own drum. It’s your job to figure out what makes them tick. The tools that you give Jenna may be completely different than the tools you give Brandon. Jenna may be a visual learner. Brandon may be a list maker. A great manager can really consider each team member and give them what they need to excel. (If you’re not sure, it never hurts to ask.)

This does not mean yell, yell, yell or preach, preach, preach or poke, poke, poke. Coaching is far more productive and less annoying. Go back to the way each team member ticks. Some of them thrive on words of affirmation. Some of them appreciate more responsibility and autonomy. Others are rock-solid with current procedures but need to be walked through a process four times before they nail it. Patience and understanding are key!

Terrible day? Nothing went right? One person quit? All the rooms waited a minimum of 30 minutes past their appointment time? Two team members were crying? It’s happened to all of us, so you’re in good company—but don’t shift the blame onto team members or bosses or clients. The first place to look after a day like this is in the mirror, not to beat up on yourself, but to consider what else you can do, what’s in your power. Ask yourself:

 Have you given your team the tools to be successful in their jobs?

 Is everyone in the right seat on your proverbial bus, or are you trying to shove a round peg into a square hole?

Self-reflection before, during and at the end of workdays is a surefire way to improve your emotional intelligence and help you be more proactive, and less reactive, so you don’t take all the craziness of a bad day personally. This is all about how you can position your team and yourself better to achieve success and not have to endure days like this. Take the emotions out of it and think these things through.

Nothing was given to me as I was moving my way into management. So much energy was lost in scratching, clawing and crying to get where I am today. So, don’t do that: Share and share freely. Don’t play mean-girl games; coach team members, and give them the tools to not make the same mistakes again.

Take ownership of your actions—good and bad. Your team is depending on you. This could be your best year yet, but I suggest taking a moment to look in the mirror at the person who will make that happen.

Emily Shiver, CVPM, is practice manager at Cleveland Heights Animal Hospital in Lakeland, Florida.

If you want more out of your veterinary team, look to what you can do, not what you’ve decided they can’t do.

Want more from your team? Look in the mirror

 speaker and dvm360.com contributor Bash Halow pitched us this somewhat imaginary interaction with a real-ish veterinary practice owner with some very real advice from a smart Canadian economist. We accepted it. Enjoy.)

Hi, dvm360! It's Bash. I hate to bother you, but I've gotten myself into a shouting match with a veterinarian, and I'm hoping you can get a fancy Canadian economist on the line to tell the doctor that I'm right and she's wrong.

Her name is Dr. Claudine Pickle (not really), and she owns Kaiserville Veterinary Clinic, a practice with annual gross revenue of $3.1 million.

Dr. Pickle spends $13,000 a year on advertising. When I ask her where all that money goes, she puts down her half-eaten PB&J sandwich on an exam table and makes some whirling gestures with her hand in the air: “Oh, I don't know,” she says wearily. “The high school hits me up to buy the back page cover of their sports program. I need to spend something on Yelp and on Google Ads. Don't ask me what it's for-I don't know. Can you let me eat in peace? You were cute in that 

Well, I went digging. The practice has been terrible in tracking how clients find them, and while the Google ad is showing some clicks, it turns out many of the calls that come from the ad are from existing clients inquiring about the practice's hours or address.

After Dr. Pickle swallows her last bite of sandwich, I hit her up before she can sneak away.

“Look, I've done some investigating,” I say. “I don't think your advertising dollars are working to bring in new clients, and I have an idea on how you can improve.”

“Wonderful,” she says, digging some bread out of her teeth. “Can't wait to hear it.”

Undeterred by her eye-rolling tone, I run my thoughts past her: “Since we're already budgeting $13,000 for advertising that doesn't appear to be working, what if we use it as credit for hard-up clients who are experiencing a pet emergency but who are low on funds instead? Not everyone will default-and actually when you think about it, the cost of the default to the practice is actually much less than the amount of credit you extend. Plus, the goodwill you buy from grateful clients who pay their bill in full, the reviews they'll put online, and the word-of-mouth your kindness will generate will make the investment worthwhile.”

Dr. Pickle pops two aspirin and polishes off what's left in her Diet Coke can. After a beat or two, she says flatly, “And you get paid for this kind of advice, huh?”

Hey, dvm360 team, please help me get an economist on the line and see if he'll tell her I'm right.

Darren Osborne, director of economic research for the Ontario Veterinary Medical Association, responds

In my experience, most advertising does not pay. Google ads work in the right place, but if you're up against corporate practices or anyone with any kind of internet savvy, you'll fail. According to my data, most new clients come from word-of-mouth referrals.

But let's assume the $13,000 is misspent, and we can allocate $13,000 to a program that will improve the practice.

The idea of offering credit is one option to grow the practice. By extending credit to clients who need it, you can grow the practice by doing procedures you otherwise would not be doing, and you'll get referrals from new clients who tell everyone their story.

Financially, I don't think you'll lose. In general practice, emergency work is “found” money, and most of the revenue goes to net. Let's consider this thought experiment:

$1,000 fee charged to client for the procedure

$230 production-based pay to the veterinarian

I won't consider other costs (salaries, heating, rent, equipment rental, etc.), which are already sunk.

So, let's start with that $13,000 cushion when there's a default. To be fair, we should top up the fund with all the “found money” from procedures where the clients pay a bill in full. If the client pays the $1,000 bill, put $590 back into the $13,000 fund or, to keep things simple, let's just put half of the bill in.

Even if every other client defaults, you'll still make money and the fund will grow.

But this is financial theory and probably a nonstarter for most veterinary practice owners. If you 

 get a lot of defaulters, most practice owners will freak out and pull the plug on the program. Management might also question how effective referrals are from pet owners who can't afford emergency care.

I know you didn't ask for alternatives, but what if you spend the $13,000 to improve your customer service instead? As I said at the outset, the No. 1 way that clients find out about veterinary hospitals is by positive word-of-mouth. If your whole team can improve the client experience, the clients on the receiving end of that care will surely share their service story with other pet owners they know and you'll draw more people into your place for care.

Bash Halow, LVT, CVPM, is a practice consultant and owner of Halow Consulting. (Editor's note: Yes, he comes up with this stuff off the top of his head.)

I had a crazy idea to put your veterinary practice advertising dollars somewhere else, but I gut-checked myself with an economist first.

Here's a crazy idea: Stop advertising so you can give away veterinary care

 djoronimo/stock.adobe.comI recently saw a job ad on Facebook for a full-time veterinarian. The ad claimed that the veterinarian would work 32 hours a week, four days a week. A skeptic had commented below the ad post: “Nice job, advertisement. It's a nice thought, but we all know that veterinarians don't actually work eight hours a day when scheduled … we almost always go overtime.”

	That skeptic had a point. You know the deal. Your four days turn into five days, because you come in on your day off to catch up on notes or check up on a patient. Then your 32 hours turn into 40 hours and possibly even 50 when you stay a couple hours behind to finish an appointment or come in early to prep for surgery. Is that a problem?

	Henry Ford was one of the first employers to implement the eight-hour workday during the Industrial Revolution. Prior to the 20th century, it was common for workers to put in 12 or more hours a day, perhaps six or seven days a week.

	The truth of the matter is, there was no science behind his decision-he just thought it was a good idea and made business sense. After he shortened the workday, employee productivity soared and the company's profit margins doubled. What's wrong with that? Let me tell you.

	I personally understood the importance of reducing my hours at work when I realized it could be making me dumber. A 2009 study concluded that 

working longer hours was associated with lower scores on cognitive performance tests.

 In other words, you are literally working your employees stupid.

	All jokes aside, I just realized that I didn't have enough recovery time from the cognitive and physical stress of work. I would occasionally get emotional hangovers after working some intense cases, where I literally needed to sleep all day after the end of my work week just to feel rested. The research and knowledge I've gained around the need for recovery did stem from what I learned about how traumatic stress affects the body. 

	Being an avid runner as well, I know that there are days where I absolutely cannot run if I am recovering from a tough muscular workout. There are tactics I can employ that might speed up my recovery, but I still need time to recover. It doesn't mean I don't love my job, or that I don't love running. It just means I have to be realistic about how much I can do effectively. As a relief veterinarian (and “elder” millennial), having the freedom to play around with my schedule allowed me to figure out what works best for me.

		Millennials get a bad rap for being quick to jump from one job to another, or for wanting too much pay, and not wanting to work. But in actuality, maybe it's just that millennials are trying to figure out how they can find their place in the working world 

 led by research and consulting firm Millennial Branding found that 45% of millennials prioritize workplace flexibility over pay when choosing an employer. And if they're unhappy, millennials are faster to leave for greener pastures than older generations of workers-leaving employers with expensive turnover costs.

	I usually work on average 20 hours a week in clinics. I also balance my clinical work with the work I do with the 

, public speaking and writing, which usually adds anywhere from eight to 10 hours a week.

	On average, I work a 30-hour work week. The flexibility factor is great, and not having a consecutive set of hours is helpful. In clinics where the hours are consecutive-sometimes even a 12- or 14-hour shift on a crazy day in the ER-I still feel they're manageable enough for adequate recovery time so that when I show up to my next shift, I am consistently functioning at an optimum level. The rest of my time is spent sleeping, running, hiking, traveling and spending time with family and friends. I can happily say that I have great work-life balance. If you still think work-life balance doesn't exist, you may need to re-evaluate how you're using your time.

Make the necessary changes for your overall wellbeing

	I'm not arguing that everyone should be doing what I'm doing or the way I'm doing it. I'm just suggesting that we need to start discuss ways to make time for hard work, but also full recovery from that hard work. Whether this shift comes from an attentive boss, a forward-thinking practice manager or you personally, it's worth considering. Perhaps as it did in the days of Henry Ford, reconsidering the workday may actually lead to greener pastures, and this may be a slice of history worth repeating.

 speaker Dr. Hilal Dogan, a certified clinical trauma professional, practices medicine in Denver, Colorado. She started the 

 as a senior veterinary student at Massey University in New Zealand.

It might sound crazy, but research shows that overworking could affect your brain. If you and your team are working 40-hour plus weeks, it might be time make some adjustments. 

Are you working your veterinary team stupid?

A few months ago, I saw a shocking post on Facebook about a relief veterinarian who stole another veterinarian's identity and used it to obtain controlled medications to feed her drug addiction. According to the post, this veterinarian was also caught forging checks and practicing medicine far below the standard of care. In fact, her license had actually expired. So this doctor was breaking a lot of laws and practicing bad medicine, and you mean to tell me that her colleagues and manager never suspected a thing until the damage was already done?

	Most of us veterinarians are a skeptical bunch. It might take us years before we trust the safety and efficacy of a new drug or method of treatment for our patients. So, why do we trust anyone working in our hospitals without sufficient background checks and vetting? Are we so desperate for warm bodies to shoulder the load that we're willing to risk our businesses that way? That should go against our nature as a group.

	Here are a few best practices I've developed at my staffing company for hiring associate doctors. Hopefully, they'll help improve your own hiring techniques.

		10 questions our staffing agency asks every associate every time

				How would you make a great first impression to the hospital team and clients during your first shift at a hospital?

				Describe a time when you had to follow up with a case that was not originally yours. How did you become familiar with the case, and how did you make the pet owner feel like the care was seamless among different veterinarians?

				What if the medical record-keeping was less than ideal when the patient was originally seen? How would you handle a situation like that?

				Can you describe a time when you were working in a hospital that initially (or continually) did not have an ideal medication that you wanted? How did you respond to the situation moving forward?

				As a relief veterinarian, you may only work at a practice for one day. How would you ensure that the veterinarians who come after you know exactly what you did for that animal that day?

				Did you ever need to modify your pain control protocol because a hospital where you practiced didn't carry a specific drug? How did you modify your protocol for this?

				What's important to you when choosing an appropriate analgesic for acute and chronic musculoskeletal or neurologic pain in a dog or a cat?

				What do you need to perform anesthesia on an animal to provide appropriate analgesia, sedation and monitoring?

				What have you found is most important to discuss with owners and recommend for their pets during annual examinations?

				How do you communicate with an owner prior to euthanizing their pet?

	Everything starts with a face-to-face interview. You can always begin with a phone screen, but there's nothing like sitting across from a veterinarian and asking the right questions.

	Our in-person interviews take about an hour, and, in addition to asking each candidate about themselves, we ask them questions about behavior medicine, pain management, anesthetics, preventive medicine and euthanasia. Some other areas we assess during the interview are professionalism, timeliness and ability to act under pressure. Timeliness is important for our business model. Our reputation is based on our ability to be reliable and roll with the punches at any given practice we partner with.

	It's critical to get feedback from previous employers and colleagues. It's even better when you can use your network to find people who know the person you're interviewing instead of sticking to just the reference list. We also have a standard set of questions that we ask all references:

			Describe your experience working with the candidate.

			What does this candidate do well (strengths)?

			What does this candidate need to work on (weaknesses)?

			How would this candidate do in a veterinary practice like this one?

			Would you hire this candidate to work alongside you?

	The key is listening to the tone of the responses. We gauge the enthusiasm of each reference. Sometimes that alone can tell you more than the actual words being spoken. The reference check is where we can spot red flags about a candidate. Any non-positive responses should be reason to rethink your hire.

	We've had great interviews and then have been ghosted by candidates once we send them the link to the background check. Sometimes just going through this process can weed out candidates with questionable histories. We start with these basic questions: (1) Is this person licensed? (2) Are there any complaints to the state? Remember to check all states where your candidate worked. The background check company we use will also verify job history, calling each hospital and confirming dates of work.

	We also check educational history: Do the dates on the resume match up with what the schools tell us? You'd be surprised how often there are gaps. The last piece is a criminal background check. We look at local, county, state and federal databases. We also run against FBI databases (terrorism, child abuse, etc.). Make sure you consult with your human resources experts when reviewing background information. There are state and federal laws detailing how to handle “red flags.”

	I know requesting this type of test may feel awkward, but it's important because there are controlled drugs in your hospital. We've found that clearly identifying the reason you're testing can help reduce anxiety among interviewees. It's also important to set a clear deadline for the test to be performed.

	Additionally, we use a service that coordinates the testing and reporting through a website. Our candidates can pick a location for the testing, and we get quick results. Make sure you review the tests you're running-are you testing for marijuana, for example?-and that they comply with local, state and federal laws.

	Have you ever wondered why some hires do great in the interview but then fall apart after a few months on the job? Our candidates take personality tests. Not only does it help us with the interview process, but it can help screen out candidates we know won't be a good fit for our culture. Better yet, it helps us all understand each other so we can work together long term.

	We've developed a list of personality profiles that tend to do really well for our company. It helps to have a sense of what you want before you hire-that way you can compare results against your goals. Many companies provide these services. 

 is popular in veterinary medicine; our company uses the 

Avoid the drama by following a more approach to hiring veterinary associates and team members right the first time.

Vetted February 2021