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Teacher or technician: exploring the DVM's changing role
Like it or not, lay people can learn to competently perform many routine tasks.
A few weeks ago I participated in the management team meeting of a dairy customer. The attending herd veterinarian also was there. We were on the topic of dry cow rations, and the attending veterinarian made the following comment: "I guess the dry cow rations aren't too far off. I haven't done any displacements here in the past few weeks."
Farm staff started exchanging looks. After a few moments, the manager spoke: "We have a confession to make. We actually have been seeing a few displacements, and we have been toggling them ourselves." The attending veterinarian exclaimed with obvious irritation, "Well, I hope you don't expect me to salvage your wrecks or come out and do one on a Saturday when most of your staff are off!"
I'm sure many of you have had similar experiences. As herds get larger, lay staff carries out many of the duties performed by veterinarians. Many farms now do their own pregnancy exams, with or without ultrasound. This trend is most pronounced in larger herds, but I know of a 100-head herd where the farm wife does all of the palpations and performs standing abomasopexies. Her results are good.
Like it or not, lay people can learn to competently perform many of the routine tasks that once were our responsibility. Does this mean we have no role to play? Not at all, but the role has changed. We need to be the teacher instead of the doer when our clients perceive an advantage to performing the above procedures internally.
Communication is crucial
Communication is important to attaining a positive outcome in these instances, and I suggest being pro-active about it. At your next herd check, ask clients if they have interest in doing more of the procedures that you currently perform. Most will probably decline, believing they are stretched thin enough trying to do all that is already their responsibility. These clients, however, will appreciate you for asking.
For the few clients who have an interest, you can have a more extended discussion by sharing the pros and cons of paying you to perform the procedures versus doing them with farm staff. You may make a recommendation regarding the best choice for their operation, but let them know you will support whatever decision they make. After this discussion, some will be content to stay with the status quo, but others will want to start doing some additional work on their own.
With this last group, you are now the teacher. If toggling displacements is the subject, you can schedule a time to meet with the relevant staff, and review how to accurately diagnose a displacement. You can teach what complications need to be considered. You can help them to know when toggling is not indicated. Finally, you can review the actual procedure, stressing the do's and don'ts.
This places you in the role of an ally who is trying to help them succeed rather than a disapproving authority figure from who they must keep secrets. Which role is more appealing to you?
Once a client decides to perform procedures on his or her own, there are at least three possibilities of how your role on the farm evolves. It is possible that role will simply diminish. When I was in practice, this outcome was rare.
A more common result is that clients become frustrated with their performance, and turn the job back over to you. While in practice, I saw this happen several times. The client had a new respect for my abilities after dealing with some bad outcomes, which enhanced my position of importance to the operation.
The third and most satisfying outcome was that I spent just as much time with the client and earned as much or more income, but I spent my time in a consulting role rather than a technician role. Hours previously devoted to palpating cows were now spent reviewing records, rations and protocols. Staff meetings or training sessions were on the agenda instead of three displacements. This outcome represented the true win-win scenario we should seek.
Not for every farm
While some farms want to do more procedures, others would like to do less. As I gave up palpations with some clients, I started dehorning calves or infusing pre-partum heifers for others. These farms were usually smaller operations struggling to get all the work done, and they were glad to pay me to do important procedures they simply did not get to in a timely manner.
The real key to a secure future with all of your clients is to know their needs, but more importantly, know their wants. They will make decisions based on what they want. They might want to avoid writing you a check for repairing displacements, or they might want to see their calves dehorned at an early age. They might have to rationalize to convince themselves that their wants are truly needs. Our challenge is to learn what they really want, and then be the resource that fulfills it.
Dr. Gardner is the business development manager for Agway Feed & Nutrition in eastern Pennsylvania. He also consults with dairy practitioners regarding practice management.