In an exclusive roundtable discussion, consultants told Veterinary Economics how doctors can hold on to talented technicians and veterinary assistants.
Marnette Falley: I want to kick off our discussion with a letter submitted to our sister magazine Firstline. The reader writes:
Karen E. Felsted
A veterinarian recently asked me, "What do we need to pay our technicians to keep them with us?" I explained that there's no dollar amount associated with retention and recruitment—technicians want to feel respected and need a chance to use their skills and receive fair compensation. Here are the tough questions I'm struggling with. How can we get more people interested in a veterinary technology degree? What are recently graduated technicians looking for in terms of wages, benefits, and so on? How do we keep technicians from leaving the field?
Debbie Allaben Gair
How would all of you answer these questions? If fair compensation and benefits are a given, what else can we do to make veterinary technology a long-term career?
Debbie Allaben Gair: The most common complaint I hear from technicians is that they aren't being used enough. Sometimes doctors don't want to use them more. Sometimes doctors just don't know how to better tap their skills. They don't know how great it could be to have a really excellent technician in their practice.
Karen E. Felsted: Veterinarians need to push every task down to the lowest-possible person who can do the task. It's just a general management rule.
Gair: Especially if we have technicians coming from a school that educates them about what they can do and how useful they can be in practice.
Felsted: If doctors are using staff members' skills, then they can see more appointments and the practice makes more money and provides better care. The whole thing ties together.
Sheila Grosdidier: Giving team members additional responsibilities sends the message, "We're confident in you. We know you can do this." Dentists use a three-part model to retain the hygienists on their teams. It's enrichment, encouragement, and enlightenment: the three E's. Enrichment makes sure their compensation and benefits are competitive. You determine this by asking for employee feedback. Encouragement means you regularly talk about team members' performance and what they can do to grow. One way to do this is an annual training plan: "This is what you're going to learn this year." Enlightenment is letting the employee share his or her knowledge with other individuals at the practice. Then the team member sees the whole picture, which imparts a sense of empowerment. Employees feel like they're choosing their own direction.
Marnette Denell Falley
This is a successful model for dentists and hygienists. It could be successful for veterinary practices, too.
Denise Tumblin: It's important to continue to add layers of responsibility. Technicians are motivated. They went to school. They're bright people, and learning doesn't stop. Ongoing training and growth opportunities help keep them excited and enthused about the profession. So give them management responsibilities. Give them teaching responsibilities. They can help other people in the practice grow, too.
Grosdidier: Technicians often say, "OK, I went to school. I need to be paid X amount." And then the doctor brings people in off the street, trains them, and pays them about the same. As long as someone can get into this profession without a college degree or certification exam, certified technicians will never get the recognition or pay they deserve, and practice owners will never get the longevity they'd like from team members. There should be a career path for unlicensed assistants that doesn't lessen the importance of licensed technicians.
Who's doing what?
Felsted: Bottom line, though: If you're a credentialed technician but you aren't as good as a noncredentialed assistant, should you be getting greater pay, greater responsibility? I don't know how you deal with that.
Of course, I like the fact that a credentialed technician has shown the initiative to go to school, put the time in, and spend the money. To me that says something. Those are traits you want.
Gair: Many practices use their technicians the way they use veterinary assistants or exam room assistants. I don't blame technicians for not wanting to work at those practices—especially if they come from a technician school that focused on what they can do and how useful they can be.
Grosdidier: And yet I feel as though we sometimes tell veterinary assistants they're not worthy—that their career path is to become licensed technicians. And I disagree with that thinking. Every team member manages specific responsibilities and all of them are valuable. Why can't there be a career path for assistants? There are tasks that don't need to be performed by licensed technicians. We should share those and pay based on team members' performance, not on the fact that they've been with the practice a certain length of time or are in a certain category.
Technicians and assistants can grow alongside one another. We don't need to say to assistants, "We're shoving you out of the lane you're in and into the technician lane because that's the only way you'll get anywhere."
Falley: So practices could have a technician path that's credentialed and a veterinary assistant career path that's noncredentialed? Wouldn't there be an overlap of skills? It seems like most of the skills could land in either job.
Gair: Skills may overlap. That's where a specific job description can be helpful. To be a team leader, an employee doesn't necessarily need to have the medical skills of a licensed technician, but he or she does need to have good skills as a people manager. Assistants and licensed technicians could be promoted to team leader.
Grosdidier: I see these job descriptions as being dynamic and evolving with the individuals. Let's say a doctor comes back from a conference with 50 ideas he or she can't wait to try. Those ideas sit on the desk because there's no one in place to help implement them. Team members can help with that, no matter what their titles.
It's as simple as looking at practice goals. How will you accomplish them? How is your team going to drive revenue, create patient services, and make sure your practice continues to grow?
Felsted: Few practices are fully staffed with technicians who can do all that.
Tumblin: But practices that have a higher technician-to-doctor ratio or assistant-to-doctor ratio have much higher production numbers.
Falley: At Veterinary Economics we estimated the number of people who graduated from veterinary technology programs in the past 15 years and compared that to the number of credentialed technicians working in practices today—and there's clearly a leak in the bucket. These are team members who've invested in this career but aren't sticking around. It seems like that group should have long-term interest and longevity. Yet they don't.
Grosdidier: Clinics are saying that shortages are because of geography. Ninety percent of technicians who start school already have a job to go back to in their hometown. That's the clinic they know. They don't have any exposure to other practices. If that job doesn't work out, then they go to nursing school or become a plumber.
We could help correct that issue with heavy recruiting in the schools. A doctor could call the school, send a flyer, go over there, and talk about all the things the practice does. Try to attract the technicians while they're in school so they know there are more practices out there.
Tumblin: But some technicians are very tied to their community. They don't want to move away. I have clients who say their staff members won't come to a CE meeting because they don't want to be away from home overnight.
Falley: From the practice owner's perspective, it's better to hire people who want a career because they're likely to be with you longer, so you maximize your investment in training and minimize your turnover costs. This new person will be a leader in your practice.
Does that practice owner need to say to team members, "Hey, here are the reasons why making this a career is good for you." When technicians come out of school, do they know they're making a career choice?
Grosdidier: One of the things that constantly comes up is portable job skills. When someone comes to a job, they want to know what will be taught and what they'll learn.
Tumblin: Then the doctor wonders, "Why should I do that? So technicians can take the skills to their next career?"
Gair: Good employees want to know that their employer believes in them, offers CE, and provides them with an environment to do a great job and feel good about the services they provide.
Tumblin: Educating employees is the cost of doing business. You need good training programs so you can ramp people up. You need to do that no matter how long you think the employee will stay.
Gair: Here's the flip side: Hold them back. Suppress your team members and then they won't stay, or if they do they're miserable and you don't want them around anyway.
Felsted: Are practices realistic about what they ask of team members? If you pay $25,000 or $30,000 a year, is it reasonable to expect people to stay forever? If you keep 20 percent of those people for more than 10 years, you should be thrilled. Even better, you could keep another 20 percent for three to five years with good training programs and strong management.
Tumblin: And folks who are stable and stay reduce stress.
Falley: What are your top recommendations to doctors on how to retain team members in general and licensed technicians specifically?
Felsted: Understand what motivates technicians and try to provide that.
Grosdidier: And it's OK to ask what motivates them.
Gair: You have to respect their wishes, needs, and abilities. Ask, "How can things be better here for you?"
Grosdidier: And provide continuing education.
Tumblin: I think we need to improve compensation.
Gair: If you push employees to be the best they can be and you provide an environment conducive to this, they'll buy into the practice emotionally and behave as if it's their own.
Grosdidier: Team members often say, "I don't know what's going on. I don't feel in on things. No one tells me where we're headed or what my role is." Why aren't we giving feedback to our teams like, "Do you know what you need to do to get a raise?"
Falley: Often we hear managers and doctors says they don't do this because there's no time.
Grosdidier: Use that time you save when you're not interviewing new team members.