What is a VTS?

It is not a new type of stereo equipment and it does not cost $600 at a car repair place.

I have gotten this question asked more often than I am comfortable with.  I was asked nearly every time I sent an email with VTS examinee in my credential line while I was in New Mexico where there was one VTS  in the state.  So shall we start from the beginning?

VTS stands for veterinary technician specialist.  There are numerous specialties now recognized internationally.  They include Emergency and Critical Care Specialty, Nutrition Specialty, Dentistry Specialty, Clinical Practice Specialty, Surgical Specialty, Anesthesia Specialty, Internal Medicine Specialty, Zoo Specialty, Behavior Specialty, Equine Specialty and Clinical Pathology Specialty.  These are all under the supervision of the North American Veterinary Technician Association.  There are technician specialists from the US, Switzerland, Australia, the UK, St. Kitts, Canada and the list goes on.

Veterinary technician specialists are the cream of the crop and have worked incredibly hard to get there.  The process of becoming a VTS is at least three years long.  Starting with obtaining the basic knowledge and time in the field requirements, these technicians have many hurdles to overcome.  These technicians have worked 3-5 years exclusively in their chosen field as a credentialed technician, mastered a skills list that would make a technical student cry, completed 50-75 case logs and several detailed case reports and proven their commitment by attending 40 plus hours of continuing education in their field.  Once they have the requirements, they submit an application and wait a grueling 3 months for acceptance to sit the exam.  Once accepted they spend every waking hour reviewing texts, journals, cases and flashcards.  They then sit for a several hour exam covering the breadth and depth of their specialty knowledge.  The fail rates on these exams have been as low as 27% in recent exams.  If VTS candidates do not pass in three attempts, they have to resubmit an application and the process starts again.

Now you ask why would anyone choose to do this?  Or perhaps how much of a pay raise would this bring?  The answer is for some technicians who are already at the top of their field they may receive no pay increase.  For others perhaps they have received a pay increase.  VT specialists are typically paid at the top of the veterinary field.  That having been said, most of the VTS I have asked have cited the clout and the professional advancement as reasoning for their choice.  It is a way to open new and amazing career paths that did not exist 10 years ago for veterinary technicians.  I have included a face book post from Louise O'Dwyer, VTS (ECC).

 Since obtaining my VTS(ECC) my life has completely changed - the company I work for promoted me from head nurse to clinical director meaning I am now responsible for running the largest emergency clinic in the UK and next week I am discussing career progression with my boss!! I have had the opportunity to lecture at IVECCS and hold a position on the EVECCS membership development committee as well as a position in the AVECCT nursing standards committee. My lecturing career goes from strength to strength and the qualification has given my the enthusiasm and knowledge to encourage others to persue a career on ECC. Most importantly of all it has allowed me to meet some wonderful new friends from the US ECC world!

Look for additional blogs regarding the time commitments, skills, triumphs and tribulations of becoming and being a VTS.

The Good Great Gap

Doctors, you get to the end of your day and wonder how on earth you are supposed to do everything you do when there is only one of you?  In most clinics, veterinary technicians and assistants outnumber the doctors.  This is the way of the world. So why do you continue to do the majority of the work?  

There are many answers for this question.  They are not trained well enough.  They are not skilled enough.  They may make a mistake.  It is easier if I do it myself.  

While, I understand the frustrations of taking an extra 10 minutes to show an assistant how to read a PCV during a busy day, that 10 minute investment can when multiplied by the 5 packed cell volumes you read in a day save you 50 minutes in a day, 250 minutes a week, 13,000 minutes in a year.  Let's face it, by training a veterinary support staffer on packed cell volumes, you could take a nice vacation to  Bali.  Perhaps no vacations are in your near future, but wouldn't it be great to get home to supper on time?

Now to take this one step further, do you train  your team with the "whys" of veterinary medicine as well as the "hows"?  Do they really only need to know what they are doing without background information?  Let's take our PCV example.  An assistant reads a PCV of 12% and hands you the results with no preamble.  It is one of many and you fail to notice the PCV in the midst of Mrs. Jone's wailing blocked cat.  At this point, you might tell me that this is why you read the packed cell volumes on your patients.  I would again challenge how you would divide your attentions between Mrs. Jone's cat and this pet.  In all likelihood, the PCV might not have been done prior to the cat's presentation and you are no further ahead.  Let's imagine instead that while showing Tracey, your assistant how to read the PCV, you teach her about proper sample sizes, clot presence and normal limits.  Tracey has run your PCV, found it to be scary low, re-examined her sample, redrawn the sample and now presents you with the results and a question, "would you mind re-examining this  anemic patient, while we place a catheter and draw blood in Mrs. Jone's cat?" 

In addition to saving time, trained technical staff can make us money.  We  saw an  AVMA study in 2007 that found that each credentialed technician in a veterinary practice increased total clinic revenues by $93,000.  Uncredentialed staff did not affect revenues significantly.  I have had many people ask me why.  I firmly believe that the knowledge gap plays a large role.  When a client asks a trained technician why should I do pre-anesthetic bloodwork, the answer is, "it can find kidney and liver abnormalities that could be dangerous during anesthesia".  Whereas an untrained team member may say, "because it is recommended".  This is what I call the Good Great Gap.  A good team member can hold a fractious cat, a great team member knows that the fractious cat has respiratory issues and may die with stressful handling. A good team member can recommend additional health care options, a great team member knows why they are recommending them.  

I firmly believe that not every practice can afford highly trained, credentialed staff, but no veterinary clinic can afford not to train the staff that they have.   

No time like the present

I was recently approached by a veterinary technician who was stuck in a situation where here current and past position were both unsatisfying.  While I have little experience with vocations outside of veterinary medicine, I feel like our profession has more than its share of people content with their sub-par situations to the point of avoiding change like the plague.  For my veterinary friends in New Mexico, we know that the plague is not so bad!  Is my advice to run for the hills if you don't like your job?  No, to the contrary, fight to make your job a source of pride and honor.  If you can honestly say, "yes, I have given this a fair try and it is still not the place for me."  then recognize that there are options you haven't considered yet.  In the case of my new found friend, she stated that her only two options were not going to work for her lifestyle and her career.  In a city of 153 listed veterinary clinics, there are more than two options.  Until you spend 25$ on resumes and postage, you will not know how many options you have.

Advice for staying put.  Look at why you are unhappy.  Devise plans to fix it.  Approach management or the owners with enough information to back up your proposed plan.

For example, you want to ensure that training is a priority.  Create a training plan and enlist those with academic drive to join you.  Approach a specialty and let management know how this can increase their clout and their profits.

For example, there are mean girls.  Approach the situation with care and tenacity.  Talk to those involved, let them know how you are feeling.  Talk to those in management, let them know how you are feeling.  Exhaust your options for mediation before you walk out on an otherwise great position.

For example, technicians are underutilized or underemployed compared to unlicensed staff.  Research your states practice requirements.  Bring these and examples of the training involved in licensure to management.  Bring to their attention any improvements in patient care that could be wrought from increasing the numbers of licensed staff and then encourage your coworkers to join the party.  Many states offer grandfathering for those with time in the field and now online schooling options make technical degrees an attainable option.

 I welcome your additions and comments.  A lively debate is great, but disrespect of fellow posters will never make your point.