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.