Equine
Sponsored by
Taking the Pulse of the
Equine
Veterinary Industry By Amy L. Grice, VMD, MBA
BACKGROUND IMAGE: THINKSTOCK, CHART: DR. AMY GRICE
Editor’s note: The following article was written from information presented at the 2015 AAEP Convention. This article is in addition to the feature in the Spring 2016 EquiManagement magazine and other articles from that convention brought to you by Zoetis.
A
t the 61st AAEP Annual Convention, Amy Grice, VMD, MBA (this author), reported on the findings from a survey of AAEP General Listserv members that was conducted in 2014. The survey aimed to explore the perceptions that equine vets have regarding their work environment and uncover the most pressing concerns of vets with regard to their business and professional lives. The online survey drew a total of 516 respondents from the 1,520 General Listserv members, an approximately 33% response rate yielding roughly a 95% (+/- 4%) con-fidence interval. The Listserv members who responded were made up of 38.4% solo practitioners and 61.6% group practice members. There were 60.4% female and 39.6% male respondents; 44.9% graduated between 2004 and 2014, and 55.1% graduated in or before 2003.
1 EquiManagement
Solo Practitioners By examining the demographics of the AAEP membership, Grice determined that solo practitioners have remained about 71% of the all veterinary practice owners for some time. Considering that there are clear advantages
to group practice, such as economies of scale, shared responsibilities, and professional support, the survey sought to reveal reasons for the popularity of solo practice. The survey data showed that of the 185 solo practitioners responding, 75.4% had EquiManagement.com
Sponsored by
2 EquiManagement
disappointment with practice culture was the number one reason that drove them to depart.
Group Practices Of the survey responses obtained, 297 were from equine veterinarians working in group practices. Of this group, 82.2% practiced in groups with 2-6 veterinarians and 17.6% practiced in groups of seven or more veterinarians. 57.5% of these respondents were associates, and 41.4% were partners/shareholders. Grice reported that associate respondents employed at both large and small group practices valued practice culture as highly as compensation in determining their satisfaction with their position. She also reported that when associates were asked about the importance of certain factors to their satisfaction with their positions in the group practice, they answered that practice culture and compensation were the top factors, with 90.1% responding that both of these were
“Important” or “Very Important” to their job satisfaction. When associates’ responses on what factors were the important to them for job satisfaction were compared with their responses about their actual current level of satisfaction, clear discrepancies were apparent. The survey indicated that while “Compensation” was “Very important” or “Important” to 90.1% of associates, only 31.0% reported being “Extremely satisfied” or “Very satisfied” in their current position. “Culture of practice” was similarly reported as “Very important” or “Important” to 90.1% of associates, but just 49.0% reported being “Extremely satisfied” or “Very satisfied.” Clearly many of the practices where these associates worked were not providing a satisfactory culture. Grice suggested that practice owners might not have sufficient insight into this deficit; the research showed that 69.2% of partner/shareholder respondents indicated they were extremely or very satisfied with the culture of their practices.
DR. AMY GRICE
previously worked in a group practice (not including internships). Of these, 77.8% were associates and 22.2% had been owners or partners at the group practice. The survey asked the solo practitioners: “What is the primary reason you are now in solo practice?” Nearly 40% of those respondents that were formerly associates cited “Dissatisfaction with Practice Culture” as the top reason for their choice, according to Grice. Of the respondents previously employed as partners or shareholders in a group practice, almost 30% cited partner/shareholder discord as the primary reason they are now a solo practitioner. The survey also asked solo practitioners: “How important were the following factors in your decision to open your own solo equine veterinary practice” or “How important were the following factors in your decision to leave group practice and practice as a solo practitioner?” The two factors most cited as “very important” or “important” in decisions to be in solo practice were: “Desire to make your own decisions about how to practice medicine” and “Desire to have control over work schedule and life balance.” Many veterinarians made the choice to practice alone at the beginning of their careers; 24.6% of the survey respondents had never worked in any practice other than their own, except for an internship. According to survey results, they made this choice to ensure they could be in control of their work environment—making their own clinical choices, their own work schedule and their own culture. The survey respondents who had left a group practice for solo indicated that
EquiManagement.com
NO OTHER VACCINE IS MORE TESTED AND TRUSTED. 1
6 studies vs. KY14, AYR13, TX127
vs. RIC076 vs. KY075
2 studies
vs. PA074 vs. OH033 vs. KY99, KY012
KY97 EIV* strain contained in FLUVAC INNOVATOR®
0 studies
1 study vs. CO078
RIC07 EIV strain contained in VETERA® XP
OH03 EIV strain contained in CALVENZA®-03 EIV/EHV
vs. KY98, SASK9010
vs. KY919
KY91 EIV strain contained in FLU AVERT® I.N.
MAKE SURE YOUR EQUINE INFLUENZA VIRUS (EIV) VACCINE STACKS UP. In a recent study, FLUVAC INNOVATOR® vaccinates demonstrated at least 97.4% cross-reactivity to three recent OIE** EIV isolates: Ayrshire 2013 (Clade 2), Kentucky 2014 and Texas 2012 (Clade 1’s). These high rates of seroconversion demonstrate that FLUVAC INNOVATOR continues to be immunologically relevant against newly emerging North American Clade 1 and European Clade 2 EIV strains. When you choose the most tested and trusted vaccine to help protect your horses, you can rest easy because FLUVAC INNOVATOR is backed by the most comprehensive Equine Immunization Support Guarantee in the industry. Learn more at www.fluvacinnovator.com * Equine Influenza Virus ** World Organization for Animal Health 1 West Nile-Innovator and Fluvac Innovator MDI Sales Data as of 12/31/14. Zoetis. Dec. 2014. 2-7 Data on file, Study Report No. 671-02-001R, 671-08-004.R, 766-09-002.R, 10OREQBIO-01, 14OREQBIO-1 and 15EQRGBIO-02, Zoetis Inc. 8 Calvenza vs. CO07 ACVIM 2011 abstract reference. 9
10
adapted, intranasal, equine influenza vaccine: challenge trials. Chambers TM, Holland RE, Tudor LR, Townsend HGG, Cook A, Bogdan J, Lunn DP, Hussey S, Whitaker-Dowling P, Youngner JS, Sebring RW, Penner SJ and Stiegler GL: A new
FLU-00076
Sponsored by
Practice culture is extraordinarily important, said Grice. Because equine veterinarians typically spend so much more of their time working than they do with their families, they need that time to be meaningful, enjoyable and productive. Practice owners are the leaders of their practice, and the behaviors they model become the practice culture, Grice said. If the owners communicate poorly or avoid conflict, culture suffers. If revenue production and long hours are the only things highly valued by the owners, the culture will reflect this, Grice continued. If the practice lurches reactively from crisis to crisis, and the staff has little understanding of how their work fits into the overall goals of the organization, the culture will suffer. In contrast, when a practice’s team understands the shared objectives, when the leaders are decisive as well as inclusive, and when employees understand their roles and are engaged in the work, the organization has a strong culture. These practices typically reach their strategic objectives, retain staff, and enjoy greater satisfaction in the work, according to Grice.
Control and Choice It’s no secret that many equine veterinarians are considered to have Type A personalities, Grice continued. Many are also workaholics, and they tend to have a high need for control. Interestingly, most researchers now believe that Type A personality characteristics are more of a reaction to environmental factors and are influenced by culture, and by jobs that put heavy demands on time, put heavy penalties on mistakes, create stress, or attract people with a natural tendency toward being more intense and achievement oriented, she said. The respondents favored responses that maximized their control of their practice experience, reported Grice. All of the respondent veterinarians highly valued having the ability to make their own decisions about how to practice clinically, she said, and the majority were satisfied by their actual experience in this regard. It seems that most veterinary practices have wide leeway in allowing their doctors to practice as they see fit. However, Grice shared 4 EquiManagement
THINKSTOCK
Culture
that “Management decisions” were cited more than any other stressor by associate survey respondents as a cause of extreme stress. She recommended allowing associates as much choice as possible and including them in decision making, in order to help them feel more positive about their job and their duties. Having the control to make choices about how to spend their time is a key factor in the happiness of most people, said Grice, and the responses to this survey indicated that many respondents felt dissatisfied in this regard. Global surveys of younger workers have shown that what Millennials want most is flexibility in where, when and how they work, she shared.
Work Life Balance AAEP Listserve Member survey respondents working in group practices cited life balance as the aspect of their position that made them the most dissatisfied, said Grice. Difficulty in achieving work life balance often relates to the demands of equine practice with its seasonality, the need to provide emergency services, and the pervasive culture of not establishing boundaries on work hours or days. Horse owners or others in the equine industry have responsibility for horses 24/7/365 and they expect no less of a commitment from their veterinarian. These factors can fuel a sense that control is not attainable, she stated. Grice indicated that a persistent lack of control in a person’s life often leads to depression and anxiety. Anything that makes one feel helpless and lacking fundamental
control over one’s surroundings can have a negative impact. Conversely, gaining more control of their surroundings makes a person more content and less at risk, she said. Veterinarians are often seriously affected by the lack of control in their lives. Grice cited the February 2015 Center for Disease Control’s report that over 10% of practitioners reported having serious psychological distress, and one in six veterinarians has considered suicide since their graduation from veterinary school. She recommended that practice owners engage in collaborative decision making whenever possible, provide flexible scheduling, minimize competition between doctors, and foster a culture that embraces a balanced life, led by example. Mitigation of the stress caused by the often-thwarted need for control lies in having choices, she stated.
Conclusion According to Grice, several broad themes emerged from the results of this survey: the importance of practice culture; the importance of control and choice; and the degree of stress due to poor work life balance in the profession. Strategies are needed to address these challenges, and the information gained by this study is important to all stakeholders in the equine veterinary industry. Although emotions surrounding these issues can be strong, Dr. Grice stated that it is in the best interest of all practitioners to work together to improve the experience of equine practice. EquiManagement.com
Taking the Pulse of the
Equine
Veterinary Industry By Amy L. Grice, VMD, MBA
BACKGROUND IMAGE: THINKSTOCK, CHART: DR. AMY GRICE
Editor’s note: The following article was written from information presented at the 2015 AAEP Convention. This article is in addition to the feature in the Spring 2016 EquiManagement magazine and other articles from that convention brought to you by Zoetis.
A
t the 61st AAEP Annual Convention, Amy Grice, VMD, MBA (this author), reported on the findings from a survey of AAEP General Listserv members that was conducted in 2014. The survey aimed to explore the perceptions that equine vets have regarding their work environment and uncover the most pressing concerns of vets with regard to their business and professional lives. The online survey drew a total of 516 respondents from the 1,520 General Listserv members, an approximately 33% response rate yielding roughly a 95% (+/- 4%) con-fidence interval. The Listserv members who responded were made up of 38.4% solo practitioners and 61.6% group practice members. There were 60.4% female and 39.6% male respondents; 44.9% graduated between 2004 and 2014, and 55.1% graduated in or before 2003.
1 EquiManagement
Solo Practitioners By examining the demographics of the AAEP membership, Grice determined that solo practitioners have remained about 71% of the all veterinary practice owners for some time. Considering that there are clear advantages
to group practice, such as economies of scale, shared responsibilities, and professional support, the survey sought to reveal reasons for the popularity of solo practice. The survey data showed that of the 185 solo practitioners responding, 75.4% had EquiManagement.com
Sponsored by
2 EquiManagement
disappointment with practice culture was the number one reason that drove them to depart.
Group Practices Of the survey responses obtained, 297 were from equine veterinarians working in group practices. Of this group, 82.2% practiced in groups with 2-6 veterinarians and 17.6% practiced in groups of seven or more veterinarians. 57.5% of these respondents were associates, and 41.4% were partners/shareholders. Grice reported that associate respondents employed at both large and small group practices valued practice culture as highly as compensation in determining their satisfaction with their position. She also reported that when associates were asked about the importance of certain factors to their satisfaction with their positions in the group practice, they answered that practice culture and compensation were the top factors, with 90.1% responding that both of these were
“Important” or “Very Important” to their job satisfaction. When associates’ responses on what factors were the important to them for job satisfaction were compared with their responses about their actual current level of satisfaction, clear discrepancies were apparent. The survey indicated that while “Compensation” was “Very important” or “Important” to 90.1% of associates, only 31.0% reported being “Extremely satisfied” or “Very satisfied” in their current position. “Culture of practice” was similarly reported as “Very important” or “Important” to 90.1% of associates, but just 49.0% reported being “Extremely satisfied” or “Very satisfied.” Clearly many of the practices where these associates worked were not providing a satisfactory culture. Grice suggested that practice owners might not have sufficient insight into this deficit; the research showed that 69.2% of partner/shareholder respondents indicated they were extremely or very satisfied with the culture of their practices.
DR. AMY GRICE
previously worked in a group practice (not including internships). Of these, 77.8% were associates and 22.2% had been owners or partners at the group practice. The survey asked the solo practitioners: “What is the primary reason you are now in solo practice?” Nearly 40% of those respondents that were formerly associates cited “Dissatisfaction with Practice Culture” as the top reason for their choice, according to Grice. Of the respondents previously employed as partners or shareholders in a group practice, almost 30% cited partner/shareholder discord as the primary reason they are now a solo practitioner. The survey also asked solo practitioners: “How important were the following factors in your decision to open your own solo equine veterinary practice” or “How important were the following factors in your decision to leave group practice and practice as a solo practitioner?” The two factors most cited as “very important” or “important” in decisions to be in solo practice were: “Desire to make your own decisions about how to practice medicine” and “Desire to have control over work schedule and life balance.” Many veterinarians made the choice to practice alone at the beginning of their careers; 24.6% of the survey respondents had never worked in any practice other than their own, except for an internship. According to survey results, they made this choice to ensure they could be in control of their work environment—making their own clinical choices, their own work schedule and their own culture. The survey respondents who had left a group practice for solo indicated that
EquiManagement.com
NO OTHER VACCINE IS MORE TESTED AND TRUSTED. 1
6 studies vs. KY14, AYR13, TX127
vs. RIC076 vs. KY075
2 studies
vs. PA074 vs. OH033 vs. KY99, KY012
KY97 EIV* strain contained in FLUVAC INNOVATOR®
0 studies
1 study vs. CO078
RIC07 EIV strain contained in VETERA® XP
OH03 EIV strain contained in CALVENZA®-03 EIV/EHV
vs. KY98, SASK9010
vs. KY919
KY91 EIV strain contained in FLU AVERT® I.N.
MAKE SURE YOUR EQUINE INFLUENZA VIRUS (EIV) VACCINE STACKS UP. In a recent study, FLUVAC INNOVATOR® vaccinates demonstrated at least 97.4% cross-reactivity to three recent OIE** EIV isolates: Ayrshire 2013 (Clade 2), Kentucky 2014 and Texas 2012 (Clade 1’s). These high rates of seroconversion demonstrate that FLUVAC INNOVATOR continues to be immunologically relevant against newly emerging North American Clade 1 and European Clade 2 EIV strains. When you choose the most tested and trusted vaccine to help protect your horses, you can rest easy because FLUVAC INNOVATOR is backed by the most comprehensive Equine Immunization Support Guarantee in the industry. Learn more at www.fluvacinnovator.com * Equine Influenza Virus ** World Organization for Animal Health 1 West Nile-Innovator and Fluvac Innovator MDI Sales Data as of 12/31/14. Zoetis. Dec. 2014. 2-7 Data on file, Study Report No. 671-02-001R, 671-08-004.R, 766-09-002.R, 10OREQBIO-01, 14OREQBIO-1 and 15EQRGBIO-02, Zoetis Inc. 8 Calvenza vs. CO07 ACVIM 2011 abstract reference. 9
10
adapted, intranasal, equine influenza vaccine: challenge trials. Chambers TM, Holland RE, Tudor LR, Townsend HGG, Cook A, Bogdan J, Lunn DP, Hussey S, Whitaker-Dowling P, Youngner JS, Sebring RW, Penner SJ and Stiegler GL: A new
FLU-00076
Sponsored by
Practice culture is extraordinarily important, said Grice. Because equine veterinarians typically spend so much more of their time working than they do with their families, they need that time to be meaningful, enjoyable and productive. Practice owners are the leaders of their practice, and the behaviors they model become the practice culture, Grice said. If the owners communicate poorly or avoid conflict, culture suffers. If revenue production and long hours are the only things highly valued by the owners, the culture will reflect this, Grice continued. If the practice lurches reactively from crisis to crisis, and the staff has little understanding of how their work fits into the overall goals of the organization, the culture will suffer. In contrast, when a practice’s team understands the shared objectives, when the leaders are decisive as well as inclusive, and when employees understand their roles and are engaged in the work, the organization has a strong culture. These practices typically reach their strategic objectives, retain staff, and enjoy greater satisfaction in the work, according to Grice.
Control and Choice It’s no secret that many equine veterinarians are considered to have Type A personalities, Grice continued. Many are also workaholics, and they tend to have a high need for control. Interestingly, most researchers now believe that Type A personality characteristics are more of a reaction to environmental factors and are influenced by culture, and by jobs that put heavy demands on time, put heavy penalties on mistakes, create stress, or attract people with a natural tendency toward being more intense and achievement oriented, she said. The respondents favored responses that maximized their control of their practice experience, reported Grice. All of the respondent veterinarians highly valued having the ability to make their own decisions about how to practice clinically, she said, and the majority were satisfied by their actual experience in this regard. It seems that most veterinary practices have wide leeway in allowing their doctors to practice as they see fit. However, Grice shared 4 EquiManagement
THINKSTOCK
Culture
that “Management decisions” were cited more than any other stressor by associate survey respondents as a cause of extreme stress. She recommended allowing associates as much choice as possible and including them in decision making, in order to help them feel more positive about their job and their duties. Having the control to make choices about how to spend their time is a key factor in the happiness of most people, said Grice, and the responses to this survey indicated that many respondents felt dissatisfied in this regard. Global surveys of younger workers have shown that what Millennials want most is flexibility in where, when and how they work, she shared.
Work Life Balance AAEP Listserve Member survey respondents working in group practices cited life balance as the aspect of their position that made them the most dissatisfied, said Grice. Difficulty in achieving work life balance often relates to the demands of equine practice with its seasonality, the need to provide emergency services, and the pervasive culture of not establishing boundaries on work hours or days. Horse owners or others in the equine industry have responsibility for horses 24/7/365 and they expect no less of a commitment from their veterinarian. These factors can fuel a sense that control is not attainable, she stated. Grice indicated that a persistent lack of control in a person’s life often leads to depression and anxiety. Anything that makes one feel helpless and lacking fundamental
control over one’s surroundings can have a negative impact. Conversely, gaining more control of their surroundings makes a person more content and less at risk, she said. Veterinarians are often seriously affected by the lack of control in their lives. Grice cited the February 2015 Center for Disease Control’s report that over 10% of practitioners reported having serious psychological distress, and one in six veterinarians has considered suicide since their graduation from veterinary school. She recommended that practice owners engage in collaborative decision making whenever possible, provide flexible scheduling, minimize competition between doctors, and foster a culture that embraces a balanced life, led by example. Mitigation of the stress caused by the often-thwarted need for control lies in having choices, she stated.
Conclusion According to Grice, several broad themes emerged from the results of this survey: the importance of practice culture; the importance of control and choice; and the degree of stress due to poor work life balance in the profession. Strategies are needed to address these challenges, and the information gained by this study is important to all stakeholders in the equine veterinary industry. Although emotions surrounding these issues can be strong, Dr. Grice stated that it is in the best interest of all practitioners to work together to improve the experience of equine practice. EquiManagement.com
