Two locum questions

RE: Two locum questions

pjtaylor91 — Sun, 22 Oct 2017 10:57:47 GMT

[quote user="David Mills"]

[quote user="Patrick Taylor"]

[quote user="David Mills"]

I'll try this again, as (not unexpectedly) the hackles have been raised by daring to critique locums and the insults seem to be flying.

A good practice welcomes feedback from people that give feedback within their area of (relative) expertise. Locums rarely know anything about management, the direction of a practice, or its personnel. Therefore criticising these, formally or informally, is, well, somewhat bad form. Criticising management to other members of staff is not only locum suicide, but is unprofessional and lacks any credibility.

Clinical feedback and input is welcomed, as long as it is framed constructively and not aggressively or dismissively. But it is feedback, which the practice may or may not accept. There are very rarely extreme cases of such, and the dimazon and pain relief ones I've heard before, ad nauseum.

A locum, by their nature, and relatively rich rewards, have rescinded the right to criticise the way a practice works in my view. You are there to plug a gap, so to assume that your opinion is welcomed or (ha!) sought is a triumph of ego over reality, and in the end only makes you unhappy and frustrated. The clue is in your job title - you are expected to keep a steady hand on the tiller, not revolutionise the practice. You may think you have valuable and varied experience - and you probably do - but that only matters inasmuch as it should make you clinically competent.

The latter point is a bare minimum. Given the short term nature, and the fact most are not interviewed but placed, why the prickly response to some sort of competency examination? Most practices will monitor staff through performance reviews, one to ones etc. Who monitors the locums? Or do you think you are the same, or, nay because you've jumped about a bit, above such monitoring?

[/quote]

Sounding a lot like my mother. "If you don't have something nice to say, don't say anything at all." Wise words

[/quote]

Do you have anything material to add to the debate or are you happy with your contribution thus far?

[/quote]

I agree, you shouldn't be commenting unless it's constructive. It's not the locums place. Thus the comment

RE: Two locum questions

David Mills — Sun, 22 Oct 2017 00:12:34 GMT

[quote user="Patrick Taylor"]

[quote user="David Mills"]

I'll try this again, as (not unexpectedly) the hackles have been raised by daring to critique locums and the insults seem to be flying.

[/quote]

Sounding a lot like my mother. "If you don't have something nice to say, don't say anything at all." Wise words

[/quote]

Do you have anything material to add to the debate or are you happy with your contribution thus far?

RE: Two locum questions

pjtaylor91 — Sat, 21 Oct 2017 19:58:58 GMT

[quote user="David Mills"]

I'll try this again, as (not unexpectedly) the hackles have been raised by daring to critique locums and the insults seem to be flying.

[/quote]

Sounding a lot like my mother. "If you don't have something nice to say, don't say anything at all." Wise words

RE: Two locum questions

David Mills — Sat, 21 Oct 2017 16:12:03 GMT

I'll try this again, as (not unexpectedly) the hackles have been raised by daring to critique locums and the insults seem to be flying.

RE: Two locum questions

Lindsey Edwards — Fri, 20 Oct 2017 20:36:38 GMT

[quote user="Martin Atkinson"]However, seriously I genuinely admire locums to be able to walk into a practice they are not familiar with and work within the practice protocols they may not agree with and perform from day one. It is quite an attribute,[/quote]

I locumed quite successfully (am still getting asked to do days!) for 3 years whilst I was preparing to open a new clinic and never worked under those conditions. I went in, familiarised myself with staff and diary and proceeded to be pleasant to clients whilst treating and operating as I wished to. My bugbears were a) not being able to find anything [learn never to give final plan to client without finding all drugs preferred/resorted to] and b) being asked to perform procedures I was not familiar with [learn to politely advise clients you are actually not familiar with that exact plan ,you can do it a different way or they can wait until regular/preferred option is available].

I never criticised a practitioner for their approach or asked for practice protocols or SOPs and therefore never had to go against them; on extended/repeated positions I have had open discussions about various treatment options and first line approaches but never expected myself or practice principals to change methods to conform. My first day as a locum I attempted to ask the head nurse how certain issues were handled in clinic and she looked at me quite honestly and said whatever way the vet on duty wants to, you are the professional in charge on the case whilst you have it!

RE: Two locum questions

Beats — Fri, 20 Oct 2017 19:56:10 GMT

[quote user="Francisco Gomez"]

[quote user="Gillian Mostyn"]

Lol...that's what I would enjoy..walking in, just doing the job, then walking out again. Heaven!

[/quote]

Been there. I can assure you that's not Heaven. There are things you could be strongly against, and not being able to change practice tradition because.. 'well.. we always have done it like this before & we have never had any problems' Imagine when this involves treatment of pain.

By the way,.. 'where do you guys keep the Dimazon bottle?' 'what? We don't use that'

[/quote]

I must say I rather enjoyed my, albeit fairly brief, locuming days. I found it quite refreshing. In one particularly enjoyable position I did for 3 months, I was paid the best wages I have ever had, for the least hours I have ever worked, with the least responsibility I have ever had, the least client/clinical expectation I have ever seen, and the most clinical freedom I have ever enjoyed

I particularly enjoyed not being caught up in the bureaucracy of the place and was left to just get on with doing clinical work. I could tell it was not as much fun for the permanent staff who had SOPs, appraisals, meetings, enforced tea-breaks and a culture of rehabilitating pigeons apparently.

RE: Two locum questions

Francisco Gomez — Fri, 20 Oct 2017 19:44:43 GMT

[quote user="Gillian Mostyn"]

[quote user="Francisco Gomez"]There are things you could be strongly against, and not being able to change practice tradition[/quote]

No, but you can choose not to go back.

[/quote]

True

RE: Two locum questions

Gillian Mostyn — Fri, 20 Oct 2017 19:28:09 GMT

[quote user="Francisco Gomez"]There are things you could be strongly against, and not being able to change practice tradition[/quote]

No, but you can choose not to go back.

RE: Two locum questions

Francisco Gomez — Fri, 20 Oct 2017 19:22:01 GMT

[quote user="Gillian Mostyn"]

Lol...that's what I would enjoy..walking in, just doing the job, then walking out again. Heaven!

[/quote]

By the way,.. 'where do you guys keep the Dimazon bottle?' 'what? We don't use that'

RE: Two locum questions

Gillian Mostyn — Fri, 20 Oct 2017 17:31:07 GMT

Lol...that's what I would enjoy..walking in, just doing the job, then walking out again. Heaven!

RE: Two locum questions

Martin Atkinson — Fri, 20 Oct 2017 17:26:27 GMT

[quote user="Gillian Mostyn"]One of my long term options is to start locuming, in order to get more flexibility with my time off. I wonder what the 'locum haters' would make of me!!! [/quote]Well I know I wouldn't be asked back because I just wouldn't be able to resist changing everything I didn't agree with and being rude to the bad/annoying clients. Best to stay sole charge until the day I retire/drop dead.

However, seriously I genuinely admire locums to be able to walk into a practice they are not familiar with and work within the practice protocols they may not agree with and perform from day one. It is quite an attribute,

RE: Two locum questions

Clive Ansell — Fri, 20 Oct 2017 17:11:55 GMT

[quote user="Gillian Mostyn"]One of my long term options is to start locuming, in order to get more flexibility with my time off. I wonder what the 'locum haters' would make of me!!![/quote]

Traitor. An ex practice owner who doesn't do any OOH, and no longer a martyr to the cause.

RE: Two locum questions

Gillian Mostyn — Fri, 20 Oct 2017 16:34:13 GMT

[quote user="Clive Ansell"]They didn't seem to have the first clue how private practice operated. [/quote]

Genuinely NOT having a dig at anyone in particular...but I can understand why this would be an issue. If you've always worked somewhere where the cost to the client is not your first consideration, which it unfortunately has to be in private practice, then it must be difficult to imagine how that 'works'.

For what it is worth, in my opinion I think locums may sometimes lack the managerial experience (as does anyone who hasn't done it themselves) to understand practice economics, but this is far outweighed by the knowledge they do have. I love being able to ask my locums and new staff how others do things...there is always room for improvement.

One of my long term options is to start locuming, in order to get more flexibility with my time off. I wonder what the 'locum haters' would make of me!!!

RE: Two locum questions

Martin Atkinson — Fri, 20 Oct 2017 14:52:22 GMT

[quote user="Clive Ansell"]One of the worst locums, and one of the worst working environments I have ever been in was an RSPCA clinic. I found some (not all by any means) of the veterinary staff to be dogmatic, arrogant and opinionated, in particular 2 young co-alpha males. They certainly didn't like locums, judging by the way they spoke to me, and of previous ones. That aside, they had a dislike and disdain, and were very scathing of local private practices and of local well known and respected veterinary surgeons. [/quote]So you've worked with David Mills then?

RE: Two locum questions

Clive Ansell — Fri, 20 Oct 2017 14:24:07 GMT

[quote user="Bob Russell"]We did have someone locuming for a couple of days and apparently all she did for that two days was grumble and complain because we did not have ultrasound, did not have a tonometer, did not have this, did not have that![/quote]

You'll find that most of us locums are fairly adept at being able to improvise, adapt and overcome. If you've got one, fine, if not, no worries we'll do without and find another way.

[quote user="Bob Russell"]There is no place for complaints or grumbling from a locum. If they don't like it they should talk to the person employing them. [/quote]

Exactly. If I have any issues I would speak in private with the practice owner, but it is very very rare. I have twice in 16 years had a problems with unsuitable accommodation, that was uninhabitable, being expected to sleep on the floor and no access to bath or shower.

[quote user="Bob Russell"]Just because something is done a certain way does not make it right or wrong[/quote]

Again one needs to flexible and adaptable. This is sometimes an issue with nurses who are used to a certain regime, in areas such as premeds and anaesthetics. Where I am a the moment, I tend to use Methadone a lot whereas the regular vet prefers Buphrenorphine in premeds, I like to give them on admission, the regular vet does it later on - not right, wrong, better or worse, just a different way of working.

RE: Two locum questions

Bob Russell — Fri, 20 Oct 2017 13:45:59 GMT

Constructive criticism is always welcome in a constructive way.

Just because something is done a certain way does not make it right or wrong.

We did have someone locuming for a couple of days and apparently all she did for that two days was grumble and complain because we did not have ultrasound, did not have a tonometer, did not have this, did not have that!

For our size we are very well equipped but there is no justification for a tonometer when the practice down the road has several and the expertise to deal with acute glaucoma better than I can. I could justify buying one only by using it in all sorts of routine situations to generate fee income. Not ruling it out though.

There is no place for complaints or grumbling from a locum. If they don't like it they should talk to the person employing them.

Good ideas and tips always welcome!

RE: Two locum questions

Clive Ansell — Fri, 20 Oct 2017 13:23:20 GMT

[quote user="Martin Atkinson"][quote user="Clive Ansell"] I don't drag enough back in to bag a second consult fee.[/quote]I wouldn't be going back to that practice if I was you.[/quote]

On the contrary, I've been locuming there since 2002, 6 to 8 weeks every year, and have a good working relationship. The practice has however been taken over twice this year, so will see what happens.

Because I don't work to financial targets, my alleged low C2 rate is not relevant. Maybe I'm such a good vet that everything I see gets better after one consultation

[quote user="Martin Atkinson"]I would ask is there an exam for vets who have previously worked almost entirely in the charitable sector?[/quote]

There arguably needs to be.

One of the worst locums, and one of the worst working environments I have ever been in was an RSPCA clinic. I found some (not all by any means) of the veterinary staff to be dogmatic, arrogant and opinionated, in particular 2 young co-alpha males. They certainly didn't like locums, judging by the way they spoke to me, and of previous ones. That aside, they had a dislike and disdain, and were very scathing of local private practices and of local well known and respected veterinary surgeons. There were often disparaging remarks along the lines of: that unethical b*****d wanted to charge someone to fix a puppies broken leg, or I'm going to report that a******e to the RCVS because he wouldn't do a free C-section on someone's SBT, and we got lumbered with it at midnight. They didn't seem to have the first clue how private practice operated.

RE: Two locum questions

Martin Atkinson — Fri, 20 Oct 2017 09:05:49 GMT

[quote user="Clive Ansell"] I don't drag enough back in to bag a second consult fee.[/quote]I wouldn't be going back to that practice if I was you.

[quote user="Clive Ansell"]

[quote user="David Mills"]Should there be an exam for locums? [/quote]

There already is; mine is BVSc, plus ongoing cpd of course.

[/quote]

I would ask is there an exam for vets who have previously worked almost entirely in the charitable sector?

RE: Two locum questions

Clive Ansell — Fri, 20 Oct 2017 07:28:29 GMT

[quote user="David Mills"]But they are not managed whilst working.[/quote]

We can be, certainly in larger practices where we can be assigned to consults or op, and even certain consults or ops.

I've even felt micromanaged in some places, where management will trawl through every detail within the clinical notes. I was recently informed that I have a low C2 rate, in that I don't drag enough back in to bag a second consult fee.

[quote user="David Mills"]Should there be an exam for locums? [/quote]

There already is; mine is BVSc, plus ongoing cpd of course.

RE: Two locum questions

Clive Ansell — Fri, 20 Oct 2017 07:21:12 GMT

[quote user="David Mills"]1. If a locum you employed criticised you, or your practice, to other members off staff whilst working there, what would you do?[/quote]

That would surely depend upon the context; it could range from light hearted banter within the rest room that went a little too far right through to slating someone on social media that could constitute professional misconduct.

I would not openly criticise a practice owner and colleague to their staff, although there maybe times where I don't like or agree with something, or I may do something differently, and have to say so. I would attempt to do so in a positive and professional way and in private.

[quote user="David Mills"]2. Employing a locum endows them with a status of being competent to the extent you can delegate clinical tasks to them from day one. They are unconsciously competent. Is this a fair reflection or a marketing triumph? [/quote]

Most of us come with a proven track record, and a CV and references. I have been a locum since 2001 and have worked at some of my regular practices for the last 16 years. Ask any of them for a reference, or pick up the phone and talk to them.

RE: Two locum questions

Francisco Gomez — Thu, 19 Oct 2017 22:53:39 GMT

[quote user="David Mills"]

1. Theoretical. Not formal feedback. Is that acceptable?

[/quote]

I think feedback should be welcome but personally I'd prefer it formally. I see how feedback to staff could come out of frustration and be not always helpful but I have also seen people learning from a comment made at the right time. I remember how a vn doing a locum shift in a OOH practice came back and implemented good practice in her regular job.

[quote]

2. The carrying out of tasks may be their responsibility but the consequences rarely are. Unless they're really bad their MRCVS is rarely threatened. But they are not managed whilst working.

Should there be an exam for locums?

[/quote]

I disagree with this. When several years ago did some locum, a) I was managed, I was clearly given instructions of what I could or couldn't do by supporting staff and b) I had the misfortune to find a complain about me and the practice addressed this to me very quickly. In fact, I have felt made the scapegoat of the practice shortcomings in a few situations, this is partly the reason I stopped my locum company.

RE: Two locum questions

David Mills — Thu, 19 Oct 2017 22:32:04 GMT

1. Theoretical. Not formal feedback. Is that acceptable?

2. The carrying out of tasks may be their responsibility but the consequences rarely are. Unless they're really bad their MRCVS is rarely threatened. But they are not managed whilst working.

Should there be an exam for locums?

RE: Two locum questions

Francisco Gomez — Thu, 19 Oct 2017 22:10:26 GMT

[quote user="David Mills"]

1. If a locum you employed criticised you, or your practice, to other members off staff whilst working there, what would you do?

[/quote]

What circumstances are we talking about? With your knowledge? Feedback? Behind your back? How do you know what was said?

[quote]

2. Employing a locum endows them with a status of being competent to the extent you can delegate clinical tasks to them from day one. They are unconsciously competent. Is this a fair reflection or a marketing triumph?

[/quote]

The clinical tasks are their responsibility and this status is given by their MRCVS registration, marketing triumph is only obtained after they are given the chance to prove themselves, as with any other business. If they fail, the client will stop paying, walk away and give them a bad review. What's the issue?