Locums being squeezed

RE: Locums being squeezed

Alistair Graham-Evans — Mon, 29 Apr 2019 00:46:31 GMT

I have learned over the years that locums need to be adaptable, confident and have relevant experience to be confident in the role especially if sole charge. It is more demanding than a regular job.

My limitations have usually been as a result of equipment level, and clinic owner requirements.

If just there a few days I am probably going to leave the cruciate surgery for the regular vet the following week but would obviously work up urgent cases. I have done some locums as a basic caretaker role and others where they are happy for me to do procedures that would normally be referred. In the latter case I am wary of potential complications if I am not available for follow up. Usually on day one I ask the head nurse what is needed and just get him or her to point me in the required direction and organise me.

If you find 75% of the time that locums would have been better taking a % as wage then I would suggest most are a good financial short term investment for the clinic. I name my daily rate which is fair and inflexible.

RE: Locums being squeezed

grumpyoldman — Sun, 28 Apr 2019 13:20:01 GMT

In the past I have always agreed a fixed daily rate or 25% of what they turnover while working after the VAT is taken off . They always go for the fixed rate, even though 75% of the time they would have been better off with the %. The impression and its just an impression is that they tend initially at least to just want to put everything on hold but maybe its different with longer term situations ?. One thing i have learned though over the last 30 years is that they are not going to make you lots of money and expecting them too is foolish and indicates a fundamental lack of understanding of how the vet business works, here anyway.

RE: Locums being squeezed

An On MRCVS — Fri, 26 Apr 2019 16:59:48 GMT

Trouble is when they have a local monopoly and family commitments make a longer commute difficult they can be hard to avoid!

RE: Locums being squeezed

Neil Wheadon — Thu, 25 Apr 2019 09:24:04 GMT

Sorry turboposting but Andreia raises some interesting and insightful points (and very welcome)

[quote user="Andreia Dias"]When talking about locums, I think one has to be aware that a new locum that's completely unfamiliar with the practice cannot be expected to run 10 minute appointments back to back and not run late. [/quote]

I agree with this. It's impossible for a locum however experienced to run 10 minute appointments back to back especially if over half are not boosters (can of worms there)

2 reasons

1) A locum needs to be familiar with a case, therefore needs to read the notes, that takes time. To start a conversation with a client saying ' I see Woody has had 2 ear problems in the last year' instils confidence in the client that reflects on the practice

2) Do you want good notes? I write highly detailed notes as a practice can't ask me if a client comes back, that takes time

[quote user="Andreia Dias"] Is the practice run in such a way that the locums can't perform but employed staff can?[/quote]

Anecdote maybe, but all practices I work in are very accommodating. The biggest issue is 'cooking in someone else's kitchen' so where do you keep the Cerenia? In my experience practices treat locums very well.

[quote user="Andreia Dias"]In my opinion, "unrewarded" time puts a big stretch on vets and pushes some over the edge[/quote]

In this we agree.

Neil

RE: Locums being squeezed

Neil Wheadon — Thu, 25 Apr 2019 09:08:42 GMT

[quote user="Andreia Dias"]This raises a question - how "long" is your day? Does it change from practice to practice? Are you happy to work longer hours for the same pay (i.e. earn less/hour) or do you charge extra after a certain time? If you don't mind me asking![/quote]

I specifically charge £290 for a 10 hour day and that includes an hour break at some stage. Anything above that gets charged at £35 an hour (or part of) Therefore if a surgery is running 0830-1900 that is £325. I'm not afraid to stay later if circumstances dictate for that emergency that comes in late, so this takes that into account, therefore the practice benefits and I feel properly remunerated for putting in that extra time.

A recent benefit of this is that a practice wanting me back and previously asking for 0830-1900, have reduced the hours to 0900-1900, which is absolutely fine with me. It defines the boundaries and it's a fabulous practice, so everyone is happy.

Neil

RE: Locums being squeezed

Andreia Dias — Thu, 25 Apr 2019 00:44:22 GMT

[quote user="Neil Wheadon"]

[quote user="Edward Jones"]What kind of rates are we talking about?[/quote]

I feel this is a very pertinant question simply because I have seen a variation in locum rates and do feel that sometimes rates are asked that reflect more what the market can bear rather than what a locum can offer.

Personally I charge £290/day. Running this through an online calculator this would be the equivalent of £53400/annum.

Out of that I have to pay an accountant, my own holiday pay,CPD, VDS, RCVS and more fuel and travel time, and a practice saves employer NI (£4200) For a locum of 27 years experience capable of handling anything that comes through that door, I'm not cheap but pretty equivalent to what a practice should be expecting to pay for an employee of my experience

Neil

[/quote]

Agree! I know money talks are not common in the UK as a culture but it would be important to understand what's at stake here - it's one thing to charge this value (which I find reasonable and actually, pretty cheap!!!), it's another thing to ask for £400 for a day of work doing vaccines and cat spays. At the end of the day, the vet has to bring that revenue!!!

This raises a question - how "long" is your day? Does it change from practice to practice? Are you happy to work longer hours for the same pay (i.e. earn less/hour) or do you charge extra after a certain time? If you don't mind me asking!

RE: Locums being squeezed

Andreia Dias — Thu, 25 Apr 2019 00:37:17 GMT

[quote user="Anthony Todd"]

[quote user="Andreia Dias"]In my view it's not acceptable to refuse to pay overtime.[/quote]

Depends on why the overtime is necessary. How long does a C/S take these days with some locums??

[/quote]

When being employed by someone else or "freelancing" (=locum) you are exchanging your time for money. That time you're using up is something you're never getting back.

First of all, I think locums and employed staff should be treated equally. That means that if employed staff receives overtime (which I absolutely think they should), locums should receive overtime. The reason for the vets needing to stay overtime needs to be assessed and addressed.

When talking about locums, I think one has to be aware that a new locum that's completely unfamiliar with the practice cannot be expected to run 10 minute appointments back to back and not run late. After all, would the employed staff in the same situation be expected to do so on their first week? If locums are being paid overtime because they are slow, they have either too many cases for the time they have available or not enough skills. I assume there are going to be black sheep, just like in every profession, but I would dare say that most locum vets genuinely try their best and are not really "staying late" because they want to.

Which poses some questions - is the practice doing an appropriate induction? (locums should have inductions too, I think). Is the practice run in such a way that the locums can't perform but employed staff can? Or the locum fails to perform, but so does the employed staff? Is it fair to discriminate vets with less experience? Why not reward vets based on their productivity? Then again, what would you prefer - money or time? I know which one I would prefer considering time is limited and money isn't (or at least it's not that limited)...

In my opinion, "unrewarded" time puts a big stretch on vets and pushes some over the edge, making them leave/diversify. Deep down most of us believe our work should be rewarded (including me) and it's easy to start resenting the job when it takes time away from you, rather than you choosing to give your time to it.

RE: Locums being squeezed

Neil Wheadon — Wed, 24 Apr 2019 21:59:28 GMT

[quote user="Edward Jones"]What kind of rates are we talking about?[/quote]

Personally I charge £290/day. Running this through an online calculator this would be the equivalent of £53400/annum.

Neil

RE: Locums being squeezed

vetbl.locum — Wed, 24 Apr 2019 21:44:17 GMT

[quote user="An On MRCVS"]Medivet are tightening up on locum rates and overtime. [/quote]

What is overtime ?

BITD etc

:-)

PS Never knew c/s was cat spay

RE: Locums being squeezed

Clive Ansell — Wed, 24 Apr 2019 20:46:05 GMT

aah, thought it could have been ConSultation or CorticoSteroid ;-)

RE: Locums being squeezed

Lucy Fleming — Wed, 24 Apr 2019 19:14:46 GMT

[quote user="Clive Ansell"]

[quote user="Anthony Todd"]How long does a C/S take these days with some locums??[/quote]

What is a c/s?

[/quote]

Cat spay, I believe.

RE: Locums being squeezed

Clive Ansell — Wed, 24 Apr 2019 18:44:19 GMT

[quote user="Anthony Todd"]How long does a C/S take these days with some locums??[/quote]

What is a c/s?

RE: Locums being squeezed

Clive Ansell — Wed, 24 Apr 2019 18:43:04 GMT

[quote user="An On MRCVS"]Any advice? [/quote]

Easy.

1. Don't work for them.

2. Tell them what your rates are, and that they are non negotiable.

Practices I know are struggling to fill both temporary and permanent roles, so I don't see that Medivet and their ilk are in a position to bargain really.

RE: Locums being squeezed

Anthony Todd — Wed, 24 Apr 2019 13:28:48 GMT

[quote user="Andreia Dias"]In my view it's not acceptable to refuse to pay overtime.[/quote]

Depends on why the overtime is necessary. How long does a C/S take these days with some locums??

RE: Locums being squeezed

Edward Jones — Wed, 24 Apr 2019 13:20:22 GMT

What kind of rates are we talking about?

RE: Locums being squeezed

Andreia Dias — Wed, 24 Apr 2019 12:41:11 GMT

Like I was told, profit doesn't mean cash! The thing with profit and accounts is that there are ways to make it look nice on paper, when that's not the case. For instance, if you look at their accounts, their gross profit almost doubled for 2018, yet their operating profit actually dropped - what they did is they earned £10M in interest. Are they expecting to keep that income for 2019?... Maybe not! They've also maintained the same amount of current assets, yet their net current liabilities more than tripled... So maybe they do need to reduce their expenses and costs and don't expect increasing sales will do the trick...

But they can't work without vets... So don't work for them under conditions that you do not agree with. Find someone else that values you! It's fair enough for them to decide they don't want to spend more than x on locum rates (after all you also decide the limits of the expenses of your business), but they have to accept the consequences of that (i.e. not finding locums that agree to their rates or getting lower quality locums that in turn will cost them clients and reduce their revenue). In my view it's not acceptable to refuse to pay overtime. Unless they like to spend another £280k or more on recruitment and don't mind the word-of-mouth amongst the veterinary community...

RE: Locums being squeezed

Gillian Mostyn — Wed, 24 Apr 2019 11:43:05 GMT

[quote user="Bob Russell"]If this is the most profit they are making then they need to cut costs and increase income[/quote]

Unfortunately the corporates like cutting the clinical staff costs.... which is the last place they should be looking to cut costs. They seem to struggle to see that no vets =no income.

RE: Locums being squeezed

Bob Russell — Wed, 24 Apr 2019 11:23:55 GMT

A profit of £7.3 million looks pretty miserable to me considering the size of the group. 280 practices and 18 OOH centres.

If this is the most profit they are making then they need to cut costs and increase income unless I have got my decimal point in the wrong place!

RE: Locums being squeezed

Gillian Mostyn — Wed, 24 Apr 2019 11:11:14 GMT

Refuse to lower your rates or work elsewhere. Most locum rates are perfectly reasonable.

I was talking to a GP friend at the weekend. He is a partner in a practice in the East Manchester area. He pays locums £100 to £120 per hour for normal daytime hours, and struggles to find anyone who will do more than a half day/school hours. Why would you if you're earning those numbers?