Salaries/benefits

Re: Salaries/benefits

Clive Ansell — Tue, 13 Sep 2011 23:01:53 GMT

[quote user="Jillian Hall"]

If I get a call for something that could wait until morning e.g. burst cat abscess or dog with 3 days diarrhoea, I will always offer an appointment but it's not going to be worth more than £10 to me so given the choice, I'd rather stay in bed. It's not enough of a monetary incentive that I'm going to go out of my way to presuade people to come in for something that (in my judgement and based on the information given to me over the phone) doesn't seem urgent. However, if I'm flat out all weekend or up all night with a GDV then I end up with maybe £200 which takes the sting out of the busy on-call.

But I will always offer the appointment, even to the 4am nail clip! But I'll bloomin' well make sure I charge them for it.

[/quote]

After income tax and NI your £10 is nearer to £6.70 -even less of an incentive - make it £100 and I'll start talking

similarly, your £200 when busy is really £134.

as for the 4am nail clip, forget it unless a minimum of £250 (A plumber friend charges at leat £300 for calls at night, and he only deals with the crisis and returns the following day to finish the job)

Re: Salaries/benefits

Jillian Hall — Tue, 13 Sep 2011 22:39:00 GMT

I think the 20% of OOH takings (after taking off VAT, and only if the client has paid their bill) is a very reasonable amount. If I get a call for something that could wait until morning e.g. burst cat abcess or dog with 3 days diarrhoea, I will always offer an appointment but it's not going to be worth more than £10 to me so given the choice, I'd rather stay in bed. It's not enough of a monetary incentive that I'm going to go out of my way to presuade people to come in for something that (in my judgement and based on the information given to me over the phone) doesn't seem urgent. However, if I'm flat out all weekend or up all night with a GDV then I end up with maybe £200 which takes the sting out of the busy on-call.

That level of incentive certainly doesn't persuade me to see cases that I otherwise wouldn't. It just means I can't grumble so much about a busy on-call. I get to shrug it off and buy myself something nice as a reward. A quiet on-call weekend would be an equally welcome reward.

But I will always offer the appointment, even to the 4am nail clip! But I'll bloomin' well make sure I charge them for it.

Re: Salaries/benefits

Vet2Vet — Tue, 13 Sep 2011 20:47:12 GMT

Agree Robin .

Re: Salaries/benefits

Robin Grimmer — Tue, 13 Sep 2011 20:42:34 GMT

I think clients are used to the Vets Now concept and don't expect their own vet to be working all night as well. We're open for long

enough hours during the day as it is. I couldn't go back to doing on call again. What about our own quality of life???

I think the clients do get a better OOH service from an OOH provider. The vet and nurse are on site so ready to deal with an emergency and inpatients get round the clock care that any heroic sole practitioner would struggle to provide. They are not waking up their own vet (though I used to find it really hard to sleep properly on call) and having to wait for him/her to come back to the surgery.

Yes the fees are high but then they so they should be for a 24/7 veterinary emergency service. There are some down sides - there is often a lack of continuity of cases and sometimes transporting of patients to and from the user practice can be problematic.

And I did work for an OOH service (not Vets Now) for 2 years and we never turned down an appointment. Quite the opposite - they were encouraged to be seen.

Re: Salaries/benefits

Mark Hedberg — Tue, 13 Sep 2011 20:30:20 GMT

The other question is of course "how far is the ooh provider?" Our practice gets at least one OOH call every week or two because the nearest Vets Now is 16 miles away (neighboring city), and some people don't have transport at short notice.

Re: Salaries/benefits

Gillian Mostyn — Tue, 13 Sep 2011 19:16:31 GMT

[quote user="Hannah Wynne Richards"]I don't know if you Gillian are hinting that the problem was with my practice not Vets Now,but in that case I would have expected a steady stream of case history request all days of the week,rather than a concentration on Monday morning,when the desperate owners had already taken their animals to the alternative practice[/quote]

Not at all. Just that the second practice may have insinuated that they provide a much better service when it isn't always strictly true.....

We've discussed this before so I won't go over it all again. Suffice to say that I don't believe a staff member (well, me) can work all day, followed by all night, followed by all day, and still provide the best level of care. Add to that the fact that very few practices can afford for the person on call to have both days either side off. IF the OOH provider is providing an excellent level of care, for a reasonable amount, then the benefit to my patients (maybe not their owners though) plus the massive improvement in staff working conditions means that I am willing to make compromises. But I get very few complaints about my OOH provider and I remember that when we did do our own OOH, we also got plenty of people who resented the cost!

Re: Salaries/benefits

Clive Ansell — Tue, 13 Sep 2011 16:52:36 GMT

[quote user="Hannah Wynne Richards"]

newgradvet

You wouldn't last long as my assistant, as I feel every OOH caller should be OFFERED an appointment-if they decline then any ill consequences are their fault

[/quote]

I would never go as far as saying that every OOH call should be offered an appointment on every occasion.

I would decide on a case by case basis. in an OOH clinic where one is working anyway, I would almost always offer to see private clients other than those which are clearly utter nonsense such as nail clips 4am and requests for flea treatment at midnight. PDSA clients when working for vets-now get a basic level of emergency care, most/many of these are told to come the next day; cats that have been sneezing for 3 weeks etc, and one I once had was a GSD that had had diarrhoea for 3 years.

If doing on call in addition to working all day (rare, last one was Jan 2010) I would only see what I considered to be an emergency, or if owners really insist. I see on call work as for emergencies only and not an extension of normal daytime service.

[quote user="Hannah Wynne Richards"]

I left Vets Now because of this very issue.They gave telephone advice to an owner of a vomiting dog,which subsequenyly died

Worst of all the dog is dead-and can never be brought back

Wynne

[/quote]

What was actually wrong with the dog? most cases of vomiting seen OOH are not emergencies, and most of the ones I see are given symptomatic treatment and referred to their own vets the next day.

Re: Salaries/benefits

Hannah Wynne Richards — Tue, 13 Sep 2011 15:24:29 GMT

Yes it's the lot who were in Swansea Vets Now when I left who were the problem They were in PDSA and supposed to be awake and ready to work,but whether it was laziness, or being embarrassed about fees, they weren't prepared to see anyone unless really critical. I suspect it was embarrassment about fees,because when (on 2 occasions ) I did a shift for them when they were desperate, I was put under considerable pressure from nurses/lay staff to undercharge (which, of course I resisted )

I don't know if you Gillian are hinting that the problem was with my practice not Vets Now,but in that case I would have expected a steady stream of case history request all days of the week,rather than a concentration on Monday morning,when the desperate owners had already taken their animals to the alternative practice

As tothe remark that maybe some weren't emergencies-it's an emergency if the owner thinks it's an emergency,and is prepared to pay OOH

Wynne

Re: Salaries/benefits

Evelyn Barbour-Hill — Tue, 13 Sep 2011 14:53:39 GMT

[quote user="Gillian Mostyn"]Maybe says more about the second practice than it does about Vets Now?[/quote]

Like, they don't contract out their work after closing time so clients prefer them?

Re: Salaries/benefits

Gillian Mostyn — Tue, 13 Sep 2011 14:22:04 GMT

[quote user="Hannah Wynne Richards"]and it's not the first time I had complaints from clients that Vets Now wouldn't see an animal-just the first time it had such tragic consequences[/quote]

so maybe the other cases weren't genuine emergencies afterall?? Although I know little of Vets Now, I do know their fees are (quite rightly) high, so I'll bet they get just as much criticism that they see clients needlessly.....if you want to see a vet, they're hardly going to refuse!

[quote user="Hannah Wynne Richards"]I also had a few Monday morning requests for case histories from the practice that did it's own OOH brcause clients had phoned them after Vets Now had refused/said it wasn't necessary to see animal[/quote]

Maybe says more about the second practice than it does about Vets Now?

Re: Salaries/benefits

Gillian Mostyn — Tue, 13 Sep 2011 14:18:24 GMT

Wynne - surely this was the decision of a single veterinary surgeon (or even nurse) on one particular evening. I wouldn't want to be held responsible for something a colleague did, so maybe the whole of Vets Now shouldn't be criticised for something one person did/didn't do????

Re: Salaries/benefits

Evelyn Barbour-Hill — Tue, 13 Sep 2011 14:09:57 GMT

[quote user="Hannah Wynne Richards"]and it's not the first time I had complaints from clients that Vets Now wouldn't see an animal[/quote]

That's weird. Why would Vets Now refuse to see something if the owners wanted them to? It would all be money in their pockets, and no skin off their noses.

Re: Salaries/benefits

Hannah Wynne Richards — Tue, 13 Sep 2011 13:40:53 GMT

Fair enough as long as the offer to see the animal immediately is made.My (ex ) clients weren't given the option-and it's not the first time I had complaints from clients that Vets Now wouldn't see an animal-just the first time it had such tragic consequences

I also had a few Monday morning requests for case histories from the practice that did it's own OOH brcause clients had phoned them after Vets Now had refused/said it wasn't necessary to see animal

I prefer less leisure time,and the certainty that my sick patients will not be denied treatment by people I was paying to cover

Wynne

Re: Salaries/benefits

Claire McConnell — Tue, 13 Sep 2011 13:39:59 GMT

[quote user="robloxley"]

However a lot of incentive schemes are maybe more to reward you taking the time to explain the benefits of the descale/polish where it is needed rather than not diagnosing/treating problems which can easily be overlooked.

[/quote]

I completely understand what you are saying. I just feel we should all be doing this anyway, on a daily basis and it seems wrong to require an incentive to do so when that is your job.

Re: Salaries/benefits

Claire McConnell — Tue, 13 Sep 2011 13:36:11 GMT

[quote user="Mark Holmes"]

No if you cannot behave ethically, you cannot behave ethically and you need to look at yourself, it is no good blaming the incentives.

[/quote]

I agree with this, I am not saying I personally would/wouldn't act ethically. In fact I have never had an incentive based job. I am just saying I am sure that some vets (not all) with such incentives could be encouraged to perform non necessary procedures. I also feel that as vet we should all be recommending the best treatment/options/diagnostics etc without an incentive to do so. Our incentive should be improving animal health and welfare

Re: Salaries/benefits

Claire McConnell — Tue, 13 Sep 2011 13:31:50 GMT

[quote user="Hannah Wynne Richards"]

newgradvet

You wouldn't last long as my assistant, as I feel every OOH caller should be OFFERED an appointment-if they decline then any ill consequences are their fault

[/quote]

I didn't say I don't offer appointments OOH, in fact I always offer, however can often give sensible advice to an owner from an over the phone history. There is also a difference between saying "If you are concerned I should come to see your dog" and "Your dog must be seen now."

Re: Salaries/benefits

plantagenet — Tue, 13 Sep 2011 11:55:13 GMT

Absolutely right Wynne.

I have always believed that you cannot diagnose over the phone - although apparently the NHS can. Owners are notoriously bad as evaluating how sick an animal is.

Re: Salaries/benefits

Mark Holmes — Tue, 13 Sep 2011 11:54:04 GMT

[quote user="newgradvet"]

Incentives are a good idea but raise ethical questions

[/quote]

Why is it any different to a partner or sole owner? Are you suggesting that a partner cannot be ethical bacuse his/her remuneration if directly influenced by turnover. Infact a partner is more susceptable, given that the costs of a practoce are largely fixed, any additional revenue made, £30 here £50 there is 100% profit. At least an assistant would only receive a %age of this.

No if you cannot behave ethically, you cannot behave ethically and you need to look at yourself, it is no good blaming the incentives.

Re: Salaries/benefits

Hannah Wynne Richards — Tue, 13 Sep 2011 09:30:36 GMT

newgradvet

You wouldn't last long as my assistant, as I feel every OOH caller should be OFFERED an appointment-if they decline then any ill consequences are their fault

I left Vets Now because of this very issue.They gave telephone advice to an owner of a vomiting dog,which subsequenyly died

Any profits from the transaction, if the dog had been seen would have gone to Vets Now,not me, so I didn't suffer financially directly

I suffered financially because the owners who wanted to bring the dog in,but were too polite to insist moved to another practice which did it's own OOH

I also moved, so Vets Now have lost my retainer and any profits from my work

Worst of all the dog is dead-and can never be brought back

In this area a coughing dog is certainly an emergency-maybe you're better at diagnosing Angiostrongylus over the phone than I am?-and I consider myself rather an expert!!!!!!!!!!!!!!!!!!!

Wynne

Re: Salaries/benefits

Mark Holmes — Mon, 12 Sep 2011 23:57:06 GMT

But are incentives related to turnover the best approach? They could be related to foot fall. For example a 10% increase could result in a predetermined bonus pot being split according to the ratio of salaries.

Re: Salaries/benefits

Rob Loxley — Mon, 12 Sep 2011 22:39:58 GMT

[quote user="newgradvet"]I would hate to think I would start recommending dental scales to animals with very mild plaque build up just to earn more myself if I didnt think the job really needed doing.[/quote]

And that would be unethical.

I looked on OOH incentive/commision as essentially a little reward for a broken night's sleep, rather than enough to make me encourage the non-urgent cases to drag me in in the small hours.

Re: Salaries/benefits

Claire McConnell — Mon, 12 Sep 2011 15:03:22 GMT

[quote user="macflea"]

so we see that on average assitants earning around the 40000 mark , i would like to know at the end of the day what do partners in a practice take home. for example my salary last year was 34000 plus crappy upstairs flat (unrentable ) and banger , using uktax salarycalculator my monthly income is 2833 pounds gross plus crappy flat and banger , i have seen my monthly takings varying between 10 and 14000, and i dont strain myself, for what i happily sit around chatting with the nurses . now if i were on comission totally different story there would be an incentive to work and earn myself and practise more

so does any one have figures what partners earn?i was speaking to a friend in large animal practice where he was on 30000 plus house , ther were 3 assistants and two partners , he said in that practice after tax partners taking home 130000 each.

anybody?

[/quote]

Incentives are a good idea but raise ethical questions? As a vet who has taken an oath perhaps we should alwasy be recommending th best for the individual animals. I alwasy recommending routine worming flea tx, dental care etc even though Im not n an incentive scheme. I would hate to think I would start recommending dental scales to animals with very mild plaque build up just to earn more myself if I didnt think the job really needed doing.

Re: Salaries/benefits

Claire McConnell — Mon, 12 Sep 2011 14:57:53 GMT

[quote user="Wren"]

I think the points about commission are interesting. I used to work in a practice which gave 20% commission on OOH work which worked really well and gave you a good incentive to get out of bed to see that coughing dog, rather than tell the owners to bring it in in the morning.

[/quote]

I see the point however as a vet I do not feel its my job to see every coughing dog in the night. Many of my clients are quite happy to wait until the morning and just want reassurance/advice from a vet to say it is ok to wait until th morning.

There are definately times I would see a coughing dog in the night (suspected heart failure, other serious signs or very distressed owner). Howveer there are some times where I feel it wouldn't be ethical to advise an owner with a coughing dog to come to the practice in the night. In fact I am sure many clients I have spoken to OOH would be annoyed if I always said their animal needed seeing.

Getting commission for OOH would be a nice reward however I am still unsure how many vets would see this as ethical practice? Would I be more inclined to see things OOH that I genuinely feel could wait? I am unsure but the potential is there.

Re: Salaries/benefits

Gillian Mostyn — Tue, 11 Jan 2011 16:24:35 GMT

There's a good reason the grass is always greener on the other side.

It is full of bullsh1t

Re: Salaries/benefits

Simon Neuhoff — Tue, 11 Jan 2011 14:18:47 GMT

[quote user="Clive Ansell"]

[quote user="bob lehner"]

[quote user="Clive Ansell"]

if you are all working as a "team" should not any bonus or commission be divided equally between team members? after all you may all be contributing equally, but in different ways??

[/quote]

It was very clear that over a period of time some individuals consistently generated significantly more fees than others and this was not particularly related to their years post-qualification. I think it is reasonable to say that a keen and energetic graduate say 3-5 years out of College will often be as good (or better) a fee-earner as a 10 year -plus graduate.

[/quote]

In a situation where a more experienced colleague can reach the same diagnosis and clinical outcome by carrying out fewer investiagtions than a younger less experienced one might, the former although arguably a better clinician will generate less revenue for the practice. How can the better clinician be rewarded by finance led medicine?

In the practice I am working at the moment, I do not advise pre op bloods for young healthy animals in for neutering where clinical exam is normal, yet a colleague does and therefore he generates more revenue. If we were on commision led pay (we're not) he would earn far more than I for something which in my mind is ethically questionable.

[/quote]

This.