Veterinary Advocacy in Action
Wyoming veterinary practitioner Dr. Tiffany Healey has managed a busy practice while working on advocacy efforts for her state’s veterinary medical association.
Tiffany Healey, DVM, is a big believer in organic growth. Her Cheyenne, Wyoming-based veterinary practice started as a house-call-only practice 10 years ago but has grown rapidly, even without traditional marketing efforts. Dr. Healey made a conscious decision not to advertise when starting the practice. “I really wanted to grow through doing a great job and therefore word-of-mouth referrals,” she said. Today, Cottonwood Veterinary Clinic is a three-doctor, AAHA certified practice open six days a week, Monday through Saturday. They are one of seven AAHA practices in the state.
As a companion animal-focused practice, Cottonwood Veterinary Clinic’s team works hard to serve anyone that cares deeply about their pets, Dr. Healey said. “We do not want to be a ‘rabies only’ practice, but we also don’t want an owner’s financial constraints to exclude any clients. We offer a spectrum of care to find the best option of care within an owner’s budget.”
Cottonwood’s customer service representatives know that they are not required to say “yes” to every phone call that they receive. The clinic makes their current clients a priority and will make every effort possible to see their sick/well pets in a timely fashion, Dr. Healey said. They are currently not accepting “same-day sick” appointments for new clients in order to save those appointments for existing clients. They do plan on setting up “establish care” appointments in the future for new clients.
In addition, Cottonwood’s veterinary team tries to accommodate a variety of predictable employee schedules in the practice. The leaders want staff to be able to schedule their personal appointments months in advance if necessary. Some staff work four 10-hour days while others work five 8-hour days. Lunches can be scheduled to facilitate child pickup. To qualify for benefits, an employee must work at least 32 hours. Doctors can block off extra time to catch up if they have many “same-day sick” appointments. All doctors work four days per week at Cottonwood. There are two doctors working on most days. One doctor generally has four surgical procedures and two dental procedures each day from 8 a.m. to 1 p.m. and then sees appointments until 5 p.m. A second doctor sees appointments from 8-3 p.m.
Managing ‘no shows’
An expanding patient base for a veterinary clinic inevitably leads to growth pains. Dr. Healey said the biggest frustrations she and her team deal with currently are “no shows” with new clients, and even new hires. The “no shows” with clients are somewhat expected due to volume, but the veterinary team tries to make the most of those empty calendar spots. “Because we book our new clients’ ‘establish care’ appointment 1-2 weeks out, new clients often have found another clinic able to see them sooner than their appointment scheduled with us,” Dr. Healey said. “They don’t call to let us know that they have booked with another practice. Although this is frustrating, it is generally a welcome break that allows us to catch up on other things.”
But the “no shows” with new hires can be incredibly frustrating for the Cottonwood team after they’ve done the work to interview and commit to new staff members. For instance, they recently hired for a CSR position. The first new hire didn’t show up on Day 1. The new hire called and apologized with an excuse of a family tragedy. She was scheduled to show up the following week, but did not show up again. Cottonwood then hired a second person for the same position that showed up on Day 1. But she spent the morning filling out paperwork and then went home to tend to a sick child and never returned. “I really wish there was a way to let the unemployment office know of these situations.”
Dr. Healey said online reviews can also create a lot of stress for veterinary teams. “They are such a one-sided story and can really influence doctor/employee morale.”
Navigating today’s workforce complexities is something that’s top of mind for most veterinary practice owners. Dr. Healey is heavily involved in creating solutions to those problems in her state. From June 2022 to June 2023, Dr. Healey was president of Wyoming’s Veterinary Medical Association (WVMA), and continues to serve on the board. Most of the WVMA’s focus during her tenure as president centered on veterinary technician licensure. Wyoming is one of nine states that does not have state regulated technician licensure. Currently Wyoming has a private veterinary technician association that credentials technicians and requires continuing education, “but there is really no distinction between technicians and assistants,” she said.
In June 2022, the Wyoming State Joint Agriculture committee introduced the topic of state regulated veterinary technician licensure. The topic was introduced from a third party and not by veterinarians or technicians, Dr. Healey said. “The WVMA wanted to ensure that the primary stakeholders were the ones that were outlining the path to technician licensure and a task force was formed,” she said. “I headed the task force, and over the last 12 months a group of veterinarians and technicians have reviewed other states’ veterinary practice acts and rules/regulations to develop a path for state-regulated licensure. We have discussed this path and potential legislation with the WVMA members over the last six months to hear their input and make changes that are acceptable to the veterinarians and educated technicians within our state. We are hoping to have legislation introduced in 2025.”
During the discussions of veterinary technician licensure, there were many concerns that veterinarians in rural practices would not be able to find educated licensed veterinary technicians to employ in their practices. Dr. Healey introduced this concern at the Veterinary Leadership Conference in Chicago in January 2023. A suggestion was made by Dr. Lori Teller, AVMA president, to look at the Texas A&M certified veterinary assistant program within the high school curriculum. The WVMA leadership researched the program offered by the Texas A&M extension service and decided to introduce the program to all career and technical education programs in the state.
“We are hopeful that a few school districts will implement this program in high schools in the fall of 2023,” Dr. Healey said. “This program does require clinical hours under the supervision of a veterinarian or veterinary technician. I feel that in our current competitive employment market, it is essential to get kids in the front door of veterinary practices for these students to appreciate the career paths that the veterinary field has to offer. Kids migrate to the career paths that they see: teachers, doctors, welders, construction. They need to see that career opportunities in veterinary medicine do not always have to be a DVM.”
Another topic that the WVMA has discussed is the implementation of an employee assistance program partnership with a national organization. “With workplace well-being as a top concern for employees, discounts for employers to implement these programs within their practices are important,” Dr. Healey said.
What’s behind the workforce problems in veterinary medicine? The pandemic is an oft-cited culprit. Indeed, during the height of the pandemic, veterinarians had to adjust how they practice. But Dr. Healey doesn’t believe that the pandemic is the only driver of the long-term workforce problems that veterinary medicine is currently facing. “I think the workforce issues are more related to the shift in how our younger employees/veterinarians want to live their lives,” she said.
Early career employees/veterinarians want to work fewer hours and don’t want to take after-hours calls. They want to spend time with family and enjoy time away from the office. “Because of this, we need to educate more young adults to compensate for the fewer hours worked.” If most employees want to work 32 hours/week instead of 40-50 hours/week, then there will need to be at least 20% more employees. Client demands have also increased substantially. “If we consider an increase in client expectation, we must also adjust our appointment times to be able to meet those needs and will also need more employees,” she said.