See the Full Issue
October 2024
How to Hold On Loosely
As AAHA’s Stay, Please study found, flexibility in scheduling and job duties is a strong driver of both retention and attrition in veterinary medicine. In other words, when flexibility is done well, it inspires good people to stay. But when it’s done poorly, it’s also a top reason why people leave their current jobs in clinical practice—or even clinical practice altogether.
While it was a passion for helping animals and empowering pet owners that inspired Cayla Couch, DVM, to go into clinical practice, it was the flexibility offered by her employer that made her certain she was in the right place.
Couch was a fairly recent grad when she joined Petfolk (a general veterinary practice with multiple locations) in 2021 as one of their earliest team members. While she appreciated the four-day work week Petfolk offered its full-time employees, she realized early on that what she would value even more was a flexible schedule that would allow her to enjoy time with her husband and longer weekends off to visit their families in California.
“Trying to get home for a three-day weekend just isn’t feasible when two of those days are spent traveling,” Couch said.
Fortunately, Audrey Wystrach, DVM, co-founder and co-CEO of Petfolk, and Ashley Russell, Petfolk’s head of people, were fully onboard with finding a solution. “We, as an organization, said, ‘We love Cayla, we want her to be happy, and we’re willing to change to accommodate her to make this a win,’” Wystrach said.
And a win it was. “It really had a positive impact on my home life and my marriage,” Couch said.
Then, Couch learned she was pregnant, and Petfolk worked with her to change her schedule again—first, by setting a consistent schedule so she and her husband could better arrange for childcare, then cutting her work week down to three days a week.
“This really works for us,” Couch said. “My husband is able to watch [our son] on Sundays, and we were able to afford a nanny and have her here on Mondays and Tuesdays.”
Why Focus on Flexibility?
Stories like Couch’s aren’t the norm in this profession, but as AAHA’s Stay, Please study found, flexibility in scheduling and job duties is a strong driver of both retention and attrition in veterinary medicine. In other words, when flexibility is done well, it inspires people like Couch to stay. But when it’s done poorly, it’s also a top reason why people leave their current jobs in clinical practice—or even clinical practice altogether.
Considering how challenging (not to mention expensive) it is to recruit and replace great employees, it certainly makes sense for practices to seek out any ways they can to improve retention. Modern Animal, a human-focused veterinary company with locations in California, Texas, Arizona, and Georgia, realized the importance of focusing on flexibility a few years ago when they surveyed over 300 doctors to learn what they valued most and learned that having a good work schedule ranked at the top of the list.
“Anecdotally, I know doctors will often stay in a substandard situation longer than they might otherwise if they have a good schedule,” said Christie Long, DVM, chief medical officer at Modern Animal. While her goal is not to keep doctors by only giving them a good schedule, she recognizes that offering desirable schedules is key in their goal to have doctors stay “forever.”
And sometimes, the focus on flexibility is personal.
“I’ve been in the industry for 30 years,” said Wystrach. She was in the very first class at Colorado State University in which women outnumbered men—by one. For the first 15 or 20 years of her career, she said there was zero flexibility. “You worked five days a week. You did a regular job. You may or may not have had maternity leave, and the expectation was that [if you did take maternity leave] you came right back and joined back in.”
As a mother of three with a husband who traveled five days a week, Wystrach ended up owning a lot of her own hospitals. She also didn’t take a vacation for the first three years she was practicing, and at one point, found herself working 365 days a year. “There was a huge point in time in my life where I would have given anything to have flexibility… to be able to define my schedule and satisfy the need state of my growing kiddos,” she said.
At the time, though, she simply didn’t know how to do that. “There was no permission for any conversation around it,” she said. “It was just like, you’re in it, in the deep end. Keep going. Swim, swim. Swim faster! Swim harder!”
This experience has driven her, along with Russell, to make sure Petfolk employees have a variety of scheduling options available—both when they come on board and as their need states change over time.
“You’ve got a business to run, and then you have individuals who want to be as happy in their job as they possibly can be,” Wystrach said. Petfolk’s approach to achieving those goals is to offer a bit of an employment buffet: there’s four-day full time option, part time schedules, telehealth, Petfolk Flex (a proprietary scheduling app that enabled people to remain 1099 employees and work in, essentially, a relief capacity), and even some locum shifts for doctors interested in traveling.
But they don’t limit themselves to strictly those options, said Russell. When a prospective employee asks her what kinds of flexibility they offer for scheduling, she said, “We would turn that question right around and say, ‘What do you need?’ And then we would define their job from there.”
The approach has paid off with a 98% retention rate, a fifth place ranking in Newsweek’s Top 100 Global Most Loved Workplaces, and an Employee Net Promoter Score (eNPS) that’s consistently in the mid-80s (a score that’s considered best-in-class).
Being flexible about what flexibility looks like is important to other employers as well. Modern Animal makes a point to ask, “What is your preferred schedule?” during the recruiting process.
It’s important not to assume what individual employees will value most. “I used to think everyone wanted the same thing, but that’s not true,” Jennifer Jones Shults, DVM, owner of both Veterinary Emergency Care and Veterinary Rehabilitation Hospital in Cary, North Carolina, shared. This might mean working fewer, longer days for some, while for others it means working weekends to have availability for other activities during the week or being able switch shifts with others if needed.
Attitude Matters
“Our employee retention rate is fairly high, at or above 85% on average,” said Linda McCarthy, CVPM, practice manager at the AAHA-accredited, feline-only Cat’s Corner Veterinary Hospital in Oxford, Connecticut. “I believe this is a direct result of our practice and team culture.”
Cat’s Corner has 13 employees, including two veterinarians, and McCarthy says that the practice’s commitment to making sure the team is happy in their positions is especially noted by employees who have come from toxic team cultures.
“We do not make anyone feel guilty for needing or wanting time off,” she said. “We adjust our appointment and surgery schedules to compensate (if the time-off request is planned) when we can, and we do our best to make things work when someone can’t come in unexpectedly. Being flexible with employees is crucial.”
She also stresses the importance of trusting the team and making work fun. Leadership doesn’t micromanage, and, as long as everything is getting done and patients are taken care of, they don’t mind if the team spends some time socializing, checking their phones, or taking a moment to goof around. In fact, she said, “We join them!” She believes it’s important for staff to see the human side of leadership, too.
Additionally, McCarthy suggests making a point to remain aware of the impact of “generational norms and old school mindset,” which can be rather prevalent in this industry. “We have a multigenerational workforce as a whole,” she said. “It’s important to remind the ‘seasoned’ staff members that it’s OK for students, new grads, and younger team members to have a life, and to not want to work themselves into the ground.” In fact, she said, they encourage those seasoned team members to follow suit.
The one thing I promise everyone when they join is that I will survey them more than they would like.ASHLEY RUSSELL, PETFOLK, HEAD OF PEOPLE
Beyond Babies
Often, the conversation around workplace flexibility is tied to parenting. And, while it’s true that parents do have specific needs due to childcare responsibilities, the desire for added flexibility is by no means exclusive to that demographic.
In fact, Jones-Shults said that less than 50% of the requests she receives for flexibility from her employees have anything to do with parenting. And, while she stressed that the reason for the request shouldn’t matter, the ones that she does hear about include needing to care for aging parents, wanting to travel, and being able to leave early to attend a concert, among others.
It Takes a Team
The Petfolk team has learned how important it is to have a solid system in place to facilitate the kind of flexibility they want to offer. “We built 15 hospitals in a very short period of time, and we have 16 on the horizon by the end of next year,” Wystrach said. “That’s a lot of humans. And you can’t have fragmentation where one person gets one thing and the next person gets another.”
Their recruiting and onboarding relies heavily on processes, consistencies, and information-sharing to ensure every new hire receives the same information, scheduling options, and opportunity to express their needs. This enables them to build teams full of people who understand how they contribute to the company’s mission to bring joy back to veterinary medicine and create a happy work environment.
After all, said Wystrach, “Flexibility is also making sure that, foundationally, when you walk away from your work, you feel like your patients are not suffering.” Knowing you have permission to truly shut down or walk away for a couple of days off—and being confident that there is a great state of care in your absence—is an essential part of flexibility, she said, and that simply can’t exist without exceptional teamwork and trust.
Having a strong team in place also allows for practices to pivot when last minute changes arise. (And they will arise, because no matter how much a person plans, life happens and we all have unexpected needs pull us away from work.) Building a team that can step up in order to support a team member who is running late or can’t come in—and implementing a workplace culture that makes this the default—makes a huge difference in overall satisfaction.
Keys to Success
Balancing the needs of a practice and its people can be tricky, but by taking the following suggestions to heart, you’ll be well on your way to offering the kind of flexibility that attracts top talent—and makes them want to stick around.
Ask employees what they want—and listen. “I check-in and do one-on-one meetings with each team member on a quarterly basis, or more frequently, if needed,” said McCarthy. She asks them if they can do anything differently or more efficiently, of if there’s anything that would make their jobs easier. Some of the requests that come back are simple, and others are more complex, but the most important part of this process remains the same, said McCarthy. “The team sees that we’re asking and listening about what they think will help them/patients/clients,” she said. This request gets them to invest in their job and the hospital, and creates job satisfaction.
Take surveys seriously. “The one thing I promise everyone when they join is that I will survey them more than they would like,” said Russell. Petfolk surveys employees, at minimum, seven times in the first year, and then four times a year after that. Russell’s team looks for themes and, at the same time, considers how to communicate their feedback on what they’re able to change, what they’re going to work on, or, if they can’t change something, explaining why that’s the case. “I think that feedback loop and communication plays a huge role in our retention numbers,” she said.
Our employee retention rate is fairly high, at or above 85% on average. I believe this is a direct result of our practice and team culture.LINDA MCCARTHY, CVPM, CAT’S CORNER VETERINARY HOSPITAL
Dive into the data. “It helps that we have a tremendous amount of data, so we have an understanding of supply and demand. We know when up-regulated opportunities are needed—and we also have an understanding of when it could be a little quieter,” Wystrach said. This enables Petfolk to create a schedule with full-time and part-time employees while also ensuring the hourly workers are getting at least the minimum amount of work they want (ideally without scheduling too much overtime).
“I will say that one of the greatest tools is having part-time and flex people who can help regulate some of those need states,” Wystrach said. “It’s a real puzzle of full-time, part-time, and flex. It’s not always easy, and you know that at some point in time the profit and loss is suffering a little bit and sometimes the humans have to put in a little bit more. But it’s a good balance to be able to reflect on data and analytics to understand the need states of the growing hospital.”
Plan ahead when possible. Jones Shults believes that communicating in advance is the best way to make sure the practice needs can be met while still giving the employees the flexibility they want. “Flexibility for me is more about planning out,” she shared. “Most people prefer to know farther out what their schedule is.” This allows for personnel to plan everything from doctor’s appointments to trips to continuing education conferences without having to worry about getting the time off they need.
Ignore the norm. There’s more than one way to run a successful business, so don’t be afraid to shake things up to ensure your strategy works for you. For example, at Modern Animal, they consider 30 hours a week to be full time and eligible for full benefits, which allows those who want to work a three-day schedule each week to do so. To keep shifts from running long, they cap schedules at 16 appointments per day. And, instead of “squeezing in” extra appointments to an already full schedule, each practice has a veterinarian working an urgent care shift each day to accommodate sick or injured pets that need to be seen the same day. The result of this, Long explained, is that veterinarians working a regular appointment shift can move some of their 16 scheduled cases around or turn some into drop-off appointments now and again if they need to shorten their day.
Allow for give and take. “My motto has always been that there’s no harm in asking,” Couch said. The worst thing people can say is no, after all, and while that’s not ideal, she believes there’s often room in a conversation to find some sort of compromise.
“As long as you’re not asking for anything extreme and there’s a little leeway, like a cut in pay if you’re changing your hours, a good employer is going to be willing to work with you,” she said. “So, if something is truly going to make or break you—if you’re between staying or leaving clinical practice, or if something is really impacting your life at home or your mental health—it’s a good idea to ask. Be your own biggest advocate.”