At some point every practice needs to engage help to stop the business from taking a break when the vet does. Here, the author offers some useful pointers to help make that changeover run as smoothly as possible.
WHETHER IT’S A one-vet operation or multi-site empire, at some point it is likely every practice will have a vacancy for a locum vet job. Ideally, you’ll have someone you know and trust, who you’ve used many times before and who has been filling locum positions for you long before half of the permanent team was even qualified. However, whether it is the first week of what will become a long-standing relationship, or just the week when the regular locum is already booked, there will often be occasions where he or she does not know the practice as well as the permanent staff. Worry not – most good locums will be quite used to this arrangement. Any locum with a modicum of experience will have used most of the common practice management systems and will be pretty adept at slotting him or herself into the team as needed. However, even with the most experienced locum, there are certainly steps that can (and probably should) be taken to ensure it goes as smoothly as possible. The following seven suggestions are aimed at vet roles, but many of them will be relevant to nursing roles, especially if they are largely client-facing.
Although certainly not compulsory, many locum positions nowadays are arranged through agencies. This may often result in the locum never having had any contact with the practice team before he or she begins. The ethos and personality of every practice varies. Although there are generally more similarities than differences, it is surprising how radically practices can vary. It is vitally important every member of the team pulls in the same direction and that goes for locums too. Practising in a highthroughput practice is totally different to practising in a practice with fewer patients and potentially longer consulting periods and/or higher prices. It is tremendously important for one of the vets to contact the locum beforehand. Ideally, this will take place at the practice a little time before the vacancy starts, although some locums may be unable to accommodate this. Even if it is only on the phone, a discussion should be held that should include: • length of consultations; • neutering policy; • vaccination schedule; • roles of the various team members; • policy for producing estimates (who does it, when and how); • ethos of the practice (its mission statement or similar); • preferred referral procedures and practices; • admission procedure; • surgical protocols (suture materials used, which procedures carried out – level of locum surgical comfort and expertise); • length of working day; and • overtime arrangement (will the locum expect overtime pay? How often will he or she be required to stay late?).
It is probably not too much of a stretch to say one of the tenets of veterinary practice is that clients like to see the same vet. This provides an insurmountable problem for locums as, by their very nature, they are a change from the regular vet a client will be used to seeing. In many larger practices, it will not be unusual or unexpected for a client to see a different vet, especially if he or she is only visiting annually for a health check or vaccination. In this situation, it may not be necessary to tell clients they are seeing a locum. In smaller practices, or in the case of recheck appointments or regular frequent appointments, clients should be notified they will not be seeing their regular vet. If possible this should be mentioned by the regular vet at the appointment immediately preceding the locum appointment, at the time when the appointment is made and when the client arrives. It is important the notification given to clients is not pejorative, nor should it be suggested the locum is somehow going to deliver an inferior service. The most successful examples of this notification often do not mention the word locum or temp – simply referring to the locum vet by name (for example: “You will be seeing Oli instead of Mr Permanent, is that okay?”). Reassuring the client the locum will have full access to his or her pet’s comprehensive notes will help, and if the client is unhappy to see the locum, this will give him or her an opportunity to change the appointment or to think it through. If not notified, many clients will tolerate the change in vet, but there will be occasions where clients may arrive for their consult – or worse, wait until they are in with the vet – and then refuse to see the locum. This results in a wasted slot and loss of valuable good will. Of course, the way this is done will depend very much on the length of time the locum position is for. If it is a longer period of cover (for example, maternity leave), it may be appropriate to notify the entire client base by email or newsletter.
Telling the staff the regular vet is away may seem obvious, but it is vital this is done. It is important all the staff also know the name of the locum, any types of cases (or more likely species) he or she may be uncomfortable dealing with and the reason the permanent member of staff is away. It is always a good idea to brief all of the team on the reason for the permanent staff member’s absence. It appears more professional if everyone is giving the same information and is even more important if it is inappropriate for them to tell clients about the true reason for the vet’s absence, such as acrimonious dismissal.
The charging structure in many practices is broadly similar. However, even small differences can become significant and result in missed charges if not brought to the locum’s attention. It tends to be hard to predict where mistakes will be made and what fees system any particular locum has become used to. The most reliable situation is to have the auxiliary staff responsible for the fees at all times, meaning little or no change when a locum vet is used. However, in many practices, this is not the case. Where the vet is responsible for the charging, it is a good idea to produce a folder with some example invoices and charging schedules for the 10 most common procedures and the five most common consultations. This should obviously include neuters and vaccinations, but should also include ophthalmological fees (for example, do you charge separately for fluorescein?), typical x-ray and sedation fees, euthanasia fees and other common scenarios. It does not need to be comprehensive, but must include enough estimates so they can be adapted to most scenarios and give a guide to the locum as to what he or she should be charging for.
You need not look very far to see the variety of computerised practice management software (PMS) packages available. There are large similarities between them; however, unfortunately, there are also massive differences. Add to this that even practices using exactly the same PMS may be utilising it in a completely different way and you have a situation where even simple tasks, such as charging for a consultation, may be totally unintuitive. Remember that for the permanent staff who use the PMS day in, day out, a task may seem very obvious when, in fact, it is nothing of the sort. It is tremendously beneficial to prepare a brief, written guide that can be sent to the locum (and, as an additional benefit, also used to help new or inexperienced staff members) before the term of his or her engagement starts. If a permanent member of staff is available on day one to help the locum with any areas of confusion, that is all the better, but a written reference guide will go a long way to reducing the wasted time involved trying to learn the PMS, which may be significant.
Although this may seem wasteful, I firmly believe that in most situations this will pay dividends. Additionally, in practical terms, it is probably the easiest step to implement. Ensure someone from the permanent staff is available to show the locum the layout of the practice, the PMS and explain the rhythm of the day. Ideally, another vet should do this, but a nurse or receptionist will also do a great job. Without this 30-minute induction, you will likely find the morning’s consults may not go as smoothly, and unless the clients are particularly understanding, it may end up leaving them with a sour taste if the new vet appears to not know where anything is, how things are done, or worse, the client’s name, animal’s name or last time they visited.
Clearly, the more intuitive the systems are within the practice, the easier it will be for any new member of staff (locum or permanent) to hit the ground running and become productive as quickly as possible. Critically appraising everything from the layout of the consult room, the admit procedure for patients, the names of fees on the PMS, charging policies and so on, and then adjusting it to make it more intuitive, will really help. Of course, this is likely to be the hardest step of the seven to implement, but done well, it will really benefit all new members of staff (and possibly some of the longer-serving ones as well) as it will mean simplifying procedures.