What Would Shawn Do? Dealing with an Unethical Associate Doctor

Q:

I am a tech and work with an associate doctor, “Dr. B,” who makes what I think are ethically questionable medical decisions. It happens infrequently, but often enough for me to see it as a pattern. This usually happens when he is rushed and trying to move quickly. Dr. B is very tight with the owner. If I take my concerns to her, I’m afraid she will not believe me or will take Dr. B’s side. What’s my next step?

A:

If you’re not positive the decisions are unethical, gather more evidence and document it before proceeding. Once you are certain the decisions are unethical, confront the associate doctor directly. Unless you believe there could be a risk to your own safety when dealing with Dr. B, schedule time to speak with him at the hospital, in private.

Describe specific examples of the unethical behavior, and explain why you believe it puts the patients and the hospital at risk. Ask Dr. B to commit to stopping the behavior. If he won’t agree to change, tell him you have no choice but to take the problem to the practice owner. Follow through and repeat what you told Dr. B.

The practice owner probably doesn’t know about the ethical violations or how they are jeopardizing patients or the hospital. But if she does know about these decisions and doesn’t care, you should find another job and report the violations to the state veterinary board.

Good luck!

What Would Shawn Do? Confronting a Disrespectful Associate Doctor

Q:

Help! I need some advice. Our entire staff is extremely intimidated by the associate veterinarian at our practice. Several members truly need to have a difficult conversation with her to explain the way she makes them feel. We tried to do this recently, and it didn’t go well.

I arranged for the two staff members and the associate doctor to meet after one particularly bad incident that they complained to me about. They requested that I stay to mediate because the technician had tried to have a conversation with the doctor before, but the doctor always made it out to be the employee’s problem.

I started the conversation by saying, “Doc, these ladies have a concern about how they were treated and would like to talk to you about it.” Everyone was fine with talking. The employees gave specific examples of “When you do this, it makes me/us feel like this.” The doctor reflected and said, “You need me to be more respectful with how I ask for things.”

The doctor said she had specifically asked the technician, in confidence, if she had any issues or concerns with her directly, and the technician had told her no. The employee stated that conflict is really hard for her and that she didn’t have the confidence to do it. But she had participated in this meeting, and that was a start. I wrapped up the meeting by stating that I know the doctor deeply respects the staff and that we all appreciate one another. I thought everything went very well.

The doctor told me later that day that she felt that I did not handle the meeting well at all. The doc could not get past the feeling that she had been lied to and feels that her behavior should not be questioned because she is a top producer. The next day, the owner-doctor informed me that I am not to say anything else to that doctor because he needs her to stay.

But my actions were exactly what he said he wanted–the direction he wants me to take the practice. I am using the conflict-management skills that we learned from you. What should I do?

 

A:

I am sorry you had such a frustrating experience! Pull the owner-doctor aside and say that you are just following the guidelines he gave you and using the conflict-management skills the two of you learned together, and that you did not handle it incorrectly.

Give him your opinion that the associate veterinarian is not handling the conflict well and that if he chooses to placate her rather than insisting that she participate that you cannot be responsible for the fallout. Tell him that the result of him not paying attention to the core values of the hospital is that it demoralizes you. Assure him that you can work through this, but that he needs to let you do just that.

Good luck!

What Would Shawn Do? Pay Rates for Veterinarians

Q:

What is the standard pay for specialist veterinarians?

 

A:

In terms of percentages, there are differing opinions about what the total percentage of production should be. It varies from 22% to 27.5% for internal medicine and oncology practices, which does NOT include benefits. Benefits usually account for 2.5% of total production.

I typically advise owners to pay young specialists who have less than five years’ experience at the lower end of the range and specialists with 10 years or more of experience at the higher end of the range. The MOST you ever want the total compensation to be is 30% for someone seasoned and 25% for a newbie.