Any veterinarian that works out of their truck knows that part of their job is receiving the worst directions to a farm that you’ve ever heard and then somehow, with any luck, finding that farm (usually in the dark). My first experience with bad directions for ambulatory calls occurred during veterinary school on my equine ambulatory rotation. Maybe it was all part of my training, so I’d know what to expect during my career. Ironically, the bad directions actually came from another veterinarian, another hint that they were just getting us all prepared for the real world of ambulatory medicine (or playing a practical joke on us). We were going to a veterinarian’s neighbor’s house to treat a colicky horse. We’ll just call her Dr. Jones. Dr. Jones told our equine instructor, “Turn on the highway, and when you get to the field with a donkey in it, turn left.” Our equine instructor hung up the phone and had a skeptical look on her face. “Turn left after the field with a donkey in it? What if the donkey is hiding?!” Turns out this was just a small taste of what I would experience in private practice. I have always practiced in my hometown, so one could say that I am somewhat familiar with the area. However, I was a towny. I did not spend weekends cruising county roads with my family as a child the way my husband did. Aside from the key high school party spots in the county (which I obviously wouldn’t know anything about, I just heard about them), I hadn’t explored much of the countryside of Howard County. Since I am from the area, people would automatically assume I knew where things were. I’ve separated some of my biggest direction pitfalls into categories. Enjoy! 1. Generation gap and outdated directions- My first hurdle in starting practice involved a generational gap between me and the practitioners I worked with. My boss at the time (Dr. Vroman) would try to explain to me where a farm was. He’d say, “Do you know where the old Smith farm is?” quickly followed by a blank stare from me. Turns out Mr. Smith died in 1956. I’m a Millennial, for Pete’s sake! Give me an address I can plug into my smartphone! 2. North, South, East, Whatchamacallit- If you’re giving me directions, please don’t confuse me with words like, “north, east, south, and west.” I have found that one distinguishing feature between townies and country folk in our area is the words you use for directions. Most farm people, including my husband’s family, prefer to give directions the following way: “Turn North on highway 5 then head East on the next county road past the Johnmeyer farm.” My response is normally, “First of all, where is the Johnmeyer farm, and would that be a right or a left?” Look, I realize this response probably makes me sound like an idiot to most of the farmers in this area. I realize I should understand the directions the major roadways go in my area. But I don’t. It’s so much easier if I can explain what direction I’m coming from (normally the Armstrong area), and they can then tell me right or left. RIGHT or LEFT, please!!! 3. Interesting landmarks- You'd be surprised the number of people that don't know their own address or how to give directions properly to places they have lived or farmed for years. When people can't give you actual road names or numbers, which is usually the case, they resort to landmarks. Don't get me wrong, landmarks can often be helpful, but for the sake of entertainment, I'll only mention the ones that make you scratch your head. - Landmarks that no longer exist- “Hey Doc, you remember that old barn that burnt down several years back? I think it was 1985? Turn left right after that.” Just an FYI, a landmark that no longer exists is not actually a landmark. - Dime-a-dozen landmarks- When receiving directions to a farm, it's inevitable that someone will try to use a landmark that is very common, making it very unhelpful. Examples of such landmarks include, but are not limited to, barns, grain bins, trees, and a field of cattle. Living in Howard County, these landmarks are everywhere. And I mean everywhere. Criteria for a helpful landmark? It should have some sort of distinguishing feature like turn left after the pink house, before the Jill Stein yard sign, or across from the Yogi Bear statue, all rare in Howard County, but there somewhere. - Using other roads as landmarks- This is never a good policy as the person receiving the directions will inevitably want to turn down that road. A perfect example of this was when a woman was trying to give me directions to a farm about 25 miles from where I live. The conversation went something like this:
I hang up the phone, and my husband says, “Wow. That was clearly a perfect example of a woman receiving directions from another woman. My husband's smartass comments aside, this is often the dialogue you hear between a veterinarian and a person giving directions. - Drama landmarks- This may seem strange to read, but people have a way of revealing family/personal drama when they give directions. I actually enjoy this part because it replaces the drama I'm missing on Netflix while I go on a farm call. An example goes something like this:
After a few years in practice, I’ve been getting much better at these directions by remembering farms I’ve been to, recognizing family names past and present, and most importantly, remembering what criminal event happened at which location as my landmark. I have not yet improved on my cardinal directions, so please, keep it left and right if you can. Even better, give me GPS coordinates for my smartphone and I’ll be there in a jiffy.
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You’ve got a few days left before Easter, and the Dollar Store has been more than helpful loading up your children’s Easter baskets. There are all the springtime outdoors stuff like pastel colored jump ropes with handles shaped like bunnies, games with a million pieces with chick- and bunny-shaped game pieces, and don’t forget the candy. Soooo much candy! I’ve finished a couple bags of the chocolate candy bars that are the same old candy bars, just in a pastel packages, but cost a dollar more. I can’t help myself. You can even go the easy route. Stores have made it easy for you. They package up themed baskets, from teeny tiny size, to the baskets bigger than most cars that most obviously say, “Hey, I’m a dysfunctional parent, but please forgive me with this year's supply of chocolate and an unsafe archery kit tucked inside this toy box in a basket.” If you don’t have children or just particularly love your pet, you don’t have all those options to get an Easter basket just for them. You have to go about it on your own unless you find some last second sales gimmick thrown together at the local pet store. (*Note to self: Create gimmicky Easter baskets next year to sell at the front desk). Here’s a list of some last minute ideas if you’d like to get your special pet something delivered by the leader of their favorite prey, the Easter Bunny:
I hope this gives you some good tips for throwing that last second Easter basket together. You might as well grab something for yourself while you’re picking up a good basket for this display. An extra large bag of chocolate bars sounds good, but if chocolate’s not your thing, get the bag anyway and drop it off at my clinic with a bottle of Moscato and a cheeseburger. It’s going to be a busy day, and I need snacks and a happy hour to look forward to.
I began my journey as a business owner of a veterinary practice in 2014. Like many veterinarians, I was trained extensively in veterinary school to diagnose and treat animals. Business training? Not so much. Many veterinarians become business owners, but very few of us have formal training on how to read a balance sheet, understand basic accounting and taxes, and how to manage people. When my associate told me about a business workshop that American Association of Bovine Practitioners was offering, a business workshop and practice analysis for recent graduates, I jumped at the opportunity and filled out the application. I got an email a month or so later saying I had been accepted into their first ever business workshop for new graduates. I was excited! Excited, that is, until I received the homework email. We were then sent an elaborate Excel spreadsheet which involved doing a three-year profit and loss summary for our practice as well as attempting three-year forecasting. Words were being thrown around that I've never heard before, like “inventory turnover ratio”, management financials, and accrual basis. I let out a long sigh and may have even started cursing Dr. Potter for putting me up to this. For the first time in almost five years since I graduated veterinary school, I had homework. But unlike veterinary school, I had a tiny human to take care of and often had about 10-minute increments of time to get any given task accomplished. So I pulled my clinic's taxes, financial statements, and dusted off the old leather binders that contained our “books” from years past. Yeah, yeah, don't make fun of me. I haven't converted to electronic accounting software yet. I slowly made progress on my homework, as any busy mother would. A few weeks later, I then got an email from the people running the workshop that there would be a conference call at 8 P.M. in a few days to go over the basics of our spreadsheet and discuss any questions we might have. “Crap!” I thought to myself. “I need to get more of this done!” Of course, I was also on call that week, which made getting anything done all the more difficult. I hurriedly tried to do as much as I could on the spreadsheet in between appointments. On the evening of the conference call, the phone in the office started ringing off the hook. A producer had a sick cow he needed looked at, and he would haul her in at 5:30. I called my husband and told him he'd need to pick up the baby from Grandma's house and worked on my homework in my office while I waited. Another phone call came and a producer had a cow that had prolapsed. He would haul her into the clinic, and I would treat it after my other sick cow. I left the clinic and got home around 7 P.M., giving me an hour to feed the baby and hopefully feed myself before the conference call. Feeding myself quickly is no problem. I have eaten a Chipotle burrito in the car before I even hit the interstate, but babies have their own concept of eating. The conference call started, and I was delighted to discover that I seemed to have a good handle on the material. Then my phone rang about 45 minutes into the conference call and dinged with a voicemail. Someone who lived about 30 miles west of my town had their dog attacked by the neighbor’s dog while they were sitting on the porch. They had been trying for hours to find a veterinarian in the area that would see their pet but were either refused or told to wait until the next morning. After being in this profession for a few years, a non-client coming from a far distance because they can't find other veterinarians that will see them is a big red flag. I explained the emergency fees for this reason, and they agreed to meet me at the clinic in 45 minutes. I sat through the conference call before I had to leave for my emergency. While I was a little apprehensive of the situation, these clients seemed to be a super nice couple that just wanted to know their dog was okay. I clipped and cleaned his wounds, set up a recheck, and sent him home with medications. I had also won them over as new clients for being willing to come in and see their dog. It had been a busy but rewarding night, but I had missed some of the conference call and wondered if I had missed important information. Most importantly, I missed my baby. A few weeks went by and I finally finished my homework with a week to spare. The next challenge was packing for the trip. This would be our first major trip with the baby. My husband agreed to take a couple of days off and stay at the hotel with the baby. We were only driving to Kansas City, but every mother knows what it's like to pack for tiny humans for a few days. I checked with the hotel to make sure there was a refrigerator in the room for milk storage. I checked with AABP to see if there were breaks mid morning or mid afternoon so I could have pumping time. I made myself a long list of stuff to pack. The miracle is that I didn’t forget anything major. Don’t worry, I’m not a witch; I did forget a couple things, but when I say nothing major, I mean that I didn’t forget the baby. We left for KC after work and got there late at night. I wasn't sure what they'd have in terms of baby beds, so we brought our pack ‘n play. The lady at the front desk said housekeeping would bring up a crib. We got settled in our room and I fed the baby. At 10 P.M., when the crib hadn't arrived, I called down to the front desk and asked if they were still bringing up a crib. She responded, “Ummm, yeah, housekeeping called and there weren't any cribs available.” “Okay,” I said, “Thanks for letting me know,” in a sarcastic tone. Strike one for the hotel. We went down to the car to get our pack ‘n play. The next morning was the first day of the business workshop. I walked into the boardroom at the hotel. There was one familiar face, a classmate of mine. All the other people were from out of state. I sat next to a young woman from Kentucky. She was an ambulatory exclusive veterinarian that worked on horses and cattle and covered about a 7-county area. Here's the kicker. She had no employees. Actually, the majority of veterinarians in this workshop just worked out of their truck. I could see the appeal. There's hardly any overhead without the expense of employees and a building holding lots of inventory. I never really thought of myself as spoiled or privileged, but I can't imagine not having employees to answer the phone for you, clean up the dog or cat poop, hold animals, and bring coffee to you. Just kidding on the bringing coffee part. Who do you think I am? Miranda Priestley from The Devil Wears Prada? If I were one of her employees, I would have spit in her coffee, sooooo, yeah, I’ll always get my own. Anyway, I remembered a work day recently when I worked without a tech for a whole three hours and wanted to gouge my eyes out. I raise my glass to the vets that do it alone. We went through the morning lessons, and the mid morning breaks I was told about were disappointingly short. I'm pretty fast, but I don't know a woman on this earth that can pump or breastfeed in two minutes. I decided I would just be the person coming back late from the breaks as I hurried back and forth from the hotel room for a quick pump break. The MBA who was teaching the course may have been just a little annoyed by the need for break time during the sessions. In fact, I sat by the leader at lunch. He was complaining about the communications leader cutting him off during his talks and telling him when it's break time. If there's anything I've learned from being in this profession, it's that people can be clueless sometimes. Some obviously don't know what it's like to have boobs that are ticking time bombs. Just another learning curve of the profession now that more women are becoming veterinarians. To move the progression on a little faster, I like to corner them while their foot is in their mouth. We finished up the day and luckily our hotel had a happy hour (free drinks and appetizers during the evening hours). I sat with some of the gals from the workshop and chatted for awhile. This is often the time during the meetings that you learn the most. I made plans to meet them at a famous BBQ joint in Kansas City. We got back to our room and Leland was ready for a long nursing session after a long day without his momma. I felt a guilt that I had never felt before at a meeting. On one hand I wanted to socialize and pick the brains of some of my colleagues, but I also wanted to be with my baby and husband. Obviously, baby and husband won that contest. I then came to the sudden realization that tomorrow's sessions lasted until 4 P.M. but hotel checkout was at noon. Crap! Where would I pump and breastfeed and what would my husband and baby do for four hours without a room? I went to the front desk and explained the situation, asking them if there's any way we could get a late checkout because I needed a place to breastfeed and pump. They said that wasn’t possible because they were totally booked the next day. It seemed strange for them to be totally booked on a Wednesday night, but whatever. I decided I'd just breastfeed or pump in their lobby. That'll show ‘em. I don't want to seem righteous or demanding, but I've been to other veterinary conventions before that had great accommodations for breastfeeding mothers who weren't even staying at the convention hotel. Being at a hotel that didn't have such accommodations felt like a slap in the face. Call it a first world problem or whatever you want to call it, but it's the 21st century. We live in a world where women are both breadwinners for their family but also milk producers for their babies. If businesses haven't planned for that yet, then I foresee challenges coming their way as more and more working mothers come to expect accommodations rather than merely asking if it’s possible. The next day was full of more educational sessions and intriguing discussions. My husband and the baby hung out in the lobby and I was able to sneak into empty boardrooms to breastfeed and pump. I feel like I got a lot out of the seminar, but don’t tell Dr. Potter. I’ve been building up my homework complaints with him to try and squeak out a few favors. My take homes from this seminar are as follows:
I look forward to attending next year's seminar. I want to thank the AABP for providing this learning experience for new grads. Owning a practice as a recent graduate is not for the faint of heart and most of us will take all the help we can get. Most people don't like to think of veterinary practices as small businesses, but they are. Without being profitable, they can't provide necessary services, pay their employees, pay their bills, etc. I definitely learned things I can change to make my clinic a more finely oiled machine. And who knows? Maybe someday I'll be the rich veterinarian that everyone thinks I already am. I won't hold my breath, though! |
Jessica Stroupe, DVM
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August 2017
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