Client Service Representative Etiquette

Client Service Representative Etiquette

Veterinary Business Advisors, Inc.

 

Abstract

Being the first impression of a clinic to clients, there is no doubt that client service representatives (CSRs) play an integral role in the logistical function of clinics. In addition to that role, CSRs are also the liaison between the client and the main medical staff. Consequently, veterinary CSRs are more strategically involved with patient care than clients or even some veterinary staff realize. This creates a need for a guide towards CSR etiquette. Who should be selected for the position and how should they be trained during their time at a veterinary clinic in order to optimize their position in patient care, client education, and positive veterinary visits for both the patient and the client.

Introduction

A basic and typical veterinary practice operates with four main roles – management, veterinarians, veterinary technicians, and client services representatives (CSR). Other roles such as kennel staff, grooming, contractors, etc. depends on additional functions a practice might integrate. While much attention and training are focused on the medical staff, CSRs are often forgotten in the crucial role they play in a client’s and patient’s veterinary experience. Considering they are often the first people in contact with a client during either appointment scheduling/walk-in and the last to bid a client goodbye after checking out, they are an integral piece in the process of client communication and patient triage. By focusing more resources and time in CSR hiring, training and follow through, veterinary clinics can practice better medicine, enhance practice efficiency, and cater a more pleasant client experience. In these sections, we will primarily focus on recruiting high-quality candidates and their subsequent training in order to operate in tangent with the medical staff on patient care.

CSR Roles and Their Importance

  1. CSR Roles and Duties

At the fundamental level, CSRs are expected to answer communications to the clinic (phone, email, social media, etc.), schedule appointments, handle billing, provide basic veterinary education, and maintain the appearance/order for the reception area. Through these roles, CSRs are the first to meet a client and their pet and “create the critically important first impression” for the practice. While their job description might sound simple, CSR’s roles are wildly more impactful to a practice than a typical reception position.

  1. Patient Care and Follow Through

CSRs are the first to triage a patient whether an owner calls the clinic or walks through the door. Asking the right questions and visually gauging a patient’s condition skillfully is imperative in assessing the urgency of that patient’s needs. By accurately fielding that patient to the correct medical professional and/or scheduling the patient accordingly trickles down to the type of medical care that patient receives. This role is especially important for clinics that expect any level of emergencies to come in.

CSRs are also important for patient follow through so that sick patients receive the attention they need. Not all clients are aware of the value of rechecks, so CSRs play a role in client education along side the veterinarian and technicians. As a result of the impact they have on patient care, CSRs should have basic medical knowledge as well as training to reflect the types of situations they might encounter.

  1. Practice Efficiency

CSRs manage the flow of the clinic through scheduling and managing the front desk area. By ensuring the schedule is reasonable without situations such as uneven distribution of patients among doctors, excessive overbooking, and correct time allotment for appointments (wellness vs. sick vs. specialty treatments), the day flows much better. This plays a role in creating a better working environment for the clinic staff as well as imparting a better experience for the client and patient. Having hectic days might give the client the impression that this clinic is disorganized. It can also add to the stress of an already stressed-out patient making delivering patient care more difficult.

  1. Building Client Relationships

CSRs are integral in earning trust and loyalty from clients through conveying a desire to help and engaging with the clients during scheduling and check-out. Just by making an effort to connect with the client during phone scheduling and check-in can make a huge difference as the client feels valued and that their pet is treated as an individual as opposed to one in thousands of patients the hospital helps. Leaving that personal touch helps create goodwill.

The Hiring Process

  1. Who makes the best candidates?

Usually, employers think people with veterinary experiences will make the best CSRs since they already have an understanding on how clinics functions and even some basic medical knowledge. However, think about the bulk of a CSR’s job – it is costumer service wrapped neatly with a lot of multi-tasking and organization. To hire the best candidate for the position, clinics must look for the candidates with adequate experiences in those areas. Previous experiences such as working in restaurants, fast food, being a flight attendant, etc. are helping. People who have worked these jobs understand how to work with various personalities, multi-task, and maintain an positive attitude. The knowledge base details can be imparted through training. It is easy to teach someone all the options for heartworm control, but it is not easy to teach someone how to maintain a calm front desk area with two phones ringing and clients waiting to be helped.

  1. The hiring process before the interview

This process should look very similar to how other positions are recruited; however, it is important to go through the steps thoroughly. Create of list of skills and characteristics that are of value to you and your practice and separate them into “must-haves” and “nice-to-haves”. Pay special attention to phone screens even if it is just calling them to schedule an interview. Based on how they conduct themselves over the phone and/or what their voicemail sounds like can say a lot about a candidate. This is especially since they will be spending much of their time on the phone with clients. If you leave a message, their promptness in returning your call can also be an indicator of professionalism although this should not be read into too carefully if the overall candidate is spectacular. Be sure to check references as they can be the best way to gauge your candidate from someone else’s experience working with them. It is a step that is commonly skipped but can add value to your hiring process. While it might take time to call managers, it will ultimately save time since less hours are spent interviewing lackluster candidates or hiring someone who is not a good fit.

  1. What questions should you ask during the interview?

Since hiring might take place out of industry, it is important to gauge the candidate’s willingness to work with animals, medicine, and all the comes with veterinary medicine. Asking a simple question such as “why do you want to work in an animal-care facility?” can tell you a lot about if the person sitting across from you truly loves animals. On the extreme end, it is important to know that this person is emotionally equipped to handle euthanasia. Gauging their experience is important as CSRs are part of the team who consoles an owner after they lose their pet. If they personally have not experienced euthanasia but are ethically in-line and willing to take on the consoling role, then this candidate has a good foundation after some experiences and training. One basic question is asking what their opinion on euthanasia is.

Next, are the technical questions. CSRs should be proficient with the computer, phone, and be able to learn how to operate equipment such as printers, fax machines, and various newer technologies such as headsets, etc. The bottom line is that they should be able to handle technology, be able to multitask between them, and learn new technology. Simply asking about their experience with these modalities can elucidate useful information. Additionally, CSRs sometimes hold a social media role in some practices. If this is the case for your practice, asking if they are familiar with popular platforms such as Instagram, Facebook, and YouTube.

Arguably the most important are the soft skills. Examples include being multitasker, organized, compassionate, understanding how to de-escalate situations, prioritization of tasks, etc. The best way to gauge these skills are experience questions (“Tell me about a time…”) and case scenarios (“How would you respond if…”). You might want to gauge how they would handle an angry client, a person in need of accommodations, non-English speakers, clients with financial difficulties, etc.

Lastly, seeing how the candidate presents themselves during an interview can be the most telling portion. Do they make eye contact? Do they speak well? Do they smile? How did they greet you and your staff? These are all representative to how they will interact with your clients in the future. Once you have hired someone who will excel at being the face of your practice, next is training them to be able to contribute to patient care.

CSR Training: Patient Triage

  1. Emergency calls

Whether triage is done over the phone or in-person, the CSRs primary job is to first differentiate a true emergency from something that can wait. If any of the following situations are mentioned, the client should bring the pet to the closest emergency room immediately:

  • Non-stop bleeding
  • Difficulty breathing
  • Severe vomiting/diarrhea
  • Toxin exposure
  • Seizures, altered mental status, or collapse with noticeable behavioral change afterwards or inability to stand-up
  • Inability to urinate
  • Severe pain
  • Ingestion of inedible foreign material followed by vomiting, constipation/diarrhea, lethargy and/or pain

If the situation has been determined to be non-immediate, more time can be taken to gather information about the patient and their situations. It is important to note that it is not the CSR’s job to diagnose the disease; therefore, communication should be strictly information gathering. Important information include:

  • Patient signalment (species, age, sex, breed, reproductive status)
  • When did the symptoms start and how long have then been going on for?
  • How is the pet doing in terms of eating, drinking, urination, defecation, and behavior?

It is important to ask open-ended questions. Simply starting off with the question “tell me what’s going on” can help get a good preliminary view of the situation. More specific questions can be asked when the exact problem is known and as CSRs gain medical experience to know what questions are helpful to ask. Once all the information is gathered, an experienced technician or a doctor should make the judgement call of how urgently the patient should be seen. However, at the end of the day, a physical examination by a veterinarian should always be offered.

Patient triage for a CSR can be very similar to a technician taking a history. This is especially true if all the technicians are busy, but a client/patient is in distress and needs help quickly. This provides an opportunity of team building where technicians and CSRs can be trained together or an experienced technician can train CSRs. As a part of this training, new CSRs should have the opportunity to observe a technician or doctor take a history from a client to understand what to ask and how to ask.

  1. Sick appointment visits

CSRs can contribute to medical care of sick patients by identifying potential infectious diseases. Animals that observed to be coughing, sneezing, and puppies with diarrhea should be place in a room immediately to prevent spread in the lobby. Before the appointment, sick patients can be triaged similarly to emergency visits to ensure there is not something going on that the owner is not aware of.

  1. Wellness appointment visits

Annuals and semi-annuals do not require so much patient triage for CSRs; however, it is important that clients are made aware to bring/send records if the practice does not already have them. This will greatly expediate appointments.

CSR Training: Client Education  

Client education does not just happen in the exam rooms. They happen when the client makes the first call. CSRs are in the unique position to communicate the value of veterinary physical exams and diagnostics. Spending a few extra friendly minutes with a new client can ensure a booking a potential lifelong patient. Even better, if the owner mentions that their pet is anxious during veterinary visits, this is their first vet visit, their pet is animal/people aggressive, or any other information, the CSRs can provide guidance in catering the most stress-free visit possible.

After the appointment is finished and the client is checking out, CSRs have the opportunity to schedule the client’s next exam. This is a chance to communicate how important yearly visits or rechecks are. Unbelievably, clients tend to confide in CSRs asking if the diets, medications, or overall treatment plans really work or ask them questions they were too shy to ask the medical team. Having basic medical knowledge can go a long way in educating the client when the veterinarian or technician is not even in the room. The added benefit is that the CSRs can most easily relay the information in layman’s terms. While veterinarians and technicians are trained to communicate well with clients, jargon tends to slip out especially if appointments are rushed and overbooked.

Working as a Team

With CSRs being in the front of the house and technicians and doctors being in the back of the house, there is literal physical distance between the two teams. Additionally, some clinics might be familiar with frustrations CSRs and technicians might have with each other that ultimately stems from miscommunication. This begs the question of how the teams can work together?

Medical training for CSRs

One common complaint technicians often have is that CSRs rely too heavily on the medical team to answer simple questions or that something was done incorrectly because of a lack of medical knowledge. While it is unreasonable to expect CSRs to be as medically knowledgeable as technicians, increasing the staff’s overall medical competencies will only help patient care and client education. Therefore, CSRs should sit in on technician training, be offered CE opportunities, as well as have opportunities to train as a technician if they decide they want to be more involved with patient care. This allows for mobility within the clinic and help cater to individual future career goals (technician/veterinary school). Veterinarians often bring a head technician with them to conferences in hopes that this technician will be able to train the rest of the team. CSRs should be treated in the same way so the entire front staff can grow together.

Technology

Living in the twenty first century with millennials quickly becoming the main workforce, technology cannot be ignored. Often when there is disagreement or discord, it is due to a lack of communication. With widely available and relatively cheap cost for Bluetooth earpieces and walkie talkies, the front and the back staff can easily communicate without having to walk back and forth which takes time and energy. Anyone can contact any one person or everyone in a certain area to ask a question, ask for help, or give updates. Additionally, computer systems like Instinct which tracks inpatient care helps everyone understand how a patient is doing, what treatments have been done, as well as updates. CSRs can simply search this information from a computer as opposed to doing the dance of finding an available technician. Team members can leave notes to each other as well through this software.

CSRs in Telemedicine

Telemedicine is certainly gaining more traction, especially after a historic pandemic. Even as society moves back to normal, some trends from 2020 are left to stay, and this includes the ability to provide more services via an online format. Especially since millennials are quickly becoming the largest market, virtual care is in demand.

While telemedicine is new to the veterinary field, CSRs can help facilitate its process. Luckily, from a CSR’s standpoint not much is different from in-person care. CSRs will need to be diligent in their organization in knowing which appointments are telemedicine and which appointments are in-person. Which telemedicine appointments are for a technician and which appointments are for doctors? This is especially important since they will be responsible for sending out information regarding how the client can log in and what materials/information they should prepare. After the practitioner and client is finish with the appointment, it is the CSRs job to handle payment. The easiest way to handle this is to ask the client to provide a credit card ahead of time. This effectively “cuts the middle man out” by allowing the practitioner and client to join the call and leave the call without needing CSR involvement unless another appointments needs to be scheduled.

References

  1. Conrad, B. C. (2017, October 18). How to hire, train receptionists better. DVM 360. https://www.dvm360.com/view/how-hire-train-receptionists-better
  2. Donnelly, A. (2021, June). The Gift of Gab. Today’s Veterinary Business. https://todaysveterinarybusiness.com/csr-communications-training/
  3. Donnelly, A. D. L. (2016, December 29). Three Ways Client Service Representatives Can Build Client Loyalty. DVM 360. https://www.dvm360.com/view/three-ways-client-service-representatives-can-build-client-loyalty
  4. Driesse, Jess. Personal Communication (2021)
  5. Ekola, K. (2021, June 15). 5 Steps to Improving Veterinary CSR Efficiency. Vet2Pet. https://vet2pet.com/2021/04/5-steps-to-improving-veterinary-csr-efficiency/
  6. Felsted, K. F. (n.d.). Critical Aspects of Effective Hiring. Today’s Veterinary Practice. Retrieved June 18, 2021, from https://todaysveterinarypractice.com/practice-building-critical-aspects-of-effective-hiring/
  7. Frederick, C. E. (2014, October). The Art of Telephone Triage. Clinician’s Brief. https://www.cliniciansbrief.com/article/art-telephone-triage
  8. JOB DESCRIPTION for Customer Service Representative (CSR) . Manchester Veterinary Clinic . (n.d.). https://www.manchestervetclinic.com/sites/site-6369/documents/CSR%20MVC%20Job%20Description.pdf.
  9. Miller, L. R. J. (2005, April 19). Simple forms can help train new hires. DVM 360. https://www.dvm360.com/view/simple-forms-can-help-train-new-hires
  10. Rowe, R. C. (2020, April 28). A starting guide for new receptionists. DVM 360. https://www.dvm360.com/view/starting-guide-new-receptionists
  11. Stafford, D. (n.d.). Emergency and Critical Care – Receptionist tips. VSPN. Retrieved June 18, 2021, from http://www.vspn.org/Library/Misc/VSPN_M02367.htm
  12. Veterinary Practice News Editors. (2017, July 24). 7 Interview Questions for Veterinary Receptionists. Veterinary Practice News. https://www.veterinarypracticenews.com/7-interview-questions-for-veterinary-receptionists/
  13. Veterinary receptionists: Anticipate clients whens, whys, and hows. (2016, June 8). DVM 360. https://www.dvm360.com/view/veterinary-receptionists-anticipate-clients-whens-whys-and-hows
  14. Veterinary receptionists’ vital role in emergency medicine. (2018, November 20). DVM 360. https://www.dvm360.com/view/veterinary-receptionists-vital-role-emergency-medicine

How Practice Managers Can Keep Up with Changing Employment Laws

How Practice Managers Can Keep Up with Changing Employment Laws

By: Kellie Olah, SPHR, SHRM-CP

Although it has always been challenging for many small business owners to keep up with evolving employment-related legislation, COVID-19 has made this situation even more problematic. Legislation is being rapidly passed, containing new and sometimes confusing information. It can be hard for your practice to keep up but it’s worth the effort because when you don’t have access to the most current information or you lag in compliance, this can lead to numerous problems. The consequences can be as serious as litigation against your practice.

As a general approach, it can be helpful to gather a list of trustworthy resources that you can regularly check. This includes reviewing the most current information on topics ranging from healthcare and injury/worker’s compensation to paid time off, unemployment, retirement, and much more. Once armed with the foundational knowledge you need, you can then determine which tasks you can handle within your practice and which ones require help from an expert, such as an employment attorney.

 

Employment Law Resources

At a federal level, the U.S. Department of Labor (U.S. DOL) provides information on a comprehensive range of employment issues. As just one example, here is their resource page that helps employers and employees to address the impact of the coronavirus. The DOL also provides a newsletter, along with contact information for your state labor office so that you can stay up to date with state-level laws and pending legislation. Subscribe to receive email updates from both a federal and state level (for each state where you practice).

If you come across a legal term that is new to you, or one where you need clarification, the Cornell Legal Information Institute has provided a wiki-style legal dictionary and encyclopedia. You can also find human-resource-related legal advice at NOLO’s free employment law center. NOLO has been publishing legal guides since 1971 and has developed into a trusted website.

You can also glean helpful information from the Society for Human Resource Management (SHRM) website, including free tools and information. This organization has a mission to empower people and workplaces by advancing human resource practices and maximizing human potential.  If you find the free content provided by SHRM to be valuable, you can also consider becoming a paid member.

The National Federation of Independent Business (NFIB) is also a helpful resource, with a small business legal center that provides information to small business owners. Plus, NFIB monitors relevant legislation and advocates for small business interests in courts. You can also find state-related employment law news and, if you need more in-depth information about issues that are specific to your practice, you can become a paid member. With that membership, you can call the legal center to ask questions.

Another in-depth resource is HR-Business and Legal Resources. There, you can find state-specific information on a variety of employment topics. There is a reasonable amount of free content with more available for members. To see if the premium content would be valuable for your practice, you can sign up for a 14-day free trial.

What we’ve provided isn’t a comprehensive list of available resources, but they are some of the most commonly used and trusted ones. If you find another credible source that provides the employment law information you need, share it with the rest of your practice.

 

Next Steps

Once you’ve identified resources for your practice to use and you have signed up for newsletters, email alerts, and so forth, what’s next? These steps can include:

  • deciding who at your practice should monitor all the information that’s coming in; if you have a discrete human resource department, that answer may be easier than if multiple employees are wearing the HR hat
  • concluding which sites and resources end up being the most valuable to your practice; it can make sense to start out by receiving and reviewing information from a larger number of organizations and then focusing more on those that provide the targeted information you need
  • determining which message format works best for you; for example, your practice might find watching videos of employment law updates is the best use of everyone’s time
  • attending relevant online trainings; these may come with a cost, but they’re likely to be much less expensive than traveling to a location where trainings are being held—and, because of the COVID-19, online resources are more practical and becoming more prevalent

Although online trainings may not allow for the in-depth personal networking that can take place over, say, a weekend-long event at a training center, they’re more affordable; can fit within busy schedules (especially if you have access to the videos after a live event); and can be ideal for practices where in-person trainings aren’t often available nearby.

As you learn new information and as employment law evolves, it’s important to review your policies and procedures; update what’s needed; and share the revised information with your practice team.

 

When to Talk to an Employment Law Attorney

The ideal situation would be to have an employment law attorney on retainer— one you trust, and who understands the legal issues that veterinary practices often face, as well as your practice’s unique workplace culture. If that’s not possible, then the next best option is to choose an attorney with expertise that dovetails with your practice needs and consult with him or her when issues of significance arise, or you need clarification on areas of employment law.

Examples of when it can make sense to consult with an employment attorney include, but are not limited to, when:

  • firing an employee; ideally, you always run employee firings past your attorney, but especially if you believe an employee might sue the practice, perhaps because of an employment contract or because he or she is in a protected class
  • an employee files a complaint or sues your practice
  • creating a contract or agreement
  • creating or updating your employee manual
  • bringing in or buying out a practice partner

 

Choosing the Right Employment Attorney

If you don’t have one yet for your practice or you’re looking to switch attorneys, be clear about what you want the attorney to do. If you want him or her to regularly update you on employment law changes, for example, then that’s different than if you want someone available when you want to address a specific issue at your practice.

Consider asking other practices and small businesses for recommendations. Ask what they like about the attorney and if they’ve had any problems with their choice. You can read online reviews of recommended attorneys, but remember to take them with a grain of salt because it’s hard to find an attorney of substance with no unhappy clients. You can also use lawyer directories such as those available through the American Bar Association, and other similar websites.

Once you have a short list of candidates, interview each one. Many attorneys, but not all, offer a free initial consultation so you can get to know one another. This can help you make the right choice. You’ll want an experienced attorney who is well versed in the laws of your state, someone you feel comfortable with and who communicates well without reverting to jargon that can be confusing. By the end of your initial conversation, you should be able to determine if that individual has a personality that you would enjoy consulting with, and has the knowledge base to successfully assist you with managing your veterinary practice.

Addressing Mental Health Challenges in The Veterinary Industry

Mental Health Challenges in the Practice: How to Identify and Combat Them

Veterinary Business Advisors, Inc.

www.veterinarybusinessadvisors.com

In February 2015, the U.S. Centers for Disease Control and Prevention (CDC) released survey results focused on responses given by more than 10,000 practicing veterinarians, most of whom were in small animal practice (69%). The results are worrying.

  • 8% of males in the profession have a serious mental illness/psychiatric disorder, with feelings of hopelessness and worthlessness; this is twice the prevalence, nationally, for males in the United States
  • Figures for females are even higher, at 10.9%, which is two to three times the national prevalence
  • 4% of males and 19.1% of females in the profession have considered suicide, three times the U.S. national average

Here’s where it gets even more concerning. The three primary stressors identified by survey respondents were:

  • Demands of veterinary practice
  • Veterinary practice management responsibilities
  • Professional mistakes and client complaints

The reason that this is so concerning: although the survey provides no empirical data about veterinary practice staff:

  • When the veterinarian is dealing with mental illness challenges, this affects the entire practice
  • The stressors that are negatively affecting the veterinarians themselves also affect the entire practice

So, it is likely that the disturbing statistics about veterinarians and their mental health challenges are just the tip of the iceberg. How, then, can this problem be addressed? First we will look at the challenges in more depth and then provide recommended strategies.

Closer look at the challenges

In an article by the American Veterinarian Medical Association titled Veterinarians and Mental Health: CDC Results and Resources, another challenge is identified: stigma. “There is a stigma among our profession,” the article reads, “toward those with mental illness, as though mental illness is a weakness that should be stifled, overcome or simply cut out like a surgeon excising a growth. But it’s not that simple. Mental illness is not a weakness or a personal or professional failing; it’s a real medical condition that must be treated.”

Harvard Health Publications acknowledges the difficulties that mental illness stigmas can create: “the stigma attached to having a psychiatric disorder,” the article reads, “is such that employees may be reluctant to seek treatment . . . out of fear that they might jeopardize their jobs. At the same time, managers may want to help but aren’t sure how to do so. And clinicians may find themselves in unfamiliar territory, simultaneously trying to treat a patient while providing advice about dealing with the illness at work. As a result, mental health disorders often go unrecognized and untreated – not only damaging an individual’s health and career, but also reducing productivity at work.”

Common psychological problems in the workplace include depression, bipolar disorder, attention deficit hyperactivity disorder and anxiety – and the economic consequences are tangible. In one study that focused on the financial impact of 25 chronic physical and mental problems, depression was most costly, with anxiety ranking fifth. Furthermore, “Many of the studies in this field have concluded that the indirect costs of mental health disorders – particularly lost productivity – exceed companies’ spending on direct costs, such as health insurance contributions and pharmacy expenses. Given the generally low rates of treatment, the researchers suggest that companies should invest in the mental health of workers – not only for the sake of the employees but to improve their own bottom line.”

Here are more granular statistics about mental illness and the U.S. workforce; note that these are not specifically focused on veterinary practices:

  • Approximately 6% of employees experience depression symptoms per year and these workers report the equivalent of 27 lost work days per year, nine because of actual absence and 18 because of lost productivity. Only 57% of employees with major depressive symptoms received mental health treatment in the past year, with only 42% of those in treatment receiving adequate help.
  • Approximately 1% of American employees deal with bipolar symptoms per year, with an average of 28 work days lost per year because of absenteeism and another 35 in lost productivity. About 2/3 received treatment, but only 9% who sought care from general practitioners received care meeting recommended guidelines, with 45% meeting that goal when they consulted with mental health professionals.
  • Approximately 6% of the population suffers from anxiety but it tends to go undiagnosed for 5 to 10 years.
  • Approximately 3.5% of employees have ADHD, and they lose, on average, 22 work days a year – and are 18 times as likely to be disciplined for behavioral/other work problems and two to four times as likely to be terminated. Only 13% of these workers are being treated in a given year.

Dealing with the challenges

Harvard suggests that employers think of mental health care as an investment. When depression is treated, as one example, “companies reduce job-related accidents, sick days, and employee turnover, as well as improve the number of hours worked and employee productivity.”

Mental Health America suggests the following strategies to help employees:

  • Ask your insurance carrier about (adequate) mental health coverage
  • Provide access to employee assistance programs (EAPs)
  • Be accommodating, creating an environment for people with special needs
  • Bring in an expert on mental health to speak to the practice
  • Create and enforce a return-to-work policy, including for those with mental illnesses

CDC suggests that practices also provide depression recognition screenings and make available confidential self-rating sheets. Meanwhile, the AMVA provides numerous resources to help practices with wellness strategies at https://www.avma.org/ProfessionalDevelopment/Personal/PeerAndWellness/Pages/default.aspx

References

“Mental health problems in the workplace,” Harvard Health Publications, February 1, 2010, http://www.health.harvard.edu/newsletter_article/mental-health-problems-in-the-workplace

Nett, Randall J., Tracy K Witte, Stacy M. Holzbauer, et. al., “Notes from the Field: Prevalence of Risk Factors for Suicide Among Veterinarians – United States, 2014,” Centers for Disease Control and Prevention, February 13, 2015, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6405a6.htm?s_cid=mm6405a6_e

“Support an Employee,” Mental Health America, http://www.mentalhealthamerica.net/support-employee

“Veterinarians and Mental Health: CDC Results and Resources,” American Veterinary Medical Association, February 12, 2015, http://atwork.avma.org/2015/02/12/veterinarians-and-mental-health-cdc-results-and-resources/

“Workplace Health Promotion: Depression,” Centers for Disease Control and Prevention, October 23, 2013, http://www.cdc.gov/workplacehealthpromotion/implementation/topics/depression.html

Exit Interviews

Exit Interviews: Who, What, When, Where, Why, and How

Kellie G. Olah, CVPM, SPHR, SHRM-CP

Veterinary Business Advisors, Inc.

 

One of the most valuable assets at your veterinary practice is the people you employ, with skilled ones having the ability to boost the quality of service you provide to clients and their animal companions. Sometimes, though, these employees leave, doing so for a variety of reasons. This can present challenges for your practice, but it also offers a silver lining opportunity if you conduct an exit interview to gather insights from that departing team member.

To help your practice extract maximum value out of these interviews, we’ll share insights into the who, what, when, where, why, and how of it all—starting with the “why.”

 

Why?

Employees often have deep insights into what works well at your practice—and what doesn’t. They may not have felt comfortable sharing their thoughts while working at the organization but may feel freer to have an honest conversation once they will be leaving.

Through these exit interviews, you can glean information about why this particular employee is leaving and then use what you learn to improve working conditions and boost productivity and retention—which in turn can save your practice money. After all, it isn’t cheap to recruit, hire, and train new employees.

Reasons why people leave can range from their salary and benefits to being recruited by another company that appeals to them, experiencing problems with management and/or other employees, and so forth. Some people may be reluctant to share issues of concern, even on their way out, while others will be happy to have the opportunity. So, it’s important to prepare an approach for either possibility.

You can also take what you learn from exit interviews to look for patterns. If one person admits she is leaving because of a particular manager, it may be a personality conflict. If four out of the last five people who left mention that same manager, that’s an entirely different situation.

 

Who?

People involved in the exit interview will include the employee who is leaving the practice, along with the person or people conducting the interview and collecting data. This raises the question of who the interviewer(s) should be. Many companies assume this is a human resources function and so they have their HR manager conduct the interview. Although this can elicit helpful information, this person will almost certainly focus on HR issues—salary, benefits, and so forth—and may miss out on the bigger scope.

Having a direct supervisor conduct the interview can create a comfortable atmosphere, given that the employee and supervisor had an open and positive relationship. However, if the employee is leaving—in part or in full—because of that supervisor, that approach can be fraught with difficulties.

Some experts suggest having the supervisor’s supervisor (or, if part of a large company, even one level above that) conduct the interviews. At a small practice, this may mean the practice owner would be the one to hold them. For some exiting employees, this could feel intimidating. For others, though, it could be viewed as a sign that their feedback is being taken seriously.

Still other companies use a consultant to conduct exit interviews. This costs money, which some practices may not want to spend. On the positive side, employees may feel more comfortable giving authentic feedback to a neutral party. Plus, an experienced consultant has the ability to draw out valuable insights and provide reliable information to the practice. Some companies have in-house exit interviews conducted, following them up with consultant-led ones.

As you can see, there is no one right answer. Think about your practice and make a savvy choice, continuing to improve upon the interviewing process whenever possible.

 

What?

The first part of the process is to schedule and hold the exit interview (more about when and where next). Explain how the purpose of the interview is to get feedback from the exiting employee to improve working conditions and otherwise meet employee needs in better ways in the future.

It makes sense to have a set of questions to use but allow for flexibility. For example, you could start by asking why the person is leaving the practice. Here are two contrasting responses you could get:

  • I got a better job.
  • I’m going to take a break from the workforce to spend more time with my young children.

You would follow up quite differently with each of these. With response one, you might use these follow-up questions:

  • What makes this a better job (salary, benefits, flexibility, etc.)?
  • When did you start looking for a new job? What was the triggering event?
  • Why did you choose to accept the new job that you did? What is more appealing to you there?

With response two, if you wanted to retain this employee, you might decide to ask if there is a way you could restructure this person’s job to allow them to have more family time while still working at your practice. Is a part-time position available?

Other questions, in general, to ask can include:

  • Did we provide you with what you needed to do your job well?
  • Did you receive helpful and clear feedback from us?
  • What else could we have provided you (training, equipment, and so forth)?
  • What are your impressions about our practice’s culture?
  • If you could change some things about our culture or working conditions, what would they be?
  • What would have helped you to stay at our practice?
  • Were you happy (or at least satisfied) with management here? If not, why not?
  • Would you consider returning here if the opportunity arose? Why or why not?

People conducting the exit interviews must be open to feedback and respectful and listen well.

 

When?

In general, it makes sense to conduct the exit interview a few days before the employee will be done at the practice. If held when the person gives notice—perhaps two weeks or a month before actually leaving—then the employee may be somewhat reluctant to share less than wonderful feedback about the practice. After all, they would still be working with the people they may criticize for a period of time.

Conversely, it’s best to avoid the last day. For some exiting employees, all they’ll be thinking about is what lies ahead and so they may not give the interview their full attention. Other employees—perhaps emotionally touched by a going away party given that day—may only give wonderful feedback, thus preventing the practice from receiving constructive criticism.

 

Where?

Exit interviews should be held, ideally in person, in a place that’s both convenient and private. Locations could range from a private office where the conversation won’t be overheard to a restaurant where a reasonably uninterrupted conversation could take place over lunch.

 

How?

How should data collected be used?

After gathering information from exit interviews, members of the practice’s management should analyze what was shared to see if changes should be made to better meet the needs of current employees. Are there, for example, voluntary benefits that you should add to your practice’s menu of choices? Should your practice offer more training opportunities? Seek out ways to build in some flex time?

After you make changes, update your employee manual appropriately and monitor the effects that changes made have on employee satisfaction, productivity, retention and so forth. Composite insights can be used in the practice’s strategic planning and recruiting strategies going forward and otherwise be factored in when making decisions that can affect employee satisfaction, productivity, and retention.

 

Sidebar: Stay Interviews

Valuable as exit interviews can be, they are still a look into a rear-view mirror. This is feedback from employees who will no longer be part of your practice. So, also consider “stay interviews” where you interview the best of your current employees. This allows you to keep a finger on your practice’s pulse. How satisfied are these employees? What issues are the most important to them? Have any of them considered seeking greener pastures? If so, when and why? Are any of them being recruited by other practices or organizations?

This gives you an opportunity to compare what you’ve learned from exit interviews with what current star employees tell you. How will this impact the changes you make at your practice? How can you use what you learn to recruit, hire, train, and retain employees in the future to strengthen your practice?

Originally published in Today’s Veterinary Business HERE.

Work Life Balance or Work Life Integration

Work-Life Balance—or Work-Life Integration?

Kellie G. Olah, CVPM, SPHR

The topic of work-life balance has been discussed for decades, with a variety of experts weighing in with different perspectives. Over the past few years, though, a new phrase has been tossed into the mix—that of work-life integration—and you may be wondering if there is really a difference, or if an old phrase has just been given a fresher name. The short answer is that the idea of work-life balance has evolved into a new and more holistic concept—that of integration. Here’s more.

Balance Versus Integration

The idea of balance suggests that the amount of time or energy spent on one activity—whether work or life outside of it—takes away from the other activity. As a visual, imagine a double-pan scale. If you put weights on one side, the other side automatically goes up while the side with the weights goes down. So, in a work-life balance scenario, time spent at work automatically takes away time spent with family, friends, and so forth—and vice versa.

This concept does have value, though. It’s simple and straightforward. You’re working or you’re otherwise living your life. Either/or. Plus, when this concept began to be discussed in the 1970s and 1980s, it did shine a spotlight on stressed, even burned out workers—initially the Baby Boomers—and it acknowledged the need for personal time.

More recently, experts and human resource leaders have begun to challenge this concept, or at least point out flaws. For example, many Millennials are looking at the work-life equation somewhat differently, in a way that doesn’t fit within the notion of balancing the two options.

These Millennials are envisioning what a meaningful life would look like to them and then seeking out jobs and pursuing careers that would allow that to happen. This is in contrast to the approach that’s traditionally been used—that of finding a job and then fitting in family and leisure activities around employment.

So, in short, work-life integration replaces an either/or dynamic with a holistic one that has more fluidity and flexibility.

 

Which Combination Resonates?

 

An example of the traditional concept of work-life balance would be a “banker’s hours” type of job where a person goes to work from, say, 9 a.m. to 5 p.m. Before they go into work and after they get home—and on the weekends—work is left behind, and they focus on other aspects of life. Shift hours don’t have to be 9 to 5; this is being used to illustrate the either/or nature of a work-life balance.

Now picture a continuum. One the far left are people whose passion for their careers is so great that they largely prefer a work-work balance. Any free time they have would preferably be spent finding additional ways to contribute, career-wise, and to advance in the workplace. On the far right are people with a life-life balance, where they may work because they have to for income, but their career is not a focus. Free time goes to friends, family members, hobbies, and so forth.

Now, the middle of our continuum can represent work-life integration, a situation where the two aspects of life fuse together in a satisfactory way. At this point of our illustration, the continuum image still works symbolically, but not literally—because the combination of work and life that works for one person won’t work for another, and it’s typically not an equal balance of the two activities. Each person can have a different spot on the continuum.

 

How Your Practice Can Respond

First, it’s important to understand what each of your employees needs, and what each one values, and then brainstorm ways to contribute. The underlying philosophy is that, as your practice’s team is able to take care of family commitments and otherwise participate in meaningful events, the more they’ll be able to provide their best quality of work. After all, even employees with the highest levels of commitment can fall short when they’re feeling burned out or worried because they can’t be present during important family moments.

Next, practice managers can hold conversations with each employee to talk about how to cooperatively create and optimize his or her work-life integration. A key component of this would be to see how flexible the work environment can be. Can employees, for example, switch shifts as long as it’s done in an equitable way that won’t leave gaps in service? Can an employee’s hours be tweaked on certain days? Are there any circumstances in which an employee can do some work remotely?

If employees struggle to fit in exercise with their work and family responsibilities, can your practice have someone lead them in yoga stretches during lunch? If they want or need to obtain continuing education credits, but find it difficult to earn them after work hours, how can you incorporate opportunities in company lunch and learns?

 

Continued Flexibility

Will this system work perfectly, every day? Of course not. Integration is an ongoing process. On some days, a work schedule may be more demanding; on other days, a personal emergency could arise. Plus, work-related needs and non-work needs can evolve, which means that a process of continual assessment and adjustment will be required.

 

Practice Managers and Owners

To help develop a flexible work culture, practice managers should also look after their own integration needs. This helps to prevent burn out and sets a good example. It’s also important to not micro-manage the flexibility options that have been given to employees. If, for example, employees are allowed to switch shifts as long as gaps as covered, don’t hover over the employees’ shoulders.

Establish reasonable processes and procedures; include them in your employee manual; communicate them clearly to employees; and then give practice team members some breathing room in implementing them. Encourage them to work out challenges together as a team, only entering the process when they have reached a stalemate.

 

How Practices Can Benefit

When a practice flexibly collaborates with employees to help them maintain work-life integration, employees are more likely to stay at that practice. This allows managers to recruit and retain quality professionals—which in turns reduces turnover costs associated with recruiting and training new employees.

Plus, when an employee is given opportunities to integrate their lives more fully, they will likely be happier and more committed to the practice—and that shows in the service they provide to clients and their animal companions. This will allow them to serve as better role models for new employees, more willing to help their office mates to achieve their own work-life integrations.

 

SIDE BAR: Work-Life Integration During COVID-19

The coronavirus pandemic has changed people’s lifestyles in numerous ways. Some people may be working fewer hours than before or have been laid off or furloughed, while others may be working more hours than ever. Some people have been directly impacted by the virus, perhaps needing to care for a loved one or to recover from illness personally. Although specifics will vary by person, today’s realities can have a significant impact on how you view work-life integration and may trigger evolutions in perspectives.

In other words, you now have an opportunity to evaluate what you truly value through a new and unexpected lens. There are no right or wrong responses when it comes to your thoughts and feelings about work-life integration during the pandemic—so analyze your own unique reactions.

How would you (re)prioritize each aspect of your life? What things that once seemed important can now be set aside for a later time? What now feels crucial to you that you wouldn’t necessary have prioritized so highly, pre-COVID? What aspects of life do you now realize you are ready to eliminate from your lifestyle? What elements of self care do you now plan to implement?

Originally posted in Today’s Veterinary Business HERE.

Workplace Issues to Consider About The Internet

Three Workplace Issues to Consider About the Internet

When you think about legal issues associated with the internet that can affect veterinary practices, you may think about telemedicine – and that is an excellent example, although not the only internet-based legal issue faced by practices today. This article provides an overview of three different legal issues associated with the internet.

Researching Potential Employees on Social Media

Social media makes it so easy to find information; including about people your practice is considering hiring. But, is it legitimate to search on social media platforms to discover information about job candidates? As with most broad questions posed about the ever-evolving internet, the answer is “it depends.”

It is not, in general, illegal to research job applicants’ social media profiles, but don’t do so haphazardly. Instead, create a clear written policy about what sites will be reviewed to find what clearly-defined pieces of information. Also determine who will review these profiles and what information will be housed in your records. To add a layer of protection to your social media policy, consider having a person without the ability to hire, a non-decision maker, do the research.

Make sure you follow your policy consistently for all candidates, not only certain ones. If you act inconsistently when an issue involves a protected class, this could open you up to a discrimination lawsuit. A protected class is any group of people with common characteristics who have legal protections from discrimination because of those characteristics. These characteristics include race, color, religion, national origin, age, gender, pregnancy status, disabilities and more.

Here’s how something could quickly go wrong. Let’s say you obtain a piece of information that theoretically could lead to your not hiring a candidate. Then let’s say you don’t hire that candidate, but this piece of information had no bearing on your decision whatsoever. The candidate could still claim a connection between your hiring decision and an employment or labor law violation.

Here’s another issue to consider. If your investigation includes a review of the job applicants’ credit history, financial history, driver’s license verification and/or other pieces of related information, you may run afoul of the U.S. Fair Credit Reporting Act.

Employee Use of the Internet

As of September 2016, 87 percent of people in the United States use the internet, according to PewInternet.org. And, according to another PewInternet.org report from November 2016, 79 percent of Americans who use the internet are on Facebook. Smaller percentages of people are on other social media channels, such as Instagram (32 percent), Pinterest (31 percent), LinkedIn (29 percent) and Twitter (24 percent).

The bottom line, though, is that virtually every veterinary practice in the country will have at least some employees who use the internet – so, how do you, as a practice, monitor employees’ internet use while on the clock? Employees want privacy in their internet use, whereas the practice wants to make sure that time on the clock is well spent. Employers also want to ensure that computer use in the practice does not involve any inappropriate or even illegal activities.

The solution? However you choose to monitor employee usage, do so consistently, and create a clear written policy about internet use during company hours. If you don’t provide this policy, then employees could have justification for a breach of privacy lawsuit. If you decide to monitor, what are your options? Some practices may decide to install site-blocking software on all office computers or use software that limits the amount of time that someone can browse a non-work-related site.

What about texting? Should your employees be allowed to text during work hours? Again, a clear written policy about text use is crucial so employees know what is and isn’t acceptable. When crafting the policy, consider context. Having an employee ask his or her child to text when he or she is home from school is a very different situation from an employee who texts about party plans when he or she should be helping with an agitated patient.

Internet Harassment and Cyber Bullying in the Workplace

A serious downside to the internet is online harassment and cyber bullying, and that unfortunately can take place among coworkers. And, at the risk of sounding like a broken record, a clear written policy about how online harassment and cyber bullying will not be tolerated is crucial. In this statement, clearly define what you mean by harassment and by bullying, and state that examples given in your policy do not constitute the full range of behaviors that fall into these two categories. Share the consequences, up to and including termination, if the policies are not followed.

Consider working with your entire practice team to develop a values statement so that employees can play a role in its formation. Besides creating a useful statement, if you sit in on the meeting, you can likely identify people who are less likely to abide by it.

If you notice higher turnover, be especially vigilant in watching for bullying behaviors and, when identified, deal with them firmly. Also watch out for behaviors and statements that are presented as jokes, with people who don’t find them funny being told they have no sense of humor and need to lighten up.

If someone comes to you to report bullying or harassing behaviors – ones that are occurring to the person reporting them or to someone else – take them seriously. Slow down, listen and respond accordingly. Also consider what resources to offer to people being bullied or harassed, from stress management strategies to counseling services.

Conclusion

These are three of the more common legal issues connected to internet use in the workplace, but this is not a comprehensive list. Use this article as your starting point and remember to update your policies and procedures as internet technology evolves. Also watch for information about court cases where boundaries of cyber bullying are adjudicated in the courtroom.