The Veterinary technician profession has been subjected to variability since birth. Today, it faces a new, and hopefully positive, change with discussions about modifying the profession’s title to “veterinary nurse”. A movement lead by the National Association for Veterinary Technicians in America (NAVTA) has illuminated differing opinions between those in and outside of the profession.
Veterinary Technician History
The profession began in 1908 when the Canine Nurses Institute made its first organized effort to train English “Veterinary Assistants”. Over the next eighty years, the profession grew. First, the American Association of Laboratory Animal Science created three different levels of “animal technician” certifications at research institutions. Next, the US Army, Purina, and State University of New York (SUNY) established “animal technician” training programs in the 1960’s, which the AVMA then began regulating in 1967. The AVMA waited until 1989 to adopt the term “veterinary technician”, feeling until then that people would be confused with the “veterinary” modifier.
Michigan State University and Nebraska Technical Colleges were the first animal technical educational programs accredited by the AVMA. There are now 230 AVMA accredited veterinary technician education programs. Of these, 21 offer four-year degrees and nine offer distance-learning (online) options. Even before the AVMA adopted the term, the North American Veterinary Technician Association (now called the National Association of Veterinary Technicians in America) was formed in 1981. It works alongside the AVMA to protect the profession and encourages veterinary technician specialty developments. However, the profession has not grown uniformly across the United States.
In the United States, 37 states have established “veterinary technician” licensure, 10 states have non-profit organizations that implement voluntary credentialing, and 5 states/territories do not have any credentialing systems. This means that being a veterinary technician today could mean that either the state government regulates your credentialing, you are privately credentialed, or someone gave you the title “veterinary technician” when you started working at a veterinary practice and there is no credentialing system in your state.
Pros of “Veterinary Nurse”
The profession is fragmented by more than their state’s accreditations. Depending on their location, Veterinary technicians currently have varying titles. There are 19 states that use “certified veterinary technician”, 15 states that use “registered veterinary technician”, 14 states that use “licensed veterinary technician”, and Tennessee uses “licensed veterinary medical technician”. With this amount of fragmentation within the profession, how do we as veterinary professionals expect the general public to understand or trust a veterinary technician’s job description? As such a close-knit profession, we forget the foreignness of our commonly-used terms. Most clients underestimate the value of their veterinary technician simply by not knowing the education process. In fact, in a NAVTA survey to human nurses, 71% did not know the difference between veterinary assistants and technicians. Yet, we are baffled when we find that credentialed veterinary technicians are repeatedly unhappy and facing low income, compassion fatigue, lack of recognition and career advancement, underutilization of skills, and competition with individuals trained on-the-job. Due to this culture, the profession has incredibly high turnover rates despite its increased demand by the growing veterinary industry; veterinary technicians are projected to grow 30% by 2022.
How can we, without spending incredible amounts on advertising, uplift our veterinary technicians in the public (and practice’s) eye? Many have suggested using the familiar and applicable “nurse” title. The word “technician” implies an individual who has mastered veterinary science and technology, while “nurse” incorporates caring for animal patients into the description. Heather Predergast, RVT, CVPM, SPHR, a specialist with Patterson Veterinary Supply, Inc., discussed the need to abolish the profession’s fragmentation. She noted that “there has long been a need for common credentialing in this area. The responsibilities and job tasks of a veterinary technician have evolved over time and are inaccurately described by the term ‘technician’, implying a definition of their identify based on technical tasks. The term ‘veterinary nurse’ will incorporate the art of caring for patients from a patient-centered perspective, in addition to the science and technology.”
For these reasons, NAVTA has launched the Veterinary Nurse Initiative in an action to unite a single title, set of credential requirements, and scope of practice. This movement would hopefully provide recognition to the profession and elevate its credibility by requiring further education. Like human nurses, differing titles would recognize individual’s efforts for further education. To distinguish associate and bachelor’s degrees, NAVTA has proposed designating Registered Veterinary Nurse for associate degrees and Bachelor of Sciences in Veterinary Nursing for bachelor’s degrees.
Australia and the United Kingdom have already changed the name to “veterinary nurse” with large success. As the movement poses potential in the States, many academic institutions and corporations, such as Purdue, Midmark Corporation, and Patterson Veterinary Supply Inc. have published endorsements for its change; however, the initiative does face fair opposition.
Cons of “Veterinary Nurse”
Many veterinary technicians still opt to keep their current title. When questioned in a 2016 NAVTA survey, the majority of veterinary technicians (54%) favored the term “veterinary nurse”, over a third (37%) wanted to keep the title “veterinary technician”, and the remaining surveyed were undecided. Most of the pro-technician responders attributed their answer to disbelief that it will be possible to change the title. Some current veterinary technicians have voiced unease at their unsure futures after working their entire careers in a state that does not require licensure. Another similar situation arises for those that have passed the veterinary technician national examination but have not graduated from a school accredited by the AVMA committee.
While, ideally, this veterinary nurse initiative works to unify the profession and ensure quality standards, we must realize that we may be alienating a population of technicians at the end of their careers that would be offended if required to pay for an accredited teaching program and learn alongside new, inexperienced future technicians. Another important consequence to consider is liability. Currently, liability for veterinary technicians falls to the veterinarian on all cases; however, human nurses have their own liability to practice under their license governed by a separate board. This is a consideration essential to address as we raise the accountability of veterinary nurses.
The Veterinary Nurse Initiative has faced opposition outside of the profession as well. In fact, the veterinary technicians initially opposed to changing the name also noted conflict with human nurses in any past attempted title changes. The Veterinary Nurse Initiative investigated this further by sending a survey to three nursing groups. Two of the three declined to even acknowledge the survey, potentially indicating apathy for veterinary-related topics. Of the one group that did complete the survey, 66% did not object to “veterinary nurse”; however, regardless of whether or not they were opposed to the title change, almost all of the responders incorrectly assumed a veterinary technician’s educational requirements. An analysis of the opposed responses to the nurse title found that the objectors believed technician education was subpar to human nursing and the title was not deserved by veterinary technicians. It suggests that the human nursing profession worries about maintaining the quality of its own title and hopes to avoid misrepresentations.
In the past, other professions, not similar in scope to human nurses, have attempted to claim a “nursing” title. For example, a Christian medical community attempted to title their “spiritual healers” as “nurses”; however, they did not share nearly the same amount of education rigor. When confronted with a potential title change in the veterinary profession, human nurses mistakenly worry that the term “veterinary nurse” will also encompass veterinary assistants. This confusion highlights the need for public awareness of technicians – if the closest human counter-part profession does not understand a technician’s role or certification, how can we expect the general public to know any differently? The veterinary profession must raise awareness to the public about the differences between its assistants and technicians.
Currently, as the veterinary nurse initiative gains a foothold in Ohio, the Ohio Nurses Association and its 170,000 members have fought its new legislation, arguing that the state legally defines the term “nurse” as caring for humans and that no other person or profession may insinuate that they practice as a nurse. With similar nurse title protection in about 24 other states, the veterinary nurse initiative is likely in for its fair share of conflict as it continues to grow.
The debate over the title of veterinary technicians remains controversial both in and outside of the veterinary community. As with any impending change, it is important to recognize its potential benefits and shortcomings in order to formulate the best strategy to improve the profession. If the Veterinary Nurse Initiative ends up being successful, the change will likely empower today’s veterinary technicians and reduce the profession’s current high turnover rates.
Originally Published in Today’s Veterinary Business October 2018
Although mentoring is not a new concept in the workplace, modern partnerships are not necessarily like those in the past. According to HR Magazine, formal mentoring relationships in previous eras would have typically lasted at least a year. Informal ones? They could last a decade. In today’s workforce, though, these relationships are often shorter and more specialty-oriented than before.
Because of this shortened timeframe and accelerated pace, lines between mentoring and coaching can be blurred. Increasingly, mentors are no longer necessarily higher on a company’s organizational chart. In fact, reverse-mentoring now exists. In reverse-mentoring situations, newer staff members are teaching older, more experienced ones about new technology, as just one example. As one scenario, a Millennial employee may be teaching her Baby Boomer supervisor about how to effectively use social media and crowdsourcing, while also sharing insights into new ways of thinking about business.
According to a survey taken by the Association for Talent Development in 2017, 29 percent of organizations have a formal program in place for mentoring, with 37 percent of them having an informal one. Mentoring opportunities are also available through professional organizations, either online or in person.
A skilled mentor can help the mentee become his or her best possible self. This happens when a mentor takes the time to really understand the person he or she is mentoring, including where the person is in a career path – and where he or she wants to go, career-wise. Once this is discerned, then each of the actions by the mentors should help the mentees participate in the types of behaviors that allow them to become aligned with their own best selves.
Now, here are seven keys to creating the best possible mentor/mentee relationship.
Key #1 Be very clear about the goals established for the mentoring program.
Are there specific job-related skills that the mentee needs to gain? If so, what are they? Is the mentor guiding someone to an understanding of a practice’s culture? Perhaps the mentee worked for a private practice that was recently bought out by a corporate one, and the mentor is serving as a guide and sounding board to an employee during a transition period. Whatever the goals are, make sure they are clearly defined and understood by all involved parties.
Key #2 Make sure the two participants are well matched.
Synergy and mutual commitment fuel mentoring relationships, so it’s crucial to put the right pairs together. As mentioned above, mentoring is no longer limited to an older and/or more experienced person at the practice mentoring someone younger and/or newer. The goal of this evolving process is to have one member of the team fill in gaps of the skills and/or experiences of another employee, so form your pairings for that purpose. It can be tempting to put together people because they’re so much alike that they’re sure to get along. They probably will get along, but that alone doesn’t fulfill the purpose of mentoring. Remember: fill in experience and skillsets through mentoring opportunities at your practice.
Key #3 Mentoring usually takes significant time and energy, so don’t expect quick results.
There are exceptions to this rule, of course. If a Millennial is paired up with a Baby Boomer to teach the use of Instagram, this can all come together rapidly. If, though, that same Millennial is paired up with that same Baby Boomer to help transition the mentee to a telecommuting role at the practice, this can take time and energy for mindsets to evolve.
Key #4 Multiple mentors sometimes make sense.
Some companies pair up a mentee with a primary mentor and are then open to people having numerous more informal mentors to boost the diversity of the learning experience. It can be very helpful, even enlightening, to have mentors from different demographics – whether that’s age, gender or something else. Being exposed to different points of view from thoughtful members of the practice can be quite beneficial.
Key #5 Mentors should provide guidance rather than setting strict requirements.
Your practice will create an overall structure for its mentorship program and, yes, participants should follow the structure you set. But, a mentor is not there to enforce rules or to lecture. Rather, a quality mentor may spend more time asking questions and listening to answers than speaking, offering advice rather than rock-solid answers. Mentees should be encouraged to listen closely to what a mentor has to say and then carefully evaluate how it fits into his or her life and career path.
Key #6 Mentees should prepare and ask questions.
The best mentoring relationships are two-way streets, with the mentee being an active partner in the relationship. Passive listening will only go so far in helping a mentee develop skills and gain knowledge. Instead, engaged mentees should share what has been helpful, what gaps exist in his or her knowledge base and skill sets, and so forth. In a sense, being mentored should also empower the mentee to pass on knowledge to the next person in the practice who needs assistance.
Key #7 Effective mentoring focuses on relationship development.
Near the beginning of this article, we shared how modern mentoring resembles coaching, at least more so than in the past. But, at its core, mentoring has been and should remain relationship-oriented. The mentee should feel safe and nurtured as he or she learns professional skills through mentoring. Although this knowledge will likely enhance the mentee’s ability to perform tasks, mentoring is not as task-oriented as coaching.
Mentoring should help employees at your practice become more self-confident and able to juggle his or her work/life balance. While coaching can be performance-driven, mentoring focuses on developing the employee, both to improve his or her skills and knowledge today and to prepare him or her better for the future.
Starting a Mentoring Program at Your Practice
Be very clear about what you want to achieve through this program and have a plan in place to measure its effectiveness. Determine who can participate, both as mentors and as mentees. Can someone, for example, volunteer or will you select them? Decide how formal or informal the program will be, how often you expect partners to meet and so forth. Explain the program to your team, adding specifics to the employee manual, and strategically pair up mentors and mentees. Invest enough resources to allow the program to be successful, be available to mentors if they need guidance, and use this program to develop your team in a way that dovetails with practice goals and dreams.
Link to the article on Today’s Veterinary Business: https://todaysveterinarybusiness.com/modern-mentoring/
Whether an owner is transitioning a practice to an associate, colleague or corporate entity, the process of onboarding can be complex. This article intends to outline the medical, financial and staff transition steps to follow, post-sale, along with the challenges each presents.
Although mergers and acquisitions (M&As) typically begin with high hopes of success, not all do succeed. Below are some statistics about practice sale shortcomings:
- 65% of all M&As do not achieve objectives set forth by deal architects
- 83% of mergers do not increase shareholder value
- 50% loss of key managers and technical employees is experienced within 12 months
- 50% of failures are due to cultural clashes
Most failures are attributed to operational, financial and/or customer relations problems. Within these broad categories, common reasons for M&As failing to achieve their objectives include the parties not doing one or more of the following:
- thoroughly consider all types of value critical to the practice
- establish priorities for integration
- identify and address risks that inhibit integration
The buyer may, for example, expect the seller’s personnel to integrate themselves, which may not happen. In other scenarios, the buyer has an integration program, but it does not run efficiently or see things to fruition. No matter the specifics, the ultimate result of poor integration is that morale drops, revenue diminishes, and objectives are not met.
In a full half of M&As, key managers and technical employees leave. This is typically an indication that a new owner has failed to implement an organizational and leadership structure that is emotionally satisfactory to employees, at least not in a timely manner. As a result, talented staff leave for better-run practices.
For a successful transition to occur, timing is key. A prolonged transition period distracts leadership from the mothership of the business. Gaps in communication contribute to a drop in customer service, which is reflected in reduced client retention—effectively leaving the practice vulnerable to veterinary competitors in the area.
There are three main areas to consider in regards to the medical side of the transition.
As part of a transition, medical records must be carefully reviewed to ensure they contain all information and documentation as required by state and federal law. Generally, the physical medical record is owned by the veterinarian or entity responsible for compiling and maintaining the medical record. To ensure no lapses occur in accessing or adding to existing medical records, the owner and buyer should clearly define how such files are to be transferred and managed.
It’s important for the buyer to have access to job descriptions of all the seller’s staff, along with the practice’s standard operating procedures. Often, sellers may propose changes to increase synergy and efficiency. For example, sellers may overhaul product or service offerings to enhance compatibility with the existing clientele or attract new ones. The operational documents created, however, should outline job descriptions and standard operating procedures—and the infrastructure required to execute them—as they currently stand.
Maintaining Medical Standards
Upholding the medical standards of a practice is intricately entwined with retaining key staff members who execute those medical processes. If the practice associates and staff intend to continue working post-sale, employment agreements should be created that include staff roles, responsibilities, and terms of agreement. The owner can suggest that the buyer wait six months to implement any significant changes, and then to do so gradually.
The first steps in planning a financial transition include to generate an expense budget, profit and loss statement, and statement of assets and liabilities. The author recommends creating an expense budget based on the latest edition of Veterinary Economics’ Benchmarks: A Study of Well-Managed Practices. A typical expense budget includes (at minimum) projected and actual values of revenue, cost of goods sold, staff, rent, equipment leases, utilities, office supplies, bank fees, and owner salary.
A profit and loss statement features year-to-date comparisons of items such as fees for professional services, laboratory services, vaccinations, pharmaceutical imaging, grooming, and dental services, as well as food and retail sales. Additionally, it lists year-to-date data on costs of goods sold, along with staff, equipment, and administrative expenses. Finally, it calculates a net income. On average, this statement should take about five to ten hours per month to generate.
A statement of assets and liabilities functions as a balance sheet for the practice. It lists both current and non-current assets; the latter is not easily converted into cash and can include buildings, equipment and motor vehicles. Current assets include money in checking or savings accounts, accounts receivable, and inventory, among other possibilities. An example of a non-current (long-term) liability is a loan taken out to buy the practice; current liabilities include accounts payable and other amounts expected to be paid in the current financial year.
In generating financial analyses of the practice, it may be important to hire an accountant. In general, accountants cost about 0.5% of gross annual revenue. Moreover, owners should consider hiring a dedicated practice manager, which will cost about 0.4% of gross annual revenue.
As a tool to help owners further interrogate data, practice management software allows owners to track gross revenue in multiple ways, perhaps weekly, monthly, and quarterly. Average transaction charges should be tracked hourly; if not, then daily, and then periodically.
Cultural clashes are defined here as differences in human elements between merging companies. For a practice to be successful, these clashes must be identified through an audit and then successfully addressed. A cultural audit would examine factors such as core values, policies and practices, work processes, leadership styles, and human emotions. More specifically, examinations in human emotions should include people’s uncertainties surrounding job security and their fear of change. The importance of an audit of staff emotions cannot be understated, as one survey suggests a 26% increase in successful mergers if human elements are resolved in pre-deal stages.
The buyer must determine the health of the seller’s practice’s human capital. Metrics helpful in determining this include rates of employee retention and/or turnover, the effectiveness of internal channels of communications, and past lawsuits, among others. Specific issues that need to be addressed with staff include any changes in benefits, pensions, compensation packages and reward and recognition programs.
To successfully transition the staff to new ownership, it’s important to plan the integration 60 to 90 days ahead of the target closing date. The buyer must define, in writing, the mission, values, leadership style, and philosophy of the new company. Additional tasks include to:
- identify potential barriers to integration
- craft strategies and solutions to overcome barriers
- prioritize work-streams, especially those that are synergistic
- assign leaders to monitor specific progress parameters
- outline predictable reward and recognition programs for employees that are driven by performance
- solicit employee input so that job descriptions are clear (this is crucial for them and the practice overall to meet expectations)
- create process maps and tools to facilitate career development
- groom potential replacements
- invest in high-potential employees year-round
- retain key employees using personal, one-on-one communication
- clearly point out channels of communication and feedback mechanisms to address employee concerns in real time
- host integration activities between the merging staffs.
If this seems overwhelming, given all the work that needs done, consider hiring a third-party professional cultural auditor. Senior executives are often too involved in the practice vision to fully assess workplace culture. Furthermore, employees may be more forthcoming with sharing their problems to an impartial outsider. Such auditors can offer different perspectives without regard for their own job security, resulting in a more objective cultural examination.
Five Things Not to Say
- “We don’t anticipate making any changes.” On the contrary, changes are to be expected, post-sale; it should be viewed as an opportunity to make improvements. Besides, when changes do occur, they will be attributed to the transition whether they are related or not.
- “This is a merger of equals.” Pre- and post-sale teams are never truly equal in authority.
- “We plan to take the best of both worlds.” This phrase is, at best, subject to the opinions of the pre- and post-sale teams.
- “It will continue to be business as usual.” Practice sales often fundamentally change the psychological tone of a clinic as it transitions to new ownership.
- “The culture of our two companies is very similar.” Although this may be true, people will focus on differences, which will bring unwanted attention to areas where expectations were not met.
Although positive outcomes cannot be guaranteed, owners can take definitive actions to help their team transition operationally, financially, and culturally. Through careful preparation and clear communication, many problems in transitioning a practice to new ownership can be prevented or at least significantly minimized.
Originally Published in Today’s Veterinary Business, August 2018
Although plenty of businesses talk about change, and although many of them devote significant time to change management, too many efforts are still failing. An article in HR Magazine titled “Why Change Efforts Fail” analyzes why this is happening and offers suggestions to help make your next change management strategies take root.
The article cites a new study by Prosci that shares how 86 percent of 1,778 change leaders expect change initiatives to continue to increase over the next two years, with 55 percent expecting them to significantly increase. But, a spokesperson cautions, 73 percent of them also shared how their organizations are either approaching, at, or past change saturation, reaching the point where it’s difficult to absorb any more changes.
Tips to help prevent change initiatives from failing in this age of saturation include remaining visible and active throughout the entire process. Sponsors of the changes can’t abdicate responsibility if they want them to succeed. And, while it’s important to communicate the nuts and bolts of proposed changes, it’s also crucial to discuss adjustments that will need made and otherwise work through the emotional components of change. This will help to reduce resistance.
Share the rationale behind the changes because, when people hear why something is happening, it’s easier for them to adjust. And, be sure to model the behavior you expect from your team. If, for example, you want more collaboration to take place among team members, demonstrate that yourself first.
In 2018, one-way, top-down communication isn’t typically effective. So, communicate changes to your team as early in the process as possible, provide time for discussion, and don’t try to do too much at once. Prioritize initatives to help prevent saturation.
A July 2017 article in Forbes, titled “1 Reason Why Most Change Management Efforts Fail,” echoes the dangers of saturation, calling it “change battle fatigue.” Citing a McKinsey and Company study that shares how 70 percent of all transformations fail (with that percentage believed to be increasing), the article details how and why battle fatigue can set in. They include past failures that plague employees’ memories (“Oh, no! Not THIS again!) and the impact of sacrifices made through an “arduous” process. Discouragement further weighs down the process and, when transformation is poorly led, efforts are even more likely to derail.
When workplaces go through significant changes, employees can become fearful, especially when past attempts at transformation failed and perhaps led to layoffs or other negative consequences. When people are worried about their careers, they aren’t as open to learning or able to think as well. So, the article points out, right when management needs the team to be at their best, they are distracted, less productive and unable to focus as effectively.
Suggestions to break this cycle include the identification of early successes, and taking time to celebrate them, as well as ensuring that the vision continues to be supported. And, to effectively identify and then celebrate early wins, milestones and timelines need to be clearly defined. When a milestone is met, people responsible for this success must be acknowledged from the top. This will help to validate the transformation vision, keep the team energized, and spur the momentum on even further. Plus, careful monitoring of early milestones will highlight if and when the plan needs to be adjusted, and how.
To continue to support the vision, it’s important to determine what aspects of your workplace culture support it, as well as which ones don’t – and which ones don’t have a significant impact, either way. What do you keep? Only those elements that support the vision. As one example, the article shares how a company had a vision for collaboration. Yet, when you went into their offices, it was an “ocean of cubicles” with people listening to headphones. Although this setup may be effective in some workplaces, it does not support the vision of collaboration. After the office space was revamped, people stopped communicating via Google Chat to someone who was only two cubicle spaces away, and they began to communicate in person.
This challenge is not new. In fact, the Harvard Business Review identified reasons why change management fails in a well-thought-out article back in 1995. Titled “Leading Change: Why Transformation Efforts Fail,” the article lists eight different reasons, the first of which focuses on not establishing a significant enough amount of urgency. More than 50 percent of transformation failures observed by this expert were caused by this factor.
Other errors include not creating strong enough transformation leadership, a lack of vision and under-communication of the vision by a “factor of ten.” Some companies, the article notes, fail to remove obstacles standing in the way of the transformed vision. Obstacles can include the way the workplace is organized, poor compensation that causes people to focus on their own self-interest over the new vision – and, worst of all, the expert says, “bosses who refuse to change and who make demands that are inconsistent with the overall effort.”
Other errors noted include not creating short-term wins or declaring victory too soon. The article states that, while celebrating a win can be a plus, declaring all to be won can be “catastrophic.” Over the first five to ten years, it’s easy to regress to old ways, while the new vision is still fragile.
Finally, this Harvard publication notes, it’s important for leaders to consciously demonstrate how the new approach is improving performance. Don’t make the team members make those connections on their own (or not make them or misinterpret them). And, it’s crucial to ensure that top management continues to implement and use the new vision and approach. The article ends with this thought: “In reality, even successful change efforts are messy and full of surprises. But just as a relatively simple vision is needed to guide people through a major change, so a vision of the change process can reduce the error rate. And fewer errors can spell the difference between success and failure.”
It is a lively Friday afternoon. As usual, just an hour from close, two separate frantic clients call into your practice: one, of a dog that has been vomiting hourly since yesterday morning, and two, of a suspected blocked cat. The cat arrives first, and you and your team swoop it to the back for further examination. The cat is aggressive, and it takes two nurses and one assistant to swaddle it into position for a cystocentesis. As you dive into the crowded huddle, needle in hand to collect the urine, you lean your left hand on the assistant’s back for support. You successfully collect the urine and finish the rest of your evening’s work. It has been a long week, but you feel good about the day’s outcome and head home. The next morning, before your shift, your practice manager calls to inform you that someone has filed a complaint against you, that you are currently under investigation, and that you are suspended until the investigation has finished. With not much time to process this sudden information, you do not ask any questions, and hang up the phone. Now what?
Sexual harassment is not an unfamiliar concept to most people today. Increasingly in the news because of the #MeToo movement, more victims are becoming courageous enough to speak up against predators that have, for many years, held a position of power and a sense of untouchability. Unfortunately for these victims, a second population exists with ulterior motives, people who are using this movement inappropriately to harm innocent colleague reputations, careers, and livelihoods. America has yet to develop a method that distinguishes a true victim from a disgruntled coworker, ultimately diluting the real victims’ stories and harming innocent people. In addition, the current misconceptions of large false reporting rates lead plenty of real victims to return to their fears of reporting sexual harassment or assault.
The Equal Employment Opportunity Commission (EEOC) defines sexual harassment as “unwelcome advances, requests for sexual favors, or other verbal or physical conduct of a sexual nature.” Sexual harassment can be performed by people of both sexes and the act does not specify that the victim is to be of the opposite sex. A harasser may be any work-related individual (colleague, supervisor, or non-employee) and the victim may be anyone affected by the offensive conduct. Sexual harassment has two main types: quid pro quo and hostile work environment. Quid pro quo, a demand for sexual favors in exchange for employment opportunities, only requires one incident to file a charge. A hostile work environment, a workplace that is sexually demeaning, hostile, or intimidating, relies upon behavioral patterns to have validity.
There are a few deadlines to consider if proceeding in a sexual harassment case. In federal sexual harassment cases, the victim has to file a charge with the EEOC within 180 days. When the EEOC responds by issuing a “right to sue,” the complainant has 90 days to file a federal lawsuit. When investigating, the EEOC will consider the context and nature of the sexual behaviors.
What explains the rise in sexual harassment across America – or at least in its reporting? Historically, individuals risked professional and social suicide by accusing a colleague of inappropriate sexual behavior, consequences strong enough to suppress most victims’ voices. This culture existed, fairly unchanged until recently; and, in fact, in 2016, the EEOC’s total number of sexual harassment complaints was 15 percent lower than in 2010.
Harvey Weinstein’s sexual harassment case, though, created in October 2017 what has been termed the “Weinstein Effect.” While the EEOC has not released its annual numbers following the Weinstein scandal, state-level numbers suggest it has already had a significant impact in empowering victims to come forward and break the societal stigma. Looking at a state level, from January to March 2018, California’s Department of Fair Employment and Housing received 939 sexual harassment complaints, an 86 percent increase from the previous year’s 504. From October 2017 to April 2018, New York’s State Division of Human Rights received 353 sexual harassment complaints, a 60 percent increase from the previous year’s 220. While the reason cannot yet be nailed to the Weinstein Effect, these numbers are noteworthy.
Dan Cassino, an associate political science professor at Fairleigh Dickinson University, wrote a Harvard Business Review article suggesting an additional factor: that the apparent increased sexual harassment claims not only reflect empowered individuals reporting abuse, but also an increase of masculine insecurity as women rise in the workforce. This insecurity could be leading to additional inappropriate actions taken by a percentage of men to maintain a sense of power.
Impact in the Veterinary Industry
Since 1986, women have outnumbered men in the veterinary industry, first in school and now in the field, and this trend is continuing. The American Veterinary Medical Association (AVMA) reports that the current veterinary market consists of 55 percent female and 45 percent male veterinarians. Feminization of the veterinary industry is even more apparent when looking at technicians, a field long consisting of females. In 2017, the Association of American Veterinary Medical Colleges reported that women hold 90 percent of veterinary technician positions. If Dan Cassino’s hypothesis is true, the veterinary profession risks significant gender conflict and potential concurrent rises in sexual harassment claims with its continuing feminization.
Here’s one example of how a large veterinary corporation is addressing sexual harassment claims. Mars (Banfield, Blue Pearl, Pet Partners, and VCA) has a zero-tolerance policy that permits immediate discipline or termination of an alleged harasser for just one indiscretion.
Accused of Sexual Harassment? What to Do
Sexual harassment remains a relatively young concept with all-too-often vague workplace guidelines for protecting employees both from sexual harassment and false sexual harassment claims. Returning to our hypothetical veterinarian faced with a sudden sexual harassment claim in this article’s introduction, the following steps must be taken if you are accused:
- Hire a qualified criminal defense attorney immediately.
- Realize the importance of these accusations and their effect upon your job stability and reputation.
- Prepare for the cost of high legal fees.
- Know that you are not required by law to say anything to the police.
- Remain calm and do not allow emotions to dictate your actions.
- Understand that, when an employer receives a sexual harassment complaint, the law requires them to take immediate remedial action. The process is going to move fast, and you will have to organize and present your thoughts.
- Participate fully in the investigation. This means to document everything, compile a list of possible witnesses, and ask to see the written complaint. In the theoretical instance we’re using, you would write down the names of the two technicians as well as any other employees in the room during the alleged event. You want to quickly be able to address any misinterpretations and to calmly share your recollection of the event.
- Disclose any mitigating factors. If, for example, this assistant was someone you used to have a sexual relationship with, that’s an important detail to share with your investigator. While the hospital may terminate both of you for holding a clandestine sexual relationship, the extra details you provide will help the investigator understand the situation.
- Share context. You may want to share, for example, that in the incident being investigated, you had not thought of the assistant’s reaction. People do not uniformly or predictably react to a brush of the hand, and addressing any misunderstandings, such as resting your hand on a coworker’s back during a busy time, will allow all parties to share viewpoints and clarify interpretations. It is important to tell your investigator you had not meant to offend anyone, and your intentions were misunderstood.
- Reaffirm your commitment to the practice’s anti-harassment policy.
There are also a few steps to avoid, and here we leave our hypothetical example and are speaking more broadly. First, when explaining the situation, you should not state that, because you and the victim were the same gender (if this is the case), the intention could have not been sexual. Second, you should not state that your actions or phrases were based on an inaccurate assumption of the victim’s gender or sexual orientation. Finally, you should not use the victim’s promiscuous history, if that’s potentially true, to explain your reasoning for an incident.
The reality is that employers today often take strict remedial actions against the alleged harasser out of concern for business liability. This is done, perhaps with the best of intentions, to avoid further antagonizing the complainant, and helps to minimize the employer’s risk if facing a discrimination charge with the EEOC. In fact, since most workplace contracts are “at will,” termination is the quickest action that the employer can take to defend the practice.
If your practice declares you guilty of sexual harassment, your attorney can negotiate your exit to receive a severance package and a neutral reference. By law, the employer must keep the allegations confidential, not discuss the situation or criticize you with others present. Ideally, this minimizes the risk to your reputation. If you are lucky enough to reach an understanding that the complainant was mistaken, you should ask the employer/investigator to refrain from putting any of this information into your personal file.
The situation is quite different, though, if a coworker filed a sexual harassment claim with malicious intentions. If these intentions become evident during the investigation and the investigator proves the claim to be false, that complainant faces a number of potential consequences: legal penalties (court fines, contempt order, and possibly even criminal charges), a slander lawsuit, perjury charges if the individual lied during a trial proceeding, and employment termination. And, because even settled false claims brand you with a virtual scarlet H by peers, you may sue the complainant for the losses associated with the false claim to cover reputation damages, lost wages, and employment termination. If terminated by the practice, you can also claim defamation.
Proactively Protect Yourself
Sexual harassment claims can cause massive detriments to practices, so many human resource departments – corporate and private alike – attempt to mitigate damage to them. This means that the human resource team often makes decisions in the best interest for the practice, so it’s best if you can simply protect yourself before an incident ever arises.
Scott Stender, a Workplace Consultant and retired police officer, states that “you don’t need to work in fear. You do, however, have to understand professional boundaries and use emotional intelligence. This can be harder than it looks, as in the workplace many of us confuse professional and personal boundaries. You need to remember that when you’re talking with a co-worker or employee, it’s not the same as talking with your friend.”
To avoid being accused of sexual harassment in today’s work environment, it is best to follow these recommendations:
- Regularly reflect on your actions and think about how they could be interpreted.
- Be cautious about mixing personal and professional lives.
- Physical contact at work should ideally be limited to a handshake.
- When giving a compliment, focus on work performed, not that person’s physical appearance.
- Remain self-aware at practice events by:
- limiting alcohol intake
- not staying late
- attending only company-sponsored activities
These are not always easy guidelines to follow in the sometimes emotion-filled veterinary profession. Ultimately, if you do something that you believe to be questionable, seek an employer’s assistance before the employer comes looking for you.
Sexual Harassment Investigations
Employers must deal with the stress of a potential lawsuit, the emotional impact of the investigation on the person making the claim, and the negative impact on the person being accused, especially challenging if the claim is difficult to investigate. It is challenging to remain objective to ensure fairness to both parties when faced with a sexual harassment complaint.
And, you, as the employer, may be held liable if you knew about or should have known of the harassment and failed to take “prompt” effective remedial actions. In some cases, the U.S. Supreme Court has ruled that employers in hostile work environments exercised reasonable care and the complainant unreasonably failed to take advantage of corrective opportunities to avoid harm. It is important to know that, while tempting, the employer cannot conduct a criminal background check using an outside agency without an employee’s prior consent.
A complaint, by itself, is not proof of sexual harassment, nor does an unproven allegation falsify a claim. You must stay open-minded and thoroughly investigate for the benefit of both parties. As this is a subjective and emotional matter, statements made should not be analyzed in a vacuum. For example, a lie does not immediately indicate that the entire story is false. The narrator may be feeling ashamed, embarrassed, or fearful about how previous actions might be interpreted. Sometimes, the accuser may not understand the definition of sexual harassment or its context. The reported conduct may have been mutual, or the accused may not have reasonably been able to know that comments made were unwelcome. When investigating, you should think of two questions to help guide the investigation:
- Did what is alleged occur?
- If it did, what is the significance of it (i.e., does it meet the standards of sexual harassment)?
These are good questions to ask not only of your two involved parties, but of every possible witness of the event. Although you want to address this issue efficiently, you must avoid acting without a thorough investigation. This risks a possible lawsuit, regardless of whether the harassment occurred. And, what should you do if it is ultimately difficult to discern the truth? If in doubt, you can justifiably refrain from taking the harshest possible response and discuss with the accused that future allegations will be seriously investigated with a strong potential for termination.
Once a conclusion is reached, the focus turns to appropriate remediation, if needed. The employer faces a few legal challenges in this area and must morally recognize the consequences of his/her decision to both parties. Here is one example, this one associated with protected class: you cannot punish a person more harshly than someone outside of his/her protected class. For example, an accused 30-year-old veterinarian should not be terminated when, a year ago, a 60-year-old veterinarian in a similar similar was given a warning.
Throughout even this part of the process, you must remain cautious about how you speak about an employee. As previously mentioned, employees may claim defamation against a practice in an attempt to remedy their livelihood or reputation. For an employee to claim defamation, the statement must be published, false, injurious, and unprivileged.
Looking to the Future
The veterinary practice provides for specific challenges with sexual harassment. Its traditionally small, owner-operated, family-type hospitals often create a culture of sharing personal issues, prevalent jokes, and methods to release stress. In addition, handling animals necessitate veterinarians and staff to work in close physical proximity. Practices expand these gray risk areas if they employ family members and/or allow intra-hospital relationships, because – even if not objectively true – this can create appearances of favoritism. In more extreme cases, this can lead to the belief that people who aren’t sleeping with the boss aren’t getting the perks.
As a practice owner or manager, you must identify and address these risk areas. While it isn’t realistic to completely change the veterinary culture, you as the employer can work to mitigate human resource nuances before they become problematic. This would include mandating employees to disclose relationships to you, minimizing family-member hires, and establishing a protocol that encourages a professional demeanor in the workplace.
So where do we go from here in the veterinary community? We go forward. We should not regard sexual harassment lightly, especially as women and men finally muster the courage to address their harassers. We should implement and share clear and firm workplace policies, discuss sexual harassment with all of our staff, and favor open conversations over quick online tutorials. When faced with a complaint, we should investigate it seriously out of respect for its consequences to both parties. If wrongly accused, we should stay present and be prepared to fight for our reputations. We must devise universal sexual harassment protocols and sexual harassment definitions to ensure appropriate remediation. Hopefully, we can take the initiative to be one of the first industries to successfully fight this world-wide phenomenon.
As pet lovers, it is our primary goal to keep our furry friends happy, healthy and pain free. However, in a world of ever-changing trends, how do owners know what is best for their pets and what is just the newest health fad? Traditionally, veterinarians have been sought out to help guide these decisions but, in this changing climate, reliance upon Dr. Google is becoming more common – and vet visits are becoming less so. An increasing number of people are searching for natural alternatives to medications, and opting for diets for their pets that are grain-free, raw and antibiotic-free. Pet owners are also more commonly using their own homeopathic remedies. While these trends are mainly driven by consumerism and distrust in big pharma, the growing desire for at-home remedies can result in unsafe, unethical and even illegal outcomes.
Veterinarian Responses to Fads
Veterinarians must rely upon scientific research and laws as guidance. Fortunately, with two of the more well-known fads, scientific evidence is relatively cut and dry: grains are not evil and eating raw meat can cause a slew of health problems, such as contracting salmonella. However, when it comes to homeopathic remedies for fleas and ticks, joint pain, dry skin and even neurologic conditions, the evidence is much harder to come by. This is largely due to the lack of regulations on many products that consumers are using for remedies. There are no FDA regulations, for example, on essential oils, herbs or nutraceutical pills, meaning there is no regulatory body confirming what is on the label; therefore, nothing confirming what is in the bottle.
Despite the lack of FDA regulation and any associated concerns expressed by veterinarians, the desire to use natural derivatives is growing among pet owners. And, one specific derivative is getting plenty of press lately: cannabis.
Two Types of Cannabis Compounds
Cannabis, dating back 6,000 years, is the only plant genus that contains the molecular compounds called cannabinoids. The two most notable compounds are tetrahydrocannabinol (THC) and cannabinol (CBD). While poorly divided, taxonomically speaking, cannabis is easily divided into two broad types based on the biochemical make-up. These two divisions are commonly referred to as marijuana and hemp.
The U.S. Drug Enforcement Administration (DEA) classifies Marijuana as a schedule 1 drug, which falls in the same category as heroin and cocaine. Due to its recreational use, it is the more well-known of the two cannabis plants. Marijuana contains high amounts of THC, the psychoactive cannabinoid, and low amounts of CBD, the anti-psychoactive compound.
Hemp, on the other hand, is grown for its seed and fiber properties. Hemp has low levels of THC and high levels of CBD (at least when compared to marijuana). Unlike marijuana, it is not possible to get high off the hemp plant. In fact, you would die of smoke inhalation before reaching high enough levels of THC from hemp to achieve a recreational high. This is due to the low concentration of THC and the fact that CBD is the anti-psychoactive that blocks the marijuana high. Because of that, some people refer to hemp as “anti-marijuana.”
Industrial hemp usage is legal in the United States but, oddly enough, actually growing industrial hemp is illegal. In fact, since 1937, it has been illegal to grow any variety of hemp in the United States. Under current law, imported hemp products are subjected to zero-tolerance standards for THC, even though the average amount of THC in marijuana is 20%, while the average amount in hemp is 0.3%. Somewhat illogically, the United States government does not distinguish between these two very different plants grown for completely different purposes.
Note About State Laws
In 2017, the number of states permitting industrial cultivation of hemp exceeded the number of states that have legalized medicinal marijuana (33 versus 29 to date). So far, though, few farms have begun cultivating hemp due to resistance from the DEA. This is because, while legalized in certain states, both marijuana and hemp are illegal federally.
Cannabis for Human Medicinal Purposes
So, what is it in these plants that has led to medicinal use? About 20 years ago, scientists discovered a system in the brain that responds to the compounds found in cannabis, specifically in marijuana. The system is called the endocannabinoid system and has been shown to play a role in the cardiovascular, digestive, endocrine, immune, reproductive and nervous systems. The discovery sparked interest in finding specific chemicals in marijuana that could be targeted to treat specific conditions. Since that time, research on medical marijuana has increased significantly but, with the schedule 1 classification, doing approved research is still difficult.
While there are plenty of studies that show promising results in treating conditions, in order to officially conduct research on cannabis, scientists must first get approval from the DEA and the Federal Drug Administration (FDA). While such studies have shown that cannabis can help manage pain and muscle spasms in multiple sclerosis, as well as improve symptoms of schizophrenia and Tourette’s Syndrome, too few of the studies were controlled clinical trials with placebo treatments.
These results have been mirrored in the series of studies permitted by the DEA at the Center of Medical Cannabis Research, University of California San Diego. The conclusion of these 13 studies was broad but simple: “cannabis may be useful medicine for certain indications.” Many researchers worried about the risk to users, though, with some patients becoming addicted (10%) and others finding the effects “intolerable.”
FDA-Approved Marijuana Drugs for Humans
Despite the unanswered questions and research-related challenges, there currently are three FDA-approved drugs made from marijuana in the United States. Marinol and Cesament are used to treat nausea in chemotherapy and AIDS patients, while Epidiolex is used to treat children’s epilepsy. Furthermore, Sativex is a drug developed in the United Kingdom that has been approved in over 24 countries to treat muscles spasms from multiple sclerosis and cancer pain, and it may be approved in the United States soon to treat pain associated with breast cancer.
Cannabis-Based Products and Pets
Because of the clinical evidence performed to date and experimental evidence by marijuana users, who have self-treated successfully, it is no wonder that people want to use cannabis-based products to help their animals. Given how difficult it is to get research approved for cannabis use in humans, one can imagine the level of difficulty involved in performing cannabis research in animals.
The most commonly used cannabis products on the veterinary market for treatment of animals all contain CBD oil. CBD can be extracted from marijuana or hemp and has claims to treat numerous disorders, including behavioral issues, seizures and pain. While many veterinarians would welcome a safe and effective new way to treat diseases like arthritis or epilepsy, lack of legality and solid clinical studies makes the situation uncertain.
Veterinary uncertainty, though, has not stopped an array of products from popping up on the market. At conferences, one can be bombarded by naturopathic vendors that appear reputable, making claims on their products that cannot be substantiated. This makes it difficult to differentiate fact from fiction and, unless veterinarians are up to date on the current AVMA and federal standards, they may be tricked into stocking these products at their practices.
In a study that that was performed by the Department of Clinical Sciences and College of Veterinary Medicine and Biomedical Sciences at Colorado State University, published in the Journal of the American Holistic Veterinary Medical Association (JAHVMA) and Scientific Report, veterinarians were assigned three objectives: find out which cannabis products pet owners purchased, their reasons for the purchase and if they perceived a difference in their pet while using the product. The results of this study included 632 pet owners (88.1% dog owners, 11.9% cat owners) who have purchased hemp products from an online site. Most of the dog and cat owners (77.6% and 81.8%, respectively) indicated that they use the hemp product for an illness or condition diagnosed by a veterinarian.
The most common conditions eliciting treatment in dogs included seizures, cancer, anxiety and arthritis. The illnesses or conditions treated in cats were comparable, with cancer, anxiety and arthritis as the most common. The most common side effects reported by both dog and cat owners were sedation and over-active appetite. When dog owners were asked about the perceived positive impacts of the hemp, they reported the highest impact in relief from pain (64.3%), followed by helping with sleep (50.5%) and relief from anxiety (49.3%). Cat owners perceived the highest impacts as relief from pain (66%), followed by reduced inflammation (56.3%) and help with sleep (44%). This information supports the growing anecdotal stories of the effects of cannabis in pets. In addition, this information provides a platform for researchers seeking to perform clinical studies on not only the effectiveness of hemp but also the adverse outcomes associated with the use of hemp.
Interestingly, this study also surveyed pet owners about their disclosures to their veterinarian about the hemp products used. Just under half of the participants had spoken with their veterinarian about the product, with most indicating that their veterinarian responded positively (61.7%), some expressing no opinion (30.7%) and very few responding negatively (7.7%). While most veterinarians would agree that anything having a positive impact on your pet is, in fact, positive, in this case, it is still illegal. In a recent article by the AVMA titled “Cannabis: what veterinarians need to know,” the AVMA cautions pet owners against the use of chews, oils and nutritional supplements containing CBD, citing the FDA as its regulatory beacon.
Currently the FDA does not approve the use of marijuana or hemp in any form in animals because of the lack of evidence about the safety and effectiveness of the products. The DEA stated in 2017 that “cannabinoids are not found in hemp, except in trace amounts. Therefore, extracts that contain more than trace amounts of cannabinoids must be part of the cannabis plants that are defined as marijuana and regulated as a schedule 1 controlled substance.”
In all this legislation, it might appear that hemp is unfairly getting a bad name; however, the ASPCA poison control center has recently reported an influx of calls and claims that ingestion of hemp-based CBD products causes the same clinical signs as ingestion of marijuana (products containing THC). It is not known whether toxicity is due to quality control issues in unregulated products, differing metabolism rates of CBD, or varying amounts of CBD in products despite label claims. The most common clinical signs include ataxia, depression, mydriatic pupils, hyperesthesia and urinary incontinence. While rare, other signs include vomiting, tremors and seizures with multiple deaths reported due to aspiration. For this reason, the FDA and AVMA caution pet owners against using these products and the FDA has issued numerous warnings to companies that sell products containing cannabidiol.
Overall, studies indicate great potential for cannabis as a treatment modality. If research was less restricted, more safety and dosing studies could be conducted. This would likely help explain, and ultimately prevent, poison-related deaths and begin to address concerns.
What is important to remember is that pet owners aren’t the people who face significant consequences for trying these products. Although it is illegal to sell products containing cannabinoids, and illegal to purchase products containing them, the only parties as of now who have been threatened to be held legally responsible are veterinarians and the cannabinoid-producing companies.
Here is just one example of how a state medical board perceives veterinary use of cannabis-based treatments. The California Veterinary Medical Board states that, while marijuana is legal for adults 21 and over, cannabis is illegal for use in animals. They go on to say that “veterinarians are in violation of California law if they are incorporating cannabis into their practices” and, if the board received a complaint regarding treatment of an animal with a hemp- or marijuana-related product, they would be “obligated to conduct an investigation and take appropriate disciplinary action if the findings so warranted.”
In conclusion, the use of cannabis products for animals warrants the attention of veterinarians and researchers and could one day be a wonderful treatment modality, but it cannot currently be recommended or stocked by veterinarians. It is suggested that both the promises and perils of medical marijuana for animals point to the need for science-based education, regulation and research. So, while we all aim to do what is best for our patients, it is most appropriate to advocate for change while remaining within the confines of the law. It is possible that one day cannabis will be a legal and accepted treatment in the veterinary community, but many steps must be achieved before then.