Category: Vetsupport

Complaints

Have you found yourself on the receiving end of a complaint to your practice… or worse via the RCVS?  If not, do you live in fear of one??  Fear not!  Despite our increasingly demanding and litigious client base, the vast majority of complaints are not upheld, or are resolved in house.  However, the process can be incredibly stressful and time consuming, and often sleep depriving.  This can adversely affect both mental and physical health, so getting help and advice early on and getting things in perspective is vital to make the process as painless as possible.  Talk to friends, colleagues, or:

GET INSURED – professional indemnity insurance is vital.  A lot of practices will insure their assistants; double check this in your contract.  Veterinary Defence Society is run by vets and is a good place to start, though other providers are available.

Have you made an error?  Here are some of our tips:

  • You WILL make mistakes because you are human.  Some of these will regrettably adversely affect morbidity, even mortality in your patients.  Forgive yourself!  We’ve all done it, so don’t beat yourself up.  Dwelling on mistakes (ruminating) or feeling guilty is nothing but counterproductive emotion.  Learn from the experience (speak to a specialist/colleague to understand what went wrong and why), put measures in place to make it less likely to happen again (e.g. double check before giving a medicine; do some CPD in the relevant area…) and move on as a better, more experienced clinician.
  • Once you know you have made a mistake, own up to a senior colleague and/or your insurers before speaking to the client if possible – getting advice on how to handle the client is vitally important in the early stages and can reduce the likelihood of a resultant complaint
  • When the complaint comes BE HONEST.  If you’re in a fluster and your survival instinct kicks in you may find an overwhelming desire to shift the blame. STOP, take 5 minutes, have a cuppa, collect your thoughts and speak the truth.  Again, seek advice from your insurers and /or legal advisor.

 

If the complaint comes it is usually one of five ways:

1. Complaints to your Practice:

Most practices will have a system for dealing with the majority of complaints raised in house.  Your employers are likely to approach you to inform you a complaint has been received and ask for your response. (see above tips)

 

2. New: Vet Client Mediation Service

The Veterinary Client Mediation Service (VCMS) is a new service for veterinary clients and practices.  It is a voluntary, independent and free mediation service for clients whose animals have received veterinary care and for the veterinary professionals providing that care. Using the process of mediation, VCMS offer help and guidance to resolve complaints in a fair, cost efficient manner that is unbiased and non-judgemental. VCMS works with both parties to try and reach a solution that is acceptable to both the client and veterinary professional. The service is funded by the RCVS.

All veterinary practices will have their own complaints procedures to deal with concerns raised by clients. Where a complaint cannot be resolved within the practice, either party can refer the complaint to the VCMS. We will obtain all details of the concern and mediate with both parties to assist in finding a resolution.  The service is provided by Nockolds Solicitors. This means it is completely impartial and each complaint is considered in a fair, timely and efficient way so that the veterinary professional and client can move on.

 

3. RCVS complaints procedure

Stage 1: Assessment and investigation – a Case Examiner is assigned to gather information from you, and the complainant.  Copies of what you supply to the RCVS may be forwarded to the complainant to see if they agree with what you have said.  This may be done by telephone for speed, but you can request correspondence is done in writing if you want to collect your thoughts and/or gain advice from your professional indemnity insurer and/or legal advisor.  Additional information may be gathered e.g. from your colleagues in practice.  A group of 3 case examiners then review the case in private.  80% of cases are resolved at this point, either with no further action, or recommendations to the veterinary surgeon.  Within approx <3months

Stage 2: Preliminary Investigation Committee – the 20% of cases that make it to this point.  The information is reviewed, additional information may be gathered.  If there is a genuine concern the vet’s conduct could affect his/her fitness to practice the matter is referred to stage 3.  If not, the case is either closed, or held open for 2 years.  Within approx <9months

Stage 3: Disciplinary Committee – a small percentage of cases make it this far.  A public hearing (similar to a courtroom) takes place to decide if the vet is guilty of serious professional misconduct.  Witnesses may be called to give evidence.  If found guilty, the vet may be given a formal reprimand, suspended for up to two years, or struck off.  The case can be held open for up to 2 years.  Within approx <12months

You can see the results of the Disciplinary Committees findings for the last 3 years here

If you are having / have had experience of this procedure, we’d love to hear from you – please contact us if you would be willing to write an anonymous blog of your experiences to provide information to colleagues who may be at the start of the process and trembling in their boots!

 

4. Social media

This relatively new forum for complaining is impossible to regulate.  In our age of social media it is inevitable that there is a risk of being exposed by a disgruntled client.  When this is on a practice page it is possible to moderate the content.  When it is on a user’s private page it is more complicated; the issue of whether or not to respond, and how, is a complex one.  Contact Us if you have any experience of this, especially where you reached a successful conclusion.

This book ‘So You’ve Been Publicly Shamed‘ by  Jon Ronson explores the origins and re-emergence of public shaming, especially on social media.  It may help you gain understanding and perspective if you’ve been on the receiving end

 

5. The Media

Certain papers or program makers are too quick to take a ‘shocking’ complaint from a member of the public as being the whole truth, and publish/film fantastical headline stories.  This type of complaint tends to involve large establishments/organisations, rarely an individual.  There is the capacity for response and in some cases, an apology is issued where a media source has published/aired prior to investigating the facts.  Regrettably, the apologies are less interesting than the shocking headlines, so tend to have less penetrance.

First Job Tips

FIRST YEAR OUT – there’s no way around it; your most important lessons in practice will come through learning by mistakes… hopefully mostly other people’s (see the VDS newsletters for some classic examples), but inevitably largely through your own.  A large proportion of these will be in your first year.  You will need support to help you rationalise and learn from these mistakes, without beating yourself up (after all, we tend to be a demographic of ‘neurotic perfectionists’).  Support from within your practice, friends and family, local vets network, and social networks will all help you to maintain perspective and stay positive despite the inevitable ups and downs.  You can join local Young Vet Network groups run by the BVA.

THRIVE IN FIVE – the VIN Foundation has created a survival toolkit for your first 5 years in practice – everything from model contracts to how to survive a night shift.  This is a great free resource.

100 TIPS FOR NEW GRADUATES

PDP QUERIES?  Download the BVA’s PDP guide.

JOB SELECTION

Have a look at this great infographic from Grads to Vets with great advice on your first job hunt

Your first job is arguably the most important as it can shape your future career choices.  I recently heard an interesting description of vet job types:

Academic A-grade jobs – Academic / referral / research – even if your first job isn’t an internship in an academic or referral institute, if this is where you want to be headed look for jobs in places with links to referrals, involvement in research, certificate holders etc.

Common sense C-grade jobs –  General practice, especially rural practices / mixed.  These are the jobs where common sense, compassion and charisma will get you a lot further with clients than your knowledge of the latest lymphoma treatment options.

Note: a C-grade job is in no way inferior to an A-grade job.  We’re all academic as we’re all vets.  That’s the given.  How to get on with clients and use common sense above pure science in your approach is a skill that often can’t be taught, and can be hard to learn. But that’s what makes a good vet GREAT!  In many ways it’s harder to be a good GP vet than a good referral clinician; to do an optimal job for the patient and client, often with limited resources and finance, is a real skill.

Interview tips:

  • Interview your interviewer e.g. find out what plans they have for the practice, how robust their support systems are.
  • Speak to the head nurse, nursing team, receptionists… these are the people who will be your ‘team’.  How long have they been at the practice (a good work ethic means staff stay loyal)? What’s their ‘vibe’ about new graduates – make sure they seem supportive and enthusiastic at the prospect of having you join them.
  • Will you be working at the branch you’re interviewed at?  Or the crummy shack in the next village with the outdoor loo?!
  • Checkout glassdoor.co.uk – it’s a universal job site with a difference… employees can anonymously rate their boss and practice, and state if they’d recommend it to friends or not.  It’s not reached the veterinary world at the time of writing, but it would be worth a look just in case someone has some pertinent feedback.

INTERNSHIPS / NEW GRAD PROGRAMMES: These can be useful stepping stones, and increasing numbers of practices are setting up such schemes.  BUT BEWARE – there are no guidelines or regulations for the application of these terms, and practices are free interpret them as they wish.  You could find yourself doing a normal vets job for a lesser salary, with promised support never quite materialising, and exit-clauses in the fine print.  There’s a useful Vet Record blog on the subject by Adrian Pratt here

Tailor your CV/interview to the job you’re applying for:

A Grade jobs: emphasise your academic achievements, additional research, elective topic, and future goals and career ambitions.

C Grade jobs: your common sense, charisma, communication / practical skills are more important.  Working in a small team means your hobbies and interests are likely to affect your working relationships more than academic accolades.  You’ve qualified, so you have the knowledge.  Now sell all your personal skills.

PREPARE FOR LIFE IN PRACTICE – You’ve wanted to be a vet since you were a child.  The central focus of your education and life thus far has been qualifying as a vet.  Now you’re there with a whole degree of privilege at your disposal, and a lot of drugs and sharp instruments to wield.  And you’re going to get PAID for it!  But beware – the novelty can wear off as reality doesn’t meet with expectation.  We’re taught in a linear manner; get a clinical history, recognise signalment and clinical signs, perform the correct diagnostic tests and procedures, and institute the correct treatment and hey presto!  You’re a vet diagnosing and curing disease in bone fide patients.

NOT!  Practice life is 90% mundane with vaccines, skin disease, gastroenteritis… it won’t be long before you can do these consults in your sleep.  When it gets to the more stimulating cases it’s rarely black and white.  Owners who can’t agree on when the dog last ate (if indeed it ate at all); conflicting clinical signs leading you in 4 different directions; a broken blood machine or clogged endoscope scuppering your diagnostic tests; poor compliance with administration of your treatment…. and then a complaint from a client because of the costs and lack of resolution.  It gets grating when clients all assume we’re raking in the big bucks, and have no idea how hard we work and the stresses we’re under.  Privilege can all too soon turn into frustration and disillusionment.

Solutions:

Reset your expectations; you will make mistakes; owners will complain – often unfairly; you will be limited by time, staffing issues, equipment; interesting cases are the exception, not the rule (and you’re often limited in how far you can get with your workups).  Preparing yourself for this will help you take it in your stride.  Have an adaptable ‘growth’ mindset, rather than a stagnant fixed expectation of life in practice will help you reset your expectations – a recent study revealed this mentality improved wellbeing in vet students; click here for the article.

Make the mundane interesting – the 90% mundane CLINICAL cases can all become stimulating and interesting if you use these times to engage with the client.  Become a people person!  Not only will you build good relations with the client base, you’ll find your job more interesting and fulfilling.

Ask – if there are no colleagues available to ask for their opinion phone a friend, use online forums such as vetsurgeon.org, Veterinary Information Network, Vettimes.  Be honest with owners and explain you’ll need to get back to them later in the day.

Book your first holiday – ask for a week off about 12 weeks in…. you’ll need it to draw breath, relax and recharge, catch up with friends and family.  By the time you figure that out, it’s too late to book the time off.  Book it when you start and you’ll be glad you did.

Don’t Ruminate on mistakes – You will make mistakes – ruminating on them may adversely affect you mentally and physically.  Read more HERE

All too much?  Pressure in practice is inevitable.  Unmanageable pressure becomes stress.  Stress affects mental and physical health.  You may benefit from mindfulness or resilience coaching to help manage pressure more effectively.

PREPARE FOR LIFE!

You’ve been in academia since you were 4.  Now you have to learn how to run a house, budget, deal with all the complexities and pressures of adult life, often for the first time… at the most intense time of your career.  Prepare in advance – budget plan, update your bank account, ensure you have all the necessary insurances etc. in place.  Be prepared – living is a lot more work than you thought it might be… and often you’re living on your own for the first time.  It’s a huge change in lifestyle, so be prepared and think what might help you deal with this.

Suggestions: Get a budget planner in place and USE it from the moment you graduate to get a handle on your finances (downloadable versions are available from the Money Advice Service or National Debtline – see our Financial Support page, which has some great links to sites which will save you time, money and stress).  Join local community FB pages and go along to local events – important for networking and e.g. finding out who a reliable local plumber is.  Local buy and sell pages will often have free/cheap second hand furniture and household wares on offer (moreso than Gumtree, eBay etc).

Loneliness can be a problem –  Social media is good, but face-to-face friendships are vital; make time and space for it and you won’t regret it.  Read more about loneliness HERE.  Plan your first job near good friends or family.  Join local sports or social groups – if you have on call work you’ll need to explain your attendance will be sporadic!  Join a local BVA Young Vet Network group.

Growing Up – ‘finding yourself’ was a bit of a buzz-phrase when I graduated.  I hate buzz-words, but I reluctantly have to admit there is mileage in figuring out what is going to make you happy and how to get there.  There’s a thoughtful blog on Psychology Today – Essential Skills to Being a Grown Up.  It’s worth  read and having at the back of your mind as you start your career and life outside University.

Careers

If you can’t find what you’re looking for check out our FAQs and forums, or contact us with a query and we’ll do our best to answer.

The Good, the Bad and the Ugly – read our blogs on different job experiences.

EMS – use this time to try different types and structure of practice – rural mixed vs. large inner city hospital; private vs. corporate; zoo vs. OV work

Know yourself – the best way to find the perfect job for you is to take time writing down your skill set and passions (click here for a guide).  If you can find a job that plays to your strengths and allows you to follow your passion then you’re well on the way to enjoying your work.  Base your career path and tailor your CV around your skill set, and match it to jobs available.  If you have no luck, send your CV to practices you like the look of; you never know they may have a job coming up they haven’t got around to advertising.  Phone practices and have a chat about their ethos before applying.  At interview, find out if the job they are offering matches your skill set.  If not, you may find it hard to fit in and enjoy work.  Click here for my example.

CV writing – Dave Nichol’s, team leader, practice owner and recruitment specialist, has written an excellent blog – click here.

BVA member services – Download the full BVA Guide to job hunting.  They also run a careers service (accessible for a fee).  The BVA’s Young Vets Network exists to provide support for recent graduates.

SPVS member services – Final year congress in Lancaster with careers advice.  They also provide support and guidance on employment contracts and professional matters or just to give support at difficult times. Contact SPVS office on 01926 410454 or email rgso@spvs.org.uk They also operate a CV Reading Service – email your CV to office@spvs.org.uk for advice and amendments.

Future Developments – One of the goals of Vet futures Action Plan 2016-2020 is to create an online veterinary careers hub, to include careers advice for school students and veterinary undergraduates, extramural studies (EMS) opportunities, and career development guidance for vets at all stages in their careers (see pg 22 of the report)

“The development of an online hub, as a portal for gathering together or signposting to this information, should help better measure expectations of those entering the profession, improve awareness of the greater range of veterinary roles available and encourage diversi cation, provide clear career paths and stimulate EMS and continuing professional development (CPD) providers to develop relevant learning opportunities.

In addition, careers materials should be reviewed and developed with an eye to ensuring that potential students, their parents and careers advisors will have a clear picture of the realities of life at vet school and the career paths that may follow. This ought to reduce some of the dissonance between expectation and reality that can cause stress in later life.

Public promotion of the hub will also help us to meet the objective of raising public awareness of the wider roles that veterinary surgeons play in society. Promotion of the hub will be accompanied by activities such the recruitment of careers ambassadors, talks at events such as the Society of Practising Veterinary Surgeons (SPVS) Final-year Seminar, and the social media communication of some of the hub’s resources (such as case studies).”

Fancy something different…

Training as a vet gives you a whole set of transferrable skills which make you eminently employable in many sectors.  Many of us use our degree in the first few years, then look for new challenges.  Sadly this if often as our enthusiasm wanes or stress increases.  Try to make the change a proactive, positive move TOWARDS something you are passionate about, rather than just moving away from a job you’re not happy with.   Options include:

Locum work – allows for greater flexibility, and trying out different practice set ups.  It’s not for everyone and it’s important to be informed to make sure you’re suited to locum work – this guide from Simply Locums is a good place to start.  It can be a great stop-gap while you’re exploring other career paths too.

Practice ownership  – Jumping in with both feet – setting up a practice or becoming a partner or director of an existing practice.  There are some new, exciting models being trialled by entrepreneurial vets – practices set up to improve working standards.  If you don’t like your practice model then how about developing a better one?  The VIN Foundation in the USA have a StartUp club for those looking to start practices.  Contact them for support and advice.

Specialisation – internship, residency, specialisation… this often enables us to follow the diagnostic and treatment trail further, allowing us to do what we trained for more often than we experience in first opinion practice.  These positions are fiercely contested and require dedicated time and effort.  Only start on this route if you’re 100% sure it’s what you want to do.  It should NOT be the default path for those disillusioned with general practice.

Education – with new veterinary schools popping up, there are more opportunities to get involved with education.  Teaching starts in practice, with vet students and vet nursing students.  If you enjoy being an educator, then knock on the doors of local animal welfare colleges, veterinary nursing institutions etc. and see if they have any positions or opportunities.

Research – PhD, research, academia… With the development of the One Health initiative there is more collaboration across the medical/veterinary professions than ever before, to make a difference to health and welfare for people and animals across the globe.

Industry – be it pharmaceutical/ food/ suppliers, there are a huge range of opportunities for vets to transfer across.  If you fancy a job which often involves travelling and development of new skill sets this is worth looking into.

Public health – both within the private and public sectors.  This isn’t just meat inspection, but everything from advising petting zoos to disaster planning in the event of a natural disaster.

Charity work – from local shelter medicine, to veterinary advisors within global welfare charities, charity work can give a genuine sense of wellbeing and progress animal health and welfare across a much broader scale.  If no charity job offers are advertised, contact a charity you’re passionate about and ask if they need or want advice or practical help.  You’ll meet inspiring people and gain a real sense of fulfilment.

Other options:

Something completely different… ever fancied yourself as an entrepreneur?  Read Lawrence Brown’s blog

The Facebook community ‘Veterinary: stay, go, diversify‘ showcases career profiles, interviews and posts from vets pursuing different career paths.  Or checkout the website from the recent live event.

Here’s a great blog on 10 ways to use your degree 

 

Mindfulness

Description: Professor Mark Williams, former director of the Oxford Mindfulness Centre, says that mindfulness means knowing directly what is going on inside and outside ourselves, moment by moment.

“It’s easy to stop noticing the world around us. It’s also easy to lose touch with the way our bodies are feeling and to end up living ‘in our heads’ caught up in our thoughts without stopping to notice how those thoughts are driving our emotions and behaviour,” he says.

“An important part of mindfulness is reconnecting with our bodies and the sensations they experience. This means waking up to the sights, sounds, smells and tastes of the present moment. That might be something as simple as the feel of a banister as we walk upstairs.

“Another important part of mindfulness is an awareness of our thoughts and feelings as they happen moment to moment.

“It’s about allowing ourselves to see the present moment clearly. When

we do that, it can positively change the way we see ourselves and our lives.”

There are many practitioners of and tools to help with mindfulness.  Here are some we can recommend:

Headspace – useful app

Purple Cat Coaching – Leadership coaching and mindfulness practitioner.  Presented a Mindfulness seminar at London Vet Show 2016

Mind – the Mental Health charity has a comprehensive mindfulness guide; Click here

Resilience

SINK OR SWIM?  Is it water off a duck’s back?

Resilience has been described as :

“The capacity to maintain personal control and robust attitudes in the face of challenging events and behaviours.” Professor Mowbray

Resources:

VDS training offer resilience workshops

The Webinarvet has several webinars on resilience topics

The RVC are running a 4 day Webinar Plus course on resilience in June 2018

The Open University runs a FREE course for developing career resilience

Blogs:

Developing Resilience to Survive in Practice is a BVA blog written by Carolyne Crowe, explaining what resilience is and the fact it is not something we’re born with, but a process we have to work on.

Jenny Moffat of Skills Tree wrote for Vet Times on Resilience and Thriving in Practice

Resilience vs. improving practice:

Do we need to steel ourselves and become mentally tougher to deal with the challenges of practice life… or is enough, finally enough and should we be changing the way practice works for the betterment of its members?  The latter will take time, so we need to encourage the former so our workforce doesn’t burn out in the interim.  Join the debate – comment below or on our forums

Or have your say and take part in this RCVS Mindmatters survey on stress and resilience in practice.