Podcast Episode #11 – Dr. Rochelle Prudic

Dr. Prudic was a resident when I was on faculty and also rented one of my rental houses! She is passionate about oncology and tells you all about this amazing specialty.

Should You Create a Professional Social Media Profile?

I realize that social media is in a constant state of flux, much like the internet itself.  Sites come and go (who remembers Myspace?) and user interest ebbs and flows.  Since you are a veterinary professional, I think you should create a professional profile on LinkedIn or a similar system.  Here are some reasons why.

1) It’s fairly painless to do.  The system can be a bit detailed about your skills etc., and entering your education and jobs may be tedious, but it really should only take half an hour.  Make sure to add a professional picture of yourself.

2) You can create professional connections.  I don’t know about you, but I don’t connect with many veterinary types on my other social media platforms.  My accounts on those platforms are for me and my friends.  On LinkedIn, though, you can connect with casual professional acquaintances, students you taught a decade ago, and new colleagues.  It’s a very low-level commitment since people aren’t posting things on the site you feel you have to keep up with.  I have more than 200 contacts but my feed consists primarily of ads and a handful of relevant posts.

3) Professional connections can lead to jobs.  Although the job market is currently, “Do you have a heartbeat?  Hired!” it can turn on a dime to where finding a job may be difficult.  Or maybe you want a particular job in a particular part of the country.  Most people get jobs because they Know Someone in the hiring system.  It’s just human nature- we’re social creatures, and we trust people we know more than strangers, even if the level of connection is superficial.

4) You get exposure as a professional.  If you are trying to promote an image of yourself as a professional, making a profile is a convenient way to make that step.  Every now and then I search for one of my friends or colleagues and can’t find a profile.  I think, “That’s odd….”  You COULD go so far as to build your own website for your professional presence, but most people won’t do that.  Creating a LinkedIn profile is sufficient for most professionals.

5) You can learn some cool stuff.  I have followed my almae matres and some interesting professional organizations.  They often post things that I find interesting and relevant.  This isn’t material posted by some friend of yours on Facebook.  This is usually curated content which LinkedIn believes is relevant to you.  In my experience, it usually is.  I like learning new things, so enjoy reading some of the articles I come upon.  It’s also an easy way to keep in touch with my almae matres and see what’s going on there.

6) I want you to.  This is partly a selfish plea since I promote some of my posts on LinkedIn because it’s relevant to the veterinary professionals there.  I only post things oriented at faculty members- not things oriented at students.  I get people reading my articles, which makes me think they find them relevant.

Having a professional social media profile won’t help your application, or make you a better candidate, or otherwise affect a hiring or selection decision.  I’ve never searched for any social media for an applicant for a position.  But one day you will want a job, and having numerous connections throughout the veterinary world may help you achieve that goal.  It’s an easy step to take to improve your future professional prospects.

The Financial Implications of Private Practice vs. Academia

Image by DarkWorkX from Pixabay

(This post was originally written as a guest post for Richer Life DVM. If you haven’t read her blog, you should. It’s a great resource about finances for veterinarians. And if you didn’t read it there first, it’s new to you!)

In discussions among academic veterinarians attempting to recruit a new faculty member, salary is often the first and last word on the matter.  “Well, they can make so much more in practice, so they don’t want to enter academia.”  I’ve heard this argument for years, but it’s never made sense to me.  I think specialists entering private practice may not be earning as much as they think they are.

There are practical differences between the jobs- in private practice specialists are primarily doing clinic duty, with possibly some teaching of interns and residents and the occasional student.  In private practice, specialists may work four day weeks (80% clinic time).  In academia, specialists do clinic duty, teaching, and research.  A typical distribution for a tenure-track clinical specialist is 50% clinic time, 30% teaching, and 20% research.  The financial differences come down to four domains: geographical arbitrage, taxes, benefits, and salary.  Let’s go through each of them.

GEOGRAPHICAL ARBITRAGE

Almost every specialty veterinary hospital is located in a fairly large city, because that’s the population which can support expensive, specialized care.  In sharp contrast, because many veterinary schools are part of land-grant colleges, they are in rural locations.  The cost of living (COL) differential can be substantial.  I had a friend go from a university job in a low cost-of-living area to a private practice job in San Diego and acknowledged, “I will be saving much less money, even though the salary is much higher.”

Arbitrage is when you take advantage of different prices of the same asset.  Geographical arbitrage is using a different location to reduce your cost of living.  Specialist veterinarians can’t even practice in rural areas, UNLESS they work for a university.  The cost of living difference can be substantial.  You pay much less for life in most towns where a vet school is than in most large cities where private practices are.  Here are some examples of how far $100k goes in different cities where specialty practices are and towns where veterinary schools are according to Salary.com:

City w/Specialty PracticeTown w/University
Los Angeles $70kDavis CA $83k
Seattle $84kPullman WA $114k
Atlanta $98kAthens GA $109k
Chicago $86kUrbana-Champagne IL $118k
Washington DC $63kBlacksburg VA $113k
New York $55kIthaca NY $105k

Obviously, there are some veterinary schools in expensive towns: Fort Collins, Madison, Minneapolis, and Philadelphia come to mind.  And Davis is only less expensive relative to other cities in California- it’s far more expensive than most rural veterinary schools.  From this quick subset of examples, though, $100k ‘earns’ you about $30k more in a rural town than in a large city (average city in this example = $76k, average town = $107k).  Since this is a percentage function, the higher your salary, the greater the absolute difference.  Advantage: ACADEMIA.

TAXES

It goes without saying that, as your income increases, your tax burden also increases.  Let’s look at two typical salaries for a starting veterinary anesthesiologist.  In private practice, they may expect to make $160k and, in a university setting, about $120k.  Assume state and local taxes are similar and the person is married.  The private practitioner will have after-tax income of $121k and the university practitioner will have $93k.  That difference of $40k in salary now becomes a difference of only $28k of after-tax pay.  

This is because the university practitioner pays 22% between $77k and $120k whereas the private practitioner pays 22% between $77k and $160k.  The difference would be even more striking if the private practitioner earned a $200k salary- their after-tax income would be $150k.  A difference of $80k in salary but a difference of only $57k after taxes are paid.  Obviously, $150k is still a lot more than $93k, but it’s less than it seems on paper when you are evaluating straight salaries in an employment offer.  Advantage: DRAW.

BENEFITS

Everyone knows the benefits in academia are incredible.  “Sure, yes, university benefits are great.”  I had a fairly blase attitude towards my university benefits until I began comparing notes with some private practice colleagues.  “What do you mean your practice doesn’t pay for your health insurance?”  “What do you mean your practice doesn’t contribute to your retirement plans?”  I had no idea, but it is not uncommon for private veterinary practices to provide absolutely atrocious benefits.  As in, almost none, besides paying for the state license fee and continuing education.

The benefits in academia are, frankly, incredible.  In addition to generous annual and sick leave and holidays (although those depend on your clinic responsibilities), there is health insurance, retirement, and numerous miscellaneous benefits like reduced tuition for your children and the ability to pay off loans with Public Service Loan Forgiveness (PSLF).  The retirement benefits alone can be incredible- a defined benefit plan (pension) for the rest of your life!  A match on 403b contributions!  One employer I had just put whatever was 10% of our salary into a 403b- no contributions on our end required.  The benefits can easily be a 50% bump over and above the salary.

Corporate veterinary medicine benefits are fairly strong, though I have yet to find one that gives a pension.  Also, unless they are a non-profit, they won’t qualify you for PSLF.  Quantifying the difference between corporate specialty practices and academia is difficult, but let’s put the difference around 10% of your salary.  Therefore, an entry-level private practitioner making $160k would put $16k of their salary towards benefits, whereas an entry-level academic making $120k would put $0 towards benefits.  Advantage: ACADEMIA.

SALARY

Finally, of course, is the absolute salary.  This is the basis on which everything depends.  On the face, the private practitioner makes more.  In some disciplines, like radiology, this gulf can be vast- making $300k in private practice vs. $130k in academia.  Most specialties have less of a spread, though.  Most academic institutions allow the opportunity for locums.  If you are income-motivated, it’s not hard to do a locum for 2-4 weeks a year.  These vary in payment, but if you assume $5k/week, you could plan to add add $10k-20k to your salary.  Often, travel and living expenses are covered by the institution so, except for taxes, the majority of this income goes to you.  I have not heard of private practices offering to send their employees away on locums.  Nonetheless, private practitioners will almost always make more.  Advantage: PRIVATE PRACTICE.

So let’s do a complete breakdown of a theoretical new married veterinary anesthesiologist.  One goes into private practice in San Diego making $160k.  Another goes into academia in Pullman, WA making $120k and does 2 weeks of locum to add $10k.

Private Practice in San Diego CAAcademia in Pullman WA
Salary: $160kSalary + Locum: $130k
After-tax: $120kAfter-tax: $99k
After benefits: $104kAfter benefits: $99k
COL adjustment: $75kCOL adjustment: $111k

In the end, your effective take-home pay is actually LOWER in private practice than in academia, even though the starting salary is 33% higher.

All veterinarians should consider the influence of these variables on their effective income, but it is particularly true for specialists.  Some specialists practice in low COLA areas (Phoenix, Columbus, OH) and some universities are in high COLA areas (Madison, Fort Collins).  The cost of living, the benefits, and the impact of taxes will dramatically affect your take-home pay.  In my experience, all of these variables are ignored by specialists talking about private practice vs. academia.
This focus on The Salary as the bottom line, and the only variable of interest, is problematic. Obviously, there are lifestyle and professional interest variables in play.  But I rarely hear about those.  What gets brought up by residents when they discuss academia vs. private practice?  Salary.  And the ignorance of finances, benefits, and geographical arbitrage is leading to more residents choosing private practice.  If they read Richer Life DVM, understood finance, and really looked at the bottom line, I believe more would choose academia.

Top 5 Ways to Sink Your Veterinary Career

Image by Yuri_B from Pixabay

I’ve been reading the Physician on FIRE blog lately and he, like me, appreciates the utility of a top 5 list a la John Cusack’s character in High Fidelity.  I’m going to be applying the principle to some concepts on the blog going forward.  I hope you enjoy!

  1. Be a jerk.  This violates the simple principle of being an RFHB.  If you consistently treat people badly, yell at them, get snarky, or are otherwise difficult to deal with, you are unlikely to get good letters of recommendation.  Once you do get a position, it is unlikely you will stay in it for long.  If you treat clients and staff poorly, don’t communicate effectively, and have no compassion for others, you aren’t long for this profession.  A specialist I worked with treated people quite poorly, and eventually was forced out of that position.
  2. Borrow too much for vet school.  This may be due to going to a private school, buying a new BMW during school, and other bad money decisions.  A loan more than twice your starting salary will make you a slave to money.  You will have to pursue more lucrative jobs, you won’t be able to start your life as easily (buy a house, enjoy trips), and every decision you make will have the idea of your debt infecting it.  Once you borrow it, you can’t get rid of it- it’s like having a child.  I once worked with a vet who did buy a new car during vet school and had upwards of $250k in debt from school.  It affected every single professional decision he made.
  3. Practice bad medicine.  If you don’t stay up on the latest treatments, don’t maintain your curiosity, and don’t consult with colleagues, your medical knowledge will become stale.  You will make poorer choices for your patients.  Your colleagues and staff may begin to notice and quietly shuffle cases away from you.  As a student/intern/resident, you will get poor evaluations and letters of recommendation.  It’s understood that students/interns/residents are learning, so you don’t have to be PERFECT.  In fact, that would be weird.  But you can’t practice BAD medicine.  I worked with a vet who had questionable decisions with the care of their patients and they were eventually blocked from seeing cases.  They subsequently left the position and continued to have trouble at other positions.
  4. Do something unethical.  It may be _legal_ to sleep with your clients, but it’s probably unethical and also dumb.  Ditto sleeping with students.  Overcharging your clients, selling them services or diagnostics they don’t need, and stiffing your employees all come to mind.  This is separate from being a jerk because there are plenty of very nice people out there doing very unethical things.  It’s also possible to do unethical things and practice good medicine.  One faculty member I worked with (who was a very collegial, helpful faculty member) had some sketchy side-deal with a drug company which, when discovered, led to their termination.
  5. Break the law.  This is probably the best, fastest way to sink your career.  Abusing controlled drugs, drinking on the job, and committing a felony will all get you a quick trip out the door.  And it is highly unlikely you will be able to progress in veterinary medicine after that.  You’ll probably have to find a different career.  One faculty member at an institution was abusing opioids, got caught, and got fired (and probably blacklisted from the profession).

Those are my top 5.  You can avoid all of them by just being an RFHB and thinking things through.  It doesn’t seem hard, yet people do the above top 5 ways every day.  Don’t be one of them.

Daily Challenge: Appreciation

Tracking one’s behavior enjoyed brief popularity recently and has waned a bit since then.  It is the concept of keeping track of your time, activities, etc.  I was first introduced to this concept by the owner of a yoga studio who maintained an “Exemplary Behavior” sheet where he kept track of healthy behaviors he did each day.  He created his own activities, which included things like doing yoga twice a day, eating 5 servings of vegetables, giving someone a compliment, etc.  I thought this was fantastic.

Years later, I had a job that rewarded you for engaging in self-set healthy behaviors.  One of them was expressing gratitude.  You didn’t need to tell anyone, but the goal was to reflect on what you had or experienced and express appreciation for that.  I filled out a daily ‘gratitude log’ and found it to be a wonderful exercise.

Gratitude and appreciation are poorly expressed in our culture.  But they are tremendously powerful and can make you happier and healthier.  I think cultivating gratitude is a valuable professional skill to develop.  Employees express that they want appreciation at work more than job security and good wages.  The most effective leaders I have worked with are excellent at showing appreciation.

Appreciation is also essential to personal relationships.  Early in my relationship with my (now) wife, our couples’ counselor suggested we do an ‘appreciation exercise’.  At the end of each day, take a minute to tell each other something we appreciated that the other did.  We did this and it was fantastic.  We felt closer, more loved, and more caring towards each other.  We continued it for months and it evolved in a very organic process where now we regularly express appreciation to each other throughout the day.

Here is my challenge to you to improve your skills at giving appreciation: practice doing it every day.  Be intentional.  Look for opportunities to express appreciation.  And I don’t mean a simple “thanks”.  I mean something like, “I really appreciate you taking care of that for me.”  Some statement of how you feel which the receiver understands as you making special note of their actions.

It may feel awkward and weird at first.  “But isn’t it their JOB to do that thing?”  Maybe.  But they like knowing that their efforts are appreciated anyways.  If you’re busy and a tech offers to clean a cage for you, come back later that day and say, “Thank you for cleaning that cage for me, it was a really big help to my day.”  If a classmate set up for an event, go up to them and say, “Thank you so much for organizing this, it’s great that you took the time and energy to put this together.”  If a professor holds a special out-of-hours review session for you, offer a quick, “Thanks for taking the time to do this after hours!”

Look for opportunities to express appreciation EVERY DAY.  You may be surprised at how this makes YOU feel.  People like being appreciated, and they’ll often have a positive bump in their mood.  You perceive this and that makes YOU feel good.  I think it is similar to charitable giving.  Yes, you do it to make that person’s life better but, in doing so, it makes YOUR life better. Reminding yourself about nice things people do for you will help you have a more positive perspective on life.

At the end of the day, reflect back.  Did you hit your target?  If so, great!  Keep it up and it will eventually become a habit and automatic.  If not, think about tomorrow and what opportunities you might have.  We have dozens or hundreds of encounters with others every day.  In at least one of those, someone went slightly out of their way to improve our lives.  Shouldn’t they know that you noticed?

How to Be Successful: Admit Mistakes

Last week, I was teaching a cardiovascular course.  I am not a cardiologist.  I said that in PDA cases, the right ventricle will dilate due to overload from the left side.  I think I was visualizing a VSD in my mind when I gave that answer.  One of the students pointed out that the textbook indicated that PDAs develop left ventricular hypertrophy, but didn’t say anything about right-sided changes.  I read up on the topic more and realized I had misspoken.  I addressed it with the student who brought it to my attention and then told the class about it so they could correct it.  Did I feel a little awkward?  Sure.  But that’s what professionals do.

Everyone makes mistakes.  Error is an intrinsic function in human activity.  We are not perfect.  Countless cognitive biases ensure that we do not perceive reality objectively and do not act in perfect rationality or with perfect clarity.  Mistakes happen due to complex reasons.  For the purposes of this post, the question isn’t, “Who made this mistake”, the question is, “What do you do WHEN you make a mistake?”

One university I worked for had a discussion among the faculty: what do we do with students who make a medical error which results in patient harm?  We ultimately decided on three scenarios:

  1. The student realizes the mistake.  They identify it and notify the supervising clinician.  They take responsibility for it.  Maybe they explain how or why they made the mistake.  They may offer to talk to the client about it.
  2. The student realizes the mistake.  They identify it but do not report it.  They report it but blame someone else, like the technicians.  They do not take responsibility for making or contributing to the error.
  3. The student does not realize the mistake.  They carry on with their day, and the patient suffers.

In scenario 1, the student may still get an ‘A’ grade for that rotation.  In scenario 2 or 3, the student may fail that rotation.  EVERYONE MAKES MISTAKES.  The issue is, how do you deal with it?

One of the best pieces of advice I ever received was, “In ANY situation, what could YOU have done differently to affect the outcome?”  Even if it wasn’t your fault.  Someone cuts you off in traffic?  What could you have done?  Maybe you could have left more space for the next car.  Does a student get hurt in a martial arts class?  What could you have done?  You could have changed the exercise or partner assignments.  One of my students fails an exam?  What could I have done?  Maybe I could have identified them early and contacted them to provide suggestions for answering my exam questions.  WHAT COULD YOU HAVE DONE? None of these is to say that it was your fault that something happened. You’re simply admitting that you could have taken action that might have mitigated the circumstances.

Admit mistakes.  Accept responsibility.  Humans are imperfect, flawed beings.  You will mess up.  When you do, acknowledge it, take responsibility, and work to make it better.

More Interest in Veterinary Specialties?

Although it’s been more than a year since I saw this article, I think it’s still germane and good to share: Chart of the month: Shifting demand for veterinarians.  In the article, there is a graph indicating the percentage of veterinarians in general practice, specialty practice, and emergency practice.  You can see that there is a steady progressive decrease in general practitioners, and an increase in specialty and emergency practitioners.

They further break down the change in the number of specialists for some disciplines over two periods: 2007-2012 and 2012-2018.  You can see that most specialties have grown in both periods, but more in the 2012-2018 period.  I dug into the original data for some more insights.

Compared with 2011, in 2018 there were fewer specialists in 2 specialty colleges: ABVP and ACPV.  Within ABVP, the Avian, Canine & Feline, Equine, Feline, and Swine subspecialties all had decreased.  In contrast, there were more specialists in 15 specialty colleges with at least 50 members in 2018: Welfare, Anesthesia, Behavior, Clinical Pharmacology, Dermatology, Emergency, Internal Medicine, Nutrition, Ophthalmology, Pathology, Radiology, Sports Medicine, Surgery, Zoo Med, and Dentistry.  The greatest change was in Sports Medicine, which had an incredible growth of 733% in 2018 compared with 2011!  Other large growers were Small Animal Surgery (124%), Welfare (96%), Large Animal Surgery (81%), and Emergency (80%).

What can you conclude from this data, as someone continuing their path through veterinary medicine?  First, general practice is absolutely still a viable career path and one that is necessary and valuable.  Second, that specialty practice is expanding, so there may be more opportunities than in the past for specialty training.

For those of you interested in specialty practice and academia, it’s a very exciting time!  There is more demand from clients, more amazing technology and knowledge and techniques, and more opportunities than ever before.  Let me help guide your path and improve your applications- email me at vetducator@gmail.com today!

Be Nice

When I visit hospitals and people ask how those hospitals are, the most resounding compliment anyone can give is, “Everyone is very nice!”  What do I mean by that and how could you facilitate that feeling in your place of work/school?  People in positive work environments are welcoming, friendly, and humble.

Be Welcoming

When there is someone new or a visitor, say hello.  Smile.  Introduce yourself.  “Hey, you must be the new locum/faculty/intern.  My name is John Smith.”  Don’t include “Dr.”, that’s a rookie move.  Shake hands.  Say, “Nice to meet you.  I look forward to working with you!”  That’s it.  It’s not hard.  It’s a small bit of effort, but if people DON’T take that small effort, what signal do you think that sends?  That this new person or visitor is not worth even a small expenditure of energy.  That’s a bit insulting.

Be Friendly

Smile when you interact with the new person/visitor.  Ask them some question(s) which show you are interested in them- where they’re from, where they went to school, where they are staying, etc.  If appropriate, invite them to out-of-work open social functions.  Treat them as an appreciated, valuable colleague.

Be Humble

Ask the new person/visitor their opinion.  Acknowledge that they may know something you do not.  Make them know how they are contributing by showing appreciation for their efforts and knowledge.

As a professional in veterinary medicine, you ARE a leader, even if you’re not an administrator.  The way you act and treat others will be observed, and others will follow your lead.  If you treat new people and visitors nicely, it will help create a positive culture and those new people and visitors will appreciate the effort.  Hopefully they will enjoy working there, and will tell others they enjoyed working there.  Positivity is everyone’s job.  Do your part.

Podcast Episode #10 – Dr. Jordan Nickell

I met Dr. Nickell when he interviewed for a job at an institution where I worked. Later, he and I worked at the same university and got along very well. He has since moved on to private practice, and will provide perspective on the balance between academia and private practice and provide insight on anesthesia in veterinary medicine.

Eating Healthy on Interviews

Interviewing for a faculty position is exciting.  You’re investigating an institution for where you may want to work, and they are investigating you.  Interviews are also a recruiting tool- the institutions want you to come there, so they wine and dine you.  Most faculty interviews will have at least one lunch and one dinner, and some will have two breakfasts, two lunches, and two or even three dinners.  It adds up to a lot of calories.  If you do a lot of interviews, it adds up.  How do you still eat healthy when you are going on so many interviews?

This problem is two-fold.  One, you are going out to eat for every meal.  Meals eaten out tend to be higher in calories than meals eaten at home.  They can also be deceptively high-calorie.  Two, there is some social pressure to conform to social norms as regards eating.  If an interviewer orders an appetizer, it may be considered rude not to have some.  Similarly, if an interviewer orders a dessert, there is an implication you should, too.  So what do you do?

  1. Do not order appetizers yourself.  If the interviewer(s) do so, have 1-2 pieces to be polite, but no more.
  2. Be mindful of the caloric content of the meals.  Some restaurants post the calories in their items.  Just because it is a salad doesn’t mean it is low-calorie.  Fish and chicken entrees tend to have fewer calories than others.
  3. Do not order dessert yourself.  If the interviewer(s) do so, order a decaf coffee instead.
  4. For breakfast, focus on fruits or veggie-heavy omelets and avoid high-calorie carbs like pancakes and french toast.
  5. Feel free to leave some (<50%) of your food on the plate.  You don’t have to finish everything.  You DO have to finish MOST of the food- just pushing it around on your plate may seem unappreciative or rude.
  6. If the interviewers order alcohol, and you want to have a drink, choose wine or spirits neat or on the rocks preferentially over a high-alcohol beer or a cocktail.

Eating healthily makes you feel better and may make your interview performance is better.  You can balance the social niceties of eating out at interviews with minding calories so you stay healthy.  These are not hard-and-fast rules, but more helpful guidelines.  If you are mindful, you can successfully endure numerous interviews with a minimal caloric burden.