I am paid a base salary, plus 20% of my monthly production. This is the best arrangement according to what we were told in my business management courses in school. It makes sense. A straight salary does not always reflect the actual amount of time and effort that you put into a day or week of work. If I calculate my equivalent hourly wage based on my salary alone, it becomes depressing to think about how little I make given the energy and personal investment that I put into each case that I see. With a production bonus each month, theoretically I am being rewarded for my hard work.
This is assuming that you can monetarily quantify how hard someone is working by looking at average transaction amounts. How do you quantify the time spent on the phone consoling a client over the loss of a pet? Taking the time to thoroughly writeup charts results in better continuity of care and a potentially better outcome for the practice in the case of a lawsuit in the long run, but how do you account for this added time-consuming diligence? Each of these things add value to the practice but are not associated with immediate or direct financial gain.
At times I am conflicted about my compensation arrangement. When I was in my first trimester of pregnancy and had severe hyperemesis, the practice was extremely busy and 14-hour days without a lunch break were quite common. I was able to keep going in my ketotic state partially because I knew this extra time and effort would result in extra money that could be saved toward maternity leave and the expenses associated with having a baby.
However, during slow periods where there just aren’t enough appointments to meet production goals, not only is the bonus understandably not earned (arguably through no control of my own) but it also creates a production deficit that must be made up in subsequent months. Although I can understand this system through a business model, it still seems like a double penalty.
The biggest concern or potential drawback that I see to a production-based system is that it basically equates higher average transactions with higher quality medicine. This may be true in some cases, but the veterinary—client—patient relationship is much more complex. Especially with the poor economy and many clients losing a large percentage of their assets, I have to help them decide what the most important plan of care at this time is given the individual pet and the client’s financial constraints.
Sure, it is the best standard of care to vaccinate an apparently healthy indoor cat for rabies and distemper, run a fecal sample, do a senior blood panel on it if it is over a certain age, and make sure that it goes home with flea, tick, and heartworm preventative at the very least. However, if the client’s budget does not allow for all of that, even after the value and importance of each of these things has been discussed, priorities must be established. By creating an acceptable (although less ideal) plan together with the client, there is the unquantifiable value of maintaining a bond with the client. Perhaps in this scenario I would provide the rabies vaccine required by law and find a less expensive, more limited blood panel that can screen for common older cat illnesses (kidney values, thyroid level, CBC, glucose, etc). Although the cat is not getting the distemper vaccine, a fecal analysis, or the parasite preventative, one may argue that in this cat’s case, as it does not go outside and the potential for exposure is less, these services can wait until the client’s financial status improves. Even if it means that the amount of money that this visit brings in is decreased, I’d rather keep a client and address the highest risk problems for a patient than lose the client altogether or have the animal not be seen at all.
Although at times I think that just being paid an hourly wage would be the best form of compensation, I have made peace with my conflicting thoughts about my current arrangement. As long as I maintain my integrity and walk into each appointment thinking about how to best serve the client and pet, rather than looking at each animal as another opportunity to run more tests, I feel confident that I will be providing a high standard of care while still being a productive member of the practice. Everything equals out in the end.
How does the way your practice structures compensation affect your team’s performance?