Taboo

It's the biggest taboo of all. Survey after survey indicates that people (North American people at least) are more comfortable revealing details of their sex lives than details of their paycheques. For a variety of cultural and historical reasons it is considered exceptionally rude to ask someone how much they earn. Yet people wonder.

I think most people believe that veterinarians are reasonably well paid, but not nearly as well as human doctors or dentists. And in broad strokes this is correct, so I could just stop there, but for those who are curious I will lift the veil more completely. But first a short story.

We have all said things in the past that make us squirm with embarrassment when we think back on them. I have a veritable catalogue of such statements to draw on, but one in particular is relevant here. When I was a university student I made one of my then very rare visits to the dentist. The dentist was a very pleasant fellow and we had a good chat about summer plans (well, one of those dental chair good chats where the dentist asks questions and I reply, "mm, mm, mhmm"). He really was a nice guy and he did a good job. I don't recall specifically what was done or what the bill was, but I do vividly recall doing the math on how long I was in the chair and then declaring to my friends and anyone that would listen that this guy must make $200 an hour! I was an asshole. And I had done my math wrong, way wrong. Now, thirty years later, I know that "overhead" is the 800 lb gorilla of the balance sheet. It probably ate up 70% of his bill. I feel bad for implying that he was gouging.

Fast forward to the present day when a lot of my day is spent doing ultrasounds, which take around  half an hour (although the client only sees 15 to 20 minutes of that as the rest is report writing) and cost around $300. Most people are not as ignorant as I was at 22, but I'm sure there are a few who walk out thinking, "This guy is making $600 an hour! Must be nice."

One zero too many. I earn $60 an hour.

Some clinics pay a percentage of billings, but we pay a straight salary to the doctors. It's an annual salary rather than a true hourly wage, so there is no overtime or anything like that. As far as I can tell my salary is fairly typical for a small animal veterinarian in general practice with 27 years of experience. It's pretty close to the top end for a non-specialist. New graduates start in the $35 range.

A few of you are probably still thinking, "Sixty bucks an hour - must be nice!" It is nice and I am not going to complain. But allow me to point out two important factors that make it perhaps less nice than it seems on the surface.

First of all, we put in six to eight years of university where rather than working and earning money we are generating debt. Lots and lots of debt. The median debt on graduation has grown dramatically to $65,000 now in Canada. In the US it's $135,000!

And secondly, most of us do not have company or civil service pension plans. A significant amount of our income has to be diverted into retirement savings to make up for this. At least if we are able to and if we are smart enough to...

In the interests of full disclosure, there is another potential income stream. Some of us, myself included, are also practice owners and earn money from any profit the practice might generate (most do generate some, but some don't...). Here, however, there are also two important factors to take into account.

The first is that profit is not free money. Potential owners have to take out massive loans to buy into practices. This money could have been invested elsewhere, like in the stock market or bonds or real estate, but we have chosen to invest it where we work.

 And secondly, I am part of a fortunate minority to have had the opportunity to buy into the practice. Younger veterinarians are having a harder time affording it because of the aforementioned debt load. Also, large corporations are increasingly buying practices which prevents the doctors working there from ever becoming owners.

I know how lucky I am. It's not a life of luxury, but I never aspired to that and it is a very good life. I have the trust of the thousands of pet owners who have come to me to thank for that. So if you are one of those and are reading this, thank you!

Haiku For My Dog

Barker at the dawn;
Thief of snacks and foul tissues;
Soft brown eyes meet mine.

His name is Orbit, and he is five years old today. I didn't think we were ready for a dog. We were busy people with two young children and two dog-averse cats. We both worked and we traveled a lot. But my daughter talked us into it. "When will I ever get a dog?" she sobbed. And in my heart I wondered what sort of a veterinarian did not have a dog.

As intended, Orbit was my daughter's dog. She loved him so much. She brushed him and fed him and helped train him and walked him at least some of the time. But then in almost imperceptible increments this changed. Did the novelty slowly wear off for her, as everyone said it would? Did he grow on me in soft stealthy steps, as everyone said he would? Yes, both I think. My daughter still loves him, of course, but I love now too, fiercely even. I brush him and feed him and walk him and spend a ridiculous portion of the commute home looking forward to his greeting. And the hilarious thing is that he isn't even objectively "a good dog". He's actually a bit of an idiot. But he is a lovable idiot and, naive as I know it is, I manage to believe that his heart is pure. And this is really all that matters.

So when I enter an exam room and see a dog sitting beside their human companion I now have a more personal and immediate sense of what can pass between them.

Thank you for this Orbit. And for those greetings and dawn walks and everything else. Happy birthday.

The Other Side Of The Mountain

(This is not a lame Toblerone sketch. It is a real graph generated from our numbers.)

If you are the type of pet owner who we affectionately refer to as a "frequent flier" and are in the clinic monthly (or more...), then you might have noticed that the staff and the doctors look more relaxed, more cheerful, less tired and less frazzled than they did a couple months ago. You were probably offered a range of appointment times and when you got there the waiting room no longer looked like a scene from "Pets Gone Wild 2". August is the other side of the mountain.*

Small animal practice has become highly seasonal. You can see from the graph that the seven months from August through February are pretty steady and then sometime in March we begin climbing, at first gradually and then sharply, reaching the peak around mid to late May. We are almost twice as busy then as in the slowest time of year.

Why is this? In a word, heartworm (and to a lesser extent ticks; I guess that's two words...). The start of prevention of heartworm disease has to happen in a fairly narrow window, pretty much exactly defining the mountain. This by itself only accounts for a portion of the traffic though. What has happened is that many dog owners would rather only come in once a year, so we've seen the annual physicals and vaccinations drift into this time-frame too. And then, when they're in for their physicals, we sometimes end up finding medical issues that need further attention, so more and more work gets piled into the peak months.

This makes staffing appropriately an enormous challenge. With a few exceptions the labour market for veterinarians and veterinary staff does not permit hiring people seasonally, so you end up staffing for a moderately busy scenario and then being short-staffed when it is really busy and over-staffed when it is quiet. A few tweaks can be made, such as discouraging vacation time during the peak season, but generally you just expect to be exhausted come the end of June, accompanied by the nagging feeling that you haven't given some of your patients the full time and attention they deserve because you were being pulled in too many directions at once (see: http://vetography.blogspot.ca/2017/06/supersonic-octopus.html).

Is there anything you the pet owner can do to help? I'm glad you asked! To begin with, cat owners should be aware that the mountain is mostly made up of dogs. Consequently, unless your cat really delights in the sights, sounds and smells of dozens of hyperactive and stressed out dogs, you should give some thought to booking his annual physical and vaccinations some other time of year. And then for dog owners I have one suggestion. If your dog's annual visit is during the spring and if she has a significant chronic medical condition you'd like to discuss, there are are some advantages to making a separate appointment for that during the fall or winter. The veterinarian will likely have a clearer head and more time for you. The spring visit can then be used as a quick recheck. Paying for two visits this way might seem extravagant, but I think in many cases this strategy will actually save money in the long run by resulting in more carefully thought out treatment strategies.

But if you have to come in May with your list of fifteen problems, don't worry. We still try our hardest and most of the time everything works out fine. Just don't ask about the bags under my eyes...


*Although sometimes we don't notice it until September because if our colleagues are on summer vacation in August the same amount of work gets dumped on fewer laps...