Simple Steps to Optimize Your Relief Vets

Prior to joining IndeVets, I worked at the same practice for over 11 years. I was very used to the way “we” did things, and assumed other practices did things similarly. Now, having been an IndeVet for two years and worked at over 40 different partner hospitals, I can assure you that no two practices do things the same way!

The idea of going into a practice as a relief vet can be daunting, and it can be equally daunting as a practice to have a relief vet come into your hospital. Throughout this blog, I will suggest things that you can do as a hospital to best prepare for and continually optimize relief vets.

Preparation Helps

Before our arrival, it can be very helpful to us if you:

• Have a typed sheet with the most critical things we need to know such as:
  • Computer and EMR logins
  • Login information for outside labratories such as Antech/Idexx and radiology consult
  • Wifi password as well as phone, fax, and email information readily available for use near phones or computers
  • List of preferred ER and speciality hospitals, as well as which types of specialists come into your practice
• Designate a computer station for us.
  • Most of us have our SOAPs and other templates saved in our email, allowing for more efficient and thorough charting.
• Provide staff name tags (even if it’s just something you wear on days when a relief vet is in the hospital).
  • It can be very overwhelming to try and remember everyone’s name, especially in large hospitals. Being able to quickly glance at a name tag allows for better flow and communication.
• Make sure clients know that they are not seeing their “regular” doctor.
  • Rather than using words like “relief” or “locum,” saying “part time associate” puts clients more at ease.
• If possible, allot 15 minutes at the beginning of the shift for us to become familiar with patient history. This allows patient care to appear seamless to clients.
  • On the first shift, 30 minutes is ideal for a new relief veterinarian at your hospital. That will allow us time to familiarize ourselves with the hospital, the medical records system, the appointment flow and protocols, pharmacy and injectable medications, wellness plans, and more.

When we arrive

• A tour of the hospital is super helpful upon arrival!
  • Before the tour begins, show us where to put our belongings. That way, we have a free hand to take notes when needed.
  • Don’t forget to include the bathrooms and breakrooms on the tour!
  • Some of the most helpful parts of the tour include the pharmacy, location of injectables, the crash cart/emergency drugs, and finally the controlled substances. And don’t forget to tell us who has access.
• A brief rundown of appointment flow and protocols allows for continuity of care and a sense of familiarity for clients and staff. Things to discuss:
  • Does the assistant put the client into a room and get a history? Do they get vitals?
  • Are the exams done in the room or in treatment?
  • Are samples obtained prior to or after exams?
  • Are there ophthalmoscopes and otoscopes in the rooms or do those need to be brought in?
  • Does the client get sent home with a report card or discharge instructions and if so, what document do we use?
  • Do you have drop-offs and if so, what is the policy for seeing these?
• Even though many places use the same EMR software, no two places use it exactly the same way. Please give us a run-through of how you specifically utilize software tools such as diagnoses, alerts, call backs, plans, etc.
• How do the phone systems work? Do all the phones ring for the main line or are calls transferred specifically to certain locations? When should your relief veterinarian be answering these calls if at all? At some hospitals, communication within the hospital is done via the phone and so when it rings on a backline, it should be answered. Do we need to press anything to dial out?
• Are there any strict hospital policies we should know about? For instance, “every animal needs an exam with a distemper vaccine” or “every dog <5 pounds gets pre-medicated before vaccines” or “every cat gets an Onsior when getting 3 vaccines.” These things vary greatly between hospitals, and providing this information beforehand can minimize miscommunication over more routine practices.
• Do you have specific locations for injectable medications or vaccines? If so, please let us know or provide diagrams for vaccination locations.

Other helpful tips

• Having an assistant or tech in the room with us is very helpful. Client questions that we may not be able to answer can be more easily and quickly managed with a knowledgable technician/assistant in the room. This allows for more efficient appointments and an overall better experience for clients/patients.
• Having a dedicated team assigned to your relief veterinarian allows for a recognizable point of contact for questions and needs throughout the day. When possible, please try not to pair us with entirely new staff. This can lead to inefficiency, unease on the part of the clients, and charge errors. Having us work with at least one experienced tech or assistant will help the day go much smoother for everyone involved. Things tend to work better if our tech or assistant puts in the charges, allowing the relief veterinarian to be a second set of eyes given that protocols and charges vary hospital to hospital.
• When multiple vets are onsite, please let us know how work-ins or drop offs work. Salaried versus production-based associates may feel differently about how these are handled. We would hate to step on toes and take a case (and thus potential profit) from one of the other vets working with us and alternatively want to share in the workload and provide help where needed.
• Surgical and procedural estimates can be difficult to make, and leave room for error when created by your relief veterinarians, especially if we are new to your practice.  Comfort level with certain surgeries, pre-operative and intra-operative requirements, and protocols can also vary between veterinarians and practices. Aside from routine spay and neuters, surgical consults are probably better scheduled with one of your regular veterinarians.
• If your hospital routinely sends out blood work, please let us know how best to ensure follow up. Should we leave an extra print-out of the requisition, leave a note for specific doctors, put in a communication task on your EMR system? Making sure there is a plan in place means less chance of things falling through the cracks. Also, if there is any follow up on blood work for your regular doctors, please let us know. Unless time sensitive, results associated with chronic cases are best managed by one of the associate veterinarians.
• Along those same lines, there is a lot of variation in the way hospitals and individual doctors manage certain conditions. Maintaining detailed notes regarding next steps and client communication is necessary in navigating more chronic cases. Without this, these cases can be hard for us to navigate in a manner fitting your practice. Diabetes is a prime example. Doctors and hospitals have their preferred types of insulin, monitoring (in-hospital blood glucose curves, curves at home, continuous glucose monitors, etc.), and also preferred parameters for glucose readings and rechecks. Depending on the case and the condition, chronic conditions that require intense management are probably not the ideal patients to schedule for a new relief vet to your practice.
• New clients/patients may be best scheduled with an associate veterinarian as they are often wanting to establish care and a long-term relationship with the practice and doctor(s). Once established or with more consistent relief, this is not as much of a concern.
• Record keeping is something that we strive to do very thoroughly as relief vets. All records are completed by the end of our shift, and our goal is for associate and relief doctors to gain the following from the record:
  • Detailed exam findings
  • Diagnostic results and interpretation
  • Differential diagnoses
  • Treatments in hospital and locations of administration
  • Medications and treatments recommendations for discharge
  • Client communication
  • Next steps
  • It is very helpful if thorough records are written for all patients, as it can be very hard to recheck a case when you do not have all the necessary information and communication from previous visits at hand.

I love learning from other veterinarians- different ways to do things and what works or doesn’t work. I also strive to be a resource for the practices I go to, sharing the knowledge I have learned with them along the way.

The partnership between relief veterinarians and partner hospitals is a mutually beneficial one that is integral to veterinary medicine. Through our continued collaboration, we can further elevate the standards of care for our patients and the level of service for our clients.