Have you ever worked with a veterinarian who bristled anytime a technician tried to offer a suggestion or otherwise attempted a collaborative relationship? Unfortunately, it is a common enough veterinary MO—particularly among newbies who have not yet had a tech save their skin or demonstrate a greater understanding of patient care than their own—but it afflicts all sorts, including some of the best minds in our field.

Indeed, plenty of veterinarians will spend their entire professional careers discarding valuable insights, undermining the quality of their medicine, simply because they believe their grueling schooling makes them their team members’ intellectual betters. Grumbling over techs who “over step” or “back-talk” are among the more unexceptional examples of overt disrespect (after all, a veterinarian would seldom grouse about another in such scornful terms).

More egregious—and more to the point of this column—is the diminished esteem we display in the more mundane dealings we engage in vis á vis our technicians and the many other non-veterinarian team members who we rely on for the work we do in clinical settings. Most salient is my ongoing gripe with the fact many of our crucial employees are systematically overworked and under-compensated—which, of course, is the most expressive sign of under-appreciation we could possibly manifest in a culture such as ours.

But it is mostly about the money

What we earn—whether it is in cold hard cash and other financially measurable benefits, or by way of less tangible niceties, such as schedule flexibility, emergency time off, work-from-home options, and other perquisites—is what we are told we are worth. So, when most of our best technicians and nurses max out at less than half an entry-level veterinarian’s take-home pay, it is safe to say we have a disrespect problem in our profession.

Sure, you could say they have not amassed the debt the average veterinarian has, but debt-load is not how we pay veterinarians, either. It is a factor in the higher starting salaries, yes, but it is not as if we pay veterinarians based on the debt they have amassed any more than we pay other staff members for their accumulated burdens in service of this profession.

The fact is, we are probably all underpaid given the unvoiced assumption that we are willing to exchange at least some of our income potential for the privilege of serving animals.

While this unspoken expectation has long since reached a fever pitch of resentment among those whose lived experience under this economic model has undermined their income streams, the loudest voices have historically been those of veterinarians. Technicians/nurses and other “support” staff have remained relatively silent until recently.

Addressing the hierarchy

While technician appreciation week is celebrated in October, allow me this month’s column to discuss the systematic ways in which our über-hierarchical profession too often relegates veterinary nurses-slash-technicians to roles several rungs below their veterinary-degreed colleagues. My goal is to highlight the damage this attitude does to our practices, to our workplace cultures, and, above all, to our patients’ care.

I am not saying there is no value to hierarchy or chain of command—indeed, these are essential to keeping any enterprise functioning efficiently. Yet, it is easy to cite a myriad of ways in which the veterinary profession has kept a thumb firmly on the scales to the detriment our non-veterinarian veterinary colleagues—and the damage that is done to our profession overall.

How we fail

Here is a rundown of some of the ways our profession has systematically limited the efficacy, advancement, and financial success of some of our most valuable team members:

Limited representation. Our professional organizations have historically focused almost exclusively on the interests of veterinarians. They have tended to neglect or even undermine the unique needs and concerns of other vet professionals.
Scope of practice. The American Veterinary Medical Association (AVMA) has not adequately supported the expansion of paraprofessional roles and responsibilities. In fact, it has been downright obstructive in most cases where technicians/nurses have sought to increase the scope of their duties.
Education and training. Access to high-quality education and training at accredited programs has long been a point of contention. How are we supposed to foster an educated, more effective workforce if the opportunity for advanced training is not valued by organizations like the AVMA?
Advocacy and recognition. Veterinary technicians/nurses and other veterinary professionals have consistently expressed frustration over what they perceive as a lack of advocacy and recognition for their contributions.

Techs are not a renewable resource

Given these lapses, how do we expect to foster new talent, reduce turnover, and run practices efficiently? Veterinarians who act as if technicians are an eternally renewable resource are either lying to themselves or just not paying attention. When we lose technicians, we are not just losing them to other practices, we are losing them to other professions—forever.

This kind of “brain drain” is something our profession can ill-afford, much less when veterinarians are in short supply. After all, in my experience, one good technician is worth way more than a recent graduate. Here’s how:

I can see two to three times as many appointments when I have great techs taking notes for me during exams, performing all my diagnostics, doing all the heavy lifting on client education, screening my lab work, and making most of my callbacks. I can also rest easy on my busy surgical days knowing induction and recovery will always run smoothly, and pre- and post-op duties will be expertly handled while I work on notes or I field emergencies.

The economics of a less professional workforce

However, we cannot make that happen if we support a revolving stable of 20 poorly-paid technicians with minimal to no benefits to offer their families. Would you not rather have eight top-tier performers making well over your area’s average tech pay with four to six less experienced/less schooled “trainees” learning the ropes by their side (all of whom are still earning a living wage)? Without these well-compensated employees, there will be blood (proverbially and literally speaking).

Make no mistake, paying techs less is expensive in the long run. Patient care will suffer when high tech turnover happens (more mistakes, more basic questions, more stress). Our Worker’s Compensation premiums will be higher (more bites and more injuries overall). Our HR duties will double (a less professional nursing team always means more drama), and our clients will experience a decline in the quality of customer care.

I mean, there are only so many veterinarians to go around. Our time is better spent managing more complex cases, devoting face time to needier clients, and being available to solve bigger issues in our practices.

Enter the unions

Unfortunately, this attitude is not widespread. Paying technicians “what the market will bear,” where few technicians/nurses make more than their average counterpart, has seemingly been de rigeur for the entirety of our profession’s history. Well-compensated, career technicians are the exception. It is no wonder, then, that unions are finally making inroads into our larger practice groups…can’t blame them at all.

Don’t get me wrong, though. Union activity is the last thing I would like to see happen to my practice, but I’m well aware it can happen anywhere. After all, it is what tends to occur when people committed to a profession feel chronically mistreated, under-appreciated, and their legitimate concerns are chronically ignored.

As veterinary medicine becomes increasingly corporatized it seems likely we’ll see more of this activity. When labor becomes a less personal concern for practices, labor tends to care less for their bosses. So, yes, it is inevitable that worker organization is coming to a practice near you, but it does not have to happen to yours. All you have to do is respect your team like you expect them to respect you.

Patty Khuly, VMD, MBA, owns a small animal practice in Miami, Fla. and is available at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.