This year I helped make a decision that caused a considerable amount of strife among the DoveLewis technician staff and even anger and disappointment for a few of my most senior technicians. No one likes to deal with conflict so while you might assume that means I regret that decision, I don’t. It is part of my job as a leader to look at the possible outcome of any decision and make the best decision for DoveLewis. Not the best decision for me, or people I like, but the best decision for DoveLewis. That’s what makes being a leader hard.
Here’s what happened. I helped decide and supported the decision to hire not just CVTs onto our nursing staff, but also to hire experienced Veterinary Assistants. If you have read any of our past blogs about the Technician Licensing Debate you can understand that this was a major shift in our hiring philosophy. And one that brought about many emotional conversations. Those conversations sometimes included tears. They also included long discussions about ideals, ethics, and debates about whether some people wanted to continue their employment with DoveLewis. Those conversations left some people feeling undervalued and not supported. Those conversations sucked. It was a hard process over the last year to get to this point, but, again, I don’t regret it.
Here’s how we got there.
Over the last two years, DoveLewis’ CVT staff has been chronically understaffed. Part of it was some natural turnover that we expected when the recession thawed and part of it was the tremendous growth we experienced over the last several years. We went from seeing a little over 13,000 patients in 2014 to almost 16,000 this year. We added to our staff over the last few years, but handling and adjusting for that increase has been difficult.
On top of this we are experiencing one of the tightest labor markets seen in decades. The national unemployment vacancy rate, currently trending at 5%, is almost down to where it was in 2006. For managers, this means we are in a Game of Thrones type feud for top talent. You see the signs everywhere (literally – help wanted signs are hanging in every window around Portland and in a lot of major cities throughout the country).
And we aren’t even talking about CVTs. CVTs are in a whole other situation. There are just not enough of them to go around. Literally.
The shortage for credentialed and licensed techs is widespread and while some states have not been affected, most have been. The BIG issue – the industry is simply not retaining technicians. Their career span is a short 5 years. We lose them to other careers, commonly they go to human healthcare nursing where they can make significantly more. The other issue that comes up often is a lack of respect for the technician profession. Many technicians are not given the autonomy to do the job they want to do – nursing. Finally, like all those in the healthcare fields, compassion fatigue takes its toll on many and for a technician; a career change is often a viable solution to burn out.
Here in the Portland metropolitan area we have approximately 660 CVTs to work at approximately 450 clinics. That is about 1.5 CVTs per clinic and some clinics, like DoveLewis, have 25 to 30 CVTs on staff. Obviously, there is a math problem here. DoveLewis for years has recruited nationally. This has been a good strategy for us until about two years ago when we had two major changes happen.
The first was that the Oregon Veterinary Medical Examining Board (OVMEB) updated their regulations which resulted in out of state applicants having an extremely difficult time getting their licenses recognized in Oregon. As you can imagine that has proved challenging for DoveLewis that helps pay for a technician to move across the country only to learn their CVT application is denied.
The second issue is that we had what is called the “Portlandia Effect.” Portland, OR has become a very popular place to relocate to. For us, this has caused our once affordable city to become one of the most expensive places to live. This has had a financial strain on our staff and has made it difficult for candidates to relocate to Portland. It has had a strain on DoveLewis as well. Just this year we spent $100,000 on market adjustments to compensation to help our staff with the rising costs of the city. We will spend another $100,000 next year.
So about 8 months ago, I began to try to find new solutions to our problem. Along with my technician management I looked at a number of different solutions, but none that would solve the simple math problem we were facing – there are not enough CVTs to fill our openings.
About a month ago we surveyed the technician staff to just get a pulse on where they were on things. Hands down the number one issue listed was they were understaffed. This caused them to be exhausted, feel overwhelmed, and have a low morale. When asked about the issue of hiring Veterinary Assistants they were split. 65% for, 35% against. That 35% includes some of more passionate, top performing CVTs. Here is where the hard part of leadership comes in. Ron Morgan (DoveLewis’ CEO), Dr. Lee Herold (DoveLewis’ Chief Medical Officer), and I had to sit down and decide what was best for DoveLewis. What was best for our patients. And what was best for our entire staff. And that’s how we came to the decision that we did.
About this issue, Dr. Herold stated, “DoveLewis’ past, present, and future philosophy has been and always will be to hire CVTs. As veterinarians we know that technicians are indispensable and the shortage of CVTs significantly affects how we run our clinics. I want to hire CVTs but the deficits in the workforce are real, and many of us have to fall back on training up motivated individuals to perform tech skills the way that we used to historically.”
As I stated earlier, DoveLewis’s technician staff is split on this decision. Some feel that this decision does not help move the technician profession forward whereas others feel that highly skilled Veterinary Assistants can enhance the staff and help us from being understaffed. At the end of the day, from an ideological standpoint I agree with wanting to promote the CVT profession. That being said, advocacy in that regard needs to happen at both the state and national level. DoveLewis is not the place for this advocacy, though I will support my staff members who want to work with their state associations on changes in this area. There are a great number of smart, highly skilled CVTs out there. There are also a great number of smart, highly skilled Veterinary Assistants out there. We want to be open to hiring them both. We HAVE to be open to hiring both in the current recruiting climate we are in. My staff’s sanity depends on it. And I have to understand that means I might lose a few people in the process. Again, that’s what makes leadership so hard.
Progress is impossible without change, and those who cannot change their minds cannot change anything – George Bernard Shaw