javma news
Relief practice not just a temporary gig
Rather, it's a career for many and a mainstay of veterinary medicine
By Katie Burns
information-circle This article is more than 3 years old
Working as a relief veterinarian has taken Dr. Cindy Trice from Florida to Montana to California and back.
"I found that I really, really loved it and that I got this real sense of satisfaction at helping my colleagues take time off," she said. "I thought, this could be a whole career choice."
Like many relief veterinarians, Dr. Trice enjoys the variety and flexibility of the work. She has indeed made a career out of relief work and recently founded Relief Rover, an online community for relief veterinarians.
Relief practice long predates the gig economy and is a mainstay in veterinary medicine and other medical professions. A new California law that classifies more gig workers as employees rather than independent contractors made specific exceptions for physicians, veterinarians, and certain other medical professionals.
Among veterinarians for whom the AVMA has data on position type, the number of relief veterinarians has grown from about 1,800 in 2008 to about 2,300 in 2018, a 30% increase in 10 years—on par with the percentage increase in actively working veterinarians. Relief veterinarians comprise the largest segment of the veterinary profession outside of practice owners, associates, and interns or residents.
Dr. Andrew Heller of the staffing company Independent Vets presented the session "It's Not You, It's Me: Changing Labor Markets and the Impact on Hospital Owners & Associates" during AVMA Convention 2019 this past August in Washington, D.C. He said relief veterinarians provide one solution to staffing challenges resulting from the profession's changing demographics, as the increasing number of women and younger people seek everything from maternity leave to nontraditional schedules.
There are more and more veterinarians who want to do this, and there are more and more practices that need veterinarians who provide these services.
Dr. Cindy Trice, relief veterinarian
Relief Rover
Dr. Trice worked as an associate and completed an internship before trying relief work as a way to check out other practices around Bradenton, Florida. Then her husband had a job opportunity to work in Missoula, Montana, for six months at a time. For several years, Dr. Trice split her time between being the only full-time relief veterinarian in the Missoula area and doing relief work in the Bradenton area.
Afterward, she became an associate in Bradenton, but she did some relief work to make extra money and keep her foot in the field. She thought about partnering or practice ownership but felt her true passion was relief work.
On one occasion, Dr. Trice covered maternity leave for a single-doctor practice in Truckee, California, near Lake Tahoe. She thought: "I can't possibly be the only relief vet who is willing to travel for work and who uses this career choice partly as a lifestyle choice and as an excuse to go live other places and explore other places. And I thought, there could be all manner of reasons for doing that."
The trouble was that a platform didn't exist for people to connect that way.
Dr. Cindy Trice takes care of a patient while working a relief shift at Bradenton Veterinary Emergency in Bradenton, Florida. (Courtesy of Dr. Trice)
So Dr. Trice founded Relief Rover to empower veterinarians who want to start their own business, to be business-to-business service providers. She said the niche has existed a long time but needs development because little attention has been paid to rules and regulations and to business development. She said, "There are more and more veterinarians who want to do this, and there are more and more practices that need veterinarians who provide these services."
Through Relief Rover, Dr. Trice wants to share advice from lawyers, accountants, and insurance professionals. The distinction between independent contractors and employees varies by state and is also subject to federal regulations. Payroll taxes must be handled by the relief veterinarians or the employers. Relief veterinarians need their own insurance, including professional liability insurance.
Relief Rover connects relief veterinarians with employers as well as with one another. Dr. Trice said many relief veterinarians have more work than they can handle because so many veterinarians want to work fewer hours.
According to AVMA economic data for 2014-18, more female veterinarians want to work fewer hours than want to work additional hours, and for the third time since 2016, the percentage of male veterinarians who wish to work less is also greater than the percentage who wish to work more hours per week. In 2018, 31% of men and 37% of women desired a reduction in hours per week of 10-19 hours, an increase from 2017. Overall, more women reported wanting to work fewer hours than men, and this desire increases the further out veterinarians are from when they entered the veterinary workforce.
Independent Vets
Dr. Heller is chief growth officer for Independent Vets, which covers northern Virginia up to the New York metropolitan area. The company provides interim staffing for hospitals down a doctor because of hiring gaps, maternity leave, vacation, or unexpected openings.
The company vets its 50 or so doctors via background checks, drug screenings, clinical and personality assessments, and references. The doctors work near their homes and are employees of Independent Vets, receiving benefits if they work 25 hours a week or more on average, while still being able to customize their schedules. They also meet internally for social events and continuing education.
Dr. Marisa Brunetti (left) is chief medical officer of Independent Vets, and Dr. Kristine Stellato has been with the company for over a year. (Courtesy of Independent Vets)
Dr. Heller, while previously working at a two-doctor small animal practice, was thinking about starting his own practice when he met entrepreneur Michael Raphael. Raphael had co-founded a network of animal hospitals and saw a need for relief veterinarians. The two started Independent Vets in Philadelphia, with Raphael as CEO, and expanded north and south.
Dr. Heller has gone to many practices, in between developing Independent Vets. He said: "I love the variety. I love that I don't have anybody in charge of my schedule, and it allows me the freedom to spend more time outside of work with my family and doing things that I like to do. And I can learn more. I can expand my horizons and meet new people and build my own reputation, as well, in the community of my peers."
Dr. Heller thinks technology, the demand for veterinary services, and the gig economy have accelerated relief practice. He doesn't think practice owners realize how much relief veterinarians are a part of their practice, especially with doctors not staying at the same practice as much as they used to.
In terms of technology, Independent Vets has developed its own platform to better schedule its veterinarians. The platform allows hospitals to upload shifts directly, and the doctors can choose among the shifts.
Large animal emergency relief service
After earning her veterinary degree in 2001, Dr. Meggan T. Graves joined an equine practice serving parts of South Carolina, Georgia, and Tennessee, but she struggled to balance the hours with starting a family. After having her first son, she proposed covering night and weekend emergencies only. It was a game changer.
Later, she started her own practice in North Carolina providing emergency relief services for seven large animal practices. She didn't have any business background, so she hired a lawyer to get incorporated and an accountant to handle her taxes. In 2013, she brought the model to the University of Tennessee.
Dr. Graves now has four sons, one in middle school and three in high school. She home-schools them during the day and takes over the phones for large animal practitioners in the area at night and on weekends, but not every night and weekend. Her service is incorporated into the field service clinical rotation at the University of Tennessee. The caseload has quadrupled since 2013.
Dr. Meggan T. Graves examines a horse on a farm in Knoxville, Tennessee. She provides a night and weekend large animal emergency relief service through the University of Tennessee. (Photo by Phil Snow/UT College of Veterinary Medicine)
Dr. Graves said the relief setting allows veterinarians to let their lives dictate their jobs instead of the other way around. Just as she occasionally did prior to providing relief services, she has a few nights a year with little or no sleep, but most animal owners aren't in the barn after midnight. She does live the on-call life, but it's all worthwhile when she's spending time with her kids in the afternoons.
"The best part about it now is that I have students and interns with me, and I am able to show them that it's not horrible when your phone rings," Dr. Graves said. "You are literally coming to these owners in their greatest time of need, when they feel panicked and helpless. That's a great feeling to be able to help others that way. And specifically for me, when I am providing this after-hours emergency care, I'm improving the quality of life of the veterinarians that I'm covering for as well."
Dr. Graves continued, "As we stress more and more as a profession what work-life balance looks like, considering a business model like this one is important," especially for large animal practices trying to hold onto associates.
Action Vet Tech Services LLC
Jacklyn Phillips, a veterinary technician, started relief work by taking a temporary position helping reopen the Saving Lives Spay/Neuter Clinic through the Society for the Prevention of Cruelty to Animals of Wake County in Raleigh, North Carolina. (Courtesy of Jacklyn Phillips)
In North Carolina, Jacklyn Phillips worked for 15-plus years as a veterinary technician in small animal practice, mostly emergency practice, and also was a manager for about five years. The practice always had staff shortages because of turnover or someone being out.
She left clinical practice for sales in 2016 to make better money and because she was burned out. She didn't feel fulfilled in sales, though, and she realized she was last happy on the job when she worked as a veterinary technician and not in management. She took a temporary job helping reopen a spay-neuter clinic. From there, she reached out to other clinics about relief work.
"I like people," Phillips said. "I like seeing different ways of doing medicine. I like the variety. I like working for myself."
Phillips founded Action Vet Tech Services LLC, targeting mostly emergency clinics. She turned to the Small Business Administration for help getting started, as well as an accountant and a lawyer. She wants to create a staffing company to provide veterinary technicians for clinics that have a crisis, turnover, inexperienced staff, or someone on maternity leave or vacation. Another veterinary technician recently joined the roster.
Phillips doesn't know exactly why there aren't more relief veterinary technicians. Some clinics think a veterinary technician will need training for at least two weeks, wondering how Phillips can show up and be useful. She says, "Try me." She said veterinary technicians with experience and communication skills can function about the same from clinic to clinic.
The demand by practices for relief veterinary technicians is bigger than Phillips realized. She said, "Usually, it's that they've had turnover or their staff is really young and underexperienced—even if they're licensed, they are underexperienced—so they need leadership on the floor."
At first, Phillips contacted clinics that had an ad out for a veterinary technician, asking if they wanted to hire her in the meantime. Now she is working at least 50 hours a week, sometimes 60, as she builds her business.
"I wanted to be able to do what I'm passionate about," she said.
Production medicine
National legislation & regulation
State legislation & regulation
Business & economic issues
Related JAVMA content:
Tips for relief veterinarians
Best practices for employers