Employees: Do You Need Help?

Should you hire one or more people to help you? The answer partially depends on your cost / benefit ratio. How much benefit will you get, and at what cost? You can approach this from a strictly monetary standpoint (will the employee pay for him or herself?) or from a benefits standpoint (even if you make less money because of the added expense, it’s worth having more time or flexibility).
Are there chores you hate doing so much that you are willing to pay to have them done? Are you busy enough that you can earn more money doing your main job (being a doctor) than you’d pay someone to do non-veterinarian work? Think of it this way: every time you perform a task that a less-skilled person could perform, you are basically hiring yourself at that person’s wages and, at the same time, taking your “doctor self” away from work (i.e., you are not earning doctor’s wages by seeing clients.)
If you aren’t seeing enough clients to fill each day, then you may as well spend your spare time doing paperwork and telephone chores. However, if you are busy, you’ll be dollars ahead to hire someone to help you. If you can bill your time at $50/hr and pay someone $10/hr to help you, then you’re ahead.
Also consider the value of non-work time: if you spend every waking hour working, then what happens to family, hobbies, peace of mind? If you fill each day with appointments, then the only time to do paperwork is when you are “off.”
An assistant can come with you on house calls or work at your home. At first it might seem like a luxury to have an assistant with you at all times.
However, that arrangement makes good sense for a variety of reasons. If you work at night or in a large city you might be reassured at the presence of an assistant. Having someone help with animal restraint lessens your liability worries. And your record keeping and billing will be easier with an assistant.
You can concentrate on examining the animal while your assistant writes up the record and the bill, dispenses medication or food, and collects from the client. An assistant can help you navigate in new neighborhoods or in the dark.
Another option is to hire an assistant for only one or two days a week. On those days you would schedule procedures with which you might need help, or appointments with fractious animals that need skilled restraint.

Define your work

What kind of employee will best serve your needs? It is likely you won’t have all these employees; use this list to determine which tasks you most want to delegate. Potential employees include:

• Technician / assistant
• Receptionist / phone assistant
• Bookkeeper
• Handy person: sorts your mail, files, and performs other office tasks.
• Household employees
• Tax preparer
• Someone to do any mundane, repetitive chores that take up your time, whether that be in your office or in your home.

Make a list of all the chores that you could use help with. Group them under categories to help you see which category you need help in the most.

• Office work
• Filing
• Call-backs
• Ordering inventory
• Answering phone
• Client visits
• Driving
• Filling out records
• Restraint
• Preparing bills
• Home cleaning
• Garden maintenance
• Child care (days/hours)

Household help

An alternative to hiring business help is to instead hire household help. You thus free up some of your “personal” time (that was actually spent working, doing home chores) to allow more “work” time (to do your house call practice work). The advantage to this is that you are then considered a “household employer,” and you can pay that person up to $1500/yr before you must withhold taxes (check amount for current year – IRS Pub 926, Employer’s Tax Guide at http://www.irs.gov/Forms-&-Pubs; See Appendix.).
For instance, you might hire someone to clean your home, water the plants, mow the lawn, care for your children (especially to fill the gap from after school until dinnertime), or do the laundry. One downside to hiring household help instead of business help is that the latter is a business deduction and the former is not. On the other hand, household help may cost less than business help.
 

Part-Time, Full-Time, or Independent Contractor?

Know the status of the person you hire.

Independent contractor

An independent contractor is a self-employed person who performs a specific task for you and other businesses. These people usually perform this work at their own offices (although they can come to your office), and they always bill you for their time or by the specific job (rather than receiving a regular paycheck). Hiring an independent contractor is far easier than hiring an employee, and it may save you money since you pay for only specific work to be done. It also relieves you of the need to withhold taxes, provide benefits, and so on.
For example, a bookkeeper may have a bookkeeping business with her own business license; she will keep books, bill clients, and so on, for several different businesses including yours. An answering service may answer calls from several businesses, including yours.
You may hire a ‘handy person’ just once a month to file all those papers piled up on your desk. If you get a lot of mail, you may hire someone to pick it up, open it, and sort it for you, then you attend to the sorted mail just once a week.
You can’t just make people into self-employed independent contractors simply by calling them that. The IRS considers three basic factors in deciding whether someone is self-employed or an employee: Behavioral control; financial control; and type of relationship. Who controls the work? Does the worker have a continual, consistent relationship with the practice?
The most important points are that independent contractors set their own schedule, control their own work environment, and cannot be fired. (You are hiring them to perform a specific task; once they finish it, you can either hire them again or not). Once they perform a task for you, then they bill you for that job. They offer similar services to more than one business.
Don’t try to hire someone for part-time work and “make” them into a self-employed person. Although they may work for lower wages, you are taking a risk. An audit may determine that you had an employee after all, and you will end up having to pay back taxes and penalties.
If you hire people to answer your phone or do your books, and they don’t offer that service to other businesses and don’t have their own business license, then you should treat them as employees. If you aren’t sure how to classify someone who works for you, ask your accountant. See Taxes section for details on the paperwork you need to keep for independent contractors.

Part-time or full-time employee

An alternative to the independent contractor is to hire someone for a full-time or part-time position. Carefully evaluate the pros and cons of doing so before you start. You will have to devote a certain amount of time to any employee, so be sure that employee will make up for that by saving you even more time and effort. A survey by the American Association of House call Veterinarians (see Appendix) showed that 25% of its members use a full-time technician, and 20% use a part-time technician.
An assistant who travels to house calls with you can be an ideal part-time employee. By not promising full-time work, you can pay by the hour only for time worked. However, you must take care to schedule the assistant’s time well in advance. Don’t assume they will always be “on call” for you, or you will have high employee turnover.
Be sure to define in advance the range of hours you will expect the employee to work (i.e., 20 to 30 hours per week) so there is no resentment or surprises. If it’s hard to find a part-timer, consider “sharing” a tech with another house call veterinarian, giving the tech the equivalent of a full-time job.
A “handy person” who comes to your home office one or two days a week is another ideal part-time worker. This person can open and sort mail, get food or medications ready to go out, place orders, answer the telephone, send out reminder cards, and perform other tasks.
See Taxes section for details on the paperwork you need to keep for employees.

Where to find help

Where you look for help partially depends on the tasks you want performed. For nonskilled “busy work,” you might look to a neighbor (teenager, homemaker, disabled or retired person). If you can’t think of someone you know who might fill this need, consider contacting your local senior citizen’s center, or look under “Disabled persons” in the directory.
If you have a one-time chore that you need done (filing all your journals, for instance), consider calling a temp agency if you can’t get help from someone you know.
Find a part- or full-time bookkeeper or technician by word of mouth or by advertising. The best way to avoid problems is to carefully interview, call references, and then hire the person for a temporary period while you evaluate their abilities before committing to a long-term relationship.
If you are looking for an independent contractor, look for someone who has already established their own business, rather than first finding the person and then trying to “make” them into an independent contractor. For instance, look in the directory under “bookkeeping” to find a bookkeeper, or under “Secretarial services” to find office help.
Another option is to find an “apprentice,” a pre-veterinary or veterinary student who can help you out on vacations or work study. Contact the nearest college for more information. The college needn’t be in your town; you might hope to find someone, though, who grew up in your town (and still has family there) so you don’t have to worry about providing or paying for housing.

What to pay

Find out what to pay by asking other veterinarians (and other business owners!) what they pay a person who performs similar tasks. One house call veterinarian advises that you also ask how long that veterinarian’s employee has been employed. Her reasoning is that if there is high turnover, that’s a sign that the pay is too low, so you should use as your guideline the businesses that retain their employees for several years. AAHA’s Financial Pulsepoints includes some data about average salaries.
Read Veterinary Economics and other magazines to learn about employee management. In a house call practice, things tend to get informal and it is easy to think of an employee as “family.” Nonetheless, you should always think of yourself as an employer, too. A little formality will help preserve the friendship you develop with your employee. Schedule performance reviews and define the criteria for pay raises.

Hiring “under the table”

Why not just hire someone you know and pay them “under the table?” This is a bad idea because of tax, legal, and liability consequences. If audited, you’ll have to pay back taxes for that person. You are taking advantage of them, holding out on their social security, and worst of all, exposing yourself to liability. The latter could be your most expensive mistake.
What if your helper gets hurt, say badly bitten by a dog? Without worker’s compensation or health insurance provided by you, you could be sued for a lot of money. (It’s not that they’ll be malicious; their insurance company or the hospital will want you to pay and will sue in their name). Don’t take the risk, and don’t think, “she’s good with dogs, so she won’t get hurt.” We all know that no one expects accidents to happen (if you did, they wouldn’t happen!) It’s not that difficult to treat employees properly. Just do it.
 

Tips for Hiring

OSHA regulations

The Occupational Safety and Health Administration oversees the safety of workers. If you have any employees or volunteers, you must be sure that they are aware of the hazards in their workplace.
If you have even one employee (for work, not household), you must comply with OSHA regulations. That means you must educate the employee about hazards in the workplace (zoonoses, bite injuries, sharps), and provide protective or monitoring gear when necessary (e.g., a dosimeter for monitoring x-ray exposure). Contact your state veterinary association, or your local OSHA representative, for details. (Or the OSHA web site: http://www.osha.gov)
Be sure your employees are vaccinated against rabies and tetanus. Require this as a condition of employment, and offer to pay for the rabies vaccination yourself. Tetanus is advised because small cuts are reportable under OSHA rules only if a tetanus booster is necessary.
Every item you use must be properly labeled (e.g., when you pour iodine solution from the 1- gallon bottle into a smaller bottle, you must first be sure the smaller container has a label with all the same info on it as does the larger one). You must also have MSDS sheets easily available for both yourself and the employee. (Note: small cuts are reportable if a doctor’s treatment or tetanus booster is needed; be sure your employees and volunteers are up-to-date on their tetanus vaccinations.)

Using volunteers

Volunteers must be trained the same way you would train an employee; OSHA regulations apply. It is illegal to allow minors to perform hazardous tasks such as restraining animals. Check with the AVMA liability insurance trust (or your other insurance carrier) for information about how to minimize liability for volunteers, and about low-cost insurance coverage for them.

Hiring other professionals: attorney and accountant

At some point in your business life you will need to hire an attorney and an accountant. This book will give you basic background information, but it cannot give you specific legal or accounting advice. What’s more, it is impossible for us to cover every potential situation. Once you finish reading, you should have a list of questions that these professionals can answer for your specific situation. You can do many minor legal and accounting tasks yourself, but it is wise to establish a good relationship with these professionals early in your house call career.
To start your search, get recommendations from other people with small businesses. It is especially important that your accountant is experienced with home-office-based small business, since the tax laws in this area continually change.
Remember that accountants “specialize” (that is, they focus on certain business types, whether or not they’ll admit it), and each one has a particular type of business they are most familiar with. Likewise, your attorney should be interested in small business and familiar with the questions you may have regarding employees, business licensing, liability, and so on.
The most cost effective way to use these professionals is to become educated about business law and taxes and to be prepared when you make an appointment. For instance, the records you give to your accountant for tax preparation should be organized by category in parallel with the tax forms that you will need to have filled out. Use the accountant to help you devise your tax strategy, to minimize your tax burden and to advise you about the best way to manage your business for that objective, not just to fill out the forms or to organize your paperwork.
The same goes for an attorney. For instance, if you want an employee’s contract written up, first write down as much as you can and then take that to the attorney for final polishing. You can get a book or software that contains typical legal forms for a huge variety of situations; modify those to fit your needs, then run it by your attorney for final modification and approval. If your attorney doesn’t like this approach, find another. There’s no reason to pay over $200 per hour to have him or her pump out forms. However, we do recommend that you have an attorney finalize any document, to be sure you’ve covered all the necessary items (which vary by state).

Hiring other veterinarians

What about hiring another veterinarian? You may consider hiring a relief veterinarian when you go on vacation, or you may be thinking of hiring someone full- or part-time to help ease your work load. Both of these are fraught with difficulty, but possible.

Hiring a relief veterinarian

Because a house call practice tends to depend on personal interaction, your clients are uniquely bonded to you. Also, many of the calls you go on are for routine health care. Thus a relief veterinarian may find him or herself without much work to do while you are gone.
An additional problem with a reliever is simply one of logistics. This person is going to have to figure out where everyone lives, and how to best get there. If the reliever schedules appointments, he or she may not be familiar enough with your area to efficiently schedule appointments by geographic area.
If you hire a reliever, you must do so without the expectation that you will make money. In fact, after paying a typical day’s wages (about $200 or more) you will probably lose money. Is it worth it to you to please your clients by having a reliever available? Only you can answer that. The alternatives are

1. to not take any vacations;
2. to refer clients to another clinic; or 
3. to refer calls to another house call veterinarian during your absence.

Hiring a part-time or full-time veterinarian

Are you so busy that you could keep another veterinarian busy a few days a week? Before you think of how much another veterinarian could ease your work load, first consider these potential problems.
What advantages can you offer another veterinarian over that of starting their own house call practice? You may have a client base, telephone answering, scheduling, inventory, and so on.
If you hire another veterinarian, then that person will either have to begin using your home office, or set up their own home office. As their employer, you will have to provide their inventory (if you don’t, then there is no advantage in working for you over working for themselves). You might make yourself the “manager,” and have the employee check with you each morning to find out what calls he or she is to go on, and to load needed items into his or her vehicle; each evening the person would drop off paperwork and other items at your home office.
An employee veterinarian will want at least a minimum guaranteed salary, and you can expect to lose money at first (for the same reasons you will probably lose money hiring a reliever). You might consider a small base salary, with additional income based on a percentage of the veterinarian’s gross income.
If you do hire someone to help you, it is essential that you have them sign a non-compete agreement (they can’t open a house call practice in a certain radius for a certain amount of time) and non-solicitation agreement (if they stop working for you, they can’t solicit your clients). Contact your attorney and be sure that is possible before you go any further.
What about hiring another veterinarian as an independent contractor? Two big problems: first, you will probably lose money; second, if you try to avoid losing money by only paying them a percentage of their gross income, then there is no advantage for them in working for you over starting their own business (that is, why should they do all the work required of a self-employed person, only to give you part of the income?).
See “Too much work?” under Scheduling for more information.

Communicate your needs

Whether you hire household help, a technician, an office worker, or another veterinarian, if you have someone come to your home to work, keep these tips in mind. Give the employee a place to work. They will be most comfortable if they don’t feel like they are invading your personal space (see Your Home Office).
Explain what you expect. What bathroom should the employee use? What food and drink can they get from your kitchen? How much talking (with you and others in the home) is acceptable? Can they make personal calls on your telephone? Specifically define their working hours, how many breaks they can take and how long those breaks can be, and so on.
If you have children or pets at home, keep them from interrupting y at work (it not only bothers the worker, but it wastes your money). If both you and the person you hire have children, you can work out a unique arrangement that helps you both. For instance, you may hire that person during school hours to do paperwork or answer your phone. Or, you can hire child care for both your own and your assistant’s children during the time you use the assistant.