R. J. Ramirez & Associates

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Welcome to the web site of R. J. Ramirez & Associates. Our company has been providing worry free Relief Veterinarian logotemporary services since 1989.

We allow the greatest people in the world to enjoy a worry free time away: the Veterinarian. These Doctors of Veterinary Medicine are important to our country, so we are committed to helping them.

Our service allows the Doctor to attend Continuing Education conferences and Symposia, or take a well deserved vacation from the regular day to day life of practice.

Our main Doctor

Raymond J. Ramirez D.V.M.
is proud to have one of his writings published in Veterinary Economics in the January 2007 issue.

As you might imagine, some editing and reduction has to take place to allow the article to be published.
With the permission of Veterinary Economics, I am placing the entire proposed article here on my web site.

Please contact me email if you have any questions.

Preface- talking about getting a break- vacation and benefits.

How often do you hear of friends outside the veterinary world who have taken long trips and think: I could never do that? Why not? Why can't you take a 2 week trip to a that wonderful location you dreamt? Are you just a shadow of yourself at your family events?What about that family reunion you want to attend, then maybe go visiting for a week afterwards? Have you read about the recent ideas within Veterinary Economics and wondered, "but how can I leave the practice?" "I could never leave the practice? Who would see the clients? Maybe you are a solo practitioner, or maybe a multi doctor practice that is scheduling well, but if someone is gone for an extended period, then the remaining doctors schedule becomes overbooked. Practice is not enjoyable because everyone is stretched. You come back and think "I don't want this to happen again." But is the solution never to go to a conference, or attend vacation? Of course not, and it does not have to happen this way.

The answer is: your regular staff with a locum tenens veterinarian.

Elyse waiting for someone to read with her A locum tenens veterinarian is an individual that does 'relief work'. S/he is a temporary that is only working at your practice while one of the Doctors is gone. Many of the Doctors who perform locum tenens work conduct the work full time. The doctor does so for a variety of reasons including flexibility of work schedule. That flexibility also helps you, the clinic owner, because the times can be flexible to cover the days or weeks that your clinic has the needs.

When you start looking for a locum tenen's veterinarian, where do you look?

Rachel catching what she was looking for Your colleagues in the area are a great resource. Ask them if they have names of individuals they are pleased with or if they know of other colleagues who have used individuals and get their names

Another good place are your local drug representatives. A trusted representative can give you recommendations from what they have heard from the clinics in their territory. The representative gets a chance to visit different clinics in your area and may have some leads on doctors who are doing locum tenens work, and the clinics who have used them and are pleased with their work.

State Veterinary Medical Association newsletters are also good resources. Some of the publications allow a listing of state members who perform locum tenens work and that publication would be a valuable resource.

Online or toll free national services are a source of names. These services offer the matching of names of locum tenens Doctors' with clinics and allow you to get some connections.

Once you have some names, the next step is important and should not be skipped- checking references. It is best to conduct this search as if you were hiring an associate. After all, the Doctor that is coming is going to be taking care of your clients and patients, and working with your staff. You want to try to make your absence from the clinic go as smoothly as possible and take the guesswork out of the experience as much as possible.

Once you have some names of some locum tenens Doctors, you should contact them. This is when you ask general questions about practice and experience. You can get some specific questions answered regarding prices, and ask for some references. It is helpful to ask for the last two or three clinics and phone numbers where they have worked. Then contact those references, and ask questions. If you or your clinic had a bad experience in the past, you may have specific questions to ask the locum tenens Doctor and the references regarding a similar situation. Don't be afraid to ask those questions now. Your goal is to make sure this is a relaxing trip for you. Do not feel uncomfortable or awkward to ask pointed questions about following general clinic practices.

Some locum tenens Doctors have been performing temporary services for a period of time, and other veterinarians, this may be their first job. Neither situation should discourage you from using that individual's services. What you want to do is make sure the Doctor will be a good match in your practice.

Therese staring down an interviewee If possible, set up an interview with the locum tenens Doctor at your practice prior to your planned trip. This allows the locum tenens Doctor to get a tour of the facility, find out where the emergency drugs are located, and get a general knowledge of the practice layout, and how the practice runs. And most importantly, this gives the Doctor a chance to meet the staff. This gives both you and the locum tenens Doctor a chance to ask questions, clarify situations, testing and vaccine protocols, etc. I use a form that has some of the commonly seen problems, and how you as the clinic owner likes to treat the patients. This gives the locum tenens Doctor an opportunity to observe your practice philosophy in action, and allows for clarification questions for both the clinic owner and locum tenens Doctor.

If the initial interview seems to go well, you might want to set up a 'trial run' where you take an extended weekend - say Thursday, Friday, Saturday off, and have the locum tenens Doctor come to work. This gives you a chance to take a break, and also gives you and the locum tenens Doctor a chance to see if the situation is a good fit for the practice.

One interesting note here- what are you looking for with these references, interview and trial visit? As we all know there are many different styles of practice. Each practice has a unique philosophy that the owner has worked very hard to cultivate and encourage through the support staff that you have hired and trained. What you want is someone who will be a good fit into that atmosphere. Not everyone will. That does not necessarily mean an individual is a bad Doctor or good Doctor, it just means they are not a good match for your practice style. What causes many of the problems between the clinic and locum tenens Doctor is when the situation is not a good match for your practice. What you want to try to do is find someone who will fit in, and that is what you are trying to ascertain through this process before you take that long, well deserved break.

One other suggestion:make a list of those brief procedures you know about and perform on a routine bases, and write them down in a notebook. Maybe you know that when you run the How do you keep a butterfly on your shoulder, Mary?radiograph film through the processor, if the processor stops, the lid is probably not fit tightly. Perhaps when you come in every morning, you turn on the radiograph processor and put down the lid (that you turned off the night before and raised the lid), teach the staff how to do those little procedures. This is a chance to teach your staff some cross training skills so they can help each other, and help the locum tenens doctor. Also in your notebook, put down the name of the plumber, electrician, HVAC person and other mechanical services your clinic may use.

Now is the time to enjoy the time away worry free. You have done your homework, and laid the groundwork to enjoy as worry free vacation as any Doctor and practice owner can have. It doesn't mean you may not wake up one vacation morning and think about "Whitney" Jones who you saw the week before you left, -"Augh, I should have suggested we perform an ACTH stim to rule out adrenal disease". If you do, that is normal (at least for me it is) and it just shows you need this time to recharge your batteries.

Once you find a locum tenens Doctor that fits your practice, consider using their services more often. Take those longer weekends and week-long trips with your family if they are young. Children grow up too fast (from what I have been told). And I have yet to hear someone say they wish they spent more time at the office. If your family is out of the home, take those trips you Laura Ingalls Wilder cabin Pa builtalways thought and dreamt about. Then share those wonderful adventures with your staff and clients. I have vicariously traveled to Grand Caymen chasing a total eclipse, to Canada fishing, to Alaska fishing and sightseeing, to Hawaii (does it matter- it's Hawaii!), Las Vegas, Florida, Texas, Germany, India, Australia, Figi, South Pole, and more places that elude my thoughts now. Join the fun. As one good friend said on a return from a trip: "Being a veterinarian is great because you can take some nice trips, yet it keeps you grounded so you don't get too comfortable. And I know you will fit right in when I am gone".

The other reason to use a good locum tenens Doctor is practical. If the Locum tenens Doctor does not find enough work to take care of their needs, then s/he will find a regular full time job, then all your work finding a good fit is back to square one.

In many practices Doctors perform their own procedures, and learn the unique quirks of the equipment. Keep notes on what those tasks are, and where supplies are kept that you know about. That way the Locum Dr can still perform these procedures as long as they know where the supplies are located to perform the specific tasks.

Just because you may have more than one Doctor working in your practice does not mean you will never use the services of a locum tenens Doctor. Many multi-Doctor practices find their appointment schedules so full that it is arduous when one Doctor is gone to a conference or on a vacation. The appointments are so crowded, the remaining Doctor feels like s/he is rushing the clients through, and not giving them the service they deserve while one of the Doctors is gone. If that is the case, then consider hiring a locum tenens Doctor when a doctor is away from the practice.

Financial:

How do you keep the butterfly on your nose, Natalie?The finance arrangements will vary depending on various situations. Payment arrangements are typically one of three scenarios: Hourly rate, Daily rate, or weekly rate. This is one of the questions to ask at the beginning of the process so the owner is aware of the situation.

The other important factor is how the locum tenens Doctor's business is set up for tax identification purposes. This affects how your clinic will pay the locum tenens doctor. The most common situations are: Corporation, business ID with sole proprietor, sole proprietor. Corporation: the locum Tenens DVM has set up a corporation that He/she works for and your clinic pays the corporation. This is the entity that your practice will pay.

Business ID with sole proprietor: the Locum tenens has a Federal ID set up and files under that business name on the schedule C. You write your check to a business name, and receive a W-9 from the business prior to working, and send them a 1099R at the end of the year.

Individual/Sole Proprietor still will give you a W-9 with their Social Security number. The check of the clinic may be made out to the Doctor, and a 1099 is still sent if you pay the individual more than $600/year.

In some long term locum tenens situations, where the work schedule is semi-regular, the clinic owner may elect to have the locum tenens Doctor paid as an employee with regular withholding. Federal IRS guidelines are good beginning points, but state classifications may be different depending on the agency that might look into the relationship. The state Workers Compensation agency may use one set of guidelines, and the state Internal revenue department may use a completely different set of guidelines to determine the relationship.

 The Ramirez Family at Easter 2006 States and countries vary on how they will define the Doctor who seems to be working a semiregular schedule for an extended period of time. It would be wise to get advise from your accountant regarding how your state will handle such a situation. Each situation will have different benefits for you, and the locum tenens Doctor.

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