Weeks 9 and 10: Animal Care Clinic Externship!

Unicorn Practice: A practice that seems to be too good to be true filled with genuine connection, a true passion for helping animals, and a culture that flips burnout on its head. 

Over the past two weeks, I had the opportunity to spend some time at Animal Care Clinic in San Luis Obispo. Throughout my time at Cal Poly, I had heard wonderful things about this practice and knew that it would be at the top of my list of externship opportunities. One of my favorite mentors had always spoken highly of this clinic and was vet school classmates with the owner. I had also known many people who had worked at ACC during undergrad and had nothing but great things to say about the practice. All that being said, I had high expectations, and I’m sure there were some expectations from their side given all of our common connections.

Miguel - future UCD first year!

As soon as I walked through the door Monday morning, I was greeted by Lola’s bright smiling face. She introduced me to some team members, and I was then given a hospital tour. The facility is incredible, and the layout facilitates a high level of communication and teamwork. The doctors are at the center of the facility with windows into the pharmacy, procedure room, hall, and a few steps away from the treatment room. This open layout fosters communication and a way to stay connected to the team regardless of whether you are on rooms or procedures for the day. From an outside perspective, this clinic may look like your average well-run veterinary hospital, but after spending the past two weeks immersed in their culture, I can tell you this practice is anything but ordinary. 

From the management, technicians, CSR, support team, and doctors, I can confidently say that this practice is unlike anything I have ever seen and doubt I will see anywhere else. The team dynamic is phenomenal, and every case is approached with a high level of medical knowledge and compassion. Difficult cases are met with collaboration between doctors as well as the technical staff, which allows the patient to benefit from multiple perspectives. During my stay, I had the privilege of working under the guidance of five different brilliant veterinarians, bouncing between four procedure days and six appointment days. Every day was different, and I was able to learn how to adapt to different styles while continuing to develop my clinical thinking skills. 

One of the amazing parts of this experience was the ability to learn from so many different doctors. While I initially felt like a deer in the headlights walking into a clinic with over 36 team members and working under the guidance of a new veterinarian each day, by the end of the two weeks I was so grateful that the externship was organized in a way that provided such a unique opportunity to work with a variety of clinicians. Each of them practiced high-quality medicine but had their own style. This was a great way for me to learn different ways to approach a similar situation and observe different communication styles. It was also a great way to practice taking the knowledge I learned in the classroom and applying it in a practical setting. Another key component of this experience was understanding how to meet people where they are while still providing the best level of patient care. Training at a tertiary referral center can create an unrealistic perspective on what treatment options most owners can, and wish to pursue for their pets, so experience in general practice is a refreshing reminder that high-quality medicine can be practiced in a multitude of settings. 

Throughout my time at the practice, I was constantly amazed by the communication skills that everyone demonstrated. The team truly seemed to care about each other, and anytime a potential problem arose, things were handled professionally and maturely. Every Wednesday morning there was a staff meeting, and during that time, the clinic was closed. This intentionally allowed a period of time to be set aside each week so that the team could meet, hear announcements, celebrate successes, and learn about areas that need improvement. Each meeting started with a series of accolades, which were little papers that could be filled out over the course of the week recognizing staff members who were doing a great job. I was also taken by surprise when the team broke out in song to celebrate Julie’s 16-year work anniversary. It was like a scene from High School Musical, except this was real life from people who genuinely care about each other and want to celebrate those around them. I can also tell that this isn’t something new… they all knew the words and pitch of the song. That is a clear sign that this is not their first rodeo and that people stick around, indicating the turnover rate is pretty dang low. 

These activities are a great way to kick off the meeting and recognize people who went above and beyond during the previous week. It also turns the idea of a meeting, which usually doesn’t have the best connotation, into something that is fun and a way to celebrate the highs and discuss how to improve in other aspects. After the initial announcements and group discussion, the meetings are then split into smaller groups where team members can meet and discuss things pertinent to their realm of work. I think that setting aside time for meetings such as this is one of the reasons this clinic can function at such a high level and maintain an excellent culture. 

This externship also gave me the opportunity to practice my presentation skills. During the second week, I presented a case during the team meeting and spoke about the importance of diagnostic testing, especially prior to surgical/dental procedures. I have an innate passion for teaching so this was a fun opportunity to learn how to tailor my presentation to meet the needs of each staff member and help them gain valuable information for their respective positions.

I also had the opportunity to get some rehab experience with Dr. Cherry and discuss acupuncture plans with Dr. Riedel. Dr. Riedel obtained her acupuncture certification through CuraCore training under Dr. Robinson whom I had met at a conference a few years back during the time I was taking a similar course through Chi University. It was a blast discussing the variation and similarities in our training and sharing techniques.

Dr. Cherry!

It is easy to preach about the importance of having a positive team culture, but implementing the principles and values to get there is a whole other level. Building a robust team is a slow process that involves intentionality, trust, vulnerability, and hard conversations. This team did not come together by accident; it was carefully constructed and trained. The onboarding is meticulous and conducted over the course of 60 days. There is also continuous support for each team member and open communication between the leadership/management team. Each employee is treated like a valuable investment, and that is shown in the way they conduct themselves.

While the purpose of this externship was to expand my medical knowledge and practice thinking like a clinician, I also kept a careful eye on the team dynamic and was continuously impressed by the way the clinic ran. It is easy to hide crazy for a day or two, but over a two-week period things are bound to get a little wild and reveal people’s true colors. Day by day I was waiting for the shoe to drop and for something to reveal a crack in my perception of this “perfect clinic,” but that never happened. Any time something didn’t go according to plan it was handled in a mature manner then life went on. No festering over anything or pushing it under the rug. After one of the meetings, I could sense that a hard conversation was had, and by the end of the day that person’s desk was filled with sweet little notes, treats, and encouragement. This clinic functions as a unified team, so much so that when one staff member’s pet decided to eat something that was not edible, at least three other staff pets also ate inanimate objects (within 36 hours of each other), and one needed a foreign body surgery. But in all seriousness, at this clinic, when someone is hurting or navigating a challenge, it does not go unnoticed and that person does not have to carry it alone. 

I also paid careful attention to the leadership and how their presence was received by the team. Instead of preaching certain strategies and telling the team how they needed to act, Dr. Markoff demonstrated these values through her actions. She was always checking in on the team, and when we had three urgent care appointments come in at the same time, she quickly jumped into action and took one of the appointments to lessen the load of the other doctors. Her robust leadership training and genuine desire to help her team reach their full potential are evident and I am grateful she gave me the opportunity to connect with her team.

This was my first externship of the year, and I truly couldn’t have found a better general practice. As a bonus, the schedule allowed me to attend multiple important gatherings with friends and family including one of my friends' weddings, my sister’s graduation, and my cousin’s wedding. I also rounded out the trip by getting to go on a fun run with my dad to celebrate Father’s Day. The ability to spend time with friends and family outside of school during your fourth year of vet school is not always as accessible as one may hope due to the unpredictability of our schedules, but this was a special way to make things work. 

Quote of the rotation: “Not always clocked in, but always locked in.” – Miguel