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Are you struggling to retain your lab employees? You are not alone. Retention is a commonly-discussed issue across the field of reproductive medicine, but no one is hurting more than the lab. On this episode of Inside Reproductive Health, Griffin talks to Bill Venier, IVF Lab Director at San Diego Fertility Center. Together, they discuss what SDFC is doing to keep their employees in for the long haul, as well as some ideas to ease the training process of new reproductive biologists.
Learn more about Mr. Venier and his staff at San Diego Fertility Center here.
Other episodes mentioned in this episode:
Simon Sinek books mentioned in this episode:
Start with Why
Leaders Eat Last
To get started on a marketing plan for your company, complete the Goal and Competitive Diagnostic at FertilityBridge.com.
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Welcome to Inside Reproductive Health, the shoptalk of the fertility field. Here, you'll hear authentic and unscripted conversations about practice management, patient relations, and business development from the most forward-thinking experts in our field.
Wall Street and Silicon Valley both want your patients, but there is a plan if you're willing to take action. Visit fertilitybridge.com to learn about the first piece of building a Fertility Marketing System--The Goal and Competitive Diagnostic. Now, here's the founder of Fertility Bridge and the host of Inside Reproductive Health, Griffin Jones.
GRIFFIN JONES
Today on Inside Reproductive Health, I'm joined by Bill Venier who has over 30 years experience in embryology, andrology, and state of the art IVF lab techniques. He has a Master’s of Science in Human Reproductive Biology from Imperial University of London and is certified by the American Board of Bioanalysis as an Embryology Laboratory Director. Bill was trained with some of the top industry professionals in the clinical IVF field in the US, UK, and Australia. And that's the reason why he's on our show today. Mr. Venier, Bill, welcome to Inside Reproductive Health.
BILL VENIER
Thanks for having me, Griffin.
JONES
I wanted to speak to you because I've had a few more lab guests on the show recently, so by the time your episode airs, we will, maybe, have five of our 50 episodes having dealt with the lab and one pain point that I often hear practice owners and executives talk about is retention of IVF lab staff. It's not something that I can really counsel on, so I wanted to bring someone who can. And first, maybe, can you give us some context of--is this a problem that you see across labs? I know you talked to a lot of other lab directors and have relationships with a lot of different groups. Is this an isolated phenomena that some people are seeing more often than not? Or is this something in the field where retention of IVF lab staff is really an issue?
VENIER
It is an issue, Griffin. It's tough to recruit new people and get them interested in our field. There's not much out there from an educational standpoint, there is a few Master’s programs and things like that, but a lot of those are people that are already in the field and have already attached to a lab, but, you know, want to get the book smarts behind it and some education behind getting an FTS technical supervisor-type certification. And then you have to worry about training someone and then once they're fully trained, are they dedicated to staying with you, or essentially, once you're trained, it's really the demand outweighs the supply. So these people can go wherever they want, to be honest with you. So you have to do some special things to keep your staff intact.
JONES
It seems to me like the problem of one should be the solution to the other. That is to say, if the problem with retention is because they're so in demand and they can make good money and have different career options, that should be enticing for recruitment. So why is the same problem that we're having with retention--meaning people can go anywhere--not drawing people in to the field for recruitment?
VENIER
That's a great question. Because early on, you know, when I first got in it, most of us were Animal Science majors, so we already had a career in something else. We had the manipulation skills with eggs and embryos, and that type of thing. So we were semi-trained already, before moving to the human field and human IVF labs. Nowadays, they're coming to us with really, absolutely no experience and the time and dedication that's needed to train someone is really putting a strain on the lab. The workload has increased, so our time has decreased to train people. I'm not sure if that's answering your question directly, but you know, once you have someone trained, there could be someone down the street or an hour away that says, “Hey, we'll give you double what you're making,” or something, you know, ridiculous like that. I mean, the lack of supply is definitely driving up salaries. And we have to keep up with it. And it used to be, hey, let's look at this every three to five years. This has to be looked at annually and you have to get together with local lab directors in your area, even if the physicians don't get along, the embryologists tend to get along. The lab directors need to get together, meet a couple times a year or something, hey, this is where we're at. This is in the range of what we're paying the tiers of embryology. You know, where do we fit into that, and those types of things and that's going to change in each region.
JONES
It makes me think of a tangential topic--I tend to be a sort of a free market guy. That is to say, I tend to prefer free market solutions when they're available, but I do see a limit, not only in our field, but across the market that there often isn't a market incentive to train newcomers into a specialty. And you could say that there would be, well, this company has a market bound incentive to bring people in to train them because they have those positions to fill. But it's often not true for the reasons that you described--that you can put all the investment into training someone and they can go across the street. And so I think there is a real market limitation that is not self-fulfilling across specialties and not limited to ours. But where does the onus fall then? Whose job should be to be recruiting embryologists and trading lab staff?
VENIER
So one thing this training center can do is polish specific skills on someone that's already in the business. Maybe taking a Junior Embryologist up a notch or two to do some of the higher tech procedures like ICSI, biopsy, vitrification, those types of things, but also have a three month course, where you're dedicated five days out of the week in those three months to train someone aggressively to get them from knowing nothing to be able to manipulate eggs, embryos, and sperm, and be efficient in a laboratory environment. And then you can also increase that with a month course down the line for high tech stuff, but there's a vital need for outside training. We just can't do it in our labs anymore.
JONES
So who do you envision, operating, facilitating, launching those Regional Training Centers? Would it be ASRM? Would it be another body? Would it be a for-profit entity? Would it be the universities? Who would do that?
VENIER
Essentially, it could be any of the above. I don't want to pitch my own thing, but we are going to get something going so it's on the private sector. But, you know, something like ABB, they’re the ones that certify us, so why don't they have something like that? Or, you know, why don't they have someone come to them and say, hey, I'll start it, but I need your blessing on certifying these people. Like, in over in England, I mean, you have to you have to be certified to be doing embryology work in an IVF setting. I think we need that here! And we would love to do it, not only on a national level, but an international level and get people trained and joining our field. We need it!
JONES
Well, feel free to pitch your own thing because my follow-up question was going to be, it sounds like there's someone qualified to do this that sees the market need and there is the market need. So talk to us more about what you want this to look like.
VENIER
Sure. I'm not gonna just pitch myself and my desire to get it undergoing and hopefully that will be in 2020. So you know, probably the old guard, the past mentors that are off the bench, you know, here's something they can do pretty much in retirement to do this. Let's get their knowledge out. So I would like to use--I want to use those types of people to come in and give a lecture, but definitely do mostly hands on stuff. We want to give the background and history of why we do things the way we do it--not just teach him how to do something on a bench. But hey, this is why we do this type of thing. And how to troubleshoot--the troubleshooting comes when when we're in trouble and not prior to. So us old guard know how to work and troubleshoot if something goes wrong. We know how to fix things pretty quickly, whereas today's generation, they'll panic and we want to teach that. We want to teach there's no reason to panic. There's always a way to fix things. And that’s what we want to get out there. Just a strong teaching training on the bench, but definitely the background behind it would be vital.
JONES
Talk about the background. And it makes me think of the Simon Sinek book, “Start With Why” I think whenever there's an issue of passing the torch or sustaining an organization or growing an organization--always go back to start with why and you mentioned the old guard, helping the younger embryologist and team members to do that. I talked about this on a previous episode with Shaun Reed. I want to encourage the listeners to go back and listen to that episode, because I might not be doing Shaun's perspective justice. He's a fellow millennial, I’m a millennial, he's even younger than me. And Shaun's take really was that there is a less invested generation of embryologists that might be coming through and that they're not enthusiastic about taking over a lot of what you've described. I hope by the end of our conversation, my conversation with him, got him a little bit more optimistic, because of the inspiration of starting with why, but do you see the same issue of less engaged, younger staff? And do you think it's hopeless? If so, why? And if not, then what's the solution?
VENIER
It's never hopeless. And I did listen to that podcast--that was very good. He brought up some great points and it's true. And it may not just be the young that's not asking the why. It maybe us older ones that are not really contributing to that. We shouldn't be waiting for them to ask the question why, maybe we should tell them ahead of time. Hey, here's how you do it. This is why you do it this way. We have done it different ways in the past, this is the best way to do it, or these are the best two ways to do it. This is why we abandoned certain things. Give them some background knowledge of that. And again, are we getting too tired? Do we have too much stuff to do in the lab where we can't spend that time one-on-one with people? So we are in a catch-22, kind of not to repeat myself too much. But again, increased workload, decreased time to train people and just increased responsibilities with the lab. I know our lab and probably several labs--we actually have our own office, own administrative staff. Embryologists used to do everything! We used to do SART entries, stats, you know, inventory, all these types of things outside of the lab. But now that the bench work--I mean, the patient load every day keeps us on that bench. So when we walk out of the lab, eight hours, at the least--it's probably more like nine to 10 hours a day--to come out and try to do something else. It's pretty tough to train, not only on the new people, but on the people that have to train them. So that's the issue. I don't want to blame the young people. It's the workload that has increased drastically.
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JONES
So we've got an issue with recruitment--there's not enough embryologists coming into the field relative to the demand. We’ve got an issue with training because senior lab directors and embryologists have less time to be able to train, motivate, form younger team members. And then we have the retention, possibly as a symptom of this because folks can go just about anywhere. But before we solve these other two problems, let's talk about how we can solve retention because from what I understand, you're doing a pretty good job of it despite these two other factors. So, how do you retain staff before we as a field solve these problems of recruitment and training?
VENIER
Sure. Our program has always been looked at as very generous. So things that we do do is staff retreats. So, get out of the office totally on the clinic itself to do happy hours, to do an enormous holiday party, but every other year, we take a trip. And it's been international and national, but it is paid for by the physician owners and it's usually for a long weekend--these days it's tough to shut down--but it’s usually for a long weekend. We try to pick something all inclusive, so no one has to worry about paying for stuff once we get to Hawaii, Paris, Puerto Vallarta, Cabo San Lucas, Napa. You know, we've been to some awesome places and yeah, the treatment of your staff--I'm just speaking of myself--treat the individual like they’re equal to you. And I think I've-- even though I'm the lab director, the boss--I try to be elbow-to-elbow. I'm in the dark with them as much as possible, as much as I can do for them when we're short-staffed, I gotta jump in there. And I just want them to hopefully understand that I've got their back. I know they have mine. We may not be the highest paying clinic, but we have to be pretty close. So, again, we have to keep up with what the demand is giving out there. And if people are paying really high salaries, well, we got to sit down and look at that, and hopefully treat our staff that way. And, you know, I'll lose some because they may chase a 60% raise, and I can't stop someone from doing that. Am I going to, you know, burn my bridge with that person? There's no way. I understand it. So, we are a small family, I treat people this is my second family. And I think everyone has really adhered to that. And it's tough when we have different personalities and stuff. We have to gel, just like families, we're gonna get into fight once in a while, we’re not going to like each other for a day, but we got to talk it out and get through it and just understand that, hey, everyone's voice is important. everyone's job is important and go from there.
JONES
That perspective of viewing the team as family, jumping in when things get really busy, and you're there elbow-to-elbow with them reminds me of my second Simon Sinek book recommendation of the episode, which is called Leaders Eat Last, so I recommend the listeners who are facing a couple of these issues, if they want some reading on two of the principles that Bill's brought up this far. First is called Start with Why, the second is called Leaders Eat Last, both by Simon Sinek. I want to help break down some of the math because one of the benefits that you mentioned, in addition to very competitive, higher tier salaries, is a long weekend for example. And you said the words Hawaii and Paris and all-inclusive and I can hear a lot of practice owners just thinking, gosh, how much does that cost? Well, I don't know the math of all the airfare depending on the size of the team, but let's say it's $20-30-40,000. I would suggest that comparing that against what it costs to train somebody else, what it costs to pay somebody overtime, or what it costs to try to negotiate a contract of somebody who left and you're trying to get back, or someone who has all the leverage, that it's a lot less expensive than that. But whose responsibility is it to make that business case? Because if we look at a lot of independently-owned practices--or a lot of practices, whether they're in the universities or they're privately-owned--the lab director is often not one of the proprietors. So can there be tension in making that business case to the principals or to management, and how do you best make it?
VENIER
Speaking for myself, I am a part owner, so I am in that conversation. So let me go back to the trips--it's usually every other year, sometimes it's three years, you know, two years and it's a third year out. What we feel is this is when you get into a mode where, hey, everyone is kind of relaxed in their position and hey, what can we do to push them maybe to do a little bit extra, a little bit more, increase, whether it's patient satisfaction whether it's revenue or patient volume itself. So it these trips are incentive-based. So it's usually a tiered thing. We've never not hit the top tier, so it is something where everyone really takes pride in it, and does their best to contribute to making that top-tier trip possible for everybody. So, you know, the ownership comes up with it, but it's really driven once the incentives are out there, it's driven by the leaders of each department. It really is something to kickstart, hey, how can I be a little bit better. And that's all we need is every couple of years, we need someone just to be a little bit better and not just doing the everyday thing, and be happy with that. Let's just push a little bit every once in a while, and we can achieve greater things.
JONES
And off-site retreats like that are critical for that type of thinking. I really don't think it can be understated. I know I've had this conversation on the show before, not about with lab staff, but about off-site retreats, and sometimes people cheat and they say, Well, you know, we want to get everybody in so we'll have it at the office. I just think it's a completely different dynamic, even if you're just two hours away. You're just out of reach of the normal distractions of daily life and of office life, then the capacity for long-term thinking and getting the team to think about the vision as opposed to the minutiae of what they typically have to bear. I just think it's, it can't be understated.
VENIER
Yeah. And that's why, you know, again, that's a reason why we retained so not only lab staff here, but in all departments. We don’t lose too many people to unhappiness. We’ve lot a few, but for the majority of stuff, we do pretty well.
JONES
You mentioned the principle of not burning bridges, which I'd like to explore a little bit further, because I think this is so crucial for--it's technically not recruitment or retention, but we simply don't exist in career field any longer, not just in our field, in general, where a person is going to advance their career the most by staying in one company. It just typically isn't the case. People are going to advance the most in their career by switching companies every 3-7 years. Which means that it's almost always going to be in someone's interest to move eventually. And if that's the case, it can also be the case that it's in their best interest to come back at some point. And if they come back, they're going to be even more valuable. And if you're able to maintain that relationship, you might be the person that they come back to in 3 years or shorter if the grass isn't greener, but I love hiring employees that have had a different experience so that they can see what our management style and culture really is compared to something else. And I certainly invite them to come back if they left on good terms, because they will have all that experience elsewhere that might be valuable to bring in to our organization. Discuss that a bit.
VENIER
Yeah, sure. That’s a great point because there's more than one way to do it right. So yeah, I mean, we've had in other departments in our clinic, not necessarily lab, but people have come full circle and they've come back including myself! But I left to get my masters, so I completely stopped working and went over to London because there was nothing here. However, it is great to get outside perspective on things and not only, you know, on a rehired staff, but we used to and I've kind of switch that a little. We used to bring someone in every you know, 3-4 years, from outside another well-known lab director would come in and just for the day, and at the end of the day, give me your pros and cons of how we're doing? What can we do better? What can we do different to be better? And I'm starting to send people out to do things in other labs. And the embryology field is very--they have a great camaraderie. So not only at conferences, do we hang out and have fun, but we have our social networks that we ask questions about. And no one's afraid to ask a question and that's great! It is very good and I think it should probably be used more and more, maybe more of an annual thing of bringing other lab people in for a visit to your own lab or sending someone out to visit another lab. I think we have that ability to do it and we should do it more often. That way, you're not really rehiring people that come back to the area, unfortunately they don't really come back to San Diego because the weather's great, but the taxes are awful.
JONES
I was hoping to slide a weather barb in there, coming from Buffalo, New York. But let's talk about the networking a little bit more because I didn't know this until just before our conversation that you founded a group, which on the group's website, I can't find what the acronym stands for. SCARBSoCal, So I'm going to guess that I'm going to take a stab, Southern California Association of Reproductive Biologists, ok. And why did you start that group?
VENIER
It was actually started by me, but through someone else. I’ll mention Barry Behr had said, “Hey, we have NCARB in Northern California, I think it'd be a good time to start, and a good thing to start something down here in Southern California.” So we kind of took, you know, somewhat of their model, and said, “Yeah, I mean, let's do this.” And we're trying to go from LA down. We once in a while we get people from Santa Barbara and stuff because there's not too much going on in that area. LA kind of has something but with Reproductive Endocrinologists involved and stuff, but we want to keep it in a lab level, not at a lab physician level. That way we can really speak our mind and not be afraid of a physician cracking down like, Hey, you can't say that kind of thing. Or you can’t ask that question or something along those lines. We are willing to share stuff. We don't keep secrets, and we're willing to reach out when something is not going right. Like, “Hey, our pregnancy rates aren't going great. Has anyone else seen a dip here in the area? Is there something going on? What media are you using those types of things?” So one, it's a good let your hair down, have a couple of cocktails and listen to a speaker, but really get together and rub elbows and ask questions and that type of thing. And see who’s new there! So it's really a great thing. And I think it's all over the country. I mean, we have these things all over the place and it's really, really good. And maybe that's something that we should consider, too. Maybe an embryologist from SCARB can go to an NCARB meeting or a meeting in Chicago or New England just to get a different perspective.
JONES
Bill, you've given us so much insight into the challenges and opportunities for lab teams. How would you like to conclude about growing, retaining, and nurturing embryologists, lab directors, and lab staff?
VENIER
Again, I think us mentors, or lab directors, or lab supervisors who have been in this since the beginning. Let's go out into retirement and really, whether it's a small 1 to 2 day thing or a week or you know, whatever it is, let's educate these people, train these people. We have to do it outside our clinics these days and keep it in a regional thing where other physicians or other practices are not afraid to send people to be trained. We have to take the competitiveness out of it. We need people to be in the field. We need to grow these people, as you said, or the future doesn't look bright. So I really think it's got to be outside any programs, not just in your clinic these days.
JONES
Very well said. Bill Venier, thank you very much for your contribution to Inside Reproductive Health.
VENIER
Griffin, thanks for having me.
You’ve been listening to the Inside Reproductive Health Podcast with Griffin Jones. If you're ready to take action to make sure that your practice drives beyond the revolutionary changes that are happening in our field and in society, visit fertiltybridge.com to begin the first piece of the Fertility Marketing System, the Goal and Competitive Diagnostic. Thank you for listening to Inside Reproductive Health.