What's This Episode About?
This week on the podcast, Dr. Andy Roark and Stephanie Goss are tackling a mailbag letter from a practice owner whose inquiring mind wants to know: how do I get my associate(s) to be more productive and still support work-life balance? The ask by this practice owner is being influenced by the fact that they seem to produce more revenue in 3 days than an associate can produce in 4 days a week. The practice is growing and profitable and everyone is on board with the idea of expanding their hospital footprint and this practice owner is feeling the weight of the world on their shoulders, financially speaking, and want to feel support from their associates in terms of increasing revenue, to help feel better about leaping into big financial investment in terms of renovation. Andy and Stephanie dive into their thoughts on these concerns and questions and talk about how they would approach the conversation and the action plan. Let’s get into this…
You can listen to the episode on Apple Podcasts, Spotify, Google Podcasts, or wherever you get your podcasts.
Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag
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Episode Transcript
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Stephanie Goss:
Hey, everybody. I am Stephanie Goss and this is another episode of the Uncharted Podcast. This week on the podcast, Andy and I are tackling a topic from the mailbag. We got a letter from a practice owner who has a very inquiring mind, and they want to know, “How do I get my associates to be more productive and still support their work-life balance?” The ask is being motivated by the fact that the practice owner seems to produce more revenue in a three-day-a-week period working with patients than the associates are all producing in four days a week. The practice is growing and profitable, and everybody wants to expand the practice footprint, and the practice owner is totally onboard for this, and so they're wondering, “How do I get them to produce more? And also how do I support them, because I don't want to run them ragged? Is there a common ground?” Let's get into this, shall we?
Stephanie Goss:
And now, the Uncharted Podcast.
Andy Roark:
And we are back. It's me, Dr. Andy Roark, and Stephanie check-your-balance Goss.
Stephanie Goss:
How's it going, Andy?
Andy Roark:
Good. Good. It's good.
Stephanie Goss:
Good.
Andy Roark:
We're recording this over the holiday break, and I did a Tacky Lights Tour with the kids.
Stephanie Goss:
Fun.
Andy Roark:
And with my wife, and we went to the Greenville Spartanburg Motor Speedway.
Stephanie Goss:
Nice.
Andy Roark:
Because they had lights. And man, you talk about knowing your audience. There we are, family's in the minivan, and you go through the line. You have to pay admission to get in and drive around, and ultimately we ended up on the racetrack with the minivan and a bunch of other cars. And so we're driving around the racetrack, and they've got the racetrack really decorated, and you're listening to the radio station that comes from the Tacky Lights Tour, right?
Stephanie Goss:
Okay.
Andy Roark:
And so you're listening. And at one point, one half of the track starts to blink, and this one big Christmas tree shaped light starts to flash, and on the radio you hear it. And then the voice, the female voice of this tree, it said, “Boy, I sure do love how my side of the track looks,” and then the other side starts flashing, and there's another tree over there, and they're like, “Yeah, but my side is better,” and the first one goes, “Nuh-Uh. My side is better.” And then they say, “Let the people decide. If you like my side, honk them horns.”
Stephanie Goss:
Stop it.
Andy Roark:
I am not kidding. I'm like, “These people know their audience.” Right? And then the other side is like, “If you like my side, let ‘er rip. Honk them horns!” And I'm driving around the Speedway blowing my horn in the minivan, and I'm like, “This is amazing. I got every penny of my money's worth to come here.” And my wife… And I have been settling debates all week, because we'll argue, and then I'll look at the kids and go, “Hey, if you think your dad's right, let ‘er rip! Honk them horns!”
Stephanie Goss:
I'm sure Allison loves that.
Andy Roark:
Oh, she was in stitches. Honestly, know your target market. And the people who come to look at Christmas lights at the Greenville Spartanburg Motor Speedway, they're all about honking their horns.
Stephanie Goss:
That's fantastic.
Andy Roark:
They drive around they're like, “Woo!” Honk, honk, honk. But, oh man, that was the most exciting thing that happened to me in the last couple of days. “Let ‘er rip! Honk them horns!”
Stephanie Goss:
I love it.
Andy Roark:
Oh, man. How about you? Can you compete with that?
Stephanie Goss:
No. I don't think there's any competing with that. No, it's been quiet around here.
Andy Roark:
Yeah. I have a feeling the Olympic Peninsula Motor Speedway would sound different.
Stephanie Goss:
Not.
Andy Roark:
Maybe not, though. I would like to go see.
Stephanie Goss:
I have a feeling it would, if that existed. No, it's been really quiet. We actually got the white Christmas that the kids are hoping for, and so the Upper Olympic Peninsula in Washington is not prepared for snow, and so when it snows here… I've lived here now for seven years, and it has snowed almost every single year, and yet they are completely unprepared for it, and everything shuts down because they don't… They have plows, but they don't salt the roads, they just sand them, and so it becomes a sheet of ice and it's a hot mess, so we have just been hanging out. The kids have been running around in the snow, and thoroughly happy with their five inches of snow that's on the ground, and have been flooding, and spending most of the day outside, and I have been curled up in front of the fire with a book because it is freezing out and I have less than no desire to be outside in six degree weather.
Andy Roark:
Oh, man.
Stephanie Goss:
There's that.
Andy Roark:
Yeah. One of my favorite movies is… I love the recent Muppet movies. You know the ones that came out with Jason Segel, and then there was a more recent one that had Tina Faye in it and Ricky Gervais. Anyway, they're both amazing. That one, I love that movie. And in that movie, there's this thing where the Muppets are being subverted by the bad guy, and of course Kermit is the voice of reason at the beginning of the movie, and Gonzo wants to do an indoor running of the bulls, and Kermit is like, “This is a terrible idea. This is completely going to be a nightmare,” and [inaudible 00:05:55]. Well, ultimately Kermit gets ejected and removed, and Gonzo does the indoor running of the bulls, and someone runs into the screen and goes, “The bulls are out of control!” and someone else goes, “Who could've foreseen this?” and I die laughing at that every time. And when the most obvious thing in the world happens, my wife looks at me and goes, “Who could've foreseen this?” Like “honk them horns” and “who could've foreseen this” are two inside jokes. And so whenever they're like, “Oh, man. It snowed again and we didn't salt the road,” who could've foreseen this?
Stephanie Goss:
Basically. So we're staying home, and we have been just playing games, and reading books, and doing low-key stuff, and it's been great. I love the snow when I don't have to be out in it for extended periods of time. I went out and did the snow thing with the kids, and we played, and cleaned off the driveway, and all of the cars, and then I was like, “Okay, I'm done now. I can watch it from inside where it's pretty.”
Andy Roark:
Oh, man.
Stephanie Goss:
So it's good. It's good. But we have some questions from the mailbag.
Andy Roark:
Yeah.
Stephanie Goss:
Which I'm excited to talk about.
Andy Roark:
Let's do it.
Stephanie Goss:
This one is a good one. We got a question from a practice owner who has a question about their associate vets, and they were wanting to know, “How do I get my associate vets to be more productive?” Currently, they bring into the practice… They're seeing patients three days a week, and they're bringing in more revenue-wise than any of the associates do seeing patients four days a week, and so they are looking at the team and the wishlist, and the things they want to do as a hospital, which includes an expansion, and this practice owner is feeling like, “We could be way more profitable and we could start working on the expansion. And I would feel much more comfortable, from a money perspective, if I could get them to say yes more often to taking on extra cases, and being more profitable in their four days a week.” And so this practice owner is asking, “How do I find the balance between pushing them a little to see more and do more, and then also promoting good work-life balance for them and for the team?”
Andy Roark:
Yeah. This is a great question, and business owners everywhere wrestle so much with this, and I have wrestled with this at many different times. And so headspace is really important here, and so we need to lay down some headspace pieces. And if you get this, you're going to be okay; if you don't get this, then you're going to continue to struggle, in my experience. Okay? Here's how it goes.
Andy Roark:
First of all, 100% validate the scenery. I think every business owner feels this way at some point and goes, “If the other people that work for me would work as hard as I do, then boy so much would be possible, and this would be amazing. And why don't they work like I do?” Everyone has that thought if they own a business. And even if they don't own the business, I think at some point we all look around and believe that we're working harder than everyone else around us. You know what I mean?
Stephanie Goss:
Yeah.
Andy Roark:
It's called information bias. There's a natural tendency where we don't know what people are doing and we assume that they're not doing as much as us, and so I think everybody has that. Okay. So validation comes first and say, “Yeah, I see that. I hear that. I think everyone who is a manager has felt that.” The truth of the matter is, first, information bias is a thing, meaning a lot of times we don't know what other people are really doing. We look at one specific aspect of their job and say, “Well, if they did this as well as I do, then things would be different,” and you go, “Well, if you did the other things that they're doing, then you wouldn't be as productive in this area,” and thus you'd have a more fair comparison. And so that's just one thing I always put on, is a lot of times we don't exactly know what other people are doing, we don't necessarily understand if their role are different than ours, and so first thing to do is put that in perspective.
Andy Roark:
The second thing is to know that perspective is wholly location dependent, meaning where you are standing dictates what you see.
Stephanie Goss:
Sure.
Andy Roark:
I had a friend who was one of the most liberal in their political views, people that I know, so they were very much about employee benefits and employee rights, and taking the position of the worker. [inaudible 00:10:42] turn people off by saying it's liberal in their political views, but that is very much… The picture is very much like workers' rights, take care of people.
Stephanie Goss:
Pro-employee. Sure.
Andy Roark:
Yeah. That's very much who they were, and they held those beliefs until they became the owner of a business, and that is the biggest change I have seen in someone that I have known well in my life. And don't get me wrong, they didn't become Scrooge McDuck.
Stephanie Goss:
Right.
Andy Roark:
It wasn't a radical change, but boy were these strongly held beliefs re-evaluated once they were the one who could see what the books were, and could see what was going on in the business, and was really forced to look and make hard choices about what we were able to do, and what we were not able to do, and what was in the budget, and what was not in the budget.
Stephanie Goss:
Sure.
Andy Roark:
And again, it was not like comedic, “This person is a completely different person.” No, they were still the same person. But man, so much of their beliefs just shifted when they were on the other side of the balance sheet looking at the real numbers and trying to figure out how to make this work. And I'll never forget that change in this person. I think it was one of the things in my life that really hammered home for me that what you see depends on where you're standing.
Stephanie Goss:
Sure.
Andy Roark:
And I put that down not for good or bad, for any other reason, other than to say most people who are business owners did not look at the practice the way they look at it now before they were business owners. Right? And the idea that people who are not business owners are going to look at your business as if they're business owners, that's just not realistic to me. They're just in a different place.
Andy Roark:
And I think everyone should work to have empathy for everyone else. It shouldn't be no one has empathy for the business owner unless they're a business owner, and it shouldn't be that business owners have no empathy for workers who aren't business… All of that is ridiculous. It's just true that perspective comes from where you are. And people who are not a business owner, and never been a business owner, they're not going to feel the same way that the business owner is going to feel, and I think everybody should just acknowledge that and be okay with it, because being mad about it is not helpful. You're not going to talk people into it. They have the perspective or they don't have the perspective, and to some degree we just have to accept this is how they see their job, and it's different from how you see their job, and you better just come to peace with it.
Stephanie Goss:
Yeah. That makes total sense. Having been on both sides of the coin, I can see that, and I can say that I have perspective now that I didn't have-
Andy Roark:
Sure.
Stephanie Goss:
… as just an employee. And as an employee, even someone who… I feel like I was always the employee who was willing to go the extra mile, and I think I did have a bit of a business sense even before I looked at it from the practice owner perspective; and at the same time, it is a job.
Andy Roark:
Right. Yeah.
Stephanie Goss:
And I was always the team member who was accused of being the one who cared more than the practice owners, and that's hard too, right?
Andy Roark:
Yeah.
Stephanie Goss:
You can have team members who care in a way that is different, and then you're between a different rock and a hard place, so I think that that's super important.
Stephanie Goss:
And I think your point about perspective is a really good one, especially for this practice owner in terms of getting into the headspace to really look at this honestly. Because if you're coming at it from a perspective of, “They don't care as much as I do. I need them to do more,” I don't think that the problem-solving and the action steps are going to go as well. I think your point about the headspace, and the perspective at which you're looking at this, are really, really important.
Andy Roark:
There's another piece of it too, right? The first part is just people who aren't in a leadership role don't necessarily understand what is needed by the practice, and so you say, “Well, why aren't they jumping in and doing these things?” and you go, “They don't know or they don't see it,” or they don't have perspective that you have because they haven't… and they don't spend time in the position that you spend time in, and I think it's important.
Andy Roark:
I think another part of it too is I think a lot of us as business owners forget what it was like to not have the organizational power that we have, right?
Stephanie Goss:
Uh-huh (affirmative).
Andy Roark:
And it's really easy to feel bought into something when you have the power to change it and mold it in your vision. Right?
Stephanie Goss:
Uh-huh (affirmative).
Andy Roark:
And so you go, “Well, why don't they care about it as much as I do?” and it's because you have the power to change it and they don't have the power to change it. It's a job for them, and their power in that job is fairly limited, and so their ownership of that job is going to be directly proportional to the amount of power that they have in it, and so it's interesting. I think sometimes we say, “Why don't they feel about it like I do?” and you go, “Because they don't experience it the way that you do.”
Stephanie Goss:
Right.
Andy Roark:
And I think that that's really important to think about as well. Ultimately, we go through this mental exercise of trying to separate-out the… So yes, to separate apart what it means to be a good employee from what it means to jump to ownership-type responsibilities. I want to pull those things apart. These people maybe don't… they're not doing what you think they should do, and I think that there are good reasons for that.
Andy Roark:
And I think that what we're ultimately trying to get here is that we need to achieve a balance, and I really think… I applaud the way this question was written because I get the sense that they get that. It's about trying to achieve a balance. We want to push people, right?
Stephanie Goss:
Uh-huh (affirmative).
Andy Roark:
We want to motivate people. We want people to work hard. And the idea, “Oh, no. How dare you try to motivate people to see more cases than they see right now?” you go, “Well, that's the job of the leader and manager is to motivate people.”
Stephanie Goss:
Sure.
Andy Roark:
And I think we all need some motivation at some point. At the same time, we should not have the expectation that someone is going to love your baby as much as you do; and if that's your expectation, then you're always going to think that your employees are not living up to their potential, and that's just unrealistic. And so all of that to say what we're trying to find here, the headspace is: what is the healthy place where people are motivated, but where I as a business owner/leader also have a realistic understanding that these people are not owners in this business. It's a job for them, it's not their business that they own and that they're trying to grow, and so we're trying to strike the balance between those things. Being the owner and being the associate of that are a fundamentally different thing; and in this headspace, we should also therefore not necessarily compare performance of the associate to performance of the business owner; they're just radically different things.
Stephanie Goss:
Yeah. I think that is totally fair, and I think that point goes to what this practice owner asked in their question, which is, “How do I promote a good work-life balance for them?” And I think that the work-life balance, the way that someone can view themselves in a work-life balance, is fundamentally different between an associate for whom it is a job, and they may love it. It may be something that they're super passionate about. They love their clients, they love their team, they're your A+ rockstar associate: at the end of the day it's still a job. And if they had a family emergency… or if someone, their partner, got a job halfway across the world… they could away tomorrow and be okay with that because it is just a job; and at the end of the day, the practice owner has made the choice-
Andy Roark:
Sure.
Stephanie Goss:
… to have that commitment to maybe not walk away. Maybe still they could walk away from it, but they're viewing it through a very, very different lens. And so I think your point about not comparing is really, really healthy from a headspace perspective. Because if you wait for your team to look at it the same way that you do, you will be disappointed until the end of time.
Andy Roark:
Yeah. I just think it's a hundred percent vital, right? The practice owners that you and I work with at Uncharted, they think about their business all the time.
Stephanie Goss:
Right.
Andy Roark:
You know? They take a bath and think about their business, and they cook dinner and think about their business.
Stephanie Goss:
Right.
Andy Roark:
And it's not obsession, but it's constantly there, and it's not that way for the associate who comes in, sees their case. They may go home and think about the cases that they're working on, but they don't think about the business.
Stephanie Goss:
Right.
Andy Roark:
And that is why I go, “Those two positions are so fundamentally different.” The first piece of advice I would give to our writer is to say: stop comparing the associates to you, even in production.
Stephanie Goss:
Right.
Andy Roark:
Now, I get where they're coming from, but I don't know… Sure, there are blazing fast associate vets out there that tear through rooms and work hard and can produce, outproduced, the practice owners, that definitely happens: those are exceptions to the rule, not the rule. I think that generally, because of their position, because of their perspective, the practice owners are going to be generally more motivated to do these types of things than the associates are, and I think that that's reasonable and we have to be okay with that. And so the first thing I would say is I would discourage you from saying, “This is what I produce. Therefore, this is the target that others must meet in order to be seen as good or competent associates, in my eyes.” I think that is a recipe for frustration.
Stephanie Goss:
I agree. And I would say, when we start to talk about action steps, for me a lot of it is centered around, “How do we take the emotion out of it? And how do we look at the concrete?” and not just from a numbers perspective, because the revenue piece of it can be a very good driver for associates and team members who are financially motivated, and it can be a very sharp edge for those who are not financially motivated. And so the quickest way to divide the team, or turn off and get people to shut down who are not financially motivated, is to come at it from a perspective that is looking at it from the revenue point of view.
Stephanie Goss:
For me, it is very much, when we think about action steps, it is about looking at things as concretely as possible; and looking, for me, at the workflow, and looking at what is the same and what is different. Because I will tell you, as a practice manager who has worked with a variety of different practice owners over the years, practice owners have the ability, we all as humans have the ability, to look at things and have our perspective very clouded by the lens with which we're filtering it through. And I have worked with lots of practice owners who are amazing vets and who could do things very fast, and often think of themselves as being more efficient or more expedient or faster than the associates, or looking at it from very much the similar position that this practice owner is, “Why can I outproduce them? I'm only working three days and I produce more than them, and so how do I fix that?” And for me, when you dive into the specifics and you start to look at the concrete, often there are things that skew it in favor of the practice owner.
Stephanie Goss:
I've worked in many practices where the practice owner works at a significantly higher tech-to-doctor ratio; so yes, they're producing more, but they have more bodies every day. Or they are doing appointments in a different style. It comes down to, when we look at the concrete stuff, there can often be specific things that can be pulled apart, and I think that that's the really important part. When I think about looking at it from an action step perspective, is how do we make this… how do we take it out of the shades of gray, and how do we look at it from the black-and-white concrete perspective so that you level the playing field in a way that feels as equitable as possible, and you take the ownership piece out of it, and look at it on a doctor-to-doctor perspective.
Andy Roark:
Ah, interesting. I'd push back against this a little bit, and here's why. For me, the steps to resolving this issue are separate… Discard the idea that the owner and the associate vets are the same, and look at the associate vets as their own entity; and then address the problem, which is still the problem of, “I think that the associate vets could be more productive, and we could be more profitable, and then add the expansion that we want to add if they sell more cases.” I guess why I say that is I think comparing the production of the associates to the owner, as you were saying, it generally doesn't make a lot of sense. And we can dig in, and we can find all these different reasons that those things are not the same. To me it doesn't matter. You know what I mean?
Andy Roark:
If you need to dig into the reasons to convince yourself that these positions are not the same, then that may be a good exercise that someone might need to do to get into a good headspace. If you can buy into the idea that associate vets are associate vets, and we should set aside comparison to anyone else and just manage the associate vets that we have, then I think you're going to have a much more straightforward challenge than teasing apart, “Well, this is why their experience is different from mine.”
Stephanie Goss:
I think that makes sense, and I think that works significantly easier in a practice if you have multiple associates. If you can compare associate to associate, then you're talking more honestly about apples to apples, versus apples oranges, and you still have to sort out the things that are different. Are they all seeing the same time, length of appointments? Are they working the same days? Is one working more surgery days than another? There's inequities that have to be sorted out and teased apart when you're looking at the actual numbers. But to your point, when you're looking at associates to associates, and you're taking the owner as a doctor out of the equation, it is much easier to have it be equitable. And where I have seen this be a big struggle is for smaller practices that have one or two associates, and often it's a lot harder to make that equity. When you only have one associate, you don't have anybody to compare them to, or you have two associates, but there might be differences between those two associates. Right?
Andy Roark:
Yeah.
Stephanie Goss:
And so I think that, for me, is about if you don't have the ability to separate it out… To your point, if you have that ability, phenomenal, do it, take the owner out of the equation and look at it just from an associate to an associate perspective. And if you are a practice owner who's like, “Well, I only have one associate,” or “I have two of them, but there are differences,” that's where for me you really have to lean into picking it apart in a way that sets it on the most level playing field possible, and all of those things are really important to look at when you're looking at metrics because they do all impact it. When you have a doctor who does way more surgery days… or who works Mondays than Fridays, which are arguably the busiest days for any practice… the numbers and the dollars are probably going to be dramatically different, through no fault of their own, to the associate who then works Tuesday, Wednesday, Thursday. Right?
Andy Roark:
Yeah. No, you're exactly right. And I'm right back with you. That makes a ton of sense. Yeah. And let me put one more thing forward here. Because when you're talking about equity and you say we should look at the schedules, and are people working different schedules? And if you've got a doctor that works Saturdays versus… You know, if one of your three days is Saturday, and they don't work on Saturdays, I go, “Well, I'm not surprised that you're doing as much as they are,” because you're doing Saturday, which you know is a bonkers day, and so anyways I think that's important.
Andy Roark:
But here's the other one I think is more important, from looking at these things equitably, and I see this all the time. I see practice owners who get really frustrated at the production of the veterinarians, and like, “I do so much more and I produce so much more than this person,” and often… And again, I don't know this scenario specifically to say this was going on here, but I would just say I see it a lot. Often, the owner has been there for a decade and has built relationships with these clients, and the name of the building is after them, and the practice owner has credibility and relationships with clients, and loyalty from clients, that the new associate who's been there two years just doesn't have, and it's not about your skill in the exam room. It's about the fact that you have talked to your clients and known them for eight years, and this new associate has known her clients for one-and-a-half years. And so when you recommend a dental cleaning, you're more likely to have that person agree to it and do it because you have that longstanding relationship, which the other person doesn't have. It's why we talk so much about, when new vets come in, endorsement from the owner or the established vet to help build them that trust and credibility.
Stephanie Goss:
Sure.
Andy Roark:
That stuff is so important. But anyway, the point being sometimes there's nothing different that the new vet is doing or the younger vet is doing than the older vet; they simply don't have the long-term relationships. And I think a lot of times we say, “Oh, I'm working harder,” or “I make better recommendations,” and the truth is like, “No, you've been here a long time and people know you, and they like you, and you should be proud of that,” but oftentimes it can just be a matter of time, and those things can even factor in. So again, comparison is the thief of joy. Comparing yourself to others, for good or ill, generally just leads us to be unhappy, other than setting a certain benchmark for what we think is possible.
Stephanie Goss:
If you're a practice owner and you are in the place that this practice owner is, how do we actually attack this and try and answer the question for, “How do I find that balance?” And for me, that's a question of, “How do I address it with them?” Because you can't find balance without talking to the team about it.
Andy Roark:
Oh, yeah. Well, yeah. Let's take a break, and we'll come back, and we'll dig into the actual plan.
Stephanie Goss:
Okay.
Stephanie Goss:
Hey, everybody. It's Stephanie. I just have to break in here for one second and make sure that you know about an awesome opportunity that is coming up that we do not want you to miss. We are back. We are back in person in April in Greenville. That's right. Our flagship conference in Greenville, South Carolina, is happening in person for the first time in three years, and we are so, so excited to be back with you guys. It is happening April 21st to the 23rd, so put that on your calendar now. And if you head over to the website at UnchartedVet.com/April, you can find all of the details as we sort them out, and you will get to see the schedule as soon as we have it, you will get to see information on the speakers. We've got an event FAQ. You can shop for Uncharted gear. We've got safety information if you're wondering about being back in person. So if this sounds like something you would be interested in, head over to the website at UnchartedVet.com/April and reserve your spot. This event will sell out. We cannot wait to see you, so don't wait to put this on your calendar. You do have to be an Uncharted member to attend. You can find out all the details at the website.
Stephanie Goss:
We'll see you soon. Now back to the podcast.
Andy Roark:
All right. Let's get into what are we going to do here, right? We want to increase the production of our associate vets; and if we did that, we'd have a more profitable practice, and we could even do an expansion maybe. How do you go and say to the vet, “Hey, I need you to work harder, and do more stuff, and sell more stuff,” but do it ethically, and don't take advantage of people, and don't upsell people, and be someone who's worthy of the reputation of my vet clinic, and take care of pet owners, but also get your production up and work harder.
Stephanie Goss:
Right.
Andy Roark:
And do more things, and life balance. Don't forget life balance. Go. Right?
Stephanie Goss:
Uh-huh (affirmative).
Andy Roark:
Okay. How do we do that? Here's the thing. The first point that I made I think is set aside comparison between… Just manage the person, and help that person to find motivation, give that person the resources and the support that they need to be successful, and then help them manage life balance by setting boundaries to take care of that person. How that person stacks up to you is not important, unless it means that person is unmotivated or unsupported or is not getting their work done.
Andy Roark:
The way that I would start, there's really three steps I think in this problem; and these are very simplistic, but I think that's what they are. The first one is that metrics are key. If you don't measure it, then you won't manage it. You know?
Stephanie Goss:
Uh-huh (affirmative).
Andy Roark:
And that's what it means. If production is important, then we need to measure production, and we need to talk to the owners about production, right? We need to say, “Hey, this is what you did. This is what we're looking for. This is what our targets are,” and people won't even have those basic level of conversation about expectations. And I can tell, as an associate vet, I would like to know what your expectation is; and if I'm not meeting it, I want to know that. But I think I'll lot of times we have these talks and we say, “Well, they should be producing more,” and I say, “Well, what are they producing now?” and they're like, “Well, I'm not exactly sure,” and then you say, “Well, what should they be producing?” and they're like, “Well, I don't exactly know that either.” The very first step is you've got to start to get some data. Right?
Stephanie Goss:
Yeah.
Andy Roark:
You can't have a production-based conversation when you don't have production data and you're not willing to share production data.
Stephanie Goss:
Yeah. And I would say that this is the first step, and this is often where I see practice owners make the biggest mistake because too many times I think people try and go from zero to a hundred with no plan. And so practice owners will often… I think this is a great example. You have a practice owner who wants to expand their facility. The team's brought, there's team openness and discussion to wanting to expand the practice. For a lot of practice owners, instead of approaching it from, “Hey, this is something we all want. What is it going to take for us to get there?” which is very much an open-armed getting their buy-in approach to it, too many times people look at it, see the first step as being important, see that we need to be looking at metrics, and try and go from having no discussion about numbers and revenue, to throwing open the books in a way that comes across as dumping your problems on everybody else and expecting them to solve it, and that is the biggest mistake.
Stephanie Goss:
And so this is where this part makes me super happy because I love spreadsheets, and I love of getting nerdy with numbers, and so this is where I would say to this practice owner, or any practice owner, “If this is not you, if the numbers scare you, if you don't like spreadsheets, get someone on your team who can help you because you need someone who can look at it from an objective, unbiased perspective.” And so whether that's your practice manager or a CPA, this is an investment worth making, and it's one worth taking your time for. And so my suggestion would be to start actually looking at the numbers and pulling together the data, and doing it quietly and to yourself before you go jumping in the deep end with your associate team because that is where the most mistakes get made, in my experience.
Andy Roark:
Absolutely. No, I completely agree. If all of this is new and it's all at once, it feels awful and feels like the whole place has sold out-
Stephanie Goss:
Right.
Andy Roark:
… to try to make money and revenue, and that's very demotivating for a lot of people in vet medicine, probably most people in vet medicine. I love the idea. My point is it's more so than making a presentation to the associates or the staff. It is you have got to start picking these numbers up.
Andy Roark:
The other thing is the metric that we were given was, “Here's what the associate makes compared to me the owner,” and I go, “I'm more interested in what did the associate make this spring compared to last spring.”
Stephanie Goss:
Right.
Andy Roark:
That's what I'm more interested in.
Stephanie Goss:
Sure.
Andy Roark:
And there's wild variation month to month, and you go, “Oh, look at December. We lost money. ” Well, guess what? You lose money every December, right?
Stephanie Goss:
Right.
Andy Roark:
Every December things fall off, it's not a continuous upward trajectory, but you have to have some back data to know those things.
Stephanie Goss:
Yeah. And that's where someone who is going to look at it objectively can help you pick out parameters, and even it out, so that you're not looking at it in an obsessive blip-to-blip fashion, which is so easy to get siloed when you're looking at numbers, into those little things, and you have to be able to zoom out and look at it from the big picture perspective, and so I totally agree that that makes sense.
Stephanie Goss:
And I think that there can be value, if you have multiple associates, in looking at them in comparison to one another, if you level the playing field. But to your point, it is far more valuable to look at a new associate who's been with you two years, and look at what is their year-over-year growth as an individual, versus how are they comparing to your other associate vet who's been with you for 10 years, for example, and has been out of school for 20. Those things impact. And again, we're not comparing apples to apples, to your point, when you have a new associate on your team. All of those things matter. And so starting to strip away some of that, and also take the pieces that need to be taken into consideration, in terms of balancing your skills, is really important.
Stephanie Goss:
So I agree. I think starting to talk about the metrics is important. And I would caution practice owners that if this is the first time that you're really starting to talk with your associate vet, or associate vet team, about metrics, this is a long game. This is very much a marathon, not a sprint. And if you approach it as a sprint, it will probably fall apart.
Andy Roark:
Yeah. I completely agree with that. This is slow. It's introducing the idea. The first part of this is not holding people to metrics; it's just introducing the metrics. Be like, “Hey, we're going to start looking at some numbers.” But I do think it's amazing; just sharing metrics with people is motivating. I remember the first place that I worked as a vet, every quarter I got my production numbers, and I had a spreadsheet at home that I put them into just so I could look and say, “How am I doing? Am I getting better? Am I growing and am I meeting expectations?” It depends on the individual, of course, but just getting… You have to get numbers on the table; otherwise, it's about how you're feeling.
Andy Roark:
And one of the things I will say is some of the hardest working veterinarians that I know are the lowest producers, because they run themselves ragged doing work that doesn't get paid for, doesn't get billed for, or things like that, and so it's not about how hard you work. A lot of times it is what systems are you using, and how are you moving clients through the building, and how are you working-up your cases? And so that's the first part is really metrics are key. If we're not looking at numbers and looking at numbers with our associates, we need to start introducing that. Because if we're going to try to manage them to production, we need to introduce the idea of production early on and let people get used to it.
Andy Roark:
The second part is presenting the problem with true curiosity. I think one of the mistakes that people make is they go to the associate and say, “Hey, you are not working as fast as I am,” or “You are not seeing as many cases as I am,” or “You are not working-up your cases as much as I do, and that's why your average client transaction is not as high.” And once you put that on the table, you have just framed this issue very tightly. And what I have found usually, I'm a big believer in seek first to understand, I don't know why this vet's numbers are what they are in the exam room because I'm not in the exam room with him or her. You know? I may be able to paint a picture and I can look at some things, but I don't really know.
Andy Roark:
It's amazing. Again, another thing I see is practice owners that have their go-to technician who only works with them, and she's amazing. And meanwhile the associate vets have other very nice technicians who are much less experienced, for example, and then that senior vet goes, “Gosh, I crush you guys. Why can't you keep up?” and it's like, “Oh, because you have… ” You know?
Stephanie Goss:
Yeah.
Andy Roark:
You have Obi-Wan Kenobi technician with you, and I have a six months of experience technician with me who's going to be great, but right now she's learning as I'm learning, and it's unfair to compare those two things.
Stephanie Goss:
I think for me those are where, going back to what we were talking about earlier, that's where, from a metrics perspective, for me we have to look at some of the inequalities, and I don't mean from a revenue perspective. This is not just a conversation about money. This has to be a conversation about workflow and process in your practice and your team as well, and so it only behooves you as the practice owner to identify some of those inequalities and figure out how do you level the playing field. Because if you want to be more profitable, is it more profitable for you to keep your super experienced technician all to yourself three days a week, or is it more profitable for you to lend that technician out two days a week and work on them training some of the newer two members to gain more skills with the associate vets, so that in the long run they're producing more as a result of that. That's where for me part of it is digging into the workflow and looking at the pieces that may not be the same between the practice owner and the associate, but also associate to associate. Picking apart all of those things.
Stephanie Goss:
And then the other piece, to your point, I love the idea of presenting a problem with curiosity. The other thing for me is this is about getting buy-in, and so for me the balance… This practice owner is asking, “How do find the balance,” right?
Andy Roark:
Uh-huh (affirmative).
Stephanie Goss:
Between pushing them and promoting good work-life balance. To me, the answer only lies in them being bought into the vision. And so if they want to expand the practice, my road and my path to having this conversation, and whatever results may come of it, is going to be far easier if they're bought in on that than if they don't want that. If they're an associate who's like, “I want to work two days a week and go home, and I could care less about what's happening around here on the other days,” those are two very, very different things.
Stephanie Goss:
And so for me, part of it is from a place of curiosity and buy-in, in that, “How do I get them onboard with where we're trying to go, in a way that feels inclusive to them?” And so I would look at it from that perspective and think about what is important to them in terms of their work-life balance. What are they asking for? Because if they want new equipment or new facilities, or an expansion, it's way easier to have the conversation… any of the conversations, including the hard ones… about some of the metrics and workflow that you're going to have to tease apart, if they're bought into that idea.
Andy Roark:
Yeah. Here's the thing, because they do ask, “How do we maintain work-life balance?” and it's always my assumption, when we talk to the associates, that maintaining work-life balance is important. I think it just is. It's how you treat them. If I come to you, Stephanie, and you're an associate vet, and I say, “Dr. Goss, you are not seeing enough appointments in a day and I need you to go faster,” that is a tightly framed conversation. You know what I mean?
Stephanie Goss:
Yeah. Absolutely.
Andy Roark:
And does it take into account your work-life balance?
Stephanie Goss:
No.
Andy Roark:
Or your stress level, or your anxiety, or any of these things? No, it doesn't. I gave you a problem with only one solution, which is work faster.
Stephanie Goss:
Go faster.
Andy Roark:
And quite honestly, do I know what you're up against or if working faster is even a possibility for you? No, I don't know. And I see all the time people go, “You know what? I'm just going to be honest with you. You don't see enough appointments, and you work faster.”
Stephanie Goss:
Right.
Andy Roark:
And I'm like, “Oh, man. You made a bunch of assumptions about Dr. Goss and about what is possible.” And going to someone who's working as fast as she can and saying, “The only answer is for you to work faster,” that's how people break and quit. You know?
Stephanie Goss:
Yeah.
Andy Roark:
But here's the thing: none of us get compensated for how fast we go, right? None of our practices are successful because of the speed with which people move through the building. If they were, you'd have practices where people just sprinted around all the time. Sprinting does not translate to patient care.
Stephanie Goss:
Right.
Andy Roark:
Or to revenue. It doesn't. And so don't tell them the problem is that they're not going fast enough. Go to them and present the problem and listen with curiosity, which means… The problem is not, “You are not moving fast enough.” The problem is, “We need to increase revenue in our hospital, and I need your help, and I want to talk about ideas that you have and what might be possible,” and now my friends: now we're talking about what is possible. And it may be, “Hey, I need to speed up,” or more likely the associate vet is going to look at me in my eyes and say, “If I had trained technicians like you do, I could do a lot more business.” And what happens? My head just deflates because the whole time I was like, “I'm so much faster, and I need you to go as fast as I am,” and then it's shown clear to me, “Oh, I'm faster because I have high-quality support staff clustered around me, and the associate has the less trained, less experienced support staff clustered around her.
Stephanie Goss:
Right.
Andy Roark:
And so now it's not about her going faster. It's about us doing training protocols, and shuffling our technicians, and cross-training and mentoring support staff, paraprofessionals, so that we can build efficiencies and move people through the room a whole lot faster, and she's not working faster. It may turn out that she's twiddling her thumbs in the exam rooms because she doesn't have the support staff around her that she needs, and I just use that as an example of what might potentially be the problem. But if you go and you say, “I need you to go faster because you need to see more rooms,” that is a very narrow framing, and it does not take into account what is possible or what is accurate, and it's probably going to go badly. The more wider framing of, “We need to raise revenue, and I would like your help with that, and I need to know what your ideas and thoughts are. Start thinking about it, and we're going to talk in a couple of days, and I want you to go through with me what do you think is going to help, because we need to get our numbers up.”
Stephanie Goss:
And this is where I think the headspace piece is most important for the practice owner because it can be very easy… When you start the conversation and you start to pick apart some of this stuff, it can be very easy to take it personally, and to take what they're saying personally, “Well, I don't have the most experienced technician. That's not true.” Right?
Andy Roark:
Yeah.
Stephanie Goss:
That's a really easy human response to being presented with that, and so this is where the headspace is really, really important. And so for me, the challenge is not only in presenting the problem with true curiosity, but then sitting back and truly listening to what is said. And I would offer to you as the practice owner: just listen, take notes, hear them out, and then say, “You guys have given me a lot to think about. Thank you for your feedback. Thank you for sharing. I want to process this.” Right?
Andy Roark:
Yeah.
Stephanie Goss:
Walk away from the conversation because no good is going to come from you trying to respond in the moment regardless of how positive their feedback might be. The best thing for you is to say… to shut up, listen, and then say thank you, and walk away for a little bit, and really truly digest it. Because it can be very, very easy to take it personally. Because, to your point in the very beginning, no one is ever going to love your baby the way that you do, and they are talking about your baby, whether you consciously think about it that way or not in the moment.
Andy Roark:
Yeah. No, I agree. And I love the way you said that too because it really does hammer on that point that I wanted to make so clear at the beginning, is you have got to separate the associate vet from yourself because they are going to give feedback and they are going to have ideas. And if you say, “Oh, no. This is a competition between the two of us, and this person is being measured against me,” you're never going to be open and receptive to their feedback. They're not the practice owner, they're not you, and so just put your performance aside and have this open conversation with them coming from a positive and supportive place. How can I help you?
Andy Roark:
One of the things that also I'll put forward as a tool for having this conversation, about presenting a problem, a lot of times what happens is we go to people and we say, “This is not working. Here is the problem,” and we present like that, and it's very demotivating.
Stephanie Goss:
Sure.
Andy Roark:
Think about someone coming up to you and saying, “Look, there's a problem. This isn't working.” You just feel the wind going out of your sails. One of the best things we can do is go in when a person has been successful, and has been having a good day. It's when you go in and you recognize that they had the most productive month they've ever had before.
Stephanie Goss:
Right.
Andy Roark:
And that's when you go to them and say, “Hey, you had a fantastic month last month, from a production standpoint. What happened? What was good about it? What made this work? Tell me about the things that happened, so that we could have more months like this, because you were amazing. You're doing so great. I want to support this.” And then what happens, you're coming to someone saying, “I see you winning, I see you succeeding, I see you excelling, and want to help you do more of this. How can I support you so that this is easier or there's more,” I don't know, more routine, or so this happens every day you come in? And that's just a nice way to open the conversation up, and a way the person generally receives very well. Everyone likes to be told, “Hey, I see you doing an amazing job. What are you doing? What has changed? What is helping you? How can I support you where you are now? Because you're just putting up awesome numbers.” Yeah. I think that is a happy, positive reinforcement way to approach it.
Andy Roark:
The last part for me: we've talked about metrics are key, you've got to have some concrete numbers, you've got to present it as a problem, and then listen to what the person has to say, and try to get their input, because that's how… You can't guess what their life-balance needs are. I just think that's such an important lesson. You can't guess what someone else's life-balance needs… You're like, “Well, I scheduled you so you would have life balance.” It doesn't work that way. The person that has got to say, “Hey, this is how I'm feeling. This is what I'm experiencing. These are the constraints that I have. This what I'm working against.” I can't know those things. The person has to tell me. And so presenting that problem and listening with curiosity is the only way I get there.
Andy Roark:
And the last part is flexing to motivate, and I think a lot of people assume that money is a universal motivator or that's what people really want. It's like, “Well, I pay them a percentage of their production, so they're going to obviously want to generate more money,” and you go, “You know what? A lot of people are not motivated by money in medicine,” and good. You know?
Stephanie Goss:
Uh-huh (affirmative).
Andy Roark:
For a lot of people, and again I'm talking specifically about veterinarians: once you have enough money, money is much less of a motivator for a lot of people.
Stephanie Goss:
Sure.
Andy Roark:
Once your base needs are met you go, “Oh, well. I'm not really here for the money. I'm here because I want to do good work,” or “Because I like the challenge of this job,” or “I want to work with people and support people.” If the only motivator you have is, “You need to hit these numbers and I'll pay you more,” you're going to find a significant percentage of our colleagues who are not going to be motivated by that, and that's not a flaw; that's a feature. That's the people that we are and the people that we deal with, and so we have got to figure out, “What does this person care about, and what does motivate them, and how can we lean into that?” Does this person… Do they respond to educational opportunities? Do they respond to days off for schedule flexibility? Do they respond to bonuses? Do they respond to leadership opportunities, to moving up, to having more ownership of the operation. You know?
Stephanie Goss:
Uh-huh (affirmative).
Andy Roark:
To having more input into how the practice is run, and people respond to different things. I need to figure out what motivates this person and try to lean into their motives. A lot of times what happens is, and this is one of the downsides I think in production-based compensation, there's a lot of people who said it and forget it, and they say, “Well, the doctors get paid a certain percentage of what they do in the exam room. Motivation: check. Moving on.”
Stephanie Goss:
Right.
Andy Roark:
And I go, “That's not how you motivate people.” And so are we motivating effectively?
Stephanie Goss:
Well, and I think, to the motivation, for me, also here is very easily tied to ownership. And so as an owner, if you're looking at this and you're feeling like you're producing more than your associates, you're only looking at one piece of the ownership puzzle. And so the reality is there are doctors on your team who are motivated by the patient, and the patient care matters the most to them: that's an opportunity for you to create ownership drive in them in a way that it's still going to benefit your practice in the long run. Put them in charge of creating new patient care policies or protocols, or training the team or… There are a million different facets of that from an ownership perspective, and that takes something off of your plate. It doesn't all have to be financial. There are associates that are driven by their interactions with the team and their love of the team that they're working with. Create opportunities for them to take ownership of that.
Stephanie Goss:
Again, you are not directly solving your revenue question, but practice ownership is not solely a picture of numbers and revenue. And so this is an opportunity for you as a practice owner to maybe take some things off of your plate in other areas of ownership, even just a little bit, by allowing your associates to take ownership in other areas, that then frees you up to think more creatively about the revenue pieces, if that's not something that motivates them. Because I think your point is really important, Andy, which is that so many times we forget that the money doesn't motivate, I would say honestly the vast majority of people in veterinary medicine, and so we need to think creatively about, “How are we going to motivate them?”
Andy Roark:
Yeah. There's a scene from the show, Mad Men, that I always really liked, and it was just one that… I did not follow the show very closely, but this is a scene that I saw that just stuck with me or whatever. Don Draper is there and he's been paying his assistant, and she's doing this work, and she's doing this creative work, and at some point she's upset and she's going to leave, and Don says, “Why are you leaving?” and she says, “You don't show me appreciation,” and he said, “That's what the money is for,” and I see that sentiment.
Stephanie Goss:
Sure.
Andy Roark:
Like, “What do you mean? That's what the money is for.” And that resonated so strongly with me of like… Because you see that mentality and you go, “Yeah.” That's not what a lot of us are looking for. So anyway.
Andy Roark:
I think this has been really good. I'm glad we walked through it and everything. I hope this is helpful to the writer. It's a good challenge. It's a creative challenge.
Andy Roark:
I think, just to summarize: if you let yourself get into the mental pigeon hole of, “This person is not as effective as me,” and the only answer to this solution is for this person to work harder and faster, I think that your options are very limited, and I've seen that challenge go very badly. I think if you say, “The problem here is… ” my production uninvolved in this, removing myself from this equation, “we need to get revenue for our practice up.”
Stephanie Goss:
Sure.
Andy Roark:
“And I would like to go have a conversation about how we're going to do that,” and the first thing we're going to do is start tracking our revenue.
Stephanie Goss:
Right.
Andy Roark:
And looking at production. But then beyond that, we need to talk about what we can do to increase production. And the reason I would say that too is, to put it this way: if there is a solution where the associate veterinarian does not work any faster and generates significantly more revenue for your practice, are you with that, or do you just really need this person to work faster?
Stephanie Goss:
It's a good question.
Andy Roark:
Yeah. That's the point. Open yourself up to a broader conversation. And at the end, we're working with what we're working with, which means it doesn't matter that the other associates are motivated by X if the associate I need to motivate is motivated by Y. It doesn't matter that that's how people are motivated.
Stephanie Goss:
Right.
Andy Roark:
And it doesn't matter what I do versus what someone else does.
Stephanie Goss:
Sure.
Andy Roark:
And it may also be that this veterinarian is not fast and they're not going to be fast.
Stephanie Goss:
Right.
Andy Roark:
And does that mean you're going to chase them off because they're not as fast as you would like them to be? If you've got your pick of veterinarians and they're just lined up down the road waiting for an opportunity, and you've got so many of them, then maybe it does mean that they're not going to work out. But if they're a good cultural fit and the biggest problem is they're not as fast as you like, I don't know if that's something I want to part ways over.
Stephanie Goss:
Yeah. Agree.
Andy Roark:
Cool.
Stephanie Goss:
Have a great week, everybody.
Andy Roark:
Yeah, everybody. I hope this was helpful. You guys take care of yourselves.
Stephanie Goss:
Well, again that's a wrap on another episode of the podcast; and as always, this was so fun to dive into the mailbag and answer this question. And I would really love to see more things like this come through the mailbag. If there is something that you would love to have a talk about on the podcast, or a question that you are hoping that we might be able to help with, feel free to reach out and send us a message. You can always find the mailbag at the website. The address is UnchartedVet.com/mailbag, or you can email us at podcast@unchartedvet.com.
Stephanie Goss:
Take care, everybody, and have a great week. We'll see you again next time.