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Dustin Bays

Jul 05 2023

I Can’t Afford to Give Them All Raises

Uncharted Veterinary Podcast Episode 239 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are in the mailbag to take on a question from a practice manager colleague who is struggling with hiring. They have a candidate who feels like a good culture fit. This is a huge win and probably has you wondering “What is the problem???” Well, this candidate is a good culture fit and they are less skilled than the manager's current assistants. And they are currently making a wage that is both higher than the existing assistants AND over the top end of this practice's pay scale. The manager is wondering what to do but more so, how do they know when it is time to adjust the pay scale? Because they thought they were paying well. This sparked some lively discussion between Andy and Stephanie. Let's get into this…

Uncharted Veterinary Podcast · UVP – 239 – I Can't Afford To Give Them All Raises

You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Amazon Music or wherever you get your podcasts.

Submit your questions here: unchartedvet.com/mailbag


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Episode Transcript

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 jumping into a letter that we got in the mailbag from a manager who has a good cultural fit assistant candidate that has been working for another vet in town. And this assistant is making quite a bit more money than this manager's existing assistants. And they are wondering what to do about the situation, but their question isn't what you might think given the situation. This was a really fun one for Andy and I to debate. Let's get into this, shall we?
And now the Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark and the one and only Stephanie I guess the change in my pocket wasn't enough Goss. Ah,

Stephanie Goss:
That's funny. I was like, where's he going with this? And then…

Dr. Andy Roark:
Then you got it.

Stephanie Goss:
And then I realized where you were going with this.

Dr. Andy Roark:
Ah, then you got it.

Stephanie Goss:
How's it going?

Dr. Andy Roark:
It's good. It's good. Yeah, things are good. I can't complain. I've been doing the driver's ed with my daughter where she has her learner's permit and so we go out and we drive. And so yes, last night she was like, “All right, we are going out on this big…” It's like it's five lanes in each direction, a big road. And she's like, “I'm doing it.” And my mom was down visiting and I think she wanted to show her grandmother what a good driver she was. And so she was like, “I'm not afraid. We are going out past Target on the big road.” And so she gets in the big road and she's in the center lane and we're just driving and we just keep driving. And finally I was like, “Jacqueline, where are we going?” We've left Greenville, like we're leaving Greer South Carolina. We're in different county.
She's just driving on this big road always in the center lane. And she's like, “No, I'm going to turn around and we just keep going.” And I was like, “Jacqueline, what are we doing?” And I realized that the traffic was whipping by and she was afraid to change lanes and so we were trapped in the center lane of this big road because every time she would like… And then she really started to feel pressure and so she'd put her turn signal on and people were just kind of jerks.
And they would just move into her blind spot. We went another 15 minutes before she could get out of the middle lane. And it was one of those things where you were like, I wanted to be “Jacqueline for God's sake, figure this out.” But that doesn't help the 15-year-old girl who's driving the car-

Stephanie Goss:
Poor Jacqueline.

Dr. Andy Roark:
… feeling a lot of anxiety and she desperately wants to do everything right. And so giving her a hard time is not helping. And also we should apply some pressure here. So I did what I do, which is just lean into humor and I started texting people that I was glad to have known them.

Stephanie Goss:
You're never coming back because you're going to be stuck in the middle lane forever.

Dr. Andy Roark:
Exactly right. I was like, “Tell Hannah her father loved her and I'm sorry I wasn't there for her 12th birthday, but just know that somewhere I'm still driving in the middle lane.” At that point I was probably somewhere around Milwaukee.

Stephanie Goss:
Oh man. Hey listen, I've driven out by your Target and it is crazy. So-

Dr. Andy Roark:
It is crazy.

Stephanie Goss:
… I don't blame her.

Dr. Andy Roark:
No.

Stephanie Goss:
Okay. I hate that part of town.

Dr. Andy Roark:
No, just the whole thing reminded me of European vacation with Chevy Chase-

Stephanie Goss:
That's so funny.

Dr. Andy Roark:
You know when he's stuck in the roundabout?

Stephanie Goss:
Yes, yes.

Dr. Andy Roark:
I'm like, “That was it.” So the roundabout was just a straight road.

Stephanie Goss:
That's so funny. So I had my first driving experience with my kid this last week. Now she does not have her learner's permit yet. She's 14.

Dr. Andy Roark:
So you're just breaking the law.

Stephanie Goss:
Yes.

Dr. Andy Roark:
Okay.

Stephanie Goss:
But I was on our property.

Dr. Andy Roark:
Okay. Was it like a lawnmower driving experience?

Stephanie Goss:
Nope. Nope. She's done that. She's done the golf cart. So we progressed to an actual car and I had to move the cars around in the driveway and I was like, “Sissy, do you want to want to back the one car up and then we'll move the other car and then you can drive it back up the driveway.” And she was very excited.

Dr. Andy Roark:
Yeah. This sounds like an idea I would have. This is 100% sounds like an Andy Roark idea of-

Stephanie Goss:
Mow my driveway is-

Dr. Andy Roark:
Just going to get her to park down the driveway. What's the big deal?

Stephanie Goss:
My driveway is not as steep as your driveway, but it is steep and it does have a ditch off to one side. I did not learn my lesson from listening to you talk about Jacqueline, however, there was no falling off the side of… She did great. But what I is, my poor kid is going to be the kid who's literally in a booster seat to drive. She is my grandmother.
Our driveway is steep. And so it's hard enough when you're short to see over. I am very short. It's hard enough to see over the dashboard when you're short. Going straight uphill when you're short is a significant challenge. And bless her heart, she was just creeping because she's like, “I don't want to crash into anything.” And I'm like, “Thank you for not crashing my car, but also can you step on the gas?” Taking 20 minutes to go up the driveway. Oh. But it was that moment of “I'm not ready for this.”

Dr. Andy Roark:
Yeah. Oh, it's a whole… Yeah. The joys of parenting never end. But you know-

Stephanie Goss:
I'm not ready.

Dr. Andy Roark:
… philosophically it's funny. That's life in a lot of ways because we don't give ourself enough credit for the hardships that we've overcome. We were all there at some point where we were freaked out to change lanes and now we don't even think about it, but we don't go back and pat ourselves like “Yeah, I got past that.” We get past it and we go on, but it's just funny that that's life. And so I really love where my daughters are right now sort of developmentally in that I'm watching these wonderful people figure out what it means to be an adult human being. And the challenges they're facing are challenges that I can relate to. I get traffic stress, I get it. I didn't necessarily get… I can't find my video I want towatch on YouTube anymore.
That was not a part of my childhood that I relate to. But the stuff when they start acting like real adults, I'm getting it. And so Jacqueline, I think she's going to do some work for us over the summer at Uncharted probably doing some website stuff and some data management stuff, which is sort of an interest of her, but she has to interview for the job. And so she's going to come meet with Tyler and Stephanie-

Stephanie Goss:
I love it.

Dr. Andy Roark:
… and Danielsson and she's going to have an interview with them later this week. And so she's stressing about her job interview at her dad's company.

Stephanie Goss:
Oh my gosh, that's so funny.

Dr. Andy Roark:
But I'm enjoying it. So it's awesome. It's awesome.

Stephanie Goss:
I love it. I love it. Well, I'm excited about today's episode. So we had a mail bag that I just loved and it was from a manager who was struggling because they have a good cultural fit candidate who has been working for another vet in town who is older and getting ready to retire. And they've been with that practice for a long time. And so this assistant unlicensed is making more than the high end of this new practice's assistant pay scale. And so the manager was like, “We have good culture, it's a good environment. There's lots more opportunities at our practice, but when I just look at the finances, this assistant would be taking a pretty significant pay cut to make the change over to our practice.” And they were like, “I really don't feel like I can justify paying them more than the current assistants because my current assistants have more skillset than they do.”
So this is an experienced assistant, but they have a lower set of skills because they have not been doing the same level of things in their current practice. And so that's the backstory. But what the manager was asking was that this made them reflect about their current hiring process and they were like, “I'm worried that I'm not attracting good candidates at our current pay scale, which I thought was pretty competitive and I'm looking at increasing the whole scale, but I have no idea how to tell if I can actually afford that, when I can afford it, how I can afford it.” And they were like, “I've raised prices and I'm planning on a significant price increase again, but how do I know when I can afford to give people raises essentially by increasing my pay scale?

Dr. Andy Roark:
There's a couple of things here. So let's start with head space in general. And so I want to immediately push back on where this is going and just, I'm not saying… Just hear me in terms of head space is where we provide context and we try to zoom out and look at the whole picture. And so one of the things that I want to say, and there's some baseline assumptions here, I think this is interesting. I understand this is definitely coming from a place of privilege, but just hear me out. There seems to be this idea in our culture that as you go through life, you will always make more money. You will make more money and more money and more money. And the idea of making less money than you made before is somehow innately a failure. And I see that a lot and I kind of look at that idea and I push back on it a bit.
Now, I'm not saying I think this sounds a lot differently when we're talking about people who are not making a living wage or things like that. But I'll give you an example. I saw there was this consultant in our industry, he's in vet medicine and he does a bunch of positive psychology and stuff like that. And he's not associated with Uncharted in any way, but his business was growing and he wanted to hire another consultant. And he said, “I'm looking for a young consultant or someone who doesn't have experience. And I would train them and help them and they would work with me and this is a position that we would like to grow.” And he could pay the person something like $60,000, right?
And then I saw a discussion of this in some of the manager groups and stuff in Facebook and uniformly, they were like, “This is offensive that he would offer this job because we make so much more now doing what we're doing managing this hospital. It would be a massive pay cut to go and do this.” And some people were really upset that this job offer existed. And to me, I just sat and looked at it and again, this idea that you have to move upward in pay in your life continuously. I don't think that that's true. And I think it's possible that this person who wants to hire and grow a young consultant and says, “This is what I can pay.”
I don't know that it's about worth or someone says, “Oh, you're not worth that or anything.” It's just a simple matter of this is the opportunity that “We have and this is what it pays. And you have to factor that into your decision of do you want to do this work or not.” And as someone who owns his own business, let me tell you, I have not made more money every year. That has not happened. There's good years and there's less good years. You know what I mean? And I could tell you the first year that I stepped back from being full-time in practice to try to do some of my own weird writing and speaking things, my pay went down. And that's not failure. That's just me saying I'm not being a full-time doctor anymore. I'm being a part-time doctor and I'm doing these other things and that job just doesn't pay as much as the other job.
And again, so there's not anything right or wrong about it and I hope people aren't hearing this the wrong way. My whole point in this is just if this person is a great fit and they think that they would be a great fit and you have a really good opportunity for them, they don't necessarily have to make the same money that they made in their last job in my mind, to come there. I will tell you, I have worked at a couple of places that I would take big pay cuts to work at because their culture was great. And I would say, “Yeah, I get it.” And again, all this is based on I had my needs met, my wife works full-time, like I get it, that's not everybody. But the idea, just this is part of pay scales. If you put pay scales in place, the benefit to pay scales is wage transparency and people kind of know what they make and you get some standardization.
The downside is that sometimes people are going to come and they're going to say, “I'm worth more than what your scale has put in place.” And that's their perception of what they're worth. But they're going to say that and then you are going to feel trapped because you either have to change your scales, which has a big weight attached to it, or you're going to have to say to the person, “I'm sorry, this is what I can offer you based on the scales that we established.” And sometimes I think people think that that's a deal breaker right away. Well this person said “That's what they're currently making and I can't offer them that, so they're not going to take the job.” And I would say “Maybe that's true.” I think that if it saved me 25 minutes of driving in each direction and I was coming to work at a place that had a great culture as opposed to a toxic dump, I would take a rather significant reduction in pay to have that job.
And so anyway, I just want to kind of open up with head space and say, I don't think that we're obligated to match someone's current salary or to give them a raise as they come in. If we have standard pay scales and we have a good reason or just say “This is what we can do,” that doesn't make us bad. And again, the person might not take you up on it, that's their right and their prerogative is to say, “No, I really need to make what I make now because that's what my budget is on.” And that might be a deal breaker for them.
But anyway, I just want to start with that and say just because you have someone who you think would be a good fit and they don't match up with your current pay scale, that's not necessarily the end of the world. It's something that you would need to talk about with that person. But I always put that forward because I feel like people think that it's an assumption that's chiseled in stone is whatever the person has made before we have to match that. And I don't know that that's true.

Stephanie Goss:
Okay. So much to unpack there. So two things I want to pick apart. One is I totally agree with you on the taking a step sideways in terms of pay for the right position. And I think that that is totally true and I am 100% on board with that. And I think for a lot of us being in veterinary medicine, we have historically, when we're talking about the paraprofessional staff, we have historically a lot of, I would say as a whole grossly underpaid our paraprofessional staff.

Dr. Andy Roark:
Mm-hmm. I agree. Yeah.

Stephanie Goss:
And so when we talk about the paraprofessional staff, I feel like the conversation has to separate a little bit from the professional staff because I will agree with you 100% like the tracks for me, when I was in the beginning of my career, I had to keep moving up and up and up because I was a paraprofessional staff member who was living on my own and paying my bills and I had to keep making more money because we weren't talking about vast amounts of money, we weren't talking about salary level money, we were talking about hourly wage. So for me, that upward mobility meant changes in my life and my lifestyle and that was a need at that point in my life and allowed me to accomplish desires as well beyond basic needs. And when we talk about the professional staff, I absolutely agree with you and think that I was really happy when I got to the point in my career where I could have the choice to make a move sideways when it came to pay.
And my last two jobs actually, I have taken both when I moved to my last practice, and I'll be candid and share with everybody, when I came to Uncharted you and I had honest conversation because I was making significantly more in the practice when I tied everything up together, my base salary, bonuses, all of those things. And you and I had an honest conversation of this is where the company is, this is the salary schedule that I've set. And for me it was very much to your point about considering what are the things that I'm gaining that have nothing to do with money, the schedule flexibility, the culture, the ability to be doing something that I'm passionate about, all of those things that you spoke to. And it was the same for me in practice. I moved from a practice where I was working 60 hours a week to a practice where I could set my own schedule, where I was able to do Uncharted things as well as be in the practice where I had flexibility.
All of those things had worth and value to me. And so I'm absolutely a believer in that cultural component of it. And I think that it would be tone deaf to not speak to the fact that that freedom and flexibility comes significantly easier when we are professional. And I mean high salary level professionals. The difference between that and paraprofessional staff that is hourly pay wages. Because I think that that piece of the conversation to your point is important and people have the right to say “No, this is a need. I need to make this amount because my budget is set off this.” And professionals have that right as well. I could say as a new vet, that's the conversation that we have a lot of times when it comes to recruiting is like, “Look, if a new grad tells me that they're not going to take less than $150,000 as base salary, great more power to you. If that's what you need, you go, I can't give you that.”
To your point, that may be something that my practice can't do. And I think that when it comes to the wage scales, I love that they're asking this question because I think that the whole point of the pay scales is to have that transparency that you were talking about and to set some equity across the team. And the way that this manager is asking the question, they're talking about it being a good fit and taking the pay cut, and they're talking about the fact that at least they're looking at the fact that they have assistants now who have higher skills and more training and therefore should be making at the high end of their pay scale. And this is how we got to where we are at veterinary medicine because for years and years and years, we as untrained business professionals, managers and practice owners gave into, “Well, this person feels like they're a good fit and they're telling me that they make more money, so therefore I must pay them more to get them on the team and get them in the door.”
And this is what created the inequity in our industry when it comes to pay. And so I'm so proud of this writer who was just like, “Dude, I've already got the pay scales and they're asking great, great questions.” And I think that a lot of us are not even there. And so I love that you opened with that point that if you don't have scales starting with just the thought process that it shouldn't always mean that we increase and increase and increase I think is so great. And I love that.

Dr. Andy Roark:
Well, I appreciate you saying that. I agree with everything. I agree with everything you said. Yeah, I wanted to hit that point on pay scales is to say that's the downside of scales is there will be some person and you're like, “God, they're perfect, but they want more than our pay scale and-“

Stephanie Goss:
Then they're not perfect

Dr. Andy Roark:
And also it's not a pay scale. If you have a pay scale and you break it to get somebody that is unethical. That you've told everyone this is what the deal is and then you've kind of gone and made a deal that doesn't adhere to those guidelines with somebody else. That's not fair. So anyway, but I wanted to put that out just to say I felt like, and I don't know that a writer meant this, but I have seen this very simplistic logic of we have a pay scale. There's someone else who's come to interview, they were getting paid more than our pay scale, which means our pay scale must be raised across the board to match what this other person was receiving. And two things I want to point out to that is just to say, and again, I know most everyone who listens is going to immediately know this or pick up on this.
Just remember, salary and total compensation are not the same thing. And if someone comes to you and goes, “I made this amount of money,” and they're like, great, “Did you get a CE budget? Nope. Did you get vacation? Nope. Did you have a 401k? Did you get any sort of retirement matching? Did you get health insurance? Any of that?” Like “Nope, nope, nope, nope, nope.” Then you're comparing apples and oranges to say this is the salary. And so anyway, just remember to think in terms of total compensation for sure. And then the other thing is there are some simple things like geography where this person was working in downtown San Diego and now I live an hour and a half outside of San Diego and well, you are not going to make what you made in downtown San Diego because we can't charge what that clinic in downtown San Diego charged.
Those are some basic realities that most people would sort of understand, but also I just want to put them out and go, “Just remember that as we start to talk about this.” I think everybody should hold those numbers loosely. And at the same time, let me just say that sometimes there is this painful thing where someone says, “I want this job,” and you say, “I want you to have this job.” And they say, “I really do need to make this amount of money to make this work for me.” And you say, “I can't give you that amount of money.”
And man, everybody feels bad, but that's not an ethical failing at all. Sometimes it's just the way that it works and that's heartbreaking for everybody when it happens, but sometimes it just happens. And so I think that that is a good opening head space is what we need to look at this with clear eyes and just look at what's possible and set aside some preconceived notions about this person's never going to come here or they can't come here if we can't match what they currently make or we're obligated to give them what they currently make or we're somehow disrespecting them.
I think we have to set those things aside.

Stephanie Goss:
And I love that point and I think that the piece that I would add to it from a head space perspective in terms of trying to make a decision about potentially changing your pay scales. You said, “Do you have this one person who has come and is like, ‘I need to make this amount,' and you're bummed and you're looking at potentially changing your whole pay scale because of this one person.” I would say that the better head space would be to zoom out and say, “This manager asked the question, they're concerned that they're not attracting good applicants.” Are people going on a regular basis? Have you been trying to hire forever and you aren't getting applicants even in the door? Is this the first person who's walked in the door?
Or are you in a space where you do have long-term employees, you're not losing people because of pay and this one person who feels like a good fit has said that this doesn't fit for them. This is where the challenge with scales is because we're driven by people and we're driven by the emotion. This is where we're letting the emotions guide potentially the decision making process and where we have to zoom out and say, “We established the pay scales for a reason,” to your point. “And is there actually a motivation to change the pay scale or are we being swayed by the emotion of the situation because we like this person and we want to hire them?”

Dr. Andy Roark:
Yeah, I love that. I think if you're going to have pay scales, there's a couple things you have to own and one of them is you should not fall in love with the idea of the new employee. And if you have scales and you're like, “This is what I'm bound to.” This person comes in, they're a great fit, it is easy to fall head over heels and say, “Yes, this is the person for us. We've been waiting for this.” Don't do that because it's going to break your heart really badly when it doesn't work because they don't match into the scales that you have set and the way your business is set up. And that's going to hurt. The other thing is you can't take this personally, which means if this person says, “I'm sorry, I can't come here because my needs are not going to be met.” That's not a judgment on you as a person.
It's not a judgment of your business. It's like you have pay scales and you set them up this way and this is what you're able to do. You can't take it personally. And I think I see both of those things all the time. People fall in love with the hire that they're hoping to make and it breaks their heart when it doesn't happen. And when the person says, “I'm sorry, I can't do it for that,” they take it personally and they're like, “God, my business is a failure. No one wants to work here. I'm the worst. This practice is terrible. Everything is going down. Clearly we're going out of business very, very soon.”

Stephanie Goss:
Get out of new manager Stephanie's head because that was, I remember vividly, it's so funny that you just talked about that because I remember vividly as a new young manager, I was trying to hire a lead receptionist and I had an ad that I had worked really hard on and I found this candidate and she was amazing. And she came from outside veterinary medicine, but she had all of these relatable skills. She was personable, she was warm. I fell in love with her on the phone and then she came in for her interview and I was completely head over heels, like “Will you marry me?” So excited. And then I got to the point in my interview process at the time where I was like, “Tell me what you are looking at for salary.” And she told me a salary that was more than double what my pay scale was because she was coming from outside vet med and she had all these experiences and it was totally justified for the prior industry that she'd been in.
And there was zero correlation at the time to veterinary medicine. And I was crushed. And I was like, “Well, our salary range is here.” And she just looked at me and she was just like, “Oh,” and she was very kind and she was just like, “I am really sorry.” And she had great boundaries and she was like, “I'm really sorry.” She was just like, “That just is not where I need it to be.” And she's like, “I really liked you.” She didn't try and put pressure on, which was great and we parted ways, but you were in new manager Stephanie's head because I was like, “I totally failed. Nobody wants to come work for us. This is awful.” And once I got through all of that, the lesson that I learned the really, really hard way was there are limits, right? There is a structure.
And I knew going in into it, and that was the moment where probably 15 years ago where I started publishing in all of my ads, what our pay scale was and what the position paid because I never wanted to get to that point again where I was heartbroken and I had fallen in love with somebody and then here they are telling me that their expectation and my abilities are two wildly different planets and we're not even in the same solar system. I did not want to get to that space ever again. And so that's kind of an action step thing for me when it comes to hiring, but it seems so simple, but it's amazing to me how many of us do it to ourselves over and over and over again where we have this plan and we don't put it out there. And so I think that's really important, both the, not falling in love with it, but also putting up those boundaries and sticking to them.
And this would be a case where I think our writer said “We have a pay scale. We have a pay scale for a reason.” And if you immediately drop those boundaries because you've fallen in love with somebody, it's only going to hurt you and the rest of your team who is going to be frustrated when you have higher skilled people. We look at our peers who do this, you get somebody who is, you're desperate for a person and somebody comes in and they feel like a good culture fit and your head is telling you “Don't do this,” but your heart is like, “I want to help my people.” And so you do the thing and then one of your existing assistants finds out that the new person who has less skills is making $2 an hour or more. Yeah. And now your whole team is p off.

Dr. Andy Roark:
Exactly.

Stephanie Goss:
That's the exact reason why we create pay skills in the first place.

Dr. Andy Roark:
Yeah. Oh, you're exactly right. And I'll tell you this, the other emotional part of it too in head space for me very much is offering someone a job is putting yourself out there for judgment. Like asking someone on a date kind of. You know what I mean? Where you're like “Hey, I don't know if you'd be interested in this. I think you're kind of great.” And you're like, “Andy, that's ridiculous because one of them is clearly you putting yourself out there and the other one is just this company that you work for.” And I'm like, “I don't know.” Maybe it's just because I own, it's because I own the company that I work for, but you know what I mean? It sure is. There's a lot of identity tied up in that of I work so hard in a leadership role and I think most managers feel this way and a good manager feels pride in the place that they work and they should because they should be a big part of it.
And so they should, you do feel pride. And so when you're saying, “Hey, this is what I can do for you and we'd like to have you here,” there definitely is some fear of rejection there where someone goes, “No, I can't know, oh, I'm doing so much better at this other place.” You go, “Oh, maybe my practice is not as attractive as I thought. Or maybe we're not doing as good a job as I thought.” And I think a lot of people feel that pain a lot. So anyway, I think for me, all of this kind of comes back around to that head space of try not to fall in love with the idea, try not to take it personally. This is a relationship and it's kind of got to work for everybody. And so let's just start with that and kind of shake it out because I think as soon as we buy into the idea of salaries can never go down.
People will never, ever take less money than what they had before regardless of extenuating circumstances. And if they don't take the job, it's because you are not worthy. I think those are emotions that people actually have, even though they sound ridiculous when you say them out loud, I think you have to set those things aside. That's kind of my big thing. I think the last part of head space that I would say is there seems like there's a number of questions bundled together here.
And whenever I have a bunch of questions bundled together, it always feels like the Gordian knot, meaning it's the magical untiable knot and I'm like, ah, I can't figure this out. And the truth is usually what happens when I'm having feelings like this, I'm having questions like this, one of the healthiest things from a head space standpoint I can do is sit down and say, “What are the questions that I need answered in order to move forward?” And that's the mental process that I use. And so just sort of stepping back, what are the action steps? Well actually you know what, I'm going to put a pause here and say, how do I untangle this? How do we break this down into the action steps or into the questions that we need to get figured out? Let's take a break and then we'll come back and we'll do those as action steps.

Stephanie Goss:
Okay, sounds good. Hey friends,
I just wanted to talk for a quick second about some maths with you all because I've been thinking a lot about the workshops. And normally here's where we tell you what's coming up and we've got some great stuff happening. So you're going to want to head to unchartedvet.com/events and check out the upcoming calendar. But I want to talk about maths because if you are not already an uncharted member, you can attend any one of our workshops and pay $99 a piece. Most of them are just 99. You can do it as a one-off, great and fine. However, that adds up really quick. And if you do the monthly workshop with us, and I've seen some of you there as repeat customers, which is amazing, but you could spend almost $1,200 over the course of the year doing workshops with us.
Or you could pay $699 and get a 12-month membership, which means you get all of the workshops that we do at no extra charge. You also get access to our amazing conversation in the community, our community members and all of our community resources. And it is hopping over there. We've got conversation 24/7, we have got activities, we've got book club. We're writing our handbooks together in Handbook Helper Group this year.
We are talking about development and leadership growth, doing our development pathway this year. We are doing hallway conversations where we're talking about topics. These are sessions that are community led, community driven. It is topics about things that are going on in your practice that you want to talk about with your peers. All of that is happening and it's all included for your $699 membership. So simple math, do you pay almost $1,200 for the year or do you pay $699? If you're not currently a member, you should head over to the website and use this argument to convince your boss, “Hey boss, I need to be a part of this amazing community because Stephanie told me so and because she's telling you that you will save money.” Hopefully that works, but I couldn't resist. I hope to see you at our upcoming workshops again unchartedvet.com/events for everything that's coming. And now back to the podcast.

Dr. Andy Roark:
All right, so let's come back here. So I just said the last thing for me with head space is whenever I have something like this that feels tangled, I need to break it apart. And the way I break it apart is to say “What questions do I need to have answered in order to move forward?” And so the questions here are, what is my current scale really? Which means do not get drawn into the dollar for dollar salary comparison. You need to look at your total compensation package and say, “What are we really doing?” Because it's easy. And I know a lot of practices that are like, “God, we can't pay people.” Well, other people pay them and I'll look. And I was like, “Man, you, you're offering health insurance and you are matching their retirement contributions and you have an EAP and you offer all these other services and you have a generous paid time off plan. No wonder you're not offering the salary that other peoples are.”
That's not right or wrong, it's just different. And beating yourself up because the salary offer you make while you've got these wonder, this nice collection of perks and supplemental things is that that's comparing apples and oranges. So what is your actual scale when we look at total compensation? Because that's what we want to compare to others. The next question for me is, is my pay scale competitive? And I don't know the fact that this one person comes and says, “I made more, I have less skill but I make more of this other place.” Maybe I'm not wrong. Maybe the other place was wildly overpaying this person and I'm sorry-

Stephanie Goss:
That's a thing that happens.

Dr. Andy Roark:
There's a 50% chance that if you go, “Either I'm low or she's high,” or they're both a little bit true, I don't know. And so is my pay scale actually competitive? If my pay scale is not competitive, can I afford to change it right now? And if it's not competitive and I can't afford to change it right now, how can I change it going forward? Meaning I might not be able to afford this person's salary now, or make, make the pay scale shift now. However, if I'm not competitive, I can make a plan to become competitive and maybe I can get this person to come along for the ride and maybe not, but I will remedy this problem and I'll be more competitive in hiring in the future if my pay scale is competitive and I say, “You know what? I'm doing what I can do. I feel like this is a competitive offer. I don't know that this person is going to find someone who will pay her or him what they were being paid at their last job.”
I'm not going to say that necessarily, but I am going to figure out how to present the fact that our scale is competitive and we'd really like to have them there. And I encourage you to shop around, obviously look and look and see what other places can do. This is what we can do and we would like to have you and I think you would be a wonderful fit here. How do I present that knowing that I'm not going to change my scales? And so those are the questions that I have. And if I can go through and answer each of those questions, bam, I'm golden.

Stephanie Goss:
Well, I thought kind of the same way because when I started reading the email, I thought they were going to go in the direction of, “Well, what if I wind up paying them more than I'm paying my existing team?” Which is one question, what is the potential risk factors there?

Dr. Andy Roark:
Yeah. Because the answer is don't do that.

Stephanie Goss:
Right.

Dr. Andy Roark:
The answer don't do that.

Stephanie Goss:
But then they-

Dr. Andy Roark:
You have a pay scale. You bought into it. Just so many bad things can happen.

Stephanie Goss:
But then they steered away from that in their email and were like, “That's not actually what I'm asking. What I'm asking is how do I know if I can afford to adjust my current pay scale?” And I think we talked from a head space perspective of do you need to adjust the pay scale? And I think you have to look at that. And I think your point about looking at is this a one off, is this an outlier or is this a consistent trend? And then I love your point about looking at is your scale competitive? Well, how do you know that? Well, you have to know what goes into your scale. To your point, it has to be about total compensation. You have to be able to compare apples to apples instead of apples to oranges. And you have to look at what other people are paying.
And that often is very, very hard to find in veterinary medicine because we are secretive AF. We don't share pay scales freely. We don't advertise as a whole and change is coming. There are lots of us who have been doing that for some time and now states are making it easier because states are requiring employers to provide pay information in their job ads, which I love. I that level of transparency. I think it's only going to benefit us in veterinary medicine. But being able to look at what is actually competitive and then looking at your own team. Are you losing people because of the pay or do you have really long-term satisfied employees? Is there a reason to make this change? And then to your point, the question that they actually asked, I love, and this is where I get super nerdy about how do you actually figure out if you can afford it? And I'm going to give a shameless plug for myself, which is really hard for me to do.

Dr. Andy Roark:
I know, do it, get up on the stage.

Stephanie Goss:
But also for our community. So I have a workshop in our community, in our knowledge library, which is where we house all of the materials from prior workshops and conferences that we've done. And I love this topic. This is a soapbox for me for sure. And I actually have a workshop that I've done about exactly this. How do you figure out how to afford it? And as part of that, I put together a spreadsheet for everybody. And so if you're a community member, you can access that in the library. And if you're not a community member, I'm just saying that's the kind of resources that we share in the community on a regular basis. But that's where I would start as a manager is it starts with a spreadsheet. And I know that not everybody loves spreadsheets as much as I do. In fact, I know Any Roark does not like spreadsheets.

Dr. Andy Roark:
It's not that I don't like them. I do like them, I don't love them like other people do.

Stephanie Goss:
But I have a color-coded spreadsheet for you guys for this.

Dr. Andy Roark:
I know I-

Stephanie Goss:
But I'm going to break it down.

Dr. Andy Roark:
I like a basic spreadsheet that's just-

Stephanie Goss:
I'm going to give the-

Dr. Andy Roark:
… plain numbers. It's just like a vanilla spreadsheet.

Stephanie Goss:
I'm going to give you the vanilla recipe right here. Okay? So the question is how do we actually know if we can afford it? And so what you have to know is what are you currently paying? What is your existing team cost you at their scale? Which means looking at their current wages and also their current average hours. And then you're looking at that as a percentage of your revenue and that's your pay, the percentage of your budget that makes up your paraprofessional wages. And now for most of us, the initial knee-jerk reaction is to say, “Well, my staff ratio is 25% or 19% or 28%,” whatever it is. And to go say, “Well, what does the industry tell me that that percent should be?” But that's the wrong question. The question we should be asking ourselves is where are we compared to where we have been before?
Which is are we trending up, are trending down compared to ourselves year over year? Because it doesn't do me any good. To your point about the pay scales and having, what did you say, Fort Jenkins, Texas. Having a practice in or outside of San Diego. Having a practice an hour and a half outside of downtown San Diego and a practice in the middle of downtown San Diego in the Gaslamp, just the rent alone on those two practices going to be wildly different. So there's going to be different expenses. It goes the same to staff. And so if I look at the industry trends, I do get some value by comparing myself to average practices. And AHA summarizes this really, really nicely. There's two resources that I would say AHA's benchmarks around compensation. And VH made us one as well, but the well managed practice study gives some really good industry benchmarks as well.
But it still doesn't do me, I don't think enough good to say, “Well, three to five doctor practices in a suburban area.” Well, what does that actually mean? Because the suburbs of San Diego could have wildly different pricings than the suburbs of Des Moines, Iowa. They're still suburbs, but those are two wildly different locations geographically. And so what I want to do is look at where am I trending as a practice? And so looking at that percent of gross revenue and then using that spreadsheet to play with the numbers. And so there's two ways that we affect change here. We can pay people more and not change the revenue and there's three pieces at play. There's our gross revenue, there's our cost to employ our team, and there's our other costs of running the business. So to impact those numbers, there are really three levers that we can pull.
We can increase our revenue, which would decrease the other two percentages because when we make more money and the costs stay the same, the percent goes down. We could increase the cost to our staff and not increase the revenue, which means that that percent is going to go up and then we have to cut costs elsewhere. Or we could do some sort of balancing of all of the things. There's a lot of things that we can do here, and this is where the spreadsheet comes into play. Because if you put in the simple numbers, you have your team, you list everybody and you just list them by their initials, put their salary, then in another column, put their average hours, get the total of your team's hours and the total salary that you're paying on them on average, and you can pull that straight out of your timecard software.
How many hours have people worked on average over the last quarter through the last three months? And then you look at that total wage and you look at it relative to your revenue, then you have the ability to say, “Well, if I gave everybody a $5 an hour raise,” and you can just plug that into the spreadsheet, Excel's going to do the work for you and tell you what that does to your percentage without changing your revenue. So then you have the ability to know, “Well, can I afford to do this without making any changes? Yes or no?” It becomes very black and white. You also have the ability to say, “Oh God, that number looks really, really high. If I give everybody $5 an hour raises, that's a,” I don't know. I'm just going to pick a number out of thin air, “that's $40,000.”
Well, that's a big scary number to a lot of us who own businesses, right? $40,000 is not chump change. So then I have the ability to go in there and play with it and say, “Well, if I cut some costs in other areas, what does that do to the percent? If I increase my revenue, if I make $10,000 more in that same quarter, how much does that suppress the percent?” It gives you the ability to play with those numbers. And that is by far the best way that I have ever found to do… You have to run projections and it has to do with the math. And not everybody loves math, but this is where you have to play and figure out how can I afford it? And most of us are afraid of this because we don't have the training, we don't have the knowledge.
I didn't know how to do any of this until I got got training and honestly, until I took business math class at the community college, I had no idea how to do any of this. And it made my life so much easier once I figured out how to do it. And I will tell you that I think that's where we got to in veterinary medicine is because a lot of us are either afraid of it don't know how, or a combination. And so we make those emotional decisions. Instead, we've fallen in love with the idea or we're like, “This is a good cultural fit,” or “My team is working so, so hard and we just need another person.” We make that gut emotional decision to say, “I'm sacrificing for the greater good. My team needs another body, so I'm going to pay this person $2 more than everybody else because it's going to make them happy.”
Well, guess what? In the long run it won't because someone will find out that the new person is making $2 an hour more than them and it will cause havoc in your staff. That's why we set up pay scales in the first place. And so I think that that's where we make the emotional decision because we don't know how to do that math. And that's a huge part of what made me so excited when we got this email. Because I was like, “Oh my gosh, this is a huge soapbox and I want to nerd for a minute, even though Andy's just going to sit there and give me the stare like ‘Really, you're talking about spreadsheets?'”

Dr. Andy Roark:
This is much spreadsheet time airtime as we've ever given in everything. There's never been –

Stephanie Goss:
Thank you for indulging me Andy Roark.

Dr. Andy Roark:
… this much airtime devoted to a spreadsheet.

Stephanie Goss:
I'm just saying.

Dr. Andy Roark:
No, it's good. It's good. It's just…

Stephanie Goss:
Andy's like “If you didn't understand any of what Stephanie just said in the last five minutes, you can go check out the financial workshops that her and Jen Galvin have done.”

Dr. Andy Roark:
There you go. We have financial workshops that cover exactly this. If you're like “Uh oh, tell me more. My heart purrs.” If you're just like, “I want more of this specific spreadsheet focus,” then we got you covered. We totally got you covered.

Stephanie Goss:
We do. We've got t-shirts.

Dr. Andy Roark:
You do have a t-shirt that says something like, “I have a spreadsheet for this, don't you?”

Stephanie Goss:
I do. I do. It was given to me by one of our community members who knows my love of spreadsheets.

Dr. Andy Roark:
Speaking of our community members, getting this back on the rails here. I was talking to one of our community members recently and he was talking about at his practice, they did some surveying of their staff, which I always think is great. And they're like, “What are the stresses of our staff?” It was a burnout type survey. And they were actually really surprised to come to understand that their staff was feeling a lot of financial strain. They live in a major metropolitan area and they didn't recognize how difficult it was for a lot of their staff to live in this area getting paid what they were paying. And of course they felt like they were doing a good job of trying to compensate their people. I think it's hard to get your head around what it really costs to live in a major urban area today.
And so anyway, but they saw that and when they saw that, they said, “This is not okay, we want to fix this.” And so they actually decided they were going to raise their prices and give 100% of that raise to the staff. And so they said to the staff, “We're going to raise prices and 100% of this goes to giving you guys cost of living raises.”
And then they sent an email to the clients and they said, “Just so you know, prices are going to be going up and here's why they're going to be going up.” And they explained that they needed to raise prices so their staff could have a living wage and not be financially strained. And so 100% of this price increase is going to the staff. And I said, “How did it go?” And he was like, “Oh, great. It went great. The clients seemed to understand. We didn't get any pushback at all. The staff were in board on implementing the raise in price because they knew it was important and they knew where it was going.” And I was just like, “That's a beautiful thing.” I just thought it's, again, thinking outside the box and being like, “Oh, we have a very specific problem. We're going to come up with a very specific solution to said problem. And here we go.” So anyway, there's definitely things that we can do.

Stephanie Goss:
I love it. And I think about that from my own behaviors as a consumer. And I think about, I lived in the Bay Area in California and they implemented healthcare for the restaurant industry and for restaurant workers, which is unheard of in the service industry that you would have healthcare coverage. And the business owners, restaurant owners were like, “How the hell are we going to afford this?” And so the conversation was, “We have to increase prices. There has to be something to offset this.” And so I know some of my favorite places who did exactly what you're talking about, and they just went to their clients and they're like, “Hey, this is why we're doing it. This is what we're doing with the money and we hope that you'll go along with us for the ride. And if you don't, we understand.” And I remember being impacted by that.
I would have paid it and I probably would have paid it and grumbled about it if they hadn't have been so forward. But once I got that, I remember seeing a notice when I went into one of my favorite restaurants and I was just like, “Okay, that totally makes sense.” Not only will I be happy to pay that extra amount, but I actually changed my behaviors to think about it and was like, “Here, let me tip.” Let me… I'm going to tip, I'm going to tip more. Which is I recognize not necessarily normal, but it was that emotional heart connection. And to your point, when we think about it and we put it in that context, it goes back to something you and I talk about all the time on the podcast, which is we can't be all things to all people. And we are going to have clients who would get that email and would be like, “I don't want to go there. I need a budget conscious vet practice.”
Totally understand. Totally understand. We might not be your people, and that's okay. It's the same as when the candidate that you're interviewing says, “Well, this is what I need to make for my budget,” to say “I totally get that. And I wish you the best of luck.” Because to your point earlier in the episode you talked about how do we have that conversation with them and explained to them like, “This is what I can offer you.” And for a lot of people that fills this with anxiety because we're just like, “How do I have to explain myself?” You don't have to explain yourself. You just say, “Thank you. I completely understand and I wish you the best of luck,” and move on because it's not going to be the right fit. You cannot be all things to all people, whether it's your team, whether it's your clients, stop. We've got to stop. And so I love that you use that example.

Dr. Andy Roark:
Yeah. Oh, good deal. All right. Well, that's what I got my friend. I don't think I have anything else.

Stephanie Goss:
Okay. I love this. Thank you for letting me talk about spreadsheets.

Dr. Andy Roark:
Oh, my pleasure. I'm so glad we got to do this.

Stephanie Goss:
You're not, but thank you for lying anyways. Take care everybody.

Dr. Andy Roark:
See you everybody.

Stephanie Goss:
Well, gang, 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 us 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. Take care everybody, and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: compensation, culture, Practice ownership, raise, wages

Jun 28 2023

How Do We Speak Their Language: The Next Gen of Pet Owners

Cover Image for Episode 238 of the Uncharted Veterinary Podcast

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are in the mailbag to take on a question from a practice manager colleague who is wondering what they can do at their practice to support the next generation of pet owners. Andy and Stephanie face up to their age a bit as a genXers, acknowledge that we need to stop thinking/talking about millennials being the new “young” clients and start really looking at the next big leap forward. Stephanie immediately ran wide with ideas on technology and Andy had a little more reserved approach. They managed to find middle ground and talk options in the end. Let's get into this…

Uncharted Veterinary Podcast · UVP – 238 – How Do We Speak Their Language- The Next Gen Of Pet Owners

You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Amazon Music or wherever you get your podcasts.

This episode is made possibly by SimpleTexting. For more information about helping your clinic communicate effortlessly with your clients, check out the SimpleTexting website.

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

This is your LAST CHANCE to register for our upcoming workshop happening July 1, 2023, 4-6 PM ET/1-3 PM PT with Maria Pirita, CVPM – EFFECTIVE & EFFICIENT TEAM MEETINGS

Have you ever felt like your team would benefit from meeting more often, or maybe a little less often? Do you struggle to find techniques that truly make your team meetings effective? Finding the right balance between improving team communication and a meeting cadence that is respectful of people’s time can be a challenge. In this workshop, Maria Pirita, CVPM will review the 40-20-40 principle and help you learn to properly plan, execute, and follow up after meetings to ensure that you and your team are getting the most out of meetings at your veterinary practice.

When: July 1, 2023, 4-6 PM ET/1-3 PM PT

$99 to register, FREE for Uncharted Members

Register here

Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Stephanie Goss:
Hey, everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. Today's episode is brought to us by our friends at Simple Texting. I love this because Simple Texting believes that better care starts with better communication. Today's episode is all about better communication. Andy and I got a letter in the mailbag from a practice manager colleague who was wondering what they can do at their practice to support the next generation of pet owners. Very sadly, Andy and I realized that we are old AF, because we are not talking about Gen Xers. We are also not talking about Millennials because they're old too.
We are talking about Gen Z and maybe even the generation that comes after Gen Z and what we can do to lean into communicating and meeting them where they are at. We want to take into account all the different styles of communication that our clients, regardless of generation, want to use. This was a fun episode because I definitely ran wide with the ideas on technology and Andy had a little bit more of a reserved approach, but as we usually do, we've managed to find some middle ground. So, let's get into this. Now, the Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark, and the one and only, Stephanie, do you speak-a my language, Goss.

Stephanie Goss:
How's it going, Andy?

Dr. Andy Roark:
She just giggled and gave me a Vegemite sandwich, Goss.

Stephanie Goss:
Oh, I am not a Vegemite fan.

Dr. Andy Roark:
Yeah, I think I've had it one time. I think it's an Australian thing.

Stephanie Goss:
It is.

Dr. Andy Roark:
I don't even know where you find it.

Stephanie Goss:
It is.

Dr. Andy Roark:
But every kid of the '80s knows exactly what a Vegemite sandwich is, at least in concept.

Stephanie Goss:
Oh, true story. How's it going?

Dr. Andy Roark:
Oh, man, it's good. I took Hannah… I'm hoping that she'll run cross country over the summer, so they've got cross country practice. Okay, so here's why. There's a backstory here. I remember when I was a young doctor, I was working in Washington, DC and I'll never forget this family. I don't know why they stuck in my head because they had a sick pet. I don't even remember the pet, what it was sick about, but it was an ongoing case when I saw this family multiple times over a two-week period. Every time I saw the family, it was the father, the mother, and the three daughters. Every time I saw any of them, they were decked out in full running gear. They were ready to take flight. You know what I mean?
Windbreakers, shorts, all of them in different levels of warmup suit, but I felt like their clothes were breakaway. I could just snatch them off and run. They always had running shoes on. They were 100% dressed to run away right now. I said to the father at one point, and Jacqueline was probably two years old at this point. I said something to him, “Yeah, it's great that your whole family's into running.” He was like, “Yeah.” I said, “I have a daughter.” He's like, “Let me tell you something, get them into running. They're too tired to be interested in boys.” I don't know that that's true, but in my head somewhere, some part of me was like, “Write this down, Andy.” So Hannah is my girl with attitude.
So, I'm like, “Well, I don't know about boys,” but she'll be less bad if she's exhausted is what I think. So, anyway, I've got it in my head just from a long time that this is a good thing that Hannah would do and that she could be good at. So, I've wanted to get her into cross country and she's just finished the sixth grade. So, she's going to the seventh grade next year. So, the middle school coach has reached out. So, she texted me and said, “Hey, this is Coach Connolly. Hannah is a great runner. We're doing cross country, and I really think she should check it out at the high school. It's the parents' information meeting, bring your kids.”

Stephanie Goss:
Sure.

Dr. Andy Roark:
So she says, “You should go and also tell Hannah, I'm going to be involved with the girls team, but just make sure she knows that.” I'm like, “Okay, I'll tell her.” Okay. So, anyway, we go to the information gathering and we get there. It's at the high school and Hannah's going into the seventh grade. So, this is real intimidating. We get there and there's three coaches that present themselves, not the female coach from middle school. It's the quintessential, if Saturday Night Live did a sketch with football coaches, it'd be these guys.
You know what I mean? Two of them in their 60s and one of them in his 20s, and they've all got thumbs and belt loops rocking back on their feet. The young one looked like he could run. The other two have not run in a long time, I'm confident. They start to have this informational meeting.

Stephanie Goss:
Sure.

Dr. Andy Roark:
Stephanie, it was the strangest informational meeting I've ever seen. It wasn't like this meeting could have been an email. I don't think it could have been an email, but the most infuriating thing was this could have been a 10-minute meeting, but it was an hour.

Stephanie Goss:
Oh, geez.

Dr. Andy Roark:
Because the head coach liked to tell stories, and so he was telling stories. So, at one point, we're sitting there in the bleachers. Hannah's seventh grade. There's like 12th grade boys around. This is a tense thing. I'm like, “Baby, everything's cool. This is going to be good. Just stay with me. Just check this out. It's going to be fine.” The guy is just going through the handout they gave the parents. He's like, “Yeah, we got to have a waiver because things happen. I mean, we're not going to let anything bad happen. The kids have to run beside the road, but at the end, they're not going to get hit by a car except one time there was a kid who got hit by a car.” He's telling us at the informational meeting, he's like, “There was a kid that got hit by a car.”
So all the parents get real quiet. Really it's a good story. He says, “There's this kid Jimmy and Jimmy is out.” This is why the meeting took an hour because he just kept going. He was like, “There's this kid Jimmy and Jimmy is out and he's running. He was a knucklehead. So, he's a knucklehead and he is running by the side of the road. He is not paying attention to where he is going. There's this woman and she pulled up at the stoplight. She's sitting in a stoplight and she's just minding her business and the car's at a full stop. Jimmy just runs into the side of her car, wasn't looking, just came right off the sidewalk, ran right into her car. That wouldn't have been bad except the windows were down because it was a nice day. Knucklehead Jimmy just bust right through the window.
He went bang into her car. His head goes into the window. She thinks she's being carjacked because he screamed when he ran into her car. So, she punches the gas and runs through the red light with Jimmy hanging out the window.” Everybody's sitting there just wide-eyed staring at this informational session about why you should send your seventh grade daughter to cross country. The whole meeting went that way. That was just one example of where the meaning went wildly off the rails. As soon as it was over, I got a text from Coach Connolly saying, “Don't leave. Don't leave. It's not that way. It's not going to be that way. I promise your child will not get hit by a car. I promise I will be the girls' coach. I will be there.” So anyway.

Stephanie Goss:
Oh, my gosh.

Dr. Andy Roark:
The jury's still out on whether or not we're going to do cross country this year.

Stephanie Goss:
I was going to say, what was Hannah's reaction after sitting through the hour of that? She's a kid who will tell you how it is.

Dr. Andy Roark:
Yeah. Yeah. She basically said, “Those guys are scary.” She was like, “Those guys are scary.” That's it. That was funny. It affects some of my thinking here too is it was right as school was ending. So, she saw Coach Connolly the next day and the coach came up to her and said, “Hey, I really think you should do this. I really think your friend should do it as well and do it with you.”

Stephanie Goss:
Sure.

Dr. Andy Roark:
I reached out to the parents of the best friend and we're like, “Hey, do you guys want to do this over the summer? Maybe they can just drop in and do some of these running practices and see what they think.” When the other kid got on board and Hannah wasn't alone, I think, she's come around to this might be a thing that we can do together. But it was just funny. It was obviously really important to both of the girls that this female coach who's young and energetic and positive be there. It's just really interesting to look at my daughter and see the effect that these guys who I'm sure are really nice guys. You know what I mean? I am sure they are really nice guys, but they don't present necessarily a welcoming facade to a 12-year-old girl.
So, just the importance of having this younger coach there was really big. I wish she'd been more involved in the program, even just from a representation standpoint of just being there and standing up with the guys. I might say that to her at some point because she was there, but then she just disappeared into the background and she sat with the parents. Anyway, I think you never understand the politics of what are going on. I think she wants to be involved. I suspect she's new and getting going, but anyway, it's really been just interesting in thinking about that of what makes people want to be a part of things and how we present what we're doing funny. So, I don't know.

Stephanie Goss:
It's funny.

Dr. Andy Roark:
It's been an interesting time. I don't think I care that much either way. I really don't because she's really young to be going and doing this. Boy, I'll never forget about knucklehead Jimmy running into that car and the woman thinking she's being carjacked and punching it through the red light. Oh man, parenting. Nobody tells you how to do this stuff.

Stephanie Goss:
Oh, man. That's pretty fantastic.

Dr. Andy Roark:
Just another day in high school sports.

Stephanie Goss:
Oh, man. Well, I'm excited for our topic today.

Dr. Andy Roark:
Speaking of high school.

Stephanie Goss:
Speaking of high school, not even high school at this point. So, we had a great question in the mailbag that I'm super excited about discussing with you. So, it was from someone who was asking about supporting younger client basis. So, they were talking about how COVID has really launched the majority of veterinary medicine, at least into the texting realm and how their clinic has been doing some online booking and they started doing some preventive care plans as a way to give a subscription model or payment options beyond the traditional ones, but they were saying that it feels like as an industry as a whole, we're almost always playing catch up. So, they were asking how do we speak their language? How do we focus on younger clients?
I think it's a great question for a whole bunch of reasons, least of which is that we know that younger pet owners. It's so funny because I think it says how behind the times we are in veterinary medicine that when we talk about younger clients, we're still using millennials as the example.

Dr. Andy Roark:
Millennials are 35.

Stephanie Goss:
Right? That's the thing is that I hate to break it to us all, but millennials are old. So, when we look at the makeup of pet owners and all of the market research that is out there that has nothing to do with veterinary medicine, but just pet ownership in general, Gen Z is the fastest growing segment of the market when it comes to pet owners. They have been for some time, and there are things that set millennials and Gen Z wildly apart from the generations that came before them. So, I thought it was a great question and I'm really looking forward to going through it with you.

Dr. Andy Roark:
Yeah, no, I always like this stuff. I think this is really interesting. Obviously, I like innovation, I like change. So, I have a lot of feelings of excitement around that. At the same time, I can be crotchety and I can be crotchety.

Stephanie Goss:
You can be a 60-year-old track coach.

Dr. Andy Roark:
I can loop my fingers through my belt and say, “One time…” I don't know about this whole Texan thing. At one point, one of the coaches said… I don't know if this is true or not. It was the assistant coach. They refer to each other as coach. So, if you all look in the handout there, you'll see Coach Daniels and you'll see a cell phone number. That's my cell phone number. You will not see a cell phone number for coach. Why? Because coach doesn't have a cell phone. I'm his cell phone. I was like, “Is that real? Does he really not have a cell phone or are you setting boundaries to prevent people from texting the head coach?”
But looking at him, he might not have had a cell phone. It's been a couple days. I'm like, “Does that man really not have a cell?” I mean, it's possible he just did. He just smirked and rocked back on his heels. If ever there was a man who didn't have a cell phone, it could've been that guy. I'm like, “That's ridiculous. Also, I'm into what you're doing there, buddy. I'm into this.”

Stephanie Goss:
Oh, okay. So, you can be crotchety.

Dr. Andy Roark:
Okay. So, you're not going to get a rah-rah technology lecture from me, I'll tell you that. You're going to get a weird mixture of enthusiasm and caution.

Stephanie Goss:
Okay, fair.

Dr. Andy Roark:
So yeah, that's what I will do.

Stephanie Goss:
I will pick up my pompoms for us on the technology side.

Dr. Andy Roark:
Yeah. I know. I saw your notes and I'm like, “Well, gosh, let's pump the brakes here.” This seems to be one of those conversations where your friend is so positive that you feel obligated to take the other side. We have to keep this in proportion here. That's going to be me.

Stephanie Goss:
All right, fantastic.

Dr. Andy Roark:
All right.

Stephanie Goss:
Should we start with that? Should we start with headspace?

Dr. Andy Roark:
Let's start with some headspace. All right, let's start with some headspace. So, I appreciate this. I appreciate this letter a lot and it is undeniable that the world is changing and it is changing faster than it has ever changed before. I mean ever. The industrial revolution did not cause us to move as fast as how we are changing right now with artificial intelligence. I use artificial intelligence today. Today, I took handouts, right? I took a bullet pointed outline of a presentation I'm going to be giving. So, I've got all bullet pointed out. That's all I've got is the bullet pointed outline. I put a lot of thoughts in this outline. I took that thing and ran it through ChatGPT and said, “Make me slides.”
It was like, “I'm a text thing. I can't make slides, but if I made you slides, here's what would be on them.” It just said, “Bam.” So then I took that slide. I copy and pasted. I dropped it into PowerPoint, just straight up, dropped it in, and then I hit their automated graphic design button. Voila, I got a slide deck. It's beautiful. It's much better than what I used to make in old school. I had the old school PowerPoints that look like a middle schooler's project with just solid color backgrounds and what looks like five by seven pictures laying next to some text.

Stephanie Goss:
On top.

Dr. Andy Roark:
Yeah, on top. That's what I used to do. This thing is so far better than what I used to do. That's just today. It took me 12 minutes to do something that used to would've taken me an afternoon. The outcome is much better and I'll tinker with it, but for the most part, it's done. So, boy, that's just happened in the last year. So, anyway, things are changing like crazy. The idea that we don't have to keep up, that's ridiculous. The way we communicate is different. The way we use technology is different. Change is coming and we need to be thinking about it. I think our clients are absolutely going to expect us to be… I don't think they expect us to be bleeding edge. I don't think they expect us to be innovating. The truth is, I think about it as a consumer too.
I don't want people asking me to download apps or register for weird stuff. I want you to only ask me to do things that are going to make my life more convenient. Technology for the sake of technology I think is bad. However, our world is changing fast and I like the fact that this is a recognition of that. Given the world is changing, what do we do? So that's my first part of headspace is look around you. The world is not what it was 10 years ago and it is getting faster and how it changes. So, I think this is a worthwhile conversation. Do you agree?

Stephanie Goss:
Oh, totally. Totally. I also agree with their sentiment that we are behind the curve. So, I agree with you. I don't think any of our consumers, even the ones who wish that we would get more ahead than where we are, I don't think that they by and large want us to be cutting edge. I think to your point, they just want it to be more convenient.

Dr. Andy Roark:
Well, cutting edge means so many things to so many different people. I don't think people want us to be less human than we used to be. I think that that's really important to people. I don't believe that people are pushing to have less interaction with the healthcare team. It was funny.

Stephanie Goss:
I would agree.

Dr. Andy Roark:
Well, you and I were talking with people on our team and we were talking about paying for bills at restaurants and somebody was saying, “I think we should have a tablet at the table. You just do all of your transactions there and you don't talk to the waiter or the wait staff.” I was just like, “I could see that.” In another way, I was also like, “Ooh, I don't like moving away from the human aspect. I don't like us not talking to each other as much.”
At the same time, paying on the tablet that's built into the table is probably a much faster way to get things done. Also, it's cheaper for the restaurant and all those things. So, I get it. I don't know that when we say get cutting edge, I think it's important to remember that people don't want less human interaction with their veterinarian or vet team, I don't think.

Stephanie Goss:
Yes. Yeah, no, I would agree with that.

Dr. Andy Roark:
So yeah, I think that keeping up is a process and not a destination. I think that's important to remember too. I think a lot of people look at getting on board with technology. They used to look at having electronic medical records.

Stephanie Goss:
Sure.

Dr. Andy Roark:
Oh, boy, this is a huge lift, but once we do it, then we'll be done. I'm like, “Hmm, I don't think this is ever going to end.” I think that that's a good headspace to get into is this is a process.

Stephanie Goss:
Yeah, for sure.

Dr. Andy Roark:
I don't think you're going to make it if you don't start with why. I think the idea that we need to embrace technology full-stop, I don't think that's motivating enough to actually get it done for most practices and most people.

Stephanie Goss:
Sure.

Dr. Andy Roark:
I think the first part of this in a headspace is to say, “Why do we need to embrace technology? What are we accomplishing?” I think that that's a big thing in technology overall is a lot of times people are like, “Oh, we need to upgrade because upgrades exist.” This is the crotchety Andy is going, “Just because you could do something in a more fancy way, to me, that doesn't mean by itself that you should do it in a more fancy way.”

Stephanie Goss:
Yes. So, I would actually agree with that. I think anybody who has used some of our traditional practice management softwares for a long time would agree. I never had the most up-to-date Avimark version. You know why? Because there's always bugs. So, if you're upgrading just for the upgrade, there are cons to that. There are pros, right? You get new features, you get things ahead of the curve, but there are also significant cons and the learning curve that goes along with it. The reality is in your average veterinary practice, to your point, nobody's got time for that. So, yeah, I agree with you. I don't think that that is where most of us want to strive to be. I think it's about finding that balance.

Dr. Andy Roark:
Yeah. Well, I mean, think about technology in general. There are definite downsides to racing to be a first adapter for technology. You think of the old Betamax and no one had that after any of my time. What were the DVDs that were really big? What were those things? They weren't Blu-Rays because that became a thing that stuck around.

Stephanie Goss:
Yeah, they had them at school. When you moved off tape, that's how you would watch your science videos and stuff. The hell were those things called.

Dr. Andy Roark:
It was like a record sized DVD is what it looked like. I remember that. Those things, I remember seeing them at the stores. Nobody that I knew had them except for my uncle. So, my uncle was one of those. He loves technology stuff. As soon as it came out, he had it. As a result, he had a lot of cool stuff. He also had a lot of weird stuff that was going to be big and then just never was. I'm like, “Why do you have this?” He was like, “There was a time that this was the next big thing.”

Stephanie Goss:
The laser discs.

Dr. Andy Roark:
The laser discs, yes.

Stephanie Goss:
I was like, “Google, what the hell are those things called?”

Dr. Andy Roark:
Imagine going hard on laser discs. There's definitely a problem with racing to get up first in technology. So, that's why I say I can be a little bit crochety here. I think it's wise. There's definite downsides to racing ahead and being super cutting edge. Unless that's your jam, unless you're like, “I love it. I want to do this. I've got the resources to do it. I'm all about it.” I think for most of us, it's okay to look at where people are. I guess this is part of my big takeaway with keeping up with the times is I want to meet people where they are. We talk about that a lot in a lot of different contexts. Same thing here. It's like you know where people are? They're on their phones getting texts, they're not in their voicemail, they're not talking on the phone, but that's where they are right now.
I think people are looking for more telehealth and more convenience. I think convenience is where people really are. What can we do to bring convenience about? At the same time, we have to balance those things and say, “Okay, I want to meet them where they are and I need to be able to balance the needs of our practice and not feel like I'm a slave to technology innovation necessarily.” Again, it goes back to what is the why? Why are we doing this? Why are we making these changes and where are our clients?
I mean this metaphorically, where are they? But I also mean it literally, which says you should consider the clients you actually serve, not the clients that you imagine in your mind. Because if you are in Downtown Manhattan, you are going to see a different clientele than if you're in Fort Jenkins, Texas, which is not a real place in Texas, but just you know if it does exist, if it did exist, it would be a small town in Texas. That's not at all like Manhattan.

Stephanie Goss:
Fair, but here's the thing. I think that that is true, and I think that there is a lot to be said for looking at the data and the research and who do we serve. Because I'll tell you, so when I moved here, this is largely still a retirement area. Everybody advertised in the phone books still when I moved here, and that was only eight years ago. Yet when I looked at our actual client base and I started asking questions of the actual client base, they were online. They're older people, but to your point about your track coach, maybe he didn't actually have a cell phone, but maybe he did and just didn't want everybody having the cell phone number.

Dr. Andy Roark:
Which is super progressive. That's why this blows my mind so much, because he could be a complete Luddite. He could also be living in 2030 where people are like, “Hey, the cool thing is to not tell people you don't have a cell phone.” I can't tell where that guy is, but I'm sorry, but go ahead.

Stephanie Goss:
For real, we know that the generations, I mean when you look at who is using a social media tool like Facebook, which is where a lot of veterinary practices still are, the fastest growing market segment for them is older people. So, I think part of it is to your point about meeting our clients where they are at, I do think that part of the headspace is about doing your homework. Really I think as a whole, we need to open up our minds and look at what the research is saying. It was really interesting to me. So, those of you who have been listening to this podcast now, I like spreadsheets, I like numbers, I'm super nerdy. My brother-in-law and my sister-in-law are both in marketing and my sister-in-law in particular is in human healthcare market research.
So, I really like super nerdy market research stuff. So, I was looking at some studies in preparation for this episode and I thought that it was super, super interesting, because in the human healthcare side, 40% of people were saying that they find barriers to online access to healthcare. I was like, “Well, that tracks with veterinary medicine, because by and large, the majority of us put up significant barriers for our clients to have access to us.” Now we do it for a good reason because we're trying to protect our team and we're trying to find balance. To your point, it has to fit with what we're doing.
So, there are reasons for it, but when we look at the reason that in the veterinary space that clients are switching practices is super interesting to me, because Weave did a study and 35% of the pet owners in the study listed a lack of digital access as a reason for switching vets or the access to digital care and/or digital access to the practice as being a reason why they were attracted to a practice. That 35% is huge. So, I think it is really important to look at our existing client bases and start asking the questions of what do they actually want. So, from a headspace perspective, I do think it's important to do some homework, look at the studies. There's numerous ones.
Banfield has done a lot of research with outside companies outside of veterinary medicine looking at market research from a pet owners' perspective. There's some great research out there about what pet owners are. People are asking the questions of what do they want and they are telling us. If we are not actively as practices looking at the answers that they are giving us, we are behind the curve.

Dr. Andy Roark:
Yeah, I completely agree with that. I do agree with that. I think that we've both see 100% utility in being honest about who we're serving and what they want. I think that when you look at the world, as I said at the very beginning, there's clearly momentum in this direction. Everything is moving towards a more connected digital interface. I think we all have to own that. The other part I want to say as we start to think about technology and making technology changes in our practice from a headspace standpoint is remember to think outside the box. I think a lot of the real kickback resistance to technology we get is because people make assumptions or they lock their brain in linearly.
So, they decide what getting on board with technology or what keeping up with technology means. They say, “I'm not doing that.” They dig their heels in and they react to this imagined reality. So, I'll give you an example because I am guilty of this as well. I think everybody is. We make an archetype of an idea, meaning we get a picture in our head of what something means and that's all that we can see. So, keeping up with technology is a nebulous term as far as what the heck does that actually mean. So, I will tell you there is technology that I am radically opposed to and it's TikTok. I have railed against TikTok for years. I am not on TikTok. I don't want to be on TikTok.
I cannot tell you how many people who work for me and who don't work for me have been like, “Andy, you know what the future is?” I'm like, “Don't say it.” They're like, “TikTok.” I'm like, “Damn you.” Here's why. Because when I imagine TikTok, I imagine me dancing like a doofus. I'm 46 years old. Me dancing on TikTok is not good for anybody. It's not. I'm talking to Kelsey Carpenter. I'm like, “This is not a brand builder, Kelsey.” It's growing like crazy. So, I have this knee-jerk negative reaction to TikTok because I have the picture of people dancing and popping little information bubbles and I'm like, “I'm not doing it.” No shade on people who do do it. It's just not my thing. It's not going to happen. It's not going to happen.
If you hear this language I'm using, that's exactly the language that people have when they're like, “We're not texting people, we're not texting,” or “We're not doing telemedicine.” I'm not doing it because they get a picture in their head of what it would be like and they're like, “We're not doing it.” I was talking to Caitlin DeWilde who does all sorts of marketing and social media stuff recently, and I was like, “I don't know. What do you think about social media? So how do we still use this as a tool?” She's familiar with all of our stuff and everything. I was like, “Do you have any advice?” She was like, “You should get on TikTok.” I was like, “Caitlin, I'm not doing it.”
But here's what she said. She said, “You are imagining you dancing on TikTok and it doesn't have to be that. You are already doing video content. You already talk constantly. You're telling stories, just put them on TikTok and it'll be fine. No one said you had to dance. That's not even a thing that anyone wants.”

Stephanie Goss:
Nobody wants you dancing, Andy.

Dr. Andy Roark:
I'm like, “Well, good.” Then of course, I was like, “Well, I could dance if I wanted to,” but as soon as I was told not to, I was like, “I could do it if I wanted to.” But all of that to come back around and say it just didn't occur to me that this could be a useful tool that manifests in a different way than the weird way that I latched onto. That's true in telemedicine. They just don't immediately imagine not being able to leave their house because people were just constantly blowing them up and they would lose their day off. I think for a lot of people, they're like, “The only respite I have from work is leaving the building. If we start doing telemedicine, it doesn't matter that I left the building because people can pop up on my cell phone and there is no off switch from me.”
That's exactly what I say is I get it. I deeply, deeply get it. You have to reject that thinking. You have to reject the I'm going to lose my free time if I do this. You have to say, “Okay, this is a tool and it could be used in a way that would be beneficial to us.” I'm open to discussing what those ways might be without just having a knee jerk, dig your heels in, stomp your feet, I'm not doing TikTok reaction. That's my headspace piece.

Stephanie Goss:
I love it so much. First of all, I love Caitlin so much.

Dr. Andy Roark:
I know. She's not afraid to tell me things I don't want to hear. That's been our relationship a long time.

Stephanie Goss:
You just made Tannetje Crocker's day. She's going to hear this episode. She's going to be like, “I told you so.”

Dr. Andy Roark:
Yeah, Tannetje, I met her when she was at a bar and she saw me and I'd never met her in my life. She was like, “I heard you talking trash about TikTok, Roark.” That's how I made a friend.

Stephanie Goss:
I love her, but I'm going to take yours and I'm going to one up it because I love it. I think this is a great veterinary example. So, your example of TikTok is so great because you had that kneejerk reaction from a brand perspective with inside veterinary medicine. You said, “The dancing and the pointing at things, how is that going to resonate with the people that I serve? It doesn't make sense. It's not me. It's not who I am.” You attach to that linearly. The same is true in our practices. I've had this conversation with so many managers and veterinarians about online booking, right? Which when we get to action steps is one of my basics. If you're not doing it, I'm going to get on that soap box real hot. But here's why.
Because so many people, to your point about telemedicine, think that if I open up my schedule for clients to be able to book appointments online, it means that inmates are running the asylum and it'll be pandemonium and clients can be just putting crap on the schedule whenever they want. But people think about it so linearly that the only way that they can see it is wide open and clients are going to do whatever they want or not at all. There is no in between.
We have that very black and white thinking for an industry that lives in the shades of gray every day, all day when it comes to how we make decisions about clients and patients. We do so much of our thinking, particularly when it comes to technology, as one end of the spectrum or the other. It is black or white. There is no in between. We have to shift our mindset.

Dr. Andy Roark:
Yeah, no, I get it. I completely agree. So, that's my thought on technology. I think one last way it's been put to me in the past was… I love our practices at Uncharted. I love our get-togethers. I love our live events so much, and it's for reasons like this. I remember being in a room with some really smart practitioners and we were talking about wages going up in our profession. This was a lot of practice owners who were in the room and they were like, “I don't know how I'm going to pay for this.” That was the discussion until one of the practice owners stood up and said, “Hey, listen, the thing that has helped us the most is recognizing that we've got to raise our wages. We've got to. So, given that we have to raise our wages, how are we going to do this?”
That's the question we've been asking ourselves. That was transformative to that session and to that conversation, because suddenly, it went from a lot of I don't know and I don't want to do this and the client pain is going to be this and all this wrestling with this idea. But when it was reframed as, “This has to happen, how can we make it happen?”, suddenly, the conversation got so much more productive and it was so much more problem focused and just the whole thing unlocked. So, I say that, because to me, technology is a lot of that way as well where we can absolutely wrestle with I don't want to do this. This is going to be so much work. It's going to be such a headache and it's going to be expensive and there's going to be so much training, but we can have these thoughts.
At some point, it's helpful to step back and say, “This is going to happen. We are going to have to move into the new era. How are we going to do this?” Then start getting serious about what your options are and what you're going to do and what you're not going to do. But getting past that whole circling around wrestling with anxiety and the headaches and woe is me, I have to do this, and just going, “Nope, given that it's got to happen, how are we going to do it?” How is a wide open question. I really do think that that's a very productive mindset.

Stephanie Goss:
I love that and I think that's a good spot to take a quick break and then come back and talk about the actual how. How do we do the thing? Hey, friends, it's Stephanie. I wanted to pop in here for a second because I never thought at this point in 2023 we would still be having this conversation, but here we are. Every day, I see posts in the manager groups that I'm a part of from practice managers and practice owners who are still, despite where we are in 2023, not using texting to communicate with their clients. It boggles my mind, because we know that 90% of text messages are opened within the first five minutes after being sent, which makes it a great way for us to reach our clients.
Now, I know a lot of you who weren't already texting picked it up during the pandemic and you have been off to the races, which is wonderful. This episode is all about ways that we can take it one step further. So, our friends at Simple Texting wanted to bring today's episode to you because they believe in helping us help our clients because we know that our clients want to text. It gives them the freedom to reply when they can. How many times have we gotten a call from our doctor's office or our dentist's office and we're at work and we can't answer the phone? But if we get a text, we can probably reply much faster than finding time to step off the floor for five minutes and call them back.
So, if you are interested in looking at a texting option for your practice that is simple, that is easy to set up, that integrates with tools that you're already using, like Google, Facebook, and tons of others, head over to simpletexting.com/uncharted. They have put together a promo for you and you can get $100 worth of free credits when you sign up to try Simple Texting. Again, that is simpletexting.com/uncharted and you'll be able to get $100 worth of free credits if you sign up today. Now, back to the podcast.

Dr. Andy Roark:
You've got some action steps, Goss. I've got two action steps. I've got two action steps. That's all that I've got because this is a nebulous philosophic question and episode.

Stephanie Goss:
You went with the headspace. I went straight into dumping down my ideas for action steps.

Dr. Andy Roark:
Here's where you go. So, the reason I don't have a ton of action steps is because of what I said before about know thyself and know what your clients want and who you are trying to reach and what is going to benefit your culture and your values and the practice you want to have and the people that you serve. So, I think that there's a lot of personalization here. There's not many things that I'm like, “Yes, every practice should do this.” There's just practices are so different. So, I don't necessarily jump right into that. The big things I would put forward as far as action steps are consider what you might do.
Going back to what I said right before the break of if we're going to get on board with technology, if we recognize the world is going this way and we're going to have to go in this direction, how do we want to do that? Then start looking at what your options are. Then the two big things that I would say to get this done is first, remember your 80/20 rule. There are some things that you can get on board with that are going to make a significant impact, that you are going to be able to do them. People are going to use them. You are going to have a big impact on what you're doing. There's lots of other things that are bells and whistles that really are not going to do that much for you. They're not going to shake the earth.
The clients are probably going to largely not notice them. You're only going to use them with a certain small number of clients, things like that. This is change management 101. Think about the changes that you can make that you think are going to most significantly positively impact the experience of your clients, your clients, and which ones are going to be simple to implement. Which ones do you think you can get your team on board? Then you're going to find the balance of what is simple to implement, what can I get my team on board with, and what are the clients going to find the most value in? Then just do those. Beware of doing summer of technology where we're doing 10 different things. No, just pick one, implement it, and then in three months, you can move on to the next thing.
But my advice is slow is smooth. Smooth is fast. Go slow and implement stuff in a way that makes sense. So, remember your 80/20 rule. 80% of your success comes from 20% of your efforts. Pick the 20% that are going to give you 80% of the client experience you're trying to create. Then after you get that laid down, you can tinker, you can add some bells and whistles, but just be smart about what you pick up because you will always be able to find more things to add if you want to. The other part is this. It's just a little action step about getting inspired. You know and I work with a lot of consultants. We work with presenters, speakers, writers, people like that in our industry.
One of the things that people have said to me again and again is they'll say, “Well, I need to get inspired.” If I was inspired, this would be easy. I look at TikTok and I'm like, “If I was inspired, I could jump into this.” You know what I mean? And really have fun.

Stephanie Goss:
Sure.

Dr. Andy Roark:
But I'm not inspired and so I'm going to wait until I'm inspired to do this. So, I have young consultants and speakers who are at Uncharted that say that to me all the time. I'll say, “Look, I get it. It's wonderful to be inspired, but inspiration to some degree is for amateurs and professionals hit deadlines.” What that means is I can't sit on my hands until inspiration strikes me because sometimes it doesn't. So, in those cases, my advice is generally this is. If you're someone who's going, “Boy, if I was inspired, I could get to work on this. I could really figure some stuff out, but I just need to get fired up.”
This may sound silly, but I promise you, it works or it can work. Imagine for a second that you were inspired. What would you do if you were inspired? Then write that down and that's your to-do list and now go do it. You're like, “But I'm not inspired.” It doesn't matter. You have a to-do list. Go do your to-do list. Hopefully, you'll find inspiration on the way. But it's just silly. It's funny.

Stephanie Goss:
Sure.

Dr. Andy Roark:
I'll have people that come to me and they're like, “Well, I want to renovate this practice, but God, I'm just not feeling it. I'm just not inspired.” I'll say, “Great, if you were inspired, tell me about what you would be doing. Just imagine that.” They'd be, “Oh, well, I would be pulling magazines of vet magazines and looking at photos. I would be messaging some of my friends and asking who had a hospital design that they really liked. What do they liked about it? I would be doing all of these things.” I'm like, “Great, why don't you just go ahead and start doing those things and then we'll see if we find inspiration along the way?” So anyway, that may sound silly, but guys, I promise for things like this, it can be a really helpful tool.

Stephanie Goss:
Okay, so I'm going to take your what if you were inspired, and I am going to flip it because I know that we have a lot of veterinarians and a lot of veterinary practice owners that listen to the podcast. We probably have a lot of people listening right now who are feeling a lot like you and TikTok and they're just like, “Technology does not inspire me.” This whole conversation that you all have just had makes me want to run screaming into the forest and live in a box in the woods. I have no desire to do it. It doesn't have to be you. This is another aspect of our linear thinking is that it doesn't have to be you. It doesn't have to be you as the manager. It doesn't have to be you as the practice owner.
If we want to know how to communicate in another language, generally, the best success is immersion and we find someone else who already speaks that language. So, as adult learners, that is the number one tenet for learning a new language. It's the same here. We're talking about learning how to communicate with the younger generation. Pick someone who's younger. It could be somebody who's on your team now. If you have a team that doesn't have somebody who's younger on your generation, younger generationally on your team, you can outsource this because there is a lot of the things. To your point, pick one thing and do it slowly. I would agree with that 100% when it comes to implementing things that impact the team and the workflow.
I think that there are a lot of things when it comes to technology and communicating with clients that happen on the backend that can have very little impact for the team. I think that's where we can start if you are worried about it. You can get a lot of traction and a lot of motion by having one person on your team or somebody that you outsource, whether it's using one of your third-party vendors and leveraging somebody on their team, whether it's hiring someone to just do this work for you. Because believe it or not, in this crazy world full of technology, there are websites that exist to solely hire people to help with projects like this. You can outsource this. This is something that you can ask for help getting done. There are things like putting online booking in place.
Now, yes, your team has to know how it integrates with your software and what the appointments look like when they come in, but that piece of it is so small and the vast majority of it is client facing. It has to do with getting it on your website. It has to do with getting it on your social media. It has to do with getting the things set up. That's an area where you can work in tandem with someone else to put a system in place that is immediately going to drop a barrier of access for your clients and give them more accessibility to you using technology that they are asking for to be able to get in and see you. That is going to drive revenue, which in turn is going to allow you to do the things that you care about in your practice.
Pay your team more, buy new equipment, all of those things come when we practice good quality medicine and we get more clients in the door. So, I think some of it is I see where you're coming from in terms of looking at the 80/20 rule and picking one thing to focus on at a time and doing things slowly. But when I sat down and I was brainstorming a list of things, there's probably 10 things on my list that are what I would consider basics. At least half of them are things that someone could help you implement in your practice that are on the backend, that are going to be client facing, that are going to have minimal implications for the team in terms of management. Because they are things that someone who speaks the language, who likes using the technology could run.
That person doesn't have to be someone on your team and they're things that you can do to be talking directly to your clients, which was the question at the very beginning. So, I think for me, I think the action steps have to start with looking at the basics. There are some barriers that we know we put up for clients. The phones is a big one. How many of us are still using the phones in our practice as our primary source of communication with clients? Yet we know that the studies show that clients are almost always put on hold. Think about the last time that someone called your practice and somebody on your team didn't have to put them on hold either at the start of that conversation or during the course of that conversation.
We know that after being on hold for 1 minute and 55 seconds, so it's less than two minutes, the majority of clients will hang up and a huge number, 34% won't call back. So, think about that. If we put clients on hold, 34% of those clients that we put on hold are walking out the door and not coming back. That's a huge number. So, when I think about that barrier, we have to think about basics. It's doing the things like texting, which our writer at the start talked about, which is awesome. But believe it or not, we still have clinics out there who haven't started texting. We have clinics out there who are not doing online booking.
I mean true booking, not having clients request, “Hey, I'd like to come in on a Tuesday and see Dr. Roark,” and sending an email and going back and forth, but actually when I book an appointment, I went this weekend, I took my kids. We went and got pedicures. I can go on the salon's website. I can look at their calendar. I can see what the options are. I can book the appointment. I don't have to talk to anybody. I can pick the thing that works for my calendar. We have to start to think about reaching those clients where they're at, and we know that that's something that they want. We've been talking about forward booking in veterinary medicine forever.
If you're not looking at how do we get clients in the door ahead of time, that for sure has to go on the basics list, because it helps us communicate better with them when we already know what the next touchpoint is. When they're already on the schedule, yes, they may have to reschedule the appointment because we're booking it 6 months or 12 months in advance, but it gives us that next point of contact versus making our team do the work for it. The clients are already there. They're already saying yes, right? So there are things like that we've been talking about. Since COVID hit, we've been talking about digitizing our forms. A lot of us did that in the beginning for the basics, but how many of us have continued that?
There are still so many practices that are paper forms for all of the things, new client forms, anesthetic, permission forms, boarding forms. We have got to think about how do we lower that barrier so that clients can come in, drop their pet off, and go out the door. So, I think for me, the basics really start with some of those things, but there's all kinds of cool things that practices are doing. This is where, to your point about inspiration, one of the things that I love the most about our Uncharted community is that we have some of those practices that are doing things that when I heard of what they were doing, I was like, “Holy cow, that seems so cutting edge, so progressive.” But it's about finding that inspiration.
So, it's about talking to your peers, seeing what other practices are doing, because to me, the basics, the things that I just talked about, those are things that we should have been doing 5 to 10 years ago. If you're not doing that, that's where you have to start, but for most of us, we're doing those things. So, what is that next step, which is what the writer was asking, right? How do we go beyond the basics? How do we start engaging with them? To me, it's about getting inspiration. I would look in veterinary medicine, but to be honest, this is where I as a manager always leaned outside of veterinary medicine. What is human healthcare doing? What are dentists doing? Dentists have a very similar model to veterinary medicine in a lot of ways.
I have been consistently inspired by what my colleagues in the dental field have been doing for years. Things like being able to offer preventative care plans, looking at making it personal, knowing our clients, knowing who they are, using a client relationship management tool, a CRM, to know who our clients are. When you go to the dentist, my dentist, anyways, always asks me, “Hey, how are Riley and Jackson?” They know the kids' names. They know what activities they're involved in. They know about my family. They know what I do for work. Hey, how are things at the clinic? They don't remember all of that. They write it all down. It's things like that that millennials, that Gen Z, when we look at the data, there are a few things that they really care about.
That personal touch, that small business feeling statistically in market research has been proven over and over again that it is something that Gen Z cares dramatically about. So, starting to look for that inspiration, both inside veterinary medicine in places like the Uncharted community, even some of the groups that you can find online and on Facebook, seeing what your peers are doing, talking to them when you go to a conference, having those conversations. That's why I love Uncharted so much because we have that community that feels like the conference that never ends. So, we don't just go one time and the conversation ends, but asking your peers what they're doing and looking outside the box of veterinary medicine.
I think to your point, when we were getting ready to start this section, I was like, “Dude, I have so many ideas.” I think this is one of those episodes where I'm going to be like, “I want to write a blog article about this.” Because I think that there's so many things that we can do. For me, to your point, it's about finding that inspiration and really doing our homework. So, for me as manager, it was about who is my client and making that archetype, looking at the research, finding out what is it they're actually asking for when it comes to pet ownership. For millennials and Gen Z, there's five real buckets that market research has demonstrated. So, I would approach it like, “What are the buckets? What are the things that they care about?”
Then to your point about how do I minimize the impact on the team, what are things that we're already doing that fall into one of those buckets? Then what are simple things that I can build on, that I can put in each of those buckets and slowly but surely work on strengthening those relationships and speaking their language in more intentional ways? You can't go from 0 to 100. We prove that over and over again in the practice, and we most often fail. We've got to figure out what are those baby steps to get there.
So, for me, it's about doing your homework, looking at the data, looking at the data that has been brought over into veterinary medicine for us, figuring out who our existing client base is, looking at what are the things that we are already doing, and then getting that inspiration and figuring out how do I put that system in place. We have to stop thinking linearly that we have to be the ones to do all of this and think about what are those things that we can do in the background that don't impact the team's day-to-day workflow that can allow us to speak to the younger generation of veterinary medicine in ways that they are going to immediately soak up and love.

Dr. Andy Roark:
Yeah, no, I like that a lot. I think it's super smart. It's always good to take a data-driven approach. I think that's a great balance of, like I said, the non-linear thinking. It's about looking at state of best practices. It's about remembering who you are trying to serve. Like I said, there are people who have very progressive tech forward client basis and there's people who have the opposite of that, who are definitely not tech forward progressive audiences or client bases. Again, I think it's knowing your people. So, I like all that. I think that makes a lot of sense and I think that's just a good approach. Again, if you're starting to feel overwhelmed, fall back into keeping up is a process. It's not a destination. This is not going to end.
Pick the things that are going to help the most, that are going to make the biggest difference. Get them in place and move forward and move forward. Just know that we're going to have to keep adjusting. I am confident the world is going to look very different five years from now than it does now. So, people go, “Well, I'll just wait five years before I do anything.” I was like, “I'm pretty sure it's going to be a building process.”

Stephanie Goss:
Start now.

Dr. Andy Roark:
Again, starting now and being intentional I think makes a lot of sense, but yeah, I really like your idea of delegating it too. I think this is absolutely something that can be delegated. You can mentor a young leader, find someone who it's their passion and support them. Yeah, I think that makes a ton of sense.

Stephanie Goss:
I want a soapbox, but we're out of time.

Dr. Andy Roark:
We'll stop recording and then you can just soapbox to me if you want.

Stephanie Goss:
My mind is running. Yeah, this is one of those ones.

Dr. Andy Roark:
Soapbox in the Uncharted community. Just go in there and start posting and talking to people.

Stephanie Goss:
Guys, Andy wouldn't let me talk on the podcast today. So, now I'm going to give it all to you.

Dr. Andy Roark:
Everybody, huddle up. I got something to tell you. But yeah, if you're like, “Well, boy, I would really love to hang out with some really smart, innovative practice leaders, managers, head techs, medical directors, practice owners,” and get some ideas about what they're doing so I could pick the best path for me, come on over, join the Unchartered community, jump in 24/7, 365. It is a vibrant, engaged community that's always happy to help. So, anyway, that's all I got, Stephanie Goss.

Stephanie Goss:
Me, too. This was so fun. Have a fantastic week, friends.

Dr. Andy Roark:
Thanks, everybody.

Stephanie Goss:
Well, gang, that's a wrap on another episode of the podcast. As always, this was so fun to dive into the mailbag and answer this question. I would really love to see more things like this come through the mailbag. If there is something that you would love to have us 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. Take care, everybody, and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: closing, fear, Practice ownership

Jun 21 2023

Fear in Veterinary Medicine

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are taking a recent topic they were discussing with a colleague and diving in for a deeper conversation. Their colleague was pointing out the perspective that it feels like there is a lot of fear swirling around veterinary medicine these days. Veterinarians are afraid of being sued and board complaints; they and their teams are anxiously awaiting the next negative client interaction; they are terrified of online reviews especially the ones that go sideways and get mob mentality attached to them. Andy and Stephanie walk through their take on some questions like “Is this normal? Has the profession really changed that much in this regard in the last 20 or 30 years. Are all professions like this? And most importantly, can this be changed? Let's get into this…

Uncharted Veterinary Podcast · UVP – 236 – Fear In Veterinary Medicine

You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Amazon Music or wherever you get your podcasts.

Submit your questions here: unchartedvet.com/mailbag


Episode Resources

Upcoming events: unchartedvet.com/upcoming-events/

All Links: linktr.ee/UnchartedVet


Episode Transcript

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 continuing a conversation that got started recently with a colleague. We were talking about the current state of veterinary medicine, and one of the things that came up was that it feels like to some of us, that one of the predominant emotions in veterinary medicine right now is fear.
And we talked about a bunch of examples, and we'll dive into that in the episode. And there were some great questions that came out of the conversation that Andy and I really wanted to take some time and discuss in more detail here on the podcast. There was questions like, “Is this normal? Are other professions like this? Are all professions like this? Are we an anomaly?” We talked about, has the profession changed, and how has it changed over the last 20 or 30 years?
And I think the most important question of all was the hopepunk rebellion question of, can this be changed? If this is truly our state, is this something that we as an industry can change? Andy and I had so much fun with this one. Let's get into it.

Speaker 2:
And now, the Uncharted podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark, and the one and only Stephanie. I want to see you be brave Goss. I want to see you be… I have a soft spot in my heart for that positive female empower… Like a small boat on the ocean. Anyway, I can't.

Stephanie Goss:
I was going to say, that's a little out of your range.

Dr. Andy Roark:
It is. It is. What is my range? I don't know. I just go for it and then we find out.

Stephanie Goss:
I don't think Rachel Platten's in your range.

Dr. Andy Roark:
Thank you. You knew what it was, which is great. As I said, I was like, “No one's going to know what that is.”

Stephanie Goss:
I totally knew what it was. That's one of my favorite songs.

Dr. Andy Roark:
This is my fight song, take back my right song, or turn on the light song. Anyway, it's something like that. I love that kind of empowerment music. When I'm in the mood, it's my jam. I just like it.

Stephanie Goss:
I know. Your playlist is full of that for when we go to events and stuff.

Dr. Andy Roark:
Yeah, I know. That's one of the hard parts of my life, is the Uncharted Spotify account is also the Dr. Andy Roark personal Spotify account. And so I get criticized for my music by… 11 employees are all like, “Look at this.” Oh man.

Stephanie Goss:
So fantastic. How's it going?

Dr. Andy Roark:
I've got a new segment of the show. I have a new segment for our show.

Stephanie Goss:
Okay.

Dr. Andy Roark:
It's life lessons from advanced beginner hiphop dance class, with Dr. Andy Roark.

Stephanie Goss:
Okay. So we've moved on from the garden to advanced beginner. Advanced beginner hip hop. Okay, lay it on me.

Dr. Andy Roark:
Advanced beginner hip hop dance class. I find inspiration everywhere in this joyful world Stephanie Goss-

Stephanie Goss:
Wait is it beginner, beginner?

Dr. Andy Roark:
It's advanced beginner.

Stephanie Goss:
Okay.

Dr. Andy Roark:
Advanced beginner. It's like there's the beginners, and then there's advanced beginners. And my daughter is in the advanced beginners class. And I saw they had their recital yesterday, and I was there.
And what was funny is, she's been working on… It's a dance. So it's a dance. First of all, the dance that they chose is Kanye West Jesus Walks, which is not remotely appropriate, not remotely appropriate for 11 to 13 year old dancers.
And yes, they play a clean version. But you can't find the clean version. So every time your kid wants to show someone, every time they want to practice, you're like, “Whoa, whoa.” It was just, the choice of song was real, I struggle a bit. It was a bold choice.

Stephanie Goss:
The adult oversight there.

Dr. Andy Roark:
It was. I was like, “Mr. Trey, we need to talk. I'm going to give you some feedback when we're done.” And so it's Jesus Walks okay. And every day, Hannah comes home from dance practice and she's flustered and she's like, “The kids. There's one kid that's not paying attention and the other kids are not… The spacing is not right. It's a trapezoid shape. We're doing a trapezoid shape on the stage. And this one kid doesn't know the difference in a square and a trapezoid.” She's very upset.
And so she's given this really specific critiques, like down to people are not hitting their marks, things like that. So I've heard this for eight weeks and I'm like, “Oh boy, this is a production. And Hannah is very serious about getting”… And I get there and it is exactly what you expect for an advanced beginner 11 year old hip hop dance class recital, as is to say it's chaos.
It's The Muppet Show up there. You know what I mean? The kids are looking at each other. You know what I mean? To make sure they're doing it right. It is not the Fly Girls from In Living Color or any other dance troop that you might associate with hip-hop dance.
Anyway, the life lesson I took away was make sure that you are not the person who's trying to perfect the presentation when you're in advanced beginner hip hop class. You know what I mean? We all know people who their perfection level is turned so far up beyond, of whatever is going happen in real life. And I'm like, “That's Hannah.” And so I had to have a conversation with Hannah about accepting that sometimes we're in advanced beginner hip hop dance and people aren't going to hit their marks. And we have to be a little bit careful about the trust fall part of the dance. And that's just what we have to be careful about. Anyway, so make sure that you are not going for perfection when you're working in advanced beginner hip hop dance, or else you're going to be frustrated. And that's life lessons from advanced beginner hip hop dance class with Dr. Andy Roark. I felt so bad for her because she was like, “Can you believe they didn't hit their marks?” And I'm like, “I can. I can believe that.”

Stephanie Goss:
“What I can't believe is that y'all are out here dancing to Jesus Walks.”

Dr. Andy Roark:
“Of all the things that I'm struggling to believe, that's not the one.”

Stephanie Goss:
Oh man. Okay. My face hurts from laughing already, and we haven't even started. We have a fun one this weekend I think. This one came kind of via the mailbag, but came from a community conversation in Uncharted.
And one of our friends was asking a question about fear in veterinary medicine. And I thought it was such a good question. And it was like this is an older veterinarian, and he's wonderful, and progressive, and was just like, “I've been around a long time and I feel like we've gotten way more fearful. And I feel like the profession has changed radically over the last 20 or 30 years. I feel like now we live as a whole collective group in this state of fear. We're afraid of being sued. We're afraid of negative client interactions. We're afraid of bad reviews online. We're afraid of not being perfect for everybody all the time,” and on and on and on. He was asking, “Is this the new normal? Have we really changed that much?”
And the other questions that I found were super, super interesting, are all professions like this? Is it just us in veterinary medicine? And the best question was, can we change this? And I would add, how do we change it, to that list of questions. And I thought it was such a fun one, and I said, “Hey, we would love to talk about this on the podcast, because I have thoughts and I bet Andy has thoughts.” I would love to do what we do best, which is you sit in your basement, and me sit in my closet, and let's soapbox about it.

Dr. Andy Roark:
Oh yeah. I'm all about it. I'm all about it. Yeah, I like this question. I think this is a big, sprawling topic, and I think it's good to talk about. I really do. I like this question a lot.
I think that there's two parts of this. There's the larger culture that we live in, and then there's the way that we communicate inside that culture. And that's kind of where I start.
So we'll start in head space here as we start talking about, “Man, why is everybody so afraid in vet medicine? Is it just vet medicine?” Stuff like that. I don't think it's just vet medicine. I'll just say that. I don't think that vet medicine is any scarier than a lot of other jobs. And people say, “But we have lives in our hands,” and we do. And lots of other people have lives in their hands as well, or they have other things that really matter.
And so I get it. I don't think that we own the market on… If things go bad in our job, they really go bad. And that's true for bus drivers as well, and airplane pilots, and all sorts of people, police officers and on and on. So anyway, there's that.
I think that overall, we live in a safety culture right now. And there's been a lot of research on this. And we have come to a place in a culture where we are very worried about things. And I think a lot of that comes from how we communicate stuff.
You and I have talked about this a number of times with our kids, and we talk about the kids. And I really like this because I think this is important. So I think about my own childhood. When I was 11 years old, I ran free in the neighborhood. My parents had no idea where I was until I came home at dark.
And man, there is no time in the day where I don't know where my 11-year-old is now. I'm not trying to enforce that… But can I just tell you, so my daughter's 11, my youngest hip hop dance class daughter. And I have a little apprehension about her walking the dog, and just by herself, and off in the neighborhood. And it is not rational. It is not rational at all, but I do. And it's just because people are like, “Oh man, you let your daughter walk away?”
We had this thing called Artisphere in Greenville last weekend. It's when they have all the little art exhibits set up on Main Street and everything. And I got there and kind of whispered to my wife, “Hey, are we okay if the girls go off on their own?” Man, my girls are 15 and 11 in downtown Greenville in the middle of the day. Alison was like, “Let's see if they ask.” She's like, “I'm happy to be together as a family, but if they want to go off, then we'll let them ask and do it.” But just the fact that I was like, “Hey, we should have a huddle about this.” And then I go, “What am I thinking? How did we get to this place where our anxiety is so ratcheted up?”
When as we look at the numbers, the chances of something bad happening to our kids are lower than they've ever been. Their safety is pretty flipping great, and we have this fear about it.
So anyway, I'm not trying to jump onto a parenting bandwagon, but I just use that as an example of the type of culture that we live in where we are so aware now and there's this sort of feeling of, “Oh boy, you do not want something bad to happen.” And I think it permeates everything that we do. I definitely don't think it's a vet medicine thing. What do you think about when I lay that out?

Stephanie Goss:
Yeah, no, I agree. You and I have definitely had this conversation about parenting. And there's a book that both of us have read that was written by a parent about the idea of free-range parenting and letting our kids have this space.
I'm with you. I vividly remember as a kid, free-ranging all over our small town. I mean, I would ride my bike miles. Because my parents worked both of them, and they weren't home. And we were, by the time I was my kid's age, I was a latchkey kid and had been for several years.
And so if I wanted to see my friends during the summer, get on your bike and go or get on your skateboard and go. That's your choice, or get on the bus. And I was like, “Dude, my kids don't know how to ride the bus by themselves.” I'd been riding the transit by myself for several years by the time I was their age.
And so I read that book, and it was after I had a conversation with my parents that dramatically changed my foundation of how I parent. But I'm with you. I think that I was sure in the course of this conversation that we were in a more dangerous place as a society. And I had an argument with my parents and my mom said what you said, which is that statistically, no, it's no different now. It's actually probably safer now than it was.
And I was like, “No way.” Because all you hear about is the bad things. And so I was like, “No way. This got to be up.” And so the C in me was like, “I'm going to go and get all the statistics, and all the facts and figures, and I'm going to prove my parents wrong.”
So I looked it up, and I looked it up for our small town. And sure enough, all the rates were less than they were when I was a kid. And I really sat back, and it was a self-awareness moment for me because I sat back and looked at it and I was like, “Okay, but why?” And I was trying to ask myself, why would I think this? Anyway, so I went down a rabbit hole as a parent, but I agree with you.
And where I landed was on a piece that I think really affects us fundamentally in veterinary medicine, which is that we as society have become more connected and we have social media, we have instant connection. When you and I were kids, if something happened in town, you didn't learn about it until you went to the grocery store, or until you went to church on Sunday, or you went to school the next day. You had to have the personal connection to hear about the things. Or it had to be printed in the newspaper, which had a 24-hour delay.
And now, there's instant news. Something happens across the world, and it starts broadcasting on the computer that we hold in our hands. And so there's this connectedness that accelerates the share of information, which is wonderful and is a very, very double-edged sword. And I think for us in veterinary medicine, and professions like ours, that connectivity and that ability for people to instantly connect in ways that they didn't before dramatically impacts our state of mind.

Dr. Andy Roark:
Yeah, so I completely agree with that. And I would take it one step further too, is to say, I would zoom out a little bit and just say, we live in the attention economy. And so what that means is we have in our media, accepted a business model that's about getting and holding your attention.
And I would say even before social media, the first thing I think that really started to amp us up towards being afraid all the time, it was 24-hour news. And going back to your point, it's very much in the vein of we used to get news when it came out in the newspaper, and there's only so much space in the newspaper. And then we heard it from other people.
Well, when the Nightly News came on at 6:00 PM and it was one hour, we got one hour's worth of news. And now we've got how many cable news channels or news outlets, not counting what's on the internet, trying to fill 24 hours worth of content. And they are just covering everything that they can find just to fill the day with a reason to keep watching. And so back to your point of we saw this thing that happened in your local town, the truth is there was something just absolutely bonkers that happened one state away in a small town, and you never heard about it, but you hear about it now.
I saw an extreme example. And again, I'm not saying the things that happened in other places aren't noteworthy or they aren't tragic or terrifying. They are. We just didn't used to know about them.
So I saw a great in depth coverage recently in the New York Times about a school shooting in Sudan, which is a country in North Africa. And I'm like, “This is awful.” And it's not remotely close to us. And that doesn't mean it's not important or anything.
But the problem I think that we have as human beings is we are really bad at maintaining perspective. We just don't understand how big the United States of America, or Canada, or Australia are. When we say, “Oh boy, this terrible thing happened at a supermarket in this town somewhere else in the US.” And you're like, “It is terrible.” And do you know how many supermarkets there are in this country?
And so we just don't do a good job of hearing a story and putting it in proportion with how actually likely is this to affect us, like ourselves. And that's not how we're wired. You think back. We're still running the hard-wiring from millions of years ago when we evolved as a species. You know what I mean? We have the absolute belief… It's funny.
When we're talking about fitness or whatever, people are like, “Listen to your body.” I'm like, “My body thinks that winter is coming and that the pizza tree is going to go out of bloom any time now. Anytime. And we better get ready.”
And that's the model that it's running on is there is a much better chance in my body's mind of me starving to death, you know what I mean, than anything else. That's the number one concern that my body has is, “But what if we starve to death?” And I am wired hard in that way.
It's the same thing here. It's like my body thinks that there's a tribe of maybe 50 people that we're interacting with. And so when it hears a story, it believes that it's a story from those 50 people that we live with. And it's like, “No, this is a story from some guy on YouTube that's in Switzerland.” But my deep lizard brain doesn't get that. And so I just think that connectivity, that battle for attention is a big deal.
And so besides filling up 24/7/365 on news networks and also on the internet and things like that, in social media, we know that the goal is engagement to keep people on social media. And we know that if you want to get attention there, emotion is what carries it. And honestly, fear and outrage are the two biggest, most sticky emotions that get people to pay attention.
And so look at our news and look at the headlines, and just look at how geared towards fear and outrage the headlines are. That's not a flaw, that's a feature. That's how they were made. They were tweaked and tweaked to get there. And I go, we swim around in fear. So again, I go back to, I don't think it's vet medicine. Do I think that we are more fearful now? I absolutely do.

Stephanie Goss:
Yeah, I would agree. And I think the other piece of connectivity that's important when we talk about this, specifically in the vet med context is that we have also… So we've experienced this cultural shift of going to the 24-hour news cycle and having instant connection. To your point, the whole world is in your hand if you have a smartphone, and you are connected to that guy in Switzerland or in New York City, in ways that you never were before. You would send a letter and it would take two weeks to get there previously.
And so for us in vet med, we also have the connectivity shift that has happened in regards to our pets. And so I remember when we were kids, our family pets, when I was young, our dogs lived in the backyard. They didn't come in the house. They were part of the family, but they were backyard dogs. And we loved them, but that was where they lived. And they had a two-story dog house because that's my dad. They lived in the backyard.
And so we have had this shift where our pets have become parts of our family. And I love this, and I think this is fantastic. And, we also have shifted as a culture to traveling and bringing our pets with us. And so with that has come this connectivity in our local communities in regards to pets in ways that we never had before.
So when our pets lived in our backyards, we didn't go to the dog park and have conversations with other people who were experiencing veterinary medicine in similar and also very dissimilar ways, because they're going different places. And so now, people are bringing their pets to places that are pet-friendly businesses, and they're going to the dog park, and they're talking, and they're connecting, and they're sharing experiences. Not dissimilarly to the way that social media allows us to share with people that are the same but also different from us. And so there has become this connection point that allows that information to spread significantly faster.
And it is good because we get tons of client referrals that way. We lean into that as an industry. We want our clients to go to the dog park and tell every Mrs. Smith and Jones that they meet, how amazing their experience is at our hospital.
And we also know, to your point, that as a society, we have been conditioned to focus on the sensational and the negative headlines. And so what is the vast majority of the information that's shared, especially on social media? It's negative. It's the bad. It's the one case out of 1,000 in your practice that went sideways or that went badly.
And it's so timely that we're talking about this, because I got an email, speaking of 24-hour connection. I got an email yesterday with the updates from Nextdoor, which is an online community for your local neighborhood. And I get it. Just because it cracks me up to see what the old people in our neighborhood are bitching about, I live in a retirement community, and they're around 24/7. So there's constantly conversation, and it's hilarious to me.
So I'm flipping through and there's an article about a local practice in our area, and the practice closed, and there was some concerns with the practice. But one of the comments really stuck out to me, which was someone who made the comment that, “Like pediatricians, there's no room for error when it comes to our pets' lives. Veterinarians should be held to a higher standard.”
And I have been sitting with that since yesterday because I was just like, “Are you kidding me? We're human. Mistakes are going to happen. No one of us is infallible.” And yet there is this sense… I knew that this person was not alone because the comments started and everybody was jumping on that bandwagon.
And I do think that that connectivity, if one person had a bad experience that led them to thinking that thought or one person had a frame of mind or a frame of reference, but they didn't have that connectivity before, they might share with the people that they interacted locally, but it wasn't on that global scale.
And so I think that that connection in vet med has helped us. And I think that it also has hurt us on a core level in terms of being fearful and being negative. And so I would agree with you. I think we are way more fearful than we were when I started in vet med 20 years ago. And I think that there's good reason for a lot of it.

Dr. Andy Roark:
Yeah. So I have a friend who does a standup set, and he talks about Nextdoor, the social media platform. And he's like, “Nextdoor is a social media platform that you would think would be the best, but it's the worst.” And it's the worst because it shows you so clearly how nuts the people who live right around you are. And it's just like you know these people, and they live next door. And you're like, “Oh boy, I'm learning things about people that I see that I wish I did not know.” And I thought that was super funny.
I think there's a lot in what you said just to unpack. I would say yes, the connectivity that we have means that unhappy people can now write online reviews and post in Facebook groups and things like that, that they did not used to be able to do.

Stephanie Goss:
Right.

Dr. Andy Roark:
So I do think that there's more potential real damage there, and that's true for everybody. If you run a restaurant and people have a bad experience, every profession has that. But that is an actual thing that has ratcheted up fear.
The other part about it is the changing relationship to pets… And I do think that there's some truth to that, and that's one place where I would say, here's a place where I could say that actually, the tension in vet medicine may have moved up a couple cliques when it wouldn't have necessarily, in a way it wouldn't have another professions. And that is just, people take their pets really seriously now. And yeah, it's not what it used to be.
But here's the other part too though, is while pets may have gotten more important to pet owners, I don't know that they've gotten more important to veterinarians or vet professionals, because we already cared a ton. I just think that the average pet owner is getting closer to where your vet professionals have already been. We cared enough to go into this profession. We were already at that level.
And so managing the emotional reactions of the pet owners is harder when they're more invested sometimes. And I do think that's true. So I would say I get that. And that may be a stressor that causes fear. That wasn't the way that it used to be.
There's two other things that I see a lot just in the way that we communicate. Well, three other things. So the three things, number one is before we had specifically social media, we as veterinarians or vet professionals did not see exactly what was happening in other people's clinics.

Stephanie Goss:
Right.

Dr. Andy Roark:
You know what I mean? If we had an angry client, we had an angry client. But we didn't have angry clients every day. It happened every now and then. But now through the wonders of social media, we can be immersed all day every day in people telling us the story about the angry person they just had.
And while absolutely nothing has changed in our practice, we can feel like pet owners are out of control and everyone is mad. And again, it goes back to that proportionality in our brain, that specific to vet medicine of people in the practice saying, “Boy, can you believe pet owners do this,” or, “This person did this thing.” And just someone in another town far away. But man, you feel connected to them because they're talking in a language that you understand. And so that connectivity is the first thing. The second one is the way that a lot of our media works to make us feel like individual one-off things are a pattern, that there's a sweeping change.
And so there's this thing in psychology called the Texas sharpshooter fallacy. And the Texas sharpshooter fallacy, the way it works is just imagine that you had someone with a gun, and you told them to shoot at a barn. And so they stand back and they just shoot, shoot, shoot at this barn. And then you walk up to the barn and you look at where all the holes are, and then you paint a bullseye where the holes are. And you go, “Look at this clustered.” It looks like they were shooting at a bullseye. The truth is, these are just random smattering across the side of this barn. But when you draw a bullseye and you say, “This is what it means, this is the pattern.” You can make a pattern appear where there absolutely wasn't one. And so we'll hear a lot of stuff in our news or our media and they'll talk about, “This shocking trend.”
And I think that that happens a lot when you say, “Boy, pet owners really are more difficult than they've ever been.” And I'm like, “You went and found five different instances across the entire continent of North America, and now you're calling it a trend. And the truth is, some of it's just coincidence, and some of it is just, ‘Hey, we happen to have angry people in our continent this week.'”
But you can package that stuff together and tell the story that it's a trend. And that makes it more scary, more sensational, more likely to get people to take a look. And so I feel like that's a journalistic practice that we see a lot online. And we get swept up into this as far as, “Oh my gosh, things are getting bad. Veterinarians are getting bullied in a way they didn't used to.”
And I think veterinarians are getting bullied more because there's more tools that people can use to bully people. But I don't know that it's a shocking trend that's going somewhere, that this is just building and building, and getting worse and worse. I don't know that, but it looks that way.
And then the last thing, I've heard it called nut farming. And nut farming is when we look at the continent and we find one example of one just wild, over-the-top example, of something scary, something bad. And we put it forward and say, “Look at this, it could happen to you.” And I'm like, “Boy, you went deep down a Twitter rabbit hole to find this one person,” that you're now holding up as if they're an example of what the average pet owner is. And that's just not true.
But we see it all the time, and it still works. I know that that's what's happening. And still, if they find the right person, it can make me feel angry, and unappreciated, and afraid. And I'm aware of this trick, and it still gets at me. So I think all of those things are things that happen, that I think add to our fear of practice.

Stephanie Goss:
Yeah, I think I agree with you. And then I think from a head space perspective, the last thing… You and I have talked about this a few times because we've kind of come to this place as a industry where we're talking about the changes in veterinary medicine, which are good. We have seen radical changes in the 20 years that I have been in the field. And there is some of the trends that I think are maybe not as good.
And one of those has to do with the vet schools in the training, and the educational perspective, and this let's do the gold standard. And I think one of the things from a fear perspective… And again, now that we're having this conversation, I'm questioning, is it actually happening more frequently, or am I just thinking that it's happening more frequently because we're connected and we're sharing experiences? And so I'm hearing other people's, and so maybe it's happening at the same rate it was before.
But thinking about my own perspective, and having new grads in my practice, and having doctors who are just like, “I'm not qualified. Let's send this to the specialist. Let's send this for review. I want somebody to double check my work.” And I have to wonder, is that fear coming from the people themselves, or is that coming from the way that we're training them, or the way that we're approaching it in veterinary medicine?

Dr. Andy Roark:
I was doing a podcast with this neurologist, a veterinary neurologist named Dr. Sean Sanders. And I've really enjoyed talking to him. I've had him on The Cone of Shame podcast twice now. I don't know if the second episode's come out yet, but if it hasn't, it'll be out really soon. But it'll be out by the time this episode comes out. Anyway, he's a neat guy. He's interesting.
He makes this really strong point. And his belief is that years ago, maybe in the last 20, less than 20 years, up to maybe 20 years ago, we had these veterinary specialists coming out, and they were being trained at the vet schools. And the vet specialists would do our education in the vet school. We were trained by specialists. And there were plenty of specialists coming out, and they're sort of being put out.
And his implication was that there is a bias in teaching to train young doctors to refer things up to specialists. And when there was a really focus on delivering gold standard of care, we teach gold standard of care. That's what we want our doctors to know. Well, the gold standard of care is often to send this case to a specialist who's a boarded surgeon, who does surgery all day long, because they'll do a better job. And I go, “That's true.” If it's a splenectomy, or a GDV, or especially orthopedics, I assure you that a boarded surgeon is going to do a better job than me. And it is a better goal standard of care for you to go to that person.
And his idea was that because we were trained and trained, that line of where we refer, it might have been slipping farther down saying, “Well, maybe you should refer that as well, and you should refer that as well.”
And I do think, I remember in my training, there was definitely an inclination. I remember people saying things to me like, “Well, you're not going to actually do this, but I'm going to show it to you.” And again, we've heard a lot of doctors come out who are not comfortable doing advanced procedures and things like that.
And so I think that there is a certain amount of fear that the gold standard of care and the way we're educated puts into us of, “You want to send this away. There's someone else out there who has the appropriate training for this, and it's really not you.” And I do think that that approach in teaching has sunk into a lot of us.
From what I am hearing now, what I believe is the rise of spectrum of care approach and the idea that gold standard is getting maybe a bit unattainable for a lot of pet owners. Let's start to talk about what an acceptable silver standard looks like or a basic standard looks like. And we're starting to see some shifts in that.
And I've heard that education is shifting that way, and I think that makes me happy. I think that's a good place to be. But I do think for a lot of us, I think there's a lot of doctors out there who came out in the last 20 years, who have some concerns about doing things that they're not the best person to do. And I think that may have been baked into us a bit when we were coming out. And so I do think that that is a type of fear that probably did not exist in doctors that came out more than 20 years ago when it was much more like, “No, you're the vet, and you're going to go, and you're going to deal with what comes in.”

Stephanie Goss:
Right. All creatures great and small. Like, it walks in your door, you got to be prepared to deal with it.

Dr. Andy Roark:
Yeah. So I think that's the last thing. I'm totally with you there. I think there's a part of our education that may have caused that type of fear. So yeah. Anyway, I think from a head space standpoint, we always talk about, why do we feel this way? And we came all this way, what are we going to do about it? I think we could, let's take a break here, and then we'll come back and let's start to talk about how do we manage this?
Because I absolutely think there are things that we as a profession can do. Mostly, I think we as individuals can manage this. And I really like that because it empowers people to do it themselves. I think that we can control our own fear and how we go forward, and be really smart about it.

Stephanie Goss:
I love that. Let's take a break. Hi, friends. Do you struggle with finding the right cadence for team meetings in your practice? Do you feel like maybe you're meeting not enough, or maybe you're meeting too often and you're stuck in meeting hell?
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Dr. Andy Roark:
All right, so let's get into what we do about this. I don't like being afraid. Something I've noticed in myself over the years is having some anxiety about things that don't warrant having anxiety. And so this is something obviously, I've thought a lot about, and have really tried to build safety catches and pushbacks against into my own life. And boy, talk about return on investment. Getting out of a head space like this and feeling more comfortable, boy, it's worth the effort.

Stephanie Goss:
Yeah, I would agree. This episode really excited me, and I was excited to have this conversation. And I also had some trepidation, because I feel this when I look back at my own career. I quit being a veterinary technician because I was afraid. I was someone who had significant fear for some of the reasons that we talked about and their stories there.
But at the end of the day, when it comes to how did I have to deal with it, well, I was afraid. And so I had an opportunity to make a change in my career. And so I ran away. I was afraid and I said, “I'm just going to quit.” And I'm not a quitter. I've never been a quitter. You know me. That's not my personality.

Dr. Andy Roark:
Oh no, you stick around. You're like a non-healing draining track. You just keep going.

Stephanie Goss:
Thank you. Thank you for that.

Dr. Andy Roark:
You're like methicillin resistant Stephgossius.

Stephanie Goss:
I can't.

Dr. Andy Roark:
I wanted to agree enthusiastically with you.

Stephanie Goss:
Thank you. Thank you.

Dr. Andy Roark:
I like to make sure my employees feel empowered and supported. So I'm on board with this statement.

Stephanie Goss:
A draining wound track. That's me.

Dr. Andy Roark:
A draining, she's like nidus of infection, does not stop.

Stephanie Goss:
But I did. I did stop and I ran away, because I was afraid, and I had to do a lot of work. And for me, the work started completely unrelated. I was going to therapy and talking about some other things, and realized that I had some work to do.
And where it had to start was the question of why. “Does it all come back to Simon Sinek?” Well, let's start with why. But for me, when it comes to the fear and the action steps of this, whether it was me on a personal level, or team members that I've worked with, or industry as a whole, I think we have to start with the why.
And there's a whole multitude of reasons why. Whether it's individual. In my case, having some horrific experiences with anesthesia, and specifically having my own fears. Or whether it's us as an industry being worried about the increasing social connectivity and the ability, the fact that we're living in a litigious society and that we could get sued at any minute, or we could have a board case brought against us at any minute.
We have to start with examining where the fear is coming from, because I think the answer, the action steps are going to vary depending on where that fear is coming from.

Dr. Andy Roark:
Yeah, I completely agree with that. And so step one, when we're feeling fearful about practice or things in practice that give us an anxiety, I agree with you. So a couple things you put there. I'm going to start and say, “Why am I afraid? What does this fear mean to me?” I really do think that that is the underlying reason.
I think for a lot of us in vet medicine, a lot of us are perfectionists. A lot of us put a ton of weight on our shoulders. I have found, it is true for me. I found it to be true again and again with veterinarians that I have worked with, is a lot of times there's anxiety about or fear about doing things. I think a lot of us have this struggle with feeling worthy. We feel like imposters. And, what if people find out that I'm an imposter? What if I make a mistake and people don't respect me anymore? What if I make a mistake and they don't see value in me anymore as a person? And that may sound over the top, but I assure you it's not. And it is a very common approach.
It comes a lot from… As we do this, I'm getting ready to get in the car and I'm going to drive out to one of the veterinary schools, and I'm speaking at the graduation, which is always an honor. And one of the points that I've decided I want to make in my brief time talking to them is, I really do want to encourage them to remember that veterinary medicine is what you do. It's not who you are.
And some people don't like that. And we talk about the calling of medicine, but I'm really pushing back on the other side and say, the key for me to enjoying being a veterinarian is not defining myself as a veterinarian. I am a dad, and I am a husband, and I am a gardener, and I attend advanced beginner hip-hop dance classes, and things like… I have other things that I do, and then I do vet medicine. And if vet medicine doesn't go well, that's not devastating to me in my identity.
But boy, it was for a while. When I was getting started and I was Dr. Andy Roark, and social media was big, and I was doing a ton of stuff there. I really had a lot of fear about, “What if this doesn't work out, and what if I mislead people, or if some of my advice isn't good? Or what if someone who knows more than me about a specific topic, what if they challenge me, and what if they're right and I'm not?” I go, “Boy.” I was so wrapped up in this identity or feeling. And no one else thought that.
No one was like, “I need some real insight. Let's see what Andy Roark has to say on GDV surgeries,” like I'm not your guy. But I was very worried like oh boy if I say things, then people… And again, it was a feeling of worthiness and being seen as someone of value. And it wasn't until I really burned out back in 2019 when I really had to step back and look at my life and go, “Buddy, your whole identity is wrapped up in professional success and how you're being perceived, and it's killing you. And it's not fun.” And that was a big part is setting that aside.
So anyway, we got to figure out why we're afraid. Why does this bother us? And the answer may still be, there's a thing that I don't like to do. If you say, “I don't like surgery. It gives me anxiety. I don't like it.” I think it's worth exploring why we don't like surgery. Know thyself. There is nothing wrong with saying, “I don't like to do surgery, and I let the other doctors do it.” That's not bad. But I think there's real value in figuring that out. One of the things that you mentioned as well, as I say, I truly believe that therapy can be wonderful in that it helps people unpack that.
The way I look at therapy and I talk about therapy is this. There are times in my business when I don't exactly know what to do, or I kind of know where we should go, but I don't really know how to get there. Or, I'm just not the right person to fix the problem. And I say, “Okay, I need an outside perspective. I need different language that I personally don't have. I need a fresh set of eyes here.” And it's not that I'm not good enough, it's just other people have this expertise. It's hard to see yourself. It's really hard to get an outside perspective when you are up to your neck working on whatever you're working on.
And so at that point, it's worth hiring a business consultant. I say, “I'd pay somebody. I don't know how to get out of this hole, or I feel like I'm going in circles. And I just need a fresh idea, fresh perspective. I'm going to pay somebody for their time.” At first, I'm going to talk to my friends and things like that. But at some point, I'm going to pay somebody for their time.
And that's how I see therapy as well. It's like, man, if you're rolling around and wrestling with something, and you can't get a good perspective because you're so deep in it, and your friends and spouse are sick of hearing you talk about it, and they don't know how to help you anymore, or you don't want to talk to them anymore, well it's time to hire somebody and just be like, “Hey, I'm bringing you in.”
Again, people have different things that they want in therapy, and I'm not trying to tell people what you should want. I am super pragmatic, problem oriented. And so in times that I've used a therapist, I've been like, “Hey, this is what I'm struggling with. This is a thing I'm working with, and I could use some encouragement. I need to get a perspective on this. Help me work through this.” And then I do it. And then when it's over, I'm like, “Great, thanks a lot. Got what I needed. I feel good. I got this thing worked out. I'll call you if I need you in the future.”
That's it. It does not have to be an all-in. I think a lot of people are like, it's the lifestyle. It can be, doesn't have to be. But anyway, I just put that forward as to say this has been my perspective on therapy and how I have personally used it at times in my past when I've wrestled with stuff. So anyway, I know that that's a big soapbox that you love to climb on. And I don't mean to squeeze you on your soapbox, but I do think it's a good place if you're like, “Man, I really want to work on this.”
I think where you go from here is, what did you find? What did you find when you dug in? Was it like, “I'm not confident in these things”? I go, great. Can we do CE and training? You know what I mean? If it's, “I'm not comfortable, I'm afraid of anesthesia.” Great. Can we get educated on anesthesia? Can we go do work and put in time so that we go, “Oh, okay, this doesn't feel like such food anymore. I was okay before, but now I really feel good and sharp, and now I'm ready to give this another try, start slowly dip my toe in the water and kind of go from there.”
A lot of it is about getting comfortable, getting what we need, whether it's support. Some of it may be, “I don't feel comfortable because I don't have the relationship I need to have with this person that I'm working with.” I'm the technician, and then I don't have a good relationship with a doctor. Well, maybe we can work on that and see how it comes out.
I think a lot of times when we talk about being fearful, one of the big therapy approaches is cognitive behavioral therapy. Which is basically like, “Hey, if you're afraid of something and you want to do it, then avoidance is not what we want.” You know what I mean? We want to work towards it. We want to do scary things or do hard things so that we know that they don't have to be scary and so we can have some good experiences. But you want to be smart and set yourself up so that you can dip your toe in. You can do this scary thing in a safe way and start to build confidence.
And it's a process. And I think a lot of times people are like, “I'm afraid of this thing, and tomorrow I'm going to throw myself into it and I'm not going to be afraid anymore.” It's like, I don't know if that works for some people. I don't think that works for most of us. I think if there's something like this that makes you fearful or you struggle with, I think one of the kindest things can do for yourself is say, “This is a process.” I don't think it's wrong to say, if you're afraid of anesthesia to say, “My June 2023 to 2024 program self-development program, it's going to be about anesthesia. And by June of 2024, I want to feel comfortable.” And I'm like, “Man, you got 12 months to get there.” And so start small, set little milestones, and work to it. I don't know. I don't know. You're laughing. What do you think?

Stephanie Goss:
This is not Andy coaching Stephanie, because that will not be my 2024 goal.

Dr. Andy Roark:
Stephanie Goss, when I look at you, I'm like, “You know what Goss needs? Anesthesia coaching.” I don't kind of, because what would happen is I'm going to get tranquilized. If we were traveling together and you were reading a book on anesthesia, I would be so concerned, like this is-

Stephanie Goss:
No. I will leave that to McNerd all day long. That is never going to a thing. I will never be in Anesthesia Nerds. As much as I love Tasha, that is not my jam. And I did the work. I did the work to figure out the why. And then I put myself through the process of, I avoided the fear for a really long time. And then I was like, “Okay, I need to actually overcome this fear.” So I took the cognitive behavioral therapy approach, and I tried the thing in a safe environment and small doses. And at the end of the day I was like, “Okay, I can do this thing and I can survive. I am a sweaty, disgusting mess, but I can do the thing.” And it was enough for me to say, “Okay, I've done the thing and I am perfectly fine walking away and leaving the thing behind me.”
Because a part of it, to your point, was that identity work, and figuring out who I actually am. And saying, “I'm okay with this not being my whole identity,” because there's this whole new part of me that has opened up as a result. And I'm thankful. I love medicine. I love veterinary medicine. I love the science part of it. I could nerd out about so many facets of medicine from a tech perspective. And what I recognized is that my jam is not there. I love it and it's a happy place, but that's not my thing. I love the people piece of it. And I don't know that I would have ever explored it if I hadn't had done that piece of it. I might have just quit completely and walked away from it.
And so I think it goes back to that starting with why. And we were talking about the schools and coming out. And I've had a couple new grads now who have come out and they have been in that place to your point of referring, “Well, somebody who knows more than me should do this case. Somebody else should take care of this patient. I'm not qualified to do this thing.”
And I had a lot of guilt about pushing some of them to do the thing anyways, because I have practiced in places where we don't have a specialty practice down the street. They're going an hour to get critical care or specialty care, or two hours.
And so to your point, not everybody can afford it. Not everybody wants it. Not everybody wants that travel. And so we have a lot of clients who are like, “Oh no, I'm fine if you guys do the thing. Can you just do it?” And so that's part of the reality of practicing medicine where I live.
And so I went through that with some of our new grads and recognizing they have to figure this out for themselves. I can't want it more than they do, and I also have to figure out how to work with them.
And recognizing that if practicing medicine where I live means that they have to do these things, it's okay if they want to draw a hard line in the sand and say, “I do not want to practice surgery. I want to just do outpatient.” And the results of that might mean I might be able to get them a plan. I might be able to print out that blueprint, like you said, and work your way towards facing the fear. And, it might be okay that it's a line in the sand for them. And, the result of that might mean they're not the right fit for my practice.
And I think so many of us are so wrapped up in that identity piece of it, that we force ourselves to make situations work that that isn't necessarily the best choice for us, for our patients, for our peers. Because we're afraid of that identity piece.

Dr. Andy Roark:
Yeah, I agree with that. I can tell you one for me that I had to unlock, which all this code was kind of tied together, but I really stressed out about clients getting angry at me. I really did not want to have angry clients. And I very much wanted to make them happy.
Until I started to say, “Well Andy, why? Why does this bother you?” And then really started to go, it's because I am defining myself and my success by how I make pet owners feel. And until I unlock that, I was stuck in that kind of loop of, “Oh my gosh, this person's experience, their facial expressions, their online reviews mean so much to me.” And I go, “God, what a horribly unhealthy place to be.”
There's this part of the first season of Ted Lasso when Ted asked the star soccer player, he was like, “If you could be any animal, what would you want to be?” And he was like, “Why would I want to be any animal, I'm me?” And Ted goes, “I don't think you understand how healthy that is.” And it was like, that is healthy. It's like, “Nah, this is what I am.”
Again, it doesn't mean that I don't care. Of course I still do. But I think some of it was I had to go through those experiences of having clients get angry at me, and recognize that the sky didn't fall, and work past it.
So anyway, the next one I'll sort of lay down from an action step, and this has just been a big one for me and my career, is get present. I think we live in a state of perpetual distraction. And I think honestly, if there was one thing, and this is not easy to do. But if someone said, “Andy Roark, real quick, I've got 30 seconds left and I'm going to disappear, and you're never going to see me again, and I will do whatever you say. How do I be happy in practice?”
I would say get present. Get out of your head. Get into what you're doing. Be fully present with what you're doing right now in the day. Throw yourself into your work and just focus on being there with the pet, the pet owner, and with your team. And if you do that, you'll be great. And then they would disappear. And that would be my piece of advice. It's much easier said than done.
But I think a lot of us, we live up in our heads. We go, “What if this happens? What if this goes bad? What if this doesn't turn out the way that I thought?” Well, the truth is, you'll cross that bridge when you come to it. You can ask yourself this question then say, “Is this going to change how I am behaving right now, the choices that I'm making?” If the answer is no, then put it away. Get back into what you're doing in the moment.
I think another thing that I've been thinking about saying to the graduates when I get up there… And again, I won't be able to say all these things. It'll come together. I promise it will work, and it'll be better than I'm making it sound now. I promise. But if I can give them a piece of advice, it's try to love the mundane work of being a veterinarian. Not to define yourself by the outcomes, but to actually enjoy just doing the work. Being in the room, enjoy talking to the clients, enjoy talking to the staff. Just try to enjoy the mundane parts of actually doing.
And I think a lot of that is absolutely key to getting out of your head about being afraid, being anxious, being fearful. Just get present. Are you going to do this surgery? They're not going to the specialist. This dog's got a splenic tumor that's bleeding. Are you going in there, or are you not going in there?
And if you're going in there, get present, deep breaths, get your stuff together, what prep do you need to do? And then go to work, and just put yourself into it. And I think that that's really the key for getting past a lot of this stuff, and also just enjoying what we do for a living.

Stephanie Goss:
Yeah, I would agree with that. And I think that when I look back at my career and I think about some of the highlights, I think some of the best days are the days where you were fully present. Whether it was for a period of time sitting with the owner while they said goodbye to their best friend, or even doing the difficult surgery, truly being present and letting go of all of the distraction, and just doing the work. Those are some of the best days.
And especially as we shift in our career I, think to a leadership perspective, your point is such a good one. Because I think about how many days I showed up in the practice for my team, and I was thinking about 10 million other things. And I never did my best work when I was thinking about all of the other things, when I set it all down and said, “I'm going to give my full attention to this thing.” Whether it was holding a patient in the treatment room because they needed help or sitting down and having a one-on-one with somebody on my team, that's where we engage with ourselves, with our patients, with our clients. And also with our fears. Because if we're not really giving it 100%, we're never going to be able to address those.

Dr. Andy Roark:
Yeah, I agree. I saw an interview with basketball coach Phil Jackson… And the guy's like a legend, and he's won 11 NBA titles and whatever. He was just talking about his players and he was like, “Getting these players to be present in the moment when the media is around them, and taking pictures of them, and making stories, and people are trying to get their attention.” And it's so much distraction.
So he would have all of his players wear a rubber band around their wrist. And the idea was that they would snap that rubber band and that little ouch would bring them back to the present. But he was like, “Yep, everybody on the team wore it, and we would snap it, or we would have other people would reach over. And if they thought you were zoned out, they would snap it to get you to come back.” And the whole thing was meant to be, “Get back here in the moment,” right here in the here and now. I think it's a big part. So I've got that stuff. I've got one last piece for me. Are you ready for this?

Stephanie Goss:
Lay it on me.

Dr. Andy Roark:
All right. So this has been an important thing for me recently, and it's where I've been living. And man, I really love this. So I saw a quote. It was from Tumblr, and it was a science fiction writer. But she wrote this thing that said, “The opposite of grimdark is hopepunk. Pass it on.” And what she meant was, there's so much of a desire in our society to be afraid, and to be cynical and to say yes, things are bad and they're going to be bad.
And people seem to believe that if you want to look smart, you should assume that things are going to end badly, and you should expect the worst. And we all know people in vet medicine that as soon as a sick pet comes in, they go, “I bet it's got parvo.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And they'll just go straight to the cynical, to the darkness, and they do it because it's a self-protection mechanism. If you assume that things are going to be bad, then you're not disappointed when they're not. And there's a lot of people who just live there.
So when I talk about the opposite of grimdark is hopepunk, the idea is I really believe that we have settled into a society that's built on fear, and it's built on cynicism. The idea that things are bad and they're going to continue to be bad, and it's all founded on badness, and everything is a crisis, and blah, blah, blah. And they hold onto that.
And I don't say that hopepunk, it's not a rejection of those things. I'm not saying that there aren't hardships in medicine. There are. I'm not saying you're not going to get a group of people on Facebook who hate your guts and are coming after you, or that a case isn't going to go bad and you're going to have a pet die. That's going to happen. This is a hard job and people are hard to deal with. They are. And anyone who tells you, “No, that's just a mindset.” Those people are out of their minds. It's not. That's true. That's real, right?

Stephanie Goss:
Yeah.

Dr. Andy Roark:
Things can be real and you can still push against them. You can still rebel against the system and the society. And that's kind of where I am, is I think it's time for rebellion. I think it's time for revolution.
And the way that we revolt against cynicism and fear in practice, it's not positivity. It's not saying, “No, things are good.” That's got its own toxicity, right? That's rejecting things that are objectively true, which is like, this is scary or this is hard.
The way we rebel against fear and cynicism is with optimism and hope, right? It's going in and saying, “Yeah, I get it. Things are hard. And you know what? I'm going to stick it to the system by believing that tomorrow might be better than today, by believing that I have the power to make something good right here, right now.”
And I get it. Life is hard, but I am going to go out of my way to help somebody else. Not because I want them to write a review, just because I want to push back against darkness in the world. And guys, I think it's time for rebellion in vet medicine. I think it's time for a hopepunk rebellion. I do.
I keep going back to punk, right? Because punk rock music, I like punk rock. I like the idea of people who are like, “You know what? I'm a misfit. I don't fit in with this, and I'm okay with it.” And I'm like, yeah, I'm a optimism punk. That's what I am. I've got a smile and a wink for a Mohawk, and I've got a freaking, “Hey buddy, let me help you out,” face tattoo. And that's it. I am going to wear that punk rock sneer, because I know that I'm going to jump in and help you. And if there's a change that has to happen, I'm going to say, “What if this works out even better than it has been guys? What if this turns into something really good?” Because that is punk rock today. The idea that things could be better in the future than they are now is so anti-establishment I love it. So last thing I would say is hope punk revolution in vet medicine. That's what I want.

Stephanie Goss:
Come over to our side. We have Andy and a mohawk, and tattoos, face tattoos.

Dr. Andy Roark:
That's right. Face tattoo that says, “Have a nice day,” and, “This might all work out great.” That's what my tattoos say. And that's it. Join the hopepunk rebellion. I don't know if there's anything better against feeling fearful than to say, “You know what? I am going to embrace optimism. In your face.”

Stephanie Goss:
With my face.

Dr. Andy Roark:
With my, that's it. That's all I got.

Stephanie Goss:
That's all I got.

Dr. Andy Roark:
All right, good. All right. I think we're out of time. I'm pretty sure we are over time here. Yeah, we better wrap this one up. All right guys, thanks for being here. See you next year… See you next week. I'll see you next week. You know why I'll see you next week? Because you're non-healing wound.

Stephanie Goss:
A festering wound of MRSA that's never going to leave you alone.

Dr. Andy Roark:
Yeah. Yeah. You were mine, met cell and resistance staph infection-

Stephanie Goss:
I'm with you for life now. Like a face tattoo. Have a great week everybody.

Dr. Andy Roark:
Stephanie Goss is my face tattoo like, “It might have been a mistake when I got her, but I'm in it now. I'm in it now.” All right. Thanks buddy. Bye.

Stephanie Goss:
Well gang, 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 us 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. Take care everybody, and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: closing, fear, Practice ownership

Jun 14 2023

A Case For (and Against) Saturdays

This week on the podcast…

Leslie Mamalis, Senior Consultant at Summit Veterinary Advisors, joins Dr. Andy Roark to walk through how she advises veterinary clinic owners or leaders on how and when to consider closing on Saturdays.

ABOUT OUR GUEST:

Leslie is the Senior Consultant with Summit Veterinary Advisors, a nationally recognized business consulting firm. Leslie’s specialties include practice valuations, profitability assessments, feasibility analyses, and transition planning for veterinarians across the country. 

Leslie has an MBA and an MS in Information Technology and became a Certified Valuation Analyst in 2013. She worked for the American Animal Hospital Association (AAHA) for seven years, beginning with management education seminars and then becoming involved with the accreditation program. She is a member of the National Association of Certified Valuators and Analysts, the Veterinary Hospital Managers Association, VetPartners, and the VetPartners Valuation Council.  

Ms. Mamalis is an author and frequent speaker on practice value, profitability, and owner transition. She is an original columnist in Today’s Veterinary Business. Leslie has extensive experience helping veterinarians and managers understand financial reports so they can use that information to increase practice profitability and value. 

Uncharted Veterinary Podcast · UVP – 236 – A Case For (and Against) Saturdays

You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Amazon Music or wherever you get your podcasts.

Submit your questions here: unchartedvet.com/mailbag


Episode Resources

Summit Veterinary Advisors – https://summitveterinaryadvisors.com/

Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/

Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark


Episode Transcript

Dr. Andy Roark:
Welcome, everybody to the Uncharted Veterinary Podcast. I'm your host, Dr. Andy Roark. I actually, I made this podcast, guys, the one you're listening to right now with my friend, Leslie Mamalis, and I was going to put it out through my Cone of Shame Veterinary Podcast. It's a podcast I talk about what's going on in medicine and I tend to have guests on and do interviews, and I really liked this interview with Leslie a lot, and I was talking to Stephanie Goss about the case for and against Saturdays, and she said, “That's an Uncharted podcast, Andy.
These are the types of management decisions that we work on and weighing the pros and cons and looking into how to make decisions about when we're open and what we do with our hours, I think that's a great Uncharted episode,” and so she really, she twisted my arm and so I'm going to put this out as an Uncharted podcast. Guys, I hope that you'll love it. It's a little bit shorter than our regular Uncharted podcast, but I think it's a really, really good one. Leslie's amazing. She is a senior consultant at Summit Veterinary Advisors, and I give her more of an introduction when we get into the episode. Guys, let's get into this.

Speaker 2:
And now, the Uncharted Podcast.

Dr. Andy Roark:
Welcome to the podcast, Leslie Mamalis. How are you?

Leslie Mamalis:
I'm doing great, Andy. Thank you so much for having me.

Dr. Andy Roark:
It's my pleasure. So I was checking and confirming your title before you came on, and it is Queen of the Universe.

Leslie Mamalis:
It is, yes.

Dr. Andy Roark:
Okay, good. Boy, I got to tell you, the quality of guests I'm getting on this podcast just keeps going up. It's amazing.

Leslie Mamalis:
You're moving up in the world.

Dr. Andy Roark:
Really pulling them in. As a queen of the universe, Leslie Mamalis, you are also, when just have free time, you are senior consultant at Summit Veterinary Advisors.

Leslie Mamalis:
That's right. That's right. Summit just celebrated 25 years too so it's tradition.

Dr. Andy Roark:
You and I have known each other for a long time. We've been on the speaking circuit together doing practice management stuff and things like that. You write a column that I really enjoy in Today's Veterinary Business. I like to read your stuff on practice and practice management, and you had a column not long ago, that was The Case for and Against Saturdays, and I enjoyed it. I think that there's a lot of value in coming with a balance of saying, well, sometimes this makes sense and sometimes it doesn't.
I think a lot of people have really felt shoehorned into Saturdays. I think the pandemic was a really interesting shakeup time when people started to really question, wait a second, what are we doing and how much do we have to do and what do people really want, and so I wanted just to go through the exercise with you of evaluating the case for and against Saturdays if you're a small animal medical practice. Is that okay?

Leslie Mamalis:
Absolutely. Absolutely. And just as you're saying, there's been pretty significant social changes over the past few years that are making veterinarians reconsider Saturdays and office hours in general.

Dr. Andy Roark:
Well, talk to me about that. Let's just start at a high level. Why are we having this conversation? What are the social changes you're referring to?

Leslie Mamalis:
Well, for forever, veterinary practices were open six days a week or five full days, plus Saturday mornings at least, sometimes later, and that has been the expectation for eons because you needed to be available for clients who needed to come in on Saturdays because they were working. Well, with the pandemic, oh my gosh, things changed so much because for one thing, some practices weren't open at all for a period of time and then there had to be so much caution taken with segregating staff, making sure that the employees were safe and healthy so that you could continue to have the practice open, and Saturdays just were not feasible. It was so hard to staff Monday through Friday, and frankly, clients weren't going anywhere. There weren't going into the office frequently, kids weren't at school, there weren't after school activities.
Social life really got very quiet for a long time, and so veterinary practices who closed on Saturdays because of the pandemic now have come out of that and wondered, should we reopen, and honestly, during the pandemic, I think a lot of people got back to what really matters in their life and they enjoyed having a little slower pace, and Saturdays became family time or personal time and not time to run around doing errands or working, and the value that comes from having two consecutive days off is tremendous. If you have just one day off a week or you have one day off and not the following day, you're spending that day doing errands, doing chores. You're not getting any time to relax and refresh. By having two days in a row though, you can accomplish all of those must-dos and also have time for yourself and your family.

Dr. Andy Roark:
Do you see a labor shortage in veterinary medicine and do you think that contributes to the idea to either not do Saturdays or to continue, or to either drop Saturdays or to continue not doing Saturdays? So I don't want to make too many assumptions. When you're shorthanded, I feel like people look for reasons. One is how do we make it go with the staff that we have, but then I also, I can go from there into recruiting people and is that a perk that people like is not having to work on Saturdays, and so is that hooey? Is that made up, or do you think that's real?

Leslie Mamalis:
I think it's real. I think maybe we're taking it a little farther than reality truly suggests, but is there a labor shortage? I think there's a labor shortage in almost every industry right now, and it's not that there aren't enough people. It's that people don't want to work as much as they used to because they're not seeing the value. The money isn't as important for whatever reason, and that's true even now that so many of the government incentives and extended unemployment, et cetera, those benefits have ended, but we're not seeing a rush of people back to, especially some of the less skilled jobs.
And I'm not seeing that there are many unskilled jobs in veterinary medicine, but if you look at fast food or retail, something like that where you don't have to undergo a lot of training in order to do work, there's still not a rush to go back to those jobs. So I also believe that it can be a shortage of people who want to work for what you're paying, and that certainly has changed somewhat in veterinary medicine because practices have had to pay more to keep people, and honestly, high time. It's time that veterinary medicine wasn't the underpaid profession, especially for veterinary nurses, for receptionists, for veterinary assistance. People should be able to make… I'm sorry, I'm really going off on a tangent here.

Dr. Andy Roark:
No, no, go ahead. I love it.

Leslie Mamalis:
So people need to be able to work at a veterinary practice and support themselves and their families. So it was important and a very necessary change that wages have increased. They needed to, absolutely, because I'm tired of seeing good people leave the profession because they can make more money doing something else.

Dr. Andy Roark:
Sure. I think all that makes sense. Let's go with this a little bit and let's just say that I am the owner of a three doctor practice and I have increased wages for my staff, so I've got a bigger payroll than I've had before, you know what I mean? I'm able to retain people the way that I've wanted to, and the staff has brought me this idea that maybe we don't need to be open on Saturdays, and so maybe my kids are young and then I would like to have two consecutive days off as much as anybody.
Walk me through how you would advise me here. So Leslie, I brought you in and I say, “I'm looking at this. I don't really know where to start. It's a scary thing. I know that Saturday is my busiest day. I know that people show up. The idea of not being here is scary, and at the same time, I would really like to not be here and people are telling me, ‘oh, don't worry. The clients will come on other days,' and I don't know if that's true. I've got at least a couple of people who have told me they're not coming if I'm not open on Saturdays.” How do you walk me through a decision making process?

Leslie Mamalis:
Absolutely. Absolutely. So we need to start from where are you located because if you're in Denver like I am, it's a different decision than if you're in Lander, Wyoming where I grew up and it's about 10,000 people and there are two veterinary practices. So if closing on Saturday is not going to impact your clients or your community in a negative way such that it outweighs the benefit that your practice will get, then that's one decision, and I'll talk a little bit more about that. So if you're in a metropolitan area and there are emergency clinics that are open on weekends, open during the evening, it's less of an issue for you to close your practice on Saturdays.
So yes, there are absolutely clients who need to come in on Saturday, whether it's because they just prefer to come in on Saturday or they cannot get in because they cannot get time off work or they've got little kids at home, or there's some reason why they can't come in. So there are so many things that go into a decision related to closing on Saturdays. So certainly, there's the doctors and staff at your practice, there's your clients and what their needs are, and then there's the community needs, and we need to consider all of those together.

Speaker 4:
Hi, friends. Do you struggle with finding the right cadence for team meetings in your practice? Do you feel like maybe you're meeting not enough or maybe you're meeting too often and you're stuck in meeting hell? I feel you. Finding that balance, trying to work on improving communication, make sure everybody stays on the same page and getting things done in a busy vet practice is really, really hard, but we've got a solution for you. Join the Uncharted community on July 1st, 2023 from 4:00 to 6:00 PM Eastern Time. That's 1:00 to 3:00 PM Pacific for an Uncharted workshop presented by my friend and colleague, Maria Pirita.
She's a CVPM and if you've not met Maria before, you are in for a spicy treat. She is amazing and she is super excited to kick off the conversation, talking about team meetings with her take on making them effective and efficient. That's right. It's called Effective and Efficient Team Meetings. It's $99 to register, but it's free for our Uncharted members. Now, if you've never been to an Uncharted workshop before, this is not your traditional webinar where the presenter or the speaker sits there and talks at you for an hour. The goal for our community workshops is to make them live.
We don't want you to sit silently in front of your screen. We want you to be engaged and interacting for the one to two hours that you're meeting with our speakers to have the chance to ask your questions, to talk to your peers, and interact with other rockstar veterinary professionals because that's what you are, and we want to see you there. So head on over to unchartedvet.com/events to sign up for this workshop and check out what's coming because we've got a bunch of stuff coming up in the future that you don't want to miss, and now, back to the podcast.

Leslie Mamalis:
Saturdays so often are a pain in the butt to schedule, not for the clients, but for the staff. Doctors don't want to work Saturdays, staff don't want to work Saturdays, and too often, the Saturday shifts end up with people calling out for whatever reason, and so the people who are left working, they're overburdened, and after a while, that becomes to feel really unfair. The other thing is if for those clients who have Saturday appointments, if they're coming into a practice that's now understaffed, their experience is not going to be nearly as positive as it might be during the week, and Saturdays can absolutely become crazy.
Some Saturdays are nice and everything works really well, and staff show up, clients are on time, nobody has an issue, but those Saturdays are so few and far between. It's much more likely that Saturdays are going to be crazy. There's going to be a mob scene because you're going to have clients who have to come in today, can't possibly wait until Monday, refuse to go to the emergency clinic for whatever reason. Perhaps it's because it's really not an emergency. So often, the stress level in the practice goes up, the quality of client communication and client care goes down.
Patient care, I'm going to hope is always good. May not be absolutely what you wanted it to be, but it's always good care. It's the client that gets the raw end of that deal, either through needing to wait much longer than they expected for their appointment or they're not getting the attention they expected, they're not getting the full explanation maybe from the receptionist, et cetera. So that can be difficult. For staff, I never minded working Saturdays when I knew that I was going to go in and come out and at the time I expected, but I would work my shift and go home.
So often, that doesn't work though because you've got to stay late to finish appointments, deal with that emergency or transfer the case to the emergency clinic. You've got to clean like crazy and you're there for two or three hours later than you expected to be. Once in a while, that comes with the territory of working in veterinary medicine. Once in a while, that's not a big deal. Every time, that becomes a big deal and so you start getting dissatisfaction and disgruntlement with staff. People start resenting working on Saturdays and which makes it even harder to schedule them.

Dr. Andy Roark:
Okay, this is not the argument I thought you were going to make, which is interesting. I think all this makes sense and I have 100%, I was lamenting recently, I was working in the clinic on a Saturday and we were really busy and I had some people who went up to the front desk and they were like, “Is Dr. Roark always so rushed? We didn't feel like we got to ask him these questions,” and they had a pet with allergies and they had transferred from another vet, and it was just interesting in that I was doing my best to try to keep up with the flow of patients coming in and I didn't have time to sit down and do the whole allergy talk with them.
And so I tried to specifically answer their questions and then I was onto the next room, and it bothered me because I thought their critique was valid. I really did, and at the same time, I don't know what I would do differently because I had other sick patients and so I was really pinched, and it was one of those ones where I rolled around and I go, I see their criticism. I see its validity. I don't know what I would do differently if I was back in that position, and that always bothers me as systemically, it feels broken, and so it's interesting to me that you say, well, all these things happen.
And I see them all, you're exactly right, the staying in the afternoon, the people calling out, and then we're shorthanded and we're still dealing with this, the dump truckload of stress, but they're all tied around this being a really popular day, and so I have a hard time teasing those two things apart. If I was this practice owner, I'm looking at you and saying, wow, but these are all problems of popularity and people wanting the service. Are there things that you can do to help assuage my fears that the biggest day of the year, if I just stop doing it, that all that revenue's going to go away? How do you help people not grab onto that idea and just cling to it?

Leslie Mamalis:
Sure, and that can be difficult. So my recommendation would be start by closing every other Saturday. If you're really worried about losing a lot of revenue because you're not open on Saturdays, start by closing every other Saturday and look at other times during the week when you may be able to expand hours. So could you stay open until 7:00 or 8:00 one night a week? Could you open a little bit earlier? Could you do more to encourage people to use drop-off appointments? Are there other ways that you can move cases during the week, but allow your clients to still have the flexibility of dropping that pet off and not needing to take time off of work or to still get their kids to school on time?
So certainly, looking for other places during the week where perhaps you could expand hours. Many of the practices we work with work half days on Wednesdays. Could you open Wednesday afternoons, and again, just adding even if you stayed open until 6:00 or 7:00, assuming that you… I'm surprised by the number of clients I work with that are open 9:00 to 5:00. I kind of wonder, when would I take my pet then, but if you're open 9:00 to 6:00, could you stay open until 7:00 twice a week and just stagger employees. If you're not doing telemedicine, so many practices had an immediate turn to telemedicine during the pandemic and a lot of them have stopped.
It's like, why, because if you can do telemedicine, now I don't have to worry about juggling my three cranky cats and trying to get them into the practice during the week right after work, right before work. So finding ways to use telemedicine, finding ways to use more technician appointments, finding ways to just expand the ability of the practice to serve clients with existing staff and also in existing office hours. Now some people are going to leave, absolutely, and unfortunately, a couple of those people are going to be people that really surprise you. They're the ones that you've really enjoyed working with, but for whatever reason, they just can't fit into your hours. That's okay. We have to let it be okay for clients to choose to go somewhere else and not take it as a crushing blow to our egos.

Dr. Andy Roark:
Easier said than done.

Leslie Mamalis:
Absolutely. Absolutely.

Dr. Andy Roark:
But yes, you're right, but oh boy, that hurts.

Leslie Mamalis:
It does.

Dr. Andy Roark:
Oh, man.

Leslie Mamalis:
It absolutely does, but if you can have a calmer environment, happier staff who are more engaging with clients, it will be easier to replace the clients that you lost by not being open on Saturdays. So by starting to just taper Saturday hours so that you're open every other week instead of every week. Gosh, look back to what people were doing prior to easy access to emergency care. Veterinary practices, you rotated. It's like you got together with a group of your colleagues and everybody picked a weekend and you were on call that weekend and it worked. So sometimes it's okay to go back to what worked long before you were a veterinarian, just because if people really need access on Saturdays, they can still get that care.

Dr. Andy Roark:
I think this really speaks to a fundamental philosophic shift that I think a lot of people have gone through, and I think you put your finger on the very beginning of going back to the pandemic and people spending some time at home and starting to think about what they wanted their lives to be like and things like that. I always thought in my thirties especially, I was pretty darn convinced that bigger was better. You wanted to have more doctors, you wanted to be open more days, more hours, see more patients.
And that's what success was, was this escalation of service capabilities and service providing to the public and that was where the success path went, and I remember I was running strategic planning for this veterinary practice owner and I was talking to her about where she saw herself in 10 years, and I was like, “What's your big plan? Where does this look in 10 years,” and she said, “Andy, I have a three vet practice and I love it, and I don't want any more vets and I don't want any more clients. I want to do what I'm doing now and I would like that to be simpler. I would like it to be easier for me to do what I'm doing now,” and that absolutely broke my brain at the time.

Leslie Mamalis:
Absolutely, absolutely. Because we've all been taught that bigger is better and if you're not moving, if you're not growing, you're in trouble, right?

Dr. Andy Roark:
Yeah, exactly. And this is a conscious movement away from that. This is consolidation to say, no, we're going to see a little bit less. We're going to ratchet this down. We're going to have more time away from the business, and I really do think that's a very modern idea and I think it's probably a really healthy one. Leslie, thanks so much for being here and thanks for talking through this with me. I really appreciate your time. Where can people find you online? Where can they read more of your stuff? Where can they learn more?

Leslie Mamalis:
Sure. Summitveterinaryadvisors.com is our website. We're on Facebook and the Insta, and you can find my articles on Today's Veterinary Business. I write the Money Matters column.

Dr. Andy Roark:
Excellent. Well, guys, thanks so much for tuning in. Leslie, thanks so much for being here. Take care of yourselves, everybody. And that's it, guys. That's the episode. That's what I got for you guys. I hope you enjoyed Leslie. Again, I really appreciate her. She's wonderful to work with. She's so insightful and so, gang, anyway, Stephanie Goss and I will be back for you next week doing our regular thing. Can't wait to talk to you then. All right. Take care of yourselves. Be well. Bye.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: closing, culture, Practice ownership

Jun 07 2023

Are We Still Doing Non-Competes?

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are in the mailbag with a question that might just light this episode on fire. An associate vet who is thinking ahead to owning their own practice is asking if they are nuts for considering throwing away the non-compete option someday as a practice owner. Especially when they view it in light of their own personal experience trying to separate from a toxic practice they found themselves in! Andy and Stephanie have some fairly strong opinions on this one so hang on folks, let's get into this…

Uncharted Veterinary Podcast · UVP – 235 – Are We Still Doing Non – Competes?

You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Amazon Music or wherever you get your podcasts.

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

June 21, 2023: Teaching Strategies That Foster Team Learning and Development with Josh Lucas

This event is for Uncharted Members. Learn more about teaching strategies for your team from former teacher-turned-practice-manager Josh Lucas. This is a members-only event. Join the Community for more content like this coming soon!

July 1, 2023: Effective & Efficient Team Meetings with Maria Pirita

Have you ever felt like your team would benefit from meeting more often, or maybe a little less often? Do you struggle to find techniques that truly make your team meetings effective? Find the right balance in this workshop.


Episode Transcript

Stephanie Goss:
Hey, everybody, I am Stephanie Goss and this is another episode of the Uncharted Podcast. This week we're diving into the mail bag, but we're picking out a letter. This one was kind of handpicked because I had a wonderful time talking about this exact topic with some of my peers last week at our Uncharted April Veterinary conference. So we're recording this, this isn't coming out until the end of May, but I was having this conversation about non-competes and feeling pretty fiery about it and lo and behold, there was something in the queue from the mail bag from an associate vet who is asking the question, “Am I kind of on planet crazy to consider one day, when I own my own practice, not having non-compete be a thing in that practice?” Andy and I have some strong thoughts on this topic, so let's get into this one, shall we?

Speaker 2:
And now the Uncharted Podcast.

Andrew Roark:
And we are back. It's me, Dr. Andy Roark and Stephanie, a kiss is not a contract, Goss.

Stephanie Goss:
That time you weren't ready.

Andrew Roark:
No, I… Okay. I was like, “Yeah, no, we're going.” And then I didn't. I double took. Yeah, A Kiss is Not a Contract actually is a song by Flight of the Conchords who I love.

Stephanie Goss:
I've not heard from those guys in a hot minute.

Andrew Roark:
Oh no. I still listen to the classics. Business time, still makes me just laugh.

Stephanie Goss:
Oh man.

Andrew Roark:
Oh man, I celebrate their collection. Oh boy.

Stephanie Goss:
How's it going?

Andrew Roark:
Oh man, it's good. It's good. It's raining here and so I've got a rowdy doodle that-

Stephanie Goss:
Wants to go out.

Andrew Roark:
That's determined to just make havoc because he can't go out.

Stephanie Goss:
Yes.

Andrew Roark:
So yeah, he woke up-

Stephanie Goss:
Shockingly it is also raining in Washington.

Andrew Roark:
Oh wow. Yeah. Oh, well, works out sometimes.

Stephanie Goss:
Because it's always raining here.

Andrew Roark:
Yeah, no. It's been beautiful.

Stephanie Goss:
Yeah.

Andrew Roark:
We're getting into the summertime in South Carolina at this point when it's coming out and boy, it's beautiful here, but it's nice to get a little bit of rain.

Stephanie Goss:
Yeah. Well, I am excited. I picked this one out of the mail bag. You guys have been doing a great job of sending in questions because there's quite the little queue built up in there, but I was having some conversation… Our Uncharted April event, when we're recording this, you and I just finished that last week and we're having some conversation about this topic and when I saw this mailbag question, I was like, “Ooh, let's do that one,” because I'm still super, super excited about it. So we got an email from someone who is currently an associate vet, but who is wanting to become a practice owner. And so they had quite a toxic environment that they were working in and quit their practice and the resulting interactions between themselves and the practice owner as they were exiting that practice left them thinking ahead to what they don't want to do one day when they're a practice owner.
And so their specific questions have to do with employment contracts and non-competes. So they were saying, “I find non-competes to be a little bit outdated, especially since I live in a pretty dense urban area. The non-solicitation piece I totally get, but who am I to begrudge an employee if they can find a better opportunity elsewhere? And with clients, there are so many of them that I really feel like, in an urban setting, “Does this really matter?”” And they were asking, “When I'm thinking ahead as a practice owner, am I crazy for thinking about disregarding non-competes from my contracts? What are your guys' takes on non-competes?” And I just was like, “Oh yeah, let's talk about this one.”

Andrew Roark:
Yeah, I think this is good. I think non-competes are an area where there are some significant changes that are taking place.

Stephanie Goss:
Yes.

Andrew Roark:
It is a big deal. I was talking to my friend, Dr. Lance Roasa, who's a veterinarian and also a lawyer, and he helps veterinarians with contracts. He's an awesome guy. I've interviewed him a couple times on the Cone of Shame podcast and this was something that he really teed off on as far as a hot area where change is really happening. So I think that that's really cool. So I'm happy to talk about this and where I think it's going and where it seems to be going. And then also I think we could talk in a little bit broader context about contracts in general. I think that that's a fun conversation.

Stephanie Goss:
Sure. Okay. I'm up for it. Like I said, we were having some soapboxy kind of conversation about this last week, so I'm excited. I'm here for it.

Andrew Roark:
Yeah. So before we start talking about non-competes, we need to talk about what the importance of the contract is. And I think a lot of people hand wave over this and they say, “Well, you get a contract. That's just what you do.” And I think there's a couple things about contracts that people maybe don't really think about or don't really understand. And so I will share with you through a school of hard knocks a couple things I have learned about contracts. I am a big believer in the idea that a contract is probably only worth the reputation of the two people who sign it. I really am. I think a lot of people, because they want to believe they have control in this world, believe that they're going to get a contract and that is what will be, and what is written in that contract is chiseled in stone.
And I can tell you, having navigated more of the legal system than I ever wanted to, that's not true. And I wish that it was, but it's not. You say, “Well, this is written down. How could that not be held accountable?” The two things that I would say to people is some people just flat out lie. You could say, “Well, they didn't do this.” And they'd say, “Yes, I did.” And you're like, “No, you didn't.” And unless you can prove that they did not do something, they can say that they did. And it is wildly frustrating, but there's nothing you can do about it. And I think that happens a lot. And they can also make up things and say that you did them. Unless you can prove that you didn't do the made up things that they said, they can muddy the waters.
Oh boy, that's a story for another day. But anyway, it is just a truth about our legal system is I always naively just kind of assume that people would be honest and what was written down would be enforced. And I can tell you, having played the game for a little bit, it ain't that way. The other thing is that enforcing contracts is really expensive. I mean, it is really expensive. Because you're hiring a lawyer at hundreds of dollars an hour to wade into trying to enforce this contract. And if you are going up against, especially a big company, one of my friends, as he put it, was, “Andy, you're fighting a grizzly bear with a pocket knife and it's not going to end well.”

Stephanie Goss:
That's a good analogy.

Andrew Roark:
It's a good analogy. You go, “Oh, I'm going to go up against the legal department of this massive corporation with my buddy Earl, the local attorney. This is going to go well.” Nope, nope. So anyway, those are hard lessons about contracts that I have learned, and I should have given a trigger warning before I laid that down because some people just really don't want to hear that, I'll just tell you that. That's the American legal system in a lot of ways. And I can't speak to the Canadian legal system, but that's it. I will also say, just as we talk about contracts, that suing people is a terrible, horrible experience that you really, really, really want to avoid. You want to avoid suing people as much as you want to avoid being sued. The whole thing is awful. And so when you start thinking about contracts, start thinking about, “What does this really mean and what is really going to be enforceable? And what am I actually going to do if this person violates these things? What are we going to actually do?”
And I'll save you a lot of turmoil that I went through over the years but the ultimate outcome is it's all relationships. It's all relationships and clear expectations. And so I'm not saying I don't use contracts, of course I do, but I think have a pretty healthy view of them, which is, I really don't want to use this. I think the big things that I want here are clear expectations about what I expect and what you can expect from me, and that is the most valuable part of the contract. And then just a focus on a relationship, which means I want to be a good, trustworthy, honest person and I want you to be a good, trustworthy, honest person. And we're going to communicate as we go along as if we didn't have a contract and we just had to work it out on good faith. And that's my best advice on contracts. And so as I start to lay that out and say, “This is what I've learned about contracts,” you can already probably see where I'm starting to go as far as non-competes and things like that.

Stephanie Goss:
Yes. And the other thing that I would add is I think it's funny, I remember really fairly early on in my career as a manager, I remember being asked to sign a contract. And I remember talking about it with my colleagues. And at the time, managers didn't have contracts, it was just doctors and everybody thought I was crazy. But I'll tell you the secret from a headspace perspective, because I think you're spot on, Andy. And for me, maybe I was just young enough and dumb enough and naive enough to not be worried about the legal perspective of it. And what I mean by that is I understood the gravity and I understood, “This is a legally binding document and I'm signing the thing.” I got all of that. And to your point, for me it was about spelling out the plan, spelling out the expectations on both sides.
And I was looking at it from a headspace perspective of, “Am I going to feel good going to sleep at night if I live up to the terms that I'm agreeing to? And on the flip side of that, if the other person in this relationship or persons in this relationship don't live up to their side of the bargain…?” I had a mentor explain it to me, and this was the light bulb moment, they were like, “You should have no qualms about walking away if you've lived up to your side of the bargain and they don't.” That's how I sleep easy at night. And that was really from a headspace perspective was the light bulb for me because it shifted my mindset when it came to the contract into the space that I think you're talking about, Andy, which is, “What's the point? What's the why behind it?”
Well, for me, on a personal level, I'm a big advocate for it, even for our team members, which a lot of managers look at me like I've completely lost my mind when I bring that up. But it's about clear expectations. It's about knowing what I want, what I can expect on both sides, and what my employer, in this case, generally can expect from me as an employee and what I can expect to receive from them.

Andrew Roark:
It should be a two-way document like that. That is the why of the contract for me. Now, additional point I want to add, as you say that, it is amazing to me how many people sign contracts without reading them.

Stephanie Goss:
Oh my gosh, yes.

Andrew Roark:
That's bonkers.

Stephanie Goss:
That's frightening.

Andrew Roark:
And I have seen it so many times and in big companies, I've been like, “You guys signed this thing, you signed this?” And don't be that person. Do not be that person. When you ask Andy Roark for advice and I look at it and go, “You signed this?” It's important, it's important if you're going to sign it… Especially if you're going to sign something that someone else wrote, you better really just read it and know what's in it.

Stephanie Goss:
Yes.

Andrew Roark:
And so that's the other part. The last thing I'll say about contracts, and this is sort of where I came to in my career a while back with contracts. And so this is what I aspire to, and I think that our writer will probably like this. I've talked on the podcast a number of times about Rawls' Veil of Ignorance and Rawls' Veil of Ignorance is this sort of mental exercise where you look at a system and you say, “If I was dropped into a different chair at the table than the one I'm at now, would I be okay with that? Would I feel like the arrangement was fair?” I'm not saying, “Would I be happy necessarily but would I feel like it was fair?” And that's Rawls' Veil of Ignorance. So I run Uncharted and we hire presenters and speakers and I have worked as a presenter and speaker for years and years, like 15 years now I've done this.
And it's interesting to be on the other side of the table because I'm looking at the event part and saying, “Boy, we got to pay the hotel and we got catering, all these things and blah, blah, blah.” And it has always been important to me to put forward a contract that I would think was fair if I was a speaker. That doesn't mean I would take it. I might say, “This is not enough money for me,” or blah blah, blah, blah, but I would feel that it was fair and I would not feel that it was a manipulative contract or it was trying to take more than what I thought was a fair agreement. And so I really tried to work it backwards and forwards to say, “Do I feel good about this as a person writing the contract? Would I feel that this was fair if I was signing the contract?”
And again, this is sort of a philosophical point, but I really think that that's what we should aspire to. I think that's part of being a good, honest, ethical person and a good employer is to say, “I want an agreement that works for me and I believe it's going to work for them and we can talk back and forth about it, but for the most part, I want this to be something that if I was on the other side, I would say, “Okay, I understand why you're asking for what you're asking for.” And we can decide whether it's 14 days of vacation or 10 or 20, but the basic idea being, “Okay, there's a limited amount of vacation and it's clearly stated and I'm on board with that.”

Stephanie Goss:
Yeah, I'm so glad you brought up the point about the fairness and looking at it from through Rawls' Veil of Ignorance, but also the perspective of, “Did you read this because I really can't believe you signed this?” From a headspace perspective, that's really important to me because if you read it and it seems incredulous, you should probably ask. You know what I mean? You should listen to the Spidey senses. And I speak not so much from personal experience, but I've had multiple conversations with young veterinarians and I know, Lance, having worked with as many vets as he has over the years, has heard this time and time again. To your point, people can ask for whatever they want. So as a practice owner, there's nothing to stop me from throwing out a contract that says you have to give me 12 months notice as a veterinarian because maybe in a perfect world, that's what I would want.
On the flip side of that, that's where I would be like from a headspace perspective, “Oh buddy, if you don't read that and you don't look at that and go, “I'm not signing this,” I'm giving you permission, look at that and say, “I'm not signing this,” because that's nuts.” That's where from a headspace perspective, we have to think about it from the perspective of a relationship. And sometimes relationships work great and everything works out really well and sometimes they don't. And so not to assume bad intent because we want to assume good intent, and so when we're framing it on both sides, we should think about it through the lens of good intent. And we should also think about it from the lens of, “This is a relationship and what happens if it doesn't work out? What does that look like?”
And it amazes me how often… And unfortunately this veterinarian who wrote into us found themselves in that predicament where they were trying to get out of their contract and they then went back and read their contract and sure enough, there was a clause in there that bit them in the butt in a big way. And they were like, “Well, never going to do that again,” which is where this came from. And it never ceases to amaze me how often I see that being the case for veterinarians and it makes me really sad.

Andrew Roark:
Well, the notice of leave part is one of the three big bugaboos that I see in contracts with veterinarians, and it's a really wonderful example of that Rawls' Veil Of Ignorance. And I say this because I talk to friends who are practice owners and they say, “Well, if you tell me you're leaving, Associate Vet Andy, it's going to take me four months to get another doctor given the hiring climate right now. And so I need you to give me four to six months notice so that I can find another veterinarian and my business is not damaged and I don't have to worry about having to lay off support staff because we don't have enough doctors,” and blah blah. And they have a very reasonable case from their side of the table on why they would like six months of notice.
And that's why the Rawls' Veil is really good because I said, “All right, clear your mind for a second. Now you come sit on my side of the table and you're an associate vet who's unhappy here or whose spouse is trying to leave. Are you going to stick around for six months after realizing that you need to go? Would you be willing to live apart from your spouse because they got a new job and you have to live alone for six months and pay two rents or a rent and a mortgage? Come on.” That's ridiculous if you put yourself on the other side of the table. And again, I'm not trying to vilify the owners, I understand exactly why they feel the way they do, but part of a good contract is to say, “I see this. Surely the associate vet recognizes, hopefully they recognize, why I need some runway. I need to know a bit ahead of time.”
And I don't know if people understand or not, I mean I hope that they do. So there is a reasonable amount of time to say, “Hey, go find yourself another vet and I want to give you some time and support you while you do that. And at the same time, I need to be free to go on and live my life after I decide that I need to go somewhere else.” And that seems very reasonable as well. So that's a big one. And again, I've seen so many doctors that when they recognize how much notice they're supposed to give is when they decided to leave and they're like, “Oh, 90 days? I'm supposed to do 90 days?” I'm like, “Yeah, that's what you agreed to.” So there's that. The other two areas I always throw out when I say to people, “You didn't read your contract?” The non-competes are a big one.
And I feel like the vet schools have done a good job where there's been a lot of business education in vet schools in a way there did not used to be. So I feel like this is less common, but boy, I remember 10, 12, 15 years ago, there were a lot of doctors who looked around and they were like, “I'm not happy here. I'm going to go work across the street.” And they looked down and it was like, “Oh no, I signed a 30 mile. I am not able to work in this town. My 30 miles runs out in the farmland outside of town, which means basically I have to leave town because it didn't work at this practice.” And I go, “Oh boy, that's a big one.”
The last one is negative accrual, which is again, it was phrased in a way that people didn't really recognize what it meant. And so what happened was the doctors would say, “Oh, I get paid on production, that's great. Let's go.” And what they didn't realize is that if they didn't hit their production numbers, they had to give back the amount… Oh, not really. But the amount that they came up short would be held against them as opposed to resetting and letting them try again next month. And so they would come in as a new graduate into a new system and they wouldn't have cases lined up and they wouldn't come anywhere close to hitting their assigned number.
And then they're so deep in the hole that when they are a good productive veterinarian, they're still buried underneath the deficit they had when they weren't fast and they weren't seeing cases. And again, I also understand from the practice owner's standpoint, when they say, “Well, I'm supposed to pay this person and if they're not generating revenue, then I shouldn't have to pay.” I'm like, “I get it kind of,” but also put yourself in the position of the doctor and you go, “This is not going to fly.”

Stephanie Goss:
It's funny because I can absolutely see both sides on all three of those points. The non-compete, the negative accrual, the leave, I can see arguments on both sides like you laid out. And so for me now where I'm at in my career, I look at it and I think for a lot of practices, particularly I would say that the reasoning behind it is different I think in corporate practice structure often from private practice structure, but ultimately I feel like there's a root of commonality between the two. And that is, “We don't like conflict.” And really for a lot of people, the contract serves to avoid communicating about those hard things. And so the negative accrual often is one of those things. And it's funny because I worked in a practice that paid their doctors solely on production, private practice, and we had negative accrual and I didn't think twice about it for a really, really long time.
And then I had an associate who was on the other side of the table and was asking some really great questions that really made me think about it. And what I realized is that that is a perfect illustration for we choose to have the contracts because we're afraid of the communication that has to come once someone isn't doing the thing that they're supposed to be doing, right? They're not upholding their end of the bargain. And from a headspace perspective, I think it helps get us into the place where we can assume good intent on both sides because if we look at it through the lens of, “Oh, we might be trying to have this document that will help us avoid some of this conflict,” it becomes easier to I think assume that good intent. And what I would say is, as leaders, whether you're a manager, practice owner or director, it's bullshit. You have to communicate.
So now my point of view has changed radically. I don't want to have to have a contract that has a non-compete or has a negative accrual because realistically, I really truly believe I'm not doing my job as a manager if I can't have the hard conversation with an associate, whether they're a new grad or a tenured doctor like yourself who's been practicing for years. If there's a change in your production level over time and you're not producing to pay yourself, that's a conversation that I should be able to have. I shouldn't have to say, “Your contract says this is what you're going to do, so this is the lever that I'm going to pull to get you to do what I want.” I should be able to take accountability for that and I should be able to have that hard conversation.

Andrew Roark:
Well, I love that you say that. It is amazing how many policies and contractual pieces are put into place to avoid having to actually manage people. And there's this fairytale of, “If you set it up the right way, you don't have to manage people.” That's the whole pro-sol mentality for doctors is, “We pay them, they have a base salary and then we pay them on production, and then that way they're going to work hard and they're going to work up cases and I don't have to talk to them about their medical skills and what they're recommending in the rooms because it all takes care of itself. And I guess-“

Stephanie Goss:
“Because if they want to get paid, they're going to do the things that I want them to do.”

Andrew Roark:
Exactly. And you go, “That is not true. You still have to manage those people,” but it's amazing how much that's set up to be that way. One of the things I want to say about contracts, and you propped this into my mind, one of the absolute critical things to remember with contracts is there is no right or wrong here. A lot of people are like, “Okay, Andy, tell me what to ask for my contract and I'll go and get it. So negative accrual, out. Six months of notice, out, blah, blah.” The truth is none of those things are chiseled in stone. My thing is not to say to you, “Don't take a negative accrual contract.” It's not. It's to say, “You need to understand what the deal is and then you need to decide what is right for you and your family.”
I don't think my employer would mind me saying this at the vet clinic, but I work on a straight production at the vet clinic where I work and I love it and I do not expect any sort of a base salary or anything like that because I have great schedule flexibility and I travel and I do lots of other things. And the deal with them was, “Hey, let me come and work and I'll have sort of a flexible schedule, but I want to be here. I want to see cases and then we'll do a production deal and that's all you have to pay me. And that way if I travel, you're not losing any money,” whatever. It works great for us and for where I am in my career. So I would not knock anybody that. If a vet understands what negative accrual is and says, “I understand why you want this, and so I'm going to agree to it,” I'm fine with that. I really am, as long as everybody's eyes' wide open about what the deal is and why it is.
And I'm trying to think of a reason an employer would want that. Maybe the vet is pushing for a really high base salary and the employer's like, “I don't know that you can make this.” And so they say, “Well, we'll do a negative accrual then.” Maybe that's a compromise that works. And so if so, I don't want people to say, “Oh, she said the words negative accrual and Andy says that's horrible.” It's not. That's not how life works. It really is about your specific relationship and what you get. And so the last part I want to put forward sort of in headspace on contracts is this. And so I want you to hear this because this is really important. If you go into a contract trying to get ahead, you are limiting probably the outcome that you can achieve.
It's like the prisoner's dilemma. So the prisoner's dilemma is this psychology game where we set it up and the game can be a little bit complex, but basically the idea with the prisoner's dilemma is you have two players in this game and the best outcome for you in the short term is to try to screw over the other person. And if you screw over the other person, then you will get the better outcome. However, if both people try to screw each other over, you get the worst outcome. And so in the short term, the best thing is for you to screw the other person over and then not to screw you over. If you play the game multiple times in an ongoing way, you very quickly realize that the best possible outcome is collaboration. Don't screw them over and they don't screw you over and we get the second-best outcome again and again and again and again and again and again. Otherwise, you'll screw them one time and then they'll try to screw you and then you both end up screwing each other and you get the worst outcome again and again and again.
And I see contracts like that. So I hope that's not too far of a stretch, but basically the idea is if you go into it going, “Aha, I'm going to stick this associate vet I'm hiring,” or you're the associate vet and you're like, “I'm going to ask for this ridiculous thing and force it…” Like, “I'm going to ask for a salary that's way beyond what I can actually earn or justify and I'm going to use hardball tactics, I'm going to get it,” you might get it, but you're going to have a short tenure at that practice and it's not going to be fun and you're going to feel less than and you're going to have to sit to a lot of conversations about how you're not producing what your salary warrants and then ultimately you're going to leave and that's going to be how it's going to go.
And you're probably not going to be super popular when you go. And I say that to both sides. I really believe going into contracts, the best thing is to treat this like a relationship. It really is. “These are my needs, these are your needs. I want you to understand where I'm coming from and why I'm coming from here. I want to understand where you're coming from, what's important to you. Let's make this thing in a way that we both get what we need and then let's continue to communicate on an ongoing basis to make those adjustments.” And that is the strategy I think for having a healthy, happy employment.

Stephanie Goss:
Yeah, I love it. How do you feel about taking a break here?

Andrew Roark:
Yeah, let's take a break.

Stephanie Goss:
Hey, friends, I just wanted to talk for a quick second about the maths with you all because I've been thinking a lot about the workshops and normally here's where we tell you what's coming up and we've got some great stuff happening so you're going to want to head to unchartedvet.com/events and check out the upcoming calendar but I want to talk about maths because if you are not already an Uncharted member, you can attend any one of our workshops and pay $99 a piece. Most of them are just $99. You can do it as a one-off, great and fine. However, that adds up really quick. And if you do the monthly workshop with us, and I've seen some of you there as repeat customers, which is amazing, but you could spend almost $1,200 over the course of the year doing workshops with us, or you could pay $699 and get a 12-month membership, which means you get all of the workshops that we do at no extra charge.
You also get access to our amazing conversation in the community, our community members, and all of our community resources. And it is hopping over there. We've got conversation 24/7, we have got activities, we've got book club. We're writing our handbooks together in Handbook Helper Group. This year we are talking about development and leadership growth, doing our development pathway this year. We are doing hallway conversations where we're talking about topics. These are sessions that are community led, community driven. It is topics about things that are going on in your practice that you want to talk about with your peers. All of that is happening and it's all included for your $699 membership. So simple m, do you pay almost $1200 for the year or do you pay $699?
If you're not currently a member, you should head over to the website and use this argument to convince your boss. “Hey, boss, I need to be a part of this amazing community because Stephanie told me and because she's telling you that you will save money.” Hopefully that works, but I couldn't resist. I hope to see you at our upcoming workshops. Again unchartedvet.com/events for everything that's coming. And now back to the podcast.

Andrew Roark:
All right, so let's get into the actual question that we were asked.

Stephanie Goss:
Okay.

Andrew Roark:
Which is basically, “I'm thinking about not having a non-compete. I am sensing that there may be a falling out of favor. Am I about to make a really terrible decision decision?”

Stephanie Goss:
Sure.

Andrew Roark:
Exactly. All right, cool. The way I like to look at this is let's look at the non-compete real fast and let's just look at the pros and the cons. So we'll start with that. I think that people in the last… Before we took a break, I said, “We need to be really honest about what do we want and need.” And if you're like, “Hey, negative accrual works for me and I understand why you want it,” then you can do that. I think non-competes can be that way too. The question for me has to be, “Why do you, practice, want me to sign this non-compete? What do you care about?”
And if they say, “Well, I don't want you to work for anybody else in town,” I would say, “Hey, you're going to need to go jump in the lake.” That's ridiculous because I would say, “I'm not interested in signing a contract that's going to make it so that I have to move away if this doesn't work out.” I'm not interested in signing that. If you're thinking about adding a non-compete, what do you care about? And I think most people when they stop and, again Rawls' Veil Of Ignorance, and they put themselves in the position of their doctor, they go, “Okay, my real fear is that they're going to go literally set up a practice across the street,” or, “They're going to get this clientele and they're going to go to our main competitor who we have a Hatfield-McCoy's feud with, and they're going to take our clients and go work there.”
And so that's why people put it forward. The other reason that a lot of businesses put it forward, just to be clear and candid about what's out there, if you're running a practice like you might sell your practice, a lot of the big buyers of practices really like non-competes. They want to have the doctors locked in there in a way that makes it hard for the doctors to leave if the sale goes through. And so what their worry is that the practice gets bought and the doctors all just flee, and now they've bought this practice, they don't have any doctors in it, and so they really like non-competes. And so there is some stability that comes from that, and there's a lot of places that want that. And so just talking about why it happens, I think there are the big reasons. Are there other reasons that you have, Stephanie?

Stephanie Goss:
I could see both of those for sure. The other way I guess that I've seen the non-compete use that makes some valid sense to me is the opening your own practice within a certain radius of the existing practice, because that feels radically different from the seat of the business owner. My associate not being a fit for my practice or being unhappy and going to work at another practice across town feels very different than my associate being mentored by me and my team and then going and opening their own practice right across the street. Those two things feel very different. And so I could totally see something in there from that perspective. But again, when you use Rawls' Veil, is it enough to justify having it in the contract? I don't know.

Andrew Roark:
Yeah, I don't know. Yeah, exactly. A lot of it was-

Stephanie Goss:
But I get wanting to ask for that.

Andrew Roark:
Of course.

Stephanie Goss:
For sure.

Andrew Roark:
And a lot of it is following suit forever. If you were an employer, you put a non-compete in, that's what you did. And so there was great pressure of, “This is how it's done and this is how it works.” So anyway, those are the reasons that I could come up with. “I don't want you to go work for a mega competitor,” “I don't want you to go and start up your own place and take half of our clients away from us. And again, can you accomplish some of that, “Don't take half of our clients away,” with non-solicitation agreements? I think you can to some degree. I really do. And then if you plan to sell the business, a buyer likes to know that doctors are locked in there. It gives them some security. So I get why that happens. What's funny is I start talking about training up a doctor and introducing them to your clients and they grow this clientele and then they leave and they work somewhere else.
You and I did a podcast back in April. It was the April 26th Uncharted. And it was about the technician that got trained and licensed and then left the practice after the practice had paid for licensing. And boy, this feels really similar. It really is that. “I'm investing into this person and putting all of this time and energy into them. And then what if they leave?” And you go, “Okay, I get it.” I think it hits very much on that same scarcity mentality of investing and then having someone go away and we don't like that. So anyway, I'll put this forward as reasons you would have a non-compete. I think the reasons that not have a non-compete, some of it would be, if you do the Rawls' Veil Of Ignorance and say, “I think most of us, we recognize that sometimes things don't work out.”
Someone comes and they work and then it doesn't work and they leave. And I would not feel good with saying to someone, “You have to leave town. You can't work in this town, so sit on your hands for two years.” I think morally I would sort of struggle with that. It doesn't feel like an equitable thing to do. So that's a big part of it. The other thing is that the winds are changing. The law is changing. In human medicine and in the legal profession, non-competes are now done. They're not allowed. And the rationale that was put forward to break that and make those things illegal is we should not have a system where doctors have a relationship with patients and then that patient-doctor relationship gets broken because the doctor has to leave because of a non-compete. We should keep that patient doctor relationship intact. The legal counsel-client relationship, same thing. That should not get broken if that person goes to work on their own or something else.
And so in order to protect those relationships, the non-competes have been struck down. I fully expect that veterinary medicine will probably fall into that same category for those same reasons. And we're already seeing that in a number of different states. There's a lot of pushback on this, right?

Stephanie Goss:
Yeah, it's been interesting to see the transition here in Washington, because they're not enforceable. And so it's been interesting to see the transition, especially working in corporate medicine. And there's often the perception of, “Well, every corporate contract has a non-compete,” and it's not true.

Andrew Roark:
Yes, I think that's important.

Stephanie Goss:
Like you said, we're already seeing it and I would expect that we continue to see it more and more and more. And from this, looking at the pros of why would you not have a non-compete, I think it's a lot healthier in so many ways. And I love the point about human medicine and legal profession because I think there's legitimacy to that. If you have a client or a patient that's particularly bonded to one of your veterinarians and that veterinarian is deeply unhappy or there's circumstances that make them want to leave their practice or they want to open their own practice or whatever it is, mentally, ethically, I guess my personal take is, “Do I really want to get in the way of that?” Leaning into your point about human medicine, if they have a relationship, go with them and I think it goes back to what you said about the scarcity mentality.
I think so many of us are afraid of losing clients, and we think about the one client, but we don't just think about the one client. We can't stop ourselves at the one client. We go from the one client to living in the forest in a cardboard box. We can't. It's just human nature. We can't stop ourselves from catastrophizing that. And so on the practice owner, the practice leader side of it, we go from that, “Well, maybe a few clients or their really loyal clients will follow them.” Well, that should be good. It should be good that they worked in my practice and they built a loyal client base who wants to stay with them because I should look at it from the perspective of, “I shouldn't be in a place where that change should make or break my business.” And I think that scarcity mentality is something that is really hard for a lot of us, myself included. It took me a really long time to get to this place. It's really hard for us to wrap our brains around because it's scary.

Andrew Roark:
Yeah, I agree with that. There's just a couple things that are just sort of absurd in non-competes that I see that people haven't really questioned for a while. Some of it was the distance in the non-competes. Like, look, if somebody's willing to drive 10 miles to see a veterinarian, for God's sakes, let them drive that far. I mean, at that point, you're getting into a relationship that that person really cares a lot about, right? And I have seen that. I've seen people put these huge non-competes out there and you go, “This is ridiculous. No one's going to take your clients at scale at anything beyond a couple of miles.” And then the other part is, and this has always kind of baffled my mind, so here's the thing, you're a veterinarian and you're going in to take a job and you're like, “I've never worked here before and I don't know anybody.”
And they're like, “Here's a one-year contract, sign this non-compete.” And you're like, “How fast do you think I'm going to meet people?” And I get that the idea is introducing it early on but here's the thing too, there's a very good chance that I'm going to come here for one year, it's not going to be a great fit, and that I'm going to leave. We don't like to believe it… I think a huge percentage of relationship, especially with brand new veterinarians, that first year in practice, they're going to leave after a year. Why in the world are you making it so they can't stay in town? It doesn't make any sense. Now, I understand when people are like, “Oh, this person's been here 10 years and they have this huge clientele,” and blah, blah, blah. That feels different. I think there's different reasons there to say, “Well, this person at this point has kind of earned these relationships,” and so on and so forth.
But anyway, that was a thing as a… I remember being a brand new graduate or even not a brand new graduate, but as someone who would move to an area and they're like, “Here's the contract. Also if this doesn't work out, you can't work anywhere near here for two years.” And I'm like, “That's ridiculous. If we get six months into this and it's not working, I shouldn't be blown up for two years. That's not right.” So anyway, I've seen a lot of that stuff.

Stephanie Goss:
And I think on the flip side for a second, you just brought up a really, really good point. So I think there's validity for not having a non-compete. From the perspective of the associate, to your point, if it doesn't work out for me, I should not be restricted for two years from moving on. That is total BS. And this is where it's about, “We don't want to communicate,” coming into play. On the flip side, as a practice owner or practice manager, why, for the love of all that is holy, why would I want to trap an employee into a contract with me where if they are miserable, they might stay just to live out their crappy contract that I gave them in the first place because they're afraid of getting sued? I don't want them to be in my practice making my life and everybody else in the practice's lives miserable for two years because they're afraid of that.
Why would I do that to myself? And yet I see it time in time again from practice owners because they're thinking about leveraging it in the positive to protect themselves. But realistically, it, also to your point, opens you up just as often to that from the negative side because it is a relationship and sometimes it works and sometimes it doesn't. And we have to think about that because we are also trapping ourselves when we use the non-compete in that regard, especially when it comes to those leave notices or the, “Don't go to another practice within a such and such certain distance.”

Andrew Roark:
It can feel punitive rather than strategic meaning, “Oh, you want to leave? I am going to shut you down. I am going to punish you. I'm going to give you a two-year headache because you left.” And that's not a good place to build a reputation. The last part, when you factor this in, is there are more and more practice groups that are advertising no non-competes. They are like, “We don't believe in non-competes and we are not doing it.” And you can take them at their word and go, “Wow, some people are really great.” Or you can be more cynical and say, “Ooh, that's a hiring advantage. They've figured out that they're probably not going to be able to keep using these anyway. And so they're casting them down and trying to use that as a strategic advantage in hiring.”
But that said, I think more and more doctors are going to hear about places that don't need non-competes or require non-competes. And so I don't know how widespread that's going to be, but I do think it's probably going to happen. And so anyway, all that around, so takeaways from me and then you can decide if you want to jump in on this, these working relationships are relationships. Everybody should be open about what they're offering and what they need. And the plan should be that the contract is part of the ongoing conversation of us working together, and they should put that down. I think non-competes are falling out of favor across the country. I don't know if that will be a complete sweeping change in the next 10 years or if that will be spotty, but they are starting to fall out of favor.
I think your options as an employer are either to say, “We are not going to use them and we're going to focus instead on just trying to maintain good relationships. And we understand that there's some risk, just like we understand there's a risk of us training our staff and then having them leave to go work somewhere else. It's just a risk that we incur.” I think that's probably the healthiest way to go. The other alternative would be to say, “Hey, I have these very specific concerns and this is kind of what I need to feel safe.” And I would say you should dig into what those specific concerns are and communicate upfront.
I mean, there is a way to say, “We're going to have non-compete. It does not kick in until you've worked here for three years. And at that point, if you're here for three years, then it's going to be a fairly limited range, and it's for these really important reasons.” I think you can talk about that just like we talked about the other parts of the contract and say, “If you have a good why and you're willing to make concessions to get the other person to agree to that, and you can articulate what your needs are, if you're okay with it and the vet's okay with it and everybody feels good, then go with it.”

Stephanie Goss:
Yeah. Yeah. I love it. And the only other thing that I would add to your point about it's a relationship and the contract helps define that relationship is on both sides. Especially knowing that this ask came to us from a potential practice owner, I'm going to throw out there, “Don't forget that needs change and they change on both sides.” And so the other piece of this that often doesn't get talked about, but I think that goes along with the ideas of non-competes and negative accrual and stuff like that, that is the winds of favor are shifting, is the perpetual contracts where it's like, “I don't review your contract again until you bring it up.” And as a manager, oh man, so much anxiety, especially early on in my career when one of my associate doctors would be like, “I would like to discuss my contract,” because it felt very negative.
It felt like, “Oh gosh, they're going to ask for some big change and it's going to be the end of the world.” The reality is we're humans in a relationship on both sides, and my needs change as an associate in the practice and my needs as a practice owner change, and we should have a system and a structure. Again, it goes back to the contract can't be the thing that you hide behind because you're afraid of the hard conversations. It has to be set up so that both people in the relationship have the ability to communicate their needs and make it work for them together. And to your point, Andy, sometimes we are in different corners. How do we bridge that gap to come together?
And so I think that's the other piece as a practice owner is if you're doing that to your team, if you're just like, “We're going to do your contract and then we're not going to review it again until you bring it up,” that would definitely be something that I would suggest. Take the stress and anxiety out of it and make a system for it so everybody knows, that it's communicated upfront like, “This is what we're going to do, this is how we're going to do it, this is when we're going to do it.” Put it on the calendar and then actually follow through.

Andrew Roark:
No, I agree.

Stephanie Goss:
Cool, cool.

Andrew Roark:
Well, I mean that's what I got. It's not the firm, “This is how you do it,” answer, but hopefully it's a good way of thinking about contracts in general. Start with the end in mind. What do we want to accomplish? Then going into the relationship, talking about needs that I have, needs the other side has, and then trying to come up with something that works for everybody. Know that non-competes seem to be losing favor. Know that there's other companies that are going without them and using that as a recruiting tool. Just adjust and react appropriately.

Stephanie Goss:
This is so fun. Take care, everybody. Have a fantastic week.

Andrew Roark:
Thanks, everybody. Take care.

Stephanie Goss:
Well, gang, 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 us 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. Take care, everybody, and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: culture, doctor, hiring, management, Practice ownership

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