• Skip to main content

Uncharted Veterinary Conference

Revolutionary veterinary marketing & business conference for those forging their own paths and telling their own stories.

  • Account
    • Log In/Out
  •  

Dustin Bays

Jan 18 2023

The Economics and Emotions of Workplace Culture

This week on the podcast…

Scott Burton MBA, CVPM joins Dr. Andy Roark to discuss the economics and emotions of workplace culture. They talk about the impact of culture on veterinary teams, veterinary clients and even in discussing cost of veterinary care.


Uncharted Veterinary Podcast · UVP – 211 – The Importance Of Culture In Veterinary Medicine (including The Culture Around Money)

This episode is made possible ad-free by CareCredit!


ABOUT OUR GUEST:

Scott Burton is the Hospital Administrator of Southern Regional Veterinary Specialists and Southern Regional Veterinary Emergency Services. Scott also prides himself on being a scholar-practitioner as he currently works on completing his doctorate in executive leadership.

The fourteen years of administration experience combined with his formal education (BA in Bible and Theology, MBA in human resources, CVPM certification, and Doctoral work/dissertation research) give Scott a unique perspective that will continue to be an asset to those around him. Before his time in veterinary medicine, Scott had extensive exposure to the financial sector as the Assistant Vice-President of a community bank. He served as the IT security officer and was in charge of consumer construction lending. His leadership skills were also recognized while he served as a personal banker with Bank of America and was recognized for his sales and leadership capacity. Scott transitioned into veterinary medicine primarily due to his wife’s experience as a licensed veterinary technician.

As a hospital administrator, Scott learned about the complex ecosystem in the veterinary hospital and the delicate balance required to generate interdependent relationships. The development of this ecosystem perspective has guided him through his doctoral research and continues to function as an illustration of cultural continuity.

Scott’s leadership model focuses on the inner nature of the individuals within the organization. His passion for creating a positive culture is more than “Friday Pizza” and involves an in-depth analysis of the emotional intelligence and vertical development of those he leads.

Scott is married to his best friend of almost twenty years (married 16) and has four beautiful children (all under 9). We enjoy campfires, smores, and hotdogs while we play soccer or bocce ball in the backyard. We also have two Greyhounds and one German Short-Hair Pointer.

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

Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Episode Resources

Strategy as Practice: https://amzn.to/3ERkOmX

Organizational Culture and Leadership: https://amzn.to/3ERkOmX

An Everyone Culture: Becoming a Deliberately Developmental Organization: https://amzn.to/3ERkOmX

Upcoming events: unchartedvet.com/upcoming-events/

Links to Amazon.com are affiliate links and help support the show. (They're also much smaller than normal links and easier to copy when typing up show notes!)


Episode Transcript

Andy:
Welcome everybody. This is the Uncharted Veterinary Podcast. Guys, I'm here with a special bonus episode. I am here with the one and only Scott Burton. Scott is an MBA-certified vet practice manager, he is working on his PhD in leadership, he has got a ton to say about culture. We get into culture as it affects the team, as it affects the clients, and we even touch a bit on the culture as it comes to talking about money in our team and with our pet owners.
So guys, I hope you're going to enjoy this. I think Scott's really, really interesting guy. Boy, he knows the research backwards and forwards. Get your pens and papers ready if you want resources. I grabbed them, I put links in the show notes to the things that he talks about, but man, get ready for a lot of information on culture from a very academic interesting place, coming at ya.
Without further ado, let's get into this episode. But before we do, I got to tell you real fast, this episode is made possible, add free, by CareCredit. Let's go.

Meg:
And now the Uncharted podcast.

Andy:
And we are back. It's me Dr. Andy Roark and my friend Scott Burton, hospital administrator. Scott, how are you?

Scott:
Hi, I'm doing just fine. Thank you so much for having me today.

Andy:
Oh man, I'm glad that you're here. So every now and then I like to step out and have conversations with other people in the industry who talk about business and think about business and vet medicine in interesting ways. And you fall into that category for me. You have an interesting background, for sure. You have a theology degree. Is that how you majored, in theology? Is that true?

Scott:
Yeah, so my undergraduate was in Bible and Theology and I minored in Youth Ministries, and so people have always been important to me. It's been very important to me and just their wellbeing. And from a spiritual level, ultimately, very compassionate about where people end up eternally. So from the spiritual side of things where I ended up. And then my master's in Business Administration, I focused on Human Resources. So that was the physical aspect of just people in the work environment and understanding how that plays into things and just the overall wellbeing of individuals.

Andy:
Gotcha. You have an MBA and a CVPM. You worked with Bank of America for a while. You were the Hospital Administrator at Southern Regional Veterinary Specialist in Dothan, Alabama, and you're working on a PhD in Executive Leadership, mostly focused on culture, is what it sounds like to me. Is that correct? I mean there's a lot of language around that, but that's what it feels like to me. Explain that a little bit.

Scott:
So essentially what I'm going to be doing for my dissertation is looking at culture in the veterinary space and culture is much broader than veterinary medicine and it goes outside of veterinary medicine, and it's really important in all organizations or any groups of people, whether it be the church, whether it be veterinary hospitals or a Fortune 500 company. And Edgar Schein has done extensive research on organizational culture and leadership and how those things fit together at infancy, an organization does have some flexibility in their culture and they're defining it and it's kind of fluid, but after a period of time it becomes very rigid and Schein outlines that stagnation period occurs and there's some concrete that sets in and organizations fail to adapt. And I think that we've seen that with COVID-19, leaders are not prepared for the unexpected.
So what culture is, or what I want to look at, is how we can have an adaptive culture where we have individuals who are coming in to our organization, we have turnover rates and our culture changes as individuals change. Our experience is different, what we've lived through is different. And so our culture has to change for those individuals. We can't stay stagnant. But if we do, what we're doing is we're asking those individuals to conform to the standards that we have already preset. It's probably best to go ahead and start with the definition of what culture is.

Andy:
So I'm going to frame this before we dive into culture overall. And so just one of the things I think is interesting about you is, I'm looking at trends and problems and patterns, challenges facing our industry and there's busyness, there's staff shortages, there's burnout, sort of rising prices for pet owners and things like that. And one of the things I think is really interesting about you, which I really want to talk about today is, your response to this is culture, culture, culture. And I'm a huge believer in positive work culture and defining a good culture in the practice and things like that.
You explicitly tag these problems with culture as a solution. And so before you start to unpack culture, I kind of want to just lay that down of what I'm looking at and the reason that I wanted to have you here and dive into this is, I want to understand how you look at those things. So I do agree, I think defining culture in your words at the beginning, I think it's really useful, so do that for me, but then go ahead and let's start to unpack how you see culture as a solution to these very real problems that are pretty common right now.

Scott:
And then that's part of what I'm trying to understand with my dissertation and the research that I'm going to be conducting is really trying to get to the root of the issue and understanding what exactly is the underlying cause of some of these things or phenomenon that's occurring in veterinary medicine. But the definition of culture that I adhere to is again from Edgar Schein and it's a pattern of basic assumptions invented, discovered or developed by given group as it learns.
So the assumption there is that culture is not just a mission statement at the front of a book. It's not pizza on Fridays. But it is a consistent message from leadership, to develop and nurture individuals and their function within the organization. So it's woven into everything that we do in our daily work life.

Andy:
Take that and bring it down for me and help me see what that looks like. I hear the words and I'm going, okay, I agree, it's not donuts and coffee, it's not a frilly mission statement. Bring that around and take me to a hypothetical practice where I can see what that looks like.

Scott:
I'm not going to use the word culture. So the environment, it's probably best illustrated through an ecosystem. And Bolton, through complexity theory, talks about or frequently uses ecosystems to describe diversity. And so if we're looking at a practice and the way the practice functions, we want to, of course, foster that diversity because in diverse environments we have the most advantage for sustainability.
But when it comes to just day-to-day life, what we see, and I'm sorry to be quoting so many different books, but An Everyone Culture, by Kegan, and it has really struck me in my thinking about just the way that we function and operate, because we all have weaknesses and when we come into an organization we try to hide those weaknesses. So when we're hired to do a job, we're essentially doing two jobs. One, we're doing the job we were hired to do, and secondly, we're hiding our weaknesses.

Andy:
Okay.

Scott:
So we're spending 50% of our time hiding our weaknesses and spending the other 50% of the time doing the job that we were hired to do. So we've come into, and it's natural, it's a survival instinct, we don't want to be fired, we don't want to lose our job, we don't want to lose our position, we want to impress, so what if in a veterinary practice we said, “You know what? I want to know what your weaknesses are.” And we focus on those weaknesses and then we start developing those individuals.

Andy:
Let me ask you about that. I love it. So it's owning the whole person, is kind of what it sounds like. So taking that, we all have strengths and weaknesses, I'm a huge believer in that. I think my thing has always been trying to figure out what my strengths are and how to lean into them. And then in other people trying to put in them into positions to really emphasize their strengths over trying to necessarily correct their strengths. Are you saying that as we sort of identify this and we put them into a framework, is this about fixing or patching weaknesses, or is this about shielding people and putting them into advantageous positions for their own skillsets? Help me understand that.

Scott:
Well actually Amy Edmondson is great, I don't know if you're familiar with Psychological Safety, but she is a great proponent of developing an arena or an environment where individuals feel safe to be able to have open dialogue and discussions with their superiors without fear of retaliation or any kind of retribution. And so if we're creating these safe spaces so that employees can come to us and say, “Hey listen, I'm really struggling with interacting with clients. I'm just not getting it”. And so instead of that individual shying away from the client interactions, they're coming to leadership and saying, “Hey, I really need help with this”. They're no longer hiding who they really are. They may have a personality conflict or a personality issue that limits them emotionally or psychologically that just keeps them from having those interactions and barriers. But knowing what those weaknesses are, we can put them in a role, like you said, where they can shine, where they can stand out instead of putting them in a position where they're uncomfortable or a position where they're destined to fail.
So instead of trying to fill spots, we need to know our individuals well enough to be able to put them in the right place. And so to me, when we look back at Edgar Schein's definition, it's a pattern of basic assumptions invented, discovered, that's that discovery portion, or developed by a given group as it learns. So we're going to be learning together. So leadership needs to be open to learn and the individuals in our environment need to be open to learn. And we need to have a two-way dialogue, two-way discussion where individuals can come to us, we can come to them and we can talk about what's really going on with people and their lives. The days of being able to hang problems at the door as we walk into work, those are over.

Andy:
I'm going to come back to that. Okay, you kind of blew my mind. The one thing I have to ask you first, and then I'm going to come back to hanging our problems at the door when we come in, because I'm going to need you to unpack that for me a second.
I'm going to be vulnerable here for a second and say one of the things that's bothered me about my own business for years is that I have always been such a big believer in getting people in and seeing what they're good at and adapting to their strengths. And the pushback that I have gotten a little bit internally is, and it comes from a good place as some people say, but Andy, we need to have job descriptions to hire and people need to come in and we need to know what they're going to do and then we're going to hire them and then we need to set clear expectations for what they're going to do. And I a hundred percent hear that.
But in practice I have never made a hiring job description that ended up being what the person actually did, and pardon me, but I've been pretty successful at getting people in and retaining them and really growing some rock stars. I take no credit for that other than not getting in their way, that's it, that's as much as I brought to the table was, ideally I like to think I put them in a place where they could shine and stayed out of their way.
But I have felt less than, at times in the past, for not having a clearly defined job description, having a role, having a spot, hiring this person and clipping them into the spot and having them effective, this is what you're doing. I always bring it in.
We just went through a period, so in our business we've gone to an expansion recently and I'll just be honest, there's a lot of times when people look at me and go, but Andy, whose job is it to do this thing? And I'm like, I don't know yet. Ask me in two weeks and I'll know whose job it is, but right now I don't know. And I felt embarrassed about that. So Scott, tell me, first of all, am I off base here? Does that kind of track with what you're saying as far as adapting to the people that are there? How do you look at that when I say it? And feel free to tell me, yes, you're off base, Andy, you should have job descriptions and stick to them from the very beginning.

Scott:
So multiple things, you hit on multiple things there, and we could probably spend the rest of the time just dissecting what you said right there. But you're looking at several different factors. So do you need a job description so people know what to expect? Of course you do. But at the same time, when you're hiring somebody, what it sounds like you're doing is you're hiring based on culture fit and people know you, people know your hospital and they're coming to you because they know what you stand for, they know what your hospital stands for and they say, I want to be a part of that.
They're not necessarily coming for the job description, they're coming for the culture that you have created. And that's what we need to do as leaders and practice owners is we need to establish our culture such, and it's not a brand, but we need to establish our culture such that people desire or want to be a part of what we're trying to do. We've established something that feels good and it's not a feel good to feel good, it's not a warm fuzzy feel good, but it feels good because you're part of something and we all have this innate desire to be part of something special.
And so what I'm hearing from you is that you have created this environment that people want to be a part of and they want to stay a part of it. On the flip side, what I'm hearing is that you have employees that may be wondering, “Hey, I don't know who is supposed to do what”. So we need to define these functions. And I'm also a believer in that if we have these functions that need to be done, we're all in this together. We're all on the same ship. If we have a hole in the ship, are we just going to point fingers and see who's going to plug the hole or are we just going to dive on the hole and try to keep us from sinking? And that's a pretty extreme example, but if our culture is such, we care enough about each other's survival in the practice, and survival's probably a strong word, but if we can care enough about each other, it shouldn't matter. It shouldn't matter. Because of eventually at some point the tables will turn and it'll be received instead of given.

Andy:
Yeah. So in this example, what happens is ultimately we do end up with clear expectations. It just takes some time after new people come in and we move things around and we figure out how to fit people in. And so ultimately we get to that place of clear expectations. So let me ask you about something you said earlier on. So coming from here is what I'm describing to you, so imagine these people coming in and they're rock stars and we're putting them in, we're trying them in some different areas, we're seeing where their skills are, what they seem to like, where they excel. And we're kind of shuffling some seats on the bus around a little bit on who does what to get the strongest skillsets where they can really shine. And so there is some uncertainty there as we move things around and fit people in. And then ultimately we sort of crystallize and turn these into nuclear expectations.
At the beginning of the podcast you jumped right in and started talking about culture and stagnation. Is this an example in your mind of periods of stagnation and breaking through stagnation where you say, this is how we interact with each other and now we have new people coming in and so if there's going to be some uncertainty that feels like there's no path out of stagnation without uncertainty in my mind. Do you agree with that? Is that an example of what you were talking about or am I off base?

Scott:
Stagnation would be more, I'm not open to changing. So stagnation would be leadership taking the mindset that we have created this, we're not open to looking at a change, we're not open to developing any more change. We are what we've created and this is who we're going to stay, which for a particular culture, that's okay, I mean you can develop a culture but you also have to understand that individuals change. And so if you're maintaining a similar culture, that's okay, but if you're saying you have to fit this mold, that's not okay. So that would be the stagnation point.

Andy:
It sounds like you are talking about culture as this sort of… I don't want to say culture as a process to you. It sounds like you are talking about an ever-changing fluctuating thing. I think a lot of people like to think, I know I've had these thoughts in my past, I'm going to get a good culture established and then I will have a good culture and from then on we will protect that culture. And what you're kind of saying is, no, it doesn't work that way buddy. You're always going to have a changing culture and so you better keep trying to keep it positive, but also know your culture this year is going to be different than it was last year. Is that true?

Scott:
Yes, it is very true. And so one of my professors, Dr. White, mentioned to me just recently that any change in culture, especially if you're trying to incite change, can take up to three years to actually implement and take place. With that is going to require leadership to be constantly monitoring and to have a strategic plan in place as far as where we are and where we're going. Culture can happen accidentally, but good culture doesn't happen overnight, and it's not set it and forget it. It is an ongoing process that never ends.
So if we're under the assumption that we have arrived as a culture, again, that's where we fall victim to that stagnation and our culture will immediately start to decline. Edgar Schein goes on to say that if we don't manage culture, culture will manage us. And if you look at some of the hospitals that are struggling with it, if they're truly transparent and honest with themselves, what they have done is they have focused on the processes of what needs to happen. I need a person, I need a warm body, I need somebody to draw blood. They hire the person to draw blood, they're meeting that immediate need, but the long-term need of that culture is sacrificed. And when they sacrifice that culture, it makes it harder to hire that next person.

Andy:
When you talked about managing culture, I hear that. You've also talked about asking people to leave their personal issues at the door, that's not how it works anymore. And so I want you, as we talk about managing culture, I want you to go back to that statement and sort of unpack that for me as well because I think a lot of people have said, I know it sounds cold-hearted when people say, look, leave your personal things at the door. What they're really saying is, they're trying to figure out how to reduce drama and extra emotion inserted into the practice. And so it sounds like a good idea to tell people don't bring your personal issues to work, come to work and be at work and then go home and be at home. And I a hundred percent can understand that. Talk to me a little bit about your perspective on that. So you don't like the idea that we leave our personal issues at the door? Tell me more.

Scott:
Yeah, I can just tell you from personal experience. This past month my children were ill with the flu. I had the flu, my wife had the flu. It was incredibly difficult and we had to depend very heavily on our staff and our hospital to help carry us through that. And they were very understanding and very gracious in allowing us, and I say allow us, because we didn't hear any grief from them, we didn't hear any complaining from them regarding our absence when we were ill or taking care of our sick children. That was outside of the practice, but it affects the practice.
And so we cannot ignore the fact that we have lives outside of practice. The whole work-life balance thing has become almost trite that it's said so much. And when you're talking about work-life balance, what does that mean? What is that definition? And really what it boils down to is what am I willing to tolerate at work to justify being at work, to justify not being at home. And that's that work-life balance, or how I see that work-life balance.
When I left the banking industry, I was working 25 hours a week, I was getting paid for holidays, had 12 Mondays off a year, had two weeks of vacation, on top of that had tons of time off. You talk about a work-life balance, it was great. And I left that to work 45 – 50 hours a week. Now tell me how that makes sense from a work-life balance situation. Well, what it ultimately amounted to is what I was doing at the bank didn't align with what I needed personally in my personal development. And so I went somewhere that did.

Andy:
I love that. I love that way of putting out work-life balance. I don't like that term work-life balance, I think you perfectly illustrated why. To me it's really sort of work-life integration, right? I'm sure I'm not the only one. My life's kind of complicated and things come to work with me and things go home with me and I try to make sure I have time to rest. But the idea of, I need to work eight hours in a day, be with my family for four hours in a day, sleep eight hours a day, and that is perfect work-life balance. Well that doesn't tend to work out. I think my math is off, but you get the point. Four hours of personal time of me doing hobbies.
Anyway, that never works. It's always kind of a hodgepodge back and forth and so when you lay out this theoretically nice schedule that you had and say, well this isn't work-life balance that I'm okay with, and then you jump into another thing where you're working much more, I get that. That to me matches the reality that I see when we talk about the idea of work-life balance.
Talk to me a bit about managing sort of emotions inside the practice. So we're still talking about culture and we've talked about that sort of psychological safety and that makes a lot of sense, but I can only stay after this integration of me being a human being and not being able just to put the fact that my kids are sick but beside me or leave it out outside, I'm bringing that in. Talk to me a bit about how we integrate the emotional experience that people have into a positive culture, as opposing to try to get people to be non-emotional or leave their personal life outside.

Scott:
And that's a very difficult thing to do. I think that there is certainly some voids there, and certainly in the emergency arena where you're dealing with a lot of trauma, you're dealing with a lot of clients that have emotional shock from what has just happened to their pet, to euthanasia. I think from the emotional standpoint, we have to be able to have a networked community within our hospital to provide that emotional support. We cannot be cold, callous or say you just need to suck it up and do your job. We need to allow for breaks, we need to allow for time for recovery after those events. Because our staff, our doctors, are very much connected to the cases, especially when they're trying to save them or something unexpected happens that they're trying to do CPR, they're trying to revive them, any number of different things, something goes wrong and then they have to go tell the family and the children that a member of their family is no longer with them.
That takes an emotional toll and over time that weighs down on a person. And so there needs to be an emotional release of that. There needs to be a way for them to talk about that, what they're feeling, how they're feeling. And as leaders, we need to be able to sense that. We need to be able to pick up on that. And it's not just, how you're doing, I'm doing fine, and move on about our day. We checked it off, they're okay, we're moving on. No, we need to have meetings, we need to have debriefs and talk about what just happened.
We have a client that comes in, it's a bloat, they don't have the financial means to take care of it, they end up euthanizing the dog. Emotional toll on the staff, well let's talk about it. Listen, that wasn't your decision. It was out of your control. This was a choice that they made. This wasn't a choice that you made. You did what you could do, you did your part. How does this make you feel? Probing questions, allowing them to vent, allowing them to cry if they need to. Just providing that safe space, again, just that emotional safety is key to providing safe environments in the culture. Because if we're telling them, listen, that's not okay here, you've got to pretend to be something else. Again, we go back to that, we're hiring you to do this, but we need you to fake and be somebody else.

Andy:
I can feel a certain subset of listeners recoiling, and I feel it too. So in your mind, these type of probing questions, this is a leadership skill, is asking people to sort of unpack how they felt about this and to have these types of conversations. Where is the line in that where we say, I do want to be supportive and at the same time I'm not a therapist. And I worry about the slippery slope, obviously, of everyone coming to me every day to talk about how they're feeling about things and I go, I'm not really qualified to have this level of input into how you're coping with things. Help me understand that a little bit.

Scott:
Well, and I think it's with anything, and especially with our industry and so many suicides within our profession, I think that as leaders we need to be aware of the emotional state of our staff and be able to help them find the resources that they need. We don't necessarily need to provide the answers, we need to provide them with ways to find the answers. So I'm not going to have the solution to provide them, but sometimes they just need somebody to sit there and listen.
And I've found a lot of the time it's just being able to listen. My wife has told me multiple times, I don't want you to fix the problem, I just want you to listen. And listening goes a long way to just helping people feel important, help them feel like they're being heard, to be able to vocalize the way that they feel can have a major impact on just how they're internalizing their emotions, to be able to just get it out there on the table.

Andy:
So I definitely hear that. I think you're onto something as far as, again, I like the idea of psychological safety and people knowing that they're able to talk about how they're feeling, especially when things are coming up inside the practice. I think that that's really important. And also I also buy into the idea of being able to ask these types of questions as a modern leadership skill. I think maybe 40 years ago you said no, you leave personal life at home and we go… I don't think that resonates with the people that we're leading anymore, so I'm on board with where you're going. Convince me that this sort of approach on culture and an evolving culture, convince me that the pet owners see and feel this, that actually has a positive impact on the pet owner experience. Because you talk a lot about culture with financial conversations, like with pet owners who are having a negative experience. Talk me through how you make that leap.

Scott:
So the best example that I could provide you is just, in our practice we have pet owners who interact with our staff and they just appreciate the communication. They can tell a difference in the way things are communicated. It's hard to put a pulse point or put it into words how that culture is communicated or translated to the clients, but there is a connection and a bond that's transferred so that they can feel the interconnectedness and the relationships and the bond that we have as a hospital, and they feel safe. I can't tell you how many times pets have come into our hospital and the client is saying they're going to freak out, they're not going to feel safe, and even the pets respond differently in our hospital. So I mean there is definitely something to that low tension interconnectedness that takes place, that does transform and create an environment that is welcoming and open to others who enter it.

Andy:
Do you buy the idea that if you create a workspace where your employees feel sort of psychologically safe, where they feel like mistakes are not the end of the world and where they're not continuously being judged, or they're being judged fairly and they know what expectations are, those people are more likely to interact with pet owners in a more relaxed manner or more natural manner and sort of head off some of the more emotional confrontations that we see.
I think some of the real conflicts that I see are when I have a support staff member who feels like she's stuck and she needs to toe the line or her hands are very tied, and then I have a pet owner who feels very stuck and that their hands are very tied and I see an escalation that I don't tend to see in interactions where the staff members are maybe a little bit more laid back. They can still enforce policies and protocols, but they do it with a, I'll just say a certain confidence that they don't otherwise have. Does that make any sense to you? Does that resonate at all?

Scott:
It does. It does, because when you empower your employees to be able to act on your behalf and they're not having to second guess everything that they do, they're able to act more freely, but they're also less prone to make mistakes because they know that if they do make a mistake, it's either, one, fixable or two, it's okay and I'm going to learn what the right way is.
Early on when I started, I was very rigid in the way that I approached those things and tried to have protocols for everything, but you can't predict every scenario and you can't predict every interaction that's going to take place. And so the theme started to become, listen, we need to do what's best for the client. We need to do what's best for the client. And then in the end it will ultimately be what's best for us. And so we've adapted and changed the way that we do those things and I think that individuals feel more empowered, individuals feel more free to make decisions on their own within the framework of what they already know is acceptable and okay.
And the best illustration that I can give you is a playground company did a study of kindergartners, they built a playground, it was an enormous playground, and they put all these nice playground structures up and they just let the kids lose. Well, what they found is the kids only played with the implements that were stationed next to where the teachers were standing. The really big stuff or the nice stuff that was in the back of the field, they didn't even go back there, until they put up a fence. Once they put up the fence, the kids explored every inch of the field, they engaged in more interactive play, they ventured further away from the teachers.
And I think that that's where we need to be as leaders, is we need to clearly define what the parameters are and say listen, within these parameters, go at it. And give them the freedom to innovate, to come up with ideas, collaborate with each other, have imaginative play, and find new ways to handle the problems that we're facing today. It's not just up to me, it's up to everyone, and let's collaborate and come up with a better solution.

Andy:
I love it. Okay, so here as we're sort of coming to the end, what are the biggest steps that you see that people can take to start to build a culture like this? So first of all, I love that story. I've not heard the fence story before. It completely makes sense to me, I really like that analogy. How do you build that fence, I guess, what are the big things that you think are easy steps that practices can start to take. And again, this is going to be a work in progress, but what can we start to do to build out our culture that's going to make for better practices?

Scott:
So I'm one of those people that I see articles that say 10 steps to success, or 10 steps to a better practice, and I just start laughing because not every practice is identical and not every practice is going to have the same people working for them or in there and they're not going to have the same experiences. So it's very comical to think that there's a do step one, two, three, four and ta-da, you're there.
For me, if it's about building a better culture, I think the biggest thing that has to happen is that it has to start with leadership in just establishing some transparency and saying, listen, we know, or just admitting and saying something's not right. Okay. What is it? Being transparent with yourself and saying, I don't have all the answers. They may. My staff may. Am I willing to listen to my staff, hear what they have to say and change because of it? And if you're not at that point, you're not ready for cultural change. Because if you're not ready to change based on what your staff are telling you, then you're not ready for it. You're not ready for it. Because ultimately culture involves everyone. And if you're going to be dogmatic in your thinking, then you basically have isolated yourself in a silo and everybody else is going to do the same thing and it's not a collaborative environment anymore.

Andy:
Yeah, I like that a lot. I think a willingness to try things is a big one for me. I think a lot of people hear conversations like this and they go, I don't know if I'm ready to let go of control, and what if they want to do these things that are terrifying and I go, one of the big things for me has been, not saying we're going to radically change what we're doing, you just have to be willing to try some new things and see how they go. And that helped me early on to let go of the steering wheel so hard and just go, you know what, we're going to listen and we're going to try some things and then we're going to make some adjustments, but I found that to be really good.
Scott, what are your favorite resources in this arena? I know that's a huge topic. You've thrown on a number of different studies and books and things that you like, but if someone's like, man, I really like what Scott's talking about, this makes a lot of sense to me. What are some of your favorite resources to get people started on the topic?

Scott:
Well, if you're looking for a complete overview of organizational culture, I would say Edgar Schein's Organizational Culture and Leadership is probably the best handbook regarding culture. I think that that is going to provide you with a overall framework of what culture is, how it works and things that you can do. But it's just an overall in-depth understanding of what culture is.

Andy:
I'll put links to all these in the notes. I know people are probably frantically scrambling for a pen. No, go ahead and finish up, but I'll put links to these in the show notes.

Scott:
And Everyone Culture by Kegan, it is another book. It gives some case studies of organizations. One organization specifically, they bring people in, send them through a bootcamp and then have the organization vote as to whether or not the individual is buying into the culture. If they're not, they give them $5,000 and tell them to go on their way. I mean, it's just amazing the different ideas that you can glean from that book. It's where I've got some of the resources and some of the quotes from, some of the things that I mentioned today.
Another one is, and it's not something that I really mentioned today, is Strategy as Practice, which is Paula Jarzabkowski, which is a very hard name to spell and pronounce, but she's a professor in Australia. But she looks at an organization and basically what we do is part of strategy culture in the organization. So she gives an example of a man who was a brake attendant on a train, and he was realizing that there was excessive wear on one of the wheels, so he was putting extra oil on it. When he retired, he left, new person came in and the wheels kept burning up, they couldn't figure out why. Ended up costing the rail company tremendous amount of money because that experience and knowledge was lost when that man left. And so Strategy as Practice is a great resource to help us realize the value of the individual and just how important that knowledge is and that experience is from each individual person. We may not know their value until they're gone, but we need to dig deep and understand their contributions.

Andy:
Oh man. Scott, thanks so much for being here. I really appreciate your time, man. Guys, I'm going to put links to the show notes for the books that Scott laid out for us. Gang, take care of yourselves, be well and we'll talk to you soon.
And that is our episode, guys. I hope you enjoyed it, I hope you got something out of it. Big thanks to Scott for being here. Big thanks to Care Credit for making this episode happen without any advertisements. We can't do it without support of our partners. Gang, that's it, that's what I got. I hope to talk to you very soon. Take care, be well. See you soon.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: culture, management, money

Jan 11 2023

Coaching Spicy Tenured Team Members

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and special guest practice manager Maria Pirita break down the problem of what to do when one of your seasoned team members turns spicy! In this question from a conference attendee, we have a lead technician who is not doing the “menial” parts of her job and is being rude to other team members. How are we going to handle it? Let's get into this…

Uncharted Veterinary Podcast · UVP – 213 – Coaching Spicy Tenured Team Members
guardianvets logo

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

Thank you to our sponsors! To learn more about this week's sponsor, GuardianVets, check out their website HERE.


Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Upcoming Events

January 21, 2023 – Start The Year Off Right Series: Loading the Bus with Stephanie Goss

Do you have the right people to go where you want to go? This workshop will help you look at the people in your practice and find their strengths, acknowledge the challenges and still reach the goals of your practice together. We'll help you look objectively to make sure everyone is in the right seat on the bus and discuss what to do when we decide someone needs a new seat or maybe should get off our bus altogether.

April 20-22, 2023 – The Uncharted Veterinary Conference

Climb aboard with members of the Uncharted Community and our sea-worthy crew for a new adventure in veterinary medicine April 20-22, 2023 in Greenville, SC. 

Get ready to explore new harbors together in overcoming digital communication pitfalls, developing resilience in an emotionally taxing field, and focusing on communication to build a positive team culture.

All upcoming events

A UVC MEMBERSHIP IS YOUR KEY TO FINALLY GETTING THINGS DONE AND GROWING YOUR VETERINARY PRACTICE.


Episode Transcript

Banfield Pet Hospital Logo

This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.

Dr. Andy Roark:
Hey, Stephanie Goss. You got a second to talk about GuardianVets?

Stephanie Goss:
Yeah. What do you want to talk about?

Dr. Andy Roark:
Man, I hear from people all the time that are overwhelmed because the phones never stop ringing. And I'm sure you hear from these people as well, our caseload is blowing up, and the doctors are busy, and the phones just don't stop.

Stephanie Goss:
They never stop. That is true story.

Dr. Andy Roark:
I'm amazed by how few veterinarians know about GuardianVets. This is a service where you have registered technicians who can jump in virtually and help you on the phones. You can flip the switch and GuardianVets can jump in and take some of the load off the front desk, and they can handle your clients and get them booked for your appointments and give them support, and it really is a godsend.

Stephanie Goss:
Pre-pandemic, it was amazing to me how many people hadn't heard about it for after-hours call help. But at this point, I can't believe how many people don't realize that they are offering help during the daytime as well, which I would think right now is a huge benefit to practices because everybody is shorthanded. Everybody is drowning in phone calls. And so we talk about it, we've talked about GuardianVets a lot on the podcast and every time we do, we always get somebody who says, “What is that?”

Dr. Andy Roark:
Guys, if you're not familiar with GuardianVets, if you think that you could use some help on the phones or up at the front desk, check them out. It's guardianvets.com and if you mention our podcast, me and Stephanie Goss, you get a month free. So check it out, guardianvets.com.

Dr. Andy Roark:
Hey, everybody. I'm Dr. Andy Roark and this is the Uncharted Podcast. Man, it's been a while since I got to do that. Welcome, welcome, everybody. I am here with Maria Pirita today. We are breaking down how to coach the spicy tenured team member. What do you do when you've got somebody who's been on the team for some time? They may be a shift lead, a team lead, a department lead, and they're just not performing.
Maybe they're not doing menial tasks, they're not cleaning cages or cleaning up the surgery suite because they think it's beneath them. Maybe they're just grumbling, maybe they're just snapping at people, maybe they're not treating people in a way that that person feels respected or they're throwing their weight around a little bit. What do you do? How do you talk to that person? That's what this episode is all about. Guys, let's get into it.

Speaker 3:
And now the Uncharted Podcast.

Dr. Andy Roark:
Hey, and we are back. It's me, Dr. Andy Roark and the one and only Maria Pirita. Hello, my friend.

Maria Pirita:
Hello. How are you doing?

Dr. Andy Roark:
Man, I am so good. How are you doing?

Maria Pirita:
I am so good. We just got into Chicago, and we beat the blizzard, so I'm feeling great.

Dr. Andy Roark:
Like you raced to your little den and lit your fire, and then the snow came down outside and now you're toasty as a bug in a rug.

Maria Pirita:
Yeah. I literally got hot cocoa, so now I'm just going to make my hot cocoa and watch the snowfall.

Dr. Andy Roark:
You are who I aspire to be at Christmas time. We did a workshop together, you and I, and it was like 50 doctors. And we couldn't get anything done because Maria has a Christmas tree that rotates and it was behind her, and so everyone was watching her Christmas tree just rotate, and there was like every three minutes someone would notice it and the chat would just blow up with, “I know.” And so you do Christmas really, really well. I have to say.

Maria Pirita:
I love Christmas. I've always loved everything about Christmas. My birthday's 10 days before Christmas, so I don't know if it's a mixture of both of them going together or the fact that my family always did it so big. That rotating base actually was a recommendation for my sister a long time ago. And then one time my base actually broke and I needed to go to get one, and all they had was the rotating one, so I had to get it, and it turned out to be a great purchase until we did the workshop and-

Dr. Andy Roark:
And shut it down.

Maria Pirita:
… we couldn't get through the workshop because everybody wanted to hear about the rotating base.

Dr. Andy Roark:
Yeah. The whole thing.

Maria Pirita:
It's available. It's a real thing.

Dr. Andy Roark:
The whole thing ground to a halt. Yeah. When this episode comes out, it'll be New Year. You're a big New Year person too that you go all in for 20 days.

Maria Pirita:
Yeah. I love New Year's. Man, it's a lot of fun. I prepare a lot for New Year's. My husband and I have a great tradition where we make surf and turf steak and lobster dinner, and we write out goals and aspirations for the new year, and we light a fire. And then once midnight hits, we celebrate with all of these Latin traditions, which are crazy and out there, but I absolutely love all of them. Some of them, a lot of people know about like you wear red underwear if you want love in the new year, or you wear yellow underwear if you want money. You can put lentils in your wallet and that represents that you're going to spend your money well in the new year, and all these crazy things. We do all of them. So we put 12 grapes in our-

Dr. Andy Roark:
Yes. You got multiple pairs of underwear.

Maria Pirita:
Yeah. All at once. You got to want all of them. You got to wear all the underwear. We put 12 grapes in our pockets and you make a wish with each one. But my favorite one is that at midnight you take your suitcase, and you walk around the block with your suitcase and that represents that you're going to travel a lot in the new year. And last year was actually the first year that we did that. And I will say that this past year we went to Paris and Rome, and I got to go to Greenville for the conference, and we went to Indianapolis for work too. So I would say that it worked. So if you're trying to travel in the New Year at midnight, grab your suitcase, go walk around the block with your suitcase, and you'll probably travel is all I'm saying, unless it was just a fluke.

Dr. Andy Roark:
I think some people can just stop the podcast right now. They're like, “I got what I needed for… Yep. I got what I needed.”

Maria Pirita:
Unless this comes out after New Year's, then it'll have them the next year.

Dr. Andy Roark:
Yeah. And they're like, “Ah.” Going to have to put it on the calendar. Yeah. Oh, man. So for those who don't know you, you are a newly minted CVPM. Congratulations on your new certification.

Maria Pirita:
Yeah. Thank you.

Dr. Andy Roark:
You work with us over at Uncharted, you're doing more and more of the lecturing and the lifting. And I've been so happy working with you, and I just enjoy the heck out of you.

Maria Pirita:
Oh, thank you.

Dr. Andy Roark:
And so anyway, I want to talk to you about what we got. It wasn't the mail bag, we got it at a conference. Do you want to go ahead and break down what we're looking at?

Maria Pirita:
Yeah, actually. So we were at a conference in Indianapolis and this amazing practice manager, if you're listening, you are amazing, but she was telling us about a challenge that she's having and it's essentially that she has this tenured team member who's a little spicy, we'll say. She has been with the clinic for a really, really long time. Great skills, however, lately, she's been doing things like she's been not wanting to clean up after surgery because she thinks it might be beneath her, or she's just been a little bit spicier in the way that she talks to people. And what was crazy is we started talking about it and it turns out a lot of people were struggling with this challenge, and that's when we thought, “This would actually make a great podcast episode because there are definitely things that can be done.” And I've certainly been there. Have you been there?

Dr. Andy Roark:
Yeah. Yeah, yeah. Oh yeah, totally. I think we all were. I like the term here for spicy. This is one of the things I think that you do really well. It's like that's your word. And I think it's a healthy way to look at it to say, “Oh, well, this person's a bit spicy.” It's not that they're not aggressive or angry, but once we frame them that way, they take on a villainous personality and you say, “Well, they're spicy.” And I go, “I like that, I can work with spicy. Sometimes spice is okay.”
And so I like that you frame it that way. It also brings across a lot of times what the behavior with the attitude is. And so I just want to start upfront and say, “I like how you frame this question,” and by making this person framing them as spicy, I think you're already opening up a lot of good doors for us to get things done. I don't want to be told that I'm aggressive, I don't want to be told that I'm a bully. I don't want to be told that I'm hard to work with. But if you tell me I'm being a bit spicy today, I'm not going to take that particularly hard. I think language matters and how we frame things matters. And so I like how you set that up. Just open up.

Maria Pirita:
Thanks.

Dr. Andy Roark:
So yeah, I have a lot of ideas on this.

Maria Pirita:
I love the term spicy too because… Well, I think we started using it in clinic because when we became Fear Free, that was one of the big things that they taught you is try to stop using the word aggressive or mean when you're talking about patient because they're not, they're just fearful, stressed, or anxious. And so you changing your mindset there. So we adopted it and we started using it a lot, and one of my favorite things to say to people would be, “Ooh, that came out a little spicy. How can we add some sour cream?” And it became a hit because it'd be like, okay, it's not that you are a mean person. It is totally that it just came out spicy and sometimes we all wake up a little spicy and that's okay. Just get that done and done with some sour cream. That's it.

Dr. Andy Roark:
Yeah. I like that. I think that's part of building a good culture is setting it up where we can give each other feedback that's not catastrophic or devastating, that doesn't strike at who you are as a person. But yeah, it's a little thing. I always say one of the real tricks to giving people feedback is lowering the stakes, trying to make it so it's not a big deal for me to say, “Hey, when you said this, it had this impact that you didn't really anticipate. I need you to do that differently.” How do I make that not a big deal? Like, “Hey, I know you know this.” But whenever you say something that starts with, “Hey, you”, people get real defensive real fast, and I just want to make sure you get heard. And so “let's do that differently next time. Alright. Thanks, man.” And just try to make it so it doesn't matter.
And I think a lot of times we don't say anything when it doesn't matter, and then we wait until it does matter and then we have these high-stakes conversation. So anyway, just anything that just takes the edge off and it's just like, “Hey, man, this is okay. We're just going to break it down a couple notches, but also I need you do this differently for me. Thanks, man.” I think that that's just good feedback coaching headspace.

Maria Pirita:
Yeah. Absolutely.

Dr. Andy Roark:
So speaking of headspace, let's get to headspace here. All right. Cool. So first, we start talking about this. I want to point something out in the question itself. And so one of the examples was, “Hey, this person's not cleaning up after surgery, things like that. She acts like maybe this is beneath her.” I would say, does she say that it's beneath her or is that the assumption that I, as the manager, and making about her, right?

Maria Pirita:
Absolutely.

Dr. Andy Roark:
Because one of the first things we want to try to do is assume noble intent, assume good intent. I don't want to be like, “Oh, she didn't do it.” That clearly means that she thinks she's better than this like, “I don't know what it means. I don't know why she's not doing it and neither do you.” So until we ask her, “Hey, I saw this thing didn't happen. It seems like it's starting to become a pattern. What's going on? What's the story?” That's straight up, those are the exact words I would use. “Hey, I see this, it seems like it's starting to become a pattern going on. Just what's the story here?” And then I'm going to shut up, and I'm going to let her tell me, but I don't want to try to assume what her intentions are. And she might be like, “That's not my job.”
And now I go, “Okay. Okay. I get that.” At least I understand now that she does not believe this is her job. That's not an assumption. That's what she told me. And then we can start to work on that. So yeah, I think we start off assuming good intent. It's our safe headspace, right?

Maria Pirita:
Yeah.

Dr. Andy Roark:
Can I sit next to this person? Can I smile at them? Don't give them the feedback when you are triggered. Just let it go for a day. The key is put it on your calendar. If you're triggered, you're like, “I can't talk to this person right now.” If you're me, I can't talk to this person right now and then tomorrow's not going to seem like that big a deal, and I really don't like conflict, and so I'm not going to do it tomorrow. And then after that it's going to disappear. It's not going to happen. And then we're going to do this again. So put on the calendar, be like, “All right. I'm going to talk to this person on, if I haven't talked to them by Thursday morning, we're going to talk on Thursday morning.”
But can you sit next to them? Can you smile? Are you assuming good intent? Have they been set up to fail? If she thinks this is not her job and it is her job, that's on me because I didn't communicate to her, “This is your job.” And so maybe she's been set up to fail, maybe our job descriptions are not what they should be. Maybe she didn't review her job description, maybe she didn't sign her job description. Maybe she hasn't gotten an evaluation on performance, reviewing her job description, whatever. Maybe she's been set up to fail.
And the last thing is the end result like, “What do I want?” And this is a big thing of like, look, I don't want her to apologize for not cleaning up the surgery suite. I don't care. I just want her to clean it up next time or do what she's supposed to do or come to an agreement with the other tech so that it gets done. But basically, I want it to get done. I want everybody to feel like they're being treated fairly. That's what I want. And so that's the end result I'm working towards.

Maria Pirita:
Yeah. Absolutely. And one thing that I think is really important in that is when you're seeking to understand is that sometimes it could be so many other things as far as why a person is spicy. So it really is important to ask that question, how did this person even get here in the first place? And so having that discussion, you might find out this person might be frustrated from other things happening in the clinic. Perhaps she may need some change here or there. If she's a registered veterinary technician and she thinks maybe she should be doing more as a registered tech. How many of us have credentialed technicians that we're not utilizing to their fullest potential or treating them like assistants? And so the only way you're really going to figure out how this person got here is by having that conversation and, like you said, seeking to understand.

Dr. Andy Roark:
Yeah. Sometimes these people get set up to get caught. Sometimes they're just not as savvy as the people who are really doing the dirty stuff. I hate to compare it to my kids, but it was like with my kids. My older one could just tweak my younger child so that my younger child would go off, and then everyone would look at the younger child. And it didn't take long as a parent before you realize, you're like, “Okay. Hey, older kid, I know that you are the one who caused this problem.” And you put our younger kid in a position where they're going to get in trouble. And sometimes that happens with the staff where the person who gets mad is not the person at fault, they're the person who's reacting and they're probably not reacting appropriately or else they would've done this another way. But sometimes they're reacting inappropriately to something that's not fair or just something else where somebody else has screwed them over. And that's again, that's why you just got to ask the question.
The other thing is they specifically said this is a tenured person. And so there's a couple different types of problems that come up with tenured staff that are less likely to come up with younger staff. This is broad generalities, but to me the term tenured, matters. When there's certain types of behaviors that we get, it's often they're power play behaviors of, “That's not my job, that's someone else's job.” So just some of that stuff. But the other thing is when you have tenured staff members and they're having patterns of behavior, they didn't get that way overnight. It's like you hired this person and then you were surprised that they acted this way. They've been around for a long time. So my question is, what has changed? Has this been a slow steady creep or is this something where there's something going on that has changed their behavior?
The other thing is if they're tenured, they've conceivably had a history of being successful in your practice. And I think that that's something that we can lean on. So we talk about headspace, we go, “Well, this person's been here a long time, why is this becoming an issue now?” And again, I do find it's helpful for me when I can assume responsibility and say, “Well, I've been her boss for some time and this creep has happened on my watch and I haven't corrected it.” So I got to look at myself and say, “Where did I miss a trick?” And that's just a healthy headspace to get into, make you really effective when you go and talk to the person. So that's it too.
I asked myself questions a lot about burnout and fatigue. When I have people who are tenured, they've been doing this a long time, is this person burned out? Are they just done? Is this just a general, not about work, it's just about life or things like that? Is there something else going on with them? Those are all things I'm looking for and trying to figure out, again, what is the underlying thing? Is it just straight up, “I don't want to clean up the surgery suite”? Or is it, “I'm tired, I don't see a future for myself here. I don't feel like I'm appreciated, I don't feel like I'm respected”? Those things matter.
And I'm not saying the person is right, and we may disagree. Sometimes people say, “I don't feel appreciated.” And sometimes that's valid and sometimes it's not. And usually, the truth is somewhere in the middle where they should be appreciated for some things that they do. And there's some other things that maybe they don't do that they should do. It's always a mixed bag. It's always shades of gray with people. But I'm just trying to get down into their psyche of where are they coming from and what's the real issue?

Maria Pirita:
Yeah. And I think sometimes as practice managers too, we're putting ourselves in this position where we think, “Oh, this person has great skills. They've been here a really long time. I'm afraid of losing them. So then we fail to have some of the conversations that we should have.” So another question that I would ask myself is, how often has she gotten away with this without us discussing it over and over again to the point where she thinks that this is now how it should be?
Or in some cases, they try to push buttons… Not push buttons. That's a bad way of saying it. But they try to see what they can get away with because they themselves know they're high tech skills. They know that they have the ability to draw blood, and drop catheters, and they can be in surgery, and they can do all of these great things. So there is something, as a practice manager, you have to ask yourself, “How often has this been happening? Did this become a pattern and I didn't say it so now it has become the norm?” And getting into that space mentally before you have these conversations.

Dr. Andy Roark:
Yeah. I agree with that. And I think the other thing we want to think about with a tenured team member is where do they want to go and what do they want to see in the future? And a lot of times I feel like these spicy team member, tenured team member things, they come from a place from where this person topped out, and they don't really know where they want to go in the future, or what they're going to do, or what's going to be different. So they're like, “I'm the head surgery tech and I don't want to be the practice manager or there's already a practice manager and there's not space for me. And so here I am, but I'm tired of this, but I don't really know where I want to go. And so I'm just generally at a loss for who I am and where I'm going.”
And I think that this starts to really unlock the key for me with dealing with tenured, more senior people. This person has climbed up to a place where let's say their career path may be a bit hazy in the future or they topped out in what they can do, and if they're burning out because of that, if they're bored because of that, if they're just like, “No, no, I don't see myself in the future, so I'm just going to do what I want to do right now.” That's a vision problem. It's a motivation problem. It's a vision problem. And so again, it starts we try to figure out, “Where's this person coming from? What's driving this? Is it that they don't know where they're going?” And you can ask those questions like, “Where do you want to go in next year?”
We just did with our team. Maria and I were talking and the team was there, but I was basically like, “What's your development goal for 2023? What do you want to be? What do you want to learn? How do you want to grow?” You can do that professionally. I want to do it professionally but also personally. And so just like Maria's walking around the block with her suitcase because she wants to travel. I want to know where people want to go. It's not something to hold people to, but I ask people that and now it's a great time to say, “Hey, it's the new year. Where do you want to go in the next year? How do you want to grow? How do you want to develop?” And ask them, and then when they say that, try to figure out how to get them there, how to keep growing. There's a lot more latitudes for people to grow in that medicine than we give credence to.
For example, we're like, “We have a vet assistants, and we have vet techs, and then we have lead vet techs, and that's the end of the story.” And I'm like, “No, it's not.” There's so many different subjects that we can expand to. There's so much expertise. There's credentialing, advanced credentialing, there's technician specialists, there's management credits, there's leadership opportunities, there's communication things, there's workshops, there's skill workshops, there's all these things that they can do. You can spend years getting great at dentistry, and then just roll off of that into anesthesia, and roll off of that into pain management, and into low-stress handling, into fear free. And you can work your whole career learning and growing and learning and growing. But if you think your whole path is assistant vet tech, head vet tech, that's it. That's a very short, stunted path that leads to a lot of frustration.
And so one of the big things is where do these people want to go, and can they see themselves in the future being developed, and do they feel like they're moving towards something greater? And if you can't make them see that, a lot of times you can't coach them very well. And so anyway, when we start thinking about senior people, do they see the vision for the future? Do they see where they can go? Do they see how they can grow? Are they engaged with that vision? And if the answer is no, then from a headspace standpoint, I need to figure that out because this person's going to be consistently hard to manage and they're going to be consistently hard to motivate if I can't make them see a future where they are better and more developed than they are right now.

Maria Pirita:
Yeah, Andy, and I'm so glad you said that because it actually reminds me of a spicy team member who I had when I was a practice manager. And she was amazing. She had amazing skills, the kind that you could always trust to hit the vein or drop the catheter, but she did have a bit of a spiciness around, especially around new people. It seemed like she would get frustrated during the training. So it was one of the situations where I looked at her and I was like, “Man, she could go so far. We just have to work on that one thing.” So I remember sitting down with her and having this discussion and we started on that, and on that topic is development. I asked her, “Where do you see yourself?” And she said, “Actually, I have been thinking about that a lot.” She was a veterinary assistant at the time. She's like, “I think I want to go into CVT school. And I also think that the treatment manager position looks really great.” Treatment manager was taking care of the hospitalized patients, right?

Dr. Andy Roark:
Yeah.

Maria Pirita:
And so I was like, “Okay. That sounds awesome. Yeah. Those are definitely areas we could talk about going.” And as we were discussing the treatment manager role, we got into discussing training. And so it was a perfect opportunity for me to talk to her about, “Well, I've noticed you can get a little spicy around new people. And so if we want to go down that path, there's things that we should work on there, but that's totally normal. We can work on those things. There are tons of leadership webinars that we can talk about books and bottom line, nobody became a leader overnight. And so this is great that this is the route you want to go in.” And so she said, “I know what you're talking about. The issue is that I never notice when I'm doing it until it's too late.” And I said, “I get that. I grew up around siblings, so I have a sassiness to me.” Andy, I'm sure you've seen it at conferences and whatnot, that it can happen to anyone.

Dr. Andy Roark:
You have more than a sassiness to you, just for people who don't know. You have amazing sass. I'm going to stop you right here because this is important. Maria and I were having dinner and we were at Tupelo Honey restaurant.

Maria Pirita:
Oh, no.

Dr. Andy Roark:
And she was looking at her straw. She was like, “I think the straw is made of honey.” And I was like, “I don't think that's a thing.” And she was like, “No, I'm pretty sure this is an organic straw made of honey.” And I looked and there was another straw on the table and it had the wrapper on it. And I picked it up, and it said, I read it out loud, I was like, “Made from 100% pure agave.” And Maria goes, “Who's laughing now?”

Maria Pirita:
It still wasn't honey, guys.

Dr. Andy Roark:
But that's the same thing. But you were like, “It's organic, it counts. Who's laughing now, Roark?”

Maria Pirita:
It's close enough.

Dr. Andy Roark:
Yeah. It's close enough. And I will say, I learned a couple days later, there's a store that sells honey products in Greenville. I looked in there, I was like, “Do you have straws?” And they were like, “Yes, we do.” I was like, “Oh, she could have been right.” But then I thought when they were like, “Yes, we do.” I was like, “Who's laughing now?”

Maria Pirita:
Who's laughing now?

Dr. Andy Roark:
[inaudible 00:25:13]. It's not a little bit of sass. It's a pretty defining characteristic. I love it, but let's not downplay it.

Maria Pirita:
So that's exactly what I was talking about. When I was talking to her about it, I said, “Yeah, I have sass too.” It's a matter of where to use it, and we were out at dinner in this example. So that's when my sass comes out is because I'm not working. I got it, but it's also… Obviously, I didn't talk to her about that because it hadn't happened yet.
But when I was talking to this team member, I basically told her it happens. It happens to all of us. It happens to me. And so I asked her, “What's a good system that you think would work for us to help you in this journey?” And she said, “Well, actually, if you could just point it out when you see it, if there could be a signal?” And I said, “Yeah. Absolutely.” So we decided that I would give her this eye contact and make the peace sign. Eventually, I didn't even need to make this peace sign with my hands. The number two, looks like a two. But I got to the point where I didn't even have to, I would just look over when I heard it, and you could hear her going back in herself, the way she was talking and try to formulate it a different way. And that helped a lot.
And we also talked about leadership as a whole and what kind of resources were available to her and giving her the time to do some of those and some recommendations on books. And I still remember she came to me so excited one time, she's like, “Hey, I spent this weekend reading this book that you recommended. I think it really helped me a lot.” And I will say that there was a noticeable improvement in her because she was striving towards this goal of becoming a manager and a leader because obviously, she had great assistant skills. She had done so much there that she was ready to move up to that next level. And putting in, not only giving her the resources, but also acknowledging that there was this area that we could work on helped tremendously.
To this day, she's still going strong in her position as treatment manager, and she's going to school still for her CVT, and she's loving it. And it's definitely something that I love seeing in people because they got to have that strive to want that, and she had it, and she did it. And big props to her. I hope she listens to this episode one day.

Dr. Andy Roark:
Yeah. Okay. I love that story, and it's awesome. And I want to break it down step by step into action. So let's pause for a second here. Let's take a break and then we'll come back, and I want to run back through that story and just tell you what I love about it because that's going to… I think we should use that story to frame the action steps because that's [inaudible 00:27:50] with us how you do it, you crushed.
Hey, guys, I just want to hop in really quick and give a quick plug. The Uncharted Veterinary Conference is coming in April. Guys, I founded the Uncharted Veterinary Conference in 2017. It is a one-of-a-kind conference. It is all about business. It is about internal communications working effectively inside your practice if you're a leader. That means you can be a medical director. It means you can be an associate vet who really wants to work well with your technicians. It means you can be a head technician, a head CSR, you can be a practice owner, practice manager, multi-site manager, multi-site medical director. We work with a lot of those people. This is all about building systems, setting expectations to work effectively with your people.
Guys, Uncharted is a pure mentorship conference. That means that we come together and there is a lot of discussion. We create a significant percentage of the schedule, the agenda at the event, which means we are going to talk about the things that you are interested in. It is always, as I said, business communication focused, but a lot of freedom inside that to make sure that you get to talk about what you want to talk about. We really prioritize people being able to have one-on-one conversations, to pick people's brains, to get advice from people who have wrestled with the problems that they are currently wrestling with. We make all that stuff happen. If you want to come to a conference where you do not sit and get lectured at, but you work on your own practice, your own challenges, your own growth and development, that's what Uncharted is. Take a chance, give us a look, come and check it out. It is in April. I'll put a link in the show notes for registration, ask anybody who's been, it's something special. All right. Let's get back into this episode.
Okay. Let's get back into this. So you just told the story, I love it. I want to break down some things that I see in the story when you were talking about coaching this person. Number one, the first thing you did, which is absolutely amazing, I love it, is you framed your feedback not as corrective, not as like, “Hey, you really screwed this up and we need to go through, and look at what you did, and you need to apologize.” It wasn't corrective feedback, it wasn't, “I want you to own your mistake.” You 100% were like, “Where do you want to go?” And you got a picture of where she was going, and then you framed your feedback as developmental feedback. This is how we want to get there.
And so especially with your tenured team members, if they've been around a long time, if they're a shift lead, a department lead, stuff like that, they may not take just straight up, “Hey, you messed this up” feedback very well. They can feel like they're being taken down a peg. Really, really dislike that. Those people tend to respond better, in my experience, to developmental feedback of, “I see you, I see your skills, I want to talk about how we're going to grow you and where you go from here and these are the changes you're going to need to make to get there.” And so I think that was just a textbook lesson and how you give developmental feedback and figure out what people care about.
The one thing that the tech had going for her, which I think is really, really important, it's just a self-awareness when she's like, “Yeah. I do that. My thing is I don't realize it until it's over.” I go, man, self-awareness is an underutilized, underappreciated characteristic for people to have. And then the last thing is you talked to her, you came up with a plan about how you were going to help her, and then you were there to catch her in the moment like, “I'll give you the sign,” but you were there to give her the feedback. And when you're like, “I didn't have to give the sign anymore,” probably just the fact that you were there was enough for her to be like, “You are a sign of, ‘Oh yeah, I'm trying to do my best or I'm trying to do better.'” So I don't know. When I lay that down, do you agree with that or are there other pieces to it that you think should be called on?

Maria Pirita:
Yeah. Absolutely. And I agree with all of that. I think it's interesting. I would talk about the sign and just being there because I think we forget that sometimes with sass or with spiciness, coming from an expert in it, it does take the habit. It's a habit.

Dr. Andy Roark:
It is a habit. Yeah.

Maria Pirita:
It is a habit. You have to break a habit in order to be a better leader. And it's something that obviously, being a leader myself, we had to get over that, but it's going to take time to break a habit. And so the other part to that is being able to give them the time to do that but also the follow-up. When we're talking about… In this example, following up later on within the 30, 60, 90-day mark, whatever you decide to do on, and giving them feedback that, “I see you working on this and it's going great. Keep up the good work.” Or seeing, making sure that we don't just talk about it once and then forgetting about it, but also going back, giving that feedback, and talking about it again later on.

Dr. Andy Roark:
Yeah. How do you get tenured team members to tell you what their goals are when they don't know what their goals are? So let me ask you that.

Maria Pirita:
That's a really good question because-

Dr. Andy Roark:
It's hard.

Maria Pirita:
It is hard. It's hard and sometimes they need time to think about it themselves too because they haven't sat down and thought about it themselves to say, “This is exactly where I want to go.” And a lot of times, they don't even know of the possibilities that are out there. You said it yourself, we put them in veterinary assistant, certified tech, practice manager, and there's all these other linear possibilities. Unless we're constantly talking about these things, they're not going to know about them. So if I have a technician or a veterinary assistant that's like, “I don't really know where I want to go next.” I think the most valuable thing you can do be like, “Yeah. Okay. Well, take some time to think about that. Here is a list of just ideas and see which one you feel the most passionate about and think about it in the next couple of weeks, and we'll revisit this conversation in a couple of weeks.”
Because in that time they're going to be like, “Oh, I noticed that I really like behavior, and Fear Free is really important to me, and I realized that I want to do perhaps do Fear Free because I want to become a Fear Free certified professional.” The other thing too is telling them what they're good at. Andy, you're really good at that. You're really good at telling people, “Hey, I noticed that you're really good at this and so would you ever consider doing this or…” Maybe you should talk, and say how you do it because you do it so much better.

Dr. Andy Roark:
No. Well, thank you for saying that. I think that's a good… what's worked well for me is to look at people from the outside because you can see people more clearly than they can see themselves. And we tend to like the things that we're good at. And so if you see somebody who's crushing a thing, you should tell them, “You crushed this thing.” And it's amazing to me, in my life, how many people will be just fantastic at dentistry. They'll just be great at it. And you say, “Well, what do you want to work on? What do you want to grow?” And they're like, “I don't know.” And you go, “Well, I notice you're really good at dentistry.” And they're like, “Really?” I'm like, “Yeah.” And I don't know if their self-confidence doesn't let them believe that they're good at dentistry. They needed some random shmo on the outside to tell them that they're good. I don't know.
But I have found again and again that when I see somebody, they're just doing something that's obviously good at, if I just say, “Hey, you know what, I think you're really good at that. Not like you have to do this, but I'll tell you what I think you're good at. I see you doing these things.” And two things happened. Number one, they get some clarity, and they go, “Well, now that this has been validated, I'm going to own the fact that, yeah, I'm good at these things.”
And the other thing is they rise. They rise to that even more. So if I say, Maria, one of the things that you are really good at is you are a wonderful communicator in how you do developmental feedback, you'll do more of that in my experience. You'll be more ready to do it and more likely to practice and just lean into that skill, and then you really get better at it. And it's just this weird self-fulfilling prophecy when you tell people what they're good at. So thank you for saying that. I do try to call it out, but I'm always amazed by how powerful it seems to be when you just tell people what they're good at. I love the idea of just having people pay attention.
One of the questions that I ask that seems to help a lot is, “What do you love the most about your job?” Just framing it that way. Not what do you want to do, but what do you love the most? And then or I'll ask them like, “Hey, I want you to think about the last couple of weeks. What was the best day that you had? Just tell me what the best day was or squish the last two or three weeks together and make me an imaginary best day. What does the best day look like for you?” And a lot of times they'll tell you what they want to do and they want to… You say, “What do you want to do?” And then, “I don't know.” “Tell me what the best day at the practice looks like though.” “Well, I come in and I hit the dentistry table right off the bat.” I'm like, “Okay.” Not now.

Maria Pirita:
Well, there it is.

Dr. Andy Roark:
Yeah. There it is. But it's funny, and we've all had the experiences where someone asks you a question in one way and I got no answer. You ask me another way and I'm like, “Oh, well, here's the obvious answer.” And so we play the role of therapist in that way of being like, “Hey, I'm trying to tease out of you, what do you like, what makes you happy? What makes you excited to come to work?” And you pair that with the idea of giving them some time to think about it in the coming days. “I think you've really got something,” and then you tell them what you think that they're good at and the skills that you are impressed by them. I like to use the words to say, “You know what I most admire about you is,” or, “The skills that you have that I try to emulate are…” And boy, people really are flattered when you say that. I only say if it's true.
But people are not used to hearing the things when you say, “You know what I admire about you,” or, “What I try to emulate that you do really well is this.” That's just, man, that's powerful feedback. And you make people feel really seen and really appreciated. And again, especially for your tenured people, your upper-level people, that stuff hits them pretty hard and it gets their attention, and it makes them feel like they're doing something that people notice. So those approaches have worked well for me. So I like that stuff a lot. So I think that's a good way of trying to tease these things out of it and then coach them about where they're going. What do you do, Maria, when we don't get traction? We have these conversations and we've got this tenured person, and we talk to them and we're doing the 30, 60, 90 follow-up. What does that look like when the bar is not moving?

Maria Pirita:
I think that that's when you've got to revisit your own policies and protocols on what the next steps are. And as much as we all hate it as managers, none of us ever wants to let anyone go. I get that and then there's anxiety in that, but sometimes you do have somebody that may not be the appropriate fit for your clinic, and that's not necessarily a bad thing. Maybe their heart is set on becoming an ultrasound specialist and you don't have ultrasound in your practice.
You have to sit down with that scenario and really lay it out because at the end of the day, if you do have somebody that's a little too spicy, it's going to affect your clinic. It's going to bring down the tone. Your other team members are going to become resentful. “How come she never cleans the surgery suite? And we always have to clean the surgery suite.” And then you have really key valuable players that may quit just because you're trying to hold on to one player that may have the skills but may not have the tone that you need for your clinic. So those become a little bit harder, but it's a matter of what the disciplinary actions are at your clinic and following through with those because if you don't, it's just going to continue to affect your clinic, unfortunately.

Dr. Andy Roark:
Yeah. No, I think you're right. I think you're smart too. You got to look at the ripple effects. At some point, it's not about the surgery suite not getting cleaned, it's about the fact that the other techs are going to fold if they have to clean up this mess again while this other person refuses to do their part. At some point, it becomes this thing about fairness of this, “We're being treated unfairly because this person's getting preferential treatment.” And it's not about the surgery suite not getting cleaned, it's about, “I'm being disrespected, and I'm being forced to do this and management is not supporting me, and they're allowing this to happen.” And so it's much, much, much more than the surgery suite not getting cleaned. It's a cultural problem that's impacting other members of the team. So a lot of management is picking your poison.
All right. How do you want to struggle? How do you want to suffer? Do you want to struggle and suffer putting up with this person who won't clean the surgery suite, or do you want to put up and struggle with not having that person on board? And I go, “Well, it depends on how much that person is affecting the rest of the team to make that decision.” The last part too is, and it's hard to hear, but I always got to put it back on the table, is people change and life comes in phases. And sometimes people are done. Sometimes they've done the vet tech thing for 10 years, and they're just done. And maybe it correlates with them starting a family. Maybe it correlates with their kids going off to school and their life is just changing or going off to college, maybe their kids moved away. Maybe it has nothing to do with kids, Andy.
Maybe it's just their spouse has a new job and she's wildly fulfilled with the job and this person is realizing, “Hey, I've fallen out of love with this, and I want to be in love with something.” And you can't do much about that. People just change. And so I try to remind managers and leaders and owners that sometimes people are going to leave, and it's not about you, it's just about them and what's going on in their lives and what they want. And I don't think any of us really think that we're going to make a job that people are going to spend their whole lives in. You know what I mean?

Maria Pirita:
Yeah.

Dr. Andy Roark:
And if they leave that's because we failed them. But man, it feels that way sometimes. And so sometimes it's just good just to call it out and go, “Sometimes people outgrow your clinics, sometimes they outgrow the job that they have. Sometimes they just want to change.” And that's not failure. But if they've outgrown your clinic and they've checked out, but they're still showing up, cashing a paycheck, and they're causing headaches for other people, that's not okay. We're not going to do that.

Maria Pirita:
Yeah. Absolutely. I agree.

Dr. Andy Roark:
Cool. Well, I think that's all I got. Have you got anything else to add to this?

Maria Pirita:
No, I don't think so. Other than I hope we see you all in April. Actually, we have Practice Manager Summit coming out.

Dr. Andy Roark:
Oh yeah, the April conference. Yeah. Talk about the Practice Manager Summit. You're speaking at that.

Maria Pirita:
I am speaking. I'm so excited. I have a great workshop lined up for you, guys, on one-on-ones, which actually leads to this episode really well because we're going to talk about one-on-ones, how to make them work for you and how to make time for them because they can be very, very time-consuming. And I think that a lot of us could be having them more often, but we don't because we're like, “Where do you find the time?” And so I have a lot of great information for you, guys. And I think that's something that you could work with these spicy tenured team members. After all, that's where we can find out a lot about their development and what they want for the future. So that's exciting. That's coming up here soon.

Dr. Andy Roark:
Yeah. It's March 22nd is the Uncharted Practice Manager Summit is a virtual event. Anybody's welcome to attend but it is 100% targeted at practice managers. Registration is opening up very, very soon. You can find more at unchartedvet.com. All right. Cool. So thanks for running through everything with me, Maria. Guys, thanks for tuning in. I hope this was helpful and we'll see you guys next week.
And that is our episode. Guys, I hope you enjoyed, I hope you got something out of it. Thanks to Maria for being here. Gang, as always, if you got something out of the episode, if you enjoyed it, share with your friends, help us spread the word, help us get the Uncharted gospel out into the world to light people's lives, or just write us a review on Apple or wherever you get your podcast, that's also a thing you can do. Anyway, guys, enough silliness. Take care of yourselves. I'll talk to you later on.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: behavior, culture, management

Jan 04 2023

They Admitted They’re Using Drugs… Now What Do I Do?

This week on the podcast…

This week on the Uncharted Podcast, practice manager Stephanie Goss is joined by her dear friend, Dr. Phil Richmond. Phil is the Chief Medical & Team Wellbeing Officer at Veterinary United and the Founder of Flourishing Phoenix Veterinary Consultants. He is an advocate for positive culture and individual, team and organizational psychological health, safety, and wellbeing in veterinary workplaces. Phil was also voted Most Funny in his high school class, was the NASA 1996 FL State Powerlifting champion (Juniors, 23 & under) and has seen Rush in concert more than any other band. That's what I call a bio!

Stephanie and Phil are talking through a recent conversation had with some managers after a team member at someone's clinic called off for several days and then told their manager that they were admitted to the hospital following an overdose. This is someone who is newer to the team, performing well and this manager was asking how to navigate this. The discussion turned towards disciplinary-like actions – taking away keys, possible termination for the no call, no show, drug testing and more. Stephanie and Phil wanted to talk through why the default response is often to frame substance/alcohol use disorder and mental health crises in a disciplinary way; what we can do to examine our own bias when it comes to these challenges and leadership and how to begin taking steps to change the culture within our practices, our communities and veterinary medicine as a whole. Let's get into this…

Uncharted Veterinary Podcast · UVP – 212 – They Admitted Using Drugs… Now What Do I Do?
guardianvets logo

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

Thank you to our sponsors! To learn more about this week's sponsor, GuardianVets, check out their website HERE.


Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Upcoming Events

New Workshop Series! Practice Owners and Managers, are you ready for some workshops to help kick-start 2023? Is this the year that you tackle creating a foundation of culture for your organization? Do you want to have a practice vision and values that do more than just look pretty on your wall? Do you want to have the right people in place on your team so that you can move forward in the same direction this year? Are you lost at where to start with leading meetings like this for your team? If the answer to any of these questions is YES, we've got you! The “Start Your Year Off Right” workshops can be taken together as a series or independently based on your practice needs.

Start The Year Off Right: Finding Values & Your North Star with Dr. Andy Roark

Start The Year Off Right: Loading the Bus with Stephanie Goss

Start The Year Off Right: Lead A Vision & Values Meeting with Dr. Andy Roark & Stephanie Goss

Upcoming events: unchartedvet.com/upcoming-events/

Episode Resources

VMX Talk: come see Stephanie and Phil present together: When a Team Member Needs Help… What To Do When

Sunday, Jan 15 at 8am in Hyatt management area

At VMX: Veterinary Recovery Meeting is Sunday Jan 15 at the Hyatt from 4-8pm in Celebration 14.

ACES Assessment/Information

PERMAH Survey Information – Workplace (and personal) well-being assessments

Mental Health Audit – Use the workplace mental health audit tool to find out how your workplace measures up.

Vets4Vets – VIN Foundation Vet Peer Support Network


Episode Transcript

Banfield Pet Hospital Logo

This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.

Andy Roark:
Hey Stephanie Goss, you got a second to talk about GuardianVets?

Stephanie Goss:
Yeah. What do you want to talk about?

Andy Roark:
Man, I hear from people all the time that are overwhelmed because the phones never stop ringing. And I'm sure you hear from these people as well, like our caseload is blowing up, and the doctors are busy, and the phones just don't stop.

Stephanie Goss:
They never stop. That is a true story.

Andy Roark:
I'm amazed by how few veterinarians know about GuardianVets. This is a service where you have registered technicians who can jump in virtually and help you on the phones. You can flip the switch and GuardianVets can jump in and take some of the load off the front desk. And they can handle your clients and get them booked for your appointments and give them support. And it really is a godsend.

Stephanie Goss:
Pre-pandemic, it was amazing to me how many people hadn't heard about it for after-hours call help. But at this point, I can't believe how many people don't realize that they are offering help during the daytime as well. Which I would think right now is a huge benefit to practices because everybody is shorthanded. Everybody is drowning in phone calls and so we talk about it, we've talked about GuardianVets a lot on the podcast. And every time we do, we always get somebody who says, “What is that?”

Andy Roark:
Guys, if you're not familiar with GuardianVets, if you think that you could use them help on the phones or up at the front desk, check them out. It's guardianvets.com and if you mention our podcast, me and Stephanie Goss, you get a month free. So check it out guardianvets.com.

Stephanie Goss:
Hey everybody, I am Stephanie Goss and this is another episode of the Uncharted Podcast. Just a quick warning at the front of this episode, there is some swearing in this episode so if you are listening with kids in the car or at home, you may just want to be aware of that. Or other people who just don't like to hear swearing. Know that that is a thing that happens a few times in this episode. Number two, we are talking about substance use disorder, alcohol use disorder. We do talk about suicidal ideation and suicide. So heavy topics that we did our best to cover in a way that hopefully is not upsetting or triggering to anybody. And as always, we want to be upfront and make you aware of what's happening before we get into it. So if those subjects are upsetting to you and you may want to take a break from the episode, that's totally fine. We'll see you back next week. If not, let's get into this.

Meg:
And now the Uncharted Podcast.

Stephanie Goss:
Hey everybody, welcome back to another episode of the Uncharted Podcast. Andy is not with me this week and that makes me very excited because sometimes I think we need a break from our energy. And because it means I get to have one of my most favorite people in veterinary medicine with us today. As a special guest, my dear friend Dr. Phil Richmond is here. We are going to talk today about substance use in veterinary medicine. It is a passion, something that is near and dear topically to both Phil and I's hearts. I'm going to let him introduce himself. Phil, welcome to the podcast.

Dr. Phil Richmond:
Hey, thanks Steph. It's great to be here. And I would say, I know Andy's not here, I'm like the Wish app version of Andy Roark. For anyone not seeing the video.

Stephanie Goss:
You're a good substitute for Andy. So for the people who are listening who have not had the chance to see you, hear you, know you, in veterinary medicine. Can you tell us a little bit about your background and how you and I came to be connected?

Dr. Phil Richmond:
So I'm really grateful. I sit right now in a seat with a group called Veterinary United. I'm the Chief Medical and Wellbeing Officer and super cool is Tom Bankstahl, Dr. B who's the CEO. He and I right now are the only two veterinarians in the US who have a certification in applied positive psychology. So he feels really strongly about that aspect of veterinary medicine. So super, super excited about working there. But on a grander level, and this is why all of us are doing what we're doing is trying to change the face of vet med.
And trying to change what has been, keeping what's working well. But then what are we struggling with certainly in work design and that. I also sit as the chair of the Florida Veterinary Medical Associations Wellbeing Committee, and I am super excited, I get to work every time I say this is… So I'm sitting on a committee for the CDC in NIOSH for healthcare and psychological health and safety. And then just really working on a number of projects around that in Vet Med and I get to work with some of the coolest people including you, Stephanie Goss in veterinary medicine. So just very, very grateful and I think we might be able to get into a little bit of my story of that as we go on.

Stephanie Goss:
So you and I are both red dot people as I'm listening to you talking, I'm like, “Oh, that's a lot of projects on Phil's plate.” Let's just acknowledge that right up front. We are red dot people and we bonded immediately I think probably within the first 10 minutes of talking to one another. We did the jumping up and down like, “Did we just become best friends kind of moment?”

Dr. Phil Richmond:
Totally stepbrothers.

Stephanie Goss:
Which I've never actually seen that movie, but I can picture the jumping up and down in my head. Because that's what Phil and I did because we just have a lot in common. And then as we started talking and getting to know each other more and discovered some things about our own personal lives and histories, we were just like, “Oh my gosh, we had way more in common than we thought.” So we have been a part of the Uncharted Community together for several years now and you and I both nerd out about wanting to make change in veterinary medicine. And our work together started in a very small corner within the Uncharted community in terms of creating safety and space for those in recovery in our community and has grown. And we are actually, a few short weeks from doing this recording, we are headed to Florida to do to speak at VMX together, which we are both really excited about.

Dr. Phil Richmond:
Super excited.

Stephanie Goss:
And if you're listening and you're going to be at VMX, you should come say hi. I will drop our session info into the show notes. But we are presenting on Sunday morning together with two human medicine doctors and we're talking about pieces and facets of veterinary leadership when it comes to helping our people. Like when we know that there's a problem, how do we handle crises and support? And so we're super excited to do that and as we are getting ready for that, you and I have started, we have this text chain where we see things or we hear things, we have people ask us questions and both of us regularly get questions from managers but hospital leaders in general asking, “Hey, there's this situation happening with a member of my team. Or someone I know is in this position when it comes to substance use or alcohol use or mental health challenges and I don't know what to do.”
And there was something recently that came up, somebody asked me a question because they had a member of their team who hadn't been with their team really long and they have by their admittance, been a pretty good employee. And then last week they texted and said, “Hey I'm not going to make it into work.” And there was no follow-up and no details. And then a few days later they replied back to this manager that I was talking to and were like, “Hey, I am actually in the hospital. I overdosed last week and I'm going to be here for a little bit and I'm not sure what it looks like from here.” And I thought it was great that this manager was asking questions and in the group that we were having the conversation with a lot of the response, an initial reaction from fellow managers was tread really carefully. And let's look at this from a disciplinary perspective.
They know called, no showed. They should just like what is your policy on that? You can just dismiss them and get rid of the problem. And I immediately texted you and was just like, “This makes me see red.” And you and I had a great conversation, I was like, “Let's do a podcast about this.” Because we get asked questions like this all the time and I think it's one of the things that you and I are both passionate about. Breaking down the stigma when it comes to mental health challenges, substance use in veterinary medicine. And so that's the context of what we're going to talk about today. We're going to talk about our typical headspace and actions in this specific instance. But as I suspect knowing Phil and I's conversations will probably meander a little bit along the way. Right?

Dr. Phil Richmond:
Right.

Stephanie Goss:
So let's start though with a headspace perspective. So why does this kind of thing make both you and I see red? And also how do we keep ourselves from just being angry about it? What do we do about it? Why are we here? Why are we talking about this in vet med?

Dr. Phil Richmond:
Absolutely. And the thing is that in the US the stigmatization of alcohol and substance use disorder is significant. And that's really where the crux of the issue comes up, is that we look at, Oprah just published a book. But there's an excellent psychiatrist, neurologist, and he says what we need to ask the question is instead of saying what's wrong with you is ask what happened to you. And some of the numbers that I wasn't aware of until I got involved in this is one of the things that we know is that in medical professions, medical professionals at a rate of 12 to 15% at some point in their career are going to meet criteria for alcohol or substance use disorder. In two, go ahead.

Stephanie Goss:
That's a huge number.

Dr. Phil Richmond:
Huge number. And so if you don't know that number, that's more than one in 10, is that we're out there. But what do we think about when we think about somebody who's in, when we use the term alcoholic. Even that image that pops up, sometimes It's somebody with an overcoat, in the stigmatization of under the bridge, drinking out of, unable to stop drinking. And that is not what, it can be. Some of us can go to that place, but that is not what it is. Many of us are intelligent medical professionals and intelligence has intelligence, moral fortitude and grit have nothing to do with alcoholism, alcohol use disorder and substance use disorder. It is not a moral failure and that is the thing, it's a mental condition that we have. And so it's really how do we frame it in the first place? And I just love that reframe of instead of asking what's wrong with you, compassion and saying what happened to you. And go ahead and stop.

Stephanie Goss:
I think that's huge, because the stigma, starts with the mental image when you ask somebody. And I think that's why these questions make me see red is because the answer for most of us just as humans is we have been conditioned as a society to look at substance use disorder, alcohol use disorder, mental health challenges as other people. As a problem that couldn't affect us, that happens to other people in this dark and shady and nefarious kind of way. And the picture that comes to mind is a very negative one. And so we start by already being biased in our thinking because of the stigma that surrounds it.
And so when there are challenges in our own backyard, and I love that you brought up the medical professionals because that's huge and we are a part of that as veterinarians. And we also know that on a very, very broad level, I think the most recent numbers that I saw are a little bit older at this point. They're from 2017, but the substance abuse, mental health services administration does a survey and the 2017 number said 20 million Americans 12 and older had been impacted by substance use disorders. That's statistically a staggering number. And so and I were talking about the fact that when we talk to people and you were saying when you lecture, you actually ask the question, “How many people have been impacted or know someone who's been impacted?” And lots of hands in the room go up.

Dr. Phil Richmond:
Lots of hands, most hands.

Stephanie Goss:
And at the same time when it comes to a leadership perspective, when I ask the question, “Hey, have you ever had someone who's been impacted by this in your practice?” I see so many leaders say, “No.” And I think the answer really is yes and they just don't know it. It didn't impact work, it was a secret. And so I think for me a big part of the stigma is to look at the perspective that, not normalize it in the sense that this is okay, but normalize it in the sense that this is happening. And it impacts a vast majority of us and we have to start to talk about it.

Dr. Phil Richmond:
And like you said is that it was a secret. And then we ask ourselves why is it a secret? Why is it a secret? There was a study that just came out, you and I were talking about it just recently. Is in September of 2022 there was a survey that came out. One in seven physicians, one in seven physicians admitted to consuming alcohol or controlled substances at work, one in seven.

Stephanie Goss:
At work?

Dr. Phil Richmond:
At work, that's at work. More than one in five say that they consume alcohol or controlled substances multiple times per day. And then in 2017 there was a survey done by the Mayo Clinic and it was a robust survey. They had, I think it was about I think 7,500 physicians. The 7,400 physicians answered this survey. In that survey, just alcohol is what they were talking about, just alcohol. 12.9% of male physicians and 21.4% of female physicians met criteria for alcohol use disorder.
Almost one in four of us, one in six to one in four meet criteria. So why in the hell are we not, why do we not talk about it? We also know in talking about suicide, just to give a warning is that 50 to 60% of suicides have alcohol or drug relation to it. And so that is something I feel very strongly about and both you and I are certainly advocates for suicide prevention in the profession. But if we're not talking about this, we can't truly be helping one another. And it's like, “Why are we not having these discussions?” And it's stigmatization and then it's the fear of if I come forward with this, what's our knee-jerk response is that it's going to be a performance issue. It's going to be a fitness-to-practice issue. And so what happens is that we hide it.
You just mentioned the secret and this was my story, is I hid it until I couldn't hide it anymore and I almost didn't make it Steph. But yet this could have been, people saw and I'm not saying that, but the signs were there long before I got to that point. And so if the climate was changed and we can have these open and honest conversations and say, “Wow, I've noticed I'm coming home and I'm having three or four drinks where I haven't done that before.” Because what was funny for me is I took that self, the assessment, the 20 questions that see if you're an alcoholic. And I took, I got a 19 out of 20 and it was like there's a hot, and I'm like, “Well this is bullshit, crap.” And I'm like, “Because if this was true-“

Stephanie Goss:
I don't have a problem.

Dr. Phil Richmond:
I do not have a problem, I'm in-

Stephanie Goss:
I'd be falling down at work.

Dr. Phil Richmond:
Right, because I started moving the goalposts. I was like, “Yeah, I can't have a problem.” And that's the old rationalization is because I don't want to be viewed as the person in the overcoat with the bottle in the bag under the bridge. I don't want to be viewed like that, I'm a medical professional, I'm going to school, whatever. But those two things are not…we need to be able to have this conversation in a psychologically healthy and safe space. So that's what we really want to change. And changing the intervention from where there's a crisis where we have to take, where somebody is visibly affected-

Stephanie Goss:
We have to act.

Dr. Phil Richmond:
… at work and we have and we have to act. To where if we roll back the clock or if we go back, we saw those things. And this is, I think what we're going to get into today, is what are we doing in our practices? What are we doing in our workplaces to set the tone to say it is okay to come forward with these things. Are we doing things where we talk about the access to our mental health resources are there. Are we engaged with our employees? Are we somewhat vulnerable with our employees as well about our own struggles as leaders to a safe point? But do we feel safe coming forward with that? And that, the goal is, not when we talk about don't, instead of just pulling people out of the river, let's go a mile up and find out what could we do to help them from falling in the river in the first place. And that's the goal.

Stephanie Goss:
And I love that and I think as a leader and as a manager and from an HR perspective, you and I were talking before we started recording. And I was saying when I became a manager there were no classes on this. I didn't get taught this shit. Nobody said, “Hey, you should think about these things.” Being totally candid and honest, the bare-bones information that I got from an HR perspective was, your handbook needs to have a drug-free workplace policy. And that was it for years and years and years. That was how I managed was, there was one policy in our handbook that we are a drug-free workplace. Because I could then use that to performance manage problems away. So if we had to cross that bridge, we had the safety net that said, “Hey, legally as an employer I've got this in here and if this is violated, I don't have to do anything else but write the discharge and move on.”
And so I think for me a lot of it starts with getting honest about the fact that we don't talk about it and start to talk about it. Start to talk about it more, which is a passion for both you and I, like breaking down those walls because we know that stigma continues to happen because we're not talking about it. And we're not talking about it loud enough and often enough. And that's when change starts to happen and becomes radical when we start to talk about it. So for me, I think a lot of it is starting with looking at our own perspectives as leaders in a candid way. What are our biases? What are we thinking? It's human and it's okay. And I'm saying this from the perspective, even someone who has been a part of the recovery community, someone who has been touched in my own personal life by substance use disorder. And has had family impacted by substance use disorder, I still completely admit that for a long time, the bias that I had was that this is something that happens to other people.
I was raised in a good family, I was the first person in my family to go to college. This isn't something that happens to people like me, that happens to people like my family. And so I had to do a lot of work on a personal level to break down my own bias and my own self feelings but also feelings towards others. And so I think as leaders taking that first step and looking at how are we thinking, how are we viewing it? Because just statistically if we keep thinking about it from the perspective of this happens to other people, it doesn't happen in my clinic. We're going to always be behind the curve. Because the reality is it is happening in your clinic. And if you think that it isn't, if you think that it hasn't, you're wrong. It just happened in secret.

Dr. Phil Richmond:
A hundred percent. And that is interesting and this is and the well-meaning, I mean this out of a huge amount of respect. When I was at UF and we were talking about it and I asked, I said, “How many students have we had referred to Florida's physician's health program?” And they said, “Zero.” And I said, “Okay.” And this is what I'm saying, is that this is an institutional, it's just not something that's talked about. And in human medicine the data's all there. So they see it and they're taking positive actions for this and opening up the conversation. Because again, they have the surveys, they have the data. We have a couple, a handful of studies, but there was one that came out from medical students. And medical students, 32.4% of medical students met criteria for alcohol use disorder.
And there was a study that came out, I think it was in 2017 and they did one with vet students, same thing. This is to everybody in the hospital, is affected, just it doesn't, alcohol and substance use disorder doesn't go, “Oh I'm just going to affect accountants or whatever.” It's that we are human beings who were taught to do the job of veterinary medicine. So we as human beings have things that happen to us that put us at a higher risk of this being there. And that was something that I thought we might step into too, talking about adverse childhood experiences and trauma-informed workplaces, if that feels right.

Stephanie Goss:
Yeah, I love it. So I think that is a good segue for us to talk about what are some of the, so we recognize that there are problems. We recognize that there are challenges and usually for most of us as leaders, because there still is the stigma because it is secretive. There is generally, we're finding out further down the line, like you said, we're a mile down the river. There is a crisis. Someone is actively suicidal, somebody is actively in substance use crisis, somebody has OD'ed at work or at home. And like this fellow manager that I was talking to, we're getting the call saying, “Hey, I'm not coming to work.” Then we're managing in crisis mode. And so I think for you and I, a lot of it is we need to do things better as a community, as an industry, to have resources to support the crisis mode. And that's a whole other soapbox. But I think for you and I, a huge piece of it is how can we start to turn back time?

Dr. Phil Richmond:
Yes.

Stephanie Goss:
How can we wear our Time Turner necklace and flip it back a notch, and be able to look at, how do we start to impact and support the team? How do we start to look at the team as human beings recognizing that this is something that impacts a vast majority of the American population. How do we start to do things to create a safe space in our practices where people can be human, where someone can say, “Hey, I need this help.” You and I are both the kind of people that we might go up to our manager and be like, “Hi, I am in recovery and I need to go to a meeting today.” But recognizing that not everybody is going to be able to have that forwardness and how they address it with their management.
But creating this space where if somebody on our team says, “Hey, I need to go to medical, I need to go to some medical appointments over the next couple of weeks and I need to flex my schedule to make that happen.” Where we create this culture of safety where somebody can say that and we're going to support them instead of being like, “Well we've got patients to see I need you here.” How do we start to look at people as humans? And I think you have so much to share in that arena. So maybe let's take a quick break here and then we'll come back and we'll start to dig into some of the action steps. What are some of the things that we can do as leaders? What are some of the processes that we can put in place? How are ways that we can support and educate our team to be seen as human beings first. And veterinary professionals maybe second. And how do we support each other in that regard? Does that sound like a plan?

Dr. Phil Richmond:
Perfect, love it.

Stephanie Goss:
Okay, let's take a quick break. Hey everyone, it's Stephanie and I just want to jump in here for a quick second and say Happy New Year. I am hoping that in the new year you are thinking about spending some of your CE money and coming to join our community, if you're not already a member. We've got all kinds of great things happening in the community regularly. And one of the big benefits of being an Uncharted member, means you get access to all of our monthly workshops at no additional cost.
But if you're like, “I can't afford to do membership right now, but I would love to get in on some of the things you're doing.” Head over to the website unchartedvet.com/events because we have got a rapidly growing calendar of all of the things that are coming in 2023. Andy and I are kicking off the year with a three-part, start-the-year off-right workshop series in January and February and we would love to have you join us. You can come for one, you can come for all three, you do you, but we would love to see you there. And now back to the podcast.

Stephanie Goss:
Okay, well we are back. So we talked a little bit about the headspace and a lot of it is about just acknowledging the stigma and doing some self-reflection and some looking at how we're approaching things. And it's funny because I get asked questions a lot like this question from this fellow manager and my first response always now, and it wasn't always this way. But now my first response is, “If you had a team member text you and say, I'm in the hospital, I just found out I have cancer” what would you do? Because the response to that should be no different than the response for any other reason that somebody's in the hospital. The reason shouldn't matter. But it does, because as a society there is stigma and there is judgment. And we look at somebody who has cancer as, “Holy shit that's not something they could control.”
Like for them, this happened to them. And we don't afford that same outlook to people who are having mental health challenges or crises or a disease. We don't afford that to substance use disorder or alcohol use disorder. We look at it as they are in control of this, this is their fault. And so we look at it very punitively. And so I think the first thing from an action step perspective after we do some self-reflection is start to look at how can we, we have an incredible power to teach our team that our first response is as fellow humans and is one of empathy.
Which is you are hurting, you are in pain, you are in the hospital. How can I support you? Can I send you food? What do you need? Because it's no different. And so I think for me, it's about how do we start to set that groundwork consciously and unconsciously in our team, to look at substance use disorder, to look at alcohol use disorder, to look at mental health and disease and say, “How can we approach it from a more stigma free perspective?” This is not something that they chose. This is not something that they can control from that perspective. Yes, there are things, I can control my actions and I should be held accountable for my actions and at the same time, this is a disease process. And what would we do if one of our patients had a disease?

Dr. Phil Richmond:
And I think there's a way that we can frame that conversation that makes it easier for us to have more cognitive empathy for what's going on with our team members.

Stephanie Goss:
Yeah, you're doing some great stuff here with your teams. Tell us about some of the framework that you're using for clinics to be able to start to look at this.

Dr. Phil Richmond:
So one of the fascinating things to me was that I found out maybe three or four years ago, maybe not even that long, actually, of this assessment that was done back in the late nineties, early two thousands. And it was a big study that was done by the CDC and Kaiser. And what they looked at is they found that people who have these experiences that are adverse, and that's a kind word and we'll go into a little bit what some of those are. But they had an assessment of 10 adverse childhood experiences that they would ask, they were yes or no questions. Did these things happen to you before the age of 18? The critical point is that our brains are still forming. And that is from a neurobiology and pathophysiology point of view, it is genuinely fascinating. Although these things happened to me, to know what happened in my brain when I was 8, 9, 10 years old.
That set the stage for some of these things that came up later in life. So this assessment is, were you ever physically abused by a family member or someone in the household? Were you ever sexually abused by someone in the household? Were you ever verbally abused? Were you ever felt to feel like you weren't loved? Was there often not enough money to pay for food? Did you have a family member who had an alcohol or substance use disorder? Did you have a family member who had a mental illness? Did you see violence in the home? Did you have a parent who was incarcerated? Those types of things. What they found, and this is amazing, is that if you had four or more of those experiences in childhood, you are seven to 10 times, seven to 10 times more likely to have an alcohol or substance use disorder.
You are 6.8 times more likely to have anxiety and when it comes to depression, five times more likely to have depression. All of these things are connected. And then we talk about suicidal ideation, 10 times more likely to have suicidal ideations. 37.5 times higher rate than someone with zero ACEs to have attempted suicide. So if we had any of our patients have risk factors that gave us those kind of numbers, as clinicians, as veterinary professionals, we would do everything that we could to minimize those. Now we're in a position in the workplace that we can't minimize those, but I want to let everybody know is that 12.5% of Americans have four more of those. So not just in the workplace, but think about, so people that we work with, we're sure they have-

Stephanie Goss:
People we interact with.

Dr. Phil Richmond:
Clients that have it, that act in a way sometimes that we don't like. It's learned behavior that kept them protected when they were children. And I really came onto that when I got some bad feedback. I was like, “Dammit, I act like I was 10 years old.” And it was like this light bulb went on and I was like, “Dammit, it is.” That's part of it. And so neither one of us are mental health professionals. This is just an observation on this. So it just was fascinating to me. And so what we ended up seeing at the practice that I was at before is we had someone who went through, had an issue with feedback and I was very vulnerable and open. Now from an HR perspective, I'm not going to necessarily recommend doing this, so-

Stephanie Goss:
I'm going to stick my fingers in my ear for a second-

Dr. Phil Richmond:
So, “La, la, la, la, la.”

Stephanie Goss:
“La, la, la, la, la.”

Dr. Phil Richmond:
But we are at work practice, we were very intentional about psychological safety and vulnerability and support. And so I said, I felt the same way. And I said, what was interesting is that I had taken this assessment and had this and everybody in our clinic up until, well, not everybody in our clinic. The medical team, up to that point, we had all taken this ace. Remember four or more, you get all these things, six or more, which I have six out of 10. Six or more, we potentially will on average die 20 years earlier than the general pop or people with zero. But all these manifestations come up. Our average in our medical team was six. And so it fundamentally changed how we interacted with one another.

Stephanie Goss:
And you have a small team.

Dr. Phil Richmond:
It's smaller, yeah.

Stephanie Goss:
You're not talking about working in a hundred-person hospital?

Dr. Phil Richmond:
Right. Maybe we had 10 people in the medical team.

Stephanie Goss:
Because I think for a lot of us, when we think about it and we think about this, again, it goes back to that this happens to other people. This is why I love this example from you is we think, “Oh, okay, in a big hospital where they have a hundred people, maybe a lot of the people on your medical team, this could happen to you.” When we think about, “We're a small practice and there's 10 of us, or there's right eight of us, we couldn't possibly have those numbers statistically.” And that's what I think for me, it was so impactful in hearing that. Yeah, absolutely eye opening.

Dr. Phil Richmond:
And so the other thing that's interesting, so we know my source, so I've been in recovery since 2008. But I was on a podcast with a PTSD specialist that works with veterans and first responders and that. And so I was talking about my initial burnout when I was working, on my days off I was working and I was doing all this. And she goes, “Welcome to another trauma response.” So the same behaviors that helped protect it, because the alcohol and substances helped, they were a way to change the chemistry in my brain and for me to deal with that anxiety and the other things that were going on. However, overworking, workaholism, being a workaholic, those type, but what happens-

Stephanie Goss:
Staying till 10 at night in the practice.

Dr. Phil Richmond:
We reward it and we're not watching out for those people. And dammit, those are our superstars, potentially are just manifesting it in a different way. And we got to watch out for them too. And that's what we're going to get into next is how do we then have those discussions? What are we doing structurally as a practice to set the foundation so that these conversations can potentially happen? Not necessarily talking about ACEs, but just mental health in general and normalizing the discussion around mental health. Normalizing taking time off, normalizing utilizing our EAPs. Normalizing utilizing what we have at our disposal.
And then hopefully we can be a mile up the river and help our folks so that we can have these discussions so that we don't have a fear that I'm going to get fired. Or I don't have a fear that this is going to happen. And as a manager, my only option isn't creating a performance improvement plan with the thought that I'm probably going to fire this person in three weeks because they're not… Because if nothing changes, nothing changes. We all know, if there's no intervention and I can't change me with the same brain that got me into it in the first place. You can't just tell me stop doing X because it's hardwired in my brain. I need help to do that.

Stephanie Goss:
And I'm so glad that you brought that up because that is one of the things that is really, it's hard for me to see, and I see it every single day. I check in with the communities and groups in veterinary medicine that I'm a part of, and every single day somebody has made a post about, “Yep, I was here again till 10, and now I'm sitting at home and I poured myself a glass of wine and I'm going to sit here and I'm going to numb my thoughts about the day.” And we normalize that because generally the responses are, “Cheers, I'm sitting here with my glass too.” There are the, “Yeah, but we took care of the patients. Yeah but, yeah but, yeah but.” And I think that for me is one of the most important pieces is to not overlook those things that are not overtly negative. And this is an area where we don't know what we don't know.
And I'm glad that you said neither of us is a mental health professional. And this is where I as a manager had to lean into educating myself, to learning from the HR perspective, certainly. And from the legal perspective as a business person, as an employer, what do I need to do to protect my people, to protect myself? All of those things are valid. But also doing some education about just in general, what is trauma? Learning about tools and resources like ACEs, learning about psychological safety as a topic.
And I think we've come a long way in veterinary medicine in some ways towards opening our mouths and starting to have these conversations, but not far enough. So let's talk specifically about some of the things that you are super passionate about and things that we can do as leaders in our practices to start to open the doors to the conversations. And we're a mile ahead. We're looking at before we know that there's a problem, what are things that we can do to open the door to the office, so to speak. And have the honesty and the vulnerability and the safety for our teams to start to talk.

Dr. Phil Richmond:
So it's very much like when we have an emergency come in, the best thing to do is that everybody has been taught, everybody knows what their role is before that emergency walks in the door. So it's all laid out. It's all set down. We all know how we respond so that it's normalized. That's the beautiful thing about, and it's a beautiful well-oiled machine when an emergency comes, well, when we're doing all those things. And it can be a thing of beauty, why are we not doing that again? Right now, we're in such a reactive, reactionary state in veterinary medicine that we're reacting to a mental health crisis. So let's look, just like we would look if we're checking the books or we're doing that. Can we do a mental health audit of our practices, policies, systems that are in place? And so that's what we can do. We can-

Stephanie Goss:
What does that look like?

Dr. Phil Richmond:
So we can start asking ourselves just some fairly straightforward, simple questions. What's our practices mental health policy? Oh, we don't have one. Let's look into what-

Stephanie Goss:
Okay, let's start there.

Dr. Phil Richmond:
Yeah, so let's say, what's the vision? What do we envision that to look like? What would we want, if we were in that spot, what would we want within the realm of HR? But there are options within that realm that we can do to support people. The US unfortunately is about five to 10 years behind every other civilized country in the world when it comes-

Stephanie Goss:
Not surprising.

Dr. Phil Richmond:
Yeah, not surprising. But Canada, so I'm certified for the psychosocial risks and psychological health and safety process that is the Canadian standard. And then I work with a big group in Australia who's one of the leaders in workplace wellbeing. And so these psychosocial risks, think about it like OSHA for our brains, that's how I like to describe it. We do this stuff for OSHA.

Stephanie Goss:
I love that.

Dr. Phil Richmond:
We do, you go in, you take radiographs, you better damn well have your thyroid shield on your plate. You got to have your gloves on.

Stephanie Goss:
The gloves.

Dr. Phil Richmond:
As low as reasonably available or ALARA, I forgot what the whole radiologist, just skip that. But if we know the things that can potentially increase our risk for psychological damage, what are we doing proactively to decrease those? Are we doing things as far, or do we have role clarity? Do we have job clarity? Do we give autonomy? What about reward and recognition? Are we making sure that our teams know that they're doing a good job? Things that we intuitively know, especially in Uncharted groups. But what's cool is the data supports it, is that we need to be very intentional about crafting these things. How are mistakes handled? That's a big one when we talk about psychological health and safety. Do we have situations where technicians get lit up in treatment verbally by the doctor if they make a medical error? And I guarantee you the doctors have made errors. I mean have, that's part of… A hundred percent-

Stephanie Goss:
And how are we leading by example as leaders when we make those mistakes, whether it's as a clinician or as a leader. Are we leading with vulnerability? Are we leading with candor? Are we saying, “Hey, I screwed this up and I need you guys to know, A, that I screwed it up. But also, B, what I want to do to fix this in the future so that you don't have to feel those feelings that I'm feeling right now. Because I feel horrible.”

Dr. Phil Richmond:
And as diagnosticians, as clinicians, as medical professionals, as people who need data to make decisions, are we regularly assessing those psychosocial risks. And are we measuring the well-being of our teams regularly? Probably not. Probably not.

Stephanie Goss:
Probably not. I knew that this, as it always does, when you and I start talking, time is always the crunch. And I said to Phil, I'm like, “Listen, we got to keep it tight.” And there are people who are listening who are like, “That sounds great. And where do I even start?” And so Phil and I are going to drop a bunch of resource info-

Dr. Phil Richmond:
A hundred percent.

Stephanie Goss:
… into the show notes this week for you guys so that you can find access to learning more about some of the things we've talked about. The ACEs assessment, the mental health and wellbeing audits in your practice, things like that. So we'll give you resource info. So don't panic because we're not going to dive into a lot of specifics from the time perspective, but we'll put some of that in the show notes for all of you.

Dr. Phil Richmond:
And have our leaders gone through mental health awareness training? Have we given them the tools just like everything else? Have we done that?

Stephanie Goss:
How many of us have mandatory training for our leaders? How many of us have our people assessed in QPR training? How many of us have our teams take just, I'm so glad you said the OSHA thing. There should be somebody on our team whose is CPR and first aid certified, who on our team is getting mental health education? Who is getting education in things like substance use disorder, alcohol use disorder. How are we educating ourselves, that has to be a part of the process for us if we are truly running open, honest, caring, people-forward practices. And I think that's the space that you and I both look forward to impacting the most for sure.

Dr. Phil Richmond:
And so just really getting curious about some of those questions. And if we have an EAP, most practices have one and they don't know how to access it.

Stephanie Goss:
Or what's included.

Dr. Phil Richmond:
And is that information, on a regular basis put out? So it's not, “Hey, we have this EAP. What the hell does EAP stand for? Okay, what does that mean?” Really going over what the benefits are during a team meeting and do we address those things regularly? Do we feel that that's important enough to put on our regular team meetings? Do we have a wellbeing update? Do we have a psychosocial risk update? Are we putting those things on the agenda to talk about?

Stephanie Goss:
I love that. And I think one of the other things that as leaders that we can think about is, Andy and I talk a lot about employee assistance programs and EAPs on the podcast. But going beyond that, when I sat down to think about this and I was thinking about what are some of the things that I learned about in my own journey. Things that wouldn't have even occurred to me as a manager to ask. Like what's included when we are providing medical benefits for our team, what's included in those benefits? Is it included for recovery support services? Can somebody go to inpatient treatment or outpatient treatment as part of our medical health plan? What is their access level to meds to treat substance use and manage addiction? Are they wildly cost-prohibitive if the insurance doesn't cover it? Does our medical services offer alternatives for pain management, like chiropractic or acupuncture or physical therapy?
Basic things like that, that are a part of the benefits that we already offer. To your point about the EAP, it's the same with medical benefits. We can be asking those questions not only knowing the answers to those questions, but making sure that we're highlighting that information for our team. So again, they don't feel secretive about it. I make no secret in my practices now. I don't take meds unless I absolutely have to. And so one of the questions that I always ask an employer is, what does the medical plan look like? I've been using acupuncture to help control pain for years. What does acupuncture or chiropractic coverage look like? Asking those questions so that it isn't a secret so that it isn't something that I feel uncomfortable having to ask about, thinking about those things. The other thing that became a passion project for me is how can we help make the community better and decrease risk factors, especially when it comes to substance use.
I live in an area of the country that has really, really high opioid use and we're up near the Canadian border and it's a systemic issue here. And one of the things that I got really passionate about was can we as someone in the community who dispenses drugs to our patients, can we get involved in drug takebacks? Can we get involved in pharmacy blue box projects where the community can bring back meds, no questions asked. And dispose of them safely in conjunction with the DEA, so that we help limit some of the risk factors. Not only for our team members in terms of making our own homes safer, but making the homes safer of our clients and our friends and family in the community. So things like that, that we wouldn't even necessarily think of that really impact how we're showing up for our team as leaders. And thinking about them as whole human beings and not just the person who's showing up to clock in and do the work for us.

Dr. Phil Richmond:
And I would say, if there's one big takeaway of where to focus is that I love the concept in this group that I work with in Australia is very, very big on this concept, which is a me, we and us. So there's individual responsibility and individual things. And this is where I think human medicine got down the road of really pushing resilience training. Resilience training is excellent. Resilience training, individual resilience training will not fix systemic problems. However, and then when we talk about the me part and the we part, me as the team, what makes up a team is individuals, obviously. So we need to have people that can then, and then on a team level, can we create a situation where I feel comfortable admitting a mistake to you. Or I feel comfortable having a discussion with you and you're not going to judge me.
And some of those resilience factors go into the psychological health and safety or the psychological safety of a team. And then on top of that then organizationally is that things that are out of the hands of the employees, what are we doing as leaders and as organizations to facilitate these things? Are we doing our mental health audits? Are we looking at, is everybody taking their PTO? Are we measuring wellbeing? Are we measuring burnout in our team members? What are we doing at that level? And all of those things actually have to come together to create the, as Stephanie Goss's term that I know she loves, unicorn veterinary-

Stephanie Goss:
Unicorn practice. I love it. And I would say as I'm listening to you and I'm thinking about the moving from me to we to us, listening to this, I suspect that there are some people who are like, “Holy hell, this is so much stuff that I never even thought about. And where do I find time for this? Where do I put this on top of the million other things that I have to do as a practice leader, as a business leader?” And I think the thing that both you and I are in firm agreement is this is not a, if you were going along your merry way and you had a drug… If you were me in my early career and you had a drug-free workplace policy and that was it. That was all you did, that was the box you checked. You are not going to be able to go from that at zero to a hundred miles an hour overnight. Recognizing that this is a marathon, not a sprint.
So pick one place, whether it's starting to do some audits with the team, starting to do building, again, psychological safety also doesn't happen overnight. So you can't go from not talking about things that are personal and private and vulnerable with your team if you haven't been doing that. And you all of a sudden are like, “We're going to sit down and we're going to have a group therapy session.” They're going to shit bricks. So it's about finding the places where you can start small and try one thing. Like you said, let's talk about what happens when we make a mistake. How are we going to acknowledge that to each other? How are we going to admit it? What does that look like? Starting small, finding that first building block and then figuring out how do we layer in those other building blocks as we go.

Dr. Phil Richmond:
And on an organizational level, what is our mental health policy? We could literally just ask that question. And that can be our thing for the month is just, do we have one? Can we craft one? What might that look like? And then the other thing that I think about is when we talk about civility in practice, small things that we can do that have a ton of impact, is how would I like to be treated at work? What are three things that we could sit down as a team and say, “When we're talking to another team member, we put our phone down.” We all just have that agree, simple little things like that. And we take three of those things for how we want to treat each other in practice. And that's the step we take. And the thing is that those build on one another and then we have a win. We've done something positive for the practice, and then we just build one on another.

Stephanie Goss:
I love it. As always, you and I could sit here and-

Dr. Phil Richmond:
I know.

Stephanie Goss:
… continue this conversation for half a day. If you were listening to this and you're like, “I'm super enjoying this conversation.” And you're going to be at VMX, I'm going to drop the details on our session into the show notes for you guys, because we would love to see you there. And definitely come talk to us and tell us that you listened to the podcast. That'll make it even more special. But we will also drop resource information into the show notes and some info on how to contact Phil if you have questions or honestly, if you want to nerd out with either of us on these topics, we're always open to further the conversation. And we actually have the first veterinary recovery meeting happening at VMX as well.

Dr. Phil Richmond:
At VMX, yes, we do.

Stephanie Goss:
Which is huge and exciting. That is going to be happening on Sunday afternoon as well. And we'll drop that info in because that is something you and I are both passionate about. Breaking down the barriers so that it's not just about the licensed medical professionals as veterinarians, obviously we need to serve them. But the veterinary community goes far beyond just our licensed veterinarians. And so you and I are both passionate about providing access to recovery resources and just opening the doors to all the members of our team, paraprofessional and professionals. So that is a big win and that's happening at VMX as well. So lots of fun stuff coming in the next few weeks. It's going to be a busy few weeks for us.

Dr. Phil Richmond:
Yes, yes. And I'd also say if you want to get in a meeting, an online meeting, if you're a veterinarian, the Vets for Vets program from the VIN Foundation, Bree Montana, bree@vinfoundation.org, you can get involved with that. We have a great meeting that happens every Sunday. And it's one of my favorite recovery meetings and it's just wonderful and we've got some more resources coming forth as well. So, excited.

Stephanie Goss:
Yeah, I love it. Thanks for being here, Phil-

Dr. Phil Richmond:
Thank you.

Stephanie Goss:
… and starting this conversation. I imagine that as you and I always do, this will spin into multiple other like, “How do we answer this question,” kind of episodes. But this was the first, this was great. Take care everybody, have a wonderful week. Take care of yourselves and hopefully Phil and I will see you in Florida in a few short weeks.

Dr. Phil Richmond:
Looking forward to it.

Stephanie Goss:
Take care. 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: behavior, culture, drug use, management

Dec 28 2022

HOF – The Team Is Mad When I Won’t Cover For Them

Uncharted Veterinary Podcast Episode 211 Cover Image with a grumpy gray cat

What's This Episode About?

This week on the podcast, we've got a great Hall of Fame episode for you!

Dr. Andy Roark and Stephanie Goss are sharing a conversation they recently had with a group of managers who were struggling with something that feels familiar to us all at this point. These managers are short-handed and a lot of them came into their role from the team side so they have the skills to fill in on the floor when needed. Their teams are really getting frustrated and/or angry with them when they refuse to cover gaps in the schedule in order to get their own jobs done including things like trying to hire, interview, and payroll. It feels like the ultimate rock and a hard place conversation. Let’s get into this…

Uncharted Veterinary Podcast · UVP – 211 – (HOF)The Team Is Mad I Won't Cover Staff Shortages
guardianvets logo

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

Thank you to our sponsors! To learn more about this week's sponsor, GuardianVets, check out their website HERE.

Upcoming Events

New Workshop Series! Practice Owners and Managers, are you ready for some workshops to help kick-start 2023? Is this the year that you tackle creating a foundation of culture for your organization? Do you want to have a practice vision and values that do more than just look pretty on your wall? Do you want to have the right people in place on your team so that you can move forward in the same direction this year? Are you lost at where to start with leading meetings like this for your team? If the answer to any of these questions is YES, we've got you! The “Start Your Year Off Right” workshops can be taken together as a series or independently based on your practice needs.

Start The Year Off Right: Finding Values & Your North Star with Dr. Andy Roark

Start The Year Off Right: Loading the Bus with Stephanie Goss

Start The Year Off Right: Lead A Vision & Values Meeting with Dr. Andy Roark & Stephanie Goss

All Upcoming Events

A UVC MEMBERSHIP IS YOUR KEY TO FINALLY GETTING THINGS DONE AND GROWING YOUR VETERINARY PRACTICE.


Episode Transcript

Banfield Pet Hospital Logo

This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.

Stephanie Goss:

Hey everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. So this week on the podcast, Andy and I are letting you guys in on a conversation that we had recently with some managers that we were meeting with. Because someone asked the question, what do I do when the team is mad because we are shorthanded and I won't jump in and help on the floor.

Stephanie Goss:

And I thought it was a fantastic question. So did Andy. We thought it would be great to talk about with you all on the podcast, because we love spending this kind of time and talking through these things with you. So let's just say that I have a lot of empathy for this conversation. I want to be vulnerable and share some of my failings as a manager during this episode with you. And I hope that you not only understand, can relate to and find some solutions in the conversation that Andy and I have. Let's get into this. And now, The Uncharted Podcast.

Dr. Andy Roark:

And we are back. It's me, Dr. Andy Roark and Stephanie-that-sounds-like-a-you-problem-Goss.

Stephanie Goss:

Oh, I love it. How's it going, Andy?

Dr. Andy Roark:

Oh, one foot in front of the other. Making it through this crazy year.

Stephanie Goss:

It's crazy times. I think when this episode comes out, we will be in Las Vegas for WVC. Either there or heading there the following week. And I'm looking forward to that and getting excited about seeing our friends and colleagues. I had so much fun when we went to VMX in January. It was so good to see people and I'm looking forward to that. It's that busy time, man. There's so much happening. All the things are spinning at once and it is crazy busy right now.

Dr. Andy Roark:

Yeah, it is. But you know, there's some good things too. The spring is coming. I can see, I'm starting to see little shoots popping up through the ground. Some of my plants that lost all their leaves have these little buds on them. Never forget that life is good. And also, everything comes in cycles. I think that's where I'm living right now. Is that everything comes in cycles and this too shall pass.

Dr. Andy Roark:

And so, my family's had a rough start to the year, which is people being sick and just stressful stuff. But overall, we're really, really lucky. We haven't had any serious health problems like a lot of people who get COVID have had. And you know what I mean? When you really zoom out, you go, this is all okay. It's going to be fine.

Dr. Andy Roark:

And anyway, it's just, I'm thinking a lot about that as cycles just come and go. I saw an interview with, it was the Actor Studio, and somebody asked Tom Hanks, if he could give advice to his younger self, what would he say? And he said, this too shall pass.

Dr. Andy Roark:

And he said, when you make a movie and everybody hates you, this will pass. And when you make a great movie and everybody loves you, that's also going to pass. And I was like, you're speaking to me, Tom.

Stephanie Goss:

That's some solid advice.

Dr. Andy Roark:

Yeah. You're speaking to me buddy. That's where we are.

Stephanie Goss:

Oh, man. Well, I am excited for today's episode. You and I recently were doing a meeting and where we're hanging out with a bunch of practice managers mostly, and had a great conversation with them about a question that somebody asked. And they asked, how do I balance doing my job when the team gets mad and feels unsupported when I don't cover staff shortages, because everybody is short-staffed right now. Everybody is dealing with the normal winter sick plus the COVID and everybody's tired and burned out and people are taking vacations and all of the things.

Stephanie Goss:

And so everybody is dealing with being shorthanded more regularly, I think, than potentially in the past. And so, this one immediately resonated with me so hard because I struggled with this more than once in my time in the clinic because it's so hard. And it's so common. And so, I think we both were like, “Yes, we should talk about this on the podcast.” Because it is not exclusive to the group of managers we are with. It is something that happens to everybody.

Stephanie Goss:

And I think it's worth talking about both from a headspace perspective as we do, and also a logistical like how do you avoid this? How do you set yourself and your team up for success?

Dr. Andy Roark:

You know what's funny, is the actual avoiding it is generally the easy part. It's the mindset that is required. That is the hard part. But it makes or breaks you. That's why I really like this question. And I see a lot of managers. Specifically managers. And sometimes head techs, but often it's managers, and the group that seems to be most affected in my mind are the people who have been veterinarians who have moved up into a management role, like a medical director role or a practice owner role.

Stephanie Goss:

Yes.

Dr. Andy Roark:

And technician support staff, front desk staff who have moved up into a practice manager role. That was you as well right, Steph? You did that.

Stephanie Goss:

Oh yeah. That's the hardest part. Because you have the skills, right?

Dr. Andy Roark:

Yeah. And I'll lay out why those groups really get pinched. I think people who come in as a manager, have so much easier of a road in this specific way. So, I really like this problem and this is some real psychology judo, that we get to do. And so I'm going to really try to throw some people around today and like, I got to shake you and make you see this a little differently.

Dr. Andy Roark:

And then you have to believe it so that you can communicate it in meaningful ways to other people. But this is a common problem. Especially during the times when so many practices are shorthanded.

Stephanie Goss:

All right. So let's start as we do with the headspace.

Dr. Andy Roark:

The first thing that we got to do is get not defensive, not combative, not frustrated. It's really easy to get ticked off because you are leading this team, you are working your butt off and someone says, “Can you put on lead apron and take these radiographs?” And you're like, “No, I can't.” And they're like, “Agh, thought you cared about pets. I thought you cared about the staff.”

Stephanie Goss:

Well, and it usually happens when you are running through the hospital, doing something else. Right? It's not happening in the moment when you are on the floor to observe the team. And it's like, “Hey, can you help us with this patient here in the moment.” The frustration comes when you are clearly doing something else in your mind, and the team is also asking you, “Hey, can you do this thing?”

Dr. Andy Roark:

Yeah. Well, because if you were hanging out on the floor, like, “Hey, I'm here to support you guys.” And they're like, “Can you put in these lead apron and do this thing that you've been trained to do and have plenty of experience with.” You would just do it and then no one would get upset. And then you wouldn't even think about it again. It's only when you are busy, you're doing other things. You've got 87 fires.

Dr. Andy Roark:

You are looking for a doctor to sign some paperwork or to explain what happened in the one-star review that you just found online. Because the person is going to call with a reporter and wants to talk to you. And you're like, “I need this now.” And someone's like, “Can you hold this cat, for some blood.” And you're like, “No.”

Dr. Andy Roark:

And they're like, “Ah, fine then. Just leave us here.” And then you feel like crap. Right? Something we've been talking a lot about recently incongruence is this mindset. And I love this. I wrote about it recently when I was writing about people who struggle with, are you a real vet? So people who had been in full-time practice and then were not anymore.

Dr. Andy Roark:

And I think a lot of those people really struggle with the question of, Hey, now that I'm not practicing every day, am I a real vet? And when we talk about that and how we feel that way, it really focuses on this idea of incongruence. And what that means is, there is an ideal way that we see ourselves. Like when you look at Stephanie Goss, and you look in the mirror and say, “This is ideal Stephanie Goss.” Like what I want to be.

Dr. Andy Roark:

And then you say, who am I actually? And if the, who am I actually, and what is ideal Stephanie Goss, if those are different, that's a problem. It makes us feel uncomfortable. It makes us feel like we're not who we want to be. When I was 15 years old and I thought ideal Andy Roark looked like Arnold Schwarzenegger, and I stepped in front of the mirror. A scrawny pasty, 165-pound Andy Roark. I was like, “I'm failing. I'm clearly not where I want to be.”

Dr. Andy Roark:

Again, it's that comparison is a thief of joy. But you can compare yourself to the ideal version of yourself, and steal your own joy. It's this weird internal self-damaging mindset. And so we see that. And that's why it hurts. Is because when the technician says to you, “Hey, can you jump in and help out?” You see yourself as the person who jumps in and helps out. You may still identify as the veterinarian on the floor or the technician on the floor or the CSR on the floor. And your ideal version of yourself would totally fix that problem and help that person.

Stephanie Goss:

Yep.

Dr. Andy Roark:

But your actual person does not have time to put on that lead apron. They don't have time to jump up and start taking those phone calls. And so then, your actual self and your ideal self are not matching up. And you get this deep-seated unease, where you go, I'm not who I'm supposed to be. I'm not the hero that I want to be. And that's called incongruence. And it bothers us deeply.

Dr. Andy Roark:

And so that's why we feel that way. At the same time, it's totally reasonable for someone to say, “Hey, I need help. And I know that you have these skills and you seem to be just walking past.”

Dr. Andy Roark:

And so them asking you does not seem unreasonable or bad. And so anyway, that's where we end up with, why does this happen? Well, because someone needs help and they see you, a capable person who could help them. And they ask you, and you have a vision in your head of being a person who jumps in and helps. But now you're not doing that.

Dr. Andy Roark:

And there's the internal irritation. And there's the external irritation. When the person who needs help sees you walking by and asks for help. And you say, “I don't have time to help you.” It can make them feel unimportant.

Stephanie Goss:

Sure.

Dr. Andy Roark:

You know?

Stephanie Goss:

Yep. I think it happens and I think it's hard because, from the team's perspective, your job is to make the practice run. And the practice runs taking care of patients and clients. And so it doesn't matter which side of the coin we're talking about. It doesn't matter whether the front desk is flagging you down or the team in the treatment room needs help with the patient.

Stephanie Goss:

This is exponentially more common and more difficult when you have a skillset because you were once part of the team. Right?

Dr. Andy Roark:

Sure,

Stephanie Goss:

Whether it's that team or another team, you were a player, you were on the field. You did this stuff and the things. And so they see you, and they have a patient in front of them or a client in front of them. And the path of least resistance for them is to say, “Oh, Stephanie, I need your help with this thing. Makes perfect logical sense to them. And so the reason why it happens is because when you step into a role as manager, you absorb the knowledge that your job is more than just doing the stuff and the things.

Stephanie Goss:

And you have to do your job to really push things forward. And so the struggle happens when you're having that internal argument that you were talking about, Andy, in terms of how you see yourself and what you think you're supposed to be doing and how you identify in that regard.

Stephanie Goss:

They're just seeing a problem in front of them, and you are the answer. And in your brain, there are multiple other answers. And so the why it happens, the frustration, the reason why it happens is because your answer is not the answer they want. Right.

Dr. Andy Roark:

Yeah. Exactly.

Stephanie Goss:

That's the path of least resistance. Is if your answer is the answer that they want, and you just do what they want you to. And you know that to be successful at your job, it means that sometimes arguably most of the time, your answer should be no. And that sets you up for a battle.

Dr. Andy Roark:

Yeah. And that's exactly it. Right? The first step in the head space on this is like, why does it happen? It's obvious why it happens. And if you were in the sports staff, you would ask for help as well. That's a common thing. Especially when most of us beat the drum and say, “We're a team. We look out for each other. We support each other. All for one, one for all. Teamwork first.”

Dr. Andy Roark:

The message of, no, I can't help you, seems incongruous with that messaging that we put forward. And so it's totally understandable why it happens. I think you're absolutely right. In the short term, for their problem, you jumping in and helping them is the easiest solution. And the other thing is, we all tend to be a bit self-interested. We all tend to look at the problem that we have and think that it is the most important problem because we have it.

Dr. Andy Roark:

And so, when they are waiting to get help and they need help to take these radiographs, they need help to draw this blood, they need help to get these charges put into the computer, whatever they need help with, they have a strong bias towards wanting to solve this specific problem.

Dr. Andy Roark:

And so they push that forward. Starting with compassion is key. Right? These are not bad people. They're not being jerks. And I think it's easy to be like, why don't they see value in me? Look, man, they're just busy. You're taking this too personally. They're just busy and they're just trying to do their job.

Dr. Andy Roark:

And honestly, most of them are working shorthanded. And that's stressful for anybody. So this person is under stress trying to do a lot of things, just understand where they're coming from. That doesn't mean that you have to jump in and do it. And we're going to talk about how we set ourselves up for success in that regard.

Dr. Andy Roark:

But at least, it's just, everything is easier if you don't take it personally that they're asking. And just understand. Yeah. That's why they feel this way. And this is why I feel this way. And this is what's going on. And no one is the bad guy and no one's trying to be the bad guy. Just put all that stuff aside.

Stephanie Goss:

Yes. I agree. You have to have compassion to not take it personally.

Dr. Andy Roark:

Yeah.

Stephanie Goss:

Because the second that you take it personally, that's when it turns from mild frustration in the moment that you've said no, into a thing of some degree. Whether it's that person is just now ticked off and is in a bad mood for the rest of the day, or they then are like, it builds. It builds when we take it personally.

Stephanie Goss:

And so I think that for me is like the self-awareness. And compassion place like this is where you have to have empathy for them and empathy for yourself and force yourself to take a step backwards and tell yourself, and believe me, I've been there in the moment. This is not about you.

Dr. Andy Roark:

Totally.

Stephanie Goss:

It's not about you. Don't take it personally.

Dr. Andy Roark:

Yeah. That's exactly right. And people get frustrated and they're like, these people have no idea what I do. That's true. [crosstalk 00:16:23]. They don't have an idea what you do. You go into the office and you close your door and they have as much of an idea of what you do as you had an idea of what the manager did before you became the manager.

Stephanie Goss:

Yes.

Dr. Andy Roark:

That's it. That shouldn't be something that makes us angry. That should be something that makes us compassionate. And when we say, they just have no idea what compounds this. And this is why this is so important to talk about. You and I have absolutely seen people who have been just handcuffed by an inability to get past this and get off the floor.

Dr. Andy Roark:

Like guys, the number one career limiting situation that I see for managers and medical directors, is the inability to work on the business. Because they're so fixated on working in the business. And that's it. How many practices out there are just treading water because the leadership is seeing appointments all day, instead of actually leading and growing the business.

Dr. Andy Roark:

Solving the problems that would make the appointments more of efficient and more, I don't know, more likely to achieve great client, patient outcomes and more lucrative for the practice. A lot of them. I see so many people who are like, “I don't have time to fix problems because I'm just seeing patients.” And I'm like, that's a bad choice.

Stephanie Goss:

Yeah.

Dr. Andy Roark:

That's a bad choice. And again, and it's not your role to see patients. It's your role to lead the practice and take care of things at an organizational level. If you are doing individual work, when it's your job to run the organization, you're doing the wrong thing. And there's no path out of there.

Dr. Andy Roark:

And everyone wants to say like, “Oh, if I just work on the floor a little bit harder, then I'll get time to go and do the management.” I'm like, “No, you won't. Never happens.” Here's the thing, if you jump in and do the management, then life on the floor for everyone is going to get easier.

Stephanie Goss:

Yeah.

Dr. Andy Roark:

But you have to believe that. And a lot of people, especially when they came up from the floor, they don't believe it. They either don't believe it because they've never been in a practice where they had strong leadership that was really able to make things happen. They don't believe it because of the long progression that it takes.

Dr. Andy Roark:

It's funny, there are very few things in leadership. We always like to believe that there are wins that we can go in and we can do something on Monday and by Friday, people will be celebrating our genius and our work. Like that doesn't tend to happen. It really is a long time. But what happens is, two years later, people look back and go, “This place is a different place to work.”

Dr. Andy Roark:

And it's amazing, but you don't get that immediate positive pat on the back, that reward of when you held the cat for the blood draw, and people go, “Hey, thanks buddy. Really appreciate you jumping in.” People aren't like, “Hey, thanks a lot for working on those standard operating protocols and job descriptions. You really, boy, that was great.”

Dr. Andy Roark:

But the truth is the standard operating procedures and the job descriptions across the organization had an exponentially greater impact, than you holding one single catch for a blood draw.

Stephanie Goss:

Yeah.

Dr. Andy Roark:

But those things are hard to see.

Stephanie Goss:

I think the last piece of that that you didn't address is that they're not empowered to do it. And I see this a lot where the expectation that is set for the role is that you lead, and work on the business and you do all of this stuff. And you're being asked to work in a role capacity, whether it's at the front desk or as a technician or as a doctor.

Stephanie Goss:

And I think the empowerment piece is a big piece of the conversation. And it's not exclusive to corporate practice. I hear the conversation a lot for people who are managers or medical directors and leading in a corporate environment. But I will also tell you, I have seen and worked in private practice where, I have not been empowered by the practice owner to do the actual job that they've hired me to do, because the expectation is also that I'm doing this other thing.

Stephanie Goss:

And I think there has to be a conversation about what is realistic. And this is a giant soapbox for me because I think you and I both align very much so that it is an unrealistic expectation.

Dr. Andy Roark:

Yeah.

Stephanie Goss:

To ask someone to do a full-time job, leading a practice in a truly administrative role, and also work a majority of the time in a role in the practice. It's a lose-lose situation for that person. And it's also a lose-lose situation for the team. And so I think the empowerment piece is the last piece of that triangle that has to be talked about.

Dr. Andy Roark:

Well, it's funny. It's become a bit that you and I do. It is how many times have we tag-teamed and beat up people that we love. Like the leaders, the practice owners, the medical directors who come to us. And we say to them this thing where they'll say, I got a practice manager and I got my head tech and I gave them a job to do, and I gave them a job description.

Dr. Andy Roark:

And then you look at them in their face and say, did you give them time to do the job that you gave to them? And they just look back and you can see the gears turning. And I've seen it so times now. I try not to enjoy it, but I do. I enjoy the painful growth that this person is having.

Dr. Andy Roark:

You know what I mean? And it's good for them. And they have to. And trust me, I have that same painful growth. It's leader-like. We all grow. Growth is painful and it's uncomfortable. Especially like, we all like to think that we just hear the right answer and we just get it immediately. There's a lot of things where we just have to sit with them for a while.

Stephanie Goss:

Yeah.

Dr. Andy Roark:

And this is one of the things that so many people sit with is they'll say, “Well, I made this job description and I got this person. And I handed it off to my technician and I made them the head technician.” Or, “I made the CSR into the office manager. And they're supposed to be handling this.” And they'll say, “They're supposed to be handling this.” And then we will say, “Did you give them time to handle this?”

Stephanie Goss:

Yeah.

Dr. Andy Roark:

And they're like, “No.” And I'm like, making the job description and saying all the things, but then not having time to do the things, that's not any better than not making the job description. Because it probably just makes them feel worse because now they know they're failing in a thing. As opposed to before, they were just doing the work and we're happy with that.

Dr. Andy Roark:

And so, I think you're totally right. Part of it is the empowerment. Hey, you have the ability to do these things, but are we giving them the time, the capacity to actually carry these things out? The answer for a lot of this is no. And what that really does, that sets up a really interesting conversation between the medical director, the practice owner, and the manager. Or between the manager and the head technician or the lead CSR or whatever.

Dr. Andy Roark:

When the lead CSR says to the manager, “Hey, you have these things you want me to do. And we've decided their priorities and they're really important. Help me figure out when I'm supposed to do this stuff.” And that should not be an earth-shaking mind-blowing conversation opener, but it is for a lot of people.

Stephanie Goss:

Yes.

Dr. Andy Roark:

And they go, “I don't know.” And said we'll get into that in the action steps but, no, I think you're exactly right. And again, nobody's bad. I feel like I talk about this and people go, because they see themselves in it. Let me just be honestly, a hundred percent candid. Guys, I run my team. And the things that I give to them and then later on, they'll say, “When am I supposed to do this?” And I go, “Oh, yeah. Sorry.” I'm bad about this.

Stephanie Goss:

Yes. We all are.

Dr. Andy Roark:

I just assume people are going to get it done and if they can't get it done, they're going to let me know. And I think that that is a dangerous assumption and it's one that I am so bad about making. And so, I think when I say I enjoy seeing leaders have this painful growth, it's because it's commiseration. You know what I mean? It's like, uh-huh, you also have to feel this pain that I feel.

Stephanie Goss:

Well. And I joke and say, it's because I have no filter, but it's also because I have been in that position on both sides of the coin. And so I ask the question because I know how painful it is on both sides. And I also know that I have never, in my personal experience, been able to solve this problem without, I call that piece of it, the elephant in the room. Like until you address that, you're trying to manage up to unrealistic expectations, and you're set up to fail.

Stephanie Goss:

And so, we talk on the podcast a lot about, what are the building blocks to have some of these conversations and approach some of these. And this is very much one of those things where you have to look at yourself and say, how have I been set up to fail as the manager?

Stephanie Goss:

And the number one culprit in my experience is that you're not actually empowered to do what you're supposed to be doing. There's unrealistic expectations about how you're spending your time and what you're supposed to be accomplishing. Or on the flip side, there's unrealistic expectations on your team's part.

Stephanie Goss:

And so your team, and that's where the taking it personally comes in here. Look, when your team is mad and frustrated, because they're shorthanded. And they're just bitter that you're not helping them and you're doing other things. They don't know what your job is. They don't care what your job is. And you can waste your time and energy. And I approached it this way on more than one occasion, trying to explain to them what my job was and why it was so important. At the end of the day, it still doesn't matter. They still don't care.

Stephanie Goss:

And that comes off as mean, and everybody gets offended by it. But the reality is, they don't care. It doesn't change their day radically to understand what your job is. Your job is to figure out how do I help them solve their problem and eliminate some of the barriers to move them beyond this piece of it. And so in that regard, we have set them up to fail when there aren't clear communications and expectations about what your job is.

Stephanie Goss:

And that's the piece I think that a lot of people leave out. Is they're like, well, the manager has this big, important job. They're in charge of HR and payroll and running the practice. But the team doesn't understand that on a granular level. And so the step because people are like, I don't know how to explain all of the things that I possibly could do to the team.

Stephanie Goss:

The step that most of us miss is communicating the expectations to the team of what they can expect from you. And this is a great example of that. Look, the team should know when you're shorthanded, when do you jump in and when do you not. That should be an expectation. It could be an unwritten rule of thumb, but I have on a personal level, my own barometer that I use to say, “Okay, are they truly drowning?”

Stephanie Goss:

And the long-term effects of them drowning here, or a patient dying because there is improper supervision or someone just absolutely losing their minds and walking out the door today. Like in a split second, measure that in my own brain and decide, is this truly a moment where it is more effective for me to step in and help them with the thing, or is it more important for me to do my job so that I can finish the interview. So that I can hire the extra body. So I can do the other things. Right?

Stephanie Goss:

And communicating a measure of expectation to them about that decision-making process. I think is really, really important, and it's a piece of the process that we skip a lot of the time. Because we focus from a headspace perspective on, we've got to get them to understand what my job is. But that's not actually, I don't think how you solve this problem.

Dr. Andy Roark:

No, I agree with that. We're going to talk about how to try that. And I think that you should at least make a passing attempt at it. And there are some ways that can make it successful, but I completely agree with you. There's not a scenario where they say, I'm not going to ask that person who's wearing scrubs, and standing there with her hands in her pockets for help, because I know at a deep level, how important what her main job is. That's not the answer.

Dr. Andy Roark:

The answer is that you as the manager too, and this is the mental judo I talked about at the beginning, you have to believe in the value of managing as opposed to working as a technician. I don't mean a vet tech, I mean a technician and someone who actually puts their hands on the thing and does the work.

Dr. Andy Roark:

And so I think that's the biggest thing that I see. And it's a perspective change. It's a short view change. The classic example of this is the independent practice. And you've got a veterinarian, who's also the practice owner and they have this manager. And they got a manager because there were enough things that they needed someone to do that aren't technician work. So they gave this person a title.

Dr. Andy Roark:

But they don't really understand what that role is or know how to use that person. And so in their mind, this person is support staff with a fancy title who has to get these other things done. And I go, “Buddy, you are fundamentally missing the boat. That is not what this is.” And the best analogy I can give, which is not very good. I don't think. It's like a chessboard.

Dr. Andy Roark:

And then when I say that technicians, meaning people who work with their hands or pawns, don't get me wrong. I mean that just analogy of a chessboard. And the doctors are technicians as well. It's the staff. And you're trying to take this person and make them a Bishop. You're trying to make them a piece beyond something that has a greater impact and influence.

Dr. Andy Roark:

And it's funny how many people don't want a Bishop. They just want another pawn. And you go, “This is dumb.” You're taking something that could be very helpful and transformative, and using it in a, not unimportant, but a very small-scoped way. And it's like misusing your tools.

Dr. Andy Roark:

And so I think the managers themselves have to see themselves as managers. And have to have that mental perspective of, I play at the organizational level. It's my job to make this business run more smoothly, not the individual patient experience.

Dr. Andy Roark:

That's not my job. And I know when I say it that clearly people are going to recoil. And I think I push that hard because so many people are on the other side. And they're like, “No, you should totally jump in here with this specific pet.” I'm like, “You should not be practicing at the individual level. You should be practicing at the organizational/business level.

Dr. Andy Roark:

And when you keep getting pulled down to the individual level, especially if that means you're not getting to do the organizational level, everyone is being negatively impacted by that. In a very small way that they don't even see, but it's there. And so you have to see it. You have to believe it.

Stephanie Goss:

A hundred percent. Because when you do your job for them, nobody wins in the long term. I truly believe that. And there's two really big pieces of that for me. One is, if you are not observing them, but you're just doing the actual job, the team doesn't ever get any lessons from you in how they can improve. You don't have that 30,000 mile view if you're on the field. You can't step back and have that perspective.

Stephanie Goss:

And the second piece is, oh I say this because I know the very painful place that results when you do this. When you do the job long enough and you jump in and save them over and over again, not only does that become your business model, but you wind up with a team that cannot function without your intervention or involvement. And that is the worst-case scenario for everybody.

Stephanie Goss:

And that is one of the biggest dangers in this moment. And that's where I was talking about, like I have to, in order to truly grow as a leader, you have to develop your own internal split-second decision-making tool to figure out and factor for yourself, is this a case where I need to say no, because if I say, yes, I'm just going to keep doing the job. And I'm not going to actually be able to help them grow and learn and move beyond as a team.

Stephanie Goss:

That is one of the hardest things to learn how to do. And I'll be totally vulnerable and honest with you guys, I've been doing this a long time and at my practice even right before I left I was so guilty of this. Because it's hard when you have the skillset and you can do the things. The path of least resistance for you is to put on the cape and be the hero and save the day and jump in and hold that pet. Or scrub in and help in surgery, or sit at the front desk and cover because somebody's out again.

Stephanie Goss:

It feels really good to feel like you're helping the team in the very short run. And in the long run, it feels really, really crappy because I have never not had it be a situation where ultimately the team gets super frustrated and they're angry with you. And then you're dealing with the fallout of the fact that you've been trying to do what you think is right which is help them and saved the day. And they're still pissed at you. That's your lose-lose situation.

Dr. Andy Roark:

Yeah. I agree. You want to take a little break here and then we'll come back and get into some action steps.

Stephanie Goss:

Yep. I love it.

Dr. Andy Roark:

Hey, Stephanie Goss, you got a second and talk about GuardianVets?

Stephanie Goss:

Yeah. What do you want to talk about?

Dr. Andy Roark:

Man, I hear from people all the time that are overwhelmed because the phones never stop ringing. And I'm sure you hear from these people as well. Our caseload is blowing up and the doctors are busy and the phones just don't stop.

Stephanie Goss:

They never stop. That is a true story.

Dr. Andy Roark:

I'm amazed by how few veterinarians know about GuardianVets. This is a service where you have registered technicians who can jump in virtually and help you on the phones. You can flip a switch and GuardianVets can jump in and take some of the load off the front desk and they can handle your clients and get them booked for your appointments and give them support. And it really is a godsend.

Stephanie Goss:

Pre-pandemic it was amazing to me how many people hadn't heard about it for after-hours call help. But at this point, I can't believe how many people don't realize that they're offering help during the daytime as well, which I would think right now is a huge benefit to practices because everybody is shorthanded. Everybody is drowning in phone calls. And so we talk about it. We've talked about GuardianVets a lot on the podcast and every time we do, we always get somebody who says, what is that?

Dr. Andy Roark:

Guys, if you're not familiar with GuardianVets, if you think that you could use some help on the phones or up at the front desk, check them out, it's guardianvets.com. And if you mention our podcast me and Stephanie Goss, you get a month free. So check it out guardianvets.com.

Stephanie Goss:

Hey, you? What's you got happening on your calendar in March because the Uncharted Veterinary community has lots of things coming up that I don't think you're going to want to miss. First up in March, we have an awesome workshop by my friend Dr. Saye Clement. Saye is going to be talking about client curation with us. She's going to teach us how to learn to identify the types of clients that you want for your practice. And then what are things that you and your team can do to attract those kind of clients specifically.

Stephanie Goss:

It's happening March 13th at 12:00 PM Eastern time, 9:00 AM Pacific, and it is a two-hour workshop. So put that on your clinic calendar, take a lunch break, go in late for the day if you're here on the West Coast. It is $99. It's free as always for our Uncharted members. And you can sign up at unchartedvet.com/events.

Stephanie Goss:

And then in the back half of the month on March 24th, my dear friend, Bret Canfield is doing a presentation that I am super pumped about. He and I are going to do some tag teaming on this. I am his wing man, moderator, and I am so excited for this because I went to Bret at the beginning of the year and said, “Hey, you are the person that comes to mind when I think about this topic, because you live this and you help teams breathe this. And I want to bring this to Uncharted and to the veterinary community at large.”

Stephanie Goss:

And that is the idea of more than an EAP. What can we do to make wellness happen in our practices? Brett is going to talk to us about the benefits of programs like EAPs but beyond that, what are some ways and things that we can do to create sustainability for our teams? Again, this is a two-hour workshop. It's $99 for the general public and it's free for our Uncharted members. It's happening on March 24th at 2:00 PM Eastern time. So 11:00 AM Pacific. So this one will hit my West Coasters lunchtime and mid-afternoon for those East Coasters.

Stephanie Goss:

It's a two-hour one. So again, make sure to check out unchartedvet.com/events for all of the upcoming events and registration. And I want to take a quick second to pause before we head back to the podcast. I have to show some serious gratitude to our friends at Banfield Pet Hospital. Andy and I have wanted to do transcripts for the blog for a while because we've had multiple colleagues reach out to us and say, “Hey, I've heard great things about the podcast. I would love to listen, but this is not accessible to me.”

Stephanie Goss:

And while we were trying to figure that out our friends over at Banfield stepped up and said, “Hey, we see you. And this is something that fits our values and our culture as a practice. We want to increase diversity and inclusion in veterinary medicine, and we would love to help with that.” And so they stepped in but in a big way and are sponsoring all of our transcripts for 2022.

Stephanie Goss:

So if you know someone who hasn't accessed the podcast, because there weren't transcripts available previously, send them to unchartedvet.com/blog. They can find all of the transcribed podcasts for 2022. And they can also find out more or you can find out more about all of the things that Banfield Pet Hospital is doing to increase diversity, inclusion and equity in veterinary medicine. And now back to the podcast.

Dr. Andy Roark:

All right? Well, let's start to unpack this, shall we?

Stephanie Goss:

Sounds good.

Dr. Andy Roark:

All right. We often start our action steps with expectations. And I think that that's where we go here.

Stephanie Goss:

Yes.

Dr. Andy Roark:

We talked before about, the people that you work with are not going to understand what you do and that's not the goal. That doesn't mean they can't have expectations about how available you're going to be. And I think a lot of times when I say set expectations, they're like, that means I'm going to explain to everybody all the things that I'm doing. No, just, we need to let them know. Especially if you have been on the floor a lot. It is not wrong to step up at the staff meeting and say, I need to give you guys a heads up. I know that you're working hard.

Dr. Andy Roark:

Our business is growing. We are moving to shift and handle some different things and to evolve. I am not going to be as available on the floor as I have been in the past. And I just want you guys to all hear that and just be aware that you're probably not going to be able to pull me in the way that you have in the past. And that's just starting to set expectations.

Dr. Andy Roark:

You might go full on with them and say, guys I'm no longer be able to jump in and work on the floor. The management piece of this has just gotten too big and I'm going to be putting in my time there. And so I'm not going to be wearing scrubs. I'm not going to be able to jump in and do work on the floor. Please know that I love you, but I'm not going to be available. And then you're not telling them that when they're holding a squirmming cat.

Stephanie Goss:

Yes.

Dr. Andy Roark:

Right. When they're standing there with lead apron and thyroid protector on going, “Hey, we could just get this done if you would jump in here.” You're letting them know when there aren't any patients in the building.

Stephanie Goss:

Yes.

Dr. Andy Roark:

“Hey, this is coming.” And oftentimes that is the best thing to do is, break the news to them when they're not panicking. And then when you gently enforce the barrier later on, it's not news to them. So start off by setting expectations and just saying, “Hey, this is what you can expect. Things are going to be a little bit different going forward.”

Stephanie Goss:

And I think in my experience, it's really important to set expectations and start in a very small and measurable way for them. So for example, if the team is shorthanded right now, this is not the time to have the big grand conversation about my job as a manager is really involved and takes a lot of time. So I'm going to be shifting my time and energy to that, right?

Stephanie Goss:

That is an important piece of the conversation, but they're not going to absorb that in any way, shape or form if they're panicked in the moment. And so for me, I would say the wins come easier when you say, “Hey guys, I need your help in the next week. I'm looking at the schedule, we've got three people out sick. We are shorthanded. I am trying to complete interviews so I can reschedule these interviews and I can step in and I can put myself on the schedule or I can finish the interviews so we hopefully can get another person starting sooner rather than later.”

Stephanie Goss:

Sometimes it's about giving them simple choices. Sometimes you might not give them a choice at all. You might just tell them this is the thing, but being very specific and granular about the choice and the transparency I think is really, really helpful. Because when they are experiencing the situation that causes that frustration over feeling like they're shorthanded and you're not helping zooming out to that big picture is a leap that often most teams as a whole collectively have a really hard time making.

Stephanie Goss:

So start with a small specific piece, “Hey, this week.” “Hey, the next two weeks, this is what my schedule change is going to be and why?” There's a big, we have to change our payroll system and I want to make sure you guys are going to get paid. And so here's what that means for my schedule. I just want to let you guys know, because I know we're shorthanded and I know in the past, historically, I've jumped in and I've stepped into role and I've worked on the floor, in order for this to happen I cannot do that.

Stephanie Goss:

And I just want everybody to know so we're all on the same page before we head into the next two weeks.” Right. It's about being very specific and clear and transparent with them about a specific situation.

Dr. Andy Roark:

Yeah. I agree. Education is key after expectations, right?

Stephanie Goss:

Mm-hmm (affirmative).

Dr. Andy Roark:

They don't know what you do. And if you are a black box, they're going to continue to be frustrated. And I see that a lot. This does not mean that you are going to show them your to-do list. Because I have 100% seen people will just be like, and then I had to do this, and then I had to do this. The staff's like, we don't care. There is some level of information sharing when you say guys going into this week, my top priorities in the manager office are going to be to work on hiring.

Dr. Andy Roark:

And I really want to push this and get it done. We're going to be trying out some new strategies to get people in, but my work is going to be on expanding the team to reduce the workload on you guys. So, sharing just in broad terms, what are you doing so that they can at least say, “Hey, she's not coming in and helping us on radiographs. She's working on hiring.”

Stephanie Goss:

Yes.

Dr. Andy Roark:

Just that level is fine. The other piece to this education. And I think you really hit on it very nicely Stephanie is, they care most about what you are doing in the context of helping them.

Stephanie Goss:

Yes.

Dr. Andy Roark:

Which means-

Stephanie Goss:

The what's in it for me?

Dr. Andy Roark:

Exactly. Right. And I want them to feel that way. I want them to believe that the sacrifice they are making by not asking me to jump in on the floor is an investment that they are making. That's really where my head goes is, you guys are not going to ask me to jump in and do stuff or you're not going to get upset if I say no, because you know that I am doing something that is going to be beneficial for you. And that is the way you look at people, and again, everybody's self-interested.

Dr. Andy Roark:

You know I said, everybody looks at what they're trying to do and getting home at the end of the day to their family, safe and sound and happy, so that they can enjoy their life. That's how they look at it. And so how do I make it so that not asking me for help in the moment is in your best interest. And I'm just going to think about messaging. And again, this is not a big deal.

Dr. Andy Roark:

I'm not trying to shore this up and make up PowerPoint presentation where they do the math and figure it out. But I have to give them at least something where they can go, okay, it's possible that I'm better off not asking Andy because he is at least working on these things that I think will benefit me or make my life easier.

Stephanie Goss:

Yes.

Dr. Andy Roark:

And so those are the keys for me with education. Give them something so that you are not a black box and they have some idea what's going on, do your best to frame it in a way where they see value for them in letting you get your work done.

Stephanie Goss:

Mm-hmm (affirmative). Yep. I totally agree.

Dr. Andy Roark:

So, yeah, beyond that once you set the expectations and you give them some education, you need to make yourself inaccessible. And there's a couple of different ways to do this. And I think this is the thing that just screws people up as the managers who are like, I don't have time to do all the work. And I say, well, what do you do? And they're like, I wear scrubs and walk through the treatment room on a very regular basis.

Dr. Andy Roark:

And I'm like, Hmm, I see why you may be having headaches here. You know? Big drums that I beat really hard. The biggest bad habit that I see in managers is multitasking. And again, it's because they come from the floor and they're like, I can do all the things. And they are leading people, growing the organization, answering a continuously ringing phone, walking through the treatment area where people are shouting questions at them, and asking them to do things.

Dr. Andy Roark:

And I'm like, I'm sorry, buddy. You are wildly inefficient right now. When it comes down to getting your work done, this is a terrible way to get your work done. And so you and I talk about time management and we talk about blocking your time. I am a big believer in work blocks and time blocks. You should put a block on your calendar that says, I'm doing payroll at this time.

Dr. Andy Roark:

And you should not be walking through the clinic, and you should not be taking phone calls, you should get payroll done. And when you get it done, then it will be out of your way. And then you can take phone calls, and then you could walk through the clinic and you may be able to jump in and help people. Right? But you have got to block this thing off. I'm a big fan of managers having some work-from-home time.

Dr. Andy Roark:

I mean, how many managers do you know who are like, I do payroll or inventory management from home over the weekend? And I'm like, that you shouldn't be doing over the weekend. But the point is they're like, I can get it done in half the time if I do it at home. Yes. That's true. And so why don't you do it from home every week or every other week? Right?

Stephanie Goss:

Right.

Dr. Andy Roark:

Block that time. I'm a big fan of my manager being at home for a half a day, once a week. And just say, these are the things that I knock out and I do it and no one comes and gets me, and the phone doesn't ring and I get these things done. Multitasking is a lie. It's not true. It's not efficient. People can't do it. It ultimately makes the quality of your work less and it takes more time. And so blocking that time, I'm not available. I'm doing these things. That stuff is so important.

Stephanie Goss:

Well, to add to that, I have some food for thought and I might blow some people's minds and I might make some people mad when I say this, but I will say that when I think about starting in a practice and I think about moving up into a leadership role, part of why I was given my job was because the doctor, owner of the practice was getting interrupted with the stuff and the things, and they couldn't be the doctor, or they couldn't be off on their day off because they were getting these stuff and the things, they were getting interrupted.

Stephanie Goss:

So the manager role gets layered in there because now you can interrupt the manager, that's your go-to person. So instead of asking the owner doctor or the leader doctor who's doing the important things, you're going to ask the manager. And that is where I think a lot of us have been set up to fail on a fundamental level. And that's some of what I was talking about in terms of empowerment.

Stephanie Goss:

You should be able to say to your team, “Hey, don't interrupt me for the next hour, because I'm doing payroll and I need to get it done.” And I will tell you having been in this position and having said just that, walked through the building, told everybody I'm going to go, I'm shutting my door. I'm doing payroll. Unless the building's on fire and you're trying to tell me to evacuate, don't come interrupt me. And then someone will come and knock on the door and they're like, but Mrs. Smith is on the phone and she's really angry, so I don't want to interrupt the doctor.

Stephanie Goss:

So I need you to know what I'm supposed to do with her. Well, when we think about what we've trained our teams to do in terms of not interrupting the doctor, the step that we miss a lot of the time is giving them that same training for us as the managers. There needs to be some boundaries like Mrs. Smith literally does not need me to get on the phone with her right this second.

Stephanie Goss:

If the team has been trained and empowered to say, you know what Mrs. Smith, she's in a meeting right now. Let me let her know what you and I have just talked about and I will have her call you back as soon as she is done, or by two o'clock this afternoon, or however you choose to empower the team to communicate that. But the answer is we have set ourselves up for failure.

Stephanie Goss:

And I think it trickles down from the reason why a lot of, especially in private practice, why a lot of managers got their role in the first place to your point is you've got an owner doctor who's like, I'm doing too many things. I can't do all of these things. So I'm going to put a manager in place. And then we don't set up those same boundaries and expectations. And that's where we fail to empower them fully in a lot of ways.

Stephanie Goss:

And I think it's really important to your point, you could only accomplish those work blocks if one of two things happens. If you leave the building and you're completely out of sight out of mind, whether you're working from home or you go to the Starbucks down the street and work for an hour or whatever that looks like, they literally can't see you. They can't find you. So unless they come walk down the street to Starbucks and find you, you could be uninterrupted in a place like that.

Stephanie Goss:

Or we've set up the expectation that like, look, when I say this, I really mean it. Because I will tell you guys so many countless times. That knock on my door happened and I was like, I could just tell them to go away and I could coach them in the moment. And I could remind them of all the things they're supposed to say to Mrs. Smith. But the path of least resistance to me as the manager right now feels like let me just get on the phone and solve this problem so I can move on with my day.

Stephanie Goss:

And I give in to that. And that is I think on a fundamental level one of the single most difficult lessons that I had to learn as a leader. And it is one that I am still learning to this day, I will tell you. Learning the lesson that you have to have the self-control to lead and not do the thing. No one is going to stop you from doing the thing. They're always going to say, thank you for jumping in and helping this patient. Thank you for talking to Mrs. Smith.

Stephanie Goss:

They might not even thank you, but they are going to continue to ask you to do it if you do it. The only one who can stop that cycle is you. And that is one of the hardest skills to master as a leader.

Dr. Andy Roark:

Yeah. That's about being intentional in making yourself into the manager, right? It's seeing the value in the role. And then I think your example of the communication empowerment and what should they say to the angry person on the phone that's spot on. You have to train them on what to say when you're not available.

Stephanie Goss:

Right.

Dr. Andy Roark:

And it's so funny because we don't. We go, I don't have time to train them. I guess I'm just going to keep being interrupted during my job for the rest of my life. I understand the short-term math is, it's easier for me to get the phone. The long-term math is for God's sake train these people so that they are empowered to say something.

Dr. Andy Roark:

To set boundaries for you so that you can then do the work. And I'm like, boy, when you do the math on that the investment is a no-brainer, but it's amazing how few people do it. And so, yeah. You're going to have to talk to them about what to say when you are in your work head-down time. But do it.

Stephanie Goss:

Yes. Because it's no different. It's been a long time since I've been in a clinic where if a client called and said, I need to talk to the doctor that the team's answer would be, okay, let me get them for you. That's not a thing that happens. Right? We have created protocols and processes to deal with that situation.

Stephanie Goss:

And it's amazing to me, how many instances when someone says, whether it's client or a member of the team, I need the manager or let me get Stephanie, it's amazing how many of us fail to have those same processes in protocols. And you can't do the work blocks. You can't chunk your time. You can't do what you were talking about, which is stop the multitasking and just really lean in and focus and get a single thing done.

Stephanie Goss:

You can't do that if those safety mechanisms are not in place and the doctor doing their doctoring work is just as important as you doing the work to run the practice. And so I would challenge those of you guys who are like, well, my role is to be the one who can be interrupted because the doctor can't, I challenge you to rethink that. Because it's not healthy and you're not going to succeed in the long run if you don't.

Dr. Andy Roark:

Yeah. I completely agree with that. I think that's super important. Big takeaways for me, you need to be intentional about your time as a manager. You need to recognize that it takes time to do your actual work and you need to believe that the time of a manager is more valuable than the time of an individual technical person on the ground doing the work because you're working on the whole business and they're working on one patient inside of that business.

Dr. Andy Roark:

It doesn't mean that what they're doing is not critically important, but it just means you have a different job and a different responsibility. And if you abandon your job to jump in and help the individual patients inside the practice, in the long run, everyone is going to suffer compared to where they could have been had you stated your post as a leader and continued to build the practice and build the systems. Set expectations.

Dr. Andy Roark:

Let people know this is coming. Give them some training. Give them some tools to enable you to not be available. If it's the constant interruptions. Set clear visual barriers to them getting you. The best one is, you're not there. That's a clear barrier. I can't harass him if he's not here. Short of that, consider not wearing scrubs. If you don't want to be doing technical work, don't wear scrubs. Wear manager clothes, wear nice clothes and just say, I can't jump in today guys.

Dr. Andy Roark:

And people won't generally ask you when they see you in your slacks. If you'll get down on the floor and wrestle this big slobbery dog, some people will, most people won't. You're sending them a clear signal about what your role is and what you're planning to do today with your time. Get a big piece of red poster board and tape it up onto your door that says, “Do not disturb. I'm not kidding, Donna. I'm serious. Don't do it.” And put it up.

Dr. Andy Roark:

I have people who are like, I don't have an office. Go and get big ass, air traffic controller, headphones. The huge nozzles that you stick on the side of your head, and they're noise-canceling headphones. And people are like, oh, I have airpods to do that. Don't use them. I want something enormous. I don't care if they block sound, go get safety ear protection from the hardware store that's big neon orange and say to the team when I have this on, do not bother me.

Dr. Andy Roark:

These are my magic I am not here headphones. Or ear protection that I am putting on. And that sounds ridiculous, but it really is. I don't have an office to go into and close the door. So I'm putting this on my body, on my head and please do not bother me when I have these things on. And just try to create space like that. But guys that's the key to it.

Stephanie Goss:

Yeah. The other trick that I used for years when I didn't have an office was a sign that would go on the back of my chair. Right? Like Andy was saying, you put the big sign up on your office door. If you have one great. If you don't, you need to make sure that people approaching you from any direction are going to realize that you are in a bubble. And so whatever that looks like in your space, the earphones are great because to Andy's point, people can't see the earbuds when they're in your ears.

Stephanie Goss:

I can't tell you how many times I would be wearing earbuds and someone would come up, and I'm on a call, I'm talking sometimes even to a client and someone comes up and starts talking to me because they have no idea that I'm on the phone. That is the downside to creating the ability to talk with a little tiny thing in our ear. Right?

Stephanie Goss:

And so thinking about how do I visually cue them? The headphones are great. The sign on the back of your chair. At one point I literally would wear a sign hanging around my neck and wear one on the back of my chair. That was, unless the building is on fire-

Dr. Andy Roark:

Like one of those sandwich boards?

Stephanie Goss:

Yes. Don't interrupt me. For years they had a hanging sign that went around my neck. And it just was like, I can't. This is how I can visually cue you. And that came out of a conversation with the team because they would say, oh, we don't realize that you're on the phone. Okay. So how do we solve that visually? I think that that is so important.

Stephanie Goss:

And I think the last thing for me from a solving it perspective is, you're going to disappoint them, that's the best word I can think of, to some degree when you say no because they are looking at you, they're like, can you help? And you say, no. There's going to be some level of disappointment. So the challenge that I would give to all of you who are struggling with this is, tell them what you can do for them and be intentional about how you do it.

Stephanie Goss:

And so when we were really shorthanded and I was struggling so hard because we were shorthanded, look, I came up from the front desk, but I became a technician. I went to school, I had the skills on both sides. There were so many days where I was like, look, I'm shorthanded in both departments. And I could jump in and solve this problem, whether it was them asking me or me just knowing that was the solution. It's a really hard position to be in.

Stephanie Goss:

And so look at it and be intentional because if I'm doing that job, then I can't do the interviews. Right? I can't get more bodies in place. I can't update the payroll system so everybody gets paid. The answer cannot be that you're just going to do the work on the floor and take all of that work home with you and do it at night until two o'clock in the morning. Or work a 60-hour week, week after week after week.

Stephanie Goss:

You can do that in the short term, and sometimes it's warranted. That's what you get paid a salary to do. Because sometimes you have to work a 50-hour week to get something done, and that's the trade-off. That should not be the norm. And so for most of us we make that the norm. And so the best way, I'm going to challenge you guys to approach this, tell them what you can do for them. So when you are in that shorthanded space, it's like, look.

Stephanie Goss:

I sometimes had to break it down on a week-by-week level. Look, this week I've looked at the schedule. The two days we're the shortest are Monday and Friday. So I'm going to be available to you guys Monday and Friday to jump in wherever you need me, whether it's for the whole day or three-quarters of the shift or whatever I can give them, and Tuesday, Wednesday, Thursday from these hours to these hours or for the whole day or whatever, I'm completely unavailable.

Stephanie Goss:

Because this is what I'm doing instead. I'm scheduling interviews. I'm doing the payroll thing. Be clear and specific and you can't just tell them once. This is not a one and done. You have to tell them and you have to visually give them a queue. So whether that's posting your schedule up in the hallway where everybody can see it, putting it on slack every morning, “Hey reminder guys, I'm available today. I'm not available tomorrow.”

Stephanie Goss:

You got to be consistent and continue to give them that visual transparency to what your schedule is and what you can do for them. That is the only thing that I ever found in the moment to truly get them past that disappointment and get them back on the even ground where they're like, oh yeah, okay. I see you, you are communicating in a way that is making sense to me. And so they might still be disappointed, but it lessens that I feel like significantly so.

Dr. Andy Roark:

Yeah, I think that's great. I think that's a really good approach. Tell them what you can do. It's almost like you can't be all things to all people.

Stephanie Goss:

Funny.

Dr. Andy Roark:

It's so weird.

Stephanie Goss:

So weird.

Dr. Andy Roark:

Guys, thanks so much for being here. Guys, I hope this was helpful. Stephanie, thanks for talking to this with me.

Stephanie Goss:

This was a good one. Have a great week everybody take care.

Stephanie Goss:

While getting 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

Dec 21 2022

When a Great Tech Calls Out ALL. THE. TIME.

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are talking through a question that Stephanie admits she could have written in to the mailbag at one point in her management career. We had a manager write in and ask what to do about a great skilled, talented tech who just happens to call out ALL. THE. TIME? They are amazing for the patients and the team loves them when they are here. This management team just isn't sure how to take it from here. Let's get into this…

Uncharted Veterinary Podcast · UVP – 210 – When A Great Tech Calls Out ALL. THE. TIME.

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

Help Us Make More Great Podcasts in 2023!

Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Upcoming Events

New Workshop Series! Practice Owners and Managers, are you ready for some workshops to help kick-start 2023? Is this the year that you tackle creating a foundation of culture for your organization? Do you want to have a practice vision and values that do more than just look pretty on your wall? Do you want to have the right people in place on your team so that you can move forward in the same direction this year? Are you lost at where to start with leading meetings like this for your team? If the answer to any of these questions is YES, we've got you! The “Start Your Year Off Right” workshops can be taken together as a series or independently based on your practice needs.

Start The Year Off Right: Finding Values & Your North Star with Dr. Andy Roark

Start The Year Off Right: Loading the Bus with Stephanie Goss

Start The Year Off Right: Lead A Vision & Values Meeting with Dr. Andy Roark & Stephanie Goss

Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Banfield Pet Hospital Logo

This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.

Stephanie Goss:
Hey, everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. Andy and I had another great letter in the mailbag this week, and we are diving into it in this episode. We got a ask from a manager who is wondering, “What do I do about a great and really high skilled technician who just happens to call out all the time?” And I mean excessive amounts. I actually did the math during the episode and this technician has missed almost 50% of the weeks in a year. And so this manager is wondering, “What do I do? How do I deal with it?” Especially because there have been some conversations along the way, but maybe not as frequently as they should have happened. And I have a feeling that it's probably hit the point where the rest of the team is super frustrated about this situation. This was a fun one. Let's get into it.
And now the Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark, and Stephanie, you're never there, Goss. You're never there. So all right, I just got back from jury duty.

Stephanie Goss:
Oh, yeah?

Dr. Andy Roark:
I just got back from jury duty, and it was an experience. Have you ever had jury duty?

Stephanie Goss:
I have. I'm excited to hear how your… This was your first experience?

Dr. Andy Roark:
Oh yeah. Oh yeah. I don't know how they found me, but they did. I'm worried that… people were like, “Oh, once they get you, they keep calling you.” And it was the experience. I got summoned for jury duty, and I did not have time to go to jury duty. I talked to my brother who's a lawyer. I'm like, “I don't have time.” And he was like, “They don't care.”

Stephanie Goss:
Nope.

Dr. Andy Roark:
They could not care less.

Stephanie Goss:
They give zero figs.

Dr. Andy Roark:
Yes. And I did find that to be true, which is interesting. Because when was the last time that someone just looked at you in your face and was like, “I don't care what you want.” It was when my children were like two years old. Right?

Stephanie Goss:
Yeah.

Dr. Andy Roark:
When a two-year-old would look at you in your face and be like, “I don't care what your schedule is or what you have to do at work.”

Stephanie Goss:
I want it right now.

Dr. Andy Roark:
“You're going to do what I want.” And it was two-year-old and jury duty are the times in my adult life when someone looked at me and were like, “I don't…” And then they carried out the threat. They were like, “Watch how much I care.”

Stephanie Goss:
They're like, “Bam, you're on the jury.”

Dr. Andy Roark:
Yeah, no, it reminds me of when my daughter was two years old and her sock came off as we were driving. And she was like, “You need to stop the car and get my sock.” And I was like, “No, we have places to be.” And she's like, “I'm going to make you.” And then she just melted down until I got off the highway and got her sock. And I'm like, “That's jury duty.” They're like, “I can bend you to my will.” And so they did. They totally did. I went, and I got picked and put on a jury and I watched a case. I watched it because they made me, because they took my phone away. What do you call it? The bailiff?

Stephanie Goss:
Yes.

Dr. Andy Roark:
He takes your phone away from you. And not you can have this back at the breaks. He's like, you can have this back-

Stephanie Goss:
When you leave.

Dr. Andy Roark:
… when you are done. Done, done. So I sat there without my phone, like a caveman. And I watched these two people tell completely contradictory stories about what happened in a parking lot accident. I then I went and [inaudible 00:03:40] people.

Stephanie Goss:
But you lucked out in a way, because it had a relatively short trial.

Dr. Andy Roark:
Oh yeah. It was great. It was a half day. I got the experience of being on a jury in a half day, and then they let me go for the week. And I was like, “No, that was definitely it.” That was the best thing, was I go to-

Stephanie Goss:
Best possible scenario.

Dr. Andy Roark:
I got to go sit in a little jury room, I got to sit in a jury box. I got to see-

Stephanie Goss:
The whole nine yards.

Dr. Andy Roark:
… the whole courtroom thing. And then it was five hours, I was done. The longest part was sitting with the jury in the little back room.

Stephanie Goss:
For deliberation?

Dr. Andy Roark:
They don't let you leave until all 12 of you agree. And I don't know if you've ever tried to get 12 people to agree on anything, but it's a horrible system, I think. They're like, “Nope, you all have to agree.” And we went in, and I, of course, I couldn't not talk, because it's me. And so I was like, “Quick temperature check, who here thinks this person… who thinks they've proved negligence on this person?” Two people raised their hands and I'm like, “Dammit.” It's 10 people were like, “Let's be done.” And two people were like, “No, we're going to do this.” And so we asked the people, “Why do you feel this way?” And they're like, “I just feel this way.” And I'm like, “That's not…”

Stephanie Goss:
Not an answer.

Dr. Andy Roark:
Yeah, you cannot just be like, “I just feel this way,” and go against the 10 of the rest of us who are like… Okay. I was like, “But what does the evidence say?” And they're like, “You know, it's my gut evidence.” And I'm like, “That's not a thing. It's not a thing.” And basically we sat there for two hours and stared at them til they're like, “You know what? It's okay, it's fine.” Then we all left. That was justice that day. We stared at them until the got uncomfortable and just wanted to go home.

Stephanie Goss:
I think that we have listeners who would pay to be on a jury with you, just for the comedic entertainment value.

Dr. Andy Roark:
Oh, it's funny. When you're sitting in the jury room and they take your phones away and then they just leave you there until you can all agree. They come in there and be like, “Hey, it's time for a break.” And I'm like, “What does a break constitute, because we can't have phones, we can't leave the room?” It's like if I put you in a room that was like, “I need you to do this thing that involves talking to the people.” And then I came in, I was like, “Okay, you're on break now, but you can't leave the room and you're still here with the other people and you can't have your phone.” You would be like, “This isn't a break. This is me just doing the exact same thing I was doing minute ago.”

Stephanie Goss:
This is just dragging this out and prolonging it.

Dr. Andy Roark:
Yeah. I was like, “I don't want a break. I want to go home.”

Stephanie Goss:
Oh man.

Dr. Andy Roark:
So [inaudible 00:06:30], it was interesting. It was interesting. The funniest part was, it's a straight-up traffic accident in a parking lot. And one person was like… Both people said the other person was driving like a maniac and slammed in.

Stephanie Goss:
Of course.

Dr. Andy Roark:
“I was basically at a stop and the other person's a maniac.” And they both said that the accident happened in slightly different places, which fit with who ran in into who. Right?

Stephanie Goss:
Right.

Dr. Andy Roark:
If you believe it was this person, it probably happened over here, and if you believe it was that person, it's probably about 15 feet back this way. And there's no footage of it or anything. But one of the people was like, “You could see in the photo they showed us from the arrows that were drawn that this person was not at fault.” And I was like, “That person's lawyer drew that arrow. You can't…”

Stephanie Goss:
It's not actually evidence.

Dr. Andy Roark:
Yes. It's like, “That person's lawyer drew those arrows so that it would look like their client did not do the thing.”

Stephanie Goss:
Oh gosh.

Dr. Andy Roark:
But it was just funny that somebody was like, “If you look at these arrows, it's pretty clear who's at fault.” And I'm like, “You mean the arrows that their lawyer drew to protect their client and explain what happened? Those arrows?”

Stephanie Goss:
Oh, so funny. So funny.

Dr. Andy Roark:
So anyway, I was glad to be done.

Stephanie Goss:
We have a great letter from the mailbag for this week. I'm excited. This is going to be, I think, one of those ones where we go down a little bit of a culture rabbit hole. We got an email from someone asking, “What do I do with having an excellent technician with very skilled, good technical skills. They just happened to call out. And by call out, I mean excessively call out.” And so they were like, “I went back and looked, and this year this person called out over 30 times, sometimes for multiple days at a time for each instance.” And so they were like, “Look, the leadership team, floor lead, practice manager, multiple people have had conversations with them, and in the course of the conversations it's been productive and good. This person has opened up and they're having some mental health challenges.”
And so they were like, “Look, we are in a good place. We have resources. We've got an EAP. We've got a mental health coaching platform that we use. We've got therapy, psychiatry through our health benefits. This person has a lot of resources and they're using them. And the result is still that this person is out a lot, and it's a small hospital.” And so this manager was like, “We're a really small team, we only have four technicians.” And I say only, and lots of hospitals are sitting here going, “I don't even have one technician.”

Dr. Andy Roark:
Sure, yeah.

Stephanie Goss:
“Don't talk to me about being small team.” But they've got three doctors and four technicians to rotate through all the days that they're open. And so they're like, “When anybody on the team, doesn't matter that it's just this one person, when anybody's gone, we're severely short staffed and it puts a significant amount of strain on us. We lose revenue because we can't operate at full capacity.”
And so they were just like, “It's a reoccurring problem. And so what do we do now that it doesn't seem to be changing and there is this pattern? Because every single time it happens, it puts strain on everybody because we're working shorthanded.” And this manager was like, “It's also at the point where it's affecting me on a personal level because I'm the one who has to deal with the schedule, I'm the one who has to rearrange everything at the last minute and try and make it work, and I feel taken advantage of.” And so they were like, “We've tried talking to them, we've tried reducing their work schedule, doing less hours. We reduce it down to the minimum possible to be able to keep their health insurance benefits and none of the things that we've tried are working.” And so they were just like, “How do I deal with this? Where do I go from here?”

Dr. Andy Roark:
How dos from Stephanie Goss? What magic wand do you have that's going to fix this?

Stephanie Goss:
Oh, this is one of those asks where it's like, “What's the magic wand?” There is no magic wand.

Dr. Andy Roark:
It can be a short episode. Make the call. That's it, make the call. Anyway, we'll unpack this. We'll unpack this.

Stephanie Goss:
Let's do it. Let's do it.

Dr. Andy Roark:
But the thing is, you know who this is. It's the story of this lady who finds the frozen snake, and she picks the snake up and she sticks it in her shirt. You don't know the story?

Stephanie Goss:
No.

Dr. Andy Roark:
Fine. So there's this lady, and she's walking home at night in the winter, and she finds a snake frozen solid. She picks the snake up and she puts it into her shirt. And by the time she gets home, it has warmed up to get sort of life back into it, and so it bites her.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And she dies. And as she's laying there dying, she says to the snake, “Why did you bite me?” And he says, “You knew I was a snake when you picked me up.” And that's the story. There's a Buddhist story that's the same story about the-

Stephanie Goss:
That's really funny.

Dr. Andy Roark:
… scorpion and the frog. And anyway, just basically the scorpion says to the frog, “I need to get across this river.” And the frog's like, “Okay.” And the frog swims halfway across the river with the scorpion on its back, and then the scorpion just stabs the frog and kills it.

Stephanie Goss:
Sure, and stings it.

Dr. Andy Roark:
The frog is like, “Why did you stab me?” He's like, “You knew I was a scorpion when you put me on your back.” And again, this person is not bad. It doesn't sound like they're a bad person. It sounds like they're probably really struggling. Everybody's fighting a battle we don't know anything about.

Stephanie Goss:
Yes.

Dr. Andy Roark:
At some point you know what this is and you know who this person is. So that's headspace for me, it's the biggest headspace thing [inaudible 00:12:53], for me is this. And I've seen this. I've wrestled with this so many times in my life, is the if this person would just blank problem, which is when you look at the person like this and you say, “But she's a great technician and everybody likes her, and she's funny, and she's positive. If she would just show up and do her job, she would be amazing.”
I was like, “If she would just not steal money from the cash register, she would be incredible. If she just didn't sell drugs out the back of the practice, she would be awesome.” And again, I'm conflating these things that are wildly more problematic, but you get the point. That's the hardest thing as a manager, is when you see someone who is great in so many ways, but they have this thing that they're doing that is toxic and they will not stop doing the toxic thing. And it tortures me because I desperately just want them to stop doing the toxic thing and this'll be great. I have struggled with these people in my career because I think, “Oh, if she would just stop doing this or she would just do that.” And it is so painful to come to the point of realization that she's not going to stop.

Stephanie Goss:
Well or maybe she can't. Right?

Dr. Andy Roark:
Or maybe she can't, absolutely. Yes, very fair.

Stephanie Goss:
And so I think here that is, for me, part of the headspace is acceptance. For me, that is almost the totality of headspace is acceptance. At some point we have to accept…

Dr. Andy Roark:
It seems that way, because they seem like they've done a really good job.

Stephanie Goss:
Yes. Yes.

Dr. Andy Roark:
It's like at some point it really stinks when people come to us and they're clearly Uncharted listeners or they're Uncharted members and they're in there with us and they do it. It sucks because they come to us and they're like, “I did all of these things.” And I'm like, “Oh, you did all the things. There's nothing left. You did them all.”

Stephanie Goss:
It's so funny you said that.

Dr. Andy Roark:
Congratulations, you're boned at this point because none of this has worked. That's so bad.

Stephanie Goss:
It's so funny that you said that, because in my first thought as I was reading it was… But let's zoom out for the people who maybe haven't, who have been in this position who haven't tried all of the things. Right?

Dr. Andy Roark:
Okay, all right.

Stephanie Goss:
Let's give kudos to this management team.

Dr. Andy Roark:
Absolutely.

Stephanie Goss:
Because they were like, “Let's start with the resources. Here's what we got.”

Dr. Andy Roark:
Totally.

Stephanie Goss:
They're doing the right things. They've got an EAP, an employee assistance program. They have got additional mental health support in a coaching app, which I love the sound of that. I would like to find out more about that. They've got access to therapy and psychiatry through their health benefits which they're providing to their team, so all of these things are great. And they've been super supportive, where this person is like, “Hey, I need to take time off.” “Okay, take care of yourself. We've got it. We'll figure it out.” So big kudos there. That's step number one.
Step number two was they were like, “Hey, culture is important to us. This person is highly skilled and they are a great cultural fit.” And so you know what you talk a lot about how do we evaluate employees and we need to look at fit and we need to look at skill.

Dr. Andy Roark:
True.

Stephanie Goss:
So these managers are like, “We looked at the fit and we looked at the skill. When she's here, she's an incredible fit and she's highly skilled. This is the kind of person that we want on our team. This is the kind of person that we want to retain.”

Dr. Andy Roark:
“When she's here” is the operative words.

Stephanie Goss:
Exactly. That's exactly it. So the head space, I think, and the challenge for this management team is we have to come to a place of acceptance. And so this is a little bit of when the same thing happens over and over again, at some point it's become your business model. And so that is the case here. It has become the business model. There was some information shared, which it sounds like this person is not always necessarily being truthful when they're calling out. There is some far farfetched stories. Because I could hallucinate a planet where if someone is having struggles, whether they're physical health or mental health or within their family or home environment or whatever, at some point I've been there where it feels embarrassing to say the same thing over and over again. And so I could totally hallucinate a place where this person is like, “I can't just say I'm having a hard day again. I've got to come up with a very good reason.”
And so it sounds like they ventured into that territory where some stories have been made up, there's been some crazy-ass farfetched things that have been thrown out there as to reasons why they can't. And as a result of that, the leadership team is feeling like, “Well, now we can't trust her,” which is quite unfortunate. Because they were like, “If they would just say, ‘I need a mental health day,' that's fine. That is something we can support.” But now we're in this position where we feel like we have to deal with a problem that they have created because they're not just telling the truth. I think that that is something that we can pick apart and talk about. But I think overall, the answer is acceptance.

Dr. Andy Roark:
Well, you know what part of all this is? This stuff always gets me. So you've got this practice, and they are doing all of the things, you know what I mean?

Stephanie Goss:
Yes.

Dr. Andy Roark:
They've got psychiatric support, they've the EAP going, they're working on flexible scheduling and shortening hours and doing everything. And I'm like, “Man, these guys are crushing it as far as supporting this employee.” And you know what the experience of the other employees is? If you went and asked them or were like, “Hey, what's it working here?” They wouldn't be like, “These guys are amazing.” They would be, “It kind of sucks because this person just doesn't show up and then we just have to deal with it, and it happens over, and over, and over again. And so what is my experience? My experience is being surprised to be shorthanded again and again and again. That's my experience.” And god that sounds awful, doesn't it?

Stephanie Goss:
Yes.

Dr. Andy Roark:
Tell me I'm off base, right?

Stephanie Goss:
No.

Dr. Andy Roark:
That's how I see it go out all the time, is like you're in the leadership role and you are pouring your heart and soul into this, and the rest of the team is not impressed. In fact, they're just irritated, because what they see is not all the support that you're pouring in. They're seeing their own position, which is, “We're shorthanded again, and again, and again.” And again, they don't know why and they shouldn't know why. Right?

Stephanie Goss:
Right. Right.

Dr. Andy Roark:
We don't share these types of information about why we do what we do. That's an HR no, no. So they don't have the information. And so try to put yourself in their shoes and how does this look to them? It doesn't look good. And it's one of those things where sometimes no good deed goes unpunished, where we do what we can for this employee and we work so hard, that we end up irritating the rest of our staff and now our generosity has backfired on us. I don't know that that's happening here, but again, when we talk about finding balance, that's a big part of it. We want to help this person, and we need to help the staff and make sure that they're taken care of, the rest of the staff.
And we need to take care of clients, which mean clients need to know that they're going to receive a certain standard of care when they come in, and all those sorts of things. It all has to balance out. If you have one person that just keeps tipping farther and farther back on the scale, at some point you go, “We've done everything we can to try and balance this, but we just can't go that far.” I think that's where we come to acceptance, is go, “We've done everything and it's still not going to work.”
I think that's a bitter pill to swallow, but I think sometimes we have to that swallow pill. But let's go ahead and get into headspace here, and talk about where they are from a general place. Because this is pretty far down the line. Let's talk about what they did and how they did it and what we think about that. Does that sound good?

Stephanie Goss:
Yeah.

Dr. Andy Roark:
All right, sweet. We're going to have people who are going to struggle at different times in their lives.

Stephanie Goss:
Sure.

Dr. Andy Roark:
That was the thing I didn't understand when I was younger. But as someone who has had a wife go through breast cancer, and had different employees at different times wrestle with personal things, and these are people I care deeply about. I don't know man, I just didn't understand earlier in my life how hard life is sometimes, and how complicated it is, and how good people go through hard things.
And I also didn't understand earlier on how much it meant to me to be a good employer and a good supporter of my people, how much it meant to me to say, “Hey, I understand you're going through something hard. Take care of yourself and take care of your family, and we're going to help support you through this because we care about you.” That feels great. And that is something that has meant a lot to me. And so I put that forward in headspace and sort of say, “Know what your values are. Know what you care about. Know about the type of employer that you want to be.”
I was… to say, “This is a relationship, and I want you to treat it like a relationship.” And man, I don't want to be in a relationship with somebody who's going to cut me off the moment I don't do everything that suits them. Or, the moment I'm struggling with something they're like, “Sorry, we don't have time for your stuff,” and dump you. I don't want that. At the same time, I don't want to be in a relationship with someone who continues to take, and take, and take, and take, even if they don't mean to. At some point, it's kind of like it is some of those things that I've heard and read something different things about. People who struggle with family members who just continue to drain, and drain, and drain. You say, “This is my family member.” But at some point you've got to say, “I'm sorry, I'm putting boundaries up to protect myself, even though this is a hard decision.”
I think that there's some parallels as employers of saying, “I'm going to be here. I'm going to support you, but at some point I'm going to be a part of the healthy relationship and I'm going to have to do what I need to do to keep my own head above water,” you know?

Stephanie Goss:
Oh yeah, 100%. When you don't do anything to have balance and set boundaries, you are 100% creating the co-dependent relationship. They are taking, and taking, and taking. But by you not creating any boundaries and saying, “Okay, I'm giving grace and these are the rules that we need to play by,” you are equally responsible for creating that codependency. And so I think that's part of the acceptance for sure from a headspace perspective. It's like, “All right, this is where we're at,” and ownership of that.

Dr. Andy Roark:
Well, the lack of truthfulness about what's been going on, I think this is an interesting life lesson. And again, a lot of the stuff we talk about… I think the reason that people like what we talk about and how we look at things in Uncharted is we tend to keep things pretty darn simple. I try to frame them that way, and they are. The truth is, once someone catches you not being truthful or their perception is that what you're sharing is not honest, you're going to lose that trust. Right?

Stephanie Goss:
Yeah, yeah.

Dr. Andy Roark:
Trust is hard to build and easy to lose. And once you lose someone's trust, one, it's hard to get back. But number two, it affects how they treat you and the grace that they extend to you. And so when they say, “We found this person not being truthful about what had happened or given these very farfetched stories,” and things like that, I'm not going to say to these people, “Oh, you can't hold that against this person,” or, “Don't let that factor into your decision.” It does factor into your decisions.
And so I think really, the truth is in personal responsibility, just as an employer or employee, as an individual. I think one of my sayings is, “Integrity above all else.” And the truth is come clean and be honest. And once people question your integrity, it closes a lot of doors for you. And I would say that's another reason… If I sounded flippant at the very beginning, this is part of the reason why, is because it's really hard to go forward with somebody that you're trying to take care of with the knowledge that they have not been truthful and they may not be truthful in the future.
It's really hard to do that. If you're dealing with someone who's struggling and they're being upfront about how they're struggling… And again, that doesn't mean sharing everything. Right?

Stephanie Goss:
Right, yes.

Dr. Andy Roark:
We all have privacy and expectation of privacy. But if they're not misleading us in any intentional way, I'm much more likely to try to keep going with them and saying, “Everyone's acting in good faith.” But man, once people start being less than honest about what's going on with them, that really closes the doors in the number of ways that we can work with them, just because we never know what we're dealing with.

Stephanie Goss:
Yeah, yeah. No, I think that that is totally true. I think the last piece of headspace for me goes along with that. Because, for me, part of the headspace is wrapping my brain around my own acceptance, as a leader, of letting it get to the point that it's at. Again, we're only hearing one side of it, and we're just reading the email and interpreting. But they were like, “We're at the end of the year. I did a look back, this person has called out more than 30 times this year, and there's been multiple wild stories and we've caught them in lies.” My question is acceptance of, okay, I have to own that. Did I have the conversation with them the first time it happened? Did I have the conversation with them the second, third, 10th time that happened?
And acceptance of the fact that, okay, we've gone far enough down the road that now it's not an easy conversation of, “Hey, yesterday when you called out, this is what you said.” I'm going to use a common example, “Then you posted on social media, or you sent a text message to the rest of the team and said, ‘This is what I'm doing.' So I know full well that that wasn't what you needed. I just need you to know, you don't have to give me details. It's okay to just say, ‘I need to take a mental health day.' Or, ‘I can't talk about it, but I need to take a personal day off.' That's what they're there for. I don't need the details, but I do need you to be honest.” Right?

Dr. Andy Roark:
Yeah.

Stephanie Goss:
So for me, part of it is acceptance of my own level of responsibility as a leader. I will tell you, again, this is an episode that there was a time in my career that I could have written this letter.

Dr. Andy Roark:
Yeah, sure.

Stephanie Goss:
And part of it, part of the very bitter part of the pill, was the fact that I was… Like you said, I wanted so badly to support that person and be there and be accepting, that the pendulum swung way too far in one direction. And then when the rest of the team was raising their hands and saying, “But what about us?” I was struggling because I was like, “But I was trying to do the right thing for this person.” And the reality is, yes, I was. I was trying to do the right thing for that person. I was trying to give them grace. I was trying to support them. I was trying to not look like the manager who's like, “Screw that. You called off for this second time, you're fired.”
Because there are managers like that in our industry, and I get that these leaders were trying to do the right thing in supporting their people. There has to be the balance. If they team is like, “Hey, we're constantly short-handed,” and you, as a leader, are saying, “I'm the one constantly having to readjust the schedule and now it's affecting my mental health,” that's part of the acceptance pill to say, “Hey, maybe the pendulum has swung too far and I need to get into a headspace about my ownership of that.” Because in the action steps, in having some of those hard conversations, it'll probably make it a lot easier to potentially have a better outcome if you can own some of that.

Dr. Andy Roark:
Yeah. The last headspace thing for me, which I think is actually probably the most interesting part of this whole quandary here, is the mental health card. And that's an interesting term, but I'm hearing this term more often, the mental health card. And so to me, it's interesting because this has been put forward as this person is having mental health struggles. And that's one of the things that's been put forward.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And I think a lot of leaders out there are struggling with employees that are… or team members, or coworkers, or fellow doctors who are not performing, not meeting expectations. And the justification is, “Well, I'm having mental health challenges.” What do you do about that, and how do you balance compassion and support for this person with the reality that we have to have expectations to get met? We can't have people just not show up for work again and again. It's not fair to the other team. It's not sustainable. It shakes our whole business. Or, the behaviors that are manifesting are not acceptable behaviors.
I understand that you're struggling, and I can be compassionate about that. At the same time, I still can't have you yelling at the staff when you get stressed. That can't happen. And so I think that's an interesting thing. I'm saying I think there's a big spectrum of this. There is 100% the this person has legitimate mental health struggles and are struggling to meet performance. How do we manage someone who's struggling to meet performance because of mental health challenges?
And then there's the far extreme where there is the one that says this person may have other reasons for not meeting performance, but they're saying it's a mental health struggle because they think that that's going to get them more leniency than if they just said-

Stephanie Goss:
Sure, it's a free pass.

Dr. Andy Roark:
… “I just didn't feel like coming in.” Exactly right. And you'd hate to think that anyone would do that, but it's a big world and I'm certain that there are some of that.
And so people say, “Well, how do you manage these things and navigate these things?” And so I think we'll talk about this in action steps. But I think the headspace is assume good intent, assume that everyone is doing their best, compassion first. And this is all about balance, which means I can believe that you're having mental health struggles and I can be compassionate and empathetic, and at the same time just know that my job is to balance the needs of the individual with the needs of the team and the needs of the clients. And so I can be empathetic and compassionate and still say, “I need to balance these things out. And we have to figure out how to make that happen.” And we'll talk about that when we get into action steps.

Stephanie Goss:
Yeah, I like it. Do we want to take a break and then dive into the action steps?

Dr. Andy Roark:
Yeah, let's do it.

Stephanie Goss:
Okay.
Hey, friends, I just want to jump in here for a quick second and say that I am super, super pumped about all of the awesome things that we have coming down the pipeline in 2023. Now, we haven't announced all of the surprises that we have coming for all of you, but there are lots of great things coming to kick off the year. If you haven't signed up for some of the workshops and events that are happening in the first quarter of 2023, you want to head your little self over to UncharteredVet.com/events, and check out what we've got coming.
If you are a member, all of the workshops are listed there. You can log into your account and sign up for free. If you are not a member, you should check out what's coming and consider a membership for 2023, because you could pay $99 per workshop, but you also could pay $6.99 and sign up for a whole year of registration as a member and then you get access, not only to all of the workshops that we do, but all of the amazing content that happens over in our workplace group and our community. It is so fun, it is lively. It is just jampacked with conversation from the community about what's going on in their practices, how to solve challenges, how to support each other. It is one of my favorite places to spend time. I would love to see you there.
If you need that address one more time, it's Unchartedvet.com/events. Now, back to the podcast.

Dr. Andy Roark:
Let's get in some action steps here.

Stephanie Goss:
Okay.

Dr. Andy Roark:
Okay, cool. I'm going to start with your favorite thing. Let's talk about what they did, because they did a lot really well. Let's talk about what they did, and let's walk all the way up to where they are. And so, one of the first things that we've got to do to be successful… And I deeply believe you have to learn this the hard way. Every policy that we have probably came from a mistake that we made in the past. And so it takes a while for people to get here.

Stephanie Goss:
Yes.

Dr. Andy Roark:
You're going to love this.

Stephanie Goss:
Are you going to say it?

Dr. Andy Roark:
But we need to have our handbook. What is our attendance policy? What is it?

Stephanie Goss:
What does your handbook say?

Dr. Andy Roark:
And what systems do we have to support people who are having mental health challenges? I know you love it.

Stephanie Goss:
I do. Can I just bask in that for one second?

Dr. Andy Roark:
Yes, just soak that in. You should have-

Stephanie Goss:
What does your handbook say? Okay, okay. I like it.

Dr. Andy Roark:
What does your handbook say? But that has to be it, right?

Stephanie Goss:
Yeah.

Dr. Andy Roark:
Hear me on this, this is how we make the balance happen, is we sit down, not in the moment, not when we're dealing somebody, not when it looks punitive. But we just sit down and say, “Okay, what is our calling out policy?” knowing that life happens and we want to be generous to people, and we want to be supportive of people. I'm not making some Alcatraz calling out policy where if we can't find you then you can be off for the day.

Stephanie Goss:
Right.

Dr. Andy Roark:
It's not that. But what is the policy here? Because these guys said she's called 30 times. I don't know what the policy is, but it's not 30. That's not where we want to be.

Stephanie Goss:
And I love that. Obviously, I love that you said, “What does the handbook say?” But also I think that that's a good use case to look at and say, “Okay, we feel like there should be some sort of attendance policy, and someone who's called out 30 times feels a little excessive.” Let's look at that. When we think about what is… Okay, if there's 52 weeks in a year and everybody gets vacation and you figure out what is your actual working… How many weeks in a year does your average team member work? It's probably somewhere between 40 and 48 for a lot of people. What does that look like? Look at your own policies and then figure out…
Okay, let's just look at that. What is half of that? What is 50%? When you look at that, even if you just take 52 weeks. I don't know what their vacation policies are, so if I take 52 weeks, half of that is 26. If this person has called out 30 times, that means that they've only been there half of the weeks in the year. That is wildly excessive to me. Clear-cut, no brainer. Anyone could look at that math and say, “This is excessive.” It doesn't feel subjective, it doesn't feel punitive, it just feels excessive. And so it's easy to say, “Okay, if this feels super excessive and we know we want some sort… what does the middle ground look like?” You know?

Dr. Andy Roark:
Yeah. There's this exercise I talk about every now and there called Rawls' veil of ignorance. Rawls' veil of ignorance is the idea that if you look at a system, if you didn't get to pick where you were in that system, would you think it was fair? And if the answer is yes, then it's fair. I've always aspired to that. If I was the CEO, would I think that this was a good, fair approach? And if I was the janitor, would I think that this was a good, fair approach? And if I was a doctor, would I think it was a good, fair approach? And if the answer is all the things is, “Yes, I would think it was fair,” then you're probably doing pretty good.
And so I like Rawls' veil of ignorance, especially in this regard, because my goal is to come up with something that works for me, as the business owner, it would work for me if I was one of the technicians on the floor trying to get the work done. Or, if I was the person who was having some challenges and had to call out, I'd be like, “Yep, the system seems fair.”

Stephanie Goss:
Sure.

Dr. Andy Roark:
And so when they sit to make these, I really like Rawls' veil of ignorance because I don't know if I'm going to be the boss, I don't know if I'm going to be the laborer, I don't know if I'm going to be the person who's calling out sick because I'm having a family emergency or nagging health problems for my kid, or whatever. I think that my goal in this would be to say, “I don't know which of those people I would be in this situation, but wherever it was, I would think it was fair.” That doesn't mean I'd be thrilled with it. That doesn't mean that it would solve all of my problems. But I would understand and say, “Yeah, I think this is fair.”
And so when we start talking about these things, I think that's what we talk about. Say, “What's fair to the person who is out? What's fair to the team that is expecting support and not getting it when the person's out? What's fair to me, as the person making the schedule and scheduling the staff? What's fair there?” I think laying that stuff down ahead of time, I think that that's really key. And that's your attendance policy. At what point do they have to start having to have doctor's notes? Where does that happen? What does that do? But we need to lay those things down.

Stephanie Goss:
Sure.

Dr. Andy Roark:
The other part is to say when we talk about mental health stuff, I'm not a therapist and you're not a therapist. I am not a mental health professional and that shouldn't be part of my business model, I don't expect to be. However, I do what people to have support when they need it. And so when I'm done setting my attendance policy, I'm going to look at my mental health support options and resources and lay those things in and say, “If people are struggling, if they're having mental health issues, this is how we're going to get them support.” That's not me making it up and pulling it out of my ear as we go along.
It's like, “No, this is what we have, and this is how we're going to support these people.” And basically what I want, ultimately, is for those two things to come together and to make a good support structure to say, “This is our attendance policy and these are the resources that we have.” The expectations are that you leverage these resources and still abide by this policy that was put in place with the idea that some people would go through hard times. You know?

Stephanie Goss:
Right. Yeah.

Dr. Andy Roark:
But you can still check those boxes. And when the team comes to me and says, “Hey, Andy, why is Stephanie not here all these times?” I can say, “Hey, she is following our protocols that we have laid down. She has met the requirements to be able to request this time off and do these things. We're supporting her. But I assure you, she is working by the same policies that you would have accessible and available to you if you were in her position.”
And bam, I'm not telling you what it is. I'm not going into resources, or what resources you're using, but I can look at you in the face and say, “She's using the same playbook that is open to you when you face these challenges.”

Stephanie Goss:
It's equitable. Yeah, yeah. I think that's so important. And I think that's the hard part, because… And I will tell you I have done this, I will own this 100%, where as manager, somebody has figured out another loophole. I say that with all the love. And then I'm, “I am going to take my flaming, raging sword of justice and I'm going to update the handbook, because screw this.”
And then it never goes well.

Dr. Andy Roark:
Yeah, sure.

Stephanie Goss:
Everybody can see it for what it is. And sometimes that's a good thing, right? Sometimes, from an HR perspective, I can't share information. I can also let the team know, without saying much, “Hey, here's the new policy I need everybody to be aware of.” You know? Right?

Dr. Andy Roark:
Yeah, yeah.

Stephanie Goss:
And sometimes that is a tool. That should not be the first tool that you reach for. It's really easy when we're frustrated or we're angry, which is reasonable given the circumstances, that it's easy to reach for that tool first, and it shouldn't be the one that we reach for first. But I love that idea of doing it when you're not… Not punitively, not in the moment. But looking at the policies, looking at the protocols, looking at the support systems, I love that, because then everybody knows what to expect.

Dr. Andy Roark:
Yeah. And I find that to be true. I talked about the mental health card, and people say, “Well, what do you do when this person can't perform?” And they're pointing to this and say… If we've set up our systems well, then ultimately they're going to get support. And at some point they're going to come to a place where you say, “Hey, you've used up all your away time without a doctor's note and this is where we are,” and they have access to resources and stuff like that. But at some point you have to say, “This is where we're coming down on this issue.”
I tell you what's a nightmare to do, is to say, “Hey, we don't have any policies, but I feel like you've been gone too much and now I'm going to force this issue.” You don't want to have that conversation. The point of laying in these protocols is to have built in systemic boundaries where you can say, “Hey, just so you know, we're coming up on this and we're going to need to figure out what to do about it. You need to be aware that this is what our policy says and where you are in the program.”

Stephanie Goss:
Yes, and I love that you said that, because, for me, that is a huge part of the action plan and acceptance here, is the fact that we're doing this now. We're doing this as a look back. This person has now missed 30 call-outs in a year… I'm assuming in a year period.

Dr. Andy Roark:
Yeah, sure.

Stephanie Goss:
But whatever period of time. 30 call-outs and now I'm looking at it. And so now I'm like it's not, “Hey, you're coming up on the end of the policy. We get two weeks in a year. You've used a week and a half. Just FYI, I just wanted you to be aware of it.” It's the afterwards. And so it sucks, because in a way, and again, I say this as the manager who has done this, so please, if you're listening, don't take offense to this, you've tied your own hands. Because now you're having to have the conversation way after you should have laid the groundwork and had that framework conversation. Or probably multiple framework conversations and said, “Hey, this is where we're to.”
Now you have no choice but for it to potentially come across as feeling punitive, because no matter what you do at this point, it's reactive, because you're coming at it from a place of, “This has already happened, and now I need this to change,” which is not the place you want to be able to come at it from. You want to be able to come at it, like you said, Andy, from that place of, “Hey, this is how far into it we are, just a heads-up, just an FYI.” Because you're laying that groundwork, because then the conversation becomes easier. “Hey, remember how we had that conversation that you had a week left. You've used up that week, and so we're at that point, I just want to check in. I want to know how you are. How are you feeling? Do you think this is going to be an ongoing problem? Do we need to come up with a new plan? Do we need to talk about FMLA?” What are all of those options? You're doing it ahead of time when you do it the way that you just said.

Dr. Andy Roark:
Well, this philosophy, this approach that we use at Uncharted, it comes from dealing with clients who are strapped for cash, so clients who come in who don't have money for procedures. Originally, I spent a lot of time working on this. Exam room communication's a passion of mine, it has been for a long, long time. I wrestled with this for years. I can't look at somebody and know what their financial status is. I don't know if you have money or not, and I don't want to guess. It makes me feel gross and to look at someone and go, “Do you think she can afford this?” I don't freaking know. I don't know.
If you say to me, “Oh, that's a lot of money.” I don't know if that's because you don't have the money or if you just are someone who is cheap and is like-

Stephanie Goss:
That's a lot of money.

Dr. Andy Roark:
… “I have the money but I don't want to spend it.” And again, I'm never going to know. The place that makes me happy, where I found comfort is to say, “I've built a system for dealing with clients that doesn't…” I don't care what you have. I'm not going to treat you differently based on how much money I think you have. I'm going to make a system where we bring people in, we do our physical examination, we walk them through the process, we articulate what we are doing, we are open and transparent about our prices, and ultimately we come down to a place where we're going to present estimates and say, “This is what we want to do, and this is how we want to go forward.” We may give people options, or whatever we're going to do. But we walk through.
And again, it's not based on how much money we think you have in your pocket. Everybody gets treated the same as far as how things are laid out and what communications we have. And then ultimately, I don't really care if you have the money or not, I just need you to be open about where you are, and I'm going to be open about where I am. We're going to have resources in place to help you. If you don't have that money, we're going to have payment options, we're going to have lending options, we're going to have whatever else, a way to walk you through this.
But what's not going to happen is you're going to come in and make some vague hints about not having the money to take care of your pet, and then I'm going to throw all the rules out the window and just do everything that I can for you, not paying any attention to my staff and what the practice needs. I'm not throwing all that stuff away. That can't happen. And I see a lot of people do that. And so it really bothered me for years and years, until finally we just drilled in and we're like, “This is how we do the exam room.” And that's it.
If you're interested in that, I've got a team training course called Exam Room Communication Toolkit. It's at DrAndyRoark.com, where I do staff training. But all that stuff is 17 tools, but they all come from this type of approach of being like, “This is how we talk to people, and we work everyone through the same system. And ultimately, if there's a money problem, it comes out and we work through it within healthy boundaries.” And so when we start talking about absenteeism, when we start talking about people having mental health challenges in the profession and practices, and again, it's something I've wrestled with.
I went through a period of significant burnout a couple of years ago. It really, really sucked. My practice was greatly supportive of me. They were wonderful, and I would want to give that to other people. And at the same time, I expect the practice to have healthy boundaries and to take care of itself and to take care of the other employees, and take care of the pets. And that means having some guidelines in place before we get here that say, “I want to be supportive of you, and at the same time, you have some obligations here as well.” Whether it's cash-strapped clients or whether it's employees that are having mental health struggles, I think that that's the healthiest, most compassionate approach for everybody. I really do.

Stephanie Goss:
Yeah. And I think we're kind of at that point where we have gone past the pre-work. We talked about action steps that we can do in the future, and things that we can do to set ourselves up better for success next time. And at the same time, with this current technician, I think it's time to sit down and have a conversation. I would do it from a place of compassion and a place of care, but I would just say, “Hey, I need to sit down and have a chat with you.” And then I would kind of just lay out, “Hey, okay, here's where we're at.” This is a potential to own some of it on your own, and I found that it softens the blow.
I like to use this as a tool. It doesn't fit right for everybody, but I would 100% say, “Hey, I wasn't on top of this and I didn't realize that we're at the 30 mark, 30 call-outs for the year. That's on me. And now that I recognize it, I need your help because I can't go into the new year with this happening because it doesn't work for the rest of the team. I want to support you.” And again, I want to recruit them into the conversation. And so the way I would probably approach it is to say, “I can see a couple of potential solutions here, but I want to talk through all of them with you because you might have some ideas that I might not have thought of that I want to have on the table. But we've got to address this, because we can't keep going the way we're going.”

Dr. Andy Roark:
I love that so much. I love it. I love it because you owned it. And the more accountability we can accept, the more open a conversation we're going to have. I just think that, “Hey, it's on me that we got to 30.” I love that so much. I think that's excellent. And another thing that I really love in the wording that you used there is it's very future facing. “This is where we are. We're going into 2023, let's talk about what we're going to do differently, or let's talk about what we need to do in the coming year because we need to make some adjustments. And I said it's on me that we got this far this year. We cannot do this again next year, just so you know.”
And so I love that. I love laying it down like that and keeping it positive, and keeping it future facing.

Stephanie Goss:
And I think the other thing too, is to acknowledge that they may be in a situation that they can't control. Right?

Dr. Andy Roark:
Yeah.

Stephanie Goss:
And so it's okay to say, “We may be in a situation where you need to continue to have time off, and that's okay. And here's how we can support you.” It's okay to say to them, “We can support you in the capacity that you're a part-time on-call, or on-call team member.” That could be a potential solution. It doesn't have to be, “We're going to keep you full-time and keep scrambling at the last minute.” It is perfectly okay to take that off the table and to just call a spade a spade and say, “I can't continue to be in the position where we're having to change the schedule last minute and the rest of the team is working short-handed, because it's impacting me on a mental health perspective, it's impacting the team. Short-handedness, it impacts the clients. I need your help to figure out how I can support you and not continue to be in this situation, because I want to do both of those two things.”
It's okay to put some of the accountability and responsibility back on them, because regardless of what they're going through, mental health or not, it is an unrealistic expectation, for any employee to have, to expect that they can show up when they want. That's not how real life works. I think that for a lot of us, we get afraid to be the adult and put the boundaries in place because we're like… For me, it was always like, “I don't want them to not like me. I don't want to be the mean one.” Right?

Dr. Andy Roark:
Yeah.

Stephanie Goss:
And the reality is, I can't run a business if my team isn't here. And so maybe the answer is I hire more staff, because if I know I'm going to be short-handed, maybe I need to hire more people. That falls on me, not on them. Maybe they need to go to part-time. Maybe they need to be the on-call employee. This is where, for me, it's about the brainstorming. Because I won't know what's possible until we lay all the cards on the table. For me, the best case scenario is for them to be active and engaged in that part of the conversation, and also recognizing that they may be in a place where that's not possible.
If they are really struggling mental health wise, or they are having a challenge, they may not be in a place to contribute to that. I want to create a safe space where they can say, “I don't know. I just know that I need flexibility.” “Okay, then here's what I can do to support that for you. If you need flexibility, here's what I can do to support that.”

Dr. Andy Roark:
Cool. I want to hammer on this right here as well and say, remember that this doesn't have to be one meeting. I really like your idea of going in… Because to me, I always feel there's pressure to go in and say, “Well, what can you do? Okay, then here's what we're going to do.” It's like, “I'm sorry, I'm not that smart. I'm not that fast.”

Stephanie Goss:
Yes. Mm-mm. Nope.

Dr. Andy Roark:
I need to gather information and then I need to go away and I need to think about it. I need to think about what they say they can do or what their needs are, and then I need to think about what my needs are and what that looks like, and then I can come back and say, “Hey, this is what we need to do next year.” But it doesn't have to be at one time. Don't be afraid to step away. The other thing is ultimately you can do information gathering, and you are going to need to clearly communicate what you need to this person. Because otherwise it's not fair to not tell them what the realities are. And so you don't have to do that today, but you need to say, “Hey, we're at 30 days, that's on me. We got to do things differently. Let's talk about what you're looking at. Let's talk about what would be realistic expectations for next year. Let's talk about how we're going to move forward. I just need to hear where your heads at and what you think you could do to help me meet these needs.”
If this person needs to go part-time, then you go part-time. They might not like that, and I might not like that, but continuing to do the same thing again and again, and expecting a different outcome is the definition of insanity.

Stephanie Goss:
Yes.

Dr. Andy Roark:
If you just keep going and go, “I don't know, she just keeps up not showing up. I don't know what to do about it,” I think, “Well at some point it's not a surprise anymore, it's your business model.” And so anyway, I think that at some point, we have to say, “Look, this is what I need.” And you have to say what you mean, and you have to mean what you say. At the very beginning I said, “I see where this is going.” We can do all the things that we said, and ultimately this person… We can't make this person show up for work.

Stephanie Goss:
Nope.

Dr. Andy Roark:
Like I said, we can do all the systems in place and everything like that, and we can't make the person show up for work. There are ramifications of this person not showing up for work. It is going to cause you problems to have someone who no-shows again, and again, and again. It's going to cause you real problems to have someone who no-shows again and again, and there don't seem to be any repercussions for that person. That's going to have fallout, and you need to be honest about it, and you need to use what… You've already seen, I'm sure, to forecast what that looks like. And then, my friends, you're going to pick your poison at some point.
You've got three options. You can end this now, you can keep it going as it is and accept the fallout from this behavior continuing, which I would not recommend, or you can try to modify expectations and come to an agreement, knowing that if that agreement does not work, you're going to move to termination. And I think honestly, that's probably where I'd be, is I'd get real honest with this person. I would figure out what I really need. I would think about what a fair attendance policy looks like that accounts for people who have unexpected illnesses or sicknesses or mental health challenges, but it's still fair to them and to the rest of the team, and to me, as the practice owner.
I would put those things in place and say, “Look, this is where we are and this is where we're going, and this is what it's going to look like when we get close to running out of these days, and this is what it's going to look like when we hit those days. And this is what it's going to look like when we go past those days.”

Stephanie Goss:
Yeah. I love that so much. And I will say that for me, like I said, I was this manager at a point in my career, and I wasn't sure of where to start. And if you're like, “What would that even look like?” My suggestion would be even if you're a small business who doesn't… to whom FMLA isn't applicable, I would look at the Family Medical Leave Act. I would look at the standards there and say, “Okay, if I was a business of this size, this is what would be legally be required of me.” That's what FMLA says, is that when I have over a certain number of employees, these are the things that I have to provide for them in terms of leave.
And for a lot of businesses, they choose to have all of the leaves fall under that similar umbrella. There are other specific leaves of absence we have to be able to provide our employees, military service, domestic violence protection, et cetera. But most people look at it under that FMLA umbrella and say, “Okay, if someone was going to take a leave of absence for a physical health thing, I'm going to apply mental health the same way.” I looked at those guidelines and said, “Okay, this is what would be required of me. Could I make this work? Could I not? What pieces of it don't work for me as a small business?” If this really a small practice and their techs… their ability to lean into other support members is significant different in a practice that has four technicians versus a practice that has 100 plus employees and you have a bigger pool to draw from.
And so that's why FMLA is not applicable to everybody. But I would use that as the starting point. And for me it was like, “Okay, I can't give 12 weeks, but I could find a happy medium between what we currently have and 12 weeks.” To say, “This is what we could do.” Maybe it's some combination of intermittent. Looking at those kind of things and using it as a baseline to figure out where do I go from here, that would be my best suggestion.

Dr. Andy Roark:
Yeah. I completely agree. Yeah, I think that's it. I think that's kind of what I got. I hope that's helpful, as far as just thinking about. I hope he doesn't feel like we're beating up on our writers.

Stephanie Goss:
I hope so.

Dr. Andy Roark:
It's like it's one of those things where when you play the game really, really well, and then you're still like, “And the person still doesn't respond.” I go, “You've done everything right. The problem is, I'm sorry, I don't have a magical next thing for you to do.”

Stephanie Goss:
There's not a magic wand.

Dr. Andy Roark:
I think you know exactly what you're looking at, exactly who this is and exactly how they're behaving and what the pattern is. None of this is a surprise. I think you're at the place where there's nothing else to do but make the call, and the call is either, “I'm not doing this any more,” or the call is, “I'm going to put up with this,” or the call is, “I'm going to go to them and say, ‘This is the cahnge that I'm going to require to go forward. And if this change doesn't happen, then we cannot continue on together.'” I think those are your three options. I think I would go for number three.

Stephanie Goss:
Yeah, me too. Have a good week, everybody.

Dr. Andy Roark:
Yeah, everybody. Take care of yourselves. We'll see you later on.

Stephanie Goss:
Well, that's wrap on another episode of the podcast. This was so fun. Andy and I always enjoy spending part of our week with you all. We hope you enjoyed it. If you did, and you have an issue going on in your practice, or a question that you would love to hear us answer, or if there is something that you would like to hear us role play, talk through the details of what to say and how to say it on the podcast, please send us a message. You can find the mailbag at UnchartedVet.com/mailbag. Send us a message, whether you want to be anonymous or have a secret codename or not, send us your message and we would love to feature it on an upcoming podcast episode.
Take care, everybody. Have a great week.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: behavior, culture, fatigue, management

  • « Go to Previous Page
  • Page 1
  • Interim pages omitted …
  • Page 5
  • Page 6
  • Page 7
  • Page 8
  • Page 9
  • Interim pages omitted …
  • Page 14
  • Go to Next Page »
  • Membership
  • Account
  • Cart
  • Privacy

Copyright © 2026 UNCHARTED VETERINARY CONFERENCE | WEBSITE BY OFFICETHUG