This week on the podcast…
This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss jump back into the mailbag to make history. That's right, we got a topic we loved so much this week that we are splitting this episode into two! This week, we will dive into the headspace of the challenge facing our repeat mailbag writer who was previously feeling squashed and stubborn. They are still at it and just as stubborn as ever, only this time, they are struggling with not letting client frustration over scheduling woes get them down. They are booked pretty far in advance and doing all the things they can to manage the schedule and clients are still really frustrated. They are voicing it to the team and it is starting to crop up in online reviews and this doctor is asking for help in getting into a good headspace and not letting it get them or the team down. And also looking for help on how to communicate to clients that they have to wait and why it's okay to wait in some cases, without clients feeling brushed off. This was a super fun challenge of an episode – don't forget to stay tuned next week for part two – the action steps! Let's get into this…
You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Amazon Music or wherever you get your podcasts.
Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag
Thank you to our sponsors! To learn more about this week's sponsor, GuardianVets, check out their website HERE.
Upcoming Events
The Secret Sauce to Optimizing Workflow with Senani Ratnayake, RVT
Back by popular demand! It's time to take a look at the workflows that aren't working and come up with a plan to move forward with a strategy that makes sense.
Date: November 30
Time: 5:30pm ET/2:30pm PT – 7:30pm ET/4:30pm PT
All Uncharted Veterinary Community Workshops are LIVE! You will be able to ask the instructor questions that help you address your practice’s unique problems. This will not be 2 hours of silent screen time. Gear up for interactive, fun learning!
All Links: linktr.ee/UnchartedVet
Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag
Episode Transcript
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
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 knew 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 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. And this week on the podcast, Andy and I are making history. That's right, we had a fantastic email from the mailbag and I'm going to set it up in just a second. But it was so good that we decided to split this episode into two parts. That's right, we're tackling headspace and we're tackling action steps, but we had so much great conversation about this specific topic that we decided to make the headspace part one and the action part two. So if you love this week's episode, stay tuned because next week will be part two. We're going to cover all the action steps and we hope it's worth it for this little bit of a lengthier than normal episode because this is a fantastic topic that came to us from Squashed but Stubborn.
I just want to take a quick second and give a big shout shoutout to our friends at Banfield Pet Hospital for making the transcriptions of this podcast possible. The podcast transcripts are brought to you, thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity all across the veterinary profession. If you would love to find out more about the DEI initiatives for Banfield, you can head on over to the link in the show notes. And now let's get into this, shall we?
Announcer:
And now the Uncharted Podcast.
Andy Roark:
And we are back. It's me, Dr. Andy Roark and the one and only Stephanie, I'm a hard working Goss.
Stephanie Goss:
I do. I feel that this week. It is a hard working time of year. How's it going Andy Roark?
Andy Roark:
It's insane. It's insane and it is a very hard working time of year. Holy cripes, we got a lot going on.
Stephanie Goss:
Hell yeah.
Andy Roark:
We got two new uncharted team members last week. Last week we got two new and they are both bad A, bad mamajamas. People aren't going to even recognize Uncharted in about three years. We've got Batman's secret lair and we've got a lot of people down there building a bat mobile or two or three. It's going to be freaking nuts. So anyway, we've got awesome stuff going on here. How are you doing?
Stephanie Goss:
I'm good. It is busy. We have a lot on our plate. And it is that time when we're recording this, it's right before we do Get Sh*t Done. And I'm super, super excited about that. And then you and I and one of our other team members have an event the week after and it's just busy, busy, busy. And it's busy with the kids. So it's that time of year the weather is changing and it is crazy, but it is good. I'm here for it. I'm along for the ride.
Andy Roark:
Well, you write the book you need to read. It's like we put on the conference, we need to have… I'm like, “Boy, we really need a Get Sh*t Done conference.”
Stephanie Goss:
When you're overwhelmed.
Andy Roark:
Yeah, exactly right. When you're overwhelmed. That's exactly… Like, let's get some smarter people than us in here. Yeah, no it's funny. Boy, it's a stressful time here. Two stressful things. Tomorrow we go to the hospital. Allison's going to get the nasty little lump in the breast tissue under her left arm removed. And so that's a big time for us and our family and so a little bit stressed about that. And then the other stressful thing, I would say equally stressful, is on the advice of behaviorists that I interview on the other podcast I do, Cone of Shame-
Stephanie Goss:
Oh, no.
Andy Roark:
I moved my bad dog, Skipper, to food puzzles for his meals because he needs intellectual stimulation and he-
Stephanie Goss:
How's that working out for you?
Andy Roark:
He does not agree that food in a food puzzle is one of his two meals. That's it. He has chewed up the measuring cup and all the other things. He is still convinced that he is supposed to get food in a bowl twice a day and a certain amount of food in a bowl. What is being introduced in the food puzzle, he does not see that as a substitute for it.
Stephanie Goss:
Sure.
Andy Roark:
Which I kind of get because if you gave me a lasagna in a lockbox and I got into it and you were like, “Well that was your dinner,” I'd be like, “Oh no. Dinner comes on the table.”
Stephanie Goss:
Right.
Andy Roark:
“Dinner's on a plate. This was just lockbox lasagna. This is extra.
Stephanie Goss:
Lockbox lasagna. I love it.
Andy Roark:
Yeah. So I get it. But he'd chewed up the measuring cup this morning.
Stephanie Goss:
Oh gosh.
Andy Roark:
Yeah, that's where we are.
Stephanie Goss:
He's one of a kind. That's going to work.
Andy Roark:
Yeah. Oh wow.
Stephanie Goss:
Oh man. Well, I am-
Andy Roark:
Well, that's how things are going here.
Stephanie Goss:
I am super excited. We have got a letter from a practice owner, and this excites me because I think it falls in line with a lot of the kind of questions that our community members have been asking and we're getting ready to Get Sh*t Done in a week, but then we're already thinking ahead to December for our Practice Owner Summit. And I'm super excited to tackle questions like this because I think so many practice leaders and practice owners in particular are feeling overwhelmed but also feeling this fighting spirit of like, “I'm going to figure this out.” So I love seeing questions like this.
It came to us from our previous writer in the mailbag who said, “This is how you know me. And I'm still stubborn, but I am in a new place and I am feeling a little bit apathetic, which is not me.” Their clinic is scheduled weeks out and have gotten to the place where they're not taking new clients. They lost half of their licensed technician team in the last year and they lost two and half doctors to it sounds like retirement and life. So nothing that anybody can control. Just had some changes. “I say two and a half because one of the doctors that retired this year has already come back part-time to help us out because we're so overwhelmed.”
They said, “I can't get my regular clients in. I'm struggling with what to say and how to say it when it comes to us not having an appointment for their first time issues for things like never been itchy before and now has flaming allergies or has crazy diarrhea.” These are things that they know that they need to be seen for and they want to get them in and they just don't have a space to do with them and to put them.
This practice owner was like, “Look, I know what to do with the immediate, urgent fire things that we can't handle, but what do I do with those things that I know need to be seen but won't go to the emergency room and I can't see them for days or weeks and I'm struggling to explain it myself. And also my team is struggling to explain it to clients in a way that isn't then opening up the doors to negativity and criticism.”
And so this doctor was like, “Look, I've been the anti negative review person for a long time, but really the client's reviews matter to me. Don't tell anybody. Don't tell, but it does. I take it to heart. It matters. And they're struggling. What do I say? Like, ‘I can't help you because my client or my doctors are about to go get other jobs because they're too overwhelmed and they're too overworked'? I feel like I'm running out of ideas and I need a strategy.”
They are just in that rut where they are overwhelmed, they have too small of a staff to handle their patient load. Everybody's constantly in training and they just don't know how to direct that energy at clients in a way that doesn't feel negative when it feels like clients are just like, “Help me, help me, help me.” And so he said, “I need help. Sighed. I can't give up. I won't.” And I just loved this question because they are not alone. We get this question a lot. I think it's just such a good one for us to tackle as we head into what's another usually crazy part of the year for most clinics.
Andy Roark:
Yeah. This is the defining question of vet medicine right now, in my experience. This is the question that people ask me all the time. There is no beautiful, “Hey, I have the solution you haven't thought of answer.” But there are absolutely best practices, and I think that's really important. I was really glad to see this question come through the mailbag because we got a lot of experience answering it at this point. There are best practices, there is really good headspace that I personally think is really, really important. And I want to try to lay it down eloquently today if I can. But headspace, it really matters.
And then the other thing is what can you actually do and what can you actually control? I think that there are things that you can do and that you can control.
Stephanie Goss:
Yeah, totally.
Andy Roark:
I'm excited to get into this and start to lay this stuff down. You ready?
Stephanie Goss:
Yeah, let's do it.
Andy Roark:
All right. So let's start with some head space.
Stephanie Goss:
Okay.
Andy Roark:
Okay. All right. I don't know what happened with their doctors, things like that. There's two contributing factors. One of them is what I call walking the rain and one of them is called the death spiral. So I'm going to talk about both of them in kind of how I see this, but I know that I don't have any more information than what you guys just heard from this mailbag. So anyway, that's it.
All right. I mentioned starting this podcast that tomorrow my wife and I are going to the hospital to deal with this breast cancer. And it sucks, my friends. I do not recommend… If anyone's like, “Hey, you want to try breast cancer?” You should say no. You should say no. If you are given the option, hard pass. Hard pass. My wife is… She wouldn't mind me saying this. She's 43 years old. Why does someone who's 43 have breast cancer? Why does that happen? And the answer is, I don't know. I don't know what happens. I don't know why sometimes we end up with a bunch of patients and we can't hire people. You know what I mean? I don't know why sometimes really great staff members move away and go to somewhere else. I don't think we did anything wrong. You can't convince me that we did anything wrong.
Sometimes through no fault of our own, we have to walk in the rain. And that's kind of how I put it, is because I don't have any control. You guys have probably heard me talk in the podcast before. I think that I say we're all backpackers. And that's really what I believe. I believe that we're all out exploring this profession in this world and we're all walking. And hopefully we find good partners to walk with. Sometimes we walk with a team. And that's great, but at some point we're all walking. And we all walk and sometimes we get beautiful views and sometimes we get eaten by mosquitoes and sometimes it pours rain on us.
There's really not a lot of options that we have other than be smart in how we pick our paths. And if we find ourselves circling back to the same spot again and again and again, we need to pick a different path. We need to change that. But there is truth at some point you're just going to walk and sometimes you're going to climb big hills and there is no path that does not have hills on it and there is no path that doesn't have mosquitoes on it and there is no path that doesn't get rained on.
And so sometimes guys, we just get rained on and we have to walk in the rain. We can be angry about it or we can be sad about it or we can sing a song while we get rained on. That is generally the power that we have. But we have the power to choose our path. But you should still know that every path gets rained on. And so I put that forward first when I say sometimes staff leave. So many of us are shorthanded. And guys, it's really, really hard to hire people right now. And I'm talking about across the US and Canada. Boy, it is very, very difficult to get people. We have a labor shortage. And so if you're looking around and you're like, “Gosh, I can't hire people and we've got a ton of work,” I want to put forward the idea that you're probably not doing anything wrong. You're probably just walking in the rain like the rest of us are. And so I want to remove those feelings of guilt first of all.
Stephanie Goss:
Yeah, I think the other thing that's really important about the metaphor, because I think it's such a good one and it's certainly more positive than thinking life sucks sometimes, right?
Andy Roark:
Yeah.
Stephanie Goss:
That's how I looked at things for a really long time. But I love the idea that yeah, it does, but you just have a choice. I think the danger is that there are people in the world who are eternal optimists and who always try and look at things on the sunny side and who will look at this and say, “You can choose to sing while you're walking in the rain.” There are certainly times where that is the tool that I want to reach for. And I also just think that it's important to say like, “Sometimes you need to just sit in the rain and cry,” right? And that's okay too. Sometimes somebody joins you and then you have a friend. Sometimes you run to try and outrun the mosquitoes.
The reality is the choices that you're making are not wrong. I think this is one of those places where it's really easy to beat ourselves up because we are perfectionists in veterinary medicine and it's really easy to focus on, “Well, I feel really, really crappy about this and I'm sad and I'm mad and I don't know what to do to help my team and I feel lost.” And it's really easy to add more emotions to that by letting yourself sink into the guilt by feeling like, “Well, I should figure out how to sing in the rain and be happy about this.” I think it's really important to acknowledge all of the emotions are valid and you're going to go through all of them. That's the whole point. It should always be this cycle.
And at some point, if you sit there in the rain too long, you're going to get pruny and you're going to have side effects from it. And so yes, you shouldn't sit there forever. There should be then the place where you pick yourself up and you figure out how you start walking again, right? But in the moment, don't let yourself feel bad for wherever you are on that journey. And if you need to stop, you need to stop. That's why I loved how they started with, “Okay, well I thought a stopping point would be not taking new clients. And so I did that thing,” right?
Andy Roark:
Yeah, totally.
Stephanie Goss:
So I think it's really important to acknowledge that there are places along the way that all of us are going to stop and there's nothing wrong with that.
Andy Roark:
Right. I agree. Well, that's another part that I put to this backpacking metaphor, is if anyone who goes out in backpacks, you better take breaks. There's no scenario where you get up and you put your pack on your back in the morning and you walk all day and you never stop and drink some water. Breaks are required to enjoy backpacking. If you're walking and walking and you never stop to rest for a minute or have a snack or have a drink of water, I think you're doing it wrong.
There are some people who sit down and take a break and just never get back up and get going again, and that's not good either. But again, and I'll move on past this metaphor in a second, I really like the idea of just imagine that you're walking in a crappy place. There is a desire to hustle to get through that place. And I think that that's good. However, there's also a thing where you say, “This is a big stretch of bad place. I'm going to have to take some breaks here. I cannot sprint five miles down this trail. I can't. I'm going to have to walk. I'm going to take care of myself. I'm going to take breaks. Even though it's not where I want to be, but I'm going to rest because I can't push myself and I can't push my team hard without stopping to get through this to come to the other side.”
And again, if it's raining, you can push yourself as hard as you want. It's still going to rain. So anyway, that's it. But I want to put that forward because I feel like when we start talking about this, I think a lot of people are wrestling with a lot of guilt. And I just want to put forward that, “Hey, this is probably not about you. This is a hard time for a lot of practices.” And there's not a magic answer. Sometimes we walk in the rain.
And so I think to our writer I would say, “Hey buddy, you're walking in the rain, and that's all right.” I don't expect most of us to sing in the rain. I'm not pushing those sorts of things. But I would say the most enlightened of us can still enjoy the views even when it's raining when we come to them. And I really think that's the key. If you are miserable in the rain and you can't enjoy the views and you can't enjoy anything at all because all you can focus on is it's raining, I think that's a really hard, really dark place to be. I think enlightenment is being aware that it's raining and still saying, “You know what? I'm going to appreciate where I am and I'm going to appreciate what I have. I'm going to stop and I'm going to celebrate the beauty that I find even though it's in the rain.”
So anyway, that's the first thing I talk about. So I want to put that head space out and say, “Hey, sometimes we walk in the rain and we need to put the guilt aside.”
Stephanie Goss:
Sure.
Andy Roark:
The other part of that I see in a lot of practices that are in this place is what I call the death spiral. The death spiral is this, it's where we say, “I am super overwhelmed and we have so much to work to do. There's nothing we can do but put our head down and work, work, work really hard to get through it.” And what happens is, and we have the best of intentions, it is 100%. It's not about, “I want to make all the money. It's not that.” It's, “People need my help and I need to go and there's no other alternative but to put our head down and just work, work, work.” And what happens is you burn out your people.
Stephanie Goss:
Sure.
Andy Roark:
And they quit because they don't own the practice. And so they say, “I'm miserable. I'm stressed. I'm burned out. I come home and I cry at night. My spouse is telling me that this is not acceptable.”
Stephanie Goss:
[inaudible 00:20:12]. Yeah.
Andy Roark:
“This is affecting me. I have to take care of myself and I'm going to leave.” And basically going back to our backpacking metaphor, this is someone that we forced marched to the point that they say, “I'm not hiking with you anymore. I'm getting off this trail.” And they leave. And now you're in a worse place because you have fewer team members. You know what I mean?
Stephanie Goss:
Yeah.
Andy Roark:
And I saw that. I saw this during the pandemic it was a big one because I saw people put their head down and work because they thought that was the answer. And then they burn their people out and their people quit. And now they have just as much demand for their services with a smaller team. And so that goes back. And all that stuff ties together and it's really important. Like I said, a lot of times people leave because their spouse gets another job or they get another offer.
I had one of my favorite doctors in the world say to me that he had just lost one of his licensed technicians and he said, “I can't blame her. She got a job 30 minutes closer to home and at $6 an hour more than I can pay. I can't blame her for taking that.” And I was like, “Good. You shouldn't blame her for taking that. And you also shouldn't feel guilty if you can't magically make her be 30 minutes closer to…” I mean the 30 minutes is a big deal and then $6 an hour. If you can't pay that, then you can't pay that and you shouldn't beat yourself up about it. But you should also not hold it against her or feel bad that she went to this other place.
So I think a lot of it is that accepting where other people are and knowing, “Okay, I cannot drive these people. If I drive these people until they quit, then now I'm making this worse. I can't control the rain, but I can control whether or not we let people rest and how we take care of them and how we respond. And so anyway, the death spiral is the other part of this that I see where people say there is no answer but through as hard as we can go. And you end up burning your people out and then you lose them. The patient number doesn't go down, it stays the same but you're more shorthanded.
Stephanie Goss:
Hey friends, there is a workshop coming up that some of you are not going to want to miss. This last weekend was Uncharted Get Shit Done. There was a lot of conversation about workflow challenges in our practice and how a lot of us are struggling with things not working very well. Things feel pretty inefficient. We're all struggling to do more with less, less time, less people, less resources. There was a lot of conversation about how do we get more efficient and effective in our workflows.
And so while a lot of you were there with us this weekend, not all of you were. And so I want to give you all an opportunity to join us coming up in November, November 30th at 5:30 Eastern, 2:30 Pacific, we are offering a two-hour workshop with my dear friend, Senani Ratnayake. Senani is an RVT. So she is a licensed technician, she is a general badass, she is a practice management consultant and she loves talking about workflow. And so Senani has agreed to come back and lead a workshop that was voted one of our most popular in all of 2021 in Uncharted, and that is the Secret Sauce to Optimizing Workflow. This two-hour workshop is here to help you and your team dissect your workflow so that you can get out of the place where everything feels inefficient and ineffective. So if you are struggling with efficiency and effectiveness in your practice, head on over to unchartedvet.com/events and sign up for the workshop. We would love to see you there. And now back to the podcast.
Stephanie Goss:
I think this is one that is really hard for a lot of leaders to wrap their heads around because they care so much about their patients and they care about their teams too. They care about their clients, they want to make everybody happy, right? We're a field full of perfectionist people pleasers. Let's be honest about what we are. And so there are a lot of leaders who look at it and say,” Well I just want to take care of the patients. Everybody let's huddle together and let's support each other, but also let's lean in and just do the thing.” I think that it's done with the best of intentions.
The thing that I always struggled with, and I had several partners in practice, whether it's medical director or a co-owner, where we butted heads about this because it is not a single option here because the other side of this coin is that there are people to take care of and there are people to consider as well. We want to do right by our patients and at the same time we also need to do right by our clients and our team. It's really easy to reach for the pet lever and pull it because we all have empathy. And even the people who are here because they people care about the patients and care about the animals. And so when we say like, “Let's just put our heads down. Let's take care of all of our patients. We want to be there for them,” that's a really easy one. And I think it's one to remind ourselves like, before you pull that lever is really important to take the step back and look at it from the people perspective as well.
I say this for two reasons. One, to the point you brought up, Andy, which is that if you put your heads down and just work and work and work, and I saw this with lots of my colleagues during the pandemic, people will leave. They will 100% leave. They'll get overwhelmed, they will burn out and they will leave. And then you are worse off.
And also we are superheroes, all of us. We do amazing things for our patients every single day. And at the same time, what level of medicine can we practice when we're down three or four people? Can we be our best team of superheroes when we are not rested, when we worked a 16 hour day, we went home and slept for five or six hours and then we come back and do it again? The reality is you can do that for a short period of time, but that's not sustainable long term. And that's where I think it's important to think about the people side of it.
The other piece that I encourage a lot of us to think about that I think we don't, we should think about it more than we do is the client piece of it. Because just as much as we are there for our patients, we also need to be there for our clients. And are we serving our clients if we are driving our teams to take care of our patients and we are overwhelmed and we are running behind. And now we shift the business model so that clients are constantly on hold, they're waiting hours because we've taken in more patients than we can see, they're not getting calls back. And we are doing our best. Don't get me wrong. We are trying to take care of those clients. But are we serving them in the best way possible when we just put our head down into, your point, go into that death spiral and focus solely on, “Let's just take care of the patients. We have to be there to take care of the patients”?
And so I think it's really, really important to consider that you cannot pull one of these levers, either of them, pets or people, without it becoming a lopsided equation. And so I think it's really, really important from a head space perspective to consider the fact that we have to consider both sides of it and really try and figure out how do we strike that balance. And it's hard. Don't get me wrong. I have done this. I have done this wrong. I have had it go well, but I've also done it really wrong. And so I think it's important piece of head space to keep in mind because so many of us immediately, myself included, can lean into the patient piece of it because that's what we're here for, and forget about the people piece of it, and it is equally important to the balance.
Andy Roark:
Well, that is the leadership challenge, isn't it? I mean, it's the classic challenge of getting the most out of your people so that you can pursue your goal, your mission, your purpose, the reason that we do this. We need people to work hard and we want to get the most out of them. But you can push that too far until they break and people say, “Well, where is that line?” And I go, “Boy, that line is a moving target, isn't it?”
Stephanie Goss:
Yes.
Andy Roark:
And sometimes your people… I mean, I've had it with our team. With our team, there was a time everybody on our team was sick. It was funny. We had COVID go through our office, which is funny because we're virtual and we lived hundreds of miles apart from each other, yet we all got COVID. Like within two weeks, I got it.
Stephanie Goss:
It is true.
Andy Roark:
Yeah. We had that happen at one point and you go, “Boy, cracking the whip and really pushing people.” Not “We crack the whip,” but you get the point. We're really trying to push people hard.
Stephanie Goss:
We had a ton of deadlines. Yeah, It was crazy busy.
Andy Roark:
I was like we were busy but also our people were just down and sick and you go, “Look, we're not going to get the work done that we would get done when people are healthy. And trying to get that same amount of work done right now is a bad idea because all we're going to do is really break people.” So it's always that balance of as the leader, you have challenge that every sports coach has, which is “How do I motivate? How do I inspire? How do I get the most out of my people without pushing them to the point that they get injured or that they don't enjoy playing this game anymore and they don't come back?” That's the real challenge that we all have here. And so we need to keep that.
When I talk about getting the most out of people and sort of building this thing and the mission and the purpose in where we're going, the last part I want to bring up in headspace is the sunk cost fallacy because I see this really messing with a lot of people's heads right now.
What happens in the sunk cost fallacy, the sunk cost fallacy is the idea that I have invested so much to get here. Stepping back or changing what I'm doing now feels like I wasted that energy to get here. And so what that looks like right now in a lot of places is we built our clientele up to a certain level. We built, we have 10 exam rooms now and we have been seeing X number of clients a day and not using some of those exam rooms feels like failure. Significantly, reducing the number of clients we see a day, that feels like mega failure.
Stephanie Goss:
Sure.
Andy Roark:
Like, “I worked 10 years to get to this place where we did this amount of cases and everything and now going back down feels like all the energy we spent to get here was wasted.” And that's the sunk cost fallacy. And so the last thing I'm going to call out head space wise before we go into this is to say, “Hey, I see you there. I see you overwhelmed. I see you struggling. You need to not think about what you've done in the past. You need to do the mental exercise of thinking, if you were starting your practice right now today with the team that you have, how many exam rooms would you run and how many patients would you see? And the number of patients that you saw two years ago, that doesn't matter because it's not two years ago, it's today.”
Realistic expectations about if we were starting right now today, what would we service? And the fact that we serviced more last year when we had two and a half more technicians and two more doctors than we have today, that doesn't matter because that ain't where we're living right now.
Stephanie Goss:
Nope. And listen, this is one of the things that I struggled with the most in practice, particularly in my journey as a corporate practice manager, and I'm going to talk to my fellow colleagues here for a second, because when we run our practices from a leadership perspective, it is our job as business people to be concerned about the numbers. I'm not going to lie, that is part of your job. As the business side of the leadership, your job is to think about the numbers. And to your point Andy, our practices should be built on what can we do when we are efficient and effective, right?
Andy Roark:
Yeah.
Stephanie Goss:
How can we maximize seeing and doing the best work for the best number of patients? And we know that when we practice good medicine like that, the revenue follows. And that is good thing, right? And at the same time, it's really, really easy to get caught up in micromanaging or being micromanaged to the numbers. And so a lot of us, particularly those of us who have managed in corporate medicine, say, “Well, we have to see certain number of cases because our whole structure is built on that.”
The thing that I will tell you, and don't get me wrong, it got me in trouble more than once, but I will say I stand by it. The reality is, if your practice, any practice, private corporate does not matter, if your practice can't stand to say, “This month we are going to change things and it's not permanent, but right this second this is what's best for the people. Whether it's the clients, your team, a combination of all of the above, we're going to step back and we are going to see 10 patients a day instead of 25,” or whatever it is that you need to do-
Andy Roark:
That's quite a step.
Stephanie Goss:
But here's the thing, if you go from four doctors to one, going from 25 patients a day to 10, maybe your only option, right?
Andy Roark:
Yeah.
Stephanie Goss:
So even if you can't, you have to be able to take even a radical step like that for a short period of time. If your practice can't sustain that, you weren't running a good business in the first place. You should be able to sustain that for a short period of time, right? You should be able to pivot and do what you need to do for a short period of time. And that short period of time is going to be different for all of us. We are all in different places in our business. We all have different levels of buffer. We all have different levels of reserves in the bank. I recognize that all of those things matter. But if we're running it so close to the line that we have to live forever in the place of sunk cost fallacy and we can't look at things and say, “I am going to make these changes temporarily to take care of my people, to take care of my clients,” whatever the reason is, then we have to change the business model because it's not going to work for anyone long term.
Andy Roark:
Boy, leadership in modern vet medicine is more about advocating up the chain than it's ever been before. Don't you agree?
Stephanie Goss:
100%.
Andy Roark:
Boy, wouldn't it be great if there was a place like a community that you could go and you could work with other people who have the same struggles and advocate up the chain for their people and that would provide ongoing support and guidance and lessons learned and hard fought battle experience? Wouldn't that be amazing?
Stephanie Goss:
Uh-huh. That would be so amazing.
Andy Roark:
God, I can't think of a place like that.
Stephanie Goss:
Neither… I wonder where one might exist.
Andy Roark:
Oh, there's a place, it's called Unchartered Veterinary Community and that is what we do. We have literally hundreds of leaders who are in corporate practice that are also leading teams on the ground. We work with them because that's what we do. And yeah, we 100% help people advocate up and down the chain. And you're like, “No one's ever told me how to communicate up the chain to take care of my people.” I was like, “Well, that's the thing that we definitely do at Unchartered.” So if you're interested in that, then check us out.
Wait, there's one more thing. I said that was my last thing to say and now I'm like, “Oh, there's one more thing I have to say because, and I hadn't planned on talking about this, but then when you were going through what this person said in their letter, there's one thing that popped out and it hit me like a thorn. It was like a splinter and I'm like, “That's going to hang with me and it's going to bother the heck out of me.”
Stephanie Goss:
Okay.
Andy Roark:
This person said their clients won't go to the emergency room, right?
Stephanie Goss:
Uh-huh.
Andy Roark:
And what they were saying was like, it's like an allergy flare up.
Stephanie Goss:
Sure.
Andy Roark:
And they won't go to the emergency room. And it's like, I get it. I can 100% understand the person saying, “I don't want to pay that money to go to that emergency room and I don't want to go there and wait for hours to get seen.” I totally get it for sure. But this is a thing, and this is going to sound maybe a bit harsh, but I need everybody to hear it, right? It is not your responsibility to solve the problem of a pet owner that won't go to the emergency room or they won't go somewhere else. That doesn't mean I'm heartless, it doesn't mean don't care. I totally do care. But in order for you to keep your sanity, you need to know that that's not your pet, and all you can do is advocate and be honest and compassionate and do the best that you can do without burning yourself out, right?
Stephanie Goss:
Yes.
Andy Roark:
Because you giving everything you can today and leaving this profession in three years, that is not the best outcome. And I say this because I can see it in the writing of the person who wrote in. I see all the time guys, the trap in vet medicine is people jump in, they say, “I'm here for the pets and the people and I'm going to take care of them.” And they do everything they can for five years and they burn out and they leave the profession. And I say, “You know what? If you had made some hard calls and set some boundaries that made you unpopular at the time, you would still be here 10 years from now and the net number of people and pets you would've helped is much greater.”
And so the greatest outcome over your life is not seeing everything that you can see and taking responsibility for everything. It is being honest about what you can do and taking care of yourself, working hard of course, but still setting those boundaries. And so it sounds awful when I say it's not my responsibility to handle problems when the pet owner says, “Well, I'm not going somewhere else.” And I would say, your job is to present them honestly with their options and to set clear expectations and let them know what you can do and what you can't do. And that is what they have to decide. So maybe they're not going to take their allergy dog to the emergency clinic.
And here's another thing that's really, really hard for vets to hear. If I can't see your pet because I am swamped and overwhelmed, I'm going to recommend you go to a different vet practice. And people go, “That is harassing. Oh my god.” There's some competitiveness to it. There is some scarcity mentality. There is the fear that one day I'm not going to have enough clients and I'm going to go out of business and we're all going to live in a box by the street.
Stephanie Goss:
Under the tree. Uh-huh.
Andy Roark:
Under the trees. All of those things are scarcity mentality that kick in. But I'm saying is in order to feel whole, is to look around and say, “I can't see you. You're not willing to go to the emergency clinic and pay emergency prices. I don't see this changing in the near future and your pet is having an allergy flare up. My recommendation is that you need to go find another veterinary clinic and I'll send your records over. I hate it, but I'm just being honest with you. I can't get you in and I don't want your pet to suffer and this is what I'm doing.”
Stephanie Goss:
Yeah. I think that is such a struggle for us in veterinary medicine for so-
Andy Roark:
People hate it.
Stephanie Goss:
… Oh my god, for so many reasons. But I'll also tell you it feels like this boring concept, and it shouldn't. Because at the end of the day, we are in the customer service business. And let me tell you, when I was really young, when I was at university, I was a manager for a book chains. It's not around anymore, but I worked for Borders and was the manager for the children's department. I was covering at the customer service desk one day and we had a customer come up to the desk and they were looking for a particular book and we didn't have it in stock and I wasn't going to be able to get it for two and a half or three weeks. And they were just like, “Thanks, but I really wanted to get it.” And I said, “Well, hang on. Do you have just a moment?” I said, “Let me see if anywhere else locally has it.”
The next closest Borders to us was like 45 minutes away. So it was like this poor customer is looking for this thing. And they had told me why and it was for school and it was really important. So I picked up the phone and I called Barnes & Nobles, which was 10 minutes down the street, and I said, “Hey, do you happen to have a copy of this? I'm calling from Borders.” And they put me on hold and then they said yes. And I said, “Great, I have a customer here.” I gave them her name and I said, “I'm going to send her over. Can you set it aside for her at the front desk?” And they were like, “Yeah.”
And that client was like, “Oh my gosh, I can't believe. Did you say Barnes & Nobles? Are you sure?” And I said, “Yeah, it's right down the street. Go ahead. They have it waiting at the front desk for you.” She went. And it was so funny because it was on and she went on her day and I didn't think about it. Later that night I got a page to come to the customer service desk and I go up to the customer service desk and the woman is standing there and she has a bag in her hand and a coffee and she's just like, “I had no idea what you liked, but I just wanted to say thank you. You saved my day for school.” She's like, “I picked it up.” And she's like, “But I just want you to know I'm going to come back here.”
Andy Roark:
Wow.
Stephanie Goss:
“It made a huge difference in my day. And the fact that you would send me to your competitor, that means something to me.” And then I saw her over and over because she would come in once a week to do school stuff. It stuck with me because I just didn't think twice about it. I had a conversation with my manager about it. And they were just like, “Well, but you sent her to a competitor.” And I was like, “Yeah, but she's a loyal client now. She's a loyal customer. She's coming back. So what? So we lost the $10 on that book sale, but look at what we've gained in the long term in that relationship.”
I think it's really important and it stuck with me and I have used that for myself and with my team, especially my client service team. Because at the end of the day, we are here to take care of our patients and our clients. And if there's something that we can do that is better for that pet than the care we can provide, or different care that we can't provide for that pet, we should have no doubt in our mind to send them to someone even just down the street, right?
And so if that client is telling you, “I can't go to the emergency hospital for whatever reason,” but their pet is miserable, then I love that you said that because sometimes the answer should be, “Okay, I really feel strongly that this shouldn't wait. And so if you're not willing to do this, here's my suggestion.” Because you know what the alternative is? The alternative is they're going to go home and they're going to do what that customer would done, which is look it up herself, see that the Barnes & Noble down the street has it and go there anyways. So they're going to go home, they're going to Dr. Google and they're going to either find somebody else's care or they're going to try and treat things themselves. So it really matters to me that we keep in mind that we are in the customer service business at the end of the day.
And so I will tell you, there have been times where I've spent sent really good clients to our competition. Because here's the thing that I know, I know that if I take care of those clients, if I help them, they will on an overwhelming average comeback, even really good clients. And people are like, “Oh my God, but what if they have a better experience at that hospital? And what if we lose them as a client?”, then we weren't doing our jobs. If they could go for a one and done appointment and be so impressed by somebody else, that's okay. That teaches us some lessons about where we have opportunities as a practice. And if you're not willing to take those risks as a leader, I think you're selling yourself and your team short.
Andy Roark:
Yeah. Well, we create this inescapable trap for ourselves where it's like we are overwhelmed and we can't see all the pets. And also the idea of referring them to someone else is-
Stephanie Goss:
Yes, but nobody else can [inaudible 00:43:48].
Andy Roark:
… absolutely unacceptable. And they go, “Wait a second, you have 100% created this soul sucking trap that's burning you and your people out.” And I go, “This isn't worth it.' The other thing too is I would say let your purpose guide you. I have just found in life that if you have a purpose and that's what you follow, everything else seems to work itself out. You know what I mean? If you believe, I say, “I'm going to do what's best for pets,” and you set your prices appropriately, you will have a healthy business because you will take care of pets and make sure that the money makes sense and it works. But you can 100% focus not on the money, but on taking care of the pets and the money will take care of itself.
The same thing is true with this, is if you want to take care of the pets, at some point, that might mean I can't get these pets in and I'm sending them away, then you're going to sleep well at night knowing that you did what was best for pets and you're not going to burn out and quit and you'll be here years from now.
And so anyway, the idea that you would send people away because you're overwhelmed and then all of a sudden you can't get enough people to come in and support your business, I don't buy that. I don't believe that. I think that's a scarcity mentality and it's a recipe for disaster.
Stephanie Goss:
Yeah.
Andy Roark:
Hey, we are about 40 some minutes into this episode and I feel like this has all been really good head space, and I know a lot of people are really struggling with this. I don't want to sprint through the action steps. Are you okay Stephanie, what if we split this episode and then next week we'll come back and we'll just do action steps?
Stephanie Goss:
Yeah, let's do it. We're going to try something different, everybody. I love this because we've got some good action steps and I don't want to rush into these, Andy. Let's take our time and let's do it. So let's do our first two parter.
Andy Roark:
Our first two parter. Yeah, I think that's it. I'm looking at the action steps and stuff I have kind of laid out here that I want to unpack them. I think they're really helpful. So let's not rush. Let's just do head space right here. We're going to call this an episode.
Stephanie Goss:
Part one.
Andy Roark:
And then we'll see guys back next week and we will run through the rest of our action steps.
Stephanie Goss:
Stay tuned overwhelmed and won't give up because we'll be back.
Well, again, that's a wrap on another episode of the podcast. And as always, this was so fun to dive into the mail bag and answer this question. I would really love to see more things like this come through the mail bag. 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 mail bag 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.
