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May 10 2023

How Artificial Intelligence (AI) Can Grow Your Veterinary Practice

This week on the podcast…

This week on the Uncharted Podcast, Veterinary marketer Brandon Breshears joins Dr. Andy Roark to discuss how AI can be put to work in growing veterinary practices. He talks about the headaches that ChatGPT and similar programs can take off your plate right now, and where he sees AI changing our profession in the next few years. This is one of the most practical conversations I've had on AI, and it's one I think people will be able to put to use immediately. Let get into this…

Uncharted Veterinary Podcast · UVP – 231 – How AI Can Grow Your Veterinary Practice

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


RESOURCES

Brandon's AI Marketing Course: How AI Can Grow Your Practice

TPLO SEO ChatGPT Plan Prompt

Veterinary Marketing Podcast

Check out upcoming events at Uncharted!

Pod Squeeze (For Podcasters)

AIPRM for ChatGPT (For Marketers)

ABOUT OUR GUEST:

Brandon Breshears is a Digital Marketer, Paid Advertising Expert, Podcaster & Speaker


Episode Transcript

Dr. Andy Roark (00:00):
Hey everybody, it's me, Dr. Andy Roark, and I am here today, not with the one and only Stephanie Goss, but with my friend veterinary marketing genius, Brandon Breshears. I have Brandon on, Stephanie Goss is traveling, and I was like, man, this is a chance for me to jump on with one of my friends and talk about something that I like to nerd out about and that's artificial intelligence and how it's going to change the future in vet medicine. So anyway, I am on with Brandon. This is a shorter episode. We just get right into the heart of the matter, and I have him lay down some stuff he's doing with some online training on how to supercharge your veterinary marketing using artificial intelligence. Guys, let's get into this.

Meg (00:43):
And now the Uncharted podcast.

Dr. Andy Roark (00:48):
Welcome to the podcast my friend Brandon Breshears. Thanks for being here, man.

Brandon Breshears (00:52):
Thank you so much, Andy. I'm so excited to be here. It's really cool. Appreciate it.

Dr. Andy Roark (00:55):
Oh man. I always love getting to catch up with you. You and I go way back. You are the host of the Veterinary Marketing podcast. You are the founder of the Veterinary Marketing Nerds Facebook group. You have been a speaker at Uncharted. You and I have collaborated on projects in the past. I think that you're amazing and I enjoy talking with you. You think in a very different way than I do. And so I always get a lot of our conversations because you kind of look at practice and marketing specifically in a different way than I do. And so I always feel challenged when we talk and I always have to stretch to get my head around what you're doing and the level that you're playing on. And I reached out to you because I want to get you back on the podcast because the stuff that I see you doing with artificial intelligence in marketing of veterinary clinics and services is bonkers.

(01:48):
It is next level stuff. And I'm so interested in AI, I'm so interested in things like chat GPT and text generation and things like that. I believe that these services are going to make our lives better. I think that there's a lot of work that we don't really like doing that we're going to be able to offload to AI. And I feel like that's really where you are going and you're actually running, you actually have an on-demand course on using AI to streamline your marketing and communication. And so I just had to get you on and just wanted to start walking through this with me. So can you start at a high level and just start to talk to me about how you look at AI and the possibilities for veterinary clinics using it to communicate and to make their lives easier?

Brandon Breshears (02:34):
Definitely. So I think it's really exciting because like you mentioned, it has a lot of applications, especially for the things that people know that they should be doing, but they just haven't done. And that's I think, one of the biggest applications that is going to be really helpful. But from a large level, AI has really taken off since about November of 2022 when chat GPT was open to the public, it was chat GPT three. They released two updates since and we're on chat GPT four. It's incredible how good it is now, but what this really lets us do is use this language learning model to give it input and get high quality output and the better input that you give it too, it's very important. The better input that you give it, the better output that you give it are going to get from it. Excuse me. And so it can do anything related to marketing. It's incredible. There's also tools like Mid Journey out there that let us build images. There's editing tools that are going to be coming out, like video editing tools, podcast editing tools. It's making content creation easier than ever. And it's also making content just readily available and high quality content that you can build out that's going to actually get response also, which is really cool.

Dr. Andy Roark (03:51):
Well, I've already been jumping in using chat GPT to write some first drafts of just bland things. You know what I mean? If you have a newsletter and if you say, Hey, write, you can go to chat GPT and say, write a newsletter to pet owners about how the temperatures are rising and ticks are getting more active and how they should protect their pets against tickborne illness with a good tick preventive, and make this in the style of a veterinary clinic newsletter that will be interesting and important, valuable to them. And it will write you a competent first draft. It will be a bland first draft because it will just sort of sound generic, but it will give you something solid to work off of and you go through and add your own voice and add your own examples and things.

(04:44):
And boy, you can shave a lot of time off of those types of fairly mundane things where you say, I need a short newsletter. It needs to be 500 words long and it needs to make these three points. And you can say that and it will give you something and you'll say, I don't like this. Try again. It will give you something different. And then to me, I go, man, that is the type of stuff where if you're not excited about writing a newsletter, that is one example of things I have already seen where I just go, this is so easy to get a basic starting point that's going to save me 50% of the time. It would take me to hammer this out by myself.

Brandon Breshears (05:19):
Yeah, definitely. And I think the cool thing about that too is that you can train it so that it can speak in your voice. And again, it goes back to giving it good input and talking to it more like an assistant rather than Google. I think that's one thing when I work with clients that are starting to use this for different things. So if you wanted to write a newsletter for example, I would probably start off by saying that you're going to be an expert copywriter, and the goal is to target pet owners. The ideal outcome is that they're going to book an appointment. So you're giving it this additional context and then you could say, here are four things that I've written in the past to use as a model for my style. And so write it in my tone and my voice and add a call to action and make a direct response.

(06:06):
And then also be sure to throw in a dad joke. And so it will then create a much better output that is more aligned with your brand. That's going to save even more editing time. But I a hundred percent agree that it shouldn't just be the thing that's spitting out content, because if you're just taking the content from chat GPT and throwing it at your clients, there's no difference between them reading your email and them going to chat GPT to search for what should I do for ticks for my pet this summer.

Dr. Andy Roark (06:36):
Yeah, I think that makes sense that that's a good point. I've heard people talking about training, training, AI training, chatGPT and stuff like that. Is that kind of what people mean when they say that? When they're like, oh, I, I'm going to upload some versions of my writing or some previous newsletters that we've had and say this is the style that we're going for. I guess I always just sort of imagined it being a more complex process than that.

Brandon Breshears (07:00):
Is that true that that's would be one of the ways to train it? And there's, but a bunch of other cool things that you can do with APIs that's more advanced and that's going to be just the stuff that's coming out now and the stuff that it can do with coding. You could, for example, upload an employee manual for your practice and then if they ever have questions about HR processes or things like that, you could use that specific document that it's now trained on and have its very own specific HR manual that then it responds back knowing what your policies are for your company. And so training it is just giving it feedback and then helping it to really understand the context of where you're coming from and then what you want. So with each of these chat channels that you create, you'll be able to get better results every time you add to it, which is really cool.

Dr. Andy Roark (07:53):
That's amazing. The idea of having a chatbot that your employees could use to ask questions about what's in the handbook and things like that, is that, that's amazing. I've seen things where these are generally bloggers in other areas of industry so that a marketing blogger, for example, did this and he uploaded his entire 10 year blog history into one of these AI sort of programs and then made a chatbot where you could ask that chatbot questions and based on 300 to 800 articles that he had written, it would respond using his database of like, well, this guy would probably say this and give them that sort of advice. And I just thought, holy cripes, it's based on the writings of an individual and it's going to answer in that style and those types of response. And I just thought, man, that's amazing. And it's also amazing in that taking this over, and I don't know if you've seen anything like this, but let's just say that you've got a veterinarian who writes a lot or blogs or writes newsletters and things like that, and it seems wholly possible to get some sort of an automated response that would have that style and actually kind of sound like that individual person.

(09:15):
And so I know a lot of people are immediately cringing and going, but what if it tells 'em something wrong? And I'm like, okay, I get that. But just for a second, let's think purely about just the communication potential and then obviously the liability part has to get processed, but there's that. So do you see things like that? Are you, let's go ahead and start to lay down kind of the actual applications that we're talking about, because I think a lot of people, myself and included, are looking at AI and things like this and saying, I think the potential here is huge, but I don't exactly know how or why it's huge. How exactly is this going to make my life better? I can see in things like customer service, I think that is the easiest application ever of just, boy, you can take a robust training manual and load it in, and then you can have an artificial intelligence chat bot that can answer the vast majority of questions. Any questions people log on and answer that are in the user's manual that they never read, that could a hundred percent be handled by AI, but what are the applications that you would see possibly for a vet clinic?

Brandon Breshears (10:19):
Yeah, so for marketing, there's endless opportunities. I think that veterinarians in general are really good at producing information, but they're not good at marketing. And I think that's the biggest gap in storytelling and engaging people and also creating actually compelling marketing that's going to help to drive response. And so a lot of times people will create content for their practice and it's great information, but it doesn't convert. Nobody sees it. And so taking content that you've already created and telling Chat GPT to write, rewrite this with a clickbait style headline that's going to get as much views as possible and a compelling call to action, a lot of times people will just make it so boring because it's informational, so it can rewrite all of that great information in your voice, but make it interesting. And so if you've ever felt like I wrote something that was awesome, but nobody responded to it, you can have it be your expert copywriter.

(11:10):
And if so, if you're telling it to write in the style of an advertorial, which is informational, but with a call to action, that's really helpful. And just giving it the direction so that it's going to produce better. So that's one thing. And then going through all of your old content libraries. So if you have YouTube videos or videos anywhere, if you tell it to write an optimized title and description for a video, it'll give you much better response and click through, I've tested it on old stuff and I'm getting stuff that I've already produced, way better results just because it's written better for SEO and things like that. So there's SEO stuff you could do if you have a post that works really good that you put on Facebook, for example, you could say, take this Facebook post and turn it into a Google business profile post, and then it'll post it in the right format to Google business profile. And so you can create one thing and if it works well on one platform, repurpose it and use it for other platforms. And that would take a lot of time in the past. Plus there was individual formatting requirements and things, and now you don't have to worry about that. You just copy and paste it because it knows how many characters to put in and all of that stuff now, which is really cool.

Dr. Andy Roark (12:19):
That's amazing. Yeah, that's really cool.

Brandon Breshears (12:22):
I was going to say too that there's just a lot of opportunity with things like Google business profile posts that people aren't using, and that's one of the easiest ways to get ranking almost immediately for keywords and stuff that Google's going to rank and show your Google My Business listing, which is just going to drive more clients in for sure.

Dr. Andy Roark (12:42):
So what you're saying is, you're blowing my mind because this makes so much sense. And I had not thought about taking my Google business profile and having that optimized in any way. I just kind of typed out that this is our hospital and this is what we do, but you're saying, take that, run it through chat GPT with the specific directions of optimize this to get found in our local area. And you're saying that you feel like you're going to get results out that are superior to a smart conscientious person sitting down, but not necessarily knowing the backs inside out of SEO, modern-day SEO. You think you're going to get better results with that?

Brandon Breshears (13:22):
Definitely. And there's a prompt that I made on, I'll let, it's on Google Docs, so you can access it free. I'll put it so you can have everybody access it, but it goes through and it will create an expert level SEO plan. It creates the keyword clusters, it creates the titles and metadata for all of the stuff. So it's all of the technical things that you probably don't know about when it comes to SEO for blog content or Google My business posts. And then it gives you content ideas. So you could build it around TPLO for example. You could build it around dental procedures, you could build it for flea and tick and the list goes on. But you can take that as a starting point and then you'll have an expert created SEO plan that you can then just copy and paste and use, which is really cool. So all of that technical stuff that's difficult is now a lot easier if you know what questions to ask.

Dr. Andy Roark (14:11):
Yeah, that's really the key, isn't it? Right. It really is.

Stephanie Goss (14:16):
Hey, friends, I want to make sure that you know about an upcoming workshop that you're not going to want to miss. And I know I say that about a lot of our workshops, but I mean it about this one. Well, I mean about all of them, let's be real. But this one holds a special place, near and dear to my heart. Two reasons. One, my friend Dr. Jen Quammen is leading the workshop. Number two, it's about technology. And if you've listened to the podcast, what a techno nerd I am. I super excited to have Jen with us. Thanks to our friends at Televet. She is going to be talking on May 24th at 8:00 PM Eastern, so 5:00 PM Pacific about trending technology in the veterinary space. Now, I love technology. We've talked about it on the podcast. We've had guests on the podcast. And one of the conversations that has been going around and around in a lot of the groups I'm in lately has been about chat GPT or artificial intelligence AI.

(15:09):
And so if you've ever wondered about using AI in your practice or if you have wondered about wearable technology for pets, communication tools and techniques that use artificial intelligence or advanced technologies, those are the kind of things that Jen is going to dive into during this workshop because most of us have wondered when we've talked about those technologies, if they actually will save us any time or energy or if they're just a new trend. So Jen is going to dive into some of the things that have come to market, some of the things that are actively being used in veterinary medicine that you might not know about, and ways that we can incorporate technology into the veterinary space in a way that works with us and not against us. So if this sounds like something that you'd love to get in on, head on over to the website at Unchartedvet.com/events to find out more. We'll see you there. And now back to the podcast

Dr. Andy Roark (16:09):
I was just reading a couple of days ago, and again, I felt like such a noob when I read it cause I've been so excited about this and I jump in and I get it to do things. But I was reading an article and this person was sort of building a creative, I can't even remember what it was, but it was sort of this, it was this thing that would generate different types of descriptions of different products that he had made. And the way he did it, he made a rule set. He said, okay, none of the descriptions can have, all of the descriptions should be written in this style. And some of my favorite words for descriptions are these flowery words. Do you understand? It was like, yep. He's like, okay, none of the descriptions can contain or should contain words like this or should lean into this type of imagery.

(17:00):
Do you understand? It was like, yep. And the person just kept laying down these rules. And then finally after they were all sort of in there, he said, great, I'm going to tell you what the product is and then you are going to write this description. And at that point, he could just crank these things out and he was getting consistent quality results that matched the specific rules that he had already laid in. And I know that probably sounds really simple, but it just never occurred to me to take that time, set up a series of rules and then start to produce content or the pieces that I need in an ongoing basis. So that to me, just, it was really mind-blowing.

Brandon Breshears (17:40):
Definitely. There's this tool that's really cool. It's called AIPRM, so it's a chrome extension that you can use and it has a prompt library that different marketers have put together, and so that way you don't have to start from scratch. And they've developed really, really in-depth prompts that are going to give you good results. And it has all kinds of cool things in there. I mean, it has a one click book writer, it'll write a book, you tell it the topic, it'll write an entire book out for you, which is amazing. So you could use that for different kinds of lead magnets that you'd want to create for your different segments of pet owners. But I mean, it can do email writing, text message writing, responses for everything. And I think that you really have to approach this from thinking that large companies are probably going to start trying to figure out a way to use this to circumvent veterinary advice and things.

(18:36):
And so it's definitely coming, like chewy.com is probably going to have a veterinarian chatbot that it's a plugin. And so I think approaching it from the standpoint of this is something that you need to learn how to use because if you don't, you're just going to be left behind. I mean, it's just like the internet. I think we're right now a lot of people see it kind of as a novelty, kind of like, I'm going to ask you what to make with the picture of what's in my fridge right now, which is kind of cool. But it, it's going to be I think in every aspect of everything that we do very shortly

Dr. Andy Roark (19:15):
Amazing. I think that sounds terrifying, but it does. I think it's, but I think it's absolutely true. I really don't think going, we as veterinarians or vet professionals are going away. The ability to put your hands on a pet to look at the person and talk to them, to empathize with them, to build trust and build a connection with them, that stuff is not going away. I think a lot of it is going to be how do we use this to do a lot of the mundane tasks that we don't want to do or we don't enjoy doing? And then how do we spend our time and energy in the ways that computers can't? And that's building relationships, building trust, working with clients, making people feel heard, empathizing, all of those sorts of things. I don't see that stuff disappearing. And so I do think it's going to be painful in some ways, and I think that there's going to be some parts of our job that we just never thought we would not do that we are going to not be doing.

(20:09):
I a hundred percent agree. I think you're going to continue to see the march towards chat interfaces and texting and things like that. It's how people want to communicate. They're more and more comfortable with it. I think you're exactly right. There are going to be AI, veterinary support hotlines for pet owners. My hope and belief is that they're going to be fairly conservative because they don't want to give people bad advice and then have them and then get sued for telling them that they could give coconut oil and stay home when their pet had a GDV, things like that. And so I suspect that they're going to be rather quick to pull the trigger to say, should actually have a medical professional look at this, but I'm confident they are going to be out there answering the most common problems about how to get rid of fleas and ticks is this strange noise my dog making normal, all of those sorts of things that we get questions about.

(21:05):
Should I take my squinting dog to see the veterinarian? The answer is yes. But those sorts of things, I think I a hundred percent believe that those things are coming. And if you think about a lot of the questions that come to the front desk, well, we get the same sort of questions over and over and over again. It makes sense that those would get put into an AI interface and they can be answered and suddenly we've got a lot more capacity at the front desk. So anyway, I understand that being scary, but also I think it's going to be good.

Brandon Breshears (21:32):
Yeah, I agree. I think that what it makes more valuable is insight, because information is, I mean, it's been readily available for a long time and so that's why informational posts don't generally do get from pet hospitals in general. So you have to pull out a lot more insight and also build value every time you're showing up for any kind of marketing engagement or activity. So anything that you do, just because there's more noise than ever, I think content is just going to start to get churn out at a ridiculous level because this is available now. Yeah. And so you have to stand out by providing actual value in every single interaction. And as this grows and they've just released what are called plugins, which allow different APIs to, so you could say to your voice, it has a voice engagement now, so you can talk to it and things and you could say, last Tuesday I was at a Thai restaurant and I had this, can you make a list of things for me to order so I could make it at home?

(22:29):
And then it'll go into Instacart and put together a list so that it can buy it. So it's doing all of those kinds of things. I think we have to expect that it's going to be infiltrating everything that we do from your phone when you get text messages, it'll read it for you and decide, is this spam, is it not? Same thing with emails. And you're probably going to have a lot less direct interface with text and content in general. So I think it's more important than ever to actually start building value so that people want to hear from you rather than just throwing out more content to try to get the quick win. Because right now it's still early enough that you can put out tons of content and be ahead of everybody. But I think that the days of that kind of stuff are definitely numbered.

Dr. Andy Roark (23:13):
Oh, I agree. When I got started in my career, I was doing a lot of writing for a company that's not in existence anymore, but it was a pet owner facing company and I wrote so many articles on the top three, summertime pet dangers you should be aware of, and the five most dangerous plants to have for your cats. There's a theme, but you get the idea. It was the type of themes and where it was just basic content of what to do when your pet comes home limping and man, that stuff is dead. There's use in writing it anymore. It's just everywhere. It's information over insight is exactly kind of what you were talking about and it's just the that, but I remember there was a time that was viable outlet and people wanted to read it because there just wasn't a ton of it. And now there's just such an ocean and those are the things I remember looking at AI and being like, boy, those types of articles are dead. They're gone. There's, there's no reason for a human being to write that type of stuff unless you've got something really interesting, insightful or different to say. It's just too easy to have AI look at an enormous amount of content that already exists and repackage the standard information. That's not a thing that people are required for anymore.

Brandon Breshears (24:38):
So I agreed everybody thinking to do your 4th of July dangers or those kinds of posts that everybody does, just got to think of something more interesting, for sure.

Dr. Andy Roark (24:49):
Yeah, I agree with that. But I still think to your point, there's opportunity there of there's going to be there. I think that's probably going to be more of a desire for interesting content as the same sort of generic content piles up around. Yes. If you have things to say, I still think you're going to be able to have an audience and have people listen. If there are people who are like, all right, I get it and I'm kind of interested in this. We're running sort of your standard practice. We've got some texting capabilities and things like that. Brandon, where do you think that people get started if they're starting to think about, okay, how do I start to add some of these tools into my repertoire? Where do you even go and how do you break the ice and start gaining some familiarity with this?

Brandon Breshears (25:36):
Yeah, I think that with these tools, it's just like any marketing activity that you want to do. You want to start with your goals first. And typically I suggest people start at their bottom of the funnel. So everything that's going to help to drive revenue and build out those systems in place as much as possible. So if you have emails that you know should be writing that aren't there for follow up, for referrals, for those kinds of things, build out all of those bottom of funnel type things that are going to help to drive the attention that you're getting into actual clients and customers and then work from there. I think a lot of times people start at the top where they're just creating more content and trying to create more attention and get more activity, but that doesn't translate into conversion because they don't have anything in place to help them to take that attention and then convert it.

(26:20):
So I would start with all of the things that are going to drive more clients in the door, and if you can test and measure that as you go, when you start to add more attention to it, it's going to convert better because all of those things will be in place. And so I think that creating offers and having help to create offers and promotions and things that are going to create urgency, scarcity, increase the likelihood of people feeling like they're confident that this is going to get a better outcome for them, those kinds of things that you're going to want to develop to help meet the goals that your practice has and then go from there. But I mean, it can do everything for you. It can help to create content calendars, it can come up with ideas and idea generation, and I think that's probably one of the best uses too, is just because starting with the blank page is probably the most difficult thing for most people. They don't know what they should write about or what they should do. So start with ideas, schedule and batch creation of content and then have it start or revise what you're doing. But I think your input needs to be in there. So either have it start and you edit or you create something and tell it to edit it. I think those are the two ways to do it rather than just say, create something and then post it.

Dr. Andy Roark (27:33):
Yeah, that absolutely makes sense. I'll tell you, for me, the white page problem is the number one reason I look at it. It's just get me started here. I mean, I've seen it, I've seen it for everything over in Uncharted people building out handbooks and they're like, look, just write me a first draft attendance policy for, and this is my hospital, this is what we do, this is our culture. Write a two paragraph to three paragraph attendance policy for the employee handbook and you get a solid first draft. And once I see it, I go, oh, well they didn't add this, or they should totally have that, or I don't really want that, but now all of a sudden I'm in editing mode and I'm fixing and I'm also expanding off of what's been there. But a lot of times just getting that first draft down on stuff like that, especially stuff where I go, I'm not really strong at this. That stuff is a game changer. Absolutely.

Brandon Breshears (28:27):
Absolutely.

Dr. Andy Roark (28:28):
Tell me a little bit about your course. So you have an on demand course, you start off with you, I think you planned to do it live, but it was so big, people were like, look, can't we can't keep coming. We have to have it on demand. Yes. Tell me about that.

Brandon Breshears (28:41):
So I saw these tools coming out and I wanted to create something that would be really just very practical. And so I think it's eight modules and I'm adding to it as things are updated. So there was plug-in update and different cool tools that, for example, there's a tool called Pod Squeeze that just came out that helps you to edit podcasts. It does all your transcription automatically. It creates show notes, it creates tweets and social posts with it. Just like there's so much exciting stuff because it just takes all of this stuff that I hate doing with content creation and makes it automatic so you don't have to think about it, which is cool. But it has different modules from SEO to offer creation to content creation to using automations. There's a lot of things that you can set up right now. It doesn't interact with the web in general.

(29:26):
It's confined to these individual tools. And so you can take tools like Zapier and build out automations that help it to do things automatically. So if you're creating content ideas or something in a list, you can have that list be updated onto chat gpt, so it can create a blog post out of those ideas for you and post them automatically and then create Facebook posts automatically and just really help to systematize a lot of those things. So it's just very practical to help practices get a lot more out of these different tools and hopefully get better results out of them so that they're more effective.

Dr. Andy Roark (30:02):
I'll put a link in the show notes so people can find that and definitely check it out. So I think that's really useful. The last sort of question I have for you is just kind of when a lot of these AI programs came out, they were open to the public and sort of free and so like chat GPT was free and now there's a paid version and there's things like that. Do you think that we are going to be able to continue to play around on the free versions? Do you feel like you're getting a lot of what you need using those sorts of open AI services or are we in a place now where the benefits to paying, I think it's like $20 a month for the chat GPT, are we getting to a place where that actually makes some sense? If you really want to get in and play, you should probably go ahead at least for a while and pay the fee and be a subscriber. Tell me what's your impression there?

Brandon Breshears (30:49):
I think it's worth it. In my opinion, the chat GPT four that you have access to, which is their newest model is much better as far as the results that you get. And you also get the benefit of if there's peak times where there's outages because so many people are using it, you don't have to worry about that. So if you want a more consistent result, I think paying for it is definitely worth it, especially if you have somebody that's going to be on staff. That's, I think using these tools to help your staff create content instead of just hoping that they're going to be great at writing and know how to create great marketing. I think it's just really 10x's their output and gets just much better results because I saw, in my opinion, it's worth it. And I would suggest that if you're using it, and especially if you want to have people consistently use it, having outages and somebody goes to sit down and use it and they can't, that is going to cut your productivity. So I think it's worth it. And then for those specialized tools like that tool pod squeeze, they have a free version that gives you 50 minutes free, but I think the output is so valuable and I think that these niche tools that they're going to be building out, there's going to be video editing tools that are going to be incredible. I am not good at video editing, so I'm excited about stuff like that. We're just going to,

Dr. Andy Roark (32:07):
Oh, I enjoy video editing. It's a massive time sucker. I, I'm super excited about that. That's awesome. Brandon, thank you so much for being here. I really appreciate you. Guys, I'll put links to as many of these things that could run down from what Brandon was talking about, links to his class, also to the Veterinary Marketing podcast, and anything else like that that we've come up with, I'll try to drop it down in the notes to keep people going. Brandon, thanks so much for being here. Guys, thanks so much for tuning in. Take care of yourselves. Thanks. And that is our episode, guys. I hope you enjoyed it. I hope you got something out of it. Thanks to Brandon Breshears for being here. I put links in the show notes to his podcast and course, yeah, guys, take care of yourselves. I hope you, you got some interesting ideas. I am. I'm googling some stuff and talking to chat GPT right now as I record this. So anyway, gang, take care of yourselves. Be well. I'll talk to you later on.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: technology

May 08 2023

The Future of Financing Pet Healthcare

Uncharted Veterinary Podcast Episode 230 Cover Image

This week on the podcast…

Jonathan Wainberg joins Dr. Andy Roark to discuss how lending and insurance will play a role in pet owners affording veterinary care in the coming years. The discussion covers current trends in pet owner spending on wellness, best practices for communicating cost of care, and where the lending and pet insurance markets may be going in the coming years.

This episode is made possible ad-free by CareCredit credit card. For more information about helping pet owners in your practice pay for care or access pet insurance for their furry family members, check out the CareCredit website or the Pets Best Pet Insurance website, both Synchrony solutions.

Uncharted Veterinary Podcast · UVP – 230 – The Future Of Financing Pet Healthcare

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

Carecredit logo

This episode is made possible ad-free by CareCredit credit card. For more information about helping pet owners in your practice pay for care or access pet insurance for their furry family members, check out the CareCredit website or the Pets Best Pet Insurance website, both Synchrony solutions.

ABOUT OUR GUEST:

Jonathan Wainberg General Manager, Senior Vice President, Pet

Jonathan Wainberg brings over 15 years of financial services expertise, and a record of commercial ingenuity, market expansion and energetic leadership driving revenue growth to his role as CareCredit’s General Manager, Senior Vice President, Pet. In this newly established vertical, Jonathan will lead CareCredit’s expansion of the veterinarian credit business, pet insurance and additional market adjacencies.

Prior to this, Jonathan served as SVP, General Manager GAP. He joined Synchrony following a 15-year tenure with GE Capital, where he was the Senior Managing Director, Global Sales for Industrial Finance in London. He was a key member of the senior leadership team that reorganized and streamlined GE Capital. Jonathan developed the strategy and led the efforts that allowed GE to provide financing support to global customers in new markets, surpassing sales targets by more than 30%. With on-the-ground roles in the US, Europe and Asia, he’s managed teams around the world and delivered complex strategies in more than 50 countries.

Earlier, Jonathan joined GE Capital in Corporate Finance in New York, ultimately becoming Managing Director, responsible for the Eastern US, Canada and private equity firms, in 2012. As Managing Director, Jonathan originated, structured and negotiated leveraged loans and highly structured financings for leveraged buyouts, re-financings, expansions and restructurings of middle market and large cap retail companies. He was a top individual sales contributor from 2007-2010.

Jonathan has an MBA from Georgetown University and a BA in History with a concentration in Marketing from Concordia University in Montreal, Canada. He began his career in the executive training program at Macy’s in New York, where he also had various merchant/management roles.

Jonathan is a native of Canada, with a dual US-Canada citizenship. He has traveled to over 85 counties, enjoys entertaining, wine and playing with his energetic 2-year-old son.

While based in Costa Mesa, Jonathan currently resides in Bal Harbour, Florida with his wife and son, Jonathan will relocate to Southern California soon.

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

Language That Works Infographic: https://www.carecredit.com/sites/pc/pdf/speak-pet-owner-healthier-pets.pdf

Uncharted upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Andy Roark:

Welcome everybody to The Uncharted Veterinary Podcast. Guys, I am your host, Dr. Andy Roark. Guys, I got a special bonus episode for you today with the one and only Jonathan Wainberg. For those who don't know Jonathan or didn't hear him on a previous episode, he is Senior Vice President for Synchrony, working with teams at CareCredit and Pets Best, both Synchrony solutions. Guys, he's got his finger absolutely on the pulse of what is happening in finance, in vet medicine, and that's what we're going to be talking about today is keeping care affordable. What does the future look like for pet owners paying for vet medicine? Guys, this is a sprawling conversation to ask him about where he sees the industry going, where lending is going, things like that. He's got a lot of ideas. I found it really, really interesting. So guys, without further ado, let's get into this episode and this episode as a bonus is brought to you ad free by CareCredit.

Speaker 1:

And now, The Uncharted Podcast.

Andy Roark:

And we are back. It's me, Dr. Andy Roark and my friend Jonathan Wainberg. How are you?

Jonathan Wainberg:

I'm doing great. I'm just happy to have been invited back to one of your podcasts. I thought for sure on my first one, I tanked it, but listen, I'll take it.

Andy Roark:

The exact opposite. No, I appreciate you being here. For those who don't know, you are the Senior Vice President and General Manager of Pets at Synchrony, which encompasses CareCredit and Pets Best pet insurance. Yeah. So I wanted to have you on today to talk to you a little bit about the finances of this profession and the economy in general and where things are going from an economic standpoint in our profession. I think that you have an interesting perspective on this because of your involvement with both CareCredit and Pets Best. Can you go ahead and start at a high level of when you look at the economy at large and we're seeing rising inflation and things like that, where do you see our economy going and then how do you see the economy of veterinary medicine going forward?

Jonathan Wainberg:

Yeah, no, and thanks for having me. And this topic is so important now given everything that's going on in the economy, but just a headline news, we're living this day to day and so it is something that is important for us to discuss. And I think the last time you had me on, we talked about lifetime of care and all the costs associated with pet wellness. Listen, things have changed so much in the last six months and I think it's great that we're here to talk about that. Quite frankly, I think financing and financing solutions and flexible means of payment are going to become even more important as people do unfortunately struggle with some of the changes in the economy, whether it has to do with employment issues or interest rate issues with some of the other expenses going up, and we need to be prepared for that.

Andy Roark:

Yeah. Helping people pay for care is a problem that's not going to go away. If anything, it seems to me obvious that that's going to be a bigger and bigger part of what our jobs are going to be. I was thinking recently, one of the things that landed on me was emergency pyometra on the weekend, and this was a dog that was pretty healthy on Thursday and Friday and then they're at the vet clinic on Saturday with this emergency procedure. It's a $6,000 surgery to get it done, and I understand the economics of that and I understand why it costs what it costs.

At the same time as a pet owner, you look around and you go, “Man, I don't know a lot of people with six grand laying around that they're like, ‘This is not a problem.'” In the vein of sticker shock, I guess, is there messaging that you would like to see from a professional level? Should we be doing things to try to make people more aware of financial planning for pets? ‘Cause I think that's what you and I are ultimately going to end up talking about is, what is financial payment planning for pets, and then how do we encourage people who are pet owners who are generally just going about their lives, they have no idea what medicine costs. How do we get those guys into that headspace?

Jonathan Wainberg:

Yeah, no, I think… And this is the audience that we need to be talking to because they bear the brunt. This is the first line, right, your vet professionals and listening to this and the people that have to assess the health but then provide a treatment plan and show them. So a couple of things we've done, we've partnered with the AVMA on a study language of care, and I have it here in front of me, can't see it obviously on the podcast, but talks to best practices on things to say, and words do matter when you are communicating to pet parents, right. If we think about a term that we like to use in the industry preventative, well that doesn't resonate so much with our pet parents. Something like routine or checkup does much more for that.

And so it's little changes like that to think about, okay, how do we get people just getting more involved in first part compliance of care, wellness of care, because we know that just like humans, pets, if you provide them the standard care, are probably going to live a longer life and a healthier life and a happier life and not have those acute experiences perhaps as much. So try to reduce that. When you think about the financing element of it, we are there's language there as well where don't avoid the conversation, but talk about it in the right way. Address the elephant in the air in the room, right. People are so… The human animal bond relationship has grown so strong over the last few decades that people are willing to spend much more for the health of their family members or pet family members.

And so just preparing them upfront is integral. And so it starts when you… At the puppy stage, right. And you see some expenses, kind of jump up and talk to them about insurance, talk to them about CareCredit and tools that they should have. Because ultimately, as much as we like to plan, there are going to be surprises. Dogs and cats and [inaudible 00:06:34] companion animals, we don't know exactly what's going to happen and so we just got to make sure that we're prepared for the unexpected.

Andy Roark:

Yeah. I want you to expand on that a little bit. Talk to me about best practices inside the vet clinic that you see.

Jonathan Wainberg:

Yeah, I think it's having that open dialogue, right. And it's not an easy kind of conversation, but we need to shift the way the veterinarian teams communicate with their pet owners and perceptions about the value and the importance of veterinary care, right. And offering personalized recommendations. Use language vets reassuring about clients. 53% of pet owners want to hear recommendations from their vet owners and they don't want to be blindsided. We know that that came out of a study that we did from AVMA. They appreciate it. The veterinarian and the hospital managers and the vet techs, they are the most trusted resource for anything to do with your pet.

And so we need to work with our vet provider networks and the vet community to be able to have that open dialogue, talk about some of the costs that you can expect to spend. So just so you know, a first year pet ownership for a cat can range from about a $1,000 to $2,500. Dogs even more. Talk about those different courses of treatments and what people can expect and to some degree put together a plan of care when they're at that young age, or even if they then have some sort of acute need and a high ticket surprise, that's the ever time to say, “Well, let's make this just a onetime occurrence so that you're not caught off guard again.”

Andy Roark:

Yeah, that totally makes sense to me. So sign posting early on. I think that makes a lot of sense. I'm going to link to the lifetime of care study that you referenced. So you were on last time we talked about the $45,000 cat. And still I think that's such a powerful study just because you say that $45,000 cat and it blows people's minds and you can say, “Oh no, over the life of an animal, especially an animal that has some health problems, we can get up into these extremely high numbers.”

Jonathan Wainberg:

It's interesting, and it is. And I think in one of the interviews with one of the publications, we talked about a dog or $55,000. You say, “Lifetime care of a dog.” Someone says, “That's a very nice car.” And not to be crass about it, 'cause I take my dog over a $55,000 car any day of the week.

Andy Roark:

Of course.

Jonathan Wainberg:

She probably can't get me where I need to get to, but when you think about… She's a miniature poodle, I can't-

Andy Roark:

[inaudible 00:09:27] that small. Yeah, I get.

Jonathan Wainberg:

No, yeah, no, I don't think so. And pretty much now that she's 12, I'm spending more time carrying her than she is walk… But what I'd say is I think about that example, and it's an interesting example and I'd like your point of view on this. I go back to, well you have a $55,000 car, let's use that as an example. Well yeah, you got to provide that car with the right amount of maintenance. You don't just go to the shop or change the oil, you know, you don't change it… And then when you get an accident, you finally take care of it. No, you have to throughout that lifetime provide that care. And I know that that is something that our industry really tries to work with our patients on whatever it is, wellness and routine visits.

Well, in this study, and we didn't really get into it, but part of me is convinced that to some degree your pet within some standard deviation, it's going to cost the same amount. The question is, it's over how many years, right. So your pet is going to live longer if you give them that good care over the course of that life and they're going to be happier and healthier and a better companion and part of that family. And that that's something that really stuck out to me when I was looking deeper into the numbers and thinking about it with my own experience.

Andy Roark:

Yeah. I've gone back and forth on this. I really do think that we need to get these numbers out in front of people, right. For them to… How many of our pet owners have the realization of what it costs to have a pet, like, as the time that they're seeing a quote for an emergency procedure or something like that, and that's not how we want people to learn. And then I think part of it's, I'm not callous, I believe the human animal bond. And you see that the health benefits and the wellness benefits of having pets and things, we need to figure out ways to make this affordable so that people will continue to have pets and they're not a luxury. But it's always that balance.

Jonathan Wainberg:

You're absolutely right. Just having these numbers of the study in front of me, right. 38% of cat owners thought they were ready for a pet expense, but they weren't, right. And so if you think about that, that's 60% basically, 62% didn't, right. And that's a big, big number. And it's not dissimilar in the canine space, right, and so we got to keep banging this drum because the more we talk about it, the more people are going to be prepared and the more they'll be more proactive. Because the last thing you want to do is have to, you know, when you're dealing with the stress of an emergency of your family dog, your family cat, even in the equine space, the last thing you want to be thinking about is making a choice between cost or care, right. You want to be prepared upfront for that. And that's where being educated and educating your pet parent clients in the veterinary industry is so critical.

Andy Roark:

Yeah, I'm not surprised by the number as far as number of people who think that they're prepared and then they're not. I really think that there's a perception problem about veterinary care and what it costs. I think people have got anchored in their mind, you know, cost from 20 years ago and I go, man, there's been significant changes in where we are. So I see pet owners all the time that seem to be just caught by that. I guess that goes back to my earlier question when I talked about setting expectations and things. It's just something I think about. I think people don't get frustrated as much about things that they're not surprised by as they do when they're caught off guard, meaning what they expect to pay. If they expect to pay what it costs. They're generally okay, and it's a frustration and a challenge, but we hope to get the emotion is when they expect to pay much less than what it turns out to be.

And now they say, I'm wildly unprepared. And also I think all of us have had this problem of when pet owners feel like they don't have any options, they don't know how they're going to pay for this, suddenly it becomes a much more dire and emotional situation. And so I think that that's sort of where I was going earlier on when I was saying how do we normalize this? So let me circle back around to that and just sort of say, how do we normalize financial planning or even borrowing money for care as like, “Hey, this is a thing that happens.” I think a lot of people are still surprised that there are companies like CareCredit that exists for this purpose. How do we let people know about that ahead of time and make that sort of a more normal part of the conversation?

Jonathan Wainberg:

Yeah. We've tried to make it as easy as possible. We're accepting in about 85% of the vet practices in the US and so it's been around a long time CareCredit's been through all the cycles, it's something that is trusted and we have an incredible amount of network with millions of cardholders just in the veterinary space. I think… Listen, we believe that when someone gets a puppy or adopts a rescue, they should be presented with options of insurance, right for us Pets Best and as well as finance. And I think you're spot on about expectations and surprises and being scared off by stuff. So it's so important to talk about this upfront to get people to enroll. So it's a great tool. It works… And the great thing about CareCredit is it doesn't only work in the veterinarian channel, it works in other areas. So a lot of people actually have the CareCredit card in their pocket but may not know that it's accepted in that vet practice 'cause maybe they took it out for their kid's orthodontistry or if they had a laser surgery on their eyes, and that card has that inter-flexibility.

And the great thing about CareCredit is that unlike a lot of these buy now pay later products, it's something that you could reuse. It's a dedicated line of credit. We're a regulated bank, we have all the reserves, you know that we're here. We've been in the industry for 27 years. You know that you have that support. So by us having both Pets Best and CareCredit, you have different choices on how you can manage and prepare for those decisions. But ultimately, the thing I also want to point out, because I know we got a lot of vet professionals in your audience, I think that's our main target audience in this forum is it's also good business for the practice. You don't want to be taking on debts, your job and thank God it is your job and we're so lucky to have an industry where people are so passionate about caring for our animals and all the trials and tribulations that go with that.

But your job is not to be a bank. Your job is not to be a financing solution and you don't want to have receivables from clients. ‘Cause imagine how much harder that conversation is if they owe you money. How much harder it's for your cash flow and for your practices' financials if you're not getting that money. Whereas if CareCredit has it, you get it in that short amount of time. You don't have to damage or have those tough conversations with your clients on bad debts and stuff like that. We don't like to have those conversations either, but that is our job. We ultimately, if it comes to that, which we hope it isn't, but then we also have programs and practices to help people that perhaps could manage that in a more efficient way.

So I think that's also super important for people to think through as we go through a more challenging economic period. It's not just the owner or pet parent, it's also the practice. And all of you in the profession need to make sure that you're taken care of yourself as well. And this is one easy way to do it because I come from a family of doctors, I could say this, right. I've been blessed to have people in my family that are so passionate and it's in human health, but passionate about their clients. But you talk to them about the business part of that element and thankfully, to some degree, it's a secondary part because we need them focusing on the clinical part, and you shouldn't have that be a worry.

Andy Roark:

Well, the optics of vets shaking people down for debt is awful. I mean, it does not look good. It doesn't feel good in a world of social media where people can see your practice and your practice brand is out there and you want people to buy it and trust you. It looks awful and it feels awful for us to be like, “Hey, where's that money that you owe us?” You don't want any part of this. So that's a big part of it. The other part of it for me is staying in that optics vein and we look at social media and the way of the world these days.

I think if we're going to continue to be a trusted resource and to be able to stand out there and say, “Hey, we care about your pets and we value your pets.” We've got to continue to find ways to make care accessible and at least to give people options. So we say, “Hey, we're trying our best. We're giving people options on how they can make this possible.” We just don't want to have the image of people who say, “Yeah, we love your pets like family. You owe us this money and you better come up with cash in hand.” That's not who we are and none of us want it. And so I look a lot at that and say, “I don't want that in our future.”

Jonathan Wainberg:

No. And as that lifetime of care study showed and our a AVMA study that we partnered with the AVMA with, the veterinarian and the staff of the veterinarians are the most trusted resource and that relationship is everything. And you don't want anything coming in between that. Obviously we're fortunate to have those in the profession that are so dedicated to the space. But if there's something that can take away from any tension in that relationship, and we know that finance is not an easy conversation to have, but doing it early and then putting the… I wouldn't say the burden, right, 'cause it's our job, but at least removing that burden from you on that sort of financing and receivable side to a company that specializes in it makes sense. And it's almost, in my opinion, not worth the while to get into it. And there's just too much receivables in that space that it's just almost self-inflicted pain. I hate to say it.

Andy Roark:

Yeah, no, I get that. When you look into your crystal ball, Jonathan, you look ahead five years, what, what's patient care finance look like? What's different in five years than it is today? Are you predicting significant increases to the number of people who have pet insurance? Are there different financial products that we're not seeing yet or we're just starting to see, help me see the future of this?

Jonathan Wainberg:

Yeah, listen, I think pet insurance penetration is going to increase in the US. We're about 3% now in the US, but that's still very small. Is it going to get to the levels where in the UK it's 25% and in parts of the continent, even higher, European continent even higher? No, I don't think so because I think there's major cultural differences between the insurance experience, not necessarily pet insurance, but just general insurance experience in the US versus Europe and socialized medicine and stuff like that. And I know in Sweden there's certain pet kind of responsibilities that the government puts on as a pet owner that makes insurance something that's a lot stickier, making it claims automation. So you're making it quicker, making it easier for medical records to be uploaded. I think the other part of that is the app experience and the online experience very digitally native, which we know in our industry, and it is probably not where we stand out as being the most technologically advanced in our practice management systems and so on.

So working together with some of those partners to make that easier. I do also see, I don't think credit's going away. I think there's a place for both. And what I'm thinking is I think there's going to be a place where those two products work even more closely together, right. And how you can reduce the out-of-pocket experience in the short term while you're waiting to be reimbursed or even quicker reimbursement even at the time of care are things that, hey, how do we go and operationalize that and commercialize that as something that that's very important. So it's going to play a bigger role, and so these financial tools are going to continue to be prevalent.

Andy Roark:

Yeah. You got me thinking about what's possible. That's interesting. That's what I wanted. So I'm going to go ahead in the show notes. Guys, I'm going to link to the pet lifetime of care study that we referenced a couple of times. I'm going to link to the AVMA CareCredit collaboration, the Language of Care, which has got some really interesting things about setting expectations when talking to pet owners about finance and money, which I like a lot. Jonathan, for people who want more information, they're like, “Hey, I want to understand third party payments more. I want to understand Pets Best pet insurance, what resources do you like for them?

Jonathan Wainberg:

Of course, I'd say carecredit.com is a great place to start. You'll see there's a toggle that you can either choose as a patient or as a provider, right. And then there's sub sites on the industry, so obviously you click on the veterinarian space. You can also find a link there to Pets Best, but you go to petsbest.com directly also, to look more into insurance and how that works. What I can tell you is that people that have CareCredit and people that have Pets Best, we know for a fact that they have a better compliance of care for their pets than those that don't.

And so it is an important thing out there. We all have the same goal. We're all aligned here in A, making sure that your clients and your patients have that compliance of care and the best care and the best lifetime that they can, we want to help provide on the financial side that flexibility and that safety net that can enable them to do that. And so it all comes back to preparation, communication, and that relationship that you guys have is our strongest resource.

Andy Roark:

Yeah. No, that totally makes sense. Jonathan, thank you so much for being here, guys. I'll put links to the show notes for all these things down below. Take care of yourselves, everybody. We'll talk to you soon.

And that's it, guys. That's what I got for you. I hope you enjoyed it. I hope you got something out of it. Thanks to Jonathan for being here with us guys. Guys, I always enjoy these high level conversations, sort of predicting the future and looking at trends inside the industry. If you do, stick around. We're back every week. Come check out some more episodes. This is a Monday episode. I have another Uncharted Vet episode with the one and only practice management goddess Stephanie Goss coming out on Wednesday. I'd love to see you there. Take care everybody. Talk to you later. Bye.

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

May 03 2023

They HAVE To Be Talking Behind My Back, Right?

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are in the mailbag to tackle a question about what to do when you think people might be talking about you behind your back at work. In fact you are pretty darn sure it is happening because your bosses are alluding to people being unhappy with you but you aren't actually getting concrete examples or feedback to work with. Plus at least one team member was recently EXTRA salty with you on a shift, seemingly out of nowhere. This tech is feeling Undefined and Rudderless and asking for help. Let's get into this…

Uncharted Veterinary Podcast · UVP – 229 – They HAVE To Be Talking Behind My Back, Right?

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


RESOURCES

Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Stephanie Goss:
Hey everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. This week on the podcast, Andy and I got a letter in the mailbag that tugged at my heartstrings. We got a letter from a technician who called themselves Undefined and Rudderless, and he is really struggling as a male in a female-dominated industry now because he is having some challenges where he feels like his team is talking behind his back at work and he is really struggling. He has asked for feedback. He has talked to his bosses who actually have commented on the issue, but have provided no concrete feedback that has helped him change his behavior and he is really struggling. This one was one that Andy and I really enjoyed getting into the weeds on. So let's dive into it, shall we?

Speaker 2:
And now, the Uncharted Podcast.

Dr. Andy Roark :
And we are back. It's me, Dr. Andy Roark and the one and only Stephanie, give it to me straight, Goss.

Stephanie Goss:
That is very appropriate for today's episode.

Dr. Andy Roark :
Yes. Don't send no mixed messages. Give it to me straight. Yeah.

Stephanie Goss:
Give it to me straight. I will give it to you straight.

Dr. Andy Roark :
I know.

Stephanie Goss:
That is my M.O. I shoot straight from the hip.

Dr. Andy Roark :
There you go. There you go. How are things?

Stephanie Goss:
Things are trucking.

Dr. Andy Roark :
Things are trucking.

Stephanie Goss:
Trucking along.

Dr. Andy Roark :
Yeah. Holy moly, we're busier than a long tail cat in a room full of rocking chairs, as they say where I'm from. Oh, Appalachian Mountain sayings.

Stephanie Goss:
I was going to say got to love the Appalachian sayings. None of them make any sense.

Dr. Andy Roark :
Oh, well. Oh, man.

Stephanie Goss:
Oh, man. No, things are good. We are slammed. We are busy. We are recording this and it is the end of March. So we are just couple weeks away from the April Uncharted Conference, which is going to be amazing. I'm super excited about that and getting to see everybody. We just had Practice Manager Summit last week, so still riding the high from that was amazing.

Dr. Andy Roark :
That was amazing. That was a one-day virtual event. It was freaking amazing.

Stephanie Goss:
It was.

Dr. Andy Roark :
It went so well. And it's like our virtual events are not webinars. They are interactive workshops, and discussion groups. And especially, I really like this one-day format because people did a great job of putting the clinic aside for one day and just being all in on it. And man, it was great. I mean, it was really good.

Stephanie Goss:
It was.

Dr. Andy Roark :
We had a good number of people. I'll tell you my favorite part of that was we have some French listeners for this podcast.

Stephanie Goss:
We do?

Dr. Andy Roark :
And I see it on the statistics. I'm like, “There's a couple people in France listening.” We met them. It's a pair of sisters.

Stephanie Goss:
Yes. Yes.

Dr. Andy Roark :
It's Martine and Maryanne. Yes. And Martine was there. It was in the middle of the night and she was like, “I am here for this.”

Stephanie Goss:
It was 2:00 AM. I know.

Dr. Andy Roark :
Here I am.

Stephanie Goss:
It was absolutely amazing to me. And Maryanne has actually written into the mailbag, we have done several podcast episodes with questions that she has asked. And when you guys told me, I got a message during the conference and you are all like, “Have you seen Martine? She's here and she's from France.” And I was like, “Oh, I wonder if,” and I was just like, “It's her sister.”

Dr. Andy Roark :
Oh, man.

Stephanie Goss:
That made my day because it just, it's so surreal.

Dr. Andy Roark :
It was amazing. Yeah, it was amazing. And she was right in there. I was like, “Buddy, if you think the things you're struggling with in your practice only apply to you, you are so out of your mind.” These things are so universal and everybody is fighting different battles that seem quite familiar and similar in a lot of ways. And man, just getting really good managers together in that session for those days, for that one day, God, that was great.

Stephanie Goss:
It was. It was awesome.

Dr. Andy Roark :
I was so happy when it was over. I was so energized.

Stephanie Goss:
And it's funny to me because to your point, we all think that we're the only ones having the problems, right? And that's the number one thing that I think you and I both get told about the podcast is, “Oh my gosh. You guys were talking about exactly my issue.” And I think that's the thing is that we're not alone and we just did Manager Summit and Martine was there and it was 2:00 AM in France. And then last night we had a workshop with our teammate Tyler Grogan talking about creating fans in our practice. And we have a handful of members that are from Australia and one of them, Terry was there last night and it was today, it was a day ahead. And she's there and she's rocking. And you were talking about practice differences from country to country, place to place, it doesn't matter. We have similarity. We're all facing different facets of the same challenges. And so man, it's a good time right now. I'm jazzed about all we're doing and all we're talking about, whether it's in the community or at events. It's a fun time.

Dr. Andy Roark :
Well, especially if you're into management, the benefit of having people who have wildly different practice styles and cultures is huge. I was speaking in the Netherlands a while back. And so their economy is a little bit different. They have high taxes and they do a lot for their people. They have high taxes. And so employing people is very expensive. So most vet clinics are very small, like a doctor and two technicians and that's it. And they answer the phones and they do all the things, and it's just a wildly different model in a lot of ways. But man, when you ask them, how do you guys do this? The ideas that they have and the way they set their businesses up, you just go, “Oh, man. Boy, we can learn some things about efficiency from them.” And then they look around and go, “Wow. You guys, you do things wildly different because of how you're set up.” If you like new ideas, boy, doing some international work like we do with Uncharted every now and then, that stuff is so good. It always just cracks open my creative part of my brain.

Stephanie Goss:
Yeah, for sure. For sure. Well, we have got a great mailbag question.

Dr. Andy Roark :
I like this question.

Stephanie Goss:
And I'm excited to see where we're going to go with this because you and I were just talking getting ready for the episode and I was like, “I think we have multiple different problems in this question.” And you're like, “Nope. We've got one hour.”

Dr. Andy Roark :
I don't know. But we'll see.

Stephanie Goss:
I love it.

Dr. Andy Roark :
There's one question that needs to be answered and fix this problem. I don't know if it can be answered. I don't know if we can fix it, but I think that there's one.

Stephanie Goss:
Okay. So we got a mailbag question and it's from Undefined and Rudderless. And they wrote in and said, “How do you address the problem if it's not defined, if you don't know what it is?” So they've been dealing with people talking behind their back at work because the bosses keep eluding with comments and/or talking about problems during reviews or one-on-ones. And they were like, “Well, but of course I ask, ‘What am I doing wrong?'”

Dr. Andy Roark :
What is the problem?

Stephanie Goss:
“What is the problem? How can I change my behavior? What can I do to avoid these situations?” And repeatedly they are getting told, “Don't worry about it. You're doing a great job. Just keep working on being a team player,” alluding to the fact that it's not you, it's someone else, right? We've all had that conversation, “It's not you, it's me.” I got the sense that that's what they were being told. But then they said, “I was at work today and one of my teammates came up to me and literally started shouting at me about how I was lying about work that they were doing. And that they didn't want to work with me anymore and that they were sick of working with me. And this happens to be a letter from a male in our industry.” And they were saying, “As a man in a woman-dominated industry, I am often very careful about what I say. And when I get stressed during busy days, I tend to withdraw into myself and focus on my work.”
And so they were like, “I want to fix this. I want to be a good team player. I want to work well with my colleagues, but how do I address the problem if I don't actually know what it is? And how do I address my bosses continually telling me not to worry about it, turn up and do my job? But then have days like this where my colleagues are clearly angry at me not wanting to work with me. Clearly there's a problem and I want to do something about it.”

Dr. Andy Roark :
Yeah. I felt this. Just reading through, I imagine the frustration of being like, “I'm sorry. What did I do?” And they're like, “I think you know.” That really is, “I don't know,” “I think you do, the issue.”

Stephanie Goss:
Oh, man.

Dr. Andy Roark :
It's just the issue. What is the issue? It's the thing you need to work on.

Stephanie Goss:
I would be seeing red. I would be so angry.

Dr. Andy Roark :
I would like, “Are you pranking me?”

Stephanie Goss:
Am I on Punked?

Dr. Andy Roark :
I'm like, “This is it.” So that's why I said, “I think there's one problem here.” I'll come around to it at the end. But here's what I think the problem is and I hope that my old man brain will hold on so I can remember what it is at the end. I forget what I was going to say. It's a real… Should make a note for myself. All right. But let's start with that case. So I want to approach this from the perspective of the person who wrote the letter, right? Because they asked, “What do I do?”

Stephanie Goss:
Sure.

Dr. Andy Roark :
And so I can look at this from a lot of different ways, and my gut is always to look at it from a leadership, mentorship, manager position looking down. That's not what we're dealing with here.

Stephanie Goss:
No. Yeah.

Dr. Andy Roark :
And so I really want to help out Undefined and Rudderless from where he is in this situation. Okay?

Stephanie Goss:
Yep.

Dr. Andy Roark :
So the first thing is I would say, you have to try to be positive in this situation, right? And you have to try to be positive. This is not fair. What I'm about to say it's not fair and I want to own that it's not fair. It's not fair. It's not fair that other people seem to have a problem with you and they won't tell you what it is, but if you get mad, you are going to look like the bad guy.

Stephanie Goss:
Sure. Yeah.

Dr. Andy Roark :
And that's not flipping fair, but fair is where pigs win ribbons.

Stephanie Goss:
That one actually makes sense.

Dr. Andy Roark :
The first one made sense too. Have you ever seen a long-tailed cat in a room full of rocking chairs? She doesn't sit still.

Stephanie Goss:
Okay. I digress.

Dr. Andy Roark :
Fair is where pigs win ribbons, right? If you get mad, there's a decent chance this is going to get tagged onto you as the bad guy. And that's not fair. It's like when you're an older sibling and your younger sibling keeps messing with you, and you know if you get mad, you are going to get in trouble. And your sibling knows if you get mad, you're going to get in trouble. It's that thing. And you go, “I thought I grew out of this at age 12,” but you didn't because people are children their whole lives.

Stephanie Goss:
As an older child, I am feeling the pain right this second because I know that pain.

Dr. Andy Roark :
Well, that's why I said I felt this so much is like, I'm like, “Oh man, that's such a sucky position to be in,” where you're like, “I feel like I'm getting treated unfairly,” and it sounds like you are. And if you mishandled this, there's a chance you're going to end up looking bad. They can hang this on you as the bad guy, and that sucks. But know that up front, we're going to take some deep breaths and that's why we got to get our heads straight here. We've got to get into know that, but don't let that burn resentment into you. Just know we need to be careful in how we handle this. So careful in how we handle this is the first thing. The second thing is I'm going to say you have options. Never forget that you have options, right?
And so we're going to fix this or I'm going to recommend that you consider going somewhere else. That's where we're going to go, that's the ultimate solution here. So it's not fair, but we're going to fix it. And if we can't fix it, I'm going to recommend that you go somewhere else. And I think you're going to find a lot of opportunities because men are diversity in this industry, which is ridiculous, but true. There's a lot of vet practices that would love to have some dude energy in their practice. And so you will have opportunities if you want to go somewhere else.

Stephanie Goss:
Fair, fair.

Dr. Andy Roark :
Okay. All right. So that's that. Okay. So the first thing, start in good faith.

Stephanie Goss:
Yes.

Dr. Andy Roark :
Start in good faith and come from a point of curiosity. I actually really like the way that this was written of like, “I don't know what I'm doing and I ask about it, and I'm not being told what the answer is.” I think at one point, I think the big thing is, look, at this point out, take some deep breaths. We're going to take a step back. We're going to hit the reset button. We're going to go at this with a blank slate. And so let's get our head straight. So we're going to go over the blank slate. We're going to go back into this and from a genuine point of curiosity and to ask questions, and to ask for help and understanding.

Stephanie Goss:
Yes. Yes. Okay. So a lot of times when we talk on the podcast, we talk about safe and we talk about having a safe conversation. And certainly if people are shouting, that's not the time to have the conversation. But there's two pieces of safe that are I think are really important here. One is the assuming good intent. And so getting your point about getting curious with your bosses and just asking questions is a great one. And before that, I would start with the pre-work and ask yourself, “What else could this possibly mean?” And the reason that I say that, and when we talk about safe, we usually talk about, how have you been set up to fail? And one of the reasons why you should ask yourself, “What else could this mean?” Is that as a manager from an HR perspective, when there are multiple people involved, I can't always tell you what you want to hear, right?
And so I could totally hallucinate a situation, especially with some of the additional information we were given with the other person literally shouting and yelling at you. I could totally hallucinate a situation where maybe you have a coworker that is not behaving the way that they should. And as a manager, I am dealing with that situation from an HR perspective, I can't necessarily disclose that to you, I can't necessarily talk to you about specifics. And so I think assuming good intent and then asking yourself, “What else could this mean?” helps set you up for a good head space to go into a conversation with your bosses where you can get curious and ask questions.

Dr. Andy Roark :
I agree with that. I think this conversation, I think there's two conversations here that could potentially happen, which is why I think you said that there were two problems when we started. I would say I think there's two problems or two conversations that you could have. And so the first one is up at management, which means if you say, “I feel like there's people who are unhappy with me. I'm not sure what to do. I'm not receiving feedback. I don't know what behaviors to change or how to address this.” That's the conversation to have up the chain. And it sounds like this person has gone that way. I'm going to say when we do fresh slate, I'm going to go have this conversation again. And I really want to push you to push harder in this conversation, because you've tried it and it didn't go anywhere.
And so the conversation I would have up the chain is you go in, I'm going to go in with a spirit of curiosity, but I'm also going to remember that clear is kind and I want to be kind to the management because I'm getting tired of this. I'm tired enough about this that I'm writing to Andy and Stephanie, and calling myself Undefined and Rudderless, right? That means something. You know what I mean?

Stephanie Goss:
Yes. Yes.

Dr. Andy Roark :
Okay. This is not like, “I had a rough afternoon.” This is like, “No. This is weighing on you, my friend.” And so I'm going to go have that conversation. I'm going to say, “Hey, I continue to feel like people are unhappy with me. I had someone come up and shout at me and I don't understand why. I genuinely don't know what I'm doing here and I really need feedback because this is affecting me.” And if they say, “No, just do better and be more of a team player,” I would then push back and say, “I need specific action steps and I need areas to focus on and develop. And so I need feedback on exactly what that means so that I can make changes or address problems. And I don't know what it means to be a good team player or to do better.”

Stephanie Goss:
And I would also tell them how it's impacting you, because nobody wants to go to work and feel like people are talking about them behind their back. And so if you say exactly what you just said, Andy, which is like, “I need to know what that looks like. I need to know what that sounds like. Give me the feedback,” and then it's crickets. Or they tell you, “You're doing fine. Just be a team player,” then that's where you need to say, “I can't actually accept that as an answer because this is affecting me. I don't want to come to work in a place where I feel like people are talking about me behind my back, where I feel like I'm making people angry or I'm upsetting people. This is not working for me. And so I need you to help me, or I am going to have to make changes,” that could involve leaving your job. And it's not a threat, right? “This is how it's impacting me and I need you to understand how serious this is to me because that's not fair.” It's not fair.

Dr. Andy Roark :
Yeah. When I have this conversation, I'm exactly with you. That is step three is to say, “This is the impact it's having on me.” I completely agree. When I have those conversations, I never want to threaten, I never want to be like, “You're going to tell me or I'm going to quit.” Oh, don't do that. That's nasty. And people don't like ultimatums.

Stephanie Goss:
Yeah.

Dr. Andy Roark :
And it just escalates the whole thing. It's not worth it. The language, however that I specifically honestly use, but I'll say, “This is how I'm feeling and this arrangement is not working for me. And it's making me uncomfortable to a level that is not sustainable.” And that's where I stop because I'm not saying I'm going to leave and I'm not bluffing. This is not a negotiation tactic. This is clear as kind. But I see a lot of people who don't say that. They don't say, “This is not working for me, and the experience that I'm having at work it's not pleasant and it's not sustainable for me. So I'm going to need a resolution here and I'm happy to do what I need to do on my side to make that happen, but I need guidance in what that is so that we can resolve this. And I can get back to being comfortable here.”

Stephanie Goss:
Yeah. Because I think otherwise you run the risk that they don't understand how much you're bothered by it. They don't understand how much it's impacting you. They don't understand how much it means to you. And there have been conversations in my life when I think about it where I had no idea that the other person felt the way that they did until they said something that made me realize the gravity of the situation, right? And this is the moment where you have to figure out how do you do it in your language, in your comfort level to say what you're saying, Andy, which is, “This is affecting me and I can't keep doing this.”

Dr. Andy Roark :
Yeah. You don't have to be wildly dramatic too.

Stephanie Goss:
Right.

Dr. Andy Roark :
And I don't know how much to play gender into this as being a man and having these feelings of not fitting in and being bothered by that. And because I don't know this person. And when you say, a lot of times people don't know how other people are feeling. At one point this person mentions in their email, “I tend to get stressed on busy days and I withdraw to focus on my work.” If you're kind of the quiet guy who's just doing his stuff, people make assumptions about how much or how little you're affected by what's going on. And again, this doesn't mean you have to be an emotional presentation if that's not who you are. You can be calm and reserved and also articulate about, you can say, “This is how I feel and this is the impact this is having on me. And this is where I am as far as my feelings coming into work in the morning.”

Stephanie Goss:
Yeah. I think you were spot on where I think that there's two separate conversations, right?

Dr. Andy Roark :
Sure.

Stephanie Goss:
And I think from an action-step perspective with this first conversation is you have to have the conversations with your boss. Because they are the only ones who can do something about it, right? This is your relationship with them. And if you are not getting what you need and your needs are not being met inside of a relationship, the only other person who can solve that with you is the other person or the other people. And so you have to have the conversation with your bosses and use the language that is going to matter and tell them how it's impacting you, how it's affecting you, and ask them for their help in resolving the situation. Because there's something going on here, whether it's that they are just avoiding conflict, whether there's an HR issue and they can't actually talk to you about it. Maybe they just don't know how to manage really well. There's a bunch of different reasons why it could be going the way that it is. We don't have enough information and can't hallucinate why that would be happening, but they're the only ones who can help you solve that problem.

Dr. Andy Roark :
I agree. The last point in this conversation up the chain that I would really emphasize is, remember speak in specifics, especially since this person came up and yelled at you. I would go in specifically reference like, “Hey, on Tuesday of last week this person came in the treatment room and yelled at me, and this is what she said. And I do not understand. I didn't know what that was a reference to, but I'm literally being yelled at.”

Stephanie Goss:
Yes.

Dr. Andy Roark :
And put that forward because that's not okay. It's not okay for someone to come in and yell at another employee in the building. That's not professional. That's not how a place with a good culture would people treat each other. And so we need to talk about that. And again, I'm not going to necessarily tattle and like, “Oh, you need to fix this.” I am going to say, “This is what happened. This is a case in point. I am not making things up about people seeming uncomfortable or talking behind my back. This altercation happened.”

Stephanie Goss:
And it is their job to provide a safe workplace. And no one should be working in a workplace where people are literally shouting at each other, or screaming at each other, or there's physical altercations, that is a hard stop. It is their job as an owner, as a manager to provide a safe work environment and that includes a psychologically safe work environment. And so that is your opportunity to very clearly give them the specifics and then ask them for help in resolving the situation. Knowing you're going to do your part, you want to get better, you want to work on things, and you're asking them openly for that feedback. But if someone comes up and just starts shouting at you, if that's what happened, you didn't do anything wrong in that situation. So there isn't anything for you to work on in that instance that is about them doing their jobs as leaders.

Dr. Andy Roark :
Sure. Well, I agree. And to put an even tighter pinch on the leaders. Let's say that he did do something wrong. Let's say that he's doing something that's really hacking people off. He's microwaving salmon for lunch or he has shoes that squeak really loudly all the time. Yelling at him is not how we handle this problem, right? The person who is frustrated has two options. They can go and talk to Rudderless and say, “Hey buddy, we need to have a talk about the break room in lunchtime.” Or they can go and if they don't feel comfortable talking to him, then they can go to management and say, “Hey, this is a problem,” and then management needs to talk to our writer, Rudderless. At no point is rolling up and shouting at another worker. That's not step three, that's not on the list of steps.

Stephanie Goss:
Right.

Dr. Andy Roark :
So anyway, that's it. That's again, if this person who's frustrated feels like they have a legitimate concern, and one of the things I really liked about this letter was the writer seemed very open to the idea that he might be doing something that's frustrating people, he just doesn't know what it is.

Stephanie Goss:
Right.

Dr. Andy Roark :
That made me like him a lot. I've said it a bunch of times. The number one most underrated leadership, communication, teamwork skill that exists is self-awareness. The most underrated. Because if you're dealing with somebody who does not have self-awareness, they are never going to get better. You know why? Because they don't know that they need to, or they don't have an accurate view of how they could get better. When somebody says, “Hey, I might be messing this up, I would like to know how so that I can fix it.”

Stephanie Goss:
Right. So I can work on it.

Dr. Andy Roark :
I generally immediately like that person and go, “You, my friend, seem to have the potential.”

Stephanie Goss:
Yes. Yes.

Dr. Andy Roark :
And again, that's an initial reaction. So putting the squeeze on the leadership, our writer is not getting clear feedback, which should not be the case, especially if there's something that's bothering him and he's asking for feedback. They're letting him down.

Stephanie Goss:
Yes.

Dr. Andy Roark :
If this other person is angry and has sent that complaint up the chain, leadership is also letting her down because her concerns are not being articulated at all in a clear way to the person who would be able to address them. And so both of those are squeezes on the leadership. And so that's my thought there. And again, I'm not passing sentence here because as you said, a lot of times with HR stuff, we can't tell people different things and I don't know, I don't know what's going on about this.

Stephanie Goss:
Right.

Dr. Andy Roark :
So that's the first conversation with me is up the chain.

Stephanie Goss:
Okay.

Dr. Andy Roark :
The second conversation is obviously going to be with the other person, and I would not do this. So we always start with timing like, “I'm not going to go talk to this person 30 seconds after they yelled at me.” But the next day I would go and say, “Hey, can we talk about yesterday?” And then when they say, “Yes,” I would say, “I don't know what I did to upset you. It was not my intention to upset you. I want to be good to work with. Can you tell me what I did or what you think or heard that I did that made you upset?” And then I would stop and listen, and that's it like, “Can you tell me what's going on?”

Stephanie Goss:
Yeah.

Dr. Andy Roark :
Yeah. I would open up with the why, which is, “I want to be good to work with and I honestly don't know what I did. And I just want to understand. Can you help me understand what did I do?” And then listen.

Stephanie Goss:
Yeah. Because hopefully they're going to jump into the conversation and you're going to get some clarity that you're not getting from your bosses, number one.

Dr. Andy Roark :
Yep. Sure.

Stephanie Goss:
And then number two, when you practice active listening there, then hopefully it opens up the path for the last part of that conversation, which has to be, how do you move forward? Because it wouldn't for me, I'll own it. And on a personal level, I do not want to work somewhere where colleagues are going to shout at me. And so it would not work for me to continue to work with this person. And so I am going to listen to them and I am going to hear them out. And it may be that I need to actually process what they're saying and I might not be able to resolve it right then and there. And I still want to figure out a way, whether it's in the moment or the next day or after I've had some time to process whatever that looks like, to come back to the conversation and talk about how are we going to move this forward and make the ask of them.
There's a few a things I could hallucinate I would want to ask for, “Hey, if you've got a problem with me, let's just talk about it. Before you're ready to full-on, be screaming at me in the treatment room, right? Let's talk about that.” But also setting the expectation. “I don't want to be screamed at. It doesn't make me feel good and I don't want to work in an environment like that.” Whatever the ask is, and it's going to be different to different people because there are some people who could be like, got full on, got screamed at rolls right off their back and could care less, and they just want to know what they did wrong so they can fix it. And you'd have other people who might be like, “Oh, I will fix the thing that I did wrong, but also don't scream at me,” right? Everybody's going to have a different response to that.
But no matter what your response is, you have to figure out a way to move it forward and ask for something different. Because being undefined and being rudderless is not, to your point, Andy, is not a sustainable place to live. And so I love that you said like, “Just shut up and listen,” and practice active listening skills and engage with what they're saying. Repeat back to them what you hear them saying, asking for clarity, asking for more detail. Tell me what that looks like. Tell me what that sounds like. Because what they tell you could go a million different ways.

Dr. Andy Roark :
Sure.

Stephanie Goss:
But practicing all those active listening skills that we employ in the exam room every single day with clients, with your colleague, and then figuring out, how are you going to move the conversation forward? What do you need to ask from them? How do you need to resolve this situation? Do you need an apology? Whatever that looks like, what is the forward motion going to be?

Dr. Andy Roark :
Yeah, I agree. I completely agree. Well, do you want to pause here for a second and take a little break, and then we'll come back and we rolled headspace and action steps together this week. But let's come back and I want to get into what this second peer-to-peer employee-to-employee conversation looks like. Sound good?

Stephanie Goss:
Okay. Yeah, sounds great. Hey friends, I want to make sure that you know about an upcoming workshop that you're not going to want to miss. And I know I say that about a lot of our workshops, but I mean it about this one. Well, I mean about all of them, let's be real. But this one holds a special place, near and dear to my heart, two reasons. One, my friend Dr. Jen Quammen is leading the workshop. Number two, it's about technology. And if you've listened to the podcast, you know what a techno nerd I am. I super excited to have Jen with us. Thanks to our friends at TeleVet. She is going to be talking on May 24th at 8:00 PM Eastern, so 5:00 PM Pacific, about trending technology in the veterinary space. Now, I love technology. We've talked about it on the podcast. We've had guests on the podcast. And one of the conversations that has been going around and around in a lot of the groups I'm in lately has been about ChatGPT or artificial intelligence, AI.
And so if you've ever wondered about using AI in your practice or if you have wondered about wearable technology for pets, communication tools and techniques that use artificial intelligence or advanced technologies, those are the things that Jen is going to dive into during this workshop. Because most of us have wondered when we've talked about those technologies, if they actually will save us any time or energy, or if they're just a new trend. So Jen is going to dive into some of the things that have come to market, some of the things that are actively being used in veterinary medicine that you might not know about, and ways that we can incorporate technology into the veterinary space in a way that works with us and not against us. So if this sounds like something that you'd love to get in on, head on over to the website at unchartedvet.com/events to find out more. We'll see you there. And now back to the podcast.

Dr. Andy Roark :
All right. So when we go into these conversations, especially if we're dealing with somebody who yelled at us yesterday. I want to go in with a good, healthy mindset for this specific conversation, right? And so the two things that I want to do is the first thing I want to do is lower the stakes, and we talk a lot about lowering the stakes.

Stephanie Goss:
Sure.

Dr. Andy Roark :
I do not want to engage this person in a cross swords battle for justice and truth. I just, “Hey, I know what you say yesterday. I want to understand what I did. I want to be good to work with. Can you talk me through where your frustration is coming from? Because I want you to enjoy working with me.”

Stephanie Goss:
Sure.

Dr. Andy Roark :
And that's it. Not, “I need you to justify what you said. I need you to prove that you're right, and I think that you're wrong, and how dare you.” No, no, no, no. It's got to be lower the stakes. “Look, I would like to understand because I want us to work well together. Can you tell me where you're coming from?” So try to lower the stakes down. Okay? Remember that sometimes people can give us good feedback, but not in the way that we like. And I've had to learn this in my career on social media and being pretty well known is I get emails that may have valid feedback, not in a kind way. It doesn't mean their point's not valid, they just did not deliver their feedback in a way that I would liked. You know what I mean?

Stephanie Goss:
Sure.

Dr. Andy Roark :
There was definitely ways they could have given me the feedback that would be much nicer, but I don't get to control how people give their feedback. It doesn't mean we're going to let people be abusive to us, of course. But it just means sometimes people will say something in a mean way, but their point is not entirely invalid. And so I'm going to try to parse out and so to say, “Okay. This person might not talk to me. They might not give me the feedback in the way that I want. But I'm going to really try to hear what is their complaint? What is their concern? What is the piece of information that I need? And I'm going to try to not let the rest of it affect me too much. I'm digging for what I need.”
The last part or the next part at least anyway, is going to be, I'm going to take it, and this is where I take it. I'm going to hear what they say. And at this point, we're going to have to get a little bit flexible. If they say things that are untrue, I'll probably say, “That didn't happen,” or, “Look, I promise you, I did not say that. I don't know where that came from, but that's not what happened.” And so I am definitely open to having those conversations. Again, I'm here to listen. That doesn't mean I won't respond, but I'm going to have to choose not to actively jump in and defend myself. I'm going to have to say, “You know what? I may not agree with what she says, but I'm going to be here to listen and where possible, I'll provide some clarity.”
And if there are some things that she's saying that are not true, I'm probably going to say, “That's not accurate.” And I'll put that forward, “I don't think that my goal today is going to be to reach a resolution in this first conversation.” And I think a lot of people really want that. They want to go and hash it out and be done. And maybe you can, but I think for a lot of times what I want to do is go in there and hear what they're saying, and then I'm going to say, “Great. Hey, I appreciate you giving the feedback. Can you tell me where you're coming from? I'm going to process this a little bit. So let me have some time with this, and then I may ask you some more questions if that's okay.” And then I'm going to end the conversation. I'm going to end it there. I'm not looking for an apology, anything like that, but I'm trying, I came here to hear and understand what the behavior was.
And then for me personally, what I'll often do is I'll go away. And now the question is when you get feedback from somebody, I fully reject the idea that all feedback is valid. I, as a public figure, I get a lot of feedback and a lot of it is dumb. And again, I'm very warmhearted and I like everybody. That doesn't mean that everyone who opens their mouth has good feedback, you should take in and internalize and follow.

Stephanie Goss:
True story.

Dr. Andy Roark :
Some people have feedback that's dumb. And so I'm not going to tell them it's dumb, but I'm not going to follow it like a religious text like, “I'm going to take it.” And sometimes in the moment things that sound dumb might have some more truth to them or they might require some follow up questions, but I am going to take it away. And the next part of me is say, “Okay. Of what feedback I received, what do I think is valid or may have some validity?” And so I'm going to sit with that a little bit. This is often a point where I call in other people, people that I work with that I like, people who know me, who work in the clinic, and I can say, “Hey, I got some feedback about this or behaving this way. Have you ever seen me do that? Or do you think that that's an accurate representation of what it's like to work around me?”
And sometimes I need that external validation of the scenery because it's hard to see ourselves. And if someone says, “Andy, when you get busy, you make these faces and you look really severe or you look really angry.” I didn't know that I did that with my face, let's just say. Stop laughing. I don't do that.

Stephanie Goss:
Let's just say.

Dr. Andy Roark :
Let's just say. I don't think I do. But if someone said that, I would go ask other people and say, “Is this true?” I don't know. I don't know what people would say, but I would ask other people who know me, “Hey, have you seen this in me? Do you think this is valid feedback based on working with me?” And again, I'm trying to keep it low stakes because I want the person to feel safe and comfortable saying, “Yeah, Andy, I've seen that a couple times.”

Stephanie Goss:
Right.

Dr. Andy Roark :
Okay. So I'm trying to figure out for myself, and sometimes I'll put other people what is valid, and then I'm going to go back and I'll probably either rehab the conversation or I'll take this feedback and I'll start to put it into practice. But that's generally what that looks like. If this person just goes off the rails and says hateful things or mean things, I'm going to hopefully screen that out as not being valid. And then those would be the things I would have a conversation with management again. I would say, “Hey, I feel like I'm being mistreated. I'm being called these names. I asked what the problem was and I got yelled at again. And so I'm really at a standstill. I don't know how to engage with this person.”

Stephanie Goss:
Right. I need help.

Dr. Andy Roark :
“I'm going to need some guidance and I'm going to need support in ending this conflict. And you take it back to management.”

Stephanie Goss:
Yeah. And I think the important piece of that process that gets skipped a lot in the clinic is the initial step of talking to each other. And sometimes there are instances where it truly might not be safe. And that's why I said if someone is threatening or intimidating or physically, verbally, which I could see an argument here where this is the case. I could totally see a case where you bypass having the conversation with the person and just talking to your boss about it. Because if you truly are not, if it's not a safe situation, that is absolutely appropriate. However, in the clinic, a lot of the time there is conflict and there is…
That it is very often that people will come and sit in my office and tell me about conflict where they have not actually had a conversation with the other person. That they're mad about something or the other person did something to them, or whatever it is, perceived real, what have you. And so for me as the manager, going back to the bosses here, normally I would say to my team, “What is your plan to do something about it?” And so I like your part about you have to at least have the conversation with them as long as it's safe to do so. And then if you're not getting help, then it's perfectly, to me, it's perfectly acceptable to say, “Okay. This is what I tried.” Now, like you said, “I'm at a standstill. I don't know what to do with this. I tried, here was my try, here's what I did, here's how I did it, and then I need your help.”
But I think that's a step that gets skipped a lot in the clinic. And it is a trick as a manager that we need to stop trying to be the hero and the conflict mediator before we ask our team to learn the communication skills. And if Undefined and Rudderless can go to their teammate and say, “Hey, look, I want to be a better team member, and I am sorry that I did something that clearly upset you because you were to the point where you were shouting at me, and I don't want you to feel like that. Can you please tell me what I did? Or tell me more about the situation so I can understand because I truly don't want to put you in that position again. I don't want you to feel like that.” Even if I was crazy hacked off, if somebody came to me and had that conversation with me, I would engage with them. I would have a rational conversation with them. And so I think definitely having that conversation with the colleague is the other piece of it for me.

Dr. Andy Roark :
Yeah. Yeah. No, I completely agree with that. So yeah, I think that's how I would take this. The worst case scenario is you come all the way back around after this and you're right back where you started. And you say, “I still don't know what I'm doing here. I feel like people don't like me or they're talking about behind my back.” I think if you've gone all the way through this exercise and you still don't know what is going on and you don't feel comfortable here, I think we've got a couple of options, right? We've got a couple of options.
The first option would be to try to say, “All right. This is not bad enough for me to leave. I'm going to stick it out for now and see what happens. I think what I would try to do possibly is find a mentor in the practice, someone who I could say, ‘Hey, I'm having these feelings. I don't feel like I'm getting along with people. Would you be willing to give me some feedback as I could go along, or look out for me, or give me any insight about where people's heads are so that I don't continue to deal with these problems?'”

Stephanie Goss:
Well, that goes back to your point that you made earlier about sometimes we get feedback and it is dumb. We shouldn't believe it all. And sometimes there's truth to it. And so I think everybody needs to find what I call their inner circle and find someone or some ones that you can truly ask and trust to tell you the truth. And candidly, you and I just had one of those conversations where you were like, “Hey, you were in this situation with me.” This is what I did and said, “Did I do anything wrong? Could I have done it differently? What do you think?” I think finding those people who you trust to give you that feedback are really, really important because we can all improve.
And if your bosses aren't going to tell you the truth and if you can't get it out of this other person, to your point, finding someone in the practice and just say, “Hey, look, I want to get better at doing my job, and in particular, I want to get better at being a better teammate. So can you help me work on it? What are some things that you think that I could work on?” And asking them to help you facilitate that is great.

Dr. Andy Roark :
Yeah. Yeah. I agree. And the last part is you look around and you say, “I don't feel comfortable here. Management is not helping me. I don't see this problem getting better. I'm not getting any coaching or guidance on what I need to do to try to address this problem for myself. I don't want to keep being here. This is not where I want to be.” Especially if you've worked to other places in the past and not had any problems like this, I would say. Well, this may be a place where they've got a bully, or a toxic person, or a cultural problem, or something like that, and management does not seem willing or able to bring this under control. So it's a positive work experience for you, then you have options.
As I said at the beginning, which is to say, “I'm going to go on and go somewhere else and give it a shot, and hopefully get some feedback or have a culture where this is not a problem.” I don't think that's wrong. I don't think it's a failure. I think it sucks if you're asking for feedback or asking how to address this issue, and nobody will tell you until you have to leave because you're unhappy. That seems awful, but fair is where pigs win ribbons.

Stephanie Goss:
Well, it goes back to what you were saying earlier too about self-awareness, right? If there really are things that you could work on and you have that self-awareness, then you can see the feedback, right? You can hear the things that are true in the mixture of things that might not be true or noise, right? And I can also sleep just fine at night with the self-awareness of knowing, “Look, I asked for the feedback. I worked on things that I thought that I could work on. I didn't get any more information out of anybody. I have no problem changing jobs. I have no problem sleeping at night,” right? That's where the self-awareness comes in and works in your favor sometimes.

Dr. Andy Roark :
Yeah. No, I agree.

Stephanie Goss:
Okay. So we weren't as far apart as I thought when you said, “I don't really think there's two things.”

Dr. Andy Roark :
But I do think it's one problem and that one problem is we are not getting feedback. We're not getting feedback from management. We're not getting feedback from our peers. This is a feedback and feedback solicitation problem. I do lay this at the feet of management based on what the information that we've got, because not all employees are equipped to give good feedback, and that is when management has to step in and say, “This person is asking for feedback. They're feeling uncomfortable. This person has feedback they want to give. I'm going to step in and facilitate this feedback.” Or if this is something where other people are having this feedback and only one of them has blown up so far, again, those things should have gone through management. They should have been made part of the personal development plan for the person who wrote to us and said, “I'm unhappy and I'm feeling like people are talking behind my back.”
Those are the things that management should have intervened and have given that person more clarity. If this is something that they're handling elsewhere, like say a toxic team member or something that needs to get snuffed out, then they need to be abs- They don't have to tell our writer what's happening.

Stephanie Goss:
Yes. But they need to be clear.

Dr. Andy Roark :
But they need to be absolutely clear that, “You are doing just fine. Your performance is excellent. This is not a problem about you.” You can't be vague and say, “Try to be more of a team player.” What does that mean?

Stephanie Goss:
No. Yeah.

Dr. Andy Roark :
You've got to either have to come with more details about what this person could do, or you need to tell them, “No, your performance is exemplary. You don't need to change anything, and this is an issue that we are addressing that is external to you. So if you can ignore it, that is the best thing while we work through it.”

Stephanie Goss:
Yeah. Well, I love that language. Oh, man. Okay. I think that's it for me. Anything else for you?

Dr. Andy Roark :
I think that's it from me too. Thanks for talking through it with me.

Stephanie Goss:
Yeah. Hopefully, Undefined and Rudderless, they still love the podcast after this.

Dr. Andy Roark :
I hope so. I hope so. I hope it's helpful.

Stephanie Goss:
I know. Take care everybody. Have a great week.

Dr. Andy Roark :
See you guys.

Stephanie Goss:
Well, gang, that's a wrap on another episode of the podcast, and as always, this was so fun to dive into the mailbag and answer this question. And I would really love to see more things like this come through the mailbag. If there is something that you would love to have us talk about on the podcast or a question that you are hoping that we might be able to help with, feel free to reach out and send us a message. You can always find the mailbag at the website, the address is unchartedvet.com/mailbag, or you can email us at podcast@unchartedvet.com. Take care everybody and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: culture, gossip, management, Technician, Vet Tech

Apr 26 2023

We Paid for EVERYTHING and Then They Resigned

Uncharted Veterinary Podcast Episode 228 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice management nerd Stephanie Goss are in the mailbag to tackle a question about what to do when you are supporting your veterinary assistants becoming technicians. A manager was asking about how to proceed after feeling like they were burned hard after paying for tech school for one of their rockstar team members, only to have that person resign and head to another clinic in their area within months of completing their licensing process. Stephanie felt this deep in her soul after experiencing something just like this in her practice so her soapbox might have even been on fire this time, just maybe not in the way you think. Let's get into this…

Uncharted Veterinary Podcast · UVP – 228 – We Paid For EVERYTHING And Then They Resigned

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


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Episode Transcript

Stephanie Goss:
Hey, friends. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. This week on the podcast, Andy and I are diving into the mailbag. We are tackling a question that came to us from a manager who was wondering what to do when you're supporting veterinary assistants becoming technicians. Now, this seems like a no-brainer. We know we have a shortage of veterinary technicians in the industry. We know that we need to train from within, and yet there's some curve balls that come with this set of questions. This one was a fun one. Let's get into it.

Speaker 2:
Now, the Uncharted Podcast.

Andy Roark:
We are back. It's me, it's Dr. Andy Roark, and the one and only Stephanie can we find love again Goss.

Stephanie Goss:
How is it going, Andy Roark?

Andy Roark:
Oh, man, it's good, I think. It's good. I don't think about the world.

Stephanie Goss:
You were in the clinic today. Did you see any cute puppies and kittens this morning?

Andy Roark:
I did. I saw a number of cute puppies and kittens. Eyes on no kittens, only puppies.

Stephanie Goss:
So you lied.

Andy Roark:
Not by choice.

Stephanie Goss:
So you lied right off the bat.

Andy Roark:
I know I did. When you said puppy and kittens I'm like, “I saw cuteness this morning,” and then as I drilled into it, I was like, “Oh, I only saw puppies this morning.” Yeah, I saw a Great Dane puppy, which always I do. They make good puppies just because they're all feet-

Stephanie Goss:
They're real cute.

Andy Roark:
Yeah, they're feet and ears. I saw a Cocker Spaniel, whose ears were perfect, and I was like, “Good. Oh, thank God.”

Stephanie Goss:
“Keep them that way.”

Andy Roark:
Yeah. So a cute little dog, but yeah, it was good. It was really good.

Stephanie Goss:
Good.

Andy Roark:
So things are. All the things that matter are good. You know what I mean? It's a good time of year. How about you?

Stephanie Goss:
Things are good. We had sunshine yesterday, and it was beautiful here. We have been having peeks of sunshine, which is fantastic. It's back to rainy and foggy today, but it is sunny and it's busy. Man, it is busy. It's that time of year where you're going different directions and the days are getting longer, which just seems like you're trying to cram more stuff into the same time period.

Andy Roark:
The sun goes down late at night and it means that I feel like the night is truncated. I'll just be hustling and hustling and also just time for bed.

Stephanie Goss:
Yes. Yesterday, it's the time of year where, especially because we're so far north, once the days start lightening up, we have daylight hours. I mean, in the summertime, it's light out here until almost 11:00 PM, but this time of year, I looked up yesterday and it was 7:15 and I was like, “Oh, my gosh.” A, it still feels like daytime, and B, I got to go because I'm late to go get my kid and I was still sitting at my desk working on some stuff. So it's that time of year, for sure.

Andy Roark:
Yeah. Well, cool. Let's dig into our mailbag a little bit. You want to?

Stephanie Goss:
Yeah. We have a great one. So it's funny because this is going to be one where I think people are going to be like, “Are they talking about me?” Full transparency, I could have written this word for word in a lot of ways at my prior practice. So I was talking to a manager and they had a technician resign, and it was not just any tech, but their rockstar. If you could clone them, you would want an entire practice worth of this person kind of tech. This tech happened to have just graduated tech school and passed their VTNE and gotten their license.
The big caveat is that the clinic paid for all of the things. So they helped pay for school, they paid for licensing, testing, all the CE, all the things. So that just finished, and it's only been a few months, and the tech submitted their resignation. So the manager was really, really frustrated and angry and bitter and all kinds of emotions for several reasons.
They were just like, “Dude, am I the A-hole for wanting to be angry and bitter and hacked off that we bent over backwards to accommodate this person? We supported them. We were their cheerleader. We helped them with schooling. We did all of these things and then they just up and left.”
Then they were also really, really frustrated because they were like, “This is a really great employee. This is a really great team member. I have a great relationship with them and I'm feeling really hurt that they didn't come to me and talk to me about it,” because the reasons for the resignation were that this tech said, “I need more money and more hours, and I've therefore accepted a leadership position with another local clinic that is going to give me both of those things.”
The manager friend was just like, “I'm super, super frustrated because I feel like I have an open door. I feel like we have a good relationship, and I can't believe that they didn't come talk to me about it.” So they were just like, “What do I do with this in the future because I'm hurt, I'm angry. I don't want to get burned twice. So do I create a contract? Do I not pay for school anymore? What do I do moving forward to avoid these things? How do I do better next time?”

Andy Roark:
Yeah. I see this a lot, and I think this is a really good one. I think this is going to be a really heavy head space episode and really light on the action steps, and you'll understand why when we get into it unless you have action steps. I think when you lay out the head space for me, unfortunately, I don't know that there's a whole lot you can actually do about this. I'll lay out why that is.
Let me just go ahead and give a trigger warning at the very beginning. What I'm going to say is going to hack some people off today. Some people are going to really love it and some they're going to really hate it, and I get it, and I won't begrudge anyone who says, “Shut your face, Andy Roark. I hate what you're saying.” I 100% understand why some people don't like what I'm going to say, but I do think this is really important and I got to call it like I see it, and this is definitely not a new issue that I've run into. All right?

Stephanie Goss:
Okay. Fair. Yup. Got it. Okay. Warning accepted.

Andy Roark:
Warning accepted. Now, the first piece of controversy that some people might get upset about, which is not what I was referring to, but the first thing that might hack people off that I'm going to say is right here at the beginning. I want to pause this show for one second and step up onto a soapbox that I promise it's related to. I'm going to step up on the soapbox.
Number one, we talk a lot about the virtues of our employees and our staff, and we talk about how great they are, and we should talk about how great they are, and we should beat that drum, and we should make our employees feel appreciated and things like that. However, praise and appreciation and celebration often go down the chain way more often than they go up the chain, which means a lot of owners, a lot of managers, a lot of bosses celebrate their staff like they should.
It's much less common to see celebration of bosses. You know what I mean? Appreciation should go down the chain, and so that's not it, but as the owner of a small business, I just want to say for one second, it's hard. It is really, really hard to be the person who invests into other people and puts a smile on your face and trains and grows and cheerleads and celebrates and supports and pays the bill, picks up the tab. You know what I mean?
Ultimately, just think about what would happen if the payroll came out of your own personal checking account. That's the reality for a lot of business owners. Just think about that and that pressure and that stress and trying to keep the lights on. I think a lot of small business owners quietly carry that weight on their shoulders. It's a heavy weight.
So when you have something like this where you say, “We invested in this person and we did this training and we did these things, and that person left,” I think it's important to empathize with that practice owner upfront and say, “I understand how somebody would feel this and feel this really deeply.”
So I see a lot of times these conversations go immediately into what are the workers' rights and what should the business have done and blah, blah, blah. I just want to pause for a second and just empathize with the emotions of someone who is the owner or even the manager who said, “We made these sacrifices and we reallocated these resources and we did these things and it didn't work out. I'm hurt by that. You know what I mean? Yeah, I'm hurt by that.”
I think that's a very human thing, and I don't think you can have a meaningful conversation if you don't allow the owners or the managers to be human beings for a moment. So I think that's where I would start from a head space standpoint and say, “You know what?” and we're going to do that for our employee too. Don't think I'm going to villainize the technician that left and be like, “How dare that person? She owes her soul to this practice who paid for her education.” That's not true either. She's a human being and she's got needs and everybody's trying to do their best, but I want empathy to go both ways as we start to talk about this.

Stephanie Goss:
Yeah, for sure. My response immediately was, “No, you are not the asshole.” The reality is, look, the thing is, to your point about being human, humans experience a wide range of emotions, and emotions are not good or bad, they just are, right? It's how we're processing what is happening to us, what we're thinking, all of those things. So you have every right to feel disappointed, angry, hurt, whatever the emotion is that you're feeling like. There is nothing wrong with that. Feel it. Embrace the suck, wallow in it even for a day or two.
For me, that's the giving yourself space to be human, right? You can't stay in that place as a leader because staying in that place is how we find ourselves heading down the road of being the slippery slope that leads to toxicity, right? So I totally empathize with them and feel them. Like I said, this was literally me and I was real, real mad.
I went home that day and I was really happy for my team member. There were the conflicting emotions because like you said, Andy, I'm not going to villainize them. I'm not going to begrudge them. I understood on a human-to-human level why they were making the decision, and I still felt like crap and I went home and cried because I was sad. I was sad to lose this person that I genuinely liked. I was also angry that I had put time and energy into it. I was frustrated that I was going to have to start hiring again. All of those emotions are valid and real. So I agree with you. I think it has to start with, “That's okay,” and, “No, you're not the jerk for wanting to feel those things and even wallowing it for a little bit,” but the difference for me is how you choose to move on from there.

Andy Roark:
Yeah. I agree with that. Whenever we have conversations like this, there's a cartoon I always bring up. It's one of my favorites. It's these two veterinarians and they're arguing and one says, “What if we train these people and then they leave?” The other one says, “What if we don't train them and they stay?” I love that cartoon because that sums up so much of this.
We have a choice about, do you grow people and develop them or do you not? If you don't develop them, then you have to work with people who are not developed. If you do grow and develop them, there's a chance that their interests might take them away from your practice or opportunities will become open to them that have not existed in the past that they might decide they need to pursue. That's just the reality of the choice that we make. There's no escaping from that choice, I don't believe. So I just think that that's important to lay down.

Stephanie Goss:
I think that about the cartoon and about which choice do we make, and we think about our team members, you made the point of you want to work with someone who is developed, right? You don't want to work with undeveloped people. So here's the thing. I could do nothing for my team members and life could still happen, and they could get a job opportunity elsewhere. They could have a partner who needs to move. There's a million other reasons besides talent that would take someone away from my practice.
So if as a leader we allow ourselves, that's what I mean about the wallowing, if we allow ourselves to stay in that place of fear and anxiety and emotions that are in that vein when it comes to our team, we will never go anywhere because the reality is life is always going to happen, and whether we engage with and support and encourage and grow our people from within.
So for me, that's a big part of the head space piece is that philosophical stand that you have to take as a practice owner, as a practice manager on, do you want to work with people that you were trying to grow and develop and better or do you want to just take people wherever they're at and leave them where they're at until they leave your employee? It seems so simple, but it's also not.

Andy Roark:
Yeah. Oh, it is totally not. So the second thing I wanted to put down, which is very related to that, is it is this idea of impermanence. You said, it's frustrating this person went to another vet clinic. What if she had, this is terrible, what if she'd gotten hit by a bus? What if her spouse had moved to another town with his job and she went with him? There's a million reasons that people leave a job or what if they get injured, they're unable to do the job? There's a million things that can happen to someone that makes this not go the way that you imagined it going.
I think that part of it is holding onto that idea of impermanence just like, “I don't know. I want to support this person in their education, but who knows what's going to happen tomorrow or next year?” I think where we get in trouble is trying to convince ourselves that we have a lot of control and that this is permanent. So that's where I get into this idea with teams.
I think that this is a huge trap and a huge pain point for people who are leading teams. I have been very guilty of this. This is one of the most painful lessons in my career is I really love the people I work with and I love the people who work for me, and I care a lot about them. I've always had this idea that I would build this wonderful culture with these great people, and we would all live together for 30 years, and we would all retire on the same day. You know what I'm talking about?

Stephanie Goss:
Yes.

Andy Roark:
It's like a sitcom like Friends. We would all be there hanging out, having fun for 12 years, and then we would all be like, “All right. It's been a great career.” There would be an ending montage for each one of us going off into the sunset, and that would be it, and we will have come together and all been there for each other the whole time, and then we'll all go off our own ways, all with the same decision to do so so that no one's unhappy, but we all decide that this is where our clinic ends-

Stephanie Goss:
Together.

Andy Roark:
… and we leave together, and a new group of veterinary professionals moves in and starts the season, the next season of the sitcom. It's just new cast, and they all start over. That's this beautiful stupid idea that I have had forever. So the pain of Andy Roark is seeing my team torn apart every three years. That is what I have lived with in my life is I will get people and they will be wonderful, and then the world will change or they will change or their needs will change or what our company is doing changes, and that team gets pulled apart or it grows and new people join, and suddenly the dynamics change and the friendships shift around, and the time that we spend with certain people shifts around and it's just not what it was anymore.
I know I'm not the only one who has this experience. Think about your friends in high school and you had this friend group. Then think about your friends in college and this different friend group. Then think about when you had your first job, and then when you moved and you got a new friend group. Your whole inner circle has been torn apart and reassembled multiple different times.
That's life and that is what life is and what it's supposed to be, but gosh, we lied to ourselves. We just keep telling ourselves, “Nope, we're going to get it right, and we're going to get that friend group, and then we're all going to be the golden girls in 60 years,” like, “60 years from now, that clinic will be the golden girls. We'll be really, really old people who've been together forever.” It's not how the world works for the vast, vast majority of us.
So I think internalizing that is important and saying don't be afraid of impermanence. So if you buy into what I'm saying and you say, “Okay, Andy. I get it. As much as I want to believe I'll bring these people in and grow them and we'll bond and they will just stay here for the rest of their career, that's probably not going to happen. Well, what the heck is the point then, Andy?”
My answer to it is, I think the most zen way to look at this is to try to get yourself into a head space where you have people who come through your doors and they join your team and they have a good job and they enjoy the work and they grow as people and as caregivers and as colleagues. Then ultimately, they almost certainly move on to do something else, but you've hired new people who have come in and they're going to grow and they're going to develop. If you're lucky, you get them staggered out enough so that somebody wonderful is leaving and that opens up a hole for somebody else to grow.
Don't feel bad if you look around and you have someone who leaves, your A-plus rockstar tech, and you're like, “I don't know who's going to step into this hole.” It happens, and it might not happen the way that you think. There's this saying. The cemeteries of London are full of indispensable men. The idea, it shouldn't be gendered, but the old saying is, but the idea being, we all want to look around and say, “Boy, we've got this person. We couldn't do it without her.” Yeah, you could. You could and you would. The world would turn and you would figure it out and people would flex and shift and step up in ways you didn't expect and know that person would not be replaced, but the team itself would change and that place would get taken.
So it's just amazing where two other people would expand and cover that job, and then you would hire someone and they would not replace the person who left, but they would take workload off of the people who shifted over, and now you're like, “This team functions entirely differently.” That's normal. That's how it's supposed to happen. So those are my big things is, what if we train these people and they leave? What if we don't and they stay? Then the idea of impermanence of your team is … Our whole lives are spent trying to … We're all on a river, we're on a stream and we're all trying to gather a raft around us that is stable, that we can rely on, that just is going to take us down this raft in as much comfort as possible. Then our raft gets torn apart every two years, and then we spend two more years trying to rebuild a new raft.

Stephanie Goss:
Put it back together.

Andy Roark:
Then we do, and then it all gets torn apart again, and that's the human experience. So it is just part of it, and it's just built into having the team. So I wrote an article a year or so ago that I really liked, but it was in a response to a question basically identical to this, and I thought, “What if we could get into this place where our goal was to bring people in, give them a great place to work, grow them, run a good healthy business while we did it, and then when they left, we celebrated them and said, ‘Thank you for being here. Good luck to you on your adventures. I'm glad we were part of your growth.'”
I know doctors who have that experience. I know doctors who are just proud of the people who come up and they go on. You see it a lot in people who come in as assistants and they work and they work, and at some point they go to tech school and then they decide they want to be a tech somewhere else or in another city or an emergency clinic or they come up and then they go to vet school and they become a veterinarian and they go live in another state. Then that doctor will see that young veterinarian or that young vet tech, and there's no awkwardness about, “Oh, why didn't you come back to our clinic?” but it was rather, “I'm so proud of you.” Isn't that beautiful?

Stephanie Goss:
Yeah, it really is, and that is one lesson that I learned on a personal level, and by watching my former bosses, that was my experience at my first practice. I was growing and we hit that place where I wanted to do more things and I was ready for more things and the clinic wasn't really ready, and they could have been. I was doing a lot in the clinic at that point in time and they could have chosen to be negative or to be sad or disappointed about me leaving. Instead, they looked at me and they said, “We're really excited for you. We wish you the best of luck.”
I remember I moved towns. I was still living where I was, but I was commuting about 35 minutes then for my new position. I remember running into them at our state VMA conference. It was a few years later, and it was so good to see them, and they gave me giant hugs and they were just like, “Tell us how everything's been going. We're super excited to hear how it's been going.”
I carried that with me, that feeling of it didn't feel awkward, I felt supported, I felt encouraged, I felt believed in. I've carried all of those feelings forward with me as a manager and felt really lucky that I had that example set for me because that's how I want to make my team feel.
That's what I mean about, and this starts my action step section, honestly, is the philosophical conversation as a practice owner in particular, but as a practice manager, if you're working with an owner or medical director, sit down and have that philosophical conversation about the impermanence and the truth that we are working in an industry with a massive shortage of qualified personnel.
The reality is if we all sit around and wait for a certified veterinary technician to drop out of the sky at all of our practices to solve all of our problems, there's going to be a whole hell of a lot of us sitting there waiting forever, right? So I think we have to have that philosophical conversation about, what does growing people from within look like? It really has to start with getting on the same page about the impermanence of it because no matter what you decide to do, whether you have just a homegrown on-the-job training program or whether you're going down the road like this clinic did, where you're paying for structured school and you're supporting them in different ways, So that philosophical conversation about impermanence I think is the first place to actually start.

Andy Roark:
Yeah, I agree with that.

Stephanie Goss:
Hey, friends. I want to make sure that you know about an upcoming workshop that you're not going to want to miss. I know I say that about a lot of our workshops, but I mean it about this one. Well, I mean about all of them, let's be real, but this one holds a special place dear and dear to my heart. Two reasons. One, my friend Dr. Jen Quammen is leading the workshop. Number two, it's about technology. If you've listened to the podcast, what a techno nerd I am. I super excited to have Jen with us. Thanks to our friends TeleVet. She is going to be talking on May 24th at 8:00 PM Eastern, so 5:00 PM Pacific, about trending technology in the veterinary space.
Now, I love technology. We've talked about it on the podcast. We've had guests on the podcast. One of the conversations that has been going around and around in a lot of the groups I'm in lately has been about ChatGPT or artificial intelligence, AI. So if you've ever wondered about using AI in your practice or if you have wondered about wearable technology for pets, communication tools and techniques that use artificial intelligence or advanced technologies, those are the kind of things that Jen is going to dive into during this workshop because most of us have wondered when we've talked about those technologies if they actually will save us any time or energy or if they're just a new trend.
So Jen is going to dive into some of the things that have come to market, some of the things that are actively being used in veterinary medicine that you might not know about, and ways that we can incorporate technology into the veterinary space in a way that works with us and not against us. So if this sounds like something that you'd love to get in on, head on over to the website at unchartedvet.com/events to find out more. We'll see you there, and now, back to the podcast.

Andy Roark:
I think the second part for me in where you go is this, and this is another lesson hard learned. When I was a young business consultant, so I was practicing as a doctor and I've been doing more consulting and media and things on the vet side and for big vet companies. So I was doing some of that work early on, and I've been in practice for three years as a doctor. I was doing that and I was balancing it. I had this idea that if I worked with these companies and I really went above and beyond and I really did all that I could to help them, especially as they were getting up and getting going or getting projects started, that when the projects worked out, then they would remember or recognize the extra work that I had put in and how much I had tried, and that would come back to me and I would get more opportunities or I would at least be celebrated for, “Oh, man, Andy, you really pushed this and you did these extra things and you opened these doors.”

Stephanie Goss:
“Thanks for making this happen.”

Andy Roark:
“Thanks for making this happen,” and I really went after it and just didn't really set personal boundaries for myself because I was like, “No, they're going to be so happy when this is done. They're going to be so happy when this turns out.” What I found is that it usually didn't happen. It almost never happened. I don't think those people were being jerks. I think people are just innately self-centered and they have short memories. You know what I mean? It is a what have you done for me lately thing because that's what people remember.
So I remember being resentful early in my career because I felt like I had thrown in and did these kind things because I thought they would come back to me. Through lessons like that, I came to believe that you should not do kind things because you would want them to come back to you or you expect that they're going to come back to you. You should do kind things because you want to do kind things. Then if everyone forgets that you did the kind thing, you still feel fine with it because you wanted to do it right and-

Stephanie Goss:
Right, yeah, you were doing it.

Andy Roark:
… it was not about, “Am I going to get recognized later on? Is this going to come back to me? Am I going to benefit in the future?” I learned that lesson painfully, but it stuck with me and I still believe it, and I still do it a lot. I feel like one of the big headaches that I see a lot of leaders struggle with is appreciation programs where they're like, “We did this appreciation program and nobody cared. Nobody said thank you to us.” You know what? That's really crappy, and I totally understand, and just in this instance, the person who does that and says, “I took a whole day and decorated everybody's lockers, and I hired a masseuse to come in, and no one even said thank you.” Ouch, ouch, ouch, ouch. I fully understand why that would hurt.
At the same time, the healthiest place you can be is to say, “I decorated their lockers because I wanted to, because I knew I wanted to brighten this place up. It would make me happy to do it and I thought it would bring some joy into their day, and if they don't say thank you, I still did it because I wanted to do it, and I got the masseuse because I wanted to say thank you to them not because I wanted them to say thank you to me. So I just do it.”
So I really do think that that's important in how we look at just giving to other people. It's so much healthier to say, “I'm going to give, I'm going to make this sacrifice because I think it's the right thing to do and I want to do it and not necessarily because I want something in return.” So I think that that's a big part of head space.

Stephanie Goss:
Was that this is probably going to make hack people off? Was that your second?

Andy Roark:
We're coming into it. That was the first step down the path towards we're going to hack people off.

Stephanie Goss:
Okay. Just checking.

Andy Roark:
All right. Tell me when you're ready for the second step.

Stephanie Goss:
Let's go for it.

Andy Roark:
All right. So if you buy into that, the next question that people will always put to me is to say, “But Andy, this is an investment, right? This is an investment. I'm going to pay for this school and then I need to get return on my investment, and shouldn't I have them sign a contract that says that they're going to stay after they're done with this?” You're shaking your head. We both know people who do this in their practices and they're very successful practices, and they would argue with me in a heartbeat about this. I don't care because they don't have a podcast and I do. So just deal with it. I'm the one with the microphone, so here it goes.
I think the answer here is you should have clear expectations and ongoing transparency about how everybody is doing. I think that that is where I think this employee dropped the ball. I think this is where I'm going to criticize the staff member that left. I know that's where I'm going to criticize this person, but I think you have clear expectations and you talk about what you're doing and why you're doing it and what the expectations are, and I think you have those conversations.
I don't know that you want to have someone in your clinic who does not want to be there, but they have a contract that says that they're not allowed to leave. I don't know that you want that. I think the cost of culture are too high. Full stop.

Stephanie Goss:
Yes, I'm on board with you. It's very much our pick your poison, right?

Andy Roark:
Yup. It is.

Stephanie Goss:
To me, people who stay and are miserable because they are too afraid to break a contract, can't afford to break a contract, can't afford to stay working the hours or whatever the reasoning is, there's a million different reasons, that you have that choice where you keep them, and then to your point, I agree with you 100%. Full stop, there's a huge cost to culture with that or you accept the fact that you are going to pay for some things for some people who will leave, and you have to make that choice about the poison that you want to consume and that you want your team to consume, and I am in full agreement with you.
It's funny because I was not always. I was the manager for a lot of years where myself included, when my hospital paid for school and I worked in exchange for going to school, and it was normal. So it was normal for me when I was a team member, and so it became normal for me when I was a manager, and I was like, “Well, of course, if I'm making this big investment and I'm essentially on behalf of the practice acting as a bank and lending you this money to pay for school that I'm going to expect that it gets paid back, either actually paid back in cash or paid back in time served.” It sounds-

Andy Roark:
That's how you thought about your clinic was time served. I heard that.

Stephanie Goss:
Right, but it's an awful frame of mind. When I step back-

Andy Roark:
They're going to have to break a lot of rocks.

Stephanie Goss:
Yes. When I step back, I have to look at a lot of freaking fecals under the microscope to pay that back. I'm on poop duty for two years, man, but I feel this way about a lot of things now that were standard and normal when I started in veterinary medicine, and maybe I'm just old now, but I have learned new tricks. For me, the value of having good people who know that I care about them, who enjoy their job, who want to show up and give it their all and who want to work together with the team, I want that over having a body in a position because they feel a debt that they have to repay.

Andy Roark:
Well, because not even that they feel it, that it's written down and contractually they're not able to leave. When you think it all the way through and you say, “Oh, boy, do I want to have somebody who has a contract and they can't leave even though they want to?” most of us go, “No, that's not what we want.” I do think we need to have clear expectations upfront and just say, “Hey, this is a lot of money and this is a big deal and I really want you to be here. What's it going to take to do that? Let's make sure we continue to talk.”
Is there a chance that you're going to get taken advantage of? The answer is yes. This is, again, where people disagree with me sometimes, and maybe I'm hopelessly optimistic or my faith in people is too high. I don't think you close your heart. You don't think you close goodwill just because someone somewhere is going to take advantage and they will.
It's funny, this is the difference in politics is I know people who are like, “We should have so many government programs and they should all be great.” I know other people who are like, “We should have no government programs because people will take advantage.” The truth is you should have smart government programs and know that some people somewhere are going to take advantage, but the greater good overall is served, and that's it. I think that that's the healthy way to run the business is to balance between not offering programs to support people and just having programs all over the place with no metrics and no thought about what we're trying to do and, “Does this make sense?”
The path is the middle. If you work with human beings, you're going get screwed over at some point, and there's going to be somebody who's going to take advantage of the system. There is. This has to be the long game. It has to be part of your philosophy to say, “This is what we want to try to offer to our people.” Some of them are going to stay and some of them are not, but ultimately over time, you're going to end up building a great culture and you're going to build people who are loyal to be there.
I think it's important to also say, you see the emphasis that I'm putting on building loyalty with people after it's over. I really do think you have to do that because if you buy into what I'm saying, there's a lot of people out there who are like, “We're going to pay for you to get this degree and then we are not going to compensate you for having that degree because we just paid for the thing. So you're going to keep working at this lower rate because we picked up the tab for your education.”

Stephanie Goss:
“We just paid for it.”

Andy Roark:
That goes back to what I said before about people unfortunately have short memories and tend up being actually self-interested, which means it's only a matter of time until that person who's now got a degree starts to look around and somebody else goes, “Why are you there, man? You make $5 an hour or more.”

Stephanie Goss:
“I'll pay you more.”

Andy Roark:
They go, “Oh, that seems fair,” and they go. If you try to stop them from going, now you've got a resentful person under contract and that's not what you want. So it really is, it's just hard. This is the situation that we end up in. So anyway, all that to come around and say, I don't have a whole lot of criticism for what this manager did, and I think that they are 100% entitled to their feelings.
There is one thing that I would call bullshit on and say this is not okay, and it goes into a lot of how we teach negotiation up the chain when we talk to people who are working inside of practices. I do agree with this manager that the person not coming to the manager and saying, “Hey, I've been offered this other thing. I'm seeing other opportunities to earn more of a living, and I live paycheck to paycheck and this is a significant deal for me.” I do not think that you can get frustrated at this person for leaving for a job where they got paid more money.
I do, however, think that you can feel betrayed or you can feel like you were not treated fairly by this person not communicating to you that they were thinking about leaving or that they had opportunities or giving you the opportunity to try to retain them. You don't have to stay where you are, but if it really is just about the money, it goes back to what we always say, “What is kind?” Is it kind to just take another job and say, “Hey, I have to go because I've got more money”? It's kind to you and it's kind to your family and it is important, but then the kindest thing overall is to say, “Hey, I've gotten this job and it's what my family needs and I need to do this, but I like working here. I appreciate all that you've done for me. I wanted to ask if you thought there was any chance that you guys could match this so that I could get this thing that my family needs and that I need and that's available to me and still stay on.”
If the practice says, “I'm sorry, we can't pay you that,” then everybody should be sad, but no one should be angry or resentful. I do understand the anger and the resentment in this issue because they didn't feel like they were given a chance.

Stephanie Goss:
I think that's spot on. I think I don't know, and we don't want to assume in this situation, but when we said, “Okay. We don't have very many action steps,” there were two that were really closely tied together for me, and that was as a manager, I agree with you, I can totally understand all of those feelings, feeling frustrated, angry, hurt like, “I thought I had an open door and I'm shocked that they didn't come talk to me.” That is a crappy, crappy feeling. Sometimes you can have that and you can have a great relationship with your team, and sometimes it doesn't matter.
I've been in the same position where someone I thought who would've come and talked to me didn't, and when time went by and we were actually safe to have the conversation, I had a followup conversation with that person and they were just like, “I was really afraid. I was really afraid of what you would say, and so I just chickened out. I could have come to talk to you.” I couldn't have done anything more as a manager to control that, and that made me feel better just getting to that head space of sometimes you can't control what other people are going to do, and sometimes you can do all of the things right and it still works out that way.
So I think give yourself a little bit of grace, especially if you are one of those managers that is sitting down and having active conversations, and from a action set perspective, if you are a leader in your practice and you're not having regular one-on-one conversations with your team, and there's two pieces of it that are pertinent, I think, to this situation that are really important. I would say start having one-on-one conversations, and one of them is developmentally.
If you're not asking your people, “What do you want to be when you grow up?” in some way, shape or form on a regular basis and asking, “Where do they want to go? Do they want to become a licensed technician? Do they want to become a lead tech?” and that was part of this here is that this technician was like, “Hey, I'm taking a role as a lead.” Well, did you know that they wanted to be a leader? Did you know that they wanted more hours? Did you know that they needed more money? They may not have told you, but we've got to have the conversations that would lead to unearthing that information or them volunteering that information. So developmentally, where do they want to go in their career, who do they want to be when they grow up.
The other piece of it, and this is a curve ball, and a lot of managers stray away from it because we're afraid of conflict in veterinary medicine, and we're also afraid to talk about money because it's really personal, but one of the things that we need to be asking our team on a semi-regular basis is the question, “If you were offered a job somewhere else for more money, would you entertain it?” because we need to know what do our people need, right? We still may not be able to change the outcome, but we should have that knowledge and should be having conversations about money and about what we're paying our people and knowing what our pay skills are, and the way that we get to doing that hard work is by asking the questions.
So from an action step perspective, the only thing that I could really think about is if you're out there and you're like, “Ooh, this has happened to me,” and you're a manager who's not sitting down and having those one-on-one conversations with your team, I think that having those conversations and asking them the questions about where do they want to go financially in their career and where do they want to go developmentally in their career are both really, really important action steps.

Andy Roark:
Yeah, I do agree with that. I had an employee recently that I had coffee with, and I had heard at the grapevine this person wasn't really happy and that they weren't feeling included in a number of things that were going on. So I said, “Let's get coffee,” and we went out. I sat down with the person and I talked to her and I said, “You're amazing, and I want you to be here, and I really love working with you. I love your work. It bothers me that I heard from someone else that you were feeling excluded or you weren't being able to do things that you wanted to do. I wish that you had told me. I want you to reach out to me and tell me these things. I want to know.”
She said, “Well, I assumed that you were so busy. I didn't want to bring this up because I knew how much you had on your plate and I knew that you were busy. I knew you were working.”
I said, “Well, I saw you working independently and doing great and so I thought, ‘She doesn't need to be bothered, and she's busy, and I don't need pull her into a one-on-one when she's crushing it.'”
So she was like, “Well, I assumed you weren't pulling me in for these things because you didn't want me there.”
I was like, “No, I wasn't pulling in because I thought you were really busy, and I thought that you would tell me if you wanted to be a part of this.”
She was like, “Well, I didn't tell you I want to be a part of it because I thought you were really busy and you had other things.”
I was like, “Okay. Let's go ahead and let's fix this.”

Stephanie Goss:
This sounds familiar.

Andy Roark:
Yeah, “Let's fix this.” Then it was a fairly darn easy fix because I want her to be happy, and she knew what she was interested in, and I was like, “Okay,” but I didn't know and she didn't want to tell me because she made assumptions about me or the awkwardness of the conversation, and I made assumptions about her. I just say all that in that you can have wonderful people who are doing great and thriving, and we can make assumptions about our need to engage with them with the thought that they're going to come and let us know if they need something, but they make the exact same assumptions that we do about it being awkward or not being the right time or us not having time.
So somebody's got to go first. So really, that was an eyeopener for me about making sure I'm checking in with my high performers. There's a lot of people who make time to circle up to the people who bring a lot of drama, you know what I mean, or who are very vocal about their feelings, and we'll often let our quiet high performers just go, and there's a real risk to that. I was reminded of that soon, more recently.

Stephanie Goss:
Yeah. I would agree with that 100%. I think it's just human nature. We believe in them. This manager was like, “I would clone this person. This is my rockstar.” So you think, “All right, out of the fires that are …” especially as a manager like, “Look, dude, our job is dealing with the fact that everything in the clinic every day is on fire for a lot of us.” So you're staring at all of the fires in front of you and you're like, “Oh, look, she's not on fire. So I'm going to look at all of this stuff over here.” I think it's just that lesson of that still doesn't mean that we don't need to nurture and take tender care of those relationships. So I think that would be from an action step perspective is really carving out that time because I've had team members say that to me, “You're so busy. I just don't want to put one more thing on your plate.”
I'm like, “No, this is the thing that I need on my plate. I need to make this time. You are important. I need you to feel supported and heard, and so let's do this thing.” I think if you are a manager who has had those conversations or is having those conversations with your team, for me, that was the warning sign or the wake up call of like, “Oh, hey, look, I need to carve out time for these people and be able to sit down with my team where they have my full attention and they're not having to ask for it.” So I think that's what I want is create that space to do it and make it a natural part of your process and make everybody feel heard, but I think you're spot on. We can't leave the high performers out of that.

Andy Roark:
Sure. Well, there is a rockstar problem that a lot of places have where I see a lot of practices that are set up around having a rockstar, and then everybody else is a backup singer and the clinic is fine with that. The risk to that is, first of all, rockstars are the people who are most likely to get opportunities to go other places. If you have a little band and you have one rockstar, the specialty hospital down the road who can pay more money than you, they're going to want to meet that person. Those are the people who might get opportunities with industry because the pharma reps come in and they see this person, they go, “Wow, she's really charismatic. She's super smart. She learns fast. She does all these things.” They're going to get offered other opportunities because they're a high performer.
If you are not growing other rockstars for if and when this person leaves for another adventure, I think that you are being shortsighted. I think it falls into that impermanence thing we talked about before where they're like, “Oh, no, we've got somebody who kicks butt. We're just going to let her keep kicking butt and everybody else can just help her,” and I'm like, “She might not walk in the door tomorrow for a variety of reasons, and you missed the chance to use her to bring up and mentor other people, you know what I mean, to spread the wealth around so you have a more uniformly strong team that's more resilient.” If your team depends on an individual, that's not a resilient team. That's a team that can get decimated in its capacity for work output really fast.

Stephanie Goss:
Oh, man, this one was fun.

Andy Roark:
Oh, man. Yeah. This is one of the hard ones where I think this is almost entirely a head space thing. I don't know really what you do about it. Like I said, I wish the employee had said something, but I think we have to own the fact that oftentimes they're not going to, and you can't make people. The other thing too, and I don't know anything about this, but there is a chance sometimes the people say, “Well, I took this other job and I didn't talk to you because I was embarrassed,” or blah, blah, blah. The truth is they were unhappy in their job and they didn't want to stay here, and so they were going to leave. You'll never know that. Don't eat yourself about that. You don't know.
I think we laid down a lot of the key ideas is you got to get yourself in a healthy head space as far as we are dedicated to growing these people. We know that teams are impermanent and they're going to turnover. They just are. We're going to do training and learning and development because we want to do it, not because we are investing for an outcome down the road. You might get a great outcome down the road, but that's not why you should do it. It's a real risk if you are. The last thing is good open door conversation. Check in with your people. Try to make sure that they're doing okay. Stay engaged, all of those sorts of things.

Stephanie Goss:
Yeah. I love it. Have a fantastic week, everybody.

Andy Roark:
Yeah, everybody, take care of yourselves.

Stephanie Goss:
Bye, guys.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: culture, management, Practice ownership, Technician, Training, Vet Tech

Apr 14 2023

Why are the Client Money Conversations SO Hard for the Team?

This week on the podcast…

This week on the Uncharted Podcast, Stephanie Goss is flying without Andy but she invited a friend to join in a very special conversation. Certified Veterinary Practice Manager Debbie Boone joins Stephanie to talk through something that strikes fear into the heart of a lot of veterinary teams – money conversations. Specifically, the anxiety that teams feel about “sales” in veterinary medicine and the difficult money conversations we find ourselves facing. Thanks to our friends at CareCredit, a Synchrony solution, Debbie and Stephanie are wading into the idea of shifting our mindset from “financial policies” to “providing financial care” for our clients as part of the greater client care we provide every day! Let's get into this…

Uncharted Veterinary Podcast · UVP – 227 – Why Are The Client Money Conversations SO Hard For The Team?

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 sponsor, CareCredit, a Synchrony solution.

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RESOURCES

For Financial Ideas to Help Pet Owners – https://debbieboonecvpm.com/help-for-pet-owners/

For more information on offering Care Credit in your practice: www.carecredit.com/vetinsights

This content is subject to change without notice and offered for informational use only. You are urged to consult with your individual business, financial, legal, tax and/or other advisors with respect to any information presented. Synchrony and any of its affiliates, including CareCredit, (collectively, “Synchrony”) makes no representations or warranties regarding this content and accept no liability for any loss or harm arising from the use of the information provided. All statements and opinions in the Uncharted podcast are the sole opinions of the speaker. Your receipt of this material constitutes your acceptance of these terms and conditions.


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!

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RESOURCES

For Financial Ideas to Help Pet Owners – https://debbieboonecvpm.com/help-for-pet-owners/

For more information on offering Care Credit in your practice: www.carecredit.com/vetinsights

Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Stephanie Goss:

Hey everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. Well, this week I am on my own, Andy is on a break, but I am not truly alone because I have a wonderful guest with me. This week. I have been wanting to do a podcast with my friend Debbie Boone for quite some time. And an opportunity arose thanks to our friends at CareCredit. They came to Andy and I with an idea for a podcast about practice finances and about the idea that money conversations with the team are so hard some of the time. The team hates talking about money generally, there's also almost always somebody on the team who gets anxiety when it comes to the idea of being salespeople in the room. And when I thought about who I could jump into and nerd out on this topic with, Debbie immediately came to my mind.

If you don't know Debbie, you are in for a treat. She is a CVPM, so certified veterinary practice manager. She is a practice manager with years of experience in the industry over 30 years, and she is now a industry consultant. She works with practices. And what I love about Debbie's style as a consultant is that, she really wants to work with practices to teach and coach them to learn about smart business practices so that they can do it on their own. Her goal is to set them up for success and then let them fly. And I just love that philosophy. She brings it to how she speaks, she is an industry speaker and how she works with her practices individually and also how she educates. Debbie taught curriculum for Patterson U for a long time, and so she has got a lot of knowledge to bring to this table and the conversation today. And I am super excited to share this one.

This week's episode is brought to us ad free by our friends at CareCredit, and this is a fun conversation. So let's get into it, shall we?

And now the Uncharted Podcast.

And we're back. I am Stephanie Goss and I'm here this week, not with Andy Roark, but with my friend the amazing and wonderful CVPM, Debbie Boone. Now Debbie is a practice manager. We have known each other a long time. She is like me not practicing these days, right Debbie? But tell us a little bit about yourself. Welcome to the podcast.

Debbie Boone:

Yeah, thanks for having me, Steph. Every time Steph and I see each other, it's like, oh boy, big hug. But we only see each other at conferences, so.

Stephanie Goss:

Debbie gives the best hugs. I look forward to it. Every time we see each other.

Debbie Boone:

We preplan it so we can find each other, so we can do things.

Stephanie Goss:

It's true. It's true.

Debbie Boone:

Oh, man. But as Stephanie said, I am a CVPM and I managed hospitals for 23 years before starting my own private consulting business. And I focus a lot on communication, client service, culture building, leadership skills for veterinary teams. And for years I wrote a column called Culture Coach for Vet Team Brief, a magazine I still love and miss. And then I've done a lot of writing and currently thank you to CareCredit's support. I am writing a book called Hospitality and Healthcare that I will be signing at AVMA about how to-

Stephanie Goss:

So excited.

Debbie Boone:

I'm pretty pumped about it. I've got 30,000 words written and a St. Patrick's Day deadline, so I've got to keep pushing the gas on that.

Stephanie Goss:

Oh man, I am so excited for that and for you, and it's funny because we were working on the plans for this podcast and I was talking to our friends at CareCredit and the team over there. And we were talking about financial care versus financial policies is what we're going to talk about today. And we were talking about who would be a good person to have the conversation with? And you were immediately on my mind, A, because you are fun and I've been looking for a reason for you and I to do a podcast together for a while. But also B, you what I love about your style, your consulting style, but also just your presence in our field and the way that you interact with other managers, is that it's always been focused on the customer care aspect.

And that's what I love and what I'm excited about today is podcast is it's important for us to have financial policies, but really one of the things that I love to do as a manager and that I love that CareCredit helps us promote as an industry is how do we think about it from a financial care perspective, from a wellness perspective so that it's more well-rounded and it's not just, oh, hey, we're having an emergency and now we need to have the money conversation. But we're thinking about it from the very beginning. And so when we started talking about it, I was like, I think this would be a great one to do with Debbie. So I'm super excited to have the conversation today.

Debbie Boone:

Yeah, I'm really excited to talk about this because it's one of the things is, I have a whole chapter in the book about why do we hate to talk about money? And we avoid, and a lot of times I actually think about, it's really a cultural thing because we're trained from the time we're young to say, you don't talk about money. It's like, don't ask people's age. You're fine if you're five. You can ask people how old you are if you're five, but when you're 45, you don't ask people how old they are. So it's the same principle. And so we don't talk about salary to our detriment. And we don't talk about finances again to our detriment.

But I've laughed because for years my husband was in sales. And he coached me having had sales classes. And of course if you say sales to any veterinary team, they keel over like one of those fainting goats. And you're like, wow. In fact, I was at the Uncharted Conference, I always remember this story. This veterinarian was talking about her team and she was talking about the difficulty in getting people to say yes to stuff. And she said, “And I don't want them to sell but.” And I went, yes you do. You really do.

Stephanie Goss:

You do.

Debbie Boone:

You do.

Stephanie Goss:

You do. Okay. So that's where I think this conversation starts. When we think about finances in the practice, policies, care, just the discussion with clients, there really are few things that give the team more anxiety or overwhelmed than quote-unquote sales or the money conversations. From the beginning, even when I was at the front desk, it always amazed me, I never had a problem with it. I guess probably because I had had retail and formal sales experience before coming to veterinary medicine. But my colleagues who came solely from veterinary medicine, they had so much anxiety and stress over having those conversations. And so I have always wondered and have asked the question a lot of my colleagues, but also of my team, where does this anxiety come from? What is so scary about the idea of sales in veterinary medicine?

Debbie Boone:

Well, I think it's the idea of if the concept of sales, it's that used car salesman push stuff on people that's unnecessary. But when I am teaching classes about sales, I say, look, it's education. You really are teaching people what their pet needs because they don't know on their own or they're going to go out and they're going to get some wacko misinformation if you are not the educator. So, when you're talking about sales, if you think how many people walk in your door and go, “Hey, I think my new puppy that I've never had a dog before in my life is probably going to need some parasite prevention and heartworm prevention and some appropriate nutrition?”

They don't do that. They expect us to do that. And that's selling, that's selling. But it is presenting and in a way that you're showing the value for it because that is the challenge. Is a lot of times we just want to reel off this grocery list, but we also have to back up and say, this is the feature. This is like, here's your Volvo, here's the feature. It's boxy, but it's good. It's one of my favorite lines from a movie.

Stephanie Goss:

It's totally, totally true. And I think that, that is one of the pieces that as managers, we all know that it starts with the education, but I think that for a lot of us, the conversation doesn't often go beyond the surface when it comes to the concerns both the team's concerns and their concerns on behalf of the client. Because I think some of the anxiety comes from whether it's a preconceived notion or truth that the team members may know about a client, they are also concerned on behalf of the clients about money. But at the same time, it's not our job to be able to control the client's finances or even know what the client's finances or financial situation is. Like you said, we can't control that we don't know. And so how do we get the team to open up and talk about what their concerns are? And where do we start with the battle? Because I feel like if we just say, okay, well you need to educate them, it's always a yes, but or yes and from the team. Yes, but this is what I can't do.

Debbie Boone:

Well, I've taught like 10,000 plus people when I was teaching the Patterson classes, and we talk about this. And I said, “First of all, when you're pre-judging somebody, how arrogant of you, how dare you? Because you have no idea where this pet's place is in the home.” In my experience, I worked at a very high-end practice in my first 19 years, and I've worked in a rural practice my second three and a half years before I started consulting. And in every one of those you had people of modest means who would say, whatever it takes, I will pay it, here's my credit card, here's four credit cards, for the things on this, this and this. And you've also had people who were mega wealthy who said, “I'm not going to pay for that. I don't want to.” Because that was a part of their values.

So it really goes back to we have to start paying close attention to the people in front of us and we can't stereotype or bump them into, well, this one's got some money and they're going to pay and this one doesn't have any money and they're not going to pay. One of my favorite stories, I used to do some work with Zoetis and they always made me tell this story. But one Saturday morning, it was the rural practice and this man came into the practice and he was carrying a chicken under his arm and he had blue jeans on and they were ratty and he had his straw hat on, it's ratty and it's an old faded shirt.

And you're looking at him and going, this man doesn't have two nickels to rub together. But the chicken had apparently attempted to cross the road and really didn't make it to the other side. So she did get bumped by a car. Well, we put her into an exam room and figured out that she did have a broken leg, and we gave her estimate for an orthopedic pit placement. And the client said, “Yes.” Well come to find out.

Stephanie Goss:

Talk about upsetting the stereotype for your team.

Debbie Boone:

So then three days later after she was hospitalized, he comes back to pick up Henrietta. And at that point in time we find out that he had actually been to two other veterinary hospitals who looked at him and said, the first one said, “I don't know. I don't know how to do this.” [inaudible 00:11:55]. Honestly, the second one, and remember this is rural North Carolina, looked at him and said, “Are you crazy? It's a chicken break it's neck, eat it for lunch and move on.”

Stephanie Goss:

Right. I was going to say it's not worth doing the surgery. They were judging the value.

Debbie Boone:

$5, right?

Stephanie Goss:

Right.

Debbie Boone:

So this was a $700 bill. And we find out at that point in time that this is a human physician who works at the local hospital and he's a hobby farmer. And so he's so thrilled with the work that we did, he moved all his animals to our practice and he had 23 animals because he had everything. And then he goes back to work and he tells everybody what an amazing thing that we did, and he sends us this whole referral base of people who are working in the hospital.

So you cannot judge who is in front of you, you just offer the best you can. Now that being said, would we have figured out a way if he wanted to and could not pay you $700 in one fell swoop to figure out how to pay for Henrietta? Yeah, we would have, we would have offered him CareCredit. You have to have a policy in place and people need to know that you have the policy in place. I could remember many years ago, this is probably back in the nineties, and I used to go take classes. I'm sure you used to do the same things, career track classes and all these. And they said, one of the things that you need to do, is to make sure that people understand that you have payment options before they walk in the door. Because that gives them a sense of safety and security that whatever is happening, they have a way to figure out how to cover it.

So they said, always put your little stickers, MasterCard, VISA, Discover, American Express right near your door handle so that when people are walking in, you push the door, they can read it all. And so sure enough, now you got to remember, I've been doing this a really long time, so I predate CareCredit. So.

Stephanie Goss:

I love that so much.

Debbie Boone:

So just shut up, Stephanie. So when CareCredit came out in the 90s, I was so happy because our practice for years had billed people. And every 15 days we would go through it and we would copy statements and we would stuff envelopes, and it was an inordinate amount of time to do all this. And these were a lot of very wealthy people who just didn't want to bother to write a check, and then they would have their people send stuff money in. But when CareCredit came out, we just said, okay, we're not doing this anymore. Here's the brochure. We stuffed envelopes with the brochure and said, “We are out of the banking business. We're not supposed to be bankers anyway, let's do this.” So we had an out and people took advantage of it. But it was about having a strategy ahead of time. I've been in practices as a consultant, and somebody yells across the counter, you'll love this because I know you've seen it. “Hey Doc, can Mrs. Jones bill that $300? She doesn't have any money today.” And he'll go, “Sure, that's fine.” That's the credit policy.

Stephanie Goss:

I'm laughing because I've heard it.

Debbie Boone:

Yes, yes. So even if you're going to do that, have a system in place where people have to sit down and fill out some information about themselves and how you can track them down and all this good stuff. One of my good friends was a credit collection agent, and I learned a lot from Elaine about the bad mistakes that people would make in these credit situations. But really, we have options in our world and we really need to have systems in place. Even, I mean, CareCredit is an obvious one that we all use, but there are other things that we can do to split bills. And I actually had a client who paid me monthly like the mortgage, and she would just build up a credit in her Cornerstone account and then bring three dogs in and wipe it all out. But I've had managers push back on that because shouldn't we escrow that? I went, seriously, you're doing somebody a favor. They're not going to press you for escrowing their money. It's a credit on their account. Just help. Just be there and help.

Stephanie Goss:

Well, it's funny that… So I want to unpack a few things that you said. So first thing that is crazy to me is almost as crazy when we are getting ready to do this episode when we're talking about the software and Zoom, and I was laughing because I'm still amazed every day that we're this far into life online during and after the pandemic where there are people who don't use Zoom. And similarly, I am shocked, Debbie, at how often you and I are both in a lot of the industry practice manager groups ranging from professional organizations like VHMA where you're paying a membership fee to be a part of them to the free Facebook groups. And I'm still shocked, a week hasn't gone by where somebody doesn't ask, “Hey, what do you think about CareCredit?” Or “Hey, what do you guys think about Scratchpay or VetBilling or one of the other options?”

And it amazes me, especially, especially when people ask about CareCredit. Because I'm like, this is not new. This is not new you guys. This has been out for so long. And it is amazing to me how many practices still don't offer it to their clients, especially because it's one of the things that shocked me. So occasionally I get super nerdy and I get into catching up on journals and research studies. And Synchrony did the lifetime of care study. And if you are a manager in veterinary medicine or practice owner in veterinary medicine and you haven't read through this, at least skim through the cliffs notes version, you should because there is some excellent, excellent information about care in veterinary medicine and what our clients think and affordability and lots of different topics. But there was two things that really caught my eye when I was skimming through things.

One was that, one in four pet owners when they were surveyed said an unexpected expense of $250 or even less would be a financial issue for them. And that a bill of $250 was enough to trigger anxiety for them over how to pay. And I think about that, and I don't know about you all, but it's been a long time since an annual visit with vaccines and preventative and lab work and their exam wasn't over $250. And so when I think about those two things together, it amazes me how we are not doing more to have the conversation. And you were saying like have the policy. And I think so many of us say, “Okay, well we have a policy. We don't accept payments or we take held checks or we offer CareCredit.” Whatever your policy is, a lot of hospitals have it defined. But it's an unspoken policy.

I mean it never ceases to amaze me how many practices will talk about it at the time of need when we have to have the conversation with clients, but there are so many of us that are not proactively and preventatively talking finances with clients. And the reality is that, paying for care, any care whether it's human healthcare, pet healthcare, it is expensive and it is a big undertaking. And we have got to do better by our clients to have that conversation earlier and more often. It can't be a one and done, it especially can't be a one and done conversation at the time of crisis. We have got to start when clients come in, to your point, before they walk in the door, do they see it on our website? Do they see it on our social media? And more than just the stickers that we had in the 90s of, “Hey, we take Visa, MasterCard, Discover.” But this is what our actual policy is.

We expect payment at the time of service if… Here are the payment options that we accept. And then defining what are the circumstances where billing is allowed or payment options are allowed beyond those acceptable options? That we're talking about it before they come in at that first visit, especially when they're puppies and kittens. That we're extending the financial conversation at that point in life beyond just financing like CareCredit. But we're talking about pet insurance and things like that, that we're talking about it when they're young and that we're continuing to have that conversation as they evolve lifetime-wise in our practice.

Debbie Boone:

I think one of the misconceptions that we have, first of all, is that people are medically knowledgeable. Because one of the questions I've asked for years in my classes is, how many of you have had someone come into your hospital who doesn't know if their dog is male or female? And 100% of my students raise their hand. So we're starting with a misconception of that premise that people understand what we're talking about. And then the second one is that, people have a concept of how much things should be. I think you probably remembered this study that Karen Felsted did for VHMA about the cost of vaccines and exams. And people were pretty close to vaccine costs because they do that a lot. But their misconception of the cost of a dental cleaning was that it should cost $55 and it's closer to 500 as an average.

So if we are not talking to people about how much like, this lifetime of care study, how much a dog or a cat costs you in its lifetime. Then we are doing those people a disservice because they don't have a good concept of what the reality is. How much they should even prepare to spend. Because they're thinking about it, okay, maybe I'll go to Tractor Supply and they're what, $2 a mile or something in there. So we really need to have that discussion. And when I was managing hospitals, I always did a lifetime care brochure and we would start out with puppies and kittens and here's what they need and here's what they need as an adult, and here's when they get six or eight, here's what they need. So for years, you are prepping people for advanced care as they get older and older. And you're also sharing how much that costs with people so that they're not blindsided when they get to that point in the game.

And I think that's one of the things that we talk a lot about clients being upset with us and how difficult people are being, and certainly over the pandemic, everybody had lost their mind. But one of the things that we've done is we have continuously blindsided our customers and not prepped them appropriately to understand the cost and be prepared for payment and to give them some of the tools that we have. I think one of my favorite tools, and you and I have talked about this before, is Pawlicy. And so Pawlicy advisors is like a hub of multiple different pet insurances. And what you do is you go in and you put your pet's information, name, age, breed, size, any major problems that they've had, and this algorithm figures out the best pet insurance policy for that pet and gives you the cost. And you can say, okay, do I want to cover all the vaccines and dental cleanings or can I afford that on my own? And do I want just disaster insurance or big problem insurance? And you can obviously probably hear Tucker barking in the background on occasion. I apologize for.

Stephanie Goss:

No, it's so great. Debbie has a naughty little COVID puppy.

Debbie Boone:

Yes, I do. I do. Although-

Stephanie Goss:

He is adorable.

Debbie Boone:

He's so cute. But he gets in a lot of trouble. I've wanted him insured, but I've wanted him insured and Bichons, he's a Bichon. So come subsequently, their genetic problems are cataracts and bad knees and things like that. So putting that information in, Pawlicy was able to find me the best policy for my breed of dog, which actually ended up being pet's best insurance. And so we got him a monthly payment and he's been insured since the day he walked in the door. And I would say, I tell everybody now, I tell friends who get pets, insure your pet. Because when I started in vet med, and we won't talk about how long ago that has been. But life was simple. We talked about fleas, we dispensed prednisone like water. And-

Stephanie Goss:

Heartworm.

Debbie Boone:

The heartworms, and then we talked about hit by cars, hotspots and all the flea allergy dermatitis that was our life was about that, especially in the south. But now, I mean, I have practices that I work with that have CT scans in their general practice. And we're doing complex work, we're doing human-level work. And without insurance, people have no concept and no ability to pay that for the most part. Because we need to tell people that they need these things. And people don't, I mean, I've still have people who don't even know pet insurance exists. We have a huge opportunity… I'm sure Paul Camilla, who for years was Jan Bellow's practice manager. Well, Paul has started with some partners, some veterinary hospitals, and his major focus was that people be insured and 60% of the pets that come into his hospital have a pet insurance policy.

And he said, “Deb, we don't talk about, I can't afford it in my hospital.” People are like, “I have insurance. Let's just do it.” And for his front office team, he said, “I didn't hire medical people. I hired salespeople who know how to share the benefits of this stuff.” So years and years ago, Dr. Wendy Hauser and I wrote a book called The Veterinarian's Guide to Healthy Pet Plans, and it was about the advantages of having monthly paid wellness plans. So my concept is if you have the combination of a wellness plan and pet insurance, then you got it knocked when it comes to taking care of your pet.

Stephanie Goss:

Yeah, I love both of those things. I am a huge advocate. And it's funny, I was anti-wellness plans for a really long time. And then I had done them in-house and had experimented with industry options. But now I'm on board because I saw how when they're done really well and they're modeled off of your practice's standard of care, then to your point in the very beginning, it's not about selling, it's about educating. And if it's what you believe in and are recommending anyways, really it's just another way for clients to be able to access the care because you're providing them a payment plan. Is really all ours, we did not have a huge discount built into ours. There was a small discount, but certainly not big because my doctors were earning on production and we wanted it to be fair on both sides.

And they were like, “Hey, this is good for the patients and so we're going to do it.” And we also need it to be fair for us from a pay compensation perspective. And so I think our discount was capped at 10%. It was like five or 10%, it wasn't huge. But clients were happy to have some sort of discount. And really they were just like, “Oh, I can pay it over 12 months, great, sign me up.” It made the yes an automatic. And to your point about insurance, I think that is a shift. The conversation I've been having with our colleagues for years is, why are we not, it doesn't even, I don't think have to be about selling. It's about changing our language. Because if you ask a client, are we billing pet insurance today? When they come in for their appointment, you're not making a recommendation outright, but you are making a very clear recommendation of, hey, we want our patients to have pet insurance.

And it opens the door for those conversations about, “Oh, pet insurance is a thing. Tell me more about that.” Because that's what you get more often than not is, “I didn't know pet insurance existed. Tell me more.” And so I think I love that, and I love how there has been a focus on accessibility, especially when it comes to pet insurance and making it more accessible to our clients because God love us, as an industry we have really struggled. And I acknowledge the challenge for my colleagues in not wanting to stake their flag and say, “This is who I recommend.” Because the nuances of pet care are so much, and the nuances of insurance are so much, and there is no one size fits all. And it really has to be about the patient. To your point, Tucker, when you have a pet who's predisposed genetically to certain things, what your needs are as the pet owner are different than what my needs are as a pet owner.

And so it shouldn't be about, let me try and take a one size fits all approach because that does feel, in my personal opinion, that can feel really salesy. And if the conversation is about, I don't care who you use as long as you're using someone and here is where you can find more information versus go with God, Dr. Google and figure it out on your own, that is a bad approach. But there are so many hospitals that that's the approach that they're taking because they're afraid to have the conversation. And so options like Pawlicy is fantastic for us as an industry. I'm old enough to remember when we had a list of preferred providers with AAHA, and it was really easy to be like, here's some options. And that has always been my encouragement is, ask your clients, who are your clients using?

And so that was how I operated as a practice manager was once a year I would send out a survey to all of our clients who were using insurance, and we had a code in our PIMS so we could pull a report and see who was on insurance. And I would send them a survey and a simple, tell us about your experience with pet insurance, we wanted the good and the bad, and just like, are you happy with your policy? Yes or no? And we would get their perspective. And then I would say to our client, I would compile that and then I would be like, here's some of the companies that our clients use. If you're looking for more information, and here's where to find it. And yes, it was a project and it was an undertaking, but I feel like it really allowed us as a practice to stretch that care conversation and that financial conversation out beyond the one-and-done.

Because as human beings, that's not how we learn. We know what is it you have to hear something seven times before you actually change the habit. So for our clients, if we're just having a one-and-done conversation when they come in for urgent care and they're like, “What are my payment options today?” They're not actually going to absorb that. We have got to do better by them and start to have that conversation earlier and more often. And it doesn't have to be huge on the sales. It can be little things that we change, even as simple as our language of are we billing pet insurance today to open up the door to those bigger conversations.

Debbie Boone:

Well, we have to remember too, when people are in our practice, they're often in stressful situations. And even if it's just, I've got two kids and a dog and I'm trying to juggle all this stuff and I got to get back to work, their mind is not really focused on what we are telling them. And that's often why they go home and call back and go, “What did you tell me to do with this medicine?” So we give too much credence to verbal instructions, and we really need to be giving people supporting materials. There's a reason they give actors scripts and they just don't stand up there and go pretend to be Joe Blow up here in this movie. They really give them very detailed scripts, and we need to do the same thing.

We need to practice, we need to have our teams practice scripts so that they're comfortable saying just what you said, are we billing your pet insurance today? And then they're like, “I didn't even know pet insurance exists.” Well, sure. And then you might want to explain to people that it is really different from human insurance, that it is more like property insurance. And so it's a reimbursement, but it really does help people afford care

Stephanie Goss:

Those unexpected things.

Debbie Boone:

Yeah. We care. Because you and I have been in this business long enough to know that a dog will eat anything. And some of the stuff, I have seen them in jazz including a 13 carat sapphire and diamond ring, which they pooped out in my kennel one day. Thank goodness we had honest team members because Katie Dons ate, her mother owed a jewelry store and she ate this beautiful ring and my God cleaned it up and returned it to the owner.

Stephanie Goss:

Oh man.

Debbie Boone:

See you just never know where her conversation is going to go with me and Steph.

Stephanie Goss:

That's fantastic. That's fantastic. No, I was thinking of our Lola, our, of course, the lab, what else would it be? Who multiple, multiple enterotomies for eating rocks, like the same piles of rocks. I'm thinking about that patient or the underwear-eating bulldog. But fine jewelry? Maybe now I've heard it all.

Debbie Boone:

This is a schnauzer. If it'd had been a lab, it would probably wipe out the case. But it just was a funny one. So yeah, these things are unexpected and people just, I mean, I'll laugh because when I got Tucker, I grilled the breeder just right at left, and I thought, she thought I had lost my mind. I said, “But you don't understand what I've seen. And so these are the questions that I'm asking you because I have seen the bad part of this deal, and I don't want to buy a lemon and I've got to drive all the way up to Detroit and I want to make sure that I don't have this behavior problem or a multitude of allergies or any other things.” But people, they need something in writing, they need us to be teaching them on our website.

Maybe we have a whole page on our website about financial options. One of the things, I just redid my entire website, but for years I had had a document on that site called Helpful Ideas for pet owners. And randomly I will get calls for people going, “I heard you help pay for pets.” I'm like, “No, there's just a whole idea sheet here.” And on those ideas, there's links to the pet insurance companies and links for the practices to use, and there's charities available. And all this stuff helps people. And because we prepared it ahead of time, what they understand from that is we understand that it's expensive and it certainly can be, but we worked to help. And so it's not just you don't care about us, you don't care about anything but the money. No, you really do care and you care enough to provide tools and information and some support for us.

And we get it, even though we may not be happy about our $3,000 bill when the dog ate rocks. We understand. We go into it with the assumption that people are bound to know that it costs money, and they do, but they don't know how much it could possibly cost. Because they're used to their own $40 copay and getting a bill for 1% of their medical bill because their insurance has covered it, their health insurance has covered it. So people don't know, and that doesn't mean they are idiots. I think you probably saw the reset post that got a little pushback on that, and I was glad to see that pushback because people are not idiots because they don't know all the things that we know. They may be uninformed, but that's because we didn't teach them, that's our job.

Stephanie Goss:

Well, and that client shaming is a big soapbox. And at the same time, that could be a whole other episode. But I think that the truth there for me is that before we go pointing the finger at clients, we need to look back at these three fingers that are pointing back at ourselves and say, what are we doing to prepare clients for the understanding? So back to in the beginning when we were talking about the financial policies. So lots of us have financial policies, but are they written down? Are clients A, reading them, and B, are they signing it? Are you getting agreement to them that they understand it, that they've had the opportunity to ask the questions? And then if I think back to my experience in veterinary medicine, I mean, we started going to my family vet that I ultimately was the first vet practice that I worked at. We started going there when I was a kid.

If you had given my mom a financial policies information when we had our first backyard dogs when I was seven or eight, and then she never saw it again, it's an unrealistic expectation that then years later when she's had three or four different pets, and now I'm the college kid bringing the pet to the vet, and I'm like, “I don't tell me what my payment options are.” It's unrealistic to expect that clients are going to remember those things when it's one and done. And so some of the things that I think we need to do when we're pointing the fingers back at ourselves is look at, do we have financial policies? Are clients agreeing to them and signing them? And then beyond that, are you re-reviewing it? Because if they signed it once in 1999 and they're still your client, that doesn't mean that they actually still accept it and also that you haven't modified your policies because the payment options we took in… When I started in 2000 in veterinary medicine, the payment options then were Visa, MasterCard, nobody took Discover or Amex because it was super expensive.

It was Visa, MasterCard checks and then CareCredit when CareCredit came along. And so I think about it now, we'll accept just about anything under the sun, Apple Pay.

Debbie Boone:

Yeah, there's so many options.

Stephanie Goss:

Amex. Right? There's so many. And if we're not updating those policies, if we're not, then rediscussing them with the clients, I think we're doing them a disservice because that's not how we learn as humans. We've got to continue to present the information. You said something that was super interesting to me that I want to unpack, which is about the written information for clients and not just verbally sending client information home. Because I had that on my list as well in terms of how are we presenting the cost conversations to clients? In my practice, my rule was a treatment plan for every client, every patient, every time, full stop. And everybody would argue with me, and they'd be like, for, “The annual wellness, do I really need to do a treatment plan?” “Yes, you do.” And here's why. Because your point, when you have the mom who's got her two kids plus wrangling the dog in the exam room, she is listening and she is doing her best to listen to you.

She's listening to you with half an ear maybe if you're lucky. And it's certainly not going to necessarily be easy to recall that information when she goes home to have the conversation with her partner and the rest of the family that's taking care of the pet. So I think figuring out how we communicate, particularly when it comes to treatment plans in a more reliable method, is something that we need to do to do better for our clients. And then the other piece of it that goes to your point is discharge instructions. And that the discharge instructions not only include the medical information that you're verbal vomiting on them during the appointment, but also those financial conversations. And we talked about pet insurance today, and I do not expect you to remember that I told you about Pawlicy, here's the link.

And now it doesn't like we've come a long way, especially since COVID as an industry in terms of technology. It doesn't just have to be literally printing a piece of paper and hoping that it makes it home with them. We have everybody's email, so why are we not sending it with the hyperlink so they can just click the button and have it open up on their phone screen or their computer screen? I think those are areas where we really, we can do better by the clients I think.

Debbie Boone:

We can. Well, I can remember years and years ago when we were talking about discharge instructions, and all we did was we created templates and links and I mean, we discharged instructions for everything, and they were linked to service codes. And they were fairly elaborate compared to some of the stuff I'm even seeing today. But the other thing is, there's a message at the bottom of almost every invoice, and why wouldn't it be the bottom? I mean, people ignore that, they never change it. They put maybe their address or something. People know where you are and they're in your building.

So let's put something valuable on the bottom of the invoice. Maybe here's a link to Pawlicy or here's a link to CareCredit. Yeah. It's just put some information on there and you can change that monthly. When I work with practices, I develop a monthly marketing campaign for them, and every month we have a focus on something else. So focusing on payment options and lifetime cost of care and informing people about making a plan. I even have a friend, Debra Hamilton, who creates something called a map plan. And people do not understand, they make this assumption that if something happened to them or they had to be in the hospital for weeks, that some family members just going to step in and take care of all their pets, but do they really know it? And do they have a financial plan for reimbursing those people?

And do they have written down what food these animals eat or any of those things? So there's a lot of planning that people should do for their animals just like they would do having godparents for their kids. I know my husband and I were godparents for our best friend's children, and we sat down and we said, okay, here's the plan, and if something happens to you guys, this is us, then we take over. But people forget that they need to do that for their animals too. And this is all about creating a strategy so that people get what they want. And what they want is a really healthy animal that doesn't have many medical problems that's really well taken care of and that they enjoy living with.

Because that is one of the things that we talk a little bit about in vet medicine and our job is to be the hero of the story and save the day when disaster strikes. But what we really don't realize is we're not the hero of the story. The client is the hero of the story. The pet is often the dilemma, the journey through the story. And we are the wise counselor. We're the Obi-Wan Kenobi to Luke Skywalker, and we are supposed to be the guide. And when we look at ourselves and we put ourselves in that place rather than being this hero, then we're going to find out, first of all, our work is more sustainable because it's hard work being a hero for everybody. And it's much easier to be the counselor and something that you're an expert in. And so that's what our job is to be, is to be this counselor and to teach people all these things. Because we live in it every day and we know it.

And if you've been doing it a long time, you've watched it expand into what we can do. I mean, we can do transplants for animals, we clone animals. We're doing MRIs on animals. There's so much specialty work that's done. And do you want to have to say, no, I'm going to euthanize my 12 year old dog because I can't afford having it go through cancer treatment when it has a great prognosis going through cancer treatment, but it's $12,000 or more. So we want people to not have to make those horrible decisions, and we don't want to have to be on part of it either, because it breaks us. It breaks us when we have to do that too.

Stephanie Goss:

Well, I think that adds a lot to it. And I think when I think about going back to where we started, the anxiety for the team and talking about sales and money, it's uncomfortable and it brings up a lot of feelings and emotions. And I think a lot of it comes down to the lens, which with we choose to look through it. Because if we, as an industry or as an individual practice, if we're looking at your example of, okay, now we have a patient who needs cancer treatment and the costs are upwards of $12,000, that's a huge, huge amount of money. And that for anybody, or almost anybody, I think would hit that panic button of how do I afford this? And when I think about what the clients told us in the lifetime of care study, we're not talking about $12,000.

We're talking about $250, sometimes less being a threshold for people that we should think about, Hey, this is not just that occasional client who's facing the $12,000 cancer treatment or the client whose patient needs orthopedic surgery and it's going to be super expensive or needs specialized care that they have to go to the university for. We're talking about all of our clients really almost every single day. And So I think when we think about making it be financial care over the life of the patient versus just we have a financial policy and here's the payment options that we accept, we can't redo the client's a disservice if that's where we're stopping it. And so I think we have to think about all of the options. And I love what you said about building out resources for clients, because I think one of the other things that is a challenge for us is a lot of times we only help clients understand the options that are available with us.

A lot of times, we and we're doing it with good intentions and we want to take care of our clients ourselves. And sometimes the best thing for our client, or sometimes the best thing for our patient is to get care somewhere else that's not us. And so many of us operate from this scarcity mentality place where we're afraid to send them to other people because we're like, well, we don't want to send them to our competition. The reality is our competition rarely is who we think our competition is in veterinary medicine. And we've got to stop living that way because the reality is, sometimes what is be best for that client or that patient is to go somewhere else. And wouldn't I rather help that patient get care, even if it means we don't provide the care, we are in it for the patients.

And so I think that goes to what you were saying about we're thinking about it ahead of time and we're deciding how do we feel about those things to pull together that resource information. Whether it's here are the low-cost vaccine clinics in the area, or here are the low-cost spay neuter options in the area, or here are, I mean, my ER that was local to us, had a resource sheet for clients that included options including local pawn shops and was like, here's options for finding money when we need it.

And so we have done our job ahead of time to think about those things. And really, we're trying to work with clients at that point, I think, instead of against them. And that, I think feels better to me, even though in the moment, I've been a part of those conversations with the team, it's hard for the team sometimes because we do care about our patients. And there is this thought of, why can't we just help them? Is it really going to kill us if we just do all of this thing for this one patient for free? But the conversation with them has to go, “Hey, look, we're not talking about just this one patient.

Debbie Boone:

It can happen 10 times a day. I ran emergency. And you're talking about emergency?

Stephanie Goss:

Yes.

Debbie Boone:

Yeah, that happens almost every day.

Stephanie Goss:

Yes.

Debbie Boone:

Yeah.

Stephanie Goss:

Yes. And so I think we have to start to think about it from that whole… I love the shift that's happening in the industry where we're starting to have those conversations to talk about it in a whole lifetime of care, spectrum of care, looking at the bigger picture and saying, how do we as a practice become an active, engaged participant in this conversation? We're also asking the client to show up and be an active, engaged part of the conversation. This is not us doing all of the work and dragging them along behind us, but we still have to play our part, I think, in having the conversations.

So beyond talking to the clients about all of the options and looking at how do we do right by them, and in some cases do better by them and offer them all kinds of options. The other piece of it when it comes to where we started, which was this anxiety about sales and money conversation is, how are we talking to the team about their feelings around the money and finance conversations? Because you mentioned it earlier, referenced it earlier, the emotional impact that it has to the team when we have to say no, when we have to put a pet to sleep because their owner can't afford care or something like that, that absolutely has an impact on us. So how do we talk to the team about their feelings and draw it out into the open?

Debbie Boone:

Well, for one thing, it is about preparation. And we really are not doing a very good job training our teams period, in a lot of different ways. I mean, I can't even show you how many practice [inaudible 00:50:32].

Stephanie Goss:

That's a soapbox.

Debbie Boone:

I don't even have time to do that. When somebody said, “I don't have time to do that.” That means you don't have time to do surgery or do any vaccines because it's just as important as doing the medicine is training your team. But I think scripts help a lot and roleplaying, and even though everybody goes, Ooh, in roleplay, it is helpful-

Stephanie Goss:

Don't call it role playing.

Debbie Boone:

Yes, it is helpful when they explore and act out. And I love going back and saying, let's talk about some scenarios in the hospital, and if we had had this conversation ahead of time, how do you think it would've played out? And so you're kind of going back and you're doing that dissection of these issues that you have. And then coming up and making a plan because the issues repeat themselves. During COVID, everybody was talking about the difficulty of clients, and I was going to give a talk for all mine, I thought, well, let me find out why people are firing clients. And so I asked them, and I found out there was a list of 18 things, and all 18 except for two had been stuff I'd been dealing with for 30 years. So nothing changes under the sun. These were the same list except for, “I don't want to wear a mask and I want to come in the building.” So there's nothing new. So we need to know that there's comfort in having these conversations because we're going to, and you can't turf them all to the manager the manager has stuff to do.

And so everybody on your team needs to be really comfortable with it. And I think the technicians, typically are the ones who are presenting treatment plans to folks. And Carrie Bagrund has a really good policy in her hospital and she says, “We know that this is pricey. And we have systems set in place if you need help.” And she said, “People are so appreciative of it, even if they don't need them, even if they have that credit limit, that's fine to cover that with their credit card. But there's this, I acknowledge that there's a problem and so I'm going to proactively put things in place for you. And we have a plan, we have plan to help. And that in itself is a plus.

If we think about could we save lives by having a plan? Could we save lives by doing the role-play that we all hate? Could we save our own soul by not having to put animals to sleep for lack of affordability then I think the motivation is much higher for us to power through something that's really uncomfortable for us and do it well. As opposed to, “Oh, I just don't like to do that. I just don't like to do it.” Nobody likes to do it. Nobody likes to have an uncomfortable conversation. But getting a skill set that says, I can have uncomfortable conversations with people. And if I learn to have them much further in advance than waiting until the ball has dropped, it's too late then and it's too late to talk about it, then we need to have had this conversation with our clients multitudes of time.

And even maybe on that first visit, we used to always do a folder and then it would have some instructions about the hospital and the doctor's bios and some information. But it also had information about the CareCredit credit card, and it had different, what was good for the life of your pet, it was a plan. And we put it in a package and said, these are all good things for you to know. Here are some tools we built for you.

It's my favorite. AVMA has one, but veterinary care is definitely my favorite one. And why not stockpile some charitable funds for these situations when they really won't qualify for any credit card, but can we still do something? We must still do something. And you talked a middle little bit about the spectrum of care work that's being done now in our profession. And thinking about my history in the profession, which is really spanning over 35 years now, we were creative. It wasn't always, we didn't always have to always do gold standard because there was stuff that worked. And it wasn't absolutely the best, it wasn't what the Ivory Tower might have taught. One of my fondest memories is my practice owner, a puppy came in, tested a not strong positive for parvo, but he was starting to be symptomatic and the people just really didn't have anything. And this was in the days before our CareCredit credit card came to exist.

And he sent the dog home and said, every two hours give this dog chicken broth because hydration is what it needs and the puppy left. So there's things that work that we need to be creative. The other thing is, we don't have to do everything all at once, and that's our mindset. I had an older veterinarian say to me, one day, “Well, Debbie, I can't get people to come in one time a year, much less come in two.” Because I was recommending twice a year annual exams or semi-annual exams. And I said, “That's because you make it a horrible experience for them.” When you make a place of hospitality where people enjoy coming into the practice where they feel that you really care about them and you're on their team, they will come as many times as they need to come to get the work done. So we can divide and conquer and that makes things affordable too. And people can spend $100 three times over a year's period of time and spending $300 once might be out of range.

Stephanie Goss:

I think that's great. And I think forward planning and forward booking is a very underutilized tool like that. Remembering we don't have to do it all at once and how can we have that conversation with them about maybe today we do this and then we're going to see you back in two weeks or four weeks or six weeks and here's the next step and then here's the next step in over the next, maybe it's not an acute situation. And so we can say over the next three months, we're going to get to this end result and that works for them or their pocketbook. And going back to something that you said when it comes to CareCredit and the CareCredit credit card and financing options for our clients, there are clients who are going to get turned down. And I think about it, when I think about our team. In my very first practice, one of the processes was we had, of onboarding, was to have a conversation about our own pets and what the pet benefits were, but also then how are we going to pay for care?

Because we had the same conversations with our team that we had with our clients. And so I was like, at the time, I was just out of grad school and I didn't have any pets. So I was like, nah, it's not really relevant. And then I had been at the practice, I don't know, about a year before I suckered into taking home my first pet. And I got a kitten and I had just finished grad school and I was broke. I was like, I have no money and the conversation was how, here's what you get as a benefit, but also then how are you going to pay for your pet's care? And I remember applying for CareCredit and I got declined and I had thousands of dollars in student loans. And so it was not shocking to me, but also mortifying to be like, I work here. And I didn't get approved. I didn't get approved for CareCredit.

And my practice owners were just like, “It's okay. Not everybody gets a proof of CareCredit and you're going to have to have this exact same conversation with clients.” And so what next? What are the options? And it's amazing to me how often we forget the next step of the conversation doesn't have to be it's one and done or there are no other options. It's no longer just the exam, the flea conversation and heartworm conversation. It is advanced-level, human-level medicine and we have to have those conversations with the team so we can put ourselves in the client's shoes. Yeah, I And that we can have that empathy and we can understand how that feels.

And it's funny because I think back to it now and I think about how ashamed I was and how embarrassed I was when I got declined at that first point in time. But now, I can't imagine having a pet without having a CareCredit credit card. I can't imagine not having pet insurance. I can't imagine not having those things. I probably wouldn't have persisted in having those hard conversations with clients if I hadn't experienced that on my own. And so I think the biggest thing for me is, we've got to start to talk about it. Whether it's how is the team going to afford the care? And we've had some podcast episodes on that. How are we going to extend those charity options to our clients? Like you were talking about, Andy just did a great episode with our friend Tannetje Crocker about discounting care and intentional discounting of care and being able to provide charity support when needed.

How do we talk to the team about how they feel about money and support them as managers? What are things that we're doing from an HR perspective to further the conversation about financial stability and awareness just as human beings to support them having a whole life and being able to know what those tools are. I think when we start to think about the money conversation as a well-rounded whole life thing for ourselves, for our clients, I think that's where we really start to achieve that Jedi mastery like you were talking about.

Debbie Boone:

That's exactly right. Obi-Wan Kenobi.

Stephanie Goss:

I love it. Debbie, this has been wonderful. You and I could continue this conversation all day. But thank you so much for having the conversation with me. This has been great. I'm going to drop some links in the show notes for everybody to some of the things that Debbie and I talked about because there was a lot, certainly some of the reference materials. If you haven't checked out the Synchrony Lifetime Of Care Study, you definitely should, especially if you're a practice owner, a practice manager, it is worth your time. Thank you so much for being here and thanks to our friends at Synchrony for making this episode happen ad free because you and I crammed every bit into our hour-long episode.

Debbie Boone:

We did. We did. I appreciate it.

Stephanie Goss:

I can't wait to talk to you again soon, friends. Yeah,

Debbie Boone:

It's always fun. So I guess we'll maybe see each other at AVMA and I guess my afternoon, we'll be spent finishing that book

Stephanie Goss:

Take care everybody. Have a fantastic week.

Debbie Boone:

Thank you so much.

A special thank you to our friends at CareCredit

Written by Dustin Bays · Categorized: Blog, Podcast

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