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This Week on the Uncharted Podcast…

Have you ever hired someone or had someone join the team and when they get started, it is obvious to the whole team that this person WAY oversold their skillset and abilities? This week on the podcast, Dr. Andy Roark and Stephanie Goss tackle a great question from a practice manager in this very predicament who is asking “What can I do to fix this problem and bridge the gap between their skills and what we need while also addressing the fact that they are currently being grossly overpaid considering their actual skill abilities. We loved the positive and fresh take on this challenge and had a lot of fun with it. Let's get into this…

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

Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag

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Episode Transcript

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

Stephanie Goss:
Hey everybody. Hi, I'm Stephanie Goss. And this is another episode of the Uncharted Podcast. This week on the podcast is kind of a mailbag question, but really there is a situation that a colleague of mine who is a fellow practice manager, reached out to our manager community that we're in and asked for help on. And when I thought I reached out to her and said, “Hey, I don't know that I have a whole lot of answers, but I would really love to talk about this on the podcast with Andy,” because I think that this is something that happens more frequently than we realized.

Stephanie Goss:
And it's really important A, to band together and realize that you're not alone in this situation and B, I loved how this practice manager was approaching it from a place of, how do I actually fix this problem? Versus running away from it. Curious yet? We're going to talk about what happens when we hire someone who has very oversold their abilities and their skillset. And they are being paid a wage that is not really commensurate with the experience level or their abilities once they join the team. And this manager is wondering, I could jump ship and I could run now, but could I fix this? Can I bridge the gap between where they are and where they should be to pay them what we're paying them. Curious? Let's get into this one.

Meg:
And now, the Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark and Stephanie. The case is mistaken identity, Goss.

Stephanie Goss:
Oh, how funny? Is it mistaken identity? I'm not so sure.

Dr. Andy Roark:
No, I don't know. I don't know.

Stephanie Goss:
I like it. How's it going, Andy?

Dr. Andy Roark:
Man, it's good. The weather here is beautiful, things are moving along nicely. For we've moved into that part of the school year, where the school lets you know, hey, there's one month left of school and we now have 47 events for you to attend in the middle of the day, every day. Surely you'll be there for the 11th AM Awards ceremony for almost perfect attendance.

Stephanie Goss:
True story.

Dr. Andy Roark:
Surely the 1:00 PM cookie lunch with dad is important to you.

Stephanie Goss:
And surely, it all needs to be crammed into the last four weeks of school.

Dr. Andy Roark:
It's called Springfest. Is it on Saturday? No, it's on Monday.

Stephanie Goss:
Oh, I am very, very glad we are in our last two weeks of school and I am very glad I am ready for a break. I'm ready to be done. The kids are getting very excited. I think they have one more like real week of school next week and then the last week is fun and games and-

Dr. Andy Roark:
That's a joke.

Stephanie Goss:
Yeah. Bless their teachers for embracing it. We're having a school camp out the night before the last day of school and they're like, “Yeah, we're not actually even going to have school on the last day. We're just going to all hang out and have breakfast together, then everybody's going home.” I was like, great. I can roll with that.

Dr. Andy Roark:
Yeah. I have mixed emotions. Here's some genius for you. My 10 year old daughter's teacher is like, “We're doing social studies in the modern era.” And I'm like, “What does that mean?” And it turns out she's listening to songs and watching movies of the '70'S, '80'S and '90'S. And I'm like, that's genius.

Stephanie Goss:
My kid also just, they were doing something with music of the '80's and they were listening to some YouTube channel and it was like, top 10's of different genres from the '80's. And she was just like, “I knew this many songs and nobody else in my class knew these songs.” I was like, “Because I'm the old parent in your class. That's why this is happening.”

Dr. Andy Roark:
Yeah. On the upside, they listened to, I Will Survive and some beachy songs like Stayin' Alive, and I was like, that's great. On the downside, the teacher decided to show the fourth grade class, Michael Jackson's Thriller. And it took me three days, to get Hannah to sleep through the night again. And I was like, I remember being nine, 10 years old and seeing Michael Jackson's Thriller, it is intense.

Stephanie Goss:
Yeah. That was on the list of songs and yeah. So that's an intense one. Oh man.

Dr. Andy Roark:
That's good. All right. That's enough of that. We're making it into the summer. It's going to be good. We're almost there.

Stephanie Goss:
We have a question from the mailbag today that comes in preparation for the summer craziest. And this is actually a conversation that I was having with a colleague who is a manager and their clinic is shorthanded as a lot of us are, and they are hiring multiple positions and they have been looking and have been trying to intentionally find the right people. And they have someone who has joined the team who seems to have slipped through the cracks. And it is a licensed technician who seems to have very much oversold themselves and their abilities.

Stephanie Goss:
And they were given an offer letter where they are paid at the very top of the field because they are licensed and theoretically have all of the skills that they said that they had. And so my manager friend was like, “Hey, we're in at will state and so I could just cut and run, but I feel a responsibility because I think we missed some tricks in terms of our interviewing process here and so what can we do to help this person reach their pay grade versus cut and run?” And I thought this is a really great question. And the reason that I loved it was because I felt like it was a really positive approach. I think a lot of people would look at it and say, “You cut and run. That's what you do.”

Dr. Andy Roark:
That's not necessarily wrong. It's not necessarily wrong. And it's going to be up front and say, it's not wrong. I like where this person's head is. I don't think that they're wrong for having that thought.

Stephanie Goss:
Yeah, no. And so I thought this will be a fun one for you and I to debate and talk through.

Dr. Andy Roark:
Yeah. I like it a lot. There's two issues here. There's the issue, the obvious issue and there's the issue they asked us about. And the obvious issue is, how do we get here and how do we not get here next time? And then the question they asked us about is, given that we're here, What do we do about it? And I think they're both great questions. I don't want to get sucked into the first question because that's not what we were asked, but I think we should touch on it. Do you want to do a speed round, real fast of what do we do to make sure we don't end up in a position where we just paid top dollar for someone who's not skill wise, how they represented themselves to be?

Dr. Andy Roark:
That could be technician. That could be CSR. That can be doctor who has got three years of experience and acted like they were a hundred percent, they were wildly experienced and comfortable and competent and then you get them in the clinic and they really are not so comfortable and or competent. And you go, Ooh! So anyway, I'm not trying to make this about technicians, but this is anybody who maybe represents themselves in the best possible light during the interview process.

Stephanie Goss:
Yeah. So I think it's funny because this colleague asked this question in a group that we're in and immediately a lot of the responses were very much like, this never should have happened. Like why didn't you have a system in place?

Dr. Andy Roark:
I hate those responses. Like the whole, I'm going to rent here for a second. I hate social media in this way. I hate it so much when people go in and they're vulnerable and they're like, “Hey, this is what happens and I'm trying to figure out where to go from here.” And people just push each other out of the way to go, “Oh, let me tell you where you screwed up six months ago.” And you're like, “That's not what I asked about? I said, I got it. I saw that it happened, you telling me that only an idiot would hire this way, is not helpful and not productive.” And it's like, I'm sorry. I see that all the time. And I hate it so much. I have to have a say-

Stephanie Goss:
I understand.

Dr. Andy Roark:
… I hate it and I see it all the time. And so if you're feeling that way and you're like, “You know what? I would love to ask questions and not have people behave that way. I wish that social media was that way. I wish social media was that way too.” It's not. You know what? Is the Uncharted Online Community Im just throwing that out there, it's what you wish social media was, it actually is those people who jump in with the support and the advice and encouragement that you need. Sorry. I'm antisocial media today.

Stephanie Goss:
I know, I feel a hundred percent because I was reading this and I was like, “Gosh, why are we ganging up on this person for having-“

Dr. Andy Roark:
I know. It's awful.

Stephanie Goss:
… in this case, I don't even think was their control, it was a decision that was made by a doctor. But still, it doesn't matter, even if they had made it, it doesn't do any good to gang up on. This is like when we give feedback about stuff that happened six months ago, not helpful, not productive to anybody. This is where, but where are we going to start? Well, I think we're not wrong that we should talk about how do we prevent this from happening in the future, because this is not, this is the kind of thing that I see in here and you and I get asked about a lot and there are a lot of people out there who don't have systems in place.

Stephanie Goss:
And so I want to make sure that we do some due diligence and make sure that everybody is thinking about some things that we can do to avoid this in the future. So I think there should be a system in place for hiring and the hiring process. And that pipeline should help you prevent some of these challenges. So in this particular case, and particularly with any licensed or credentialed person, there are really three pieces of it that are important reference checks that I want to put a pin in that and come back to it because it's a little bit bigger. Verifications of credentials. So if you have somebody, whether they're a doctor or technician who say that they're a credentialed potential team member, it is free in every state for you to look up and see the status of their current license. And that is a step that a lot of people miss and don't bother to take the time, because I think some of us are doing background checks and assume that if that's not valid, it will come up as part of the background check.

Stephanie Goss:
And I will also tell you that's not always true with a lot of companies who do background checks, where you have to ask specifically. And particularly when you're talking about your technician staff, to have them look at that whereas with your doctors, generally, they're looking for the credentials, but for a lot of companies, you have to ask for it. And then a lot of us don't know what we don't know and we assume if we're asking for a background check on a Dr. Andy Roark, that they're going to check whether his doctor's license is valid in the state that I'm in, but that's not necessarily true. So having a system that is looking in particular for our credentialed team members, technicians, and doctors, looking at their current credentials and the state, and if there's been any pings or concerns with their credentials, and then the reference check piece is big. And that's like a bigger podcast because there's pros and cons to it. But reference checks are a thing for a reason. And that can help avoid challenges there.

Stephanie Goss:
But the big part for this here system wise, part of the interview process has to be, if you're looking at skilled team members. So whether they are licensed or not, it doesn't matter. If I'm interviewing a skilled CSR who has previous veterinary experience, or if I'm interviewing a licensed technician who's going to work with my team, I want the ability to assess their skills as an employer. And that can take a lot of forms that can look like pre-employment testing, like asking somebody, do they actually know the alphabet and giving them a test to figure out. If you have paper charts, can they file charts accordingly? Can they calculate drug doses?

Stephanie Goss:
Those things are super valid and can, and should be a part of your hiring process. But the other big piece is physically asking them to do the job. And this is where veterinary medicine gets itself into a lot of trouble because oftentimes we say, “Oh yeah, let's do a working interview and come and chat out and hang out for the day and I'm not going to pay you, but I want you to stay. Because, I want to see how you're going to do the job.” That is bad, bad, bad.

Dr. Andy Roark:
Bad. I agree.

Stephanie Goss:
And nothing gets me on my soapbox faster than when somebody says, “Oh, this is my process.” But, for two reasons-

Dr. Andy Roark:
You know what gets me on my soapbox faster than that, social media. Thought you know. I'm good. That's it, I didn't have to say.

Stephanie Goss:
But here's the thing you guys, we have to protect ourselves and we have to protect that person. So there are a lot of people now who like reference checks, will just say, “Don't bother doing them because you can't ask the questions anyways.” And that's not true. If you're going to do working interviews, there is a proper way to do it so that you and that person are covered. And it involves generally two very important and easy things. One, you have to compensate them. You have to compensate them for your time. I am not going to ask someone to come in and spend the whole day or half day with my team and not compensate them for my time. I wouldn't want to go to an interview and be asked to stay and work for free.

Dr. Andy Roark:
Yep. If you bring this person in and you compensate them for their time and then you don't hire them, that was the best money you ever spent.

Stephanie Goss:
Absolutely.

Dr. Andy Roark:
That is an outstanding investment, period, full stop. But if you do bring them in and hire them, it's-

Stephanie Goss:
Also good investment.

Dr. Andy Roark:
… it's a drop in the bucket and it's a good investment of starting off in a good foot. I mean, just that's it. I agree.

Stephanie Goss:
So you have to pay them. And then the second piece of it, which often is covered by paying them, if you do it correctly, is you have to protect them and yourself insurance wise. And so that's why I don't even call them working interviews anymore. What I say to people is, we would love to have you come and spend a day with us as a relief person, so that we can assess your skills and you'll be able to meet the rest of the team, they'll be able to interact with you, you'll be able to assess us, just don't ever forget that they're interviewing you too. And so you set them up and you pay them and I'm not going to get into the rules, but there are rules around how you pay them and what you do. But generally when you pay them to be there and you do it correctly, you are covering your own ass when it comes to insurance and liability.

Stephanie Goss:
And so I am a huge fan. Can't state it enough. You should have an interview process that helps you stay out of this situation that our manager friend finds themselves in. And when you do it generally involves having a working interview as part of your process so that you can do exactly that. You are continuing to interview them, you are assessing them for their fit with your team, you also have the opportunity to have them put their hands on your patients and get a feel for their actual skills.

Dr. Andy Roark:
Yep. Totally. That's it. That's the much I want to say about that. That's exactly, it's like, “All right, next time, we'll do these differently. But hey, we all make mistakes. We all learn the hard way.” Anyone who acts like they didn't learn this the hard way, was either just lucky or they lie. And that's it. So anyway, being [crosstalk 00:15:48].

Stephanie Goss:
I learnt this the hard way.

Dr. Andy Roark:
… mistake like this, is ridiculous. So anyway, that happens to the best if we all learn, that's just how we learn sometimes. So anyway, I just wanted to cover that. Perfect. Done. Let's pick it from where we are.

Stephanie Goss:
But also not the question. Yeah. The question that was asked is-

Dr. Andy Roark:
Not the question.

Stephanie Goss:
… okay, this has been done, so now what do I do to help this person come up in their skillset and reach their pay grade?

Dr. Andy Roark:
Okay. So what do we do to get them up there? The healthiest thing from a head space standpoint, and that's where we start, is head space. It's to focus on the present and the future and just to put the pass behind you. It doesn't matter how we got here. There's no reason to think what if, or I wish I had done this differently or I would do… You didn't. And here we are. And so be kind to yourself by forgiving yourself and accepting our position and just moving on and starting fresh here clear ride. So, I don't know. I'm sure I'm not the only person who has a bad habit of beating himself up about mistakes I made and things I should have done and didn't do. It is not helpful.

Dr. Andy Roark:
Hard truth is this person that we're dealing with probably possibly wasn't entirely truthful about their experience level or charitably, maybe didn't understand what we were asking or-

Stephanie Goss:
Somewhere in between.

Dr. Andy Roark:
… confused their knowledge with actually being able to do the thing, which isn't different. So, okay. That's kind of what we're looking at. Let's just be honest about where we are and what we're dealing with. Put a pin in that for the future and file it away. My mother's favorite saying what she got from Oprah, we quote the book of Oprah in our house. My mother's favorite saying from Oprah is, “When someone shows you what they are, believe them.”

Dr. Andy Roark:
And I go, “Yeah, okay. Let's remember that and just move on.” Starting now, what needs to happen to keep this salary and this job ranked? Full-stop. That is the question that we need to not talking to the person, sit down, involve the decision makers, like is the medical director on board with us? Who do we need to get on board? But say, I would like to keep this person where they are and we need to skill wise, get them where they need to be. What needs to happen to make that a reality? And then I think you start there.

Stephanie Goss:
Yeah. I think that's a great way to approach it. And I think that there are people who are listening, who are like, “But what do I do about the other technicians? And what do I do about the rest of the team who has no certification, but has the skills that this person doesn't possess in this moment.” I'm going to say this. None of that matters. Well, it does matter. But in this context, it doesn't. Though your point, Andy is, look, we have to start here and now doesn't matter what happened in the past. It doesn't matter how we got here, starting here and now, how do we make the change?

Stephanie Goss:
Now, the reason that I said that stuff doesn't matter is because this should be a conversation about this person in the context solely of themselves and their skills. Not comparing them to the other team members, not pitting them against each other. But this is looking at this person and saying, okay, here's the skills, here's you, let's identify the gaps and figure out how we're going to fix them. Not, “Well, the rest of the team can do this and you can't. So this is something we need to fix.” That sets them up for failure on both sides. It sets the team up for failure and it sets that person up for failure straight out of the gate.

Dr. Andy Roark:
I think it's our job as leaders to try to achieve balance. And so, yeah, I think you have to at least look over at the compensation side and say, what do we need so that people feel okay? And I don't mean what do the other support staff need to feel? I don't think that, the best thing is they should not know anything about this, other than this person is credentialed and they were brought into this level and they should not know what their compensation is. Ideally, that's the case. The truth is if they're looking at this person and he's a level 3 technician, and he can't do what the other level 1's and 2's can do, that's a problem. And they're going to see it and they're going to, it may not have anything to do with money, but they're going to say, “Why is this person level 3, when they cannot do the things that the rest of us can do?” That is a problem that we need to at least file it away and know that it's real.

Stephanie Goss:
Yes. I don't disagree there, which feels contradictory to saying that it doesn't matter. But I do. I think that in the moment when you're having the conversation with your new technician, what other people can do or can't do, and the comparisons don't matter, but when you step back and you zoom out for a second, it a hundred percent matters. The team is watching. Equity is important. And to your point, I actually would advocate that I would want the team to know what they're all getting paid because I would want there to be equity in a pay scale. And I would want someone to know if we just hired a level 3 technician that this is where that pay scale starts.

Stephanie Goss:
And so they can see, not assume, not ask for information behind closed doors or have the whispered conversations, which is how it happens in a lot of clinics, but I would actually want them to have that transparency because I do think that the equity matters and what I would say to this manager is I think they are doing a good thing because they are setting the bar and they are acknowledging for their team that, “Hey, things happen, mistakes happen. And I'm not going to go into details. I'm not going to elaborate to the team because my role as an HR professional is not to do that, it's to it's to keep it quiet and to manage it.” But I also can still say to them, “I recognize that there are discrepancies and here's what we're doing to address that.” And I think that's what matters when it comes to the team, if there are concerns and if those kind of things are being voiced, I think it's important to address. We're human and mistakes get made and here's what I'm doing to fix it.

Dr. Andy Roark:
Yeah. And I am also going to circle back to what we said at the beginning and I have to put on my pragmatist hat here. And I would say also as part of head space, I think you, as the decision maker, you need to get comfortable with the idea that this might all fall apart and burn. And it just might, and I think you can accept that and be graceful about it. And the truth is not take too much responsibility on yourself to say this person misrepresented their skills and their expertise and we did not catch it in the interview process and did not take steps to verify. And so when they came in, they were paid at a high pay level. They were not able to do the skills. Their skillset did not match up with their job status or rating and the other team saw that and ultimately it all fell apart and did not work out.

Dr. Andy Roark:
I think that the healthiest thing is to go ahead and accept, this might not work out. This person might not be capable of getting where you need them to be. The rest of the team might rebel and hopefully they won't. But if this becomes every day, one of the team members comes in and says, “Your level 3 technician messed this up again and they're not able to do that and it's causing tension in the practice and every day I have to be an apologist for this person.” Or I have to work it out. Ultimately I'm going to pick my poison and I have a couple of options.

Dr. Andy Roark:
I can continue to stick to my guns and I'll do that until it becomes unfeasible or unpleasant, significantly unpleasant for me to do that, I can adjust the person's level and say, “Hey, look, I need to drop you down to a level 2 instead of a level 3. And with a plan that we mutually create to get you back up to level 3, but you're going to need to drop down to level 2. And that's just what's going to need to happen in order to have other people feeling okay about working with you.”

Dr. Andy Roark:
Or it's going to be, “Hey, this isn't working and we're going to need to part ways.” And so I think those are the three outcomes. And I don't think that you have to decide on the first day, which of those three things you do. I think you can a hundred percent start off with rosy glasses on and say, “you know what, let's fix this, let's come up with a plan to get you up where you need to be, we're going to work hard on this. Let's see how it goes.”

Dr. Andy Roark:
And maybe it'll work really great. Maybe the person will respond. Maybe their confidence will blossom and they'll grow quickly. And I've seen, that it can happen. Maybe they'll crash and burn and this whole thing will go south and the misunderstanding during the hiring process is just a preview of misunderstandings that we can expect to have with this person going forward and the whole thing is gonna fall apart. I don't know. But I think the healthy head space is to Say, “Yeah, I have some concerns that this is not going to work out in the long term. Going to give it my best. But I am not going to stake my happiness on this particular thing working out.”

Stephanie Goss:
Yeah. And I think that really, for me, from a manager perspective, I think the potential for it to go sideways comes from the perception of the team in two ways. One, what you're doing in the moment, right now. Like if it's very obvious and in this case, it was very obvious that this technician oversold their abilities, it's going to be obvious to the rest of the team. And so it's what you're doing in the moment and also the timeliness in which you address this. And so I think that it's really important to sit down for yourself and think, “Okay, what is a realistic timeframe and ask.”

Stephanie Goss:
Because I will tell you too many times I have seen friends and colleagues go, “I've got to deal with this situation.” And six weeks later, eight weeks later, 12 weeks later, this person is still employed, still in the same position that they were in the beginning, because we haven't put a timely plan in place and we haven't acted on it and now we're three months in, and this person still doesn't have any more skills than they had on day one and now the rest of the team is pissed. And so I think for me, when I zoom out and think about this issue, that other than the pay challenge potentially blowing up in your face and I have some thoughts on how to look at that, I think the other piece of it is the timeliness.

Stephanie Goss:
And so for me, that is, “Hey, look, if you have somebody, if you actually have skill levels and expectations for skills in your practice, and you should, even if it's to minimally to say, licensed technicians in our state should be able to and are capable of doing X, Y, and Z. When we license technicians, there are things that we say they can do. And if you're using that as your baseline and this person isn't meeting up to the baseline, the question for you is how much time are you going to put on that? And I would caution, I would really caution any of my manager friends and would caution myself to say, this is something that I probably should have a plan to fix in 30 days or less, because the reality is if I can't fix this than 30 days or less, there's a bigger conversation that needs to be had here.

Stephanie Goss:
And that goes to your point, Andy, about sitting down with the person and saying, “Hey, this is what our level 2 or level 3 techs should be able to do. And you're at skill level 1, that is a big gap. And there's no way that we can bridge that gap in 30 days.” And so here's what a realistic plan might look like. The reality is, I think it's really important to zoom out and do that time assessment because it will not take the team long to get real mad, real fast if they don't feel like things are equitable amongst their peers. And so I think you need to look at the time piece of it. And so for me, the way that I would approach… We've gone out of head space because I think the head space is, we have to focus on the present and the future.

Stephanie Goss:
That's where we started. Focus on the here and now we can't do anything about what has already happened. We have to acknowledge for ourselves that they may have not been honest and or maybe they didn't understand or a combination of those things. So we're in a safe head space. We're assuming good intent. And we're going to have a conversation with them. And we're going to say, “Hey, this is what happened. We hired you, we had an expectation for a technician coming into our practice with a license to have X, Y, and Z set of skills. You told us that your skills were here.” Whether they told you verbally, they put it in writing in their resume. Like there's a whole bunch of ways that this could have gone sideways, but be very clear about how they indicated to you what their skillset was and where you are.

Stephanie Goss:
And then it's okay to say that based on your observations or interactions with them so far, you see a gap between those two things. And then I would ask them for their help. And I would say, “I need your help to figure out how we're going to approach this, because there are a variety of options here and it needs to be addressed.” There's no getting around to the fact that you have to address this both with them and the team. And so by asking for their help and asking them, it doesn't feel so close ended. It feels like they're a part of the solution. And then the conversation can be, are they skills deficient in a few areas where you might be able to get them from where they are now to where they need to be in a short period of time. Maybe.

Stephanie Goss:
And then, “Okay, here's the plan. Here's what we're going to do. We're going to pair you with our most experienced technician. We're going to get you into, whatever the deficiency area is, you can come up with a game plan for that. If you have a very vast canyon, which it sounds like this person does, between the skills and the expectation,” then I would say, “Looking at this list, this is more than we want to support you and we want to help facilitate this training. This is more than we can accomplish in a 30, 60, 90 day period.” Whatever that time period is, here's what I need to do.

Stephanie Goss:
I need to address the pay. I need to address your skill level. There has to be a plan because that is where I think it will go sideways very quickly with the team. Is if they feel like it's not being addressed in a timely manner and when there is discrepancy with the pay and it is okay to say to someone, “Hey, we brought you in with this expectation, the skill, the pay is tied to that expectation of skill level and we have a gap. And so until we bridge that gap, I can't pay you $50 an hour or $25 an hour or whatever top end of pay scale looks like for you. I can't pay you that. Because that is not where you are skill wise. And so here's what I can do to bridge that gap.” And offer them a plan.

Stephanie Goss:
So timely, you have to address the money. And then I think the last thing is you have to live up to your end of the bargain and you have to hold them accountable. And if you don't do one of those two things, it's going to fall apart. And so I think asking them to be a part of the solution, they may say no. And they may say, “Well, I don't want, I feel confident and if you don't believe me, fine. I'm going to leave.” They may say, “Well, I feel like I'm at this level.” And they may engage and argue like where you go next could look a million different ways, which it makes it kind of hard to tie this conversation up with a nice, pretty bow, because the response from that person is so variable.

Stephanie Goss:
But I think if you, as the manager say, “I'm acknowledging what has happened. Here's where we are today. Here's where I would like us to move in such short timeframe here, future, this is what I need from you to attack this plan. Can we do this together?” I think you're going to come out of that conversation with a lot more clarity and a lot more solutions. And at the end of the day, lucky for our colleague, they're in and at will state. And if it's not going to work out, it gives you the ability to cut and run to move on.

Stephanie Goss:
But I think there definitely are ways to approach it, but for me it would involve looking at the skills and being clear about this is the gap and specific, because that doesn't make it subjective. It doesn't make it, “Well, Sarah's been here for 10 years and she thinks you can't place catheters as well as she can. So she should be making more money than you.” That's the kind of thing that the team might be feeling those things, but that's super subjective and we need to move this conversation into the objective. Here's the skills, here's the gap, here's the pay that's tied to that. How do we move forward from this moment in time?

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

Stephanie Goss:
Hey everybody, this is Stephanie. And I'm going to jump in here for one quick second and make sure that you know about a few things that are coming up, that I'm pretty sure you're not going to want to miss. But before I do that, I have to say thanks to a generous gift from our friends at Banfield Pet Hospital, we are now able to provide transcripts for all of our podcast episodes. And we have to just say, thank you, thank you, thank you so much. Andy and I have wanted to make the podcast more accessible and when we were pondering the idea of how do we make transcripts a thing, our friends at Bandfield stepped up in a big way and said, “Hey, we are striving to increase accessibility and inclusivity across the profession. This fits with that mission for us. And we would love to sponsor it.”

Stephanie Goss:
So the 2022 podcast episodes are all now being transcribed and brought to you by our friends at Banfield Pet Hospital. To check out the transcript and find out more about what Banfield is doing to increase accessibility and inclusivity across the vet profession, head over to unchartedvet.com/blog and you could find each one of the podcast episodes and a link to find out more about equity, inclusion, and diversity at Bandfield. And now I'm going to jump over and make sure that you know about some things that are coming up that I don't think that you're going to want to miss. You might not be the person who's in charge of marketing for your practice, if not write this down and pass it along. Because we are being joined by none other than the Bill Schroeder from InTouch Practice Communications.

Stephanie Goss:
Bill is amazing. He is wonderful, he is funny, he is kind and down to earth and he loves nothing more than working with veterinary practices and cheering them on about digital marketing. And Bill is joining us on Wednesday, June 8: Creating Content That Clients Crave from 7:00 PM to 9:00 PM ET, which is 4:00 PM to 6:00 PM PT. And he is talking about creating content that clients crave. He is going to teach us how to explore contents that are the most valuable and that have a huge impact and talk about proven methods for great content development. Bill did this workshop for us live, in-person previously and I said, “Hey, bill, I would love for you to bring this to the Uncharted Community, but also to veterinary medicine and beyond.” And he is doing just that on Wednesday, June 8th, if you would like to find out about this and all of the upcoming events from Uncharted, head on over to the website @unchartedvet.com/events and you'll be able to find all of the things that are coming, that you are not going to want to miss. Now back to the podcast.

Dr. Andy Roark:
This is a really advanced leadership challenge. And here's why, because there's so much uncertainty around it. And I think a lot of people, it's hard for you and me to coach in this right now, because the long term is so unclear and this could go so many different ways. And so I think that it's oftentimes kind of frustrating for the people who hear this direction, but just try to bear with me here for a second. I agree with everything that Stephanie said, and you guys have heard us talk back and forth about this, and you've heard me say, “I don't know if it's going to work.” And I don't know if it's going to work. And I can tell you if the other person doesn't want it to work, it's not going to work. And I can also tell you, I don't have any control over whether or not that person wants it to work.

Dr. Andy Roark:
And so people say, “Well, how's this going to end?” Then I go, “How?” And, “What are we going to do in a month?” I have no idea which you're going to do in the month. The frustrating thing is, you're going to go talk to this person and you're going to have your head straight and you're going to need to be nice, kind, I would like this relationship to be great, but you're going to need to be honest about what you need and where you are and unemotionally honest, meaning if they do what Stephanie mentioned, which is flip out and go, “How dare you. I could get this salary from 10 other practices in the area.” They might say that. And here's the other thing, they might be right. That does not change what your pay structure is, what you need in order to be fair to your team or what you need in order to balance the needs of all of your support staff and your clients and everything else, those things don't change.

Dr. Andy Roark:
And so you are going to have to go talk to this person and explain your position and what you need and where you are. And then you're going to have to listen and see what they say. And they might get mad and they might say, “Okay, I hear you.” I don't know what they're going to say, but when they say it, you're going to need to roll out a plan and say, “Let's talk about how we're going to get you where we need to be.” And I think you should make that plan, but know that they might not want to do your plan. And you need to think about what that means. But the other thing is, I would say, I wouldn't overthink it until they tell me, “F your plan.”

Dr. Andy Roark:
And when they say F your plan, then I'm going to say, “Okay, that's an interesting position.” I hear that. I'm going to need to sit with this response a little bit and come back to you. But you don't have to have all the answers and you don't have to know what you're going to do next, because there's no telling what they're going to say. So you have to know what your needs are. You need to talk to them about where your head's at, ask them how they're feeling, what they want to do, how you guys are going to move forward. And then you're going to have to step away and process. And ultimately, hopefully, they'll take your training plan to get where they need to go. And then you're going to try it. And it might work and yet might not work. My experience tells me, it'll be somewhere in between those two extremes, meaning it'll kind of work. I bet.

Dr. Andy Roark:
I bet they'll get better and they'll get closer to where you need. And then you'll need to reassess and be like, is this good enough? Are we moving fast enough? Are we going to reduce their compensation a little bit? Because they did make strides, but they didn't get where we needed. How are they going to respond to that? I have no idea. I don't believe there's more clarity than that. I think you are going to have to go through the process of trying this and seeing how the person responds and what they want to do. I don't think that there's a long term strategy other than what we said of be honest, tell them what you need, come up with a plan to get them where you need them to be, come up with metrics and checkpoints to assure that they actually are getting there, monitor the response of your team.

Dr. Andy Roark:
The only other action step that I would take honestly, is I would try to recruit some mentors, champions, allies from my team, meaning, can I do this training? And oftentimes if I can pull good technicians in and say, “Hey, this person's coming in, they're new, they're credentialed, I am working with them to get their skills up technically where we want them to be.” And I'd figure out how to say it based on what the response was from the individual. But I would like to recruit one or two of my techs to help mentor this person and bring them up.

Dr. Andy Roark:
That does a couple things. Number one, it can help get this person trained the way that they want to. And number two, it can take two of my strongest techs and get them off my back. You know what I mean? As far as this person's not where they are, it gives them some skin in the game and gets them involved in fixing the problem and also gets them to know this person a bit more, which might get them to give him or her a little bit more grace. And so I would kind of try to recruit some of those people into the process of training. Beyond that, I think you're just going to have to see how it goes and how they respond.

Stephanie Goss:
Yeah. I think something that you say a lot on the podcast and in general is really important here and kind of ties it all up, which is, clear is kind. And I think this is the case where you don't know how they're going to react, and if they blow a gasket, it's okay to say, “I understand that you feel like this doesn't work for you. I think that tells us everything that we need to know about the fact that this should be the time where we part ways. Because it's not going to work for you. And if you can't be agreeable to this, it's not going to work for us either. So we wish you the best of luck.” It makes it easy to have that conversation moving forward, being clear is kind. It's okay to say “There's some gaps here. There's some incongruency with what you told me.”

Stephanie Goss:
It's not about accusing them of lying. It's not about making them wrong or putting them on the defensive. It's about just saying, “Hey, here's what we need and how are we going to get there together?” And then wait and see what happens and what their response is. And when I say, wait and see, don't wait six months, don't wait 12 months. There has to be a plan. Or I promise you from my own painful, personal experience, your team will mutiny. Things will not turn out well for you.

Dr. Andy Roark:
And that's why I said, we have to get okay with the idea, this is not going to work. Because the worst case scenario is very real here. And the worst case scenario for our manager friend is our manager friend and the leadership feels resentful. Because they feel misled and duped into hiring and that they're paying too much. And the person who is hired feels resentful because they feel like they're not being honored for their accomplishments, for their education, that they're not being paid what they deserve or that they are being paid what they're deserved and everybody's treating them like crap for it and so they're resentful. And the rest of the team is resentful because they think this person's been giving status that they do not deserve based on their actual ability to do the work and they're getting paid more than the rest of the staff and they're not delivering the results that the rest of the staff does.

Dr. Andy Roark:
And so then you've got you feeling resentful, the higher feeling resentful and your team feeling resentful. That is the worst outcome. It is not worth that. And so when I say do what is kind, I mean do what is kind to the new hire, to yourself and to your staff. To me, that's, “Let's have a clear conversation and get this out in the open and then let's talk about what we're going to do. And if you are not willing to do that, I'm afraid that you run a very high risk of ending up with the resentment that we talked about.” The other thing is when we say what is kind, having this person come in and not communicating to them how you're feeling or what they need to do to keep their job and just sitting there behind the scenes going, “This is an at-will state and we can fire her. If it doesn't work, we're just going to fire her.”

Dr. Andy Roark:
I'm like, that's not a kind thing to do to somebody. If her job's on the line, tell her, her job's on the line. Say it nicely, say it with empathy, but be honest with her about where she stands and then she'll either leave or she'll, get on board with doing what she needs to do to stay. But I'm just not a fan of not communicating to people where they're at and then just pulling the rug out from under. That doesn't feel bright to me.

Stephanie Goss:
Yeah. No, I agree.

Dr. Andy Roark:
Awesome.

Stephanie Goss:
Oh man. Well, this was one of those ones that I think, I hope that was helpful. It's one of those things where you can't really tie a bow on it and make it pretty because there is a million different ways that this could go. The reason that I wanted to have this conversation is because looking back like this is one of those conversations that I wish someone had had with me as a new manager of like, “You're going to get in these situations and you're going to have to figure out how to tackle it. And if you haven't faced something like this yet, you're lucky because you will.”

Stephanie Goss:
And I wish that someone had said, “It's okay to be human.” And say, “There's some gaps.” You think either you need to take responsibility forward. And to your point earlier in the episode, you take all the responsibility, which is not right either, because this other person involved had responsibility to share honestly, and openly and maybe they didn't understand, we're not going to question the intent there, but we are going to say, “This is where we're at and there's gap here. How do we fix this?”

Dr. Andy Roark:
Yeah. Well, look, that's why I say there's social media crowd, that's like, “You should have done this.” It's like, “Morons. I didn't need that.” Anyway and I say that because here's the God's honest truth, so hear this, okay. Running a bad business is making the same damn mistake over and over again. And running a great business is making a different damnedest mistake every day. That's it. That's the truth. And so the idea that you're supposed to get it all right and you don't make mistakes and people need to get kicked from making a mistake. That's just so dumb. And that just shows me that those people do not know what they're really talking about. When I see people doing that, I'm like, “You don't, if you were actually good at this, you would know that crapping on people like that is stupid.”

Dr. Andy Roark:
Because it's going to happen to you. And the only thing is your bet, it's not going to end up on social media. And so anyway, that's it. But I hope people take that and really hear that. Because man, it took me a long time to realize that. And I'll just be honest and transparent right now was guys, I made mistakes today. Today I made mistakes. And it was things that I'll just tell you, I'm making a video for somebody. And I was like, “Okay, who is the guest that we're having on here? And how do you pronounce their name?” And I'm like, “I don't know how to say this person's name. And I'm supposed to record a video where it's going to be clear that I don't know how to say their name if we don't fix this.”

Dr. Andy Roark:
And you would think after 10 years of making videos and five years of doing podcasts, that I would've gotten it down by now where we get a pronunciation of people's names, if I don't know them. And we just today, we were like, “You know what? We should figure out how to fix this so it doesn't happen again.” And that literally happened 10 minutes before we got on this podcast. And do I feel terrible about it? Do I feel stupid? The answer is no, because I've been doing it for 10 years and we do just fine, making mistakes, not getting upset about them and then just fixing them so they don't happen again. And so guys, I want to leave you with that thought, two thoughts. Number one, success in your career is continuing to make mistakes. And if you never make mistakes, you are not doing enough and you are not trying new things. It is make mistakes and make them once, that is success. That's the first thing I want to say. And the second thing is, shut up social media. Shut it.

Stephanie Goss:
Oh, and we're off this soapbox.

Dr. Andy Roark:
And we're done. That's it. If you'll excuse me, I have to go check my Facebook account. No, I don't.

Stephanie Goss:
Have a fantastic week everyone.

Dr. Andy Roark:
Take care everybody, don't post anything on social media. We'll start a movement here. We're going to put Facebook out of business by encouraging people in our audience tonight. All right. Okay. I'm done. I'm good. See you everybody.

Stephanie Goss:
Bye. Gang, that's 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 a mailbag at the website. The address is unchartedvet.com/mailbag. Or you can email us podcast@unchartedvet.com Take care everybody, and have a great week. We'll see you again next time.

This Week on the Uncharted Podcast…

Have you ever worked in a practice where there is a hot-headed boss? Someone who is reactive? Someone who flies off the handle or is extremely emotional in their reactions to things that don't seem to warrant that level of reaction? A lot of us have worked with someone like that. The question this week on the podcast is what do we do when the hot-head is in charge? Join Dr. Andy Roark and Stephanie Goss as they tackle a fantastic question from the mailbag about what to do when the manager of the practice is the hot-head and their fellow leader in the practice isn't their direct boss who can hold them accountable for their behaviors. Let's get into this…

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

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

Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag

Upcoming Events

June 8: Creating Content That Clients Crave

Many practices have heard that “content is king”, but few have systems in place that actually generate impactful content.

This extremely interactive session will explore the types of content that are most valuable, the potential impact of such, and proven methods for great content development.

All Upcoming Events

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

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Episode Transcript

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

Stephanie Goss:
Hey, everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. Have you ever worked in a practice where there's a hothead in the building? I think a lot of us can raise our hands and say, yes, to that one. This episode is a little bit different, because we are talking about a very important question that came into us through the mailbag, and that is, what do we do when the hothead is the one in charge?

Stephanie Goss:
This was a question about a medical director wondering what to do when they have a practice manager who is the one who is the hothead. They are reactive. They come from a place of emotion rather than logics, when people question them or their judgment, or they perceive that someone is questioning them. And this medical director is wondering, what in the heck do I do with this? How do I get the team to understand that this is not acceptable behavior? How do I change the behavior, especially when I'm not actually this person's boss? This one's going to be a fun one, so let's get into this.

Meg:
And now the Uncharted Podcast.

Andy Roark:
And we are back, it's as me, Dr. Andy Roark, and Stephanie, feeling hot, hot, hot, Goss.

Stephanie Goss:
How's it going, Andy?

Andy Roark:
It's frustrating. I'm having that day where I have worked all day, and I have finished nothing. Nothing has been finished. Everything has ended with me running into a roadblock that requires waiting for someone else, or needing to make an edit after I show it to someone or… Yeah, just having to go back to the drawing board or us running out of the thing that we need. Like, I'm like, “This is finished.” They're like, “No, we're out of printer ink. It's not finished, because I can't print it, until the ink is here.” I have busted my hump today. And if someone's like, “What did you finish?” The answer is-

Stephanie Goss:
Nothing.

Andy Roark:
Absolutely nothing.

Stephanie Goss:
I hate days like that.

Andy Roark:
I took my child all the way to school. If that matches the rest of my day, Hannah would be like in the neighborhood somewhere, halfway there.

Stephanie Goss:
Or I was going to say, you got all the way home, and then they called and said, “Hey, she doesn't have her lunch or her permission slip,” or something, right?

Andy Roark:
That's right. Like, “Darn, I have to go take her lunch to school.” That's exactly where we're at. That would have been 100% par for the course today. I'm super loving the work I'm doing, but I just wish it would end.

Stephanie Goss:
Oh, man, I'm sorry. Well, those days are frustrating, because on one hand you feel really productive, because you're just chugging through and you're getting shit done. And on the other hand-

Andy Roark:
I'm super impressed, with the things that I've done.

Stephanie Goss:
… you don't feel like you've done anything.

Andy Roark:
Yeah. Oh, yeah. The work that I have done today is good work. I've worked hard. And if someone said, “Show me what you did today.” I could lay down a lot of things, and they would be like, “Oh man, you put some thought into this, and you some research here. And this is going to, very soon, be something that you're proud of.” I'm like, “Yep. It's just-

Stephanie Goss:
Not today.

Andy Roark:
… not finished.” Exactly. Right, not today. Not today.

Stephanie Goss:
Oh, man.

Andy Roark:
Oh, man. So that;s me, how about you? How were things with… You woke up with a migraine.

Stephanie Goss:
It's one of those days. This has been the longest, coldest, wettest spring we have had in the eight years that I have lived here. It is still pouring down rain, every day. But we have started having mornings where we wake up and it teases us like it's going to be sunny, and it's bright and there's blue sky, and then it starts pouring. And so I just think that like the shift in the weather and the pollen… The plants are so confused, because they're getting some sunshine, and then it starts pouring again, and there's pollen everywhere. And I woke up this morning and just was like, “Okay, my head feels like it's going to explode.” But other than that things are good. There's lots happening. We are busy, busy, busy, and [inaudible 00:04:03] it's good. It's good. Things are good.

Andy Roark:
Yeah. No, I agree. We are working so hard behind the scenes. People have no idea. We're in stealth mode, banging away, got on a bunch of stuff, let me tell you.

Stephanie Goss:
We've got some stuff coming up in the next couple of weeks that's going to come out and launch or open up. And I am really excited about a lot of the things that are coming.

Andy Roark:
No, me too. All right. We have a good question today. This is one that a lot of people I think have, and this is going to let you and me really geek out on some stuff that we love to talk about. This is a strong suit for the two of us. Yeah, let's get into working with hotheads.

Stephanie Goss:
Yep. So we got a letter in the mailbag from a friend and colleague of ours. And it was so funny, because their first sentence was, how do I calm down the practice hothead? And then the second sentence was, and how do I do that when the hothead is the one in charge? And I started laughing. I was like, oh fantastic. And then they went on to fill us in on the longer version. So this is a practice who has a practice manager, who is the one who is very reactive. And this perception is coming from the team.

Stephanie Goss:
In particular, they are really reactive when they get feedback from anybody on the team. And so they are asking for feedback from the team, and the team feels like when it is being given or when questions are being asked about things that this manager is doing, the manager is reacting from a very emotional place, not from a place of logic at all. So a example that they gave us was, hey, one of the doctors on the team had a question. The manager said they were going to look into it. In the meantime, this doctor emailed some other people to ask to see if anybody knew the answer, and included the manager in the email. And the manager went back to the associate vet and was like, “If you've got something to say to me, say it to my face, don't email my boss.” Very angry that they had emailed anybody else.

Stephanie Goss:
And so the person who wrote this to us is a medical director, so they're working directly with this manager, but they are in the position where they are not actually their boss, which is pretty common in a corporate structure. If you're not the practice owner and you're a medical director, often, the practice manager is being day-to-day managed by someone else. And so this medical director is like, “Look, I've talked to this person about these things. The team is talking to them about it. But at the end of the day, I'm not their direct boss. So I can't hold them accountable in a formal capacity. But I am talking to the team, and I am trying to set the example for the team that some of the things that are being said and done are inappropriate, and the behavior needs to be changed.” And so they were asking, “What else can I do here? I feel like my hands are kind of tied.”

Andy Roark:
Yeah, no, I like this question a lot. And the manager part adds a nice little layer of complexity. It's like an art project, it's got a nice little flare to it. We're not just buildings stick house. No, no, we're-

Stephanie Goss:
We're going to sprinkle some glitter on this one.

Andy Roark:
Exactly. We're make a cupola on top. And that makes me excited about the project. I have been spending too much time with you.

Stephanie Goss:
Or with your D&D nerd friends.

Andy Roark:
Oh, yeah, or with my nerd friends.

Stephanie Goss:
I love it.

Andy Roark:
Don't out my nerd hobbies.

Stephanie Goss:
I love it.

Andy Roark:
Yeah, I'm definitely doing more crafting.

Stephanie Goss:
That's a fairy tale word. I love it.

Andy Roark:
Yeah. Okay. Yeah. That's true. All right.

Stephanie Goss:
Andy says, “We're moving on now.”

Andy Roark:
We're going to move on now. Past my various hobbies and onto the question at hand, which is-

Stephanie Goss:
Where do we start?

Andy Roark:
… where the heck do we start? Where do we always start, Stephanie?

Stephanie Goss:
We always start with head space.

Andy Roark:
We always start with head space. All right, so usually when we talk to head space, we start talking about getting in the head space to talk to this person. I think we should get in the head space in this case of what do we think about this person? Before we even start to think about how we're going to talk, the first thing we got to do is figure out what are we going to say to them?

Andy Roark:
Why does this happen? Why do we have people who respond emotionally to feedback? Because that's what we're talking about, right?

Stephanie Goss:
Mm-hmm.

Andy Roark:
Okay. So it comes from a couple of reasons. Number one, some of us are massive perfectionists.

Stephanie Goss:
Yes.

Andy Roark:
And we don't like the idea that someone else thinks we didn't do it right. And that is a huge thing. So is it a perfectionist, and this person doesn't like to be wrong? And I know a lot of people who are like that. The idea that they did something “incorrectly,” they don't like that-

Stephanie Goss:
Yes.

Andy Roark:
… being pointed out. The other part of this and this especially comes, I see it a lot, whenever I hear, “If you have something to say, say it to my face,” and I have heard that a number of times in my career related to emails that went up the chain.

Stephanie Goss:
Sure.

Andy Roark:
Right?

Stephanie Goss:
Yeah.

Andy Roark:
That's insecurity.

Stephanie Goss:
Sure.

Andy Roark:
That is not perfectionism, and usually in my mind, and the things can go together. But oftentimes that's insecurity, which is basically, “I'm unsecure about my position here in the practice or my authority or my status, and when you talk about me or something I'm related to, I feel like my status is being challenged. And that pushes some emotional buttons for me.”

Andy Roark:
And the last thing is nobody teaches us how to take feedback. I mean, we just don't talk about it. I think about it with my own kids. And I'm like, “Have I told my kids or talked to my kids about how to take feedback?” I hope I've modeled it for them. Because I think that's the only way to really teach it is to take feedback from other people and people see you do it. And they say, “Okay, well, I see this person who I respect and that's how they receive feedback.” So those are my big three things, perfectionism, insecurity, and a lack of modeling or training in how to take feedback. I think those are some of the big reasons that we sort of start to see these behaviors.

Stephanie Goss:
Yeah. I think this is a case for me of needing to look at the other person and say, “Okay, their response, whatever that is, seems incongruent with the reaction that I would have that I personally would have, or that I would expect someone to have if they were given this kind of feedback.” And so for me, that is a situation where then I try and ask myself what else could be happening here. Or look at it from the perspective of, I clearly don't have all the information. Because, to your point, there could be multiple reasons why this is happening.

Stephanie Goss:
Maybe this is a trigger for them because they were in a situation previously where something did go wrong. And this isn't that case, but in their heads, the story their subconscious tells them is this situation is the same. And so you have that fight or flight kind of reaction. So for me, it's really about, okay, if this reaction feels wildly disproportionate to how I might react or how I would expect somebody to react, the first question that I want to ask is, what's going on inside their head?

Stephanie Goss:
And I think this is the danger zone, because a lot of times we hypothesize what could be going on, and then we pick something out of that list and make up a story in our own head about why they're reacting. And too often we don't ask them, “Hey, what's going on?” Right> and we don't-

Andy Roark:
Yeah.

Stephanie Goss:
… go to them and ask them to translate what's happening in their brain. And so from a head space perspective, I think it's really important to think, and one of the questions that I have learned to ask myself is what could be going on? And I try and think of reasons why someone might react that way. The danger in that is when you ask yourself those kind of questions, you have to do something with that to try and actually get more information. Otherwise, you're just making up stories in your head and that's going to complicate things even further.

Andy Roark:
Yeah, I agree. I think that there's a split here. Is this a one-off instance or is this-

Stephanie Goss:
Sure.

Andy Roark:
… a pattern of behavior?

Stephanie Goss:
Yeah, absolutely.

Andy Roark:
So I completely agree, if this is a one-off out of character instance, this person gets mad and that doesn't usually happen, then I think the easy thing to do is to go to them and say, “Hey, that's not like you. What's going on? Or what happened?” And go with compassion and empathy and just a curiosity to understand. And so, yeah, I completely agree with that.

Andy Roark:
The second part of that is when this is a pattern of behavior, and this person consistently does not handle feedback well, at some point you say, hey, it's not a different reason every day. It's just whenever this person gets feedback they consistently don't don't handle it well.

Stephanie Goss:
Sure.

Andy Roark:
I think separating those two things of, is this a one-off? Is this a bad time for them? Is this out of character? Or is this a pattern of just not taking any sort of critical feedback well? I think separating those things is important. Really, the other things I'll put in my mind is, this person can grow out of this behavior. And I have a 100% seen people move past this specific behavior. I have worked with people who reacted strongly or emotionally to negative information and negative feedback. And they decided they didn't like that, and they came to realize that they were shooting themselves in the foot, or that they were their own worst enemy, or they made situations significantly worse. And that experience for them allowed them to decide they were going to do better.

Andy Roark:
And this is something that if the person wants to move past, I 100% believe you can move past it. I believe that we can be the masters of our emotions. If people are serious about changing this behavior, they can change it. I don't buy into the idea of, “That's just how I am. I can help it.” Yes, you can help it. But they have to want to help it, which means there is no feedback that I can give, if they don't see the problem. They have to want-

Stephanie Goss:
Yep.

Andy Roark:
… to change this behavior about themselves. And so to the point of the writer, at the very beginning, I would say to them, “You're right. You are not going to change this person, unless they want to change.” And here's the other thing, it doesn't matter if you are their boss, if they don't see a problem=.

Stephanie Goss:
True story.

Andy Roark:
… you're not going to change them. It doesn't matter. And so really I think if you internalize that, I think that that gives you a lot of options in how to approach it. And ultimately that's the path to success is, “I can't make this person do anything, but I can talk to them honestly about the repercussions of how they receive information and the effect that they're having when they react this way on other people.” I can say to them, “Honestly, this is career limiting,” and it is. “Your ability to move up or to do other things or to expand or to take on more responsibility or be in this role as the hospital grows-

Stephanie Goss:
Yes.

Andy Roark:
… all those things are limited by your inability to receive critical feedback without getting angry.”

Stephanie Goss:
Yes.

Andy Roark:
And the other thing that I tend to say to the people that I think is helpful, is, and this is true to some degree, “It's not necessarily about the way you respond. It's about the way that your response affects other people, and how they interpret your response.” And so, for whatever reason, I think that's a much more palatable thing than, “You are hurting everyone's feelings.”

Andy Roark:
To say, “Your reaction is being highly scrutinized. And people are really taking it very, very seriously, and are making assumptions that you don't like them or that you are angry and will continue to be angry at them. And it is undermining your relationship with them and their productivity, because they're out for the rest of the day, mentally checked out.” I think that those are helpful ways to approach the conversation that we have and just kind of try to lower the stakes for the individual.

Stephanie Goss:
I think that's a smart distinction. And I think, for me, I agree with you, I think people can grow in this regard, and where I have seen the most growth in my own team and my own experiences have been situations where something has been said to the person that finally unlocked for them. Not so much, it was their behavior, although that was a part of it, but it was how other people were viewing their behavior or the impact that it was having on the other people. That once they saw that really truly heard it and saw it, it was like, “Oh, I never would want to hurt people that way.” They understood that it was coming across in a very negative and a very, in some cases, hurtful way.

Stephanie Goss:
And that, for whatever reason, it was like, the conversation had been had different ways multiple times, I was at the point where it felt like I wasn't getting through to this person. And then there was a conversation where it was unlocked, and they were like, “Oh, other people are perceiving what I'm doing as bullying. I'm perceiving myself as just being angry. And letting off steam and doing what I do.”

Stephanie Goss:
But for them, it was finally hearing the perception that it wasn't coming across angry, it was coming across bullying or whatever that was, it unlocked-

Andy Roark:
Sure.

Stephanie Goss:
… that emotionally for them on a way that allowed them to grow with it. So I think that's a really important distinction. Sometimes it is also about their own actions and what they're doing, but sometimes it's just about the perception that other people on the team are having and the impact that has.

Andy Roark:
I would say, it's always about the impact they're having on the other people. Unless, okay, now let's get into the nuance of getting angry a bit, because this is important and it's not black and white, no one ever gets upset, no one ever gets angry, and I think that's really important. We are all human beings-

Stephanie Goss:
Yes.

Andy Roark:
… we're not the Buddha.

Stephanie Goss:
Yes.

Andy Roark:
And I have a 100% worked with people who will come and give me horrible news, and then be upset that I am angry about the news that I received. You know what I mean? I mean, it would be something awful. Like, I don't know, like, “Your patient just died.” And I'll be like, “What?” And they're like, “Why are you so upset? Don't be upset.” And I'm like, “Of course I'm upset. Not at you.” To some degree, I use that as an awkward example of, we're human beings dealing-

Stephanie Goss:
Yes.

Andy Roark:
… with emotional things. There is some amount of giving people the grace to react to this situation and the news. We're not robots. And your boss is not the Buddha. And I think seeing them as a real person, just like you, I do think that there's some point to that.

Andy Roark:
I also would go along with the idea that communication happens at the ear, not at the mouth. And that's also why anger is so interesting to me, it's because we all perceive anger very differently.

Stephanie Goss:
Yes.

Andy Roark:
And it can be very different among families. It's very different among cultures. I grew up in a family where people did not raise their voices to each other, very often. It almost never happened.

Stephanie Goss:
Yes.

Andy Roark:
And I know other people who come from loving families that scream at each other-

Stephanie Goss:
Yes.

Andy Roark:
… all the time.

Stephanie Goss:
Yes.

Andy Roark:
And I remember being a young person, I remember being an adult, and I've gone to people's houses and they're yelling at each other.

Stephanie Goss:
Yes.

Andy Roark:
And I'm like, “I feel so awkward. I shouldn't be here. This is…” And then they're like, “And we're ready for dinner. Let's everybody sit down.” And we're like, “Okay.” And then it's like, it never happened. And I'm like, “Do you understand the fallout of that yelling exchange at my house?” That would be-

Stephanie Goss:
Yes.

Andy Roark:
… a big deal. And they're like, “Nope, that's just appetizers.”

Stephanie Goss:
Welcome to holidays at my in-laws.

Andy Roark:
And, again, at casa Goss.

Stephanie Goss:
It's true. It's totally true though. It's a big difference within families. And it is jarring when you are used to or have grown up in a situation or culture that is vastly different than the one that's being presented. And I think the same kind of thing applies here, because I have worked with people who grew up, so to speak, in clinic environments that you would look at and say, “This is the quiet family.” And then you go to the family's house where they communicate by shouting at one another, that is a very jarring experience.

Stephanie Goss:
And so I think that that applies very truly here that people can, not only on a personal level, have grown up in different ways and experience different things throughout their life, but also from a work perspective.

Andy Roark:
Sure.

Stephanie Goss:
There is culture in our practices and people are impacted by that and their reactions and the way that they respond often are conditioned and influenced by that.

Andy Roark:
Well, I mean, the other part of this that feeds into it too, one is how people respond by getting angry or yelling or whatever, the other part is, how they give feedback-

Stephanie Goss:
Yes.

Andy Roark:
… which is another part of this equation.

Stephanie Goss:
Yes.

Andy Roark:
My wife's extended family, a big piece of that extended family is from Nicaragua. And they are, shall we say, direct with each other. They a 100%b would just say how they're feeling about what you just said, right to your face, in very clear language. You know what I mean?

Stephanie Goss:
Uh-huh.

Andy Roark:
And it's kind of, you think of, I don't know, conversations on, I don't know, like Pawn Stars or Jersey Shore, where people are, they love each other, they are right up in each other's face. That's how they communicate. And I'm just like, “Oh, boy, if someone gave me feedback that direct, I would have to process that.” And they're like, “Nope. I said you were lazy, and I meant that you were lazy.” And I'm like, “Wow, you guys just went at each other.” And they're like, “Nope, we're just communicating how we feel.”

Andy Roark:
And, again, I say all this and we're laughing, the point is that is a 100% fine, as long as everybody's on board, and we all know what the ground rules are, and we're all comfortable communicating that way. That's why it works in families. Families can all yell at each other as long as they're all comfortable giving and receiving yelling. And a lot of people are. And so I'm not judging. It's just, for me, I go, “Holy crap.” I can see people saying, “Wow, that guy was yelling and that's really bad.” And he's going, “That's just, I was just communicating.”

Andy Roark:
And I also see other people saying, “Why does this person get so upset when I give them feedback?” And I'm like, “Oh, buddy, the feedback you are giving is extremely direct. And maybe not gracefully given.” And they go, “Well, that's how I give feedback in my family,” or, where I came from before.” And so all of that, I just introduced, to intentionally muddy the waters a little bit around this person responds in an emotional way. I go, this is not as cut and dry as people like to think it is. And I think that's good because it's much easier to coach people when you are in a little bit of murky water. When it's not, “Hey, you are clearly the bad guy who needs to change.”

Andy Roark:
It's much easier to say, “Hey, look, everyone is different in how they give and receive feedback. Everyone is different in their comfort with emotion and showing emotion. If you're not bad, you're not wrong even, you are being perceived this way. And there are other people who will perceive you this way as you go on in your career. And while you're not wrong, you are less effective than you should be or could be. And there are some changes you can make to make yourself much more effective.” And I just think that's so much easier to think and to say than to try to say, “You are a bully and people are complaining.”

Stephanie Goss:
Yeah. I think the other thing, I like that we're talking about the murky waters, because I think it is important to be able to see some perspective from both sides here. Because like you said, it's not cut and dry that we're talking about someone who is a horribly toxic person, and their behaviors are like, “This is flaming and it just needs to go.” We've had some episodes where we said, “This is our answer, because it's clear cut.”

Stephanie Goss:
I don't think that this is the case. The one thing I will say that, for me, brings things into focus and gives me a good direction to head in is that our writer said a lot of the communication here that is problematic is happening over email. And so I think it crystallizes it for me because email lacks the ability to read tone and emotion, the way that you can, when you're in a room with someone and you're looking at their face and you're hearing the tone of their voice, and you're seeing their body language.

Stephanie Goss:
We were talking about communicating in families and that kind of environment. And I am a big advocate that there should be professional bars set in our workplace. And I'm not a fan of the idea that let's just have one big happy family at work, because I haven't seen that work out too well, too often. And so, for me, that's something that I struggle with. And the area where I feel like it allows us to have some focus here is that we're specifically talking about most frequently the context of email. And so that is something that makes it actionable for us, because it's not like they're all sitting in the same room. And so it makes the ability to coach and make it actionable a little bit easier, I feel like.

Andy Roark:
Yeah, I agree. And the last part of me for head space is if you are someone who deals with this person and you have to deal with these blowups, you're dealing with this. I think you need to get a head space for that. And the head space for me is personal boundaries are important to me. And dignity is important to me. And self-respect are important to me. Which means I am not going to have you trample on my dignity-

Stephanie Goss:
Sure.

Andy Roark:
… and I am not going to abandon my self-respect and let you yell at me. I'm just, I'm not going to do that. And I would encourage people to decide what are you willing to tolerate? And what are you not willing to tolerate? And this is beyond your practice protocols. It's the ability and the willingness to say, “Excuse me, I don't appreciate you speaking to me like that.” And people say, “Oh, my God, you say that.” And I do. And the reason I would say that is because you have a choice to make, when you deal with someone who reacts this way, do you want to have awkwardness as you deal with this person getting angry? Or do you want to have resentment, because you didn't deal with this person getting angry? And now they have continued to act this way and you don't know when it's going to happen again.

Andy Roark:
And this doesn't have to be a first time it happens, I'm ready for it. But if this is a thing that happens, at some point, you have to ask yourself, “Am I willing to be spoken to like this?” And if the answer is, no, that doesn't mean I'm going to get mad. It doesn't mean I'm going to yell back. I'm not, but I am going to tell you, “Listen, I do not appreciate being spoken to like that.” And it may not be at the time this person is reacting emotionally.

Andy Roark:
I may come back and say, “Hey, can we talk about yesterday afternoon? When you did this, it was not acceptable. And it ruined my day. And I went home and talked to my spouse about it, because that's how much it bothered me. And I want you to know that's the effect it had on me. And I'm not willing to have those conversations or be treated like that again. And I'll go get another job.” Seriously, and I do believe in that. There's plenty of vet jobs out there, and I'm not going to be yelled at. And it's funny, you can back people down real fast if you just tell them that.

Andy Roark:
And again, I'm not trying to be callous. I'm not trying to be a jerk. I'm being honest about what I need to be in this relationship. And I go back again and again, to what we always say is that, “Guys, your job is a relationship, and you should treat it like a relationship. And I'm not going to be in a relationship with people who yell at me.” And I would say that to people I call my friends. I would say that to my family members. Like, “Hey, I'm not going to call you if you're going to yell at me and berate me. I'm not putting myself in that position, and you need to know that.” And that's why I go back to personal boundaries, to dignity and self-respect, is go, “I'm not willing to tolerate this.” And I will tell you that. And you can do with that information, what you will. I'm not kidding.

Stephanie Goss:
Well, should we take a break here and then jump into, how do we take this head space and try and address some of what is happening?

Andy Roark:
Yeah. I think that there's a lot of stuff that we can do. I think this is usually I can get pretty good outcomes on these conversations. So yeah. Let's take a break and then we'll get into it.

Stephanie Goss:
Okay.

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

Stephanie Goss:
Yeah, what do you want to talk about?

Andy Roark:
Man, I hear from people all the time that are overwhelmed, because the phones never stop ringing.

Stephanie Goss:
Yes.

Andy Roark:
And I'm sure you hear from these people as well. Our caseload is blowing up and the doctors are busy and the phones just don't stop.

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

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

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

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

Stephanie Goss:
Hey, everybody, it's Stephanie. And I want to jump in here for just one quick second and make sure that you know about a workshop that's coming up from the Uncharted community that you are not going to want to miss. Now you might not be the person who's in charge of marketing for your practice, if not write this down and pass it along, because we are being joined by none other than the Bill Schroeder from InTouch Practice Communications. Bill is amazing. He is a wonderful. He is funny. He is kind and down to earth, and he loves nothing more than working with veterinary practices and cheering them on about digital marketing.

Stephanie Goss:
And Bill is joining us on Wednesday, June 8th, from 7:00 to 9:00 PM Eastern, which is 4:00 to 6:00 PM Pacific. And he is talking about creating content that clients crave. He is going to teach us how to explore contents that are the most valuable and that have a huge impact. And talk about proven methods for great content development.

Stephanie Goss:
Bill did this workshop for us live in person previously, and I said, “Hey, Bill, I would love for you to bring this to the Uncharted community, but also to veterinary medicine and beyond.” And he is doing just that on Wednesday, June 8th. If you would like to find out about this and all of the upcoming events from Uncharted, head on over to the website at unchartedvet.com/events. And you'll be able to find all of the things that are coming that you are not going to want to miss. Now back to the podcast.

Andy Roark:
All right. You ready to unpack this a little bit?

Stephanie Goss:
Yeah, let's do it.

Andy Roark:
All right, cool. Let's jump into specifics here. So specifics, as we have this conversation, number one, lower the stakes. It goes back to what we were talking about before. I don't want this person necessarily to feel judged, any more than I have to. I want to make this not a big deal. When people have a personal flaw, like a personality trait that's causing problems, it is easy for them to feel like you are attacking their identity and who they are. And that can stimulate strong emotions, feelings of shame, things like that. None of those things help me change this person's behavior.

Stephanie Goss:
Sure.

Andy Roark:
And that is why I'm going to go ahead and try to lean into what we talked about before of, “Hey, communication happens at the ear, not at the mouth. And you are being perceived in this way, or you are having these negative effects on people when they are seeing this emotional response, or hear this specific language,” to try to lower the stakes.

Andy Roark:
Number two, and you heard me just kind of stumble on it. You can't say, “You're being a hothead. You're getting angry.” Because people will say, “No, I'm not.” You need to speak in specifics. What are you talking about? Are they raising their voice? Are they using foul language? Because that is not acceptable, that's in the employee handbook. And that's not okay. Are they giving feedback that is being taken as, I don't know, mean. Exactly what feedback are we talking about? We got to give them examples. It's not fair to say, “Hey, when you give feedback, people really don't like it.” And they're like, “What do I do? Or what am I doing? And they're, “I don't know. Whatever you're doing, they hate it.” And they're like, “Well, I don't know what to do with that.” So we've got to speak in specifics.

Stephanie Goss:
And I think that goes on both sides. And I want to pull something out from some of what was shared with us. Our medical director said, an example of one of the emails was that they had sent an email to multiple people on the team saying, “Hey, when you guys do this thing,” and told them what the thing is, they told them what their response was. But the way that they phrased their response was, “This feels like a slap in the face to me, and I'm not going to tolerate it moving forward.” That is a really good example of where it's not clear. It's not specific.

Stephanie Goss:
So giving them the example is wonderful, you should tell them exactly what happened. They need context, but telling them that it feels like a slap in the face to you, what does that mean? That's so subjective there, that could be interpreted a million different ways by five different people on your team. And to follow it up with, “I won't tolerate it,” feels, again, very subjective. Because, again, what does that mean?

Stephanie Goss:
Does that mean that you are not going to talk to me anymore? Does that mean that you're going to write me up? Does that mean you're going to report me? What does that actually mean? And so I think on both sides of the equation, everything for me around this has to do with very clear action steps, and giving clear examples and clear responses on both sides or you're not going to get anywhere.

Andy Roark:
I agree. I also go back to our email 101 rule that we talk about quite frequently.

Stephanie Goss:
Yes.

Andy Roark:
Anything that is going to elicit emotion or that you have a motion tied into-

Stephanie Goss:
Yes.

Andy Roark:
… that's not an email my friends. That's at least the phone call. And that's just it, it's too easy to misinterpret tone, to read tone in. We have all heard people reading things in the worst possible assumptions being made.

Stephanie Goss:
Yes.

Andy Roark:
And they're like, “Can you believe he said, ‘That's fine, see you later.' Can you believe he said that?” And you're like, “I don't think he said, ‘That's fine.' I think he said, ‘That's fine.'” And they're like, “Nope, that's not what he said. He said, clearly, ‘That's fine.'”

Stephanie Goss:
It's so funny that you called that out, because that's actually an improv exercise that I learned in school. And I actually love doing that with my team in team meetings. You can 100% take a phrase, couple of sentences at the most, and have five people read it. And tell them, “Read it however you want to read it.” And you will get five different tones, five different inflections, five different emotions played into the exact same wording. And so you want to talk about eye opening for your team, when you're talking about customer service stuff or stuff that's coming in from clients, it's a great example. And it applies here to the team, too, when you're talking about sending emails to each other, particularly. You're spot on, you're going to have different reactions from different people.

Stephanie Goss:
And so it's funny, because you were saying earlier that we don't get taught how to take feedback. And I would say that one of the things that it often is not taught enough either is how to write professional emails. And it's funny, because I actually took a class in business school about business communication, and one whole semester was on email, and it was a short course. But it was weeks of how do you write professional emails? What things go into them? What don't? What kind of grammar? How do we use language appropriately? And that is something that I think that we don't teach enough, just in general, as a life skill. And then when we take people, a lot of times in veterinary medicine, and we promote them because they're good at the job they had, we don't often equip them with the skills that they need to be successful in the job that they have now.

Stephanie Goss:
And this for me is usually an example of one of those things. Because we think it should be common sense for people to know what should go at an email and what should not, but it is not. That is a teachable skill and it is something that we don't often put enough emphasis on. And so I think that part is really important. Teaching our teams, “Okay, these are…” I love how simply you state the rule. Like, if this is something you have emotion for, or you feel like it might elicit an emotional response on the part of the other person, don't put it in email.

Andy Roark:
Yeah. People-

Stephanie Goss:
Simple rule.

Andy Roark:
… overuse email. They do. Emails should be short.

Stephanie Goss:
Or text.

Andy Roark:
They should be… Exactly, or text, especially text. There should not be any emotion in text. It should be a hundred percent straight up wrote information that this is what… What time are we meeting? Thank you.

Stephanie Goss:
Yes.

Andy Roark:
What is the phone number?

Stephanie Goss:
Yes.

Andy Roark:
I will be there five minutes late. It should be straight up communications like that.

Stephanie Goss:
Yes.

Andy Roark:
People way over use email. It should be short information exchanges.

Stephanie Goss:
Yes.

Andy Roark:
Two things I would say on that. My favorite one, when we talk about tone, my favorite example is this, it's, “I didn't say you made a mistake.” “I didn't say you made a mistake.” “I didn't say you made a mistake.” “I didn't say you made a mistake.” “And I didn't say you made a mistake.” And those are all different.

Stephanie Goss:
Yes.

Andy Roark:
And they're a 100% the same phrase, and it is just, where do you put the emphasis on that? And it's a joke, but it's not a joke. And that is why I say, “Anything that has emotion, just text is not the right way to sent it. It's just not.” So there's that.

Andy Roark:
The other thing, as far as your professional email course, I will say this, I have been thinking about this recently. I believe that the most valuable videos on YouTube are the boring videos of things you do all the time, and would never watch a video of. I think the number one how-to YouTube video that anyone should watch is how to use your own cell phone. And people are like, “I'm not watching how to use my iPhone.” I'm like, “I bet the amount of time and quality of your life would go up substantially, if you watched the 25 minute, here's the top 10 tricks you didn't know about your iPhone. I'm confident of that.” In that vein, I think a class on how to write a professional email, everyone goes, “Other people need that, I don't need that.” I'm like, “You should take the freaking class.”

Stephanie Goss:
Everyone needs it.

Andy Roark:
Everyone probably needs it. And it's just one of those things where, yes, you would sit through it, and yes, you would probably pick up two or three little things, but those two or three little things might save your bacon a couple of times throughout the 30 year career of you using email.

Stephanie Goss:
I will tell you, I took that class 20 plus years ago, and I couldn't tell you three quarters of the content, but I will tell you the three things that stuck with me from that class I don't ever do when I'm putting it… Your point is solid. There were three things that stuck out to me, and every time I write an email, I hear the professor's voice in my head, and I'm checking to see, am I doing or not doing those three things? I think it's super, super valid.

Andy Roark:
So, yeah, I agree with that. So get off email, separate the person from the behavior. And I know we've said this a couple of different ways. Let's talk about the behavior-

Stephanie Goss:
Yes.

Andy Roark:
… not about the person getting angry.

Stephanie Goss:
Yes.

Andy Roark:
Maybe they need anger management classes. I don't know and neither do you. They need to not communicate in the way that it's making others believe that they're angry. And if they need to go to anger management to accomplish that, then that's fine. But separate the person from the behavior. And let's talk about the behavior, not about the person as someone who can't control their emotions.

Stephanie Goss:
I agree. And so our medical director asks like, “Okay, I'm not their boss-

Andy Roark:
Nope.

Stephanie Goss:
… so what can I do?” It doesn't matter whether you're someone's boss or not. You're a human being who has to interact with them on a regular basis. And so there's nothing wrong with you speaking directly to them about the impact that it has on you or the impact that it has on you and the rest of the team. And so, for me, I think the action steps start there. And I think the point you just made about separating the person and the behavior is really important.

Stephanie Goss:
And so, for me, it's about assuming good intent and trying to come from a place of good intentions. And I always start with asking for help, because I could probably count on one hand the number of times that I have asked somebody else for help and they have flat out refused. And so, for me, it is, “I need your help.” And then give them a specific, “The other day when you sent the email about,” and tell them exactly specifically, so that they understand the email that you're referencing. “When I read the section on you telling the team when they do this thing, it feels like a slap in the face. My response, my emotional response, or my interpretation of that was X.” And tell them how that made you feel.

Stephanie Goss:
By intentionally using words like, “I responded this way,” or, “I interpreted that to mean,” or, “I thought,” “I felt,” you are taking it onto yourself and there's nothing wrong with how your brain interpreted it. You're not saying they're wrong for doing it that way. It's not about them. It's about the behavior, and how the behavior made you feel or made the team feel. And then say, “That really bothers me, because,” here's why. “It bothers me because I feel like I did something wrong and I thought the conversation that we had as a group went really well. And so that leaves me really confused.” Whatever it is, and then just ask them for help, tell them what you need. “Can you tell me more about what you were thinking when you sent that email? Because, I really want to understand where you were coming from.”

Andy Roark:
I love that. And, also, one of the other things I really loved about that is it shows the differences in you and me, because I love it. I love it, because so a 100% you and I were lockstep through the whole, “Hey, I need some help when you sent that email yesterday, and it said the thing, this is how I interpreted it-

Stephanie Goss:
Sure.

Andy Roark:
… and I've heard that the team interpreted it similarly.”

Stephanie Goss:
Sure.

Andy Roark:
And then here's where you and I diverge. And I don't think those are right or wrong, I think some of it is who you are as a person.

Stephanie Goss:
Sure.

Andy Roark:
And some of it, I would say, is probably who you're talking to. So Stephanie Goss says, “I felt this way,” or, “It made me feel this way,” or, “This is the effect that it had on me.”

Stephanie Goss:
Sure.

Andy Roark:
And that is good and powerful. I would a 100% step away from you, and my first inclination is to say, “Hey, this is how it made my life harder, which is… And this is what you said, and this is how I took it. And I know it's how the team took it.

Stephanie Goss:
Sure.

Andy Roark:
And as a result, I've been dealing with upset technicians all day long, and it's making my life really hard. And I need your help to not put me in a position where I'm dealing with angry, upset people-

Stephanie Goss:
Sure.

Andy Roark:
… for three days, because of an email that I don't think really represents what you were trying to say.” And I'd say that, and again, it's not right or wrong, but Stephanie goes to, “This is how this is how I was affected.” And I go to-

Stephanie Goss:
Sure.

Andy Roark:
… “This is-

Stephanie Goss:
“This is the impact.”

Andy Roark:
Unemotionally, this is the impact that you had on me.”

Stephanie Goss:
Sure.

Andy Roark:
And again, I'm not saying right or wrong. It's a 100% who you are. I am a very goal-oriented person. Stephanie is a very relationship-oriented person. And so we do it differently, and it's not right or wrong.

Stephanie Goss:
Well, and I think you're spot on. And the other thing that I would say is that the approach that I would take, there are absolutely times where I would take your approach.

Andy Roark:
Sure.

Stephanie Goss:
And for me, it's about how does the other person I'm trying to talk to communicate as well, right? So you are very-

Andy Roark:
Yes.

Stephanie Goss:
… like you said, you're very goal-driven and I am very relationship-driven, and so that is my natural default to think that way. And at the same time, if I am talking to someone who is a no bullshit, keep it short, let's just have the conversation kind of person, I'm probably going to say, “This has been the fallout. This has been the impact that it has had on me or on the team.” And I would probably use that tactic.

Stephanie Goss:
And so I think they both are right. And they both have value. And I think it's really important to figure out for yourself what you need to relay and also where they are at. Because, in order for the conversation to move forward, most successfully, sometimes it's much more important for us to flex into their style or to lean back into our own natural state.

Andy Roark:
Yeah. I couldn't agree more, a 100%. I would absolutely flex over into your relationship style, depending on who we're talking to. If I'm talking to a relationship person, that's where I would lean. Other than, “Hey, I've been inconvenience by this,” I would lean into our relationship.

Stephanie Goss:
Sure.

Andy Roark:
I just love that. You said that because I was right with you-

Stephanie Goss:
I love it.

Andy Roark:
… and then you kind of made a move and I'm like, “Ooh, that's not the move I would've made.” And then it just made me think about, oh, that's how Stephanie and I are different.

Stephanie Goss:
Yes.

Andy Roark:
But again, it's your go-to default, but I think your point is maximum effectiveness comes from knowing the other person and making the move that connects with that person. So anyway, I'm glad that you did that. I think what I would say, and how I would say it is, “Hey, I need your help with something.”

Stephanie Goss:
Sure.

Andy Roark:
And then I would just tell them, “This is what's going on. This is what the email was. This is how I interpreted it. And it's how I know a number of members of the staff interpreted it as well.” And this is-

Stephanie Goss:
Sure. Because I-

Andy Roark:
… the impact that's had.”

Stephanie Goss:
Yeah. Absolutely, “Because I've been having people come up into my office or come to my desk all day long, because they are feeling very hurt or very angry” or whatever the impact is. That's a very powerful tool.

Andy Roark:
Yep. I agree. And so I really do think that is the conversation to have. This person is not your boss, they're not your boss and you're not their boss-

Stephanie Goss:
Yes.

Andy Roark:
… which just makes it have a conversation like a friend or a peer. The best thing is for a mentor to say, “Hey, my friend, we need to talk about this.” And frame this in a developmental conversation. And we talk about giving feedback. And if you are their boss, you have a couple different levers to pull. I would still not pull a correctional lever if I didn't have to.

Stephanie Goss:
Sure.

Andy Roark:
I would still lean much more into, “Hey, I like you. I think you're doing a good job. The number one developmental challenge that you are facing right now, to be a more effective leader, is” this perception. “That is the number one thing you need to overcome in the next year. That should be priority one in self-improvement and professional development for you to get where you need to go. Because that is the biggest thing that I think holds you back or could potentially hold you back in the future.” And that is a coaching conversation. “I'm your biggest fan. I want you to succeed. I'm telling you, buddy, this is the thing, you got to fix this. You got to nail this down. And I believe you can, but you have to want to do it. You have to do it.”

Stephanie Goss:
Yeah. And I think the important part of the conversation is that it doesn't really matter whether you're their boss or they're your boss-

Andy Roark:
No.

Stephanie Goss:
… or vice versa. Really, for me, anybody on the team should be able to have the kind of conversation that you and I just talked about to say, “Hey, look, I need your help, because this is what happened. And this is how it impacted me,” or, “this is how it made me feel.” The other members of the team should be able to have that conversation directly with that person. And so for our medical director, I know them and I know that they not only talked to this person directly, but I'm sure that they also coached other members of the team to try and get them to have the conversations directly, because that kind of communication is important to them.

Stephanie Goss:
And at the same time, I think it doesn't matter whether you are their direct boss or not, if you are taking it to the person who can do something about it. So if I am taking it to the manager and saying, “Hey, this is what happened. I need you to work with me here, because this was the impact or this is how it made me feel or the team feel,” or whatever. And you've had that conversation, especially if you've had that conversation repeatedly, which our medical director friend has, then it is not wrong to then manage up, and ask for help with this situation, because you have tried to fix it yourself.

Stephanie Goss:
And so if you have tried repeatedly and you can clearly define the steps that you have taken for someone else, it is not wrong to go to your boss or their boss and say, “Hey, here's the situation. Here's what I've done to try and fix this. I am at a point where I feel like I need some help, because I'm not getting any traction. And I really want to resolve this situation. Can you help me figure out what comes next?”

Stephanie Goss:
You're not asking them to solve it for you. You're not asking for them to take the problem on. Now, they may look at it and say, “This is not your problem. This is my problem. I will have the conversation,” but you were asking them for help, and managing up in that way, again, is a skill that we don't teach and we don't learn. And it is often looked at as, “Well, you're just telling on them.” And that's not what you're doing.

Stephanie Goss:
But there is absolutely an expectation, for me, at that level of professionalism. And if I have had a conversation repeatedly, and I have asked for changes in the behavior from a person that I have a relationship with, and I am supposed to be in a working partnership with, as a medical director and as practice manager, if I have set my expectations, if I have been clear about my boundaries, if I have had those conversations and asked for their help, and the behavior is still not changing, your next step should be to ask for someone else's help.

Andy Roark:
Yeah. I agree. And the comeback to, “You should say it to my face,” is, “I did say it to your face-

Stephanie Goss:
Yes.

Andy Roark:
… three times. And then yesterday you did this thing, and the behavior doesn't seem to be changing or this-

Stephanie Goss:
Yes.

Andy Roark:
… continues to be a problem.

Stephanie Goss:
Yes.

Andy Roark:
That's it.” But, no, I completely agree with you. I think it's really good. The last little caveat I'll put it in, which should have gone at the very beginning, but I just kind of thought in my mind, I'm like, we didn't say this clearly. But I feel like we probably should is, don't get mad yourself. Confronting the hotheaded person-

Stephanie Goss:
Yes.

Andy Roark:
… when you are triggered-

Stephanie Goss:
Yes.

Andy Roark:
… is probably, it's like, “Hey, I'm going to put this fire out with a powder keg I happen to have laying nearby.” Yeah, that's not good. “I'm going to douse this fire with some gasoline, that'll settle it down.” Nope. Make sure that you are not angry when you talk to the person. Which means going to them and saying, “Hey, I need your help. Yesterday, when you sent this email, I was really affected. And I'm not affected now, but, boy, I took-

Stephanie Goss:
Because I'm-

Andy Roark:
… that in a negative way-

Stephanie Goss:
Yes.

Andy Roark:
… yesterday.” And that just makes this conversation a lot easier as opposed to, “How dare you, sir. How dare you send me an email like this,” and you slap them with your latex glove and demand satisfaction with a catheter dual. No, it's not… Boy, [inaudible 00:53:43]… You okay, Steph?

Stephanie Goss:
That's the end of this episode.

Andy Roark:
That's the end of the show. That's it, we're done. I got nothing else. All right, guys, have a wonderful week everybody.

Stephanie Goss:
Have a fantastic week.

Andy Roark:
Don't get angry and send emails to anybody. That's your homework, until next one.

Stephanie Goss:
I love it. Have a great week, everybody. Take care.

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

This Week on the Uncharted Podcast…

This week on the podcast, Stephanie is joined by Joe Axne of IT Guru to talk about some of the wacky things that clinics do when it comes to information security and technology. Information technology (IT) can be an area where veterinary medicine struggles to keep up-to-date. It's a good example of you don't know what you don't know. We talk through some of the things that practices should consider in terms of protecting themselves from the outside as well as the top practices for educating themselves and their teams about information security. Let's get into this…

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

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

Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag

Upcoming Events

May 21: Retain Your Team: Speak the Languages of Appreciation in Your Workplace

You can be the leader of a happier, more satisfied team, and it starts with understanding how each person in your practice feels the most valued.

Join us as we discuss the languages of appreciation and how they can help you motivate, train and retain your staff in this 2-hour, LIVE workshop.

June 8: Creating Content That Clients Crave

Many practices have heard that “content is king”, but few have systems in place that actually generate impactful content.

This extremely interactive session will explore the types of content that are most valuable, the potential impact of such, and proven methods for great content development.

All Upcoming Events

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

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Episode Transcript

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

Stephanie Goss:
Hey, everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. So, this week on the podcast, I am not joined by Dr. Andy Roark. But in fact, I am joined by another person who I really enjoy having conversations with, and that is my friend, Joe Axne, from I.T. Guru. Now, we are going to nerd out. We're going to get extra nerdy about information security and technology on this episode.

Stephanie Goss:
It's a little bit different than our normal format, but I promise that I have a reason for wanting to have this conversation with you guys. I recently was a part of a conversation on a management forum about something that had nothing to do with what we're talking about here. But in the course of talking to this manager, they revealed something that their team was doing that is a common mistake that I see practices making all the time.

Stephanie Goss:
When I thought, “Oh my gosh, this is a big, giant flaming red flag. And this is something that more people need to know is big problem and talk about.” So, I sent Joe an email. And I said, “Hey, I know that you see this all the time. I would love to jump on and have a conversation with you about this issue and more. Things that we need to do to educate ourselves on how to keep our clinics, our clients' information, our team's information safe from the outside in. And from the inside out.” So, let's get into this one, shall we?

Meg:
And now the Uncharted Podcast.

Stephanie Goss:
Hey, everybody. It is Stephanie. And while I do not have my usual partner in crime, Andy Roark here with me this week, I am super excited to introduce you guys to one of my friends. I have been throwing around the idea of doing an episode like this with Joe for quite some time. And I'm super excited that Joe Axne from I.T. Guru is here with me today.

Stephanie Goss:
Now, Joe and I met, gosh, probably four or five years ago. I met you at VHMA. Joe was actually presenting at the Annual VHMA Conference. I think we might have been in New Orleans. I will tell you guys, I was still working in the practice. And Joe was talking about IT-related things. In his session, he had a picture of a clinic that he was working with. And he had before-and-after pictures of what their IT closet setup looked like.

Stephanie Goss:
I remember sitting in that session and I immediately was texting my practice owners from your session, Joe. And I was like, “We need to hire this guy. This is amazing. Our attic looks like the rat's-nest-before picture he showed. And now I want it to look like the after pictures.” I came up to you afterwards. And I remember telling you, “Hey, I would love to talk to you and pick your brain.” And I have really enjoyed our conversations ever since then. So, welcome to the podcast.

Joe Axne:
Yeah. I think I remember too. I think I was exposing that IDX123 was the password. Yeah, if you're still using that password, that's … I just have a clinic right now I'm working out of Houston. I'm like, “Let me guess, your password's this.” They're like, “How did you know?” I'm like, “Well, it's-“

Stephanie Goss:
Because that's everybody's password. Before we get into it a little bit, because I have a very specific question that I sent you an email about recently. Because I was talking to some fellow managers in a manager group I'm in. I saw a post and I was like, “Oh my gosh, I want to talk about this with Joe.” Tell us a little bit about you and I.T. Guru so that everybody gets to know you a little bit.

Joe Axne:
Oh, sure. So, I.T. Guru, we help clinics and hospitals with their computers and networks. So, think of us like a strategic partner. We help … There's all this technology out there and demands in the veterinary clinic, as we know, are higher with short staff and such. So, we're just helping clinics pick solutions that help them become more productive, more efficient, more effective, work smarter versus harder.

Joe Axne:
And then, just make sure that it's really riding on the proper platform. In this case, foundation. Like a foundation of a house, you got to have that foundation in place, proper foundation, before you just build anything on top of it. So, we're very foundational, very proactive. But we help them with all their IT needs and picking and selecting solutions that integrate well with veterinary practices.

Stephanie Goss:
I love it. You guys, one of the things that I love about talking to Joe is that from the very first time I heard you talking about IT stuff … IT stuff can be tricky. I have the computer-minded brain. I've always been the IT troubleshooter at my practice. But for a lot of people, it gets really complicated really fast.

Stephanie Goss:
And one of the things that I love about you and your team, Joe, is that you really make the complex themes seem not overwhelming. And I never walk away from a conversation with you guys feeling like I've done something wrong, which is not the case a lot of time when it come to IT. We're looking at it and we're like, “Oh gosh, I've been doing everything wrong for so long.”

Joe Axne:
Yeah. I always feel like everything. But the standards have changed, right?

Stephanie Goss:
Yeah.

Joe Axne:
So, as we go from year to year to year … There are new standards in 2022, which, in our opinion, everybody should be aligned to. But the reality is they're not. And we got to get them there. So, we're seeing … Even if you get to standards that are, say, 2018, 2020 standards, it's better than being on the 2014 to 2016 standards. So, it's just the move shift the mind frame of, “We get it.”

Joe Axne:
A little bit behind the times on the technology curve. COVID really drove us into that. And I think we're starting to up steam around that. But yeah, there are a lot of changes around these security standards. Stability standards that you want to really start getting an understanding around that maybe doesn't really fall in the lap of a practice manager anymore. Their main responsibility. It's hard for those practice …

Joe Axne:
They're doing so much today. And it was. Back in, 2013, 2014, yeah, they could … I know some really, really sharp practice managers through VHMA. They're maintaining on their own. But for the majority, yeah, it's tough to do on your own for sure.

Stephanie Goss:
You need help.

Joe Axne:
You need help.

Stephanie Goss:
Well, I think you had a great point that COVID drove a lot of our practices to using technologies and using information in ways that we never had before. Both in terms of using it, but also accessing information from clients. So, that was actually why I reached out to you because I was in one of the manager forums. And having a conversation with a fellow manager. And they were asking for some help from the group.

Stephanie Goss:
They were like, “Hey, my team … ” They were in AVImark practice and they were talking about something else completely. But one of the things that caught my eye was that they said, “Well, in our client area, in AVImark, we are putting the client credit card and driver's license information. Because when I came to the practice, I found a set of note cards in the filing cabinet where they were literally handwriting client information.

Stephanie Goss:
“So, I want to get it into AVImark so that we don't have handwritten credit card information laying around.” And I was just like, “Oh, man.” And I remember immediately sending you an email because I was like, “Oh, it drives me crazy how few people understand the huge liability that we take on ourselves when we don't understand the risks when it comes to protecting our client information. So, that was kind of what I wanted to talk to you a little bit about today.

Stephanie Goss:
That case specifically. But also just in general, you've seen a lot of crazy things. Your team sees things repeatedly when it comes to information security. So, I thought we could talk about that a little bit. So, tell me, you've got to have seen some crazy things in terms of bad information security, and practices that are happening regularly in the industry. What are some of the things that you guys see repeatedly that practices are doing that are really risky, that they may not realize are risky?

Joe Axne:
I think number one is the password on the monitor. I mean, it's right there on the monitor. So, there are crew and cleaning crews that come in. There can be people that can get into the environment and they can get physical access. Let's not give them that much ease of access. There are stories of cleaning crew logging in and using the credentials that are right on the monitor. They're getting into the system. So, we don't see that.

Joe Axne:
Everything you were referencing the very beginning there of confidential client information, let's just call it payment information. That all falls underneath what's called PCI. That's the Payment Card Industry Data Security Standard. So, an acronym for that is PCI DSS. So, every business is under this standard, okay?

Stephanie Goss:
Yeah.

Joe Axne:
If you take credit cards or you're getting any financial information, whether it be over the phone or whatnot, or online, et cetera, you fall underneath becoming PCI compliant. So, there's a compliance here that many folks don't understand. Sometimes there's even these questionnaires that go out. And you have to be able to answer, “Yes,” to those questions. If you answer, “Yes,” and you're not actually doing them, and then something happens, you're going to be held on the hook.

Joe Axne:
The credit card company is going to wash their hands like, “We didn't cause this. You caused it. You get to pay for this, not us.” So, it all falls underneath that PCI, which we just call it PCI. So, even the written, like you were saying. Even having a handwritten note still falls under PCI. I mean, it's just, you're not supposed to have that.

Stephanie Goss:
Right. I remember when I started in practice, we thought we were doing one better by starting to ask clients to sign a waiver like, “I'm okay with leaving you my credit card info.” Because we thought, “Well, at least that way we're getting permission versus just the Post-it Notes that had somebody's credit card information written on it.” But I think, to your point, it really is one of those cases where we don't always know what we don't know.

Stephanie Goss:
I remember finding out for the very first time about PCI compliance the hard way. Because we had had a client's card. And someone else had brought the pet in, and we had run some charges. And they reported a charge back to their credit card because they were like, “I didn't give permission for this.” And we thought, “Well, you had given us your credit card to have on file. And we thought this was an appropriate situation to use it.”

Stephanie Goss:
My team and I learned the hard way because the bank was like, “No, we're not responsible for this charge. This was hand processed. You didn't have permission. None of these boxes were checked.” So, we wound up not only having to pay for it and have it come out of our profit. But have to pay the fees associated with that charge back. So, I think practices learn about some of that stuff the hard way. But we really do, I think, are doing it with good intentions, right?

Joe Axne:
Right.

Stephanie Goss:
And some of us are even doing it like, “Oh, well, if I get their written permission or if I get them to sign off on it, it must meet the standards.” And I think that's what's so interesting. I would love for you to share a little bit more about some of those things that not only practices should think about in terms of getting some education to understand what their role is.

Stephanie Goss:
But also, the hard part is where do we find that kind of information? That's the part that often, as a manager, feels so overwhelming to me. A company like yours, that does IT services, it makes sense that you guys would know all of that kind of information. But if I'm a practice manager, where do I even start with trying to educate myself on stuff like that?

Joe Axne:
Yeah. You want to start with a payment processor. That's always the best route to go. They're going to educate you quite a bit around that because they themselves will even tell you that you have to become PCI-compliant. Or even though you're using, say, a credit card terminal that is tokenized, that had encrypts … What that means is it encrypts … So, PCI compliance really comes down to making sure everything that is stored and transmitted is done so in a secure fashion. So, encryption is key there.

Joe Axne:
So, back to, say, AVImark and you putting it into an open-text file, a field inside that database. That database is not encrypted. So, that field is not … Certain practice management systems nowadays, like the web-based ones that are coming out, the web-based PIMS. If they're storing credit card information in there, yeah, they know on the backend what it has to comply to from a PCI compliance aspect.

Joe Axne:
So, you can store that information with a provider that allows you to … We have an online payment portal as well. So, we never touch our clients' credit cards anymore. They have to put all in there and it's all stays within a completely PCI-compliant platform that they're maintaining. But I still have to go through the questionnaires. I still have to answer everything that goes with that outside of that network. Because there's a quite a bit to it.

Joe Axne:
And it really comes down to there's certain PCI controls that you have to have in place. And the number one is building and maintaining a secure network. So, you have to have that in play. So, that's big. When we say that you have to have that proper firewall, which we don't typically see. This is that device that protects everything coming in and out. All your default system passwords for all your gear on your network have to be changed. I mean, that's a requirement. That's a requirement now.

Joe Axne:
I'm doing an assessment right now. I swear, I hopped on a server. There's a switch that's online. I go to the web interface and switch … It's just a web login that I can get to. And it's, in this case, a NETGEAR switch. So, all I do is I look up that model, default password, Google it, bam, there it is. Pasted it in. Bam, I'm in-

Stephanie Goss:
Sure enough.

Joe Axne:
I'm all the way in, and that's how the bad guys … That's how the bad actors are also doing this as well.

Stephanie Goss:
Sure. Well, that makes sense to me. When I think about it from the practice's perspective … One of the things that I love about how you approach IT, and in the conversations that I've had with you is, practice managers are … Again, and practice owners … they are busy. And this is usually an area where we acknowledge what we don't know what we don't know. So, we're like, “I don't understand how any of this works. I'm literally going to plug the thing in. And if I change the password and then I ask you to deal with it, that seems messier than just leaving the password the way that it is.”

Stephanie Goss:
So, it's coming from a place of good intention. And they're thinking, “This'll make it easier for somebody else to help me down the line.” But for your point and your perspective, the minute that, that gets plugged in, then the clinic becomes at risk just as much if they have the password written on the monitor or the bottom of the router. As if someone like you, who has some experience of knowledge, knows to just say, “Well, what model is this? Let me just Google it. And I have a hot chance of finding out the default password.”

Joe Axne:
Bam. So, it's really that there's a lot to that. And there's a lot going on in segmentation now that has to happen in clinics or hospitals. So, we see a lot of clinics and hospitals just … We call it just one big flat network. You have that thing in the back that all the cables are plugged into. That's your switch. So, everything can see everything.

Joe Axne:
So, your Amazon Alexa, and your Sonos, or your Sonos Music System, or your Voice over IP phones, or your IP-enabled cameras. Whatever it is, Google Smart whatever they call it, it's all connected to the same network, right?

Stephanie Goss:
Sure.

Joe Axne:
So, we're promoting as new standards for 2022 is really … That all has to be segment. So, we want our phones over here, over on this in this little segment and network that doesn't necessarily have to talk to anything else in the clinic. So, does Amazon Alexa really have to interact with your AVImark database? No, it doesn't. So, it's proper segmentation of these devices or these smart devices.

Joe Axne:
It's Internet of Things is what it's really called. That's what we're getting to. We're getting to this, everything you touch. And we're talking about it even from a worker's phone, a private … One of the staff's private personal phone. Should that be on the private network of the clinic? No, it should be on a public network. But that public network is completely … Everybody that attaches to that public network is completely isolated from each other. So, they can't see each other. You're in a bubble.

Joe Axne:
Or think of it like a swimming pool in a … If you envision a swimming pool, you don't get the whole pool to play in. You just get a lap lane. But think of it even more as you can't see what's going on in any other lap lanes besides what's in your lap lane. So, that's really what [inaudible 00:17:18] is getting to is that we have to really segment. It's really important. We are working with more and more clinics. Even printing, segmenting printing. So, printing on its own segment. Voice over IP on its own segment.

Joe Axne:
So, segmentation's key there so that we're allowing the only access that needs to be allowed between … Say, you do have an on-prem phone system and it's like, “Well, I need the access, because we get recordings.” Well, that's okay. But that's the only thing allowed over to that system is to get into the recording. And a lot of these camera systems are exposed to the internet as well? And they're sitting on the same network.

Stephanie Goss:
Right, yeah. Because you want to have access to it when you're not there. So, that the clinic is thinking about it from that perspective like, “I need it to connect because I need to be able to see it from my phone when I'm at home. Because otherwise, what good does it do if it's recording?”

Joe Axne:
Correct. Agreed. Agreed. But if somebody gets into that, and say, let's not quite … When somebody gets into that, what are they really going to have access to? Maybe they only have access to that system. But it can't bleed over until your other systems like, oh, now they have access to all your shares and all your information. And maybe even your AVImark database where they actually have access to the information inside that database. Now they have credit card numbers.

Stephanie Goss:
Yeah. Well, it's not a far reach when you think about it. If you have somebody who can get into your network and they can access your video cameras. To illustrate your point, if they're seeing your video cameras and your practice has … I will raise my hand. Guilty as charged. I'm picturing the monitor in my head at my front desk as someone new was training. And they were just like, “I cannot remember the password,” and wrote it.

Stephanie Goss:
And it was posted literally at the front of top of the monitor. And if someone can access your video cameras, and now they're looking at your front desk, they're seeing the password. And to your point, if everything is on that same network and they have access to the passwords, they could get in. And just type in the password and start accessing more and more information.

Stephanie Goss:
I think we think that something like that is far-fetched and it's not going to happen to us. But you and I both know that it happens to clinics constantly. Maybe not to that degree, that someone hacks in. Maybe it's more likely that someone within the clinic or someone who has access to the building accesses some of their information. But you and I connected a few years ago over … I was working in a clinic. And we actually did have some challenges with outside coming in.

Stephanie Goss:
And we got a virus that filtrated through a few practices that I was working with. Our servers went down, and we were down for weeks. We couldn't access any our information. We had no access to AVImark. All of the systems were affected because it was virus-based. So, once it got in, it started spreading, and then other things were affected. And it was catastrophic in a lot of ways for a lot of the practices that were affected.

Stephanie Goss:
It's one of those things where I've always been comfortable with computers. I like technology and I like getting nerdy. So, it doesn't surprise me. And I have a lot of colleagues who don't like technology. And who are the ones who are like, “I got this email and I open this file.” And I'm just like, “Oh, please don't open … Who is it from? What is happening?”

Stephanie Goss:
So, I think that's the hard part about veterinary medicine is that we have a lot of practice owners and a lot of practice managers and people in general who are learning new technologies for the first time. I really believe that this is one of those times where we should be okay with not knowing what we don't know and play to our strengths. And say, if we don't understand the technology but we're using it, we have a duty to get somebody on our team to help us understand that technology. And make sure that we are playing it safe.

Stephanie Goss:
Because I will tell you, I mean, I think when it first happened, I have colleagues at another local practice who were affected by our server outage, who were still reconstructing files. And having challenges six months later. It took them six months to rebuild. They had to get a brand new server. Even then, there was challenges. I mean, we freak out if we lose power in the clinic for a couple hours on a stormy afternoon.

Stephanie Goss:
Imagine if you're faced with six months of not being able to access your AVImark mark files or your patient charts. Trying to remember, “Well, this pet was here six months ago. And I have no idea what their blood work was.” That's utter pandemonium.

Joe Axne:
It just reach havoc on your productivity. And we can't do that right now.

Stephanie Goss:
Hey, everybody, it's Stephanie. I want to jump in here for just one quick second and make sure that you know about a workshop that's coming up from the Uncharted community that you are not going to want to miss. Now, you might not be the person who's in charge of marketing for your practice. If not, write this down and pass it along, because we are being joined by none other than the Bill Schroeder from InTouch Practice Communications.

Stephanie Goss:
Bill is amazing. He is a wonderful, he is funny, he is kind, and down to earth. And he loves nothing more than working with veterinary practices and cheering them on about digital marketing. And Bill is joining us on Wednesday, June 8th, from 7:00 to 9:00 PM Eastern, which is 4:00 to 6:00 PM Pacific. He is talking about creating content that clients crave. He is going to teach us how to explore contents that are the most valuable and that have a huge impact.

Stephanie Goss:
And talk about proven methods for great content development. Bill did this workshop for us live in person previously. And I said, “Hey, Bill, I would love for you to bring this to the Uncharted community, but also to veterinary medicine and beyond.” And he is doing just that on Wednesday, June 8th, if you would like to find out about this and all of the upcoming events from Uncharted, head on over to the website at unchartedvet.com/events. And you'll be able to find all of the things that are coming, that you are not going to want to miss. Now back to the podcast.

Joe Axne:
We know the trends. We understand it's hard to find staff. We understand this new term out there is the Great Recession. The Great Resignation of everything that's happening. People getting burned out, changing careers, all this kind of stuff. So, every business is trying to more with less right now, which you is hard. So, we have to hold this thing together technology-wise, so that you're never in that down situation.

Joe Axne:
So, there's a whole prevent model that gets you there. And there's not one thing that will protect your practice. There's not just one thing that does it. So, these PCI compliance … And really, there's now more and more clinics are coming to us and say, “Hey, we're thinking about cyber insurance. We're hearing about these clinics getting … ” The experience you went through called-

Stephanie Goss:
Ransomware.

Joe Axne:
… ransomware. So, it's malware. It's different than a virus. Virus is signature-based and it could be stopped by antivirus software. But that's not what we're blocking anymore. So, we're blocking malware, and rogue detection, and just bad actors. People that get a foothold. So, they get a foothold by phishing you with a link. Then, it installs a small piece of software on a computer that gives them backend controls.

Joe Axne:
Now they're in. Now they have a foothold. And now they're doing the traversal. Now they're looking. “Okay, how can I laterally move throughout this network? And then strategically position a complete attack, so it shuts everything down on you.” And you're held with a ransom bill that says, “Hey, pay us $8,000, $10,000. And we'll give your information back, or good luck.”

Joe Axne:
Number-one thing with that is you have to understand. You have to have visibility of what you have today. And make sure that you have the right prevention techniques in. That's a layered approach. So, that includes firewall, antivirus, web filtering, patching of the computers, like Microsoft Patching. Third-party application patching like a Java, Adobe Flash. All the third-party apps and such that go with that. So, that's that prevent.

Joe Axne:
When I say, “Antivirus,” it's really what we're considering, it's called Next-Gen AVImark. I'm going to get technical here, but it's called EDR solution, endpoint detection and response. So, the easiest way to think about this is that your clinic or hospital today, they lock their windows, lock the doors at least when they go home. Nobody's leaving the clinic unlocked that night, right?

Stephanie Goss:
Right. Yeah. Sure. Yeah.

Joe Axne:
Most clinics though, they have camera systems and even alarm systems that give them insight of what's happening in that practice, right?

Stephanie Goss:
Right.

Joe Axne:
So, the alarm system is there, say, through big, popular ones like ADP. ADT Alarm System, motion goes off. Somebody's walking through the clinic that should be walking through that clinic, it's going to set off an alarm. And get the authorities involved that need to get involved to go find out what's happening. That's what EDR is.

Joe Axne:
We got to have an understanding where you're at today. We got to make sure you have the prevention pieces that are in place. But now we have to have a way to detect and respond if that bad actor gets in. So, it's just that alarm system. So, the good EDR solutions are going to have things like, “Well, that's … ” And the ones that are being made are being obviously made by the ex-NSA folks. They're the ones that kind of put us in this situation, to be honest with you.

Joe Axne:
But we've got great relationship with these folks about what are the methods really used to start doing that? So, then now it's not signature-based anymore, but it's strange behavior that's happening. Again, technically, it's like, “Well, it loaded the script. And it accessed and it's testing its rights. Then, it also downloaded this weird network scan tool. Why would a doctor want to network stand tool on their PC? They wouldn't. So, that's the alarm. Bam, something's wrong. Now we got something to do.”

Stephanie Goss:
So, instead of being like the motion-sensor alarm physically at the clinic. And you think about, if somebody walks into your building, it's going to trip the motion sensor. The EDR technology is looking for those things that would be like motion in your practice. But on a information-technology level like, “Has something out of the ordinary been installed? Is there some new script that's running in the background that just looks weird?” Then, when something like that does pop up, then it triggers that alarm, right?

Joe Axne:
Yeah.

Stephanie Goss:
So, that somebody who … Whether it's the program that you're using, or if you use a company. And you guys do something like this. You have the ability to help practices monitor that kind of stuff. But it triggers that alarm so that somebody says, “Hey, you should look at this because this is not normal.” Am I understanding that right?

Joe Axne:
Yeah. Well, it's just like how ADP goes to another alarm company. Same thing here, it goes to a SOC, we call it. A security operation center. They review it, look at it. If they really feel that something bad's happening, then at a click of a button, they can isolate that computer. So, it can't touch anything. It can't talk to anything else. It's just, now it's back into … Like with that lap lane we had talked about, it can check in and see what's happening.

Joe Axne:
So, we've seen things get caught like somebody opened up a Microsoft attachment. We're back to macros, believe or not. I mean, macros were old-school ways to hack. But there's macros that can fire and prompt like it's trying to log into your Office 365 account. You put your credentials in. Bam, now they have your credentials. Now they have your email, you know?

Stephanie Goss:
Yeah.

Joe Axne:
Now in the meantime, it's running. But boom, we want to isolate that machine. So, it can talk back to the secure server, but that's it until we get it cleaned up. And first of all, understood. And that response is part of, understand what's really happened here. How did this initiate? How this happened. But stop it in its track before it becomes full-blown. So, 1 system down in the clinic is much better than 25 systems down in the clinic, right?

Stephanie Goss:
Yeah, absolutely. I would way rather have one piece of it out for a while than the whole thing. Because let me tell you guys, it was painful. It was so painful. Even prior to … That was probably the worst thing. But I remember a few years before that, my practice also, we were using AVImark. We actually had a system for making backups, which is another common source of challenge for practices, I think, from an IT perspective, There are a lot of …

Stephanie Goss:
We know that we probably should be backing up our data. I think a lot of us do. But there's a lot of people who don't know that, that is something that is your responsibility. I was in a practice where we did. We had a process. Every night, someone would literally sit there with the tape in the server and run the backup through AVImark. We came across a challenge.

Stephanie Goss:
We had a problem with our AVImark data, and the AVImark team was great. And were supporting us. They're like, “We need to go back to the previous version.” When we went to open, it didn't work, so we had to go back and as it turns out, we had been having problems and we didn't realize it, because we weren't testing the information regularly. And we wound up having to go back to two or three weeks before we found a version that could be restored.

Stephanie Goss:
And we had lost three weeks' worth of patient visits, and chart notes, and charges, and changes. I will tell you guys, it's one of those … It seemed so small, but I mean, again, it took us probably six months to catch up from being set back three weeks' worth of work. Because think about how many things that we do all day in the practice that involve our computer systems.

Stephanie Goss:
I mean, we're putting stuff into your PIMS all day long. Patient notes, schedule notes, chart notes, charges, all of those things. Now all of a sudden you have to recreate three weeks' worth of that while you're still trying to see patients all day long. And manage the workflow that's still coming in the door. I think a lot of us just don't think about those things because we love animals.

Stephanie Goss:
Our vets went to vet school to be vets, not to be computer people. So, I hear that and I hear it a lot. And one of the reasons I wanted to talk to you was because I think it's time for us to acknowledge, okay, we don't have to be computer people. But that doesn't give us the right to stick our heads in the sand. And just ignore it and pretend like it's not happening, because we have moved into the current millennia in terms of technology. And we're utilizing stuff left and right.

Stephanie Goss:
And it is our job to protect not only our businesses and ourselves, if we're practice owners or practice managers. But also, to protect the information that clients are sharing with us. That is legally and policy-wise … PCI is a great example of that … a duty that we have signed away when we accept credit cards that our practice, saying we are going to protect and uphold this information safety. And that responsibility gets taken seriously at some point, whether we want it to be or not.

Joe Axne:
So, yeah, so you got the awareness of what you have, the prevention, detection response. There's always recovery. So, we want to move away from the word backups. Backups is singularity and it typically means just you're backing up a subset of data. Okay, do you have backups of your pictures, right?

Stephanie Goss:
Sure.

Joe Axne:
Do you have backups … What we really want to-

Stephanie Goss:
Yeah, like my iPhone makes the backup to the cloud. I think that people get that.

Joe Axne:
Yeah. And it's automated. You know that. So, you have that iCloud. So, do I. I love it. I had to increase it because I'm using more and more space, whatever. But I want that, because I want to make sure I can always recover it. Because I have a lot of information on there. And I'd never want to go through a whole setup and redownload all my apps and stuff. It'd be a nightmare.

Joe Axne:
But yeah. It's called business continuity and disaster recovery. So, you need a business continuity plan, but you have to have disaster recovery. So, just like fire, flood, tornadoes, earthquakes, hurricanes, we can't prevent those. We're not going to prevent the natural catastrophe. It's literally impossible. It's extremely, extremely difficult. But you have to be prepared for that. You have to be prepared for the worst-case scenario.

Joe Axne:
And that includes today that a bad actor gets in. And then spreads its ransomware to every single machine and takes you down. How are you going to recover from that? So, really the question really comes down to two simple things that you need to be asking your IT folks, if you're working with folks, is, what's my RPO and RTO, we call it. So, a real-time protection option.

Joe Axne:
How often are we backing up throughout the day? That's a number you should know. So, we recommend hourly. That's where you should be. Hourly at least. We see mostly people every 24 hours. But that means, worst-case scenario, you're rolling back a full day's worth of work. Maybe two days or maybe three weeks if that backup wasn't running. So, yeah, RPL, real-time protection.

Joe Axne:
So, ask that question. How often are we backing up? And it needs to be periodically throughout the day, because more and more clinics are paper-light and utilize this technology. So, then number two is, how quickly can we get back up and running, should a failure occur? That's really important. And that's one that no one really asks until it hits. And that's not the time. It's not time to deal with fire when your house is on fire, right? We want to know before that.

Joe Axne:
And there's technology out there that does that. So, it backs up every hour and offsite replicates every hour. It can spin up every night a test to make sure it works properly. And it alerts you if it's not working properly. But it can also act as a lifeboat, we call it. So, say your server gets hit and it gets completely wiped out.

Joe Axne:
We actually have a clinic running on our lifeboat right now as we speak, on the East Coast, out of North Carolina. So, their server, in this particular case, wasn't a hack or anything. It was just servers … The age and equipment was old. We rebooted it. It didn't want to come back online, so we note the disaster-recovery plan. Hour later, bam. Less than hour, we had them up and running. Emergency gone. They're seeing patients. And they've been running for good 25 days on it. So, I think this week, yeah, it just was just [inaudible 00:37:18].

Stephanie Goss:
Wait, can we just stop for a second and think about that? Because I'm going to date myself here and tell you all how old I am. But when I started in veterinary medicine, it was literally like you ordered a server from Dell and it would take three weeks for it to show up in your clinic. Then, once it got there, you had to wait for your IT people locally to come out and plug everything back in. And set everything back up.

Stephanie Goss:
Then, you had to call AVImark and get everything reinstalled. You're talking about a four-to-six week process if your server goes down. But you just said that your server could go completely down and you have a practice back up and running within an hour. And not only that, but they can sustain that run?

Joe Axne:
Yeah. Yeah.

Stephanie Goss:
That's crazy.

Joe Axne:
We have to now because Dell servers now averaging more around 45 to 60 days to get it because of the whole change.

Stephanie Goss:
Sure, supply chain.

Joe Axne:
I had one, it took six months to do it. But yeah.

Stephanie Goss:
Oh my gosh.

Joe Axne:
You can run it and sustain it on a lifeboat. And it's a exact clone. Everything's there. It's the whole thing. It's just cloned so that there's no reinstallation of AVImark. Everything's exactly the same. So, server fails, it gets hacked, or whatever, you get put in place. And then you get back up. So, we just have this philosophy of never pay the ransom. With the right … And this technology is not cutting-edge, bleeding-edge. This is stuff that's been around for now 10 years. So, 10 years.

Joe Axne:
So, we've been riding this stuff ourselves for over eight years. So, this isn't cutting-edge, bleeding-edge type of stuff. It's affordable, but it's just one that many people don't know until they ask these questions. Because you really need to ask, “How quickly can we get back up and run and should a major issue occur?” Know that number.

Stephanie Goss:
That was going to be my question, because this is super interesting to me. So, if the technology has now been around for some time, as you and I both know that it has. And it is not expensive, especially not when you consider the grand scheme of loss of work and the labor that has to go into doing it yourself if your server goes down. We're talking about weeks to months of work.

Stephanie Goss:
Like I said, it took us six months when you … And you factor in all my extra staff time. And we worked overtime at night, reentering all of the data. That is a huge cost for practices. Why do you think more practices aren't looking at this and investing in this kind of technology, in this kind of support on an IT level? What is the barrier there?

Joe Axne:
I think the barrier is they don't know. So, that's why it goes back to that first one. You have to know. So, maybe you're not in charge of it anymore of implementing it as a practice manager. Because maybe it's outside your skillset to be able to handle as a practice manager. But you have to be in charge of it. So, we have a philosophy that somebody has to be responsible for it. But you can ask or partner with folks that responsible for implementing and ensuring that that's in place.

Joe Axne:
But the number-one reason is they don't really know the risk that they're in. So, you really have to understand that first. So, if no one's giving you insight of, say, your technology lifecycle management, like how old machines are. What do you have? Reports that are showing you a clean, concise, centralized report of all activity around your Next-Gen AV solution showing you everything that's been caught, was caught, was isolated from the web protection piece.

Joe Axne:
Because I mean, that's the number-one conversation we're having right now with folks is phishing. Phishing is on the rise. I mean, it's the number-one thing that we're seeing within security report. So, you need to be given reports, so it gives you insight. So, you can make the decisions. If you're not getting that information, you can't make that decision. I think that's the number-one reason. It's just, they don't know what they don't know.

Stephanie Goss:
So, if you're a practice manager or a practice owner who's listening this. And going, “I don't even know where to start.” You talked about two things that every practice should be able to understand and know. And if they don't, they need to ask their IT person, which is the … Tell us again … the R … the response time.

Joe Axne:
Yeah, yeah. RPO, the real-time protection option, and the RTO. So, it just goes to how often are we backing up? Then, how quickly can we get back and running? Yeah. So, those are the two questions.

Stephanie Goss:
Okay. Besides those two things, yeah, what are some of the things that they should know?

Joe Axne:
Yeah. Well, they need to look at status reports. Security-level reports. Just things that are in place. So, whoever you're working with should be working with something that's centrally controlled. And be able to report to you what activity that is catching or preventing. So, all those reports help you. And then that regular backup … So, yeah, look at those reports. And understand, have there been any problems?

Joe Axne:
By asking for the reports, it's holding the people that are responsible for protecting you or assisting you, it holds them to that level of-

Stephanie Goss:
Sure. Accountable.

Joe Axne:
… making sure that they can provide it to you. But more importantly, can they explain it to you in a easily explained manner?

Stephanie Goss:
In English.

Joe Axne:
Right, in English instead of geek speak, right?

Stephanie Goss:
Yep. In simple English.

Joe Axne:
We'll let them see what we have. And be honest and say, “Whoa, whoa, whoa, I don't understand. Re-explain that. So, there are many times that I have conversations. If I ever talk too technical, just let know. And I'll try to bring it down to more of layman's terms because … But yeah, the regular assessments and reporting on the data backup strategy. Making sure those managed data … Offsite replication's occurring.

Joe Axne:
The security and what's in place. What's being caught? What are the trends? What's happening? Again, the number-one conversation we're having right now from our web security piece is that we're catching people clicking on something. But our web security's preventing it from getting the payload. Does that make sense? So, because [inaudible 00:43:29] email.

Stephanie Goss:
Yeah, sure. So, somebody's accidentally clicking and they're not realizing.

Joe Axne:
Right. So, then now we have a conversation around, we need to really look at your email controls here. And we need to really control that centrally. In this particular case, I'll be honest, this clinic that we were showing these reports to, everybody uses personal email still. Gmail, AOL, Hotmail, Yahoo. It's like, “Let's use a domain name. Let's get everything in. Let's put the proper spam protection, phishing protection.” Then, we're also going to be adding a little bit of another layer.

Joe Axne:
And that is ethical phishing here. It's like, “We'll try to you ourselves. And if somebody gets caught, we'll provide them training to why. So, that we can help you stop this so it doesn't become an issue.” Because we're preventing it. That's great. But there may be something that could slip through. But we have other layers to help from the slip throughs. But this is an area of concern. So, just again, getting the data. Getting it understood. Looking at those reports and making informed decisions now, you know?

Stephanie Goss:
Yeah.

Joe Axne:
You're making truly informed decisions around IT security in that case, because you now have the power of proper information. That's what's key here, the proper information. Insight.

Stephanie Goss:
Yeah. I love it. I think about it in terms of, I always ask our IT person, “Can you explain it to me like on my 10-year-old? Just talk to me at that level. I need to understand it.” I think that's one of the things that I always tell my manager friends is, “Don't be afraid … Don't worry about feeling dumb because people who speak a geek speak, who have that background, it's just like us when we start talking in veterinary terms.”

Stephanie Goss:
Sometimes we find ourselves talking with clients. And we start throwing around the jargon and the big words. And clients are looking at us and it's just going right over their head. That's the same for us when we work with IT people, because we didn't go to computer science school. We didn't take programming. We don't understand the language that's being used. You really truly are talking about two different languages.

Stephanie Goss:
So, I think I tell my colleagues all the time, “There's nothing wrong with saying, ‘This is not my job. I don't understand how to do this. I need you to translate and talk to me in basic layman's terms. Because I really do want to understand it.'” And I think that's one of the best things that we could do for ourselves is to just say, “It's okay to know what we don't know.” It doesn't absolve us from really the need to figure it out. Because ignorance will only carry us so far.

Stephanie Goss:
But when we get hacked and our server's down for four months, I don't want to be in the boat of feeling then really crappy that I didn't know what I didn't know, you know?

Joe Axne:
Yeah. That's not the time to … Time to have those conversations ahead of time. And then yeah, I agree. I just was at an IT conference, because we stay up on professional development, trends, and what we're seeing. And even some of these folks, my peers, they'll talk with everybody. I was like, “I don't understand what you're saying. You need to … ” I'll say the same thing.

Joe Axne:
Because literally, they'll sling some acronyms around. I'm like, “I don't know. Okay, you got to help me [inaudible 00:46:57].” But it's okay. And you're right. You can't … Then, once you understand that, “Okay. Okay. Oh yeah. Okay. That makes sense now.” But right. Making informed decisions on what you have, that's what's key. And assuring that you're aligning to some type of standards.

Joe Axne:
So, that's another big key that you really want to make sure that your IT folks you're working with, they have some type of standard that they're shooting at. So, that's, in our case, standard operating system, like Windows 10. That's what we want. We don't want to see Windows 7 or XP. And you can't see that Windows 7 bad, XP worse. 7's just as bad. But I mean, you want-

Stephanie Goss:
I'm laughing because my practice was the practice with the computers still on XP. It's that legacy system that you can't get them to retire.

Joe Axne:
Because they don't patch. Microsoft doesn't patch anymore. You know what? The hackers that. They have the vulnerabilities there. So, all it takes is you going … Your endpoint into that endpoint. So, it's kind of strange. The new endpoint isn't the machine anymore. It's like, what's running on the machine? So, it's the browser is the … So, that browser's not even being updated.

Joe Axne:
So, these hackers know that. Then, so they know the vulnerabilities to get in. So, you're low-hanging fruit in that case. You're easily picked off. You don't want to be that low-hanging fruit. There is no 100% secure, but you just got to position yourself way up there. Again, there's no 100%. But the majority of people out there are going to pick off the low-hanging fruit ones, because it's lot easier than having go through hoops and ladder to get where they need to go. But yeah, I mean-

Stephanie Goss:
Sure. Well, it's the path of least resistance.

Joe Axne:
… what we talked about today is really 2022 type of standards. 2020 standards would be you have to understand what you have. You have to understand the trends or what's happening. And got to get insight and glean into that. That's going to help you make the informed decisions.

Stephanie Goss:
Well, the whole reason I wanted to have this conversation with you was because I'm hoping that there are a lot of our listeners out there who are listening and actually going, “I don't understand any of this. But I'm now a little nervous because I feel like my practice is … ” I don't know what I don't know. And I'm hoping that people are like, “Now I can educate.”

Stephanie Goss:
And I would love to see us as a industry, as a whole, investing more time and energy into having some basic conversations. Because we can't give ourselves technology and tools. And think about just how many things we've added technologies-wise into our systems, into our everyday lives, over the last two and a half years. If something goes wrong and all of that stops working overnight, think about how many of us would be in a panic.

Stephanie Goss:
It's scary to think about. But I think it's really important as a manager, as a leader, as a practice owner to think about, okay, this is a part where I raise my hand and say 1-800 phone a friend. Because I don't understand this, so where do I start? So, if we have people who are listening or who are feeling that panic. And want to reach out to you, or who have questions about, “Where can I educate myself? How do I get more information about this?” Where can people find you?

Joe Axne:
Sure. Just the web's easiest, itguru.vet. So, I-T-G-U-R-U.vet. We're an IT company. All we is focus on vet clinics and hospitals. So, we standards of care developed that when we align the standards of care, one, you're going to have less issues. Two, when you have issues, we'll fix them really quick. There's Schedule a Consult and Contact Us forms on our website.

Joe Axne:
The Schedule a Consult's the easiest way. It has a link directly to my calendar and allows you to book some time to just chat. Let's just take a 10-, 15-minute chat. Let's understand who you are. What type of practice you're. What your concerns are. Then, from there, if it makes sense, we can do an IT assessment or a security assessment. And yeah, take it from there. So, let's just chat.

Joe Axne:
See what's keeping you up at night around this. If there's certain thing, or if there's a certain problem that you've been through that you never want to be through, again, we can help you through that. But we're helping clinics one at a time, just get them educated on what they have. That's the best thing.

Joe Axne:
Once you have that information, think about … It's like, diagnostic in labs. Now can now give you the proper treatment plan. So, we got to do the diagnostic in labs.

Stephanie Goss:
That's one of the things that I love about chatting with you. I promise, you guys, it's painless to have a conversation with Joe. Your whole team is fantastic. But I think if you do nothing but get some more information out of the conversation. And figure out, where do you even start? Because I remember after you and I had the first conversation, I went back to my practice. And I was super fired up after that VHMA.

Stephanie Goss:
And I was like, “We need to look at overhauling our system.” And my practice owners were like, “No.” And I was like, “Okay. But really we should think about this.” They were like, “We can't deal with this right now. We don't have time to look at all of this.” But for me, it was eyeopening to just start to think about, where are we? And that initial conversation with you gave me that little bit of knowledge to say, “Okay, I need to educate myself more.” So, that when I did a little bit more digging and I understood, I could point out very specific things that were at risk.

Stephanie Goss:
And when I brought those to my practice owners and I said, “Hey, guys. We're storing the client's credit card information in the Notes section in AVImark. And this is not encrypted. It is not password secured. We are also using credit card processor. We're bound by PCI compliance. If we don't start storing the numbers through that, and a client information gets out, then this is what the potential penalties would be.”

Stephanie Goss:
And I just had a conversation like that in one of our one-on-ones with them. And they were just like, “We had no idea. Please sign us … Fix it. Do whatever needs to get done. Get it fixed.” And it became, again, a path least resistance. But we're not going to know what we don't know until we start the conversation.

Stephanie Goss:
So, if you're listening, you're like, “I have no idea where to start, but I also am not sure that my practice owner is going to go all in on the idea of making radical changes.” Or if you're a practice owner who's like, “I can't possibly afford this,” I think is worth having a conversation. And just starting to get some basic knowledge and having a starting point.

Joe Axne:
Yeah. Everybody that's listening to this, just mentioned this call. We'll do this free at no cost. No cost. No obligation to buy anything. It's our-

Stephanie Goss:
Joe is about educating.

Joe Axne:
It is. It's all about education. And we're doing it one practice at a time right now. It's a lot of them. Hundreds of them. But we're there to help you. And one thing that I always promise folks is I'm not going to be that pesky sales guy that just … I have those guys that call me every single week, that's trying to sell me something. And I always see the number come up. I'm like, “I'm not going to do that.”

Joe Axne:
So, it's, “Hey, here's what we found on the diagnostic and the labs. Here's a proper treatment plan. If it makes sense, let's do it. If doesn't, you're not going to hurt our feelings.” But you're going to walk away knowing everything about your specific environment that you need to make informed decisions on. So, take advantage of that because it's well worth it.

Stephanie Goss:
I love it.

Joe Axne:
Well worth it.

Stephanie Goss:
Thank you so much for having this conversation with me today, Joe. This was so, so fun. I hope that it feels helpful to those of you who are listening. And we will drop the link to I.T. Guru in the show notes for all of you. Thank you so much for your time and for joining me today, Joe. I really had fun.

Joe Axne:
I appreciate it. Thank you for having me. Appreciate it. Thanks, Stephanie.

Stephanie Goss:
Take care, everybody. Have a great week. Well, everybody, that's a wrap on another episode of the podcast. Thanks so much for spending your time with us. We truly enjoy spending part of our week with you. As always, Andy and I enjoyed getting into this topic. I have a tiny, little favorite ask. Actually, two of them. One is if you can go to wherever you source your podcast from. And hit the Review button and leave us a review. We love hearing your feedback and knowing what you think of the podcast. And number two, if you haven't already, hit the Subscribe button. Thanks so much for listening, guys. We'll see you soon.

This Week on the Uncharted Podcast…

A veterinarian who seems afraid of their patients… is it possible? This week on the podcast, Dr. Andy Roark and Stephanie Goss are tackling a letter from the mailbag, asking for some input on a veterinarian in their practice who seems to struggle with aggressive patients. The team and clients have complained about how this doctor interacts with and handles pets. Andy and Stephanie share some of their experiences on both sides of this coin – let's get into this…

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

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

Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag

Upcoming Events

May 21: Retain Your Team: Speak the Languages of Appreciation in Your Workplace

You can be the leader of a happier, more satisfied team, and it starts with understanding how each person in your practice feels the most valued.

Join us as we discuss the languages of appreciation and how they can help you motivate, train and retain your staff in this 2-hour, LIVE workshop.

June 8: Creating Content That Clients Crave

Many practices have heard that “content is king”, but few have systems in place that actually generate impactful content.

This extremely interactive session will explore the types of content that are most valuable, the potential impact of such, and proven methods for great content development.

All Upcoming Events

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

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Episode Transcript

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

Stephanie Goss:
Hey everybody. I am Stephanie Goss, and this is another episode of the Uncharted podcast. So this week on the podcast, Andy and I are tackling a very simple question that doesn't have such a simple answer. We got an email from a lead veterinarian at a fairly large hospital who was asking, “Do I have a doctor on my team who is afraid of our patients?” This is something that I am really excited to talk through with Andy and with you all, because it's something that I've been on both sides of this discussion for. I have gone through having a veterinarian on my team who is nervous or anxious around aggressive patients, and I've also been the technician to have some fears of my own. I share that, and Andy and I get into it and more on this episode. So let's get into this, shall we?

Meg:
And now, the Uncharted podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark, and the one and only Stephanie “Kitty's Got Claws” Goss.

Stephanie Goss:
I like that one.

Dr. Andy Roark:
It's a good one.

Stephanie Goss:
How's it going, Andy Roark?

Dr. Andy Roark:
It is good. You and I had a big week and a busy week working with a group of about 75 doctors.

Stephanie Goss:
Yes.

Dr. Andy Roark:
And talking to them about leadership and managing people and running hospitals, and we worked with them for a couple of consecutive days.

Stephanie Goss:
Yes.

Dr. Andy Roark:
And then we're going to talk with them every two weeks for about the next eight months.

Stephanie Goss:
I know.

Dr. Andy Roark:
And man, this is Uncharted next-level stuff. I love working with groups like this. Boy, we are building communities inside of other organizations and really getting people support and teaching them stuff and having them work on their own issues and challenges together. This is the future.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
We're living in the year 3000.

Stephanie Goss:
It is so much fun. This is not our first time with this company. We had another group of doctors like this last year, and that group was pure joy. It was our first time working with them and we had so much fun.

Stephanie Goss:
And I was a little bit nervous about starting this program because I thought last year was so amazing. How can we top that? And I have to say that this new group, they rose to the challenge. These people are amazing, and I am so looking forward to spending the time with them this year.

Stephanie Goss:
I think you're spot on. This is so fun. It's something totally different for you and I. I love getting into the weeds about what their individual specific challenges are in their practices. This is the kind of stuff that really fills my cup, and so I am really looking forward to it. It is going to be a fun year.

Dr. Andy Roark:
Yeah. One of the analogies that I think about in leadership… And so bear with me here for a second, because it's going to seem really weird. For a long time, I was a big college sports fan, football and basketball especially. I love college football and college basketball. And one of the things that made those sports so exciting for me was that, at that level, momentum is a huge factor.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And I think a lot of it is because you're dealing with younger people, but also they care a lot. These are college athletes. And so momentum was a huge thing. And so you would see games that would just shift as one team gets excited and gets momentum and the other team feels down.

Stephanie Goss:
Yes.

Dr. Andy Roark:
And you could see huge upsets because the lower-ranked or the lesser-experienced team would start to win and they would get fired up, and the other team would get scared or demoralized and fall off. And I bring that up because that was a driving force in college sports, and I always thought it's fascinating.

Dr. Andy Roark:
But Stephanie, I have really come to believe that that phenomena is true in leadership.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And it is something that I've always, again and again and again in my career, I have found it to be absolutely the case of if you can generate momentum, if you can make your team feel excited and feel good, they will perform. And when they perform, if you add to the momentum, you do the wave by yourself. You are a one-person cheering section and you share positive comments from clients, and you celebrate them, and you thank them individually and you tell them what winners they are, you can make them believe that they are winners. And then, when the next challenge comes, they step up.

Dr. Andy Roark:
And I will tell you, this is the power of culture. And a lot of people say, “Oh, culture, culture.” And a lot of it is momentum of we jumped in and we created a positive experience and we made people feel good, and then we hired more people.

Dr. Andy Roark:
And that's the beautiful part. You have this culture. You have this positive experience or atmosphere, and then you add more people to it, and those people just get swept up in it. They're like, “I guess we're doing this.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And so often when we have people who are saying, “We're dealing with negativity in our practice,” and things like that, a lot of times it's because they- and they don't have any momentum, right? That's it.

Stephanie Goss:
Sure.

Dr. Andy Roark:
Everyone is neutral, and you've got some negative people. And it's starting to roll the boulder on flat ground. And you go, “This is all effort.” But if you can get some wins on the board, if you can show people what is good and what is ahead, if you can get them to believe a little bit, then everything is easier. And then you make them believe some more, and you show them some more good things, and you show them what the practice can be when we get along, and they'll continue to improve. And often times you can run the person who's determined to be negative. They'll just be like, “I don't like it here anymore.” And I'm like, “Good.”

Stephanie Goss:
Good.

Dr. Andy Roark:
Good.

Stephanie Goss:
See you later.

Dr. Andy Roark:
And they'll leave. But anyway, I bring that up because the group that we were working with, as we had worked with this other group and it had gone so well.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And on the first day of bringing in this new group and working with them, it was obvious. They had talked to the first group and they were like, “We're here for this.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And as a result, they threw themselves into it and it was massively successful and much better than we could have ever made it be if you and I had to do all the heavy lifting. They came as active participants. And again, I use this as a teaching analogy for everybody and everything, get a group of people in your practice and get some wins on the board.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And it doesn't have to be everybody. If you have a great CSR group, there's nothing wrong with working with the CSRs and doing some stuff with them and getting some wins and making some changes, and then taking what you've done with the CSRs to the other group and saying, “We've been doing this up front and we figured a lot of things out and they're excited about it, and you guys have started to see this working. I'm going to share this with you guys now.” And you can sweep people a lot of times up in enthusiasm and get them on board because you've already got momentum.

Dr. Andy Roark:
And so anyway, that was just the lesson that was in my mind, if I was thinking, why did this go so well?

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And it went so well because we'd already won.

Stephanie Goss:
Right.

Dr. Andy Roark:
We'd already won. We'd already put a lot of points on the board. And people had a lot of fun.

Stephanie Goss:
Yes.

Dr. Andy Roark:
And so bringing in new people, they were like, “I'm ready to have fun. I'm ready to put points on the board.” And man, they went to work. And then it's a self-fulfilling prophecy.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
Like that's the thing is they showed up ready to kick butt and, surprise surprise, they kicked butt.

Stephanie Goss:
They kicked butt.

Dr. Andy Roark:
Yeah. It's confirmation bias. They believed that it was going to be awesome, and so they acted in a way that would make it awesome, and then it was awesome.

Stephanie Goss:
Yeah. It's so true, and it's such a great example. It's going to be a good year. It's certainly been a good week, that is for sure.

Dr. Andy Roark:
Going to be a good year, yeah.

Stephanie Goss:
Everybody's like, “Where is this going?” And it is not going towards the episode.

Dr. Andy Roark:
That was it. That was the stand-alone. That was a free mini episode inside the larger episode.

Stephanie Goss:
We're just telling you guys about our week.

Dr. Andy Roark:
It's like when you watch a Pixar movie and they have the cartoon at the beginning.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
That's like four minutes long.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
That's not connected to the other thing. It's like the squirrel chasing the acorn through the Arctic. That's what you just got right there.

Stephanie Goss:
I can already see Dustin, our editor, coming up with ideas for how he's going to attach a cartoon to this.

Dr. Andy Roark:
Yeah. I see Dustin our editor going, “I know seven minutes that I can cut right now.”

Stephanie Goss:
Okay. Reigning it in.

Dr. Andy Roark:
All right. All right, here we go. Here we go, back on track.

Stephanie Goss:
We have got a good one for everyone this week. I think I'm excited about this. We got a mailbag question that was a little bit different than the ones we normally got. And at first I thought, I don't know if our podcast is the right place to talk about this. And I honestly thought maybe this is a good one for the Cone of Shame podcast. But the more I thought about it, I thought, “No, I'm interested in this. I certainly have seen this.” So I'm excited to talk about it.

Stephanie Goss:
So our mailbag question is that: I'm the lead veterinarian at a fairly large hospital. I have one doctor on the team that I'm consistently receiving complaints from staff and clients in regards to how this doctor is dealing with animals. They basically seem scared to death of them if they look at the doctor wrong. They are an amazing, intelligent doctor, and so our lead vet is struggling with how do I deal with this? This doctor has been through fear-free training. So, specifics that they gave us generally, when they're talking to owners about their concerns regarding their pets, they're using words like “extremely aggressive” and they are making the technicians manhandle them and definitely not use their fear-free or low-stress handling techniques because it makes them feel more comfortable, I'm assuming.

Stephanie Goss:
This doctor usually is not the one helping or assisting with any of the treatments. And so our lead vet says, “I find myself sometimes watching in horror, or I end up just jumping in and assisting the technicians and assistants myself to get things done. Is there some guidance for this situation? Should I be telling my team to avoid scheduling known anxious, worried, fearful, aggressive animals with this doctor?” And I thought this was such a good one.

Dr. Andy Roark:
That's a great one. Yeah, I love this question. And this is real life. I guess I see this behavior, but to [inaudible 00:11:03] I really love about this is you can take fear of pets and replace it with any unacceptable behavior-

Stephanie Goss:
Sure.

Dr. Andy Roark:
-that comes from a place of fear or insecurity.

Stephanie Goss:
Yes. Yep.

Dr. Andy Roark:
The steps that we're going to use here- The point that I really want to make in this whole podcast, and I'll make it right now right up front, is yeah, we are going to approach this in a very logical, strategic, matter-of-fact, behavioral change way. And it doesn't really matter what the behavior is. And that's what I kind of want to lay down. And so when we say, “Is this an Uncharted podcast? ‘Cause this is more animal handling.”

Dr. Andy Roark:
I'm like, “No, it's not. It's a behavior change.” A doctor is exhibiting a behavior that the staff and clients are complaining about, and we need to address that behavior. And so I think this is going to be a really useful podcast, even though at first blush, it may sound kind of niche. First of all, I think it's much more common than people think it is. I would be really curious to hear from the audience. Do you see this in your practice? ‘Cause I've seen it a number of times. And so first of all, I wonder how common it is. And part two is this is a coaching behavioral change podcast. And man, this is the Swiss army knife of podcasts.

Stephanie Goss:
It's so funny because, as usual, you and I are thinking the same way. Sometimes it's scary how much in each other's heads we can be, because I had the same thoughts. When I was thinking about, okay, what is this? Well really at the end of the day, we have to do our jobs, and taking care of animals is part of our job. And there are different ways that we can approach that, and different things that we can try in terms of coaching behavior and changing behavior, like you mentioned, but our jobs involve animals who we know aren't always calm and gentle and comfortable with us, and fear is a powerful thing on both sides, on the animal side and on our side. And so for me, it was like, “Look, we know that fear could get us hurt when we're working with our patients, if they sense it.”

Stephanie Goss:
And we also know that lack of respect or caution on our part can get our team hurt. And so there's concern on both sides. So we've got to find the middle ground, because this person is a veterinarian and we have to help them do their job. So I thought very much the same way. So I'm excited to talk about this and I agree with you. When I read it, the reason I was interested in it was because I went through this with one of my veterinarians at my practice. And it is hard because I will tell you, I felt stumped at first as a manager. This is kind of our job. What do you mean you're afraid? You know? I was at a loss for how do I approach this? So I think this one's going to be fun. So should we start with our head space as we do?

Dr. Andy Roark:
Yeah, sure. Always. Yeah, always. All right. So first let's just get real basic head space. Start with empathy.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
Start with compassion. Start with kindness. Getting angry at someone who is afraid, or who is frustrated, or is anxious, that is counterproductive. You know? Yeah. Getting frustrated with this person is not going to be helpful. And if you are frustrated, which you could be because you're getting complaints from the staff and now a client's complaining and you have to call them, it'd be really easy to be like, “This has to stop, and you need to suck it up and you need to do your job.” And that is a human emotion to feel. Yeah, that's very understandable. Do not communicate that, please. Just take that home and sit with it, and try to breathe through it and empathize and say, “This is a good person, and they are struggling.”

Dr. Andy Roark:
We all struggle with certain things about practice and our professional- None of us are perfect. We're all flawed human beings. And so they're struggling with a thing, and I just want to try to be forgiving of that because I also have things that I struggle with. Everybody's got their thing. The other thing is to seek first to understand. It's easy to make assumptions about why people behave the way that they do. And one, I want to validate that that assumption is correct. Are they making assumptions about pets that aren't true? You know what I mean? Are they really afraid of pets that they should not be afraid of? Or are they actually seeing things and they just disagree? We've all had pet owners who were like, “How dare you muscle my dog.”

Stephanie Goss:
Right?

Dr. Andy Roark:
And their dog is literally lunging-

Stephanie Goss:
Right.

Dr. Andy Roark:
-and snapping at people. You got to be kidding me. I know you think Fluffy is wonderful. I'm looking at bared teeth, and I do this all day every day and I'm not risking my face, or my hands, or my technician's personal safety so that you get to keep telling yourself your dog doesn't need a muzzle. I'm not going to do it.

Stephanie Goss:
Right.

Dr. Andy Roark:
There's balance here. Let's go, “Okay, well, what is real?” And the other thing is, and seek first to understand, man, there are people who have had real experiences that if you had them, it would change the way that you think.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
You know? You and I both know a RVT who got bitten by a cat in her job, and then she had anaphylactic reaction to the antibiotics that she got to treat it. And ultimately, she ended up not being able to work on the floor anymore. It was career-ending for her.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And she works in a different part of vet medicine now, but that was it for her.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And you go, “Man, that sits in the back of my mind sometimes,” of hey, you never know what's going to happen.

Stephanie Goss:
Oh yeah.

Dr. Andy Roark:
And so getting bitten is not a thing to blow off. I mean, I have friends with permanent nerve damage in hands from dog bites or cat bites. I have friends with facial scars.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
I have a friend who was, I think it was a cat, a cat bit her right on the lip. This is recently. And she's going to go to the plastic surgeon, and get it put back together. This is not something to blow off.

Dr. Andy Roark:
So again, let's put that in our minds and be like, “Hey,” empathy, seek first to understand what's going on and what's driving this person. What are their actual concerns, and let's start to dig into this. If you think, “This person just won't, they're not doing their job,” that is a blunt statement that is not productive. I can't work with that. That doesn't give me any nuance, any room for collaboration, any room to work with the person on their behaviors. I don't know where to begin training on that. I don't know how to address their concerns because I don't know what their real concerns are.

Stephanie Goss:
Right.

Dr. Andy Roark:
That is a dead-end mindset. And so get curious and get empathetic, and have this conversation because you want to help this person. And so that's my opening head space position.

Stephanie Goss:
Yeah. I was thinking very much the same in terms of the “have empathy for me”. It was also about assuming good intent, and really when you said it, “have empathy”, I agree with that. More than make sure that you're controlling your response outwardly, I think it's about asking yourself some questions like, could you understand where this could be a concern? Because a lot of times it's not that you're outwardly going, “Oh my God, this person is awful.” And I didn't get that sense here at all from our mailbag writer. I got the sense that they were just like, “I kind of don't know how to relate to this, so I don't know what to do with it,” which I imagine is the case for a lot of people.

Stephanie Goss:
And so for me, it's about this person. I truly believe no one becomes a veterinarian if they don't love animals. I don't know how you could, to some degree. And so for me, it's about assuming good intent. This person is clearly here for a reason, because they want to be. And so my job as the leader is to ask different questions. And so for me, the head space is about, I agree a hundred percent, having empathy and leaning into, okay, “What could be some reasons why this person could be afraid or concerned or worried about the behavior?” To your point, I totally understand that, and I will say that this episode is hard for me because I've been there on both sides.

Stephanie Goss:
I've been the manager who has worked with a doctor who genuinely was afraid of a certain type of patient and had to work through that. And I've also been the technician, and I'm going to out myself here, I've been the technician very early in my career taking x-rays with another very competent qualified technician with a canine patient. It was a really sweet, old golden retriever. We had it on its back on the x-ray table. It was when we had film x-rays, so the x-ray room is totally dark. And my other technician screams and I flip on the lights, and their whole face and neck is bleeding because the dog got painful and snapped her right in the face. And it scared the hell out of me.

Stephanie Goss:
And I will tell you that I was then the technician where, for a really long period of time, I would not want to work with golden patients without a muzzle on because it caught me so by surprise. Because we think generally they're so sweet and happy, right? And this patient had been no exception to that, super sweet, but it was just one of those fluke things. But it evoked a response in me that was something that I couldn't control.

Dr. Andy Roark:
Yeah.

Stephanie Goss:
And I remember having other technicians and other teammates be like, “Are you kidding me? I'm not going to put a muscle on this patient. It's totally fine.” But it made me very, very nervous because of something that I had experienced. And so a lot of what we're going to talk about, I was thinking, I could put myself in someone's shoes. I could understand where they could be nervous or worried because maybe they have had an experience. And so for me, it's about how do we think about putting ourselves in somebody else's shoes?

Stephanie Goss:
And so we get to the action points. One of the things is you got to have a conversation about, “Did something happen?” Have they had that experience? Because let me tell you, when I would share with other technicians, particularly when I left that practice or we had people come in who weren't there when it happened, and I shared that experience, there was an immediate empathetic response of, “Oh my gosh, I totally understand that.”

Stephanie Goss:
And we could work together to find middle ground, but until that information was shared, I had other people judging me. And they were just like, “Why? You're such a bad technician. You're such a bad restrainer that you couldn't work with a golden retriever without putting a muzzle on it?” That wasn't the case at all. But it was a hard thing to go through. And so I think when we, when we talk about finding the empathy, I think it's really important in terms of starting at the beginning and asking what happened. And so that really is an action step here, but I think your point about empathy is spot on there.

Dr. Andy Roark:
Well, I think you take me to the second point that I want to make too, which is when we start to have this conversation, commonality is key, right? I don't want this person to feel like they're a freak in vet medicine. I know that's a strong word, but it is how I don't want them to feel. I don't want them to feel like, “Oh, you're the weirdo who's afraid of pets.” I think that your experience is not uncommon.

Stephanie Goss:
Yep.

Dr. Andy Roark:
Also imagine how the team looked at that and they're like, “Stephanie's putting muzzles on all the golden retrievers? This is bonkers.” But when you tell that story-

Stephanie Goss:
True story.

Dr. Andy Roark:
I understand how that would affect you.

Stephanie Goss:
Yes.

Dr. Andy Roark:
Again, I think it's part of the human experience. I will share for myself, I've never been super comfortable with horses.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
I don't run screaming from the paddock, but I didn't grow up with horses. I never planned to practice on horses. I was like, “Hey, vet school, I'll sign a waiver that says I'm not going to touch a horse. And then you just let me go do more small animal courses and I'll be pumped.” And they did not go for it.

Stephanie Goss:
They were like, no, actually you get the first rotation. Here you go.

Dr. Andy Roark:
Oh, totally. But I have these thoughts too, because when I took a job years ago and they were like, “Hey, we take call because we have a mixed animal component.” And they're like, “You won't see horses or mixed animal stuff during the day, but if you have to take call, you're going to have to go see that stuff.” And I thought, man, I have to brush up on it. It's just not something that I'm comfortable with. And I know the clients would've noticed that. And so I just said this is-

Stephanie Goss:
Not the right thing.

Dr. Andy Roark:
You need to know that this is not in my repertoire and it's not something I'm going to be comfortable doing.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
But anyway, I put that forward because having these conversations, this goes back to empathy, is can you think of a time when something happened to you or an experience when you were uncomfortable? That's going to help you get into a good head space to talk to this person. And even if you've never felt that way, just the stories I told earlier of my friend having permanent nerve damage or my other friend having an anaphylactic reaction to the antibiotics from a cat bite and then having it end her career on the floor, those things are good to get in your head. So again, just empathize, seek to understand, look for commonality because that's how we're going to connect to this person and make them not feel judged and outcast.

Dr. Andy Roark:
And because when I come to them and say, “Hey, we need to talk about something,” and I want to hear where you're coming from. I need to understand what's going on. And I get it, and I can see that. And I'm not dismissing you as you're doing something that's ridiculous, I can't abide by. I think you and I need to get into a spot of this is human behavior. And I'm curious as to where it came from and why you feel it. The other thing I think that we need to figure out is why is this true? So here's the hard thing with this case is that when the staff says, “The doctor seems afraid of these patients, and the clients say the doctor seems afraid of these patients,” if I go to the doctor and say, “Hey, why are you afraid of patients?” What are they going to say?

Stephanie Goss:
“I'm not.”

Dr. Andy Roark:
“I'm not afraid of those patients. I'm just being cautious and keeping people safe.” And that's an argument you can't win, because being afraid of patients is completely subjective.

Stephanie Goss:
Yes, yes.

Dr. Andy Roark:
And you can't do it. And so talking to them about being afraid, that's a challenging thing, which is why we're going to have to build empathy and trust.

Stephanie Goss:
Yes.

Dr. Andy Roark:
Because you're not going to be able to prove that they're afraid of patients because only they know-

Stephanie Goss:
Right.

Dr. Andy Roark:
-if they're afraid, and they may be in denial about it.

Stephanie Goss:
Yes. Yeah, I think the last thing for head space, for me, which ties directly to then starting to have that conversation, is I think you have to be able to be honest and also be vulnerable yourself. And what I mean by that is if you were looking at this other person and you were thinking, “I don't understand why you're putting the muzzle on every golden retriever,” you have to be willing to be vulnerable and honest and say something when it comes to having the conversation, something along the lines of “I care about you and I want to make sure that you feel comfortable here at work. These are some things that I've noticed and they seem unique to you. And so I want to understand more.” When I say being honest and vulnerable, it means you can share that you may not understand or that there are things that you are worried about in a way that doesn't feel like you are attacking them.

Stephanie Goss:
Like you said so well, it's like if you say, “I think the way you're acting makes it seem like you're afraid of animals to the client,” they absolutely can and should, as a veterinarian who is responsible for protecting their team, there should be some part of them that is thinking “I want to be safe with all of my patients.” Right? And so you can't argue that safety side of it. But if you can be honest and you can be vulnerable with them and share, even if you don't understand, I think that's going to go a long way to helping have the conversations that you need to have in order to unlock this and start to do some problem solving.

Dr. Andy Roark:
Yeah, I agree. I got a couple other things that are related to that, but I'll lay them down when we start talking about action steps.

Stephanie Goss:
Okay. That sounds good. Should we take a break here and then get into how we tackle this?

Dr. Andy Roark:
Yeah.

Dr. Andy Roark:
Hey, Stephanie Goss, you got a second to talk about Guardian Vets?

Stephanie Goss:
Yeah, what do you want to talk about?

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

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

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

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

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

Stephanie Goss:
Two workshops coming at you from our dear friend, Dr. Tracy Sands. Tracy is passionate about amazing teams, building a intentional culture of appreciation, and that is exactly what she is going to talk to us about. She is leading the first workshop May 21st and it is “Retain your team: speak the languages of appreciation in your workplace.” She's going to talk to us and work with us on how to learn about the languages of appreciation, but also talk about how do they influence our team and clinic cultures. That is happening May 21st at 2pm Eastern, that's 11am here on the west coast. It is $99. You can participate if you are not an Uncharted member. And if you are an Uncharted member already, it's free as always.

Stephanie Goss:
And part two is happening in June. It is June 25th. It is also a two-hour workshop, also $99 for our non-members and free to our members. And it is “Be a part of a happier team: strategies to build an appreciation culture in your practice.” So this is going to be an even more in-depth look at workplace appreciation, but the actual practical how do we apply it in our practices. To find out more, head on over to the website at unchartedvet.com.

Dr. Andy Roark:
All right, well, let's talk about how we start to tackle this and have this conversation. Okay?

Stephanie Goss:
Do it. Yep.

Dr. Andy Roark:
Perfect. And to no one's surprise, the first thing that I'm going to talk about is expectations and clear communication.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And that goes back to what we talked about before about I don't want to pull a doctor in and say, “Hey, you're afraid of pets.” That's not the conversation that I want to have because I can't prove it and it's unspecific, and it leads immediately to debate about fear.

Stephanie Goss:
Right.

Dr. Andy Roark:
And a lot of people were raised with the mindset that being afraid is to be cowardly. You know what I mean? There are societal or cultural stereotypes and norms around fear. I grew up in rural North Carolina. And if you called me afraid, when I was 15, 14, 12 years old, I would negatively react to that.

Stephanie Goss:
Sure.

Dr. Andy Roark:
Even if it was true, I would a hundred percent tell you it wasn't. And that's a cultural thing, and so everybody's different with that. Talking about being afraid of pets is an unproductive conversation.

Stephanie Goss:
Yep.

Dr. Andy Roark:
Period, full stop. And so the first thing we laid on action steps is speak in specifics.

Stephanie Goss:
Yes.

Dr. Andy Roark:
What are clients complaining about? What is the staff concerned about? So in the example you gave about the golden retriever, it's not about “Stephanie's afraid of golden retrievers.” It's “Stephanie muzzles every golden retriever patient that comes in, and the rest of the staff-” and I'm not going to say they hate it, or they are upset about it. I'm going to say “they don't understand.” And I feel like that is true.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And that is not judgmental.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And this is not a disciplinary conversation, but, “Hey, I have heard from a number of people that you muzzle every golden retriever that comes in and some people don't understand, and they're trying to process that and they worry about the stress that the muzzle causes.”

Dr. Andy Roark:
And so let me ask you about that. Does that ring true in your ears or do you think that's a valid thought that other people are putting forward? And that is how I'm going to open this up very softly, very broadly, but I'm not going to talk to you about being afraid. I'm going to talk to you about the behavior. Hey, and you see this a lot. A lot of people who are afraid of cats are cat scruffers. They handle cats aggressively. They grab the cats.

Stephanie Goss:
Yes.

Dr. Andy Roark:
Things like that. And people who are cat people do not like that, and rightfully so.

Stephanie Goss:
Yes.

Dr. Andy Roark:
And what I hear a lot is, “This person doesn't care about low-stress handling. They don't like cats. They hate cats. They're mean to cats. They're untrained.” The truth is, they're afraid.

Stephanie Goss:
Right.

Dr. Andy Roark:
And that is a vulnerable thought to have, is, “I'm doing this because I'm afraid of cats and I need to work through this.” But that is true. That's the conversation to have is not, “Hey, you are man-handling cats. You are being rough with cats.” It's, “Hey, people don't understand the level of control that you are taking. Help me understand what your process is and what your thought process is when you deal with these patients.”

Stephanie Goss:
Yep.

Dr. Andy Roark:
And I'm just trying to get into your head. Is it a lack of knowledge? ‘Cause a lot of people are like, “Clearly this person hasn't been trained,” and I go, “I bet they have been trained, but I bet that they're afraid and they're not messing around.” At some point we do have to deal with that, and we're going to come back around to what that looks like in a bit.

Stephanie Goss:
Yeah. No, I agree. I have been thinking, not only do you have to be specific, but also I think it's really important to have it be recent examples. When it comes to feedback, nothing puts people more immediately on the defense than giving them an example that happened far in the past. Right?

Dr. Andy Roark:
Right.

Stephanie Goss:
It's one thing if you say, “Hey, I got a call from Mrs. Jones who was here on Monday and she said this was how you reacted in the room. Can you tell me more about what was going on? Because I really want to understand,” right? That feels radically different than saying, “Well, over the last six months I've gotten 15 complaints from clients about the way that you've acted with their patients in the room, and so let's talk about Fluffy. I understand she was here three months ago but this owner was particularly upset. So let's talk about that,” right?

Stephanie Goss:
And I think as a manager, our logic brain can immediately go to, “Let's take a really clear-” and by clear, our brains often interpret that as the most severe of the examples, right? And that isn't necessarily, I think, the best tact to take here. I think it's really important to have a really concrete example to be able to share with them, especially concrete examples of the kind of feedback that you're getting from the team. And you gave some really beautiful ones of how you can transform the words that you may be given from the team or from a client into something that is softer and less aggressive in terms of talking about it with the other person.

Stephanie Goss:
But it's got to be specific. And for me, I agree with you. It's just starts with, “Tell me more about what was going on.” Like you're seeking to understand, you don't want to put them on the defensive, you just want to know because the ideal situation, regardless, for you as the leader, is for them to open up and tell you something, tell you about their experience as a baby technician with the golden retriever, tell you about an incident that they had with a cat that really scared them. That's the goal is to get them talking, and so you've got to use vocabulary and word choices that are going to help support that.

Dr. Andy Roark:
Yeah. The other significant Jedi trick that I use in these cases, and that's what I said, this is any sort of a behavioral change, but anything that comes back from the staff or it comes back from the clients and you didn't see it, and you don't know what happens. One of the approaches that I have used many, many times, and I find it very successful, is to not argue about what happened, because I wasn't there.

Stephanie Goss:
Right.

Dr. Andy Roark:
But I am going to talk to you about the perception of those who were there.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And so I'm not saying you're afraid, I'm saying that there clearly is a perception among the clients, the client who called me.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
Their perception was that you were afraid. That's what they said. I'm not saying that you handled the cat overly aggressively. I wasn't there. The perception of the staff was that this patient was unnecessarily restrained in a way that caused stress. That was their perception. Now perception is not reality, but it's what they saw. And here's the reason I bring that up is because if I say to you, “Stephanie, you did this bad thing,” you're going to feel shame. You're going to feel-

Stephanie Goss:
I'm going to turn tomato red immediately.

Dr. Andy Roark:
You're going to turn to tomato red. You're going to feel shame. You're probably going to feel anger. You may disagree that that's what happened. You're going to feel falsely judged, all of those things. But if I say to you, “Stephanie, there was a perception that this is what happened-“

Stephanie Goss:
I wasn't there so it doesn't [crosstalk 00:38:27]

Dr. Andy Roark:
And so tell me what you saw and what happened.

Stephanie Goss:
Yep.

Dr. Andy Roark:
And so one, that helps me unlock the conversation, but number two, and bear with me, I swear it's true- What do I care about? The truth is, I can't fix the past, right?

Stephanie Goss:
Right.

Dr. Andy Roark:
What happened is over. What I care about is future behaviors. Now listen, I do not care if you change your behavior because you admit that you are afraid, or if you change your behavior because you understand other people have the perception that you're afraid, and you want to make sure that you address that perception and you are going to behave differently to address that perception. I don't care. But addressing the perception of others is much less challenging to my self-image than addressing some significant thing about myself.

Stephanie Goss:
Yes.

Dr. Andy Roark:
And so I have just found, again and again and again, that it's easier to talk about perception than it is to talk about, “Andy, you're afraid of this, and you need to stop. Andy, you lose your temper and get angry.” And I go, “No, I don't.” And now I'm talking about who I am as a person, and that's scary.

Stephanie Goss:
Right.

Dr. Andy Roark:
But if you said to me, “Andy, the staff has a perception that you have a short fuse,” I can say, “Well, why do they think that?” And they'll say, “Well, this is where you raise your voice, and because you're 6'3″ (I'm not 6'3″) because you're 6'3″ and you raise your voice. It's very intimidating. People think that you're very upset.” And I go, “Well, that's not true.” And I say, “Well, it doesn't matter that it's not true. It's the perception that the team has, and so we need to address it.” And oftentimes people take that- You love the idea that I imagine myself as 6'3″. In my head, I see myself like a chihuahua sees himself. You know what I mean? That's how I view. When I look in the mirror, chihuahua Andy sees mastiff Andy. And I'm like, “Damn, I'm intimidating. I have to tone it down.”

Stephanie Goss:
I can't, I can't.

Dr. Andy Roark:
Let's get back on track. Okay, I'll give you this example. So this is the example of perception versus truth in my life, okay? And I've told this story before, but it's the best example that I have. I remember being a parent of young children and I was working a lot, and my wife was teaching a college course that was a three-week course where they traveled. She had gone to Ecuador with a bunch of students. And so I've got the kids for three weeks, right? And so I'm busting my hump and I'm working hard, and I am full-time dad for two little kids. Shout out to all the single parents out there. You guys are amazing. Anyway, and I'm doing it. And so my parents call, and they're like, “Hey, would you like to come up for the weekend?” And I thought, “Yes, I would. Yes.”

Dr. Andy Roark:
And so I take the kids up there-

Stephanie Goss:
You're like, “Help!”

Dr. Andy Roark:
-hand them to my parents. Yeah. And then I disappear into one of the back rooms with my laptop and just bang out work for two days. And then the weekend was over and I emerged from the room and I'm like, “Hey, thanks a lot, guys. See you later.” And my dad looked at me and he said to me, “Hey son, I'm concerned about the relationship you have with your kids.” And I was like, “What?” And he was like, “You were completely absent this whole weekend, and we did all these things. They're not going to remember having you around. I'm worried about you, and I want you to think about this.”

Dr. Andy Roark:
And guys, I have a great relationship with my kids, and I did then too. A very engaged dad. I can say that in all honesty. I love the kids and I spend a lot of time with them, but, and so I went home and that's why I was so bothered by this, is I feel like I'm a really engaged dad.

Stephanie Goss:
Right.

Dr. Andy Roark:
And so I called my brother who knows me really well and who's around a lot, and talks to me all the time. And I said, “Man, Dad said this thing to me and it really upset me.” And he said, “Well, Andy, you have a perception problem.” He said, “All that they see is that you show up and disappear.”

Stephanie Goss:
Right.

Dr. Andy Roark:
“And they don't see the rest of the things.”

Stephanie Goss:
Right.

Dr. Andy Roark:
“And so you do not have a ‘I'm a bad dad' problem, you have a ‘my parents perceive me as being absent' problem. And so you need to address that perception that they have.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And as a result, when I go up there, I'm fully engaged and I'm involved in this. And I just realized, well, “Hey, I can't go up there and clock out and do my own thing. I need to be engaged because this is the picture my parents have of me and my relationship with my kids” And that has always been a lot to me because if you said to me, “Andy, you're a bad dad,” I would fight with you, like really throw down, because I'm huge and powerful and intimidating.

Stephanie Goss:
Because you're a mastiff. Okay, got it.

Dr. Andy Roark:
I would write you a passive-aggressive letter on flower stationery. That's the real thing that would happen. But I don't want to think that, and I don't want to hear that, and I don't want to believe that.

Stephanie Goss:
Right.

Dr. Andy Roark:
But when my brother says, “You have a perception problem,” I go, “I can fix that perception problem.”

Stephanie Goss:
Right. That makes sense, yeah.

Dr. Andy Roark:
And so I do. I know it's a long way to go, but I think this is a really important point. When we talk about behaviors that are being reported by the staff and the team, is I can say to you, “The truth is, I don't know how you feel and I wasn't there, but I'm going to talk to you about the perception that people have, and you and I are going to work on that perception.”

Dr. Andy Roark:
And that brings me to the next part of this. There is an excellent opportunity here not to correct this person-

Stephanie Goss:
Right.

Dr. Andy Roark:
-but to recruit this person.

Stephanie Goss:
Right.

Dr. Andy Roark:
And that unlocks this conversation in yet another way, because people say, “Well, how do I bring them in and tell them they need to stop being afraid of pets?” Or “How do I bring them in and tell them they need to do training?”

Stephanie Goss:
You don't.

Dr. Andy Roark:
And the answer is you don't. Here's the beautiful Jedi maneuver is I'm going to bring them in and I'm going to say, “Hey, Stephanie, I got a call from this client that you saw yesterday, and they had this concern and this is what they said.” And I have to tell you, relatedly, “I have gotten feedback in the last couple of weeks about another patient where the staff felt like this patient was over-restrained and they mentioned it to me, and I just want to talk to you about that.”

Dr. Andy Roark:
And then I'm going to ultimately, if the person pushes back and say, “Well, I don't agree that these things are going on,” or “I don't agree that the way this was done was out of line.” And I'll say, “Well, you can choose to disagree. The perception of the clients and the staff is not favorable, and that needs to be addressed. Because I can't have the staff working with a doctor that they are worried about, It's bad for you and it's bad for me, for the perception of the staff to be that we're not doing what we're supposed to do. And so let's, you and me, circle up and let's figure out how we're going to control this perception and what needs to happen.

Dr. Andy Roark:
And I'm happy to invest in you. We can do team training and focus on this. If that will help make them more comfortable, if that will make you more comfortable.” But again, and here's the other thing, I can't propose action steps until I know why this behavior is happening.

Stephanie Goss:
Yes.

Dr. Andy Roark:
Because like to Stephanie's point, if you're worried because you saw this thing happen and I'm like, “Let's get you more fear-free training,” then that's not going to fix the fact that you had this experience.

Stephanie Goss:
Yes.

Dr. Andy Roark:
We're going to need to work through that in a different way. But the big last sort of point I want to hit on here is I don't have to fix this problem directly, meaning it's not on me to fix you because I don't know how to do that.

Dr. Andy Roark:
When feedback comes from the clients, one of the easiest things to do is to say to the doctor, “The perception of the client was X and we need to figure out how to control that perception in the future.” What can we do to make sure that clients do not feel this way? And often we can fix the problem by, say, “Oh, no no, it's not about you. It's about other people and their perception of this. And we need to fix it because we can't have this in the building.” Great. As long as the behavior gets fixed, I don't care how it's presented.

Stephanie Goss:
And I think the nice part about looking at it from the perception perspective is that it becomes easier for the person receiving the feedback to put on their empathy hat. Because if you told me, “Stephanie, the perception of Mrs. Jones was that you were man-handling her patient. And I know you, I don't think that was the case, but that was her perception. And so we have to figure out how do we address it in the future so that she doesn't feel that concern or that other people don't feel that concern?” I would immediately much more easily be able to lean into having empathy because I, as a person who cares about animals, but also who cares about my clients, I wouldn't want clients thinking that I man-handled their pet.

Dr. Andy Roark:
Exactly.

Stephanie Goss:
Right? So it unlocks the empathy. You are approaching it from an empathetic perspective as a leader, but it also allows the ability to unlock some of those emotions, too, for the doctor to be able to put themselves in the client's shoes or the staff's shoes and unlock their own empathy in a way that doesn't feel like I am in trouble because I did this thing. And we're talking about why I did the thing, the why doesn't matter. And so I think that's spot on and I love it.

Dr. Andy Roark:
Well, it's just flipping it around from a place where you're arguing with the person about what happened, because I wasn't there.

Stephanie Goss:
Right.

Dr. Andy Roark:
But it's not an argument for me to tell you, “This is how people perceived what happened.”

Stephanie Goss:
Yep.

Dr. Andy Roark:
That's statement of fact that can't be argued with. Yeah. I wasn't there, I don't know if it was inappropriate restraint or not. The perception was that it was beyond what was necessary. And that's the second complaint in that vein that I've gotten in a short period of time, and we need to figure out how to fix this perception lest it become your reputation and something that we have to deal with.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
Right. So those, I think, are the big ways that I would have this conversation, okay? And so then people go, “Okay, well, that's great, and I understand how you explain it. What do you actually do? And what do you do if this doesn't work?” And so the big point that I want to make here, when we talk about moving into action steps, I think a lot of us have a tendency, myself included, to think very black and white. I can let this person go, or I can demand that they fix this and fix it full stop, continue. And if they don't fix it, then I'm going to have to let them go. And people freak out and they're like, “What am I going to do?” It's like, okay.

Stephanie Goss:
Right.

Dr. Andy Roark:
The first thing to try to do with this is try to partner with the person, “Hey, what are we going to do? How are we going to move forward? What's the underlying cause? How do we address it?” Because that's going to inform us in what we're going to do, okay? Now, I feel much better emotionally when I can just look at things pragmatically, and so here's the truth. If this person is afraid of the pets to the point that they're not able to do their job, I have a couple of options, okay? Let's say that they are not able to change their behavior. It may be possible for me to compromise. Maybe Stephanie Goss doesn't see golden retrievers. And people go, “Oh my God.” I'm like, “Look, does anybody care that Stephanie doesn't see golden retrievers?”

Dr. Andy Roark:
Now, if it's Stephanie Goss doesn't see fractious cats and she's one of two paraprofessionals that we have, that's different.

Stephanie Goss:
Right. Yes.

Dr. Andy Roark:
But if we have a lot techs that are very comfortable with- Maybe Stephanie doesn't see cats, and that's just what it is. And if you can staff for that and it doesn't feel like favoritism to the rest of the team, it feels like, “Hey, this is a reasonable thing and we're okay to have Steph just be a dog tech,” then go with it. You know what I mean? Don't overthink it. Not everything has to be set in stone. Let's try to be flexible here, but can we compromise?

Stephanie Goss:
Well, and I think it also doesn't have to be huge. And I think our minds immediately go to these big grand sweeping things that we have to change and that's not necessarily the case. So in my case, there were other pieces to it too, and I think that we'll talk about these in a second, but the compromise with the team was I didn't feel comfortable being the doer in front of those patients anymore because I had been holding and someone had gotten hurt. But the early compromise was could I try being the holder and just doing things where we weren't going to potentially invoke a reaction from a patient. And so it was baby steps, right?

Stephanie Goss:
Or for a while, I didn't touch the golden retriever patients. And I worked in a hospital where there was six or seven of us, and so it was really easy to say, “Hey, I'm going to take your cat over here and I'm going to hold it instead, and we're going to swap out,” right? And I think a lot of the times we think about, well, that means that you can't be on the floor, you can't do your job. And we think in these grand sweeping things, and that doesn't necessarily have to be the case. Because the reality is, we can't go through our careers on skates. All of us are going to have a really difficult case, a really hard situation with a patient or with a client. We're all going to have things that upset us. And so the compromise can be really small, but it can make a world of difference for that person.

Dr. Andy Roark:
I completely agree. I mean, other examples, our original question here was about a doctor and I would have that conversation. And again, this is part of partnership, is, “What do you need to feel comfortable?” and “What do we need to address this perception?” And it may be that this doctor needs to be partnered with a technician who has very strong animal handling skills.

Stephanie Goss:
Yes.

Dr. Andy Roark:
Or a technician that he or she is comfortable with, so they trust the animal handling skills of that person.

Stephanie Goss:
Yes.

Dr. Andy Roark:
And can say, “I feel safe because this person is doing the handling.” That may be what we need to address that perception of “this person over-restrains.” And so I go, “Well, can we have someone else restrain for you that you trust? And then they can do it in the way that we like, and you can have a restrained patient to do what you need to do.”

Dr. Andy Roark:
And again, I don't know. We have to talk to the person and kind of see where their head is, but compromise is part of it.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And I love what you said. I think so many of us blow this up and we catastrophize and we go, “Oh, I can't have a doctor that's afraid of big dogs, because 60% of our patients are big dogs and they'll be ruined. And if I don't let them see those cases, then they're not going to make their bonus, and then blah, blah, they're going to leave, and other doctors are going to not want to see big dogs either, and then I'm going to have 12 doctors that only see cats and dogs less than 25 pounds. And you know who's going to have to see all the patients? It's me. I'm going to see 75% of our caseload, and I'm one person. I'm going to work all day and all night, and my spouse is going to leave and my plants are going to die because I'm never home to water them. And no one's going to clean my house and I'll never, ever, ever get to watch season 2 of Bridgerton because I won't have time ever. And then I'm going to die and not know what happened.

Stephanie Goss:
Oh, god. This episode is 100%-

Dr. Andy Roark:
Yeah, that's the mindset we have. Instead, this is probably not a big deal. Let's figure this out. Let's make some compromises. Let's make some tweaks. It's probably not going to be in the end of the world. That's it. Option two, of course, is training. If the person is not comfortable and they say, “I'm just not comfortable with cats,” then you could say, “Can we get you some training?”

Stephanie Goss:
Yeah.

Dr. Andy Roark:
I would tell you, that's the thing for me with horses. Like I said, I don't have a lot of experience with horses. And if someone said to me, “Hey, we want you to be able to do this and we're willing to train you, and we're willing to put in time, and we're willing to mentor you, and you're going to work with horses and you're going to work with them for three months.” I would be like, you know what? I can do that.

Dr. Andy Roark:
I'm not terrified, I just don't have a lot of experience and it makes me uncomfortable to be alone out there. You want to pair me up with an experienced equine vet, they're going to mentor me, man. I'm a mentorship sponge. I love to be mentored.

Stephanie Goss:
Sure.

Dr. Andy Roark:
I'll 100% take that. And that's training. The compromise was, “How about this? How about you work this way? And you take these emergency cases, or you do these things, or you're available at these times, but you don't go out to the farms and you don't do rural house calls.” Great, that's a compromise that work for me and work for the practice.

Stephanie Goss:
I think the last important thing for me, both about compromise and about support and getting them some answers and some training, because I think that can absolutely be part of the solution package, is that is really important to recognize if there actually is fear or if they have had an experience like my experience, it is really important to recognize that you, as the practice leader, even you as a lead veterinarian or the practice owner in your practice, you're not a professional therapist. You're a professional animal person, but you are not prepared or equipped to deal with your team member's emotions, full stop. You should not put yourself in that role. And so it's really important to think about, how do you pair those things together? And there are lots of things when it comes to professional therapy and support in terms of overcoming fears.

Stephanie Goss:
And so if there is a legitimate fear concern, or if they have had an experience pairing some training, learning some low-stress handling techniques, I'm a huge fan of Sophia Yin's techniques, learning about fear-free, which our mailbag writer doctor said that they already had tackled, but partnering that with the offer of, “Let's get you some support.” Do we have an EAP? Do we have an employee assistance program where they can talk to somebody?

Stephanie Goss:
You're not talking about, “You need to commit to therapy forever, because this is going to be a lifelong issue for you.” Like your example with the horses, sometimes it's about desensitizing ourselves. And it is important to address it from a work perspective, but it's also important to give them a safe space with actual professionals when it comes to mental health support to work through that as well. And it doesn't have to be a permanent thing, but if you can offer them support there, that is a role that you shouldn't put yourself in as the leader. But it is something that is really important to pair with this, if fear is genuinely a concern.

Dr. Andy Roark:
Well, and if the person is open to it and if it's part of the need, right? Remember, seek first to understand what are we dealing with. I don't need therapy for my inexperience with horses, but 100% those sorts of anxiety, when you say, “I'm very concerned. I was bitten. And I'm very concerned about that, and it's causing me stress, or I'm literally having panic attacks here.” Yeah, absolutely.

Dr. Andy Roark:
But all that comes down from doing your diagnostics on what exactly were you talking about here? Yeah, I think that's probably about all I've got. The last thing I want to circle back to, and I think I said earlier, remember to be vulnerable first. Find commonality. I don't want to make this person feel like, “I can't believe that you're doing this.”

Dr. Andy Roark:
Say, “No, I get it. This is a stressful job. And honestly, that's dangerous.” Dog bites are nothing to joke about, and cat bites, even worse. We do a dangerous job, and we should be honest about that, not shame someone for being cautious. I think there's a lot of options here in sort of how to go forward. Let me touch on worst case scenario, because some people have that idea and say, “Well, that's great, Andy, but what if you can't compromise? And what if they refuse to get training or they take the training, and it doesn't change their behavior?” This is the last reason that we want to make sure we're speaking in specifics. What exactly are we measuring here? It's not fear, because I can't measure your fear.

Stephanie Goss:
Right.

Dr. Andy Roark:
But it is complaints about specific handling behaviors. It's complaints from the pet owners, things like that. My take on this is we're going to have the conversation. We're going to do everything that we talked about. We're going to try to partner with this person. We're going to talk about changing the perception that is out there, and making sure that we are perceived as doing right by the patients and taking the best care that we possibly can. And we're going to do all those sorts of things. And we are going to continue to measure the problem behaviors. And if we continue to get negative feedback from the staff and things like that, ultimately what I would say is, in my mind, I'm looking at this, I'm going to set a deadline on this. It would depend on what the plan is.

Dr. Andy Roark:
If they're like, “I don't need a plan. I don't need training. I can 100% handle this. It's not going to happen again,” then I'm going to set a fairly short deadline of if, after a month, you got one month and if after a month I'm getting more complaints, you and I are going to have another conversation and it's going to be much more direct. And it's going to be much more about, again, I don't know what's happening and I'm not going to argue with you about the quality of your handling. All I'm going to say is, “I continue to get complaints about your handling and we're not able to have those.” And ultimately I am going to pick my poison, which is what I do. And picking the poison means you're going to be allowing this person to continue to behave the way that they are, and dealing with the fallout from that behavior. Emotional customer service, staff retention, moral on my part because I'm probably having significant concerns about what exactly is happening and what is happening to the patients here.

Dr. Andy Roark:
And I have responsibility to keep them safe. So do I deal with the fallout of keeping this person, or do I deal with the fallout of letting this person go? Because if we've tried everything to compromise and train and it's not going forward, and we don't see any other path to change behavior, those are your two options: deal with the fallout of keeping them, deal with fallout of letting them go. And ultimately to me, that's not a question, that's a done deal.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And I go, “Well, that's it.” And I have to be okay with that. And so I think that's the emotional part for me is to say, “I talked to this person. I did all the things right. I connected with them. I tried to understand, I offered them help, I tried to come up with whatever ways would remedy the problem and support them, and I gave them time to do that and to go through the process. And I asked for patience from the staff, but ultimately the staff trusts me. And they trust me to not allow these things to happen.”

Dr. Andy Roark:
Generally, if you say to your people, “Hey, we're, working through things, we're doing training, we're doing whatever, we're working on some new systems,” they'll generally give you some grace. But at some point they're going to say, “We've given you grace, and this does not seem to be changing.” Right? And at that point, you have to make the call and then you shouldn't feel bad about it. You had the conversation, you took the steps, it did not improve, and you decided that this was not the standard of care. You were willing to offer it your practice. And so you did what you had to do. No [inaudible 01:02:06] go on. Feel good about it.

Stephanie Goss:
Well, and I will say when I got to the point of having that conversation with my doctor, who was having some fear concerns with patient, we tried all the things. We went through those steps. And when we had the conversation, they were the one to tell me, “I hear what you're saying, and I've actually decided that I'm going to leave the practice because I need to be in a position where I'm actually not dealing with this type of patient, and I recognize that this hospital is not that.” I was coming to the table to make that decision, but they made it for me, and so I think a lot of times you'll be pleasantly surprised, and don't think you need to gear yourself up for, “I have to let this person go.” But I think you're right. You got to be ready to pick your poison.

Dr. Andy Roark:
Yeah, sure, and I think that's important to remember. I'm going to end on that. A lot of times, we think that we are making the hard decision, and if we let this person go, they're going to be devastated. Look, I'll tell you if I went and worked in equine practice and I was mentored for three to six months, and I'm still anxious and nervous and my palms are sweating at every appointment, man, I don't want to be there either. You know what I mean? You're not going to break my heart if you part ways with me.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
Because we did it and we tried, it didn't work. That's it. Oftentimes this is the kindest thing for- And honestly, would you want to be in a job where people keep saying, “Stephanie's not handling patients well, and she's doing these things,” and people are complaining to the manager about you? No, you should go somewhere else or you should do something else. Anyway, that's all I got, Steph.

Stephanie Goss:
This was a good one. I hope everybody has a great week.

Dr. Andy Roark:
Yeah. Take care of yourself, everybody.

Stephanie Goss:
Well, everybody, that's a wrap on another episode of the podcast. Thanks so much for spending your time with us. We truly enjoy spending part of our week with you, as always. Andy and I enjoyed getting into this topic. I have a tiny little favor to ask. Actually, two of them. One is if you can go to wherever you source your podcasts from and hit the “review” button and leave us a review, we love hearing your feedback and knowing what you think of the podcast. And number two, if you haven't already, hit the subscribe button. Thanks so much for listening, guys. We'll see you soon.