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What's This Episode About?

This week on the podcast, Dr. Andy Roark and Stephanie Goss are tackling a mailbag letter from a practice manager who is wondering how to handle an issue with a veterinary technician's safety. This team member is a wonderful veterinary technician, who is generally well-liked by the team. They seem to have one habit that gets them into (sometimes BIG) trouble. They put themselves into situations sometimes that are unnecessarily risky – trying to do jugular blood draws by themselves, for example. The rest of the tech team has nicknamed this person “Cowboy” and while they can sometimes get things done super quickly, they have also been bitten, scratched, exposed to zoonotic things – all unnecessarily in this manager’s opinion. The team has protocols in place that include having help so this manager is at a loss for how to address the situation, get this cowboy tech to slow down, and be safe. Let’s get into this…

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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. This week on the podcast, Andy and I are tackling another question from the mail bag. You guys have been on fire lately, and this one is no exception. We got an email from a manager who is struggling with a team member who is phenomenal. They have been a great fit for the team, but there's just one slight problem, which is that they have earned themselves a nickname with the team, and that is the cowboy. So let's get into this and find out why this person has been nicknamed the cowboy and what we can possibly do about this situation, because I think this will be another episode where hopefully, you love Andy's nickname for me, as much as I do. And you are wondering, “Are they talking about my practice?” Let's get into this.

Speaker 2:

And now, the Uncharted Podcast.

Andy Roark:

We are back. It's me, Dr. Andy Roark and Stephanie “Mamas Don't Let Your Babies Grow Up To Be Cowboys Or Girls” Goss.

Stephanie Goss:

That might be one of my favorites that you've ever done.

Andy Roark:

We don't do enough Willie Nelson, Stephanie Goss, mashups. Stephanie “Blue Eyes Crying In The Rain” Goss, Stephanie “Whiskey River Take My Mind” Goss. Oh, it's an untapped well that's just been unlocked.

Stephanie Goss:

I love it. It's amazing. How's it going?

Andy Roark:

It's good. It's good. It was great to see you in person just a few days ago.

Stephanie Goss:

I know.

Andy Roark:

And to get to catch up. And man, VMX was great. I really had a good time and I was really happy to be there.

Stephanie Goss:

It was so awesome. It was so great to just see our friends and colleagues and just be in the same space as people, which was also overwhelming. I'm pretty cautious and we live in a pretty small bubble in terms of our interactions and stuff, and so I was having a lot of anxiety before going, but I will tell you, I think the folks over at NAVC did a great job. Everybody was pretty respectful of wearing their masks in the conference space. It was crowded, more crowded than I was expecting, but not in a way that I felt panicked or overwhelmed because then when you're in Florida and you're going out and about and doing other things, I felt a lot more crowded in other spaces outside of the conference.

Stephanie Goss:

So I think those guys definitely deserve the applause and the kudos for putting that together the way that they did because it went really, really well. I was really impressed. And it was good to feel that energy that you get watching some of your lectures and hearing people engage and asking questions, and just that excitement that comes with live in-person. CE was just so fun.

Andy Roark:

Yeah. I'm glad we got to talk about how great it was because I don't get to talk about how great it was because I came home and my wife has had children who have been snowed out at school, in a virtual school since I left. And she's like, “How was it?” And I was like, “It was awful. I wish I would've been home with you and the children and inside.” I'm like, “It was amazing, but I'm not going to tell you that.”

Stephanie Goss:

“I'm not going to tell you.” I was thinking about them actually, while we were gone, because I saw on a social media, your wife's preparation post as she got ready for snowpocalypse to hit where you guys are in South Carolina. And I was curious how it actually went and if they got the predicted disaster level snow.

Andy Roark:

Oh, it actually happened, yeah. They did, they got like five inches of snow, which is a lot in South Carolina, really crazy. Everyone got to watch on social media for Orlando as my wife's set up a generator in the snow.

Stephanie Goss:

Because she's badass like that.

Andy Roark:

And social media was like, “Ooh.” They would look and they would see her with pink cheeks, pulling the rip cord on social media, and then they would slowly turn and they would look at me with my mojito and-

Stephanie Goss:

Sitting by the pool in Orlando.

Andy Roark:

… my place tree ice mask.

Stephanie Goss:

Yeah. I love it.

Andy Roark:

Oh man. I love you honey.

Stephanie Goss:

I am excited for our Willie Nelson episode today because-

Andy Roark:

Let's do it.

Stephanie Goss:

… we have got a good cowboy one. It's funny, this question came up in a manager group that I'm in, and I reached out to the person who posted and asked them, I said, “Hey, this struck a chord with me because I have been in your same shoes. I've been the manager who's been supervising someone like this on my team, and I know that I'm not alone. Would you be okay if we talked about this on the podcast?” And they were like, “I think that'd be great because I'm at a loss for what to do, which is why I reached out to everybody.” So I think, again, this is going to be one of those episodes where people are like, “Are they talking about my clinic?” Because I think a lot of us have been there.

Stephanie Goss:

It's a clinic that has a technician who has been a great addition to their team, they put a lot of pressure on themselves, they have a lot of high expectations for themselves in terms of their skillset. And this technician has been doing some things that the manager feels like are putting them at unnecessary risk, like trying to do jugular blood draws by themselves. And some of the rest of the tech team have nicknamed this person the cowboy, because they are trying to do so much by themselves. And the team's perception is that this person is trying to prove something to them.

Stephanie Goss:

And this manager's like, “I feel like I need to talk to them, A, just about how to ask for help. B, talk about clarifying because it is not in our protocols or policies for team members to be doing something like a jugular job by themselves,” for the exact reason that they put this forward, which is that in the time period that this person has worked with them, they have been bitten and scratched and had their own health put at risk by their interactions with their patients because it has not been super safe. And so they were like, “I feel like they really need to slow down, and I'm wondering, has anybody had this type of employee and what worked in terms of addressing it with them?”

Stephanie Goss:

And like I said, it really resonated with me because I have more than once worked with this person in was just like, this was a hard one, I struggled with it as a manager. So I'm excited for you and I to go through this one today.

Andy Roark:

Yeah. I like this a lot. This is a classic management trap, and I see it already. And I think this is a great question, and I appreciate the person who let us take a crack at it. I think the trap is, and we're already seeing this here, is focusing on the idea that, I need to talk to this person about how to ask for help, or that this is going to be a process discussion, because neither of those things address the underlying issue here. I'm not saying you can fix it every time, but I'm saying your only hope of fixing it is recognizing what drives this behavior, discovering it, digging it out, and then fixing that underlying problem, which is generating the cowboy mentality and the cowboy actions.

Andy Roark:

The cowboy actions are rarely the problem themselves, they're generally a symptom of some sort of psychological position this employee has put themselves in. And if we can reset that vision, then we can often change that behavior. But it's a whole lot easier to talk to the underlying problem so that this behavior goes away than it is to hold people accountable, reprimand, or coach them out of this specific behavior. So I like that a lot. Let's go ahead and get in a good head space for this. You ready?

Stephanie Goss:

Yep. Sounds good.

Andy Roark:

So let's talk about why this happens. Why do we see this type of behavior, when we see these people who are just going above and beyond to do things that are unsafe or risky to get it done? There's a number of reasons. And so I'll give you a couple of them that pop into my mind. Generally, it's not not knowing how to ask for help, that may be it, but usually, it's not it. It's also usually not about not knowing or understanding the policies, it's usually about tribal status, which is, I want to be perceived in a certain way by the team. And when I say that, it plugs a lot into self-worth and insecurity.

Andy Roark:

People who are willing to take risks with themselves and their health are often insecure of their position in the team. They want other people to think that they're valuable or that they're really good at their job. And they're like, “I'll take this risk to try to prove to people that I'm willing to do this.” And so there's insecurity there and they question their self-worth, “If I don't do these things, then they won't see value in me.” There's identity in doing things that others can't or won't do. “How do I fit? What's my role in the team? I'm the one who gets it done. I'm the one who will do the things that others' won't do or that they can do.”

Andy Roark:

These people get positive reinforcement for these behaviors. So as a manager, we were like, “You did a blood draw by yourself? Are you crazy?” On the floor, people get these raised eyebrows and like, “Wow, that went really well.” And they get these subtle, “Boy, you really are a cat whisperer to be able to do that. Wow, you really are fast. You get things done.” And they're feeling their emotional bucket, and the risk they're taking are not good risks, but there's a bad habit of us to go, “Wow, that was crazy. Boy, you jump in when other people would stand wait.” And they get positively reinforced for these behaviors that are ultimately in the long term, really problematic.

Andy Roark:

There's a thing called present bias, and present bias is the idea of like right now in this moment, the good thing is to get this case done. The long term view is, honestly, in the long term, the best thing is for me to stay safe and healthy and to maintain our standard of care over the long term. But right now in this moment, when we're behind schedule and people are waiting up front and all the exam rooms are full, just get this thing done. That is the immediate pressure that people feel, and so they often fold to present bias of, do the thing that's right in front of you that will give you immediate gratification or immediate pat on the back and discount the long term detriments of this immediate behavior.

Andy Roark:

I see that driving it. Are there other reasons? There can be. Like I said, these are just the main personal drivers that I see. It's possible that people have real self-identity issues or self-worth issues and things, and that's beyond what we're going to get into as their boss or their employer or their colleague. But those types of issues are generally what drive this more so than an understanding or a lack of understanding about policies and how to get help.

Stephanie Goss:

Well, I think the last reasoning for me is one of our biggest challenges in veterinary medicine, which is that the people that I have worked with have been this kind of team member, they go rogue or they cowboy or cowgirl, have often come from high pressure, high stress environments that very much exist in the present bias, whether it's a high volume hospital, ER environment where they're on nights and there is minimal staff, so you learn how to do a lot more with less, or shelter medicine where cost is a concern, and so you often have more of a skeleton crew because that's what the funding and the budget supports, those kind of environments.

Stephanie Goss:

I have seen people grow up in those environments and they're doing what they have always done, because that's how they learned. And there are so many things in veterinary medicine where we get trapped in that hole. And so I think that it very much ties to your point of present bias. They are very much probably thinking about it from, “Let's get this case done and over with,” because that is what they know, and that's what feels comfortable. They may know that they should ask for help, but getting the case done and over with, “Oh, I could do this by myself and just move on.” It's very easy to put that pressure on themselves.

Andy Roark:

Yeah. I agree with that. I think that's a great point, but what you talk about positive reinforcement, when you are trained and you're told, this is how you do it, and then you do it and they go, “Great job today, you did well,” that's the positive reinforcement part coming back in, is, this is a behavior that has gotten praised in the past, and now… I think most of us struggle, especially if we can came up this way and there's years of a positive reinforcement structure to be like, “Oh, I'm in a new place, and what got me positive reinforcement before doesn't get it for me anymore.” That's not something that you discard and then put back on something else like you're changing jackets?

Andy Roark:

We have been trained and wired that way. Honestly, think about this, and you've heard me talk about this a lot. And I say, humans are simple animals and I don't care how smart you are, how many degrees you have, you're a simple animal. And think about people that you know who have… We'll make it simple, think about dogs that you know and they have been trained to do something. And then think about how much it takes to untrain them from the behaviors that they have had, where they have been positively reinforced, where there's been a stimulus and a response. And again, people are different, they are smarter than dogs, of course, but we still have that same internal wiring of how we're trained and how we respond to repeated positive reinforcement.

Andy Roark:

And again, this is about every human being, I don't care how smart you are. I believe that that's how we're made. And so when you think about the difficulties of untraining behaviors in pets that have been positively reinforced, it's hard, and it's hard in people. I think going into it with that headspace of like, “This is what we're up against,” I think that can help set really clear, realistic expectations of how we get through this, because we can get through it, but it's not a switch. Really think that that's critically important as I think a lot of people think, when they see stuff like this, “I'm going to go tell this person that they have to stop doing this,” and then they'll stop doing it.

Andy Roark:

And maybe they will, maybe if they are showing up and they're like, “This makes me uncomfortable, but I really need to show out for the rest of the team,” then maybe I can have a conversation with them. But if it is something that is how they've been in the past or how they were trained, it can take a while. And so I would go in this hoping that this is a feedback conversation, but expecting that it's going to be a coaching conversation, which is probably going to take more time. And if I think that, then I'm not disappointed when the behavior doesn't immediately go away.

Andy Roark:

So I think a lot about, how do we reach this person? And the answer is compassion. And I think this gets us into the right head space to have the conversation. If I go and say, “Look, you're putting yourself at risk, you're putting your team at risk, you're putting the patients at risk. You're not delivering the quality of care that we deliver.” Now, I'm hitting this person in ways that really hurt.” I don't want to be told that I'm not taking good care of patients or that I'm putting my team at risk. Those are heavy accusations. And most of us are not in an emotional place to be able to take that kind of criticism, even if it's true.

Andy Roark:

We don't want to hear that, it is painful and it hurts too much. And so we get defensive. We say, “You guys don't know what you're doing.” We put up walls to keep ourselves safe, and that's just the human animal. And so if you want help this person, you can't go after them with negative feedback and pointing out the problems necessarily with what they're doing. We'll have that discussion, but we're going to do it very much in a way that is kind and that is caring. The people who often struggle with this are often panicking inside. They're trying to do everything that they could do.

Andy Roark:

And people who risk their health or that push the boundaries like this, they often feel like they have something to prove or that they're in a position where taking your time and working with a team is not available. It reminds me a lot, we've been watching a lot of Incanto at my house and that song on Surface Pressure that Luisa sings. And if you haven't seen Incanto, you should see it. It's so good. And honestly, it's a happy, fun song and it almost makes me cry when I hear it, because I see it so often in others and in myself. But basically, it's this character who has this super human strength and she does everything for everybody, and she sings a song about how strong she looks on the outside, but how the whole time she can't make any mistakes, she can't let anyone down, she's terrified, she's not going to be strong enough.

Stephanie Goss:

She's carrying that weight.

Andy Roark:

“I have to carry this weight for everyone else because I'm the strong one.” And God, it resonates so strong, and it is so amazing. But I've been thinking a lot about that. But that's what I see when I see the cowboy in some ways. And again, I'm generalizing, but boy, there's a lot of Louisa cowboys out there who, they'll get it done, they'll take this risk. But on the inside, they're really stressing about their own value and what worth they really bring. We've all been insecure and we've all been worried about how other people look at us, so I think that's the pathway to engage in these types of conversations.

Stephanie Goss:

Yeah, no, I agree 100% with that, because I think about the people in my career that I have worked with who have been this person, and I think about myself and some of my friends. I had some really good conversations at VMX this last week, but there was a few conversations with some really good friends who I look at and see as very confident people. And when you have that confidence, it's really hard to look at people like that and think that they could be insecure, but it is amazing to me when you have the comfort and the trust to be able to let your guard down and have those conversations. And I was talking with some friends and talking to them about how much I admired their ability to look confident.

Stephanie Goss:

Because I feel like in situations like that, I feel like I look as terrified as I am on the inside, on the outside. I don't look at myself as having confidence. And the conversation very much was, “Are you kidding me?” I know I can do it, and I'm still nervous. I'm nervous every time I do this thing or I face this fear. And so when I think about those people that I have worked with in my career who have been this person, I have had the pleasure of actually knowing them over time well enough to know that they, the confidence comes from that place of insecurity, of feeling like, I have to do it, or, the weight it is on me.

Stephanie Goss:

And so I think your analogy and your tie to Luisa, having seen that movie is a very good one, because I think that is really easy to feel like, “Well, I have to hold the weight of this, and so I can't let anybody see the pressure that I'm putting on myself to make this good.” But I think about the people on my team, and I would way rather work with someone like this who is, in this manager's word, a wonderful addition to their team, who is putting the high expectations on themselves. I would way rather work with that person as a manager and as a leader to try and get them to develop those self-awareness skills and get to the place where they feel like it's safe and it's okay to say, “Oh, maybe I should pause for a second and ask for help.”

Stephanie Goss:

I would really rather do that than work with somebody who has no desire, no motive, is on that opposite end of the spectrum of like, I have to really poke this person with a cattle prod to get them to do what I want them to do. Yeah, exactly.

Andy Roark:

Yes. But you're exactly right. Think about it as a spectrum. Would you rather work with a person who cares so much that they take risks that they shouldn't take, or would you rather work with someone who cares so little that they will not engage unless it is convenient for them? You know what I mean? Unless they're walked by the hand up to the engagement? No, give me the person who cares too much. But I'm going to work with them and try to get them to come down. We're going to this exercise and talking about this because when I get in the head space to have this conversation, I want value in this person, and I do not want to get lost that I see where they're coming from, and I see them, and I understand that this, that there are probably some reasons beyond a lack of policy understanding that are driving this behaviors.

Andy Roark:

And the last thing as we get into head space and start talking about putting these things together, are you safe to have the conversation? And you talk a lot about this. I feel like we left it off the list a lot recently, which is fine because we talk about it so much. But are you safe to have the conversation? Can you sit next to this person? And can you smile? It is not the right time to go and talk to this person when you're mad.

Stephanie Goss:

In the moment.

Andy Roark:

Let's just say that this has just overstepped and they've got big cat scratches down their arm. And you're like, “Look, we need to talk about this now.” Because they're feeling shame Or embarrassment from trying this thing. And so if they're insecure and insecurity's driving this and they just had a setback in front of the whole team, and now you are coming at them and saying, “Hey, we've got to talk about this.” You're making it worse and really pushing that insecurity monster into a corner. I don't want that. And so, can I sit next to this person? And if I can't, we may have to schedule this for tomorrow when we're going to talk about it. Am I assuming good intent? And that's why we had this big conversation in the beginning.

Andy Roark:

This person is not willfully ignorant, they don't disrespect you and the rules, they're not doing things their own way and bucking authority. They've got something in their mind that they feel like they have to prove, they don't think that they're worthy of respect unless they push the envelope and do things that other people do. They've got some weird value system that has been taught and positively reinforced in the past that they're working again. These people, like I said, the most important thing to remember is you're dealing with someone who cares so much that they're willing to put themselves at risk.

Andy Roark:

And that helps me to see them in a positive light, which is going to make this a better and easier conversation. F is, has this person been set up to fail. And do we have policies? Do we have protocols about how we restrain and how we handle? Do we do animal restraint, low stress, animal training? Things like that. Because if this person was trained somewhere and they came in and we said, “Get on the floor and go to work,” we set them up to fail.

Stephanie Goss:

Well, and I feel like this is one of those areas where, especially with experienced team members, that we as an industry really do need to own the F a little bit. I can think of my own career of so many times that I set team members up to fail because they were experienced and they had the skillset and they came in and I made assumptions because I knew their skillset, and I knew they had proven their abilities, that I was like, “Cool, go at it,” and let them loose thinking it would be condescending or it would be like I was questioning their abilities if I sat down with them and said, “Hey, this is how we do this here. This is our protocol. This is our process.”

Stephanie Goss:

And I think that that's assumption that a lot of us managers can make, is when we do have experienced team members come on board, it is equally important to have that training process and go through the things with them to reaffirm that their skills actually are what we think that they are, but also just to integrate them into our culture. This is where we really have to, before we point the finger at someone else, we have to look at the fingers pointing back at us and say, “Hey… “And maybe this manager did this as part of their onboarding process, I don't know.

Stephanie Goss:

But I know that for myself and for many of my fellow managers, we can all think of times where we have put an experienced person and let them loose because we knew their skillset, and yet we're doing them a disservice and we're doing the team a disservice when we don't take the time to have a training process for them the same way we would for an assistant who came in and who had the zero experience, or a tech just out of school that didn't have a whole lot of on the floor experience prior to going to tech school. So I think that this one is a really important one, and it's often one that we can overlook.

Andy Roark:

Yeah. And then E in SAFE is the end result. What is the end result that you want? I don't want this person to apologize. I'm not trying to get them to say that they made mistake. I want their behavior in the future to change, I want them to be safe and I want them to practice the standard of care that we practice, but I don't want this, again, to be a punishing thing, I don't want it to be a painful thing. I want it to be a growth thing. Yep. That's what I want. And so that's the end result that I'm looking for.

Stephanie Goss:

I love it. Should we take a quick break here and then jump into some action and steps?

Andy Roark:

Yeah, let's do it. Hey, Stephanie Goss, you got a second to talk about GuardianVets?

Stephanie Goss:

Yeah. What do you want to talk?

Andy Roark:

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

Stephanie Goss:

They never stop. That is a true story.

Andy Roark:

I'm amazed by how few veterinarians know about GuardianVets. This is a service where you have registered technicians who can jump in virtually and help you on the phones. You can flip a switch and GuardianVets can jump in and take some of the load off the front desk and they can handle your clients and get them to book 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, 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 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 everyone, it's Stephanie and I just want to jump in here for one quick second and make sure that you know about a couple of things that are coming up that you may not want to miss. Andy and I just kicked off our Strategic Planning Workshop series. We've been doing this at the top of the year, every year for the last few, because it gives us a chance to talk about how do we set the team up for success when we look ahead at a coming year? We've done the first session already by the time this comes out, but you can still join us for the remaining three. We're going to be talking about setting vision, mission, talking about values with our team and really living and breathing it versus something fancy that just goes up on our wall.

Stephanie Goss:

We're going to talk about loading the bus, getting the right people in the right seats and forward. And then we're going to talk about KPIs and what do we need to look at from a numbers perspective to smartly manage the practice. And also, how do we get our team bought-in to that? So you can join us for that. And then the other thing I want to make sure you don't miss is we have a class coming up on February 17th. It is a workshop that is being led by my friend, Dr. Adam Little. This is a workshop that Adam did for us previously at an Uncharted Event. And we heard so much great feedback about this that I wanted to figure out a way to bring this to you guys virtually. And Adam rose to the challenge that I am super stoked about this.

Stephanie Goss:

You're not going to want to miss it. It is called What Vet Med can Learn from Improv. And Adam is going to be talking about how to learn, how to take the fundamental foundations of improv and apply it not only to comedy, but to life and practice. So how do we learn to think quick on our feet and be more comfortable with what is often the uncomfortable or the unexpected? So that workshop is kicking off on February 17th, registration is still open. You can find out about these and more at unchartedvet.com/events. And now back to the podcast.

Andy Roark:

Let's get in some action steps.

Stephanie Goss:

Okay.

Andy Roark:

All right. One of the big reasons I wanted to bring up the safe conversations in the head space is because it's critical in our first action step. And the first action step is cliché, start with why. It's easy to bring this person in and say, “You got to stop doing that. You did this thing and it be caused a problem.” Now, if that happens, if this person has done something one time and was a bit cavalier then just saying, “Hey, when you put yourself at risk like this is, this the outcome or this is what can happen. Please don't do that again.” And as simple feedback, it takes 10 seconds. You look them in the eye, you smile at them and you just say, “Hey, can I talk to you for a second?”

Andy Roark:

When you do this, you put yourself at risk, you put the team at risk, we don't live our values, we don't deliver the patient care that we have set forth to deliver. Can you do that differently next time for me, buddy? Thanks, man. You're the best. And that's it. That's the whole conversation. That's that quick feedback and it's just done. If this is a pattern behavior, and we're seeing this person, especially if they have a reputation of the cowboy, this is not a one-and-done feedback on a specific behavior. This is about the pattern of behavior. And so we need to talk about why, we need to talk about why do you want this person to stop?

Andy Roark:

And it's not because it's a violation of our policies, although that's part of it, but I can say, “I worry about you, I want you to be here, I don't want you to be injured. I don't think it makes you look good. When these things happen and you end up getting bitten and go into urgent care, that's not good for you. And we lose a great technician off the floor.” I'm going to talk about their longevity and their profession. I'm going to talk about the example that they set for others and others look up to them. I'm going to talk about the impact on patient care. I'm going to talk about legal liability of the practice and say, “Hey, I know you to don't mean this, but you put us in a really hard spot because we can end up getting sued. If people say how we work or sure or there's workers comp problems or things like that.”

Andy Roark:

So there's a lot of reasons why this is not a good idea. It has nothing to do with, I don't believe you are that good or things like that. I want to validate the value of their worth outside of these reckless behaviors. You are valuable, we want you here. And this is me really to trying to speak to that idea of a lot of times, these behaviors come from insecurity. And so I want to validate this person, I want to provide them the security so that they can stop doing these reckless things. But if they feel insecure and pushing themselves beyond what is ideal, we shall say, if pushing the something beyond what is ideal is the way that they try to show their value, and then I just take that tool away from them without fixing the underlying problem, now I have this insecure person who felt like the one thing that they could do to show their value has been stripped from them.

Andy Roark:

And they're going to leave, they're going to push back, they're going to find something else that tries to demonstrate their value, and that may not be a healthy behavior. I want to address the underlying problem, which is, “Hey, we want you here, we like you here. Everybody likes you, you are well established. You don't need to do these things.” And so it works, that validation, that big part of the starting, it works in combination with explaining why we're having this conversation.

Stephanie Goss:

I think that piece is so important and it's amazing how big of an impact. It's so simple, but I will tell you in my own personal experience after bumbling through it, eventually got through trial and error on my own, got to the place where it was like, “Look, I think that you're amazing technician. These are the things that you do so well. I don't need you to do jug draws by yourself, I need you to be whole and healthy. And when you have to miss days of work because you got bit and are on antibiotics and the doctors told you to stay home for three days, that's what I don't need. I need you here.” And then leading into how do we solve the problem together, but it's about, “Look, this is what I do think is great about you.”

Stephanie Goss:

And it was amazing to me how simple and powerful the words of, “I don't need you to do this thing.” And then calling out the behavior, what a radical difference that made in turning on the light bulb for that person. Because if they are feeling insecure, they are probably coming at it from a place of, to some degree of, “I want to be needed. It's nice to feel needed.” And when you can do that thing that nobody else is willing to do, or that gets the race eyebrows, that is often them wanting to feel needed in that way. And so hearing, I “I don't need you to do that, these are the other things that you do that are amazing and fantastic. I need you to do more of that.”

Andy Roark:

Yeah. It's not wrong to just ask them as well. We've made a number of assumptions here, but ideally I'd like those assumptions to be validated. So asking questions of, tell me, “Tell me honestly, why do you do that? Why would you put yourself to risk like that?

Stephanie Goss:

Seek to understand. Yeah.

Andy Roark:

Just help me understand what you're thinking here. And that's a very open-end question, and a lot of times remember, they're not going to say, “It's because I'm insecure. And I question myself worth on the team.” They're not going to say that.

Stephanie Goss:

But they may tell you, “Well, at my previous hospital, this was how I was trained, this how I learned and we needed to get stuff done. And it just seemed to be the most efficient way. So that's the way I've always done it.”

Andy Roark:

Or they'll point out to you legitimate concerns that they have, that taking risks that they're taking is not the appropriate response, but there is a reason that they are doing and they may say, “Hey, look, we are not moving efficiently and there's other people who are standing around that. I am trying to pick up the slack and set an example to get those guys to get engaged. And yes, I know I push too hard, but that is why I'm doing these things alone is because people are standing around.” And so then what I would say is you have a different management problem on your hands.

Andy Roark:

And if that's true, then the agreement is, “Hey, look, you're going to stop taking these risks and I am going to get on board with motivating these people and figuring out how to get those things done, because that should not be happening.” And that may be empowering other people, it may be protocols, it may be whatever it is, but I don't want to… You know what I mean? I think we should start talking as if there would be no legitimate reason for this, but sometimes people, again, not the right course of actions, but sometimes we make a poor choice in response to a very legitimate problem. And so again, this is a way of me relieving that pressure to try to coach this person back to where they need to be.

Andy Roark:

We got to do positive reinforcement on the safe and the responsible behaviors. You and I talk a lot about building culture, that's our sweet spot, it's where we live. It is really hard to police culture. It is hard to catch people not doing culture and get them in trouble. The better play in these things is it's positive reinforcement. Positive reinforcement got this person into these behaviors, positive reinforcement is going to get them back out, just like we talked about retraining pets. I'm not going to negatively reinforce my way out of something that they were trained to do, I need to use positive reinforcement to coaching, to grow them. And that's it. So are we positively reinforcing safe behavior, responsible handling, teamwork, collaboration, things like that? How do we do that?

Stephanie Goss:

Yeah. I think one of the things that I tried that worked really well was coming at it from an accountability perspective. And so I had the conversation one-on-one with the person and was just like, “Look, I need you here and I need you safe. And what you're doing is not safe for you. And it's also not safe all the time for your patients either. And so I know that you care about your patients and I know that you would never want to hurt anybody. And let's talk about the risk.” And so then I said, “Okay, I need you to be accountable, not to me because I'm your boss, I need you to be able to be accountable to yourself because I know that you want to be here and be a part of this team.”

Stephanie Goss:

And so I opened up the door to having the conversation about, “Well, what would accountability look like to you?” And it caught me so off guard, but the very first time that I dealt with this as a manager, it was a veterinary assistant who was the cowgirl and we were having the conversation. And she said to me, “Maybe I could have a code word.” And I was confused so I said, “Well, tell me more about that.” And she said, “Well, sometimes I can feel myself going to go rogue and do the thing because I feel like it's just better, and so maybe I can have a code word for you or for somebody else on the team to ask for help, because saying, “Hey, I need your help with this,” when they're in the middle of doing something else, then I feel guilty because I feel like I'm pulling them away from their job and what they're supposed to be doing.

Stephanie Goss:

And it like lightning bolt moment for me because I realized part of why they were doing what they were doing was because they didn't want to inconvenience other people. And so to your point, it was a different management problem, but it gave me a starting place. And so we had a conversation one-on-one and talked about it and it was great because the idea came from this person. And then we moved out to have a conversation with the team as a whole and just say, “Hey, we've been talking about this and we want to set up some accountability for each other and protect each other.

Stephanie Goss:

“And so would it work for everybody if we set up a system where we had a code word, where if we see somebody struggling or trying to do something by themselves that they probably shouldn't that we're all if we use this code word,” and it was pineapple. “And if we say pineapple to somebody, that means, “Hey, either I need help or, hey, you need some help.” And we had to have a conversation about being okay with accepting that help in the moment even if we didn't feel like we needed it, but I will tell you, it was amazing how much of a difference it made, for your reason, which was it created the environment where we could reinforce the good behavior.

Stephanie Goss:

We weren't catching them, screwing it up and not asking for help again when they should have, but it created an environment where I could say, “I'm feeling like I just need to get this thing done and I know that I shouldn't rest. And so I'm going to ask for help, even if the other people are involved in something else, because they've given me permission to not feel guilty about it.” Or as a team member, this person has given me the okay to help them and say, “Hey Pineapple, let me let hop in and help you. What do you need? Do you want me to hold… ” and ask them for help in a way that felt very, very safe. And it was slow. It took changing the behavior, so it didn't happen very often, but I made it my job to pay attention to the situation.

Stephanie Goss:

And I was the one to be brave and call out pineapple and set the example for them. But slowly but surely, I watched them react to each other and develop that positive reinforcement with each other because not only were they doing it, not only were they calling each other pineapple, but it created the safety where they were like, “Hey, great job on that. Thanks for letting me help you.” And create that positive reinforcement and the group dynamic shifted when they saw the power in being able to help each other and support each other there. And it was such a great experience for me. And they haven't all gone like that. I've had go spectacularly sideways even when we talked about it as a team.

Stephanie Goss:

But I think your point of figuring out what that positive reinforcement looks and catching people doing good, but also figuring out without throwing someone under the bus, without making someone, the center of attention in a way that feels uncomfortable. How can I get the team to point out when we're doing things that are good? So if the rest of the team has given this person, the cowboy nickname, maybe it's having a team conversation, or maybe it's as a manager, having a separate side conversation with the rest of the tech team and saying, “Hey guys, I know that this has been a thing, I know you've all been joking about it. It really bothers me, and I really want your help. I need your help to fix this. Here's what I need.” And then ask them for help and get them involved in the process.

Andy Roark:

Well, that's the hard part with positively reinforcing your way out of problems, how often are you standing around this person when they do something? You've got to recruit, I'm not saying you have a team meeting where everybody's going to help Darrell, but I'm going to say to my head technicians, “Hey guys, this is what's going on. And this is the behaviors that I want to do. I'm not asking you to police Darrell, but I am asking you to pay attention and positively reinforce those behaviors.” And just gets a support system around who's there to say, “Yeah, hey, that was really great.”

Andy Roark:

Ultimately, whether it's in the first conversation that we have, or the ongoing feedback processes that we're talking about, for a lot of people, I'm really trying to get them to redefine their self-worth so that they don't see their value in this, but they still see value in themselves, or they believe that other people see value in them. And I need to talk to them about why I see value in them at this meeting and what their value to us is and how I appreciate them and how I want to keep them and why I want to keep them, but at the same time, I need people on the floor to also support that revision of what self-worth is.

Andy Roark:

And we do that by celebrating the person when they do the things that are positive and healthy, self-worth, self-valuing behaviors and celebrating them for things that are good and sustainable as much or more than we need to catch the things that are not healthy or that are problematic, that we want to stop. The last thing I would say, and we talked about this the beginning, but I'll just hit it one more time. Coaching is a process. It is a process. We are talking about changing people, a lot of times we are talking about changing people who have long established behaviors, they have underlying drivers that are making these behaviors happen. Be patient, be kind, remember that this person is putting themselves at risk because they care a lot.

Andy Roark:

And that's the type of person we want to work with and we want to keep, but we want to keep them healthy, and we want to keep our practice safe and we want to keep our other people learning and growing in ways that are good and that we're proud of. But what we can balance those things, it just takes time. It's going to take more than one conversation. Make sure you're having positive conversations as much or more than you're having any negative conversation.

Stephanie Goss:

Well, and I think that's really important because I think it's an ongoing process, and I think your points are spot on. And I think we said in the beginning, this is not necessarily about someone not knowing the protocol or not knowing what your policies are. And I think the coaching piece a lot of times can be looked at as, “Oh, I'm going to do the positive and I'm going to do the supportive part of it.” And the accountability piece does get left out a lot. And so I think it's really important to say, “Look, you should not start with accountability.” There has to be the stuff that you and I just spent the last half hour talking about all of that has to be set up, and there has to be ongoing support. And you have to create the environment world where that person feels like they are trusted and have trust in you.

Stephanie Goss:

And if the behaviors, because as a manager, it is important to recognize, “I am in charge of the safety of the team. And if I have a team member who is being reckless and who is endangering themselves and their team members, there is accountability that has to be put in place. And so when you have a team member that is bitten, that is scratched, that gets the ringworm cases because they're not doing what they're supposed to be doing, those things, at some point, there has to be accountability for that. And so I think the important part for you and I is that is absolutely not where I would start this conversation. And when it comes to coaching, don't forget that accountability is a part of that process.

Stephanie Goss:

And so if you have had the conversation and you have had the follow-up conversations, and you're still having the conversation after having multiple follow-up conversations, then I think it's not about what they're doing, it's not about them being a cowboy, it's not about them being reckless. It's about their behavior is not changing and there does need to be accountability because at the end of the day, your patient safety, your whole team safety, their safety as an individual employee is your responsibility as a manager. And so don't forget that that piece should be a part of the conversation. I think it's really easy to be like, “Oh, okay, this, it's leaning into the people piece of it and the emotional and the touchy feely piece of it.”

Stephanie Goss:

And knowing that there does come a point where when behavior doesn't change, now you're not talking about the thing that they're doing or not doing that is the problem, now you're talking about the fact that they are refusing to change their behavior, and that can be unacceptable. And it is okay to discipline that process and have a process, whether you put them on a performance improvement plan or whatever your disciplinary process looks like in your hospital, but you should have that process. That's not the tool that you should reach for first in the situation, you need to do the pre-work.

Stephanie Goss:

But if you get to the point where you're four months in and this employee has still been bit five or six times and nobody else on the team has gotten bit, now it is perfectly acceptable, probably a little bit too late to be having that conversation about, “Look, this is continuing to happen, it's not happening to anybody else. Now, we're talking about the fact that your behavior is not changing and this is unacceptable and here's the accountability piece of that.”

Andy Roark:

Yeah. And you're not showing a willingness to change. And I don't have any reason to believe that you will change in the future. And now I am making decisions about the future based on the information that I have. But patterns are key, spotting patterns is really the heart and soul of management. Man, I heard the best quote today, you and I were there and we were talking to one of our friends and he said something like, “If you make the same mistake over and over, and over again, at some point it's not a mistake, it's your culture.” And I'm like, “Yeah, that's really good. It's totally true.”

Stephanie Goss:

Totally true.

Andy Roark:

That one is a great one.

Stephanie Goss:

Totally true.

Andy Roark:

All right, buddy. Thanks for doing this with me.

Stephanie Goss:

Yeah. This is a great one. Have a great week, everybody.

Andy Roark:

Yeah. Guys, take care of yourselves, be well, don't let your babies grow up to be cowboys. I can tell you my babies want to be a fashion designer and a paleontologist. So I think I'm going to be in the clear.

Stephanie Goss:

You're safe.

Andy Roark:

Yeah. See you. Take care guys. Bye.

Stephanie Goss:

Bye guys.

Stephanie Goss:

Well, everybody, that's 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 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.

What's This Episode About?

This week on the podcast, Dr. Andy Roark and Stephanie Goss are tackling a challenge from a practice manager who has quite the challenge and an incredible opportunity on their hands. This manager previously had a practice owner who didn’t deal with any of the interpersonal conflicts, gossip, or lack of communication skills on the team. Now they have moved on out of the picture and this manager is being supported by leadership to address the issues. They have been approaching the gossip culture and lack of direct communication in a fantastic coaching way. And it doesn’t seem to be getting much traction. They are wondering what to do next to stop having the same conversations over and over and get the team communicating with each other directly. Let’s get into this…

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

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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. This week on the podcast, I think this is going to be one of those episodes where we have a lot of listeners who are wondering, “Are they talking about my clinic?” I think this is one that a lot of people can relate to simply because we have a problem in Veterinary Medicine and that is we have a lot of people in positions of leadership who struggle with dealing with interpersonal conflicts. And as a result, we have a lot of things that are left to fester for probably too long.

Stephanie Goss:

And this is a case where we had a manager who has been in a position where they have some toxic interpersonal behavior that has been happening between the team for quite some time. And their prior practice owner never wanted to deal with the interpersonal drama and so, they just swept it under the rug. Now, that practice owner is out of the picture and this manager is feeling empowered to deal with it and is wondering, “I seem to be having the same kind of conversations with my team over and over again. At what point should I expect them to figure this out, and expect them to have open communication amongst themselves without me having to handhold?”

Stephanie Goss:

Let's get into this one. And now, The Uncharted podcast.

Dr. Andy Roark:

And we are back. It's me, Dr. Andy Roark and Stephanie, people are talking, talking about people Goss.

Stephanie Goss:

How's it going. Andy?

Dr. Andy Roark:

It's awful. It is freaking awful. I appreciate you asking. I made a deal with Jamie Holmes, who I talk to every morning, that we are going to stop asking each other how we're doing in the morning because it's just been 2022, every day has been like, “Why do you ask me that? Don't ask me that. I don't want it.” My whole family is sick in different ways. They all have different illnesses. And bad dog Skipper Roark has discovered a deep and unending love for cough drops. And so…

Stephanie Goss:

Oh, no.

Dr. Andy Roark:

… he seeks them out and they give him diarrhea. So now, I have cough drop diarrheal golden doodle Skipper to deal with, on top of sick children, who don't go to school, Stephanie Goss. They've been in school in four times this year.

Stephanie Goss:

Oh, no.

Dr. Andy Roark:

See? I'm at the end of my rope here. I can't keep doing this.

Stephanie Goss:

And I will say I have deep empathy for you because that, I remember that stage about last year where you're not doing it by choice and you don't know when the plan is going to shift again. Are they going to go back to school? Are they not going to go back to school? That place sucks. Whether it's weather or the unexpected. If I plan for, like now my kids didn't go back after the pandemic and we're doing a homeschool coop. But I know that they're going to be home and we have a plan and a structure and everyday has a schedule and we're running it and it feels fine and it doesn't.

Stephanie Goss:

But in that limbo land, like you're in, because you guys had that big storm, so they were home and then, the weather made them sick, I feel so bad for you and Allie.

Dr. Andy Roark:

Yes, but when you said you could empathize, I thought you could empathize with menthol diarrhea for a minute. And I was like, “No, this is a special kind of hell. I don't know if you can empathize with this. What?” I was like, I said something to our friend, Shelly Adrian, Shelly. Dr. Shelly Adrian is the Purina Institute Ambassador for the US and she's awesome.

Stephanie Goss:

Oh, God.

Dr. Andy Roark:

And she's Uncharted, she's great. And anyway, well, so she does a lot of lectures on nutrition and communication. She's doing that and I was talking to her about awfulness. And she was on a webinar, Stephanie, recently and she's doing this presentation and her dog comes into the screen and starts yurking behind her as she's lecturing. And everyone can see this dog just standing behind the lecture or just. And she was like the powerlessness, just to be like, just to be tied to this screen.

Dr. Andy Roark:

And you can see yourself in the screen, so you can see what's behind you and everyone watching and I was like that made me feel a little bit better about the position I'm in, just because yeah, it can be worse. Skipper could be yurking in front of the international audience while I'm powerless to stop him. There'd be a video of me going, “Get out.” Dragging him off the carpet, how you do. You know what I mean? “Off the carpet, off the carpet, off the carpet.'

Stephanie Goss:

Oh, man. Okay, well, clearly we are going to be on fire for this episode.

Dr. Andy Roark:

No, I'm beyond that. I'm beyond that. I think it's actually let's do some work. We're bringing this back in.

Stephanie Goss:

Okay, so I'm not going to ask you about how you're doing. We're going to move on.

Dr. Andy Roark:

Yeah. I think we're past that.

Stephanie Goss:

We are going to talk about communication problems. We're going to be talking about communication problems in a team. So, I was recently talking to another manager who was excited and also feeling overwhelmed and frustrated. And so, they are excited because previously they had been a private practice and they were recently made the transition to being a corporate practice. And so, the reason that they were excited about this is because previously they had a practice owner who was really not into dealing with the people, and didn't want to take action, when team members should have had some accountability happening.

Stephanie Goss:

So, this manager is like, “I'm finally in a position where I am empowered, and I can make some cultural changes and some shifts. And so, I am super excited about this.” The challenge is that the team has kind of come along through the transition, so there have been some years of some bad behavior, some gossiping, passive aggressive behavior amongst the team, the real people, stuff that, let's be honest, I've watched a lot of practice owners just ignore because they don't want to deal with the conflict.

Dr. Andy Roark:

Sure.

Participant:

And so, this manager is like, “Look, here's what I'm doing. When somebody comes to me, I'm saying to them, I'm kind of asking them a question, ‘Why are you talking to me, you should be talking to this other person, because I can't do anything about it.' And I'm trying to help them. If they want help, trying to figure out what to say, I'm totally happy to talk to them. But I'm trying to get them to talk to each other. And when they're just like, ‘Well, I don't want to do that,' then I have offered to help like, ‘I'll be there with you. I can mediate the conversation.'”

Participant:

But the team is basically refusing to take responsibility and accountability for any of their problems with each other. And so, my manager friend was like, “Look, I'm at the point where I feel like I want to look at them and be like, ‘Look, what do you want me to do about it? I can't, if you're not willing to talk to the other person and deal with this on your own, this is interpersonal conflict and I don't know how to help you.'” And so, they were really struggling with “How do I get out of this cycle? Because I feel I'm constantly coaching them and it's going nowhere,” or “Everything seems to go okay and the conversation seems to be resolved, but then the behavior is continuing to occur.” And so, they were like, “At what point should I expect them to be able to do this on their own? When can I bow out of some of these conversations? Because I'm feeling super, super frustrated.”

Dr. Andy Roark:

Yeah. This sounds like a lipstick on a pig situation to me. And yeah, so okay. I am super thrilled about this. I'm like I love this so much because we're going to go work on it.

Stephanie Goss:

Yep.

Dr. Andy Roark:

So, the first thing I want to talk about is, if you have a couple of employees who don't get along, then you have an employee problem, probably. And if you have a whole team who doesn't get along and you're sorting out different problems every day, you don't have an employee problem, you have a culture problem. You have a significant under the surface problem.

Stephanie Goss:

Fair.

Dr. Andy Roark:

And so, it sounds like we're using employee tools on a culture problem and that is just a recipe, that's menthol diarrhea. It's just, it's not going away. It permeates. I could just go deeper. But it is, you don't want it. That's the take home. It's a special kind of thing that you don't want and if you don't have the right carpet cleaner, you're out of luck. And we're going to talk about culture cleaning carpet, culture carpet cleaning.

Dr. Andy Roark:

I'm sorry. I haven't sleeping well because everyone is awake in my house. I'm just, I'm really holding on. Okay.

Stephanie Goss:

Oh, good Lord.

Dr. Andy Roark:

All right. Let's start. Let's start again. Okay, here we go. All right. This is not a coaching problem for myself. This is a cultural problem. Okay? And so all right, we're going to get back up. We're going to get off the silly drain, and get back to work. Here we go. All right. Talk about elements.

Dr. Andy Roark:

First thing we're going to talk about when we look at this. Okay, so we had this owner, practice owner who was there and they took our hands off the wheel, and they didn't want to deal with the conflict and things became what they are. This is a shifting baseline problem. So remember, shifting baseline when we talk about culture, shifting baseline is the phenomenon where we have a normal team or practice. And then, the owner just doesn't want to get involved in the conflict, so things get a little, they get a little bad. We get a little bit.

Dr. Andy Roark:

We start to have some gossiping. We start to have some people who snipe at each other. We have some people who maybe figure out that if they can get in the manager's office and talk then they don't have to work as much in the treatment room because we got to. And we find all these bad things. We've been figuring out that they show up a little bit late. Nobody is saying anything. Just five minutes late. And that becomes normal. The norm becomes, and we gossip a little bit and we share some snarky things to each other.

Dr. Andy Roark:

In the end, it shifts a little bit more. And now, we're saying a little bit more snarky things and we're arguing a little bit more often and we're showing up 10 minutes instead of five minutes late, but 10 minutes is pretty normal. Now, norm on time is 10 minutes late. That's the new on time and it just slowly slides. It was not fine and then all of a sudden, it switched and now, everybody's fighting with each other. That's my point.

Dr. Andy Roark:

This is shifting baseline. It takes a long time and has been a slow creep to the behaviors that we have now. And so, the idea that we're probably going to step in and have a couple conversations that's going to jump back to where it was, that's probably not true. This has slowly grown to be what it is. It can be fixed, 100%, it can be fast, but this is going to be a process. And so, the first headspace is, “Okay, we need to put to bed the idea that if you have the right conversation, this is going to go away tomorrow.” Those are expectations that are going to frustrate you.

Dr. Andy Roark:

This is a systemic problem, not insurmountable, we can do this. And it's not the worst systemic problem by far, but just go ahead and set expectations for yourself. This is going to take some doing to unpack and just be okay with that. And so, this is going to be, this is my 2022 project, that's what it is. I'm going to work on it and that's how this is going to go. So, shifting baseline, I'm going to start with.

Dr. Andy Roark:

So, why does this happen? It's funny, there's two things that I see there are good examples of the next point I want to make, which is present bias. So, we talked about shifting baseline, now, we're going to talk about present bias and present bias is the natural inclination we have to do the thing that is easiest or the most pleasurable in the moment, even though it is not the best thing in the long term. We are wired to prioritize things that immediately give us something good, as opposed to delayed gratification, potential benefit in the future.

Dr. Andy Roark:

And so, the first place we see this where it really screwed up is the practice owner. Because in the moment, not just not dealing with it is the easier thing, because nobody wants to have these hard conversations. So when you look at it down the long view, not having these conversations is bad and leads to a toxic workplace that nobody wants to be and just constant headaches and things you have to deal with every day. But in the moment, “I don't want to deal with this,” is the easiest thing to say where you get an immediate reward compared to going and dealing with.

Dr. Andy Roark:

For the manager, when we see I want to say a lot when we have these sort of problems or people not getting along, we see present bias is “I'm going to jump in and moderate these two people. I'm going to jump in and fix this thing right now. I'm going to jump in and put this dumpster fire out. Because it's easier for me just to jump in and do it than it is for me to make them work out themselves and circle back up with them and have them muddle through it and get hurt feelings without me being involved.”

Dr. Andy Roark:

And so the present bias is “You come here and you come here. I'm just going to moderate. I'm going to make you two act like adults.” And now, you're going to do it and now it's done. And that's easiest thing in the short term. The problem is I have now trained these people to do what? To come to me with their problems. And so, present bias when you're fixing communication problems can very be, fair will be that you have trained people to come to you whenever they have a problem. And now, you're spending your whole day sussing out the root cause between two people arguing.

Dr. Andy Roark:

And they should be able to fix it themselves, but they have been trained to come to you and make you involved. And now you're involved in a bunch of stuff that really is not your job, and it really doesn't make you happy and it's really not where you want to be right, but we put ourselves in that position because the easiest thing in the moment, just to wait in and fix the problem. So, that's present bias. And I just, I point that out. Because, man, a lot of us spend our days putting out dumpster fires and I always talk about present bias and see if any light bulbs go off because people go, “Oh, I'm may and yeah.”

Stephanie Goss:

And for those of you guys who are listening going, “Oh, Jesus, that's me,” you're not alone.

Dr. Andy Roark:

Yeah. Oh, yeah.

Stephanie Goss:

In fact, I remember very clearly the moment my light bulb went off in the middle of Andy and I doing a podcast actually, where I was like, “Uh-oh, he's talking about me. This is me. These are the choices I'm making with my team in the clinic.” And it was, I remember it really super vividly because I was having this internal dialogue and turned bright red, and you were like, “Are you okay?” It's like, “Yeah. A light bulb just went off. It's fine.” It's really easy because that's how we're wired as human beings, so if you're sitting here listening to this, don't feel guilty.

Dr. Andy Roark:

No, you shouldn't feel guilty.

Stephanie Goss:

Give yourselves some grace because we all do it.

Dr. Andy Roark:

It's a trap for people who are perfectionist, who want to get it right. It's a trap for people who are helpers and supporters.

Stephanie Goss:

Yep, people pleasers.

Dr. Andy Roark:

And that's Stephanie is she wants to help. She wants to serve and so, she jumps right in and does it. It's just, it's a trap. It's laid for good people. When it comes to this, the shifting baseline, the “I don't have time to deal with this,” that's a very different trap. And we get there in a very different way, but I'm going to take on all the dumpster fires is an easy trap for people who care a lot. And so you shouldn't feel bad, but once you see it, you have the responsibility to then go, “Okay. I need to make different choices.” It comes back when we start talking about this and the dumpster fires and fixing the interpersonal problems, the moderating and mediating, things like that.

Dr. Andy Roark:

It comes back to the Karpman Drama Triangle, which is something I like to talk a lot about. And so, the Karpman Drama Triangle is the hero-villain-victim triangle. And so, in most conflicts, there's a villain. There is the person who is the bad guy. They have wronged someone else. They have taken a case that was not their case. They have failed to put back the travel sheet where it was supposed to go and now, it's lost and that person is a villain. And then there's the victim who is the person who has been wronged by the villain and they have come seeking aid. They need to be protected. They need to be saved. Stephanie Goss. And the last is the hero, and they want you to be the hero. The victim wants the hero to vanquish the villain and restore justice in the social norm.

Dr. Andy Roark:

And that is the Karpman Drama Triangle. You don't want to be the hero. You don't want to be the hero. You want the victim to be the hero. That is the answer to the Karpman Drama Triangle is to make it a line where these two people have a problem and they work it out and you're not there. The problem is we want to be heroes. Everybody likes to be a superhero, especially in Vet Medicine because we attract that personality type. We want to jump in and we want to save victims from villains and we want to right wrongs. It's never ending. It's never ending. The victim will find more villains and the process continues.

Stephanie Goss:

Yeah. Well, and-

Participant:

And so, the headspace has got to be, “I don't want to be your hero. I need you to be your own hero.”

Stephanie Goss:

Well, and that's why I think this whole episode goes back to what you said at the beginning, which is that this is a culture problem. This is a big messy thing. This is not something that is solvable, because this manager is already doing that. They recognize this, whether they knew about the Karpman Drama Triangle or not and said, “Okay, I can coach you. Let's talk about how do you want to say this. I can help you address it.” They are doing that.

Stephanie Goss:

They are looking at this victim and saying, “I don't want you to be the victim. I want you to be able to be your own hero. Let me help you solve that.” That is great management. If that was a Band-Aid that could solve this problem, it would have worked already. And so, the fact that there's still blood hemorrhaging around the Band-Aid tells us that maybe this is not a Band-Aid problem.

Dr. Andy Roark:

Yeah. Well, it sounds like they're doing it at the individual level and we need to address this at the organizational level, at the practice level. And so, yeah, no, but I completely agree. I really was really impressed to see the way they approached it where it sound like they're 100% coaching this way. But it just keeps happening, it's happening all around them in different places. But I still like to lay that out just because I feel there's enough people who need to hear it. But I think you're right in your assessment that understanding the Drama Triangle is not the problem that we're having here today.

Stephanie Goss:

Yep. Yeah.

Dr. Andy Roark:

And I think the sort of last part for me in the headspace, as we think about this, and say, “This is a cultural problem.” And you put your finger on this early on, you got to forgive yourself, you got to forgive yourself for what happened in the past. You didn't cause this problem. We talked about how the circumstances were different. We weren't getting the support. These behaviors were allowed to manifest. Shifting baseline happens. It's a natural thing. It's how humans sort of drift and they become established. It's not your fault, but now, we're going to deal with it.

Dr. Andy Roark:

You need to be kind to yourself and you need to be patient, and you need to not focus on where we are right now, but let's focus on the future. Let's talk about making this better. Let's talk about get it back on the track. But as long as you keep looking into the future, you're going to be just fine. When you get frustrated about how things are and how they were allowed to be, that's not a productive headspace and it's just not going to move you forward where you need to go.

Stephanie Goss:

Yeah. I think about that movie that was playing in my head when you were just talking. It's like, I'm going to date myself here. There was a TV show when I was a kid, where the girl could point her fingers at each other and freeze time. And then she could think about what was happening or reset what was going on. And then magically, she could make it undo and then she could move on with a purpose.

Stephanie Goss:

It's that moment for you. It's taking the time to say, “Okay, I'm going to forgive myself. I'm going to think about how do I move this forward in the future.” And you're calling that timeout both for yourself and probably with your team and say, “Hey, we need to have a little bit of a reset here. Regroup, get yourself together and then think about how are we going to push this down so that we are looking at it in future facing tense.” Because I think that that's really, that's really, really smart.

Stephanie Goss:

I totally understand why you said that because when the team looks at it, when you do start to talk about it with the team, if they're looking at it, it's very, very easy to fall into the, “Well, so and so did this or last week this happened.” No good comes of that, especially when you're hashing it out at a team level. You're never going to get anywhere. The team has to look at it from a future facing perspective of, “What do we want to do tomorrow if something this was to occur?”

Stephanie Goss:

Because then it's not about the blame game. It's not about Lauren and Jessica pointing fingers at each other going, “Well, you were talking about me in the hallway yesterday, and I heard you.” Like that, the blame game does nobody any good. You have to get yourself and the whole rest of the team in order for it to be actionable to look down the road at the future.

Dr. Andy Roark:

Yeah, I agree. Let's take a break. And then we'll come back and we'll crack this thing open.

Stephanie Goss:

Sounds good.

Stephanie Goss:

Hey, everybody, this is Stephanie and I have to jump in here for just one minute to make sure that you know about a few things that are happening that you are not going to want to miss that are coming to you from us. That's right, the team behind The Uncharted, but we have a bunch happening in February, in March and April, so if you have not headed over to the website recently at unchartedvet.com/events, you need to hit pause right now. And check out all of the workshops that are coming.

Stephanie Goss:

We've got an awesome improv comedy workshop that is coming to you from our friend, Dr. Adam Liddell. If you're not into improv comedy, you think about it this way, Adam is going to take some of the tenants of improv acting and bring it to life in practice. And teach you how to feel comfortable with guiding those conversations with your team about what do we say and how do we say it, so that we can improve our client service interaction.

Stephanie Goss:

I don't know a single peer, myself included, who would not have jumped at the chance for this as a manager. So, if you haven't headed on over to sign up for that, you should. We've got the remaining part of our strategic planning course, which Andy and I are talking about, at the end of this episode today. There is an upcoming session that is specific to this week's episode. If you want to sign up for that, you can and more. There's tons of workshops coming across calendar up at the website, so you should head over there and check it out.

Stephanie Goss:

And before we get back to the podcast, I just have to pause for a second and say a huge giant thank you to our friends at Banfield Pet Hospital. Andy and I have wanted to bring transcripts to the podcast for a while now. We've had multiple colleagues reach out to us and say, “Hey, we've heard wonderful things about the podcast, but it's not accessible to us because it's not transcribed. Is there something that you can do about that?”

Stephanie Goss:

And we were wanting to make that happen and Banfield stepped up in a major way and said, “Yes, this goes to one of the core beliefs that we hold, which is that we want to make veterinary medicine more accessible and inclusive across the board. And so, they have sponsored the transcripts for us for 2022 and we couldn't do it without them and we are just so appreciative.

Stephanie Goss:

So, if somebody who would love to access this and maybe haven't previously, because it has not been transcribed, send them to the blog in unchartedvet.com/blog. Every single one of the podcast episode is there. They can find the transcript. And they can also find more information about all of the awesome programs that Banfield is offering to increase equity, inclusion and diversity in our profession. So, thank you guys. And now, back to the podcast.

Dr. Andy Roark:

So, let's get into that. Let's get into how you actually fix this. Are you ready?

Stephanie Goss:

Okay, let's do it.

Dr. Andy Roark:

I mean, we talked a little bit about it at the very beginning. You have to trust the process, you have to accept that this is not going to be a single conversation. This is like we have to fix something under the surface and so, it's just going to be a little bit more involved. And this is going to be an investment of time. It is worth it. This is going to be worth the process.

Dr. Andy Roark:

It is going to be worth putting in the time and having the conversations and getting everyone as a group on board, as opposed to playing Whac-A-Mole, where we're dealing every day with individual conflicts. And so, yes, this is a bigger upfront investment, but it's going to pay off. And so, I think people should have that expectation, just at the very start.

Stephanie Goss:

Yeah, and I will tell you, if you are in a position like this as a manager, and you're looking at solving some of these big cultural challenges, the best gift and the best tool that I ever gave myself was the idea of under promising and over delivering. I was going to say that backwards and didn't. And so, when you look at this, if you tell yourself, “I have a cultural problem. This change is going to take me two years,” and it happens in six months or 12 months, you feel really dang good.

Stephanie Goss:

And if it takes two years, you've set that expectation, so you're okay with that. And I will tell you having inherited more than one practice with deep cultural challenges over the years, I was miserable the first time that I was in that position, because I wanted the change to happen so much faster. And I set unrealistic expectations for myself, and then I felt crappy about my role as a leader and questioned my abilities to manage because I thought I was doing something wrong, because it wasn't going as fast as I wanted it to go. And I will tell you that the next go around, setting the expectation that, “This is a long game. This is not something I can fix in 30 days, 90 days, even six months.” I am talking about a year and a half to three-year turnaround.

Stephanie Goss:

If you have deep rooted-cultural problems, giving yourself that expectation and then let me tell you how good it feels when it happens a little bit faster. Even if it's just a little bit. It's just that it's that under promising and being able to over, whatever. You know where I'm going with that.

Dr. Andy Roark:

Yep. No, you got it. No, I agree. I think you start with these expectations, right? And then the next part is investigation, we need to get into why this is happening. There's something underlying that's causing this is. Is this really a gossiping problem or is gossiping a symptom of another problem? And often gossiping is a symptom of another problem.

Dr. Andy Roark:

Some of the main problems that I see with gossips are bullies. There's a lot of bullies that use gossip as a weapon to control information to cause some in group/out group stuff, to beat up on some people, to keep leverage on people are their cliques. And again, cliques often run with bullies, because bullies tend to form cliques. But yeah, is this a clique problem of the front versus the back or the AM shift and the PM shift. Is there a group of friends that kind of sticks together and they don't like other people and other people don't like them?

Dr. Andy Roark:

Is this a pot stir problem? And pot stirs are people who like drama and you know those people. You know their name. They just feed on it. They enjoy it. I don't know them. I can't be in their head, but to me, it seems that they just look around and go, “He's pretty quiet. Let's start some stuff.” You know what I mean? What can I make happen?

Stephanie Goss:

I don't understand it, but there are 100% people that are wired that way. They drive when there's drama happening.

Dr. Andy Roark:

Yeah. And I don't even think it's a conscious thing, but they just for whatever reason, it's just, it's what they do. I don't know if it's a thing that people do to get attention. I don't know, if it's a way that they connect with people is being in drama with them, but there are pot stirrers that just. And some of them are so nice, but they just always have drama swirling around them. The last one is the info broker and they are people who have tried to affect their status…

Stephanie Goss:

Yes, power.

Dr. Andy Roark:

… through their access. Yeah, they try to get power through access to information. So, they have it and they get it and they dole it out in strategic ways, just to try to lift themselves up and to make them. It's essentially them trying to make themselves valuable by what they know and what they share. And they often want to make what they know juicy and interesting and so, they spice it up a little bit. And now, we've got a real problem.

Dr. Andy Roark:

And so, those are just some of the things that I see that drive this, but a lot of it is your internal diagnostics of if you're treating a gossip problem and you've got a bully, your gossip problem is not going away as long as your bully is there unchecked. It's just not. And so, you can keep talking to the team, but if the pot stirrer continues to stir the pot, you're going to continue to have these problems.

Dr. Andy Roark:

And so, we need to do some diagnosis and try to figure out, what's going on here? Is gossiping and conflict, is that really the problem? Like we just genuinely don't each other? Or more likely, is this a symptom of another problem that's going on under the surface? And what is that?

Stephanie Goss:

Yeah, yeah, that makes sense. I think the next place is kind of where this manager started, which is you have to have a united front on a leadership level to deal with cultural change. And so, unfortunately for this manager, previously working with practice owner who wanted nothing to do with the communications problems, like I've been there. That is a crappy place to be a manager because your hands are tied behind your back and you cannot affect the change.

Stephanie Goss:

And if you are in a position now where you have the support and the agreement at a leadership level to affect change, that is the ideal scenario. And if you are not in that place, that's the place that you need to get to because you cannot fix deep-rooted cultural issues if you do not have support from the whole level, as far as leadership team goes. Whether you're working as a medical director or it's you. You could take outside of this example, if you're in private practice if you have practice owner, or if it's multiple practice owners, and one is in agreement, the other is not, there has to be a united front on addressing this, and how you address it, or it's going to go nowhere.

Dr. Andy Roark:

Yeah and that's so sad. It's so sad. And you and I see it all the time that the manager…

Stephanie Goss:

All the time.

Dr. Andy Roark:

… who's just given her heart and she's not getting support from the other leadership. And like you, culture comes from the top. It really does. And one person no matter how much they want it, when the rest of leadership doesn't support or when they undermine either actively or passively, God, it's the most demoralizing, demotivating road to go down. And we see people who struggle with that. So I mean, I completely agree.

Dr. Andy Roark:

You got to get buy in at the leadership level. So, I'd say to this manager, “Hey, new leadership, it's time to get buy in” with your Medical Director, with your Area Chief, or whatever your structure is. But it's not just getting by and like, “Hey, I need you to support me in general.” It's like to say, “Hey, this is specifically the problem that I see. Will you agree that it is a problem?”

Dr. Andy Roark:

And again, when we talk about getting buy in with people, getting people to buy into an action that or action plan that you have already decided and set up is actually really hard, because it's not their idea. And they might have done it differently and you're like, “Hey, I'm here.” And even if they do it, even if they would do the same way that you have done it, they didn't think it all the way through. And so, when they see the plan you're proposing, it may not look like what they would do or they don't understand why you want exactly what to do these specific steps.

Dr. Andy Roark:

And so, it's really a hard way to go. The best way, and again, and so, this is a culture problem, it's going to take some time, don't get buy in on the plan. Get buy in on the problem. Go and say, “This is the number one problem in our practice. Do you agree? And here's some examples of how this problem manifests and what I see.” And speaking specifics, which means, you should be documenting if you don't do anything with it, other than to say, “Here's six examples from the last three months of these types of behaviors that I'm seeing.”

Dr. Andy Roark:

And so, get buy in on the problem, right? Veterinarians and people in that mess are generally pretty problem-focused people and if you give them a problem, they like to fix it. So, go to leadership first, and just say, “Hey, this is the problem that I see. Do you see this problem as well?” I go to the team after that or at least start to have some of these conversations about culture in general. And so, I've got the other leadership on board, so you see this problem and get them get them to say yes.

Dr. Andy Roark:

And once they'll say, “Yeah, yeah, I see it,” now, it's time to start laying the groundwork. And this is why I said, this is an investment because you're going to say, “Hey, you're not fixing the problem.” And I go, “Yeah, I am. It's just don't look that way yet.' But at this point, I've got people in there arguing and they're fighting, and they're not getting along. It's time to have a conversation about our values as a team. It's time for us to talk about why we do what we do. Why do we come to work here? What's your favorite thing about working here? Why is this a better place to work than the three other hospitals around us? What do you love most about your job?

Dr. Andy Roark:

And let's build some commonality. Let's lay that on the table and let the whole team say, “You know what? This is what's important about our team, and this is what we care about and why we're here.” And it might be a serving the patients. It might be serving the community. It might be taking care of the clients. It might be giving back. It might be because we love to learn. It might be because we pride ourselves on the best patient care in the area.

Dr. Andy Roark:

None of those are wrong, they're all fine. I just need the team to come together and say, “Hey, I like that and you like that. And it makes me proud and it makes you proud. I think that's what we're here for.” Because if I can't get the team to agree that there's a reason that we're here together, I'm never going to agree to get them to come together and work together. There's got to be something that makes it worth coming to work with these people and making my relationship with those people work and so, it's setting the larger context.

Dr. Andy Roark:

If you think about it like a marriage counseling, it's coming together at the beginning and committing to the marriage. They're like, “This is a thing that I want to be a part of and this is why. And now, that we have both seen the value of this and agreed to the value of it and committed to it, now let's start to talk about what we're actually doing.” And so, that's the same general idea here.

Stephanie Goss:

Yeah. And I will tell you as a manager, who's been in this position, it can be hard to keep a positive headspace and to feel excitement for playing the long game, because you're just so tired of dealing with the BS, you just want to fix the problem. And I will also tell you that I have never done this. I've never started with the why and started by talking about values and asking questions.

Stephanie Goss:

Like the examples you gave Andy about like, “Tell me what your favorite part of your job is. Tell me why you like working here. Why this specific hospital? What makes this hospital different than any other hospital that you've worked in? I have never asked those questions and not been completely surprised by at least one person's answer.

Stephanie Goss:

And that is why I do it because it changes your whole frame of mind, when you can look at these people who you're so frustrated with, and I swear to God, I just want to look at them and wring their necks. And then somebody says something, and I'm like, “I didn't see that coming. That's great. I can work with that.”

Stephanie Goss:

Even if you do it as an exercise for yourself, I will tell you that that helps with staying in a positive frame of mind because we don't ask it. We don't ask it enough and at all, and giving them the chance to start over and start at the beginning, even if they're reluctant. And let me tell you, I've sat in plenty of these meetings where they have all been looking at me like, “This is total BS. Why are we here?” But you just got to, I keep the smile on.

Dr. Andy Roark:

Well, it starts that way. It always starts that way. It really does. They're always going to look at you. The way that you and I did this at The Uncharted Strategic Planning meeting when our team got together and sort of started to talk about what we want to do and where we're going in 2022. I think my question to the group was, “When you think back in the last year, what are you most proud of?” And I like that question.

Dr. Andy Roark:

And it was really insightful to go around and have each person sort of say, “Well, this is what I'm most proud of that we do.” And it was really a wonderful bonding kind of experience. And I came to understand people in a slightly different way and go, “Oh, it's funny that that's, that's the thing that made you most proud. I love it, but it wasn't my thing, but now, I see that it's your thing.”

Dr. Andy Roark:

And I go, “Okay, I know how to talk to you now in a different way.” You know what I mean? Or I understand why you're behind some things and not behind other things. And it was just, it's nothing short of just trying to understand people. But the other thing is when you say, “What are you most proud of,” is just a super positive way. You're not going to get a lot of negativity from that. You're not going to go to your vet team and be like, “What are you most proud of?” “I'm most proud of how Carol doesn't suck so much as the rest of the CSRs.”

Dr. Andy Roark:

No one is going to say that. Maybe, they will, but I doubt it. I think we have a very straightforward problem if someone stems from that. But yeah, it may sound woo-woo, but it's really not. It really is about what are we doing here? So, yeah, those types of questions just to get people to talk to them about what you care about. And you might not tie this to gossiping. In fact, it's a process. Just having a talk. Maybe it's just the CSRs. Maybe it's the whole team. It depends on your system and where you are and how you're set up. But it is really just, it's just a process of figuring out, “Hey, what do you guys like here? What's important to you?” And sort of collecting those things.

Stephanie Goss:

And I actually would take that and expand it even further, I would hazard a guess that if there's deep-rooted cultural challenges within a practice like this practice, it's easier, far easier to build psychological safety with smaller groups than it is with bigger groups from the start. And so, my suggestion would actually be as the leader at tackling this, I would 100% do some smaller meetings. Start with just the CSRs, start with just the tech team, start with the kennel team.

Stephanie Goss:

Break it out into a smaller group because if you can take three to five to 10 people, and get them talking and agreeing on things and then layer. And then take a separate group of three or five or 10 people and get them talking about things, then your job of building the bridge becomes exponentially easier. Because you have information from those groups that they don't have about each other yet, that helps you do your job to build that bridge. And help create that layer of safety because you can spot the commonality and you can help use that to the long-term advantage of the conversation. About be like, “Hey, look, I met with the CSRS and they said these awesome things about the tech team and the tech team had these things to say.”

Stephanie Goss:

So knowing that you guys all feel that way, this is how we can move the conversation forward. I would strongly argue for that versus if you have a really small team and you have only five people, sure, you could totally attack this all out, right? But if you've got a medium to bigger size team, it is far easier to take smaller groups and layer them on top of each other than it is to go all in.

Dr. Andy Roark:

No, I completely agree. And again, it depends a lot on your team. It depends a lot on the problem, right? If this is a CSR problem then I might just start by talking to the CSRs and try to iron things out. It really depends on the specifics of what's happening. If you're going to work in groups, and there's some real benefits to working in groups as opposed to working with the whole practice. Especially if you got a bigger practice, this may be too sprawling a conversation to have with a big group.

Dr. Andy Roark:

So, the classic approach that we started talking about in Uncharted, we talked about getting our leadership on the same page, right? And then we talk about getting the doctors on the same page. And I would do the exact same way is I'll get the doctors together. And I would say, “What do you guys like most about being here?” And then I would also say, “Hey, do you guys see this problem going on in the team?”

Dr. Andy Roark:

And I would give the doctors the problem and say, “We have people that there seem to be arguing all the time. And we seem to have a lot of interpersonal conflict. Do you guys see that? What insight do you have about why that's happening? What are your thoughts? I want to fix this. I want to make this better. And I could really use your advice, and I could really use your support.”

Dr. Andy Roark:

And now, I'm recruiting the doctor into this. I'm showing them the problem. I'm asking them for their advice, and doctors love to give advice, we do. I will give you all the advice. I have literally 170 podcasts. You're listening to one of them right now, of me giving advice, unsolicited. Like it's just Exhibit A of doctors who just give advice. That's this guy.

Stephanie Goss:

Well, I also think to your point earlier about doctors being problem solvers is super valid here. If you unite them around the problem, now it becomes a puzzle that they can solve.

Dr. Andy Roark:

Yeah. So, bring the doctors in and just say, “Hey, guys, do you see this?” Because remember, culture comes from the top and if you can get your fellow leader on board, and then if you can get the doctors to say, “Yeah, we don't like this. And if we see something, we're going to say something about it.” And that's the powerful thing is the doctors to say to the technicians they're working with, “Hey, guys, let's not talk about people who aren't here, okay?”

Dr. Andy Roark:

Whatever the specifics are that you're facing, but getting the doctors on board. And just to say, “Yeah, we don't condone this behavior, and we're not going to participate in it,” that's a huge win. And then, I go to the key opinion leaders. I go to my head techs. I go to my big personalities, the ring leaders. They might have a title, but people look to them.

Dr. Andy Roark:

And I would say, “Hey, guys. Let's talk to you guys. People look up to you. Hey, do you guys see this? I want your insight. Why do you think it's happening? Can you help me? I talk to the doctors and I really want to make this change. But I know you guys are really important because people look up to you.” And now again, I'm still trying to recruit these people.

Dr. Andy Roark:

And you see, it's going to take some time to meet with each of these groups of people, but I'm slowly turning the soil, so that I can start to grow something beautiful. And at some point, I'm going to meet with the dissenters. I'm going to meet with the people who are the ones who've seem most likely to have arguments with people. And I'm going to say, “Hey, look, I want this to be a good place to work. Why do you think these things happen? Do you see that we're having a lot of conflict in our staff?”

Dr. Andy Roark:

And I may be kind of vague about not trying to go in and have a disciplinary talk, but just to sort of say, “Why do you think that we have conflict the way that we do here?” And see if I can get them on board. And the last thing is, at that point then I go to the rest of the team. And now, if I've done it right, I've got the leaders on board. I've got most of the doctors on board. I got most of the big personalities and key leaders on board.

Dr. Andy Roark:

And I can get some enthusiasm, so by the time I roll it out to the rest of the team, I should have a pretty darn good amount of support. And I also shouldn't be surprised by the pushback that I get or what people say. There should not be someone who goes, “Well, we can't get along when so and so is doing this, that you've never heard of.” Man, if I've had all these meetings and no one's mentioning this big obvious problem, I can't imagine that happening. That would just be too far of a stretch.

Stephanie Goss:

Yeah. And that's really key for me, I learned that lesson very early on as a leader. And it's one of the tools that I use the most is, I don't ever want to go into a group conversation like that without knowing what the outcome is going to be to a degree. And so for me, it is all about I want to get those people siloed out in a safe space and hear what they have to say. So, that I hear it for the first time in private and have time to process it. And have time to come up with my game plan before I get whacked with it in front of everybody in a team meeting.

Stephanie Goss:

That's the goal. Good, bad, and ugly. It doesn't always have to be bad or ugly. Sometimes, you want to hear that good stuff, so that you can punch it up even more. So if your doctors are like, “Hey, I watched this thing happen, but then so and so did this and I really was proud of what they did.” “Look, that's a great example. Let's think about how we can get the rest of the team to do what Jessica just did.” Those are the things that I want to know, ahead of time so that I can game plan, so that when we do talk about it with the whole team, I'm not caught off guard.

Dr. Andy Roark:

No, I agree. I think getting that game plan down is key. Working sort of through those groups is a really nice way to kind of break this up into bite-sized manageable conversations that I can do. And then ultimately, I'm going to try to get under the team and really, if you want to really do it well, ask the team how they want to handle it or what they want to do or what rules they would like to see in place. And you'll be amazed. Honestly, if the ideas come from them, they tend to buy into it more than they're ever going to buy in ideas that come from you or me.

Dr. Andy Roark:

And so, I think, Stephanie, you do this really well. You're very good at sort of saying to the team, “What rules would you guys like to have or how do you think this should be approached? And what would you like to see done or what reward? How can we reward people who are or whatever term the team uses, our cultural warriors, our happy people, our smiley people, our people who are lifting others up?”

Dr. Andy Roark:

How do we recognize those people? How do we reward them. And you'll see the team get really excited about the idea of shutting this stuff down, because they don't, nobody likes to work in a place where gossiping is going on and people are getting arguments all the time. And we've talked a bit about psychological safety in the last couple of weeks.

Dr. Andy Roark:

This is a perfect example. I don't want to go to work where I'm always watching my back and people are going to get mad at me. And they're going to say stuff about me that's not true. I don't want that. And so, if you say any, “What can we do about this? Are there rules that we should have? How do we approach this? How do we celebrate people who aren't doing this? And who were supporting people and lifting them up?” I'm like, I can get really excited about that conversation.

Stephanie Goss:

Yeah, if you're-

Dr. Andy Roark:

And I'm a doctor, so I'll give you advice.

Stephanie Goss:

And if you're sitting there listening to this, and going, “Oh, pick me, pick me. I want to learn how to do that.” We actually are going to have a workshop at our April Conference, which is coming up. If you haven't checked it out, we're going to have a workshop on psychological safety with our friend, Phil Richmond, talking about how to build this.

Stephanie Goss:

And yes, to your point about agreements, that was something I learned early on in my career. And one of the things that I realized after spending years feeling very disappointed and frustrated, because it seems like no matter what I did, when it came time to get feedback from the team, there was I struggled with hearing that they didn't think that I was doing a good enough job holding people accountable. And I really struggled with that, because I spent a lot of time focusing on putting systems and protocols and processes in place, so that we could have team accountability.

Stephanie Goss:

And it took a very, very long time for this light bulb to go off. And I mean, I sat through multiple reviews, and then went home and cried my face off, because I was like, “Everyone thinks I'm a crappy boss.” And that wasn't what was being said, but it took a really long time for the light bulbs go on. And it ties back to appreciation in a way for me, which is that, we have all, most of us have heard of the languages of appreciation at work. And we think about the idea that people like appreciation in different ways.

Stephanie Goss:

Accountability looks different to different people and it took me so long to flip that light bulb on and realize that what I thought was accountability, and what I was working towards what systems and protocols and processes was not what accountability looked liked the rest of my team. And so to your point, when you're asking the team, “How do you want to handle this?” the word that I specifically use is, “How are we going to hold each other accountable?”

Stephanie Goss:

And then I asked them, “What does that look ?” And I will make them close their eyes and tell me, “Okay, if gossip is our problem,” and I use myself as the example. “If I was in the treatment room, and I was just talking smack with Andy and I was just talking about Jessica, and this is exactly what we were talking about. Tell me, you describe to me, my eyes are shut, what does accountability look in that moment?”

Stephanie Goss:

What do we say? What do we do? How does it sound? Is it loud? Is it soft? Is it private? Do I say, “Hey, can I talk to you away from everybody else?” What does that actually look ? Because accountability looks very different to different people. And once that light bulb went off and I started having those conversations, for the first time, I started being able to affect change and feel like I was being, I was doing what they thought of as my job.

Stephanie Goss:

Even though I've been my job all along, I was able to change the perception around accountability because it does look different to different people. For some people, accountability looks like, “Look if somebody does the wrong thing, I want them to get written up.” Okay, I know what that process and protocol looks like. I know how to document employee disciplinary issues. I know how to discipline somebody out of a role when it is appropriate. But it doesn't look that for everybody.

Stephanie Goss:

For some people, it's just like, “Look, I just want them to not do it again.” Okay, well, but how do we make sure that that happens? What does that system look ? And so, it's asking that question about, “What does the accountability look like?” And then asking the better question, which is not, how do I, Stephanie, as the boss hold you guys accountable? It is how are we as a team go and hold each other accountable?

Stephanie Goss:

Because if Andy and I are in the treatment room gossiping about Jessica, and Dr. Sarah walks by and hears it, I want Dr. Sarah to say, “Hey, you guys. I really don't think that that's a conversation that you should be having in the treatment room or at all, honestly. If you have a problem with Sarah, you probably should go talk to her. That is what I want accountability to look like amongst the team. The team has to talk about that. And they have to all come to an agreement about this is how we're going to hold each other accountable because it can't just be Stephanie, as the manager policing everybody, because ain't nobody got time for that.

Stephanie Goss:

And I don't, as much as my kids, they believe I have eyes in the back of my head still, I don't have eyes in the back of my head and I can't be seeing all things at all times. It just is impossible. And so, this is where we have to get their buy in and ask them, “What are the rules? How are we going to show up for each other? How do we want to handle it when we screw up?” Because we will screw up. We are building new habits. We are building new systems.

Dr. Andy Roark:

Sure. And as you say, we've got habits at this point. And that's the sad thing is that these have been allowed to become habits. And so people will do them.

Stephanie Goss:

Yes, years of it.

Dr. Andy Roark:

Yeah. And so, you just know, like I said, we're in this for the long haul. It's not going to be perfect, but we're going to keep circling back. And then we're going to have some follow-up meetings and be like, “How's everything going? I'm starting to see an uptick in these behaviors again. Can we review our rules? How's everybody feeling about it? Are we still comfortable holding people accountable, as we said?”

Dr. Andy Roark:

And just having those conversations again, but bringing it back up to the surface and working on this. Because we're working on culture, it drives everything else. And it takes time to change, especially when people have built habits, but it is worth it. So, yeah, I think that's great. How do we hold each other accountable? How are we going to measure and reward drama free behavior? How do we celebrate the people who were setting a good example?

Dr. Andy Roark:

I really, I keep going back to that. It's so hard to police culture. It's easier to reward the people who live it the way that makes you proud. And so, how do you catch those people and lift them up. And then the last thing… go ahead.

Stephanie Goss:

Well, I was just going to say that one has to be multimodal, because appreciation looks different for everybody. And so, that's another conversation that you have to have as a team and recognize that for some of the team, if we can all break a habit and we have good healthy behavior and we can document that. Maybe for some of the team, success and reward would be amazing if we had, a taco truck come by and feed everybody after work one day.

Stephanie Goss:

But for a bunch of the team, it's not going to check their box when it comes to appreciation. So, this is about getting to know your team as people and recognizing how do they all value appreciation? And can we find commonality around one specific issue and come to an agreement about what does that look ?

Dr. Andy Roark:

I agree. I think that's so true. And the last thing is, now, that we have had this conversation, now that we have talked about what's important, now that we have talked about what we believe in and what our values are, and what the problem is, and how we're going to hold each other accountable, now is the time to start holding people accountable.

Dr. Andy Roark:

And I really emphasize start, and this is why I started the beginning by saying, we're talking about the future.

Stephanie Goss:

Right. Not the past.

Dr. Andy Roark:

We are not starting now and retro actively trying to punish people who have been bad actors in the past or poor performers. That's gone. It's over. We have all talked about why we're happy to be here. We've all talked about what we see. We've all talked about what we agree to do to make this place better. And now, we start to hold people accountable in a meaningful way. Clean slate for everybody. I'm not holding anything against anyone, but now we start.

Dr. Andy Roark:

And we start building our naughty list and our nice list. And when people have problems or when we hear about gossip or pin, when people start to come and they're bringing conflict and things like that, we can start to have a coaching conversation. We can start to give them feedback and say, “Hey, this is really something that you should be dealing with yourself. Hey, we're here, that we're having these conversations. What's going on?”

Dr. Andy Roark:

And when people are caught spreading gossip and doing things that are damaging to the culture, we need to hold them accountable. And if they show that they are unwilling to change or if they show that they have values that simply do not match and run counter to our practice, meaning, “I'm going to cause drama. It's just who I am. It's just what I love to do.”

Dr. Andy Roark:

And the core values of the practice are, we're very kind and and happy place to work. That person is a bad value fit. And they need to go. That's it. you know what I mean? But ultimately, it's not about, “Hey, you were gossiping, and you need to go.” That's not how this happens and it's not even about, “Hey, you continue to gossiping, and I'm writing you up for gossiping.”

Dr. Andy Roark:

At some point in the conversation, now that I'm holding people accountable, it's going to change to “I have talked to you multiple times about your behavior and you keep saying that you're going to change your behavior, but you're not changing your behavior. And now I'm going to talk to you about your unwillingness to change. Take it on board with the team and your truthfulness because you keep telling me you're going to change and then you're not changing.”

Dr. Andy Roark:

And that's ultimately why that person is going to be let go is because they're not being truthful and they're not willing to change and to get on board with our practice, or they're a bad values fit. They just, they do not believe what we believe here. And they're just a bad fit, and it's not going to get better.

Stephanie Goss:

And for those people who struggle with how do you hold somebody accountable and how do you let somebody go for what a values fit looks ? I would say that going back to the team agreements, if you have conversations with your team, there should be a Code of Conduct. There should be a line in the sands that everybody on the team agrees that these are immediately actionable offenses, if I mistreat a patient, if I leave a patient without water. Those are things from a patient perspective that people could look at and say, “I could see where someone could get let go on a first offense for those things.

Stephanie Goss:

It's the same with behavior. Theft is a big one, That's on our nonnegotiable list with my team at every hospital I've been at, because if someone steals from us, it's a nonnegotiable, and we're going to let them go. It is also similarly, our code of conduct and ethics is we want people on our team who are truthful. So, if I have team members who are lying, and repeatedly, telling me that you're going to do something and not doing it is lying in a way. You're not telling me the truth.

Stephanie Goss:

That becomes easier to say, “Hey, look, this is our code of conduct that we all agreed to. This is our Code of Ethics,” whatever you want to call it, that fits for you and your team. But having those lines in the sand of, “These are the one and dones. This is where we draw the line in the sand and say someone is going to get off our bus, if they can't get on board with these things.” It makes those conversations a no brainer. They are not hard conversations to have.

Stephanie Goss:

We think about them being hard conversations, because we haven't taken the time to define where that line in the sand should be and get agreement from the team as a whole. Because a lot of us have some of that in our handbook, but it's the thing that we hope that people read when they start employment with us. It's not something that they participated in making necessarily, or that you've talked about, on a regular basis with a team that everybody knows. It's not a living breathing thing.

Stephanie Goss:

And so, this is where another exercise that is so invaluable is take the time to build a Code of Conduct. Build an Ethics Clause for your handbook as a team and review it every year, at least, so that the team knows, “This is where our line in the sand is drawn.” Because then those conversations are so easy to have.

Dr. Andy Roark:

Yeah, no, I agree. And for people who are struggling with evaluating employees and having those hard conversations, I think this podcast will probably come out a little bit late for that. On February 23rd, you and I, Stephanie are teaching our Evaluating Employees and Loading the Bus Workshop in Uncharted.

Dr. Andy Roark:

So, I think this, I think that we'll already have done it when this episode drops, but if you're Unchartered member it will be in our Knowledge Library and you are welcome to check it out. It's a workshop that you and I run about every year, just because people really like it and they really need it. So, anyway, that is there if you're an Unchartered member. Check it out.

Dr. Andy Roark:

Guys, that's it for me, Steph. I don't think I have anything else. Do you?

Stephanie Goss:

No, that's it. Have a great week, everybody. Take care. May you have less menthol diarrhea in your house than Andy has in his.

Dr. Andy Roark:

Yes, yes. That's how we measure, “How's your year?” “Didn't have any menthol diarrhea.” Sounds like a good stuff. Must be living right. All right. All gone.

Stephanie Goss:

Take care, everybody.

Dr. Andy Roark:

See you guys. Bye.

Stephanie Goss:

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

What's This Episode About?

This week on the podcast, Dr. Andy Roark and Stephanie Goss are tackling a mailbag letter from a practice manager. The entire world is struggling these days with short tempers, disgruntled with life attitudes, frustrations shared publicly about things that weren’t always so public before. Everyone in veterinary medicine has been impacted by at least one grumpy or short-tempered person since this pandemic began – Andy and Stephanie both certainly understood where this manager was coming from. Their question is – when the team handles frustrated people day after day – how do I keep the client negativity from wearing on them? What protocols can this manager put in place to handle clients who are negative or angry to help shield the team from the emotional impact? Let’s get into this…

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

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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. This week on the podcast, Andy and I are catching up on a conversation that I had with a fellow manager over the holiday break. We were discussing something that their team is really struggling with, and they were asking for some help because they have a practice that is continuing to accept new clients. They're one of the only ones in the area, and there's a lot of negativity coming from clients as a result of that. Existing clients are mad they can't get in. New clients are mad that they have to wait and everybody seems frustrated. My manager friend was asking, “How do I keep this negativity from the clients from affecting the whole team? What can I do to support them? What do I do to shield them from the negativity? How do I boost morale?” I thought it was a great question and one that I really had a lot of fun getting into with Andy. Let's get into this. Shall we?

Speaker 3:

Now, the Uncharted podcast.

Dr. Andy Roark:

Hey. We are back. It's me, Dr. Andy Roark and Stephanie, I will be your shelter in the storm, Goss.

Stephanie Goss:

I like it. How's it going, Andy?

Dr. Andy Roark:

Man, it's good. It's good. This part of January is the Monday of the year. That's what I've decided. Monday is the day when it is just wide open, doing all the things. Everybody who thought of things they wanted to do over the weekend just trying to talk to me about them all at once and it's just pandemonium, this part of January is the Monday of the year. I'm just trying to make it through Monday.

Stephanie Goss:

Yeah, it is crazy and it's funny because our team took time off after the holidays and it was really quiet and-

Dr. Andy Roark:

It was too quiet. It was too quiet.

Stephanie Goss:

It was too quiet. It was too quiet.

Dr. Andy Roark:

I was like, “Why are …” It's like when your kid disappears and you're like, “Where are they? It's real quiet.” That's me. Instead of a kid, it was you guys. It was a half dozen employees.

Stephanie Goss:

It's totally true. Then Monday morning happened and it's like, when it's been too quiet and then you walk in the bathroom and you find your toddler in the toilet with your makeup smeared all over their face. That was how Monday felt.

Dr. Andy Roark:

I love our team. They had a week off. Everybody, I think we were really blessed that everyone on our team seems to really love their jobs and like what we do and think that it's awesome. So we, when they get a week off, they all quietly work on their own ideas and pet projects and things that they're pumped about. Then I just open the front door and people are like, “Hey, I got a week's worth of ideas I've been sitting on.” Boom. I love it. There is that thing about if you love what you do, you don't work a day in your life. It's like, I'm working my tush off, but I still really like it and I like what we do and I like new things.

Dr. Andy Roark:

It is simultaneously exhausting and also awesome. Thinking about this, it's the Monday of the year, there's this really great headspace if you can get into it of looking at your job as a challenge. There's two kinds of challenge. We talk about challenges. What we're really saying is, what is sucky? What is hard? What is difficult? But then there's also the challenges of a video game or a sports event or a hobby that you're going to do where you're like, “I'm going to paint this picture that's probably beyond my skillset. But I'm going to do it and it's going to be a fun challenge.” If you can get your head about your work into that mind space, man, it's amazing.

Dr. Andy Roark:

That's where I am now is I'm like, “I have got way too many things going on and they are challenging, but I feel I am up for this challenge.” I am 100% feeling positive stress. Oftentimes, you can get your head in that position if you want to. If you can, God, it's awesome. It's re-energizing and rewarding to be like, “Yeah, this is not easy and that's fun.” If it was easy, it would be monotonous. I don't know. That's where I am right now. 2022 so far, I am looking at it as a worthy motivating challenge. I'm going to try to keep my head in that place as long as I can, because that is really a sweet spot. I go to bed at night feeling like I did good work and excited about tackling the challenges of tomorrow.

Stephanie Goss:

Yeah. I mean, I'm excited about this year as well. Like to your point, there's so much good stuff coming down the road, it's hard to not be excited about change. At the same time, it's easily overwhelming because to your point, it feels like Monday. Mondays can be overwhelming. I'm excited for today's podcast because-

Dr. Andy Roark:

I was just just going to say-

Stephanie Goss:

… I was talking to a manager friend over the break and catching up and they run a fairly large to mid-size practice. They have multiple doctors and have a bigger team, and so they were asking for help. They are struggling with something that I suspect is kind of probably common for practices who are still taking new clients. They are one of the only practice in their area who is accepting new clients, all of the other GPs, particularly the smaller one and two doctor practices in the area, stopped taking new clients because they just can't handle the caseload. My manager friend was saying, “We actually are feeling really blessed right now because we are not fully staffed, but we have enough team to handle the caseload. At the same, because we're the only ones taking new clients our appointment schedule is really full. We have existing clients who are getting ticked off at us because we can't fit them in yesterday. Then new clients who don't understand why we're telling them it's a two week wait for them to have to get in to be seen.”

Stephanie Goss:

They were saying their team is really struggling because they feel like they are getting hit on both sides with constant negativity from client interactions. Because everybody is frustrated with wait times, with how long it takes to get an appointment, with how long they're on hold to talk to somebody, all of those things. Everybody is having to navigate changes again for a lot of places to COVID protocols and lots of practices are going back to curbside or making changes because they are shorthanded or they have people out. We're kind of in a space, it reminded me a lot of where we were probably three to six months after this whole thing started two years ago.

Stephanie Goss:

Where my manager friend was like, “I'm just exhausted because it feels negative all the time. I'm trying to keep it to myself because I don't want my team to see that I am struggling, but I am really struggling because I feel powerless. I feel like the clients are mad and they are disgruntled with the team constantly. I need help with figuring out how do I keep the negativity from the clients from affecting the team. What can I do to kind of shield them and be their buffer and how do I boost their morale? Because I am worried we're not having the problem that a lot of practices are of handling the caseload.” She said, “I've heard you guys talk about that on the podcast and that's not us. We can handle the caseload. I just don't know how to handle the negativity.” I thought this was such a good one for you and I to talk about.

Dr. Andy Roark:

I like this a lot. There are three pieces to this that I see. Man, this is so timely and it's so good, but let's start to go ahead and break this apart here. Let's start with headspace, shall we?

Stephanie Goss:

Okay. Sounds good.

Dr. Andy Roark:

All right. There's three pieces of this that I see. Number one is, I want to shield my staff from negativity. How do I shield them from negativity? Number two is, how do I deal with the clients that are complaining from a strategic standpoint? What policies do I have for dealing with the actual problem of things that the people are complaining about? Then the last part is, how do I support the wellness of my people? A little bit different than how do I sort of control the negativity? How do I engender the supportive culture that we need and lift people up? Those are the general three ideas. I want to start with the biggest pain point that I see. So try to put the most useful advice right here at the very beginning. Again, I could be wrong here and no one could be feeling this way that I'm about to say, but I'm not wrong. Here we go. I'm just going to go ahead and say, I would bet you that the vast majority of people who are interested in this problem are having the following problem.

Dr. Andy Roark:

I am making an assumption, which I do apologize for, but I think this will be helpful for a lot of people. The number one pain point here is the belief that I, the manager, can control the negativity that is heading towards my staff. I talked to a manager literally three days ago, and I was talking to this person and she was telling me how she was exhausted because she was making changes to save, and that's the word she used, to save Angela at the front desk. Angela at the front desk is a rockstar. She's amazing. She is fantastic and she is tired and she is talking about how she might quit. The manager cannot have Angela quit because we're shorthanded and we need Angela and she's great. So the manager is helping on the phones whenever she can. She is having the text come to her, the manager, instead of anything that needs to go up to Angela because Angela is fragile and we don't want to push Angela over the edge.

Dr. Andy Roark:

Then any client that has any sense of frustration is being referred away from the front desk to the manager so that Angela doesn't get called in sure to oversee it because we have to save Angela. My advice to her was, you need to get realistic about your power to save Angela. The truth is, if any of these things are going to cause Angela to throw her hands and quit, she was going to quit anyway. She was already there. The point being, I'm not saying I don't care about the mental health and wellness at the front desk. Of course, I care about them. But the idea that this manager can throw her body in front of all of the bullets flying at the front desk and absorb them all so that not one of them hits Angela and causes her to quit, that's just not realistic. You know what I mean?

Stephanie Goss:

Yeah.

Dr. Andy Roark:

If she is so burned out that she's going to quit, probably she may need to quit. That may be the best thing for her. It may be the best thing for you. It may be the thing that needs to happen and you should come to peace with that.

Stephanie Goss:

That's a hard thing.

Dr. Andy Roark:

It is hard. It is-

Stephanie Goss:

It's a hard thing for people to wrap their head around.

Dr. Andy Roark:

… and we want to believe … Again, I hope I'm not butchering this into delivery of the point that I'm trying to make is, you don't have the power to save your staff from your clients. The clients have direct access to staff. I cannot absorb the negativity. I can't shield them from it. Now, there are lots of things that I can do, and we're going to talk about what those things are. But the first thing that you have to do as a manager, as a practice owner, as a vet who's stressing about their people, is get realistic about how much control you have. The answer is, very little. You need to be smart in how you use that control, but at some point, if you were staying awake at night worrying that someone is going to quit and thinking that you're going to throw your body in front of negativity to save that person, you are wrong.

Dr. Andy Roark:

You are beating yourself up and you are putting unrealistic expectations on yourself. You do not have that power and you need to recognize that and relax and take care of yourself and approach this from a healthier, more nuanced perspective. That's going to let you actually do things that matter, but also is going to protect you emotionally. I see people who have someone who quits at their practice and they fall into a puddle and accept blame for that. I didn't save this person. You don't have the power to save this person. Let's get realistic about what is possible and be kind to ourselves and approach this from a way that's healthy for us.

Stephanie Goss:

I mean, I think that's super fair and I think it's a good headspace to be in. I think that's the hardest. Getting there is the hardest thing to do because we care. We care about our people. We care about the team. The conversation that I had and I'm sure the one that you had, you're coming from a place of good intention. When you were telling about talking to the manager that you were just talking about recently, that made sense to me and resonated to me because I've been there and done that. I've gotten myself into trouble by being that person who's like, “I'll jump in and help save them.” It's good human, decent human being human nature to want to try and help. I think getting into that space is really hard.

Dr. Andy Roark:

Well, I guess the analogy I would give is, I care deeply about my children and I care deeply about my staff. They're different, but I care about them. When people on the playground are mean to my kids, you better believe that I feel the urge to go to the school and hang out. Like, “When's your recess. I'll be on the playground.” But that's not realistic. You know what I mean? It's like, I can't shield my children from all of the negativity of the other kids. There are things that I can do to protect my children. There are things that I can do to put them in situations where they are not going to have to deal with a bunch of crap they shouldn't have to deal with. You better believe I'm a to do those things, but at some point, if I believe that my children having a negative interaction with other kids and coming home crying is a failure on my part in parenting, I'm going to have serious problems with my own mental health. You know what I mean?

Stephanie Goss:

Yeah.

Dr. Andy Roark:

Wellness. I guess that's the analogy I'm trying to draw. A lot of us think that we can protect our staff from the clients that they are alone in the exam room with. I can't protect them. I can support them. I can put them in a position to succeed and keep them healthy and happy, but I can't be there to protect them every day, all the way. I think the first thing it's accepting that I can help up to a point and that I need to be honest about am I helping up to the point that I can? Beyond that, I have to say, I cannot stop negativity from occurring at some points.

Stephanie Goss:

I mean, I think that's super fair. I hadn't thought about it from the perspective of trying to stop trying to save the team because ultimately at the end of the day, they have to interact with the world. You can't be the human shield. I had been thinking about it from a headspace perspective from the opposite side, which is that conversely I can't really make clients do a lot of things that I want them to do either as a manager. There are lots of things that I can do. To your point, I can put policies and protocols in place and I can have zero tolerance for a lot of things, and there can be consequences. I can fire clients or there can be other consequences, positive and negative, for their behavioral choices. At the end of the day, I can't control it. I can't make them do it. I can only control how we, as a team, as a company, how we respond to the things that the clients do and say. Right?

Dr. Andy Roark:

Yeah. I mean, it's like being a military commander. I'm not there on the ground to keep these soldiers safe. What I have to do is create plans and protocols and policies and situations where my people are going to be safe because that's the level that I have. But I'm not in the foxhole when the actual fighting happens. That's the best analogy. I hate using military analogies because they paint the picture of the pet owner as the villain or as the adversary, and that's not true. But that's the best analogy I can give as far as what we have to get ourselves into realistically, in order to have a reasonable expectation for our role in these conflicts.

Stephanie Goss:

Sure. That makes sense.

Dr. Andy Roark:

That's the first thing I guess I'd say. Is zero negativity should not be the goal. It's just it's-

Stephanie Goss:

Unrealistic.

Dr. Andy Roark:

Yeah. It's beyond our capacity. I think your point about pet owners too, is like, this is the reason why the zero negativity is not a goal is because we don't have any control over pet owners. They are going to do what they can do. I'm not saying I throw up my hands and go, “I don't care.” I'm going to put policies in place to protect my people, and we're to talk about what those are and how we do those. At the same time, realize that they are still going to run into negativity. That can't be removed. The example I'll give you for this is, remember when the pandemic started and we told pet owners to stay in their car and we put a sign out in front of the building that said, please stay in your car and text this number?

Dr. Andy Roark:

We put a sign on the door that says, go back to your car and text this number. Then we locked the door and clients still, they walked past the sign in the parking lot. They looked past the sign on the door and they jiggled the door handle and then put their hands and face against the window to peer inside. They pointed at the door as if you had accidentally locked them out. Remember that? There is no amount of signage and policies that are going to stop clients from bringing this nonsense to your people. It's going to happen. The same thing is true with negativity.

Stephanie Goss:

That's so true.

Dr. Andy Roark:

The idea that you are going to make signage and policies and language that will stop negativity from coming to your people is nonsense. Know who we're up against. Know who we're dealing with and be honest about it.

Stephanie Goss:

Yeah. I mean, it's totally true. When I think about it, there have been moments where I have reminded myself, just remember the day where the client literally picked up the sandwich board sign that was blocking the door and moved it to jiggle the door handle and put their eyes and face up against the door and find out why we weren't unlocking the door for them. I reminded myself of that on a regular basis. Like, “You can't control this.” People are just going to do what they're going to do.

Dr. Andy Roark:

No, you can't. No matter how good your policies and planning are, they will go around it. It will happen, and so just resign yourself to that. I say all of this because the strategy is not to end negativity. The strategy is to systematically remove negativity 80%, and then 80% of what's left, and 80% of what's left. I want to add policies so that 87% of pet owners stay in their car and the front desk can deal with the 10% that still walk up to the window and ask what's going on. As opposed to not having any signs and 100% of the people walk up to the window and ask what's going on. I think that that's what we're going for. I'm trying to get people into that headspace of, “Okay. I want to do things that remove negativity and remove 50% more negativity and remove 50% of that negativity. Those are the things that I want to accomplish.” Then try to set it up that way so that it's realistic in the expectations of what's coming.

Stephanie Goss:

Is there anything else when we're thinking about this? Because your points about accepting that we can't control the situation and that we don't have the power to protect everybody, they're going to interact with clients. We know that we can't get to zero negativity because that's not actually a thing. But from a headspace perspective, when I was thinking and prepping for this, I was struggling to think, what kind of headspace do I need to be in to actually tackle this and come at it from a solution driven perspective? Because that's really important, and that's always the second half of what we do here on the podcast. Is talk about how can we actually tackle it. But I really struggled with thinking about what else from a headspace perspective? Was there anything else that you thought of in terms of how to get there?

Dr. Andy Roark:

Yeah. To get out of this, if the answer is not throw myself in front of negativity, then what is the answer? In order to get to the answer, in order to make this production, you have got to zoom out. This is one of those problems where, by the time you get to this problem, it's too late to grab the steering wheel. You're not in a good position to grab the steering wheel. You have got to intercept this problem before it gets to this problem. That is the answer. You have got to zoom back out. It's not about absorbing negativity so it doesn't get to your team. It's not about throwing your body in front of clients to not let them have negative interactions with your staff. It's about zooming out and taking the bigger view, which is quite simply, what can I do to build a positive practice culture to absorb this? What organizational boundaries and protocols can I put in place to remove a lot of this crap before it gets on my team?

Dr. Andy Roark:

What are wellness resources that I can put forward for my people to help support them along and along? Those are the three things really from the organizational standpoint, for me as a manager. Under that, I want to empower individual people to believe that they have personal agency and to believe and enforce their own personal boundaries. I can talk a little bit more about what that means when we get into action steps, but that is the answer for me in headspace. Is let go of the idea that you are going to shield your people or that you can make your people stay or that you can make your people happy or that you can save them on an individual level. You are the battlefield commander, step back, get a clear view of the situation. What are you doing to build a positive culture that is going to support them knowing that clients are going to be frustrated? What policies and procedures and boundaries have you put in place to take care of them and what wellness resources do you have for your people?

Stephanie Goss:

Yeah. I love that. I think the only thing that really stuck out for me besides if you are feeling very negative about the whole situation or you're feeling really overwhelmed or upset about the negativity, whether you dealt with it on the client side that day or you dealt with the team side at day, obviously not being triggered when you have a conversation with people is really important. But there was something that really stuck with me after this catch up call with my friend, which was, they made a comment about not letting the team see how they felt and how it was affecting them. I would say that if you are the leader, a, I think it's important to be vulnerable and honest with the team and share with them. At the same time, they are not your therapist.

Stephanie Goss:

This is where I'm going to insert another plug for, this is hard. Being a leader right now in the middle of everything that we are dealing with is really, really hard. If you were in a position where you were trying to manage the struggle and not dump your emotions or feelings onto your team, or you're trying to figure ow do I share a little bit of it because I feel like if I open up a little bit with them, I might volcano, because I've been there, this is where having your own support system, including a professional when you need one, and having somebody to talk to about your own feelings and emotions before you tackle it with your team, was the best thing that I ever could have done for myself as a manager.

Stephanie Goss:

The ability to have a conversation with somebody outside, get some perspective, wrap my brain around it, sort through my own feelings, it made it so much easier for me to come in and have conversations and maintain positivity with the team no matter what the negativity or the reason for the negativity. Over the years, I found that I was able to handle those situations so much more smoothly when I had done some planning for myself. If you're in a position like this, I would just say, you got to take care of yourself too. It's like you put the oxygen mask on before you can help anybody else. This is definitely a similar situation because the negativity is affecting my friend. I know that, and so I would say, it's important to take care of yourself first before you try and take care of the team and the clients too.

Dr. Andy Roark:

Well, I think the healthiest way to look at this is, you are part of the team. What we're talking about is vulnerability with moderation. Vulnerability with boundaries. Meaning, I'm not going to come apart. At the same time, then I guess that's why I hit so hard on this idea at the very beginning of, you're not saving your people. The reason is because you are in it with them. You are getting negativity as well. I think the way that you talk to your staff is, everybody should try to drop this idea that you are a superhero that's going to save them. You're not. You are on this boat with them and you're all there together. The healthiest conversation you can have is, “Hey, guys, I feel what you feel. What can we as a team do to make our situation better?”

Dr. Andy Roark:

You listen to the people, but that is the healthiest mindset to have. I'm not Superman. I can't fly around saving everyone and I am being affected as much as you are being affected. Let's all just be honest about that. Now, I am with you. What are we going to do as a group?

Stephanie Goss:

I love it.

Dr. Andy Roark:

I just think that that's super key. But that level of vulnerability, I think is important. I think there's complete charade when you're like, “I don't want the team to know that I don't know what to do.” Why not? You don't know what to do. We've all been around people who clearly didn't know what to do and they tried to act like they did and they just destroyed their credibility. We've also been around people who had great credibility, who said, “I don't know what the answer is. Let's figure this out together.” You go, “Okay. I can work with that person.” I think that is the forgiving healthy headspace to get into.

Stephanie Goss:

Okay. Well, do you want to take a quick break here and then we can come back and talk about how do we actually tackle the challenge here?

Dr. Andy Roark:

Let's do it.

Stephanie Goss:

Hey, everyone. It's Stephanie and I just want to jump in here for one quick second and make sure that you know about a couple of things that are coming up that you may not want to miss. Andy and I just kicked off our Strategic Planning Workshop Series. We've been doing this at the top of the year, every year for the last few, because it gives us a chance to talk about how do we set the team up for success when we look ahead at a coming year. We've done the first session already by the time this comes out, but you can still join us for the remaining three. We're going to be talking about setting vision, mission, talking about values with our team and really living and breathing it versus something fancy that just goes up on our wall. We're going to talk about loading the bus, getting the right people in the right seats and moving forward.

Stephanie Goss:

Then we're going to talk about KPIs and what do we need to look at from a numbers perspective to smartly manage the practice and also how at our team bought into that. You can join us for that. Then the other thing I want to make sure you don't miss is, we have a class coming up on February 17th. It is a workshop that is being led by my friend, Dr. Adam Little. This is a workshop that Adam did for us previously at an Uncharted event and we heard so much great feedback about this, that I wanted to figure out a way to bring this to you guys virtually. Adam Rose to the challenge and I am super stoked about this. You're not going to want to miss it. It is called What Vet Med Can Learn From Improv. Adam is going to be talking about how to learn, how to take the fundamental foundations of improv and apply it not only to comedy, but to life and practice. So how do we learn to think quick on our feet and be more comfortable with what is often the uncomfortable or the unexpected?

Stephanie Goss:

That workshop is kicking off on February 17th. Registration is still open. You can find out about these and more at unchartedvet.com/events. Now back to the podcast.

Dr. Andy Roark:

All right. Let's get into what we're actually going to do with this thing. The first thing that I want to talk about, I said there was three parts of this. I said that there is the control part. Like, what can I control and what is beyond my control? I said that there's the strategy part and there's the wellness part. The strategy part, this is where we're going to get into the action steps, the strategy part. I don't know this practice, I'm just hearing what they're saying. At some point, I do have to ask the question, if no one else is taking new clients and you are taking new clients and taking new clients is making the new clients unhappy and your existing clients unhappy, I have to question, and I just got to ask, are you sure that taking clients is a good idea?

Dr. Andy Roark:

Because it sounds, and I could be wrong, it sounds like you're trying to make everybody happy. There is an old quote that I really like, I don't know what the key to success is, but the key to failure is trying to make everybody happy. I'm like, “Yep, that's it.” I 100% see practices out there that are ticking off their long-term clients and doing a crappy job serving new clients and their team is getting beaten up. I'm going, “What in the world are you doing?” They usually give me some explanation about, “Hey, well, other clinics aren't taking people.” Stuff like that, and I see some of that. But at the same time I go, “If we take the long view, you burning out your staff, having them quit, making your long-term clients angry because they don't feel prioritized, they feel mistreated, and doing a poor job serving new clients, that's not good.”

Dr. Andy Roark:

There's no long-term benefit that comes from that. That is the worst long-term outcome. This is one of those things where sometimes setting some boundaries and saying, “We're not taking new clients, period.” You do the most long-term good because you retain your staff and you are able to continue to work in the long-term with a good, happy, motivated team. As opposed to saying, “We are going help everybody.” Then people just drop like flies and then you have a skeleton crew of burned out people that are just laboring away at a job that they don't enjoy. That's just the first question I got to ask. Are you trying to make everyone happy to the point that you are damaging the long-term good you could do?

Stephanie Goss:

Well, I think it's a really good point. I think it's one of the things that I asked. Was, “Okay. If we are two years into this at this point and your existing clients still have the expectation that they would be able to be seen within a seven to 10 day period, what have you've been doing for the last two years?” Because I don't know very many practices who over the last two years have been able to continue to serve their existing clients in that short of a time turnaround that we may have been able to accommodate pre-COVID. That was the part of it that I struggled to wrap my brain around, and I asked. I was just like, “What are you guys doing to manage expectations?” From a solution perspective, that certainly is part of it. For me is, maybe you don't have to stop seeing new clients because I think to your point, I appreciate the clinics who are still trying to serve new clients.

Stephanie Goss:

Because there's the conversation about, should you be penalized just because you became a pet owner now? People are like, “Well, you should have had a a pet sooner.” Whatever. There's lots of reasons, or I just moved here, whatever. There's a lot of reasons that people, through no fault of their own, could need a new vet. I appreciate what they're trying to do and at the same time, the question I would have is, what are we doing to manage expectations for our existing clients? Because how anybody got through the last two years and didn't get to a point where clients should kind of be expecting at this point and understanding and have been educated over the last two years on the fact that we can't operate the way we did before, things have had to change and we need a longer runway.

Dr. Andy Roark:

Well, I hear that. I guess that I'll push back a little bit in that, if you have a healthy cat or a dog that's two years old or three old, that means it was one year old when the pandemic started. Which means you have been to the vet exactly twice in the last two years. You know what I mean? Again, they don't think about this. You know what I mean? When you've got a healthy pet at home and you're an architect and your spouse is a plumber, you don't think about what is going on at the vet clinic except when you need that. I guess I 100% can see how the education would not happen for people. You know what I mean? Over a two year period, if they haven't been coming in on the regular.

Stephanie Goss:

Sure. I would push back on that and say, okay, well, what is your team doing when people need to book appointments? How are we communicating? Because sure, your point is super valid. We have a huge amount of our client base who aren't the frequent flyers. We have, all of us do, a huge amount of clients who come in once a year or twice if we're really lucky. So they're not going to get it. But what are we doing to communicate that? I would look at that and I would encourage all of us, especially those of my colleagues who are still seeing new clients, to think about what are we doing to educate our existing client base and managing those expectations?

Stephanie Goss:

Because it's the failure to manage those expectations, I think, that leads to a majority of the disgruntled nature on the part of our existing clients, because we're not doing enough to communicate to them. To the point in the story that you told earlier, we should learn from the man who stuck his up against the front door and peeked in the window. We have to tell them a bajillion different ways because one and done, or a sign, literally a sandwich board in front of the door, is not going to be enough. We have to manage that expectation and just accept the fact that we're going to have to repeat it until we're blue in the face. This was one of the things early on in the pandemic that I really tried to lean into almost like a mantra to myself. Is I reminded myself about a lesson learned Disney teaches their employees.

Stephanie Goss:

If you think about it, park employees at Disney get asked 100 times a day, what time is the 5:00 parade at? They get asked questions that seem really silly. They literally just asked me what time is the 5:00 parade start at? Well, the answer is in the question that you just asked. But as an employee, the culture of Disney is very much, you're going to answer that question whether it's the first time or the 100th time you have been asked that day with a smile on your face. Because for the client who is asking you that question, it's the first time they've asked it. That for me really became a, yes, it's exhausting to answer the same questions about why you can't come in the building over and over and over again.

Stephanie Goss:

But the client that I'm talking to in that moment on the phone, it's their first time hearing it. Part of managing that expectation, for me, was leaning into that Disney model for myself and with the team of like, how do I do this with a smile on my face and remind myself that the person on the other end of the phone or the person outside the building that I'm talking to, it's their first time asking those questions and having the interaction?

Dr. Andy Roark:

Let me put this into a framework. What I would say is, the first part of solving this problem is organizational boundaries and policies. I need to handle as much negativity as I can with policies so that the few people who are still frustrated are a manageable number. We have reduced that over. We start with policies. Whenever we talk about boundaries and policies, it all is based on expectations. People don't get upset about what they get. They get upset about the difference between what they expected to get and what they got. That's what they get mad about. To your point, people who are showing up and they're not expecting a wait time, we have put ourselves in a position to have them be mad at us because their expectation is they're going to walk right in.

Dr. Andy Roark:

It's kind of like if I go to a restaurant and they tell me, “It's a 45 minute wait, do you want to wait?” I say, yes. Then I wait 20 minutes, I think that's great. I'm happy to have waited 20 minutes because I thought it was going to be 45. A lot of this is setting the expectation. Do they know what's happening and what's coming on? We have got to communicate clearly. If they're not going to be allowed in the building, we need to tell them when they book the appointment. Then we need to send them a reminder email that says, Hey, remember to expect to stay in your car. There needs to be a sign when they pull up that tells them, Hey, by the way, stay in your car. Then when someone comes out, they'll be like, “Thank you for waiting in your car today.”

Dr. Andy Roark:

That is the level of communication that we need to bring across. The thing is, people say, “Oh my gosh, Andy, how many touch points am I supposed to have really?” I say, “You know what? Start with a couple and if people continue to walk up to the building, then add more.”

Stephanie Goss:

Add more.

Dr. Andy Roark:

Exactly right. If people don't realize what was happening and they're mad at the front desk, we need to add more. A lot of that is just saying, what are people upset about? How could we let them know this again before they come into the building? Continuing to rinse and repeat and rinse and repeat and push those things forward. But when we talk about setting policies, it's expectations about what they're going to get and what they can expect from you and just say it. If they want to go somewhere else, fine, they can go somewhere else. But they knew upfront before they decided to come in. It's patient rights and responsibilities. I'm a big fan of this with negativity. We should tell clients, this is what you can expect from us and this is what we expect from you.

Dr. Andy Roark:

If they not adhere to the responsibilities of clients, then we can say to them, “Hey, this is what our rights and responsibilities are. This is how the visit went. We are not going to be able to be your veterinarian anymore.” Put that forward, but have a framework for what behavioral standards you expect. If they can't follow those standards, then they can go somewhere else. This doesn't happen a lot. It shouldn't happen a lot. If you're communicating expectations, you should not have people who are violating rights and responsibilities very often. But when they do, they can go somewhere else. If you're really trying to see your clients plus new clients coming in, I don't know why you feel like you have to let clients who misbehave stick around. They had their shot and they did not treat me the way that I require being treated, and so they're going to go somewhere else. I think we should all get happier with that.

Stephanie Goss:

I think part of the challenge is, in the course of the dialogue was, we take a stand against the super naughty clients. Like we're letting clients go when they're acting badly. The ones who are screaming at the CSRs when they get told they can't get in two weeks, those are the one-offs that are easier to deal with. But I think the reason that the conversation was happening is, if someone acts very angry or acts super crazy, it's easier now to deal with those than ever before. Because I have seen our industry start to take a much stronger stand for ourselves in terms of not tolerating that kind of bad behavior, which is fantastic.

Stephanie Goss:

I think the harder part when it comes to negativity kind of seeping into the team in the practice, is that it's really easy to ignore when you have a client who seems frustrated or snaps at you on the phone or whatever when it's a one-off. But the reality of the world right now is that everybody's tired and everybody's grumpy. In my own personal life, I'm just thinking about it like, it is far more often that I engage with somebody who is grumpy or irritated about something. When you stack that person after person, after person, all day, every day, it may not have anything to do with you. They're just grumpy. That is the exhausting part and I think that that is the negativity and the frustration and the little things that build one after the other.

Stephanie Goss:

I think that is what was part of the struggle here, is, how do I keep the team positive? How do I keep them feeling like they can be the Disney employee who can brush off the frustration and negativity when they get asked where the restrooms are for the 100th time in the day? How do I keep that pep happening? That's a lot harder to do because you can't control that with policy or protocol. I can control the naughty clients with policy and protocol really easily, but how do I impact the morale and the frame of mind for the team is I think a lot harder of a process.

Dr. Andy Roark:

Yeah. There's no one thing where you're like, “I did this and now that's fixed.” It comes down to, the employees who answer the same question again and again and who feel good about it or can put a smile on their face, they have a couple things in common. The first one is, they believe that what they're doing has a purpose. They have to. No one can answer the same question again and again and again and their only motivation is because they get paid X number of dollars per hour. You can't. You have to believe. The people at Disney have to believe that they're creating magic and that they're making an experience in the lives of the people who are asking these questions.

Dr. Andy Roark:

That's the only way that I could do it. Is I would have to believe that this is an important thing that I'm doing and it's meaningful. So I'm going to answer your question again and again because I truly want you to have a magical experience here and for this to be a vacation that you remember for the rest of your life. So the same sort of thing with our clinic is, and it sounds a bit circuitous to get there, but the truth is, they have to believe in the values of your organization and what you're doing. They have to believe that their work matters. They have to believe that they serve a higher purpose, a greater good. If you believe I'm doing this for a reason that matters, then you can put up with a lot of stuff.

Dr. Andy Roark:

I think that that's the first part. Is, you have to have a purpose and values that your team can see and that they buy into. The culture has to be modeled by the formal leadership. Meaning, ownership has to say, “I like this work. It's hard work, but it's good work and I like it. I treat you with respect and you treat me with respect and we treat our clients with respect and I am respected, and I'm going to model that for you. Hopefully you'll feel that way as well.” But the other part of it is, in psychology it's called deep acting. I like my clients. I choose to like my clients. I choose to like my staff. I choose to like my other doctors. I choose to like the guys that I work for as an associate that … You know what I mean?

Dr. Andy Roark:

One of the things, when I say, “Hey, how do I make my clients or how do I help my team get back up if they're having negative interactions with the clients?” Is, do not under any circumstances allow your relationship as a team with clients to become adversarial. Do not allow the whole like, “It's clients.” Because once you're dealing with negativity and you have started to go down a road of, these clients are a headache, everything just compounds and steamrolls. You have to keep going back to, “Hey, everybody's fighting a battle that we don't know anything about. If they didn't care about their pets, they never would've come in in the first place. Hey, these are good people in a hard time. They're trying to do right. They're frustrated that it's hard to get in. Let's be patient with them. Remember they're good people and they are are people. They put food on the table for us and they do take care of their pets and let's remember to lean into the good that our clients do.”

Dr. Andy Roark:

That may sound simple, but, man, there's really strong research behind it. I have just found it personally so helpful in my own career to decide I like my clients and I like the people that I work with. As long as I stick to those guns, things tend to work out pretty well.

Stephanie Goss:

Yeah. No, I totally agree. I was just looking to try and figure out what number it was, but you and I did a podcast at the beginning of last year about what to do with the grumpy team and grumpy clients, because we had a team that had gotten to the place where they were starting to become anti-client. We talked a lot about what do we do with that? I'll keep trying to find the episode, but I think that that's super important because it happens so fast. One, you slip up because you're frustrated and somebody's like, “God, clients suck.” Then before you know it, it's really easy for the whole team to develop that anti-client attitude. I agree with that. I can totally see why it gets there fast.

Dr. Andy Roark:

Yeah. The last part I would say too is, you have got to generate the positive moments. Is play as a big a role as you can in the positive moments. If your team is getting negative interactions with clients, and say that they're getting three a day, how many positive interactions do they need to have to offset that? Because it really is a ratio. If I go in to work and one person says something to me today and it was negative, then 100% of the things I heard today were negative and that's awful. But if I get seven good things, pats on the back and one negative thing, I go, “Mostly it was good. I tend to put extra weight on the bad thing because I'm a human being, but for the most part …” Those are just very different experiences. You see that a lot in the leadership literature, things about giving positive and negative feedback. There's a number, but I'm not convinced it's a very valuable number. But the number is something around five.

Dr. Andy Roark:

You're supposed to have five positive interactions for every negative piece of feedback that you deliver. It is something that was beared out in the study. But again, I'm not convinced that number is the precise mathematical number. I think the point is valid though, of you better have more positive interactions than negative interactions. As a team leader, I want to think about how do I increase the number of positive interactions my teams have. Meaning, how do I lift them up? How do I make them feel appreciated? Then the depths of the positive interactions. Meaning, how can I throw extra light onto the good things that happen? Because it's easy for those things to get minimized. When clients say nice things, am I amplifying those nice things so that the whole team hears them? That's something easy that I can do.

Stephanie Goss:

Yeah. It's funny. I think that that makes total sense and the number never made sense to me either. But what makes sense to me is when you are feeling negative and someone tries to combat that negativity by sharing something positive, it feels natural and intuitive to want to help by trying to counteract and find some balance. You've tipped to one side and it feels negative, and so human nature told us we should try and balance that out. My own human experience is that when that happens though, it doesn't feel positive. It pisses me off because it feels really argumentative in the moment as that person. I'll give you an example. We were having an argument recently in my house because the kids over the break, they're home, they're stuck inside, they're sniping with each other and at each other constantly.

Stephanie Goss:

The fighting is just driving both me and their dad crazy. We wound up having a big argument because I was like, “I am so sick of them fighting.” He was just like, “Well, all kids fight. They're not that bad. They get along really well.” I was like, “Oh my God, I just want to throttle you right now because they're driving me nuts.” Because I was mad. I was like, “Why aren't you helping me?” I looked at him and I was like, “I don't want you to tell me that it's not that bad. I just want you to understand. I just want you to say, I know. I understand how you're feeling. Stop trying to fix it.” Because he was like, “I'll break them up. I'll send them to separate rooms. It'll be fine.”

Stephanie Goss:

I was like, “No, that's not what I want. What I want is you to say, I hear you. I see you. I see your frustration.” That's hard because human nature is to try and combat it. I think for me, the first step comes out of that human place of argument. Which is you have to seek to understand. I think when it comes to dealing with the team feeling very negative, I think the important part is to validate them. The caveat for me is try and validate on middle ground. You don't have to make their negative behavior okay. It is okay to tell them, you can't act like this. But they do have to feel heard or it's just going to continue.

Stephanie Goss:

So, a, telling them that you are listening. “I hear you. I see you.” Those are very important steps as a leader. Then trying to find the middle ground where you can say, “Okay, let's talk about this piece here.” Or agree with something, find some middle ground, common ground between what they're feeling and where you are, because that's the only way to have the positivity truly take effect, I think. Otherwise, it's very easy for it to be viewed as dismissive or toxic positivity. Like, “I'm telling you that everything is falling apart and you're just telling me that it should be sunshine and rainbows.” We've all been there and felt that frustration.

Dr. Andy Roark:

Yeah. Well, I think that's really valid. I'm really glad you said that. The key for me in this, and this is why I said you have to zoom out, because if you zoom in what happens is, it does feel exact with like what you're saying of something bad happened and now I'm going to counter it with something good. I feel like that is a bad place to be and it does feel like toxic positivity. The team says, “This person was really awful.” You say, “But this other person was great, so we're good.” But that feels dismissive. The best analogy I'll give is how I feel about one star reviews, and you've heard me talk about this a number of times. When someone leaves a one star review, I think a lot of people feel desire to jump on and counter that review.

Dr. Andy Roark:

I don't recommend that. My thing is, if someone leaves an honest review and they're angry, you don't counter them with, “But here's the good things that we did.” You say, “I hear you. I hear you.” Then quietly behind the scenes, you accumulate five star reviews so that their are one star review happen in this much larger context of good things. I think it's a very, very important point about positivity and creating positivity. I am not using positivity to combat negativity. I am using positivity to build a positive contextual framework so that when this negative thing happens, it happens amongst a lot of positive things. It is not a light saber battle with the red negativity light saber against the green positivity light saber.

Dr. Andy Roark:

It is 100% there's just good stuff. I am just making other good stuff in the world so that when bad stuff happens, I'm not countering it, but it's bad stuff happening inside of an otherwise positive context. I think that's so important to make that distinction. I'm really glad you brought that up. I talked in the beginning about being realistic about what leaders can control and what they can't control about how we set policies to reduced negativity coming at our staff as much as possible and about how building a good culture that is not reactionary to negativity, but instead is separate ongoing positive culture is vital. The three ideas that are key points for me that I just want to touch briefly on at the end here, number one is support staff wellness.

Dr. Andy Roark:

We talked about policies. We talked about culture. The last part is wellness. You and I talk a lot about employee assistance programs, things like that, to make sure that our staff has a safety net. Things that you can do to support your staff. Be on the lookout. I don't want my people to burn out. I want to support their wellness however I can, regardless of the negativity that we're getting. Again, the same thing as like positivity, not countering negativity, I don't want wellness to counter negativity. Like, “Hey, you guys are getting beaten up, so I'm doing this to try to make it okay.” It's like, no. A culture of wellness and supporting staff wellness in an ongoing way is really critical. All right. The next part that I think is overlooked a lot is personal agency.

Dr. Andy Roark:

When I talk about personal agency, from a psychological standpoint, it is vital that your staff believe they have options. If any of your people come to believe that they have to take abuse from pets owners and there's nothing they can do about it, they are done. They are toast. They are going to burn out. They are going to quit. They are going to leave. No one wants to believe that they have no options or that they are trapped. This is where some of the negativity from clients can get really. For God's sakes, we have got to figure out what are your employees options when a client is misbehaving, when they're being nasty, when they're bringing down negativity. It should at least be, “Hey, you need to know that you can come and get me the manager at any time. You need to know that I will not be mad if you come and get me. I will step up for you. You can put the person in an exam room and I will come in there and I will handle this. Or I will back you up.”

Dr. Andy Roark:

Or I will put someone who has the power to either accommodate-

Stephanie Goss:

Do something.

Dr. Andy Roark:

… or set boundaries to this client. You know what I mean there?

Stephanie Goss:

Sure.

Dr. Andy Roark:

Don't let your people feel like they don't have any agency. Like there's no choices they can make. They're stuck and they have to just take it. The last part is personal boundaries. At some point, everybody needs to take care of themselves. There's no leadership position that can replace personal boundaries for the employees. This is on all of us, is prioritize your own health, prioritize your own wellness, set boundaries and communicate those boundaries to other people. There's no policy that's going to ever make that need go away. At some point, we are all going to have to say, “Hey, this is how I expect to be treated by my clients, by my boss, by my coworkers.” Live those boundaries.

Stephanie Goss:

Yeah. I think that all makes total so sense to me and totally supports the last piece that I had, which goes back to the original question that we talked about, which was how do I boost the team's morale? I think that, for me, that all supported and dovetailed into what you're talking about. Because boosting the morale is not super, super hard, but it is time intensive. When things are overwhelming, when clients are acting naughty, when the team is upset and frustrated, that's the exact time when we need to take the time to do it and we don't because we feel overwhelmed. The things that were on my list in addition to yours were, don't talk to them. Meet with them and then listen to what they have to say. Give them the floor. Hear what they have to say what is causing the problems?

Stephanie Goss:

What are the stresses? Listen more than you're talking. That is the number one morale booster that most managers forget to reach for that tool. It's such a simple one, but it's the one that is the easiest to … Our brains go to problem solving mode and we try and fix it before we actually listen. So meet with your team and listen. In addition to that, we have to give them tools to give us feedback and take feedback from us. You and I talk about that a lot on the podcast, but this is one where we have to open the door to them and ask them to give us feedback. What's not working for them. What is working for them? The same goes for us. We have to have those tools to give and take.

Stephanie Goss:

We've got a bunch of podcast episodes that go along with that and courses that you and I have done through Uncharted. But I think that that's really, really important when it comes to morale boosting. Is the ability to give and take feedback is so important and leaning into developing our team. People don't stay in jobs they don't have good morale. They're not happy if they don't see a path forward. Not only do you help them figure out a path forward through the negativity that's currently happening with clients, but back to what you and I talked about, where if 10 good things happen in a day and one crappy thing happens, it's a lot easier to overlook the crappy thing, the same with their viewpoint for themselves in your team.

Stephanie Goss:

If there's lots of good stuff coming and happening, if they feel like they are heard, if they feel like your door is open and they can speak to you about what's on their mind, if they feel like they are supported, that there are development opportunities for them, and that they're also appreciated, it's a lot easier to overlook the crappy stuff that comes along. The last one goes along right along with that, which is, have fun with them. Figure out a way to make it fun. Because when things are negative, when clients are grumpy, the phones are ringing off the hook when everybody is shorthanded, the fun goes right along with listening to them in that, it's the first thing that we overlook because we feel like we don't have time for it. But I would argue that none of us have time not to make time for it.

Stephanie Goss:

We have to figure out how to support them and have fun with them and lighten that load so that people feel like they can leave those bad things at the clinic when it happens and walk away and feel like they still had a good day at work.

Dr. Andy Roark:

Yeah. I think that that's so important. I think a lot of people are sort of problem focused people and they say, “My team's experienced this negativity. We need to talk about the negativity. We need to focus on the negativity. We need to fix the negativity.” It's one of those weird things in life, and I'm grasping for another example, there are things … I guess the old saying that I've heard is, muddied water is best cleared by leaving it alone. So the idea. There definitely is a scenario where addressing negativity and talking about negativity and harping on negativity, doesn't actually help your team deal with negativity. It's almost like if you're in a relationship and there's something that you and your partner disagree about and you talk about that thing all the time. You know what I mean?

Dr. Andy Roark:

You're like, “We have to keep working through this.” At some point, maybe just do what you do. Maybe if you just put it down and focus on doing the things that you love to do together and that you enjoy as a couple and things like that, it's funny how sometimes stuff doesn't matter as much when it's in the context of these other things. Sort of I butchered that metaphor, but I hope people get it.

Stephanie Goss:

No, it makes total sense.

Dr. Andy Roark:

Okay. Yeah. I was talking to my wife not long ago and she was telling me about a headache at work, and I fell right into that trap of trying to fix the problem. You know what I mean?

Stephanie Goss:

Yeah.

Dr. Andy Roark:

I was like, “Did you say this? Did you say that? You could put together a document that says this.” She was like, “Stop. I don't want you to fix the problem. I just want you to hear the problem and understand the problem. Remind me that care and that everything is going to be okay. Then I'll fix the problem, but I need you to just be in it with me for a second.” Boy, if you're a goal-oriented problem solving, smart goal setting guy like me, I suck at that. It's a learned skill.

Stephanie Goss:

It's hard.

Dr. Andy Roark:

But I really do think for a lot of the culture stuff, setting up our people to keep them safe and to fix the problem is good. But we also have to be able to step away from that and just let them be human. Also, just to step away from that and say, “Hey, I can't control what people do, but I can show you how much I appreciate you and I can talk to you about what I like about you and about the work that you do. I can and show you the value in what you do in the world and I can remind you that you are important. You're important to me and you're important to the people that you work with.” That's not addressing the negativity of clients, but it's part of overcoming that negativity.

Stephanie Goss:

Yeah. I love it. This was so great. I really had fun with this conversation and I hope it was helpful.

Dr. Andy Roark:

Yeah, definitely. Always the hope. Always the-

Stephanie Goss:

I know. Have a great week, everybody. Take care.

Dr. Andy Roark:

See you guys.

Stephanie Goss:

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

What's This Episode About?

This week, Dr. Andy Roark and Dr. Dave Nicol talk about Nicol’s co-authored research piece Leadership Actions and their Effects on Practice Culture. They discuss the importance of culture, why it is so rarely prioritized, what effect increasing corporatization is having on veterinary workplace culture, and which actions leaders take (or don’t take) that most directly impact clinic culture.

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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.

Dr. Andy Roark:

Hey everybody. My name is Dr. Andy Roark, and this is the Uncharted Veterinary Podcast. Guys, I got a great one today, a little bit different. It's me and my good friend, Dr. Dave Nicol. We are talking about some research that he's done recently, and it is on what leadership actions actually affect workplace culture and to what degree. And so if you're ever like, Hey, I know that leadership drives culture, but what does that mean? And what part of leadership drives culture? And what are the most important things for leaders in the practice to do in order to drive culture? That's what we're talking about. It is a great episode. Two quick things I want to shout out. Number one is there is a language warning in this episode. So if you really, really don't like salty language, this might be one to skip. And number two, I have got to give a huge shout out to Banfield Pet Hospital for making possible transcripts. That's right.

Dr. Andy Roark:

We now have transcripts of this podcast and the Cone of Shame veterinary podcast, because Banfield has made that possible. It is to increase accessibility to this information, to be inclusive, to bring all of our colleagues together and make these podcasts accessible and available and useful to them. And so, man, this means the world to me, I'm excited about it for 2022, we will have transcripts of the podcast. You can find them on the Uncharted website and Dr. Andy Roark website. You'll see them through social media, but thank you, thank you to Banfield for making this possible. It's such a super wonderful thing that they have done. So guys, without further ado, let's get into this episode.

Speaker 3:

And now the Uncharted Podcast.

Dr. Andy Roark:

And we are back it's me, Dr. Andy Roark and Dr. Dave, my brother from another mother, Nicol on the podcast, standing in for Stephanie Goss. How are you my friend?

Dr. Dave Nicol:

Really, really good. I'm sorry, Stephanie. I'm going to try and not wreck this thing. I'm good. I'm good. How're you man?

Dr. Andy Roark:

Stephanie is like, what have I done?

Dr. Dave Nicol:

No. When you said that my adrenal lines contracted, I got a square of adrenaline. I'm like, oh no, if I screw this up, then Stephanie's going to kick my backside.

Dr. Andy Roark:

People going to be like, he's no Stephanie Goss. But we know that none, none of us are Stephanie Goss. Here we go. Dave, so welcome. So you and I had known each other a long time. People often know me from goofy vet videos. And what they don't know is the first goofy vet video ever made was at your urging and with you as my wingman. And we made it at the CDC conference because those guys clearly have poor quality control at the time. And they allowed us to get in front of the camera and do what we wanted to do.

Dr. Dave Nicol:

As I recall, that was after I possibly one flight of tequila, too many at Cinco De Mayo.

Dr. Andy Roark:

People think it takes a lot of planning to make videos that come out on well, respected websites happen. That's not true.

Dr. Dave Nicol:

It takes a lot of time to plan them. It takes just literally seconds to ruin it.

Dr. Andy Roark:

So, that's how we got to know each other. And we've been friends ever since. I wanted to have you on, you've got a new study out it's called leadership actions and their effects on veterinary practice culture. And so, as a fan of leadership and culture and veterinary and practice. I wanted to have all of those things that are in the article. I thought that it would be a good time for us to get together and talk about, I just want to talk about what you've been doing and kind of what you're leading up to and what you're finding. So, leadership action affecting culture. Let's start at a high level and just talk to me a bit about that. What matters about practice culture, I guess is my question. And then how does that interface with leadership?

Dr. Dave Nicol:

Okay, well, I might pull it back one step further and just go, why now? Why this? Because family practices have had culture and leadership for a very long time, but if you look at the world through the lens of some brutal truths, then you'd have to been hiding under a rock not to have noticed that it's kind of been a really hard couple of years. And so there's several brutal trips that we need to sort of face up to. There's partnership and the impacts that COVID has had that are beneficial in terms of volume of cases, but I'd say pretty hard in terms of an already stress system couldn't cope brilliantly is being hit with more cases. How many more? Is clearly a point for some debates, because there isn't really a point of truth information source, but certainly more puppies around and I think certainly over this side of the pond, some arching 4, 5, 6% seems to be about the right number.

Dr. Dave Nicol:

But then we've also got the economic uncertainty, inflation hitting us, the complexity of cases, the process efficiencies, the curbside caused. Culture is coming to focus because all these things are causing pressure and then education and burnout. And all this backdrop is just like this perfect storm. And so, we're seeing people burning out, we're seeing a contractor in the size of the profession, and we're seeing long range efforts to alleviate that in terms of increasing class sizes, more veterinarians. But I just think that's the wrong, it's part of the answer, but it's a really, really stupid answer if we haven't fixed something that I think is at the heart of the problem. And that is that the market's kind of voting with its feet. We've had relative wage stagnation for a long time. We've got a completely different setup in terms of when I graduated in '97, '98, we didn't have such intense scrutiny or glare from social media or the perception of it.

Dr. Dave Nicol:

And we didn't necessarily have the sort of felt like it was more of a safety net. We didn't have the ownership structures that we have now. So that a lot has changed. And I think that's where for me culture becomes so important because if we can create cultures where people thrive, then I don't think we have a problem. If you look at veterinary medicine, does it tick boxes in terms of meeting human needs in terms of certainty, in terms of significance, in terms of variety, in terms of growth, in terms of connection, in terms of purpose. It ticks every box, or it should do. So, why is it failing people to the extent that we see this recruitment and retention problem that we've got? And I think the answer is because we're not being intentional about cultures and when we're not intentional about cultures, we get agendas, and fighting, backstabbing, toxicity of many different kinds, all driven by fear, uncertainty, stress coming to the front.

Dr. Dave Nicol:

And it becomes almost a, the culture becomes a cult of personality within practices. And it's the person with the biggest personality. I think it was Sean McVey first heard use the term the mean girls that rule the rest. So, that's what veterinary and has been. AKA culture has been a hot mess that's just been neglected or been unintentional. So with the report, I thought it was really important to try and to put culture in a map, to define it, because it's a little hard for people to define and to link actions that leaders can take in order to manage culture proactively so that we can create a better future for ourselves as business owners, but also for our teams. And really we're only going to create a better future for ourselves if we have happy teams. So it felt really important to try and do that work to link, partly to empower those who feel a little bit hopeless or lost and what they could work on. Partly just to kick people up the butt to say, we can do this.

Dr. Andy Roark:

I like where your head's at. I think this makes a lot of sense, right? It's funny, I've talked about this many times in the past. Culture in the workplace is one of those kind of, it almost makes you sound like some sort of a guru when you talk about it, just because, and I think this is the trap, right? When you say to someone what's important about running a veterinary clinic? They talk to you about patient care. They talk to you about average client transaction. They talk to you about being profitable. They talk to you, you know what I mean about all of these things, medical standards, things like that. And culture and relationships and the way people feel about their job. Man, that's all kind of some warm, fuzzy stuff. It's hard to get your hands around. You can't really measure it. You know what I mean? You could absolutely measure the number of patients that you saw yesterday, right?

Dr. Andy Roark:

And you can measure customer service scores and we do. And it's one of those things in life, in the world, where there is a fundamental requirement that if you don't take care of everything else is going to struggle and suffer. And you're never going to know why, you know what I mean? The beatings will continue until morale improves and you go, you are just driving this so hard, but until you take care of people, it's not going to happen. Think about other relationships you have in your life, where you rely on this person or you work with this person. And if you don't maintain that relationship, then everything else is going to be exponentially harder when you come together. And you can wave your hands and lie to yourself and say, well, she's a professional and I'm professional. And so we're going to show up and we're going to do our jobs and we're going to get them done. That's just not how human beings work. And I think it's less so. I think that there's a changing role in work, in our lives right now.

Dr. Andy Roark:

I'm really thinking a lot about this, is that like man, our jobs. And I mean, all of our jobs, not just vet medicine, but our jobs are replacing a lot of social outlets that we've had in the past. Do you know what I mean? How many of us look at our job as our social circle? How many of us look at our job as part of our identity? How many of us look at our job for purpose? You know what I mean? And meaning, and I go, man, our job is really creeping into a lot of our lives. And so the idea that we're going to put our feelings aside and we're just going to be professional and investing into the underlying relationship to make these people function together and feel comfortable together. That's a big misstep, but it's really easy to make when you get myopic about this is a business, these are the metrics. This is what we're paying attention to.

Dr. Dave Nicol:

Listen, and it's a business like ours, where there's so many things that demand attention, particularly as leaders. And I say that not because attention demands are not high for everybody else, but the primary job of a leader is not clinical medicine unless you're clinical leader, of course, but most leaders are team leaders. And as soon as you take that role on your primary job stopped being clinical medicine, your primary job started being team and team building and team wellbeing. And of course, that just isn't a skillset that you're trained with. It's not something that has an immediate payoff and it just seems to constantly be a thorn on your side. So clinical is partly retreat, partly highly addictive. It has immediate beneficial results for our wellbeing because stuff gets better relatively quickly. And there's a fairly straight connecting line between the work we put in as a clinician and the inputs and the outputs of resolved case, happy client, fixed pet and money coming in.

Dr. Dave Nicol:

It's addictive enough before that's being the case and it's profitable, it's what our businesses are apparently there to do. So it's very, very easy to hide out there, but it's such a giant mistake. So, time and what we spend on is absolutely critical.

Dr. Andy Roark:

Well, I mean, look at how we're trained, right? We're to practice the medicine and we're paid on production and neither of those things interface with team culture and leadership, you know?

Dr. Dave Nicol:

Well, it's funny. I saw a fun little infographic, which was describing as soon as your measures become targets, this used to be useful. And it is a measure of volume and the quantity of nails, and they were just tiny, tiny nails that had been made or a measure of.

Dr. Andy Roark:

The story on that is it was in communist Russia. And this is a real story, but it was communist Russia and the dictum came down that workers would be judged on, at first it was, they were going to be judged on the weight of the nails that they produced. And so we're just going to weigh the nails that you make and that's how you'll be paid. And so the workers just made these enormous nails that were completely functionally useless, but they weighed a ton. And then the higher up saw that and they were like, oh, no, no, no. Okay. We're going to fix that. We're going to pay you on the number of nails you make. And they just made a thumb tax and just cranked them out. And again, I got such a great illustration of you pick these targets and say this is what it is. And you miss the forest for the trees, man. That's such a great story.

Dr. Dave Nicol:

And possibly also why the KGB exists.

Dr. Andy Roark:

Exactly. It leads to interesting management structures we'll say.

Dr. Dave Nicol:

Exactly.

Dr. Andy Roark:

Let's get it to this, right? Actually, before we do, I want to ask you, so we are seeing a growth in corporate ownership of that practices, right? And in the UK, you guys are already what? You guys are well ahead of the US as far as corporate ownership, meaning was it at least half of UK practices? Right?

Dr. Dave Nicol:

Probably getting up to about 70% now.

Dr. Andy Roark:

And so my speculation is the US is going to be following that and will be at 50, 60%. That's kind of just, that's what my crystal ball says, but it's been a bit dodgy the last couple years, but anyway, I think that we're going that way. Does that make the problem better, worse or is it a net neutral?

Dr. Dave Nicol:

I love the question because it begs for an easy answer. And the easy answer is it's easy to kick corporate medicine.

Dr. Andy Roark:

Oh, yeah, totally.

Dr. Dave Nicol:

And it's the answer that I think a lot of practitioners want to hear because somebody needs to be at blame, at fault for all of this. But there are plenty of toxic independent practices, and there are plenty of very well run business units in corporate practice. I think it is my much more down to leadership skill and that comes down to individuals. It's not something that is particularly scalable in the way that technology is. It doesn't grow on trees. It doesn't arrive quickly. Heck, it took 15 years for me to get to this point of being fairly average in my leadership career as I see it. I started out with a model of leadership that was pretty hopeless. And now I think I'm better at it, but it's like everything and everything suffers the Dunning-Kruger effect. And the more I learn about leadership, I think I'm a reasonable leader, but the more I learn about it, the more I think, God damn it, I've only started touching the surface of this, could be so much better.

Dr. Dave Nicol:

But then I look back at where I was as a leader. I'm like, oh, no, but actually I think I'm pretty good at this now. And I've got the principles down, but I think that's part of the problem that exists in that corporate structures in theory, should create more space and introduce more professional managers and professional managers should have been exposed to better leadership skills and training because in vet medicine, we don't get exposed to anything. The reality is that corporate managers are generally completely over tasked, have far too many business units to look after, a few and far between and burn out just as fast as anybody else. And are also coming from other business sectors that as much as I don't buy the line that we're different because we're vets. I do think veterinary practices are still businesses and almost everything is still applicable from one business to the next, but where we are very different in is that we are absolutely purpose driven individuals who chose this profession.

Dr. Dave Nicol:

And we did not choose it for money. And we've got corporate measures that are necessarily particularly because of shareholders growth, and when you've got this much private equity money swell into an industry, it has to be about money. There's the rub. So, I think that's an uncomfortable thing. That's a brutal truth for corporate practice to deal with. And if it doesn't deal with it, then it's got one hell of a balance sheet problem building up that doesn't show up in a balance sheet, but it is called the Goodwill between clients and vets. That's going to walk out the door. But it's certainly, that is a long way from saying that corporate practice is to blame for poor leadership. Poor leadership's been around for forever.

Dr. Andy Roark:

Oh yeah. No, no, no. And I wasn't trying to tee up and say, oh, corporates are making this work. I was genuinely asking the question, is this helping or not? I think my take on it is, I think everything you said is very true, right? So, let's just own the fact that leadership on the ground plays a massive role in the culture of the practice that you work in. Right? And so speaking and sweeping generalizations of corporate, non corporate, I think you and I are both 1005% in agreement that the culture on the ground, the management and the leadership you have in the building that so far exceeds what logo is on their jacket. It just does. I think honestly my take and again, you've known me to be a perpetual optimist, I agree with you. And when I look at culture in vet medicine, I think the historic cultural problems in that medicine have maybe been, it has been a passion, right?

Dr. Andy Roark:

It has been this calling of this is who we are. We do this for the love. And as a result, we struggle with burnout because we keep this to our self identity and we lean into it. And my optimistic view is that corporations coming into our profession may help to swing the pendulum a little bit. You know what I mean? You know what I mean? We're seeing them come in and they're offering job perks that weren't offered in the past. And they're pushing up wages in a way that wasn't pushed up in the past. And I think a lot of people find it easier to separate their work and their selves when they work for a company, as opposed to when they work shoulder to shoulder with the owner. And this is our little thing that we made together. And again, that's all speculation, but I don't know, I think you answered my question pretty well as far as mixed bag, but the shifting landscape I do think is affecting some of the work experiences that we're having.

Dr. Dave Nicol:

And some of those things I think it's important to touch on, those things are clearly positives. There are what I think one of the best ways to illustrate this, I'll refer to another bit of study work that we're working on moment, but it's very, very easy to increase pay when you've got a big bucket of money. And a lot of independent practices don't have that bucket of money. It's very easy to apply what could be seen as band aids fixes to issues. And I'm not saying that this is what corporate medicine is all about. I don't think it is, but it is still very easy to put things that are sweeteners on there, which will not help if culture is rotten. And one thing that corporate is not, has not got right at all and needs to deal with is the fact that when a practice is acquired, an owner stays on for a bit of time, but frequently we'll start checking out, because that's generally what happens when you sell a business or leaves after one or two years, and then who takes over.

Dr. Dave Nicol:

And it's not that common that it's somebody with a heck of a lot of leadership experience. So you're losing somebody with all that mentoring, all that Goodwill, all that just that relationship knowhow and smart. And now you're bringing in somebody who's a three or four year old graduate vet. Well, Andy, when you were a three or four year old graduate vet, I don't know what you were like, but I know that there's no way that, I wasn't even doing veterinary medicine very well at that point. So, to do that and then layer in the stuff on top, that's a big, big ask. And so we are seeing the leadership echelons being younger than they were, and asking them to take on a leadership role without great training in a stressful environment, without the best of support necessarily, at the same time as building a clinical skillset is an incredibly stressful thing.

Dr. Dave Nicol:

And so, I think that in theory things can be better, but in practice the shortage of talent, the shortage of available talent and the retention of talent beyond that sort of really critical five year point where we see people burning out in the first year and a half, we see them burning out round by that five year mark for slightly different reasons. But the leadership coming from a clinical base that has the clinical work established, that baseline established, and then building on top of that, the secondary skill set that is going to serve them. And it's completely different skillset. That's a really necessary transition that we've got to get a lot of people through order to right the wrongs. I'm utterly agnostic about practice ownership. Yes, I'm an independent practice owner, but I work with corporate practices.

Dr. Dave Nicol:

Doesn't matter if they want to make leadership better, I'm very, very willing and happy to speak to them because the more people we can look after and give a great experience of veterinary medicine, the more people we retain for all of us to be able to hire. So if I look after a vet and I'm a good stepping stone in their journey, and they move on to your practice, I want them to go to your practice and go, wow, it was great working with Dave. It was just what I needed at that stage of my career. Now I'm a happy, great resource, and I'm excited to work with you, Andy. And neither of us loses. If I blow it, I've had a bad experience with that individual. Maybe they leave, maybe they go at you grumpy, it's not a good long term place. I think leadership is important and leaders enact, or control or shape is probably the better word. I like the word farm, actually the farm culture. It's a very organic process. You have to do certain things and go through a process in order to intentionally alter culture.

Dr. Andy Roark:

Well, let's talk about the interface of leadership on the ground with culture. Because we both sort of come back to this too, is the biggest driving factor is going to be, what is the leadership on the ground as far as how your experiences at work? So you guys put out this new study and I'll put a link in this show notes as well, so people can definitely check it out. But so when we talk about leadership on the ground, what are we talking about as far as the behaviors that matter? What affects people's experiences?

Dr. Dave Nicol:

So, we looked at four factors and their impact on culture and looked to assign a sort of a quantitative score to what that action actually was bringing to the table in terms of impact on culture. And so the four factors that we looked at were a really clearly articulated vision, the ability to manage time and prioritize, particularly prioritize leadership activities, the ability to deal with toxic staff behavior and the ability to hire effectively and effectively is one of those withy words. So, hire people who are the right technical and values fit for your organization in a timely way.

Dr. Andy Roark:

Okay.

Dr. Dave Nicol:

When you do those four things, your leader score, we created this and I'll say a couple of things about the numbers in a second, but the culture score of practices where leaders did not do those four things was a 5.3 out of a score one to 10. The culture score for leaders who did those things was an eight out of 10. And I think the slightly, the interesting things are that we did these surveys at two conferences, one across here in the United States and the other at conference in the US. So, it's great to get the data from wide locations, but these were management conferences. So these are practices that are actively interested in these subjects who care to answer the questions. And also there's an element of self grading here. So who's going to give themself a three out of 10, right? So, I think the scores are probably scoring a little higher than they should, but the differential is clear. You score slightly above a 50% if you do not look after these things, that's a hot mess for culture, but you can get up 80%.

Dr. Dave Nicol:

And in actual fact, we measure the culture scores for people when we've gone through and worked with them on those four specific areas in much more detail. And we know that we can get them much closer to nine. We get them to about an 8.9 out of 10, once they do these things and they're executing on it really well. So, the data is really compelling to say, well, actually, the two challenges with leadership from the culture, one, what is leadership? and what is culture? And there's so many things that could be defined as leadership, how my best place to spend my time. And so the message from this was really clear. You have to create a really clearly articulated vision that consists of a purpose, a mission, and a set of values. You have to use that set of values to hire effectively. You have to learn to put down the things that call for your attention, like clinical work and rebalance your time so you make time to work on things like vision.

Dr. Dave Nicol:

And if you've got some toxic people and mostly those are values clashes, then you have to deal with those regardless of how much pain that might cause you in the short term. That toxic staff behavior was the number one impact that made the biggest difference. Out of all four things, it was dealing with toxic behavior, the biggest impact on culture. But it's really hard. You can't set cultural tone, unless you've got a vision, you can't create a vision unless you create the time to work on that. And you can't really hire well, unless you've created the vision as well.

Dr. Andy Roark:

Okay. So all that makes sense. Unpack for me what it means when you say the number one thing that affect workplace culture was the ability to deal with the toxic employee. Give me some examples, paint me a picture of what that looks like. Give me conflicting, here's what I want. I want contrasting examples. What does it look like when a leader does not have the ability to do this, or doesn't have the desire to do it versus when they do? Can you help me see that image?

Dr. Dave Nicol:

So a good example would be the leader. Let's say, you have a very effective technician on your team. And it could be a veterinarian. I don't want to beat up on technicians, as a team member, choose your poison. Okay? So, I'm going to think about a technician who is very influential. Who's very, very good at their job. They know where everything lives. They get stuff done on time, but they don't like change. And they're vocal about not liking that change, but they're also behind the scenes. They're going to undermine that change that you want to put in. And so that person seeks to sow the seeds of doubt. They tell people why they should resist the change. They build up opposition to whatever thing that you're wanting to work on. And they create a verminous moment or situation in your practice on this one issue but perhaps on many issues. They might be doing that because they feel threatened by it. They may be doing that because, and that's the number one reason why people resist change is because they're scared.

Dr. Dave Nicol:

What does this mean for me? What am I going to lose? What I mean of less of something, not against something. What does this mean for me? And so we tend to resist things that we don't understand, even if they might be good things for us to do in the long term. So, that that person creates and sows distrust. Now, they're not going to get everybody to resist, but they're going to sow doubt in people that might have gone with you, are going to be a bit more resistant. They're going to look for allies and other people who don't want this change, whatever it is. Let's say you're into using a new anesthesia protocol and you want to start using different drugs, or you want to go to using fluids or blood testing as a standard beforehand. But that narrative flows through and now the doctors are not behind it. They don't actually. And you know when a doctor doesn't get behind something, doesn't fully believe in something, that doesn't come across. It's disingenuous and the clients see through it in a heartbeat.

Dr. Dave Nicol:

It's not sold well, it's not presented well. And so the thing doesn't happen and it's real easy. Oh, the clients aren't really into this so maybe we should stop doing it. Or that person, there's the side chats that are happening and you walk in a room and everything stops talking. And suddenly you feel like you're an enemy in your own practice. That kind of carry on happens every day, up and down country. You leave that person in place because they're not that bad. And they're really good at their job. So let's just leave them be, but who really controls the culture? Who's setting it to own and the pace for the practice culture right now? It's not you as the owner. There is leadership happening, but it's not coming from you. You're leading by abdication because you just want it to be okay, because it's really hard to hire technicians. And if I lose this person, they're going to burn this whole place down and that could be true. I've experienced it.

Dr. Dave Nicol:

Now you compare and contrast that against the person who gets it, who understands where you're going with the vision, their agendas is your agenda, because both your agenda is a shared purpose, because you've cooked this purpose up together as a team. I think actually this is one of the challenges you have with corporate practice when you've got the big board level, C-suite mission, vision, values, all of that stuff. And you've got the words, the values, integrity. And then you've got a whole host of people who are not necessarily interpreting that, but just trying to get by an action, start happening, that start grading or violating those values and everyone calls bullshit. And now we just do it, we're our own little enclave here. So we've got a very, very solid local culture of them and us against the corporate machine. And we're going to do veterinary medicine really well, but we are not aligned really with that thing up there, our purpose is we're a Merry band of squash buckling pirates, doing our thing on the high seas, but we're not part of the Navy as it were.

Dr. Dave Nicol:

So, back to your example, so that could be one toxic behavior. You could have another person who is a veterinarian, let's choose a veterinarian who explodes, who has anger issues. They're really, really good at their job. They create tons of value in terms of doing cases, but they blow up or they bitch and they moan about the technicians openly to a colleague to another vet. And it just crushes the technician team lose confidence. So they refuse to work for that person. Or it's so stressful. You've got absenteeism or people not showing up to, they're calling in sick, they're leaving. You've got Mary go around a staff, walking in the door, these things hammer culture. And of course every time someone new comes in the team reverts to the storming phase of Melbourne's team curve. As you've got forming, storming, norming, performing and adjourning on the Bevin's team development curve and anytime a team go through change, you go through this curve. So if you've got a toxic team, your team is always stuck in storming phase.

Dr. Dave Nicol:

And if you've got team members leaving and coming in, that will add to the storming phase, because nothing ever gets to be normal in a way that's functional or maybe, and actually I would put myself in this bracket as I would describe myself, not it would never have been described as toxic, but I was always going to do it my way. I was really resistant doing it according to the process. The standard operating protocol? Not me, sir. No way I've been taught to do it this way and that's the way I'm going to do it, or hell mend you. That's toxic. Looking back and I think God, that was really ego behavior.

Dr. Andy Roark:

Well, I think you and I both came from that place and I think it's part of the growth of a leader, right? Especially if you're someone who makes your own thing or you start the practice or you start the business. And I think that's both of our personalities is, we have very strong ideas about how things should be done and how we're going to do it and how this is going to work. And they're driven by passion and they're driven by a vision. I think the life cycle of the business is I think that works really well up front. You know what I mean? When you're getting something started that person who says, Nope, this is what we're doing. This is how we're doing it. They're really valuable. They really get things up and going. I think you and I both had the painful experience of growing our businesses to a place where it's not just us anymore. And it's not just us and two or three other people, it's enough people that you can't just do what you want to do anymore.

Dr. Andy Roark:

There's too many people affected by the ripples when you splash around. And so process ultimately rises up, when you zoom out and you look at startup culture and entrepreneurship and things like that, that is a classic lifestyle or life cycle of the entrepreneur. Is you come in, you move fast, you break things, you do things, you do them in weird ways and you get the energy up and you create the experience. And then after that generally process people sort of take over, and we standardize and we streamline and we systematize. And a lot of times the entrepreneurs sort of people, they either grow into that system or they chase against it. And they often leave. And so I think that is a life's cycle growth project for a leader.

Dr. Dave Nicol:

It definitely is. But that's a real challenge for depending on what you're, if you're in a startup vet practice, that's where it will be for many of us. And if you've got a more mature business and now I own a clinic that's been around for 15 years. I've not owned it for that long, but it's been there for a while and this team has been together and one guys or another for several years now. That's a different beast because I don't go in it. I'm not there ever. So the cultural tone might be set by me, but that culture's formed by a team, a group of people who we came together and said, right, what do we want this practice to be about? And we literally built the vision, a four year vision in this case. And everybody was involved. All the senior leadership team was involved. And so now everybody's behind it and we want that. We're going to make that thing happen. Lo and behold it's happening. And do we hire people sometimes aren't great fit for it? Yes.

Dr. Dave Nicol:

But it's really obvious really soon. And the team has the confidence to say, this is not the right fit, time to move on from that person. And it never goes straight to that, but we're also really clear about this is the expectation. This is how we do things here. And these things are, hiring effectively. There is not a job ad that doesn't reference our vision and values. There's not a person works that hasn't been through a value assessment and three or four other steps in the recruitment process. So, it gets it right more than it gets it wrong. And this is what we've got to do to make veterinary medicine sustainable. It's been sustainable from a profit point of view for forever. It's been sustainable from a clinical point of view for forever. We tick the boxes there. It's not been sustainable from a team point of view. And increasingly business owners now are struggling with sustainability, and that's partly what's driving them to sell practice because it's just too hard.

Dr. Dave Nicol:

But the difference between a practice that is an absolute delight and a practice that's a total nightmare is the vision, and culture flows straight out that vision. It's just not this E throw, oh, I don't know how to make folk culture. It's really easy, create your vision. And a part of that vision will be articulate your values. I wouldn't have more than five or six. Don't just articulate them in a word, articulate what that word means in your culture and in your setting, and then tell everybody what those things are. Better still, come up with that code of conduct yourself. But if you've got six values and you've got three things that you, three definitions of what that word means, integrity, what does that mean? Best practice. What does that mean? What does innovation mean for you? Because it will mean something different for me than it does for you. And that's fine.

Dr. Andy Roark:

Sure.

Dr. Dave Nicol:

But just define it and then stick to it. And I was onboarding a new team member today and we went through part of the training exercise. We talked about what our values are, what they mean, when you should use them. And I cannot dream of bringing anybody onto a team where we do not, call it brainwashing or indoctrination or onboarding or whatever, but there is no way that-

Dr. Andy Roark:

Indoctrination has gotten a bad rap. Indoctrination has gotten a bad rap, that is a loaded word.

Dr. Dave Nicol:

Brainwashing?

Dr. Andy Roark:

That's sort what we're talking about. I mean, brainwashing has been out of favor for a while now but it's coming back. It's all- [crosstalk 00:40:51]

Dr. Dave Nicol:

I mean, pulling back because there's just a lot that you can kind of focus on. It's interesting, the things that came out of the study that were really interesting to me were there were certain, I don't know if I should call them hidden gems or complete shockers, maybe both. But if you at a conference ask people what their vision was, it's funny. We found 40 just about 45% of practices have absolutely no vision at all. I either just showing up and doing veterinary medicine day after day, after day, after day, no wonder people are exhausted. Three quarters of practice owners have no time for leadership behaviors. Interestingly, only four hours-

Dr. Andy Roark:

That always blow that always blows my mind. Right? That's the working in the business versus working on the business trap that our friend Peter Weinstein likes to talk about.

Dr. Dave Nicol:

Well, and it's so it's so clear why it happens is because the clinical work that they're spending time on is so overwhelming and so never ending. And so what they know what to do, it's the comfort blanket and it also generates revenue but it's-

Dr. Andy Roark:

Oh yeah. You can justify seeing cases all day long. Right? And the other part, I didn't think a lot about this recently. Well it, and it's the sunk cost thing too. You're right. Like I gave eight years of my life to do training, to be able to do these things. And now you're telling me I shouldn't do them? Someone else should do them. That feels wrong, I think at a deep level. But like, yeah, that is what I'm telling you.

Dr. Dave Nicol:

40% of practice are the ones we spoke to have, what they describe as toxic behavior. And coming back to your point, the reason people don't deal with it is because they're scared to deal with it. We're conflict averse as well, or it's not the right moment. I'll just do that in a day or two and then the clinical work gets in the way again. So each of these four things, it's really hard to separate them out. But the number one thing, the first step is for the leader to take the mental leap to say, I'm going to put this thing here down, not completely down, but let's say instead of doing 90% clinical and 10% absolute firefighting, how about I drop to 60% clinical? And I can do 10% leadership and 20%, 10% firefighting, 10% pro active team management. What would happen if I did that? Oh, I might have to hire somebody new. Yes. And then you might also see your family and your friends and it's great. You can't be the richest person in the graveyard. What's the point in that?

Dr. Andy Roark:

Well, the other part too, that again, it kind of goes back to that whole working on the relationship is not immediately visible and apparent, you know what I mean? There's other things that are clearly much more visible and measurable, but that culture work, that relationship work. Same thing with people are like, ah, but then I have to hire someone else. And I would say, every time I have hired someone else, I have gnashed my teeth about it. And then my business has expanded to, you know what I mean? To generate that revenue plus more. It is just getting to that place where I go, God, I need more help. And then getting more help and getting the right help. It has always worked out.

Dr. Dave Nicol:

Well. Right. And that's because you've invested time and energy in the skills to allow that to happen. So, if you fear it and then you hire badly and the person doesn't work out, it's too easy to say, well, that don't work or give up, but there's millions of businesses around this world that are working just fine on that basis. So, why are you special? The answer is you just didn't focus on the right skill set. But if you take the time to think about why you need this person and you take the time to think about what skills they need and what values they must have, and how you're going to assess, select for those. And then you put time and energy into that recruitment process. I describe that as 10,000 or maybe even a hundred thousand dollars in artwork, the problem is it doesn't have a dotted line straight to the revenue line of your accounts or the end of day takings. In fact it has a negative impact on your immediate end of day takings, because you're not doing clinical work when you're doing it.

Dr. Dave Nicol:

So it hurts a little bit. And then you grow because that person shows up, does a good job. And now you've got space. And then you've just got to deal with your guilt about not doing all the work in your practice because that's another thing that vet leaders carry. We see a source of power being able to do everything and know everything. And that's how people respect us. And as we help people grow and we bring people into the business and suddenly there's not that much pressure on us. It's like taking time off. How many veterinarians feel bad about taking time off? They feel edgy. They feel like I should be doing something. And it takes me 5 to 7 days to get over that feeling of being away from work-

Dr. Andy Roark:

And then it's over.

Dr. Dave Nicol:

Right? Exactly. So, I'm like I'm good.

Dr. Andy Roark:

I can have one day, and then I go back.

Dr. Dave Nicol:

Exactly. But as a leader, if you can. Listen, if you love doing the clinical work, get somebody in to do this for you, but commit 10% your time to working with them so that the culture they want to grow on your behalf, you're not one of the people resisting it. If you love big picture strategy work, put some of the clinical down and get into this stuff because it is incredibly good fun being in charge and have this blank sheet that is your business. Our businesses don't own us or they shouldn't own us, but frequently they do. I feel like they do.

Dr. Andy Roark:

No, I completely agree. Dr. Dave Nicols, Dave Nicol, you and Dr. Dermot McNerney wrote leadership actions and their effects on veterinary practice culture. I'll put a link in the show notes, where can people find you if they want to learn more from you?

Dr. Dave Nicol:

So two best places. So all of the work that we're doing is published on the VetX International website @vxinternational.com. I've decided, so my new year's resolution this year Andy is to spend less time on Instagram. I have to say, I'm going to make Twitter my place to hang out this year.

Dr. Andy Roark:

That sounds like a terrible idea. Twitter? Are you going to hang out on Twitter? [crosstalk 00:47:41] I'm sorry. I have very strong negative Twitter emotions.

Dr. Dave Nicol:

I know. And I feel like-

Dr. Andy Roark:

Instagram is negative.

Dr. Dave Nicol:

It could be a horrible thing.

Dr. Andy Roark:

It's like Florida's too hot, let me go to hell. That's the analogy that I heard.

Dr. Dave Nicol:

Well, I'm enjoying the conversation and a bit of the back and forth. And obviously I feel like that's going to be about a month until I feel absolutely like, this was a horrible idea, but I'm I also, at Dr. Dave Nicol, spelled N-I-C-O-L, anywhere on the socials I will be, but I will be actively managing my Twitter account. Others will be actively managing my other accounts. So if you want to reach me, Twitter's the one to go for.

Dr. Andy Roark:

Oh man. All right. Thanks for being here my friend.

Dr. Dave Nicol:

It's a pleasure. Thanks for having me, Andy. I appreciate you brother.

Dr. Andy Roark:

And that is our episode. Guys, I hope you enjoyed it. I hope you got something out of it. Thanks to Dave Nicol for being with me. I love that guy. It's always hard to schedule because he's on the other side of the pond talking to me. And again, I appreciate him making time to hang out. This episode will be on YouTube. That's right. Dave was very gracious in letting me use the video feature on our software for the first time. And guys, I'm playing around with the idea of putting some podcasts on YouTube. I know a lot of podcasts get a lot of listenership. A lot of people like to be on YouTube and they can consume podcasts that way with sort of the video component of it. It's not super exciting video, it's just me and Dave talking to each other, but we'll see how it goes.

Dr. Andy Roark:

If you are a big a YouTube person, you're like, man, I just wish that Andy would put some podcasts on YouTube. So I could just listen to them there. Check out the Dr. Andy Roark YouTube channel, and we're going to see how this goes for a little while. So anyway, exciting times over here. Gang, take care of yourselves. Be well, talk to you later. Bye.