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Podcast

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

This week on the podcast…

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

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

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

Help Us Make More Great Podcasts in 2023!

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

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

Submit it here: unchartedvet.com/mailbag


Upcoming Events

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

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

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

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

Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

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

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

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

Stephanie Goss:
Oh, yeah?

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

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

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

Stephanie Goss:
Nope.

Dr. Andy Roark:
They could not care less.

Stephanie Goss:
They give zero figs.

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

Stephanie Goss:
Yeah.

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

Stephanie Goss:
I want it right now.

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

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

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

Stephanie Goss:
Yes.

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

Stephanie Goss:
When you leave.

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

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

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

Stephanie Goss:
Best possible scenario.

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

Stephanie Goss:
The whole nine yards.

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

Stephanie Goss:
For deliberation?

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

Stephanie Goss:
Not an answer.

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

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

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

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

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

Stephanie Goss:
Oh man.

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

Stephanie Goss:
Of course.

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

Stephanie Goss:
Right.

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

Stephanie Goss:
It's not actually evidence.

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

Stephanie Goss:
Oh gosh.

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

Stephanie Goss:
Oh, so funny. So funny.

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

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

Dr. Andy Roark:
Sure, yeah.

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

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

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

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

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

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

Stephanie Goss:
No.

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

Stephanie Goss:
Sure.

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

Stephanie Goss:
That's really funny.

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

Stephanie Goss:
Sure, and stings it.

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

Stephanie Goss:
Yes.

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

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

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

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

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

Stephanie Goss:
Yes. Yes.

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

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

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

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

Dr. Andy Roark:
Okay, all right.

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

Dr. Andy Roark:
Absolutely.

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

Dr. Andy Roark:
Totally.

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

Dr. Andy Roark:
True.

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

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

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

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

Stephanie Goss:
Yes.

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

Stephanie Goss:
Yes.

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

Stephanie Goss:
No.

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

Stephanie Goss:
Right. Right.

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

Stephanie Goss:
Yeah.

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

Stephanie Goss:
Sure.

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

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

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

Stephanie Goss:
Yeah, yeah.

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

Stephanie Goss:
Right, yes.

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

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

Dr. Andy Roark:
Yeah.

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

Dr. Andy Roark:
Yeah, sure.

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

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

Stephanie Goss:
Sure.

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

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

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

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

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

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

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

Stephanie Goss:
Okay.

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

Stephanie Goss:
Yes.

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

Stephanie Goss:
Are you going to say it?

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

Stephanie Goss:
What does your handbook say?

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

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

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

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

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

Stephanie Goss:
Yeah.

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

Stephanie Goss:
Right.

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

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

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

Stephanie Goss:
Sure.

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

Stephanie Goss:
Sure.

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

Stephanie Goss:
Right. Yeah.

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

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

Dr. Andy Roark:
Yeah, sure.

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

Dr. Andy Roark:
Yeah, yeah.

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

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

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

Dr. Andy Roark:
Yeah, sure.

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

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

Stephanie Goss:
That's a lot of money.

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

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

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

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

Dr. Andy Roark:
Yeah.

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

Dr. Andy Roark:
Yeah.

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

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

Stephanie Goss:
Yes. Mm-mm. Nope.

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

Stephanie Goss:
Yes.

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

Stephanie Goss:
Nope.

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

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

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

Stephanie Goss:
I hope so.

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

Stephanie Goss:
There's not a magic wand.

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

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

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

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

Deteriorating Doctor

Uncharted Veterinary Podcast Episode 209 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are working on a challenge question from the mailbag. A veterinarian wrote in because they have an associate who they thought was a great fit and the team was super excited about when they hired them. A year later and the sparkle seems to have worn off and this associate seems unhappy, anxious and angry a lot of the time. They are micromanaging the team, snapping and sniping at people constantly and this practice owner is worried about this associate. Can this situation be saved? How can the owner help the doctor and what support the team who is super frustrated are all the questions being asked? Let's get into this…

Uncharted Veterinary Podcast · UVP – 209 – Deteriorating Doctor

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

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Episode Transcript

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

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

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

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

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

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

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

Andy Roark:
Guys, if you're not familiar with GuardianVets, if you think that you could use them help on the phones or up 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. Check it out, guardianvets.com.

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 dive into a letter from the mailbag from a doctor who has an associate vet who seems very unhappy, and as a result, they're making life very challenging for the team and they kind of seem to be deteriorating mood-wise, behavior-wise, all of the things. This doctor is looking for some advice on how to handle the situation. This was a fun one, so let's get into it.

Speaker 3:
And now, the Uncharted Podcast!

Andy Roark:
We are back. It's me, Dr. Andy Roark, and Stephanie, I am barely breathing Goss. (singing)

Stephanie Goss:
I mean, at the end of the year, it always feels that way. That is not an untrue name right now. I can appreciate that one very much. It is crazy.

Andy Roark:
That's a Thanksgiving song for me. I'm barely breathing and my pants are way too tight. It's like… I can't expand my chest because I ate so much. That's it.

Stephanie Goss:
So funny. How was Thanksgiving with your family?

Andy Roark:
It was good, I think. It was good. We did two Thanksgivings, which is great. Always recommend two Thanksgiving. If I can get in and do Canadian Thanksgiving a month or two ahead, I would do that too. I would do three Thanksgivings if I could. I'm not sure how to make that work, but I'm looking for it. Anyway, it was good. I did the thing with the family and we just rolled with it. And so, I wrote this article that I actually really like a lot and it was this article from this woman who writes cookbooks and she was talking about her Thanksgiving and she was like, “I have taught all of my children and my in-law children how to make these dishes. Everyone has assignments. We have spreadsheets. We review the spreadsheets. We have oven signup times.” They were like, “We do group grocery lists. We have organizational apps that we use to track ingredients for purchasing.” And she's like, “Then, it's total chaos every time.”
I thought that was so funny because she laid down so much work. Every Thanksgiving, her mother sits down and does a postmortem and reviews the dishes. She was like, “Oh, the time that my son's brand-new wife brought a pie that got a B minus was like… This is a tense family time.” And so, she goes through, she says all these things to emphasize how organized she is and then says, “And it's total chaos.” Then she says, “The chaos is the point. The point of this is to forge these memories of everyone crammed into the kitchen together, pushing each other out of the way and stepping on each other. That's what the holiday is and if it's not chaotic then it's not memorable. The chaos is what we remember of that almost forced togetherness and the challenge of trying to make this thing happen, so we have this sort of shared memorable experience.”
Man, I really love that because I think a lot of times people go into the holidays or in other aspects of their life with this idea that it's going to be just this well-oiled machine, and then it's not, and it never is. The sad thing is they feel like a failure. When I lecture a lot of times, I will put up a picture of the Disney princesses and say, “We talk about vet clinics as if this is what we're supposed to be. We're supposed to be these pictures of happy, lovable perfection and everybody's got all their stuff together and everyone's in a beautiful gown and this all looks great, but we're not Disney princesses.”
Then, I'll hit the next slide, and it's The Muppet Show, but we're the freaking Muppet Show. There's yelling. There's drum banging. Someone's riding a bull through the living room. That's what life really is. I think aspiring to be Disney princesses, I think you can aspire as long as you recognize that you are one of the Muppets trying to be a Disney princess and-

Stephanie Goss:
I love it.

Andy Roark:
… [inaudible 00:06:11]. Anyway, all of that to come around to say that's what I've been thinking a lot of was how was my Thanksgiving? It was chaos and I think that that's the point and I'm really happy with it.

Stephanie Goss:
I like it.

Andy Roark:
How about you?

Stephanie Goss:
It was good. It was mellow, it was quiet. The kids and I had some rowdy board games time and there was lots of laughing, which is the best. It was the stress of, it's always this challenge for me because we're getting ready to leave or I'm getting ready to leave to come to Greenville for a Practice Owner's Summit. I was weighing the do I get a tree now and avoid the stress of coming home and being like, “There's two weeks till Christmas, let's go get a tree,” and risk getting to Christmas and the tree is dry and dropping needles everywhere and my house is a wreck, or do I take the trade-off and wait until I come back and then have the last minute panic.
Ultimately, we chose just getting it now. It felt super early and there was nobody out looking for trees yet because it's right after Thanksgiving, but it was great. The house is decorated and we've hit that stage where the kids can do a lot of the work and it's amazing and I take full advantage of it as a parent. I'm like, “You guys go to town,” just going to sit right here.

Andy Roark:
I agree with that. That's the evolution of it along is that the kids, you can throw them into this and it's good for them. It's good for them to feel some ownership of what we do. At some point, I was putting up the Christmas tree, I look around and my daughters are just lounging on the couches and I was like, “What is this?” You are the ones who want this. That came to a screeching halt for them. They slammed head-first into what I call reality and they were put to work.

Stephanie Goss:
I'm like, “You want it? You have to help do the work. I'm not going to do all the work or it just doesn't happen.” We had one year where I was like, “No, if you guys aren't going to do it…” and our tree sat there for several days without anything on it because I was like, “I'm not going to do all this work by myself.”

Andy Roark:
Just a naked tree sitting there.

Stephanie Goss:
That was the one and only time, and ever since, they have been great and they're all about it. We had a great day decorating yesterday. It was good.

Andy Roark:
I imagine a really sad tree. Is it the Charlie Brown special where there's like this tiny little tree, it's got one ornament on it and it bends over.

Stephanie Goss:
I do. That is a good mental picture. No, it is. This year, they chose a big giant nine-foot tree. There was ladders involved this year. I was like, “Okay, all right. This is where we're at.”

Andy Roark:
When you're living in Washington, I expect an impressive evergreen from you.

Stephanie Goss:
Yes, I do. One of the things I love about being here is the availability of fresh ingredients to decorate. We always have the cedar garland and the whole nine yards. It is quite fun. I enjoy it but now it's back to reality because then you sit down at your desk Monday morning and there's just piles of work and hundreds of emails and the pain of taking a long weekend and having some break, but it's good, it's good. It's just the busy time of year.

Andy Roark:
I walked right into that of all the things that I said, “Oh look, we'll do that after the holiday.” They were all just standing and waiting for me, like walking into a circle of bullies who were waiting after school. That's what it felt like for me to come to work.

Stephanie Goss:
But it's all good. I'm excited to come to Greenville and I'm excited to get into some of the work that we've got some good stuff happening and it feels good to be creative. I'm excited about this week's episode. We got a good question from the mailbag and it's funny because there's a time in my career where I could have written this email. I thought it was a great one. It was kind of long, so I'm just going to give us the summary and the gist and then we can pick out pieces out of it because I think, again, I think this will be one of those episodes where lots of people are like, “Is this my clinic?”
We have an associate vet who has joined a practice and the associate seems really unhappy. She is making life very challenging for the team. She previously had been doing relief work and came and did relief work at this practice and the team really loved her. They all got along really well when she was doing relief and everything seemed good. And so, they offered her a position as an associate. And so, she's come on full time and since joining the practice, things have seemed to fall apart a bit. She's really overwhelmed, seems really anxious, is struggling when the team doesn't do things the way that she wants or what she thinks is the right way following… they're doing things that are differing from protocols.
A lot of it seemed to me like she is struggling in a world of gray because she is seeing things in black and white. And so, it seems like she's really unhappy and that's manifesting itself like what they're seeing in this practice is lots of snappy tone of voice, micromanaging, getting all over people when little mistakes are made. At the same time, she has lots of overwhelm in her own work. She's got stack of charts on her desk, things left undone for weeks at a time, messages that haven't been called back that are a week overdue, that kind of stuff.
And so, the doctor that sent in the message was like, okay, looking at it now, it seems like they're a very poor fit for us. And so, I'm wondering what do I here, because the market for vets is really, really slim. I feel like this person isn't a fit for us. In fact, the practice had someone in doing an internship in their practice and apparently that person made a comment, I would never treat my team that way after seeing the associate doctor go off on somebody for making a mistake.
And so, they're really struggling with what do I do with this situation? How do I manage it? For context, it doesn't seem like a whole lot of regular communication has happened, sounds like they've had some conversations about how can we support you, how can we make this better, but not a lot of regular visiting of that conversation. And so, they're like, “How do I get them in a better headspace? How do I solve this problem?”

Andy Roark:
This is unfortunately a fairly common presentation. When we get questions like this, the devil's in the details. We have an associate vet who's not getting along with the staff. Someone else goes, “I have that same problem.” It's true because you have wildly different problems, but they get lumped together as the we're not getting along. We're not getting along can mean a lot of different things. And so, we have to always start these things.
Let's start with headspace as we usually do. Assume good intent upfront. It's easy to get locked in on an idea of this person is messing up and so I'm going to get really fixated on them and I'm going to watch for them to mess up and just add a laundry list of things. I'm sure I'm not alone in seeing that with people where you go, “Oh, first of all, you are right. This person is struggling and you watching them like a hawk and documenting every misstep they make during the day and blowing it up because it's not a tiny mistake, it's further confirmation of this significant problem.” That doesn't help get past the problem. It doesn't set the person being watched like a hawk up for success, and it's miserable from the person who's hyper-attuned to this because they take every misstep as a huge failing. And so, that's not a good headspace to be in.
Now at the same time, we're not going to let this person go on and be awful to the staff. I am really bothered by the fact that someone was there and said, “I will never treat my staff that way.” I really don't like that, but we can balance those things. Try to start with the good headspace is always my first thing is go, “You know what? Let's try not to judge. Instead, let's try to diagnose.” I really think a lot of this comes down to what is going on. We had this person and they were doing relief work and they seemed to know what we were doing. Honestly, this is the ideal hiring scenario. They know your staff, you know them, you've seen them in battle conditions, and it seemed to work and it seemed good and they came on. How did we get to this toxic, bad, dark place when we had such a nice start of being open and transparent and everybody knows everybody?
And so, I would start off with that and say, “What is the diagnosis?” When I read this letter, it's like a number of the letters that we get where people will come forward and they have a laundry list of the things that are problems. Well, the person is a micromanager and they're mean to the staff and they get really huffy and they don't write up their records. I'm sort of pulling these out of the air, not that's what it was here, but we get a list of behaviors like that. I generally look at it and I go, “No, I don't know what to do with this when we're looking at people and managing people.”
My question is, is this 10 different problems or is this one problem that's manifesting 10 different ways? If it's 10 different problems, that's usually really bad. There's usually not much that we can do. You know what I mean? If you're like, “I have 10 problems with this person.” I go, “The answer is going to be for you and that person to part ways because 10 problems is too many problems.”
If you're like, “I have one problem with this person,” and it manifests all these different ways, then that's very doable. For example, if I have a doctor who refuses to take days off, who calls multiple times when she's off, she won't go home at night because she's writing up records, she rides the staff really hard because she says they're not doing it the right way. She won't let other doctors see “her cases.” That may sound like a laundry list to you. To me, I say, “Oh, this person does not trust the practice that she's in.”

Stephanie Goss:
Trust.

Andy Roark:
This is a tough problem. All of those behaviors are from one behavior which this person doesn't trust what is happening in the practice and other people taking care of what they're supposed to take care of. And so, that's not 10 problems, that's one problem. We can talk to this person about trust and it may be that we can meet their needs and get them to let go a little bit. We can come to a workable solution here as opposed to this person is doing 10 radically different things that are culturally incompatible with what we're doing. They go, “I probably can't help you there. This is probably just not a relationship that's going to work.” Anyway, that's the thing I put first from a headspace standpoint is we need to do some diagnostics here. Seek first to understand is this a lot of different problems or is this one problem? What are your thoughts from that when you look at this? Are you seeing a pattern here? Are you seeing one problem?

Stephanie Goss:
Well, it's interesting because I probably… No, there's not one clear-cut problem here when I read this, and I also am not sure that it's actually 10 different problems. When I was looking at this, I was trying to pick apart what is the root here? What is the real challenge? For me from a headspace perspective, I wondered if it was a little bit of what you were talking about earlier, which is when we see something as negative, so from a personal, I went through a period of time where I was struggling to get along with somebody that was on my team.

Andy Roark:
Was it me? It was me, wasn't it?

Stephanie Goss:
I was struggling to get along with somebody on my team. No, it was not you. Although this could apply to you, it could apply to anybody, because here's what happens. When we're frustrated and we're angry or any of those strong emotions, it is really, really easy to do exactly what you said, which is if I'm frustrated with you or I'm mad at you about something, it's really easy for me to look at you. Now, all of a sudden, instead of being able to see any of the good things, all I'm seeing are the things that are irritating me because I am irritated, I am in a state of upset, I am frustrated, I am angry, whatever that emotion is. Now, all of a sudden, it's really easy to start picking at all the little things that on a completely average ordinary day, I would give zero Fs about. I would not even notice care, think twice about, but because I'm frustrated because I'm angry because I'm irritated, all of those things seem huge.
And so, to me in reading this, it seems like there might be a little bit of that happening and I could totally be wrong. These could all be-

Andy Roark:
No, I agree.

Stephanie Goss:
… regularly occurring patterns of behavior that really are 10 different problems. At the same time, it's really easy to get into that negative headspace. I mean, I have done it with you. I've done it with some of my closest friends or with my family. When you get irritated, that's all you see. You really do have to work extra hard to force yourself to be in that good headspace and assume good intent and say, okay, let's start with the good, let's put together a good list, because one of the things that I would say from a headspace perspective here is that you need the ability to step back a second and do some weighing from a pro-con perspective because to your point, if it is really 10 things and you probably should part ways, one of the things that I want to do before I get to that step is to figure out is there something worth saving here? In order to do that, I have to look at the good as well.
And so, for me, some of it is, let's step back, let's assume good intent for a second and say, “What are the things that this person is doing well? What is the good in this relationship?” And really try to find those examples so that I can do a little balancing and a little perspective exercise for myself and say, “Am I just nitpicking the hell out of this because I'm irritated with this person and I just want to stab them in the eyeball with a fork?” Because that's a real place that we get to in our heads and it's really easy to be that negative or is there good?

Andy Roark:
I think you're totally right. I mean, I've seen this exact behavior in myself with my wife who I love dearly, deeply. I think anyone who's been married, and maybe I'm wrong, but I really believe probably anyone who has been married for any amount of time, you're like, “I got married last week but I haven't seen this.” I'm like, “Okay.” But other than that-

Stephanie Goss:
Come back to us in a year.

Andy Roark:
… if you've been married for any amount of time, you have come to a period where your spouse has just irked you and everything they do is seen through the lens that you're looking through as something else that further irks you. I think that happens with anybody, but I'm trying to think of examples that aren't going to get me in trouble when they get back to my wife.

Stephanie Goss:
When I get in that headspace, I get real mad and I'm like, “You're unloading the dishwasher incorrectly.” It's that little level, just like, “You're taking out the trash wrong. Can you do that quieter?”

Andy Roark:
Absolutely. I can give you an example, our story about this person who she believed her boss was out to get her and she was asked why she thought her boss was out to get her. She said, “Because the boss has moved all the birthday celebrations to Tuesday at lunch.” And the person said, “Why is that?” She's like, “Because he hates me.” He said, “Well how is this him hating you?” She was like, “He knows that on Tuesdays I have this thing and I never get done on time. And so, I always get to lunch a half an hour late. And so, he's put birthdays on Tuesdays to spite me so that I…” She was 100% serious that this was-

Stephanie Goss:
Out to get you.

Andy Roark:
Now, she could be right. Her boss could be next level… I mean that is Dr. Evil freaking… I mean honestly, there are petty, petty people who are playing the games at that level. I'm sure there are. But to me, I just sit and go, “Are you serious right now?” I have had those thoughts of, “You are unloading the dishwasher right now because I'm listening to a podcast I'm very excited about and you know how distracting it is when you do that.” It's just something ridiculous.
But we all have these thoughts and I say them jokingly, but once they happen, sometimes it's hard to get your head pulled out of your coat and say, “Wait a second, let's hold on now. Let's reset mentally here.” That's really hard. When it really gets hard is like, pardon me, but the old Middle Eastern conflict model where I don't even remember what you did that made me irked, but you did something and so I did something back and that made you irked, and now, this thing has built up over you did a thing, and so I in my resentment did a thing and now we've both spun up to the point you go, “What is this even about?” And nobody remembers, but here we are. I've seen those things happen as well.
Anyway, my point here in getting to the diagnosis, so part one was what is this really about? Is this multiple problems or is this one problem? If it's multiple problems, I do think you are right is can we reset here? I think that's going to be a big part of action steps. The first thing we're going to talk about is an intervention to try to hit a reset button. We've been able to pull these out when we get to that point, but what is going on here?
Then the other part of being fair to the other person is what is my role here? Let's start with our safe for the conversation. Can I sit next to this person, smile at him? And that goes into assuming good intent. Okay, they're doing this thing, this is not acceptable. If I can't smile at this person or just talk to them, I'm not in a headspace to have this. I'm triggered and this is going to go badly. A is assume good intent like okay, something is going on with this person. I really like the fact that they said the associate that she's overwhelmed and anxious. I think that's the words that she used at the beginning, but definitely overwhelmed and struggling. I say, “You know what? That's a good way to look at this as overwhelmed and struggling because we can all empathize with that feeling.” So, assuming good intent. She's not trying to be toxic, she's not trying to run you out of business. She's not trying to chase the staff away. She's struggling.
F is set up to fail. I think this is a big one. Has this person been set up to fail? Meaning, have expectations been communicated? Have we said anything at the very beginning of these behaviors or are these behaviors that have piled up without us having a real heart-to-heart conversation? Has she been misled about what her days were going to be like? Is she being supported by a staff that was fair given her experiences as a relief vet? If you're like, “It's the exact same staff that she's known as a relief vet.” I would say, “Well, that seems like she set out pretty clear expectations.” Has she been coached on these behaviors or is this something where we've just let this all bubble and boil and now we've got to deal with it?

Stephanie Goss:
I think that the F is a big one for me. This was one where I was like, “Oh.” This episode might be a little bit of Camp Tough Love because for me, a lot of this is think you got to own some of this as, and I'm going to speak to manager and it could be practice owner who's managing or the practice manager, but whoever is actually in charge of this situation, I think that there's some self-reflection here. That ultimately, when this was me in the practice, this was a bitter pill to swallow but is an important one in terms of leadership growth because relief is not the same as full-time. And so, you said, “Is this the team that she has been working with since the beginning?” I think that there's value in asking those questions. At the same time, I've never once worked with a relief doctor where the expectations for them and the nitty gritty nuance of how we work with them is exactly the same as it would be an associate doctor of practice. There is always flexibility and there's always difference there.
I ran a ship where I expected a lot out of my relief doctors and I communicated that upfront, “Here's what we want. We have a certain level of medicine that we're practicing and these are our standards of care. Do you agree with this?” There is a whole interview process to make sure that culturally, it was a good fit with a relief doctor so that our clients got the same level of experience and at the same time, there was lots of things that we let slip and that slid around when a relief vet was present because it's not the same. Those are two different things.
I say that because the expectations for you as a practice are radically different even if it's unspoken, and also the expectations as on the flip side as the doctor, those are two very different things. Practicing relief in a practice that you like the team and you get along with everybody is still radically different than being there every day or four days a week, whatever a full-time schedule is, as an associate vet. Those two things are radically different. I think that there's probably a lot of the unpacking of this conversation falls around expectations. I'm so glad you said that.

Andy Roark:
I think you're really spot on with that. The last part of safe is E, is what is the end result? I think people go, “Well, I want this person to immediately cease and desist all negative behaviors.” And I go, “Well, that's probably not going to happen right off the bat.” I think the end result for having this conversation is I want this person to feel heard and I want to feel heard and I want to have a path forward for how we're going to work through this.
What I don't want as an end result, what I'm not looking for is apology for past behavior, just owning things a person did before. I would like that, but really my focus here is not on adjudicating what happened before and did this person micromanage, were they mean, was what that intern said valid? I can't change the past. It was or it wasn't. It doesn't really matter. What does matter is that things have to change going forward. And so, just remember to keep that forward focus as you move into this conversation. I think that that's really important.
I think the last part for headspace for me is sometimes, especially we see changes in behavior like this, sometimes it's because people really are struggling and there's nuance here, but it helps me to be empathetic and I think to be a good leader if I can talk to someone and understand that this person is behaving the way they are because they are struggling. That just helps me to get into a good headspace.
This is important because there's nuance here. Someone can be struggling and still be held accountable to our core standards and our standards of behavior. That doesn't make me a monster for saying, “I understand that you're having a hard time and I want you to be successful and I want you to be here and I'm willing to invest in you to try to keep you here and to make these things happen, and, at the same time, I cannot have our staff members complaining about feeling unsafe. I can't have our staff members complaining that they feel tyrannized or yelled at. Those things cannot happen.” I really think that we're going to talk a little bit about that when we get into action steps about laying those things down.
We've had a couple episodes recently that have touched on this. There really is that balance and we're going into the Practice Owner Summit and that's the focus of my presentation at Practice Owner Summit is it's not about making everyone happy, it's about finding the balance between people. I want to meet the needs of this associate vet, but at the same time, it's my job to protect the staff and make sure their needs are being met. And so, part of balance is to say, I want to support you and I want to help you, and I can commit to giving you my time and energy or coaching or support or whatever else you need as long as these other needs that I have for my associate vets are being met. If they can't meet my needs, then this is not going to work.
It doesn't mean they're a bad person. It doesn't mean I'm mad about it. It doesn't mean that they aren't struggling or I think that they're not doing their best, it's just it doesn't work for me, it doesn't work for the team. And so, there is nuance in that where you can have someone, and I think a lot of people in vet medicine struggle with this. You can have someone who is struggling, and at the same time, they can't continue to work here because their behaviors are not changing.

Stephanie Goss:
I totally agree with that. I feel like this is a good spot to take a quick break and then we come back and talk about action steps.

Andy Roark:
Yeah, let's do it.

Stephanie Goss:
Hey friends, I just want to jump in here for a quick second and say that I am super, super pumped about all of the awesome things that we have coming down the pipeline in 2023. Now, we haven't announced all of the surprises that we have coming for all of you, but there are lots of great things coming to kick off the year. If you haven't signed up for some of the workshops and events that are happening in the first quarter of 2023, you want to head your little self over to unchartedvet.com/events and check out what we've got coming.
If you are a member, all of the workshops are listed there. You can log into your account and sign up for free. If you are not a member, you should check out what's coming and consider a membership for 2023 because you could pay $99 per workshop, but you also could pay $699 and sign up for a whole year of registration as a member and then you get access not only to all of the workshops that we do, but all of the amazing content that happens over in our workplace group and our community. It is so fun, it is lively, it is just jam-packed with conversation from the community about what's going on in their practices, how to solve challenges, how to support each other, and it is one of my favorite places to spend time. I would love to see you there. If you need that address one more time, it's unchartedvet.com/events. Now, back to the podcast.

Andy Roark:
All right, let's get in some action steps here. The first thing I just want to lay down is, and I said this in the first half, but this is why I took the microphone when we came back because I'm like, I'm going to say this before Stephanie says something else. Action steps are, it's time for an intervention. I call this an intervention because I don't like interventions, let me just say. Some people would be like, “This is the come to Jesus talk.” I'm like, nah, it kind of is. I don't want it to be, I really don't like this. The best way to handle this situation is to get in your time machine and go back six months or a year or two years. As soon as that behavior first started, you say, “Hey, that's not like you. Help me understand. What happened here?” I'm going to say, what are you thinking, but I'm going to try to say it in person. It's like, “Hey, you know we don't do that here. Tell me, what's going on?” That's the best thing.
If you got a time machine, you should use it and go back to the first time it happened and say something right then at the very beginning that brings this out in the open. Barring that, and given the fact that this has gotten to this place and all of these behaviors have been documented, we've had this experience with the intern coming and being like, “What is this?” It's our best hope is intervention with follow-up. I think a lot of people are like, “We're going to have the big talk and then I'm going to go right back to how things were before and this person's behavior is just going to be different and they're going to just be changed by themselves.”
I'm like, “No. We need to try to hit the reset button, which is a big thing.” It goes back to what we were talking about before about the spinning up and the resentment upon resentment or looking through this negative lens at other things and the list of grievances getting bigger and bigger. We need to hit that reset button to get a fresh start and then we need to have ongoing conversations or coaching conversations thereafter. And so, I think if your expectation is have the conversation and then be done, that's not where we are, that's unrealistic expectations. You're going to be unhappy with the results you get. Do you agree with that?

Stephanie Goss:
100%. I think that for me, a huge part of where we start actions stepwise, like I said, goes back to looking at the F because looking at the email, this person has done some great things in terms of trying to manage this. They were like, “We have had some conversations about the specific way that this associate is talking to the team and confronting them and the impact that it has on the team,” which is wonderful and amazing and they were like, “And then we get a couple of weeks where the behavior starts to shift and then we go back to the snapping and the criticizing and the way that it was.” And so, I think you're spot on with that, which is when we're asking for behavioral training, we have to follow the training model that we know works.
We've talked about this on the podcast before. We are simple animals and training requires doing the same things over and over and over again and rewarding the good. And so, I think that for me, there was a lot of things in the list of things that are frustrating this person where I'm like, “Okay, are you having a lot of the come to Jesus conversations or are you having ongoing conversations about how is this going? What went well here and what needs to change?” Because when we're talking about behavioral things, it needs to lean much more towards high frequency in terms of the touchpoints than low frequency. This needs to be a regular, “Hey, today was a great day. Thank you for the hard work today. I know that it was a challenging day, but you did a great job and you gave the team, you interacted with them really well and I really appreciate it.” It's that kind of ongoing.

Andy Roark:
Or are you having Andy Roark 2010 conversations that were conversations that only I know I'm having and the other person's oblivious to, where you're like, I'm so subtle, I'm not convinced the other person understood the conversation that happened. And so, there'll be people who, I'll be like, “Did you speak to them about them being mean to the staff?” They'll be like, “Yeah.” I'll be like, “What did you say?” They were like, “I asked them how was your day?” I was like, “Yeah?” And they said it was fine. I said, “Good, fine days are good.” I think they got the message.

Stephanie Goss:
I have tell you the best story that illustrates that point perfectly. I, once upon a time, had a manager and the expectation was that we would have regular one-on-ones when we had time scheduled where they were in the practice because they weren't in the practice all the time. The expectation for me for a one-on-one was we're going to actually sit down and have a conversation about how are things going, we're going to talk about specifics, we're going to talk about what's going well, what's not working, and get into the details.
We never talked about what the actual expectations would look like. I just was one-on-one. We're going to have time on the calendar, this means we'll sit down, we'll have a whole conversation. Probably, I don't know, the first three months went by and they came regularly. They showed up when they were supposed to, they brought coffee for everybody. They were like, “Hey, how's it going? How's everything going in the practice?” I'm like, “Things are going okay. We're just trucking along.” Then before I knew it, the day was done and they had left and we hadn't actually sat down to have a conversation, oh, they've got other stuff going on in their schedule like we'll sit down and have a conversation.
And so, it came time to do our reviews and one of the questions asked was how are one-on-ones going with your boss? I gave a really low score and my boss's boss was like, “Hey, I want to talk to you about this low score that you gave.” I was like, “Okay.” They were like, “Well, why was your score low?” I was like, “Well, because I haven't actually had a one-on-one with them.” I was like, “I guess that they'll get better. I know things have been really busy, assuming good intent. I know they've got a lot going on.” They were like, “Well, they said that you guys have been meeting every time that they have been at the practice.” I was like, “They did?” In the other person's head, the one-on-one for them was, how's it going? It was them asking the question, how's it going? My answer was the answer to a one-on-one in their head. My expectation and their expectation were at two opposite ends of the scale.

Andy Roark:
Oh no, that's funny.

Stephanie Goss:
Because I'm over here thinking we haven't had a single one-on-one yet.

Andy Roark:
And they're like, “She said she was fine. And so, I wrote that down.”

Stephanie Goss:
100%. 100%.

Andy Roark:
Bam! Nailing this management thing.

Stephanie Goss:
But it's like that, that's part of it from an expectations perspective. Also to your point, the communication perspective, are you actually having the conversation you think you are having? Super, super important. Part of that is you have to get it out of your head and you have to be able to communicate it to them and vice versa so that you know what are the actual expectations. For me, a lot of the F when I was looking at this, and again, we hyper-focus on the negative because when I was reading this, I was picking it apart and I'm like, “Oh, well as a manager, they should be doing this and they should be doing this and they should be doing this.” Then I was like, “You're picking them apart too,” which is also not fair.
At the same time, for me, some of it is, okay, look, if you're having a challenge with a thing, with the behavior, in order to change that behavior, there has to be regular follow-up and regular conversation. Not just a, “Hey, today was really bad, let's have a conversation about how bad it was because I'm going to ask you to fix it.” Those conversations are important, but equally important is the, “Hey, this was a really good day,” or, “Hey, this was kind of in between. Here's what you did great and here's what we still need to work on,” and it needs to be regularly occurring versus just those spot conversations when it's really not so great, which again, the devil's in the details and we're only getting part of the story in this email, but I suspect that there's maybe a little bit of that happening where, to your point, it's the come to Jesus conversations and not as much of that regular follow-up.

Andy Roark:
I agree. One of the things I think I want to try to do in the podcast, I'm looking at 2023 and I'm thinking about what we do here. I love our podcast and I love our conversations. I think I want to challenge myself in 2023 to try to do a little bit more role-play stuff on the podcast. I know a lot of people are like, “Man.”

Stephanie Goss:
We get asked for that a lot.

Andy Roark:
We do get asked for how do you say that? When we do it, people tend to really like it and we get really good feedback on it. I don't know, I think I'm just going to try to factor that in a little bit more. Let's role play a little bit right here. We're talking about action steps and we're talking about this intervention. And so, people say, “Well, what does that look like?”
The first thing that I want to do is say, “Okay, remember when we're going to go in, we need to speak in specifics,” because if we go in and say, “Hey, I don't think things are going well,” what does that mean, or, “The staff is unhappy,” that's hard to get people. I don't understand what that means. If you came to me and said, “Andy, the staff is unhappy, how do you think things are going?” I'm like, “Stephanie, I don't know what you mean. How are they unhappy and why? What did I do that made them, I don't understand.” But I do see a lot of that where people go, “The staff feel, they feel micromanaged, they feel unhappy,” and they'll drop that on the doctor and the doctor's like, that's the worst kind feedback because they're powerless. I don't know-

Stephanie Goss:
It's vague and it's subjective. It is so vague and it is so subjective. There's nothing concrete or specific. You couldn't say to me, “Stephanie, close your eyes. What does you micromanaging the team look like?” I couldn't give you a picture of what that looks like from what you just told me.

Andy Roark:
I agree. I hear that feedback given to people all the time. Guys, it's destructive because it makes the person feel terrible and does not give them anything actionable they can do to change their behavior. And so, a lot of it's when we're just speaking specifics because this person's going to need to know specifics. I'm assuming there's something that's going to bring this to a head or there's something that we're seeing a behavior, but we need to have some sort of a specific thing to have this behavior.
Remember, clear is kind. If you're struggling, you're like, “How? This is going to be a terrible conversation.” Remember, clear is kind because I need to fix this problem because what's happening, it's not okay to keep happening. And so, we're at that place where we're going to have this intervention conversation and clear is kind. What we're doing is it just doesn't work and I need to say that it doesn't work. If this person's like, “I hate it here. I hate these people here. I'm not going to change my behavior,” then they need to leave. That's where we are.
And so, it's time to put cards on the table. That doesn't mean I'm giving an ultimatum, but if that's how they feel, I need them to know that what's going on is not working for me and that's fine. A lot of times when I say we're going to do an intervention, people say, “Oh, you're going to bring them in the office and we're going to close the door.” I'm like, “No, no, no.” Just because it's an important conversation doesn't mean it needs to be a stressful conversation. I want to lower the stakes. I want to be empathetic. I want to have a real conversation with this person, not a performative flex on them, not a, I'm going to twist your arm, not a, it's two and a half strikes buddy. It's not that. Especially if you've got multiple problems or this person's acting out in these different ways, we need to really try to come together. Here it goes. And so, you can help coach me through this.
I guess what I'm going to try to do is we need to set a time, make sure we have time to talk with them. And so, “Hey, can you come in tomorrow morning? I want to do a touch base with you and talk through how things are going and where we are as we come into the end of the year. “I like to use landmarks like the end of the year to make it be like, “Yeah, we're going to the end of the year wrap-up.” And so, “Hey, can you come in? Let's find a time or can I take you to lunch tomorrow and we can talk through things and see how things are going, but I want to make sure I have time to do it.”
The big thing is I'm going to try to bring them in and lay out the problem and say, “Hey, I love having you here.” I tend to like to start in a positive conversation and try to frame the issue. I think a lot of times, we mess this up and we go too specific. I say, “Hey Stephanie Goss, welcome to my office. Yesterday you said this negative thing and it's a problem.” You know what I mean?

Stephanie Goss:
Yes.

Andy Roark:
That makes you feel like everything between you and me is bad. And so, I'm going to start out wide. I'm going to say, “Hey Stephanie, first of all, we're coming to the end of the year, I'm looking back at the year and I am glad you're here and I want you to know that. I want you to know that I think that you're a really good doctor. We've gotten a number of positive comments from clients about you over the last year. Here's looking over our online reviews and I see this positive feedback and I think you have great medical knowledge and I think that you are really popular with our clients and I know how hard you try to keep our clients happy. I can see that effort in you and I can see that care and compassion for the pets. I just want you to know that all those things are really obvious and I really personally appreciate them.”
And so, now, I'm trying to lay this down. It's not everything is bad and I'm not going to say it if it's not true. And so, I'm trying to say to them honestly what I wanted to do. If you can't come up with anything that's true and positive, this relationship is not worth having. I'm going to try to open up that and say, “Hey, this is where I am, this is how I feel.”
The other thing is I'm trying to lower the stakes. This is not do or die. There's lots of good things about our relationship. I laid down what's positive and what's going well, then I'm going to transition over to where we're going. I don't want to make this an accusatory thing and say, “Well, the staff says you were mean to them and so you were mean to them.” What I'm going to say is, “Hey, so these are the things that I love about… One of the points that I want you to focus on or that we need to talk about in development is interactions with the staff. There has been a perception that you can be really negative about the performance of the staff or how they're doing and I have some staff members who feel like they walk on eggshells because they're worried about making you unhappy. I'll give you some examples that don't divulge these people's identity, but for example, I've had people doing [inaudible 00:49:34].”

Stephanie Goss:
Or even if it does, if it's something that you see, that's a great place as a manager. Even if it puts the spotlight on another person on the team, if you have seen something yourself like in the email, they gave us a great example of where this doctor snapped really badly at an assistant who was stocking the room and put what the doctor thought was too many needles in the needle bin and they snapped at them.
That's a great concrete example of you see something like that, say, “I know it's a really small thing, but this felt like a really good example for me of what I'm talking about, because I know that you didn't mean to make her feel bad. I know that you didn't intend for your tone of voice to come off as mean. You want it done right and I appreciate that. At the same time, this is how it came across to me or this is how they perceived it and that's what we have to talk about because we can't have that. I don't want that to be that kind of interaction between you and somebody else on a regular basis,” or something like that.

Andy Roark:
I like that as well. The best thing is when we see that happen, that's the best time to intervene. And so, the best thing is if we can see something like that happen and this person snaps at one of the support staff because they put too many needles into the container and they raise their voice, the best thing is say, “Hey, can we talk real quick? Hey, listen, when you raise your voice to the staff like that, it rattles them to their core. They respect you and she's trying to do her best. That type of feedback, it damages the trust that they have in you. Also raising your voice like that, that's not what we do and that's not the behavior that I expect from you. Is everything okay?”
I really like that is everything or what happened, but if it happens and I see it, I'd say, “Hey man, that's not what we do here. Are you doing okay? Is everything all right? That's not how you tend to behave. I'm a little worried about you.” I use those phrases a lot of, what happened, is everything okay, I'm a little bit worried about you. Those are true and they're compassionate statements of not like, “How could you yell at her like a monster?” But instead, “Hey, that's not like you and that's not what we do here. Are you doing okay, man? I'm a little worried about your behavior, what's going on?” That's exactly where I want to get to. It's in that what's going on conversation. I really like that.
If I'm having a sit down with the person, again, catching them in the moment is always, and having this specific conversation is always the best. But if I'm doing an evaluation type thing, let's say this is something that's slowly, steadily building, I'm going to start with all the things that I like about them and then I'm going to say, “Hey, this is a developmental plan just so you know where we're at. We've gotten negative feedback from the staff about these behaviors. Their perception is that you are unhappy with the work that they do.” And that's important.
I'd say, “Their perception is, I didn't say you yell at them. I said their perception is that you are aggressive about mistakes that they make. Honestly, some of them seem to be fearful in their interactions with you, and that's a behavior we need to fix. Do you see those behaviors or do you remember interactions like that?” I'm trying to get them to say, “Yes, I see that behavior,” or, “No, I don't see that behavior.” We can open the conversation up from there.

Stephanie Goss:
I love that. I liked the idea of being able to use a landmark if that is appropriate. The other thing that I like to do is to just use the wide end of the net from the place of compassion. If I was going to have this conversation, it's probably going to feel a little bit like a come to Jesus, because it sounds like, and again, we only have part of the story, we only know what they sent us in the email, but it sounds like there's stuff that has maybe been building and hasn't been addressed really regularly. And so, I would probably start with, “Hey, I just want to touch base and check in with you because you don't seem okay. You seem really anxious. You seem really overwhelmed and I'm worried about you. I want to know where your head's at and how you're feeling so I can help figure out how I can support you and how we can support you.”

Andy Roark:
I like it.

Stephanie Goss:
Then we're coming from a place of compassion and I like them to direct the conversation. Ultimately, I don't like having conversations where I don't know how it's going to end because I'm a control freak, and at the same time, I'm okay with taking some detours. And so, I would rather open it up and have them tell me how do you think things are going? Even if ultimately, I want to get to the place of accountability and have the conversation about these are the changes I need to see from you, this is the behavior that I expect, I still want to know what's the backstory, because there are always at least two sides to every story and the truth is usually somewhere in the middle.
And so, I am looking at this from the perspective of the team is frustrated. I am frustrated. I have all of the stuff on one side of the story and I need the other side of it. I need to know what's going on for them, or is there stuff going on at home? Are they frustrated because maybe there was an incident I don't know about with the team member and now there are trust issues? Opening the door to that kind of dialogue is the only way that I'm going to get that information.
Now, they may sit across from me and be like, “Everything's fine.” And then this is where as a leader, it is a superpower to become comfortable with the uncomfortable and lean into the silence because that is where I will just sit and let them actually tell me, is it actually okay? Because one of two things happens, either they keep repeating it's okay, it's okay. You've said that three times now, that isn't actually reassuring me. In fact, it's making me feel like there is something wrong and you just don't want to talk about it. But if that is actually true, I'm cool with that. I would love to know what is going well. Give me some examples. Tell me what is going okay, and push back and drill down. Some of this is going to take work on your part to uncover where they're going.
But I have found to your point from the coaching conversation perspective, part of it is about getting them on your team, getting on the same page. I find it way easier to do that if it's coming from them because now, if they'll open up and they'll tell me about some of the things that are going on with the tech team or something's going on at home or whatever, now I have more of the story and now I can reevaluate. I'll tell you, I've gone into some of these conversations armed with a plan to, look, I've got to address this behavior and that is still true and I come out of it with a completely different plan than I had in my head going into it because they gave me information that I didn't have at the start of that conversation.

Andy Roark:
I agree with that. I think from a strategy standpoint, you put your finger right on it. I don't want this to be an adversarial conversation where I'm telling you that you are failing and you're telling me that you're not, or you're telling me I'm a jerk. I want this to be a conversation where we acknowledge that you are having some struggles with the staff and I'm supporting you. I'm going to help you figure out how to get through this, how to be successful, how to get you what you need and open doors for you with the staff so you can build those relationships. That's where I want to get to.
And so, asking them, and again, it's so much more powerful if I say to you, “Stephanie, how are things going?” And you say, “Andy, I don't think they're going very well.” And I go, “Okay, let's talk about what's going on.” That's so much better than me saying, “Stephanie, things are not going well. I'm going to need you to make some changes.” You feel how tight that is and it's the opportunities for us to work together for you as the associate vet to make your own decisions and own your own development. Those opportunities go away.
The other thing that I want to go back to is when you were like, they say, “It's fine,” or they say, “I don't know,” or “Everything is good,” I completely agree that you can't let things like that lie. And so, the phrasing that I'll use a lot in those things is, “I know you say that things are okay, but I'm seeing these issues from the staff and I need to work with you to figure out how to resolve them. I know that you keep saying it's fine, but I really don't feel like you feel it is based on our conversation,” or, “You keep saying it's fine, but the truth is we still need to deal with the outcomes and what the staff is saying and how they're feeling.”
It's a way of moving that conversation first, but I think we both agree, you can't let the person say I'm fine and then cross their arms. We can push in a number of times. A lot of these things are, you set yourself up for the best case scenario. The first thing is I want to lower the stakes here. I want to convince them that I see value in them and in our relationship. Then I want to ask them how they think it's going and I want the conversation to open up as they tell me where they're struggling. That's great.
If that's not going to happen, then we're going to fall back to, I'm going to present to them what I see going on and then ask them if they agree with that representation or if they have ideas about how we might move forward with it. If they say, “Nope, I don't agree with this, everything is fine,” and I can't draw them out, then ultimately, I'm going to fall back to the least favorite of mine, which is, “Hey, this is what I see and this is not acceptable for our culture. It's not okay. It's not how we run a practice. It's not the place that we want to come and work at. It's not okay for the staff to be worried about getting yelled at and I need you just to hear that that's not a thing that we're going to be able to do or that we're going to allow to go on in this clinic.”
I'd say, “I like you. I want you to be here, but I need you to hear from me that this is not acceptable and it cannot happen again and I want to support you. If there are things that frustrate you, I want you to communicate them to me so I can try to work on them, because I do want our practice to get better. I know our practice isn't perfect and no practice is perfect, but you got to work through these things with me and you cannot blow up at the staff and make them untrusting of you or scared to make decisions or to work independently. That's not okay. It's not in line with our values. It's not the workplace culture that we want to create. Can you help me with that? Can you make that happen?”
That's the type of wording that I'll use even if I have somebody whose arms are crossed and ultimately, I say clear is kind, it doesn't get much more clear than, “We cannot have doctors raising their voice to the technicians. That cannot happen. That's not in line with our culture. The damage to our team morale is huge and it undermines everything we're trying to build from a workplace standpoint. The optics for you are terrible. Really, it is what people will remember about you and it can't happen and it cannot happen again.”

Stephanie Goss:
I think that for me, that's the resolution note. Really at the end of the day, and you put your finger on this early on in the episode, which is like we've got to do some pre-work and some zooming out and some looking at this from a big picture perspective and really do some assessment pros and cons wise on does this feel saveable? Because if the answer's no, then as much as it's painful and as much as doctors are hard to find, and I think this person knows the answer because they were just like finding good people to work with us is also a challenge. And so, I don't want to lose a doctor, but I don't want them to run the team out of town. And so, you might know the answer already and it may just be doing the hard thing that you don't want to do and parting ways.
If you zoom out and you do the assessment and you're like, “There's some serious pros here and I would like to try and save this relationship,” then I think you have to look at this from the perspective of how can I start to have some of these conversations and you have to, for me, the last piece of advice on the action steps in gearing up to have this conversation is the trap, the giant gopher trap as manager that you can very easily fall into is now I've done this work and I've listed out all of these things that are going wrong or that this person is doing that are not okay or that I'm irritated by. The giant gopher trap is to fall down into that hole and say, “Here's the 30 things that are driving me crazy that you need to fix,” because all that is going to do is make them be like, “All I'm hearing is negative, all I'm being told is that I'm bad. I'm not doing things right. I might as well give up.” That is immediately going to set them up for failure.
And so, you have to resist the temptation to be like, “I need you to not raise your voice to the staff, and also, I notice that you have records that haven't been written up still sitting on your desk from two weeks ago, and I notice that you have client callbacks that you haven't made from last week. I need you to deal with all of those things.” It's such an easy temptation to give into as a manager to want to address all of those things. And this is where I think you have to pick your poison and you have to pick the place where you start and then recognize that this is if we are truly going to coach this person out of it, and I don't think that it's unsaveable.
I would look at this and say, “Well, I would want the opportunity to coach if there are enough redeeming things in the pros column. I would want the opportunity to do that. I also need to be realistic. Rome was not built in a day. I'm not going to change this situation overnight either. I have to pick a place that feels like the most middle ground.” For me, that's also part of why I'm going to do everything I possibly can to get them talking, because I want to know is there some middle ground? Is there a bone that they will throw out to me that I can pick up and gnaw on because it feels like a good starting place. Where can we meet in the middle? What can I help them work on? And then work my way forward, keeping my eye on all of those other things but also recognizing that things that have gone unspoken for months, you cannot dump it all in here. It'd be like, “Let me have this conversation.”

Andy Roark:
I think that's totally true. Well first of all, you don't know if this is salvageable, because you cannot change this person. It 100% depends on that person and whether or not they're going to change and you don't have any power of that. If you say, “Andy, is this going to work out?” No idea. Go have the conversation and the person sometimes they surprise you and they'll say, “Look, this is what I'm going through,” or, “This is what I'm dealing with,” or, “This is the thing that really bothers me.” I say, “You know what? I can support you through that or I can work with you through that.” Sometimes they'll say, “I understand what you're saying and I see that and I don't like it about myself and it's something I'm willing to work on.” Or sometimes they say, “Screw you. If you can't handle me on the bad days, you don't deserve me on the good days.” And you go-

Stephanie Goss:
Or sometimes they say, “I am really unhappy and I actually, I was going to give you my notice.” Sometimes it works out easy for you.

Andy Roark:
Exactly right. And so, you don't know what's going to happen. All you can do is tell this person what you need and go from there. The other thing to your point, sometimes we stage these conversations. We say these are the problems. When it's at the very beginning when a diagnosis and try to figure out, is this an underlying problem that's manifesting out? One of the reasons I want to do that is because when I bring them in, I don't want to talk to them about the 10 symptoms. I want to talk to them about the one problem. You don't seem to have a good relationship with staff from what I see, or the staff does not perceive you as being approachable and here's examples of things that they've given feedback on.
I'm trying to get to what is the big thing that manifests out multiple ways, so we can talk about one thing. If there's not one thing connected, then you need to pick one. You need to pick the most urgent one and you need to talk to them about that. A lot of times what happens is you can get that person to say, “Well, this is why I do that.” You go, “Oh, now I understand why you do the six other things that you also do.” A lot of times you can unlock that. But to your point, if you just back the dump truck of complaints up and just dump it on them, they're going to feel like it's pointless. No one wants to hear 87 things that are wrong with them because they go, “Well, you just don't like me and you're not going to like me and this is everything about me you don't like, what are we doing here?” And so, that kills it. But to your point, pick the things that matter and push for it.
The last thing is, you said pick your poison. That's always it. I think a lot of people ride in on their white stallion with their flaming raging sort of justice and say, “This person's a bad cultural fit and they're gone. You're better off without them.” I've always thought it's amazing how often we are better off without people when we think, “Oh, I can't hire anyone, I don't have an option.” A lot of times you are better off without the person.
At the same time to me, I'm pretty darn pragmatic. This is a math problem. You need to look at the discomfort of working with this person for the foreseeable future versus the discomfort of working without this person for the foreseeable future. Honestly, from this, it sounds like even if that person can't be replaced, the scales may still not balance it. You may have less discomfort without this person not being able to replace them than you do with this person. If you are able to replace them, then that's a bonus.

Stephanie Goss:
Oh man.

Andy Roark:
That's a lot.

Stephanie Goss:
This one was a lot, but also fun. I really like your idea about doing some more role-play because we get that a lot.

Andy Roark:
How was that? It's not as smooth as I hoped it would be probably.

Stephanie Goss:
That was on the fly.

Andy Roark:
Well, but here's the thing too. I think if we want to do more role play, and I should have said this from the very beginning is I don't plan to graph this out. I'm not interested in coming in because I think the real problem is when you have consultants and they do role play, they sit down with their spreadsheet or their laptop and their word processor and they wordsmith some BS that you would never actually say to someone. The truth is it's not perfect and it's never going to be perfect. We are not perfect when we have these conversations. I think we're pretty good at them.
I think what I would say is if we're going to do more role play type stuff, the way I would do it is to say, “How do I think I would do this? Let's talk about it. What might this look like?” Because the other thing is you don't know how the person's going to react, and so, I'm willing, I think that's what's held me back from doing more role play stuff is to say, “Well, there's not a perfect way to say this and I don't want to be critiqued on that.” And I say, “I'm willing to do some more role play stuff with everyone recognizing that you and I are just hammering through this and we're going to take our best shot.” Sometimes it works, sometimes it doesn't work and you never know what the person's going to say. Anyway, I'm interested in trying to do some more of that.

Stephanie Goss:
I love it. I love it. Our call to action to all of you is that if there is something that you would love to hear role-played or that you would love to talk through from a specific perspective, send us a shout-out in the mailbag because we would love to see it. Awesome.

Andy Roark:
I think that's fine. Let's try it out and see how it goes.

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

Andy Roark:
See you, everybody.

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

What Do We Do When Accidents Happen?

Uncharted Veterinary Podcast Episode 208 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are tackling some serious questions that Stephanie lumped together from the mailbag. We've received some asks from veterinarians and managers facing the angry clients, online mobs, in-person harassment/bullying from people when the horrible, unexpected things happen. When a pet slips a leash and runs into the road in front of the clinic; when a patient dies with no warning during an exam; when a pet in boarding is gravely injured trying to escape their run during a thunderstorm. Things we all hope don't ever happen to us but are out of our control for the most part. These stories matter and the questions being asked by these brave leaders facing these situations matter, maybe even more than the story. Questions like “how do I emotionally support my doctor who is berating themselves for not knowing that pet was suddenly going to die with no warning?” or “how do I be there as a leader and support my team when we are getting death threats on our voicemail and people are being called out by name or their personal information shared online? How do I make sure we are all mentally okay at the end of the day?” These are wonderfully compassionate questions that Andy and Stephanie enjoyed looking at from multiple angles. Let's get into this…

Uncharted Veterinary Podcast · UVP – 208 – What Do We Do When Accidents Happen?

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


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She will also give you a comprehensive list of the obvious and lesser known hiccups clinics encounter along the way when hiring relief veterinarians and how to avoid them so you're at the top of your favorite relief vet's list in 2023.

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Episode Transcript

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

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

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

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

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

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

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

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

Stephanie Goss:
Hey everybody, I am Stephanie Goss, and this is another episode of The Uncharted Podcast. So this week's episode is brought to you courtesy of a handful of letters that we've received over the months in the mailbag. And they are all the big picture questions that have to do with when we have a catastrophic event in the clinic, something that involves a patient or a client. A patient dies under anesthesia, a pet getting walked in from the parking lot escapes, slips their leash and escapes, a pet who is boarding during a thunderstorm escapes and gravely injures themselves, those kind of things. When it's catastrophic, what do we do to support ourselves as the medical professionals involved in the cases? What do we do to support our team when we're leaders?
Because we've gotten some letters from leaders who have gone through these situations and are really struggling with feeling like not only are they trying to keep it together and deal with the lawyers and deal with the liability and the weight of all of that sitting on their shoulders, but they're also trying to deal with the weight for the emotional toll that it has not only on themselves but on the team, particularly when clients go on the warpath and there is cyberbullying or people coming into the practice and harassing or berating the team, when there's death threats, nasty voicemails, all of those things that we've talked about in prior episodes that can happen when something goes sideways and people go on the warpath.
These questions all have to do with how do we support ourselves mentally and emotionally, and how do we support the team? How do we be good leaders in times of crisis? Andy and I leaned into some of our own experiences and really wanted to talk through what do we do and how do we do this. I hope that this helps. I hope that it is a really good episode. Andy and I really enjoyed this conversation. So let's get into this one.

Speaker 3:
And now, The Uncharted Podcast.

Andy Roark:
And we are back. It's me, Dr. Andy Roark, and Stephanie, she drives me crazy, Goss.

Stephanie Goss:
I was waiting for a good one. Are you going to sing me the song, please?

Andy Roark:
She drives me crazy. I was thinking, we're like 200 episodes and change, and it's getting progressively harder to find names for you.

Stephanie Goss:
Hey-

Andy Roark:
I do want to say something to you because I've got a website here.

Stephanie Goss:
You started this game.

Andy Roark:
The 1,001 awesome nicknames, is what it is. And I'm like, I need to pull from this. And so I'm looking at it, and how do you feel about, and we are back, it's me, Dr. Andy Roark, and Stephanie, the talent, Goss. They've got-

Stephanie Goss:
Awkward.

Andy Roark:
Stephanie Tomahawk Goss. They've got animal themed ones. Stephanie the Mastodon Goss, or just Wild Cat Goss.

Stephanie Goss:
It puts me back to grade school when dumb boys used just random things to make fun of you.

Andy Roark:
Stephanie, Lord Privy Seal, Goss.

Stephanie Goss:
I can't with you.

Andy Roark:
What if I just called you subwoofer? Okay, I don't know what to do with this list, but someone put a lot of time into this, and these are good. Cornflake. If I could go back to being a child, I would have a friend and his nickname would be Cornflake. And I don't care, it would get tagged on someone.

Stephanie Goss:
For me, it was Snuffleupagus.

Andy Roark:
No. Really?

Stephanie Goss:
Yeah, that was about the fifth-grade dumb boy teasing. Got pretty epic with Snuffleupagus for a long time.

Andy Roark:
Oh, man. I told you I gave myself a nickname, right? The camp story. My brother and I were going to that summer camp and my mom was like, “It says here, it asked if you have nicknames, do you have nicknames?” And I said, “Yeah.” I said, “I'm Hawk and he's Ace.” And my brother and I were Hawk and Ace when we went to camp that year.

Stephanie Goss:
Did anybody actually call you Hawk or Ace?

Andy Roark:
Oh, yeah. Oh, they went with it. They were like, “We're supposed to call him Hawk.” Yeah, they called me Hawk. I was embarrassed by it by 10 minutes after I was there. I was like, this was a bad idea. It was one of those things where like three months before summer camp when you're filling out the paperwork, it seemed like a good idea. When you were actually there and people did it, it was like, no, this was a mistake.

Stephanie Goss:
That's fantastic. I love it.

Andy Roark:
Oh man. How have you been?

Stephanie Goss:
It's busy. It is full-fledged fall. We had our first storm of the season out here yesterday, and it was crazy. I live in the boonies so we lose power. I went to try to go to the post office to mail actually something to you and something to Tyler, and there was no power. And I was like, I guess … I'd been carrying it around in my car for a week and I was so proud of myself. I'm like, I'm finally going to the post office. No power. He's like, “I can't help you. I can't print stamps.” I was like, “Gosh darn it.”

Andy Roark:
Yeah. Oh boy.

Stephanie Goss:
How have you been?

Andy Roark:
Oh man, living the dream. I was like how have I been? Just running as hard as we can, building out next year at Uncharted. It's going to be amazing.

Stephanie Goss:
I feel like it's the time of planning this, it was always this way for me in the clinic too. Fall hits and you've got all of the craziness of the end of the year, but then you're also excitedly thinking forward to the new year, of what are we going to do? What changes are we going to implement? What are we doing for marketing and social media and all of that kind of stuff? And I always enjoy this time of the year, but I feel like it adds a whole layer of chaos to the chaos that already exists in the fall.

Andy Roark:
Yeah, I do agree with that. I will tell you that part of growing a business is planning farther and farther forward. So when you have a small business, you don't have to plan all that far in advance. And then the more people you have to coordinate, the earlier you have to plan and start communicating what you're doing. And I'm not saying this as a joke, this is really what I've learned.
And so it used to be that December was the time of planning for the next year, and then it was November and now it's October, pushing into-

Stephanie Goss:
July. August.

Andy Roark:
Honestly, it was like by September we really need to be working on what we're doing next year, like really need to be working. And I'm like, it's just interesting that things change, and I think that everybody wants to believe that there is a plan that a quote unquote good business runs. And I'm like, it wholly depends on where you are in the lifespan of your business and the size of the business and the type that you have.
And just one of the big things that you and I talk a lot about is it's not one size fits all. It depends on your culture and your team and your location and your objectives and your challenges and the skillsets of your people. And all these things play into how you run your business. But that also means that as those things change, the way you run your business is going to continue to change.

Stephanie Goss:
Well, and I think it's funny because we get asked questions a lot where the answer is if you have a team of three, you have a doctor and a technician and a CSR, the answer's probably vastly different than if you have a team of 100 or 30 or 23. And we talk a lot about that scale, and it's funny because you think about it uniquely siloed to the perspective of the clinic, but when you zoom out, those same problems exist in a different way in every business as it grows and as it scales.
And it's funny, I've been reflecting a lot on how a lot of what we're going through as a team in Uncharted is very similar to a lot of the things, different specifics, but same rules apply to a lot of the questions and things that you struggle with in the clinic. So on one hand, it's nice to know that you're not alone because everybody has the same kind of challenges.

Andy Roark:
Yeah. I remember I was in vet school and there was an essay contest, and it was a business essay contest. And I was like, I'm going to crush this. I'm going to tee up on this essay contest. And it was about, I can't remember the specifics of it now, but it was something about you're having this sort of toxicity or whatever inside this practice, or they're trying to get the practice organized. I can't remember. There was a growth thing going on.
Anyway, but I distinctly remember it was a one vet practice is what it was. And I think based on the finalists of the essay among which I was not one, it became clear that they were looking for this organizational idea, and the winner was like, “Well, we need to have department meetings and a surgery department meeting and all these other things.” And I remember just sitting there and looking at it and saying-

Stephanie Goss:
They have one doctor.

Andy Roark:
It's a one vet practice. What are you talking about? In my thing, I was very much like, these are important conversations. I thought on an individual level, I would make sure this person is on board with this and talk to this other person about this and understand their feelings on that. And that was not what they were looking for. They were a hundred percent looking for an org chart of how these things are going to go. But I just remember being like, “A surgical team meeting in a one vet practice?” You know what I mean? And it was so overbuilt, and I just, I've never gotten past that.

Stephanie Goss:
That's funny.

Andy Roark:
Anyway, just the dissonance of what they said it was and then the organization that they celebrated, I was like, these things are not compatible. What are we doing? Anyway.

Stephanie Goss:
It's just funny.

Andy Roark:
I hold that up not because I'm still bitter about losing the contest in vet school.

Stephanie Goss:
Uh huh, sure. Nope, not at all.

Andy Roark:
But because it goes to my point of I think that a lot of people think that there is a way that a practice is supposed to run, and I'm like, that's not correct.

Stephanie Goss:
So all of this has nothing to do with what we're going to talk about today. Storytime.

Andy Roark:
We should note the recording time and just let people know you can just skip to the four-minute mark if you like.

Stephanie Goss:
Storytime with Andy and Stephanie. No, we have a good one today. And so this is going to be an episode. It's interesting we've gotten some, I've been kind of collecting a few asks from the mailbag and they're all very different, and I don't want to share specifics from any one of them because I think they're representative of a bigger concern. And they were situations where something catastrophic happened in the practice from a medicine perspective.
So a patient escaped, got off the leash and escaped, or they had a death under anesthesia, or a patient was not under anesthesia, was just in the care of the hospital, and died. Things that are really either accidents or out of our control where there actually wasn't anything wrong. When you zoom out, and bless you all for giving us specifics, when we zoom out and look at the questions we would ask to make sure that we did the right things along the way, all of those boxes were checked but something catastrophic happened and you have the reactions of the clients and the people immediately involved.
And in all of these situations, obviously there was upset and anger and hurt and emotions on the part of the clients. And that is then all getting directed at the doctors, at the team, at the hospital. And in several circumstances, we've done episodes on this before, it explodes into the online arena. And then there is bullying and cyberbullying and people who are not a part of the immediate family berating the clinic and the team. And in some instances, personal information is getting shared online, people are being called by name, they're getting attacked.
So unfortunately we've seen enough of these circumstances in veterinary medicine in the last few years, and I was holding onto these because I wanted to talk not so much about what do we necessarily do in the moment, although a little bit of that, but there was some questions that were asked in each of these that really stood out to me because they were not so much related to the how do I deal with this, right? Should I get an attorney? Who should I talk to? But they were about, when we think about the bigger picture, how do we keep the team safe? How do we lead the team through challenges like this? And there were several cases where people were like, I feel like I did the right, we got an attorney, or I work for a company that has an HR and a legal department, and they were there to help us with all of the paperwork pieces of it, but how do I support the people who are involved?
And my heart went out when I read some of these because these are good people who are trying to do the best for their teams and their patients, and they're just feeling really, really overwhelmed with how do I create the space, the emotional space, and how do I deal with it? And I thought this is really good for Andy and I because so much of it is headspace, which is what we spend a lot of time talking about on the podcast.
And then also, there are actionable things and what can we do to help the team in specific. So some of the questions that I really liked is when the worst case happens, when clients are angry about something, how do we keep the team safe? How do we lead them through the challenges, and really, how do we handle the extra sticky situations like this?

Andy Roark:
Yeah, no, I'm glad you brought this up. And I really like the fact that they broke this apart and said just the people part. And I go, great, because this is a big sticky wicket. And depending on the specifics of the case, I would give you different advice on handling the other things. I really like the way they set it up and they were like, “We got our lawyer, we got our liability insurance people involved. We are checking the boxes, we are covering our bases, we've got the social media part under control. We've locked down things, turned off comments, we've done stuff.” All right, so I really like this a lot.
So what do we say to the team? I think one of the big things is the way that we address this with the team is the way that we address trauma with any group of people, whether it's family or any group of people who are going through a hard time. I think the first thing we do is acknowledge the elephant in the room. And that may sound silly, but a lot of people miss that trick because they're like, “I don't want to bring it up because they might not know.” It's like, they know. They are acutely aware, and you not talking about it, it doesn't show leadership, it makes them feel isolated and cut off, or it makes them feel powerless. It makes them question what is being done? What should we expect? Are we just being left alone in this?
And so I think it starts there. I think the first thing is start with the elephant in the room, is having some clear conversation that just says, “We see that this is going on.” And I don't want to heighten it. I don't want to say, “Boy, really hope people's addresses don't start getting posted online.” Don't give them ideas, don't heighten this beyond where it is. Resist the urge to let this spiral into something else. And I think that's a big part of bringing it back.
So I'll talk about the spiral part in a second, but that's how I would open it up, is to say, “The first thing to know is the staff is aware of this.” I think your job in leadership is reassurance. You don't have to fix the problem, you don't have the power to fix the problem, but let them know that they're not alone and you see it and we're this together. I'm not going to let you sit up at the front desk and be abused while I stay back in my office and pretend this isn't happening.

Stephanie Goss:
And on the flip side of that, I think, you said that the team is aware that this is happening. And I think that that's true. And I think that our first inclination, my first inclination, I had a situation where we had a patient who was in a carrier, we were bringing it in from the parking lot. The client was walking beside the member of my team. And it was a large cat, and they got freaked out by a noise in the parking lot and shifted their weight, and the carrier dropped and it popped open and the cat exploded out of the box and took off and was gone for three days. And it was hugely scary.
And the team who was there at the time that day knew what was happening because the person ran inside and said, “Hey, I need a couple of people to come help me fan out. We're going to look for the pet.” But then the rest of the day goes on, we still have patients, other patients that are being seen. Not everybody knows. And I think my inclination at the time was to try and control the potential for the game of telephone. And so I was like, “I only want to tell them what they need to know.”
And I think there can be the inclination to lean into not telling people because it's like you just keep doing what you're doing, don't worry about what's happening over here. And so I think on the flip side of that, it is important to know that when something like this happens, particularly if you have a larger hospital where team members aren't present, it's really important I think from a headspace perspective to think about how do you make sure everybody is aware of what happened and not so much everybody needs to know all of the details.
Because I think that is an important piece of the action. They don't need to know all the details. And sometimes, especially if it's a case where it's a legal situation, you might not want to tell them all of the details. But I do think it's important to make sure that everybody does know what happened. So the next, if you're on shift and you have a death under anesthesia, man, that is freaking hard. Those are some of the hardest days in veterinary medicine, and I hate to say it, but when you come in the next day, maybe you've been able to tamp it down and you're trying not to think about it, but it usually doesn't mean you've shaken it off.
And if you're working with somebody who wasn't on shift the day before, they're not going to know what happened and they're also going to not know maybe why you're acting the way that you are or where your head is at. And so I think it is important to make sure that everybody knows, hey, this is what happened. And that there is a process to talk about those things when they do happen.

Andy Roark:
Yeah, I think that that's a really good point. I think one of the things that I, one of the first things I want to talk about with the team, and now we're shifting away from dealing with medical mistakes, which we have a podcast episode about that and communicating that with the team and things like that. I'm shifting a little bit away from how we communicate medical mistakes inside our team to the client component. Because that's specifically what we're talking about, is when the clients go on the warpath and they go on social media and there's this external nastiness coming in.
I think one of the things that I want to do, so we start with communication about the elephant in the room, and the next thing that I want to talk about is valid versus invalid anger. And it's about, I think part of the communication stuff with the team is hey, we empathize with people and we try to understand where they're coming from and how they're feeling.
And I feel like we have done that. We want to do that, we want to think about this from their perspective. And at some point, there is a limit to what is valid in people's behaviors. Can you be upset because your pet escaped for three days? Of course you can. Can you make death threats to the people who own the building? No, you cannot. That is not normal, rational behavior. And sometimes we just have to call it out, especially for the people who are dealing with the client, because people will say, “You are horrible, you are a terrible person. I hope your children are injured,” blah blah blah. And sometimes when people say that to us, a voice in our head says, “Do I deserve this? Did I mess up this bad? I know this went really badly, but do I deserve this?”
So I think bringing your people together and saying, “We are going to empathize with these people, and then also, we are going to be clear about what is acceptable and what is not acceptable and what is unreasonable and what is unwarranted.” Because I do think that a lot of people struggle, especially, I tell you, I can remember cases in my past where things have not gone well and the clients have blamed me for things to my face. And I have eaten myself alive, saying, “Why didn't I anticipate this? Why didn't I see this coming?”
And I needed another doctor, my friend, to come to me and say, “What are you talking about Andy? You're not omniscient. You didn't do anything wrong. You didn't imagine everything that a pet might do in that moment. That's not failure, that's being a human being.”
And I just think it's really important to have those types of conversations about what happened and then about what is a reasonable reaction that pet owners can have and what behaviors are over the line. And that gives people permission to put up some barriers. It gives people permission to feel sadness for this person, responsibility, upset, and also say, “And at the same time, you posting online in every forum you can find that I'm a terrible person, that's not okay and that's not warranted and that's not justified, given what actually happened.” And so sometimes it is those conversations to validate what is okay and what is not okay.

Stephanie Goss:
Yeah, I like that. I like that a lot. I also think it creates an opportunity, too, for the team to talk about some of the things that might actually have nothing to do with this situation that's currently going on, but that may have happened in the past, that kind of got set aside, like the emotional blackmail situations with clients. It opens up the doors and creates opportunity to talk about those things, particularly with your front desk team, who gets it really, really bad sometimes from clients, about what is invalid anger, what is invalid behavior? Not just in terms of they're in the lobby shouting, but the specifics of what they're shouting. Where do we draw those lines?
And I think the good part is that it opens the door to having those conversations because in the moment, I think a lot of the time we may not take the time to have that because we're trying to let the emotions process and dissipate, like let's calm down before we have this conversation. And then I think a lot of the times the chaos of every day, it comes into play, and we have the best of intentions, but I'll be honest, I didn't always circle back and have those conversations.
And so I think taking it as an opportunity to say, “Hey, let's talk about some things that we have experienced, and we don't need specifics. We're not going to rehash old situations, but what are the specific behaviors? What are the specific instances that you guys feel like would be invalid behavior, invalid anger from a client?”

Andy Roark:
Yeah, I think those types of conversations are important, because here's the thing, and this is why it's important to have the conversation too, is the question is how do I help support the staff? I can tell you, Stephanie Goss, that I think what you're dealing with is complete garbage and no one should talk to you that way or no one should say that to you. Me telling you that is never going to be as powerful as you coming to that conclusion for yourself. And so me asking you, well, what do you think is valid and what do you think is over the line in the interaction that you had with this person?
And if you can say, “Well, I understand them being mad, and I would be mad too.” I would say, “I agree.” And you say, “But I do not think that they should use homophobic, racist language, slurs, whatever, profanity, whatever they're doing. I don't think that they should do that.” And I would say, “I agree with you. I do not think that that's acceptable.” And now it's not me just saying, “Hey Stephanie, that's not acceptable,” and I'm telling it to you. You're coming to that conclusion on your own, and there's real power in hearing your colleagues say, “Well, this was not okay,” and just coming to that consensus.
And so I'm trying to build solidarity, and that's why we have these conversations about what do you guys think about this? Now, the important thing is I think it's good to go here and have this conversation about what do we think and what is over the line in how we're being treated, how do you guys feel about what's happening? I think that's good, but we want to bounce out of that area fairly quickly. I want people to be able to say and validate and reach a consensus about what is justified and what is not, and then we need to move on.
And so I want to evolve the conversation from that to, okay, what will we do or can we do to prevent things like this from happening again in the future? And the answer may be nothing. It may be this is a hundred percent out of our control. This was a lightning strike thing. The owner put the cat in the carrier, and the carrier was not put together well, and it didn't even make it across the parking lot to us. I don't know what we do. Maybe send people a text reminder to make sure if they have any questions about assembling their cat carrier, they can call us. I don't know.
So for example, we had a case years and years ago, I worked at a place and we had dog boarding, and a thunderstorm came up and this dog that we did not know was storm phobic just went bananas. And I can't remember how he got out of his run, but it was something that should not have happened, meaning he tore through chain link or something. Something you go, superhuman panic. It's heartbreaking, right?

Stephanie Goss:
Yes.

Andy Roark:
The panic. And then the dog sprints down the hallway, jumps up, hits the bar on the emergency door, and is gone into the night in the storm. And it's just like, oh my God. The question is, what can we do differently? Is it questions, direct questions about how does your pet respond to storms? Things like that. Maybe if we can't do anything to, we should lock the fire door. You can't do that. That's not going to go over. But are there questions we can ask? Are there other things? Maybe pets that have storm phobias, they go into different areas. Maybe there's a different monitoring, I don't know what's possible. We can get creative.
It's called credibility. And when I teach dealing with angry or complaining clients, I talk a lot about credibility. Credibility is figuring out what happened, why it happened, and what we're going to do to prevent it from happening in the future. And I like it for a couple of ways. Number one, it's one of the most powerful things you can say to the pet owner. You can say, “This is what happened, this is why it happened, and this is what we're doing to prevent this from ever happening again in the future.” And it's owning the mistake in an appropriate, productive way and talking about how this is going to be taken care of and it's not going to happen to anyone else again. And that is a very powerful thing that often doesn't happen.
So I like it because it is cathartic for the pet owners. It makes them feel like justice is being served and moving forward and this has been owned and it's being fixed, but also, it puts the power of the situation back to some degree into our hands as vet professionals and say, “All right guys, what in this situation do we have control of? We have control of what we do to prevent this in the future.” And so it's giving some power back to people who might otherwise feel powerless.
Finally, it also gives you clear talking points. So if you are being attacked from the outside, on social media, things like that, I don't want my people engaging on social media. However, if we're going to communicate, we can communicate what we are going to do or what policy changes we are making to make sure this does not ever happen again. It shows how much we care, it shows that we're working on it. It is a positive thing to put forward to say, “We are reviewing all of our policies and protocols. We plan to make some updates to things that will prevent accidents like this from occurring in the future.” Things like that. And again, without knowing specific, without talking about specific instances, I can't tell you exactly what the wording would be.

Stephanie Goss:
And I think one of the things too, and this certainly does not apply in every situation, but I think that there also creates opportunity there. And it's why I feel really thankful that I have the tool in my toolbox of knowing that I can always apologize for the impact to somebody. I can't apologize for something that was out of my control. Like your example, I can't apologize that a storm hit. I do not control that. But I can absolutely apologize for the impact that it had to them because I am sorry, I am so sorry that their pet was so scared and that it escaped and that whatever happened to it happened. And even in that worst case scenario, I can empathize with them, and that is a superpower here.
And I've been in the situation where empathizing with the owner, and to your point, Andy, having the conversation with them to say, “I can't change this for you. I wish that I could. I can't change it for you. I can't make them come back.” I remember being a very young practice manager and having a situation happen in our clinic where a pet that was supposed to have a private cremation was not tagged and they were group cremated. And I remember it was my first time handling something big like this, and I remember sitting in an exam room with the client and I remember just looking at her and saying, “I wish that I could fix this, but there's literally nothing that I can do to solve this for you. But I want you to know that I am hearing you, I am seeing you, and if I could make this different for you, I would. And I need you to understand that I'm going to do everything in my power to make sure that this doesn't happen to somebody else.”
And that may not bring them comfort in the moment, but being able to say that opened the door for that client, who actually called me a couple weeks later and said, “I've been thinking a lot about what you said, and I have some questions about what you do do.” And they were wonderful. Unfortunately, it was one of my all-time favorite clients, but she had this conversation with me and she asked me questions that I hadn't yet thought of, of what were our processes in the clinic.
And it actually helped me figure out how could we help prevent this from happening again. Because they weren't looking at it from the narrow inside perspective that I was, which is like, what are we doing? How can we fix this? She was asking different questions, and it enabled us to look at our protocols and processes in a way that was completely different and helped us solve some of the challenges. And I think we don't get to do that if we don't open ourselves up for that vulnerability. And it's not always right. There are absolutely circumstances where I would not touch that conversation with a 10-foot pole and without an attorney present, right?

Andy Roark:
Yeah, sure.

Stephanie Goss:
And at the same time, I think we can always apologize for the impact.

Andy Roark:
Yeah, I like that. I just start tying credibility and apology together. I think it's important.
I met this vet one time, and we were just talking and we were just telling stories. And I wasn't speaking, I was at a CE event, I was totally doing my own thing. And I met this guy and we were just talking and it was kind of, you sort of bump into somebody and you're just killing time and one thing kind of leads to another and you end up having this really weird, deep conversation. You know what I'm talking about?

Stephanie Goss:
Yep.

Andy Roark:
It was that. I was talking to this guy and he told me this story, and I don't remember if I asked him for a, I don't remember how in the world I got him to tell me the story, but he said, and I swear this is true. He said, “I've got a story for you.”
He said, “I was doing a dental cleaning on this cat, and the clients were wonderful clients. They had multiple cats who came to our practice.” And the cat had a mouth gag when it was intubated, and they extubated the cat and put it into one of the dens to recover, and nobody watched the cat. And it comes to the end of the day, the cat's dead in the den. And he goes and he looks and the mouth gag was still in. Nobody pulled the mouth gag.

Stephanie Goss:
Oh no.

Andy Roark:
And so the cat suffocated and died.

Stephanie Goss:
Oh no.

Andy Roark:
And he said to the pet owners that there was an unexpected complication during recovery and the cat died.

Stephanie Goss:
Oh no.

Andy Roark:
And the owners were just distraught and they went home. And he sat there and he just couldn't live with himself. And so he leaves the clinic and he goes and gets in his car and he drives to their house, because he has their address, and he knocks on their door and he tells them, “What I said was not true. This is what happened.”

Stephanie Goss:
Oh no.

Andy Roark:
And, “I am so, so sorry.” And he said, “I'm going to figure out how to make sure this never happens again.” And those clients were involved with him figuring out what the protocols were going to be in the future, and he kept them in the loop about what they would do. And he kept them as clients, and they continued to come back because they were like, “You came and you sat here in our house and you owned up and you told us what happened and then what you were doing about it.” And he kept them as clients.
I have never forgotten that story of just like, I get it. You know what I mean? It's the human experience on display where this is a terrible mistake and you can't fix it. And I understand panic and saying, well, just tell them there was a complication. Which is technically true. I get it. I get that impulse. I also get the impulse of being eaten alive by guilt and saying that's not true and that's not fair.
So anyway, but I've never forgotten that story of just owning it. This is what happened, this is why it happened, and I'm going to figure out how to make sure it never happens again. And I'm serious about that. And so I do think that those types of conversations about what can we own here, again, after setting aside what is, as far as anger, what is valid and what is invalid, then we can say what are we going to do about it? Because if you don't set aside valid and invalid, you make people feel like they deserve, we made a mistake and we deserve this. You have to pull those apart. I think that's really, really important.
I think that when we start talking about where do we go from here, one of the things that you're going to battle in yourself for very, very valid reasons, and in your team, is defensiveness, right?

Stephanie Goss:
Yeah.

Andy Roark:
I mean, when people are online attacking you, it feels awful. And you do get defensive and you feel like your reputation, which you have worked so hard for, is being destroyed. And I've got a news flash for people. Brace yourself, buckle up. You're not going to hear this coming. You're not always treated fairly in the court of public opinion.

Stephanie Goss:
Imagine that.

Andy Roark:
And I talk a lot about this too, and this is one of the things I'm really anti-social media, I'm really anti-social media in general these days in a lot of ways. But this is one thing I'm specifically, intentionally, very much over the top focused on, is the fact that veterinarians make great villains online. Everybody hates a hypocrite. It's why Ellen DeGeneres got torn down, like career ended when people found out she wasn't nice. If people found out Clint Eastwood isn't nice, they'd be like, yep, that tracks. You know what I mean? Like yep, he's a grumpy-

Stephanie Goss:
He's a grumpy man.

Andy Roark:
Being nice is not required for adoration unless you're Ellen DeGeneres, who has this reputation of being the queen of nice. James Corden is getting torched right now because of being crappy to a waiter. And I don't know whether he deserves that or not, but you can't convince me he's not getting torched entirely because his whole persona is Carpool Karaoke, happy, fun guy. And people go, “He's pretending to be happy and fun. In reality, he was nasty to a server.” And so they torch him for it. People hate a hypocrite.
And the problem that we as veterinarians have and vet professionals is, is that we have Ellen DeGeneres' reputation, we have James Corden's reputation of being the fun, wonderful, happy, loving people who would do anything for you. And then when things don't go right or when we're not able to do anything for you, we take the fall like Ellen and James Corden do. Because if your attorney, if someone's like, “My attorney screwed me over,” people are like, “Welcome to the club. Are we getting mad about that now?” It's kind of a thing that they're known for. And my brother's an attorney, I can say that. But no one gets their hackles up when people say, “My attorney is a crook.” They're like, “Of course he's a crook, he's an attorney.”
And that's not fair to attorneys. But I just use that to illustrate the difference between them and veterinarians. And in this social media world, being dubbed a loved profession, it has a downside. And it's that you make a great villain, you make a hypocrite, you make a horrible villain. And so I don't know that attorneys get mobbed the way that we do by strangers who don't have any idea what's going on. And maybe I'm wrong in that. But I do think that we are uniquely situated to get absolutely hammered on social media by faceless mobs.

Stephanie Goss:
Yeah, I think that makes sense. And we know that the keyboard warriors exist because there is the facelessness, right? People can say whatever they want and there's no consequences because there's a screen and a keyboard between them and the people. And I think that we've talked about this lots of times on the podcast, how social media has this ability for people to be able to be big and scream and rant and have it be this huge thing.
And I think it makes sense, what you said was a light bulb moment, because it totally makes sense. People think about veterinarians as the big hearts, the all creatures great and small. And it's at the heart of a lot of our challenges in veterinary medicine, particularly when it comes to things like money, but also when it comes to problems like this because then we make a really good, easy villain.

Andy Roark:
Yeah, that's my point. So I think that we get unfairly targeted or we draw passion from online mobs in a way that a lot of other professions don't. Nobody mobs the auto mechanic. Not that I can see, but maybe, again, maybe if you're in the auto mechanic Facebook group you're seeing a lot of things I'm not, I don't know. But it doesn't feel that way to me. It really is, everybody online hates a hypocrite. And when people say, “These people could have saved my pet and didn't. They charged me for money that I couldn't afford and they wouldn't take care of my pet,” we hit that-

Stephanie Goss:
It's an easy target.

Andy Roark:
… button in their mind. And we get torched in a way other people don't. And that's why I think I specifically look at social media as being bad for vet professionals. Now what I was saying was, resist the urge to get defensive. The reason is because it does not help. If you are wading into an irrational mob, it does not help. And again, I've had lots of debates with other people about responding to negativity online. And I will be up front, I own my position and I have had plenty of people who are very, very smart argue with me on it. My position remains unchanged, with very rare exception. It is better not to engage.
And people are like, “No, you should do it.” No. You should talk to the individual who's involved, you should communicate, you should do things like that. But wading into online drama does not tend to go well. It just doesn't. All it does is re-attract attention, stimulate people to post more, to write more, to call more. And it keeps the drama going, as opposed to laying low and letting it go.
And again, this is very much about the specifics of the case, but I think people feel too much of a pressure to respond to the masses. And I don't think those people deserve a response. They don't know what's going on. They don't have the information. And you are not going to change their mind because they don't want to have their mind changed.

Stephanie Goss:
Right, exactly. Yeah.

Andy Roark:
You can choose to be righteous or effective, and if you want to be righteous, you can wade into the crowd with your flaming, raging sort of justice, seeking to defend your honor. You can do that, or you can be effective and to say, “How do I make this go away as fast as possible?” And a lot of it is don't engage with it, and it's going to run its course in three days and it will be a distant bad memory in three weeks.

Stephanie Goss:
How do you feel about taking a break and then coming back and talking about some of the actual, like some of action steps in particular for how do we support a team?

Andy Roark:
Yeah.

Stephanie Goss:
Hey friends, it's Stephanie, and I'm jumping in here for one quick second because there's a workshop coming up and it is one of the last ones for this year of 2022. And I want to make sure that you don't miss it because it is coming to you from my dear friend Maggie Brown-Bury. Maggie is a former emergency veterinarian who lives in Newfoundland, Canada. And a few years ago, Maggie made the decision to make a change, and she moved out of ER medicine into being a relief veterinarian. And I remember Maggie telling us within weeks of opening up her schedule, her whole first year was booked.
And so we asked Maggie to come and do a workshop for how to get the most out of the relationships that you build as a practice with your relief veterinarians. Because more and more practices, as we face the veterinarian shortage, are struggling with needing to have relief doctors on their schedule, maybe more regularly than we would have previously. And Maggie's got some great ideas after working with a ton of different practices on how you can leverage that relationship and set yourself up for success, set your relief veterinarian up for success, and set your clients up for success. So if this sounds like something you'd be interested in, head on over to unchartedvet.com/events and find all of the information about the workshop and how to sign up. I hope to see you there. And now back to the podcast.

Andy Roark:
All right, let's start to transition a little bit. I've ranted about the internet and mobs and negativity.

Stephanie Goss:
You, Andy Roark, getting on a soapbox?

Andy Roark:
I know. All right, let's change this into some actual action steps. So number one, like I said, open communication with your team about what's going on within legal boundaries. Obviously we don't fill you in on the details on something that may be going to the state board. But they need to know what's going on, especially if they're getting hate from outside, the phones are ringing. They need to know what's going on. So part of it is they need to know that this is not being ignored. It is being worked on, that it's being addressed. That's number one.
Number two, we should have a conversation about what is valid here and what is not valid here. And so that we're all in agreement and we can have this conversation and support each other. We can start to shift the conversation from there into what are we going to do about this? Where do we go from here? How do we prevent these things from happening in the future? And part of that is making our people feel empowered. And it's also about coming up with what our talking points are going to be.
And that's the next part for me in this, and this is still equipping your people, but it's figuring out what are the talking points that they're going to have? What are they going to say when people call? What are their options? And they don't have to talk everyone into pieces. My favorite thing is called the broken record defense, is where you say, “This is what we can say, this is what we're working on, this is where it goes from here. And that's really all that I can tell you.”
And when people ask questions, basically you end up with-

Stephanie Goss:
Repeating.

Andy Roark:
Those little three pieces of information, and we give it, but we're not going to get drawn off track. We're not going to comment on other things. No, we're not going to connect you to the doctor. This is where we are. And it's helping people know what to say so they feel prepared and they feel supported.

Stephanie Goss:
Yeah. I think for me, when I think about the question of how do we support the team, it struck me because in one of the mail bag letters we got, they were like, “We had the legal side of this covered and that was great.” And I think it's important to say this is when the worst things happen, right? We're talking about the really unexpected and the things that are really catastrophic for an owner. Do not DIY this. Do not go it alone. This is where you pay professionals.
And my fellow private practice owners, this is where we have to say, we're going to dig into our pocketbook, because you should not, and [inaudible 00:50:31] is wonderful and they have attorneys on staff and obviously you should utilize all of the liability resources that you have. But this is also, especially, especially if people are sharing, calling people out by name on social media or in reviews and stuff, giving personal information about your team, you have to outsource this. You have to get a lawyer and get help because there's so many ways that they can help. And even if it's not something that they can provide, they can provide you additional resources that you should have at your disposal for those catastrophic situations. So don't go it alone.
And I think for me it's the same when it comes to supporting the team. This is where we need to lean into thinking about our responsibility as employers. And so I'm going to put on the HR hat for a second and step on that soapbox because at the end of the day, it is our responsibility to provide a safe workplace. And so if we have catastrophic situations which are inevitable, we can't control everything in veterinary medicine and accidents are going to happen, we have to still provide a safe workspace for our teams.
And so if there are situations like this and a perception is that we're not doing things to make it safer for our team, we can absolutely be sued as employers. And so I say that not to create fear and make you panic and go, “Oh God, that's another thing that's going to keep me up at night,” but it is something that we should think about.
And so for supporting the team, you and I, Andy, talk a lot for a variety of reasons of why, and employee assistance programs or EAPs are great, that is a really easy first step here in terms of supporting the team. So having a program in place where they can get assistance, including counseling, because when we have situations like this, where especially if a mistake was made, having access to counseling, having access to professionals who can help your team talk through those situations and deal with the emotions that they are going to feel, is really, really important. And if you don't have an EAP, or even if you do, depending on the circumstances, you may want to consider outsourcing additional help, like bringing in a grief counselor to talk to the team as a whole or individually, offering ongoing therapy for your doctors.
Generally, every time I had a doctor have a board complaint, part of it was that they needed to have access to talking to somebody. And if they declined, that was fine. But I wanted them to know that, hey, this is hard. You're going to have to defend yourself, and even if you did nothing wrong, that is a hard thing to go through as a human being, and I want to recognize that and provide you the opportunity to have someone who is professional. It's not my job as the manager, it's not my job as a practice owner, and I'm not qualified to do it, but you should have access to somebody. So providing them the support and resources that are professional I think is really important.

Andy Roark:
Yeah, I agree with that. So at Uncharted we have BetterHelp as an employee benefit, and it's not a plug for BetterHelp, but it's the one that we use and we have. So the way it's set up, I actually like the way it's set up. The way it's set up basically is you set it up as an employer and then if people want to schedule time with a counselor, they can. And I don't know those who use it and who doesn't. I get a breakdown on how much it was used and things like that. And that's it. It's not super cheap, it's not super expensive, but it is a thing that we've done as an employee benefit.
I don't see anything wrong with having it as a short term employee benefit if your staff is going through something like this, and what if you said we're going to offer this for three months and anyone who wants to have a counselor for three months can have it, and that's what we plan to do. It was not hard to set up. It has got some nice privacy controls on it as well, and it was just a thing that we were able to make available and our people can use it as they need to.
And so anyway, I like the EAP a lot. If your EAP has limitations in how much counseling there are or if you feel like your team needs something more than that, there are other ways that you can access professionals and get them some support as well.

Stephanie Goss:
I think the last thing in terms of resources and professionals that ties to this, and it's a little bit of the in the moment, but also a little bit of the abusive behavior, and so your team should know who to call for help. And I say that because I had a situation where we had a client who was being verbally abusive. It started pretty mildly in the lobby and escalated very quickly. And when I found out about it and then they went out, they finally left the building and they were hanging out in the parking lot. And when one of the team members went out to get another patient, they physically accosted the team member in the parking lot.
And when I was asking the team about what happened, because I wasn't there at the time, they were just like, “We were fine. We felt like we could handle it.” And I asked the question, I was like, “Did anybody call the police?” Literally the police station was across the street from the practice. They were like, “No.” I was like, “Why not?” And they're like, “Well, because it didn't feel serious enough.” And I was like, “You guys.” Then it opened up an opportunity for us to talk about it as a team because the person involved didn't think that it was a big deal. But when I looked at it, I was like, dude, if they're physically accosting us in the parking lot, you should have called the police because that's what they're there for. They're there to help protect us.
And I think it goes back to what we were talking about earlier, Andy, which is you want them to bring up the ideas, but also, we're all going to have different ideas on what the level of invalid is, righteous, or sorry, valid or invalid anger. And so for me, I was like, this is invalid behavior. This is a line in the sand. And it created an opportunity for the team to talk about it and for us to talk about those protocols of what do we do for personal safety, what does that look like, at what point? And we had a wonderful conversation, and it helped pave the way for me to create this rule with my team, which is no one should ever feel like they cannot pick up the phone and call 911.
If there is truly, they feel threatened or intimidated, that's what I want them to do before they do anything else. Get a professional there to help you. And I can think of a whole multitude of situations in veterinary medicine where that might be applicable, but your team won't necessarily use that if they don't feel like you're advocating for it.
And so I think part of it was having the conversation open the door to me in my mind, even as a manager, of like, hey, remember when you're in grade school and you do the safety drills and you know to get under the desk and duck and cover when we have an earthquake? I lived on the West coast as a kid, obviously. That's a thing for a reason and it kind of stops in adulthood, but it shouldn't. Like when we think about our practices, for me the last piece of this is we should be prepared for what we can be. And some of that is the safety drills. It is knowing who to call, when to call, and having those ongoing conversations, but also practicing it so that everybody knows this is what we do when those catastrophic things happen.

Andy Roark:
Yeah, I like that a lot. I think that that's really good. I think that those are some hard and fast resources for keep taking care of the team. There's one more sort of soft resource that I want to add to this, and I need to couch it just the right way because I don't want it to come off wrong. When people are going through cyberbullying or they're feeling this pressure from clients, they're feeling a lot of negativity, it's important to [inaudible 00:58:21] everything that we talked about, justify them, validate them, support them, all those sorts of things. I find that it's really important to try to point to the good things that are going on in the practice and what is going well and the good that we do in the world. And I'm not saying that in a way that invalidates the bad feelings that they have.
So there's two things that I point out. I picked my daughter up from high school yesterday and I was taking her out, she wanted to get a birthday gift for one of her friends, and so we had to drive. So I pick her up at 4:30 and we're going right into traffic. And Greenville is a growing city and we're going into the city part, and it sucked. The roads were packed, and there was this guy in this like BMW SUV and he was driving like a maniac. He came shooting down the road, he did that thing where he was in the left lane, he cut right behind me. He literally missed my back bumper by three feet, you know what I mean? As he cut all the way over in the other lane, and you just see him cutting people off and cutting back.
And he's doing that thing where he's driving wildly, aggressively, and he gets to the stoplight one car length ahead of where he would've been if he had just calmed the eff down, you know what I mean? And driven. And you see the guy and he's cutting through and just, he's driving like a maniac. So I get my daughter through all this stuff and we get back home and my wife goes, “Well, how was it?” And I was like, “Traffic is terrible. People are crazy.” And I thought about it later, I was like, you know what, I was probably next to 800 cars. There was one guy that was crazy, one guy. That's like a 0.01% of the population. But that guy wildly affected my interaction, my perception of this interaction I had with a thousand other drivers.
And I bring that up because it's negativity bias. We have this one thing that we, oh my God, and it deeply affects everything else. Well, the same thing is true when we have bad experiences like this, if something goes wrong or people really go over the edge in being negative or angry, and that same thing of, oh my gosh, traffic was horrible. The truth is, it's one guy. It's sort of the same thing with this.
And so getting people to realize and say, so I talk about, it's called negativity bias. It's our natural instinct to remember the negative things and give negative things more weight in our mind because it keeps us safe. That's why it's hardwired in, because it keeps us safe. And so putting those sorts of things out and just talking to the team and saying, “Hey, when we have a negative experience, we tend to see negativity everywhere. And I want you guys to remember that we do great work, and there's so many people that we help and so many people who are supportive of us, and don't forget those things.”
And then don't make it a big deal, but go the extra mile to call out the things that you see people doing well. And it's not about, hey, don't worry about this other thing because of blank. It's like, no, it's just, “Hey, I saw you doing this thing and it was really great. Thank you very much. You're really great at your job. Hey, those people were just completely smitten with you and how you treated them. That was really amazing to see. Thank you.” And lift people back up because they're getting beaten on, you know what I mean? You can make their day a little bit better just by recognizing them and appreciating them for the work that they do, to try to offset the crap that's falling from above.

Stephanie Goss:
Yeah, I like that. I think the other thing too, besides seeing the good things, and this is going to sound silly and it is a little bit silly, but it's also not meant to belittle it, is sometimes leaning into things that really make us happy in veterinary medicine. So find the puppies and kittens, man. Bring a petting zoo to your team. Do the things that are positive. And it's small and maybe it is silly, but I remember a period in my career where I was helping, I was working off the floor as a manager, but we had new people at the front desk and the area that they hadn't gone through in terms of training yet was euthanasia. And so I got called to come in and do the front desk piece for all of the end of life cases that came in.
And it sounds strange, but I enjoy that piece of work, but it also is not without a toll. And so I remember feeling really, really negative because I was like, dude, I get all the crappy sad all the time. That's all I'm focusing on. And I remember venting about it to one of my technician friends at the time, and I just needed to say something. I wasn't saying it and actually asking for help. And I remember, I don't know, half hour, 20 minutes later, she comes in my office and she's like, “Come with me right now.” And I was like, oh God, another case, I can't, I can't. And she brings me into an exam room and there's a literally a bucket of puppies in the room.

Andy Roark:
Oh man.

Stephanie Goss:
And it was so good. She's like, “You needed puppies.” And she's like, “You just need to sit in here for 15 minutes.” She's like, “We're not even ready to deal with them. Just sit in here and entertain them.” And it was so good and it was so simple and it was silly and it was what I needed to break out of that.
But I think thinking about those little things that we can do to think about what is really good about our jobs and get them to think about smiling, because we can't fix it. The reality is we can't make the behavior stop right away. We can't make the negative reviews stop coming in. I mean, we can kick a client out of the building, but we can't do anything to take away that feeling in the moment. And so I think your point about what is the positive, what can we control in this situation, and what are some of those things that we can do to just bring a little smile to somebody's face? Even if it doesn't take it away, for that moment it felt really good to sit there and cuddle puppies.

Andy Roark:
Yeah. You remind me of what we talked about not long ago. It's like sometimes you have to walk in the rain. You may not have done anything wrong, but it just, it's going to rain on you. And that's just life. We all have to walk in the rain. Yeah, I've been thinking about it a lot recently. It's like we go through hard times, and you can't make the rain stop. You know what I mean? It's out of your control.
But you can find little things to enjoy on your walk in the rain. You know what I mean? You can find little warm spots, maybe little dry spots along the way. You know what I mean? And I think a lot of times that's the best that we can do. I don't know. I think that's all that I got. I think we've kind of worked through.
I think sometimes it's really hard, and these things are a lot like a force of nature. It's about motivating your people to walk in the rain. It's about trying to make them find enjoyment in what we do. It's not invalidating the fact that we're walking in the rain. It's walking in the rain with them. And just being a part of it. Make sure you get them all the support that you can, but then just be there for them and know that sometimes we can't fix things, sometimes we just have to walk through them. But my experience in all of these things is that this too shall pass. It will pass.

Stephanie Goss:
Yeah.

Andy Roark:
Well, Stephanie High Octane Goss.

Stephanie Goss:
Was that from your website?

Andy Roark:
It was.

Stephanie Goss:
Ace. Ace was-

Andy Roark:
How about Stephanie Half Pipe Goss? Mustang. There's literally 1,001 of them here.

Stephanie Goss:
Okay, I think we're done for the day.

Andy Roark:
I think that's enough.

Stephanie Goss:
Take care, everybody.

Andy Roark:
See you, everybody.

Stephanie Goss:
Well everyone, that's a wrap on another episode of the podcast. Thanks for tuning in again this week, as always. We love spending time with you. And before we go, I just wanted to say I am getting so excited to head to Greenville in just a few short weeks. We will be there for our Practice Owner Summit, which is happening December 8th through 10th. This is a giant, giant thank you shout out to our sponsors for helping make this event happen. This is one of my favorite events of the whole year. It is so much fun.
If you are going to be there, I can't wait to see your face. I have all the hugs for everybody, including our sponsor friends. And so I just want to shout out and say thanks to Royal Canin, Hill's, Care Credit, IT Guru, and Chronos for making this event happen. Take care, everyone. Have a fantastic week. Be kind, and we'll talk to you again soon.

Playing Nice With Your Competition – What’s the Point?

Uncharted Veterinary Podcast Episode 207 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are tackling a question Andy was asked about working together with our (local) competition. A manager in a rural/remote area is wanting to connect with other managers. It seems the veterinarians in the area don't all get along and see no reason to work together. These managers are looking at it from a different lens and wondering “Isn't there a point to us working together?” better yet, they are asking “how do we explain this to the vets who don't agree with us?” Let's get into this…

Uncharted Veterinary Podcast · UVP – 207 – Playing Nice With Your Competition – What's The Point?

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

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Episode Transcript

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

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

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

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

Stephanie Goss:
Yes.

Dr. Andy Roark:
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.

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

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

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

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 answering a question that he got sent about playing nice with your competition. It is from a manager who lives in a small town, rural environment and is wondering what the benefits are of getting to know the other managers in the area. The doctors involved in their practice and the other practices don't seem to get along, don't seem to care, don't seem to want to get along, and they are looking at it from a different perspective and wondering, “Is there a point to playing nice with our competition? Are there benefits if I work together? because I like the manager at this other practice over here and I would like to get together and pick their brain about some things. How do I go about doing this?” I'm going to tell you, this is an episode where I get really excited because this is my jam and I can't wait to talk about this. So let's get into it.

Speaker 3:
And now, The Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark and Stephanie Fight Like A Title Holder Goss. That's a song. It's punk. I've been listening to a lot of punk rock music recently. I have just been feeling like an anarchist recently and I listen to Rancid Radio on Amazon Music.

Stephanie Goss:
Stop it.

Dr. Andy Roark:
No, I'm serious. I missed a trick when I was young. I should have been into punk music. I love it. I love it.

Stephanie Goss:
The mental image I have in my head right now of Andy Roark as a punk is amazing. It is a job for Jen Galvin's photoshopping skills because it is an amazing mental picture. I need to just enjoy this for a second.

Dr. Andy Roark:
Blue mohawk and a thick nose ring, like a big ring.

Stephanie Goss:
Oh, I was imagining a nose ring. I was imagining some eyeliner, black, ripped clothes, safety pins. Oh, it is a good mental picture.

Dr. Andy Roark:
I could have… I'm serious like-

Stephanie Goss:
Stop it.

Dr. Andy Roark:
There is a pathway in my life… It was a door never opened to me. My parents never showed me that door and I didn't have punk rock friends. I think I was 10 years too late for punk rock. I hit high school in 1991 and I think if I had hit high school in 1981, I would've been counterculture, I think.

Stephanie Goss:
I can't.

Dr. Andy Roark:
The band 311 was just blowing up and I saw a show they did in this little community center and there was a mosh pit and it was so great. I was like, “I've never done this before but I really enjoy it.”

Stephanie Goss:
Oh my gosh.

Dr. Andy Roark:
I can see through the multiverse. There is a… Not this-

Stephanie Goss:
There is a punk Andy Roark.

Dr. Andy Roark:
I'm still punk rock veterinarian because I don't see that changing. So I've got a chihuahua that also has a mohawk. I would get a Chinese Crested with a Mohawk-

Stephanie Goss:
Oh stop. Oh my god.

Dr. Andy Roark:
Stick it to the man.

Stephanie Goss:
That's amazing. Okay. Add that to the pile of facts that I did not know about Andy Roark.

Dr. Andy Roark:
Yeah.

Stephanie Goss:
This is a mental picture. I'm quite enjoying this. Thank you for starting off the afternoon like that.

Dr. Andy Roark:
I discovered the band NOFX. I'm not sing you anything that they sing-

Stephanie Goss:
I actually know NOFX. Okay.

Dr. Andy Roark:
Yeah. That was a new discovery for me. I was like, “This is music I was unaware of.”

Stephanie Goss:
Okay. I kind of like it. I kind of like-

Dr. Andy Roark:
I think it's what I'm going to do with my 50s. I've got a couple years before I get there. I think when I turn 50, it's going to be like, “I'm starting over. Leather and chains.”

Stephanie Goss:
That's so funny. No. Okay. So now, I have to know, what was the musical choices of Andy Roark, the teenager, the actual high school? If you weren't listening to NOFX back then, what were you listening to in the '90s?

Dr. Andy Roark:
Oh man. Probably my favorite band in high school was Red Hot Chili Peppers. The album Blood Sugar Sex Magik came out, the best album ever. I love it which is why I could also say, I can 100% say punk rock Andy Roark given how much I enjoyed Red Hot Chili Peppers like there's-

Stephanie Goss:
Were you allowed to actually have the CD or did you have to get it in secret because your parents wouldn't-

Dr. Andy Roark:
Oh no. Well, I had an underground pipeline of music. I listened to a lot of gangster rap like I was N.W.A, Ice Cube. I had all of that stuff and… Exactly. I'm like, “Oh, punk rock.” Actually, punk rock might have been a better fit for me but we went with N.W.A and Ice Cube and I had a great time and enjoyed it.

Stephanie Goss:
Okay.

Dr. Andy Roark:
So anyway. Yeah, that was it.

Stephanie Goss:
I like it. I like it a lot.

Dr. Andy Roark:
Who knows? Maybe if I get to go around the world again, I'll go a different direction next time.

Stephanie Goss:
I like the multiverse punk Andy Roark. That is a mental picture that's not going to leave me anytime soon. I like it.

Dr. Andy Roark:
Oh. That's good.

Stephanie Goss:
All right.

Dr. Andy Roark:
All right. What do we-

Stephanie Goss:
Well, speaking of high school, we got a great message from someone who is a manager and they're a manager in a rural or more remote area and they've had a lot of practices in their area who have had transition. It was kind of all of the vets who were getting older and been in practice a long time and now, all of a sudden there's a lot of young whipper snapper vets buying the practices and/or corporate practices that have come into the area.
And so, the doctors have some animosity between clinics. There's not really a friendly vibe in the area that the clinics get along and there are managers in these clinics who have not been a part of any of that drama and who are looking at how can we connect with each other. How can we work together and have relationships, good healthy relationships with our competitors?
Gosh. Gasp, right?

Dr. Andy Roark:
Yeah.

Stephanie Goss:
How do we have relationships? Particularly, in a small town environment that are good. How do we play nice? But also, it asks a bigger question of like, “What's the point?” Because that was one of the questions that their owner doctor asked, “What's the point of playing nice with our competition?” and I just thought this was such a great fun question and I have some ideas having been come up as baby manager in a rural environment like that. So I have some thoughts but I thought you would have some thoughts on this as well.

Dr. Andy Roark:
Yeah. No, no. Definitely. Yeah, definitely. I think the questions of… So this is an old-school problem, right? I've been hearing about this for a long time about our competitors. I don't get the feeling that this is much of a thing with the new school owners and managers, right? I think it was much more, when there used to be single vet practices and I think when there were smaller towns or when there was overlapping call areas, I feel like there was a lot more competition.

Stephanie Goss:
Sure.

Dr. Andy Roark:
I feel like now… I mean, the truth is like, if you are the practice manager at Banfield, do you have animosity for the practice manager at NVA eight miles away? You shouldn't.

Stephanie Goss:
No.

Dr. Andy Roark:
That's ridiculous. The impact that person has on you is nothing but they have a lot of shared experiences with you and other people don't have those, right? Being a practice manager is a lonely job because there's no one else in the hospital, generally, that has the same experience you have.

Stephanie Goss:
Right.

Dr. Andy Roark:
And so, there's a lot of benefits to being able to say, “Hey, friend of mine who generally knows what I do for a living in my job, I really appreciate you to validate the scenery or possibly give some advice to me,” or, “We're out of an item that we need and it's going to be three days before we get it. Can you cover?”

Stephanie Goss:
Yes.

Dr. Andy Roark:
And so, for me… Anyway. I think a lot of new school owners, especially people in corporate practices, I don't know that animosity exists but it definitely does in the old-school crowd. I've always thought it was ridiculous. I think it was ridiculous in the old-school crowd. I'll tell you, just from a headspace standpoint, the first thing is like, “Who's your competition?” and people would say, “Oh, the guy down the road,” and I would say, “No. It's inactivity on the part of the pet owners. That's your competition.”
Your competition is not… It's not, “I'm not going to get to see this pet because they're going to go to someone else.” It's like, “No. You're not going to see that pet because that person's not going to get off the couch and bring their cat to the vet. That's why you don't see pets.” And so, when you look at it like that you say, “What I lose to another veterinary clinic is just so tiny compared to the pet owners not bringing their pets in, us not booking recheck appointments, us not scheduling follow ups, us not working up cases.” There's so many other factors that are holding you back from practicing the medicine that you want to practice. The guy down the road is such a tiny, tiny piece of any sort of obstacle you have.

Stephanie Goss:
But it's so funny because I think about it and I think about almost, really, every practice that I ever worked in, even the ones that ultimately had great relationships with our peers in the area, there has always been this mentality since I started in veterinary medicine to a degree and I agree with you. I think it was much more strongly expressed by the old-school crowd because I remember starting in veterinary medicine where it was all about everybody else is our competition and you are spot on. Even back then, if we zoomed out for a hot second and looked at it, they were not actually our competition. They had a different culture, a different clientele. It was not competition but that outwardly was definitely expressed by leadership in veterinary medicine much more prevalently than I think that it is now.
I would argue with you. I think even now there is… I talk about it with managers all the time where there is this single-sided view of other practices as our direct competitors. When you start asking questions as I do, I'm like, “Tell me what their practice is like.” It's like, “They're not actually competition.” I think if we zoom out, most of us could probably count on one finger the number of true competition that we have in our little practice radius, right? But most of us have other practices and even if they're completely, radically, polar opposites of us as a practice, there is still this prevalent thought in veterinary medicine that everybody else who is a colleague is competition.

Dr. Andy Roark:
Yeah, so I get it. I understand. I still don't get it. I thought I'd get it. I just don't. I understand. I think there's two things that traditionally have led us to have practices that see each other as competitors and we don't talk to them or we don't talk about them and we don't work with them, whatever. So there is-

Stephanie Goss:
Or we talk about them and it's all negative.

Dr. Andy Roark:
Exactly. There's scarcity mentality, right? So little behavioral psychology. It's the idea that winter is going to come and I'm not going to have stored up enough food and I'm going to die of famine. That is the caveman mindset. And so, it's scarcity mentality is you see someone else who's doing the thing that you are doing and you say, “Oh my gosh. What if I don't get enough to support myself and I starve to death?” and that's scarcity mentality which you can see from an evolutionary standpoint, having those thoughts is probably motivating for you to get out and work hard to harvest the fields. Do you know what I mean? So that you and your family can live on and make more babies and stay alive and do the evolutionary thing that you're trying to do. I get that. So that's scarcity mentality.
The other one is zero sum thinking and a lot of people look at the world as if you get something, that means that I lost something or the potential for something. If you get ahead, it means that I somehow got farther behind and that's even just all the way to keeping up with the Jones's. I knew some people who will be like, “Oh, you moved into a bigger house. Now, I feel offended because in order to keep up with you, I have to move into a bigger house,” and you go, “Golly. That's a weird construct that only exists in your mind but here we are.” And so, that's zero sum thinking. If the other veterinary practice down the road gets something, does something, succeeds in some way, then I'm falling behind and I'm saying, “You're falling behind in a game that only exists in your mind. It's not real.”

Stephanie Goss:
Yeah. Yeah. In-

Dr. Andy Roark:
So-

Stephanie Goss:
Oh, go ahead.

Dr. Andy Roark:
No. So those are, I think, are the traditional drivers of why this division has existed.

Stephanie Goss:
Yeah. I think for me in my own personal experiences in working with the practice owners that I have, both of those things, scarcity mentality and the abundance mentality, those two things put your finger right on why they were thinking the way that they were, right? It's like if this client doesn't come see us and they go see the team down the street, then we're not going to be able to make payroll, right?

Dr. Andy Roark:
Yeah.

Stephanie Goss:
The reality is that client better not be the only thing standing between us and not making payroll.

Dr. Andy Roark:
Yeah. Exactly right. Yeah.

Stephanie Goss:
That should not be how we're running our businesses but that's how we let ourselves think and I think the reason that I loved this question and for me, the question was, “What is the point of playing nice with our competition?” I think that for me, I'm super pumped because to me the point is, there are so many more benefits to having relationships and having a community in veterinary medicine than there are real potential losses when it comes to our clients or to our standard of care or who we are as a clinic.
Like your point, really, the scarcity mentality, most of the time doesn't happen. That's not how life actually works. Most of us are not running… Our business is on that razor edge where that one client or even ten clients that go see our competition make or break us as a practice. But the things that come from having a community and having collaboration, all of those benefits, those actually can make or break us as a practice. And so, I'm super excited to talk about it from a headspace perspective because the benefits, to me, far outweigh the risks here. I think that's what I would lean into in terms of trying to explain or get my boss who might not be onboard, onboard with what those would be, is to lean into the benefits.

Dr. Andy Roark:
Yeah. Yeah. I think that's really it. It's a cost benefit analysis, right? So you say, “Well, what is the cost of collaborating?” and we said, “Do you believe in zero sum thinking? Do you believe in a scarcity mentality? Do you think that you're being hurt by this person doing this work?” It's even more eye rolling to me right now is because… I know this is regional. So many practices, I was going to say most, but so many practices are as busy as they can be or as busy as they want to be-

Stephanie Goss:
They have clients coming out of their ears.

Dr. Andy Roark:
Exactly. I can 100% empathize with people who are wary of their “competitor” when there's not much work to do, when things are slim. As far as staying busy I would say, “Oh boy. Having a client or two every week go down the road, that does hurt when we are really trying to hang on and have enough to do.” I just don't see that as people's reality today.

Stephanie Goss:
Well, I think that goes back to the point you made earlier about the older school, the older generation and I think there is validity there. I think part of the reason of that is think back to when you and I started in veterinary medicine, the majority of our patients now are members of the family and they're getting care in ways that they never did when we started in veterinary… I mean, I remember starting in veterinary medicine, our family dogs, they didn't live in the house. We had a backyard, the dogs lived in the backyard. Now… I mean, my mom's dogs share the bed and sleep under the covers.
The shift in the last 20 years in veterinary medicine has been great. And so, I remember starting in veterinary medicine almost 20 years ago and there were plenty of days where the phone didn't ring and we didn't have clients coming in because we saw a lot of backyard pets and we saw a lot of farm animals. And so, we were seeing emergency cases and abscesses and we see all of that now but it was really, really different because the relationship that we had with our pets and with animals as a society was radically different even just 20 years ago.
And so, I think about why that might be prevalent in that older school generationally and I think that's part of it because we experienced those droughts from a business perspective and not having clients come in the door. And so, there were plenty of times where those clients leaving could have made the difference between being able to pay payroll or not. But I think, I said it and I didn't mean to say it in jest because I think the point is now for most, to your point, most practices are in a place where we're booked weeks out. We can't get the clients all in the door. And so, that environment doesn't exist now for most practices the way that it did back then.

Dr. Andy Roark:
I agree with that. I'll also say this and I can say it because I'm a vet and I love veterinarians and you guys know I love veterinarians. Veterinarians traditionally are some of the cheapest people that I've ever met in my life and I'm in it. Stephanie Goss is laughing because I also have a frugal streak and-

Stephanie Goss:
A mile wide.

Dr. Andy Roark:
A mile wide perhaps but I am a veterinarian to my bones and we are some cheap ass people and I get it, right? Because you come up and you're like, “We got to make it work.”

Stephanie Goss:
It's the only way you survive vet school, is being cheap.

Dr. Andy Roark:
Yeah. They're like, “Did you have an ultrasound machine?” “No, I just listened with my ear,” like, “I don't need an ultrasound machine.” I even have vets who are like, “You use a needle one time? Pansy,” like, “Back in my day, we shaved metal off the surgical table and used it for scalpel blades. We wore a barrel with straps, that was our surgical scrub that we wore.” It's like every veterinarian I know lived through the Great Depression in their mind but like, “Okay, I love it,” but that is our people. We are traditional people which means the idea of someone going somewhere else and us not getting that $32 for a physical exam from 1981, that's hard to bear.

Stephanie Goss:
Right. It matters. Yeah. No, I agree with that. Okay. So I want to move us a little bit from headspace to-

Dr. Andy Roark:
Do you want to talk more about… Let's talk about some other money-saving steps that we can take in the-

Stephanie Goss:
No. I don't but I want to talk about benefits. The benefits of collaboration is part of the headspace but it's also a part of the action here so how do we get to doing this? I want to talk about that because this is my heart, this is my jam. I love collaboration. It's part of what I love about Uncharted but I have loved it from the very beginning and I think…
So for me, the headspace piece of it and the advice for these managers is like, “Okay. You may not ever be able to get your practice owners onboard because they may be the veterinarians Andy was talking about who were like, “I wore a barrel for my surgical scrubs,” right? They may not get it but do they have to?” and the answer for me is a resounding no. I can still create a community and I can still drive those relationships independent of what they think and are doing and there is very much a benefit to doing that because I will tell you, my local community forging those relationships with the other practices in my area has saved my butt more times than I can count.

Dr. Andy Roark:
Okay. So let's take a break here and then when we come back, what I want to do is I want to talk about… Okay. Joking aside, how do we articulate the desire to work collaboratively with other practices to our higher-ups? And then, regardless of whether or not they go with it, what does that mean for us as individuals because we can do what we want with our lives when we're not clocked in and we can talk about that and what that looks like.

Stephanie Goss:
Okay. I love it.

Dr. Andy Roark:
What's inbounds and what's out of bounds? So let's take a break and we'll come back.

Stephanie Goss:
Okay.
Hey friends, it's Stephanie, and I'm jumping in here for one quick second because there's a workshop coming up and it is one of the last ones for this year of 2022 and I want to make sure that you don't miss it because it is coming to you from my dear friend Maggie Brown-Bury. Maggie is a former emergency veterinarian who lives in Newfoundland, Canada. A few years ago, Maggie made the decision to make a change and she moved out of ER medicine into being a relief veterinarian.
I remember Maggie telling us within weeks of opening up her schedule, her whole first year was booked. And so, we asked Maggie to come and do a workshop for how to get the most out of the relationships that you build as a practice with your relief veterinarians because more and more practices, as we face the veterinarian shortage, are struggling with needing to have relief doctors on their schedule maybe more regularly than we would have previously.
Maggie's got some great ideas after working with a ton of different practices on how you can leverage that relationship and set yourself up for success, set your relief veterinarian up for success, and set your clients up for success. So if this sounds like something you'd be interested in, head on over to unchartedvet.com/events and find all of the information about the workshop and how to sign up. I hope to see you there.
And now, back to the podcast.

Dr. Andy Roark:
All right. So let's talk about communicating this up the chain, right? So we're in a vet practice and we are interested in having a more collaborative relationship with the enemy, the competitor down the road. Basically, simple cost benefit analysis is generally a pretty solid way to go here. The question you're going to get is, “Why? Why would we collaborate with them?” and I think you should just honor that question for what it's worth and say, “Well, what are the benefits of us talking to these people?” I think the idea that there are drawbacks is pretty hard and I think that as we're so busy, I think there's even less room for people to be like, “Oh, but think about how we're going to get hurt.” I think you need to think about what is the benefits of having this open relationship?
I would tell you just as a general philosophy and then we'll get into some specifics. Guys, I look at the workload the vets have, I look at the labor shortage, and I don't see it going away. Now, pet owner spending habits might change and there's some interesting data about that and we can talk about that. But for the most part, there's no magical surplus of veterinarians that are going to get dumped out into the profession anytime soon or certified vet techs or honestly, there's no reason to think that hiring is going to get significantly easier in the short term.
And so, we've got our hands full and the work is not going to stop. And so, really, one way I look at it is us, as veterinary professionals all in this together, trying to meet the needs of our society for pet healthcare and that's how I look at the world. You know what, guys? I like that view. I like to believe that we're all in this together. I like to believe that everyone who listens to this podcast, we're on the same team and I care about you. I really do. I want you to be successful and I want us to be successful and I want us to come together and take care of the pets and the people that we see. I just tend to look at our profession as us doing good in the world and I like to minimize us sniping between each other and just say, “Hey, we're all in this together. Let's be in this together.” And so, philosophically, that's where I like to start.

Stephanie Goss:
I think I love that because the reality is we're not competitors. And so, if we let go of that scarcity mentality and we start from a place, “What are the benefits?” We start from that place. First thing, what happens when you do run out of rabies vaccine? Who do you call? There's just the pure benefit of being able to say, “Hey, help me out. I'm in this spot,” and that has saved me more times than I can count. Whatever it is from our… I have even gone to another practice and borrowed their digital dental x-ray probe because a patient bit down on ours and it was going to be six weeks before we get the new one, right? That is some serious mojo. Could you imagine not doing dentals for six weeks with our current caseload but that practice was like, “Well, we only do surgery two days a week, so the other three days a week, you guys are welcome to use it.”
Obviously, if anything happens, we would take care of it and pay for it but we kept being able to do dentals for six weeks while we waited for our new probe. So that, in and of itself, number one, is a huge, huge benefit. But the other piece from the competition perspective, which you brought up, Andy, I think is really important is that we're not going to be the right fit for all people. And so, let me tell you how awesome it is to be able to refer needs that clients have that I can't meet to other places and be able to give them a name and a number and say, “You should call over here and see what they can do for you.”
Whether they offer procedures that we don't, they have an ultrasound machine and we don't, or it's just a matter of, “I have a client who is particularly cash strapped and they're looking for a vaccine clinic environment.” If that's not something that I offer but it's something that another clinic in town offers, why would I not tell them that's the option for them and help them get care for their pet? If I can't provide it or if it doesn't meet our needs as a clinic and who we are, why are we thinking about it from a competition perspective and not thinking about it from the perspective of, “Let's help this client get what they need,” or, “Let's help this patient get what they need.”

Dr. Andy Roark:
Well, the future of vet medicine is fragmentation. That's what I believe. I believe that the days of us all doing basically the same thing in each of our practices, those days are over, friends. That means we are going to have high end, white glove, expensive practices. We're going to have specialty practices. We're going to have emergency practices. We're going to have middle of the road practices. We are going to have middle of the road, high communication practices and we're going to have middle of the road convenience-based practices that get people in and out and turned around and are super flexible. We're going to have low cost spay and neuter clinics. We're going to have just low cost clinics that focus on accessibility, access to care, things like that. We're going to have mobile vets. We're going to have house call vets. We're going to have hospice vets. We're going to have ultrasound. We're going to have acupuncture, holistic veterinarians.
Everybody's doing different things and I think that's going to continue. I think it's really interesting. I'm excited about it. But if you think that this fragmentation is true and that practices really are segregating out into different areas and moving into different niches, then it just opens up the idea of, “Hey, we should communicate because we're doing different things.” It opens up that more and further reduces that feeling that we're competing. And so, I really like what you're saying.
Oh, we had a practice down the road from ours and it was a one vet practice and they were very much focused on accessibility and affordability of care. Their doctor went on vacation one time and the relief vet fell through somehow. I don't know how that happened. It was never made clear to me how it happened. But hey, there was no relief vet. And so, that person went on vacation and told the front desk to send them down the road and they started sending their clients to us and we got more one-star reviews that week than we had gotten in 20 years and it's because those were not our people. It was not our clients. They were not looking for what we were doing. I'm not bashing them, they were bashing us. I'm not bashing them. We just did not provide the service that they wanted at the price that they wanted but our clients who come to us were very, very happy with what we do and how we do it.
That is the thing in my life where I really crystallized in my head, these people were very happy with their vet and these are not our clients and we don't want these clients. It's not bashing them, it's just they don't want what we are selling and they don't want what we're doing.

Stephanie Goss:
I think the honesty about that is really great. So my practice, when I first moved to Washington, a really small town and there's our practice which is a large multi-site practice and there's another one doctor practice in town and it's an older school veterinarian, small practice, like you said, they're focused on convenience and cost for the clients. So two radically different models but that doctor didn't do surgery. And so, their process was to refer their surgical patients to us. But unlike you, the conversation that they then had with their clients was, “I don't do surgery because there is a time and cost associated with all of this. And so, when you go over there, you are not going to pay my prices. You're going to pay because they have surgeons on staff and this is what they do.”
And so, the clients were still, sometimes you have that, very different models, and there were still clients that were displeased but by and large, the majority of the clients who came over were prepared for that and they were willing to do it because there was a collaboration between the two clinics and that's the kind of example… Their clients weren't our kind of clients and if they were like, “Hey, we really had a great experience here,” we would have some questions for them about whether it was a good fit to continue the relationship or not but it was really, really nice to be able to know that we could provide that service and not have a veterinarian who had clearly defined boundaries and was like, “I don't want to do surgery,” not have to feel like they have to be all things to all people because we could work together.
For me, that is a perfect example of why this can be a huge bit of it because it allows you to do the things that you want to do and also lean into not having to do the things that you don't necessarily want to do because there usually are people out there who want to do those things.

Dr. Andy Roark:
Yeah. Yeah, I completely agree. And so, if you buy into that, you start to see the benefits of having these connections, right? So the big things for me, there's too much work to do. I'm starting to push for referral to other GPs and people are like, “That's heresy,” and it is heresy. It is the sacred cow. We've talked about this before on this podcast a number of times but like, “Look, man. If you've got…” I've noticed I'm starting to say, “Look, man,” a lot. I'm like, “Look, man.” It's like-

Stephanie Goss:
Are you leaning into your '90s punk?

Dr. Andy Roark:
I guess so. Anyway, look, man, if you have more work than you can do and people are getting angry that they can't get in to see you, it makes sense to refer clients away. It does. Now, I would start by not taking new clients. If you haven't done that yet, that's the easy thing is try to retain and service your current clients but send new clients away. But referring to other practices, it's like, “We're not taking new clients. We're unable to get people in. If you need to get in sooner, here are two other practices that are nearby that we recommend,” and send them to practices that you would recommend. Again, it's that scarcity mentality of, “I can't send work away.” I was like, “You can't get all of your work done. You're going to burn yourself and your people out.”
At some point you say, “I've got all the business that I can do and I'm going to take good care of the people that I have coming in. And then, I'm going to send the other people away and I'm not going to lay awake at night. I'm not going to feel guilty or angry about it. I am going to take care of the people that I'm going to take care of.” People say, “But we're not as profitable as we need to be,” and I would say, “You cannot do any more work. If you're not as profitable as you need to be, you need to figure out how to cut your costs or increase your prices and those are the only two options or increase your efficiency,” but a lot of people who have pushed their efficiency as far as they can, at some point, just wanting to see more patients doesn't make it possible.

Stephanie Goss:
Yeah. I think for the other piece of this and I'll be honest, I was really lucky to have exposure to this collaborative environment in private practice from the very beginning of my career in veterinary medicine but I will also say that my belief in collaboration got even stronger when I worked in corporate practice because now, I had the benefit of a built-in community that private practices don't have. I have the ability to call my sister clinic eight miles down the road and be like, “Hey, we're really shorthanded today. Can you guys spare anybody? Can you send them over?” and that was a game changer. And so, for me, it made me think a lot about the relationships that I forged early on in private practice and how as we grow and as veterinary medicine changes and as we continue to have more clients than we can handle and not enough staff, that is not something that's going away anytime soon.
The ability to band together as small groups of practices, whether we're independent private practices or corporate practices, is really, really powerful to be able to say, “Hey, I need help here.” Whether it's borrowing equipment or borrowing team members or, we've talked about this, I think, and I've told this story on the podcast, but I had somebody that I interviewed and I really, really liked them. They were not a fit for my clinic and my team but I thought they were a great candidate. And so, you want to talk about heresy, I called up another manager and I said, “Hey, I interviewed this person today. They are not a fit for our team but I think they might be a really good fit for your practice. Can I send them over to you?”
It was another independent practice. There was no connection. It just was a manager that I knew from my local manager's group which is why I think this topic is so important. I called them up and I said, “Hey, would you like to interview them?” and they hired that person and they stayed. They are still at that practice years later and it felt so good. It felt good to help out a colleague but also, it was such a game-changing experience for me because I got to help another practice but it was the first time I felt in private practice where it didn't feel like every man for himself.

Dr. Andy Roark:
Yeah. The last point that I want to make on this as far as collaboration between practices, collaboration on high level is one of the critical takeaways that people need to remember is you have got to build the bridge before you can walk on it which means you cannot wait until your dental radiograph probe breaks to make a friend. That's not going to-

Stephanie Goss:
Right. It's not going to work out well for you.

Dr. Andy Roark:
Yeah. You need to have that relationship in place. And so, when the practice owner says, “Why should we talk to these people?” and you say, “Because one time Stephanie Goss's… Their dental radiograph probe broke,” and he's like, “But our radiograph probe is not broken.” You could say, “But-

Stephanie Goss:
But the day will come-

Dr. Andy Roark:
“If we don't have that relationship when it happens, we are going to be out of luck. And so, you have to build…” That's a phrase I've used for a long time is, “You have to build a bridge before you can walk on it,” which means you have to make relationships with people when you don't want anything. Because if you make relationships with people only when you want things, that's not a good look and it doesn't feel good. And so, that's a big part of it for me.

Stephanie Goss:
The last thing… I'm so glad you used the bridge analogy because I think you have to build it before you can walk on it and you also should not burn it to the ground. I'm going to say it for the person who asked this question, they were saying that it feels like there's animosity between some of the practice owners and I will say, the point, part of why it matters to build collaboration and play nice with our competition is because veterinary medicine is smaller than the smallest community.
We are closer than six degrees of Kevin Bacon, you guys. The reality is everybody is connected to somebody else, especially in small towns and that is important. When you burn those bridges, man, it is spectacularly flaming and you don't want to do it. And so, even if you don't like the person on a personal level or you don't like their medicine or the way that they run their practice, there is still benefit in being professionals and looking at it as, these are our colleagues and we should be able to have relationships. We should be able to come together and share things whether it's the vets getting together in having radiology rounds and talking about cases or doing case rounds together. Those are things that you get the automatic benefit when you're in corporate practice.
We had lots of… I went through a period where I had a bunch of new grads and I didn't have enough experienced doctors to help train them but collaboratively in our local area, there was plenty of mentorship available. The ability to send one of my new grads to participate in case rounds or radiology rounds with another clinic was a huge benefit. That doesn't have to only exist in corporate medicine.
My very first practice that I participated in veterinary medicine at was a small town. There was three vets in town. We literally were all on the same road, one at each end of town and one in the middle. They're all private practices and those vets got together once a month and did radiology rounds so that they could help pick each other's brains and pick apart the experience that comes… We had one vet who was older and who was very experienced and those younger vets got to take advantage of picking his brain and the medicine that he had seen in his career.
It wasn't that they weren't looking at each other like competition, they were looking at how can we help each other and how can we grow and get that without having to go call up a boarded radiologist or go to a CE that's two hours away? We leaned into the local community and I think that's something that a lot of people often think about it solely as a benefit of corporate practice and something that we can't do.
This is where I would be happy if somebody said, “But Stephanie Goss told me I can.” You do not just have to be in corporate practice to make this happen. You can make it happen in private practice and I think though, the why it matters and why I love this question is because you can do it on your own. This is where you can lead the charge from within the team.
Now, obviously, if your practice owner is not onboard, you might not get to go on the clock and meet with other practice managers for lunch once a month. That might be off the table but there's nothing stopping you from saying, “Hey, we're going to get together once a month in the evening and talk about what's going on in our practices and pick each other's brains about some things.” There is nothing stopping you from furthering yourself from a professional development perspective and I will tell you that the fact that veterinary medicine is so small and it is such a close-knit community, I can't tell you how many times that kind of networking and remembering the fact that I don't want to burn those bridges has really been helpful and impactful in terms of my career and growing myself.

Dr. Andy Roark:
Yeah. No, I completely agree with that. I think I've just benefited throughout my career from my connections more than anything. It's people who show me what's possible. It's people who talk about what they're doing and I go, “I didn't realize you could do that.” I've just had so many beneficial conversations and it's also people opening doors for me and people saying, “Hey, there's an opportunity for… I know this person who is unhappy where they are and they're looking for another place to go and your practice is a happy practice and has good culture and I thought maybe they might be happy. Would you like to talk to them?” Those things don't happen if you live in a silo and people don't know you. There's so many of those little benefits. The one thing that I want to say is, you can be connected and you can benefit from connections and you can talk to a lot of people and still maintain some level of confidentiality for your practice.

Stephanie Goss:
Oh yeah.

Dr. Andy Roark:
I think that's important because I can imagine business owners saying, “Andy and Stephanie are saying you can just go and tell them everything that's going on in your practice,” and I'm like, “That's not what we're saying.” There's some common sense to it about what you can share. But in general, you can avoid sharing details that would be damaging to other people's reputations or make them feel bad or would make your practice owners uncomfortable or things like that. That's not hard to do. Just speak in terms where you say, “I want to protect people's privacy and I still want to have these relationships.” Those things are totally manageable. You just have to think about it and then be intentional about the questions that you ask and how you engage.

Stephanie Goss:
Yeah. I think the last question that got asked by the person who reached out was, “Where do I start?” I think you can want the end goal to be I would love to have a local area manager's group. I think that's a fantastic goal and I'm a huge advocate for that and I ran our local one for years. It didn't start out that way. It started as a group of people who were like, “Let's get together for lunch,” and it was a one-time thing. And then, it was like, “Guys, this was so fun. Let's do it again,” and it very quickly became a once-a-month thing.
And then, we started having some structure and then we started talking about could we tie some CE to this and could we get some speakers to come and talk to us and it grew from there but it didn't start there. If you want to start there, if that's your end goal, that's great too but it doesn't have to be giant. You don't have to overbuild it. It can start with, “Let's go have a cup of coffee. Let's go have lunch. Let's have dinner,” right? Let's just pick each other's brain. It doesn't have to be a big thing. It can start small.

Dr. Andy Roark:
Yeah. I like it. All right. Cool. I think that's great. I think that's some good… Hopefully, that's good insight for people. Hopefully, it gets people some permission they need to make those connections and just start to grow their network.

Stephanie Goss:
Yeah. I like it. It was clearly my jam.

Dr. Andy Roark:
Yeah, definitely. Cool, guys. All right then.

Stephanie Goss:
All right. Have a great week, everybody.

Dr. Andy Roark:
Take care, everybody.

Stephanie Goss:
Well, everyone, that's a wrap on another episode of the podcast. Thanks for tuning in again this week. As always, we love spending time with you. Before we go, I just wanted to say I am getting so excited to head to Greenville. We will be there for our Practice Owner Summit which is happening December 8th through 10th. This is a giant, giant thank you. Shoutout to our sponsors for helping make this event happen. This is one of my favorite events of the whole year. It is so much fun.
If you are going to be there, I can't wait to see your face. I have all the hugs for everybody, including our sponsor friends. And so, I just want to shout out and say thanks to Royal Canin, Hills, CareCredit, IT Guru, and Chronos for making this event happen. Take care, everyone. Have a fantastic week. Be kind and we'll talk to you again soon.

Managing a Neurodiverse Clinic Doctor

Uncharted Veterinary Podcast Episode 206 Cover Image

This week on the podcast…

Dr. Amanda Doran joins Dr. Andy Roark to discuss managing (and being) a neurodiverse doctor. Very little of the conversation is specific to veterinarians as opposed to other members of the vet healthcare team, and everyone in the clinic can benefit from this conversation. We cover common behaviors as well as resources and management strategies for supporting a diverse group of individuals across an organization. Let's get into this!

Uncharted Veterinary Podcast · UVP – 206 – Managing A Neurodiverse Clinic Doctor

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

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


About Our Guest & Recommended Reading

Dr. Amanda Doran: @dr_amanda_doran

Love and Work: How to Find What You Love, Love What You Do, and Do It for the Rest of Your Life – https://amzn.to/3c7ZL5i


Upcoming Events

The Secret Sauce to Optimizing Workflow with Senani Ratnayake

Back by popular demand! It's time to take a look at the workflows that aren't working and come up with a plan to move forward with a strategy that makes sense.

Date: November 30

Time: 5:30pm ET/2:30pm PT – 7:30pm ET/4:30pm PT

Getting The Most Out of Relief Vet Relationships with Dr. Maggie Brown-Bury

Dr. Maggie Brown-Bury is a relief veterinarian in Canada and she is already booked for all of 2023. How does she do it? Who ends up at the top of her list of availability? If you're struggling to find a consistent relief veterinarian or don't know where to start, this 1-hour workshop can help.

Date: December 13

Time: 7pm ET/4pm PT – 8pm ET/5pm PT

All Uncharted Veterinary Community Workshops are LIVE! You will be able to ask the instructor questions that help you address your practice’s unique problems. This will not be 2 hours of silent screen time. Gear up for interactive, fun learning!

JOIN UNCHARTED! https://unchartedvet.com/uvc-membership/


Episode Transcript

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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:
Welcome, welcome, welcome, boys and girls to the Uncharted Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I am here with the one and only Dr. Amanda Doran. We are talking about managing the Neurodiverse Doctor. We start off talking about that, then we talk mostly about being a neurodiverse doctor and what that is like and what that experience is like. This is a fun episode, it is a make you think episode just about how people are different and about working with people who see the world differently in your practice. I think this is one of those things where we talk about neurodiverse doctors and really we're just talking about is people are people and people are different, and we all have different skills and strengths, and things that we're good at and things that exhaust us, and things that we're not good at.
And we're not cookie cutters. We're our own beautiful distinct human beings. And when you understand that, then a lot of ideas for how to support people become really clear. And so anyway, this is a fun conversation. It's a neat make you think sort of conversation. It's a good reminder about the humanity of our professionals, so whether you are a doctor, or a tech, or front desk, or manager, I think this is going to be just a good general episode to hear. Guys, without further ado, let's get into this episode.

Meg:
And now the Uncharted Podcast.

Dr. Andy Roark:
Welcome to the podcast, Dr. Amanda Doran. How are you?

Dr. Amanda Doran:
I'm great. How are you?

Dr. Andy Roark:
Man, I'm doing great. It is good to see you again. It has been a minute. How are things going?

Dr. Amanda Doran:
Oh, good. Living the dream. Northern Minnesota's very beautiful several months of the year. The rest of the time it is hot.

Dr. Andy Roark:
Yeah.

Dr. Amanda Doran:
But it's gorgeous right now.

Dr. Andy Roark:
That's awesome. Well it's good to see you in person. You actually came down and stayed with me and my family a couple of years ago pre-pandemic.

Dr. Amanda Doran:
Right before, yeah.

Dr. Andy Roark:
Yeah, it was right before working on some business projects and that was a awesome thing. And the family says, hi. What are we doing here? We are here, so those who don't know you are Dr. Amanda Doran, you are doing some speaking and writing, especially particularly kind of in the wellness space in vet medicine. You are an associate vet with Minnesota Pets, which is a home hospice veterinary company. And you do a lot of different things. You have a lot of different interests. I love it. I'm a big fan of people having what I call a third space, which is things you do that are like not normal home stuff and not work stuff. And so you have a booth at the farmer's market called Wicked Witch of the West End.
And you also have, you just told me, I was actually humbled. You have 35 cherry tomato plants. I have three tomato plants that I have fought all summer long just to have, and they have a high tomato failure rate. Let's just say that there is a lot fewer harvested than grow on that thing. But anyway, welcome to the podcast. I'm glad you're here. I asked you to be on because you did a workshop for Uncharted very recently that was extremely popular and well attended and it was on managing the neurodivergent doctor. And boy, we got a lot of positive feedback on that session. A lot of people who said they wanted to know more, they weren't able to come to the workshop. And so I just thought that would be a great opportunity to have you in to kind of run through this topic with you. And it's something I really honestly don't know a whole lot about. This is a weakness of my own and so I'm really excited just to start breaking this down, you ready?

Dr. Amanda Doran:
Yeah. Thanks. Good to be here. I feel like we only scratched the surface in the workshop, so definitely.

Dr. Andy Roark:
Oh, I know. Well that was the feedback that I got was there's a lot there. Well, let's just start out at a high level when we talk about managing the neurodivergent doctor, what are we talking about? Give me an idea going into this workshop, and again, neurodivergent can mean a million different things. Help me start to piece this together in my mind. I want to get my head around what am I talking about? I think a lot of us are probably managing neurodivergent doctors and we don't even know that we're doing that. Many of us may be neurodivergent doctors who have not yet realized or recognize that that is a part of who we are. And so talk to me a little bit about that. What does that look like as people come in? Paint me a picture in the clinic of the neurodivergent doctor, if you don't mind.

Dr. Amanda Doran:
Absolutely. Yeah, so I think definitely newer terminology that we're talking about. And so I think kind of neurodivergence as a term was really developed to help talk about and develop acceptance for people with autism. But the umbrella's gotten a little bit bigger and includes a lot of other different conditions in neurodivergence. And probably the most common one I think we do see anecdotally and I have personal experience with is people with ADHD. And so these might be people who are having a really hard time managing time, or managing different tasks, or they might have problems with memory, or organizing things, or starting projects and following through, they might have some challenges with emotional control, or paying attention, or focusing, they might get sucked into the vortex of time in the exam rooms, and might have a hard time consistently following goals, especially with something that they're not interested in. And we are neurodiverse as a population.

Dr. Andy Roark:
Yeah, so like goals that were set from someone else?

Dr. Amanda Doran:
Yeah, if it's something that people don't have a strong interest in, they might have a hard time working towards that goal.

Dr. Andy Roark:
Okay, so going back to those things, do me a favor, pick back up. And so you listed time management, task management, organizing, emotional control, paying attention, pick back up with neurodivergence. We're all sort of a diverse group and just kind of I think that's a laundry list of behaviors sort of help to put that into an organized framework, I guess. How do you start to look at these things?

Dr. Amanda Doran:
I guess essentially what neurodiversity means is that within our population of humans, we have a variation of cognitive function, right? Our population is neurodiverse, and in kind of thinking back to like back to basics of left brain versus right brain and kind of logic versus creativity and how we process things and how we engage in projects and how we perceive things and even how we solve problems. We all have all the things, but we do different things differently. And there's kind of this societal standard and then many people have traits that make it easier for them to adapt to those standards. And some people have traits that maybe are leaning a little bit more towards right side of the brain and make it more difficult to adapt to those expectations or those cultural standards that we have.

Dr. Andy Roark:
Sure.

Dr. Amanda Doran:
Does that kind of make sense?

Dr. Andy Roark:
Yeah. Yeah, no, it does. I will tell you sort of, okay, I like the way that you're starting to lay this things out, so I'll just sort tell you a position that I sort of have on the way that people's minds work and where it comes from.

Dr. Amanda Doran:
Yeah.

Dr. Andy Roark:
I was diagnosed with attention deficit disorder when I was in the second grade. And the doctors, the psychologist who did the child testing, told my parents not to expect too much from me. I probably wouldn't go to college, I probably wouldn't go on and do these other things. And my dad was a surgeon, so I think that that was the idea my parents maybe had. Now this was in 1982, which is the stone ages for child psychology, things like that. I am, listen, this is how I think about it, so I said something, I have a friend and her child was just diagnosed with attention deficit disorder and he is about seven years old now, I think.
He's probably second grade, something like that. And my friend had just gotten the diagnosis of her child had ADD, and she was obviously kind of worried about what does this mean and things like that. And what I said to her was, I'll tell you based on my life experience, we live our lives in a construct. I think that was made. We've got this crazy system, pardon the phrase, but we have this ridiculous system where kids are supposed to go and sit on their bottom for six to eight consecutive hours with a 15 minute recess break, which is what elementary school kids get now. And that's how their success is measured, is their ability to sit still and to take these tests that are put in front of them. And I say, this is ridiculous. Think back about how evolutionarily we came along.
The kid that never sat still, that was always exploring, that was always sort of investigating and doing new things, that loved to socialize with others, that kid's bound for success in the wild in a lot of ways. But that's not what success today looks like in the modern society that we have. And so when I think a lot about that, I will say that a lot of my career success comes from my inability to calm my mind in a lot of ways. I'm known as a pretty creative person. I like to think that I'm a fairly innovative person. Innovation and creativity come from smashing disparate ideas together, taking something and combining it with something else. And that's just kind of what my brain does. But if you are looking for somebody who can come and sit at a desk for eight consecutive hours and push paperwork, I'm not your guy, I'm never going to make it. And that's just the way that I am wired.
And so when you talk about neurodivergence and you talk about all the different types of behaviors that we see people who are not organized raising my hand, people who have problems paying attention, raising my hands, people who forget things, raising my hand. I check those boxes and that's sort of where I am. And so my big thing is I think that people have often thought that they is normal and abnormal and I reject that categorization. I would say what's what is beneficial is often context specific. And some of us may not thrive in the classic academic or classic work environments because that's not how we're wired. But that does not mean we are wildly successful in other ways or in other, I don't know, pathways. I know doctors who are forgetful and they can't stay focused and they're creative and funny and kind of, there's people who are sort of scattered and they bounce all over the place and the clients love them, the client, the techs are driven nuts by them, but the clients love them because they're fun and they're engaging.
Yeah, exactly right. Amanda is raising her hand. Exactly right. And I go, that's not a downside to me. And that's why I wanted to bring you on here was my position very much is I don't buy this normal/abnormal categorization in a lot of ways. I think that we all have strengths and we all have weaknesses and we're all very different. I think understanding what your strengths and weaknesses are is absolutely vital to your career success. I think having an understanding of the strengths and weaknesses of the people that you manage, I think that, that's vital to being a good manager. If you take someone who has a hard time organizing and push them into a position where they are going to organize come hell or high water, you're often going to burn that person out rather than have them figure it out. That's just my position. I'm curious how that sounds as I say it?

Dr. Amanda Doran:
Yeah, absolutely. Yeah, that's going to make some people miserable. This makes me think of this book that I read recently by Marcus Buckingham, it's called Love Plus Work. And he was one of the people that developed the Strengths Assessment and he talked about strengths and weaknesses in a way that I'd never heard before. And it changed a lot of perspective for me and not so much as strengths are things that you're good at and weaknesses are things that you're bad at, but strengths are actually as things that give you strength, give you energy. You don't have to be good at it, but do you like it? Do you want to do it? Do you want to get better at it?

Dr. Andy Roark:
Yeah.

Dr. Amanda Doran:
And weaknesses as things that you don't like, you can be really, really good at things that you hate doing. There is definitely some things in general practice that I had to adapt to and put masks on for and cope with that from the outside looks like strengths because I was really good at it, but I hated it. It left me completely drained at the end of the day. And so-

Dr. Andy Roark:
Oh interesting.

Dr. Amanda Doran:
I think as employee and manager kind of working together to help people find what are those strengths? And it's not, like you said, not necessarily giving people things. Like if you don't like organizing, you're going to have a hard time doing it. Are you in the right seat on the bus following your strengths, finding that love in your work and if you have that drive to want to do the thing that you like, even if you're bad at it, you can put in the hours to get better at it. And I think we don't always know what those things we are, we don't feel like we're allowed to follow those loves. I feel like that was one of my challenges in practice. I feel like I have to do this but I don't really want to do it, but I'm good at it and people keep telling me I should keep doing it but I kind of hate it.

Dr. Andy Roark:
Yeah.

Dr. Amanda Doran:
Yeah, finding those strengths and redefining, what does it mean. A lot to unpack there.

Dr. Andy Roark:
There's a lot to unpack there. I completely agree. Okay.

Stephanie Goss:
Hey friends. It's Stephanie and I'm jumping in here for one quick second because there's a workshop coming up and it is one of the last ones for this year of 2022. And I want to make sure that you don't miss it because it is coming to you from my dear friend Maggie Brown Bury. Maggie is a former emergency veterinarian who lives in Newfoundland, Canada. And a few years ago Maggie made the decision to make a change and she moved out of ER medicine into being a relief veterinarian. And I remember Maggie telling us within weeks of opening up her schedule, her whole first year was booked. And so we asked Maggie to come and do a workshop for how to get the most out of the relationships that you build as a practice with your relief veterinarians.
Because more and more practices as we face the veterinarian shortage, are struggling with needing to have relief doctors on their schedule maybe more regularly than we would have previously. And he's got some great ideas after working with a ton of different practices on how you can leverage that relationship and set yourself up for success, set your relief veterinarian up for success, and set your clients up for success, so if this sounds like something you'd be interested in, head on over to unchartedvet.com/events and find all of the information about the workshop and how to sign up. I hope to see you there. And now back to the podcast.

Dr. Andy Roark:
One of the things I always talk to people about when we talk about employee management is there's two different questions that I usually ask about employees, is when you're trying to delegate something away, you're like, Hey, would you do this thing for me? The question is, does the person get it? Meaning do they understand what you're asking for or what needs to happen? And the next question is, do they want it? And to your point, there are a lot of us that are good at things that we don't enjoy. This is an interesting idea of your strengths are things that give you strength and your weaknesses, you might be good at them, but they take strength from you, they take effort. There are things that I am good at that people ask me to do and they are exhausting and there are things that I am good at, people ask me to do that once you ask me to do them, I'm not going to stop.
I'm just going to get going and I am going to shake hands and kiss babies or kiss hands and shake babies, whatever, I'll just get going. And I'm not going to quit because I love doing it. But I think that's a really interesting way to think about it, so is this being good at something and wanting to do that thing I think are entirely different. I also really like your thoughts about when you are someone who has different skill sets, when you have these things that make you happier, that fill you up and things that don't. And you got to march to the beat of your own drum as a lot of us do. I think that there is a lot of weight in the veterinary culture on behaving in a certain way and following certain norms that have been laid down. And again, I'm just sort of talking off the cuff here, but you can't tell me that… We all took the same path, right.
We all went through undergraduate to become veterinarians and then we went through vet school and then there's some strong cultural norms in vet medicine and we all think that a veterinarian looks a certain way or acts a certain way and the technicians look a certain way or act a certain way or things like that. And I feel like there is this implied pressure to conform in a lot of ways. And I have found, and this is so stupid and simple, but for years people have asked when they ask for any career advice or anything, I always tell them the most valuable thing that I have ever found that I tell everybody is if you want to be successful, figure out what you like doing and figure out how to do more of it and figure out what you don't like doing and figure out how to do less of it.
And I think a lot of people don't think they have permission to do that. They're like, no, I have to do all of the vet things. And I go, no you don't. You're talking to a guy who literally works one day a week in the vet clinic and otherwise does what he wants to do. I was doing Facebook and people were telling me I was ridiculous and why are you spending your time doing Facebook? And I was like, it worked out for me in the long run. But those, I enjoyed it. I enjoyed expressing myself and this was before I didn't enjoy Facebook anymore, but at the time I enjoyed expressing myself and doing those things and other people, I mean I made these goofy, I don't know if back in the day I made these goofy videos that I, there's videos out there of me in a dog suit, a hundred percent running around.
And I remember well respected colleagues of mine being mortified on my behalf that I was making these things and I was like, I think it's funny. I am having a good time and I get that it's not your thing but I can do it. And it makes people laugh and I enjoy it. It makes me excited about that medicine so I'm going to do it. I really like that you said that it was like, I think some of us maybe need permission to say I'm not going to function the way that the other doctors do in the practice and I'm going, Hey buddy, as long as you can make that swing around and balance out with other people so their needs are being met and that you are not leaving other people hanging, go forth with confidence and do it.

Dr. Amanda Doran:
Yeah. Well, I think if anything it helps. It's helped me show up better every day when I do work, when I'm able to do those things. I think more so than balance or harmony, it's this idea of resonance. There's never going to be this perfect scale where it's like okay, my work and my life are balanced. It's kind of taking that it's like a dance that you have to do those other things. I remember hearing everybody say that in vet school. Oh yes, you must have these things outside of veterinary medicine that you do.

Dr. Andy Roark:
Yeah.

Dr. Amanda Doran:
But I feel like it's one of those lessons where you got to get burned. Some people know fire back because they've been told, well you got to figure out for yourself. Nobody knows what you love. And I think a lot of times we're conditioned to look for that external validation of people saying, yes, you're doing the thing. But it's a huge shift to shift that internally and follow what your weird little heart wants.

Dr. Andy Roark:
I completely agree with that, but I think when we're talking about managing people who are just different or who marched to the beat of their own drum.

Dr. Amanda Doran:
Yeah.

Dr. Andy Roark:
Or just have different skills, I think that not waiting for someone else to validate you is so important. And I think it's really hard. I think a lot of us who approach the world of differently, I think a lot of us live in shame, you know what I mean? Why can't I keep my calendar the way that other people do and why can't I just sit down and do these things that other people just sit down and grind through? And I say, look, we all have to figure out how to get those things done. We all have to figure out our own ways. But I completely agree with you as far as I think that we need to think about what makes us happy and making sure that we're doing the things we need to do.
But beyond that, the fact that the other doctors don't work one day a week, they work six days a week or four days a week, that doesn't affect me. That's not what I'm doing right now and that's not taking anything away from them. But I'm not doing it and I'm not feeling bad about not doing it. This is kind of where I am and what I'm doing. And so I think a lot of us need to hear that as, hey, this is fine.

Dr. Amanda Doran:
Yeah.

Dr. Andy Roark:
As far as the work life balance stuff, it's funny you bring that up. I had a conversation literally yesterday with a good friend of mine and we were talking about work life balance and I've never been able to categorize work life balance like a lot of other people can. I've never been able to be like this in my work self and this is my home self. And it is just, again, because of I think, the way that I see the world or whatever, that split has never worked for me, so I'm a big fan of Danny McVety calls it work life integration and it's just sort of like, I do a lot of different stuff.
I mean I write about that medicine when I'm at home and sometimes when I'm at the vet clinic on my lunch break, I'm doing other things and just I hang out with the technicians and we'll talk about our hobbies and just geek out about whatever the TV shows we're watching are, things like that. But I just mix those things together. But for me it's an outlet that works and keeping it separate just doesn't work for me.

Dr. Amanda Doran:
Yeah.

Dr. Andy Roark:
But it totally works for other people. And so I would never tell someone else, don't prioritize life balance. I would just say, well life balance for me looks very different than it does for other people. But I know after 15 years of doing it this way as a professional, this works for me and that's it. Well let's bring this back around to what this looks like professionally and working with others.

Dr. Amanda Doran:
Yeah.

Dr. Andy Roark:
And so we talked about managing sort of a neurodiverse doctor. We all have these different ways of approaching our job, of what we're good at. It's funny that when I said What does this look like? You listed a long string of problems, you know what I mean, of like oh they forget this. So this person, they don't get that done and they don't do this. What's funny is that when we ask about a neurodivergent doctor, people don't say, oh well these are typically creative people. These are people who bring diversity of perspective to the scene. These are people who often have ideas that others haven't thought about. They're think they're people who maybe have a different perspective when you ask what's going on that you just haven't rolled around and considered.
And I go, we always think about the things that we see where people don't match up in a positive way to the benchmarks that are set, but we don't really stop and say, well why do they exceed these other areas so strongly? I think that that's an important thing to consider when we talk about sort of neurodivergence and neurodivergent doctors is you cannot look at this as a detriment. What you have to do is look at the person as a specific package and start to identify what are their strengths and what are their weaknesses. And I love the idea of the strengths as what fills them up, what makes them stronger. Do you agree?

Dr. Amanda Doran:
Absolutely. And yeah, kind of what we talked about a little bit before in veterinary medicine, we kind of live by this kind of strict calendaring, very planned timeline and that makes some people very, very miserable. And you can very much struggle to manage time and to be productive when kind of the processes and practices that you're using don't match those natural tendencies that you have.

Dr. Andy Roark:
Yeah.

Dr. Amanda Doran:
And so I think when we think about neurodivergence, at least personally as I've started talking about it, people are coming and asking me all the time, how do I help this person who gets sucked into the Bermuda Triangle in an appointment? Whether that's in practice or an in-home euthanasia where they just completely lose track of time. And I think realizing that it's not an intentional disregard, like for some people it is actually a sensory issue and time doesn't exist if you're not looking at it. And so yeah, I was definitely that doctor who you'd send a search party because I was still in the exam room, well after the time it should be over, so I feel like that's where it comes up the most.

Dr. Andy Roark:
Yeah, I definitely see that. I think that to me, again, it depends on the individual a lot. I think classic organization and focus are often things that we see in doctors. What have you seen that can be helpful in setting, I know this is such a broad category of individual, it's hard to drill too deep into specifics, but in general terms, what are the steps that practices take to make these people successful and to bolster them up and to make them feel comfortable and happy in the workplace?

Dr. Amanda Doran:
I think the biggest thing is making sure that there's space to have those conversations. For people to be vulnerable and not blame them and see it as an intentional disregard for time. Helping them be able, you might have to help them a little bit in developing some of those skills, so consciously tracking time, like when are you going in, when are you coming out? What's happening in there? What appointments are these happening in? Are these appointments that give you strength and you're just so excited to talk to these people and help them? Or are these strengths that are weaknesses and it's sucking your energy to be in there and you feel like you can't get out?
Making sure everybody I think it's important for, but especially people who are neurodivergent, making sure you're taking breaks and eating food and going outside and getting exercise. Maybe having an afternoon coffee, because I think you do have a natural tendency to forget to do some of those things. I worked in the practice that didn't have clocks in the room and I found that really challenging. I felt rude always looking at my watch. But unless looking at the clock, I don't know times exists. And even when I was in general practice, kind of having buffer time in throughout the day to make sure I had a quiet place to go with no noise to catch up on my records so that I wasn't doing other things.
Because there's always 10,000 things going on in the treatment room and you want to help people. But unless I had a quiet place with no distractions, I couldn't get my records done before the end of the day. And I think another thing that would be helpful too is doing some role playing with language to help move visits along. I think sometimes we don't necessarily know the words to help people get back on track and be like, okay, what is our intention for this appointment? What is our desired income? What words can we give people to have light, moderate, or more heavy nudges to get us back on task? And I think those skills kind of develop over time, not the classes that they have in school always.

Dr. Andy Roark:
Yeah. Oh no, I love it. I just wrote down words to move appointments along. I'm like, oh, that's super great. Okay, so what I hear you saying, and this all makes total sense with me, I really love it. Assume good intent. We talk a lot uncharted about assuming good intent and just say, this person, they're not running late because they don't care, they're not failing to fill out paperwork because they're jerks and they're disrespecting you or blah blah, blah. Assume good intent. Everybody's trying their best. Some things come easier to some people than other people. I think that's just a great opening head space. I love the idea of just asking what happened. When this person is running late instead of saying, you are not going fast enough. It's going, Hey, I'm noticing that you're getting stuck in these rooms or you're spending a lot of time in certain rooms.
Why do you think that is? Is there something, and the rooms that you were in, why do you think that ended up being a trap? I also love flipping it around. I'm a big fan of positive inquiry, which is asking people about what worked well and then figuring out why it worked well, so you can know other places, so I can say, Hey, yesterday I felt like you were really moving efficiently through the exam rooms. I felt like you were doing a great job as far as staying on time. And that's what the tech said. What was good about yesterday? Why do you think you were you able to do that so well? And that can often give you some insight into, oh, this is how I support this person. And they go, oh well, yesterday I saw these types of appointments or I had this set up, or yesterday my technician was doing this thing that was helpful for me.
And I go, ah. And now it's not, Hey, tell me about why you're failing. Tell me about why you're running behind. Tell me about why people are frustrated.

Dr. Amanda Doran:
Great.

Dr. Andy Roark:
Yeah, it's tell me about why these appointments were particularly good. And I've just found that, that is a very soft, nice way to get, it's to help me to help you you know what I mean? Help me help you. I don't know what's going to be helpful for someone else, especially someone who sees the world differently or perceives it differently than I do or has different strengths than I have. I'm like I don't know how to help you because I don't have the skills that you have, I have different skills and I really like that. And then the big thing is, and the way I just phrased it is the way I would phrase it talking to the person, is not what can we do to get you to conform?
What can we do to fix you? No, it's what can I do to support you? How can I help you? How can I lift your workload? How can I make your time here more enjoyable? How can I help you meet the needs of the staff or any of those things? But how can I help you? How can I support you? What would you like me to do? What would make your time here easier? What would set you up for success? What does a great day of appointments look like for you? Those are all the types of questions that I try to get to get in there and develop specific action steps to support this person at an organizational level without making them feel like, oh, you are coming up short and so I need to give you a crutch. It's not that. And I don't want anybody to feel that way.
And that's not true. It really is more you kick butt in a different way than the rest of the doctors do. And so I need to make sure that you have support for your style and I need to understand what that would be, because I don't know your style as well as you do. And then I really like your point about enforcing breaks. I just, it's funny as you say that, I go, oh man, that makes so much sense of, hey, we've all had doctors that we have to stuff a sandwich into their hand and be like, you need to eat this. When was the last time you went to the bathroom? When was the last time you drank water, Amanda? We've all had those conversations, right?

Dr. Amanda Doran:
Have you seen the sun today?

Dr. Andy Roark:
It's so simple. Yeah, exactly. But that makes so much sense when you say that. And I go, oh, and it's an easy thing to do and it's a good thing to do, right? I mean, many of us work in states where breaks are enforced. A lot of us work in states where that's not necessarily true. We should still do it. And I just think that this is a good thing. It's one of those things where sometimes you slow down to go fast. And I find that that's really true in taking care of our staff and our doctors, especially with some people. I have to get them to slow down so that they can feel better, and so that they can focus, and so that they can then be productive and we can go fast. And so I think all of those are really, really great. Amanda, do you have resources that you really like? You mentioned one of the Love and Work book.

Dr. Amanda Doran:
Yes.

Dr. Andy Roark:
I'm going to check that out. It's not one I'm familiar with. Any other resources that pop to your mind that you think are particularly useful that you like?

Dr. Amanda Doran:
I do like reading books about time management, particularly related to neurodivergent people because I feel like a lot of the kind of more popular books, some of those things don't work. And so even people who may experience neurodiversity, even looking into like ADHD coaches or other people to help with non-traditional kind of executive functioning I found is really helpful.

Dr. Andy Roark:
Yeah.

Dr. Amanda Doran:
Part of that is I don't really remember names very well.

Dr. Andy Roark:
Sure, gotcha.

Dr. Amanda Doran:
Yeah.

Dr. Andy Roark:
What does somebody search for to find that, because you're talking about this thing, and I'm like that makes total sense to me. It's not a genre that I'm familiar with. What are some of the terms that when you look like you said executive functioning, coaches, ADHD coaches, things like that-

Dr. Amanda Doran:
ADHD Coaches.

Dr. Andy Roark:
Are there certain terms that you kind of look for?

Dr. Amanda Doran:
Yeah, I feel like ADHD coaching is a big thing that's becoming more popular. Or maybe just noticing it more and even kind of learning more about time and how different people relate to time and how it varies for everybody. We talked just briefly about those kind of languages for progressing with visits. I'm doing a talk at the hospice conference later in the fall kind of talking about how to do that with in-home euthanasia visits. And yeah, just kind of recognizing some of the more traditional approaches for kind of “neurotypical” people. If you feel like you're struggling with them as a neurodivergent person, it may be that there are other resources that can be helpful, so ADHD coaching is something that's really helped me and those people are full of resources.

Dr. Andy Roark:
That's awesome. That's really, really cool. Amanda, where can people find you online? Where can they follow you and keep up with your adventures?

Dr. Amanda Doran:
I do have a website @dramandadoran.com and the little social media on the Instagram @dramandadoran. And you can also find Wicked Witch West End on Instagram too. But most of my projects and other things that I've done on that Dr. Amanda Doran website, and if anybody has questions or wants to reach out, my email address is dramandadoran@gmail.com.

Dr. Andy Roark:
Awesome. That sounds great. Well thank you so much for that, guys. I'll put links to everything we talked about down in the show notes.

Dr. Amanda Doran:
Thank you.

Dr. Andy Roark:
Everybody have a wonderful week. Amanda, thanks again for being here.

Dr. Amanda Doran:
Thank you, Andy.

Dr. Andy Roark:
And that is our show. Guys, I hope you enjoyed it. I hope you got something out of it. Got to give us a special shout out to Banfield the Pet Hospital for making transcripts possible. Speaking of inclusion and accessibility in vet medicine, Banfield makes transcripts possible so that people can more easily access the information in this podcast. And they didn't have to do that and we could not do it without them, so I just got to stop and give a shout out to those guys. Guys, if you got any questions for us, shoot us a question in the mail bag. The email address is podcast@unchartedvet.com and Stephanie Goss and I are happy to tackle that. I'll be back with the goddess Stephanie Goss next week and we will see you then. Take care, everybody.

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