Should veterinary medicine introduce a mid-level practitioner role? With the landscape of veterinary care changing, there's a proposal in Colorado to create a Veterinary Professional Associate (VPA) role, sitting between licensed technicians and veterinarians. In this episode of the Uncharted Veterinary Podcast, Dr. Andy Roark and Stephanie Goss discuss the potential impact of expanding technician responsibilities and how this could redefine roles in general practice. What does this mean for access to veterinary care, the utilization of support staff, and the future of our profession? They explore the nuances of this issue, touching on staffing shortages, licensing, and the evolving structure of veterinary practices. Whether you're a veterinarian, practice manager, technician, or a passionate veterinary professional, this conversation is a must-listen as we navigate the possibilities and challenges ahead. Let’s get into this episode!
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🌟 Check out Dr. Andy Roark's Article!
Dr. Andy Roark is a practicing veterinarian, international speaker, author, and media personality. He is the founder of the Uncharted Veterinary Conference and DrAndyRoark.com. He has been an award-winning columnist for DVM360 and his popular Facebook page, website, podcast, and YouTube show reach millions of people every month. Dr. Roark has received the NAVC Practice Management Speaker of the Year Award three times, the WVC Practice Management Educator of the Year Award, the Outstanding Young Alumni Award from the University of Florida’s College of Veterinary Medicine, and the Veterinarian of the Year Award from the South Carolina Association of Veterinarians.
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Episode Transcript
Stephanie Goss: Hey, everybody. I am Stephanie Goss, and this is another episode of the Uncharted podcast. This week on the podcast, we have an email in the mailbag from a technician who is living world reality in Colorado right now. And for those of you who have your head buried in the sand, like I have had, know that there is an initiative on Colorado's ballot to enact a mid level veterinary practitioner.
It is happening. It is already on the ballot for November and this technician and manager is asking some great questions about whether licensed technicians and a mid level practitioner can coexist. This one's spicy. Let's get into it.
Dr. Andy Roark: And we are back, it's me, Dr. Andy Roark and the one and only Stephanie Weekend Working out Goss.
Stephanie Goss: Oh, that is,
Dr. Andy Roark: Weekend Working Out Goss.
Stephanie Goss: That's good. That's not that's not the song lyric I thought you were going to go with.
Dr. Andy Roark: I didn't think it was. You were like, I thought of one for myself, I wonder if it's the same one. I just thought, the answer is no, Stephanie Goss. I can assure you. If you had known the song I was going to pick, then I would have just, I would have left. I'd have been like, what is that? You just do the podcast.
Stephanie Goss: I did know that song, but I, I thought of something else when I thought of this mailbag question. I was singing in my head. It's the end of the world as we know it.
Dr. Andy Roark: Yeah, mine is more optimistic. I have more positive can do approach than you.
Stephanie Goss: it's the end of the world as we
Dr. Andy Roark: Yeah, it's funny. It's funny how often we could just do take this job and shove it and like it was just like we did every episode we could sing that song and just be done.
Stephanie Goss: How's it going Andy Roark?
Dr. Andy Roark: It's good. There's a lot going on here. I did my last improv comedy show for a while on Friday night. And I decided to rotate kind of off of the team that I've been on for a long time and take a season, at least a season off and and it was good, it was just, it was one of the sad things where I think it's sad.
My hobby was starting to feel a lot like my job, it would, it was the seeing it on my calendar was not sparking joy. I, what really got me was I, I started to feel like my hobby when I saw it on my calendar, it felt exactly the same to me as like a work thing on my calendar. It wasn't bad cause I love my job.
So I wasn't like, I'm not like near, but I'm just like At 3 p. m. I have to go and, participate in this meeting to make this decision. And then at 7 p. m. I have to be downtown to go and do improv comedy. And like just my feelings about those things were pretty much the same and I thought that's not good. You know, that's not good.
This is supposed to spark joy. It's supposed to fill my cup and it didn't it didn't feel my cup. It is it was another thing on my schedule And so I finally decided I was like i'm gonna be done for a while and that was painful But I'm glad I did. However, so I did this show on Friday and my daughter came along and she was in the audience and it was really fun and it was, it was a good show.
And then on Sunday, I went to a work thing for my wife and there was a bunch of faculty members from Furman University there and their spouses and this guy was there and, and we were just talking about whatever and, and someone mentioned I did improv comedy and he, he said, Oh, I'm always, I'm fascinated with improv comedy.
And he'd lived in Chicago and he'd seen the groundlings and second city and all these other improv comedy groups. And so he was really into it. And I started talking to him and he had never done it at all. And really didn't know much about how it actually works. And he was like, how do you practice?
How do you practice improv comedy? You're supposed to make it all up. And so I sort of explain the theory behind creating theater on the spot. And there's a lot of theory behind it and there's a lot of skill and there are tons of techniques and ways to challenge yourself and improve your skills and your timing and things like that, and so we just started talking about that and as I was talking to him, I could feel my enthusiasm like winding back up, I was, it was funny and talking to him. I remembered all the things that I really loved about it. You know what I mean? And like, oh, and he would ask me questions and I am just chomping at the bit to, to explain more of, Oh, you do it this way. And this is how we set it up. And these are some of the things that you look for.
And these are things that are really challenges to overcome. And, and I just, I love the idea of making theater on, on, on the spot and reacting in the moment in front of an audience. And it was funny, it took someone asking me questions about it for me to refine that spark. And then I was like I'm glad I took this time off.
And I suspect I will, I suspect I will be back on the ground in, you know, in, in six months or 12 months or something like that. it was just it was one of those interesting things about how we fall out of love with our hobbies and how we can fall back in.
Stephanie Goss: Yeah. Oh, that's funny. there's seasons in life and sometimes it's a season for it. And sometimes it's a season for a break and scheduling less than saying no to more. And,
Dr. Andy Roark: Yeah.
Stephanie Goss: and it seems like that's that's where you're at. And that's, I like that.
Dr. Andy Roark: Yeah. I mean, yeah, I think you're I think you're spot on. I I think that's it was funny I was I was talking to my kids were asking me about stuff because you know they're my oldest is getting close to going to college and she's I think she's feeling a lot of pressure to have her life figured out And so we were very much talking about that phases of life and seasons of life idea of, you know, you want different things at different times.
And I don't know why I had that same mentality of stopping something is failure or putting things down as failure. The fact that I did improv comedy for 10 years, And then took a year, stopped for a year. Does that mean that I failed? Does that mean that 10 years of practice and work and shows were a waste of time because I did not get famous?
Which was never the goal. You know what I mean? And then one day, I just stop doing it and I go I think that's I think that's been a lesson for me as a goal oriented person I think one of the healthiest things about improv comedy for me is there's nothing created by it. It's you know You go and you do this show and no one who's not no one who's outside the room will ever know what you did.
No one records it. There's no there's no memory of it I mean, it's your own memory in your mind, but even then I found improv is really hard to remember and so You There is nothing to improv, except the process of doing improv. And I think that is something that's really healthy for me to be reminded of again and again and again.
Because to me, if it doesn't end in a goal, a certificate, a metric, an outcome, I'm always like was it worth it? And I've, it's something I've, I've had to really try to stretch my mind around to be a happy adult.
Stephanie Goss: I love it. Speaking of stretching our minds this one might stretch some people's minds,
Dr. Andy Roark: Stretch their adrenals, that's for sure.
Stephanie Goss: Yeah, it's gonna probably fire some people up, but I feel like it's about time just, Take a deep breath. Everybody take a deep breath.
Collectively. We're going to talk through something. And timing wise, when this episode comes out, I'm just going to say that it is, it's a chaotic time in the world. And it is It's election season and there's a lot of noise and there's a lot of shouting and sometimes it happens within our own field and we're going to talk a little bit about that.
But I also want to start from a place of hope and positivity, Andy Roark since you said I have such a negative worldview and I just want to remind everybody that no matter what, you have a vote. You can use it and I don't mean that politically. In terms of our scenario here. So we got a mailbag from a technician who is licensed technician and they said, Hey, I recently read Andy's article where you were talking about GPs defining their future and leveraging technicians in general practice.
And so they said, as an, as an RVT and a practice manager, I love it. And this person lives in Colorado and for anyone who has been living with their head in the sand, which was me hi, it's me, I'm the problem, it's me. Until recently, I didn't, I mean, I knew the mid level practitioner thing was a discussion in veterinary medicine, but I didn't actually know it was on the ballot until just a couple of weeks ago.
And this technician lives in Colorado where the veterinary community is in an uproar because there is something on the ballot for this November about creating a mid level veterinary professional associate, is what they're calling it in Colorado. So a mid level practitioner that would be between technicians, licensed technicians, and DVMs.
And so their question to us, one of several, is do, we think that it's possible to elevate our licensed technicians by expanding their scope of practice and add mid level practitioners into our field. And so they were saying that, they, after reading your article and thinking about it as a manager, they see the need for more bodies.
And more people in our field, we have a vastly underserved communities around the world, but in the United States, specifically where we're practicing we have a shortage of technicians. We have a shortage of doctors. We have an overwhelming amount of patients and clients, and there are a lot of people who are not being served.
And so they said from a manager hat on, I can see where a mid level practitioner is an obvious answer and as a technician, obviously, I want to see technicians being trusted more and allowed to do more because we are already licensed. There is already a structure in place to vet what technicians are allowed or not allowed to do.
And so they said, I would love to see us trusted with more. Could we imagine, or could we hallucinate, a place where technicians could be allowed to do things that would make an impact in terms of access to veterinary care, like allowing techs to establish a VCPR and have that valid client patient relationship prescribing meds?
Could technicians become mid level practitioner and could there be a practitioner stage between absolutely no experience in the kennel and licensed technicians. What does that look like? And so they said, you know, this topic has already created such divisiveness in the veterinary community and it's really disheartening.
They understand how adding that mid level practitioner role might threaten people who are in existing roles. And they said, as a, as a manager, as a practitioner, all of these things together, I feel like if we don't make changes to set us up for success in the future, we're all going to burn out because we're in this place where people are leaving the field in droves.
And so they said, we, I want to know what your standpoints are on this issue. And I thought this is beefy and meaty And it's almost time for the election. Like, let's talk about a hot topic. Let's get a little sassy.
Dr. Andy Roark: I really like your rock the boat intro to the mailbag. That's good. Just get that out there. Get out. Get out vote.
Stephanie Goss: Get out there. Look I'm just saying everyone has a vote.
Dr. Andy Roark: Yeah.
Stephanie Goss: How you choose to use it as is personal. And it's true here. Everybody has an opinion and everybody has the ability to make an impact here. And so I'm curious to see where you go with this.
Dr. Andy Roark: Yeah. I'm happy to talk about this. And I'm also going to use this as an opportunity, to talk about managing when the future is largely unknowable. And so I think that this falls into my category of managing to the unknowable future. And so, yeah, that's kind of where I want to talk about. All right.
Let me summarize the article that they were referring to at the very beginning. Quite simply my position has been. One of the ways that we can keep care affordable for pet owners and stop doctors from being overwhelmed, cause we have a shortage of doctors is to leverage our paraprofessionals and have them do more and the more things that we're not paying veterinarians to do, but we're paying paraprofessionals. We should be able to have more affordable services because of those things. And so it's not about charging what you would charge for a doctor to do a thing and having a technician do it. It's about charging less than what would require a doctor because a doctor is not doing it.
And I think we could theoretically give our support staff a raise. I think we could actually decrease the prices of some services to the pet owners, and we could also increase accessibility, meaning they can get in more often, and we can also reduce the workload on the veterinarians. And so to me, all that stuff makes sense.
The example of this, which most people have already seen, is technician vaccine appointments. Generally, practices charge less to get vaccines done with a technician than they do with a doctor. And, if we get pets back in and they get boosters with a technician, It's usually easier to schedule those appointments.
The technicians get to do it. They get to use their skills. They feel engaged. And the price point is lower for the pet owners. It's sort of an all around win. And so that's been kind of my thing. And so I think that's where we need to go to paraprofessionals. But then the question becomes, if we have paraprofessionals that are doing more and more of the wellness stuff, then what are doctors going to do?
Are we taking the job away from the doctors? And the obvious caveat here that I haven't heard anybody say is if you really want your technicians to work at the top of their license, then that is going to require that veterinarians also work at the top of their license and there is plenty of space for veterinarians to be doing more technical work, working up sick patients hospitalizing cases, just doing more, more types of aggressive, more aggressive, more sort of a higher standard of care sort of work.
And so I, it can all work. But everybody's going to have to shift around a little bit. We can't have the technicians doing all the wellness work and then veterinarians comfortably doing wellness work as well. Cause then you got everybody who's just doing wellness work and, you know, how does that fit?
So anyway, that, that's the basic gist of the article. I promise you, it's much more eloquent than the way I made it sound but that's really it.
Stephanie Goss: We’ll put a link if you haven't read it. We'll put a link to the article in the show notes.
Dr. Andy Roark: Yeah. So this person's point of, I really liked the idea of of the support staff doing more and then the doctors sort of being able to do more and kind of practice at the highest part of their license as well. So that's kind of where they're starting. And then, and then what are we doing here with the With the VPAs, the veterinary professional associates.
So this is sort of the mid level practitioners. I call them probably mid level practitioners just because it's easier for me to remember and then versus our RVTs. Okay. So let's start with some headspace. The big things for me. Is if you are the practice manager here and you're in a practice and this is happening around you just to just for your to protect your peace and to make this podcast something that doesn't get me burned at the stake I Let's talk about Let's talk about what we actually have power to do and not what should happen, because if you get into what should happen, it's this big theoretical thing, and it's all these different contingencies, and I have, I'll just state up front, I have no idea what's going to happen.
I have no idea if it's going to pass. I have no idea if it does pass. I don't know what the interactions of RVTs and VPAs is going to look like. I have no idea about any of those things. I don't find it productive at this point, to say whether this should pass or this shouldn't pass or we should do this and we shouldn't do this I think all that we can do really in a productive way is to say this is what we are looking at.
What action steps are we going to take? And so that's kind of how I want to approach this if you're in colorado It's already on the ballot and there there are schools that are turning these people out to fill this job they're already in place. And so these things are happening. That doesn't mean I'm saying they're going to go through smoothly.
And like I said, I don't know how that exactly how they're going to work with the structure we already have but they're already in place. It helps me to think about things like this where there is a ballot initiative as a force of nature I think the healthiest thing that you can do in your mind is to say there's a storm coming and i'm not going to run around and shake my fist at the sky, you know? It's am I concerned sure i'm concerned when I hear that there's a hurricane bearing down on South Carolina. Like I I get concerned.
I really hope we don't end up in a situation where we lose power for a week and it sucks But There's a fairly limited number of things I can do. I make sure I've got gas for the backup generator and, you know, and, and that's about it. I think this is important. There was Elizabeth Warren had this sort of public letter about corporate consolidation and vet medicine a while ago.
And my advice to people was the same thing then of Elizabeth Warren is so far outside my sphere of influence. She might as well be a solar eclipse. I just, I have no power over what one of the US senators does. All I can do is look and say, what am I going to do in my little practice? And, and I just, I think that's true for a lot of people, as far as dealing with this, we'll talk about, we'll talk about advocacy and shaping the profession in a moment, but for the most part, as far as figuring out how to react, I think getting a proper perspective on
the size of the events in motion is going to make you a lot a lot happier. I think that I think it's important to believe that the future of veterinary medicine is fragmentation. And so it's been something I came up with years ago. The future of vet medicine is so many practices doing things in wildly different ways.
When I was a young doctor, basically vet medicine was practiced in a standard form. And there was, there were different sort of levels of care and there were some, higher end practices and lower end practices. But for the most part, we were all really pretty much running the same playbook.
And it's not that way anymore. We've got concierge doctors that just do house calls and come to your house. This was before, when I graduated, the whole home hospice was, and I knew it was happening, but it was not mainstream at all. It was really niche. And then it really took off in 2009 with Lap of Love.
And but that was just, wasn't a thing. You couldn't be a doctor that only did. Hospice care and euthanasia and you saw two appointments a day. Yet here we are. I remember I remember mostly reading as a vet student when Banfield was coming up in our profession, people hated Banfield.
The idea that there would be vet clinics inside of Petco or PetSmart. They hated it. And it was some bad blood, and the doctors that. We're shamed back in the day, and I saw a parallel to that when we saw the vaccine trucks, and I don't feel like the resentment is there like it used to be at all, but there for a while.
But if you were a veterinarian, you worked at a vaccine truck. Oh, my God, you were pariah. And people were like, how could you? How dare you? And now I think we sort of come to accept like, okay. This is an accessibility of care thing. There are people that, that need this service. This is good for others. It's not going to put the rest of us out of business.
You know, we're going to find people who want what we have that continued spreading out of the clinics, I think is what's going to continue to happen. I think you're going to have some that really leveraged support staff. And then I think guys, I think you're going to have other practices that don't have techs.
I could literally see a vet and an assistant being the only people that you would see at a practice, and you're probably going to play it. You're probably going to pay a premium price because you only talk to the veterinarian, but some people will pay that price and that, I suspect if you're that clinic, you probably limit the number of clients that you will take on.
And I guess the concierge model is I'm going to have a thousand clients. And they're all going to pay me a flat fee every month. And I, and they have my cell phone number. And you go, that's not how we do medicine. It can be and a lot of people
Stephanie Goss: do it.
Hmm. hmm.
Dr. Andy Roark: And so anyway, I think that's the future.
And when you look at the VPA or mid level practitioner or things like that, I suspect it's going to happen in some states. And it's not going to happen in other states. And you're just going to see styles of practice some places that you're not going to see other places, but I don't think this is going to be sweeping, everyone gets reset.
I could be wrong, but I really doubt it.
Stephanie Goss: Yeah, I think from a headspace perspective, that is where I started to, which is that this is a conversation that is full of nuance and the differences across our even just our map here in the United States are vast, right? So, to your point, it's really easy to fall into the kind of should thinking and should, what should thinking looks like for someone who is practicing currently in Colorado, maybe vastly different than should thinking looks for someone who is practicing in Alabama or, you know, New York City, or like we have always had differences in veterinary medicine based on where we are.
And I think this is an example of one of those conversations that has to be nuanced because of those differences and a lot of the conversation that kind of runs parallel to this is we already have those differences and we see them in our existing licensed staff or lack thereof in some states that don't require licensure and so I think remembering that this is a conversation that is full of nuance and remembering that there are a lot of differences.
I think that it's really, really important. I love that you started with the eliminating the idea of should from the conversation, because I think that I love your example of the vaccine clinics, because I remember when I first started in practice as well, and the idea that we would refer someone to a vaccine clinic was
Dr. Andy Roark: Heresy. It was heresy.
Stephanie Goss: it was heresy. And I remember the very first time I was sitting at the front desk and I remember I was talking to a client. It was kind of an older client and they were, she was just like, she was very emotional. And she said, I'm on a fixed income and I'm really struggling. And I had just given her a treatment plan for what it would cost to come in for an annual visit.
And she said I cannot afford that. What can I do? And I knew that the answer was, to talk to her about like our clinic answer and our standard of care was to talk to her about care credit and the payment plans that we offered. And I had already talked to her about, I knew that she already had Care Credit because she had had her pet in the week before because it had been sick.
And I said, there are other options. And so then I had a conversation with her about the vaccine clinic that operated at the feed store across the street from us. And we hung up the phone and she was, she was thrilled and she was just like, thank you so much.
And what she said to me stuck with me to this day. And it's been over 20 years. She, she said, I, this is why I'm a client there because you see me as a person and I will bring Mia in for care with you when she really needs it because you're helping me afford the basic everyday care by sending me to the vaccine clinic.
And I remember hanging up the phone and I remember just feeling my coworker who was older than me and was the lead at the time. I feeling her just stare boring into my back. And she was just like, what did you just do? And we had this conversation and it came from this place of having a scarcity mentality and feeling like if we refer clients to other places, there won't be enough work for all of us.
We'll go out of business if I send a client to the vaccine clinic. And when you step back from that emotion in the moment, the reality of that is yeah. Equally heresy, right? Like it really, are we going to go out of business because we send a client who, who needs it somewhere else? No. You know what happened?
We got two new clients because that client went and was telling other people about how kind we were and about the conversation she had with me. And she sent two of her friends in as referrals. And so we gained two new clients because we met her where she was at. And I think there's, It is really easy to fall into this headspace of all or nothing thinking when we're talking about the things like the shoulds.
And so this, just like political conversations and other conversations that we have in our industry, I see so many of us falling into this giant trap of It has to be this way or that way, and there's no in between. And that is how I have seen this conversation about mid level practitioners set up, is if we introduce mid level practitioners, it is the end of the world as we know it for technicians.
They're all going to leave the field, the ones who've worked so hard to get their license. They're going to be so angry about this. They're all going to leave the field. And we're not going to be like, It is that black and white, all or nothing thinking. And so for me, the headspace is really simple about remembering that this is a conversation full of nuance, remembering that we all are coming from a already different space.
And so if we want this conversation to be at all productive as an industry, we have to stop thinking about it as all or nothing and come to the table prepared to accept those three things from a headspace perspective or it's going to be a completely unproductive conversation.
Dr. Andy Roark: I think you're, I think you're spot on. It's I saw some conflict recently, on social media in the vet sphere about this, uh, practice that decided they were not going to do nail trims anymore. They said it was it was stressing out the staff and they the doctor who owned the practice hated doing nail trims trims anymore. We don't do it And boy that divided people up and there was a lot of people apparently and she made a video about it. The owner did about being really criticized like how could you do this?
This is your job. You need to do it and it was just it was really this strange highlight of how people get things fixed in their mind of this is what it should be and this is how they work and how dare you do them differently. and everybody should just accept that and get ready.
Is it going to be good or bad? Whenever I have things like this that are large scale or sweeping and multifactorial and you really don't know exactly what's going to happen. The best story that comes into my mind is the story of the Chinese farmer. And this is the old parable about the guy whose, um, whose horse runs away and the neighbor says, Oh, that's terrible luck.
And the farmer says, well, we'll see. And then the horse comes back and it's got another horse with it. And the neighbor goes, this is amazing. You now have two horses. It's incredible. And the farmer goes, Well, we'll see. And then his son goes, Rides one of the horses, the new horse, and he falls and he breaks his leg and the neighbor says, this is terrible.
And the farmer says, well, we'll see. And then the military comes through recruiting men to go off to a battle where they're all killed. But because the son's leg is broken, he doesn't have to go and he's not killed. And you know, and it just, goes on and on and on that way.
My wife and daughter do Olympic weightlifting and they had this coach that they've worked with for some time and she was great and she had changes in her personal life and had to, and decided she was going to quit coaching and she told my wife, I can't coach you guys anymore. And Allison was devastated. She really, she was like, this is the person and we've got this great rapport with her. And we've got, all of these things worked out and we've been working with her for years. And this is, we're losing this stability and who's going to work with us on our schedule and all of those things.
And it looked really dark. And then. She was introduced to someone else who she had kind of met in passing years ago. And this person was like, sure, I'll coach you. Let's do a trial. And this person is amazing. And, and again, it's not even about being better than the previous coach. It's just, the style is completely different.
The way they communicate is completely different. I think Allison feels very refreshed and recharged. And my daughter really likes this person and it's just, it went, but it went from this is terrible too. This is great, and it never would have happened if we hadn't been pushed out of our comfortable place by this coach saying, I can't coach you guys anymore.
So anyway, is it good or is it bad? It's impossible to know. And I just think that's a really healthy thing to to think about. And it brings me to the sort of the final point I want to make in Headspace. And I see this a lot. Beware of focusing intently on an uncertain future.
Stephanie Goss: Sure.
Dr. Andy Roark: There's, when we look ahead and we don't know the future, and guys, we never know the future.
Who knows what's going to happen? Who knows how these things will be implemented? There's just, there's no way to tell. There's this weird seduction about ruminating about the future and planning for the future and coming up with contingency plans. They're all useless, yet this is real time and real emotional energy that we're burning.
Looking at a scenario that we do not have the clarity to navigate at all. And I see people do that all the time. And What we can do right now is to say we foresee a future where support staff will be leveraged more fully and in a more advanced capacity
Stephanie Goss:Mm hmm.
Dr. Andy Roark: than they are now. I think we can all agree with that.
What can we do right now to begin modernizing our own practice? Let's do those things. Is that going to move all the way to a VPA? I have no idea. But, We can go ahead and start building workflows to leverage our paraprofessionals and our support staff. We can go ahead and start working with the staff that we have to handle more of our communication and customer service and start to build norms around the direction we think things are going without knowing exactly what the future is going to bring.
I don't think it's going to be possible to start making protocols of how we're going to leverage these people, which a don't exist yet. And B, we haven't hired yet. You know, I, I don't think that makes sense. I think that you can start marching in a direction, doing the things you can actually do, working on the things that are in front of you.
And you can make your practice better and you can take better care of your clients. And by the time you get that far down the road, you will have clarity about what the future is going to be, and you will be able to do that. Continue to implement and innovate the big mistake. I don't want people to make is analysis paralysis.
And I see that a lot. We are so worried about what's going to happen. We're going to have meetings and conversations and draw things on white boards and use post it notes and send emails to each other around something that is so uncertain. We were never going to. We can't move forward, but we feel like we're doing quote unquote strategic planning and I go you're hypothesizing, you're writing a fantasy novel, you know, you just, you don't, you don't have the ability to actually do anything.
And so my advice is resist the urge to ruminate on a wildly uncertain future. Put your finger in the wind, see which direction is blowing, start moving your practice in that way in a measured. Organized, just keep everybody on board sort of way, and then you'll be ready to go if those opportunities open up, and if you don't open up, you still will have a better practice.
Stephanie Goss: How do you feel about Headspace? You feel like that's pretty solid? I mean, that covers the things I had on my list here.
Dr. Andy Roark: Yeah, I think I do. I think I really like that. You called out all or nothing thinking. I think that's a really big thing to call out. I don't think our writer has it. I think she's looking at possibilities The all or nothing thinking, I think is important. The catastrophic thinking of this is going to be bad.
And then the techs are going to fight with these new people. And then the people who are technicians are going to be angry and they're going to leave and then they're going to, you know, whatever, like that's catastrophic thinking. Be beware of storytelling. When we say these rich corporations are going to force this through when they've bought the politicians and they're going to make these things happen and like, just.
Those are all stories that, that we make up in our minds. Just, I see those exact things all the time. Try to avoid getting sucked up in. It's just not productive for you. It's not going to make you feel better. It doesn't help you make choices. Just remember forces of nature. Go ahead and decide where you think the industry is going and where you want your practice to go.
And remember the future of medicine is fragmentation. No one's going to make you do anything. Your practice can be what you want it to be and what your clients need it to be. And just control the things that are in front of you that you can control. So that's the headspace for me.
Stephanie Goss: Okay. Why don't we take a break and then we can dive into some, are there actually action steps? I have some ideas.
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Dr. Andy Roark: All right. All right. I think our action steps are pretty short in this regard. I mean, but I still want to lay them down just for this
Stephanie Goss: I think if we don't talk about action steps, right? Like we're just, aren't, aren't we just contributing to the shouting into the wind? There are things that we can do. And so rather than getting spun up and wringing our hands, I think that there are a few solid action steps, and I think that's, for me, that's where I try and lean into the conversation, otherwise it's just gonna be a kick in the adrenals.
Dr. Andy Roark: totally. So there are things you can do. Here they are. The first thing is get educated on what's going on in your area in terms of mid level practitioners. Like this is coming, it's on the ballot in Colorado. It is going to come to other states. You can just bet on it. Get educated on what is on the ballot in your state.
And there are there are groups that are working on this. If you want to get involved and see which groups are active in your state, reach out to your state veterinary medical association. And so that's number one is get educated. Number two is get involved in organized medicine. And again, I have been skeptical of organized medicine in the past.
I have not always been a pro, AVMA state VMA guy. I've never been negative, but I've been, I've been neutral. I am less neutral now than I have been in the past. If you want to be involved in what happens, you need to understand what's happening. You need to reach out to your local organizations.
And if you can donate your time. And be a part of the committees that are working to make recommendations on how mid level practitioners would be used or how technicians would be used so that mid level practitioners are not necessary. And again, there's a lot of debate around that. Do not sit in your own practice, twiddle your thumbs, get angry, and not make your voice heard in any sort of a meaningful way.
Even if you say, Andy, I do not have time to be involved in these things. You need to be a member of your state and local organizations.
Stephanie Goss: Yes.
Dr. Andy Roark: stroke them a check, give them some resources so that they can advocate because people who want to they want to have our way, their way in our industry.
They have got resources and the local VMAs in my experience are generally good people who are trying to look out for veterinary professionals. They really are. They need resources. And so if you're not a member of the AVMA and you're not a member of the state VMA, then you're And you're not donating your time in a leader position.
I think that you're, I think that you're a sailor and you're not a captain here. You know what I mean? You're gonna, you're gonna go along and you're gonna deal with what happens. That's a choice. I'm not trying to shame anybody, but I believe that right now, veterinarians specifically, But all veterinary professionals, this is the time to use your voice.
And what that means is you have got to be collaborative. You have got to find ways to work with other veterinarians. Anywhere that you have veterinarians coming together, we should be talking to each other. We should be talking about what we want in practice and what we think our role as veterinarians should look like.
We should be advocating for veterinarians and veterinarians involvement. We should not dig our heels in and cross our arms and go, no, we're not doing any of this. It's all bad. We're not doing any of it. If we do that, we are going to get the door closed in our face and we are going to be excluded from the conversation.
We have got to engage, hear what people want, including pet owners, including including corporations that are going to have a big voice at the table. And we have got to navigate. And be firm about what are deal breakers for us, but we also need to come with solutions that are going to take care of pet owners and get pets the care that they need.
And so anyway, that is my call. If you're really eating up about this, there are things that you can do that's kind of my, my action, across the industry, there's a, decisions are happening now and I think this is an important time if you want to be involved, you can be involved, but people need to step up and lead.
There's a lot of empty seats in leadership committees that would really benefit from having vets that care, that are open minded about the future and that want to actually guide this in a way that's going to, that's going to work for everybody.
Stephanie Goss: And I think, for me, it I agree, and those were my two as, as well, and I think It goes beyond, for me, obviously, as a paraprofessional staff, it goes beyond the veterinarians, and I will say I have my own, beef with, and have in the past, and to now with, AVMA in terms of being inclusive of all paraprofessionals.
And just because we don't have a voice at that table doesn't mean that we don't have a voice at the table. And so again, this is an example for me of all or nothing thinking where I have seen a lot of paraprofessionals say, well, we can't be members of the AVMA. And so how do we have a voice? And so I think for me, it's about, we said, be engaged in organized medicine.
We didn't say become a member of the AVMA. That's not the only way to be involved in organized medicine. And I think there, again, it's another illustration of that all or nothing thinking in our field where we think that's the only solution. And so I think educating yourself in terms of what's going on in your area and then recognizing that you can make a huge impact at your local level.
Can you make an impact on a nationwide level? Yes, And it takes way more bodies and way more voices to make that impact at that higher level. And so it has to start with the local level. And so getting involved to your point, Andy, and your local VMA, but also getting involved in the other organizations that are out there, whether it is your local tech association, as an employer sponsoring your employees.
to be a part of local organizations and not because you want them to think the way that you are, but because you're empowering them to have a voice and you're empowering them to create a world of veterinary medicine that they can see themselves in. And it's again, you know, I said in the beginning, like this is going to be charged and it's hard for me to not liken it to the political landscape in our country right now a little bit, but the reality is I believe everybody should have a voice and what I have to accept if I believe that is not everyone is going to have the same voice as me and I'm still going to advocate for everybody to be able to have a voice.
And so I think it's the same way with our team. We, there are things we can do as employers, as bosses, as peers and colleagues just advocating, making sure that young technicians coming up know what organizations are out there. I can't tell you how often I talk to young technicians, young managers who have been homegrown, right?
Who are growing from within. We've already started building that future as uncertain as it may be, we have already started building that future by growing people from within our practices. And so often I talk to them and they have no idea that organized medicine exists. They have no idea that VHMA, that NAVTA, that all of these associations and groups and organizations that are out there, they have no idea that they exist.
And so I think for me, part of educating yourself. in what is going on in your area has to do with what are the licensure requirements? What does the landscape look like when it comes to a mid level practitioner? What is the scope of practice for veterinarians? All of those things. And it also goes to educating yourself on what does the local landscape look like?
What are the local associations? Are there groups that your team can join? How can you get involved to your point? How can you not be, uh, paying member and put dues towards things that you believe in, but also how can you volunteer your time? Because that is something that organizations generally need more than anything else is people who are willing to show up and help.
And, That's the power of it is that you get a choice to your point. You can join an association that is for house call vets. If that's your passion, if that's the space of veterinary medicine that you want to impact, you can join the anesthesia nerds. You can, there's a million different local areas that you can impact based on what you believe in and the medicine that you want to practice.
So we've got to stop that all or nothing thinking and recognize that we need to educate ourselves and that we have a choice to engage in organized medicine. And it's not as black or white as to say, you If you're not engaged and involved with AVMA, then you're not a part of organized medicine. And I think too often we fall into that.
We fall into that trap.
Dr. Andy Roark: Yeah. I think that, I think that you're spot on. I think beyond that, if you say hear that for what it is, I, I really am a big believer that vet, I speak to veterinarians. But this is also true of our technicians. It has never been more important to be connected. than it is right now and so whether it's, whether it's being an Uncharted, whether it's being in the American Animal Hospital Association, whether it's being in your state VMA, the more you have access to other veterinarians so that you can talk as a group and say, What are you guys doing?
This is what we're doing. We can share information. There's going to be a lot of power at the state level for your state practice act. And being involved in how that is adapted with changing rules being introduced across the country, that stuff really matters. And so anyway, we do have the ability to be heard.
We are not powerless, but it takes group action and you should do the things that make you feel good. You know, you should be as involved as you want. To be don't feel powerless inside your practice. Go ahead and get in the habit of training, of empowering, of delegating, of featuring your paraprofessionals.
And just don't, don't know what your practice is. Now, your practice act is now. And start building up the use of these technicians, of your assistants, of your CSRs, and just go ahead and start moving in that direction. The worst thing that you can do is sit back and say, boy, we're going to do a ton with our support staff as soon as massive legal changes are made, then we're going to flip a switch and go fast.
No, you're not. You, go ahead. If that's where you want to go, if that's the general direction, most of us are underutilizing the support staff we have now. We could go ahead, we could focus on the training that is available to us now and having people do the things that they can technically do now in the State Practice Act.
We could go ahead and be working on those things. And so, don't sit back and feel like you're not allowed to get started. You can go ahead and get started. And then you can accelerate as opportunities open up for you. But don't wait until you get a big waving green flag before you get started. Go ahead and start today.
So yeah, that's what I'll get for access steps.
Stephanie Goss: I love it. I love it. What do you think we're going to get burned at the stake
Dr. Andy Roark: I hope not. We'll see. I said, I go back, please don't write me emails and say, I disagree with your beliefs about what should happen. I don't want to argue about what should happen. I said, I, I have been much happier in my life being a pragmatist and saying, what is happening and where are we in the process and what power do I have right now?
And again, I think I'll leave you this. So here's a story. Have you ever heard the parable of the second arrow, Stephanie? The parable of the second arrow is a Buddhist, sort of a Buddhist proverb, and the idea is and I'll give you the paraphrased version, but basically the Buddha says to one of the disciples, does it get hurt to be shot with an arrow?
And the guy says, yes. And he says, does it hurt more to be shot with a second arrow? And the person says, yes, and the point the Buddha goes on to make is the arrow is the actual problem. The second arrow is worry about the future and the second arrow is optional. And so we cannot avoid the pain of the present.
We can avoid often the pain of worrying about the future. So anyway, my hope today is that we did not take away the pain of the first arrow. Change is always going to happen. It's going to be uncomfortable. We're going to have to navigate it. My hope is that I helped convince you to not get hit by the second arrow.
Stephanie Goss: I like it. I like it. All right.
Dr. Andy Roark: All right, guys. Thanks for being here
Stephanie Goss: That’s a good ending spot. Have a good week, everyone.
Dr. Andy Roark: See you gang.
