This week on the podcast…
This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are taking a recent topic they were discussing with a colleague and diving in for a deeper conversation. Their colleague was pointing out the perspective that it feels like there is a lot of fear swirling around veterinary medicine these days. Veterinarians are afraid of being sued and board complaints; they and their teams are anxiously awaiting the next negative client interaction; they are terrified of online reviews especially the ones that go sideways and get mob mentality attached to them. Andy and Stephanie walk through their take on some questions like “Is this normal? Has the profession really changed that much in this regard in the last 20 or 30 years. Are all professions like this? And most importantly, can this be changed? Let's get into this…
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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, Andy and I are continuing a conversation that got started recently with a colleague. We were talking about the current state of veterinary medicine, and one of the things that came up was that it feels like to some of us, that one of the predominant emotions in veterinary medicine right now is fear.
And we talked about a bunch of examples, and we'll dive into that in the episode. And there were some great questions that came out of the conversation that Andy and I really wanted to take some time and discuss in more detail here on the podcast. There was questions like, “Is this normal? Are other professions like this? Are all professions like this? Are we an anomaly?” We talked about, has the profession changed, and how has it changed over the last 20 or 30 years?
And I think the most important question of all was the hopepunk rebellion question of, can this be changed? If this is truly our state, is this something that we as an industry can change? Andy and I had so much fun with this one. Let's get into it.
Speaker 2:
And now, the Uncharted podcast.
Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark, and the one and only Stephanie. I want to see you be brave Goss. I want to see you be… I have a soft spot in my heart for that positive female empower… Like a small boat on the ocean. Anyway, I can't.
Stephanie Goss:
I was going to say, that's a little out of your range.
Dr. Andy Roark:
It is. It is. What is my range? I don't know. I just go for it and then we find out.
Stephanie Goss:
I don't think Rachel Platten's in your range.
Dr. Andy Roark:
Thank you. You knew what it was, which is great. As I said, I was like, “No one's going to know what that is.”
Stephanie Goss:
I totally knew what it was. That's one of my favorite songs.
Dr. Andy Roark:
This is my fight song, take back my right song, or turn on the light song. Anyway, it's something like that. I love that kind of empowerment music. When I'm in the mood, it's my jam. I just like it.
Stephanie Goss:
I know. Your playlist is full of that for when we go to events and stuff.
Dr. Andy Roark:
Yeah, I know. That's one of the hard parts of my life, is the Uncharted Spotify account is also the Dr. Andy Roark personal Spotify account. And so I get criticized for my music by… 11 employees are all like, “Look at this.” Oh man.
Stephanie Goss:
So fantastic. How's it going?
Dr. Andy Roark:
I've got a new segment of the show. I have a new segment for our show.
Stephanie Goss:
Okay.
Dr. Andy Roark:
It's life lessons from advanced beginner hiphop dance class, with Dr. Andy Roark.
Stephanie Goss:
Okay. So we've moved on from the garden to advanced beginner. Advanced beginner hip hop. Okay, lay it on me.
Dr. Andy Roark:
Advanced beginner hip hop dance class. I find inspiration everywhere in this joyful world Stephanie Goss-
Stephanie Goss:
Wait is it beginner, beginner?
Dr. Andy Roark:
It's advanced beginner.
Stephanie Goss:
Okay.
Dr. Andy Roark:
Advanced beginner. It's like there's the beginners, and then there's advanced beginners. And my daughter is in the advanced beginners class. And I saw they had their recital yesterday, and I was there.
And what was funny is, she's been working on… It's a dance. So it's a dance. First of all, the dance that they chose is Kanye West Jesus Walks, which is not remotely appropriate, not remotely appropriate for 11 to 13 year old dancers.
And yes, they play a clean version. But you can't find the clean version. So every time your kid wants to show someone, every time they want to practice, you're like, “Whoa, whoa.” It was just, the choice of song was real, I struggle a bit. It was a bold choice.
Stephanie Goss:
The adult oversight there.
Dr. Andy Roark:
It was. I was like, “Mr. Trey, we need to talk. I'm going to give you some feedback when we're done.” And so it's Jesus Walks okay. And every day, Hannah comes home from dance practice and she's flustered and she's like, “The kids. There's one kid that's not paying attention and the other kids are not… The spacing is not right. It's a trapezoid shape. We're doing a trapezoid shape on the stage. And this one kid doesn't know the difference in a square and a trapezoid.” She's very upset.
And so she's given this really specific critiques, like down to people are not hitting their marks, things like that. So I've heard this for eight weeks and I'm like, “Oh boy, this is a production. And Hannah is very serious about getting”… And I get there and it is exactly what you expect for an advanced beginner 11 year old hip hop dance class recital, as is to say it's chaos.
It's The Muppet Show up there. You know what I mean? The kids are looking at each other. You know what I mean? To make sure they're doing it right. It is not the Fly Girls from In Living Color or any other dance troop that you might associate with hip-hop dance.
Anyway, the life lesson I took away was make sure that you are not the person who's trying to perfect the presentation when you're in advanced beginner hip hop class. You know what I mean? We all know people who their perfection level is turned so far up beyond, of whatever is going happen in real life. And I'm like, “That's Hannah.” And so I had to have a conversation with Hannah about accepting that sometimes we're in advanced beginner hip hop dance and people aren't going to hit their marks. And we have to be a little bit careful about the trust fall part of the dance. And that's just what we have to be careful about. Anyway, so make sure that you are not going for perfection when you're working in advanced beginner hip hop dance, or else you're going to be frustrated. And that's life lessons from advanced beginner hip hop dance class with Dr. Andy Roark. I felt so bad for her because she was like, “Can you believe they didn't hit their marks?” And I'm like, “I can. I can believe that.”
Stephanie Goss:
“What I can't believe is that y'all are out here dancing to Jesus Walks.”
Dr. Andy Roark:
“Of all the things that I'm struggling to believe, that's not the one.”
Stephanie Goss:
Oh man. Okay. My face hurts from laughing already, and we haven't even started. We have a fun one this weekend I think. This one came kind of via the mailbag, but came from a community conversation in Uncharted.
And one of our friends was asking a question about fear in veterinary medicine. And I thought it was such a good question. And it was like this is an older veterinarian, and he's wonderful, and progressive, and was just like, “I've been around a long time and I feel like we've gotten way more fearful. And I feel like the profession has changed radically over the last 20 or 30 years. I feel like now we live as a whole collective group in this state of fear. We're afraid of being sued. We're afraid of negative client interactions. We're afraid of bad reviews online. We're afraid of not being perfect for everybody all the time,” and on and on and on. He was asking, “Is this the new normal? Have we really changed that much?”
And the other questions that I found were super, super interesting, are all professions like this? Is it just us in veterinary medicine? And the best question was, can we change this? And I would add, how do we change it, to that list of questions. And I thought it was such a fun one, and I said, “Hey, we would love to talk about this on the podcast, because I have thoughts and I bet Andy has thoughts.” I would love to do what we do best, which is you sit in your basement, and me sit in my closet, and let's soapbox about it.
Dr. Andy Roark:
Oh yeah. I'm all about it. I'm all about it. Yeah, I like this question. I think this is a big, sprawling topic, and I think it's good to talk about. I really do. I like this question a lot.
I think that there's two parts of this. There's the larger culture that we live in, and then there's the way that we communicate inside that culture. And that's kind of where I start.
So we'll start in head space here as we start talking about, “Man, why is everybody so afraid in vet medicine? Is it just vet medicine?” Stuff like that. I don't think it's just vet medicine. I'll just say that. I don't think that vet medicine is any scarier than a lot of other jobs. And people say, “But we have lives in our hands,” and we do. And lots of other people have lives in their hands as well, or they have other things that really matter.
And so I get it. I don't think that we own the market on… If things go bad in our job, they really go bad. And that's true for bus drivers as well, and airplane pilots, and all sorts of people, police officers and on and on. So anyway, there's that.
I think that overall, we live in a safety culture right now. And there's been a lot of research on this. And we have come to a place in a culture where we are very worried about things. And I think a lot of that comes from how we communicate stuff.
You and I have talked about this a number of times with our kids, and we talk about the kids. And I really like this because I think this is important. So I think about my own childhood. When I was 11 years old, I ran free in the neighborhood. My parents had no idea where I was until I came home at dark.
And man, there is no time in the day where I don't know where my 11-year-old is now. I'm not trying to enforce that… But can I just tell you, so my daughter's 11, my youngest hip hop dance class daughter. And I have a little apprehension about her walking the dog, and just by herself, and off in the neighborhood. And it is not rational. It is not rational at all, but I do. And it's just because people are like, “Oh man, you let your daughter walk away?”
We had this thing called Artisphere in Greenville last weekend. It's when they have all the little art exhibits set up on Main Street and everything. And I got there and kind of whispered to my wife, “Hey, are we okay if the girls go off on their own?” Man, my girls are 15 and 11 in downtown Greenville in the middle of the day. Alison was like, “Let's see if they ask.” She's like, “I'm happy to be together as a family, but if they want to go off, then we'll let them ask and do it.” But just the fact that I was like, “Hey, we should have a huddle about this.” And then I go, “What am I thinking? How did we get to this place where our anxiety is so ratcheted up?”
When as we look at the numbers, the chances of something bad happening to our kids are lower than they've ever been. Their safety is pretty flipping great, and we have this fear about it.
So anyway, I'm not trying to jump onto a parenting bandwagon, but I just use that as an example of the type of culture that we live in where we are so aware now and there's this sort of feeling of, “Oh boy, you do not want something bad to happen.” And I think it permeates everything that we do. I definitely don't think it's a vet medicine thing. What do you think about when I lay that out?
Stephanie Goss:
Yeah, no, I agree. You and I have definitely had this conversation about parenting. And there's a book that both of us have read that was written by a parent about the idea of free-range parenting and letting our kids have this space.
I'm with you. I vividly remember as a kid, free-ranging all over our small town. I mean, I would ride my bike miles. Because my parents worked both of them, and they weren't home. And we were, by the time I was my kid's age, I was a latchkey kid and had been for several years.
And so if I wanted to see my friends during the summer, get on your bike and go or get on your skateboard and go. That's your choice, or get on the bus. And I was like, “Dude, my kids don't know how to ride the bus by themselves.” I'd been riding the transit by myself for several years by the time I was their age.
And so I read that book, and it was after I had a conversation with my parents that dramatically changed my foundation of how I parent. But I'm with you. I think that I was sure in the course of this conversation that we were in a more dangerous place as a society. And I had an argument with my parents and my mom said what you said, which is that statistically, no, it's no different now. It's actually probably safer now than it was.
And I was like, “No way.” Because all you hear about is the bad things. And so I was like, “No way. This got to be up.” And so the C in me was like, “I'm going to go and get all the statistics, and all the facts and figures, and I'm going to prove my parents wrong.”
So I looked it up, and I looked it up for our small town. And sure enough, all the rates were less than they were when I was a kid. And I really sat back, and it was a self-awareness moment for me because I sat back and looked at it and I was like, “Okay, but why?” And I was trying to ask myself, why would I think this? Anyway, so I went down a rabbit hole as a parent, but I agree with you.
And where I landed was on a piece that I think really affects us fundamentally in veterinary medicine, which is that we as society have become more connected and we have social media, we have instant connection. When you and I were kids, if something happened in town, you didn't learn about it until you went to the grocery store, or until you went to church on Sunday, or you went to school the next day. You had to have the personal connection to hear about the things. Or it had to be printed in the newspaper, which had a 24-hour delay.
And now, there's instant news. Something happens across the world, and it starts broadcasting on the computer that we hold in our hands. And so there's this connectedness that accelerates the share of information, which is wonderful and is a very, very double-edged sword. And I think for us in veterinary medicine, and professions like ours, that connectivity and that ability for people to instantly connect in ways that they didn't before dramatically impacts our state of mind.
Dr. Andy Roark:
Yeah, so I completely agree with that. And I would take it one step further too, is to say, I would zoom out a little bit and just say, we live in the attention economy. And so what that means is we have in our media, accepted a business model that's about getting and holding your attention.
And I would say even before social media, the first thing I think that really started to amp us up towards being afraid all the time, it was 24-hour news. And going back to your point, it's very much in the vein of we used to get news when it came out in the newspaper, and there's only so much space in the newspaper. And then we heard it from other people.
Well, when the Nightly News came on at 6:00 PM and it was one hour, we got one hour's worth of news. And now we've got how many cable news channels or news outlets, not counting what's on the internet, trying to fill 24 hours worth of content. And they are just covering everything that they can find just to fill the day with a reason to keep watching. And so back to your point of we saw this thing that happened in your local town, the truth is there was something just absolutely bonkers that happened one state away in a small town, and you never heard about it, but you hear about it now.
I saw an extreme example. And again, I'm not saying the things that happened in other places aren't noteworthy or they aren't tragic or terrifying. They are. We just didn't used to know about them.
So I saw a great in depth coverage recently in the New York Times about a school shooting in Sudan, which is a country in North Africa. And I'm like, “This is awful.” And it's not remotely close to us. And that doesn't mean it's not important or anything.
But the problem I think that we have as human beings is we are really bad at maintaining perspective. We just don't understand how big the United States of America, or Canada, or Australia are. When we say, “Oh boy, this terrible thing happened at a supermarket in this town somewhere else in the US.” And you're like, “It is terrible.” And do you know how many supermarkets there are in this country?
And so we just don't do a good job of hearing a story and putting it in proportion with how actually likely is this to affect us, like ourselves. And that's not how we're wired. You think back. We're still running the hard-wiring from millions of years ago when we evolved as a species. You know what I mean? We have the absolute belief… It's funny.
When we're talking about fitness or whatever, people are like, “Listen to your body.” I'm like, “My body thinks that winter is coming and that the pizza tree is going to go out of bloom any time now. Anytime. And we better get ready.”
And that's the model that it's running on is there is a much better chance in my body's mind of me starving to death, you know what I mean, than anything else. That's the number one concern that my body has is, “But what if we starve to death?” And I am wired hard in that way.
It's the same thing here. It's like my body thinks that there's a tribe of maybe 50 people that we're interacting with. And so when it hears a story, it believes that it's a story from those 50 people that we live with. And it's like, “No, this is a story from some guy on YouTube that's in Switzerland.” But my deep lizard brain doesn't get that. And so I just think that connectivity, that battle for attention is a big deal.
And so besides filling up 24/7/365 on news networks and also on the internet and things like that, in social media, we know that the goal is engagement to keep people on social media. And we know that if you want to get attention there, emotion is what carries it. And honestly, fear and outrage are the two biggest, most sticky emotions that get people to pay attention.
And so look at our news and look at the headlines, and just look at how geared towards fear and outrage the headlines are. That's not a flaw, that's a feature. That's how they were made. They were tweaked and tweaked to get there. And I go, we swim around in fear. So again, I go back to, I don't think it's vet medicine. Do I think that we are more fearful now? I absolutely do.
Stephanie Goss:
Yeah, I would agree. And I think the other piece of connectivity that's important when we talk about this, specifically in the vet med context is that we have also… So we've experienced this cultural shift of going to the 24-hour news cycle and having instant connection. To your point, the whole world is in your hand if you have a smartphone, and you are connected to that guy in Switzerland or in New York City, in ways that you never were before. You would send a letter and it would take two weeks to get there previously.
And so for us in vet med, we also have the connectivity shift that has happened in regards to our pets. And so I remember when we were kids, our family pets, when I was young, our dogs lived in the backyard. They didn't come in the house. They were part of the family, but they were backyard dogs. And we loved them, but that was where they lived. And they had a two-story dog house because that's my dad. They lived in the backyard.
And so we have had this shift where our pets have become parts of our family. And I love this, and I think this is fantastic. And, we also have shifted as a culture to traveling and bringing our pets with us. And so with that has come this connectivity in our local communities in regards to pets in ways that we never had before.
So when our pets lived in our backyards, we didn't go to the dog park and have conversations with other people who were experiencing veterinary medicine in similar and also very dissimilar ways, because they're going different places. And so now, people are bringing their pets to places that are pet-friendly businesses, and they're going to the dog park, and they're talking, and they're connecting, and they're sharing experiences. Not dissimilarly to the way that social media allows us to share with people that are the same but also different from us. And so there has become this connection point that allows that information to spread significantly faster.
And it is good because we get tons of client referrals that way. We lean into that as an industry. We want our clients to go to the dog park and tell every Mrs. Smith and Jones that they meet, how amazing their experience is at our hospital.
And we also know, to your point, that as a society, we have been conditioned to focus on the sensational and the negative headlines. And so what is the vast majority of the information that's shared, especially on social media? It's negative. It's the bad. It's the one case out of 1,000 in your practice that went sideways or that went badly.
And it's so timely that we're talking about this, because I got an email, speaking of 24-hour connection. I got an email yesterday with the updates from Nextdoor, which is an online community for your local neighborhood. And I get it. Just because it cracks me up to see what the old people in our neighborhood are bitching about, I live in a retirement community, and they're around 24/7. So there's constantly conversation, and it's hilarious to me.
So I'm flipping through and there's an article about a local practice in our area, and the practice closed, and there was some concerns with the practice. But one of the comments really stuck out to me, which was someone who made the comment that, “Like pediatricians, there's no room for error when it comes to our pets' lives. Veterinarians should be held to a higher standard.”
And I have been sitting with that since yesterday because I was just like, “Are you kidding me? We're human. Mistakes are going to happen. No one of us is infallible.” And yet there is this sense… I knew that this person was not alone because the comments started and everybody was jumping on that bandwagon.
And I do think that that connectivity, if one person had a bad experience that led them to thinking that thought or one person had a frame of mind or a frame of reference, but they didn't have that connectivity before, they might share with the people that they interacted locally, but it wasn't on that global scale.
And so I think that that connection in vet med has helped us. And I think that it also has hurt us on a core level in terms of being fearful and being negative. And so I would agree with you. I think we are way more fearful than we were when I started in vet med 20 years ago. And I think that there's good reason for a lot of it.
Dr. Andy Roark:
Yeah. So I have a friend who does a standup set, and he talks about Nextdoor, the social media platform. And he's like, “Nextdoor is a social media platform that you would think would be the best, but it's the worst.” And it's the worst because it shows you so clearly how nuts the people who live right around you are. And it's just like you know these people, and they live next door. And you're like, “Oh boy, I'm learning things about people that I see that I wish I did not know.” And I thought that was super funny.
I think there's a lot in what you said just to unpack. I would say yes, the connectivity that we have means that unhappy people can now write online reviews and post in Facebook groups and things like that, that they did not used to be able to do.
Stephanie Goss:
Right.
Dr. Andy Roark:
So I do think that there's more potential real damage there, and that's true for everybody. If you run a restaurant and people have a bad experience, every profession has that. But that is an actual thing that has ratcheted up fear.
The other part about it is the changing relationship to pets… And I do think that there's some truth to that, and that's one place where I would say, here's a place where I could say that actually, the tension in vet medicine may have moved up a couple cliques when it wouldn't have necessarily, in a way it wouldn't have another professions. And that is just, people take their pets really seriously now. And yeah, it's not what it used to be.
But here's the other part too though, is while pets may have gotten more important to pet owners, I don't know that they've gotten more important to veterinarians or vet professionals, because we already cared a ton. I just think that the average pet owner is getting closer to where your vet professionals have already been. We cared enough to go into this profession. We were already at that level.
And so managing the emotional reactions of the pet owners is harder when they're more invested sometimes. And I do think that's true. So I would say I get that. And that may be a stressor that causes fear. That wasn't the way that it used to be.
There's two other things that I see a lot just in the way that we communicate. Well, three other things. So the three things, number one is before we had specifically social media, we as veterinarians or vet professionals did not see exactly what was happening in other people's clinics.
Stephanie Goss:
Right.
Dr. Andy Roark:
You know what I mean? If we had an angry client, we had an angry client. But we didn't have angry clients every day. It happened every now and then. But now through the wonders of social media, we can be immersed all day every day in people telling us the story about the angry person they just had.
And while absolutely nothing has changed in our practice, we can feel like pet owners are out of control and everyone is mad. And again, it goes back to that proportionality in our brain, that specific to vet medicine of people in the practice saying, “Boy, can you believe pet owners do this,” or, “This person did this thing.” And just someone in another town far away. But man, you feel connected to them because they're talking in a language that you understand. And so that connectivity is the first thing. The second one is the way that a lot of our media works to make us feel like individual one-off things are a pattern, that there's a sweeping change.
And so there's this thing in psychology called the Texas sharpshooter fallacy. And the Texas sharpshooter fallacy, the way it works is just imagine that you had someone with a gun, and you told them to shoot at a barn. And so they stand back and they just shoot, shoot, shoot at this barn. And then you walk up to the barn and you look at where all the holes are, and then you paint a bullseye where the holes are. And you go, “Look at this clustered.” It looks like they were shooting at a bullseye. The truth is, these are just random smattering across the side of this barn. But when you draw a bullseye and you say, “This is what it means, this is the pattern.” You can make a pattern appear where there absolutely wasn't one. And so we'll hear a lot of stuff in our news or our media and they'll talk about, “This shocking trend.”
And I think that that happens a lot when you say, “Boy, pet owners really are more difficult than they've ever been.” And I'm like, “You went and found five different instances across the entire continent of North America, and now you're calling it a trend. And the truth is, some of it's just coincidence, and some of it is just, ‘Hey, we happen to have angry people in our continent this week.'”
But you can package that stuff together and tell the story that it's a trend. And that makes it more scary, more sensational, more likely to get people to take a look. And so I feel like that's a journalistic practice that we see a lot online. And we get swept up into this as far as, “Oh my gosh, things are getting bad. Veterinarians are getting bullied in a way they didn't used to.”
And I think veterinarians are getting bullied more because there's more tools that people can use to bully people. But I don't know that it's a shocking trend that's going somewhere, that this is just building and building, and getting worse and worse. I don't know that, but it looks that way.
And then the last thing, I've heard it called nut farming. And nut farming is when we look at the continent and we find one example of one just wild, over-the-top example, of something scary, something bad. And we put it forward and say, “Look at this, it could happen to you.” And I'm like, “Boy, you went deep down a Twitter rabbit hole to find this one person,” that you're now holding up as if they're an example of what the average pet owner is. And that's just not true.
But we see it all the time, and it still works. I know that that's what's happening. And still, if they find the right person, it can make me feel angry, and unappreciated, and afraid. And I'm aware of this trick, and it still gets at me. So I think all of those things are things that happen, that I think add to our fear of practice.
Stephanie Goss:
Yeah, I think I agree with you. And then I think from a head space perspective, the last thing… You and I have talked about this a few times because we've kind of come to this place as a industry where we're talking about the changes in veterinary medicine, which are good. We have seen radical changes in the 20 years that I have been in the field. And there is some of the trends that I think are maybe not as good.
And one of those has to do with the vet schools in the training, and the educational perspective, and this let's do the gold standard. And I think one of the things from a fear perspective… And again, now that we're having this conversation, I'm questioning, is it actually happening more frequently, or am I just thinking that it's happening more frequently because we're connected and we're sharing experiences? And so I'm hearing other people's, and so maybe it's happening at the same rate it was before.
But thinking about my own perspective, and having new grads in my practice, and having doctors who are just like, “I'm not qualified. Let's send this to the specialist. Let's send this for review. I want somebody to double check my work.” And I have to wonder, is that fear coming from the people themselves, or is that coming from the way that we're training them, or the way that we're approaching it in veterinary medicine?
Dr. Andy Roark:
I was doing a podcast with this neurologist, a veterinary neurologist named Dr. Sean Sanders. And I've really enjoyed talking to him. I've had him on The Cone of Shame podcast twice now. I don't know if the second episode's come out yet, but if it hasn't, it'll be out really soon. But it'll be out by the time this episode comes out. Anyway, he's a neat guy. He's interesting.
He makes this really strong point. And his belief is that years ago, maybe in the last 20, less than 20 years, up to maybe 20 years ago, we had these veterinary specialists coming out, and they were being trained at the vet schools. And the vet specialists would do our education in the vet school. We were trained by specialists. And there were plenty of specialists coming out, and they're sort of being put out.
And his implication was that there is a bias in teaching to train young doctors to refer things up to specialists. And when there was a really focus on delivering gold standard of care, we teach gold standard of care. That's what we want our doctors to know. Well, the gold standard of care is often to send this case to a specialist who's a boarded surgeon, who does surgery all day long, because they'll do a better job. And I go, “That's true.” If it's a splenectomy, or a GDV, or especially orthopedics, I assure you that a boarded surgeon is going to do a better job than me. And it is a better goal standard of care for you to go to that person.
And his idea was that because we were trained and trained, that line of where we refer, it might have been slipping farther down saying, “Well, maybe you should refer that as well, and you should refer that as well.”
And I do think, I remember in my training, there was definitely an inclination. I remember people saying things to me like, “Well, you're not going to actually do this, but I'm going to show it to you.” And again, we've heard a lot of doctors come out who are not comfortable doing advanced procedures and things like that.
And so I think that there is a certain amount of fear that the gold standard of care and the way we're educated puts into us of, “You want to send this away. There's someone else out there who has the appropriate training for this, and it's really not you.” And I do think that that approach in teaching has sunk into a lot of us.
From what I am hearing now, what I believe is the rise of spectrum of care approach and the idea that gold standard is getting maybe a bit unattainable for a lot of pet owners. Let's start to talk about what an acceptable silver standard looks like or a basic standard looks like. And we're starting to see some shifts in that.
And I've heard that education is shifting that way, and I think that makes me happy. I think that's a good place to be. But I do think for a lot of us, I think there's a lot of doctors out there who came out in the last 20 years, who have some concerns about doing things that they're not the best person to do. And I think that may have been baked into us a bit when we were coming out. And so I do think that that is a type of fear that probably did not exist in doctors that came out more than 20 years ago when it was much more like, “No, you're the vet, and you're going to go, and you're going to deal with what comes in.”
Stephanie Goss:
Right. All creatures great and small. Like, it walks in your door, you got to be prepared to deal with it.
Dr. Andy Roark:
Yeah. So I think that's the last thing. I'm totally with you there. I think there's a part of our education that may have caused that type of fear. So yeah. Anyway, I think from a head space standpoint, we always talk about, why do we feel this way? And we came all this way, what are we going to do about it? I think we could, let's take a break here, and then we'll come back and let's start to talk about how do we manage this?
Because I absolutely think there are things that we as a profession can do. Mostly, I think we as individuals can manage this. And I really like that because it empowers people to do it themselves. I think that we can control our own fear and how we go forward, and be really smart about it.
Stephanie Goss:
I love that. Let's take a break. Hi, friends. Do you struggle with finding the right cadence for team meetings in your practice? Do you feel like maybe you're meeting not enough, or maybe you're meeting too often and you're stuck in meeting hell?
I feel you. Finding that balance, trying to work on improving communication, make sure everybody stays on the same page, and getting things done in a busy vet practice is really, really hard.
But we've got a solution for you. Join the Uncharted community on July 1st, 2023 from 4:00 to 6:00 PM Eastern Time, that's one to 3:00 PM Pacific, for an Uncharted workshop presented by my friend and colleague Maria Pirita. She's a CVPM. And if you've not met Maria before, you are in for a spicy treat. She is amazing, and she is super excited to kick off the conversation talking about team meetings with her take on making them effective and efficient. That's right. It's called Effective & Efficient Team Meetings. It's $99 to register, but it's free for our Uncharted members.
Now, if you've never been to an Uncharted workshop before, this is not your traditional webinar where the presenter or the speaker sits there and talks at you for an hour. The goal for our community workshops is to make them live. We don't want you to sit silently in front of your screen. We want you to be engaged and interacting for the one to two hours that you're meeting with our speakers to have the chance to ask your questions, to talk to your peers, and interact with other rockstar veterinary professionals, because that's what you are, and we want to see you there. So head on over to unchartedvet.com/events to sign up for this workshop, and check out what's coming because we've got a bunch of stuff coming up in the future that you don't want to miss. And now, back to the podcast.
Dr. Andy Roark:
All right, so let's get into what we do about this. I don't like being afraid. Something I've noticed in myself over the years is having some anxiety about things that don't warrant having anxiety. And so this is something obviously, I've thought a lot about, and have really tried to build safety catches and pushbacks against into my own life. And boy, talk about return on investment. Getting out of a head space like this and feeling more comfortable, boy, it's worth the effort.
Stephanie Goss:
Yeah, I would agree. This episode really excited me, and I was excited to have this conversation. And I also had some trepidation, because I feel this when I look back at my own career. I quit being a veterinary technician because I was afraid. I was someone who had significant fear for some of the reasons that we talked about and their stories there.
But at the end of the day, when it comes to how did I have to deal with it, well, I was afraid. And so I had an opportunity to make a change in my career. And so I ran away. I was afraid and I said, “I'm just going to quit.” And I'm not a quitter. I've never been a quitter. You know me. That's not my personality.
Dr. Andy Roark:
Oh no, you stick around. You're like a non-healing draining track. You just keep going.
Stephanie Goss:
Thank you. Thank you for that.
Dr. Andy Roark:
You're like methicillin resistant Stephgossius.
Stephanie Goss:
I can't.
Dr. Andy Roark:
I wanted to agree enthusiastically with you.
Stephanie Goss:
Thank you. Thank you.
Dr. Andy Roark:
I like to make sure my employees feel empowered and supported. So I'm on board with this statement.
Stephanie Goss:
A draining wound track. That's me.
Dr. Andy Roark:
A draining, she's like nidus of infection, does not stop.
Stephanie Goss:
But I did. I did stop and I ran away, because I was afraid, and I had to do a lot of work. And for me, the work started completely unrelated. I was going to therapy and talking about some other things, and realized that I had some work to do.
And where it had to start was the question of why. “Does it all come back to Simon Sinek?” Well, let's start with why. But for me, when it comes to the fear and the action steps of this, whether it was me on a personal level, or team members that I've worked with, or industry as a whole, I think we have to start with the why.
And there's a whole multitude of reasons why. Whether it's individual. In my case, having some horrific experiences with anesthesia, and specifically having my own fears. Or whether it's us as an industry being worried about the increasing social connectivity and the ability, the fact that we're living in a litigious society and that we could get sued at any minute, or we could have a board case brought against us at any minute.
We have to start with examining where the fear is coming from, because I think the answer, the action steps are going to vary depending on where that fear is coming from.
Dr. Andy Roark:
Yeah, I completely agree with that. And so step one, when we're feeling fearful about practice or things in practice that give us an anxiety, I agree with you. So a couple things you put there. I'm going to start and say, “Why am I afraid? What does this fear mean to me?” I really do think that that is the underlying reason.
I think for a lot of us in vet medicine, a lot of us are perfectionists. A lot of us put a ton of weight on our shoulders. I have found, it is true for me. I found it to be true again and again with veterinarians that I have worked with, is a lot of times there's anxiety about or fear about doing things. I think a lot of us have this struggle with feeling worthy. We feel like imposters. And, what if people find out that I'm an imposter? What if I make a mistake and people don't respect me anymore? What if I make a mistake and they don't see value in me anymore as a person? And that may sound over the top, but I assure you it's not. And it is a very common approach.
It comes a lot from… As we do this, I'm getting ready to get in the car and I'm going to drive out to one of the veterinary schools, and I'm speaking at the graduation, which is always an honor. And one of the points that I've decided I want to make in my brief time talking to them is, I really do want to encourage them to remember that veterinary medicine is what you do. It's not who you are.
And some people don't like that. And we talk about the calling of medicine, but I'm really pushing back on the other side and say, the key for me to enjoying being a veterinarian is not defining myself as a veterinarian. I am a dad, and I am a husband, and I am a gardener, and I attend advanced beginner hip-hop dance classes, and things like… I have other things that I do, and then I do vet medicine. And if vet medicine doesn't go well, that's not devastating to me in my identity.
But boy, it was for a while. When I was getting started and I was Dr. Andy Roark, and social media was big, and I was doing a ton of stuff there. I really had a lot of fear about, “What if this doesn't work out, and what if I mislead people, or if some of my advice isn't good? Or what if someone who knows more than me about a specific topic, what if they challenge me, and what if they're right and I'm not?” I go, “Boy.” I was so wrapped up in this identity or feeling. And no one else thought that.
No one was like, “I need some real insight. Let's see what Andy Roark has to say on GDV surgeries,” like I'm not your guy. But I was very worried like oh boy if I say things, then people… And again, it was a feeling of worthiness and being seen as someone of value. And it wasn't until I really burned out back in 2019 when I really had to step back and look at my life and go, “Buddy, your whole identity is wrapped up in professional success and how you're being perceived, and it's killing you. And it's not fun.” And that was a big part is setting that aside.
So anyway, we got to figure out why we're afraid. Why does this bother us? And the answer may still be, there's a thing that I don't like to do. If you say, “I don't like surgery. It gives me anxiety. I don't like it.” I think it's worth exploring why we don't like surgery. Know thyself. There is nothing wrong with saying, “I don't like to do surgery, and I let the other doctors do it.” That's not bad. But I think there's real value in figuring that out. One of the things that you mentioned as well, as I say, I truly believe that therapy can be wonderful in that it helps people unpack that.
The way I look at therapy and I talk about therapy is this. There are times in my business when I don't exactly know what to do, or I kind of know where we should go, but I don't really know how to get there. Or, I'm just not the right person to fix the problem. And I say, “Okay, I need an outside perspective. I need different language that I personally don't have. I need a fresh set of eyes here.” And it's not that I'm not good enough, it's just other people have this expertise. It's hard to see yourself. It's really hard to get an outside perspective when you are up to your neck working on whatever you're working on.
And so at that point, it's worth hiring a business consultant. I say, “I'd pay somebody. I don't know how to get out of this hole, or I feel like I'm going in circles. And I just need a fresh idea, fresh perspective. I'm going to pay somebody for their time.” At first, I'm going to talk to my friends and things like that. But at some point, I'm going to pay somebody for their time.
And that's how I see therapy as well. It's like, man, if you're rolling around and wrestling with something, and you can't get a good perspective because you're so deep in it, and your friends and spouse are sick of hearing you talk about it, and they don't know how to help you anymore, or you don't want to talk to them anymore, well it's time to hire somebody and just be like, “Hey, I'm bringing you in.”
Again, people have different things that they want in therapy, and I'm not trying to tell people what you should want. I am super pragmatic, problem oriented. And so in times that I've used a therapist, I've been like, “Hey, this is what I'm struggling with. This is a thing I'm working with, and I could use some encouragement. I need to get a perspective on this. Help me work through this.” And then I do it. And then when it's over, I'm like, “Great, thanks a lot. Got what I needed. I feel good. I got this thing worked out. I'll call you if I need you in the future.”
That's it. It does not have to be an all-in. I think a lot of people are like, it's the lifestyle. It can be, doesn't have to be. But anyway, I just put that forward as to say this has been my perspective on therapy and how I have personally used it at times in my past when I've wrestled with stuff. So anyway, I know that that's a big soapbox that you love to climb on. And I don't mean to squeeze you on your soapbox, but I do think it's a good place if you're like, “Man, I really want to work on this.”
I think where you go from here is, what did you find? What did you find when you dug in? Was it like, “I'm not confident in these things”? I go, great. Can we do CE and training? You know what I mean? If it's, “I'm not comfortable, I'm afraid of anesthesia.” Great. Can we get educated on anesthesia? Can we go do work and put in time so that we go, “Oh, okay, this doesn't feel like such food anymore. I was okay before, but now I really feel good and sharp, and now I'm ready to give this another try, start slowly dip my toe in the water and kind of go from there.”
A lot of it is about getting comfortable, getting what we need, whether it's support. Some of it may be, “I don't feel comfortable because I don't have the relationship I need to have with this person that I'm working with.” I'm the technician, and then I don't have a good relationship with a doctor. Well, maybe we can work on that and see how it comes out.
I think a lot of times when we talk about being fearful, one of the big therapy approaches is cognitive behavioral therapy. Which is basically like, “Hey, if you're afraid of something and you want to do it, then avoidance is not what we want.” You know what I mean? We want to work towards it. We want to do scary things or do hard things so that we know that they don't have to be scary and so we can have some good experiences. But you want to be smart and set yourself up so that you can dip your toe in. You can do this scary thing in a safe way and start to build confidence.
And it's a process. And I think a lot of times people are like, “I'm afraid of this thing, and tomorrow I'm going to throw myself into it and I'm not going to be afraid anymore.” It's like, I don't know if that works for some people. I don't think that works for most of us. I think if there's something like this that makes you fearful or you struggle with, I think one of the kindest things can do for yourself is say, “This is a process.” I don't think it's wrong to say, if you're afraid of anesthesia to say, “My June 2023 to 2024 program self-development program, it's going to be about anesthesia. And by June of 2024, I want to feel comfortable.” And I'm like, “Man, you got 12 months to get there.” And so start small, set little milestones, and work to it. I don't know. I don't know. You're laughing. What do you think?
Stephanie Goss:
This is not Andy coaching Stephanie, because that will not be my 2024 goal.
Dr. Andy Roark:
Stephanie Goss, when I look at you, I'm like, “You know what Goss needs? Anesthesia coaching.” I don't kind of, because what would happen is I'm going to get tranquilized. If we were traveling together and you were reading a book on anesthesia, I would be so concerned, like this is-
Stephanie Goss:
No. I will leave that to McNerd all day long. That is never going to a thing. I will never be in Anesthesia Nerds. As much as I love Tasha, that is not my jam. And I did the work. I did the work to figure out the why. And then I put myself through the process of, I avoided the fear for a really long time. And then I was like, “Okay, I need to actually overcome this fear.” So I took the cognitive behavioral therapy approach, and I tried the thing in a safe environment and small doses. And at the end of the day I was like, “Okay, I can do this thing and I can survive. I am a sweaty, disgusting mess, but I can do the thing.” And it was enough for me to say, “Okay, I've done the thing and I am perfectly fine walking away and leaving the thing behind me.”
Because a part of it, to your point, was that identity work, and figuring out who I actually am. And saying, “I'm okay with this not being my whole identity,” because there's this whole new part of me that has opened up as a result. And I'm thankful. I love medicine. I love veterinary medicine. I love the science part of it. I could nerd out about so many facets of medicine from a tech perspective. And what I recognized is that my jam is not there. I love it and it's a happy place, but that's not my thing. I love the people piece of it. And I don't know that I would have ever explored it if I hadn't had done that piece of it. I might have just quit completely and walked away from it.
And so I think it goes back to that starting with why. And we were talking about the schools and coming out. And I've had a couple new grads now who have come out and they have been in that place to your point of referring, “Well, somebody who knows more than me should do this case. Somebody else should take care of this patient. I'm not qualified to do this thing.”
And I had a lot of guilt about pushing some of them to do the thing anyways, because I have practiced in places where we don't have a specialty practice down the street. They're going an hour to get critical care or specialty care, or two hours.
And so to your point, not everybody can afford it. Not everybody wants it. Not everybody wants that travel. And so we have a lot of clients who are like, “Oh no, I'm fine if you guys do the thing. Can you just do it?” And so that's part of the reality of practicing medicine where I live.
And so I went through that with some of our new grads and recognizing they have to figure this out for themselves. I can't want it more than they do, and I also have to figure out how to work with them.
And recognizing that if practicing medicine where I live means that they have to do these things, it's okay if they want to draw a hard line in the sand and say, “I do not want to practice surgery. I want to just do outpatient.” And the results of that might mean I might be able to get them a plan. I might be able to print out that blueprint, like you said, and work your way towards facing the fear. And, it might be okay that it's a line in the sand for them. And, the result of that might mean they're not the right fit for my practice.
And I think so many of us are so wrapped up in that identity piece of it, that we force ourselves to make situations work that that isn't necessarily the best choice for us, for our patients, for our peers. Because we're afraid of that identity piece.
Dr. Andy Roark:
Yeah, I agree with that. I can tell you one for me that I had to unlock, which all this code was kind of tied together, but I really stressed out about clients getting angry at me. I really did not want to have angry clients. And I very much wanted to make them happy.
Until I started to say, “Well Andy, why? Why does this bother you?” And then really started to go, it's because I am defining myself and my success by how I make pet owners feel. And until I unlock that, I was stuck in that kind of loop of, “Oh my gosh, this person's experience, their facial expressions, their online reviews mean so much to me.” And I go, “God, what a horribly unhealthy place to be.”
There's this part of the first season of Ted Lasso when Ted asked the star soccer player, he was like, “If you could be any animal, what would you want to be?” And he was like, “Why would I want to be any animal, I'm me?” And Ted goes, “I don't think you understand how healthy that is.” And it was like, that is healthy. It's like, “Nah, this is what I am.”
Again, it doesn't mean that I don't care. Of course I still do. But I think some of it was I had to go through those experiences of having clients get angry at me, and recognize that the sky didn't fall, and work past it.
So anyway, the next one I'll sort of lay down from an action step, and this has just been a big one for me and my career, is get present. I think we live in a state of perpetual distraction. And I think honestly, if there was one thing, and this is not easy to do. But if someone said, “Andy Roark, real quick, I've got 30 seconds left and I'm going to disappear, and you're never going to see me again, and I will do whatever you say. How do I be happy in practice?”
I would say get present. Get out of your head. Get into what you're doing. Be fully present with what you're doing right now in the day. Throw yourself into your work and just focus on being there with the pet, the pet owner, and with your team. And if you do that, you'll be great. And then they would disappear. And that would be my piece of advice. It's much easier said than done.
But I think a lot of us, we live up in our heads. We go, “What if this happens? What if this goes bad? What if this doesn't turn out the way that I thought?” Well, the truth is, you'll cross that bridge when you come to it. You can ask yourself this question then say, “Is this going to change how I am behaving right now, the choices that I'm making?” If the answer is no, then put it away. Get back into what you're doing in the moment.
I think another thing that I've been thinking about saying to the graduates when I get up there… And again, I won't be able to say all these things. It'll come together. I promise it will work, and it'll be better than I'm making it sound now. I promise. But if I can give them a piece of advice, it's try to love the mundane work of being a veterinarian. Not to define yourself by the outcomes, but to actually enjoy just doing the work. Being in the room, enjoy talking to the clients, enjoy talking to the staff. Just try to enjoy the mundane parts of actually doing.
And I think a lot of that is absolutely key to getting out of your head about being afraid, being anxious, being fearful. Just get present. Are you going to do this surgery? They're not going to the specialist. This dog's got a splenic tumor that's bleeding. Are you going in there, or are you not going in there?
And if you're going in there, get present, deep breaths, get your stuff together, what prep do you need to do? And then go to work, and just put yourself into it. And I think that that's really the key for getting past a lot of this stuff, and also just enjoying what we do for a living.
Stephanie Goss:
Yeah, I would agree with that. And I think that when I look back at my career and I think about some of the highlights, I think some of the best days are the days where you were fully present. Whether it was for a period of time sitting with the owner while they said goodbye to their best friend, or even doing the difficult surgery, truly being present and letting go of all of the distraction, and just doing the work. Those are some of the best days.
And especially as we shift in our career I, think to a leadership perspective, your point is such a good one. Because I think about how many days I showed up in the practice for my team, and I was thinking about 10 million other things. And I never did my best work when I was thinking about all of the other things, when I set it all down and said, “I'm going to give my full attention to this thing.” Whether it was holding a patient in the treatment room because they needed help or sitting down and having a one-on-one with somebody on my team, that's where we engage with ourselves, with our patients, with our clients. And also with our fears. Because if we're not really giving it 100%, we're never going to be able to address those.
Dr. Andy Roark:
Yeah, I agree. I saw an interview with basketball coach Phil Jackson… And the guy's like a legend, and he's won 11 NBA titles and whatever. He was just talking about his players and he was like, “Getting these players to be present in the moment when the media is around them, and taking pictures of them, and making stories, and people are trying to get their attention.” And it's so much distraction.
So he would have all of his players wear a rubber band around their wrist. And the idea was that they would snap that rubber band and that little ouch would bring them back to the present. But he was like, “Yep, everybody on the team wore it, and we would snap it, or we would have other people would reach over. And if they thought you were zoned out, they would snap it to get you to come back.” And the whole thing was meant to be, “Get back here in the moment,” right here in the here and now. I think it's a big part. So I've got that stuff. I've got one last piece for me. Are you ready for this?
Stephanie Goss:
Lay it on me.
Dr. Andy Roark:
All right. So this has been an important thing for me recently, and it's where I've been living. And man, I really love this. So I saw a quote. It was from Tumblr, and it was a science fiction writer. But she wrote this thing that said, “The opposite of grimdark is hopepunk. Pass it on.” And what she meant was, there's so much of a desire in our society to be afraid, and to be cynical and to say yes, things are bad and they're going to be bad.
And people seem to believe that if you want to look smart, you should assume that things are going to end badly, and you should expect the worst. And we all know people in vet medicine that as soon as a sick pet comes in, they go, “I bet it's got parvo.”
Stephanie Goss:
Right.
Dr. Andy Roark:
And they'll just go straight to the cynical, to the darkness, and they do it because it's a self-protection mechanism. If you assume that things are going to be bad, then you're not disappointed when they're not. And there's a lot of people who just live there.
So when I talk about the opposite of grimdark is hopepunk, the idea is I really believe that we have settled into a society that's built on fear, and it's built on cynicism. The idea that things are bad and they're going to continue to be bad, and it's all founded on badness, and everything is a crisis, and blah, blah, blah. And they hold onto that.
And I don't say that hopepunk, it's not a rejection of those things. I'm not saying that there aren't hardships in medicine. There are. I'm not saying you're not going to get a group of people on Facebook who hate your guts and are coming after you, or that a case isn't going to go bad and you're going to have a pet die. That's going to happen. This is a hard job and people are hard to deal with. They are. And anyone who tells you, “No, that's just a mindset.” Those people are out of their minds. It's not. That's true. That's real, right?
Stephanie Goss:
Yeah.
Dr. Andy Roark:
Things can be real and you can still push against them. You can still rebel against the system and the society. And that's kind of where I am, is I think it's time for rebellion. I think it's time for revolution.
And the way that we revolt against cynicism and fear in practice, it's not positivity. It's not saying, “No, things are good.” That's got its own toxicity, right? That's rejecting things that are objectively true, which is like, this is scary or this is hard.
The way we rebel against fear and cynicism is with optimism and hope, right? It's going in and saying, “Yeah, I get it. Things are hard. And you know what? I'm going to stick it to the system by believing that tomorrow might be better than today, by believing that I have the power to make something good right here, right now.”
And I get it. Life is hard, but I am going to go out of my way to help somebody else. Not because I want them to write a review, just because I want to push back against darkness in the world. And guys, I think it's time for rebellion in vet medicine. I think it's time for a hopepunk rebellion. I do.
I keep going back to punk, right? Because punk rock music, I like punk rock. I like the idea of people who are like, “You know what? I'm a misfit. I don't fit in with this, and I'm okay with it.” And I'm like, yeah, I'm a optimism punk. That's what I am. I've got a smile and a wink for a Mohawk, and I've got a freaking, “Hey buddy, let me help you out,” face tattoo. And that's it. I am going to wear that punk rock sneer, because I know that I'm going to jump in and help you. And if there's a change that has to happen, I'm going to say, “What if this works out even better than it has been guys? What if this turns into something really good?” Because that is punk rock today. The idea that things could be better in the future than they are now is so anti-establishment I love it. So last thing I would say is hope punk revolution in vet medicine. That's what I want.
Stephanie Goss:
Come over to our side. We have Andy and a mohawk, and tattoos, face tattoos.
Dr. Andy Roark:
That's right. Face tattoo that says, “Have a nice day,” and, “This might all work out great.” That's what my tattoos say. And that's it. Join the hopepunk rebellion. I don't know if there's anything better against feeling fearful than to say, “You know what? I am going to embrace optimism. In your face.”
Stephanie Goss:
With my face.
Dr. Andy Roark:
With my, that's it. That's all I got.
Stephanie Goss:
That's all I got.
Dr. Andy Roark:
All right, good. All right. I think we're out of time. I'm pretty sure we are over time here. Yeah, we better wrap this one up. All right guys, thanks for being here. See you next year… See you next week. I'll see you next week. You know why I'll see you next week? Because you're non-healing wound.
Stephanie Goss:
A festering wound of MRSA that's never going to leave you alone.
Dr. Andy Roark:
Yeah. Yeah. You were mine, met cell and resistance staph infection-
Stephanie Goss:
I'm with you for life now. Like a face tattoo. Have a great week everybody.
Dr. Andy Roark:
Stephanie Goss is my face tattoo like, “It might have been a mistake when I got her, but I'm in it now. I'm in it now.” All right. Thanks buddy. Bye.
Stephanie Goss:
Well gang, that's a wrap on another episode of the podcast. And as always, this was so fun to dive into the mailbag and answer this question. And I would really love to see more things like this come through the mailbag. If there is something that you would love to have us talk about on the podcast or a question that you are hoping that we might be able to help with, feel free to reach out and send us a message. You can always find the mailbag at the website. The address is unchartedvet.com/mailbag. Or you can email us at podcast@unchartedvet.com. Take care everybody, and have a great week. We'll see you again next time.