This week on the Uncharted Podcast, practice management super nerd, Stephanie Goss, is joined by a very special guest co-host. Debbie Boone, CVPM joins the podcast again, this time to discuss a topic near and dear to Stephanie's heart – the art of client care. For those of you who haven't met Debbie, let us introduce her. Debbie is a CVPM and Fear FreeSM Certified. She has worked for the veterinary profession for more than 35 years. Debbie's business, 2 Manage Vets Consulting, helps practices develop extraordinary team communication and business skills, enhancing patient care, improving profitability, and increasing practice value. She strives to improve the lives of animals by using her expertise to improve workplace culture and the well-being of veterinary professionals.
Debbie recently published her first book, Hospitality in Healthcare and Stephanie wanted to take the chance to talk with Debbie about hospitality and what lessons we can learn and apply inside our practices when it comes to making clients feel welcome and invited in to our practices. Let's get into this…
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Episode Transcript
Stephanie Goss (00:00):
Before we get into the episode today, I just have to say a huge thank you! I would be remiss if I take get a chance to say that PLS, The Practice Leaders Summit is happening in just a few short days when you’re listening to this podcast episode. And that means we’re all getting together in Greenville, South Carlina, to celebrate the unique and wonderful position that is being a leader in veterinary medicine. We’re getting together with some of the best and brightest practice owners, practice managers and we’re talking about the real challenges that face us when we run our practices day to day and I am super super excited. And this is a very different event. It is small. It is boutique. It is designed so that everybody that comes gets to meet every other single attendee that is there. We get to talk about the nitty gritty in real time, about the challenges we’re facing as practices, the wins we have with our teams and really set a plan for the new year so that we can walk into 2024 set up with success. And we couldn’t do it without our industry partners and we have some amazing ones this year and I just want to take a second to say thank you from the bottom of our Uncharted hearts to our Anchor Club sponsors. We have different level partners and we have a lot of amazing ones, but this group, these guys are fantastic. They stepped up in a big way to help make us successful in terms of throwing the Uncharted events for you and your team and I just want to say thanks. So to Nationwide Pet Insurance, Hill’s Pet Nutrition and Total Practice Solutions Group, thank you, thank you, thank you for being Anchor Club Sponsors. Thank you for letting us go out on a limb, try some new and crazy things, like our Practice Leaders Summit and for coming to Greenville and having a good time with us. Okay, now we can start the podcast.
Hey everybody, I am Stephanie Goss, and this is another episode of the Uncharted Podcast. And this week on the podcast, I am joined by a very special guest host, my friend Debbie Boone. For those of you who have not met Debbie or heard her previously on the podcast, Debbie is CVPM. She's Fear Fear-Free Certified. She has been around in veterinary medicine for over 35 years. She's one of those voices that I think about when the conversation turns to team communication and creating positive culture. And she does some consulting now and amongst other things and she's written a book. And when Debbie's book launched, I was super excited about the idea of having her on the podcast because her book is about hospitality in healthcare. And in fact, that is actually the title of the book. And I'm particularly interested in having a conversation about the idea of hospitality in veterinary medicine. For those of you who know me, I started at the front desk and I'm super, super passionate about the client relationship and the care that we give our clients in addition to our patients. And so I thought this would be a great opportunity to have Debbie on the podcast again and nerd out about the art of hospitality in veterinary medicine. So, let's get into this.
Speaker 2 (01:31):
And now the Uncharted podcast.
Stephanie Goss (01:39):
And we're back. It's me, Stephanie Goss, and I am here with a special guest. Today I'm back by Popular Demand with my good friend and colleague, Debbie Boone. We did a podcast together previously talking about customer service, and Debbie has just released a new book. And when it was getting ready to come out, I said we have to do a podcast and talk about the book. And so I'm taking advantage of the fact that when I am recording this, Andy is on vacation. And so Debbie and I are having a conversation and sitting in the Andy Roark chair so that we can talk about customer service and veterinary medicine and hospitality. Welcome to the podcast, Debbie. I'm so glad to see your face.
Debbie Boone (02:21):
It's good to be back and I'm so looking forward to, we were laughingly calling it our Meanderings because this is what we do. We both are so adamant about taking care of people in the veterinary world that we go off on tangents, but hopefully you guys enjoy some of our tangents.
Stephanie Goss (02:40):
I have a feeling I'm going to try and keep us on the rails, but I have a feeling
Debbie Boone (02:44):
We'll try.
Stephanie Goss (02:44):
I have a feeling this will be one of those conversations. So I want to start real big because you just had the book come out and I want to talk about the book. So, tell us what the book is called and where we can find it.
Debbie Boone (02:57):
Sure. The name of the book is called Hospitality and Healthcare: How Top Performing Practices Boost Team Happiness and Give the Best In Care to Their Patients. So the idea behind the book is that when we learn good hospitality skills, great communication skills, we not only make the lives of our clients better, but we make our own lives better because clients are not upset with us. And so we have a better work environment. And then hospitality skills can be used internally too. They're not always facing the customer. So when we understand each other better, we develop good listing skills, we learn to observe people's body language and know their personality styles. We actually can develop a much better culture and enjoy our work more.
Stephanie Goss (03:49):
So as long as I have known you, you have had this focus on kind of, the white Glove, Ritz-Carlton customer service experience, and that has been both in your practice as a manager and then as a consultant working with practices that has been a passion and a focus for you. My first question about the book was I started reading and I started, I hear it in your voice when I'm reading it, it feels like a conversation with a friend. I love the feel of it, but what I noticed was that you went really broad with the book in the sense that it wasn't, you weren't just talking about veterinary medicine, you were talking, you chose intentionally to talk about healthcare in general. And I think that there is a lot of lessons as consumers and as people who partake in healthcare on a human level. I think that there's a lot of applicable lessons there. But for you, why when you sat down and said, I'm going to do this thing and I'm going to tell the story, you have so much that ties to veterinary medicine and your experiences there. Why did you choose to go broad with the topic?
Debbie Boone (05:03):
Well, truthfully, it was my own experience as a consumer of human health. And I think everybody who knows me, first of all, you asked me a question I didn't answer, which is vailable on Amazon, Barnes and Noble and all the routine places.
Stephanie Goss (05:18):
And we'll put links in the show notes. Everybody can find it easy.
Debbie Boone (05:22):
Yes. But if you think about as a patient, we go through some experiences ourselves with our care providers and those experiences are negative. We don't get our doctors paying attention to us, they're not listening to us. The staff is not trained on good customer service. So we don't feel welcomed into the practices. We just run through a machine. And I feel like in order to get good healthcare and my mother is almost 90 so I've been doing a lot of caregiving and helping her with her stuff, a lot of this is just done for efficiency but not done for great patient care. And in veterinary medicine, my great fear is that with so many corporates and many of them not to bash investment bankers, thank you for putting money into our profession. But the problem is that they don't see it the way we see it. And we should be looking at it as caregivers who are connected with the client or as a human connecting with the patient.
(06:33):
So we're actually getting a whole picture of the person that we're trying to care for. We don't listen very well. And that's a problem because we miss things. It's important things and our clients and our patients feel disrespected. And so when that disrespect kicks in, then they become antagonistic and then our work life suffers because now we're battling people instead of collaborating with them. And so the whole idea behind the book is let me teach you skills on both sides of that exam table to be able to better work with humans and understand where their needs are and why they're doing the things they're doing and why their reactions are what they are. And then maybe we can better serve them and they will be more supportive of us. So it's a win on both sides. And I know this because I lived it.
Stephanie Goss (07:28):
Right. Okay. So much good stuff there to unpack. So let's start with the human healthcare side because I think there's some really good parallels here to veterinarian medicine. In reading. At first I was like Debbie, in my head I was like, Debbie has so many experiences that relate to veterinary medicine. And in my head I was like, why doesn't she should go hard in the paint on our stuff because there's so much that you have experience wise that contributes to that. And then I was reading the story about your own healthcare journey and navigating both good and bad care and knowing what it feels like to have exceptionally negative care that leaves you not really feeling like a human, but feeling like a statistic in their practice. And thought about the parallels to that thought about my own experiences, but also thought about the parallels to that to veterinary medicine.
(08:27):
And I think in that moment, the first light bulb went off for me in reading it, which was doctors go to med school to treat patients the same way that veterinarians go to school to learn how to treat patients and no one, and especially in human healthcare, the model is not also learn how to run a business because they are almost solely set up now. It's not even 30 or 40 years ago where you go to med school and then you open your own practice and you're like a veterinarian and that you're learning how to run the business. And so to your point about corporates, I think we're in that, I don't know that it's just corporate, but I do think that in veterinary medicine anyways, there are definitely people involved in running the business side of things who fall on one end of the spectrum, the extreme ends of the spectrum where if you focus on business to the exclusion of all else, to your point, you forget about the humans involved and you forget about the animals involved and you're just focusing on the numbers and the patients and on the other end of that spectrum are practices both in veterinary medicine and in human healthcare where you're focusing solely on the patients and not practicing good business practices.
(09:44):
And so you're not successful. And so a lot of things that Andy and I talk about on the podcast, I think it's really about finding that balance. And I think that there's this narrative both in human healthcare and in veterinary medicine that comes up, that it's about the structure and the system and the man and corporate and in human healthcare, the same conversation happens because now all of these hospitals are set up to be run by corporations. But I don't know that when you step back, and this was the sense that I got in when I was reading through about your own experiences, it's not really about that. It's about, to your point, it's about looking at our clients, whether we are a client in a medical practice as a human, or we are a four-legged patient in a practice that has a client in our building and we are taking care of them in veterinary medicine.
(10:39):
It's about treating each other like humans and not forgetting even as we run the business, even as we are efficient, even as we are effective, not forgetting that it's about the human connection and the human experience and how do we put that front and center and focus on not to the exclusion of not having good business practices, not to the exclusion of all else, but when we put that front and center and practice good medicine and take care of the people within our teams, our clients, that the money follows, right?
Debbie Boone (11:12):
It does. Yeah.
Stephanie Goss (11:12):
And so does, that's a message that I have always heard you had. And so I love that I ultimately in the beginning, although I was questioning it as I read through your own personal story, and I don't want to share it because I want people to read it because it's wonderful in reading it to reading through it in the book, and I was sitting there with you in some of the situations that you were experiencing, I could correlate that to my own medical experiences. And even if I couldn't, I think anybody who reads it would have empathy for you as a human being as a patient feeling like you are in a cold, sterile room and you are just another number in a practice. And I hate when we have those experiences where our clients feel that way. And so I love that you chose to go widen and look at it from that perspective.
Debbie Boone (12:01):
Well, I felt like no matter what position you held in the animal hospital, if you had almost everybody's been a patient at some point in time, and so we tend to lose sight of the fact that when we're the medical provider that at one point in time we were sitting on the other side of the exam table and tend to remember how it felt when you were unsure and when people were talking over your head or when people were basically had your life in their hands and they acted like it was nothing more than a clinical problem to be solved.
Stephanie Goss (12:39):
Mmmm-hmm, just another day.
Debbie Boone (12:42):
Just another day for them. But I'd make a mention of the woman who was my radiologist when I was getting my ultrasound for diagnosed me with cancer and she was worried about her in-laws visiting, and I said, she was not the most stressed person in the room. I was waiting for a cancer diagnosis and she was ignoring me completely and thinking about herself and talking about herself to her coworker. So I feel like we need to pay attention to people, and that's really the premise of the book. Now, the other thing that I think people, oh, this takes too much time. We don't have time. We're running and riffing and racing, it doesn't take long. It just takes seconds and it just takes awareness and concentration to not forget that there are people involved, whether it's the pet owner or whether it's the human being in front of you.
(13:40):
These are people's lives and the pet is important to them or they wouldn't be in your door. This is something that matters to them. And we all know, especially with millennial and Gen Z generation, these are sort of good children for a lot of people. And so I used to teach my doctors, and this is years back, you are furry children, pediatricians. And I think I was having a premonition of what it would become, but that's the way I felt like we should treat people. And it worked. Certainly it worked. I always laugh and say, my practice owner retired with three homes. It works pretty well if you listen, so we can do so much better. And the other part of this is by listening better, we actually speed ourselves up because we don't miss things if we are intently listening. And the exercise I've always given to students when I'm teaching is if you're trying to teach somebody how to actively listen, think about playing.
(14:42):
Simon says, and when you were a child and you were playing, Simon says, and Simon says, sit up. Simon says, sit down, stand up. I messed up because I didn't listen. So we have that intensity about it, but when we do and we listen without distraction, we don't miss things that matter like, oh, I was supposed to give this dog a bath before it went home, or, oh, he needed a rabies vaccine. The owner okayed it and I forgot to write it down. So those are the little things that slow us down is missing those types of requests by clients or missing subtle things that they may have said that all of a sudden will make your light bulb go off for the diagnosis went, oh my gosh, you didn't tell me he swam in a lake of green algae.
Stephanie Goss (15:29):
That makes sense.
Debbie Boone (15:30):
Now it comes back. So we need to do better job listing, a better job asking those open-ended questions, which we're all taught to do when we are looking at conversation or diagnosis or talking to our fellow coworker. I know you and I, we've talked about being curious when it comes to coworkers, and we talked a little bit about being curious in this book because curiosity solves so many problems rather than accusations. And so we have a client come in and this dog is emaciated or it's been limping, and we instantly make this judgment. So there's a toll chapter about judgment. So instantly make this judgment, this is a bad pet owner when what we may not understand is this dog may have gone missing in the thunderstorm, it's been out roaming for two weeks. They finally got it back after putting it 500 posters and it's coming into your door. And yeah, it's emaciated, it looks terrible, but let's ask the situation first rather than judging. And I think we do that with people too. Our staff is like, well, she's always late for work. And then we start going, well, it's why is she late for work? What's going on in your life that is causing you to have these challenges and what can we do to help you overcome those things rather than the accusation that automatically puts people into defense mode? It never helps.
Stephanie Goss (16:54):
And no. So there's two things that I think you hit spot on there. So the first one was when you were talking about human healthcare and your experience with the radiologist tech that I think that we forget that, and I think they do this in human healthcare too, to your point and the story, and you illustrate this really well with your words in the book, it may have been the 19th patient that that person saw in the day and they were doing their job really well and getting you in and out and not making it physically, trying not to make it physically uncomfortable. And that's only a piece of it. But you talked about addressing the emotional piece of it because for you it was your first time experiencing the anxiety and the overwhelm and fighting the panic within yourself of, am I going to hear a life-changing diagnosis today or not?
(17:54):
And it's the same for our clients, even on a very small level, I think in veterinary medicine, we are really good at empathizing. And so when we do the big things, giving someone a cancer diagnosis, talking to them about the fact that their pet needs to have a limb amputated, maybe it's time to consider quality of life, and you have the quality of life in euthanasia conversation, we do those really, really well where I think a lot of us struggle within our practices, and I know this ebbs and flows, and I remember times we're vividly struggling with this with my team is remembering in the day-to-day mundane to your point, to not judge and remember that it might be that client's first time. So we think about a puppy visit that comes in the door and they have 20 million questions for us, and we're like, come on, we've got to stay on time.
(18:49):
We've got to get in and out of this appointment to us. It's another process. And it might be our 19th time that day giving the conversation exactly for that client. It might be their very first time having a puppy. They may not have done this before. And so I always think in the conversation that I always tried to have with my team came from, and I think you'll recognize this, but it came from my own experience with being a Disney fanatic, but also I had a dream once upon a time, my life dream was to be a Disney cast member, believe it or not, at one point in my life, I wanted to be the dancing Mickey in Fantasmic, and I hate Southern California, but I grew up in California and I was like, I'm going to move to LA. I want to be the dancing Mickey.
(19:47):
I was a mascot all through university and high school, so I was going for it. I wanted to be a professional mascot. That was the thing that I wanted to do. Ultimately, I was too short, but went through the process and went through interviewing and going through Disney casting process. And one of the things that Disney does really, really well is the client experience inarguably. You can think what you want about Disney and about politics and all of the things that people tend to talk about when we talk about Disney these days. And the client experience has always been number one for them. And part of the training that every single cast member receives, whether you are in costume, whether you work in the studio offices or whether you are sweeping and picking up garbage in the park, is how to put the client and the customer first.
(20:39):
And so I'll never forget reading the story about the people, cast members who are working in the getting training specifically to answer the question, what time is the three o'clock parade? And when you hear that question, you're like, that's a really stupid thing to train people on. The answer is in the question it's at three, not the point. The point is when someone in the park asked you, what time is the three o'clock parade, the answer is three, what time the parade starts? And that's the point, is that their question isn't about where does it start at three o'clock? Their question might be, where does it end? Where can I get the best view? What time will it reach me if I'm standing halfway through the park when you're asking this question? And so cast members are taught to your point, to ask more questions and dig below the surface and find out what is it that they're actually trying to answer.
(21:33):
And I think that that is, I have always tried to take that lesson in active listening and in not judging and in being calm. And really, I think in some ways I put it at the top of the list trying to treat every client. It might be their first time. And so even though I've already given the puppy spiel eight times today and we're running behind and I want to get out of the exam room, I need to try and put my best foot forward and listen to what they're actually asking and treat it. It could be their first time having a puppy. And the reality is we're not going to succeed all of the time. There are going to be days where we're busy and where we're rushing. And to the point that I think you illustrated so well with your own story in the book.
(22:22):
You'll never know when you may know, but you may not know when you screw that up for someone else and whether you make their first time or the most important day of their life so far, or that big news moment when you mess that up for them and the ripple effects that it then has on them and their experiences and other people who interact with them. And so I love that, and I love the focus on not judging because it's really easy to do. I can think of times where I'm like, really? That's the question that we have 10 minutes left in this exam room. That's the question you're asking me right now.
Debbie Boone (23:00):
Yeah, yeah. Well, it's human nature to judge and it makes us feel better. I gave the talk at AVMA about some brain science stuff and human nature says, we judge up or we judged down. So am I-
Stephanie Goss (23:17):
Or are you better than me?
Debbie Boone (23:18):
And so yes. So then I'm judging and going, yeah, I'm a little better, and then are you better than me? And that's where imposter syndrome comes in because we're judging other people. It's better than we're, but the truth of matter is we just really need to have a moment to self-talk. And like you said, you learn the skill of talking to yourself. And this comes into the self-awareness part of it. So I talked about self-awareness. I went to the Veterinary Innovation Summit last year and I listened to Dr. Tasha Eurich and she was giving a talk on self-awareness and the light bulbs started to go off. This is just wonderful because we're not self-aware, and I love the illustration that she gave. She asked everybody, how many of you think that people cannot drive these days?
Stephanie Goss (24:01):
Everyobdy raises their hands.
Debbie Boone (24:03):
And she said, okay, if everybody can't drive and all of you raised your head, then somebody in this room can't drive and it's going to have to be one of you. And so we don't have self-awareness that we're a bad driver, and that's just part of it. So if we learn self-awareness, then even when we're talking about discrimination, biases, stereotypes, and I have a whole chapter in the book about this, is that we learn to catch our brain in its mid shortcut, which is all, this is what this is, and we go, stop. This is not sensible. It is not smart thinking. It is a reactive thinking where my brain intentionally tries to conserve energy because this is one of the things, it's kind of my geek out topic is neuroscience. And when I started studying the brain of what it does, and there's a shelves of books behind me with all kinds of ridiculous information for some people.
(25:02):
But anyway, if we start to think about that and our brain intentionally tries to conserve energy and it does this by quickly making decisions and judging otherwise, we would be exhausted. If we had to decide everything in our environment instantaneous, we would be exhausted. We wouldn't. So the slide I used was, okay, we put some people up and they're in uniform. There's the police officer and there's a nurse and there's a firefighter and we're a doctor. And we go, oh, we know who these people are, we judge them. Well, and then I switched the slide and I said, unless they're the village people, you can't do that. You can't even assume that people in lab coats could work in a meat market. So it's training your brain and training yourself to stop in mid grouping sorting, which is our nature, and say, let me see what the reality of this is. These all statements. I always say when you think about lumping people into a group that's in the sentence says all these, whatever they are, do whatever this is, it's an automatic mistake because people are not all everything. And again, is our brain would like that to be that easy, but it's not ever that easy because people are individuals.
Stephanie Goss (26:28):
Our brain tries to shift us to one end of the spectrum or the other. And the reality is we need to stay in that middle gray zone most of the time. And that is very true in veterinary medicine. It's not all one end of the spectrum or the other because generally the black and white of it is not negative, but when we get at the ends of the spectrum, it can be right. And so how do we blend those together to find the middle ground and to find the gray? And how do we say, well, this person might be a doctor, but this person might, to your point, they might work in a lab or they might be working in a meat market. And so I love that. I think that so many of the lessons, I love that the book very much has a storytelling tone.
(27:21):
Like I said, I'm reading it, I'm only part of the way through because I was telling you before we started, I have also been reading our friend Josh Vaisman's book at the same time, and I started both of them coming back from AVMA and they're both so good. I was like, I can't put one down and finish the other first. I can't decide because they're great and they're different. So I'm reading through them both at the same time, but I love it because it feels like it's so real. And that's one of the things that I admire about you and your approach to practice management, but also your approach in educating within industry is not to make anyone feel bad. So we're not judging down. We're not like, oh, they're better than me. And so I'm going to build that imposter syndrome.
(28:13):
I also read Dr. Eurich's books. I really enjoy her work and I've gotten to hear her speak as well. And I think it makes total sense that idea of the self-assessment and the science and stuff behind it. So I love that you included some of that in the book and lessons because I think that this is going back to something you said really early on when we started talking, yes, we get training, but I'm going to caveat that because I asked at AVMA, because we were both there as speakers, and I asked in one of my sessions how many of them in the room were veterinarians, and there was a lot of hands, which was awesome because I was speaking in the practice manager track, and I normally get to talk to managers and techs, not a lot of doctors, and so many of them put up their hands and I said, how many of you got communication training and client service training in veterinary medicine? And there was in vet school and there was far fewer hands than one up than I was expecting because most of the vet schools have put that in place now and they're doing it, but the percentage compared to everything else is very small. And it's only been recent that a lot of schools have put that in place as part of the mandatory training that they're giving veterinarians.
Debbie Boone (29:28):
And some of it's only two weeks. That's the other thing. It's not long enough to really make it stick.
Stephanie Goss (29:33):
And so we're getting, yes, veterinarians are getting some of that training, but I would say when you think about the vast majority, majority of our teams, how many of us get actual training in listening, in active listening in client service? I might have had experience in waiting tables or being a barista. I might have customer service experience or hospitality experience going back to the book, working in a hotel where I have, by the nature of the job, learned some of the lessons. If I'm really lucky, I might have had the experience of working for an employer like Chick-fil-A or Ritz Carlton, Disney, Neiman Marcus, like the high-end employers who are going to put the time and energy into actually providing that training for teams. But the majority of us, even when we work in customer service fields like veterinary medicine, don't actually get that formal training.
(30:32):
We just have the expectation as leaders, and I say we, because I include myself, I have done this and made this judgment and it's something that I am now conscious of as a bias and actively trying to work against it, where I just assume that if I'm hiring someone for a client service position that they understand the rules of engagement when it comes to client service. The reality is we have to learn that. And to your point, we have to practice it over and over and over again. And so telling someone once, this is how I expect you to react when a client walks in the door, I want you to stand up. I want you to greet them with a smile. So many of us, because busy in our brains are moving 10 million miles a minute. I'm not saying that anyone is intentionally going thinking about it from a negative perspective. I'm teaching this, why can't you retain the information? But so many of us go, oh, I've checked that box and now we're going to move on to the medical stuff. The stuff that's really hard, the stuff I know takes repetition and practice. The client service stuff should be a one and done check the box. And that model has got to get flipped on its head in veterinary medicine for us to get successful. Absolutely.
(31:43):
Hey everyone, I am so proud that Andy and I have released our very first certificate course that you can take online. That's right. We have released into the Wild, the Uncharted Leadership Essentials certificate. We had a conversation one day and we were talking about what it would be like if there was a course online that you could take that had some of the content that we really think is foundational to being a leader in practice. What would that look like? And let me tell you, we dream some big dreams that day, and I am so excited that part of those dreams is now coming true and coming straight through the interwebs to your computer. That's right. If you head over to unchartedvet.com/certificates, that's the Plural Certificates. You can find out all of the details about our first certificate, which is the leadership essentials. It includes things like building trust, vision and core values, whether it's for your team or for yourself as a leader.
(32:43):
Understanding communication styles, using disc feedback, coaching, achieving team buy-in setting priorities and getting things done. It is kind of the foundations to running a practice and becoming a leader. You don't have to have a position of power in your practice to take this course. We've set it up like an online course. It's got modules so you can do a little bit at a time. You don't have to sit down and do a whole hour long course at a time. You can do it on your own time at the clinic. You can work on it at home if you want. But regardless, I want you to check it out because I am so, so proud of this and I'm so excited to see what you all think. And I know Andy is too. So head over to the website at unchartedvet.com/certificates, plural, and check out all of the information that is there. We can't wait to hear your feedback. And now back to the podcast,
Debbie Boone (33:39):
I was recently at the Vet Partners meeting, we talked about how we have about a shortage of veterinarians, a shortage of technicians, and everybody was talking about utilizing your technicians better. And I agree with all of that. I think that's important, but I think the missing piece of the puzzle is that we are not teaching our teams how to handle the public, and this is a public facing job. And so we're setting them up for failure and to live in an environment where people are constantly beating them up verbally, sometimes physically, quite honestly in some of the environments, and a lot of that comes from we set them up for failure. We did not teach them how to manage a situation before it escalated to the point where it became a meltdown. I often think about the recent event in the animal hospital where the guy got shot and I thought I would've if I was a fly on the wall, could have I coached it so that it did happen.
(34:48):
And I think yes. I think somehow in those conversations between those two people, they escalated rather than deescalated because they didn't have the tools. And that's so frustrating to me because they're not hard to find. When I was managing hospitals, my staff had to go through training modules and one was called gold star customer service, and the other was the employee manual because nobody ever reads the thing. And then common telephone questions and the answers, and then preventative care protocols and the components of and why those things were important, and my CSRs were all trained on those things. And then once they passed the modules, they got a dollar an hour raise because they were now much more as an employee. They go, oh, I got to figure this was like a 2005. So a dollar then would be the equivalent, like three now. But once that happened, there was such a confidence level in all those team members that had had that training.
(35:53):
And there was a really consistent message from the front of the hospital to the back of the hospital about what we believe, how we did things, why we did the things that we did, and then everybody could educate the clients. And that was what I've always considered our job is we think about we provide medical care, but primarily we should educate people about not needing us. How could they not need us? And that is certainly much better for our patients, but we don't take the time to train those things and look at it from how can we help our clients? In the book, there's a chapter called Who's the Hero of Your Story? Hint, hint, it's not you. So when we look at what our place and our role is, it's not to be the hero of the story. We are the wise counselor to the hero who is the client.
(36:45):
And the patient is usually the challenge or the dilemma that we are following the path of to the happy ending because the happy ending happens for the patient, but it happens for the client when the patient's well or the resolution happens. And instead of us coming in going, we are the savior of all things. We're like, no, we're here to coach you how to be a great pet owner. We're here to coach you how to get this fed through this illness. We're here as your support. And when we start to look at ourselves as collaborators rather than authoritarian figures that dictate down, we get much more cooperation from our clients. They certainly think we walk on water, they don't get experiences like that in the world, and our patients are the winners because the patients get it. And the same thing goes for human health when we feel like the team has our back, when we feel like they're truly listening to the challenges that we face, what are the simple things that we have to start thinking about what it's like to not fit the normal mold?
(37:53):
And so points are made in this, I don't think you might not have gotten into it yet, but the simple act of filling out a patient history form. If you are an adult and they want your family history, what if you're adopted and you don't know it? There's no place for you to put that or you're estranged from your family. There's no place for you to put that. And then what if your child is adopted and then you have to go through all this, so there should be, right? Give us more information. A place that says, I don't know my family history. It's a simple thing. Give us some more information and then why do we have to repeat it over and over again? Why do we not have a system in place that says, Hey, I had you fill out when you were a new patient. I'm guaranteeing that your parents who were 86 when they died probably haven't had any new health information that we need to add. So maybe we can build onto it. Well, why don't we have and say, we have this information, you don't need to fill it out. Again, it's aggravating to people because we didn't pay attention to the information they gave, right?
Stephanie Goss (38:56):
It's that same experience when we ask clients to give us a detailed history and then we ask questions. And I'm not talking about clarifying questions, right? I'm talking about the obvious same questions. It's frustrating for them and they get aggravated. It's that same experience that we have in human healthcare. It's interesting because I think about, so you, I've had some health challenges and experiences over the year with different medical teams and have had horrible experiences as well, which is why there was so much empathy when I was reading through your own experience. And I've also come to a place now in the last couple of years where I have a excellent, amazing healthcare team that treats me like a whole person. And it took a long time and a lot of fighting to make that happen. But one of the things that I truly appreciate is my general practitioner who I live in the middle of nowhere, as those of you listening to podcasts know, Andy likes to tease me about it constantly that I live in the land of no internet, but I have to see my general practitioner for a lot of things.
(40:13):
My specialists are pretty far away, and so they help with that. My general practitioner knows that I work in healthcare. And so after I remember vividly having our first appointment when I was going through my diagnosis and asking a lot of questions, and at the end of the appointment we were well over time for the visit, he could have been frustrated, he could have been irritated that he was behind. He had other patients waiting and instead of going, okay, I've got to go and move on to the next patient, what he said stuck with me and Will always, because he said, I love that you're asking so many questions, and I love that you have clear, he's like, now I understand you're in the healthcare field. He's like, I would like to set up your appointments differently in the future. He's like, I would like to set you up for extended appointments because the things that you and I are talking about are a different level than I would be talking about with a patient who has no medical knowledge.
(41:10):
I'm asking questions about the drugs and the pharmacology and because I have that knowledge. And so instead of being irritated by that, he intentionally chose to work with me as a collaborator. And so now when I get booked in, the first thing the CSR says to me when she answers the phone or when I send in an appointment request is, oh, it looks like you're marked for extended time. And they don't make me feel about that. I don't feel like that client who's taking more time out of the day, I feel like, oh, he has asked for this to be a thing so that we can have the conversation and it's not taking up more time. And I think about it in parallels to our clients, and there's this conversation that happens in veterinary medicine where so many of us, myself included, get really irritated that clients are doctor Googling.
(41:58):
And when we step back and we take the emotion out of it, aren't we glad when we have a client who comes in who is taking the time to educate themselves because the conversation, and I think that we should be asking a different question, which is where are they getting the information that they're getting? And that is the battle we should be fighting in veterinary medicine because if we're putting out valid information that clients can access, right? And that when we think about Dr. Google, we kind of lump it under this. It's all quack crap umbrella, which is bullshit. It's not true. There are so much good information out there that they can access. Now, shouldn't we be glad when a client walks in the exam room and wants to understand and wants to ask questions? And there are times when we are glad, and there are also times when holy hell, it annoys the hell out of us because all we want to do is get out of that exam room.
(42:51):
And so I think that's another one of those moments to remember where as a human being working with another human being, we always have a choice. We can choose to treat that client and make them feel bad for the fact that they have researched and that they have questions and they're asking things that are inconvenient to us because we're running behind or we've got patients waiting or whatever. And we can also choose kindness, and we can choose to say, you know what? I love that you have prepared for this visit. I want to be able to answer all of your questions. And my next appointment is waiting. Can we schedule a follow-up consult by email or can we schedule a follow-up where we can come in an extended visit and I'll happily answer all of your questions, give them a plan. Because when we do that, they're not mad about it and they're willing to be partners in the healthcare conversation with us.
Debbie Boone (43:45):
Exactly. And that's it. It's about the partnership. Well, I've always been very frustrated with any business who asks you what your occupation is and then never looked at these papers again. Why did you even bother when if you looked at this, you would see that I have been in healthcare for 35 plus years, and you can say some stuff to me. I actually know anatomy. I know some things, right? And so we can talk at a different level, but there's other aspects too. I mean, we also will look at people from especially in veterinary medicine coming in from the human side and immediately do the eye roll and go, “oh my God, the nurses are the worst, right? They're going to try to treat their pet.” One of my very best was a nurse. She was the voted the best nurse in the state of North Carolina. We absolutely adored her.
Stephanie Goss (44:39):
Oh, my Gosh. That's awesome.
Debbie Boone (44:39):
And when she moved, she kept driving to us two and a half hours for her care. So that's the bond we had with our clients. But this was an exemplary person as a nurse. She didn't try to treat her animal. And we had another one killed her dog by giving it Advil. But it's a whole different story.
Stephanie Goss (44:57):
It takes all kind, and let's be real again, remember that we have the choice because to your point, we roll our eyes when we see that someone in human healthcare is coming in. But aren't we also, and I don't mean all of us, we, but think about it. How many of us know someone in veterinary medicine who treat ourselves because we know about veterinary medicine, and so we choose to self-treat or start ourselves on cephalexin or whatever it is.
Debbie Boone (45:24):
Let's take it. I took my own X-ray to the orthopedist when I broke my finger. But here's the thing. My X-ray was digital and theirs was not. My X-ray was so superior to their stuff. I went, you don't have digital x-Ray. This is specialist. Are you kidding? I said, look, I understand you hate it. We hate it, but I did it anyway. So here it's just confess it off the top of your head. And I love the example that you gave about saying to that client, I would love to continue this conversation because I'm so glad that you asked these things, but I've got another client waiting and I'm committed to being on time just like I was for you. So let's set up another time. Let's set up a phone call or email each other back and forth. We can do that because then the clients don't feel like you're just blowing 'em off and you don't care.
(46:18):
But they'd also appreciate the fact that you have a commitment to being on time because they want you to be on time for them too. I just don't understand why we think we can't say the graceful no. Right. It's setting the boundaries. It's setting the expectations. I can remember a conversation I had with a client one day was extremely anxious about her dog. And yes, I think she had some issues, but she called her practice 52 times before lunch, and the staff is just like, ah. So when she came in, I said, let's just sit down. Let's just sit down and have a conversation. I said, Nancy, why are you calling us so much? I said, we can't even look after Casey because you're calling us all the time. Don't you want the doctor to look after him? She said, yeah. I said, then she can't be on the phone with you and look after him.
(47:08):
She said, I know Debbie, but I'm so anxious. I said, well, please just try to understand that we are trying to help him, but we can't if you're constantly pulling us away. So we're going to call you as soon as we know something. We understand your anxiety. We appreciate your anxiety, but you're killing us here, right? You're killing us. And so she's like, I know it's my anxiety. So we can say things to people nicely. We can let them know that our doctors have lives and that they are not going to be coming in at three o'clock in the morning just because you want to fix a broken toenail. Things are not going to happen. But there's a way to do everything. And I think that is the training that's missing. We put a hand in people's face and we say, no, we can't do these things. Instead of learning how to say, we are happy to help you. Here's what I have available. How can that work for you? Let's work together to find a solution here. But we don't train people to do those things. It's just the automatic, no, I don't have time. We don't do that.
Stephanie Goss (48:15):
I love it. I feel like the book is so full of lessons that you have learned as a leader, but where I want us to end, is there a leadership lesson that you have come to appreciate now where you are in your career that you wish that you had learned before you became a leader?
Debbie Boone (48:36):
Wow, you got, we don't have enough time for this. I think the most important thing that I have learned is going back to the questioning, is just being curious and asking people what's going on with them. And that goes for clients that when I was solving conflict problems, just asking those questions and not trying to get my point across, or not trying to be judgmental or upset or irritated or angry, and to learn that that says no. Let's find out. Let's keep digging until we find out one of the quotes. It's in the book, but it talks about when therapists and psychiatrists are being trained, it says, the problem that the patient brings to you is never really the problem. So you have to keep asking the question. And I think that looking at the problem on the surface, it may seem as this, but then once you really start to figure out and dig down and ask questions and care about people, then you're going to find out that the problem is not really the problem. So why is that person late for work three mornings of the week because their kid just turned two and decided to go to school naked every day? That's why. So these are the things that you find out when you start asking questions. And these are real.
Stephanie Goss (50:03):
Yes, yes, like your client who called 52 times in the day. That's a lot of times when we get the, well, I have huge amounts of anxiety, and I'll never forget being in the exam room with a client just like that, having a similar conversation. We'll come to find out that the pet belonged to their son who passed away, and this is the last link that they had. And so the anxiety was coming, yes, they cared about the pet, but it was more and it was about the loss and the grief and the fear over losing that link to their son. And now all of a sudden, the whole team has a radically different perspective on Nancy calling 52 times before lunchtime. So I think that that's a great answer. I love that. Love that one. I was like, ask more questions and I love it so much. This has been so fun, as it always is talking to you.
(51:08):
So I'm going to drop links in the show notes if you want. I'm just going to go out a limb and say, everybody should have a copy of this book in their practice. It's wonderful, and I will give you more feedback when I actually finished the entire thing, but I'm loving it so far. The book link will be in the show notes along with the link to your website, and we were talking about Dr. Eurich. I'll put the link to her reference in there as well. But one of the things I love about your website, Debbie, besides being able to contact you, is that you've got a list of recommended books. And so if you're like, I'm nerding out on this, I'd like to find out more about this kind of stuff. There's some great books on your list. I was spying it while we were talking, and so I'll put that in the show notes as well so people can find you and find all the things. Thanks. Thanks for the conversation, friend. This has been great. You're
Debbie Boone (51:58):
Welcome. Always a pleasure to be with you, and I'm glad you're liking the book so far. I can't wait to hear your feedback. I value your opinion since it's so much like mine.
Stephanie Goss (52:10):
Well, lemme fluff your pillows, as Andy will say and tell you that so far I am loving it. And when you read it now you've heard Debbie and I have a conversation. Tell me if you read it in her voice like you're having a conversation with a friend. That is certainly how I am reading. It's wonderful. This has been great. Have a fantastic rest of your week, everybody who's listening, and you, Debbie, and we will see all next time.
(52:38):
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.
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