The practice manager at this clinic struggles between business operations and team communication. Dr. Andy Roark and Stephanie Goss address a mailbag question from a medical director struggling with a practice manager who excels in metrics but falters in team interaction. Andy and Stephanie dive into the friction often seen between the business and medical sides of veterinary practices, especially in corporate settings. They emphasize the importance of empathy, trust, and good intent, providing actionable steps to bridge the gap between operations and medicine. They also offer strategies for giving positive feedback and fostering a supportive environment. 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 tackling an email from the mailbag that actually was kind of an easy one. We were really excited to get into this. We had a medical director who was asking about helping their practice manager partner, who seems to be floundering with the team. And I say it was easy because Andy and I's answer to the question, should I help them or not, was a resounding yes and we both enjoyed getting into some of the tools that we've spent the last few years working on with some of our clients in both public, private practice, and corporate practices. Let's get into this one, shall we?
Announcer: And now, the Uncharted Podcast.
Dr. Andy Roark: And we are back. It's me, Dr. Andy Roark and the one and only Stephanie, do you understand the words that are coming out of my mouth? Goss.
Stephanie Goss: Oh, I love that one so much because I hear a completely different voice in my head when you do that. But that's a, that's a good one and it's a very appropriate for what we're eventually going to talk about today.
Dr. Andy Roark: Yeah, it's, yeah, that's fun. Chris Tucker is hilarious!
Stephanie Goss: You know, when we get there, eventually.
Dr. Andy Roark: We, we, when we wind on, we wind on that, we wind on that way. Well, it's, it's
Stephanie Goss: We got to go off the rails. How's it going, Andy Roark?
Dr. Andy Roark: We have a new car at our house!
Stephanie Goss: Yeah.
Dr. Andy Roark: My 16 year old spent her entire life savings. Yeah. And, and now we have a 2012 Ford Fusion. Ford, yeah, it's a Ford Fusion. But yeah, she, actually she got, it's, it's been sitting in a garage somewhere. It's like 30, 000 miles on it. It's a, it's a, it's a nice, it's a, for where, for where she is in her budget, it's a deal of a lifetime. It was amazing. So, anyway.
Stephanie Goss: That's great. That's great. Is she, is she, is she super excited? Cause I know she was going through a period where she was like, I want to drive everywhere. Like any, I'll drive you down. I'll drive you to the airport. I'll drive you wherever you want to go. Cause driving was like the novelty. It, how, how is she like super pumped to have a car?
Dr. Andy Roark: She's, she is over the moon about it, and she's really just deeply happy about it. I am amazed by how little she actually drives. Like, she's got the car, and she loves the car. She's way more interested in buying decorations for the car than actively, actively driving it. So like, she, she, again, she's like, I got it. The most exciting thing she's had is not driving it to pick her friends up. It has been that she found a sticker that goes in the, in the makeup mirror on the driver's side, you know, that says, “hello beautiful.” And she's like, look at the makeup mirror and it says, hello beautiful. And she's like, I found another one and I ordered it for the passenger side and it says, passenger princess. And like, that's what she is the most excited about is stickers that say passenger princess.
Stephanie Goss: I love her so much.
Dr. Andy Roark: Oh, yeah, she's got she ordered these fake succulent plants
Stephanie Goss: Uh-Huh,
Dr. Andy Roark: that clip onto the vents. So her vents are going to have these little pots with fake succulents in them and like she's like, can you believe it and I'm like of all the things, this is the thing I have the least trouble believing.
Stephanie Goss: You're like, I could, we could have spent a whole lot less money in giving you something to decorate if that was what you wanted. Something that doesn’t require insurance.
Dr. Andy Roark: Oh yeah, she’s gotten like I could, I could have gotten something towed to the house And then she could have just decorated it and it saved me a lot. Oh buddy, I didn't realize your insurance goes up when your kid gets a license and then it goes way up when they get a car I'm, like, of course it's on our the cars. It can't be on her insurance. It's on ours. And so I was like, oh It's anyway, it's good. It's oh boy.
Stephanie Goss: Teenagers are, teenagers are expensive.
Dr. Andy Roark: But this was the point. The point was to raise a functioning adult. And we are. I just, I didn't, hmm, I didn't anticipate this level of bloodletting at this phase of the game. I was like, oh boy. I was, college is gonna be hard, and then weddings. Like, there's so many steps between here and there that are also expensive. Oh man.
Stephanie Goss: Yes. I feel that. So I went, I actually went car shopping with Riley recently and she's about to get her permit and I said, okay, listen, I need a new car. And so why don't I think about getting something now that is fine, and I don't mind striving it, and then in, you know, a year and a half let's make it affordable enough that you could take over and make payments with your part time job when you get your, when you get your license.
And I will tell you The fear and the pride at the very same time that struck my heart like a lightning bolt when I saw her sitting in the driver's seat at the car dealership. And it was just, it was unreal. I was like, I am not ready for this. And at the same time, I had such intense pride because she was talking about, she was talking to the car salesman about her job and about how she's, you know, knows that she's going to have to pay for her insurance. And she's, you know, she's, she's so. Like a mini adult sometimes and then I look at her and I'm like, but you're still two years old.
Dr. Andy Roark: Oh
Stephanie Goss: You're just a little, a little chubby faced toddler.
Dr. Andy Roark: Seeing my kid talk to the car dealer, that was, that was really mind blowing. So we were there, like we went to CarMax at one point and we're, we're there. And like, they take you into the mega mall that is CarMax, which I had no idea what a big business that is, it's ridiculous. And so there's people coming and go, it's like the grocery store in there. There's people in the aisles.
Stephanie Goss: Yes.
Dr. Andy Roark: Anyway, so there's my daughter and she's sitting down and she's talking to the person at her computer and I'm like this is surreal to see, but I'm going to lean back and I'm going to let her lead the conversation and the dealer turns and type some stuff into the computer and then looks at my daughter and says, well, what do you want in a car?
And Jacqueline goes, what do you have that’s green? And I was like, I'm taking this conversation back. “Hi, I'm dad. It's time for me, it's time for me to step in.” That was a fun experiment on independence. Let's talk about reliability. What do you have that's green? It's like, nope. And I'm taking the microphone and I will be setting the agenda for the rest of this meeting.
Stephanie Goss: That's fantastic.
Dr. Andy Roark: A complete, a complete lean back and let go of the wheel failure on my part. But I…
Stephanie Goss: Which is so funny because I would have expected, I would have expected out of Jay what I got from. from Riley, which was, I, I would like to look at these, these, like she had done the research and she was like, you have these three hybrids on your lot. I would like to take a look at all of them. And she was just like, here's all the details that I would have expected. I would have expected that from Jay.
Dr. Andy Roark: Nah, it was, anyway,
Stephanie Goss: What do you have? What do you have in green?
Dr. Andy Roark: Yeah. Ah,
Stephanie Goss: I love it. Well, speaking of details, Speaking of numbers, we have got a great mailbag letter this week. We got a, we got an email from a medical director and they were struggling with something in the partnership with their practice manager.
And so they said, you know, here's, here's the deal. My practice manager is super great with the operations side of things. It's like, they get the numbers and the metrics and they speak the. Language that the business side of the company wants to wants to speak there in a corporate practice. And and so she was like, they're all good communicating on that side of the fence.
What is not so good is communicating with the team because they live in that land of numbers and metrics and And when it comes to talking about things with the team, the team doesn't care. You know, and this is such a familiar story. And so this medical director is like, Hey, I'm not this person's boss.
And I don't want to tell them how to do their job. But I'm really struggling because the practice is suffering because they're not able to connect with the team and the team is really turned off by their leadership approach. And so they were just like, do I, do I say something? And if I do, how do I say something?
Or do I just stay in my lane and let her struggle and flounder and potentially fail with, with a team and the practice suffer as a result from it?
Dr. Andy Roark: Yeah, this is a great question. I love this. So we're, so there's a lot of these types of issues that you and I are playing with these days. This is this is something that we did not see a whole lot when that medicine was primarily independent practices. And when we have corporate structures moving in, this is a very, very common issue.
And so you and I have fortunately been able to spend the last three, four years wrestling with. And so, I feel, I feel very fortunate for us to have had the experiences that we did. And so, this is not outside our wheelhouse at all. So, anyway I want to start with this. Let's go ahead and start with, with Headspace.
So, I think I think headspace for me to open up is say empathy first, right? Be, be a supporter of this person, of the manager. So if you're, so okay, let me frame, actually headspace first, let me frame this up. In modern veterinary practice, there is an inherent friction between people who are passionate about and devoted to the medicine, and people who are passionate about and devoted to the operations side, which are like the business metrics.
Stephanie Goss: Yes.
Dr. Andy Roark: There's, it is not good and bad, although, People can feel that way. People can feel that the operations people are evil and they care about money and the operations people can feel that the medicine people are naive and silly and they clearly don't understand that we have to make payroll. What are you guys doing?
And so, Those are the base instincts that each side seems to have, and again, I, neither one of them is wrong, but if you're feeling one of those two ways, just know you're not alone, and this is common. And so that friction is very common. The answer to that friction is trust and communication and empathy and understanding and a belief that we can both do good and do well as a business.
And you have to believe those things and be willing to work with people. And you have to assume good intent. Like that's, like that's the first thing that breaks down is, as soon as the operations people stop assuming good intent by the medicine people or vice versa, Everything gets so much harder. And so this is just a daily affirmation that we have to make going into the practice is, I am going to assume good intent on the part of my partners, and I'm going to believe that we are all trying to do good in the world, and also take care of our business and our, and our, our teammates, and provide for our, for our people.
Framing it up that way and just sort of getting started, I think you have to start with, I think you have to start with that for Headspace. Do you agree?
Stephanie Goss: Yes. I, I think that's, I think that that is super smart. And I think the in this specific circumstance, we have a medical director who really should want and need everybody to be in that place of empathy because the reality is their job, although it might be on the medicine side, is to make sure that it is a thriving practice.
Like when, you know, when you're, when you're put into a role, like medical director role, and it doesn't matter whether it's a corporate practice or a private practice, if you're a medical director or you're a practice manager in a practice, your job is to make sure that things are successful. And to your point, on two sides, one is on the, the day to day side, the peep, which I would consider the people side, you know, what's happening within the walls every day in the building and the, the operations side, the business side, because to your point, can't open the doors without being able to pay payroll.
And so unless you are working. In veterinary medicine in a, in a privately funded institution, which I would say, you know, would be, would, would be you know, vet schools or research labs, et cetera, you're, even if you work for a nonprofit, They still have to make enough money to cover their costs.
Like, they may be getting donors to offset some of the costs, but, but the reality is it still is a business and it has to run. And so I think getting into that place of empathy and understanding that even if it's not your job, you still have to wrap your head around and, and be supportive of the fact that it is, is business is important.
Dr. Andy Roark: Yes. I agree. There's also this part to it that is just true. There's certain things in life, and I'm trying to come up with good examples, but there are certain things in life where the more you stress about them, the harder the outcome you want to achieve. becomes. And so if you want to dance, the more stressed out you get about being a bad dancer, the lower the chances are that you're going to be able to relax and dance.
You know, I'm just, I'm, I'm sort of thinking, thinking of things like that. It's a lot of times with surgery, the more stressed you are about surgery The harder it's going to be for you to just relax and let the tension out of your shoulders and really be present in the moment and pay attention to what you're doing.
And the same thing is true when we get into medicine versus operations. I have seen operations. People freak out about operations. They're like, we have to have these numbers. And as soon as you start to do that, the medicine people are all detaching. The more you. The more you shout at them about not hitting the metrics that we're paying attention to, the more they're going to disengage and the thing is going to fall apart.
And the same thing is true for the medicine people. The more you go in and shout at the operations people about, We're not doing what we're supposed to do, and this is not the top standard of care. And like, as soon as you get frustrated, they're going to get defensive and everything is just going to lock up.
And now you're really not doing the medicine you want to do. And and you're not going to be doing it for a while. Cause you're going to have to either blow this whole thing up, or you're going to have to calm down and do an apology tour and, and rebuild the trust. And so anyway, I put that forward to, I, again, I think I really love this writer's approach of like, Hey, I'm looking at this.
I'm seeing it. How much should I care? I'm like, that's a good headspace to be in is. I don't know. I think I'd like to help here, but I'm not really sure how. That's a really good headspace as opposed to, Oh my god, this is terrible. It's all falling apart. So anyway, so there's that. Empathy first is a big thing for me.
I think that we can all get, especially we're talking about medical director practice manager partners. Empathy is the number one thing. You are better able to guide someone when you're in their corner than when you're in the opposing corner. You know, if you can be a cheerleader of this person, a supporter of this person, and they see you as a cheerleader and a supporter, you are much better to have You're much better able to have gentle conversations, and not be seen as threatening, you know, punishing undermining, anything like that.
Because the person says, well, I know Stephanie's, she's trying to help, or Stephanie's my friend, or Stephanie looks out for me, or Stephanie has my best interest at heart. We're much, we're all much, much better. more likely to hear conversations coming from that person. And so the first thing I would say is avoid those combative positions, be this person's friend, be a cheerleader for them.
Remember, just go ahead and if you're not in the habit of giving positive feedback and reinforcement, just go ahead and lean into that. And again, you can figure out what you're going to say over the next couple of weeks. But go ahead and get started giving positive feedback without any and all so's or here's the, here's the secret bit of criticism hidden inside.
Stephanie Goss: Not the, yeah, not the compliment sandwich.
Dr. Andy Roark: Exactly. Just, just start praising them for what they do well, supporting them, celebrating them, appreciating them, making them feel appreciated, and just start building that trust so that when you start to give some feedback, it's coming, not in a vacuum, but it's coming as a. big piece of this healthy relationship that the two of you have. And so anyway, empathy first start.
Stephanie Goss: and I, I love your point about being in their corner, because I think the reality, it sounds like in this situation is that. The medical director said, you know, I'm, I'm not their boss, so should I, should I get involved here, right, is the, is kind of the question they were asking, and I think it's a really, it's a really important question to ask, and I would say that the medical director actually has a significant amount of power in this situation because they have the ability to influence the team, which is already from their perspective, suffering as a result of the way that this practice manager is approaching the, the business.
And so, if they want the hospital to be successful, being in the practice manager's corner and supporting them with the team is the most important thing that they can do. Because if they don't, they're If they are, and, and just being silent is still a choice, right, if they are silent and don't say anything to support the manager, or if they detract the manager with the rest of the team, if they say, you know, yes, I don't like talking about the numbers either, I'd rather focus on the medicine or, you know, even something that doesn't feel Super overtly negative, but comes across to the team as okay, she's on our side versus the manager side.
It's going to be exceptionally detrimental to this, this manager and so this, the, the medical director in this situation has the ability to do a great amount of good here and the potential to do a great amount of harm depending on how they approach it. And so I think it's really, really important to think about the fact that you may have.
Two very distinctly different roles. And I have, I have seen that both in, in private practice and in corporate practice where it's like your job as the PM is to do this. And my job as the practice owner or the practice manager is to do that or the medical director is to do this. And we both have our separate responsibilities and it's not that working together kind of partnership.
And I have had, I've had the opposite and everything in between. And so. Even if you have two distinctly different roles, you're still working together to try and better the practice and move things forward. And so I think coming at it from that place of empathy and recognizing the power, like you said, Andy, of being in their corner is really, really important in this, in this situation.
Dr. Andy Roark: Well, there's, there's great power in maintaining the united front. You know, there's great power in being able to lead the team when the medical director and the practice manager are to the, to the outside in alignment and supporting each other. And that is, that is just a healthy place to be. And again, here's the truth.
Behind the scenes, you're not always going to agree. Like, that's it. I'll tell you a deep dark secret. My wife and I don't always agree. Like, there are things we do not agree on. But we don't hash them out in front of, in front of the kids, and we don't talk separately to the kids about what we don't agree on.
And again, I'm not, I'm not trying to give marital advice here, but there is great benefit in leading the team in the long term. in the medical director and the practice manager being on the same page and appearing to be on the same page. And you, that doesn't mean you can't listen to other people when they come and they have complaints or feedback.
You can take that feedback without throwing the other person under the bus or taking sides and going, yeah, you know, I can't get him to do that either. You know, it's, it's, but it is temp, it is tempting when, especially if you're having Frustration it is tempting to kind of go. Yeah, you know what? I'm kind of I'm kind of with you guys on this So just be mindful of that and again, it's not about misleading people But that united front is is important You definitely don't want to get yourself into a place where the team feels comfortable playing the medical director against the manager Or vice versa that's i've seen that plenty of times and we really want to avoid that But it comes down to the the manager and the medical director communicating But anyway that from a headspace standpoint Empathy you know, remember that, that we're on the same team, remember, you know, choose, choose choose good intentions, you know, to, to see people good intentions and all that sort of stuff.
So anyway, I, I think that those are sort of, that's sort of the loving kind of communicative headspace I want to get into. And then, and then the other, the other thing is, you know, I, there's some, some ways I would sort of start to That I was sort of sort of lay these things down. I think from a headspace standpoint you say well, is this worth Saying something about and it depends on your relationship if you're like, oh, I can't even talk to this person then no This is this is probably bad, but it doesn't seem that that's the case and for most people it's not the case So I'll have the American Animal Hospital Association just put out a white paper It's this retention attrition white paper and they survey the cat You It was funny.
I was talking to Dr. Jessica Vogel saying is the chief medical officer there. And she said that generally when they put out like a survey they get two or three thousand responses and they put this thing out and they got 15, 000 responses people were like I'll tell you what I care. Oh, yeah It was all about what are you thinking about leaving your job? And if so, yeah, if so, why and are you thinking about staying and if so, why and people are staying and if so, why?
Stephanie Goss: Uh-Huh.
Dr. Andy Roark: Yeah, and so anyway. You the, the number one reason that the doctors say that they're staying and the number one reason the technicians say they're staying overlap completely. They're the same, which is fascinating because they broke everything up by role. And so whenever you've got the docs and the techs 100 percent in alignment, this is the top priority. And that priority is meaningful work. That is the number one reason that people are staying. If you're a doctor or a technician, they feel that the work is meaningful. Cool.
Stephanie Goss: Yeah.
Dr. Andy Roark: It's worth talking to your operations people about their language if you buy that and say, Hey, everybody's here is here for meaningful work, which means the average client transaction is probably not going to be inspiring to them.
Like that's, to some people, that's a hundred percent. To some people, that may be antithetical to meaningful work. If you put the dollar value on it, it almost undermines the meaning in their eyes. I don't think it has to be that way. I don't feel that way at all. But some people do, and again, yeah, this takes me to sort of the next sort of headspace point is, I like this a lot.
Remember that listening happens at the ear, not at the mouth, which means what you say is not as important as what they hear when we're trying to achieve outcomes. And so I say that for two reasons is, okay, if the team is not hearing What they need to hear to feel that their work is valued or meaningful, or they're not feeling appreciated. We need to address that. The other thing is internalizing that idea, that concept listening happens at the ear, not the mouth. It does make it much easier to talk to the manager. And now we're starting to move towards some action steps. Here is you can talk to someone and you don't have to say you're saying this wrong, you sound bad, you sound foolish. The way that I would approach this is to say, I'm not sure the team is hearing what you're saying…
Stephanie Goss: hmm.
Dr. Andy Roark: in a productive way. And that may sound small, but, but that is really important. I think it's amazing how much more open people are to hearing, hey, I'm not sure that your message was received the way that you intended.
Stephanie Goss: Yes.
Dr. Andy Roark: As opposed to, hey, your message is bad, you're not communicating well. People are much more open to the former.
Stephanie Goss: I love it. For me, like you said, it's kind of veering into the action steps, but I think the language matters. And like one of, one of the first lessons that I learned as a leader was a former practice owner of mine who used to say all of the time, if we practice good medicine, the money will follow and it's so, so simple, but it is so true that if we're practicing good medicine and we're taking care of our clients and our patients, if we are also running a smart business.
We don't have to worry about the metrics and manage to a spreadsheet. It's when one of those things is out of whack that we do. If we're not practicing good medicine, if we're not taking care of our clients, if we're not taking care of our patients, or if the business piece of it is out of whack, we're not priced appropriately, we're not you know, capturing fees, etc.
Like, those things, they have to come, they have to come together, and so I think you can think about the language that you want to use. And this is why I said the medical director has an incredible position of power here, because they can influence the team when it comes to that, that language. And so to your point, Andy, being able to say, Hey, I want to make sure that the team hears your message when you deliver it.
And so when you, you know, when you talk to them about the average client charge, that doesn't, that doesn't maybe come across the same to their ears as when we take care of patients and we practice our standard of care, this is the kind of result that we have on the business side. And so I want to make sure that we're taking care of our patients and we're getting them the care they need.
And that means capturing the charges every time, et cetera. Like you can give them, you can give that practice manager the example that puts it into words that the technicians are going to hear and that's going to resonate with them and do it in a way that presents that united supportive front to them.
Like, yeah, I want to make sure that you're heard and I worry that you might not be, you know, and, and for me, that is you know, the tool of, of being, being honest, especially as the medical director. If sometimes you hear it or you hear numbers or worrying about labor hours and stuff like that, and it is a struggle for you, which I've worked with many medical directors who have told me, like, when you start to talk about numbers or you start to talk about the business stuff, I have to really fight to not have that glazed over look on my face, right?
So this is where the honesty comes into play as partners and the practice is just say, Hey, look, I want to make sure that your message is coming across and the language really matters. And you can be an incredibly powerful teacher in this moment, and to your point leaning into the listening happens at the ear, like, it's the perception that is really important here.
Dr. Andy Roark: Yeah, I think that's true. I think the last, the last story I'll tell here in headspace is one that really affected me in my, sort of in my career. So I had I had a mentor early in my career who was really just wonderful. He taught me so much about about running practices, but also just about running businesses and just about have enjoying your life while you're doing it and one day I said to him, I said, you know, I don't know how you do it, but you tend to give me feedback. I had noticed you give it to me with the directness that I need to hear it. But you don't tend to make me feel ashamed or make me feel bad. And I, that's honestly what I said to him was like, it's amazing that he could give me feedback and just consistently I heard him, but I didn't really feel bad about it.
You know what I mean? I didn't feel beaten up or ashamed. And so I said that to him and I said, you know, you, you seem to know how direct to be, how do you do that? And he laughed and he said, well, Andy, if there's something I see, I just kind of mention it to you. And then if you. Just keep doing that thing.
Then I mentioned it a little bit more directly and I just keep getting a little bit more direct until you hear it. And then I stop. And it was so funny. The idea that he had probably given me lots of feedback that I just did not, did not hear at all. Was it was, I was like, Oh yeah. I probably ignoring a lot of things until, until he's direct enough to get my attention.
But that's, but that's how he would do it. And you have to have the perspective that everything is not on fire. You know, you have to believe like, hey, this is a thing. We're just going to, we're going to work on it and I'm going to mention it. And if it doesn't work and he doesn't hear it, I'm just going to mention it again a little bit more directly.
And so anyway, that's the last headspace for me is like, is it worth this conversation? I'm not this person's boss. You can, one of the ways to approach that is to say, I'm not this person's boss, I'm not going to bring them in and sit them down in the office, I might just mention it to them, and then we'll see where it goes, and again, it goes back to what I was saying before of like, there's things in life where the more you, as soon as you feel desperate, or the more you care about them, the harder they become to achieve, feedback is that way, like the more freaked out you are about it, The harder it's going to be for you to deliver a message to someone.
That's just, it's just what we're talking about right now. I don't care if you listen to me or not, this is what it is. And they go, Oh, okay, well, that's fine. And it's not an issue. But the more you ramp your blood pressure up, the more intentional you get about sitting down and connecting eye to eye, the harder, the harder it is. So anyway, I think that's my headset headspace. You got anything else?
Stephanie Goss: No, I, I think that is a good place to stop. You want to take a break and then we'll come back and talk about action steps?
Dr. Andy Roark: Let's do it.
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All right, so we've talked a bit about the headspace. We've talked, we've actually, we've shown a lot of our cards I think about how, how we're gonna try to try to play this out. Again, I love this I love the mention up front of like this person. I'm not their boss. How do I do this? And it's I think that that's, I think that's the fun part of this.
Dr. Andy Roark: All right. So, I mentioned in the first half of the show in headspace make sure you're laying a good positive groundwork for this relationship like the person Medical director, practice manager, partnership, you and I both believe in and really teach hard on this, that relationship is really, really important and you want to, you want to take care of it, you want to honor it, you want to polish it up, you want to honestly just, you want to let some things go because they're just not worth holding on to, like you want to try to preserve goodwill around this relationship and And keep it going.
So, so start with that. A big part of that is positive feedback. And we talk about training people all the time. Look. None of us, hopefully, are training animals with negative feedback. None of us are shouting at our Labrador until he sits down. Like, I hope. People, people are simple animals. I don't, I,
Stephanie Goss: Unless maybe, unless maybe it's a really bad doodle and you're just like for the love of Pete, can you just sit?
Dr. Andy Roark: I know. I'm not saying Skipper doesn't get yelled at. But it's definitely, he's definitely not being trained that way. So again, positive reinforcement training. Like we know that that's how you train animals and people are animals. I don't care how smart you are.
And so just go ahead and whenever possible, Positively reinforce this person if you see this and you say, well, they have a tendency to talk in operations terms when they don't talk in operations terms, take 10 seconds, 10 seconds to pull them aside and say, Hey, can we talk real quick about the conversation you just had with Tina just for a second?
Hey, look, I love the way that you explained to her why we do what we do. I thought that, I thought that was so well done. I think it really probably resonated a lot more with her than talking about dollars or money. I wouldn't say it resonated with her a lot more than talking about dollars and money like you usually do.
I would just say what you did worked really well. And I anyway, I just wanted to point out like I saw it. I thought that was a really great approach. I just wanted to tell you I thought that was really well done. And then walk away. That's it. Don't, don't keep talking. Don't make it a big thing. Don't turn it into the conversation about how we need to do these other things. Just be done. Just be done.
Stephanie Goss: Right.
Dr. Andy Roark: Anyway, one of the easiest things that we can do is just start positively reinforcing the behaviors that you want to see. It's amazing how far you can go in that direction. And so, just start with that. So that's number one. One of the simple things that I like to do in these medical director practice manager teams is talk about our team meaning me and the practice manager or me and the medical director and if you don't want to say hey You should really consider talking less about the hard core metrics and more about the quality metrics. Then you should instead say, Hey, you know what I think we might want to work on? I was thinking that you and me as a leadership team might want to focus on really talking about quality medicine metrics over operations metrics. And I'm feeling that whenever I talk about the ops metrics, I'm Getting blank stares.
I'm getting feedback that people are pushing back. And so as a leadership pair, as a dynamic duo, I just, I'm thinking going forward, I would like to lean into more quality standards. Now we'll still watch our metrics, of course, but I just, I that's some communication that I'm looking at for the, for our leadership team.
What do you think? And try to present it that way. See what happens.
Stephanie Goss: Yeah. I think it's funny because that's where where for action steps wise, that's where I was going to start was the question of, should I help her or do I stay in my lane? Absolutely not. You do not stay in your lane because it doesn't, it doesn't matter if you have distinctly different jobs, your jobs, both.
Have to be done in order for the practice to be successful. Therefore, you are a team, for better or for worse, whether you like it or not, whether your company has set you up to be a team or not. Nothing there's nothing bad that can come from, I, I, maybe I guess there could be, but, I, because you never say never, but there's nothing bad that can come from working together as a team.
And so I think to your point, sitting down and having the conversation about how do we want to approach this with the practice? How do we want to do this? Opens the doors for you to both be able to honestly talk to each other about the fact that You both need to get your job done. You need the team to focus on medical quality as a medical director.
You need them to care about the patients. You need them to be able to do things right and in a quality manner and the practice manager needs the team to capture the, capture the charges for what they're doing and make sure that everything gets taken out of inventory and all of the pieces that go into running a smart business.
And so to your point, Andy, the sitting down and, and starting with. How are we going to work together? How are we going to present that united front to the team matters? And I can tell you, I have never experienced more failure as a manager than when I didn't start from there. And I, and I ran my role as a practice manager or hospital administrator Independent of my medical director partner and we didn't sit down and start from that place of how are we going to work together and I will tell you, I spent, it's been a whole year feeling like.
I've never done crew or rowing or anything like that, but if you're not, you know, going at the same pace and the same, like, you're just going to go in circles, right? And you're not going to be able to get anywhere. And it's that same feeling of if you are both going in different directions, it doesn't matter how hard you are working as the medical director or as the practice manager, if there is not some synchronization of what you're trying to do, it's never going to move it forward.
And so, you know, I mean, you and I spend. A huge portion of our work life having those conversations about how do we work together effectively as a, as a leadership team because it's very, very rare to have a practice where you can have one person who wears all of those hats now in this day and age.
Like, it doesn't matter whether it's corporate or private. The version of veterinary medicine that we practice now generally requires more than one person to do all of those things and wear all of those hats. And so usually there is another person involved and sitting down and starting from that place of partnership is really, really important.
Dr. Andy Roark: Yeah. I, I, I, I agree with that. I, I think you're, I think you're spot on. It was funny. I, one of the stories that stuck with me for a long time, there was this guy who was an internist and he worked at this really huge, well known veterinary practice. And he was in charge of the interns that came and worked at the specialty practice.
And one time, he had an intern who came in who had a problem. body odor, like bad body odor. And it was being reported as like, Hey, this is a problem. And so they turned to him and they're like, you have to go tell this
Stephanie Goss: You have to deal with it.
Dr. Andy Roark: You have to deal with this person's body odor issue. And so he thought and thought and thought about it. Cause this is a delicate conversation. Ultimately what he went with was he called the person and he was like, Hey, so, you know, there have been some complaints. Apparently you and I have body odor issues. What are you doing? I'll tell you what I'm doing. Let's work, let's work through this together.
And he, and that was his approach. And you can say, well, he wasn't being entirely honest. And I could, I could, I can agree with that. However, I can't imagine a gentler way to have the conversation. And it also did not make it adversarial. He was like, alright, the word is that you and I have to work on this.
And let's talk about how we work on it. And the story makes me, it makes me chuckle. I feel, I feel bad for everyone involved, but in another way, there is often so much truth to the idea that I can tell someone what they need to work on. Or I can tell someone what we need to work on. And the second one is often much easier than the, than the first one, especially if it's something where we're a leadership team and we're in this together, let's talk about what we're going to work on.
So there's that. I think, I think one of the keys here, too, is if I'm going to start to talk to this person a little bit, and again, we're not having a formal meeting here. All of this is sort of subtle trying to sort of train and guide in the direction we want to go. Take time to recognize and verbalize the value of the person's perspective.
Like, if someone thinks in ops, language and they talk in Ops language and they care about Ops language. That's not a flaw. That's a feature. That is a good thing that is going to help your practice be a successful one as a practice. And then two inside the larger organization that you're a part of. It's not a weakness.
It's, it is, it is valuable to have someone who has that mindset. And so whenever you can praise that mindset, I think that it's smart to do that. do that. And I think you know, 100 percent praise that and also have the conversation about talking in medical quality standards terms to the team. And those things are very complimentary.
And they further sort of reduce the sting of the conversation what we're talking about. And so, If you're going to get someone to try to change their communication style, you can lean in and validate what they do really well, and how they see the world, and what they pay attention to, because all of those things are, are good and valuable.
Stephanie Goss: Well, it's like your story about having the body odor conversation, right? It's you can, you can approach it the way that it That, that person did. And there's the total commonality of, Hey, we need to work on this. And to your point, there are some people that might feel uncomfortable, uncomfortable telling that kind of white lie.
And so in this instance, you can absolutely say to the manager, Hey, like you were really good at this piece and we benefit from that. And I want to help you continue to grow things. And I feel like. We might need to change some of the language that we're using when we're talking to the team so that it's, so that everyone receives it in a way that is going to maximize.
You're, the things that you're doing well, right, like you can say that to them in a way that makes them feel like you've now just come alongside them and linked your arm with them and you're going to, you know, you're going to skip down the road together because you're a team versus, hey, you, you're over here in your lane and I'm over here in my lane and we both need to do a good job to move the practice forward.
It's that. hey, there's, there's commonality. And also, hey, I'm here to support you. So, you know, are there things that I can do to help you out with this problem? Because I want you to feel comfortable here at work, you know?
Dr. Andy Roark: Yeah, I agree with that. The last action step for me is around specific feedback. And so now this is sort of the most direct path here. So hopefully we've tried these other things. We've leaned into sort of the, the forward facing planning of where we want to go as a leadership team. We're, we're, we're validating, we're doing all these sorts of things.
Well, at some point we need to actually talk about what. What is happening? And so I like, I like the SBI feedback model, which is a situation behavior impact, like if you're going to give somebody feedback, tell them the situation like, Hey, yesterday, when you were talking to the technician team, I. I heard you talk to them about this thing, or I heard you say this.
So, yesterday when you're talking to the technician team, is the situation, the behavior is, you told them that we needed to get our client number per day up.
Stephanie Goss: Right.
Dr. Andy Roark: Full stop. And then, tell them what the impact is. The impression that I got was, Talking like looking at them and then hearing them talk later on was that all they heard was you're not doing enough. You're not working hard enough.
Stephanie Goss: Right. You need to work harder. Yep.
Dr. Andy Roark: And so that's what I saw. That's the situation. That's the behavior. That's the impact now. I don't think that that's what you said just so you know I don't, that's not how I took it, but that was how they took it. And so I think I wanted to one, I wanted to sort of make you aware of it, but then two, I think together as a leadership team, we might, we might want to start really trying to focus on communicating our metrics in a way they're going to hear them.
Stephanie Goss: Yeah, because that gets you to the end result of the conversation, right? So the, the piece, the piece about, I love that, the SBI format as well. And I think the piece that for, for me, it has always been missing is it, what good does it do to give someone feedback? Even if you're talking in specifics about what they're doing, if you don't set an end result of where I've just told you this, but now where are we going to go from here?
And so I think to your point, being able to describe the situation and to, to give them clear example of the behavior. So what I heard you say was, was this, and to your point, the impact, like I heard them talking later and clearly the messaging to me, it seems like the messaging that they took away from that was they just need to work harder.
Right. And I know. And then that's where you're moving into the, how do you build commonality? I know that that's not what you meant. I didn't take it that way. I didn't hear it that way. You know, however you, you chose to say it, this is, this is what I, this is what I know you were getting to. And. Where do we go from here?
So, hey, next time, maybe try saying that same thing, but try saying it this way, right, and give them an alternative that uses your experience being able to look at things from the medical side, but also wanting them to succeed and use their skill set and give them a concrete example or say, hey, next time, would you like to sit down next time?
Bye. And talk about it before you lead the team meeting so that I can give you some, some input, or I can give you feedback on how it's coming across to me so that you feel like super confident before you talk to the team about numbers or whatever it is, right? There are ways that you can then move the conversation to where do we go from here that helps them move it along versus, yeah, I've just given you this truth bomb and I've dropped it in your lap and set it off.
And now. I'm just gonna walk away, right? Like, who, how does that help anyone? So I think remembering to take that, that end piece and say, do I help you get from A to Z is a really good way to wrap that use of SBI up for sure.
Dr. Andy Roark: Yeah. I, I, I like that a lot. I, you know, you don't have to say everything in your mind at once, too. I, I think I would sort of say, Hey, you know, I think maybe we can, maybe we can talk about this. differently or I was thinking we as a leadership team should maybe lean into more of this sort of messaging and then I would stop talking and I would see what they have to say And it's that I'm not trying to again as soon as people think you're lecturing at them, you know, this all goes it comes apart It's really hard sometimes not to give your whole spiel.
But again same thing with clients, you know Like it's chunk and check hits give them a chunk of information Check in, see what they're thinking, where their head's at. And so I think I would, I would sort of give that to them, sort of see what they did with it. And then to your point, you know, based on what they said, I would say something along the lines of, you know, I think maybe we need to talk about keeping, making sure that we're getting our patients in who need to be seen as opposed to talking about our, our, our client number per day, you know, just as a straight up number.
And again, I, again, I would even say, I don't know. And that's just. That's, that's one idea that I had. And it's enough to kind of, just kind of cajole them without making them feel, get the wheels turning. Let them, let them come up with it on their own. But the goal, like, you're not this person's boss. And so, if you want to get credit for being a genius, this is the wrong person.
This is the wrong game to play. If you just want to make this person more successful, then you can do that very subtly, and they'll never really know that you helped them, and you have to be okay with that. And I think, but I think that, guys, that is really the Jedi level, is when you have a way of asking the question.
There's a Buddhist story, but it's something along the lines of, you know, the true master, you know, causes the student to have a realization and the student never knew that he was taught, you know, something like that. And it's, it's that, it's that, but again, if the goal is to make your place a better place to be and to make this person successful for the good of the team and the patients and the clients, then you can sort of say those things and just don't, don't even make it a thing.
Let them, let them figure out how they're going to say it differently. And just kind of, and remember it, lean into your positive reinforcement. And you can very gently, you know, kind of move this situation often where you, where you want to be, or you can at least make it 80 percent better without, without a whole lot of, without a whole lot of effort, but you have to have the emotional maturity to not get credit for the work that you're doing.
And I think a lot of people get in trouble because they need to be seen as a mentor. It was like, if you just didn't care about that and just work to make the practice better and not cared about who caught the credit, I think that you could have a happier place to work much faster.
Stephanie Goss: I love it. That was fun.
Dr. Andy Roark: Yeah, I think that's really fun. I'm glad that they asked this question. It's a great one. The old medical director manager interpersonal interactions, like, man, that's fertile ground. There's just, there's so much there and there's so many people who sort of struggle to navigate that relationship.
And, and honestly, that the importance of that relationship has shot up exponentially in the last five years. And, you know, yeah. Ten years ago, the medical director manager relationship wasn't nearly as important for most practices as it is today. And like, that's just, yeah, it's it's, it's how, it's, I don't know, it's, I, I love, I love that stuff.
I think it's a neat picture of how our profession is changing and how medicine is changing and how practice is changing. And just, I don't know, it's I'm glad, I'm glad to get questions about it.
Stephanie Goss: Have a great week everyone.Take care.
Dr. Andy Roark: See you, gang.
Stephanie Goss: And that's a wrap on another episode of the Uncharted Podcast. Thanks for joining us and spending your week with us. If you enjoyed this week's episode, head over to wherever you get your podcasts and leave us a review. It's the best way to let us know that you love listening. We'll see you next time.
