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Oct 09 2024

Can They Do Homework On the Clock?

A medical director is having trouble navigating the balance between supporting paraprofessional staff in tech school and ensuring they have the necessary technical skills for their role. In this episode of the Uncharted Veterinary Podcast, Stephanie and Dr. Andy Roark discuss a specific scenario where a veterinary assistant, allowed to study on the clock, is struggling with skill development. The conversation turns into a thoughtful debate about trust, team expectations, and the challenges of leading a veterinary team with fairness and empathy. They explore how communication and adjusting expectations can prevent feeling like the “bad guy” while supporting staff in skill growth. Let's get into this episode!

Uncharted Veterinary Podcast · 308 – Can They Do Homework On The Clock?

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

Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.

Submit your questions here: unchartedvet.com/mailbag


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Episode Transcript

Stephanie Goss: Hey everybody, I'm Stephanie Goss and this is another episode of the Uncharted Podcast. And this week on the podcast, we are tackling a letter in the mailbag from a veterinarian who has moved into a lead chief of staff role in their practice. And they're really struggling because this practice has some particular quirks that they've inherited, including veterinary assistants who are quite in school being allowed to do homework on the clock.

This vet is struggling with not only wondering if they did the right thing with how they approached it. They're also struggling with the aftermath that seems to be happening within the team. This was a interesting one. We got a little spicy. Let's get into it.

Dr. Andy Roark: And we are back, it's me, Dr. Andy Roark, and the one and only Stephanie, it's the end of the world as we know it, Goss. Oh man, how are you doing, today?

Stephanie Goss: I I thought that would might be what you were going to use, but I was waiting for you to sing it to me. And I was singing  it in my head. 

Dr. Andy Roark: It’s the end of the world. They kind of chant the song, which is good. 

Stephanie Goss: Yep. It's good for, it's good for your singing. 

Dr. Andy Roark: I love that old Tommy boy clip where they're singing it in the car and they get about six lines into it and then it just kind of runs away from them. That's my favorite. One of my favorite little, little, little clips.

Oh, man. 

Stephanie Goss: I am good. How are you? 

Dr. Andy Roark: I'm good. I'm good. Things are, uh, moving fast these days, you know, the fall has really kicked into high gear, 

Stephanie Goss: This year has just like. I feel like that's a sign that you're getting old AF is that every year you say, Oh, this year has just flown by. But I really feel that way about

Dr. Andy Roark: I mean, the fourth quarter of the year is right up on us. And again, now it's like Q4. I remember we were getting started. I was writing resolutions for the year and like doing predictions and, oh my gosh. Yep, another year in the books where I wildly, inaccurately predicted how the year would go.

Stephanie Goss: And all of the things that you didn't have on your bingo card at the start of the year. 

Dr. Andy Roark: Oh my gosh. This year has been completely bonkers in the world in general like in the world in general assassination attempts late candidate swaps for the election just absolute chaos.

Stephanie Goss: I had one, I had one this morning, like, it's so funny because so you and I both have over this last couple of years, but for me really in particular this year, I have really backed off of my consumption of social media and, 

Dr. Andy Roark: Good for you.

Stephanie Goss: and on, on occasion, I'm just like, let me see. And I, it's funny because I am very intentional about my choices and I'm.

And I'm old. So I'm not generally on the TikTok but I watch my things on the Instagram reel, like the boomer that I am. And, uh, I was watching some reels this morning and I could tell you, I did not have it on my bingo card. Just like I did not have that Snoop Dogg would be like the star of the Olympics on my bingo card.

I did not have on my bingo card this year that RuPaul would be teaching the young Gen Z's how to change the attire on their car and be a at home mechanic. I saw that, I swear to God, I saw it on the Instagram Reel today and I was like, I didn't have that on my bingo card, but that's freaking amazing.

Where did you learn how to change attire? Oh, a drag queen taught me. Like I just made me, made my, it was fantastic. If you haven't seen it, you should go and watch it cause it was amazing. 

Dr. Andy Roark: Was it demure? You know? Like, like I didn't That was also Didn't see that coming. There's other things like that that have come up on, online. Do you know who Theo Vaughn is? 

Stephanie Goss: No. 

Dr. Andy Roark: Theo Vaughn is this, Comedian, right? And he's from Louisiana and he rocks like a hardcore mullet.

You know what I mean? Like, 

Stephanie Goss: a mullet? Okay. Yep. This tracks. 

Dr. Andy Roark: Picture, jean shorts and a mullet You know what I mean? And like a little goatee. And, and he leans into that, like that's his shtick, right? And, he's, he's a comedian. I don't know where he falls on the political spectrum, but he's edgy in some ways, but I, I do a lot of comedy and stuff, so, so I, I tend to see a lot of comedians and stuff.

Uh, he's, he's interesting in, in that way. I saw him on the Instagram Reels. He has a podcast, right? So comedian, mullet, jean short podcast. In the last month, he interviewed Bernie Sanders and Donald Trump. He's interviewing Donald. He's got jean shorts a sport coat and a mullet and he's interviewing the Donald presumably like Mar a Lago, and again, I don't want him this to be political or anything 

Stephanie Goss: We're sure. 

Dr. Andy Roark: The idea that this comedian again, no shade against him as a comedian. He's just he's like the um, 

Stephanie Goss: That’s so random. 

Dr. Andy Roark: He's like a modern Jeff Foxworthy like Uh huh. That's uh huh. Yep. Jeff Foxworthy interviewing the Republican presidential nominee, you know, like nominee.

He's not even the primaries and I'm just like And Bernie this and Bernie Sanders on the other side the week earlier He got Bernie and was like the idea that this is 

Stephanie Goss: Not on my bingo card. 

Dr. Andy Roark: .. what media is today. It's just had never would have happened when I was a kid, Bill Clinton was not talking to, you know, there's, there's, I say as podcasters.

Yeah. And it was just, again no, I don't, I don't know what that means and there's no shade or anything. But I, as I watched it, I was just like, 

Stephanie Goss: It means we're old. 

Dr. Andy Roark:  Goodness, gracious, the world is a different place than it was when I was young. 

Stephanie Goss: This whole intro makes us sound like the boomers we are is, 

Dr. Andy Roark: It totally does. I really wrestle with that. It's so funny you say that.

I was like, I feel like I'm becoming the old person who doesn't exactly recognize the world anymore. And like, I'm not that old, but I'm like, but, in my defense, I don't think the world used to move this fast. I think the difference between the world in 1960 to 1990 would be. And the difference between 1995 and 2025, I think those are radically different things.

I mean, that's, the pace has clearly picked up. But, goodness gracious, there's just so much change. But, alright, anyway, I, sorry, 

Stephanie Goss: Yes, yes, so the, take the takeaways, 

Dr. Andy Roark: If you're feeling like the world's changing, you're not alone. You're not alone.

Stephanie Goss: Go watch. Go watch RuPaul. Learn how to change a tire. Tire. Change a tire. Okay, so we have got we've got a great mailbag letter today though that I want us to dive into. 'cause it is a little bit of, is it the end of the world? So we've got a letter from a lead lead. Vet at a practice and, um, 

Dr. Andy Roark: a medical director?

Stephanie Goss: medical director, Chief of staff what have you. But they're, they're a doctor, right? And so they but they're in a corporate group and they have not worked at this practice location, but they have worked at several other local practices. They joined the practice and they learned that the paraprofessional team, in particular, they have some vet assistants that are going to tech school. And at this location, apparently previously the assistants had been allowed to work on schoolwork during their downtime. So they were allowed to the, they were in tech school, the school is being paid for in part or in whole by work as a benefit, which is something that happens sometimes, and they are also getting paid on the clock to work on their schoolwork.

And so, there is in particular, this vet is struggling because they have an assistant who is struggling with their technical skills. And they're getting close to being done with their program, and they still don't have all of the technical skills that this doctor would expect that a soon to be licensed technician would have.

And they're seeming to prioritize doing schoolwork over practicing and working on technical skills. And so, the doctor had a conversation with the hospital manager because they said, look, there's, I've been here now for a while. I've been watching all of the assistance. There are some gaps in their skill set that I would like to rectify so that we can improve our patient care, that we can work more efficiently, more effectively, all of those kinds of things.

So they had a conversation with the assistants and this one in particular had, it sounds like a meltdown and because they said that they felt threatened and singled out and said all kinds of, uh, things in the heat of the moment. And this chief of staff or medical director is like, what do I do with this?

It doesn't seem like, and none of the other hospital locations I've worked at ever allowed their staff to get paid to do school on the clock. These team members need to work on their technical skills. How do I enforce this, get them to work on this, but also how do I get them to look at themselves critically and recognize where they are lacking in skills? How do I get them to reprioritize their time? And most importantly, they asked, how do I earn the trust and respect of these team members who now are, for all intents and purposes, looking at me like I'm the root of all evil because I've told them you can't do schoolwork on the clock anymore.

And I thought this was a great one. I have some thoughts, certainly from the manager perspective, but I thought we could have some fun diving into this one.

Dr. Andy Roark: Yeah. Yeah. I have, I have, I have thoughts on that.

Stephanie Goss: I figured you might have some thoughts. Uh 

Dr. Andy Roark: You know, when you look at something from the outside and you see someone making mistakes that you made yourself like 20 years ago and you're like? and again, you like, you love the person cause you're like, I know exactly what you think. I know exactly why you think that, and I know exactly how this is going to go, because I did exactly what you're doing, and it did not go well, it blew up in my face.

Stephanie Goss: You're like, I I see that. I see that gopher trap because I stepped in it. 

Dr. Andy Roark: yeah, in a way it makes this, makes me really happy, because it validates mistakes that I made early in my career, and I'm like, oh good, here's someone else who had the same thoughts that I had, and the same explosion in the face is happening again.

alright, um, I think we're gonna go ahead and need to, we're gonna need the theme song right up front, because we're going to Camp Tough Love, 

Stephanie Goss: Camp Tough Love

Dr. Andy Roark:   Camp Tough Love. here. Here we go. All aboard. 

Dustin Bays: All  aboard! Get ready for a SAFE talk. You might need a stress walk. That's what we do at Camp Tough Love!

Dr. Andy Roark: All right. So Camp Tough Love. Um, I get yeah, so I get it. I get where we are and I say this to this writer with love and we're gonna fix this.

It's all good. We're gonna fix it. First thing we gotta do here is Flaming Raging Sword of Justice check and I get it. I get it You're there and 

Stephanie Goss: Maybe it's a little late for that.

Dr. Andy Roark: It's, it is late. It is late, but I just want look slowly down and off to your dominant hand and if there's a flaming raging sword in it you have pulled the flaming raging sword of justice and put it to use and I feel like where is a cleanup job from the flaming raging sort of justice is what I feel like this is and so okay not insurmountable all good, but I totally understand.

You're there. You're busting your butt. This person is not where they need to be as far as skills. It's probably frustrating to work with someone who doesn't have the skills they need and then you look around and are they practicing their skills? No, they're working on homework for a class that they're taking while they're on the clock.

I get it. And I think we can all, if you think about that for a moment, we can all imagine snatching the sword of justice and taking some heads, making, making the justice happen. We can all get it. However, the Flaming Raging Sword of Justice cuts both ways, and we've got some self-inflicted wounds now to deal with.

And so that's it. So I just gotta say that up front. Okay, from a headspace standpoint, number one, Flaming Raging Sword of Justice check. Number two, the way that we talk about decisions we make with our staff, it really matters. Okay. 

Stephanie Goss: Mm example I want to put forward is the difference in fees and discounts.

Dr. Andy Roark: If I run my vet clinic and I said to you, Hey, I'm going to charge you a fee to use your credit card. Or I'm going to charge you a fee to come on on the same day of the service. I'd probably make you mad. 

Stephanie Goss: Mm 

Dr. Andy Roark: I instead. said to you, I'm going to give you a discount for paying in cash, or I'm going to give you a discount booking further than one day in advance. You'd probably be okay with it. 

And it's amazing how that matters to people because ultimately charging fees versus giving discounts is often the exact same thing. It's the exact same thing.

Stephanie Goss: Mm hmm. Because how many people are still going to whip out their wallet and pay with credit card? 

Dr. Andy Roark: Plenty of them. Exactly right, but they're going to be really mad about it if they have to pay a fee, if you're upcharging a fee. If you get a discount for paying in cash, you're like, great, well I wish I had cash, I'd get a discount, but I don't have, I don't have, I can't get the cash discount. It's the exact same thing.

And, when we have when we have staff members that are taking advantage of a policy, It's important that we try to not make them feel like we're taking something away from them. Now, our writer says, none of the other hospitals in our group would ever let this happen. This is not supposed to be part of the job.

They're not supposed to be getting this. And I say, I understand, however, the mind of your team, they're not getting. They're not getting a perk. 

Stephanie Goss: Right, 

Dr. Andy Roark: is just what it means to work here. 

Stephanie Goss: right. It is what it is. 

Dr. Andy Roark: Yeah, exactly right. They're not, they have not been enjoying a benefit. They have been just working and now they're taking a penalty.

Stephanie Goss: Mm hmm. 

Dr. Andy Roark: And I think that that's really important to 

Stephanie Goss: Because you joined the team. 

Dr. Andy Roark: You join the team and now their compensation, if you think of it like that, part of their compensation is being able to work on their homework and get paid. That's a nice little perk. If you can get it, you should take it because it's a sweet perk.

You're taking that perk away from them. So you came in and they lost a perk that they were actively using. Just like the fees and the discounts, we can navigate this, but we need to get smart about how we communicate what's going to happen when it's going to happen, how it's going to happen, the iterations to get from where we are to there. But just remember that that's a big part of it 

Stephanie Goss: And I love that you put, I love that you put it in that headspace because the parallel that I'm sure some of my fellow manager colleagues listening immediately made because it's the parallel that my mind jumped to the second that you said it that way. And I hadn't thought about it this way previously.

I immediately jumped to the age old debate in veterinary medicine where the manager or the practice owner is like, Oh, I suddenly became aware that the IRS has rules about what we're allowed to discount and how we're allowed to do it. And so we're going to follow the IRS rules and the team loses their mind because they don't view it as you're trying to follow the rules.

They view it as you're taking away a benefit that they have had. And it's it's that same exact, it's, that same exact scenario. 

Dr. Andy Roark: It's exactly that. So I think that's, that's because that's the first part, right? The fees versus discounts, the way we talk about what we're giving and taking, it, it really matters. The idea about what the job is important. Okay. This is coming from a guy that has all remote employees.

An unlimited vacation in his company. And so you better believe that I have questions sometimes about how people are spending their time. I just do. There's no way you could run my business and not have some questions about what people are doing. And I still choose to do that. We don't have tracking software.

We, I, again, I don't. It's unlimited vacation. I shifted my mindset a long time ago to what are the outcomes that I expect from people. And I think that the mindset of This person is clocked in for this many minutes and they should be doing this and that. I think that's becoming increasingly sort of antiquated in some ways.

I don't want people to lose their mind thinking about that. But I do think it's hard in the modern workplace. And I think fewer and fewer people really look at it as I'm on the clock and this, these minutes are worth this. I think more and more our society is shifting to the idea of what is the work output or outcome that this person is being paid for and it was it was just interesting. 

I really think that when the pandemic hit and a lot of people went to working from home, that became very clear because what people found is that they could get their whole entire job done in less time when they were working at home.

And then the debate became well, I'm paying you for 40 hours. You should be working for 40 hours. And other people said, I'm doing my job. And I'm getting done in 32 hours, that should be fine. And it's really, and there's not right or wrong, it's really what have you agreed to, is the answer. What are the expectations of what have you agreed to?

I can imagine some people's blood boiling right now, but bear with me. There's nothing wrong with saying, this is the work I expect you to get done, and this is what I'm paying you for. Which is how we run Uncharted. Like I, we have work outcomes. That are expected and paid for. I don't I'm not tracking people's hours.

Other side is to say this is exactly how we're doing it. And your hours matter. That's what you're paid for. There's not a right or wrong. It's just everybody needs to be in agreement about what it is. And there should be clear expectations about this is how it looks when I was. When I was an associate vet, I was not a brand new baby associate vet, I had been a vet for a long time.

And I worked, I was working this practice years back, it's not the practice I'm currently at. But in this practice there were a couple of kennel kids, and I call them kennel kids because they were kennel kids. They were 16 to 18 years old, like they were high school kids, coming in and working. And they would come in and they would work, and they would wear their headphones and listen to music, and they would practice dance routines. I'm not kidding. They would practice dance routines together, and they would film them for social media. 

And they did it on the clock. That was just, you would go back in the back, and they would be hanging out filming each other, doing dances.

And it happened a lot. It came to a point where, it kind of bugged me, not really, I didn't, I was not relying on them to get my job or my work done, they were not really involved in patient care, but it does it catches your eye when you're busting your butt and you go into the break room, and they're there, cooking a meal in the toaster oven, and What are you guys, what are we doing here?

And so I, I actually said something to one of the owners. I was like, hey, you're being too soft on the kennel kids. You're being, I mean, you're being too soft on them, man. They're, they're hiding in the back. They're, they're goofing off on social media and stuff like that.

And he really blew me off. And he said he said, they're, he said, don't worry about them, Andy. They're fine. They work hard. And I, so I let it go. I said my piece. I said it to him. If it was my business, I'd appreciate if somebody said something to me of man, might want to look at this.

But not my business, not my circus, not my monkeys. And so he said that and, and, and I said, okay, fine. And I, I let it go, but I've thought back to it a number of times. And of course, it makes me go, am I the bad guy? In the 1980s comedy movie, he's like, oh, those kids should be working harder.

I don't know that I was, but I think, and I've sort of had some inferences here. I think that what he was saying was, we probably, he probably paid those people minimum wage. And I think that he saw that flexibility and that time with their friends as part of their compensation. For more information, visit www.

FEMA. gov And so I think he was probably fine for them to film videos and bounce around and then when the staff called for them on the overhead, they showed up and they did it and that was how it worked and I sat with that for a while and I think what I saw was I think the conflict in this letter, which is this idea of it.

These people are clocked in and they're getting paid. They should be working. Versus we know what the expectations are and they know what the expectations are and they're going to hang out on the clock and wait to be called and that's fine. And I know that as the employer and I'm writing their paychecks and I'm fine with that arrangement.

Stephanie Goss: Yes. 

Dr. Andy Roark: Then I think that that's got to be okay. You know what I mean? Then that's fine. It really comes down to what's the expectation. But that's when I was like, Oh, that's an entirely different way of looking at employees than how I have. And I think it's also fine to say, that's not how our vet assistants were treated.

And that's not how the front desk was treated. And that's not how anybody else was treated. But also, I suspect all those people were getting paid a different level than the young kennel attendants. 

Stephanie Goss: And I think, so I think there's a couple of things in what you said to, to unpack. One is, I think the key point there is that understanding on all sides what the expectation is, right? So, you as an associate in the practice, you're working hard, you're busting your butt. It's not your business.

So you don't know what he has worked out with them. And so you say something, but he could have clearly worked out with them. Look, I don't, as long as the pets all have water, they're walked regularly, they're cleaned regularly, they, like whatever those things are, and we, you know?

we call on the overhead and you, and you're paged and you come.

Then the rest of your time is yours to do with it what you want, right? Like, that could have been a conversation that happened with them. If he has that clarity and they have that clarity, that's great. Where it becomes a problem is when there isn't the transparency across the board. And I think that happens in practices more often than not, right?

Where, to your point, it's kind of like the pay piece. There may be some benefits that one group gets, but if there's not transparency across the board, of course it's going to create drama when another group finds out what they're getting if they don't understand the why, right? And so I think that's, I think that's part of the solution and the process here is to figure out how do you actually communicate the expectations. Both, to both sides, immediately involved, but to the rest of the team as a whole. 

Dr. Andy Roark: Totally. Yep. I agree with that. So it's, it is a part of it about, is about expectations. The other part here for me in Headspace is Phil Richmond, Dr. Phil Richmond says this really well. When he says when he has an emotional reaction when something makes him mad, the healthiest thing he can do is stop and say to himself, why am I reacting this way? I think that's a question I would put to our readers to say, I get it. I think I understand why, but why are we reacting this way? Is it about the lack of skills? Is it about this, the sort of a justice mindset of, if you're on the clock, you should be working for the company? Is it the fact that people at other clinics don't have this perk, and these people do have this perk, and there's an unfairness thing?

Dr. Andy Roark: Again, I 

Stephanie Goss: Do you feel taken advantage of? Like, what is the underlying emotion? 

Dr. Andy Roark: Exactly, but I think that that's really important from a Headspace standpoint to figure out what do you really need here and what's, what's driving this on your side. Because ultimately we need to put that flaming raging sword of justice down and it's hard to do that if we don't understand why we feel the need to pull it in the first place.

And so there's, there's that. I, so that's kind of that. I, I, those are, so those are sort of my, my, my big, Headspace here is bleeding into the action steps. But I think that's good for me, for Headspace.

Stephanie Goss: I agree with that. I think the bus trip to Camp Tough Love is definitely warranted. Like we've got to look at where you're at. And I love how you how you pointed out how Phil approaches that. Cause I think it's really healthy, right? Like asking ourselves the question, why do I feel like this?

And that's a question that only the writer can answer, but I think it's really important to sit with that because I think that's going to help. you figure out where you go from here and whether it's a productive path to walk down or not. 

Dr. Andy Roark: Yeah. And let me wrap up Headspace here by restating what I said, hopefully at the very beginning. I'm not saying that our medical director is wrong. I'm not saying like this could, is this totally valid? I mean, I think it's a totally valid thing to say is, no one else in the organization is getting paid to study on the clock.

And this person who's studying has got real holes in his or her clinical skills that are hurting our team. That's not a bad thought to have. That's not wrong. I think it's, I think most of it goes, yeah, it's totally, it's totally legit. Everything that we have laid out has been Trying to get the perspective of the other side in view and to start to get real strategic about what we're going to accomplish so I'm good with that for headspace.

Let's take a break and we'll come back and we'll get into action steps 

Stephanie Goss: Sounds great. 

Dr. Andy Roark: All right, so action steps here. It's easy–what are the sayings I've come back to recently a lot is the old environmentalist saying of think globally act locally right?

Stephanie Goss: Okay. 

Dr. Andy Roark: So I think that it's okay to think in a global sense about what is fair and what does it mean to be on the clock and have those thoughts but ultimately the action that we take is not at a global level like I'm not making employees across the country change I am working with Sarah who is trying to pass her courses, her high school courses, college courses, that I am working with Sarah who is trying to study for her exams, and I need to see her as a person, understand what is important to me, understand what's important to the clinic, and then go and engage with her in a way that does not involve the flaming raging sort of justice.

Okay? And so the first thing that I want to do here Is relax the tensions. I'm going to do that in two ways. Number one, I'm going to take the time component off of this. Listen, this kennel assistant VA, whatever, they have been doing this for some time now. The building is not going to fall down. If it goes on for another six, eight, 12 weeks, 

Stephanie Goss: Mm hmm. 

Dr. Andy Roark: This is how it's been.

Stephanie Goss: Right. How is it going to make a difference if you change this today versus changing it two weeks from now, two months from now, end of the year? 

Dr. Andy Roark: I mean, that's it. Yeah. End of the year. When, when the semester is over. It's not. There are some things. One of the things I've learned as a leader, I think I'm good at this. You always question if you're doing it right, but I think I'm good at this is, I have gotten to the place where I recognize mistakes I have made in my judgment.

And I have not grabbed the steering wheel and spun it to try to correct. I have taken the steering wheel, gently turned it, and rectified the mistake that I made over the next three months. You know? And that has gotten so much better. And been so much easier, and it has been so much better for people's trust in me, because my team does not feel like things are being snatched away from them.

They are being told that next year, we're not going to be able to do this anymore. So everybody just know that. And then we roll right on up, and I give them a reminder at the beginning of December. And then we change and everybody's okay. And there's maybe some grumbling, but it's not if I weighed in on the Wednesday and say, starting Thursday, there will be an organizational change that will affect all of you.

Stephanie Goss: It feels very, it does feel very reactive. And it also, when it's time bound like that, and it's urgent, it also is very easy, from a headspace perspective, assuming good intent on all sides, it's very easy for that to feel punitive, even if it's not, because it feels so abrupt.

Especially when something has been going on for a long time and that's the conversation, going back to what I said about the IRS, like that's the conversation that I have with manager peers all the time is well, how long have they been getting vet services for free at this clinic? And if they say, well, the owner has been doing it for the 20 years that I've been here, but I've, I know that we need to do this to be in compliance with the IRS.

Okay. That's not the best choice. If they've been doing something for 20 years and you want to roll up in and be like, sorry guys, we're going to change this tomorrow. There is no world where that doesn't feel punitive to somebody. 

Dr. Andy Roark: Oh, yeah, that's 

Stephanie Goss: And it, it's not that that's the way you intend it, but that's still the way they're going to feel.

Dr. Andy Roark: Of course they are. Imagine that you're the only person who smokes cigarettes in your practice. And then suddenly there's a policy about what is required for every person who smokes cigarettes in the practice. There's no world where you don't say, Hey! This is a hundred percent aimed at me because then you're the only one smoking cigarettes. Of course the smoking policy is aimed at you like it is and like you're going to take it personally.

It's the same thing. It's the same thing here. There's only one person studying for tests on the clock She's gonna catch on when the test plus studying policy has changed 

Stephanie Goss: Well, and even if there's multiple, it still is going to feel punitive. You know, like that's just the way the human mind works, 

Dr. Andy Roark: Well, I mean, especially if you talk to the person. This is the thing, is if you go and you say, Hey, I've noticed this, I'd like to make some changes, and da da da da da, and you talk to them, and then you change the policy they really feel like they're singled out.

And again, I get it, I'm not saying that changing the policy is wrong. This is 100 percent about how it's being perceived by the team. Yeah, I have no doubt they feel singled out. I totally get it. And the truth is we are making this policy adjustment because of this person. And so they're not wrong.

Anyway, it's, it's part of it's that. My, my big thing here as far as removing stress is one, to try to lengthen the timeline on this and say, this does not have to get fixed today. I agree that it needs to be corrected, but as soon as we lean back a little bit, we can make this happen much more smoothly.

And so that's sort of the big thing for me is, that's sort of my, my first action step is to take that constraint off of yourself.

Stephanie Goss: I think that's really smart and I think you also can add to that because you can, there can be things that are time bound, right? So like you, as you said, okay, is it, what is it going to hurt if we go another, you know, three weeks, eight weeks, 12 weeks, whatever. If there are things that are life threatening level urgent, right?

Like we cannot have a patient on IV fluids where the pump is alarming and they're being ignored so that anyone can work on their school work. I don't think that there's any member of a team who cares about patients who wouldn't understand that rationalization and not, and be able to separate the personal feelings and the emotions from that.

So I do think that it is totally okay to, if you can, as, and it's hard I want to empathize with our writer because I feel like we've done a lot of pointing out, pointing the mirror in their direction and saying, maybe we pulled the flaming raging sword of justice a little fast, right? And that hurts.

Dr. Andy Roark: It's okay. 

Stephanie Goss: And in order to fix it, if you can get to the space where you can recognize, okay, there are things I can do to fix this. If you can let yourself get even okay, you may not love the idea of continuing to let them do it, but if you can get okay with it and try and find the middle ground, it is also okay to put some parameters in place to say, okay, Mike, you're in the middle of your program.

To be honest, if I was in this person's shoes, I could even be talked into a year long or even a two long, two year long period if there were some other parameters put in place, right? If the thing that was really bothering me was the fact that pets were sitting in soiled kennels or they were, you know, the alarm was going off and they were being ignored or if there were things that for a patient care reason felt urgent, if you came to me and said, okay.

“Hey, look. I feel like maybe I went a little too fast and I want to apologize for that. I really, you know, I really want to try and come to a middle ground. Here's what I would like to do, right?” And then you told me, Hey, I would, I would like to, eventually we're going to have to get to a place where this is not a perk anymore.

That's, if that's the decision you make, fine. If you tell me what the timeline is, and you give me a little bit of, you throw me a bone, and I give a little that's what compromise is about, right? It's about the give and take, and can we come to this from that place, if you can get to that headspace, it's, you're going to have a much better outcome as a leader, and it's going to be much more palatable to, the team as well, if it feels like there is give and take, because although no one wants to be called a dictator, no one wants to be told, you know, you're I think you're the root of all evil.

If you come down on them and you say, it's, this is the way it's going to be. I understand where they're coming from. You know? 

Dr. Andy Roark: Yep. I agree with that and that was on my on my list as well Is does this have to be all or none? Meaning are your two choices: this person studies and doesn't do their job or Studying is now banned fully and again, I don't think I don't think something being banned fully is a bad idea But does it have to be fully banned today?

And also I'm not convinced that you can't do anything today. I think the other part for me and again, this is sort of an action step headspace. But I think for the action step here as far as lowering the stakes to is I need to get curious and go Talk to me about what's going on with your classes. How much do you have left?

“What are you trying to do? What is your study schedule? What are you trying to accomplish? Because I want to I want to support you And I have some needs of things that need to get done in the practice and then maybe, maybe the arrangement can become, you can study, but only after these things are done Or, yeah, that, you can study after these requirements are met something like that.”

And that's fine. I would personally, I would take a position like that where I would say this is my immediate needs and then you can study around this and then know that you're not going to be able to study next semester. So we're going to let this ride till the end of the year. We'll get you through your fall exams,

Stephanie Goss: Current load. 

Dr. Andy Roark: and your current load because again, it's quite possible this person committed to their case or their 

Stephanie Goss: It's a class load. 

Dr. Andy Roark: Yeah, their case load, or their, what, class load, yeah their class load, based on the understanding that they would have time to work on it. And if you take that away from them, now they're hopelessly overloaded with classes. And again, they be paid to study? I don't, again, I don't know, but they made choices with the belief that they would be, and that belief was based on the fact that they were allowed to in the past.

And so I get it. Let's see if we can support them through the short term. And then this is one of the things we're going to correct over the long term. And so anyway get curious. Figure out if this can be somewhere between all and none. Think about an incremental phase out over time, let people know it's coming and then go from there. 

Stephanie Goss: Mm 

Dr. Andy Roark: The other alternative you have, and this might fit in with the conversation we said before, you can go forward and not really address the studying thing. If, and this goes back to, what are we really upset about? If it is, this person does not have the skills they're supposed to have. 

You don't have to tell them Take the studying away from them to just say to them, your clinical skills are not where they need to be.

And this is the, we need to figure out a program that's going to get your clinical skills where they need to be in the next 12 weeks. Let's figure out what that looks like. And you don't have to take away the ability for her to study. You just give her the requirements of what it's going to take to continue to be there and to, and to meet the requirements for a job.

And maybe she can continue to study that. Maybe she can just get significantly more efficient in other areas. And now she's doing everything she was doing before. Plus she's meeting your standards. Plus she's still finding time to study. What do you care? You're paying her the same amount. She's doing the thing that she, that she wanted.

Now we all know that's probably not going to happen. There's probably going to be some sacrificing of study time to get these things done. 

Stephanie Goss: I think it's that knowledge that it, that it is. Likely not to work out that way that makes people, that makes leaders tie those two things together. And this is where I want to say to our writer, like, you're not alone. Like Andy said, in the very beginning, this is a gopher trap we see coming because we've stepped in it.

And so, you're not alone in making that, that gut response to tie two and, two and two is equaling four in your brain. And in this scenario, and I think you're spot on, Andy, and if you approach it from a different perspective, and you let one thing set to the side, and you actually focus on what is the problem here. Is the problem that they're doing schoolwork, the root, like reading this, and again, we only hear one, see one side of the story, but reading this email, my thought was the problem is not the fact that they're doing schoolwork on the clock. The problem is that they don't have the skills that they need.

Those are two different problems, but it's the tying them together that as the team member who is involved immediately feels punitive. 

Dr. Andy Roark: Yeah it's if I want my kids to spend less time on their cell phones, I have found it's much easier for me to sign them up for extracurriculars, take them to the swimming pool, yeah and, and have family movie night than it is to take their phone away. And like, They spend less time on their phone when we're on a hiking trip together.

And it's sort of like, I didn't take their phone away. I just gave them something else that we were doing that needed to get done. That doesn't lend itself to a phone. It's kind of the same thing for that. So anyway, I don't mean that to be manipulative. And I would go back to the whole thing of, maybe this person is really relying on this time because they thought they would have it from past precedent and I really don't want to screw them over. And at the same time, this is not a sustainable long term. 

So anyway, I think hopefully that comes across as a little trip to Camp Tough Love. As far as the way that we sort of approach it and the decisions that we make about shutting down this thing that they perceive as a perk.

And then a shift in mindset over to what do I really feel this way? What do we really need to accomplish? Can we meet them in the middle? Can we phase this behavior out over time so that they know going into next semester They're not going to have study time and that's fine? They knew it going into the semester like can we do some things that are not going to cause them to panic?

But are going to take a little bit of time and make this problem just go away And I really do think if we can take those if we can take that mindset and we can take those softer steps We can gently take this little perk away from the employees in a way that, that is not going to be a big deal because the vast majority of your employees, they're not doing this.

They don't care. We're just going to, we can support this person out, close the door behind them and lock that door. And honestly, guys, that's the way a lot of business gets done and it will make you happier and it'll make your team happier. There have been a lot of things in my career that have not worked the way I wanted.

And instead of just shutting them down. I let them ride out until some created deadline. Whether it was the, the first of the summer, the end of the year, the Thanksgiving holiday, the next conference that we were putting on, and then we're not going to be doing this anymore after that. And a lot of times it's just better to let this annoyance go on.

Until a natural conclusion point and then end it in a way that everybody's cool with than it is to try to squash this annoyance and then deal with the collateral damage that comes from that.

Stephanie Goss: I love that and I agree with that and I want to offer, like, where I want to end is, I want to offer some food for thought on the opposite. On the opposite side of that argument because I think what you, you know, you talked in the beginning about the world has changed and employees showing up and doing 40 hours of work versus doing the job that needs to get done in 32 hours and being okay with that.

I think that's really important and really relevant. And I also think it's applicable here. When I think about our industry and I think about the changes. We need credentialed technicians, we need qualified, rounded credentialed technicians. 

And so food for thought, just on the other side of the argument that I would offer is I know what it's like to be the manager who's trying to find a technician for years on end.

It's a really hard place to be in. And so most of us turn inwardly, right? Which is exactly what this practice is doing. They're like, Hey, we're going to grow it from within. So we're going to take our assistance and we're going to encourage those who want to go to school. And we're going to support them in ways that can look like them, paying for school or offering them the opportunity to do cases on the clock, whatever it is.

And I don't think that's inherently a bad thing. And I think as an industry, when I have talked to my peers as, and colleagues as a manager, there is this headspace as an industry that we look at it like. So negatively, like why would we allow them to do schoolwork on the clock?

Why would we create that environment? And I would actually argue that it is a way for us to help. It is a solution, not a what's the word I'm trying to say? Not a, not a negative, right? In the, in this, And if I, if I think about it and I think about my own practice, because that's how I used to feel like I, you know, I used to be that manager who, if my, myself included, went to tech school, if I left the practice, you know, within two years of working finishing my degree, then I would have had to pay my practice back.

And for a long time I did that and now my beliefs have radically shifted and I feel the way about this as well if we want to grow and develop. We know that our paraprofessional staff, most of, a lot of them are living, I won't say most, a lot of them are living paycheck to paycheck. A lot of them are vastly underpaid for the work that they do.

If we want to change that, we have to think about ways that we can impact that and make a big difference. And this is one of those ways that I have seen firsthand can make a big difference for team members if we can support them. Now, that's not to say. And please hear me when I say this, that's not to say that I don't still expect them to do their job.

Dr. Andy Roark: I heard Stephanie say that they get to sit at a desk and just do their school work and you’re going to pay them.

Stephanie Goss: No, no, that's not what I'm saying. And I do think that it's important to look at really being clear about those communications. And I think that's a step that we often miss. And thinking about what you said about the practice owner that you worked for. I love that.

the idea of a world, and I love it because this is a world in my own practice that I helped create, where I can have the conversation with the team members and the expectations are very clear. Here's the job I need you to perform. This is your first priority. And if we can accomplish this job, if you can have the skills that you need to be qualified for it, I have no problem with you spending, The extra time working on schoolwork within these parameters, right?

And it's such a, most of us think about it in an automatically just by default in a black and white thinking like, well, if I give them an inch, they're going to take a mile. And I think we have, I think that kind of mindset is very self damaging. I think we have to change that as an industry. And so on, I just want to put it out there because we talked a lot about, well, we can take this benefit away and that is one choice.

And it may be the applicable and the right choice to make in this practice. Again, we only see one side of the story that we get in the mailbag letter. And so I don't think there's anything wrong with doing what you said, Andy, and I agree with it. Like we can take it away. And if we do it, let's do it in a, in the way that we described.

And I just want to put it out there that there is another potential, which is maybe we create a world where we help provide more texts to an industry that desperately needs it by shifting our mindset as leaders about how we could approach a situation.

Dr. Andy Roark: I just, I think one of my, one of my fundamental beliefs, and I'll, I'll shut up after this, but one of my fundamental beliefs is there is no should in in, in any of this, in this life, there is no should

Stephanie Goss: Four letter 

Dr. Andy Roark: It's “what do the two affected parties agree on?” Eyes wide open, clear expectations.

And so, that's what we do in our company. As I say, you know, you're remote, you work at home, I don't track your hours, and you have unlimited vacation. I'm going to be clear with you about what your salary is, I'm going to be clear with you about what the deadlines are that we have coming up, and we're going to talk about the workload that you have, and if I don't feel like you're producing enough work, I'm going to tell you that gently, not in a mean way, and if you feel like you're being overwhelmed with work and your salary is not supportive of the level of work that you have, that you're doing, I expect you to say that to me and let's keep working on it.

And as long as we can come to an agreement, we both feel good about, then this just works out. And it's the same thing. Am I opposed to having, I don't know, let's say a kennel technician that makes Let's, I'm just pulling numbers out of the air. That makes 12 an hour and gets to study on the clock instead of a kennel technician that makes 15 an hour and does not study on the clock at all.

No, I'm not because the 15 an hour person is generating more work at the end of the day than the person who is spending part of their day studying. Basically it's, it comes down to, if I believe that this person, you know, that I'm getting one extra hour of work from the kennel person who's not studying, then I'm going to try to compensate that person for that hour.

And the other person that may be clocked in the same amount of time, but they're not doing the same work as the person who's not studying. And there's that. And again, now we're getting pay scales and stuff. There's a million ways to look at this, and it doesn't, again, It doesn't matter about what should be, but it really comes down to what do both parties agree to that it's fair and it needs to be in balance for the rest of the team, there's. 

It's not fair for one vet and the company to agree that Dr.Goss is going to make five times more money than all the other vets and they both agree to that. So that's it. It's there's some other parts of this, but anyway, it's a long way to go. There's a lot of gray here, but I hope we didn't come down too hard on the writer. I, again, I, I meant what I said at the beginning of, I laugh and I chuckle because I a hundred percent have been here.

I have lived this. I have had these thoughts. I have had sweaty palms about what people are doing with their times. And I, I get it. I totally get it. You gotta be careful and don't blow your face off here. By rushing in and ripping the wires out of the bomb that you see. It's nah sometimes we're gonna let this clock tick down for a while before we deal with it. And that's, that's okay. 

Stephanie Goss: Yep, I love it. 

Dr. Andy Roark: Alright, that's all I got!

Stephanie Goss: Have a great week everybody, take care! Dr. Andy Roark: See ya, everybody!

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: behavior, communication, culture, management, Technician, Training, Vet Tech

Jun 12 2024

Speak The Team Language

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…

Uncharted Veterinary Podcast · 291 – Speak The Team Language

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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. 

Yeti Nano: Hey, everybody. I want to talk for a quick second about something brand new. That is a member benefit of being an uncharted member. One of the things that has brought our uncharted members together since the beginning has been the love of getting together and feeling that connection, that cup filling experience that you get when you're with your peers. 

And so we have our brand new uncharted anchor Fest. We've pulled together a bunch of our favorite community events. We get together one time a month, we spend three or four hours together. It's broken up into different chunks, so you can attend to some of it. You can attend all of it, but it's there for you. 

It's a flexible and customized structure that features workshops. We've got case study activities where we dive into specifics about things that could actually be happening in your practice. We have hallway conversations to dive into the topics that our community is asking about the most. And all of these things are tied together to help you excel in your practice. 

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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.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: behavior, communication, culture, management

May 22 2024

Does Anyone Care About The Details?

A frustrated veterinary practice leader wonders why it seems like the details no longer matter to their team. This week on the Uncharted Veterinary Podcast, Practice Management expert Stephanie Goss and Dr. Andy Roark tackle their shortest mailbag question ever: does anyone care about the details? Together, they work through the headspace behind this question, discussing the complexities of veterinary medicine and how to foster honest conversations that lead to accountability. From fecal loops to technician tasks to tardiness, Dr. Andy Roark and Stephanie Goss walk through real-life examples, offering valuable action steps to help the team understand why the details matter. Let's get into this episode…

Uncharted Veterinary Podcast · UVP – 288 – Does Anyone Care About The Details

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

Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

🌟 Join us for the Uncharted Medical Director Summit!

This immersive one-day virtual event is tailored for medical directors seeking balance in their roles while positively impacting their teams and patients. Led by experienced speakers, our interactive workshops provide actionable insights on team management, clinical practice, and leadership. Connect with peers, gain valuable knowledge, and get re-energized to lead your team effectively. Visit https://unchartedvet.com/uvc-membership/ to learn more and sign up today.

🌟 Join Us for Conflict Training at HiVE in Minneapolis!

On June 15 and 16, 2024, Uncharted is bringing immersive conflict management training to HiVE Minneapolis. This one-day event will equip veterinary leaders and team members with essential tools to handle conflict, navigate difficult conversations, and improve team collaboration. Spend a day developing real conflict management skills and connect with fellow practice managers or vet nurses and techs. Empower your veterinary career with the skills to confidently manage workplace conflicts and create a positive work environment. Visit https://unchartedvet.com/uvc-membership/ to learn more and sign up today.

Upcoming events: unchartedvet.com/upcoming-events/


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 taking what might be the shortest mailbag question that we have ever gotten. And that doesn't mean that there isn't plenty for us to get into. We had a great time answering this question of how do we get the team to care about their whole job, even the pieces that are not so much fun?

We'll tell you more about it when we get into it. Let's get into this, shall we?

Dr. Andy Roark: And we are back, it's me, Dr. Andy Roark! And the one and only Stephanie, all the small things, Goss!

Stephanie Goss: I can't, I can’t with you.

Dr. Andy Roark: I totally did this introduction without a microphone, and then I just pulled the microphone up and just immediately did it again and Stephanie just..

Stephanie Goss: That’s fine. We're off the rails already.

Dr. Andy Roark: Yeah, it was not the most graceful launch. Have you ever seen a pelican? Have you ever seen a pelican take flight? That's kind of what it looked like. It was not graceful. Got like a fish flopping around in his mouth. Like that's that's what this launch session is looking

Stephanie Goss: Andy, the Pelican Roark.

Dr. Andy Roark: That’s right.

Stephanie Goss: How's it going, Andy Roark?

Dr. Andy Roark: It's good. It's really good. Oh yeah. Heck yeah. Stayin busy havin a good time. yeah, it's funny, I, I'm feeling real validated right now. I'm feeling really validated. There's a, there's a book, there's a book that came out recently called Bad Therapy.

And it's about kids in therapy. And, it's not anti therapy at all. But it's about you know, maybe not all therapy is good. And maybe some people who call themselves therapists, just like people who call themselves mechanics or veterinarians, are not the best. Yeah, exactly right. And, one of the big things that it hammers on, which I have felt for a long time, is the idea that maybe rumination over hard things, or bad things, without a plan, is a bad idea.

Like, maybe, just bringing up painful memories and sitting with them, if you don't have a plan to do something with them it might be a bad idea. And, it's super validating, because I figured that out a year or two ago, and was just like, this is, I'm not doing this anymore. And, at that time, I stopped reading the news.

And Allison was like, you're not gonna stop reading. And I was like, I am, and I did. Like, last September, I stopped reading the news because I'm like, this is not actionable. Like, I will read news on things that I actually have a voice in, or that I can intervene in, but I'm not reading it other than that.

And my life has been so much better. And ask me how many major news stories I have been unaware of. Zero. I don't live in a bubble. I just don't have to go and wait around in a lot of the awfulness, so. Anyway, that's– I just feeling real validated today when I was like, yeah. I figured that out. I don't need to sit in angry hurtful emotions or stuff like that.

If, if I don't have a reason to do that and it's not actionable. And so anyway, feeling, feeling just validated. How about you? How are you, how are you doing? Good.

Stephanie Goss: You know, you know, I am great. The sun is out in Washington again, and..

Dr. Andy Roark: You're in your, you're back in your closet, brought, where you record?

Stephanie Goss: I am back in the cloffice and I am, I am back in the cloffice and I am actually contemplating ripping out a wall and putting in a window this weekend. So, you know, we'll see where that goes.

Dr. Andy Roark: In the closet? You're gonna put a window in the closet? 

Stephanie Goss: in the, in the cloffice.

I need, I need a window. I need some light. I need some sunshine. So I'm, I'm contemplating, I'm contemplating tackling putting in a window myself this weekend. So we'll see how that goes.

Dr. Andy Roark: I like the cloffice. It just, when you first said it, it made me think of where vampires work, like the coffice. But it's nice, the cloffice.  

Stephanie Goss: I have it's interesting. So we have this, this is kind of, kind of a mailbag. We, we got a mailbag question that was maybe the shortest question we've ever gotten.

Dr. Andy Roark: We got a one sentence mailbag question. I was like, bam, deal with this.

Stephanie Goss: And it's..

Dr. Andy Roark: It was like a mic, it was like a mic drop mailbag question. Boom.

Stephanie Goss: It was interesting because I'd been reading some posts in some of the groups that I'm in around the same time that I had read this mailbag and I saw some conversation that linked to it. So even though this was. The shortest mailbag we've ever gotten.

I think there's some serious legitimacy here. And I know that as a manager and a practice leader, like I have felt this, but basically, if someone was like, how do I have the team know that the little things matter, like the little pieces of their job that are their job. It might not be fun, but it's still really important and it matters.

And so how do I get them to care about the little things? And it's so, I thought it was so funny because we generally have this conversation a lot with practice, I mean, I think anybody who's in charge of managing people feels it because of the difference between what you expect and what you get.

And so I was like, Oh, there's a lot of, even though this is the shortest email we've ever gotten. I think there's a lot of meat on this bone for you and I to go after.

Dr. Andy Roark: Yeah. I am, I'm super fired up about this. So, yeah, this is, this is a good one. How do you have the team know that the little things matter? headspace, we start with headspace just, and again, I don't know exactly what this refers to.

First of all, let me just say, I love when there is like a, a battle on the internet, just the whole vet internet gets into a fight and then we, and then we get a mailbag question that's just like kind of, kind of vague, but if you're looking at the internet, you're like, I know exactly what this is about.

And so I, I always love that. And so it just,

Stephanie Goss: Oh, I, I, well, I'll give us a great example right off the bat. The first thing that came to my mind when I read this was my own experience over the years when you have someone who is VA, who's training to be a licensed technician, or you have someone who has gone from being unlicensed to licensed and so now they can all of a sudden help in surgery and they can you know, do all the blood draws and place catheters and do all of those things. And it is, I have had to wage, battle here when it comes to, I hear you and I know that surgery is fun for you and I know that you want to place all the catheters and do all the things and you still have to clean up after yourself because that's part of your job.

And so I think that's the first example that came to my mind is like shining of this is the fun shiny thing. And so of course you want to do that piece of your job and this is the other side of that piece of your job. And just because it's not fun and shiny doesn't mean that you don't have to do it.

Dr. Andy Roark: Yeah. Okay, cool. Alright, so let's start with headspace here. Now, I, because this is the headspace section of the podcast, I am going to say some things. It's just kind of what I would say to the person who's writing to roll around in their mind. The first thing that I always want to put forward here is just a little bit, this is a case of possibly making sure I don't need to check myself before I wreck myself. Meaning this is one of those angry manager thoughts, right? It's not the flaming raging sword of justice necessarily, but there's something there when you're like, “Why aren't these people following the rules? Details matter, people! Details matter”  And like, you can hear this, and maybe they're right, but also there's a reason that you can, like, totally hear this in manager voice details matt. Am I the only one who pays attention to standards and…?

Stephanie Goss: Can you please rephrase that and say that that's like the nitpicky, irritated manager voice? Cause I don't think I sound like that all the time.

Dr. Andy Roark: No, not all the time. Not all the time, but just when you’re having a bad day.

Stephanie Goss: Or just, just a lot of the time.

Dr. Andy Roark: Just most of the time. No, just when you're having a bad– It usually comes, it usually comes when things are hard. Again, this is like

Stephanie Goss: Sure.

Dr. Andy Roark: We're just goofing off here. But this is often what I hear when the straw breaks the camel's back. You know what I mean? There's like 

Stephanie Goss: Yeah, you're at the end of your rope. 

Dr. Andy Roark: There's seven real problems and someone left a fecal loop in the sink and don't standards matter anymore? And that's, that's where this disco says. So anyway, I just want to put that for us first. Put that up front and say let's make sure let's just take some deep breaths. Is this really about standards or is there other stuff going on?

Okay, so let's just say that there's stuff there really is stuff going on and people are you know, not doing the basic stuff. Okay, Flaming raging sword of justice check. We always talk about that. We talk about pulling the flaming raging sword of justice and taking heads. Do not allow yourself to get into a mindset.

The person asking this question has already kind of probably taken a bunch of little things and then rolled them together into a big thing. And now we're reacting to a big thing. And so you always got to be careful with that. And again, I'm so guilty of this too. And so, you know, let's just say that we, you know, we wake up in the morning and we get to the clinic and there's trash in the parking lot.

And then we go inside and I hear somebody telling like an inappropriate joke and there's no pet owners around or anything but they I catch the end of an inappropriate joke and laughs in the treatment room and then I go and sit down and there's a note to call somebody back because a client yesterday didn't feel like the invoice was explained clearly and those are those are three annoying little things And I can say, like, okay, these are the three things I have to work through.

Or I can roll them together and say, our practice doesn't care about quality. These people are not doing their jobs. And it's catastrophizing. But you just have to be careful about rolling those things together. When, like, I always say, you know, the difference between a struggling business and a thriving business, the struggling business has the same damn problem every day, and the thriving business has a different damn problem every day, and that's the only difference.

And so, we're always going to have these headaches. Just be careful about rolling them together into something bigger than they are, and, and, and like ascribing this, the team doesn't uphold standards idea to it. And I'm not saying that's what this person is doing, but, but I, I want to be wary of that and so that's just my first opening sort of cautionary position is let's just look at this and maybe have a snack let's maybe have a snack first and then let’s make sure..

Stephanie Goss: Make sure we're not Snickers 

Andy Roark: yeah exactly right just make sure that we're not we're not just just hangry 

uh if if we also feel like everyone is mad at us then that like I don't know maybe there's something going on here we should just put a pin in this for a couple of days see how we feel so let's start with that. 

Stephanie Goss: Yeah. And I think the other piece of that, that I try and ask myself is, am I rolling these things together? And the other, the other piece of it for me is, am I mad because this is a repeat thing or am I mad because. I'm hangry, or today just sucks, or whatever. Because if I'm not, if I'm not mad because it's a repeat thing then I can, it's much easier to set that aside.

And like you said, go, okay, maybe I'm hangry, maybe I'm rolling these things together, whatever. If it is a repeat thing, that helps me get into a much healthier headspace of, Okay, if this is a repeat thing, how have I handled it to this point? And start asking my questions about the rest of the headspace, like, am I assuming good intent?

Have I talked to them? Have I, you know, made myself clear? All of those things that we normally get into when it comes to headspace. And, and so I think that that for me asking myself, is this, is this a repeat? Really helps me know which direction to go in.

Dr. Andy Roark: This is fertile ground for telling ourselves stories

Stephanie Goss: Mm-hmm.

Dr. Andy Roark: You know what I mean? It's like, and so, so the question I would ask myself is, what story am I telling? And it's like, well, this happened, and this happened, and this happened, and

Stephanie Goss: So she doesn't care about her job.

Dr. Andy Roark: That means that. And again, I don't know that's what this person is writing about, but that's what I have seen, and I've done that. I mean, we've all done that. Just check, check yourself real quick. Are we, are we telling ourselves stories? Okay, cool. Now, let's wade into this. So let's say that this is going on, and we sort of checked ourself. We say, nah, it was just, you know, Standards aren't aren't getting upheld the way they should okay cool the first thing for me, and this is cliche But it's a cliche for a reason, Seek first to understand um like hey guys umm What's, what's going on?

Like, why is this not getting done? Like, it's like, I'm making the assumption they don't care. They don't, their, their standards, their quality standards aren't as high as mine. Those are all assumptions. Like, what's, go, go with curiosity and compassion in your heart. And patience. And again, snack. If you haven't had the snack, you should have the snack. Have the snack. And then, and then just, but then go, the first thing is seek, seek first to understand. What do I not know? How have these people been set up to fail? What can I take ownership of? Like, what's my fault? What has not been communicated? And again, this is the open hearted, like, let's really figure out what's going on.

It reminds me of the movie Office Space, which I just love, but the old Office Space movie where they're always filling out TPS reports, and everybody's filling out TPS reports, and TPS reports are a system, and they were probably created with a good intention, and they're supposed to keep things organized, but now we've built this system in this movie where you have TPS reports have to be done all the time on everything, and it's, it's just, It's just perfect.

It's a busy work, and it's an obstacle to actually getting the real work done, or at least that's how they perceive it. Seek first to understand, like, what is the perception here? What is the reality? What's going on? How did, how did we get here? And just don't tell yourself stories, and related to that is of course assuming good intent.

Assume that these, don't, do not assume these people don't care as much as you do. Don't assume that they're lazy. Just assume there's something that you, that you don't know about, that there's a legitimate problem that we kind of have to address here. But that, I think that gets that gets you into that right headspace.

So that's, I think that's the opening place for me with headspace. And then I've got a couple of little bits after that, but I don't know. So assuming good intent, are you on board with that?

Stephanie Goss: Yeah, for sure. And I think the the, you know, our, our friend, Erika Cartwright tells I think she was doing a mic drop about, you know, the client's side of the story. And she told this story about how she's a very charismatic and outgoing personality. For those of you who have not experienced, Erika. She's crazy and, and loud and fun and all of the things that would go along with that. And she and I are trucker mouth friends. And so you can imagine her driving along in her, she's like, you know, barely five feet. And you can imagine her driving along in her big giant SUV just getting irritated and yelling at people who are driving like idiots or cutting people off or whatever. And the road rage is a real thing. And she was talking about how the way that she kind of cured herself of the road rage and really like brought her blood pressure down, cause it was real concern was to just force herself to look at the other car and say, Hmm. I wonder if they might be having diarrhea today.

And she just started asking herself that, like, what if that was happening? You know, it's like when you're driving and you see someone speeding and you ask yourself, maybe the person in the car with them is in labor. It's that same kind of thing of like, what is happening with them? And so I think the thing that Like you know, if you don't want to think about, is this person having diarrhea today?

The thing that I ask myself is like, you said this is ripe ground for us to make up stories in our head. And I think part of the way that I helped stop that in my own brain was to ask myself, could I tell another story here? And could I tell the story that they do care about the job? They just don't understand.

And whether it's understand what I want, understand what is expected of them, understand what the protocol is, what the process is… there's a, you know, a million different options that come at the end of that sentence. And it's the same kind of thing as like, what if that driver who's being a total a hole and just cut me off?

What if they're driving to the hospital because there's an emergency, you know, it's asking yourself that same kind of question. And when we say assume good intent, I've had people. I've had people who listen to the podcast go, I know you guys walk us through, you know, the steps that I know you walk us through safe.

And I know you, you know, I know you guys have talked about, assume good intent a million times and I don't know how to do that because, you know, because the stories that I'm telling myself in my head are X, Y, and Z. And so I I, that resonates with me because it is, it is a hard thing to do cause, you know, it's so the thing you should do, but that doesn't mean that getting yourself to that side is any easier.

And so I think one of the tools that I've really learned for myself is, if there's a possibility that I'm making up a story in my head about the situation, is to ask myself, what could the other story be here? 

Dr. Andy Roark: Yeah, I agree. Okay. I want to make I want to end headspace here with a caveat I've got a little section of headspace here for my perfectionists in the audience or People who are maybe managing someone who is a perfectionist who's coming with us and again, this doesn't play everybody. But I will tell you the way I've seen this go down.

So one there's the person who goes these people are upholding standards. There's the other person who's in a management role. That has someone who comes to them and says these other people are upholding standards and it's driving me nuts. And so I, I think I've seen it. I have been the person who has been frustrated that people are upholding standards.

And I have been managing someone who's frustrated when I'm maybe not frustrated. And so those are different things. But anyway, just hear this out as I kind of roll it together. For my perfectionist people out there, one question that you want to think here when you're like, people aren't upholding these standards.

Stephanie Goss: Mm-hmm.

Dr. Andy Roark: Remember to ask yourself sometimes. Is this a hill I want to die on? Is this a hill worth dying on? And I, I hate it. I have always, when I was young, I imagined the perfect team and the perfect business and everything runs smoothly and instead, you know what I got, Stephanie Goss. I got Stephanie Goss. That's what I got. It's the Muppet show over here. That's the, that's the business that I run. It’s Tyler Grogan and Ron Sosa, Stephanie Goss, Maria Pirita, just the list goes on. God, Dustin Bays, it is the absolute chaos and pandemonium in our business. 

Stephanie Goss: I was gonna say the, the biggest offender on our team is probably Kelsey Beth Carpenter.

Dr. Andy Roark: Kelsey Beth Carpenter. She’s like…

Stephanie Goss: Steph, Steph D is probably the closest to following all the rules on the team. 

Dr. Andy Roark: It’s a battle, it’s a battle of Order Muppets and the Chaos Muppets. But anyway, all joking aside there are, there are things that are worth fighting the battle with your team over, and there are things that are not worth fighting the battle with your team over. And just maybe let them not park as far away from the building as possible.

Maybe just give up on that dream. And maybe they can't park in front of the front door. But maybe just don't fight with them about parking as far from the building as possible and just let that one go. And so anyway, if that's you just think about is this a hill you want to die on. 

Stephanie Goss: Mm-hmm. 

Dr. Andy Roark: And then the other thing that I will say now again, switching back to a little bit more serious tone here, too.

When I hear people come to me or they'll come to management or leadership and they're like these people aren't following the rules. Sometimes they have a legitimate point and corners are getting cut and we need to fix that and that's true. There's a couple other things that sometimes happen number one.

There are times when people want to feel like they have control by enforcing the rules and so they want to enforce a feeling of power or a feeling of control not in a malicious way. But they're like these things are supposed to happen and these people aren't doing the things that are written down and for them it's a feeling of these people need to be made to behave in the way that the rules are written and It's almost like a moral battle for them like this cannot stand this represents anarchy. And so I don't know if that makes sense or but if you've seen that but I I've definitely seen there's some people who have really really don't like it when they feel like the rules aren't being followed and it's not really about the rules and it's not even about the impact of not following the rules. It's about the fact that rules should be followed and that's not happening And so there's kind of that mentality.

Stephanie Goss: Right. And I think, I think, I'm glad you brought that up because I think as a manager part of, I like that you, you know, you brought up picking your battles. I think as a, as a manager, certainly, and as the leader of the hospital, if you cannot find a healthy place between the facts that. Some rules are going to be broken, and things are always not going to be perfect, and sometimes it's very messy, because veterinary medicine is a place where we live in the shades of gray.

If you cannot wrap your head around that as a manager, like, you are going to have a hard time, because we, we do have a lot of managers who in particular, who are, process and order people and they need there to be structure and they really struggle here with the team members who are like yeah, and I let go of that patient and immediately went to go help with this patient and so I felt like the patient care was a bigger priority than taking the fecal loop out of the sink and cleaning it, Right?

Like there are always, there's always going to be that battle. And if you can't– on either side of the equation, if you can't find that place of peace to be able to ask yourself, is this the hill I want to die on? You're gonna, you're gonna be super, super miserable. And so I think the thing for me, because on, on the other side of this, let me just say and acknowledge and validate, I have been that person who gets very frustrated with the fact that rules are not being followed because I'm like, why do we have the rules? If they're not gonna be followed like just do the damn thing so there I see that side of it and I have also been the person on the other side of it who is like I just need the job to get done.

Like, I know that there's a process, but can you just do this thing? Like, get it done. And so, I think for me, one of the tools here to overcome the, the perfectionist tendencies or the need for it to be so black and white on either side is to ask myself, why is this a rule, or a system, or a process? And if I can't answer that question, like really, truly, and the answer can't just be, well, because that's the way we've always done it. If I can't tell you why we're doing something, and if the other person involved can't tell you why we're doing something, then there's a breakdown in communication, and that's That's the thing that I really need to work on, not the fact that they left the fecal loop in the sink, right?

Like that, I need to be able to answer that to not only assume good intent, but also to do my job as far as training the team and making sure that they have all the resources to do their job.

Dr. Andy Roark: Yeah, you want to be careful about rule enforcement as a brake pedal against change and I've seen that a lot as well. So there are people who don't like change and they don't want your business to change or they don't want to innovate or do things differently. They like the way things were and they want to stay that way and I have seen people who with that mentality.

And again, I don't think it's malicious. They like rules because rules entrench the current state into the into the culture. And they make change much harder because now change involves breaking rules or changing rules, which is a bureaucratic process, as opposed to just like, no, you know what, we're going to do a little bit differently today.

Well, if, if I say, you know what, guys, we're going to run, we're going to run dentistry's a little differently today in our, in our, in our general prep. If that's against the rules, then you have a weapon to shut that down and say, Oh, no, we're not Andy. We're going to do it the same way we always do. Cause those are the rules. And so again, just not to vilify, but again, I just, I do see those behaviors and I don't think people are malicious. I think some people really don't like change and the rules make them very comfortable. And so enforcing rules can be a brake pedal when things are starting to change or evolve or adapt, which is something to be aware of.

And then last is just be careful of rules as an enemy to autonomy, meaning like, like you said, it was a perfect example of I left the fecal loop in the sink because I saw a patient that needed help and so that seemed to me in the moment, looking around using my eyes and my training and my judgment that was the right call and you say well the rules would go against the call that you made and you go well, that's that's taking away this person's autonomy and so we want to be careful about having rules that are that nitpicky. And the last thing is if rules show your team that you don't trust them. Yeah, you have rules because I don't trust you to make common sense decisions.

I would say yeah, that's a little it's a little sticky. So anyway, I'm sorry. I've talked all about headspace. I've talked all about headspace and a lot about checking ourselves and checking complaints about rules but it's just because I I do see that stuff a lot and seek first to understand, don't be, be aware of the stories you're telling yourself, and all that to say, if we come down to a place and the standards are not being met, we're going to fix it.

And so let's let's take a break, Stephanie, and then we'll come back, and let's get into the action steps of actually getting, getting the small things done.

Stephanie Goss: Okay. That sounds good.

Hey friends. If you're listening to today's podcast and you happen to be in a medical director role. Listen up because this one's for you on May 29th, we are doing our second annual Uncharted Medical Director Summit. That is, we are bringing together medical directors from all walks of veterinary life. Doesn't matter whether you are in private practice, corporate practice, nonprofit GP, ER shelter, medicine, academia, and so much more. If you are in a medical director role, we have got something that you are not going to want to miss. So, if you've never experienced an Uncharted Summit, you're going to want to check this out because it's different from a usual conference. We'll have an awesome general session presented by our friend, Dr. Addie Reinhard from MentorVet. We also will have a workshop session with three different workshops being presented by myself, Dr. Andy Roark and our dear friend, Dr. Erica Pounds, who is a multi-site medical director and all of them are going to be on topics relevant to the medical director role specifically. 

And then what makes it a summit? Giving you time to network and collaborate with your peers on the challenges that are unique to the veterinary medical director role. So it's going to be a jam packed day. It's one day it's on zoom. It's fast and it’s furious. It's not your usual zoom where you're sitting there listening to people talk at you, camera's on, we're going to talk to each other. We're going to engage. We're going to problem-solve real-world challenges that happen in your practices. So if this sounds like something you don't want to miss, head over to the website at unchartedvet.com/events. And sign up today now back to the podcast.

Dr. Andy Roark: We're back from our break. Okay 

Stephanie Goss: We gotta actually get serious.

Dr. Andy Roark: We gotta get serious here and get some work done. All right, so for me, action steps, if you want people to actually do the small things and pay attention to the details, the first thing is, you have to talk about why the details matter. Like why is this important? And there are some people who are like, it's a rule. It's written down. That's good enough, and I will tell you that is not good enough for a segment of people. I don't know how big a segment it is, but there are some people who are like, I don't, What, what are we, why is this important? Like why does it, why can't the fecal loop sit in the sink while I finish up with this patient and get this client out the door?

Why can't it just be there? And I'm not saying there's not a right answer, but that's their honest to God question is, why? What is the concern about this? And oftentimes, oftentimes, we can meet these people in the middle. And you say, well, because what happens is, all the fecal loops pile up, and then one person gets stuck doing them, and blah, you know, and blah, blah.

Maybe there's a, there, maybe there's a way to meet in the middle between, you need to make the client wait while you do this, and these have piled up and now there's a bunch of them and people are cleaning up other people's fecal loops and it feels, you know, they feel resentful and blah, blah, blah. Maybe, maybe, maybe there's a, maybe there's a healthy middle another way we could do this, but, but we gotta start off with, with why.

Stephanie Goss: It's so funny that you said that because I was talking to some so when I was reading some of the, the threads around the time we got this, and there was one in particular, that was someone who was struggling with this scenario I gave at the, at the beginning of this, which is like, they have a newly promoted technician and they're leaving parts of their job for other people to do because they're like, well, I am qualified now to do this job, all of these other things. And so that should be my first priority. And other people who are not licensed should be able to do some of these tasks. And that's, some of the managers, like the first set of responses was, well, you need it, you need to have it written down in their job description that they have to do this, or you need a protocol that says they have to do this, this piece of it.

And it was so funny because that's where the like, what you were saying in the headspace about that you're trying to enforce rules to have control. Like that was the response from a bunch of the managers who were like, we'll put it in writing and then it will solve the problem.

Dr. Andy Roark: Yeah, put it in writing and make them do it! Enforce your control! Flaming raging sword of justice! Like yeah, I get it. 

Stephanie Goss: And it's so, and it's so funny because I was like, okay, for me, it's a yes, and because if it is really important, it absolutely should be in writing, it should be written down. And if you can't answer the why, it goes back to what I said, if you can't answer why, and the other people on your team don't understand or can't answer why, don't write it down.

Because it's not actually important enough to be included in protocols or processes or policies if everybody on the team doesn't understand the why.

Dr. Andy Roark: Yeah. Well, look, look I mean hear this if you have an idea you have a thing that you want and your way of implementing it is not explaining it and not getting people to buy into it, your way of implementing is writing it down and make it a rule and then punish people who break the rule, you're going to have a shitty culture, pardon me. You're going to have a, you're going to have a, beatings will continue until morale improves culture, that is not, it's not how you make people want to work at your place by creating rules that seem arbitrary to them and then saying it's written down and so you're out of line, like that's not, it's a terrible place to work and again, I get it.

And I've seen this, but this is the, this is one of the frustrating things in leadership. If you want to be good, sometimes you have to slow down to go fast. And what that means is you have to have the conversation with people about what we're doing and why we're doing it. And then you can write it down and then you can hold people accountable to it and you can remind them of why we're doing this, but if you don't have a compelling reason why your rule is what it is, I'm not sure that person's in the wrong. I think maybe you should think about whether or not this rule really makes sense.

Stephanie Goss: Right. And, and I think that it's, this is one of those things that you know, when, when I read it, it hurts my heart because I know that for the vast majority of people who I see reading it, responding in this way of, I need to write it down because then I can enforce the rule and I can hold people accountable.

They don't have the malicious intent. They don't have the intention to have the, the, you know, the beatings will continue until culture improves morale. Right. They're using the tool that someone has shown them, and it's like, it's like, you know, when you're taught that giving someone feedback means you give them the compliment sandwich, and you give them a compliment, and then you smash the feedback in the middle as the crappy part, and then you give them another compliment to soften that blow.

We do it because we do it because maybe we don't know any different or because that's the tool that we've been given. And I see this style of, I'm going to write it down and I'm going to incorporate it into our processes or protocols or handbook or whatever. I see that from a lot of young managers. And that was when, for, for me, that was a tool that I was given in the beginning of my career, my practice owners were like, yeah, this is unacceptable, so write it down, and then if somebody does it, then we have a reason to let them, let them go, right? Like that, that was, 

Dr. Andy Roark: That’s a hard tool.

Stephanie Goss: It is a hard tool. And when you're, you don't know, you don't have the training. I always say, you know, veterinarians go to vet school to become veterinarians.

They don't go to vet school to become business leaders. Most of them. And it's the same for, for managers. Like so many of us have come up and, and leaders on the floor have come up. And so, you know, I think it's important to recognize, like, I, I see you and I hear you. I have been that person who's like, Oh, well, this is the tool that I'm going to apply.

And I think your point, Andy, is super, super valid, which is, you can absolutely do that. And, having done it, and having screwed it up, I can say, I think both you and I can safely say, this is a way that we have royally screwed this up. And so,

Dr. Andy Roark: Well, let me, I think, I think this really summarizes the core belief, the core philosophy of Uncharted right here. And so a lot of people listen to this podcast and they're like, well, what exactly is Uncharted? I mean, Andy and Stephanie talk about business stuff, but what is, what is Uncharted relative to everything else?

This is, this is what Uncharted is. So Uncharted is taking this tool, which is a good tool. It works. And Uncharted's philosophy is, this is a good tool. You are not going to use this tool until you sit down with people and look at them in the eye and talk to them about why this is important. And listen to them. 

Stephanie Goss: Give them time to learn.

Dr. Andy Roark: Give them time to learn and listen to them. And have an honest conversation about why this is important. What we want the experience of working here to be and what our values are and and and how we care for our patients and what experience we want to create for our clients.

Stephanie Goss: And hear, and hear their feedback, because they may have, they may have an experience that is completely different from yours, and if you can't listen to anything that they have to say, and, and the, I know that the first thing that comes out of a lot of people's mouths is, well, but what happens when it's just an excuse? Like what happens if they're just using it as an excuse to not do their job? You have to remind yourself. That's the, that's the angry, that's the angry manager headspace that we were talking about at the very beginning of this podcast. You're in that headspace because the reality is people don't come to work every day wanting to do a bad job.

And if, and if that is your gut reaction is like, well, they're just giving me an excuse. Like I am listening to them. I'm asking them why it happened. And cause this is part of the learning process. Like it takes time to get there. And you get into the space of, okay, well, I asked them and I listened and then their feedback was, well, I just went to do this other thing, but this is still important. And so they're still not doing their job. You have to like, really, really listen,

Dr. Andy Roark: Yeah, you do.

Stephanie Goss: You know, because it may be in the moment, they didn't do it. And it and it is somewhat of an excuse. And if there is feedback there, like, This may not be realistic because dot, dot, dot. And then they tell you something to your point, Andy, like that's how you learn the middle ground to meet them in the middle.

Dr. Andy Roark: Yeah. You can't discount the idea that perhaps the person who's working on the floor actually doing the thing has some insight into it that you in your manager's office or in your doctor's office don't have. And so, again, don't, I mean, again. Maybe they are making excuses too. What is the worst case scenario?

The worst case scenario is, you end up doing what you were planning to do anyway, but at least you have tried to engage this person, and you have an understanding of what their feedback is, and you're still going ahead and doing it. But at least you tried the easy way and so that's that's the first thing is you've got to get a foundation in why why do we and again it doesn't people like I have to have this conversation for every little rule. No, no, you don't you need. 

Stephanie Goss: Cause if there is a clear why you don't have to have the 

Dr. Andy Roark: Exactly if you say so again, so so. Let's just explore this why a little bit. Generally I'm not gonna have a conversation with the team about every little rule but all of the little rules come together to create the overall experience.

And so if you haven't sat down with your team and said to them, Hey guys, let's, let's, I want to have a conversation with you guys. I want you to imagine a really great veterinary team. I want you to imagine that. What does that team look like? How do they behave? What does their clinic look like? And they're going to say things like, well, they treat each other with respect, and they smile, and the clinic is clean, and the equipment is well maintained.

You go, yep, and you're going to write all those things down. And then you're going to say, what do they sound like? They give each other positive feedback, and they encourage each other, and they don't badmouth the clients. You say, okay, cool. What does it feel like to work in that team, guys? At the end of the day, what does that feel like?

And they're going to say, it feels like, it feels rewarding. It feels like we're working hard, and we're getting things done. It feels like we're making a difference. They're going to say whatever they're going to say. And every team is going to be different. There's not a right answer, but they're going to tell you what that is. And then at the end of that conversation, you're going to say, are some things that we can do, or what are some things that we can agree to as a team so that we can look like and sound like, and feel like a great veterinary team, and then you're going to shut up and you're going to let them tell you what they want to do and what they're excited about.

And then you're going to lean in and you're going to support them. Then we're gonna get started, and we're gonna, and we're, this is our time to say, hey, we've got some, we've got some rules in place, we're agreeing that we're gonna do this, and, and this is, and now we're gonna start, we're gonna go forward, and I wanna support you guys in this, and it shouldn't all be stick either, like, that's the other thing, is 

Stephanie Goss: Yes. 

Dr. Andy Roark: It should not be, it should not be a punishment culture. It should be a positive, are you celebrating them when they live the values? Are you celebrating them when they do the good work? Oftentimes, you know, I use this example all the time. People are simple animals. I don't care how many degrees you have, how smart you are, you're a simple animal. And we don't train people, we don't train simple animals with negative reinforcement, do we?

Like, we figure out how to positively reinforce and we do it. And humans are the same way. And so if you want people to follow the rules, what are you doing to positively reinforce them following the rules? Like, how do you, how do you do that? And anyone who tries to push back and say, well, it's their job.

I go, all right, seriously, let's think about this. My job, my dog's job is to be a good dog. He ain't doing it. If he doesn't get positive reinforcement, you know, it's just, you've got to, if you want to have a good culture, you have to build it with positivity, you

Stephanie Goss: It can't be, it can't be a transactional. It can't be the, you just show up and do your job and I give you a paycheck. And that's why we have a relationship because that is, no one wants to work in that environment.

Dr. Andy Roark: Well, even the example that you gave earlier, I think is a good one, right? So we've got this person. Let's say that they were a VA and they have finished their training and now they're a vet tech. Right. So they've gotten credentialed and they're doing it now. And they're like, well, I shouldn't have to do those things because other people are more capable of doing those things.

That person is not necessarily wrong. You can run your business in different ways. You could a hundred percent, like it's not heresy or stupid to say, I want my credit credentialed vet techs doing things that only credentialed vet techs could do. That's not a bad business model and that's not wrong, but if everyone's expectation is no, we all, we all take cases from start to finish and that's how we run our business. That's not wrong or bad either. Not at all. But you can't have one person whose philosophy is credential vet techs only do things credential vet techs can do. And another person who says, no, we all take a case and we stay with that case from beginning to end.

Those are conflicting systems. And so sitting and talking with them is not bad, but hear them, hear what they say, and talk about the decision that was made and talk about, Hey, you know, here's the thing. We, we look at that model, the downside, and I would, I, I always like to ask the other person the question.

What do you think the downside of that model is? Think about, think about where, where does that model, why do some people not like that model? Well, because when you're new, you're cleaning fecal loops all the time while the experienced people are doing all the fun stuff. Like, yeah, that's the answer. And we want, we have a, and if it's on growing and training.

And so that's why we decided this is not because we don't think your skills are valuable. Not because we think that you couldn't do other things or we don't have enough work. We want to grow and develop people, which means we don't want to have people who can only do the most basic of work because other people get to do all the fun stuff.

And so that's just what we decided. And that's the why. And if they, if they hate that why, they go, I fundamentally don't agree. Unfortunately, they might not be a good person for your practice because that's, yeah, That's, that's your, how you decide to grow your business. But at least we're having conversation about the purpose and, and why things are the way they are.

And, that person can feel heard and I'm going to do my best job to be a good active listener. And then ultimately we're going to say, well, this was the decision that was made and this is how we need to go forward. And now we're going to switch over and start holding people accountable.

Stephanie Goss: And I think when you, the other thing that I would say is a lot of the time, and I don't know about you, Andy, but I feel like a lot of the time I get asked the question of like, I don't want to have to be the one to mediate these conversations. Like, how do I get them to talk to each other? Like when somebody is, you know, when somebody is leaving their mess for other people to clean up, how do I get them to talk to each other about that instead of coming to me and being like, well, you know, now that Avery's a, you know, an RVT, she's not finishing her cases. She's just bailing and leaving our mess for, you know, Sarah to clean up as the, as the VA. When you have a culture where you consistently have everybody involved in creating the why, and they understand it from both sides, it makes it easier for them to hold each other accountable.

It makes it easier for Sarah to be able to say, hey Avery, you know, I know you wanted to get that next patient into, you know, into surgery and I know that you were, you know, just trying to get, get things going and this is how it impacted my case cause you know, then Dr. Sarah asked me to bring a patient in and there was no clean space and so, hey next time would you, you know, be able to just finish your case from start to finish because we all, we all agreed that that was how we were going to do cases in the hospital.

Like, would that, you know, can you, can you help me out there? Those conversations only happen in an environment where there is the psychological safety, but also where there is the trust and the trust comes from what, when everyone understands the why. And so for me, the Jedi place as a leader is to get to the, the team has those easy, hard conversations, if you will, of talking to each other because they all know the why and they can have, they can say that to one another.

And I have to deal as the leader with the ones where they're like, hey, we've had these conversations and this is consistently still happening. And the reason I've been given is just because I don't agree with that. And so I'm going to do it my way because that's something they can't deal with as a team member.

That's something that's for me to deal with as a leader, to your point, to say, Hey, maybe this is not the right hospital for you. I want to deal with those kinds of conversations, but that only comes when we create that space where they're all involved in the why. And it's just as easy for one of them to say, hey, I need your help. Can, can we, can we do this? Like that comes naturally when they're involved in the why.

Dr. Andy Roark: Yeah, that, that is the Uncharted way. Like, that is the uncharted way. It's not about me policing people. I hate that. It's about us having a good conversation with the group and having them encourage, support, appreciate, praise, and sometimes gently correct.

Stephanie Goss: Right.

Dr. Andy Roark: And, but that only happens with this conversation.

Okay. Once you get through that step, which I think is really important, and there's a million ways to do it, it depends on, on what we're talking about. Once you get through that step, the internet advice is probably fairly accurate from the basic blocking and tackling. Set clear, set clear expectations, have clear metrics that people can see, so they know that there, if I thought I cleaned the exam room and I didn't meet your standards of cleaning the exam room, I don't know that because I thought I cleaned it and you're like, he didn't clean it. And so, that's, those are, the expectation may be clear to some, that the exam room has to be cleaned, but the metric you're using for cleanliness, I'm, I'm not understanding.

Stephanie Goss: Yeah. What does clean look like? Yeah.

Dr. Andy Roark: Exactly yeah, and so, clear expectations, clear metrics, and then, and then, this again, this is also uncharted territory right here. Feedback. Culture. You cannot police culture. You cannot catch people breaking the rules until you have a good culture. You have got to celebrate culture. You have to celebrate the people who are showing the values that you care about, that are making your hospital the place you want it to be. Celebrate, celebrate, celebrate. And a lot of us, we don't do that because it takes a lot of work.

Stephanie Goss: Yes.

Dr. Andy Roark: But that is, that is where the rubber meets the road. And so, talking to people about not meeting expectations should be a small part of the feedback you give. The majority should be saying, Hey, I saw you grabbing those fecal loops and cleaning everything up, and I know that those probably were not all your cases, and I just want you to say, I saw you, and I appreciate you.

Thank you for doing that. You know, or write a thank you note and just say, Hey, I just wanted you to know, I've noticed recently how much you do around here, and it really matters to me. And again, that is time well spent, but a lot of us, we say, if it's not broke, I'm not going to touch it. That's, that's, that's not a, it's not the investment you think it is.

So anyway, so there's that. Document mistakes. And then manage the wrong people out, you know, so if we had the conversation and we said these are the expectations and people fail to meet the standards or they don't follow the rules or they continue to cut corners and you say, you're cutting corners in a way that is not acceptable, we are going to be a higher quality practice than the medicine that you are determined to practice.

There's no reconciling that. You know, if I have communicated it and I'm holding someone accountable and they refuse to change, there's, there's only one way out of this. Again, you always, you pick your poison. You always pick your poison. Do you want to be a practice that practices that quality of medicine?

Or do you want to part ways with that person who's determined to practice that way? Those are the only two options after you've had conversations and managed. If they're not changing, pick your poison. Those are your two paths. 

Stephanie Goss: Mm hmm. And I think where you, where you started in the very beginning with the idea of, is this the hill you want to die on? That's really important here because do you want to fire someone because they're leaving fecal loops in the sink? You, as a manager, you have to ask yourself questions that seem nuts like that.

It's like, this seems really, I can't, it's surreal that I would fire somebody for leaving fecal loops in the sink. If your answer, if you don't understand why your answer would be yes, probably not the hill you want to die on. And so if your answer is yes, then you, from an action set perspective, absolutely have to ask yourself, like, did I make it clear?

Do they know how to do, to your point, do they know what clean looks like in the exam room? Have we trained them? Have we practiced? Have we done all of the things? And that, that comes with the documentation. And for, again, for a lot of us, this is where our tools as managers was, well, you just tell them that they didn't do it.

And then after you've told them once, then you write them up and then you write them up again, and then you fire them the third time. Well, okay. But telling someone, hey, you didn't do this thing is vastly different from actually making sure that they understand not only what does that mean, but to your point, how to do it right.

And then giving yourself, like if you on the other side of that equation are not working harder to recognize them doing it right, then you are working at catching them doing it wrong again, then you're not doing your job ass a leader. And I think that that's one of the hard realities because for a lot of us, we, that's the tool we're given.

Dr. Andy Roark: I, no, I agree with that. That's, that's the tool we're taught and we're given. It's just, I don't know, that's not, that's not the relationship you want to have. That's not the job you want to have. You know, it's just it's sad. But here's, here's the other reason it doesn't work, too. And I'll say this and everybody will be like, oh, yeah.

You know, so you're given that tool and so let's say that you've got this technician who just became a technician and now she's doing these things and she's doing other things. Let's just say that she's busting her butt. Say that she's not doing fecal loops. She's not cleaning up exam rooms, but she's everywhere else doing all sorts of stuff.

You're telling me you're gonna fire this person because she doesn't clean fecal loops. That's what you're gonna tell me and again, I see people in that boat all the time. They're like, she has failed to follow this rule, and now she's being written up. And I'm like, yeah, now what you gonna do?

You're gonna fire her over this rule that's kind of dumb, or that's not really that big a deal, even though she has this massively positive impact in all these other areas? How about you just talk to her instead, you know, but, but that is when people realize, I think that's when people feel really powerless is because someone said, this is the tool.

And when you first hear it, you're like, yep, that makes sense. And then you find yourself in the position I just described where you've got someone who did not buy into the why for this specific rule or these specific sets of rules, but otherwise are a good person who works hard and matches the values of the practice.

And you're like, what are you going to do? You're going to continue to hammer on this person that's 85 percent good for your practice and your patients that the clients like or are you going to step back and have a conversation and just sort of like try to try to reach a middle ground here and try to try to understand each other but people skip that step and it's just it ends up in a sad place.

Stephanie Goss: I think it's really important to be able to ask yourself about the hill and, and whether this is, whether this is a hill to die on, because for some people and for some practices, it may be, it may be the fecal loops in the sink are absolutely unacceptable. And there may be a reason in that practice that that is the case. And that may be a choice that you want to make is like, if you cannot do this, you cannot work for our team. Okay. That's, you know, it's, it's your business and it's your choice and you, you can absolutely do that. And where I see this come up a lot to your point, Andy, of If they're doing everything else great and it has to do with being late. I see it so much where people are like, well, I have a doctor or I have a technician and they're amazing and they're always like 15 or 20 minutes late or they're always 10 minutes late.

If you are, and this is where it gets dicey for the people who, our can, our process people and systems people and control people is like, well, if you're going to hold everybody else accountable to this rule, but you're going to let them slide because they're doing everything else right, then how is it actually A, fair, and B, a rule. And I think this is where you have to ask yourself that question as a leader, which is, have I done my part? Because if there is a really strong why to having that, it is important that the team all be here so that we can be on time for our clients. That's a super valid why. And if you have a team member that you cannot hold accountable to that, it doesn't matter if they're a licensed technician or a doctor.

If you, if there is a strong why and there's buy in from the entire team, if you don't hold them accountable, that's how you help as a leader create a toxic environment in your practice. And so the flip side of this is, would I as a leader choose to have fecal loops be my thing? Probably not, man. I'm going to be honest with you.

I'm going to let that one slide if they're doing everything else right. I'm going to try and find some middle ground. If it's something that the whole rest of the team agrees in, is bought in on, and there's a really strong compelling why. You absolutely have to, to work on that and deal with the person.

And it may mean if you actually have told them and you actually have walked through the process and you have helped them, you can say, I've done everything I can to help them understand the why, that's a, that's a slippery slope if you don't do something about it.

Dr. Andy Roark: Yeah, I agree. That's all I got.

Stephanie Goss: Whew, man! This one was a fun one. And look at that. It was our, it was our shortest episode, but yet we still managed to find lots to chat about.

Dr. Andy Roark: Yeah, sure. Our shortest, shortest question. Not our shortest episode.

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

Dr. Andy Roark: Thanks, everybody.

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.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: behavior, communication, culture, management, Training

Jan 17 2024

We’ve Got a Narcissist in The Practice: What Do I Do?

This week on the podcast, Dr. Andy Roark and practice manager Stephanie Goss are in the mailbag to tackle an email from a member of a hospital leadership team who is worried they have a narcissist on the team and it doesn't seem like the practice owner is willing to deal with the behavior from this person or get rid of them. The team is dropping like flies as a result of naughty behavior from this team member and this leader is wondering what they can do to help in this situation. Let's get into this…

Uncharted Veterinary Podcast · UVP – 268 – We've Got A Narcissist In The Practice- What Do I Do?

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

Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.

Submit your questions here: unchartedvet.com/mailbag


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Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Stephanie Goss:
Hey, everybody, I am Stephanie Goss and this is another episode of the Uncharted Podcast. This week on the podcast, we've got an email from someone who is struggling with a narcissistic team member and a practice owner who doesn't seem to want to deal with the problems that are being created as a result. This one was a tricky one but, also, really enjoyed the conversation that Andy and I got into and I hope you do as well. Let's get into this.

Announcer:
And now, the Uncharted Podcast.

Andy Roark:
And we are back. It's me, Dr. Andy Roark and the one and only, Stephanie, I bet you think this song is about you, Goss.

Stephanie Goss:
I think this is going to be one of those episodes where people maybe say, “Is this about my clinic?”

Andy Roark:
Oh, is this one about me?

Stephanie Goss:
Is this about my clinic? Is this about me?

Andy Roark:
Oh, yeah.

Stephanie Goss:
Maybe not is this about me but is this about that person in my clinic.

Andy Roark:
Oh, yeah, totally. Oh, yeah.

Stephanie Goss:
Hi, Andy Roark. How's it going?

Andy Roark:
Oh, man, it's great. We're recording this right before the Christmas holiday. Everything is decked, you'll probably hear crashes and footsteps as my kids are home from school. I'm wearing my holiday sweater that says I like them real thick and sprucy and it's got evergreen trees on it.

Stephanie Goss:
I can't. Oh, yeah, he's serious, y'all.

Andy Roark:
Oh, yeah.

Stephanie Goss:
And when he stood up in front of the camera this morning, I just about died laughing. It is absolutely fantastic and I think that our whole team should get them as Christmas sweaters next year.

Andy Roark:
Oh, man.

Stephanie Goss:
This year, you got us Uncharted swag, next year, next year, we get-

Andy Roark:
Oh, ugly Christmas sweaters for the Uncharted team.

Stephanie Goss:
… Sir Mix-a-Lot ugly Christmas sweaters.

Andy Roark:
Oh, man, yeah. Oh, boy. But it's funny, you were like, “Do you really have a life-size Santa cut out of yourself next to your Christmas tree?” I was like, “Yes, I do.” I had to hide it from my wife but I have it.

Stephanie Goss:
That was the absolute best gift that I've ever had the pleasure of watching you experience thanks to our friends Erika Cartwright and Jen Galvin last year. And it is true, Andy received life-size cardboard cutouts of himself and he squirreled them away in the basement, so good.

Andy Roark:
Well, it's one Santa and a bunch of Andy elves. We call him Santy. Santy, the elves did not last all that … Well, they were not as well constructed and they have broken down but Santi is … In the Christmas Carol, which is my favorite Christmas movie, when he's got the lamp and his wife keeps trying to break it?

Stephanie Goss:
Yes.

Andy Roark:
Suddenly trying to break it? I was like, “Allison's going to take up smoking just so she has a reason to have a lighter around the Christmas tree-

Stephanie Goss:
And set Santi on fire?

Andy Roark:
And set Santi on fire, yeah. I don't know, the doors were opening, he blew out into the rainstorm. Sure he did, Allison.

Stephanie Goss:
Oh, man. Well, I'm excited about our episode today because I do think this is one of those episodes. I remember, when I read this letter we got in the mailbag, I thought, “Man, I have been in a practice where I have felt this as a team member and struggled,” and so I think that it'll feel familiar. We don't have a whole lot of details about the scenario here and so Andy and I are probably … I think you and I are probably going to make up some of it so that we can get deeper into the conversation in terms of an example.
But we have someone who is a part of a leadership team in a hospital and so, for the purposes of this conversation, we're going to assume that they're part of the leadership team but not this person's direct supervisor so they don't have positional power in this scenario and they are struggling because there is member of the team whose behavior feels very narcissistic. We don't know if they actually truly are narcissistic personality but they feel and that was how the letter came across is that we have a narcissistic member of the team and the practice owner won't fire them.
Their behavior has caused multiple valued members of the team to quit over time and they don't ever take responsibility for themselves, for their actions for upsets that happen on the team and yet the practice owner is unwilling, it seems, to do anything about the scenario and so they're just like, “What do I do?” both, I think, on a personal level but also when you're a member of leadership in a practice like that and you don't condone the behavior, you want to make change.
And really, so I think for me, that's at the crux of this episode is, when you're in that position as a leader where you want there to be change but also you see in the team that there needs to be change and you are not in a position to enforce that change or make that change happening, what do you do?

Andy Roark:
Yeah, yeah. We can talk as if this person is a leader in the practice. For me, it doesn't matter all that much. If you don't have positional power over this person, then you don't have positional power over this person and we have to navigate using very limited organizational tools or no organizational tools. I think that's how I'd like to set it up today is to just go ahead and go at it like that and talk about it. We get a lot of this. So, we're going to talk about a narcissist today and most of what we're going to talk about, I suspect, really carries over to any challenging personality.

Stephanie Goss:
Personality.

Andy Roark:
Yeah, exactly.

Stephanie Goss:
Yeah, I was thinking the same thing.

Andy Roark:
But we'll hit some stuff specifically for narcissism but, for the most part, you're going to find a lot of commonalities to the toxic employee, the micromanager in some ways, things like that.

Stephanie Goss:
Yeah.

Andy Roark:
All right, let's get into this with some headspace. Ready?

Stephanie Goss:
Okay. Yeah, sounds good.

Andy Roark:
All right, cool. One of my favorite sayings that I have been using for the last year is there's three things you can't control, the past, the future and other people. There are lots of other things but three things we should remember, the past, the future and other people. And so, people are like, “What do I do? How can I make this person change since they're not leaving? How can I make the practice owner get rid of this person? How can I make the rest of the team understand what's happening?” And the answer is you cannot, you cannot control the people. And then they go, “And what will the future be? What will it be like in a year? Is this still going to be happening next year? What does my career look like if I stay here? What opportunities am I missing if I leave?

Stephanie Goss:
And then, all of a sudden, you're living in a cardboard box in the woods.

Andy Roark:
Exactly right. You can't control the future.

Stephanie Goss:
Right.

Andy Roark:
This person, they might put in their notice and leave tomorrow, they might stay here forever, I don't know. It might get better, it might get worse, it'll probably get better and then get worse and then get better and cycle along like that. I don't know and so I think it's very important to start to frame this up from the beginning in the headspace standpoint is you can't control the past, you can't control the future, you can't control other people, including this person, including your boss who has the potential to get rid of this person or the power to, you just can't.
And so, right off the bat, we have to let some things go. We have to stop talking to ourselves about what should be and what people should do and how people should act because it doesn't matter because you can't control it. And so, that's going to be a bitter pill to swallow right up front but everything gets easier if you can just catch yourself and say should is not real, it doesn't matter what should be. I'm not going to use the word should but a lot of us sit and talk about what management should do, what the person should do and so on and it's not productive.

Stephanie Goss:
Yeah, no, I agree with that, for sure. And it's funny because, when I sat down and thought about this, I was like, “Well, there's so much you can't control in this kind of scenario,” and so, really, for me, when I was thinking about headspace, I was like, “Really, it's about getting Zen and finding that place of I'm going to deal with what I can control,” because I think that's really the only way you can approach it. Because from a headspace perspective, if you think about what should they do or you think about I wish someone else would do this, you're going to drive yourself loopy. It's not worth the toll that that kind of mental anguish that you put on yourself gives you.
And so, the best headspace advice is just looking at it from the perspective and saying what can I control here and then just sitting, I'm going to date myself here, pop in a DVD, watch some Elsa and Anna and just channel Elsa's badass behavior and just let that shit go because you can't force other people to do what you want them to do.

Andy Roark:
That's right. You can watch your own VHS tapes but you can't-

Stephanie Goss:
I almost said pop in a tape.

Andy Roark:
You just pop in a tape, hit rewind, then hit play. Oh, man.

Stephanie Goss:
Listen, Linda. You want to talk about dating yourselves? Wait until you open your Christmas present.

Andy Roark:
Oh, boy. Oh, wow, man. I watched Die Hard with my kids two nights ago because they've never seen it before and there's the whole thing about Die Hard is a Christmas movie and they're like, “What is this?” I was like, “All right, you guys should probably see this movie.” And the terrorists, right at the very beginning, they cut the phone lines and my kids were like, “What the heck is that?” I was like, “Oh, that was a 1980s problem.” Yeah, all right so, okay.

Stephanie Goss:
Anyways.

Andy Roark:
Anyway. This is not your circus and these are not your monkeys and we say not my circus, not my monkeys. And it's funny, sometimes I start to give advice like this and it might sound cynical or jaded and I definitely see people say, “Well, not my circus, not my monkeys.” I don't mean it to be cynical and jaded, I mean it in a take care of yourself way.

Stephanie Goss:
Right. Yeah, yeah, absolutely.

Andy Roark:
This is not your circus and they are not your monkeys and the reason I say that is because there are two mindsets that I see people go into when they have problems like this and both of them are really damaging to that individual. And so, the first one is the martyr mindset which is I will absorb the abuse to protect others.

Stephanie Goss:
The team, yeah.

Andy Roark:
I will protect the team.

Stephanie Goss:
Especially if you're a leader, absolutely. I will take that behavior so that the rest of the team doesn't have to experience the wrath.

Andy Roark:
Exactly. I will be the one who wades in and challenges this person and continuously battles with them and every day I will wage a war made up of five different battles from the treatment room to the front desk back to the break room and there's these just little altercations but I am standing up-

Stephanie Goss:
For the team.

Andy Roark:
… because I don't want the team to suffer and so I will suffer for them. And the other one is very closely related, it's the defender mentality which is very, very similar but it is I am not going to suffer, I am going to battle and cause this person pain and I will square off with them. And it's basically I will fight the bully so that other people don't.

Stephanie Goss:
Don't have to fight.

Andy Roark:
Exactly right. And the first mindset is I'll take the beating from the bully so that other people don't have to and the second one is I will brawl with the bully so that others are safe. And those behaviors, they end up looking quite different but, ultimately, they lead to the same thing. And again, both of these mindsets come from an idea of service to others, being a protector which you can tell is a common mindset in our profession. We have a lot of people who are heroes, who are protectors, who look out for the weak and the small and so you can see there's a lot of people who have mentalities like this and I get it and I do get it. I truly believe it comes from a place of trying to do good and to be a good person.
But ultimately what happens is it just leads to continuous conflict and the whole treatment zone or the whole treatment room becomes a war zone. And so, you're like, “Well, I'm fighting them so others don't have to.” It's like, “Man, others are just living in a war zone and it's not worth it, it's not worth it.” There's the saying you can be right or you can be together when it comes to conflict sometimes and you can totally stand up and be the champion or you can do the thing that is going to deescalate the situation and make the days easier to get through.
But a lot of people really struggle with the idea that you have someone who's a narcissist and they're not being challenged on their narcissism, they're allowed to continue these behaviors and that does not feel right or just to them. And ultimately, they really struggle to decide that it's not my circus and it's not my monkeys and I'm just going to step back and I'm going to get my job done, it's just a job and I'm going to try not to engage with this and that's it. But I don't know, I think a lot of people struggle with that but I think that's an important piece of headspace.

Stephanie Goss:
Yeah, I would agree with that. And I think I struggled when we were getting ready to have this conversation for a myriad of reasons, least of which was what you just described, the two types of behavior when it comes to not your circus. Hi, I have been that manager on both sides where I was like, “Oh, I'm going to fight the battle for everybody else so that they don't have to do it,” and I have also been the one who's like, “Oh, I'm just going to take it from this person so that nobody else has to deal with it.” And you're spot on, at least from my experience and my perspective, when I was in that role, it was not a conscious decision, it was a I care about the team, I don't want them … I see how much this is bothering me.
And a lot of times, especially if you're in a position of leadership, whether you're a manager or assistant manager, whatever, you often are privy to how other people are feeling. Either they're coming and sitting and talking to you or you're hearing second-hand this person is really struggling and so, as an empathetic individual, you want to protect the team and you want to make it better. Part of what attracts you to a leadership or a management role is caring about other people and so it's really easy to fall into those two things. And it's funny because, when I sat down and thought about this from an episode perspective, I was like, “Well, other than channeling Elsa and just figuring out how to let it go, I'm not sure that there's a whole lot from a headspace perspective for me because it really is all…”
I think, normally, when we talk about headspace, it's what are things that you can do and what are things that you can control and a lot of this headspace is about letting go of all the things you can't control. So, I don't know that I have a whole lot more from a headspace perspective. How do you feel? Is there anything else that you've got from a headspace perspective?

Andy Roark:
No, that's a good place to wrap up headspace because my first action step is really tied into how we respond. And so, this is a good place to take a break and then we'll come back in and we'll get into our action steps.

Stephanie Goss:
Okay, sounds great. Hey, everyone. I have to jump in here real quick and remind you all of something that I'm hoping you already know about but, if you didn't, I wanted to put it on your radar. And that is that we have registration open for our Uncharted April Conference. Now, this is going to be our last one in Greenville for a while, we're super excited, we're going to hit the road as a team and try some different locations but we're going to do it up pretty big and it's going to be a whole lot of fun and I would love to see you there but I want to make sure that early bird pricing is closing.
That's right, it's closing January 17th, you don't want to miss it. If you would like to be there live and in person with us in Greenville, head over to unchartedvet.com and register today because we would love to see you and who doesn't want to get their ticket at a cheaper price. And now, back to the podcast.

Andy Roark:
All right. So, for me, the very first action step here which just absolutely dovetails off of what we just talked about before the break is don't respond. It's the old Viktor Frankl, between every action and the reaction, there's a pause. And in that moment, my advice is, especially since you don't have power over this person, is to try to pause and take a breath and try not to respond to behaviors that we're seeing. And a lot of times, narcissistic people can get really upset if they feel criticized, they want attention to be about them, they want conversations to be about them, they want accolades to be about them, they get unhappy if accolades are about other people or other people are getting celebrated.
It's just things like that and, in that moment, between when you see the behavior and it makes you angry, you have the chance to pause. And the reason I think that that is so important is direct conflict and confrontation with narcissists is usually almost entirely unproductive. You are not going to talk them out of their behavior or their worldview, it's who they are in a lot of ways and so direct conflict and confrontation with a narcissist usually does not go well. The other truth of office politics is this. I grew up watching sports and one of the things that always bothered me so much in sports is I'd be rooting for a team, whether it's basketball or football or whatever, and there would be somebody who would do something like shove another player to the ground and then they would get in trouble.
And on the replay on TV, it would clearly show the first person punching the other guy in the crotch and then getting shoved to the ground and the guy who got punched in the crotch is the guy who gets in trouble for shoving him to the ground. And it's just that's life in so many ways. And it's just the second person often gets in trouble which is that person will do their behavior and you'll react to it strongly and everyone turns and looks at you because you were the second loud voice or you were the one who really responded aggressively or assertively, whereas, the other person was just trying to make snide comments or things like that.
And the second person often gets caught in the altercation which means, if you respond and you respond immediately and especially aggressively, oftentimes, you are going to bear the brunt of the frustration of the team or especially of management, you are going to be the one who gets called and so I think that that's a big part of it. The other part is, a lot of times, with the team, management is interested in maintaining harmony and you're going to get labeled as a brawler, you're going to get labeled as somebody who … It takes two people to have an argument and you get-

Stephanie Goss:
Antagonistic.

Andy Roark:
Yeah, exactly right. And you may be just responding to behaviors but you are one of the two people who has arguments and that puts you on the naughty list. And so, anyway, that's part of my thing up front is I know it's hard, it sucks, pause, try to not react, try to … It doesn't mean you're not going to react but don't react in the moment, especially don't react emotionally, there's a very good chance that you are going to get caught and you are not going to change this person's behavior with direct conflict or confrontation.

Stephanie Goss:
So, two things. One, I was laughing there because, as you were talking about the antagonistic behavior and the response behavior, young manager Stephanie, believe it or not, was a bit of a hothead.

Andy Roark:
No.

Stephanie Goss:
Yeah, that was totally me. It was like, “You're going to shove me? I'm going to shove you right back.” And so, I was laughing because I can totally see myself in that behavior at that point in time. And it's not necessarily intentional, it's just, when you're provoked, that's what we want to do, I think it's human nature.

Andy Roark:
Sure.

Stephanie Goss:
But also, I'm glad that you talked about giving the pause and it's interesting because there actually is a method for dealing with narcissists and narcissistic behavior and it comes out of … It's actual psychological method and comes out of therapy and it's called the Grey Rock Method. And so, it's funny because when I was thinking about this from action steps, I was like, “Oh, I had Grey Rock down,” and then I was like, “Oh, now Andy did his part, it's the exact same thing.” It's that idea that, to your point, what people who truly are narcissistic want is full attention, they want to be center stage, they want all eyes on them. And so, just like on the basketball court, when they punch someone, that's because they want the attention, right?

Andy Roark:
Right.

Stephanie Goss:
And so, when you respond and react, you're giving them exactly what they want and so the Grey Rock Method is the idea that, if you are just dull and boring and you don't respond and let yourself intentionally try and become emotionally detached, it weakens their ability to get pleasure out of poking at you. And so, the idea is you just become a boring gray rock and that's very different from completely disengaging. And I think that that's really important here because, when you completely disengage from someone that causes the … It's like on the basketball court, if you poke at someone and they have no response, they don't just walk away, they poke at them again in the way that's going to let me hit you on the nuts kind of response.
So, I think it's important to think about how do we deal with this person and I think that there really are steps that we can do to disengage in a way that is still I'm doing my job and I am not ignoring you because that, in a way, is giving them the negative attention that they want but just keeping it short and brief and how can I minimize the interactions with this person. So, if you're someone who is looking at this, there's actually a lot of great articles and info on the Grey Rock Method because it actually is a thing.

Andy Roark:
Yeah, I got to be honest, when you said young Stephanie Goss used the Grey Rock Method to deal with narcissists, this was not what I was thinking was going to happen. I use the baseball bat management style. It's like a baseball bat that just lays there, it doesn't respond. Not what I was thinking, okay. All right, so we are in agreement that not responding is a good opening position.

Stephanie Goss:
Yes, give the pause.

Andy Roark:
Yeah, cool.

Stephanie Goss:
Give the pause, okay.

Andy Roark:
Yeah. Remember that narcissists tend to make promises and talk about a future that's often based in fantasy. It's big promises, it's big talk about what will be and how things will be, don't buy into that. And again, it's not about being aggressive but we're going to talk to this person in facts and deadlines and we're going to ask when will these things be done by and when can you have this or can you do this specific thing, when do you think you'll have a chance to do that or will you have a chance to do that this morning. And it's just about trying to communicate clearly because, otherwise, you're going to get big talk about how things will change and what will be done and then it won't be done and they will continue to rewrite the history so that they don't look bad.
And so, anyway, it's not about intentionally trying to trap people but it's about talking in specifics so that it is very clear who did what they were supposed to do and who did not do what they were supposed to do.

Stephanie Goss:
Yeah, I think that goes hand in hand with the idea of … I love your response about being very clear, particularly from both a boundary perspective on your end but also with them. To your point, when you are engaging, if you're not the person who is in control, if you're not the person who is their direct supervisor and you can't necessarily deal with things, you can still help by teaching the rest of the team to give really clear instructions and really clear guidance and having that kind of conversation with the team which is like, “Look, let's be really clear about this. This behavior is really affecting the rest of the team and so what can we control, what boundaries can we set to make this go more smoothly?”

Andy Roark:
Yeah, I agree with that. Speaking of boundaries, I think one of the action steps has got to be shoring up your personal boundaries. We talked already a little bit about this is not my circus, it's not my monkey, we need to have a good perspective and be able to leave work at work which is, again, I said this is going to be a lot about just having toxic people in general, doing your best. And I was going to say don't but it's really hard not to sometimes but do your absolute best to not let this person live rent-free in your head.

Stephanie Goss:
Yeah.

Andy Roark:
Try to set yourself up so that you go in and you do your job and you focus on the clients and you focus on the patients and you focus on the things that you enjoy and then you put those things to bed. Maybe figure out what you're leaving the clinic ritual is that lets you put your job down, put your job down and go home and do something else but do not go home and ruminate on this if you can avoid it.

Stephanie Goss:
And I think that that's so important because one of the things to remember in particular about someone who is truly narcissistic is that they are taking enjoyment and pleasure out of you ruminating on it and causing the distress and the upset. The attention, that response, that reaction is 100% what they want and so, if you have the ability to, like you said, figure out how to I'm going to leave this here and I'm going to walk away. Even if you can't, everybody gets pushed past, even hothead Stephanie gets pushed past her limits, at some point you are like, “I'm going to go take five and I'm going to walk away and I'm going to go have a breather.” I think your point about a ritual for yourself so that you can say, “Hey, I am going to walk away here and I'm going to truly try and leave this at work,” and then you get home and you're like, “Ugh, I'm still thinking about it.”
Whatever that thing is, if you need to deal with it, deal with it away from them versus in the moment where they get the satisfaction of seeing that they're getting to you. And I know that that's easier said than done because, when a bully is picking on you, you want to, it's really easy especially if you're a hothead, to always want to go into attack mode. But I love that, keeping the boundaries and letting work be at work because they're only going to get more satisfaction if they see that it is impacting you or anybody else on the team.

Andy Roark:
Yeah, I completely agree with that. I think that one of the action steps we take is refusing to suffer in silence. And you say, “But, Andy, you just said not to respond or not to react,” that is true. Also, you should not martyr yourself meaning you shouldn't be a punching bag, you shouldn't take it. Remember the people who are narcissists, they like to look good. They want to look good, they want to be the heroes which means, if you tell them, “Hey, this is not a popular position when you take it, that, when you did this, this is the impact that it had on the rest of the team,” they don't like that and you can negatively reinforce behaviors. You're not going to get this person to change their driving behavior but they want attention, they want to feel important, things like that.
And so, you can give some feedback and you can push back and you can say this is the ramifications of the behavior that you had but, when you did this, this was the outcome that it had and I would really appreciate it if you didn't do that again. And I would do it privately and not in a way that's going to get them more attention or things like that. I would be brief and I would be done, I would not give them a gossip story to go and spin to other people but I would just say, “Hey, this was not acceptable when you did it.” Remember that one of my favorite analogies, I keep pointing this out, is the relationship we have with work is just that, it's a relationship. And we have some control over how people treat us and it's not wrong to say, “Look, I'm not going to be treated this way,” and just to mean it and it doesn't have to be dramatic.
You can be a safe conversation as best as possible where we make sure that we're not triggered emotionally because we don't want this to become a big deal. It's where we try to assume good intent on the other person's part, we think about how they've been set up to fail and we think about the end result that we want to bring about. And so, it's a relationship, how are you going to be treated? And so, I think it's a healthy thing to say it's not acceptable, I am not going to be treated like this. And if you're in a workplace and you are in a relationship with your workplace where you say this is abusive, this is terrible, I feel unappreciated, I feel beaten down, then it would be the same, for me, as if you're being in relationship with a person who's unappreciative and who mistreats you and who makes you feel awful.
And I really like that analogy because I think it works quite well and so I'm not going to spend time with someone who doesn't respect me. I'm not going to be in that relationship, I'm just not. And your practice is the same way. If you say, “Boy, the feelings I'm having,” if they were coming directly from a person, “I would not have a relationship with this person. I would not engage with them, I would not be around.” Then I would say you need to make that true for yourself in this regard as well. And so, anyway, it's a healthy relationship. It's not perfection, it's not the other person reading our minds and knowing what we want, it involves us being clear about what we want, talking about our needs and our desires and sharing when things are not acceptable or when we're starting to struggle, it's having open dialogue about that and getting that from the other side as well.
And so, anyway, I put that, one, to the person meaning I'm not going to be in a relationship with someone who doesn't respect me or who treats me with disdain but then also to the practice. And at this point, we're starting to shift our conversation a little bit to the practice owner or to the management team and I am in a relationship at work which means, if I am unhappy in my relationship at work, I'm not going to not say anything and then walk away from the relationship, that's not how grownups have relationships. I'm going to communicate where I'm at and I'm going to say, “Hey, look, I got to be honest with you, the last couple of weeks have not been particularly good and I have some concerns about how things are going, I'd like to share them and see what your thoughts are.”
And that's how I talk to my wife of like, “Hey, when we went out…” We went to holiday parties and, based on previous years, we have come up with a set of ground rules where we have a signal that either of us can give which is like, “It's time to leave. The kids are done…” You know what I mean? The kids are done, this is it. But we came up with that signal based on a healthy conversation about, “Hey, I felt stranded at this party or whatever,” and it was something that worked out, the same thing. Just run your career like you're having a relationship and communicate where you're at and that means telling management what's up and then giving them some time and some grace to act.
And some people go, “Oh, well, they're not doing anything about this behavior,” and it's one of the things we always hear and you never really know what's going on behind the scenes. It might be that management is not doing anything, it might be that management is actively doing everything they can and you just don't know about it and they're not able to tell you. It's amazing to me … I think, generally, again, I'm speaking in broad generalities, I can't prove that this is true, it's rare that, when you take a problem like this to management, they are not aware of the problem in any way, shape or form.

Stephanie Goss:
Yes, yes.

Andy Roark:
Assuming good intent, I think most management teams are moving through a process of trying to either correct the behavior or they're moving through the steps of saying this person's behavior is unacceptable and they need to go away. Where they are in that process may not be where you are, you might … You going in there, if you go in and say, “I'm going to say this and then they're going to get rid of this person,” I think you're going to be disappointed, I think what's most likely is that you will maybe speed up that process that they're going through. That's my impression in most of the management interactions like this. But anyway, all that just to say they're not allowed to tell you where their head's at.

Stephanie Goss:
Yes. And I want to throw out a third thing that I wish was not as common in veterinary medicine as it is which is that we have a lot of conflict averse people in veterinary medicine. And so, from the mailbag letter here, I could hallucinate that they might be working for a practice owner who is very conflict averse, who doesn't … Because they were like, “It doesn't seem like they seem protected by this owner.” Well, a lot of times, it's not necessarily that that practice owner even likes the behavior, they might be just as hacked off about it as you and they could just be really, really conflict averse and be struggling with what do I even do and how do I deal with this. And it seems so simple to say, well, you just fire them and then everything will be fine but, to your point, nothing is ever that simple, I wish that it was, right?

Andy Roark:
Yeah.

Stephanie Goss:
As a manager myself and as someone who has been in charge of running the practice and having the weight of everybody's paychecks on my shoulder, it's not as simple as that. And so, I think part of it, to your point about it is a relationship, is going into the conversation having empathy and seeking first to understand and getting curious with your practice owner so that, when you have the conversation, just say, “Hey, I would like to understand because these are the behaviors that I'm seeing and these are the consequences that I'm seeing with the rest of the team. And I know that you care about us and I know that you want this to be a great hospital, I'm worried that it appears like you're not doing anything to protect the team and I don't think that that's actually true. So, help me understand where things stand.”
And I think that that's important for a couple of reasons. One, I think it opens the door to honesty and furthering your relationship with the practice owner which, if you really want to stay in this practice, is a good thing. Two, I think it gives them the space to say something like, “Oh, well, just so you know, I am working on things. Can't talk about it but just know that I am working on things.” And as an employee who's been on the receiving end of that conversation, that is a huge weight off of your shoulders because it lets you know that they're … Because in your head, like it or not, you're probably making up stories about what you think they're not doing.
And so, when you hear that, I've been the one to tell my team that and I've also been the one to hear that, and when you hear that, it's like, “Oh, okay, so I'm not just out on planet cuckoo and thinking that they're not doing anything about this.” You still may not like how slow it is, you still may not like what's happening or the way that it's happening but at least you know and so I think opening the door to that conversation is super, super healthy. It also opens the door for them to say maybe I don't know what to do about the situation or I don't like conflict and it opens the door to possibilities and so I would approach it from that method.
And the second reason that I would approach it from that method is because it is a relationship, and you and I talk about this a lot and I don't know if you're getting to this, but, for me, when I read this mailbag, I was like, “Oh, we're going to have the conversation about picking your poison,” because, really, if you don't control, if you're not their direct supervisor and you don't control what happens with this person, you can only do so much and, at some point, you have to decide when enough is enough and when you're going to stay and put up with the behavior, like you said, or when you're going to say I don't think it's acceptable to be treated this way, I don't want my coworkers to be treated this way and I'm going to make a change.
And so, I think that, for me, opening that door to the conversation, let me, as a team member … I remember very clearly as a young technician working with another technician who was older and was a bit toxic, I wouldn't say that they were narcissistic but they were a bit toxic, I was like, “I really love everybody else on this team and I love this practice and I feel like I would be just a quitter if I walked away and my parents didn't raise me to be a quitter.” But I was like, “I feel like I have to say something,” and saying something really made me feel like, “Oh, okay, I got the clarity I needed to know that this was a situation where the practice owner actually was not going to do something about it,” and so I didn't feel bad saying, “Okay,” and then finding another position for myself.
Because I knew that I couldn't change it but it wouldn't have necessarily felt good about making that, on a personal level, felt good about making that decision without having all that information. And so, I think going to the practice owner and having that conversation and opening that door would help me sleep better at night.

Andy Roark:
Yeah, I agree. I think the real Jedi level here, if you want to really be amazing, I think that you go back in time and you tell the practice owner, “Hey, are you aware of the Uncharted Leadership Essential Certificate that's available? It's available on VetFolio and free to Uncharted members because they have workshops in there on getting team buy-in on coaching and feedback and development and effective delegation and holding people accountable and it's this nice little eight hours of RACE CE bundle and … Anyway.” But if you had mentioned that in the past and then gotten them to take it, then they would have the tools to have these types of developmental and feedback conversations that then, when you went in and said this is not working for me, they'd be like, “I know what to do, I have the skills for this,” and then they would go and they would handle it and, voila, and everyone would celebrate you.
And I'm not saying pizza party but, if they don't throw confetti, I would be surprised at the end of this scenario.

Stephanie Goss:
I can't with you.

Andy Roark:
That's right, okay. Where you ultimately ended up, that's where I end this. You have to communicate where you are with the team, in my opinion, if you want to be here. You don't owe these people anything. You are a grown-up, you have this job, you show up, you focus, you do the job, that's all that you have agreed to. You didn't marry these people, you didn't sign a long-term contract and you don't owe them anything. I think, from a personal respect standpoint, I think telling people where I'm at, I think that just goes back to that whole relationship way of looking at our jobs which I think is healthy. And then, beyond that, never forget that you always have power. You always have the power of your presence, you always have that power and you can leave.
And at some point you have to say I am going to be unhappy in one of two ways. I am either going to be unhappy because I'm going to continue to be here or I'm going to be unhappy because I'm going to leave and one of those unhappiness is just short term and one of them is longer term. And a lot of it is trying to figure out what that … To do the math on how much pain is this. I don't want to leave and things turn around and get better, I don't want to leave the day before the toxic person, the narcissist person leaves and everybody else is like, “Whew, now things are turning around.” But at the same time, if the writing's on the wall and everybody has been up front with you about where they are and what the future's going to be like, at some point, stop putting your discomfort on them.
You've been given all the facts and so now it's up to you to decide what you're going to do with those facts and that often should be, it should be bailing out, it should be leaving and so you pick your poison. Some people really struggle with guilt, they're like, “But if I leave, the rest of the team will still have this problem.” And I get it and that is a valiant way to feel but it very much falls into the martyrdom category for me. And so, what I would say to you if you said that is, and this is tough love, let's go to camp tough love.

Stephanie Goss:
Camp tough love.

Andy Roark:
Oh, boy, roll the theme song.

Dustin Bays:
All aboard. (singing) Well it's Camp Tough Love, like drinking dish suds. See the creation of determination. Get ready for a safe talk, you might need a stress walk. That's what we do at Camp Tough Love.

Andy Roark:
This is camp tough love here. You didn't make this problem, you didn't make this problem. You didn't want this problem and you don't benefit from this problem and so this is not your responsibility. You didn't make it, you didn't want it and you don't benefit from it and so it is not your responsibility. And these people who work in your vet clinic, they're grown ass adults, they are, they don't need you to defend them. They're grown-ups.

Stephanie Goss:
Yeah, that's what I was going to say. At the end of the day, they are also grown-ups and so-

Andy Roark:
They are grown-ups.

Stephanie Goss:
… just like you get to make a choice, they can make their own choice as well.

Andy Roark:
Exactly. And again, that's camp tough love and we're just going to swing through it real fast. But some people need to hear that because they're there and they're martyring themselves and they're not in a healthy place. And so, no, you've got to put that stuff down, you have to pick your poison and decide what you're going to do and then you need to do what's going to be right for you and for your family. That's what you need to do.

Stephanie Goss:
Yeah. And the other piece, the last piece about having the conversation with the practice owner besides getting the facts that I think is really important is this person used the language in their email about feeling like the narcissist in their practice is being protected by the owner. And I think that it's really important to point out that your practice owner has a responsibility to your whole team and so it is their job to provide a safe work environment for you including a mentally and psychologically safe environment. And so, at the end of the day, you should absolve yourself of any guilt that you might feel if you were doing everything that you can and they are not providing that for you because there are so many vet practices out there that have healthy cultures and that have great teams who want people to come and join them.
So often, you and I get asked questions and I see so many people, especially on social media, who are grappling with the idea of leaving what sounds like a toxic cesspool or an abusive relationship and I just want to squeeze all of them and hug them and say, “You know what, there's so many practices out there and, yes, it might mean that you have to move or you might have a further commute and there are consequences and repercussions to every choice we make and that is true,” but I think where you and I both end is you're still picking your poison because you do still have a choice. And at the end of the day, you're choosing to stay or you're choosing to do something about it. And if you can't control the situation, if you didn't make it, you don't want it, you don't benefit from it, your choice could be to walk away.

Andy Roark:
That's what I got. That's what I would say to this person who's like, “What do I do?” Those are all my pieces of advice, yeah. You got anything else?

Stephanie Goss:
No, I don't think so.

Andy Roark:
Cool.

Stephanie Goss:
This was good, I hope it helped. I hope it helped. To our writer, if you were listening to this episode and you were like, “Ooh, hi, they're talking about my practice,” I hope that it gave you a little bit of help as well. Have a great rest of the week, everyone, and we'll hear you again here soon.

Andy Roark:
Take care, everybody.

Stephanie Goss:
Well, gang, that's a wrap on another episode of the podcast and, as always, this was so fun to dive into the mailbag and answer this question and I would really love to see more things like this come through the mailbag. If there is something that you would love to have us talk about on the podcast or a question that you are hoping that we might be able to help with, feel free to reach out and send us a message. You can always find the mailbag at the website, the address is unchartedvet.com/mailbag or you can email us at podcast@unchartedvet.com. Take care, everybody, and have a great week. We'll see you again next time.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: behavior, communication, culture, management

Dec 06 2023

Making Sure It’s Written Down: How Do We Keep Discipline Consistent Across the Practice(s)?

Dr. Erica Pounds joins Dr. Andy Roark to answer a question about if, when, and how discipline and disciplinary actions should be systematized across practices in a multi-site organization. Is it fair that some people have stricter managers than others? Should everyone in every location expect the same response if they come up short in an important way? Let's get into this!

Uncharted Veterinary Podcast · UVP-262-Making Sure It's Written Down-How Do We Keep Discipline Consistent Across The Practice(s)?

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

ABOUT OUR GUEST:

My name is Dr. Erica Pounds, and I am an Area Chief of Staff for Banfield Pet Hospital in the Tennessee Market. I graduated from Mississippi State University in 2008 with a B.S in Biochemistry and Molecular Biology and then went on to receive my DVM from the University of Tennessee College of Veterinary Medicine in 2011. I started with Banfield Pet Hospital following graduation and will be celebrating 12 years with the practice in August.

My clinical interests include dermatology, internal medicine, and of course preventive care! Throughout my career with Banfield, I have been able to grow and develop from an associate DVM to Area Chief of Staff and even spent time as Interim Director of Veterinary Quality. I have a passion for development and love being able to see my hospital teams grow and achieve their goals. On the personal side, I am the mom of 4 amazing little boys and thrive in the land of Legos, Superheroes, and Soccer! I love running Spartan races with my husband and brothers. I am a big-time quilter and my sewing room is one of my most favorite retreats.

Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

DO NOT MISS OUT ON THIS WORKSHOP:

RECRUITING AND RETAINING MILLENNIALS with Dr. Tierra Price

Did you know millennials are currently the largest generation in the US and the largest generation currently in the veterinary workforce? If you’re hiring veterinarians for your practice, you need to know how to attract and retain this pool of talent!

Dr. Tierra Price has supported practice owners in creating successful applications geared toward millennial veterinarians. This experience, combined with her own experience in her recent job search as a new graduate, has led to a compilation of factors to consider in order to recruit and retain millennials in veterinary medicine!

In her workshop, we will cover:

 ⚓ Traits that characterize the millennial generation

 ⚓ Factors millennials consider when looking for jobs

 ⚓ How to build an irresistible job offer for millennials

Live and virtual, this interactive workshop provides an engaging learning experience. Join us and close 2023 with a positive move toward hiring your next great team member!

When: December 12, 2023, 1:00 pm – 3:00 pm ET / 10:00 am – 12:00 pm PT

$99 to register, FREE for Uncharted Members.

Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Stephanie Goss:
Before we get into the episode today, I just have to say a huge thank you. I would be remiss if I didn't take 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 are all getting together in Greenville, South Carolina 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 are 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 who comes gets to meet every single other attendee that is there. We get to talk about the nitty-gritty in real time, about the challenges that we're facing as practices, the wins that we have with our teams, and really set a plan for the new year so that we can walk into 2024 set up for 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've got a lot of amazing ones, but this group, these guys, are fantastic. They stepped up in a big way and helped 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 Leader Summit and for coming to Greenville and having a good time with us.
Okay, now we can start the podcast.

Dr. Andy Roark:
Hey everybody, welcome to the Uncharted Veterinary Podcast. I'm your host, Dr. Andy Roark.
Guys, I got a special one for you today. Dr. Erica Pounds is joining me to take a question about multi-site management. So if you don't know Dr. Erica Pounds, you're about to because she is amazing. I've been working with her for a couple of years. She is an incredible leader and trainer and teacher and she came to us through one of our Uncharted corporate programs. If you have a multi-site practice, we actually do programs specifically for multi-site practices. And she came to us that way and then she sort of moved up through the programs that we've done and now she's in our Train the Trainer Program where we work with multi-site leaders to be facilitators and managers across multiple locations and to help grow and develop other doctors.
And so anyway, she just continues to excel and be just such a rock star. And so I was like, “Hey, I love your insight on these topics, specifically multi-site management. Can you come in and break this one down with me and let's give Stephanie Goss a break?” And she did, and, boy, she crushed it. So anyway, this is a great episode. If you have ever wondered about managing multiple hospitals and kind of keeping them on the same page, you're going to really like this episode. So without further ado, let's get into it.

Speaker 3:
And now the Uncharted Podcast.

Dr. Andy Roark:
Welcome to the Podcast, Dr. Erica Pounds. How are you?

Dr. Erica Pounds:
I'm good, how are you?

Dr. Andy Roark:
I am so good. Thanks for coming on and doing this with me. I really appreciate your time. For those who don't know you, you are an Area Chief of Staff with Banfield. You have a passion for training and educating in leadership and communication. You and I have worked together for about three years now.

Dr. Erica Pounds:
I know.

Dr. Andy Roark:
Through one of our corporate programs that we have at Uncharted. And so you have been my wingman in a number of workshops and lectures and I just admire you. And I had a question that came into our mailbag that I thought, “I think Erica would be really insightful in this question.” And so I wanted to pull you in. Is that okay?

Dr. Erica Pounds:
Yeah, that sounds great. I'm super excited.

Dr. Andy Roark:
Awesome. So the question that came in was about consistent discipline across supervisors. So the question that was, it was from a manager, and this manager is part of a multi-site practice, so they've got a number of locations. And it seems like they're, again, this is me kind of reading between the lines in the question, it seemed like they're sort of a fairly young corporation that's got a couple of different locations, and there's starting to be a push inside their organization for consistency in discipline across locations.
So imagine that you've got, let's make it easy, I'm just going to say three locations, which is probably much smaller, but it's easy enough to hold in our minds to kind of work with. So imagine you've got three locations. And you're starting to get some pushback in one location where they say, “Well, you guys are much stricter on us over here and over at the other location they're getting away with a lot more. And we think that there should be consistency in how people get in trouble.” And so the question that came in is, “Is this a thing? Should we do this? How do we do this? What does this even look like?”
And so that's kind of the question that was asked. So let me just pause here for a second and kind put that to you and say when you hear this question, what are your first thoughts? I mean how many hospitals do you oversee right now?

Dr. Erica Pounds:
Yeah, so right now, just as we just recently moved, I'm down to one, but I've had as many as four at a time.

Dr. Andy Roark:
Okay.

Dr. Erica Pounds:
So three is a very real number that a lot of people in our position work with and this is very much a thing. Certainly as you move hospitals and you're coming in as that brand new leader to that location, you could deal with those differing opinions about the way in which maybe your previous leader led. Or if they know your other hospital locations to that point, “Well over there, that's not a thing. So why are you being so strict over here?”

Dr. Andy Roark:
Yeah. No, I think you're right. I hadn't really thought about a leader coming in, because way the question was framed up was this is something. Again, I suspect these were practices that were acquired and are kind of coming together underneath an umbrella, but the idea of, “Our last boss, our last manager, treated us this way and now here you are and I bet the other managers don't treat us or don't push this hard, they're not so strict or whatever.” I think all of that makes sense.
Let's start it at a headspace standpoint and just say, “Okay, we're starting to get some questions that people are saying, ‘Hey, why aren't we more consistent?'” And again, it's funny because this is specifically about discipline. It's like “When we get in trouble here, it's different than we get in trouble over there or we feel like we get in trouble faster or things like that.” So yeah, let's go ahead. When you start to just look at this and you're a leader coming in and somebody says to you, “Erica, we're thinking about trying to standardize discipline across our hospitals.” Where do you start from a headspace?

Dr. Erica Pounds:
Yeah, so I think kind of in two different camps. So I think that there's the systems piece of how in the world do we actually do this? What's our process? What does it look like from the step one all the way through to an end point? And then I think there's the people piece. So not only is it going to be the leader and individual that you're going to be having this conversation with, but it also has to do with the team's perception of how accountability is handled within the practice.
And I think a lot of times the team's perception around accountability really becomes a make it or break it as far as the culture around what that looks like and whether or not people are going to perceive these conversations as punitive and truly disciplinary or if they're going to take on, “This is because this leader wants me to grow. And right now there is something that is standing in my way of reaching my full potential and I have an opportunity to be able to course correct.” And so I think that really is where I center on with that discussion.

Dr. Andy Roark:
Okay. I love this. I think 100% from headspace there's something about accountability here we want to unpack. You put your finger on a little bit of it too. I think, and again, I don't want to be critical at all here, but when people start saying, “What is our disciplinary process?” My first thought is, “How often are you disciplining people? How big a deal is this?” As opposed to, “Hey, we've got some opportunity for improvement here. And we're going to work on your development plan.” And that framing of the issue, it may sound silly where there's a way of saying, when my kids make a mistake and they drop the ball, let's just say that my youngest daughter who's about to get her driver's license just blows curfew. She can get in trouble and be penalized or we could talk to her about a learning opportunity and a potential for growth and those things are often rolled together. But everybody can tell the difference in tone and how the culture feels when people are concerned about getting in trouble and other people getting in trouble versus being held accountable and how we grow and develop and push for improvement.
That's the first thing that gets into my head a little bit. I think it's really interesting, we started talking about their feelings about accountability, and I think that there's probably a diagnostic piece there first to be like, “Okay, where is this really coming from?” And just things that pop up into my head immediately, it's funny. There's people who they're worried about them getting in trouble and then they're also worried about other people getting away with stuff that they don't get away with. And I'm like, “What are we talking about here? Are you worried that the other practices are not applying themselves like you are? That they're on easy street and you're not? Is it that you feel like you're being held to a standard the other practices are not being held to? And what does that look like and what does that mean?”
And I think one of the first things you really have to do is try to get into this a little bit because, especially when you have multiple locations, people want to speak in big generalities. Like, “We need to hold people accountable.” And I go, “What exactly are we talking about here?” Because otherwise it's all theoretical hand waving of accountability and go, “What exactly is it? Was there a case where some person was written up for a behavior in another place? It happens all the time and nobody says anything. Is that what we're talking about?” Because I would say that the problems may not be consistency and discipline, but rather consistency in performance of those hospitals. I think you have hospitals that are not performing the same. And then the discipline will take care of itself if we fix the performance issue.
So there's a lot of stuff like that around where I'm like, “Be wary of going straight down to how do we punish people?” I just think that that's just dark bloody business. And then the other part is like, “What are we really talking about here?” I think it's also from a leader standpoint, I think another part of my headspace would be, just to throw this out at the very beginning, is the empathy component of, “Where's this coming from and how are they feeling?”
Fairness is a big deal for a lot of people and it would be very easy to look at this and say, “Well, this is just kind of silly. This person got in trouble here and this person just didn't get in so much trouble.” But the truth is there's a bunch of backstory here and the circumstances were all a bit different. And so this is just silly. And I go, “Well, perception of fairness to your point is really important.” And if the perception is that these hospitals are not the same and they're not being treated the same, that can affect people at an emotional level, that can make them sort of abandon rationality. And you end up with an absolute mutiny over nothing except people's feelings. And so I think you got to manage that.

Dr. Erica Pounds:
Yeah, for sure. Because the fairness perspective, again, I think we use our kids a lot as examples. And my oldest, he is a firstborn through and through, so his feelings of what is fair, what is just, is oh my stars. And I have to use that logic sometimes with the teams that I oversee because, again, you're going to have some people that you're never going to hear anything out of them. If they have a team member that perhaps is not carrying their weight one day, you'll never hear anything out of them. They're just going to do it, and potentially when you talk to them, they are going to do what we hope that everyone would do, is assuming that positive intent, that person did not wake up that day and say, “I'm just going to suck at my job today and make everyone's life miserable.” But they're like, “Something's going on with my teammate. I'm going to pick up the slack. It's okay.”
And then you're going to have the others that are like, “This is absolutely not fair. If I'm doing all of these things, why is this person not? And what are you going to do about it?” And they don't take the time to go, “Is there something more going on here?” Because oftentimes when you get into these conversations with the team, you end up finding out that there's something else that is driving the behavior response. They again, most people do not just say, “I'm just not going to do that because I don't feel like it.” There's often is it that they, did we check for understanding? Do they even understand their job role? Do they even understand what we're asking them to do? Do they have the ability to do what we ask them to do? There's so many things that you have to unpack when somebody is either not doing what we ask them to do or just failing to execute on performance.
But for the team, do they have the skill to be able to have that conversation or do they need to? No, but us as leaders, we're here to help manage that so that we can say, “It is going to be fair. We are going to be fair and mutual across the board when it comes to accountability conversations. And this is the way that this is going to look.”

Dr. Andy Roark:
Yeah. No, I think that that's really important. I want to go back to, you mentioned the team's perception of accountability. I think that's really important is there should be some consistency. Also, managing perception is often different from fixing a problem. It's like the way that they think about it or the way that they perceive it, it may not be accurate. And that happens a lot. There's a lot of people who are like, “Oh, that person gets away with everything.” And the truth is they don't. Or especially across hospitals, there's a lot of storytelling that gets done.

Dr. Erica Pounds:
So much.

Dr. Andy Roark:
It's like, “You're not there. You didn't see what happened. You invented details that were not true.” There's just so much of that. And I think one of the frustrating truths of leadership is, especially across multiple facilities, is you want to, and in a way you're right, but you want to say, “It's not your problem what happens over there and it's not your business.”
And that's true. And if you say that they will often continue to tell themselves stories and wind this up and you're going to end up with a massive human issue that you have to deal with, that my very logical people absolutely struggle with. They're like, “None of this makes sense. It's not their business.” It's like, “All of that's true. Do you want to be right or do you want to be effective?” Because you can be right and just hold what you got. Or you can be effective and figure out how to wade into this and help adjust perspective so that people can feel okay and kind of see more that this is not radically different.
I wanted to go back to the first thing that you said when you talked about the systems piece. And this is the thing that I'm really interested to hear from you on because I've wrestled with this for a long time. Okay, so let me lay out a thesis and I want you to punch it full of holes. Okay? All right.
I believe that in management, especially across multiple locations, we all want control. And as you add more people, and especially as you add more locations, your level of control, of direct control, it keeps going down. You're less of the sailor with this tiny little sailboat where you can grab all the ropes and more of this admiral of a fleet and there's multiple boats going different ways. You know what I mean? And they take longer to turn by far and just the immediate control you have just goes down less and less and less, as far as being able to grab the wheel and turn things. So I think a lot of people have that experience. And when people have that experience, there are forces, there are business gurus, there are consultants, there's just probably our innate desire to have control that say, “We need more systems. You need protocols. You need more rules because I'm losing control and I need to keep control, so I want to make more rules.” And when I say rules, I'm talking about protocols and checklists and things like that.
And they go that way, and of course if you are expanding and you're not adding in systems and you're not adding in protocols, you are setting yourself up for absolute disaster. But my thesis comes in here where I say, at some level you can go too far with systems and protocols. When you get down to the place where there is a protocol for someone to ask a question at a staff meeting, I'm like, “Do we really need to go that far down the order hole? Do we need that level?” Or can we just at some point say, “You know what? We've got systems that get us 90% of the way and then 10% of the way we're going to let people be autonomous. We're going to hire smart people. We're going to talk to them about why we're doing what we're doing. And we're going to let them make choices and have some flexibility on the ground to accommodate the specific people they're managing, their clientele, the way that they want to work, what they think is important, what their values are, what their vision is and stuff like that.”
So, yeah, that's kind of where I've gone over time is the push towards rules is interesting and the protocols is interesting and I think at the macro level it's good. But I do think that there is a tipping point where we start to make things, we take away people's freedom to make calls on the ground based on the nuance of the situation and who's involved and what their strengths are and what wishes and desires of the people they're managing are. I think we take that away.
The other part is, I think it's sort of funny is, when people are talking about managing other people, they're very pro rules. They're like, “Yep, we should have rules.” But when they themselves are being managed.

Dr. Erica Pounds:
They do not want those rules.

Dr. Andy Roark:
They do not want endless rules because then that's being micromanaged, right? I remember doctors, when we first started to see corporate medicine or multi-site practices and stuff in vet medicine, boy, the doctors really raged against what was called cookbook medicine and “Don't tell me how to do it. I don't want to follow this recipe.” And it was a strong pushback of, “Don't take away my autonomy,” is really what it was. And so I feel that from a management standpoint on some degrees of you can have some consistency, but I do think if you ever got to a point where everything was written down in a protocol form, that would be a miserable place to work work and people would hate it. So all right, that's my thesis. Shoot it full of holes. Am I right? Am I off? Where does this break down?

Dr. Erica Pounds:
Yeah, so I think for the vast part of that, you're spot on. Because, as leaders, and we could all think of times like this, where maybe you're not getting the potential outcome that perhaps your line managers or those that you're reporting to are wanting, and so here comes a way to track your progress and a way to do this and a way to do that and a way to do this and a way to do that.
And we're not all the same. To your point, the nuances within a hospital context as you're leading them is going to look different. There have been so many times where I will have hospitals that are on polar opposite ends of the spectrum. This one is struggling with this while this one is a player and vice versa. And so if I sit here and I just say, “I'm going to do the exact same thing in both hospitals.” Well I'm going to get nowhere because the people that are doing well on this hand now feel micromanaged, and the people that are over here, again, they might not have the skill or ability or understand what I'm even asking them to do because their contexts are so different. And so with leaders, I think that there is a balance in which you can have enough of a structure and enough of a system that you know here's step one to step two, to step three, to step four. However, you're given the freedom and the ability to lead the way that you need to lead for your hospitals.
There have been times before where I might be in a situation and I'm like, “Well, I could proceed boom, boom, boom, boom. Step 1, 2, 3. And we're going to go straight through. I do not think that that is the right call here.” Because if I'm leading my people well and I know what is going on with them, I know what their motivators are, I know what is disengaging to them. When I really take that holistic picture into this, is going straight through a disciplinary action protocol just like it is on paper, is that the right call? Or is this an opportunity for me to do a very, very, very, very important step here, which is to take partnership and manage up to those that you report to of, “Hey, here is the situation. As I take this all into perspective, this is how I want to handle this situation and these are the outcomes that I am looking for in this timeframe. If that doesn't happen, absolutely we're going to check and adjust and we're going to dial it back, but I really feel, as I'm leading in this context, this is the way that we need to go.”

Dr. Andy Roark:
Yeah. Okay. So let me say this back to you, and again, we're still sort of in a headspace and really right now we're sort of talking about management across multiple hospitals, which I always think it's interesting.
So would you agree that when we start getting into action steps here, I think that there's more about management of hospital leadership in individual locations then there is about management from the manager down to the staff below. And so what I'm saying is this, I'm completely in agreement with you here. You started talking about objectives and you say, “Okay, great. So let's say that I'm the practice manager, I'm the medical director, in one of these hospitals.” There's a situation. I'm going to communicate up, “Hey, this is how I plan to handle this and these are the outcomes that I'm looking for.” And I think the outcomes that I'm looking for are absolutely really critical because when we start talking about standardizing disciplinary actions, we're talking about processes, and standardizing processes, and there's no flexibility there at all.
I am a much bigger fan, and this is kind of where I'm going to go when we get into action steps a bit more of saying, “What is the outcomes that we're trying to achieve and then how do we manage those outcomes? And if a practice is not getting those outcomes, we need to lean on the leadership in that practice so we need to support those people, we need to make sure that they have clear expectations of what's going on.
So for example, let's say that in Hospital A people get penalized pretty harshly if they don't show up for work or they show up late for work. But at Hospital B, they don't seem to get penalized for showing up late for work and it's much more lackadaisical. And the people in Hospital A are frustrated with that. I get that. I'm not convinced that making a formal process that says, “Hospital A has got to write up people if they're late, no ifs, ands, or buts.” I think the actual play is to go to Hospital A and say, “Hey, we're looking at these metrics which are absenteeism, it's tardiness, it's things like that. And you guys are really winding this up in a way that we don't have at our other hospitals. What's the plan for getting this back on track?”
And then I can say to the people at the other hospital who are starting to complain and say, “Hey, you know what? This is being addressed. I don't know how they found out that this was actually a systemic problem, but if they did, this is being addressed. We're going to work on it.” But I would push back and say, “I don't think that standardizing discipline for people who are late is the answer.” I think it's talking to hospital leadership and saying, “Great. This is where we are with our other practice. You can see that you're a significant outlier here. You guys know your team, you know how you lead, you know what your styles are. I don't really care how you do it. I just need you to come in line with the other practices. Let's work together and come up with a plan. And you can think about it, come back. I'll think about it. We'll come together. I'll try to support you.” But I think that's how your regional leadership supports your practice leadership there. But I don't know, does that track with where you were going?

Dr. Erica Pounds:
Yeah, absolutely. Because I think the biggest part of any conversation, whether you're talking to a whole hospital unit or whether you're talking on that individual basis, if you just go in and you're like, “You're not meeting this performance standard.” And again, that could be a whole spectrum of things from showing up for work on time to performance operations, but if you just go in and you're like, “You're not meeting this. This is what we're doing. You're getting written up,” and all that. That's not going to necessarily give you the outcome. Now they're doing it out of fear versus really understanding and having this belief in what you are trying to accomplish.
And so if we miss the checking for understanding point, if we do not go in from a curiosity state and say, “Hey, I noticed XYZ. I'd love for you to just say a little bit more about what's going on.” There's so much power in say more and then just sit back. Because that is often where then that human aspect, now we get the context, now we get the backstory, now we're understanding what's driving the behavior. And then we can solve for that. If we're solving sheerly off of some type of number or some type of goal, we run the risk of getting it completely wrong, disengaging the individual and the process, having the team thinking that we're not following up on anything, and here we are in a muteness situation where we have now zero control because it's just gone off the rails.

Dr. Andy Roark:
Yeah. No, I like that a lot too. And I think you're also spot on about how we motivate. I've heard the quote, and I can't remember where it was, but it's basically like, “If you motivate someone with fear of getting in trouble, they're going to do just enough to not get in trouble.” They're going to check that box to avoid the punishment and they're going to go on. And if we go in and we talk to them about what we're trying to accomplish and we try to get them to buy into where we're going and motivate and praise and positively reinforce and celebrate, we can get them to go above and beyond that.
All right, I want to square this sort of headspace with you a little bit because I like your position on measuring and overusing those sort of numbers of measurement. So I think when I look at this and we're about to go into action steps here, but when we start talking about our action steps, to me part of it's got to be, what are we trying to accomplish? And so do you think that when we say, “Okay, what are we trying to accomplish in this hospital?” How critical are setting objectives and measurements for that?
So for example, we talked about tardiness. And that's an easy one. You just look at when people clock in and when they're supposed to clock in and you can figure out a tardiness rate or measure, whatever. But when we're talking about providing the client experience, if we're surveying our clients and we're getting client feedback, that's something. When we talk about having a good staff culture, if we're doing employee engagement surveys to see how engaged people are, I think that's good. And then we also look at our retention. But I think that looking at numbers like that to say, “Okay, we've got lower engagement at this location. We've got lower retention at this location.” I don't know that going in and standardizing punitive behaviors inside that location is going to be nearly as effective as saying, “All right, what's going on holistically? And let's look at this.” But I still think that those measurements are really important. Do you line up with that or do you think I'm overstating the importance of these metrics?

Dr. Erica Pounds:
No, I think they're incredibly important. And the hard thing is, is that we are constantly, especially as medical leaders but operational leaders too, but as medical leaders, we are always walking this tightrope and this balance line of discussing a metric or a number or a measure, versus a lot of times the medical team, you will hear them often say, “Oh, all you talk about is numbers, blah blah, blah.” And they will all of a sudden hackles up and they can't hear anything that you say because, “Here we are. You're just measuring where we are again, and you're not looking at other things. It's just our ability to hit a metric.”
And I think that the way in which I use this with my doctors all of the time, and I think we use this with the outcomes that we'll talk about in the action steps with this too, you can use it in the same token. How do I know that a patient is healthy? As a doctor? Well, I do an exam. We're observing the team. We're taking in the information and all the things. And then I'm going to do diagnostics to back up my assessment and to help me know that I'm right. And those diagnostics are going to be lab work, they're going to be a fecal exam, urinalysis, so on and so forth. And guess what? All of those are numbers. And those numbers are super important indicators to me to let me know the health of that patient or where I need to press in.
And so the same thing goes when we are looking at metrics and measures and the way in which we help to translate that to the team. How do I know that our team is healthy? Well, if I never ask you an engagement question, I'm sheerly going off of the way that I feel, but I have nothing to actually validate that and say, “We're a very healthy, highly functioning team.” We could say that to kingdom come, but if we can't back it up, then again, how do we actually know?
And so I think a big piece that I think we'll hit on in a little bit for the team is this perception of follow-up. If you're going to hold somebody accountable, how do we know that you held them accountable? Do you actually see the follow-up? And so I think when we're talking with the teams as well of the overarching theme of disciplinary or accountability conversations, the measure point afterwards is the way in which we know that we even make any movement forward. Otherwise we're just going to sit and spin our wheels. So I do think the measures play a huge role in how effective these conversations are.

Dr. Andy Roark:
All right. I like this a lot. I think you're laying this out really nicely. Let's take a quick break and then we're going to come back and let's just get into our action steps. And I know we're sort of talking in general terms of how do we set this up, but I think you and I have kind of laid out where we're coming down and it's going to be a balance of some accountability work, but it's a balance is going to be of systems and then also asking people questions that's going to give them some autonomy to fix what's inside their own specific clinic. So let's take a break and we'll come back.

Stephanie Goss:
Hey, friends. What are you doing on Tuesday, December 12th from 1:00 to 3:00 PM Eastern? So that would be 10:00 to 12:00 Pacific. If your answer was nothing or taking my lunch break or having a few minutes of free time or you would like to join in an awesome webinar that we are hosting, well, you should head over to unchartedvet.com/events because we have the wonderful and amazingly talented Dr. Tierra Price joining us. For those of you who have not had the pleasure, Tierra is a all around wonderful human being. She is a practicing veterinarian. She is the founder of Black DVM Network and she is a superpower dynamo in veterinary medicine and she's going to lead another workshop for us. She did a keynote for us and is very impressive as a speaker and I'm super excited about this one because she is going to come talk about recruiting and retaining Millennials and Gen Z.
And so if any of you are hiring right now, and most of us probably put our hands up because who isn't, most of us are drawing from a talent pool that includes a lot of Millennials and Gen Z as they make their way into the workforce. And so I think it is really really important for us to talk about this topic and Tierra is going to bring it together for us before we're done with the year. So if you don't have anything on your calendar, add that right now and you can do it by heading over to unchartedvet.com/events and signing up. It's free, as always, to our Uncharted members and if you're not currently a community member, it's $99 for the workshop and we would love to see you there. And now back to the podcast.

Dr. Andy Roark:
All right, so I think this has been really good headspace. I like our thought patterns here. I think we've both sort of laid out concerns we have about going straight to disciplinary standardization versus other things. So we've laid all these things out and we've walked one way and then back the other way and I think we circled around and made this sufficiently muddy to bring across the nuance of the situation.
All right, so let's go ahead and start to talk about what we actually do from action steps. And so for me, I'm going to start with one that I always start with is clear expectations. I think if you don't communicate clear expectations to the leadership in the practice, in this individual practice of, “This is what we care about. And this is what's important. And these are the behavior standards of the staff that we expect. And this is how we expect our practice to run. And this is the experience that we expect to treat our clients with,” I think you're setting them up for failure.
And that may sound silly or redundant, but I see that a lot, especially when you have practices that are established that have come together under an umbrella. And I understand wanting to give those groups autonomy, but if you bring them in and say we're going to give them autonomy and we don't communicate expectations for them to strive toward, one, we can demotivate those people because hey don't know what they're supposed to do and they're kind of feeling lost. And then the other thing is we can make them really, really frustrated because all of a sudden we're coming down and saying, “Well, you're not holding people accountable for these things.” And they say, “I never knew that was a thing.”
I remember early in my career I was a brand new veterinarian, brand new veterinarian, and I ended up working at this startup satellite clinic and it was just me and a technician. And then we were out there for a couple of weeks on and off and all of a sudden I get kind of brought in and they're like, “Roark, you have not set up the surgery suite in this way and you haven't done these other things.” And this was all absolute news to me. And they were like, “Also, the technician has failed to do these things.” And I remember saying, “I'm sorry, am I her boss?” They were like, “No, you're not her boss, but you are being held accountable for these performance things,” that were news to me. I just remember how frustrated I was to say, “Look, you sent me out there to take care of the clients and I did. These other operational organizational things, they were never communicated to me, and now I'm being taken to task over them.”
So anyway, for me, it's just you got to figure out what is our clear expectations? What are we trying to accomplish overall? And is everybody on board with that and are they all communicating that? Because honestly, a lot of times if we can just communicate clear expectations, that's to the management, that's from the management down to the team, clear expectations oftentimes they make a lot of the disciplinary stuff go away because people go, “Oh, that's important and I didn't know it was important.” So anyway, that's where I'd start.

Dr. Erica Pounds:
Yeah, absolutely. Because the expectation piece, if they don't know what you're asking them to do, then how can you expect to hold them accountable to something that they had no clue about? And to your point, it was incredibly disengaging when they were like, “Hey, why aren't you doing these things?” And you're like, “Because I didn't know. No one ever had that conversation with me.” And so obviously this is a piece where we can get this wrong. And this is a spot where we as leaders have to really press into that vulnerability piece to say, “Guys, I messed this up. I got this a little wrong. Let's dial this back a little bit because I would like to reset some expectations.” So if you've already traveled down this path a little bit and you're not really getting the results that you need, this is the point where you can be like, “It's okay, I can dial it back.” Because we're all going to do that at some point in time across laying down expectations.
I think too, this is another really good place to really help the team to understand what is being accomplished when you're having to have these follow-up conversations. Again, if we're coming from a place of disciplinary action, disciplinary action will always evoke this negative kind of connotation and, “This seems punitive and I'm going to get punished and I'm in trouble,” and all of these things. And that can set up that space where, “This is not a psychologically safe environment anymore. If I'm so fearful that I'm going to get written up about something, if I make a mistake, am I going to come forward and say, ‘Hey, my bad. I messed this up.' Or am I going to be so fearful that that's going to result in me getting written up that I'm going to say nothing?” And that is not a good space to live in.
So really helping the team to understand as you lay down these expectations, “When we're talking about accountability, this is because we care about each other as a team. I care about you as your leader. I care enough to have a difficult conversation with you so that you can grow and achieve your highest potential. This is all because I care about you.” And I think in every single conversation that I have, if it's small or if it's something larger, I always lead with that. “Hey, we're going to chat today. I'm going to give you some feedback. Always, know that as I give you this feedback, this is coming from a place of caring. I care about you and I want to check in because I'm seeing X, Y, and Z happen. Can you share a little bit about what's going on?”
And creating that space for them to be then able to talk. And I think as we set the expectations, if we can lay that as the groundwork of, “This is how our practice is going to function around accountability,” I think that then that will help to open up that feeling of grace from the team of like, “This is a safe space to grow.” Even if it's a tough conversation.

Dr. Andy Roark:
Well, You did so many things in that beautifully. So I love the phrasing. I love the word choice. I love the psychological safety of, “Tet's talk about this.” I think that that dove tails into the next step for me, which is the shift in focus a little bit to outcomes. And so what it means is I like to try to figure out how to move away from being punitive and more developmental. Meaning, without knowing specific behaviors it's hard to lay this down and say, “This is the outcome I would look for.” But basically, what are we trying to accomplish, what is our mission, and where are we trying to go? And then what I would say is, “How is this behavior detrimental to the outcome that we're trying to achieve?”
And let me be really clear here, and you and I sort of touched on this a little bit earlier in the first half I think, is people do not want to hear about their revenue generation numbers. That's not an outcome I'm talking about. They don't want to hear about it. They don't care about it. If absenteeism is causing us to have high wait times and our clients, they're just waiting. If our staff is feeling burned out and stressed and doctors are working through lunch and we're having to really watch people to make sure they get their lunch breaks and things and push them out the door, those are the outcomes that I'm going to focus on rather than, “Hey, you really screwed up.” It's, “Hey, these things are really important and we need to make these things happen going forward.”
And so a lot of times, again, I really like to push things into the future tense as opposed to the past tense. So when we talk about discipline, we're talking about how you messed up yesterday versus development is, “Hey, what are we going to do different in the future to make sure this doesn't happen?” And then if it continues to happen, ultimately we may have to have disciplinary conversations, but it's going to be, “Hey, if we have disciplinary conversations, it will be because we've talked about this a number of times and your behavior's not changing and we are not accomplishing this thing that's really important to us.”
And so anyway, it's just a way of starting to frame that up, but starting to switch to the outcomes. What are we trying to accomplish? And then make sure that your clinic leadership knows what the outcomes are that you're trying to accomplish, and then make sure that the staff knows, and that they know it and it's framed in a way that they know, “This is about providing great healthcare. This is about having a great culture and taking care of each other and taking care of patients.” And so getting those outcomes out there where everybody can see them and see how behaviors interface with those outcomes, I think that that's really important.

Dr. Erica Pounds:
I think that sometimes the hard ones will be for our intangible outcomes, so to speak. So I don't know how many times we have all as leaders, and the conversation is not necessarily about somebody's quantifiable performance, but it has to do with their attitude, and it has to do perhaps with the way in which they're interacting with the team. So it becomes this interpersonal dynamic that sometimes is causing breakdowns, then inefficiency and communication and the success towards the day. And I think a lot of times as we are trying to provide accountability and coaching and development in those situations, being able to try to work with that individual to say, “This is the situation. This is what we have seen. How are you feeling about that?” And then also really involving them in the process of like, “If we were to work on this for the next two weeks, what does success look like to you?” When we don't have that quantifiable measure, how are we going to know that we even got anywhere?
I think a lot of times I think about doctors that get very stressed in surgery and the teams will say, “This doctor, they are being so mean to me. They're not talking to me.” And it's all about their perception of maybe the doctor's tone as they're directing at that time and these kinds of things. And when you really drill that down, the doctor is not meaning to be that way towards the team. They just have other things on their mind. But we still have to address this situation. And so sometimes it's those outcomes and those action steps for this individual of how do we signpost for the team? How do we engage them in a conversation to say, “Hey, this is nothing to do with you guys today. I just need to stay a little focused right now and then we'll be able to kind of move on.” Because I find that often when I am trying to have conversations, the quantifiable measures and the quantifiable performance outcomes, those are the easy conversations. The hard ones are the people piece and the interpersonal dynamics.

Dr. Andy Roark:
Yeah, I agree with that. I think those are also really hard to put disciplinary actions around. As much as I would like for people to get in trouble for not getting along, that is an absolute quagmire to get bogged down in. It very quickly turns into the old, “The beatings will continue until morale improves.”

Dr. Erica Pounds:
Yes.

Dr. Andy Roark:
And it just goes right to that. And again, trust me, I get it. Emotionally, I get it. It's so frustrating when you're trying to balance, again, interpersonal stuff. And punishment is a very hard tool to use in this regard. You can lean into giving people feedback and you can have conversations and you can look for patterns of behaviors and you can start to call things out in a nice and supportive way. And then measure progress, I think is where we were getting to, is starting to watch how we're doing. And if we continue to fall back and we're saying, “Hey, I don't know what happened. I wasn't there. You've told me what happened. But we talked about this two weeks ago about you and Michael not getting along. And now here we are again with you and Michael having these problems. And the problem doesn't seem to be getting better and we're going to need to start making some adjustments.”
We've got to be able to have those, as you said, the signposts of, how is it going, where are we going from here, and things like that. I still, I'm a big believer that you've got to give leaders on the ground some autonomy to fix the problem. And you can only build protocols and systems that go so far down before they really start to become handcuffs that take people's enjoyment away and also that don't account for nuance and just become things that people fight about. So I think that's a big part of it. And so I would go from there, I think, and this is where I would really start to look at this issue, I think a lot is, we need to be having a good relationship from above with our site managers and having expectations for them and then having accountability conversations with them.
And when I say accountability, again, I don't want to go back to the idea that the manager should get in trouble because their people aren't doing what they're supposed to be doing. It's what are we trying to talk about? Does this person have a clear view of what success looks like? Do they know how they're doing and how they're performing? Do they understand the strengths of their team? Do they understand the weaknesses of their team? Do they have support that they need to try to address the weaknesses? Because a lot of us don't know. We struggle in this area and it's probably something that I'm not innately good at, which is why I don't know exactly how to fix it. I don't think there's any shame in that. That's just being a human being and recognizing that we've all got different strengths and skill sets.
I mean, there's people that you could bring into your practice who would immediately look at your systems and your protocols and say, “Oh, we can fix this and this and this.” And I'm not that guy. But I can wade into a practice where people are arguing, we've got some interpersonal stuff, we have a sense of people are unengaged or they're detached and I can bring them back and get them excited about the work and I can generally kind of push them into getting to work together and come together as a group. But I'm not your operations guy and if you've got an operations problem, you may have to support me in that because that's not my natural strength or skill set.

Dr. Erica Pounds:
I think that that's the hard part right, though, for us as leaders is you do have to get to that point of being comfortable. To your point, there's no shame in saying, “Hey, this is a space that I don't feel that natural tendency to be able to lead in. I feel uncomfortable in these situations.” And being able to go ahead and reach out for help. I mean, quite honestly, we joke about this all of the time, my husband and I, because in my personal life I will avoid conflict like the plague. Like, “Nope. Absolutely not. Let me walk away. They can just chill out. It's okay. I'll come back later.” But I will avoid conflict. At work, I'm like, “Hey, everything cool? I feel like something's going on here. Let's go ahead and chat about it.”
And my husband all the time, if he comes by to pick me up for lunch or something like that, there's been a couple of times where he has observed the, “Hey, what's going on?” And he was like, “Who is this person?” And I'm like, “Well, the thing is is that that was something that when I was a leader early on, I really had to work on getting comfortable with the uncomfortable, getting comfortable to have that difficult conversation.” But again, as we've talked about many times during this conversation, my viewpoint and my vantage point going into these conversations as a manager is key to the way in which I'm going to feel in that situation.
If I'm going in saying that I'm going to have to get somebody in trouble, I'm going to struggle really, really hard because that conflict aversion is going to come out some kind of fierce. However, if I go in and I'm like, “this is because I care about you. This is for your development. I see something in you and we need to hone it and we need to refine it, and this is how we're going to do this together,” all of the sudden that's my space that I'm comfortable in and I can have that conversation and I can help them and we can get to the outcomes that we need to.
So for me, that was a huge thing of this is not a space that I feel comfortable in. This is not a space that I feel good in. But I was able to say, “Hey, I need help with this,” and have been able to work on it. And again, that vantage point of going into the conversation is going to have a huge impact on how the conversation goes.

Dr. Andy Roark:
I just want to give you an amen. You just spoke directly to my experience as well. It's exact same thing. I don't like conflict. I like to be popular, with my team, and I want them to like me and to working for me, and that means a lot to me. And I feel like they don't like working for me? That's a hard burden for me. I don't handle that well. And so I also, I struggled so much with holding people accountable until I was able to frame it in my mind as, “I'm helping you, because if I don't say something to you, this behavior's going to continue because no one's going to say anything and you're going to keep doing it. And it's probably going to get worse and ultimately you're going to end up getting fired, or this place is going to become a toxic swamp and we're going to continue to fail and there's going to be this other punishments that come down or these negative repercussions or the clients are going to be upset and then I'm going to have to deal with them.”
But ultimately I came to the place where you sort of pick your poison. Do you say something which is uncomfortable or do you not say something? And I guess part of it was just the experience of saying, “Oh, I now know what that path looks like and it is equally bad or generally worse.” But I really love the way that you frame it. You're exactly right. In my mind when I give someone feedback, it's because I care about them and I'm trying to help them and I'm trying to move them forward. And if I had to frame it in my own mind of I'm going to have to punish this person. I really don't want to do that. And I would also really struggle with that. It would take a lot of enjoyment out of it for me.
And here's the other thing too, is I don't know how to say to somebody, “Hey, I'm saying this to you because I care about you. And also can you sign this piece of paper that says that you accept the terms of this reprimand or whatever?” It kills so much of what I'm trying to build as far as a good work culture. So anyway, I am right there with you. I really love it.
The last thing I'll tell you, I had this really wonderful conversation over the weekend. And I asked a very thoughtful veterinarian who lives in California and she's so successful and she's just so wonderful. And we were hanging out together. It was sort of a retreat that we did. And there's a number of us there. And I asked her, ‘Do you think that people change?” I said, “Do you think that people change?” And she thought about it for a while and she said, “No.” She said, “I think that you are who you are. You are the person that you were when you were a child. However, we learn how to show up differently in different situations and at different times in our life. So in your essence, you are the same person you've always been, but you do learn how to show up. And the way that you show up can change depending on who you're with and what you're doing and where you are.”
And so when you were telling the story of being conflict averse, but then when you're there, you say, “Hey, can we talk about this?” I say, “You, Erica Pounds, are the same person you always have been, but you have learned how to show up in this role in a way that's effective and it works.” And so I just wanted to call that out because I think a lot of people see themselves as leaders or managers and they say, “Man, this is not who I am. I really struggle with this.” And I would say, ` And I don't know, that really spoke to me. So I thought it was really great.
Any way, Dr. Erica Pounds, thank you so much for being here. You are amazing. I really appreciate you talking through all this with me. Guys, everybody else, thanks for tuning in and listening. I hope you got something out out of it. Take care of yourselves, everybody.
And that's it. That's the episode. That's what I got for you guys. Thanks to Erica Pounds for being here. She is amazing, as you know. If you like the podcast, if you get a lot out of it, do me a favor and do all the stuff you're supposed to do for podcasts that you like. And mostly that's tell your friends, text, share the episode with them, and write us an honest review wherever you get your podcast. If there's a five star button, hit that button. And it just means the world to me and Stephanie and everybody on the Uncharted team. So anyway, guys, that's what I got for you. Thanks for being here. I'll talk to you soon.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: behavior, communication, culture, doctor, management

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