This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are talking through an interesting challenge that a veterinary technician wrote in to the mailbag with. This tech works in a practice with 15 other team members. They have no practice manager. Who solves the problems that the team can't solve? How come it feels like anarchy over there? This team member is asking for help. Let's get into this…
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Episode Transcript
Stephanie Goss:
Hey everybody, I am Stephanie Goss and this is another episode of the Uncharted podcast. This week on the podcast, Andy and I are diving into the mailbag to take an email from a technician who is struggling because their practice brought 15 team members and their practice owner doesn't seem to want to hire a practice manager. This technician feels like the team's size is too big for them to work everything out amongst themselves and it feels like they need some leadership in the practice every day. The practice owner doesn't want to budge. This is going to be a wild one. Well, let's get into it.
Speaker 2:
And now, the Uncharted podcast.
Dr Andy Roark:
And we're back. It's me, Dr. Andy Roark and the one and only Stephanie, you-and-me-and-the-devil-makes-three Goss.
Stephanie Goss:
I was not disappointed. That was a good one.
Dr Andy Roark:
Oh, yeah. I heard that song recently. I was like, “I'm using that one.” That was a good song.
Stephanie Goss:
I love it.
Dr Andy Roark:
Oh, yeah. How are you?
Stephanie Goss:
How's it going?
Dr Andy Roark:
Oh, it's good. I just got back from a big vacation with my family. We went camping and hiking in Maine and Nova Scotia and Prince Edward Island. It was absolutely glorious. I learned something about my wife on this trip that you'll appreciate. So we go. It's not that we unplugged. It's that there's no cell service. First of all, there's no American Cell Service. But there's like… A lot of Nova Scotia is real remote and also we have American cell-
Stephanie Goss:
It's forced unplugging.
Dr Andy Roark:
Yeah, it's forced unplugging. So we are there and we're doing this beautiful hikes and camps. We got a rental car, a minivan. We're driving from one place to another and we're doing these things. Alison and I are just talking about how awesome this sort of go with the flow, making our way across the country. Trip is going. We're just talking about it's really awesome to be unplugged and absolutely just going with the tides and it's beautiful.
And so we're out there. We're like seven days into this trip and this is the vibe. We're hiking along these rocks next to the ocean and overlooking it. We come off of this hike. Our plan is to make our way into this nearby town and go to this little whale museum, museum about whales. We're coming out of the woods and we're just walking. I'm holding Alison's hand and I hear her whisper under her breath, “We're 16 minutes ahead of schedule.” And I realize that this whole trip she had planned to the minute. While I thought we were just blissfully rolling across the countryside, she was 100% running the schedule. It was like we were a weekend and she said, “We're 16 minutes ahead of schedule.” And I realized it was all a lie. The whole thing was absolutely planned. It's like the facade of relaxation was like, “Oh, there's a schedule. There's a schedule and I am being managed on that schedule.” And I had no idea.
Stephanie Goss:
That's pretty fantastic.
Dr Andy Roark:
I thought you would like that. When I tell a story about my life with Alison, I'll remember her holding my hand and we're coming off this-
Stephanie Goss:
You're 16 minutes ahead of schedule.
Dr Andy Roark:
… beautiful hike. And I was like, “That was one of the most beautiful places I've ever been.” And she was like, “We're 16 minutes ahead of the schedule.” “Okay. Okay.”
Stephanie Goss:
That's fantastic. That's fantastic. So you had… I have so many questions. We're going to have to have a conversation because we haven't talked about it. That means you had a little bit of a forced unplugging because you didn't have service. So I'm like, I can't wait to hear about how that piece went for you. Because when we did our unplugging episode last year with our friend Eric Garcia and Tyler Grogan, I remember Eric issuing you a challenge trying some unplugged time.
Dr Andy Roark:
It was great. It was particularly great because my two daughters were with us. They're 12 and 15 and their cell phones are-
Stephanie Goss:
Didn't work either.
Dr Andy Roark:
Yeah, exactly. Are important to them. They're not on social media, either one of them, but they text their friends and they watch YouTube videos and listen to their music and stuff like that. It really was this great. It was going to be one of those all-time favorite vacations just because it was a lot of family time in the minivan and hiking together and things like that. But it really was great. It was great in this way too, so they didn't have any access to cell stuff because they don't have a Canadian plan. But we could go places and get on wifi and they could send texts and download things and get episodes to watch or whatever they wanted to do. They could do that too. I really think that was beautiful. My position… So we talked with Eric Garcia a while ago and Eric does these things where he goes away and he unplugs and I get that. But I think everybody has to find what works for them.
My position on unplugging is this. I thought a lot about it on the walk. I knew you'd ask me about it. But I thought a lot about it on my hike and stuff like this. I really liken unplugging to eating healthy. Yeah, to eating healthy and like meditating. To eating healthy and meditating. Meaning unplugging and being disconnected is good for you. It is good for you. Eric going away for a month and being unplugged the whole time is comparable to a juice cleanse for 30 days in my mind. It's so healthy. I have no interest in it. I got into meditation a couple of years ago and I was like, as I do, I get big into things at the beginning. I find the thing-
Stephanie Goss:
You go all in…
Dr Andy Roark:
… and I get really excited about it. I was meditating a couple of times a day for like 10, 20 minutes at a time, 10 or 15 minutes. But I would do it a couple of times. I was really into it. One of my friends was like, “You got to come to this meditation retreat.” I was like, “Yes I do.” I was like, “How long is it?” And they were like, “10 days silent.” I was like, “What do you mean 10 days silent?” And they're like, “You go there and you don't talk for 10 days.” I was like, “What do you do?” And they were like, “You sit and you meditate and you eat soup.” I was like, “Why do you eat soup?” And they're like, “Because you're not doing anything with your body so you don't want a lot of calories. So you just eat soup.”
I was like, “I bet that's probably a spiritual thing that speaks to people. I'm happy doing the Headspace app for 10 minutes. That's where I am. I don't need a 10-day silent meditation retreat. I don't need to do a whole 30. I can do a whole five and then eat pizza on the weekend. That's where I want to live.” The same thing is true with unplugging. I don't want to unplug for 30 days. I like to unplug for 16 hours and then check and then have a little snack.
Stephanie Goss:
But I think that's the whole point. That there is no one-size-fits-all approach. You're finding what works for you. What works for you is different from what works for me, different from what works for Tyler and what works for Eric. Each one of us has made up our own rules and is finding that place. It sounds to me like you did the things behind the idea of unplugging, which is you spent time present with your family and with your girls. I will say it doesn't surprise me that you would rank this as one of your top favorite vacations. Because I have to say, I feel like we've entered a whole new stage as parents that our kids… For those who don't know our kids are right about the same ages. It is so fun. I love hanging out with them and I love spending time with them. I loved going and doing things and going on vacation with them when they were little. It held different joy than it holds for me as a parent now.
They're real little half grown humans at this point and I get to experience the world through their eyes in a radically different way than experiencing the world through their three and four year old little eyes. I love this. I love this stage. It scares the hell out of me that they're starting high school and that they're growing up. This summer has really hit home for me that I only have a few short years left with them at home before they start to make their way in the world. But I really am digging this stage as a parent, so it doesn't surprise me that you found that with them this summer.
Dr Andy Roark:
No, I completely agree. I tried unplugging for 90 minutes right before this podcast episode. Do you remember what happened? I unplugged for 90 minutes. What's wrong? About what time we were podcasting, I got three text messages and six phone calls from people saying, “Are you okay? Where are you?” And I was like-
Stephanie Goss:
But in my defense-
Dr Andy Roark:
… unplugging in the middle of a workday is not best.
Stephanie Goss:
But in my defense and in your defense, I was worried about you because although you generally run on Andy time, you always communicate. You broke rule number one about unplugging, which is that you have to let everybody know ahead of time that you're going to unplug.
Dr Andy Roark:
All right, that's fair.
Stephanie Goss:
Okay, we're off the rails already. Let's get into this episode because-
Dr Andy Roark:
Just kidding-
Stephanie Goss:
We have-
Dr Andy Roark:
We got a lot to cover here.
Stephanie Goss:
Yeah, we do. We have a good one. We got a mailbag letter from a technician who is working at a small-ish practice. It is private practice. They have about 15 team members in total and they do not have a manager of any sort. They don't have any leads. They don't have a office manager, a practice manager or anything. It's the practice owner and the team. What has started to happen as they have grown is that problems come up and the practice owner expects the team to figure it out and solve problems for themselves, which is wonderful and has benefits that I think we're going to talk about. There are also cons to it. This letter comes from the place of looking at some of the cons because they are struggling with feeling like there is animosity, there is a front versus back mentality because there is no one doing the, quote, unquote, “managing” from this team member's perspective.
What they're looking for here in the management sense is someone to help problem-solve and to deal with the challenges in a leadership capacity. Someone to be the decision-maker and help them all sort it out. They were just asking, “What is our option here?” Because they have asked the practice owner about hiring a manager and they have flat out said no. So this team is wondering, “What do we do? We're not all happy. We feel like there's strife. We feel like there's no one to help us solve the problems. We're really struggling. What is our best option for going forward from here?”
Dr Andy Roark:
I have some thoughts. This is always really challenging because the devil is definitely in the details here about what's our best option. I don't know what tools do we have to work with and what exactly is happening. But I think we can talk in general terms about this idea of we've got a team of say 15 or so. We don't have a manager and we're having strife and the owner has pushed back against that. I want to go ahead and start… Let's start with headspace as we do. I want to call out a trend, a thought pattern that I see a lot in not just in veterinary business management but in business management in general. There is this belief with a fairly large segment of the population, I think, that if you have problems in your organization, the obvious path forward is you should add managers, you should add administrators, you should add systems.
That's it. Like, “We're not getting along. We need a manager. We need some administrative person. We need more rules for sure. More rules are going to help us solve this front versus back problem.” It's funny because people are like there's a problem, we add more managers and more rules. If you keep following that then the idea is the path to utopia is more rules and more management. I don't think anybody wants to work at a place that has tons of management, tons of administration, tons of rules. No one wants that outcome, but everybody seems to think that moving in that direction is the obvious path to make their job better. I think that's funny. I think if you look at human healthcare, you will see the manifestation of this. Human healthcare in America, one of the reasons it is so ridiculously expensive is the layers and layers of management, administration and bureaucracy. It's completely out of control.
You've got these healthcare providers at the bottom supporting all of this management and administrative infrastructure and the whole system is broken. It's the same in universities. Anyway, it happens in our government, don't even get me started. But it's that sort of thing of you add these things that add things that add things. Now that's not always. I'm not, absolutely not saying that managers aren't important and there's no benefits to having manager or anything of that. But I want to call this out because I do think people quickly jump right to, “We are not getting along. If we had a manager involved or more management or more systems or protocols or rules, we could get out of this interpersonal problem.” And I would say I want you to really analyze that assumption and think about it. Okay, cool. Just full stop. I'm doing the thing that I do where I'm not saying they're wrong, but I want to punch holes into that bedrock belief of we need to add a manager. That's what we need.
It's funny, this letter ended a little differently than I thought it was going to. We often get these emails, and I started reading this one, and it felt this way, where people will be like, “Hey Andy and Stephanie, here's the problem. Here is the obvious solution that I have. Question, how do I get everyone to recognize that I am right and do what I want to do?”
Stephanie Goss:
It's true.
Dr Andy Roark:
You know. We get those letters all time.
Stephanie Goss:
We do.
Dr Andy Roark:
And yes, I laugh. I chuckle every time I read them, “Here's the problem. Here's the obvious solution that I have that is clearly correct. Question, how do I get other people to recognize my correctness in this matter and do what I think we should do?” And I'm like, “That is not an interesting question for me.” Well-
Stephanie Goss:
And to be clear-
Dr Andy Roark:
… of course, I did not say that.
Stephanie Goss:
… sometimes we do agree with them. But sometimes it's like, “That would make a boring conversation.” Yes, we agree with you, end of podcast.
Dr Andy Roark:
A lot of times they're not entirely right. A lot of times they have made some… Generally when I say, “There is one correct solution and here's what it is.” If your team has not bought into it, if other people don't feel any ownership of this solution, it's probably not the correct solution even if you can make a stronger case for it than anything else. Anyway, that's not what they did here. They did not end with, “How do I get the practice owner to hire a manager?” They ended with, “What's our best option?” I was like, “Okay, I'll pivot here. I do appreciate that.”
But anyway, I have those thoughts a lot and we see a lot of those. Anyway, when it came down to, “We don't have a manager, what do we do?” I needed to call out the idea of like, okay, I would just want to punch some holes in the assumption that a manager is the right answer to this problem. It might be, definitely might be. But there should be at least enough uncertainty that we can discuss other options. If there's not that level of uncertainty, I think it's going to be hard to move forward towards a resolution everybody feels good about.
Stephanie Goss:
I would agree with that and I think you presented a good headspace challenge. I think the answer… For me a lot of the time in veterinary medicine, I used to drive my team nuts because my answer was it depends. Because so much of veterinary medicine and life in general exists in the middle gray zone. And so this was one when I read through it that I was like, “Oh, okay. The answer probably is somewhere in the middle.” It wasn't a clear, this is the only right answer, because there's no one-size-fits-all approach to this. Every practice is different. Every business owner has different needs and every team has different needs. But from a headspace perspective, I think you presented a great challenge, which is I would say action step-wise, sit yourself down and think about one end of the extreme, like you presented, and think about the levels of bureaucracy that get layered in the bigger you get.
Human healthcare is a great example. Is that what you want or need for your practice? Let yourself go there from a headspace perspective. Then on the opposite end, it sounds from their email like it might be a little bit closer to the end that they feel like they're at, where it's a free-for-all and everybody can do whatever they want. There's no rules. There's no structure. There's no systems. It is a total free-for-all. Because once you wrap your head around what those two extremes look like, it is a lot easier in my experience to try and find multiple different paths that start in the middle and take the pros out of both ends and find the path that works for you and your team that feels individual.
Dr Andy Roark:
I want to touch on both of those two extremes real quick and again, I haven't yet revealed my position here and I want to be clear about that. I'm just shaking the construct that has been laid down to let everybody see that it's not as rock solid as people like to think it is. It's funny. There are a lot of… There's a tendency to think that managers are the answer to interpersonal problems. I've not found that to be true in a lot of cases. Meaning, people will say to me, “We have this person who is an absolute toxic person.” And they don't have a strong manager. And I'm like, “Let me give you a little piece of bad news. If they're an absolute toxic person, it doesn't matter if they have a strong manager. They're going to be a toxic person.”
There's a lot of people who have this. They tell themselves that if this person who I despise was managed, I wouldn't despise them. They're like, “I hate Carol and what I need is a manager that will make Carol not act like Carol, but like the ideal version of Carol I have in my mind.” And I'm like, there is no manager that-
Stephanie Goss:
That's not how-
Dr Andy Roark:
… is going to-
Stephanie Goss:
… that works.
Dr Andy Roark:
… make that happen. That's a magician, not a manager.
Stephanie Goss:
Yeah, you're so spot on. That's not how that works guys.
Dr Andy Roark:
Anyway, I just want to say that and put that in the con manager camp. So I have beaten my anti-manager drum here. Now let me beat my pro manager drum for a second. You and I talked about our vacation and going to Maine. We took tents and we went camping. There was four of us and we flew to Maine and then rented a minivan. Then we tent camped and we did all these different things to everything. Do you know how we packed? We did not have four people run around and pack everything that they thought we needed for this trip. That is not at all how we packed.
Stephanie Goss:
Let me guess. I would guess that Alison Roark was the general and said, “This is what we're going to pack and how we're going to do it.”
Dr Andy Roark:
Exactly. Alison had the list.
Stephanie Goss:
The list.
Dr Andy Roark:
I don't want people to think that Alison did this by herself. Absolutely did not. I was involved in planning and all of those sorts of things. Do not think she was abandoned and that's why. I was very involved in this, still, when it came down to packing, given that I was very involved in this and very excited about it and we went through everything together and I made sure that we had what we needed off of her list and things like that. It's important to say I was very invested in this and I put a lot of time and effort into it. When it came time to pack, Alison Roark with her checklist pointing where things went and asking for this and telling what she needed. This goes here and this goes in the car first and this goes and those things are going to be packed together and that's in a check bag and we're going to carry these things on. That was the way to get this done.
It was having a manager, an organizer, a general, a conductor. And we were exponentially more efficient and effective for having one person whose job was to organize the three of us, me and my two daughters, running around, packing the things, bringing things, loading things into the car. It made so much more sense for her to stand back and coordinate us as opposed to throwing in herself into the chaos and running around and doing things. That's how we packed. There's absolutely a point, a tipping point, where you say, “We are not organized and having someone step back and get us organized, that makes a ton of sense for efficiency and effectiveness.”
Stephanie Goss:
Yes, I agree with all of that. I love it.
Dr Andy Roark:
Okay. So we talked about the pros and the cons. There is a way to avoid bureaucracy and to own the difficulties of interpersonal relationships. Also, to say, we are not organized and we have to get organized, that do not necessarily involve hiring a full-time manager for a staff of 15. It's definitely possible. It's really hard because now you're really starting to get into how would you do this and it really depends on the talent that you have on the floor as far as what your options are. And so anyway, I just want to start to lay that out. The last part of headspace before we start to get into how I would try to start, what your options are or how I should line this up, the last part I want to lay out is I am a big believer in flat organizations or flat-ish organizations. I am not 100% bought into the idea that a hierarchy is required to get things done and create a good place to work.
I think you can do it that way and you and I have both seen it done that way where everybody has a clear manager. The manager manages the people right underneath them and everybody moves in that clear lockstep, direct boss looking over your shoulder, maybe micromanaging, maybe not. But everything has a clear direct hierarchy of if you don't like what this person did, you can go directly to their boss and blah blah, blah, blah, blah. I think that there's a lot of benefit in hiring good people and supporting them as communicators and giving them autonomy to say, “Hey, these are our values and this is the general system in which we work.” I want you to look around and assess what's going on and make it the best decision in the moment rather than following some cookbook protocol that was laid out with no thought to this specific situation.
I think it is not too much to ask that grownup people do some actual relationship building and a little bit of conflict management. I think that there is a problem with conflict management skills, a lack of conflict management skills in our profession and I'm not convinced that if you have people who are not good at conflict management, the obvious answer is a babysitter to wade in and fix their problems. I think that you can make a strong case for facilitating conversations and giving responsibility back to people to fix their own issues. I do think that there is a tendency sometimes to say, “These people are not getting along. Bring to me, the manager, your problems and let me sort out your interpersonal issues.”
And we both know where that goes because we've seen managers who do nothing except deal with interpersonal issues all day long. They should have pushed those issues back onto the people who were having them a long time ago and said, “I want you both to go. Here's a $25 gift card to Starbucks. I want you guys to go to Starbucks. I don't want you to come back until you're able to work together.” That may sound archaic, but I promise you it absolutely can work. Sometimes it doesn't. We have to escalate. But I see a lot of people who are way too quick to take interpersonal issues and take them up the chain as opposed to empowering people and expecting people to handle their own issues. Then it just becomes management time is completely saturated dealing with interpersonal issues.
Stephanie Goss:
Well, let me shout out a big positive here because this team member called out their practice owner wanting and expecting the team to be empowered to solve their problems on their own. From a headspace/action step perspective, I agree with you. I think a lot of practices would look at this situation and say, “We're going to put a manager in place.” And go about it the way you said, which is, “Okay, the manager is going to be the one to solve the problem.” While it may resolve some of the conflict, I promise and guarantee you that that approach is absolutely going to create a whole new set of problems. It is because then you are not empowering anybody. Then you are creating a bottleneck where everybody has to go to one person to get answers to their questions and their solutions. And so now you have a whole new problem on your hands.
I love that they pointed it out in this practice owner's defense. I do absolutely think that every member of our team, part of our role as leaders, whether you're a practice owner or you're a practice manager, when you run a hospital, part of the tools in your toolkit should absolutely be that the members of your team get taught interpersonal skills in conflict resolution. Because the reality is we're human and we're working with other humans and it is never going to be all kumbaya, everything is hunky-dory 100% of the time. That is just not reality. If we don't teach them how to mediate conflict themselves, how to work things out, how to speak to each other with kindness and compassion and it seems… I know. I hear in my head the practice owners who are listening right now going, “But why is it my job to parent them? Why didn't they already come to me with those skills? I'm hiring adults.”
That is not reality. We can be mad about that or we can just accept the fact that even if they do have skills, we can still help them get more skills, and so get over the mad. I'm saying that with all the love and kindness but camped off love because I've been there. You can get sucked down in the mad or you can teach them how to do the thing that you're frustrated that they can't do, and in this case it's a soft skill. I think when we look at it, shout out to this practice owner because they are expecting them to work things out and we don't know because we didn't get all of the information. We're only getting one side of this story.
But if they're expecting that and not equipping the team with the tools to actually do it, then they're shooting themselves in the foot. Because you don't get that many people, especially like, I'm just going to go out on a limb and make a generalization, veterinary medicine is very female-dominated at this point in our industry. You don't get that many people or that many women in the same space without having conflict. It just doesn't happen. You are crazy to think that that is a thing. It is irrational for us to think that you could put 15 people on a team in close-knit space and not expect there to be conflict at some point in time. If you are not helping them equip with the skills to deal with that, you're just shooting yourself in the foot.
Dr Andy Roark:
Well, there was four of us in the minivan and we all love each other deeply and there was conflict. There was conflict. No, I really like this about people sorting out their own issues. I just want to call out, because I'm not saying that this is going on here necessarily, but whenever we get into this I need to call out either-or thinking, and this is a behavioral psychology trap that people follow too. And so people are like, “Well, either they need to solve their own problems.” Or, “If I weighed in, then they're always going to come to me and I will be stuck doing this forever.” And I go, “That's either-or thinking. That's not true.” That's not true. You can be very cognizant of the desire to not be involved in a lot of interpersonal issues and also recognize that sometimes we do have to get involved and we can get involved in a way that does not mean that we're going to see an increase frequency in this. But I think a lot of people are afraid of that. They're like, “If I weigh into this, I'll have to weigh into every one.”
Here's my last piece of headspace, when do I wade into interpersonal conflicts? I'll tell you when. This goes down to the thing you've heard me say many times before. The difference in a struggling business and a thriving business is this. A thriving business has a new during problem every day and a struggling business has the same during problem every day. And when I feel like we're having the same during problem every day, at some point I have to intervene and that can be, “Hey, you guys need to sort this out.” Or if in fact we've tried that and that has not yielded results and we're still stuck on this problem, I am going to get increasingly involved in this problem one way or another. How it turns out will remain to be seen. It may turn out with one less team member than we had going in. It may, two less team members. Hopefully it won't.
But that for me, just so you know, when I'm like, “When do I know to keep pushing this back to them and pushing this back to them versus letting it go.” To me, it's that, if there is a problem that I see in our team, in our business and it's the same problem again and again and I have nudged them and I have told them they need to work this out and the same problem persists, at some point you're picking your poison. You're either deciding to live with this problem which may very well go ahead and escalate or you are deciding to get involved in this specific problem. But not many problems rise to that level and that's important or else you get stuck in either-or thinking of, “If I help these people, if I get involved, I'm getting involved in everything.” I go, “No.” You're only going to get involved in things that you have pushed and tried to have them resolve themselves again and again and again and they are past frustrated and now you're going to get involved. I think that's okay. That's what I got for headspace.
Stephanie Goss:
I love it. Should we pause here and take a quick break and then come back and talk about action steps?
Dr Andy Roark:
Let's do it.
Stephanie Goss:
Did you know that we offer workshops for our Uncharted members and for our non-members? So if you're listening to today's podcast and you are not a member of Uncharted yet, you should be. But this is not a conversation about joining Uncharted. This is a conversation about all of the amazing content that we have coming at all of you, whether or not you're a member, through our workshop series. You should head over to the website at unchartedvet.com/events and check out what is coming. We have got an amazing lineup on the regular. We've got something every month, sometimes two or three things in a month, coming at you to expand your brain, to talk about leadership, to talk about practice management, and dive into the kind of topics that Andy and I talk about on the podcast every week.
Now's your chance. Stop what you're doing, pick up your cell phone, I know it's not far from you, and type in unchartedvet.com/events, see what's coming and sign up. They are always free to our Uncharted members and they have a small fee attached to them if you are not currently a member. You can get all of the details, pricing, dates, times, and register, head over to the website now. I want to see you there.
Dr Andy Roark:
All right, so let's get into action steps here. The question that was asked was the owner is opposed to having a manager, what are the best options? I would start to lay this down in my responses to our technician that was writing. This is how I would coach that person who's asking me what do I do? Where do I go from here? The first part of headspace for me is assume good intent.
If you decide the practice owner is stupid, that he's a jerk, he doesn't know what he's doing, he doesn't know how to run a business, you are setting yourself up for a really hard go of it and you're not going to be very effective in talking this out. You're not going to be very effective in finding solutions. The first thing is I would just say assume that there is a good reason that the practice owner feels this way and assume that the practice owner is trying his best and he really wants to have a good place to work. Just go ahead and get that in your head. To me that is the low bar for engaging in this conversation.
Stephanie Goss:
I think one of the best tools that I've ever been taught to help do that… Because when you're sitting there looking at it from your perspective, it is hard to get yourself out sometimes of the emotions that go along with viewing it through your lens. One of the most helpful tools that I was ever given was someone taught me to ask the question, what else could this mean or what else could be going on here? And so when I actually forced myself to sit down and answer that question, what could be happening, there are a million other things besides the fact that they truly are just trying to make my life more difficult by not hiring a manager. Let's be real. When you're in that situation, that is a part of how you're probably feeling, which is my life is immeasurably more difficult because none of these people are getting along and I have to come to work and deal with this BS every day. That could absolutely be where this technician is sitting.
There could also be a million other reasons, why. When I ask myself that question and I let myself hallucinate in that way of what else could this mean? Why else could they be making this choice? Maybe they can't afford it yet. Maybe they're not sure that it will solve the problem. Maybe they had bad experiences in the past with a manager. When you let yourself go down that road and hallucinate different answers it, in my experience, has become a lot easier for me to find that place of not only assuming good intent but also putting on my empathy shoes so that when I sit down to have this conversation with them and try and understand, I am ready and prepared to do that.
Dr Andy Roark:
Yeah, I agree. That takes me right to the next step. I think this is probably two different conversations. I don't know that you can do this in the same conversation about what I'm going to say. The first thing that I would like to do is seek first to understand why does the owner not want a manager? Honestly, there is so much value there and you have to figure out how to ask this question in a way that doesn't come off as challenging. Because just imagine that Stephanie has been just writing me about hiring a manager and she's like, “Andy, we need a manager. Andy, we need a manager. Why aren't we hiring a manager?” It's a match. Then she comes to me one day and says, “I have a question for you. Why won't you hire a manager?” There's a very good chance that that's going to sound like challenging. It sounds like we're headed right back into this argument again. You're not going to get good information on me.
I'm going to put my guard up. I may not be totally honest with you, especially if it's because I'm afraid I can't afford a manager. It's because I had a bad experience with a manager before. They embezzled a bunch from the practice. Say something like that. If I'm feeling defensive, I'm probably not going to share that information with you. So you really want to try to figure out the best way to broach this subject in a way that feels safe and allows the person to be open. It's sort of genuine curiosity. But I would like to know why this person who's got a team of 15 does not want to have a manager. I'm not saying they're wrong, that's why I laid that down up front.
It's like I made great reasons. I said, “I absolutely had a mentor that I worked with who had a practice manager and she took him for $90,000, I think, embezzlement. He felt so betrayed and taken that he did not want to have a manager. He wanted to be the one who knew all this stuff and he did not want to delegate to someone else because he had been so burned and felt so betrayed.” I'm not saying that's how you should feel, that's how he felt. I'm not saying he's right, but I'm saying I get it. It may not mean like they get it-
Stephanie Goss:
There may be reasons for their behavior. There may be motivation behind their behavior in that sense of something that they've experienced.
Dr Andy Roark:
There may be constraints on the business that we don't know. He might be like, “Look, we have not been profitable in the last three years. And having someone who comes in who does not generate revenue directly does not make sense for us.” I think you can make an argument that the person could justify their salary, but if that's what he thinks, at least we can understand, “Okay, we've got significant financial constraints,” that changes the picture. All of these things affect what is our best option because the question was what's our best option? He goes, “I can't tell you because I don't know where all these… I don't know where the pinch points are. I don't know what's holding us back. I don't know what the real internal obstacles are.” But we got to understand that before we can pick our next move. Anyway, to me, why are we opposed to having a manager? And the more clear answer I can get to that, the more I can understand what options are in play.
Stephanie Goss:
Okay, when you were talking about potentially feeling challenged when somebody asks you about this, I immediately flashed to… I remember before I became a parent and I swore that I would not tell my kids, “Because I told you so.” Then I can think of a lot of times in the heat of the moment when I'm super frustrated and I've gone on the defensive and the answer is because I told you so. And that's the end of story and will walk away. Because it's that feeling challenge. So how do we set up that question in a way that makes somebody less likely to be defensive?
Dr Andy Roark:
Sure, everybody's a little bit different, of course. Ideally you have a good personal relationship with this person. You know them as a person, they like you. You have a good relationship and that makes it a little easier. But basically I think probably if I was going to do it, start shooting from the hip. I think this is how I'd step it up. I would step in, I would lead with vulnerability and then appreciation.
Basically how this would start off is I would say something along the lines of, “Hey, I love working here. I love this clinic. I love being here. I really appreciate the opportunity to be here. I enjoy what we do here. I really want our clinic to be very successful. I look at what we're doing and we've got 15 people. I look at all the other vet practices that I knew of that have 15 people and they have someone who's in a designated manager role and we don't. Obviously, that's an intentional decision and I was wondering why you made that choice. What's important about not having a manager? I want to understand because I want to be helpful and I know a lot of other places that have gone this way, and so are you willing to tell me what you think?” So it would sound something like that.
Again, when would I do it, ideally? I don't know. The time and the place, all that stuff matters. You know what I mean? There's a lot of different ways to do it. But basically, that would be it, is to say, “I really love it here. I like this practice. I respect what you're doing. I want to be a contributor to this practice, growing and growing. I look around, I see other practices that have a designated manager, and it seems like we're getting to that size, but you've made it clear that's not something that you plan for. I want to understand why that was. What is your philosophy on managers?” And then I would honestly listen. I would not argue. I would not be like, “But, but, but…” Nope, you asked the question, just listen.
Stephanie Goss:
No, you need to let them be heard.
Dr Andy Roark:
And now you got to let them be heard. I would just go, “Okay, I got it. No, I just wanted to understand. Thank you.” I would take that and I would probably go away with it, but I would not let it turn into a debate because otherwise, and then a lot of people mess this up because they'll even get the question right and the other person will open up and share the information and then the person asking the question will disagree with the perspective of the person who's explaining their why, and then it will turn right back into the same old argument and it goes nowhere. That's not the point. The end result we're looking for here is to understand. Anyway, that's how I would set that up and sort of how I would try to frame it.
Stephanie Goss:
Yeah, I love that. I would probably do very similar. I would start with talking about how you care about the team and about them. You have noticed that there seem to be challenges in the team. One of the things that you thought of that might help the situation would be someone to play that conductor role.
Like you were talking about Alison in that role being the conductor to help solve some of the flow and challenges and take… I would frame it in the way of helping them take some of the burden of that off of their shoulders and then ask them, “I really would love to help you. I would just love to understand where your head is at when it comes to having someone in a position to manage the day-to-day of the practice. Tell me why it looks the way that it looks in your head and really just open up the door from that hopeful… I want to help you. I want to understand.” I think that that feels very different than when, fellow parents will understand, when my kid is like, “But why?” That's just immediately going to make me be like, “Because I freaking said so.”
Dr Andy Roark:
Yeah.
Stephanie Goss:
That's your point about arguing back, right? Then you're right back in that argument loop and the answer has not changed. When you ask it from a place of curiosity and then say, “Thanks, I really appreciate that. I would love to… You've given me a lot to think about.” My phrase is, “I want to marinate on that, I want to process that.” Then I agree with you, this is not one conversation, this is, potentially, multiple conversations. Then I would walk away, change the subject, let it drop.
Dr Andy Roark:
Yeah, I agree with that. That's the first conversation I would try to get is this, is why is this person opposed to a manager? There's a second conversation you can have and you do not have to have the first conversation before we go to the second one. Doing that conversation and understanding where the person's coming from can be helpful. It's not required to have the other conversation. The other conversation is this, okay, the other conversation that we want to have is we want to step back one rung on the decision making ladder. Imagine this for a second. Imagine that we're in a vet hospital and we've got this place and we are having front versus back issues, meaning the techs and the CSRs are fighting and it's going on.
So Stephanie Goss is sitting here and she's thinking about this and she's working the practice and she says, “The front and the back are fighting, so we need a manager.” She goes to me and she says, “Andy, we need a manager.” I'm like, “Goss, we're not getting a manager.” She's like, “We need a manager.” “We're not getting a manager. Not going to.” Well, what's the obvious next step? I've told her we're not getting a manager. We can either continue to fight about a manager and why can't we get a manager? And what if we got a part-time manager or we can step back one rung and say, “Andy, the front and the back continue to fight and here are examples of them fighting. Here is the impact this has had on the clients. This is how the fight manifested yesterday and this is how it manifested last week. They are clearly fighting. What are we going to do about the front and the back fighting?”
Stephanie Goss:
And I would add one thing in there that would be really powerful, which is that I would say, “I know your expectation is that we're empowered to solve this ourselves, and these are the things that we have tried,” especially from your perspective of what have you done to help solve the problem, call that out too. And then say, “I need your help because I feel like I'm stuck and I don't know what the next step is. This is what I've tried. These are the examples, this is what I've tried to solve the problem. I'm at a loss for where to go and I would love your perspective and your help on how you would like us to approach this situation, or how you would approach the situation if you were me.”
Dr Andy Roark:
I really like that, asking for help. I like that, asking for help. That's a really good play. I also like, “This is what we've tried,” and I really think that that's the play in my mind, is you need to put the manager thing aside and don't take him a request for a manager, take him the problems and say, “These problems persist. This is what we've tried. We're really stuck. How do we want to move forward from here?” And then have that conversation. It's very possible that the owner will look at the problem and ultimately say, “You know what might help this?”
Stephanie Goss:
“A manager.”
Dr Andy Roark:
“A manager.” And then it's their idea. And don't make them feel stupid. Don't say, “I told you so.”
Stephanie Goss:
That's a great idea.
Dr Andy Roark:
Yeah, that's a great idea. That's exactly it. It really is. That is to say, “Here's the problem,” or if there's three different problems, I would say, “These are the problems that I see that persist,” and lay it out one, two, and three. It might be that a manager would fix all those problems. It might not be, I don't know. I don't have the insight or the background to be able to know what those are. But regardless, that's how I would lay it out. I think that there's probably some people who've listened to this whole episode and they're just mad because they're like, “Andy, it's a team of 15 and they don't have a manager. How could you tell them that they don't need a manager?” But every team is different in what they're trying to do and that the players on the field really matter.
I have seen putting a weak manager over a strong team generally just frustrates people. You can absolutely do more… Managers can do more harm than good. Don't think they can't.
Stephanie Goss:
Oh yes, absolutely.
Dr Andy Roark:
They can absolutely make things worse.
Stephanie Goss:
Yes.
Dr Andy Roark:
And so just the presence of a human being with a pulse in a management role, I don't know that's worth anything.
Stephanie Goss:
No.
Dr Andy Roark:
I mean I can a hundred percent say, and this is just kind of how my mind works and stuff too, it depends on the people you have. So we said we got 15 people, so just walk with me for a second. Imagine that one of these people is an office manager, this is the person that does the administrative stuff for the practice, they pay the bills, do inventory, whatever, office manager. All right, so you got that person, you got three doctors, so that's four employees. You got four people at the front desk. So now we're at eight. We got seven support staff, right? I don't know, two techs, five assistants, stuff like that. That's your 15 people. I can a hundred percent see a high functioning team that has an office manager.
The practice owner is the lead doctor, let's say. You elevate one of your CSRs to be the lead CSR, and you elevate one of your techs or support staff to be the lead tech or a lead support staff or whatever. Well now you've got a lead doctor, a lead tech, and a lead CSR and an administrative support person. I think you can run a damn good team of 15 with a lead doctor, a lead tech and a lead CSR. I think you can do it. And again, but it depends on the people that you've got and things like that. Anybody who's just like, “The obvious answer is this,” I would say there's a lot of different ways to make a team work and function. Anyway, that's kind of where I come out.
Stephanie Goss:
Well, and I think that that goes back to where we started from the headspace perspective is remember the two extreme ends of the spectrum. You can have the layers of bureaucracy at one end where you have managers who have managers who have managers, or you could have, it's just a total free for all and there's no rules and it's total anarchy. We said finding that space in the middle. Part of it is thinking outside the box of what those solutions could be to find the right fit for you and your team and asking the question, why do I think we need a manager? What am I looking? Am I looking for someone to be a mediator or a problem solver? Because if that's the reason you think you need a manager, you don't need a manager. You need to teach everybody on your team the tools to be able to mediate the conflict management and be able to mediate the problems themselves and someone on the team who can act in that mediator role.
And that might be your practice owner, it might be somebody else on the team, might be somebody from outside the hospital, but you can solve that problem without saying, “We're going to hire a full-time, 40-hour-a-week person to fill this role.” So it goes back to the why are you asking, are you also asking because the practice owner is overwhelmed and you're getting paid a day late sometimes because they're trying to do payroll and they're trying to be all things, all people. What is the why behind it? Because I don't think that you can get to that creative problem solving space on both parts, the practice owner's part and on the team's part in terms of trying to help, without having asked yourself the question of what does that middle ground look like? Why are we asking this question? What do I think the practice manager's just job is actually going?
Dr Andy Roark:
Yeah, I think you're spot on. Anyway, that's how I'd approach it. I think that's my big take. I enjoyed this a lot. I like to be a bit of an anarchist and a little bit contrary about some of these things.
Stephanie Goss:
You do?
Dr Andy Roark:
I do. I like to push back on the idea that more rules and more managers and administrators is always the answer for a more harmonious workplace. I do not buy that. In some cases obviously, adding managers and systems makes all the sense in the world, but there's a point of diminishing returns and it's not always the obvious answer that people think it is. So anyway, I'm glad we got to talk about that and why.
Stephanie Goss:
Yeah, me too. This was fun. Take care everybody. Have a fantastic rest of your week.
Dr Andy Roark:
Yeah, thanks guys.
Stephanie Goss:
Well, gang, that's a wrap on another episode of the podcast. As always, this was so fun to dive into the mailbag and answer this question. 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.
