This Week on the Uncharted Podcast…
Can you lead people to water and make them drink? This week's episode starts out with a mailbag question where the writer already has part of their answer. And life is always a little more complicated than at first glance so Dr. Andy Roark and practice manager Stephanie Goss dive into this mailbag entry from a veterinarian who is considering joining a new practice. This practice is quite different from what this vet is used to AND wanting. They want a practice that utilizes their technicians for more than nail trims, where the DVMs aren't doing tech work and that is more efficient. This DVM wants to know “Can I hope to change this practice and how do I start the conversation with grace?” This one is seemingly uncomplicated but Andy and Stephanie always find a twist. Let's get into this…
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Got a question for the mailbag? Submit it here: unchartedvet.com/mailbag
Thank you to our sponsors! To learn more about this week's sponsor, GuardianVets, check out their website HERE.
Upcoming Events
October 6-8, 2022 – Get Sh*t Done Shorthanded Virtual Veterinary Conference
This 3-day live, interactive virtual conference features a customizable learning journey for practice leaders who are tired of being overwhelmed and want to get their practice back under control. Explore how you’re working, isolate challenges, diagnose pain points, share best practices and pull together a sustainable plan to overcome obstacles.
While Uncharted Membership is always encouraged, you DO NOT have to be a member to join us for GSD! Non-members, here’s your chance to see what all the buzz is about and get a taste of the Uncharted experience.
October 19 – Leveraging Technicians: Making Practice Less Stressful with Melissa Entrekin, LVT
In this workshop, we will:
- Explore how to create trust among your team so that
veterinarians will fully utilize technicians and technicians will fully utilize veterinary assistants - Discuss how to cultivate a well-balanced team resulting in less stress for everyone to create positive client and patient experiences.
Episode Transcript
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Dr. Andy Roark:
Hey Stephanie Goss. You got a second to talk about GuardianVets?
Stephanie Goss:
Yeah. What do you want to talk about?
Dr. Andy Roark:
I hear from people all the time that are overwhelmed because the phones never stop ringing.
Stephanie Goss:
Yes.
Dr. Andy Roark:
And I'm sure you hear from these people as well. Like, “Our caseload is blowing up and the doctors are busy and the phones just don't stop.”
Stephanie Goss:
They never stop. That is a true story.
Dr. Andy Roark:
I'm amazed by how few veterinarians knew about Guardian Vets. This is a service where you have registered technicians who can jump in virtually and help you on the phones. You can flip the switch and GuardianVets can jump in and take some of the load off the front desk and they can handle your clients to get them booked for your appointments and give them support. And it really is a godsend.
Stephanie Goss:
Pre-pandemic, it was amazing to me how many people hadn't heard about it for after hours call help. But at this point, I can't believe how many people don't realize that they are offering help during the daytime as well, which I would think right now is a huge benefit to practices, because everybody is shorthanded. Everybody is drowning in phone calls. And so we talk about it. We've talked about GuardianVets a lot on the podcast and every time we do, we always get somebody who says, “What is that?”
Dr. Andy Roark:
Guys, if you're not familiar with GuardianVets, if you think that you could use some help on the phones or up the front desk, check them out. It's GuardianVets.com and if you mention our podcast, me and Stephanie Goss, you get a month free. So check it out. GuardianVets.com.
Stephanie Goss:
Hey everybody, I am Stephanie Goss and this is another episode of the Uncharted Podcast.
Stephanie Goss:
This week on the podcast, Andy and I got an email in the mail bag. It is from a doctor who asked us ultimately a question, “Can you lead people to water and make them drink?” The answer to this is no. And therefore Andy and I are taking you on another journey to Camp Tough Love with this one.
Stephanie Goss:
That's right. We've got a doctor who is looking at a practice that maybe isn't all that they want it to be, and they're wondering, how do I change this practice? The answer is they are answering their own question in the email. But we've got some ideas and we had a lot of fun diving into this one, so let's get into it, shall we?
Speaker 3:
And now the Uncharted Podcast.
Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark and Stephanie you-can't-make-me-love-you Goss, that's how it is. No, I can't make you love me. Is that what it is? Can't make me. Help me out Goss.
Stephanie Goss:
I don't know. I don't even know where you're going with that
Dr. Andy Roark:
Can't make me love you. Now I can't even remember what song it's from. I Can't Make You Love Me. Is that what it's called? Oh, I had it in my head and then when the pressure was on, I was like, “I can't remember the lyrics.
Stephanie Goss:
I can't remember the song.
Dr. Andy Roark:
Yeah. I Can't Make you Love Me? I did it anyway. Hello.
Stephanie Goss:
Anyways. Hi.
Dr. Andy Roark:
How are things?
Stephanie Goss:
Things are good. How are things with you?
Dr. Andy Roark:
Oh, they're crazy. It's first week of school. Of new school. New school. So I got one kid that's going to middle school for the first time and I got one kid that's going to high school for the first time. It's been a-
Stephanie Goss:
It's been insane.
Dr. Andy Roark:
… hectic, stressful week. Oh it's insane. And the most insane part are parents learning the traffic pattern at the school. And that is a real problem. This high school, let's be honest, I think that the most tortuous part of taking my kid to high school was the idea… Picture this, this high school was taken and it was plopped down on a couple of two lane roads. And this is a big A high school. There is no way that the infrastructure of this high school can handle the number of students driving themselves, which is already horrifying. And parents dropping their kids off.
Dr. Andy Roark:
It's just complete pandemonium, and absolutely baffled my wife on the first day. And I went the second day and I… First of all my wife is, she's a perfectionist, Grade A, near perfect score on the SAT. She gets it right and she knows the rules and she follows the rules.
Dr. Andy Roark:
And on the first day driving my kid, I was stuck in traffic and I see children everywhere just walking through down the road. And I'm like, “Where are all these kids coming from? There's thousands of kids wandering to the school. They don't live in this neighborhood. What is happening?”
Dr. Andy Roark:
And then I was like, “Oh, everyone else has already given up on this system and they're just dumping their kids off a block and a half away from school. That's the only explanation.”
Dr. Andy Roark:
So I started driving around the neighborhoods around the school and I saw, I was like, I see it.
Dr. Andy Roark:
Sure. And I'm catching people. I went home and I told my wife and I was like, “Forget this. We're dropping Jacqueline off at Half Mile Lake, a half mile from the high school.”
Dr. Andy Roark:
It should be called half mile from the high school lake, and it should have a little drop off zone. And Allison was like, “Oh no. Oh no. You have to go through the car line and drop our child there. And then you have to drop the child off.”
Dr. Andy Roark:
And that brings me to something that I have really learned in the last few months. Stephanie Goss, I have learned that… I don't know why it took me 45 years to learn this. There are moments in my life when I can choose peace, or I can choose engagement and to defend myself in my position. And I have learned that I choose peace.
Dr. Andy Roark:
And so she says, “No, you have to go through the drop off line.”
Dr. Andy Roark:
And I said, “Mm-hmm. Well I think it's admirable that you do that.”
Dr. Andy Roark:
And that was the end of the conversation. It was, “You know what? If you have to go through the drop off line, I'm not going to talk you out of it.”
Dr. Andy Roark:
The funny thing is that my high school daughter just looked at me was like… It was awesome. It was this inside, father-daughter. She gave me, she's in high school, she doesn't want to get dropped off by me and my Subaru in front of the high school. She's like, “Half Mile Lake it is, Dad.”
Dr. Andy Roark:
I'm like, “Yeah.”
Stephanie Goss:
I can totally imagine the look on Allison's face. She's like, “No, You actually know the rules and do the thing.”
Dr. Andy Roark:
Yeah. She's like, “Here's a series of eight different streets that you can take to get you close the drop off and then only one person has to be nice and let you in and then you can drop the kid off.”
Stephanie Goss:
Hard pass.
Dr. Andy Roark:
And I was like, “Or I can just slow down and she can tuck and roll.”
Stephanie Goss:
Jump out.
Dr. Andy Roark:
Yeah. Like a freaking air drop. The door's open. I'm like, “Go, go, go.” And out she goes. And we're both happy with that.
Dr. Andy Roark:
She's like, “How long were you in the car line?”
Dr. Andy Roark:
And I was like, “Car lines are, they're tough. They're tough. And that's all I'm going to say, car lines are tough.”
Dr. Andy Roark:
“How long were you in the line though?”
Dr. Andy Roark:
“Honey, it's not about the minutes in line.”
Stephanie Goss:
Oh my God.
Dr. Andy Roark:
“It's really about just being at peace with the choices that we make and how important an education is. That's really what I think about.”
Stephanie Goss:
It explains so much why we make such good partners, because I'm a hundred percent the same way. Literally, so my kids haven't gone to public school since the pandemic started, but when they were still at public school, I can't with the carpool line. And they have always taken the bus, but occasionally there would be some reason why they would have to get to school before the bus could get them there, whatever.
Stephanie Goss:
I'm like, “Do you have your backpack on? You strap into your car seat.. I'm literally going to roll up. You're going to open the door, you're going to jump out and I'm done. I'm not sitting here, I'm not messing around. Screw this, because those lines are ridiculous and fierce.”
Stephanie Goss:
And my kids were like, “Okay, we're on it. Like jumping out of a plane.” That was it. “Bye Mom.” Slam the door. Goodbye. Go on my own way.
Dr. Andy Roark:
Oh, my rebellion really came and this is just… So the first lesson of this podcast is protect your peace. You don't have to be right. You can just let people believe things that they want to believe sometimes.
Stephanie Goss:
Sure.
Dr. Andy Roark:
45 years ladies and gentlemen, it took me to realize that I can just go, “Okay.” And go on with my life. I feel real grown up.
Dr. Andy Roark:
So that's the first lesson is, protect your peace. You don't have to be right. You can just let someone be wrong and just go on and be at peace with yourself. And the other part is this, and here's the story. All this started back when I had one kid in elementary school and one kid in middle school, so last year. Last year I kid in middle school, and a kid in elementary school.
Dr. Andy Roark:
And when you go pick your kid up at this elementary school, it is a well-oiled machine.
Dr. Andy Roark:
If the Germans ran a carpool line, like BMW put together a carpool line, this is the carpool line they would put together. Just plug in kids into cars, boom, boom, boom. It is like a three minute carpool line. The principal of the school has a walkie-talkie, and he is at the driveway, at the entrance of the driveway. And everyone has cards and he's pointing at each parent so that you were seen, because he points right at you. And you see him saying your kids' number into the walkie talkie. And people are just scurrying back at the school and they're just snatching kids up and just boom. And man, that line moves.
Dr. Andy Roark:
The middle school, which is dealing with kids that are-
Stephanie Goss:
Don't want to listen to adults anymore.
Dr. Andy Roark:
… sixth grade or over. But honestly, objectively speaking, they're smarter people.
Stephanie Goss:
Sure.
Dr. Andy Roark:
They're smarter than the elementary school. Objectively speaking, they have twice as much life experience as the kid at elementary school.
Dr. Andy Roark:
This should go better because you're dealing with people with twice as much life experience. It is a complete shit show at the middle school. There is no one at the car line. Kids are literally wandering along the line of cars looking for their family. And they're not on the sidewalk, they're in between the cars, wandering. They're completely lost.
Dr. Andy Roark:
And then one parent can't find their kid and so they just stop. And every [inaudible 00:10:57] Yes. And every other parent waits for… Boy into elementary school, if you can't find your kid-
Stephanie Goss:
Get out of line and come back.
Dr. Andy Roark:
Yeah. You get out of line. And they are on it. They will shift your car if you don't move it.
Stephanie Goss:
Oh yeah.
Dr. Andy Roark:
And I tell you, I'm only so aware of the middle school line, because once you've been through the elementary school line, you're spoiled.
Stephanie Goss:
Yes.
Dr. Andy Roark:
You know what I mean? And the two schools share a piece of land. There's like a big field and one school is in one corner and the other school's in the other corner. And one of them, you could just see the elementary school parents just plowing through and you're sitting there for long periods of time. And the fact that you can see someone else who is running a system that is working, and you are just sitting still, makes you so painfully aware and irritated. Because you know how much better this could be, and it's just not because people don't have their stuff together.
Dr. Andy Roark:
And so that is the other lesson in leadership is, boy if people see what a good thing is and then you don't give it to them, they recognize it. And anyway, those are my two life lessons from the carpool lane so far this year.
Stephanie Goss:
So everybody's like, “Okay, they're off the rails already.”
Dr. Andy Roark:
They were like, that was a solid 10 minutes of carpool metaphors. But I'm telling you there's gold in that. Listen to that 10 minutes again.
Stephanie Goss:
I actually think that there's some lessons in that last story about our question today. So we got a great question in the mail bag from a doctor who is looking at starting to work with a practice now. They are not currently employed at this practice. So, that's how it has to start. They're not currently employed but they're looking at a practice. And they have recognized that this practice does not utilize the team in a productive way. The doctors are basically being doctors and technicians, because there is one technician for three doctors. And the technician is doing assistant work like nail trims and drawing blood work versus utilizing her technical skills as a licensed technician. So that's problem number one.
Stephanie Goss:
Problem number two is that they said, “Okay, well so of course because of that it seems like the doctors are on the edge of burnout. Maybe some of them are already there.” And they said, “I'm a doctor, I've been out of practice for quite some time. And I've worked in plenty of practices that just have given up saying that, ‘Well we just have to work with what we've got because we're rural and we don't have a lot of a large talent pool. And so it just is what it is.'”
Stephanie Goss:
And so they are like, “Well if I join this practice, I'm going to have more experience than some of the other doctors. And so I am wondering could I even hope to come to them as the new fresh face and be able to bring my experience to the table and say, ‘Look, I think we could change this. I think we could be happier. I think that we could be more productive. But it requires change.'”
Stephanie Goss:
And their question was, “Can you lead people to water and make them drink? Can I hope to change this practice? And how do I start that conversation with grace, if there's any hope there?”
Stephanie Goss:
I just thought that this was such a great question and I do think that there's some hidden lessons in your carpool soapbox that relate to this.
Dr. Andy Roark:
If people haven't learned, the reason that I tell stories at the very beginning, it's often that they do tie into the point. I will say not always. Sometimes I'm just chasing deer out of the yard with a cowbell, and it doesn't have anything to do with anything else. But often these things are tied together. And it's because I'm thinking about what we're going to say and then I'm just thinking about what's happening in my life and I put them together.
Dr. Andy Roark:
Anyway, I love this question. This person doesn't need an answer from us. They literally said, “Can you lead people to water and make them drink?”
Dr. Andy Roark:
And I'm like, I'm sorry if you're writing an email to the podcast about leading people to water and making them drink… The whole reason people say the whole thing about the horse leading to water and making him drink is that you can't do it. It's the whole point of the saying. That's where… Guys, you can't.
Stephanie Goss:
I was like, “Well you could force them to drink. If you force people to inhale water, they drown. And a lot of times they probably die.”
Dr. Andy Roark:
Here's what I love is the person who wrote to us sees the situation so clearly they actually summed it up as, “Can you lead these people to water and make them drink?”
Dr. Andy Roark:
Your read on this is so good. It's so good that I have bad news for you it's real good.
Stephanie Goss:
You've given us the answer.
Dr. Andy Roark:
Yeah. Yes and no. Yes and no. But I wanted to hit on that, at the very beginning, because let's call a spade a spade. I don't want to drag people along like… Yeah, I can't make you love me, you can't make me love you. I don't remember. It was one of those. You can't make them love you if they don't. I think is how it goes.
Dr. Andy Roark:
Anyway, the person writing it has got a pretty good read on this. I'm going to call a spade a spade here and say, this looks dicey. I'm just going to be honest. It looks dicey. There's some things we can do that might work, but it's going to be a bit of a long game.
Dr. Andy Roark:
My question to this person was why do you want this job? Why do you want this job?
Stephanie Goss:
Yes.
Dr. Andy Roark:
In all seriousness, and again, I hate when people ask us questions and I say things back to them that are hard and I don't want it to shake people up. But my question back, and I get the impression this is a mixed animal practitioner who's got a pretty matter-of-fact style. And I would say to this person, Why do you want this job?
Stephanie Goss:
Yes.
Dr. Andy Roark:
You're looking at this and you see these people working themselves to death and not using their techs, and just hustling all over the place. And you're like, “Yeah, that's the place for me,” with the job market that we have now? Why is that?
Dr. Andy Roark:
And I suspect that there's probably a good reason. It's probably they're in a very rural arrow, something like that. But that'd be the first thing I would say is, given that you're already looking at this and wondering about it, you sure that this is a job you want? And so let me just ask, if you're going to take this job, I think the first… and we're talking headspace now as we always start out with headspace, my first thing is realistic expectations.
Dr. Andy Roark:
This is the way this practice has run for a long time. And you might be the most senior vet when you come in. That doesn't matter. That's how they've done it from the top to the bottom. Everyone has run this way. This is their normal and that's how they feel comfortable. And even if you try to get them to change to a better way, change is still scary. Even if it is undoubtedly better, it's still hard and scary. And you're getting a big group of people to move.
Dr. Andy Roark:
And these people don't know you. You're brand new, you don't have strength of relationships or a lot of trust built up in the trust account. And so can you make this work? Yeah, I mean I think you can. There's a chance you can. It really depends a lot on how they respond to the things that I'm going to recommend for you to try. But it's possible. I would just say have realistic expectations that this is going to be an ongoing source of… I hope it's not frustration, but it's going to be a sustained effort on the part of our writer to integrate into this and to not get swept up in the chaos.
Stephanie Goss:
My thought from a headspace perspective was very similar to yours, which is that asking yourself the question, why this job? For me it was like, this feels, from what the writer has given us, a situation where don't be blind. Look at it. Look at it and call the spade a spade, and then ask yourself the question of why. Because there may be a real driving factor, geography plays a part for a lot of areas of the country where people are there because maybe their parents are there or their spouse has a job there or whatever.
Dr. Andy Roark:
Sure.
Stephanie Goss:
Whatever the reasons, you've got to understand your why before you go into it, because you cannot go into this blind. You've already told us this is a situation that is less than your ideal. And so for me, in order to get into a good headspace and think about what an action plan would look like, I agree with you, it has to start with why are you doing this? Don't be blind about it. Do your homework, and then figure out how do you move forward with all of that in mind.
Stephanie Goss:
And I think the other piece of headspace for me, other than what we've already talked about, there was really only one other one for me, which is recognizing from the beginning, that if it doesn't feel like it could be a perfect fit, and it feels like you already have significant challenges, I think you have to go into it recognizing that there is probable impermanence to this decision. And so I don't think-
Dr. Andy Roark:
Probable impermanence. Yeah, I like it.
Stephanie Goss:
It may go wonderfully, and surprise you, and could turn out to be your dream job. But from the descriptor we got, this is not your dream job. And so the probability that this is an impermanent situation, and this is a trial run is very high. And so from a headspace perspective, for me, it's about recognizing that. And if you are okay with that, sure, go ahead. If all the other reasons line up, there's got to be some driving factor. Or to your point, Andy, with all of the jobs out there, if there wasn't driving factors, you wouldn't even be asking this question. So, recognizing that the driving factors exist, fine. But you also have to, don't go into it blindly. Recognize that this may not be a permanent solution and be okay with that.
Dr. Andy Roark:
Yep, totally. And I think that's really key. And again, it just goes back to expectations. One of the boundary things that … and I say this because it has helped me a lot in my career. There are times when you go into situations like this, and the healthiest thing you can do is in your mind headspace decide this is just a job. This is not defining me, this is not my dream job. This might not last for more than a year. It might be a one and that's it. You sign a one-year contract for the moment.
Dr. Andy Roark:
I think it takes a lot of pressure off people. People are like, “I have to take the right job.”
Dr. Andy Roark:
And I'm like, “It's a one year contract. We're going to do this for a year. And then you're going to decide.”
Stephanie Goss:
See what happens.
Dr. Andy Roark:
Exactly. “Am I staying here or am I going to go do something else now?”
Dr. Andy Roark:
And that is all the weight that there is to it. And if you put that in your mind, it will take a lot of pressure off of your shoulders to get things right.
Dr. Andy Roark:
So anyway, this is a one-year contract, it's just a job. We're going to see how it goes. It is not going to make or break your success as a veterinarian, anything like that. So those are the big things for me as far as just headspace, protect your peace. Just like I said at the very beginning, this might not end well and that's okay.
Stephanie Goss:
Yeah.
Dr. Andy Roark:
You might try to tell these people, and honestly, this is exactly why I told the story. You might tell these people there is a better way. And they go, “But you can't do it that way. You have to go in the car line.”
Dr. Andy Roark:
And you have to be able to say, “Okay, okay, you know what? That's the thing. I don't have to go in the car line, but okay.”
Dr. Andy Roark:
But that's, again, I don't even really like that. I'm always someone who's like, I want to get on board with what people are doing. But at the same time, I am not going to sacrifice myself, my happiness, my mental health just because everyone around me is doing that.
Dr. Andy Roark:
Anyway, those would be the things I'd put forward in headspace is, protect your peace going in. So that's it.
Dr. Andy Roark:
Now I think we have done a good job of being like, “Oof.” Now it's time for us to actually talk about what are we going to do here? So let's say we take this job and we're going into it. I am not fatalistic. I am a positive, optimistic, upbeat person. I'm going to play the best game that I can with the cards that I'm dealt. And so before we do this, actually let's take a break, and then you and I will come back and we will talk about how do we play these cards? What is our best shot for making this into something workable in the short term that might actually turn into something really good in the long term?
Stephanie Goss:
Yep. I like it.
Stephanie Goss:
Hey everyone, I just want to make sure that you know about some upcoming events from Uncharted that you are not going to want to miss. We have a workshop that is happening in October. It is the wonderful, the amazing Melissa Entrekin, LVT. For those of you who don't know Melissa, she is an amazing technician and she helps out our team on the Dr. Andy Roark side of things, on the medicine side of things. And she is doing her very first Uncharted thing. And I am so excited about this.
Stephanie Goss:
Melissa is going to be leading a workshop for us in October. It is happening October 19th and it is called Leveraging Technicians, Making Practice Less Stressful for You, Them, and Your Patients. I cannot wait for this one. It is going to be happening at 7:00 PM Eastern. So that's 4:00 PM Pacific on the 19th. And it will be a two-hour workshop, which means it'll be over at 9:00 PM Eastern, 6:00 PM Pacific.
Stephanie Goss:
It is, as always, free to our members. So if you are an Uncharted member, head on over to the website at unchartedvet.com/events. You can click the register button and register for free. And if you're not a member of Uncharted, you can join us. It's $99 for the workshop. Or you can look at all of the awesome upcoming events that we have, and it may make sense, very quickly, for you to say, “Hey, I'd like to get an Uncharted membership, because you get all of this stuff for free.”
Stephanie Goss:
So come join us for Melissa's workshop. You don't want to miss it. And hopefully, we'll see you in the community soon. And now back to the podcast.
Dr. Andy Roark:
Alright, so we are going to go ahead and talk about, how do we kick this thing off? So, Stephanie, you've taken the job. You are the doctor. You have signed on the dotted line. You're in this thing for a one-year contract. What are the steps that you're going to start to take to actually try to make this thing fly?
Stephanie Goss:
The question that I have, that is part of my answer to your question is, are you… Because I think, so they asked two more questions, right? They said, “Can I hope to change this practice? And then how do I start the conversation?”
Stephanie Goss:
So for the can I hope to change this practice piece, I think the other piece that falls between headspace and action for me is are you stepping into a position of positional power within the clinic where you actually can enact change? Are you buying into the practice or are you stepping in as a leader, medical director, senior doctor, whatever? Because the path I think that you take to addressing it, there is one path that is, “I've signed a one-year contract, I'm just a staff veterinarian. I'm an associate. I don't have a responsibility or the authority to implement changes.”
Stephanie Goss:
That feels very different than, are you actually stepping into a position where you can make decisions and can impact it? So that would be part of the question for me because going back to where we wrapped up with headspace, I think if you are stepping into a position as a leader, the headspace piece of it there, as you pulled it out is this is a long-term play. If you're stepping in and you can make change, this is not a one-year change plan. This is a long-term change plan.
Stephanie Goss:
And so, I think that's important to think about for a minute. But if you're stepping in and you're like, “I'm an associate vet. I'm going to sign a one-year contract and I'm going to see…” That's where I think, for me, the third question they asked is most relevant. Which is, how do I start the conversation? How do I start that process? I think that looks a lot different from that seat than it does from a seat of, “I actually have power and authority to make some of these changes on my own or with the rest of the group.”
Dr. Andy Roark:
I don't think it looks as different as most people would believe it does. I hear what you're saying about being the medical director and coming in. You do have some positional power, but I think I just want to dissuade anyone out there who hears this and goes, “Oh yeah, if you're the medical director you can totally change it.”
Dr. Andy Roark:
And I'm like, I don't-
Stephanie Goss:
Oo, I don't think it's any easier.
Dr. Andy Roark:
No. That's exactly it. Yeah. It's different. I do agree it's different. I'm not that much more optimistic in being the medical director versus being a regular doctor, because having positional power is nice. Relationship power is what gets people to actually change. They have to trust you and believe that what you are doing makes sense, and that they can get on board with what you're doing, and that they're going to be successful themselves if they come along with you.
Dr. Andy Roark:
And I think some people think it like, “Oh I'm the medical director, of course they're going to trust me now.”
Dr. Andy Roark:
And I'm like, “No. I've never had that experience really.” I think that people overestimate what being a manager or medical director does for them as far as getting people to change. And they underestimate what they can do as a non-positional leader. They underestimate the impact that they can have without a title. And I think that those things are important.
Dr. Andy Roark:
So I do think that that is a good distinction. Are you a formal manager or not? Based on this letter, I'm going to assume this person is not a formal leader. Just that they have may have more experience than the other doctors, but they're not coming in into a leadership, a formal organizational leadership position.
Stephanie Goss:
Yeah.
Dr. Andy Roark:
I do like that.
Stephanie Goss:
I agree. And so I think for me, how do I start the conversation? I think the answer is you have to give it time, because there is no relationship, right? And so you're talking about the most effective way to lead from the middle is relational power. There is no relationship. You're a brand new doctor, you're new to this team. And if you're asking this question before even taking a job, it's a great question to ask, but the answer could change dramatically once you get to know people. And so that, for me, is a bit of the pickle here is I don't think you can… I mean you could walk right in the door and be like, “I want to change this. How can we make this happen?” I don't recommend that.
Dr. Andy Roark:
I don't. No.
Stephanie Goss:
Probably not going to the way you want it.
Dr. Andy Roark:
Yeah, no.
Stephanie Goss:
Probably not going to go so well.
Dr. Andy Roark:
Yeah. So I agree with you on this. So step one for me is, relationships are going to be your biggest tool. So the first thing to do is just build relationships. Just meet people. Just get to know them. Get to know what they care about, get to know what their pains and their frustrations are. Don't do anything, except figure out what bothers them, and what is important to them. And why do they do this job? And what are the values of this practice?
Dr. Andy Roark:
And you say, “But I don't know what the values are. They're not written down anywhere.”
Dr. Andy Roark:
And I would say, what gets celebrated here? What gets positively reinforced here? Those are the values. And so figure out what these people care about. Figure out what their pain point is.
Dr. Andy Roark:
And people always say, “We know what their pain point is. They're working themselves to death.”
Dr. Andy Roark:
And I say, but that may not be how they perceive their pain. Their pain point might 100% be, “We're not able to see all the pets.” And if you go in and start talking about saying fewer pets, they're going to fight you even though you are clearly trying to help them in your mind. They're freaking out because they're not seeing all the pets, and you're trying to talk to them about seeing less pets. That's a mistake.
Dr. Andy Roark:
What is the alternative? The alternative is to say, “Well they care about seeing all the pets.” You need to talk to them about resting and about being able to keep themselves up so they don't burn out. And then they don't see any more pets. And that's how I approach that. It's not, “We're going to see fewer pets.” But, “We're going to keep you healthier and keep you around here, so you don't burn out and quit. Because that is the antithesis of seeing more of the pets.”
Dr. Andy Roark:
So anyway, but you can't take that approach if you don't know what they care about. So, number one is you've got to get to know them.
Dr. Andy Roark:
Number two, and this is really tied into that, is start with why. What is their why? Why are they doing this? Why are they working so hard? Why are they working the way that they're working? Is it because the doctors don't trust the technicians? Well then we need to figure out how to get them to trust the technicians. Is it because they have never had any sort of a structure or a program and they just simply don't know how to not step on each other's toes? It's always been this way and just no one ever got organized, and got consensus about what we're doing? Is it because the doctors all practiced wildly different medicine so we can't have a protocol?
Dr. Andy Roark:
Those are all very different. They can all be addressed. None of them are snap your fingers easy but they can all be addressed. But for God's sake, if you don't know which one is the number one cause, then you are going to be over there talking about what you care about and it's not even connecting to what other people are seeing or feeling. So build their relationships, and then figure out what their why is.
Dr. Andy Roark:
And then when you start to talk to them, talk about what your why is. And your why should be them. It should be about compassion for them.
Stephanie Goss:
Yes.
Dr. Andy Roark:
It should not be, “I don't want to work this hard.” That's not motivating. It should be, “I've never seen a place working as hard as you guys are working, and I'm worried about ya.” And that feels very different than, “I don't want to work this hard.”
Stephanie Goss:
I agree. You have to connect with them. And in order to do that you have to know what matters to them. And you have to be able to frame your needs inside of what matters to them for this conversation to be most successful. And so I think it's important to lead with the fact once you've made that connection that they matter.
Stephanie Goss:
Right now that's a potential. They could matter to you, but you're not even coworkers yet. So you can't say, “You know, matter to me, I care about you.” You could say it, but it's going to come off as false if you don't have that relationship. So you have to take the time to connect to them and then you have to lead with the why, which I think is a pretty obvious one. And you said it really well. You don't want people to burn out. None of us want our colleagues to burn out. And so, you can talk about that in so many different ways, but you have to be able to make that connection.
Stephanie Goss:
And for me, the second piece of how do you approach it, comes with the in-between because getting to the place where you have the connection to them, that's going to take time. You have to build the relationship, you have to get to know each other. And there are things that you can do to build relationships more quickly. But it's still going to take getting to know each other in a little bit of time.
Stephanie Goss:
Let's just hallucinate and say that you're really good at building relationships. You got to work with them, I would think for at least probably a few weeks before you could start to maybe even broach the subject. And so before-
Dr. Andy Roark:
Before you even start to needle along, yeah.
Stephanie Goss:
What do you do in those first couple of weeks while you're doing that? And so to me, the answer there goes, okay, you could lead by example. So if you've decided that this is the job you're going to take for whatever the reasons are, you don't have to work the same way that they are. You can lead by example. You can have a conversation with that technician and say, “Hey, I want to leverage your skills, I want to utilize you more. So when we work together I would like to work in this way. Is that okay with you? How does that work for you?”
Stephanie Goss:
You can then show them things and do things and try things. And say, “Hey guys, I've noticed that you do this this way. Tell me more about that because I'm used to doing it this way. And I would love to understand the why.”
Stephanie Goss:
You can start to poke at some of those things and lead by example, which goes directly to your point Andy, about the carpool line. Allie's going to do it her way, and that's okay. And you're going to be okay doing it your way. And Jacqueline's on board with that. And when she's with you, she'll hop out of the car two blocks away and be just fine. And when she's with Allie in the car, she's going to hop out of the car at the school's door, and she'll be fine with that too. It's that same thing with the rest of the team, the technician and the support staff. It's figuring out how do you lead by example while you're concurrently building those relationships I think.
Dr. Andy Roark:
Yeah. Okay, so I'm going to put a little framework on this. Okay, so we started off talking about what do we hope to accomplish? Where strategically are we trying to go? And now I think with the last thing you just said, we have switched over into that's a great idea, that's a great plan that we're trying to go. If we're taking this job, how do we tread water and not get sucked into the chaos that is here while we build that trust? And so I think you're exactly right. I think leading by example is a super positive thing, A good way to go.
Dr. Andy Roark:
As I said at the beginning, I think a lot of us underestimate how much power we have as a non-positional leader. Remember your positive reinforcement. It's so funny, people are like, “Is it okay for me to give feedback?”
Dr. Andy Roark:
And I'm like, positive feedback is always okay. No one is going to say, “How dare you praise me for being good at something. How dare you point out a success that I had and how impressed you were. How dare you?”
Dr. Andy Roark:
No one does that. It's just funny when we say “Can I give feedback?” What we mean is can I give negative feedback?
Stephanie Goss:
Right. Yes.
Dr. Andy Roark:
And that's how much we discount positive feedback is that when we say feedback we mean negative feedback. And I go, “No, you can a hundred percent see the things that you like and praise them and you can go ahead and start training your techs the way you want them to go, just by telling them what they do that you love and asking them if they'll do more of it. And telling them that how much of a difference it makes and say, ‘Hey I love that you do this. Could I make you a little request of you? When you do it this way, which is awesome. Would you be willing to make this modification or would you willing be to try it this way? Because I love what you're doing, and you would blow my mind if you did exactly what you're doing plus this one other step. Would you be willing to do that extra thing for me? It just makes a big difference.'”
Dr. Andy Roark:
And that's all positive, it's all grateful, it's all thank you stuff but man you can read with lead positive reinforcement. And the last thing that I say, and I think this because I think this is real important because I said I'm going to call a spade a spade here. And I don't want to hand wave away this or act like, “And then that's the answer.” Because that's often not how this goes. This is always hard.
Dr. Andy Roark:
The best thing that you can do, and I say this especially to this writer because they have indicated that they are a senior doctor. And I don't know how you do this when you're a young doctor. But if you've been in the game 10 years, 20 years, you have a pretty good idea of what your boundaries are, or you should. You should know what you're willing to do and what you're not willing to do, and how you're willing to be contacted on the weekends and how you're not willing to be contacted, or if you're willing to be contacted. You should know those things. How blood work is handled when on your days off and things like that. And so part of it is setting personal boundaries, if you want to set personal boundaries, you don't want to set them up when you're in the middle of a relationship, if you can help it. The best way to set personal boundaries is to set them up at the very beginning before … you know what I mean?
Stephanie Goss:
Yeah.
Dr. Andy Roark:
You set some boundaries before you go on your first date, and then they're a whole lot easier to enforce than trying to establish them later on in the relationship. And so being upfront about just asking the questions, it's not making demands. I would not be like, “Hey you're going to do this and you're going to do that.” But I would ask very pointed questions about, “How do you do this? And how do you do that? And if I wanted to have a technician with me to do this thing, could I have that and how would that be scheduled?” And it's just asking those questions.
Dr. Andy Roark:
So what's funny is a lot of people will say to me, “But Andy, what if I ask these questions and just sort of say, ‘Hey, I just need you to know I'm not going to come in on my day off.'”
Dr. Andy Roark:
And people go, “You would say that at a job interview?”
Dr. Andy Roark:
And I'm like, “You would.”
Dr. Andy Roark:
And they were like, “But what if you don't get the job?”
Dr. Andy Roark:
And I'm like, “But what if I do get it and they make me come in on my day off? I would much rather not get the job.”
Dr. Andy Roark:
I'll give you an example. So when I moved to Greenville, this has been a decade or more ago, I went to this practice and I was interviewing there and I really liked this practice. They were mixed animal practice, and I only do small animal. And they said, “Great.” They said, “We are mixed animal, and we a notice you don't do mixed animal.”
Dr. Andy Roark:
I said, “Yes, that's true.”
Dr. Andy Roark:
And they said, “Well would you be willing to take call? Because in order to have mixed animal, we do take call and the other doctors all take it. And so, you would be seeing mixed animal on call.”
Dr. Andy Roark:
And I knew that I was doing… I mean I was already traveling and speaking and doing all these things and I had a young family. “Guys, the truth is, and no shade on anybody. I'm not taking call. I'm just not.” And again, I don't-
Stephanie Goss:
Yeah. That was a need for you.
Dr. Andy Roark:
Exactly right. That's just where I was. And so I just said no. I said, “I would like to be here, I think this is great. I don't do mixed animal, and so I would not be able to be on call. And I totally understand if that doesn't work for you guys, but I just need to be honest upfront about what I need.”
Dr. Andy Roark:
And they still hired me. And whenever it came up, “Why doesn't Roark take call?”
Dr. Andy Roark:
I said, “Like I said at the job interview, that I'm not doing it. And I have always said that and that was the deal when I came on.”
Dr. Andy Roark:
And after a year or so, our clinic quit taking call. We quit doing mixed animal. We quit taking call. I put that forward. It's because I wanted that job. I wanted that job. And every instinct in me was, “Tell them you'll do it. Just tell them that you'll do it. You'll figure it out. You'll shadow another doctor and get it down enough.”
Dr. Andy Roark:
And it just was me saying, “No, no, I'm not going to do this and I'll go find another job if I have to. And I understand if it doesn't work. If you guys are going to be resentful because I don't take call then don't hire me, because I don't want to be in a place where I'm going to be resented. But I'm just going to be open with you about what I want to do.”
Dr. Andy Roark:
So anyway, I put that forward as far as personal boundaries, the more of these things that you can set up, not in a jerk way, not in a make demand way. Ask questions so that you can open up the conversation and just say, “Hey, this is really where my lines are. This is really what I need.” And if they say they're not going to hire you because you are not willing to dance in the streets of CrazyTown, then move on.
Stephanie Goss:
You dodged a bullet.
Dr. Andy Roark:
You dodged a bullet. Yeah, you just did.
Stephanie Goss:
And that's the hard part, right? Is that, I get the sense from our writer that they may end up be in a position where they feel like they don't have another choice. And that's okay. Sometimes just calling that spade a spade and saying, “Look, right this second, I don't have a choice. So if that's the case, how can I make the best out of this situation?”
Stephanie Goss:
And so you could have looked at that and said, “Right now I need this job. It feels like it fits. I will agree, concede, do on call in the short term, and in the back of my head I know I'm going into this knowing that this is not going to work for me long term.” You could have done that.
Stephanie Goss:
The other choice that our writer has is if they're back at… And sometimes that's okay. You guys, we're humans. Sometimes life throws curve balls at us. And sometimes we are choosing between the lesser of two evils and sometimes that's okay. It is okay to look at a job and look at it with that level of impermanence and say, “Right now, while I have parents who are dealing with terminal illness and I need to be right near them for the next year, I am okay making that sacrifice.” That is an okay thing to say. And that's a personal thing to have to decide.
Stephanie Goss:
If your back is not up against the wall, that is where it goes back to that do your homework. If there are things that matter to you as a doctor when it comes to being a technician, if you're like, “I don't feel comfortable doing these things. I don't have the skillset to do these things,” you need to be asking those questions upfront.
Stephanie Goss:
And I love that you said during the interview process, Andy, because too many people wait until they've accepted the job and then start asking those questions. And then they're disappointed and frustrated. And so if there are boundary lines for you, especially because the questions that this doctor has is about being a technician, because the other doctors are working as a doctor and a tech because they're not utilizing the technician that they do have and their skill set. I would ask those questions as part of the investigative process during the interview.
Stephanie Goss:
“Do I have to answer on weekends when you call me? Can I take a tech and ask them to do these things with skills that I would expect them to have?”
Stephanie Goss:
I'm going to just give an example, if you're in a state where technicians can do dental extractions and you're a doctor who normally lets your texts do it, if they have that skillset, you should be asking that question. Because if their answer is hard no, you have to decide if that's a line in the sand boundary for you or not.
Stephanie Goss:
And to your point, it is far better to know what those things are, like on call, like answering your phone on the weekends, like not being able to utilize your techs to do the things that they're allowed to do by the state's law. Whatever those boundaries are, it's far easier to have those conversations before you get into it, than already signed the contract, not have your back be up against a wall, get two or three weeks in and be like, “This was the wrong choice.” Because you just wasted your own time, plus their time.
Dr. Andy Roark:
Yep. I completely agree. And again, some of that comes from experience. Being a doctor who has worked in a couple of places… And I don't even know if you can do that really well if you've worked in one place. I think you have to work in a couple places and be like, “Okay, let's see. I see general variances, these are the questions I want to ask.”
Stephanie Goss:
Yes.
Dr. Andy Roark:
But what I would say on the flip side is, it's funny, both doctors and practices have this twisted idea that the point is to hire the other person and I want to hire them. And the reality is no, you want to understand the other person, and make sure it's a good fit.
Dr. Andy Roark:
And so I think that a good practice asks those questions. Because it doesn't benefit anyone to get someone hired and then have them be angry or resentful or to refuse to play the game. And so if you are interviewing a young doctor, you should say, “Hey, just so you know, this is how we communicate with doctors on their day off. Or this is the level of communication we expect with doctors when they're not in the hospital.” [inaudible 00:46:17]
Stephanie Goss:
How do you feel about that?
Dr. Andy Roark:
Exactly right. And people go, “Oh my god. Andy, you ask them that?”
Dr. Andy Roark:
I would say, “Yeah, because I sure as heck rather find out if we have a problem now than when they're board.”
Dr. Andy Roark:
And again, there's a lot of people who are so focused on getting a doctor hired that they don't want to ask questions they might not like the answer to. And they promise the moon to the doctors. And then ultimately, I don't know how that ends other than-
Stephanie Goss:
Not, Well
Dr. Andy Roark:
Not well. But I swear to God-
Stephanie Goss:
I tell you [inaudible 00:46:46].
Dr. Andy Roark:
Yeah, exactly. But you see what I'm saying though, right?
Stephanie Goss:
Yes.
Dr. Andy Roark:
Those practices are out there and I go, how do you think this is going to end? I don't know.
Stephanie Goss:
That's the most powerful lesson I learned in interviewing as a manager. And what you're talking about, Andy, there's a great story about the guy who founded Zappos and his cultural belief. The idea was he would pay people during the interview and onboarding process to not take the job. And I remember learning that story and I remember the first time I heard it and I thought, that's like you're crazy. Why would you pay people to not take your job? Aren't you trying to get people?
Stephanie Goss:
And his belief, and the culture that he was creating at the company was, “No, look, we want to know who we are and we want to find people that are a fit for us.”
Stephanie Goss:
And I will tell you guys, that is the most powerful lesson that I ever learned as a manager when it comes to interviewing. Because the reality is my interview process now is dramatically different than it was when I started out as a manager, as a result of learning that, and some painful lessons by making wrong hires along the way or giving into that, “Oh my God, I need a body in a seat and so let me just hire somebody.”
Stephanie Goss:
And every single time I regretted it. And now I have no problem asking those questions during the interview process. And I love teaching. Because to your point Andy, it's hard to learn that if you don't have the perspective of having worked in multiple places. Because the grass is always greener, you don't know what's happening on the other side of the fence.
Stephanie Goss:
And I love working with vet students and talking to them about, “Look, these are questions that they should ask you, but if they're not asking you the question you need to ask them. Because it's just as much about finding the right fit for you as it is for them trying to find the right fit for themselves as a clinic.”
Stephanie Goss:
And so asking those questions, I would far rather go through an interview process now as a manager and have somebody say to me, “Thank you for your time. I don't think this is the right fit for me.” And I have designed my interview process to be supportive of that, because I would rather have that than have somebody take the job, not have it be the right fit for them, and go to lunch the second day and never come back.
Dr. Andy Roark:
Yeah, no, I completely agree. I think that's a great analogy. Tony Shay, I think his name was. And he would offer people $5,000. I can't remember if it was to not take the job or if it was that 90 days to quit, it was one of the two.
Stephanie Goss:
To not take the job I think.
Dr. Andy Roark:
To not take the job. Yeah. Anyway, no, I'm on board.
Dr. Andy Roark:
So anyway, that's it. The big things to come back around to are, it's not impossible to go into the situation. It is very hard. And I just want to be upfront about that. If you're going to do it, set a plan that involves change over time. Realistic expectations. Protect your peace. Just set good personal boundaries for yourself so you don't get sucked up into this. Get in there, start meeting people, figuring out what they care about. Start building trust and ask them about what's important to them and why they do things the way that they do. And then that's going to give you the best opportunity to have these conversations and to make some changes. That's all I got. Stephanie. Anything to add to that?
Stephanie Goss:
No, I love it. That's it. Hopefully, this was one of those ones where the trip to Camp Tough Love wasn't too painful. But, this is another Camp Tough Love, because I think as our writer gave us the answer in their questions. You can impact change, but you cannot force this to happen.
Dr. Andy Roark:
Well if nothing else in this episode, I came up with the phrase dancing on the streets of Crazy Town, which I'm sorry, I heard that coming out of my own mouth and I'm like, “This is gold. I'm going to protect my peace from people dancing on the streets of Crazy Town.”
Stephanie Goss:
I love it. Have a great week, everybody. Take care.
Dr. Andy Roark:
See ya everybody.
Stephanie Goss:
Hey friends. Have you been over the website lately to check out all the fun and exciting things that are coming from the Uncharted veterinary team? If not, you should stop right now and head over there, because we have got some awesome stuff coming late summer and into the fall and winter. And I want you to be there with us.
Stephanie Goss:
We have our Get Shit Done Conference coming in the fall, that is happening in October. Before that, we've got a workshop coming in September from my dear friend, Dr. Phil Richmond. He's going to be talking about avoiding toxic teams, how to create psychological safety in our practices.
Stephanie Goss:
We've got the amazing and wonderful technician, Melissa Entrekin, who is leading a workshop in October about leveraging technicians, making practice less stressful for you, them, and your patients, and all kinds of other fantastic things you are not going to want to miss out on.
Stephanie Goss:
So, if you haven't been over there lately, head on over to unchartedvet.com. You can hit forward slash events if you want to go straight to the events page, but that will show you everything that is coming. And remember, if you are an Uncharted member, your membership gets you access to all of these workshops that we do on a regular basis for free.
Stephanie Goss:
And if you are not currently a member, you can check out the membership information, because it will save you big bucks throughout the year on accessing all of the workshops and it scores you access to the conferences when we have them, like Get Shit Done, for less money. That's right. Get a discount. And who doesn't love a good discount. Thanks so much for listening, guys. We'll see you soon.