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management

Mar 08 2023

Conflicting Team Members Who Won’t Talk To Each Other

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are answering a question you asked in the mailbag! That's right, this is going to be one of those episodes where everyone is asking “Are they talking about my practice? Are they talking about my front desk team? We had a manager reach out and ask us some questions about front desk team members who are butting heads and seem to be at each other's throats. They both have been coming to the manager or the practice owner or both and complaining about the behaviours from their teammate. Both of these team members fully admit they are horrible about talking to each other about the issues first. This manager is at their wits end and wanting to know “do we mediate, do we let them talk it out themselves?” Andy and Stephanie loved these questions. Let's get into this…

Uncharted Veterinary Podcast · UVP – 221 – Conflicting Team Members Who Won't Talk To Each Other

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


Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


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We know you are unique. Managing the business. Fielding never-ending questions from the team. Fixing broken printers, again. You wear more hats than anyone else in the practice. All of these look great on you, of course. But do you ever wonder “Am I actually in charge if I don’t own the practice? How do I manage the endless responsibilities of this job with limited power and resources? How can I keep growing professionally?”

If you’re itching to talk to people who really get what it means to be a manager, this is the event for you!

It’s time to connect with your fellow practice managers to share what gets you excited about your role, find solutions for what needs your focus now, and discover new ways to shine even brighter as a manager.

While Uncharted Membership is always encouraged, it is not required for event attendance! Non-members, here’s your chance to see what all the buzz is about and get a taste of the Uncharted experience. 

This 1-day virtual event on March 22, 2023 – don't miss your chance to join us!


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 continuing a conversation that started in our Uncharted community where a manager was asking for some help dealing with two team members who are butting heads. And they keep coming to this person as the manager or it's the practice owner and complaining about each other.
And this manager was like, “How do I deal with this? Do I mediate it? Do I make them talk it out? What do I do?”
And Andy and I had a lot of fun talking about this. I admitted some of my own greatest mistakes as a practice manager when it came to dealing with this in my-not so-recent path actually. We talk a little bit about my lack of poker face and we have a lot of fun. So let's get into this one.

Meg:
And now the Uncharted podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark and Stephanie I'm way too fine to feel this stressed Goss.

Stephanie Goss:
I don't even know what song that comes from, but I appreciate it very much.

Dr. Andy Roark:
It's from your anthem that you didn't know you had called “It's About Damn Time” by Lizzo. “It's About Damn Time.”

Stephanie Goss:
That's fantastic.

Dr. Andy Roark:
It's funny, my kids play it. And I refuse to admit that there's bad words in songs, even though it's obvious. And so I just sing really loudly, it's about that time. And they're like, “That's not the words.” And I was like, “I'm certain those are the words.” But the name of the song is “It's About Damn Time”.

Stephanie Goss:
So clearly this episode needs an explicit warning right off the bat.

Dr. Andy Roark:
Yeah, we come honestly, right off the bat.

Stephanie Goss:
Oh, it's so funny, because we had some community members this week who had the stories of their clinics get published. A friend of mine, Robin Brockton, was writing an article for today's Veterinary Business and was featuring some independent practices and some of the things that they're doing differently to live their truth and be their own people in our field, which is becoming increasingly consolidated in some ways.
And so we had two Uncharted community members who had their clinics featured as part of it, or three of them, excuse me. And one of the doctors, I shouted her out in the community because she's new and she just joined.
And she was like, “Oh yeah, there was a lot of listening to the Uncharted podcast to get to the place where I am and where we filled this culture.”
And I was like, “Uh-oh.” She's like, “I listened in the car with my kids a lot.”
And so I was like, “Oh, I'm really sorry for any swearing we did without a warning on it.” And she was like, “Oh, that's okay. They've heard far worse when I'm gardening at the house.”

Dr. Andy Roark:
We've talked about that before. We're pretty darn clean in our nature. So then people are like, “Sure, the kids can listen to this.”
And then every and now, and there's one bad word an episode, and I'm like, “We're probably in the worst place. We probably swear just enough to bother people who are listening with kids, but not enough to be cool for people who are really hardcore like us.”

Stephanie Goss:
Because let's be clear, when we're not recording podcasts.

Dr. Andy Roark:
So hardcore.

Stephanie Goss:
I definitely, yeah, I'm a swearer. And I told her the story. I said, “I'm that mom. My kids learned swear words from Broadway albums in the car when they were toddlers.” And I would sing the bad words and Jackson would go, “Mama, that's a word you shouldn't say.”
He was that kid though who would refuse to repeat them. He wasn't the kid who heard it, learned it, and went to school and was using the words. He was the kid who was like, “Oh, that's a bad word. You shouldn't use that word.”

Dr. Andy Roark:
I am not that way at all. I am the closet smoker of bad words. I sneak outside. I'll be on the phone outside and I'll be swearing, like, “Oh, you got to be kidding me.” But then in the house it's like, “Nope.”

Stephanie Goss:
It does. It sneaks out and you're just like, “Oh, Andy's on fire.”

Dr. Andy Roark:
I do, when I get fired up, there's something about a couple of bad words to really carry some weight. But I don't know. I keep going. I should just stop. I should be done with profanity altogether. But I don't know, I never quite do it. I wax and wain too. I'll get really good and then I'll just get really bad.

Stephanie Goss:
It makes my world a more colorful place.

Dr. Andy Roark:
I'll tell you why I had bad words just starting this episode off, because I talked to the credit card company today. And of course they're just jerking me around with like, “Oh, you have to provide this information.” I'm like, “No, I don't. What are you talking about?”

Stephanie Goss:
You're like I am me. It's been a very Monday, for a Friday.

Dr. Andy Roark:
And they're like, “We don't believe you.” They were like, “You have to fax us this documentation.” And I laughed. I was like, “Where am I going to get a fax machine?”

Stephanie Goss:
Yeah, who faxes?

Dr. Andy Roark:
I'm sorry.

Stephanie Goss:
Hi, it's 2023.

Dr. Andy Roark:
I'm just going to head down to 1990 and then I'll be reaching out to you. Anyway.

Stephanie Goss:
Oh man. It has been a Monday. It has been a Monday on a Friday, that is for sure.

Dr. Andy Roark:
It's been a Monday on a Friday, I agree.

Stephanie Goss:
But I'm excited because we had some conversation happening in, speaking of the community, they're awesome and doing amazing things. And we had some conversation about someone was struggling because they have some team members who are really struggling to communicate well and butting heads a lot. And both have independently come to their department leads or the practice manager or the practice owner and voiced concerns about the other person and working with them.
But they are not talking to each other. And they both admit it. They both admit like, no, I haven't had the conversation with them. They have different styles of just in general personality styles. One is really upfront and vocal, and the other one tends to be more passive and afraid of conflict. And gets really easily flustered when there is conflict.
And so the community member was asking like, Hey, how do we help this? Do we mediate between the two of them? Do we let them talk it out themselves and figure it out? Do we just hope that it resolves itself?
And they were like, I feel like maybe you guys did a podcast on this that I should listen to. And you and I both went, “That is a great podcast that we have not done yet.

Dr. Andy Roark:
I looked for it. I went back and looked. I'm like, surely we've done this? And I literally went back, and I was like, I don't think we have, I never found anything that looked like it.

Stephanie Goss:
No, I love it. So I'm excited. I'm excited.

Dr. Andy Roark:
Well, yeah, I am too. We get a lot of questions like this.
All right, cool. So let's go ahead and start to lay this thing down. We've got two people not getting along. They're both tattling on each other up to the leadership, and we got to figure out what to do with this. So as we do, let's start with headspace.
Where's your head at when you're looking at this?

Stephanie Goss:
My head immediately went to empathy in two ways. One is I have been this team member, I was this team member early on in my career and in a practice. And then also empathy on the leadership side, because oh boy, I have been there. And I think it is really common, this is the episode where everybody goes, “They're talking about my team, they're talking about my practice.”
And so I think that it's one of those things that we can easily recognize the emotions in. The frustration, the irritation, all of the emotions. I read the question and was like, oh yeah, I recognize this. I recognize this tree. I've seen it before.

Dr. Andy Roark:
I went immediately to frustration. This immediately frustrates the heck out of me. Because I'll just tell you, my emotional reaction immediately is “why can't you just grow up and fix it? Talk to each other like you're not six-year-olds.” And that is the crotchety, immediate frustration [inaudible 00:08:33].

Stephanie Goss:
Old man, “Get off my lawn.”

Dr. Andy Roark:
Yeah, exactly right. Figure it out like you are not infants. And go on. And that is, I'm just being totally honest, with the emotional reaction I have, because I'm a human being and I have dealt with this many times. But it is wildly frustrating. And that's why it's worth talking about because it's easy to blow this up. And that's why headspace is so important.
And so when we talk about headspace guys, I want you guys to know I like to lay down headspace. It is not because I live in a zen world, it's because I do not live in a zen world and I need to get my head straight so that I don't blow my face off when I load into this.

Stephanie Goss:
So you don't come down the crotchety Clint Eastwood and yell, “get off my lawn.” Because that's how you're feeling in your head.

Dr. Andy Roark:
That's exactly what's in my head, is figure this out. What are you, seven? But that's not fair. It's not fair.

Stephanie Goss:
But it's human.

Dr. Andy Roark:
Well, to empathize with the leader you've got… Here's the thing, here's where this blows me up. This is where I get blown up as a leader, is I have 87 things on my plate. And I have some real fires burning, like real things that need to get fixed. And then I've got Donna and Dave and they're like, “Dave is not talking to me.” And Dave's like, “Donna's just being a nag.”
And I'm like, “Look at my face. What on my face says I'm excited to handle this and I have time for it? Do you see that on my face? Would you look at me, because it's not there. Because I don't.”
And it always gets dropped on top of things that are actively burning. And so the self-control part of this is so important because it really does. It really does needle. It really does needle me.

Stephanie Goss:
It is huge, and I'm going to tell you guys a story. At one point in the not so distant past as a manager, I hit a place where I was feeling really burned out and I was not my best manager self. And I was doing a lot of things very, very wrong. And I was having some conflict amongst my team. And like you Andy, I was like… I'm laughing so hard because I can picture my face, and you have given me the feedback that I have a very expressive face.

Dr. Andy Roark:
You do have it, an overly expressive face.

Stephanie Goss:
I do not have a poker face.

Dr. Andy Roark:
You need to tone down your transparency a little bit sometimes.

Stephanie Goss:
I do not have a poker face. And I will tell you. So I was really struggling with my team and I was really struggling with some of the tattling. And to your point, it would always be when there was fires flaming. And I could not control my face and I could not control the epic eye roll that wanted to happen the second somebody opened their mouth to start tattling on somebody else.
And so I rearranged my office so that my desk, my back was to the door. So that when they came to the door and started to tell me about the thing, I had a few moments to pull my face together so that they wouldn't see my face, which was not, definitely not my best manager moment. And at the same time I get it, and I empathize so hard with that.

Dr. Andy Roark:
First of all, sometimes we need a crutch. It's like if you can't control your face, then maybe you should face away from the door. Just at some point you have to accept that me trying to control my face is not working. I need help.
The other thing is when you said that, I imagined you doing that so that when they come in and go, “Dave is really is being a jerk.” You could slowly turn your chair around.

Stephanie Goss:
That was the other thing that I learned.

Dr. Andy Roark:
Like a high back Dr. Evil chair and you could just slowly turn it around and say, “What did you say?”
Anyway.

Stephanie Goss:
The ultimate passive aggressive physical behavior right there, but I will admit, I leaned into it because it's hard. It's really hard not to be frustrated by that. So I empathize with your statement of immediately going to frustration.

Dr. Andy Roark:
I think that's hilarious. I wouldn't do it. But the idea of your employees coming to you and saying, “Donna is making me crazy.” And then you just slowly turn your chair around away from them so that the high back chair is hiding you. That's funny.
Also, Stephanie's [inaudible laughter 00:13:07], is shaking.

Stephanie Goss:
Oh my God. We're off the rails.

Dr. Andy Roark:
Okay, so hold on. We are and we're not. Let me pull this back around to make the point. What happens is we're busy and everybody's busy, and things are stressful and tensions are high. And that is when the interpersonal relationships break.
So you're not imagining that these things happen when other fires are burning, it's because other fires are burning that these things are happening. It's the overall tension and hustle and pace that cause breakdowns in communication. It's easy to communicate when nobody cares and nothing is at stake, and we're largely bored and got more time than things to do. That's an easy time to communicate.
It's like getting along with your significant other on vacation. That's not super hard. It's getting along with your significant other when you're both trying to go to work and the kids are doing things and the bills are coming due, that's a different beast.
Same thing. And so anyway, I know that felt like a fun tangent, but it also is meant to make the point of that frustration is very real. And that's when people blow themselves up, is because generally the leader is stressed by the hustle and bustle. And the same things that are stressing these people who are communicating are also sitting on our shoulders, so now this feels like a new problem.
And unlike the fact of, I don't know how to get all these pet owners in, I don't know how to get people the raises that they want. You complaining to me about Dave is a very tangible problem, and there's someone who's responsible for it and they're standing in my office right in front of me. And so it's easy to take frustration out on this situation, and I've seen a lot of people get in trouble when they do it.
So the first part of headspace is recognize that this is going to come at an inconvenient time. It always comes at an inconvenient time. And it's just part of the actual underlying drama. First thing is recognize that frustration is a real problem that blows this thing up.
And it's not going to be like, oh, they're going to come to me when I have lots of free time and I'm in a good headspace and I'll deal with it then. Know that that's probably not going to happen. They're going to come to you this time. Okay, so that's it.
All right. Now, there's a significant headspace question that we really need to parse through that I think cause a lot of people problems. And it's separating out two similar but different things. So let me go ahead and put some pieces on the board.
So the first thing, whenever I have two people that are not getting along in the practice and they come to me, we have to talk about the Karpman drama triangle. And so Karpman drama triangle is one of my favorite things. But it's this dynamic, it's called the hero-villain-victim triangle.
And so whenever you have conflict in your practice, look, and you'll see three roles being played. There is a victim who is the person who is being wronged, and there's a villain who is the person who is doing the thing that they're not supposed to do. And there's a hero, which is the person who comes in and saves the victim.
Now, you need to know this if you're a leader, because people will try to graph you into that hierarchy. And you don't want to be there.
What happens often is the victim comes to you, the manager, the doctor, the owner, the medical director, and they say, “There's a villain.” And they want you to go vanquish the villain and save the victim. And that makes you the hero. And so you want to do it because we all like to be the hero. Don't do it. Don't do it.
Because what happens is you train people to be victims and you train them that you are going to be the hero who solves their problem. The answer to the Karpman drama triangle is it to make it a drama line, which is the victim is also the hero who advocates for themselves and works it out with the quote unquote villain. Who also believes that they're the victim and that the other victim is actually the villain. And you know how it goes.
But I don't want to be in this drama triangle and I need to be very wary about getting sucked in. And a lot of people are listening and just putting their hand on their forehead and going, “I am the hero. I am the hero all day long, every day.”
And what I'm saying to you right now is that's never going to end. That's your life. That's your job. Because you have trained people that you'll be the hero, like Batman. How tired does Batman get of that stupid bat signal getting turned on? How often is he like, “Why can't you people just solve problems for yourself?”
It's got to be every night. He's been going on call for years.
And I joke, but think about it for a second. Like, don't worry about it, Batman will show up. You are Batman. I'm Batman. But it's not as cool as you thought it would be. It's exhausting.

Stephanie Goss:
It's true. And I would actually say that I definitely put myself in that space in that instance that I was talking about, because I trained the team. So my thought process in the moment talking about headspace was, okay, if I solve this problem, if I play the mediator, if I help them figure this out, this will go away and I can do the 25 things that were sitting in front of me that I need to do.
But to your point, I just was training them that they didn't have the tools to do it themselves. And so then there was never not a problem. There was always something. And it was a very, very painful lesson for me to learn as a leader, to recognize this is my life and I have created this life. And now how the hell do I get out of this life because I don't want it anymore?
I do not want to be Batman. I do not want to wear a cape. I do not want to have to solve their problems. I want you all to be grownups and solve your own problems.

Dr. Andy Roark:
So clearly this is where the episode ends and we just say the answer is they have to figure out themselves, don't get involved. Right. Wrong. And that is the distinction that I'm talking about making.
Now, there is a distinction between going to people and sorting out their problems and being the hero that fixes the issue. There's a difference between being that and being the coach who works with people on how exactly to solve their own problems because they don't have the tools to solve them.
But I'm going to coach you on how to solve this problem so that I can then step away and you have the tools. It's like if someone comes to you and says, “I'm hungry,” and you say, “Don't worry, I'll go catch you a fish.” As opposed to saying, “Okay, I'm going to go with you and teach you how to fish and then you're going to catch your own fish.”
But you have to go with them. You can't just be like, “Just go find food for yourself.” That doesn't help them. But there is a difference. You can be the person who coaches on how to find food without being the person who goes and finds food every day for these people who are not fighting for themselves.
And so anyway, that's the subtle distinction. I think a lot of people, and myself included, when this happens and I get frustrated, I'm like, I'm not fixing this problem for you, fix it for yourself. Because I don't want to continually be involved in “Dave won't tell me where he put the toilet paper and it's not where it's supposed to be.” Whatever the issue is.

Stephanie Goss:
How about “Dave didn't put the toilet paper roll on the roll holder.”

Dr. Andy Roark:
That's what it was, okay. But here's the thing. For headspace, you have got to frame this problem correctly. The problem cannot be, “Dave didn't do what he was supposed to do with the toilet paper and I need to fix it.” The problem has to be “Carol and Dave are not communicating, and I'm going to fix the Carol and Dave communicating problem.” And then the toilet paper, which is not a real problem, it's a symptom of the other problem which is communication, that's going to go away. And all the future symptoms are going to away.
Because if you keep focusing on what they're complaining about, you're playing whack-a-mole with symptoms that keep popping up again and again and again. And they will never end until you recognize the real problem is not that Dave parked in Carol's favorite parking space, it is that they don't know how to talk to each other and there's no end to the conflict they're going to have until they figure out how to talk to each other.
And that, my friends, that is a finite problem that you can involve yourself in, that you can set deliverables and timelines and metrics on. And you can attack it like a project, and you can do it and you can have it done, and then you can make it clear that the project has moved beyond your hands and they now have the skills to solve their own issues. And you can be out, but you have to recognize the distinction between those things or this is going to feel like a hopeless, frustrating thing.

Stephanie Goss:
Yes, and I think part of it from a headspace perspective is recognizing… I liken it a little bit to being a parent and that your job is never done. And I think one of the mistakes that I made from a headspace perspective was thinking, okay, if I teach them all these skills, then at some point I can brush my hands and walk away and I won't have to deal with the problems.
And you're spot on, that when we teach them how to communicate, then the job becomes significantly easier. And I think that need to be a coach sometimes is never going to go away.

Dr. Andy Roark:
No, never.

Stephanie Goss:
And I think that there are a lot of people who lean into, oh well, if I teach them these things, then I won't have to do this part of the job. It'll take care of itself. And the reality is that's part of your job. It will always be there. There will always be the need to be the guardrails and be a support system. And there will be times where you will have to say, what are your tools? Let's review them. Let's go through this. Because it's like being a parent. It never stops. It's always there. Even when they grow up and leave the house, you're still worried about it.

Dr. Andy Roark:
Well, when we were talking earlier, so you and I started off this podcast and we were talking about having a potty mouth. And how sometimes it gets bad and sometimes it's not so bad. And then we talked about the frustration that you feel when people come and they're like, they're having this problem, and it's really easy to not be kind or to be really angry.
And sometimes we're in a good headspace and we just handle it. And I was really thinking, you know what's true? And I was trying to be really honest at the beginning and say, “I have 100% screwed this up.” And I do these headspace things because I have to get into this headspace. The analogy now that I'm thinking about it is a lot of management, a lot of people management, a lot of leadership, a lot of communication, it's like eating healthy.
Where you can get into the habit of it and it's good and you can know all the things, but eating healthy every day all day is really, really hard.
And most of us, we have times when we're doing a good job and we're eating healthy, and then we have other times when we're not eating, we fall off the wagon a bit. I think that that's leadership and I think that's honest. And the idea that we're going to do this and then we're not going to have to manage anymore, that's like saying I'm going to eat healthy and then I'm not going to have to worry about it anymore.
It's like, no, it's an ongoing constant thing that you're going to have to pay attention to and you're going to have to have some discipline. And you're going to fail sometimes, and you're going to have to not beat yourself up. And get back up and just say, “Hey, I'm going to get back on to eating a little bit better.”
Same thing with our patients and our people. It really never goes away. And I think that's good in setting expectations so that we can be kind to ourselves.

Stephanie Goss:
Yeah. And I think the other piece of that from a bright light perspective as a leader is that the good news is is that when we actually take the time to tend and nurture this and we teach the team the skills and they become over time masters at those skills themselves, you create that cultural foundation where now instead of you being the person who has to do all the teaching, now you have multiple teachers who can help bring new people into the fold and teach them those same skills. And now it's not all on your shoulders.
And so for me, that was the driving force for me. It's like I don't want to have to be the only one to do this anymore or feel this way. I want to be able to teach them, not only these two who might be having the problem right here, right now, I want to teach them those skills, but I want to create a foundation where the expectation from within the team is we are going to use these skills and they are going to help create and drive that culture moving forward.

Dr. Andy Roark:
Well, and that is the positive. I don't want anyone to think that I'm saying you're on a hamster wheel, and you're going to work really hard at being a good leader and good communicator and a good listener, but ultimately it doesn't go anywhere and it never gets easier. And you're always going to be struggling.
You're always going to be working hard. I heard this thing recently that I really like, where life is uncertainty, pain, and hard work. And it just is, and it never goes away. And that's always part of it. And I do think that that's important for just to recognize that that's what it means to be alive. And at the same time, when you do a good job in these regards, when you eat healthy, if you will, ultimately you build healthy habits in your team and people around you. And you train other people how to treat each other.
And so when you fall off the wagon, it's not that big a deal cause other people didn't. You know what I mean? It's not systemic. If you have good relationships with your people and you've trained them to be autonomous and you've trained them to be responsible and good communicators, and then you have a bad day, the wheels aren't going to fall off. You have a bad month, you have a bad quarter, you have a tough year, which some of us have tough years. If you have manifested your values for long enough and you've got good people, and got them to buy into how we treat each other and our values, you can have a bad year.
And that doesn't mean you're a jerk every day, but it means you have hard days. Things won't fall apart. But you have to build that and you build that with a consistency.
So anyway, that's where I want to try to get my head in this is I don't want to blow my face off by getting really frustrated. This is probably going to happen when other things are happening and when I'm already stressed, it just is. That's not imaginary, that's how it is. And I need to accept that this is not the Karpman drama triangle, because I'm not going to fix their problem. I'm going to figure out what the underlying issue is, which is communication.
And I'm going to coach them and help them solve their own problems. But my part, I'm going to go in, I want to fix this issue, and I'm hoping that it's going to stay fixed. And I know that there's going to be breakdowns, there's going to be setbacks, there's going to be times that we may still need some attention on this problem, but for the most part I really want to try to address this as teaching them how to fish for themselves as opposed to me showing up every day and fixing problems and feeding them.

Stephanie Goss:
Yeah, I love that.

Dr. Andy Roark:
There's a lot of food metaphors going on right now, and they're mixed. There's some fishing.

Stephanie Goss:
My stomach is healthy growling. You're making me hungry.

Dr. Andy Roark:
I know. It's like you go, “Oh, is fish health food? Is that what he's talking about?”
It's not that deep. I'm mixing metaphors. I'm sorry.
Okay, let's take a break here, and then we're going to come back and let's talk about how we actually do this.

Stephanie Goss:
Okay, sounds good.
Have you done it yet? Have you headed over to the Uncharted website? The one that's at unchartedvet.com/events, and have you clicked on that link for the April conference?
If you haven't, friends, you need to head over and click on that link, and then you need to hit the register button. Because I want to see you with us in sunny Greenville, South Carolina.
In less than 80 days, we are going to be diving deep into tackling internal communications this spring. We want to talk about how do we improve our communications amongst our teams in a whole myriad of ways. How do we set boundaries? How do we have conversations about affordability of pet care and communications outwardly towards our clients as a result? How do we use language and maybe think about changing some of the language we're using to have better communication as a team?
Just previews of some of the awesome stuff that we're going to be talking about. So if you haven't done the thing, if you haven't put your fingers to your keyboard and typed unchartedvet.com/events, go do it now. Because I have hugs waiting for you in Greenville and you should not miss out on this.
And now back to the podcast.

Dr. Andy Roark:
All right, so let's go back and let's get into having this conversation. So we need to help these guys communicate with each other.
And you do this really well, Stephanie, as far as setting ourselves up for success and having conversations that are going to work with people. The first thing that you need to do, and this is where a lot of people get it wrong, be intentional about the time and the place that you do this. And it is really easy for, Dave comes in and goes, “Brad's doing the thing again and he won't stop.”
And I go, “Damn it, Brad.” And I jump up, I spin around in my chair, then I hop up, I charge out. And I go, “We're doing this now.”
And of course, Brad's trying to actively do something and this is no time to have this conversation. And it's a delicate conversation and I'm defusing a bomb with a hammer and then I make it worse. And then somebody's feelings are hurt and they feel unappreciated and unheard.
And then I got to sort that out before I actually get into trying to fix this going forward. I've literally made another problem for myself. And anyway, if this sounds like the voice of experience, totally not, I've never done anything like this. Never had an issue or a setback like this at all.

Stephanie Goss:
Oh man. Okay, so I love where you're going with this. I would love to take one step back from a starting point perspective and say, so the question was do we mediate? Do we let them talk it out themselves?
And I think where you're going is how do we teach them tools while mediating to get them to communicate with each other?

Dr. Andy Roark:
Yes.

Stephanie Goss:
And I would say, I think one of the most powerful lessons that I ever learned about coaching and being a leader was the value in stopping, what you were saying, taking not right now, but still engaging with them. And so now the most useful tool for me is when someone comes in, I give them my attention.
So it is an interruption to me, but I'm going to give them my attention and then I'm going to ask them, did they have the conversation with the other person?
And now our colleague from the community said they've acknowledged that they're not talking to each other. But it is very powerful and impactful for me to be able to ask my team, “did you talk to the other person already?”
Because when they say, “No, I did not,” or, “No, I'm really mad and I can't talk to them about it right now.” Cool, let's talk through what you might want to say and how you might want to say it so that you feel prepared to have that conversation.
Because I think that for me, jumping into the mediating didn't remove me enough from the Karpman drama triangle. I was still jumping into hero mode because I was jumping in to help them solve the problem. And yes, I was doing the thing and teaching them the communication tools and ultimately making it better, but the road was significantly longer to get there because I was still trying to jump into that hero role and solve their problems.
And so I think one of the most powerful tools is recognizing that this can be a coaching opportunity one-on-one before it moves into a coaching opportunity you with the two of them together.

Dr. Andy Roark:
Oh, interesting. Okay, I have to think about that. I hear what you're saying. I think my take would be, so the two options given were, do you let them work it out? Do you mediate the issue? And the answer to that is neither. It's neither.
You don't just let them go and work it out, because if they don't have the tools.

Stephanie Goss:
They won't work it out.

Dr. Andy Roark:
They're just going to damage each other more and it's going to get worse.
Mediating the issue of Brad parked in my parking spot, that's not of interest to me either. So in my experience, and you're not wrong. I guess it's probably your personal style. I have to think about it a little bit. I think for me, my take would be I'm going to bring them together and lay the foundation of trust. And I'm going to work on trust and start with ways of working, and then follow those with individual coaching as opposed to doing individual coaching and then bringing them together.
I don't think you're wrong. I think it's what you want to do. Let's explore this a little bit more and I want to figure out where our ideas differ here.
So for me, I want to bring them together and work on them. They're going to have to have this conversation. And so for me, time and place. I want to make sure that when we have this conversation of how are we working… It's a ways of working conversation. But when we have our ways of working conversation, do we have enough time? It should not be in between appointments. It should not be 15 minutes before the start. There should be some time.
And then also it's the place. I want to set them up for success, which means I really don't want other people walking in. I don't want other people coming into the conversation asking what's going on, things like that. This is an awkward conversation to have in a break room. You don't want to have it at the front desk and other people are walking up. The manager's office feels intense to me. I would get them out of there.
I would send them to Starbucks. Our friend Brian Conrad always did that. He would just send employees who are having problems together, he would send them, he'd give them a gift card and send them to Starbucks together. And tell them not to come back until you got this figured out.
And so I do think that there's value in get them offsite, get them out of there. They can be punched in because they're working through issues, but make sure they have time and make sure that they're in a place where they can focus and talk and not feel stressed out.
So that's the first thing that I would lay down to start getting my head straight.

Stephanie Goss:
Yeah, I agree with all of that. I think that you want to lower the stakes. They're already frustrated with each other, that's the reason that they came to vent or tattle or however it felt in your mind. That's the reason that they came to you in the first place is because they're frustrated. And so being intentional about giving space to be human and whatever that looks like, but lowering the stakes for them.
Like nobody's in trouble, we're just going to have a conversation. Because you guys need to figure out how to work together, because the reality is you're both employees and I value you both. And I want you to both be here, and we've got to figure out out a way to make this easier for both of you because you're frustrated, you're frustrated. I don't want to be frustrated, so I'm willing to help you. And we have to change this.

Dr. Andy Roark:
As I think about setting this thing up and going in and what I would say, I think I changed my position. I think that I do agree with you. I think what I would say to them before they had this meeting, I think my intention before this meeting would not be to coach them necessarily, but to try to get them to empathize with the other person.
And I would say, “How do you think Carol feels about this?” Or, “If I brought her in, what do you think she would say? How do you think she's feeling? What would her frustrations be?”
And I think that those are really valuable questions to ask one-on-one separately, because if they go into this meeting in a more empathetic headspace, I do think that you're loading the deck to be more successful.
And so when we first started talking about it, I'm like, how would I coach them before they talk to each other? Now, I think you're right, but I wouldn't aim for this is what we need to do. But I think my thrust ahead of time would be to talk to both of them and try to help them empathize with each other. And then if I can get them to empathize, then I say, “Let's get together and let's talk this out.”
And if I can bring them together in an open mind frame instead of having them come together with their arms crossed, I do think that that probably sets it up as successful. I think that you're probably exactly right, that that's a worthwhile investment of time before the meeting. I think that's a good call.

Stephanie Goss:
So part of it is in what you asked them to talk about. And so I think part of it for me is yes, what is bothering you? And getting to the root of it and figuring out, what are you actually upset about? Because a lot of the times the thing, it's a symptom, like you were saying. It's not actually the thing that you're frustrated about or upset about. And so getting them to ask themselves some questions, one of which I love what you said, one of which is what else could this possibly mean? What else could possibly be going on?
Is it possible that Carol lost her keys when she was trying to get out the door this morning and then she had a flat tire, and she has had a horrible morning and she is just in a really horrible mood? And so her response to you had nothing to do with you at all, but just was a byproduct of how horrible her morning was.
Can we get them into the empathy place? And the best question for that is what else could be going on? But also the secondary question to that is what story have I told myself in my head? And I think that's a big part of the communication toolkit for me, is recognizing, because we talk a lot about assuming good intent. And I think you can't assume good intent until you ask yourself, what am I actually thinking? What story am I telling myself here?
Because usually it's not one that starts with assuming good intent. Usually we're assuming wrong on behalf of the other person. And so getting them to think about what are they actually upset about, but also is it possible that there's something else going on here?
Could they hallucinate a place where there is an alternate reality, where it is happening and it has nothing to do with them? Because that's going to get them into a head space where they are more open-minded and they are more willing to empathize with the other person. And you can't problem solve with somebody until they have the capacity to get past the emotions that they're feeling.
And so sometimes it's having that conversation with them and sometimes it's like, oh, okay, you're really upset about this. And I'm here, we can totally vent about… This is a safe space. I want to listen to you and I want to actually help you solve this problem. And so if you need to call a timeout and you need to walk away from this, especially when team members are really angry at each other, there have definitely been times where I'm like, let's take a break and let's come back to this afternoon or tomorrow morning.
It's okay that you're mad. And this has to actually become actionable, so I want to help you do that. And you can't do that when you're amped up and you're in your feelings. And so I think getting them to think about that, to move them eventually towards the place of coaching in terms of what do you actually want to get out of this? How do you want to solve the problem?
And I think that kind of conversation, especially in the beginning when you're teaching everybody these skills, I think that's where it really has to start. Because it's so much more of an uphill climb to try and make that journey together in a group of three or a group of four than it is one-on-one. Even though you're repeating the process with them each individually, it's more time on your part as the leader. That has just been easier for me to do that kind of one-on-one with them.

Dr. Andy Roark:
So to restate this point maybe a different way, make sure we're on the same page. So I am on board 100% with having the conversation ahead of time. My goal in this conversation is not to convince them that they're wrong. It is to make them question if there's more to the story and to think about how the other person… They might not be a ruthless villain, they might also have a point. They might have a perception of the events, because they don't know things or maybe because they see things differently or how their experience is.
And so my point is not to make this person say, “Yeah, it's probably my fault.” It's like, nope, I just need to introduce the doubt, and make them say maybe this person isn't bad and maybe you guys just aren't communicating well.
And then that's where I would take it into a come together point. And so the way that I would do this in my mind is that encouraging, almost demanding that we assume good intent about people.
And say, “Hey, it doesn't sound like you're allowing good intentions on their part. You're assuming the worst in some ways. And how might this be a noble intention that's being misunderstood?”
And then I would set the time and the place, and say, “Let's go ahead and do this.”
So coming into this meeting, and I would bring them together. And then what I would probably do again, I'm saying this is a nagging problem. These people are not getting along. I'm assuming they've exhausted basic work it out strategies. For me, this meeting has the following agenda. And this is not something I would share with them necessarily, but for me it is.
I'm going in, the first thing is I want to state clear objectives. This is not a hangout session, it's not a therapy session. This is about us coming together to talk about how we're working. And I want us to figure out how to work together effectively and get along. And the way that I talk is going to be future facing. I'm not going to talk about what happened yesterday. I'm not going to talk about Brad and the toilet paper incident from two weeks ago.
My goal is not to be the judge of the case from last week. I'm not interested in that. I want to come along and talk about going forward, how do we communicate with each other? What's causing these issues so that we can not have them in the future. I'm not interested in guilt, I'm not interested in a fault, I'm not interested in justice.
And that's it. And I will be upfront about that. I'm going to pour a lot of praise on both of them and say, “You guys are great. I really want you here. I want you guys to work together.”
And so clear objectives, forward facing conversation. I'm going to start with the why. And I'm going to say we are here because you guys are both great. And I like you both, and I want you both to be part of our team. And I need you guys to get along and be able to work together.
And without me coming and being consistently involved, I can't be the referee for you guys. And so start with why. And beyond that we're going to move into commonality and values. And I'm going to start to say, “Look, you guys both do such a good job in these ways and you work so hard, and you're both a great fit for our practice. Because these are our practice values and you both have those values or serve those values. This is our mission and you guys both pursue that mission. You're part of the team, you do great stuff. How much you care is absolutely obvious for both of you.”
And what I'm trying to do is build this framework so they go, “Okay, I don't get along with this person, but we're not entirely different. And we do want a lot of the same things and we both want very similar outcomes at the end of the day. We both want to have a good place to work. We both do not want to be stressed. We both don't want to have to watch our backs all the time. We both want to believe we're making a difference for the pets that come in. We both want to believe that we're providing a good experience for pet owners who need us. We have a lot in common.”
And what I'm really trying to do is make the division between them feel small compared to all the things they have in common.
And so those are the things that I start laying down as I open this conversation up. And so just you know, this is what mediation with Andy looks like. What are we doing here? How are we going to go forward? I don't care about what happened in the past. I'm not going to tell them I don't care. But I'm going to say, “Look, the past is done. It's behind us. I want to go forward.”
And then I'm going to talk about why I want to go forward, it's because I think you guys are great. I'm going to talk about the values that we all share, the things we have in common. And I want to talk about those things, and that's why we're here. And so that's how I'd set this thing up to open it up. What do you think about that?

Stephanie Goss:
Yeah. No, I love it. I think that it is a great framework. And like you said, it doesn't have to be an agenda that they both have, but I think you have to try and work them towards feeling heard and then work them towards finding the commonality between the two of them.
And sometimes the reality is I don't have to like everybody that I work with. Sometimes you have people that you work with that you actually don't like, and that doesn't mean that you don't care about each other. Because if you both care about the work that you're doing, there can be commonality in that. And so the reality is even if you don't like them, who they are as a person, and I can't imagine a place where you or I or any of our friends would have people on their team who truly were horrible people.
That's not what we're about. We're about having good culture. And so the reality is if somebody is truly doing something that is malicious or has the intent to be mean or harmful, that's the stuff, that's my lines in the sand. That's my I'm not going to tolerate that. So I think we're not talking about that. We're talking about two people who do care about what they're doing, and maybe even about each other.
But even if they don't like each other, they still care. And so there is that commonality. And so I think finding that middle ground where they can recognize, “Hey, look, I that you wouldn't intentionally hurt my feelings or that you wouldn't intentionally be mean to me, but yet when you did this thing,” and actually calling out, what are we actually upset about?
So that's where that pre-work comes into play for me is what are they actually upset about so that you can work them to that place, like you said, of leaning into the commonality and the values to solve the problem, which is okay, is this an instance where we just have hurt feelings and you both need to resolve your hurt feelings? Does somebody need an apology from somebody else?
Is somebody actually doing something wrong? Is a job not being done? What is the actual issue and what do they both need to resolve that issue? And that for me as part of that pre-work is figuring out what is actually going on here and what do they need? And that's a very personal thing, because there are times where I'm like, I am not going to ever feel good about this situation if I don't get an apology from this other person.
If I'm mad at you, Andy, and I might be like, “Dude, I'm not going to feel good about this situation until Andy gives me an apology.” And there are plenty of times where I'm like, oh, I just need to feel like Andy sees that he hurt my feelings and then I move on with it. And it varies situationally and it changes every time.
So part of it is asking them, what do they actually need to get out of this? How do we resolve this? And making it actionable on their part in terms of how do you guys want to solve this problem? I'm not you, it has to be something that is going to work for the two of you. Because ultimately once you find that commonality, you have to drive it forward. And I love your approach of it all being future facing.
And so how do we move forward from this? What does that look like? How do we work, to your point, how do we work together? What are those ways of working? Do we need to put some rules in place for how we communicate with each other? What do we need to resolve this situation? And I think there are tools from a communication perspective that we can teach them that help with all of these things, teaching them how to actually give apologies to each other.
The reality is we are taught as children how to say the words I'm sorry, but we don't actually get the knowledge and the learning, most of us, for what actually makes up a good apology. And how do we do that without… You can apologize, it's one of my favorite things to talk about is you can apologize always. There's never a situation where you couldn't apologize for the impact that whatever happened had on someone else.
It doesn't mean that I think I'm wrong. It doesn't mean that I am even taking it back. Although lots of times want to hear how I've made another person feel, I'm like, “Oh gosh, that was not my intention. I did not mean that. I truly am sorry.”
And at the same time, there's also been times where people have been hacked off and I'm like, “Oh dude, that was not my intention. I'm sorry that you felt that way. And I don't think that what I did was wrong.”
It doesn't mean that you're acknowledging you did something bad, which is something that I had to learn. You don't learn that in communication as a child. And so I think that's part of it for me is teaching them those ongoing tools so that they can start to recognize how they create that relationship together, even if they don't actually like each other, because they don't all have to be friends.

Dr. Andy Roark:
Yeah, I completely agree. I think where we go after, so the commonality groundwork stuff is 100% dependent on what's going on. And I completely agree with you. I don't know how to make a structure to say, “And then you say this.”
I really like your idea of what's going on? What do we need to go forward? I will tell you there are a number of tools that can make this conversation so much easier. And I'm not saying you should have all of these, but you can. A few of the tools that I like and have had a lot of success with is we use DISC in Uncharted. Sure. We used it for our employees and Stephanie teaches it in some of our communication training stuff.
It's a thing that we use to help people work together. And we use it in exam room training and communication training. If you are having team members that are having hard times communicating with each other, DISC is great.

Stephanie Goss:
Super helpful.

Dr. Andy Roark:
It's generally very affordable. It's a staff meeting. You can do it in a staff meeting.

Stephanie Goss:
Because it's not about right or wrong. That's what I love about DISC. It's not about right or wrong, it's about how we feel and learning how to take how other people receive information and change what we're doing to have a better approach. It's not a negative thing. That's part of what I love about it so much.

Dr. Andy Roark:
That's exactly right. Everyone's got different communication styles, and I feel like you can use DISC to unlock a lot. If you have that doctor that is just dominant or just bulldozes people, that person may be a high D personality. And if you say, “Hey, this is what you are and this is what other people are, and this is how they communicate and how they like to be communicated with. And because of that, they see you as an intimidating person or they're feeling bulldozed by your communication style.”
And then you can also say to the person who feels bulldozed, “Hey, you're not wrong. This is the style this person has. No, it's not because they don't like you. It's not because they think you're stupid. It's because this is their communication style.”
And that doesn't mean that's okay, but it does mean that this is where they're coming from. And it's a nice tool to open those conversations up about why we communicate in different ways. And so DISC, D-I-S-C, you can find it and check it out, but we use it for Uncharted in our team and we use it when we teach exam room communication stuff.

Stephanie Goss:
And I love, because it takes… When you have two people who have different communication styles, ultimately it goes back to what I was saying, which is how are we going to move forward? When you look at DISC and you look at the different styles, you learn, how do we meet in the middle, somewhere in the middle. Maybe it's more one-sided than the other, but how do we both move from where we are to move forward in the future?
It's like how do you take those differences and make something new with it? And I think it goes along with how do we solve this problem? How do we meet in the middle? And I think it's a super, super helpful tool.

Dr. Andy Roark:
The second tool I'd put out here is languages of appreciation. Being able to get positive reinforcement that other people feel, that's an important part of building a relationship. If nothing that you say to the person is seen positively, if you can't make them smile, then you're always starting at neutral. And it's really easy to go down, but you don't know how to make it go up. You don't know how to gain brownie points in that person's eye if you don't know how they like to be appreciated.
And so just having a general way in your staff where you try to assess how people like to be appreciated, it's just a smart investment. It's part of onboarding. I really like it a lot. And Stephanie and I have talked about this a number of times in different episodes, but it's questions like, tell me about a time that you felt really celebrated.
Tell me about a time that you felt really appreciated for a job well done. What did that look like? And I'm trying to figure out, is this an affirmation person? Is this a gift person? Is this a service person? Meaning if you want to make me feel appreciated, jump in and help me. My wife and I have two very different styles. I am a verbal affirmation person. I want you to tell me I'm doing a good job. And my wife is a service person. She wants you to jump in and help.
And I can't tell you how many times early in our marriage, I'd be like, “You're amazing.” And she's like, “Why don't you shut up and help me?” And not really that, but that was basically what it came down to was I am pouring out verbal affirmation for her, and all she wants is for me to come and be involved in the project that she's doing so she can get done.
And it's funny, I'm like, “Oh, I'm happy to do the work by myself. I just want you to tell me that you appreciate me and I'm doing great, and I'm awesome.
She's like, “I don't need you to tell me I'm awesome. I need you to come and help me do the thing, because that shows me that I'm appreciated.”
So anyway, I just used that as an example of different styles. And so anyway, languages of appreciation, if you're interested in that stuff there's a book called Five Languages Of Appreciation In The Workplace, and you can check that out.
But I do like to ask the staff how they like to be appreciated because that can help us to appreciate each other. And then the last thing is a good old fashioned ways of working conversation or a ways of working tool form kit thing, thingamajig.
Yeah, it's not a formal thing. This is a thing you make yourself. But basically it is worth the time to ask people, how do you like to receive feedback? What's important to you a when you about… When you do a good job, how do you want to hear about it?
If someone wants to give you feedback, how do you like to get feedback? Do you like to just get it directly? Do you like to have it come later on? What are the expectations that you like to have in and around your work and around how we communicate? And again, that plugs into the disc thing as well, but I just think anything that we can work on and just say, “Do you want to have one-on-ones? Do you like to have check-in meetings? How do you feel engaged? How do you feel informed? How much oversight do you have? How much do you like people to check over your shoulders?”
Things like that. If you can get some sort of a sense of how people work, a lot of times their ways of working can be very different. And you end up with someone who says, “I love when people check after me. I want to make sure I'm doing everything right.”
And you have someone else who says, “I hate when people check up after me. Just tell me what you want from me and leave me alone.” And those are not wrong. They're not bad people. But when we have someone who says, “I really like to have people check up on everything I do.”
I go, “Okay, how do I get this person to be able to work more autonomously so we don't have to do that?” And people who say, “I never want to be checked up on, how do I get this person to understand, I don't want you to go too far off the rails before anybody notices and comes along to have to make adjustments about things that maybe you just didn't know about.”
And so anyway, if I don't know that that's how you'd like to work or what your ways of working style is, it's really hard for me to help you. And so having those conversations ahead of time can be valuable.

Stephanie Goss:
Well, and I think it's really important, because they're all tools that help them develop empathy for one another, that you're asking them to look at things that help find the common ground. And imagine a place where they could put themselves in the other person's shoes, which is honestly the best tool that I have ever found for getting them to communicate better. Is what does middle grounds look like and how do we get there? And so I think all of those are great resources, because you got to get them to be able to empathize with each other.

Dr. Andy Roark:
Yeah, I completely agree. And so that's what that conversation looks like. It's definitely, I'm not trying to get to the bottom of it. It really is, “Hey, so how do we go forward and communicate? And what do you guys need from each other?”
And honestly, at this point, I might leave the meeting and be like, “Hey, I want to leave you guys here. I want to let you guys just talk it through how you work together, what you need from each other, how you can be happy working together, how you guys can respect each other and collaborate? And when you guys get it all worked out or when you feel good and you guys feel like you have a groundwork for being collaborative and being happy together, then come on back.”
And at that point, because they do need to work through it on their own. And I don't want to be there holding their hand until the end. But I can facilitate this, get it started, talk about why we're doing this and what we need. Give them some tools, and then step away and let them work on it and work on how they want to communicate and how they want to work so that they feel good. And anyway, that's how I would set it up.

Stephanie Goss:
I think the two last pieces that go with that is then you have to know that there're going to be slip-ups; we're human. And you're not going to jump from radical miscommunication to perfection. And so recognizing when there are slip-ups, being able to come back to the foundation that they created together and remind them, “Hey, we talked about this before and this was what you guys agreed you were going to do. Have you done that thing?”
And then the last piece is you got to catch it when it's going good. And so it becomes your job as the leader to start to pay attention to this and call it out. And with the hope that they get excited about the wins. And that's the real Yoda place for me is when they come tell me, “Hey, this thing happened today and instead of getting pissed off at each other, this is what we did to solve it. And I just wanted you to know.”
Because when they feel proud of that, and that comes from training like we would any other simple animal, which is rewarding when the good happens. And so I think that as our job is not just to give them the tools and then walk away, and go, Jesus, take the wheel. That's not how we operate. We have to be able to say, “Hey guys, you guys did a great job today. How do you think this week went?” And have those follow-up conversations to keep that the good ball rolling.

Dr. Andy Roark:
Yeah, I agree. All right, guys, that's all we got. I hope it's helpful.

Stephanie Goss:
Have a great week, everybody. Take care.
Well gang, that's a wrap on another episode of the podcast. And as always, this was so fun to dive into the mail bag and answer this question. And I would really love to see more things like this come through the mail bag.
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 mail bag at the website. The address is unchartedvet.com/mailbag, or you can email us at podcast@unchartedvet.com.
Take care everybody, and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: behavior, culture, management

Mar 01 2023

I’m Drowning In Lengthy Patient Records

Uncharted Veterinary Podcast Episode 220 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are answering a question you asked in the mailbag! That's right, this is going to be one of those episodes where everyone is asking “Are they talking about my practice? Are they talking about my doctors? *Gasp* Are they talking about… me??? Stephanie felt a bit seen too when they recorded this episode so fear not, you are all in good company. We received an email from a veterinarian who said “I’m drowning in records and it is the major source of my anxiety in life right now. I look at my colleagues to see how they do it, but I realized they literally just don’t do them. That’s not an option for me and I need help!”

Let's get into this…

Uncharted Veterinary Podcast · UVP – 220 – I'm Drowning In Lengthy Patient Records

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


Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Upcoming Events

Do you struggle with team building? Does the mere mention of it make you break out in a cold sweat or make your team roll their eyeballs so far back in their head, you worry they might stick? Or do you LOVE playing games with your team and are looking for some new ways to have fun with them? No matter how you slice it, team building is Camp Counselor Stephanie's jam and we are going to have a blast digging in to team-building exercises that are fun, accessible for everyone regardless of physical abilities and won’t inspire eye rolls from the team. Get ready to learn quick, easy-to-execute games and activities you can lead with minimal prep time. Every exercise takes less than a 60-minute staff meeting to run – most of them topping out at 5 or 10 minutes!

March 5, 2023

Time: 4pm ET/1pm PT – 6pm ET/3pm PT

Learn fun, accessible and easy-to-execute team-building activities.

Calling All Practice Managers – The Uncharted Practice Manager Summit is Happening!

We know you are unique. Managing the business. Fielding never-ending questions from the team. Fixing broken printers, again. You wear more hats than anyone else in the practice. All of these look great on you, of course. But do you ever wonder “Am I actually in charge if I don’t own the practice? How do I manage the endless responsibilities of this job with limited power and resources? How can I keep growing professionally?”

If you’re itching to talk to people who really get what it means to be a manager, this is the event for you!

It’s time to connect with your fellow practice managers to share what gets you excited about your role, find solutions for what needs your focus now, and discover new ways to shine even brighter as a manager.

While Uncharted Membership is always encouraged, it is not required for event attendance! Non-members, here’s your chance to see what all the buzz is about and get a taste of the Uncharted experience. 

This 1-day virtual event on March 22, 2023.


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 a question from the mailbag, from a doctor who finds themselves absolutely drowning in records. And they are struggling with their own mental health and well-being as a result of it. And it's complicated further by the fact that their partner is also a veterinarian who finds themselves in the same boat. And now, they've found themselves spending time that they want to be spending together outside of work, working on work. It just doesn't feel like a sustainable situation, and they are wondering, “How do I get out of this mess?” Let's get into it.

Speaker 2:

And now, The Uncharted Podcast.

Dr. Andy Roark:

We are back. It's me, Dr. Andy Roark, and Stephanie Goss.

Did you hear that? Do you hear that? Behold the technological might of the Uncharted Veterinary Podcast. Didn't know we had power like that at our fingertips, did you, Goss?

Stephanie Goss:

I didn't know you had power like that at your fingertips.

Dr. Andy Roark:

I think if you said something and then sound effect, I think it would happen.

Stephanie Goss:

I've always suspected that Dustin Bays has that power at his fingertips.

Dr. Andy Roark:

Well, Dustin, who puts our podcast together because he holds the power. Yes. Cool. How are you doing here?

Stephanie Goss:

I am good. I am good. It is been a crazy busy morning. Yeah, it's like when you go away. So we just got back from VMX and this was the first time that we've traveled since the beginning of December. And so I actually felt really good about leaving this time. I felt like I had my little checklist, did I get all the things done? Did I give everybody they needed so that everything, the wheels can keep turning while you're gone. And even when you do all the things and then you come back and it's like you got to dig out of the email and the messages. And I got back yesterday and I was like, “Holy Batman, there's like 900 Slack messages to read.” And it's good, but it's just that busy, busy feeling of jumping back in. And I always feel guilty because I've gotten to this place where I usually block a day or two after coming back from something to catch up and dig out where my calendar isn't really open, I'm not doing things.

Dr. Andy Roark:

Yeah. I did not feel good leaving, because my daughter turned 15 last week, and the Friday that we were leaving for VMX, she had Friday off, that was the Friday before Martin Luther King Day and she went for her driver's permit test and she did not pass it. And so as I'm trying to go to the airport, my daughter is coming home and she's devastated, because of course she's told her friends, getting my permit and she will not come out of her room. And I'm like, “See you in five days.” And it sucked so much.

So I thought on the teaching of Stephanie Goss and I was like, I want her to feel supported even though I got to go. And so I thought, what is her language of appreciation? What is her love language? And Jacqueline's love language is gifts. And so I sprinted to the grocery store and bought her a bouquet of flowers and sprinted back and I was like, “These are for you. I love you. Everything is going to be fine. I also failed my permit test the first time it happens to everybody. Here you go.” And I came with the flowers and I left, and she survived. And so I got home and she had gone to get her permit and so I get home the day that she actually went, she rescheduled, went in the morning next week when I got back from VMX and got her permit.

And so her mother, who's a rule follower, was like, “We're going to wait until this weekend and then we're going to go to a parking lot and we're going to let her drive the car that we think she's probably going to drive around and she's going to get acclimated to the brakes and things like that.” And her mother left last night and Jacqueline looked at me and she was like, “Hey, can you show me the buttons in your car?”

And I was like, “The buttons? Us? Let's go for a ride.” And so I took Jacqueline out and it's like nine o'clock at night is pitch black and we live in the country, but I'm like, “What could possibly happen?” And so I've got her on this road in our neighborhood and I'm letting her drive and she almost put us in the ditch about three times. But once I was in it, I couldn't be like, You know what? This is a bad idea. Just put it in park and get out because this is a mistake.” But I'm a smile on my face. Super dad. And I'm like, yep, no, it's okay. That tree came,

Stephanie Goss:

I changed my mind.

Dr. Andy Roark:

… out of nowhere. So anyway, we made our way down and back.

Stephanie Goss:

Okay. Yeah. In fairness. Wait, wait, wait. In fairness, I've driven on your road and I would not want to drive on your road as a brand new driver at night when it's pitch black. That's like you made the fatal mistake where you should have taken her to an empty parking lot.

Dr. Andy Roark:

That's what my wife said, and I am willing to consider the idea that my decision might have been bold. I will also say for the rest of her life, she'll remember the day she got her permit and she and her dad drove down the cul-de-sac by themselves.

Stephanie Goss:

Almost driving in the ditch.

Dr. Andy Roark:

I don't know that she knew how close we were. It's kind of like…

Stephanie Goss:

Fair. It's probably better for her that way.

Dr. Andy Roark:

Oh yeah. I didn't want to be like, “Oh, by the way, if that could have been really bad.” I was like, “Nope. We had it the whole way.” Basically the first three years of me being a practicing veterinarian have trained me to be like, everything's fine,

Stephanie Goss:

Everything's fine.

Dr. Andy Roark:

No, it's all good. I know exactly what I'm doing and everything is fine. And so I have those muscles and I used the heck out of them last night.

Stephanie Goss:

Oh, poor Jacqueline.

Dr. Andy Roark:

No, she was so happy. She was so happy. And it was absolutely worth the risk of property, life, limb and neighborhoods, and the neighbor's mailboxes. They were all worth the risk that was taken.

Stephanie Goss:

The parking lot at the school is usually a good choice. Not when school's in session but after hours because it's usually pretty wide open because of all the bus space and there's usually nobody around.

Dr. Andy Roark:

Well, we're going to do that, but it just…

Stephanie Goss:

Let's start on your road, which is narrow. It has lots of trees, ditches off to both sides. It sounds like a great idea. And to put this in perspective for you guys, I've been to Andy's house and I'm afraid to drive backwards down your driveway.

Dr. Andy Roark:

Yeah, well I drove her out of the driveway and then just kind of let her go. But yeah, it's one of-

Stephanie Goss:

Like, Goss, you're not helping the story here.

Dr. Andy Roark:

No, you're not helping me at all. But it is one of those things too where after it's over, you look back and go, wow, that was a bold choice. There's a number of things in my life where I'm looking back, I'm like, I see how that could have gone badly, but it didn't. And so we're just going on. Everybody's going to be cool.

Stephanie Goss:

Oh, man. Oh, man. Well, I am excited about today's mailbag questions. This one is, it's funny because it is business related but also a little bit medicine related and I just thought it was a good one and one that we have gotten kind of repeatedly in different ways. So we got some mailbag questions about record writing because they basically all said, “Oh my God, I need tips because I am drowning in records, I'm drowning in records. How do you keep up with record writing, particularly as the veterinarian?” And we have seen several of these. And this, I thought I pulled out some pieces out of this one because it was so great. They were just, “Records are a major source of anxiety in my life right now I'm looking at my colleagues to see what they're doing because they're all leaving at the end of the night. They finish their cases and they walk out the door and I'm there for hours. And so I was looking to them to see what could I learn from them. And what I realized is that they just aren't writing the records.

And so this vet was like, that's not an option for me and I need help because I find myself working all day and then I'm staying late. I spend days off doing them and I'm still behind. And their partner is also a veterinarian and they are also in the same boat. And they both feel like they're spending so much of their free time that they should be spending together. They are spending it together, but they're spending it together, writing up their charts, which is miserable. And as they were saying, it's straining us both. And I don't think that it's sustainable. So they were like, “It seems like a easy answer should be work stays at work and home time is home. But we can't seem to manage that while being overwhelmed with patients at the clinic.” And so they were like, “I know this is a common problem, I've talked to some of my peers and other people are having it too. But is this just something that I need to accept? How can I balance and try and keep up with the record writing?”

Dr. Andy Roark:

Yeah. I love this topic. I love this. I could speak very passionately about it and I'm going to, and I'm going to.

Stephanie Goss:

Is this is going to be a soapbox episode for Andy.

Dr. Andy Roark:

Okay, let's begin. Because writing up charts is part of being a doctor. It is a big part of being a doctor. People don't recognize how big a part of being a doctor it is. And God, a lot of people really suck at it. I mean I don't come on here and say, boy, people suck a lot, but this kills me.

Stephanie Goss:

That's a truth.

Dr. Andy Roark:

People suck at this and the vet schools train people in a crap way to do this thing. And it starts at the vet schools and people are like, “This is how you do it.” And I'm like, “That's a terrible way to do it.” And I'm going to talk about why it's a terrible way to do it, but I'm not telling saying the vet schools should do it differently and I'll impact that in a second. But here it comes here. So we just came to-

Stephanie Goss:

They do it terrible. But don't James the way you're doing it.

Dr. Andy Roark:

It's terrible. It's terrible and, okay here's why it's terrible. The point of medical records in a vet school are to teach people. It is basically like you writing an essay about the case that you're on for your attending clinician to read and understand your thought process and see if you understand what we're doing. And so for that reason, a robust medical record of your thoughts and feelings and emotional journey with this case is valuable.

Stephanie Goss:

Ok. Fair.

Dr. Andy Roark:

That is not the point when you're in general practice and you're trying to push cases through your clinic and get care to people on a deadline, right? It is, you're not being graded by anyone. The robustness of your entries is a negative, it's not a plus. But we're trained in vet school to write more. There were times in vet school I was a hundred percent hammered for not writing more, giving more possible differentials, explaining more what could be done and when. And I go, I get that in vet school they were trying to get me to extrapolate on what I knew. In practice, that's a massive problem and I'll walk through that. But that's why I say, I'm not saying the vet schools should do it differently. I think the vet schools should say, “This is how you do it in vet school.” And before you leave vet school, here's how you do it in practice. And that's what I think. So anyway, it's a bit of a racket.

Stephanie Goss:

This is going to be a feisty episode because I feel like I disagree.

Dr. Andy Roark:

Okay, well let me lay out my position-

Stephanie Goss:

Go for it.

Dr. Andy Roark:

… before you start to disagree.

Stephanie Goss:

Go for it.

Dr. Andy Roark:

But here's the thing.

Stephanie Goss:

All right.

Dr. Andy Roark:

Medical records are important and we were just at VMX and I talked to a veterinarian who works for the AAVSB, American Association of Veterinary State Boards. And these are the people who review your medical license when there's a board complaint made against you. And she was wonderful. I'm so glad we got to meet. She was very kind, but basically she was like, “Help us to help you. If it's not written down, if you don't have a medical record, we can't help you. You're toast and we can't help you. But if you have a basic functional medical record that says a couple of things, you are probably going to be okay in most board complaints, assuming you didn't do anything obviously medically negligent.” The chances of someone's mad at you and you didn't really do anything wrong. If you don't have a medical record, the chances are good that you're going to be in trouble. And if you do have a medical record just are good, you're going to be just fine.

But these are a big thing. They're also obviously a big thing for patient care. And I don't have to tell you the importance of writing up your chart with care. But anyway, let's start with head space. Okay, so we got a question, how do we do this? And my husband and I are both tapping out and other doctors just aren't doing it. And what do we do? Okay, so the first thing in head space, and I challenge doctors that are working in practice to do this. I need you to sit down and think of for a second and think about your medical records and then think to yourself what is the point?

I mean seriously, what's the point of a medical record? What is the point in vet school, which I already said. The point in vet school is a lot of times a learning opportunity and they're trying to teach the most legally sound approach to medicine. I get it. Okay, what is the point in emergency medicine? And in emergency medicine, the point of a medical record is different than in GP because you are not going to see this patient again. They are going back to their regular veterinarian, and part of your medical record is communication back to the doctor of what did I see? What did I say, what did I do? So that you can pick this case back up tomorrow and you feel comfortable about what was done and you know what expectations have been set.

And the last is what the point in general practice. So let's just say that you're a general practice vet like myself and you're seeing case patients, what's the point? The point of the medical record is to, in an accessible way, and that's critically important, in an accessible way to document key findings, to document recommendations that were made, to document client decisions and to lay out the plan going forward. That's it. That's it. Those are the things. That's the whole point.

And so put aside the novels that you were taught to write in vet school and just say, if this is the point, document key findings, document recommendations, document client decisions, and lay out the plan. You should think about how you're going to accomplish that and stop just doing things the way you've done them in the past. And so that's the head space for me is stop. Stop if you're doing it and it's not working for you, you need to stop and you need to say what is the point in this? And then get a clear point in your mind. And now let's come up with a new way to do your records. So that's where I go in head space first.

Stephanie Goss:

Okay. I'm kind of on board there. I'm with you. It has to be accessible and I think your points about the key findings, the recommendations, the client decisions and the plans going forward are great. And I think that what you said about the point in emergency medicine is, for a lot of us in general practice, is also somewhat the point in general practice. Because gone are the days where you're the solo vet and you're picking up after yourself. Right?

Now somebody else, whether it's a member of your front desk team who then is faced with talking to the client and trying to interpret what you did or why you did it, or another doctor who's picking up because the pet's back two days later or whatever, were for me, what I think about it from the business perspective and the manager perspective and having been on both sides as the patient care team, the technician, and on the client care team, as a front desk person, I have to know where your head was at. That's where I love your bullet points. What were the key findings? What were the recommendations? What did you talk about with the client and what did they decide and what is the plan moving forward? That's it. Yeah.

Dr. Andy Roark:

So almost there. The other thing I want to make a couple other pushes here to rethink the way you're doing medical records. So the first one is a time benefit, okay? Think about how many medical records you touch in a day. Okay? You're in practice. How many medical records come through your hands? Now think about how many times you log into your system and open that record back up, right? So one is, how many patients did you see? How many records did you look at? And then how many times from different computers did you log into this record, right? It's a huge amount of time. It's a huge amount of time.

Stephanie Goss:

How many do you think you touch on an average shift?

Dr. Andy Roark:

So this is the question of how many appointments should a doctor see? Which is a dangerous question because practices are very different. I would say in a day, I'm probably somewhere in the mid-twenties, you know what I mean? Of how many patients I see versus also people calling in to talk to the doctor, making recommendations on the phone. Things like that. You started thinking about, and I'm not talking about repeat visits to a record, I'm talking about how many different records pass through my hands.

Stephanie Goss:

A single record that gets open. Yeah. No, that's why when you said that, that was where my head was going. And I would say, like you said, everybody's clinical structure is set up and we have clinics that our colleagues work at that they might see seven to 13 patients in a day. And we also have other practices where they are seeing 25 or 30 patients in a day or ER, which I could imagine could be way more than that in a super busy shift. But then you think about to your point, what about the prescription refills and that where the client had a question and all this. It's probably upwards of a hundred or more that the average team member touches in a day.

Dr. Andy Roark:

It could be. It's a lot.

Stephanie Goss:

It's a lot.

Dr. Andy Roark:

Okay. So it's a lot. And when you're dealing with a lot in a day and every day, think about how that adds up. Now think about the difference that one minute per record makes. That's huge.

Stephanie Goss:

I'm with you.

Dr. Andy Roark:

That is huge. It's big in a day. It's real big in a week. It's enormous in a month. It's a lot. It's a lot of time. So the idea of getting intentional and smart about how you're doing your records, this is work-life balance, my friend. This is a significant thing for opening up time, is in this medical records. And people just, they refuse to think critically about how they do their records. And it's dumb when you think about how many you do. There's a communication benefit. I am a big believer of putting tangible pieces of information about what was happening into a client's hands. Give them something they can see. I like to print it off and give it to them because it's tangible. They paid their money, they have something they can hold in their hand.

It empowers the person who came in and deals with you to be able to defend their purchase decisions to people at home. Like think about the percentage of people who like, there ain't a lot of us that are the sole financial decision makers in our family and nobody questions how we spend the family money. That's not most of our realities. And so I like to equip pet owners who were there to go home to their spouse and say, “This is what we did. Yes, we paid that money and this is what we got and this is what we did. And here's a thing that you can hold that we learned.” It's a CYA by providing it to the pet owner in writing. And so if you said, “I strongly recommend heartworm. Told owner that heartworm disease is extremely prevalent in our area. Owner declines heartworm at this time.” And you give it to them, worst case scenario, push comes to shove. I wrote it down, I told you, yeah, I wrote it down and I gave it to you. And you even have a copy of it.

It's just a quick CYA. And the last thing is signposting for the next visits and for follow-ups. It is so nice to say to people, you say, “Great, you've elected to treat this patient empirically. If this patient does not get better in 24 hours, you're going to come back and you can expect to do, or at that time we will do radiographs, blood work X, Y, and Z.” And they come back in and I told them what was going to happen, and it's in print what was going to happen. And they come in and they're like, “Well, I guess this is what's going to happen.” And it's just really easy for getting compliance and getting them on board and it saves me time, but it's a big motivational thing for them coming in and doing the diagnostics that we need to do. And so that's called signposting.

And the last thing is the tech leverage benefit that a lot of people don't think of. If you want to leverage your technicians, if you want to work collaboratively with your paraprofessionals, they need to know what is going on and what your plan is. And the medical records are a far superior way than you individually telling each one of them with your mouth while you're doing other things, what the plan is. And so your technicians are prepared to do callbacks to see tech appointment follow-ups, to do rechecks, to do so much communication for you. But they can't do it if they don't know what the plan is. So just the ability to get good use out of your techs comes from doing a good medical record that's accessible to them. And so getting medical records right and doing them efficiently is really, really important. There's huge benefits to stopping what you're doing and stepping back and going, “Okay, we can do this differently.” And it's worth thinking about how we do it and to make some workflow changes.

Stephanie Goss:

I would agree with all of that and I think most of my argument probably is going to come in the action steps part.

Dr. Andy Roark:

Okay. All right.

Stephanie Goss:

Because I'm still with you. I agree in all of that.

Dr. Andy Roark:

Okay, well then we will take a break here and we'll come back and we'll get into the action steps of what exactly should we do according to Andy in this situation. And then you can tell me where I'm wrong.

Stephanie Goss:

Have you done it yet? Have you headed it over to the Uncharted website? The one that's at unchartedvet.com/events and have you clicked on that link for the April conference? If you haven't, friends, you need to head over and click on that link and then you need to hit the register button because I want to see you with us in sunny Greenville, South Carolina in less than 80 days. We are going to be diving deep into tackling internal communications this Spring. We want to talk about how do we improve our communications amongst our teams in a whole myriad of ways. How do we set boundaries? How do we have conversations about the affordability of pet care and communications outwardly towards our clients as a result? How do we use language and maybe think about changing some of the language we're using to have better communication as a team.

Just previews of some of the awesome stuff that we're going to be talking about. So if you haven't done the thing, if you haven't, put your fingers to your keyboard and typed unchartedvet.com/events, go do it now because I have hugs waiting for you in Greenville and you should not miss out on this. And now back to the podcast.

Dr. Andy Roark:

All right, so let's get into how we actually start to do these medical records. Okay? Now, I'm going to break this down the way that we break down efficiency and core processes in a practice. So the first thing I'm going to do is step back and look at the system as a whole. And so bear with me, this is really honest to God how I think about appointments, okay? Let's step back when we're going to look at the system as a whole. And so medical records are part of the workflow of the doctor. My belief and I can back this about a number of different ways is, one of the mistakes that doctors make and it isn't just how we're trained, but it's true. They think of an appointment as a single unit. I see 13 appointments a day. That's what I see.

I think that that's a really limited way to think about what you do and it's limited in how efficient you can make yourself if you think of an appointment as a unit, right? Appointments should be thought of modularly. There's admission of the pet owner, there is the patient history, there is the physical examination, there is the recommendation, there is the diagnostics, there is the treatment, there is the follow-up diagnostics after the first diagnostics. And you can break this thing all the way down into being a couple of modules. I like to break an appointment up into modules and then I like to look at who does what. So for example, when an appointment comes in for me, my technician gets a TPR and gets the client history and then Andy comes in, does the physical examination, makes the recommendations, steps out, technician does the diagnostics, does any treatments that are needed, and then I return with diagnostic results and recommend additional diagnostics or additional treatments, based on those results.

Or we move to discharge, which is done by the technician. And so really when you look at an appointment, it's not one block. It's technician, me, technician, me, and then that repeats if we need to do advanced diagnostics and then discharge is by technician with my medical records in their hands. Okay? So that's the workflow. If you break your appointment apart like that, you can really start to make this thing go. You can dial into training your technicians specifically on history taking. I can dig into how long am I spending doing a physical examination? How long am I spending doing recommendations? And then when I'm done with recommendations, how long is my team taking to take pets out to get diagnostics done? I can drill into the specific efficiencies of each of those steps and you guys can see, I'm really serious about making this thing flow.

But if you're doing 25 appointments a day, every day, for the rest of your career, shaving three, four minutes off of your appointment time, buddy, that pays real dividends in you getting things done and you getting out on time, on you being able to help more people. And the medical record is part of that. While my technicians are doing the treatment or the diagnostics, I am writing up the medical record. That's where I go. And so I know that I go in, physical exam, out, medical record, in to report, out, update medical record, and then off with a discharge and it goes out. So I really believe you have to understand that's how I think about appointments. I'm not messing around, they don't kind of willy-nilly get done. But that approach is it allows me to really leverage my techs, which is why I'm such a huge fan of techs and to pull people in and for us to run a well-oiled machine. Okay?

Stephanie Goss:

Yes, I'm with you on that.

Dr. Andy Roark:

Cool. So when we talk specifically about the medical record part of this, this is a module in that system. And so I want to drill into this like it's an efficiency exercise.

And so when we have efficiency exercises and you want to go faster, the first thing you do is document your current workflow. And so you need to look at how this is actually happening. What is going on? And what happens is people say, “Well, what do you mean what's going on? I sit down, I think about the thing and I write it down.” And I say, “No, you don't. No, you don't. Touched this medical record three different times at three different computers, logging in each one, navigating your way to find the patient to open that file up. You're waiting for it to load, then you're getting over to the soap and you're doing this three different times. That's wildly inefficient.” You want to minimize the number of touches you have on any project. That's just across the board.

I don't want to go over to the pharmacy four different times to get one appointment out the door. That's not efficient. I want to think about going to the pharmacy one time, grabbing the four things that I need, getting them done, packaged and out the door. And so that's what we talk about when we start to really drill into the efficiency. So think about the number of times that you're that you're touching this. And so I want to minimize the number of touches I have on the record. I want to open it up and I want to largely get it done as fast as I can with as few engagement with it as possible. And the last thing is inside that record, I want to automate as many steps as possible. It's amazing how many of us basically do the same physical exam for every patient and we type that physical exam in every time.

That's bonkers. Automate, automate, automate that thing. And it's amazing, I don't have a problem with doctors saying to the management, “Hey, would you be okay if I set up my own template for physical exam findings and just be like this? It'll be Andy's wellness exam and I can pop it up and I can use it.” Think about the number of appointments or charts we see in a day and then think about how much time over the course of a year you would save by having this thing generate your objective findings, and then also your plan. Even just in a template of how do you write your plans if you're always like, these are the next steps, these are the follow-up things, whatever. The more of that stuff you can just auto-generate so you're quickly filling it out, the better off you're going to be. And this matters because of how many records we touch.

Stephanie Goss:

So I don't disagree with any of that. Where I think for me, I zoom out even further and it's actually something you taught me, when you think about it, and this works for, I really do believe all branches of veterinary medicine, including ER. If you zoom out and you think about in an average day what kind of cases we see. It's going to be easier, if you are a cat-only practice, you might have a handful of things that you see wellness appointments for cats, you might see dentistry appointments for cats, you might see sick cats. And then your sick cat, you might have five or six different things that you see really commonly. And there's going to be zebras, there are always zebras. But on your average day, what are those things that you see? If you think about that from a clinical perspective, you can probably count on two hands everybody, the kinds of cases we see.

We've got vomiting, we've got diarrhea, we've got the ADR.

Dr. Andy Roark:

Skin, yeah.

Stephanie Goss:

You've got itchy skin or itchy ears, you got itch factor of some variety. So if you start at the beginning and think about what kind of cases does your practice see, no matter what type of practice it is, and what I mean by even the ER, like ERs see some crazy, crazy things. And there are things that they see every single day just like GP, right? So what are those things? Hit by car, broken bone, things like that. If we zoom out and we think about what are those things and make a list and then we start by thinking, okay, to your point, I love your point Andy about it doesn't even have to be the same across the board because each doctor's approach to those things might be different.

But, and if I ask you Andy, “Okay, take a vomiting pet, a pet with diarrhea, an itchy pet, and write down, think about the most high-maintenance client that you could see with a pet with that issue, what would your chart look like?” And if you take the time to sit down and think about what would that look like, how would I hold their hand? How would I communicate those things? And you write it out, it takes time to do that process and you're doing it once and then you're done. And what I mean by that is if you think about that case and a high-maintenance client, chances are you can use that template to cover 99% of the bases, because then it's just deleting. Then it's just taking out things that might not be applicable, adding in some things that might be applicable to this case and now you're just editing, instead of writing.

And I every day, hear from people who are like, it used to happen to me in the practice and I would have doctors who would sit there, they're seeing the same things, but they're literally doing what you said, which is typing out the whole thing every single time. And it blows my mind that that's still where we are as a field, because to your point, we have the technology to fix that problem. Even if your PIMS is not the most advanced of PIMS, there is nothing to stop you from opening a Google Doc and writing your templates in a single Google Doc, and making a table of contents for yourself so that you can pull out of that what you need when you need it. But I think when we, I've done this exercise with my practice multiple times with multiple doctors, and what we found was they all were like, “We all write our charts differently.”

Fair. You all went to different medical schools, you all have different backgrounds, you all have different things that you feel more strongly about than others. And the reality is for most practices, there is an average in there somewhere. And so it is once you start this process to look at, what are we writing and how are we writing it? It becomes easier to make the template and then look for those commonalities. And in some practices, it works for there to be one template that works for everybody. And in other practices, it works because there's a system, to your point, for each doctor to have it individualized. And your practice management software can do that. You can do it with a push of a button. I can literally hit three keys in Avimark and drop in my customized, I've written this out as technician notes that are different from my team members' notes.

It's not hard to do, but I agree a hundred percent. I think we have to zoom out from a starting perspective and it's a worthwhile exercise to your point about shaving tons of time off in the long run, to sit down, make a list of the cases, the kind of cases you see, and start working your way down it. And what I found when I did this process, most of my doctors, if I said to you, “Hey Andy, what's the last super itchy pet you saw?” You probably could have a patient that would come to mind.

And then I could say, “Great, I'm going to pull up that chart. I'm going to take, going to cut and paste. Here's what you wrote for that case. Is there anything else? If you are making this your standard, is there anything else you would want to add to this? Anything you want to change?” Now, instead of you having to sit down and say, “Oh, Stephanie wanted me to think about what I would write for an itchy pet.” Now you're taking something that you've already done and now you're just editing the work, which makes the process exponentially easier. I think a lot of us are like, “Oh gosh, I have to.” It's this huge bit. We make it into a mountain when it really can be really easy to start with a molehill, because those patients stick out in our minds.

Dr. Andy Roark:

So the way I handle this, okay, and there's you got to be a little bit careful here, because I can get on board with this, but going all the way back to the beginning where I say, “What is the point?” Right? If the point is client education, we need to be upfront about that, because I didn't put that in my list, but it's not wrong. You know what I mean? To be like if you say, I want to write this in a way that my most demanding client is going to get it. I think you can do that. But I think that, and here's exactly why I rant about the vet schools and maybe I was unfair, but I don't think so.

Stephanie Goss:

I don't think you're unfair.

Dr. Andy Roark:

When I do a medical record, it is for my techs and my other doctors, and I know that they are super busy. And what kills me is I have worked with veterinarians who are great veterinarians, but they write four pages in their medical record and it makes me angry every time I look at what they did. And I know they're like, I'm such a good doctor. I wrote 3000 words on that thing. And I'm like, “You know what? I'm not reading this crap. I'm going to skim it as fast as I can, and then I'm going to go look at what you invoiced so I can see what you actually did because this is ridiculous.” I don't have eight minutes to read that they had an ear infection last time they were here. And again, I know this is heresy and people go, “What? My four-page description of an ear infection is a masterpiece.”

And I go, “It's wildly inconvenient for me. You are slowing me down when I am overbooked and trying to get to an emergency because you did not communicate efficiently.” And so I think you can do that client education part and write up a robust template that you say, “Aha, here's the thing.” I would say you should put that at the bottom of your medical record so that everyone else on staff can immediately skip it. They'll say, “Here is important points for the pet owner.” Or “Have your plan and have your real plan and then below it have your templated in plan that clearly explains everything, but I can ignore that and just look at your assessment and your actual plan and know where we're going and what we're doing.” And so that's my sticking point.

The vet school teach you to take, in my opinion and experience with a limited number of vet schools, they take all the information, they put it in one place, which makes it confusing for the pet owners and overwhelming for busy practitioners and technicians who have just been handed a telephone and said, “Talk to this person.” And they're like, “I'm sorry, I'm going to have to call you back when I get to chapter three because that's where we are.” So anyway, I think I do love your point about you doing your client communications on a template. My point is I have strong feelings that separating the intra-hospital communications and the client-facing communications, if you're going to go into great depth, I think that's important.

Stephanie Goss:

Yes, I am a hundred percent with you. I think we've come to this place in veterinary medicine where, and like you were saying, I don't know if it comes from the vet schools or because we're just living in a litigious world now. We've just come to this place where the patient care side of the chart and the client care side of the chart have melded together for a lot of us. And I am absolutely a huge advocate, and my number one rule in my team, if it isn't written in the chart, it didn't happen, right? Because that's like to the point about the medical board, that's how they look at it. What is written? Because we can only go off of what is written in the chart. And so I, a hundred percent agree with you, and I love setting up a practice management software so that you have that separation because I'm with you.

It used to drive me crazy when I would be the tech and I would have the client on the phone and I'm digging through four or five paragraphs trying to figure out what you actually said. I want the high level and I want to make sure that the important pieces are called out. And that's where I think our technology allows us to do that. And so many of us underutilize our practice management software to leverage that and make it easier for the team. Because I think your point about minimizing those touches and thinking about how do we automate those steps, is really, really important. Because if I can think about how do I, nine times out of 10, how do my doctors treat an itchy skin case? And I think about the bullet points that I would want that record to include, that's what I'm talking about from a template perspective.

Like what does that say, so that if I'm picking it up, you Andy, were in my practice as a relief doctor two weeks ago and we haven't talked to you since, and now Mrs. Smith is on the phone asking questions? I want to be able to go pick up that record as a technician and go, “Yeah, I could get inside Dr. Roark's head because it's all here. I know what he was thinking. I know what those major concerns were. I know what he recommended to you. I know what the plan was and I know what your decision was as the client at that point in time.”

Dr. Andy Roark:

The last part of this that I think is really important, and this is a hill I will fight and die on. The filling out the medical record is part of the appointment, right? It is a module and it is there. Separating the time that you do medical records from when you see patients is a mistake. A doctor should dig their heels in and push against it. And your practice might not like that, and I think you should tell them to stick it. And you don't hear me say that a lot, but you should. This is me coming down on the part of the doctors. You should tell them to stick it. And it's because first of all, it's not good medicine for you to see an appointment and then three hours later use your recall to remember what you talked about and put yourself in there, is not good medicine.

And the other part is, this is a way, it's a subtle way, and I don't think people mean to, they don't think about it. It's not an evil plan. But it is a way of making doctors take work into their lunch breaks and take them home with them. And when we're dealing in major burnout, that's not okay. That needs to change. We never say to someone who worked at a fast food restaurant, “Hey, go ahead and make french fries while you're at home tonight, so they're ready for tomorrow.” It's like, “No, that's part of the job. And I do it at work on the clock.” The same thing is true with your medical records. The thing that needs to happen here is, the doctors need to dig their heels in and say, “My appointment is not over until I finish this medical record.” And I think that you should fight that fight and just say, “That's how it is.” And that's how you get out of here on time.

The fact that if the practice says to you, “But if you write up your medical records, we can't see all the patients that we want to see.” I would say, “Then we don't have capacity to see the patients that you want to see.” Because writing up the medical record is part of the job. So again, I don't think it comes from a bitter place. I don't think that practitioners are trying to take advantage of doctors. I don't think they're like, “Ha ha, let's make them spend their nights writing these things.” They are just trying to see all the patients and to do all the work. And one way to stuff it into a certain number of hours is to just not ask questions about when the charts are getting done because the doctors are going to do it, because they have a moral obligation to it, and they're good people and they also want to protect their license, so they're going to do it.

So that's how that kind of gets set up. And I just feel really strongly it's time to push back against that and say, “No, these things go together.” Now to be fair, and on the flip side, if you have a doctor that takes 22 minutes to write up a chart, and I know those doctors. Yes, I understand why the clinic would say, “This is not okay for you to take 50 minutes to see a 30-minute appointment.” That's not hard to understand, and the staff's going to get frustrated and everything. That means that there has to be some flexibility on the side of the doctor, which goes back to efficiency, which is, I'm going to write these charts up, but I'm going to do them in an efficient way that doesn't involve me writing 5,000 word essays on every one of them. And if the doctors are unwilling to make that concession, then none of this stuff that I'm talking about is going to work.

Stephanie Goss:

And I think, I have been there working with doctors who have the mini novel for the records, and to your point, from the vet school lens, they were beautiful. If I sat there for 25 minutes and read through their whole mini novel, I would have a fantastic idea of what they were thinking, why they were thinking and what's coming next for this patient. I would. They're so thorough and complete and beautiful. And if you are that doctor, it's also not wrong to figure out how to make that for yourself and make it replicable, because you can't expect yourself to have to have to write that out over and over and over again. Because otherwise you're going to be this doctor who's there till 10 o'clock at night, writing up their charts. You have got to figure out a system. So I'm totally with you, I think.

And I think if we're not doing our jobs as managers, if there isn't some sort of process to look at this and evaluate this and make sure that we're supporting all of our doctors. So for me, that conversation would look like, “Look, I get it. Maybe I can't ask you to change right now.” Because especially when you're working with newer grad doctors, that is how they sometimes get to their thoughts. Or when you're standing there, I remember being a new technician and thinking, if I don't talk through in my head all of the possibilities, how will I know that I'm not missing something? So I know what that feeling feels like, and that's where you have to be willing to accept help from your team. And so you have to figure out a system that is going to allow the rest of the team to help you. But this is not a healthy place to be where you're sitting there until 10 o'clock at night.

And so if you're like, “This is the only acceptable way for me to do it.” Totally fair. You have to be willing to work with me to create a system. Because as the manager, I also have the responsibility to the rest of the team, to the business, to our patient care model because there's other patients waiting for you that also need your attention, to say, “I have to help hold you accountable to being able to move this along because it does not work for you to take 50 minutes to do a 30-minute appointment and constantly be making your clients wait 20 to 30 minutes and be running behind.” That's not fair to the patients. It's not fair to the clients, so I need you to help me. And it's about finding that middle ground.

Dr. Andy Roark:

Well, I'm glad you said that, and I'm glad you brought that up because I just want to really emphasize, I don't think I said this very clearly before. When I'm looking at my systems and my workflows, there are other people besides me, the veterinarian making $75 an hour or whatever. There's other people besides me that can do 80% of the medical record for me and my assistants can, my technicians can. And so I didn't say that super clearly, and I think I've been talking as if the doctors is the one king and all this. That's part of the system of the workflow is to go, “Okay, how do we do this and where are other people and how this, can be broken up.” I mean, I know doctors that are a high-producing doctors and they have a scribe chasing behind them. When I go see my doctor, the GP, every one of them now has a scribe in the room and they're doing the records and they're making it happen.

The economics of vet medicine are a little bit different, maybe a little bit. But I do know that I do have, I've worked at those practices. I've worked at a practice that I had the doctor, the technician and the assistant all go into the room, and it's this really beautiful rotation of, the technician is asking questions while the assistant is getting the pet ready, and then the doctor is in, and the doctor is doing the physical exam, and the technician has rotated over to the keyboard and they're serving as the scribe, and then the technician is doing the diagnostics and feeding them back to the doctor. And it's this beautifully coordinated dance. But that record is done every time they're done in that room. And it's impressive. It's super impressive.

Stephanie Goss:

Yeah. No, I'm on that page. That was my preferred method in my own practice because it makes you be able to be leveraged to, as a team member to your skillset. The doctor is putting their hands on the patient and diagnosing and answering the client questions that need to be answered to make a diagnosis or move forward. And then I want to be able to help the doc. I want to be able to take all of the patient care pieces off of their plate. I want to be able to help drive that forward. And also, I'm the tech that love client education, so why should my doctor stand in the room and answer some of those questions that I'm totally capable of answering for that client? Because then I also can not only answer the question, but I can have the financial conversation.

So I'm with you. I'm a big fan of figuring out what that dance looks like. And look, this is where, should is a very dangerous word because it's different in every practice. What works in my practice is not necessarily what's going to work in Andy's practice or your practice. Everybody is going to have something different, and everyone needs to have a system and a process. And the fact that we, as an industry, spend hundreds and hundreds of thousands of hours doing this over the course of a year in practice and years in practice, and so many of us don't take the time to on this as a team and figure out those systems, is really, really sad because it is a part that is, it is broken. And it should not be up to just the doctors to say, “Hey, I'm drowning, and this doesn't work for me on a personal level because I'm spending all of my time off work, working on work.” The whole of the team should look at this and say, “How do we make this better for each other and also for our patients and our clients?”

Dr. Andy Roark:

Yeah. I just have really strong feelings about this is you can tell it's because I have seen my good friends burn out and quit. I mean, I know veterinarians that work at IDEXX because they couldn't go home before nine o'clock, and not that working at IDEXX is bad. It's great, but it hurts my soul because I want my friends to be in practice. I know that's what they want to do, and I feel like I'm bashing IDEXX. I love IDEXX. I don't seeing my people burn out in the trenches in vet medicine. I love clinical practice and I don't like seeing people leave for burnout.

And I've seen good friends break their marriages for this exact reason. And I go, “I'm sorry if your marriage is breaking down because you don't come home before 9:30 at night because you're writing up records. That's not okay.” And that's the emotional driver for me to say, “Nope, the record gets done when the appointment gets done, and I hand the record to the pet owner because that stops me from falling back into that habit of, I'll fill these out later on.” But to me, it's a wellness strategy to say, “Nope, I'm tying these things together. I'm not interested in breaking them apart because I don't want to live that life.” And just, I've seen that too much.

Stephanie Goss:

Yeah, no, I agree with you a hundred percent. It hurts when you have people on your team who truly love clinical practice, and I think that's what I heard you say when you were talking about somebody leaving and going to work in industry. There are people who are suited for industry. They try clinical practice and they are not happy and they go elsewhere. That is not the problem. It's when people who genuinely love clinical practice but leave for an alternative, whether it's industry or leaving the industry altogether, because they can't figure out how to find that work life balance, that's the one that hurts them. That hurts. Right? That's the one where you look at it and you feel like, this isn't good.

Dr. Andy Roark:

I agree.

Stephanie Goss:

And I think it's our job as leaders to help fix that. And so this is an elephant, and if your practice has no system and everybody is doing it a different way, especially if you have multiple doctors and multiple techs, and each different team does it differently, this is not a thing where you're going to be like, “All right, we're going to call a huddle and in the next 15 minutes we're going to solve this problem.” That is not a thing that's going to happen.

Dr. Andy Roark:

You have to do the math. You have to do the math and recognize how many appointments you see in a day and how many people log in and search for a pet and pull them up. And just think about how much time you spend logging in and pulling up a pet on one computer, and then five minutes later you log in and you pull it up on a different computer and oh, you can't access it because it's still open on the first computer, and so you have to go figure out where you open up. It's just ridiculous. But those things, especially across a three-doctor, five-doctor, 10-doctor practice, they're bonkers. Also, I feel like we going to need to do some sort of hiring push for IDEXX because I'm like, I wasn't trying to use them as a bad example, and now I'm really torn with guilt. I'm like, so if you're thinking, if you are burned out-

Stephanie Goss:

I understand what you were saying.

Dr. Andy Roark:

If you are burned out and you're thinking about leaving a clinic, consider IDEXX because I do have friends who have gone there, but they're very happy. And so just think about it.

Stephanie Goss:

I think you're just digging the hole for yourself.

Dr. Andy Roark:

This episode not sponsored by IDEXX.

Stephanie Goss:

Not brought to you by IDEXX.

Oh man, I love it. I love it so much. If you're sitting here and you're listening and you're just like, “Okay, guys, this sounds fantastic, but how do I actually do this?” This is the kind of thing that I love about the Uncharted community because we ask these of kind of questions. We are asking our peers, I have no idea how to do this. I know I need to do it because I have doctors who are sitting here until 10 o'clock at night. I want to fix this problem, and this is the kind of conversation that I love seeing happen in our community because it's where we dig into the weeds of what are we actually doing? What are the different styles of doing it? How do you approach this? What are people's different perspectives to how do you project managements this?

Because it is an elephant and you have to eat it one bite at a time, and there's no better way, I think to do that than to sit down with some of your peers and say, “How might I approach this and how may I also be able to ask for help?” Because it will be a process. It is an undertaking. I have done it with multiple practices. At my last practice, it took us a year once we identified like, “Hey, we need to solve this.” Because we did it in stages. And it started like everybody's going to write up, let's take a wellness appointment. What does that look like? And you just chip away at it, little by little by little.

But you know what? When we got there and when the wheels started churning faster and faster and that train started chugging down the track, it feels really good because there is a world that exists where you can go into an exam room, you can see an appointment, and you can walk out of that exam room and the client can leave the building and your chart is done. And all of the client communication is in the client. Like you said, the client left with a copy of whether it's a report card or copy of the record or whatever. They leave with that in their hands. There is a world where that can exist. I'm here for that world.

Dr. Andy Roark:

Yeah, I agree. Awesome. Well, thanks for talking through with me, Steph.

Stephanie Goss:

Yeah, this is a good one. Have a fantastic week everybody.

Dr. Andy Roark:

Thanks, everybody.

Stephanie Goss:

Well, that's a wrap on another episode of the podcast, and as always, this was so fun to dive into the mail bag and answer this question, and I would really love to see more things like this come through the mail bag. 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 mail bag at the website. The address is unchartedvet.com/mailbag, or you can email us at podcast@unchartedvet.com. Take care everybody, and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: management

Feb 22 2023

Our Practice Leader is Driving People Away!

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are answering a question you asked in the mailbag! We received an email from an associate veterinarian who joined their practice after working in at as a regular relief vet. They thought they found their home clinic but now that they have settled in, they are finding almost the entire team has turned over since they started. Some left on their own and recently, even though the team was down to a skeleton crew, the practice owner made the decision to fire 2 more team members. This associate is struggling hard with the decision and wondering how they go about addressing their concerns with the practice owner that if they don't figure out how to make some changes, there won't be any team left. They are also wondering how to tell when it might be time to give up and find a new home clinic, if this really isn't the right place for them. Andy and Stephanie really enjoyed talking through this one from a variety of angles. Let's get into this…

Uncharted Veterinary Podcast · UVP – 219 – Our Practice Leader Is Driving People Away!

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


Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Upcoming Events

We have TWO amazing events coming up – one virtual just for managers and one in person that anyone on the team can attend! Don't miss your chance to join us either virtually or in person in beautiful Greenville, SC.

The Practice Manager Summit – March 23, 2023

We know you are unique. Managing the business. Fielding never-ending questions from the team. Fixing broken printers, again. You wear more hats than anyone else in the practice. All of these look great on you, of course. But do you ever wonder “Am I actually in charge if I don’t own the practice? How do I manage the endless responsibilities of this job with limited power and resources? How can I keep growing professionally?”

If you’re itching to talk to people who really get what it means to be a manager, this is the event for you!

It’s time to connect with your fellow practice managers to share what gets you excited about your role, find solutions for what needs your focus now, and discover new ways to shine even brighter as a manager.

While Uncharted Membership is always encouraged, it is not required for event attendance! Non-members, here’s your chance to see what all the buzz is about and get a taste of the Uncharted experience. 

The Uncharted Veterinary Conference – April 20-23, 2023

Our flagship three-day live conference event in Greenville, SC. Come join us in Greenville!


Episode Transcript

Stephanie Goss:
Hey friends, this is Stephanie Goss and I'm bringing you another episode of the Uncharted Podcast. This week on the podcast, Andy and I are diving deep in the mailbag. We had so much fun doing this one. It was a question that has come to us from an associate doctor who is really struggling with some of the decisions that their practice owners is making in the recent past about terminating some of the members of their team. They've had a lot of turnover and this doctor is really struggling with why this turnover is happening. They understand that it is the owner's private practice and they can, at the end of the day, do exactly what they want with it. They're really wondering when and how do I speak up about this because it's really bothering me. We've got some great stuff to unpack here. Let's get into it.

Meg:
And now the Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me Dr. Andy Roark and the one and only Stephanie should I stay or should I go now Goss?

Stephanie Goss:
That is very, very good one. How is it going Andy Roark?

Dr. Andy Roark:
If I stay there will be trouble. And if I go it might be trouble maybe it's switched around anyway-

Stephanie Goss:
Maybe it's always trouble when I'm involved.

Dr. Andy Roark:
It's definitely, that's a song about picking the better of two bad options it's what I think it is.

Stephanie Goss:
Oh, how's it going?

Dr. Andy Roark:
Oh boy, it's crazy talk. It's wild.

Stephanie Goss:
I feel like I've seen your face a lot lately.

Dr. Andy Roark:
Yes. You and I just spent five days together from sunup until well past sundown-

Stephanie Goss:
Well past sundown.

Dr. Andy Roark:
At the VMX conference, yeah, yeah.

Stephanie Goss:
It was so fun. It was so good to see everybody back in person and to feel that pre-pandemic energy and excitement about veterinary medicine, about change and growth in our community. And I had a great time.

Dr. Andy Roark:
I had a mixed time. There were things that were great and there were things that were hard for me. And one of the things that was hard for me was that Stephanie Goss was packing lecture rooms until people could not get in. I'm talking, it's like, rooms that seat 800 and they're turning people away. I'm not kidding. I went up to the door and they were like, “You can't go in there.” And I said, “Do you know who I am?” And they were like, “We do not know or care at all.” And so I saw Eric Garcia, who's the program chair, and I was like, “Eric, they won't let me get in there.” And Eric Garcia goes, “Official NAVC business, we're just going to check a room count, oh, and he's with me.”
So that's how I got in to see, the only way I could get into Stephanie Goss was to phone a friend and get him to essentially lie to the security people so that I could watch you do your thing. And then no less than two dozen people stopped me in the hall to say, “I didn't see you in the program. Are you not in the program?” And I wasn't. I did not do any speaking as the first time in forever. I'm not exactly sure how it happened, but it just shaped up that way. And then I'm watching, basically what it was, you know when your friends are like, “Hey buddy, you want to come and do this awesome thing?” And you're like, “No, I'm going to be responsible because I have a lot of things going on in my life and my plate is really full and I'm going to stay in tonight and get my work done.” And then they send you drunken selfies from the greatest party in the history of the world. That's basically my experience with this conference watching Goss just crush-

Stephanie Goss:
Poor Andy.

Dr. Andy Roark:
I know. I literally asked someone at one point is like, “Are popup lectures a thing?” They're like, “Like flash lectures?”

Stephanie Goss:
Flash mob in the hallway. Andy Roark lecture in the middle of the hallway. There were plenty of opportunities because there were some lines and you could have just done a flash mob in the hallway.

Dr. Andy Roark:
I could have lectured to people in line for other things. I said that to somebody and they looked at me and they were like, “Yes, that's a thing, it's called street Street preaching.” And it's like, “That's not what I'm going for.”

Stephanie Goss:
That's not the level that you've reached.

Dr. Andy Roark:
No, but once they said it, I was like, that is exactly a picture in my mind. I was just imagining street preaching that went really well which is probably what every street preacher imagines and how they get started.

Stephanie Goss:
Oh, man. Yeah, we had a good time. It was good to see everybody and meet some new people. And the future of veterinary medicine is bright and I'm here for it. I'm excited, it's going to be a good year. It's going to be a real good year.

Dr. Andy Roark:
I am super optimistic for this year. I really am. Last year was a tough year in a couple ways, but man, things are looking pretty darn good. Life goes on, one foot in front of the other. I see a lot of opportunity ahead for vet medicine. I think my wife and I have gone through some health stuff and man, we're on the other side. All that stuff is done. It's all behind us. It's looking good, buddy.

Stephanie Goss:
Yeah, I know. And April is just a few short months away and we're going to get to see our whole Uncharted crew in Greenville and it's just creeping closer and closer. Florida was just a little taste of sunshine. And then we're going to be in Vegas in a few weeks and it's like there's all these little milestones creeping towards being all back together with our Uncharted crew in April. And I'm so excited for that.

Dr. Andy Roark:
Boy, it's almost, it's half sold out already.

Stephanie Goss:
I know.I know. That is crazy to me. We have sold out every year, but this is the fastest that it has moved.

Dr. Andy Roark:
Well, and we pushed the capacity up this year. We're like, if we open the door to this closet and then we let people sit in there, we can get more like that's what we did.

Stephanie Goss:
Andy's going to put me in the closet.

Dr. Andy Roark:
It still hurts, Goss can get over here.

Stephanie Goss:
You do it when I'm working from home, you put me back in the closet. So how is that different when we're at the Westin?

Dr. Andy Roark:
And it's not my fault the best acoustics in your house are in a closet.

Stephanie Goss:
Oh man, we're off the rails already.

Dr. Andy Roark:
All right, okay, now let's start to get into this. This is a fun one. This is a good one.

Stephanie Goss:
But if you want to come hang out with us in April and meet the Uncharted community, you should sign up because we are already halfway sold out and it's only January 20th when we're recording this. So if you've been thinking about coming and you haven't already bought a ticket, you definitely should.

Dr. Andy Roark:
Well, you don't even have to do that because you and I are doing our development path where people work with us every other week. If you're an Uncharted member, you can jump in with me and Stephanie and Maria Pirita. Every other week we get together and we work on a topic and we work on part of the practice and it's us. So I'm super excited about, again, talk about 2023 being a great year, we've never done this before, but if you're an Uncharted member, you can jump on a Zoom call with me and Stephanie and just we're getting to work and it'll be every two weeks. And yeah, we're going to be with you through the summertime at least trying it out, seeing how it goes. But my plan is to hopefully keep doing it for a long time.

Stephanie Goss:
All right. So today we've got a good one I think in that we had somebody write into the mailbag and when I read this one I was like, oh, this is one of those you can lead horse-to-water conversations. So we had a vet who was super excited, they had been doing some relief work and found a practice that they really thought that they gelled with. And so they decided, okay, I've done the relief vet thing maybe I want to go back to being an associate vet. And so they agreed to work with one of the practices they had been working with and that started last year and since that start, middle of last year, not like the end of December last year. And so they've been there a while. And in that time almost the entire team has either been let go or has chosen to leave and new team members hired.
So they've had a turn almost completely in the team since this doctor came on board. They went from multi-doctors, multiple licensed technicians, down to only two licensed technicians. And so recently one of the techs quit and one of the CSRs was let go. And the conversation with the team was about personality conflicts with these people from the practice leadership. And this is a private practice, it was a practice owner, but you and I were talking about this before we started and it's totally applicable to any leadership in the hospital really. It doesn't have to just be a private practice because we've both seen this happen in situations where you've got a medical director or non-practice owner leading the helm. But basically this practice owner is having personality conflicts left and right with people and has been choosing to part ways with people. And in this case, the technician and the CSR were putting in effort to take feedback, get better at their jobs, try and meet the expectations that were being set with them.
And so this associate doctor is like, “Look, I am really struggling here.” Because these are two people who both brought great skills to the table. They were outgoing, they wanted to help, they wanted to bring more clients in the door, they wanted to take care of their patients. The tech in particular was great with aggressive patients. And so this associate's like, “Look, I understand that it's a practice owner's practice and they can basically do whatever they want, but firing somebody for what feels like perspective-wise to the associate doctor, mild personality disagreements feels like a really poor choice, especially when we're in a place where good team members are hard to find right now.”
And so they were like, “Why aren't we training? Why aren't we counseling? Why aren't we doing some management?” And so this associate was like, “Look, I've had a lot of leadership training and I've done a lot of CE in this area because it's something I'm interested in and everything about this does not sit well with me.” And so they were like, okay, would you address the practice owner about these things as an associate vet? And if so, how do you go about basically questioning their management decisions and if the staffing of the hospital seems to be based on how well you get along with the practice owner, whether you can become buddy-buddy or not, versus their skills and what they bring to the table. If this was you, would you guys be looking for another practice?

Dr. Andy Roark:
Yeah. All right. This is a great question. There's a lot to unpack here. So let's start with headspace as we do. So the first thing that I would say here is assume good intent. And this is a good healthy way to think about it. The truth is why does this happen? We don't know. I don't know why these people got let go. I don't. Is it possible that there was that they-

Stephanie Goss:
More to the story?

Dr. Andy Roark:
Yeah, that there's more to the story? Of course there is. Is it possible that they mildly irritated this practice owner and he or she let them go? It's possible. It's hard for me to really get my head around in today's labor shortage and stuff, but that doesn't mean it's not true. I've seen people do some things I can't figure out. I can't get my brain around. I think the kind thing is to say, I don't know what happened and for HR reasons, this person, I don't expect that they're going to tell me exactly what happened. So I don't know. And I think the reason for that and I say I don't know, is it just stops me from making assumptions and jumping to conclusions that might not be correct. And that's just a safe place for me to pragmatically look at the situation. And at the same time, there's a saying, once an accident, twice a coincidence, three times a pattern. And so if there was an employee that I was like, “Man, that person's great, I have no idea why they got let go.” It's a whole lot easier for me to say, “There's more to this story.” Then that would be my first thought is there's more to the story.
But if it seems to be happening again and again and again, it gets harder and harder for me to be like, “There's more to this story and there's more to that story and there's more to the other story.” At some point there's a common denominator when I go, “Interactions with the practice owner are not going well.” But I think you can balance both of those things of assuming good intent and then also starting to say, “I'm not concerned about this because of it happening once, I'm concerned about a pattern that I'm seeing there.” I think those are both healthy things to hold in your mind at the same time.

Stephanie Goss:
I think that's super fair. And I think the reality is most practices at some point or another go through a complete turn of their team. There are absolutely practices out there that have a longtime team, the whole team has been the same for 10, 20, even 30 years or the vast majority of the team. And for the average multi-doctor practice, the reality is turnover happens. It happens for a whole lot of reasons that have nothing to do with performance. People move, people have babies, people leave the field, all of those things. So it's not atypical even for your average practice of size to go through a turn. And for this associate vet, they're sitting in the position where the turn happened, and they're wondering was this a one-time thing? Like you said, was this once an accident? This is a thing, it happened, we're moving on.
And now they're continuing to see things that make them think that it's a pattern. And so I can totally understand being in this headspace of like, this doesn't look so good. And I think this associate is in a good headspace because they're asking great questions and they are like, “I don't want this to be the case. I want it to be different. I don't know if I can make it different, but I want it to be different. And so I'm asking the questions.” Which I think even if you can't completely assume good intent because you are noticing some patterns, I think it's a good healthy head space to be.

Dr. Andy Roark:
Yeah, I agree. And I think the other part of perspective is a little bit different, but kind of the same. You do and I'm just I'm so happy with this letter, just the perspective of the person's writing I think is just so good. But they're very measured and they're looking at it in a very smart non-emotional way, which I think is exactly how you want to approach big questions like this. But it is possible to hold in your mind and recognize this is not my circus and that's going to happen whether you're in private practice or corporate practice as well. It's like there's going to be decisions that are made that you are not invited to the table to make. And you have to be okay with that. And you have to say, “That decision was made above my pay grade.”
Exactly. And so you need to make peace with that. And at the same time you can also be honest and own the fact that the decisions made above your pay grade will affect you and therefore you do have a reason to care about this. And so just saying, “It's not my business. I am out.” You might be out of the decision and that's true and you have to be comfortable being out of this decision. However, to your practice owner, I would say, yeah, you don't need to include your associate in this decision, however, you do need to be painfully aware that the decision you make will affect your associate veterinarian. And I expect he or she to make decisions based on what their circumstances are. So I don't know if I'm explaining that very well, but basically I'm saying from a perspective standpoint, I would not be resentful that I was not included in these decisions. I think that that's to be expected and I can also have a strong opinion on this based on how I am affected by the decisions that are happening.

Stephanie Goss:
Sure, sure. Yeah, it impacts your ability to do your job and so it makes sense that you would potentially have feelings about the impact that it has to you for sure.

Dr. Andy Roark:
Exactly. Yeah. And so going on from there in the head space, I get to ask myself, how do I feel about this and what do I want to do from here? And I think that's exactly where the associate should be. It's not resentful that I was included, not assuming bad intent, but still saying, “I am looking at reality around me and I have concerns, and so I am going to strategically plan for myself.” And I think that that's a healthy headspace is kind of where we need to get to.

Stephanie Goss:
Yeah, totally, totally. That makes sense. And to look at it from the perspective of, okay, this does impact me. I am interested in leadership because I've done some self-development here. I like what I'm doing, I came here for a reason and all of those things adding up to, okay, this impacts me. Is there a place where I can have some influence? And that I think is a good healthy headspace to be because that is a place of hope. It's a place of maybe I could influence or change this situation, which is better, is a place I like to live more than feeling like not my circus, not my monkeys, and there's absolutely nothing I can do about it except sit here and be miserable which is certainly a place from a headspace perspective that you could be sitting at this point in time.

Dr. Andy Roark:
Sure. I've seen a lot of people there and so have you. There's a lot of people who feel helpless in these situations and that may sound simplistic, but I promise you it's easy, especially when it happens over time. At some point people started leaving and you got in your head, I have to carry the load and people continue to leave, and you just doubled down on that thinking without ever stepping back and going, “Wait a second, have my situations changed to a place where just carrying the load might not be a good strategy anymore?” I think that that's really important. I also think that there's not a right answer here just on the information that we have, and I want people to know that, and it's going to be different for everybody in that how exactly are you being affected? Is it people in my practice are leaving, but the main technicians that I work with are the same and my actual work day-to-day is largely unaffected or is it people are leaving and they're the people that I rely on and my work is radically changing?
Those are different scenarios. The other thing is how do you feel about those changes? I know some doctors who want to work highly leveraged across multiple technicians and if their techs start leaving, they're going to be really unhappy. And I know other doctors that don't leverage their technicians, wrongfully so in my mind, but, and going from two technicians down to one technician or going from a technician assistant down to just an assistant, it might not really bother them that much. And we're not here to adjudicate how you use your support staff. My point is just some people are going to feel very differently about that than other people. It's not right or wrong, it's how do you feel? The last part of this really is, so much of it is about the relationship with the decision maker and perceptions of what the future looks like.
And say I'm the associate vet and the practice owner is having these interactions that people are leaving, and I don't really know why, the truth is on the scales do I think this practice owner, this leader is doing their best? Do I think that they're probably making decisions for the right reasons? And if I think that they're, sometimes things are hard, but I'm following a leader who's doing her best and who I believe is truly making these hard decisions. She's making them for the right reasons. I'm more likely to stick with that person than someone who's doing it because they want to bump profitability for the third quarter. You know what I mean? And that's what their driving decision is in my mind. Dude, does the person appreciate me? It's one thing if people are leaving and nobody says anything to me other than, “I guess you got more appointments to see.” Versus them saying, “Hey, I know this is challenging time and I appreciate you and I appreciate the work you're putting in.”
Man, that stuff matters when we're doing the math of what am I going to do? Do they value my input? You don't have to follow my decisions, but I do like to be heard. And I'll just tell you, we teach leaders all the time that making people feel heard and making them feel like they have input that's truly listened to, even if you go a different way, that's a huge part about people being okay with the hard decisions that were made. And you don't have to do what I say, but I pay attention to, did you communicate with me? Did you ask me what I thought or did you check in on me? That stuff matters. Is this somebody who's just had shit luck? And we all know people who have hit a real streak of bad luck. And I go, man, if we're in a tough place just because of bad luck, which happens, that makes me feel different, then we're here because of negligence.
We're here because this person is apathetic, because they checked out, because they're purely focused on personal gain. That stuff matters. And the last thing in all of this is, and I'll just tell you, when you go through periods of really hard work, especially in this case, you're shorthanded and everybody's working hard, I will tell you that one of the biggest difference makers is, do the people in the trenches with you, do they see a light ahead? And if they're like, “Nope, we're shorthanded and I have no reason to believe that that's going to change and this is my new reality.”

Stephanie Goss:
We're going to be shorthanded until the end of time, there's no change.

Dr. Andy Roark:
That is a different emotional experience than we are shorthanded and I believe that we will not be for long and the future will be better and we are going through this period of offloading people who needed to come off of our bus for some reason, and we are actively going to load back on some good people and the days ahead will be brighter. All of those things factor into the equation of how do I behave and what decision do I make going forward? And so I know that's a lot to unpack, but I really just want to say there's not one where I say, “In this situation, the answer is you leave.” I would say, “Boy, there's a lot of nuance here.” But just try to get those things in your head. It can be someone else's decision and you can be affected by it. You can-

Stephanie Goss:
Because I think what you were saying about how it's easier to stick with somebody through the hard stuff when you feel some of those things, when you feel that somebody's appreciating you, when you feel like they're hearing you. And even sometimes I remember vividly a point where I literally had four people quit at the same time within two weeks of each other, all different reasons, I could not control it. And I was devastated. And my team looked at me and they were like, “It's okay. We'll figure it out.” Because they could look at it through that filter you said of sometimes you just have shit luck. Sometimes the person who's been trying to have a baby for two years finally gets pregnant and is like, “I'm not going to work anymore.” Those things happen. And so I think from a head space perspective for me that this is head space and action because when it comes to your point, what are you going to do next?
Are you going to quit? Are you going to leave? Are you going to stay? Are you going to do something about all of those things we're going to talk about when we get to action steps? Looking at it through that lens and figuring out, how do I feel about my relationship with this person and the rest of the team I think is really, really important because you're going to need to, no matter what happens next, no matter what choice this associate vet makes, it's going to be hard. And so being able to look at, I'm doing this and I believe in this, and being able to hold that as your little flame of hope is so so important.

Dr. Andy Roark:
I completely agree. Let's take a break here and then we'll come back and we'll get into the actual action steps of what do we say and how do we say it.

Stephanie Goss:
That sounds great.

Dr. Andy Roark:
All right, so I love that this person made this job really easy for us by giving us two specific questions numbered one and two. I'm like, I like the way you work. You have clearly put some thought into this. So the first question was, would you address the owner about these decisions as the associate veterinarian and how would you go about questioning their decision? So to me the answer is absolutely yes. If we have so little trust in our relationship that I can't ask you go, “Hey, I couldn't help but notice that no one else works here anymore.” Then you don't have a relationship anyway. And what are you doing there? I'm sorry, at some point this is the elephant in the room and it would be weird for me to not ask you about it. And so I always say, I treat jobs like a relationship and I expect to be treated in a certain way and I plan to treat other people in a certain way. And I expect to be able to ask some questions about where we go.
And I don't take it personally if other people ask me questions about, “Hey, where are we going?” It's just a basic common understanding of what it means to work together with other people. And so no, just me. The big thing is, there's a couple big parts here. There's a difference in challenging the decision that was made and trying to understand what happened.

Stephanie Goss:
Yes, I would totally agree with that.

Dr. Andy Roark:
And it's funny how often people screw themselves right there. I'm not going to walk in and make demands. I really don't want to walk in and make assumptions. The two most powerful words in management, and this goes to managing up as well, are what happened? And I just seek first to understand, what happened? And so that I would say absolutely you have the conversation. Absolutely. Because how can you make a decision to go forward without asking some basic questions?
You're totally flying blind. And so I think that's a no-brainer. And so then the question becomes how exactly do you talk to them without them feeling that as they put, you're questioning their decision. The big thing for me is I use phrases like, help me understand, like “Hey, I noticed that we've had another one of our paraprofessionals go out. It feels like there's been a trend of people leaving and I'm wondering if you could help me understand what's going on.” And that's it. And then I would stop talking and that's it. And I would say it exactly like that, “Hey, I just want to want to know what's up and first of all, what's going on and then what the plan is. Can you help me understand and then stop talking?” And let them go.
After I try to get this open up and they say, this is what happened or this is where we are or whatever, the next part for me is going to explain how I am being affected or how I've been affected and what my concerns are about not being able to keep the staff. And I'm not going to say you firing people has done this or that. I'm going to say, “Hey, I know you know this, but it's not easy seeing appointments with half the support staff that we usually have.” And this is me communicating where I'm at because remember, I truly believe this is a relationship and if you and I are in a relationship together, I want you to tell me where you're at and how you're feeling. And I also am going to tell you where I'm at and how I'm feeling.
I'm not going to play the guess what I'm thinking game. And so, “Hey, I'm concerned that this work is getting harder to do and that we might lose more people just because without support around them, their job is harder. I'm worried about us being able to keep people that we have now that we're so shorthanded.” And the last part, the way I frame it is, I'm going to ask for advice or I'm going to ask for guidance on how I should go forward to best support the practice. And so that I know what to expect. So I'm going to say things like, “Hey, can you give me some guidance on what I should be trying to do to keep the staff that we have or to support the practice or help me have a clear expectation of what the plan is from here.” And that's it.
And I just tried to use as much of the actual wording as I would use, but that's exactly how I would say it. It's very soft. It's not argumentative. I'm not trying to put this person on the defensive. I want to know what happened. I want you to know how I'm feeling so that I can just say, “Hey, just giving you the information so you can make future decisions. This is where I'm at, what's the plan? What should I expect? How can I support you in going forward?” And then see what they say and actually really listen to them. And for me, that's the end of the conversation. A lot of people will say, “But then we needed to talk about what if I leave?”
I said, “No, no, no, no, no. You got the information, you got what you need. Go home. Just go home and sit with it and just process. There's no need to have this one conversation this one time. Just sit with it.” And there's nothing wrong with coming back in three days or 10 days and saying, “Hey, I've been thinking a lot about what you said and I just want to be transparent in what my thoughts are.” That's how I would do it. If you decide going in that you would like to be more involved in these decisions, you can even say, “Hey, I think it's important to me going forward, just that I feel like I know what's going on because I felt like the rug was pulled out from under me in some ways. And I'm not saying that what happened didn't need to happen, but it would really help me if I had a little bit more, I don't know, lead time before changes were made, if that's possible.” And just ask for what you need. I guess that's me telling you where I am, but I don't know, what do you think about that? How does that sound when I say it?

Stephanie Goss:
Yeah, no, I love that. I think for me that my framework is super, super similar. So it's really hard for someone to be immediately on their defense when you start the conversation by asking for help. So whether it's help me understand or “Hey, I need your help, I am struggling, I feel like the team is struggling and I'm sure you must be struggling because we've had a lot of change and we've had a lot of turnover and this seems to be affecting all of us and I want to help you. And so I thought the best way to do that would be for us to start with a conversation, which is why I'm here. I want to understand what is going on and how I can help you and in turn help myself and the rest of the team.” And then to your point, you have to shut up and listen because especially if we have nerves about having conversations like this, our natural tendency is to just keep talking.
But if you don't sit back and let them actually answer, you are missing your opportunity. Because this first, I agree with you, this is not one lengthy conversation. This is a multi-part conversation in that part one is about info gathering because one of the things that you taught me is that there are defining moments in our relationship building with people and people always eventually show us who they are. And so if you have a situation where somebody is under a lot of stress and this practice owner might be in a place where they're just like, I've got a lot. There's a million reasons why this could be happening. And they could take the opportunity to so they could apologize. This is one direction it could go. They could say, “I'm really sorry, I know that this is a lot. This is not where I was intending for it to go, here's what's going on.” And they could fill you in.
They also could be like, “Hey, it is what it is. We're moving on. Thanks for your ask, but I've got a plan and we're working on it. And they could totally shut you out like that.” And it could go a million different shades of gray between those two points. The whole point of this conversation is for you to info gather because I gather from the questions that the associate vet was asking, and this is why I said I love the headspace that they were in. At the start of this, they haven't already quit. They haven't already made up their mind. And so this first conversation is about info gathering. And I think that while we all have moments where we are not our best selves, when you start a conversation with somebody and you ask them how you can help, it tends to be a situation that is going to put someone into a better possible light than others might.
And so take this as a info gathering opportunity and just hear what they have to say and then offer what help you might be able to give like, “Hey, I would love to help with trying to find new team members.” Again, info gathering. And to your point, you might have to marinate and say, “You know what? I would love to really think on this because I'm up for helping. I want to fix this. I like what we're doing. I think that we have some great people and I would like to see us keep the great people that we have and continue to add great people to this team.” There are lots of ways that you can easily walk out of this conversation no matter what is said, but I agree with you, spot on, just hear what they have to say and then close the door to conversation number one.

Dr. Andy Roark:
Yeah, exactly. It's amazing how often people say, “All right, what do I do? Option A, I stay option B, I leave.” And I'm like, “How about option C? I get more information about what's going to happen in the near future.” I vote option C. And then ask me again. And that's exactly what we're doing. And then the second question that they ask is, if staffing based on being buddy-buddy with the owner versus skills and merit continues, would you look for another practice? I'd say, all right, first we have made the assumption here that the reason people are leaving is because they're not buddy-buddy with the owner. Which I would say you might be right.

Stephanie Goss:
You have to info gather first.

Dr. Andy Roark:
I would assume good intent and I would info gather to stress test that assumption. But it may be that that's what happens. And so the first thing is I would check that assumption and see if it's really true. The answer to the question is at some point I would do some math. I would look at the pros of staying and subtract the cons of staying. And if I got a negative number, meaning the cons are bigger than the pros, I would leave or if the pros and the cons were about a wash, but there was a pattern towards steady decline, a trend downward, I would say, I know I'm worried about this. And so I would do some math and then, so we talk about this all the time, so much of management, and this is about personal management, this is career management, it's picking your poison.
It's summing up, okay, if I stay here, these are the bad things and if I leave, these are the bad things. And it's looking at, it's not just the bad things today, but it's the bad things going forward. I don't know if that really helps, but really, I guess my basic thing is just at some point you have to sit around and say, “How much do I like being here? And how hard is this?” And then subtract how hard is it to go find another job? And that's why another thing, I can't tell you what the answer is. You are the only one who could say, “There's 10 other practices in a five mile radius that I could absolutely go to. In fact, one of them is trying to hire me and they seem amazing.” That's very different from, “I live in a middle of nowhere and if I leave, I have to move my family to a different place.” There's just different things. And so you have to do that math for yourself, but what are the pros of staying versus what are the cons of staying? What are the pros of leaving and the cons of leaving and see how all that stuff sorts out. The last part I want to say on the math part is, what? What are you smiling at?

Stephanie Goss:
Keep going, keep going. I'll hop in when you're done. Keep going.

Dr. Andy Roark:
Okay. The last part of it, and this goes back to what we said before of don't get confused and think that your options are, I leave now or I stay forever and the options are really, I stay for a while and I don't say anything. I stay for a while and I work to improve the situation I'm in. I stay with a commitment of reassessing my decision in three months and that helps me sometimes to say, “I'm going to say something and then I'm going to wait until June 1st.” And on June 1st, if my situation is not better than it is now, I am going to leave, I'm going to plan to leave. Sometimes just putting that pinned in the calendar where you're like, “I'm not trapped. I am going to make a decision in the future. Right now I'm going to say something and then I'm going to give it some time to see what happens. That's not a bad strategy and I'm going to make a plan to leave, which is I'm not giving my notice right now, but I'm going to go ahead and start investigating my options.”
And then your last option is leave, “Yeah, I'm out.” You have a lot of options and that's my point in this. And so I think where people screw themselves up is they make assumptions about what's happening and they say, I'm in or I'm out and I go, oh buddy, there's so much more nuance to this. But anyway, that's how I would look at it and lay it down. And generally I tend to come somewhere down around, I do my math, but I'm going to say something and we're going to talk about it and I'm going to ask what the plan is and then I'm going to give them enough time to see if the plan works or if it's actually getting implemented. And then I'm going to circle back around. And when I do my math again, one of the cons of staying is, based on previous performance, I do not believe that things are going to get better and that may be a big knock in the cons side. Anyway, but that's how I would do it.

Stephanie Goss:
Yeah, no, I love it. I love that you were looking on the bright side and I think you're, I agree 100% about doing the math and I think being able to sit back and work those steps depends entirely upon how your info gathering goes. Because again, those are steps that require you to be able to be in a place of positive head space and assuming good intent. Because if you are not, it's really hard to look at it and say, “How am I going to stay?” To working your way through even staying and thinking about the three, I love your idea of three months or giving yourself a timeframe and when you feel like you have a super negative outlook on a situation is really hard to do that. So I love that you looked at it from that perspective of you got to do the math and make the pro list and make the con list. I think it's funny because when I read the question, my answer was radically different from yours in that-

Dr. Andy Roark:
You're like, “Get out of there.”

Stephanie Goss:
Yeah, so yes, so the question was if staffing is based on being buddy-buddy with the owner versus someone's skills and merit, and if that trend continues, would you look for another practice? And my answer is absolutely hell yes. Because what I would say is hell yes with a caveat. So if the staffing being, is if you have done your info gathering and there is actually a trend and you have assumed good intent and you have seen a pattern that is undeniable, and there are hospitals out there where this is 100% the case. We've had episodes where we've talked about when one of the techs is really good friends with the practice leader and so they get good opportunities or they're the bias of being friends or being buddy-buddy is undeniable.
So there are situations where that is totally the case. If that was the case on a personal level, I would absolutely look for another practice because to me there are so many great practices out there that need great people and it is, maybe it's just the place that I'm at in my career, but I have come to this place where it is important to me to work with good people who want to do good work and who believe good things. And if I felt like I was in an environment where the staffing was solely based on whether somebody could get along with a practice owner or not, hell yes, I would be gone. And I love what you said because it's a significantly better answer in the sense of you should still do that math. And I guess I say hell yes, because I agree with you.
I would have done the mental math and I am that person. I believe the best in people. And I have had, can think of two instances in my own career where I was really struggling with things that were happening with our practice leaders. And I felt like I had some significant skin in the game, obviously as a practice manager. And it was not my practice in either situation. And so I was in the place exactly where you talked about where I sat down and I literally made pros and cons lists and I looked at the math and then I looked at all of those options and thought through them similar to what you just said, which is, okay, I could stay and not say anything and be miserable and I see people on my team and that's the choice they're making and I don't want to be that person, so what's the next thing?
And I moved my way down and ultimately I am a big fan of the camp in the middle, giving, staying, and here's the commitment, I'm going to reassess this. And so in both of those situations, I gave myself a timeframe and I was like, this is the timeframe. And I did exactly what you said, at home, I wrote it on my calendar and I circled the date in red and I was like, I'm going to give it until this day and I'm going to give 110% as I have been until this day, and then I'm going to reassess and I'm going to look at it with fresh perspective. And if I still feel the same way that I do now or I don't feel significant change, then it'll be easier for me to make my decision one way or the other.
So I think you look at it from a very pragmatic perspective, and I think that that's important. And I'm going to advocate, I feel like almost always on the side of there are so many great practices out there and I see so many people and this letter reminded me of that, of people who are good people who want to do good in the world and are in these practices that, and again, we only hear one perspective. And the truth is funny, man. There are always at least two sides to every story and the truth usually lies somewhere in the middle. And so we only have one tiny filtered-down view from the email that we get in the mailbag. And when we zoom out and we talk through all the things we talk through on this episode, it's really easy to imagine a place where this is reality and maybe this practice owner is toxic and this is what's happening. And then I'm a big advocate for being the cheerleader for my fellow colleagues to say, “Heck yes, man, don't stay in a toxic place. Don't let yourself feel trapped like that.”

Dr. Andy Roark:
Yeah, I'll put a little bit of spin on this as well, just so you look at, because I think you'll appreciate it, what if it's not that the practice owner wants people they're buddy-buddy with? What if they're a weak manager and they're not able to manage people that are not very similar to them? Does that change the way you look at the situation? It doesn't change the outcome if people are getting chased away but again, it just goes back to assuming good intent.

Stephanie Goss:
Yes. And so the info gathering, because if we were info gathering and that practice owner said what you just said, I'm struggling, this last person who left was radically different from me. If I got that out of the conversation, hell yes, I would be willing to help and look at it completely differently.

Dr. Andy Roark:
It's just interesting. It's just a thing I've done for years and years and years. People will say, “I have a bad boss.” And I'll listen to them and I'll say, “It sounds to me like you have a struggling boss.” And they're like, “Yeah.” And now that does not mean that you have to sacrifice yourself. It does not mean that you should be miserable or that you need to stick with this because the boss is struggling to lead people. You didn't marry this person, you just took a job. But it does help me to feel better about my decisions and put things into some context that I don't know. It just for me, when my heart is open like that, it can help me pick my way through it.
I think your point is also really good is when we do some math, ease of leaving right now with so many hospitals that are desperately looking for people, especially really good, that does swing the math equation. If you're like, I'm pretty confident I could go to a place that is really good. Ultimately I go back to the very beginning, which is they're not obligated to include you in their decisions, but you are affected by the outcome of those decisions and you are therefore empowered and you should not feel bad about making the decisions that are best for you because that's what they did as well.

Stephanie Goss:
Yeah, and I think to your point there, I think some of it is self-reflection on what do you want in your role? And I have worked with associate veterinarians who are like, “I want nothing to do with being a leader, whether it's from within the team or in a position of power. I want to come to work, I want to take care of my patients, I want to do a good job, and then I want to go home.” If you are an associate veterinarian who likes management, who is interested in leadership, who is interested in growth and development, which is the sense that I got from the mailbag letter that we got, then this is also a good opportunity for you to look at what you want. So it was so easy for me to say, hell yes, I would look for another practice because I did that reflection on what do I want in my own career path?
What is important to me? What are the values that are important to me in a practice? What's the environment? And if you told me you were going to go work in a practice every day and you wouldn't be able to have a conversation or have any impact from even within the team, that would not be a fit for me and it would be easier for me to do that math. And so I think that's that for this associate that I think some of it is thinking about what do they want in the bigger scheme of things and then maybe what they want and what the practice owner is struggling with, talk about it feels maybe like lightning in a bottle, but what if you have a practice owner who is struggling to manage people and you have an associate who is interested in managing? What if you guys can work together, could you turn this around? Hell yeah, you could. So I think coming at it from that inquisitive state and info gathering is the most important part because I don't think you can make your decision without that.

Dr. Andy Roark:
No, I completely agree. Well, then that's what I got. I think that's all I got with this one.

Stephanie Goss:
This was a fun one. Take care everybody. Have a fantastic week.

Dr. Andy Roark:
See you everybody.

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

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: culture, management

Feb 16 2023

Performance Reviews That Don’t Suck

Uncharted Veterinary Podcast Episode 218 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are answering a question you asked in the mailbag! We received an email from a practice leader who was asking questions about employee reviews. They wanted to know what are some of the best and most effective questions that should be asked. They were also curious about our take on who should be answering those questions, especially to help give the best overall picture of an employee. And lastly, they wanted to know should management be reviewed and if so, who should review them? If you have listened to the podcast before, you might already know that Stephanie and Andy both think should is a dirty word. This was a fun episode, let's get into this…

Uncharted Veterinary Podcast · UVP – 218 – Employee Reviews

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


Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Upcoming Events

We have TWO amazing events coming up – one virtual just for managers and one in person that anyone on the team can attend! Don't miss your chance to join us either virtually or in person in beautiful Greenville, SC.

Calling All Practice Managers – The Uncharted Practice Manager Summit is Happening!

We know you are unique. Managing the business. Fielding never-ending questions from the team. Fixing broken printers, again. You wear more hats than anyone else in the practice. All of these look great on you, of course. But do you ever wonder “Am I actually in charge if I don’t own the practice? How do I manage the endless responsibilities of this job with limited power and resources? How can I keep growing professionally?”

If you’re itching to talk to people who really get what it means to be a manager, this is the event for you!

It’s time to connect with your fellow practice managers to share what gets you excited about your role, find solutions for what needs your focus now, and discover new ways to shine even brighter as a manager.

While Uncharted Membership is always encouraged, it is not required for event attendance! Non-members, here’s your chance to see what all the buzz is about and get a taste of the Uncharted experience. 

This 1-day virtual event on March 22, 2023.

April 20-22, 2023: The Uncharted Veterinary Conference

Our flagship three-day live conference event in Greenville, SC. Closed event. Only available to Uncharted members. Come join us in Greenville!


Episode Transcript

Stephanie Goss:
Hey everybody, this is Stephanie Goss. I'm coming at you with another episode of the Uncharted Podcast. This week on the podcast, Andy and I had so much fun diving into a question from the mailbag about how do we do reviews that don't suck. Now, fair warning, we did this episode right after I had just done a session at VMX on performance reviews and things that are better than a performance review. So I was super fired up. Andy got fired up as well. There's some soapbox moments, a lot of fun. And we talk about the mailbag question, which was, what are some of the most or effective and or best questions that should be asked on a performance review? Who should be answering those questions and should management get reviewed too? This was a lot of fun, let's get into it. And now, the Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark, and the one and only Stephanie-I-made-you-look-Goss. I made you look.

Stephanie Goss:
Oh, you actually did your job that time.

Dr. Andy Roark:
I did. I remember. I was like, what song? We're talking about performance reviews today. And I was like, “That kind of fits.” Also, my 11-year-old daughter is very into the Meghan Trainor song, I made you look.

Stephanie Goss:
I was going to say is that playing regularly at your house.

Dr. Andy Roark:
Oh, yeah. It plays regularly and there's lots of strong eye contact and dance moves. Like it plays and she just locks eyes with me and breaks it down. And I'm like, “What is this?”

Stephanie Goss:
If you have not seen the Instagram Reel, I think it's called… I need a social media lesson from Tyler and Kelsey. I don't know what any of the things are called. I'm not on TikTok, so I know it's not TikTok. But if you have not seen the video on Instagram of Kevin Bacon and his daughter doing a dance to that song, you have got to watch it. I have watched it probably 25 times. It makes me smile so big every time I watch it. When I need to smile, I'm like, “Well, let's watch Kevin Bacon dance to this because it is…” Especially if you're a parent, I think you'll find it funny. It was hilarious to me.

Dr. Andy Roark:
Man, I have a resolution for the New Year that I've been keeping so far. I know this sounds familiar.

Stephanie Goss:
Are you going to join TikTok?

Dr. Andy Roark:
No, that's the resolution a lot of people have been hoping for.

Stephanie Goss:
I thought you were about to make Tannetje's day and then we could have an announcement on the podcast.

Dr. Andy Roark:
… you need to do TikTok. And I'm like, “Ah, don't hold your breath.”

Stephanie Goss:
Not TikTok. What is your resolution?

Dr. Andy Roark:
It's the opposite of TikTok. I'm not kidding in this, but my resolution for 2023 is to be more bored. Not more boring, but more bored. I mean that because I noticed about myself that I sort of seek constant distraction, you know what I mean? And I listen to a lot of podcasts. Generally, I have a bunch of podcasts I listen to, I listen to audiobooks. I'm always reading multiple books and that's not bad. In fact, most people are like, “Oh, that's really good because it's not junk,” but I'm feeding my brain and blah, blah, blah. But Stephanie, what I realized about myself at the end of the year was I kind of live in this perpetually distracted state. I'm always listening to something, I'm always thinking about something. I'm always doing something. And I think it's contrary to being present in the moment in a lot of ways.
And so, what I mean, when I say that is I found that it's been my resolution so far, is just not having that phone in my hand all the time or even on my body and to not put my headphones in whenever I have a moment. And so, I like to wash the dishes and listen to podcasts or listen to audiobooks. But I decided it's like, you know what? I'm just going to take a break from doing that for a little while. And what I found is that when I don't have my headphones in and I'm washing the dishes, my kids come and talk to me and they don't come and talk to me when my headphones are in. And my wife walks in and she didn't say anything, but I'm just standing there washing dishes. And so, I say, “How was your day?” And I'm genuinely asking, not just a perfunctory greeting, but how's your day?
And so I've found that I'm having these conversations and I'll go walk the dog and I won't listen to my audiobook or I won't make a phone call just to talk. I'll just walk. And I feel like I get good time just to think. And then the neighbors come out and talk to me. And so, I'm talking to the neighbors now and I'm like, “I've only been doing this for a couple of weeks. But I feel like I'm really connecting to people in a lot of ways.” And I think I do feel like my level of mental fatigue has kind of gone down. But I just say that because my daughter has been dancing at me a lot, but it's because I'm just there and I'm goofing off and I'm not doing anything. And she'll start dancing and you know what I mean? And then it just kind of turns into this thing-

Stephanie Goss:
She's engaging with you.

Dr. Andy Roark:
… when I'm on my phone. And so, I don't know, it's just when we were talking about dancing fathers and daughters, it made me think about being bored.

Stephanie Goss:
I like it.

Dr. Andy Roark:
And it was funny though, I had this thought as far as we're talking about performance evaluations and stuff. So I was in the kitchen and I had my headphones out and I was just washing dishes. And my wife came in and we were talking and I said something about trying to be more bored. And she was like, “Oh, is that why you don't wear your headphones?” And I was like, “Yeah.” And she goes, “I think it's really great that you're doing that.” And I was like, “Ah, well, thanks for saying that.” She was like, “I hated when you had your headphones at all time. It made me so mad.” And it was funny because my language of appreciation is affirmation. Like that's my love language, affirmation. And so, tell me that I'm doing something good and you'll make me really happy. It's funny because I felt really happy and then I felt really not happy. And I just wonder how much positive feedback is given on the way to negative feedback. You know what I mean?

Stephanie Goss:
A lot.

Dr. Andy Roark:
Oh, I really love how you handled that client. Usually, you're kind of a jerk and you know…

Stephanie Goss:
It's the poop sandwich.

Dr. Andy Roark:
It is. It's the poop sandwich, but it's without a top bun. It's like, “Oh, I wonder how many of us are like, I'm saying something nice and he seems really appreciative. Now, it's my chance to say the mean thing or just the critical thing.” Now's my chance to be critical because I said this nice thing and I'm like, “How much maturity does it take to say the nice thing and then not say the critical thing that you have in your pocket and just be done?” And I think that's really funny, but I was just thinking about it when I was like, “Oh, speaking of performance reviews…”

Stephanie Goss:
I just got one from my wife.

Dr. Andy Roark:
I got one from my wife that sounded like praise. And then quickly turned into, let me tell you how, I hate when you wear your headphones and wash dishes.

Stephanie Goss:
Oh, so funny.

Dr. Andy Roark:
She's not wrong. But just all the joy from her initial praise of my resolution just went right down the toilet.

Stephanie Goss:
So it's funny that you say that because we've been fighting that. We've been fighting the same thing. Both of the kids are, and they're same as you. They're listening to audiobooks, they're reading, they're listening to podcasts, and they're really smart kids. And they share stuff with me and I'm like, “I didn't even know that, that's history.” They constantly teach me things. And at the same time, it totally bugs me that they're constantly having earbuds in or have their headphones on. And we'll be in the same room, we're sharing space. But we're all listening to something separate. So on New Year's, I intentionally put my phone down and took my ears out and I was like, “Hey, you two, tiny people, let's have a conversation about what we want to do this year.” And so, we did some bucket listing and some goal setting, but it came about like we were talking about things that we wanted to learn this year.
And I told the kids one of my goals for myself this year, which was to work on my fluency in Irish. So I lived in Ireland and taught high school there and taught in a bilingual school. And so, I can read a decent amount, but my conversational Irish has never been great. And I would love to improve that because I really want to take the kids to Ireland and have them be able to see all of my old haunts and all of that kind of stuff. And so, that was a goal that I set for myself. And I was talking to them about languages and they both were telling me, I was kind of surprised. They were like, “I want to also learn a second language.” And my daughter was like, “I want to become fluent in ASL.” And I've been teaching her ASL since she was little and she actually has quite a good grasp on it.
Honestly, her skills in fluency is surpassing mine at this point, which she was like, “I want to actually be able to converse with people and have total conversations.” And my son was like, “I want to learn Russian.” And I was like, “Where did that come from?” But really, he's like, “I think that I actually want to learn Mandarin.” He's like, “Because it is one of the most commonly used languages in the whole world.” And he starts spouting off about statistics and being able to converse with people. And I was like, “This is great.” And so, we were talking about different ways to learn language, and I was telling them, and I've been using an app and they have been quietly watching me apparently the last three days. Because I started using a language app and was doing my 15 minutes a day and sitting there and practicing. And last night, I come in the front room and they both have their headphones in and I'm like, “Oh, not again.” But I stopped for a second. They're both freaking working on languages.

Dr. Andy Roark:
That's cool.

Stephanie Goss:
And I was like, “This is awesome.”

Dr. Andy Roark:
That's very cool. I like it.

Stephanie Goss:
So yeah, I'm a fan.

Dr. Andy Roark:
The takeaway is there's a balance. It is about intentionally doing things and using your time and then also making some space to just unplug. So like I said, I'm not saying I'm giving up podcasts. I enjoy that stuff, but I think I'm going to be more intentional about when I am listening to audiobooks and when I am intentionally not listening to audiobooks-

Stephanie Goss:
And being bored.

Dr. Andy Roark:
… and I'm just being bored.

Stephanie Goss:
Well, let's talk about intentions a little bit because we got a mailbag question about employee reviews. And it's really funny because we're recording this. By the time this comes out, VMX will be done and over. But I'm actually speaking at VMX with our friend, Megan Brashear, and we're doing a session about employee evaluations. And so, I was really excited for us to talk about this on the podcast.

Dr. Andy Roark:
Get it, Stephanie. Get it.

Stephanie Goss:
I can't wait. And Megan is so fun, it's going to be a great session.

Dr. Andy Roark:
She's amazing. She's absolutely an amazing person.

Stephanie Goss:
Oh, she is.

Dr. Andy Roark:
She's so great.

Stephanie Goss:
And we both feel passionately about this subject, so I'm super excited. But we got a question in the mail bag about being effective with reviews. And specifically they were asking about questions that are effective for being asked. But they were also specifically asking about who should answer questions on a review? How do you get the best overall picture of an employee? And then they were also asking, should management be reviewed? Like as a manager, should I be getting an annual review? And if so, who should be reviewing me? And I just thought it was a great collection of questions that could go in you and I's hands, could go in a million different ways. But I just thought this would be such a fun one to talk about on the podcast.

Dr. Andy Roark:
Yeah, this is hard. And I'm not sure how we're going to talk about this exactly. Because it's like where do we talk about what should be and where do we talk about what is in making the best of it? You know what I mean? It's like if someone said, I want to eat ice cream for all three meals and a hot fudge and caramel on top, which flavor of ice cream should I have for breakfast? And you're like, “I think we should back up past what flavor should I have for breakfast and talk about the underlying plan.”

Stephanie Goss:
Should we eat ice cream for all three meals?

Dr. Andy Roark:
You know what I mean? I don't know if that made any sense at all. But that's how I feel when people are like, “What question should we ask in this annual evaluation?” I'm like, “What flavor of ice cream should we have under the chocolate syrup at breakfast?” I'm like, “Wait, how did we get here?”

Stephanie Goss:
That is such a great analogy. I love it so much.

Dr. Andy Roark:
This can just spin wildly out of control. But that's how I feel, I'm like, they swept up somewhere along the way.

Stephanie Goss:
I love it.

Dr. Andy Roark:
And now we're in this bad place asking the final question.

Stephanie Goss:
Well, people get frustrated because I get asked this question a lot as a manager and as someone who speaks as a manager in our industry, I get asked this question a lot or a lot of should questions about reviews. And if you have listened to the podcast, you know that Andy and I both feel like should is a very dangerous word. And my question back to them is, what's the point? Why are you doing a review? What are you trying to do with it? Because that will shape the answer or the opinion that you get. And the why has to be at the forefront of this question. And I feel like the why is almost always the afterthought.

Dr. Andy Roark:
Oh, completely.

Stephanie Goss:
And it's the how, that's the first questions.

Dr. Andy Roark:
Exactly. How do you do this? And not the question of, why do you want to do this and what is the point? And it doesn't shape how you do it, it completely defines how you do it. And so, when people say, “What question should I ask?” My response to them is, “What do you want to know? What is the purpose of this exercise?” And they're like, “I don't know. To perform an evaluation.” I'm like, Well, then, ask whatever you want.”

Stephanie Goss:
Because someone told me that I had to check a box once a year.

Dr. Andy Roark:
The point is to perform a review, ask whatever the hell you want. And then really, this is a scheduling exercise. But on the schedule, wait until the time has passed and the person has appeared and then you're done and that's it. You have performed a review and that's it. But I'm not kidding. And again, this is why I go off the rails. I'm like, “what are we doing here?” Anyway, but as we know, there are some people who are like, “I am required to do this evaluation. And so, now, cocky, just tell me now that I have to do this, what do I ask?” But my answer is still the same. “What do you want to know and what are you trying to accomplish?” And so, I don't believe that there is a right way to do an evaluation because there's not a right goal you should be aiming for.
The questions I would ask you, Stephanie Goss, if we sat down together and I was going to do your employee evaluation, they're night and day different from what I would ask Maria Pirita, who works with us as well. And you're both wonderful and you both have similar jobs or do kind of similar things, but you're in wildly different places in your development and in your skillsets and in what your interests are and where you're going and how you're developing, and what's important to you and who you interact with. And all of those things are going to dictate what I would ask you in an evaluation. And that's not even taking into the fact or the idea of, “Is a once a year evaluation a good idea as a format?” And I go, “Well, no.”

Stephanie Goss:
Well…

Dr. Andy Roark:
But inside of it, it would be very different.

Stephanie Goss:
I think because that answer speaks to why you would give us evaluations in the first place. So the why for you would be to have a developmental conversation and talk about goals and the vehicle would be asking us different questions based on who we are, what our interests are, where we are in our career, what we're working on. When you give that answer, you are looking at it from that perspective. And when it comes to employee reviews as a whole, a vast majority of managers and business owners are taught to, and or choose to look at it as a box that has to be checked, number one. Something that has to be done on a prescribed timeline, number two. And is being done, the why is documentation to cover their ass really.

Dr. Andy Roark:
Oh, yes.

Stephanie Goss:
Or to figure out how to pay their people. Both of those two things are inherently stupid and messed up systems that I am absolutely against. And so, it is a wild soapbox for me. And it's funny because Megan and I got together and were talking about our session for VMX, and she's like, “How do you feel about annual performance reviews?” And I was like, “Oh, okay, you just handed me a soapbox. Like 10 feet high and said, climb up.”

Dr. Andy Roark:
45 minutes later, you stopped talking. And she was like, ‘Well, that's our presentation, then I'll ask you that question and then I'll go have lunch and you'll just go off.”

Stephanie Goss:
No, but really, that is really unfortunate because it is leftover from where industry and work and employment started in the stone ages. And that is one of those things that has not progressed anywhere near along with wages anywhere near the rate of inflation. We haven't changed this process. We're still trying to apply this process that has been used forever and ever and ever to what we're doing now.

Dr. Andy Roark:
Well, and a lot of it is driven, and you said this before. A lot of it's just driven by HR. If you're a corporation and not only in corporation in a Megan sense, you'd be a small business. Especially your employment lawyer will tell you, you should be evaluating people and documenting their performance because this is required. So anyway, the frustration, it's not real frustration, but a little bit that you hear is, I am super pragmatic. I want to get things done. And the idea of having an annual evaluation or even these scheduled formal evaluations, I go, “I think they're largely counterproductive to actually growing human beings and leaders and developing people.” But I get that, again, I think it's an HR liability legal thing.
And then also, it's a way when people say, “We want to give raises and we need a formal structure to do that.” That feels fair, and in some way objective. Then evaluations and some sort of a formal grading scales come into that. And so, don't get me wrong, I'm not saying don't do them. I'm just saying that the way they're usually put forward is not only not super helpful, it's often counterproductive. It drives anxiety levels and cortisol levels through the roof. It makes people really uncomfortable.

Stephanie Goss:
The team hates it.

Dr. Andy Roark:
The team hates it.

Stephanie Goss:
They're driven by anxiety. The managers hate it because I will tell you, having run bigger practices, who wants to spend three to four weeks of their life, trying to think back on the last year for my entire team and actually make that actionable and individual? It's an impossible task and it gives everybody anxiety.

Dr. Andy Roark:
Yeah, I agree. That's our general philosophy on evaluations, the better way… So here's what should happen in Andy's magical world that doesn't exist. In Andy's magical world, that doesn't exist, you would talk to your people in an ongoing basis and you would trust them. And when they did things that were good, you would say, “Hey, that was really great.” And you would not say it on your way to telling them what they had done before that you didn't like.

Stephanie Goss:
It would be a complete full sentence.

Dr. Andy Roark:
It would be a complete…

Stephanie Goss:
You did this thing and it was wonderful, thank you.

Dr. Andy Roark:
Exactly. It would even be a full sentence. It would be a full interaction. That would be the stop and then we would leave. We would go to other places and stop communicating for a certain amount of time.

Stephanie Goss:
All right.

Dr. Andy Roark:
But we would tell them what they did that was good. And then when there was room for improvement or we as a mentor or colleagues saw a place where they could develop, we would say, “Hey, I noticed that you did this thing. Can I give you some feedback on it?” Or, “Hey, this is what you did really well. This is what I need you to work on going forward. Can you do that for me?” And that's the whole interaction there. It's not, “Here's nine things and here's a running history.” It's, “Hey, I saw this go down. Did you see it? Do you agree that that's kind of what happened? Let me tell you what the perception was, looking at it from the outside. Can you do that differently next time?”
And you just give them the feedback right then, not with a pen and paper in your hand. Not in a scary way with a door closed. You just say, “Hey, I need you to work on this. You are really good at this thing. This is what I need you to work on going forward.” And then you go on with your life and you don't treat them like a pariah. You don't avoid talking to them for the rest of the day. You just say it and then they go, “Okay.” And then you go on. And ideally, when the boss says something that hurts their feelings, they say, “Hey, yesterday when you said this, it hurt my feelings.” And you'll say, “I'm sorry. I didn't mean it that way. That makes sense that you would hear it that way. That's not how I intended it, but I understand how you heard it. I'm sorry. I'll do that differently next time.” And that's how this whole thing should work. And doesn't that sound like a beautiful, wonderful place to be? Like, does that make sense?

Stephanie Goss:
Yes, it totally does. And then it leads to the question of, well, if we're doing that, what is the point? Because it still asks the question, what's the point of having a review structure? And I would argue that in that hallucinatory world, there is true power. The power gets unlocked in terms of the employee review because then you have the ability to say, “Let's look at where we've been. Let's review the journey.” The word review means let's look back. So what is the look back? Where did we start the year? Where did we end the year? And you have the ability to look at it in the context of the good and the challenges. And what I mean by the challenges is what progress did we make on the challenges? Not these are the things you screwed up and it feels punitive, but these were the challenges you had and this is how you overcame those challenges.
This is the progress you made around those challenges. So it is positive and it is forward focused in the sense of, what are we going to continue doing to continue to change this or improve? And so, for me, when people ask me this question, I ask them, what's the point? What are you trying to do there? Because for me, I as an employee want to exist in Andy's hallucinatory kind of world where the review process and the structure from an HR sense exists to support an employee driven process where I am engaged in my work. Where I get to set goals, where I get to have conversations with you, Andy, that says, “Hey, this is the thing I'm super interested in. This is why I'm interested in it, and why I think it can benefit me and why I think it can benefit the company.”
And we have had those conversations and then we're monitoring the progress of that work. That's the kind of review process I want to be a part of. I hate feeling like I have a system and a structure and I have to check the boxes. And I recognize that myself included in both private and corporate practice, the expectation was set that this is a box you're going to check and you're going to check it once a year. And for a lot of my career, it was tied to money and it was tied to pay evaluations for the team. And that is the thing that I hate more than anything. And I won't soapbox because I could do a whole episode on that alone, not alone. But I recognize that that is a structure that a lot of people have to live within. And so, I think that's really asking the question of what is the point? What are we trying to achieve so that we can manage expectations as best we can is the best possible thing we can do When it comes to reviews.

Dr. Andy Roark:
I just like the term evaluation and I think you're hitting around that as well. I don't want to be evaluated, like weighed, judged, measured. I don't like that.

Stephanie Goss:
Because it puts the power in somebody else's hands.

Dr. Andy Roark:
Exactly right. You, Stephanie Goss are going to tell me my worth in some way in, and it's not. It's like there's a judge, but no ability for me to say, “Well, this is what was going on,” or “This is the context in which I made decisions,” or “This was going on in my personal life.” And again, I know I'm thinking a little bit far, but not really. I don't like that term, evaluation. You and I do a lot of work with leaders at Banfield and they have their PDP, which is their personal development plan. And I'm like, “I will a 100% show up for my development plan meeting where we talk about what I have done, what I'm doing well, and what I could do in the future or how I could grow and develop going forward.” I'm much more on board with that meeting than we're going to evaluate your performance in the last year and tell you your worth.

Stephanie Goss:
Well, and I think that's the thing that a lot of people wrestle with because for a lot of companies, that was the structure in theory for me in the corporate environment that I worked in. And at the same time, it was still tied to my compensation. It was still the evaluation. And to your point, I think a lot of people try and combat the evaluation by saying, “Well, we're going to have a self-assessment as part of this.” So you get a voice and you get a say. And most of the time, that voice and that say isn't really factored in to balancing out the scale and equaling out the scale. They're giving you the chance to say what you have to say, but how much of that is weighted into your score? And so, I think the system and the structure is inherently flawed and it's something that I love to fight against in terms of veterinary medicine.
But the whole point of the podcast is like, okay, how do we actually make this actionable? What do we do with it? And there's two sides to this. One is the place where you get to live in Andy's hallucinatory world because there are people who are the boss or who are in a position where their practice owner says, “I don't care what you do, as long as you do it and you get to make it all up.” That's the best seat to be in because you get to ask the question, what's the point? What are we trying to do here? What questions are we trying to answer? And you get to make it up, or you're in the camp where there is a structure you maybe don't have say in it, and you still have to do the thing. And so, then how do you make it the most least anxiety driven for you and for your team and how you make it the most effective within the constraints that are placed upon you.

Dr. Andy Roark:
What I want to do, let's take a break here.

Stephanie Goss:
I love it.

Dr. Andy Roark:
And then we're going to come back and we're going to talk about, given the constraints that we're in, let's talk about how we do this. Let's talk about, great, we've told you what we think. That doesn't change the fact that it has to get done. Let's come back and let's talk about how to do it. But one thing I do want to say just before I forget, I think we need to separate the idea of compensation tied to evaluations. That's too much, it's too big to-

Stephanie Goss:
It's a whole soapbox.

Dr. Andy Roark:
You know what I mean?

Stephanie Goss:
Yeah, it's a whole soapbox.

Dr. Andy Roark:
The whole other thing. So we're going to put aside anything about how compensation is tied to evaluation. Just how do you do evaluations that don't suck. That's our plan, all right?

Stephanie Goss:
Okay. I like it.

Dr. Andy Roark:
All right, so we are back. Let's go ahead and start to lay this thing down. Now though, I want to talk about this chronologically. I said before the break, Andy's fantasy world where we give feedback on an ongoing basis. Do that thing, and the fact that you have to do an annual evaluation, that should not change. It's not like, well, I'm not going to give feedback in the moment because they're going to get it later on. We all know the idea of giving someone feedback on something they did three months ago is dumb.

Stephanie Goss:
Yeah, oh, totally. I think the trick that a lot of us miss, myself included, for a really long time was that I would give that feedback and then I wouldn't document it. And so, then, if you are doing some sort of evaluation structure, then you sit down and you're like, “I don't remember what happened over the last year, but I remember the last thing they did that annoyed me.” And that's what we focus on, it's whatever. That's how our human brains are conditioned to look at that negative. So the trick is that documentation. And you're not going to write every little thing down, but you have to have a system for yourself as a leader and as a manager to capture the big things, good and challenging and document it on an ongoing basis.

Dr. Andy Roark:
There's a million ways to do this. I use Notion, I love the app Notion. It's just a great brainstorming app. I'm not talking about sharing with a team. I have it for myself. I have a team gallery, it has all of my people and they have their pictures there and it has their contact information and it has personal things that I want to remember about them, their birthdays, spouse names, kids names, things like that. That I'm like, “I want to just make sure I have all stuff.” And then for each one of them, when I have an interaction with them or something, and I do it when they crush it too. And that's a big point I want to make is do not go around and record all the bad stuff and ignore the good stuff. And then you're like, “What's this evaluation about?” And you look back and you have all the crap, all the bad stuff, all the bad days. Don't be that person.
When they do something great, write it down. And when they do something that needs to be corrected or something you want to work on or an ongoing pattern of behavior, jot that down. But the big thing with this is just have a system. And honestly, I make sure it's on your phone and I say your phone because you're going to think about it when you are at the post office and you're like, “Oh man, that was really great.” And when you get that idea of that person, what they just said was really kind. Pull your phone out, jot the date down, jot down what you saw. And then when you come around to the end of the year, you're like, “Hey look, here's a couple of things I just want to call out. One of the things that I admire most about you is this characteristic.”
And I saw it multiple times through the year. I remember on this date, I saw it here on this date, I saw it here and this day I saw it here. And people go, “Oh wow, you really have been paying attention.” We always think that we're going to remember things. No, you're not going to remember it. You got to have a system to write it down. The evaluation doesn't happen at the evaluation. It should be working throughout the whole year to build a fair and helpful picture of what we're trying to do.

Stephanie Goss:
Yeah, I do very similar except for I am the kind of person where I have to actually write it. So I use a reMarkable tablet and it's basically like a digital notebook. And when I was at the practice, I had a folder for the practice and there was a folder for the team. And just like you with Notion, everybody had their own notebook and I would write it down and you can index the pages. It's like super cool, it's one of my favorite work tools. But it has to be something where you are recording it on an ongoing basis, whether it's your phone or handwriting, but remembering if you're handwriting things, that's what I love about the reMarkable, is that I can then digitally upload it because so many of our hospitals are using HR software.
And the last thing you want to have to do is write it down for yourself in multiple places or then have to spend the time uploading it to the place where it's supposed to go. So looking at your own individual hospital and your own individual systems and figuring out how do I organize this in a way that is not, I have to go unlock a cabinet, pull out Andy's employee file, find the section, and then insert my page here. That should not be your system.

Dr. Andy Roark:
And so, start your system way in advance and start gathering information so you have real examples. The other thing to do at the same time, probably even before that is figure out what you're doing here. What's the point of this evaluation? Is it, I'm going to bring my employees together so they all know what I think of them? That's arrogant and stupid and not helpful. Who cares what you think of them? Is it so that you can reap justice upon them? And all the people who got away with things will be held accountable. That's a terrible twisted system. Is it so that I can help mentor them and help them grow and help them enjoy their time here and help them be more successful in their career and where they want to go? I mean, the thing is the point of the evaluations, it's not for me.
If I have a problem, I'm going to call you or I'm going to walk up to you and I'm going to tell you about it. And that's how I'm going to handle it. And it will get handled. And so, if we're going to have this sit down meeting, it's not because I need something. Because if I needed something, I would've told you about it already so that I can help you to be happy here and to grow. Because I really feel like as leaders, we have a personal responsibility to try to grow the people underneath us. And sometimes that means we grow them and they outgrow us and I think that that's a good problem to have. That means you're doing good in the world and what are we trying to do here? And you can't hold a meeting if you don't know what you're trying to accomplish.

Stephanie Goss:
And for me, that is the place that I settled that allowed me to sleep at night as a manager was to say, okay, even if I have a system and a structure and I have to live within this, my own personal drive for reviews was to look at how can I help grow this person? What are their goals? What do they want? And so, for me, it was about making it goal driven in whatever form that took with an individual employee because it actually allowed me a lot of freedom and flexibility to say, well, this person has professional development goals like, they want to become a certified tech. Or maybe there was something that they were working on that fit the ladder developmentally.
But it also allowed me the freedom and flexibility to take the people on my team who were like, “I don't actually know what I want to do.” Or, “I really love my job, and yet, I don't want to grow up the ladder, but I still want to learn.” Maybe it's about, I want to learn how to be… I mean, I had one of my team members who was CSR and she was older and I remember the first time we sat down and she said to me, she's like, “I'm probably going to cry.” And she's like, “But you asked me what my goal was going to be for myself in this next year.” And she's like, “I want to learn how to get faster with the computer.” She's like, “Because I feel like I'm always holding everybody up.” And it was so funny because everybody looked at her through that lens of she was the older person who didn't love the computers and she saw that in herself and wanted to fix that.
And it took huge cahonés for her to say that and be vulnerable. And I was like, “Oh my gosh, we can totally help you with that. That's a great goal. It benefits you because it's something that you want and you desire, but it also benefits the team as a whole. Hell yeah, let's come up with some goals around that and a plan to help you get better.” And what does better mean to you? How do we define that? It gives you that flexibility as a manager. And that was where I kind of sat with the whole process is like, how can we make this about where do people want to grow?

Dr. Andy Roark:
Yeah, I love it. I think there's three pieces to what we put into this evaluation, right?

Stephanie Goss:
Okay.

Dr. Andy Roark:
So when I'm putting together and I go, “What's going to happen in this evaluation?” So I've generally got an idea of what I'm trying to accomplish. I've been hopefully documenting behaviors that I want to talk about or things that I feel like are capstone moments for this person throughout the year. Three things. Number one, the questions to ask what I'm trying to figure out what they are. Because I can't tell you what they're, because they're different for everybody.

Stephanie Goss:
Sure.

Dr. Andy Roark:
I, Andy Roark as the leader, what do I want or need to know so that I can help this person to grow and develop? So what are those questions? What do I need to understand so that I can better serve you as a manager, as a boss, as a leader, as a grower and mentor of people?

Stephanie Goss:
What do you love about your job? What do you find most challenging about your job? What feels like the biggest success you've had in the last whatever time period?

Dr. Andy Roark:
Oh, and remember, I love positive inquiry. When you think back on the last year, what have been the highlights for you? When you think about the best day that you can remember working here, what was it? Tell me about your dream day. And again, I'm trying to figure out what you love. Why? Because if I know what you love, I can open up doors for you. I can put you in positions, I can give you opportunities that are going to make you happy. As opposed to being like… And we've all seen things where you're like, “I'm going to give this person opportunity.” And they're like, “Why did you punish me this way?”

Stephanie Goss:
I didn't want that opportunity.

Dr. Andy Roark:
I know this is the worst thing ever. I've had people on our team. I'm like, “You're going to do a one-hour presentation at the conference.” And they're like, “What did I do to you?”

Stephanie Goss:
Oh-oh.

Dr. Andy Roark:
I mean, you've got great things to share and I thought you would, and they're crying. And anyway, all right, what do I need to know so that I can support you? If I was getting evaluated, what would I want to have happen? It's the golden rule. And so, people are like, “What should we ask in the evaluation?” I would say, “I don't know. If you were getting evaluated, what would you hope that they asked you?” Or “What would you want to be asked?” And then, bam. And that's it. So part of it is give the evaluation that you would like to have. And that doesn't mean from a grading standpoint. But it's like, well, I don't know, evaluation should benefit the employee. They shouldn't be a punishment they have to go through. And so, it's the golden rule. If you were them, what would you hope happens at this evaluation?
And then number three, what would be beneficial to that actual person? And that involves asking them before the evaluation, “Hey, is there anything that you're hoping to talk about at the evaluation? Is there anything that you're looking for? Is there anything that you're going to want to discuss about the coming year?” And ask them. And they might be like, “Oh, I would like to talk more about opportunities for me to learn new skills that I don't have.” And I would say, “Great, I will look around. It will be top of mind for me. Maybe I'll try to get some ideas and then you can come and we'll discuss that then.” And then when they say, “Hey, in this evaluation in the next year, I would really like to do more of this. I'm not caught flatfooted. I've got some ideas.” I'll be like, “Cool, tell me more about what that means.”
And I can at least know what they're going to be interested in and just do a little pre-thought on what questions do I have for them? What do I need to understand to be supportive there? So anyway, just to summarize, what do I need to support this person? What do I need to know? If I was this person, what would I want to have happen? And then number three, just straight up asking them, what do you hope to get out of this meeting? And ask them ahead of time so that I can incorporate that into their evaluation. And I feel like if you ask yourself those three questions and you find that, you can figure out what questions to ask that are going to get you what you need. Between those three things, you've got a multi-hour evaluation session that you're never going to be able to get through anyway.

Stephanie Goss:
Oh, yeah. So the format that I ultimately kind of settled on for myself, and you have to make, find what works for you. For me, it was splitting it into three parts as well. The first was where have we been? So the look back. And when I say that, our natural human brain wiring is to go to the negative a lot of the time, and what were the things that stand out? Well, the things that stand out are the client who came into the lobby and got shouty, right? Because that's an event that triggered our brain. And so, when we look back, we often look for those negative things. And so, my own challenge for myself was that if I was going to put anything on the lookback list that was constructive or was a challenge for every one of those, I had to have four other positive landmarks.
So 4-to-1 rule. So for every five things that I looked back at, four of them had to be positive. And I mean really solid concrete examples, not just, “Oh, I said one negative thing. So now I have to come up with four good things to outweigh that.” Because I've been in that position in a structure where I felt like I had to say positive things just to say positive things. But I want to look back at the last year and I want to ask the team member to do the same. What was the last year like for you? And if we're doing our job and we have the documentation, you should have a whole notebook full of positive things that have happened over the last year. Let's pick out some of those highlights and look at it on a developmental curve.
Where has the growth been over the last year versus the last year has been not so great? Which is where review processes tend to focus, I think a lot of the time. And then the middle part is where are we right now? So current state, how are things going? How do you feel about your job? What do you love the most about your job right now? What are you finding most challenging about your job right now? Present state, how are things going? State of the Union on both sides. And this is a conversation, this is not, I've thought about all these traps to catch you in this conversation. It is about really how do you feel about your job? Are you happy? Are you not happy? And where are you going? And there's tons of resources out there for specific questions that you can ask your team in terms of one-on-ones and asking them how they feel about their current state at work.
And then the last part for me is where I try and spend the bulk of the time in a review, which is where are we going? Where do you want to go? What do you want to do in the future? Having it be as future-facing as possible, and looking at it very much from the perspective of what excites them? What do they love about their job? What do they want to do more of? And I love that you ask that question, how can I help them do more of the things that they love, Andy? Because that's really where you get the excitement and the enthusiasm and then the structure, having to set goals, make them smart, figure out how to check those boxes.
That becomes easier to do when there's excitement and passion behind, and a why behind it. If somebody feels like they're doing it just to check the box, you're going to get BS. It's going to be crap in and crap out. And so, for me, it's about what actually excites them about their job, and then focusing on the questions that I want to ask to unlock that and drilling down into their why.

Dr. Andy Roark:
Yeah, I agree with that. So quick pearls for doing these as well. So other things I want to put out, I agree with you and I are on the same page as far as figure out what you're trying to do. I liked your idea of past, present, and future. It's a good way to set and organize the thing.

Stephanie Goss:
The structure.

Dr. Andy Roark:
Yeah, the structure. It's a good structure. I like to sit and think about what is my purpose? What am I trying to create and accomplish here? That's just how my brain tends to work. I think you can put those two things together into something really beautiful and make something. Rules of thumb for me is ideally the person should not be surprised by anything they hear in the meeting. And if you're thinking about your structure and you're like, “Oh boy, they're not going to know that I'm going to say this.”
Then I would say, “Why haven't you communicated that to them before?” If you buy into the Andy idea of we talk about how things are going, not in a scary way, just in a matter of fact like, “Hey, I care about you. I want you to be successful. I want to support you. I'm really honest and transparent about what I need. I want you to be honest and transparent about what you need.” You shouldn't get to the evaluation and someone goes, “Andy, it's been a bad year for you.” And I'm like, “What? I know it's been a great year for me.” “No, it hasn't, Andy.” I don't want that, and nobody wants that. So they should not be surprised by what you're going to say. And if they're going to be surprised, then we have some communication challenges that have nothing to do with the meeting itself, and we need to work on that.
So number one, they should not be surprised. Number two, do everything you can to lower the stakes here. Try not to make this a big scary meeting that they're going to stress out about for a week. And they're going to walk in and their palms are going to sweat and their heart's going to race. That's not productive for actually accomplishing the goals that we talked about. If you're like, “I want to support and develop this person.” Okay, why don't you talk to them they're having a panic attack. That'll be a great approach to take. That'll really help. You're going to crush it, go ahead. It doesn't make any sense. So do everything you can to not make this scary. And the other way you do that is by not telling them things they don't already know.

Stephanie Goss:
Yeah. So what's your third? You said three.

Dr. Andy Roark:
Oh, so keep them four.

Stephanie Goss:
I've got a third.

Dr. Andy Roark:
Oh, well, I mean, I'll have a four if I want.

Stephanie Goss:
So, well, the last big thing for me that we haven't talked about is for most people, the point of doing this is because there has to be some sort of scorekeeping. There has to be some sort of metric. And so, for me, when it comes to thinking about the questions and even just making it, looking back at the past, looking at the future state and the present state, the question for me is what kind of metrics am I going to use? How do I know what success looks like there?
And I mean, even if you have to use a scale, and I've been there where it's like you get one point for this thing. Then work together to figure out what that success looks like so that you can define a way for them to know what the scale is and how it applies to them. Because that is one of the biggest sources of anxiety when it comes to employee evaluations, is feeling like you don't actually know what the scale is. And whoever's giving you your evaluation is making up the rules as they go.

Dr. Andy Roark:
I know, I love that.

Stephanie Goss:
So it's as simple as smart goal setting. If somebody says, “I want to become a licensed technician in the next year,” well, that's maybe not an attainable goal depending on where they are. But it's a great goal because you can absolutely work backwards from there and break it down into a smart goal format where it's time bound and you can measure it. Have they met or have they missed the mark for each one of those steps? And so, for me, that future facing is about, let's dream big, but then let's take some time. And I like to make them two separate meetings because then your point, you're not sitting in a super long meeting. It's like, okay, look, we're excited about these things. How are we going to get there? What is the actual goal going to look like?
And sometimes you have team members who come in right off the bat and they know how to do that on their own. And you're also going to have team members that have no idea how to make that actually actionable and make a plan. But for me, that focus, that excites me, that's my jam. I love sitting there and helping them figure out how are we going to do this? What is that going to look like? And how are we together going to measure this at the end of the time period next month when I ask you, “Hey, how's it going working towards the goal? What is the scale that you are going to grade yourself on and that you would be okay with me grading you on as well?”

Dr. Andy Roark:
Yeah. I think that's great. Jumping back to the original question, there was how do we do these evaluations? What questions do you ask? Who should answer the questions? And I think the implication here is if you're trying to get a complete picture of someone in their performance, do you just ask that person or do you ask other people? And the last question is, should management get evaluated? And so, let's go ahead. I would take five minutes right here at the end, Stephanie Goss, should management get evaluated?

Stephanie Goss:
Oh my gosh, you're going to open up another soapbox at the end of the episode?

Dr. Andy Roark:
We're going to hammer this out in five minutes. I think another episode of how should leadership get evaluated? I think it's a whole episode, but let's just lay this down real fast. On the count of three, let's both say whether or not management should get evaluations. 1, 2, 3.

Stephanie Goss:
Hell yes!

Dr. Andy Roark:
Yes. All right. Oh God, I didn't know how that was going to go. I was like, “This is going to be awkward.”

Stephanie Goss:
No.

Dr. Andy Roark:
No. The answer is hell yes. And why? Because go back to what I said. What's the point? If the point is to support this person and develop this person, I'm sorry. Would you like to have one of these mystery things that supports and develops? You would say Absolutely. And so, if this thing is meant to support you and develop you, then you would want one. And if you don't want one, I think that's a really interesting thing for you to stop and think about and be like, “I tell people I don't want an evaluation.” And I go, “Okay, well, maybe we should change the evaluation.” You know what I mean?

Stephanie Goss:
Yes.

Dr. Andy Roark:
And so, anyway, so the answer is if you buy into what Steph and I have been saying about evaluations, first of all, I hate the name. But if you buy into a personal development plan meeting, a personal development checkup or whatever, if you buy into that, then it's more important that leaders get them than anybody. It's like, you need feedback just like the employees do. We're all human, we all have big blind spots. We're all doing our best, but we can't necessarily tell how we impact other people all the time. And so, yes, absolutely, leaders should have them.
And so, then the question becomes who should do them and how do we do them? And I think that that's a whole other episode. My basic thing is this, remember why we're doing this, right? Remember, it's about mentoring people and growing people. It's about getting feedback. It's about getting some guidance in how we develop basic things. If you want to pull in guidance from other people on your team to help get a more complete picture, you can do that. I have seen people blow their faces off doing this. And I'll tell you what you're not going to do-

Stephanie Goss:
The 360 anonymous review.

Dr. Andy Roark:
That's exactly it. You are not going to do a 360 anonymous review. That's a terrible idea.

Stephanie Goss:
That's a horrible idea.

Dr. Andy Roark:
It's a terrible idea. It's a great idea. It's a terrible, horrible, in practice reality thing. People, it is awful, we don't have time to get into it. It's awful, don't do it. And Stephanie, you've seen me ask for evaluation in our team, and you kind of know how I try to get that feedback and you can comment about how well it works or whatever. But one of my true beliefs is if you are going to get feedback on other people on your team from their coworkers, or if you are the leader and you are asking for feedback, you want to ask in a way that minimizes the chances of bad behavior and unfair analysis and things like that.
And so, one of the quick ways I'll say that I do is I'm a big fan of what I call stars and wishes. And so I'll say, “Hey guys, I'm looking for stars and wishes on Stephanie Goss.” And stars and wishes means a star is, tell me what she's great at. Tell me what she does that you appreciate. Tell me what she's wonderful about. And then a wish is, what would you like to see Stephanie work on in the future? And those are the two questions. Tell me, she's great at, tell me what you love about her. Tell me what you'd like to see her work on in the future. Do not tell me about what she did last week. Tell me about the time that she hurt your feelings. That that's it, just tell me that stuff. And honestly, I have never done anonymous evaluations just because God, I hope that my people trust-

Stephanie Goss:
Oh, I hope it's an awful…

Dr. Andy Roark:
… I hope my people trust enough to say, “Hey, this is a concern that I have,” and it's up to me to be a good steward of their trust. It's up to me. I hope that anyone on my team who had a problem with someone else would come to me and say, “Hey, I'm having this problem,” or “This is a concern that I'm having.” And if they wouldn't do that, I'm like, “Oh man, I have not been doing a good job as being a steward of the trust of my team and I need to work on that.” So anyway, that's in a nutshell, those are my big takeaways on those sorts of other-person reviews.

Stephanie Goss:
I think that that piece needs to be very targeted and very smart in the questions that you're asking because that is the most dangerous part of the evaluation process. It's where I see it blow up every single time where it's blown up on me as a manager, having used that framework and where it has blown up on me as a team member. Giving people an anonymous open-ended source to be able to just vent. “Don't do it. Don't blow your foot off.” That's all I'm going to say. But it is an area where it can be really useful. You have to choose the right questions. And so, asking about things that are objective is the key here. Because if you are asking questions that basically allow people to not be objective and to let their feelings and emotions weigh into it, it's going to get messy really quick.
And so, asking things that are truly objective and measuring, weighing it within the context of the relationship, I need to know. And that's why I hate it being anonymous, because I might have a kennel team member that has worked with me one day in a whole year. I want to be able to hear what they have to say, but weigh that differently than the feedback that might come from you, Andy, where we've worked together as doctor and technician side by side, three days a week for the last 12 months. I want that to be able to have weight, and I can't do that if it's an anonymous system.

Dr. Andy Roark:
Yeah, I completely agree. All right, well, that's what we've got…

Stephanie Goss:
We've created four other podcast episodes for ourselves on this conversation.

Dr. Andy Roark:
A lot of ranting in this podcast. I hope that there were some good actual useful tips, I hope there was.

Stephanie Goss:
I have ideas for three different blogs.

Dr. Andy Roark:
We got that going for us and that's nice. All right, everybody.

Stephanie Goss:
Take care everybody. Have a fantastic week.

Dr. Andy Roark:
See you everybody. Bye.

Stephanie Goss:
Well, gang, that's a wrap on another episode of the podcast. And as always, this was so fun to dive into the mail bag and answer this question. And I would really love to see more things like this come through the mail bag. 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 mail bag at the website. The address is unchartedvet.com/mailbag, or you can email us at podcast@unchartedvet.com. Take care everybody, and have a great week. We'll see you again next time.

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: culture, management, review

Feb 09 2023

I Have the Most Highly Paid Staff and I Am Proud of It

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice manager Stephanie Goss are talking through a conversation they recently had with a colleague who wants to proudly raise their hands and shout “Me, me, me” when someone asks who pays their team more than anyone else in their area. And this practice owner was also asking how to do that while still not pricing their working clients out of affording their services. This was a spicy one full of strong thoughts from both Andy and Stephanie so let's get into this…

Uncharted Veterinary Podcast · UVP – 213 – Coaching Spicy Tenured Team Members

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


Do you have something that you would love Andy and Stephanie to role-play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag!

We want to hear about your challenges and would love to feature your scenario on the podcast.

Submit it here: unchartedvet.com/mailbag


Upcoming Events

TEXTING IT TO THE NEXT LEVEL with Maria Pirita

If you've ever been misunderstood through text messages – this workshop is for you! Using digital communications like email and text is without a doubt extremely efficient, but written messages can often be misinterpreted. There is also a perception that text communications feel less personal. This doesn't have to be the case!

In this workshop, Maria Pirita will be giving you techniques, tips and tricks that will take your texting to the next level! You will learn the benefits of text communication, a comprehensive list of do's and don'ts when texting, and formulate a protocol that can be adopted right away in your practice.

When: February 15, 2023, 8-10 PM ET/5 – 7 PM PT

April 20-22, 2023 – The Uncharted Veterinary Conference

Climb aboard with members of the Uncharted Community and our sea-worthy crew for a new adventure in veterinary medicine April 20-22, 2023 in Greenville, SC. 

Get ready to explore new harbors together in overcoming digital communication pitfalls, developing resilience in an emotionally taxing field, and focusing on communication to build a positive team culture.

All upcoming events

A UVC MEMBERSHIP IS YOUR KEY TO FINALLY GETTING THINGS DONE AND GROWING YOUR VETERINARY PRACTICE.


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 continuing a conversation that got started with a colleague about how do we have the most highly compensated team in our area, and how do we do it simultaneously while still providing services that the working class families who come to us as clients can afford. This one was so fun. There is definitely some soapboxing from Andy and I, about a couple of topics, but I think we both really enjoyed getting into this in the meat and potatoes of it and talking with all of you about what we can do to leverage our teams and get the most out of the team as a whole, so that the techs in particular and the patient care team can help produce revenue for the practice and raise the pay ceiling for everybody. Let's get into this, shall we?

Meg:
And now, the Uncharted Podcast.

Andy Roark:
And we are back. It's me, Dr. Andy Roark, and Stephanie I have not remotely thought about what her nickname is Goss.

Stephanie Goss:
Talk about me about being unprepared.

Andy Roark:
Yeah, oh, and I was so relishing just going, are you ready yet? I'm going to hit record, are you ready yet? And watching you flail around that I completely forgot what my role was when I hit record. No, that was on me.

Stephanie Goss:
Karma.

Andy Roark:
Yes. That was 100%. It's 100% karma. It's absolutely on brand for right now, too. We're recording this the first week of the year, and the first week of the year is the Monday of the year.

Stephanie Goss:
Uh-huh.

Andy Roark:
You know what I mean? It's a week, maybe more of just consecutive Mondays because everyone's like, “Oh, crap. Let's be honest, we took most of the last month off.” All those things you were like, “That sounds like a 2023 problem.” They're all waiting-

Stephanie Goss:
Now, it's 2023.

Andy Roark:
… right here and it has been.

Stephanie Goss:
Oh, man it's so-

Andy Roark:
It's been absolutely bonkers.

Stephanie Goss:
It's so funny because you called me, and we were talking on not Monday. Yeah, on Monday, Tuesday, I don't know, beginning of the week, and you called me, and I had to take a breath because I was right in the middle of something and you're like, “Are you okay?” And I'm like, “It's a Monday.”

Andy Roark:
Yeah.

Stephanie Goss:
Because it is like my desk is covered in crap. There's a to-do list 10 miles long. I need time to just organize before I can even set my thought train on the tracks.

Andy Roark:
Well, I was like, “I'm going to use the last week of the year to clean out my office and get it all ready.” And I did the whole job where you get all the crap out and sorted into piles. And then, I ran out of steam-

Stephanie Goss:
And then, you put it back.

Andy Roark:
… and now, my office is unusable. I'm starting the year with a worse office than I had before because it's filled with the holy crap-

Stephanie Goss:
You and I…

Andy Roark:
… it's neatly sorted. But it did not get put away after I got it all out, and I emptied all the drawers out, and now, they're just sitting on top of the desk. I'm doing that.

Stephanie Goss:
You and I are so alike. Sometimes it's funny, not funny because a lot of the time, I have my camera with a blurred background on our meetings because my office is my master bedroom closet. And so, I'm in a tiny corner of the main bedroom closet and there's clothes all around me. And so, normally I have my background blurred. But this week, I have had it blurred for the same reason as you because I did the same thing. I'm like, “Oh, I'm going to clean, and I'm going to organize the things.” And I pulled everything out and now, there's just a pile. Like you, it's organized piles of crap. But there are literally piles of crap stacked up a waist-high behind me because it's a tiny little closet.

Andy Roark:
Oh, it's really-

Stephanie Goss:
Don't work for it to go.

Andy Roark:
… If you ever hear me talking about Stephanie Goss coming out of the closet, you'll think we're done podcasting. That's it. That's all it means. So, ridiculous.

Stephanie Goss:
Oh, man. Yeah, it's the beginning of the year.

Andy Roark:
I have a coping mechanism though. It's not healthy. But it's-

Stephanie Goss:
Oh, yeah?

Andy Roark:
… it's working for me. Yeah. Allison got me an espresso machine for my birthday. Remember that?

Stephanie Goss:
Yes.

Andy Roark:
I'm sucking those things down.

Stephanie Goss:
Just making more espresso.

Andy Roark:
Yeah. It's like it's water. And that's how I have made it through the first week of the year. It's going to be bad. I'm going to have a problem. I realized they make… The espresso people were like, “Oh, this is for people who sip coffee.” And I'm like, “I do not sip-“

Stephanie Goss:
I gulp.

Andy Roark:
… I don't say I don't sip. I do not sip.

Stephanie Goss:
So, what I hear you telling me is that I'm going to be waiting outside the men's room more frequently at VMX than normal because you normally already have to pee after coffee-

Andy Roark:
Yeah, totally.

Stephanie Goss:
… because you drink so much.

Andy Roark:
Yeah, I'm going to need… I don't know what the espresso to run-of-the-mill coffee translation is. I can be at liters now. I have no idea how much what my caffeine intake is. I drank too much yesterday. I felt my heart was going to explode. I felt awful. I had to ratchet back. Just in the middle of the day, I was like, “I feel horrible, horrible.” And I was like, “I can't see this again tomorrow.” So, I only tried two-

Stephanie Goss:
We have half-caff.

Andy Roark:
…double espressos.

Stephanie Goss:
We have-

Andy Roark:
Yeah. I-

Stephanie Goss:
Two double espressos.

Andy Roark:
… I only drink two double espressos, and now, I have a headache.

Stephanie Goss:
We have half-caff Andy for the podcast today.

Andy Roark:
Yeah.

Stephanie Goss:
Oh, man. Okay. Well, this one is a good one. You and I were having a conversation with some of our friends recently, and we were talking about team compensation. And where the conversation started going was in a really good direction, and I'm excited to talk about this with you. So, we had somebody who was saying, “I want to pay my team really well.” In fact, a goal for myself is to be able to say that I have the most highly compensated team in our metro area, right? I want them to have good pay, good benefits, feel good about where they're working. That is a goal for me as an employer. And at the same time, as a business owner, I want to make sure that I'm not pricing out the working families who are our client base from affording our services.”
And so, the conversation was really about how do you get the most out of the team? How do you leverage the team so that they are producing revenue that is helping raise the ceiling, particularly when it comes to team wages. And I just thought this will be a lot of fun to talk about on the podcast.

Andy Roark:
Yeah, no, I definitely agree. So, I super love this. I love this mentality. I've been thinking a lot about business in America in the last year, which sounds crazy, but it's true. I've been thinking a lot about business in America, and I consider myself to be a capitalist. I like the idea of people who work hard, get rewarded, and you take risks. And as a business owner, it makes sense to me, and I do like it. But I don't like all the ways that capitalism has manifested and has come to manifest in our country with this idea that capitalism means maximizing shareholder value. And when you have publicly traded companies, what that means is the job of the CEO is to make the most money for the people who own stock possible. And I go, “I don't think it has to be that way. And that's not what I aspire to.”
I think there's something really beautiful and wonderful about saying I own a business, and the goal is for me to get my needs met and to create a workplace that I'm happy to be in, and that I think other people are going to really love working in. And to pay the people who work with me really well, so that they have a good life, and they have income, and they have a nice positive environment to be in, and they feel like they're working with friends. I think that to me, that's the goal. That's the aspiration. It's not the maximize, maximize, maximize dollars to the stakeholders like that.
Anyway, that's just a bigger philosophy for me. But when I see this question, really, I just love it so much because it really speaks to what some of my values are of like. I want people to say, “Wow, that guy pays more than and pays better than anybody else.” I love that. I want that reputation. That's great. And I think it's great for us to aspire too. And so, then, you start to look at the nuts and bolts and you say, “Well, yeah, how do we actually do that?” And so, that's what I'm looking at today, and I start to think about this. When we get into headspace, and we start talking about things like this, and the question is really how do I use my technicians, so that we can produce the revenue that will raise their income. There's a couple caveats we have to put on the table up front.

Stephanie Goss:
Okay.

Andy Roark:
And some big things to just think about before we start talking about possibilities here is, number one, I believe that the future of vet medicine is fragmentation, right? And what that means is there's not our right way to practice medicine going forward. I think that when you look ahead at that medicine in 10 years, you are going to see a wild hodgepodge of different types and styles of that medicine that is just mind-blowing to anyone who's traveled here from the past 30 years ago when there was a basic… This is generally how we do vet medicine. I think those days are over, and there's just going to be a wild variety of ways that people are delivering services to pet owners.
So, when we start talking about these, no, I'm not saying that everyone should do them, and every practice is going to be different. And I think ultimately that's not a flaw, that's a feature. There will be people who just say, “We practice white glove, gold standard of care all the time.” And there'll be people who say, “We do high volume affordability focused medicine.” And there'll be people who say, “I'm a mobile vet, and I have one technician, and they work full-time with me,” and they'll be someone else who says, “I'm a virtual vet, and this is how I interact with technicians who are spread across the country.” And none of those are wrong. They're all just really different.

Stephanie Goss:
Yeah. No, I agree with that 100%. And I think we're starting to see that already like this. And that's one of the things that I think you and I do a lot, especially, lately on our personal views on social media, but one of the things that I love about social media is I really enjoy seeing the differences in our practices and seeing those different styles. And I tell you, there'll be times where I am scrolling through some hashtags on Instagram and I see what some practices are doing, and I see what their look is and how radically different it is compared to the practices that I have practiced it in. And the first thought in my head is, “That's freaking cool.” It's not, oh my gosh, I want to compete with that. That's really cool. I love what they're doing. I don't necessarily want to do that, but I think it's freaking awesome. And I think that there's a place for it with not only our clients, because we're not one size fits all. There have always been room for us to create our own cultures that are fit for client, also, let's think about it from the team perspective way to create different environments that suit different people in different ways. I just think it can only be a win I feel for veterinary medicine.

Andy Roark:
Oh, sure. I just want to put that forward because I know it's really easy. I've walked into lectures before and people say, “Well, this is what you do in your practice and blah, blah, blah.” And they go, “That's not what I'm doing.” And that I don't-

Stephanie Goss:
That's what you can't do in your practice.

Andy Roark:
Exactly. And so, I just think it's good too upfront to say, “We're going to talk about what's possible here, and know that it is not my belief that this is what everyone should do or where everyone is going.” And so, it's just… I don't know. This is going to be one of those buffet podcasts where it's like you need to walk along, you look at everything and maybe you'll pick up some things and maybe you won't pick up other things, and that's okay. This is what Andy and Stephanie think it should be-

Stephanie Goss:
It's the right answer.

Andy Roark:
… to have technicians, and this is the right answer. Yeah, totally.
So, yeah. I just want to lay that stuff out.

Stephanie Goss:
Okay.

Andy Roark:
There's some sacred cows that we're going to poke in this episode as well. And what I mean by that is these sacred cows are things that people believe you can't change that, you can't do that. That's not how it is. And I think it's important for people just to know, you need to think about what your sacred cows are when it comes to leveraging your staff. And the reason I say this is because a lot of us came up in vet medicine over the years, and there was a way that we worked, and there was a relationship that technicians had to clients and their assistants had to clients, and there were things the front desks did and ways that they did, and that was just how it was.
For example, some people really felt strongly that receptionists needed to be in the building, and that's not true. But to me that was a sacred cow is like, “Wait a second, the person who checks the pet on or out is not in the building. You can't do that. Yeah, you can. We have hospitals in Uncharted that do it. They have screens on the wall and credit card readers, and they have employee working from home with a logo of the hospital behind them. And that person just pops up on the screen in the exam room and checks the client out right there, and they work from home, and you go, “That's bonkers.” It wasn't that long ago the idea of an offsite phone center or phone room was just completely ridiculous, and it was heresy. It was like, “No, you can't have people who aren't in the building because they don't know what's going on.” And you say, “Well, that's not true.” And just because it's how we've always done it doesn't mean we always have to do it going forward.
And then, moving that closer to the topic at hand is the way that we use technicians and technicians the way they work under doctors. And you say, “Well, just because technicians haven't had autonomy before does not mean that that's not something that can't happen or can't be done very differently than what you've seen done before in your career.”

Stephanie Goss:
Yes. And I think for me, from a headspace perspective, it starts… I'm glad you talked about poking the sacred cow because that was a big sacred cow at the top of my list. And I think from a headspace perspective, I think we have to think about what are our limiting beliefs. And when I first started in veterinary medicine, and I feel really old at this point because it's been a lot of years.
Well, I think about when I started in veterinary medicine and the pervasive thought process was the veterinarians went to school, and they have the degrees, and they're the ones who generate the money for the practice. And that is still somewhat of a sacred cow in a lot of practices. And I think that it is, when it comes to this conversation, is very much a limiting belief.
And so, that's the first cow is who makes the revenue for your practice. And I would argue that in a lot of practices, even a practice where the primary revenue driver is, a doctor, there are things that if you really sit back and look at it. There is revenue that is being generated by the paraprofessional members of your team. And so, for me, it starts with what limiting beliefs might, I personally, might we, collectively as a team, might we, including our clients have about who actually generates revenue for the practice.

Andy Roark:
Yeah. Well, it's this basic idea that the technicians are backup dancers to the doctor.

Stephanie Goss:
Yes.

Andy Roark:
And that's how it's always been.

Stephanie Goss:
Right.

Andy Roark:
And the truth is that technicians can have their own show, and pet owners can be excited about that show.

Stephanie Goss:
Absolutely.

Andy Roark:
And it doesn't detract from the veterinarian show, it's just a different show. And I don't know about you. I watch more than one television show at a time, and sometimes, I need different things. Anyway, I don't want to stress the metaphor too far, but that's really the way that I think a lot of people have looked at technicians. If they're the backup dancers, and I, the veterinarian, and the main attraction, and I'm what people buy tickets to see, and I'd say, “Ah, I get it.” And that is how it used to be. It really is how it used to be. I don't think it's that way anymore, and I don't think it should be that way anymore. And I think our education system, the way we educate our techs has changed and continues to change in a way that makes that not necessary anymore.
And I would say that that model doesn't scale especially, when there's a shortage of veterinarians which means, if you can have a bunch of backup dancers, but you can't get a veterinarian to lead the show, then you're done. You're toast. Your business can't grow. The number of pets you can see is limited in that model. And so, I think starting to work through and say, “Okay, let's do this a little differently. Let's look at our technicians differently.” That's the sacred cow that you have to kill that cow in order to move into new pastures. I've lost my way on this metaphor to kill the cow, to take its pasture. And yeah, anyway-

Stephanie Goss:
It's just all Barnyard Math. It's hard at this point. Okay. So-

Andy Roark:
It's a murdering bloody barnyard-

Stephanie Goss:
So, we-

Andy Roark:
… metaphor.

Stephanie Goss:
We have to… I think the headspace has to start with poking some cows, which I love, and also, looking at what are the limiting beliefs like what do we think is possible or not possible, and then, can we flip those thoughts upside down, can we turn them sideways, what does that look like, and I think that's a big part of the headspace.
And I think the other piece of it going back to your thought about fragmentation is coming to the conversation, coming to this, even if it's a conversation with yourself in your head at this point, coming to the table with what could we do with the idea that if we just sit here and hallucinate for a second, what could be possible? How do you think that fragmentation has started to occur? It started to occur because someone had the idea, what if we had a model where we go to people's homes and we perform euthanasia at their home instead of them bringing the pets to the clinic? What if we had a model where we offered clients services that they might want while they waited for their pets at the vet? What if we combined two things together? What if we had a model that brought funds? There's a bunch of different things that people are doing, and it started with them not putting the stealing on themselves.
And so, from that perspective, I think the other big piece of headspace is let's just sit for a minute and think about what is possible. Because there's a ton of different things that we can do. And I'm excited to talk about the action steps here. What can we do? Where can we try and drive the revenue to answer the original question, which is how do we do things to help raise the ceiling? But I think a big part of it is about, let's think about what is possible.

Andy Roark:
Yeah. Yes. Let's think about what's possible. And some people are not going to like all of these things, but they are out there, and they are happening and there are things that we should start to tinker around with. This is why I said at the very beginning, some people are not going to be for them all the times, but when I start to look at the way that I see, not imagine, but the way that I see practices across the US and Canada using technicians, it varies widely in what people are doing and everybody's in different places. So, the most basic thing is tech appointments. And it blows my mind that some practices still don't offer technician appointments where people make an appointment to see the tech and not to see the doctor. Again, that's just the most basic level of like, “Okay, that's the first step in breaking your techs out.” But then-

Stephanie Goss:
Wait. But it blows my mind even more that there are more clinics that are doing tech appointments and not actually charging for them. So, they're offering it. They're offering it as a service, service for their clients, but they're not charging for the tech's time the same way that they are for the doctors.

Andy Roark:
Yes.

Stephanie Goss:
It blows my mind that this is still where we're at as an industry.

Andy Roark:
But that's a sacred cow problem. Somewhere at some level, I'm not a conscious thought at a subconscious level, someone's like, “We charge for doctor time. That's what our business is.” And I'm like, “I get it, and I know that that's been cooked in, but that's like, check your biases now because that doesn't make any sense.” But again, a lot of people, I think you're exactly right as they do these things and they're like, “Oh, we don't charge for that.” Look, we see the salaries of technicians going up and they should. Do some basic math. What does it cost? You're paying this person for an hour of their labor. What do you need to earn from pet owners in order to justify that salary? And how do you make it so that person earns that amount or brings in that amount?
So, it's got to work for everybody. But just the idea of like, “Oh, we don't charge anything for our techs, but we want to pay them a good salary, or we need to pay them a salary to retain them.” They go, “Well, that doesn't work.” But it's just starting to get out of there. I mean, technician productivity tracking I think is so important in the future. I'm amazed by how little of this we see.
The PIM systems, they really need to make it easier to look and be able to sort and say, “This doctor did this with this technician. And being able to sort well and look at your productivity by technician. That's how we look at our doctors.” And again, if we want to make our technicians productive and to pay them, and you and I have talked before in episodes about paying technicians on productivity, and you go, “Well, it works for doctors. Why is it taboo to talk about it for technicians and so…” But the first thing is that is you've got to measure it. You've got to see what your technicians are doing for you and come up with ways to do that.

Stephanie Goss:
Yeah and-

Andy Roark:
There's a…

Stephanie Goss:
… I would argue that that's actually not a technology problem. The technology is there. It's a sacred cow problem. It goes back to not charging for the tech time. We are choosing not to look at it collectively from a management perspective. The technology is there. I had that structure in my practice. We could tell you which technician, which assistant, who was in, what was in, who was in which exam that we could tell you time, we could tell you their production, all of those things, the technology is there, and it's been there for a long time. It's a sacred cow that it goes back to your thought about the vets are the lead singer and the rest of the team is the backup dancers. And so, we're consciously choosing not to set ourselves up for that kind of success. And I think that's the limiting belief. That's this we need to slay that cow and poke that there because it's not-

Andy Roark:
Display that cow for that. It's like old McDonald's farm up in here.

Stephanie Goss:
I can't. I need to say something about poking the cow, but I just said slay the cow so, I'm going to throw bears of this.

Andy Roark:
Slay the [inaudible 00:24:57] just slay, that cow-

Stephanie Goss:
It's barnyard.

Andy Roark:
It's barnyard. All right.

Stephanie Goss:
This is just going to be one of those podcasts.

Andy Roark:
Yeah, no, yeah. We're going to get better as the year goes on. It's just January. We're just breaking the ice. We're just getting loose for 2023. There's a company called BoosterPet out in Washington, state of Washington, something near you. And I don't know if you've seen this, but I actually did an interview with the founder on the Cone of Shame podcast that I do. And when COVID started, there were some changes to the patient client, patient, client, veterinarian relationship to help with virtual visits of things. And this person has started a practice where she opened up…
Basically, it's satellite practice, it's a wellness practice and it's staffed by technicians only. And there are big screens in all the exam rooms, and the doctor pops in virtually. And the whole practice is staffed by technicians. There's no doctor on site. That doctor appears in the room virtually, communicates with the technician who's doing the examination and the history, and they can back channel, communicate. They can go back in the treatment room and talk to the doctor privately, but they've got a doctor working virtually that's seeing all the rooms at this satellite practice. And there's no doctor there. It's only the techs. And the techs do everything, history, physical exam, vaccines, all the stuff.
The doctor appears on the screen, the technician and the pet owner are together, explain to the doctor what's going on. The doctor can see everything the tech has put into the medical records, and that's how they roll. And they turn appointments around, and they have online scheduling for the pet owners. And anyway, it's bonkers. If you want to learn more about that, keep an eye out on the Cone of Shame Podcast when that episode comes out. But again, this is not tech appointments. Every appointment is a tech appointment with the doctor coming in virtually to consult, to validate, to take a look at things. They've got video otoscopes where the tech can show the doctor what you need here and things like that. Okay, go.

Meg:
I love it so much.

Andy Roark:
It's incredible.

Meg:
I mean that-

Andy Roark:
I mean, incredible.

Stephanie Goss:
… that talks, that goes specifically to talk about two pieces, right? That is poking a sacred cow in multiple ways. The techs are in charge, the doctor is now the backup dancer, really in the sense that the techs are leading a show and they're running the thing, and it's poking some sacred cows in terms of technology that is highly, that is leveraging technology on a whole other level like I'm here for that kind of stuff.

Andy Roark:
It is, but it's not. Really at its essence, it's a Zoom call. I mean, it's not radical. I mean, I'm sure they have a fancy medical system that does it and its basic level. It's a Zoom call that we use all the time. And then, the otoscope, plenty of us have had video otoscope, that's not new. It's just the video's getting displayed 30 miles away-

Stephanie Goss:
But that's what I mean. That is taking that and turning that on its head, because that is the example where lots of people would look at that and be like, “That couldn't possibly work,” right? Because we can't think beyond a doctor has to physically be on the premises for us to practice medicine. That is a core foundational thing for veterinary medicine, and that is poking a sacred cow in a big way.

Andy Roark:
Yeah. Well, I like that you said technicians is, or the doctors the backup dancer. And that's another thing that I see that a lot of practices do as well is are you endorsing your technicians. Are you highlighting your technicians? Are you facilitating relationship building between the pet owners and the technicians? And again, I'm not saying you have to. I'm not saying that has to be your model, but there are a lot of practices that do. Well, I mean, if you're a-

Stephanie Goss:
I'm going to say you have to.

Andy Roark:
No, but I don't agree. I don't agree that you have to. I don't. In that, if you are a high volume, low-cost practice, it's about getting people in and getting them out and that relationship center maybe not-

Stephanie Goss:
[inaudible 00:29:26] to that.

Andy Roark:
It's necessary there, but I would say the advantages of this are pretty significant and substantial. So, one, it's good for the technicians having people request the technician that they want to see. That's good for your business, it's good for your practice. It builds that relationship. And the other thing is you're a doctor. See, I think initial reactions from doctors that I talk to are usually they recoil and go, “Oh, no, I'm the one.” It's a little jealousy, right? It's a little bit of jealousy.

Stephanie Goss:
It goes back to your metaphor about the doctors being like fighter pilots. There's jealousy there. It's like there's a… They're the head honcho. They're the big man on campus and they're definitely-

Andy Roark:
They're the lead singer.

Stephanie Goss:
Yeah.

Andy Roark:
They're the lead singer. What do you mean? They don't want to see me. They want to see someone else. So, they recoil oftentimes. Sometimes they stay recoiled, and they're just like, “Nope, my ego can't handle this, or this is just not the practice I want to work in.” Which is fine. I'm not going to argue it. Like I said, there's a lot of a pass.

Stephanie Goss:
That's a form of fragmentation, really. There's a place that fits. If that's how you feel, there's nothing wrong with that. There is a practice for you that isn't model.

Andy Roark:
Well, imagine for a second that… And again, just put people's fears at ease when we talk about things like this but imagine for a second that became the norm. You better believe that there would be practices that would then say, “At this practice, you only talk to the doctor.” It would just like, “It's not,” and you're not going to get exile.
No. It's never going to be like, “I don't want to talk to the doctor.” It's not going to happen. But what often brings doctors around is this idea of like, “Hey buddy, think about what you do with your day. Think about how much communication you do. How nice would it be if the pet owner knew someone else at the practice that they felt comfortable with and connected to? How would that be good for you as you try to get through your day and get things done?”

Stephanie Goss:
I'm going to maybe blow some doctor minds for a second because I want you guys to hallucinate with me for a second. So, Andy, imagine that you'd been seeing a full… Your Dr. Andy hat is on. You've been seeing a full day of patients. And imagine instead of having to end each exam with, you're still going to ask them what questions, “Do you have that we haven't answered? Is there anything else?” And to be able to say, “We're going to have follow up on these labs.” Stephanie's my technician today, her info is going to be on your invoice. She's going to give you a call, or someone on the team that she's talked to is going to give you a call in a couple of days when the lab work comes back, and this is the plan.
And then, now, instead of the stack of all of those calls that have come in from clients who are like, “I have a question for Dr. Roark. I was there two days ago, and I have questions that I need to ask him questions.” Instead of dealing with all of that, you have offloaded a lot of work when it comes to client communication off of your plate. And you're empowering your team to take the lead, to take an interest in their cases. You are creating a patient and client bond for your team as well. And let me tell you, it is a game changer for everybody.

Andy Roark:
Oh, absolutely. No, that's it. That's what we're talking about, right? It's setting expectations. It's just thinking creatively about like, “How do I spend my time, and what can my technicians do to help me? What are services of value?” And you say, “Well, how does the technician doing these callbacks? How does that increase their value? Because they're not seeing patients.” And I would say, “Well, if your doctors aren't doing this, they should be able to pick up more… There's other things they do with their time.” They're either adding more appointments because they're not having to do this maintenance and the communication. Let's be honest, it's hard work. It's mentally draining work. Is that client communication? It takes time and effort and mental energy. And so, you can possibly pick up more appointments, but what's more likely is you're probably spending a little bit more time with the clients that you have. You're probably recommending that dental cleaning when in the past you would've said, “Those teeth are… they're okay for now, and I don't have time. I'm running behind. I'm just going to say this is good enough and go on.” Which of course, no one ever has thoughts like that when they're busy.

Stephanie Goss:
No, never.

Andy Roark:
But yeah. You get it.

Stephanie Goss:
Well, and also, they're generating the revenue that didn't get generated in the exam room. So, how many times have you, Andy, had a conversation with an owner and you're like, “You know, we really should do a dental, and there's all like this. There's five other problems. So, let's start here.” And when you build the relationship for the technician to then be empowered to have the follow-up with the owner. When the owner calls in and has the questions, and the technician or the assistant can spend the time on the phone with them that you didn't have in the exam room, and they can answer those questions. And now, the recommendations you made that were declined the first time, they're generating that follow-up revenue because now, they have answered Mrs. Smith's questions and now, she's going to bring Fluffy back to do X, Y, and Z that was recommended, that was declined at the first visit.
So, you, as the doctor generated the idea of that revenue and your recommendations as you should from the medical perspective. And the revenue still walked out the door when Mrs. Smith left that day. And it's being generated when the team has that follow up and says, “Well, it looks like in the chart Dr. Roark was recommending that we do this and this. What questions do you have that I can answer for you about those recommendations?” And when they get Mrs. Smith back in the door, that's revenue that is coming back in the door that wouldn't have necessarily come back in the door otherwise.

Andy Roark:
What do you think about tipping the team? Talk about sacred cow. People recoil from that. There's not many places that I go now that don't ask for you to tip the staff, and I'm not saying I agree with it. Okay. So, the most benign example is there's numerous counter service restaurants that I go to where I stand at the counter and I order the food, and then, they call my number and I come and get the food. And they still ask me for a tip, right? When I swipe my card, they're like, “Would you like to give us a tip?” And I'm like, “A tip for what? You made the food.” But then, I press $1 every time because I don't want to be a guy like, “Oh, well, I'm trying to help these guys doing the work, share the wealth and just…” I'm fine, especially, I don't want them to spit my food, so I'd give them a tip, but there's that. But then, if you get a massage, you get your haircut. I go and get my haircut and they're like, “This is what a haircut costs.” And I'm like, “That's ridiculous. I'm not that old. I remember when the haircut was 10 bucks, and then, I'm like, “This is what a haircut cost-“

Stephanie Goss:
I was waiting.

Andy Roark:
… are you freaking kidding?

Stephanie Goss:
I was the waiting for the walking backwards uphill both ways in the snow with no snowshoes on story. I was waiting for it. Okay. It's haircuts. All right. This is where we're at.

Andy Roark:
So, that means, I know I'm not the only one who's had this experience. But anyway, you've just get the haircut and they're like, “The default is a 20% tip.” Which is like $8, and I'm like, “An $8 tip on a $35 haircut which there's no hard cost. It's just you and some scissors.” But it's the norm, and it's clearly been normalized, and people clearly give tips. And so, anyway, I'm kicking those things around. I do escape rooms with my wife and they're like, “Oh, it's not cheap to go book an escape room. But then, when you're done, you better believe they're going to ask you to tip the staff who was involved and gave you the lecture and blah, blah blah.” And I go, “Man, I'm not arguing whether or not this is how society should be because that doesn't make any difference.
But I do look around and at some point, you say, “Is tipping for service ubiquitous in our society?” And if it is, is it ridiculous to allow not let me own courage, but just facilitate pet owners tipping the technicians and receptionist, the support staff for the extra care? How many people who have hospitalized pets and feel the support staff did-

Stephanie Goss:
Go above and beyond.

Andy Roark:
… an amazing job, above and beyond how many of those people would be like, “Here's 100 bucks for the staff.” And again, I'm not really endorsing this. But I am honestly, I need to think about it more. But again, sacred cow, you go, how dare you tipping for a medical service that's heresy. And another part of me goes, I mean, I don't know. It seems pretty standard. It's pretty easy to do when people are paying with credit cards. They can decline the tip if they want. Is this a thing? And I honestly asked the question, what kind of revenue would that be? I'm sure people have done it. I'm just curious. Are we talking about, is that $500 a week for the whole paraprofessional staff, or is that $500 a day for the whole paraprofessional staff that worked? Or is it more than that? I have no idea what we're talking about. But I don't know. Again, I'm not endorsing it, but if a lot of other industries are using tipping to supplement the income of their frontline workforce.

Stephanie Goss:
Yeah. It's an interesting argument for sure.

Andy Roark:
I'm honestly not pushing forward it. I'm asking-

Stephanie Goss:
Yeah, it's a good question.

Andy Roark:
… I'm asking a question.

Stephanie Goss:
It's a good question. It's a question to ask.

Andy Roark:
I'm surprised I haven't seen in that mess, yeah.

Stephanie Goss:
Because it is a sacred cow for sure. It is one that's worth poking.

Andy Roark:
Yeah, [inaudible 00:39:47]. All right, let's take a break, and then, we'll get back and we'll just get into some extra stuff real fast.

Stephanie Goss:
Okay.
Hey, it's Stephanie, and I'm jumping in here for one quick second because we have a workshop coming up next week that you are not going to want to miss. Our friend and colleague Maria Purita CVPM is going to be leading a workshop that is open to the public and to our members on February 15th, 2023. It is at 8:00 PM Eastern, 5:00 PM Pacific, and it is called texting it to the next level. That's right. Maria is going to be tackling, talking about some of the dos and don'ts when it comes to texting with our clients, and really how to take what we all jumped in and started doing full tilt during the pandemic and use it to level up and build a stronger bond with our clients without lengthy phone calls. And hopefully, save you and your team some headache and some time and some stress and recoup that time back into your day.
So, if this sounds like something you'd be in on, head on over to unchartedvet.com/events. Check it out. If you are a member, you always get in for a free. If you're not a member, you can join. It is $99 for this workshop or check out an uncharted membership because you get all of the workshops that we do in the course of the year at no additional charge with the cost of your membership. So, check it out, unchartedvet.com/events.
Now, back to the podcast.

Andy Roark:
All right, let's get into action steps-

Stephanie Goss:
Okay.

Andy Roark:
Sound good?

Stephanie Goss:
Yes.

Andy Roark:
All right. I've got three major categories. I think there's three levers you can pull if you want to set your technicians up to generate more revenue, okay? So, you can make them more effective in their current role. You can free up their capacity so that they can get more done, and you can add new services that they can perform to generate revenue. Those are really the only three. I have a fourth one that we can change the relationship that our paraprofessionals have with the pet owners, but I think that falls under making them more effective now. Does that make sense?

Stephanie Goss:
Uh-huh, it totally does. So, I agree with that, and I'll roll it back one step further so zooming all the way out and looking at the question of how do I get the most out of them, so that we're producing revenue and we can raise this. How do I raise the ceiling on staff wages when we zoom all the way out? We look at it from a business perspective. This is a simple math problem because we can control our pricing, we can control our volume of patients that we see, and we can control our costs in other areas or some combination of those three things. But from a business perspective, that is how we control the revenue that is being generated from our practice. And so, I think it has to start with looking at those three things and figuring out what amount of pressure are we going to apply in which category.
And there is a school of thought that's like, let's just cut our other costs. At some point, we can only be efficient and effective… At some point if we cut everything off of our shelves, we don't have the tools we need to do our job. So, when you look at each of these, and I think that's why I love the question that got asked in the conversation we had because this practice owner was like, “I'm acknowledging that. Yes, I need to be pricing appropriately because that's one of the three options. And if I solely leverage the increase on pricing alone, at some point, I will price clients out of my services.”
And this is a core value. We want to serve the people that we are serving. And so, I know that that can't be the only lever that I am pushing on. And so, how do I take those three things, the pricing, the volume of cases we see, the cutting costs, and then, looking at those three things and deciding where I'm going to apply pressure and in what combination, then how do we roll it down at the next level, which is your level of what do we do with the team, and where can they help us apply pressure on those three levers. Their efficiency, their effectiveness, those things directly influence those three levers above in terms of pricing and volume and cutting costs.

Andy Roark:
Yeah. If you're interested in that type of cost cutting, pricing, things like that, I just did. It was the last episode of Cone of Shame Podcast of 2022. So, it was like December 27th or something. It's called the Art of Pricing Veterinary Medicine, and I interviewed Fritz Wood, who is, I a mentor of mine. He's amazing. But you want to hear a 40-minute conversation on, basically I said, “Pretend I'm a practice owner who's coming to you and saying, Fritz, I really need to bridge my prices. Walk me through that process. What advice would you give me? What would you tell me to do and not do?”

Stephanie Goss:
I love it.

Andy Roark:
And so, if you're like, “Oh, what does that look like?” I got a whole podcast with you. It just came out a couple weeks ago. So, you can check out Code of Shame. It's called the Art of Pricing Vet Medicine. It was out at the end of December in 2022. But it's definitely worth listening to.

Stephanie Goss:
So, I think it starts there because that's a simple math problem. You cannot apply math to this problem. You have to look statistically at how are you going to apply the pressure on those three areas, and in what order, and that's a decision. That's where you have to do you. And there's not going to be a right answer. And first, would tell you that there's not one right answer that is going to solve that everybody's problems. It has to be the makeup of your practice, the makeup of your expenses, all of those things have to be taken into account. So, if you start at that layer, and then, if you go down to the next layer which is “We're asking this question because of the team. We're asking because we want to compensate our people. We care about them. We love having them work with us, and how do we that? And so give me your list again.”

Andy Roark:
Yeah, so getting more efficient at what you're doing. And so, what I would say then is this is a way of not raising prices. It's about getting better compliance from pet owners for about making them trust the practice more, feeling more comfortable, understanding the services that we recommend and why we recommend them, things like that. So, it doesn't mean that-

Stephanie Goss:
Is that effective or efficient?

Andy Roark:
Say what?

Stephanie Goss:
Is that effective or is that efficient?

Andy Roark:
Oh, both. Well, efficient is seeing more pet owners.

Stephanie Goss:
Yeah, that's what I was going to say. I would say that's effective, and if you're effective, you're going to drive more revenue.

Andy Roark:
Right, so getting better at what we're currently doing-

Stephanie Goss:
Okay. Love it.

Andy Roark:
… is that right? So, you're talking being efficient is moving through more cases, but being effective, like we talked about with endorsing pet owners or endorsing technicians-

Stephanie Goss:
The team.

Andy Roark:
… things like that. You can build better relationships. We can empower our paraprofessionals to make basic wellness recommendations or talk about these products and services. We can stop and train them to be more effective in the exam room. And this is a simple thing that any team can do. It's just about saying, how do we say this? How do we build trust? How do we get a good rapport? How do we build rapport in the first 30 seconds when we walk into the exam room? Have you trained your staff on that? I mean, honestly, how important is that? It's vital important. It makes this huge difference over time, just being able to connect with clients to know how to recommend wellness care, to know what's going to happen in the practice to do all those things. And it's amazing to me how many practices actually say, “Guys, let's get together and let's talk about how we do this. And let's get on the same page. We just throw people in there.” And so, that was one of the reasons. So, quick, honest to God plug.
I made a team training course called exam room communication toolkit. It's at drandyroark.com. It is made for your team to watch together. It's broken up into little five minute modules, so you can just pick one and say, “I'm just going to show this video to the team,” and then, there's discussion questions, and I'm going to ask the team the discussion questions, so that they can talk about what they do, and what works well, and share ideas and best practices.
And I tried to make it so easy to just get your team together. It can be just your text, it can be just your front desk. Pick a five-minute module, pick two of them, do them, talk about them, and watch people just raise their game by hearing what their colleagues do, and what works for them. It is so simple, but people just… we don't train on what to say in the exam room and it baffles my mind. So, really, I was like this, “There's got to be something that can help people.”
So, anyway, exam room communication toolkit, it's at drandyroark.com. You can definitely check that out if that's something that you want to do to pull that lever.

Stephanie Goss:
And I will tell you, as someone who has tracked team production, the efficacy of that training your team what to say, and how to say it in the exam room and looking as a collectively as a team on what client education, what standard of care medicine we want to have as a whole. And then, teaching the team how to deliver that messaging and taking some of the weight of that off of the shoulders of the doctors, I will tell you that our practice went from very low six figures for revenue that was generated from preventive medicine like flea, tick, heartworm, heartworm testing, fecal testing, et cetera. And when we really focused as a team and as a hospital on making sure everybody on the team understood what our standard risk care was, what we were recommending, why we were recommending it, and then, trained them how to have those conversations with the clients.
And we restructured our process to empower them and put that on them because to your point, the doctors were busy man. And they were trying to be like, “Okay, there's like 10 problems here in this visit. Let's take the top three medical issues and focus there.” Who has time to talk about the fact that, yeah, they see their journey that they probably actually need a dental? When we focus on that, the revenue that was being generated by the paraprofessional team and that regard went from that low six-figure number well up over the seven figures. And it makes the huge difference. And it is all about the mindset and about looking… deciding what you're going to do and how you're going to do it, and then monitoring it to your point. If you're tracking that, it is amazing to watch. And it's really exciting as a practice owner to then be able to look at that and be like, “Holy cow, you guys hit the mark here, and now I can give it back. Now I can pay it back. Now I can give everybody raises. Now I can have bonus programs,” that kind of stuff. So, I think that's super empowering.

Andy Roark:
Yeah, the second one was capacity. And it's just trying to figure out how do I increase the capacity for my technicians to do good to see pets? I mean, at some way this distills down often. This is just, are you using your technicians at the top of their licensure? Are they doing the most advanced, most valuable things that they are licensed in your state to do? And if the answer is no, they're holding dogs, I'm like, “Man, you are not using them in the capacity that they can be leveraged.” And so, just stop for a second and go, “Are we using our techs the right way? Are we using them at the top of their licensure?” It's pretty much just worth every practice looking at what your state allows registered technicians to do. And that makes it hard for me and Stephanie to talk on the podcast about do exactly this or do exactly that-

Stephanie Goss:
Because it's so different.

Andy Roark:
There's so different between states. But look at Washington, what I was just talking about and the BoosterPet that's like, “There's not a doctor in the building, they're just on the screen.” Washington is one state, a state. Your state is probably very different. But are you leveraging your technicians in the way that makes sense given the restrictions that you're working under?

Stephanie Goss:
And I think from the brainstorming idea, that's knowing your practice act and knowing what you can and can't do, and then, also looking at what else is included in other states. And so, there's some great resource material out there through AVMA. There's a tech skills list that basically the schools that AVMA certifies as being tech training programs have to have a certain list of skills that they have to say, “Yes, we are teaching them, and this is how we're teaching them how to obtain these skills.” And so, looking at that skillset list and trying to figure out what could we do, getting some idea, don't try and reinvent the wheel. Come up with some ideas from there and either, like you said, Andy, there's going to be things that you can't do in your state, but it gives you a place to start brainstorming.

Andy Roark:
Exactly. Yeah. I mean, in the capacity as well. It's like, “Do they have to be in the building? Can they work from home? Can we leverage them virtually to see… to interact with pet owners in a meaningful way?” In a way that pet owners will see value in. Or whether they're paying for it directly, or whether it's taking work off of the vet's place, either one.
The other part, the last part is new services. Are there things, are there services that your technicians could perform that are not currently being offered as technician services? And the answer is we say, “How do you keep prices down and make techs more valuable?” Introduce new services that are priced fairly and appropriately and that the technicians can add to the menu of things that you're already doing. And so, that's tech appointments. Things like we said, if you have tech appointments, you're not charging for them. That doesn't make any sense because the techs are getting paid. They're on the clock. That doesn't make any sense to me, but I do see it as well. Are there technician wellness appointments? Do you have boarding in your facility? If you have boarding, are there opportunities for technicians to work with pets and boarding that pet owners would see value in and would opt into and things like that. There's just the sky is the limit, really. It's really about looking at services that you could offer to pet owners and seeing about what would pet owners see value in.

Stephanie Goss:
And I think that's another one where, again, just thinking about it from the no ceiling perspective, and I'll tell you my practice. We got ultrasound which we had not had previously in the practice, and we got ultrasound with the intention of the team was going to do this thing, not the doctors. And the team got trained and certified as ultrasonographers, and then we leveraged technology to have it read by board of specialists and be able to give the doctor a full report and say, “This is my recommendations as a specialist in this case area.” And it was a whole new area of service and revenue for the practice. And it was driven by the team, and it talk about empowering the technicians, teaching them, continuing to grow them and their education, but also, bringing new services in. And so, I think it's about looking at it from an open minds perspective. And so, I agree with you.
My last step is, look at what you can and can't do as far as your locality, but then, also, dream about it on your own, but also, with your team ignoring the ceiling. Let's put aside the limiting beliefs. Let make a list, and then, pick a couple. Don't try and eat the whole elephant. Make a giant list and be like, “What is one or two or three things at the most, things that we could try, that we could act? Can we start charging for tech appointments? Did we buy a laser, but we've never really focused on doing it? Can we get somebody trained? Can somebody on the tech team start offering laser services?” Whatever that is, whatever it looks like in your practice, pick a couple of those things and then, start to do them. And when you're doing them consistently and effectively and you're monitoring that revenue growth that's coming in, add a couple more.

Andy Roark:
Yeah. Canine rehabilitation is one. I've seen technicians just blow up. It was like, “Oh, we don't have time for that.” And I was working with a practice in New York, and they had a technician who got all fired up at CE, and she had a practice manager who bought into her and said, “What? If you want to try to make this, go I'll give you a closet, and you can work. I'm serious and you can work as closet.” And now, they're currently building a new building for her, and it's because she blew it up but it's true.
The last thing I would say is, and I'll be done, but if you want clients to trust your technicians, you have to endorse your technicians. You have to lean into building the technician brand. And people say, “Oh, the pet owners don't want to talk to the tech. They want to talk to the doctors.” And I'll say, “Well, that's because you have not convinced them of the value of the technicians, which is a problem that you can address.”
It takes intentionality. It's one foot in front of the other, but it's intentionally featuring your technicians, facilitating their relationships, talking to the pet owners about the technicians, giving the technicians some weight in the conversations. And when we talk about their value and their expertise, setting expectations that the pet owner will talk to the technician. It's all of those things, and they're subtle things. But people want to know that they're talking to someone who is competent, someone who has the power to fix their problems and to help them. And if you convince them that the technician is competent and has the power to fix their problems, they will be happy to talk to the technician because it's a whole lot easier to get the technician on the phone at least it should be.

Stephanie Goss:
Why you got to go open a whole soapbox.

Andy Roark:
I know we got to go. We're out of time.

Stephanie Goss:
At the end of an episode, that needs to be its own episode, Andy Roark. Because I have so many thoughts, but we're done for the day. We're going to do that. You realize that now you've opened the can of worms. We're going to have to do that as an episode.

Andy Roark:
I'm going to need another espresso before we do.

Stephanie Goss:
Take care everybody. Have a fantastic week.

Andy Roark:
See you everybody.

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

Written by Dustin Bays · Categorized: Blog, Podcast · Tagged: appreciation, culture, management

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