How do you manage staff anxiety about the upcoming schedule without turning away clients and compromising care? In this episode of the Uncharted Veterinary Podcast, Dr. Andy Roark and practice management super star, Stephanie Goss dive into a mailbag question that resonates deeply with many veterinary teams. A concerned manager writes in about their team’s growing habit of preemptively freaking out when they see a busy day ahead, leading to requests for limiting appointments and turning pets away, even though most days end up going smoothly. Stephanie Goss, with her extensive experience in practice management, and Dr. Andy Roark tackle this issue head-on, discussing the delicate balance between preparing for a busy schedule and maintaining a calm, productive work environment. They explore the common cognitive biases like catastrophizing and negativity bias that can exacerbate these fears and share actionable strategies for addressing these challenges. Together, they walk you through action steps that you can implement in your clinic to avoid this chicken little mentality. Let's get into this episode….
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Episode Transcript
Stephanie Goss: Hey everybody, I am Stephanie Goss and this is another episode of the Uncharted podcast. This week on the podcast, we have got a letter from the mailbag from a manager who is struggling with the team that is doing a good thing. They're looking ahead at the schedule every day, but they are freaking out at what's on it.
So they are asking to limit appointments and sometimes asking to turn pets away. And this manager is wondering, how do we take care of our clients? How do we serve our patients if we're turning them away? How do I keep the team happy, but balance this problem? Let's get into it.
Dr. Andy Roark: And we are back. It's me, Dr. Andy Roark and the one and only Stephanie Freakout Goss. Le Freak, So Chic,, Freakout. How are you today?
Stephanie Goss: I'm good. How are you?
Dr. Andy Roark: I am, I am good. Life is, oh boy, life is hurtling by. I mean, it is, it is really hurtling. Oh boy, there was drama at my house yesterday. So, yeah, so Allison went I'm gonna break all sorts of HIPAA laws here.
My wife went to see the doctor yesterday. And so it's, it's, it's the oncologist. And I haven't talked about this before is she, she was diagnosed with breast cancer a couple years ago. And all good. Everything is good. You know, she had her scans and stuff. Everything is fine. It looks like this is over in, in the rear view.
But, of course, obviously we're gonna be checking in. Yeah, well, it's just, just the, the, the advanced screening, and we do, and we just gotta check in. So anyway, so she goes to the oncologist, and so he's got her there, he's doing the exam, and there's a nurse in the room and everything, and he's like, wow, and he sort of feels her shoulders, and he's like, wow, look how strong she is, and my wife is very strong, just so you know.
She is, she is badass. She does like Olympic weightlifting and stuff. She's 45. And so, anyway, then she He he puts his hand, like, on her leg, like, like mid, like, not inappropriate, she's wearing a gown or whatever, but it's like mid thigh, and he's like, wow, this, like, just look at this, and, and my wife says, yeah, you know, those are my tree trunks, you know, she's got big, big powerful quads from, from lifting and stuff, and the guy says, you know, Oh, you're still weightlifting.
And Allison's like, yeah. And he goes, I give it a year. He says, I give it a year. And Allison says, I'm sorry, what, what, what did you say? And he was like, you know, as we get older, our chances for injury go up. And so this weightlifting thing might not be, continue, it might not be sustainable. And the nurse goes, yeah, maybe you could do brisk walking like that. And I, I said, what did you say? And Allison
Stephanie Goss: I can only imagine the look on Allison's face.
Dr. Andy Roark: I, I, she was so mad. She was like, I'm 45. I'm not dead. I'm 45. The woman's like, who you should brisk walking is really where you should be. And Allison was just so offended, offended and mad. It was like, Oh, did he tell you you should have help out of the chair?
Like, you know, and it was just, Oh boy. It was, I mean, it was a, it was a big deal. Well, I can't like. I, I'm a firm believer in Allison's too, it's like, we should have people as they get older, you should be working more on being strong, you know, and, and, you know, like, we should be encouraging people to work out, not, not unsafely, you know what I mean, if you're like, Yeah, I'm doing this thing, and I've injured myself once a month for the last eight months.
Like, you shouldn't do that thing anymore. But if you're happily minding your business, not being hurt or injured, doing your thing, like, the doctor should not tell you you should take it down about
Stephanie Goss: right?
Dr. Andy Roark: I just, I don't know. But, oh boy. It was a big deal at our house. It was not. Oh.
Stephanie Goss: Speaking about taking it down a few notches,
Dr. Andy Roark: Oh yeah!
Stephanie Goss: We have got a great mailbag episode today. I am, I'm excited about this one. I feel this in my bones and in my soul. And I think, honestly, I think every clinic experiences this at some point and some of us experienced it a little bit more frequently than, than others.
So, we got an email from a manager who was like, Hey, I have, my team is doing a great thing, right? They're looking at the schedule and they're looking ahead because they want to prepare themselves for what's coming in. Now most of us as managers would look at that and say, that's amazing. I wish I could get my team to look at the schedule and be prepared ahead of time,
cause most of us just fly by the seat of our pants and roll with whatever walks in the door next. But they were like, okay, they're looking at the schedule and then they're freaking out because they're seeing everything that's on the schedule. And so as a result of that, now they're asking, can we limit appointments?
Can we put more blocks in? And then they are asking to turn pets away. Even though 95 percent of the time everything works out, it's a full schedule and everybody's happy. So this manager has had some conversations with the leadership team and they were like, We don't want to turn people away for a variety of reasons.
They want to be able to provide care to pets. And so if we put block offs in and then a pet needs to come in and we say no to them, like, How are we, how are we serving our clients? And then obviously from a business perspective, this manager is like, it's a balance, right? We need revenue. We need clients coming in the door to pay all the bills, including to pay for the team.
And so they're like, this is how do we, how do we get them to, to pay attention to that? Cause we've pointed out to them when they start to freak out that most of the time that things work out fine. But they're really struggling with feeling like the team doesn't believe it. And they said, you know, the, when things happen and the team do have to stay late or don't get a lunch or whatever.
It's like they hold on to that and clutch, clutch it like they're pearls. And they're like, no, every, every time we have to, you know, we wind up staying till 8pm. Or, you know, every time we wind up missing lunches. And so, They're, they're leaning into that negative experience and this manager is like, but what about all the times when things go well?
And they're frustrated because they feel like overall this, this team is doing really well and that they get out on time and all of that. And so they're like, how do I get them to just slow their roll and relax a little bit and see the patients that need to be seen? Right. And have a balance between
being prepared, looking ahead, being proactive, and putting enough, you know, as a manager, one of the challenges is we want to put enough blocks in the schedule so that we can see the patients that need us last minute, right? And we're not just dumping appointments on top of a completely booked schedule.
So they're like, how do I, how do I balance all of this? Mm
Dr. Andy Roark: I see this a lot. I, and you've heard me rant about this with doctors before, so the whole team has done this. I've ranted about this with doctors. I generally discourage veterinarians, even young veterinarians, honestly, probably especially young veterinarians, from looking ahead at the schedule for tomorrow.
Because and people are like, why wouldn't you? Of course they want to prepare. Look, if you're looking at the schedule, and then you're using that information to prepare, then go forth and be successful. Go forth and be happy. However, most people are not doing doing that. And that's what it sounds like this team, when you said, you know, most managers would love for their team to look at the schedule.
And my big question is why, why are they looking at the schedule and what are they doing with the information they are getting from looking at the schedule? To me, the best analogy for this is people who just stay glued to the news. They're like, I'm watching the news. I'm staying informed. And I'm like, what are you doing with that?
They're like, I'm freaking out. I'm not sleeping well and I'm fighting with my spouse. That's what I do with the news. And I'm like, I don't, I don't, like, again, you don't want to be blissfully, ignorantly naïve and not have information you need to make choices or participate in what's going on, and at the same time, at some point, what are we really doing here?
And so, When I hear that staff is looking at the schedule, I would say to them, My question is why are they looking at the schedule? So I I see this a lot. I call this the chicken little effect, right? And you see it and and what happens is people look at the schedule and someone is going to freak out. They're going to look and some again.
I've not seen this team. I don't know this team I am just speaking in broad stereotypical generalities In my experience when we have a team that looks at the schedule usually it's people because we have people that have figured out that they can get attention by looking at the schedule and then panicking because everybody will talk about this.
Like a lot of times, you know, if we're, if we're bored, if we're bored, I think at some subconscious level, we're like, what are people going to engage in? Let's get something going here. Let's look at tomorrow and talk about that because everybody's got tomorrow in common and it's something we can all talk about because we're all going to have to go through it. And the chicken little effect is this idea that we're going to look and we're going to see something and we're going to catastrophize and we're going to say, Oh, look, the sky is falling. This is going to be terrible. And of course, there's nothing we can do today about how tomorrow is going to go and panicking,
makes no sense, but I see people do it. So we, so we, we get these cognitive biases kicking in these things we do mentally negativity bias. Our writer called that out. People tend to remember the bad things when they look at the schedule. They and I get I've done this. I look at the schedule. I scroll along.
All of the happy kitten visits and the clients I love to see, they're invisible to me. It's basically like when I look at social media and I skim through the comments looking for someone to tell me I suck or, you know what I mean, that this is terri and I skim over all the people who are like, Boy, this vet clinic was wonderful.
I had the best experience here. Five star review. Those are invisible. I'm looking for the one thing that's going to be horrible or make me upset. And I think we all do that and it's called negativity bias. The other one is just catastrophizing, which is we look at things and we look at their problem and some people have a tendency to catastrophize, meaning they see something that could be difficult and they imagine it in the worst possible iteration, you know.
So, the, they'll be my cat is breathing funny. We'll be on the schedule for tomorrow. And there's some people who lose their mind, and they're like this cat is struggling to breathe. That's an emergency. They should have been in, you know, but, and the truth is maybe, maybe it's emergency. I would have asked the question, but I've seen a lot of cats struggling to breathe.
I'm like, oh no, your cat doesn't look like he used to when he breathes because he's gained seven pounds. You know, and like, you know, That's it. He's just, he's, he's an obesity. It could be, it can be anything. Sometimes they bring him in and you go, I don't see anything at all. But, but you just never know.
Anyone who's been in vet medicine for any amount of time knows that what the client tells you before they come in the door Should be held on to very loosely and I'm not trying to dunk on clients. They just don't know And they will leave out critical details. We've all seen people who are like i'm here for a nail trim Also, my dog's bleeding everywhere, like they tell you that when they get there.
And, and we've seen people who have left out critical details, and we've seen people who have way overplayed the severity. His toe is hanging off, and like, he's cracked, you know, the tip of his toenail. And, and, we've all seen it. You just, You can't get spun up that much. It just doesn't make sense.
As long as you're asking the questions as people come in, and you've trained your front desk staff to try to extract important information, and they kind of know generally how to triage cases, you just, you, you have to wait and see what comes in the door. But, but people, they just, they just don't. And so, I just want to first start off in headspace here and say, you know, let me just validate that this happens a lot.
I think it's healthy to go ahead and decide that people do this because they want the best outcomes for patients. Because they want clients to have a good experience. I think it's easy to get frustrated and say, you guys are always trying to get out of doing work. Why are you such, you know, why are you such case dodgers?
Why are you? And again, like We can all get in the negative headspace. Don't, don't do that. It's not worth it. Assume good intent on the part of your team. Assume that they're trying. And know that this is normal and what you're seeing is just normal human behaviors as people look ahead and prognosticate.
Stephanie Goss: Yeah. That, that makes sense. I think, I think a big part of it and this comes along with the action steps is, you know, just trying to seek first to understand, right? Like trying to figure out where is this coming from? Because that will, that will make a lot of difference. Cause you know, you asked, why would they, why would they be looking ahead at the schedule?
And I think that the reasons. And so, you know, because I think that there are going to be people who are catastrophizing, you know, they're looking ahead at the schedule and they're catastrophizing because they're, you know, thinking about the fact that they made plans to go out to dinner for their anniversary with their spouse and they're worried they may not get out on time.
And then there are people who are going to look at the schedule. catastrophize because they see appointments that don't have enough information and they're detail oriented people. Like, the reasons are going to be different. And I think this manager is struggling because it sounds like there's multiple of them who are doing the same thing.
And so in order for it to be effective, I think for anyone on the team to be looking at the schedule, You have to understand the why and and you know you you talked about some of the things I think this is to me. This is It's a little bit of a people problem, but I actually see this as a systems problem So it'll be it'll be it'll be interesting once we once we get into it get into
Dr. Andy Roark: it might be a systems problem. I agree with you. So when we get into action steps, my first action step 100 percent is investigate, investigate, investigate. Like, we do not want to make assumptions about what's going on here. I have seen everything from this is complete hand waving waste of time and energy.
I've 100 percent seen that. Two, I have seen unrealistic expectations on the part of the practice, and these people are actually getting ground down. I have also seen, and this is another one, where the people in leadership positions are honestly having a very different experience from the other people.
So, I have been the vet, and walked out and been like, pfft, that was a great day. And my technician stumbles out behind me, like, you know, like, like hair
Stephanie Goss: uh-huh
Dr. Andy Roark: Sticking out like, like, you know, like half a ponytail and like, like anal glands in her hair and like, she's just like, she barely makes them like, man, that we crushed it today.
And she's like, you and I did not have the same day, Andy. Um, And like that has happened. And so again, the first step is going to 100 percent be investigating. It's funny it could be a systems problem. It could be a, it could be a, just a personality thing. If the whole team is legitimately freaking out, that's probably a systems problem.
I do agree with that. It's quite likely that we've got the old everybody's upset problem that you and I have talked about. We said that we had this in the Uncharted community recently. There was a rash of this across the practices of the employees. Someone, someone comes and says, everybody is mad about this thing.
And their friend is with them. It's like, yeah, really mad. And the owner goes, or the manager or the medical director goes, Oh, no, everyone is mad. The truth is two people are mad and no one else wants to argue with them. And so they're just kind of staying quiet and nodding their head and you're getting the message the whole team is about to revolt and in reality, they're they're largely fine. And so but we we just don't know I have a friend and i'm sure you do too that catastrophizes everything in that they look at the schedule and they're like this is going to go badly.
You know what I mean? You're like, Hey, I got us tickets to the zoo and they're like, it's gonna be a hundred degrees and I bet bottled water is gonna cost 12 and I'm not gonna pay that and I'm gonna get dehydrated and boy, if I forget my sunscreen, it's gonna like and you're just like how could you take this free trip to the zoo and turn it into, you know, this horrible experience, but they do.
Stephanie Goss: Yeah. It's just the person who's just the, the Eeyore. Right? The, the black cloud. Yeah. Yeah.
Dr. Andy Roark: I have another friend and she imagines winning and how that's going to cause problems. And that's the one that always blows my mind. She's like, we're going to go to the zoo and all the animals are going to love us. And then the zoo keepers are going to be like, why don't you come back more often?
Because these animals need you. And then I'm going to feel obligated to go to the zoo all the time because they love us there. And how am I going to fit that in that into my schedule. I am not kidding. I have 100 percent had people like I had someone I asked them to do a presentation for Uncharted. I was like, hey, would you come and do a presentation?
And she was like, it's probably gonna go really well. I'm not kidding. I'm probably gonna go really well. And then everyone's gonna really, you know, like my advice, and then they're gonna, you know, follow up and ask me questions. And then, like, people are gonna just want to know more from me. And then, like, they're gonna be bothering me at work.
And I just, I don't know that I have this time in my schedule going forward. And I was like, it's, I like, I just. I don't think you're going to succeed to the level that groupies are going to stop you from working back at your practice after it's over. But like, that was, that was the way that they catastrophize was, what if this works so well that it just absolutely tanks everything else I'm doing?
And so people are interesting and they're just different in kind of how they, in how they catastrophize. And so my point with all of this is just to say, what is, what is going on here? How are people, how are people looking at it? The other part I want to say here is, is when we start to talk about messaging with things like this, and this is, this is kind of, this is more headspace than than action steps because it's sort of philosophy.
And, you know, I was, I was reading recently about the old parenting question of what do you do when your kid falls down and skins their knee? Do you rush to your kid and go, oh baby, oh, are you okay? Ooh, this looks bad. Or, do you laugh? And go, ah, ha, ha, ha, ha, oh, you're fine. And act like it's not a big deal at all.
We have all seen kids fall down, skin their knee, and then look at their parent, like, am I okay? And if you go, ooh, they will burst into tears. And if you go, psst, you're fine, get over there and get your ball before it rolls away. Then they just hop up and they run and get their ball. And there's always a balance of like, I care about these people. I really do.
Stephanie Goss: Yeah.
Dr. Andy Roark: How do I react here when they say the schedule for tomorrow is? It's terrifying, and we need to turn people away. And I'm like, none of this is happening. I don't want to be callous. If my kid falls and scrapes her knee, and is crying, I don't want to turn my back on her. You know, if she's injured, I'm not going to turn her back on her.
I also recognize that there is a downside to me rushing in and validating. Oh my god, this is terrible. And so there's, just from a headspace standpoint, we want to sort of thread that needle a little bit of making ourselves available, making ourselves open to what they're talking about, be wary of shutting them down, sending the message, you guys need to suck it up.
That's a bad look. It's a, it's a bad look.
You can balance. Not telling people to suck it up with the reality that this practice is not a democracy. And it's not like, everybody raise your hand if you feel like doing this, like, that's, that's not, like, we've got a job to do. And so anyway, you, you've got to kind of, you've got to kind of thread that needle.
The, the, the big part with me here is I would say, as you're going to go into this, keep a good attitude. Right? You're gonna be positive, you're gonna be encouraging, try to avoid, suck it up, you know, that, that sort of language, things like that. But also at the same time, don't, don't, Don't bend yourself all out of shape thinking that the team is going to take over and, you know, no one's going to be able to be seen.
So, just try to keep that, keep that, that positivity. And then my advice here is, now is a really good time to revisit your team values. It's a really good time if they're going, we, look at this, we, we've got these people coming in, and this is going to be a sick pet, and we're never going to get out of here.
They are very much in the logistics, and some of them are probably having strong, like, again, negative emotional experiences. I'm not saying we're going to dismiss them, but the other side of the scale is purpose and meaning. So they look at the logistics and go, look, this is too, we are too busy. Rather than arguing with them about whether or not they're too busy, I want to make sure I lean a little bit into, what are we all doing here guys?
Like what is important to us as a team? And Again, that does not mean it's going to invalidate their, their concerns. It might be that they're like, we're too busy and you look at your values and your values are compassionate, care you know, the highest standard of care. And you go, well, they're saying we're too busy and maybe we're not providing the highest standard of care because we're packing these people in here.
Maybe you need to make some systems changes. Again, it, the values don't, don't use them as a club to beat your staff back, but look at them and introduce them into the conversation so that we can remember what we're trying to accomplish and what good balance looks like here. And so I think that's where I sort of try to get my head, my head before I went and engaged in the problem.
Stephanie Goss: Mm hmm. at my very first practice our doctor had a favorite refrain, , and it used to drive me, drive me nuts until I became a manager. And then I understood it significantly more, which is the clients are the meaning for our work. You know, not an interruption to it.
And, they used to use that when, when the team was having the freak out moments. And in that moment, it felt very much like the club that we were being beat over the head with, right? And when you take a step back and you think about that just from a pure values perspective, if you are a practice and this practice does, which is, you know, we, we believe in providing service to our patients.
We believe in providing service to our clients. We want to be there when our clients need us.
Dr. Andy Roark: Yeah.
Stephanie Goss: If that is the kind of practice that you have, those are the values that you have, it's a lot easier to lean into. Okay. Well, we can't do our job if there's not patients in the building, right? Like we can't do our jobs if clients, if clients don't call us.
And so I think as a, as a leader, the tricky part here is to get the team to be able to take that step back and think about it from that perspective, because, you know, they, they mentioned in their, their mailbag, like we want to be able to take care of the patients and also we need the revenue, right? And if we say no to clients, then we're, then we're not getting, getting the revenue.
Well, if you go and have a conversation with the team and you're like, well, if you guys want to get paid, we have to see clients. They're just going to look at that and be like, F off, you know, like this. And so you have to find that sweet spot between appealing to, to your point, appealing to the values, appealing to the shared vision.
Like why are, why are we here? What do we love about our job? And also recognizing that we're here to do a job, and if we protect ourselves so much, we can't do that job. And so it's trying to find that sweet spot in terms of the headspace that is, that is really important both for the team and also for the, for the leaders who are trying to have the conversations that are going to need to be had with the team members who are freaking out because you kind of, you've got to find that, that zen space.
Dr. Andy Roark: Yeah. I, I agree with that. I, and we'll also say here, sort of the end of Headspace. For me, I, In my experience, the average person working in veterinary medicine wants to help pets and they want to help clients. They, they do. I, I do not find teams where everyone is trying to dodge work and would rather turn a pet or a client away who needs, who needs care and go home.
And again, that's not universal. There are some people who you know, for whatever reason, maybe it's even just a temporary thing and what's going on with them, who don't, who don't. Maybe are not as engaged as we like to see, but for the most part the average team is good to go and they want to do a good job and And again, and so just don't don't go into this dismissive and angry I try don't don't allow yourself to go into an us versus them mentality.
I just um Believe, believe in your people, believe that they're good, assume good intent, and then let's, let's get some action steps. We'll, we'll, we'll walk through this, but I think we're gonna come out in a good place.
Stephanie Goss: Sounds good. You want to take a break and then come back in and dive into that?
Dr. Andy Roark: Yeah, let's do it.
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Dr. Andy Roark: Right, let's get in some action steps here I think you you already brought up two of the ones that I kind of put into action step area I think you're spot on number one is a language check.
Your staff doesn't want to hear about revenue targets. And if they're saying, we're overwhelmed, we're never going to get out of here, and you're like, but you need to make money for this practice. It is going to have the opposite effect from the one that you intend. It is not motivating to them. I, yes, trust me, as a business owner, Believe me when I say I understand that we have got to make revenue and we have got to make payroll and we've got to pay bills.
I get it. Just go ahead and accept that your staff is not motivated by that. They, it's not why they come to work. It's not why they work hard. And just, we need to put that language away because it will drive a wedge further in and create more of this. The organization is trying to extract unreasonable demands from the workers sort of mentality. And we just
Stephanie Goss: Well, and that's, and that's the hard part, right? Because as a, as a, as a leader and you know this, like, you could be, you could be feeling the chicken little effect on the opposite side. Like if you're looking at the schedule and you're like, we're turning away clients, but we're short revenue and I'm worried about making payroll this month, you could be in your own head, having the chicken little of
Dr. Andy Roark: Sure.
Stephanie Goss: catastrophizing of like, well, what, what if we don't make enough money?
And what if we don't, you know, what if it's, what if everybody doesn't make their bonus? And I know somebody is living paycheck to paycheck. And is that going to impact them? Like you could be doing all of that in your head. And so as a leader, if that's happening, or even if you're feeling pressure, I've been in this scenario working in a practice structure where I had field leaders where You know, they're looking at balancing things and so they're looking at the spreadsheet and the data and they're asking these questions.
When you live in this world where you're looking at the numbers and you're looking at the revenue, it is hard to switch gears and you have to be able to switch gears as a leader because to your point, your team doesn't care about that. You care about that. And part of your role as a leader regardless of your practice structure, whether you're private or corporate or whatever.
When you're a, when you're a team leader, when you're a practice manager, when you're a practice owner, a medical director. part of your job is figuring out how to be that translator so that you can get the team to understand that you are supporting their desire to help more pets. And for you, by, by helping more pets, the, the cases walk in the door, the numbers balance out and everything works out on your end.
And that's a really, that's a really hard thing to do, especially in the moment, because I've been there where, you know, I get off a call with my boss who's like, Hey, We need to increase the numbers for this month. Like you're trending downwards. The cases have been have dropped off. It's really easy to walk away from that conversation or that chicken little feeling and and go to your team and be like, hey guys, we we need to we need to take the block offs off the schedule.
Like we need to have the doors wide open. We need to get people in the door. It's really easy to lead with that fear or that language because it is hard to switch that gear. And so I think the language check here go is, is doubly important because you have to, your job is to be that translator. And so it has to be intentional so going along with that, like if you are someone who is feeling that pressure or you are having those thoughts or you're having those conversations, like in addition to the language check, give yourself a break.
Like, take a minute, take a deep breath. Don't go have those conversations with the team if that's how you're feeling because making that switch into translator mode is going to be incredibly hard to do.
Dr. Andy Roark: Yeah. I completely agree. I think one of the most interesting things about modern veterinary medicine is the division of people into medicine and operations. And there are medicine people and there are operations people. And some people wear both hats and those people are really valuable. Neither one is wrong.
Medicine people are the people who are looking at the patient care and getting the work done with the clients and with the patients. And the operations people are the people who are looking at the revenue and how do we pay for this stuff. And they are both very important. They do not tend to speak the same language, and that is probably the most common source of conflict that we see today, is especially prevalent in corporate practices, but not exclusively.
And it is that this exact conversation around check your language is 100 percent about do not run into a conversation with a bunch of medicine motivated people and talk to them in operations language, especially if you're having emotions or they're having emotions. It's just, it's really, really infuriating.
The only analogy I can think of this right now off the top of my head is, I remember being the father of young kids and I remember saying to them, we are late. To get to the dentist, we have to leave right now. And they're like, my dress is not the right dress. Yeah, it's not the right color. It was something like that.
And, I'm not trying to put any category, either medicine, into either of these categories, but it was just, we were speaking entirely different languages. Like, my daughter did not, she was not motivated to get to the dentist on time. That did not mean anything for her. Any parent that has tried to get to, like, take their kid to daycare and then get to work on time knows exactly what I'm talking about.
When you were like, I have to go to work, and your kids are like, Nah, nah, nah, nah, nah, nah, nah, nah, do not, do not hear this. And they have, they have their own kid things that they're dealing with.
Anyway, check your language, try to just, you just, you've got, I think you called it out really, really well.
This gets really bad and really blows up when you freak out more about we have got to make this revenue and they will just hear that and just dig in more of you're not sacrificing us. So that you can make more money. We're not going to do it. And then things really escalate. You just, you just have to check your language.
You have to go. That's why I said, go back to the clinic values. And one of the clinic values should not be. You know, to earn money. What do we do in here, guys? Let's go back and everybody, you know, just bring it down a couple notches and let's talk about what success looks like. So let's start with that.
Number two, and we brought this up before, is seek first to understand. You have got to put away your flaming, raging sword of justice where you're saying you guys are going to do this work because we have to pay the bills. What's wrong with you? Put that away. And you need to go and really investigate.
And so it's funny because you and I kind of leaned in different ways about what this is. We don't, we don't know because we're not there. Is this a person problem? If it's a person problem, what that likely means is you've got a person or maybe two or maybe even three, but probably not more than three, who are looking at the schedule and feeling anxious, and, and they're amping everybody else up. They're they're talking about how bad this is going to be. They're sort of introducing the stress, or perpetuating the stress. And I say, okay, well in that case, you know, this is a this is going to be a person management problem.
We need to go talk to them and say, Hey guys, look, let's talk about the impact of this behavior of looking at the next day's schedule is actually having on the team, you know, and we can sort of manage out of that. If everybody's feeling this way, then we need to really dig into that because perhaps they are being overwhelmed and perhaps, you know, we need, we do need to make some changes.
But the first thing is trying to figure out where is this coming from? What, how valid is it? I mean, they've probably got some points. Oftentimes, this is not an all or none situation. It's not, turn these people away, or just prostrate yourself, you know, under the system that exists, and suck it up. Often it's like, okay, what adjustments can we make to facilitate tomorrow getting done?
Let's think about this. And it's funny, but people don't think that. Some people double down, they're like, take them off the schedule. That's the only answer. And other people are like, See them all! That's the only answer. That's a, that's a, that's a, I don't know. That's a, it's a trapped way of thinking.
Stephanie Goss: It's, it's funny because that that mindset is one that is really common and I, and I, there is not intentional, I, I really think it's subconscious, but it's I've had this conversation a lot with people. managers and practice owners or medical directors where they're like, I don't want the doctors to be able to put their own block offs in the schedule.
Because if they can do that, then they're going to block off everything, right? And it's very much that all or nothing, that all or nothing thinking. And I think that comes into play here a little bit too, because if I was this manager, like I, I would, there would be a part of me that would go to that catastrophic place where it's like, if I let them control the schedule, we're just not going to see any patients and then we're not going to make payroll, right?
Like it's, it is that all or nothing thinking. And so part of it solutions wise for me is and part of why I think it said that it was a systems process is because I do think that every practice needs a process so that someone is capable of looking at the schedule and doing some analysis and trying to be the one, be the, be the decision maker, be the one to help figure out when are we really full?
When do we need more blocks? And, and when do we need to take away some of the blocks? And where can we squeeze extra patients in and stuff like that. And I think you're, you're spot on. And not everybody can think that way. There very much are people who can, who only look in the all or nothing. And that doesn't mean that I want those people to be ignored.
And so that's why I think the investigative part is so, so important. So that you can understand why it's happening, where the anxiety is coming from, or where the worry is coming from, and that you can address that really, really well and in a healthy way. But I also think that part of it is trying to identify who that person or persons on your team are that have that capacity to think about those some obvious solutions, even in the face of panic, right?
It's probably the person who is the most calm when you have an emergency walk in the door or, you know, like you need someone who can look at it and say, okay, we're not going to panic. Like this is how we're going to, this is how we're going to approach it.
Dr. Andy Roark: It's, you know, when your only tool is a hammer, every problem is a nail. It's kind of like, if the only thing the staff knows is, put a block in! We're behind! Put a block in! We're behind! Put a block in! If that's all that they know then you're going to see a lot of blocks. There have got to be some other things that we can do to adjust pressure.
My, my advice generally is we need to talk about how we adjust pressure, but not based on what we think could happen tomorrow. And so that's a big part of this conversation is not saying we're overwhelmed. It's saying we believe we're going to be overwhelmed. And so I, but I think that that's really important, you know.
Some of my favorite ways to sort of handle this, and you want to do this not in a condescending way, but the staff comes and they're like, this is gonna be awful. I, I like to ask the questions, like, okay guys, we're looking, what assumptions are we making here? Like, we're looking at this, none of this has happened.
We haven't seen any patients. Let's just talk for a minute about, about what assumptions we're making. So what assumptions are we making? We're looking at this, we're looking at this lump and assuming it's going to require a full workup. And you know, come on, what percentage of the time is that even true?
And how often do we see lumps and we, you know, we aspirate them and it, it goes on. It is, who, who knows what this is going to be. I've seen cases where, you know, people come in for a lump and I was like, that's just your, that's your hip. That's, that's the dog, dog has got a layer of fat, or it's got a layer of fat over their hips.
And it's like, if you look on the other side, you'll see there's a symmetrical lump for the other And that, but again, I'm not trying to make fun of, but I, I've 100 percent had people come in for check lumps. They're, you know, large lumps. Those are, those are, those are the hips underneath a layer fat.
Anyway, but it's like, okay, and again, I'm not going to fight them on this. I'm not telling them they're wrong. I'm just saying, let's just, let's just, Check our assumptions real quick. Okay, cool. And then, I really like to to empower and coach the team to solve their own problems. And so what I say is, alright, look, we're looking at this.
I agree. It looks like it's going to be a busy day. Now, we've not seen any of this and it may not be a busy day. What what options do we have right now? And what I really want them to do is to start thinking about what the problem actually is and how to handle it. We said before, when you've only got one tool and it's a hammer, every problem's a nail.
I'm ready for my team to start talking about some time management skills. If, if we're going to be busy tomorrow, can I rely on the surgery team to be here on time, coffee in hand, ready to go? Can we already have tentative induction protocols written up ready to go so that we bust them in? Can we have it delegated who's going to get in and start drawing up medications?
However you want to do it. If you think tomorrow's going to be bad, my question to you is, well, what are you going to do to try to make this day run better? And oftentimes, it's incredible what we can do with just deciding to get in, everybody commit to being on time, let's get organized tonight. And a lot of times, we can get in,
kick butt and take names. And that's it. But it's funny that people will say, Well, what are we going to do about this? And I'm like, What are you going to do? Nothing. We You need to tell people not to come. I was like, How about we just get about we just look at this honestly, and and kind of get organized, and let's just see how it goes.
And Again, you can put it back on the team. And what I really want to do, and this is important. I don't want to just roll in and fix their problem necessarily. I want them to, to, to talk about it because what I'd really like is for them to start having these conversations on their own and saying, Hey, look guys, we've got a big schedule tomorrow.
Let's go ahead surgery team. Let's make sure that we're ready to go. Hey, I'm, you know, I'm going to go ahead and start looking at our patients coming in and pulling those charts and getting ready, you know, in whatever way we decided to get ready, I'm going to write them up on board, like, let's go ahead and build some efficiency stuff in our practice that, that comes from the team and they feel good about.
And so, I don't know, it's just it's really that of kind of like, Hey, what options do we have for handling this besides telling people just to go somewhere else? And it's, it's, it's funny. It's, it's always interesting what responses you get.
Well, and I think for me, that's part of why I said, I think that this might be a systems problem because part of the process that I used to help get out of this, but that that helped manage it on an ongoing basis was when you do have that person who is capable of looking objectively at the schedule when they're looking at it ahead of time.
They can help guide and lead the team to having those, having that time management prep happen ahead of time. And so for a lot of practices, it's like, well, it's 7 p. m. We're trying to walk out the door, but today's been a shit show, so let's take a look at tomorrow's schedule. What are you going to do about it 7 o'clock when you're trying to walk out the door, right?
Like that helps nobody except for to say, well, we better tell everybody to have their Wheaties and get here with their coffee because we're going to have to move. Okay. It's a systems problem. So if there is a structure and a system in place where someone is looking at that ahead of time, you have the ability as a team to a plan the time management.
And I love some of your ideas, like prepping the protocols ahead of time, even, you know, drawing up, getting all the charts ready, drawing, drawing up drugs, even sometimes ahead of time, like whatever that looks like for you, your team, but getting, getting things ready so that it, the, the day goes smoother, but also being able to spot those spaces where,
you may be able to preemptively fix things, right? You may see a snafu in the schedule and you're like, ooh, this, this actually could be a pretty long appointment. Maybe we call them because we're looking at it two days ahead a day ahead. Maybe we call them and ask them, can they come in a little bit earlier because we want a little bit of extra time or swapping things around or whatever, but it doesn't do us any good to do that at the last minute. And I, I think from experience being in the practice, like when this kind of freaking out happens with the team, it's usually happening at the last which doesn't do anybody
Exactly. And, and, can they, can they drop that off? There's a lot of times where, again, it's the old hammer. It's like, turn them away. I don't know, could they be dropped off? Could, you know, could they, could they see a different doctor? What can we, can we look at on the schedule and turn into a technician appointment?
Is there anything? that we could do that. You know what I mean? Like, it's, it's, there's, there's, we got a lot, a lot of options to your point. But we need to get serious serious about them. And so it's, I don't know. I just, I think that there's a lot of opportunity. But people will only hear you if they think that you are genuinely
trying to work in their best interest and the best interest of the pets, they will not hear you if they think that you're trying to figure out how to get more dollars. And so I, I think that that is, that is very true. And they'll only hear you if they don't feel patronized by you. Like you're just going, suck it up.
You can still wade in here. And be positive and kind of matter of fact about, you know, we're, this is, this is, this is how we're, we're going to sort this out. I, we are going to get through it. Let's talk about what we're gonna do. It can be, even, even as simple as, I, it's amazing how much difference this can make.
I have seen teams come together, they're looking at tomorrow and the, and the. The resolution the team came away with is we're going to get we are going to make sure the first people who go to lunch are going out on time because if they stick around to help, then they're going to get bogged down and then lunches are going to get backed up.
And then we're gonna be in trouble later on. And it's amazing that sometimes the answer is we are going to go ahead today and commit to getting our breaks done. Tagging, tagging people out when someone says, Hey, I need to go to lunch. We're not going to give them lip. We are going to jump in and relieve them with the case that they're on so that they can get out the door and the rotation continues and people have time to rest.
And it's like, that's the type of positive problem solving that I'm loving to see. And again, this does not mean that you're going to work people to death and they can sort it themselves. However, I have seen the vast, vast majority of busy days addressed so beautifully this way over just telling people, no, no, no, no, we're, we're panicked tomorrow and we can't see you.
Stephanie Goss: Yeah. I think the other piece of that, that's really an important, you know, you, you pointed out they have to believe that you're doing it, you know, for, for with them in mind, I think for me, it has been most successful when that, when those people who are looking at the schedule are members of the team, right?
Because if I'm a manager, who's not working on the floor. I'm not having the same experience as them. I can think that I am all I want, but I'm not. And so by having a member of the team, they're going to be in the thick of it. And so they, you know, they'd like the team has to believe that it's that it's happening for the right reasons.
And I think that that really helps the other piece. So I think there's the prepping ahead piece that is a systems piece that can help make this go more smoothly. The other piece that is part of prepping ahead, but a lot closer to it is you know, you said something about having them talk about what options do we have to handle it and what does the team want to do.
I think if you're not, if you're a hospital that isn't having morning rounds and utilizing a few minutes of your morning rounds, to go through the schedule and figure out how you're going to work together to deal with the potential complications on the schedule, you're missing, you're missing a big trick.
So part of our rounds process was to go through the schedule and say, does anybody have any concerns about the schedule today? And it was an opportunity for people to speak up and say, well, I saw that Mrs. Smith is on at 10 o'clock and she's only scheduled for a 20 minute appointment. And you know, she's the, she's the talker.
And then we've got this complicated looking case right behind it. How, you know, how, what can we do to, to make sure that this goes smoothly, right? And it can come from both sides. Sometimes the CSR team has information about those complications that is just as valuable, if not more valuable than, than the just looking at the patients.
And so if you're not having morning rounds and at least getting a member of each team in one space and talking about the day, I think you're missing the opportunity to get the team bought in and on board with how they're going to problem solve in the moment together. And I think that that's a really, really valuable and important piece here because they should have a voice and they should be part of the solution.
It shouldn't just be you know, I'm the manager coming down from on high to tell you here's how we're going to solve the problem because, you know, that sets them up to feel like you're not you're not advocating for them.
Dr. Andy Roark: Well, you know, one of my favorite sayings is, you know, the impact of your idea is the quality of the idea times the buy in. Meaning, you can be a genius and if the team has zero buy in, your idea is going nowhere. And so, having them involved, I think, is mission critical in fixing this going forward.
The last part for me in action steps is kind of a big bucket here, but it's important. We need to go ahead. And with a smile on our face and patience, we need to train through this behavior. And again, if there's a real problem, we need to fix the problem. This is not putting it back on the staff. However, let's just say that this is a regular thing and they look and they freak out about the schedule tomorrow and 95 percent of the time it's great, but they don't remember that and they only remember the bad stuff.
Let's just say that that is 100 percent true and that's how it actually goes. All right. For, for me, there's a couple of things here, but, cognitive behavioral therapy is sort of a, a behavioral tool for dealing with anxiety. And, and the basic idea is, and again, there's a lot of nuance here, but just the basic concept is, if there's something that makes us nervous and we avoid that thing, we're probably going to continue to be anxious and nervous about it.
You know, avoidance of things that make us nervous just, it just solidifies that behavior. You know what I mean? If my team comes to me and they're like, We're, you know, we're freaking out about tomorrow. If they have a good point, then, then I'm good. We're going to engage. If it's something where I go, it does look busy. I want to be gentle, but also I should know that, you know, if you start If you hadn't taken stuff off the schedule the day before, you're kind of validating the idea that, yeah, we would have gotten, we could not have handled that, that would have been, that would have been a problem. And so, I really, I want to listen to them, I want to make adjustments as needed, but I'm going to be a little bit wary of sort of just taking stuff off the schedule or canceling things or shutting everything down.
What, what I want to do instead is to Is to, is to work with them to figure out how we're going to handle this. And then I just want to really call out when things go well. And I think that that's a thing that's easy to do is, you know, they're, they're nervous about this and the day and the day comes along and we make it through and nobody really says anything and we go home.
I think that we should, if they're nervous about it, we should have a genuine conversation about it and what we're going to do. And then, I, as the leader, I'm going to make it a big deal. I'm going to high five people at lunch. I'm going to cheer for them when we are rolling through the day. At the end, at the end of the day, I'm going to give high fives.
And then here's what I'm going to do to train through it as well. You know, I'm a huge believer in positive feedback. And positive feedback is. Being specific with people about the behaviors that you saw, talking to them about the impact that those behaviors had, telling them how much you appreciated those behaviors, giving them a reputation as someone that you can count on and rely on, and I am going to say to them the day after or two days after, Hey, I just want to go back to Wednesday, we were all really nervous.
I have never seen you step up as the lead technician and just run the exam or the treatment room the way that you did and like I saw you specifically These are the things I saw you do and bang bang bang and give it to and what you're doing is You're saying to this person that was a challenging time and you excelled You did a great job.
You were successful. I saw you being successful You are excellent Good at your job, and I'm gonna tell them that because I want them to come to believe it because a team that believes in themselves is so much more valuable than a team that they thinks that they they they sort of need to be protected. And so anyway, I just really want to lean into this and again, they won't even know That this is about Wednesday or about this pattern of behavior. I just want to look at these days and i'm going to pay extra extra close attention to the behaviors that I see and I am going to praise the people who step up and and Try to use their, try to use their language of appreciation and just really make them know this was, you crushed it and I saw it and I appreciate it because what's going to happen is I want to train them so that next time we have a busy day, they say, I know what to do.
I have been through this before. I have received positive feedback on certain behaviors and I, without even thinking about it, I know how to handle a busy day. And buddy, that's it. Now we're growing a team that, one, is resilient, but, two, has the skills and the knowledge and the confidence to, to bang out some busy days.
Again, you can't take advantage of this. People are people. They have a work capacity. We don't want to burn our people out. We need to look out for them. And, at the same time, you can do a lot with a motivated team that is confident and knows how to handle a little bit of chaos.
Stephanie Goss: Yeah. Well, I didn't take us off the rails at the beginning of this episode, so I'm gonna end us by taking us, , taking us off the rails here with, with my last action step. So the last thing I would say is your team does need to feel empowered. And so, if if you're having this challenge, my last suggestion would be you know, this is uncharted after dark.
Give them a safe word. And this is really important because, because if you guys can, if you guys could see Andy's face on video right now.
Dr. Andy Roark: I thought we were just going finish this episode and it was gonna be fine and there was not gonna be any weird comments.
Stephanie Goss: taking it off the, no, I'm taking it off the rails. They need, they need a safe word and they need, they need to, because here's the thing,
they need to feel, yes, they need to feel empowered.
They need to feel like they are a part of the solution. And so we're going to keep it clean, but they need a red and a yellow because they need to be able to say, Hey, I'm feeling. I'm feeling like mid level overwhelmed, like I would like to keep going, but I, but I'm feeling a little anxiety and they need the panic button.
They need the red to be able to say, okay, timeout, right? And why this is important and why it worked really well for me is because if everybody on the team knows like, when we're doing this, if we have a rounds process in place, if the, if the day before we were looking at the schedule and we were freaking out, if I go round and pull the team and I have the ability to say, how are you feeling about this, the schedule today, and everybody is giving their, giving their, well, I'm a green, I'm a yellow, I'm a red.
You have the ability to see like, is this everybody and is this everybody consistently? Where are they at in the schedule? Because the reality is the power to impact the schedule should not just live with the manager. It should not just live with one of the doctors. Because to your earlier point, our experience is vastly different than the paraprofessional team's experience.
Because they are, they are carrying this big boat on their shoulders. They have this huge amount of work. And so they need the ability To stand up and say, Hey, I'm, I am feeling overwhelmed, and then we have the ability if we know that it's just one individual who's like, Oh, well, boy, I'm, I'm freaking out about the schedule and everybody else is, is, you know, greens, then you have the ability to say, Okay, well, Let's sit down for a minute and talk about this before we dive into the day, because I want to help you get set up, set up for success.
Right. And so that, that really, I know it sounds a little, it sounds a little kinky, sounds a little crazy, but
Dr. Andy Roark: You don't have to call it a safe, you don't have to call it a safe word, Goss. You could just say..
Stephanie Goss: Yes you do!
Dr. Andy Roark: no you don't, you don't have to call it a safe word.
Stephanie Goss: my team,
Dr. Andy Roark: You could just say, give me a green, a yellow, or a red? And then nobody has to call HR.
Stephanie Goss: Giving them safe words and letting them say, Hey, this is how I feel. was hugely empowering for them because previously they just felt like they could, they were speaking up about it, but they felt like they were shouting into the void because the person who was in charge of changing the schedule, saying no to clients, putting block off sin or whatever, was someone who wasn't having the same experience as them.
And so that, that really, really helped be able to do two things. One, it helps give them a voice, but also two, it helped me gauge, to your, where we started point, is this a one or two person problem, and is it happening consistently, is this a pattern, or is it a one off, or is this actually everybody, because this will help this manager, and me, if I was in this position to say, is this really 95 percent of the time that things are working out fine? Or am I just looking at things from the sunny side of the street?
Dr. Andy Roark: Call it a rescue flare, don't call, you don't have to call it a safe word. It's a good idea, it's a good idea. It has a, it has a, it has a branding problem, I think. We're not calling it the Uncharted Safe Word.
Stephanie Goss: I think that's another, I think that's another, the Unturned Safe Word.
Dr. Andy Roark: It's not the Uncharted save point. We're gonna, like, we're gonna workshop this a little bit. I think there's good ideas behind it.
Stephanie Goss: That’s a whole other episode entirely.
Dr. Andy Roark: I'm, like, I'm done. I'm done with this.
Stephanie Goss: An Unturned After Dark episode.
Dr. Andy Roark: I'm finished. I'm leaving now.
Stephanie Goss: Have a great week, everybody.
Dr. Andy Roark: See you later, everybody.
Stephanie Goss: And that's a wrap on another episode of the Uncharted Podcast. Thanks for joining us and spending your week with us. If you enjoyed this week's episode, head over to wherever you get your podcasts and leave us a review. It's the best way to let us know that you love listening. We'll see you next time.
