This clinic is struggling with big changes, leading to being short-staffed, and the kicker? The boss simply cannot hire right now. This week on the Uncharted Veterinary Podcast, Dr. Andy Roark and Stephanie Goss address a mailbag letter from a practice trying to maintain high-quality care after losing team members, leaving them as a single-doctor practice. They explore how to balance patient and client care while being severely short-handed and whether to make sacrifices or adjust their business model. Andy shares valuable advice on recognizing capacity limits and not trying to be all things to all people, while Stephanie offers practical business solutions, focusing on numbers and pragmatic adjustments. 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, Andy and I are in the mailbag as we are and we're responding to an email from a practice manager.
Now I'll admit, this gave me some pause when I first got it because when I first read it, I thought “I wonder if there's very many people who could relate to this email?” Because there's a lot of things in it that are fairly specific. And, the more and more, I thought about it. The more I realized that everyone in veterinary medicine can relate to one thing. And that is, we've all experienced, um, being short handed at some point in time and at the heart of it. This email is about that experience in a very specific way. This one was a lot of fun. I hope you get a kick. Out of it, let's get into it.
Dr. Andy Roark: We are back. It's me, Dr. Andy Roark. And the one and only Stephanie I've got your help right here, Goss. That's not a song. That's not a song.
Stephanie Goss: I was waiting to see what you were going to come up with because we didn't have a song lyric.
Dr. Andy Roark: I got nothing for this episode. It's uh, this is uh, Stephanie, the Practice is small and the boss refuses to hire Oolala Goss. It’s a very niche song.
Stephanie Goss: It's a very niche song. You might not have heard it.
Dr. Andy Roark: It's an indie band, very cool. Very cool indie band. Yeah.
Stephanie Goss: How's it going, Andy Roark?
Dr. Andy Roark: Ah, it's rainy and it's rainy and nasty here. It's the kind of day when you just open the door and your glasses fog up. It's that day. It's like poof..
Stephanie Goss: Yep,
Dr. Andy Roark: It's like a not warm enough sauna. It's like a, it's like a lukewarm, it's a lukewarm, gross sauna day here. How about you?
Stephanie Goss: That does not, that does not make me excited to come to South Carolina in a week.
Dr. Andy Roark: Yeah. No, it'll be beautiful out there. We just got, we just got a little, a little bit of a nasty, a little bit of a nasty streak going on, but generally beautiful here. Everything, you know, spring has fully sprung at this point and uh,
Stephanie Goss: I have started my allergy meds in advance of my visit.
Dr. Andy Roark: Yeah, probably smart.
Stephanie Goss: Probably I am, I'm preparing for all of the, all of the trees and all, all of the pollen. Well, yeah, no it, things are, things are, things are busy. Things are hopping. It's you know, it's that, that time of year.
Dr. Andy Roark:Yeah, yeah but wait, here's the thing, I don't, we've just gotten into a place in our lives where we just say, Well, it's just that time of year, and we say it, and every time of year, we're like, I guess it's that time of year.
Stephanie Goss: It's that kind of year.
Dr. Andy Roark: That time of year?
Stephanie Goss: Well is that is that a statement on how old and boring we are? Cause I feel like that could be it.
Dr. Andy Roark: I don't know. I think, I mean, I think that it's a statement to how, how, how busy we are. Where it's like, there's a, there's a meme always like there's something like being an adult is saying I'm really busy now, but I think things calm down in two weeks.
Stephanie Goss: Over and over and over again. Yeah. Yeah. Um, yeah, I feel like there's a little bit though of us just being old. Like I, I know, I got you a present that made me think of you and it was a magnet meme about being as old as the music at the grocery store is like your, your playlist.
Dr. Andy Roark: Oh yeah! That makes me smile every time I look at it. It's on my fridge. Yeah.
Stephanie Goss: And I, you know, it's true. Like we are, we are that we are that old.
Dr. Andy Roark: Oh yeah, I was um, I was at the bank earlier today and I looked around and I was the oldest person. I was older than all the employees at the bank. And that was, that was weird because I always assume that there's an adult at the bank and no one was older than me which means there was no adult
Stephanie Goss: There's no adult.
Dr. Andy Roark: In my mind, you know like, I'm like, oh it's just us young folks. It's like, no Andy.
Stephanie Goss: Yes. Yes.
Dr. Andy Roark: I look around, there was me and like six, seven women, and I was clearly the oldest person that was, that was there. It was all the, all the employees and me.
Stephanie Goss: Yeah, I think that like, I remember very vividly that moment for me in the clinic where I looked around and I had just hired a new doctor and like he like was starting um, like starting, high school when I graduated, like, university. And there was just like, I just felt really, really old.
And there was one day and I stood in the treatment room and I looked around and I was like, dude, I'm the oldest person in this building by like 15 years.
Dr. Andy Roark: Yeah.
Stephanie Goss: And I feel really freaking old right now.
Dr. Andy Roark: Oh, yeah. Oh, yeah. Well, there's also like the conversations that you hear people have where you're like, I can't relate to this at all.
Stephanie Goss: Yes, yes, yes.
Dr. Andy Roark: A lot of it for me is like around dating apps and stuff and I'm like you guys do like how does it work?
Stephanie Goss: You what? What? How does this work? Yes. Yes. That is, that is really that is really that's a whole other, that's a whole other, we could do an Uncharted After Dark, After Dark podcast and the whole, whole other conversation. Well, I'm excited. We got a podcast mailbag letter that is, Oh boy we're, we're gonna leave out like a majority of it because this, this poor, this poor clinic has got some stuff going on.
And at the heart of what they were telling us about was they're in a situation where they have lost team members and they have a, they are a single doctor practice. And so they're wondering, like, how do we balance providing excellent care and, and by care, they mean both patient care and also client care when we are providing excellent care like, super, super shorthanded.
And at first glance, when you and I read their letter, we both were like, can, this is not, I don't know that a lot of people are going to relate to this, this scenario that's going on in the practice because of the other details. And I think at the heart of that. For me, I was like, okay, well, if we step back and we look at it, everybody can relate to a period in time where they felt really, really short handed.
And I don't just mean like, you've got two people out because somebody's on vacation and somebody gets the stomach flu. I mean those days where you have, you know, one or two people and they're like the rest of the team, for whatever reason, the rest of the team is gone and you're just trying to make it to the end of the day because there's a hundred patients and there's two of you.
That, that kind of day feeling or the, that, that kind of day being that kind of day. There have been days where I can think of for whatever, for a variety of reasons where it's been, you know, you and two or three other people and you're holding down the fort. And I know certainly our, our friends and our colleagues in like ER feel that way a lot.
Like I have lots of friends who are just like, man, that's a regular occurrence where we're just trying to juggle things and take care of patients and we're shorthanded. So I think you and I thought it'd be kind of fun to talk about if our model is that high quality care and we're really trying to continue with that model, do we make sacrifices when we're really, really short handed to keep up our model?
Or do we do things to shift the way that we're running the business when we're really, really short handed? Okay.
Dr. Andy Roark: This is an interesting question. I'm gonna color in a little bit of lines that you sort of left out just just because I think there's some important flavor here and honestly I'm gonna say and I'm curious if you're gonna agree with me when we're all done I think this is a little bit easier than some of the other you questions and cases we get that are around. Like being short handed and I'll tell you why so let me color this the lines a little bit.
So in this practice, I think it's important to note they're shorthanded because one of the two doctors passed away or actually that one of the doctors passed away, leaving just a single doctor and like that's it. So I just want to paint that picture because it's important about kind of how we how we got here and then We, we had a manager that had to go and so just some, some, caught, caught doing bad stuff and had to go.
Stephanie Goss: Naughty behavior. Yeah.
Dr. Andy Roark: I mean, not, not naughty, but like illegal, she busted. So anyway, so that was, that was, that was bad, so we've had kind of a house cleaning here, which I think is in, in that regard, but these are, these are lightning strike weird things, and I say this because it's not, don't, I don't want people to think, oh, this clinic, but is a toxic dump and people don't want to be there and have left but you know what I mean?
It's it's they they've just by the wheel of fate have ended up short handed and I think that that's important because I think that there's a number of things in management and in medicine in general where it's like, I was I was dealing with a we'll say a young doctor who recently had the first client that did not want to see her anymore.
Stephanie Goss: Um, Mm hmm.
Dr. Andy Roark: And she was wrecked. I mean, just wrecked. And I said to her, “don't you know, haven't I told you that every great doctor has a client that refuses to see them?” And she says, well, “yes, but not me.”
Stephanie Goss: Right.
Dr. Andy Roark: These things like, there are these things that we're
Stephanie Goss: Everyone loves me.
Dr. Andy Roark: And well, it's like, it's like, we're like, sure people practices end up short handed and not because of anything they do wrong. Wink, wink.
It's not wouldn't like, and we, and we, think like that because it gives us this illusion that we have control. Like I, as long as I take care of my people, I won't ever end up shorthanded. And it's like, well, that's, unfortunately that's not a guarantee that you get in this life. And so anyway, that–
Stephanie Goss: I think if you think about it too, like there's lots of things that we run through our head in that way. Like the other example that it makes me think of is everybody thinks, well, if I write up all my records really well, then I won't get a board complaint. You know, or if I do, that's, that's another really, or like, if I do everything under the sun and explain everything in super detail, then I won't get a board complaint.
Well, the reality is that's something you can't control. You know, I just had that conversation with, one of my friends and she's a young, same young doctor you know, thinking, Oh, I'm doing of the, of the newer generation of doctors, they're writing really thorough records. Doing all of the things really high you know, white glove kind of customer service. And she was just like devastated. And I'm like, this is, this is a part of your life as a practitioner. This is a part of the circle of life. And to your point, Andy, it's like, we wish that it wouldn't happen to us. But if we sit there and think that it's never going to happen, we're, we're kind of kidding ourselves.
Dr. Andy Roark: Right. And I completely agree. And so, so I wanted, I just wanted to call that out of, yes, I think it's important to note in this context, like how, how we got here and people to serve. And the other thing that I think is important is it sounds like the new practice owner has been very clear. That his resources are tied up. He has got another investment that his money has sunk into. And he, he does not have, he does not have free cash right now.
And, and that's why I say this, that may actually be a little bit easier than a lot of these other shorthanded questions, because if you, you know, a lot of times people say we're trying to hire, but we can't hire, how long do we wait before we start making fundamental changes? And everyone's hoping. That all of a sudden they're going to get three hires. And sometimes you do. It's like that. We've all, we've all seen that happen where you're like, we couldn't hire anybody. Couldn't hire anybody. And then all of a sudden we got three people. You're always wondering about that in this case, I'd say it's a little bit easier because it's sort of like, well, if we don't have any capital and we're not going to have any capital.
It makes the decision about when do we make adjustments a whole lot easier because this does not look like a situation we're gonna change. So anyway, I I just wanna use that to sort of color in the lines a little bit and sort of say, okay. Just to restate, we are shorthanded. We have a tiny practice, like one vet, one employee, a tiny practice. The the vet is, is fully leveraged elsewhere. There's, and, and, and he's the owner. So there's not, there's not a lot of other resources coming in here. Given those things. Oh, and, and we're slammed. We are absolutely overwhelmed. What, what do we do? And so that, that's the question. Let's start with headspace. Is that okay?
Stephanie Goss: Yeah, let's do it.
Dr. Andy Roark: All right, cool. I, I love this question. I, I, I think that one of the things that I have tried to champion in this industry, and I think one of the things that, that I am proud of in my career, is that I feel like I have been a person, maybe, maybe one of the loudest people in the industry who says you have got to be intentional about how you give of yourself to this industry and that's just, it is such a big deal for me. It's not sexy and it's not the warm fuzzy message that a lot of people want in vet medicine.
But I, I, I think, I think that has been my position is I want to help people. I want to serve and for goodness sakes, I believe that you can only do that if you take care of yourself first. And so, you have got to be intentional about how you practice, and I'm talking to everybody here, not just these people who wrote, you've got to be intentional about how you practice. You have got to work to make medicine less reactionary. And what I mean by that is, the default in medicine is, I don't know what's coming through the door, even if they have an appointment, I don't really know what's going to show up. And so the default state is reacting to the things that happen to you.
Stephanie Goss: Sure.
Dr. Andy Roark: If you just say, that's what it is. We're just going to see what happens and react to it. Then you live in a reactionary state. And we all know people who live there and their, their cell phone rings. And they're like, I don't, I, I have never considered what I would do if someone called me on my cell phone. And now I guess I'm doing this again, and you know, and it's, it's all, it's all sort of this life that's out of your hands.
And I just think that that is a really dangerous place to live, but I think that that is the default setting when you get your golden ticket into that medicine. And so one of my, one of my big things is. We have got to be intentional. We have got to make medicine less reactionary. And that means that we have to, we have to say no to people. But if you don't say no to people, you're going, you're going to burn out. You're going to have real problems. You're going to turn your staff over and not keep the people that you have.
And it's, it's time for a reckoning of yeah, there are consequences to not being available 24/7, and there are hardships to not being available 24/7. However, there are consequences and, and hardships, and they are the long term consequences and hardships of being available all the time and just reacting to everything and just paddling harder, even though there's no end in sight.
Stephanie Goss: Yeah. I, I, I I really like that, that idea of you gotta look at it in a, in a less that reactionary is such a, such a good word. Cause we don't, we don't think about it, right? Like we just think about, we're just going through our day and we're, Oh, well, like this is, this is the train wreck case that said it was a wellness. And now I'm two hours behind in my schedule. And you know, you, you look at it from that perspective of, It is what it is. And sometimes that's true. And there's lots of other things that we can do and that we can spot coming to help us be less reactionary to the day.
Dr. Andy Roark: Yeah, I mean, it, you, you're sort of very related to that. You can't be all things to all people especially if you've got, especially if you're wildly shorthanded, you can't, you can't be all things to all people. You can't, you can't take that case to surgery in the middle of the afternoon because you're booked solid with other appointments and no one's here to recover this pet.
Like, I know people that do. They would be like, yep, we're going to surgery and we'll somehow, we'll get these appointments done and then we'll suck it up and we'll have dinner at the vet clinic. And I'm like, you, you're in this marathon.
You can't, you cannot run like that because you will not make it to the end. Like just go ahead. One or two things can happen. You can accept that you cannot run like that right now while you still feel okay and you still have employees or you can accept that you can't run like that when you're talking to your primary care doctor about your depressive episodes and your staff is left. Those are kind of I don't mean to be overly dramatic but that's often where people have that realization that I can't run like this is way past the point of their of their you know body and team breaking down.
I don't want that for people And that's but that's why i'm so Just adamant and straightforward about, you've got to be less reactionary, and that means you can't be all things to all people, and just remember you cannot pour from an empty cup, and you cannot feed from an empty pantry, and what that means is you have got to make sure that you have gas in the tank for tomorrow, because if you don't have it for tomorrow, you're not going to help those pets, and if you burn out and quit after five years in practice, I would say you left all the goodness on the table, that you would have done in the next 15 years of your career had you said no to some things along the way.
Stephanie Goss: Yeah. It's interesting to me and it has always been interesting to me observing. It feels like a very, very fine line. And I'm amazed at how many of us don't see how fine it really is between having that day where, you know, the emergency, the emergency hit by car, the emergency c-section comes in and to your point, you're just like, we're just gonna, we'll figure out how to see the rest of these patients.
We're going to surgery. We're going to do the thing. We're going to take care of the patient. When something like that happens on a one off day and to your point, you're, you eat dinner at the clinic, you're there till 10 recovering the pet, someone's sleeping on the floor. Like when you do that and it's a one off that fills your cup in so many ways where it's so rewarding to feel like we can take care of a patient and we can, we can make a difference both for the pet and for the clients.
That feeling is why we make that choice. And it is a razor fine line between doing that as a one off and letting that kind of reactionary behavior become your every day. Because that's where it's like, it's like you're walking the edge of this cliff and Just one step is going to take you off the edge to the place that you, you were talking about, Andy, which is like, you're, you're saying yes to all of the things and now you're on call 24/7 and you're one person.
And then before you know it, you're you know, you're in that state of total burnout and you're wondering what the hell happened. It's amazing to me how many of us can't see how fine that line is. Because to me, like, stepping back now, I, I can look at it and think, Oh yeah, there's a, there's a canyon between doing it once in a while and feeling really good and having the whole team feel like you have run that marathon at a sprint pace and you are just, you are on the ground exhausted.
Dr. Andy Roark: Do you really think it's a do you really think it's a fine line though? Like, I, I just, I don't know. I think I've been thinking a lot about this, is, I think it's a slippery slope, which is different from fine line. Right? so, I think it's a slippery slope, because, I, cause here's, so, I, I, so, I love how you set this up, in that, staying until 10pm, one time, it can make you feel like a hero, and it can, you know what I mean, especially, you've got this case, and you have a personal attachment to it, and you feel supported, and people are like, yeah, let's do it. That can be absolutely wonderful.
And then also what we said about this, everyone's tired, the job never seems to end. That's the other part. I do think there's a fair amount of gray in there. And I say that because I, while I don't want everybody to stay late all the time and burn their team out. I also don't want people to be like, if we stay tonight, that's it. That's it. Everybody's going to therapy. We are, we are so, we are so toast.
It's just I don't think it's that. I do think it's a slippery slope where if you don't believe that you can say no, then there's no other outlet for that, and you get, you get drawn farther and further down into it, but I really do think it's important to give people some hope here, because you can't– you can decide, hey, we did that, but guys, now we're shorthanded.
Stephanie Goss: Right.
Dr. Andy Roark: And so things like that are, we're just, we're not going to do that anymore, We can't do that now. But if, if we get fully staffed, then maybe, you know, we'll, we'll go back on our late rotation. And, and, you know, it's important to serve our community that way. And when we're properly staffed, we kind of, a lot of people enjoy it and feel good about it. And so maybe we'll go back to it. And it's just, I think that that, I think that nuance is healthy of, you know, we, we can every now and then we can, we can go above and beyond. And it's not like we're going to lose ourselves, you know, down, down the cliff.
Stephanie Goss: Okay. So here's why I think it exactly what you just said is why I think it's a fine line because so many of us have that, whether we have that dialogue internally or we have it with the people around us have that conversation of, okay, we can't do, we can't do this every night. Right. And then we look at, okay, well, what does that mean?
We still want to take care of our patients. We still want to take care of our clients. If we're not doing it, what, what are, what are the options we want to be able to provide? The caretaker in us the immediate reaction is we want to be able to provide that same level of care for all of our clients.
And so if we don't have an E.R. close by, if we don't have options that feel good, that's where we, the, the the spiral starts, I feel like, because so many of us look at it and think, well, I can't think of a better option. So this is my, like, this is, I'm just going to keep doing it because I don't want patients to suffer. And so I think for me, that's where the spiral so easily starts because you want, like, it starts, it's coming from a good place.
And, it's really hard as caretakers to look at it and do what you, do what you said, which is, okay, I recognize this. We cannot pour from an empty cup. We cannot feed from an empty pantry. Let's get staffed. And then we can take care of these patients again. Even if that makes rational sense in your brain, it is emotionally really hard to set aside those patients because at the end of the day, your brain is doing the, what if game. Your brain is doing the, well, what if a client needs us in the middle of the night? And what if, and so I think for a lot of us, instead and this is going to maybe sound too woo, but instead of working through that, instead of asking those questions, instead of getting the support that we might.
What we might need to work through those questions, we just let ourselves do it, which is how I think so many of us find ourselves in that position of, okay, well, I just have to be the one to do it because we don't work through the and get to get to the place that you said, which is, if I keep doing this, I will get to a place where I leave in five years or two years or whatever, and then think about all of these other patients that I will never be helping with the rest of my career.
So many of us just can't see past that canyon jump and don't work through it, I think. And it's not, they're not doing it intentionally. It's just, it's coming from a really good place. And I think we as a, as a group, as a, as an industry really have to think about the rational that you just gave us, like the, we can't do it if we don't take care of ourselves and get more team members.We won't be able to do it for a long time. That is so easily overlooked.
Dr. Andy Roark: Let me see if we've come to a point of agreement here. So, so we both agree that sometimes pushing the boundaries feels good and it can be a positive thing. And we both have agreed that if you are, if you're overwhelmed or you're really short handed and you do not make an intentional choice to set boundaries, you're going to drift away from that most likely to, to being overwhelmed all the time.
And it's not fun anymore. And so I think you and I are both there. I don't think that it's, I don't think that it's if you stay late from work three times, that's it. You're done. It's not that. But I do think if you stay away from work three times, I think your question of why will the fourth time be any different? I think that's a very valid question. I think without intentional action and decision, the path is to slide that direction. It's okay. I think you are in agreement there. All right. I love it. I'm totally fine with that.
Stephanie Goss: What else from a headspace perspective, because I think that you can't be all things to all people. It sounds so simple and like you can't pour for an empty cup. And I think that's some of the hardest work to actually truly accept that from a Headspace perspective and, and, and, and do that and lead that way. What else do you think of when you think of headspace?
Dr. Andy Roark: Remember that your job as a leader is balance, right? It's not your job to make the clients happy. It's not your job to see all the pets. It is your job to balance the needs of the pets, of the clients, and of the staff, and of you, and of your family who you go home to.
And you have got to keep those things in balance. And when we tend to be shorthanded, what happens is, the needs of the staff and my family and myself tend to get overlooked while I try to meet the needs of the pets and the clients. And that's not in balance. And so for me, I think that that perspective is really key is you have got to build, you cannot throw yourself on the sword of, I have to see all the pets. It has to be, I have to achieve balance. And when our work capacity goes down.
Stephanie Goss: Then I can do all the things.
Dr. Andy Roark: Then things have to get rebalanced because suddenly the, the, the, the number of pets coming in did not go down. So we've, we've got that weight, but the amount of weight on the staff side has gone up and now we're tilted and way out of balance.
And so remember the goal, it has to be balanced and that doesn't, it involves taking care of your team, taking care of yourself and taking care of your family.
And the people in your life that care about you. And the last thing is to say, we have got to, at some point, look at this situation, not through a moral lens of am I meeting, am I meeting my obligations to, to the community, blah, blah, blah, things like that.
I think it's okay to use that lens, but then you have got to set that lens aside and you have got to look at it through a pragmatic lens and make decisions based on resources and capacity, right? In some cases like this, the best analogy that I can give to people who are in a practice that's shorthanded and overwhelmed is you're faced with a lot of the challenges that animal shelters have been faced with for decades and decades and decades where you say, the supply of pets and the pets in need, they don't stop coming.
And you, and you unfortunately have to play the resource allocation game. And that's what you have to play. And if you, if you can hire and staff and grow and charge appropriately, you don't have to play the resource allocation game because you're ready. Clients come in, you charge them, you, you know, you meet their needs and blah, blah, blah. But unfortunately at some point it does become about resource management just like shelters and that is a hard transition to make but I say that because there is a precedent because I think a lot of times vets are like that's it I am a terrible person for turning some pets away and making but as I that's that's not unprecedented. That's what it means oftentimes to work with animals. I– my daughter's friend has a litter of kittens under her under her porch.
And so Jacqueline comes to me with these pictures of her of these cats and of course, I immediately said the veterinarian thing, which was, they, those cats need to get spayed and neutered. Like immediately, I had the first, she's like, look at these kittens. I'm like, we need to get some cat traps. And you know, those cats need to get spayed and neutered.
That was the first thing I thought. And so then I started looking around and I was like, I don't know, I don't know a place that does, you know, trap. I, cause I was just like, I don't have any tie to these cats. What I really want is a trap neuter release, you know, Operation Catnip style thing of get, get, get the ears clipped and back out they go. That's what I wanted. And so what I found is that the, the county animal shelter will do that. But they can only take the number of pets that they can handle in a day.
So there's a line that forms at 730. I've driven past there on, on my way, you know, on my way back from CrossFit at 7:30. I've driven past it. And I like, I was like, wow, what people really want to adopt today. It's like, nope, Andy, they were dropping. That's it. But, But,they only take that. And, and, and, and I, and I asked around and the story I heard was, you know, sometimes people will show up at 7:30 and the people in front of them, like, that's it. That's all the capacity we have. And they get, they, an hour later, they get turned away.
And I go, that's, the shelter's not bad. They're doing what they can with what they have.
Stephanie Goss: The best they can with what they have. Yeah. Yeah.
Dr. Andy Roark: So they’re not bad, just like you're not bad for saying this is the capacity that we have. So anyway, I think, I think, I hope that I'm talking to an audience that has love in their heart for, for shelters and for animal rescued animal work. We need to extend that same grace to ourselves when we simply have limited resources. And so anyway, but that has helped me to not be okay with saying, I'm sorry, I know we're booked out. We're closing on Saturdays, like, or we can't see you until tomorrow. We don't have capacity to take on any more pets tonight. It doesn't make it feel good, but it helps me to know that there is a precedent that this is what often, what it means to try to serve
Stephanie Goss: To keep going another day. Yeah.
Dr. Andy Roark: exactly to keep going another day. And like,
Stephanie Goss: Because it's like, if the shelter doesn't do that, then the, think of the hundreds of thousands of pets in the next five years that they won't be able to help. That totally makes sense to me.
Dr. Andy Roark: Yeah, when, when they can't keep a vet because the vets, you know, overwhelmed and burned out and exhausted then think about the net loss to that community. And so anyway, I think we should give ourselves the same grace when we have vet clinics that are shorthanded. Again, I know these are for profit clinics, but the simple math of trying to be there for your patients, that, that, that's the same. And so we should hold onto that. So I think that's it for me, for headspace.
Stephanie Goss: Okay. You want to take a break and then come back and talk about some action steps?
Dr. Andy Roark: Yeah, let's do it. Let's try to help these people.
Stephanie Goss: Okay. Hey, everybody. I want to talk for a quick second about something brand new. That is a member benefit of being an Uncharted member. One of the things that has brought our Uncharted members together since the beginning has been the love of getting together and feeling that connection, that cup filling experience that you get when you're with your peers.
And so we have our brand new Uncharted Anchor Fest. We've pulled together a bunch of our favorite community events. We get together one time a month, we spend three or four hours together. It's broken up into different chunks, so you can attend to some of it. You can attend all of it, but it's there for you.
It's a flexible and customized structure that features workshops. We've got case study activities where we dive into specifics about things that could actually be happening in your practice. We have hallway conversations to dive into the topics that our community is asking about the most. And all of these things are tied together to help you excel in your practice.
So, if you haven't been over to the website lately, go check out our Uncharted events calendar. It is amazing. We have got so much coming and you're not going to want to miss it, including our upcoming anchor Fest. Unchartedvet.com/events will get you all the info that you need. And now back to the podcast.
Dr. Andy Roark: All right. So first, the first action step for me is we have got to we have got to, we've got to lock the door. We have to lock the door for just a moment. We might, especially if you've only got a couple of people like they do, it might be time to go out to dinner together and let's, and let's go out to dinner and let's get, let's get pizza. And so everybody can eat their fill and just get all carved up and let's just have a comfortable dinner together and let's talk about where we are and let's talk about what's, what is feasible, right?
And there's really, to me, there's two steps here. The first is, can we be more efficient? Are there things where we are not working together? Are there simple things that we can do to speed up? Let me be clear here. I don't think you're going to solve your problem here.
Stephanie Goss: With efficiency.
Dr. Andy Roark: With efficiency, but are there simple screws that we can turn to get more efficient before we start setting our boundaries? You know what I mean? So like jumping, jumping back to the shelter example, are there ways that we could how can we work efficiently to do spays and neuters so that we can take 20 cats instead of 13 and you say, well, like that's seven a day.
That's 35 a week. You know, that's 150 a month. Like it is anyway, but you get the point. It can't— can, are there screws that we can turn? And so a lot of times what happens is we look at our, we look at our practice and we say, okay, can we get more efficient? And I'm not talking about, can we work harder? Can we run faster?
Which a lot of people hear efficiency is going faster. I'm like, no, are there things that are tripping us up that are slowing us down. Are there places where we see redundancy and work, meaning I, the technician, am doing a bunch of stuff. And then I see you, the doctor, doing the same stuff again. Like, that's frustrating. And I see, I just see a lot of that stuff. Are there, are there systems that we could build just for getting people checked in, things like that? Do we have to, you know, is it time to turn on a phone tree?
Stephanie Goss: Right.
Dr. Andy Roark: Instead of answering the phones in the morning, something like that, all of those, that's, that's the type of stuff that I'm talking about is what are your options to try to make your life easier without limiting our services?
Let's start with that and see what we can do.
Stephanie Goss: I agree, I agree with that. And I would say for me, the step before that, and this is, this is, this is a hard, a hard one because if it's not your practice, getting your practice owner to look at this might be hard. And as a manager, the first place that I would start is, okay, my needs from a business perspective in terms of cash flow are dramatically different if I have one employee and I'm open eight hours a day versus if I have six employees and I'm open 10 hours a day, right?
Like the, the needs are dramatically different. And so. from a rational headspace place, it makes sense to say, I, I cannot, nor do I need to do the volume that I was doing with six team members when I have one. And a lot of us skip looking at that step and we just think, well, we've been at this, this is where we've been.
And so even though we're down here now, we still need to try and operate up here where we've, where we've been. And so I think the first piece of it is looking at what is that actual gap, particularly if there's money concerns in this instance, in terms of investments and stuff like that.
If there's, if there's money concerns, like sit back and look at what is the actual cashflow necessity, and then look at that from the perspective of, okay, if this is how much we need to keep the doors open for these hours, how many patients can we take care of? And then go to your, to your point, Andy, how can we maximize our efficiency to take care of as many patients in that space that will allow us to cover the bills and not be, you know, not be worrying like, are we going to be able to make payroll on Friday kind of a thing.
And I think that a lot of us skip that step and go straight to the, well, To your point, they don't even look at the, can we be more efficient? They just think, how can I work harder? Cause you, cause it's that, it's that panic reaction.
Dr. Andy Roark: Yeah. I mean, I think I always have to throw this out. Supply and demand. When you are shorthanded, that means the supply of care is low, and that means the demand goes up. The classic business approach to this problem is to raise prices.
Stephanie Goss: Right.
Dr. Andy Roark: We are doing more work than we can do. The prices are going to go up and people go, but then some clients will leave.
And you go, yeah, that's, that's, part of the point. Is, you know, we, we have got to, we are working at max capacity. We need some people to go somewhere
else and, and raising the prices away. to kind of make that happen now of course I'm not trying to jack prices up on people that's not that's not what i'm talking about but it is how basic business works is if your capacity uh if i if i can make 100 widgets in a day and sell them and they all get bought and then my partner leaves and now i can make 50 widgets in a and people are standing in line trying to get widgets, the price of those widgets is going to go up.
Stephanie Goss: Go up.
Dr. Andy Roark: And, and some people are going to stop standing in line, and that's okay, because the people who want it are going to get it, and I'm able to, to keep to keep going. And so anyway, that's, there's part of that, and I don't like advocating for raising prices, but in this case, I think it's probably part of the overall It would make sense, especially if we were like, Hey, the owner's cash strapped, we can't afford to hire somebody. It's possible that if we raise prices and we would able to one, get our overwhelmed down and to generate enough money that we could then get some more people in.
Stephanie Goss: Yeah, I think, I think, that makes sense. And I think that's, that is absolutely part of the, that like strategic thinking in terms of like, okay, let's get out of the panic headspace and let's look at what do we actually need? And then to your point, can we, can we make this more workable by doing, doing an increase?
Are we at that lower end? Do we have space to do that? Cause that will, you know, maybe solve some of the, the client problems. And again, I think we, I think so many of us hesitate to think that way. And I know I experienced this every time it was time to do price increases in the practice. And the team would worry and they're like, well, we're going to lose clients if we raise prices.
And my response to them always was, yes, we will. And You got to work through why are you worried about that? Because where it's really coming from is that feeling of we have to be all things to all people. No, we don't. We're going to lose some clients. And that is true. Are we going to lose some clients that maybe we really like and we wish that we didn't lose. That is also possible.
And when we look at the business itself, the we know from Pareto's principle that 20 percent of our client base is giving us 80 percent of the business. And so if we're losing some clients at the bottom end, does it suck? Yes. But is it going to be the end of the world? It's not.
And so many of us, so many of the team like looked at it, like we can't lose any clients. You, you, you can and you should, because there is a, there is a fine point of what you can do as a business. And so I think your point, Andy, is great. And I love looking at that as part of that, that strategic plan. And, and for most of us, because we're in that panic state, it's really hard to sit down and think about it from that practical perspective.
Dr. Andy Roark: Yeah, I think you’re spot on. Let’s talk about the conversation here. Cause we talked about this person was like, I'm not the practice owner, but, but I gotta, I need to talk to this person.
I I think, I think the conversation with the team is a sticky wicket for a lot of people. And so, you know, I, I think in, in my mind, I'm just going to put this out as a general conversation, regardless of who you are.
I think I think a well done conversation around this, it starts with vulnerability. Right? It is not about the sky is falling. It's, I, I would avoid flowery language, you know what I mean? Of like, we're all getting ground to pieces. Like, it's like, let's, let's not, let's not get dramatic here.
Let, again, that doesn't, that doesn't help. But let's get honest about how we're feeling and sort of say, hey, you know, we, we are. I don't know that we're keeping up with the, with the requests we're getting for care and then, and then try to speak in specifics. This is, these are the behaviors that I'm seeing.
We, you know, we've got, we're, we're, we have not gotten out of the clinic yeah, eight o'clock at night for the last, for the last two weeks. And I, I want to just touch base and say, is that the plan for the future? Is this again? I, I have gotten that's been sort of a go to for me recently as I just, is it, is it the plan that we're going to continue to get out of here around 8 o'clock at night?
Is that what the plan is? And I do that because it often is not perceived as being aggressive. But it, but that's frame up the issue as well. If the answer is yes, we're going to suck it up and work until eight o'clock. I'd like you to tell me that now and if, but, but it makes it, it draws that conversation out in a fairly productive way.
At least, at least that's what I've seen recently. And so anyway what are, what are, what are we talking about here? And, and, and what is, and are you guys seeing this? And what is the plan? We want to make sure that we speak in specifics about what we're seeing and hearing. And this is a part that we have to tease out in these meetings that often these where these meetings go off the rails. It is one of the one of the things we have to get pragmatic about is it's one thing to say, I'm tired. I'm burned out. We're working all the time. It's another thing to say, these are the specific situations that are causing me the most frustration. But if you can't make that jump, it's really hard to fix.
And so I hear a lot of people get together and they all talk about how burned out they are or how tired they are. But there's no consensus about what needs to be addressed in order to reduce that. It's just, we, we, we can't be this tired. And so a lot of times I'll seek practice and they're like, great, we're going to close on Wednesday afternoons.
And maybe that's what you need to do. But, but I have seen clinics where there's a half dozen clients that treat the staff like crap and yell at them. And then your staff tells you that you're burned out and you close Wednesday afternoons. And now you haven't done anything to actually address the problem.
And I want to be kind to people here and say, it's funny. Sometimes these are really hard to articulate. Think about, you know, context matters and the situation matters when people think it does. If you're running a race. And you think that you're in 1st place and someone says, how do you feel? You would probably respond to that question differently than if you were in last place and everyone was running away in front of you, even if you're running at the exact same pace and someone says, how do you feel?
You're going to get radically different answers. And so a lot of times the team says, I'm so tired. I'm so burned out. The truth is there. They are frustrated. Because they don't think they're having an impact. They are frustrated because they're hearing negativity from clients and they're not feeling appreciated.
Again, not always. I'm not trying to say ignore You know the words that we're exhausted but we have got to dig into this a little bit because there's sort of vague language around how we're feeling.
That doesn't translate to something pragmatic. And so we've really got to get into that. So the questions I'm asking these meetings are “How are you guys feeling about how things are going? to um What, what are, what are the situations you think that are having the biggest impact on us or making us the most frustrated or making us the most tired?
What are some things and what are some things that, that we can make changes and help?” And in this case too, I'm going to really lean back into our affirmative inquiry, which is asking the team not what is bad because a lot of times they don't, they'll tell you what's bad, but they don't know how to fix it.
One of the best ways to approach it is to say, Remember the last really great day you had. What happened in that day? Why was that a great day?
And they'll say, Oh, well, we did not have a single client raise his voice to us. And you go, Oh, that's, that's constitutes a great day. Oh, but, but, but they've just given you some real clarity about what we can do to, to intervene and try to make a difference here.
And so anyway, but those are the types of questions I would have is what does a great day look like for you guys?
And then we start to kind of work around, work around in that, in that regard. Know that as you start to make some adjustments here, Rome wasn't built in a day. And I would tell the team, we're going to try some stuff. And if it doesn't work, we're going to try some other stuff. Or if it kind of works, but it doesn't work enough, then we're going to add more.
And if we do this for a while and it's great, and then we feel like, hey, we can loosen back up and make ourselves more available or help more people, then we'll loosen back up.
But that's really important because a lot of people get into the mindset of, We're making permanent changes right now and that's too much stress and pressure. And then also you don't know how big an impact some changes to the way you practice is going to have. And so be kind to yourself and try some things, set the expectation that we're going to keep making adjustments.
Stephanie Goss: Well, and I think that's where it falls apart, particularly when it comes to being short handed in, in two ways. So one is, I think for a lot of us, we think if we can just get more people everything is going to be easier. And the reality is, that's never true. Because when we add a person, there's always a significant increase in the workload at first, because you have to train them, you have to show them where things are, you, and that's why so many of us operate in that place you're just jumping in the deep end and figure out how to swim because we don't plan for that additional workload that comes with adding to people to the team.
So I think that's number one is don't expect that if you just add bodies or, or throw bodies at the problem, that it's actually going to solve the problem because it's probably gonna make the problem worse.
Dr. Andy Roark: Yeah, you're gonna have to onboard. I think that's a really good point. I, I think anybody who's holding on to the, we'll get three more people in here and then we'll be back at full capacity. No, you won't. You get three people in there and then it'll be three to six months of onboarding and getting them up to speed and hopefully you'll get
Stephanie Goss: Yes. And, and that's the, uh, the other half of that where it falls apart is for, and this is, I'm speaking to the managers and owners because I have made this mistake myself. And I think it's a, I think it's one that we make commonly and it is absolutely detrimental to the team, which is, okay, now we've thrown bodies at this problem.
Now we're going to go back to that patient load, or now we're going to go back to that business load. And we raise, we, we increase. So we crank the pressure up because we're like, we've got the bodies. Now let's go back to running a wide open, like we, we, compress things. We stopped seeing as many patients.
We, you know, we, we started, um, you know, not taking patients after four, whatever the things were we did to make space in the schedule and survive the being short. When we put those bodies into place, too many of us don't actually think about that time period that it takes. Cause you've got more work.
You've got to figure out new systems. You've got to figure out the new people, all of that. And we immediately crank that pressure back up within the first, some of us wait. you know, two to two to four weeks. Then we're like, cool, everybody's doing great. Let's, let's start taking more patients and let's open the schedule back up.
Because there's the things I, especially when cashflow is an issue, there's this thought of, well, now I've added more bodies. Now I need more money. Now, so it's this spiral of, bad, bad choices made for good reasons, right? I get why we're making the, the choices and they're still the wrong ones because when we turn that pressure up, then we get to the place where everybody is immediately overwhelmed.
We don't support the new staff. They don't get the training they need. And then things fall apart six months later when everybody quits again. Right? So I think that's, those two things have been got to be considered when we do the action step that you talked about, Andy, which is like, this is not going to happen overnight.
Rome was not built in a day. This is a, this is a process. I think we have to consider both of those two things and try and avoid those two giant gopher holes that are waiting for us.
Dr. Andy Roark: Once you get the chaos into the box, for God's sakes, don't hire three people and then throw the lid open again, you know? And I see it, I see it all the time and see it because I don't think it's generally profit driven. Uh, you know what I mean? I, I mean, I'm sure sometimes maybe it is, but I, I, it's not usually my impression.
I think my impression is that everybody in vet medicine hates saying no, they don't like conflict and they don't like saying no. And so as soon as they perceive that they are staffed to where they don't have to say no, they stop saying no, they start saying yes.
Stephanie Goss: Yes.Yes.
Dr. Andy Roark: You know, I, I think, I think to someone who was like, well, I, I want to say yes, I would say, okay, well, once we have gotten the chaos back into the box and we have set some boundaries, uh, you can see the pattern here.
Stephanie Goss: Keep it in the box.
Dr. Andy Roark: If you, if you want to increase capacity, we should be, rather than throwing the doors open and letting the chaos run back in, we should be intentional about how we're going to increase capacity. And let's be smart. It's funny. Um, I think it's the natural cycle of business is you open the doors and you have minimal systems, and then you just go until things are completely nuts.
And then you go, this is not working. We can't do this. And then you fight the chaos back into the box. And then you're like, whoo, I feel good. And then you release a different kind of chaos, uh, into the, you know, into the building.
Stephanie Goss: This doesn't sound, this doesn't sound remotely familiar at all.
Dr. Andy Roark: I, I win. I went to the Nutramax headquarters, you know, Nutramax that makes Dasuquin and stuff like those, it's got, they're, they're great but, but they're great, but they, they're based here in South Carolina and I was invited to, to their headquarters to see the facility, everything. And so, so I went and it was funny. It was sort of, I took about half of the Uncharted team and we were there and we got to meet with the leadership team at Nutramax and sort of the, the, the, Founder head of of Nutramax is there.
He's a veterinarian. He's just a neat guy. But he was sort of asking me about the future for Uncharted. And I said, well, you know, we're going to try some things and we're going to see how they go. And uh, some of them probably work and some of them probably won't. And the whole Nutramax team fell out laughing.
I said, I just kind of looked at him and he looked at his team and he said, You guys have heard something like this before haven't you had like, they, they were like, they just rolled on the floor and it made me feel great because it was like, see, Stephanie, guys, other companies do it this way too, is they're like, we're going to try some stuff. some of us going to work and some of us not. And we're going to clean up. We're going to clean up the mess from the part that didn't work. And we're going to keep doing the part that did. And that is how you run a business, Goss.
Stephanie Goss: I can't you know, I have a feeling we have listeners who are like Dying laughing just because we're laughing but also I have a feeling we have listeners who are like Oh, Yeah. That sounds really familiar.
Dr. Andy Roark: Yeah.
Stephanie Goss: Because it's not just us, right? It's not, that's, that's, and, and I think the, the big thing where I look, I look at you sometimes when we do it and I, and I say, Hey, If we do the same thing over and over again and expect different results, it's insanity, right?
And if we do the same thing over and over again, at some point it becomes your business model. So if we make mistakes, let's make different mistakes next time. Like let's not make the same
Dr. Andy Roark: We come up with new and creative mistakes. I'll tell you that. We don't make the same mistake again and again, that's for sure.
Stephanie Goss: Oh man, this was, this was, this was fun.
Dr. Andy Roark: Yeah, this is a good one. Thanks for talking through with me.
Stephanie Goss: Yeah. Have a great week, everybody.
Dr. Andy Roark: See ya 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.
