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Practice ownership

Nov 13 2024

Is Selling To Corporate My Only Option?

This Practice Owner is worried about their next steps after being with the practice for over 10 years. In this episode of the Uncharted Veterinary Podcast, Stephanie Goss and guest Bret Halishak discuss the challenges solo veterinary practice owners face when considering their exit strategy, and how to position their practice for future success. Bret provides valuable insights on maximizing practice value, operational efficiency, and the importance of team development. He emphasizes the need for practice owners to understand their financials, leverage their team's skills, and build a strong practice brand that is not solely reliant on the owner. By implementing these strategies, practice owners can create a sustainable and attractive business, ensuring a successful transition and preserving the legacy of their independent practice.

Bret Halishak is a practice broker with Total Practice Solutions Group, specializing in helping veterinary practice owners in the Great Lakes region navigate the complexities of selling their practice. With a background in practice management and a deep understanding of the veterinary industry, Bret is passionate about helping practice owners achieve their financial goals and find the right buyer for their practice.

Uncharted Veterinary Podcast · UVP – 314 – Is Selling To Corporate My Only Option

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

Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

🌟 Level Up at the 2024 Practice Owner Summit! 🌟

Ready to take your practice to the next level? From December 5-7, 2024, the Uncharted Practice Owner Summit in Atlanta is the ultimate event for veterinary practice owners looking to grow their business and gain control over their future. This year, connect with Bret Halishak, a seasoned practice broker who specializes in guiding practice owners through buying, selling, and maximizing the value of their businesses. Join like-minded owners facing similar challenges, learn proven strategies from top experts, and work on your long-term goals in a collaborative, fun environment. Whether you’re looking to streamline operations, explore transition options, or reclaim more of your day, this summit will give you the tools and connections you need to thrive. Don’t miss out—secure your spot now and join a community dedicated to helping you succeed!

🌟 Get Ready for Uncharted’s New Conflict Resolution Certificate! 🌟

How do you teach your team to handle conflict? How do they talk through the tough stuff—the tiffs, the beefs, the classic front vs. back friction? This is one of the biggest questions we get asked, and after years of hard work, the Uncharted team is excited to bring you a brand-new certificate in the foundations of conflict resolution. This isn’t about managers solving every problem; it’s about empowering every team member to approach conflict in a healthy, productive way. Get ready to help your team build stronger connections, communicate confidently, and lean into positive conflict. We can’t spill all the beans yet, but head over to www.unchartedvet.com/conflict to sign up for updates. Be the first to know when it launches!

Upcoming events: unchartedvet.com/upcoming-events/

All Links: linktr.ee/UnchartedVet


Episode Transcript

Stephanie Goss: Hey everybody, I am Stephanie Goss, and this is another episode of the Uncharted Podcast. And this week on the podcast, I am joined not by my partner in crime, Dr. Andy Roark, but by my dear friend, Bret Halishak. Bret is a practice broker , which means that he helps practice owners find buyers for their practices.

He helps practices understand what their practice is worth long before they're thinking about selling. He works with Total Practice Solutions Group and he is in the Midwest. He is a dear friend. They are a supporter of Uncharted, but Bret is here today because he and I have had such great conversations over the years about how to help private practice owners stay private and be indie and have that rebel spirit. And we got a mailbag from a private practice owner who is a one doctor practice who maybe is asking some questions about Is it wrong if I want to stay a one doctor practice and is it wrong if I want to stay independent in this ever increasing consolidated world of veterinary medicine?

This was such a fun episode. Let's get into it.

And we are back. It's me, Stephanie Goss, and this week I am joined by my Dear friend, Bret Halishak. Bret is a practice broker with Total Practice Solutions Group, and Bret and I have known each other for a few years now, and we got a mailbag question from a practice owner who has some questions about exit strategy. And Bret was the first person who came to mind to talk this through. Bret, welcome to the podcast.

Bret Halishak: Long time. First time. I'm happy to be a part of it. Thanks for having me. 

Stephanie Goss: I know. I'm so excited. Bret and I have had awesome conversations along the lines of this mailbag question before. And so I was really excited to bring him on to the podcast. Bret, do you want to introduce yourself to everybody and tell them a little bit about how we, you know, how we got to work together at Uncharted and kind of what you're up to because your role, you've been in the industry a long time in multiple facets and you your role has kind of changed in the time that we've worked together at Uncharted.

Bret Halishak: Currently I'm a practice broker with Total Practice Solutions. I'm in the Great Lakes, so I'm in the great city of Cleveland, Ohio. I know, I know it's not for everybody, but it's near and dear to my heart. 

Stephanie Goss: Yes, I was just there this weekend. We were just talking about that.

Bret Halishak: Yeah. Everyone loves to come to visit. Everyone loves to leave sometimes,

Stephanie Goss: Yep.

Bret Halishak: but neither here nor there, there's obvious discourse on Cleveland.

But I've been a part wit h TPSG for almost two years now. And I love what I do. You know, sometimes practice owners are well prepared to exit. Sometimes they're not. So we meet in the middle, we help provide practice valuations so they understand the financial health of their practice, which is great.

Sometimes that can be eyeopening. Sometimes that can be reassuring depending on what side of the coin you're on. But ultimately we help people buy and sell their practices whether that's on a private sector or in the corporate world as well. We're a one stop shop for veterinarians, which is great.

Stephanie Goss: Yeah, you and I have had a lot of conversation because we met working together for our practice owner summit several years ago. And you've been kind of all over the map in different, in different facets of, of the industry, like we talked about, and you have such a unique perspective, I think, because you've, you've worked on both sides, like you've worked with practices not obviously at their end of life and trying to sell and get out of practice as a broker.

But and one of the first conversations that you and I ever had was about how often we have practice owners who get to a place where they are ready to get out of practice and they have no clue how many years of prep work they have in front of them. And they're like, okay, I'm ready to be done now, not realizing that they should have started that process of, okay, I'm ready to be done now, probably five, and even in some cases, 10 years ago, to get their practice to the place where they want it to be in order to get out of practice and maximize their sale. And so you and I kind of bonded over our desire to help practice owners understand their own finances, understand their own, you know, practice numbers and really help set them up for success so that they weren't in the position where.

Their only option was to sell to a low ball corporate offer or close their doors entirely because they were what's considered a no low practice. So no, or low value at the time of sale. And nobody wants to buy it from them or a bank won't fund the private sale to an associate if they find one or, or whatever.

So, I love your, passion for helping. Practice owners. And it's a big part of why we're going to have, we're going to see you. I'm going to get to see your face in real time in, it feels like just a couple of short weeks, but we're going to be together in Atlanta December 5th through 7th.

We have our, this year's practice owner summit, and there's still time. If you are a private practice owner and you want to join us and join other practice owners Bret is going to be there. You're doing a workshop, right. At practice owner summit.

Bret Halishak: So yeah, we'll have a couple of my colleagues down there, but we'll be doing a workshop on just planning for your financial future. You know, for the first hour, we'll do some discussions around where your expense ratio should be. Some KPIs, some key performance indicators. And then the second half we'll be doing some applications.

So rather than just, you know, listening to the talk, we'll go through some numbers, see where you stand, see where we can maybe make some improvements. Some attagirls, some attaboys, you know, we'll make sure to cover the whole gamut to make sure everyone is on the same page with where they stand and where they need to be.

Stephanie Goss: That’s one of the things that I love about working with you is that you really want to help practice owners understand it and make it simple for them. And so I'm excited to, for them to actually be able to bring their own practice numbers and kind of dive into things in the workshop with you and with their your colleagues and we've got a great lineup for Practice Owner Summit. So if you're listening today and you're a practice owner and you'd like to join us, you still can and if you head over to the website at unchartedvet.com/events you can find the details for Practice Owners Summit.

Summit, and if you're listening today and you're like, but I'm not a practice owner. I think that if you have an interest in being a practice owner or really honestly, if you are a practice manager, this episode is also for you because one of the key functions for me as a practice manager always was to help my practice owner when I was in private practice.

But applicable I think to corporate practice as well. Like your job as a manager is to help the success from a business perspective of your practice. And so understanding what is required to get out of practice or to grow practice to that next level is really really important. And that's what we're gonna be talking about today.

So I got a mailbag letter from a practice owner who is a solo practitioner. So this is a private practice model. But again, I think this applies to corporate practices as well. Having worked in corporate practice as a manager in terms of leveling up and growing the practice to the next step. But this is a solo practitioner.

They've been in practice and out of out of school for about 10 years. And they said, you know, like, like many of us, I'm seeing a significant shift in our industry practices that used to be one or two vets and sell as a one or two vet practices seem to be growing to that three to five doctor model in order to sell.

And so they find themselves considering that what is the path forward? Is this the right path for their own practice? And they said, you know, I'm trying to find a single associate, but that's hard. And so. Growth is exciting and it comes with a lot of questions and what you know, especially as someone who is looking at continuing to be a private practice owner and their email was so great.

They had so much wonderful things to say about their clients and their team and the culture. That as a solo practitioner, they've spent 10 years building. And I can imagine in my head after reading this email, this practice, right? It's the kind where the doctor probably knows all of the clients. The team knows the client.

You walk in the lobby and you immediately get that. Everybody knows me here kind of feel right. Like that's what is so special about those smaller practices that really have that that strong culture where they have. built a little corner of their community. And so this doctor is like, look, I love that.

And I have been committed to building that kind of culture so that I could bring on an associate who would want to buy the practice from me. And they're feeling pressure because they're at a point where they are starting to think about what. Their exit strategy might be, and they feel like what they're seeing from their perspective, and I'm curious to hear, Bret, your thoughts on is this actually reality, or is this just their perception based on their seat where they are at the moment?

But they said, you know, it seems like banks are less willing to fund the sale of privately owned practices especially for smaller practices that they want to see the bigger returns that corporate Corporate practices are still offering significantly higher multiple multipliers compared to private practice sales.

And so they're like, you know, I feel this fear that the deck is stacked against independent. practice owners and future owners, and that I'm worried that if I do grow my practice and I become a three to five doctor practice or even a two to three doctor practice, that then my only option will be to sell to corporate because banks won't fund a single owner when you have that two to two to five doctor volume, gross volume, I guess, and revenue every year.

And so they said, how do I, how do we continue to support that midsize and very small practice model, ensuring that they can stay private when it feels like the financial barriers are stacked so high against them. And so they're asking like, how do we keep private practice ownership, attractive to people and feasible in rising corporate interests.

You know, we've seen the landscape shift significantly, even just in the last five years in terms of corporate versus private. And so I just thought this was such a well crafted question and ask and is really, really relevant in the landscape of the industry today. And I thought there was no one better for me to chat this through than my friend, Bret Halishak. So let's get into it, friends.

Bret Halishak: Absolutely. 

Stephanie Goss: So what do you think like off the bat from a headspace perspective, because this is one of the things that you do so well, you have such a gift with empathy and really seeing the world from the perspective of the practice owner. So if you're this practice owner and you've been out of school 10 years you're probably in your, you know, I would say maybe mid forties, you're thinking ahead smartly to retirement.

Which is not imminent necessarily. So you're thinking ahead. What are some of the things that you should think about from a headspace perspective as you kind of approach this? Do I do the dance with the devil and grow and become corporate? Do I stay small and be an indie rebel? Like I love that spirit and I wanna, I wanna take care of my team and my clients.

And in the middle of that is this, the wrestling between the two sides of when you buy a practice and you are a practice owner, I don't care who you are. I don't care what you think your goals are. A part of that decision is this is part of the nest egg strategy for retirement. It may be all of the nest egg, or it may be part of the nest egg, depending on how well you've planned.

But no one gets into practice ownership without thinking about the return on the investment at some point down the line. So what are some of those things that this practice owner and all practice owners should kind of think about from a Headspace perspective?

Bret Halishak: Yeah, absolutely. And you know, that's a great mailbag question. So thanks for thinking of me and having me on again. But to your point, this conversation happens frequently, whether it's a phone call, you know, an email a trade show booth, you know, people walk by or just want to talk to say, Hey, I'm a single doctor.

What do I do? Like they're already maligned to the fact that they are on one end of the spectrum where they don't want to be, but they want to be somewhere else. So

Like you said, I like to be empathetic, but also comforting. Like you're not alone. There's a lot of people out there like this. And to your point, the question is, do I rip off, rip off the bandaid?

Do I jump in? Do I go, okay, I got to grow this by another doctor or two. What's involved in that? How do I do that? How's my staff going to react? Because it's going to be longer hours for them, potentially, you know, there's a whole not massive shift, but yes, there is, there's a paradigm shift involved with doing that.

And it all depends on the type of practice and the type of mentality that I find with the owners. You know, for this, you know, one specifically, you know, in their early, mid forties, you know, there's a lot of time left. It depends on when your retirement age is and what your goal is to your point. The nest egg, is it all?

Is it some of it? Hopefully it's not all of it. You know, that's one thing we encourage practice owners is, you know, don't bank on your, your exit strategy being your loan nest egg to fuel your future. You want to make sure that you're doing some other things that you're not put in that situation. But in this situation, I would definitely say go for it.

You know, there's some things that you got to make sure are in line, like I mentioned staff and some other things. But the one thing that I constantly see with some single doctor practices that are on the cusp of do I grow or do I stay the same, you know, the Indy model, like you mentioned, it's one of those where how can I invest in the practice without disrupting the practice?

I think sometimes that's where a lot of practice owners get wrapped around the wheel is I have to do this. I have to do that. Well, let's take this apart piece by piece. What can we do here? What can we do there? Where's some short term gains and where's some longterm gains? What are some things that I can implement with my staff?

That's not going to disrupt everybody. That's the low on a change management dial. And, you know, to your point, being in the industry for 16 plus years I've had a wealth of knowledge with practice, workflow, practice, efficiencies, things of those natures that can help aid to that growth before you actually take the rip at the mandate off and say, okay, let's go find an associate.

Let's go find a partner, a co-owner, all depends on what type of structure that you're looking to implement in your, in your practice. Again, you know, for this type of question and this type of, you know, where they're at in their career, hopefully they're working with some type of externship or internships where they're able to get some more newer potential opportunities in the, in the practice.

You know, I think that's where a lot of people have had success that I've worked with some operators throughout the country and, you know, specifically in the great lakes, you know, luckily, you know, we're in big 10 country where I'm at. So there's a lot of veterinary schools around us, which is, you know, very fortunate for a lot of people I'm talking to, but, you know, making sure you're engaged with those communities is huge, whether it's the technician school, whether it's, you know, with the school itself.

You know, there's a lot of different students that are looking to come back to where they're, you know, where they're from and try to see what they can do. It's one of those where again, if you're able to implement, you know, some minor items to help make your practice attractive, that's huge. 

Stephanie Goss: There's a couple things that you just said that I want to, that I want to pick apart. And I want to, I want to go back to one of the, one of the first things you said, because I think for a lot of people there is this question of should I grow? And when we ask ourselves that question, one of the things that we're doing is comparing ourselves to others, right?

And Andy and I talk about this on the podcast all the time. Should is a very dangerous word. And I think there is this perception and I got this sense from this mailbag letter. There is this perception in our industry that everyone has to grow or you're going to die, and I think one of the headspace pieces that's really important, and one of the things that I love about your what you just said, and this is the second piece I want to pick apart, is that No one is telling you, no one is standing over your shoulder saying you have to grow and I think that there's this perception for practice owners that like the idea is you're going to always grow incrementally year over year over year and I think one of the things that I love about the uncharted community and being able to connect with so many different people in so many different geographic areas.

I mean, we have members across the entire world which big shout out to our Australian members who listen in what is like the middle of the night or the middle of the night, their time in the middle of the night, our time. But you know, we have people in all different demographics and the reality is there always have been and always will be practices of different size and The should is really dangerous here because I think from a headspace perspective, I think it's okay to spend some time wrapping your head around, what is it that you actually want?

Like, stop comparing yourself to everybody else. Stop worrying about what you think you should do. And I think the question from a sales perspective, and this was, this was a question you and I talked about the very first conversation we had, where we had practice owners who were all fired up and had no clue about their practice finances was like, let's stop thinking about the should and think about what is it that you want?

Number one. And then the second question, which is a very separate question, is what is it that you need? And so I think those two are really important because you do this work as a broker now. But it's like, what do you want? Okay. If you want to stay in an independent practice, if having the culture, if having the team taken care of, if those things are high on your list.

You got to write those down. That's important. It's important to know what are those things that you want and what are the things that you need is the secondary question because you may want to stay in independent practice, right? You may want to take care of your team and you may need to get the highest amount of sale possible because you haven't planned for your future. Knowing the answers to those two questions, you're never going to be able to walk yourself easily down a sale path and figure out how to get the best possible sale. But the other piece of that, that from a should perspective that I think is really important is I can't tell you how many times I talk to owners who are comparing themselves to their peers, to the other practices around them, who feel like they should grow and that all they're seeing is this emphasis and I see it as a manager, our industry puts a significant emphasis on growth, year over year growth, revenue growth, change in the number of doctors, change in the size of the staff, all of those things, and it is perfectly acceptable to lean back and say, I don't want to grow, right?

Like, and I think that's the big, the big scary that people are afraid to say no. And so I, I think it's really important to tease that out from what you were saying, because there is a path. forward for all size practices that have to your point. And this was the other piece that I want to get into. You can make changes, especially now, if you're a younger practice owner, you can make changes that allow you to say, you know what? I want to stay a one doctor practice. Like maybe the thing that you want. Yeah. is to sell to an associate who is going to have the practice be their baby the way that the practice has been your baby.

You can do that. And to your point, that still involves making some changes. It still involves workflow analysis. It still involves the prep. Because when you sell as a one doctor practice, It is going to be, and correct me if I'm wrong, from your experience as a broker, it is going to be light years easier to sell to a new grad if you have an electronic medical record system versus paper records.

If you have a team that is efficient and effective, if you have a staff training program in place where you are investing in to your point, whether it's an, an extern program, or you're bringing people in from the outside to develop them as, as licensed technicians, whether it is training from within and supporting and, you know, pouring back into your team.

Practice owners. There are practice owners, potential practice owners out there who desire every size practice and every look practice under the sun. There are people out there for you. And I think I'm curious about your experience with this as a broker. Like the magic is in creating the appearance. The picture and painting that picture for your potential buyers so that the matchmaking happens significantly easier.

Is that accurate in your, in your perspective?

Bret Halishak: Yes and you just took the words right out of my mouth. You know, you can take a step back a little bit. I know the Uncharted communities, you know, very supportive of the V BMA as am I you know, for college students, the Veterinary Business Management Association being Andy's you know, a co-founder or

Stephanie Goss: Yes.

Bret Halishak: You know, I love speaking to them. I love interacting with them. They're a great bunch. Even if you're not a VBMA member, right. You know, it's always good when I go back to schools and talk to them. And it's one of those where you don't know what you don't know. So what I usually educate them on is yes, practice ownership is a reality.

It's not as hard as it may have been in previous decades, you know, whether it's, you know, financing some other opportunities, you know, there's a lot of different opportunities that prior generations did not have that they have, and we don't know that. So I always have a survey at the end of every session just to say, Hey, listen here, you know, where are you located?

Do you need help finding a clinic for an externship? And more importantly, are you interested in ownership? And usually, you know, depending on how many students you have attend those lectures, you I hate calling them lecturers because you don't want to, you know, you know, talk like that to them. It's more of a conversation.

But anyways, you know, they usually say yes from 60 to 80 percent of the time, yes, I want to be, you know, so that's a great start is yes, they want to do it, but how does that become a reality? So to your point, You know, when I'm working with single doctor practices and we go through an office tour or whether it's, you know, me seeing the practice for the first time or a potential buyer seeing the practice to your time, the first time you're right, they go through and there's almost like a checklist.

Does it have this? Does it have that? Does it have this? And if there's a lot of no’s the back of their mind, they're like, well, I got to spend money here. I got to spend money there. I got to spend money here. So it was almost like a laundry list of improvements that they think they have to make day one is almost insurmountable in their eyes.

They listen, you know, this practice is, you know, doing great profitability. It's, you know, it's doing great for the community, but I already have to fix up the exam room. I have to fix up the break room. I have to do this. I have to do that. And it can be overwhelming to a potential buyers. So to your point, you want to illustrate or paint that picture.

As well as you can so that it's not turnkey. We know You know, we, we know that every clinic or every practice cannot have all the bells and whistles. You know, we can't have all the diagnostic equipment they want and depending on their budget and, you know, how they've, you know, they've kept up with the facility over, you know, over the last couple of years.

But at the same time, if you minimize that punch list of things that need to be improved upon or planned out. That helps exponentially for a lot of single doctor practices and even, you know, bigger practices than that, you know, that's the unfortunate part is, you know, I'm a numbers guy. I know numbers are not for everybody, but it's one of those where numbers tell a lot.

You can tell a lot through the numbers. You can see how a clinic operates even without getting in there, but then once you get in there, you can say, okay, you know, this is good. This is good. This needs work. You know, so on, so forth. So the more that you're able to have that picture as completed as possible puts you in a way better position than a lot of other still not to practices you know, on the flip side, you know, when I work with some, some practices, I walk in and say, okay, this is needs a drastic overhaul.

Then that's where, you know, a lot of people are like, okay, do I do a startup? Do I do this? Do I do that? And we all know that with the cost of materials, startups are maybe not as cost effective as they used to be. So it's one of those where you have to weigh all the pros and cons. And the more that you set yourself up to make yourself attractive to a lot of different associates or new grads, that's huge.

It really sets you up to make sure that you're set up for success.

Stephanie Goss: Are there other questions, I guess, because you, you know, you, you have worked with practice owners throughout your career. The different facets of your career. Are there other questions besides asking yourself, what do I want and what do I need? Are there other questions that someone who is in this practice owner shoes and thinking about, you know, how do I figure out which path forward?

Right? And that's what I loved about their question is I imagined this person standing and they've got, they see multiple paths laid out in front of them. They're not pigeonholed into one, necessarily into one path. They're like, oh, well, I could find a single associate and sell to them. I could grow to a two doctor practice.

I could, you know, like they're seeing the potential and they're young enough in their career that they're like, okay, let's do it. I have all these paths in front of me and so doing the work to ask yourself, what do I want, what do I think I need at the end of this, if I was this practice owner and I came to you as a broker and I said, hey, I'm interested in knowing what the value of my practice is currently because I'm thinking ahead, I'm, you know, planning ahead, I've got plenty of time until retirement.

Here's my wish list of the things that I want to get out of the sale of my practice. Eventually, you know, I want to take care of my team. I want to take care of my clients, whatever that list looks like. And here's the list of the needs. I need to sell my practice for X number of dollars, or I need to sell it for X multiplier, or I need to make sure that I keep the real estate or whatever that list is.

And it's going to look different for every practice owner based on the setup of their practice. Are there other questions off the top of your head that you can think of that someone should ask themselves before they start digging into the actual action steps and work that they need to do to prep themselves for potential sale someday?

Bret Halishak: I mean, I think we'll, we'll start with what you said first is just, you know, do they understand their practice financials and does it support potentially the growth, you know, We all know that the cost of labor is increasing, the cost of, you know, goods sold is increasing, you know, whether it's distributors or manufacturers.

You know, it used to be promised that there was, you know, one price increase a year, and now I'm talking to clients that they're incurring anywhere from, you know, two to three to four price increases a year. And, you know, one of my first questions I always ask an operator or an owner is, when is the last time you had a price increase?

And I'm not here to say that, you know, price increases are mandatory, you know, yes, they should be strategic and they're not something you should be doing once a year. But at the same time, there's costs being injected into the practice all over the place. You need to plan for that. And to your point, you know, it's one of those, okay, I've established my want list.

I've established my need list. How do I go from here? You need to make sure that you have a practice evaluation done every so often, because if you don't understand your own practice expense ratios or where you are aligned with some certain items, your projected retirement could be way further out than you think.

So to your point, it's one of those where if I say, okay, I'm ready, I'm, I'm grossing just over a million dollars, you know, we're turning away clients. I'm booked out of surgeries, you know, three or four weeks. We hear this all the time. What do I do next? Well, it says, okay, how is your cost of goods sold compared to everything else?

How is your, your support or your lay staff? Because unfortunately, you know, what we've seen a lot is those numbers have ballooned up and they haven't fixed the other things around them to make sure that it's offsetting those, those increases. 

Stephanie Goss: I love that you said that because I think we both know most people get to that place where they're booked out, you know, a month or further, they've got clients coming out their ears. The team is running from the minute they open the doors until the minute that they close.

And the first thought that goes through everyone's head is I need another doctor. And the smart question that should run through our head is, have I maximized efficiency in the other areas of my practice? To your point, have I looked at my numbers? And that's scary for a lot of people who don't understand how to approach Even tackle it, what the numbers mean, how to approach them, what do you look at?

How often, all of those questions. And the other piece of it is have I looked at our efficiencies and processes? And I love that you bring that up because if you haven't looked at those two things, no matter how busy you are, you're not actually ready for another doctor.

Bret Halishak: Yeah. And, you know, unfortunately when I talk to clients, it's like, Oh, my top line revenue, it's growing. It's growing year over year. I'm, I'm above 10%. I'm like, that's great. That's great. But do you know if it's a leaky bucket if our ratios and our expenses aren't where they need to be. Sometimes it doesn't matter how much you grow revenue.

You're still having problems with the infrastructure. So if you're, you know, there's all these different key performance indicators, depending if you're rural or suburban or, you know, whatever different types of area where your lay help or your support help support staff help percentage should be, you know, it can range in a wide variety and also the type of practice, whether it's, GP, whether it's, you know, ER, so on and so forth.

So it's one of those where if you don't know, you don't know, you could just you can just literally be losing everything out the bottom of it, just because you don't know how the infrastructure is set up, how it's maintained and what you need to do to make sure it is maximized efficiently.

Stephanie Goss: So I want to be Mythbusters here for a second because I think that this is really important and this is, this is important especially for my practice managers who may hopefully are still listening to this because I as a practice manager knew that one of my areas getting into being a practice manager one of my areas of weakness was I didn't understand the business financials.

So I took business classes and I did education. I went to CE and I soaked up like all of the financial lectures. Denise Tumlin, Karen Felstad, they became like my financial gurus. And I learned so much and I am that kind of person where I'll talk to anybody. And so as a young manager, I remember very distinctly going up to Denise after one of her lectures and saying, Hey, I have a bunch of questions. Can I, I don't know if my practice owners know the answers to any of these. And so can I pick your brain? And so I formed relationships with her and Karen over the years and I learned a lot by asking them. 

And so as a manager, that's how I learned from the two of them, this myth busting, which is, I think a lot of practice owners and practice managers think that the only time That you do a practice valuation and a lot of people are like what is even a practice valuation and at its simplest and correct me if I'm wrong the practice valuation is someone a professional sometimes it can be a CPA someone that sometimes it can be a broker someone helping you look at your practice on a working level the valuation looks at your practice looks at the numbers and says if you were to sell your practice today this is the ballpark.

Now, if you're not doing evaluation for a sale, it's not as fine tuned. If you're doing a working valuation, it's more of a ballpark range, but it gives you an idea of, to your point, do I really have the option to sell in the next five years? Or is this forecasted 10 to 20 years down the road?

Because I have the leaky bucket and I may be making the top line revenue, but it's not trickling down to the bottom line. And so I am currently sitting on a very low return practice because the growth is not trickling down to the bottom line. And you can do that. You like, this is a service that you guys provide.

And so that was as a manager, like I learned this and I, who knew that was a thing. And I remember the day that Karen, Karen looked at me and she said, well, when is the last time that you practiced at evaluation? And I was like, okay. I don't think that they even know what that is. So I'm going to say never.

So she's like, okay, step one let's start there. And so I learned as a manager, like you, like you had said earlier, this is something you should be doing periodically. And so from that point forward, generally every two to three years. I was having our practice evaluated and getting that ballpark of what is our actual growth, not what do I think the growth is, how do I interpret the numbers as a person working from inside the practice, but how does someone on the outside who would be helping either to find a buyer or helping us sell the practice.

How does a professional value this? And that way I'm armed with more information when I have conversations with, let's say that young associate that I found through an intern program. And now they're asking me about what is the potential for me to buy in as a, as an owner someday, or, you know, I'm like, well, Sutton, something has happened in my personal life.

And now I need to, Get out of ownership and I'm going to go to the table and do the dance with a corporate group. Information is power. And so that's I think one of the things that I love that you're such a strong advocate for is know what you don't know what you don't know. And so let's start with that before you go You know trying to figure out how do I add another doctor?

How do I hire another associate like let's start with the things about the business that you may not be comfortable with 

Bret Halishak: yeah. And I, I'm a big proponent of working backwards. So, you know, to get into this, let's say this, you know, we go back to the 40 year old owner that we talked to over mid forties. It's one of those, well, let's say hypothetically, they did find someone that was wanting to come on on their staff and we don't know their ownership ambitions, you know, playing that seed or having that conversation, not right away.

Like, you know, day one, say, Hey, do you want to be an owner? You know, obviously it'll let them get acclimated to the practice, but eventually having that conversation and establishing timelines is crucial. So again, going back to that mid 40 owners, let's say hypothetically that new grad wants to buy in with the next five years after they get their feet wet, they understand the practice, they understand the community that puts you at 50.

Let's say now you grow in the office. Let's say you have maybe an expansion. You go from three exam rooms to four just because you guys are busting at the seams and you need more room for the staff. You know, that's another five years. And then the conversation becomes, okay, what is your goal? What, what do you want to become?

So now just, and again, I know this is all hypotheticals. We've already advanced almost a decade from our original conversation. We're in our mid fifties. You know, if they have a family of their own, maybe they're off to college, they want to go support them in college. You want to be able to go there on the weekends for football games, whatever that, you know, whatever the scenario is, you have to work backwards and establish that timeline.

And I think you, you really struck a chord that really resonated with me and, you know, I love my job. I'm a glass half full person. I wake up every day and say, Hey, we're going to change the world today. Um, Obviously, you know, there's some, there's sometimes where you're put back in your seat and say, listen, today's not that day we'll, we'll take that on another day, but it's one of those where, you know, some phone calls I get is, you know, Hey, something happened to either me, my spouse, my partner, and I need to sell the practice today.

And it's just like, okay, to your point, when's the last time you had a practice valuation, never had it. And that's where I'm always like, okay, we're going to get, we're going to be in for a bumpy ride potentially. And obviously you're hoping for the best, but it's one of those where you always want to be ready.

And it's not something you want to say, you know, you have to be extra vigilant to say, Hey, we can't do this. We can't do that. You know, there are some certain things that you don't want to make sure you want to make sure you don't do if you're ready, if you're getting ready to sell, you know, is it the smartest thing to sign a five year agreement?

If you know you're going to sell in two to three years, not necessarily because you don't know if those are reassignable, if those could be assumed to the new owner things of that nature. But ultimately you always want to stay ready because you never know when you're going to get that phone call to say, listen, you know, life's changed.

We need to do the X, Y, Z. And that's what, you know, the unfortunate part of my day is, you know, when I have that phone call, it's like, okay, listen, I have to reset expectations. You know, if we do sell your, your, your life's work, it's not going to be worth the value you think it is. You know, sometimes there's the misnomer out there.

It's, you know, I do a million dollars in sales. You owe me a million dollars for my crack. And to your point, you know what, that's what we do with the valuation is we go through tax returns, we go through W2s, payrolls production reports, you know, all these litany of reports to help us come at an adjusted EBITDA, earnings before interest, tax depreciation, amortization.

So I don't work for the IRS. I don't, I'm not a CPA. You know, what's your CPA helps structure for your tax returns is one thing. You know, what we help provide is what that true adjusted income or profitability of your practice is, you know, so we go through our bags. So there are, you know, we'll start soft and hard and backs, you know, do you, do you offer health insurance?

Do you do this? Do you do that? So that's where we come up with our adjusted EBITDA and that helps us let us know what your practice is worth. 

Stephanie Goss: Let's take a quick break and then I want to jump in here with your, like, tips for, how do we plan to keep private practice ownership feasible?

What are those things that you need to do? to keep that private practice ownership feasible for the next generation who you're hopefully going to attract to your practice, whether that's as an associate, you know, who works for you for years and buys in or someone who walks in the door and says, Hey, I would love to buy your practice tomorrow. No matter how that looks, that we're doing the things that we need to do in laying that groundwork to keep private practice ownership feasible.

Does that sound good?

Bret Halishak: sounds great to me 

Stephanie Goss: You know, Andy and I have both been doing this a long time, and I think the collective years in vet med across our entire team is like a billion. It feels like most days. And one of the number one things that all of us, especially in an, I get asked when we go to conferences. When we talk to our colleagues, when we talk to peers, how do I teach my team how to handle conflict? 

How do I teach them to talk to each other? How do I teach them to manage the TIFs, the beefs, the front versus back, all of that. And, we have been working so, so hard as a team for a new certificate set up for y'all and I am so excited to say it is. Almost here. I can't entirely spill the beans, but I can tell you that the uncharted team has put together an awesome certificate on the foundations of how we handle conflict. 

And I don't mean how you, as the manager solve everyone's problems or you as the practice owner. I mediate the conflict in the practice. I mean, how do you as a person learn how to approach other people, learn how to talk through conflict and learn how to lean into healthy conflict in the practice. I have been waiting years for us to be able to do this certificate. And it's almost here. I can't tell you more, but head over to the website unchartedvet.com forward/conflict. Our team has put a mail list, sign up. Sign up for that mail less because you will be the first to get all of the details. 

As soon as the certificate is ready to drop. And it is. Almost here. And now. Back to the podcast.

Let's talk about those action steps that we need to think about. Whether you're a manager, whether you're an owner. And if you're one of those, if you're a medical director and you're thinking about like growing your size, this still is, a lot of these tips are still relevant. 

You may not order a valuation the same way that a private practice would, but knowing the numbers and, and, you know, let's, we, we talked to a little bit about that and starting with the valuation. So top line steps, if you are in your mid forties, you're this practice owner, you want to stay independent.

You want to keep the independent model alive. How do I make private practice ownership attractive? Step number one is we, we talked about in Headspace is knowing what your needs and knowing what your wants are because, and being crystal clear on that, right? From a very early point in time. And then we also talked about what are some of the things that we need to do to keep it attractive?

One of those is we've got to understand what our opportunities for improved efficiencies and effectiveness in our practice is. It's not just getting to the place where the schedule is booked out and we can't get clients in. So we just add another doctor. That's what a lot of practices do. They're like, hey, my top line growth is really heavy.

I can't get clients in. I'm going to add another doctor or I'm going to add more staff. And a lot of practices don't do that homework to look at the efficiencies, the effectiveness, cost of goods, other costs that you can control to see is that top line revenue growth trickling down to the bottom line.

So we talked about that. We also talked about You know, this idea that valuation and look and what that is, is and what that is looking at the formal value of your practice to your point. And I think that this is so, so important. I can't tell you how many practice owners I've met and worked with over the years who have the idea and I can understand why it's how I thought it worked when I started as a manager where whatever my top line revenue growth is, if I gross a million dollars a year or two million a year as a single practitioner, that's what my practice is worth. Some multiplier of that. It's gonna, I'm gonna get two million dollars plus for my practice when I sell it someday. And I think that there are a lot of practice leaders out there who don't understand what we just talked about in terms of the adjusted EBITDA, the, that bottom line number, where it comes from, how it's made up, all of those things.

So homework, they need their wants and their needs. They need to understand what their practice is. actually worth, they have to look at those efficiencies. And so they've got, they're at this point, they're probably working with someone, whether it's a CPI, a broker, to get that bottom line dollar.

Once we've done that work, what do you think from your perspective as a broker are the top things, like the top two or three things that a practice owner could do? To make their practice look most attractive, to keep it as a private practice.

Bret Halishak: Absolutely. You know, it all depends, you know, if they have an existing associate there or if they have someone that's in the wings at school that's waiting to graduate. But you want to make sure that you're operationally set up for growth. And I know that sounds maybe just, you know, like jibber jabber or just, you know, just something off the tongue,

Stephanie Goss: Yeah, I was gonna say, tell, tell us, unpack that a little, tell us what you mean by that.

Bret Halishak: Yeah, absolutely. I mean, I can't tell you how many doctors I still talk to that don't maximize technicians in the exam room. It's one of those where. You know, it's one of the first questions I, I, yeah, exactly is when I ask, I say, Hey, you know, how do you, how do you operate an appointment? What's your head to tail?

And if they don't say, well, my technician goes in there or my assistant goes in there and grabs the history, I kind of stopped them there. I said, well, walk me through the workflow. Why are you not maximizing your staff members to help you? No offense. You are the highest producer in here. You are the person that is their time is invaluable.

You need to be your heads everywhere. You need to be focused on the client patient in front of you. But what are you doing with those staff members to help free you up to do something else? You know, there's some great studies 

Stephanie Goss: Yeah so taking yourself in, making sure, so step number one, and I love that you started here, that you have to be the doctor. Get yourself out of the technician nursing role. Stop doing the things that other people on your team should be able to do. And if you don't have people on your team who can do them, and that's why you're doing them, because sometimes solo practitioners find themselves in that position because they haven't been able to train their team, they haven't been able to find licensed techs, whatever the reason is.

Step number one, start with getting yourself out of the nursing seat and into the doctoring seat. And invest in the training and leveraging your support staff to the top of their abilities and licensure.

Bret Halishak: Absolutely. And that's why you pay them everything you do. I mean, payroll is, you know, is the top expense in the clinic. So you want to maximize that. And I'm not ashamed to say my personal veterinarian, he's been paperless now for geez, more than 10 years. And it's one of those where I see his staff more than I see him or his associates.

Whenever I'm there to go see him, I would love to sit there and talk to him, chat his ear off and everything like that. Trust me, you know, we've been friends for a long time. But it's one of those where I spend more time with his team members than him or his other associates, which is fine with me because I know I'm still getting the standard of care.

I'm getting all the items that are recommended, but at the end of the day, his staff members are able to get his history, his objective. He's literally going out doing his act is the rest of his soap and he's hopping to the next appointment. So it's one of those where whether you're staggering your appointments.

You're hopping room to room, however your appointment schedule is set up. You need to realize that your time is the most important time in the, yes, you're not neglecting the staff, but you can't be everywhere at the same time. You should be hopping in and out of exam rooms, taking care of those patients, coming up with your assessment and your plan and moving on.

So, and that's where, you know, back to the whole, you know, crux of the conversation is. If that's not set up day one, your associates can be flustered. They're like, well, what, what, what goes over here? What goes over there? What goes here? And it's one of those like, oh, don't worry about it. We'll just roll with it.

We'll get, we'll talk at lunch. And then next thing you know the emergency patient comes in. So lunch is now that lunch conversations now scrap. Oh, don't worry about it. We'll catch up after hours or, you know, coming to work early tomorrow as a new associate, you know, coming into a practice, you know, just coming into work early to catch up, sound great?

It might be okay the first couple of times, but then the next time, okay, what are we doing here? Are we are we do is this how everyday operates? So it's one of those where if the infrastructure doesn't support the growth It's good The house of cards is gonna fall quickly and then at least a frustrated staff members frustrated associate and eventually the owner has to you know face, you know face the facts say listen we need to take a step back.

We need to make sure we're operationally set up for this. I don't think we're ready to see appointments both the same time. You know, we need to restructure this to, you know, make sure we're all on the same page, make sure everyone knows where the left and the right are doing so that we can make sure that this looks great to us and also to our clients as well.

Stephanie Goss: I love that. And I think like I, I meant it like a breach, you know, the best thing we can do is support and leverage the paraprofessional staff as an independent practice that being able to leverage the team, invest in them. support them in their training and skills acquisition that in and of itself builds tremendous culture.

And I think for me as the manager and I don't know if you have anything else besides what we've already talked about, but for me, the last thing in terms of making yourself attractive as an independent practice is the brand cannot be your face, like as a, especially as a solo practitioner, if the brand to this point has been you, Dr. Smith, and everybody knows you and everybody loves you and you can't get out of the exam room because to your point, like you are in there chatting with all of your clients, that is going to be the, it doesn't matter how profitable you are. That is going to be the single biggest barrier to independent sale and corporate sale.

To be honest, because that is a complete turnaround as a manager. I have to walk into that practice and that certainly as someone, a prospective buyer, I have to walk into that practice and look at this not as a, I can walk in day one and start working, but as a. This is a two to five year turnaround because I have to build the trust bank with the clients.

I have to build the trust bank with the staff. I have to do all of those things that I would have to do in a sale anyway. And I have to completely rebrand the practice in that image that I want as a new owner, because most new, it's like paper records, right? New younger doctors, they don't want to necessarily be, you know, The solo owner, they have a vision for where they want to go in the future.

And it usually involves a leverage team that clients can talk to just as easily as they can talk to easier than they can talk to you. To your point, that vision of your own, your own family veterinarian that you experienced, Bret, like, that's what independent owners want. And so if the, if you are the brand, I think that's the last thing that I would say is that you've got to work, look very critically at that and start undoing that and you can do it gently. 

I'm not saying like radical, like stop seeing clients, stop returning phone calls, none of those things, but it goes back to your point, investing in the team and getting them the skillset from the front desk to the kennels and everywhere in between, to getting them the skill sets so that they can serve the clients as much, if not more than you are serving the clients.

That is often the biggest hurdle and the one that takes the most time because you can't go from being the doctor that has done all of the things for 10 years to being the doctor who now suddenly leverages their team overnight. That is a long, that is the long game and that if you do find yourself in those circumstances where you have to suddenly make a change in your long term plan and sell the practice tomorrow, that's where so many people find themselves at your doorstep going, what do I do?

Bret Halishak: Yeah, right.

Stephanie Goss: And they're just, and they're devastated because they know that they are not going to get that maximal return on investment when they, that is a two to five year turnaround project for whoever walks in the door behind them.

Bret Halishak: Yeah. I mean, people used to make fun of me all the time and they still make fun of me. But anyways, I always have this motto of one team, one dream. Like we're all in this together. It's not just me. It's not just you. It's we're all in this together. And to your point, I'm a huge advocate of development and I know some people are not complacent.

They're okay with where they're at. They don't want to be, they don't want to have benchmarks. They don't want to have here or there. But to your point, You know, whether it's Karen Felstead or, or Denise Tumlin or somebody else, I love, I mean, even Andy I, after he's done speaking, I usually be line up there and say, Hey, listen, you had two or three nuggets that I want to talk to you about.

He's like, Bret, we're in the middle of a workshop. I was like, okay, okay. I'll talk to you later about it. And I mean, I want to talk to you later, but it's one of those where if you're only developing in it for yourself and your top line revenue, it's going to show in your staff. You need to believe in your staff and you need to empower them.

I know that's, you know, some things that, you know, you write on a chalkboard or a dry erase board, you know, you know, and it just stays there. But you really need to practice what you preach because there's, there's something that I love whenever you can tell a lot about a practice from their website, you know, for better or worse, you know what, and I'm not even talking about Yelp reviews and Google reviews.

This is outside of that. Some of the best things that I can see when I look at a practice is if I go there and I see the office manager has worked there for 20 years, but not in the same role. He or she or they started as a boarding person or kennel person, and then they went to a technician school and then they did this and then they did that speaks volumes to me or, and this is applicable to anybody.

And that's where the message needs to get out there is, you know, again, I work in the Great Lakes, you know, Minnesota, Wisconsin. Some of these areas are very rural. It's not easy to find people, but again, going back to what I just said about an office manager, there's nothing better to see when there's an associate doctor that said, yes, I worked here as an assistant when I was in high school and I knew I wanted to be.

Stephanie Goss: Yes.

Bret Halishak: And then that clinic or that staff supported him or her or they throughout the whole process of going to undergrad and postgraduate. And then you know what? Maybe they want to move back home. Maybe they don't, maybe they go somewhere for a little bit and then they come back, whatever the scenario or situation is, it works itself out.

But again, like to read that on a website, like how do you not as a client? Say, wow, I don't want to go here. Like someone that spent their whole life working at this clinic that doesn't even own the clinic wants to be a part of this. Like that speaks volumes for somebody. And you can't, you can't teach that.

You can't buy that. You can't go to a lecture and say, you know what? I'm going to, I'm going to do that in my clinic. It happens because you reinvest yourself in the staff and you empower them and you develop them. So

Stephanie Goss: Oh, man. I love that so much and it speaks to it speaks to my, honestly, to, to my own story and I'll I'll leave us there because it's so funny that we, unintentionally got here because I've had this letter sitting in the mailbag for so long from someone who said, you know, I I'm just a you know, I'm just a team member, but I would love to become a practice manager someday.

And like how, you know, what kind of education should I do for myself? And they were like, how did Stephanie get to where she is? And I'm the example of that. I didn't come from the, I was not one of those people who said, I want to work in a vet practice one day. I, my background, my degrees are in theater and music.

I was a teacher and I fell into the vet fields and I was really lucky to be in a practice who had practice owners that invested in me. And I went from that front desk person and it was like getting the education they put me through tech school. I was one, I went through one of the first aha. At the time it was the aha program with Cedar Cedar Valley in Texas.

I went through one of the first online tech programs. I became a technician. I learned about that aspect of the hospital. I earned about, I learned about animal care and then it was like, okay, well, I don't know anything about finances or business or any of the stuff that I can pull out of thin air now, 20 years I didn't know any of that when I started.

It started with a desire for me to learn because I loved what we were doing and I fell in love with the profession and practice owners who supported my development and said, yes, we want the hometown kids working in our practice. We want our clients to see the neighbors, the kids that their kids went to school with.

We want that feel, and we're going to invest heavily in that. And they, you know, that was that practice's growth story. It was my own growth story. And so, I love. I love that you ended us there because that is, I think, such a wise piece of advice for this practice owner and any practice owner is like, invest in your team, get yourself out of the exam room, teach the team to be the face just as much as you are, but more.

And I love your point about the website, get them out there, get rid of the stock photos, get your team on the website, give your clients and prospective buyers a sense of what would it be like to walk in the door. to this practice today. I want to know what that's gonna, I want to know what that's going to feel like.

Thank you so much, Bret. This was so fun. If you, I hope that our writer got something out of it and you know, the recap of our, our, we covered, I think the top tips so, so well. And those will be in our, in the show notes in bullet point format for my note takers. And if you are like, I am, I would love to potentially be a practice owner, I'm on my way to practice ownership.

If you are a practice owner whether you're in the beginnings of ownership and have no idea what you're doing, or have the drive to go from the one doctor practice to the ten doctor practice, whether you're thinking about your exit strategy, especially if you're thinking about your exit strategy, You can come join Bret's workshop when we are in Atlanta in December the 5th through the 7th and get some help and hands on experience with our Uncharted community.

But regardless of how you approach it, I think you've given us some wonderful tips, Bret, for where to kind of get started. And get started early. Early, early, early, early, like as soon as the thought occurs to you, start planning.

Bret Halishak: Exactly. Well, thanks again for having me, Stephanie. It was a blast.

Stephanie Goss: Thank you so much for joining me. Take care everybody and we'll see you next time.

Thanks so much for listening to this week's episode. We really enjoyed it and we hope you did as well. I just wanted to take a quick second and say, if Stephanie Goss: Thanks so much for listening to this week's episode. We really enjoyed it and we hope you did as well. I just wanted to take a quick second and say, thank you to Nationwide, Hill's Pet Nutrition and Pet Desk for being our Anchor Club Sponsors for this year's Practice Owner Summit. And I also want to say thank you to the practice owners who are joining us this year in Atlanta, December 5th, through 7th. Thanks so much for joining us today. We'll see you next time!

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: communication, Practice ownership

Mar 06 2024

Managing With a Married Couple

Dr. Andy Roark and practice management super geek, Stephanie Goss are back with another letter from our mailbag. This time a manager writes in who is struggling with communication in her practice. This manager's newish to practice ownership DVM struggles to communicate with the team as a whole. The manager is fielding complaints from the team about the holes in communication. And to make it more challenging, the practice owner's wife is also heavily involved in the practice, despite her lack of veterinary background. This manager is struggling with knowing how to address the team's concerns when they share some of them as well as struggling to find their own place in the triangle between the practice owner, their partner and the manager. This one is a doozy, let's get into this….

Uncharted Veterinary Podcast · UVP – 276 – Managing With A Husband And Wife Team

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

Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

UPCOMING EVENTS/INFO

🌟 Unlock the potential of your veterinary leadership team by embarking on a transformative journey together! In this episode, we explore the power of continued education in aligning leadership perspectives and the Leadership Essentials Certificate is the perfect opportunity,

This on-demand certificate program, spanning 8 hours of CE, is designed to equip veterinary professionals with the skills needed to lead high-performing and collaborative teams. Join forces with your practice owner and partner to enhance your leadership dynamics. For Uncharted members, this valuable resource is included in your membership – making now the perfect time to join our community and elevate your leadership game. Shape your practice's future by investing in the shared growth of your leadership team!

🚀 Accelerate your leadership journey with the Uncharted Leadership Essentials Roadshows

Calling all veterinary leaders to join Dr. Andy Roark, Stephanie Goss, and Maria Pirita at the Uncharted Leadership Essentials Roadshow in Atlanta, Georgia, on May 5th and 6th. Picture two days of dynamic, Uncharted-style engagement where you'll not only explore the Leadership Essentials Certificate program but also engage in real-world discussions about strategically working ON, not just IN, YOUR veterinary practice.

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Episode Transcript

Stephanie Goss: Hey everybody. I am Stephanie Goss, and this is another episode of the Uncharted Podcast. Andy and I are back this week with another letter from the mailbag. We received an email from a practice manager. Who is struggling because their lead DVM seems to have some serious communication issues. And it's starting to impact the entire team from this manager's perspective. They're struggling with getting everybody to be able to communicate with each other. 

It seems like there is a loss of trust. The team is really frustrated and this manager is wondering, how do I approach this when the person who is causing all of this challenge in turmoil is the person who's in charge of the practice?

This was a great question, Andy and I had a lot of fun. We might've gone a little bit off the rails as we do, but we brought it back together quite nicely. 

I think let's get into this, shall we? 

Dr. Andy Roark: And we are back. It's me, Dr. Andy Roark and the one and only Stephanie-1-2-3-Goss. That's right. Getting down with three P. Everybody loves three. I just yeah, I haven't heard any late career Britney Spears in a while, and that's where I'm like, you know what?

Stephanie Goss: Let's just, get into some Britney. I can be supportive of that. I'm a Britney, I'm a Britney fan. I'm a Britney fan.

Dr. Andy Roark: I, one of my great regrets is that Eric Garcia was in Las Vegas when I was also in Las Vegas, and he went to Britney and I didn't go. 

Stephanie Goss: Of course he did.

Dr. Andy Roark: and I regret, like there's not many things I regret in my life. 

Stephanie Goss: That's a life regret.

Dr. Andy Roark: Missing Britney Spears in Las Vegas with Eric Garcia is one of those things.

Stephanie Goss: Fair. I would also regret that. That was a bad life choice on your part.

Dr. Andy Roark: Oh, he came back and he was like, there's an enormous tree, and she like swung out of the branches, and I was like, shut up. Oh, man.

Stephanie Goss: That would be a life regret. I can understand. You made a bad life choice.

Dr. Andy Roark: Yeah. I feel like I'm regretting life choices all over the place right now. I'm Stephanie, I'm busier than a one legged man in a butt kicking contest. I'm telling you. It's a lot right now. It's a lot going on.

Stephanie Goss: It is. It is. I feel that. I, posted on my– I posted on my Instagram this morning because I was in my kitchen this morning and we do have a lot going on and I am very stressed. Like on, I like, for those people who don't actually know me, I actually work really well under pressure and my ADHD,

Dr. Andy Roark: That's– welcome aboard! Like,

Stephanie Goss: I'll go

Dr. Andy Roark: It's like, what? Why does Stephanie Goss thrive at Uncharted? Well, let me tell you about how Stephanie Goss works.

Stephanie Goss: Because she works well under pressure. I, my ADHD is like, oh yeah, it's fine. Let's just like do other things and be distracted by shiny objects. And then at the last minute, turn out 40 hours of work in a four hour period. Like, that's me. And also there's a very fine line between. And like complete, utter panic and overwhelm.

And I'm, I was like, I posted a story this morning as I was walking that fine line while I'm stress eating a brownie for breakfast. Just like, okay…

Dr. Andy Roark: I said, well,

Stephanie Goss: I'm dangerously close to the line.

Dr. Andy Roark: You knew you were in trouble, so you're stress eating the brownie for breakfast, and then I started messaging you at like 6 a. m. your time, and that, because you get up early, let me just stop and say, that's not unusual, like, you, you work East Coast hours, and we've decided that, so this is not boss waking, but, so, but I message you, And you wouldn't have, you wouldn't have got it if your phone was silenced or whatever, but it was like, “Call, me when you're up and moving.”

And so you see that while you're on the phone. And then I start calling the person you're on the phone with, to talk to them. And Tyler was like, I just, I hung up with Stephanie. She said, you messaged her, and now you're calling me. And she's like, and what is that grinding sound? And I'm like, that's the espresso machine, Tyler.

Let's go! And so it's that kind of energy,

Stephanie Goss: It’s that kind of, it's that kind of, well, we might need that kind of energy to deal with this mailbag question.

Dr. Andy Roark: This catastrophic mailbag. This is redonkulous.

Stephanie Goss: it is a whole, it's a hot special. It's a hot special. That's all I'm going to say.

Dr. Andy Roark: I like this. I'm excited about this. I'm excited about it because it's not me. I don't have to do it. But I'm very, it's like, I'll give you a plan that I don't have to carry out. I'm all about it. And so, I got a plan here. It's got multiple steps, it's got phases, it's got two different battlefronts that we're gonna fight, and like, it's, it is a robust plan.

Stephanie Goss: Andy went to town. 

Andy Roark: That, very well might not work. Like, it's like, there's a significant chance that we're just gonna burn the whole area and leave. That's how this might end up. We'll see. I'll tell you, I'll give you my best shot and we'll talk about when we cut bait. And, what does, getting out of this look.

Stephanie Goss: That's fair, because I, my first thought when I looked at this was that the answer is no.

Dr. Andy Roark: It's just like, no, there's a shot. There's a shot. But you have to set some clear boundaries. You have to set a timeline about how much you're gonna put up with. And then, what your checkpoints are going to be along the way and so anyway, I think this is a really good conversation if anybody is dealing with a situation that has multiple like there's multiple fires burning here i'm gonna lay down for you my best advice on how to fight a multi-front war and also like how to decide when you're like, this is not it's not worth it anymore. But it's not an emotional decision of “I've had enough today. I'm out.” 

It's like no, let's get smarter than that let's get more strategic than that and let's make a plan but also let's have a way of measuring success in our plan and making decisions about when we're gonna pull the pin on this plan and just blow it up and bail.

Stephanie Goss: Yeah. Okay. So let's set it up for everybody. Cause they're like, gosh, what are you guys going to talk about? So we got we got a mailbag email from a practice manager who is struggling in their practice because they have a lead DVM who has some communication challenges and most of it from, their perspective, most of it seems to stem from a lack of communication and so just not talking to the team enough but it causes a lot of challenges with the team, and so this practice manager is like, look, I'm constantly having to field complaints about the communication, about the lack of communication, and And bridge things between the team they said, you know, this is this is a doctor who is newer to owning a practice and they're awkwardly trying to figure it out as they go.

And that's, you know, understandable. You're doing something for the first time, there's going to be some challenges. And this manager is like, it doesn't seem to be getting, like, they don't seem to be learning from their challenges. And, so it's compounded this practice manager's like, you know, look, I'm all in.

I'm willing to help. I'm trying to bridge the gap between the team and do some teaching correction to like help you grow as a leader. And it's compounded by the fact that this uh, doctor who's the practice owner, their partner is also playing a big role in the practice. They are not on the medicine side, but they are playing a big role in the running of the practice.

And we don't have enough details to know, but having been a manager who's worked in plenty of hospitals where it is a partnership, husband and wife, and wife, husband and husband, whatever kind of partnership where you are cohabitating and also running your business together. Like, I have been in that management position at almost every practice that I've been at, so I have strong thoughts about that. But this manager is like, look, this is the situation because they're involved in the practice and it's really frustrating and causing challenges because there's three people trying to give directions and we're all giving directions differently.

And the manager's like, look, I'm at the point where I have team members, including doctors, who are Wanting to leave or threatening to leave and they said, I myself have thought about leaving because I feel like I don't get to do my job and I feel like I, I don't have a say because their partner is also so heavily involved in the practice.

And so they were like, I'm super frustrated. And what I love about it is that it wasn't– it didn't end there. And they were like, yes, I am super frustrated. And I'm reaching out to you guys because I'm wondering, like, can I? How can I approach conversations because the practice has a lot of potential. I believe in it.

I believe in my team and I feel like we've made a lot of strides since I have been working on things. And I also feel like there's more potential to, there's potential to do more and they feel like there's some significant roadblocks here and they're just wondering like how to even, where to even start.

Dr. Andy Roark: yeah. Alright, so there's a lot here. There's a lot here. This, again, I don't know what the answer is. We're gonna wade into this a little bit. It really depends on how people respond when we start pushing some buttons. And so, alright, so let's talk–Let's just talk headspace.

And so I'm going to go ahead and get the negative part out of the way before I get optimistic. And so, the negative part is, at the end of this, the question at the end, there's a couple of red flags that I have recognized a number of times, right? And so, the thing is, the practice has so much potential.

Right as they said that the practice has so much potential and to me, that's always a red flag because she this person I'm gonna say she's probably right that it has potential and that doesn't mean anything. The number of people I have worked with or employees that I have had I tell you what it's ripped my heart out is employees that have so much potential if they would just blank.

Stephanie Goss: Right.

Dr. Andy Roark: and they won't and they won't or they don't and I cannot I can't want it more than them I can't make anything for them But it guts me to see so much potential in a person and they would I'm confident they would just take off like a rocket if they would just blank and I tell them hey, this is what we need to work on and they're like, yeah, I'm not doing it I'm not gonna do that and like, and I can't make decisions about my life and my career and my business based on what I wish someone else would do. I can only make decisions on what they're actually doing and so again, I see that and i'm like it has so much potential i'm like, oh Grit your teeth my friend because the potential it has, it's something worth weighing, but do not make choices based on what someone else should do or what we wish they would do.

So that's the first part. The other part is, they say, you know, the practice has grown. I have grown the practice quite a bit since I've been there. And I go, ooh, that sounds like a sunk cost fallacy to me. That sounds like I have put so much into this, I am really reluctant to let it go. to let it go. And the truth is, would you take this job if it was offered to you today?

And if the answer is no, then you should think about that. That doesn't mean you're going to pick up and leave because we all go through hard parts. But, I think we have a natural tendency, I have poured so much into here, I can't leave. And I would say, boy, what you did in the past, that's over, that's gone.

Life moves on. You did that, and you put a lot in there. And, we're not thinking about the past. We're deciding about how we go forward. And so, beware sunk cost fallacy of, I've given so much, I can't bail on my investment now. And so, both of those two sort of flags I see at the end. Any other mental flags that you see like that, other than the obvious problems?

Stephanie Goss: Yeah, I will. It's funny. So, first of all, I want to say like, I see this person and I feel them and I you know, quite candidly, I– in different, completely different circumstances, I was this person and the pep talk that you just gave about looking at both of those things. Like I– when I was in that position.

I looked at it the same way. Like I remember vividly having a conversation with you that was like, I've poured my heart and soul into this place and it has so much potential. Like we've come so far and it could go so much further. and at the same time, like when I stepped back and it was, that fear of like, I have given up so much and recognizing what I had given up and how much I had, you know, sacrifice and how much the team has sacrificed and not wanting to let go of that. And it wasn't looking at, I was not looking at it from the perspective of what I take this job today. And when I asked myself that question, my answer was very different.

Dr. Andy Roark: It's absolutely freaking not.

Stephanie Goss: Not quite that fast, but it definitely was, it

Dr. Andy Roark: Would I? No. The answer is no.

Stephanie Goss: Which is so funny because I read this, that was the other piece. I read this and my initial thought was. no, this is a hot mess. There is no solving this. And then when I stepped back for a second, I really thought about it. And I was like, okay, this is a really tricky situation.

And it might not be a no win situation. There is always a choice. And even if the choice is leaving, that doesn't mean the choice equates to losing. And so I think thinking about it from a healthy headspace that there is, there are always options is really important. And just like, you know, as you say, like fluff your pillows, I think you're, spot on with the first two and I will tell you all like it worked on it, you know, that Andy's little pep talk worked on me.

Um, So, right.

Dr. Andy Roark: Well, thank you for saying that. I think you put your finger right on number three, which I had not thought of, but you're spot on. I do not think, from a headspace standpoint, I do not think that you can look at leaving as failure. And if you're like, for me to leave is for me to fail, and that is a fundamental flaw in thinking, I'm really glad you said that out loud, because I, in order to do this, we're about to get optimistic.

I'm gonna be optimistic about it. And, in order for that to happen, I need you, writer, to decide that leaving is not failure. It's just the, it's, where we have to go from here. It's playing the hand that we're dealt. It does not mean we failed because you didn't have the power to control the situation.

You don't have the power to control the situation. So, if the situation does not work, and you had no power, you didn't fail. You went along for the ride. And that's it. And so, I hope that we can exert some influence. And help try to get this thing back on the track, or at least get it to a place where you're comfortable going forward.

But if we can't get it back on the track, that's not failure, that's inability to reach a healthy place with two other people. Which is, again, they've got two thirds of this drama, and you've got one third. And, so anyway, I just think that's really important. I think it's also funny, just jumping back for a second. It's interesting to me, so the sunk cost parts kind of works with you a bit.

I, I'm the other way. It's the, I'm such an optimist. I look at what could be and, yeah, and where we could go and what we could achieve, and just the idea of seeing that potential. And then going, but it's not going to happen, so I'm walking. That's really hard for me. I'm much less bound by sunk costs and much more about missed opportunity.

And I'm like, the opportunity is so big, but it's not going to, it's not going to happen. And so anyway, that's kind of that.

Stephanie Goss: Yeah, that's funny. So okay, so I have a headspace piece. It's funny because like when we were sitting down and like thinking about it from Headspace I was like, well for me part of the headspace is our safe acronym But I actually I have it. I have a new acronym For our podcast listeners that I was like, oh this one feels really perfect for this situation because I do think that I, do think that this is not a no win situation, and I do see a possibility here where there is some addressing the concerns and there is conversation in the action step piece, and I think the SAFE acronym is, super important, but there's an acronym that I actually learned and I, my midwife taught it to me and it was the, acronym. About prenatal care that is called BRAIN, and I really love it because it is about making informed choices, and I think it just applies for all human behavior, and so the B stands for benefits, and asking yourself, like, what are the benefits of making this decision that I'm thinking about making, whatever it is. And so when I'm looking at a hard situation, I ask myself, okay, what could be potential benefits of the decision that I'm looking at making? Whether it's leaving, staying, whatever. What are the benefits? Then the second one is R, which is risk.

What are the risks involved if I go one way or the other here? And then A is alternative. So are there any other alternatives? And part of this for me is forcing my brain to think about beyond the immediate. There is a winning scenario and there is a losing scenario because that's just part of how my brain works.

I go like, black and white, here's one or the other, and so asking myself, like, what are the benefits, what are the risks, but then also, are there other alternatives, forces me to slow down and kind of think about that, and then I stands for intuition. And so it's the idea of what is my gut telling me?

Like, how do I really actually feel about this? And then N is for nothing. What happens if I do nothing? Or if I just wait it out? And for anybody who has been in labor, it is so painful for them to just say, just keep waiting. You're like, oh my God, get this thing out of me. But sometimes doing nothing is the best thing for everybody.

And I think that goes for us as humans. And so thinking about it from that perspective and forcing myself to do the headspace work asking myself, what do I, like, what are the benefits here? What are the risks? What are the alternatives? Where could this go is really healthy, has been really healthy mental work for me in terms of thinking about big challenges like this, because, you know, we've talked about it on the podcast before and young manager, Stephanie was quite a bit of a hothead.

And would just go guns blazing at whatever I thought was, that my gut says do this thing and I would just do that thing. And I learned some very painful lessons about taking some steps back, taking a deep breath, and thinking it through a little bit more before I act.

Dr. Andy Roark: I think the idea that there are strong parallels between managing a vet hospital and being in labor are hilarious. Like, I just, I'm like, ooooh, just gotta breathe, ooooh, 

Stephanie Goss: true! 

Dr. Andy Roark: Just, it's all gonna be worth it. Keep telling yourself it's all gonna be worth it. it's all gonna be worth it. If he doesn't get in here and help, I'm gonna lose my stuff. Like, it's like, it's just, they're basically the same activity in a lot of ways.

Stephanie Goss: I am laughing so hard right now because I'm just imagining so many of our listeners who might be shouting out loud in their cars right now, Stephanie is so right! Andy, shut up! Because it's true!

Dr. Andy Roark: I’m going to be honest here, I don’t have a lot of experience in this domain. Us non-baby makers are just like okay, I’m here for the ride. But no, I like it. I like it. I don't think—I like your acronym. I very much like your acronym. I don't think it, I don't feel it the way you do, I think. But like, I am, I'm confident

Stephanie Goss: You'll go along for the ride with me. 

Dr. Andy Roark: I am, no, but I am like, okay. I don't see me doing this in a lecture, just so you know. Like it's, I think it's more of a Stephanie Goss lecture than an Andy Roark lecture. So you don't have to worry about me stealing this one.

Stephanie Goss: He's like this, one time when I was labor. 

Dr. Andy Roark: Let's talk about labor. I saw this in the notes, like BRAIN/Labor and I was like, I don't know where this is going. But, I'm confident this is going to be focused and on topic. Alright, we might need to take a break here. Let's take a break here, and then we'll come back.

​

Stephanie Goss: Hey friends, I just wanted to talk for a quick second about the math with you all, because I've been thinking a lot about the workshops and normally here's where we tell you what's coming up and we've got some great stuff happening. So you're going to want to head to https://unchartedvet.com/events and check out the upcoming calendar.

But I want to talk about maths because if you are not already an Uncharted member, you can attend any one of our workshops and pay $99 a piece. Most of them are just $99. You can do it as a one off, great and fine. However, that adds up really quick and if you do the monthly workshop with us, and I've seen some of you there as repeat customers, which is amazing, but you could spend almost 1, over the course of the year doing workshops with us, or you can pay $699 and get a 12 month membership, which means you get all of the workshops that we do at no extra charge. You also get access to our amazing conversation in the community, our community members, and all of our community resources. And it is hopping over there. We've got conversation 24/7. We have got activities.

We've got book club. We are talking about, uh, development and, uh, leadership growth, doing our development pathway this year. We are doing hallway conversations where we're talking about topics. These are, uh, sessions that are community led, community driven.

It is topics about things that are going on in your practice that you want to talk about with your peers. All of that is happening and it's all included for your $699 membership. So simple math. Do you pay almost $1200 for the year? Or do you pay $699? If you're not currently a member, you should head over to the website and use this argument to convince your boss, Hey boss, I need to be a part of this amazing community because Stephanie told me so.

And because she's telling you that you will save money. Hopefully that works. Uh, but you know, I couldn't, I couldn't resist. I hope to see you at our upcoming workshops again and try to vet. com forward slash events for everything that's coming. And now back to the podcast.

Dr. Andy Roark: Okay, alright

Stephanie Goss: Breaks over.

Dr. Andy Roark: Break's over, and we have never had to take a break halfway through Headspace before, but 

Stephanie Goss: There's a first time for everything with me, Andy Roark.

Dr. Andy Roark: I know– I've only got, I think, all this is, I like everything we said for Headspace I think, the last thing I would say here is, sometimes, Often, I would say, I'm gonna say often, I'm gonna ratchet it up, often. 

Stephanie Goss: Ooh, often.

Dr. Andy Roark: When you have a problem that looks insurmountable, it's actually a couple of problems. And if you can break it apart into its component problems, it feels much different. And it's actually much more approachable. If you've just got a six headed problem, you're like, oh, this is amazing. But if I can break it apart into six problems, some of these problems I can address today and some of them I can accept and say, well, that's just gonna be around 

Stephanie Goss: That’s a problem. 

Dr. Andy Roark: That's a tomorrow problem. That's a 2026 problem. Like, like you can do that, but it doesn't feel so like existential. It feels real and actionable. And so I think it's important here in Headspace. Go ahead and separate this into two problems. So number one, we've got a communication problem with a new practice owner that is not giving the team the communication they need and that is.

That is a real problem. We can coach to that problem. We can work to that problem. And then the other problem is the spousal involvement. And I would try to de-emotionalize this. I don't think that's a term, but you get the idea. Basically, this is a job description accountability problem. And so we've got a job description accountability problem, which is what is, I'm unclear as to what everyone's job is now that your spouse is here playing a role and that, that, that's it.

But neither of those problems sound absolutely catastrophic to me. They're, you know, it's a clarity job description. Accountability problem, and it's a, and it's a coaching communication problem. And again, you can't make people do anything they don't want to do, and if you play all your cards and at the end you still don't know what your job description is, and what you're supposed to be doing, and you have a practice owner that the team is trying to mind read because he won't talk or communicate,

You've played all your cards, and now you need to decide what you're going to do.

But for right now, at least, you haven't played all your cards, and so you've got cards left to play. The only choice you have to make are, am I gonna play these cards, or am I so unhappy that I don't care how the game goes, and I'm gonna walk? And based on the fact that we heard this about how much we've invested, and the potential that's here, I think, it seems to me like they have decided to play the cards. 

Stephanie Goss: They wanna try and play.

Dr. Andy Roark: And so we have decided to play the cards.

Exactly. And so we've decided to play the cards, so let's just get into a good headspace. Let's get optimistic. Let's manifest positivity into the future. And then let's start laying these things down in action steps. Sound good?

Stephanie Goss: Yeah. Yeah.

Dr. Andy Roark: So, first one for me, split this into two problems, right?

Stephanie Goss: I love that. 

Dr. Andy Roark: So, split it into two problems, and I would probably have two different, I like to notebook my problems, I like to write things out. Try to separate and make the two problems crystal, so that you can just work on that problem. So when you're talking about what is the role for the spouse, Don't start talking about the communication issue. Now, they are related because one of the reasons you don't have clarity on your job and what the heck you're supposed to be doing is probably because the owner isn't communicating.

But let's get empathetic here, right? So we said we're gonna have a safe conversation. So safe is, can I sit next to this person, smile at them. Right? Am I triggered? A is can I assume good intent? And F is has this person been set up to fail? What here is my fault? And the last thing is E, what is the end result I want to achieve?

And so, so assuming good intent and assuming this person was set up to fail, let's give the wife a break here and say maybe she's all up in the business. Because he's not communicating what's going on. He's got the family savings tied up in this thing. She's not— she's looking at the family checking account and going, What the heck is going on?

And she's not getting answers from him. He's not clear about what the plan is. You know, I think that we can empathize with this person coming in from the outside. It's really easy to cast her as the villain. Like the immediate Here's the wife who's stickin her head in. I'm like, wait a second. What if the wife is desperate trying to keep this ship afloat?

And again, I don't know. But it's just healthier and better for us to assume that's a possibility. And to go forward assuming good intent and maybe a little bit of desperation on the part of others and saying, let's, come together because if the wife is feeling desperation and then you start fighting her for the steering wheel, it's probably going to escalate further.

It's going to get worse. And so just, that probably should have gone into headspace, but that's kind of where I am about splitting into two problems. When we split them into two problems, first thing split into two problems. When we split it into two problems. I want to talk about framing communication, okay?

And so from an action standpoint, the way we talk about problems is key. And the way that we discuss things can get people to lean forward or to lean back and cross their arms. If we go to the practice owner and the wife and say, Practice owner is not communicating. Nobody knows what he's thinking. He is a poor communicator.

Stephanie Goss: That immediately makes you defensive.

Dr. Andy Roark: Absolutely. You're going to get a defensive reaction. It's not going to go well. And so, I would frame this not in terms of the practice owner being a bad communicator. I would frame it in terms of the needs of the team and the perception that they don't know what's going on. And maybe you're letting them know, but they're not getting that messaging the way it's currently being delivered.

And you see the difference in that of like, message is not being delivered in a way that's working for them or get, or making them feel comfortable and you can kind of put it on the team is, I don't know, I don't know what to tell you, but they're, not getting it. We got to do something different and that puts me in a collaborator role of what does, what do we want information dissemination to look like here?

If you don't want to disseminate to them, can you and I have one on ones and you can let me know what the plan is, and then I can disseminate that information. I can do it in staff meetings, I can do it in morning rounds, I can do it in company emails, I can do it in our Slack channels, like, however you want to do it, but let's figure it out.

But part of, I think, having the team work well together feel comfortable, feel safe, have a good culture is, they feel like they need more information, they want to know more clearly what's expected of them, and they're, for whatever reason, they're not getting it under the current communication. And so, let's, how can I help with that?

The other thing I would empathize is if you're a brand new business owner, and this is a lesson I learned. I lean towards overcommunication just because I like to hear myself talk. But, it was still hard for me. 

Stephanie Goss: Really? You, Andy Roark? You like to hear your, you like to hear yourself talk?

Dr. Andy Roark: Well, since we're getting vulnerable, yes I do. And,

Stephanie Goss: He talks to, he, you talk to Skipper. 

Does he talk back, Does he talk back, yet in Spanish is what I want to know.

Dr. Andy Roark: Not yet, not yet. I talked to Skipper in Spanish. That's a whole other story. Let's not go, let's not go there. We've been– we did your labor a bit. Let's just put a pin in Skipper learning Spanish for right now. Okay, so, Where was I? All right, stop it, Goss all right um—

Stephanie Goss: This is my fault?

Dr. Andy Roark: It is. Okay.

Stephanie Goss: We were talking about communication and the perception problem.  

Dr. Andy Roark: The perception problem. Yeah, so, I when I was a young business owner, I, again, I really struggled with slowing down to go fast and the more pressure I felt, the less I wanted to communicate about why we were doing what we were doing, how we're going to do it, let's have a talk, let's all come to consensus, what are you guys already doing and how do we build on that?

Because I'm like, let's go. And I had to blow my face off. A number of times. I still blow my face off that way, but That was not at all what, that was not at all what happened when I messaged you and then called Tyler and then told Tyler to wait for my espresso machine to finish.

It was not at all me going ridiculously fast and not slowing down and communicating.

Stephanie Goss: I didn't say, I didn't say a word.

Dr. Andy Roark: Good. All right. Let's move on. Anyway, it's hard as a business owner, especially a brand new business owner, you have, I think you have to get burned a couple of times before you go, Okay, we're going to have this conversation.

We're gonna lay these things out. We're all gonna talk about this. It takes some people a lot of convincing before they realize that this is the significantly faster path. Then just let's go and you guys watch me and you'll figure out what's going on.

Stephanie Goss: Well, and I think, you know, you, mentioned earlier framing the, you know, the communication and looking at, can we have empathy for the wife versus painting her as the villain? And I think it's really important. You know, I am a huge– I have gotten on my soapbox on more than one occasion and talked about the fact that for so many of us who are managers. We learned by screwing it up and we learned by doing because they're not they're not a lot of us who go through our schooling and then go into the opportunity to become a manager and learn after the fact. We usually do it backward. And I think it is important to give empathy to practice owners as well, because the fact is, especially if you have a veterinarian practice owner, they didn't go to school to become a business person, like they didn't get their MBA first, most of them, they went to vet school. And so I think for me, the exercise and empathy is equally important from a communication perspective. And I think this is a really good opportunity. from a manager perspective to lean into skills that you should possess as a manager and help teach someone else some communication and people skills.

And it might go, that might apply to the wife too, or the partner too. We don't have enough information to know, but like if they're not a business person, part of it is like, you don't know what you don't know. And to your point, when you are a young business owner and you're doing it for the first time, You're just trying to, like, not have it completely fall apart, really.

Like, I can't, so many nights I've sat there and thought, the wheels didn't fall off today, and that feels like success. And I, it, like, the, you're setting the bar low a lot of the time because you don't know what you don't know. And so I think from an empathy perspective in terms of action steps, like, this could be a great opportunity, not only to ask yourself, like, what else could be happening here?

But how could you apply your skills as a manager to solve this problem and do some coaching and some teaching in a way that that opens the door to someone that in a way that doesn't feel like you have a communication problem or you're not good at communicating, but is more like, Hey, like I want to get better.

Would you be willing to work on this with me? You know?

Dr. Andy Roark: Oh, sure. Well, I would take that one step further, and just, I don't know if this is possible to set up, but I will tell you, if you really want to make a massive impact really fast, if you could get the practice owner and the wife and you to all take the Uncharted Leadership Essentials Certificate together, that Whether that's on demand or when we do it in person in Atlanta or in Minneapolis in June or in California

Stephanie Goss: In Anaheim in

Dr. Andy Roark: in Anaheim in November.

Yeah, so we're out on the road. We're doing it live so you can see it live. But anyway, and I'm not joking when I say this, first of all, the leadership positional certificate has got everything about. Building trust with the team. It's got getting team buy-in. It's got communication styles, which is a big deal.

It has got…

Stephanie Goss: Feedback and coaching

Dr. Andy Roark: It's got— the big thing is strategic, planning basics. So, vision and the core values

Stephanie Goss: How to come together as a team.

Dr. Andy Roark: and how to come together. And then, when you get it online, it's got discussion questions in it. It has, like, these are the questions that we would have groups talk about.

And so the three of you can do it, decide that you're going to do the first module, and then talk about it. And then actually just say, what's this look like in our practice? and I say that in all sincerity and honesty, because one, Especially if you've got a brand new practice owner and the wife is jumping in and she's probably, you know, learning a lot as she goes too. It's great, freaking great coaching for anybody who's leading or managing.

But number two, the conversations that are going to come up are going to be wildly valuable and you don't have to bring the stuff up. That's the thing. it's not you going and saying. I'd like to talk to you guys about trust building, and do you think we're building trust with our team? It's, hey, we all watch this thing, and this is what Andy was talking about,

Stephanie Goss: Andy said we have to do our homework.

Dr. Andy Roark: Look, and exactly, and, here's the homework, and I just wanted to kind of have lunch with you guys and talk about where we were, and let's do that.

And so anyway, I don't know if that's possible. I don't mean to oversell it. I'm not really, genuinely not trying to oversell it. I truly believe if you could get them to do it, it is a, non confrontational way to bring up the basics and essence of running a practice. It's like, I love it for medical directors and practice managers that are kind of struggling to see eye to eye.

Anyway, it just works really well for that. So anyway, Uncharted Leadership Essentials Certificate. Jumping back real quick. The way that we frame the question matters. So, for the non communicative, Doctor, I frame this as the team's perception is that they're not getting the information they need to be effective.

Stephanie Goss: hmm. Sure. 

Dr. Andy Roark: And for the wife stepping on toes wrestling for the steering wheel problem, I would frame that as a project management job description. It's not, hey, who the heck are you to come in and, you know, change the plan, take my job. It's, I don't want to step on your toes. I don't want you to step on my toes. I don't want redundancy in our work. I don't want to reinvent the wheel if you're doing something blank. Or if I'm doing something and you're not going to be happy with how I'm doing it, I'd rather know that before I do it.

That's how I'd frame that. And so I think you can frame both of those in healthy and productive ways. And so anyway, what I'd like to do. Now, if you're up for it, yes, we're sort of heading into the end of the podcast here. I split it into two problems. I want to action step each of the two problems.

You okay with that? 

Stephanie Goss: Yeah, let's talk about the doctor first.

Dr. Andy Roark: All right, cool. If I was going to go and talk to this doctor, we set the headspace and said, you know, get safe, right? we shouldn't be triggered here. I don't know if I'm going to have this conversation with him or with him and his wife.

It really depends on how intertwined she is. I, my worry about having the wife. there is that he's going to get defensive and feel ganged up on the upside would be if he wasn't defensive and I could frame it as a conversation about how leadership communicates to the team, I might be able to get us all to kind of work collaboratively together and maybe recruit the wife to help me get the communication flowing that I need.

But I don't really know. You'd have to kind of feel that relationship. What do you think about that? Thank you, Stephanie. Am I ridiculous to even think about this, or do you see the potential that I'm talking about?

Stephanie Goss: Yeah, I totally can see it. I think a lot of it has to do with dissecting what the actual problem is. And so from our writer's perspective, we don't know. We just know that the doctor is struggling with communication from the team. And so that could be anything from they're getting angry when they come out of the exam room and what they want done, isn't ready because they literally haven't talk to the team about it, or like, they're not mind readers. It could mean that they're telling what, like, tell– This is why I was laughing when you were talking about being the business owner. I remember a time where as a new business owner, like you just wanted to do all the things and solve all the problems and where you would start something and you would have a conversation with one person and then you're working on another piece with another person and then you are all playing the telephone game because everybody has little pieces of the conversation, right?

Like there could be a million different examples. We're humans, and communication is so much of our day, and how many times do we all screw it up in some way during the course of the day, right? So part of it, I think, is dissecting that apart, and I would agree with you that there could be potential to have this conversation from a leadership “Let's get united and let's come at it together” perspective, and I think probably the smarter play I would suspect is that there's probably enough, if they really are struggling communicating with everybody, there's probably enough to talk to them one on one about the communication side of things.

And I think it's important to have specific examples for the team from the perception perspective to kind of ease into that, because that is an easy win in the sense of, hey, this is what we I want to be able to help the team help you more, and if they are feeling like they don't get clear communication about what your expectations are, they can't work more efficiently and effectively.

And that's a problem that I would love to help you tackle. Would you be willing to talk about how we communicate expectations, how we communicate in the exam room, and kind of look at some of that with me? That feels radically different than. We've got even, more different than your approach, which I still love, but like we, we've got a perception problem, right?

And we can fix this because that feels very uniting and like, let's come together. But I think framing it for me, it has always been the path of least resistance. It's like, Hey, there's a problem in your life, even if you don't know it's a problem. And I would like to help you solve it.

Dr. Andy Roark: Yeah, no, I agree with that. Okay, so, walk with me. Communication issues, I'm totally with you. So, step one is ask for help, in my mind, which is what you just said is, help me, how do we handle this, right? State the problem. The problem not being “You're a terrible communicator.” The problem being, “the team doesn't feel informed. They're unsure of what the expectations are, and as a result, things are not getting done. Like, blank, and blank.” And so, give clear examples is number three. Ask for help, state the problem, give clear examples. And then, ask for solutions. how do we, how are we going to do this, right? Because this is supposed to be, I want it to be a discussion, not a speech.

Stephanie Goss: Sure. You're recruiting them to be a part of the solution.

Dr. Andy Roark: Exactly, and so. What, I mean, I'm trying to figure out, what, how can we get this information to them in a way that works for you? As opposed to, how about this? I'll meet with you twice a week, and we'll do one hour meetings, and blah blah blah blah, like, I don't know if he's gonna go for that or not. He'll like it a lot more if it's his idea, I promise you that.

And so what are our options? How can we approach this? Try to ask for solutions from them and then present your own solutions as appropriate, meaning, this is where you put your thumb on the scale. If he presents an idea, a solution that you've already thought of that you like, don't say, I also had that thought, say, that's a great thought.

I really love that idea, you know, and lean into it. And then ask for a pilot program, because these things are scary. And you're asking him to commit to communicating differently and just say, Can we do this from now until June 1st or the 4th of July? And just pick a time, and name it, and ask for that pilot program.

And it's a whole lot, if he hates it, then we're, then we'll stop doing it. But I think that the practice will work better, and you'll be happier, and the team will be happier if we do this. And so I'd really like to, if you'll commit, just three months. Let's try it for three months and really lean into it.

Can we do that? And then results will speak for themselves, or they won't. But that's kind of how I would approach the communication problem.

Stephanie Goss: The other thing that I would add to that is when you do, if you can, so to your point, asking them for help and, giving them the problem, giving them examples and then asking them to be a part of the solution and recruiting them to be, on board. I think a big part of it that. Where it often falls off the rails is in the follow through and the follow up because you, I am a firm believer that people can change and that you can teach old dogs new tricks and it doesn't happen in a vacuum and so part of it has to be the follow up and the encouragement and the catching them doing things well and talking about when things I'm going to, you know, beat you with a stick.

Right? But in a, Hey, I know things have been going really, well. And I saw you really frustrated the other day. Like, let's talk about it. Cause I want to, you know, I want to help you work through it. There's gotta be some sort of system or mechanism for followup on the part of the team, on the part of the doctor.

Cause otherwise you're not going to take someone who is. In the words of our writer, like significantly struggling with communicating with everyone and turn them overnight by one conversation into someone who's a master communicator, like this takes everyday progress and work. And so I think the last thing I would add to that is I love the pilot program idea.

There has to be check ins as you go. And then, hey, okay, we've been doing this for a month or we've been doing this for three months. What next? Like, how, where, do we go from here?

Dr. Andy Roark: Yep, totally. I agree with that. For the wife interactions, I would have a different conversation. I would, and again, I would, probably have this with both the owner and the wife together, because I think we, I do think we need to get clarity here, and I would really try to not, is really can't go to, if this goes to a defensive place, you're going to lose, you're going to get blasted.

And there's a chance that they're going to turn on you and hang, the problems on you and be like, well, you're it and you go, but why if like, I'm clearly not, I'm like, well, I tell you this as a spouse, it's a whole lot easier for me to hang problems on somebody that doesn't live in my house than to hang them on my spouse who I'm going to see all the time.

And some people will do that. And we've all seen it. They would much rather protect their comfort level at home than to actually fix a problem. And that's sad, but it's not everybody, but I think I would come to a place of peace of if this doesn't work and they're not going to hear this I'm going to be okay because I said what I wanted to say and I gave it my best shot and I'm not going to, and, if this becomes a terrible place for me to work, I'm going to go somewhere else.

And so I, that's why I want to make that peace. Alright, I would lean into confusion in this conversation, meaning I, you know, I'm unclear about what the expectations are for me. I think the staff at, I think the staff is, yeah, I'm not saying I would play dumb, but I would lean very much into, I don't know what the expectations are for me.

I don't know that the staff knows who to listen to, or I think the staff is getting mixed messaging. And that's causing some confusion. I see that— I feel like I'm doing a lot of work that's then being done again, or I feel like I'm doing work that was already done. I'm feeling like I don't know where I can act with autonomy and where I need to ask for permission.

I don't know. And so I don't feel like I'm serving you guys in a good way. And I'm, quite honestly, I'm starting to get to a point where I'm a bit frustrated about it. And so that's, actually what I would say. And then, I would remember your motivators. I don't know what this owner cares about.

I don't know what the spouse cares about. But I would like to understand that. Is it, is, are they being driven by a desire to make money because they have borrowed against their house, and they're gonna lose their house if this business goes under? Then I'm like, okay, money's not a dirty conversation in my mind, especially if you were like, we sunk everything we own into this practice and we're scared as hell. That's not dirty. That's the human condition. And so let's just talk about it and say, help me to get to help you get profitable, but you've got to give me a clear job description. You have to let me know what I'm allowed to do and how I'm allowed to work, right?

Ask them what done looks like, and this is why I would ask them together, because if you ask them separately, they'll probably tell you two different things. Ask them when they're together and say, I need to understand, when you think about having a manager in this practice, what does that manager's job look like?

What do they do, and what do you do? And I would like to make a list or talk through what those things are so I can understand your vision. And if you guys need to think about it for a little bit and then come back and we can talk about it more, that's fine too. But I really need to hear from both of you what the shared vision for my job is or what my role is.

But that's why I would ask them together for sure. I would not ask them separately.

Stephanie Goss: Yeah, that makes sense. And to, to your point if you have asked, if you have thought about what is motivating them or how they are motivated, then when you have the conversation about what done looks like and you have the rest of the conversation and particularly when you're having the follow up and pushing things along With people who might not be so willing to go on the journey with you It becomes significantly easier if you can frame it in the context of their motivators so if they are worried about the finances in the practice then you can speak to it from the framing of “Hey, I want to make sure that we're them As maximally efficient as possible.

I don't wanna burn salary hours by doing work that, that you also wanna do or that you would rather do yourself than have me do.” Or you know, like you can frame it in that language, because that's gonna push that urgency button for them because it is important to them.

Dr. Andy Roark: I agree with that. Figure out what done looks like. And get them to agree on what done looks like. And then, write it down. Write it down, type it up, give it back to them. And say, hey, I typed this up. I want to make sure that you guys, that this looks good to you guys. This will look like a job description.

Because it is.

But give it back to them. And say, are we in agreement? This is what I wrote down. I want to make sure everything looks okay for you guys. This is how we vision my job and what we're trying to get to. And I, ideally I'd like them to agree and say yes, but I'm putting it into their hand in writing, this is what you guys said, what the three of us agreed I would be doing.

And you can already see where I'm going with this. But, create it, make it real, put it back into their hand. What is the plan for us to get to this point? What needs to happen so that you guys are comfortable with me performing it this way? Are you good for me to start doing these things right now?

What do we need? And again, I would write that down as well. I'd say, this is what we need. And then, I am going to hold them to the plan and say, This is what we agreed on. This is my job. I'm going to give them clear feedback. Rome wasn't built in a day, just like we talked about before. They may be like, Oh yeah, you're right.

You know, I did kind of step on your toes here. Or I'm trying to get out of this, but I'm not out of it yet. And I felt like I needed to help. And anyway, give it some time, but Push steadily on that written list of what done looks like and give them feedback. And if you're feeling frustrated because you're not getting to do this, you want to know what the timeline is before you can take it over.

You want to know what training or steps or things they need to feel comfortable with you doing these things. We can have those conversations. But you have got a written plan you're working against and then let them know where your head's at as you go on without threatening It's not if I don't get to do this and I'm gonna

leave it's I feel like I'm I feel like this It's our expectations that were laid down But I'm not getting to do the bottom half of this list, and I've been asking on what does it take so I can get to the place where everybody's comfortable with me doing this, and I'm not getting a clear answer, and so I feel like I'm kind of stuck in a place where I'm always failing, and I don't know how to get out of this, and I feel like I'm not doing my job, and I don't know how I'm going to get to do my job, and so I just want you guys to know this is taking a toll on me, and I'm, starting to feel kind of frustrated with where we're going.

And the opportunities for me to have an impact here going forward. And I, anyway, I've asked before about what the plan is, and I understand the concerns. But I just wanted to be open and candid about where my head's at.

And then, if it continues not to work, you should leave. Um, That's it.

That's it. I mean, but if you've done all of these things and you have said to them, this was our plan, and honestly the same way I'm gonna use the plan for the job description, I'm going to try to use a communication plan and say, what is our plan for communicating better, blah, blah, blah. But ultimately it's a two pro.

I said at the beginning, we're gonna fight a two front war. Yep. It's fighting the war to get communication flowing to the team, and it's fighting a war of what's my job? I will tell you in my experience. These two things are probably tied together. They probably are stepping all over each other at the top, at the leadership level, and that's why communication is so bad down to the team level, they're probably not in agreement, or they don't know, and they don't want to say things that aren't going to be true.

And so oftentimes the not communicating and not having a clear organizational structure and decision making framework, those things are often interlinked. And so, but I'd still fight it as a two front war. But know that if you don't get the decision making mechanism sorted out, then communication is always going to be a challenge because you're not going to agree on what to communicate because you're not going to exactly know what the story is.

Stephanie Goss: And I think remembering that like people, we don't know what we don't know. And I can't, I mean, pretty much every single partnership team that I have worked for. didn't actually have a clear division of roles between themselves. There was one team that I worked for that there was, pretty after, after years of working together, there was very clear, this is my end of things.

This is your end of things. And here's how we divide the stuff in the middle. But, for a lot of people, it's like, you know, I've met a lot of practice owners where. One of them wants to do this thing and they want to buy the business and the other wants to support their partner. But they don't, they're giving up control.

And so if we assume good intent and we put our empathy shoes on, it is easy to imagine a world where maybe one person just feels like they're on along for the ride. And I know for me, if I feel like the ride is getting out of control, like I gripped the grip, the sides of the seat, you know, and hold on.

And so I think that thinking about it from that perspective helps with breaking the problems apart and asking them the questions in a way that doesn't feel like threatening or like, I don't, you know, it's not, necessarily about you, even though it is, it's about how can you guys work together.

And at the same time, I love what you said about “just leave” because the reality is the hard truth that I had to learn as a manager. It, and it was Andy was with me for, I learned this lesson very painfully. The reality is it's not your practice. And at the end of the day, you can't care more than they do.

And I have been there and it is a very painful place to work through that emotion because you do want it. And that says something about you as a person. And I love my fellow managers for it. And. it hurts, but the reality is you can't care more than they do and you can't make them do things that they don't want to do like you talked about in the beginning, Andy.

And so at the end of the day, like there is acceptance in the fact that it's not. It's not threatening, it just is. And if you do all of those steps and you, do all of the things, and that was, I'm telling you guys, this, episode is a real life therapy coaching that Andy gives Stephanie along the way because there was a time in my life where we had these conversations and I set the plan and I put it on the calendar and I said, I'm going to work this plan.

I'm going to do the things. And at the end of the day. The change didn't happen. And I said, I'm okay with it still hurt tremendously. And there was still a lot of emotions. But at the end of the day, I was like, I'm okay walking away because I did my part and I can't make somebody do something that they don't want for themselves.

Like I can't make it happen. 

Dr. Andy Roark: I think sometimes we need to take that shot and then Give up. But like that's it. So at the very beginning, I said, I hope I didn't over promise, but I said, I want to lay down like, when do we get out of this? And I would say, I would work this plan and go through each of the steps. And if at any point, there's an insurmountable barrier where they're like, we're not going to talk to you about your job description.

Stephanie Goss: Peace out. 

Dr. Andy Roark: I think, I would say, but exactly right, I would say I did it, I laid down my plan, I put in, I, I offered to have the meetings, I offered to try to make it work, and it didn't happen, and I'm going to, I'm going to walk, but I'm not going to go into every meeting being like, this has to go good, or else I'm out of here, but at some point I'm going to say, I laid down the plan, I, would say, I guess I would add, you know, I would probably set a timeline for yourself, and say, I don't know if it's six months if you don't see progress in six months, but if you're going to do that, what I would do is sort of jot down Some ideas about where we are right now, and how it feels, and what we see, and what the, like, actual problems are.

And then if you get to six months from now, and those are still the same problems, I would have a hard time going on. But I would say, but, when I got frustrated between now and six months, I'm say, I would say to myself, six months, I'm doing six months, I'm gonna keep my chin up, I'm gonna do my best, and we're gonna see where we are.

Stephanie Goss: Set a realistic timeline. Don't tell yourself 18 months from now, this is where I want to be because let me tell you, those 18 months will be miserable AF.

Just don't do, don't do, what I did.

Dr. Andy Roark: When you said that, I thought you were going to say, set up a realistic timeline, like three months, and I'm like, I think three months is too short.

Six to twelve months, I think, is, especially if you've got a lot of, if you've got a long history here. I mean, you know, it's the longer you've been in a relationship, kind of, the longer it sort of takes to emotionally extract yourself.

You know, set a timeline that gives you time for change, but also is not going to let you continue to be miserable for a long period. You know, Stephanie, you know how I feel when we are finished with a podcast? That I'm really proud of.

Stephanie Goss: How?

Dr. Andy Roark: J Just like when you have a baby. Like, that's how I feel. Like, it's, I feel like I delivered a baby with you. And I think that's the only way to explain it. I think that's probably the most accurate explanation that I can give. Now, let's slap this baby on the rear and send it out into the world. We should make an acronym. We should make an acronym for when we birth a podcast baby. Stephanie, she just left.

She just left the recording booth. Stephanie, come back! You don't, leave me with our baby, Stephanie! All right,

Stephanie Goss: I can't with you.

Dr. Andy Roark: You guys, take care. I'm gonna, I'm gonna take, enjoy our podcast, baby, that we made for you.

Stephanie Goss: Happy birthing day everybody.

Dr. Andy Roark: Happy birthing day.

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.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: communication, culture, management, Practice ownership

Oct 04 2023

We Are TOO Big Not to Have A Manager, Right?

Uncharted Veterinary Podcast Episode 252 Cover Image

This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are talking through an interesting challenge that a veterinary technician wrote in to the mailbag with. This tech works in a practice with 15 other team members. They have no practice manager. Who solves the problems that the team can't solve? How come it feels like anarchy over there? This team member is asking for help. Let's get into this…

Uncharted Veterinary Podcast · UVP – 252 – We Are TOO Big To Not Have A Manager, Right?

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

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

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

October 25: Team Meetings That Build A Financially-Informed Culture with Ron Sosa

Are you struggling to create a balance between a money-focused environment and a culture that values more than just profits? Do you feel judged for how your practice manages its finances? Get ready to tackle the challenges surrounding financial transparency and foster a culture that goes beyond mere numbers.

Uncover ways to create a stronger, more financially savvy practice that thrives on teamwork and a shared vision. In this live virtual workshop you will:

1️⃣ Foster a Financially-Informed Culture:

Learn how to engage your team in understanding and appreciating the financial aspects of your practice. By involving them in setting metrics, you’ll create a united front in driving financial success while maintaining a strong cultural identity.

2️⃣ Promote Transparency and Trust:

Break down the barriers between team members and financial matters. Openly share enough financial information to ensure transparency, building trust and eliminating judgment within your practice.

3️⃣ Cultivate United Engagement:

Discover strategies to keep your cultural feel intact while introducing necessary financial metrics. By involving your team in the process, you’ll create a sense of ownership and engagement in achieving both financial success and a positive work environment.

Gain the knowledge and skills needed to navigate financial matters effectively, align your team with strategic goals, and foster a culture of financial awareness and accountability within your practice. Don’t miss this opportunity to transform your financial meetings and drive your practice toward greater success.

When: October 25, 2023, 12-2 PM ET/9-11 AM PT

$99 to register, FREE for Uncharted Members


Episode Transcript

Stephanie Goss:
Hey everybody, I am Stephanie Goss and this is another episode of the Uncharted podcast. This week on the podcast, Andy and I are diving into the mailbag to take an email from a technician who is struggling because their practice brought 15 team members and their practice owner doesn't seem to want to hire a practice manager. This technician feels like the team's size is too big for them to work everything out amongst themselves and it feels like they need some leadership in the practice every day. The practice owner doesn't want to budge. This is going to be a wild one. Well, let's get into it.

Speaker 2:
And now, the Uncharted podcast.

Dr Andy Roark:
And we're back. It's me, Dr. Andy Roark and the one and only Stephanie, you-and-me-and-the-devil-makes-three Goss.

Stephanie Goss:
I was not disappointed. That was a good one.

Dr Andy Roark:
Oh, yeah. I heard that song recently. I was like, “I'm using that one.” That was a good song.

Stephanie Goss:
I love it.

Dr Andy Roark:
Oh, yeah. How are you?

Stephanie Goss:
How's it going?

Dr Andy Roark:
Oh, it's good. I just got back from a big vacation with my family. We went camping and hiking in Maine and Nova Scotia and Prince Edward Island. It was absolutely glorious. I learned something about my wife on this trip that you'll appreciate. So we go. It's not that we unplugged. It's that there's no cell service. First of all, there's no American Cell Service. But there's like… A lot of Nova Scotia is real remote and also we have American cell-

Stephanie Goss:
It's forced unplugging.

Dr Andy Roark:
Yeah, it's forced unplugging. So we are there and we're doing this beautiful hikes and camps. We got a rental car, a minivan. We're driving from one place to another and we're doing these things. Alison and I are just talking about how awesome this sort of go with the flow, making our way across the country. Trip is going. We're just talking about it's really awesome to be unplugged and absolutely just going with the tides and it's beautiful.
And so we're out there. We're like seven days into this trip and this is the vibe. We're hiking along these rocks next to the ocean and overlooking it. We come off of this hike. Our plan is to make our way into this nearby town and go to this little whale museum, museum about whales. We're coming out of the woods and we're just walking. I'm holding Alison's hand and I hear her whisper under her breath, “We're 16 minutes ahead of schedule.” And I realize that this whole trip she had planned to the minute. While I thought we were just blissfully rolling across the countryside, she was 100% running the schedule. It was like we were a weekend and she said, “We're 16 minutes ahead of schedule.” And I realized it was all a lie. The whole thing was absolutely planned. It's like the facade of relaxation was like, “Oh, there's a schedule. There's a schedule and I am being managed on that schedule.” And I had no idea.

Stephanie Goss:
That's pretty fantastic.

Dr Andy Roark:
I thought you would like that. When I tell a story about my life with Alison, I'll remember her holding my hand and we're coming off this-

Stephanie Goss:
You're 16 minutes ahead of schedule.

Dr Andy Roark:
… beautiful hike. And I was like, “That was one of the most beautiful places I've ever been.” And she was like, “We're 16 minutes ahead of the schedule.” “Okay. Okay.”

Stephanie Goss:
That's fantastic. That's fantastic. So you had… I have so many questions. We're going to have to have a conversation because we haven't talked about it. That means you had a little bit of a forced unplugging because you didn't have service. So I'm like, I can't wait to hear about how that piece went for you. Because when we did our unplugging episode last year with our friend Eric Garcia and Tyler Grogan, I remember Eric issuing you a challenge trying some unplugged time.

Dr Andy Roark:
It was great. It was particularly great because my two daughters were with us. They're 12 and 15 and their cell phones are-

Stephanie Goss:
Didn't work either.

Dr Andy Roark:
Yeah, exactly. Are important to them. They're not on social media, either one of them, but they text their friends and they watch YouTube videos and listen to their music and stuff like that. It really was this great. It was going to be one of those all-time favorite vacations just because it was a lot of family time in the minivan and hiking together and things like that. But it really was great. It was great in this way too, so they didn't have any access to cell stuff because they don't have a Canadian plan. But we could go places and get on wifi and they could send texts and download things and get episodes to watch or whatever they wanted to do. They could do that too. I really think that was beautiful. My position… So we talked with Eric Garcia a while ago and Eric does these things where he goes away and he unplugs and I get that. But I think everybody has to find what works for them.
My position on unplugging is this. I thought a lot about it on the walk. I knew you'd ask me about it. But I thought a lot about it on my hike and stuff like this. I really liken unplugging to eating healthy. Yeah, to eating healthy and like meditating. To eating healthy and meditating. Meaning unplugging and being disconnected is good for you. It is good for you. Eric going away for a month and being unplugged the whole time is comparable to a juice cleanse for 30 days in my mind. It's so healthy. I have no interest in it. I got into meditation a couple of years ago and I was like, as I do, I get big into things at the beginning. I find the thing-

Stephanie Goss:
You go all in…

Dr Andy Roark:
… and I get really excited about it. I was meditating a couple of times a day for like 10, 20 minutes at a time, 10 or 15 minutes. But I would do it a couple of times. I was really into it. One of my friends was like, “You got to come to this meditation retreat.” I was like, “Yes I do.” I was like, “How long is it?” And they were like, “10 days silent.” I was like, “What do you mean 10 days silent?” And they're like, “You go there and you don't talk for 10 days.” I was like, “What do you do?” And they were like, “You sit and you meditate and you eat soup.” I was like, “Why do you eat soup?” And they're like, “Because you're not doing anything with your body so you don't want a lot of calories. So you just eat soup.”
I was like, “I bet that's probably a spiritual thing that speaks to people. I'm happy doing the Headspace app for 10 minutes. That's where I am. I don't need a 10-day silent meditation retreat. I don't need to do a whole 30. I can do a whole five and then eat pizza on the weekend. That's where I want to live.” The same thing is true with unplugging. I don't want to unplug for 30 days. I like to unplug for 16 hours and then check and then have a little snack.

Stephanie Goss:
But I think that's the whole point. That there is no one-size-fits-all approach. You're finding what works for you. What works for you is different from what works for me, different from what works for Tyler and what works for Eric. Each one of us has made up our own rules and is finding that place. It sounds to me like you did the things behind the idea of unplugging, which is you spent time present with your family and with your girls. I will say it doesn't surprise me that you would rank this as one of your top favorite vacations. Because I have to say, I feel like we've entered a whole new stage as parents that our kids… For those who don't know our kids are right about the same ages. It is so fun. I love hanging out with them and I love spending time with them. I loved going and doing things and going on vacation with them when they were little. It held different joy than it holds for me as a parent now.
They're real little half grown humans at this point and I get to experience the world through their eyes in a radically different way than experiencing the world through their three and four year old little eyes. I love this. I love this stage. It scares the hell out of me that they're starting high school and that they're growing up. This summer has really hit home for me that I only have a few short years left with them at home before they start to make their way in the world. But I really am digging this stage as a parent, so it doesn't surprise me that you found that with them this summer.

Dr Andy Roark:
No, I completely agree. I tried unplugging for 90 minutes right before this podcast episode. Do you remember what happened? I unplugged for 90 minutes. What's wrong? About what time we were podcasting, I got three text messages and six phone calls from people saying, “Are you okay? Where are you?” And I was like-

Stephanie Goss:
But in my defense-

Dr Andy Roark:
… unplugging in the middle of a workday is not best.

Stephanie Goss:
But in my defense and in your defense, I was worried about you because although you generally run on Andy time, you always communicate. You broke rule number one about unplugging, which is that you have to let everybody know ahead of time that you're going to unplug.

Dr Andy Roark:
All right, that's fair.

Stephanie Goss:
Okay, we're off the rails already. Let's get into this episode because-

Dr Andy Roark:
Just kidding-

Stephanie Goss:
We have-

Dr Andy Roark:
We got a lot to cover here.

Stephanie Goss:
Yeah, we do. We have a good one. We got a mailbag letter from a technician who is working at a small-ish practice. It is private practice. They have about 15 team members in total and they do not have a manager of any sort. They don't have any leads. They don't have a office manager, a practice manager or anything. It's the practice owner and the team. What has started to happen as they have grown is that problems come up and the practice owner expects the team to figure it out and solve problems for themselves, which is wonderful and has benefits that I think we're going to talk about. There are also cons to it. This letter comes from the place of looking at some of the cons because they are struggling with feeling like there is animosity, there is a front versus back mentality because there is no one doing the, quote, unquote, “managing” from this team member's perspective.
What they're looking for here in the management sense is someone to help problem-solve and to deal with the challenges in a leadership capacity. Someone to be the decision-maker and help them all sort it out. They were just asking, “What is our option here?” Because they have asked the practice owner about hiring a manager and they have flat out said no. So this team is wondering, “What do we do? We're not all happy. We feel like there's strife. We feel like there's no one to help us solve the problems. We're really struggling. What is our best option for going forward from here?”

Dr Andy Roark:
I have some thoughts. This is always really challenging because the devil is definitely in the details here about what's our best option. I don't know what tools do we have to work with and what exactly is happening. But I think we can talk in general terms about this idea of we've got a team of say 15 or so. We don't have a manager and we're having strife and the owner has pushed back against that. I want to go ahead and start… Let's start with headspace as we do. I want to call out a trend, a thought pattern that I see a lot in not just in veterinary business management but in business management in general. There is this belief with a fairly large segment of the population, I think, that if you have problems in your organization, the obvious path forward is you should add managers, you should add administrators, you should add systems.
That's it. Like, “We're not getting along. We need a manager. We need some administrative person. We need more rules for sure. More rules are going to help us solve this front versus back problem.” It's funny because people are like there's a problem, we add more managers and more rules. If you keep following that then the idea is the path to utopia is more rules and more management. I don't think anybody wants to work at a place that has tons of management, tons of administration, tons of rules. No one wants that outcome, but everybody seems to think that moving in that direction is the obvious path to make their job better. I think that's funny. I think if you look at human healthcare, you will see the manifestation of this. Human healthcare in America, one of the reasons it is so ridiculously expensive is the layers and layers of management, administration and bureaucracy. It's completely out of control.
You've got these healthcare providers at the bottom supporting all of this management and administrative infrastructure and the whole system is broken. It's the same in universities. Anyway, it happens in our government, don't even get me started. But it's that sort of thing of you add these things that add things that add things. Now that's not always. I'm not, absolutely not saying that managers aren't important and there's no benefits to having manager or anything of that. But I want to call this out because I do think people quickly jump right to, “We are not getting along. If we had a manager involved or more management or more systems or protocols or rules, we could get out of this interpersonal problem.” And I would say I want you to really analyze that assumption and think about it. Okay, cool. Just full stop. I'm doing the thing that I do where I'm not saying they're wrong, but I want to punch holes into that bedrock belief of we need to add a manager. That's what we need.
It's funny, this letter ended a little differently than I thought it was going to. We often get these emails, and I started reading this one, and it felt this way, where people will be like, “Hey Andy and Stephanie, here's the problem. Here is the obvious solution that I have. Question, how do I get everyone to recognize that I am right and do what I want to do?”

Stephanie Goss:
It's true.

Dr Andy Roark:
You know. We get those letters all time.

Stephanie Goss:
We do.

Dr Andy Roark:
And yes, I laugh. I chuckle every time I read them, “Here's the problem. Here's the obvious solution that I have that is clearly correct. Question, how do I get other people to recognize my correctness in this matter and do what I think we should do?” And I'm like, “That is not an interesting question for me.” Well-

Stephanie Goss:
And to be clear-

Dr Andy Roark:
… of course, I did not say that.

Stephanie Goss:
… sometimes we do agree with them. But sometimes it's like, “That would make a boring conversation.” Yes, we agree with you, end of podcast.

Dr Andy Roark:
A lot of times they're not entirely right. A lot of times they have made some… Generally when I say, “There is one correct solution and here's what it is.” If your team has not bought into it, if other people don't feel any ownership of this solution, it's probably not the correct solution even if you can make a stronger case for it than anything else. Anyway, that's not what they did here. They did not end with, “How do I get the practice owner to hire a manager?” They ended with, “What's our best option?” I was like, “Okay, I'll pivot here. I do appreciate that.”
But anyway, I have those thoughts a lot and we see a lot of those. Anyway, when it came down to, “We don't have a manager, what do we do?” I needed to call out the idea of like, okay, I would just want to punch some holes in the assumption that a manager is the right answer to this problem. It might be, definitely might be. But there should be at least enough uncertainty that we can discuss other options. If there's not that level of uncertainty, I think it's going to be hard to move forward towards a resolution everybody feels good about.

Stephanie Goss:
I would agree with that and I think you presented a good headspace challenge. I think the answer… For me a lot of the time in veterinary medicine, I used to drive my team nuts because my answer was it depends. Because so much of veterinary medicine and life in general exists in the middle gray zone. And so this was one when I read through it that I was like, “Oh, okay. The answer probably is somewhere in the middle.” It wasn't a clear, this is the only right answer, because there's no one-size-fits-all approach to this. Every practice is different. Every business owner has different needs and every team has different needs. But from a headspace perspective, I think you presented a great challenge, which is I would say action step-wise, sit yourself down and think about one end of the extreme, like you presented, and think about the levels of bureaucracy that get layered in the bigger you get.
Human healthcare is a great example. Is that what you want or need for your practice? Let yourself go there from a headspace perspective. Then on the opposite end, it sounds from their email like it might be a little bit closer to the end that they feel like they're at, where it's a free-for-all and everybody can do whatever they want. There's no rules. There's no structure. There's no systems. It is a total free-for-all. Because once you wrap your head around what those two extremes look like, it is a lot easier in my experience to try and find multiple different paths that start in the middle and take the pros out of both ends and find the path that works for you and your team that feels individual.

Dr Andy Roark:
I want to touch on both of those two extremes real quick and again, I haven't yet revealed my position here and I want to be clear about that. I'm just shaking the construct that has been laid down to let everybody see that it's not as rock solid as people like to think it is. It's funny. There are a lot of… There's a tendency to think that managers are the answer to interpersonal problems. I've not found that to be true in a lot of cases. Meaning, people will say to me, “We have this person who is an absolute toxic person.” And they don't have a strong manager. And I'm like, “Let me give you a little piece of bad news. If they're an absolute toxic person, it doesn't matter if they have a strong manager. They're going to be a toxic person.”
There's a lot of people who have this. They tell themselves that if this person who I despise was managed, I wouldn't despise them. They're like, “I hate Carol and what I need is a manager that will make Carol not act like Carol, but like the ideal version of Carol I have in my mind.” And I'm like, there is no manager that-

Stephanie Goss:
That's not how-

Dr Andy Roark:
… is going to-

Stephanie Goss:
… that works.

Dr Andy Roark:
… make that happen. That's a magician, not a manager.

Stephanie Goss:
Yeah, you're so spot on. That's not how that works guys.

Dr Andy Roark:
Anyway, I just want to say that and put that in the con manager camp. So I have beaten my anti-manager drum here. Now let me beat my pro manager drum for a second. You and I talked about our vacation and going to Maine. We took tents and we went camping. There was four of us and we flew to Maine and then rented a minivan. Then we tent camped and we did all these different things to everything. Do you know how we packed? We did not have four people run around and pack everything that they thought we needed for this trip. That is not at all how we packed.

Stephanie Goss:
Let me guess. I would guess that Alison Roark was the general and said, “This is what we're going to pack and how we're going to do it.”

Dr Andy Roark:
Exactly. Alison had the list.

Stephanie Goss:
The list.

Dr Andy Roark:
I don't want people to think that Alison did this by herself. Absolutely did not. I was involved in planning and all of those sorts of things. Do not think she was abandoned and that's why. I was very involved in this, still, when it came down to packing, given that I was very involved in this and very excited about it and we went through everything together and I made sure that we had what we needed off of her list and things like that. It's important to say I was very invested in this and I put a lot of time and effort into it. When it came time to pack, Alison Roark with her checklist pointing where things went and asking for this and telling what she needed. This goes here and this goes in the car first and this goes and those things are going to be packed together and that's in a check bag and we're going to carry these things on. That was the way to get this done.
It was having a manager, an organizer, a general, a conductor. And we were exponentially more efficient and effective for having one person whose job was to organize the three of us, me and my two daughters, running around, packing the things, bringing things, loading things into the car. It made so much more sense for her to stand back and coordinate us as opposed to throwing in herself into the chaos and running around and doing things. That's how we packed. There's absolutely a point, a tipping point, where you say, “We are not organized and having someone step back and get us organized, that makes a ton of sense for efficiency and effectiveness.”

Stephanie Goss:
Yes, I agree with all of that. I love it.

Dr Andy Roark:
Okay. So we talked about the pros and the cons. There is a way to avoid bureaucracy and to own the difficulties of interpersonal relationships. Also, to say, we are not organized and we have to get organized, that do not necessarily involve hiring a full-time manager for a staff of 15. It's definitely possible. It's really hard because now you're really starting to get into how would you do this and it really depends on the talent that you have on the floor as far as what your options are. And so anyway, I just want to start to lay that out. The last part of headspace before we start to get into how I would try to start, what your options are or how I should line this up, the last part I want to lay out is I am a big believer in flat organizations or flat-ish organizations. I am not 100% bought into the idea that a hierarchy is required to get things done and create a good place to work.
I think you can do it that way and you and I have both seen it done that way where everybody has a clear manager. The manager manages the people right underneath them and everybody moves in that clear lockstep, direct boss looking over your shoulder, maybe micromanaging, maybe not. But everything has a clear direct hierarchy of if you don't like what this person did, you can go directly to their boss and blah blah, blah, blah, blah. I think that there's a lot of benefit in hiring good people and supporting them as communicators and giving them autonomy to say, “Hey, these are our values and this is the general system in which we work.” I want you to look around and assess what's going on and make it the best decision in the moment rather than following some cookbook protocol that was laid out with no thought to this specific situation.
I think it is not too much to ask that grownup people do some actual relationship building and a little bit of conflict management. I think that there is a problem with conflict management skills, a lack of conflict management skills in our profession and I'm not convinced that if you have people who are not good at conflict management, the obvious answer is a babysitter to wade in and fix their problems. I think that you can make a strong case for facilitating conversations and giving responsibility back to people to fix their own issues. I do think that there is a tendency sometimes to say, “These people are not getting along. Bring to me, the manager, your problems and let me sort out your interpersonal issues.”
And we both know where that goes because we've seen managers who do nothing except deal with interpersonal issues all day long. They should have pushed those issues back onto the people who were having them a long time ago and said, “I want you both to go. Here's a $25 gift card to Starbucks. I want you guys to go to Starbucks. I don't want you to come back until you're able to work together.” That may sound archaic, but I promise you it absolutely can work. Sometimes it doesn't. We have to escalate. But I see a lot of people who are way too quick to take interpersonal issues and take them up the chain as opposed to empowering people and expecting people to handle their own issues. Then it just becomes management time is completely saturated dealing with interpersonal issues.

Stephanie Goss:
Well, let me shout out a big positive here because this team member called out their practice owner wanting and expecting the team to be empowered to solve their problems on their own. From a headspace/action step perspective, I agree with you. I think a lot of practices would look at this situation and say, “We're going to put a manager in place.” And go about it the way you said, which is, “Okay, the manager is going to be the one to solve the problem.” While it may resolve some of the conflict, I promise and guarantee you that that approach is absolutely going to create a whole new set of problems. It is because then you are not empowering anybody. Then you are creating a bottleneck where everybody has to go to one person to get answers to their questions and their solutions. And so now you have a whole new problem on your hands.
I love that they pointed it out in this practice owner's defense. I do absolutely think that every member of our team, part of our role as leaders, whether you're a practice owner or you're a practice manager, when you run a hospital, part of the tools in your toolkit should absolutely be that the members of your team get taught interpersonal skills in conflict resolution. Because the reality is we're human and we're working with other humans and it is never going to be all kumbaya, everything is hunky-dory 100% of the time. That is just not reality. If we don't teach them how to mediate conflict themselves, how to work things out, how to speak to each other with kindness and compassion and it seems… I know. I hear in my head the practice owners who are listening right now going, “But why is it my job to parent them? Why didn't they already come to me with those skills? I'm hiring adults.”
That is not reality. We can be mad about that or we can just accept the fact that even if they do have skills, we can still help them get more skills, and so get over the mad. I'm saying that with all the love and kindness but camped off love because I've been there. You can get sucked down in the mad or you can teach them how to do the thing that you're frustrated that they can't do, and in this case it's a soft skill. I think when we look at it, shout out to this practice owner because they are expecting them to work things out and we don't know because we didn't get all of the information. We're only getting one side of this story.
But if they're expecting that and not equipping the team with the tools to actually do it, then they're shooting themselves in the foot. Because you don't get that many people, especially like, I'm just going to go out on a limb and make a generalization, veterinary medicine is very female-dominated at this point in our industry. You don't get that many people or that many women in the same space without having conflict. It just doesn't happen. You are crazy to think that that is a thing. It is irrational for us to think that you could put 15 people on a team in close-knit space and not expect there to be conflict at some point in time. If you are not helping them equip with the skills to deal with that, you're just shooting yourself in the foot.

Dr Andy Roark:
Well, there was four of us in the minivan and we all love each other deeply and there was conflict. There was conflict. No, I really like this about people sorting out their own issues. I just want to call out, because I'm not saying that this is going on here necessarily, but whenever we get into this I need to call out either-or thinking, and this is a behavioral psychology trap that people follow too. And so people are like, “Well, either they need to solve their own problems.” Or, “If I weighed in, then they're always going to come to me and I will be stuck doing this forever.” And I go, “That's either-or thinking. That's not true.” That's not true. You can be very cognizant of the desire to not be involved in a lot of interpersonal issues and also recognize that sometimes we do have to get involved and we can get involved in a way that does not mean that we're going to see an increase frequency in this. But I think a lot of people are afraid of that. They're like, “If I weigh into this, I'll have to weigh into every one.”
Here's my last piece of headspace, when do I wade into interpersonal conflicts? I'll tell you when. This goes down to the thing you've heard me say many times before. The difference in a struggling business and a thriving business is this. A thriving business has a new during problem every day and a struggling business has the same during problem every day. And when I feel like we're having the same during problem every day, at some point I have to intervene and that can be, “Hey, you guys need to sort this out.” Or if in fact we've tried that and that has not yielded results and we're still stuck on this problem, I am going to get increasingly involved in this problem one way or another. How it turns out will remain to be seen. It may turn out with one less team member than we had going in. It may, two less team members. Hopefully it won't.
But that for me, just so you know, when I'm like, “When do I know to keep pushing this back to them and pushing this back to them versus letting it go.” To me, it's that, if there is a problem that I see in our team, in our business and it's the same problem again and again and I have nudged them and I have told them they need to work this out and the same problem persists, at some point you're picking your poison. You're either deciding to live with this problem which may very well go ahead and escalate or you are deciding to get involved in this specific problem. But not many problems rise to that level and that's important or else you get stuck in either-or thinking of, “If I help these people, if I get involved, I'm getting involved in everything.” I go, “No.” You're only going to get involved in things that you have pushed and tried to have them resolve themselves again and again and again and they are past frustrated and now you're going to get involved. I think that's okay. That's what I got for headspace.

Stephanie Goss:
I love it. Should we pause here and take a quick break and then come back and talk about action steps?

Dr Andy Roark:
Let's do it.

Stephanie Goss:
Did you know that we offer workshops for our Uncharted members and for our non-members? So if you're listening to today's podcast and you are not a member of Uncharted yet, you should be. But this is not a conversation about joining Uncharted. This is a conversation about all of the amazing content that we have coming at all of you, whether or not you're a member, through our workshop series. You should head over to the website at unchartedvet.com/events and check out what is coming. We have got an amazing lineup on the regular. We've got something every month, sometimes two or three things in a month, coming at you to expand your brain, to talk about leadership, to talk about practice management, and dive into the kind of topics that Andy and I talk about on the podcast every week.
Now's your chance. Stop what you're doing, pick up your cell phone, I know it's not far from you, and type in unchartedvet.com/events, see what's coming and sign up. They are always free to our Uncharted members and they have a small fee attached to them if you are not currently a member. You can get all of the details, pricing, dates, times, and register, head over to the website now. I want to see you there.

Dr Andy Roark:
All right, so let's get into action steps here. The question that was asked was the owner is opposed to having a manager, what are the best options? I would start to lay this down in my responses to our technician that was writing. This is how I would coach that person who's asking me what do I do? Where do I go from here? The first part of headspace for me is assume good intent.
If you decide the practice owner is stupid, that he's a jerk, he doesn't know what he's doing, he doesn't know how to run a business, you are setting yourself up for a really hard go of it and you're not going to be very effective in talking this out. You're not going to be very effective in finding solutions. The first thing is I would just say assume that there is a good reason that the practice owner feels this way and assume that the practice owner is trying his best and he really wants to have a good place to work. Just go ahead and get that in your head. To me that is the low bar for engaging in this conversation.

Stephanie Goss:
I think one of the best tools that I've ever been taught to help do that… Because when you're sitting there looking at it from your perspective, it is hard to get yourself out sometimes of the emotions that go along with viewing it through your lens. One of the most helpful tools that I was ever given was someone taught me to ask the question, what else could this mean or what else could be going on here? And so when I actually forced myself to sit down and answer that question, what could be happening, there are a million other things besides the fact that they truly are just trying to make my life more difficult by not hiring a manager. Let's be real. When you're in that situation, that is a part of how you're probably feeling, which is my life is immeasurably more difficult because none of these people are getting along and I have to come to work and deal with this BS every day. That could absolutely be where this technician is sitting.
There could also be a million other reasons, why. When I ask myself that question and I let myself hallucinate in that way of what else could this mean? Why else could they be making this choice? Maybe they can't afford it yet. Maybe they're not sure that it will solve the problem. Maybe they had bad experiences in the past with a manager. When you let yourself go down that road and hallucinate different answers it, in my experience, has become a lot easier for me to find that place of not only assuming good intent but also putting on my empathy shoes so that when I sit down to have this conversation with them and try and understand, I am ready and prepared to do that.

Dr Andy Roark:
Yeah, I agree. That takes me right to the next step. I think this is probably two different conversations. I don't know that you can do this in the same conversation about what I'm going to say. The first thing that I would like to do is seek first to understand why does the owner not want a manager? Honestly, there is so much value there and you have to figure out how to ask this question in a way that doesn't come off as challenging. Because just imagine that Stephanie has been just writing me about hiring a manager and she's like, “Andy, we need a manager. Andy, we need a manager. Why aren't we hiring a manager?” It's a match. Then she comes to me one day and says, “I have a question for you. Why won't you hire a manager?” There's a very good chance that that's going to sound like challenging. It sounds like we're headed right back into this argument again. You're not going to get good information on me.
I'm going to put my guard up. I may not be totally honest with you, especially if it's because I'm afraid I can't afford a manager. It's because I had a bad experience with a manager before. They embezzled a bunch from the practice. Say something like that. If I'm feeling defensive, I'm probably not going to share that information with you. So you really want to try to figure out the best way to broach this subject in a way that feels safe and allows the person to be open. It's sort of genuine curiosity. But I would like to know why this person who's got a team of 15 does not want to have a manager. I'm not saying they're wrong, that's why I laid that down up front.
It's like I made great reasons. I said, “I absolutely had a mentor that I worked with who had a practice manager and she took him for $90,000, I think, embezzlement. He felt so betrayed and taken that he did not want to have a manager. He wanted to be the one who knew all this stuff and he did not want to delegate to someone else because he had been so burned and felt so betrayed.” I'm not saying that's how you should feel, that's how he felt. I'm not saying he's right, but I'm saying I get it. It may not mean like they get it-

Stephanie Goss:
There may be reasons for their behavior. There may be motivation behind their behavior in that sense of something that they've experienced.

Dr Andy Roark:
There may be constraints on the business that we don't know. He might be like, “Look, we have not been profitable in the last three years. And having someone who comes in who does not generate revenue directly does not make sense for us.” I think you can make an argument that the person could justify their salary, but if that's what he thinks, at least we can understand, “Okay, we've got significant financial constraints,” that changes the picture. All of these things affect what is our best option because the question was what's our best option? He goes, “I can't tell you because I don't know where all these… I don't know where the pinch points are. I don't know what's holding us back. I don't know what the real internal obstacles are.” But we got to understand that before we can pick our next move. Anyway, to me, why are we opposed to having a manager? And the more clear answer I can get to that, the more I can understand what options are in play.

Stephanie Goss:
Okay, when you were talking about potentially feeling challenged when somebody asks you about this, I immediately flashed to… I remember before I became a parent and I swore that I would not tell my kids, “Because I told you so.” Then I can think of a lot of times in the heat of the moment when I'm super frustrated and I've gone on the defensive and the answer is because I told you so. And that's the end of story and will walk away. Because it's that feeling challenge. So how do we set up that question in a way that makes somebody less likely to be defensive?

Dr Andy Roark:
Sure, everybody's a little bit different, of course. Ideally you have a good personal relationship with this person. You know them as a person, they like you. You have a good relationship and that makes it a little easier. But basically I think probably if I was going to do it, start shooting from the hip. I think this is how I'd step it up. I would step in, I would lead with vulnerability and then appreciation.
Basically how this would start off is I would say something along the lines of, “Hey, I love working here. I love this clinic. I love being here. I really appreciate the opportunity to be here. I enjoy what we do here. I really want our clinic to be very successful. I look at what we're doing and we've got 15 people. I look at all the other vet practices that I knew of that have 15 people and they have someone who's in a designated manager role and we don't. Obviously, that's an intentional decision and I was wondering why you made that choice. What's important about not having a manager? I want to understand because I want to be helpful and I know a lot of other places that have gone this way, and so are you willing to tell me what you think?” So it would sound something like that.
Again, when would I do it, ideally? I don't know. The time and the place, all that stuff matters. You know what I mean? There's a lot of different ways to do it. But basically, that would be it, is to say, “I really love it here. I like this practice. I respect what you're doing. I want to be a contributor to this practice, growing and growing. I look around, I see other practices that have a designated manager, and it seems like we're getting to that size, but you've made it clear that's not something that you plan for. I want to understand why that was. What is your philosophy on managers?” And then I would honestly listen. I would not argue. I would not be like, “But, but, but…” Nope, you asked the question, just listen.

Stephanie Goss:
No, you need to let them be heard.

Dr Andy Roark:
And now you got to let them be heard. I would just go, “Okay, I got it. No, I just wanted to understand. Thank you.” I would take that and I would probably go away with it, but I would not let it turn into a debate because otherwise, and then a lot of people mess this up because they'll even get the question right and the other person will open up and share the information and then the person asking the question will disagree with the perspective of the person who's explaining their why, and then it will turn right back into the same old argument and it goes nowhere. That's not the point. The end result we're looking for here is to understand. Anyway, that's how I would set that up and sort of how I would try to frame it.

Stephanie Goss:
Yeah, I love that. I would probably do very similar. I would start with talking about how you care about the team and about them. You have noticed that there seem to be challenges in the team. One of the things that you thought of that might help the situation would be someone to play that conductor role.
Like you were talking about Alison in that role being the conductor to help solve some of the flow and challenges and take… I would frame it in the way of helping them take some of the burden of that off of their shoulders and then ask them, “I really would love to help you. I would just love to understand where your head is at when it comes to having someone in a position to manage the day-to-day of the practice. Tell me why it looks the way that it looks in your head and really just open up the door from that hopeful… I want to help you. I want to understand.” I think that that feels very different than when, fellow parents will understand, when my kid is like, “But why?” That's just immediately going to make me be like, “Because I freaking said so.”

Dr Andy Roark:
Yeah.

Stephanie Goss:
That's your point about arguing back, right? Then you're right back in that argument loop and the answer has not changed. When you ask it from a place of curiosity and then say, “Thanks, I really appreciate that. I would love to… You've given me a lot to think about.” My phrase is, “I want to marinate on that, I want to process that.” Then I agree with you, this is not one conversation, this is, potentially, multiple conversations. Then I would walk away, change the subject, let it drop.

Dr Andy Roark:
Yeah, I agree with that. That's the first conversation I would try to get is this, is why is this person opposed to a manager? There's a second conversation you can have and you do not have to have the first conversation before we go to the second one. Doing that conversation and understanding where the person's coming from can be helpful. It's not required to have the other conversation. The other conversation is this, okay, the other conversation that we want to have is we want to step back one rung on the decision making ladder. Imagine this for a second. Imagine that we're in a vet hospital and we've got this place and we are having front versus back issues, meaning the techs and the CSRs are fighting and it's going on.
So Stephanie Goss is sitting here and she's thinking about this and she's working the practice and she says, “The front and the back are fighting, so we need a manager.” She goes to me and she says, “Andy, we need a manager.” I'm like, “Goss, we're not getting a manager.” She's like, “We need a manager.” “We're not getting a manager. Not going to.” Well, what's the obvious next step? I've told her we're not getting a manager. We can either continue to fight about a manager and why can't we get a manager? And what if we got a part-time manager or we can step back one rung and say, “Andy, the front and the back continue to fight and here are examples of them fighting. Here is the impact this has had on the clients. This is how the fight manifested yesterday and this is how it manifested last week. They are clearly fighting. What are we going to do about the front and the back fighting?”

Stephanie Goss:
And I would add one thing in there that would be really powerful, which is that I would say, “I know your expectation is that we're empowered to solve this ourselves, and these are the things that we have tried,” especially from your perspective of what have you done to help solve the problem, call that out too. And then say, “I need your help because I feel like I'm stuck and I don't know what the next step is. This is what I've tried. These are the examples, this is what I've tried to solve the problem. I'm at a loss for where to go and I would love your perspective and your help on how you would like us to approach this situation, or how you would approach the situation if you were me.”

Dr Andy Roark:
I really like that, asking for help. I like that, asking for help. That's a really good play. I also like, “This is what we've tried,” and I really think that that's the play in my mind, is you need to put the manager thing aside and don't take him a request for a manager, take him the problems and say, “These problems persist. This is what we've tried. We're really stuck. How do we want to move forward from here?” And then have that conversation. It's very possible that the owner will look at the problem and ultimately say, “You know what might help this?”

Stephanie Goss:
“A manager.”

Dr Andy Roark:
“A manager.” And then it's their idea. And don't make them feel stupid. Don't say, “I told you so.”

Stephanie Goss:
That's a great idea.

Dr Andy Roark:
Yeah, that's a great idea. That's exactly it. It really is. That is to say, “Here's the problem,” or if there's three different problems, I would say, “These are the problems that I see that persist,” and lay it out one, two, and three. It might be that a manager would fix all those problems. It might not be, I don't know. I don't have the insight or the background to be able to know what those are. But regardless, that's how I would lay it out. I think that there's probably some people who've listened to this whole episode and they're just mad because they're like, “Andy, it's a team of 15 and they don't have a manager. How could you tell them that they don't need a manager?” But every team is different in what they're trying to do and that the players on the field really matter.
I have seen putting a weak manager over a strong team generally just frustrates people. You can absolutely do more… Managers can do more harm than good. Don't think they can't.

Stephanie Goss:
Oh yes, absolutely.

Dr Andy Roark:
They can absolutely make things worse.

Stephanie Goss:
Yes.

Dr Andy Roark:
And so just the presence of a human being with a pulse in a management role, I don't know that's worth anything.

Stephanie Goss:
No.

Dr Andy Roark:
I mean I can a hundred percent say, and this is just kind of how my mind works and stuff too, it depends on the people you have. So we said we got 15 people, so just walk with me for a second. Imagine that one of these people is an office manager, this is the person that does the administrative stuff for the practice, they pay the bills, do inventory, whatever, office manager. All right, so you got that person, you got three doctors, so that's four employees. You got four people at the front desk. So now we're at eight. We got seven support staff, right? I don't know, two techs, five assistants, stuff like that. That's your 15 people. I can a hundred percent see a high functioning team that has an office manager.
The practice owner is the lead doctor, let's say. You elevate one of your CSRs to be the lead CSR, and you elevate one of your techs or support staff to be the lead tech or a lead support staff or whatever. Well now you've got a lead doctor, a lead tech, and a lead CSR and an administrative support person. I think you can run a damn good team of 15 with a lead doctor, a lead tech and a lead CSR. I think you can do it. And again, but it depends on the people that you've got and things like that. Anybody who's just like, “The obvious answer is this,” I would say there's a lot of different ways to make a team work and function. Anyway, that's kind of where I come out.

Stephanie Goss:
Well, and I think that that goes back to where we started from the headspace perspective is remember the two extreme ends of the spectrum. You can have the layers of bureaucracy at one end where you have managers who have managers who have managers, or you could have, it's just a total free for all and there's no rules and it's total anarchy. We said finding that space in the middle. Part of it is thinking outside the box of what those solutions could be to find the right fit for you and your team and asking the question, why do I think we need a manager? What am I looking? Am I looking for someone to be a mediator or a problem solver? Because if that's the reason you think you need a manager, you don't need a manager. You need to teach everybody on your team the tools to be able to mediate the conflict management and be able to mediate the problems themselves and someone on the team who can act in that mediator role.
And that might be your practice owner, it might be somebody else on the team, might be somebody from outside the hospital, but you can solve that problem without saying, “We're going to hire a full-time, 40-hour-a-week person to fill this role.” So it goes back to the why are you asking, are you also asking because the practice owner is overwhelmed and you're getting paid a day late sometimes because they're trying to do payroll and they're trying to be all things, all people. What is the why behind it? Because I don't think that you can get to that creative problem solving space on both parts, the practice owner's part and on the team's part in terms of trying to help, without having asked yourself the question of what does that middle ground look like? Why are we asking this question? What do I think the practice manager's just job is actually going?

Dr Andy Roark:
Yeah, I think you're spot on. Anyway, that's how I'd approach it. I think that's my big take. I enjoyed this a lot. I like to be a bit of an anarchist and a little bit contrary about some of these things.

Stephanie Goss:
You do?

Dr Andy Roark:
I do. I like to push back on the idea that more rules and more managers and administrators is always the answer for a more harmonious workplace. I do not buy that. In some cases obviously, adding managers and systems makes all the sense in the world, but there's a point of diminishing returns and it's not always the obvious answer that people think it is. So anyway, I'm glad we got to talk about that and why.

Stephanie Goss:
Yeah, me too. This was fun. Take care everybody. Have a fantastic rest of your week.

Dr Andy Roark:
Yeah, thanks guys.

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


Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: culture, fatigue, management, Practice ownership, Training

Sep 27 2023

Burnout is Real – True Stories of Leadership with Phil Richmond

Uncharted Veterinary Podcast Episode 251 Cover Image

This week on the podcast…

This week on the Uncharted Podcast, practice management geek Stephanie Goss invited Dr. Phil Richmond back to the podcast to tackle a personal perspective on burnout together. Dr. Richmond is the Founder of Flourishing Phoenix Veterinary Consultants and a practicing veterinarian. He is an advocate for positive culture and individual, team and organizational psychological health, safety, and wellbeing in veterinary workplaces. Dr. Richmond both leads and is involved in state, national and international projects for the advancement of wellbeing and culture in veterinary medicine. This episode was inspired by a mailbag email but led Stephanie and Phil on a journey through some of the tricks and tips they each have learned while on the winding journey of aiming to become better leaders than the day before. Let's get into this…

Uncharted Veterinary Podcast · UVP – 251 – Burnout Is Real – True Stories Of Leadership With Phil Richmond

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

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

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

Calling all Team Leads – if you are a lead CSR, a lead Technician, a lead Kennel tech – we want you to come connect with your peers and our Uncharted Community! We have a brand new event we want to see your faces at.

Uncharted’s Team Leads Summit is an immersive 1-day virtual event designed to connect team leads and help you tackle the challenges unique to your role in veterinary practice. Kick off the day with an inspiring general session, learn from some of the brightest minds in vet med, and then dive in to gain exactly what you need with a discussion-based format to create game-changing connections for your career. This Summit features interactive workshops and Choose Your Own Adventure sessions, a signature of Uncharted events. Start the day telling us what you need RIGHT NOW, and leave having worked on exactly that.

✨ Sessions on navigating burnout, thriving in veterinary practice, motivating your teams and team training techniques

✨ Small group discussions to cultivate connections with people who understand your role

✨ A day that will make your boss thrilled they gave you a CE budget

✨ Inspiration and a recharge to continue to make waves!

SIGN UP TODAY

Upcoming events: unchartedvet.com/upcoming-events/


Episode Transcript

Stephanie Goss:
Hey, everybody. I'm Stephanie Goss, and this is another episode of the Uncharted Podcast. This week on the podcast, I am joined by one of my favorite people in veterinary medicine. He is a beacon of light and positivity. He is an Uncharted member. He is a colleague. And he is truly a dear, dear personal friend, Dr. Phil Richmond, joins me as my co-host. And we are having a conversation about burnout.
But before you turn the podcast off because you're like, “Not another burnout conversation,” Phil is one of the most positive people that I know, which says a lot because I feel like I'm pretty positive and bubbly. But Phil is truly a beacon of light, and we have a mailbag question that started with addressing burnout in teams, especially in on-call settings.
And as it does, our conversation meandered and we wound up talking about our own experiences with exhaustion and some burnouts in veterinary medicine, and giving some candid stories. But also, really some leadership lessons that we wish that we had learned before we became leaders. So, I had a lot of fun recording this episode. I hope you all enjoy it. And now, let's get into it.

Speaker 2:
And now, the Uncharted Podcast.

Stephanie Goss:
And we're back. It is me, myself, and I. I am here today but I am, sans Andy, but I am instead joined by one of my most favorite human beings on planet Earth, my dear friend and colleague, Dr. Phil Richmond. Hi, Phil.

Dr. Phil Richmond:
Hi, Stephanie. And as I like to call myself the Wish app, Andy Roark.

Stephanie Goss:
Oh, man. So many ways I could respond to that.

Dr. Phil Richmond:
It doesn't really look like or sound like him.

Stephanie Goss:
No, it isn't. It doesn't.

Dr. Phil Richmond:
But, okay.

Stephanie Goss:
This episode is not going to look or sounds like a typical Unchartered Podcast episode in the slightest. There's going to be lots of laughing, probably lots of squirreling. But we are together today because we got a mailbag topic. And we're not actually going to answer the direct question that was asked in the mailbag as I do with you, because when I read it, I was like, “Ooh, I want to have a conversation with Phil about this,” because it involves some bigger themes that relate to you, what you do in veterinary medicine. And I just thought it would be a good chance for you and I to have some good conversation.
And since Andy is on vacation when we're filming this, while the cat is away, the mice will play. So, let's begin and have some fun. So, for our listeners who don't know you, welcome to the podcast. If you have not had the opportunity to interact with or talk to or hear Dr. Phil Richmond's present, you are missing out because you are an amazing human being, and you have a lot of wonderful things that you are sharing with our profession. And we're going to get into by way of the mailbag, get into some of what you're doing.
So, the mailbag topic I got was about a hospital who is a specialty practice there, specialty surgery practice. And by the nature of their work, they have after hours on-call rotations for their team. So, they're taking care of their patients postoperatively. So, they have on-call hours, overnights, and weekends. And so, it is one of those things that is inescapable in some facets of veterinary medicine. On-call has to happen for them to support patients postoperatively. And I totally get that.
And the manager who wrote in was like, “This takes an incredible toll on the team because being on-call is hard.” And they were looking for some tips and tricks that we'll get into in another episode in terms of how do we structure that and support it from a systems perspective. But what interested me in talking with you with the burnout aspect, and because we have big pieces of veterinary medicine and specialty practices in ER practices. And even GP practices that… Particularly, the ones that are more rural and don't have overnight.
There's lots of people in veterinary medicine who can't avoid being on-call. And this manager's point was that, burnout is a real thing and it impacts the team. And so, when I was thinking about it, I was like, “Who better to talk about this with than my friend, Phil?” So, tell us a little bit, Phil, about who you are and why you and I would want to talk about this because it's right up your alley in terms of the work that you're doing in veterinary medicine.

Dr. Phil Richmond:
Yeah. Thanks, Steph. And it's just always a pleasure for us to get together and talk. And we just have so many things in common, and I just love being able to share space with you.

Stephanie Goss:
We love your face, friend.

Dr. Phil Richmond:
Thank you. And it is. So, I jokingly say, those of us that are working in this field, none of us… I wasn't in vet school fourth year going, “You know what? I cannot wait to work on wellbeing and burnout in the profession.” And I say that like, “This is someone tongue in cheek, but where it is, is that most of us have lived experience or personal story, why it's so important for us.”

Stephanie Goss:
Sure.

Dr. Phil Richmond:
And so, briefly, I was a new grad. It was about 2008, dating myself a little bit. But I was working, I mean, this is right up this alley. I was working 60, 70, sometimes 80 hours a week. Now, that was self-imposed. I also want to say is that, I was working on my days off at a clinic that I grew up working at. And then, I was picking up emergency shifts on the weekends.
I would come in on my days off to do surgeries that I hadn't done before, which I'm not suggesting that you shouldn't do that because there's some benefit to doing those things. However, even the owner of the practice was like, “Hey, you need to throttle it down.”

Stephanie Goss:
That's a lot.

Dr. Phil Richmond:
Yeah, that's a lot.

Stephanie Goss:
Right.

Dr. Phil Richmond:
But some of that stuff was not… It was self-imposed for me. And so, what I found was is that, I got to this point where I had the hallmark signs of burnout are exhaustion, cynicism, and inefficacy. It's just taking us longer to do things. We just can't get through stuff, that type of thing. And I only had one tool in the toolbox, and you and I have shared our stories, but I just had alcohol and substances like, that was it.
And so, add that to all the stresses of veterinary medicine and all of this. And then, getting into burnout. And I really was in a dark place, and I'm going to mention suicidal ideation, but that was where I got. So, what I realized was, is I ended up going to treatment. I got a lot of tools, individual tools that were very helpful for me, and they helped save my life, and helped me love veterinary medicine again.
What I realized though is that, when I went back into practice is that it wasn't the whole story, is that I played a big part in some of that like, I misinterpreted things. And how I viewed situations, that was stressful for me and burned a lot of emotional energy. But even when I do that, there can be external factors, which is really what burnout is, is burnout is really a systems issue. It's not a personal failure.

Stephanie Goss:
Right.

Dr. Phil Richmond:
And when I learned that both of those things were true, it was one of the things that pushed me to want to help our colleagues and because it's so common for all of us. And especially now, with COVID and that type of thing. So, not only leaning into the individual nature, the things that we can do with resilience training, with gratitude, with intentional induction and positive emotion, and these types of things as well as seeking mental health support from professionals.
But then, also the importance of team level, wellbeing team level, psychological safety, where our leaders and how we work as a team is vital. And then, the third thing is organizationally, or when we talk about the me, we, us. And I just love that model. So, me being the individual. We being team and leadership. And then, us, being the organization.
And then, organizationally, looking as the organization, do we have policies in place? Are we measuring burnout? Are we measuring the wellbeing? I mean, we're all clinicians listening to this. We all know, “Hey, if something's going on with our patients, we run tests.” How often are we doing that in veterinary medicine? How often are we taking the pulse? Excuse me, if our team… To find out what's going on.
So, those things are important. And then, okay, now we get this information, what do we do with it? And so, those things are just, what I found is that I want… I have a vision, like a lot of us in veterinary medicine, I want it to be here for years to come. And it's a beautiful profession. It really, there's a lot of joy and a lot of reward that can come from this profession. And we just need to… There's some things that need to be in place to make that happen.
So, the sky is not falling. But there's things that we need to address that are challenging. And then, we also need to lift up the positive aspects of the profession. So, in a nutshell, that's what I do is working on psychological health and safety, and team cohesion and individual skills of resiliency, and that type of thing. And how important that is to patient care, how important that is to longevity and sustainability as a veterinary professional.
It's things that we don't generally get taught. I mean, we're much better now, I should say. But just not taught in vet school or tech school, or I think it's more now in the CVPM that's part of, part of that as some of the leadership development and wellbeing of the teams. So, I'm glad there's much more awareness, but yeah.

Stephanie Goss:
Okay. So, as you do… I love you so much. There's so much to unpack there because you just crammed 10 pounds in a 5-pound bags there, friends. Okay. So, let's go back to a little bit about… So, what you're doing now with your work has to do with falling in love with the profession again and wanting to help yourself and help your peers, which led you to where you are? Let's go back for a second because this topic resonated with you because you found yourself in a place of burnouts.
And you and I have similar steps along our path where we found ourselves in dark places, and feeling really overwhelmed and exhausted. And you and I, both being long-term members of the recovery community. I think both found ourselves looking inward as you do when you're in recovery, you do a lot of work on yourself, hopefully.
But also, looking outside of ourselves and recognizing that we can only do so much on a personal level. And I love… You're actually going to be talking about this topic at the Uncharted Culture Conference…

Dr. Phil Richmond:
I am.

Stephanie Goss:
… shameless plug here, because you were going to be doing a session specifically on your… You mentioned the idea of we, me and us, right? How do we as individuals exist in veterinary medicine? There is responsibility and work that we can do on an individual level. And it doesn't exist in a vacuum, right?
The burnout on us can't only be on the individual because as you mentioned, there's external factors that impact from a team level, and team dynamics, and the safety that the team has in being able to talk to each other, ask for help, support each other, all of that. And then, there's the systems piece of it in the organizational structure.
And so, I'm super pumped. You are actually going to be doing a session for everybody who is attending the Culture Conference in October, and I'm super excited about that. So, if you're listening to this and you're already like, “I want to hear more about what Phil has to say,” you should head over to the website and sign up for that. Because it's virtual, so anybody can come, you don't have to be an Uncharted member, and you're going to be doing a general session.
And so, I don't want to spoiler too much of the details of what you're going to talk about there, but I do want to dig a little bit about where you started and empathizing with that on the personal me level. And then, talk a little bit about the organizational stuff.
So, when you found yourself out of school and getting into practice and you found yourself at the place where you recognized that you were burned out, was that a place where you could see what you were doing to your… So, you said that you were doing it to yourself regularly or you were working extra hours and you were taking on more and more and more in that space though, was that something that you recognized in yourself? Or was that something that others pointed out to you? Because like you said, your practice owner even said to you like, “Hey, you need to throttle this down.” What did that look like for you?

Dr. Phil Richmond:
No. So, I had an incorrect assumption on what I was supposed to do and what I was supposed to be capable of my first years out. And I thought, I just had this idea that I was going to go in, that I came out of vet school, I should have all the answers. If something went wrong, it was this weird thing is, for me, one of my thinking traps was, is that if something went wrong, I would blame everything else. But I also would then question like, “How responsible am I?” But it was almost like a defense mechanism.
And so, a lot of us in recovery have that. But when I'm going with this is that, the biggest thing was, is that I had… Now, I can see the signs of burnout in myself. And those signs were so clear back then, but I looked at them as they were failure. And instead of saying, “Hey, I need a break,” it was like, that horrible negative self-talk was, “You're just weak. You should be able to do this.”

Stephanie Goss:
You can't get it all done.

Dr. Phil Richmond:
Yeah.

Stephanie Goss:
You can't hang.

Dr. Phil Richmond:
Yeah. The reason why is, you're just not working hard enough. You need to be up later. You need to…

Stephanie Goss:
Just work harder, yeah.

Dr. Phil Richmond:
Just work harder, right?

Stephanie Goss:
Yeah.

Dr. Phil Richmond:
And as we know, I mean, it's like the battery analogy and the phone, you're just not even magically going to put all that in there. The spoon's theory is that, we've got a certain number of spoons we can use during the day. And it's like, when they're gone, they're gone. And that whole concept was just… I didn't have that, and I didn't know. I just thought the answer to everything was work harder.

Stephanie Goss:
And so, going back, you said the three of the classic hallmarks of burnout are the inability to focus and stay focused. Tell me what the three that you said again.

Dr. Phil Richmond:
Right. Yeah, absolutely. So, and there are different definitions certainly, but this is what the World Health Organization describes it as. So, there's exhaustion. So, that's really a feeling. I think we can obviously all relate to just that physical, mental, emotional drain that we feel.

Stephanie Goss:
Yeah.

Dr. Phil Richmond:
And what happens is, when we go through that just chronically, we begin to isolate. And as we know in recovery like isolation is that's when we start spiraling, is that when I disconnect from people, that's a challenge. So, exhaustion is one.
The second is cynicism and, “Ooh, do I… Yeah, leaning in the negative?” So, and to give you an idea of what this looks like on the ground in a veterinary hospital, our clinic, I should say the practice that I love… I'm getting to go back to the great group of practices. We worked really hard on psychological safety on all of these things and teamwork. And we just, generally speaking, I mean, we just didn't talk stuff about clients or one another. I mean, we were very intentional about that over the years.
And it was a red flag for me, is that I noticed when our team started, and this was during COVID. When they started talking stuff about clients. It wasn't normal for us. It was out of the norm.

Stephanie Goss:
Sure.

Dr. Phil Richmond:
And for myself, because I've been in some burnout lately, and I just become… The negativity bias kicks in. And instead of looking at the positive, I start going into the negativity bias. And so, that cynicism of the everything is bad, everything is this. And then, what happens is that, that creates a spiral as well. And then, the last thing is the inefficacy. So, go ahead. Yeah, I think the cynicism is…

Stephanie Goss:
No, no, I was just… You're getting there. It's funny because listening to you describe those things and you were saying like, “What does it look like in veterinary medicine?” I can totally recognize that exhaustion. And we talk about it jokingly in a lot of the manager groups that I'm in. But when you think about painting that picture and you think about how many… Everybody wakes up and is like, everybody has bad days, right?

Dr. Phil Richmond:
Yeah.

Stephanie Goss:
Everybody has stuff going on in their lives. And there are absolutely times where you wake up and you're just like, “I don't want to go to work today.” You feel tired. You wake up and you're just like, “I can't… I'm dragging.” I mean, I knew I was getting up and getting to talk to you today, and I still was like, “I'm so tired. I just want to go back to bed,” where everybody has those days.
And when you were talking and thinking about it from the burnout perspective, and then leading to the place of cynicism, I think about when I was really struggling in the practice. It's that every day you wake up and you're like, “I just am so freaking exhausted. I don't want to get up. I don't like, I can't.” I got it. I'm getting up, and I'm pounding multiple energy drinks in the morning. And then, I walk in the door of the clinic and that cynicism immediately kicks in, and it's that that.
When I'm going in the door with that frame of mind of what such hell is awaiting me or everything is just like, “Can't you guys just leave me?” Somebody asked me, “Hey, when you're ready and you're settled in, can we talk about something for a second?” And I'm like, “For the love of God, why can't you just leave me alone?” I found myself in that place where it was like everything was reactive, everything was negative. And so, hearing you talk about that immediately, I can empathize with that because I can see it in myself.

Dr. Phil Richmond:
Yeah. And so, what's interesting about these concepts is that, I mean, it's a blurry line. It's not all overload necessarily. And that's where the recovery stuff came in is that, I found that I learned ways to challenge my negativity bias like, “Oh, this person did that.” And it's like, “Really? Did that like, am I filling in the blanks with stuff?” And that was something that I learned over time.
What was interesting to me is almost like an experiment is like, here, I have the tools and I still can't overcome it. I'm going… And that's what's been not just personally, but that's what's fascinating, if I can even say that about burnout, is that again, it's an external issue. And man, that's cynicism. I mean, we have our great friend Josh Weissman, amazing human being. And I shared that with him a few weeks ago. I was like, “I can just tell, because it's not my norm to be looking at the bad side of things. Or, oh, this is crap, or this is that.” It's like, “Damn, what's going on with me?” It's a sign. It's a clinical, almost like a clinical sign.

Stephanie Goss:
It's a sign, yeah.

Dr. Phil Richmond:
Yeah. But it's also, sometimes, when you're inside the pickle jar, it's hard to read the label. And so, if you have people that can… When you're in it, sometimes you don't know that you're in it, you're just… But I had friends, and then my wife is very kind of, to let me know, “Hey, you've mentioned this.”

Stephanie Goss:
You're not yourself.

Dr. Phil Richmond:
Yeah, that you're bitching about for the fifth time. Maybe you need to…

Stephanie Goss:
Nineteenth time.

Dr. Phil Richmond:
Yeah, right, right, right, yeah.

Stephanie Goss:
Hey, friends, you have heard Andy and I talking about some of the big things that are coming in the back half of 2023 for Uncharted, but we are not done. In fact, we are not even close to done with releasing all of the new fun and exciting stuff that our team has been working on.
So, I want to make sure you don't miss out on it. Now, if you listen to the podcast, you're going to hear about it. But if you want to guarantee that you are the first to hear about the big giant announcement that we have coming soon. So, so, so soon, but not soon enough.
You want to head over to the website, unchartedvet.com/insight, that's I-N-S-I-G-H-T, unchartedvet.com/insight, and sign up for the newsletter. That will get you on the list and guarantee that you have first dibs access to the big, big news that is coming soon. Don't miss it. I promise. You're not going to want to miss out. And now, back to the podcast.
Okay. So, the exhaustion and the cynicism, and then I was emphasizing and cut you off with the last one, yeah.

Dr. Phil Richmond:
Which here comes the shame spiral like Brené Brown. Inefficacy. is that the harder we try to push, the less efficient we can be, which is ironically, which is why, we well, burn out, is that when we do that, the cure for it is rest and changing the system. But what we do?

Stephanie Goss:
Oh, we just try and work harder.

Dr. Phil Richmond:
We do the opposite. And that's what all the evidence shows us is that, we can't do those things. And that, maybe we can go 110% on the reactor for a few weeks maybe, but it can't be a chronic state. Our bodies then physiologically, the release, excuse me, the chronic release of the stress hormones and all of these things, our bodies are not meant to function at that level. We can only do it for so long before body's just kind like, “Hey, I'm out.” And then, we start to see physical manifestations. And we get into that.

Stephanie Goss:
That feeds right back into the loop, right?

Dr. Phil Richmond:
100%.

Stephanie Goss:
Then, you're exhausted.

Dr. Phil Richmond:
Yup, yeah, right.

Stephanie Goss:
And it feeds the exhaustion model because you're physically feeling the toll of that. And then, it spirals and you feel like, you can't get out of it.

Dr. Phil Richmond:
And then, you're not doing… You can't do as much work as you did even though you're trying. And then, what happened?

Stephanie Goss:
Inefficient?

Dr. Phil Richmond:
And then, inefficient. And then, oh… And then, as I said in the Uncharted Conference, my inner critic's name is Carl. And then, Carl's up here going, “Oh, Phil, you are POS like, you really, you shouldn't even be doing this job. You can't do this. You can't do this. You're not getting this done. You are… Man, you are worthless.” And all that negative self-talk.
So, and we'll get into a little bit of what are some of the ways that we can combat that. I think as we go in the future. And just really, I have to do a shout-out to Dr. Michelle McQuaid and Dr. Danielle Jacobs from the Wellbeing Lab in Australia because they've done a lot of the work on this that I really lean into. And so, anyway, I just wanted to say like, yeah.

Stephanie Goss:
Yeah, okay. So, let's talk about that. So, you like career wise and path wise, you got out in vet school…

Dr. Phil Richmond:
Right.

Stephanie Goss:
… and you were a new grad, and you almost crashed and burned, right? Because you were…

Dr. Phil Richmond:
Definitely, yeah. I mean, I would say by… I mean, I was out of practice. So, I reached the bottom, I guess we can say to where I was pulled out of practice. I was in a treatment facility for 90 days, which by the way, is way more common than we just don't hear about it. But that saved my life. Not only did it give me the rest because of that. Remember we were talking about the physiologic stuff, chronic stuff, and then filling my cup back with tools that I then had to go back into that environment that I didn't have before. So, yeah.

Stephanie Goss:
And so, that kicked off the passion for you because when you meet Phil, one of the words that immediately comes to mind, if you have had the pleasure of spending time in your company, Phil is passionate. And I think that you are passionate about just life in general, which is one of the things that I love about you.
You just have great energy and being around you is wonderful, but you're so passionate about looking at veterinary medicine, and it would have been very easy for you to come out of treatment and stepping back into practice. It would've been very easy for you to look at it in a very cynical way because there is a lot that is challenging. And so many people will say, veterinary medicine is broken, and we're a hot mess. And there are a lot of people that look at it from a negative perspective, and feel like it's so systemically, we have so many problems, it's not fixable.
And you chose to look at it from the perspective that resonates with me, which is there is so much that is wonderful about veterinary medicine, and we need some help. And so, I feel like that kickstarted getting those tools and starting to fill your toolbox, kickstarted for you very much the same way my own experiences and my own… I mean, I was in recovery before veterinary medicine. But very much, we have similar paths in that way of like, it became a passion project for you.

Dr. Phil Richmond:
Yeah, yeah.

Stephanie Goss:
And so, you started doing education and work around wellbeing and burnout, which led you down a path of positive psychology and the wellbeing work that you're doing now with Dr. McQuaid and the team in Australia. So, tell us a little bit about where your winding path took you next.

Dr. Phil Richmond:
Yeah, so quickly. So, there was a 10-year area where I was in practice. I was going to meetings. I was trying to help medical professionals in recovery. But I was really quiet about it because of the stigma. And then, just as we know, the anonymous nature of 12-step recovery.
And then, there was just a point where I got to where I had the opportunity to be of service for the FVMA. And where I'm going with this is that it was like, now I knew these things worked. I knew these concepts and these principles and these things worked. But how was I going to go into talking to veterinary professionals and say, “Hey, I'm in AA, and this works.” And it's like… And then, so what happened was, is that I got put in a position of… And this is where Carl comes in, by the way. Carl, it was like, “Hey, you're just some drunk that learned some stuff and it just makes your life.” But…

Stephanie Goss:
What qualifies you to talk?

Dr. Phil Richmond:
… what qualifies you to… And then, I was like, “Shit. Shoot, sorry.” I was like, “Maybe I should go do…” So, I looked into potentially getting a master's. But then, so now, I'm a certification nut.

Stephanie Goss:
Junkie?

Dr. Phil Richmond:
Yeah, yeah. I mean, anyhow. But yes, I do. So, yeah.

Stephanie Goss:
I know, I know. Trying to change our language.

Dr. Phil Richmond:
Trying to change our language because it does matter. It does matter, by the way, everybody that's listening. However…

Stephanie Goss:
It does matter. It does matter.

Dr. Phil Richmond:
So, the first certification I took was… But I ended up taking the compassion fatigue professional certification. At the end of that, it talks about the cure for compassion fatigue or the treatment for compassion fatigue is skills of resiliency. I look at these and I say, “Steph,” if we knew each other back then.

Stephanie Goss:
Yeah.

Dr. Phil Richmond:
I'm like, “Oh, my gosh. This is exactly the same stuff that I learned in 12-step recovery.” It's just there's… I jokingly said, “There's $20 words associated with it.” And I'm like, “That's it. And truths are truths.” So, I just got down. I was like it, “This is it. This is it.”
So, I got into positive psychology and cognitive behavioral coaching. And all these things that basically take the same, they take very similar principles and put that together. But then, I remembered also is that there is an importance to the self-portion of this or the me portion of this. But it is multifactorial, is that we do need, our leaders have an outsized influence on that. And how we work as a team is vitally important, and is the organization there. So, I ended up getting a bunch of certifications because Carl told me that I needed to.

Stephanie Goss:
Qualified.

Dr. Phil Richmond:
Yeah. And so, now, I don't know. It's like, 22… I think, yeah, I have 22.

Stephanie Goss:
I was going to say, you have an alphabet. You have an alphabet after your name.

Dr. Phil Richmond:
So, but I mean, I also, one of my strengths is love of learning. So, my wife's like, “Well, whatever. At least he's not doing what he was doing 15 years ago.” So, she was with me, by the way, through all that. God bless her. She's a veterinarian as well. She's amazing that she is.

Stephanie Goss:
She's a wonderful, wonderful human being.

Dr. Phil Richmond:
Carl… So, where were we?

Stephanie Goss:
You were heading towards what you're doing now…

Dr. Phil Richmond:
Yes, that's right.

Stephanie Goss:
… and looking at other countries that are doing way more about it, less than we are in the United States. Because you recognized, as did I, that while you… Especially as a person who is in recovery, you're hyperfocused on the me part, right?

Dr. Phil Richmond:
Right.

Stephanie Goss:
Because you're working on yourself, you're working on what can I control? What can I do to make amends? Like fix your own backyard first before you go fix in anybody else's, right?

Dr. Phil Richmond:
Right. Which is as the phrase that we use in recovery stuff, as you know, is what is my part? What's my part in this situation? And so, while that is vitally important for us in veterinary medicine, if the organization has a part or if the team or the leader has a part, we do need to work on both. So…

Stephanie Goss:
Right. They don't exist in a vacuum.

Dr. Phil Richmond:
Yeah, right.

Stephanie Goss:
You can't just solve your way out of burnout or fatigue by looking onto me.

Dr. Phil Richmond:
Right. And then, what happens, as we know, and this gets into what we were talking about is that, if I am at as close to 100% spiritual… I'm doing all the things right. If the environment I'm in, if I'm having to see 50, 60 patients a day, I'm short staff, and my boss doesn't care about me, it doesn't like…

Stephanie Goss:
It doesn't matter how hard you work.

Dr. Phil Richmond:
It doesn't overcome those things.

Stephanie Goss:
Yeah, yeah.

Dr. Phil Richmond:
So, we need to help those things. Now, the flip side is, if I have a great leader and they're doing all these things and I'm like, “Oh, this is just… Everything's crap and this is crap, and this is…”

Stephanie Goss:
Right.

Dr. Phil Richmond:
That part is on, I need…

Stephanie Goss:
If you're not taking the ownership.

Dr. Phil Richmond:
Right. But usually, again, it's not a black and white line. There's parts of all of this.

Stephanie Goss:
They've study you make sure of all three.

Dr. Phil Richmond:
Right. And so, intuitively, it's like you start looking at, “What are these things in the workplace?” And so, come to find… So, when I did my positive psychology certification, I also did a certification and positive psychology consulting. So, actually, taking positive psychology into workplaces like, how does this actually…

Stephanie Goss:
Right.

Dr. Phil Richmond:
These concepts sound all good, but what's the evidence that this actually works in a workplace? Obviously, there's ton. There's a whole field of study. We know Adam Grant from University of Pennsylvania is one person that we really hear a lot about. But this field of positive organizational scholarship, which means, how does this stuff work in business? How does this stuff work in the workplace?

Stephanie Goss:
Right. Right.

Dr. Phil Richmond:
And so, that led to finding out about the ISO 45003. And ISO is like international OSHA. And 45003 are the psychological health and safety standards, international psychological health and safety standards. So, things that need to be in place in workplaces. So, the way that I like to describe it to veterinary professionals is, we go in and take x-rays on a patient. What do we do, Steph? Do I go into my scrubs?

Stephanie Goss:
No.

Dr. Phil Richmond:
No, I don't because I know that that x-ray is dangerous. So, I take precautions. I put on my lead down.

Stephanie Goss:
Put on your lead down.

Dr. Phil Richmond:
Put on my thyroid shield. I put on my gloves. Yes, wear your gloves.

Stephanie Goss:
Yes, yes, yup. Put on your gloves and dosimetry badge.

Dr. Phil Richmond:
Because I know that's a hazard.

Stephanie Goss:
Right.

Dr. Phil Richmond:
Well, guess what is that? Those things… There are psychological hazards in our workplaces that we can take the same precautions of. Or if we can't remove them, at least we can mitigate them, is that we can do that.

Stephanie Goss:
Sure.

Dr. Phil Richmond:
And that's one. And then, the other aspect is that we have to actively promote flourishing and thriving. We have to do the positive things as well. And it's not enough to… We're not coming in and just saying, “Oh, everything's… Good vibes only.” I'm not saying that.

Stephanie Goss:
Right.

Dr. Phil Richmond:
There are evidence-based ways of inducing positive emotion, engagement using our strengths, building positive relationships at work. All of those things are vital. And saying, for instance, conflict management. Saying, we know that if I want to implement a change at work, and I just go in and I say, “Okay, we're getting a new PiMS system. It's starting Monday. I'm changing the prices on everything, and you guys are now all responsible for…” We're also doing 12 new initiatives around all these things. “And we're going to do them all at once and we're going to do them now, and that starts Monday. Cool, everybody good? Bye.” That's poor change management. And however, we're not…

Stephanie Goss:
I'm laughing because I guarantee that there are people who are listening to this episode who are like, “Oh, my God, he just described what the hospital…”

Dr. Phil Richmond:
Describe the what? How? How? The part of it…

Stephanie Goss:
I'm laughing. I'm laughing not because I empathize with that because I have been there in the organization…

Dr. Phil Richmond:
You know what? 100%.

Stephanie Goss:
… that has changes…

Dr. Phil Richmond:
And by the way, everyone that's listening, that's in recovery. Somebody shares something to the outside would seem horrible, and then the whole room laughs because we all know like, we've all been there. It's all the same thing, yeah.

Stephanie Goss:
Yeah. Get it, yeah.

Dr. Phil Richmond:
So, but in all seriousness, poor change management, and they found this out in Australia through McQuaid's research. Is that poor change management was one of the highest psycho… So, these things that we see are called psychosocial risks or psychosocial hazards. That was one of the biggest areas that caused psychological harm, and workplaces was poor change management.
So, knowing when I do that, I'm going to instantly drop the level of like, if I just say, “Hey, we're switching PiMS, and go in. If I don't know the level of stress or the things that are going to happen to my team in doing that, and not throttle the schedule, and not do this, and not do things to mitigate that, knowing that I've just… I don't want to say throw a grenade. But I've put something into my team that is going to negatively affect their mental health because it takes time to learn. It's like onboarding.

Stephanie Goss:
Right, right.

Dr. Phil Richmond:
We can't just throw somebody into a clinic and just expect them to know everything day one. Same thing with the PiMS like, it's going to take us… No matter what it is, no matter how great the system is, it's going to take us… We're human beings probably, take us three months to catch our groove.

Stephanie Goss:
Right, right.

Dr. Phil Richmond:
If we haven't scheduled that in, we're setting our teams up for psychological harm. We're setting them up for burnout. The other thing…

Stephanie Goss:
And so, there are places where… There are actually, places in the world shocking because as Americans, having had the privilege of living in multiple countries, it's funny how I can see the American viewpoint. And this feels like very one of them because shocking to know that there are countries outside of the United States. We are not the center of the world. And there are places in the rest of the world where like, you were telling us that there's the ISO standards…

Dr. Phil Richmond:
Yeah.

Stephanie Goss:
There are actually places that say, “Hey, not only can you not do this…” And here's what the… But they set the bar in terms of expectation for employers, just like OSHA would hear with setting the safety standards, you have to take care of your team and protect them safety wise.

Dr. Phil Richmond:
Yeah.

Stephanie Goss:
There are standards that are applicable in other countries that say, “Hey, when it comes to your team and their wellbeing and their mental health and their emotional, you're responsible for that emotional safety. And here's what the expectation is.” And that's fascinating to me like, fascinating to me because I'm like, it makes perfect sense. And also, it makes me sad that we are once again, so behind other countries.

Dr. Phil Richmond:
Yes, but there's more. There's chapter two, which is exciting. So, one, just knock on your roof. I know you're in Washington. Just knock on your roof and wave to our neighbors, to the North.

Stephanie Goss:
Canadian neighbors, yup.

Dr. Phil Richmond:
Yeah, one of those certifications I have is I'm a certified psychological health and safety advisor, and I had to get that from Canada because we don't have…

Stephanie Goss:
You can't get it here, yeah.

Dr. Phil Richmond:
No. So, shout out to the Surgeon General of the United States. Surgeon General's Office, just put out recommendations for US workplaces. So, they're great. So, there's a five spoke area on that that's all centered around worker voice and equity. So, that's the central cog, if you will, in the wheel. And so, it's protection from harm.
So, we want to mitigate these things, connection to community, creating belonging, work-life harmony, creating opportunities for us, knowing that leaving our stuff at the door is BS like, that doesn't work, mattering at work. And then, having opportunities to grow. And mattering means, as a leader, as a team, you let me know through reward and recognition. You let me know I'm doing a good job. You give me constructive feedback. You do these things. And then, obviously, opportunities to learn and grow and that sort of thing.
So, in general, the ISO 45003 standards encompass a lot of those things. So, now, each country, most countries or many countries have their own psychological health and safety standards. And again, the US has come out with that and kind of cool things. It's not super-secret, but I'm on this awesome team. Josh is on it, Makenzie Peterson from used to be with AVMC, working with veterinary visionaries to help create psychological health and safety standards for US veterinary organizations.
So, but what is that again? How do we protect our brains? How do we protect our brains and souls from the stuff that we see in veterinary medicine? Because there are things that are specific to veterinary medicine. But the interesting thing is that most of the things like conflict management, we're not the only ones that have conflict management. Oh, yeah, poor change management? We're not the only ones that…
But yet, those are the things that cause it and role clarity. That was, by the way, in Australia in the study that McQuaid's group just put out, low like, not understanding, not being very clear on what my job is and who do I go to for what? And when this happens, when low role clarity was the most encountered psychosocial risks that caused harm. So, that's amazing. Yeah, go ahead.

Stephanie Goss:
It would shock no one to think about veterinary medicine, and think about how many of us have worked in jobs in veterinary medicine where we have no idea what our actual role is…

Dr. Phil Richmond:
I didn't know… Yeah, and then what happened? And then, throwing out all these terms, low psychological safety. Doctor comes in or owner, “Why didn't you do, whatever?” I didn't know…

Stephanie Goss:
I didn't know…

Dr. Phil Richmond:
And then, that person gets mad, then they're blaming you for something that you didn't even know that you were responsible for. And that is not… And everybody listening has been in a situation similar to that where it's like, we're almost held… Why didn't you know? Like, I don't know. How am I supposed to know that? I can't intuitively know it.
And so, again, it becomes how important it is. And this starts to even go into onboarding, why it's so important to connect people to onboarding and what role clarity and where you go to for what. Because when that stuff hits the fan, we want to know what the plan is.

Stephanie Goss:
Right.

Dr. Phil Richmond:
And also, that increases efficiency, which efficiency is, it's not sexy, so to speak. But that is a huge area of importance for wellbeing in the workplace is practice efficiency, is if I'm doing…

Stephanie Goss:
Right. Yeah, well… And, I mean…

Dr. Phil Richmond:
Yeah, go ahead.

Stephanie Goss:
That makes perfect sense because it's the third, the inefficiency is the third wheel of the burnout. So, it makes total sense that those two things are tied super closely together.

Dr. Phil Richmond:
Yeah, yup.

Stephanie Goss:
Okay. Don't give away the…

Dr. Phil Richmond:
No, this just the sprinkles. This isn't even the cake.

Stephanie Goss:
Okay. Friend, I can talk to you all day long. But…

Dr. Phil Richmond:
Yeah. Oh, my gosh.

Stephanie Goss:
Andy will kill me if we do a five-hour podcast. But I have a question for you before we wrap up.

Dr. Phil Richmond:
Yeah, that's right.

Stephanie Goss:
So, one of the…

Dr. Phil Richmond:
Can I say just some of the things to try to look into combat, and this won't give stuff away?

Stephanie Goss:
Oh, yes, of course, of course.

Dr. Phil Richmond:
If we've got these, because I don't want to go, “Oh, here's all the crap.” The things that is going on is making sure… So, four things, and this was actually from McQuaid research as well, is that Carl…

Stephanie Goss:
Okay. And we'll put links to…

Dr. Phil Richmond:
Yeah, we'll put links to the article.

Stephanie Goss:
… what the thing that Carl is talking about the article and the research in the show notes. So, don't worry about that. Okay. So, Carl…

Dr. Phil Richmond:
So, Carl's talking crap about me. There's a concept that's called self-compassion, and we've talked about it. Our friend Jamie at Uncharted, really leans into this. I found coaching wise, that is the tool that I lean into more than anything else with people is self-compassion, replacing self-criticism with self-compassion.
Kristin Neff, N-E-F-F, we'll put a link to her stuff in the notes as well. She's the Founder of the Concept of Self-Compassion. Great, great stuff. It really helps change our thinking. What are we crappy at setting for ourselves as veterinary professionals?

Stephanie Goss:
Yeah, boundaries.

Dr. Phil Richmond:
Boundaries, that's what…

Stephanie Goss:
Boundaries.

Dr. Phil Richmond:
Yeah, we got to learn how to do that. That's another… I'll just leave that. I'll leave in that, yeah.

Stephanie Goss:
All right. So, I was going to say, you just gave us two giant boulders because…

Dr. Phil Richmond:
Boulders. So, lean and self… Yeah.

Stephanie Goss:
Self-compassion is hard, AF. And boundaries…

Dr. Phil Richmond:
Yeah, but get curious, get curious.

Stephanie Goss:
… are real hard.

Dr. Phil Richmond:
Yeah.

Stephanie Goss:
Okay. All right. So, we got some mountains to climb. Keep going.

Dr. Phil Richmond:
So, then rest… When people take vacation, make that reward and recognition like honor people for taking vacation. Like, “Hey, make this a good thing.” Not, “Oh, I can't believe you're leaving us in the lurch.” It's like, because again, remember, if we get beat up chronically, our bodies can't… They can't recover. We have to prioritize rest and recovery. We have to prioritize rest and recovery. We have to prioritize rest and recovery.

Stephanie Goss:
Yeah, rest and recovery. That is what we are doing right now because we are reporting this. You and I are not resting and recovering, but we are doing this because Andy is resting and recovering…

Dr. Phil Richmond:
Fearless leader.

Stephanie Goss:
… and taking… The fearless leader is taking a break. And I will tell you that that, I mean, some of you heard the podcast that I did with our dear friend Eric Garcia, and my colleague and amazing partner in crime, Tyler Grogan from our team last year…

Dr. Phil Richmond:
Oh, my God. Such great people.

Stephanie Goss:
… on unplugging, they are both amazing. But we talked about unplugging and rest and recovery. And we are actually, about to record a follow-up to that episode for everybody because we've been getting a lot of questions about how it's going now. And all of us took some unplugged time off this summer, and we're talking about that.
But I love that because your point is a really valid one because that's another boulder for veterinary medicine. Because what do we do? What do you think about it in the burnout spiral? And you think about Carl sitting on your shoulder and being the negative self-talker in your ear, we just tell ourselves, “Oh, just keep working. Work harder, work harder, work harder.” And you'll dig yourself out of this hole. And we do not think about it in terms of rest and recovery. And we just try and work harder as the answer. And that is exactly what leads us to the place of burnout.

Dr. Phil Richmond:
Yeah. And the last…

Stephanie Goss:
Okay.

Dr. Phil Richmond:
Prioritizing opportunities to experience positive emotion, gratitude.

Stephanie Goss:
What?

Dr. Phil Richmond:
What? That's the evidence. I'm not just making that up because the sun shine. That is literally prioritizing positive emotion is that… And as I said in Unchartered, celebrate the wins, hold the trophy, hunt the good stuff. I love saying that, is that be intentional because good stuff is like, Teflon and bad stuff is like Velcro, is that we have to be very intentional about experiencing positive emotions in veterinary hospitals.
And what does that mean is that, as leaders, we need to do that, is that we have to stop and celebrate the wins. We have to sit down and let the puppy kiss us in the face that we saved, sit with those things. And so, what's wonderful is I, now because we've been so intentional about it, I can remember those things in the workplace. Yes, Stephanie.

Stephanie Goss:
That does not mean you sit down and let the puppy give you kisses in the face, and then bring that puppy home. Just throwing it out there, friends. Because…

Dr. Phil Richmond:
One puppy, maybe. I can't…

Stephanie Goss:
No. No more puppies. So…

Dr. Phil Richmond:
I'm wrong. So…

Stephanie Goss:
You're the problem.

Dr. Phil Richmond:
So, this awesome like, super quick. So, I got to go back and help a mentor, a new grad vet that used or works where I used to work. And they sent me a text message like 9:00 at night and were like, “Hey, sent me pictures of this fracture.” And I was like, “Y'all want me to come up and give you a hand?” And they're like, “Would you?” And I'm like, “Yeah.”
So, I came up. We're doing the fracture repair and Dr. Ortiz does it. I look at, and he's just trying to help this kitten. It's a 10-week-old kitten that got hit by a car. It's got a fractured femur. So, we fixed it. And I look up at him and I said, “You know, this is your cat, right?” And he's like, I mean, he's like, “I thought about it.” I was like, “No, no, no, no.” I said, “This is your cat.” I said, “That's the rule.” I said, “Because that's what I did.”

Stephanie Goss:
It's not a rule!

Dr. Phil Richmond:
It is a rule. Hold on, let me qualify that. Let me qualify that. Your first fracture repair on a kitten that got dumped and like, it can be your cat. It's not a rule. It's not a rule. But it can be. It doesn't have to be a rule. But it happened to me, is what I was saying.
So, 15 years ago or whatever, that's what happened. I had a kitty that got… She got shot 18 times with a BB gun, and had a fractured femur. And they brought her in. She was on the news, and everything. And we fixed it. And she was on national news. And our receptionist was like, she's like, “You're going to keep this kitten, aren't you?” I was like… I mean… She's like, “Will you just please?” Because she's like, “I'm getting calls from all over the country to adopt this kitten. Will you please just tell me that you're taking the kitten?”

Stephanie Goss:
That you're keeping it?

Dr. Phil Richmond:
Yeah. And so, I did. And her name was BB. And she was great.

Stephanie Goss:
So, that's fantastic. So, did Dr. Ortiz adopt the little kitten?

Dr. Phil Richmond:
He did. He did. The kitten is great.

Stephanie Goss:
Shut up.

Dr. Phil Richmond:
Of course, he did!

Stephanie Goss:
You're such an enabler.

Dr. Phil Richmond:
But I will say… I will say, is that that's part… So, you don't have to have 20 cats. But you could have one, if you're not allergic. You could have one kitten that you saved. You could. Everybody's got… I mean…most

Stephanie Goss:
I want to do a whole podcast series on the stories of the animals…

Dr. Phil Richmond:
How did people got…

Stephanie Goss:
… from, yeah.

Dr. Phil Richmond:
Oh, yeah.

Stephanie Goss:
Because you are the shining representation of having no boundaries in veterinary medicine when it comes to animals. And saying…

Dr. Phil Richmond:
That's my wife. My wonderful wife that we described like, how many animals are in this house that I'm directly responsible of for? None. Like zero now. None. None of them. She brought everyone in the house. She brought every one of them all. Every one of them. But…

Stephanie Goss:
But wouldn't that make a fun podcast series?

Dr. Phil Richmond:
It would. I mean, yeah, we'd have to be a video podcast and that we… We probably should have like a Nat Geo show. I don't even know. I told you we got finches now too.

Stephanie Goss:
Oh, my Gosh.

Dr. Phil Richmond:
So, everyone, we had zero birds in January of 2022, and we have 17 birds now.

Stephanie Goss:
Because Carl can't say no.

Dr. Phil Richmond:
Because I was at VLC with Tasha, and we were speaking and I get a message and she's like, “This happened.” And there's a giant cage in the back of her sister's huge pickup truck because she bought a Macaw, and we had no birds January 2022, we had no birds. And now, we have a Macaw, two Caiques, and a Conure and 13… We have 11 finches and two canaries. But it brings us joy. It brings us joy.

Stephanie Goss:
Oh, my gosh. I can't.

Dr. Phil Richmond:
I know.

Stephanie Goss:
But it brings you joy.

Dr. Phil Richmond:
Send help. And help us, please. Please, anyone.

Stephanie Goss:
We are going to drop… We've done it now. It's done completely.

Dr. Phil Richmond:
We squirrel, we squirrel.

Stephanie Goss:
Normally, Andy and I go off the rails in the beginning of an episode. But we, you and I, I think mostly saved it until the end of it.

Dr. Phil Richmond:
Yeah.

Stephanie Goss:
We did good. We did good.

Dr. Phil Richmond:
Yeah, we did good. We did good.

Stephanie Goss:
Okay. So, if people want to find you, we're going to drop in the show notes links to some of the resources and research that you were talking about. But if people want to find you, they can find you at Uncharted in October, as I already said. But besides that, where can people find you on social media?

Dr. Phil Richmond:
Yeah. So, I am at Flourishing Phoenix Vet on Facebook and Instagram and www.flourishingphoenix.com. And then, on LinkedIn it's preferred. Pretty positive like, I like LinkedIn. So, LinkedIn, I think it's Dr. Phil Richmond is my account, yeah.

Stephanie Goss:
Okay, I love it. I love it so much. Thanks for having this conversation with me today, friend.

Dr. Phil Richmond:
Yeah, thank you.

Stephanie Goss:
This has been fun. Thank you all for listening. We'll see how many people got to the end of this one because as always, we did some squirreling. But we stayed… High-five friends because we stayed decently for two people that have as much in common as we do, whose brains work very similarly.

Dr. Phil Richmond:
Yeah, we feel good.

Stephanie Goss:
I feel like, we did justice.

Dr. Phil Richmond:
We did good.

Stephanie Goss:
So, we're staying a little bit on target with this. We're knocking Carl, I'm flicking him off my shoulder. We're patting ourselves on the back with this one.

Dr. Phil Richmond:
And by the way, if not… So, I worked with an amazing human being named Carl Ashman. Carl, if you happen like, it's not you at all. This was long before I knew you. So, I just want you to know it's 100% not you.

Stephanie Goss:
Disclaimer.

Dr. Phil Richmond:
Yeah, disclaimer. Carl is not that Carl at all. Carl is a wonderful human being.

Stephanie Goss:
Thanks so much for joining me today, Phil. And thank you all for listening and have a fantastic rest of the week, everybody. We'll see you next time.

Dr. Phil Richmond:
Bye. Thank you.

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 podcast and leave us a review. It's the best way to let us know that you love listening. We'll see you next time.


Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: culture, fatigue, management, Practice ownership, Training

Sep 20 2023

I Should Switch From Salary to Pro-Sal Right?

This week on the podcast…

This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek, Stephanie Goss, are back and taking a fantastic email from our mailbag. A young associate is writing in to ask some questions about pro-sal. They started at their practice out of vet school on salary, which suited them fine. The practice was everything they were hoping for in a first job – good culture, good mentorship, good people. Now that they are a few years in to practicing, they find themselves hearing a lot about what colleagues are making. It seems like everyone else is on pro-sal and making the financial rewards that come from jam packed summer schedules. Our associate has a schedule that comes and goes in terms of busy-ness and they are wondering if they should be asking for a different setup than they have now. This episode is full of shoulds, which means Andy and Stephanie approach the word with caution because it can be dangerous. Let's get into this…

Uncharted Veterinary Podcast · UVP – 250 – I Should Switch From Salary To Pro – Sal, Right?

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

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

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

Calling all Practice Managers and Practice Owners!

Every partnership (like every veterinary practice) is unique and faces very specific challenges. To be successful, you must identify your strengths and weaknesses as individuals and as a pair. By working to further your skills within your respective role, then coming together to work collaboratively with your partner, you can quickly break problems down into manageable pieces and move forward as a team. 

This December, The Uncharted Practice Leaders Summit is here to infuse the powerful veterinary partnership of practice owners and practice managers with renewed energy and understanding. You both want a strengthened foundation to guide the practice (or practices!) you lead so that it can continue on to future success.

Upcoming events: unchartedvet.com/upcoming-events/


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're taking an email from the mailbag. We've got an associate doctor who fell in love with their practice as a new grad coming out and they found mentorship, support, and a lot of the things that they were looking for in a job. Now they've been out of practice a few years and they are wondering: “Should my circumstances here change? Should I be getting paid more? Should I be getting paid differently? Should I get things that are different now than I needed them to be when I'd just got out of school?” There's lot of shoulds in this episode. It was really fun to dive into all the questions. Let's get into this.

Speaker 2:
And now: the Uncharted Podcast.

Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark, and the one and only Stephanie where-the-ocean-meets-the-sky-I'll-be-sailing Goss. How are you doing?

Stephanie Goss:
I want to hear you sing that one.

Dr. Andy Roark:
I've been working on my… Anyway, it's not gravely enough. I'm working on it.

Stephanie Goss:
I'm good. How are you?

Dr. Andy Roark:
I'm good. I was in the car with Allison and that song had been on. It had been on and it was long over, and I was thinking about it. And I turned to Allison, my wife, and I said, “You know who I have become a fan of, who I really didn't appreciate until recently?” And she said, “Who?” and I said, “Rod Stewart.” And she did not look at me. She just said, “God, you're old.”
And I wonder if there's a phase in every man's life when Rod Stewart just takes on a different level of meaning. You know how old I am? I'm “Rod Stewart fan” years old. That's how old I am. I'm just like, “Oh man. Wake up, Maggie. I think I've got something to say to you.” It's like, Rod, you're speaking to me in a way that you didn't when I was in my thirties.

Stephanie Goss:
That is fantastic. You just completely dated yourself as middle-aged.

Dr. Andy Roark:
Oh, totally!

Stephanie Goss:
… and I love it so much.

Dr. Andy Roark:
Yeah. You're like, “How old is Andy?” It's like, “I think he's getting into Rod Stewart.”

Stephanie Goss:
Oh God, that's fantastic. It's so funny, because I was listening to the nineties channel on my Sirius XM in my car, and Bryan Adams came on. And I had that same kind of moment where I was like, “Oh, I remember this.” And I remember my parents listening to this and thinking, “God, this is so old,” and I'm jamming along, and I was like, “Maybe I've hit that stage.”

Dr. Andy Roark:
Oh man. Yeah, I think there's phases. I am not “Tony Bennett fan” old. I like Frank Sinatra just fine, but I could see another level that I will go to in the… You know what I mean?

Stephanie Goss:
Uh-huh. Yes, yes, yes! Absolutely!

Dr. Andy Roark:
I get Frank Sinatra. I do enjoy some Frank Sinatra, but there's a level of fandom that I could absolutely move to. I'm just not there yet. I'm just not there yet.

Stephanie Goss:
You're not that old.

Dr. Andy Roark:
I'm not that old. You're exactly right. But 10 years from now, ask me again. I'll turn to Allison in 10 years and be like, “You know, I never really appreciated…”

Stephanie Goss:
Tony Bennett.

Dr. Andy Roark:
“Tony Bennett.”

Stephanie Goss:
And you know what your kids are going to say to you? Your kids are going to say, “Isn't that guy that was like 100 that sang with Lady Gaga?”

Dr. Andy Roark:
Yeah. Yeah.

Stephanie Goss:
That's going to be how your kids know who you're talking about.

Dr. Andy Roark:
Yeah. And then, when they come to me on my deathbed, I'll be laying there and I'll be like, “You know who they play in the hospital? Barry Manilow. And I like it. I just realized that I really like Barry Manilow.” And they'll cry and cry and cry. “He's leaving us.”

Stephanie Goss:
This is off to a fantastic start. We're off the rails. We're off the rails already and we're three minutes in.

Dr. Andy Roark:
Yeah.

Stephanie Goss:
It's fantastic.

Dr. Andy Roark:
Well, we can reign this back in and get started. Hey. Just like people that know where I am in my life-

Stephanie Goss:
All right, so-

Dr. Andy Roark:
… and how things are going.

Stephanie Goss:
… we are at the Rod Stewart level. Just so y'all know, that is where we're starting this episode today. And I guarantee you that there are people listening right now who are going, “Who the hell is Rod Stewart?”

Dr. Andy Roark:
Mm-hmm.

Stephanie Goss:
Because-

Dr. Andy Roark:
Young people.

Stephanie Goss:
… you and I are old.

Dr. Andy Roark:
Yeah, young people.

Stephanie Goss:
Exactly.

Dr. Andy Roark:
Yeah. Worth a Google. He's worth a Google.

Stephanie Goss:
There's young whipper-snapper team members who are listening to this going, “Who the hell are these two talking about?”

Dr. Andy Roark:
I know. A lot of name-dropping people. People that are not remembered. All right.

Stephanie Goss:
That's where we're at today. Okay. I am excited about today because we have got a ProSal conversation that I think is going to be a fun one. We got a mailbag letter from a young associate who has been in practice for a few years now since getting out of vet school, and they joined their practice. And it had all the things that they wanted in a first practice out of vet school. They had good culture. Good people. They really liked the team. They liked the practice owner. They had good mentorship, which was really important to them and still is. And they took a salary and they felt good about that coming out of vet school, right? Because a good security blanket so you don't have to stress that about anything. “I'm just going to make a good salary and I feel good about this.”
And now a few years out, they are thinking about the advice that they got in vet school about financial compensation and looking at their setup and wondering, “Is it time that I should make the switch to ProSal? Because it seems like I could be making more money than I am if I looked at switching to that model.” And so, they're kind of looking at: What are they doing? Which I thought was a great first step. They looked at: What are they producing? What are they doing now? And they're in a practice where it seems kind of cyclical with their appointments. Sometimes it's up; sometimes it's down. Sometimes they're super busy and sometimes they're not. And they're just wondering: “When it is super busy, if I'm on ProSal, I get compensated for that, right?” So, lots of questions and just wondering: Where do they go?
So, they went to their boss and said, “I would like to make some more money,” and they asked for a raise; and good for them for advocating for themselves. But they apparently were turned down and the conversation was about taking more time off, which they were initially excited about, but also wondering: “How much time should I take off? How much time is too much time to ask for?” And so, lots of questions about compensation and how to be maximizing what they are making. They're happy where they are. They love the clients. They love the team and they recognize that they have benefits at this practice that they might not get other places that are non-monetary benefits. And at the same time, they are feeling like they are getting the short end of the stick when it comes to salary. And so, they asked: “Should I be advocating for more money at this point in my career given all of the things that I've shared with you guys?”

Dr. Andy Roark:
Yeah. I like this question a lot, because I think that the asker is in a headspace that I see a whole lot. And so, I have advice. I have thoughts.

Stephanie Goss:
Okay.

Dr. Andy Roark:
So, let's start with this. There's two things that I want to put out at the very beginning in headspace right here. Right. So, the two things: Nothing matters except that this is a healthy relationship and both sides are getting what they need. There is no right contract. There is no right way to work.

Stephanie Goss:
Sure.

Dr. Andy Roark:
There is no: “This is how it has to be.” All that matters is that you as an employee are in a healthy relationship and you're getting what you need, and that your employers are in a healthy relationship and they're getting what they need. There's not, “I should be on this,” or, “I should be on that,” or, “This is how it should be,” or, “This is how much paid time off I should have,” and, “That's too much time off,” and, “This is not enough time off.” None of that matters. There is no judge or jury who's going to look at your contract and say, “This is not right.” If it works for you and it works for them, then you guys should just go on.
And again, I just think, philosophically, that is really important, because I see so many people who just chew their fingernails about the agreement that they have. And I say, “Does this agreement suck? Does this agreement work for you?” And they're like, “Well, yeah.” And I was like, “Does it work for the other side?” They're like, “Well, yeah.” And I'm like, “Okay, good. Then I don't think that you should sit and ruminate over what it should be or what other people are going to think about the agreement. If it works for you and it works for them, the mission accomplished. Go on.” And so, that's the first place I just want to put down, because a lot of people are like, “Is this right?” And I'm like, “There is no right. No one's going to grade your agreement and say, ‘Ooh, you got a good agreement,' or, ‘You didn't get a good agreement.'” There's no such thing. And so, the other thing I want to call out, and this is a big part of headspace for me, is: Boy, this email is packed full of “should.”

Stephanie Goss:
Mm-hmm.

Dr. Andy Roark:
“Should I be paid on ProSal? Other people are paid on ProSal. How much time should I take off? Should I get this perk? Should I have that perk? Should I get paid for when the place is busy? Should I be held accountable for when the clinic is not busy?” Should, should, should, should, should. Should is a dead end every time. There is no should. “Should I be on ProSal? How much vacation should a vet take? How should my salary stack up to my classmates'? Shouldn't I make as much as them, or more than them?”
Again, should doesn't matter and we make ourselves so miserable talking about what “should be” and how we “should have” this or we “should have” that; and there's no right there. And so, anyway, I don't mean to be critical of the person writing the email. I hope it doesn't sound that way. But just in headspace, at the very beginning, the answer to my question is going to be a hundred percent predicated on the idea that: There is no right relationship. All that matters is having a good relationship that gives you what you need and gives them what they need, and then going on. And then, the other part is: Beware of the word “should.” And we can start to dig into those things.

Stephanie Goss:
Yeah. And I think that there's two pieces that go along with that, right? The first one that you lay down, and you say this a lot, which is: Comparison is the thief of joy.

Dr. Andy Roark:
Right.

Stephanie Goss:
And I think that culturally, especially here in the States, we are conditioned to look at others and compare. Our whole lives, it's like… I will give an example from my own life. As a young… I'm not young. I'm old. We just talked about how old we are. But as a middle-aged mom-

Dr. Andy Roark:
Are you into Rod Stewart yet-

Stephanie Goss:
No.

Dr. Andy Roark:
… or are you still not there?

Stephanie Goss:
I'm still not there. I'm “Bryan Adams” level.

Dr. Andy Roark:
Oh, okay, you're “Bryan Adams” old. Oh, I remember that phase. Yeah, that was good. Back in the day. I remember that. Okay.

Stephanie Goss:
I remember vividly being a mom with toddlers and working a more-than-full-time job in the clinic, and I would come home and I would look at Instagram. And all I could think was that all of my friends, who I loved dearly and who also had kids my same age that I had known from playgroup and stuff, all I saw was: Their houses were clean. There wasn't kids' toys everywhere. There wasn't dishes piled in the sink. And all I could ever do was compare myself to them.

Dr. Andy Roark:
Yeah.

Stephanie Goss:
And I wasn't looking at it and thinking, “God, they suck.” I was looking at it thinking, “God, I suck.”

Dr. Andy Roark:
Yeah. Mm-hmm.

Stephanie Goss:
“Why can't I keep it together? Why can't I have the time and energy?” And so, I think that is just a thing, especially with social media, it makes it really, really easy to compare ourselves to others. So, number one, just recognizing that that is something that we are subconsciously, and sometimes consciously, conditioned to do to ourselves is compare. So, that's-

Dr. Andy Roark:
What-

Stephanie Goss:
Oh, go ahead.

Dr. Andy Roark:
No, I just want to jump in on this, because I completely agree on the social media part; but I just want to jump in real quick, because I've been thinking about this a lot recently. Now, I think there are good things about social media and people being connected and our industry being much more connected. It's kind of like knowing what's going on with the neighbors, where if there's something you're struggling with and you understand that the neighbors are also struggling, it's validating. You go, “Oh. Yeah.”

Stephanie Goss:
Sure.

Dr. Andy Roark:
And so, I think there's a lot of stuff with burnout and mental health that has been really good so that people don't feel like they're so alone.

Stephanie Goss:
Sure.

Dr. Andy Roark:
I also think that at some point you can know too much about the neighbors-

Stephanie Goss:
Right.

Dr. Andy Roark:
… and you can get wrapped up in what the neighbors are doing and: “How do we compare to the neighbors”? And I think that those are two sides of the same coin.

Stephanie Goss:
Yes.

Dr. Andy Roark:
I don't know how you could ever have social media in a way where you got all the good parts of being connected, but not the comparison parts of being connected.

Stephanie Goss:
Yes.

Dr. Andy Roark:
So, anyway, I've just been thinking about this recently, the whole “comparison's the thief of joy.” I think social media ratcheted that up for people in a way that it didn't use to.

Stephanie Goss:
Yes. Yes.

Dr. Andy Roark:
We just didn't have access to people constantly to compare ourselves to them. The neighbors went to work and we went to work, and then you might see them watering their lawn later in the day.

Stephanie Goss:
Right.

Dr. Andy Roark:
But it's not now. It's like you're with them at work and you're seeing inside their house and all of these things and it's just… I don't know. I use “neighbors” as a metaphor for other professionals, but I think you get it.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
So, anyway, I'm right there with you.

Stephanie Goss:
Yeah. So, that's the first piece. And then, the second piece that you talked about is the shoulds.

Dr. Andy Roark:
Yeah.

Stephanie Goss:
And I think it's worth talking about a point that I have discussed a lot with my colleagues in practice, but also with vet students and with newer grads. And I think that there is a movement in the vet schools which is very positive in that they are teaching the students to advocate for themselves and really talking about the different options for salary, and when it comes to contract negotiations, and they're getting a lot of education, which is wonderful. And the way that the information is being received… I'm not currently in vet school so I can't judge it firsthand.
The way that the information seems to be received, and therefore the perception of professionals engaging with young students who are coming out of school and trying to hire them, is that they are being told what they should do. Not that it's being presented in, “Here's all the options,” but that there's a lot of advocacy for a gold standard, if you will, of: “This is what a contract should look like when you get out of school.” And I think that that is adding to this comparison anxiety for a lot of these young grads coming out, which is: “Oh, this is what they told me in school that I should ask for or that I should get.” And I've had conversations with some of them and have asked point-blank, “Tell me what you learned about in school. Tell me what they taught you about contract negotiations, about salary, and how this works in the real world.”
And the perception as a professional interviewing these new grads is very much that they are getting, from some of their professors, a very specific view that seems to be slanted towards “should,” which has very strong pros and cons, right? I'm really glad that they are advocating for themselves and I'm glad that they are having conversations that a lot of people didn't feel empowered to do even just a 5-year or 10-year generation ago of vets, right? I think about vets who went to vet school around the time that you did and they were just like, “I came out and was like, ‘I just need this amount of money to pay my loans,' and I am not really going to have in-depth conversations about what I want or what I think I should get.” It was like, “This is the going salary rate. As long as you're offering me that, it's great.” Right?

Dr. Andy Roark:
Yeah.

Stephanie Goss:
And now it is a very much a: “Well, in school they told me that I should get this and I should get this and I should get this,” and so I think that some of that should-ing is coming from a place that has very good intentions but has ill-advised consequences when it comes to the new grads comparing themselves to each other or comparing themselves to a standard that a professor has shared with them that they should be setting.

Dr. Andy Roark:
Yeah. So, I'm going to pause here and talk about “should,” and then we'll talk about ProSal specifically. We'll get into that. But I just want to pause here. I have seen people wreck so many wonderful opportunities because they get hung up on what “should” be and how this “should” go.

Stephanie Goss:
Mm-hmm.

Dr. Andy Roark:
So, for example, I cannot tell you, because the weird job I have, how many people I've interacted with in the last, say, 15 years who have had opportunities that they were genuinely very excited about, and they went and they researched these opportunities and said, “What should I get paid for this and how should this go?” And they have grabbed onto these numbers, or these conditions, that they went and they found and they made them deal-breakers.

Stephanie Goss:
Right.

Dr. Andy Roark:
Like, “I need to get this or else I'm not doing it.” And for whatever reason, the other side is like, “We can't do that,” and then the whole thing falls apart. And I'm like, “Man, you ended up not getting to do this thing you were excited about because you found some sort of arbitrary number that you thought you should get paid, or title that you should have, or perk that you didn't really care about but you thought you should get this, and because the other side was not able to give you this thing that you found, you were like, ‘Well, I should get that, and I'm not getting that, so I'm not going to do this.'” And ultimately, you go, “Great. You gained nothing. You went right back to where you were because you didn't get your employee parking spot that you were told you should have.”

Stephanie Goss:
Right, right.

Dr. Andy Roark:
And I was like, “Was that really worth it?” I'll give you another example. So, I remember distinctly I was working with somebody and there was a marketing position in their own practice that was being created. And so, they worked on the floor. They were a technician. Something like that. And the practice was going to have a marketing position. It was going to be a couple hours a week or whatever, and they were just going to do marketing and things like that. And this person went, and they really wanted to do it. They liked marketing. They wanted to do social media. It was a skillset they wanted to grow and expand. They looked up salaries for marketing managers, and if you find salaries for marketing managers in other industries, those numbers don't line up with what you can expect to get paid in that medicine, in my experience.

Stephanie Goss:
Right.

Dr. Andy Roark:
But this person was like, “No, this is what I should get paid.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And ultimately, of course the vet clinic was like, “Look, we can't pay that.” And she said, “Well, that's what I should get paid, and so I just can't do it if I don't get this. Because this is what I should make.” And she didn't get the position and somebody else got it, and somebody else happily got a little pay bump and then got to go and do these things and learn these skills and shake up their job a little bit and try new things.
I look at that and I was like, “You could have gotten a little pay bump and done work that you were excited about doing and grown yourself. And maybe after you had gotten these skills, if you wanted to leave the industry and go to a different industry where that is the pay scale, then you could have had the opportunity. But now you don't have that experience and so you can't even do that in the future because of what you decided you should get paid.” And again, there's always a line here, right? Everything's on a spectrum. Stephanie and I are not saying, “Oh, you should take whatever people offer you.” You know what I mean? “And you should be naive about what your time and your energy is worth.”

Stephanie Goss:
Right.

Dr. Andy Roark:
But I've just seen so many people who grab onto something in their mind and they don't do something that could make them really happy purely because they “should” get something else or they “should” be able to achieve something they're not achieving or they “should” be treated in a way they don't feel like they're being treated. And so, I've just seen that tank so many opportunities that people could have been happy about if they had just said, “All right, how much do I want to do this?”

Stephanie Goss:
Right.

Dr. Andy Roark:
“Am I happy? What would this allow me to do… Not monetarily, but just as far as my enjoyment and my skills and my development. Okay, great. What do I need to make here so that I don't feel taken advantage of and so my needs are met?” And I have found that that is such a healthy way to approach it, where everybody feels good. And then, if you get into it and you're like, “Oh man, this is way more work than I thought. I'm not being compensated where I should be. I'm going to go back and say, ‘Hey, this is way more than I thought it was. I want to talk about the compensation here based on the amount of hours and the time and…'” blah, blah, blah, blah, blah, and you should be able to go back and have those discussions. But, again, people… Oftentimes, they just kind of freak themselves out about what should be. And I think it's driven a lot by… There's a lot of perfectionism around it of: “I need to get this right.”

Stephanie Goss:
Right.

Dr. Andy Roark:
Yeah. And what is “right” is so arbitrary. Anyway, that's the “should.” Let me talk about ProSal for a second, because that's another big part of this that people have sort of put forward.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
And, again, I don't know exactly what people… I think everyone probably has a slightly different approach to this. I don't know how common it's for vet schools to say, “You need to make ProSal.” I don't know. So, for people who don't know, ProSal is this way of paying, generally, doctors, where you guarantee the doctor a base salary. And this should be a low base salary, but the idea is, “Hey, no matter what happens, you can expect to make this amount of money.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And so, the basic thing is they give you a floor in what you will earn, and then they track your production numbers. And they pay you either the base salary or 20%, 22%, 24% of what you produce, whichever one is greater. And the idea is if things are slim and there's not a lot of people coming in the practice, you're still going to get paid. You're going to get paid at your base salary. So you know that you can count on that.
But if you were absolutely slam bonkers, you're not going to work yourself like crazy and make the salary. You are going to benefit from the extra work that you do, because you're going to get paid for that extra work. And so, that's how ProSal works. And you can see that there are benefits of it, because if you think that you are going to do X amount of work and when you get there, you're actually doing 2X amount of work, that's still probably very stressful.

Stephanie Goss:
Sure.

Dr. Andy Roark:
But you're going to get compensated for that higher amount of work that you're doing. And so, in that way, you don't feel taken advantage of; and that's good. However, there are drawbacks to ProSal that I would put forward here. And there's really two big ones for me. The first drawback to paying doctors on ProSal, for me, is the ethical concern. And, again, I'm not saying that ProSal is bad; however, I do think that you can make a strong argument… And I heard this argument made this week. And I've had this argument in my head for a long time, but I had heard it out loud from someone else just this week. And it is: “How do you feel about doctors that are paid on commission?”
Because that's what it is. Do you feel okay if you were a pet owner and a doctor was like, “Hey, I think what we're going to need to do is we're going to need to do these extra tests,” or, “We're going to do these tests and here's the estimate for a dental cleaning, and I really think you should get this dental cleaning done”? If you knew the doctor was taken home 22% of whatever you spent, would you feel differently about those recommendations than if you knew that the doctor was paid on salary and she doesn't really care? Whether you do it or not do it, it doesn't mean anything to her. She's making this recommendation because she think it's the right thing to do. Does that matter to you?

Stephanie Goss:
Sure.

Dr. Andy Roark:
And, to me, that's always bothered me a little bit, just in the back of my mind. And when pet owners get mad and they say, “Well, you're just doing this for the money,” the fact that there is a direct relation between this person following my recommendation and me getting paid: I don't like that. It makes their criticism feel a little bit more defendable than it would if I got a salary and I'm like, “I don't care what you do, lady. I'm just telling you what I think is best for your pet.” And so, this was said back to me this week. I was talking to an emergency vet, and he talked about being paid on salary. And he said he had a pet owner that flipped out and was screaming at him that he was just doing this for his own-

Stephanie Goss:
For the money.

Dr. Andy Roark:
Yeah, for the money and his own salary.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And he got to look at her and say, “Ma'am, I'm paid on a salary. I get paid exactly the same if you say yes and I do this, or if you leave and I go to bed. I get paid the exact same.” And that kind of diffused that situation for her, and I thought, “Man, there's power in that position.”

Stephanie Goss:
Well, I think we have framed the discussion around it… Because people in veterinary medicine are compassionate, caring people and they are doing it for the patients, and the money conversation has never sat well for the majority of people in veterinary medicine… Although, there are people in veterinary medicine who are money-motivated and that is a motivator for them.

Dr. Andy Roark:
Mm-hmm. Sure.

Stephanie Goss:
But the vast majority of them have looked at it in the sense of how hard they work and the volume of cases that they're seeing versus the individual “I'm going to make recommendations that I don't believe in,” that has always been the line, I think, with anybody that I have worked with. It has been like, “I don't want to be the used car salesman.” Right?

Dr. Andy Roark:
Totally. Yeah.

Stephanie Goss:
I don't ever want to make a client feel like I am upselling them for my recommendations. I want them to trust me. And I can see your point that, regardless of how we frame it, the end result is their pay is still impacted by what the owner decides and you can't back away from that.

Dr. Andy Roark:
Yeah. Yeah.

Stephanie Goss:
That is the reality. And I think most people don't look at it that way because it has been framed, we have consciously or unconsciously framed it for ourselves as an industry, about: “If I work this hard or if I work this much harder or I see this many patients…” And honestly, for most of the veterinarians that I've worked with, the conversation in their head has been, “If I skip lunch, if I take this hour away from my kids, if I stay late and give up something for my patients, then I should benefit.”
And I think, when you think about it, like talking this out loud, that argument is just as dangerous as the financial argument of: “Are we upselling them to get more money in our paychecks?” Because I can see the truth of it there, and I can see a lot of truth in the way that we have chosen to frame that conversation for ourselves as an industry in the direct impact to mental health and the way that the burnout and the stress factor that veterinarians have. Because veterinarians who are on ProSal, that is absolutely the way that it is framed in a lot of their minds and the way that they're looking at it is, “If I just give up being home in time for dinner with my kids, I'll see these patients and…”
They're not thinking about it, “I'll see these patients and therefore I'll get paid more in the moment.” Right? To be clear, I am not judging anybody. I have never worked with a veterinarian who in the moment is like, “Well, I'm going to see this case because when I get my paycheck, it's going to be bigger.” It has always been about, “I'm going to take care of this patient,” and the reason in the very back of their mind that they say yes is because the trade-off is there financially. That's the security net at the end of the month, right? And so, I think that there is something to that about how it impacts the mental health and the burnout rates in veterinary medicine, because we've conditioned ourselves to look at it that way.

Dr. Andy Roark:
Yeah. So, I'm going to jump in here and I want to agree strongly with something you said at the beginning. Let me be clear about my position on ProSal. I am not anti-ProSal. I am explaining why I don't think ProSal is a perfect solution, and they are valid criticisms against it that I see. And so, I agree with you completely, Stephanie. I'd like to say I don't know any, but I don't know many at all who I feel like are financially motivated and using production pay in an unethical way.

Stephanie Goss:
Yes. Yes. Yes.

Dr. Andy Roark:
And I do think that if you do ProSal in your practice, it's your responsibility as management to watch that and manage that. Which means if people are doing sleazy stuff to run up-

Stephanie Goss:
Right.

Dr. Andy Roark:
You need to manage that.

Stephanie Goss:
Right. Absolutely.

Dr. Andy Roark:
That is not okay. And that's what ProSal going off the rails looks like. Now, every system needs management, so that's not a deal-breaker. I completely agree that, for most vets, they look at it as, “Hey, when I work really hard, at least I feel like I benefit from that.”

Stephanie Goss:
Right.

Dr. Andy Roark:
It's not, “I'm getting paid on commission and I'm going to act like a sleazy salesman.” I'm saying that, one way or another, and I know that it's not how most vets act or behave, we are getting paid on commission, basically, with that.

Stephanie Goss:
Yeah. Yeah.

Dr. Andy Roark:
And I think we need to talk about what that looks like. And it's always bothered me that I wouldn't want the pet owners to know that. And if there's ever something that I look around and I'm like, “I'm dealing with this person, I don't want them to know something,” I always stop and check myself, because I go, “Ooh, I don't”-

Stephanie Goss:
Sure.

Dr. Andy Roark:
You know what I mean?

Stephanie Goss:
Yeah.

Dr. Andy Roark:
I like to be completely transparent. And anytime I'm embarrassed about how I get compensated, that bothers me. And so, anyway, I think it's true. I think you're totally right, too. And, again, I'm not trying to push on this too, too hard because I'm not anti-ProSal. I'm really not. But if you get into ProSal and you're making your bonus pay, you're just disincentivized to take vacation.

Stephanie Goss:
Right.

Dr. Andy Roark:
You are disincentivized to take your lunch break. You are disincentivized to use your time off just in general. You just are. It's how you look at it. So, you look at this and you're like: Man, when you're in the clinic, you're earning your bonus. Well, what that means is when you're not in the clinic, you're not earning your bonus. And so, it can flip around, and so by that compensation strategy, there is this certain pressure for you as the vet to be there and be seeing patients and cases.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And so, I think that that's just true and it kind of puts an extra sort of level of stress onto what we're doing. And the last thing I'm going to say about ProSal is this, and I've just seen this just in people in general: The grass is always greener on the other side. And so, what happens is when I see doctors who are on salary and they're busy, they're like, “Ugh, why am I not on ProSal? Why am I not getting paid production?” But then, when the clinic slows way down, if they're on ProSal, they're like, “Ugh, why am I on salary?”

Stephanie Goss:
Right. Yes. Yes.

Dr. Andy Roark:
“It's not my fault this isn't coming in.” I think some people paint this picture that ProSal is basically salary, and if you do any more work than you think is warranted, then you get paid extra for that. And I'm like, “Hmm, that's not really how it is.” The difference in ProSal and salary is… One of the benefits of ProSal is, for the owners: If they put you on it and things slow down, you're not earning bonuses. So your salary is not as big as it would otherwise be, and that gives them some peace of mind if they're not sure that they're going to stay busy.

Stephanie Goss:
Sure.

Dr. Andy Roark:
That's just how it works. It's not, “Let me figure out what to pay you in salary and then I'll just bonus you on top of that.” Generally, the way to really look at salary too, and then I'll move off of this: I think salary done well is basically ProSal on a very long cycle; which means, for the most part, if I was going to put a doctor on salary, especially a doctor who'd been there, I would look at what the doctor produced last year, and that would be a pretty strong guide in what their salary for this year was going to be.

Stephanie Goss:
Yes. Yes.

Dr. Andy Roark:
And you say, “But, Andy, that's the same thing.” I would say: Yeah, it is, but it's over a whole year. And so, those day-to-day pressures of, “I should skip my lunch break and see this patient,” that's just not there, because over the course of the year, it's not the same driver as: Boy, every three months you're going to get this bonus check if you do this. It takes a lot of the pressure off and the spreads everything out. But, again, I'm sure coming out of this, people are going to be like, “Andy Roark says we should all get paid on salary.” Didn't say that. Just saying, I'm laying all of this down, because I need to make the point here that I think there are some very good reasons that a clinic would not pay a doctor on ProSal. And it's not about taking advantage of them. It's just saying, “Hey, we have beliefs about work-life balance. We have beliefs about what we're going to tell pet owners about how our people are compensated, about whatever. This is just our business model. We are getting started as practice owners and we know that we can pay this salary. We can put it into our budget. It makes sense for us. We're going to do it.” I think that there's just a lot of reasons to not pay ProSal. Again, not wrong to want to be paid that way, but there are some good arguments against it.

Stephanie Goss:
Yeah. I agree with you. We talked about ProSal, but from the headspace perspective, is there anything else headspace-wise that you can think of before we jump into action steps?

Dr. Andy Roark:
Yeah. Yeah. Last things I'm going to throw in for headspace is: Empathy for the bosses that are starting out. So, and this request is like, “Hey, we've got these doctors and they're getting this new practice up and going,” and I would try to have some empathy for the other side and say: Boy, when you're starting a new practice, you don't know what you're getting into. You don't know if pet owners are going to show up or not. You've got these hopes.
I'll tell you as a business owner, boy, I've had plenty of times where I thought, “Boy, this is really going to grow,” and it did not grow. Or it grew, but it took five times longer than I thought it was going to take; and you just don't know. And so, I think having some empathy for the other side when they're like, “We don't exactly know where things are going to be a year from now, and so we're trying to couch this.” When this person says, “They say I can have unlimited vacation,” to me, that's often a strategy where someone says, “I don't know how much cash I'm going to have. I just don't know much cash I'm going to have, but vacation is valuable and we will figure out how to let you be off because we know we can do that.”

Stephanie Goss:
Right?

Dr. Andy Roark:
You know what I mean?

Stephanie Goss:
Yes, absolutely.

Dr. Andy Roark:
And so, having some empathy for them I think is important. This all goes back to: How much time off should a veterinarian take? There's not a right answer about what you should be. If they say, “Take this time off,” and you take a month off and, yeah, your salary is lower than your peers, but you got a month off.

Stephanie Goss:
Right. Yes. Yes.

Dr. Andy Roark:
If you're happy about that, then go and rock out. And it's not wrong if you say, “No, I really need to make more money than these people can pay us.” It doesn't make you bad.

Stephanie Goss:
Right.

Dr. Andy Roark:
It doesn't make you bad. It's just, they can't pay you that, and it's not good or bad. I think it'd be important to not get caught up in “should,” what I “should” make, and say, “Is this working for me and is it working for them?”

Stephanie Goss:
Right. Yep.

Dr. Andy Roark:
Enjoy your time off. When I graduated from vet school, I had a classmate who went on to be wildly successful as a doctor. Wildly successful. She took the lowest salary of any of my friends, and she got six weeks off a year because she liked to travel. And so, she was like, “Yeah.” She'd had the lowest salary of any of the vets that I knew, and she was off two to three times more than the rest of us. And she turned out just fine. But that's what she wanted.
And so, anyway, the last thing is: Remember that first job concerns are common. Right? You don't know yourself starting your first job. You don't know what you're going to need. You don't know how you're going to want to work. Don't beat yourself up and say, “Oh, this doesn't look right,” or I don't know. Just know that it's much easier to have these conversations after you practice for a while and you know what you care about and you know what your priorities are. You just don't have the experience usually starting your first job as a doctor to do that. So, anyway, that's my headspace.

Stephanie Goss:
I love it. Okay. You started to steer into some of my thoughts for action steps, so let's take a break here and then we'll come back and dive into: Okay, how do we answer the “should” questions that were asked?

Dr. Andy Roark:
Let's do it.

Stephanie Goss:
Hey, friends. Are you a veterinary practice owner? No? Well, are you a veterinary practice manager? If the answer to either of these questions is yes, I want you to keep listening. If it's not yes, you can take a quick pee break or get some water before we head back into the podcast, because I've got something for my practice owners and my practice managers. We are hosting our first ever practice leader summit. And if you're not an owner or manager and you're still listening and you're thinking, “But I'm a practice leader,” don't worry. We've got you. We've got more events coming. But this first one is happening in December in Greenville, South Carolina. It will be decorated for the holidays. We are going to come together.
Now, we're going to come together, but we're going to be separate. What are you talking about, Stephanie? Well, Andy and I have planned a whole bunch of new content with our team, and we are excited to bring managers together to talk to other managers, and owners together to talk to other practice owners, and then we're going to put everybody together and we are going to get to work. That's right. We are going to work on our practices. Our ideal hope would be that manager and owner combos can come together, but we recognize that won't work for some practices, so we have plans to hook you up with other owners and managers if you're coming solo on either side. So don't worry, but don't delay.
Head over to the website unchartedvet.com/events because we want to see you there, and that means you have to sign up because this will sell out. Don't miss your chance to come work on your practice with your practice owner, with your practice manager. You can find out more information, including a letter that you can use to convince your boss if you are a practice manager. Or maybe practice owners: some reverse psychology to use on your manager to get them to come to Greenville with you. Again, it's all up at the website at unchartedvet.com/events. And now, back to the podcast.

Dr. Andy Roark:
All right, so what do you want to do for action steps?

Stephanie Goss:
Well, I think one of the action steps you already started to call out, which for me is a little bit of a headspace, but it's action in the sense that I think that this veterinarian, and anyone who finds similarities between their situation and this veterinarian's situation, is that you have to sit down and look at yourself. Stop thinking about “should.” Stop comparing yourself to other people. Think about yourself. Are you happy or are you not happy? And if you're not happy, why? Have your circumstances changed? Do you need to make more money than you're actually making? What is that floor that you need to feel good about your job? And asking all of those questions on a personal level is very, very important, because I don't think you can have a conversation with your bosses about what you need and advocate for yourself in any way until you have actually answered the questions of: What is it that you want? Are you truly looking at this because you feel like you should?
And as you pointed out, Andy, earlier: Stop looking at the “shoulds.” Look at yourself, and if you don't have a problem with it, then let it go and move on with your life. Right? Or if you're looking at it and you're like, “Well, I asked for more money and they gave me more time off,” are you okay with that? Does that suit you? Does that suit your lifestyle? Stop looking at yourself compared to other people and sit down and do the mental gymnastics of: “What do I actually want?” And then, there's also a step in between “where I am now” and “what I want,” which is: “What do I need?” And figuring out for yourself where those three lines are. Where am I now? What do I need? And what do I want? And then, I think only when you have done that work are you actually ready to think about: “How do I actually have this conversation with them?”

Dr. Andy Roark:
Yep. Yeah. I'm right there with you. Remember, it's not about good or bad. They're not trying to rip you off. It does not sound at all like anyone's trying to take advantage of anyone. They're trying to do what they can do and they're trying to offer you what they can offer you. And you've got to figure out what you need and go back, and know that for everything you asked for, you're probably going to have to give something else up, and it's about making it work for everybody.

Stephanie Goss:
Yes.

Dr. Andy Roark:
That's what it is.

Stephanie Goss:
Yes.

Dr. Andy Roark:
All right. And so then, yeah, we're ready to have the conversation. But first, you have to know yourself, and you have to put aside what you should have and figure out: What do you really need? What do you really want? And then, go in and have a SAFE conversation; and we talk about this a lot. We talk about SAFE. SAFE is… “S” is: Can you sit next to this person? Can you smile at them? Do not go in there when you're angry. Just do not.

Stephanie Goss:
Right.

Dr. Andy Roark:
You should just get into a healthy headspace.

Stephanie Goss:
Or when you've had a long day or you're angry.

Dr. Andy Roark:
Yes.

Stephanie Goss:
Like you've been seeing patients and you skip lunch, that's not the day to have this conversation.

Dr. Andy Roark:
Exactly.

Stephanie Goss:
Even if you have it scheduled, that's not the day to have the conversation.

Dr. Andy Roark:
“A” is: Assume good intent, which means it's in your best interest to believe these people are doing their best. They're trying to run a practice. They're trying to make you happy and also not overcommit and put themselves out of business in their mind. Things like that.

Stephanie Goss:
Right. Yeah.

Dr. Andy Roark:
Assume that they're doing their best and they're trying. “F:” have they been set up to fail? What here is your fault? And what I mean is: It helps me to go in and say, “What have I not told them?” If I'm upset about my salary, but I haven't told them that I'm upset about my salary, then that's on me.

Stephanie Goss:
Right.

Dr. Andy Roark:
If I have something that's changing in my life that's going to require more money, and so that's weighing on me, but I haven't communicated to them that I'm feeling this financial pressure, I can't be mad at them for something I didn't tell them or that they don't know.

Stephanie Goss:
Right.

Dr. Andy Roark:
So, “Have they been set up to fail?” meaning: Is there information they haven't had? Things I haven't communicated? What's my fault? Same thing. And the last thing is “E,” which is: End result, which is, “What do you want the end result to be?” And I think that that's part of knowing what your needs are going in. And I would say the other part for end result is, remember, a lot of times the end result is not to get what we want. A lot of times, the end result is to inform them of where our head's at, ask some good questions, acquire some more information, and continue the conversation forward. A lot of times, it's not, “I'm going in there, I'm going to tell them what they need, and they're going to give it to me or there's going to be consequences.” That's a terrible way to go to this meeting. It's to go in. It's to communicate. It's to try to understand where they're coming from, to communicate what I need, and then see if we can move this conversation forward.

Stephanie Goss:
And I think the step for me that comes there along with SAFE that has to do with the prep work is that: If the end result is to have both sides be seen and understand where they're coming from and acknowledge the fact that they're not out to get you, they're not out to rip you off, they're taking care of you, from the business side, I think part of that prep work is you should know what your total compensation looks like. Because as this associate mentioned in their email, they understand that the money, the salary is only a piece of it.
There are also the benefits, both financial fringe benefits, things like paid time off, things like healthcare benefits or that kind of thing, that actually has a hard cost for the business, and there are the soft costs benefits; being able to truly have mentorship that you feel supported and believed in by. Being able to have a high staff to doctor ratio. There's a lot of those things that often don't get factored in when someone is… My experience as a manager is that I have had countless conversations with team members, from paraprofessional staff to my doctors, where we have sat down and nothing but the salary has been factored into the conversation.

Dr. Andy Roark:
Mm-hmm.

Stephanie Goss:
And so, from a prep perspective, part of getting SAFE is to understand that as a business owner, I am absolutely going to look at the conversation from the big picture. And so, as an employee, in terms of how have you been set up to fail, but also maybe how have they been set up to fail, if you haven't done your homework and you haven't looked at what is your actual total compensation, my suggestion would be don't have the conversation yet. Don't skip that step. Sit down and do it, because the first thing that I'm going to do as a business owner, whether I do it with you or whether I do it when we're done with that first conversation, is look at: What is your total compensation and where does that percentage fall? Because that is an absolutely important critical piece of the mathematical equation for whether I am breaking even with an employee or not.

Dr. Andy Roark:
Yeah. I agree. I think you start this conversation with appreciation and stating your desire to maintain the relationship. And that seems like a small thing.

Stephanie Goss:
Sure.

Dr. Andy Roark:
It's a huge thing, and people miss it, is: Open up the conversation talking about your appreciation for them and the clinic that they're running and the culture that they've built. And I would go ahead and start by laying out all the things I love about being at this hospital.

Stephanie Goss:
Right. Being supported, having the mentorship, all of those things.

Dr. Andy Roark:
Absolutely.

Stephanie Goss:
Yep.

Dr. Andy Roark:
Exactly. I would lay all those things down so that they feel seen and appreciated. There's nothing worse, as a business owner or a boss, when you are doing all that you can for somebody and they walk in and they look at you and they say, “My friends make more money than I do.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And it just discounts all of the things that you have tried to do for them because, in that moment, it sounds like all they care about is the dollars.

Stephanie Goss:
Sure.

Dr. Andy Roark:
And it's so demoralizing and it makes you feel so unseen and so unappreciated. And so, anyway, start with appreciation. And state up front: “I want to be here. I like this place. I want to be here.” And that will just lower the stakes a bit for everybody. Because as a manager, again, when somebody comes in and goes, “I need to make more money,” for whatever reason, we catastrophize right away as, “Oh, she's saying she needs to make more money or she's going to leave.”

Stephanie Goss:
Yes. Absolutely.

Dr. Andy Roark:
Right.

Stephanie Goss:
I was going to say, even if you don't phrase it in any way, shape, or form like an ultimatum, when you start with the money and there is not the appreciation tie, it absolutely already, in my head, feels like an ultimatum, even before more words have come out of your mouth. That's our little caveman brains. That's where it jumps to every time.

Dr. Andy Roark:
Yeah. And so, then after that, the next step for me is ask questions. I wouldn't even go in and say, “I need to make more money.” I would go in and say, “Are you open to talking about salaries and how the doctors here are compensated?”

Stephanie Goss:
Right.

Dr. Andy Roark:
“And why you chose to pay salary to the doctors.”

Stephanie Goss:
Sure.

Dr. Andy Roark:
“Would you be open to talking about that?”

Stephanie Goss:
Sure.

Dr. Andy Roark:
And ask questions. “Why do they pay salary? Why don't they do ProSal?”

Stephanie Goss:
Right.

Dr. Andy Roark:
“Would you be open to talking about production-based compensation or a ProSal model?”

Stephanie Goss:
Right. Yeah, I love that.

Dr. Andy Roark:
“Do you have concerns about that?” And I'm sure that the thought has crossed their mind, but again, it's seek first to understand and just asking those questions of: “Why is this set up the way that it is?” And they might say, “Look, I'm going to be honest with you. We have startup costs and we try to avoid taking loans early on and we are really strapped for cash. And so, this allows us to be safe. And we try to give you guys a bunch of vacation to make up, because we know that we can't pay what other people pay, and this is why we're doing it.” And then, at least you know what they're up against and what you're dealing with. You're just so much better off having this conversation that way.

Stephanie Goss:
Yeah. Because I think on the flip side, too: I have absolutely worked with practice owners where the conversation has been: “I guess I just never considered it because I figured you would feel safer getting a salary and not having to worry about whether you're going to make your check or not.” Right? It is not always in our heads. We frame ourselves for the negative argument, and I think that you absolutely have to look at it that there is not always a negative argument. Sometimes it is that they made that choice because they thought it was what you wanted or because they thought that it was what was going to be most supportive. And so, just by asking the question, it opens the door for them to be like, “Yeah, let's talk about it, because I never thought that that'd be something you'd be interested in.”

Dr. Andy Roark:
Oh, totally. What if… And I'm just spitballing. What if they were like, “Man, when I was a vet, I wanted time off. I wanted to be able to walk away from the practice. We really care about burnout, so we're going to let you be away. And if we give you a bunch of time off but we pay you on production, you're not going to use the time off and it totally undermines the whole central thing we're trying to do that we think you'll love”? And, again, I can see that being the rationale, but you just got to ask the question. You already mentioned it. Beware ultimatums. People do not like the “old tomato,” as we used to say at my house. Do not give them the old tomato.

Stephanie Goss:
Yes.

Dr. Andy Roark:
No one wants to feel stuck of, “We're having a negotiation and you're going to make me happy, or else.” That's just bad juju. And, again, I hope that that's not the plan. Some people actually make plans to do that, which is terrible. More often than not, we don't think about how we're presenting ourself and we end up giving the impression that, “You make me happy or I'm going to walk,” and that just makes everybody's cortisol shoot up. They get really tense. People do not like to feel threatened and ultimatums could feel like threats. Just don't frame as ultimatum. Ask questions. Ask them what's possible.
Remember that clear is kind, and I think between talking about looking at your total package, your total compensation, thinking about what you actually need, what you actually want, what's going to make you happy, and then communicating to them what you think you need, ideally why you think you need that, that's just good business. As an employer, I would much rather someone come to me and say, “Hey, I'm really struggling. I'm not getting what I need to get. These are my financial realities.” And I would love them to say that to me as opposed to not saying that to me and just take another job and be like, “Hey, I took another job because I'm not getting what I need here.” I would feel stabbed in the back. I'd feel like you didn't give me an opportunity to try to figure out how to meet your needs. I would much rather know where your head's at, in a non-accusatory way, than to be surprised.

Stephanie Goss:
Yeah. Yeah, because you can't help if you don't have the information. And I'm not talking about you need to spill your whole life story and the details of your bank account to your boss, but if there is a place that you are at where you're like, “I can't help you if I don't know what you need,” and so you have to be able to communicate that. Is it you need $1,000 more a month or is it $10,000 more a month? I need that kind of information to know what is feasible for me as a business, right? And I can just guess, really, because without that information, that's what I'm doing. It's just taking a shot in the dark and hoping that it works.

Dr. Andy Roark:
Yeah. And the last thing for me is: Get creative. I think a lot of times, especially when we talk about money, we're like, “All right, we're talking about money.”

Stephanie Goss:
Right.

Dr. Andy Roark:
And the problem with money is money is a zero-sum game every time, which is: “The more you get, the less I have.” One of us is getting money and the other one is giving up money-

Stephanie Goss:
Is not. Yeah, yeah.

Dr. Andy Roark:
… and there's no way around that. That's what money is. However, if you look at this conversation as a mutually beneficial problem-solving exercise, suddenly everything gets so much easier. Do you need money or are there schedule flexibilities that you would like to have? Do we need to get over this guilt about taking time off and feel good? I don't know. Are there ways that the practice could help you out that's not bumping your sound up? Maybe not. But the more ways that we can approach this, the more tools that we can use to meet my needs and meet your needs, the more likely we are to succeed.
If there's only one tool and that's dollars, well, if I don't have the dollars to give to you, I don't know how we make this work; and that's sad. Oftentimes, it's not really just about straight dollars. A lot of times, there's other things that we can do. We can get creative in how to get our needs met. But I've seen a lot of people shut all the doors except the money door, and then no resolution is met and everyone's unhappy and whole thing falls apart. And so, that's it.
The last, last thing I would say is: You signed a one-year commitment, and that's it. That's all. You should not feel guilty about leaving if this doesn't work for you. And, again, that's how I look at a lot of these things is: When I do an agreement as a doctor, or as an employer, we look at this and we say, “All right, look, you're going to come here and this is what we're going to pay you and we're going to see how it goes.” And honestly, your contract should have termination clauses in it which says, “If either side is unhappy, this is how we end this agreement.”
That stuff is all laid out that you can end that agreement. And my advice is just be professional and be kind, and try not to take this personally. Sometimes relationships don't work out, and that's okay; as long as you've done the other things and you've communicated and you've tried to make it work. I see some people who were like, “Man, I took this job. I did it for a year and then when my contract came up, I didn't renew and I feel terrible about it.” And honestly, one of our most popular episodes ever, it may be the single most popular Uncharted Podcast episode ever, is how to put in our notice without the guilt.

Stephanie Goss:
Mm-hmm. Yeah.

Dr. Andy Roark:
And I think we had an episode on that.

Stephanie Goss:
Yeah.

Dr. Andy Roark:
But anyway, that's my last thing is to say: Sometimes these things don't work out. It's not a moral failing. It is what it is. It doesn't mean that they're villains because they couldn't keep you there. It doesn't mean that you're a jerk because your needs were not getting met after a year and you wanted to go try another type of practice. It is what it is.

Stephanie Goss:
Oh, this was a fun one.

Dr. Andy Roark:
There's a lot here. Yeah.

Stephanie Goss:
I think we had unpacked quite a bit into that. There was lots of gems, including how old you are and that you have hit middle-aged dad status.

Dr. Andy Roark:
Yeah. Yeah.

Stephanie Goss:
Rod Stewart.

Dr. Andy Roark:
Rod Stewart.

Stephanie Goss:
I can't wait to see the magic that Dustin does with that gem when he edits it.

Dr. Andy Roark:
With Rod Stewart? Oh, man.

Stephanie Goss:
I'm going to be highly disappointed if I don't hear some Rod Stewart in the background.

Dr. Andy Roark:
I don't know that we can sample Rod Stewart. I have no idea what's involved in that.

Stephanie Goss:
Take care, everybody.

Dr. Andy Roark:
All right.

Stephanie Goss:
Have a fantastic week.

Dr. Andy Roark:
Thanks, guys. Bye.

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


Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: culture, management, Practice ownership, Training

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