This week on the podcast…
This week on the Uncharted Podcast, practice management geek Stephanie Goss is joined by a very special guest: former practice manager and author of the new AAHA press book Lead to Thrive – The Science of Crafting a Positive Veterinary Culture, Josh Vaisman, MAPPCP (PgD).
Josh believes all veterinary professionals deserve to feel fulfilled by their work each and every day. Through his company, Flourish Veterinary Consulting, he draws on over 20 years of veterinary experience, a master’s degree in applied Positive Psychology & Coaching Psychology, education in Positive Leadership and Positive Organizational Scholarship and a passion for guiding leaders to cultivate work environments in which people can thrive.
Fun fact – Josh is also an avid beekeeper who teaches beginning beekeepers how to tend to their buzzing buddies.
Josh and Stephanie are looking at Josh's new book through the lens of his practice management road and the journey he took to becoming a positive leader and force for good in our field. They discuss their own success and failures in an unflinchingly honest and vulnerable way. Let's get into this…
Buy Josh's New Book – Lead to Thrive here (AAHA MEMBERSHIP NOT REQUIRED TO BUY!)
Find Josh and his team here and here!
Links for resources shared by Josh during the episode
Adam Grant's website (including book links)
Martin Seligman's website (including book links)
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. Head over to the mailbag and submit it here
Submit your questions here: unchartedvet.com/mailbag
Upcoming Events
Episode Transcript
Stephanie Goss:
Hey everybody! I am Stephanie Goss, and this is another episode of The Uncharted Podcast. Today I am joined by a very special guest, my dear friend and colleague, Josh Vaisman. Josh is joining me to talk about his journey as a leader and how do we lead to thrive. He's got a new book out that has the title, coincidentally has the same name, and he and I are talking through the science of crafting a positive workplace. It ties directly to Josh's journey as leader. And I had so much fun talking through this journey that he has been on and just having a conversation with a dear friend. I would love for you to join me. And now let's get into this.
Speaker 2:
And now The Uncharted Podcast.
Stephanie Goss:
And we are back. It is me, myself, and I, Andy is on vacation this week; however, fear not, friends because I am so, so excited to bring a conversation to you with my friend Josh Vaisman, who is here joining me on the podcast today. Hi Josh.
Josh Vaisman:
Hey, Stephanie. I just want to say really quickly, I'm so sorry, but Andy is on vacation. It's like 105 degrees here in Colorado, and you're in a closet. Something doesn't seem right in the universe.
Stephanie Goss:
You hear that, Andy Roark? I think Josh is saying that I should be let out of the closet more often, although I do not want to be in 105 degree Denver weather either, because that's gross.
Josh Vaisman:
No, not fun, man. Not fun.
Stephanie Goss:
How are you, friend? I feel like I'm really excited to see your face and talk to you. And also I feel like my cup is still full because I just got to spend a whole bunch of time with you at AVMA recently, which was amazing.
Josh Vaisman:
It was amazing. I was literally going to say the same thing. I'm still seriously walking through life on a high from that event. Seeing you and just like all of the, gosh, there are so many really, really good human beings trying really hard to do really good things for the profession and getting to spend that much time with so many of them in one space, it's just such a heart filler. It was pretty awesome.
Stephanie Goss:
And you had extra special, amazing time at AVMA because, so for those who don't know, I am bringing Josh to you for so many reasons, least of which is that he's just an amazing human being. And if you don't know who Josh is, you need to check out the link to find him in the show notes because he's amazing in doing wonderful things in our profession, and he is smart, and he wrote a book and it is fantastic.
I am not all the way through yet. I started reading it on the plane on the way home from Denver, but Josh had his book launch party at AVMA and it was so fun because Josh knows all of the great human beings in veterinary medicine, and they were all in one room at AVMA to celebrate you. And it was so much fun to have the energy in that room and to see all of, like you said, the people who really care about making a positive difference in veterinary medicine, I feel like in one place.
Josh Vaisman:
Yeah, it was so awesome looking out on that room and seeing such amazing humans. Yeah, it was pretty cool, cool experience.
Stephanie Goss:
And there was lots of fun too because your team helped decorate with googly eyes all over the place, which was so fun.
Josh Vaisman:
Okay, so since we're in the business of outing here, I'm going to out one of the infamous Uncharted members, Dr. Sarah Wolfe, whose idea sparked a movement, #AVMAGooglyEyes. It was-
Stephanie Goss:
Is that really a thing? I have not seen that hashtag. Oh, I need to go down that rabbit hole now.
Josh Vaisman:
We definitely did it. We definitely did our best to represent the hashtag well throughout the conference.
Stephanie Goss:
Okay. I love it so much because it's very Sarah, it's very Uncharted. We have our own several things. We have the Janelle Hutton challenge, where everybody tries to catch Andy in the background and point at him and their selfie without him noticing you. And so that is right on brand for us to have the googly eyes. This does not surprise me one bit that Sarah was involved in that.
Josh Vaisman:
Oh my god, it was so fun. It just made AVMA that much better.
Stephanie Goss:
Okay, I'm going to have to go down that rabbit hole and view things on social media, but so you and I have known each other for a while and I want to make sure that our listeners who maybe they haven't heard of you or they didn't know that you have a book out, so let's start there. Tell us a little bit about you, your background in veterinary medicine, because really you are a positive, wonderful human being, and I know that you would be that way without veterinary medicine, but tell me how you got to where you are in vet med and how you got so excited about creating a positive culture, because that is really a drive for you.
Josh Vaisman:
Big time drive. Well, Stephanie, I'm a Pisces who enjoys leisurely walks and … Yeah, so I-
Stephanie Goss:
Oh my God, your microphone is going to make you sound so fantastic right there. I love it so much.
Josh Vaisman:
I sort of stumbled into veterinary medicine. I had moved to Colorado from Wisconsin actually in the late '90s, and I was working at a PetSmart in Boulder, Colorado. I was in the specialty department, so I was the guy that you saw about the fish.
Stephanie Goss:
Love it.
Josh Vaisman:
And we had a PetSmart Veterinary Services in our building, which is dating myself pretty well now. I got really intrigued by what they were doing over there. I sort of befriended the chief of staff and some of the team members and started to have these ideas that maybe I'd want to go to vet school someday. I like to think of it as the time in my life where I had a psychotic break. I have since been disabused of this troublesome mindset, but I thought if I'm going to go to vet school, I should probably know what it's like to work in a veterinary hospital. And I walked over there and I asked if I could volunteer on my days off, and they were like, no, we can't really do that, but we can hire you. Which was a surprise.
So I switched from PetSmart to PetSmart Veterinary Services and was trained as a technician assistant and worked there for a number of years, and that was in '98. So that's how I started in vet med. I just immediately fell in love with it. Obviously the animals part, we have a small menagerie of creatures in our home, and animals have been a central part of my life for as long as I can remember. But the truth is it was really the people that drew me in. The people that come to work in veterinary medicine are a special kind, and you can take that as a double entendre as far as you'd like, really some of the very best people.
Like that laugh that you just had is such a common thing in a veterinary space. And to be able to be that real and that raw and that joyful and that vulnerable and be around people who are like that is, oh God, it's just such a good feeling. And so it stuck with me, and I did that for quite a while. A few different hospitals all around Colorado, pretty much all small animal, most of it GP, a little bit of ER work. And then one day a hospital that I had worked at was sold to a veterinarian and a vet tech, and that was the first time that it occurred to me that you don't have to have DVM, or sorry, VMD after your name to own a veterinary hospital, at least in the state of Colorado.
This was like mid 2000s and I'm making maybe $9 an hour or 9.50 or something like that. And I walked into the doctor's office and I sat down next to one of the associates there and I was like, “I feel like we could do this. You want to buy a vet hospital with me?” And six months later we did that.
Stephanie Goss:
Oh my God, shut up.
Josh Vaisman:
Yes. So myself and two veterinarians, I found a way to get us financing to buy a hospital that just purely coincidentally had gone up for sale publicly. It was through a brokerage, which was very uncommon in the Boulder market. It was at the time a one doctor practice that had been two to two and a half. It was kind of declining, and he was really ready to get out of ownership. And so we got in a banging deal and it was four miles from the practice that we had worked at.
Stephanie Goss:
Oh, that's awesome.
Josh Vaisman:
So we had built in clientele. So we bought that practice, and over the next five plus years, we had a good bit of success. We took this hospital that was a one doctor practice, and when I left, there were four doctors on staff. We had tripled the revenue from when we bought it, all the standard metrics of success that people look at, and I felt like, “Gosh, I'm good at this. I like it. If I could do it once, I could probably do it 15 times. Maybe I should start trying to do that.” And so I ended up leaving that practice and going to another practice, bought that hospital along with a friend and business partner and a brand new startup group, so a corporate group that was just getting off the ground.
And so we all got together and bought this hospital. It was our first partnered acquisition. It was this corporate group's first acquisition, and they were raring to go to buy multiple hospitals. I got under the ground level with these guys. I thought, that's it. This is how the launch is going to start. This hospital, as I said, is about 75 miles from where I live here in Firestone, Colorado. I was going to be the managing partner of the practice and the onsite hospital director. So I started commuting to this practice 75 miles from my house every day. Hospital was open seven days a week, and I was often there-
Stephanie Goss:
Of course it was.
Josh Vaisman:
Yeah, of course.
Stephanie Goss:
You couldn't have picked a eight to five, four day a week GP practice.
Josh Vaisman:
Oh, gosh, no, no, no, definitely. No, no, no. We picked the seven day a week extended hours, sort of like pseudo defacto emergency facility in the area. And vastly underperforming financially and culturally a pretty big mess. So all of the, I'm using air quotes, “opportunities.”
Stephanie Goss:
The dumpster fire that was awaiting you.
Josh Vaisman:
The dumpster fire that was awaiting me. Now, keep in mind though, I was really excited. I thought this was an opportunity not just for a business venture, but really to make a difference in the lives of 40 people working there and in the community. And that's really what I got most excited about. So I dove in, I dove in headfirst, and I really tried to turn that place around as best I could.
Now, the first year that we owned the hospital, we did the highest gross that that practice had ever done in its 34-year history. So on one side of the coin, you could say, “Wow, it was a success.” What I've sort of come to realize is that success can be defined in a whole variety of ways, and the way that I'm defining it these days is very different than I defined it those days. Yeah, I just completely obliterated myself and some of that, at the time there was definitely a bit of the finger pointing and the blame game. I pointed fingers at my partners and I pointed fingers at the community and I pointed fingers at people on the team, the prior owner who stuck around and felt like he had to keep an eye on me, all that kind of stuff.
But the truth is that I really allowed myself to be in that a position where I started to create a mind story of what I thought people wanted, in particular my business partners who had invested so much time and energy and money into this venture and put me in charge of it. And I allowed myself to start making decisions that put what I thought were the values in that head story ahead of my own values. And what that ultimately resulted in was me harming people and harming myself in the name of the bottom line. And it worked for a while until it didn't.
Stephanie Goss:
As it does, yeah.
Josh Vaisman:
I completely broke down, like the ugly on the kitchen floor crying one morning, total breakdown for literally no apparent reason as I'm getting ready to get in my car and make the drive yet again. It took me a while to realize that I didn't have to be in that space. That was in March. I didn't actually leave that practice and that partnership for another six months.
But when I finally did, because I knew that I wasn't going to get healthy if I didn't separate myself from the environment that was contributing to it, when I finally did, I had a realization that business is a human endeavor and there is no such thing as business without people. And as the people go, so goes the business. And I had put the business ahead of the humans, and I was never going to do that again. And so at first I wasn't really sure if I was ever going to come back to vet med.
Stephanie Goss:
I totally can empathize with that and understand that because a hard space to be, and it's real easy to look outside of ourselves and be like, “This is a hot mess. Maybe I'll just go find a less hot mess place to live.”
Josh Vaisman:
Right. Maybe there's something that's, I don't know, let's go with warm and mildly disorganized. That would be an improvement. You say that and the sense that I get when you empathize with what I just shared, the sense that I get is that maybe you've been in a place like that before?
Stephanie Goss:
Oh, yeah. Oh yeah, for sure. It's funny because as I'm listening to you tell your story and will save mine for another day. But yes, 100%. And I think so many people I've met in veterinary medicine have gone in some way, shape or form through what you're talking about and what you're describing. And your story is a familiar one because so many people, nobody gets into veterinary medicine for the money. Everybody is here for the patients, for the people both. You and I are very similar in that we're here for the people. And of course I love the animals and love the why of what we do to take care of the animals.
But for me it was always about the people as well. And recognizing in yourself, and I've talked about it on the podcast, it took me a lot of therapy to get to a healthy place where I stopped beating myself up for the times when I did make the mistakes and stop putting the humans before the business. I think that's something that's really easy to forget and for a myriad of reasons, least of which is “I'm intentionally.” I don't think I ever was the person that's like I'm putting money ahead of the people on my team, but there's always some reasons like well, I want to hire more people, so I want to make more money so that we can take care of more people.
And that is good intention, but when you focus on that to the exclusion of all else, it still puts the people behind. And so I a hundred percent know what you're talking about and have been there in that place where it's like I don't really like myself very much and what I'm doing here, and really it's funny because since doing the work that I get to do with Uncharted and the changes that have happened with my career in the last few years, I have so many people tell me, and I'm sure you do too, because you're a very positive person. I have a lot of people who are just like, “You're so good at what you do.” And I'm like, “I'm real bad at what I do. I think I'm just real good at being honest about it. Stop trying to put me on a pedestal when it comes to managing because I've screwed up just as many ways as I've done it right.”
And so for hearing you and recognizing that, it takes a lot to not just walk away and that is the piece that I feel the most because I was right there with you. Maybe I just really shouldn't be doing this. Maybe I just suck that much at this and I should go find … I had a career outside of vet med, before vet med, and do I leave altogether and go find something else that I can harm other people less and harm myself less doing? So that place on your kitchen floor, I feel that, Josh.
Josh Vaisman:
Yeah. Gosh, thank you for sharing that with me. It's very validating to hear somebody with your level of success and where you stand in the community now, share that experience that mirrors a lot of what I went through. You said you started to question if maybe you're not that good at this and maybe I should go find something else to do. I distinctly recall saying to myself, “I don't belong here. I really don't. They don't want me.” Gosh, that one really hit me.
So I separated myself from all of that for a while and then it gave me the space to start exploring things, and that's when I really started taking a deep dive into, at first it was Shawn Achor's work, his book, The Happiness Advantage and some of that, and then that turned me on to Martin Seligman and Applied Positive Psychology, and I took a few Coursera courses on that put on by the University of Pennsylvania with him and Angela Duckworth and Karen Reivich and the titans of positive psychology, and it just kept ringing in my head, this is what we're missing.
This is what we need. I had this realization, I think this is going to resonate with you. You said it wasn't like you ever sat there and thought, “Okay, I'm going to make the people second. The money's …” But you never did that. You, I'm certain, have always had people's best intentions in mind as, I have come to realize, almost every single person in veterinary leadership that I have met over the last several years, and I've met a lot of people over the last several years. I can count on one hand the number of people that I can confidently say they don't have good intentions in veterinary medicine. Almost everybody is trying to do the very best they can each and every day with what they have to uplift, support, amplify, benefit the people around them. And no one's ever taught us how to do it.
No one ever taught me, I stumbled into it. Nobody ever taught you. Nobody teaches us. We learn all of these great technical skills, but nobody actually teaches us. How do we actually create an environment that allows people to not just survive, but actually thrive in and through the work that they do? No one ever taught us. And it felt to me like positive psychology had something special to share. I love it. And so that's been my mission ever since then. That's why we started Flourish Veterinary Consulting. That's why we do the work that we do through our organization. That's why I wrote the book is I really want to empower everybody in a leadership position, whether that's by title or in formal leadership.
You're the RVT who's worked in the hospital for 15 years and I don't ever want to be a manager, but everybody on the team comes to you. Guess what? You're a leader. You're an associate veterinarian who just graduated just past your board and is starting your first ever job. Guess what? You got a license. You're the tip of the healthcare sphere. You're a leader. Like anybody who's in that position, I want to make sure that they've got tangible evidence-based skills to create the kind of environment that actually allows people to be at their best. And hey, what do you know? Everything else gets better when that happens.
Stephanie Goss:
Oh my gosh, I love it so much. And there's so much to unpack there, and this podcast could be like nine hours long. But so what I really want to do, I want everybody who's listening to go and buy your book and we'll drop that at the end where they can find it. Because like I said, I'm reading it and I sent you an email right after I started it because you guys, I think I got maybe a chapter and a half or two chapters in and I was so impressed because I could hear you, Josh, in my head, but I also loved that I was reading it and I have done a lot of work, but I will say I have read some of the authors that you were mentioning, but the positive psychology piece is definitely not my realm of education.
And when I was reading it, I didn't feel dumb and I felt like you were speaking my language and you were saying things that I could feel in any position in the practice and that it would resonate with. And so that's just one of the things that I have loved about it so far is that I feel like you can, whether I was in my CSR role and I could have picked up this book and read it, or I could be in the kennel and just wanting to learn more about working in a good environment and pick up this book and least of all be a practice owner or practice manager whose job it is to make sure that you believe in things like this.
I think it's a tool for everybody, but will you tell us a little bit about the basics of, because positive psychology is a phrase that is getting more attention in veterinary medicine, and I'm so glad that it is, and I also think that it's used very interchangeably with positive culture and those are two radically different things, and there's a lot of work and science behind the positive psychology. Will you break that down a little bit for us? Just on a really basic level, and I think that probably ties to maybe why you wanted to write the book in the first place.
Josh Vaisman:
So I like to talk about these kinds of concepts using metaphors, and so if we think of the lived experience of just being a human being as a garden, there are things that happen in a garden. Sometimes weeds show up. You could think of those as the challenges or the bad things in life, and sometimes the weeds get, they're pretty noxious and they take over and maybe the result in the garden really not doing well and it's suffering. That could be mental health issues, things of that nature. Traditional psychology has been very interested, not always, this is not ubiquitous, I want to be very clear about this. It's not everywhere all the time, but generally speaking, there's been a heavy focus traditionally in psychological research on weed management. What are the things that we can do to make sure that the weeds don't show up, that when they show up, we can nip them in the bud, that when they get real thick and bad, that we can alleviate those problems?
Stephanie Goss:
Know how to get rid of them.
Josh Vaisman:
Yeah, eliminate them. That's an important part of keeping a garden. Anybody who has a garden knows that weed management is important. But let's assume that that's the only thing that you do in the garden. If the only thing we do is focus on weeds, first of all, probably not actually going to succeed. There's really no such thing as a garden that's a hundred percent absent of weeds a hundred percent of the time, and that's the truth for life. Life is hard. There are difficult things. We have this word in our lexicon called stressors for a reason because they're everywhere. Every single one of us faces stressors on a daily basis, so we're never going to get rid of all the weeds from the garden. But even if you could, let's just imagine we'll play a mental game here. We'll imagine that somebody comes up with that special spray that you spray in the garden, and never again are there weeds. Great. What's left? Dirt.
Part of gardening is also growing things. Positive psychology is interested in what are the things that we can grow in the garden? What are the nutrients we can add to them to make sure that they really thrive and flourish to their full potential, so that even in the presence of weeds, we're going to look at that garden and say, “Ah, that's a beautiful garden worth keeping.” It's the same thing with life. So positive psychology is very, very interested in what are the nutrients that add to a life worth living?
Stephanie Goss:
I love that metaphor so much because A, because I followed it and I feel not dumb and because it's midday and I've not had enough of my caffeine yet, and B, that speaks to my soul because what person, especially in a job like veterinary medicine where we genuinely get into it because we love what we do and we care about the patients, who wants a job that consists only of managing weeds? That job would suck. I don't want the job where all I'm doing is the thing, but to your point earlier, I think so many of us in leadership roles, we don't have that intention and the tools that we are given generally are focused on weed management and solely on weed management.
So most of us are not equipped to do more than look at that general psychology view of, “Okay, I know that if I have a discipline problem, these are the steps that I have to take to solve that problem.” We don't look beyond that. And that for me, in a management role in veterinary medicine, I like all the weird things that other people do. I love spreadsheets. I love all of the weird number crunching. Don't ask 4th grade Stephanie about that because I hated numbers as a kid.
Josh Vaisman:
Stephanie, I have to tell you this really quickly because Tess will not forgive me if I don't share it. Andy and I attended one of your talks at AVMA and on the slide you had, if I remember the wording, it was something along the lines of Airtable Nerd.
Stephanie Goss:
Yes.
Josh Vaisman:
I told that to Tess and she lit up. Lit up, came alive.
Stephanie Goss:
I love it so much.
Josh Vaisman:
It's not just me.
Stephanie Goss:
No, I love spreadsheets. I love Airtable. I love all the nerdy organizational stuff and nothing devoured my soul faster than having to deal with the problem management all of the time. I got zero joy and satisfaction from that as a manager, and unfortunately I spent a lot of time doing that in veterinary medicine. To your point earlier, some of it was the circumstances of the hospital and growth and change and reaching for that bar and moving from one doctor to four and all of the normal growing pains, and I am self-aware enough and have done enough therapy to have this conversation honestly with you. A lot of it was my own making because I was just like this is the tool that I have been given and for a really long time, instead of going in search of more tools and instead of just saying, “Hey, nobody taught me how to do this, maybe I should learn.”
I was like, reach for the management tools and then go garden the hell out of that garden with the tools that I have. And unfortunately, they were the tools that were really just focused on eliminating the problems and not actually dealing with making the garden pretty and focusing on the culture and the people and that feel good thing, even though that was always my intention. I love people and I love talking to people and I love everybody being happy at work. And so of course I wanted to cultivate that, but it took me a really long time to get to the place where I understood that does not happen in a vacuum. You have to actually dedicate time and energy and resources to making that happen.
So it's one of the things that I'm really glad that you are shining a light on in veterinary medicine, because you can read a book and learn lots of things and you guys all should. I'm going to drop Josh's book link in the show notes because you mentioned some authors who I really, really enjoyed reading. And this is a thing you have to do and practice and live, and it has to be ongoing because you don't just get the beautiful garden without a ton of work.
Josh Vaisman:
100%. I totally agree.
Stephanie Goss:
Hey, friend, we have been talking a lot about how we have a bunch of new events coming in the back half of 2023 that are going to let our team share our experience that we have gleaned over the last few years working with hundreds of leaders across veterinary medicine in all kinds of different positions, from support staff to doctors to regional leaders. We have been putting together something big that is coming. I can't tell you all the details yet, but I promise you are not going to want to miss out on this big, big, big announcement that is coming soon, but not soon enough for me. So I want you to head over to uncharted vet.com/insight and sign up for the newsletter. That is the only way to make sure that you have the information as soon as it's ready to hit the presses. It is exciting and I cannot wait to share it with you.
Josh Vaisman:
I would like to validate something or at least attempt to validate something. When you talked about your experience as a manager who was sort of stuck in the cycle of weed management, you talked a bit about context, but you also talked about your own making and the tools that you had. I want to try and normalize that a bit for folks that are listening. I recognize the persona that I carry with me these days, and especially imbued in the work that I do. I can come across as the always positive, always happy person, and sometimes I also recognize that there's a danger in that and that people can sometimes feel like when you're around somebody like that, that you can't ever be anything but the same. And I really want to normalize, Stephanie, you're also … Andy's not here to argue with this, by the way.
You're also a normal human being and because you're a normal human being, you have some very normal psychological features that are literally hardwired into the physiology of your brain, and I use that word feature on purpose. I really want to hammer that home. These are features, they're not problems. One of those features is a negativity bias. And so of course when you're stuck in the stress of a management role, and you're carrying the weight of the context and environment and the bars that you're striving for, and things feel like they're on fire around you without any other tools, without any other support, without any other structure, we're all going to default to our normal brain features. And one of those features is, “What's wrong? How do I fix it?” That's where all of us go. I just want people who are listening to recognize that that doesn't make you bad or broken, that makes you normal.
Stephanie Goss:
I love it so much. You said it with a lot more education and clarity behind what you said than I would, but that's a lot of what I feel like I get to do on the podcast. That's one of the things that I love the most about just doing the work that I'm doing now is like, let's be real because we're all human and there are things that we all do are not great or that we wish were better. But the cool part is we get to choose and we get to be intentional about it, and that's one of the things that I love about you is recognizing that you're not advocating for toxic positivity.
You're not advocating for you've got to have a sunny outlook no matter what, you are looking at how do we acknowledge that the weeds live here too, and how do we try to have less weeds over time? And not even just an instant, but this is going to take time and work and effort and the ultimate goal would be to have less weeds. But the garden, it makes it unique, and that's one of the things I always thought it felt very zen to me to get into that headspace. Andy calls it when he has Buddhist moments, but for me it was very much like oh, just remind yourself it wouldn't be the same without them. Even the people who drive me crazy, our beautiful little messy group would not be the same without the drum major who just cannot keep beat. Sometimes you just have to roll with what you got.
That's one of the things that I love about your work and your approach, whether it's in the book or how you engage with people at events or lecturing or any of the consulting work that you do, just like looking at it from that perspective of I think there's this natural inclination in veterinary medicine in particular, to just go to one side of the extreme or the other. So if you are advocating for education around positive culture and positive psychology and focusing on some of these things, I think there's a lot of people who look at it and say, well, you have to do all of that to the exclusion of other things.
There's this feeling of if you're not all in and you're not making it all touchy-feely and everybody's not sitting in a circle and singing Kumbaya, then you're doing it wrong. And I can promise everyone, I may make people sing in my practice, but it never looked like sitting in a circle and singing Kumbaya. It looked like Boy Band Friday Dance Party in the treatment room and forcing my doctors to sing Backstreet Boys. That is a thing that has happened.
But I do think that people think we've got to be all touchy-feely, everybody's got to be all up in everybody else's business, and that's part of what I love that you break down so well in the book is like, no, no, people are people and you are going to be negative sometimes and you are going to have bias. And we have to look at that and acknowledge that and figure out okay, then what do we do with it? If we acknowledge that that's going to happen, how do we make it better in the future?
Josh Vaisman:
Yeah, it's funny now I'm thinking we should have titled the book Lead to Thrive, the Science of Crafting a Human Culture.
Stephanie Goss:
I like that. I like that too. But I also like the focus specific on veterinary medicine, but I also love that so much of what you talk about is applicable to everybody inside and outside of veterinary medicine. I think we needed a little bit more in veterinary medicine right now, so we need a little love.
Josh Vaisman:
I don't disagree.
Stephanie Goss:
Okay, so there's two big pieces that I want to talk about before we're done here. One has to do with the book. So there's a lot of education and science and study behind positive psychology as a whole, but in particular the work that you share in your book and in your work. And when I was thinking about it and I was talking with my coworker, Maria Pirita, who loves and adores you and is very jealous that I'm getting podcasts with you right now.
Josh Vaisman:
I love and adore her too. She's pretty amazing. Those of you out there who don't know Maria yet, you will and you'll be better for it.
Stephanie Goss:
The world is better for having Maria Pirita in it. But we were talking about it and she was just like, “I think one of the things that both of us were thinking about in getting into the book was why the science is important to positive psychology.” And there is a lot of, again, probably the same people in veterinary medicine who would look at it and be like, “It's too touchy feely” would probably be like, “There's no science behind it,” but there is a lot. And for me, where it really resonated when I was thinking about it was I've worked with practice owners who have looked at life and looked at their team and looked at the practice and gone, “I'm paying them really good wages.”
These are good practice owners, good people who care about the people who work for them. And they're like, “I am paying them really well. I am providing for them. They're getting benefits. Everybody gets breaks. Like I am busting my butt to take care of these people, and isn't that enough? Because I pay them well and I treat them well, shouldn't my responsibility end there? Why should I have to do more work to create a positive culture and a positive workplace?” And I think that there's science behind that and positive psychology that helps explain the why, and I would love your perspective on that.
Josh Vaisman:
Awesome. Thank you. It's so wonderful question. It's one of my favorite ones. I do do get it frequently. I will never forget the first large scale workshop that I was doing delivering this and 60 something people in the room for the day. And about halfway through as I had just gotten done, talking about the science of positive psychology, this gentleman raises his hand and he says, “You know, Josh, this is all fine and dandy, but it's not really my job to make people happy at work.” It was so awesome watching everybody else in the room perk up and watch to see how I would respond.
Stephanie Goss:
Okay, so I'm not the first one.
Josh Vaisman:
You are not. No, no, but oh God, it's a good one. It's a good one. There's so many different tactics. If I'm feeling particularly cheeky, I'll respond to people and I'll say, “You're absolutely right. There is no federal mandate for you to make people happy at work. And how is that working out for you? Tell me about your turnover. Tell me about your productivity.” If I'm feeling a little bit snarky down that day, sassified.
The reality is I think you can actually, for those of us who take that sort of economic tilt, if you go to … I am not an economist by the way, so maybe Matt Soloy should follow me after this and he can tell you more about this. But if you look at traditional economics, traditional economics made the assumptions that human beings are rational creatures and that if A makes more sense than B rationally, then human beings will universally select A. And yet when you go out into the world, we see that people routinely make “bad decisions” for themselves when it comes to economic decisions. Why the heck is that? Well, we got some really great answers when people like Daniel Kahneman came around and showed us that actually human beings really aren't rational creatures. We're emotional creatures who have this unbelievable capacity to rationalize our decisions that are often steeped in emotions.
And that's a bit of an oversimplification, but the reality is that that's how we are. We are driven by psychological drives, by psychological needs, by these desires that we have that really sit more in our emotional centers. We've also evolved as part of our brain that allows us to think at a higher level and we can justify things and rationalize things, and yes, we can have moments where we make really, really good rational decisions. And yes, you're correct that it “should” be from a purely rational perspective. If I pay you to do a job, you will do the job to the T of what the job expectation is. And yet everywhere we look, that doesn't happen. So we can decide to be really annoyed by that and just complain and people should and wave our hands and probably just continue to have the same kinds of problems that we have now, or we can embrace the reality that human beings are psychological and emotional creatures.
And what we see consistently in the research is that when those psychological needs are met, people perform better. One of the ones that I've been using a lot lately, I'll put up a slide in a presentation and it just has the number 15 on it and I tell people, just remember this number. The next time you feel like, “Well, I pay people, well, they should.” A meta-analysis that was conducted 8 or 10 years ago, 92 studies looking at factors that predict job satisfaction, so job satisfaction is one of the best on the research side. It's one of the best antecedents we have to job performance, things like productivity, efficiency, turnover, all those kinds of things. People who are satisfied where they work tend to do better and stay longer. That's just the reality of the research. So what are the things that predict job satisfaction?
What this meta-analysis did was it tried to identify what is the correlation between compensation satisfaction and job satisfaction? So I am happy with how I'm compensated here, my salary, my benefits, so on and so forth, and I am happy to work here, which then predicts all these other outcomes. What they found in this 92 study meta-analysis was that compensation satisfaction accounts for about 15% of the variance in job satisfaction scores, 15%. Now, that's not zero. That's something. What we pay people matters. We have to pay people well, if we want them to be satisfied and do well, we got to pay them well for what they do. It should not be an excuse for us to underpay people, and it should also make us realize that while money matters, where we work matters more and the environment that we're in accounts for 85% of the variance in job satisfaction scores, at least according to this study.
So we've got to recognize that what we're inputting into that environment every day is going to influence the output we get from the people there. Outputs, patient care, number of new clients, average transactions, client turnover, team turnover, all of those things are lagging indicators of human input. What we put into that environment results in those things. So yes, pay people, pay them, well expect them to do a job for that pay and don't rely only on that because it only accounts for about 15%.
Stephanie Goss:
Which is absolutely crazy when you think about it just in general, that number blows my mind because I didn't expect it to be so low. Honestly, I expected it to be higher. But when you think about the conversation in veterinary medicine as a whole, as an industry, we've pretty exclusively, for a long time, focused on the money. And rightly so, because to your point, we were lagging very far behind. And so the conversation needed to be about money. And I think that there's a lot of people, and I don't think that it's a generational thing. I think the stick that everybody immediately reaches for is the older generation of veterinarians made it a generational thing, but I think that's total bull–. I think that there is this tendency to be like well, if we deal with the money part and then our work is done, we've done that part and why does it have to be the rest of it?
So I love that you shared that data so succinctly and smartly, that's only a tiny, tiny piece. The 85% is what we really need to focus on next. We've got to take care, hear me, because there will be people who listen to this and are like, “Stephanie says we don't have to worry about paying people.” That is not what I said. That is not what Josh said. You absolutely have to pay people and pay them well, and they cannot be worrying about where the next meal on their table at home comes from. If that is the case, the rest doesn't matter. And when we have taken care of those needs and we are compensating people, well, we have to return the rest of the focus on the culture piece and the other 85%.
What I love about that statistically and science-wise is that it leads right to the output, which I think you and I both knew as leaders in veterinary medicine, if you take care of the people and you practice good medicine, the numbers follow and that the proof is in the pudding there. Those numbers are going to rise or fall as they should when you take care of the people and you practice good medicine.
Josh Vaisman:
I like to think of money, compensation can be a really good recruitment tool. It's not necessarily a great retention tool unless your intention is indentured servitude. If you want people to feel the weight of golden handcuffs, then you could probably use money to keep people longer, but you're not going to get performance out of them if that's what you're after. There are other things. Is it okay if I share another piece of data?
Stephanie Goss:
Yeah. Yeah, yeah. Go for it.
Josh Vaisman:
So last year we at Flourish got really interested in looking at what are some of the things that might contribute to that other 85%. We were in particular interested in retention, but we looked at a few other things as well. So we took basically the four pillars from the book from Lead to Thrive, and we built an assessment tool around it and then we put out a call to the veterinary community. So this was last fall, in 2022. We just said, “Hey, if you work in veterinary practice and you have a boss, we would like to hear about your experience with that boss.” Those were the qualifications. We got just under 600 people, veterinarians, technicians, CSRs, practice managers, small animal, large animal, mixed animal, general practice specialty.
There was a mix of everything, the whole gamut. And then we asked them to rate, does your boss do these positive leadership behaviors? The things that are laid out in the book, do they do these four things that contribute to psychological safety? Do they do these four things that contribute to purpose, to path to partnership, agree or disagree? That was it on a scale, seven point scale with four being neutral. We weren't asking them, “Do you have a good boss or a bad boss?” We just like, “Do they do these behaviors or not?” That's it.
Then we ask them things like, “Hey, how satisfied are you where you work? How often do you think of quitting your job? How often do you think of leaving the profession? What is your workplace wellbeing like these days?” Those kinds of things. And then we collected all this stuff and then we compared them. We looked for relationships. Now there's a couple interesting things. Number one, on our seven point scale, with four being a neutral, the average response for my leader does or doesn't do these things was 4.4, which is just a hair north of neutral. So it's not happening all the time.
However, it was a pretty even distribution. It was really interesting. So if we took out the neutrals, the people who averaged between three and a half and four and a half, we set them aside. Anybody who had over 4.5, we called them our high positive. So they're on some level agreeing that “Yes, my leader does these positive leadership behaviors.” And then anybody below 3.5, they're saying, “No, I disagree.”
Stephanie Goss:
Generally no.
Josh Vaisman:
“On some level, generally no, they don't do these things.” We looked at the relationship between those two groups and all those outcomes people who said, “My leaders do not practice these positive leadership behaviors,” the average response to how often do you think of quitting your job was often 4.2 out of 5.
Stephanie Goss:
4.2. That doesn't surprise me.
Josh Vaisman:
The people who said, “My leaders do do these things to some extent,” the average response to how often they think of quitting their job was rarely, 1.8 compared to 4.2. That's a 2.3x difference.
Stephanie Goss:
It's huge.
Josh Vaisman:
Yes, money matters. It absolutely matters. And if your goal is to keep people in your hospital and keep them engaged, this stuff matters more.
Stephanie Goss:
Yeah. Oh my gosh, my mind is boggling. And now I want to nerd out with you for another hour about numbers. The last thing I want to ask you about before we wrap it up is a fun question. So I would love to know what is one lesson that you wish that you had learned before you became a leader? Andy and I have been sharing some of our lessons lately, and we had so much fun. I'm like, “I'm going to ask Josh this question.”
Josh Vaisman:
I love that you're asking me this. So I was recently listening to the two part series that you did on those thoughts. Yeah, man, I don't know, because there's so many different ones. So one that I've been playing with a lot lately with some of the clients that we work with is this idea of that you can spend more time to save time, I guess is the way that I'm thinking of it. It's being very intentional in how we spend our time. Relationship development as a leader, it turns out that it's actually a pretty exceptional time saver. So I was really inspired by this originally. There's a researcher out of the University of Michigan Ross Business School, Dr. Kim Cameron. He is one of the founding members of the field of positive organizational scholarship, which you could think of as positive psychology on the organizational level.
In one of his books, he talks about these studies that were done on these very targeted one-on-one check-in meetings, essentially interviews between manager and direct report. And in one particular study showed some really, really impressive impacts on productivity, job satisfaction, and a reduction in turnover just by implementing these in a fairly well controlled study across a variety of organizations. The thing that really stood out to me though is that they interviewed the managers that had to do these. So this is how this program was done. Stephanie, you've got seven people on your team that directly report to you. Here's what we're going to do. You're going to sit down with each of them a minimum of once a month for one hour, one-on-one. So I'm asking you to add, quote unquote, add seven hours of additional work to your regular life as a manager. That can feel burdensome. A lot of people get turned off by that. You want me to do more? I hardly have time to do what I'm doing now.
Stephanie Goss:
Yeah, 100%. I can totally imagine the days where that would've been in the first thing that came out of my mouth. I don't have seven more hours in my month. What are you talking about?
Josh Vaisman:
You cray, buddy. You cray.
Stephanie Goss:
Yeah, exactly.
Josh Vaisman:
That's cute that you think I'm going to do that. So they had these managers do that, and then the ones that did it for the entire 18-month study, they asked them at the end of it how it impacted their ability to do their own work. So they had basically three options. Over the past 18 months, did you find you had less time to do all of your other managerial duties? Did it have zero impact on your ability to do your other managerial duties or did it actually open up time?
And to a T, they all said, “I had more time.” And the average response was, “I found I had an additional eight hours a month to do my work.” Because when we develop those kinds of relationships with the people on our team, when we show them that we actually care about them as human beings, when we help them develop, so we don't look at them as problems, we look at them as possibilities. When we show them how the work that they do matters and the impact and contribution that they're making and how that ties to the higher goals of the organization, and when we give people an opportunity to really express their perspective and voice and feel heard as if they belong somewhere, hey, guess what? They stopped knocking on our door. Because they're doing the work.
Stephanie Goss:
I love that that's the lesson that you shared. As a manager, I would've been happy if you had told me that it was a net-zero. If I just come out even, I would be happy because I would be getting to know my people and it wouldn't be costing me any more time. But how could you look at that? How could you hear that, see the data and not get all behind the idea of, “Look, if we take care of our people, if we grow them, if we develop them, this will come back to us tenfold.”
But where so many of us get caught up is the first reaction I had, which is the holy hell, where in the hell am I going to find seven more hours to spend with people once a month? But if you think about that, 18 months is a very short timeframe in the lifespan in veterinary medicine, and I could do anything for a year and a half, this is not that hard. I love that so much. You did not disappoint with that answer, Josh.
Josh Vaisman:
Thank you. Thank you. I tell you, for me personally in the role that I play now at Flourish with our team, it's been life-changing to have those things. It's just on the schedule all the time. We meet routinely to talk about these kinds of things, and it's all about supporting them and helping them excel in their roles. And I can honestly tell you that I feel three times as productive as a human being now than I ever did as a hospital owner and practice manager.
Stephanie Goss:
We should do a podcast about that. Let me learn your Yoda master ways. I have a feeling that lots of people would like to hear about that. So I want everybody to immediately run out and buy the book because it's amazing and you are wonderful. But where can people find you on the interwebs to connect with you and to find the book?
Josh Vaisman:
Yeah, absolutely. So you can find Flourish at our website, which is just flourish.vet, F-L-O-U-R-I-S-H dot V-E-T. I am pretty active on LinkedIn, so you can find me and Flourish on LinkedIn. We're on Facebook and Instagram as well, and at most of your neighborhood lead conferences.
Stephanie Goss:
I love it so much. And the book is an AAHA Press book. So I have to head over to AAHA's website, but I don't have to be an AAHA member to buy it.
Josh Vaisman:
Correct.
Stephanie Goss:
Fun fact, Stephanie is not currently an AAHA member and I was able to buy it.
Josh Vaisman:
Me neither. And I wrote a book for them.
Stephanie Goss:
At the non-AAHA member price. But you can head over to AAHA's website to purchase the book. Josh, this has been an absolute delight. Thank you so much for joining me today, and I will hope that Andy doesn't listen and say you were a wonderful stand-in and you are welcome to sit in Andy's chair on the podcast anytime.
Josh Vaisman:
I'm not going to lie, Stephanie, talking to you is an absolute highlight for me. You're so genuinely curious. You are hilarious. You bring levity, but you have this unreal ability to do serious things without taking it too seriously. It really fills my cup, so thank you for bringing me on. It's been a joy.
Stephanie Goss:
Thank you. You guys can't see me, but I'm tomato red now. Thank you, Josh, from the bottom of my heart, I really have enjoyed having you here. And Andy's going to be jealous now because he's going to be like, “Goddamn it, Josh is trying to take my spot.” But you are welcome back as a co-host anytime.
Josh Vaisman:
The plan is working.
Stephanie Goss:
Till my thoughts take over the world. It'll be like Pinky in the Brain over here. I love it. Take care everybody. Have a fantastic rest of the week and go check out Josh's book.
Josh Vaisman:
Thanks everybody.
Stephanie Goss:
Well, everybody that's a wrap on another episode of the podcast. Thanks so much for spending your time with us. We truly enjoy spending part of our week with you. As always, Andy and I enjoyed getting into this topic. I have a tiny little favor to ask; actually, two of them. One is if you can go to wherever you source your podcast from and hit the review button and leave us a review, we love hearing your feedback and knowing what you think of the podcast. And number two, if you haven't already, hit the subscribe button. Thanks so much for listening, guys. We'll see you soon.
