This Week on the Uncharted Podcast…
When is a leadership practice or decision SO bad that you need to go to the state veterinary board? That's the question being asked today in our mailbag! Dr. Andy Roark and Maria Pirita wade into how we parse ethical questions, what steps our writer might take and when, exactly, do we “bite the hand that feeds us.”
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Episode Transcript
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Andy Roark:
Hey, Stephanie Goss. You got a second to talk about Guardian Vets?
Stephanie Goss:
Yeah. What do you want to talk about?
Andy Roark:
Man, I hear from people all the time that are overwhelmed because the phones never stop ringing.
Stephanie Goss:
Yes.
Andy Roark:
And I'm sure you hear from these people as well, like, “Our caseload is blowing up and the doctors are busy and the phones just don't stop.”
Stephanie Goss:
They never stop. That is a true story.
Andy Roark:
I'm amazed by how few veterinarians know about Guardian Vets. This is a service where you have registered technicians who can jump in virtually and help you on the phones. You can flip the switch and Guardian Vets can jump in and take some of the load off the front desk and they can handle your clients and get them booked for your appointments and give them support, and it really is a godsend.
Stephanie Goss:
Pre-pandemic it was amazing to me how many people hadn't heard about it for after hours call help. But at this point I can't believe how many people don't realize that they are offering help during the daytime as well, which I would think right now is a huge benefit to practices, because everybody is shorthanded. Everybody is drowning in phone calls. And so we talk about it. We've talked about Guardian Vets a lot on the podcast, and every time we do, we always get somebody who says, “What is that?”
Andy Roark:
Guys, if you're not familiar with Guardian Vets, if you think that you could use some help on the phones or at the front desk, check them out. It's guardianvets.com. And if you mention our podcast, me and Stephanie Goss, you get a month free. So check it out, guardianvets.com.
Andy Roark:
Welcome, everybody, to the Uncharted Veterinary Podcast. I am your host, Dr. Andrew Roark. Guys, I am here today with the amazing Maria Pirita stepping in for her first time. I am so thrilled that she is here. Stephanie Goss is off traveling right now, so Maria is coming in. And we are taking a question from our mail bag where someone says, “Hey, I've worked at a vet practice that is doing some really shady stuff. When do you take your own vet practice to the state board?”
Andy Roark:
When do you talk to leadership, and they're the ones doing the shady stuff and nothing's changing and this is not okay. What steps do you take and how aggressive do you need to be? We get into ethics. We're talking about ethics and how do we draw lines and how do we weigh consequences and the need to take action with real world of survival and working in a job and having real needs and things like that. Knowing that is an imperfect world and that people make mistakes and balancing that with, “Hey, some mistakes are not okay and you guys are not fixing the problem.” So anyway, guys, it is a really interesting episode. We get right into it. Let's just let's get on into this episode.
Meg:
And now the Uncharted podcast.
Andy Roark:
And we are back. It's me, Dr. Andy Roark, and the one and only practice manager, former practice manager, new employee goddess, Maria Pirita. Thanks for being here, Maria Pirita, stepping in for Stephanie Goss, who's traveling. How are you?
Maria Parita:
I'm good. Thank you so much for that. I've never been called Goddess before. That's amazing.
Andy Roark:
Oh, you're on the Goddess Squad. It's you and Stephanie Goss together now. There is no other Stephanie Goss, but you are your own celestial entity. Thanks for being here. So for people who don't know you, because even a lot of our Uncharted members are like, because [inaudible 00:03:41]. You haven't been at one of our live events yet, so we haven't even rolled that out. And so let's get a quick background on you. You want to tell a little bit about yourself?
Maria Parita:
Yeah, I'd love to. I am, as you said, a former practice manager. I started in veterinary medicine about 2013, and before that most of my experience was in management in other industries. And when I started veterinary medicine I actually took a pay cut to be a receptionist because I really wanted to work with animals and because I really wanted to work with for this particular doctor. And I found veterinary medicine to be this interesting time capsule, because it felt like the whole world was living in 2013 but veterinary medicine was living in like 1995. And it was just so interesting.
Maria Parita:
And so I quickly started helping out that practice owner with a lot of just marketing stuff that I had done at other practices. And I became their director of PR marketing for a few years, and then I became the practice manager for another few years. And in between there I went to conferences and met a bunch of people and loved everything about veterinary medicine and the community and people. And actually, I believe I was in a different podcast that was shared on a management group and I tagged Stephanie Goss in that, because I talked about how I love this podcast so much, and that's my first fangirl moment. Because she told me she listened to it in there and I was like, “Oh, my god. The Stephanie Goss listened to the podcast that I was in? No way.”
Maria Parita:
And from there, I don't know, I just kept doing things. And then when I had to move and looking for new job, the Uncharted team was looking and I was like, “No way. Everything is aligning.” And I had been a fan of Dr. Andy Roark since probably 2013 also, because I think that's when I found your videos. So it's really amazing to be here, really. I feel like the main character of the movie.
Andy Roark:
That's awesome. Yeah, Stephanie, you got to know Stephanie a bit and then, yeah, when, boy, Uncharted is growing like crazy and we needed some more help in all the things that we're doing. And Stephanie was like, “I know somebody who I've been getting to know, and I think she's our people.” And so yeah, I was thrilled to meet you and I'm super glad that you're here.
Andy Roark:
All right. Let's go ahead and I'm going to let you copilot the plane here, which is a scary thing. But let's go ahead and get into this episode. We got a mailbag question that I think that you are going to be great about. So here it goes. The subject line of the mail bag question was, “Dare I bite the hand that feeds me?” And good opener. Well played to our sender.
Andy Roark:
Can we talk about owners, manager, supervisors and leads that break the rules and continue to get away with it? And not just any rules. I'm talking about things that go against our practice act. Do you have advice to support staff that are conflicted about reporting their boss or bosses to the board? I have witnessed horrible things at a former clinic, but my colleagues chose to keep their heads down because the violators were the ones who signed their paychecks. A few examples of things that went on include not establishing a VCPR before prescribing medications, excessive restraint that resulted in death from asphyxiation.” Oh, my God. “Drowning as a form of euthanasia.” That's horrible. “And using expired medications on patients. After all, how can we hope for change in this field if we don't speak up for our patients or ourselves?”
Andy Roark:
All right, cool. So Maria, that's super heady stuff.
Maria Parita:
Yeah.
Andy Roark:
Let's go ahead and start at a high level here.
Maria Parita:
That hurt me to my core a little bit, because I felt so much when I read this. And I think ethically this person knows what they have to do, and so that's really important to me. And I think that where we're talking about this, it's a hard place to be. It sounds like the person that submitted this already left that practice, too, and it sounds like they left behind a few people, which also makes it hard, because I can see where they're coming from on that. But I think that a lot of this is going to be removing the guilt that this person's feeling, for one, and understanding that they're already being kept up at night by this even though they've already left the practice. And that's something to think about already.
Andy Roark:
Yeah. No, I agree with that, and I think you're absolutely right. I do get that vibe as well that this person has left and this is still bothering them. All right. So I want to go ahead. Let's start at a head space place with this. And the truth in a lot of these questions is that they come off as black or white. And people very much like to say, “Do this. Do that.” There's no questions. There's no gray. Well, there is a lot of gray. And I'm not saying with the examples that she gives, that takes all the gray away for me in this specific case, but I want to talk about it more. I think a lot of people wrestle with the ethics of when do I say something and when do I report the place that I work or when do I go up the chain to the regional director or go to the state board? Those are really big questions. And so I don't want to get so tied to the specifics of this case that we just spend our time ranting and righteously shaking our fists.
Andy Roark:
But I want to get more into how do you parse these things. When we start to talk about ethics, there's a lot of different shades of gray in how we look at this. So even the list of things that she gives, doing medications when you don't have the valid VCPR, it depends. The details matter. And that is not the same as euthanasia by drowning, for God's sakes. Those are radically different. Those are radically different things. Some people are like, “Why is Andy saying that they're different?” Again, legally they may not be different. Ethically, and I think it's a big point, right? There's three levels.
Andy Roark:
I saw a TikTok video. Her name is Tenasia. I think it's Crockett, I think, is her last name. I don't have it in front of me. But anyway, she's a veterinarian on Instagram is where I see her. I don't do TikTok. I mean, I get a lot of flack for not doing the TikTok, but I don't do TikTok. And she was talking about people asking her for advice and she was like, “What are we legally required to say and what can we not say? And people make you feel bad, and how do you handle these things?”
Andy Roark:
And it really got me thinking about where are the lines when we have to make these ethical decisions? And for me there's three lines. There's what's legal, kike what am I legally bound to do? What am I liable for? And what am I ethically okay with? And sometimes something is legal but I'm not ethically okay with it. And sometimes something is ethical, but legally it's not allowed. And so I think we just separate those things out. Are you on board with that?
Maria Parita:
Absolutely. And especially because so many different things can vary from state to state in general as far as legality in the first place. And so we have people that maybe started in one state and then moved to another one. And especially when you have people conversing back and forth about those things. So as I'm reading this mailbag entry and I see the VCPR thing, I thought the same exact thing. In some cases, depending on what is needed from the patient, it is a gray zone. And some of the other things that you mentioned, absolutely not. And so it is definitely I agree 100% with that.
Andy Roark:
They are kind of over the top examples with the VCPR thing where it's like this person is calling and they're in rural North Dakota and they're like, “I'm two hours away and there's no other help and this is happening.” And you go, “I'm the only vet for 200 miles.” That's not most of our realities and it's not willy nilly. But would I say, “Oh, my gosh, this veterinarian did a euthanasia without doing a physical examination and establishing a VCPR.” It's like the pet was dying and suffering and that's what was going to happen. I think the idea of putting them through a formal process of establishing a relationship, that doesn't make sense to me. And I don't think it makes sense to anybody else. I don't see anybody doing that.
Andy Roark:
But I'm just trying to inject some shades of gray into this insight. These things in my mind are not the same. Using expired medications. I was like you know what? I have 100% seen vets give expired medications to patients when the pet owners can't afford medications. And again, I'm not endorsing that. That is kind of old school, but I do remember a time when I've seen it done before and it's like, “Hey, this stuff is expired so we were going to get rid of it, but you do not have any money. You don't have two nickels to rub together and your pet is sick. Take this medication because we can't sell it. We're going to throw it out.”
Maria Parita:
Yeah, that's a very common one, too, that I would say is I've seen as well in practice. And again, same thing. You have a person standing right in front of you, can't afford medications. You have these expired ones that you can't sell anyway, and what do you do? And absolutely there's these lines that we have to follow, but at the same time, where do we come up with and how do we support our staff with making those decisions, too?
Andy Roark:
Well, if we don't explain what we're thinking to the staff, then they often will make their own assumptions about what's happening and why it's happening. I think that is as much a problem as the actual decisions that often get made is, “I made this decision.” Let's just say that I'm in the exam room and I'm talking to this person. They've made it clear to me they do not have any funds at all, and I've got some medication that's literally a week expired that I have to get rid of. And I'm like, “Hey, look, just take this.” And again, I would never do that because that would be illegal and I would never do anything like that. But if someone did at some point in the past do something like that because they really felt like it was ethically the right thing to do and someone else on the team saw that and didn't understand that conversation was like, “Is Roark unloading expired medicines?” I think that that's where some of that stuff comes from.
Andy Roark:
So anyway, I break that out into there's legality, which is what's the law say? There's liability, which is what can you get sued for? And again, that's not really what we're talking about here, but it is important when people ask questions, meaning you might be able to give advice to someone without seeing their pet, but if that advice is bad because you didn't see the pet, and I know this is a shocker, sometimes pet owners tell you that things are happening that are not actually happening. And sometimes what they tell you is going on is 100% not going on. And anyone who's ever walked into the exam room. What percentage of the appointments do we see that are schedule that's like pet owner says this is happening and you walk in, that's not remotely what is going on.
Andy Roark:
We see that all day long in the clinic. But then someone who walks up to us and just tells us what's happening and we just take it at face value. Anyway, it may not be illegal. You still may get burned badly because you gave advice based on what they told you that was not correct. And the advice you gave was good, but what you got was not. And now they said, “The doctor told me blank.” And so that may not be illegal, but you are going to get dragged through the mud because you stuck your neck out here.
Andy Roark:
And the last one is the ethical part, which is does this check your ethical boxes? So those are the big things. Those are the big things for me. I think asking … So we got this question from someone who said, “Hey, I'm seeing the higher ups do these things,” and so I'm going to put in action steps how to ask about this. But I really think a couple of things that come to my mind is seek first to understand. And again, some of these examples that are given, I go, “There's no seeking first to understand.” But I think for a lot of these questions, like the VCPR thing, the expired medication thing, I think that there may be value in saying, “What happened there? Why are we doing this?” and asking. And it's funny, because people go, “But what if I get in trouble for asking?” I'm like, “Well, good. Then they're making your life easier on you, I think.”
Maria Parita:
Yeah. And it definitely depends the type of culture that you're cultivating at your practice and what you have there. But if you're in a practice where you can't even ask, then they're making that decision for you definitely, because you shouldn't have to deal with that. You shouldn't have to deal with that at all. And I'm a big believer that I actually like people questioning me a lot because I feel like it really does make me a better person. And that's exactly how in the clinic it feels as well. When people question things, obviously seek to understand, 100%. But it does in the end make us better people, even in veterinary medicine as well. There's so many different ways in which we grow and we learn, and asking questions is number one always.
Andy Roark:
Yeah, I agree with that. And there are people who don't like to be questioned, and I think that that's a flaw. I talk sometimes about when I was younger, I had this idea that being a good leader meant you were General Patton and you would just tell people what to do and they were like, “I don't understand, but he's a really great leader, and so I'm going to do what he says.” And you know what I mean? And I thought that that was what we aspire to. And that's garbage, man. A great leader is Kermit the frog, and Kermit the frog gets questioned all the time. Everybody's like, “But Kermit, what about this?” But the reason they question is because they trust him. And so if you work in a place where leadership is not to be questioned, to me that indicates insecurity by the leadership or a lack of trust by the people who don't ask questions. If you're a leader and nobody questions about your decisions, they don't trust you, and that's a real problem. And so I think that you're totally right.
Andy Roark:
There's actually some research in the human side of medicine which I think is really good when it comes to how do we ask questions or question decisions that are being made. And one of the things I really took out of it I think is really interesting is timing is your friend, meaning if you have questions about why [inaudible 00:18:15], it's a whole lot better to say them up front than to wait until we've done the thing and it's in the past and you're like, “Hey, I want to talk about what happened yesterday.” Because then that really feels like more of a decision was made and now I'm challenging the decision, which may need to happen, but it's an easier conversation if when it's happening and you are getting these medications together, that's the time when you say, “Hey, I'm getting this stuff together. Help me understand what we're doing here just so I know.”
Andy Roark:
And ask it and in that moment that it's going on, because obviously that gives the person a heads up to maybe reconsider their actions. But also, it doesn't feel as challenging as, “Hey, I want to come back and go over what we did yesterday,” in the heat of the moment. And again, that's just general how to question the decisions that are being made in a medical setting 101.
Maria Parita:
Yeah. And I think when we look at ourselves, too, most of us would rather be questioned in the moment. I'm the kind of person that if you come at me later on, it kind of hurts me a little bit. And it's like, “Why didn't you say anything yesterday? Why are we talking about this today?” And so timing is crucial. And if you've cultivated, like we talked about, that leadership where people trust you to be able to bring that up in the moment. I mean, that's important.
Andy Roark:
Yeah. Well, the other thing is, I can't do anything about what I did yesterday. You know what I mean? There's definitely times that I'm not perfect and in the moment sometimes you're trying to help people. It's always coming from a good place, but you make a decision and then the next day someone goes, “Well, why did you do that?” And I'm like, “Well, why didn't you ask me that yesterday when we were doing it and we could have fixed it or we could have done something differently?” It's 100%. But again, you're right when you put your finger on it and say it comes down to that trust. It's like, man, I want to work with techs that trust me enough to say in the moment, “Andy, what are we doing here?” And I'll go, “Okay,” because if I cannot explain it to the techs without couching terms, I should reconsider what I'm doing.
Andy Roark:
It's just a good ethical check. And also, we're just talking about ethics, but honestly it's just a good medicine check. If my techs, who are smart and well trained, say, “Andy, what are we doing here?” it makes me stop and go, “What are we doing here, Andy? Let's run through the thought process and make sure that we're not doing something boneheaded, having a brain fart, things like that.” I really want my techs to say something. I don't want them to be like, “We thought you knew what you were doing so we didn't say anything.” And now you have to call the client and tell them that you gave them the wrong medication or whatever dumb thing I did. So anyway, I like that a lot.
Maria Parita:
I agree. And I'm so glad you said that, too, because I think for a lot of the listeners, too, it's really, really important for technicians to be able to question, especially in that moment. Because I will say this right now, doctors do make mistakes and I have caught some before and I still remember the first time that that happened. It was a minor dosing thing, but I literally looked at it and I was like, “That's not right. That can't be right.” And I did the calculations four times because I was like, “But the doctor did this so it has to be right.” And I'm doing it and I did it again. I did it again, and I was so nervous to be bring it up. And then I did, and the doctor was immediately like, “Oh, my God, thank you so much. I don't know where my head was when I was doing that calculation, and if you wouldn't have brought that up to me.”
Maria Parita:
And immediately I felt that sense of relief, because I knew that that practice that I was working at, it was giving me that opportunity to bring that up. And this was because I was new that I was nervous. That was the only reason. Normally I'm not as nervous to bring it up. And it was also, again, the doctor. And we have this mentality that doctors don't make mistakes, but they do, and it's up to us technicians or even receptionists, because receptionists can catch those, too. We should be able to have that openness, that trust to question things. And it sounds like at this particular clinic they might not have had that.
Andy Roark:
Yeah, I completely agree. So yeah, I'm on board with you. Ask the question. I really, and I reached out to other doctors. I am a human being. I have made mistakes in my life. I have seen the best doctors I know make mistakes in my life. I remember at one point I was working with other doctors I respected absolutely, hugely. I mean, just a fan-freaking-tastic doctor. And we ordered atropine. We ordered a replacement of atropine. And small animal atropine, and forgive me if my numbers are wrong, but this is basically how I remember it. I think small animal atropine is one mg per kg, and large animal atropine, which is in a flipping identical bottle, identical bottle, is like 10 mgs per kg, and maybe it's small animal is 10 mg per kg and large animal is 100 mg per kg. It was a 10-fold difference in atropine strength between small animal and large animal. And the bottles were freaking identical except it literally said small instead of large and it was the milligram strength on the bottle in normal type.
Andy Roark:
And yeah. So the large animal atropine, which I don't know why we got large animal atropine or where it came from. It gets drawn up and it gets injected, and now we've got … Everything worked out fine. We had to sort the thing out. That dog did not spit for three days, because it was dry as a bone. But those things happen. If someone had said, “Hey, this is a different strength atropine than we usually use,” that would've been great. I don't think anyone noticed it. But those were the types of things that happened. I saw it happen to a great doctor, and I had no idea the bottle of atropine was different.
Andy Roark:
But anyway, I think I put that out because I always want to give people permission just to say, “Hey.” Come from a place of curiosity. We always say that with giving feedback is, “Hey, I just want to confirm I understand what's going on.” Or, “Hey, I just want to check and make sure I'm doing what you want me to do here.” And those are some of the words that I like, because I feel like they're very not challenging. “Hey, I want to make sure I understand so I can support you here. Why are we doing this? What's the story? Sorry, what's going on here?” And be able to ask those questions. I think that that is really good. I think that if you're in a culture where that is not tolerated, I think that that should be a huge waving red flag, especially if it's anything that has to do with ethics, with anything that has to do with medical care. If you're afraid to speak up, I think that that's bad. So just generally starting to get that stuff in my head.
Andy Roark:
Other big things when we come to ethics are so, because again, we're trying to say where is the line where I'm going to the state board with this? I'm going above and beyond. I tend to think of two things when I think of ethical questions. One is intention and one is harm. And I weigh those things in, meaning for me, people who are doing things that they're trying to hide, that's a big deal for me. To me that's a sign that someone knows that they're acting unethically and they're intentionally covering it up. And I go, “Ooh, you know this is bad, which is why you're hiding it.” That's a big flag for me. And especially when we get into ethics and stuff, especially if it's a pattern.
Andy Roark:
But even one time. At one time, I go, “Ooh,” and I check myself with that, too, sometimes and say, “Hey, if I make a decision and I would be embarrassed for my team to know that I made that decision, that's a red flag,” as far as me and just in my values and how I want to run my business and how I want to treat the people who work for me. I want to live my life in a way where you can't really catch me because I'm not going to do anything that I'm going to be embarrassed about. And that's what I aspire to. And I found it makes life simpler. I'm a horrible liar. I found that out early in life. I'm a terrible liar. And so just don't ask me to be untruthful, because I'm really bad at it.
Maria Parita:
It's funny that you-
Andy Roark:
Somebody would walk in the building and be like, “What's bothering Roark?
Maria Parita:
It's funny that you say that, because-
Andy Roark:
Oh, he's trying not to lie.
Maria Parita:
… I am the same way. I'm a terrible liar, and I learned that early on as well. And to this day people will ask me like, “Hey, Maria, can you keep a secret?” I'll be like, “It depends, because I'm a horrible liar. So if it's going to require for me to lie, then the answer is no. But if it's not going to require me lying, then yeah, yeah, sure, I could keep it.” But yeah, absolutely. When somebody's trying to hide something.
Andy Roark:
Can you keep a secret under questioning? I don't know.
Maria Parita:
Yeah, it depends.
Andy Roark:
The answer is no. If I'm questioned, no. Exactly. That's great.
Maria Parita:
If I'm questioned, no. But if it's, Yeah, no, no, no. Especially I have friends who I have to tell them that immediately when they're having, usually babies, “Can you keep a secret? I'm pregnant.”” I'll be like, Why did you tell me that? No, I can't keep a secret. I need to not talk to anybody for nine months or however long you want me to keep the secret.” Obviously not nine months, but absolutely.
Andy Roark:
Yeah, if they keep it a secret for nine months, I'm like, “That is a secretive person.”
Maria Parita:
Nine. I think it's going to show after a few months. No, but I need to let people know immediately I can't lie. And especially I agree with you. When they're trying to hide something, and to me the repeated pattern is the big one. When you have that repeated pattern of doing something and then trying to hide it, that's a big thing. And we talk about wanting to own up to our mistakes all the time, because you do. You have to own up to your mistakes, and people make them and it's okay. And when you're trying to hide them, that's where you're crossing a line of, well, that's now not okay, because we're not learning from that and we're not growing.
Andy Roark:
I like that. And also to me, it is admission that you know this is not right. And yeah, you know it's not right and you're not moving to fix it. And so that's a big thing for me. I said attention. I said harm. And harm is the big one. Our veterinary oath is to do no harm. If people are making decisions that are causing harm, that's a big deal for me. Failing to write up your medical records, you shouldn't do that. You should write your medical records and they should be good. That to me is not in the same realm as not providing the pain medications you said you were going to provide.
Andy Roark:
I had experience one time early, early in my career, and this is actually, it was back when I was still in training. There was a technician. I did not know until it all went down at the end. But we had someone who was stealing drugs and replacing the injectable opioids with saline.
Maria Parita:
Oh, no.
Andy Roark:
And they're injecting these painful pets with saline. And man, I hope that guy burns in hell. Pardon me, but I was really bothered by that because that hits right on my harm button. When I say harm, harm is real. I'm much more open to problems with record keeping or clear communication. But for me, those are big things is what are the intentions here? And if they're negative intentions or the intention to hide things, that bothers me. Is it a pattern? That bothers me. Does it cause harm? That bothers me. All of those things. I'm just trying to lay down from a headspace standpoint how I parse those. You know what I mean? The ethical things in my category of severity. There are some things where I'm going to talk to the person. There are some things when I'm going to go to the person's boss, and there are some things where I'm going to go to the state board. And you have to decide where on that spectrum you are.
Andy Roark:
And I hate to say it, but some of it depends on who you are, meaning if there's a doctor in the practice who's doing things that I have ethical problems with, if I'm a doctor, I'm going to go talk to that person, and I'm going to go talk to the practice manager. If you're a technician and you have to work with that person and under that person and they have organizational power over you and they can make your life really hard, I don't blame you if it's harder for you to go and confront that person. I think a lot of times we say, “You should just go do it,” and I go, “Let's be realistic here.” You need to do what's right.
Andy Roark:
But at the same time, let's not kid ourselves about the consequences of engaging someone who's higher up the chain. And you just need to be ready to deal with those consequences. And if you are a single parent struggling to make ends meet, working your butt off, and this is the only job in the area that you can get, you're probably going to feel differently about having these bold, righteous conversations with the doctor. It doesn't mean you're not going to do it. And again, it goes back to those degrees. At some point you say, “My soul is worth more than anything else.” But I would not look down on somebody who said, “I was afraid to do it and I was in a place where I couldn't afford to do this, and it didn't rise to the level that I was like, ‘I'm out of here.'” I understand that. I guess I'm just trying to inject some nuance into it.
Maria Parita:
Yeah, and it's very situational in so many different ways, too, because for me, one of the things that I thought about, as I said earlier, is if this is something that's keeping me up at night, it's affecting my mental health. How much anxiety is it giving me? How much is it affecting me outside of the scope of the practice? And in those kinds of cases, you do need to make a decision and it's going to require you thinking about everything. This is where I also as a manager, I feel like it's extremely important to have something in place to give your employees that ability to report things that they might have not agreed with, even in an anonymous stance, so that they can be investigated later on. Because that is something where-
Andy Roark:
Yeah, totally.
Maria Parita:
… you might get somebody, and as a manager you want to know when those things are happening because you can't be everywhere, and you want to give your team members that ability to maybe I don't feel comfortable enough to bring this up to management because I'm afraid then there are going to be repercussions here in the clinic about it and I don't want to get fired over this. But at the same time, it does need to be reported internally within the clinic. And that's where having a system to report things, whether anonymously, giving the facts and that then can be investigated is going to be important in your practice.
Andy Roark:
Yeah, I love that you say that, too, and that's really a leadership management button is to say you should have systems in place where people who see things that they don't like or they don't think are acceptable can report those things up. And it doesn't have to be a huge thing, but there should be some way that they then can pass these things up the chain or deliver them in a safe way, even if there's like, “Hey, I'd love it if you came forward and talked to me, but if you feel afraid to do that, I'm happy to take anonymous information, especially about ethical violations and run that down.” That's just kind of management 101. I think when we get to the place where leadership is actively doing this stuff, I think that must be a much harder place.
Andy Roark:
Maria, let's take a break here and then we come back. Let's get into really the meat and potatoes of what do we do about this?
Maria Parita:
Okay. Yeah, yeah. Sounds good.
Andy Roark:
Guys, I just want to jump in real quick with two updates. Number one, the Uncharted get shit done short-handed virtual conference is right on top of us. It is October 6th through the 8th. It is online. Grab Your spot. It is all about efficiency. Getting things done when you don't have a lot of manpower and when people are tired. That's what it's all about. You can check out the information on unchartedvet.com to learn more about that conference, but 6th through the 8th. Get on it.
Andy Roark:
And then I want to put another thing on your calendar. This is October the 19th. This is Leveraging Technicians: Making Practice Less Stressful For You, Them, and Your Patients. This is with Melissa Entrecki, who is an LBT. She's amazing. She's fantastic. She's been working with us over here in Uncharted on the Dr. Andy work side of the house recently. I'm a big, big fan of hers. She's going to be running this from 7:00 PM to 9:00 PM Eastern. That is 4:00 PM to 6:00 PM Pacific Time. This is free to Uncharted members. It's $99 to the public. Put links to both of these down in the show notes. Guys, I hope to see you there. Let's get back into this episode.
Andy Roark:
All right. So let's get into the action steps here. And I'm going to keep this at the general level of I have ethical concerns about what's happening in our practice and I don't know what to do. I think the first thing for me, I think you and I started with this with a headspace pretty well. I try to always assume good intent about people. If people are doing something that I don't understand, I try not to assume that they're doing something shady, that they're trying to keep secrets or skirt the rules. Seek first to understand.
Andy Roark:
And of course, obviously it's like if I see someone stabbing someone else, I'm not going to be like, “I'm assuming good intent here.” No, I got it. That's bad. But for most things, when I go, “What is happening here?” It's better for me to come from a place of curiosity than from accusation, and at least until I know what's going on, and then we're going to make decisions based on that. But jumping to conclusions is often a mistake. So I would start with that. How does that feel to you as far as an opening position?
Maria Parita:
I love what you just said about jumping to conclusions, actually, because it reminds me a lot of when I'm driving. I like to imagine that everybody has a big pot of chili in their backseat, because that's usually when I get angry as I'm driving and somebody cuts me off and I get angry immediately and I'm like, “Oh, this person just cut me off for no reason.” And I have to think, “No, they have a big pot of chili in the back.” Maybe that person has got somewhere that they really need to be and maybe they've got an emergency going on. And it's something that you can apply within your own clinic all the time, too, is don't jump to conclusions. Look for the intention. Look for what was happening and understand.
Andy Roark:
Okay, I have a question. To you, having an emergency, having somewhere you need to be equates to a big pot of chili in the back. Is that-
Maria Parita:
No, first of all, that can be an emergency in a lot of …
Andy Roark:
I can imagine them having a baby in the back. And you're like, “No, they have chili.”
Maria Parita:
It could be. So it depends all about … The pot of chili comes from one time we were driving very slowly because I had a big pot of chili in my lap and it was warm because I wanted it to get there warm. And we were driving really slowly, and somebody got angry at me because we were driving slowly. And so I think about that moment is because I had a big pot of chili. So to me, that's what I go to is I have to imagine that they have a big pot of chili. It's a metaphor for there could be something else going on that you don't know about.
Andy Roark:
Yeah, I was just wondering at what point did Maria become food motivated to the point that she's like, “I bet there's chill involved in this situation.” That totally makes sense. I love it.
Maria Parita:
Well, I am food motivated, so you're not wrong about that.
Andy Roark:
No, I am as well. Which is when you said that, “Maybe they got chill,” I'm like, “Well, you don't want to spill that.” So yeah, anyway, Okay. No, I'm on board. I'm glad there's a story to that. I was like I'm missing this whole chill emergency. There's something I feel I should be worrying about that I've never worried about before. Okay. Number one is assume they have chili and good intentions.
Andy Roark:
And the second one is ask the question. And when we talked about ask it in the moment. Just ask the question like, “Hey, help me understand what's going on here. I want to make sure I'm supporting you well. I don't understand this decision.” And if you're too afraid of where you work to ask that question, that's not good, and I don't want that for you. I think that, and again, I want to give people grace here and say I understand everybody works for different people. In some places that really would be a hard ask and there would be negative repercussions that most of us wouldn't have to deal with. And I get it.
Andy Roark:
At the same time, you pick your poison in this life, which means you can either wonder about what was going on and what you were involved in or you can ask the question, and those are your two options of ask the question and get some more information or don't ask the question and continue to wonder or have to ask the question later on, which is, as we said, less ideal than just asking it now. And so at some point you have to pick your poison. And I would say if this is bothering you, just ask. Again, that ties into assume good intent. I'm not trying to accuse anybody of anything, I just want to understand what's going on, and just ask the question.
Andy Roark:
And then you brought this up before. This is number three for me is document. And I don't think that people, when there are things like ethical issues, bullying is really a big one for me. Anything that borders on sexual harassment, anything like that. If you're involved in these things or you see these things, write them down. It doesn't have to be anywhere public. It can be on your computer. Write down the date, write down the approximate time, write down what you saw, write down as best as you can remember what exactly was said. Just write it down.
Andy Roark:
And if you never use it, that's great. But if it comes down to a thing where you say, “This happened,” and somebody else said, “It did not happen,” if you can reach into your locker and pull out the document that says, “On this day in this room at this time, these people were there and this is what you said and this is what you did,” then that is a huge deal compared to someone saying, “You did this,” the other person saying, “I did not do that.” And so whether you report it up or not, you should go ahead and start to just to document things like that that you're concerned about. You'll never be like, “Darn, I'm so angry I wrote that down.” You can 100% feel the opposite way. And so I really like your idea of documenting.
Andy Roark:
So where do we go from here, Maria?
Maria Parita:
I think like we talked about this, it's really going to be dependent on the situation and what was going on. But I agree 100% with the documentation, with everything that you said earlier about the situation. If this is something that is where it's completely unethics, and you can tell and you documented it and you went from here and you've brought it up to management and this is nothing that you can do about it, then you have no choice but to go ahead and go to the board and do what you need to do. I mean, there's no ifs, ands, and buts about it. If you've tried to bring this up internally and there's no changes, because at the end of the day we did take oaths, most of us. Even if you didn't, we went into this field to help animals, and this is something that's not helping animals. And so as much as we don't ever want to have to be in that situation, you've done what you could and now you're at this point and you have to do what you have to do.
Andy Roark:
Yeah, I agree with that. I don't know how to advise someone beyond what we said of weighing intention, weighing a pattern of behavior, and weighing harm. Is harm being done to animals? Is harm being done to people? Is harm being done to the community? Is harm being done to the coworkers? And all those things factor in. At some point you always have to … There's an idea in Buddhism I talk about a lot, life is suffering. And it's just this idea that life is always hard. And the greatest empowerment that we have is choosing how we struggle. And I think that this is very true with ethical issues. At some point you have two choices. You can go on as you are, or you can push to make change. And while I say it that way, everyone's like, “Oh, yeah, Andy's saying you should always push to make change.”
Andy Roark:
And I'm saying no. Sometimes you choose to struggle as you are because it's a bridge too far or it's not an infraction that you think warrants going to the state board. You're not being lazy. Yeah, it ticks me off that I went to the boss and the boss didn't do anything, but do I want to go through this headache, this effort of going on to the state board? I have to ask myself that question, because that's really the only question is is this how I want to struggle? Do I want to do this, or do I want to struggle living with the knowledge that I did not go to the state board? And that's it. That's 100% where we end up in the end. And I think that's a lot to balance.
Andy Roark:
I think it's very nuanced. I think and this person who's writing, they give a long list of serious things. To me, I go, That's pattern. That's a pattern, and there are things that cause significant harm. To me, those check all of my ethical boxes of I'm appealing up the chain because this is not okay with me. It's not okay. Yeah, it's not okay with me. And I feel emotional pain having been involved in this or knowing that this is here and it's continuing on. And from an ethical standpoint, I'm not okay with this. And I have chosen. I picked my poison and it is I am going to stand up and say something and say, “This is not okay.”
Andy Roark:
We all have to make those choices. It depends on the individual thing that you're dealing with. And then also, when things become a pattern, to me that's a big deal. Everybody makes mistakes. Everybody makes mistakes, and it's just part of being human. And again, there's some mistakes that you don't get forgiven for. And that's true. Most of us make human mistakes. When we have a pattern of mistakes, that's something different. When we refuse to correct or apologize for mistakes that we have made and we show no intention of changing our behaviors, all of those things matter to me a lot in trying to make these decisions.
Maria Parita:
Yeah, I completely agree with you on that.
Andy Roark:
Is there anything else that I'm forgetting here as far as trying to make this call? It is kind of a messy one, but boy, ethics are generally messy.
Maria Parita:
Yeah. I feel like, honestly, we could make this six episodes, because it's such a messy situation and there's so many different things that need to be involved for this to all go the right way. And situations are different and people are different and clinics are different and laws are different in different states, too. So we could talk about this for a really long time, but at the end core of it, it's exactly what you said, Andy. It really is.
Andy Roark:
Oh, well, thanks, buddy. Hey, thank you so much for being here with me, Maria. I appreciate it. Guys, thanks for tuning in. Take care of yourselves and we'll see you next week.
Maria Parita:
Thank you so much.
Andy Roark:
And that is our episode. Guys, that's what I got for you. I hope you enjoyed it. Thanks to Maria coming out, first time having her on the podcast. I cannot wait to have her on many more times with me and with Stephanie. And gang, I got to stop right here for a quick second and just say thanks to [inaudible 00:45:58]. I got to give them a shout out. Guys, they sponsor our transcripts. They are all about inclusivity and accessibility in our profession, and they made transcripts responsible for our podcast, which we cannot otherwise do. So big thanks to them. Find them at uncharteredvet.com. Guys, that's it. That's all I got for you. Take care of yourselves. I'll talk to you later on. Bye.