This week on the podcast…
This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are diving back into the mailbag to tackle an email from a team leader who is worried that one of their technicians has reached a point of no return with their “I don't give a flying fig” attitude. This tech used to have a ton of heart and their pride in their work showed through everything and now it seems like they just brush off every mistake they make and they are making a lot of them! This team lead is Concerned-for-her-but-also-the-patients and asking Andy and Stephanie to weigh in on a very important question – When is burned out “too” burned out to keep going? Let's get into this…
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Submit your questions here: unchartedvet.com/mailbag
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December 7-9, 2023: Uncharted Practice Leaders Summit
Episode Transcript
Stephanie Goss:
Hey everybody, I am Stephanie Goss and this is another episode of the Uncharted Podcast. This week on the podcast, Andy and I are diving back into the mailbag. We got a great letter from a technician who is concerned about one of her fellow techs. This person has been a long-time tenured employee, was previously really engaged and a rockstar on the team, and now just seems very burned out. And the technician who wrote us is really concerned about some of their behaviors and wondering when is burned out too burned out to keep on going. Let's get into this one.
Speaker 2:
And now, the Uncharted podcast.
Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark and the one and only Stephanie, the point of no return, Goss.
Stephanie Goss:
How's it going, Andy Roark?
Dr. Andy Roark:
Oh my God, Becky. Look at my summer, it is so out of control. I am on a rollercoaster that just hasn't stopped back at the station five times and I'm like, “This was fun.” And now I'm just holding on and feeling kind of beaten up.
Stephanie Goss:
I'm ready to get off.
Dr. Andy Roark:
I'm ready to… I have to go to the bathroom and I would like this rollercoaster to stop. I need everyone to stop screaming around me. I would like… stop the summer. I'm ready to get off and go back to real life. It is ready for kids to go back to school and ready. I have done all the things I wanted to do this summer, but yeah, it's been good. How about you?
Stephanie Goss:
Yeah, it's crazy right now. First of all, I miss seeing your faces, so I'm so glad that I'm staring at you right now because I haven't seen you in a week and a half because I was on vacation. But yeah, same. I had that coming down from the vacation high on Monday because I was unplugged, I spent time with my kids and I was trying really hard to not have a repeat of last summer's failures. And in fact, our friend, Eric Garcia and Tyler and I are going to do a repeat podcast about this year's challenge.
Dr. Andy Roark:
About your failure to unplug?
Stephanie Goss:
For unplugging. I did much better this year, but in my effort to do much better, I didn't look at anything until I sat down at my desk on Monday morning and then it was like, shit exploded.
Dr. Andy Roark:
And part of that was me and here's why. Because you're not the only one who hasn't seen me in a while. No one's seen me in a while. And not because I've been doing things, because everyone else has been doing things. My children are at different summer camps. My wife went on a business conference. It's just me by myself. The first thing I did was watch all the movies that I don't get to watch when other people are around, and that took about a day. I watched Renfield with Nicholas Cage as Count Dracula. I watched The Expanse, the TV show, watched a number of things and then I was kind of done. And now at this point, no one has come home, it's still just me by myself. I'm into weird shit now, Goss. I ordered a whetstone from Amazon and sharpened my kitchen knives to the point that I throw fruit in the air and cut it in half. That's how sharp my knives are right now. I bought patio furniture last night because it was Prime Day and I was like-
Stephanie Goss:
I was going to ask because it's Prime Day when we're recording this, so what did you trip over your fingers and buy?
Dr. Andy Roark:
I bought a whole set of patio furniture that my wife is going to be-
Stephanie Goss:
Surprised by.
Dr. Andy Roark:
[inaudible 00:03:46] she's going to be surprised by. I sent her a text message that says, “I made a purchase. If you hate it, we'll send it back.” And then that was the text. And then I went to bed and didn't respond to any of her follow up questions, which got increasingly frantic [inaudible 00:04:02].
Stephanie Goss:
Because she's on her business trip and she's imagining that, did he buy a car? Did he… What just happened.
Dr. Andy Roark:
Yeah. I guarantee if you made her list the things, patio furniture wouldn't have come up. It was not a family purchase we were planning on, but I was just like, “I'm doing it. No one's here to stop me.” It's like when you leave your dog and they just chew something up and you're pretty sure it's out of spite, but you can't prove it. She's like, “I left him, and so he bought patio furniture. I think he was resentful, but I'm not sure.” Anyway. I went to a CrossFit pool party because the 4th of July party was held late, and so I went to the CrossFit pool party, which you would've really enjoyed. I love the CrossFit people that I go to the gym with, but I'm not going to lie, there was very small swimsuits and lots of posing around the pool.
Stephanie Goss:
I was going to say. I mean, I would expect no less for a CrossFit party.
Dr. Andy Roark:
Yeah, there was-
Stephanie Goss:
I mean you like to show off your guns. I can only imagine people who are hardcore, hardcore, hardcore, hardcore CrossFitters and their amazing bodies showing up to guns out.
Dr. Andy Roark:
There was lots of drinking beverages in ways that really made your biceps stand out. A lot of that was going on, you know what I mean? There was a lot of just standing and… You know when models stand casually, it was a lot of that. But yeah, that was it. So I went to the CrossFit pool party and I was like, “Stephanie Goss would never stop giggling if she was here.”
Stephanie Goss:
Oh man, I would not. I would've been highly amused for probably 0.5 seconds and then I would've felt wildly uncomfortable and been like, “Yeah, this is not my thing. Why did I let Andy drag me to this?”
Dr. Andy Roark:
Yeah. I would've been like, “Come on Goss, let's go to the CrossFit pool party.”
Stephanie Goss:
I could make them all feel good about themselves because I would just be rocking my middle-aged mom bod, and just be like, “Hi.”
Dr. Andy Roark:
No, that was me. It's funny, I have a role at the CrossFit gym and it's the floor. I am the floor above which others soar. Basically that's my experience in vet school where I help make the top half of the class possible.
Stephanie Goss:
Look really good.
Dr. Andy Roark:
Yeah. I provide the bottom part of the CrossFit experience so others can monitor their progress as they shoot past me, as I get older and older and older. All right.
Stephanie Goss:
Okay.
Dr. Andy Roark:
That's it. So that's what I've been doing.
Stephanie Goss:
Well, and not only that, so it's been busy for both of us personally and work has been insane. So came back on Monday and my desk was piled full of crap that my kids dumped there, but also like 9,000 messages and emails and everything. And so we did a thing this week. In fact, we did a thing just yesterday. We did a really big thing. And so it's been a little busy.
Dr. Andy Roark:
It has been a little busy. It's been crazy. We opened up registration for our Medical Director Summit, our Team Lead summit, our Culture Conference and our Practice Leader Summit, which is open to in-person and open to practice owners and practice managers, and so that was… We opened up all those things just yesterday and we're not done for the year. But those are the big things. So yeah, I'm super excited about this stuff.
Stephanie Goss:
There's multiple new events in there and revamping of old events that we have done before in lots of different ways. And so it has been a busy time for the team and like you said, we're not done. And so it was like, okay, we're just going to coast over the top of this hill and then we're still running, running, running because there's another hill in front of us. So it has been busy. I am very excited to see you this weekend because we are headed to AVMA.
Dr. Andy Roark:
Yeah. AVMA in Denver.
Stephanie Goss:
I can't wait to see all of our friends and have that midsummer energy.
Dr. Andy Roark:
And you're speaking there, you're speaking on Friday at AVMA, which is the day before I get there. They moved you forward and so I will not able to see you.
Stephanie Goss:
You're going to miss it.
Dr. Andy Roark:
Yeah.
Stephanie Goss:
But you know what? You have a history of trying to miss out on my lectures.
Dr. Andy Roark:
Not being able to get into the room because they're crazy packed is the history.
Stephanie Goss:
Well, fingers crossed that AVMA goes well. This'll come out after that, but I'm excited to see your face. I have a feeling there's going to be a lot of conversations like what we're going to talk about today there with our colleagues because it's summer, it's crazy, it's busy, and I think this… We got a message in the mail bag that kind of fits with a lot of that summer crazy for people, but also long term. We got a letter from someone that I just loved. It's from… “Concerned for her, but also for the patients”, which I thought was a great moniker for themselves. So it was someone who wrote in and said, “Hey, we have a technician on our team who has recently just seems to decide that she just doesn't give a crap anymore. She's very polite to pet owners and other team members when they talk to her and interact directly. But she just doesn't seem to be trying and she's not doing things, she's making mistakes and she doesn't seem to not be trying to not make mistakes.”
So they gave some examples, recently sent home a patient that had been dropped off without all of the vaccines that they came in for. And when someone brought it up and they were talking to her, she just kind of was like, “Whatever.” And this is a team member who previously had a ton of hustle and heart and cared and the team is worried, this person included, because it seems like this tech is just super, super zoned out. And the person who wrote into us is also a fellow technician. When they tried to talk to her one-on-one, the response was kind of just like, “Hey, it's just a job. The fact that I'm making more mistakes…” it didn't seem to bother her.
And this technician who wrote us was really concerned because they were like, “Look, I know we've been shorthanded. Everybody is burnt out.” It's summer, it's busy, we're shorthanded, but at what point does it get to the point of no return? At what point does it get to burned out being too burned out to be allowed to keep going because this tech is concerned for her fellow tech but also for the patients. And I just thought this was a fun one for us to talk through.
Dr. Andy Roark:
Yeah, it is. This is a good one. I see this a lot. Boy, it's really sad. What breaks my heart the most is when you were working with somebody and they love their job and they were really into it and then they are not in love with it anymore. And the thing that breaks my heart is one, clearly something has happened in this person's life and that has taken their joy away. And that's just frankly really, really sad. The other thing is that it's worse to have someone who really loved their job and did a great job and then just ends up quiet quitting, than it is to have someone who was never good at the job or never really loved it because you know how happy they were or they could be.
And it's almost like I'd rather not know that they could be so happy because then it doesn't make it so stark when you look at them and go, “God, that you're really in a very, very different place.” And I'm not serious about it, about wishing to not have seen them happy, but you get the point. It really is that dichotomy is really significant. You have something to compare to. You can compare where they are now to where they have been in the past and it's really hard.
Stephanie Goss:
Right. I think subconsciously you know the difference and you can see it. And so the subconscious expectation on your part is if they had previously been at 100 and you've seen them at that point, you subconsciously have that expectation, and so it makes it all the more stark when it drops off. We all have good days and bad days and we all have days where maybe we generally perform at 100% or 110%, but then we have days that are crappy days. That's easy. But when it falls into that pattern, subconsciously, we can't help but judge how different it is now compared to how it was previously.
Dr. Andy Roark:
Oh, totally. I mean everything. The way we're wired is about comparison. I think that's why we pick up on that a lot. A lot of times there's people who are you've… I mean you've seen people who are happy, happy bouncy people and then one day they're not and you go, “Oh my gosh, are you okay?”
Stephanie Goss:
Yeah.
Dr. Andy Roark:
Versus other people that are not happy, happy bouncy people and they might behave the exact same way and you wouldn't think twice about it, it's just who they are.
Stephanie Goss:
I'm laughing because I'm actually thinking about you and me, you and I have had this conversation because I am one of those happy people.
Dr. Andy Roark:
Yes.
Stephanie Goss:
Shocking I think to everybody who's listening to the podcast right now that I could be bubbly and happy and outgoing. And I recall several occasions where you called me and you were just like, “Hey, I love you. And what is happening with your face, because you're normally so happy and upbeat?” And when we have a team meeting or we're working on something and other people can see you and you're not yourself, it is that stark noticeable difference and it impacts everyone. You were teasing me when you're like, “Hey, what's up with your face?” But really it is that stark difference when you have somebody who is so quiet and I mean, so crazy and loud and outgoing and then they're suddenly very quiet. I have gotten that at multiple times in my life as an extrovert, as an outgoing person.
Dr. Andy Roark:
I remember those conversations. I think I remember using the term poopy pants, but it was. But I say it to you, I was like, “This is not fair.” But the fact that you were known for being so bubbly and happy means that when you show up and you're not, people are like, “What's wrong with Stephanie?” versus other people show up and they're just not bubbly and happy because that's just how they are, and no one bats an eye. And I'm not saying you shouldn't be your authentic self, but it is just something to be aware of that people pay attention to who you are and they look for deviations from the mean.
It's funny, it's why we'll put up with jerks sometimes because they're always jerks. But if someone's nice and then they come in and they be a jerk, you're like, “This is a big deal.” But the person who's just always a jerk, you just learn to ignore them because you're like, “That's how they are and I'm just going to ignore them.” And you could write them off. But it's just interesting that contrast from expected norms is what hammers points home for a lot of people, so anyway. That's just what I was saying when I say I was particularly sad. But let's get into talking about this. You ready?
Stephanie Goss:
Okay. Yeah, let's do it.
Dr. Andy Roark:
All right, cool. Sweet. Let's start with some head space. The big thing that I want to start with is this, I think one of the healthiest things that we can do in our lives is develop the habit of separating people from their behaviors and saying… Instead of being like, “This person is toxic,” or, “This person is a jerk,” or, “This person is whatever.” The person is the person and they are exhibiting behaviors and the behavior does not define the individual. My friend is not a jerk. My friend, he is exhibiting jerky behavior, but that's different from being a jerk. And I just think it immediately makes people easier to get along with and to like, and everything doesn't feel so final. If you're exhibiting jerky behavior, then you can stop exhibiting jerky behavior and that will be over. But if you are a jerk, then becoming not a jerk is a long process and much more challenging than just, “Hey, stop doing the behavior that is bothering people.” You know what I mean?
Stephanie Goss:
Yeah, I do. I do.
Dr. Andy Roark:
And so when we start talking about this person who's burned out, I think it's… One of the immediate head space things that I would do is I would walk back the label, this person's burned out. I would say, “This person is exhibiting signs of burnout. They are exhibiting behaviors that make me worry about patient safety. They are showing a lack of engagement.” But it doesn't make me feel like I'm judging this person as an individual. And that's going to become important when you see where we're going. Do you agree with that?
Stephanie Goss:
Yeah, absolutely. And I think your point is spot on because when we get into the actual conversation and this tech who wrote us has already experienced that, they had the conversation, they pointed it out and said, “I'm worried because you're making too many mistakes,” it's very… The difference between feeling like someone is calling you a jerk or someone is telling you that you're burned out versus what you said, which is, “Hey, here's an example of behavior that makes me concerned for you. I'm concerned you're exhibiting some signs of burnout. Where are you at?” The way that someone can receive that is very, those two things are very starkly different.
If somebody comes to me and tells me, “Hey, you're a jerk,” I'm going to immediately go on the offense, and I'm going to either get to… I mean they're going to go defensive and be like, “No, I'm not.” Or I'm going to attack back because I feel attacked. Whereas if somebody says to me, “Hey, that thing you just said, you sounded like a total a-hole, maybe think about that.” There is just something very different in that approach to be able to be like, “Oh.” And without even thinking, I pause and think and rewind what I did instead of immediately trying to defend myself or attack back at the person.
Dr. Andy Roark:
There's a reason I put this in head space too is because you're right, one, for having the actual conversation, talking to the person about their behavior instead of about who they are or what they're being, yes, significantly easier, significantly more productive, significantly easier to coach and give feedback to, all those things true. However, I would stress that for me, not only does it make the actual conversation easier, it is an important part of head space. And the reason it's important part of head space is this, what I'm getting ready to say right now, you can care about someone and also decide not to be in a toxic relationship with that person. But you can only do that if you can separate the person and the behavior. Otherwise you're like, “Oh, there's this person and I'm tied to them and they're behaving this way,” and it's blah.
No, I love this person. I care about this person, and as long as this person exhibits this behavior that is unacceptable, I am not going to be present around that person. It doesn't mean I don't care about them, it doesn't mean I don't wish the best for them. It just means they're doing a behavior that I can't be around or it does not work for me to have an active ongoing relationship with that person. But for me I can't… I've never been able to do that until I can separate the person and the behaviors because then I can say, “I really care about Stephanie Goss and until she stops yelling at the staff, she can't come to the staff meetings. I think the world of her, she cannot be on our team because she cannot get along with this one person and it causes damage to our team. I think she's great.”
Stephanie Goss:
I'm a total tyrant.
Dr. Andy Roark:
I mean, I'm completely making up things in case that wasn't obvious.
Stephanie Goss:
I'm teasing.
Dr. Andy Roark:
But you see what I'm saying though, right?
Stephanie Goss:
Yeah, for sure, for sure.
Dr. Andy Roark:
But yeah, you've got to separate the person from the behavior and then you have to coach the behavior. You have to give feedback to the behavior. You have to hold people accountable for their behavior. None of those things mean that you don't care about that person. And if you can make that split, now we're immediately in a head space where we can start to effectively manage this person who we like and who we're worried about. And also we're going to hold this person accountable. I can't do that until I make that tactical move of separating the person and the behavior and I send my love to the person and I manage the behavior. And that might be this person is going to be managed out of the practice. I don't want that, but I manage the behavior. And if that's where it goes, because the behavior doesn't stop and it's toxic and it's damaging and it's putting patients at risk, I am going to manage that behavior possibly out of our practice. And it's not going to change my feelings about the person who is exhibiting those behaviors.
Stephanie Goss:
And the thing that I would add to that is I'm sure that there are people listening, even me listening to you, I'm thinking in my head about situations that I have been in where I have had someone who is exhibiting behavior that I don't like. This is really freaking hard. Separating the behavior from the person is really, really hard work. And so if you're sitting here and you're listening to us and you're just like, “Oh, Andy makes it sound so easy.” It's not.
Dr. Andy Roark:
No.
Stephanie Goss:
It's really hard.
Dr. Andy Roark:
No, it's not.
Stephanie Goss:
It's hard for both of us too. And I think that a big part of it for me is if you're that person who's like, “This is really, really hard.” When we get to the what do we do about it piece of it, I think that it's important to recognize that before you tackle the actual action steps, your work might begin in the head space piece and you may have to do some work, whether that is writing out how you feel, whether it's talking it out with an outside perspective person, whether it's a professional like a therapist or someone who doesn't work with your team and getting some outside perspective on it. There is actual work for all of us that has to be done there every time even if the work… For some of us, the work is like, I'm going to work through these things. And it's a relatively short process.
And there have been times in my life where I have had to work through this for someone very close to me. And that head space work was long and painful and hard. And it took me quite a while before I got to the place where I could be like you were saying Andy, “Here is the person, here is their behaviors.” And now I feel like I can move into the action space where I'm starting to have the conversations or I'm doing something about it. I think it's just worth mentioning because a lot of times I know I'll listen to people talk or I'll be at a conference, I'll be in a lecture or I'll be listening to a podcast and I'm like, oh, it sounds so nice and pretty and easy when they talk about it. And I think that's something you and I both still struggle with. And it is work. It will always be work.
Dr. Andy Roark:
Oh, sure. It's always going to be work. It's always going to be easier to say, “I can't stand that person,” than to say this person exhibits behaviors that I can't stay in. But I'll tell you one of those things is much easier to fix than the other.
Stephanie Goss:
Yeah, for sure.
Dr. Andy Roark:
So that's the first thing. The second thing for head space is remember that management is balancing needs. And we talk about this whenever we talk about people who are having mental health struggles in the practice or people who have outside life challenges that they're bringing. [inaudible 00:23:42] bring their personal life into practice always end up talking about this, but management is about balancing needs, which means you can care about this person. And also it is the responsibility of management to care about that person and to care about the other staff members and team members who are going to have to pick up the slack for this person who's not doing what they're supposed to do. And we have to balance the needs of the pet owners who do not feel like they're getting the service or the attention that they need or they're frustrated because they have to come back because their pet didn't get the services they were dropped off to get.
And we have to balance the needs of the pet that did not get the level of care that it needed to get. And so, I like that perspective a lot because it makes hard decisions a lot easier for me. If I look at one person, I get totally focused on that person and I'm like, “What do I do about this person? What do they need?” I don't know that. I know they're struggling. I know they're having this hard time. Then I can really get bogged down in, “Is it the kindest thing to let this person go? Do I give them another chance? What do you think?” Zooming out and looking at everyone's needs and how they're being affected generally makes the decisions easier. It also makes the conversation much easier because I can go to this person without judgment and ultimately say, “Hey, I'm concerned about this aspect of patient care. I'm concerned about the client experience. I'm concerned about the other team having to pick up the slack because of these behaviors.” Full stop. “I need these behaviors to end in order for us to keep working together.”
Stephanie Goss:
Yeah. Well, and I need your help too, because…
Dr. Andy Roark:
Yes.
Stephanie Goss:
I think about it from a management perspective and my inclination, there were times where I had hard conversations with my team, and I hate to say it this way, but it felt a lot of times, like I was having a conversation with one of my kids and I have two, and they're very close in age, and one of them, the conversation always tends to go back to, “Well, you didn't make them do that. You treated them differently.” And so a lot of time in the practice I would have a conversation that's like, “Well, why did you take the side of the client?” I didn't take the side of the client. I balanced in the moment and said, “Look, this pet needs to be taken care of. They were dropped off. We didn't do our job, so I'm going to make sure that we do our job, we take care of the patient, we take care of the client.” And that may feel like I am taking their side and I'm getting that.
Really what I'm doing from a manager perspective, to your point, Andy, is balancing that. Because now if I take the weight of taking care of the patient and the client off the scale, now I can look at the rest of it and I can sit down with you and I can have that conversation and say, “Hey, this isn't like you. This was the consequence, this was the conversation I had to have with the client. I had to give them their money back or I had to have… And yes, I'm worried about that, but I'm more worried about you because this is not like you. What's going on and how can I help support you?” Because to your point, this is very uncharacteristic and I can't or it can't continue, but really it's about how do I support you as a person, because then you're only weighing that person and the rest of the team. And so now instead of balancing four things, I've dealt with the client and the patient and now I'm dealing with the team and this one individual, which makes that balancing a little bit easier, I think.
Dr. Andy Roark:
Yeah, I do agree. I think part of it for me is a math problem, and I hate to… And this isn't intentionally taking the emotion out of it. You know what I mean? I don't tend to forget the human aspect, that comes very naturally to me. And so I have to work more to take the human aspect out so I can make clear-headed decisions, and so a lot of… This is a math problem because people will come to you and they'll say, “What is…” The question that was asked was, what is the point of no return? And I will say to you, “That my friend is a math problem. Add up the damages to the pet, to the pet owner, the client experience, to the doctors that are delegating the damage to their trust, the damage to the team that's having to make up for mistakes or things that are not getting done and the frustration that you feel and having to manage this and the amount of time you are putting into cleaning up this mess.”
Put that against the convenience of keeping this person, giving them time to work and figure out what the math says. And really, a lot of things really depend on what the collateral is. If the person is not making very many mistakes, and it's a once in a blue moon sort of thing, we're going to keep talking with this person and coaching this person. If they're making serious mistakes and life-threatening mistakes for our patients, that's going to be wildly different equation when we look at it. Anyway, but that's it. The whole part, I guess my first part of head space is separating the person from the behavior allows me to look more clearly at what is happening. And then the whole balance approach lets me look at all of the moving parts and pieces together in sort of a non-emotional way.
So that's where I would start. I think once you do that, then you can go into the human side and you know what the battle battlefield looks like, you know what what's happening, what the consequences of these behaviors are, what the behaviors are themselves, you know all those things. And so you can go and talk to the person and say, “Hey, I'm concerned about you. What's going on?” Is a big one. Start from point of being curious. This is just classic root cause analysis in performance evaluation is what's going on? How are you doing? Where's your head at? I couldn't help but notice these things. How are you feeling? What's going on with you? And just asking the questions. And so we start with those things and a lot of times we can come and we can talk about the behaviors and the person may have a very justifiable reason for feeling the way that they feel. And you can say the way you feel is justified and I hear it and we are working on it, and at the same time, these behaviors cannot continue, full stop.
And now I feel like to me that is a place I'm very comfortable in working because I have done the things empathetically of understanding this person, hearing where they're coming from, and I have also communicated what the obstacles look like going forward. And now I feel like I'm in a good head space to navigate this, what are their needs? What are our needs? Let's see if we can work out arrangement and we'll have to see how it goes and maybe we can get this person back on track and we can help support them and we can bring them through and out the other side. And I've definitely seen that and I've seen people re-engage, maybe they're spiraling downward and they're going to continue to spiral downward and we're going to have to be conscientious and we're going to have to set expectations and set boundaries for ourselves and our practice about what we'll put up with and what we'll tolerate and what's acceptable and what's not.
And then we're going to have to let the chips fall where they may. One of my favorite sayings just to remember is there's three things you can't control, the past, the future and other people. And so you can't make this person do anything. All you can do is be kind and supportive and clear about what your boundaries are and what is required in order to continue to be on your team.
Stephanie Goss:
Anything else? I like that. Anything else from a head space perspective for you?
Dr. Andy Roark:
No. I think that those are the big things for me and just getting my head straight about this is… Yeah. Oftentimes I'm so empathetic of people and I really want them to succeed and I'm such a cheerleader, I have to go through those. So if you're hearing these steps and you're like, “Man, Andy's getting pretty pragmatic pretty fast,” and I go, yeah, my nature to care a lot about people and to want to help and support people, and so I have to actively engage head space. For me, it has to be on the other side, which is going to be like where is the point of no return? I need to try to get some clarity on that so I can coach to it.
Stephanie Goss:
Yeah. And I agree with you. I have had to do a lot of work to do the first step that we talked about, which was caring about the person and separating them from the toxic relationship. Separating from a toxic relationship or separating them from their behavior, that's what a lot of work in recovery is about. I've done a lot of that work, so that piece comes easier for me. I would say for me, the head space work is that balancing piece. And so I think that it's about separating the behavior from the person, figuring out how you're going to balance the things.
And then I love your last point about knowing what you can control and what you can't and getting to that space where then you are like, “Now that I've worked through all of this, now I'm ready to figure out what do I do here?” Which is I think the whole point of the email they were asking what is the point of no return? But also for me, the unasked question is then what do you do about it? This is about a personal thing. And so how do you deal with that? Do you want to take a break right here and then come back and talk about the what do we about it part?
Dr. Andy Roark:
Yeah, let's do it. Okay.
Stephanie Goss:
Hey gang, I want to make sure that if you are in the role of medical director that you hear this. Andy and I talked on the episode about our Medical Director Summit and I wanted to make sure that you knew where to go to sign up because we want to see you there. Whether you're in private practice or you're in corporate practice, the position of medical director is a unique one. You have the challenge of balancing the medicine and quality for your hospital along with usually some management responsibilities and partnering with a practice manager to run the hospital efficiently, effectively, and in true partnership. And so we decided after working over this last three years with hundreds of multi-site medical directors and practice leaders, that we wanted to do a summit just for our medical directors. So we have something coming up in September. It is happening September 27th.
It is a one-day virtual summit and it is going to be awesome. We've got some workshops from people who are in medical director roles, both in private practice and corporate practice, and we are bringing people together across the industry. It doesn't matter what hospital you work for, you've got commonality. We're bringing you all together and building a community where you can share the highs and the lows of being a medical director with your peers. So head over to unchartedvet.com/events and you can see the signup link for the Medical Director Summit. Again, it's happening in September and we would love to see you there.
Dr. Andy Roark:
All right. Let's come back and start to talk about how we actually set this up. The first action step for me always is our safe conversations that we use all the time.
Stephanie Goss:
Sure.
Dr. Andy Roark:
So safe, S-A-F-E, S is can you sit next to this person? Can you smile at this person? If they have done something that has made you furious, if you just had to clean up a big mess and an angry client and you're triggered and you're mad at them, that's not the time to have the conversation. We might have to put a pin in this until you can sit next to that person and you can smile at that person because being triggered and being angry is a terrible way to start this conversation. A is assume good intent. Assume this person is trying their best. Don't assume that they don't care and they don't want to be here and they hate this place and they hate you and blah, blah, blah.
That's assuming the worst intent. It's really easy with someone like this, especially someone who's burned out to say they don't give a crap, they think it's just a job because they're telling you it's just a job. It's really easy to assume that they're lazy, they're trying to take advantage of the system, they don't really care about the patients, things like that. It's better to assume that this person is really struggling.
Stephanie Goss:
And don't assume that they're burned out, would be the other assume that I would say here, to your point earlier, which is don't confuse the person and the behavior. You've got to force yourself to be in that place. And if you can't separate that and you can't look at it like, this person is burned out. If you can't have the conversation and assume the intention thereof, I'm worried about the behaviors, you're not ready to have the conversation, I would say either.
Dr. Andy Roark:
Yeah, I think that's fair. I think that's a good point. So assume good intent or assume noble intent. F is has this person been set up to fail? What here is my fault? Have we given this person opportunities to get help or do we have things in place that can be resources for someone who is starting to, say burnout? Let's just say, if that's what's happening. Have we been working shorthanded, it sounds like? Yeah, this person in some way, they kind of have been set up to fail. We know that everybody's been really busy. One of the things I would do is make sure when I go and talk to this person, I'm not going to go, “Hey, look, your behavior is not where it needs to be.” I think what I can say is, “Hey, I understand we have been really, really busy and I think everybody is struggling a bit under the workload.”
And I think by owning that as a leader, I can help take some of the pressure off this person's shoulders and hopefully help them feel less defensive. A lot of times when you go in and say, “Hey, I want to talk to you about your behavior,” the person immediately gets defensive. When I go in and say, “Hey, I understand the situations that we've been working in are not ideal. I get it. And I know that we have been shorthanded for a long time and everybody is tired and I understand all of that.” And that just as a nice opening hopefully lowers the chances of the person going immediately super defensive and shutting the conversation down.
Stephanie Goss:
Yeah, for sure. And I think that that's it, that's a piece. It's hard as a manager and as a leader sometimes to look at that because it feels like by acknowledging that you're saying that you couldn't do your job and that can feel really, really personal. And there have been times where I have been having a conversation with someone and I feel myself starting to defend the thing and focus on their behavior because that is a really hard thing to say, but if you… I think you are so spot on that if you can say, “Hey, the schedule sucks. I realize that I am not… I am doing the schedule as best I can and I'm still short three people, and so you are working shorthanded with three less technicians. I recognize that. I know that I can control that, and I am trying really hard and it's still doesn't change the fact that I see you and I see what you guys are all working through.”
That just puts someone in a very, very different place. If there's one skill that I learned to master or that I hope to master as a manager, but that I use, it's that, because let me tell you guys the difference that it makes for people in starting with vulnerability and being honest. It just changes someone's demeanor when you start there versus, “Hey, you're doing this thing and we've got to talk about this thing that you're doing.” It just takes away that attacking feeling, I feel like in so many instances.
Dr. Andy Roark:
Yeah. I completely agree with that. And then E in safe is the end result. What is the end result you want? I would caution you against the end result, I want this person's behavior to be 100% changed and them to be their old self. I don't think that that is a reasonable end result for a conversation. The end result for me is I would like to have a clear understanding of what is going on that has caused this person's behavior to change. I would like them to understand my concerns and my needs, and then I would like to leave with ideas that I can implement that might support them, and understand how I can try to help them get back on track. That's it. And you'll say, “But Andy, you haven't actually affected the behavior.” And I would say, “No.” My first conversation is going to be an expectation communication, understanding conversation, and we're going to start to talk about what we need and then based on what is said, we'll figure out how to go from there.
Stephanie Goss:
Yeah. For me, that end result always is, I want to leave the conversation with a plan and I am 110000% okay with deciding the plan at the end of that conversation because I might go into the conversation thinking this is going to be a disciplinary conversation and I might let this person go, but what if, hallucinate with me for a second, what if I ask them what's going on and they share information that radically changes what I was thinking? I want to be okay to say, “Oh, I'm going to throw that plan out the window and now I'm going to make up a new plan.” But I think that as a leader, one of the areas where we can let our people down, to your point, making sure that they have access to the resources is hugely, hugely important because it's not our job to be mental health professionals.
It's not our job to get into their personal lives and support them. And so I think part of that action step is if you're getting information from them that there is stuff going on in their personal life, you need to support them and have resources available to separate yourself from that. And I think the E should always be, what is the plan? What is the next step? When are we going to circle back to this conversation? Because 98% of the time I would say these are not one and done conversations. Occasionally, yeah, maybe it is a one and done, it was a fluke thing, but most of the time you're sitting down because there's a pattern and there has to be some sort of follow up. And we have to be able to tell the people on our team as leaders and as managers what that follow-up plan is going to be and then actually execute on that plan.
Dr. Andy Roark:
Yeah. I'm really glad you added that. That absolutely needs to be part of the end result is where do we go from here? When will we meet back again? How are we going to measure success? I think that's exactly right. That was my point when saying, what's the end result? And this is going to be a multi-step process. Anytime you have multi-step process, you need to have clarity about what the next step is when we're getting back together. So I love that. All right. So the first one for me is safe. The second one for me is how you set yourself up. And I think a lot of people who are managers go into these conversations and they are like, “I am the law and you are going to have to meet my needs and demands.” And they don't say it that way necessarily, but in their mind they are like, “I am the enforcer of the rules. I am the one who is going to make you do the… I'm going to make you behave.”
Stephanie Goss:
They're going in with the stick of accountability.
Dr. Andy Roark:
They're going in with the stick. Exactly.
Stephanie Goss:
They're going to whack you.
Dr. Andy Roark:
Yes. All right. So you can do that. But there's another way to do it that I think is really important. And I really think this is a huge differentiator between fairly inexperienced managers and much more advanced managers. And it's where you position yourself on the playing board, on the playing field. The 4th of July, I go to this cookout and these are my wife's friends, so my wife is amazing, just so you know, my wife is, and you know this, Steph, but my wife is a amazing.
Stephanie Goss:
I do.
Dr. Andy Roark:
And she is so brilliant. I mean so much smarter than me. So much smarter. She's a college professor, she's a total badass. She does Olympic weightlifting as a hobby. She's freaking amazing. So she's badass. Anyway, so we go to the same 4th of July party every summer and one of our work colleagues puts it on. And so we're there and the husband of the work colleague comes up to me and he says, “Hey, I'd like to ask for some parenting advice from you.” Me? Alison's there. He does not ask Allison, he asked me, “Andy, I would like some parenting advice from you.” And I was like, okay. If you want to make my head swell, ask me for advice. I'm like, “No one…”
Stephanie Goss:
“I would love to give you advice.”
Dr. Andy Roark:
Exactly. No one has ever been like, “Andy Roark, talk to me about parenting.” That's never happened to me. If you want to talk to me about knife sharpening, I'm the guy right now. I got it. I've been practicing for a day straight and I have sharpened every knife I can find. I am raring to go, parenting, not so much, but anyway. So he says to me, he's like, “In our house, my husband sets the gold standard. Nothing gets done part way.” And this is why I never miss 4th of July is because everything at their gathering is just so, it is the food is amazing. The garden is weeded, the shade umbrellas are set up just so. There's lovely outdoor patio furniture, not as nice as mine when it gets here, but real good. Anyway, I might have gotten inspired by their cookout. Anyway. So he says, “Our son…” So their son is probably five.
He has recognized that one parent sets the bar real high in everything and the other parent doesn't set it as high. And what is so funny is this person was like, “Who else has a family like this?” And he looked right at Andy Roark like that's a guy who does not set the bar as high as his partner does, and totally nailed it. I was like, “I see why you walked through a room of highly intelligent, accomplished people and came directly to me.” It's like, “You look like a man who does not push for excellence the way your spouse does.”
Stephanie Goss:
It must be because he knows that you have a bad dog.
Dr. Andy Roark:
Oh, 100%. So anyway, he was like-
Stephanie Goss:
Not because you're not a good parent.
Dr. Andy Roark:
Well, Finn is like, “Hey, I'm done cleaning my room.” And Michael, it's his name. Michael has to say, “Well, you know this is not going to fly. This is not going to fly.” And so he's like, “I don't want to undermine my spouse. I don't want to roll my eyes and say, I think this is ridiculous that you have to get your room this clean. I want to be supportive of my spouse and also my kid 100% sees what's going on and knows that I would not clean the room to the level that he's being required to clean the room to.” And so I thought about for a second, and I just started talking as I do. And I was like, “All right. How familiar are you with the Hunger Games?” And he was like, “Oh, I know all about the Hunger Games.” Bear with me, I promise this is going somewhere.
The Hunger Games, I was like, “Okay. Remember the coach in the Hunger Games, Haymitch?” And he was like, “Yes, I remember Haymitch.” I was like, “Haymitch wanted the contenders to succeed.” They were his charges and he was their mentor. He wasn't their friend, he was their mentor. And was he also, he couldn't control the Hunger Games and he was respectful of it. It was like, “Hey, I love you, but…”
Stephanie Goss:
You might die.
Dr. Andy Roark:
“… this is what the deal is in the Hunger Games. I'm here to help you be successful given that this is how the world is.” That's the role I'm talking about in management. I know there's a long way to go, but instead of being like, “I am the law, you are going to do what I say because I'm holding a stick,” I see myself more as Haymitch who says, “Look, these are the rules of the Hunger Games and I'm rooting for you, and I want you to be successful, and I'm going to be your biggest cheerleader.” And so that's what I'm talking about, about putting yourself in a different position. If you go into this and you're like, “Look, I'm sorry, but I am the law and you will do what I tell you or else you'll be gone,” that's just fundamentally a terrible place to be. And no one means to be in that place, but they don't think there's an alternative and there is an alternative.
The alternative is to say, “Hey, this is what is required for our teams to feel safe, for our patients to be safe, for our pet owners to be happy and coming back for us to live up to our values. This is what is required. And I am here to support you in achieving those goals, those requirements. How can I help you get there and how fast can we get there because we cannot continue on not meeting these requirements, but I'm here for you.” And so anyway, I know that's a long weird story to get to, but it was in my mind recently, it just really crystallized the idea of, you don't have to be the law to respect the law and to say… And again, when I was giving parenting advice, I was like, “Honor your spouse. Be supportive of your spouse and also just don't BS like, “No, I would totally make you do this.” This is what it's going to be required and it's going to be required. And I am not going to undermine,” just like the manager.
I'm not going to be like, “Look, honestly, this is what the practice really requires, but I'm going to let you just…”
Stephanie Goss:
Look the other way.
Dr. Andy Roark:
“Yeah, I'm going to let you get off. No, that's not an option. I'm going to support you and I will help you in meeting the standards. And that's who I am as a leader.” So I'm communicating the standards to you and then I'm helping you to cheerlead to get there. So anyway, I know that was one of the weirdest examples I've probably given in a while, but you don't have to be the law. You can be Haymitch who is cheering and coaching and guiding someone to meet the harsh expectations that are reality. And if they fall short, then they still fall short. And you can say, “I'm sorry, we can't continue on,” but it's not make me happy or else.
Stephanie Goss:
I love that you told that story because I think that is definitely a piece of the management puzzle is that, look, ultimately maybe this person is exhibiting behaviors that are unacceptable and maybe that can't continue. And if I don't look at the F in safe and I don't look at how I set them up to fail, if I don't feel like I have been their cheerleader, I have supported them, and I have done all of the things that are within my power to do to help, then I will… If I have to let them go, I will struggle with that and I will feel bad. And I will tell you the times that I have felt bad letting somebody go, it's because I damn well knew that I didn't do my job good enough. And if I feel like I have done my job and I have supported them and I have been their cheerleader and I have been clear about the expectations and I've done all of the things, I still feel bad because I know that it's impacting someone's life on a human level.
But I don't feel bad letting them go because I have done my part. And I think your point about the Hunger Games is a true one because if you've done your role as a mentor and you have given them all of the tools and they die like that, you've got to live with that. You've got to be able to sleep at night. And so for me as a manager, that's the way that I sleep at night is to say, “Look, here are the requirements and I'm going to cheerlead you. I'm going to give you the resources. I'm going to do all the things.” But at the end of the day, to your point in the head space, I can't change the person. I can't control other people. You have to do the work. And if you don't do the work, I don't own that. And so I think that that's a really, really important part in the action step perspective because it really helps, I don't know, it helps me sleep at night.
Dr. Andy Roark:
And I completely agree with that 100%. And I agree also about being okay with it because I always wanted to be okay with this because, again, I can't control the people, which means I have to be okay if this doesn't work out. And that whole laying down the expectations, helping coach, that's a big part of it. The other thing that I messed up the most early in my career, and honestly it's probably the most common way I see people mess up, is they don't start early in enough. They wait until the behavior's become so bad you can't ignore them, and then they intervene. That's when I have felt bad before because I'll be like, “Hey, look, you've got three weeks to make a significant impact on your behavior.”
Stephanie Goss:
Right. Because the team is ready to mutiny.
Dr. Andy Roark:
Because the team is done. They are about to mutiny. And then that is a thing where I dropped the ball because I saw the behaviors. I just didn't say anything. And if I had intervened six weeks earlier, I could have… I don't know if I could save the person, but I could have probably… First of all, it's a whole lot easier to change behaviors before they get ingrained and become habits. And so I could have done a lot more if I had intervened early. So that's another one for me is start early. Too many people wait until things just can't be salvaged. The team's about the mutiny, there's high pressure and the whole thing is just too late to save.
Stephanie Goss:
Yeah.
Dr. Andy Roark:
Stay on task. When you start to talk to someone, especially if they have other things going on in their personal life, it's really easy to get drawn into what's going on with them. Don't let yourself be drawn in. You can be empathetic without drifting off task. Stick to what is required here at the clinic, what the impacts at the clinic are, what it is when we're here at work. And then you can provide resources for people. Like I said, we talked about employee assistance programs, things like that. You can be sympathetic to the person, but avoid being drawn into helping them fix their personal outside of work problems. That's just not your domain or your purview.
Stephanie Goss:
And I love that you said that because I don't know from this email if this person is a coworker, a peer of this technician, if they're a team lead and they're somewhat responsible for this person's behavior as a fellow technician or if they're a practice manager or some combination of all of those things. And I think knowing your relationship to that person and knowing how to stay on task because it's so easy to get drawn in as a peer to other people's. Easy across the board, especially if you're a peer to that person, likewise, know when to ask for help. So for me, the saying on task has to do with, have the conversation and have it in the context of your relationship with this person.
So if you're a peer, oh my gosh, go to this person and say, “Hey, I'm worried about you. I care about you as a coworker. What's going on?” And if you're getting information back that you can't do anything with and you're like, “Oh, this person needs resources,” and that's not your job, that's when you have the conversation with your team lead or your practice manager and just say, “Hey, I know someone on our team is struggling. Are there resources that are available for us as a team?” If you know what the resources are, sharing them yourself obviously, but also recognizing what is the context of your role here and not being afraid to ask for help for the conversations, that will help it stay on task here, because maybe you do need.
Maybe you are a team lead and maybe you've been struggling with this person because it is your responsibility, but look, if it's becoming a pattern of behavior, to your point about don't wait too long, the practice manager needs to be involved in that before it's to the point of like, “Okay, I've given this person 19 write-ups and now I would like to fire them.” No, no, no, no. Your practice manager needs to know when you're starting to have those conversations. “Hey, just a heads-up, this is a thing that's going on. I wanted to just put it on your radar.” Because then it makes the ask for help when you need to actually deal with the situation that much easier.
Dr. Andy Roark:
Yeah. Well, if you're a team lead, you know the first thing you need to do.
Stephanie Goss:
What?
Dr. Andy Roark:
Is sign up for the Uncharted Team Lead Summit on November the 8th. It's a one-day virtual event. It's only for team leads. There's nothing else out there to help team leads deal with this exact type of stuff and we're on it. So anyway, I know where you could find that, it's unchartedvet.com, team lead summit. I'd love to see you there. If you are the team lead, if you are the manager, if you are the peer, and this is so simple, but it gets overlooked a lot, lean into positive reinforcement. If somebody's tired and they're like, it's just a job and they've lost their passion for the job, one of the things that you can do that, A, helps correct the behavior and, B, helps respark their passion is give them-
Stephanie Goss:
Pull out the good things.
Dr. Andy Roark:
… positive feedback, catch them when they are doing a good job and just say, “Hey, thank you. That meant a lot to me. “Hey, I saw you do that thing. Man, you were amazing with that case.” “Hey, you were such a huge help for me. I just wanted to tell you how much I appreciate your help.” And you'll say, “But that's not fixing the negative things they're doing.” And I go, “Nope, it's not.” But we all know how training works. If we positively reinforce behaviors, I don't care who you are, you can be trained if we positively reinforce behaviors, we can cause those behaviors to happen more frequently. And the other thing is, everybody loves to feel appreciated. Everybody likes to be recognized. It does not mean… And again, here's the other thing, some people are like, “But if they're making mistakes, I can't positively reinforce them.” And I go, “I don't know. Let's think about training that you and I know and have seen.”
Do we not give positive reinforcement to a dog that we're trying to train if they have a mistake somewhere? No. We immediately set them back up to succeed and praise their successes. And again, I've said this a million times in case you haven't heard me say it. When I talk about training dogs, look, we are all simple animals. I don't care who you are. I don't care how many degrees you have, I don't care what your role is, you're a simple animal. And so when I talk about this, parallels between training dogs and people, I don't care who the person is, this is how mammal training works. It just is.
Stephanie Goss:
I love that.
Dr. Andy Roark:
Just making that clear.
Stephanie Goss:
I love that.
Dr. Andy Roark:
Cool. We're going to wrap up here real quick. I think you already hit on the big ones. If you're management, one-on-one meetings are your friend. Let's set a cadence. Let's get back in. Let's do check-in meetings so I can continue to support you and see how things are going. That's it. Pick your metrics. How are we going to measure success? What are the things that we're looking on? You don't need metrics as far as, I want to see your customer satisfaction scores, blah, blah, blah. I want to try to give clear examples of what I'm looking at and what I care about and how I'm going to measure success so that me and the person are both looking at the same things. I want to avoid the thing where they come in and go, “Man, did you see how I turned it around last week? I was amazing. Man, I did all the things right.”
And you're like, “Actually, the three things that I care the most about you did again, and I am wildly unhappy with you.” That is such a hard thing when they think they did good and you think that they didn't do good, and you have to tell them that, heartbreaking. And so just try to get that clarity. But again, that one-on-one, doesn't have to be a ton of time. It can be a five-minute check in, but set that cadence, put it on the calendar because otherwise you know it's not going to actually happen. Put it on the calendar, make sure it happens. Lock eyes. Talk about what we're doing, remember to lead into the positive reinforcement. A lot of these people, the fastest way to turn them around is to celebrate them. And that may not seem like it's true, I promise you it is.
Stephanie Goss:
I love it. I love it so much.
Dr. Andy Roark:
Cool.
Stephanie Goss:
Okay. I think that's all I've got except go sign up for the events that we've got coming.
Dr. Andy Roark:
Exactly. Right.
Stephanie Goss:
That's the ending of this episode.
Dr. Andy Roark:
Yeah. Head over to unchartedvet.com. We'll put a link down the show notes. Like I said, virtual Medical Director Summit. Again, there's not a lot of leadership training, there's not a lot of support from medical directors. If you are a regional medical director, you're a medical director over a… If you're a doctor and you oversee multiple hospitals, this is the best thing I think you are going to find for your role. I think you have a lot to add here. We've worked with literally hundreds of multi-site veterinary medical directors. We have done so much of that in the last couple of years. I think we got something really special for you, so come and check it out. Anyway, that's all I got.
Stephanie Goss:
Yeah, I love it. And if you're a peer and you're listening to this, good for you. I mean, good for you if you're a manager or a team lead, but especially if it's a peer who was writing this, good for you for recognizing it and asking the question. And this is what Culture Conference is all about. We're going to talk about all of that there. So there's something for everybody. You can head over to the website, unchartedvet.com/events. We'll show you all of them and you can sign up. Otherwise, have a fantastic week. Andy, I'll see you face in a few days at AVMA.
Dr. Andy Roark:
[inaudible 01:00:15]. See you very soon.
Stephanie Goss:
Take care, everybody.
Dr. Andy Roark:
Bye, 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 podcasts 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.
