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Vet Tech

Jun 05 2024

My Boss Oversteps Boundaries

An associate veterinarian who loves their job, is struggling with a practice owner's overbearing management style that pushes the boundaries of work-life balance. The team receives numerous emails and texts on their days off, and the feedback is often negative and micromanaging, creating a stressful work environment. Dr. Andy Roark and practice management super nerd, Stephanie Goss get real vulnerable sharing their own experiences with similar challenges. Together they offer insights into setting boundaries and fostering a positive workplace culture while taking our listeners on another ride to Camp Tough Love. Let's get into this episode…

Uncharted Veterinary Podcast · 290 – My Boss Oversteps Boundaries

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

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

Submit your questions here: unchartedvet.com/mailbag


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Episode Transcript

Stephanie Goss: Hey, everybody, I am Stephanie Goss, and this is another episode of the Uncharted Podcast. This week on the podcast, we're taking a letter from the mailbag from a team member who loves their job, loves their team, loves their practice, and they feel like they have a practice owner who oversteps personal and professional boundaries and really focuses on their the negative. This one's a little in depth. We got a little a little excited, a little heated, maybe a little bit vulnerable as well, as Andy and I both shared some stories from our own personal challenges on the road to becoming a leader. And It was really fun answering this question. Let's get into this.

Dr. Andy Roark: And we are back. It's me, Dr. Andy Roark, and the one and only Stephanie leave a message and I'll call you back Goss. 

Stephanie Goss: That one's so appropriate. I like that one.

Dr. Andy Roark: I thought– I was very proud of that one.

When we did this episode, like, if you haven't picked up, every, every one for the most part ties to the episode that we've got. I– some of them are subtle, some of them are a stretch, but there's always some tie.

Stephanie Goss: Some of them are a stretch. How's it, how's it going Andy Roark?

Dr. Andy Roark: Oh, it's great. It's great. I am fired up. Today, tonight, tonight, Stephanie Goss, my triumphant return to improv comedy. I took, I took six months off, and I am glad that I did. I am really glad that I did. I, when six months ago they have, so the comedy group that I'm with, they have seasons, which I think is really nice.

So they have seasons and they have a little like break time in between the seasons. And but it's a, it's a theater and, and they, but they have seasons and I, Realized that I, because in order for anything to get done in my life, it has to be on my calendar. So like, you know this, I live on my calendar and so improv goes on my calendar.

And six months ago, improv shows and practices were no different to me than Uncharted meetings or or visits to,

Stephanie Goss: Right. Work.

Dr. Andy Roark: You know what I mean? It was, they were just blocks on my calendar that I got up in the morning and I was like, Alright, looks like I've got a 7:30 p.m. to 9:30 p.m. commitment tonight. And, like, it was, it was, I just, the fun had kind of bled out of it. 

Stephanie Goss: You weren't having fun. Yeah.

Dr. Andy Roark: It was just, it wasn't that I was, I wasn't unhappy. But also, I wasn't, I wasn't looking for, if you were like, Are you looking forward to improv tonight? I would, I've not, I would not have yeah, I'm not dreading it, but also, no, it's, it's just a thing that I'm, It's right, because one more thing on top of everything. It's one more thing. Yeah. Again, and I'm blessed to have a job that I really love. So like, my calendar is full of things that I like just fine. And so anyway, but it, the magic was definitely gone. And so I, I thought I was quitting improv. It was actually kind of a little bit challenging for me. But I was just like, I, I just, this isn't doing it for me.

And my friend who runs the theater really encouraged me to take a break. And he was like, just take, just take, you can always come back. And you know what I found in life, Stephanie, is that you can always come back, and like, I did not believe that for a long time. I always thought that if I stopped practicing for a while, I could never come back.

I always thought that if I stopped traveling and speaking, nobody would invite me to their conferences anymore. And I can tell you, after just not doing anything after the pandemic, and starting to pick it back up this year, that's just not true. People will invite you back. And if you have good relationships and you take care of people and you, especially if you communicate like, Hey, I love you.

I just, I need a break from this. And then you, the door's always open to come back. And so same thing with comedy. And you know, I, I wasn't really, I, I had enjoyed having six months off and my friend reached back out to me and says, Hey man, the new season's coming. We've got a team that's getting together.

I think you'd be really, I think you'd have a lot of fun on this team and they, they could, they could use you. And man, lo and behold. 

Stephanie Goss: So, here you go.

Dr. Andy Roark: I was like, you know what? It's funny. We left, we left lunch and I said to him, you know, I did not have getting back into comedy on my bingo card today. I did not, but I, I have been so excited about it ever since that.

And um, and so, yeah, we did. We had a little audition meeting for the theater and I was like, yeah, this is this. I, I like this. Like, I'm, I'm good at this. I like it. I just, I had, I had no idea. I had started to miss it and now I'm like, yeah, this is, it's feeling like opportunity and excitement and not just another thing on my calendar.

So anyway, I think that people should take more breaks. I think people should take more breaks from hobbies. I think people should take, I think you should take breaks from your family. I think if you just want to leave for like six months, they'll take you back. You can just go away if you want. I don't know, that's not a thing that I've seen, but if improv comedy and having a family are anything alike and I think they are, then we should have, first of all we should have family seasons we should just, a grown up should get a, they should get an off season and the kids can just kind of be feral and like raise themselves for a while and then I'll come back in and everybody's gonna be recharged and ready to go.

Stephanie Goss: There is, as a parent, I, like, I want to acknowledge the truth in that, not, not leaving for six months, and I, as a parent, being on all the time, you need a break, you need a break, and, and for a whole million different reasons. Some of us are in positions where we don't get a break or we are on 24/7 and you know, I will say like I, I, I love my kids and to your point, getting to step away and look at, look at it and say, this is amazing.

Like this is why I love them and I do miss them and I'm excited to come back home. Like I think about it that way when we travel and I get asked, you know, do like, I get asked by friends who have kids or friends who have especially new kids are like, is it so hard to be away from them, from them?

And I always felt guilty being the, being the one who was like, No, because everybody else was like, Oh, I miss my kids so much. And I'm like, I'm, I'm a terrible mom. And there's truth in that for me that I am a better parent. I'm more present. I'm more grounded. I can, you know, keep my S together when I just want to lose it so much better when I have had a break and I have been able to be,

you know, me and like. Or like you said, do something that I really enjoy and then come back you know, able to like handle it and that's, I, you know, I really in joking, you know, taking a six month break and like, that's why I love having a village because sometimes you just, you got to take a break.

Dr. Andy Roark: Yeah.

Stephanie Goss: Sometimes you just gotta take a break. 

Dr. Andy Roark: Oh, I think that's true. That's one of, that's one of my knocks on, on pro sal compensation for doctors and like I'm not anti pro sal or anything, but I, but when I was practicing full time, you know, and that was my 100 percent my job, I never took actual vacations. I would always, the most I would do, I would take a, a Friday, maybe a Thursday and a Friday, but basically, and then I would be like, Oh, I got three days off.

I feel good and maybe it's just because I was younger, maybe I felt differently or I don't know. Anyway, I would put that forward to, to, to vets that are out there in practice. Like I know that it's a, it's a lift to really get off. But I think, I think getting away, away from the practice and I don't mean getting away and letting them call you with questions.

Stephanie Goss: Like truly gone.

Dr. Andy Roark: I mean, just not being a vet for two weeks. I think that that might have a significant impact on some people if they were to be able to pull it off. And again, I know that's not easy, but I'm just saying

Stephanie Goss: Yeah, we–

Dr. Andy Roark: I underestimated how much getting away and like really being away would impact me.

Stephanie Goss: Yeah, we have an episode. It's, it's an, it's, I think one of our OG episodes. I think it might've been in our very first season. But, but maybe maybe a little bit further in, but where we talked about ProSal and I think we talked about this, this episode is not about ProSal, but we talked about that and I really firmly believe in, have always like I'm a big fan of ProSell and the reason that I'm a fan is because I always did my calculations and factored in whatever their vacation is because you can't give people time off and then not allow them to take it. And so for me, then it would, their pay formula was basically, based off of if they're going to get four weeks of vacation.

Like you subtract that and then you start the, the piece. So if they want to take more than four weeks, yes, that impacts it. But if I'm going to give them the time, I want them to be able to take it and actually truly walk away because otherwise you're not letting them take that time.

Dr. Andy Roark: Four weeks?! What did you have a practice in Holland? That’s not America, Goss. We don't do that here.

Stephanie Goss: Says, says the man who runs a company with unlimited off.

Dr. Andy Roark: I do have, we do have a limited time off. That is true. 

Stephanie Goss: Anyways so we got, we got a mailbag question that was, that was great. I always love it. When Andy loves to hear how much people love us. I always love it. When people tell us how they listen to the podcast and this one came in and they said that they listen on their way to the clinic to get themselves in a positive and motivated mindset to start my day in their thank you.

And so I, I appreciate that. They were also was fawning over Andy and how amazing the, the, the podcast is, but 

Dr. Andy Roark: I didn't see that in the notes. Did you edit that out? I think you deleted that before you put it into the into the notes. Mm

Stephanie Goss: Anyways this person gave a preface that I think is really important, which is. They love their job. They love the profession. They love patient care and, and their team. And there's a situation going on at their work that they're really struggling with. And, and there was a lot of background information.

We're going to use some of that, I think, as we, as we talk about it. And, I think that it sums up with this person is, is struggling because they have a practice owner. It's a small practice. There's one vet who is the practice owner. It's not a partnership or anything. And that, that is really pushing the boundaries when it comes to work life balance.

So the team gets lots of, for example, the team gets lots of emails or texts on their days off. And, the biggest challenge, I think, is that they are they are really negative in their feedback to the team, and it comes across as micromanaging as well, because what is the focus is on pointing out the flaws.

And so the end result is a team where they feel like they're getting tons of work on their days off and they feel like all of that work is framed very negatively. Whether it's this client didn't, you forgot to call this client back or hey, you know, this, this thing happened and it's because X, Y, Z didn't do their job kind of a thing.

And so this this doctor is like, hey, Hey, what do we do about this? Because I really do love my job and this practice owner is making it miserable because I feel like it was funny. They they said it feels like there's a dark cloud over your shoulder and. ever. You're just waiting to make a mistake and for that mistake to be corrected and pointed out in a way that feels demeaning.

And when I read that it like tugged at my heartstrings because been there and I have been in that position where you have, you feel that way at work and it's a crappy place to be. And so anyways, their, their whole ask was like, Hey, when you, when you love your job, is and this is the work environment,

what do you do about that? Especially if you're in a place of potential influence, like being an associate vet or being a, you know, team leader or whatever.

Dr. Andy Roark: Yeah, this was this really spoke to me. So I want to highlight something before we get into to headspace This person said very clearly, I love my job, the profession, patient care, and the team, and that's important. This is not a toxic relationship, necessarily. Well, there's some toxic parts about it, but this is not something where this person feels beat up or abused, and I, I think that's really important, because I'm gonna go forward under that guise of, there's obviously a lot of good things about this practice and this team.

Let me start by being a little bit vulnerable here and telling a story. I spent my 30s afraid that the wheels were going to fall off of the company that I built and the things that I did. I just, I was motivated by, I was motivated by fear. I was always worried that that there would not be enough resources to support the people that I brought on.

That that, that people would lose interest in what I was doing or, or what our company was doing and things like that. And there was no amount of history that seemed to be able to talk me out of that. Looking back, it was like you were successful again and again and again, and I was always afraid and I don't know if that's just what it means to be in your thirties to to run, you know, just try like afraid that it's going to come apart.

But that's that's how I was. And so how it felt to work for me. Based on interviews with a lot of people who, who were there is I was always blessed to have people who saw the vision and I think they saw that I was in it for the right reasons and they, I think they saw how much I cared about them and how much I cared about the profession and they felt like they were a part of something that mattered and I, and that was authentic.

Like I wanted them to feel that way and that's true because that's how I felt.

Stephanie Goss: Right.

Dr. Andy Roark: But I also think that there was a lot of weight that I put on them because I cared a lot and I worked all the time. You know, it's funny one of my employees back in the day, people would ask her You know, what's, what's the secret?

Why is, why has Andy been successful? And she's like, he never stops working. And like, I like my job and I like to work. And so I, yeah, I, I work a lot and I was always worried. And so what that meant from an employee standpoint is they, I think, I think the people who worked for me cared a lot about me and about what we're doing.

And they didn't want to let me down. And they saw me working all the time and I showed them me working all the time. Like I was very transparent about what I was doing and, and then I would message them, you know, in the night and stuff like that. Not with any, any, and honestly, no, no intention they respond, but I, I wanted to get it off my plate or I wanted to be there if they were available or if they saw it, maybe they could just let me have this answer so that I could keep working at home and things like that.

And so that's, that's how I ran my company and I don't think I, I don't feel like it runs like that really anymore, Stephanie. It's, there's still, I still care a lot and I still work a lot, but I, I, I. I had to come to some realizations that I'm going to talk about in this episode a little bit about kind of why I was behaving that way and what that would look like.

And so I want to start this with great empathy for the business owner, the business leader who's doing these things. And I take the fact that this person enjoys their job to mean to me that they're not a villain, but I suspect that they probably are running kind of like I used to run. And so anyway, that's, this is sort of a personal episode for me, I think, just because I really, I see this person through this letter and I go, yeah, I think I know who you are.

I think I know, know what you are, cause I'm it too. And so anyway, I think, I think the first sort of opening part for me is like, I think. Starting with some empathy for this person is probably the healthiest part of headspace. At least it's the part that I want to start with.

Stephanie Goss: No, I I think

Dr. Andy Roark: You were there for some of it. Do you, did you have that perception?

Stephanie Goss: I, I was, I

Dr. Andy Roark: You were there for the tail end. You were there for the tail end. I got, I got, you helped me get better about running that way, I think. But you were there for some of it.

Stephanie Goss: I can't, I don't know what you're talking about, me opening my mouth and telling you. I'm telling you the truth.

Dr. Andy Roark: Yeah, I

Stephanie Goss: No, I, yeah, I mean, I think, so first of all, like, I, I think both of us will probably be a little bit candid because to, to your point, I have experienced I, I have actually experienced both sides of this.

And so I agree with you, like, I think, especially if the person involved in this case is a business owner, I think it is really important from a headspace perspective to ask yourself the like, what stories could I be telling myself here? And it's really easy to immediately lean into like, They're driving me crazy.

They're micro, they're asking me, they're micromanaging me. They're asking me to micromanage everybody else. They're not respecting my boundaries. They're texting me on my day off, all of those things. It's really easy to get into that headspace. And I completely understand why, because I have been that manager who is like, for the love of Pete, if somebody else texts me on my day off, I'm going to lose my mind, right?

I have, I can empathize with the manager here and I can empathize with the business owner, because when you have. what feels like the weight of the world. To your point, Andy, when you have employees that you're taking care of, there is always a little bit of fear. And I would say if you don't have a little bit of healthy fear, if it's always cowboy up, like it's probably not a good way to live either.

It's got to be somewhere in the, in the middle. And to your point, it's really easy to slide into that place of fear and always be working. Always be trying to go harder. Always be trying to make sure that everything is, is happening the way that it's supposed to, because you feel like you are responsible for the people on your team.

And so I think you know, you, you were really vulnerable and candid there with, with speaking to your own experience. And I think it's a really healthy place to start the headspace that just having this conversation really requires the ability to have empathy and try, really try to ask yourself the question of what else could be happening here and try and put yourself in someone else's shoes on both sides.

Because in order for this practice owner to change, they're going to have to understand what that , what the impact of that is on their team, including our writer. And to your point, I was there. And I think that I can say that some of the conversations that you and I had, although exceptionally painful, I think, probably for both of us.

You have to be able to see the other side and you, you know, I could see you working so hard and trying to, trying to impact and grow because I could see that you were worried about all of the team and taking care of everyone and I also could see the impact and the perception as someone who lives on the West Coast and could wake up at 4 a.m. my time where it's like 7am Andy's time to a whole list of messages that felt overwhelming.

And to your point, yeah, as I would like just speaking candidly, because you and I have talked about this before, like, it is overwhelming as a team member to wake up at 4am and be like, Okay, in my head, rational me knows you're three hours ahead, you're just getting a head start, you want to get things off your plate and get moving.

I knew that you didn't expect me to answer, necessarily. And I also knew there was probably a part of you that was hoping I would answer back so could get on with your day. And so I always had, I had this feeling in that period of time, like I had to always be on. And like this, this writer was saying that that feeling of when you're on your day off, like if you don't answer, are they, are they, and everything just piles up, are you going to be in trouble or someone can be angry at you because you didn't do your, do your job when it's not really the way that it is?

You're supposed to do your job, but it, but it feels that way. And so I think the, the ability to have empathy and put yourself in both sets of shoes is really important here.

Dr. Andy Roark: Yeah, I don't think people felt like they were going to get in trouble, in my experience. But they did feel like they were letting the team down. And that was, and I didn't realize at the time, I didn't realize how powerful that was. And I didn't necessarily realize how much control over that I had. And so anyway, those are, I can't, I don't, I can apologize, but it's, it wasn't.

It wasn't intentional. I didn't know. And you just, you have to I'm being open about this just because I would love to speed some people through this part of the journey.

Stephanie Goss: Right. Cause it's painful.

Dr. Andy Roark: I had to, I had to wade through it by myself and took a long time. So there's that. The other thing I would say too is I don't think you have to be a business owner for this. I think you just have to be a person who's under pressure.

Stephanie Goss: Yeah.

Dr. Andy Roark: You just have to care about your job and to be under pressure. And that can lead to these. Okay, cool. So let's get into this. So overstepping boundaries and focusing on the negatives, right? Those are fear based behaviors, as I said from my own story.

Those are fear based behaviors. Why do they reach out to you in the evenings, on the weekends? Why is everything negative about this isn't working, this is broken? So it's fear. So number one is, this is not working. We're making mistakes. We're not doing it. going to make it, whatever that it is, it is those kinds of emotions that, that drive the person to, to reach out.

They are not reaching out because they're megalomaniacs. They're not reaching out because they want to manipulate or control you for the most part. I, that's not anything I've seen. It's not because they're greedy and they want to make more money. It's generally because they're afraid at some level, and it may be, they might not even recognize that they're afraid, but those are fear based behaviors, right?

Catastrophizing and you and I joke about this all time about me living in a box in the woods. And again, those are the things that motivate you to reach out because you're like, Oh my God, we don't have this thing. We don't have this paperwork. This person is upset and I don't have the time to engage with them and they're going to quit.

And they're going to write a one star Google review saying they're ex employee and then the news is going to pick it up and they're to be on CNN and are Clients going to see it, and then they're going to believe that we're monsters, and then we're not going to be able to make our rent, and the bank is going to take my house and kids college funds, and I'm going to get divorced, and I'm going to live in a box by the river. 

Stephanie Goss: Yeah, I was going to say, that's when we know Andy's in his box in the forest.

Dr. Andy Roark: when I'm living in my box in the forest by the river. And that's how I get there, because you weren't available on Wednesday afternoon when Tina was having a meltdown because we canceled bagel morning. That's why, that's why I'm in the box in the woods. And that sounds so ridiculous.

That's classic anxiety behavior of catastrophizing. And so, like, I see it all the time. Okay there's, part of catastrophizing is this idea of the spin up of this has, I have to, and this is where the, the immediate negative feedback comes from is if I don't say something, this going to continue, other people are going to see it, and then they're going to start doing it, and so you feel compelled to say something right now.

And it's negative because you're not like, again, there's no urgency to give positive feedback. There's no urgency to tell someone that they're awesome or they're doing something great. But the idea that they're going to do something bad and other people are going to do it that way, or it's going to have all of these problems associated with it, and it needs to stop right now.

There's urgency on the negativity that's on the positivity. And so you just can't tend to get those things. And then there's also for me, part of it, the last one I'll just say real quick is, you know, as a sort of a busy person, I very much would always worry about forgetting things. And so I'm like, well, I see this.

I'm just going to go ahead and send her a note right now because it's top of mind and I don't want to forget it. And again, that was, egocentric behavior in that I want, I did want to, I wanted to, I didn't need you to respond, but I want it off my plate. But what I didn't really understand, what I think a lot of people don't understand, is sometimes taking something off your plate and putting it on someone else's plate, is putting it on their plate on their day off.

And they're going to see it there, and it's going to rob them of some of their ability to unplug and relax. And again, it took me a while to realize that. You can still take things off of your plate and put them into a Google document that you have on your phone and on your computer that you will reference when you get back into the office, or you're going to put them into Slack and you're going to hit the schedule message button to kick back in when the person is in the office and they'll get the message at that time.

But those were all lessons I learned, but that was the, that was the fear that would drive those behaviors for me.

Stephanie Goss: And I think the last two, well, all of them are, are super valid in the clinic. And I think the last two really for me and my experience in the, in the clinic have significant weight. It's the idea of like, if I don't stop this, right. Now, then something else is going to happen to your, you know, like someone else is going to start doing it, but you know, the, the spinning out, that's the, that's the start of the spin up.

Like you said, I think the last one is the most, the one that is, carries the most guilt in the practice, because let's be real, being in the practice is chaotic. It's crazy. It's busy most of the time. And so for a lot of us, and I say this myself is this was one that I, I'm still guilty of and have to work really consciously to avoid doing, which is I am super busy.

And if I don't say this thing, if I don't write it down, I will forget it. And so I think it's that way in the clinic of like, Oh, and I, cause I always used to wonder why everybody would do like the drive by, like I would be at the front desk and I'd be working and someone would be like, Oh, walking through, Oh yeah, by the way, you know, the, anesthesia machine is broken and we need you to call Patterson and it's like, I'm, can you see that I'm clearly helping a client and am I, am I going to, like, am I going to actually absorb that information?

And so I, and I know there's no mal intent on the part of the person who's telling me they're like literally walking by, they're like, I see you, I'm going to tell you. So, and I think in some ways that is even harder when you're, when you're Not face to face, because like for us and our team, like you said, we can't see each other.

So if someone walks by me in the clinic and sees that I'm talking to a client, it is easier for their brain to process that and be like, Oh, cool. I have to write that down to your point. And I can tell her about it later because she's with a client. You still are going to have people who operate from that place of fear of like, I cannot, I have to get this out because if I don't get it out, I'll forget it.

So they're going to say it. No matter that you're in front of a client or not, but when you work on a team that is remote or you have a hybrid team, I think it's really, really important to acknowledge that when you can't see each other and you don't know what other people are doing, this is the hardest, hardest piece of it is the, I'm just going to say it right now, because if I don't write it down, And the impact of that is that you have no idea what the other person is doing.

You don't know if they're with a client. You don't know if they're working on something. You don't know if they're on the phone, etc. You can't see that. And so I think that that makes it even harder to, to get into the right headspace and stop catastrophizing when you can't see each other.

Let's let's take a break here and let's come back and let's get in some action

Stephanie Goss: Okay. Sounds good.

Hey friends, in just two weeks, me and some of my favorite Uncharted team members, Dr. Andy Roark, Maria Pirita, CVPM and Tyler Grogan, LVT, will be at NAVC's HiVE event in Minneapolis. Now, I am super excited to be presenting a brand new sneak peek at some content that we are dropping late 2024, early 2025, the number one most requested thing that we have been asked for is training around conflict in practice. Whether that is peer to peer conflict, conflict between the front versus the back.

We all know that conflict exists in veterinary medicine and so we have spent some time putting together a brand new certificate on the essentials of conflict management.

 And it's not ready yet , but we are going to do a sneak peek of the content at this event that we are doing in conjunction with our friends at NAVC. So we will be in Minneapolis. It is happening June 15th and June 16th.

And because our friends at NAVC are awesome. They put together a deal where you can go to HiVE for one day and you can pick which day you want to go and then you can spend a day with us at Uncharted getting a sneak peek at the conflict management essentials and doing a whole day on conflict within the team.

So you go to our website at unchartedvet.com/events. You can find the information about conflict management essentials at NAVC HiVE. You can find out all of the details there and there are links that will take you to NAVC's website to let you register. 

There's an option for Uncharted at NAVC HiVE and it will let you register if you want to do the event with us. And this is really, really important because you can't just go to HiVE and then drop into our session. You have to register. So, go to unchartedvet.com/events check out all of the information we've got about the program.

Then head over to NAVC's website using the easy link and find out more, register, and then shout out on social media. Tell us that you're coming to join us. We can't wait to see all of your faces in just two weeks in Minneapolis. And now back to the podcast! 

Dr. Andy Roark: All right, we're back for some action steps and I have action steps for the leader here, the person sending the messages and giving the negative feedback. We're going to Camp Tough Love. yah! 

Dustin Bays: All aboard! Well, it's Camp Tough Love, like drinking dish suds. See the creation of determination. Get ready for a SAFE talk, you might need a stress walk. That's what we do at Camp Tough Love. 

Dr. Andy Roark: Alright, Camp Tough Love. Here we go. 

Stephanie Goss: We’re back again.

Dr. Andy Roark: I need you to, yep if you have the thought, everyone here should care as much as I do. Or they don't care as much as I do. I need you to hear this. Step one action step for you, my friend, is acceptance. Some Pet owners will never care as much about their pet as you do. They just won't. And some employees will no, most employees, all employees, will never care as much about the business as the person who owns it does.

Other people, some of us, live to work, and some of us work to live, and that's not right or wrong, good or bad. 

Stephanie Goss: Right, It’s just different.


Andy Roark: It's who people are, and it's what they want, and some people that you fall in love with will not love you as much as you love them, and that is just how it is. You cannot change other people and honestly, the idea that someone who doesn't own a business is going to care about as much as a person who does, that's, that's ridiculous.

It's just, it's not true. It's never going to happen. And, and even this, like, people who show up and enjoy their job and punch the clock and go home, they're not, that's not bad. That's probably healthy. They, they're not going to care about this as much as you do. Get used to the idea. Get used to it. Accept it, right? These are grown ass people, and they're going to work this job as long as it's good for them, and if it's not good for them, they're going to go somewhere else.

Stephanie Goss: Right. Right. 

Dr. Andy Roark: And if, and if your company goes out of business, you know what's going to happen to them? They're gonna go get a job somewhere else. That's it. That's the honest to God's truth. They will go on, and they won't think about you after a couple of months. I mean, they'll remember, but yeah.

Stephanie Goss: And as, as an owner, your brain tells you, if I go out of the, if I go out of business, if we don't, if everybody doesn't work as hard as I am and we go out of the business, it will be the end of the world. And I think the acceptance piece as the owner and the leader is to recognize, it won't be the end of the world. Like, you can go out of business and then still go and be a veterinarian and be a successful veterinarian. You might even own your own practice again after failing the first time. Like, failure is a part of life and that acceptance is really, really important.

Dr. Andy Roark: Absolutely. The best quote on this, the one that has given me comfort many times is this quote from Charlie Munger. He's a Warren Buffett's business partner. And Charlie Munger says, he says, any business that cannot withstand a bit of mismanagement is no business at all. And what that says to me is if your business cannot handle some bumps in the road and make it until the morning your business was already going under. Like that's that is if that makes the difference you were already toast. You are never going to make it and again that may sound ridiculous But that is how I that is how I saw it is andy if your business can't stand up overnight Without you harassing people, then you did not build a business that was strong enough to survive anyway.

And I, I don't know if that helps other people, but that was a big dose of acceptance for me. And I just decided that was true. And so if you can't let people be off, then your business has already failed. And if you can't hit your numbers without sending people text messages after they've clocked out and gone home, then you don't deserve to hit your numbers. Like that's it. You don't, and you're not going to. And if you do make it, it's not going to be worth it. Cause you're going to damage those relationships and stuff. And so I just had to come to the hard realization that I have to make my business work and run my business and manage my people during the hours that they're clocked in.

And that is a, like that is playing on hard mode compared to these people who are at my beck and call 24/7/365. But that's real life and that's part of being the type of person you want to work for is playing with those restrictions on yourself. And again, I'm not trying to shade entrepreneurs because again, I can say this now with a team of you know, eight ten people and, and, and we've got something that runs pretty darn well and we've figured a lot of things out.

Boy, back at the beginning, we ran real hard because we had to and so I'm not trying to shade people early on and maybe that startup mode, but that's not a sustainable way to live and continue to work in the long term. And so big Camp Tough Love moment is acceptance is key. Your business better be able to survive without you pinging people after they've gone home. And it better be able to survive with people, key people, taking days off. And if it can't, it's, your business isn't going to make it anyway. And you should just accept it and go find something else to do. And again, like, that's tough love, but that's, that's true. And so get it through your head. And everybody's gonna be a lot happier.

Now, that does not mean that you're gonna just throw up your hands. And it doesn't mean that you can't work when other people are clocked out and not working. It doesn't mean any of those things. It means you have to figure out how to run a business that involves you in engaging with your people when they're on the clock.

You need to figure it out. And I just, I, I, my tolerance for, People who continue to message their people through the weekends. And so it's gotten lower and lower as I've gotten older. And again, I used to be, and that's why I feel comfortable saying this because I was the worst. I was a bad offender and now I can speak inside. I've been there. I see it. I know why you're doing it. You got to stop. 

Stephanie Goss: Mm hmm. Mm hmm. Yeah. And, and on the flip side, I think I can, I ha, I ha, like I said in the beginning, I have felt but cause I've been on both sides of the equation and here I think I can speak to the manager's perspective. Like I have absolutely been that manager to your point, Andy, who loves their job and loves their team.

And so I have absolutely convinced myself that if I don't. If I don't answer this text, if I don't answer this email, that it will be the end of the world. And I think your point about, about the Camp Tough love and recognizing that some people will care and some people will not, that acceptance is, is really, really important because you cannot, what you will do if you allow yourself to not have boundaries, and if you allow other people to not have boundaries, enforce their lack of boundaries on you, where you will wind up is burnt out very quickly.

Because I did that. I like, that was, that was me. It was like, I have to answer. It doesn't matter if it's 2am. It doesn't matter if it's, you know, my day off. It doesn't matter if I'm, if I'm doing something with the kids, I have to, it's my job as the leader of the practice to take care of all of these things.

You know what? I'm not gonna be able to do my job if I can't show up tomorrow. And I say this openly and candidly as a. You know, I, I have been in long term recovery and so I can say this jokingly, but I am a workaholic as well. That is part of my addiction. That is part of my addiction cycle. And I have to work really consciously to not be that way.

To your point, Andy, now it's not because I feel like I have to, it's because I love my job and it's really, you know, it's like, it's really easy to be like, I love who we, I love our clients. I love what we do. It's really easy to be involved 24/7 because I love it. And that is my, that is my challenge as a workaholic.

Now I'm doing it, not because I'm afraid I'm going to, you know, not do my job or someone else is going to perceive me as not doing my job. If I don't do it more, Because I love it and I still have to have boundaries because you know what, I was that manager who worked myself into a place of burnout. And I can tell you now that my kids are teenagers.

I regret the hell out of missing their, basically their infancy and toddler dumb, because I, Worked myself into a place where I was convinced the world would end if I didn't jump whenever someone needed me and I missed so much of what I wanted out of that part in their life and it's, you know, your point is that the cliches are are true.

It is totally true. Everybody told me like, Oh, you'll blink and this will go by so fast. And now looking back at it, like, I do have regrets. And so when we talk about this and we talk about boundaries you know, I've had a lot of people say to me, and I know you have had this experience as well. Like, I really appreciate how open and, and honest you guys are about talking about some of these things.

And I think it's important because nobody, nobody talked about it. And I remember the first time someone told me like. I regret that period of my life. And, and so I'm working to make it different. And that unlocks something for me as a manager, because I, I like you is, you know, I regret a lot of those things that I did in my younger phase.

And so part of it for me now is like, in order to break the stigma, just talk about it. You know, we have to talk about the fears to your point. You have to be open as a business owner and talk about how it feels because it is scary to feel like you have the weight of your team on your, on your back. And it's the same for a manager feeling like, Hey, I, I want to take care of my family.

I want to be there. I want to be able to be a person. I want to be able to have work life balance. And I also really love my job and I want to take care of my team and I want them to think that I care about them. And if I miss this phone call, are they going to think that? That place of anxiety is a, is a really easy place to get to.

And I agree with you. Like the Camp Tough love piece is you gotta, you gotta accept it. You gotta have boundaries. 

Dr. Andy Roark: Whenever we talk about boundaries, cause I, cause I, I'm on board with you. I just want to be really clear about this. Whenever we talk about boundaries, to me there's two pieces. There's personal boundaries, and there's practice boundaries. And I think sometimes we screw employees over by saying, you should have better personal boundaries.

The reality is, no, your practice should protect you from having work pouring into your personal life and at the same time, at some point, again, when you're, when you're a workaholic you can't fault the practice if you're calling in asking people. How's everything going? Everything okay there? If you're texting people on your day off, then you're the one who has to have a boundary, but it's got to be both And so I think that's gonna be sort of my tough love for the manager. So my action steps for the manager.

The first thing I would say is, you know I tell you this whole story so that you might view this person with kindness and say okay I get I get it. I see them for what they are. I, I like to imagine people as, as 11 year old selves, like, you know, like middle school kids. If you imagine this person as an 11 year old texting, calling after dark, pointing out what's wrong, it makes it a little bit easier to just kind of, I don't know, kind of, kind of chuckle at it or recognize the behavior for what they are because we're all, we're all kids just masquerading.

And so these fear behaviors of. You know, telling people what to do and, and, and calling people, it's, it's all, it's all the, the, the inner child that's afraid is kind of doing it. If it, if, I don't know, that helps me to sort of see people a little bit more clearly. Remember, go in, go in for your safe conversation with your boss, right?

Can you, don't go in when you're triggered. Sit next to them, smile, assume good intent. How have they been set up to fail? What, here's my fault. What have I not communicated as far as my boundaries? Like, what should they not know about, about our communication style? And then what's the end result? Which is, what is an acceptable volume of communication to you? Under what circumstances is it acceptable for the boss to contact you? And maybe it's none. Probably it's we're probably not all or none, you know, it's probably there's probably some middle ground kind of there. But again, it really I'm not trying to there's no right or wrong. It's up to interpretation, but it's where you are, but get ready for that safe conversation. I think you need to be honest and kind with your feedback.

And so kind is not you're a monster. You're ruining my life But it's hey, remember remember our you know, our eye statements I feel this way. I, you know, I'm concerned that I'm going to burn out, and I can't, I won't be able to keep doing this, and that's a real concern that I have, and I think you should be honest about that, because if you don't give any indication that you're internalizing this, that it's affecting you this way, she's not going to know.

She, I mean, she can't, she should know, but she, she doesn't, and so if you don't communicate that, then she doesn't have the information she needs to change her behaviors, you know? 

Stephanie Goss: Yes. I think it's important that, that they understand the impact that it has on you, on the team, et cetera. Like how, whatever it is that you're talking about, they need to understand the impact. And it's really important when we talk about impact that it not be like you're pointing the finger or blaming them because that immediately makes someone defensive.

Right. So your point about, you know, when using the I statements and saying like, when you called me on your day off. This is, this is how I, you know, felt like I had to respond or this is how it made me feel, but not when you called me on my day off, it ruined my entire weekend, right? That's immediately going to put someone on the defensive.

That may be the case. You may have felt like your whole weekend was ruined. And if you lead with that, you will immediately derail any of the safe steps that you walked yourself through to be able to have that conversation with them because that person is immediately going to be on the defensive.

Dr. Andy Roark: And then the professional tool that we're going to reach for right here is the old Medical Director, Practice Manager, Ways of Working Tool. And so the Ways of Working Tool is the agreement that we have about how we're going to treat each other and how we're going to communicate. How do you like to be, how do you like to receive feedback?

When do you like to receive feedback? How do you want to have communications handled when you're not in the office? Like what works for you. Let's talk about how we want to be communicated with and and figure out, you know, what, what is going to work for us, but it's starting to have that open conversation is transitioning from this is how I'm feeling.

This is what my concerns are about the future to I would like to talk about communication strategies that are going to work for you. That are going to meet your needs and also that are going to meet my needs. And this owner, one of the things that I will say, if you were a manager of other people and your go to strategy is to message them when you have thoughts, instead of to collect your thoughts in a place that you'll be able to find them, you need to change up what you're doing.

And so one of the things I would recommend for this manager is to say in this ways of working conversation, let's go ahead and organize a standing meeting. So that you know that you and I are going to have some face time every week and if something is not absolutely burning on fire needs to be addressed right now, I'm going to ask that you add it to the agenda for that meeting and then we'll talk about it there and it's amazing.

So I mentioned early on for me, I would message people because I didn't want to forget what I was going to say. And what happened is I set up a nice little, I use Notion, but you can use Google Docs, you can use whatever. I set up a nice little Notion page with all of my team members, and when I have that thought, instead of going to Slack or text messaging, I go to Notion and I press their little face picture, and then I jot down what I was going to say, and I know that when we get together, I will have a list of those things, and it will not get forgotten.

And then I can go on with my day. But those are the types of communication tools that both of you should have. And so again, I would, I would frame this as it going both ways. I'm not going to message you on your day off because you need to unplug. And so I'm going to take these things and I'm going to add them to the agenda.

And if you want to know what's on the agenda, maybe it's a shared Google Doc, you can see what's there. Or you can ask me when you get back in the building and I'll tell you what's on the agenda. But, I'm going to take these things and save them until our meeting and you're going to take your things and save them to the meeting. And then we're going to have a really good, very action oriented conversation. And we're going to stop messaging ourselves all the time.

Stephanie Goss: And I think that this is. It's vitally important for people who are in positions of leadership. And it's usually the first thing that we skip. I think part of it is recognizing for how many of us have actually sat down with our boss or with our partner in the practice and said, what hours are we going to work?

And, and I think that it's vitally important for so many reasons, and the biggest one is just because you are invested in the practice, whether you are a manager, whether you are an owner, whether you're a medical director, if you are a leader, it does not mean that you work 24/7. I, like, I just have to put that down.

I think we put the expectation upon ourselves a lot as leaders in practice, particularly if you've been a practice owner. Being a leader means that we have to be able to handle whatever the practice is going to throw at us whenever it gets thrown at us because That's the role. That's bullshit. That's not the role.

That is a made up story that we have told ourselves in our head. Now, it may be a part of your job and I can hear people already being like, well, but I have to be on call. That's part of my job. Okay. On call is different because on call has a beginning time and an end time. You're not endlessly on call forever, 24/7.

And if you are, Like, that is not a sustainable lifestyle. I would advise you to, to think hard about that. I think that we automatically put that, that on ourselves. I did. I was like, well, I'm, I'm the manager, I'm responsible. And so of course, if there's an emergency at 2am, I should get a phone call.

You know what? It took me years to be able to really actually look at that in a healthy way and have the caught to your point, actually talk about it with my practice owners who, who literally, this was life changing for me, looked at me and said, No, if the fire alarm goes off at 2 a. m. and we had someone overnight in the building, or someone's overnight in the building, and they looked at me and they said, if the fire alarm goes off at 2 a.m., what the hell are you going to do about it?

I want them to call 911 and get the fire department to come. And that, it sounds so crazy to me now because it is so simple, but that was life changing for me to recognize I had never actually asked them. What the expectation was for me as a leader in terms of the communication.

And so to your point, if you have not actually sat down and had that conversation and there's tons of resources, I'll put some in the show notes that you can find online. Just, just Google like, ways of working or how do we work together? Working contract. You'll see so many questions that you can answer as a group to ask those questions of like, how are we going to communicate on our days off?

What are the way that we are going to agree to talk to each other? To your point, Andy, are we going to use an agenda and where is it going to live? And how do we both have access to it? All of those kinds of things are really, really important. And if you're on either side of the equation and you think that your position of leadership means that you have to be available 24/7, stop and have the conversation and ask the question because it is.

It can be absolutely life changing and for two reasons, because if the answer is, I expect you to be on call 24/7, then you have communicated it. You have been able to receive it. And then you as an employee or as an owner have a choice of what to do with that information. But if you don't have the conversation, you don't have the ability to do anything with it.

Dr. Andy Roark: That's exactly right. And I think some people are afraid of the answer they're going to get. They don't want to, no, they want to keep kidding themselves. That, oh, they don't really expect me to be available all the time. Yes, they do. I mean, maybe. I don't know. Hopefully they don't, but maybe they do. And, You know, we've had feedback from managers before that have been like, Oh, we have a group of partners and they all text me all the time. I've asked them to stop and they won't stop. And I'm like, well, they have told you what this job is going to be, and you have a couple options. You can go back and tell them how much it's going to cost for them to pay you, for you to do this job in the way they want it done.

Or, you can leave. Or, you know, you can do whatever. But, but once they told you what they are. But some people don't really want to, they don't want to believe it, and so they're afraid to ask. And so, nope. You can make that choice too. I, I don't want to hear about it. I don't want to hear about it. Eyes wide open, clear communication, this is what I need, what can I expect, and again, people are going to fail, like I said, we're starting with, we're starting with an open heart and saying, I see people are trying at some point, you're going to have to pick your poison, that's where every episode ends with, and pick your poison. And that's, that's where we're

Stephanie Goss: Well, because, because they ended their letter with, is this, like, do I just cut and run? Like, am I, is picking my poison the option that I might just have to leave my practice because I can't make another person change?

Dr. Andy Roark: Sure, I mean, and again, it's, it comes back around to how much do you enjoy your job? Cause they all said, I love my job. And I'm like, well, if you love your job. Then that's worth a lot, you know? And here's the other thing, too. Is, are we gonna flip a switch and have this problem go away? Probably not.

But we can wrestle it back. Maybe. I mean, I hope we can. But we can wrestle it back. And so, you're probably gonna still get some negative feedback. And you're probably still gonna get, you know, some text messages every now and then. But if you get half as much as you get now, would you feel differently?

Would that be enough? And maybe it would be, maybe it wouldn't be, I don't know. But at least, I mean, it's worth communicating where you're at. And then you're empowering the other person to say, well, she says she's gonna leave if this keeps going because she's gonna burn out. I have a choice to make. And the sad thing is they might not make the choice you want them to make.

They might be like, well, I'm gonna do it because I can't stop. And that's. It's funny, a lot of times we make those choices, and they're just sad. Like, they're sad because you wish people would be different than they are. But sometimes, again, like in my case, I heard it, and I tried, and I worked on it, and I'm not perfect, but I've come a whole heck of a long way. That's it. The last part, I'll just throw this in, and then we'll be done, but the last thing I would sort of say in this sort of Ways of Working, you know, conversation, two things real quick. I would, I would try to make sure you understand what the goals of the practice are. Which is, do you understand what the goals of the practice are?

Do you understand what the practice values are? Because if you understand what the goals of the practice are and the practice values are, you should be able to work autonomously. You should be able to make decisions. You know, like this, the, the owner should be able to go away. And if you know what success, what a successful day looks like, and they're like, but they're, well, you know, this thing didn't get done and you're like, but we, as we said, the most important thing is how the practice performed on that day and how the employees were treated and these other metrics. These metrics were all hit. We are fine. We will deal with these other things later, but you at least have equal footing.

If you don't know what's important or what the other person sees is important, then everything is important. And you're constantly getting text messages and you don't have an ability to push back and say, our primary objectives were met. This is something that we can handle when I get back in the office.

I will take care of it, thank you, and then be done, but, but that, it gives you that extra leverage, and the last thing is, after you've done these things, and you've talked about what expectations are, and how we're going to communicate, the last thing then, I think you go to what Stephanie said earlier, at some point, you have to set your own boundaries, and you need to compartmentalize, and so think about just the basic standard stuff I took slack off my phone, And I own the business and I took it off my phone because I'll be on it all the time.

And what I found is there's a barrier for me walking to the computer and firing it up and doing the thing. And usually, and now I still have my notes app and my notion page on my phone so I can easily make a note to myself. I can write it down, so I have that. But I just made that barrier, and then the other thing is, I don't check Slack, because it's not on my phone, and so if my computer's not there, I don't look.

And that works fine for me. If you have a business email address, maybe you're going to unhook that from your phone email app, so you're not checking your business email. And again, there's just a bunch of stuff like that that you can kind of do to give some boundaries and some barriers. And you're like, oh, she's going to go all around them and just text me.

Maybe she will, maybe she won't. It's not, it's not. There's a question of degrees to some point of how connected do you want to be? How accessible are you? So anyway, again, you're gonna have to go through this process. I think you have a good position Communicate with this person where you're at. They're gonna ultimately make some choices and you are going to listen. You're gonna give them some time to try to make these choices. Hopefully they will continue on in a good open communication style and then and then you're you're finally going to decide Is this good enough? To keep going forward or is it not and you're gonna make the call, but that's I think that's how this goes down.

Stephanie Goss: And I think it's the same too. I mean, we talked a lot about the work life balance and the call, getting calls on your day off and that kind of thing. And I think the other half of this you know, a letter to us was about the negativity focus. And I think that it's really important to say. The action steps are really no different.

You have to, you have to talk about it, and you have to talk about how it makes you feel, and you can talk about how it impacts the rest of the team as well. So this person loves their job. They love, they love their team, and it hurts them to see everybody feeling like they're getting only negative feedback and they're not hearing things positive.

And so, you know, your steps were like, you can't be triggered. You have to have the safe conversation. You have to be con, kind, and honest in your feedback. That goes for when you get calls on your day off, this, the same way it goes for, Hey, you know, yesterday when I made this mistake, and this is how you told me about the mistake and you give them one example, you don't have to give them a hundred, but you're giving them one recent example and say, this is how I, And I respect you and I know that you care about me and I know that you care about the practice.

And this made me feel really bad about myself. And I see that I know the impact that that had on me. And I see a similar impact in interactions that you have with the rest of the team. And I want to help change that, right? You can talk to them about what you're seeing, how it's affecting you, how it's affecting their team.

And then ask them for your help. And that's why I'm so glad that you said, I truly believe that people can change. And there are people that we work with where it is who they are. And for most people, you can change. It requires time, it requires support, and it requires patience. And I would say if your practice owner has been this way for a really, really long time Andy Roark, if they've been doing this for their 30s, and then you enter the picture, that's not gonna change overnight.

And I can tell you now, after Andy and I working together for, you know, seven and a half years, Now I can say, okay, I need you to get out of your box in the woods and XYZ is going right and Andy can now recognize that, not be upset that I called him out on the fact that he's spiraling and is in his box in the woods and go, okay, I can take a deep breath like that.

That can be the hint. And it took us a long time to get there. It's going to be up. It's going to be down and you have to recognize that because it's the same as training any other animal. It takes time and it takes patience and it's the same for us. And so I would say. You know, if you have to be able to talk about it, and sometimes for some people that's really, really hard.

 And you might have to write down what you want to talk about. You might have to practice it. But if you don't say something, if you don't ask the questions, you're never actually going to know the answer. You're just going to be assuming what the answer is. And you know what they say about assuming. That's all I'm going to say. So leave it there. Yeah,

Dr. Andy Roark: All right. Good deal, all right. Thanks Steph I feel good about this.

Stephanie Goss: Yeah, this was fun. Take care, everybody. Have a great week.

Dr. Andy Roark: Thanks everybody!

Stephanie Goss: And that's a wrap on another episode of the Uncharted Podcast. Thanks for joining us and spending your week with us. If you enjoyed this week's episode, head over to wherever you get your podcasts and leave us a review. It's the best way to let us know that you love listening. We'll see you next time.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: communication, culture, management, Vet Tech

May 29 2024

Do Wellness Plans Make Sense For You?

Shawna Castillo, Director of Care Plans at Otto, joins us to tackle a critical question from a practice manager struggling with client credit limitations. Despite offering CareCredit, Scratchpay, and VetBilling, many clients still face challenges. The burning question: How do we design wellness plans in a way that is not going to make my team or my doctors lose their ever-loving minds? Practice Management super nerd, Stephanie Goss and Shawna Castillo offer their perspectives on this subject. This week's episode of the Uncharted Veterinary Podcast is brought to you by Otto.

Shawna Castillo, with her 20 years of experience in the veterinary and animal health space, brings a wealth of knowledge to this topic. As a leader in people, processes, and technology, Shawna excels in influential team leadership, process improvement, client retention strategies, and customer success enablement. At Otto, she oversees the Care Memberships program, helping veterinary hospitals boost their economy, client retention, team efficiencies, and patient outcomes. Shawna's passion for understanding human and animal motivators and her love for using technology to strengthen the bond between pets, their owners, and veterinarians, makes her the perfect guest for this mailbag.

Stephanie and Shawna discuss the need for care plans, enabling pet parents, especially younger generations, to afford preventative care through manageable monthly payments. They discuss key factors to consider when designing care plans and strategies to overcome common barriers from associate DVMs, team members, and clients. Shawna's insights offer invaluable guidance for veterinary practice managers and leaders looking to implement effective wellness plans without overwhelming their teams. Let's get into this episode…

Uncharted Veterinary Podcast · 289 – Do Wellness Plans Make Sense For You

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

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

Submit your questions here: unchartedvet.com/mailbag


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Episode Transcript

Stephanie Goss: Hey everybody! I am Stephanie Goss and this is another episode of the Uncharted Podcast. Today's episode is actually brought to us by our friends at Otto. And it just so happens that I have someone who is currently on the team at Otto here with me today. 

And that is my good friend, Shawna Castillo. Now Shawna is actually here today because she and I are going to tackle a mailbag question. 

Shawna and I go way back. We were both practice managers together. We both worked in corporate medicine together, we stayed in touch when she left and went into industry. And Shawna has had a variety of experience on the business side. And she is currently the Director of Care Plans at Otto which goes to what we're going to be talking about today. 

Actually, we're going to be talking about wellness care in our practices, wellness plans, preventative care plans, whatever you want to call them. We are going to talk about how to make care accessible to our pet parents and how to do that in a variety of different ways. So let's get into this.

 And we're back. It's me, Stephanie Goss, and today I am joined by one of my favorite people in veterinary medicine. I am joined by my friend, Shawna Castillo and Shawna is currently, Shawna, what's your actual title with Otto? Because that's like, I don't want to screw that one up, because it's all professional sounding now.

Shawna Castillo: Yes, it very much is. I am the Director of Care, our care memberships.

Stephanie Goss: Director of Care with Otto, and I have known Shawna for a really long time. I feel like it's like, oh, I'm just talking to my manager friend. Shawna and I have known each other for years. We were both managers. We didn't know it at the time, but we were both managers within NVA practices at the same time.

Way back when and then Shawna and I met when she was working with our mutual friend, Dr. Stacey Santee at Vet2Pet and Shawna is one of those managers that I have just always loved connecting and nerding out with about a variety of topics. We'll, like, get on the phone to ask each other a question that should take 10 minutes and it's, like, an hour and a half later.

Shawna Castillo: Like, like minimum.

Stephanie Goss: Yes. But Shawna is here today because I got a mailbag question. I actually had several of them about wellness plan things and since that's Shawna's current role now with Otto formerly TeleVet, for those of you who are like, oh, what's Otto? I don't know that I've heard of it. I bet you have. It's our friends at TeleVet and Otto is the new brand because TeleVet is tele, TeleVet made people, I think, think of telemedicine and only that.

And so they have done work over this last year and a half or two years rebranding into Otto and really leaning into automation and AI and all of the ways that technology can really improve our practices. And we'll get into that today. But, Shawna, welcome to the podcast. I'm so excited you're here.

Shawna Castillo: Thanks, Stephanie. It's an honor to be here. I'm really excited to get into this conversation.

Stephanie Goss: Me too. So that I'm not gonna, I'm not even gonna attempt to like, read your official bio or screw up your info. So besides the fact that you started as a, as a veterinary practice manager, we've known each other for years. Do you want to tell everybody a little bit about yourself and your kind of where you're at with Otto now?

Shawna Castillo: Yeah, yeah. Well, I actually started as a veterinary assistant. I have about 20 years of experience in veterinary medicine, 15 of those are clinical. So I started, you know, as early as it was legal for me to get paid working in a veterinary practice. Doing all the things that I could do and I've kind of worked myself up and I've done basically everything except for be a doctor.

So that's been really cool. And my most recent position in a clinical setting was a practice manager. I was also an area manager for a good amount of time, actually focusing most of my time implementing care plans in area hospitals. So, and about the last five years or so, I've been on the other side of veterinary medicine, focusing more on ways that technology can enhance the clinic experience.

And so, most recently for the last couple of years, I've been at Otto running our new care membership program.

Stephanie Goss: And I'm super excited to talk about this because you and I have we're both super passionate about I think wellness is a, is a word that we use a lot in veterinary medicine but really it's the idea of preventative medicine and kind of being the foundation of everything that we do in vet med because we know, yes, we see sick patients and we also know that when we see sick patients first when they're due for things preventatively and we're doing that that maintenance work We help prevent or at least slow some of those disease processes significantly.

And so I got a mail bag Oh, so you and I are both super nerdy about the idea of preventive care and we've both worked extensively with the concept of wellness plans, both in clinical practice as managers, as team members. You and I both worked within the NVA's PAW Plan framework, which we'll talk a lot about in today's episode, I'm sure, but also you worked with wellness plans in private practice as well, right?

Shawna Castillo: That's right. Yeah. And, you know, wellness plans have been around for decades at this point. And you said something earlier that I just have to Go back to, and you said something about it being foundational. And I think that is what I'm most passionate about is this idea of like foundational medicine, not necessarily calling it wellness or preventive because wellness is not one size fits all.

It looks different for every pet. And so that's what I really think care plans can change in the world of vet med. You know, they can really enhance client conversations planning, which we know like doesn't exist in, in the pet parent kind of population, you know, planning for pet care. And so that's what I think is really, a really cool way to kind of encompass like, you know, what the whole point of wellness or care plans are, and that is like really promoting foundational medicine.

Stephanie Goss: Yeah. And I'm going to stick a pin in that because we're definitely going to come back to you. I love the– we're going to come back to the specific change in language because I love the idea of care and transitioning away from the idea of it's just preventative or it's just wellness.

There's, there's a lot there to unpack, but I want to start us at the top because we got You know, we're, we're here today, A, because I love nerding out with you and I could talk to you all day long and I feel like you are someone that our our listeners may not be as familiar with as, as far as being a, a part of our industry and so, I wanted to have you here to nerd out, but also because I had a couple of mailbag questions and there was one that came through really recently that really stuck with me because it was from a practice manager who was really struggling because they have been doing all of the things for a really long time in their practice in terms of offering financing options for clients, you know, using our friends at CareCredit or using Scratchpay VetBilling, other, other payment options that have kind of been around forever And they also use pet insurance in their, in their practice, they take it, they promote it.

And they were saying, you know, we're really struggling because we're kind of in this place where as the economy has shifted and clients are having to really think more and more again about where they're putting their dollars, we're seeing more clients recently getting declined or not qualified for credit, or they have, they have their own credit cards, like they're not interested in, in a financing option. They just are choosing not to either choosing not to or not being able to spend the credit card dollars that they do have on care for their, for their pets. And so, you and I were planning to come on here today and have that conversation, and in the last couple of weeks, as we've kind of been prepping for this and talking about it, we've had this conversation that has been happening in the Uncharted community that really tied to it.

And it was so funny because we had, we kind of planned to start with one topic and then I texted you and I was like, Hey, how do you feel about going in this opposite direction? Because they really tie together. We had a friend of ours who is a practice owner and practice manager actually in Vancouver, Canada, so on my side of the world and he was asking some questions because he saw on social media a local ish clinic who was offering care plans or, wellness plans, how, whatever you want to call, call them.

And their plans, their advertisement on Facebook really was just, hey, we're offering unlimited consults. And there was no definition of what a consult was, but the ad itself was, we're offering care plans that have unlimited consults. We're also offering a discount. In this case, it was 10 percent off of additional things like meds, foods, other services.

And they had a set price, a membership price for a year of unlimited consults. And it very clearly said both doctor consults and technician consults. And so they were running a, you know, limited time offer. And then they were going to have a pricing after their initial special.

My friend who is the practice manager was just like, has, you know, has anybody else seen this? This seems absolutely insane because the price point was a few hundred dollars. I think their introductory was like in the, below 250 and then their, their initial price was going to be between like three and 350.

So for a couple hundred dollars a year, this practice was offering unlimited consults. And so our friend was just like, This seems crazy. How can I afford for clients to be able to come in as often as they want, whenever they want, and have visits for such a low price point? Like, I could not afford to pay my staff.

And I completely understood the panic. And I was also the one who had to jump in on the conversation and say, okay, let's take a deep breath for a second and let's start with some math. And the reason that I always start there is because in my experience doing PAW plans and care plans within my own hospital We went the route of having unlimited actual exams.

So in this case just for reference with the podcast today, I'm gonna go ahead and assume that when this practice says consults, they're talking about exams whether a DVM exam or a technician exam And we all know that every hospital does those differently like my you know, my hospital was we had sliding scale. So we had 30 minutes to 60 minutes. My sister hospital right down the street was 15 to 20 minute exam.

So, I don't know about your practices, Shawna, but like everybody does it different, right? When you say an exam, it never means the same thing in veterinary medicine.

Shawna Castillo: It never does. It means sick, you know, any type of doctor exam, any tech, any progress, any recheck. But yes, let's keep– I'm like itching to say what I have to say about this. So let's keep going with it. Yeah. Yeah.

Stephanie Goss: So I, you and I started nerding out about this and really broke it down to a bunch of questions that we really wanted to tackle around the idea of wellness plans or care plans for, for the purpose of the discussion today. Why, why they shouldn't be as scary as sometimes they feel, and I think I want to talk through certainly I have some, some thoughts on that, because I empathize with our friend, because I had been in that position, like my doctors did the exact same thing of, oh my god, the sky is going to fall if we have unlimited exams, you know, and it's a scary, it's a scary thing, because we work so hard

in veterinary medicine every day to make clients understand the value of an exam and to get clients coming in through the door and so I think the initial fear like gut wrenching fear reaction is Are we undoing all of that hard work? Are we devaluing the exam if we look at care on a level that could include unlimited exams.

Clients have open access. And so, I think I want to, I want to start with you. You had both from a practice perspective, you and I had I, in this case you know, I talked candidly on the podcast. I actually had a really great experience working in corporate medicine. I've had really great experiences working in private practice.

I've also had really calming experiences working in private and corporate practices. And so I think I really sit in the middle that there's one side is not good, one side is not evil, and I think what, especially when it comes to wellness plans, I think there is a lot of stigma in veterinary medicine around it being a corporate thing, and it's subsidized, and only big practices like corporate practices can afford to do it, and so since you and I both have a experience, both on the private and corporate practice side, as well as now your, your role in Otto you've had the privilege to have access to a lot of the same kind of data, actual data research that I do. And then some, because I know you guys have put a lot of work at Otto into doing research before you launched. Your version of care plans in the last couple of years. So let's start with some of the facts and, and un, you know, unpack some of the myths, I guess, around care plans and wellness plans and unlimited exams and all of that.

Shawna Castillo: Well, I think that it's always, first of all, I want to go back to this question, the mailbag question and then the practice manager in Vancouver. I think it's a really interesting, like kind of joint question that we're going to tackle here because it really does address the problems that we're seeing in the industry right now, which is affordability and volume, you know, but then specifically about unlimited exams, I think, you know, I think that is the part that really gets to be scary because people are like, how am I ever going to afford this?

Like you said, and it's important to stick to the facts here. First of all, usually when a plan is set up with unlimited exams, that does not mean it's a free for all. It doesn't mean clients to get to come. They get to come in anytime they want. Use any exam, you know, just skirt in through your already scheduled appointments. That's not happening. 

Stephanie Goss: Right, and..

Shawna Castillo: That's number one.

Stephanie Goss: That's what, I think that's the picture that everybody gets in their head is if you offer unlimited exams, all of a sudden, any client can walk in the door whenever they want and demand your time and attention, right? Like that's the scarcity mentality for you that our lizard brain does and that's where we all are at. And that's why I empathized when the question got asked. Cause I was like, Oh yeah, cause that's exactly what my doctors thought.

Shawna Castillo: Right. And you're right, listeners. That is not feasible. It's not realistic. Like, don't do that. Don't do that. Please don't. But I think that what's really interesting about the idea of unlimited exam is it's wildly interesting to consumers, to your pet parents, because, okay, we have visits at an all time kind of low right now.

So visits are down. Compliance is down, but like spending is up. And we kind of all know that based on a million different articles that are being published right now and data that's being published and. What I think is really interesting is that when you think about shoppable items, what's the first thing that clients ask about when they call and try to make an appointment?

They'll want to be seen by a doctor or ask for meds and the responses that they need to be seen by a doctor. They always ask, well, how much is that going to cost? It's a massive barrier. So if you can break down that first barrier to getting clients through the door, then you can provide them with a treatment plan and typically encourage more from them. So I understand the strategy here of that neighbor clinic that just open that is offering unlimited exams. It makes a ton of sense to me because they want to encourage loyalty and retention from their pet parents in an age, a day and age where are the majority of our pet parents are incredibly brand disloyal.

You know, we've got millennials and Gen Zers making up a large majority of the pet parent population and they are the least brand loyal. So I think it's a really interesting way to encourage that loyalty and retention that we're all looking for.

Stephanie Goss: And I think the other thing that is really important to look at, and we'll we'll try and pull out some links for everybody in the show notes to some of the data, because there is a large amount of data and research that has been done over the years, you know, I think I know when I started doing wellness plans in my private practice, the only comparative that I had at the time really was Banfield Wellness Plans because that was the kind of the OG, you know, that was like, that was where it originated in, in vet med and It was like, okay, this is what it, this is what it is.

And I, and I think that that is what it is or can be for one company and one practice. And I, and I think that that is you know, fear myth number one. I think everybody gets it in their head that like, okay, what somebody else does is exactly what you have to do. And I, I know I fought that battle with my own doctors, even just within you know, our, our own little NVA region, you know, they have their own wellness plans.

They're called Paw Plans. And, and it was like, Oh, well, I don't want to do the same plans that our sister hospital 10 miles away does. I want to do them. You know, I don't want to do it at all because I don't want to have to do what they are doing. And I think that that is like the fear factor is that you have to take a model that someone has and you have to do it the exact same way. And I think that that, from the exam perspective, I think that that is what is really, really interesting, is that if we looked at plans that historically only included a limited number of exams, we would have never gotten to the place where someone along the line went out on a limb and said, we know that our loyal clients come in more often, right?

Like, when you think about those A clients in the practice, how often do they come in every year? They're not your once a year clients. You know, the Mrs. Smith who brings your team cookies at Christmas, she's in because she has the trainwreck pet. And she's in every six weeks for something, you know? So she's not in once or twice a year.

And we know that those clients, those, those A clients are coming in more frequently. And so somewhere along the line, someone said, well, what if we allow clients who are on a wellness plan or on a preventive care plan access to the practice? more easily? What if we give them more exams? And I think for me, I saw it in colleagues where it was like, okay, well, we'll have four exams, or we'll have two exams, and then it was like four, and then it was like, what about if we offer them, like, eight or ten?

And then it became unlimited. And so for me, watching it was a very slow progress, because I was exposed to a lot of practices, both private and corporate, who had wellness plans along the line. And I think to people who have not had that exposure, I could absolutely see where going from your model, where you maybe see the majority of your clients once or twice a year, to now saying, Hey, you could buy this plan for a couple hundred dollars and you can come in whenever you want. It seems big and scary. It totally does. Right? 

Shawna Castillo: It does seem big and scary, but I think that like when you go back to the mailbag question where these clients, what we know, the data that we know has been published was that in 2023, there was some there was a study that showed that over 60 percent of pet parents who apply for traditional credit based financing don't get approved.

So that goes right back to this mailbag question of we've got clients who want to do. I presumably want to do what's being recommended, but they cannot for whatever reason. Now, this particular study showed that it wasn't necessarily because clients didn't have good credit, but it was because they didn't have built up credit. Like they didn't have enough credit. And I think that makes sense when we think about more and more young people getting pets,

Stephanie Goss: Exactly. When you think about the volume of Gen Z clients that you have, that straight out of, straight out of even sometimes high school, but the early stages of college, they're going out and getting pets. And I didn't have I didn't have credit when I, you know, was in college and just, you know, got, there was no way.

I, in fact, I have told this story on the podcast, like my very first CareCredit account, I only got because my boss co-signed for me as a practice, as an employee benefit. Because I didn't get, I didn't, I didn't qualify because I was a college student who had college, my only credit was that I had college loans, and I did not, I did not qualify.

So I, I can totally imagine the volume of of Gen Zers, especially, or, or even millennial. You know, although we're, I guess millennials are significantly older now, right? That argument doesn't hold water anymore.

Shawna Castillo: Don't tell anyone.

Stephanie Goss: We're elderly now. I don't even want to talk about Gen Xers cuz we're old. But Gen Z, they don't have credit and so to your point, it's not because they have bad credit. It's just maybe because they don't have enough of it. But whatever the reason, if they can't have financing, I also was just Having a conversation this weekend and I think it was, I was because I was just at, I was just at Uncharted and I was having a conversation and I think it was AVMA that just put out the study.

I'll have to check, either way I'll find the study and drop it in the show notes, but where the typical pet parent is unprepared for a like $1,000 unexpected bill or a $500. It was a really low threshold

Shawna Castillo: It was the Forbes advisor survey and it showed that something like 40 to well, at least something that I saw there was a Forbes advisor survey. They do this every year. They survey, you know, pet parents, all sorts of consumers. And it showed that like something like 40 or 45 percent of pet parents would not be able to afford that.

I think it was actually a $500. They wouldn't be prepared for a $500 unexpected vet bill. And that it's wild. So that's why I think, you know, care plans, that's why I'm a wellness or care plan enthusiast. Like, these are a tool. If you can build them in a way that works for your practice, which I think we should get into, like, what factors should we consider when we're designing these, these care plans?

Because If you can do that, if you can think about how this is going to work for not only your practice, your business, your team, but also your clients and patients, it can elicit the response and the results that you're looking for.

Stephanie Goss: Yes, and so I agree with you. I want to, I want to dive into that. I think I want to just tie up the, the piece about the unlimited exams being big and scary and recognizing that that is a barrier, right, for talking about this with your team, because I have talked to so many colleagues who did exactly what this friend did and was like, Oh my gosh, no, no way, because we're hallucinating and telling ourselves a story in our head that all of a sudden, All of the F and D clients who scream at the front desk are all going to show up whenever they want in your lobby because you've made care only $200 or $250 a year, right?

I think that's the, that's the horror scenario that plays in, in all of our heads and where I was going with the data piece was that we know that even when we give access to care via a wellness plan, whatever we want to call them and we offer unlimited exams, our average client, Only uses 2.5 of those exams and the high use typically comes in at four to six exams a year for those clients.

And so even though we're offering them unlimited, we know that they're not using it. And so for me, that was a big part of the bridge that I had to build with my doctors who were like, Yeah. The sky is falling. The sky is falling. These clients are just going to show up whenever they want was having that conversation about, Okay, look, here's what the data actually shows us.

And how can we reach a point of compromise where everybody feels comfortable that the clients are not going to be allowed free access to the practice? But this is not going to train wreck our day. And still, to your point, give the clients what they want, which is the feeling that they have support and access when they want it, where they want it.

Shawna Castillo: We'll get into this later, too, but. I think it's really important to think about what happens when those clients come in those four to six times. Like, I think the scariest part for people when you think about unlimited exams is that clients may come in whenever they choose and that just doesn't happen.

If you, communicate up front that these are scheduled appointments. It's no different, you know, you're not like giving them a hall pass to your schedule, you know, like they, this is no different as far as the SOP goes for scheduling appointments. They're just going to be more encouraged to come in on day one of that ear infection versus doing what Dr.

Google says. I mean, if I had a dollar for every time a client of mine, when I was a practice manager, would call and say, my dog has an ear infection. We live really close to a lake, so we had many ear infections and

Stephanie Goss: Sure. I can smell that from here.

Shawna Castillo: And they would say, okay, I actually, I think I'm going to hold off because I read online that I can do like, a vinegar dilution and we were like, ah, like sound the alarms, you know, like, no, you have an, an, an, an, a care plan and they had exams left because our plans weren't all unlimited.

We offered them in tiers, like with multiple, you know, maybe two or three here, unlimited here. Okay. But if they had exams left on their care plan, what was really cool is that we could we saw a noticeable shift in behavior from our clients where they would come in earlier and they would come in more frequently because they had those exams.

It broke down that barrier. It got them through the door. And then I have some data to share later. About the fact that at least with Otto's care plans, not only are we seeing clients come in more frequently, but also spend more at each of those appointments. So it's like true win, win, win for the practice.

Stephanie Goss: Okay, so let's start with, let's start with the, the question because the mailbag question was about how do we, how do we design wellness plans in a way that is not going to make my team or my doctors lose their ever loving minds, really was the gist of the question. And so, so let's, let's start there.

Like what, what are some of the factors that you, cause you've got such a breadth of experience. What are the factors that we should consider when we're designing care plans for our practices?

Shawna Castillo: In short, it really boils down to simplicity, profitability, and knowing, truly knowing what behavior you want to elicit from your clients. I call it long term changed client behavior. What are you trying to get them to do more of? And the reason I say all three of these things is because when I started at Otto, we had a lot of work to do.

We were offering a very traditional model of wellness plan that just was not particularly interesting to very many hospitals or very many pet parents at the practices that we're offering this. We kind of took a step back when I started and did a ton of research, and I interviewed dozens of practice owners and practice managers who are running their own program to understand, like, what were the pain points so that we could build something that was a real solution so we could understand what not to do essentially.

And a lot of what we heard was that plans are too difficult to manage or keep up to date. You know, we do price increases twice a year. How do we update these plans? How do we consume benefits? How do we keep track of what's used and what's not used? How do we keep track of the payments? You know, like all of that should be considered whenever you are designing a wellness plan or trying to, you know, I trying to decide if you're going to essentially buy or build this program.

Stephanie Goss: Yes.

Shawna Castillo: So that's kind of number one, like the administrative effort, you know, it really should be as simple as possible. The second one is the profitability of this.

How can you build these plans to still profit your practice and boost your bottom line? I mean, that is the whole point of these. They're not supposed to be discount plans. You're not supposed to lose money on these. There is a psychology component to this and that's what I love doing. That's why I love, you know, my job and building out plans with clinic leaders is because it's not just like throwing, you know, in clinic services into a bundle and say, and like throwing it at, at,

Stephanie Goss: Yes, yes.

Shawna Castillo: parents, you know, there is a strategy. And so, And you have to use that strategy to, to be profitable. And then again, thinking about what, what behavior you want to elicit from your clients. I think one thing that I experienced as a practice manager was that with my very traditional model of wellness plans, we would deal on an almost daily basis with client, with some sort of friction in a conversation with clients about what's included and what's not included.

And what we really realized was that These were super focused on what this kind of old school idea of what quote wellness is because we built them out to be, you know, what, what you probably think of when you think of a wellness plan, exams, vaccines, couple panels of blood work and plus or minus an add on of a spay neuter or dental cleaning.

But you notice I said blood work and that's what clients hear. They hear blood work and clients don't know that there are 300 different antec or IDEX panels of blood work or blood work. Plus, you know, so usually we're really specific about that one panel of blood work that's included, but they don't know what a CBC or a Chem 10 is.

They don't know what a Chem 27 gives us in additional diagnostic information. And so we would deal with these kind of very friction-y conversations that, you know, doctors like want nothing to do with. They're like, I don't want to explain this to you.

Stephanie Goss: Yes, yeah.

Shawna Castillo: And so, but, but what we realized when we locked these clients into this annual care plan that include a Chem 10, a Chem 10 was that it wasn't really encouraging the behavior that we wanted from them because we got them through the door.

Maybe they were on unlimited exams, but then when we, you know, presented additional treatment recommendations, they were frustrated that those additional treatment recommendations weren't included in the package that they were paying for. And so that's why we kind of reconceptualized care and we'll get into that later.

But I do think that those are like the big main points. It's like, what are you trying to see your clients do more of? How are you going to build something that profits your practice? And how are you going to manage this? You know, like in the most easy way possible.

Stephanie Goss: Well, and I think and you can probably speak to this, the specific data that you've seen in particular in your experience with Otto but one of the things that sold me on the eye on how powerful plans can be to support pet parents. There's two pieces of it. One is that you mentioned earlier

looking at the demographics of pet owners today, we have a huge amount of millennial and Gen Z pet parents, like vast majority, I think, at this point. Those consumers and those clients are used to the monthly subscription model. That's what they know. They've had Netflix from the beginning, our elderly millennials, and our Gen Zers are used to literally everything from, you know, their streaming services to a monthly subscription service at Panera.

Like, it is, that is the model that Gen Z has grown up on, and millennials have been there too. So when you look at it from that perspective, they want that. That's how they budget, that's how they plan their lives. They're looking for what is this going to cost me monthly, so that I don't have to think about that expense.

And I love that you brought up the psychology of it, because we really looked at that and spent a lot of time when we onboarded the team to the idea of using plans. I spent a lot of time with the team talking to them about the psychology of knowing that when clients have that sunk cost, they've already paid for it.

They've already budgeted the monthly, the monthly care cost. It becomes significantly easier to talk about the in addition piece because that piece is already gone in their mind. You don't, you don't have to think about it. Now you're talking about what the additional pieces are. So just like when we talk about our online pharmacies, and the idea of, you know, clients are, clients are not thinking about the things that are on auto ship to their house.

Because that money is already spent to them. It's a separate transaction from whatever they're buying that day in the practice. The same rule applies here. And so I love what you said about the profitability perspective because we actually know that when our clients are on a plan. That monthly subscription cost is out of, out of sight, out of mind.

So when they do come into the practice, we know that dropping the barrier of the exam cost, in particular with unlimited exams, gets them in the door faster because they're like, cool, I'm not gonna have to pay for that. They're not, that does not mean that they're not expecting cost for the rest of the visit.

In fact, we know from a data perspective that clients who are on plans, I think it's like 2.5 times higher at every subsequent visit, they're willing to spend two and a half times more than they would have historically spent prior to being on a care plan because that sunk cost is out of sight out of mind. 

Shawna Castillo: And that's what we're seeing too with our care plans is that or the care memberships that Otto it, like you said, two times more at each step subsequent visit. Our care members are spending almost 100 percent more than they did the year prior. So the way that I always explain this is like, think about if you were to implement a program today, we, we, we would look at what the client spent on that very same pet the year prior.

And then we would wait one year and see. What we're seeing is clients are spending 100 percent more on their pets, almost when they sign up for a care membership, but then also they're spending about 65 percent more than non members. So the best of both worlds, you're, you're making good clients better.

Stephanie Goss:The ACT is going up no matter what. 

Shawna Castillo: Exactly. Exactly.

Stephanie Goss: Yeah and I love that from the profitability perspective and that was, that was how I ultimately persuaded, negotiated, negotiated. You know, gently talked into, however you want to phrase that bulldozed, I suppose. there was one doctor I had to absolutely bulldoze into it.

But that was the conversation that I had with the doctors. Because the fear, especially if you have doctors who are paid on production the fear is, I'm going to lose all of this money if I have all of these clients who are now no longer paying for exams or not paying for services, or they're getting it, especially if your plans include a discount, the hallucination or the story that the doctors tell themselves in their head is, Oh, my God, my production check is going to be half of what it was before, right?

Like you're, I'm just never, I'm never going to make any money and I'm going to be doing all of this work because clients have open access to my schedule and it's the, it's the death spiral of catastrophe. And all of a sudden all of your doctors are Andy living in a box in the woods. Because that's what he does when he catastrophizes.

And that's how, that's how the doctors, the doctors feel. And so I think from a production perspective, you absolutely have to. Get in front of that. And the conversation I had with my doctors was like, listen, I, I have a trust bank built up with you. And do you, do you trust me? If you trust me enough, I'm going to make you, I'm going to make you a proposal.

I propose and I did this in my private practice. I said, I want you to do this with me for a year. And if after a year, your average client charge and your production have not gone up year over year. I will actually pay you the difference,

at the, we'll do, we'll do a, we'll do a true up. But I was, I looked at the data and I felt really, really confident because of what you said, Shawna, which is that the numbers prove it over and over and over again.

And, we're lucky to have access to companies like NVA and Banfield who do all of this data and put it out there, publish it for the industry, so we know historically how this has, has gone. I looked at all of that, and I felt really confident, and that was the bet that I made my doctors. And I had the one doctor that I had to bulldoze into it, and that was the only way that I got her to say yes.

And she did. And the next year, I absolutely did not have to cut her check because her production was up significantly because she had a large number of clients that were on plans and had that sunk cost and they were spending more. So the profitability went up for the clinic, but the profitability went up from a doctor's on production perspective as well.

Shawna Castillo: Yeah, I mean, I could add to that, when I was a practice manager, our medical director was all in on our wellness plans and his percentage of revenue generating per potential or, you know, percentage of the bottom line was large. It was like 40 percent and his average transaction was nearly double what our other doctors were, and his attribution for enrollments was like 90%. Like he was crushing. So I am team wellness or care plan 100%

Stephanie Goss: Yeah, yeah. Okay. So I want to talk, I think you, you came up with some really good points. The pieces that we need to consider when we're designing them. So we have to look at simplicity, which I think is really good. I think you know, we talked about the facts that Nobody wants to spend a significant amount of time, and you have to do your time, you have to do your research to figure out what is going to work for your team and your workflow, because simplicity does matter, that in and of itself could be a whole podcast, you've got to look at the profitability.

And you've got I love your point about knowing what behavior you're trying to elicit from, from your, from your clients. And I think the other the only other piece that I would add to it. To this and then I think we should take a quick break and then come back and talk about the other pieces of this because I want to get to the two other kind of chunks that we have on plans in general.

And then I want to talk specifically about what you guys are doing differently at Otto because I just think it's so cool and such a neat concept. The only other piece when it comes to designing them is I think it's really important that you not compromise your medicine when you're designing your, your plans, because I have seen so many of my colleagues really struggle with feeling like they have these plans that are not actually what they want.

And you spoke, Shawna, when you were talking about the blood work perspective, and that is absolutely friction from the client perspective, but it's also friction from the team perspective. Because if now, to your point, I have to go in and have a 25 minute conversation with this client about why their plan included a CHEM 10, but why Dr. Sarah is recommending a CHEM 27 and what the difference between those two things are and why I need her to pay the additional difference in what the plan doesn't cover. Now I'm compromising my medicine to a degree because I'm having to do extra work, I'm having to deal with client frustration, I'm having to deal with team frustration, and so we know, behaviorally, that that's when it, we know that that's when the behavior of the team starts to change. We shortcut our recommendations. We hold back on saying what we really want because we don't want to deal with that frustration factor, whether it's from the client's perspective or our own time and energy perspective. And so I think I am a huge advocate for, and you and I have talked about this extensively, like your plans, however you design them, got to take into account what your standard of care is at your practice. The medicine has to be what you believe in it or the plans will never work. And I see so many of my colleagues who try and do quote unquote wellness plans and get frustrated and give up oftentimes before even the first year is out because what they have built either inputs too much friction or is not their standard of care or both.

And so from a manager perspective, like that is the single biggest piece of advice that I can give to my, my fellow managers and practice owners. Sit down and you have to start with your standard of care. Okay, let's take a quick break and then let's come back and we'll dive into the last couple of pieces here to, to get to what you guys are doing differently over at Otto.

Shawna Castillo: Can't wait to get into it.

​

Stephanie Goss: Okay. We are back and, you know, we're departing from Andy and I's normal like headspace slash action steps because I'm, I feel like there's just so much more, Shawna, that you have to share with us that is actionable. We, we left off kind of talking about how do we, what do we consider when we're designing wellness plans. And we were talking about the profitability piece, and I think I think I wanted to ask, like, from your perspective now, because you've just been so immersed in the data and the the nerdiness from a data perspective behind this, like, what what are some of the things as we're designing plans that we can do to ensure that we have profitability and that we're also addressing the client's needs when it comes to care plans and maintaining everybody's sanity from the clinic's perspective, right?

Like, it's got to be sustainable because you and I both know as managers, if there's friction for the team, if there's friction for the clients, like I said before we went on break, this thing is not going to last the first year. Like, you're going to try it, you're going to dive in, and then you're going to go give up in spectacular fashion.

Shawna Castillo: 100%. Well, I think it goes back to this idea of, you know, thinking about how to make these profitable, thinking about the behavior you want to elicit and doing the work or doing the research. So I'll do a little research for you. We have this AVMA infographic. And it's really very interesting because what this infographic shows is what the highest revenue generating services in a clinic are based on their research.

And it shows that exams and consultations take up a large majority of them. And then we have additional revenue generating items broken down by pharmacy, lab, surgery and anesthesia, vaccinations, imaging and dentistry. What's really interesting to me, and I think just something to keep in mind, is that many times clinics plans only include about half of these listed services, these listed revenue generating items, and so how, maybe ask yourself, like, how could we include more of these?

That's something that I asked myself whenever I started at Otto. It's how we kind of conceptualize care memberships because we wanted to be more inclusive so that we could drive more standards of care and SOPs at each individual practice, because, you know, SOPs are different by region, by hospital, and it's not one size fits all.

Just like I said, with wellness as a definition, it's not one size fits all. We know that clients or clinic S.O.P.'s are also not one size fits all. And so that's why we develop something that would really encompass that and promote something that does encourage long term change client behavior and does encourage more spend from clients and more compliance and more visits.

So all of the things so that's what I would say, you know, how can we, that's what I would say is like do the research and find a program or, or, or build something that is really going to speak like your hospital's truth.

Stephanie Goss: Well, and so, okay, so that was the perfect segue because, um you know, when we get asked the question, like how do I design the plans? I think there's the starting with your standard of care and looking at the pieces that we've already discussed. And then I think the next piece is, what are my choices? Well, I can build it, I can do it myself and DIY it or I can buy it, meaning that I can use a third party service to build the plans and administer the plans for me. And there are two kind of options that kind of branches out in two ways. One is the traditional way that most people think of corporate practices doing it where you're buying it quote unquote, but you're doing it in-house, meaning that there's a team that your hospital is paying within the bigger organization to manage a lot of things. That's the experience that you and I may have had within NVA although my practice selected to run 'em ourselves. But you have help doing that,

right? And then there is the third party model where you're paying a third party company completely. Veterinary specific to build out and administer the plans for you deal with the software do all of that. You and I could do a whole podcast just about that piece, so I think that's I think from a building them perspective.

All you need to know is that there's a lot of options we've actually got some prior podcasts that I'll link in the show notes about care plans and that kind of go into some of the options including third party options but like you can absolutely build it yourself, or you can buy it, whether you buy it internally or you buy it from a, from a third party, if you're a private practice but now we have a new option, and that's really the heart of what I wanted besides getting to see your beautiful face and talk to you today, like, that is the heart of why I wanted you to come and talk about what you guys are doing at Otto, because just like everything else that that Otto has kind of done in terms of trying things just a little bit differently in veterinary medicine I feel like when you came on board the team and you tackled the idea of reinventing wellness plans and turning them into something different. You guys have done something truly, truly different here and I'm super excited to talk about it. So, tell us a little bit about, kind of, how care, which is what you call your plans, how care with Otto is different from the traditional kind of wellness plan model.

Shawna Castillo: Well, first of all, let me ask you a question, Stephanie. If you were given the option to be gifted a 100 gift card to your favorite store or a 100 valued gift basket from that same store, but mind you, remember how gift baskets work. Someone else puts the things in the basket and hands it to you. You're not choosing. What would you choose?

Stephanie Goss: I would, I would a hundred percent choose the gift card unless I like had seen everything that was in the gift like sometimes you just see a gift basket and you're like You Yes, it fits. This fits. The majority of the time, though, like 9. 9 times out of 10, I'm gonna choose the gift card, hands down.

Shawna Castillo: Nine times out of ten, you're gonna get jelly, like a jar of jam that you just can't stand the flavor of. Right? You're not gonna use it all. You're not going to use it all. 

Stephanie Goss: You're not wrong.

Shawna Castillo: Okay. So, About 99 percent of the time when I ask people this question, they always say gift card because we're creatures of habit. People love control and you know you're going to get the most bang for your buck out of that.

You have control over what you're spending that on. And so that is the way that I will often describe Care via Otto and so care memberships were really built to help clients plan for pet care first and foremost. Like, so help veterinary clinics help clients plan for pet care. And the big differentiator is that instead of being incredibly specific about the benefits that are included in these plans, we've really broadened it.

And we've said, we're going to open this up and really actually focus more on flexibility because pet needs can change on a dime. And we don't want to put these pets in a box or limit what it covers or what the pet parent can do with these benefits once they enroll if their pets needs change. I know from being a pet parent and working for 15 years in a clinical setting that even if you have the healthiest pet, all it takes is one visit, one weird lump, or one weird cough for your wellness recommendations to take a complete 180 turn.

You know, we may not be focused on vaccines as much if we've got a chronically coughing dog, or if we've got a recent cancer diagnosis, or you know, if we're just dealing with chronic conditions, we've got an older pet with more chronic conditions, like priorities change.

Stephanie Goss: Or even, like, and I think that our minds as, as veterinary professionals automatically go to the old pet. But also, like, I think it's really important to think about the young puppy that, yes, they need, they need because, you know, doodles. Let's use a doodle for an example.

So Andy gets Skipper Roark the doodle, who is very bad and needs vaccines as a puppy, but then also, like, tries to eat, you know, socks out of the laundry basket, and then, all of a sudden, instead of, you need the vaccines, but maybe now you're doing surgery because you've got a foreign body, or x rays because you're worried you might have a foreign body.

Like, it's not just the older pets, it's all, it's all life stages, right?

Shawna Castillo: Exactly. And so that was another thing. We also wanted to open this up and say, this is not going to be species specific. This is not going to be age specific, breed specific. We're kind of taking all those limitations out of it. And we're saying any pet can enroll for any plan that this clinic.

Decides to build out and and it's going to be based on the actual pet's health care needs, both his both historic and anticipated needs. And so what we've done is we've kind of taken the labels off. We've said, we're not going to say that you only get five back or you, you get these five core vaccines because I know what happens there. If my pets only do for two core vaccines this year, I'm probably not going to be interested in that traditional plan.

Stephanie Goss: Mmm-hmm.

Shawna Castillo: So, we kind of opened it up and we said, let's make this a bundled credit essentially where the client enrolls in a plan. They get a predetermined amount of money. This amount of this credit is kind of based on the hospital's economic value.

So we do some economic exercises to see, you know, what have clients historically spent? What are your typical costs of very common procedures like spays, neuters, dental cleanings? Something I'm also really interested in knowing is like, if I brought an eight week old puppy in, what would my anticipated investment be in that puppy in its first year of life.

Because we all know clients are blown away by the cost of pet care. Once that new puppy kind of feeling wears off, they're like, man, this is 

Stephanie Goss: expensive. 

Shawna Castillo: Yep. Expensive. Yes. Maybe, I don't need a full year round supply of flea and tick meds if it's gonna be $400 and so we wanted to say no, like, like, really what we wanted to do was say yes.

Help clients say yes to pet care from the very beginning to get them started on that good behavior track. Because the earlier that happens, the earlier they get exposed to your, like, gold standard of care, the more likely they will be to carry that on throughout that pet's life and then future pet's lives.

So, it's a little bit like more probably involved than the way I'm explaining it, but really that is care memberships in a nutshell. We've kind of reconceptualized it and a lot of clients or, or a lot of people will say, well, is this kind of like pet insurance? And the answer is no. Because what we know about pet insurance is that it's really built to be for unexpected illnesses and injuries, and that is not.

Just what care memberships are for they are meant to be for both preventive care and maybe unexpected care. They're a lot more holistic in that sense.

Stephanie Goss: So they're basically help me, help me understand and wrap my brain around this piece. So you build out like plan offerings and the way that you guys are structuring that is to say, okay, we're going to look at the practice on an individual level, like what their standard of care is, what their medicine is like, and as a result of that, what the economic impact is.

Both from a profitability perspective to the clinic, but also as a spend amount, whether you're looking at the percent or the dollar for the average client and different like life stages. And then you guys are figuring out, okay. That could generally equate to X amount over the course of a year. And then, so then clients are able to basically make their monthly payment towards that amount.

But like, like I know when we think about insurance and one of the challenges to like get over, even on the human insurance side is like, okay, if I'm paying for insurance and I'm paying for it monthly, like, do I have to, do I have to wait the year before, you know, like when you have dental insurance, I think is the, is the best example is like you can get dental insurance, but you're not going to be able to get a, you know, a cavity filled or get a crown done until you've been on the plan for a year because they want your money before you spend it.

So how does, and I know that that's one of the barriers to conversation when it comes to pet health insurance as well as people think, Oh, there's, You know, I have to go through the waiting period or the pre existing conditions. We have all of those conversations as well. How does Care how does Care address that for them?

Shawna Castillo: So the four core benefits of care are health exams, an instant account credit, a bonus discount, and 24/7 teletriage.

And the way it works is that each hospital's plans are going to be different from other hospitals, because we're looking at each individual hospital's economic values. So we're looking at, you know, how much clients historically have spent in the year prior per pet. We're looking at what your average cost of certain various common procedures are like dental cleaning, space, neuters.

But then also, you know, I'm particularly interested in knowing, you know, what what you would tell me my anticipated investment in a new puppy or kitten would be, because we want to encourage clients to start thinking about this. We want to encourage these kind of planning conversations from the very beginning to help clients understand that their pet is an investment and that they're they really should be considering the gold standard of care.

And so, each clinic's plans are going to be specific to them in their values and in what the cost of the client is. The way it works is a client will enroll in a care membership. They will have access to the benefits for the course of 12 months. They will pay for it on a monthly basis over those 12 months, but they will get to utilize those benefits immediately after enrolling.

So the concept is really no different than a wellness plan in that you enroll and you get your benefits immediately. But the difference here is that we're saying you can really use these benefits towards anything, especially that instant account credit. We're not saying it's only good for vaccines.

We're saying it's good for whatever your doctor is recommending because what they're recommending is for your pet's wellness.

Stephanie Goss: Right, right. I love that. And do you, so I think one of the other, one of the other conversation pieces when it comes to designing plans is the debate over, are wellness plans really just a discount? You know, are you just discounting your services? How do you guys, how do you guys approach that with, with care plans?

Like, do, do you clients get a discount on everything? Do you have to give them a discount? What does that look like?

Shawna Castillo: As far as a built in plan discount it certainly helps to elicit interest from clients. Everyone loves a good deal. They're not required, so it really is dependent on each hospital's preference. My recommendation is to throw in a small built in discount just to make the plan feel really special and to encourage enrollments.

And the reason for that is because of the data that we have. And that is that when we see clients enroll their pets on these plans, they spend more, not only than they did the year prior, but then non members. So we really do just need to get these clients enrolled because it frees up their kind of, what is it called?

Discretionary like, spending, you know, they have more liquidity and they can say yes to more things when they have these monthly payments that they kind of, can bank on, you know, they're very predictable. And so I love the idea of like, kind of saying you get this savings account, if you will,

to your clients. Like we're going to help you save and plan for things that may be expected and even potentially unexpected. And then the psychology of it is that once the client spends that instant account credit, then a very small bonus discount kicks in on all out of pocket spend to encourage repeat visits and more in clinic spending to get that client loyalty because that bonus discount will be applicable to all out of pocket invoices throughout the course of the remainder of the one year subscription.

Stephanie Goss: I, I love that. I love that. And I agree with you, like, I think you and I, I don't know about your, how your plans were set up in your, in your practice, but our discount was not, was not large. Like, I think our Clients only got like a 10% discount on things. And you know that when you think about 10%, it's not that much money, like on your average ACT, like that's a couple of dollars.

It's not a whole lot of money and clients love to see that at the bottom of, it's like when you go, I hate to say it, but it's like when I go to the grocery store and I punch in my number and then they circle for me at the, and I never really look at, I mean I do like, cause I'm super competitive, like I want to, I want to get it as much as, as high as possible on every trip that I have, but I'm more interested on what have I saved over the course of the year and I think it's that same, it's that same psychology with our clients, because again, you guys, we're not trying to, we're not necessarily trying to put every client on a plan, like I think everybody's minds go to that place where we're going to try and put every F& D client who are in the lobby screaming at your CSRs and making them cry on a plan.

Stop thinking about those clients. Forget about those clients and think about your A clients. Think about the clients who are bringing your team Christmas presents. Think about the B clients that you maybe only see them twice a year, but they're really great when they're there. They make the team laugh. You like seeing the pets. They're happy to be on social. Like you're thinking about those clients now and you're, to your point, Shawna, you're trying to elicit that repeat. Spending behavior with those clients and you're incentivizing them with that that discount if they see even that small discount visit over visit and they know that they have access to, you know, additional additional content consults at a discounted rate or they're getting the benefit of being able to, like with Otto's plans, have access to the tele triage, where they can, if they have a question at 2 am they can hop on and they can ask a question of a certified team member that is really like an extension of your practice to be able to say, hey, I'm worried about this, can this wait until the morning or should I go to the emergency clinic? Or, you know, whatever those kind of things are, those are the kind of benefits that.

Bringing it back full circle to where we started this conversation, those kind of meet them where they're at. When they need it, when they want it, that is where the majority of our client base is at. Given that they are millennials and Gen Z, they want those benefits. And so I think that's why I was particularly impressed I remember when you first started at Otto and you and I had some, some nerd out sessions about plans and you you know, you told me what you were proposing and I, my mind was blown because I was like, this really is so different in so many ways. And also, I think it helps overcome a lot of the barriers, both for clients and for team members, in terms of dealing with traditional wellness plans.

Shawna Castillo: Well yeah, it kind of ticks all the boxes, right? We have what we're seeing, like a lot of hot topics right now are client loyalty, retention, volume, how can we increase ATC? That's kind of on the veterinary side of things. But what we also know about clients is that the number one barrier to pet care is finances.

So, Care plans, care memberships through Otto they really do kind of tick all the boxes, solve all the problems. And it's really cool to see and hear it from our members, you know, who are saying like, I never would have been able to do this had it not been for this Care Plan or to hear it from our clinic leaders who are using the memberships are offering it and they're saying this is completely changing our financial conversations with clients. And that's huge, right? Because no one wants to have a bad financial conversation with the pet parent. That's just you know, we don't want to avoid that at all costs.

And so if we can really create something that you can use as a tool that basically allows you to say, here is what we are recommending. Here's what we want to do with your pet today or in the future. And here is a solution. Here's a way that you could actually move forward with these recommendations.

Stephanie Goss: I love it. Okay. So, this has been, this has been super awesome. I, you and I could nerd out about, about the foundation of care, about all of the things that we've talked about today forever. And Also, our listeners are probably are probably done with us for the day I feel that way.

 Shawna Castillo: You mean, you don't want to talk about wellness plans like all day long, guys? Not like what you had in store for today?

Stephanie Goss: If you do, if you, if you, because I already can imagine the questions that are going to come in from people.

So, two questions. One is if they want to find out more about Care Plans and Otto and all of the other things that you guys are into where can, where can they go?

Shawna Castillo: Okay, so they can check us out on our website, which is otto.Vet, V as in veterinarian, E T. And under the solutions tab, they can go to Otto Care to learn more about specifically care memberships, or anyone can feel free to reach out to me on LinkedIn. 

Stephanie Goss: You know, because I love nothing more than getting access to cool things in veterinary medicine for my friends, and I consider all of our listeners  my friends, whether they know it or not. And so I went to Shawna's team and said, Hey, let's make this as easy as possible.

And so the team at auto put together a page just for our uncharted listeners. And so if you guys head over to auto and it's. O T T O dot vet, like Shawna said, V E T, forward slash uncharted. The team at Otto has put together some info about care. 

And so much Shawna for having this conversation with me today. Thanks for being here. I feel like we could parse apart like four other podcast episodes out of the things there, the things that we scratched the servers on today. 

Shawna Castillo: One hundred percent! Well, it was a pleasure to be here. I love, love, love talking about these things with you. I love just relating to you on a manager level. So thanks for taking the time.
Stephanie Goss: Yeah, this was so fun. Thank you all for being here with us today. Have a great rest of your week, friends.

Otto have also put together an amazing deal that is exclusive for our Uncharted podcast listeners. That's right. Shawna's team stepped up big. They are waving the thousand dollar implementation fee. If you sign up for Care Plans after checking out the website, maybe talking with Shawna and doing a demo, but if you mentioned that you were an uncharted podcast listener, if you go to the landing page otto.vet/uncharted to get the information, they will waive a thousand dollar implementation fee when you sign up. That is an amazing deal. So don't miss out on that head over to otto.vet/uncharted to check out more about care, connect to a Shawna and sign up for your demo because I would want a thousand dollar implementation fee waived.  No-brainer and we will see you next time!

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: communication, culture, management, Vet Tech

May 15 2024

Doctor Development – New Grad and Established Associate

This practice owner aims to develop a plan for both a new, eager graduate and an established associate who is less enthusiastic about development. Dr. Addie Reinhard, CEO of MentorVet, joins Dr. Andy Roark on this week's podcast to tackle this unique challenge.

Dr. Reinhard brings a wealth of expertise to the conversation, as the founder of MentorVet—an organization known for its evidence-based approaches to promoting well-being within veterinary medicine. Her extensive research, including her role in the Merck Animal Health Veterinary Wellbeing Study, focuses on developing interventions to support mental health and well-being in the veterinary field. All of this making her the perfect person to help us with this week's mailbag.

Together, Dr. Addie Reinhard and Dr. Andy Roark discuss the importance of tailored development plans, employee ownership, and provide actionable steps for any practice leader looking to enhance their mentorship programs. Let's get into this…

Uncharted Veterinary Podcast · UVP – 287 – Doctor Development – New Grad And Established Associate

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

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

Submit your questions here: unchartedvet.com/mailbag


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Episode Transcript

Dr. Andy Roark: Hey, everybody, it's me, Dr. Andy Roark, and this is the Uncharted Podcast. Guys, I got a good one for you today. Dr. Addie Reinhard is on the show, and we go to the mailbag to answer a question about how to develop a new graduate and also an associate vet who maybe doesn't want to be developed.

So anyway, if you are a medical director, if you are a practice owner, practice manager, somebody who's trying to develop doctors, this is a great episode for you. If you love it, remember that Dr. Addie Reinhard is going to be presenting at the Uncharted Medical Director Summit. That's right. It is a summit that we do for medical directors. It is on May the 29th. It is virtual. It is one day, but if you're a medical director it's gonna be a great one and Addie will be there running a general session for us on developing doctors. Anyway, let's get into this episode.

Announcer: And now, the Uncharted Podcast. 

Dr. Andy Roark: And we are back. It's me, Dr. Andy Roark, and the one and only Dr. Addie, gonna-make-a supersonic-fad-out-of-you, Reinhard, sitting in for Stephanie Goss today. Addie, how are you?

Dr. Addie Reinhard: I'm doing pretty well. Busy, busy, but yeah, in a good space. Yeah.

Dr. Andy Roark: In a good space? You this is off topic, but you, you just, you bought a homestead. And for those who don't know, a homestead is basically a small farm, from what I can tell. Is that true?

Dr. Addie Reinhard: Yeah, it's a 50 acre farm. We're closing on Friday, so by the time this episode airs, we will have purchased the homestead. And yeah, so 50 acres, there's an old 1800s farmhouse on it that needs a lot of renovation and repair. There's a barn that's kind of fallen down that we just got a quote on how much it would be to fix the roof, and it was a lot. And there's a garage and a tiny house, and so essentially it's just like a big money pit.

Dr. Andy Roark: It's a big–congratulations on your purchase of a financial vacuum.

Dr. Addie Reinhard: It's gonna be fun, though. It's gonna be fun.

Dr. Andy Roark: It's going to be super fun. And when you, when you come up with some cockamamie scheme to put your barn up, let me know. Cause I haven't done a barn raising before, but it seems like things that we should come together and do.

Dr. Addie Reinhard: Yeah, and I mean, that's gonna be the goal, is the community, and we have a lot of friends who are really excited about working out there, and yeah, it should be, should be a good time. We've been working out there for a couple years now, and we're purchasing it from a friend, but that is an aside, anyway.

Dr. Andy Roark: That is an aside, but so when you're not homesteading, which I recently learned it's a verb when you're not homesteading, you are also a veterinarian. You are the CEO and founder of MentorVet, and who does, MentorVet, do you want to speak quickly on, on MentorVet and kind of what, what your work is there?

Dr. Addie Reinhard: Yes, yeah, so, I guess, I think four or five years ago kind of recognized that there was a gap in resources and support specifically for vets transitioning into practice, because I was one of those vets transitioning into practice and really had good medical mentorship, but I felt like there was still resources that could be beneficial.

And so, did my master's program at UK in community and leadership development, did a lot of research on. Well being and mentorship and more importantly, what can we do about it? So developed a mentorship program for young vets that we piloted in the summer of 2020 and then that research project became MentorVet the entity that creates evidence based programming to support veterinary professionals at all stages of their career to give people, the kind of resources and tools and community that they need to, to really thrive.

And so we have mentorship programming now for early career veterinarians. We've had about a thousand young vets go through our program, our flagship program, MentorVet Leap. We now collaborate with the AVMA and run the paired mentorship program for the AVMA. We have a mid career vet program that we're piloting this year specifically with new diplomates and we have a mentor certificate program as well and a technician program.

So lots of programs, five in operation now and, and growing. So, I am I have a team now and, and my full time job is pretty much supporting them to help them do the best job that they can and help us, I think, stay on the tracks mostly because it's like a freight train and just growing fast and helping a lot of people. So I love, I love my job.

Dr. Andy Roark: Well, you are going to be speaking at the Uncharted Medical Director Summit, which is a virtual summit we are having on May 29th. And so, you're going to be there and you are going to be lecturing on growing, or workshopping is what we do. You're going to be workshopping general sessioning on growing and developing the and in a way that's targeted at medical directors.

And that is why I wanted to reach out to you to help me with the mailbag question that I have for today. Alright, you ready? I'm gonna lay it on ya.

Dr. Addie Reinhard: Let's hear it.

Dr. Andy Roark: Alright, here we go. I have a two vet practice transitioning to a three vet practice. The new graduate that's coming in says that he wants mentorship. And this person put mentorship in quotations– says he wants mentorship. The associate vet we have isn't asking for coaching or mentorship, but I think she needs it. We, we, we aren't practicing the same level of care, but every time I bring this up to her, she bristles and complains about, quote, cookbook medicine, end quote. Do you have any advice? And so what I'm getting from this is we have a practice owner who's a vet, and this person has we're just gonna call her we're gonna say she, I don't know if it's a she or he we're gonna say she has an associate that they don't exactly practice the same way, and it seems like maybe she would like to help elevate this vet's standard of care.

And then she's got a new graduate coming in, and he says he wants mentorship. Let's go ahead and start out how we usually start here at Uncharted, in sort of headspace. if you're this practice owner and you're looking at this, it's a challenge, right? We've got, basically it’s two different challenges.

I think they both go under the heading of Growing and developing doctors, but they're in fairly different places. Do you agree with that, Addie?

Dr. Addie Reinhard: Yeah. And I would say, you know, a big thing that kind of just comes up for me here is something I think about a lot is the individualized nature of, of mentorship and how it's really hard to create just even using the same terminology here of cook, cookbook medicine, but even like a, a cookie cutter mentorship program that kind of fits everyone's needs.

So that's kind of the first thing that came up is that you have two different veterinarians at different stages of their career that are likely going to have very different, needs for what they need for their development the other thing that kind of popped into my head was just the, the conflict that probably needs to be addressed even before kind of implementing mentorship with this associate veterinarian and sounds like there's some underlying disagreements on that.

Maybe values in medicine that, that might need to be addressed first. So those are kind of two of the things that just like jumped out at me initially.

Dr. Andy Roark: Yeah, I like that a lot. So, I do I think you're probably right. I think probably jumping straight to “how do I mentor this associate vet” is probably a recipe for disaster. I completely agree. I think we need to have, we need to have kind of a meeting of the minds about what success in the practice kind of looks like and some, you know, I think, I think we've got to get on the same page a little bit more about the importance of, of, of at least practicing a similar standard of care and things like that.

I've seen a lot of people lay down development plans for associates that are not interested in development plans. And then it's just basically it's a mechanism for writing the person up and managing them out of the practice, right? Like you're like, Hey, here's what you're going to do.

And the person's like, I never said I was going to do that. Well, you're behind schedule already and that, that never ends well. So, I think, I think you're right about sort of the honest conversation about what we're trying to do. I think to your point, I think that the new graduate coming in gives you a really good reason to have that career conversation about coming into alignment. You know what I mean? It doesn't have to be. Hey, you're not doing as good a job as I am. It can 100 percent be we've got someone new coming in and we want to develop this person. And I'm concerned that us practicing very different types of medicine is going to be confusing.

And also we're going to end up with a person who's practicing a third type of medicine and that's really not the direction that we want to go and so I think as this person is coming in, I would really like to work with you about the two of us figuring out where we can come together and how we can come together so that we can help mentor this new person together and then also as the practice owner, it's, it's interesting.

I see a lot of practice owners and I've, I'm notorious for this, is if there's a need, I throw myself on to the, that need, but as a result, you end up having people standing around who would love to help you, but you didn't give them the opportunity. You just assumed that as the practice owner, you have to mentor this new person coming in.

And so I, I end up throwing myself on to work that other people would be happy to help me with if I had just coordinated with them, sort of have a conversation with them, you know what I mean? And, and, and, and ask for their help.

Dr. Addie Reinhard: Yeah, and I would add, you know, I think even coming into alignment on how each vet is practicing medicine, and maybe it doesn't have to be the same, like I think that there's also value in, in diversity and, and how we approach things, and if we can get on the same page with this associate vet of kind of agreeing that maybe we are practicing in different ways and this is how we want to mentor this individual coming in and getting on the same page.

You do bring up a good point about who's going to be this person's mentor potentially, or what kind of mentor network are you going to create? And I don't, I don't think that it has to be the, the practice owner mentoring this individual and maybe the associate veterinarian is interested in doing some mentorship and might, might be interested in that role as well.

But I think, I mean, a big thing, another thing that kind of comes into my head as I, I look at this is how important it is to for development plans to come from the mentee or the individual being developed and letting them set their own goals for, for development and not imposing your own, and I think you were hitting on this, like, not imposing your own development plans on these individuals.

And I mean, the, the only way to do that is, is to ask, but that's jumping into actions, but,

Dr. Andy Roark: Well, I mean, it is. But I think, I think from a headspace standpoint, I think you make really good points. I think, I think the, the sort of the headspace part of this for me is a lot of, a lot of our, a lot of our veterinarians, a lot of our medical directors, a lot of our practice owners, a lot of our practice managers are very much high achieving people, and they like to have a plan, and they like to have control, and they like to be ready.

And so. I have found that it's really hard and can feel very frustrating when people are like, I want to write the plan down and make this program and give it to them. And you go, yeah, but you really need to talk to them and, and honestly, and honestly kind of hold this plan a little bit loosely because if they're coming out of vet school, they don't know what they're going to struggle with.

They don't know what they don't know. I have, there's just, there's certain things in life that you can get so much further ahead if you can have a loose plan and continue to check in and continue to sort of be present and to kind of come back around and make adjustments, but I think a lot of people really struggle.

They feel like they're not doing it, doing what they're supposed to be doing, or they're unprepared because how this mentorship is going to go, it's really a bit nebulous. Like I'll say stuff like all the time, like, well, we're going to, we're going to go in and we're going to work with this person. We're going to see how it goes.

And they're like, yeah, but what are we going to actually do? And I'm like, we're going to talk to them and kind of see what happens. And then we'll take that information and we'll, we'll. Make some decisions based on that. Great. But what do we put on this piece of paper that I'm holding so that I can feel like we have a clear plan when we get started?

And I think, I think giving people permission to not have a bullet pointed 32 page mentorship plan. I think that that's an important piece of headspace. And it sounds like you're, you're on board with that. Would you agree? Or am I being too cavalier?

Dr. Addie Reinhard: I, I think that, so I think what you're referring to is kind of structured flexibility. At least that's what I, how I like to think about it. Like having some plans in place, but being willing to adapt those plans to fit the needs of the individual. So I do think that before this new grad even starts that there should be some intentionality behind what is going to happen in the first three to six months, and some sort of plan put together, but that doesn't have to be done all by you and it shouldn't be done all by you. It should be done collaboratively with that new grad. Now, a lot of new grads don't really know what they need when they're in vet school, but some of them do.

I remember when I was in fourth year, I knew, I'm not confident at surgery. I'm going to need a lot of support here. And so we need to come up with some really structured plans around okay, am I going to shadow in surgery for the first few months? Am I going to do this then and and I think that would give me more confidence coming into an environment knowing okay, the plan is this and also if I, you know, exceed my own and others expectations.

We're willing to shift the plan if needed and revisit the plan. So, I think I think having some structure is important and then revisiting that structure because I will say, you know ,more and more if we're looking at what new new vet students want and need and what they're looking for. They are looking for that plan And so if we don't have some kind of plan, especially as if you're an independently owned hospital trying to compete and recruit new grad veterinarians you kind of have to have that plan in place.

Because so many of the large corporate groups have structured mentorship programming, and a lot of our vet students are looking for that and seeking that out.

Dr. Andy Roark: Yeah. Do you think it's important at this point, right, when you're, when you're thinking about what this relationship might look like and you're sort of getting ready for this person come to, to sort of come into the practice? Addie, like, I'm, I'm looking around my profession and I got this, I got this idea.

Yeah. And so I, I am starting to wonder a little bit if there's not this weird phase of people's careers that has emerged recently, which is like the baby vet phase. And so I started hearing the term baby vet, like, I don't know, it's

Dr. Addie Reinhard: I don't like that term.

Dr. Andy Roark: I don't either. I'm glad you said that. I don't like that either.

Dr. Addie Reinhard: No, because they're not babies.

Dr. Andy Roark: They're not, they are trained professionals. They've had four years of advanced school.

Dr. Addie Reinhard: Well and they call themselves that sometimes, too. And,

Dr. Andy Roark: They're told that.

Dr. Addie Reinhard: I know, yeah, they're, they're, they're doctors. Aww.

Dr. Andy Roark: I had someone say, Oh, well, you know, that was our baby vet. And I said, how long has your baby vet been there? And they said, three years. And I was like, look, if I had someone, if one of my friends was like, yeah, I have a baby. And I said, how old's your baby? And they said, three years. I'd be very much a toddler.

That is very much not a, not a baby. But so the reason I say this,

Dr. Addie Reinhard: I see it as a microaggression for sure like that can be a hurtful comment to a lot of young veterinarians,

Dr. Andy Roark: Oh, it definitely, it definitely does not help them build credibility with the staff and it definitely does not help them build credibility with the clients. When and I'm certain there's I think I think a lot of people think it's an adorable term. Again, i'm trying to bash on people that use it. It is kind of adorable. I get it. But it doesn't help build confidence 

Dr. Addie Reinhard: I do, I think people are using it as like a term of endearment with good intentions that aren't meant to hurt or harm, and I do recognize that. And also, I think anything that does have the potential to hurt or harm someone, like, I think some people might look at it as, Oh, like, but then there are other people who could be hurt by that. So, I've tried to eliminate that from my vocabulary, so.

Dr. Andy Roark: I, I agree with that. I think, I think there's two pieces to this one is, you know, I always try to tell doctors, trust is the currency that you deal in. It's trust that your staff has in you. It's trust that the clients have in you. Like there's nothing more valuable than trust. This is a relationship business, whether you're dealing with staff or dealing with clients.

And the idea that you're a baby vet. Nobody's gonna trust a baby. It's just kind of a, babies are not known for being trustworthy. It's just, and so I think that, I think that the term, again, I agree with you. I think everyone's using it in good intention. I don't think it's meant to put people down usually.

But, but, I think it undermines that. The other, the other, part of this is, I've got a little bit of concern that when we talk to vet students and say, oh, you're going to be a baby vet, or we bring people in and say, well, now you're, you're a baby vet, or even we talk to them about being mentored. And if we don't talk about the right way, I feel like there can be this weird period of almost arrested development where the person has graduated from vet school, but they don't actually see themself as a competent, fully functional veterinarian. It's almost like, like they haven't been pushed out of the nest yet. And again, I don't want to throw people out. You know what I mean? I'm definitely not a suck it up, throw them to the wolves. That's not how I, how I roll. And at the same time, there is some concern sometimes about giving people a nice, comfortable place to stay where they haven't been fully put into a place of being a decision maker. The expectation has not been set that, you know, you're you're a doctor now and you make these decisions and things like that. And so anyway, it's just when we're talking about the mentorship program and you talked a little bit about a formal mentorship program.

To me, it feels important to set general guidelines of how this program ends and kind of how we're going to move the vet out of a mentorship program. Do you agree with that? Or do you, do you think that I'm kind of overstating the case against having a formal end to a program or for having a formal end?

Dr. Addie Reinhard: I think it's important to have things that are time bound to revisit the relationship and at the same time, I think that people need mentorship throughout their entire career. And so I think development plans should always be in place. So, so, you know, I mean, and I think picking a time of how long you want this development plan to be is again around whatever the mentee kind of thinks and wants and needs, I've seen anywhere from six months, a year, two years.

And I, I think having spots where you can check in, reevaluate, see where you've been and, you know, make shifts and alter your course and your direction, I think is important. Yeah, all of our programming is, is time bound and, and I think that's just, you know, solid to do. In 

Dr. Andy Roark: Yeah. Now that you're saying this, I think for me, there's a specific onboarding period. I guess that's what I'm talking about because you're right. Like mentorship and growth should continue throughout your career. There's a certain amount of time when you're sort of onboarded until you are seen as a fully autonomous person, veterinarian and member of the staff, but I don't think mentorship should end at that point But I do think that sort of passive autonomy is important. I I think that you're totally right I think I think I would not pick an arbitrary time and say it's three months and then over the side of the boat you go like that's it shouldn't be it shouldn't be that.

Dr. Addie Reinhard: Well, and I think the individual matters in this situation, so some of my classmates and I see a lot of early career vets are just ready to go, ready to take the reins, ready to have that autonomy on day one, and they know their limits, and yeah, go for it. And also we're going to have some structured development in place and some mentorship.

And then other veterinarians are so scared of making a mistake and don't want to screw up and need a little bit more hand holding that eventually turns into a little bit of needing some pushing out of the nest as well. That's kind of my personal experience. I had great mentorship and also my mentors had to keep pushing me to build my own confidence.

And so I think so much of this is so individually dependent, and I will keep hitting on that because you really do have to know who you're helping and, and what their needs are. 

Dr. Andy Roark: Yeah, I think, I think that that makes a ton of sense. Would you, I guess now that we're sort of talking about this and getting to it from just again, what we're looking at as far as development, I think you put your finger right on it with the associate that I, I think we've gotta, we've gotta kind of sort out kind of how we're feeling and what expectations are about how similarly we're similarly we're gonna practice and, and things like that.

And, and, and make sure we can try to get this person to buy into coming together. You know, as a, as a team, I guess, in, in sort of our approach. But the nuts and bolts of the mentorship program for the established doctor feel fairly similar to me. Do you agree with that as far as, it's going to be very individual, it's going to have sort of ongoing feedback?

We need to sort of tailor it to the person that we're working with. It should ideally be something that they're really excited about and they see value in. Is there anything, it's saying that I can, if I can get the associate vet sort of deciding to go into this development with the idea that they might grow in sort of how they're practicing.

Is there anything that you're going to look at differently when you're starting to think about developing your associate over your new graduate?

Dr. Addie Reinhard: You know, I think with the associate vet we have to recognize a lot of their own knowledge and experience and expertise. And the stage that they're in is inherently different than the new graduate. And so I, I think. I do, I see underlying this there, there is this conflict in the way this person is practicing medicine and it's not matching the way that I'm practicing medicine.

And I think the question that I have is, is that a bad thing? Like where can, can we check it? Are there some underlying biases here that are affecting how I'm viewing the way that this associate is practicing medicine? And, is this, because everybody does things a little differently and if, if we can kind of come to terms with like giving this person some autonomy and maybe then they will also be more bought into development and growth of themselves if they feel more ownership in what they're doing and where they're going with their career but, but again, the same things I think that we talked about before do apply of understanding their needs you know, You know, after we get through the initial trust building and getting back on the same page.

But I think coming to them and understanding their needs, where do they want to grow? What do they want to learn? And maybe that's different than what you want them to learn. And that's okay. And being able to let them kind of decide the path of their own mentorship and development and whatever that looks like.

And that could be, maybe they want to pursue some kind of medical development. maybe they want to pursue some type of leadership development. And I think giving them some, I think a concept that I kind of come back to a lot with mentorship, especially for adults and adult learners, is self directed learning and how powerful that can be.

Right? And so, If I am really excited about a hobby, let's say homesteading, I'm going to be doing a lot more work to understand, you know, and, and I'm reading building codes to understand how to build this structure. And I'm just getting really deep into it because I'm excited about it. It's something that I want to learn and I'm interested in it versus something else that I'm not very interested in learning about. I'm, and then I feel like it's just another job added on to my day. And so finding things that people are interested in and finding those sparks of interest and encouraging those sparks of interest and providing resources and support and funding to further develop those skills and the sparks, I think, I, I think is a good, good way to go.

Dr. Andy Roark: No, I, I completely agree. Yeah, there's feeding people's innate interest always, always takes us further than, than pushing them through a program, I think.

Dr. Addie Reinhard: Yeah, and, and one more thing I will say, like, we have probably two very different stages. I don't know, did they mention where this associate was at in their career? Like mid career, early 

Dr. Andy Roark: No, it didn't say.

Dr. Addie Reinhard: Yeah, so I, I think oftentimes too, like, early career is very different than, like, mid career. I'd say, like, three years out, up to, like, 20 years. Oftentimes, what we see is, like, this boredom and just this mundanity and and I don't know if that's where this associate is at but finding things to break that cycle of job boredom and giving them something to be excited about again I think could be really important here. So when I'm looking at the inherently different two different people.

One is like eager to enter the career, excited to learn. One maybe potentially like, Hey, I've been doing this for a while, kind of bored. Like I'm just here to do my job, get my paycheck and go home. So I think you're, you're going to have like two different motivations here that you're going to have to look at and, and look at some maybe job crafting things for the, the mid career potentially, 

Dr. Andy Roark: Yeah. I love that. I think, I think you may have just cracked, I think you may have cracked that open in my mind. Like that totally makes sense. There's a lot about this that feels like we've all been there. I mean, you know, if you've, if you practice 5, 10 years a lot of the days start to kind of feel the same.

And I think there's sort of a malaise that sets in. And if you can talk to somebody about what would be exciting to you, I think sometimes people struggle to think figure that out, but I think it's worth continuing to explore. And then if you can, if you can let people grow in that area, I think, I think you should always be growing.

I think it should always be something you're getting better at, something you're always being coached at. I just, it's just general sort of perspective that again, it's, it robs you of the feeling that you are a comfortable expert, but I think in the long term, it keeps you much more engaged and, and interested in the work that you're doing.

Dr. Addie Reinhard: And for a lot of mid-career vets, that's teaching and learning and mentoring the new generation. So that could lead very nicely into what we're going to talk about next, I guess. Are we going to actions yet?

Dr. Andy Roark: Yeah, let's, all right. Let's take it. Let's take a quick break and then we're going to come back and we're going to jump into action steps. 

Hey guys, I just have to jump in with  incredible news. I will be traveling with the Uncharted Veterinary Conference team. That includes Stephanie Goss and Maria Pirita. We are going to Minneapolis for the NAVC HiVE. Conference that is there. This is on June 15th and 16th guys. We are doing a one day Uncharted conflict management training program. 

That's right. And it is included with the cost of HiVE. All you have to do is register for the HiVE conference that's $99 for two days, one day, you can spend it with us,  bring your team, send multiple people from your practice, put them together. We'll put them at round tables. We will have them working together, talking about conflict management. 

We're going to take them through a whole day. This is not a series of lectures. It's not, they're going to go to one and they're going to do something else. Nope. Check the box register for the Uncharted event at HiVE. And you will spend the day with us. And I guess you're never going to see an Uncharted event that is a day long. 

That is $99. Again, like this is the best price you will ever see on conflict management. So anyway, if you are anywhere near Minneapolis, June 15th and 16th, Come to the HiVE event it's $99 and you get a day with Uncharted. If you register for it and the other day, you can use it HiVE and get their amazing CE for technicians and managers. Anyway I'll put links in the show notes. 

You should learn more. I'm serious. If you were within hours of HiVE, there was never going to be a chance for you to sign up multiple team members to come together and do conflict management training as a group. This is a phenomenal opportunity, please don't miss it. If you're able to make it, it's going to be great. 

Let's get back into this episode.  

Dr. Andy Roark: All right, Addie, let's get into some action steps here. So we've got we've got, it seems to me like with going through headspace, there's a natural sort of order and progression that kind of makes sense, given that we've got this associate vet uh, we've kind of, kind of picked this person as, you know, she's kind of maybe mid career it's kind of, kind of what we're sort of thinking, sort of hypothesizing here and then we've got this new graduate kind of coming in and we've kind of gotten into the headspace of, you know, we're going to.

try to meet people where they are. We're going to, we're going to see how things go. We're going to have a flexible plan that we're, that we'll sort of start to, to, to put into place. We're going to talk a little bit about what people are excited about. Maybe their motivators, things like that. And sort of to bring this out.

So Addie, where, where do you start if you're this practice owner? You're looking at this situation and start kind of coming together. Just, you know, we're going to have to talk to people and kind of see how things go, but, but lay down sort of your, your chronological approach for me here, if you don't mind.

Dr. Addie Reinhard: Yep. So I think first let's go the wing of the associate vet. So the current vet. I think for that individual I would schedule some time for a one on one with that individual to have a heart to heart and I think really get to the heart, because this is a conflict you know, I'm starting to think about some of my conflict management strategies, but really defining the problem and getting to the heart of, you know, what is, what is the core of Issue here and then trying to to find a path forward together.

I think that is probably going to this is probably going to be multiple meetings with this individual. So one to to get on the same page, hopefully to find the problem next, maybe revisit it, see how we're doing. And then next say, Okay, where are we going to go with your developments? And I think at that point anytime I'm developing any type of programming, the first thing I do is a needs assessment.

And so a needs assessment is essentially just identifying and recognizing the needs of another person. So it's asking them, what, what challenges are you facing right now in your work? What do you see as areas for growth? What resources might be potentially helpful to you? What are you interested in learning more about?

And a lot of times from that conversation and asking really good open ended questions, we can start to get at the heart of, of maybe where this individual wants to grow and where to focus. And I think from there, After your needs assessment is done, collaboratively with that individual, creating some type of structure and plan for what you want that development plan to look like.

So, getting really detailed on the who, what, when, where, why, how of what we're doing. And I think that's a really easy way to think about any type of development plan. programming, including mentorship programming, that's just really easy to remember who, what, when, where, why, how. And if we can really get granular on each of those and then lay out some structure and some preliminary structure for what this development plan is going to look like based on what that individual shares.

And then not forgetting to also create some type of valuation as well, so that we can kind of track our progress and know Are we hitting the goals that we're setting together? When will we know that we've achieved the goals? When are we going to be checking in along the way? So, so that kind of needs assessment, creating structure, and evaluation plan can be done with both the associate and then also then with the, with the vet student and the new grad that's coming in.

I think that would be a really easy place to start.

Dr. Andy Roark: All right, cool. I like this a lot. There's a couple things I want to sort of flesh out I think, that I, that's sort of the way that I look at it. I'm, I'm a big fan of asking for help when it's, so we're talking to our associate vet and we've got our new graduate coming in. I think what I have found in my career is, is a powerful motivator to say, hey, we've got this new graduate coming in.

I'd really like your help in onboarding this person and in helping them have a good experience. I want us to be a practice that we wish we had. Oh, you know, when we were coming out of school, something like that. And I think that that I've just found that people in our industry are, they're so willing to help and they so want to, especially doctors mentoring other doctors who are coming out of school.

Cause we all remember being brand new and I think you can tap into that and sort of ask for that type of help. And it can be a good motivator and and sort of get people to kind of lower their defenses. Because if the. If the ask is not, I want you to do this because I want you to do it, but rather, hey, I want to, I want to try to create this environment or hey, I want us to be able to support this other person.

I need your help supporting this person. I think that could be really good. And, and sort of, it can be a nice motivator and it's a good way to open the conversation.

Dr. Addie Reinhard: Yeah, I think as long as the person wants to teach and mentor. Not

Dr. Andy Roark: exactly right. Sure. 

Dr. Addie Reinhard: Yeah, because if you ask me that no, I mean if you ask me that and and i'm not really interested in teaching And that's the expectation then that that's another conflict that we're gonna have too with this associate.

So 

Dr. Andy Roark: yeah. Good call. 

Dr. Addie Reinhard: Yeah, so I think making sure that they want to do it, but I do think that most And most people want to teach and mentor and enjoy teaching. And that's a lot of veterinarians are in this profession because they enjoy educating and teaching and mentoring. But I think yeah, making sure that this person has also bought into that as

Dr. Andy Roark: Yeah. No, I, I, I'm going to check my biases here. You're you guys, I love teaching. I'm like, yes, I will. A hundred percent. But no, I think that's a, that's a fair point. You know, the other thing I really like in talking about development and, and sort of trying to keep teaching grow doctors is I'm a big fan of future facing conversations, which are a lot about like, where do you want to be?

To be, you know, a year from now, what would you like to be doing? What would make you, what would make you happy? What would make, what would you, what would be interesting to you? What is something that you would like to do more of, you know, in the next six or 12 months. And for whatever reason, I think people have a hard time looking at last year and deciding what they want to do.

But if I can get them thinking about 2025 and what that might look like, because nothing there is written. I mean, it could be wherever you would kind of want to go. That, that. Looking into the future of what we might have or where we might go, I found that that's an easier sort of exercise for people and also, you know, I really, I totally believe there's going to be a couple of meetings, but I think kind of getting that out of like, what are you excited about?

What are areas that you would just just find interesting? Even if it's not something that you do a lot of what? Whoa, whoa. What, what might that look like and trying to get them that in that future facing mentality, I think it's really good. It's a whole lot easier to talk to people about where they're going in the future than to talk to them about where they've come from in the past.

People tend to get a little bit defensive if we start to talk about their performance in the last year or what they did in the last year as opposed to, I don't know, When you look ahead, what do you think you, you might kind of like? So I'm just a big fan of that sort of future facing sort of perspective.

Walk me through a little bit, the, the valuation plan, Addie. So I really like this, you know, if we don't measure it, we, we're not going to management. I think it's good to have some sort of some sort of check in. So we're not just saying that we're developing and then nothing's really happening. What, what would a, what, what sort of an evaluation plan for a mid career?

Associate veterinarian sort of look like.

Dr. Addie Reinhard: I think the evaluation depends on like what you're. trying to gain so, so much of evaluation is what are the goals for the program and then asking questions or using measures to track that progress and there are so many different ways to evaluate and I think this is something that I've historically seen not done very well and because most people just so any evaluation is better than none.

But you know, an evaluation could be something as simple as Seeking feedback from the individual on how the development plan is going and what they like about it and what they don't like about it and what they would want to improve for the future. It could be as intense as surveys or tracking different measures over time, tracking, financial measures or production.

So I think so much of evaluation depends on. What are you trying to accomplish here? And I think that's where with your kind of mentorship structure and 

plan, you need to really get at the heart of what, what are the goals and the objectives here? Like what are the main learning objectives? What are the main goals for both the individual as well as the practice?

And then when you can take those goals and look at, okay, what is it that we're trying to accomplish? Then the evaluation should be a little bit easier because you can design like if the goal is to make this person go from seeing one hour appointments to 30 minute appointments and so much of the development is trying to get this person More efficient and that's something that they want for themselves Maybe they're paid on production and want to be more efficient then you could look at appointment times so in six months Did we do that?

hit the 30 minute appointment time slot. So I think that it really just depends on what you're trying to accomplish. I think it's a little bit harder when we kind of start looking at more professional skills type things. So leadership skills or things like that. But even then, if you're trying to improve your communication and leadership skills, then maybe you ask the team to provide feedback before and after of, you know, Well, you know, where so there's so many different things that you can do with evaluation, but I think just spending some intentional time thinking about how you're going to measure your progress, how you're going to track your progress and put into place.

Okay, at this point, we're going to do this survey, or at this point, we're going to do a check in that can help us stay on track so that we know that what we're doing is actually. Having an impact, and then it makes us all feel better because, oh, all that time and money that we put into doing all this is actually having the desired outcome.

Dr. Andy Roark: Yeah. Are there things you stay away from, as far as evaluation? Like you, like, yeah, are there, are there things you say, I, I, I think this is a bad, this is a bad way to measure a program.

Dr. Addie Reinhard: Yeah, that's tough. some new and recent grads get freaked out, too, by just, like, Tracking their financial kind of productivity especially like really really early in the career if they're like first year out and you're constantly Telling them, you know, hey, you need to make more money here You need to do more of this and like it can feel to them I think that you're more focused on the money than actually their growth and development.

So I'm not saying to not look at those things at all and not, you know, pay attention to them, but that's kind of a, an area where we just need to proceed with caution, like, and the flashing yellow light. So just be, be, be cautious. And. I mean, because at the heart of it, you know, if we put the person first, and developing the person first, then the other things should fall into place too.

But, but yeah, other things, I don't know, like, I've never been asked, what do I not ask? 

Dr. Andy Roark: Well, I, I think you put, you went directly to where I was going, right? And that was just sort of my, my take is, to me, especially if you're calling it a mentorship program, there's not a lot of veterinarians, in my experience, that are, Well, there's some, but there's not an overwhelming majority of veterinarians that are motivated by money.

And as a measure of, boy, this program's been 

successful because you've brought in so much more money. And instead, I much more commonly see pushback against that of, I was told I needed to do a development program, and then they really didn't. Zeroed in on how much money I was making at appointments and that, I've seen that really just poison the, the waters to the point that the vet's going to leave and, and, and I don't, having, being a business owner, I totally understand.

Sometimes you go, guys, this has got to make financial sense. Like we have got to be profitable. We have to pay our staff. I 100 percent get it. And so anyway, but you mentioned, you mentioned sort of financial, you know, metrics or whatever. I was just, I was just sort of curious if that was, if you shared sort of my concerns about going to that.

I think a lot of times I, now if there's a veterinarian who says, I have a lot of student debt and I want to be a very productive veterinarian, you'd say, Hey, Great. Well, let's start working. We'll look at this and we'll pay attention to how you're moving through your day and what revenue is. But if someone says, you know, I really, I really want to practice high standard of care.

And you say, great, your average client transaction will show us that you're doing really good medicine. I don't know that people buy that. I think that there's probably other metrics that we want to. Pick, you know, ideally what you want to do is because you're trying to give this person a scoreboard and no one wants a scoreboard that makes them feel icky, you know, and so I think you have to kind of just keep that in mind and I'm not saying you should choose this or choose that, but I do think that there are some scoreboards that have a higher potential for making people feel icky than 

others. 

Dr. Addie Reinhard: yeah, and I think if your mentee or the person you're developing is really business minded and wanting to learn more about business development and all those sorts of things, then yeah, talk a ton about the money and but I would say the majority, especially of our newest grads who've only been out a year, they're just trying not to kill something at the heart of

Dr. Andy Roark: Yes. 

Dr. Addie Reinhard: Right? I 

Dr. Andy Roark: Yeah. Yeah. 

Dr. Addie Reinhard: in year one, you're just trying not to kill anything accidentally, and so I think if we can maybe make sure that we're focusing on things that build confidence and make them feel like they're a good doctor, practicing, you know, The good medicine and yeah, I think getting along with clients and the team and, and some of that can be, yeah, client feedback to how's this individual doing and, and being sure to share those positive.

Reviews and feedback. I was at a clinic. I thought this was a really Good idea, but any any clients that we had that came in That I had a good appointment with they asked me to send them a personalized email to give me a google review And so by the by year one I had like 30 really great Reviews from clients and like that made me feel really good because like oh, yeah I I clearly helped these people on this animal and these animals.

So

Dr. Andy Roark: You sent the email or they said you did  it. So you were like, hey, would you write a review on Google? That's great. 

Dr. Addie Reinhard: Yeah. I said, hey, like, I, it was great to meet you this week. I really enjoyed our appointment. I'm trying to, you know, just build my trust in the, in the community and I would love to have your feedback on how I did. If you feel comfortable, no pressure, but you know, if you're interested in sharing a review for me, I would really appreciate that.

And a lot of people did. So yeah.

Dr. Andy Roark: I would I totally especially if someone was like, hey I'm new here and I'm trying to build trust in the community I think I would a hundred percent be like, you know, what I I will support this person like that I love you do that You know the one the only last thing I would say here on metrics too is I do there's definitely value in sort of surveying You team, you know, for working on communication or things like that.

And again, this is, you know, how you get scars early in your career that like you always remember I, if you're going to do any sort of a 360 evaluation or interview, that should always go through an intermediary, 

like just opening up to the staff and just being like, Hey, tell Dr. Roark how he's doing his communication. 

It's anonymous. Like, Oh boy, I have seen that go so badly with such hurt feelings. And it's like, if this had gone through an intermediary who was not involved, who could just see the feedback and maybe process it and then say, Oh, well, overall this, you know, this is the positive things that we saw. And these are the areas.

To, to work on you assume that people on your team will communicate professionally and that's not always true. And so anyway, that's just a, that's a, that's a, that's a scar that I can show you from early in my career of, of a time that, that, that did not, that did not go as well as I wanted.

Dr. Addie Reinhard: I have one of those scars too from team feedback. Well, and I think the important piece is Asking the person if they're okay with getting feedback from the team, because I didn't know that I was getting the feedback. And it was like, and then 

Dr. Andy Roark: oh, wow. 

Dr. Addie Reinhard: oh,

Dr. Andy Roark: an intervention. You're, you're like, oh, everyone's here for, for, I'm sorry. Am I sitting down now?

Dr. Addie Reinhard: and it was all written like in a number format, but still it was like, I didn't know you all were even doing this.

And now I'm getting real defensive because like, I didn't realize and the other vet got these scores and I'm only at here. And so I think yeah, just 

Dr. Andy Roark: You got to see what the other vets got?

Dr. Addie Reinhard: Just one other vet, so.

Dr. Andy Roark: Oh, the comparison is the thief of Joy.  

Dr. Addie Reinhard: So be careful about comparison, especially if you have more than one, you know early career vet be careful about asking to let the person know what feedback you're getting and make sure they're okay with that. So they're prepared. Make sure you use lots of positives. We're fragile creatures. 

Dr. Andy Roark: Yes, we are. Yes, a lot of, there's some fragile egos. And again, myself included in the pile. there's, you know, 

Dr. Addie Reinhard: Yeah, it's providing feedback regularly that's small is gonna help much more than here's all of this for you to process, so.

Dr. Andy Roark: Yeah, I, I'm going to write a little article about this, but I just had interaction with a young veterinarian who is crushing, like she is amazing. And she got the first client that didn't want to see her. And like, it has been devastating. I mean, I'm just like, you have all of this positive feedback, all of, you know, you're doing all these things well, like you get so much positive feedback, but the idea that there's a client that does not want to see her is absolutely cutting her and I'm just, I'm good.

I don't know who needs to hear it. Every great veterinarian that I know. Has got a client who won't see them. Like, every great veteran I know has, there's someone who just will not let that person see their pet. And like, I know some amazing vets, and they've all got that client. And so, it's just, it's part of being, it's part of being human and working with other human beings.

It doesn't matter how amazing you are. But boy, it, I think everyone is devastated the first time they get a client who's like, I don't want to see, do not schedule with Dr. Roark. I'm like, Oh, fragile creatures. 

Dr. Addie Reinhard: It hurts.  I've had a couple of those, and yeah, it always you try not to take it personally, but it's impossible not to. I was gonna add one more thing about kind of your structure and your plan for your mentorship program. Don't, I, I think one thing I see people do a lot is thinking they have to do it all themselves.

And there are so many resources out there now CE, development, stuff like what you're doing at Uncharted and what we're doing at MentorVet, like, you don't have to do it all alone. And having, being able to supplement your internal development with, you know, Some external programming you know, that could even look like you know, I know we have like a CE budget, but that could also look like, here's your budget for your mentorship program.

And I know you really are interested in surgical skills. So let's find you a dental CE wet lab to go alongside this. And so I think really remembering that. Especially because we're all so busy right now that you don't have to do it all yourself and leveraging some of these external resources can be really helpful and make the person feel really valued that you're giving them something outside of the clinic too.

Dr. Andy Roark: Yeah, I completely agree with that. You know, you and I are good friends. And you know, for people who don't know, but we we are, we, we, we talk on the phone about 

Dr. Addie Reinhard: At least weekly, yeah. 

Dr. Andy Roark: At least weekly. Yeah. Yeah. You were, you were at 

my house. You were at my house eating sandwiches last weekend. yeah. And so you and I, you and I are tight. And I think we see, we see the industry through very similar eyes, I think. And we're both huge believers in the power of community and connection. And so, you know, Being able to have people that you can talk to, being able to have people who are willing to be vulnerable and say, yeah, I, I did this wrong when I got started or oh boy, I, I've, I've been there as well.

You know, just, just the ability to kind of, I don't know, to not feel like you're alone and not feel like you're alone surrounded by experts. I think that that I think you and I both both really strongly believe in that. I think yeah. Yeah, I, I, I always sort of say to people, you know, I, I'm not a big believer in the sage that knows everything.

I'm a much bigger believer in that we're all backpackers and I've seen parts of the trail that maybe you haven't seen yet and you've seen parts of the trail that maybe I haven't seen yet, but we should get together and compare our maps and you know, I can give you some encouragement and maybe I can help you not get stuck in the mud hole that I got into.

And but I just, I think that's really important. I don't think our industry necessarily innately. buys into that. I think we were all trained by the sage at the front of the room who 

was like, this is how you do it. This is, this is the right way. And so, it's just, I really, I just feel like, Addie, I'm, I'm really appreciate you being here.

I really love, you know, your approach right off the bat of, we need to talk to these people and see what their needs are and see what their interests are and see how confident and comfortable they are. It's that's, that's just meeting people where they are. And it's kind of the essence of what we do at Uncharted.

And it's the essence of what you guys do at MentorVet. And so I just think that's why it's, It's why you and I are such good friends. It's why I admire you so much as a professional and what you're doing at MentorVet.

Dr. Addie Reinhard: Aw, well, thanks, Andy. Yeah, it's always fun chatting with you about industry issues and I'm definitely, I don't know, I have to come to terms with what, what does expert even mean and I, I think that I don't claim to ever be usually an expert in, in most things because there's still so much that I don't know and even talking about this case, like, you know, I think so much of the, the solutions that we have to come up with have to happen locally with the people around us and Yeah, I think take all these suggestions.

Hopefully they helped and, and also know that we're, we're probably not the experts on all of this as well. And so there might be other solutions that, that are good, that, that might be really beneficial, but yeah, always, always enjoy our chats. It's, I always learn something new. So, yeah, thanks for having me on.

Dr. Andy Roark: Awesome. Well, Addie, thanks for being here. Guys, thanks for tuning in and listening. Take care of yourselves, everybody.

And that's what we got. Thanks so much to Addie Reinhard from MentorVet for being here, guys. I hope to see the medical directors out there at our medical director summit on May the 29th. Take care of yourselves, everybody. If you think this episode would help somebody, you know, make sure to send it to them, that's always so kind, or leave us a review wherever you get your podcasts.

Anyway, that's it. See you later, everybody.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: communication, culture, management, Vet Tech

May 01 2024

We Can’t Get Clients In

Clients are feeling extremely frustrated by not being able to get seen with a sick pet quickly enough for their liking and unfortunately, the front desk is taking the brunt of the client frustration. This week on the Uncharted Podcast, Stephanie Goss and Dr. Andy Roark jump headfirst into another mailbag episode. They received an email from a practice who is absolutely drowning in clients. They have 5 doctors offering care weekdays AND weekends and they still can't keep up. This practice is pleading for suggestions on not letting the constant backlash wear them down at the desk or on the phones. The team feels like this can be an amazing field to work in, but are feeling like its hard not to dread coming in when the bad calls start to outweigh the good. Let's get into this episode…

Uncharted Veterinary Podcast · UVP – 285 – We Can't Get Clients In

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

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

Submit your questions here: unchartedvet.com/mailbag


Upcoming Events

🌟 Ready to transform your practice's approach to conflict management? Join the Uncharted team for a dynamic conflict management training program during the Hive Event in Minneapolis on June 15th & 16th! This one-day intensive workshop, led by industry experts including Andy Roark, Stephanie Goss and Maria Pirita, will equip you with the skills and tools to handle and train your team in resolving conflicts effectively. This isn't your typical lecture-based training; expect engaging, round-table discussions where you'll dive deep into real-life scenarios, developing practical strategies that can be immediately applied in your practice. It's an investment in your team's harmony and your practice's future. Secure your spot today—check out the link in the show notes for more details. See you in Minneapolis for a day of growth, learning, and fun! https://unchartedvet.com/conflict-management-hive-waitlist/

🌟 Enhance your team's client communication skills with Dr. Andy Roark's Charming the Angry Client on-demand course! Designed for the entire veterinary team, this course offers a year of access to three practical programs: Using Active Staff Training, Charming the Angry Client with essential tools for handling complaints, and Case Study Examples for interactive learning. Empower your staff to handle difficult client interactions confidently and effectively. Enroll now and transform your client service experience! https://drandyroark.com/product/charming-the-angry-client/

Upcoming events: unchartedvet.com/upcoming-events/

All Links: linktr.ee/UnchartedVet


Episode Transcript

Stephanie Goss: Hey everybody. I am Stephanie Goss and this is another episode. Of the uncharted podcast. This week on the podcast, I had a great time talking through a mailbag question with Andy. We got an email about a clinic that is absolutely slammed with appointments. It's a bigger practice. They've got five plus doctors and. They're generally having multiple doctors see appointments every day, including Friday and Sunday as well. But they are just absolutely slammed. 

And the front desk is seeing constant backlash from owners who have sick pets and can't get in. They're wondering how to communicate with the owners that they're doing the best that they can. They're seeing as many patients as they can. And they do still care about their pets because we all know that pet owners, when they're worried can be very intense. 

And so they asked if we had any advice for not letting the backlash wear them down, especially when owners are taking out frustration on the team. Let's get into this.

Dr. Andy Roark: And we are back! It's me, Dr. Andy Roark, and the one and only Stephanie, when can I see you again, Goss?

Stephanie Goss: I really wanted you to sing that one for us.

Dr. Andy Roark: (singing) I, when, can I see you again? 

Yeah. I failed my personal development exercise when I took a break from improv. I took a season off, which is like, it's like four months. I needed a break. I was tired. I was just, I was doing too many things. And whenever your hobby starts to become, whenever your hobby feels just like your work feels that's a bad sign and I love improv comedy. But it was just another meeting on my calendar, you know, like at the end I was like, It's like “what's my monday look like I've got this and then I've got this thing from 7 to 9 on Monday. You know, and then Friday I've got this and then Friday night I've got a 7:30 to you know, 10 a thing” and it was just, it was another meeting. It was another public speaking engagement is what it was feeling like which is sad. But it's like boy when you start feeling that way you gotta take a break So I took a break and then I told myself I was like i'm gonna take a break from improv and i'm gonna take singing lessons because I like to sing and I'm not remotely good at it.

And then I never did it. I chickened out and now I'm going back to improv. I have been looped back into improv which I am now, I am ready to go back. I think people should feel much better about taking 3 to 6 months breaks from their hobbies. Like, I think people, I was always terrified.

I was like, if I quit my hobby, I'll never do it again. And they're like, well, if you don't ever do it again, it's because you don't care. It's because you don't want to do it anymore.

Stephanie Goss: It’s because you don't really like it. Yeah.

Dr. Andy Roark: Or you're just done with it, which is, like, that's not failure. It's time to find something else. But anyway, the improv bug has bitten me again.

I am ready to get back to it. But I didn't have any, I never did my singing lessons and now I don't know if they're gonna happen. And this affects you, Goss, as much as it affects me, and I just want you to think about that.

Stephanie Goss: Okay. I'll continue to be the singer in our partnership.

Dr. Andy Roark: That’s okay. That's right. You'll be, it's funny. You're the singer who does not sing, and I am the not singer who belts it every now and then. Oh, man.

Stephanie Goss: Yeah. Yeah. Well, you know, Maria Pirita can take the singing lessons for you. She is…

Dr. Andy Roark: She’s…

Stephanie Goss: It's so funny because I love her so much. She has such a competitive spirit. 

Dr. Andy Roark: Oh yeah, all I have to do is say to her, I can sing better than you. And then if you said that's true, we wouldn't have to pay for her singing lessons. She would pay for her own singing lessons to make sure that everyone knew that it was true.

Stephanie Goss: Yes, it is, she is quite competitive in that way and the three of us were, where were we? Denver? Kansas City? I don't know. We were somewhere and it’s all a blur.

Dr. Andy Roark: It's amazing, like, I don't remember like, it's all a blur. It's like, buddy, we're living a Johnny Cash song these days.

Stephanie Goss: On the road again

Dr. Andy Roark: I know, we're gonna be, we're gonna be in Minneapolis in June. Like, the Muppet Show rolls on.

Stephanie Goss: It totally does. But we were somewhere, the three of us, and we went to get tacos because that's a thing. And I was singing and Maria was just like, well, I can't sing because you just have such a good voice. And she's like, I need to take singing lessons. And that's when the whole thing started.

And she, unlike you, has actually started taking singing lessons. So, I'll be curious. I'll be curious when we're together again. We'll have to, we'll have to rope her into some singing and see how she's improved.

Dr. Andy Roark: Oh man, yeah, no, I agree. Alright.

Stephanie Goss: How's it going, Andy? How's it going, Andy Roark?

Dr. Andy Roark: It's great. It's great. Well, we've been, we're busy. We, as we're recording this, we recently did the Practice Manager Summit and it was awesome. It was awesome. It was the biggest Practice Manager Summit we've ever done. The feedback on it was phenomenal. Just phenomenal. It was really outstanding. And so you and I are just gonna, I think, uh, basking in the afterglow 

Stephanie Goss: And then we've got, yeah. Medical Director Summit coming, like, at the end of May, and I'm super excited about that. The summits have been great, and I love getting together different groups of practice leaders, you know, like we had done our Practice Management Summit earlier this year, and we're gonna have the Medical Directors Summit happening, and that, I'm excited about that, because it's fun to bring together, um, people who are in the same position, but in all different types of practice, private, corporate, big, small, ER, general practice, all of the things. So I'm really looking forward to that, but you're not wrong. We are busy bees, busy bees.

Dr. Andy Roark: Yeah, it's funny, you know, remember when you're in your 20s and people are like, We're gonna go to this bar and then we're going to this club, and then we're gonna go dancing and you were like, yeah! And then you were in your 30s and they're like, We're gonna go to this bar and you're like yeah!

And then we're gonna go this club and you're like, ooh! And then we're gonna go dancing and you're like, oh, that's, we're starting to get close to that. I'm just like, oh! Young party Andy is like, oh, this is, I'm excited about all of these things. I'm just gonna, I'm gonna need a nap between each one of them, or this is not gonna happen.

But that's where I am.

Stephanie Goss: We've hit that, we've hit that.

Dr. Andy Roark: Exactly. Alright, let's do this mailbag question.

Stephanie Goss: Okay, let's do it. 

Dr. Andy Roark: Let’s do this thing.

Stephanie Goss: Okay. So I'm excited about this one because we got a question about the front desk. So it's from a clinic who is just absolutely slammed with appointments and they are a bigger hospital. They've got or I guess medium sized they've got five doctors And so generally they've got two to three doctors seeing appointments every day.

They see appointments on Saturday and Sunday. They book their entire schedule full. They also offer drop offs. They've got same day appointments books you know, same day slots saved and then they're taking a few emergencies on top of a fully booked schedule and so they're struggling. This is from a CSR who is struggling because they feel like every day there are owners who are frustrated because they have a sick pet and they can't get in for a week and a half or two weeks and you know that the answer is you know, we, here's what we can do, or when they've hit the tipping point already in the day by the time the owners call, they, are having to say you know, we can refer you to the local emergency hospital. so their question was kind of twofold. One is they were looking for some advice on how to say the thing, right? From the two of us like how do we tell owners that we're Doing our best to get as many patients in and we care about their pets. And this is what we can do for you, right? Like how do we frame that in a way that goes over better than it's currently going over and they wanted to know if we had any advice for not letting the constant frustration and anger and upset, which is understandable from their perspective, but how do they not let that get to them?

Because they are feeling like, you know, this is a great field to work in. And there are several of the CSR team that are just really struggling with feeling like, I don't want to come in. And I especially don't want to be on the phones when I know that I'm going to have to tell people, “Sorry, we can't see you.”

And then they're going to be frustrated. And so I thought this was a great set of questions to work through.

Dr. Andy Roark: I love this. There's a lot going on here. And so I want to get right to work on this. Now, the first thing that we have to do just for us, you and me in this podcast, but then also at the clinic, this is two problems. And if you keep them as one problem, it's going to be a big tentacled monster. Yeah. You can't get your hands around.

And so we got to split them into two. So we have a problem with getting the client seen and we have a problem of dealing with the backlash. And I think that's important because. And I don't think that's what they were saying when they wrote, but you could read this as “How do we tell clients that we're unable to take care of them, or that we're unable to help them again and again?”

That's like, well, the first thing would be see, is there a way that we can help them? And then we don't have to tell them that we can't help them. And so anyway well, let's get into that. So the first thing is getting clients seen. And the second thing is dealing with black backlash. So, the headspace, we always start with headspace.

I'm going to say a thing, Stephanie Goss you have heard me say so many times, but here it goes. Do you want to guess what it is?

Stephanie Goss: I have an idea, but let's see if I'm right. Go ahead.

Dr. Andy Roark: All right. If you're surprised by something again, and again, at some point, it's not a surprise, it's your business—

Stephanie Goss: It’s your business model.

Dr. Andy Roark: Yes, and if, surprise, we have pet owners walking in with sick pets or calling with sick pets again and again at some point. Not seeing pets is your business model.

And like you you cannot act surprised anymore. And again, I'm not coming down on this writer. Like I get it. I really do get it, but you got to see that this is a problem. And so not seeing pets, it really is a problem. Not seeing sick pets, not seeing pets in pain. That is a problem. And again, I am not coming down on this person at all.

I know this pain and this struggle, but let me just lay out why this is a problem is. If you deal with people who have, who are motivated by purpose, and purpose is helping pets in need, and we're taking in happy puppies and kittens, but we're turning away dogs that have pus coming out of their ear, that's a values problem for a lot of people.

And that, that can be, that can really, be hard on the team if they stop and they look at it. Also, from a client perspective, you know, one of the things that we teach in Uncharted is that trust is the cornerstone of our business. We are a relationship business and everything we do should be around building and maintaining trust. And turning people away when they feel like they're in need That's hard to recover from a trust standpoint It is hard to get someone to trust you and then when they're like my dog has torn his dew cloth and there's blood everywhere and it's terrible and he's in pain and he won't start licking you're like, oh, well, yeah, how about next week?

How about next week like that's not the messaging of a trustworthy Like confidant and advisor. And again, I have, I've been on the other side of this, so please don't think I'm coming down on and saying, oh, people are dropping the ball but I think we have to own what a problem this is when it happens.

And so anyway, if you're surprised by something again and again, at some point, You can't be surprised by it anymore. It's your business model. And then two, not being able to see people, it is a really, it is a significant problem. And so we have to start there and lay those things down.

And then we can go into the systems of getting them seen, or we can go into the approach for not taking it personally from a headspace standpoint. Do you have a preference? What do you want to talk about headspace first? Do you want to talk about headspace for Getting into the problem or getting into the reaction to the problem.

Stephanie Goss: Yeah, I think, I think I have one more thing to add to, your perspective about it's, if you, if it happens over and over again, it's your business model. And I feel like As someone who started at the front desk, as a former CSR, I feel this person's pain for two reasons. One is, to your point, the pain of, when this happens, you've been there and it hurts.

Like it, everybody gets here at some point. You get super busy, whether it's because somebody's out sick or because you're just overwhelmed with clients. Everybody goes through this. And I think the second piece of the headspace here is, for me, is about recognizing what you actually can control as a CSR because when I hear you say, you know when it happens over and again, it's your business model and having been the employee of someone who could do something about that and being the person who couldn't do something about that on my own in the moment.

I think the headspace piece for me for the CSR is to recognize the wisdom in your headspace advice is, it's obviously, but I think it's really applicable for the people who can make decisions in the practice. And so I think from a CSR perspective, like recognizing what is actually in your control, and it might not be in your control to change the business model. It is absolutely in your control to advocate for change in the business model.

And so don't think that just because you can't make the change that you don't have the capacity to, lead change, lead, lead people to change. I think that is one of the things to remember: you can always lead from the middle of the pack. It does not have to be by title.

Dr. Andy Roark: Yeah. I think that's totally fair And I'm really glad you said it too. When I say it's your business model, the CSR is like it’s not my business model.

Stephanie Goss: It’s not mine. 

Dr. Andy Roark: And I do agree with that and that is very fair. So, okay, so I just Jumped right into looking at the problem holistically.

You're right. I think framing up from the point of CSR is important So here's headspace. I think for our CSR a person who's writing in is one. I would say I would write down on a post it note in a place that I could see at the words. It's not personal. Which is this, you know, these people are mad like they are mad There's no way that you can tell them you're worried about your personal life pet and we are not going to see your pet for a couple of days and not have them get mad.

They are going to get mad. And if you internalize the idea that they are mad at you and they are talking to you and they will try to make you feel bad because they want you to figure out how to get them in. And so they are pointing this at you, but they're not mad at you. They are mad at the hospital.

They are mad at the situation. They are mad at whatever. Whatever, higher power. Yeah, life, whatever. Like, they are mad. Why is my pet sick? Why is my pet injured? Why do pets die? You know, like that, all of that is anger and frustration. They're mad at themselves because they wish they'd possibly come in earlier.

They feel guilty because, you know, they, took the dog to the dog park and they knew that sometimes things don't go well when they, whatever, like, there's a million things for them to feel mad or angry about,

They're pointing all those things at you, and that's not fair, and you can't take it personally.

Stephanie Goss: And I think we have to remember how strong of a how strong of a reaction fear is, because one of the things that's really easy to forget working in the veterinary profession is, we know what emergencies truly are, and we know what is truly not necessarily an emergency, and we know the things that can wait, but to the average pet owner, and I've really been reminded of this, past week, because I've been visiting my parents, and they have a new newer to them puppy, and, you know, I've been having some conversations with my mom, and it's really It's really easy for me to look at the dog and be like, Oh, I know the course here.

Like, I know, I can just look at this situation after 20 years in vet med and say like, I know these things that you need to do. And I, she was just like, super taken aback at what I said because to her it seemed really extreme. To me it seems like, oh, this is just the next thing that needs to happen. And I think it's really easy for us to forget how much pet owners can get fearful.

And to your point, if a pet tore their dewclaw and they're bleeding all over the house, like it, I could totally imagine where that would be really scary to an owner, especially potentially a first time pet owner. And when we're dealing with frustrated people all day long, it's really easy for us to lose that empathy.

Dr. Andy Roark: Yeah, I completely agree. So I think that's, I think that's important to file away. One of the things that helps me, honestly, is this idea that we seek in the clinical side. And so, you've heard me say before, people are simple animals. And I, that's, it's not about how smart you are. We're all simple animals.

And so a lot of things that we know about pets really translates very well to people. And when we have a German Shepherd that comes into the practice and it's pulling on its leash and snarling and barking its head off and, you know, lunging at people. If you look at that dog as a bad dog or a mean dog, you're going to be less happy, you're going to be less empathetic, you're going to be less effective than if you look at that dog as a terrified pet.

Like that is, that dog is terrified. And again, I'm still not sticking my hand in there. But, that perspective means a lot. If you can change that perspective when you deal with pet owners. It can help you be empathetic, but also not internalize what they're sending your way as much.

Stephanie Goss: Yeah.

Dr. Andy Roark: Remember that you are the messenger. You are the messenger. It's not your policies. You know, you are conveying to them the realities of their situation. You are not deciding that they cannot come in, right? You are just, you're simply conveying the truth of the matter. This is a place where sometimes not remembering that our power is limited makes us feel terrible.

Because if you feel like you are the one who's deciding they can't come in, that feels awful. But it's not your decision. You are simply communicating the status of the situation. And so hopefully that can help you say, I am the messenger. Even if they don't believe you or hear that, you are the messenger.

And that can make it easier to not take these things personally. Remember the old saying that hurt people, hurt people. And when you get angry people, it's because they're hurt. And when they say nasty things to you, this is a hurt person, a scared person who is trying to hurt you. The last part of this I think I would say from a headspace is, and this is just general advice for anybody who's dealing with emotional clients in the vet practices, and just sort of bear with me because some people might not like this advice, but I truly believe it deeply.

You need to be careful about rumination. Like, we need to be very intentional about our feelings, and we should be very careful about sitting in our feelings. And there's just more and more research that's coming out that's talking about depression and anxiety. And just living in our feelings and ruminating in our feelings without a specific intention and in not a thoughtful way, it's not good for us.

And so this, if you're having these conversations again and again, if you need permission, I'm giving it to you now. You don't have to ruminate on these thoughts. You can do your best, you can try hard, you can empathize, you should know that this is a hard job and you're not doing it wrong. It's just a hard job.

You should insist on letting it go as best you can at the end of the day. That does not mean you don't care. It doesn't mean you're a good person or you're not a good person. It means that you have taken on a wellness strategy that's going to keep you in the game and keep you doing your best and allowing you to be happy.

Doing what is an unquestionably hard job. And so, don't ruminate. Insist on letting it go. Just do it, and it does not mean you don't care. It is, this is you putting your oxygen mask on yourself. Insist also on holding the trophy. That's the other thing I would say. I'll flip it around and so that may sound hypocritical as I say, let it go unless it's good and hold on to it.

And people say, well, that's not fair. Andy, if I'm going to let it go, I have to let it all go. No, you don't. And here's why it's called negativity bias is that we are wired to hold on to and remember the negative things that happened to us. That is a survival strategy that is hardwired into our stone age brain and you are going to hold on to negativity, like actively trying to let it go is not going to make, it's not going to make it happen, but if you don't try to let it go, it's going to be a lot worse.

And so you need to refuse rumination, try to let it go and actively circle back at the end of the day and think about all the people that you helped, all of the people who are happy and kind, all of the people who made their, who had their lives made better because of you today, because that does not register in our minds and you need to balance the scales.

And so I, from a headspace standpoint, those are the big things that I would say up front, just, in getting your head right.

Stephanie Goss: One of the things that you can do, and this is something that you can totally suggest from the team, if you have, especially if you're a team that has you know, huddles at the beginning and end of the day, one of the things that I used to do with my team was, what was one thing? That went, that we, went well or that we made us happy today.

And what's one thing that we want to be better tomorrow? It wasn't about what was one thing that went bad, right? It was very forward facing intentionally about, I can't fix what happened today and maybe I dealt with a bunch of angry clients and I'm putting it into a forward facing way so that I can walk out the door and say, you know what, I'm going to leave this negative stuff here and leave it at the door.

I'm not going to take it home to ruminate on it because tomorrow I want to, you know, try harder to get more clients in or I want to you know, help one more angry person or frustrated person. And it can be really hard to do and it can feel kind of. I guess, silly. I had team members say this is really stupid when we first started doing it.

But I will tell you to, if you persist, like, it really does change the way that you think about things.

Dr. Andy Roark: I agree. I agree. You're talking to a guy who has pushed through eye rolls from many teams. Like, I'm like, I don't care. I'm, and like, I have literally told my people or told people I work with, they're like, this is silly. I'm like, well, you do it. You're doing it for me because I want to do it. And I want you to do it with me. And so you're doing it for me.

Stephanie Goss:  Eye rolling has no effect on Andy Roark. He has a very strong badass wife, two teenage daughters, and me. So…

Dr. Andy Roark: They all roll their eyes at me all the time.

Stephanie Goss: You're pretty much immune at this point.

Dr. Andy Roark: I have, I've had lots of eye rolls at me, and I don't feel 'em anymore, but that's it. But yeah, it doesn't, the worst thing is if you roll your eyes at me and I take that ass a challenge, it's like, oh, you think that's awkward? Let me dance while we do this. Like I will take it to 11. All right. So listen, 

Stephanie Goss: Let’s talk about systems.

Dr. Andy Roark: Oh yeah. So just for systems from a head point, from a headspace standpoint I want to get myself into a good, productive place of thinking about what's possible, right? I don't, and again, I think, I thought you, I honestly, I think you did most of my systems work when you talked about, hey, this person is CSR, they can advocate, but they can't make those decisions.

And so I think from a system standpoint, the headspace is just because we've always done something one way doesn't mean we have to keep doing it that way. And there's a lot of, there's a lot of things that we take for granted or take as fact. And we put ourselves into the box. And so thinking outside the box, for example, and this may sound silly, but for a lot of people, the idea of not booking first come first serve, seems like, like that's, it's like saying gravity doesn't exist, like, if that's, what you've always known is, the phone rings, you ask them when they want to come in, and you put them there, the idea that you would not do that and be like, well, this person called first, but they're getting booked two weeks out, and this other person called three days ago, and they're getting seen today, that seems unfair or whatever, and you, look, just, we're going to unpack some stuff here, but just believe me when I say, There may be things that you were just assuming have to be that don't have to be.

So anyway, keep an open mind. Let's look for opportunities and ways to do things better. We can do this without criticizing the past. You know, again, these are things that we can advocate for and, we can have an open mind about trying to think creatively about how I help people while not undermining the team or creating chaos and havoc that the people in the back are going to have to deal with.

Stephanie Goss: And I think I agree with what you are saying a hundred percent. And I think the one thing I would add from a headspace perspective is, I think remembering how much power you do have as a team member and what I will say, just from a headspace perspective is I've been a manager for a really long time. And I was a csr for a really long time and I can tell you that there is a night and day like different planets system difference in how you present systems to the rest of the team.

And so what I mean by that is as a CSR, not that this writer sounded negative. I don't want it to come out that way because they did not. They did not. They sounded very positive in the way they were asking their questions. And I know what it's like to be a CSR team. That's like, we can't help clients. We need to fix this.

That sounds very different than, Hey, we're, we really, want our clients to feel seen and heard, and when they feel like they can't get in for two weeks, and they have a sick pet, they're expressing frustration day after day, over and over again with the front desk. We have some suggestions for ways that we could improve this.

Would it work if…. those two things feel night and day different, and so I think from a headspace perspective, holding on to that, and making sure that when you do bring ideas to the team or to your practice owner or the practice leader make sure to lead with the thing they care about which is getting patients seen and getting clients taken care of because I promise you your practice owner cares about that.

Dr. Andy Roark: Yeah. Alright, let's take a break here and then we'll come back and do action steps.

Stephanie Goss: Perfect.

Hey guys, do you wish that your team was better at handling conflict management? Are you a leader, a medical director, a practice manager, a practice owner and associate vet that wants to not only be able to handle conflict really well in your team, but also to have the tools to train your people so that they have these conversations more gracefully with each other. 

Would you like to work at a place where we're. We're not sniping at each other. We're getting along and communicating effectively. Guys, we can make that happen for you. I and the Uncharted team will be at the hive event in Minneapolis is June 15th and 16th. We are having one day. Conflict management training program. 

So it will be, my team will be there. It is through Uncharted. And so it is going to be one day of working with me and Stephanie Goss and Maria Pirita and we will be breaking down workshops on conflict management and you can drop in. You can get a day, you can spend the other day at the Hive conference. 

It is going to be an absolutely fantastic time. Guys. Ah, I'm going to put a link in the show notes, head over there, check it out, grab your spot. This is not a sit and be lectured at. This is round table workshop discussion format where you get your hands dirty. You get down to the weeds. We talk about what these tactics look like in our teams, in our practices. 

And we walk away at the end of the day with real skills to change the culture. In our practice guys, this is an investment in yourself is an investment in your team. It is an investment in your happiness and in your workplace. Do not miss the opportunity. It may not come around again. This is a great chance to work with us and to really stretch and expand your mind. 

And I promise you're gonna have a great time, gang again, June 15th and 16th in Minneapolis. Hope to see you there. Let's get back into this episode. 

Dr. Andy Roark: Alright, so action steps. What do we do here? And again, I'm going to try my best to talk about this at a hospital level, but then also very much for this CSR. So let's start with the not feeling so beat up after delivering hard messaging, right? So I've got I've got a, I've got a couple things here.

The ones that come immediately to me, I am. Again, it's just sort of covering your basis but I am a believer in having a stated patient client rights and responsibilities agreement. And so again, I see these at the human hospital whenever I have to go there or take a family member there or whatever.

These have become a, a, a part of human medicine. And it basically says, You will get seen, you will get heard. And also, We do not tolerate abusive or foul language. You will be asked to leave. You know, we, will We do have the right to not provide service to people who are treating our staff In abu in abusive way, including raising their voices.

Blah blah blah. And, It's a bummer to have that, but I do think that it's, I think it's a good thing. I think it raises awareness to people about the fact that these things do happen to vet professionals. And then also when someone does it, it gives you a nice clean way to give them feedback as a client and say, Hey, you violated this policy.

It is stated as on our website. It is in our lobby. You know, whatever but this is a policy we have and you did violate these and we're not going to be able to see you anymore.

And it's just, I have a very low tolerance of people abusing the staff and, but one of the awkwardnesses has been in the past is if someone is abusive, it's like, how do you tell them that they were abusive and how do you bring this up?

It's a whole lot easier if you lay down some ground rules at the beginning and and you can have them sign it as part of their new client. Forms and just I wouldn't make a big deal about it, but it is there but once that has been down you can come back and say this is our policy and You use profanity and raised your voice at one of our staff members and that is a violation of our abuse policy And we're as a result, you know This is your one warning or we're not gonna be able to give you services anymore And that is just a way of protecting your staff now I did say here at the beginning, we were talking about people who can't get their pets in and their pets are sick or things like [00:32:00] that.

I try to give grace and recognize people are being human at the same time, abuse, is abuse.

Stephanie Goss: Yes.

Dr. Andy Roark: I don't tend, I tend to give people grace if they raise their voice because they're really mad. And it's like, I've been really mad before. I understand that emotion. So but anyway, state, stated abuse policy.

I hate it, but I do think it's probably good. Best practices for for general practice and emergency and urgent care vet clinics today is you should have something. If you want angry client training, I have the Dr. Andy Roark Charming the Angry Client course on my website. It's at DrAndyRoark.

com and it is broken up into modules and it is meant for teams to take. But if you are like, how do we say these things? things. And how do we handle people who are mad? That is a resource that is on demand that you can have. It goes into a lot of detail. It's got a lot of examples and things to train on.

So we can link that up in the show notes and you can take a look at it. but the thing in there that I'm going to call out right now, [00:33:00] beyond, the interpersonal part of how do you talk to these people. You should have, especially if people are getting mad about the same things, you should have an escalation plan in place.

And that is a request to management to say, when I get these calls and people get angry because of this, what do I do with them? Because me sitting on the phone and just taking it, that doesn't feel good. Good. is the plan and you and I've talked about this before. Do we have a mailbox that we can send them to and say, I understand I'm going to transfer you over to this mailbox and it's for our, you know, our management team and you can give the feedback there.

Is that okay? But something to give to them. Is it to transfer them to the practice manager? Is it to, you know, what do we do to have the medical director call them back? Again, there's no right answer. It depends on your practice and what you want to do, but there's got to be a parachute pull for the front desk to say, look, I've, I have played all my cards.

I have told this person all the stuff and they continue to be angry and they are not happy and they are not satisfied. Okay. Where does this conversation go from here? And in order to protect our front desk, we have to give them tools and pathways to send these clients down so they can be received by people who have more decision making abilities.

Do you agree? 

Stephanie Goss: I don't know. It's, because, and I'll say why, I, it's a tricky, I think it's a tricky double edged sword because I have absolutely watched members of the team when there is a path, take that as the path of least resistance. And instead of trying to make the clients feel heard and do their job, the basic part of the job and the steps leading up to that, the response can just be.

I understand, let me put you through to your manager or let me pull that button. And so I think your point about giving them the tools is really important and I think part of it is our jobs as managers is to train the team to understand what pieces their job and what actually truly unacceptable behavior looks like so that they can see it, they can smell it, they.

They know it's coming, right? So that I would absolutely expect if a client is actually, like, yelling at you, or if there's profanity, things like that, like, I want them to know what those items are, and I want them to understand what constitute repetitive behavior. And so I think from the CSR perspective, something you can start doing today is is just get a notebook and start jotting down the call, what the concern was, and how it manifested. Did they raise their voice? Did they use profanity? Did they say, this is  unacceptable, I want to talk to your manager? What were the things that you are seeing? And just start to keep a log for yourself. and what the result was, like couldn't get them in for two weeks, didn't have an opening for three weeks for whatever it is, because I will tell you that Even leaders and managers and practice owners who are not data driven people cannot argue, well, they still can, but can't argue with things in black and white.

There are some people who will just argue for the sake of arguing, but if you are able to present to them, hey, this is what is happening, and you can make them see it and hear it. And they can see the quantity with which it's happening. It's far easier for a manager to say, Oh, okay, this is not just coming from one person at the front desk.

This is the team as a whole. And this is a volume. This is not just one off incident here, a one off incident there. And so I don't want to put the. Onus for dealing with the problem back on the CSRs because I think the managers do absolutely have to play a role here and It's also I think really important to make sure that the team has the tools to be empowered to do the job because as a CSR I never would have wanted to just pass someone off to my manager.

Like I did all of the things and I have absolutely worked with team members who didn't feel comfortable or just didn't Want to do that and so they would hit that button far faster and as the manager Who has struggled with team members who don't understand the difference in those things having a clear plan of this is how you ask for help I absolutely agree with you on that.

I think it's a, I think it's a fine line between giving them the tools and Teaching them and enabling them to deal with problems themselves and giving them an out button, then I could get on, then I could get on board with you. But I think there are also a lot of people who for a variety of reasons, would probably just use the ripcord if that was all you gave them.

Dr. Andy Roark: Yeah, I think that's fair. I can see that. It's always a balance, right, of supporting people but not to the point that you end up just handling things that they should be able to handle. Yeah, I, path of least resistance is something to pay attention to. So, yeah. No, I think that's, I think that's fair.

So, yeah. I think, well, when you put it that way, it seems like the Dr. Andy Roark Charming the Angry Client course really is the best solution here because it does give people the skills to have these conversations affect, you're

Stephanie Goss: I did not intentionally do that because you don't need more people to tell you how amazing you are when they take your course. 

Dr. Andy Roark: It's a good 

Stephanie Goss: Your head is already too big.

Dr. Andy Roark: It's really a good course, very, like hundreds of people have said so.

Stephanie Goss: I did not intentionally do that. Okay. So what other action steps do we have besides giving them a clear path for angry clients?

Dr. Andy Roark: So, I mean, quite, honestly, it's, there's not much you can do with the front desk other than know what your options are as far as scheduling, are there things that you can do? Because here I will tell you, I have seen people get in a lot of trouble for freestyling and then the, Technicians are the people in the back or the doctors.

They're like, What is this random client doing here? And you can be really trapped in the middle. And so it's hard because you don't have the ability to change those systems. And so knowing what resources you do have, asking continuously, What do I do in these situations? I think that is good.

The big thing is remember not to take it personally. Remember that you are the messenger training for the front desk on, dealing with angry people effectively. All that stuff is important. It is very hard to deal with angry people when they're angry about a specific thing and you don't have any ability to help them in that thing. A lot of times it's just weathering the storm, trying to make them feel heard, trying to make them feel seen. But at some point, if my dog is bleeding everywhere and at the end of our call, my dog is still bleeding everywhere and I don't, and I don't have any How am I supposed to get off that call feeling really good?

that's just really hard. So anyway, there is the personal part, the boundary part, the not taking a personal part, but that's about it for the action steps for me in that regard. The rest of it really comes, from systems, you know,

Stephanie Goss: I agree. That's when I read this. I was like, ooh I have so many ideas for how you actually Solve the problem of not the problem of letting it sit with you, but the problem of we can't get clients in So I think that this is the part where the CSRs might not be able to choose to make the change but they can absolutely choose to suggest the change. So I'm excited to talk about this part.

Dr. Andy Roark: Yeah, totally. So, so, I agree. So, we need to think about this because having sick pets come in and not get seen, that's really damaging in a lot of ways. It's damaging to the culture. It's damaging to the employees. It's damaging to the trust we're trying to build with pet owners.

It's damaging to the pets that are not getting treated. And so, you know, there's a lot of different ways to go about this. We do have a workshop in Uncharted in the Learning Library that a lot of people have used and really like. It is all about scheduling and alternative ways of scheduling.

And so that's, that is a resource I'll put forward for Uncharted members. The general approach I think that I would take is you have got to audit your appointment types and your, how you block your schedule. If you're having this problem and you're booking people first come first serve, that does not make any sense.

If you haven't transitioned over to an a smart plan that says, look, we recognize that on a given day we tend to get about this many. If you haven't looked at those numbers and kind of know what that is, then you need to start with that. What are we talking about absorbing? Are we talking about absorbing 3 pets?

10 pets? Again, it depends. Somebody goes, 10 pets? Well, I worked at a place that had 10 pets. 12 doctors on at a time, absorbing 10 pets was not an issue, right? Some of this is looking at your workflow. I was listening to a podcast recently and they were laughing saying, Oh my God, can you believe that there are vet clinics that schedule one hour appointments?

Appointments, that's so zany. How could you ever do that? And I like these people But also I have worked at a place that scheduled up one hour appointments You know why? Because we have three walk ins every hour And so you did have one hour appointments But also that's because you were doing three other appointments on top of the one that came in at the top of the hour and so again not trying to throw shade, and it's not wrong, but that was how that practice adapted to the clients they had walking in.

And again, it's not comparing apples apples to apples because some client, some clinics are all about walk-ins. The clients know they do walk-ins. The expectation is, yeah, you can have an appointment, or you can walk in. Other places do not do that. Talk about walk-ins. It's not something they advertise.

It is a rarity if it happens. It's not right or wrong. Walk in practices are great if you staff for them and you know what you're doing and you book your appointments. You just have to be honest and with yourself about what you're seeing and what you're doing. And so do we need to expand our appointment times so that we book less appointments and we can absorb people walking in?

Do we need to have day only? Appointments, where people, these appointments unlock four hours before that time and that doesn't need to be the whole staff, if you've got these appointments and then they're not filling, you need to have less of those appointments, but you should have a couple, you know what I mean, and so all of that is tinkering around and saying, all right, What you don't want to do is book your schedule full of wellness appointments and then have nothing left to see Sick patients because sick patients are not going to book three weeks out.

They're going to come in. That's just part of our business. And so anyway That audit I think is really important.

Stephanie Goss: Yep. I, and I also think you hit something on the head too. I think one of the things from an audit perspective that you do have to look at is the mixture of the same day to pre booked appointments, you know, and like how far in advance were they getting booked. But the other thing I think you have to look at is what is making up that schedule.

Like how many spaces. So we've got emergencies. We've got sick pets. We've got wellness. We've got puppy and kitten and we've got rechecks. Well, rechecks are timely. Puppy and kittens are timely. Emergencies are timely and sick pets are timely. So that leaves you one out of the five for wellness that isn't as timely.

Like those can go further out and it feels sometimes like heresy. For people to say, well, the good client who's calling ahead for their appointment, like I should be able to just put them on the schedule. And I would say, well, but look at the other four types that you have good clients who can't control when their pet gets sick.

And you have good clients who can't control that they get a, you know, eight week old puppy and that it needs to come in on a certain time schedule. Like you, it isn't just about, it isn't just about good versus not good clients. It is about the mixture and the ratio. And so I think you have to do that kind of analyzing of the schedule.

And this is where I think the CSRs can be super helpful. One of the things that worked really well for me was I wanted to make sure that We were having a problem getting clients in as well and I wanted to get a sense of you know, as a manager, I could listen to the calls. I could hear how clients were acting agitation wise.

And I knew my CSRs were, you know, there was, they were onto it and they were, I totally believed them a hundred percent. And I wasn't sure, is this, how massive of a problem is this from a schedule perspective? And one of the things you can do is it's really easy to insert a code into your PIMS that just automatically posts.

So that you can track like if a CSR schedules an appointment and it's A sick pet and they couldn't get them in within a seven day period have them put that quote in the chart And then you can run that report and see how many patients are we not who are sick? Are we not able to meet our definition of sick?

Are we not able to get in a seven day period or a 14 day period like you have got to do some things? To start to really look at how to dial in the practice. And at the same time, you can start with something super small. So this doesn't have to be this big giant system. So for the CSRs, remember this was a headspace thing, but I think it's really important when you're talking to your practice owner and to your manager, change doesn't have to be forever.

Change can be for right now. And so suggesting a trial and saying, Hey, Can we try this one thing, or maybe these two things, for the next 30 days and see how this helps us alleviate the pressure? Maybe it becomes something that you keep forever, but everybody has waves and it goes up and down like a roller coaster in terms of our scheduling.

And this may be a forever problem until you get more doctors, or it may be a spring problem. It may be a summer problem. Like, veterinary medicine is very cyclical, so I think, When you're the CSR, bringing some of the ideas to your team from a systems perspective, remember that trials are your friend.

And so suggest doing one thing or two things and then layer it on. And as a manager, like suggest to them, there are other things we can do. We can do an extensive schedule audit. We can start to listen to phone calls. We can look at putting, you know, things into the PIMS, but let's just get started. If we start with one thing and layer on to it, it will help alleviate the pressure off of the front desk right now and help to figure out what maybe a new schedule looks like for your practice.

Dr. Andy Roark: Yeah, no, I agree with that. I have to say this and some people are going to hate it, but I do think if you're at a place where you've got your clients and they come in or they need to come in and we're not be able to get them in, I think at some point you have to consider referral and you know that's obviously offering them a chance to go to the emergency clinic, but also it may be considering referring to urgent care practices.

So we've got urgent care practices opening up. They're going to go there anyway. If you tell them you can't see them for two weeks okay. All you're doing is releasing them without any support and they're going to go find somebody else and they're going to go there. At least if you say, Hey, we can't get you in, but here are some other places that might be able to see you today.

And then we'll, you know, we can follow up with you and see how everything goes later on. At least there's some retention of trust, hopefully there, and you're helping them to get support in a place that you think does fairly good work, especially if it's an urgent care practice, they're not going to take them on for their wellness needs and things.

And that may be something that you can swing and save face and try to help the client. Oh,

Stephanie Goss: going to level up the travesty to end us on a hot note because I'm going to agree with you and double down, which you Refer to other GPs. Stop being so narrow minded. There is more than enough business for all of us. If you are giving your clients no option, you are choosing to put them in somebody else's hands anyways.

So stop being so hyper competitive and find a practice. You said it perfectly, Andy, find a practice or multiple practices in your community who you feel like practice a good standard of medicine. You might not like this doctor. You might not like the staff. You might not like their culture. Find a doctor whose medicine  you generally agree with and send your clients there because they're going to search on the internet And I would far rather have them go to somebody who I believe practices good medicine Than somebody that they just pick off of google really, it's the same thing about if we let our clients go out there.

The reason they're Dr. Googling is because we're not sending them where we want them to go. We've got to stop being so competitive and start referring to other local practices. If you have an urgent care, great. By all means, give them the business. Alleviate the pressure off of your ER. But stop, we have got to stop being so close minded and start to refer to other GPs in our community.

Dr. Andy Roark: Yeah, the the last thing I'll say is this and, again, I don't know how people feel about it, but in any other industry, if you had so much work that people could not get in for an extended period of time, the answer would be obvious. It's supply and demand. The demand is huge and the supply is low.

That means the price is going to go up. And the idea is that increasing the price will help reduce the demand for services because some people will go other places. And I'm not saying necessarily that's what you should do. I know that there's a lot of people have strong feelings about making sure that their clinic is exhaustible for everybody.

I don't think all clinics are going to be priced for everybody. They're just not. And if you're at a place where you say, we've got so much demand, And we need to demand, we need to decrease demand so that we could actually take care of the people who come in the

Stephanie Goss: hmm. Mm 

Dr. Andy Roark: Then, raising prices is actually a solid business practice that would make some sense here.

That's, that is just something to consider to say, well, we don't have any appointments for weeks and people are getting angry. One way to sort of start to sort people out is to, and I would, if you're going to do it, I would say, I would communicate far ahead of time that it was going to happen.

I would let people know in three months there's going to be a price increase and I would not tell them I'm doing it because I want to decrease demand, [00:52:00] but I would just say this is, we have to, compensate our staff for the work that they're doing. and I would mean it, I would follow through on what I said I was going to do, but I would communicate early on that this was going to happen and let people know.

And that might help them. Start to reduce some of the demand that you're getting. But anyway, I'm not, I don't feel strongly about that. If you can, my, I, my, my personal preference would be to try to work the schedule around in a way that would relieve some of this. I would love to lean into efficiency in the back, see if there's things that we can do to get more pets seen.

But but at the end of the day, if you've done all you can to maximize. How we move patients through the building, and we still got more than we can do. The answer is to probably raise prices so that we have the revenue to maybe add another doctor. Consider building on to our facility, things like that.

Those are the things you should start thinking about.

Stephanie Goss: Well, and I think those are great long term supply and demand supply and demand solutions, although I disagree with you about notifying people on price increases, but that's a whole other podcast. And immediate supply and demand issues is to remember that it's not all or nothing. There are levers you can pull here.

You can slow down the flow of new clients. It doesn't have to be that you stop taking new clients. It can be that you see one new client a day and that means new clients book out six weeks for non Thick pet things like you can put some systems in place again. It doesn't have to be forever. You can restrict new clients. You can restrict the number of wellness patients you see in a day. You can, you know, try and limit the number of puppies and kittens and so on and so forth book them a little bit further out.

Not so far out that they're missing the schedule you need them to be on, but there are those restrictors that you can put in place to help narrow that funnel down a little bit and reduce the supply and the demand while you look at those long term strategies like you were talking about.

Dr. Andy Roark: Yeah. Cool. Well, that's what I got. You got anything else?

Stephanie Goss: I think that's it.

Dr. Andy Roark: cool. Well, thanks for talking to it with me.

Stephanie Goss: Yeah, hopefully hopefully this was helpful. Have a fantastic rest of your week, everybody.

Dr. Andy Roark: Yeah, everybody. Take care.

Stephanie Goss: And that's a wrap on another episode of the Uncharted Podcast. Thanks for joining us and spending your week with us. If you enjoyed this week's episode, head over to wherever you get your podcasts and leave us a review. It's the best way to let us know that you love listening. We'll see you next time.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: communication, culture, management, Vet Tech

Apr 24 2024

Medical Director Not Managing The Naughty Doctor

One experienced doctor's toxic behavior is jeopardizing team morale and driving away staff and new graduate veterinarians. In this episode of the Uncharted podcast, practice management expert Stephanie Goss and Dr. Erica Pounds from Banfield Pet Hospital dive into a critical issue faced by many practice leaders: dealing with toxic behavior from a team member. The episode begins with a heartfelt email from a frustrated practice leader detailing the challenges their practice has faced since losing several doctors after a corporate buyout. Stephanie and Dr. Pounds explore actionable strategies to address this issue effectively. Let's get into this episode…

ABOUT OUR GUEST

Dr. Erica Pounds is the enthusiastic Program Manager for Team-based Care with the Veterinary Affairs Team at Banfield Pet Hospital. Since graduating from the University of Tennessee College of Veterinary Medicine in 2011, she has climbed the ranks at Banfield, taking on pivotal roles such as Chief of Staff, Area Chief of Staff, and Interim Director of Veterinary Quality. Erica has a fervent passion for learning and particularly cherishes opportunities for leadership development.

Outside the office, Erica's life is full of adventure and creativity. She's not only the supermom to four amazing boys and a partner in crime to her husband in the bustling world of superheroes and soccer, but she also finds joy and tranquility in quilting. Her sewing room is her sanctuary, a place where colorful fabrics and intricate designs come to life, providing a perfect balance to her dynamic professional life.

Uncharted Veterinary Podcast · UVP – 284 – Medical Director Not Managing The Naughty Doctor

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

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

Submit your questions here: unchartedvet.com/mailbag


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Episode Transcript

Stephanie Goss: Hey, everybody, I am Stephanie Goss, and this is another episode of the Uncharted Podcast. This week on the podcast, I am joined by my friend, Dr. Erica Pounds. Erica is a experienced multi-site medical director and she is currently working to address the concept of team based care, the idea of fully leveraging the paraprofessional staff so that they can practice at the top of their licensure and the veterinarians can do all the veterinarian only kind of things and we can see more patients and provide access to care for more pets.

So, I think that today's topic is a perfect one for Erica to weigh in on. She has done some speaking for us at Uncharted and through her role with Banfield Pet Hospital. And Erica is going to be at our upcoming Medical Director Summit and doing a workshop for us. So when I got this topic in the mailbag, I thought Erica was the perfect person to come and join me on today's episode and try and get into it. So shall we?

And we are back. It is me, Stephanie Goss, and today I am not joined by Dr. Andy Roark, my partner in crime, but in fact, I am joined by my dear friend, Dr. Erica Pounds. Erica is well, Erica, you have been a multi site medical director with Banfield Pet Hospital for years, and you are now in a new role.

And I actually don't even know your official title of your new role. So tell us– Welcome to the podcast and also help me out here cause I was completely unprepared for your new bio and your new role.

Erica Pounds: No worries. Well, first of all, thanks so much for having me back. I'm super excited to record with you on this super exciting episode today. So new role. Yes. Last year at the end of last year, I joined our veterinary affairs team for Banfield. And I am the program manager for team based care.

So really helping to support that focus within our practice. So it's a very exciting role and great and just being able to provide support and impact to all of our hospitals across Banfield is a really exciting opportunity and I'm loving it.

Stephanie Goss: I love it. I love it. I love the idea that so much of what you all are doing and looking at and supporting from the veterinary affairs team to the hospitals in your new role is really, when you say team based care, I know enough about what you all are doing to know that it's really just the focus on, it takes the whole team and the better that, and the more efficient, the better we work together.

The better we all get along, the better we work together, the more efficient and effective we can be and therefore the more pets we can provide care to and provide access to care for and allow the veterinarians to be leveraged. When you leverage the team, you leverage the veterinarians better too to do the veterinary things.

And so I love what you guys are doing. I'm excited. You are actually going to be doing a workshop at our medical director summit and talking about the idea of how do we get to that place of efficiency and effectiveness? Because I think that's everyone' dream. Especially when we're bogged down and overwhelmed in practice.It's like we, we imagine ourselves– it's kind of weird how most veterinarians uh, and veterinary people think. I think instead of on our bad, really bad days, we probably wish we're sitting on a beach with a drink in our hands. But for most of us, it's like, what would it be like if we were fully staffed and we had no challenges and everyone was fully leveraged and we could just sit there see all the pets.

Erica Pounds: Yes, that is our ideal state. You're 100 percent correct. I think that probably is the thing that like runs through our brains the most, especially, you know, when you're on the floor and you're seeing the pets, you're just like, man, what would this look like? And how many pets could I see? And like, how many families could I positively impact?

And, you know, and I think that really just speaks to the heart of, All of us in veterinary medicine, right? So we joined this profession. We're helpers, and we want to be able to see that. So you're exactly right. I think that ideal state is probably something that runs through our heads more times than not. 

Stephanie Goss: So you're going to be doing a workshop at Medical Director Summit. And this is our second medical director summit. We did one last year and it was so great. It was so fun to bring together. You know, the idea of a medical director role, I think really kind of was born in the corporate side of veterinary medicine and over the last five years, especially as more and more practices.

Corporate and private have grown in size from that one and two doctor practice to that middle level, three to five to six doctors. You know, certainly the bigger hospitals that are six, seven doctors plus for years have been having someone at the top who is looking at the, you know, medicine side of things and kind of directing traffic, not dissimilar to the way the practice manager has always kind of directed the traffic on the people side.

Now you have someone looking at the medicine side. And so, you know, last year when we said, what would it look like if our team did some hallucinating and said, what would it look like if we pulled together people who Private practice, corporate practice, it doesn't matter, but this role is unique, and it's growing, and so can we pull medical directors together to have a day just dedicated to the the ups and the downs, the joys and the challenges of this unique role, and talk about how do we really solve some of those challenges.

So we're going to be doing it again. And so we said we have to have you back because we had so much fun last year. And so you're going to be talking about leveraging the team and creating that culture and setting the framework and the foundation for being able to get to that place where you're efficient and effective. So I'm super excited for that. 

And it's in part why I said, Hey, Erica, come back on the podcast with me because we got a mailbag episode. And I'm super excited to get into this one with you. So, there was lots of meat on the bones here. And as a veterinary person, I kind of feel weird saying that.

But there's lots of meats on this bone. So we got a mailbag. We're making the assumption that it's either from a practice manager or a team lead because they are in charge of making the staff schedule for the practice. So that's pretty much all we know about their position. But they are– they are in a bigger practice.

They have transitions. They are a corporately owned practice, but I really honestly don't think that has much relevance here. And we'll talk to that because I've experienced a similar situation like this in private practice multiple times. So I don't think it's unique to the corporate environment, but when they transitioned, they had a transition in staff and doctors.

And so they had some experienced doctors and some new grads. come on board to fill some of the gaps in their doctor team. And they have an experienced doctor who this team leader/manager for we'll just call them a manager for, ease feels like they're ruining the hard work that they have done to get everybody working together, working smoothly, working efficiently and effectively from a culture perspective.

So this manager is really frustrated because there are some behaviors that they are seeing that they are labeling as a really bad attitude and negative. And, in fact, I think it is strong enough that they said point blank, this doctor is a bully. So there is bad mouthing of the team, bad mouthing of the doctors to other team members, clients they are making comments under their breath, side comments in front of people.

And this leader in the practice is really struggling because they have a medical director counterpart and their perception is that the medical director is not acknowledging that these are issues, real issues that are impacting the team. And when they have tried, or someone on the team has tried, the per to bring it up, the perception is that the medical director glosses over things or makes excuses because this doctor, as many have experienced, is a super producer.

And so they are a revenue generator. They are capable of seeing a lot of patients. And this leader acknowledged that's not without a downside, because this doctor is very effective as a producer because they are highly leveraging their team. And so they are taking technicians' assistance, any free hands from other doctors to see all of those patients and therefore generate all of that revenue and the perception is that which it usually is when you have somebody who is exhibiting some, you know, toxic behavior, they're on their best behavior.

When the boss is around, but you know, it's like my toddlers. When my kids were toddlers, they were always great for other people. And then you get them back in at home where they feel safe and boy, is it another story. And so it sounds like that's kind of what's going on here.

And so the bottom line is this leader is really struggling because they're like, look, I have team members who have already told me they refuse to work with this doctor. And if they're scheduled with this doctor, they will call out and just not show up to work. And they have already lost team members who have privately told the manager, I'm leaving because of this doctor.

Like, I don't need to put up with this. And so, this manager, from their seat, feels like this is a toxic person with toxic behaviors. And they're looking at their medical director partner going, can you please do your job and deal with this person? So, we're gonna, we're gonna make, probably make some leaps and some assumptions and we'll kind of talk through some of those as we get there, but the bottom line question that they asked us was, how do we get them to realize that there is an issue and how do we do it fast, because I'm worried that we're going to lose half the team over it.

We're already shorthanded para professionally and I can't handle this. So help was the ask. So, I'm super excited. So let's get into this one. And as we, do we are going to start with headspace. So, when you think about getting into a good headspace for this leader or manager where do you start?

Erica Pounds: Yeah, I, because there's a lot. Right? In this there's so many different angles to, to look at and things. And so I think that the first thing is taking a moment to really take a step back and start to get into a very curious head space. This is where we are going to embody our inner three year old and we are going to ask why and why. You know and so it is definitely one of those things that we run the risk if we don't take a moment and check in our with ourselves as leaders before, you know, really facing this head on, we run the risk of the fact that we are going to fill in the blanks and we are going to make a lot of assumptions on everybody's behavior and on everybody's responses and interactions.

So I think that the first step is really taking a moment, checking in with yourself and go, I've got to sit and ask why, and resist the urge to fix the problem yet. We've got to make sure that we get all of our information so that we know that the problem that we're solving for is actually the problem and not on the surface level.

Stephanie Goss: Yeah. I love that. And I think I think, you know, your idea of getting curious and asking why is a great one. And, so I think the thing you know, Andy and I always talk about getting are, you know, are you safe to have this conversation? And I think we'll talk about that towards the end of headspace, but I think from the leader's perspective, in order to ask yourself why, in order to get curious, in order to do any of the other steps. I think the piece that I would pull out of the idea of SAFE is, are you in a place where you can get zen and just breathe about this, or are you in a place where you're triggered?

So if you are angry, if you've had to deal with this that day, if that doctor has been you know, acting naughty or acting up in front of you, like, take a walk, take a breath, take a, you know, get to a, place where you can sit and look at them in the face. And on that kind of day, on a good day with that doctor, really challenge yourself to ask the questions because I think you're spot on, we have to ask ourselves some, why questions a lot and you know, you talked about getting to the bottom of it, really being able to do some root cause analysis and figure out are we looking at the symptoms because a lot of what is just discussed in this email is, symptoms, right?

It's the, you know, the behavior, the acting out, but why is that happening? And to be able to ask yourself those questions, I think you have to be in that clear headspace to be able to ask yourself why. And then the other piece that I would add to that is I think that it's very clear that this leader is frustrated and I understand that and I can empathize with them and sympathize with them because I've been in their shoes and it's really hard to ask yourself why when you want to just wring someone's neck. And you're just like, why are you acting like this? And I think that there's, that is, coming through loud and clear. And so I think just taking a minute to acknowledge, like, we see you, we hear you. This is a really tough space to be in because as a leader, there's a lot of work here for you to do.

And if you can't get into that headspace where you're asking good questions. You're setting yourself up to fail from the start. So I think being in that clear headspace and then what I would layer on to your asking yourself why and doing it a lot to kind of get to the heart of the matter would be the ability to ask myself and question my own assumptions.

Because I think that there was a lot of really strong language used in this email, and I completely understand because when I have been frustrated, when I have had, I actually called them my naughty doctor for, I dealt with a naughty doctor for years and it is very hard to not get irritated and triggered when it has like repeated behavior, and as a leader, your job is to try and figure out how to be the example for your team and how to really ask yourself the hard questions and wrestle with the hard questions.

And so if you can't look at the behavior objectively, if you can't look at the information that is being gathered either by your own observations, by your team sharing feedback and information with you, if you can't look at it objectively and ask yourself, okay. When I hear this, I immediately assume that this doctor is doing this because X, Y, and Z. And there's a whole lot of ways you could fill in those blanks, because they are, you know, money hungry, because they are just a jerk, because they are, you know, they just think that everybody on the team is idiots. Whatever, fill in the blanks you're doing when you're angry, if you can't sit there and ask yourself, okay, what else could be?

What else could this mean? What other story could I tell myself about this doctor and their behavior? If you can't ask that question and really look at both sides of it, that's the ultimate leadership challenge in this scenario. And so the, challenge for everyone, wherever you are on your leadership journey is if you want to try and get to that place where you can ask yourself those questions, you can ask why you can, you know, do the engaging with that. And ultimately for me, I asked myself, what else could this mean? Like what other stories, what stories am I telling myself and what stories could I make up that are on the opposite end of that spectrum? So if I'm looking at this doctor and I'm like, they're just an a hole and that's like what immediately comes to mind. If I can't force myself to sit there and think, what if they're a really nice person and they're, you know, favorite aunt just died and they're sad about that. If I can't do that and put myself into a place of empathy, then I'm not ready to deal with it. And so that's the headspace challenge that I would give our writers.

Like, how are you going to get yourself to a place where you can assume good intent? And here, what I mean by good intent is asking yourself the question, what else could be happening here? What else could be going on? What, and own your own, own your own bias and ask yourself, what else could, what, am I telling myself?

What's the story that I'm telling myself about why this behavior is occurring? And if you can't, if you can't do that, you're probably not ready to have that conversation or start to deal with it and start to unpack it. And so I love your why, like channel your inner two year old.

And why is the sky blue? I don't know, mom. Why?

Erica Pounds: Yes. And you know, and I mean, thankfully for me being the mom of four boys, like I, I'm very well versed in the why-nesss, but I love your call out around being able to check in with like, again, with your own emotions even before you get to the Y state because you're exactly right.

If something happens and I'm upset or I'm frustrated, I'm angry, whatever, those really big emotions. And I try to go have this conversation with any of the people involved. Right? I could bet that it's not going to go well. I'm not going to get the response that is ultimately needed. Right. And so It doesn't do anybody good for us to do that without taking that moment to really get clear.

The other thing that I love, and, I mean, and sometimes, like, for me, I'm a super literal person and so to avoid continuing to fill in the blanks with my own assumptions, sometimes there have been situations where I've actually had to, like, write the situation down on paper. Like just everything just write it down like this is how I felt this is what was said. This is what I heard writing all of it down and then Looking at it and literally crossing out everything off that paper that I don't know to be 100 percent true and 100 percent fact.

And oftentimes, then what you're left with, again, is just very much the objective facts of the situation. And then you can kind of take a look for it and start to peel it back. And the other thing that I will say, You know, geez Louise, like it's been about three years now since we started you know, the Uncharted program with the area chiefs and Banfield.

And so, you know, we've been on this journey for a while now. And one of the things that I will say that I was most thankful for and continue to be most thankful for because even as my role has shifted, these people are still my people. And it is, you know, the, relationships formed within our leadership group.

And so sometimes too, if you're struggling to get through, and did I clear all of my stories? Have I removed all my biases? Have I taken out all the assumptions? It is great if you have someone that in a safe space, you can say, Hey y'all, this is my situation. These are my feelings. Here's what I've worked through.

Can you help me make sure that I don't have any other blind spots? So that I can really go in and show up as the leader that I need to be for my team right now. And time and time again, right? We've been able to show up for each other in those spaces and help provide that very third party, very objective lens.

And that has been something that's been so helpful. And again, those strong friendships and strong partnerships was something that came out of, you know, the Uncharted community you know, within our area chief group within Banfield.

Stephanie Goss: I love it. I feel like we could do a whole whole episode on finding your people. And I, love that you said that because I think and I love that you, know, I love that you brought up the idea of writing things out because I think that's the, you know, when Andy and I first started talking about this on the podcast Andy used to tease me and, we used to laugh because I do quite literally have like a, sheet, a worksheet that I put myself through, like when it's really tough and I'm really struggling, I don't do it, you know, every, time I have a frustration or an upset, like then you'd spend your whole life writing things out because something is always on fire as the leader in a practice.

Right? And when things are really hard, when there's emotions involved, either my emotions or potentially in this scenario, the team's emotions, I might be unemotional about the situation. I might get along with this doctor just fine. Right? I don't think that's the case of our writer here, but you know, Play Devil's Advocate, as the manager, there have absolutely been times when I get along with the person in question just fine.

The rest of the team, it can't, is losing their minds. And then my job is to figure out how to unpack their emotions? And I think being able to work through the steps. And like you said, write it out for yourself. And that part is particularly helpful for me asking myself, what else could be happening here?

And writing all of the things out and getting to that place of Zen. And then I think the other thing that you and I talked about from a headspace perspective, that is a really important to bring up here before we kind of jump into action action steps, then we'll take a quick break before we do that.

But I think it's the idea of once you ask yourself why, the last piece of that why, I think you you framed it really well because you said like, what have we done in the hospital, like, we as the leader, what have I done to actually figure out why the behavior or behaviors are changing? are happening.

And so I think that is going to speak directly to when you deal with this, when you start to action step this, you have to be able to be clear and objective. And the only way that you can do that is taking the information that other people are giving you and being able to figure out how do you frame that in your own experience and your own observations so that you can have the concrete and objective conversation with your medical director and potentially with beyond with this doctor directly with you know, help above you. If you, it gets to the point where you have to manage up and ask for help from your boss's boss or your field leaders, or however it's structured in your hospital.

But, you know, we talked about figuring out that why, and you had some really good, you know, kind of examples of things that we should look at here to try and figure out the why.

Erica Pounds: Yeah, you know, I think that it's really important because the fact of the matter is like, we're dealing very much with those interpersonal dynamics here, right? And so we want to try to be as objective as we can be. We want people to understand that as a leader, I am here to listen and to hear you and to be supportive. But also understand that I'm here to help too. So I think that you know When these situations are happening the things that were going through my head is I wonder what the conversations have looked like So far.

So in, in, all regards, right? So with the team members that are coming with those concerns, you know, what does that look like? Is it just very much a hear me moment where we're just listening and we're just taking it in or how we started to translate that to some action steps that again, we'll talk about in just a little bit, but very much into that help me moment, because I do wonder, you know, Was there a point in time for these team members where maybe they, yes, they had a concern, but they were in a space where they wanted to make that relationship better, but they didn't know how and was there an opportunity perhaps where we could have maybe helped with that situation?

Same with the doctor, right? Hearing but then helping with the solution because the biggest thing is that sometimes I think when we go into fix it mode as leaders. We have a plan, and we're moving forward with the plan. Well, if the other individuals don't see themselves as part of the plan, or if they didn't want us to solve it for them in the first place, they just wanted to vent about it, now we have some missed expectations, and could we be potentially making the problem worse?

And so, you know, I think that there's definitely that moment, you know, where I would use this a lot, And this is not something that I came up with. This is something that a dear mentor of mine told me years and years ago. And as very much of helping to set the expectations when people are coming to you with questions or concerns or a problem, right?

And that is really setting the clear understanding of what is being asked of you and what they're looking for in that. Is this a hear me moment where I really just need five minutes to vent and get these feelings off of my chest and then I'm going to be able to move on. Is this a help me? Would you please help me figure out how I could better improve this situation?

Or is this a handle it? Hey, here are all of the things that I've tried and I've not seen any amount of progress. I am at my wits end. I don't know what to do anymore. I am in a handle it. Um, and I think that just really helps and I, you know, and I do think, you know, as, I'm even saying these words out loud, right?

Is there also this moment for very clear expectation setting between this practice manager and the medical director?

Because if it hasn't been clear, does, you know, could there be a moment where perhaps this medical director thinks that this is just a hear me moment and is just listening and allowing those feelings to come off and does not understand that there's action that is

Stephanie Goss: That the manager, yeah, that the manager can help.

Erica Pounds: Again, it's an assumption, but again, when we were thinking about the spectrum of possibilities and probabilities, could there be a spot where maybe it's also along misalignment on expectations of what needs to be done going forward?

Stephanie Goss: Okay, so, the last thing from a headspace perspective, before we jump into the break here, is I think that for the manager, there's a lot of emotion. This sounds like an emotionally charged situation. The team is frustrated. I read a lot of frustration, and I could be reading into that, but the team is feeling emotions, the manager is feeling emotions, both towards this doctor and towards the medical director, because there is a perception that the medical director is not, and an assumption in that perception, I think, that the medical director is not quote unquote doing their job because the doctor is still acting out and being naughty from the team's perspective.

And so the assumption is being made that the medical director is not doing their job. And so I think the last piece is where SAFE comes in, which is once you've done the work on your own headspace and you've asked yourself why, and you've challenged, I think the team to also do some of that work as well.

You have to be able to get safe. And have the conversation with the medical director, because ultimately, when you are in a team structure, it looks different in every hospital, what the practice manager's role is, and what the medical director's role is, and sometimes there's a lot of crossover, sometimes there's none, sometimes the practice manager is actually in charge of the doctors.

Sometimes they're not. Sometimes neither of the people in the practice are actually in charge of the other doctors. Like there's a whole myriad of structures out there now and so we're not even going to get into what those all could look like. However, the important part is: When you're running the practice in the day to day, the medical director as a manager, the medical director is your partner.

And so if you cannot be safe when you sit down to talk to them about your concerns, whether you're going to them with your, and I love that you said this, the hear me, the help me or the handle it. When you sit down to have that conversation, you have to be able to be safe. So you have to be able to sit next to the medical director.

You cannot have that conversation with your partner in crime in the practice when you're angry or frustrated because you feel like they're not doing their job. Or if you are going to, you need to acknowledge that's the place that you're coming from and be able to say, I'm feeling a lot of really strong feelings and I want to work through this and I know that I could be making some assumptions and I need your help because I need you to understand that I am coming at this from an emotional place. And you need to kind of do that pre-work to, apologize if that's where you're at, because you need to be able to assume good intent on their part and also on the part of the doctor. And we talked a lot about the doctor in this scenario and not as much in the medical director, but you have to be able to look at them and assume good intent.

And that means when you are truly in a partnership and you are supposed to be working together to run the practice, you have to be able to look at that other person and say, I know that they're working hard. I know that they're trying to do their job. And if you can't say that, there's some work to be done.

There might be hard conversations between you. It might be work on your own headspace perspective, but you have to be able to assume good intent. You have to ask yourself the question, how has this person been set up to fail? Both the medical director, if you are feeling like they are not doing their job, what could be missing in this scenario?

Like what could be causing them to potentially be in a place of failure? And on the part of the other doctor, and then ultimately, before you sit down to have this conversation, you need to know what the end result is, you need to know where you want to get to in the end, and so, is this a conversation with your medical director, because you've You need to address the fact that you don't think they're doing their job?

Or is this a conversation with the medical director to say, Hey, I need to understand how you are handling this other doctor? Because those are two radically different conversations. And I don't think we can judge here which direction it is, but I do think we're going to go in the direction of, Hey, how do you, Talk to the medical director about getting this other doctor to do their, job and get along with the staff because ultimately the question that was asked in the mailbag is, how do we get them to realize that this is, an issue?

And so, I think the easiest way to get there is to talk very clearly. About the impact and the things that you're seeing and observing that are happening with this other doctor and then have the conversation about how do I help you handle this problem, right? Then it's very, then it's very clear like, Hey, I'm, coming to you.

and help me and it may also be a handle it, but it's like, hey, this problem is occurring and we need to solve this problem because there's potential impact here. So, let's take a quick break and then let's hop into talking about some action steps. Cause I had to bite my tongue not to just jump right in there too.

How do we actually have this conversation? So, let's take a quick break and come back.

Hey friends. I know that Andy and I both talk a lot on the podcast about upcoming events that Uncharted has because A, we love what we do and we have fun talking about it and B, we want you to be a part of it. So we want to make sure that nobody misses out on announcements that we have awesome stuff coming up and C, because our team is freaking rock stars and they make sure that our website stays up to date with all of the information about the events.

So that you can find us and you can join us and you can spend some time working on your business and not just in it with us, with the community, with our awesome outside speakers and more so if you haven't headed over to the website recently and checked out the events page, UnchartedVet.com/events. You should because it is jam packed full of all 2024. We've been talking about some of the awesome things that are dropping this year that are brand new, fresh and exciting for us. We've been talking about the oldies, but goodies, the things that we're continuing to do for our community, for you and beyond in 2024 and.

We're talking about stuff that is yet to come. So head over to Unchartedvet.com/events and check out everything that is on the website. We want to see you there. And now back to the podcast. 

All right. So we are back. And as you can tell, I mean, it took us a little bit to go through the headspace and I think we could, this is such a, I said at the beginning, this is a media episode. There's so many ways that we could go. And honestly, this could have been broken out. I think into like three different Pacific specific directions.

Erica Pounds: I think so. Yes. Because even as we're talking, right, I'm like, oh, that was a really good point. Oh, let me let me walk down that trail. Because there's a lot we could unpack there too. Which is great, but here's the thing, right? Like welcome to real life in leadership, right?

Because there are, in any given situation, there are so many different inputs. There are so many different, you know, people's perspectives to take into account and all of the things leadership is, not easy. I think that we all know that. But this, I think this particular example really puts that on full display just because again, there are so many different ways. 

Stephanie Goss: Moving parts 

Erica Pounds: …you can think through and approach it.

And yes.

Stephanie Goss: Yeah. Yeah. Okay. So from an action set perspective, that leads perfectly to where I think that you have to start, which is you have to recognize that clear as kind. And so when you sit down to have this conversation with your medical director partner. In order to get to the place of kindness, you have to be clear.

So I think you have to have done the headspace work to know where you're trying to go with this conversation. What questions are you trying to ask? And then you need to be crystal clear about how you talk to your partner about this doctor's behavior. And what I mean by that is not only know the pieces that you're going to bring up, but be clear in giving the what has been seen and the concrete examples to your partner, because that's the only way you're going to get to a functional place of problem solving.

If you go to your partner and you say, well, the team is really upset because they feel like the doctor is acting like a bully and she's bad mouthing the team. And she's, you know, disagreeing with clients and she's treating everybody like idiots. That, while understandable from an emotional perspective, the frustration, the anger, the hurt, I could see all of those emotions, I can't do anything with that because I can't, and I shouldn't want to change anyone's emotions.

Emotions, the emotions are not good or bad. They just are. And I, it's not my job to try and help them deal with those emotions or take those emotions away from them. It is my job to be able to deal with the behaviors, the clear, specific examples. And so for me, the clearest kind here has to do with what have I seen? And what are the concrete examples that I can give to my medical director partner about the behaviors. And so if, as the leader, if you're getting all of this from your team and it's second hand or third hand information, well, she said that this happened and I saw it and, you know, do your homework.

Go down, be on the floor. Watch the doctor interact with them. Are they acting the same way in front of you? Do you notice an observable shift in their behavior when the medical director comes on the floor? Because as a partner, I'm going to give much more weight, if I'm the medical director, I'm going to give much more weight To direct observations that you as the manager have been able to make, then I am to the team's second hand information.

And that's not to say that the team's experience is not valid because it absolutely is. But I can't move on something that is secondhand. I need to be able to have the clear conversation. And most of the time in my experience as the manager, the team is coming to you because they don't want to go to the doctor directly.

And so the team always is, okay, well, we have to be able to have the direct conversation because if you've had the direct conversation and now it is a handle it because you've had the conversations, you've talked to them, the behavior is not changing. That's a different story. And you can action on that as a partner, but I don't think you can action on dropping all of the hearsay in somebody's lap and saying, go handle it please.

Cause I can't.

Erica Pounds: Yeah, no, I completely agree. And I think that, you know, the thing is, especially, I'm going to make an assumption here. But, you know, if the medical director is, say, a multi unit medical director. So likely, they are not in that hospital every day and there could be an extreme amount of variance as to how often they are physically present there.

And so, I know in my own experience, that was incredibly difficult to be able to balance being able to hear the concerns that are being brought forward, to be able to provide a path forward that showed that I was hearing them, showed that I just wasn't dismissing, but also holding very, closely to the fact of like, I need to some way, somehow objectively figure this out. And you know, it's hard. It is incredibly difficult. And so that is where I think it's really important then when this manager is coming to the medical director, as much as they can really provide those concrete examples. This was the situation. This was the behavior that I, as the manager observed, and this was the impact.

Now we're able to start drilling it down. The other thing is to, as the manager. Even if they are not the direct line manager of the doctors, is there a moment to be brave and bold in your leadership? If you're seeing a behavior that you're like, you know what? I already know that the team is struggling a little bit with the interpersonal dynamics with this individual and I just overheard a conversation and while I don't think that there was ill intent there knowing the back story of how the team is feeling right now, I could see where this could get very very amplified.

Can I, as a leader, go in and say, you know, hey, Dr. So and so, can I just clarify what you were asking me to do? Just to make sure that we're all on the same page, almost actively diffusing the situation, you know, and then again, seeing what are the reactions, what are the reactions from the team members?

What are the reactions from this doctor? Because then again, I can then bring that to my medical director and say, Hey, I, as the manager, like I overheard this situation sounded similar to some of the things that they had brought up before. This is how I tried to coach in the moment. This is how I tried to redirect.

And then these were the, Exact behaviors that then I saw. And so what do we do, you know, kind of moving forward with this?

Stephanie Goss: Yeah. And I think you know, it's interesting because when we were getting started and, talking through some things you, were talking about the challenges with Having distinct separation. And in a lot of hospitals there is this idea that the practice manager is in charge of, and the direct manager of the, this paraprofessional staff and the medical director is the direct manager of the professional staff.

So the doctors. And I know in a lot of hospitals there is the assumption that the manager likes to stay in your lane. You deal with the team. I'll deal with the, I'll deal with the doctors. And I feel nothing. I feel nothing but sympathy for my colleagues who are in that position because the reality is. Even to your, I love that you brought up the point. It is still my job as a leader to have direct conversations. It is still my job to address the behavior when I see it. It is still my job to coach my team to have the tools in their toolbox to be able to stand up for themselves and say, hey, Dr. So and so, I really don't appreciate being spoken to like that.

It makes me angry or it makes me sad or whatever, the impact to your point of the behavior has been to that person, they should absolutely be able to speak up for themselves. I don't, and this is just a personal preference. I don't and I know I'm ruling myself out of working for a lot of companies by saying this.

I never would want to manage in a place where I couldn't empower my team to be able to do that the same way you're saying as a medical director and as a manager, I should have every ability to be able to say to the medical director partner, here's what I have done to deal with this behavior in the moment and to coach and to try and turn it around both with the team and the doctor.

And I need your help because we are partners and I feel like this behavior is getting worse, not better, or I feel like the behavior is continuing. Please let– can we have a conversation about how you are approaching this with the doctor? Because ultimately you and I talked about needing to be able to get to the end.

Like what is the end goal? Where are we trying to get to? And part of this is showing up with your own ideas. Or your own solutions and things that you have tried because if you just show up and you just sit down with your medical director and you're like, here, let me dump the team's problems in your lap, that's going to be a non starter for a conversation because I would look at you and be like, it's not my problem.

Go like, you know, if, but if you come to me as a partner and you say, Hey, Erica, I, like, I need to sit down with you and have a conversation. Cause I'm really struggling with Dr. A. You know, we have been experiencing some negativity with the team. I've had some one on one conversations with some of them.

And as a result of those conversations, I'm concerned. So I spent some time on the floor and here's what I observed and here's how my interactions went. And I need us to, I need to understand what you're currently doing to address the situation and how I can help address it differently and further in the future.

Because by having that conversation, that's opening the door to say to the medical director, hey, I need your help. Hey, I need you to realize that this is an issue and I'm not just dropping the pile of crap in your lap. I am saying this is what I've done to already problem solve. Now, let's work together to move it forward and you're not really, by presenting it that way, what you're doing is not really giving them an out to say, Oh, it's fine.

They're a super producer, so I'm just gonna ignore it because you have brought to them what you are already doing and it then would be perfectly acceptable to say, I don't think that's a viable solution. I don't think that we can just choose to ignore this because they're producing, because here's the impact that it's having to the team and I could, you know, here's how I see that playing out. I really need us to work together to come up with a solution here. And I recognize that I might not be the appropriate one to address it with them. That may be your responsibility. But I need us to work together to come to whatever end place it is that you as the manager need the team to get to.

And so if the team is at the point where they are refusing to work with that doctor, where they are quitting or have already quit as a result of that doctor, it is. Absolutely your job as the hospital leader to manage the partnership with your medical director and have that hard conversation of like, Hey, I'm doing all of these things.

The team is doing all of these things and I need you to show up in this as well. And this is what I need from you because. The next step, and this is a step that a lot of people, when you have a hierarchy structure, I see a lot of people, and I have done it myself, skip the step of having the conversation with the person and go straight to the boss because you think that the boss can actually do something about it.

And any boss is actually a leader is going to turn right back at you and say, how did that conversation with that person go? What came out of that? And if you can't answer that question, you were not, you're just trying to dump your monkey in somebody else's lap. And the reality is if you may need to have a conversation because you may not be able to work it out between yourself and your medical director.

Ultimately it is possible. I could hallucinate a scenario. It makes me sad, but I could hallucinate a scenario where they are afraid of conflict and don't want to talk to this doctor or they do talk to the doctor and the doctor is just sweet as pie to their face. That's still a problem that has to be solved and that problem may need you as a team or individually to manage up and have conversations with their boss.

Or whoever your field support is, if you're in a corporate structure or, you know, it's going to look different for everybody, but it may be asking someone else for help. And if you can't say these are the steps that we have walked through to get here, any leader at that level is going to have their hands full and is going to be, is going to be really busy.

And so they're going to want to know. What, and rightly so, what you have, what you guys have done to, to, you know, solve the problem together.

Erica Pounds: Going back to kind of where you started, like, I think that the point is, and I will say this. You know, forever. The importance of partnership, my goodness gracious, it's so vitally important. When I was managing multiple, you know, overseeing multiple hospital units, the impact that my relationship with my partner had on whether or not we were going to be successful in certain things was huge and it cannot be understated and you know Speaking of medical director summit coming up in just a little bit this was something that we spent a lot of time talking about in my workshop last year which is again like medicine and Operations or a medical director and practice manager or whatever the title is that you know, your hospital may have, that like when we siloed them Incompletely No wonder it feels like there's tension, but there really is this wonderful way in which medicine supports operations and operations supports medicine.

And that is really reflected in our partnership with one another. And so I think that, and again, we're making an assumption in this situation that these are equal counterparts, practice manager and medical director. That may not be but again, for ease. Let's consider that they are equal level partners.

And I think that's where it really is coming and saying, Hey, while, you know, from the last time that you were here you know, this situation came up, these were the things that I did. This was the impact. This is what I saw. I really do feel based on X, Y, and Z, again, really making sure that you've removed your story and you've really been able to pull objective examples forward ahead of time.

This is what I see the impact and this is what I think is at risk if we don't have a conversation and if we don't do that. And again, what is the path forward? Is this us having a conversation as hospital leader partners together with this doctor so that everyone is on the same page? Is it you having it on your own, but bringing back the commitments to me?

So it's very clear. What am I as the manager going to do when you're not here? With this associate right because very much and this was something that I said to my doctor teams This is something that we said to the whole team in general, right? I wanted them to feel comfortable. If I was not in the building, they knew that they could go to my manager and that she was going to support them and vice versa.

If my manager wasn't there, the para team felt as if they could come to me. While yes, we did have different direct reports and we were accountable for different things. At the end of the day, it was the relationship and partnership and that united front. Together, that really helps the entire team to see themselves truly as a team and not doctors

Stephanie Goss: versus,

Erica Pounds: and the rest of the team. Yeah. And so I think that is a really important thing to have. And then also again, just making sure that the intent with what you're wanting out of that conversation is very clear. And so as the manager, you know, medical director. You know, this is what I'm looking for as we come out of today's conversation.

And I would really like for us to go ahead. And make this time bound, right? Like, can we follow up on this at the end of next week? Just to see, do we need to check and adjust and make any different plans? Don't just throw it out of like, this was a one time conversation and then feel like both of you had the same expectations moving forward.

Like, let's check in again and let's be very clear with when that's going to happen.

Stephanie Goss: Yeah. I love that. And I think the other, the place where I will end from an action step perspective is, and it's a little bit headspace, a little bit action steps. One of the things that I think you have to do when you're in a situation like this, that is a meaty one. Like there's a lot to pick apart here, recognizing that this could be sit down and have a four hour marathon conversation.

I have been there and I have done that and it is never really successful. It is ugly, messy. You don't get to the heart of things. And so I think part of that headspace perspective for this manager is figuring out what are the different. Conversations that need to be had because reading this it sounds like yes, they are asking the question how do I get my medical director to realize the impact that the behavior is having on the team and the consequences that are already happening and that are could continue to happen if we don't do something about this doctor. That is one conversation that is the direct, like, here's the behavior.

Here's what I'm doing. Here's the impact to the team. And how are you going to handle it? That's one conversation. The other conversation to your point is how do I support you in handling it? And those might be able to go hand in hand. If you have a pretty good partnership, like you might be able to have that in one conversation.

It sounds like there is a big disconnect in this relationship. And it, so it sounds to me like there's probably some conversations that need to happen between this manager and the medical director to strengthen their partnership and figure out how do they support each other? How do they work together?

How do they, how does the manager support the accountability of the doctors and how does the vice versa to your point, how does the doctor as the medical director. How do they support the behavior and the job and the expectations of the manager with the paraprofessional team if that's how the division goes?

But I think there could be role clarification. Is this your job? Is it my job? Like who, you know, who's supposed to be doing what and what is the end result expectation? So I think remembering that. When you do your pre-work, part of your job to get into the headspace is to figure out what is the actual problem here.

And then once you figure out the problem, if you really truly go after the root cause here, you may only have to have a couple of conversations. But if you keep having conversations about the symptoms themselves,

Erica Pounds: You'll never get there.

Stephanie Goss: going to be having, yeah, you're going to be having the conversation until the end of time.

So you have got to figure out what is at the actual cause here, both of the dysfunction within the relationship between this Leader or the potential dysfunction between this leader and the medical director. And also, the root of where is the bad behavior and the naughtiness with this doctor coming from, and how are you going to address THAT root problem?

And really pull it out and deal with it. So, I think Recognizing from an action step perspective, clear as kind, you've got to have a plan, and part of that plan has to be able to use SBI, use the situation, use the behavior and the impact to be able to talk to your partner about what you have seen, what you have observed, and what your concrete examples are so that they understand what you have observed.

What you have tried in the scenario and what the team has tried, knowing how you're going to talk to them and how you're going to approach it. And also remembering it is also your job to bring some ideas to the table. So you cannot go into this and just be like here, handle it without really good examples of how you've already tried to handle it.

Or say, I haven't approached this because I, my understanding is that it's your role and I don't want to step on your toes. I have ideas on how we could approach this, how you could try it, how I could try it, and we could try it together. And I need us to talk through that because I need there to be some change to support the team, like figuring out what your ideas are and how you're going to present them.

And then ultimately action step wise, you have, I love that you said this, you have got to leave that meeting with a clear plan of what the, what done looks like, what the end looks like. If this medical director is doing their job and the team and you could look at this medical director and saying they're doing their job, what does that look like?

And then how do you both know that's going to get done? When are you checking back in? What are the follow up points? What are the, you know, what are the places that we're going to, you know, signposts along the way and say, Hey, this is not really getting better, or 

Erica Pounds: Mm hmm. 

Stephanie Goss: or, Hey, it's getting, it is getting better.

And like, let's celebrate those changes, right? Like there has to be a plan for what that followup is going to be. And I think how that plan looks is going to differ depending on what you decide actually the end goal is. You know, are you addressing the doctor's behavior? Are you addressing your perception that the doctor, the medical director is not doing their job? Where are you addressing both? Like where, are you actually choosing to have the conversation?

Erica Pounds: Yeah. And I think the only thing that I would add to that last part is just remembering to hold grace and space for your partner. Remember that like what we're talking about here is not a light switch problem that you are going to leave this meeting with a, who's doing what by when, and just magically in one fell swoop, it's done.

We're talking about human behavior. We're talking about interpersonal dynamics. We're talking about culture and. Let's talk about what incremental success looks like. What are those milestones? Like how do we know that we're moving forward, but then hold grace and space for your partner because if that doctor all of a sudden is just having a really bad day and starts to backtrack a little bit, that does not mean your partner failed you and didn't do their job. Like, so let's just make sure that we're having that open dialogue. We're having those check and adjust and always assuming the best of your partner and holding grace and space for them.

Stephanie Goss: Yeah, I love that. Oh man, this was so fun. Erica, thank you so much for coming on the podcast again and talking through this with me. And if you are listening to this episode and you are in a medical director role, you should come join us at the Medical Director Summit. It is virtual. It is happening May 29th.

And we are going to be on Zoom for a few hours and we're doing some workshops, we're doing a general session and then we're going to dive into some problem solving and choose our own adventures in terms of the conversations we have about the challenges and the joys we're facing in practice as medical directors and it's going to be a blast.

I'm super excited. So, hopefully we see all of you there. And if you are a leader and you are in this position, whether you're a manager or team lead or you know, the other side of this find your community, find your people. Like Eric has said in the very beginning, being able to have that community of people, whether it's a community like the Uncharted community and shameless plug for us, because it is a space that I would not have survived in the clinic without in the last few years. But whether it's your local people, another manager near you, someone you meet through an online group, you know, whether it's an organized, established association, the, you know, the tech association, NAFTA, like, VHMA, wherever you find your peers.

Get a support system because you need someone to be able to bounce those things off of and just like in your personal relationship, everybody needs those friends who will look at you and say, I love you and you're wrong, or I love you and you're being an a hole. Or, you know, like everybody needs those people in their lives.

And our career is no exception. You need to find your people who will say, Hey, and do it with kindness and grace to your point. And that's what I love about Uncharted.

Erica Pounds: Thank you.

Stephanie Goss: Is it like, have you thought about this other or this other perspective and chat, you know, the people who will challenge you and ask you to get curious and ask what else could this mean?

So anyways hopefully we will see you all soon. Take care, everybody, and have a great rest of your week.

And that's a wrap on another episode of the Uncharted Podcast. Thanks for joining us and spending your week with us. If you enjoyed this week's episode, head over to wherever you get your podcasts and leave us a review. It's the best way to let us know that you love listening. We'll see you next time.

Written by Maria Pirita · Categorized: Blog, Podcast · Tagged: communication, culture, management, Vet Tech

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