This week on the podcast…
This week on the Uncharted Podcast, Dr. Andy Roark and practice management geek Stephanie Goss are deep in conversation after reading a mailbag question from a licensed veterinary technician who work with a hospital that is growing and changing in a lot of WONDERFUL ways! Their team is working together, they are establishing strong standards of care that support their clients and their patients with excellent client service. The team is all in on the changes and growing the practice this way. The problem is there seems to be a disconnect between the team vs. the hospital leaders when it comes to “leading” the team. In their meetings and a lot of interactions with the team, the direction the hospital leaders seem to take is all about numbers & the financial advancement of the business. This is rapidly dividing the team – they already lost a few good people over the hyper focus on the business and numbers and this tech is worried they are walking down a path they can't come back from! This is a great set of questions to discuss – Let's get into this…
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Do you have something that you would love Andy and Stephanie to role play on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.
Submit your questions here: unchartedvet.com/mailbag
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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 brings us another letter from the mailbag. We've got an email that came in from a lead technician who is really struggling with finding some middle ground in their role because in their practice they seem to be having some culture issues. They've lost some team, they've maybe had some toxicity happening, and they've really been working hard as a leader within the team to grow and overcome these challenges. And they are really struggling because they feel like the practice leaders and the practice owner and practice manager just want to focus on numbers and metrics and practice growth. They're wondering if it has to be numbers versus culture or if there's any balance to be had here. Let's get into this. And now, the Uncharted Podcast.
Dr. Andy Roark:
And we are back. It's me, Dr. Andy Roark and the one and only Stephanie stuck in the middle with you Goss.
Stephanie Goss:
How's it going, Andy Roark?
Dr. Andy Roark:
Oh man, it's good. It's really good. Yeah. Summertime, it's hurdling, hurdling towards a close at our house. It is, as we record this, we're coming up in the last week of July. And then I'm doing the fast last family vacation. I'm getting the kids back from camp and then we're heading out of town to go do that. And then we come back and the next Tuesday is the first day of school. We start back early in August here, and then we're into the fall and right back going. And that, man, summer was just a blink of an eye.
Stephanie Goss:
Yeah, this year seems to be flying by so, so, so fast.
Dr. Andy Roark:
Yeah, it's scary how fast it's going.
Stephanie Goss:
Yeah, I am definitely ready for some cooler weather, but I'm not ready to give up the sunshine and the beauty of summer here. So I'm going to soak it up for a few more weeks before we go back to rainy Washington and take all the sunshine we can get. But I feel you, the summer is going by really, really quick. We're at the middle of our summer highlights. We're going to see Taylor Swift tomorrow.
Dr. Andy Roark:
Oh you are?
Stephanie Goss:
We are.
Dr. Andy Roark:
Wow. That's a big deal.
Stephanie Goss:
It is. I told my kid it is her birthday and Christmas and everything for the next five years.
Dr. Andy Roark:
Yeah. Oh, man.
Stephanie Goss:
She is very, very excited. So I will be taking a gaggle of gymnasts to Seattle this weekend and there will be lots of Starbucks involved.
Dr. Andy Roark:
It's going to be lots of singing just so you know.
Stephanie Goss:
There's going to be lots of singing.
Dr. Andy Roark:
Lots of excitement.
Stephanie Goss:
Lots of excitement. Lots of glitter and outfits and all of the things. And it's so funny because everybody keeps asking me like, “Oh, do you have your outfit planned?” And I'm like, “No.”
Dr. Andy Roark:
When we went to the AVMA convention in Denver, Taylor Swift was playing there and a hundred thousand people came to Denver for… She had to take two concerts and apparently it's easier to get tickets there. Everywhere you look there was pink and sparkles and glitter and sequence. But at least with Taylor Swift, at least it's like a positive vibe. Everyone seemed to be in a really good mood. It was actually a pretty wonderful thing to be around. I don't know, I was pleasantly surprised. It was really cool.
Stephanie Goss:
This has been weeks on end of excitement in my house and so we are looking forward to that. And then heading into the end of summer, so it's crazy busy, but it is still summer for everybody. And we got a summer crazies related email in the mailbag that I wanted to fish out and put forward sooner rather than later because we got a letter from a lead technician who is struggling with being super overwhelmed in the clinic. I thought it would be a good one for us to talk through. Actually, this was a wonderful, wonderful letter and I read it and I'm like, okay, this is like three, there's like three podcast episodes in here.
Dr. Andy Roark:
Yeah, that's a lot.
Stephanie Goss:
But basically, it came from a lead technician and they have had some awesome changes and some challenging changes in their practice over the last couple years. So they have been really working on culture and have made some real improvements and then had some changes with their staffing and actually lost a doctor. So they went from having a couple of doctors down to really being essentially a one doctor practice with some occasional help. And it's gone well because they really like each other as a team and they get along. There have been some significant challenges as they have gotten smaller and summer has hit, so they've got some summertime help, but they've also got everybody taking vacations so they're shorthanded even though they have lost a doctor. And that is causing some significant challenges because this lead tech who used to be doing culture work and having some admin time off the floor and helping lead the team, do interviews, try and hire, all of those things that happen when you are not in role for your entire shift are now on the back burner.
And this tech has stepped back into being in their role and they are struggling because there seems to be some growing disconnect between themselves and the practice owner and the practice manager because the leadership is looking at it and it's like, “We're shorthanded, we're not making our numbers, we're down in revenue.” And the lead technician is like, “Yeah, duh? I know it feels really busy, but we've cut out appointments because we have less doctors, we have less staff, we can't see as many drop-offs, fit ins, all of those things.” So they're looking at it from a place of trying to protect the culture and trying to protect the team. And they are feeling the pinch because they are feeling like the hospital leadership is just looking at it from a spreadsheet perspective and is like, we're not making our numbers. We need to do more and more and more.
And this tech is really worried about the consequences on themselves and on the remaining staff if they only look at the numbers. And ultimately, they were asking some questions at the end about, “Given everything that I have shared, does it sound like I'm just burnt out and being difficult? Or how do I get my head straight really? Because what I want to do is bridge the gap between the team and the practice leadership and I'm feeling like I'm kind of failing at that.” And so there's a lot for us to unpack as we kind of get into it. But I thought it's such a great question and I think this is going to be one of those episodes.
As soon as I read it, I was like, oh, I know that feeling. I've been there where I feel like I'm worried about the team and the culture and the people and the people above me are looking at numbers on a spreadsheet. And you have that disconnect between the numbers and the culture and it really feels like it has to be one or the other. And so I thought talking that piece through would be something fun for us to do.
Dr. Andy Roark:
I am excited to do this. I'm going to try to wrangle my emotions in on this because this is a really hard one for me to talk about. Because here's the thing, I have been the guy at the top looking at the spreadsheet.
Stephanie Goss:
I know.
Dr. Andy Roark:
I have a very specific perspective on this, and also empathize. I empathize with our writer, but I really empathize with the panicking leaders at the top. Because I've been there. So anyway, we'll start to unpack this because I think we can do this justice. I think we've been in the different positions around the board and so I think we can talk to them a little bit in an empathetic way. So I'm excited to start to unpack this. One thing I would say is if you are a team lead, just like this team lead who took the time to write to us and you are balancing pressure from above with trying to look out for the team below, you might want to check out our Uncharted Team Leads Summit. It's on November the eighth. It's a one-day virtual summit. It's open just to team leads.
And so whether you're head CSR or lead technician, this is for you. And so we will talk just exactly about managing pressure from management and looking out for the team and managing teams. Anyway, but that's the first thing I'll throw. Let's get into headspace here. Sound good?
Stephanie Goss:
Yeah, that's sounds a great place to start.
Dr. Andy Roark:
So that's generally a good place for us to start. All right, two things can be true at the same time. The first thing I would say is numbers are important. If you don't measure it, you can't manage it. And there are some unquestionable forces of practice life which is payroll is coming and you have to have the money to do that. As much as I hate it, money is like food, it's not what life is about, but buddy, if you don't have it, it becomes a very hard thing to ignore and your options for spending your time get really limited. And so money is like food in that way. And so paying attention to numbers is really important. Watching your metrics, watching the numbers of the appointments, things like that, it is critical to be able to set clear expectations. Everybody wants to know if they're doing a good job and how they're doing and how are we doing. And if you don't have some general ideas that have some numbers tied to them, you don't know how we're doing. And it's really hard to set expectations about yes, we're doing a good job, or hey, today wasn't the best day for us or things like that.
If you can't measure it, you can't manage it. You've got to have some numbers and metrics just to know how you're doing so you can organize people and get them to work together. And on the other hand, nobody got into this job to hit number targets, right? No one's like, yeah, I'm going to vet school so I can smash those pet per day numbers. Like nope, culture is critical and people want to believe that their work, it matters, and they don't want to feel like they're in the vet clinic to generate revenue. That's not why they're here. And it feels kind of gross because they get accused of just trying to build people for dollars and they don't want to believe that there's any truth to that at all. And when everything is number focused, you start to wonder sometimes, well, is it true? Do we really need to charge these things?
That is also true. So you have to hold both of those things. And then the two things swirl together where in my experience, if you have a good culture and people feel like their work matters and they feel like they're appreciated, then you generally tend to have a financially healthy practice. And if you have a financially healthy practice and you reinvest back into the culture and the people, then they tend to take care of you and it spins back up. And so they really do go hand in hand. I think that that's where the point of our writer is they're feeling like there's a lot of pressure about the numbers and not about the culture. And the culture is starting to fall apart under pressure for numbers. And I have a hundred percent seen that. So I just want to start with that.
There's this leadership pitfall and this is why this spoke to me so much and why I said I'm going to try to not get emotional about it, it's just because I've seen it so much is one of the hardest games as a leader, especially small business. But this also happens in the corporate practices where you are the medical director, you're the regional director, you're the practice manager, and you have this force from above that's holding you accountable to dollars. They're like, you need to make this money. There's very little panic that I think most business owners feel like running out of money and not being able to pay people. I will tell you that there have been times when I have looked at the numbers and been like, I don't know if everybody can keep their job. If we have a couple more months like this one, this last one, I don't know if I can keep their job.
And man, that is a hard emotional experience for me because I do, I feel like I fail people if I can't keep them employed. I hired you for this. I feel like I owe it to you to be able to take care of you and give you a good job. And I know that that's my own stories I tell myself, but man, it is really challenging. And where the real trap comes in though is when you're looking at these numbers and people are saying, these numbers are important, these numbers are important. If you want to pass that information down to the team and say, guys, I'm just being honest with you. We're in trouble. We're not doing well, we are not meeting our numbers. We are from above, the way we're being ranked, whether we're independent and we're trying to make payroll or whether we're from a bigger group and we have these expectations, we are not succeeding and I'm getting a lot of negative pressure because of that.
And so you want to be transparent with the team and let them know that. The tricky is, the problem is that if you do that in less than a graceful way, which is what you tend to do when you're actually stressed out and feeling overwhelmed is you don't tend to be your most graceful. If you do that, then the team generally knows that things aren't going that well and now they're feeling pressured about money, and each individual person has very limited control over the practice finances. It's not like Michael, the CSR, can step up and make the practice finances change by himself. He can't. And so they feel like they have limited control, they're getting kind of beaten up over something that they as individuals don't have much control over. And at some point it starts to wear you down because then you do start to feel like you are being judged on the amount of money that you make.
And as we said, a lot of people have a really negative knee-jerk reaction to that. And so I've just seen this spiral where a practice starts to struggle and it sounds like that's what happened here is they lost. They were two doctors and down to one doctor and so they lost a lot of revenue generating capacity and then other people left. And it sounds like leadership, the practice owner, the practice manager are starting to panic. And when we panic, sometimes we are not super graceful. So they're starting to talk about money and nobody wants to be in a practice that's struggling and the owners only want to talk about money. And then more people are leaving and that makes the panic worse, which makes the pressure worse and the whole thing spirals down. And that is one of the biggest leadership pitfalls I see. And I have been in that driver's seat of going, God, we're bleeding money everywhere.
And I want to be honest with the team because I don't want them mad at me because they're not getting raises this month and I need their help. I can't do it on my own. I need help. And so I feel like I need to be honest with them about why I'm panicking. But the thing is I panic and they hear it, and then a week later I'm still panicking and they're like, “No, we talked about this last week.” And I'm like, “But I'm still panicking.” And then the end of the month comes and I am panicking again and they're like, “Look, dude, three times this month you have told us that we need to make more money for the practice. I get it.” And you can see how it quickly goes. As they get resentful, I panic more because I'm like, no, you guys are not hearing me. And then you end up in this horrible beatings will continue until morale improves situation. You know what I mean? Where you are making the culture worse.
Yeah, you're making the culture worse and the culture has to get better for you to actually get out of this nosedive. But the thing that you are doing to try to get out of the nosedive is just killing the culture, which is the thing that you need to get back out of the nosedive. So anyway, it's a horrible situation. A hundred percent, I have felt this before and it's awful. It's an awful, awful feeling.
Stephanie Goss:
It is. It's a vicious cycle. And I think I'm glad that you tackled a big chunk of the headspace because I have strong personal feelings and connections because I've been there on both sides of this. I've been there as the leader and the practice owner who is like, oh, I know we need to make these numbers or there's consequences, whatever those consequences are. Whether it's like you said, are people going to be able to cash their paychecks? Been there. Or is it just like, oh, well, we're starting to trend down and I know that I'm going to get called to the hot seat with my boss and have to explain why things are happening. There are varying degrees of that, but I have definitely been in that seat and I have been in the seat of the team where it's like, to your point, none of us got into this because we want to manage numbers.
The vast majority, and by majority, I mean probably 99.9% of our profession got into it because they care about the patients. And so when you start to focus on the numbers and the business side of it, it is that head and heart disconnect for people where they're like, I'm here for the heart, I'm here for the patients. I'm here to take care of people and their pets and all of the touchy-feely things. And when you lean into the numbers and the analytics, they're just like, they shut you off. And to your point, then it spirals because both sides are like, you're not listening to me, you're not listening to me. And it's this big swirling pit of despair. And so I definitely empathize with this writer because it is a hard position to be in and it's a really, really hard position to be in from the middle, the way that they are.
Because as a lead technician or as a lead CSR, as a team lead, and honestly even as a practice manager, but much less so, more as a leader on the team, you're in the trenches. You're still working on the floor. You're part of the team, and so you see and feel and bleed the day-to-day effects the same way that they do and you're also beginning your leadership journey where you're being asked to think beyond yourselves. You're being asked to think beyond the floor and the team and you're really starting to have to try and think a little bit with a business cap on. And so I appreciate this leader asking questions and asking perspective on are they just being difficult wanting to advocate for the team and for the patients and don't burn us out. Let's practice good medicine. And to your point, shouldn't the money follow? And so I think that this is a really hard position for someone who is in a team lead role to be in. And so I really appreciate them taking the time and asking the questions because they're good questions.
Dr. Andy Roark:
I really love it. I'll give you a quick analogy how it feels to me. It's like imagine that you had a bakery, a magical bakery where the food was only good if it was cooked with love. That's it. Joy and love makes the things you make wonderful. And the bakery is about to go out of business. That's the scenario here is you're like, guys, we're going to go out of business. It's really hard to bake with joy and love when-
Stephanie Goss:
They're stressing. Anxiety, yup.
Dr. Andy Roark:
The business is about to go… Exactly, there's stress and anxiety. And it's like the thing that makes the magical cookies is being killed by the stress of needing to be more successful. But the only path to success is to bake with joy and love. And so that's exactly like the spiral. And when you're the practice owner and practice manager, you are acutely aware of how the business is doing and so they have that pressure. But I feel for the CSR or the lead tech that's in between of going, I get that financially we're struggling or that there's a hardship. And if we do not lean back into the joy and love, then this is never going to work. And that's really the position this person is in. So anyway, I think the first thing, and the reason I started with that is I think to be successful when you are in this in-between position, you need to obviously empathize with the team and know that they're not here for the money. They're here because they want to feel their work matters. They don't want to feel like they're doing this to generate revenue. That's not what they're here for.
And you also want to empathize with the management and leadership that's like, hey, we are held accountable to these revenue numbers. We just are, and they're real. And so the most savvy of leaders, it's like if you want a real test of your skill, you have to be able to hold both of those things in your hand at the same time. Which means you have to know that financially things are not going well and still lean into the culture, talk to people about why their work matters, and talk to them about how we are doing a good job. And we're doing it for the right reasons. And be transparent about like, hey, things are not going that well. Just so you guys know. And there's really this dance here. The team lead, they've got a number of options here now that we lay this out and go, okay, great, as long as you can empathize with management and where they're coming from and the pressures that they're feeling and the team on the floor, it's your job to then say, okay, can I balance these things? And sometimes you can't.
A lot of this is to the credit of the owners and managers. If you've got a leadership team that is not going to back down and they are just going to every day, they're going to hammer on this and make it a thing again and again, you're going to have a really, really hard time. Part of this is I really, as I looked at this, I'm really having to struggle to not try to coach the leadership team because that's not who's asking this question. But just if leadership team, if you happen to be listening, just as a real quick aside, recognize that the team doesn't want to hear about money. Tell them, be transparent, but then shut up because they don't want to hear about it. And you have got to lean into the culture and the purpose to make this thing happen. Make a plan, decide what you're going to do, how are we going to turn this back around, communicate it to the team, communicate what the importance is, and then shut up and stop. Try to stop looking at the numbers as best you can.
If you're going to look at the numbers, set a deadline and be like, great. We are not saying anything else about money for the next two weeks. So we've told them we are trying to do things, we're adjusting our plan. We are not going to talk to them about money or revenue or anything for the next two weeks. We are going to push the programs that we came up with and really try to push them for the right reasons knowing that good medicine, taking care of people. Look, I have a mentor who's just said to me a number of times, “Andy, if you work hard and you take care of people, things tend to work out.” And it's like, I have found that oftentimes that's true. But you got to just decide to lean into that. But I tell you, I would stop looking at financials except for set times. I would be like, I can't look at the numbers every day because it's not helping me. It's like it's not helping me. I get it. I know generally what's going on.
I know what we have to do. I need to stop looking at this and lean into trying to do good work on the ground and then we'll stop at the end of the week and we'll look at how we did. But man, I know people who look at the numbers multiple times a day and I go, this is not helping. This is helping you. And so that would be my side coaching to the leadership.
Stephanie Goss:
No, it's not helping and it's not healthy either. That obsessive managing to a spreadsheet perspective, it's not healthy because the reality is that veterinary medicine, there's a lot that we can control. And this is where I do empathize with the leaders who are looking at the number of perspective because there are a lot of things that we can control and there are a lot of changes that we can affect here. And we have a lot of people in veterinary medicine who are in leadership positions and who succeed in spite themselves and who don't have the understanding and the education background to know how to impact and affect change when it comes to the numbers. And so I have some thoughts on this when we get into the action steps perspective, but there's often this knee-jerk of things are going wrong and I know I need to fix it, but I'm not exactly sure how I'm supposed to fix it because I don't really understand the business side of it.
And so I'm just going to throw all the spaghetti at the wall and see what sticks. And it just is often there's more chaos and madness and it's like, let's not do that. Leaders, if you're listening. We'll talk about some ideas. When you think about managing to a spreadsheet, and that tends to be this knee-jerk reaction like you were saying, Andy, I should look at it more. Because if I look at it more, then I'll know what's going on with it. But the reality is in veterinary medicine, we can't control all of the things and there are things we can control. We can add more visits in. We can try and get patients who haven't been coming in to come in. There are things that we can impact and we cannot control every minute of every day. And there is so much up and down that has to happen over time.
And I think that so many people from the business perspective look at it and go, okay, there's a plan and we're going to put the plan in place and snap our fingers and poof, it's going to magically change overnight. But when you think about it, and in this case, it's actually a really good example because this team lead was like, we've had a downward trend in our numbers over the last three months, and this is typically one of the busiest times of the year for us. Which is part of what is so worrisome, I'm sure for the practice leaders, it's like if in your busy time you're really, really down. Well, it didn't happen overnight. That's three months worth of numbers and you're not going to make a change and put it in place and poof, overnight it's going to be back to the way that it was.
And so I think that hyper-focused, hyper obsessed looking at the numbers constantly is really unhealthy. Really unhealthy for so many reasons. And there is also truth in that it is not going to change overnight. And so it does no one, particularly not the people involved who are working their butts off, good for them to see you hyper-focusing and hyper obsessing and looking at the numbers constantly because those numbers will take time to change. And so I love your perspective, Andy, about let's take a certain point in time whether it's the end of the day or the end of the week or every two weeks where you're like, okay, I'm going to sit down and review this and I'm going to implement change. You don't want to go a super long period of time because you need the time to impact the change. And if it's not working, you want to adjust sooner rather than later. But to your point, it is really, really unhealthy to do that obsessing. And so from a headspace perspective, if that's part of what is happening here, that conversation about that obsessing is probably a healthy one to have.
Dr. Andy Roark:
No, I completely agree. The dials of control we have are not so fine that you need to look in the morning, in the afternoon. That's ridiculous. Everything you do takes, it takes time. And time, not in hours, not even day, but in weeks. It takes weeks to get things turned around. And so one of the skills that I've learned over time is looking at trends and going, okay, this is not going the way that I want. And so I'm going to just to tell you how I do it is I look and I say, I'm going to set this date as a significant inflection point. And if things are not trending back upwards and they continue to trend down, at this time, whether it's a date or whether it's where I hit in the savings account or whether it's when we cross into the emergency account for our business, it's like I have a plan for when we have to dip into the emergency account. And it's the get small plan and it's going to suck. We might not be able to carry.
At some point you say, I tried to carry the staff for two doctors with just one doctor, but we have not been able to replace that second doctor and now I cannot carry that much staff. I just can't. And that sucks. But you not owning that and continue just to freak out about it and pound on the staff to make more money is like that's not helping anybody.
Stephanie Goss:
You're going to lose them anyways if that's the way you approach it.
Dr. Andy Roark:
You're going to lose them anyway. I mean, quite honestly, sometimes the best call is to say, we have hit this mark, we are now into our emergency fund. I am going to let some staff members go and restructure down to a one vet practice that can be profitable, that I can afford to keep. And my hope is that one day I will be able to add a second doctor and then we'll have to rehire staff. And yes, that's not as great as if we already had them here, but it's just what we're going to have to do. And it's just funny. Again, I don't know this has happened here. And again, we got to stop talking about the leadership team, but I just can't because I just empathize so hard. There's this idea when you're driving the team and you are in charge and you're trying to make these things happen and you're trying to make good calls, there's this tendency to just white-knuckle the steering wheel. You're like, we're going to pull this out.
We're either going to pull it out or we're going to crash and burn. There's a middle path which is, well, we're going to have to make some hard choices along and along and we're going to adjust. We're not going to crash and burn. We're going to end up with a smaller team and that will suck. But we're also not going out of business. But I've seen people just drive it right out of business and I'm like, you know, if you would make some hard calls along the way and let some people go or things like that just along and along, you could have kept a smaller team and kept going and kept playing the game. But we don't think that way. We're not like, oh, what adjustments we get, it's just all or nothing thinking is we are going to make this thing fly or we're going to crash and burn.
You go, how about this? How about you're going to make something different fly because you're going to make adjustments based on what you need to do. And not in a moment of panic, but by watching and trying things and setting some guardrails where you say, well, if we're still trending down at this point, we're going to have to make some adjustments. But I tell you what, honestly, everybody's better off if you can do that and treat people with kindness and still lean into culture and honoring the work that you do and then saying, I'm sorry guys, we have to make these calls. That actually does much better for you than screaming the whole way that this isn't working and people are not showing up the way they're supposed to.
Stephanie Goss:
Yeah. Okay. So do you have anything else headspace? We started a little bit talking into the action steps, but before we make that switch, do you have anything else headspace-wise?
Dr. Andy Roark:
No, I think the last thing that I would say, again, it's just for the lead technician that wrote to us is empathize, right? Understand where it's coming from. Nobody's trying to be a monster. Everybody's fighting a battle. Just try to recognize. When you see people at their worst, try not to sum them up as a person based on their worst day. You know what I mean? That's it. And at the same time, we got to make some changes. And so let's take a break and we'll come back and then we'll get into if you're this lead tech, what do your playing cards look like?
Stephanie Goss:
Okay. Did you know that we offer workshops for our Uncharted members and for our non-members? So if you're listening to today's podcast and you are not a member of Uncharted yet, you should be. But this is not a conversation about joining Uncharted. This is a conversation about all of the amazing content that we have coming at all of you, whether or not you're a member through our workshop series. You should head over to the website at unchartedvet.com/events and check out what is coming. We have got an amazing lineup on the regular. We've got something every month, sometimes two or three things in a month coming at you to expand your brain, to talk about leadership, to talk about practice management, and dive into the kind of topics that Andy and I talk about on the podcast every week.
So now's your chance. Stop what you're doing, pick up your cell phone, I know it's not far from you, and type in unchartedvet.com/events. See what's coming and sign up. They are always free to our Uncharted members and they have a small fee attached to them if you are not currently a member. You can get all of the details, pricing, dates, times, and register, head over to the website now. I want to see you there.
Dr. Andy Roark:
All right, so let's take this. So you're the lead tech, the practice owner and practice manager keep beating the drum about money and the morale is down. You are stuck in the middle trying to help the culture on the ground and also to deal with the pressures that are coming from above. Right? Cool, sweet. As I said before, I think culture is your better motivator for your staff, right? Lean into what we're doing, the fact that we're a team, the fact that we're trying to make a difference. Remember what your team cares about. Everybody's got motivators, right? Sometimes it's patient care, sometimes it's making an impact in the communities, sometimes it's educating pet owners. What do they care about? Who are we? What are our values? And I would intentionally try to lean back into that and try to rally the troops around the values.
I would go and have a conversation with ownership. And I think the best thing that I think you can say the owner, it depends a little bit on the individual, but I think if you are stuck in the middle here, the best thing that you can do when communicating with a leadership is to make sure that they feel heard. And I will tell you as someone who's had to fly the ship and been like, oh no, I don't need people to freak out with me, but I just needed to hear someone say, Andy, we understand the situation. We got it, and now we're going to get into problem solving mode. And that's all that I needed to hear was because that's the concern is you think, boy, do they not get it? Do they not know that things are not going well? Do they not know how bad our month was? I've walked in the treatment room and people are whistling and high-fiving and I'm like, how could you be so happy right now? That's ridiculous. But the first thing you say is, I get it. I know this is important. I know we have to turn this around.
And so just try to make them feel heard and let them show you the numbers and blah, blah, blah. But just go, yep, I get it. So starting first is to try to empathize and understand, but mostly to make leadership feel heard and then remember what your team on the ground cares about.
Stephanie Goss:
And I think it's possible for this lead technician to recognize that this may not be one conversation. So there's two big things here at play. There's the conversation about the numbers and about needing to be a part of the leadership team and the solutions and figuring out how, to your point, recognizing that everyone has jobs because the business exists and if we don't run the business, we don't have jobs. And so part of this lead tech's role is looking at it from that perspective. And there's a lot going on that have to do with relationship pieces that don't have to do with the numbers that aren't the analytical piece. And this tech is feeling overwhelmed. They care about the team, it's impacting them physically. They're working extra because they're shorthanded. They're on the floor. They're impacted and they want to have things change to improve their own situation and the situation for the team.
And so recognizing that if their practice owner and their practice manager are worried about the numbers and stuff and they're trying to combine those two very different things, the relationships and the numbers into one conversation, the chances for success are very minimal. So your best bet in my opinion would be to break those things apart and be fully engaged with both conversations completely separately so that you can have the relationship conversation, you can pull those levers, you can talk about the impact to you. We'll talk about how would you set up a conversation like that. That conversation is going to go so much better when you're both in agreement that that's the conversation that you're there to have versus them wanting to have a conversation about the numbers and you wanting to have that conversation.
Because you do want to grow and this person wants to develop as a leader and also they care about the team, they care about themselves, they've got all of this other stuff. That conversation never goes well on either side. And most of us, I think it's just human nature, try and have the conversation together. I know I did, and so did my bosses. It's like, let's just sit down and let's just have the come to Jesus and let's just hash it all out in one mega long meeting. And then everybody leaves in tears. It never goes well.
Dr. Andy Roark:
And then we all cried.
Stephanie Goss:
Everybody cries.
Dr. Andy Roark:
Okay. Yes. Okay, I completely agree. I see this a million times, it is a terrible idea because this is not a let's hash it out problem. There are things where you're like, this is a hash it out problem. I guess we talk about, is this a head, heart or hands argument, right? A head argument is we are not understanding, we're looking at different facts. A heart is it means different things to different ones. And a hands is understanding how we get things done. Can we actually get this thing done? This is going to cycle between head, heart, and hands. Every time the numbers come back or they're looking like, it is going to cycle. If it's just a head problem, which means the staff does not understand this thing and we understand it and we need to make them understand it, it's possible you could get together and hash it out. And everyone goes, oh, okay, all right, I get it. I see where you're coming from. And then we put it down.
But that's not what this is. I would tell you as somebody who is looking at the numbers, like I said, it takes a long time to turn these things around to make real changes, things like that. This is not a problem you're going to hash out in an afternoon and then we're not going to worry about it anymore. It's going to continue to be a thing, which means if you are a writer, this is a relationship management thing, right? Think about it like you are supporting a friend, someone you care about who has a medical problem. It's like you're not going to hash out there a medical problem in an afternoon, be like, no buddy, listen, I empathize and I am thinking about you and I'm sending thoughts and prayers, and if we could just not talk about this anymore, that would be great. Thanks. But just know that I'm thinking about you, but also it's awkward and it makes me feel weird.
If you could just not bring it up again, that would be great. You know what I mean? It's not that. It's for the people who are trying to fly the ship, it's going to be an ongoing thing. And so I do think that as your lead technician, you are going to be in a relationship management thing. And that's not bad. It just means, trust me, this is going to come up again. It's going to keep coming up because it's not going to go away. And every time they look at the numbers or every time payroll goes through and the accountants drop or whatever, they're going to have another panic attack. And part of the challenge in managing this is you're going to have to be patient and kind every time. You're going to have to continue to say, I hear you. I understand. These are the things that are going well. I think we have a good plan.
You're going to have to reassure and then you're going to have to go back to trying to work on the culture as we do in a way that also helps support the practice. You're going to have to reapply yourself to the practice. And again, I think a lot of people think that there's something disingenuous about using different messaging to leadership and to the team, but I really don't think that there are. You know what I mean? Different people are motivated by different things or different people need different things. And so for example, this is going to be terrible because I'm just shooting from the hip. If you went to me and my wife and you were trying to get us to go on vacation somewhere, you're a vacation salesman. The thing you would say to me is very different than the thing you would say to my wife.
You would go to my wife and you would be like this, it's convenient, you're going to have the things for the kids to do are wonderful, the whole family will be entertained. And you'll look at me and be like, oh dude, it's got an open bar. I'm like, yeah, and I'm done. I'm sold. It's something stupid. It's not that. But you get the point, right? And none of that is untrue. It's just knowing who you're talking to. And so if you're the lead technician in this scenario, the conversation you have to try to support leadership to try to make them feel important, to make them understand that you understand what their needs are, that's just a different conversation than you're going to have with the team where you let them know that their needs are important, that you hear them, that you are trying to achieve what they're trying to achieve.
Again, it's not disingenuous. If you're straight up lying to one of those people, that's bad. That's not what we're doing. But the messaging up and down the chain can be different and we can still act with integrity because ultimately we are taking care of our team on the floor. Because we know and believe that if we do that along with some systemic adjustments, we can accomplish the financial metrics that are making us sweat. Things like that.
Stephanie Goss:
Yeah, absolutely. And I think that you have a significantly higher potential for success on both sides, no matter how you're framing it to your point. Like, okay, if you are the vacation salesman, ultimately you want them to buy in and go on vacation. And as you're listening to the salesman, you want to see yourself going on that vacation. And so the ultimate success for everybody is that thing happening. And so I think for this lead tech, whether they're having the numbers conversation and they're helping and stepping into that leadership space or they're having the conversation about, Hey, this is how this is impacting me on a personal level. Or they're having the conversation about, Hey, this is where the team is at. All of those conversations have a very different frame, and it is okay for them to step into that conversation and focus solely on that piece because they're going to get to the others.
That's the thing is that you're not lying. You are going through the pieces. But trust me when I say that, when you break it apart and try not to just conquer it all at the same time, nobody succeeds there. And so pick one from an action set perspective, pick one and start there. And so for our writer, I would say what feels… There's two ways you can approach it. What feels the most urgent? Is half of your team really looking for other jobs and they're going to quit in the next week if you don't address something? That might be more of an urgently flaming fire than your practice owner being worried about the numbers. It might not, but that's a gut call that you're going to have to make. Are you yourself at the point where you're just like, I'm exhausted, I'm overwhelmed, I physically cannot keep working on the floor? And if you don't change my schedule soon, it is going to break me. Is that the biggest fire? Part of it is that from an action steps perspective is figuring out where do you start. Because you can't have all those conversations at once, and so which one is the most urgent?
And then when you're communicating that and you are sitting down and having conversations. So I think your first step, we always talk about having safe conversations and we're going to get to that. The first step is to ask to sit down and have the conversation. And so when you are asking to sit down and have a conversation, I would frame it for my practice owner and my practice manager in that, Hey, there's a couple of things that I want to talk to you guys about and I would like to set up two meetings or three meetings or whatever. Because I would like to talk about this and I would like to talk about this and I would like to talk about this. I want to be in the right headspace for each conversation and I want us to really be able to focus and accomplish things, and so I would like to break them apart how can we accomplish that.
If you came to me as the practice owner, even if I was worried about money and I was worried about the numbers, if you came to me as a member of my team, I would admire that so much that you are acknowledging my concern and be much more willing to set up the safe space conversation where we're going to be able to sit next to each other or we're going to be able to assume good intent. Where we're going to be able to look at how have we maybe not set the team up for success? How have we failed the team? And ultimately, get to the E in safe, which is what is the end result, which is the problem solving, which is ultimately where the practice leaders want to get to. We all want to skip the hard stuff and just get to the end result, but the reality is we can't do that. And so we have a better chance of working through the stuff in the middle together as a team if we can acknowledge, hey, this is multiple conversations.
So I would ask to have that conversation and set it up in that way. And so I think our writer needs to sit down and think for themselves, what are the pieces that feel like they're on fire and what feels like it's the biggest fire? And then figure out which one to approach from that. That's how I would approach it anyways.
Dr. Andy Roark:
Yeah, I agree. I agree with all that. And I would also frame it in terms of asking for help. And I just find asking for help to be a really powerful approach is to go in and say, I hear you guys. I see what we're trying to do. I am concerned about what's happening on the ground, the way that people feel about these things. I need some help. I need help in delivering this experience. I need help in trying to try to take away some of the things that are most bothering to people so that I can get them motivated on whatever the initiatives are that we're going to try, things like that. But you go in and you put yourself as, Hey, I'm your friend. I am your lead technician. I am trying to help manage on the treatment floor. These are some things that I need help with. I need your support in this area.
And a lot of times, that's what people need to hear rather than saying, you need to do this, or the staff doesn't want that, or blah, blah, blah. And then you're not wrong, but it's much more productive to say, I need your help because I think that some people feel this way and I want to make sure that they know that that's not true and that X, Y, and Z are the things that we care about. And so I need your support in trying to frame these issues this way or to take some of this pressure off or to make this situation better.
Stephanie Goss:
I love that. And I think you also have, it is a good superpower to use to flip the help, you need their help and you should absolutely ask for it. And also to tell them, I want to help you, because ultimately that is a piece that is driving this person as a leader, which is I want to help be a part of the solutions here, and so I'm willing to try some things. And so I think it's a little bit about compromise. Our writer ultimately ended and was asking, am I just really burned out? Am I being really difficult? Here's the things that are weighing on me. And while we didn't get into a lot of those pieces in this conversation, I just want them to know, no, you're not wrong. Things like this impact all of us. It's a relationship and it has to be a two-way street.
And so you can dip into that trust bank and you can say, Hey, I need this and here's what I need and here's why I need it. And if you have a really strong relationship, there's going to be some give and take there. And also recognizing that as a leader, sometimes you feel like you only have 80% to give, but you figure out how to give a hundred percent anyways. And you can't do that over a sustained period of time without it becoming unhealthy and without getting to the place of burnout. And so if you are in a place where you're like, I literally can't take this anymore. This is physically impacting me, or this is mentally impacting me and I'm going to break, you have to lean into that aspect of the relationship, to your point, Andy, and say, I need your help.
I want to help you, and I feel like I can't help you until I help myself and this is physically impacting me or it's mentally impacting me, or whatever it is. And so I think leaning into that on both sides and having that honest conversation because it opens that door to the human space. And the reality is, if you've been working together and you have a good relationship and you've been there through the things, even if you're not friends with the people that you work with, you care about each other. And so I have never once leaned into that magic button of asking for help and trying to give help and not had it work out because we care about each other.
Dr. Andy Roark:
Yeah, no, I agree. I really like how you characterize this too. And this is a triage job. When you have things like this and you've got financial pressures and the metrics and you've got culture issues that are stemming from this and people are unhappy and all those sorts of things. I really do look at it like a triage job. It's one of those, it's like a multi-part surgery where you go, okay, we've got this horrible broken bone, but we're going to need to stop the bleeding before we deal with this bone. We're going to deal with the bone, but if we don't get the bleeding stop, we're not going to be able to fix the bone. It's a lot like that. And to your point, you go, okay, great, well, this is what I need. And so I've got to clamp my pain off and make sure that I can be okay. I'm going to clamp this off, and then we're going to go look at these things that the staff is really upset about that's undermining our ability to come together and be efficient. Let's see if we can fix that.
And all of that stuff is working towards the actual fixing of the problem, which is running a two vet practice. We want that. But we got to do all that stuff. But it's all interrelated, you know what I mean? It's morale gets down, so then people start showing up late, which makes the clients unhappy, which then beats up the front desk. It's like, you just got to stop. You got to try to figure out, do a little root cause analysis, try to figure out what the underlying, most painful, problematic parts are. Try to fix those things. And I'll tell you this, let me shine some sunshine here. What I have found is, because I said, you can tell I've driven this. I've flown this plane before, but what I have found is often it's not as bad as you think it is. It's not as bad as you think it is. A lot of good comes from setting some deadlines and then not looking at the metrics, like putting them aside, doing the work and then coming back at a designated time to see how you've done so you're just not beating yourself up.
And the other thing that I've found is your team wants you to succeed. They want you to succeed. They do. You can ask them for help and you'll be amazed at how if you are vulnerable and honest and you ask for help, it's amazing how people will pick up and come and get you. They'll come to where you are. And the real last part is when we have things like this and it looks bad and the staff is unhappy and things, you don't have to magically fix their problems, I found. But you have to show them that you're trying and you have to make progress. Most people, if you're making progress, if you're making an honest effort to address the problem and to get better and they can see a visible effort, they'll give you some time and they'll give you some grace for the most part. You know what I mean? But it really is, often it's that perception of are things changing? Are they going to change?
So you don't have to have the magic wand, you don't have to have the magic solution, but you have to try some things and you have to work on some things. And just say to them, Hey, we're not going to get everything right, but we're going to try and we're going to keep trying. And if this doesn't fix it, we're going to keep working. This is probably going to be a multi-step process in getting us back where we need to be, but you have my word. We're going to keep trying to fix things and we're going to keep working on them. And I've just found that it's funny, people will give you grace as long as they believe that you're trying and that things are changing. I think the biggest fear that people have is nothing is changing and nothing is going to change, and this is what it's going to be. And that's when I think people really lose heart.
Stephanie Goss:
I think the last thing for me, I'm going to talk to the practice leaders a little bit, but also to our team lead here. When we think about this from a numbers perspective, one of the things that happens to a lot of us, it's happened to me on both sides of this, which is why I'm bringing it up, is that we have this sense of panic. And Andy, I think you might be able to relate to this too, we have the sense of panic because we know that things are not going the way that they should. And so we start looking at the numbers because we know, everybody tells us, well, you should be monitoring your KPIs, you should know. But so many of us in veterinary medicine don't actually know why we're looking at each of those things. And so as a practice owner, this is what happened to me when I was a manager, was my practice owner, we got into a position where we had lost some staff and we were doing less appointments.
And so our numbers started trending down. And all of a sudden, it was like, let's obsessively look at all of these numbers because someone told us that we should look at the numbers. But I was like, are those the right numbers? What matters? And so I think your point about root cause analysis, the best thing from trying to bring the numbers and culture perspectives together, besides breaking apart those conversations is for this team lead to try and understand what is being looked at and why is it being looked at and doing that root cause analysis. So to your point, Andy, is the practice owner sitting there and they're truly worried that people might not be able to cash their paychecks? Those numbers are different numbers than if you're worried about the overall number of new clients, or you're worried about the fact that people can't get in for three months.
The root cause there is very, very different. And so I think as a team lead, stepping up and saying, I want to help this because that's how you are going to help drive the team, is to understand what are we looking at and why are we looking at it? Why do we need to impact the change? And that will, I think, unlock the ability to have that conversation on both sides for this team lead.
Dr. Andy Roark:
Yeah. Okay. I love it. I could do a whole nother episode right here based on what you just said because you're spot on. So I made some assumptions about why this is a big deal. Because I'm like, oh, you're looking at this and the number's not where they need to be. And they went from two vets down to one. And so I imagine it's fairly dire, but I do think it's probably a very, very good choice to try to understand why these numbers are important. Why are these numbers important? Because there's two things that I see. I've seen them in myself, I see them in a lot of other people who run teams is one is comparison is a thief of joy, which means, are we doing these numbers? Because your friend from vet school has a hospital and their numbers are much greater than yours.
I'm like, I have seen people a hundred percent grab onto that and they just trash the thing they have. And the truth is, the person probably didn't tell you their actual numbers anyway. But I've seen people be like, I have to get numbers like they have. And I go, they're in a different demographic, they're a different area, blah, blah, blah. Forget it. But I have a hundred percent seen people be like, yep, I have to do this. And so comparison is the thief of joy because I'm comparing to someone else. The other thing is what a practice should be, and this is something that I think tortures a lot of people, is we read management journals and we talk to consultants or we go to talks and things like that. People are like, well, your practice should be doing this and they should be doing that.
And the truth is, there is no should. There's what you hope for. There's what other practices are able to do, but there is no should. And so I am a hundred percent seeing people be like, well, I should have my practice ready to sell and blah, blah, blah. And you say, but are you planning to sell? And they're like, nope. And I'm like, okay, then that's something we should aspire to but it is not mission-critical. I felt that way at different times in my career of like, I will tell myself a story about what my business should be or how my practice should run, the practice where I work should run. And the truth is, none of that matters and it's not real. And there is no celestial body of judges who will say, yep, you ran your practice the way it should be run. That doesn't mean anything. So anyway, are we doing these numbers because these are numbers we should have? Are we doing these numbers because we're comparing ourselves to someone who's not us?
Or are we looking at the numbers and saying, well, the payroll is coming. I'm not comparing myself to anything other than I want to make sure I take care of my people and I'm worried not being able to do that. Those are three very different things.
Stephanie Goss:
We could totally do a whole separate episode on that. And to your point, I think the success for this conversation is to help me understand, start wide and ask the questions. I want to understand what we're looking at. Why are we looking at these numbers? What numbers are we looking at and why are we looking at them? I think that's a great place of inquisition to come from as a team lead. Because that's part of your journey is learning and understanding, and you might help yourself, but you may also help your practice owner and your practice manager along the way. And so I think it's a good place to start that conversation for sure.
Dr. Andy Roark:
Yeah, I agree. All right, cool.
Stephanie Goss:
Okay, well, this was a fun one.
Dr. Andy Roark:
I agree.
Stephanie Goss:
And now I see two more episodes coming out of this.
Dr. Andy Roark:
I know. This is a robust question, I'll tell you that.
Stephanie Goss:
Have a fantastic rest of the week, everyone.
Dr. Andy Roark:
Yeah. See you, everybody.
Stephanie Goss:
Well gang, that's a wrap on another episode of the podcast. And as always, this was so fun to dive into the mailbag and answer this question. And I would really love to see more things like this come through the mailbag. If there is something that you would love to have us talk about on the podcast or a question that you are hoping that we might be able to help with, feel free to reach out and send us a message. You can always find the mailbag at the website. The address is unchartedvet.com/mailbag, or you can email us at podcast@unchartedvet.com. Take care everybody, and have a great week. We'll see you again next time.
