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Articles, Videos, & Training on Pets & Veterinary Medicine

Andy Roark DVM MS

Training the Team for Recommendations and Hard Conversations

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Dr. Andy Roark engages in a dynamic conversation with Certified Veterinary Practice Manager, and Licensed Veterinary Technician, Bash Hallow. Together they delve into the art of navigating difficult conversations within veterinary practice and the significance of understanding clients’ needs for effective communication.

This episode is made possible by Purina Institute!

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Purina Institute CentreSquare

Get the new Purina Institute Clinical Nutrition Handbook for free!

The Purina Institute

Bash Halow Consulting

Better Solutions and Employee Engagement with Design Thinking

ABOUT OUR GUEST

Bash Halow CVPM, LVT, is a graduate of the College of William and Mary, a certified veterinary practice manager and a licensed veterinary technician. As a veterinary business advisor and a veteran practice manager with more than 23 years of experience, Mr. Halow has helped dozens of veterinary hospitals understand how to build stronger teams and responsibly and ethically grow their businesses. He is a frequent contributor to DVM 360, Vetted and other publications like AAHA Trends and Today’s Veterinary Business. He is a member of the advisory board for the Fetch360 veterinary conferences. He has been an invited speaker at all the major U.S. veterinary conferences including AVMA, AAHA, VMX, Western, Midwest, CVC, IVECCS; state associations, and international conferences like APVC, OVMA, the Alberta Veterinary Medical Association and addressed the Veterinary Management Association at the House of Lords, London, in June 2018. He is a member of the American Animal Hospital Association, the PVMA, founder and member of the New Jersey Veterinary Hospital Management Association, founder of the Big Apple Veterinary Management Association in New York City, and proud member of the Veterinary Hospital Managers Association. Mr. Halow was the 2013 recipient of the Pennsylvania Veterinary Medical Association’s President’s Award for management education in the state of Pennsylvania. He resides in New York City.

EPISODE TRANSCRIPT

Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary podcast. I am your host, Dr. Andy Roark. I am here with my friend, the one and only Bash Halow. Bash is a men of men and talents. He is a fantastic speaker and presenter as I talk about when we get started. He’s a CVPM. He is a credentialed technician. He is a professional consultant, but we get into a conversation that I enjoy, which is hard conversations with the staff. It’s just every team has difficult conversations to work through. There is healthy conflict and there’s unhealthy conflict. I see a lot of teams that struggle with this. I don’t think we have near enough conflict management training in our profession and that shows, and so I get into talking with Bash about this and we talk about training and just getting your staff and your team up so where they can communicate effectively with each other.
So this is a really good episode that’s just packed with pearls and so anyway, I’m super thrilled to have Bash here. I could not do it without the Purina Institute. They are bringing this episode to you ad-free. A couple of things from them. One, if you have not taken a look at the Clinical Nutrition Handbook that is made available by the Purina Institute, it is a hundred percent free. I’ll put a link in the show notes. It is wonderful. You should get it, have it on your phone, have it on the clinic computers. It is just such a wonderful resource. Also, if you haven’t done it, be sure to check out the Purina Institute Center Square resource on purinainstitute.com. A fantastic wealth of information, lots of staff training resources, just a really incredible way to learn and grow yourself and your team. And so anyway, both of those resources available are made available by the Purina Institute. I’ll link to both of them. Let’s get into this episode.

Kelsey Beth Carpenter:
(singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to The Cone of Shame with Dr. Andy Roark.

Dr. Andy Roark:
Welcome to the podcast Bash Halow. How are you my friend?

Bash Halow:
I am so good and it is a pleasure to be here with you.

Dr. Andy Roark:
It’s great to have you here. You are such a fun guy to talk to. So I have known you for years and years. You are going to go off script here for a second. How I know bash you are such a dynamic presenter and public speaker. I love your energy. You’re one of those guys who comes in and so I’ve done a lot of public speaking and a lot of times people who go in and do presentations are really kind of affected by the energy that’s in the room, which means if you have people who are really enthusiastic, they’re enthusiastic and they have people who are not that enthusiastic or they’re tired first thing in the morning, then the speaker’s energy is kind of down and you’re one of those few people, Bash who can take an audience and put them on your shoulders and just carry them from an energy perspective.
Like you can lift a whole room up and that is such a rare thing to do. I can tell you from experience, it’s exhausting to try and you do it as effortless as anyone that I’ve seen. You are a certified vet practice manager. You are a licensed veterinary technician. You are the principal at Halow Consulting. You are a gadfly man about town, a veterinary socialite. I don’t know. You are into all the things. Yeah, that’s how I know you. I got the chance have you on the podcast to talk about one of your fores, which is difficult conversations. So I’ve heard you lecture on this a number of times. You talk about it from the perspective of a practice manager and then also from a licensed veterinary technician. You practice as a technician for many years. I just think you have a really great perspective on this from different roles.
And so when the idea came up to do some hard conversation sort of strategies, I was like, I think this is our guy. So anyway, thanks for being here and talking to me about it.

Bash Halow:
Well, I need to thank you for that wonderful introduction and that enthusiasm probably has a lot to do with probably the people on the call can relate is that especially if you’re a leader at a hospital and you’re making decisions or you have ideas and it feels like you’re all alone. And boy, I would go to conferences as an attendee and I would hear things. I would go back to the practices and I would try them out and they wouldn’t work for me and I’ve just felt like a failure and I felt alone. And then when I had more of an opportunity to engage with audiences on those topics, I became excited because I was trying to figure them out along with the audience and also make friends in the industry create relationships that I could turn to so that when I went back to those practices, I could have somebody to call if I was running into difficulty.
But it’s interesting that you talk about that enthusiasm. Sometimes I’m up there enthusiastically talking about some idea that I’ve cooked up and you look out and there’s crickets in the audience and you realize I’m the only person that gets excited about this idea. Maybe like today’s topic about valuable covers, we call it difficult conversations. I really don’t validate your mouth, but I actually think that when you do them right, they really can be valuable conversations.

Dr. Andy Roark:
I coach a lot of young presenters and speakers and things and educators and one of the big things I always try to say to them is if you walk in there to try to teach others and you think your learning is over and you think you have the answer and you can’t get better, you’re really limiting yourself. The best presenters and educators are people who go in and teach and they walk away having learned more or at least they’ve added to their treasure trove of knowledge.
They have picked things up as they go. And so I have always found that working with an audience is one of the best ways to improve as an educator because they raise awareness of holes that you have in your arguments and in your ideas. They ask really hard questions because you can’t hand weigh through that stuff. I think one of the hardest things about difficult conversations, especially when we’re training, we’re working with staff members, we’re talking about how to get better is I’ve never bought this idea, Bash that there is a right way to have hard conversations. I’ve seen people roll up and they sort of have this expert hat on like, I’m going to tell you how to do this, and I go, I just don’t buy that. I think there’s too many variables. Everyone has sort of a different style and there’s definitely core concepts we have to get, but I think you’re going to have to hold onto those core concepts loosely.
Do you agree with that?

Bash Halow:
I absolutely agree with you. And when you were talking about teaching, a lot of times we have this idea that, and in Vet Med we’re going to go in there and we’re going to provide client education and that’s going to equal better service and that’s also going to equal higher sales. And I bought into that as a practice manager and as a technician I bought into that clearly I love to talk. I love to be a source of information that I think is going to be valuable. And so while I was in it and doing it all the time, it seemed right now when I’m on the outside in my capacity as a business advisor and I’m watching veterinary teams educate clients, I see that they’re doing that thing that you say is a turnoff to audiences, which is they’re not first coming to the table ready to meet the client where they are.
They are in their needs, their goals, their understanding of a thing or even their own emotions. And so when you’re talking about whether it’s having a difficult conversation with an employee or a time with a client, you cannot go in there with an agenda because it presumes that you know everything about the situation and you have to go in there first ready to listen and to learn and meet that individual where they are. Then I think that you can make a real connection and a difference in their lives.

Dr. Andy Roark:
I love that you say that it requires, oh, so let me just ask you this as a question actually. Does it require a greater level of mastery of the subject matter to go in and meet the client where they are as opposed to knowing what your script is going to be and go in and saying, these are the points that I want to make?

Bash Halow:
Well, I’ve had a lot of experience with scripts and I’ve turned off a lot of people with scripts in my day, again, interested in selling things. I thought that was what was going to mark was going to stamp my success was make sure that I had high sales, is that I’ve tried to teach people how to talk about things and trying to shove that script down people’s throats is only resulted in a lot of choking and gasping. It was only when it’s true, only when I really was able to help people understand the value. If they personally understood the value of what it is that they were doing or the value of the products that they were selling, then they were very good at marketing those services and products to clients. So I would say that certainly, certainly you’ve got to go in there with a desire to learn about what the client needs and wants and also what you believe they need, what you believe that pet needs.
But I also think it’s important that you understand the value of what it is you have and it’s worth in this specific case. So I don’t think that you can just go in there without any knowledge. It’s important that we’re all regularly given access to training on the value of the services that we have. We were talking earlier about nutrition that’s just coming to mind. The Purina company that’s sponsoring today, they’ve got an excellent website that’s a source for education for team members, team members called Center Square, and that’s just a great way to give your team members little bites of information that they can take day by day as they move on in their journey and training and learning. But it’s a combination of being able to go into the room, be ready to listen and watch for opportunities of what this client needs and what you think they need and then matching it with services and products in your practice that are of value.

Dr. Andy Roark:
How do you train people to do that, Bash? So if you’re not doing scripts, which you and I both agree going in with a script, just people can smell it. As soon as you start to say something that’s sort of in my experience, as soon as you start to say something, they recognize that this is a script that you’re going through. Everybody’s seen other people do it, right? We’ve all been at the dentist’s office and the hygienist starts to tell us about their recommended payment plans or whatever. You immediately go, oh, this is a script. What does training look like? Let’s just use nutrition. So we’re talking about that. If I want to not give my team scripts, but I want them to be prepared to go in and have hard conversations to meet clients where they are, to try to recognize what the needs of the clients are and then sort of communicate value.
How do I train, how do I know that I’m sending people in one in a way that they’re going to have a consistent message across my team because that’s important. I don’t want people to be like, Hey, go in there, see what they think, make some stuff up. You know, freestyle. I’ve seen practices do that. That’s not good. So one, how do I get ’em to have a consistent message? And then number two, how do I know that they’re not in there just blowing smoke or that they’re telling half truths or things like that. I want to do some quality control as well, so how do I train for that, Bash?

Bash Halow:
Well, it is so true. You’re actually the first person in a long time that’s told me that you worry about what team members are saying in the rooms because we should work with that. Yes, I’m in there.
I listen all the time and it’s not ideal for all kinds of reasons that we can get into in just a moment. And through no fault of their own, you send a team member think about it, we’re sending, we have up at the front desk, we’ve got people usually who are in their early twenties and they’re female and all the time they have to look at clients and say to clients, well, Mr. Halow, how was today’s visit? That’ll be $1,780 today. And that person up there has never paid a bill in their life higher than probably $150 and they have to stare down this client who just hearing the news that their bill is $1,700 and they’ve got to, we’re expecting them to somehow walk them through understanding the value of that or whatever when they just don’t have the life experience to do that.
The same happens in the rooms when we’re asking our assistants and our technicians to go over estimates for urgent care or emergency situations where the energy in the room is really fraught and they’re supposed to go over a bill that could, I dunno, be as high as four or $5,000 when they just don’t have the life experience of how to do that. Any other real training except, well, it’s common sense. It’s common sense. Just give great service. So I do think that you’re very wise to think about what it is that’s happening in the room, and I wish more people felt like they could do what I do, which is just be a fly on the wall at the front or a fly on the wall in the rooms and listen for clues as to where we need more training, not as a way to accuse or blame.
Certainly not that just as a way to figure out where we need more opportunity to train. But if I’m not being too long-winded, can I just say that to train those conversations, it begins with hopefully you have team members that you’re hiring that are interested in the things that we promote that have an interest in science behind what it is we do and also really are sitting in the front of their chair when it comes to wanting to help clients and wanting to help pets. Certainly, I hope that’s what they bring to the table and then giving them the education in the background to understand how things like nutrition or whatever other service that we’re promoting at the practice can be matched to the kind of caseload that we see. And in the case of nutrition, it can be, I mean, you can make a very strong, compelling, legitimate argument for nutrition to be a consideration when treating cognition issues, weight issues, life stage issues, heart issues, lower urinary tract disease issues, allergies, allergens, and on and on.
So almost every single case that comes through our door, there is probably a pretty good case to be made that we should think about how nutrition plays into this case and then use the cases jumping off point to talk about what it is we have to offer. That’s a great way to meet the client and the patient where they are right now.

Dr. Andy Roark:
Yeah, I really like this sort of case study approach. We also know that role-play training is about the best type of skill building that we can do. And so being able to present these cases and say, how would you approach this and what would you say? I think that makes a lot of sense. Bash, if someone’s buying into this fly on the wall idea, and I really like it. I really also very much that you said, I wish that people could be a fly on the wall not to punish, right?
This is not about catching people or criticizing people. It’s about developing them and growing them and sort of sharpening the saw. So I like that approach a lot. What does that look like in your mind? Are there ways for lead technicians, for practice managers, for medical directors to know what’s going on in the rooms and are there ways that you’ve seen that tend to work particularly well?

Bash Halow:
It’s interesting that you said that role play is a good way of training people, and I’ve found that that is one way that appeals to usually some extroverted people. I’m not sure it’s the only way. I think that there’s a process’s called design thinking. I talked about it last year at VMX and the resources are available on my website, but the process allows ideation from your group members and it encourages instead of sitting around and talking about how we train or how we learn or how we serve, it invites teams to work in small groups and actually get up and move through the practice and move through the cycle of service.
And I would say that is another great way to draw your team members into a dialogue about how it is we do, what we do and why we do what we do and to get those members of your team that might feel a little exposed in a role-playing model, an opportunity to talk because it’s a smaller safer group to do that. And I don’t know, and I’m not avoiding your question here, but I want to say that the other thing that is so valuable that I learn when I’m in the room, it’s not just about how individuals talk, it’s about the process in general about how we deliver care. And for years, as I said, I promoted that traditional cycle of service that we have where people have a need with their pet. They call up the vet, they’re confirmed, they walk in, they check in, they warm the bench, a technician comes to get them, et cetera.
I’ve promoted that for years because I felt like at each and every one of those junctures, there was an opportunity for that team member to talk to that client about a particular service or product that I wanted to promote. I could train that individual specifically on that part of their job, and we saw success and we saw sales. What I see now, even after years, I mean with great shame that I tell you that I push that also down people’s throats or up the other end, whichever way you think work better to get that message across. I see now that process is not ideal to meeting that client and that pet where they are, which is what I said was so important because usually at each and every one of those junctures, that new team member has to get uploaded on what this thing is before me.
So when you check in at the desk, they got to figure out Halow, look in the computer and figure out who the ow is. Then the technician’s got to look through the chart, maybe she looked through the chart, figure out who Halow is, goes in the room, looks in the computer, figures out more about Halow. Then the doctor comes in, they don’t know anything about Halow. They got to look in the computer and I’ve found that each and every one of those junctures is often a time for us to be hanging out near the computer, interacting with the computer, and it’s not ideal for relationships. So I’m not sure if this is really answering your question when you talk to me about observations of the team and what to do with it, but that fly on the wall, does it just identify how individual team members may need help?
It’s also understanding that this whole cycle of service that we’ve embraced is probably not ideal for relationship building. And I’ll just add this because I’m sure that there’s a million eyeballs in your audience rolling back in their head like, oh, Halow, you don’t understand. It really works, blah, blah, blah, blah, blah. If you don’t believe me, just think about your own doctor experience, which is the exact same cycle of service. And if you would just picture, and I actually asked audiences all the time when they’re thinking about their cycle of service to imagine their own experience with their doc, getting that text message confirming the appointment, walking into their doctor’s office, checking in with the front desk, warming the bench, the interaction that they have with their nurse, the interaction that they’re having with the doctor. I asked them to think about that because it is an exaggerated version of the same thing we’re doing.
We’re not nearly as bad as on the human side, but we got a whiff of that going on in our practice and I think we can fix it.

Dr. Andy Roark:
So I like this. Let’s talk about fixing it. So if a cycle of services is not good for relationship building, and I think that that’s totally true and that interface is very much with sort of a spectrum of care approach about client first, patient first approach, sort of being flexible to the needs of the people that we’re trying to service, things like that. If that’s not the approach that we want to take for relationship building, what’s the alternative? Where do we go from here if we’re not doing that classic cycle of service and not focusing on it? How do we prepare our people? How do we get the education across? Because it’s two sides, right? I totally, we’ve talked a lot about scripts not working.
We’ve talked about a lot about education and educating the client being a really hard sell and kind of making it feel like we’re forcing down their throat. If that’s not the path to getting compliant clients, then what is?

Bash Halow:
You know, I’ve spoken to some vets recently who are really into nutrition and those people, I’m sure in their practices lead entire teams that are really in nutrition, they’re like walking billboards for their understanding of the value of nutrition or else whatever the service may be, whatever product or service you’re offering. When you have people like that, they don’t spend a lot of time educating clients about the value of nutrition. What they do is they bring the client in the room, they listen to the presenting complaint, they ask them open-ended questions to make sure that they’re getting more information about where the client is on this particular topic or what their thinking is or more of their habits around whatever’s happening.
And then they tell them what they think they should do. There’s not a lot of it. They don’t have to prove a lot. They can just say, in my experience, this is what I would recommend. They’re so sure of the service and the product that they’re recommending, and if it’s nutrition, they’re pretty passionate about it. They just tell them what they think and if the client requires additional education, they can provide it. But I would say the most compelling relationships in the room, the relationships that I think that are strongest between the client and the veterinarian and the kind of interactions that lead to the highest sales are not equal to more education. It’s equal to more understanding what you think the client wants to achieve and then telling them what you think will work and believing and believing it. That confidence is a big key.

Dr. Andy Roark:
Bash, this has been great. I’m going to put a link in the show notes to Purina Center Square, which you mentioned earlier for exam room communication training tools and things like that. I’m going to put a link to your website for people who want to learn more about design thinking. Are there other resources that you really like when it comes to conversations or training like this?

Bash Halow:
No, I think that Center Square really is great. When you sign up, you get this free nutrition handbook. It’s a clinical book on nutrition, which is just excellent. So it’s a free copy of it, and then the training is doled out in bite-sized chunks so that your team members, even if they only have five minutes, can look on the site and glean something new. The way that it’s organized, everything about it is great. And when we were talking about Open-ended questions, they’ve got a number of videos there by Dr. Sarah Abood or Dr. Julie Churchill who they demonstrate how to do that. And I think it’s a lesson that everybody on this call should have to learn how to ask more open-ended questions. One of the big mistakes that we make when we’re trying to jump into education or we’re trying to get our way in a conversation is we’re asking these close-ended questions like a yes or no. So are you feeding your dog a lot of fatty treats? Yes, well, and it’s a source of blame. As soon as they answer that yes or no, it sounds like a gotcha question and you establish that there’s blame there. Whereas with an open-ended question, you’re more exploring. It’s more of an opportunity to learn what the client thinks and what their goals are, and it’s a better way to introduce your ideas for change. And I think, as I said, that website does a great job at distinguishing between how to ask questions better so that we get better information and then tee up a conversation about what we believe is best for the pet and client.

Dr. Andy Roark:
I think you’re spot on Bash. Where can people find you online? Where can they learn more from you?

Bash Halow:
Bash Halow.com is a great place to start. That’s all my contact information and I’ll be doing VMX this year. If you’re going to be in Florida, I’ll be done VMX, and I’ll also be at Long Beach for the DVM 360 fetch conferences, so awesome. And plus other places in the country. If you’re around, I’ll be there. But those are the two big conferences this year.

Dr. Andy Roark:
Well, Bash, thanks so much for being here guys. Thanks for tuning in, listening, take care of yourselves, everybody. And that’s it. That’s our episode. That’s what I got for you. Thanks so much to Bash for being here. Thanks to the Purina Institute for making this possible. Again, check out Purina Center Square. If you haven’t, check out the Clinical Nutrition Handbook, which I link in the show notes, which is totally free, and it is an amazing resource, gang. Take care yourselves. Be well. I’ll talk to you later. Bye.

Thoughts to Hold Onto: 11 Pieces of Advice I’m Giving to Myself to the Start of the Year

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I collect words of wisdom like a magpie collects tinfoil. The shiny baubles of insight catch my attention and attract me to them. 

Unfortunately, I’ve learned I can’t hold all the wonderful quotes and lessons I encounter in my brain at one time, and must occasionally audit what I want to carry with me. The start of a fresh year seems like a good time to do that.

Below are the 11 pieces of advice I’m giving to myself this month to carry me forward in 2024. I have no idea if these will be the thoughts I’ll want or need in the coming months, but they seem like a good foundation given how 2023 went. Maybe some of these will come in handy for you too.

Here we go!

1. We choose how we suffer.
Life is always going to be hard. The greatest power we have is choosing how we struggle. In veterinary medicine, we chose a hard path, but it’s a path that can offer reward, meaning and purpose. 

2. Good judgment comes from experience… and experience from bad judgment.
No one is born with all the answers. If we are not making mistakes, we probably aren’t pushing ourselves to grow enough. Like a blade being ground against a whetstone, the only way to become sharper is through friction.

3. Hurt people hurt people.
Most people who get angry at us are driven by pain. We can stand up for ourselves and still have empathy for them. We can also decide not to take their anger personally.

4. Let it go. Not for them but for you.
There are plenty of justifiable reasons to be angry at other people every single day. We, however, are the ones who must live inside the anger that we create. Let it go. Not because the other person deserves it, but because you deserve better for yourself.

5. Sometimes being kind means being a little bit deaf.
Everyone has bad days. We don’t have to catalog the mistakes, missteps and misspeaks. Sometimes just ignoring those we care about (including our clients) for a few moments is the greatest gift we can give them and ourselves.

6. Optimism costs nothing.
It’s also a much nicer way to spend our time.

7. Let yourself be bored.
Boredom is an opportunity to rest our frazzled minds, get comfortable with ourselves, and pick up useful activities (as opposed to mindless distractions). We should all aspire to be bored more often.

8. Take time to learn more about the people around you.
Our lives are made rich by the relationships we have and maintain. Take time to ask people about their lives and thoughts, and then listen to what they have to say. This is the path to really knowing people, and there’s no shortcuts.

9. Stay away from the news.
Modern news is designed to suck as much time and attention from us as possible. It’s often emotionally manipulative and almost never actionable. Research and learn whatever you want to know, but avoid scrolling through the news whenever possible (unless you really enjoy it).

10. Sometimes we walk in the rain.
Sometimes we don’t do anything wrong, but we still have to endure hardship. This is unfortunately part of life. The only power we have here is to try to find views and perspectives we can appreciate along our path, even as the rain comes down on us. 

11. Look for reasons to laugh.
Most of us are pretty diligent about scanning for potential problems and pitfalls in our daily life. We should aspire to be equally diligent about looking for things to laugh and smile about. Life, after all, is good.

New Research: What Are Veterinarians Actually Willing and Able to do about Suicide?

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Doctoral candidate Sydney Waitz-Kudla joins Dr. Andy Roark to discuss her recent peer-reviewed publication on securing lethal means for suicide in veterinary practice.

WARNING: This episode discusses suicide and the means for suicide. Listener discretion advised.

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Article: Securing lethal means for suicide: a focus group study exploring perceptions and barriers among practicing veterinarians

Lifeboat by NOMV

Sydney Waitz-Kudla on LinkedIn

Uncharted Veterinary Conference 2023

Dr. Andy Roark Exam Room Communication Tool Box Team Training Course

Dr. Andy Roark Charming the Angry Client Team Training Course

Dr. Andy Roark Swag

ABOUT OUR GUEST

Sydney Waitz-Kudla, M.S., received her BA in psychology from Vanderbilt University in 2015. She spent two years at the Vanderbilt Kennedy Center and two years at the University of Southern Mississippi as a Project Manager before coming to Auburn in 2019. Sydney is a fifth-year student in the AU Clinical Psychology Program and Presidential Graduate Research Fellow. Her current research is focused on means safety intervention and suicide prevention for veterinarians. 

Sydney loves to travel and has lived in 8 states across the US. She has two dogs named Kiwi and Mango and has been riding horses for over 20 years.

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome, everybody, to the Cone of Shame veterinary podcast. Guys, I am your host, Dr. Andy Roark. Guys, I’ve got a good episode today with my friend, Sydney Waitz- Kudla. She is here presenting her newest research. Which is on what veterinarians are actually willing and able to do about suicide. This is a suicide episode, just go ahead and give a quick warning if that’s upsetting to you. Or, and we don’t get too deep into it. It’s not a graphic episode, but we do talk, pretty, pretty candidly about suicide in the vet profession. And so, if that’s upsetting, this is probably a good episode to skip. I think this research is really important.

It’s great to think about what’s possible. I love to have conversations about how we can fix problems. I think it’s also really important to be pragmatic of what are people able to do? What are they willing to do in their practices? Because those are the changes we could actually start to make. And so Sydney has done some outstanding research and I link to it in the show notes and everything.

We get all up into it. But, but that’s, that’s what we’re talking about. So guys let’s, I’ll let her take it from here. Let’s get into this episode.

Kelsey Beth Carpenter: (singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast. Sydney Waitz-Kudla. How are you?

Sydney Waitz-Kudla: I’m good. How are you doing, Andy?

Dr. Andy Roark: I am really good. It is so good to see you. You and I have known each other for, it must be almost five years now. It’s been a few years. We’ve known each other. I I met you through, Dr. Tracy Whitty and her research that she was doing on suicide prevention and things like that. And you are, for those who don’t know you, you are a fifth year doctoral candidate at the clinical psychology department at Auburn University.

Correct?

Sydney Waitz-Kudla: Yes, under, and Tracy is my mentor.

Dr. Andy Roark: Very nice. And you specialize in suicide prevention research. And you have a new article that came out in JAVMA. I got to be a co-author on the article, although I did very little for that accolade. But hey, I’ll take it. I’ll take it.

But it was lovely to be included. I love the research that you’re doing. I think suicide prevention and veterinary medicine obviously is extremely important. Mental health and wellness is something I’m really passionate about. I really liked the, the article that you put out.

It was titled “Securing Lethal Means for Suicide”, and it was a sort of a survey article on veterinarians, and it was all about lethal means for suicide. And so let me just go ahead and pause here. And can you give me kind of an overview of the research and kind of what you set out to try to look into?

Sydney Waitz-Kudla: Yeah, and I will say too, I feel like, honestly, the consultation that we were able to get from you, just discussing all of the different ins and outs. We like Tracy and I both have been doing research in this area, but we’re not veterinarians. We don’t know what it’s like to be a veterinarian.

And so having those contacts within the veterinary community is so important. I also think that you were a vital part of us being able to get all of our participants. So thank you for all of the things that you did. 

Dr. Andy Roark: I love to support where I can. So that was, but you’re doing great stuff.

Sydney Waitz-Kudla: Thank you. And so, basically what we were doing is we know, from Dr. Witte’s 2019 study, something that she found was essentially that pentobarbital is one of the primary methods utilized by veterinarians for suicide. And so, that was actually the year that I came into the program and we said, okay, this is a problem.

And I came in saying, I want to start working towards finding a solution to this problem and saving veterinarians’ lives, how can we prevent suicide so that then we can help improve the mental health of the veterinary community. And so what we did is we kind of had to start from the ground up because there is so little research on veterinarians and suicide.

And so, what we were doing is we did a focus group study. Basically taking veterinarians from a variety of different specialties and talking to them about, “Hey, we know that pentobarbital is a primary method utilized by veterinarians. What do you see as the reason why?”, and what we saw across the board and something that, at least when I’ve discussed it with, other veterinarians hasn’t been surprising is that it’s easy access to that drug. And so, we’re approaching these focus groups with the mentality of, okay, we know that this is a problem. And so, what would veterinarians be willing and able to implement in their workplace to potentially save the lives of themselves or of coworkers?

And so that was kind of the main goal. Was investigating what to them feels like it’s not going to stop them from doing their job, but would create barriers such that. If they were suicidal or if someone else in the practice was suicidal, they wouldn’t be able to access that drug or suicide, which falls into mean safety research and is a big push in the like suicide research community right now.

Dr. Andy Roark: I love that you do this because I remember beating the drum. We talked about Four Eyes Save Lives and I was, I’ve been a big advocate for means for means safety and means control. And I really do think that we can do a lot for suicide rates for veterinarians through control of substances that , that are used for suicide.

 And then Tracy Witte put out this great paper that really supported that premise. And so, obviously I like that a lot because I was very much sold on that. And I was like, I really, this is what I see. And this is. This is, this all makes sense to me and all fits together.

And so I really liked that a lot. And so I remember her article came out, and the research came out and I was shouting it from the rooftops and I was like, this is guys, we need to pay attention to this. And there were a lot of people who listened. But I have to tell you, honestly, Sydney, I was surprised at the amount of pushback that came back from that saying, but I can’t do that in my practice.

And, this doesn’t work for us or we need to be able to move too fast. And again, I’m not saying that those people were incorrect in their assessment. It was just. It was not one size fits all. And there were a lot of individual concerns and a lot of people had very strong beliefs about what was possible to do and what was just not going to work in their practice.

There were a lot of people who were like, I’m a solo practitioner. I’m the only one who’s here. Or I do, I’m a large animal practitioner and it’s me and my truck by myself. And I have these limitations on access to lethal medications. And it was funny because I was surprised to get such pushback and it still made sense.

And so I, what I really like about the research you’re doing is starting to dive into that and saying, okay, moving past the idea that this is important. What would actually work and what are the barriers to having something that actually works there? So so yeah start to unpack for me what you found. What were your takeaways?

As far as the roadblocks and the things that people were willing to do

Sydney Waitz-Kudla: Yeah. And so I think that is actually a really important. point that you make talking about, it, you were one of the people that kind of came up and said, Hey, this is a possible solution. The Four Eyes method, having two people necessary to open pent up arbitral storage. And something we were talking about, even when we were creating this study was okay.

Andy received all of this pushback. So we need to investigate why. And also is there a solution that could work for folks? That the Four Eyes method wouldn’t work. And so, that was a lot of that conversation. And something that I know we also talked about as we were finalizing that publication is okay.

What about the Four Eyes method? What about having two people and something that we talked about and something that came up in those focus groups was essentially that. Even though that is such a good idea in theory, it was almost that of all the solutions that we discussed, that was one of the ones that for as many benefits that people talked about and for as many times as people said, I could do this, just as many people said I could not do this for the reasons that you mentioned, there are solo practitioners. There may have be times that they are the only person at their practice. They might not have even. A practice manager that is working at the front.

It’s just them or large animal practitioners that they sometimes are going in the middle of the night to. An animal and it’s just them and the truck and the animal. And so, to say, “Okay, on the one hand, could it be that, there is a solution that would work kind of across specialties, or is it that we need to have different solutions for different specialties?”

And it was something that, we really approached it saying it could be either of these. And I think I approached these focus groups saying it could be either way. What that allowed us to do is that when I talk to veterinarians and we used an iterative process that as I went through the different focus groups, sometimes we would talk about.

Here’s something that some people have mentioned. Does that seem feasible to you? And talking about, you know, what might work for different populations. We had a variety of focus groups, some of which were small animal vets, some of which were mixed animal vets and large animal vets and equine vets. And those were kind of our three big populations were a small animal, mixed animal, and then large animal and equine since they usually have similar barriers.

We did put those equine and large animal together, and then we had a variety of focus groups that had people from multiple different specialties as well as academia or government lab, animal, medicine, and those sorts of specialties. And so what we found is that across. Specialties, folks were really willing to implement adding an extra lockbox specifically for pentobarbital. So what this would be is that either within the storage for other medications or separate from that storage, there would be a lockbox that remains locked at all times, except when euthanasia is being conducted with the idea being that. What a lot of folks talked about is that okay, I need to go in and out of drug storage all day I can’t have that cabinet locked all the time because I’m so busy.

I have so many patients coming in I can’t be having to go back and forth and back and forth all day. And so talking about okay If we had pentobarbital specifically locked something that you don’t need to access all day, every day, and that was only unlocked when you needed it for your job. Is that something that you’d be willing to implement? And across the board we saw that folks “yes” and at least more so than anything else. And we also saw at post test that, by and large, most people said that would be something that they’d be willing to implement. And we had some folks that said, it was lockbox, an extra lockbox for pentobarbital, and then nothing.

And for the nothing, it was folks that already had really secure storage, already had something like this in place, and they said, okay, I wouldn’t add anything additional because I already have something similar to this.

Dr. Andy Roark: Yeah

Sydney Waitz-Kudla: That was really cool to see, just that this was something that worked across specialties.

And I think that kind of the two main barriers that came up for that method, that would be something that we would really need to take into account on a practice by practice basis is that for some folks, they said either, I just don’t have a lot of space, which especially came up for large animal vets because they are working out of a truck. It might be hard for them to find a separate place in that truck or a place within the cabinet they already have to put that extra lockbox, but is something that they were really willing to do. When we discussed, okay, mean safety does have a basis in research. We do know that this is something that is effective for preventing suicide.

Then we started to see veterinarians saying, okay, If this is something that you can say “it, it will likely work. It’s really something that could be helpful for preventing suicide. I am willing to give it a shot. I’m willing to figure out how to do it.” The other thing that came up, but I think is also something that would just need to be taken into account as far as when might it be important to keep this in mind, when might this be something that comes up is situations in which an animal might be in an emergency situation and that extra two, three, four, five minutes that it takes to unlock the extra lock box, it’s this cost benefit analysis of, is it worth that extra five minutes of suffering for that animal? And something that I think came up in our conversation in the manuscript is that’s something that, would there be more utilization of sedation in those situations using a drug that would be in that regular cabinet to make sure that dog or that animal, whatever animal it is, isn’t suffering.

And then having that extra few minutes that the animal is in a better state to access that pentobarbital and then conduct euthanasia. So those were the conversations that kind of happened, but something that was, even though we had all these conversations about barriers, which I think is really healthy because we need to discuss what barriers might come up before we can implement something.

At the same time, it was really good to see that after the fact, when we asked them at post test, what would you implement? That was something that came up time and time again, as I would add an extra lockbox or, even adding a time sensitive lock that it would take, they basically put in a code or something like that, and then it would take a few minutes before they could unlock the pentobarbital storage.

Dr. Andy Roark: Oh interesting. I like that a lot. 

Hey guys, my favorite time of the year is coming up. It is the April Uncharted Conference. Guys, April 18th through 20th in my hometown, Greenville, South Carolina. The Uncharted team and I we’re putting on the show. This is the conference that I started with the gang in 2017. If you’ve never been to an uncharted conference, it is not like anything else you have been to it is all about Active learning.

It is all about collaboration, working together. When I set out to build the Uncharted conference, I built it to be the conference that never ends. I built it to be jam packed full of new ideas and fun ideas. I built it to take those conversations that you have in the hallway, which are actually the most valuable part of a veterinary conference, and put them center stage.

This is all about connecting. Getting to know people who were running businesses, who were leading teams, who were making things happen. I want you to leave inspired. I want you to feel like everything is possible. I want you to have tons of new tools in your tool belt. I want you to have tons of new friends and new connections who are enjoying vet medicine, who like it, who are like, this is a great profession, and I’m excited to explore more.

Do new things, make waves, and have an impact on my community, on my clients, on the patients that I see. Those are the people who come to Uncharted, and so if that sounds like you, and you’re like, God, I need those people in my life, come on to the April Conference. This April is called Chaos Island. It’s Standing Out in a Sea of Noise.

This is all about refining your brand voice, your practice voice for effective communication. That’s with clients. It’s also going to be with teams. I always like to weave strategy and running teams effectively into what we do. A lot of you are seeing a drop in your client numbers. A lot of you are starting to see open appointment blocks that you did not see in the past.

Guys, we anticipate this. We saw it coming in our uncharted community, and we are going hard in the paint to get your appointments full up again, keep you busy. Make sure that your clients know the importance of what you do and they get their pets in to see you and they’re happy to see you. We’re always talking about making sure that you have the right clients for your practice and how to get those people, how to make, how to make your life better. How do we enjoy practice more? How to make your team enjoy practice more. A lot of that comes down to the messaging that we send, how we communicate, how we train, how we set up for success. The battles that we choose to fight and the battles that we don’t choose to fight. All of those things are going to be things that we are focusing on.

So if you’re like, man, I want to hang out with that type of person. I need a dose of positivity. I want to fall back in love with vet medicine. Also, I like talking to clients. I like working the exam room and being effective. I like marketing. I like thinking about who we are as a practice and what makes our practice special.

This is the conference for you. Also, this is going to be the last one we have in Greenville, South Carolina for a while. And a lot of you guys have been coming to Uncharted conferences for a long time. A lot of you love it. Some of you met the people that you married at these conferences.

Some of you have met the best friends you have in the world in these conferences. We’re going to go away from Greenville for a while and it’s going to feel different and it’s going to be fresh and fun, but also I think it’s going to be a little bit poignant. when we leave the nest, and so I do expect this event to sell out, and early bird pricing is going away, early bird pricing, it wraps up on January the 17th if you’re coming and you know you’re coming, and grab a spot before the 17th, because that’s when early bird pricing ends.

So I’ll put a link in the show note to get y’all set up and registered. If you’ve never been to Uncharted before, man, this is going to be a great one. I’d love to see you there. I’d love to shake your hand and welcome you to the tribe. So anyway, guys, let’s get back into this episode. 

Was there anything that you were really surprised by? So you’re getting this feedback, you’re doing these focus groups, you’re having conversations. Was there anything that just you were not expecting going in?

Sydney Waitz-Kudla: So I think that. A lot of it really made sense as far as what we were expecting when we were going in. I think that the one thing that I didn’t expect just as far as it was a, a good surprise was that I didn’t expect that the research backing up mean safety would have such an impact on veterinarians willingness to implement extra protocols. I think that I come from working with populations that aren’t scientists. And so it was something that as soon as it started to happen, we knew it made a lot of sense. Veterinarians are medical professionals, they listen to research, they’re really receptive to research. And so bringing up a lot of this research that is really important and has shown that mean safety can be really effective and really can prevent suicide.

Just seeing that quick shift that information caused in veterinarians’ opinions and tone was something that was really nice to see and something that I think really made us see, okay, this is how we can get that buy-in, get that willingness to do something that could make a really big impact.

Dr. Andy Roark: Yeah I liked that a lot. One of the things I was surprised about starting to have conversations and when we started talking about Four Eyes and things like that I was amazed at how many people, I guess that lived experience carries a lot of weight with people.

And I was surprised at how many people were like, “Andy, that’s never been a problem, you know, or just, I’m, I am not concerned about my own safety. This is not anything that I can imagine myself ever wrestling with,” and I think that’s probably genuinely true for those people. I think the benefit of the research was to be able to say, I understand you feel this way.

Here’s data driven proof that other people don’t necessarily don’t feel that way. And you know, I really believe that veterinarians are generally as we’re stereotyping a large group here, but I do think it’s true. I think veterinarians are very compassionate people. And so I think that the research sort of illustrating the fact that other people have this concern and or have this problem.

I think if you can show that to veterinarians, it definitely seemed to make an impact in the way they think. So I think that’s probably the most useful part of the research as a part of this really meant a lot to me. Sydney, where do you think suicide research in veterinary medicine goes from here?

Sydney Waitz-Kudla: So that is actually where we get into what we’re doing next. You know, just kind of brief overview is really investigating, okay, how can we present this in a way that might be you know, might help veterinarians say, okay. Yeah, this is something that is a good idea. And really figuring out. Okay. I know when I have a long focus group discussion with veterinarians we do get that willingness and so now it’s okay, how can we get this willingness? How can we portray what we want to do? What means safety is in a way that veterinarians have that buy in. You know the future kind of looks into what can we implement? You know, I know we talked about that. We know that a lot of veterinarians are willing to add an extra lock box for pentobarbital storage.

And so now it’s saying, okay, how can we discuss this as a protocol that could be implemented and then hopefully further down the line is seeing if we talk about it, is it something that veterinarians do implement in their workplace? Are there additional guidelines that would be necessary to put into place just as far as legal things to be able to add those extra protocols in the workplace, on a national scale?

What would we need to do, figuring out what is the red tape what, allows us to really disseminate this information. And then also do we see that once we tell veterinarians across the board, you know, okay, this is something that could be really helpful if we are able to get that buy in, do we then see that they actually implement it in their workplace?

If so, great. If we start to see that this becomes more of a cultural change. That’s awesome. And if we don’t see that kind of implementation on the back end of talking about this as an additional protocol to implement, what do we need to do additional to help get that actual implementation piece? And I will say, too, that something that you mentioned just a little bit ago, as far as veterinarians saying, “I, I’ve never experienced this. I don’t think I ever would experience this” is that was a smaller, but also, I think, pretty significant part of our findings from this study was that. When we asked veterinarians, their reasons for which they would be willing to add an additional lockbox or add additional protocols for pentobarbital storage from pre test to post test, we really saw a relatively low number of folks who said, I’d be willing to do this for myself. Like, my own safety would be a reason I’d be willing to do this. It was pretty low at pre test after we talked about it in the focus groups, pretty low post test. But, when we asked about for the sake of your co worker’s suicide risk, would you be willing to implement an additional lockbox or other protocol for pentobarbital storage, we saw that at pretest, they had some willingness to say, okay, if it was for someone else’s, suicide risk I’d be willing to do it.

And then at post test, we saw a significant increase in the number of folks who said, I’d be willing to implement this for the sake of my coworkers. And so that’s something too, that we have in our mind as we’re discussing next steps as far as how do we, you know, not only talk about how veterinarians can keep themselves safe, but also others.

And I’ll be interested to see, as we go down that line, how we can get that extra buy-in from folks that do work by themselves. Or, do work by themselves out of a truck are solo practitioners and, how can we also get that buy-in from them without having a one and a half hour conversation about mean safety?

Dr. Andy Roark: That absolutely tracks with the experiences that I’ve had talking to veterinarians about this over the years like that, that totally it’s, it’s just nice to see that bared out because just anecdotally that was, I felt like I was having that conversation again and again, it was always just interesting to me how little traction there was around, “Hey, this is for your benefit”. ” like, Eh, I’m like, I’m good”. But, there was much more interest in keeping other people safe. And I just, I don’t know, I think that maybe speaks, it speaks a little bit maybe to the personality of veterinarians. I think that’s interesting. I do think that there’s some weird ties to our culture and sort of our, our self identity as veterinarians there. So anyway, I think that’s really interesting. Sydney are there any resources that you are really big on right now that you wish that more people knew about?

Sydney Waitz-Kudla: Yeah, so one of the initiatives that I’ve been a part of since it started was Lifeboat by NOMV, Not One More Vet. And so that is a peer support anonymous resource for veterinarians. It is essentially veterinarians providing support for other veterinarians. And it’s something that you can sign up for. If you go to lifeboat.NOMV.org, I believe, and then.

Dr. Andy Roark: I’ll put a link to it in the notes. Yeah.

Sydney Waitz-Kudla: Awesome. And so that is something that if you are struggling as a veterinarian with mental health, and you really want to talk to folks that understand that’s a really great resource for those veterinarians. And additionally, if there are veterinarians out there who say, “Wait, I want to be supporting my peers, my colleagues, then they can also sign up to be companions and be the supports for other veterinarians.

Dr. Andy Roark: No, I love it. I’ve had some I’ve had some guests on recently. Lifeboat has come up a couple of different times. I said, I’ll put a link to it in the show notes so people can learn more. It’s a wonderful program. I am super happy that I love that you’re involved with it. I’m super happy that the NOMV group is putting it on.

It’s just I don’t know. It’s, it makes my heart happy to know that it’s out there and people are doing that work. Sydney, thank you so much for being here. I really appreciate your time. Where can people find you if they’re really interested in your research and they want to see when you’re publishing in the future where, where can people connect with you?

Sydney Waitz-Kudla: So as of right now, the best place to find me is on LinkedIn. And so if you search my name, you can find me. And then additionally, the paper that we just published is coming out in JAVMA in the ‘Journal of the American Veterinary Medical Association’. And so, keeping an eye on that paper or that publication and then additionally keeping track of me on Google Scholar or anything like that is where you can see a lot of my publications.

Dr. Andy Roark: I will set up links to all that stuff as best again, down in the show notes so people can find it and and keep up with you. So anyway, thank you so much for being here, guys. Thanks for tuning in and listening. Take care of yourselves, everybody.

And that’s what we got. Guys, I hope you enjoyed it. I hope you got something out of it. Thanks to Sydney for being here. Thanks for you guys for listening. Like I said, it’s a heavy topic. It’s an important topic. It really is. I want to keep our colleagues safe. Um, I want this to be a profession where people flourish.

And we need to look out for each other. And so anyway, that’s why we keep coming back here and just seeing what we can do. I love this episode because it’s actually talking about what can we do? What’s on the table? What are things that are actionable? How do we feel about this as a professional?

What are we, what steps are we willing to actually take? And so anyway, I think these conversations are really worth having. So thanks for being here and participating. Guys, take care of yourselves. I’ll talk to you later. Bye.

The Best of Dr. Andy Roark 2023

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One of my favorite ways to start the new year is to look back at what went really well in the last 12 months. Below, I have pulled three of the most popular blogs that I wrote and sent out via the Dr. Andy Roark newsletter (Which is totally free and arrives every Friday). 

I hope your year is off to an outstanding start! If you missed any of these entries when they came out, consider checking them out today. 

Sometimes it’s Worth the Risk – My wife went through cancer treatment in early 2023 (Everything is really good now! Thanks to all who sent well wishes and encouragement our way)! Partly for this reason, I think finding and holding onto hope and optimism were topics that really rolled around in my mind over the last year. This story is about my neighbor’s dog that went to surgery, and how we should remember that sometimes the best possible outcome does indeed happen.

I am a #MooseTruther – Vet medicine is often a fearful place. In 2023, I talked a lot about how perfectionism is often a manifestation of fear. Many of us are driven by anxiety around getting something “wrong” or not being exceptional in everything we do. #MooseTruther is about finding motivation through aspiration instead of fear. 

(I bought my wife a plastic moose for her Christmas stocking because I told her I’d show her one. Check and mate.)

The Hope Punk Rebellion – Cynicism is often confused with insight in our modern world. The “wise” among us see that everything is a scam, the system is always rigged, and whatever we hope for will probably turn out to be a twisted and disappointing version of what we actually want when we get there. Well… i cynicism is not wisdom. Being pessimistic doesn’t make you smarter than people who are optimistic. I’m tired of having these thoughts and keeping quiet when I hear about how everything is crappy and it will all be crappy going forward. It’s time for a rebellion! I want a punk rock, optimistic, hopefully revolt against the idea that everything is and will be awful. Who’s with me?!?!

Thanks so much to all of you who subscribed and read my writings last year. Thanks to those who wrote back to me when something I said really resonated with them, thanks to all who shared blogs with their friends and colleagues, and thanks to my neighbors who aren’t in vet medicine at all but still read what I write so we have something to talk about as I walk my dog past their houses.

In true Hope Punk style, I think 2024 is going to be a great year. I’m going to do everything in my power to make it so. I hope your year will be amazing.

Find your Moose!

– Andy

Don’t Rush the Recommendation

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Dr. Jason Coe joins Dr. Andy Roark on the podcast to discuss effective veterinarian-client communication, specifically addressing sensitive topics like pet obesity. He highlights the importance of understanding the client’s viewpoint, avoiding rushed recommendations, and advocating for a collaborative approach. Dr. Coe recommends resources such as the AAHA nutrition guidelines, communication skill books, and training programs for further learning in veterinary communication.

This episode is made possible by Purina Institute!

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Purina Institute CentreSquare

REFERENCES

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10339898/pdf/animals-13-02150.pdf 
MacMartin C, Wheat H, Coe JB. Conversation Analysis of Clients’ Active Resistance to Veterinarians’ Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada. Animals. 2023; 13(13):2150. https://doi.org/10.3390/ani13132150

2. https://bvajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/vetr.1979
Sutherland, KA, Coe, JB, O’Sullivan, TL. Assessing owners’ readiness to change their behaviour to address their companion animal’s obesity. Vet Rec. 2022;e1979. https://doi.org/10.1002/vetr.1979

3. https://avmajournals.avma.org/view/journals/javma/260/9/javma.22.01.0043.xml
Sutherland KA, Coe JB, Janke N, O’Sullivan TL, Parr JM. Veterinary professionals’ weight-related communication when discussing an overweight or obese pet with a client. J Am Vet Med Assoc. 2022 Apr 15;260(9):1076-1085. doi: 10.2460/javma.22.01.0043. PMID: 35429375.

4. https://www.aaha.org/globalassets/02-guidelines/2021-nutrition-and-weight-management/resourcepdfs/new-2021-aaha-nutrition-and-weight-management-guidelines-with-ref.pdf
Cline MG, Burns KM, Coe JB, Downing R, Durzi T, Murphy M, Parker V. 2021 AAHA Nutrition and Weight Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc. 2021 Jul 1;57(4):153-178. doi: 10.5326/JAAHA-MS-7232. PMID: 34228790.

5.https://avmajournals.avma.org/view/journals/javma/260/15/javma.22.08.0380.xml Janke, Natasha, et al. “Veterinary technicians contribute to shared decision-making during companion animal veterinary appointments.” Journal of the American Veterinary Medical Association, vol. 260, no. 15, 2022, pp. 1993–2000, https://doi.org/10.2460/javma.22.08.0380. 

6. Skills for Communicating in Veterinary Medicine by Cindy L. Adams and Suzanne Kurtz

7. Colorado State University College of Veterinary Medicine – FRANK Training

8. Relationship-Centred Veterinary Medicine at the Ontario Veterinary College

9. Relationship-Centred Veterinary Medicine at the Ontario Veterinary College Research Ream’s LinkedIn

ABOUT OUR GUEST

Dr. Jason Coe, a Professor at Ontario Veterinary College in Canada, embodies a career bridging veterinary practice and academia. After earning his DVM and returning from mixed-animal practice, he completed a PhD in veterinary communications. Currently leading the clinical-communication curriculum, he’s internationally renowned for his work on the human-animal bond and veterinary education. With over 100 peer-reviewed publications, numerous speaking engagements, and holding the VCA Canada Chair in Relationship-Centred Veterinary Medicine, Jason’s dedication to improving veterinary care through communication is recognized globally. He’s the recipient of prestigious awards, including the AVMA’s Bustad Companion Animal Veterinarian of the Year.

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I got a great one. I am here today with the amazing Dr. Jason Coe. Jason is fascinating. He is probably the best known researcher on communication in the veterinary industry that’s out there and the guy has published bajillion things.

His research is fascinating. We get all into it about different findings he’s had as far as making effective recommendations to pet owners, what they push back on, what we think works and doesn’t. It’s just, this is a really great conversation about what we know about communicating in the exam room. Gang, I am excited to get into this.

The episode is called Don’t Rush the Recommendation. However, it is about all parts of communicating and especially about communicating about awkward things. We talk a lot about communicating about pet obesity and nutrition and things like that. And just, build out from there. Anyway, it’s a great episode.

I hope you’ll love it. This episode was brought to you ad free by my friends at Purina Institute. Let’s get into this episode.

Kelsey Beth Carpenter: This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast, Dr. Jason Coe. How are you?

Dr. Jason Coe: I’m great. Thanks for having me, Andy. I know that I’ve heard your name in circles. Yet, this is the first time we’ve had a chance to meet. So it’s awesome to have finally be able to, to get together and do something together.

Dr. Andy Roark: Yeah, I have heard, I’ve heard so much about you over the years and this is, it’s amazing to me. I was like, I’ve really never met Jason before. I have not. For those who don’t know you, you are a professor at the Ontario Veterinary College. You have a PhD in the area of veterinary communications. You have published a bajillion, I think it’s the official count, of peer reviewed research papers on communications.

You have just, you are,you’re all over the world. You are probably the leading expert in the industry on communication. I know that’s probably a, a fierce battle, but you’re, you’re definitely in there. So you, you are you’re an expert in, in veterinary communications. I, I am. interest to have you in one because your reputation is just outstanding.

And I am a huge fan of communications in vet medicine and trying to have better conversations about being more persuasive about building relationships, about building trust. Those are all things that I just go back to and hammer on again and again about being successful in vet medicine. And so I just, I kind of wanted to come in and start to talk with you a little bit about, about difficult conversations with pet owners.

 Let me just ask you sort of a broader question, and this is sort of society at large Are people getting more difficult to communicate with in general? Are they getting, from a customer service standpoint? I saw an article recently. It was in the Atlantic.

It was by this guy named David Brooks. And he, he, the question he asked was, “Are Americans getting meaner?” And I was just, I think that that’s an interesting question. Just, let’s start here at a mile high. Talk to me about customer service in general and just your perceptions of, of having effective communication. 

Dr. Jason Coe: Yeah. I mean, it’s a really interesting question to kick things off with Andy. And you know, the piece that catches my attention in that, as soon as we start labeling people as difficult. It implies that we have assumptions or bias that we’re entering a conversation into. And so I think one of the things as we think about conversations that we may perceive as being difficult is really doing that gut check to check in and see, okay, why am I feeling like this is going to be a difficult conversation?

What is it that’s leading for me to have that experience? Because I think at the end of the day. Everybody is coming from a perspective, and part of it is understanding our own perspective, understanding the other person’s perspective. And that’s where I think through that, whatever it might be in terms of a challenge, we can start to explore, identify where common ground might exist in any conversation to really see what a path forward might be.

And so, again, I’m cautious about labeling people as difficult, just because I think that is in the eye of the person in terms of that. And so I just see it as an opportunity to kind of better understand the other person, which is going to be a core to communication.

Dr. Andy Roark: I think you’re probably spot on. I do think from a tactics standpoint, having those thoughts is probably a bad idea. That definitely makes sense. I like to joke that vet technicians can undermine veterinarians because they’ll come out of the exam room and they’ll hand you the file and they’ll be like, “Pfft, Good luck!”

And I’m like, Oh, and you, you’ve already set me up for failure. It’s this, let me go and experience this myself. And again, I know it comes from looking out for us. And it’s like, “I don’t want you to get blindsided when you go in there, Andy.” But I, I have had that experience before where I’m like, just, just don’t tell me just, just don’t tell me, let me walk in and, and as an empty slate, you know, a blank slate.

Dr. Jason Coe: Yeah, no, I remember those experiences too, where again, the team and the experience of the team, and they come and share that with you. And then you have. And so it is really trying to go in with as open a mind as you can, I think, around some of those elements so that, again, you can look at it with a clean slate, as you mentioned.

Dr. Andy Roark: Do you, what do you think about, do you think a lot of people carry anxiety into these hard conversations? So let’s, let’s go with sort of the classic sort of hard kind of sensitive conversation everybody’s had. So let’s talk about obesity conversations. And so, you’re getting ready to go into the exam room and there’s a cat in there, that was, that is 13 pounds and you saw it a year ago and it was nine and a half pounds and it’s six years old. And so it’s not like, you know, this is not kitten growth weight. And so you’re going, Oh boy, I’m, I’m going to go have this conversation.

Do you think a lot of people, do they have anxiety going into those conversations or do you think I don’t know. I’m just sort of trying to get my head around, around the, the emotional experiences walking in the door. 

Dr. Jason Coe: Yeah. Another interesting question. And so having had the opportunity to present and talk to different veterinary professionals around the topic of obesity, I think that I have heard from many that it can be a sensitive conversation, both from a client perspective, but also from the veterinary professional.

Part of it is. The anticipation of what is this going to lead to? Are they going to be on board? Are they going to resistant? Am I going to upset them all of those different elements that go into it? And so how do you think that there is the potential for people to carry some of those anxieties into it?

You mentioned, interestingly, You know, the cat was, I think, nine and a half, and now it’s 13 a year later, which makes me think about how do we transition into some of these more challenging conversations. And so one of the things that we did some research on was looking at how veterinary professionals, specifically veterinarians, use trends to support their conversations.

And we saw that it wasn’t actually used very often, yet we see it as a potential opportunity, yet when it is used, it’s around weight. And so I do think that weight is a perfect place to look at How can we track trends in an animal’s health trajectory? How can we start to pick up when an animal is starting to increase in weight so that we can start that conversation earlier, hopefully before it even gets outside of what might be considered a normal weight range for that animal.

And we can use that trend by showing the owner over time, how that’s creeping up where they can see, huh, it is changing. We are on a trajectory where, you know, we can then have a conversation to say what the impacts can be of having an overweight cat or dog.

Dr. Andy Roark: So, that, that totally makes sense. I had not really thought about the difference between walking in and saying, and looking at this, we’re just going to say this is an obese cat. Walking in and saying, well, you know, what I find on my physical examination is that your cat is obese. Versus coming in and saying, you know, I’m, I’m looking at the chart and I’m concerned about the, the upward trajectory that we’re seeing here.

You feel like those are different things?

Dr. Jason Coe: I do. I mean, I think, One is in terms of coming in and just kind of sharing our thoughts and ideas, where the other is starting to use a tool to create some collaboration, build some trust around that conversation. And so by using the trend, it kind of speaks for itself, where we almost don’t need to necessarily say as much other than, “hey, let’s look at this together” which starts that collaborative approach to the conversation rather than I’m sort of launching my ideas or thoughts on you, which, I mean, you probably appreciate as well.

As soon as someone tells you what they think you need to do or what’s happening, you kind of get your back up and become defensive. And so part of it is, how do we move into these conversations in a collaborative way, rather than a way that kind of creates resistance with our clients?

Dr. Andy Roark: How, how do you balance, when we talk about say obesity, so we’ve got this, this cat, and and we’re looking at this, we’re going to have this conversation. How do you sort of balance trying to understand what the pet owner cares about, what their sort of motivators are, with presenting data on health outcomes for obese patients?

Do you come in and sort of say, these are the things that I’m worried about when I see patients like this? Do you try to kind of? get information out of them as far as what their concerns are. I’ve had a hard time trying to draw out how they feel about their pet’s obesity. You know what I mean? Versus, it’s easy for me to say, well, you know, she’s six years old you know, I know it’s hard to believe, but she, it won’t be long until she’s, she’s a senior pet.

And, you know, there’s, there’s a lot of different interfaces with, with conditions we see in older cats that I want to make sure that we’re, we’re paying attention to and I want her to be healthy. I don’t know. How do, how do you sort of juggle those things? What is, what is the strongest, the stronger play?

Do you pause and ask questions? Do you kind of start to lay down your concerns and try to back that up with data? Does does it depend on the individual? How, how do you parse that out?

Dr. Jason Coe: That’s a great question. And so I think, you know, as a veterinary professional, I appreciate we’ve been trained to identify problems. We have numerous solutions and so want to share that knowledge for the benefit of our patients. And the thing that I find interesting is we published a study this year, looking at specifically, When veterinarians made nutrition recommendations to a client, and what we found was over 50 percent of the time clients push back, they demonstrated overt resistance.

So we recorded these interactions, had cameras in the corner of the examination room. We saw the veterinarian make this proposal or recommendation for a long term dietary change, and we saw clients give reason to push back. And so that in itself was interesting. So we explored a little bit further to identify what were the reasons that clients were using as a basis for pushing back.

And so pet preference was number one, multi pet household was number two, doing something already to address the concern that the veterinarian was using as a basis for the recommendation or already on the food was number four. And so when we tease that apart, what we started to recognize was these were all patient Human related factors that by incorporating or understanding these up front, we could actually tailor our recommendation in a way that address some of the things like pet preference, multi pet household.

And so to your question, you know, do you invest in some time to gather and understand where the clients coming from? My thoughts are that’s imperative. It’s the foundation of any successful recommendation. And I would step back from, yes, I see this animal is overweight. I want to gather a more broad history.

So I know the environmental factors, I know the animal factors, and I know the human factors that have led to where we are in this conversation, which is going to give me insight to where that client’s coming from, which then allows me to again, tailor a recommendation and work with the client’s recommendation.

So your question about like research and impact, Those type, that is part of the conversation. Yet I would hold that for a bit further down the road.

Dr. Andy Roark: No, that, that makes sense. So you’re sort of saying not necessarily reveal, revealing, revealing the information that you have discovered right up front. Might be the, might be the right place. So try to avoid walking and going “Wow. he’s big.” Maybe, maybe that’s not the opening that we’re looking for.

Dr. Jason Coe: Yeah, I think that’s fair. And I mean, I understand, and I’ve seen it in videos and we have this training. We have this knowledge. We can benefit our patients. And so sometimes it’s holding ourselves back from releasing that information until we understand where the client’s coming from, what’s important to them.

And then how do we take our knowledge and incorporate it into that? Cause. We do have valuable knowledge to share with clients and so it’s figuring out how we communicate that in a way that there’s going to be uptake from our clients.

So another study that we did and we published last year was looking at clients readiness for change once they self identified their animals overweight.

So we sent out a survey, we asked people to body condition score their animal using the WSAVA body condition scoring guidelines. Then those individuals that self identified their animals being overweight, we acknowledge that their animal is overweight and we ask them where are they in their readiness to take action to address their pet’s weight or obesity.

And what we found were 94 percent of the respondents were either in what’s called a pre contemplation or contemplation phase where they’re not even thinking about their animal’s weight or wanting to make changes there, or if they are thinking about it, they can come up with all the reasons they don’t.

And so the fact that so many owners identified being in that pre contemplation and contemplation phase, even when they’ve identified their animal themselves as being overweight or obese, identifies that there’s a different conversation that needs to go on there that’s going to evoke motivation to want to make change.

Versus someone who’s further down and ready to make that change, which again, is partnering and working with them on how we can make that change. And so I think that was a really, I mean, I wasn’t expecting that finding. It was really eye opening for me and recognizing that again, it’s exploring understanding where someone’s coming from so that we can really look for the opportunities to kind of move along that spectrum of change.

Dr. Andy Roark: Is is that demoralizing for you when you, like, when you hear that and you say 90, 95 percent are in this pre contemplation, contemplation phase? Where they, they’re not, they’re not They’re not really, they’re not really motivated to, they’re not thinking about making a change. They’re not, even, and this is, this is when they have self identified that you know, weight gain as a problem in their pet, right?

They were like, “yeah, he’s put on some pounds”. And then, at that point, we’re still at 90 plus percent of people are like, “I’m okay with it” Like, does that, does that demoralize you?

Dr. Jason Coe: So it doesn’t demoralize me. I can understand how some might sort of see that result and think, ah, where are my opportunities? Yeah, I do see it as an opportunity and I see it as an opportunity to change the way that we approach this conversation. So we’ve done a lot of observational research for cameras in the corner of the examination room, and we know around those obesity conversations, the approach tends to be coming in and telling clients what we think they need to know, whereas this is really stepping back and taking a different approach in relation.

And so as a follow up study, which we actually have just wrapped up, it was sponsored by Purina, who’s also Purina Institute sponsoring our podcast here. That we asked owners through a discreet choice experiment, what would get them motivated or move them towards wanting to take action if a veterinarian told them that their animal is overweight.

And it was really fascinating to see what the responses were for both the cat scenario, which we did independently of the dog scenario, impact on life expectancy was by far the number one thing that motivated clients to want to make a change around their animal being overweight. 

What was interesting in our observational research is that that is actually one of the fewest things that we bring up as a reason for why an animal or an owner should Pay attention and want to address their pets weight.

Dr. Andy Roark: Really? I, I thought the, you know, one of the, one of the studies that most impacted me was the, was the old Golden Retriever study. You know, about, about being just slightly overweight can reduce, you know, longevity on average by like two years. I, I, I would pull that out in some version again and again and again because it just, it seemed like such a powerful statistic to me.

I, I, it’s funny, I do think we talk differently about cats. I do think I don’t know, I don’t know why exactly, but. But I, I can, I can see a difference in presentation between dogs and cats, I don’t know why it would be there, but it, that, that feels kind of right to me. Yeah, it’s, I can, I, anyway, I, I can see the, the life expectancy sort of being something that plays in.

Let, let me, let me step back for a second here. So you used some, some wordage, you know, when you said, okay, you know, okay, this, this pet is overweight. Uh You said, where are you in your readiness to take action? Is that, is that a, is that a question that, that we actually ask in the exam room of saying, all right, we have, we have identified this, where are you in your readiness to deal with the problem?

Should I be asking pet owners that when I’m looking at their 14 pound cat? 

Dr. Jason Coe: Yeah. And so it might be. So the interesting thing about communication, it’s very contextual. So where you fit in, which question really depends on the interaction and where you are in that interaction. I mentioned earlier, one of the ways of transitioning into a conversation around weight is using trends.

Another that I would put out there is a permission statement. So asking a client. You know, I’d like to spend some time talking about Rory’s weight. Would you be open to that? And so it’s not explicitly asking them where they are in their stage of change. Yet you are feeling out where they are. And the reality is if a client is open to having the conversation, they’re going to say yes.

Most clients naturally, when you ask permission, are going to say yes as well, unless they’re adamantly against it. If they’re adamantly against it, they probably are in the pre contemplation, which doesn’t mean. We don’t address this at some point in time. It probably just means this is not the moment that we need to, in order to preserve the relationship.

And so again, I don’t know that I would ask that directly, although I think there will be places in a conversation that you could ask that directly. Yet I also think that a permission statement at the beginning of this before, so we’ve gathered our history and then we’re using our permission statement to transition into the conversation, which is like a soft warning shot to kind of feel out where our client’s at.

And if our client is like right on board and ready to move. We’re going to move with them. If they’re in that kind of contemplation phase where they’re like you know, I think there’s a problem here, but I’m not sure, they’re probably going to say, sure, let’s talk about it, which gives us an opportunity.

And we may feel that others that are like, hey, don’t go here right now. This is not good territory for us to be exploring, which we step back and we find other opportunities and avenues to enter the conversation.

Dr. Andy Roark: That, that, that makes sense. So I very much like the, “are you open to discussing this?” That that’s, that’s a nice way of, of sort of opening that up and it takes away a lot of the awkwardness as well, and you’re sort of saying, Hey, we’re gonna talk about this. I’m not, I’m not dumping it on you. Even if they say yes and you said the exact same thing, I think the fact that they gave you permission to engage in the conversation is probably setting you up more for success. I, I do, I agree with you that’s sort of why I was asking you about the where are you in your readiness to take action.

I, I had heard a presentation years ago and someone was talking about flea and tick prevention. And you know, the question they would ask the pet owner was something like, “what is your tolerance for fleas in your house?” And, That struck me as quite bold as, as a question to, to ask pet owners, you know, and their whole thing was, well, you know, you ask them what’s their tolerance for fleas and then, and then you make a recommendation.

But it always, I could never, I never did it and I just never had the guts to, to engage in that way. And so I, I really like your sort of reframing this question to something I could absolutely see myself saying and it feels polite rather than pointed, if that makes any sense.

Dr. Jason Coe: Yeah, I think it’s a very respectful way of entering into the conversation for sure. And I mean, how we frame questions are important, how we frame those questions are also important. And so you make a really good point with that as well.

Dr. Andy Roark: Okay, so when we, we go into these questions or we go into these, these conversations, we ask sort of for permission. I, I think you’re spot on as well, of if someone says no. The truth is you’re not going to get hurt anyway, you know, and, damaging the relationship doesn’t make sense to me. I’ve always been a big fan of like, we’re playing the long game here, right?

I’m trying to be successful over the life of the pet, not just over today’s visit. And so if they don’t want to engage with me, and I try to force the issue, in my experience, I’m going to not be successful. And I’m going to drive a wedge between us, they’re more likely to go see somebody else who’s not going to talk to him about nutrition or who’s going to let this go, you know, now and going forward. I, I don’t mean it to be arrogant, but I do think that I would like my patients to stay with me because I think that I will advocate for them well over their whole life.

And so keeping that relationship open. I, I have. There’s not many hills I’m willing to die on today. There are some, of course, when you say, We have got to stop feeding onions at every meal to this dog. You know, there’s some things where you’re like, No, no, no, no, no, you, you, you’re not hearing me. But for the most part, you go, Okay, we’re not gonna win this battle today, but I’m gonna try to strengthen this relationship, and then when they’re ready to hear me Then, you know, then I’ll be here and I’m gonna keep gently bringing it up.

But just in my experience, it’s funny, you’ll, you’ll get a new pet owner coming in and they don’t know you from, you know, the guy on the street, and they’re not willing to hear what you think about nutrition. And, and nutrition is just a classic one where they’ll have their own, they’ll have strong feelings or whatever.

And a lot of people are like, how do you get that person to change their mind? I, I don’t think you do. I think you, I think you hear them. I think you try to, you know, you know, shave the edges off of what they’re doing as best you can just to, you know, keep the patient healthy but then you try to focus on building that relationship up to the point where they finally say, okay, you know, tell me more.

I think you can get there, but that is, it’s the longer view.

Dr. Jason Coe: Yeah, I love that. I mean, I think that if we look at the short game, You know, we run that risk. We’re trying to solve the problem immediately. Whereas if we accept when it is like to work with a client, doing that now makes sense. Yet if we look at the longer game where we’re looking at relationship building, we’re planting seeds.

So the client comes around to the idea for our next conversation. I think that’s what pays off. And it’s not just in relation to an overweight animal, this is going to be relevant to all different health care recommendations or conversations that we want to have with the client. So I love that.

Dr. Andy Roark: Where, where do you see veterinarians really screw this conversation up? Like, what, what are the, what are the things, you don’t have to name names, but what are the things that what are the, what are the things that, that you see commonly in play that, that you think have a negative impact on actually getting results?

Dr. Jason Coe: Yeah, I appreciate that question. I mean, I really do look at that as an opportunity for our profession. And a big piece of it is starting to understand where our clients are coming from and using that understanding to help form how we move forward with a client. And so I think where I see, and it comes out in this paper we just published this year, looking at veterinarians recommendations is we moved too fast to our recommendation and we’re not necessarily set for that recommendation.

And so we saw when we did that, clients have resistance. They push back on it. And I’m not saying resistance is bad. I mean, it’s actually more challenging when clients don’t do anything yet. When we have resistance, it means we need to kind of step back, rework the situation to find a solution that’s going to move forward.

And from an efficiency standpoint, if we could understand that up front and build it in, we’re going to move through that recommendation in a much more smooth and probably efficient manner in relation to that. So I think, you know, the thing I would suggest is first off, just don’t rush the recommendation, understand where your client’s coming from. Have a conversation to understand the animal, their environment, what’s important to that individual client, and then use that to help inform and move into the recommendation, which you might find actually changes once you know a little bit more about the client as to what your recommendation is, because it’s about understanding where that common ground is and really partnering with the client and moving forward.

Once you’ve got the client sort of on board with that recommendation, then we can move into other areas of conversation as well.

Dr. Andy Roark: Jason, that’s fantastic. This has been, it’s been absolutely wonderful chatting with you about this. I really appreciate your time. Are there any resources that you really like? I mean, you’re, you’re publishing all over the place. I see, I see you, I see your articles in, in sort of veterinary magazines. Are there, are there any any resources out there for people who are like, man, this, this sort of exam room communication stuff is my jam.

Where would you, where would you send people?

Dr. Jason Coe: That’s a great question. So I’m going to answer 1st specific to nutrition. And so I was very fortunate to have the opportunity to be invited to be co-author on the 2020 AAHA nutrition guidelines. And in there, there was an opportunity for me to really craft, the evidence we’ve developed around nutrition and how we can craft that into a conversation.

So I would encourage people to, to look at that literature in terms of the AAHA guidelines, because I provide what I call an anatomy of a nutrition recommendation, which really takes what we’ve talked about and breaks it down even more. And so I would point people to there. Generally around communications training, I mean, I think it’s just, it’s something that you build over time.

And I really feel like there’s never going to be an expert. We all have opportunities to kind of learn and grow in this area. And so do look for offerings at different conferences that will help feed some of that curiosity. There’s also a book by Suzanne Kurtz and Cindy Adams, Skills for Communicating in Veterinary Medicine, that has got all of the evidence that’s been developed in human medicine pulled together into a framework.

So someone who’s really keen. That would be a great resource. And then there’s also other opportunities such as training. So I know Colorado State, Jane Shaw there has a pretty intensive training that if people are really interested in honing their skills as it relates to communication in the exam room would be something to explore there as well.

Dr. Andy Roark: I will put links to all that stuff, the AAHA nutrition guidelines, the skills for communication, vet medicine. I’ll see if I can run down the the Jane Shaw program as well. I’ve heard really good things about it as well. Awesome. Jason, where can people find you online?

Dr. Jason Coe: Yeah, I appreciate that. So in the last year we’ve established a research program, relationship centered veterinary medicine at the Ontario veterinary college. And so again, If you don’t mind putting a link or having people Google that, that’s the best way to get in touch with the things that we’re working on right now.

We also list out our publications, many of them of which are open access. So if  people want to dig more into some of the things I’ve talked about today, they’ll be able to access the articles and read it for themselves and kind of pull the things that they can take back and utilize in practice. We’re also very active on LinkedIn in terms of new things we’re putting out all the time.

And so those are probably the. Easiest and best ways to stay in touch with what we’re doing and the things that we’re contributing to the veterinary profession.

Dr. Andy Roark: That sounds great. I’ll put links to all that stuff in the show notes. Thanks so much for being here. Gang, thanks for tuning in and listening today. Take care of yourselves, everybody.

Dr. Jason Coe: Thanks, Andy. 

Dr. Andy Roark: And that’s it, guys. That’s what I got for you. I hope you enjoyed it. I hope you got something out of it. Thanks to Jason Coe for being here. Man, I’m gonna have him back. He was really great.

Thanks to Purina Institute for making this episode possible. Guys, take care of yourselves out there. Be well, everybody. I’ll talk to you soon.

What We Take With Us: Reflections and Predictions

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I’m not a New Year’s Resolution person. I have never been able to keep any resolutions past February, and when I drop them I just feel bad about myself. I also feel like the resolutions I make are often pulled out of the air based on what I feel like I “should” want, but not what really matters to me. 

When I’ve made resolutions, I’ve chosen the same generic stuff as everyone else. “I want to unplug more,” “I want to lose some weight,” “I want to read more books.” There’s nothing wrong with any of these resolutions. They just feel like they’ve been plucked off a list of resolutions everyone makes (and breaks). They aren’t personal or particularly motivating, so they go nowhere.

Anyway, if resolutions are your jam, I’m not trying to talk you out of them. Please ignore my opinion and continue to ratchet up your personal performance every January. If, however, you’re kind of done with resolutions and want something else to mark the end of the calendar year, might I recommend a nice reflection on what has already happened? How about a fun exercise of trying to predict the future?

I’ve been doing these two exercises for the last three years and really love them. The first is a reflection exercise. I’ve gotten a lot of enjoyment and clarity from thinking deeply about what has happened in the last 12 months and deciding what I want to hold on to.

Some of the questions I ask myself to reflect back are:

  • What do I want to remember forever about 2023? What were the achievements, surprises, and really great moments?
  • What relationships got stronger this year? Who am I most grateful for?
  • What relationships got weaker? Do I want to do anything about that?
  • What life lessons did I learn?
  • Where/when did I have my best experiences in 2023? 
  • Who was there? What can I do to increase the likelihood that I’ll have more experiences like these?

I’ve found that the insight I get from thinking back on what has really helped and mattered to me is deeply motivating when I look ahead into the coming year. The things that made last year great will probably be things I want to focus on going forward. The hard lessons I learned are usually things I want to remember to avoid pain and frustration in the future. The exercise, overall, is worth the time.

The second exercise is about predicting the future. At the end of each year, I create a document and make guesses about what will be true at the end of the coming year. I try to make my predictions short and clear so it will be obvious if they are correct or not. In some cases, I even jot down the percent certainty I have about a prediction (e.g. I will get back into watching TV and will be actively watching at least 2 shows at the end of 2024 – 66% certainty).

It helps me to break my life into parts and then make predictions in each area. I like to make predictions about: Family, Hobbies, Fitness, Job, Personal Life/Goals.

If you want to try this, just make sections that make sense for you and start writing down what you suspect will be different one year from now. Ask yourself things like:

  • Will you be healthy? How about your parents?
  • Will you have a new best friend?
  • Will you be at a new job? Will you get that promotion?
  • Will you have a new hobby? Will you have stopped doing one of your current hobbies?
  • Will your spouse still be doing yoga daily?
  • Will you still be stopping at Starbucks 5 days a week?
  • Who will win the 2024 election? How will you feel about it?
  • Where will you go on vacation? 

At the end of each year, I get to look back and see where I thought my life would be at this moment. It’s always fascinating to see how much has changed and how much or little we actually knew about the future. 

If you’ve never done these exercises before, maybe give them a try. If you’re worried about forgetting what you predicted or set out to do, I like to attach what I wrote to a calendar event I schedule for the end of the year so I’ll be sure to see it when the time comes.

I hope these little rituals might help and that you might enjoy them as much as I do. Please take care of yourself as we head to the new year, and have a fantastic 2024!

Best always,
Andy