DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Andy Roark DVM MS

The Vet Education Revolution

by

I saw the Barbie Movie last week with my family. I am a Ryan Gosling fan (and generally a fan of silly movies) so I expected to enjoy it quite a bit and I did. 

The biggest laugh in our house came when the primary mother-daughter duo in the movie were deciding if they could embark on a fantastic journey or not. The daughter asked “Will dad be okay?” and we then saw her father, for the first time ever, 100% absorbed in his phone learning Spanish with the Duolingo app. We burst out laughing because our whole family is using the app currently to try to learn Spanish together, and the visual felt really familiar.

If you’re not up on Duolingo, you’re missing out. It’s a fantastic app that teaches languages, but the desire to learn a second language isn’t what has made me so excited about Duolingo. It’s the WAY it guides people to learn.

When I took Spanish in college, it was a ton of reading from the textbook and memorizing vocabulary lists. The learning was tedious and relied heavily on rote memorization. In Duolingo, learners are taught small packets of information and then put to work using it in a variety of ways. Learners do matching drills, listening drills, speaking drills and writing drills. 

Challenges are presented in fun and different ways over and over. New information is introduced steadily to raise the complexity to a level that will challenge each individual learner.

Never once when I took Spanish classes was I excited to actually try to communicate in the real world. Now I use every opportunity to talk to my dog in español and my wife helped someone at the DMV using Spanish yesterday! We’re still high fiving.

Look, I know this is ridiculous and you didn’t sign up for these newsletters to get sales pitches for Duolingo (They are not a sponsor of any of my work, but if they’re reading this, Me gusto Duolingo mucho!). So why am I talking about it? I’m talking about the app because this is how adult learning happens and veterinary medicine generally stinks at it.

Think about the way we do continuing education. We are still anchored firmly in lecture formats. Most of us physically go to an improvised classroom, generally in a hotel, and sit in the dark for 8 consecutive hours while an instructor talks at us. Who thinks that this is an effective way for people to learn new information that is to be applied to practice?

Don’t get me wrong here. Sometimes a lecture is the most efficient way to share information, but I don’t think any of us actually think your average learner is retaining a meaningful amount of information presented in the 5th hour of a 6-hour CE day. Most of us are brain-soup at that point.

Fortunately there are signs that education in veterinary medicine is changing. We have seen a steady increase in the use of case-based learning in veterinary schools for the last 2 decades or so, and one benefit of the creation of new veterinary colleges is that they seem to be attempting innovative ways of teaching and training. Just last month, Penn Vet was launching an “immense” transformation in the way they will be teaching and that the class of 2026 will be the first to experience “the school’s fully integrated competency-based veterinary education curriculum.” I absolutely love this revolution in how we teach and train, and am committed to pushing the transition towards active learning forward. 

When I started the Uncharted Veterinary Conference with my team in 2017, we called it “the conference that never ends” because of our emphasis on interconnecting live events with ongoing online learning and social interaction. We capped the number of attendees at 120 to make sure discussion and collaboration would be central to the conference experience and leaned heavily into running workshops over lectures. We focused on making and showcasing educational content that solved problems and pushed the learner to create plans for what she or he would actually do.

In 2019, we introduced our “Choose Your Own Adventure” format where attendees would create approximately 40% of the conference program after their arrival. This approach ensured that the sessions we put on were what our learners needed and wanted right then, at that moment. We began training facilitators alongside speakers and lecturers so that we could challenge our guests in a variety of ways. We started practicing the art of making discussions action-oriented and impactful with stated action items coming at the end of the session… and I think we’ve gotten pretty good at it.

This week at VMX, the Uncharted Leadership Essentials Certificate got a lot of spotlight and love. We have partnered with Vetfolio to deliver the best guidance we have found in 7 years of running Uncharted for people who are leading or managing others. The sessions were filmed with a live audience so that the energy is great, the laughs are real, and any obvious questions got answered along the way. I love this certificate because it lets me teach the things I think people need the most, and deliver it on their phone, whenever they want, in bite-sized pieces. We also did some serious work to add optional journaling exercises with self reflection questions, and group discussion questions to help individuals and teams implement what they are learning into their clinics.

Now, Uncharted is continuing to push the envelope in how we train and learn. You can expect to see more games (we call them “challenges”) and gamification in both our virtual and live programs. We will be running live events across the country this year, and we are introducing our “learning cohorts” so groups can work through content at their own pace with a mixture of on-demand and live virtual interactive sessions.

Never before have we been able to push people to grow and develop in so many different ways. Never before have we had so many opportunities to challenge people to actually use the skills they are learning as they go. As I think about where I want to go personally and where I want Uncharted to go in 2024, these opportunities are what inspire me the most.

If you’ve never done an Uncharted program, definitely take a look at our Leadership Essentials Certificate, consider coming to our April Conference, or think about becoming an Uncharted member.

Now, I’ve got to check in on Duolingo. I’ve got a top spot on the leaderboard, and I plan to keep it… by learning more stuff.

When Veterinary Consolidation Slows Down

by

Dr. Andy Roark and guest Ryan Leech have an insightful discussion about corporate consolidation in the veterinary industry. They dive into the significant changes that have occurred since the end of 2023, and how this has shaped the business landscape. The conversation covers aspects like the impact of interest rates, the shift in executive teams in veterinary groups, and the emerging trends in the sector. They also highlight the importance of adaptability and originality in the face of these market changes. The episode is teeming with valuable insights for those interested in the business behind veterinary medicine.

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

LINKS

Article Referenced: https://todaysveterinarybusiness.com/veterinary-consolidation-112723/

Ryan Leech: https://www.linkedin.com/in/leechryan

The Bird Bath Podcast: https://www.linkedin.com/showcase/the-bird-bath-podcast/

Uncharted Leadership Essentials: https://www.vetfolio.com/learning-paths/uncharted-leadership-essentials-certificate

Uncharted Veterinary Conference 2023: https://unchartedvet.com/uvc-april-2024/

Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/

Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: https://drandyroark.com/store/

ABOUT OUR GUEST

Ryan Leech is an experienced leader with a history of growing businesses through highly scalable sales models. With a background that spans multiple industries, Ryan led sales for startups that raised over $100MM in funding and ran his own sales consulting firm. In his role at Digitail, he is responsible for overseeing collaborations and integrations with industry leaders and innovators to drive digital transformation in veterinary medicine. In addition to his professional experience as Director of Business Development at Galaxy Vets and Hippo Manager Software, Ryan is also the host of “The Bird Bath” podcast.

EPISODE TRANSCRIPT

Dr. Andy Roark: ​Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark. I have Ryan Leech on today from the Birdbath and we are talking about bidness (business). We are talking about the vet bidness (business). I’m talking with Ryan about corporate consolidation and the story of corporate consolidation and how it has radically changed since the end of 2023. There’s a story here about how money used to flow in and practices got bought and that money’s not flowing in anymore. And so the world is changing to adapt to that. And we talk about kind of what that means and what that looks like on the ground.

As Ryan’s laying down what he’s seeing, I go, “Oh, you know, I see that too. That makes sense.” It’s really a neat way of tying a number of industry trends together and I got a lot out of it. So anyway if you’re interested in the meaning of it all in overall patterns of what’s happening across our industry in understanding the business behind the business, this is a really good episode.

So anyway, I hope you enjoy it. Let’s get into it. 

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, Ryan Leech. Thanks for being here.

Ryan Leech: Thanks for having me, Andy. It’s exciting.

Dr. Andy Roark: It’s my, it’s my pleasure. I became aware of you from your podcast, The Birdbath. So you want to take a second and talk about The Birdbath at a high level and kind of what you set out to do there?

Ryan Leech: Yeah, definitely. So what I found was that there’s a mountain of information within the veterinary landscape and not everyone can be expected to read every single newsletter and listen to every single podcast and try and keep their finger on the pulse of what’s happening. And so I wanted to find a way to be able to bring all of the new sources together, to be able to partner with The Fountain Report and Intelligence, who has been a partner for me. And take all of the top stories in veterinary medicine and make it so that a  technician, a doctor driving into the clinic on their way to work within that 10 to 15 minutes every single Tuesday morning that they can get a good understanding of what’s happening in the industry that they work within.

Dr. Andy Roark: Talk about the Fountain Report for a second. So I get the Fountain Report and I’m a big fan of it, but I think probably a lot of people still don’t, aren’t familiar, don’t really know what it is.

Ryan Leech: Yeah, so the Fountain Report, it’s spectacular.

Dr. Andy Roark: It is spectacular. I agree.

Ryan Leech: They do a really great job, and the team over at Intelligence, which puts it together, they do a wonderful job of pulling together news stories from across a lot of the different sources, but then not just sort of regurgitating them to you. I think there’s a lot of newsletters that people subscribe to that just have a list of stories, or a list of links to click on.

But the fountain report has brought a different editorial and opinion related element to it that they take stories about what’s happening in our industry and bring together top industry leaders to be able to add commentary and color to those stories. So you’re not just reading about Chewy’s most recent quarterly summary and going, “Okay, they’re up 8 percent but the stock is down.”

Why do those two things connect? But you’ll actually see the understanding of, Okay, pharmaceutical sales are trending upwards, but macroeconomic climates are trending downwards, so projections for Q1 are what are driving the stock price. So, getting a little more of that context is, is the big thing there.

Dr. Andy Roark: Yeah I said, I think you’re spot on. I’ve always enjoyed that. I very much enjoy the business of vet medicine. And it’s a lot to keep up with. And so both the Fountain Report and the Birdbath have been excellent ways, that I like to just get little bite sized nuggets.

And then also I enjoy the podcast. I, I enjoy the fact that you take a lot of these nuggets, like earning reports, for example. And I find earning reports rather bland, quite honestly, but, but you do a good job of saying, and then also you see these earning reports that are in the same segment and we can start to see what this trend looks like across the industry.

And I go, “Oh, that’s really useful synthesis of information.” 

Ryan Leech: Appreciate it. Yeah, it’s, it’s, it’s fun and it’s kind of, hopefully people listen to it and then it gives me people that I can talk to about it more without them just looking at me with glazed over looks at cocktail parties. So, they don’t just think I’m a crazy guy.

Dr. Andy Roark: I enjoy that stuff, too. And there’s not a lot of people that talk that language, you know, out out and about. And it’s just like you said, it’s just a lot to keep up with. So I think I’m hoping that the Fountain Report Birdbath will both be. I hope that their their signposts that we’re going to be have deeper, sort of more educated conversations about the industry and the business and kind of where it’s going in the future.

And again, not not as a criticism of the past, but I just enjoy thinking like that. I wanted to bring you on today, because, you know, you, so, I’ve heard you on the podcast, and then I saw an article that you wrote in Today’s Veterinary Business not long ago, and you were sort of talking about, you were talking about corporate consolidation and sort of the overall trends of what is going on there.

And I, I always think that that’s really interesting, and It falls perfectly into the category of things that I struggle to keep up with because a lot of it is not public information, a lot of it is released as little snippets in a lot of different places in a lot of different ways, and it takes someone to actually go along, collect the information, roll it together, synthesize it, and sort of say, here’s the story of corporate consolidation in vet medicine, and so that’s really what I would hope to get from you today. Is I was hoping, Ryan, that you would tell me the story of corporate consolidation end of 2023 going into 2024 kind of how did we get here and where does it look like we’re going?

Ryan Leech: Definitely. Yeah. And it is, it’s definitely something that, I think inspire vet partners their IPO that they did this year. They’re a smaller group. They, the most recent one to do an IPO. And it’s been interesting [00:06:00] because now we’re starting to see a publicly traded company that’s having to release some of the books and the financials and, and all of that.

Unfortunately, their performance this year hasn’t been great. Their stock prices is pretty low. But, I think that it’s been neat to be able to see. How the market is reacting, the general public is reacting to veterinary consolidation, but what we’ve seen over the past 12 months and before that, as everyone knows, if you’re in the veterinary space, you saw an absolute boom of private equity flooding into the veterinary industry.

So we saw large private equity groups that were pumping tens of millions to billions of dollars into acquisitions of independently owned veterinary practices. And around mid 2022, late 2022, as the interest rates began to increase, the availability of capital started to shrink and the free flow of money that people were using to be able to buy these veterinary practices [00:07:00] started to dry up.

And so as that money began to dry up, the multiples, which to sort of bring it to a really ground level, the way that people that are buying veterinary practices previously, as well as they still do look at them now, is they look at a multiple on the EBITDA, so the earnings before interest, tax, depreciation, and amortization, just a business metric that any practice, you can find the majority of those things on your tax report, and then there’s some, as someone told me one day, it’s as much magic as it is math, to be able to determine a true EBITDA for a practice and they Yeah, well, there’s, yeah. Okay, what salary should we account for? What salary is going forward? What numbers here? It’s, it’s a, it’s a massaged number,

Dr. Andy Roark: Yeah, but I mean would you so basically we throw EBITDA around a lot. It’s basically earnings, right? I mean just if someone was just walking into the conversation and they didn’t want to be intimidated. 

Ryan Leech: It’s earnings. And the nice thing about it is the reason why people use an EBITDA and adjusted EBITDA is it allows you to take a metric that will allow you to look at a [00:08:00] practice in Boise, Idaho, and a practice in Miami, And be able to look at the two of them and understand where both of their EBITDAs are, and you’re not looking at top line revenue or profit or bottom line revenue or those sort of things because there’s so many other things within the mix that adjust where the business is, but for consolidation and for the acquisition of practices, people take that number, say it’s, you know, $100,000 or $200,000 and they apply the multiple onto it.

So as you hear everyone talk about multiples are up, multiples are down. It’s time about the multiples on the, on the EBITDA. And we saw them spiking into the upper teens and into the low twenties in some situations for ERs and urgent care practices. But general practices were in the upper teens for multiple years.

And that was driving by an influx of capital in the space. People were looking at buying practices, holding onto them for a little bit and then bundling them together, which is what’s arbitrage. So taking multiple things, putting them together. To reduce the overall [00:09:00] cost of them, but by putting them together, you increase the value of those multiple things.

So, 1 plus 1 equals 3 in arbitrage. And so, when you do that, you keep flipping these practices. So this is why you saw, you know, JAB would buy a group from Vet Strategy, which would buy a group from this other, and they would continue to pile on. Well, as the capital began to tighten up, People will start holding the bag.

The last at the end of the line was holding a group of practices that they owned in the 20 times EBITDA multiple, but entire groups of practices were trading for 15, you know, 13 to 15 times. So they didn’t have the availability to be able to resell these groups. And so they’re having to hold onto them and actually find ways to do, which all of us in the industry have hoped that they would do is, find ways to actually improve what they’re doing within the practice. Not just flipping them, but actually finding ways to increase the margin within the practices.

Dr. Andy Roark: So just to summarize what was happening? There’s a lot of free money hanging around. So people [00:10:00] were buying practices, rolling them together and then selling them as a higher amount because you’re like, look, there’s more of them. So I can sell them for more and then bundling up. But ultimately, that always has to end.

There’s not an infinite upward level of people who are willing to pay more and more for, you know, for groups of practices. And then as interest rates went up, money was harder to get. And some people who thought that they could buy some practices and then send them up the chain, the interest disappeared and then they were kind of holding the practices. You sound positive and optimistic about how that went. So convince me that\ the people overall who were sort of holding, holding the practices… that that’s turning out well, as opposed to, people who never had any intention of having practices being stuck with them. 

Ryan Leech: So I wouldn’t want to sound too positive on it. I’m optimistic, or hopeful perhaps is probably the right term. I at my core believe that consolidation of veterinary medicine at its core value can be a good for the industry. I think that we’re in a situation where there’s a lot of people that were [00:11:00] reluctant business owners that were independent practice owners who got into the situation where they own a practice.

Because that was the way that they were trained that they had to become a successful veterinarian. And a lot of them, when I had conversations with them when I was acquiring practices, they were like, I’m glad to be getting rid of this burden. I just want to be, I want to have made a good income, which I think a lot of them were underpaid to begin with.

And so the ownership of the practice was a way for them to be properly paid. And now they’re going, great, I can cash in on this business that I built and still continue practicing and working and doing the thing that I went to school for and, you know, cared about since I was a little kid, all the way to the point where I became a veterinarian.

So I think getting an accountant and a CFO and a head of corporate strategy to be the ones that are worried about. Okay, what’s our marketing spend, what’s our ROI, what’s our CAC, what are all of these business metrics that aren’t part of vet school? Those people [00:12:00] want to do that and let’s find a way to allow them to offload the work the veterinarians don’t want to do, but freeing up the veterinarians in the best way to be able to really follow their passion.

Now, if you have somebody that bought something with the intention purely to flip it. Uh, that’s a difficult spot to be in, but you’ll see this there. We’ve seen a shift in a lot of the executive teams at some of the groups, and we’ve seen people that are coming in now with more operator experience.

And they’re actually saying, okay, I need to look at unifying our data. So they’re looking at something like digital to, to find a unified PIMS so that they can find, Workflow optimizations. They’re looking at ways to be able to reduce labor costs. They’re looking at ways to improve and upscale the abilities of their technicians by utilizing AHA technician utilization guidelines, those sorts things versus saying, well, let’s charge more.

You know, let’s work people harder and charge more and just try to ride this wave out. So I think in its purest form, it can be a good thing. So I’m hopeful for that.

Dr. Andy Roark: [00:13:00] I like your optimism a lot. I think that’s the beautiful vision of the future that I’m I’m hoping for is that if you just want to practice then there are good, healthy places for you just to go and practice. And there are some systems in place and training is well taken care of and you’re well supported.

And if you want to do your own thing and you want to be an entrepreneur yourself and you want to run your own practice and have autonomy, that, that you have a viable way of doing that where you can be competitive in the marketplace and, Ryan, I, am optimistic.

Ryan Leech: Yeah, well, and I think also there’s this middle ground too, where people that. Want to learn the business side of things aren’t sure of what they need to know are looking at joint venture models are looking at franchise models. They’re looking at starting a small mobile practice with support. So I think as it’s become more competitive, it has opened up more avenues for people.

To be able to research and find ways where it’s not just, Okay, Dr. Roark is selling his clinic down the street. Well, I’m his associate vet and if I want to own a practice, I buy this one. It’s, let me [00:14:00] search what fits my passion.

Dr. Andy Roark: Yeah. Oh, yeah. Well, the number of vets that I know who I said to them, how did you become a practice owner? And they were like, “Well, the old one quit and somebody had to do it. And so here I am.” like that. It’s a lot of people that was, that was their model. To your point, that’s probably not the financially healthy, culturally sound way that we want to put our profession together, you know, in the long term. 

 I am so proud to unveil the biggest project I have ever worked on. This is a partnership with NAVC’s Vetfolio and Uncharted, which is the veterinary conference that I started and run for 15 years. I have worked with people on being effective as communicators and making their practice better places to be.

Now, I am so thrilled to be launching the Leadership Essentials Certificate with Uncharted and Vetfolio. Guys, these are the seven courses that I believe, really believe anyone who’s leading other people in vet medicine should have. This is vision and [00:15:00] value setting. This is basic strategic planning. It is understanding different communication styles, and I have my friend, Stephanie Goss, uh, helping teach that session is, uh, getting the team to buy in to new ideas and initiatives.

It is how to coach and give. feedback. It is how to set priorities. It is how to delegate effectively. It is how to do time management. It is the talks and the stories that I am probably most well known for giving. My red dot talk is in here. My GPA talk is in here. Everything about the north stars, everything that I Layout where I’m like, this is just so essential to managing people.

It’s, it’s the trust game. It is everything about building and maintaining trust with your team. I think that this is something that I would recommend for anyone who is a practice owner. Uh, it’s anyone who’s definitely who’s becoming a new practice owner. It is for anybody who has especially gotten promoted up into management.

It is huge for our team leads. We take people who are CSRs, we take [00:16:00] people who are technicians, and we make them lead techs or lead CSRs, and we give them zero leadership or management training. There’s no excuse for that anymore. This is, this is on demand whenever you want. It’s broken up. It’s eight hours.

It’s got race CE. It has the. Uncharted vet folio certificate with it is it is there is accessible I I really hope that people will take this and put it to work I I went really hard on this. It has been years in the making and refining to get this content down and right So it is it is really for is everybody who is leading and managing other people in vet medicine I hope you will check it out.

I’m so proud of it. I’m so glad to be partnering with nabc on it Anyway, guys, i’ll put links in the show note. I hope you’ll have a look. Let’s get back into this episode

I think, I do think it’s interesting that we’re starting to see these corporate consolidators change out and focus more on operations and actually running businesses. I think that does make me feel good. It does feel like a lot of [00:17:00] these groups that had bought up a lot of practice are getting stuff figured out, at least that’s kind of the impression that, that I getting, it really does seem to be that there’s… They’re all slightly different in what they’re doing, sort of how they’re doing it. But, I completely agree, there’s definitely more of a hands on feel now than there has been in the past as far as making practices work together and making this conglomeration make some actual sense for the people in the trenches. Where do you think this goes? Do you think that we’re going to continue to see a focus on sort of streamlining operations in what we have now?

Do you think this is going to start to crystallize? Do you think that we’re going to jump right back into an expansion phase where, as soon as interest rates drop, I mean, what is, as you look into your crystal ball, what does the next 12 to 24 months look like?

Ryan Leech: Well, so the funny thing I say about crystal balls, I was in Wyoming. No, I was in Montana. At some wild place that’s claims that they have a vortex black hole that you can walk into and feel all these different energies and they sell crystal balls there. And so that’s the best I can think about [00:18:00] for a crystal ball.

So I don’t much into my ability to tell the future. But what I do see is I see that there’s groups and there’s people that are taking steps to be able to come up with either ways to improve the groups that they’re with. Or, create new business models of what’s happening. So I think, if you’re working in a practice that was bought in the last two to three years by a group and they, at, at the point when they bought you, they said, we don’t change anything.

We don’t touch anything. Nothing’s going to happen. Prepare yourself for that conversation to shift.

Dr. Andy Roark: Yeah. I was wondering about that. That makes sense when the plan is to, you know, change owners and move these up. But at some point we’ve got to work together in some sort of organized structure to make this model any sense. 

Ryan Leech: Someone has to do work. So, don’t feel as if… I mean, you can feel a little slighted if that happens to you, but more so understand it’s probably wasn’t their plan. And it wasn’t your plan, but you’re both in this together and, you know, collaborate and work [00:19:00] together with the, the parent company so that you can find a way to be able to increase the overall value.

And you can also find a way to influence what’s going to happen. So you can say, “Hey, this isn’t how I feel we should be doing it” and really be collaborative with it versus just pushing back on those changes. I think that’s a good way to look at it. And then I think in 2024, 2025, what we’ll see going forward is there’s been an obvious boom in the de novo practices. So fresh built practices. We’ve seen groups like Pet Folk, Pet, Pet 365, Good Vet, Better Vet on the mobile side. A lot of these are, are starting to push on that side of things because when the multiples were extremely high, it was less expensive to build a practice than it was to buy a practice.

And then, the staffing shortage was, was difficult and it still is a very difficult thing. But I think. As some of these groups are starting to change what they had said they were going to do. So if you were bought by Corporation ABC and they said, we aren’t going to touch anything. Well, now they’re [00:20:00] starting to implement changes and they don’t align with your values.

You can go down the street and look at one of these de novo groups that is perhaps looking at a different work life balance or an urgent care strategy or something that fits with you. So I think they are having a good opportunity to recruit there. And then I think as well, we’re going to see a continued growth of mobile practices.

It’s something that I’ve seen a lot of new mobile groups popping up. I think that the age of the DVMs that are coming out of college right now, a lot of them were in vet school throughout Covid. They’re coming out there. You know, I’m not young anymore, unfortunately, but I still think of myself as somewhat young.

And so the DVMs and people are coming out we’re going, ” Hey, we, we want to have some flexibility. I like knowing that at four o’clock, if. I want to go see my girls play or want to take off the afternoon and spend time with my wife or do something like that that I have that flexibility. And I think that’s where we’re seeing some of the newer DVMs migrating towards a mobile practice because they can say, [00:21:00] all right, slide the van door shut and I’m done for the day, which is kind of a different take.

And I think those people are going to be. I think there’s going to be some real cream that rises to the top of people that buy into franchise model or joint venture models of mobile groups, and then become some of these business leaders that we see in the next 10, 15 years that are really saying, I built a portfolio of 10 mobile practices, and I’ve added telemedicine, and I’ve added brick and mortar and really found a way to grow that.

Dr. Andy Roark: I agree with that. I’ve thought a lot about the mobile practice for the last five to almost ten years ever since my friends Danny McVitie and Mary Gardner Started doing lap of love and I was like god the flexibility is great here And then also the willingness of pet owners to pay for at home service is is real and there is a demand for it.

People in that service, they don’t like loading the kids and their two pets into the car and go. They would much rather you come to them. And a lot people have the [00:22:00] resources to, compensate you for that. 

Ryan Leech: Yeah, and Lap of Love is a perfect example of that. I mean they have a massive call center. Not to downgrade the skill level of the people in it, but they have a major call center that takes on a lot of those things. And you know, you don’t need a front desk staff. You don’t need four or five people for every phone to ring to be into that practice.

So you can really offload a lot of that. And I think COVID showed us the ability of flexible work and the ability to hire people wherever they need to be.

Dr. Andy Roark: Yeah. And well, I think you put a your finger right on a really good example of the benefit of, you know, sort of a distributed model or a franchise model, and they’re not franchise, but like a franchise model where you say, “What would this franchise bring to the table?” It’s like a logistical support, you know, communication support, educational support.

There’s a lot of things that organization can offer to doctors and still give them a lot of, of independence and make them, I don’t know, give them a lot of ownership of what they’re doing and also still make it sense to have some sort of a corporate partner with them.

Ryan Leech: I would love to get a list and I don’t think the Banfield will ever give this to me, but if I could [00:23:00] get a list of their charter franchise owners back in, you know, from the early nineties, when they first started franchising, before they brought that back, I think you’d find a lot of those people have gone on to be extremely successful business people. Have built, you know, new groups, new models. And when you start to pull the thread on what people have learned through the franchise model, as they’ve gone into their own businesses, it is a, it’s a on the ground MBA that, that a business can help support you in.

Dr. Andy Roark: Well, I mean, just think about it. If you’re trying to grow your own career and you have sort of entrepreneurial interests and things like that. I mean, I can tell you, I spent a decade or two beating my head against the wall, figuring out the business model for the weird thing that I do. And, if I had come in 15 years ago, underneath a mentor, into an organization that had already figured a lot of things out that would have saved me a lot of time in getting my systems down, you know, I got no regrets, believe me when I say that. But also I go, “boy, I learned the hard way.” And if I had just rolled into a system that worked, I [00:24:00] think I could have picked up a lot of things really fast in my business. 

As a doctor. As a practitioner. I did that. I went to a very high functioning practice outside of Washington D.C. And I just take for granted how much I learned about how you run a practice because it was just the way it was. And a lot of other people spent 10 years figuring out just the basics that I took in in the first week of like, “Oh, yeah, that’s how you do it. That all makes.”

And so I really like that. I like your idea of a reshuffling. I need to sit with that a little bit because it does make sense to me that if we’ve got these different types of practices, especially we’ve got practices that are starting to make some changes and make some adjustments.

I think you’re, you’re gracious and a very good outlook on this to say, I don’t think that people were lied to when these practices came in and said, hey, we’re not going to mess with things, but things have changed, and now we’re not able to go on as we were before. Life is like that.

We all have to kind of adjust and, and we are in this together and having a good attitude about it I think is the healthiest thing you can do. I think it makes sense, but it does make sense to me also [00:25:00] to your point that if you’re in this place and we’re seeing a lot of changes happening, that people are going to look around and say, well, this isn’t exactly what it used to be or it’s not what I signed up for. And, there are so many opportunities. The urgent care model is a great one. I go, that seems interesting to me. I very happy in general practice, but home health care, I’ve thought about that.

I’m looking at some practices that are doing like an open hospital model I’ve never worked at one of those hospital models. I think I could get pretty fired up about it and if I’d have to throw myself into it. I don’t think you’re halfway. I think you have to do it or not. But I started going, “oh man, you know, there’s, there’s a lot of opportunity to that.” So the idea that there would be enough change that a lot of people would kind of look around and say,” you know, Hey, look, while we’re all here, I think I’m going to go get in that boat over there because that fits more what I want. But this is still a great boat and other people might want to come here because of what we’re doing.” that, makes some sense to me. 

Ryan Leech: Yeah I’ve worked at quite a few different companies in my life, and you know, I worked one that is a spectacular company it just wasn’t the right fit for me. It was Red Hat, which is a Linux software [00:26:00] company. People that work there are fanatical about the business, and they do a spectacular job. They have wonderful onboarding, a great team. I just didn’t get fired up about it, right? It didn’t mean that there was anything wrong. There’s people I’d recommend that should go and work there and have a great time. And, and I think you probably could have the same thing if you look at Blue Pearl versus VEG, right?

Those are two, if you were to run the numbers on them, they’re both, you know, ER practices that are growing rapidly. Those are completely different businesses, completely different work life balance, completely different goals. But you could thrive at either one of those. And just because you didn’t fit well at one doesn’t make it better or worse than the other.

But you should really, you know, if you’re a DVM or a practice, you know, anybody within practice, you should look at those different models and say, Do I want this flexibility? Do I want the ability to work remote? Do I want the clinic? Do I want the patients and the pet parents right next to me the whole day?

Do I want them to be dropping them off? Do I want to go to them? Look at it. This is, this is not an industry anymore where a doctor should graduate from school and [00:27:00] walk into the neighborhood clinic down the street and just go, well, this is what it is. This is what it is everywhere. And this all that I’ll have for the next 30 years of my career.

No, you can find these nuanced differences. There’s always unique places for people.

Dr. Andy Roark: I think that there’s this perception that medicine is a ladder. At least there used to be. I think it’s present. I think it’s way overrepresented, but there’s this idea that there’s better medicine. There’s a ladder of quality clinics and you start with, we don’t call it that, but it’s low quality clinics.

And then ultimately we get to specialty clinics, which are the highest quality clinics. And there’s this idea that you’re supposed to want to move up this ladder and that’s just absolutely not true. You know, it’s it’d be like the idea that that dog breeds are a ladder to the best dog breed,

Ryan Leech: Well, we do know that it, it tops out a golden retriever. I

mean there’s a ladder and what, I don’t know what the bottom rungs are, but it does top out a golden retriever. That’s that so…

Dr. Andy Roark: Yeah. It’s a model that, I think a lot of us [00:28:00] internalized that in vet school. When they were like, “this is the higher standard of care than this, and we aspire to a higher standard of care.” And if it’s that simple and you look at it, you say, well, that makes sense that there would be this upper thing.

But that’s just not the truth. The truth is there’s, there’s an ecosystem and there’s so many different variations in how we deliver care and why we deliver care and like the experience that we’re trying to create. And I would like to continue to try to bury the idea that there’s upward ladder and just “no, no, no, no, look at the beautiful diversity of our profession and, and feel free to move around. And it’s not up or down. It’s, where do you want to be?”

Ryan Leech: Yeah. I think a doctor that’s working, doing a high volume pop up clinic at a tractor supply for pet IQ is providing as valuable, and in some situations more valuable, perhaps service then, you know, the research veterinarian at Cornell who is touching four patients a year, right? Like those are completely different things that are.

[00:29:00] Extremely valuable. And, I think the data even shows, right? Like what is your goal? What’s your goal of practicing medicine? Is it most animals that you can save? Is it a hands on impact? Is it a high level research impact? Is it, you know, mentoring? Is it growing? Like, yeah, it’s, it is not a small, small industry.

The number is what? 136 billion were spent on pet care and vet care last year. So there’s room. There’s plenty of room for people to come in and participate in it.

Dr. Andy Roark: Ryan, thanks so much for coming and talking with I just, I really enjoy you. I really enjoy chatting with you. I’d love to talk to you more in the future. Where can people find you? Where can they find the birdbath? What’s a good place for people who want to follow you?

Ryan Leech: Yeah. So the birdbath, we’re a podcast. We’re on every major podcast platform, ‘The Birdbath’. You can also check us out on LinkedIn. We have a transistor website. You can also send me a LinkedIn message as well. LinkedIn.com/leech (L-E-E-C-H) Ryan. And if you’re looking for cloud practice [00:30:00] management software, I also work with digital.

I handle all of our strategic partnerships. So if you’re a large corporation, a business, or anybody that’s looking to do cloud computing in any way, make sure you reach out to digital.com as well.

Dr. Andy Roark: Outstanding. Thanks for being here. Guys, thanks for tuning in to listen. Take care of yourselves, everybody.And that’s our episode. That’s what I got for you guys. I hope you enjoyed it. I hope you got something out of it. Thanks to Ryan for being here. Take care of yourselves, everybody. I’ll talk to you later on.

Training the Team for Recommendations and Hard Conversations

by

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

by

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?

by

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

by

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